SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
Medium right arrow Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow Attach to Form 990.
Medium right arrow Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
Windsor Hospital Corporation
 
Employer identification number

03-0183721
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    154,065 0 154,065 0.23 %
b Medicaid (from Worksheet 3, column a) . . . . .     7,913,751 2,474,882 5,438,869 7.95 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     0 0 0 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 0 8,067,816 2,474,882 5,592,934 8.17 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     983,155 513,637 469,518 0.69 %
f Health professions education (from Worksheet 5) . . .     360,253 0 360,253 0.53 %
g Subsidized health services (from Worksheet 6) . . . .     9,683,979 8,337,942 1,346,037 1.97 %
h Research (from Worksheet 7) .     0 0 0 0 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     0 0 0 0 %
j Total. Other Benefits . . 0 0 11,027,387 8,851,579 2,175,808 3.18 %
k Total. Add lines 7d and 7j . 0 0 19,095,203 11,326,461 7,768,742 11.35 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing     0 0 0 0 %
2 Economic development     0 0 0 0 %
3 Community support     0 0 0 0 %
4 Environmental improvements     0 0 0 0 %
5 Leadership development and
training for community members		     0 0 0 0 %
6 Coalition building     0 0 0 0 %
7 Community health improvement advocacy     0 0 0 0 %
8 Workforce development     0 0 0 0 %
9 Other     90,953 0 90,953 0.13 %
10 Total 0 0 90,953 0 90,953 0.13 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
0
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
0
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
24,458,277
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
25,914,937
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-1,456,660
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General Medical and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 Windsor Hospital Corporation
289 County Road
Windsor,VT05089
https://www.mtascutneyhospital.org
863 		X X     X   X   Distinct Part Rehab Unit  
Schedule H (Form 990) 2022
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Schedule H (Form 990) 2022
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Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Windsor Hospital Corporation
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 21
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 21
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): HTTPS://WWW.MTASCUTNEYHOSPITAL.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2022
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Schedule H (Form 990) 2022
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Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Windsor Hospital Corporation
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
https://www.mtascutneyhospital.org/your-visit/billing-financial-assistance
b
https://www.mtascutneyhospital.org/your-visit/billing-financial-assistance
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2022
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Schedule H (Form 990) 2022
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Part VFacility Information (continued)

Billing and Collections
Windsor Hospital Corporation
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2022
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Schedule H (Form 990) 2022
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Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Windsor Hospital Corporation
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2022
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Schedule H (Form 990) 2022
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Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
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 ELEVEN COMMUNITY DISCUSSION GROUPS CONVENED IN THE MT. ASCUTNEY HOSPITAL SERVICE AREA, AND A REVIEW OF AVAILABLE POPULATION DEMOGRAPHICS AND HEALTH STATUS INDICATORS WAS DONE. THE ORGANIZATIONS OTHER THAN HOSPITALS CONSULTED IN CONDUCTING THE CHNA INCLUDED LAKE SUNAPEE REGION VNA AND HOSPICE, VISITNG NURSE AND HOSPICE OF VT AND NH (HOME-VISITNG PROGRAMS FOR FAMILIES WITH YOUNG CHILDREN AND FOR SENIORS WITH COMPLEX HEALTH NEEDS), THE NEW HAMPSHIRE COMMUNITY HEALTH INSTITUTE/JSI, AND OTHER COMMUNITY ORGANIZATIONS SERVING PEOPLE AFFECTED BY POVERTY AND POOR HEALTH. THESE GROUPS HELPED TO RECEIVE INPUT FROM ALL SECTORS, INCLUDNG THE UNINSURED, INCOME-VULNERABLE, AND MEDICALLY UNDERSERVED POPULATIONS. 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
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, 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: LAKE SUNAPEE REGION VNA AND HOSPICE, VISITING NURSE AND HOSPICE FOR VT AND NH, TECHNICAL SUPPORT FROM THE NEW HAMPSHIRE COMMUNITY HEALTH INSTITUTE/JSI; COMMUNITY PARTNERS WHO ASSISTED IN DISSEMINATING THE CHNA THROUGH THEIR NETWORKS INCLUDED WINDSOR SOUTHEAST SUPERVISORY UNION, WINDSOR CENTRAL SUPERVISORY UNION, HUMAN SERVICE AGENCIES FROM THE GREATER UPPER VALLEY INTEGRATED SERVICES TEAM, MAHHC IMMUNIZATION CLINICS, LOCAL BLACK LIVES MATTER/JEDI COMMITTEE, PARENT-CHILD CENTERS, VERMONT STUDENT ASSISTANCE CORPORATION, SOUTH EASTERN VERMONT COMMUNITY ACTION, ECONOMIC SERVICES, WISE, VEGGIE VAN GO, LOCAL TOWN GOVERNMENT'S, AND WINDSOR VT ROTARY.
