WINDSOR HOSPITAL CORPORATION: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- WINDSOR HOSPITAL CORPORATION (EIN 03-0183721)
- Tax period
- 2024-10-01 to 2025-09-30
- Filed
- 2026-08-14
- IRS object ID
- 202602279349300000
- Schema version
- 2024v5.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2026-08-14T22:52:35+00:00 | ReturnTs |
| Tax Period End | 2025-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 415375658 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE ADVISORY LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4801 OLYMPIA PARK PLAZA SUITE 4000 | AddressLine1Txt |
| City | LOUISVILLE | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 402412098 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 030183721 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WINDSOR HOSPITAL CORPORATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WIND | BusinessNameControlTxt |
| Phone | 8026746711 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 289 COUNTY ROAD | AddressLine1Txt |
| City | WINDSOR | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05089 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MATTHEW MATHIESEN | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 8026746711 | PhoneNum |
| Signature | 2026-08-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RACHEL SPURLOCK | PreparerPersonNm |
| PTIN | P01316095 | PTIN |
| Phone | 5023263996 | PhoneNum |
| Preparation | 2026-08-15 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MT ASCUTNEY HOSPITAL AND HEALTH CENTER | BusinessNameLine1Txt |
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MATTHEW FOSTER MD MMM | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 289 COUNTY ROAD | AddressLine1Txt |
| City | WINDSOR | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05089 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $76,976,854 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | MTASCUTNEYHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1933 | FormationYr |
| Legal Domicile State | VT | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE LIVES OF THOSE WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 20 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 572 | TotalEmployeeCnt |
| Total Volunteers | 80 | TotalVolunteersCnt |
| Total Gross UBI | $55,893 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $51,583 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,730,530 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,685,106 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $72,210,645 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $74,626,469 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,085,217 | PYInvestmentIncomeAmt |
| CY Investment Income | $275,185 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,502,385 | PYOtherRevenueAmt |
| CY Other Revenue | $388,269 | CYOtherRevenueAmt |
| PY Total Revenue | $76,528,777 | PYTotalRevenueAmt |
| CY Total Revenue | $76,975,029 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $20,430 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $40,751,242 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $43,076,933 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $150,902 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $33,861,207 | PYOtherExpensesAmt |
| CY Other Expenses | $33,428,510 | CYOtherExpensesAmt |
| PY Total Expenses | $74,612,449 | PYTotalExpensesAmt |
| CY Total Expenses | $76,525,873 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,916,328 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $449,156 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $91,569,667 | TotalAssetsBOYAmt |
| Total Assets EOY | $96,618,303 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $38,128,349 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $37,432,503 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $53,441,318 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $59,185,800 | NetAssetsOrFundBalancesEOYAmt |
| Mission | MT. ASCUTNEY HOSPITAL AND HEALTH CENTER'S MISSION IS TO IMPROVE THE LIVES OF THOSE WE SERVE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $71,652,716 | ExpenseAmt |
| Grant | $20,430 | GrantAmt |
| Revenue | $74,743,027 | RevenueAmt |
| Desc | MT. ASCUTNEY HOSPITAL AND HEALTH CENTER (MAHHC) OPERATES A NOT-FOR-PROFIT CRITICAL ACCESS HOSPITAL WHICH PROVIDES PRIMARY AND SECONDARY HEALTH CARE. MAHHC'S PRIMARY SERVICE AREA INCLUDES BRIDGEWATER, BROWNSVILLE, HARTLAND, READING, WEATHERSFIELD, WINDSOR, & WOODSTOCK (VT) AS WELL AS CLAREMONT, CORNISH, AND PLAINFIELD (NH). THE HOSPITAL PROVIDES ESSENTIAL HEALTH CARE SERVICES INCLUDING EMERGENCY DEPARTMENT/MEDICAL/SURGICAL INPATIENT, AND ANCILLARY DIAGNOSTIC TESTS, IMAGING/RADIOLOGY PROCEDURES, AND WELLNESS/PREVENTION SERVICES. MAHHC STAFFS A TOTAL OF 25 ACUTE MEDICAL/SURGICAL BEDS AND 10 ACUTE REHABILITATION BEDS. DURING THE YEAR, THERE WERE 1,045 DISCHARGES, 1,671 SURGERIES, 68,490 LAB TESTS, AND 15,114 IMAGING PROCEDURES. MAHHC IDENTIFIED ACCESS TO PRIMARY CARE AS A CENTRAL COMMUNITY NEED AND IS COMMITTED TO PROVIDING THE PHYSICIAN SERVICES OF FAMILY PRACTICE, INTERNAL MEDICINE AND PEDIATRICS IN WINDSOR AND WOODSTOCK. MAHHC PROVIDES FREE CARE TO PATIENTS WHO MEET CERTAIN CRITERIA. FOREGONE CHARGES FURNISHED UNDER MAHHC'S FREE CARE POLICY AMOUNT TO $680,535 IN FY25. | Desc |
| Total Program Service Expenses | $71,652,716 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 53 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 572 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 20 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Policies Reference Chapters | false | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MATTHEW MATHIESEN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8026746711 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 289 COUNTY ROAD | AddressLine1Txt |
| City | WINDSOR | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05089 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (33 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| ALAN C KEILLER | |||||||||
| TRUSTEE / TREASURER | 1.0 | 1.5 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JOCELYN CAPLE MD | |||||||||
| INTERIM CEO (THROUGH 12/8/24) | 20.0 | 20.5 | Yes (X) | Yes (X) | $0 | $375,731 | $65,717 | ||
| JOHN TANSEY | |||||||||
| TRUSTEE / CHAIR | 1.0 | 2.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MATTHEW FOSTER | |||||||||
| CEO (AS OF 12/9/24) | 20.0 | 20.5 | Yes (X) | Yes (X) | $0 | $37,005 | $2,236 | ||
| PATRICIA PUTNAM | |||||||||
| TRUSTEE/VICE CHAIR | 1.0 | 2.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| TERRI DECKER | |||||||||
| TRUSTEE/SECRETARY | 1.0 | 2.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BRYAN HUOT | |||||||||
| TRUSTEE | 0.5 | 0.5 | Yes (X) | $0 | $0 | $0 | |||
| CAROL VIVIAN | |||||||||
| TRUSTEE | 0.5 | 0.5 | Yes (X) | $0 | $0 | $0 | |||
| CHRISTOPHER NESBITT | |||||||||
| TRUSTEE (AS OF 8/27/25) | 0.5 | 0.5 | Yes (X) | $0 | $0 | $0 | |||
| CLARE DREBITKO | |||||||||
| TRUSTEE/MED STAFF PRES (THROUGH 12/31/24) | 40.0 | 0 | Yes (X) | $196,554 | $0 | $34,415 | |||
| DEANNA HOWARD | |||||||||
| TRUSTEE | 1.0 | 1.5 | Yes (X) | $0 | $0 | $0 | |||
| ERIC CRAINICH | |||||||||
| TRUSTEE | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| JEFFREY KING | |||||||||
| TRUSTEE / EX-OFFICIO MED STAFF PRESIDENT (AS OF 1/1/25) | 40.0 | 0 | Yes (X) | $237,327 | $0 | $36,072 | |||
| JOHN GILMAN | |||||||||
| TRUSTEE | 1.0 | 1.5 | Yes (X) | $0 | $0 | $0 | |||
| LISA RICHMOND | |||||||||
| TRUSTEE | 0.5 | 0.5 | Yes (X) | $0 | $0 | $0 | |||
| MATTHEW S HOUDE | |||||||||
| TRUSTEE / DH VP GOV'T RELATIONS | 1.0 | 41.0 | Yes (X) | $0 | $319,691 | $70,463 | |||
