| Form 990, Part VI, Section A, line 6 |
Copley Hospital, Inc. is a member organization whose sole corporate member is Copley Health Systems, Inc. Copley Health Systems, Inc. and the Hospital share the same board of trustees. |
| Form 990, Part VI, Section A, line 7a |
Copley Hospital, Inc. shares the same board as Copley Health Systems, Inc. Each year, the members of Copley Health Systems, Inc. will hold an annual meeting. The purposes of the annual meeting shall include the election of members to the Corporation, the election of Trustees to the Corporation's Board of Trustees, the election of the community member at large of the governance and bylaws committee, and the transaction of such other business as may properly come before the membership. The Board shall consist of up to twenty-one elected members, the Chief Executive Officer of the Corporation and the President of the Medical Staff of Copley Hospital, Inc., all as voting members. All Trustees must be members of the Corporation. |
| Form 990, Part VI, Section B, line 11 |
The finance committee reviews the Form 990 prior to submission. A complete copy of the form is made available to all members of the governing body through the finance office. |
| Form 990, Part VI, Section B, line 12c |
The Governance Committee reviews the statements and surveys completed by interested persons and maintains a list of individuals who may be considered disqualified persons under IRS regulations. The Governance Committee reports the results of its reviews annually to the Board. The internal Compliance Committee of the Corporation reviews any potential conflict of interest which involves an interested person who is not a trustee or officer of the Corporation. The internal Compliance Committee reports the results of its reviews annually to the Board. |
| Form 990, Part VI, Section B, line 15 |
The CEO's pay is determined through the use of an outside compensation firm. Senior leadership and other highly compensated individuals have their pay ranges determined through market data from Astron Solutions. The compensation for the CEO is approved by the Board. |
| Form 990, Part VI, Section C, line 19 |
The governing documents are made available upon request. The conflict of interest policy and Matrix are available upon request. The financial statements are summarized in an annual report that is available to the public. The Hospital also submits both their budget and actual financial information to the State of Vermont's Green Mountain Care Board. |
| Form 990, Part IX, line 11g |
Other Fees: Program service expenses 2,096,121. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,096,121. Contract Labor: Program service expenses 1,135,543. Management and general expenses 54,967. Fundraising expenses 0. Total expenses 1,190,510. Purchased Services: Program service expenses 3,071,651. Management and general expenses 801,824. Fundraising expenses 0. Total expenses 3,873,475. |
| Form 990, Part X, Line 10: Land, Buildings, and Equipment |
Section 1.263(a)-3(n) Election: Copley Hospital, Inc. 528 Washington Highway Morrisville, VT 05661 EIN: 03-0179423 Copley Hospital, Inc. is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). |
| Form 990, Part XI, line 9: |
Change in Beneficial Interest in Net Assets of Copley Health Systems, Inc. 65,188. |
Attach to Form 990 or 990-EZ.