2014-08-14T16:25:11-05:00 2013-09-30 PricewaterhouseCoopers LLP 125 High Street Boston MA 02110 990 2012-10-01 030219309 Fletcher Allen Health Care Inc % RICHARD VINCENT FLET 8028475959 111 COLCHESTER AVENUE Suite BURLINGTON VT 05401 JOHN R BRUMSTED MD 8028475959 2014-08-12 true 6175305000 2012 2015-11-30 17:44:51Z JOHN R BRUMSTED MD 111 COLCHESTER AVENUE BURLINGTON VT 05401 1395614303 false X WWW.FLETCHERALLEN.ORG X 1968 VT To improve the health of the people in the community we serve by integrating patient care, education, and research in a caring environment. 17 12 7372 800 372229 -119621 10506767 17114645 939830991 1044484567 11590703 31965384 590104 600849 962518565 1094165445 928841 932897 0 0 567720593 600518966 0 0 2763151 343923450 406198183 912572884 1007650046 49945681 86515399 1084994687 1155937299 589069884 579936411 495924803 576000888 X SEE SCHEDULE O false false 238682968 261335 292594183 INPATIENT SERVICES. FOR MORE INFORMATION, SEE SCHEDULE O. 352958613 386456 432681217 OUTPATIENT SERVICES. FOR MORE INFORMATION, SEE SCHEDULE O. 260394075 285106 319209167 PROFESSIONAL SERVICES. FOR MORE INFORMATION, SEE SCHEDULE O. 852035656 true true false true false false false false false true true false false false true true false true false false true false false false true false true true true true true true false false false false false false false false true true true true false false true true true true false false true 407 0 true 7372 true true true true BD false false false true true false false false false false X 17 12 true false false false true true true true true false false true true true true true true true true true true NY X RICHARD VINCENT 8028472089 111 COLCHESTER AVENUE BURLINGTON VT 05401 X DR JOHN BRUMSTED 46.0 4.0 X X 1368279 0 129901 DR RUTH UPHOLD 2.0 1.0 X ROGER STONE 2.0 2.0 X X DR PAUL DANIELSON 2.0 3.0 X A DONALD GILBERT Jr 2.0 2.0 X STEPHEN MARSH 2.0 2.0 X DR PHILIP MEAD 2.0 2.0 X DR FREDERICK C MORIN III 2.0 2.0 X JOHN NEUHAUSER PHD 2.0 2.0 X JOHN POWELL 2.0 2.0 X X PATRICIA PRELOCK PHD 2.0 X RUSSELL TRACY PHD 2.0 2.0 X X GRETCHEN MORSE 2.0 2.0 X X TIMOTHY DAVIS 2.0 1.0 X DR MARK PHILLIPPE 2.0 33.0 X 0 237509 20506 KATHLEEN GINN 2.0 2.0 X X LAWRENCE DESHAW 2.0 2.0 X ALLIE STICKNEY 2.0 X LARRY SUDBAY 2.0 X ROGER DESHAIES 49.0 3.0 X 779209 0 45219 SANDRA FELIS RN 49.0 1.0 X 582933 0 37304 SPENCER KNAPP 48.0 4.0 X 634733 0 39824 DR HOWARD M SCHAPIRO 2.0 48.0 X 0 372631 35139 DR PAUL TAHERI 46.0 4.0 X 704934 0 41034 CHARLES PODESTA 50.0 X 474360 0 44780 PAUL MACUGA 50.0 X 466998 0 43860 THERESA ALBERGHINI DIPALMA 50.0 X 468869 0 37768 TODD B MOORE 50.0 X 416112 0 40465 DR STEPHEN M LEFFLER 49.0 1.0 X 471249 0 44179 6367676 610140 559979 354 false true false PC CONSTRUCTION 193 TILLEY DRIVE SOUTH BURLINGTON VT 05403 CONSTRUCTION 2808646 MAYO COLLABORATIVE SERVICES INC PO BOX 9146 MINNEAPOLIS MN 55480 LABORATORY 2572041 FARRINGTON CONSTRUCTION CO 4788 SPEAR STREET SHELBURNE VT 05482 CONSTRUCTION 2249847 MEDIQUE USA 5900 AVENUE ANDOVER H4T 1H5 VILLE MONT-ROYAL QUEBEC CA LAUNDRY SERVICE 2201975 UVM TECHNICAL SERVICES PROGRAM 280 EAST AVENUE BURLINGTON VT 05401 TECHNICAL 1673770 141 155510 190748 16768387 11944573 17114645 PATIENT SERVICES 900099 996764238 996764238 PATIENT SERVICES - PHARMACY 446110 21090690 20718461 372229 PREMIUM REVENUE 900099 5987946 5987946 CAFETERIA 900099 5289485 5289485 MEANINGFUL USE PRGRM 900099 5041856 5041856 10310352 10310352 1044484567 4504795 4504795 0 0 1025629 418792 606837 0 606837 606837 327240000 1199233 300127000 851644 27113000 347589 27460589 27460589 45434 155510 51422 -5988 -5988 0 0 0 1094165445 1044112338 372229 32566233 830047 830047 102850 102850 0 0 4411293 4342396 68897 427307 427307 469975563 399952622 69416152 606789 31112308 27508104 3564800 39404 64046814 56246434 7685600 114780 30545681 26655857 3845800 44024 0 1300225 1300225 500473 500473 0 0 0 44095795 27324596 16202911 568288 1245152 1245152 144918995 142687931 2197004 34060 13697849 11754267 1920079 23503 0 19053491 17776652 1227202 49637 3179143 1585217 1571012 22914 0 3584229 3181210 383700 19319 16985456 8941879 8015842 27735 0 46836534 24671090 22089015 76429 15658920 13930777 1708478 19665 CONTRACT MAINTENANCE 11648330 8586540 3059445 2345 ACADEMIC SUPPORT 9651208 9651208 RECRUITMENT 6238275 461961 5776314 AFFILIATION COMMITMENT PAYMENT 33595632 33595632 34008476 34918323 -1955209 1045362 1007650046 852035656 152851239 2763151 5467535 4989792 146757768 190117971 536680 685049 110551680 114333071 0 0 0 0 8195878 3514166 20912803 21499579 32863912 45041331 860281954 446237165 398217235 414044789 326865799 329633313 0 0 22736111 19609321 0 0 11889286 12468917 1084994687 1155937299 124537359 139096374 8430153 8799352 0 0 331187487 291609354 0 0 0 0 54860000 95979362 0 0 70054885 44451969 589069884 579936411 X 448676424 526667474 21185014 22659404 26063365 26674010 495924803 576000888 1084994687 1155937299 X 86515399 -15851365 9412051 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 40459 false true 92445 132904 false LOBBYING ACTIVITY SCHEDULE C, PART II-B FLETCHER ALLEN REGULARLY MONITORS THE WORK OF THE VERMONT STATE LEGISLATURE TO IDENTIFY ISSUES THAT DIRECTLY AFFECT THE ORGANIZATION AND PERIODICALLY WORKS DIRECTLY WITH STATE LEGISLATORS TO ADVOCATE ON PARTICULAR ISSUES. STAFF EXPENDITURES ASSOCIATED WITH THESE ACTIVITIES ARE REPORTED TO THE STATE THREE TIMES A YEAR AS REQUIRED BY VERMONT LOBBYIST DISCLOSURE LAWS. STAFF ALSO WORK DIRECTLY WITH OUR CONGRESSIONAL DELEGATION (TWO SENATORS AND ONE REPRESENTATIVE) ON SPECIFIC PIECES OF LEGISLATION THAT IMPACT THE ORGANIZATION. THESE EXPENSES ARE REPORTED ON LINE G. THE ORGANIZATION ALSO BELONGS TO MEMBER ORGANIZATIONS (INCLUDING THE AMERICAN HOSPITAL ASSOCIATION, THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES, NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS, AND THE VERMONT ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS) THAT IN TURN HAVE LOBBYING EXPENSES. THE PORTION OF DUES ASSOCIATED WITH THOSE ACTIVITIES IS REPORTED ON LINE I. 27880258 104141 1836478 0 507008 0 29313869 24729696 131962 3368995 0 350395 0 27880258 24040705 117726 903730 0 332465 0 24729696 22798137 81914 1255349 0 94695 0 24040705 22578923 142738 805381 4784 724121 0 22798137 0.55000 0.45000 false false 10474988 10474988 527253468 211536569 315716899 40998835 33192644 7806191 261227988 192620015 68607973 20326675 8887937 11438738 414044789 0 ESTIMATED 3RD PARTY SETTLEMENT 14491927 SWAP LIABILITY 8565852 PENSION OBLIGATION 19165029 ASSET RETIREMENT OBLIGATION 1078558 LT FICA TAX PAYABLE 625469 DUE TO VMCIC 525134 44451969 X ENDOWMENT FUNDS SCHEDULE D, PART V, QUESTION 4 THE FUNDS, AND ALL NET EARNINGS IN ADDITION THERETO, ARE HELD TO BENEFIT CHARITY, EDUCATION, RESEARCH AND CHILDREN'S PROGRAMS. SCHEDULE D, PART X, LINE 2, FIN 48 (ASC 740) FLETCHER ALLEN HEALTH CARE IS IN THE CONSOLIDATED FINANCIAL STATEMENTS FOR FLETCHER ALLEN PARTNERS (FAP). THE FOOTNOTE STATES: FAP ACCOUNTS FOR RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH ASC 740. NO PROVISION FOR UNCERTAIN TAX POSITIONS IS RECORDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. Central America and the Caribbean 0 0 Program Services SELF-INSURANCE 7464717 Central America and the Caribbean 0 0 Investments 15805291 0 0 0 0 23270008 23270008 true false true false false false Golf Tournament 152756 121991 30765 330 4577 19100 7799 3548 JEFF WYAND RIDE 34416 22352 12064 9488 2000 1 13772 11167 2605 100 100 4380 200944 155510 45434 330 14165 19100 7899 9928 51422 -5988 SCHEDULE G, PART II, LINE 11 THE NET INCOME AMOUNT FROM FUNDRAISING EVENTS IS NET OF CHARITABLE CONTRIBUTIONS. true true X true X true X true true true false true true 8700718 8700718 0.00860 38452 199339617 167519124 31820493 0.03160 1437 2753352 1916459 836892 0.00080 39889 210793687 169435583 41358103 0.04100 4407389 4407389 0.00440 69221109 13518952 55702157 0.05530 13422756 6722449 6700307 0.00660 331259 141419 189840 0.00020 1165145 1165145 0.00120 88547658 20382820 68164838 0.06770 39889 299341345 189818403 109522941 0.10870 true 26355037 2284250 207598863 251189586 -43590723 X true true 1 1 FLETCHER ALLEN HEALTH CARE INC