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, PATCH TEAM, WINDSOR HSA COMMUNITY COLLABORATIVE, GREATER UPPER VALLEY INTEGRATED SERVICES TEAM, MAHHC COMMUNITY HEALTH COMMITTEE AND A REGIONAL CONVENING OF ALL NETWORKS AND WORKGROUPS OF THE COMMUNITY HEALTH IMPLEMENTATION PLAN. AN ELECTRONIC COPY WAS DISSEMINATED TO THE LOCAL TOWN SELECTBOARDS OF WINDSOR, HARTLAND, WEATHERSFIELD, BROWNSVILLE, AND WOODSTOCK. THE CHNA AND ALL INFORMATION IN THE NEEDS ASSESSMENT IS AVAILABLE FOR STAKEHOLDERS. THE CHNA IS ALSO AVAILABLE, UPON REQUEST, VIA PAPER COPY AT THE HOSPITAL'S MAIN INFORMATION DESK.
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. IN FISCAL YEAR 2023, 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. HEALTH EQUITY DECADES LONG STIGMATIZATION OF SUBSTANCE USE AND MENTAL HEALTH CONDITIONS HAS CREATED BARRIERS TO SEEKING HELP. MUCH OF OUR COMMUNITY WORK AIMS TO REDUCE STIGMA, HONORING THE DIGNITY OF EACH PERSON AND HELPING TO INSTILL A SENSE OF BELONGING AND WORTHINESS. SEE WWW.WEAREWORTHWHILE.ORG AND HTTPS://BIT.LY/GPA_SFL OTHER HEALTH EQUITY PROJECTS AIMED AT DECREASING HEALTH DISPARITIES INCLUDE PROVIDING TRANSPORTATION FOR MEDICAL CARE ACCESS AND INCREASED FOOD SECURITY OPTIONS. SUBSTANCE USE TREATMENT AND RECOVERY WE CONTINUED OUR COMMUNITY-BASED INVESTMENTS IN SUBSTANCE USE PREVENTION BY SUBAWARDING FUNDING FOR PREVENTION AND SUPPORTED THE TWICE ANNUAL DEA DRUG TAKE BACK EVENT COLLECTIONS. WE UPDATED A HEALTH DISPARITY DATA REPORT AND CONTINUED ROBUST IMPLEMENTATION OF OUR WWW.WEAREWORTHWHILE.ORG ANTI-SELF-STIGMA CAMPAIGN. WE CONTINUED OUR EMERGENCY DEPARTMENT INITIATIVES: INCREASE ACCESS TO MEDICATION-ASSISTED TREATMENT, ALCOHOL DETOXIFICATION, NARCAN DISTRIBUTION, AND RECOVERY COACHING. WE HAVE WORKED WITH THE SYRINGE SERVICE PROGRAM AND CONNECTICUT VALLEY ADDICTION RECOVERY (CVAR) TO INCREASE EDUCATION AND ACCESS TO HARM REDUCTION SERVICES. MAHHC IS THE ADMINSTRATIVE ENTITY FOR THE STATE OF VERMONT'S HUB AND SPOKE, MAT TREATMENT FRAMEWORK, SUPPORTIING FINANCIAL STABILITY FOR OPIOID AND ALCOHOL TREATMENT PROVIDERS. HEALTHY YOUTH AND FAMILY THROUGH PREVENTION SEVERAL FACTORS IN OUR CULTURE AND SOCIETY CAN INFLUENCE A CHILD OR A FAMILY'S LIFE FOR BETTER OR WORSE. WE WORK TO MANAGE RISK FACTORS AND BUILD PROTECTIVE FACTORS THAT CAN CONTRIBUTE TO POSITIVE, LIFE-LONG IMPACTS. OUR FAMILY WELLNESS PROGRAM PROVIDED 791 WELLNESS COACHING SESSIONS TO PATIENTS AND FAMILIES. WE INVESTED TIME AND EXPERTISE IN SUPPORTING ONGOING, WEEKLY PLAYGROUP CONNECTIONS AND MONTHLY CIRCLE OF SECURITY PARENTING SESSIONS, ONLINE AND IN PERSON. WE CONTINUE TO OFFER THE NATIONALLY RECOGNIZED DULCE PROGRAM, ENTERING THE 5TH YEAR WITH MT ASCUTNEY PEDIATRICS. 