| MICHAEL FUERST | |||||||||
| TRUSTEE | 0.5 | 0.5 | Yes (X) | $0 | $0 | $0 | |||
| PAMELA BROWN | |||||||||
| TRUSTEE | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| PATRICK F JORDAN III MBA | |||||||||
| TRUSTEE (THROUGH 6/21/25) | 0.5 | 43.0 | Yes (X) | $0 | $1,132,708 | $79,260 | |||
| SAMUEL SHIELDS | |||||||||
| TRUSTEE / DH VP - STRTGY | 0.5 | 41.0 | Yes (X) | $0 | $399,147 | $30,060 | |||
| STEPHEN D SURGENOR MD | |||||||||
| TRUSTEE / DH DIRECTOR OF ANESTHESIOLOGY | 1.0 | 40.5 | Yes (X) | $0 | $594,937 | $72,041 | |||
| TOM SULLIVAN | |||||||||
| TRUSTEE | 1.0 | 0.5 | Yes (X) | $0 | $0 | $0 | |||
| VINCENT FUSCA III | |||||||||
| TRUSTEE (THROUGH 10/31/24) | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| WILLIAM PALMER | |||||||||
| TRUSTEE/PHYSICIAN | 40.0 | 0.5 | Yes (X) | $138,740 | $0 | $4,605 | |||
| CELESTE PITTS | |||||||||
| INTERIM CFO | 20.0 | 22.0 | Yes (X) | $0 | $0 | $0 | |||
| HANNAH BIANCHI | |||||||||
| CHIEF OPERATING OFFICER | 20.0 | 20.0 | Yes (X) | $236,194 | $0 | $8,803 | |||
| CATHERINE SCHNEIDER | |||||||||
| PHYSICIAN | 40.0 | 0 | $298,055 | $0 | $33,305 | Yes (X) | |||
| DAVID SANVILLE | |||||||||
| CHIEF FINANCIAL OFFICER (THROUGH 2/29/24) | 40.0 | 0.0 | $300,864 | $0 | $6,865 | Yes (X) | |||
| FRANCESCO CONGIUSTA | |||||||||
| HOSPITALIST | 40.0 | 0 | $332,171 | $0 | $41,736 | Yes (X) | |||
| HERBERT IP | |||||||||
| PHYSICIAN | 40.0 | 0 | $335,510 | $0 | $40,172 | Yes (X) | |||
| JASON FRITZHAND | |||||||||
| PHYSICIAN | 40.0 | 0 | $331,119 | $0 | $14,205 | Yes (X) | |||
| JOSEPH L PERRAS MD | |||||||||
| FORMER CEO | 0.0 | 40.5 | $0 | $570,040 | $54,269 | Yes (X) | |||
| WINFIELD BROWN | |||||||||
| FORMER INTERIM CEO | 0.0 | 0.0 | $0 | $247,889 | $18,182 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,406,534 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,677,148 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $612,406 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 75 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (true) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| AMERICAN HEALTHCARE SERVICES ASSOCIATION | |||||
| PO BOX 670529 | DALLAS | TX | 752670529 | STAFFING SERVICES | $3,363,461 |
| EMERGENCY SERVICES OF NE INC | |||||
| PO BOX 12 | CHESTER | VT | 05143 | STAFFING SERVICES | $2,519,946 |
| MARY HITCHCOCK MEMORIAL HOSPITAL | |||||
| ONE MEDICAL CENTER DRIVE | LEBANON | NH | 03756 | HEALTHCARE SERVICES | $2,505,312 |
| NEAGLEY & CHASE CONSTRUCTION | |||||
| 66 BOWDOIN ST | SOUTH BURLINGTON | VT | 05403 | CONSTRUCTION SERVICES | $1,831,046 |
| CERNER CORP | |||||
| PO BOX 959156 | ST LOUIS | MO | 631959156 | SOFTWARE SERVICES | $983,692 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 24 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $31,019 | RelatedOrganizationsAmt |
| Government Grants | $1,176,409 | GovernmentGrantsAmt |
| All Other Contributions | $477,678 | AllOtherContributionsAmt |
| Noncash Contributions | $6,607 | NoncashContributionsAmt |
| Total Contributions | $1,685,106 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 622110 | $68,525,556 | $68,525,556 |
| HEALTH CARE REFORM PAYMENTS | 622110 | $2,045,343 | $2,045,343 |
| PROGRAM AND MISCELLANEOUS | 622110 | $4,055,570 | $4,055,570 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $74,626,469 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $277,010 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $55,893 | UnrelatedBusinessRevenueAmt |
| Exclusion | $221,117 | ExclusionAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,825 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | -$1,825 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,825 | TotalRevenueColumnAmt |
| Exclusion | -$1,825 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| CAFETERIA | 722514 | $271,711 | $271,711 | |
| PURCHASE DISCOUNTS | 622110 | $116,558 | $116,558 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $388,269 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $76,975,029 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $74,743,027 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $55,893 | UnrelatedBusinessRevenueAmt |
| Exclusion | $491,003 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,062 | TotalAmt |
| Program Services | $6,062 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,368 | TotalAmt |
| Program Services | $14,368 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $632,300 | TotalAmt |
| Program Services | $255,183 | ProgramServicesAmt |
| Management And General | $377,117 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,831,283 | TotalAmt |
| Program Services | $30,364,498 | ProgramServicesAmt |
| Management And General | $1,422,858 | ManagementAndGeneralAmt |
| Fundraising | $43,927 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,449,379 | TotalAmt |
| Program Services | $1,382,592 | ProgramServicesAmt |
| Management And General | $64,787 | ManagementAndGeneralAmt |
| Fundraising | $2,000 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,824,228 | TotalAmt |
| Program Services | $6,509,768 | ProgramServicesAmt |
| Management And General | $305,043 | ManagementAndGeneralAmt |
| Fundraising | $9,417 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,339,743 | TotalAmt |
| Program Services | $2,231,928 | ProgramServicesAmt |
| Management And General | $104,587 | ManagementAndGeneralAmt |
| Fundraising | $3,228 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,970 | TotalAmt |
| Management And General | $12,970 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,480,666 | TotalAmt |
| Program Services | $15,326,757 | ProgramServicesAmt |
| Management And General | $1,067,890 | ManagementAndGeneralAmt |
| Fundraising | $86,019 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,219 | TotalAmt |
| Program Services | $52,219 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $208,509 | TotalAmt |
| Program Services | $196,241 | ProgramServicesAmt |
| Management And General | $6,445 | ManagementAndGeneralAmt |
| Fundraising | $5,823 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $413,251 | TotalAmt |
| Program Services | $374,684 | ProgramServicesAmt |
| Management And General | $38,567 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,528,285 | TotalAmt |
| Program Services | $1,528,285 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,244 | TotalAmt |
| Program Services | $75,000 | ProgramServicesAmt |
| Management And General | $4,244 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,754 | TotalAmt |
| Program Services | $18,754 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $592,268 | TotalAmt |
| Program Services | $592,268 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,100,563 | TotalAmt |
| Program Services | $2,940,169 | ProgramServicesAmt |
| Management And General | $160,394 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $576,967 | TotalAmt |
| Program Services | $275,719 | ProgramServicesAmt |
| Management And General | $301,248 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL AND OTHER SUPPLIES | $5,374,311 | $5,374,311 | ||
| HOSPITAL PROVIDER TAXES | $2,479,207 | $2,479,207 | ||
| MISCELLANEOUS EXPENSES | $994,921 | $676,065 | $318,368 | $488 |
| DUES, FEES, AND TAXES | $586,705 | $80,574 | $506,131 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $929,670 | TotalAmt |
| Program Services | $898,064 | ProgramServicesAmt |
| Management And General | $31,606 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,525,873 | TotalAmt |
| Program Services | $71,652,716 | ProgramServicesAmt |
| Management And General | $4,722,255 | ManagementAndGeneralAmt |