111 COLCHESTER AVE BURLINGTON VT 05401

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35 JOY DRIVE SOUTH BURLINGTON VT 05403

DIALYSIS RUTLAND DIALYSIS

160 ALLEN STREET RUTLAND VT 05701

DIALYSIS BERLIN DIALYSIS

130 FISHER ROAD BERLIN VT 05602

DIALYSIS UROLOGY - ST ALBANS DIALYSIS - STE 7&8

6 CREST ROAD ST ALBANS VT 05478

MEDICAL OFFICE MCHV DIALYSIS CENTER

111 COLCHESTER AVE BURLINGTON VT 05401

DIALYSIS NORTH COUNTRY DIALYSIS

189 PROUTY DR NEWPORT VT 05855

DIALYSIS SCHEDULE H, PART I, LINE 7G: FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2013 FLETCHER ALLEN HEALTH CARE INCLUDED PHYSICIAN CLINIC EXPENSES IN SUBSIDIZED HEALTH SERVICES. FLETCHER ALLEN HEALTH CARE PHYSICIANS INCURRED $2,825,073 OF COSTS ASSOCIATED WITH PROVIDING PSYCHIATRY SERVICES. SCHEDULE H, PART I, LINE 7, COLUMN (F): THE PROVISION FOR BAD DEBT INCLUDED ON FORM 990, PART IX, LINE 25 BUT SUBTRACTED FOR PURPOSE OF CALCULATING THE AMOUNT REPORTED ON LINE 7(F) IS $0. ALL BAD DEBT IS SHOWN AS A DEDUCTION FROM PATIENT REVENUE. SCHEDULE H, PART I, LINE 7: FLETCHER ALLEN UTILIZED THE ALLIANCE FOR DECISION SUPPORT COST ACCOUNTING SYSTEM TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE ON LINE 7. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS, INCLUDING, BUT NOT LIMITED TO, INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED AND SELF PAY. THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 WAS ALSO UTILIZED FOR SOME OF THE FIGURES REPORTED IN THE TABLE ON LINE 7. APPROXIMATELY $57M OF OUR MEDICAID EXPENSE IS FLETCHER ALLEN HEALTH CARE'S ANNUAL MEDICAID PROVIDER TAX, ASSESSED ON VERMONT ACUTE CARE HOSPITALS BY THE STATE OF VERMONT. THE TAX ASSESSMENT IS CALCULATED AS 6% OF A HOSPITAL'S BASE YEAR NET PATIENT CARE REVENUE. PART I, LINE 7K(F) In FY13, FAHC received a significant payment from Medicaid in support of our physician and hospital GME programs. This payment of $67M covered the time period of July 2011 through September 2013. The community benefit percentage decreased 7% from the prior year amount due to this retroactive payment. Had this payment been received in the appropriate fiscal years, the Fy13 and FY12 community benefit percentages would have been 14.6% and 14.2%, respectively. SCHEDULE H, PART III, LINE 2 AND 3: THE AMOUNT OF BAD DEBT REPORTED ON PART III, LINE 2 REPRESENTS THE TOTAL PROVISION FOR BAD DEBT ON THE INCOME STATEMENT. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE NETTED AGAINST THE TOTAL GROSS CHARGES WHEN DETERMINING BAD DEBT EXPENSE. THE $2,284,250 REFLECTS THE ADJUSTED BAD DEBT EXPENSE FOR ALL PATIENTS WHO SUBMITTED AN INITIAL APPLICATION, HOWEVER, UPON FOLLOW-UP DID NOT RESPOND TO REQUESTS FOR ADDITIONAL INFORMATION OR SUPPORTING DOCUMENTATION. FAHC HAS A DATABASE WHICH TRACKS ALL APPLICATIONS AND THEIR STATUS; A QUERY EXTRACTED ALL INCOMPLETE/NON RESPONSIVE ARCHIVED APPLICATIONS PROVIDING A LIST OF PATIENTS & DEPENDENTS. SUBSEQUENTLY, A QUERY OF ASSOCIATED PATIENT SERVICES FROM 10/1/12 - 9/30/13 FOR "SELF PAY" AND COLLECTION ACCOUNTS WAS EXTRACTED FROM THE BILLING SYSTEM. FLETCHER ALLEN HEALTH CARE'S FINANCIAL STATEMENTS INCLUDE A FOOTNOTE DESCRIBING BAD DEBT EXPENSE. RECEIVABLES ARE REPORTED NET OF AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE PROVISION FOR BAD DEBTS IS REPORTED AS A DEDUCTION FROM GROSS REVENUE. THIS EXPENSE IS DETERMINED AS A PERCENTAGE OF GROSS PATIENT SERVICE REVENUE BASED ON ACTUAL WRITE-OFF HISTORY, REVIEWED ON A QUARTERLY BASIS AND ADJUSTED ON A SEMI-ANNUAL BASIS. SCHEDULE H, PART III, LINE 4: THE ORGANIZATION'S BAD DEBT EXPENSE IS ADDRESSED ON PAGE 40, IN FOOTNOTE 17 OF ITS MOST RECENT AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, LINE 8: THE AMOUNT REPORTED IN PART III, LINE 6, MEDICARE ALLOWABLE COSTS OF CARE, IS DERIVED FROM FLETCHER ALLEN HEALTH CARE'S FYE 9/30/13 MEDICARE COST REPORT, WORKSHEET D-1, COMPUTATION OF INPATIENT OPERATING COSTS; WORKSHEET E PART B, CALCULATION OF OUTPATIENT SETTLEMENT; AND WORKSHEET I-4, COMPUTATION OF AVERAGE COST PER TREATMENT FOR OUTPATIENT RENAL DIALYSIS. WHILE FLETCHER ALLEN HAS HISTORICALLY FOLLOWED THE CATHOLIC HOSPITAL ASSOCIATION'S GUIDANCE AND HAS NOT CONSIDERED ANY MEDICARE SHORTFALL (REPORTED IN PART III, LINE 7) AS A COMMUNITY BENEFIT, IT IS LIKELY THAT SOME PORTION OF MEDICARE PATIENTS WOULD HAVE QUALIFIED FOR CHARITY CARE UNDER OUR POLICIES IN THE ABSENCE OF MEDICARE COVERAGE, SUCH THAT SHORTFALLS ASSOCIATED WITH THOSE PATIENTS WOULD OTHERWISE HAVE BEEN INCLUDED IN OUR COMMUNITY BENEFITS. SCHEDULE H, PART III, LINE 9B: PURSUANT TO THE SELF-PAY COLLECTION PROCESS POLICY: SHOULD A PATIENT EXPRESS FINANCIAL HARDSHIP AND/OR IF THE PATIENT'S ACCOUNT BALANCE WOULD LIKELY QUALIFY FOR CATASTROPHIC ASSISTANCE, THE CUSTOMER SERVICE ACCOUNT RESOLUTION REPRESENTATIVE WILL PROVIDE PATIENTS WITH INFORMATION REGARDING THE FAHC PATIENT ASSISTANCE PROGRAM. PATIENTS EXPRESSING INTEREST IN THE PROGRAM WILL BE DIRECTED TO THE FAHC WEBSITE FOR A DOWNLOADABLE APPLICATION OR AN APPLICATION WILL BE SENT VIA THE US MAIL. IN ADDITION, HIGH DOLLAR ACCOUNTS ARE MONITORED WEEKLY AND SCREENED FOR POSSIBLE PATIENT ASSISTANCE. WHEN DIRECT CONTACT VIA THE PHONE CANNOT BE ESTABLISHED, THOSE ACCOUNTS WHERE BALANCES ARE HIGH, HAVE INTERMITTENT PAYMENT OR EMPLOYMENT HISTORY ARE FLAGGED AS POTENTIAL CATASTROPHIC QUALIFIERS. THESE PATIENTS WILL BE SENT AN APPLICATION VIA CERTIFIED MAIL, INVITING THEM TO APPLY FOR ASSISTANCE. SCHEDULE H, PART V: IN ADDITION TO THE FACILITIES OPERATED BY FLETCHER ALLEN HEALTH CARE (FAHC) LISTED IN SECTION A AND SECTION C, FAHC OPERATES 29 ADDITIONAL CLINIC SITES AROUND ITS SERVICE AREA. EACH OF THESE SITES IS COVERED UNDER THE FAHC HOSPITAL LICENSE. ALL LISTED OR NON-LISTED FACILITIES OPERATED BY FAHC OR ITS SUBSIDIARIES FOLLOW ALL OF THE SAME POLICIES AND PROCEDURES AS THE FAHC HOSPITAL. SCHEDULE H, PART V, LINE 3 FAHC took into account input from persons who represent the community we serve in many different ways. Interviews with seventeen key leaders in our community were completed in the initial phase of the work, with the leaders answering questions about healthy communities, unmet needs, important health issues, barriers, and the range of available community services and they offered recommendations for improving the quality of life for residents. These leaders were selected based on various age groups served (seniors, children, adults, families, for example) as well as a mix of subject areas (low-income, refugees, mental health, substance abuse, for example). The Leaders represented: human service agencies, state departments of health, federally qualified community health centers, schools, law enforcement, state agencies, local funders, health care, mental health care, youth services and senior services. Additionally, FAHC held Focus Groups WITH PRIORITY POPULATIONS SUCH AS AT-RISK YOUTH, LOW INCOME SENIORS, AND NEW AMERICANS to solicit feedback and receive input. Finally, FAHC provided a community wide survey - with online responses and paper responses - to receive input from the community as a whole. SCHEDULE H, PART V, LINE 5 WWW.FLETCHERALLEN.ORG SCHEDULE H, PART V, LINE 7 FAHC'S CHNA IDENTIFIED 2 COMMUNITY NEEDS WHICH WERE NOT ADDRESSED: AFFORDABLE HOUSING AND LIVABLE WAGE. BOTH ARE BELIEVED TO BE OUTSIDE OF FAHC'S PURVIEW AND ABILITY TO IMPACT CHANGE. SCHEDULE H, PART