202 FAMILIES ENGAGED IN THE DULCE ELEMENT OF PEDIATRICS. SOCIAL SERVICES OUR AREA OF VT HAS ONE OF THE MOST RAPIDLY AGING DEMOGRAPHIC POPULATIONS IN THE STATE AS WELL AS MANY EXPERIENCING POVERTY. MAHHC COMMUNITY HEALTH WORKS TO ADDRESS SENIOR HEALTH AND THE SUPPORT THE SOCIAL CONDITIONS THAT HELP MEET PEOPLE'S BASIC NEEDS. MT ASCUTNEY HEALTH CONNECTIONS IS PART OF THE VT FREE AND REFERRAL CLINICS SYSTEM IN VT. WE DISTRIBUTE VOUCHERS TO MAKE MEDICATION AND DENTAL WORK MORE AFFORDABLE FOR MANY. THE GOAL IS TO ELIMINATE BARRIERS TO ACCESSING MEDICAL CARE. MEDICATION DENTAL VOUCHER SUPPORT IN 2023 TOTALED $30,620. VOLUNTEERS IN ACTION IS PART OF SOCIAL SERVICES AT MAHHC. VIA PROVIDES SERVICES THAT ALLOW MANY TO AGE IN PLACE AND MAINTAIN INDEPENDENCE WITH ASSISTANCE WITH MEALS, TRANSPORTATION, FRIENDLY VISITING, ETC. VIA IS A NEIGHBOR-HELPING-NEIGHBOR APPROACH. IN 2023, VIA PROVIDED 1,940 VOLUNTEER RIDES, DRIVING 16,962 MILES. THE RIDES TO WELLNESS (GAS VOUCHERS TO HEALTH APPOINTMENTS) ALSO PROVIDED 416 RIDES, DRIVING 5,130 MILES. FOR FOOD SECURITY, VIA PROVIDED 19,000 MEALS ON WHEELS AND COLLABORATED WITH THE VERMONT FOOD BANK ON THE VEGGIEVANGO MONTHLY PROGRAM WHICH DISTRIBUTES FREE PRODUCE SERVING 3802 HOUSEHOLDS IN 2023. AT THE MAHHC RUN WINDSOR RESOURCE CENTER, STAFF HELPED A RECORD NUMBER OF 5,653 PEOPLE NAVIGATE TO IMPORTANT SOCIAL SERVICES. BROKEN DOWN, THESE SERVICES HELPED: 43% SENIOR CITIZENS, 21% PERSONS EXPERIENCING MENTAL HEALTH OR SUBSTANCE USE, 25% PERSONS NEEDING HELP WITH BASIC NEEDS SUCH AS FOOD, CLOTHING, LAUNDRY, PERSONAL CARE PRODUCTS, AND SHOWERS.
Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - Windsor Hospital Corporation. Patients whose family income exceeds 300% of FPL may be eligible to receive a discount based on the self-pay balance. Discounts will be granted such that the total self-pay bill does not exceed 10% of 2 years gross income, plus 10% of assets in excess of the sheltered asset calculation as described in the policy. Any discounts for patients whose family exceeds 300% of FPL must be approved by the financial assistance appeals committee based on a written appeal from the patient or responsible party.