| Fundraising | $150,902 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,438,379 | BOYAmt |
| EOY | $4,977,712 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,092,716 | BOYAmt |
| EOY | $3,218,527 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,599 | BOYAmt |
| EOY | $39,631 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,930,377 | BOYAmt |
| EOY | $7,342,652 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $493,877 | BOYAmt |
| EOY | $311,237 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $727,324 | BOYAmt |
| EOY | $4,627,259 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $59,551,013 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $37,046,486 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,721,983 | BOYAmt |
| EOY | $22,504,527 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,419,557 | BOYAmt |
| EOY | $45,449,384 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,702,855 | BOYAmt |
| EOY | $8,147,374 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,569,667 | BOYAmt |
| EOY | $96,618,303 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,664,169 | BOYAmt |
| EOY | $6,573,761 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,979,557 | BOYAmt |
| EOY | $989,778 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,484,623 | BOYAmt |
| EOY | $29,868,964 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,128,349 | BOYAmt |
| EOY | $37,432,503 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,950,233 | BOYAmt |
| EOY | $49,349,800 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,491,085 | BOYAmt |
| EOY | $9,836,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,441,318 | BOYAmt |
| EOY | $59,185,800 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,569,667 | BOYAmt |
| EOY | $96,618,303 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $449,156 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $4,116,872 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $1,178,454 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $11,248 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $11,248 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | FormAndLineReferenceDesc |
| Explanation | MT. ASCUTNEY HOSPITAL AND HEALTH CENTER PAYS DUES TO VARIOUS ORGANIZATIONS RELATED TO ITS EXEMPT MISSION. THE AMOUNT REPORTED UNDER OTHER ACTIVITIES IN LINE 1I REFERS TO THE AMOUNT OF LOBBYING ACTIVITIES IDENTIFIED IN DUES PAYMENTS TO THESE OUTSIDE ORGANIZATIONS. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,614,260 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $710,409 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $251,685 | OtherExpendituresAmt |
| End Year Balance | $7,072,984 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,714,031 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,136,315 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $236,086 | OtherExpendituresAmt |
| End Year Balance | $6,614,260 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,444,909 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $490,948 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $221,826 | OtherExpendituresAmt |
| End Year Balance | $5,714,031 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,547,496 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$885,991 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $216,596 | OtherExpendituresAmt |
| End Year Balance | $5,444,909 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,256,278 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,496,142 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $204,924 | OtherExpendituresAmt |
| End Year Balance | $6,547,496 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.0 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.5964 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.4036 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $410,000 | OtherCostOrOtherBasisAmt |
| Book Value | $410,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $18,629,152 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,878,577 | DepreciationAmt |
| Book Value | $5,750,575 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,798,908 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,603,141 | DepreciationAmt |
| Book Value | $8,195,767 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $19,712,953 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,564,768 | DepreciationAmt |
| Book Value | $8,148,185 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $22,504,527 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (5 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| CLOSELY-HELD EQUITY INTERESTS | ||
| FINANCIAL DERIVATIVES | ||
| INVESTMENT IN POOLED FUNDS | $43,326,730 | F |
| BENEFICIAL INTEREST TRUSTS | $1,993,993 | F |
| CHARITABLE REMAINDER TRUSTS | $128,661 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $45,449,384 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| RENTAL DEPOSITS | $13,278 |
| EQUITY IN SUBSIDIARY | $2,776,258 |
| OTHER RECEIVABLES | $721,568 |
| RIGHT OF USE ASSETS, NET | $4,636,270 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $8,147,374 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)
| DescDesc | AmtAmt |
|---|---|
| FEDERAL INCOME TAXES | |
| EST. SETTLEMENT W/3RD PARTY PAYORS | $2,018,609 |
| AFFILIATE NOTE PAYABLE | $17,521,839 |
| POST RETIREMENT BENEFIT OBLIGATION | $387,245 |
| RIGHT OF USE OBLIGATIONS | $4,453,508 |
| OTHER LIABILITIES | $671,764 |
| DUE TO AFFILIATE | $4,815,999 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $29,868,964 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Other Revenue | $0 | OtherRevenueAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $0 | RevenueSubtotalAmt |
| Other Revenues Not Included | $0 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $0 | TotalRevenuePerForm990Amt |
| Other Expenses Included | $0 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $0 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $0 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $0 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART V, LINE 4 INTENDED USES OF ENDOWMENT FUNDS | THE INTENDED USE OF THE ENDOWMENT FUNDS IS TO PROMOTE AND ADVANCE THE FOLLOWING MISSION-RELATED PROGRAMS: HEALTHCARE SERVICES, CHARITY CARE, COMMUNITY OUTREACH AND ADVOCACY, AND EQUIPMENT PURCHASES. |
| SCHEDULE D, PART X, LINE 2 FIN 48 (ASC 740) FOOTNOTE | THE ORGANIZATION'S PARENT COMPANY AND SUBSIDIARIES ARE EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. HOWEVER, THE ORGANIZATION IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. ASC SUBTOPIC 740-10, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, ADDRESSES THE ACCOUNTING UNCERTAINTY OF INCOME TAXES RECOGNIZED IN AN ENTERPRISE'S FINANCIAL STATEMENTS AND PRESCRIBES A THRESHOLD OF "MORE-LIKELY-THAN-NOT" FOR RECOGNITION AND DERECOGNITION OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. SUBTOPIC 740-10 ALSO PROVIDES GUIDANCE ON MEASUREMENT CLASSIFICATION, INTEREST AND PENALTIES AND DISCLOSURE. THE ORGANIZATION HAS DETERMINED THAT THE PROVISIONS OF SUBTOPIC 740-10 DO NOT HAVE A MATERIAL EFFECT ON THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ORGANIZATION BELIEVES IT IS NO LONGER SUBJECT TO EXAMINATIONS FOR FISCAL YEARS PRIOR TO 2022. