2026-08-14T22:52:35+00:00 2025-09-30 415375658 CROWE ADVISORY LLC 4801 OLYMPIA PARK PLAZA SUITE 4000 LOUISVILLE KY 402412098 990 2024-10-01 030183721 WINDSOR HOSPITAL CORPORATION WIND 8026746711 289 COUNTY ROAD WINDSOR VT 05089 MATTHEW MATHIESEN CFO 8026746711 2026-08-15 true RACHEL SPURLOCK P01316095 5023263996 2026-08-15 2024 2025-03-06 01:10:19Z MT ASCUTNEY HOSPITAL AND HEALTH CENTER MATTHEW FOSTER MD MMM 289 COUNTY ROAD WINDSOR VT 05089 76976854 false X MTASCUTNEYHOSPITAL.ORG X 1933 VT TO IMPROVE THE LIVES OF THOSE WE SERVE. 20 14 572 80 55893 51583 1730530 1685106 72210645 74626469 1085217 275185 1502385 388269 76528777 76975029 20430 0 40751242 43076933 0 150902 33861207 33428510 74612449 76525873 1916328 449156 91569667 96618303 38128349 37432503 53441318 59185800 MT. ASCUTNEY HOSPITAL AND HEALTH CENTER'S MISSION IS TO IMPROVE THE LIVES OF THOSE WE SERVE. false false 71652716 20430 74743027 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. 71652716 true true false true false false false false false true true true false true true true false true false false false false false false false false true true false true true false false false false false false false false false false false false false false false true true true false false true 53 0 true 572 true true true false false false false false false false false false false false X 20 14 false true false false true true true true true false false false true true true true true true true true false false X MATTHEW MATHIESEN 8026746711 289 COUNTY ROAD WINDSOR VT 05089 ALAN C KEILLER TRUSTEE / TREASURER 1.0 1.5 X X 0 0 0 JOCELYN CAPLE MD INTERIM CEO (THROUGH 12/8/24) 20.0 20.5 X X 0 375731 65717 JOHN TANSEY TRUSTEE / CHAIR 1.0 2.0 X X 0 0 0 MATTHEW FOSTER CEO (AS OF 12/9/24) 20.0 20.5 X X 0 37005 2236 PATRICIA PUTNAM TRUSTEE/VICE CHAIR 1.0 2.0 X X 0 0 0 TERRI DECKER TRUSTEE/SECRETARY 1.0 2.0 X X 0 0 0 BRYAN HUOT TRUSTEE 0.5 0.5 X 0 0 0 CAROL VIVIAN TRUSTEE 0.5 0.5 X 0 0 0 CHRISTOPHER NESBITT TRUSTEE (AS OF 8/27/25) 0.5 0.5 X 0 0 0 CLARE DREBITKO TRUSTEE/MED STAFF PRES (THROUGH 12/31/24) 40.0 0 X 196554 0 34415 DEANNA HOWARD TRUSTEE 1.0 1.5 X 0 0 0 ERIC CRAINICH TRUSTEE 1.0 1.0 X 0 0 0 JEFFREY KING TRUSTEE / EX-OFFICIO MED STAFF PRESIDENT (AS OF 1/1/25) 40.0 0 X 237327 0 36072 JOHN GILMAN TRUSTEE 1.0 1.5 X 0 0 0 LISA RICHMOND TRUSTEE 0.5 0.5 X 0 0 0 MATTHEW S HOUDE TRUSTEE / DH VP GOV'T RELATIONS 1.0 41.0 X 0 319691 70463 MICHAEL FUERST TRUSTEE 0.5 0.5 X 0 0 0 PAMELA BROWN TRUSTEE 1.0 1.0 X 0 0 0 PATRICK F JORDAN III MBA TRUSTEE (THROUGH 6/21/25) 0.5 43.0 X 0 1132708 79260 SAMUEL SHIELDS TRUSTEE / DH VP - STRTGY 0.5 41.0 X 0 399147 30060 STEPHEN D SURGENOR MD TRUSTEE / DH DIRECTOR OF ANESTHESIOLOGY 1.0 40.5 X 0 594937 72041 TOM SULLIVAN TRUSTEE 1.0 0.5 X 0 0 0 VINCENT FUSCA III TRUSTEE (THROUGH 10/31/24) 1.0 1.0 X 0 0 0 WILLIAM PALMER TRUSTEE/PHYSICIAN 40.0 0.5 X 138740 0 4605 CELESTE PITTS INTERIM CFO 20.0 22.0 X 0 0 0 HANNAH BIANCHI CHIEF OPERATING OFFICER 20.0 20.0 X 236194 0 8803 CATHERINE SCHNEIDER PHYSICIAN 40.0 0 X 298055 0 33305 DAVID SANVILLE CHIEF FINANCIAL OFFICER (THROUGH 2/29/24) 40.0 0.0 X 300864 0 6865 FRANCESCO CONGIUSTA HOSPITALIST 40.0 0 X 332171 0 41736 HERBERT IP PHYSICIAN 40.0 0 X 335510 0 40172 JASON FRITZHAND PHYSICIAN 40.0 0 X 331119 0 14205 JOSEPH L PERRAS MD FORMER CEO 0.0 40.5 X 0 570040 54269 WINFIELD BROWN FORMER INTERIM CEO 0.0 0.0 X 0 247889 18182 2406534 3677148 612406 75 