V, LINE 14B ALTHOUGH THE FINANCIAL ASSISTANCE POLICY IS NOT ATTACHED TO EACH BILLING INVOICE, THE POLICY IS REFERENCED ON EACH BILL. SCHEDULE H, PART V, LINE 14G IN ADDITION TO POSTING GUIDELINES ONLINE, PATIENT BROCHURES ARE AVAILABLE IN WAITING ROOMS WHICH PROVIDE CONTACT INFORMATION ON HOW PATIENTS MAY RECEIVE ASSISTANCE WITH THEIR BILLS AS WELL AS AID IN THE APPLICATION PROCESS. FROM REGISTRATION, PATIENTS ARE ROUTINELY REFERRED TO OUR FINANCIAL COUNSELING DEPARTMENT AND/OR FOR OUTPATIENT SERVICES, THE HEALTH ASSISTANCE PROGRAM AT OUR DEPARTMENT OF COMMUNITY HEALTH IMPROVEMENT. BOTH AREAS PROVIDE KNOWLEDGE AND ASSISTANCE IN THE APPLICATION PROCESS FOR CHARITY AND OTHER APPLICABLE FUNDING SOURCES. FINANCIAL COUNSELORS ACTIVELY EDUCATE ALL INPATIENT, OBSERVATION AND INVASIVE SERVICE OUTPATIENTS OF OUR PROGRAM, PRIOR TO OR CONCURRENT WITH THE PATIENTS STAY, SUBSEQUENTLY AIDING IN THE APPLICATION PROCESS FOR STATE AID AND FAHC'S FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART V, LINE 20D THE PATIENT ASSISTANCE PROGRAM (CHARITY) HAS BOTH AN INCOME AND ASSETS BASED TEST UP TO 400% OF THE FEDERAL POVERTY GUIDELINES (FPG); ALONG WITH AN APPEALS PROGRAM FOR PATIENTS WHO TEST HIGHER THAN 400% OF THE FPG. BASED UPON THE PATIENT'S FPG, A PATIENT MAY BE GRANTED FULL OR PARTIAL ASSISTANCE AT THE TIME OF APPLICATION APPROVAL. FULL ASSISTANCE EQUALS A 100% WRITE-OFF OF CHARGES FOR A 6 MONTH TIMEFRAME. PARTIAL ASSISTANCE EQUALS A SET DEDUCTIBLE FROM $250.00 - $1,000.00 MAXIMUM FOR THE 6 MONTH PERIOD FOR THOSE QUALIFYING WITHIN THE 400% LIMIT, FOLLOWED BY A 6 MONTH FULL CHARGE WRITE-OFF FOR MEDICALLY NECESSARY SERVICES. IN ESSENCE, PATIENTS WHO QUALIFY FOR ASSISTANCE MAY PAY UP TO ONE TIME MAXIMUM OF $1,000 DURING A SIX MONTH PERIOD WITH ALL OTHER CHARGES WRITTEN-OFF. THIS METHODOLOGY IS APPLIED REGARDLESS OF THE ACCOUNT BALANCE. SCHEDULE H, PART VI, LINE 2: NEEDS ASSESSMENT: Fletcher Allen has a long history of conducting needs assessments to gauge the health care and related needs of the communities, including the creation of a chartered community benefit committee in October 2011 and a community health needs assessment committee during fiscal year 2013. The community benefit committee is the successor to a community benefit advisory group comprised exclusively of Fletcher Allen staff. This newer committee includes six members from across the organization, six members from the community based Vermont Health Foundation, and is chaired by Fletcher Allen's Chief Medical Officer. In FY13, Fletcher Allen finalized their community health needs assessment and accompanying implementation plan. This document was the culmination of work over the two previous years to obtain input from the community around its needs and priorities. (See Schedule H, Part V, Line 3 disclosures for information on how the organization completed this task.) The governing body of the Board of Trustees over this area formally accepted and adopted the Community Health Needs Assessment and accompanying implementation plan in the latter part of 2013. SCHEDULE H, PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: FLETCHER ALLEN UTILIZES A VARIETY OF METHODS TO INFORM, EDUCATE AND ASSIST PATIENTS IN IDENTIFYING PAYMENT SOURCES, INCLUDING STATE / FEDERAL PROGRAMS AS WELL AS OUR PATIENT ASSISTANCE PROGRAM. EDUCATE & INFORM: -THE FAHC PATIENT ASSISTANCE (CHARITY) PROGRAM IS REFERENCED ON THE FAHC PUBLIC WEBSITE, ALONG WITH GUIDELINES, CRITERIA, FREQUENTLY ASKED QUESTIONS AND A DOWNLOADABLE APPLICATION. ALL PATIENTS ARE INVITED TO APPLY. PATIENTS WHO WOULD NOT NORMALLY QUALIFY MAY BE CONSIDERED DUE TO SPECIAL CIRCUMSTANCES. -OUR PATIENT ASSISTANCE PROGRAM IS REFERENCED ON ALL OF OUR FAHC PATIENT STATEMENTS, ALONG WITH TELEPHONE NUMBERS FOR ASSISTANCE IN THE APPLICATION PROCESS. -PAMPHLETS REGARDING OUR HEALTH ASSISTANCE PROGRAMS ARE AVAILABLE IN THE PUBLIC WAITING ROOMS AND REGISTRATION OFFICE WITH FOLLOW-UP DIRECTIONS TO OUR COMMUNITY OUTREACH CASE MANAGERS AND COORDINATORS. -VERBAL COMMUNICATION REGARDING THE PROGRAMS IS PROVIDED TO PATIENTS DURING THE PRE-REGISTRATION PROCESS IF UNINSURED OR IF INSURED PATIENTS EXPRESS HARDSHIP, AT THE POINT OF ARRIVAL AND AT THE POINT OF DISCHARGE IN THE EMERGENCY DEPARTMENT. APPLICATIONS FOR BOTH MEDICAID AND CHARITY ARE AVAILABLE TO EACH REGISTRAR AND ARE ROUTINELY PROVIDED TO PATIENTS DURING THE INTERVIEW AND/OR PATIENTS ARE DIRECTED TO OUR PATIENT FINANCIAL COUNSELORS AND CUSTOMER SERVICE REPRESENTATIVES FOR APPLICATION ASSISTANCE. -WITHIN THE PHYSICIAN CLINICS, APPLICATIONS ARE AVAILABLE FOR PATIENTS AND FOLLOW-UP REFERRALS ARE PROVIDED DIRECTLY TO THE CUSTOMER SERVICE DEPARTMENT. IN FY 14, A COPY OF THE POLICY SUMMARY IS DISTRIBUTED AT CHECK-IN FOR UNINSURED AND UNDERINSURED PATIENTS UPON ARRIVAL TO A CLINIC. -PATIENT CALLS TO THE CUSTOMER SERVICE CENTER REGARDING BILLS, PAYMENTS, BUDGET PLANS, ETC. WILL INCLUDE EDUCATION AND, WHEN NECESSARY, COUNSELING FOR PATIENTS REGARDING BOTH STATE AND FEDERAL OPTIONS AS WELL AS THE FAHC CHARITY PROGRAM. APPLICATIONS FOR ASSISTANCE WITH ALL PROGRAMS ARE MAILED TO PATIENTS UPON REQUEST. APPLICATION ASSISTANCE: -ALL INPATIENTS AND OUTPATIENT PROCEDURES ARE FINANCIALLY SCREENED TO IDENTIFY THE UNDERINSURED OR UNINSURED PATIENT POPULATION. PRIOR TO SERVICE, CONCURRENT WITH SERVICE AND POST SERVICE, OUR PATIENT FINANCIAL COUNSELORS WILL CALL AND/OR MEET WITH PATIENTS AND FAMILIES TO EDUCATE THEM ON THE AVAILABLE PROGRAMS AND WHERE APPLICABLE, ASSIST IN THE APPLICATION PROCESS. THIS INCLUDES STATE AND FEDERAL AID APPLICATIONS AND THE FAHC CHARITY APPLICATION PROCESS. -OUR COUNSELORS WILL ADDITIONALLY MEET WITH PATIENTS AT THE BEDSIDE TO HELP COMPLETE THE APPLICATIONS, PROVIDE DETAILS ON SUPPORTING DOCUMENTATION NEEDS & FACILITATE AND EXPEDITE THE REVIEW PROCESS UNTIL A NOTICE OF DECISION HAS BEEN RECEIVED. -OUR COMMUNITY HEALTH IMPROVEMENT OFFICE PROVIDES EDUCATION AND APPLICATION ASSISTANCE FOR A VARIETY OF PROGRAMS, INCLUDING THE STATE AND FEDERAL MEDICAID APPLICATION PROCESS, THE PATIENT ASSISTANCE PROGRAM APPLICATION (CHARITY) AS WELL AS ASSIST WITH FINANCIAL ASSISTANCE TO PATIENTS FOR PHARMACEUTICALS. PROCESSES HAVE BEEN ESTABLISHED TO REFER URGENT CARE AND EMERGENCY DEPARTMENT PATIENTS TO THE PROGRAM, WHERE CASE MANAGERS ASSIST IN BOTH THE APPLICATION PROCESS AND COMMUNITY RESOURCE NEEDS IDENTIFICATION. ADDITIONALLY, THE CASE MANAGERS RECEIVE AND REVIEW REPORTS FOR THE UNINSURED EMERGENCY PATIENTS WHO HAVE FREQUENTED THE EMERGENCY DEPARTMENT MORE THAN 1 TIME PER MONTH. THE MANAGERS WILL THEN REACH OUT TO THE PATIENTS, SEEKING TO ASSIST PATIENTS IN IDENTIFYING FINANCIAL SPONSORSHIP. SCHEDULE H, PART VI, LINE 4: COMMUNITY INFORMATION: FLETCHER ALLEN HEALTH CARE IS BOTH A COMMUNITY HOSPITAL AND, IN PARTNERSHIP WITH THE UNIVERSITY OF VERMONT, THE STATE'S ONLY ACADEMIC MEDICAL CENTER. IN ITS COMMUNITY HOSPITAL ROLE, FLETCHER ALLEN SERVES APPROXIMATELY 165,000 RESIDENTS IN CHITTENDEN AND GRAND ISLE COUNTIES AND PROVIDES PRIMARY CARE SERVICES AT TWELVE VERMONT SITES. THE ORGANIZATION ALSO OFFERS FREE TO THE COMMUNITY A WIDE RANGE OF HEALTH, PREVENTION AND WELLNESS PROGRAMS, ALL OF WHICH HELP TO LIMIT THE NEED FOR MORE EXPENSIVE ACUTE CARE. AS A REGIONAL REFERRAL CENTER, FLETCHER ALLEN PROVIDES ADVANCED-LEVEL CARE TO A POPULATION OF APPROXIMATELY ONE MILLION PEOPLE THROUGHOUT VERMONT AND NORTHERN NEW YORK. THE MEDICAL CENTER EXTENDS BEYOND ITS FOUR MAIN CAMPUSES IN THE BURLINGTON AREA TO INCLUDE MORE THAN 30 PATIENT CARE SITES AND 100 OUTREACH CLINICS, PROGRAMS AND SERVICES THROUGHOUT THE REGION. SCHEDULE H, PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH: FLETCHER ALLEN IS GOVERNED BY A BOARD OF COMMUNITY VOLUNTEERS FROM OUR SERVICE AREA, INCLUDING OUR PRIMARY, SECONDARY AND TERTIARY