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 250 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $298,460 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $298,460 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,333,497 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,777,443 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,556,054 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08567 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $9,631,957 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,777,443 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,854,514 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08957 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,683,380 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $831,866 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $851,514 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01113 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $496,659 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $496,659 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00649 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,826,245 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,099,606 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,726,639 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03563 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $15,006,284 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,931,472 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,074,812 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05325 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $24,638,241 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,708,915 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,929,326 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14282 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $0 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $25,997,911 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $28,647,787 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,649,876 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WINDSOR HOSPITAL CORPORATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 289 COUNTY ROAD | AddressLine1Txt |
| City | WINDSOR | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05089 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | https://www.mtascutneyhospital.org | WebsiteAddressTxt |
| State License | 863 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | DISTINCT PART REHAB UNIT | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WINDSOR HOSPITAL CORPORATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 24 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https://www.mtascutneyhospital.org/about/community-health-needs | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 24 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://WWW.MTASCUTNEYHOSPITAL.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 250.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.0 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://www.mtascutneyhospital.org/your-visit/billing-financial-assistance | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://www.mtascutneyhospital.org/your-visit/billing-financial-assistance | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://www.mtascutneyhospital.org/your-visit/billing-financial-assistance | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 3E | THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AS IDENTIFIED THROUGH THE CHNA. |
| SCHEDULE H, PART V, SECTION B, LINE 5 FACILITY , 1 | FACILITY , 1 - WINDSOR HOSPITAL CORPORATION. METHODS EMPLOYED IN THE ASSESSMENT INCLUDED A SURVEY OF AREA RESIDENTS MADE AVAILABLE THROUGH THE ELECTRONIC MAIL, PHYSICAL PRINTED SURVEYS DISTRIBUTED THROUGH THE COMMUNITIES' WEBSITE LINKS, A SURVEY OF KEY COMMUNITY STAKEHOLDERS WHO ARE AGENCY, MUNICIPAL OR HEALTH AND HUMAN SERVICE / COMMUNITY LEADERS, A SERIES OF FOUR COMMUNITY DISCUSSION GROUPS CONVENED IN THE MT. ASCUTNEY HOSPITAL SERVICE AREA, AND A REVIEW OF AVAILABLE POPULATION DEMOGRAPHICS AND HEALTH STATUS INDICATORS WAS DONE. THIS INPUT WAS GATHERED DURING THE PERIOD OCTOBER 2023 THROUGH SEPTEMBER 2024. THE CHNA WAS CONDUCTED IN PARTNERSHIP WITH DARTMOUTH HEALTH, VALLEY REGIONAL HOSPITAL, ALICE PECK DAY MEMORIAL HOSPITAL, NEW LONDON HOSPITAL, CHESHIRE MEDICAL CENTER, AND DARTMOUTH HEALTH HOME CARE (F/K/A VISITING NURSE ASSOCIATION AND HOSPICE OF VT AND NH) WITH SUPPORT PROVIDED BY THE NEW HAMPSHIRE COMMUNITY HEALTH INSTITUTE/JSI. AT THE BEGINNING OF THE KEY COMMUNITY STAKEHOLDER SURVEY, RESPONDENTS WERE ASKED TO INDICATE THE REGION THEY PRIMARILY SERVE OR ARE MOST FAMILIAR WITH. A TOTAL OF 57 KEY STAKEHOLDER RESPONDENTS INDICATED THAT THEIR RESPONSES WERE REFLECTIVE OF THE GREATER WINDSOR AREA. RESPONDENTS REPRESENTED THE FOLLOWING SECTORS: - HUMAN SERVICE/SOCIAL SERVICES - EDUCATION/YOUTH SERVICES - COMMUNITY MEMBER/VOLUNTEER - PUBLIC HEALTH - MUNICIPAL/COUNTY/STATE GOVERNMENT - MEDICAL CARE/HOSPITAL - FAITH ORGANIZATION - LONG-TERM CARE - MENTAL HEALTH/BEHAVIORAL HEALTH - CIVIC/CULTURAL ORGANIZATION - FIRE/EMERGENCY MEDICAL SERVICE - HOME HEALTH CARE - BUSINESS/OTHER POPULATIONS REPRESENTED BY THOSE PROVIDING INPUT INCLUDE: -LOW INCOME -UNINSURED -BLACK, INDIGENOUS, AND PEOPLE OF COLOR -LGBTQIA+ -ELDERLY |
| SCHEDULE H, PART V, SECTION B, LINE 6A FACILITY , 1 | FACILITY , 1 - WINDSOR HOSPITAL CORPORATION. THE CHNA WAS CONDUCTED WITH OTHER HOSPITAL FACILITIES INCLUDING DARTMOUTH-HITCHCOCK, ALICE PECK DAY MEMORIAL HOSPITAL, NEW LONDON HOSPITAL, CHESHIRE HOSPITAL AND VALLEY REGIONAL HEALTHCARE. |
| SCHEDULE H, PART V, SECTION B, LINE 6B FACILITY , 1 | FACILITY , 1 - WINDSOR HOSPITAL CORPORATION. ORGANIZATIONS OTHER THAN HOSPITALS WHO PARTICIPATED WITH MAHHC TO CONDUCT THE CHNA INCLUDED: DARTMOUTH HEALTH HOME CARE (F/K/A VISITING NURSE ASSOCIATION AND HOSPICE OF VT AND NH); TECHNICAL SUPPORT FROM THE NEW HAMPSHIRE COMMUNITY HEALTH INSTITUTE/JSI. |
| SCHEDULE H, PART V, SECTION B, LINE 7 FACILITY , 1 | FACILITY , 1 - WINDSOR HOSPITAL CORPORATION. THE CHNA REPORT WAS PREPARED AND MADE AVAILABLE AND DISTRIBUTED THROUGH PRESENTATIONS MADE TO THE HOSPITAL'S BOARD OF TRUSTEES, THE MT. ASCUTNEY COMMUNITY HEALTH COMMITTEE, AS WELL AS THE BLUEPRINT COMMUNITY HEALTH TEAM, WINDSOR CONNECTION RESOURCE CENTER, WINDSOR HSA COMMUNITY COLLABORATIVE, AND A REGIONAL CONVENING OF ALL NETWORKS AND WORKGROUPS OF THE COMMUNITY HEALTH IMPLEMENTATION PLAN. THE CHNA AND ALL INFORMATION IN THE NEEDS ASSESSMENT IS AVAILABLE FOR STAKEHOLDERS. |
| SCHEDULE H, PART V, SECTION B, LINE 11 FACILITY , 1 | FACILITY , 1 - WINDSOR HOSPITAL CORPORATION. THE MISSION OF MT. ASCUTNEY HOSPITAL AND HEALTH CENTER (MAHHC) IS TO IMPROVE THE LIVES OF THOSE WE SERVE. TO ACCOMPLISH THIS, WE AND OUR COMMUNITY PARTNERS REGULARLY REACH OUT TO ENGAGE IN DIALOGUE WITH PEOPLE ACROSS OUR AREA ABOUT PRESSING HEALTH NEEDS. THE RESULT OF THIS WORK IS A COMPREHENSIVE LOCAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THIS ASSESSMENT IS DESIGNED TO IDENTIFY COMMUNITY HEALTH CONCERNS AND PRIORITIES AND LEAD TO OPPORTUNITIES TO IMPROVE COMMUNITY HEALTH AND HEALTHCARE DELIVERY SYSTEMS. THE GEOGRAPHIC AREA COVERED BY THE ASSESSMENT INCLUDES 13 MUNICIPALITIES IN VERMONT AND NEW HAMPSHIRE THAT COMPRISE THE MAHHC SERVICE AREA. THE CHNA LEADS TO A LOCAL COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) WITH STRATEGIES AND METRICS TO IMPROVE HEALTH AND REDUCE RISKS LEADING TO CHRONIC DISEASE NOT ONLY FOR INDIVIDUALS, BUT FOR THE ENTIRE COMMUNITY. THIS CHNA/CHIP PROCESS, WHICH INCORPORATES INPUT FROM PEOPLE WHO REPRESENT THE COMMUNITY'S BROAD INTERESTS, IS AN ESSENTIAL PART OF CREATING AN ACCOUNTABLE COMMUNITY FOR HEALTH. THE ASSESSMENT PROCESS FOSTERS ENGAGEMENT, AND THE RESULTS HELP US TO UNDERSTAND THE SPECIFIC ISSUES FACING OUR COMMUNITIES SO THAT WE CAN DEVELOP EFFECTIVE, COLLECTIVE IMPACT SOLUTIONS. THE SIGNIFICANT COMMUNITY HEALTH NEEDS IDENTIFIED IN THE CHNA ARE: * ACCESS TO PRIMARY AND SPECIALTY CARE * HEALTHCARE COSTS * SOCIAL DRIVERS OF HEALTH AND WELL-BEING, SUCH AS THE NEED FOR TRANSPORTATION, HEALTH EDUCATION, AND RESOURCES FOR AGING-IN-PLACE IN FISCAL YEAR 2025, WE IMPLEMENTED THE FOLLOWING PROGRAMS WITHIN OUR COMMUNITY HEALTH IMPROVEMENT PLAN DESIGNED TO ADDRESS THE PRIORITY HEALTH NEEDS AREA OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. 