true true true AMERICAN HEALTHCARE SERVICES ASSOCIATION PO BOX 670529 DALLAS TX 752670529 STAFFING SERVICES 3363461 EMERGENCY SERVICES OF NE INC PO BOX 12 CHESTER VT 05143 STAFFING SERVICES 2519946 MARY HITCHCOCK MEMORIAL HOSPITAL ONE MEDICAL CENTER DRIVE LEBANON NH 03756 HEALTHCARE SERVICES 2505312 NEAGLEY & CHASE CONSTRUCTION 66 BOWDOIN ST SOUTH BURLINGTON VT 05403 CONSTRUCTION SERVICES 1831046 CERNER CORP PO BOX 959156 ST LOUIS MO 631959156 SOFTWARE SERVICES 983692 24 31019 1176409 477678 6607 1685106 PATIENT SERVICE REVENUE 622110 68525556 68525556 HEALTH CARE REFORM PAYMENTS 622110 2045343 2045343 PROGRAM AND MISCELLANEOUS 622110 4055570 4055570 0 0 0 0 74626469 277010 55893 221117 0 0 1825 0 -1825 -1825 -1825 CAFETERIA 722514 271711 271711 PURCHASE DISCOUNTS 622110 116558 116558 0 0 0 0 388269 76975029 74743027 55893 491003 X 6062 6062 14368 14368 632300 255183 377117 31831283 30364498 1422858 43927 1449379 1382592 64787 2000 6824228 6509768 305043 9417 2339743 2231928 104587 3228 12970 12970 16480666 15326757 1067890 86019 52219 52219 208509 196241 6445 5823 413251 374684 38567 1528285 1528285 79244 75000 4244 18754 18754 592268 592268 3100563 2940169 160394 576967 275719 301248 MEDICAL AND OTHER SUPPLIES 5374311 5374311 HOSPITAL PROVIDER TAXES 2479207 2479207 MISCELLANEOUS EXPENSES 994921 676065 318368 488 DUES, FEES, AND TAXES 586705 80574 506131 929670 898064 31606 0 76525873 71652716 4722255 150902 12438379 4977712 3092716 3218527 42599 39631 8930377 7342652 0 0 0 0 493877 311237 727324 4627259 59551013 37046486 18721983 22504527 38419557 45449384 0 8702855 8147374 91569667 96618303 10664169 6573761 1979557 989778 0 0 25484623 29868964 38128349 37432503 X 43950233 49349800 9491085 9836000 53441318 59185800 91569667 96618303 X 449156 4116872 1178454 X false true true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 11248 11248 false SCHEDULE C, PART II-B, LINE 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY 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. 6614260 710409 251685 7072984 5714031 1136315 236086 6614260 5444909 490948 221826 5714031 6547496 -885991 216596 5444909 5256278 1496142 204924 6547496 0.0 0.5964 0.4036 false false 410000 410000 18629152 12878577 5750575 20798908 12603141 8195767 19712953 11564768 8148185 22504527 CLOSELY-HELD EQUITY INTERESTS FINANCIAL DERIVATIVES INVESTMENT IN POOLED FUNDS 43326730 F BENEFICIAL INTEREST TRUSTS 1993993 F CHARITABLE REMAINDER TRUSTS 128661 F 45449384 RENTAL DEPOSITS 13278 EQUITY IN SUBSIDIARY 2776258 OTHER RECEIVABLES 721568 RIGHT OF USE ASSETS, NET 4636270 8147374 FEDERAL INCOME TAXES EST. SETTLEMENT W/3RD PARTY PAYORS 2018609 AFFILIATE NOTE PAYABLE 17521839 POST RETIREMENT BENEFIT OBLIGATION 387245 RIGHT OF USE OBLIGATIONS 4453508 OTHER LIABILITIES 671764 DUE TO AFFILIATE 4815999 29868964 X 0 0 0 0 0 0 0 0 0 0 0 0 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. true true X true X 250 true X true true false false 298460 0 298460 0.00390 9333497 2777443 6556054 0.08567 0 0 0 0.0 0 0 9631957 2777443 6854514 0.08957 1683380 831866 851514 0.01113 496659 0 496659 0.00649 12826245 10099606 2726639 0.03563 0 0 0 0.0 0 0 0 0.0 0 0 15006284 10931472 4074812 0.05325 0 0 24638241 13708915 10929326 0.14282 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 true 0 0 25997911 28647787 -2649876 X true true 1 1 WINDSOR HOSPITAL CORPORATION 289 COUNTY ROAD WINDSOR VT 05089 https://www.mtascutneyhospital.org 863 X X X X DISTINCT PART REHAB UNIT WINDSOR HOSPITAL CORPORATION 1 false false true X X X X X X X X X 24 true true true true X https://www.mtascutneyhospital.org/about/community-health-needs X X true 24 true HTTPS://WWW.MTASCUTNEYHOSPITAL.