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 reference 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.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2022
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Schedule H (Form 990) 2022
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Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?0
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2022
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Schedule H (Form 990) 2022
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Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
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 V, Section B, Line 16i The financial assistance policy located on the hospital's website is downloadable in English; other languages are available upon request. Due to the demographics of the service area another language has not been deemed necessary as the non-English speaking population is estimated to be less than 5% of the total population and consists of multiple other languages spoken by far fewer than 1,000 people each.
Schedule H, Part I, Line 7g Subsidized Health Services The organization did not include any subsidized health service costs attributable to a physician clinic on part I, line 7G.
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 II Community Building Activities THE COMMUNITY BUILDING ACTIVITIES INCLUDE COLLABORATIONS WITH VARIOUS LOCAL AGENCIES SUCH AS THE HOUSING COMMUNITY HEALTH IMPROVEMENT PLAN WORKGROUP AND THE WINDSOR IMPROVEMENT CORPORATION TO IMPROVE THE HEALTH OF THE PEOPLE IN THE AREAS THAT MAHHC SERVES. Additionally, we manage the Windsor Connection Resource Center which hosts many community partner associations including, but not limited to: independent mental health counselors, Health Care & Rehabilitation Services, Senior Solutions, Turning Point Recovery Center of Springfield, Visiting Nurse and Hospice for Vermont and New Hampshire, Vermont Adult Learning, Vermont Department for Children and Families, Vermont Department of Labor, and Vermont Economic Services.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount AS A RESULT OF NEW 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 INCLUDE 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. Because the hospital determined that these services are important to the service area, 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 IN THE FIRST HALF OF 2021 A COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED BY MT. ASCUTNEY HOSPITAL AND HEALTH CENTER IN PARTNERSHIP WITH DARTMOUTH-HITCHCOCK, ALICE PECK DAY MEMORIAL HOSPITAL, VALLEY REGIONAL HEALTH CARE, NEW LONDON HOSPITAL, VISITING NURSE AND HOSPICE OF VERMONT AND NEW HAMPSHIRE, AND THE JOHN SNOW INSTITUTE. THE PURPOSE OF THE ASSESSMENT WAS TO IDENTIFY COMMUNITY HEALTH NEEDS, PRIORITIES AND OPPORTUNITIES FOR COMMUNITY HEALTH AND HEALTH CARE DELIVERY SYSTEM IMPROVEMENT. FOR THE PURPOSE OF THE ASSESSMENT THE GEOGRAPHIC AREA FOR MT. ASCUTNEY HOSPITAL AND HEALTH CENTER WAS 13 MUNICIPALITIES IN VERMONT AND NEW HAMPSHIRE WITH A TOTAL RESIDENT POPULATION OF 44,035 PEOPLE. METHODS EMPLOYED IN THE ASSESSMENT INCLUDED SURVEYS OF COMMUNITY RESIDENTS MADE AVAILABLE ONLINE AND ON PAPER PLACED IN NUMEROUS LOCATIONS THROUGHOUT THE