TY 2023 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) ANNE BONGIORNO...................................................................... VICE CHAIR	1.8 ................. 0.2	X	X	0	0
(2) BOB BLEIMEISTER...................................................................... TREASURER	1.8 ................. 0.2	X	X	0	0
(3) DEBORAH POMEROY...................................................................... SECRETARY	1.8 ................. 0.2	X	X	0	0
(4) JOSEPH WOODIN...................................................................... CEO	37.0 ................. 3.0	X	X	549,417	21,957
(5) KATHY DEMARS...................................................................... TRUSTEE / CHAIR BEG 02/24	1.8 ................. 0.2	X	X	0	0
(6) NANCY BANKS...................................................................... CHAIR END 02/24	1.8 ................. 0.2	X	X	0	0
(7) ALDEN LAUNER...................................................................... TRUSTEE	1.8 ................. 0.2	X		0	0
(8) BETHANY SALVAS...................................................................... TRUSTEE BEG 02/24	1.8 ................. 0.2	X		0	0
(9) CAMERON PAGE...................................................................... TRUSTEE	1.8 ................. 0.2	X		0	0
(10) CARL SZLACHETKA...................................................................... TRUSTEE	3.8 ................. 1.2	X		0	0
(11) CHRISTOPHER TOWNE...................................................................... TRUSTEE	1.8 ................. 0.2	X		0	0
(12) DAN NOYES...................................................................... TRUSTEE	1.8 ................. 0.2	X		0	0
(13) DAVID SILVERMAN...................................................................... TRUSTEE END 02/24	1.8 ................. 0.2	X		0	0
(14) DIANE COTE...................................................................... TRUSTEE	1.8 ................. 0.2	X		0	0
(15) FRANCIS LANDREY...................................................................... TRUSTEE BEG 02/24	1.8 ................. 0.2	X		0	0
(16) J MARTIN LINSEISEN MD...................................................................... TRUSTEE END 02/24	39.8 ................. 0.2	X		404,314	52,647
(17) JAMES HODGE...................................................................... TRUSTEE BEG 02/24	1.8 ................. 0.2	X		0	0

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(18) KRISTEN SHARPLESS........................................................................ TRUSTEE END 06/24	1.8 .......................0.2	X			0	0
(19) MIKE FEULNER........................................................................ TRUSTEE	1.8 .......................0.2	X			0	0
(20) NAN CARLE BEAUREGARD........................................................................ TRUSTEE	1.8 .......................1.2	X			0	0
(21) PAMELA STANYON........................................................................ TRUSTEE	1.8 .......................0.2	X			0	0
(22) TRAVIS KNAPP........................................................................ TRUSTEE BEG 02/24 / ANESTHESIA DIRECTOR	39.8 .......................0.2	X			427,820	53,221
(23) WALTER FRAME........................................................................ TRUSTEE END 02/24	1.8 .......................1.2	X			0	0
(24) JEFFREY HEBERT........................................................................ CFO	37.0 .......................3.0		X		260,707	11,409
(25) LORI PROFOTA........................................................................ CNO END 02/24	38.0 .......................2.0		X		218,967	38,976
(26) SAMANTHA ALLAIRE........................................................................ NURSE MGR / INTERIM CNO BEG 07/23	38.0 .......................2.0		X		87,364	41,057
(27) WAYNE STOCKBRIDGE........................................................................ CHIEF ADMIN & HR OFFICER	37.0 .......................3.0		X		249,773	50,539
(28) BRIAN AROS........................................................................ ORTHOPEDIC SURGEON	40.0 .......................0.0			X	1,003,388	50,858
(29) BRYAN MONIER........................................................................ ORTHOPEDIC SURGEON	40.0 .......................0.0			X	608,688	50,531
(30) JOHN MACY........................................................................ ORTHOPEDIC SURGEON	40.0 .......................0.0			X	881,221	41,559
(31) JOSEPH MCLAUGHLIN........................................................................ ORTHOPEDIC SURGEON	40.0 .......................0.0			X	779,567	51,736
(32) NICHOLAS ANTELL........................................................................ ORTHOPEDIC SURGEON	40.0 .......................0.0			X	667,434	41,077

(A) Name and business address	(B) Description of services	(C) Compensation
MEDEFIS INC PO BOX 5068 NEW YORK,NY10087	CONTRACTED LABOR	5,816,919
BERSTEIN-MAGOON-GAY LLC PO BOX 830460 PHILADELPHIA,PA19182	LAUNDRY SERVICES	528,978
WEATHERBY LOCUMS INC PO BOX 972633 DALLAS,TX753972633	CONTRACTED LABOR-PROVIDERS	424,001
FORVIS MAZARS LLP PO BOX 200870 DALLAS,TX753200870	AUDIT/TAX SERVICES	261,961
UNIVERSITY MEDICAL CENTER PO BOX 1902 BURLINGTON,VT05402	LAB SERVICES	259,079
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 9

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

Copley Hospital Inc

Employer identification number

03-0179423

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2023

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf ....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2022. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2023. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990) 2023

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3 % support tests—2022. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2023

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2023

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2023

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2023

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2023 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Name of the organization

Copley Hospital Inc

Employer identification number

03-0179423

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization Copley Hospital Inc

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization Copley Hospital Inc		Employer identification number 03-0179423

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization Copley Hospital Inc			Employer identification number 03-0179423
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2023)

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

right arrow

Complete if the organization is described below. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Copley Hospital Inc

Employer identification number

03-0179423

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... right arrow

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... right arrow

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ right arrow

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... right arrow

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990) 2022

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check right arrow

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check right arrow

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2022

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

23,770

Total. Add lines 1c through 1i ....................................................................................................

23,770

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	THE ORGANIZATION PAYS DUES TO THE VERMONT ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS (VAHHS) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA). A PORTION OF THESE DUES, TOTALING $23,770, ARE ATTRIBUTABLE TO LOBBYING PURPOSES.

Schedule C (Form 990) 2022

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
right arrow

Attach to Form 990.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

Copley Hospital Inc

Employer identification number

03-0179423

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after July 25, 2006, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year right arrow

Number of states where property subject to conservation easement is located right arrow

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2022

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	5,249,881	5,034,191	4,866,658	4,765,579	4,644,722
b	Contributions ...	31,730	31,180	40,000	300	3,000
c	Net investment earnings, gains, and losses	-2,900,599	184,510	127,533	100,779	117,857
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	2,381,012	5,249,881	5,034,191	4,866,658	4,765,579

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment right arrow

0 %

Permanent endowment right arrow

100 %

Term endowment right arrow

0 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

Yes

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	1,840,040		1,840,040
b	Buildings ....	48,533,340	20,683,010	27,850,330
c	Leasehold improvements
d	Equipment ....	27,374,181	18,772,391	8,601,790
e	Other .....	2,371,965	866,521	1,505,444
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				39,797,604

Schedule D (Form 990) 2022

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3) Other (A) INTEREST IN CHSI	6,979,020	F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	6,979,020

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)DEFERRED COMPENSATION PLAN ASSETS				4,022,686
(2)RIGHT-OF-USE ASSETS				2,125,237
(3)OTHER RECEIVABLES				631,256
(4)DUE FROM AFFILIATE				387,898
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				7,167,077

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
DUE TO THIRD PARTY PAYORS	6,942,000
DEFERRED COMPENSATION	4,022,686
ESTIMATED SELF-INSURANCE	3,307,191
LEASE LIABILITIES	2,125,237
ASSET RETIREMENT OBLIGATION	1,500,000




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	17,897,114
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2022

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	107,626,908
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ...........	2d	0
e	Add lines 2a through 2d .....................			2e	0
3	Subtract line 2e from line 1..................			3	107,626,908
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b	0
c	Add lines 4a and 4b....................			4c	0
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	107,626,908

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	104,081,487
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ...........	2d	0
e	Add lines 2a through 2d....................			2e	0
3	Subtract line 2e from line 1...................			3	104,081,487
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ...........	4b	0
c	Add lines 4a and 4b.....................			4c	0
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	104,081,487

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
Schedule D, Part V, Line 4 Intended uses of endowment funds	THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS IS TO HELP SERVE THE LONG-TERM VIABILITY OF COPLEY HOSPITAL, INC. THESE ENDOWMENT FUNDS ARE HELD BY COPLEY HEALTH SYSTEM, INC.

Schedule D (Form 990) 2022

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

2023

Open to Public Inspection

Name of the organization

Copley Hospital Inc

Employer identification number

03-0179423

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other 30000 %

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: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other 60000 %

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.

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"? . . . . . . . . . . . . .

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

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? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

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) . . .			963,884		963,884	0.93 %
b	Medicaid (from Worksheet 3, column a) . . . . .			18,488,252	13,820,685	4,667,567	4.48 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .					0	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	0	19,452,136	13,820,685	5,631,451	5.41 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).			3,594	550	3,044	0 %
f	Health professions education (from Worksheet 5) . . .					0	0 %
g	Subsidized health services (from Worksheet 6) . . . .			5,752,220	1,043,383	4,708,837	4.52 %
h	Research (from Worksheet 7) .					0	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .					0	0 %
j	Total. Other Benefits . .	0	0	5,755,814	1,043,933	4,711,881	4.53 %
k	Total. Add lines 7d and 7j .	0	0	25,207,950	14,864,618	10,343,332	9.94 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

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 %
2	Economic development					0	0 %
3	Community support					0	0 %
4	Environmental improvements					0	0 %
5	Leadership development and training for community members					0	0 %
6	Coalition building					0	0 %
7	Community health improvement advocacy					0	0 %
8	Workforce development					0	0 %
9	Other					0	0 %
10	Total	0	0	0	0	0	0 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

5,155,785

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. ......

469,176

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

Enter total revenue received from Medicare (including DSH and IME).....

26,757,769

Enter Medicare allowable costs of care relating to payments on line 5.....

26,844,197

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-86,428

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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 .........................

