2024-08-14T16:00:45-05:00 2023-09-30 991856619 GRANT THORNTON ADVISORS LLC 53 STATE STREET SUITE 1600 BOSTON MA 02109 990 2022-10-01 473028931 TWIN RIVERS MEDICAL PC TWIN 5186865770 16 DANFORTH STREET HOOSICK FALLS NY 12090 ROBERT LABA CFO 5186865770 2024-08-14 1 1 ERIN COUTURE P01390592 6177237900 2022 2024-08-08 14:25:15Z CARL DOBSON 16 DANFORTH STREET HOOSICK FALLS NY 12090 1921416 0 X HTTP://RIVER.SVHEALTHCARE.ORG/TWINRIVER/ X 2015 NY TWIN RIVERS MEDICAL PC OPERATES A PRIMARY CARE PHYSICIAN OFFICE. 1 0 0 0 0 0 0 0 2051532 1921408 11 8 0 0 2051543 1921416 0 0 0 0 0 0 0 0 0 3135135 3554107 3135135 3554107 -1083592 -1632691 425776 379908 1614167 1519300 -1188391 -1139392 TWIN RIVERS MEDICAL PC OPERATES A PRIMARY CARE PHYSICIAN OFFICE. 0 0 2953021 1921408 TWIN RIVERS MEDICAL, P.C. IS A FAMILY MEDICINE PRACTICE OFFERING PRIMARY CARE TO CHILDREN, ADOLESCENTS AND ADULTS FOR THE GREATER HOOSICK FALLS AND CAMBRIDGE COMMUNITIES. THE PRACTICE WAS FORMED THROUGH THE MERGER OF MARTINEZ FAMILY PRACTICE AND VILLAGE PRIMARY CARE. TWIN RIVERS MEDICAL PC OFFERS A FULL SPECTRUM OF HEALTH CARE INCLUDING PEDIATRICS, ADOLESCENT, AND ADULT MEDICINE. 2953021 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 1 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 NY X ROBERT LABA 8024475011 16 DANFORTH STREET HOOSICK FALLS NY 12090 CARL DOBSON PRESIDENT 1.00 1.00 X X 0 456524 55245 STEPHEN D MAJETICH CFO / TREASURER 1.00 45.00 X 0 787033 148798 0 1243557 204043 0 0 1 0 0 NET PATIENT SERVICE REVENUE 621110 1921408 1921408 1921408 8 8 1921416 1921408 0 8 X 2208 2208 2744901 2252768 492133 96011 79689 16322 20664 20664 383599 322223 61376 36245 30083 6162 1780 1780 MEDICAL SUPPLIES & DRUG 266118 266118 LICENSES, DUES, SUBS. 2581 2140 441 3554107 2953021 601086 0 65180 39189 20820 19791 137398 30223 16721 16721 548476 274492 185657 273984 0 0 0 0 0 0 425776 379908 41837 74461 0 0 1572330 1444839 1614167 1519300 X -1188391 -1139392 -1188391 -1139392 425776 379908 X -1632691 1681690 X 0 1 X 1 0 X 16660 23227 59495 0 0 99382 1730127 1884360 2015761 2051532 1921408 9603188 1746787 1907587 2075256 2051532 1921408 9702570 0 0 0 9702570 72 57 40 11 8 188 72 57 40 11 8 188 1746859 1907644 2075296 2051543 1921416 9702758 1.00000 1.00000 0.00000 0.00000 X 184404 16980 167424 352967 250293 102674 11105 7219 3886 273984 DUE TO AFFILIATES 1444839 1444839 X PART X, LINE 2: UNCERTAIN TAX POSITIONS: SVHC, SVMC, TWIN RIVERS, NBM, THE FOUNDATION, MAHC, SVHCNY, SVHCHF, SVHCF, AND SVHC REALITY, INC. HAVE BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. THE CORPORATION IS SUBJECT TO TAX ON INCOME UNRELATED TO ITS EXEMPT PURPOSE UNLESS THAT INCOME IS OTHERWISE EXCLUDED BY THE CODE. EACH ORGANIZATION HAS PROCESSES PRESENTLY IN PLACE TO ENSURE THE MAINTENANCE OF ITS TAX-EXEMPT STATUS; TO IDENTIFY AND REPORT UNRELATED INCOME; TO DETERMINE ITS FILING AND TAX OBLIGATIONS IN JURISDICTIONS FOR WHICH IT HAS NEXUS; AND TO IDENTIFY AND EVALUATE OTHER MATTERS THAT MAY BE CONSIDERED TAX POSITIONS. SVHCE