Civic Intelligence

Twin Rivers Medical PC

990 • Fiscal year 2017 • EIN 47-3028931

Oct 01, 2016 to Sep 30, 2017 • Filed on Jan 26, 2018

16 Danforth StreetHoosick Falls, NY 12090

(518) 686-5770

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

98th percentile

2.33x

Higher debt load relative to assets than 98% of similar nonprofits.

2017 filings • NTEE E • $500k-$1M nonprofits • Source year 2017

Liabilities / Revenue

96th percentile

1.59x

Higher debt load relative to revenue than 96% of similar nonprofits.

2017 filings • NTEE E • $500k-$1M nonprofits • Source year 2017

Net Margin

4th percentile

-91%

Higher net margin than 4% of similar nonprofits.

2017 filings • NTEE E • $500k-$1M nonprofits • Source year 2017

Top Officer Pay

95th percentile

$414,289

Higher top officer pay than 95% of similar nonprofits.

Top officer pay equals 53.0% of source-year revenue.

2017 filings • NTEE E • $500k-$1M nonprofits • Source year 2017

Asset Growth

Score unavailable

No value available

No earlier valid filing was available within the previous three public years.

Source year 2017

Revenue Growth

Score unavailable

No value available

No earlier valid filing was available within the previous three public years.

Source year 2017

Assets

$534,840

No earlier filing loaded for comparison.

Net Assets

-$709,451

No earlier filing loaded for comparison.

Liabilities

$1,244,291

No earlier filing loaded for comparison.

Revenue

$782,303

No earlier filing loaded for comparison.

Expenses

$1,491,754

No earlier filing loaded for comparison.

Net Income

-$709,451

No earlier filing loaded for comparison.

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$4.0M$2.0M$0-$2.0M-$4.0MAssets 2017: $534,840Liabilities 2017: $1,244,291Net Assets 2017: -$709,4512017Assets 2018: $474,984Liabilities 2018: $549,510Net Assets 2018: -$74,5262018Assets 2019: $502,452Liabilities 2019: $1,734,525Net Assets 2019: -$1,232,0732019Assets 2020: $435,419Liabilities 2020: $3,040,386Net Assets 2020: -$2,604,9672020Assets 2021: $600,542Liabilities 2021: $705,341Net Assets 2021: -$104,7992021Assets 2022: $425,776Liabilities 2022: $1,614,167Net Assets 2022: -$1,188,3912022Assets 2023: $379,908Liabilities 2023: $1,519,300Net Assets 2023: -$1,139,3922023Assets 2024: $497,239Liabilities 2024: $3,328,887Net Assets 2024: -$2,831,6482024

Highlighted filing

2017

Assets$534,840
Liabilities$1,244,291
Net Assets-$709,451

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$4.0M$2.0M$0-$2.0MRevenue 2017: $782,303Expenses 2017: $1,491,754Net Income 2017: -$709,4512017Revenue 2018: $1,769,862Expenses 2018: $2,949,963Net Income 2018: -$1,180,1012018Revenue 2019: $1,746,799Expenses 2019: $2,911,846Net Income 2019: -$1,165,0472019Revenue 2020: $1,907,644Expenses 2020: $3,280,538Net Income 2020: -$1,372,8942020Revenue 2021: $2,075,296Expenses 2021: $3,237,411Net Income 2021: -$1,162,1152021Revenue 2022: $2,051,543Expenses 2022: $3,135,135Net Income 2022: -$1,083,5922022Revenue 2023: $1,921,416Expenses 2023: $3,554,107Net Income 2023: -$1,632,6912023Revenue 2024: $2,121,450Expenses 2024: $3,813,706Net Income 2024: -$1,692,2562024

Highlighted filing

2017

Revenue$782,303
Expenses$1,491,754
Net Income-$709,451
Jump To
Filing Snapshot
Filing Period
Oct 1, 2016 to Sep 30, 2017
Signed
Jan 26, 2018
Return Version
2016v3.1
Gross Receipts
$782,303
Mission and Program Overview

Mission

NONE.

Twin rivers medical pc operates a primary care physician office.