REFERRAL REGION. THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT AND NOT DIRECTLY AFFILIATED WITH THE ORGANIZATION. FLETCHER ALLEN'S MEDICAL STAFF IS AN "OPEN STAFF" MODEL WITH MEMBERSHIP GOVERNED BY THE MEDICAL STAFF'S BY-LAWS, AND INCLUDES APPROXIMATELY 580 EMPLOYED PHYSICIANS AND 150 COMMUNITY-BASED PHYSICIANS. AS A NON-PROFIT, ANY SURPLUS FUNDS GENERATED BY FLETCHER ALLEN ARE RE-INVESTED IN OUR ORGANIZATION TO SUPPORT OUR MISSION. PLEASE SEE SCHEDULE O FOR A MORE DETAILED DESCRIPTION OF FLETCHER ALLEN'S ROLE IN OUR REGIONAL HEALTH CARE SYSTEM AND OUR COMMUNITY BENEFIT ACTIVITIES. SCHEDULE H, PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM: AS OF OCTOBER 1, 2011, FLETCHER ALLEN HEALTH CARE, INC. (FAHC) AND CENTRAL VERMONT MEDICAL CENTER, INC. (CVMC), BECAME MEMBERS OF FLETCHER ALLEN PARTNERS, INC. (FAP), AN INTEGRATED SYSTEM OF CARE SERVING THE COMMUNITIES OF VERMONT AND NORTHERN NEW YORK. ON JANUARY 1, 2013 FAP ALSO BECAME THE SOLE MEMBER OF COMMUNITY PROVIDERS, INC. FLETCHER ALLEN PARTNERS IS CARRYING OUT CENTRALIZED ACTIVITIES FOR THE BENEFIT OF PATIENTS OF ALL THREE PARTNER ORGANIZATIONS, INCLUDING IMPROVING ACCESS TO LOCAL CARE, COST SAVINGS THROUGH GREATER JOINT PURCHASING POWER, ENHANCING INFORMATION TECHNOLOGY, INCREASING ACADEMIC OPPORTUNITIES FOR PHYSICIANS, ENGAGING IN REGIONAL STRATEGIC PLANNING, AND PARTICIPATING IN JOINT QUALITY AND CLINICAL INITIATIVES. COLLABORATIVE EFFORTS - FLETCHER ALLEN REGULARLY PARTNERS WITH OTHER ORGANIZATIONS AND PROVIDERS TO HELP MEET THE NEEDS OF OUR COMMUNITY. THIS INCLUDES WORKING WITH OTHER ORGANIZED SYSTEMS OF CARE (LIKE HOME HEALTH AGENCIES, OTHER VERMONT HOSPITALS, AND PHYSICIAN PRACTICES), AS WELL AS COMMUNITY-BASED ORGANIZATIONS WHOSE MISSIONS ARE SIMILAR TO OURS. FOR EXAMPLE, FLETCHER ALLEN COLLABORATES WITH COMMUNITY PARTNERS TO REGULARLY ASSESS COMMUNITY AND HEALTH CARE NEEDS, WHICH HELPS GUIDE OUR ORGANIZATION'S PRIORITIES. PLEASE READ FORM 990 PART III NARRATIVE IN SCHEDULE O FOR ADDITIONAL INFORMATION ON FLETCHER ALLEN HEALTH CARE'S INTERACTIONS IN AND WITH ITS COMMUNITY. true Community Health Center of Burlington 617 Riverside Ave Burlington VT 05401 237182584 501(c)(3) 200000 Community Health Impr. Burlington School District 150 Colchester Ave Burlington VT 05401 036000410 Other Gov't 25000 Community Health Impr. United Way of Chittenden County 412 Farrell St Suite 200 S Burlington VT 05403 030217229 501(C)(3) 140000 Community Health Impr. Vermont Ethics Network 61 ELM STREET Montpelier VT 056202951 030336174 501(c)(3) 14000 COMMUNITY HLTH IMPROV Northern Vermont Area Health Education Center 347 Emerson Falls Rd St Johnsbury VT 05819 043366707 501(c)(3) 36563 Community Health Impr. Champlain Valley Area Health Education Ctr 92 Fairfield St St Albans VT 05478 030357255 501(c)(3) 36563 Community Health Impr. Southern Vermont Area Health Education Ctr 365 Summer Street Springfield VT 05156 030360193 501(c)(3) 36563 Community Health Impr. HOWARD CENTER for Human Svc 208 FLYNN AVE BURLINGTON VT 05401 030179433 501(c)(3) 50000 Community Health Impr. Cathedral Square Corporation 412 FARRELL STSuite 100 S BURLINGTON VT 05403 030264362 501(C)(3) 50000 Community Health Impr. VERMONT WORKS FOR WOMEN INC 32A MALLETTS BAY AVE WINOOSKI VT 05404 222894557 501(C)(3) 11000 Community Health Impr. GREATER BURLINGTON YMCA 266 COLLEGE ST BURLINGTON VT 05401 030185810 501(C)(3) 9000 Community Health Impr. COLCHESTER SCHOOL DISTRICT 125 LAKER LN PO BOX 27 COLCHESTER VT 05446 030269580 Other Gov't 8500 Community Health Impr. Champlain Housing Trust 88 King St Burlington VT 05401 222536446 501(c)(3) 25000 Community Health Impr. State of VT Dept of Health 108 Cherry St BURLINGTON VT 05402 036000274 other govt 50000 Community Health Impr. Univ of VT College of Medicine One So Prospect St BURLINGTON VT 05401 030179440 other govt 36563 Community Health Impr. VT Ethics Network Inc 61 Elm St Montpelier VT 05602 030336174 501(c)(3) 14000 Community Health Impr. Visiting Nurses Association 1110 Prim Rd Colchester VT 05446 030179603 501(c)(3) 55000 Community Health Impr. 17 Nursing Scholarships 23 72500 Allied Health Scholarships 6 20650 ENDOWMENT SCHOLARSHIPS 9 9700 SCHOLARSHIP MONITORING SCHEDULE I, PART I, QUESTION 2 THE ORGANIZATION REQUIRES STRICT APPLICATION AND APPROVAL CRITERIA FOR SCHOLARSHIP RECIPIENTS TO MAINTAIN THE INTEGRITY OF EACH RESPECTIVE AWARD. NURSING SCHOLARSHIPS: NURSING SCHOOL ASSISTANCE IS AWARDED TO APPLICANTS IN ORDER FOR THEM TO OBTAIN A DEGREE IN NURSING. FOR THE APPLICANT TO QUALIFY FOR THE SCHOLARSHIP, HE/SHE MUST AGREE THAT THEY WILL USE IT TO HELP FURTHER FLETCHER ALLEN HEALTH CARE'S CHARITABLE STATUS. THIS IS DONE BY HAVING THE APPLICANT COMMIT TO TWO YEARS OF SERVICE AT THE ORGANIZATION AFTER SUCCESSFUL COMPLETION OF THE DEGREE PROGRAM. IN ADDITION, A WRITTEN PROPOSAL STATING HOW ATTAINMENT OF THE DEGREE WILL BENEFIT NURSING AT THE ORGANIZATION IS REQUIRED. ALLIED HEALTH SCHOLARSHIPS: ALLIED HEALTH SCHOLARSHIPS ARE AWARDED TO SUPPORT THE CAREER DEVELOPMENT OF FLETCHER ALLEN HEALTH CARE (FAHC) EMPLOYEES IN POSITION CATEGORIES WHERE CURRENT AND PROJECTED SHORTAGES EXIST. FOR THE APPLICANT TO QUALIFY FOR THE SCHOLARSHIP, HE OR SHE MUST BE AN EMPLOYEE OF FAHC FOR ONE YEAR OR MORE, COMPLETE AN APPLICATION AND WRITTEN ESSAY, HAVE A HISTORY OF SOLID JOB PERFORMANCE, BE ACCEPTED INTO AN APPROVED ACADEMIC PROGRAM, AND PROVIDE TWO LETTERS OF RECOMMENDATION. ONCE THE SCHOLARSHIP IS AWARDED, RECIPIENTS MUST SIGN AN AGREEMENT TO WORK FOR FAHC FOR A MINIMUM OF THREE YEARS UPON GRADUATION, TAKE A MINIMUM OF SIX CREDIT HOURS EACH SEMESTER, MAINTAIN HIGH GRADES, AND WORK A MINIMUM OF 20 HOURS PER WEEK. SCHOLARSHIPS FROM THE NURSING EDUCATION ENDOWMENT FUND AND THE MARY FLETCHER HOSPITAL SCHOOL OF NURSING ALUMNI FUND: ASSISTANCE FROM THE NURSING EDUCATION ENDOWMENT FUND IS AWARDED TO ELIGIBLE APPLICANTS GOING INTO THE NURSING FIELD. APPLICANTS MUST BE EMPLOYED AT LEAST TWO YEARS AT FAHC, WORK AT LEAST 40 HOURS PER PAY PERIOD, BE ENROLLED IN A NURSING CERTIFICATE, DEGREE OR DOCTORATE PROGRAM, AND NO CURRENT DISCIPLINARY ACTION IN THEIR FILE. DECISION TO APPROVE FUNDING IS BASED ON THE APPLICANT'S COMPLETED APPLICATION FORM, TWO LETTERS OF RECOMMENDATION, AND COMMITMENT TO TWO YEARS OF SERVICE AT FAHC AFTER SUCCESSFUL COMPLETION OF THE DEGREE PROGRAM. ASSISTANCE FROM THE MARY FLETCHER HOSPITAL SCHOOL OF NURSING ALUMNI FUND IS ALSO AWARDED TO ELIGIBLE APPLICANTS GOING INTO THE NURSING FIELD. APPLICANTS MUST BE ENROLLED IN EITHER A FORMAL OR CONTINUING EDUCATION PROGRAM RELATED TO SOME ASPECT OF HEALTH CARE (FOR EXAMPLE, HOLISTIC NURSING, CHILD-BIRTH EDUCATION, CHEMICAL DEPENDENCY, NURSE PRACTITIONER). IN ADDITION, APPLICANTS MUST MEET THE FOLLOWING REQUIREMENTS: BE EMPLOYED BY FLETCHER ALLEN HEALTH CARE FOR AT LEAST ONE YEAR, AND PROVIDE A COMPLETED APPLICATION FORM, RESUME, WRITTEN ESSAY AND TWO LETTERS OF RECOMMENDATION. X false false X X X X false true false false false false false true false ROGER DESHAIES 453533 0 250198 75478 22500 0 22719 0 824428 0 0 0 SANDRA FELIS RN 350047 0 172703 60183 12567 0 24737 0 620237 0 0 0 DR JOHN BRUMSTED 760698 0 484886 122695 107500 0 22401 0 1498180 0 0 0 SPENCER KNAPP 382851 0 187305 64577 22500 0 17324 0 674557 0 0 0 DR MARK PHILLIPPE 0 199973 37536 0 18518 0 1988 0 258015 0 0 CHARLES PODESTA 299647 0 149336 25377 17500 0 27280 0 519140 0 0 0 PAUL MACUGA 288419 0 141963 36616 22500 0 21360 0 510858 0 0 0 THERESA ALBERGHINI DIPALMA 281910 0 139462 47497 17500 0 20268 0 506637 0 0 0 TODD B MOORE 276343 0 101911 37858 17500 0 22965 0 456577 0 0 0 DR STEPHEN M LEFFLER 322032 0 116785 32432 22500 0 21679 0 515428 0 0 0 DR HOWARD M SCHAPIRO 0 279643 62874 30114 0 30000 0 5139 0 407770 0 0 DR PAUL TAHERI 390463 0 237719 76752 16597 