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) 2023

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)
1	COPLEY HOSPITAL INC 528 WASHINGTON HIGHWAY MORRISVILLE,VT05661 WWW.COPLEYVT.ORG 891	X	X	X	X

Schedule H (Form 990) 2023

Page 4

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)

	COPLEY HOSPITAL INC
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):

Yes

Community Health Needs Assessment

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?........................

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...............

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......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 23

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 .................

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..................................

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. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): HTTPS://WWW.COPLEYVT.ORG/ABOUT-US/NEWSLETTER

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 23

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): HTTPS://WWW.COPLEYVT.ORG/ABOUT-US/NEWSLETTER/

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

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) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	COPLEY HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 300.0%
and FPG family income limit for eligibility for discounted care of 600.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

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):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

WWW.COPLEYVT.ORG/FOR-PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/ASSISTANCE-PROGRAMS/

The FAP application form was widely available on a website (list url):

WWW.COPLEYVT.ORG/FOR-PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/ASSISTANCE-PROGRAMS/

A plain language summary of the FAP was widely available on a website (list url):
WWW.COPLEYVT.ORG/FOR-PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/ASSISTANCE-PROGRAMS/

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	COPLEY HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Yes

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?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	COPLEY HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Yes

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.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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? ...............................

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

Page 8

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 5 Facility , 1	Facility , 1 - COPLEY HOSPITAL. COMMUNITY INPUT: THE INFORMATION CONTAINED IN THE 2024 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS OBTAINED PRIMARILY THROUGH A COMMUNITY SURVEY TAKEN BETWEEN MAY 23 AND JUNE 24, 2024. OTHER INFORMATION WAS OBTAINED THROUGH REPORTS DEVELOPED BY THE STATE OF VERMONT, THE FEDERAL GOVERNMENT, INDEPENDENT RESEARCH ORGANIZATIONS, AND LOCAL NONPROFIT AGENCIES SERVING PEOPLE WITHIN OUR SERVICE AREA. COMMUNITY HEALTH NEEDS ASSESSMENT SURVEYS: THE 2024 COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY WAS OPEN FOR RESPONSES BETWEEN MAY 23 AND JUNE 24, 2024 AND WAS CONDUCTED THROUGH SURVEY MONKEY AS WELL AS PRINTED COPIES MADE AVAILABLE AT THE HOSPITAL AND SATELLITE OFFICES. THE LINK TO THE SURVEY MONKEY SURVEY WAS DISTRIBUTED VIA EMAIL TO COPLEY HOSPITAL TRUSTEES, COMMITTEE MEMBERS AND AMBASSADORS, LOCAL PROVIDERS, AND DIRECTLY TO MEMBERS OF THE COMMUNITY. IT WAS ALSO AVAILABLE ON OUR WEBSITE, FACEBOOK PAGE, AND ON FRONT PORCH FORUM, A COMMUNITY BULLETIN BOARD FREQUENTED BY NUMEROUS PEOPLE WITHIN OUR SERVICE AREA. ALTHOUGH HUNDREDS OF SURVEYS WERE GIVEN OUT AND THE LINK WAS AVAILABLE TO THOUSANDS OF RESIDENTS, WHEN THE SURVEY CLOSED, WE HAD RECEIVED JUST UNDER 300 RESPONSES. OF THOSE RESPONDING, 42 PERCENT WERE AGE 65 OR OLDER; 26 PERCENT WERE BETWEEN THE AGES OF 55-64; 13 PERCENT WERE BETWEEN THE AGES OF 45-54; 12 PERCENT WERE BETWEEN THE AGES 35-44; AND SIX PERCENT WERE BETWEEN THE AGES 18-34. (ONE PERCENT OF SURVEY RESPONDENTS DID NOT INDICATE THEIR AGE.)
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - COPLEY HOSPITAL. HEALTHCARE NEED #1: ACCESS TO PRIMARY CARE VERMONT IS AMONG THE MOST RURAL STATES IN THE NATION BASED ON THE SIZE OF ITS CITIES AND TOWNS, AND ACCESS TO A PHYSICIAN FOR PRIMARY AND PREVENTATIVE CARE IS CONSISTENTLY A MAJOR CONCERN. WHILE VERMONT REMAINS ONE OF THE HEALTHIEST STATES IN THE COUNTRY, IT IS ALSO THE THIRD OLDEST STATE IN THE COUNTRY (DATAPANDAS.ORG 2024), NOT ONLY IN TERMS OF ITS GENERAL POPULATION, BUT ALSO ITS PHYSICIANS AND PRIMARY CARE PROVIDERS. ACCORDING TO THE VERMONT DEPARTMENT OF HEALTH (2023), BASED ON THE MOST RECENTLY AVAILABLE STATISTICS: OF 2,633 PHYSICIANS PROVIDING PATIENT CARE IN VERMONT 2,470 IDENTIFY AS MEDICAL DOCTORS AND 163 AS DOCTORS OF OSTEOPATHY. 572 OF THESE PROVIDE TELEMEDICINE SERVICES ONLY. ALSO: - 566 PHYSICIANS PROVIDE MAINLY PRIMARY CARE, AND 584 PHYSICIANS PROVIDE "ANY" PRIMARY CARE, CORRESPONDING TO 426.3 FULL TIME EQUIVALENTS (FTES). THESE NUMBERS ARE DOWN FROM 615 PHYSICIANS PROVIDING MAINLY PRIMARY CARE; 627 PROVIDING "ANY" PRIMARY CARE; AND 435.9 FULL TIME EQUIVALENTS (FTES) IN 2018. THE NUMBER OF PRACTICING PHYSICIANS IN VERMONT HAS BEEN TRENDING DOWNWARD FOR MORE THAN A DECADE AS PHYSICIANS RETIRE OR REDUCE THE NUMBER OF PATIENTS THEY SEE. - 2,067 PHYSICIANS PROVIDE MAINLY SPECIALTY CARE. EXCLUDING RADIOLOGISTS, PATHOLOGISTS, AND TELEMEDICINE, 1,398 PHYSICIANS PROVIDE "ANY" SPECIALTY CARE, CORRESPONDING TO 974.2 FTES. UNLIKE THE DOWNWARD TREND IN PHYSICIANS OFFERING PRIMARY CARE, THIS IS AN INCREASE FROM 2018, WITH AN ADDITIONAL LARGE JUMP IN TELEMEDICINE PROVIDERS IN MULTIPLE SPECIALTIES. - 33 PERCENT OF VERMONT PRIMARY CARE PHYSICIANS ARE OVER AGE 60, A DECREASE FROM THE 36 PERCENT WHO WERE OVER AGE 60 IN 2018. WHILE THIS APPEARS TO BE A POSITIVE TREND, IT MAY ACTUALLY BE AN INDICATOR THAT SOME OLDER PHYSICIANS ARE BEGINNING TO LEAVE ACTIVE PRACTICE. IN LAMOILLE COUNTY, 37 PERCENT OF PRIMARY CARE PHYSICIANS ARE OVER AGE 60. - THE PREVALENCE OF TELEMEDICINE HAS INCREASED SIGNIFICANTLY SINCE 2018, MOSTLY IN RADIOLOGY, BUT NOW ALSO IN EMERGENCY MEDICINE, INTERNAL MEDICINE SUB-SPECIALTIES, NEUROLOGY, AND OTHER SPECIALTIES. - IN LAMOILLE COUNTY, 85 PERCENT OF PRIMARY CARE PHYSICIANS (IN OFFICE SETTINGS) CONTINUE TO ACCEPT NEW PATIENTS; 