Balance Sheet Detail
LineBeginningEndChange
Assets
Land, Buildings, and Equipment, Net$0$306,654▲ $306,654
Accounts Receivable$0$117,210▲ $117,210
Cash and Non-Interest-Bearing Accounts$0$110,176▲ $110,176
Prepaid Expenses and Deferred Charges$0$300▲ $300
Savings and Temporary Cash Investments$0$0→ $0
Other Notes and Loans Receivable, Net$0$0→ $0
Pledges and Grants Receivable$0$0→ $0
Receivable From Disqualified Prsn$0$0→ $0
Receivables From Officers Etc$0$0→ $0
Investments Other Securities$0$0→ $0
Investments Program Related$0$0→ $0
Investments in Publicly Traded Securities$0$0→ $0
Intangible Assets$0$0→ $0
Inventories for Sale or Use$0$0→ $0
Loans From Officers Directors$0$0→ $0
Total Assets$0$534,840▲ $534,840
Other Assets Total$0$500▲ $500
Liabilities
Other Liabilities$0$1,172,108▲ $1,172,108
Accounts Payable and Accrued Expenses$0$72,183▲ $72,183
Grants Payable$0$0→ $0
Mortgage Notes Payable Secured by Investment Property$0$0→ $0
Unsecured Notes Loans Payable$0$0→ $0
Deferred Revenue$0$0→ $0
Escrow Account Liability$0$0→ $0
Tax Exempt Bond Liabilities$0$0→ $0
Total Liabilities$0$1,244,291▲ $1,244,291
Net Assets / Fund Balance
Permanently Rstr Net Assets$0$0→ $0
Temporarily Rstr Net Assets$0$0→ $0
Unrestricted Net Assets$0$-709,451▼ $709,451
Total Net Assets Fund Balance$0$-709,451▼ $709,451
Total Liabilities and Net Assets / Fund Balance$0$534,840▲ $534,840

Asset Categories

AssetBook ValueDepreciationBasis
Equipment$296,099$21,059$317,158
Other Land Buildings$10,555$555$11,110
Compensation and Service Providers

Board Members and Trustees

NameTitle
Carl DobsonPresident
Stephen MajetichCFO
Revenue and Support

Revenue Composition

Contributions and Grants
$501
Program Service Revenue
$781,802
Investment Income
$0
Other Revenue
$0
Change in Net Assets
$-709,451

Audited Revenue Reconciliation

Revenue per Audited Statements
$782,303
Revenue Not Reported on Form 990
$-27,329
Total Revenue per Audited Statements
$754,974
Total Revenue per Form 990
$782,303
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$1,491,754
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Fees for Services Other$1,168,979--$1,168,979
Occupancy$70,855$8,030-$78,885
Office Expenses$3,057$60,363-$63,420
Information Technology$30,012--$30,012
Depreciation Depletion$19,414$2,200-$21,614
Other Expenses$6,653$400-$0
Fees for Services Accounting-$685-$685
Travel-$438-$438
Total Functional Expenses$1,419,638$72,116$0$1,491,754

Audited Expense Reconciliation

Line ItemAmount
Total Expenses per Form 990$1,491,754
Expenses per Audited Statements$1,464,425
Total Expenses per Audited Statements$1,464,425
Expenses Not Reported on Financial Statements$27,329
Other Expense Adjustments$27,329
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Direct Expenses$0
Fundraising Gross Income$0
Gaming Direct Expenses$0
Gaming Gross Income$0
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Loans from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Receivables from Disqualified Persons$0$0→ $0
Receivables from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Due to Affiliates$1,172,108
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
No
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
No
Other officer compensation reviewed
No
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
Yes
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, Lines 6, 7A, & 7B

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.

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 board of directors of southwestern vermont health care corp, a related organization.

Form 990, Part VI, Section B, Line 12C

Conflict of interest policy: officers, directors, trustees, and key employees are required to annually disclose interests which could result in conflicts. The compliance officer maintains records on the completion of the conflict of interest forms, any potential conflicts are discussed at the audit and compliance meeting and then recommendations are brought before the full board for a vote. In the case of a potential conflict of interest, the board member abstains from all discussion and consideration of the item that presents the potential conflict. The board of directors of a related organization, svhc, monitors the compliance of twin rivers medical pc through the work of the svhc compliance program.