0 24437 0 745968 0 0 0 PERSONAL SERVICE COMPENSATION SCHEDULE J, PART I, QUESTIONS 1A, 1B & 2 THE FOLLOWING INDIVIDUALS RECEIVED COMPENSATION OF $1,400 TO COVER TAX PREPARATION AND FINANCIAL ADVISORY SERVICES: TODD B. MOORE DR. STEPHEN M. LEFFLER ROGER DESHAIES DR. PAUL TAHERI SANDRA FELIS, R.N. DR. JOHN BRUMSTED SPENCER KNAPP CHARLES PODESTA PAUL MACUGA THERESA ALBERGHINI DIPALMA WHILE THERE IS NO ORGANIZATION-WIDE WRITTEN POLICY REGARDING PAYMENT OF THE EXPENSE DESCRIBED ABOVE, THE AMOUNT IS INCLUDED IN THE RESPECTIVE INDIVIDUAL'S EMPLOYMENT CONTRACT WHICH IS DETERMINED THROUGH ANNUAL REVIEW (AS DISCUSSED IN SCHEDULE O). PERSONAL SERVICE COMPENSATION IS A FLAT AMOUNT INCLUDED IN THE INDIVIDUAL'S RESPECTIVE W-2 AS TAXABLE INCOME. NO REIMBURSEMENT IS MADE UNDER AN ACCOUNTABLE PLAN; THEREFORE, SUBSTANTIATION OF EXPENSE IS UNNECESSARY. SCHEDULE J, PART I, QUESTION 4B Certain listed individuals participated in the Fletcher Allen Executive Benefit Plan under which participants are credited a Benefit Allowance equal to a specified percentage of base pay. Under the plan, participants may elect to have the amount of the benefit allowance deferred to a capital accumulation account subject to section 457(f). No amounts were deferred to or paid from a capital accumulation account in calendar 2012. During Calendar year 2012, Fletcher Allen Health Care entered into a Supplemental Retirement Benefit Plan (SRP) with President Brumsted. Under the SRP, FAHC makes annual deferrals equal to 10% of the president's base salary for each year through the plan year ending September 30, 2015. This amount is included in Schedule J, Part II, Column C. Amounts deferred are subject to forfeiture if certain conditions are not met. NON-FIXED PAYMENTS SCHEDULE J, PART I, QUESTION 7 FLETCHER ALLEN HEALTH CARE PAID A LUMP-SUM INCENTIVE AWARD TO UPPER MANAGEMENT (DIRECTORS, VICE PRESIDENTS, PHYSICIAN CHAIRS AND SENIOR EXECUTIVES) THROUGH ITS ANNUAL SHORT-TERM INCENTIVE (STI) PLAN AS THE PLAN'S ORGANIZATIONAL PERFORMANCE MEASURES WERE MET. THE MEASURES WERE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THESE MEASURES INCLUDED FINANCIAL QUALITY, OPERATIONAL AND HUMAN RESOURCES RELATED METRICS. CERTAIN SENIOR EXECUTIVES PARTICIPATED IN A LONG -TERM INCENTIVE (LTI) PLAN IN CALENDAR 2012. THE PLAN COVERED FISCAL YEARS 2011 THROUGH 2013. THE PLAN WAS STRUCTURED TO HELP FLETCHER ALLEN HEALTH CARE RETAIN THESE KEY EXECUTIVES OVER THE LONG TERM BY PROVIDING MEANINGFUL INCENTIVES AND REWARDS FOR SUSTAINED SUCCESS OVER THE THREE-YEAR PERIOD, AND AWARDS ARE BASED ON SATISFACTION OF SPECIFIED PERFORMANCE CRITERIA. THERE WERE NO PAYOUTS FROM THE LTI PLAN IN CALENDAR 2012. A VEHBFA SERIES 2008A & 2004B 237154467 924166CJ8 2008-05-21 215386067 REFUND BONDS ISSUED 4/15/2004 false false false B VEHBFA SERIES 2007A 237154467 924166AQ4 2007-02-25 56375337 CONSTRUCT HEALTH CARE FACILITIES false false false C VEHBFA SERIES 2004A 237154467 9241606Q2 2004-04-15 49543132 REFUND BOND ISSUED 1993 false false false D VEHBFA SERIES 2013A 237154467 2013-03-05 29500000 REFUND BOND ISSUED 2000 false false false A 13581539 0 215386067 14497082 0 0 1708089 0 0 0 198332744 0 2005 true false true true B 430702 0 56375337 5627095 0 0 895983 0 0 52387649 0 0 2005 false false true true C 16007941 0 49543132 5384060 0 0 451483 0 0 0 44196507 0 2007 true false true true D 162500 0 29500000 0 0 0 263962 0 0 0 29236038 0 2013 true false true true A false false true true false 0.00000 0.00000 0.00000 false false 0.00000 false true B false false true true false 0.00000 0.00000 0.00000 false false 0.00000 false true C 0 D 0 A false true true true CITIBANK 21.2 false false false 0 false true B false true false false 0 false 0 false true C false true false false 0 false 0 false true D false true false false 0 false 0 false true A true B true C true D true SCHEDULE K, PART I, LINES A AND B 0 THE VEHBFA SERIES 2008A BOND REISSUED THE VEHBFA SERIES 2004B BOND. THE VEHBFA SERIES 2007A BOND WAS ISSUED TO REIMBURSE FLETCHER ALLEN HEALTH CARE'S CONSTRUCTION COSTS INCURRED FOR THE AMBULATORY CARE CENTER WITHIN 18 MONTHS OF THE DATE OF ISSUE. SCHEDULE K, PART III, LINES 4-6 THE PRIVATE BUSINESS USE PERCENTAGE FOR FLETCHER ALLEN HEALTH CARE (FAHC) HAS BEEN PRESENTED AT 0%. THE TAX CERTIFICATE AND AGREEMENT FILED WITH FORMS 8038 FOR THE ISSUANCES LISTED IN COLUMNS A AND B INDICATE THAT AN EQUITY CONTRIBUTION WILL BE MADE AS A PORTION OF THE FUNDING FOR THE PROJECT. THE LANGUAGE DICTATES THAT THE EQUITY CONTRIBUTION WILL BE APPLIED TO PRIVATE USE PORTION OF THE PROJECT. THE FAHC EQUITY CONTRIBUTION REPRESENTS APPROXIMATELY 33% OF THE TOTAL CONSTRUCTION COST. VERMONT GAS SYSTEMS SEE PART V 1488501 NATURAL GAS false R ALLEN MEAD SON OF TRUSTEE MEAD 187545 WAGES false VMC INDEMNITY COMPANY LTD SEE PART V 7464717 INSURANCE PREMIUMS false SYMQUEST GROUP SEE PART V 512044 COPIER SERVICE false JANET C SCHAPIRO SEE PART V 239762 WAGES false BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS SCHEDULE L, PART IV (1) RELATIONSHIP: DONALD GILBERT, TRUSTEE, IS THE PRESIDENT AND CEO OF VERMONT GAS SYSTEMS, WHICH IS THE ORGANIZATION'S NATURAL GAS PROVIDER. (3) RELATIONSHIP: ROGER DESHAIES, SANDRA FELIS, R.N., AND DR. JOHN BRUMSTED SERVE AS OFFICERS OF VMC INDEMNITY COMPANY. DR. PAUL DANIELSON, DR. HOWARD M. SCHAPIRO, AND STEPHEN LEFFLER SERVE AS DIRECTORS OF VMC INDEMNITY COMPANY, FLETCHER ALLEN HEALTH CARE'S CAPTIVE INSURANCE COMPANY. (4) RELATIONSHIP: LARRY SUDBAY, TRUSTEE, IS THE PRESIDENT AND CEO OF SYMQUEST GROUP, WHICH IS THE ORGANIZATION'S COPIER SERVICE PROVIDER. (5) RELATIONSHIP: JANET C. SCHAPIRO, WIFE OF UVMMG INTERIM PRESIDENT & CEO HOWARD M. SCHAPIRO, RECEIVED WAGES FROM FLETCHER ALLEN HEALTH CARE, INC. X 3 X 4598 COST X 1 4000 COST X 5 102076 SALE PRICE LESS FEES X 1 11821190 APPRAISAL X 6 1800 COST X 11 858 COST X GIFT CERTIFICATES 54 10051 COST 1 false true true Schedule M, Part I, Column B Fletcher Allen Health Care, Inc. is reporting the total number of contributions. Schedule M, Part I, Line 33 Fletcher Allen Health Care, Inc. does not record revenue for SOME gifts-in-kind until they are sold. Therefore, revenue for these gifts is not included on Form 990, Part VIII, Line I. Schedule M, PART II IN MAY 2013, FLETCHER ALLEN HEALTH CARE RECEIVED THE LARGEST GIFT IN ITS HISTORY. A VERMONT PHILANTHROPIST DONATED TWO BUILDINGS ON A 15-ACRE COMMERCIAL SITE VALUED AT $11,821,190. NUMBER OF VOLUNTEERS FORM 990, PART I, QUESTION 6 THE TOTAL NUMBER OF VOLUNTEERS INCLUDES NON-COMPENSATED MEMBERS OF THE BOARD OF TRUSTEES. IN ADDITION, VOLUNTEERS WORK IN OVER 50 DEPARTMENTS TO SUPPORT THE WORK OF EMPLOYEES TO MEET PATIENT NEEDS AND ENHANCE THE PATIENT EXPERIENCE AT FLETCHER ALLEN. COMMUNITY BENEFIT REPORT FORM 990, PART III FLETCHER ALLEN HEALTH CARE IS BOTH A COMMUNITY HOSPITAL AND, IN PARTNERSHIP WITH THE UNIVERSITY OF VERMONT, THE STATE'S ONLY ACADEMIC MEDICAL CENTER. IT IS OUR MISSION TO IMPROVE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE BY INTEGRATING PATIENT CARE, EDUCATION AND RESEARCH IN A CARING ENVIRONMENT. IN ITS COMMUNITY HOSPITAL ROLE, FLETCHER ALLEN SERVES APPROXIMATELY 165,000 RESIDENTS IN CHITTENDEN AND GRAND ISLE COUNTIES AND PROVIDES PRIMARY CARE SERVICES AT ELEVEN VERMONT SITES. THE ORGANIZATION ALSO OFFERS FREE TO THE COMMUNITY A WIDE RANGE OF HEALTH, PREVENTION AND WELLNESS PROGRAMS, ALL OF WHICH HELP TO LIMIT THE NEED FOR MORE EXPENSIVE ACUTE CARE. THROUGH A VITAL PARTNERSHIP, FLETCHER ALLEN HEALTH CARE, THE UNIVERSITY OF VERMONT COLLEGE OF MEDICINE AND THE UNIVERSITY OF VERMONT COLLEGE OF NURSING AND HEALTH SCIENCES FORM VERMONT'S ACADEMIC MEDICAL CENTER - ONE OF ONLY APPROXIMATELY 130 SUCH CENTERS IN THE COUNTRY. TOGETHER, THESE INSTITUTIONS ARE COMMITTED TO HELPING IMPROVE OUR REGION'S QUALITY OF LIFE WITH INNOVATIONS IN MEDICINE AND HEALTH CARE THAT ARISE FROM NEW KNOWLEDGE AND DISCOVERY. THROUGH ITS ALLIANCE WITH THE UNIVERSITY OF VERMONT, FLETCHER ALLEN IS ABLE TO PROVIDE THE BEST PATIENT CARE POSSIBLE BY BRINGING MEDICAL EDUCATION AND RESEARCH TO THE BEDSIDE, THE DOCTOR'S OFFICE AND INTO THE COMMUNITY. AS A REGIONAL REFERRAL CENTER, FLETCHER ALLEN PROVIDES ADVANCED-LEVEL CARE TO A POPULATION OF APPROXIMATELY ONE MILLION PEOPLE THROUGHOUT VERMONT AND NORTHERN NEW YORK. THE MEDICAL CENTER EXTENDS BEYOND ITS FOUR MAIN CAMPUSES IN THE BURLINGTON AREA TO INCLUDE MORE THAN 30 PATIENT CARE SITES AND 100 OUTREACH CLINICS, PROGRAMS AND SERVICES THROUGHOUT THE REGION. EACH OF THESE RESPONSIBILITIES IS EQUALLY IMPORTANT IN FULFILLING FLETCHER ALLEN'S MISSION. 