REGION. WE DID A DIRECT EMAIL SURVEY OF KEY STAKEHOLDERS AND COMMUNITY LEADERS REPRESENTING MULTIPLE COMMUNITY SECTORS. WE ORGANIZED AND DELIVERED A SET OF COMMUNITY DISCUSSION GROUPS. WE COMPILED THE RESULTS FROM THE ASSESSMENT ACTIVITIES AND FOCUSED SPECIFICALLY ON BEHAVIORAL HEALTH NEEDS AND GAPS AND A REVIEW OF POPULATION DEMOGRAPHICS AND HEALTH STATUS INDICATORS. ALL INFORMATION FROM THE COLLECTIVE ACTIVITIES WERE ANALYZED TO PRODUCE THE ASSESSMENT WHICH LEAD US IN FOCUSING OUR WORK TO SERVE VULNERABLE AND DISPROPORTIONALLY SERVED POPULATIONS IN THE REGION INCLUDING POPULATIONS THAT EXPERIENCE LIMITED HEALTHCARE TO HEALTH-RELATED SERVICES OR RESOURCES DUE TO INCOME, AGE, DISABILITY AND SOCIAL OR PHYSICAL ISOLATION. IN ADDITION, THE MAHHC COMMUNITY HEALTH STAFF PARTICIPATE IN OR LEAD MULTIPLE COMMUNITY COALITIONS AND PROJECTS CONNECTING US TO A WIDE ARRAY OF COMMUNITY-BASED HEALTH, MUNICIPAL, SCHOOL, SERVICE ORGANIZATION, REGIONAL PLANNING AND STATE PUBLIC HEALTH STAKEHOLDERS. WE REGULARLY REVIEW EMERGING VT STATE HEALTH DATA; QUANTITATIVE AND QUALITATIVE DATA FROM LOCAL SOURCES (NEWSPAPERS, REGIONAL PLANNING OFFICES, COMMUNITY FORUMS), AND CONVERSATIONS WITH COMMUNITY PARTNERS TO IDENTIFY CONCERNS THAT ARE EMERGING, INTENSIFYING, OR ARE THE SOURCE OF LOCAL ATTENTION SINCE THE LAST CHNA WAS CONDUCTED.
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 ASSURE 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 THE HOSPITAL SUPPORTS A DIRECTOR OF COMMUNITY HEALTH, THE MT. ASCUTNEY PREVENTION PROGRAM (MAPP) AND A COMMUNITY HEALTH COMMITTEE WHICH IS A SUBCOMMITTEE OF THE BOARD OF TRUSTEES. 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 WINDSOR PATCH TEAM, THE BLUEPRINT FOR HEALTH CARE COORDINATION TEAM, THE 6 MULTISECTOR WORK GROUPS RESULTING FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT. More than half of the MAHHC Board of Trustees are independent of the organization and the Dartmouth-Health system and reside within the community service area, supporting the health of the local communities. MAHHC EXTENDS PROFESSIONAL STAFF PRIVILEGES TO QUALIFIED AND APPROPRIATE PHYSICIANS AND ALLIED MIDLEVEL PROVIDERS. THIS INCLUDES PHYSICIANS AND MIDLEVEL WHO ARE EMPLOYEES OF DARTMOUTH HITCHCOCK CLINIC, MARY HITCHCOCK MEMORIAL HOSPITAL, AND DARTMOUTH COLLEGE, WHO ALSO MAY HOLD A FACULTY APPOINTMENT AT GEISEL SCHOOL OF MEDICINE. IN ADDITION TO DH-RELATED PHYSICIANS AND MIDLEVEL PROVIDERS, MAHHC EXTENDS PRIVILEGES TO QUALIFIED AND APPROPRIATE PHYSICIANS AND MIDLEVEL PROVIDERS WHO ARE EMPLOYED BY MT. ASCUTNEY HOSPITAL AND HEALTH CENTER AND OTHER QUALIFIED AND APPROPRIATE INDEPENDENT PRACTITIONERS.
Schedule H, Part VI, Line 6 Affiliated health care system THE HOSPITAL'S DIRECTOR OF COMMUNITY HEALTH IS AN ACTIVE PARTICIPANT IN THE REGIONAL COMMUNITY HEALTH COMMITTEE WHICH IS LEAD AND ORGANIZED BY DARTMOUTH-HITCHCOCK. THE HOSPITAL IS AFFILIATED, FORMALLY, WITH DARTMOUTH-HITCHCOCK AS ARE THE OTHER LOCAL HOSPITALS, ALICE PECK DAY MEMORIAL HOSPITAL, NEW LONDON HOSPITAL, AND VALLEY REGIONAL HOSPITAL. THESE HOSPITAL REPRESENTATIVES COLLABORATE AND COMPARE SOLUTIONS AND OFFER SUPPORT TO EACH OTHER IN OUR COMMUNITY HEALTH PROGRAMS.
Schedule H (Form 990) 2022
Additional Data


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