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.

Filing and Contact Details

Filer

Filer Name
Twin Rivers Medical Pc
EIN
47-3028931
In Care Of
% CARL DOBSON
Phone
5186865770
Address
16 DANFORTH STREET, HOOSICK FALLS, NY 12090

Signing Officer

Name
Carl Dobson
Title
President
Signed
2018-01-26
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Carl Dobson
Formed
2015
Legal Domicile
Ny
Voting Board Members
1
Independent Board Members
1
Employees
0

Preparer

Firm
Bkd Llp
Address
910 E ST LOUIS 200/PO BOX 1190, SPRINGFIELD, MO 65806-2523
Preparer
Brian D Todd
Phone
4178658701
Supplemental Narrative

Additional Explanations

Form 990 Part IX Line 11G

Description:contracted services total fees:410734

Form 990 Part IX Line 11G

Description:psa fees total fees:404279

Form 990 Part IX Line 11G

Description:purchased services total fees:184855

Form 990 Part IX Line 11G

Description:locum fees total fees:169111

Financial Statement Notes

Schedule D, Part X, Line 2

Uncertain tax positions: management has evaluated their income tax positions under the guidance included in asc 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements.

Schedule D, Part XI, Line 2D

Amounts included on line 1, but not on form 990, part viii, line 12: $ ( 27,329) bad debt

Schedule D, Part XII, Line 4B

Amounts included on form 990, part ix, line 25, but not on line 1: $ 27,329 bad debt expense