1. PATIENT CARE - SERVING A POPULATION OF APPROXIMATELY ONE MILLION THROUGHOUT VERMONT AND NORTHERN NEW YORK, FLETCHER ALLEN PROVIDES A FULL RANGE OF SERVICES COVERING EVERY MAJOR AREA OF MEDICINE. THE MEDICAL CENTER AVERAGES MORE THAN A MILLION PATIENT VISITS EACH YEAR, INCLUDING INPATIENT, OUTPATIENT, EMERGENCY DEPARTMENT AND PHYSICIAN OFFICE VISITS. FLETCHER ALLEN IS AT THE LEADING EDGE OF HEALTH CARE INNOVATIONS, INCLUDING HAVING IMPLEMENTED A SYSTEM-WIDE ELECTRONIC HEALTH RECORD THAT SUPPORTS IMPROVED HEALTH CARE FOR OUR COMMUNITIES AND SERVING AS ONE OF THE FIRST TWO PILOT SITES FOR THE VERMONT BLUEPRINT FOR HEALTH, A STATEWIDE PUBLIC/PRIVATE PARTNERSHIP FOCUSED ON ENSURING THAT ALL VERMONTERS HAVE ACCESS TO PRIMARY CARE SERVICES USING THE "PATIENT-CENTERED MEDICAL HOME" CARE DELIVERY MODEL. IN LINE WITH THE BLUEPRINT, FLETCHER ALLEN HAS IMPLEMENTED A COMMUNITY HEALTH TEAM TO SERVE ALL OF OUR PRIMARY CARE PRACTICES, ALL OF WHICH HAVE BEEN RECOGNIZED BY THE NATIONAL COMMITTEE ON QUALITY ASSURANCE AS PATIENT-CENTERED MEDICAL HOMES. 2. EDUCATION - AS AN ACADEMIC MEDICAL CENTER, WE HAVE THE SPECIAL RESPONSIBILITY OF EDUCATING THE NEXT GENERATION OF DOCTORS, NURSES AND ALLIED HEALTH PROFESSIONALS. THE VAST MAJORITY OF FLETCHER ALLEN DOCTORS NOT ONLY TAKE CARE OF PATIENTS, THEY ALSO TEACH MEDICAL STUDENTS THROUGH THEIR POSITIONS AS MEMBERS OF THE UNIVERSITY OF VERMONT COLLEGE OF MEDICINE FACULTY. A NUMBER OF FLETCHER ALLEN NURSES AND ALLIED HEALTH PROFESSIONALS ALSO TEACH AT THE UNIVERSITY OF VERMONT COLLEGE OF NURSING AND HEALTH SCIENCES. FLETCHER ALLEN HEALTH CARE SERVES AS THE CLINICAL TRAINING SITE FOR THE APPROXIMATELY 450 MEDICAL STUDENTS AND 870 NURSING AND ALLIED HEALTH STUDENTS WHO ATTEND THE UNIVERSITY OF VERMONT. ADDITIONALLY, FLETCHER ALLEN IS THE TRAINING SITE FOR APPROXIMATELY 280 RESIDENTS - PHYSICIANS WHO HAVE GRADUATED FROM MEDICAL SCHOOL AND ARE COMPLETING THE ADDITIONAL CLINICAL TRAINING REQUIRED FOR THEIR AREA OF CARE. PATIENTS BENEFIT FROM HAVING RESIDENTS, MEDICAL STUDENTS AND NURSING AND ALLIED HEALTH STUDENTS AS PART OF THEIR CARE TEAM. IN COLLABORATION WITH THE UNIVERSITY OF VERMONT, FLETCHER ALLEN HEALTH CARE CONTINUES TO USE THE DEVELOPMENT OF A SIMULATION CENTER THAT INCLUDES 9,000 SQUARE FEET OF TEACHING SPACE WITH FULLY-FUNCTIONING HOSPITAL ROOMS AND HIGH-TECH MANNEQUINS THAT SIMULATE ALL KINDS OF DISEASES AND INJURIES. THE SIMULATION CENTER ALSO HAS HANDS-ON LABS FOR SKILL-BUILDING AS WELL AS A VIRTUAL REALITY TRAINER THAT IMPROVES ON OLD TEACHING METHODS. IN ADDITION TO BEING USED TO TRAIN FUTURE DOCTORS AND NURSES, THE NEW FACILITY IS OPEN TO ALL VERMONT MEDICAL PROFESSIONALS, INCLUDING EMERGENCY MEDICAL TECHNICIANS AND VERMONT NATIONAL GUARD MEDICS. 3. RESEARCH - A CORE MISSION OF THE ACADEMIC MEDICAL CENTER IS TO ADVANCE MEDICAL KNOWLEDGE THROUGH RESEARCH, SO IN ADDITION TO TEACHING AND TRAINING, MANY OF OUR PHYSICIANS, NURSES AND OTHER PROVIDERS ENGAGE IN BIOMEDICAL RESEARCH, SEEKING NEW CURES AND MORE EFFECTIVE TREATMENTS. THERE ARE OVER 1,000 ACTIVE CLINICAL TRIALS AT THE UNIVERSITY OF VERMONT AND FLETCHER ALLEN. CLINICAL TRIALS ARE RESEARCH STUDIES CONDUCTED USING VOLUNTEERS. EACH STUDY ANSWERS SCIENTIFIC QUESTIONS AND TRIES TO FIND BETTER WAYS TO PREVENT, SCREEN FOR, DIAGNOSE, OR TREAT A DISEASE. THIS ACTIVE RESEARCH PROGRAM HAS A DIRECT BENEFIT TO PATIENTS AT FLETCHER ALLEN, WHO HAVE ACCESS TO THE LATEST TREATMENTS AND TECHNOLOGY AND WHO ARE CARED FOR BY SOME OF THE LEADING EXPERTS IN THEIR FIELD. THE ACADEMIC MEDICAL CENTER IS ALSO ACTIVELY ENGAGED IN POPULATION-BASED HEALTH RESEARCH, INCLUDING EVALUATING VERMONT BLUEPRINT FOR HEALTH PILOT PROJECTS INVOLVING THE DEVELOPMENT AND IMPACT OF PATIENT-CENTERED MEDICAL HOMES WITHIN THE STATE. 4. COMMUNITY BENEFIT - IN ADDITION TO DELIVERING HEALTH CARE, EDUCATING HEALTH CARE PROFESSIONALS, AND RESEARCHING NEW KNOWLEDGE, FLETCHER ALLEN ALSO LIVES ITS MISSION - TO IMPROVE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES IT SERVES - BY REACHING OUT TO HELP PEOPLE TAKE CARE OF THEIR HEALTH. THESE EFFORTS INCLUDE, BUT ARE NOT LIMITED TO: COMMUNITY WELLNESS AND EDUCATION - FLETCHER ALLEN OFFERS NUMEROUS FREE HEALTH EDUCATION CLASSES, IN WHICH HEALTH PROFESSIONALS PROVIDE INFORMATION ON A VARIETY OF TOPICS. MANY OTHER HEALTH AND WELLNESS PROGRAMS OFFERED THROUGHOUT THE YEAR SERVE AS A VALUABLE RESOURCE TO OUR COMMUNITY, RANGING FROM CHILD PASSENGER CAR SEAT SAFETY CHECKS TO FREE BLOOD PRESSURE SCREENINGS, TOBACCO CESSATION CLASSES, AND WORKSHOPS FOR SENIORS. FRYMOYER COMMUNITY HEALTH RESOURCE CENTER - PATIENTS, FAMILIES AND THE PUBLIC ARE MORE INTERESTED THAN EVER IN GAINING ACCESS TO THE LATEST HEALTH INFORMATION AVAILABLE. THE FRYMOYER COMMUNITY HEALTH RESOURCE CENTER AT FLETCHER ALLEN OFFERS THE COMMUNITY EASY, FREE, GUIDED ACCESS TO THE BEST INFORMATION ABOUT HEALTH AND MEDICINE. COLLABORATIVE EFFORTS - FLETCHER ALLEN REGULARLY PARTNERS WITH OTHER ORGANIZATIONS AND PROVIDERS TO HELP MEET THE NEEDS OF OUR COMMUNITY. THIS INCLUDES WORKING WITH OTHER ORGANIZED SYSTEMS OF CARE (LIKE HOME HEALTH AGENCIES, OTHER VERMONT HOSPITALS, AND PHYSICIAN PRACTICES), AS WELL AS COMMUNITY-BASED ORGANIZATIONS WHOSE MISSIONS ARE SIMILAR TO OURS. FOR EXAMPLE, FLETCHER ALLEN COLLABORATES WITH COMMUNITY PARTNERS TO REGULARLY ASSESS COMMUNITY AND HEALTH CARE NEEDS, WHICH HELPS GUIDE OUR ORGANIZATION'S PRIORITIES. OUR COMMUNITY BENEFITS FALL INTO FOUR GENERAL CATEGORIES: *DIRECT FINANCIAL ASSISTANCE TO PATIENTS. THIS REPRESENTS FREE CARE GIVEN TO PATIENTS WHO QUALIFY UNDER FLETCHER ALLEN'S "PATIENT ASSISTANCE PROGRAM" POLICY. THAT POLICY OFFERS FREE CARE TO PATIENTS UNDER 200% OF THE FEDERAL POVERTY LEVEL (FPL), WITH PATIENTS BETWEEN 200% AND 400% FPL PAYING A SLIDING-SCALE DEDUCTIBLE ONLY. FOR FY 2013, WE CALCULATED THIS AMOUNT AT APPROXIMATELY $8.7 MILLION IN ACTUAL COSTS (NOT CHARGES)(SEE SCHEDULE H, LINE 7A, COLUMN E). *SUBSIDIZED PROGRAMS. THESE INCLUDE RESEARCH ACTIVITIES AND EDUCATION AND TRAINING PROGRAMS FOR HEALTH PROFESSIONALS THAT ARE NOT FULLY REIMBURSED THROUGH OTHER MEANS, AS WELL AS SUBSIDIES TO SUPPORT HEALTH SERVICES THAT BENEFIT OUR COMMUNITY, INCLUDING THE UNINSURED AND LOW-INCOME INDIVIDUALS. THOSE SERVICES INCLUDE MENTAL HEALTH SERVICES, EMERGENCY SERVICES AND CRITICAL CARE TRANSPORTATION SERVICES. FOR FY 2013, WE CALCULATED THESE SUBSIDIES AT APPROXIMATELY $6.7 MILLION IN COMMUNITY BENEFIT (SEE SCHEDULE H, LINE 7G, COLUMN E). *COMMUNITY PROGRAMS AND DIRECT GRANTS. THESE INCLUDE, FOR EXAMPLE, COMMUNITY HEALTH SERVICES (HEALTH EDUCATION CLASSES, SUPPORT GROUPS, SCREENING SERVICES, FREE CLINICS, ETC.), FINANCIAL CONTRIBUTIONS AND IN-KIND DONATIONS (CASH DONATIONS, GRANTS, IN-KIND SUPPORT SUCH AS MEETING ROOMS, PARKING VOUCHERS, ETC.), COMMUNITY-BUILDING AND LEADERSHIP ACTIVITIES (INCLUDING ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENT, ECONOMIC DEVELOPMENT, AND ENVIRONMENTAL IMPROVEMENTS), AND COMMUNITY BENEFIT OPERATIONS (INCLUDING COSTS ASSOCIATED WITH OUR