85 PERCENT ACCEPT NEW MEDICAID PATIENTS; AND 84 PERCENT ACCEPT NEW MEDICARE PATIENTS. THESE PERCENTAGES ARE ABOVE (BETTER THAN) THE OVERALL VERMONT AVERAGES. - VERMONT SAW A DECREASE OF 9.6 PRIMARY CARE FTES BETWEEN 2018 AND 2020, A 2 PERCENT DROP, AS SOME PHYSICIANS HAVE RETIRED OR REDUCED THEIR WORK HOURS. CONVERSELY, THERE IS AN INCREASE OF 42.1 FTES IN SPECIALTY CARE. IN LAMOILLE COUNTY, THERE ARE 14.5 FTE PHYSICIANS (DOWN FROM 16 IN 2021), RESULTING IN A RATIO (PHYSICIANS TO THE GENERAL POPULATION) OF 1:1,786. IN 2021 THE RATIO WAS 1:1,578. ON A NATIONAL LEVEL, THE NUMBER OF PRIMARY CARE PROVIDERS DECREASED 13% BETWEEN 2022 AND 2023 - A NATIONWIDE DECLINE OF OVER 107,000 PROVIDERS. WHILE THE TRENDS BOTH NATIONALLY AND LOCALLY ARE NOT PARTICULARLY PROMISING, VERMONT REMAINS AMONG THE MOST HEALTHY STATES IN THE COUNTRY. AS OUR POPULATION AND ITS MEDICAL PROVIDERS AGE, HOWEVER, ACCESS TO PRIMARY AND PREVENTATIVE CARE WILL CONTINUE TO BE A CONCERN. ACCESS TO PREVENTATIVE CARE REMAINS AN IMPORTANT COMPONENT OF COPLEY'S COMMITMENT TO PROVIDING HEALTHCARE TO THE PEOPLE WITHIN OUR SERVICE AREA. OUR GOAL FOR THE PAST FEW YEARS HAS BEEN - AND REMAINS - TO INCREASE THE USE OF PRIMARY CARE TO IMPROVE THE HEALTH AND HEALTH-RELATED HABITS OF BOTH PATIENTS AND NON- PATIENTS; AND TO DECREASE AVOIDABLE (AND EXPENSIVE) VISITS TO THE EMERGENCY DEPARTMENT (ED). TO ACCOMPLISH THIS GOAL, WE CONTINUE TO WORK WITH OTHER AREA MEDICAL SERVICE PROVIDERS TO EXAMINE AVAILABLE DATA (E.G. TRANSPORTATION AVAILABILITY, CARE COORDINATION BETWEEN AGENCIES, ETC.) IN ORDER TO BETTER UNDERSTAND THE NEEDS OF OUR SERVICE AREA; WE CONTINUE TO SCREEN PATIENTS WHO PRESENT AT THE ED TO DETERMINE IF THEY HAVE A PRIMARY CARE PROVIDER; AND WE CONTINUE TO UTILIZE THE SERVICES OF AN IMBEDDED SOCIAL WORKER TO CONNECT ED PATIENTS TO PROVIDERS AND PROGRAMS THAT COULD BE OF HELP TO THEM. BY IDENTIFYING AND REMOVING THE BARRIERS THAT PREVENT PATIENTS FROM GETTING THE CARE THEY NEED AND IDENTIFYING (AND PARTNERING WITH) COMMUNITY AGENCIES THAT PROVIDE CARE THAT IS NOT WITHIN COPLEY'S PURVIEW, WE HAVE BEEN ABLE TO CONNECT PATIENTS TO THE KINDS OF PREVENTATIVE CARE THEY NEED, WHICH IN TURN HAS REDUCED THE NUMBERS OF PATIENTS PRESENTING AT THE ED.
Schedule H, Part V, Section B, Line 11 Facility , 2	Facility , 2 - COPLEY HOSPITAL. HEALTHCARE NEED #2: SUBSTANCE ABUSE SUBSTANCE ABUSE WAS IDENTIFIED AS OUR COMMUNITY'S SECOND MOST CHALLENGING HEALTH CONCERN IN 2024, MOVING UP TWO NOTCHES FROM NUMBER FOUR IN 2018 AND ONE NOTCH FROM NUMBER THREE IN 2021. ACCORDING TO MOST EXPERTS, IT IS A PROBLEM THAT CONTINUES TO IMPACT COMMUNITIES ACROSS THE UNITED STATES. THE NATIONAL INSTITUTES OF HEALTH (2024) FOUND THAT INDIVIDUALS SUFFERING FROM SUBSTANCE ABUSE OFTEN FACE OBSTACLES FOR OBTAINING CARE DUE TO "INSTITUTIONAL ENVIRONMENT." INSTITUTIONAL ENVIRONMENT REFERS TO FACTORS LIKE LACK OF SUPPORT FROM A PHYSICIAN'S INSTITUTION OR EMPLOYER; INSUFFICIENT RESOURCES SUCH AS STAFF AND TRAINING; CHALLENGES IN ORGANIZATIONAL CULTURE; AND COMPETING DEMANDS. THIS REASON (INSTITUTIONAL ENVIRONMENT) WAS CITED IN 81 PERCENT OF STUDIES PUBLISHED ON THIS TOPIC OVER THE PAST 61 YEARS, FOLLOWED BY INSUFFICIENT SKILL (74%), LACK OF COGNITIVE CAPACITY TO MANAGE A CERTAIN LEVEL OF CARE (74%), AND INADEQUATE KNOWLEDGE (72%). OTHER STUDIES CITED NEGATIVE SOCIAL INFLUENCES - OR BELIEFS ABOUT PUBLIC AND COMMUNITY ACCEPTANCE OF ADDICTION CARE - AS WELL AS FEAR OF HARMING THE PATIENT-PHYSICIAN RELATIONSHIP AS DETERRENTS FOR PHYSICIANS TO INTERVENE IN ADDICTION. THE NATIONAL INSTITUTES OF HEALTH GOES ON TO SAY THAT IN 2022: - NEARLY 49 MILLION PEOPLE IN THE U.S. HAD AT LEAST ONE SUBSTANCE USE DISORDER, THOUGH ONLY AROUND A QUARTER OF THEM (13 MILLION PEOPLE) RECEIVED TREATMENT; AND - MORE THAN NINE MILLION ADULTS NEEDED TREATMENT FOR OPIOID USE DISORDER BUT FEWER THAN HALF (AROUND 46 PERCENT) RECEIVED ANY FORM OF TREATMENT. SUBSTANCE ABUSE IS DEFINED BY THE NATIONAL CENTER FOR BIOTECHNOLOGY INFORMATION AS "A MALADAPTIVE PATTERN OF SUBSTANCE USE LEADING TO CLINICALLY SIGNIFICANT IMPAIRMENT OR DISTRESS, AS MANIFESTED BY ONE (OR MORE) OF THE FOLLOWING, OCCURRING WITHIN A 12-MONTH PERIOD:" - RECURRENT SUBSTANCE USE RESULTING IN A FAILURE TO FULFILL MAJOR ROLE OBLIGATIONS AT WORK, SCHOOL, OR HOME (E.G., REPEATED ABSENCES OR POOR WORK PERFORMANCE RELATED TO SUBSTANCE USE; SUBSTANCE-RELATED ABSENCES, SUSPENSIONS, OR EXPULSIONS FROM SCHOOL; NEGLECT OF CHILDREN OR HOUSEHOLD). - RECURRENT SUBSTANCE USE IN SITUATIONS IN WHICH IT IS PHYSICALLY HAZARDOUS (E.G., DRIVING AN AUTOMOBILE OR OPERATING MACHINERY WHEN IMPAIRED BY SUBSTANCE ABUSE). - RECURRENT SUBSTANCE-RELATED LEGAL PROBLEMS (E.G., ARRESTS FOR SUBSTANCE-RELATED DISORDERLY CONDUCT). - CONTINUED SUBSTANCE USE DESPITE HAVING PERSISTENT OR RECURRENT SOCIAL OR INTERPERSONAL PROBLEMS CAUSED OR EXACERBATED BY THE EFFECTS OF THE SUBSTANCE (E.G., ARGUMENTS WITH SPOUSE ABOUT CONSEQUENCES OF INTOXICATION, PHYSICAL FIGHTS). IN VERMONT:* - DRUG OVERDOSE DEATHS INVOLVING DRUGS OF ALL KINDS TOTALED 151 IN 2018; 244 IN 2021; AND 264 IN 2022. OF THOSE DEATHS, 91 PERCENT WERE DUE TO MISUSE OF OPIOIDS. THE PERCENTAGE OF FENTANYL INVOLVEMENT IN OPIOID-RELATED DEATHS WAS 93 PERCENT IN 2022, COMPARED TO 94 PERCENT IN 2021. COCAINE (49 PERCENT IN 2022, VERSUS 46 PERCENT IN 2021) AND METHAMPHETAMINE (8 PERCENT IN 2022, VERSUS 10 PERCENT IN 2021) WERE ALSO SIMILAR. THE MAJORITY OF THOSE DEATHS (98%) WERE DETERMINED TO BE "ACCIDENTAL OR UNDETERMINED." - THE RATE OF OPIOID RELATED DEATHS PER 100,000 PEOPLE WAS 37. - EMS CALLS INVOLVING NALOXONE ADMINISTRATION PER 10,000 PEOPLE WAS 8.8. - 20 PERCENT OF ADOLESCENTS IN GRADES 9-12 REPORTED USING MARIJUANA. - IN LAMOILLE COUNTY, THERE WERE 8 REPORTED DEATHS DUE TO MISUSE OF OPIOIDS (2022). *HEALTHVERMONT.GOV - 2023 AS WELL, ACCORDING TO THE VERMONT DEPARTMENT OF HEALTH (2024): - WHILE MARIJUANA USE AMONG YOUTH AND ADULTS IS INCREASING, USE PRIOR TO AGE 13 IS DECREASING. STILL, THE PERCENTAGE OF VERMONTERS WHO TRY CANNABIS FOR THE FIRST TIME BETWEEN THE AGES OF 12 AND 17 IS HIGHER IN VERMONT THAN IN THE COUNTRY OVERALL. - VAPING USE AMONG HIGH SCHOOL STUDENTS CONTINUES TO INCREASE. AS OF 2021, 16 PERCENT OF VERMONT HIGH SCHOOL STUDENTS SAID THEY USED E-CIGARETTES AT LEAST ONCE IN THE PAST 30 DAYS. OF THOSE STUDENTS, 30 PERCENT DID SO DAILY. - THE RATE OF E-CIGARETTE USE IN THE STATE DOUBLED FROM THREE TO SIX PERCENT OF ADULT RESPONDENTS BETWEEN 2016 AND 2022. DURING THAT SAME TIME PERIOD, CIGARETTE USE DROPPED FROM 17 TO 13 PERCENT AMONG SURVEY RESPONDENTS. TO ADDRESS THIS ONGOING PROBLEM, PATIENTS WHO PRESENT AT COPLEY'S EMERGENCY DEPARTMENT (ED) HAVE A NUMBER OF SERVICES AND PROGRAMS AVAILABLE TO THEM, INCLUDING REFERRALS TO A RECOVERY COACH THROUGH THE NORTH CENTRAL VERMONT RECOVERY CENTER (NCVRC). A RECOVERY COACH HELPS PATIENTS CREATE A PERSONAL PLAN FOR RECOVERY BY SETTING REALISTIC GOALS (OFTEN WITH THE ASSISTANCE OF A "PEER" WHO HAS BEEN THROUGH THE PROCESS); AND BY EXPLORING STEPS AND SERVICES THAT ARE AVAILABLE TO THEM TO AID IN RECOVERY FROM VARIOUS FORMS OF ADDICTION AND SUBSTANCE MISUSE. ACCORDING TO NCVRC, COPLEY'S ED CALLED ON THE RECOVERY COACH IN THE EMERGENCY DEPARTMENT (RCED) TEAM 191 TIMES FOR 129 UNIQUE PATIENTS LAST YEAR (JULY 2023 - JUNE 2024)., COMPARED WITH 146 TIMES FOR 86 UNIQUE PATIENTS IN 2020.