IS A FOR PROFIT ENTITY AND ACCOUNTS FOR INCOME TAXES IN ACCORDANCE WITH INCOME TAX ACCOUNTING GUIDANCE. THE CORPORATION FOLLOWS GUIDANCE THAT CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN, INCLUDING ISSUES RELATING TO FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT. THIS GUIDANCE PROVIDES THAT THE TAX EFFECTS FROM AN UNCERTAIN TAX POSITION CAN ONLY BE RECOGNIZED IN THE FINANCIAL STATEMENTS IF THE POSITION IS "MORE-LIKELY-THAN-NOT" TO BE SUSTAINED IF THE POSITION WERE TO BE CHALLENGED BY A TAXING AUTHORITY. THE ASSESSMENT OF THE TAX POSITION IS BASED SOLELY ON THE TECHNICAL MERITS OF THE POSITION, WITHOUT REGARD TO THE LIKELIHOOD THAT THE TAX POSITION MAY BE CHALLENGED. THE CORPORATION HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS AT SEPTEMBER 30, 2023 (SUCCESSOR). 0 1 0 0 0 0 0 0 0 STEPHEN D MAJETICH CFO / TREASURER 0 397656 0 77500 0 311877 0 120012 0 28786 0 935831 0 261827 CARL DOBSON PRESIDENT 0 391024 0 65500 0 0 0 34188 0 21057 0 511769 0 0 PART I, LINE 3 TOP MANAGEMENT OFFICIAL COMPENSATION DETERMINATION: SOUTHWESTERN VERMONT MEDICAL CENTER, A RELATED ORGANIZATION, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE CEO: INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD. PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: CERTAIN LISTED INDIVIDUALS PARTICIPATED IN A NON-QUALIFIED DEFERRED COMPENSATION ARRANGEMENT IN CALENDAR YEAR 2022. UNDER THE TERMS OF THE PLAN, THE INDIVIDUAL BECOMES VESTED IF THEY REMAINED EMPLOYED THROUGH A TARGETED DATE OF THE PLAN. AMOUNTS VESTED IN THE PLAN DURING THE REPORTING PERIOD ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). AMOUNTS SUBJECT TO VESTED REQUIREMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C) AND INCLUDED BELOW. STEPHEN D. MAJETICH: $112,012 FORM 990, PART VI, SECTION A, LINE 6 MEMBERS, STOCKHOLDERS, OR OTHER PERSONS: TWIN RIVERS MEDICAL PC IS ORGANIZED AS A STOCK CORPORATION. THE CORPORATION HAS ONE AUTHORIZED SHAREHOLDER. THE SOLE SHAREHOLDER/DIRECTOR IS AUTHORIZED TO TAKE SUCH ACTIONS AND EXECUTE SUCH DOCUMENTS AS THEY DEEM NECESSARY AND APPROPRIATE TO CARRY OUT THE PURPOSE OF THE ORGANIZATION. THE AFFAIRS OF THE CORPORATION SHALL BE MANAGED AND CONDUCTED BY A SOLE DIRECTOR, SUBJECT TO THE AUTHORITY AND DIRECTION OF THE SVMC BOARD. THE SHAREHOLDER MAY NOT SELL, ASSIGN, TRANSFER, PLEDGE OR GRANT ANY OTHER SECURITY INTEREST OR OTHERWISE ENCUMBER OR DISPOSE OF (COLLECTIVELY, TRANSFER) ANY SHARES OF THE CORPORATION, WHETHER BY DEATH, DEVISE OR OTHERWISE, EXCEPT TO A PHYSICIAN WHO MEETS THE REQUIREMENTS OF ARTICLE I, SECTION 1 OF THE CORPORATION'S BYLAWS, WHICH STATE AS FOLLOWS: "THE CORPORATION'S SHAREHOLDER SHALL BE REQUIRED TO MEET THE FOLLOWING CRITERIA: (I) IS AUTHORIZED BY LAW TO PRACTICE MEDICINE IN THE STATE OF NEW YORK AND DESIGNATED BY SOUTHWESTERN VERMONT MEDICAL CENTER ("SVMC") TO BE A SHAREHOLDER OF THE CORPORATION; (II) IS AN EMPLOYEE OF SVMC AND HAS EXECUTED AN EMPLOYMENT AGREEMENT WITH SVMC; (III) IS A MEMBER OF THE MEDICAL STAFF