50+ HEALTH NETWORK, AN INTEGRAL PART OF OUR MAHHC CHIP, HAS THE AIM OF INCREASING THE CONNECTION OF OLDER ADULTS TO NEEDED RESOURCES IN THE MAHHC SERVICE AREA. STRATEGIES IMPLEMENTED DURING FY25 INCLUDED COLLABORATING WITH COMMUNITY PARTNERS AND EXPERT GUEST SPEAKERS. EXAMPLES INCLUDE END OF LIFE CARE, VERMONT 211, AND OUTREACH. ACCOMPLISHMENTS INCLUDED DISTRIBUTING HUNDREDS OF SENIOR HEALTH QUICK GUIDE MAGNETS AND FILE OF LIFE MAGNETS IN COLLABORATION WITH THE LOCAL EMERGENCY MANAGEMENT SYSTEMS, PROVIDING COMMUNITY NURSE SEED FUNDING TO THE WINDSOR COMMUNITY NURSE PROGRAM, AND PARTNERING WITH VOLUNTEERS IN ACTION (VIA). VOLUNTEERS IN ACTION (VIA) PROVIDES SERVICES THAT ENABLE MANY OLDER INDIVIDUALS AND THOSE WITH DISABILITIES, ESPECIALLY THOSE LACKING CLOSE FAMILIAL SUPPORT, TO REMAIN IN THEIR HOMES AND MAINTAIN INDEPENDENCE AS THEY AGE. VIA EMPOWERS PEOPLE TO HELP ONE ANOTHER WHILE MAINTAINING DIGNITY AND FOSTERING A SENSE OF COMMUNITY AND BELONGING. DURING THE FY25, VIA - AT NO COST - HAS: * PROVIDED TRANSPORTATION FOR 691 TRIPS FOR VARIOUS COMMUNITY MEMBERS TO MEDICAL APPOINTMENTS AND QUALITY OF LIFE NEEDS, COVERING APPROXIMATELY 10,000 MILES; * PARTNERED WITH THE VT FOODBANK TO PROVIDE OVER 4,000 MEALS AND EDUCATION/OUTREACH TO IMPROVE FOOD SECURITY THROUGH THE VEGGIEVANGO PROGRAM; * PARTNERED WITH SENIOR SOLUTIONS AND HISTORIC HOMES OF RUNNEMEDE TO DELIVER APPROXIMATELY 20,000 MEALS THROUGH THE MEALS ON WHEELS PROGRAM, ALONG WITH THE ACCOMPANYING SAFETY CHECKS; AND * SPENT COLLECTIVELY OVER 2,800 HOURS KNITTING HEARTS AND GARMENTS FOR THOSE IN NEED AND FOR COMFORT TO THOSE HOSPITALIZED AND THEIR LOVED ONES AT MT. ASCUTNEY HOSPITAL & HEALTH CENTER. THE WINDSOR RESOURCE CENTER (WRC) - AT NO COST - HAS: * IN THE MONTH OF JANUARY 2025, FOR EXAMPLE, SERVED 265 "WALK-INS" REQUESTING SUPPORT, ITEMS, OR SERVICES. BY NOVEMBER OF THIS YEAR, THE MONTHLY TOTAL HAD DOUBLED TO 533. ON AVERAGE, 47 WALK-INS PER MONTH ARE DIRECTLY SUPPORTING CHILDREN UNDER 15 YEARS OF AGE, WITH AN AVERAGE OF 10 PEOPLE PER MONTH UTILIZING OUR DIAPER BANK. A MORE DRAMATIC INCREASE HAS BEEN OBSERVED IN THE NEED FOR NUTRITIONAL SUPPORT, WITH 177 OF OUR WALK-INS ACCESSING OUR FOOD PANTRY IN JANUARY 2025. * THE WINDSOR RESOURCE CENTER PROVIDED ACCESS FOR PEOPLE, PARTICULARLY THOSE WHO ARE UNHOUSED OR PRECARIOUSLY HOUSED, TO: 1,701 SHOWERS, 186 LOADS OF LAUNDRY COMPLETED, AND 558 COMPUTER USES AND PHONE CALLS FACILITATED, CONNECTING VULNERABLE INDIVIDUALS WITH CRUCIAL SERVICES RELATED TO EMERGENCY HOUSING, FOOD SECURITY, AND SAFETY. OUR GIVING ROOM HAS DISTRIBUTED OVER 12,000 ITEMS OF CLOTHING AND PERSONAL HYGIENE PRODUCTS IN THE LAST SIX MONTHS, INCLUDING, FOR EXAMPLE, MORE THAN 60 PAIRS OF SHOES IN JULY 2025. OUR FOOD SECURITY WORKGROUP, ANOTHER INTEGRAL PART OF OUR MAHHC CHIP, WORKS TO INCREASE ACCESS TO NOURISHING FOOD FOR ALL PEOPLE IN OUR COMMUNITIES. DURING FY25, THE WORKGROUP CREATED DIGITAL MEDIA DISPLAYS INCLUSIVE FOR THOSE WITH LOW LITERACY AND LOW/LIMITED VISION, FACEBOOK CAMPAIGNS INCLUDING VEGGIEVANGO, FOOD SHELVES, WIC AWARENESS, GAP ANALYSIS, AND PARTNER COLLABORATION TO INCREASE AWARENESS AND REDUCE BARRIERS TO ACCESS TO NOURISHING, CULTURALLY APPROPRIATE FOOD. THE SPIRITUAL HEALTH WORKGROUP, PART OF OUR MAHHC CHIP, SUPPORTS AN INTERFAITH COLLABORATIVE TO ADDRESS LOCAL PUBLIC HEALTH NEEDS AND CHALLENGES. THIS WORKGROUP CONTINUED PROJECT HOPE, WHICH FOSTERS HOPE IN OUR COMMUNITY AND CELEBRATES THAT WORK THROUGH ART. THIS WORKGROUP ALSO HELPED DEFINE SPIRITUAL HEALTH FOR THE HOSPITAL, WHICH IS THE ASPECT OF OUR WELL-BEING THAT REFERS TO THE VALUES, RELATIONSHIPS, AND MEANING AND PURPOSE OF OUR LIVES. AN ADDITIONAL BRANCH OF OUR MAHHC CHIP IS THE HOUSING WORKGROUP, WHICH AIMS TO PROMOTE AND CREATE CONDITIONS FOR A BROAD, CROSS-SECTOR REGIONAL EFFORT TO INCREASE HOUSING AVAILABILITY. THIS WORKGROUP PROMOTED HOME SHARING - A MANAGEABLE WAY TO POSITIVELY IMPACT THE UPPER VALLEY HOUSING CRISIS. THEY ALSO PARTNERED WITH THE THOMPSON SENIOR CENTER AND BENEFITED FROM ONGOING CONSULTATION WITH ANNA MARIE PLUHAR AT SHARING HOUSING. ENGAGEMENT WITH LOCAL MUNICIPALITIES WAS ALSO PRIORITIZED THROUGHOUT THE YEAR. FURTHERMORE, OUR STRENGTHENING FAMILIES NETWORK, ANOTHER BRANCH OF OUR MAHHC CHIP, CONDUCTED TRAINING SESSIONS AND COLLABORATIVE MEETINGS AND PREPARED FOR THE LAUNCH OF A NEW WEBSITE TO PROMOTE SOCIAL CONNECTEDNESS AND WELL-BEING FOR FAMILIES IN THE UPPER VALLEY. THIS NETWORK ALSO FACILITATED ONGOING COMMUNICATIONS AND A VARIETY OF OPTIONS TO HELP FAMILIES FEEL CONNECTED, INCLUDING FIELD TRIPS & POSITIVE PLAYGROUP EXPERIENCES. |
| SCHEDULE H, PART V, SECTION B, LINE 13 FACILITY , 1 | FACILITY , 1 - WINDSOR HOSPITAL CORPORATION. MAHHC APPLIES A DISCOUNT, CALCULATED ANNUALLY, TO THE FAP ELIGIBLE PATIENT'S GROSS CHARGES AND BALANCES WHERE THERE IS NO INSURANCE, OR TO MEDICALLY NECESSARY SERVICES PROCESSED BY INSURANCE CARRIERS RESULTING IN A BALANCE, WHICH THE PATIENT IS EXPECTED TO PAY. THIS ASSURES A PATIENT IS NOT BILLED AT AN AMOUNT GREATER THAN GENERALLY BILLED TO PATIENTS WITH INSURANCE. THIS POLICY IS REFERENCED IN THE FINANCIAL ASSISTANCE FOR HEALTHCARE SERVICES POLICY (FAP). |
| SCHEDULE H, PART V, SECTION B, LINE 16 FACILITY , 1 | FACILITY , 1 - WINDSOR HOSPITAL CORPORATION. THE FINANCIAL ASSISTANCE POLICY IS POSTED ON MAHHC'S WEBSITE, INCLUDING THE VERBATIM POLICY AND A SHORTER, MORE PATIENT-FRIENDLY PLAIN-LANGUAGE SUMMARY. MAHHC PROVIDES THE PLAIN-LANGUAGE SUMMARY BROCHURE TO ALL INPATIENTS, EMERGENCY DEPARTMENT INTAKES, UNINSURED, AND SELF-PAY INDIVIDUALS. MAHHC CONTINUES TO NOTIFY PATIENTS ON THE BACK OF THE BILLING STATEMENT ABOUT FINANCIAL ASSISTANCE AVAILABLE TO THEM. ADDITIONALLY, MAHHC POSTS INFORMATION ABOUT THE POLICY IN PUBLIC AREAS THROUGHOUT THE FACILITIES INCLUDING ADMISSION OFFICES, PUBLIC AREA BOARDS THROUGHOUT THE FACILITIES, THE EMERGENCY ROOMS, AND FINANCIAL ASSISTANCE POLICY BROCHURES IN PATIENT AREAS. MAHHC SCREENS 100% OF UNINSURED INPATIENT AND SAME-DAY PATIENTS PRIOR TO ADMISSION. AS PART OF THIS PROCESS, MAHHC CHECKS ALL STATE AND FEDERAL PROGRAMS TO SEE IF INDIVIDUALS ARE ELIGIBLE FOR ASSISTANCE. PATIENTS ARE ALSO SCREENED TO DETERMINE QUALIFICATION FOR FINANCIAL ASSISTANCE AND THE APPLICATION IS PROVIDED AND/OR COMPLETED AT THIS TIME. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 0 | FacilityNum |
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT | THE STATE OF VERMONT DOES NOT ADMINISTER ANY COMMUNITY BENEFIT REPORTING REGULATIONS. |