Schedule H, Part V, Section B, Line 11 Facility , 3	Facility , 3 - COPLEY HOSPITAL. HEALTHCARE NEED #3: MENTAL HEALTH AS IN THE 2021 COMMUNITY HEALTH NEEDS ASSESSMENT, MENTAL HEALTH ISSUES WERE IDENTIFIED BY SURVEY RESPONDENTS AS ONE OF OUR SERVICE AREA'S MOST PRESSING CONCERNS. MENTAL HEALTH ISSUES INCLUDE DEPRESSION AND OTHER ILLNESSES LEADING TO SELF-HARM AND/OR TO SUICIDE. AS OF 2023, THE RATE OF SUICIDE DEATHS IN VERMONT WAS 19 PER 100,000 PEOPLE - DOWN FROM 22 PER 100,000 PEOPLE IN 2021. THE RATE IS HIGHEST AMONG VERMONTERS BETWEEN THE AGES OF 25-44, AND OVER AGE 65. MALES ARE FOUR TIMES MORE LIKELY TO DIE BY SUICIDE THAN FEMALES.* *VERMONT DEPARTMENT OF HEALTH 2023 AMONG VERMONT ADULTS WHO REPORTED SYMPTOMS OF ANXIETY AND/OR DEPRESSIVE DISORDER, 34 PERCENT REPORTED NEEDING, BUT NOT RECEIVING, COUNSELING OR THERAPY (SOURCE: KAISER FAMILY FOUNDATION 2024). ACCORDING TO KAISER, THE STATES WITH THE HIGHEST PERCENTAGE OF ADULTS REPORTING SYMPTOMS OF ANXIETY AND/ OR DEPRESSIVE DISORDER BUT NOT RECEIVING CARE ARE WASHINGTON DC (49.3%), ARKANSAS (38.4%), KANSAS (37.7%), ALASKA (36.8%), AND UTAH (35.9%). SUICIDE IS ONE OF THE LEADING CAUSES OF DEATH IN THE U.S. AND HAS INCREASED IN ALMOST EVERY STATE OVER TIME, MAKING IT A SERIOUS PUBLIC HEALTH CONCERN. WHILE SUICIDE IS OFTEN LINKED TO UNDERLYING MENTAL HEALTH CONDITIONS, OTHER FACTORS CAN ALSO CONTRIBUTE, INCLUDING ISOLATION, RELATIONSHIP STRUGGLES, FINANCIAL OR HOUSING INSECURITY, OR PROBLEMS WITH PHYSICAL HEALTH. MANY OF THESE CONDITIONS WERE EXACERBATED ACROSS THE COUNTRY, AS WELL AS HERE IN VERMONT, DURING THE 2020-21 COVID PANDEMIC. ACCORDING TO THE KAISER FAMILY FOUNDATION (2024): - 17.5 PERCENT OF VERMONT ADOLESCENTS AND 8.7 PERCENT OF ADULTS REPORTED A MAJOR DEPRESSIVE EPISODE WITHIN THE PAST 30 DAYS. OF NOTE: 9.7 PERCENT OF ADOLESCENTS REPORTING A MAJOR DEPRESSIVE EPISODE WERE MALE, COMPARED WITH 25.5 PERCENT FOR FEMALES. - 5.7 PERCENT OF VERMONTERS REPORTED HAVING HAD SERIOUS THOUGHTS OF COMMITTING SUICIDE. - IN VERMONT, 51.0 PERCENT OF ADULTS WITH MILD MENTAL ILLNESS; 44.3 PERCENT OF ADULTS WITH MODERATE MENTAL ILLNESS; AND 25.6 PERCENT OF ADULTS WITH SERIOUS MENTAL ILLNESS IN THE PAST YEAR DID NOT RECEIVE MENTAL HEALTH TREATMENT. ACCORDING TO STACKER.COM (2024), IN LAMOILLE COUNTY: - THERE ARE 192 RESIDENTS FOR EVERY ONE MENTAL HEALTH CARE PROVIDER. - RESIDENTS REPORT AN AVERAGE OF 4.6 POOR MENTAL HEALTH DAYS PER MONTH. - ABOUT 6 PERCENT OF RESIDENTS LACK HEALTH INSURANCE. CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) REQUIRES THAT ALL ADULT EMERGENCY DEPARTMENT (ED) PATIENTS ARE SCREENED USING THE COLUMBIA SUICIDE SEVERITY RATING SCALE - A FIVE-QUESTION SCALE THAT CAN TRIGGER REFERRAL TO CRISIS SERVICES. WHEN MENTAL HEALTH ISSUES PRESENT, PATIENTS ARE REFERRED TO THE MOBILE CRISIS TEAM AND/OR TO OUTPATIENT MENTAL HEALTH SERVICES. COPLEY HAS ENGAGED A FULL TIME EMERGENCY ROOM CARE COORDINATOR/SOCIAL WORKER WHO IS EMBEDDED INTO THE ED DURING THE DAY AND WHO SERVES AS A LIAISON WITH OUR COMMUNITY PARTNERS. APPROXIMATELY 125 REFERRALS TO VARIOUS CARE PROVIDERS ARE MADE EACH MONTH. COPLEY HOSPITAL DOES NOT YET HAVE, BUT WOULD BENEFIT FROM ENGAGING, AN EVENING ED CARE COORDINATOR. PATIENTS WHO PRESENT AT OUR ED AND UNDERGO SCREENING ARE OFTEN REFERRED TO A CARE COORDINATOR, WHO ATTEMPTS TO CONNECT THE PATIENT WITH INDIVIDUALS AND SERVICES THAT CAN HELP THEM ADDRESS THE ISSUES WITH WHICH THEY ARE STRUGGLING. A TOTAL OF 639 REFERRALS WERE MADE BY COPLEY'S ED CARE COORDINATOR BETWEEN MARCH 11 - AUGUST 11, 2024. THE TOP FIVE REFERRALS INCLUDE CONNECTING PATIENTS TO A PRIMARY CARE PROVIDER, DENTIST, SUPPORT SERVICES FOR SUBSTANCE USE AND MENTAL HEALTH, HOME HEALTH/NURSING HOME AND TRANSPORTATION.
Schedule H, Part V, Section B, Line 11 Facility , 4	Facility , 4 - COPLEY HOSPITAL. HEALTHCARE NEEDS #4: OBESITY / NUTRITION / FOOD INSECURITY OBESITY, NUTRITION, AND FOOD INSECURITY TOOK THE NUMBER FOUR SPOT IN OUR 2024 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) SURVEY, INDICATING A FAIRLY HIGH LEVEL OF CONCERN AMONG PEOPLE IN OUR SERVICE AREA ABOUT THE GROWING PROBLEM OF POOR NUTRITION. ACCORDING TO AMERICA'S HEALTH RANKINGS (2024), 11.2 PERCENT OF LAMOILLE COUNTY RESIDENTS SUFFER FROM FOOD INSECURITY, WHICH IS DEFINED AS "HOUSEHOLDS THAT ARE UNABLE TO PROVIDE ADEQUATE FOOD FOR ONE OR MORE HOUSEHOLD MEMBERS DUE TO LACK OF RESOURCES." IN VERMONT AS A WHOLE, THE RATE OF FOOD INSECURITY IS 8 PERCENT (THE 4TH BEST RANKING IN THE UNITED STATES). DESPITE VERMONT'S HIGH RANKING, HOWEVER, RESPONDENTS TO OUR 2024 CHNA SURVEY INDICATED THAT OBESITY/NUTRITION/FOOD INSECURITY IS AN ONGOING CONCERN. FOOD INSECURITY IS NOT ONLY A LEADING CAUSE OF OBESITY AND POOR NUTRITION, BUT ALSO DENTAL ISSUES. GOOD FOOD IS EXPENSIVE. INEXPENSIVE FOOD IS GENERALLY HIGH IN BOTH SODIUM AND FAT. THERE ARE SEVERAL PROGRAMS, SUCH AS SNAP (SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM), THAT ENCOURAGE THE PURCHASE AND CONSUMPTION OF HEALTHY FOODS, AND MOST SNAP BENEFITS ARE NOW ACCEPTED AT GROCERY STORES AND LOCAL FARMERS' MARKETS. THE VERMONT FOODBANK, WHICH IS THE STATE'S LARGEST ANTI-HUNGER ORGANIZATION, NOTES THAT FOOD INSECURITY CAN BE MEASURED IN PART BY THE NUMBER OF HOUSEHOLDS THAT ARE SERVED AT ITS FRESH FOOD DIRECT DISTRIBUTION SITES. OVER THE FIRST THREE MONTHS OF 2024, THE AVERAGE NUMBER OF HOUSEHOLDS SEEKING FOOD PER MONTH WAS 8,280 COMPARED TO 5,694 HOUSEHOLDS A MONTH DURING THE SAME PERIOD IN 2020. ACCORDING TO THE FOODBANK, BEFORE THE PANDEMIC THEY WERE DISTRIBUTING ABOUT 11 MILLION POUNDS OF FOOD ANNUALLY, WHEREAS AT THE HEIGHT OF THE PANDEMIC THEY WERE DISTRIBUTING ROUGHLY 20 MILLION POUNDS.