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS false true X 250.0 400.0 X X X X X X true true X X X true X https://www.mtascutneyhospital.org/your-visit/billing-financial-assistance X https://www.mtascutneyhospital.org/your-visit/billing-financial-assistance X https://www.mtascutneyhospital.org/your-visit/billing-financial-assistance X X X X X X X true X false X X X X true X false false 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. 0 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. true PATIENT ASSISTANCE 28 14368 BOOK SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING USE OF GRANT FUNDS 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. true false false false false false false false false JOSEPH L PERRAS MD FORMER CEO 0 504078 0 42400 0 23562 0 20700 0 33569 0 624309 0 0 WINFIELD BROWN FORMER INTERIM CEO 0 247353 0 0 0 536 0 14962 0 3220 0 266071 0 0 JOCELYN CAPLE MD INTERIM CEO (THROUGH 12/8/24) 0 344543 0 30000 0 1188 0 20700 0 45017 0 441448 0 0 PATRICK F JORDAN III MBA TRUSTEE (THROUGH 6/21/25) 0 875781 0 180000 0 76927 0 32970 0 46290 0 1211968 0 0 MATTHEW S HOUDE TRUSTEE / DH VP GOV'T RELATIONS 0 285450 0 30000 0 4241 0 30985 0 39478 0 390154 0 0 STEPHEN D SURGENOR MD TRUSTEE / DH DIRECTOR OF ANESTHESIOLOGY 0 572073 0 0 0 22864 0 32970 0 39071 0 666978 0 0 CLARE DREBITKO TRUSTEE/MED STAFF PRES (THROUGH 12/31/24) 196044 0 0 0 510 0 6233 0 28182 0 230969 0 0 0 JEFFREY KING TRUSTEE / EX-OFFICIO MED STAFF PRESIDENT (AS OF 1/1/25) 236817 0 0 0 510 0 7915 0 28157 0 273399 0 0 0 SAMUEL SHIELDS TRUSTEE / DH VP - STRTGY 0 347386 0 35000 0 16761 0 26070 0 3990 0 429207 0 0 HANNAH BIANCHI CHIEF OPERATING OFFICER 202653 0 13580 0 19961 0 8803 0 0 0 244997 0 0 0 DAVID SANVILLE CHIEF FINANCIAL OFFICER (THROUGH 2/29/24) 48595 0 0 0 252269 0 3672 0 3193 0 307729 0 0 0 HERBERT IP PHYSICIAN 305160 0 18600 0 11750 0 12015 0 28157 0 375682 0 0 0 FRANCESCO CONGIUSTA HOSPITALIST 331972 0 0 0 199 0 13594 0 28142 0 373907 0 0 0 JASON FRITZHAND PHYSICIAN 289734 0 40000 0 1385 0 12785 0 1420 0 345324 0 0 0 CATHERINE SCHNEIDER PHYSICIAN 289982 0 0 0 8073 0 11890 0 21415 0 331360 0 0 0 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. 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. HISTORIC HOMES OF RUNNEMEDE INC 40 MAXWELL PERKINS LANE WINDSOR VT 05089 237396147 ASSISTED LIVING FACILITY VT 501(C)(3) 10 WINDSOR HOSPITAL CORPORATION true MOUNT ASCUTNEY HOSPITAL COMMUNITY HEALTH FOUNDATION 289 COUNTY ROAD WINDSOR VT 05089 030300481 INACTIVE VT 501(C)(3) 3 WINDSOR HOSPITAL CORPORATION 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 MOUNT ASCUTNEY PROFESSIONAL CENTER OWNERS ASSOC 289 COUNTY ROAD WINDSOR VT 05089 030320283 REAL ESTATE MANAGEMENT VT WINDSOR HOSPITAL CORPORATION C CORPORATION 105649 9116 1 true BENEFICIAL INTEREST TRUST 289 COUNTY ROAD WINDSOR VT 05089 CHARITABLE TRUST VT WINDSOR HOSPITAL CORPORATION TRUST false false false true false true false false false false false true false false false true true true true false MOUNT ASCUTNEY PROFESSIONAL CENTER OWNERS ASSOC K 124106 FMV HISTORIC HOMES OF RUNNEMEDE INC Q 223196 FMV HISTORIC HOMES OF RUNNEMEDE INC R 1045613 BOOK