| SCHEDULE H, PART I, LINE 3C FACTORS USED IN DETERMINING ELIGIBILITY OTHER THAN FPG | IN ADDITION TO FALLING WITHIN CERTAIN FPG PARAMETERS, A PATIENT MUST ALSO SATISFY OTHER ELIGIBILITY CRITERIA TO QUALIFY FOR FREE OR DISCOUNTED CARE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THE PATIENT MUST BE A RESIDENT OF NEW HAMPSHIRE OR VERMONT, OR A NON-RESIDENT WHO RECEIVES EMERGENCY TREATMENT AT A DARTMOUTH HEALTH ("DH") FACILITY. THE PATIENT MUST ALSO BE UNINSURED OR UNDERINSURED, INELIGIBLE FOR BENEFITS THROUGH A GOVERNMENT HEALTH CARE PROGRAM, AND UNABLE TO PAY FOR CARE AS DESCRIBED IN THE CREDIT AND COLLECTIONS POLICY, BASED ON A DETERMINATION OF FINANCIAL NEED UNDER THIS POLICY. IN ADDITION, THE PATIENT MUST HAVE A GROSS FAMILY INCOME AT OR BELOW 600% OF FPG AND HAVE AGGREGATE BALANCES OWED FOR SERVICES PROVIDED AT DH THAT EXCEED 20% OF ONE YEAR'S FAMILY INCOME, INCLUDING SAVINGS. FOR PURPOSES OF THIS DETERMINATION, SAVINGS (WHICH INCLUDE SAVINGS ACCOUNTS, ALIMONY, AND CERTIFICATE(S) OF DEPOSIT) ARE SHELTERED UP TO 400% OF FPG. WHEN ELIGIBLE, THE PATIENT MUST ALSO DEMONSTRATE COMPLIANCE WITH THE REQUIREMENTS TO APPLY FOR QUALIFIED HEALTH PLAN COVERAGE IN THE NEW HAMPSHIRE OR VERMONT HEALTHCARE EXCHANGE PROGRAM. EXCEPTIONS TO THIS REQUIREMENT MAY BE APPROVED BY SENIOR LEADERSHIP FOR GOOD CAUSE ON A CASE-BY-CASE BASIS. "GOOD CAUSE" WILL DEPEND ON FACTS AND CIRCUMSTANCES AND MAY INCLUDE THOSE THAT MISSED THE OPEN ENROLLMENT PERIOD AND DO NOT FALL INTO A LIFE CHANGING EVENT CATEGORY OUTSIDE OF OPEN ENROLLMENT, ALONG WITH THOSE FOR WHOM THE FINANCIAL BURDEN WILL BE GREATER FOR THE PATIENT TO ENROLL IN A QUALIFIED HEALTH PLAN THAN NOT TO DO SO. IN CATASTROPHIC SITUATIONS INVOLVING EITHER UNINSURED OR INSURED PATIENTS, IF THE TOTAL AMOUNT OWED FOR EMERGENCY AND MEDICALLY NECESSARY SERVICES RENDERED EXCEEDS 20% OF THE PATIENT'S HOUSEHOLD INCOME, THEN THE AMOUNT OWED SHALL BE REDUCED SO THAT IT IS EQUAL TO 20% OF THE PATIENT'S HOUSEHOLD'S INCOME. |
| SCHEDULE H, PART I, LINE 7G SUBSIDIZED HEALTH SERVICES | A PORTION OF THE SUBSIDIZED SERVICES COSTS COMES FROM PROVIDING PRIMARY CARE SERVICES TO THE COMMUNITY IN A RURAL SETTING. MT. ASCUTNEY HOSPITAL SEES THE VALUE IN OUR COMMUNITY MEMBERS HAVING THE ABILITY TO MEET WITH A PRIMARY CARE SPECIALIST TO ADDRESS THEIR NEEDS BEFORE THEY BECOME MORE COSTLY EMERGENCIES. AS SUCH WE KEEP THE DOORS OF THESE CLINICS OPEN IN SPITE OF REVENUE AND EXPENSE LIMITATIONS THAT PREVENT INCOME FROM COMPLETELY COVERING THE EXPENSES NECESSARY TO KEEP THEM RUNNING. |
| SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY USED TO CALCULATE FINANCIAL ASSISTANCE | A COST-TO-CHARGE RATIO IS USED IN CALCULATING THE AMOUNTS IN LINES 7A. A COST ACCOUNTING SYSTEM WHICH ADDRESSES ALL PATIENTS' SEGMENTS WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE FOR ALL OTHER LINES. THERE IS NO AMOUNT OF BAD DEBT INCLUDED IN LINE 7. |
| SCHEDULE H, PART III, LINE 2 BAD DEBT EXPENSE - METHODOLOGY USED TO ESTIMATE AMOUNT | AS A RESULT OF ACCOUNTING GUIDANCE (STATEMENT 15 AND ASC 606), EFFECTIVE FY21 BAD DEBT IS NO LONGER AN EXPENSE, BUT IS INCLUDED AS A REDUCTION IN NET PATIENT REVENUE. |
| SCHEDULE H, PART III, LINE 3 BAD DEBT EXPENSE METHODOLOGY | BAD DEBT IS NO LONGER TREATED AS AN EXPENSE EFFECTIVE FY21 AS A RESULT OF NEW ACCOUNTING GUIDANCE (STATEMENT 15 AND ASC 606). AS A RESULT, AN AMOUNT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS UNABLE TO BE REASONABLY ESTIMATED. |
| SCHEDULE H, PART III, LINE 4 BAD DEBT EXPENSE - FINANCIAL STATEMENT FOOTNOTE | AS A RESULT OF ACCOUNTING CHANGES (ASC 606), BAD DEBT IS NO LONGER AN EXPENSE, BUT IS INCLUDED AS A REDUCTION IN NET PATIENT REVENUE. THEREFORE, THERE IS NO SEPARATE FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT. |
| SCHEDULE H, PART III, LINE 8 COMMUNITY BENEFIT & METHODOLOGY FOR DETERMINING MEDICARE COSTS | THE SHORTFALL REPRESENTS THE PPS REIMBURSEMENT DIFFERENCE OF THE REHAB UNITS. SINCE THE REIMBURSEMENT DOES NOT COVER THE COSTS OF THESE UNITS, A SUBSIDY IS CREATED. THE HOSPITAL BELIEVES THAT ANY MEDICARE SHORTFALL SHOULD BE CONSIDERED COMMUNITY BENEFIT BECAUSE THE HOSPITAL DETERMINED THAT THESE SERVICES ARE IMPORTANT TO THE SERVICE AREA, AND THEREFORE, THE HOSPITAL COVERS THE SUBSIDY. THE COSTING METHODOLOGY USED IN THE CALCULATION WAS THE COST TO CHARGE RATIO. |
| SCHEDULE H, PART III, LINE 9B COLLECTION PRACTICES FOR PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE | MAHHC'S COLLECTION POLICY AND CHARITABLE CARE POLICIES ARE CONSISTENTLY APPLIED TO ALL PATIENTS. OUR COLLECTION POLICY APPLIES TO ANY BALANCE OWED BY THE PATIENT WHETHER IT IS A BALANCE AFTER INSURANCE, A BALANCE WITH NO INSURANCE, OR A BALANCE AFTER AN ADJUSTMENT FOR PARTIAL CHARITABLE CARE. STATEMENTS AND WRITE-OFF CRITERIA ARE THE SAME FOR ALL LIKE BALANCES, REGARDLESS OF THE REASON FOR THE BALANCE AND REGARDLESS OF WHETHER IT IS A BALANCE AFTER CHARITABLE CARE OR NOT. PATIENTS FOR FINANCIAL ASSISTANCE RECEIVE THE APPROPRIATE ADJUSTMENT ON THEIR BILL. IF A BALANCE REMAINS AFTER THAT ADJUSTMENT, THEY ARE BILLED ACCORDING TO THE COLLECTION POLICY FOR IT. |
| SCHEDULE H, PART V, SECTION B, LINE 16A FAP WEBSITE | - WINDSOR HOSPITAL CORPORATION: LINE 16A URL: HTTPS://WWW.MTASCUTNEYHOSPITAL.ORG/YOUR-VISIT/BILLING-FINANCIAL-ASSISTANCE; |
| SCHEDULE H, PART V, SECTION B, LINE 16B FAP APPLICATION WEBSITE | - WINDSOR HOSPITAL CORPORATION: LINE 16B URL: HTTPS://WWW.MTASCUTNEYHOSPITAL.ORG/YOUR-VISIT/BILLING-FINANCIAL-ASSISTANCE; |
| SCHEDULE H, PART V, SECTION B, LINE 16C FAP PLAIN LANGUAGE SUMMARY WEBSITE | - WINDSOR HOSPITAL CORPORATION: LINE 16C URL: HTTPS://WWW.MTASCUTNEYHOSPITAL.ORG/YOUR-VISIT/BILLING-FINANCIAL-ASSISTANCE; |
| SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT | THE COMMUNITY RESIDENT SURVEY WAS DISTRIBUTED ELECTRONICALLY THROUGH EMAIL AND SOCIAL MEDIA COMMUNICATION CHANNELS, ON THE MT. ASCUTNEY HOSPITAL WEBSITE, PROMOTED THROUGH POSTERS AND FLIERS WITH LINKS AND QR CODES POSTED AROUND THE REGION, AND BY PAPER COPIES MADE AVAILABLE AT A VARIETY OF DISTRIBUTION POINTS THROUGHOUT THE REGION INCLUDING LIBRARIES, CLINICS, AND COMMUNITY MEETING SPACES. |
| SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PATIENTS WHO ARE IDENTIFIED AS WITHOUT INSURANCE AT REGISTRATION OR REFERRED TO BY A PHYSICIAN/PROVIDER ARE PROVIDED WITH INFORMATION AS TO AVAILABLE LOCAL, STATE AND FEDERAL SERVICES BY DEDICATED STAFF. PATIENTS ARE ALSO ASSISTED IN APPLYING FOR HEALTH INSURANCE, WHETHER ON THE COMMERCIAL EXCHANGE OR WITH GOVERNMENTAL INSURERS. INFORMATION AND THE APPLICATION FOR FINANCIAL ASSISTANCE IS PROVIDED, ALONG WITH ASSISTANCE IN COMPLETING THE APPLICATION IF NEEDED. THE APPLICATIONS ARE REVIEWED TO ENSURE THAT ALL REQUIRED INFORMATION IS PROVIDED. THE WEBSITE, PATIENT STATEMENTS, AND FINANCIAL BROCHURES ALL INCLUDE INFORMATION ABOUT FINANCIAL ASSISTANCE AND HOW TO APPLY. |
| SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION | MAHHC'S PRIMARY SERVICE AREA INCLUDES BRIDGEWATER, BROWNSVILLE, HARTLAND, READING, WEATHERSFIELD, WINDSOR, AND WOODSTOCK (VT) AS WELL AS CLAREMONT, CORNISH, AND PLAINFIELD (NH). MAHHC IS THE LARGEST EMPLOYER IN THE TOWN OF WINDSOR, WITH MANY OF ITS RESIDENTS HAVING LOWER THAN AVERAGE PAYING JOBS AND WHO STRUGGLE WITH FINANCIAL STABILITY, WHICH INCLUDES TRANSPORTATION DIFFICULTIES. |
| SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH | OUR STAFF CONTINUE TO ORGANIZE, LEAD AND IMPLEMENT POPULATION HEALTH PROGRAMS, HEALTH PROMOTION AND PREVENTION PROGRAMS THAT ADDRESS HIGH RISK BEHAVIOR SUCH AS ALCOHOL, TOBACCO AND DRUG MISUSE. WE PROMOTE EXERCISE AND NUTRITION PROGRAMS. WE ORGANIZED AND IMPLEMENTED THE COMMUNITY HEALTH IMPLEMENTATION PLAN. WE SERVE AS AN INTEGRATOR AND LEADER OF COMMUNITY HEALTH BY CHAIRING AND LEADING THE FOLLOWING COMMUNITY COLLABORATIONS: THE WINDSOR HSA COMMUNITY COLLABORATIVE, THE BLUEPRINT FOR HEALTH CARE COORDINATION TEAM, THE 6 MULTISECTOR WORK GROUPS RESULTING FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT. |
| SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM | THE DARTMOUTH HEALTH SYSTEM COVERS A LARGE GEOGRAPHIC AREA STRETCHING ALONG THE CONNECTICUT RIVER VALLEY AND ACROSS THE SOUTHERN PORTION OF VERMONT. THE HOSPITALS IN THE SYSTEM COVER DIFFERENT REGIONS THROUGHOUT THIS RANGE. THE AFFILIATION ALLOWS MORE PATIENTS TO RECEIVE CARE CLOSER TO HOME, FREES UP BED CAPACITY FOR TERTIARY CARE PATIENTS AT DARTMOUTH-HITCHCOCK MEDICAL CENTER IN LEBANON, NH, AND ALLOWS MT ASCUTNEY HOSPITAL TO CONTINUE TO BE A PILLAR OF QUALITY CARE ON THE VERMONT SIDE OF THE CONNECTICUT RIVER VALLEY. THE AFFILIATED HEALTH CARE SYSTEM INCLUDES MARY HITCHCOCK MEMORIAL HOSPITAL, DARTMOUTH-HITCHCOCK CLINIC, THE NEW LONDON HOSPITAL ASSOCIATION, WINDSOR HOSPITAL CORPORATION, VALLEY REGIONAL HOSPITAL, ALICE PECK DAY MEMORIAL HOSPITAL, DARTMOUTH HEALTH HOME CARE, SOUTHWESTERN VERMONT MEDICAL CENTER, AND A NUMBER OF OTHER RELATED ORGANIZATIONS WHOSE PRIMARY MISSION IS HEALTH CARE IN THE REGION. THE CHESHIRE MEDICAL CENTER AND OTHER MEMBERS OF THE AFFILIATED HEALTH CARE SYSTEM OPERATE JOINTLY THROUGH INTERLOCKING DIRECTORATES, STRATEGIC PLANNING, MANAGEMENT, AND SHARE IDENTICAL MISSIONS. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | PATIENT ASSISTANCE | GrantTypeTxt |