OF SVMC; (IV) IS ENGAGED IN THE PRACTICE OF MEDICINE IN THE CORPORATION WITHIN THIRTY (30) DAYS OF THE DATE SUCH SHARES ARE ISSUED; AND (V) SUBSCRIBES TO AND COMPLIES WITH THE SHAREHOLDER AGREEMENT WITH THE CORPORATION. UPON TERMINATION OF A SHAREHOLDER'S INTEREST IN THE CORPORATION, THE SHAREHOLDER SHALL BE ENTITLED TO RECEIVE ONLY ONE DOLLAR ($1.00) PER SHARE." THE SHAREHOLDER SHALL NOT ISSUE OR AUTHORIZE THE ISSUANCE OF ANY ADDITIONAL SHARES OR AMEND THE CERTIFICATE OF INCORPORATION OR BYLAWS IN A MANNER ADVERSE TO THE PURPOSES SET FORTH IN THIS AGREEMENT, THE CERTIFICATE OF INCORPORATION, THE BYLAWS OR WITHOUT THE PRIOR WRITTEN CONSENT OF THE CORPORATION AND SVMC. IN NOVEMBER 2022, THE BOARD OF TRUSTEES OF THE CORPORATION APPROVED AN AFFILIATION AND INTEGRATION AGREEMENT (THE AGREEMENT) WITH DARTMOUTH-HITCHCOCK HEALTH ('D-HH'). UNDER THE TERMS OF THE AGREEMENT, THE CORPORATION AND DHH WILL INTEGRATE THEIR GOVERNANCE STRUCTURES, COORDINATE THEIR FINANCIAL ACTIVITIES, AND CONSOLIDATE ADMINISTRATIVE FUNCTIONS OVER TIME TO THE EXTENT THAT EFFICIENCIES CAN BE ACHIEVED. THE AGREEMENT BECAME EFFECTIVE JULY 1, 2023, WHICH HAD D-HH AS THE SOLE CORPORATE MEMBER OF SVHC. FORM 990, PART VI, SECTION A, LINE 7A PLEASE SEE FORM 990, SECTION A, LINE 6 RESPONSE ABOVE. FORM 990, PART VI, SECTION A, LINE 7B PLEASE SEE FORM 990, SECTION A, LINE 6 RESPONSE ABOVE. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO FILING WITH THE IRS, THE DRAFT 990 IS REVIEWED BY THE SOLE DIRECTOR OF TWIN RIVERS MEDICAL PC AS WELL AS THE FINANCE COMMITTEE AND THE BOARD OF DIRECTORS OF SOUTHWESTERN VERMONT HEALTH CARE CORP, A RELATED ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 12C MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: TRUSTEES, SENIOR OFFICERS, AND SENIOR MEDICAL STAFF MEMBERS ARE REQUIRED TO DISCLOSE CONFLICTS OF INTEREST AND POTENTIAL CONFLICTS OF INTEREST TO THE CORPORATE COMPLIANCE OFFICER ANNUALLY. IF THE CORPORATE COMPLIANCE DETERMINES THAT A POTENTIAL CONFLICT OF INTEREST EXISTS, THE MATTER IS REFERRED TO THE AUDIT AND COMPLIANCE COMMITTEE FOR REVIEW AND MAY BE REFERRED TO THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION REVIEW: THE ORGANIZATION'S OFFICER COMPENSATION IS PAID BY SOUTHWESTERN VERMONT MEDICAL CENTER (SVMC). THE PROCESS SVMC USES TO DETERMINE COMPENSATION IS AS FOLLOWS: THE BOARD ENGAGES AN OUTSIDE CONSULTING FIRM TO REVIEW COMPARABLE SALARY DATA AND USES NATIONAL PROFESSIONAL ORGANIZATION SURVEY DATA IN THE DETERMINATION OF SALARY AND BENEFITS. PROCESS BEGINS WITH A REQUEST TO SVMC'S COMPENSATION CONSULTANT ASTRON SOLUTIONS TO PERFORM A MARKET ANALYSIS OF THE POSITION. THIS REPORT IS USED AS THE BASIS FOR STRUCTURING COMPENSATION DURING THE NEXT CONTRACT PERIOD. USING THE RESULTS OF THE MARKET ANALYSIS WITH INPUT FROM OUR CEO, THE COMPENSATION OFFER FOR THE NEXT CONTRACT PERIOD IS DEVELOPED AND INCORPORATED INTO THE CONTRACT. THE COMPENSATION IS THEN DISCUSSED BY THE GOVERNANCE COMMITTEE OF THE BOARD WITH ASTRON SOLUTIONS IN ATTENDANCE. ASTRON SOLUTIONS WILL PROVIDE A WRITTEN LETTER CONFIRMING THEIR AGREEMENT. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PSA FEES (DARTMOUTH HITCHCOCK): PROGRAM SERVICE EXPENSES 1,254,180. TOTAL EXPENSES 1,254,180. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 913,961. MANAGEMENT AND GENERAL EXPENSES 492,133. TOTAL EXPENSES 1,406,094. TRANSCRIPTION SERVICE: PROGRAM SERVICE EXPENSES 13,677. TOTAL EXPENSES 13,677. LOCUMS: PROGRAM SERVICE EXPENSES 70,950. TOTAL EXPENSES 70,950. FORM 990, PART XI, LINE 9: TRANSFER FROM AFFILIATES 1,681,690. SOUTHWESTERN VERMONT HEALTH CARE CORP 100 HOSPITAL DRIVE BENNINGTON VT 05201 030179435 MANAGEMENT VT 501(C)(3) LINE 3 N/A 0 MOUNT ANTHONY HOUSING CORPORATION 100 HOSPITAL DRIVE BENNINGTON VT 05201 030279740 NURSING HOMES VT 501(C)(3) LINE 10 SVHC 0 SOUTHWESTERN VERMONT MEDICAL CENTER 100 HOSPITAL DRIVE BENNINGTON VT 05201 222563241 HOSPITAL VT 501(C)(3) LINE 3 SVHC 0 SOUTHWESTERN VT HEALTH CARE FOUNDATION 100 HOSPITAL DRIVE BENNINGTON VT 05201 453362785 FUNDRAISING VT 501(C)(3) LINE 12A, I SVHC 0 NORTHERN BERKSHIRES MEDICAL PC 375 MAIN STREET WILLIAMSTOWN MA 01267 814023607 HEALTHCARE MA 501(C)(3) LINE 10 SVHC 0 HOOSICK FALLS HEALTH CENTER INC 21 DANFORTH STREET HOOSICK FALLS NY 12090 141370000 NURSING HOMES NY 501(C)(3) LINE 3 SVHC 0 HOOSICK FALLS HEALTH CENTER FOUNDATION 21 DANFORTH STREET HOOSICK FALLS NY 12090 223186959 FUNDRAISING NY 501(C)(3) LINE 7 HFHC 0 SVHC REALTY INC 100 HOSPITAL DRIVE BENNINGTON VT 05201 861399877 REAL ESTATE MANAGEMENT VT 501(C)(3) LINE 12A, I SVHC 0 DARTMOUTH-HITCHCOCK HEALTH ONE MEDICAL CENTER DRIVE LEBANON NH 03756 264812335 PARENT ORGANIZATION NH 501(C)(3) LINE 7 N/A 0 VISITING NURSE ASSOCIATION AND HOSPICE OF VERMONT AND NEW HAMPSHIRE INC 88 PROSPECT STREET WHITE RIVER JUNCTION VT 05001 036006494 HOSPICE VT 501(C)(3) LINE 10 D-HH 0 CHESHIRE MEDICAL CENTER 580 COURT STREET KEENE NH 03431 020354549 HOSPITAL NH 501(C)(3) LINE 3 D-HH 0 WINDSOR HOSPITAL CORPORATION 289 COUNTY ROAD WINDSOR VT 05089 030183721 HOSPITAL VT 501(C)(3) LINE 3 D-HH 0 MARY HITCHCOCK MEMORIAL HOSPITAL ONE MEDICAL CENTER DRIVE LEBANON NH 03756 020222140 HOSPITAL NH 501(C)(3) LINE 3 D-HH 0 DARTMOUTH-HITCHCOCK CLINIC ONE MEDICAL CENTER DRIVE LEBANON NH 03756 222519596 PHYSICIAN SERVICES NH 501(C)(3) LINE 10 D-HH 0 ALICE PECK DAY MEMORIAL HOSPITAL 10 ALICE PECK DAY DRIVE LEBANON NH 03766 020222791 HOSPITAL NH 501(C)(3) LINE 3 D-HH 0 THE NEW LONDON HOSPITAL ASSOCIATION 273 COUNTY ROAD NEW LONDON NH 03257 020222171 HOSPITAL NH 501(C)(3) LINE 3 D-HH 0 SOUTHWESTERN VT HEALTHCARE ENTERPRISES 100 HOSPITAL DRIVE BENNINGTON VT 05201 030314501 HEALTHCARE VT N/A C 0 0 0 0 1 1 0 0 0 0 0 1 0 1 0 1 0 0 0 1 SCHEDULE R PART II- IDENTIFICATION OF RELATED TAX-EXEMPT ORGANIZATIONS: THE REPORTING ORGANIZATION IS A MEMBER OF THE DARTMOUTH-HITCHCOCK HEALTH SYSTEM (ALSO KNOWN AS "DARTMOUTH HEALTH"). ADDITIONAL INFORMATION REGARDING RELATED ORGANIZATIONS CAN BE FOUND ON THE FORM 990, SCHEDULE R FOR DARTMOUTH-HITCHCOCK HEALTH