* VERMONT PUBLIC, 2024 UNFORTUNATELY, WHILE FOODBANK DISTRIBUTIONS BEGAN TO DECREASE TOWARDS THE END OF THE PANDEMIC, THEY RETURNED ONCE AGAIN TO HIGHER LEVELS FOLLOWING THE FLOODS THAT TOOK PLACE IN THE SUMMER OF 2023. ACCORDING TO THE FOODBANK: - A 2022 UVM STUDY SHOWED THAT TWO IN FIVE PEOPLE IN VERMONT HAD EXPERIENCED FOOD INSECURITY IN THE PAST YEAR. - IN THE LAST FIVE MONTHS OF 2023, THE FOODBANK DISTRIBUTED AN AVERAGE OF 1.3 MILLION POUNDS OF FOOD PER MONTH. - AS PANDEMIC-ERA SUPPORT PROGRAMS HAVE EXPIRED, [SOME VERMONTERS] ARE STILL STRUGGLING TO BECOME FOOD SECURE. OBESITY IS DEFINED (IN ADULTS) AS PEOPLE WHO HAVE A BODY MASS INDEX OF 30.0 OR HIGHER BASED ON REPORTED HEIGHT AND WEIGHT. UNDER THIS DEFINITION, 33.6 PERCENT OF AMERICANS ARE OBESE, AND 26.8 PERCENT OF VERMONTERS ARE OBESE (THE 3RD BEST RANKING IN THE UNITED STATES). IN VERMONT, 13.0% OF YOUTH AGES 10 TO 17 SUFFER FROM OBESITY, GIVING VERMONT A RANKING OF 5 AMONG THE 50 STATES AND D.C. AMONG ADULTS, HOWEVER, THAT NUMBER JUMPS TO NEARLY 27%, GIVING VERMONT A RANKING OF 49 AMONG THE 50 STATES AND D.C.* **ROBERT WOOD JOHNSON FOUNDATION, 2024 OBESITY INCREASES THE RISK OF MANY SERIOUS DISEASES AND HEALTH CONDITIONS SUCH AS HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, TYPE 2 DIABETES, CORONARY ARTERY DISEASE, STROKE, GALLBLADDER DISEASE, AND SOME CANCERS.
Schedule H, Part V, Section B, Line 11 Facility , 5	Facility , 5 - COPLEY HOSPITAL. HEALTHCARE NEED #5: LACK OF DENTAL CARE ACCORDING TO THE JOURNAL OF MULTIDISCIPLINARY CARE (DECISIONS IN DENTISTRY - JANUARY 2024) "APPROXIMATELY 46 MILLION PEOPLE IN RURAL AMERICA FACE SIGNIFICANT BARRIERS TO ORAL HEALTHCARE, AS REVEALED BY THE 2023 STATE OF ORAL HEALTH EQUITY IN AMERICA (SOHEA) SURVEY CONDUCTED BY CAREQUEST INSTITUTE FOR ORAL HEALTH. THE REPORT HIGHLIGHTS THAT 40% OF ADULTS IN RURAL AREAS HAVEN'T RECEIVED PROFESSIONAL DENTAL CARE IN MORE THAN A YEAR, SURPASSING THE FIGURES FOR URBAN (35%) AND SUBURBAN (30%) RESIDENTS. CHALLENGES IN RURAL ORAL HEALTHCARE INCLUDE PROVIDER SHORTAGES, LACK OF INSURANCE COVERAGE, AND TRANSPORTATION BARRIERS. THE FINDINGS INDICATE THAT 34 PERCENT OF RURAL INDIVIDUALS RATE THEIR ORAL HEALTH AS FAIR OR POOR, COMPARED TO 27 PERCENT AND 24 PERCENT FOR URBAN AND SUBURBAN RESIDENTS, RESPECTIVELY. FURTHERMORE, 67 PERCENT OF RURAL AREAS ARE IDENTIFIED AS DENTAL HEALTH PROFESSIONAL SHORTAGE AREAS. DENTAL INSURANCE COVERAGE IS LACKING FOR 34 PERCENT OF RURAL RESIDENTS." ALTHOUGH MEDICINE AND DENTISTRY HAVE REMAINED SEPARATE FOR MANY YEARS - SEPARATE INSURANCE, SEPARATE SCHOOLS, SEPARATE BUILDINGS - THERE IS A CONNECTION BETWEEN THE HEALTH OF THE MOUTH AND THE HEALTH OF THE BODY. PEOPLE WHO ARE MISSING TEETH OR WHO EXPERIENCE MOUTH PAIN CAN FIND IT DIFFICULT TO EAT HEALTHY FOOD LIKE WHOLE GRAINS, FRUITS, AND VEGETABLES. INFECTIONS IN THE MOUTH CAN ALSO SPREAD TO OTHER PARTS OF THE BODY, AND CAN INCREASE A PERSON'S RISK FOR HEART ATTACK OR STROKE. PEOPLE WITH DIABETES ARE ALSO MORE AT RISK FOR DENTAL PROBLEMS, WHICH CAN LEAD TO DIFFICULTY IN CONTROLLING BLOOD SUGAR LEVELS. SOME STUDIES HAVE LINKED PERIODONTAL DISEASE TO LOW BIRTH WEIGHT AND PRETERM BIRTH. AND THE BACTERIA THAT CAUSES DENTAL DECAY CAN BE PASSED FROM CAREGIVER TO CHILD. IT IS RECOMMENDED THAT CHILDREN HAVE THEIR FIRST DENTAL VISIT BY AGE ONE, BUT MANY CHILDREN DO NOT HAVE THEIR FIRST VISIT UNTIL AFTER AGE THREE.* *VERMONT DEPARTMENT OF HEALTH, 2024 ACCORDING TO THE VERMONT DEPARTMENT OF HEALTH (2024): - THE PERCENTAGE OF THIRD GRADE CHILDREN WITH DENTAL DECAY INCREASED FROM 37 PERCENT IN 2017 TO 48 PERCENT IN 2023, SIGNIFICANTLY ABOVE THE VERMONT DEPARTMENT OF HEALTH'S GOAL OF 30 PERCENT. - THE PERCENTAGE OF CHILDREN IN GRADES 1-6 USING THE STATE'S DENTAL SYSTEM DECREASED FROM 78 PERCENT IN 2017 TO 71 PERCENT IN 2023, SLIGHTLY BELOW THE VERMONT DEPARTMENT OF HEALTHS GOAL OF 80 PERCENT. - THE PERCENTAGE OF CHILDREN IN GRADES 7-12 USING THE STATE'S DENTAL SYSTEM DECREASED FROM 62 PERCENT IN 2017 TO 58 PERCENT IN 2023, SIGNIFICANTLY BELOW THE VERMONT DEPARTMENT OF HEALTH'S GOAL OF 70 PERCENT. - THE PERCENTAGE OF ADULTS USING THE STATE'S DENTAL SYSTEM DECREASED FROM 72 PERCENT IN 2017 TO 68 PERCENT IN 2022, BELOW THE VERMONT DEPARTMENT OF HEALTH'S GOAL OF 85 PERCENT. - 56 PERCENT OF VERMONT RESIDENTS WHO GET THEIR WATER FROM A PUBLIC WATER SYSTEM BENEFITED FROM SYSTEMS WITH FLUORIDATED WATER, WELL BELOW THE NATIONAL HEALTHY PEOPLE 2030 TARGET OF 77.1 PERCENT. IN FACT, VERMONT RANKS 41 OUT OF 50 WHEN IT COMES TO THIS PERCENTAGE (CDC, 2018). THE PERCENTAGE OF VERMONTERS SERVED BY FLUORIDATED WATER SYSTEMS HAS STAYED CONSISTENT SINCE 2011. - IN 2000, 61 PERCENT OF VERMONT ADULTS' AGES 45-64 HAD AT LEAST ONE TOOTH EXTRACTED BECAUSE OF TOOTH DECAY OR GUM DISEASE. THAT PERCENTAGE HAS DECREASED SIGNIFICANTLY OVER TIME TO 42 PERCENT IN 2022, WHICH IS GREAT NEWS, BUT IT DOESN'T TELL THE WHOLE STORY. WHEN THE OVERALL PERCENTAGE IS BROKEN DOWN, A DISPARITY EXISTS IN ORAL HEALTH OUTCOMES; THERE ARE HIGHER RATES OF TOOTH EXTRACTION FOR INDIVIDUALS WITH LESS EDUCATION AND LOWER INCOMES COMPARED TO THOSE WITH MORE EDUCATION AND HIGHER INCOMES. IN ORDER TO ADDRESS THESE DISPARITIES, VERMONT NEEDS TO IDENTIFY WHY ITS ORAL HEALTH CARE SYSTEM IS NOT WORKING FOR LOWER INCOME/EDUCATED VERMONTERS. LACK OF DENTAL CARE IN VERMONT IS NOT A NEW PROBLEM. ACCORDING TO A REPORT ISSUED BY THE GREEN MOUNTAIN CARE BOARD (GMCB) IN 2015: - MEDICAID ELIGIBLE UTILIZATION OF ORAL HEALTH SERVICES IS LOW AS COMPARED TO UTILIZATION OF ORAL HEALTH SERVICES BY INDIVIDUALS WITH PRIVATE INSURANCE, HOWEVER, WHILE INDIVIDUALS WITH PRIVATE DENTAL HEALTH INSURANCE UTILIZE SERVICES AT A HIGHER RATE, THEY ARE STILL SIGNIFICANTLY BELOW DESIRED LEVELS. - MEDICAID ELIGIBLES ENCOUNTER GREATER BARRIERS TO ACCESS THAN THEIR PRIVATELY INSURED COUNTERPARTS, INCLUDING A LIMITED NUMBER OF DENTISTS WILLING TO TAKE NEW MEDICAID PATIENTS. - A SIGNIFICANT PERCENT OF THE POPULATION STILL REMAINS UNINSURED FOR ORAL HEALTH SERVICES, WITH GREATER THAN HALF OF VERMONTERS WITHOUT ORAL HEALTH INSURANCE. - FOR THOSE INTERESTED IN ACCESSING ORAL HEALTH SERVICES, COST OF CARE IS A BARRIER. - HALF OF THE PRIMARY CARE DENTIST POPULATION IS AGE 55 OR OVER INDICATING A LARGE PROPORTION OF THE VERMONT DENTIST WORKFORCE IS APPROACHING RETIREMENT. AS THE DENTIST POPULATION SHRINKS, ACCESS WILL BECOME MORE LIMITED REGARDLESS OF INSURANCE STATUS. - SIGNIFICANT NUMBERS OF ADULTS 18-64 HAVE LOST ALL THEIR NATURAL TEETH TO DECAY OR DISEASE AND DO NOT ACCESS RECOMMENDED PREVENTATIVE SERVICES SUCH AS SEMI-ANNUAL CLEANINGS.