| Recipient | 28 | RecipientCnt |
| Cash Grant | $14,368 | CashGrantAmt |
| Valuation Method Used | BOOK | ValuationMethodUsedDesc |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING USE OF GRANT FUNDS | FormAndLineReferenceDesc |
| Explanation | AWARD PAYMENTS ARE PROCESSED IN ACCORDANCE WITH THE SPECIFIC TERMS OF EACH AWARD. THE COORDINATORS OF THE PROGRAM ARE RESPONSIBLE FOR ENSURING THAT ALL TERMS ARE MET, INCLUDING PROPER DOCUMENTATION OF EXPENSES WITH RECEIPTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOSEPH L PERRAS MD | ||||||||||||||
| FORMER CEO | $0 | $504,078 | $0 | $42,400 | $0 | $23,562 | $0 | $20,700 | $0 | $33,569 | $0 | $624,309 | $0 | $0 |
| WINFIELD BROWN | ||||||||||||||
| FORMER INTERIM CEO | $0 | $247,353 | $0 | $0 | $0 | $536 | $0 | $14,962 | $0 | $3,220 | $0 | $266,071 | $0 | $0 |
| JOCELYN CAPLE MD | ||||||||||||||
| INTERIM CEO (THROUGH 12/8/24) | $0 | $344,543 | $0 | $30,000 | $0 | $1,188 | $0 | $20,700 | $0 | $45,017 | $0 | $441,448 | $0 | $0 |
| PATRICK F JORDAN III MBA | ||||||||||||||
| TRUSTEE (THROUGH 6/21/25) | $0 | $875,781 | $0 | $180,000 | $0 | $76,927 | $0 | $32,970 | $0 | $46,290 | $0 | $1,211,968 | $0 | $0 |
| MATTHEW S HOUDE | ||||||||||||||
| TRUSTEE / DH VP GOV'T RELATIONS | $0 | $285,450 | $0 | $30,000 | $0 | $4,241 | $0 | $30,985 | $0 | $39,478 | $0 | $390,154 | $0 | $0 |
| STEPHEN D SURGENOR MD | ||||||||||||||
| TRUSTEE / DH DIRECTOR OF ANESTHESIOLOGY | $0 | $572,073 | $0 | $0 | $0 | $22,864 | $0 | $32,970 | $0 | $39,071 | $0 | $666,978 | $0 | $0 |
| CLARE DREBITKO | ||||||||||||||
| TRUSTEE/MED STAFF PRES (THROUGH 12/31/24) | $196,044 | $0 | $0 | $0 | $510 | $0 | $6,233 | $0 | $28,182 | $0 | $230,969 | $0 | $0 | $0 |
| JEFFREY KING | ||||||||||||||
| TRUSTEE / EX-OFFICIO MED STAFF PRESIDENT (AS OF 1/1/25) | $236,817 | $0 | $0 | $0 | $510 | $0 | $7,915 | $0 | $28,157 | $0 | $273,399 | $0 | $0 | $0 |
| SAMUEL SHIELDS | ||||||||||||||
| TRUSTEE / DH VP - STRTGY | $0 | $347,386 | $0 | $35,000 | $0 | $16,761 | $0 | $26,070 | $0 | $3,990 | $0 | $429,207 | $0 | $0 |
| HANNAH BIANCHI | ||||||||||||||
| CHIEF OPERATING OFFICER | $202,653 | $0 | $13,580 | $0 | $19,961 | $0 | $8,803 | $0 | $0 | $0 | $244,997 | $0 | $0 | $0 |
| DAVID SANVILLE | ||||||||||||||
| CHIEF FINANCIAL OFFICER (THROUGH 2/29/24) | $48,595 | $0 | $0 | $0 | $252,269 | $0 | $3,672 | $0 | $3,193 | $0 | $307,729 | $0 | $0 | $0 |
| HERBERT IP | ||||||||||||||
| PHYSICIAN | $305,160 | $0 | $18,600 | $0 | $11,750 | $0 | $12,015 | $0 | $28,157 | $0 | $375,682 | $0 | $0 | $0 |
| FRANCESCO CONGIUSTA | ||||||||||||||
| HOSPITALIST | $331,972 | $0 | $0 | $0 | $199 | $0 | $13,594 | $0 | $28,142 | $0 | $373,907 | $0 | $0 | $0 |
| JASON FRITZHAND | ||||||||||||||
| PHYSICIAN | $289,734 | $0 | $40,000 | $0 | $1,385 | $0 | $12,785 | $0 | $1,420 | $0 | $345,324 | $0 | $0 | $0 |
| CATHERINE SCHNEIDER | ||||||||||||||
| PHYSICIAN | $289,982 | $0 | $0 | $0 | $8,073 | $0 | $11,890 | $0 | $21,415 | $0 | $331,360 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 3 ARRANGEMENT USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION | THE CEO'S COMPENSATION AMOUNT IS DETERMINED BY A RELATED ORGANIZATION, WHICH USES A COMPENSATION COMMITTEE, AN INDEPENDENT CONSULTANT, A COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE MAHHC BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THE CEO'S COMPENSATION. |
| SCHEDULE J, PART I, LINE 4A SEVERANCE OR CHANGE-OF-CONTROL PAYMENT | DAVID SANVILLE, WHO WAS FORMERLY THE CFO, RECEIVED SEVERANCE PAYMENTS TOTALING $210,168 RELATED TO HIS DEPARTURE FROM THE DARTMOUTH HEALTH SYSTEM. |
| SCHEDULE J, PART II NOTE REGARDING COMPENSATION | FORM 990, SCHEDULE J, PART II COLUMN B, PARTS I, II, AND III REPRESENT ACTUAL AMOUNTS PAID TO EMPLOYEES BY MAHHC AND RELATED ORGANIZATIONS. THESE AMOUNTS ARE REPORTED TO EMPLOYEES ON THEIR ANNUAL W-2 FORMS AS COMPENSATION. COLUMNS C AND D REPRESENT ITEMS EARNED, HOWEVER, NOT PAID DIRECTLY TO THE EMPLOYEE AS CASH PAYMENTS DURING THE CALENDAR YEAR. COLUMN C INCLUDES RETIREMENT BENEFITS IN A CALENDAR YEAR. COLUMN D REPRESENTS NONTAXABLE BENEFITS SUCH AS THE COST OF HEALTHCARE COVERAGE PROVIDED BY MAHHC ON BEHALF OF ITS EMPLOYEES. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, LINE 1A DELEGATE BROAD AUTHORITY TO A COMMITTEE | AN EXECUTIVE COMMITTEE, CONSISTING OF THE CHAIR, VICE-CHAIR, SECRETARY AND TREASURER, AND D-HH CEO OR DESIGNEE. THIS COMMITTEE SHALL, IN THE INTERIM BETWEEN MEETINGS OF THE BOARD, EXERCISE ALL OF THE POWER OF THE BODY, BUT IN ACCORDANCE WITH THE GENERAL POWER OF THE HOSPITAL AND DIRECTION OF THE BOARD. |
| FORM 990, PART VI, LINE 3 DELEGATION OF MANAGEMENT DUTIES | CELESTE PITTS SERVED AS THE INTERIM CHIEF FINANCIAL OFFICER AND IS COMPENSATED BY HELMS & CO., AN INDEPENDENT ENTITY ENGAGED BY THE ORGANIZATION. MS. PITTS PERFORMED CERTAIN FINANCIAL AND MANAGEMENT FUNCTIONS UNDER THE SUPERVISION OF THE BOARD OF DIRECTORS. DURING CALENDAR YEAR 2024, A TOTAL OF $94,411 WAS PAID TO HELMS & CO. FOR THE INTERIM CFO SERVICES PROVIDED BY MS. PITTS TO MT. ASCUTNEY HOSPITAL AND HEALTH CENTER (MAHHC) AND RELATED ORGANIZATION HISTORIC HOMES OF RUNNEMEDE (HHR). THE COMPENSATION PAID BY HELMS & CO. TO MS. PITTS FOR HER INTERIM CFO SERVICES RENDERED TO MAHHC AND HHR IS UNKNOWN TO THE ORGANIZATION. |
| FORM 990, PART VI, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS | DARTMOUTH-HITCHCOCK HEALTH (D-HH), A NEW HAMPSHIRE VOLUNTARY CORPORATION, IS THE SOLE CORPORATE MEMBER OF MT. ASCUTNEY HOSPITAL AND HEALTH CENTER. |
| FORM 990, PART VI, LINE 7A MEMBERS OR STOCKHOLDERS ELECTING MEMBERS OF GOVERNING BODY | DARTMOUTH-HITCHCOCK HEALTH (D-HH), A NEW HAMPSHIRE VOLUNTARY CORPORATION, IS THE SOLE CORPORATE MEMBER OF MT. ASCUTNEY HOSPITAL AND HEALTH CENTER. D-HH HAS THE POWER TO APPOINT 1/3 OF THE MEMBERS OF THE MT. ASCUTNEY HOSPITAL AND HEALTH CENTER BOARD OF TRUSTEES. |
| FORM 990, PART VI, LINE 7B DECISIONS REQUIRING APPROVAL BY MEMBERS OR STOCKHOLDERS | THE SOLE MEMBER HAS THE RIGHT TO RATIFY MT. ASCUTNEY HOSPITAL AND HEALTH CENTER'S NOMINATION OF 2/3 OF THE MEMBERS OF THE BOARD OF TRUSTEES; REMOVE TRUSTEES AFTER CONSULTATION WITH THE CHAIRPERSON OF THE BOARD; APPROVE THE DISSOLUTION OR LIQUIDATION OF MT. ASCUTNEY HOSPITAL AND HEALTH CENTER; APPOINT, EVALUATE, TERMINATE, AND APPROVE THE COMPENSATION OF THE PRESIDENT AND CEO; AND OTHER GOVERNANCE DECISIONS. |
| FORM 990, PART VI, LINE 11B REVIEW OF FORM 990 BY GOVERNING BODY | THE FORM 990 IS REVIEWED BY EXTERNAL TAX ADVISORS AND THE CHIEF FINANCIAL OFFICER BEFORE THE FILING OF THE RETURN. IN ADDITION, ONCE THE RETURN HAS BEEN FULLY PREPARED, A FINAL 990 IS SENT TO EACH BOARD MEMBER AND TIME IS ALLOCATED FOR COMMENTS AND RESPONSES PRIOR TO THE OFFICIAL FILING OF THE FORMS. AFTER THE DATE OF THE BOARD'S REVIEW THE RETURNS MAY HAVE MINOR CHANGES ALTHOUGH NONE OF THESE CHANGES ARE SUBSTANTIVE. |