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IRS990/RcvblFromDisqualifiedPrsnGrp/BOYAmt00
IRS990/RcvblFromDisqualifiedPrsnGrp/EOYAmt00
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IRS990/ReceivablesFromOfficersEtcGrp/BOYAmt00
IRS990/ReceivablesFromOfficersEtcGrp/EOYAmt00
IRS990/ReconcilationRevenueExpnssAmt0-709451
IRS990/RegularMonitoringEnfrcInd0true
IRS990/RelatedEntityInd0true
IRS990/RelatedOrganizationCtrlEntInd0false
IRS990/RelatedOrganizationsAmt0501
IRS990/RentalIncomeOrLossGrp/PersonalAmt00
IRS990/RentalIncomeOrLossGrp/RealAmt00
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IRS990/ReportLandBuildingEquipmentInd0true
IRS990/ReportOtherAssetsInd0false
IRS990/ReportOtherLiabilitiesInd0true
IRS990/ReportProgramRelatedInvstInd0false
IRS990/RevenueAmt0781802
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IRS990/SavingsAndTempCashInvstGrp/EOYAmt00
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IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus3YearsAmt00
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus4YearsAmt00
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/TotalAmt0501
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IRS990ScheduleA/GrossInvestmentIncome509Grp/TotalAmt00
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearAmt0781802
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/TotalAmt0781802
IRS990ScheduleA/GrossReceiptsNonUnrltBusGrp/TotalAmt00
IRS990ScheduleA/InvestmentIncomeAndUBTIGrp/TotalAmt00
IRS990ScheduleA/NetIncomeFromOtherUBIGrp/TotalAmt00
IRS990ScheduleA/OtherIncome509Grp/TotalAmt00
IRS990ScheduleA/Post1975UBTIGrp/TotalAmt00
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IRS990ScheduleA/PublicSupportCY509Pct00.00000
IRS990ScheduleA/PublicSupportTotal509Amt0782303
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IRS990ScheduleA/SubstantialContributorsAmtGrp/TotalAmt00
IRS990ScheduleA/TaxRevLeviedOrgnztnlBnft509Grp/TotalAmt00
IRS990ScheduleA/Total509Grp/CurrentTaxYearAmt0782303
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus1YearAmt00
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus2YearsAmt00
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus3YearsAmt00
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus4YearsAmt00
IRS990ScheduleA/Total509Grp/TotalAmt0782303
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearAmt0782303
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus1YearAmt00
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus2YearsAmt00
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus3YearsAmt00
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus4YearsAmt00
IRS990ScheduleA/TotalSupportCalendarYearGrp/TotalAmt0782303
IRS990/ScheduleBRequiredInd0false
IRS990ScheduleD/EquipmentGrp/BookValueAmt0296099
IRS990ScheduleD/EquipmentGrp/DepreciationAmt021059
IRS990ScheduleD/EquipmentGrp/OtherCostOrOtherBasisAmt0317158
IRS990ScheduleD/ExpensesNotRptFinclStmtAmt027329
IRS990ScheduleD/ExpensesSubtotalAmt01464425
IRS990ScheduleD/FederalIncomeTaxLiabilityAmt00
IRS990ScheduleD/OtherExpensesNotIncludedAmt027329
IRS990ScheduleD/OtherLandBuildingsGrp/BookValueAmt010555
IRS990ScheduleD/OtherLandBuildingsGrp/DepreciationAmt0555
IRS990ScheduleD/OtherLandBuildingsGrp/OtherCostOrOtherBasisAmt011110
IRS990ScheduleD/OtherLiabilitiesOrgGrp/Amt01172108
IRS990ScheduleD/OtherLiabilitiesOrgGrp/Desc0DUE TO AFFILIATES
IRS990ScheduleD/OtherRevenueAmt0-27329
IRS990ScheduleD/RevenueNotReportedAmt0-27329
IRS990ScheduleD/RevenueSubtotalAmt0782303
IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt0UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt1AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $ ( 27,329) BAD DEBT
IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt2AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 27,329 BAD DEBT EXPENSE
IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc0SCHEDULE D, PART X, LINE 2
IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc1SCHEDULE D, PART XI, LINE 2D
IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc2SCHEDULE D, PART XII, LINE 4B
IRS990ScheduleD/TotalBookValueLandBuildingsAmt0306654
IRS990ScheduleD/TotalExpensesPerForm990Amt01491754
IRS990ScheduleD/TotalLiabilityAmt01172108
IRS990ScheduleD/TotalRevenuePerForm990Amt0782303
IRS990ScheduleD/TotalRevEtcAuditedFinclStmtAmt0754974
IRS990ScheduleD/TotExpnsEtcAuditedFinclStmtAmt01464425
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IRS990ScheduleJ/CompBasedOnRevenueOfFlngOrgInd0false
IRS990ScheduleJ/CompBsdNetEarnsFlngOrgInd0false
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IRS990ScheduleJ/CompBsdOnRevRelatedOrgsInd0false
IRS990ScheduleJ/EquityBasedCompArrngmInd0false
IRS990ScheduleJ/InitialContractExceptionInd0false
IRS990/ScheduleJRequiredInd0true
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusFilingOrganizationAmount00
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompReportPrior990FilingOrgAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompReportPrior990RltdOrgsAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompensationFlngOrgAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompRltdOrgsAmt028240
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/NontaxableBenefitsFilingOrgAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/NontaxableBenefitsRltdOrgsAmt025632