Schedule H (Form 990) 2023

Page 9

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?2
Name and address		Type of Facility (describe)
1	MANSFIELD ORTHOPAEDICS 555 WASHINGTON HIGHWAY MORRISVILLE,VT05661	OUTPATIENT ORTHOPAEDIC, REHAB AND RADIOLOGY SERVICES
2	MANSFIELD ORTHOPAEDICS 1979 WATERBURY-STOWE ROAD WATERBURY,VT05677	OUTPATIENT ORTHOPAEDIC, RADIOLOGY SERVICES
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2023

Page 10

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 I, Line 3c ELIGIBILITY FOR FREE CARE	IN ADDITION TO INCOME, COPLEY USES OTHER FACTORS IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE, INCLUDING RESIDENCY STATUS FOR NON-EMERGENT SERVICES AND AN ASSET THRESHOLD.
Schedule H, Part I, Line 7 COSTING METHODOLOGY	THE COST TO CHARGE RATIO COMPUTED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION ON IRS WORKSHEETS 1 AND 3.
Schedule H, Part I, Line 7f PERCENT OF TOTAL EXPENSE	TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25, OF THE FORM 990.
Schedule H, Part III, Line 3 BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE	COPLEY HOSPITAL, INC ESTIMATES THAT APPROXIMATELY 9.1% OF THE PATIENT ACCOUNTS WRITTEN OFF TO BAD DEBTS MAY QUALIFY FOR CHARITY CARE OR OTHER ASSISTANCE BUT CHOSE NOT TO APPLY. THEREFORE, THE BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING 9.1% OF THE AMOUNT REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2. SECTION A, LINE 2.
Schedule H, Part III, Line 4 BAD DEBT EXPENSE FOOTNOTE	THE AUDIT FOOTNOTE ADDRESSING BAD DEBT EXPENSE AND PATIENT ACCOUNTS RECEIVABLE IS FOUND ON PAGE 8 OF THE AUDITED FINANCIAL STATEMENTS UNDER NOTE 1, SUBTITLED "PATIENT ACCOUNTS RECEIVABLE."
Schedule H, Part III, Line 8 COMMUNITY BENEFIT	SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY.
Schedule H, Part III, Line 9b COLLECTION POLICY	FINANCIAL ASSISTANCE IS AVAILABLE TO GUARANTORS WHO MEET THE ELIGIBILITY REQUIREMENTS. INCOME LEVEL, HOUSEHOLD SIZE, RESIDENCY STATUS, ETC, DETERMINE ELIGIBILITY. FEDERAL POVERTY LEVEL GUIDELINES ARE UTILIZED TO DETERMINE THE AMOUNT OF ASSISTANCE A HOUSEHOLD MAY BE ELIGIBLE FOR. FOR THE PATIENT'S CONVENIENCE, ALL STATEMENTS HAVE AN ABBREVIATED VERSION OF THE FINANCIAL ASSISTANCE APPLICATION ON THE BACK.
Schedule H, Part VI, Line 2 NEEDS ASSESSMENT	COPLEY GATHERS AND ANALYZES INFORMATION ABOUT THE GREATER LAMOILLE VALLEY COMMUNITY AND ITS HEALTHCARE NEEDS THROUGH VARIOUS MEANS, INCLUDING: ANALYZING AND RESPONDING TO HEALTH TRENDS IN OUR PATIENTS; THROUGH AGGREGATE DATA FROM OUR QUALITY AND WELLNESS INITIATIVES, THE ONECARE VERMONT ACCOUNTABLE CARE ORGANIZATION, THE VERMONT STATE BLUEPRINT FOR HEALTH AND FROM THE UNIFIED COMMUNITY COLLABORATIVE (UCC) WHICH INCLUDES REPRESENTATIVES FROM COMMUNITY, REGIONAL AND STATE ORGANIZATIONS AND AGENCIES INVOLVED IN THE SOCIAL DETERMINANTS OF HEALTH. WE ALSO REVIEW RELEVANT DATA FROM THE VERMONT DEPARTMENT OF HEALTH, CENTERS FOR MEDICARE AND MEDICAID SERVICES, AND THE FEDERAL CENTERS FOR DISEASE CONTROL.
Schedule H, Part VI, Line 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	INFORMATION ABOUT COPLEY'S CHARITABLE CARE POLICY, WHICH INCLUDES HELPING PATIENTS APPLY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS, IS POSTED BY EACH REGISTRATION DESK (MAIN LOBBY AND EMERGENCY DEPARTMENT). IT IS ALSO AVAILABLE, ALONG WITH THE APPLICATION FORM, ONLINE ON THE HOSPITAL'S WEBSITE IN ADDITION TO THE "HOSPITAL REPORT CARD" WEBSITE OF THE GREEN MOUNTAIN CARE BOARD. DETAILS ARE ALSO INCLUDED IN THE PATIENT GUIDE FOR INPATIENTS, FAMILIES AND VISITORS. COPLEY'S CHARITABLE CARE PROGRAM IS ALSO PROMOTED IN OUR PHILANTHROPY EFFORTS AS MANY DONORS GIVE TO THE PROGRAM. ALL CARE PROVIDERS MAY REFER PATIENTS TO THE HOSPITAL'S PATIENT FINANCIAL SERVICES COUNSELORS OR TO PATIENT AND FAMILY SERVICES TO CONNECT THEM TO ASSISTANCE.
Schedule H, Part VI, Line 4 COMMUNITY INFORMATION	COPLEY HOSPITAL, DEFINES ITS SERVICE AREA AS LAMOILLE, AND PARTS OF ORLEANS AND CALEDONIA COUNTIES IN VERMONT, WHICH INCLUDES THE TOWNS OF BELVIDERE, CAMBRIDGE, JEFFERSONVILLE, WATERVILLE, EDEN, EDEN MILLS, HYDE PARK, JOHNSON, ELMORE, MORRISTOWN, MOSCOW, NORTH HYDE PARK, STOWE, WOLCOTT, CRAFTSBURY, GREENSBORO, HARDWICK AND STANNARD. COPLEY SERVES A POPULATION OF 25,977 PEOPLE.THE COMMUNITY IS PREDOMINANTLY WHITE, NON-HISPANIC, WITH A MEDIAN AGE OF 41 AND A MEDIAN HOUSEHOLD INCOME OF $69,886. THE AREA HAS POCKETS OF GREAT WEALTH AND GREAT POVERTY. NEARLY 19.5% OF THE HOSPITAL'S SERVICE AREA IS GREATER THAN 65 YEARS OF AGE WHICH HAS BEEN GROWING. NEARLY 94.2% OFADULTS 25 YEARS OF AGE OR OLDER IN THE AREA HOLD A HIGH SCHOOL DEGREE, 42.8% HOLDING A BACHELOR'S DEGREE OR HIGHER. THE MAJOR INDUSTRY IS ACCOMMODATIONS AND FOOD SERVICE, FOLLOWED BY HEALTH AND SOCIAL ASSISTANCE. OUT OF 14 VERMONT COUNTIES, LAMOILLE COUNTY RANKED 3RD HIGHEST IN "HEALTH OUTCOMES" (AS DEFINED BY REPORTED PREMATURE DEATHS, POOR HEALTH DAYS, POOR PHYSICAL HEALTH DAYS, POOR MENTAL HEALTH DAYS AND LOW WEIGHT BIRTHS); AND 9TH HIGHEST IN "HEALTH FACTORS" (AS DEFINED BY NUMBERS OF PEOPLE WHO REPORT SMOKING, DRINKING, OBESITY, STDS, AND TEEN BIRTHS; AS WELL AS HOUSING COSTS, PHYSICAL ENVIRONMENT AND SOCIO/ECONOMIC FACTORS). THE TOP 3 HEALTHCARE NEEDS IDENTIFIED FOR OUR COMMUNITY INCLUDE: ACCESS TO PRIMARY CARE, SUBSTANCE ABUSE AND MENTAL HEALTH.
Schedule H, Part VI, Line 5 PROMOTION OF COMMUNITY HEALTH	THE HOSPITAL IS GOVERNED BY A VOLUNTEER BOARD OF TRUSTEES MADE UP OF LOCAL CITIZENS REPRESENTING A CROSS SECTION OF THE COMMUNITY SERVED. THE BOARD HOLDS A PUBLIC ANNUAL MEETING IN JANUARY AND ITS ETHICS COMMITTEE HOSTS AN ANNUAL PUBLIC FORUM ON A TOPIC PERTINENT TO POPULATION HEALTH. COPLEY CONTINUES TO WORK COLLABORATIVELY WITH OTHER ORGANIZATIONS TO IDENTIFY AND ADDRESS COMMUNITY HEALTH NEEDS. OUR COLLABORATIONS INCLUDE BUT ARE NOT LIMITED TO THE UNIFIED COMMUNITY COLLABORATIVE (UCC) WHICH INCLUDES REPRESENTATIVES FROM COMMUNITY, REGIONAL AND STATE ORGANIZATIONS AND AGENCIES INVOLVED IN THE SOCIAL DETERMINANTS OF HEALTH; PRIMARY CARE PRACTICES; LAMOILLE HORNE HEALTH AND HOSPICE; LONG-TERM RESIDENTIAL CARE FACILITIES THE MANOR AND THE GREENSBORO NURSING HORNE; LAMOILLE COUNTY MENTAL HEALTH; COMMUNITY HEALTH SERVICES OF LAMOILLE VALLEY BEHAVIORAL HEALTH & WELLNESS; HEALTHY LAMOILLE VALLEY; PEOPLE IN PARTNERSHIP; THE MORRISVILLE DISTRICT OFFICE OF THE VERMONT DEPARTMENT OF HEALTH; THE LAMOILLE COMMUNITY HOUSE (WARMING SHELTER); UNITED WAY; CLARINA HOWARD NICHOLS CENTER; THE NORTH CENTRAL VERMONT RECOVERY CENTER; AND OTHERS. COPLEY HOSPITAL PROVIDES NEEDED MEDICAL SERVICES, REGARDLESS OF ABILITY TO PAY. SERVICES INCLUDES 24 HOURS/7 DAYS A WEEK EMERGENCY SERVICES, WOMEN'S AND CHILDREN'S SERVICES, GENERAL SURGERY, LABORATORY SERVICES, DIAGNOSTIC IMAGING, ORTHOPAEDICS, AND REHABILITATION. COPLEY CONTINUES ITS PARTNERSHIP WITH DARTMOUTH HITCHCOCK CONNECTED CARE TO DELIVER NEEDED SERVICES IN THE AREA WITH TELEMEDICINE; INCLUDING RHEUMATOLOGY, NEPHROLOGY AND PULMONOLOGY. IN CONJUNCTION WITH COMMUNITY HEALTH SERVICES OF LAMOILLE VALLEY, COPLEY HAS PLACED A RESOURCE REFERRAL SPECIALIST IN THE ER. THIS SPECIALIST WORKS CLOSELY WITH OUR SOCIAL WORKER AND OUR UTILIZATION REVIEW NURSE TO SCREEN AND CONNECT PATIENTS TO NEEDED SERVICES AND COMMUNITY RESOURCES TO ADDRESS A VARIETY OF ISSUES INCLUDING QUIT SMOKING, FUEL INSECURITY, FOOD INSECURITY, HOMELESSNESS OR INADEQUATE HOUSING, SUBSTANCE ABUSE, MENTAL HEALTH AND/OR LONG TERM MANAGEMENT OF COMPLEX CONDITIONS. AN ONGOING INITIATIVE FOCUSES ON IDENTIFYING PATIENTS WITH COMPLEX HEALTH ISSUES THAT ARE HIGH UTILIZERS OF EMERGENCY SERVICES AND CONNECTING THEM WITH A DEDICATED CASE WORKER TO DEVELOP A COORDINATED CARE PLAN. THIS EFFORT HAS RESULTED IN A SIGNIFICANT REDUCTION IN AVOIDABLE USE OF THE EMERGENCY ROOM, CREATING A POTENTIAL - SAVINGS FOR THE AREA'S HEALTHCARE SYSTEM. TO HELP ADDRESS HOMELESSNESS IN THE AREA, COPLEY PROVIDES LAUNDRY SERVICES TO A GRASSROOTS WARMING SHELTER THAT OPENED IN THE AREA. ALL OF THESE EFFORTS IMPROVE TRANSITIONS IN CARE AND OUTCOMES, WITH THE GOAL BEING THE IMPROVEMENT OF THE HEALTH OF OUR COMMUNITY. AS ONE OF THE LARGEST EMPLOYERS IN THE AREA, THE HOSPITAL IS INVESTING IN EDUCATION AND TRAINING IN SUPPORT OF RECRUITMENT AND RETENTION. COPLEY PARTNERS WITH VERMONT TECHNICAL COLLEGE, NORTHERN VERMONT UNIVERSITY & LAMOILLE'S WORKFORCE DEVELOPMENT GROUP TO OFFER AN ASSOCIATE DEGREE IN NURSING PROGRAM HERE IN LAMOILLE COUNTY. THE HOSPITAL WORKS WITH MANY EDUCATIONAL INSTITUTIONS, OFFERING ONSITE CLINICAL ROTATIONS ALONG WITH 8 GRADUATE PROGRAMS IN NURSING, MEDICINE AND HEALTHCARE ADMINISTRATION. THE HOSPITAL CONTINUES TO BE A KEY PARTNER IN THE LAMOILLE COUNTY CHAPTER OF RISE VERMONT, A STATE-WIDE INITIATIVE WITH THE STATE'S ACCOUNTABLE CARE ORGANIZATION. RISEVT SUPPORTS AND INSPIRES RESIDENTS TO HAVE FUN, PLAY MORE, EAT WELL AND FEEL GOOD BY AMPLIFYING AND SUPPORTING EFFORTS UNDERWAY IN THE COMMUNITY. THE RISEVT PROGRAM MANAGER IS EMPLOYED BY THE HOSPITAL. RISEVT OPERATED WELLNESS PROGRAMMING IN THE TOWNS OF MORRISVILLE AND JOHNSON, AND ATTENDS MULTIPLE HEALTH AND WELLNESS EVENTS ACROSS OUR SERVICE AREA THROUGHOUT THE YEAR. THE HOSPITAL REGULARLY PROMOTES HEALTHY LIFESTYLE CHOICES AND PREVENTATIVE INFORMATION VIA SOCIAL MEDIA OUTLETS, INCLUDING AN AWARD-WINNING COLLABORATIVE COMMUNITY BLOG (LIVEWELLLAMOILLE.COM), COMMUNITY NEWSLETTERS, INFORMATION DISTRIBUTED ON THE HOSPITAL CAMPUS, AND A YEAR-LONG SERIES OF INFORMATIONAL SEMINARS THAT COVER A RANGE OF TIMELY HEALTH AND WELLNESS TOPICS. WE PROMOTE AND SUPPORT HEALTHY, FAMILY-FRIENDLY ACTIVITIES AND EVENTS TO ENCOURAGE HEALTHY LIFESTYLE CHOICES.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED SEPTEMBER 30, 2024. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2.
Schedule H, Part V, Section B, Line 16a FAP website	- COPLEY HOSPITAL, INC: Line 16a URL: WWW.COPLEYVT.ORG/FOR-PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/ASSISTANCE-PROGRAMS/;
Schedule H, Part V, Section B, Line 16b FAP Application website	- COPLEY HOSPITAL, INC: Line 16b URL: WWW.COPLEYVT.ORG/FOR-PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/ASSISTANCE-PROGRAMS/;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- COPLEY HOSPITAL, INC: Line 16c URL: WWW.COPLEYVT.ORG/FOR-PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/ASSISTANCE-PROGRAMS/;