OFFICE OF COMMUNITY HEALTH IMPROVEMENT, COMMUNITY NEEDS ASSESSMENTS, ETC.). FOR FY 2013, WE CALCULATED THE VALUE OF THESE COMMUNITY PROGRAMS AND GRANTS AT $5.6 MILLION (SEE SCHEDULE H, LINE 7E AND 7I, COLUMN E). *MEDICAID AND OTHER PUBLIC PROGRAM UNDERPAYMENTS. THESE INCLUDE UNDERPAYMENTS FROM VERMONT'S MEDICAID PROGRAM AS WELL AS SEVERAL SMALLER PUBLIC PROGRAMS (FOR EXAMPLE, LADIES FIRST). THESE DO NOT INCLUDE ANY UNDERPAYMENTS BY MEDICARE. FOR FY 2013, WE CALCULATED THIS AMOUNT AT $31.8 MILLION (SEE SCHEDULE H, LINE 7B, COLUMN E). OUR TOTAL NET COMMUNITY BENEFIT SPENDING IN FY 2013 WAS $109.5 MILLION. THIS REPRESENTS APPROXIMATELY 10.87% OF FLETCHER ALLEN'S TOTAL PROGRAM SERVICE EXPENSE IN FY 2013 (SEE SCHEDULE H, LINE 7K, COLUMN F). In FY13, FAHC received a significant payment from Medicaid in support of our physician and hospital GME programs. This payment of $67M covered the time period of July 2011 through September 2013. The community benefit percentage decreased 7% from the prior year amount due to this retroactive payment. Had this payment been received in the appropriate fiscal years, the Fy13 and FY12 community benefit percentages would have been 14.6% and 14.2%, respectively. ORGANIZATION'S MISSION FORM 990, PART III, QUESTION 1 ACADEMIC MEDICAL CENTER AND COMMUNITY HOSPITAL. MISSION: TO IMPROVE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE BY INTEGRATING PATIENT CARE, EDUCATION, AND RESEARCH IN A CARING ENVIRONMENT. VISION: FLETCHER ALLEN IS COMMITTED TO THE DEVELOPMENT OF AN INTEGRATED DELIVERY SYSTEM WHICH PROVIDES HIGH VALUE HEALTH CARE TO THE COMMUNITIES WE SERVE AND ENHANCES OUR ACADEMIC MISSION. STATEMENT OF VALUES: *WE RESPECT THE DIGNITY OF ALL INDIVIDUALS AND ARE RESPONSIVE TO THEIR PHYSICAL, EMOTIONAL, SPIRITUAL AND SOCIAL NEEDS AND CULTURAL DIVERSITY. *WE ARE JUST AND PRUDENT STEWARDS OF LIMITED NATURAL AND FINANCIAL RESOURCES. *WE FOSTER A CLIMATE WHICH ENCOURAGES BOTH THOSE RECEIVING AND PROVIDING CARE TO MAKE RESPONSIBLE CHOICES. *WE STRIVE FOR EXCELLENCE IN QUALITY AND CARE AND SEEK TO CONTINUOUSLY LEARN AND IMPROVE. *WE ACKNOWLEDGE A PARTNERSHIP WITH THE COMMUNITY TO ENSURE THE BEST POSSIBLE CARE AT THE RIGHT TIME, IN THE RIGHT PLACE, AND BY THE RIGHT PROVIDER. *WE ARE CARING AND COMPASSIONATE TO EACH OTHER AND TO THOSE WE SERVE. *WE COMMUNICATE OPENLY AND HONESTLY WITH THE COMMUNITY WE SERVE. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, QUESTION 4A-4D FLETCHER ALLEN HEALTH CARE (FLETCHER ALLEN) IS A TERTIARY CARE TEACHING HOSPITAL THAT, IN AFFILIATION WITH THE UNIVERSITY OF VERMONT, SERVES AS VERMONT'S ONLY ACADEMIC MEDICAL CENTER. AS ARTICULATED IN OUR MISSION STATEMENT, OUR FOCUS IS ON IMPROVING THE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE BY INTEGRATING PATIENT CARE, EDUCATION, AND RESEARCH IN A CARING ENVIRONMENT. THESE EFFORTS ARE RECOGNIZED IN OUR 501(C)(3) STATUS AS A CHARITABLE AND EDUCATIONAL ORGANIZATION. AS A CHARITABLE ORGANIZATION, THE PROMOTION OF HEALTH THROUGH OUR ACADEMIC MISSION - HEALTH CARE DELIVERY, RESEARCH AND EDUCATION - IS OUR PRIMARY WORK. IN ADDITION TO THE COMMUNITY BENEFITS WE PROVIDE, FLETCHER ALLEN OFFERS THE BROAD RANGE AND SCOPE OF SERVICES NECESSARY TO ACHIEVE THAT GOAL. THIS INCLUDES A FULL-TIME EMERGENCY DEPARTMENT THAT IS CERTIFIED AS A LEVEL 1 TRAUMA CENTER BY THE AMERICAN COLLEGE OF SURGEONS, AS WELL AS NON-EMERGENCY SERVICES, ALL OF WHICH ARE AVAILABLE TO ALL PATIENTS REGARDLESS OF INSURANCE STATUS OR ABILITY TO PAY; AN OPEN MEDICAL STAFF THAT INCLUDES APPROXIMATELY 580 PHYSICIANS EMPLOYED BY FLETCHER ALLEN'S FACULTY PRACTICE (THE UNIVERSITY OF VERMONT MEDICAL GROUP), AS WELL AS ABOUT 150 COMMUNITY PHYSICIANS; AND AN INDEPENDENT BOARD OF TRUSTEES THAT REPRESENTS OUR COMMUNITY AS A WHOLE. IN TERMS OF PROGRAM SERVICES, FLETCHER ALLEN'S THREE LARGEST PROGRAMS (BY EXPENSES AND REVENUES) ARE OUR ACTUAL HEALTH CARE DELIVERY SERVICES, AS FOLLOWS: INPATIENT CARE: SERVICES PROVIDED TO THOSE PATIENTS WHO REQUIRE ACUTE-CARE SERVICES IN A HOSPITAL SETTING. THESE SERVICES INCLUDE, FOR EXAMPLE, OUR LABOR AND DELIVERY UNIT, NURSING UNITS FOR GENERAL MEDICAL AND SURGICAL ISSUES, AND OUR INTENSIVE CARE UNITS (INCLUDING A PEDIATRIC ICU, A NEONATAL ICU, A SURGICAL ICU AND A MEDICAL ICU). OUTPATIENT CARE: SERVICES PROVIDED TO THOSE PATIENTS WHO REQUIRE CARE, ON A WALK-IN BASIS, EITHER IN THE HOSPITAL OR IN ONE OF OUR MANY CLINIC SETTINGS. THESE INCLUDE ROUTINE PHYSICIAN VISITS, LABORATORY TESTS, CLINIC VISITS, EMERGENCY ROOM VISITS, AND MEDICAL EQUIPMENT AND SUPPLIES. PROFESSIONAL SERVICES: SERVICES DELIVERED BY MEMBERS OF THE UVM MEDICAL GROUP, OUR EMPLOYED GROUP OF PHYSICIANS. IN ADDITION TO THESE ACCOMPLISHMENTS, PROGRAM SERVICE REVENUES ARE EARNED FROM AND PROGRAM SERVICE EXPENSES ARE SPENT ON VARIOUS OTHER IMPORTANT ACTIVITIES RELATED TO THE ORGANIZATION'S TAX EXEMPT PURPOSE. BUSINESS RELATIONSHIPS FORM 990, PART VI, QUESTION 2 DR. JOHN BRUMSTED, PRESIDENT AND CEO OF FLETCHER ALLEN HEALTH CARE(FAHC), SERVES AS THE CHAIR OF THE BOARD OF DIRECTORS OF VERMONT MANAGED CARE INDEMNITY COMPANY (VMCIC), FAHC'S CAPTIVE INSURANCE COMPANY DOMICILED IN BERMUDA, AND PRESIDENT OF FLETCHER ALLEN HEALTH VENTURES (FAHV). ROGER DESHAIES, CFO AND TREASURER OF FAHC, SERVES AS THE TREASURER AND SECRETARY OF FAHV, AND SERVES AS THE PRESIDENT OF VMCIC. DR. HOWARD SCHAPIRO, INTERIM PRESIDENT AND CEO OF THE UVM MEDICAL GROUP, ALSO SERVES AS THE VICE PRESIDENT FOR FAHV. SANDRA FELIS, SR. VP OF PATIENT CARE SERVICES/CHIEF NURSING OFFICER, ALSO SERVES AS THE VP OF VMCIC. DR. PAUL DANIELSON, TRUSTEE, ALSO SERVES AS A DIRECTOR AT VMCIC. DR. HOWARD M. SCHAPIRO, INTERIM PRESIDENT & CEO OF UVMMG, ALSO SERVES AS A DIRECTOR AT VMCIC. ORGANIZATION MEMBER FORM 990, PART VI, LINES 6 & 7 FLETCHER ALLEN PARTNERS (FAP) HAS POWERS TO ELECT FAHC'S BOARD OF TRUSTEES AND TO APPROVE SIGNIFICANT CORPORATE ACTIONS, INCLUDING ANNUAL OPERATING AND CAPITAL BUDGETS, STRATEGIC PLANS, THE APPOINTMENT OF THE CEP, THE INCURRENCE OF LONG-TERM INDEBTEDNESS, AND AMENDMENTS TO FAHC'S BYLAWS AND ARTICLES OF ORGANIZATION. FAP IS A VERMONT NON-PROFIT CORPORATION WHICH HAS BEEN RECOGNIZED BY THE IRS AS A 501(C)(3) ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION. FORM 990 REVIEW FORM 990, PART VI, QUESTION 11B FLETCHER ALLEN HEALTH CARE'S (FAHC) FORM 990 IS PREPARED BY A PAID PREPARER AND REVIEWED BY FAHC'S INTERNAL MANAGEMENT. FOLLOWING THAT REVIEW, FAHC'S INTERNAL MANAGEMENT PRESENTS THE FORM 990 TO THE AUDIT COMMITTEE FOR REVIEW AND COMMENT. THE COMPLETED FORM 990 IS PROVIDED TO ALL MEMBERS OF THE BOARD OF TRUSTEES PRIOR TO THE FORM BEING FILED WITH THE IRS. CONFLICT OF INTEREST POLICY FORM 990, PART VI, QUESTION 12 THE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. IN ACCORDANCE WITH THE POLICY, TRUSTEES, OFFICERS, KEY EMPLOYEES AND PHYSICIANS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE AND CERTIFICATION UPON HIRING, AT LEAST ANNUALLY, PRIOR TO PARTICIPATING IN ANY DECISION THAT MAY BE AFFECTED BY A PERSONAL INTEREST, AND WHENEVER A POTENTIALLY CONFLICTING INTEREST FIRST ARISES. CONFLICT OF INTEREST DISCLOSURES AND CERTIFICATIONS MAY BE MADE ONLINE OR IN WRITING AND ARE REGULARLY REVIEWED BY THE GENERAL COUNSEL. THE CONFLICT OF INTEREST POLICY IS ENFORCED BY THE OFFICE OF GENERAL COUNSEL AND OVERSEEN BY A FIVE-PERSON CONFLICT OF INTEREST COMMITTEE. THE GENERAL COUNSEL REPORTS AT LEAST QUARTERLY ON CONFLICT OF INTEREST ISSUES TO THE AUDIT COMMITTEE OF THE BOARD OF TRUSTEES. CONFLICTS OF INTEREST ARE MANAGED IN ACCORDANCE WITH THE POLICY, WHICH PROVIDES FOR A VARIETY OF REMEDIES TO ADDRESS CONFLICTS OF INTEREST. IN ADDITION, "DISQUALIFIED PERSONS", CONSISTING OF TRUSTEES, OFFICERS AND KEY EMPLOYEES ARE SUBJECT TO SPECIAL PROCEDURES TO COMPLY WITH THE INTERMEDIATE SANCTION RULES, AS