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/OtherCompensationFilingOrgAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/OtherCompensationRltdOrgsAmt02774
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm0STEPHEN MAJETICH
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt0CFO
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationFilingOrgAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationRltdOrgsAmt0414289
IRS990ScheduleJ/SeverancePaymentInd0false
IRS990ScheduleJ/SupplementalInformationDetail/ExplanationTxt0TOP MANAGEMENT OFFICIAL COMPENSATION DETERMINATION: SOUTHWESTERN VERMONT MEDICAL CENTER, A RELATED ORGANIZATION, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE CEO: COMPENSATION COMMITTEE, WRITTEN EMPLOYMENT CONTRACT, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: CONTRIBUTIONS TO NONQUALIFIED PLANS: $ 20,240 STEPHEN MAJETICH
IRS990ScheduleJ/SupplementalInformationDetail/ExplanationTxt1BONUS DETERMINATION: THE AMOUNT OF INCENTIVE COMPENSATION IS CALCULATED IN ACCORDANCE WITH THE FORMAL INCENTIVE COMPENSATION PROGRAM THAT WAS DEVELOPED BY SVHC'S HUMAN RESOURCE DEPARTMENT IN CONJUNCTION WITH OUR COMPENSATION CONSULTANT MIKE MACIEKOWICH OF ASTRON SOLUTIONS. THE ESSENCE OF THE PROGRAM IS TO REWARD OUR CEO FOR ACHIEVING POSITIVE RESULTS ON BOTH ORGANIZATIONAL AND INDIVIDUAL GOALS. GOALS ARE ESTABLISHED BY THE GOVERNANCE COMMITTEE PRIOR TO THE BEGINNING OF THE FISCAL YEAR. TYPICALLY THERE WILL BE FIVE TO SIX ORGANIZATIONAL GOALS AND EIGHT TO TEN INDIVIDUAL GOALS. SUCCESSFUL ACHIEVEMENT OF THESE GOALS RESULTS IN ADDITIONAL COMPENSATION FOR THE CEO; HOWEVER, NO PAYOUT IS MADE UNLESS SVHC'S FINANCIAL GOAL IS ACHIEVED.
IRS990ScheduleJ/SupplementalInformationDetail/FormAndLineReferenceDesc0SCHEDULE J, PART I, LINE 3
IRS990ScheduleJ/SupplementalInformationDetail/FormAndLineReferenceDesc1SCHEDULE J, PART II, COLUMN B(II)
IRS990ScheduleJ/SupplementalNonqualRtrPlanInd0true
IRS990/ScheduleORequiredInd0true
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0MEMBERS, 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.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1FORM 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 BOARD OF DIRECTORS OF SOUTHWESTERN VERMONT HEALTH CARE CORP, A RELATED ORGANIZATION.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2CONFLICT OF INTEREST POLICY: OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO ANNUALLY DISCLOSE INTERESTS WHICH COULD RESULT IN CONFLICTS. THE COMPLIANCE OFFICER MAINTAINS RECORDS ON THE COMPLETION OF THE CONFLICT OF INTEREST FORMS, ANY POTENTIAL CONFLICTS ARE DISCUSSED AT THE AUDIT AND COMPLIANCE MEETING AND THEN RECOMMENDATIONS ARE BROUGHT BEFORE THE FULL BOARD FOR A VOTE. IN THE CASE OF A POTENTIAL CONFLICT OF INTEREST, THE BOARD MEMBER ABSTAINS FROM ALL DISCUSSION AND CONSIDERATION OF THE ITEM THAT PRESENTS THE POTENTIAL CONFLICT. THE BOARD OF DIRECTORS OF A RELATED ORGANIZATION, SVHC, MONITORS THE COMPLIANCE OF TWIN RIVERS MEDICAL PC THROUGH THE WORK OF THE SVHC COMPLIANCE PROGRAM.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3DOCUMENT DISCLOSURE: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4DESCRIPTION:CONTRACTED SERVICES TOTAL FEES:410734
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt5DESCRIPTION:PSA FEES TOTAL FEES:404279
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt6DESCRIPTION:PURCHASED SERVICES TOTAL FEES:184855
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt7DESCRIPTION:LOCUM FEES TOTAL FEES:169111
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PART VI, SECTION A, LINES 6, 7A, & 7B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PART VI, SECTION B, LINE 11B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PART VI, SECTION B, LINE 12C
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3FORM 990, PART VI, SECTION C, LINE 19
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc4FORM 990 PART IX LINE 11G
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc5FORM 990 PART IX LINE 11G
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc6FORM 990 PART IX LINE 11G
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc7FORM 990 PART IX LINE 11G
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IRS990ScheduleR/AssetSaleToOtherOrgInd0false
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IRS990ScheduleR/GiftGrntOrCapContriToOthOrgInd0false
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IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/DirectControllingEntityName/BusinessNameLine1Txt0SVHC
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/EIN0030314501
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/EntityTypeTxt0C CORP
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/LegalDomicileStateCd0VT
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/PrimaryActivitiesTxt0HEALTHCARE
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/RelatedOrganizationName/BusinessNameLine1Txt0SOUTHWESTERN VT HEALTHCARE ENTERPRISES
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/USAddress/AddressLine1Txt0100 HOSPITAL DRIVE
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/USAddress/CityNm0BENNINGTON
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/USAddress/StateAbbreviationCd0VT
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/USAddress/ZIPCd005201
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