| FORM 990, PART VI, LINE 12C CONFLICT OF INTEREST POLICY | MT. ASCUTNEY HOSPITAL AND HEALTH CENTER'S BOARD OF TRUSTEES APPROVED A POLICY CONCERNING A VOLUNTARY SELF-DISCLOSURE OF ANY POTENTIAL CONFLICT OF INTEREST. THE COMPLIANCE AND AUDIT SERVICES DEPARTMENT OF AN AFFILIATE, DARTMOUTH-HITCHCOCK, CONDUCTS AN ANNUAL SURVEY OF ALL OFFICERS AND TRUSTEES AND PERFORMS OTHER PROCEDURES AS CONSIDERED NECESSARY TO REPORT ON COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE DEPARTMENT THEN REPORTS TO EACH BOARD ANY POTENTIAL CONFLICTS FOR THEIR REVIEW. PER THE POLICY, ANY CONFLICTS OR OTHERWISE PERCEIVED CONFLICTS ARE REQUIRED TO BE ADDRESSED BY THE BOARD OF TRUSTEES ON AN ONGOING BASIS. IN THE EVENT A CONFLICT ARISES, THE INDIVIDUAL MAY BE REMOVED FROM PARTICIPATING IN ANY DECISION-MAKING REGARDING THE IDENTIFIED CONFLICT AND/OR ITS CORRESPONDING TRANSACTIONS. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM SUCH PERSON OF THE BASIS OF SUCH BELIEF AND AFFORD HIM/HER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE INTERESTED PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT SUCH PERSON HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. |
| FORM 990, PART VI, LINE 15A PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL | THE COMPENSATION COMMITTEE OF MT. ASCUTNEY HOSPITAL AND HEALTH CENTER'S BOARD MEETS ANNUALLY TO REVIEW AND APPROVE COMPENSATION FOR THE PRESIDENT/CEO, WHICH IS RECOMMENDED BY THE COMPENSATION COMMITTEE OF A RELATED ORGANIZATION. THE COMPENSATION IS DETERMINED USING AN OUTSIDE CONSULTANT AND COMPARABILITY SURVEY AND/OR STUDY INCLUDING CONTEMPORANEOUS SUBSTANTIATION. THIS PROCESS WAS LAST UNDERTAKEN IN FY25. THE COMPENSATION COMMITTEE CONSISTS OF THE EXECUTIVE COMMITTEE AND A D-HH REPRESENTATIVE. |
| FORM 990, PART VI, LINE 15B PROCESS TO ESTABLISH COMPENSATION OF OTHER EMPLOYEES | COMPENSATION FOR OFFICERS AND KEY EMPLOYEES IS EVALUATED BY INTERNAL HUMAN RESOURCES STAFF USING NATIONAL BENCHMARKING DATA (ALONG WITH ONGOING EVALUATIONS BY AN INDEPENDENT THIRD-PARTY FIRM FOR REASONABLENESS). THE LAST FORMAL PROCESS WAS COMPLETED IN 2025. EXTERNAL BENCHMARKING FROM AN INDEPENDENT THIRD PARTY HAS BEEN USED FOR ANY OFFICER WHO WAS HIRED OR RECEIVED A COMPENSATION ADJUSTMENT SINCE THE LAST FORMAL PROCESS. COMPENSATION RATES ARE DETERMINED BY FOLLOWING THE GUIDELINES OF THE COMPENSATION COMMITTEE CHARTER AND PHILOSOPHY DOCUMENTS AND A FORMAL REVIEW BY COMPENSATION COMMITTEE MEMBERS. INCLUDED IN THIS PROCESS IS THE CFO AND THE CHIEF OPERATING OFFICER. |
| FORM 990, PART VI, LINE 19 REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC | MT. ASCUTNEY HOSPITAL AND HEALTH CENTER MAKES GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO MEMBERS OF THE PUBLIC UPON REQUEST. |
| FORM 990, PART VII, SECTION A, LINE 5 COMPENSATION PAID BY UNRELATED ORGANIZATION | CELESTE PITTS SERVED AS THE INTERIM CHIEF FINANCIAL OFFICER AND IS COMPENSATED BY HELMS & CO., AN INDEPENDENT ENTITY ENGAGED BY THE ORGANIZATION. MS. PITTS PERFORMED CERTAIN FINANCIAL AND MANAGEMENT FUNCTIONS UNDER THE SUPERVISION OF THE BOARD OF DIRECTORS. DURING CALENDAR YEAR 2024, A TOTAL OF $94,411 WAS PAID TO HELMS & CO. FOR THE INTERIM CFO SERVICES PROVIDED BY MS. PITTS TO MT. ASCUTNEY HOSPITAL AND HEALTH CENTER (MAHHC) AND RELATED ORGANIZATION HISTORIC HOMES OF RUNNEMEDE (HHR). THE COMPENSATION PAID BY HELMS & CO. TO MS. PITTS FOR HER INTERIM CFO SERVICES RENDERED TO MAHHC AND HHR IS UNKNOWN TO THE ORGANIZATION. PURSUANT TO THE IRS INSTRUCTIONS FOR PART VII SECTION A OF FORM 990, THE FILING ORGANIZATION MUST REPORT PAYMENTS MADE TO AN OFFICER BY AN UNRELATED ORGANIZATION FOR SERVICES RENDERED TO THE FILING ORGANIZATION IN THAT PERSON'S CAPACITY AS AN OFFICER OF THE FILING ORGANIZATION ON FORM 990 PART VII SECTION A AS COMPENSATION FROM THE FILING ORGANIZATION IF THE FILING ORGANIZATION HAS KNOWLEDGE OF THE ARRANGEMENT. THE COMPENSATION REPORTED ON FORM 990 PART VII SECTION A FOR MS. PITTS IS ZERO BECAUSE THE ORGANIZATION DOES NOT HAVE KNOWLEDGE OF THE ARRANGEMENT BETWEEN HELMS & CO. AND MS. PITTS REGARDING THE AMOUNT OF COMPENSATION PAID TO MS. PITTS FOR HER SERVICES RENDERED TO THE ORGANIZATION. |
| FORM 990, PART IX, LINE 11G OTHER FEES | MEDICAL & HEALTH RELATED SERVICES - TOTAL EXPENSE: 6885620, PROGRAM SERVICE EXPENSE: 6344630, MANAGEMENT AND GENERAL EXPENSES: 480454, FUNDRAISING EXPENSES: 60536; PROFESSIONAL CONSULTANTS & OTHER - TOTAL EXPENSE: 9595046, PROGRAM SERVICE EXPENSE: 8982127, MANAGEMENT AND GENERAL EXPENSES: 587436, FUNDRAISING EXPENSES: 25483; |
| FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES | AMOUNT OF FUND ASSET TRANSFERS - 1178454; TOTAL - 1178454; |
| FORM 990, PART XII, LINE 3A FINANCIAL STATEMENTS AND REPORTING | MT. ASCUTNEY HOSPITAL WAS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE DARTMOUTH-HITCHCOCK HEALTH SYSTEM. DURING FISCAL YEAR 2025, MARY HITCHCOCK MEMORIAL HOSPITAL EXPENDED FEDERAL FUNDING WHICH MET THE MINIMUM THRESHOLD SET FORTH IN THE SINGLE AUDIT ACT AND UNIFORM GUIDANCE, 2 C.F.R. PART 200, SUBPART F. DUE TO THE NATURE OF THE CONSOLIDATED FINANCIAL STATEMENTS, THE AUDIT WAS PERFORMED ON THE FINANCIAL INFORMATION OF ALL ORGANIZATIONS, INCLUDING MT. ASCUTNEY HOSPITAL. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| HISTORIC HOMES OF RUNNEMEDE INC | ||||||||||
| 40 MAXWELL PERKINS LANE | WINDSOR | VT | 05089 | 237396147 | ASSISTED LIVING FACILITY | VT | 501(C)(3) | 10 | WINDSOR HOSPITAL CORPORATION | Yes (true) |
| MOUNT ASCUTNEY HOSPITAL COMMUNITY HEALTH FOUNDATION | ||||||||||
| 289 COUNTY ROAD | WINDSOR | VT | 05089 | 030300481 | INACTIVE | VT | 501(C)(3) | 3 | WINDSOR HOSPITAL CORPORATION | Yes (true) |
| DARTMOUTH-HITCHCOCK HEALTH | ||||||||||
| ONE MEDICAL CENTER DRIVE | LEBANON | NH | 03756 | 264812335 | PARENT ORG | NH | 501(C)(3) | 7 | NOT APPLICABLE | false |
| MARY HITCHCOCK MEMORIAL HOSPITAL | ||||||||||
| ONE MEDICAL CENTER DRIVE | LEBANON | NH | 03756 | 020222140 | HOSPITAL | NH | 501(C)(3) | 3 | DARTMOUTH-HITCHCOCK HEALTH | false |
| DARTMOUTH-HITCHCOCK CLINIC | ||||||||||
| ONE MEDICAL CENTER DRIVE | LEBANON | NH | 03756 | 222519596 | PHYSICIAN SERVICES | NH | 501(C)(3) | 10 | DARTMOUTH-HITCHCOCK HEALTH | false |
| THE NEW LONDON HOSPITAL ASSOCIATION INC | ||||||||||
| 273 COUNTY ROAD | NEW LONDON | NH | 03257 | 020222171 | HOSPITAL | NH | 501(C)(3) | 3 | DARTMOUTH-HITCHCOCK HEALTH | false |
| CHESHIRE MEDICAL CENTER | ||||||||||
| 580 COURT STREET | KEENE | NH | 03431 | 020354549 | HOSPITAL | NH | 501(C)(3) | 3 | DARTMOUTH-HITCHCOCK HEALTH | false |
| ALICE PECK DAY MEMORIAL HOSPITAL | ||||||||||
| 10 ALICE PECK DAY DRIVE | LEBANON | NH | 03766 | 020222791 | HOSPITAL | NH | 501(C)(3) | 3 | DARTMOUTH-HITCHCOCK HEALTH | false |
| DARTMOUTH HEALTH HOME CARE INC | ||||||||||
| 88 PROSPECT STREET | WHITE RIVER JUNCTION | VT | 05001 | 036006494 | HOSPICE | VT | 501(C)(3) | 10 | DARTMOUTH-HITCHCOCK HEALTH | false |
| SOUTHWESTERN VERMONT HEALTH CARE CORPORATION | ||||||||||
| 100 HOSPITAL DRIVE | BENNINGTON | VT | 05201 | 030179435 | HOSPITAL | VT | 501(C)(3) | 3 | DARTMOUTH-HITCHCOCK HEALTH | false |
| VALLEY REGIONAL HEALTHCARE INC | ||||||||||
| 243 ELM STREET | CLAREMONT | NH | 03743 | 020397338 | HOSPITAL | NH | 501(C)(3) | 3 | DARTMOUTH-HITCHCOCK HEALTH | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MOUNT ASCUTNEY PROFESSIONAL CENTER OWNERS ASSOC | ||||||||||||
| 289 COUNTY ROAD | WINDSOR | VT | 05089 | 030320283 | REAL ESTATE MANAGEMENT | VT | WINDSOR HOSPITAL CORPORATION | C CORPORATION | $105,649 | $9,116 | 1 | Yes (true) |
| BENEFICIAL INTEREST TRUST | ||||||||||||
| 289 COUNTY ROAD | WINDSOR | VT | 05089 | CHARITABLE TRUST | VT | WINDSOR HOSPITAL CORPORATION | TRUST | false | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| MOUNT ASCUTNEY PROFESSIONAL CENTER OWNERS ASSOC | ||
| K | $124,106 | FMV |
| HISTORIC HOMES OF RUNNEMEDE INC | ||
| Q | $223,196 | FMV |
| HISTORIC HOMES OF RUNNEMEDE INC | ||
| R | $1,045,613 | BOOK |
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