Schedule H (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

Copley Hospital Inc

Employer identification number

03-0179423

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Yes

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2023

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1JOSEPH WOODIN CEO	(i) (ii)	502,919 ------------- 0	0 ------------- 0	46,498 ------------- 0	4,910 ------------- 0	17,047 ------------- 0	571,374 ------------- 0	0 ------------- 0
2TRAVIS KNAPP TRUSTEE BEG 02/24 / ANESTHESIA DIRECTOR	(i) (ii)	406,982 ------------- 0	0 ------------- 0	20,838 ------------- 0	12,369 ------------- 0	40,852 ------------- 0	481,041 ------------- 0	0 ------------- 0
3J MARTIN LINSEISEN MD TRUSTEE END 02/24	(i) (ii)	393,316 ------------- 0	0 ------------- 0	10,998 ------------- 0	11,300 ------------- 0	41,347 ------------- 0	456,961 ------------- 0	0 ------------- 0
4JEFFREY HEBERT CFO	(i) (ii)	250,292 ------------- 0	0 ------------- 0	10,415 ------------- 0	10,241 ------------- 0	1,168 ------------- 0	272,116 ------------- 0	0 ------------- 0
5LORI PROFOTA CNO END 02/24	(i) (ii)	216,586 ------------- 0	0 ------------- 0	2,381 ------------- 0	6,238 ------------- 0	32,738 ------------- 0	257,943 ------------- 0	0 ------------- 0
6WAYNE STOCKBRIDGE CHIEF ADMIN & HR OFFICER	(i) (ii)	218,340 ------------- 0	0 ------------- 0	31,433 ------------- 0	8,647 ------------- 0	41,892 ------------- 0	300,312 ------------- 0	0 ------------- 0
7NICHOLAS ANTELL ORTHOPEDIC SURGEON	(i) (ii)	574,186 ------------- 0	50,000 ------------- 0	43,248 ------------- 0	9,750 ------------- 0	31,327 ------------- 0	708,511 ------------- 0	0 ------------- 0
8BRIAN AROS ORTHOPEDIC SURGEON	(i) (ii)	747,616 ------------- 0	175,302 ------------- 0	80,470 ------------- 0	10,250 ------------- 0	40,608 ------------- 0	1,054,246 ------------- 0	0 ------------- 0
9JOHN MACY ORTHOPEDIC SURGEON	(i) (ii)	810,525 ------------- 0	50,000 ------------- 0	20,696 ------------- 0	9,000 ------------- 0	32,559 ------------- 0	922,780 ------------- 0	0 ------------- 0
10JOSEPH MCLAUGHLIN ORTHOPEDIC SURGEON	(i) (ii)	645,091 ------------- 0	50,000 ------------- 0	84,476 ------------- 0	11,250 ------------- 0	40,486 ------------- 0	831,303 ------------- 0	0 ------------- 0
11BRYAN MONIER ORTHOPEDIC SURGEON	(i) (ii)	569,979 ------------- 0	0 ------------- 0	38,709 ------------- 0	10,010 ------------- 0	40,521 ------------- 0	659,219 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2023

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
Schedule J, Part I, Line 5a Compensation contingent on revenues of the organization	INCENTIVE BONUSES ARE PAID TO OUR ORTHOPEDIC SURGEONS BASED UPON GROSS REVENUE PRODUCED INDIVIDUALLY FOR THE HOSPITAL.