OUTLINED IN THE CONFLICT OF INTEREST POLICY. COMPENSATION DETERMINATION POLICY FORM 990, PART VI, LINE 15A & 15B *FLETCHER ALLEN'S COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES HIRES AN EXTERNAL INDEPENDENT CONSULTING FIRM, INTEGRATED HEALTHCARE STRATEGIES, TO ASSIST THE COMMITTEE IN ESTABLISHING THE TOTAL COMPENSATION FOR THE CEO, OFFICERS AND SENIOR MEMBERS OF THE LEADERSHIP TEAM. *THE COMPENSATION COMMITTEE, AIDED BY INTEGRATED HEALTHCARE STRATEGIES, HAS ESTABLISHED A COMPENSATION PHILOSOPHY FOR THE ORGANIZATION WHICH DEFINES A PEER GROUP OF ORGANIZATIONS ACROSS THE COUNTRY AND INCLUDES ORGANIZATIONS OF SIMILAR SIZE, SCOPE, AND MANAGEMENT CHALLENGE; IT HAS ALSO ESTABLISHED THE COMPETITIVE LEVEL AT WHICH THE COMMITTEE WANTS TO COMPENSATE FLETCHER ALLEN EXECUTIVES COMPARED TO THE PEER GROUP ORGANIZATIONS. *THE TOTAL COMPENSATION PLAN FOR THE EXECUTIVE STAFF INCLUDES APPROPRIATE SALARY RANGES FOR BASE SALARY ADMINISTRATION, ANNUAL AND LONG-TERM, PERFORMANCE-BASED INCENTIVE PROGRAMS AND EXECUTIVE LEVEL BENEFITS. *THE CEO'S TOTAL COMPENSATION IS REVIEWED ANNUALLY, IN CONJUNCTION WITH THE ANNUAL PERFORMANCE EVALUATION, BY THE COMPENSATION COMMITTEE WITH FINAL APPROVAL MADE BY THE BOARD OF TRUSTEES. TOTAL COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS ESTABLISHED BY THE CEO, WITHIN THE PLANS APPROVED BY THE COMMITTEE, AND REVIEWED BY THE COMPENSATION COMMITTEE ANNUALLY. *THE COMMITTEE DETERMINES PERFORMANCE INDICATORS FOR THE INCENTIVE PLANS EACH YEAR. IN ADDITION, THE COMMITTEE REVIEWS THE TOTAL COMPENSATION PLAN PERIODICALLY AND MAKES ANY RECOMMENDATIONS FOR CHANGE AS NEEDED. ALL DECISIONS OF THE COMMITTEE ARE DOCUMENTED IN MINUTES APPROVED BY THE MEMBERS OF THE COMMITTEE. *INTEGRATED HEALTHCARE STRATEGIES BENCHMARKS AND ANALYZES THE TOTAL COMPENSATION FOR THESE EMPLOYEES USING PROPRIETARY HEALTH CARE EXECUTIVE COMPENSATION SURVEYS AND OTHER COMPARATIVE MARKET PAY DATA TO ENSURE THAT THIS COMPENSATION IS COMPETITIVE, EQUITABLE AND MEETS ALL REASONABLENESS STANDARDS. DUE TO THE COMPLEXITY OF THIS REVIEW, CALENDAR YEAR ENDS ARE SOMETIMES SPANNED AND THE PROCESS DOES NOT COME TO CLOSURE EACH AND EVERY FISCAL YEAR. THE MOST RECENT PROCESS BEGAN IN FY13 AND ENDED IN FY14. *INTEGRATED HEALTHCARE STRATEGIES CONDUCTS REASONABLENESS TESTING TO ENSURE THAT THE COMPENSATION PAID TO THESE EMPLOYEES IS CONSISTENT WITH BOARD POLICIES AND IRS REGULATIONS. DOCUMENT DISCLOSURE FORM 990, PART VI, QUESTION 19 GOVERNANCE DOCUMENTS CONSIST OF THE ORGANIZATION'S ARTICLES OF INCORPORATION AND BYLAWS. THE ARTICLES OF INCORPORATION ARE FILED WITH THE VERMONT SECRETARY OF STATE AND ARE PUBLICLY AVAILABLE THROUGH THAT OFFICE. THE BYLAWS ARE NOT PUBLICLY POSTED, BUT WOULD BE FURNISHED TO ANY MEMBER OF THE PUBLIC WHO REQUESTED ONE. THE CONFLICT OF INTEREST POLICY IS NOT PUBLICLY POSTED, BUT WOULD BE FURNISHED TO ANY MEMBER OF THE PUBLIC WHO REQUESTED ONE. WITH THE ENACTMENT OF VERMONTS ACT 48 IN MAY 2011, THE GREEN MOUNTAIN CARE BOARD (GMCB) BECAME THE REGULATORY BODY OVERSEEING HOSPITALS IN THE STATE OF VERMONT. AS A RESULT, THE BUDGET FOR FLETCHER ALLEN IS SUBJECT TO REVIEW BY THE GMCB ON AN ANNUAL BASIS. ONGOING DISCLOSURE OF OPERATING RESULTS IS ALSO REQUIRED AND FLETCHER ALLEN SUBMITS ITS FINANCIAL STATEMENTS REGULARLY THROUGHOUT THE YEAR. FLETCHER ALLEN ALSO REGULARLY DISCLOSES ITS FINANCIAL RESULTS ON ITS WEBSITE AND SUBMITS PRESS RELEASES RELATING TO PERFORMANCE ON A REGULAR BASIS TO LOCAL NEWS ORGANIZATIONS. THE ANNUAL EXTERNAL AUDIT REPORT IS ALSO POSTED ON THE WEB SITE AND IS ATTACHED TO THE CURRENT YEAR'S FORM 990. RECONCILIATION OF NET ASSETS FORM 990, PART XI, LINE 9 PENSION ADJUSTMENT $11,609,000 NET ASSETS RELEASED FROM RESTRICTIONS ($2,702,918) CHANGE IN BENEFICIAL TRUSTS $505,969 ------------- TOTAL OTHER CHANGES IN NET ASSETS $9,412,051 FLETCHER ALLEN SKILLED NURSING LLC 111 COLCHESTER AVENUE BURLINGTON VT 05401 030219309 HOLDING CO VT 943000 4356000 FAHC FLETCHER ALLEN COORDINATED TRANSPORT 111 COLCHESTER AVENUE BURLINGTON VT 05401 030219309 AMBULANCE SVC VT 1049000 2604000 FAHC FLETCHER ALLEN EXECUTIVE SERVICES 111 COLCHESTER AVENUE BURLINGTON VT 05401 030219309 EXEC STAFFING VT 224000 100000 FAHC 116 REALTY LLC 111 COLCHESTER AVENUE BURLINGTON VT 05401 461594847 REALTY VT 127000 18000 FAHC UNIV OF VT MEDICAL GROUP 111 COLCHESTER AVENUE BURLINGTON VT 05401 030225105 PHYSICIAN SVC VT 501(C)(3) 11A-I FAHC true FLETCHER ALLEN MEDICAL GROUP 183 PARK STREET MALONE NY 12953 203905216 PHYSICIAN SVC NY 501(C)(3) 3 FAHC true FLETCHER ALLEN HEALTH CARE FOUNDATION 111 COLCHESTER AVENUE BURLINGTON VT 05401 263159849 FUNDRAISING VT 501(C)(3) 11A-I FAHC true FLETCHER ALLEN HEALTH CARE AUXILIARY 111 COLCHESTER AVENUE BURLINGTON VT 05401 208022004 SERVICE VT 501(C)(3) 11D-III-O NA false Fletcher Allen Partners 111 COLCHESTER AVENUE BURLINGTON VT 05401 452880726 HOLDING CO. VT 501(C)(3) 11A-I NA false Central Vermont Medical Center 130 Fisher Road BERLIN VT 05602 222547186 HOSPITAL VT 501(C)(3) 3 FAP true University Health Center 111 COLCHESTER AVENUE BURLINGTON VT 05401 030229931 HOSPITAL VT 501(C)(3) 11C-III-FI UVMMG true Community Providers Inc 75 Beekman street Plattsburgh NY 12901 222544844 Hlth Svc Coor NY 501(c)(3) 11A-I FAP true Champlain Valley Physicians Medical Ctr 75 Beekman Street Plattsburgh NY 12901 141338471 Hlth Svc Supp NY 501(c)(3) 3 CPI true Elizabethtown Community Hospital 75 ParK street Elizabethtown NY 12932 141364513 Hospital NY 501(c)(3) 3 CPI true Emergency Medical TraNsport of CVPHInc 7S Beekman Street Plattsburgh NY 12901 061718419 Ambulance Svc NY 501(c)(3) 11B-II CPI true CVPH Medical Center Foundation 7S Beekman Street Plattsburah NY 12901 141727048 Hlth Svc Supp NY 501(c)(3) 11B-II CVPH true University Medical Education Associates 89 Beaumont AVENUE Burlington VT 05405 237107832 Educational VT 501(c)(3) 9 UVMMG true OneCare Vermont Accountable Care Organiz 111 Colchester Avenue Burlington VT 05401 455399218 Accountable Care VT NA RELATED 0 25000 false 0 true 0.50000 ADIRONDACKS ACO LLC 75 BEEKMAN STREET PLATTSBURGH NY 12901 462840926 ACCOUNTABLE CARE NY NA N/A FLETCHER ALLEN HEALTH VENTURES 111 COLCHESTER AVENUE BURLINGTON VT 05401 043380045 HOLDING COMPANY VT FAHC C CORP 109858866 29514021 1.00000 true VMC INDEMNITY COMPANY LTD CAPTIVE INSURANCE BD FAHC C CORP 10237541 39846423 1.00000 true VERMONT MANAGED CARE 111 COLCHESTER AVENUE BURLINGTON VT 05401 030333056 MANAGED CARE VT FAHV C CORP true CHARITABLE REMAINDER TRUST (3) SUPPORT VT FAHC TRUST true PERPETUAL TRUST (3) SUPPORT VT FAHC TRUST true CHARITABLE IRREVOCABLE TRUST (7) SUPPORT VT FAHCCVMC TRUST true CHAMPLAIN VALLEY HEALTH NETWORK 75 BEEKMAN STREET PLATTSBURGH NY 12901 161586102 ADMIN SERVICES NY NA C CORP true MEDIQUEST INC PO BOX 1656 PLATTSBURGH NY 12901 141663061 MED. OFFICE LEASE NY NA C CORP true true false true false false false false false true true true true true true true true true true true CENTRAL VERMONT MEDICAL CENTER A 287016 FMV CENTRAL VERMONT MEDICAL CENTER I,K,L 709816 FMV FLETCHER ALLEN MEDICAL GROUP L 99996 COST FLETCHER ALLEN MEDICAL GROUP P 91749 COST UNIVERSITY OF VERMONT MEDICAL GROUP P 119733785 FMV VMC INDEMNITY COMPANY R,Q 7464717 FMV UNIVERSITY HEALTH CENTER C 980515 COST VERMONT MANAGED CAREINC L 437128 COST VERMONT MANAGED CAREINC M,P 4664009 COST VERMONT MANAGED CAREINC Q 3051328 COST VERMONT MANAGED CAREINC S 13963175 COST OneCare Vermont Accountable Care orgLLC C 25000 COST UMEA Q 9651208 COST SCHEDULE R, PART IV, LINE 6 FAHC HAS BENEFICIAL INTEREST IN 4 OF THESE TRUSTS. CVMC HAS BENEFICIAL INTEREST IN 3 OF THESE TRUSTS. SCHEDULE R, PART V FLETCHER ALLEN HEALTH CARE LEASES AND SHARES FACILITIES, EQUIPMENT, AND OTHER ASSETS WITH ITS RELATED ORGANIZATIONS. THE VALUE OF THESE TRANSACTIONS IS INDETERMINABLE.