Schedule J (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

Copley Hospital Inc

Employer identification number

03-0179423

Return Reference	Explanation
Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS	COPLEY HOSPITAL SERVES AS A VITAL RESOURCE FOR RURAL NORTH CENTRAL VERMONT. A CRITICAL ACCESS HOSPITAL, COPLEY PROVIDES A 25-BED ACUTE CARE INPATIENT UNIT INCLUDING A BIRTHING CENTER, A WIDE-RANGE OF OUTPATIENT SERVICES AND 24/7 EMERGENCY SERVICES IN ADDITION TO LABORATORY SERVICES, DIAGNOSTIC IMAGING AND REHABILITATION SERVICES. SERVICES INCLUDE CARDIOLOGY, GENERAL SURGERY, OBSTETRICS/GYNECOLOGY, ONCOLOGY, ORTHOPEDICS, AND NEUROLOGY. OUR REHABILITATION SERVICES INCLUDE PHYSICAL, OCCUPATIONAL, SPEECH & LANGUAGE, CARDIAC, PULMONARY, AND WORK CONDITIONING. OUR HOSPITAL SERVICE AREA HAS A POPULATION OF JUST OVER 30,000 PEOPLE, ACROSS MORE THAN 459 SQUARE MILES. COPLEY COLLABORATES WITH OTHER HEALTHCARE PROVIDERS, SOCIAL SERVICE AGENCIES, NOT-FOR-PROFIT ORGANIZATIONS AND BUSINESSES TO FULFILL OUR MISSION OF HELPING PEOPLE LIVE HEALTHIER LIVES. THE CLOSEST HOSPITAL IS 45 MINUTES TO ONE HOUR AWAY. IN FISCAL YEAR 2024, COPLEY HAD 108,061 OUTPATIENT VISITS AND 1,396 INPATIENT ADMISSIONS TOTALING 6,062 PATIENT DAYS. WE PERFORMED 2,526 SURGERIES AND 1,553 PROCEDURES AND HAD 13,627 EMERGENCY ROOM VISITS. OUR CHARITABLE CARE PROGRAM IS AVAILABLE TO PATIENTS WHO ARE UNINSURED, UNDERINSURED, OR HAVE OTHERWISE DEMONSTRATED THEY DO NOT HAVE FINANCIAL RESOURCES TO FULLY PAY FOR THEIR HOSPITAL CARE.
Form 990, Part V, Line 2a W-2'S FILED	COPLEY HOSPITAL, INC ALSO FILES W-2'S FOR ITS RELATED ORGANIZATIONS. THE TOTAL NUMBER OF W-2'S FILED ON THE W-3 INCLUDES THESE W-2'S. THE COMPENSATION, EMPLOYEE BENEFITS AND PAYROLL TAXES AMOUNTS ARE THEN ALLOCATED TO THE ORGANIZATION FOR THE AMOUNT THAT REPRESENTS WORK PERFORMED FOR THE ORGANIZATION. THE AMOUNT INCLUDED ON LINE 2A INCLUDES ONLY EMPLOYEES ALLOCATED TO COPLEY HOSPITAL. THE AMOUNT REPORTED ON PART IX INCLUDES ONLY THOSE AMOUNTS ALLOCATED TO WORK PERFORMED DIRECTLY FOR COPLEY HOSPITAL, INC. THE HIGHEST PAID EMPLOYEES ARE DETERMINED BY THE WORK PERFORMED FOR EACH ORGANIZATION. THEREFORE, THE FIVE HIGHEST PAID EMPLOYEES LISTED ON PART VII AND SCHEDULE J ARE THOSE EMPLOYEES WHO WORK DIRECTLY FOR COPLEY HOSPITAL, INC.
Form 990, Part VI, Line 6 7A & 7B - MEMBERS/ STOCKHOLDERS	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. 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, Line 11b Review of form 990 by governing body	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, A TENTATIVE DRAFT OF THE 990 IS REVIEWED BY THE BOARD OF DIRECTORS. A COMPLETE COPY OF THE FORM IS MADE AVAILABLE TO ALL MEMBERS OF THE GOVERNING BODY THROUGH THE FINANCE OFFICE.
Form 990, Part VI, Line 12c Conflict of interest policy	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, Line 15a Process to establish compensation of top management official	THE CEO'S COMPENSATION IS DETERMINED BY USING MARKET SURVEY DATA FROM THE NNE HEALTHCARE COMP SURVEY, IT IS ALSO APPROVED BY THE BOARD. SENIOR LEADERSHIP AND OTHER HIGHLY COMPENSATED INDIVIDUALS HAVE THEIR PAY RANGES DETERMINED THROUGH MARKET DATA FROM THE NNE HEALTHCARE COMPENSATION SURVEY.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	HUMAN RESOURCES REVIEWS MARKET SURVEY DATA FROM NNE HEALTHCARE COMP SURVEY TO DETERMINE EACH SENIOR OFFICERS POSITION UPON HIRE.
Form 990, Part VI, Line 19 Required documents available to the public	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 DEPARTMENT OF FINANCIAL REGULATION.
Form 990, Part IX, Line 11g Other Fees	CONTRACT LABOR - Total Expense: 6741841, Program Service Expense: 5911575, Management and General Expenses: 830266, Fundraising Expenses: ; PURCHASED SERVICES - Total Expense: 3959696, Program Service Expense: 2462081, Management and General Expenses: 1497615, Fundraising Expenses: ; PHYSICIAN SERVICES - Total Expense: 1184170, Program Service Expense: 1184170, Management and General Expenses: , Fundraising Expenses: ; LAB SERVICES - Total Expense: 490452, Program Service Expense: 490452, Management and General Expenses: , Fundraising Expenses: ; OTHER SERVICES - Total Expense: 352108, Program Service Expense: 345213, Management and General Expenses: 6895, Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	CHANGE IN INTEREST IN NA OF CHSI - 202219;

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

Copley Hospital Inc

Employer identification number

03-0179423

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)LAMOILLE HOUSING CORPORATION 528 WASHINGTON HIGHWAY MORRISVILLE,VT05661 03-0272055	HUD HOUSING	VT	501(c)(3)	10	CHSI		No
(2)COPLEY HEALTH SYSTEMS INC 528 WASHINGTON HIGHWAY MORRISVILLE,VT05661 03-0301457	SUPPORT	VT	501(c)(3)		NA		No
(3)COPLEY WOODLANDS 125 THOMAS LANE STOWE,VT05672 03-0352086	HOUSING	VT	501(c)(3)	10	CHSI		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2023

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No
(1) HEALTH CENTER BUILDING INC 528 WASHINGTON HIGHWAY MORRISVILLE,VT05661 03-0220357	BUILDING RENTAL	VT	CHSI	C Corporation					No

Schedule R (Form 990) 2023

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2023

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2023

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

1	Briefly describe the organization’s mission or most significant activities: COPLEY IS DEDICATED TO HELPING PEOPLE LIVE HEALTHIER LIVES; PROVIDING EXCEPTIONAL CARE, SUPERIOR SERVICE AND ASSURING PEOPLE HAVE ACCESS TO AFFORDABLE HEALTH CARE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	18
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	16
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	676
6	Total number of volunteers (estimate if necessary) .............	6	56
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	318,407	2,140,063
9	Program service revenue (Part VIII, line 2g) .........	98,020,958	105,564,636
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	103,142	-90,333
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	7,563	12,542
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	98,450,070	107,626,908
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	53,826,444	56,925,735
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	45,976,196	47,155,752
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	99,802,640	104,081,487
19	Revenue less expenses. Subtract line 18 from line 12.......	-1,352,570	3,545,421
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	78,337,251	93,963,237
21	Total liabilities (Part X, line 26).............	31,500,913	43,379,259
22	Net assets or fund balances. Subtract line 21 from line 20.....	46,836,338	50,583,978

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 87,389,956 including grants of $ 0 ) (Revenue $ 105,564,636 )
	COPLEY HOSPITAL PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT IS CRITICAL TO THE HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses87,389,956

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	6,138,660	0	505,567

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	1,080,748
e	Government grants (contributions)		1e	1,059,315

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		2,140,063

		Business Code
2a	PATIENT SERVICE REVENUE	621400	98,232,533	98,232,533
b	FIXED PROSPECTIVE REVENUE	621400	5,027,752	5,027,752
c	OTHER REVENUE	621400	1,656,589	1,656,589
d	CAFETERIA	722514	498,762	498,762
e	MANAGEMENT FEE REVENUE	541610	149,000	149,000
f	All other program service revenue.		0	0	0	0
g	Total. Add lines 2a–2f .....		105,564,636

3 Investment income (including dividends, interest, and othersimilar amounts) ......			162,639			162,639
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a	12,542
b	Less: rental expenses	6b
c	Rental income or (loss)	6c	12,542	0
d	Net rental income or (loss).......			12,542			12,542
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a		41,040
b	Less: cost or other basis and sales expenses	7b		294,012
c	Gain or (loss)	7c	0	-252,972
d	Net gain or (loss).........			-252,972			-252,972
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..

Business Code
11a
b
c
d	All other revenue ....			0	0	0	0
e	Total. Add lines 11a–11d ......			0
12	Total revenue. See instructions.....			107,626,908	105,564,636	0	-77,791

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	2,468,168	1,324,365	1,143,803
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	43,818,288	37,391,408	6,426,880
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,489,758	1,262,112	227,646
9	Other employee benefits .......	6,279,935	5,283,484	996,451
10	Payroll taxes ...........	2,869,586	2,402,713	466,873
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	47,286		47,286
c	Accounting ...........	128,151		128,151
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	12,728,267	10,393,491	2,334,776	0
12	Advertising and promotion ....	48,752	14,946	33,806
13	Office expenses .......	1,382,638	423,892	958,746
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	2,400,317	735,894	1,664,423
17	Travel ............	56,695	17,382	39,313
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	67,073	20,563	46,510
20	Interest ...........	193,371	161,910	31,461
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	3,068,709	2,811,668	257,041
23	Insurance ...	1,960,078	600,924	1,359,154
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES & DRUGS	18,454,970	18,454,970
b	PROVIDER TAX	5,856,254	5,856,254
c	REPAIRS & MAINTENANCE	393,637	120,682	272,955
d	LICENSES, DUES, & SUBSCRIPTIONS	225,259	69,060	156,199
e	All other expenses	144,295	44,238	100,057	0
25	Total functional expenses. Add lines 1 through 24e	104,081,487	87,389,956	16,691,531	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			3,000	1	3,000
2	Savings and temporary cash investments .........			11,255,543	2	17,543,166
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			16,231,085	4	17,331,258
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			2,640,515	8	2,583,760
9	Prepaid expenses and deferred charges ......			2,447,281	9	2,488,102
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	80,119,526
b	Less: accumulated depreciation	10b	40,321,922	33,188,132	10c	39,797,604
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			6,776,801	12	6,979,020
13	Investments—program-related. See Part IV, line 11 ..			0	13
14	Intangible assets ...............			73,250	14	70,250
15	Other assets. See Part IV, line 11 ...........			5,721,644	15	7,167,077
16	Total assets. Add lines 1 through 15 (must equal line 33)...			78,337,251	16	93,963,237

17	Accounts payable and accrued expenses .....	10,675,283	17	10,868,106
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	10,232,502	23	14,536,353
24	Unsecured notes and loans payable to unrelated third parties ..	145,972	24	77,686
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	10,447,156	25	17,897,114
26	Total liabilities. Add lines 17 through 25..	31,500,913	26	43,379,259

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	40,059,537	27	43,604,958
28	Net assets with donor restrictions ...........	6,776,801	28	6,979,020
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	46,836,338	32	50,583,978
33	Total liabilities and net assets/fund balances ........	78,337,251	33	93,963,237