2021-08-13T10:31:39-05:00 2020-09-30 135565207 KPMG LLP 1601 MARKET STREET PHILADELPHIA PA 19103 990 2019-10-01 060646554 BRIDGEPORT HOSPITAL BRID 2036880580 267 GRANT STREET BRIDGEPORT CT 06610 EUGENE COLUCCI SENIOR VP/CFO 2036880580 2021-08-10 0 PHILLIP E GROFF P01247783 2672561756 2019 2022-09-23 18:48:47Z EUGENE COLUCCI 267 GRANT ST BRIDGEPORT CT 06610 791305674 0 X WWW.BRIDGEPORTHOSPITAL.ORG X 1878 CT TO OPERATE AN ACUTE CARE HOSPITAL IN BRIDGEPORT, CONNECTICUT. 13 9 3903 379 571838 0 4326940 74957004 569298868 595684286 4121607 3417247 48724982 55917018 626472397 729975555 555967 544646 0 0 232536685 296652510 0 0 0 354042508 446554237 587135160 743751393 39337237 -13775838 746612659 853709766 414502847 521433859 332109812 332275907 X TO OPERATE AN ACUTE CARE HOSPITAL IN BRIDGEPORT, CONNECTICUT FOR THE CARE AND TREATMENT OF PERSONS SUFFERING FROM DISEASE OR OTHER PHYSICAL OR MENTAL CONDITIONS WITHOUT REGARD TO RACE, COLOR, CREED, SEX, AGE OR ABILITY TO PAY. 0 0 671417070 544646 639993977 SCHEDULE OWHEN COVID-19 HIT CONNECTICUT, BRIDGEPORT HOSPITAL ANSWERED THE CALL TO SUPPORT, PROTECT AND DEFEND THE COMMUNITY. THE HEALTHCARE NEEDS OF OUR COMMUNITIES, HOWEVER, DID NOT STOP DURING THE PANDEMIC. PEOPLE COUNTED ON THE HOSPITAL'S MEDICAL AND CLINICAL PROFESSIONALS TO BE THERE WHEN NEEDED FOR EMERGENCY CARE AND GROUNDBREAKING MEDICAL TREATMENTS AS WELL AS SURGERIES, PREVENTIVE SCREENINGS AND ROUTINE CARE. PANDEMIC STRESS TOOK ITS TOLL ON MANY, BRINGING MUCH-NEEDED FOCUS ON BRIDGEPORT HOSPITAL'S MENTAL HEALTH SERVICES AND THE IMPORTANCE OF WELLNESS FOR MIND AND BODY. IN RESPONSE, BRIDGEPORT HOSPITAL CONTINUED TO PROVIDE COMPASSIONATE AND SAFE CARE ALIGNED WITH OUR COMMITMENT TO DELIVERING WORLD-CLASS CARE TO THE PATIENTS WE SERVE. BRIDGEPORT HOSPITAL, AS PART OF YALE NEW HAVEN HEALTH, ADMITTED ITS FIRST COVID-POSITIVE PATIENT IN MARCH. WITH LIMITED TESTING ACROSS THE COUNTRY AT THE TIME, YNHHS QUICKLY DEVELOPED ITS OWN COVID-19 DIAGNOSTIC TEST, HELPING TO ISOLATE POSITIVE CASES AND REDUCE THE SPREAD OF THE VIRUS. WITH THE HEALTH SYSTEM'S SUPPORT, COVID-19 TESTING SITES WERE ESTABLISHED ACROSS THE GREATER BRIDGEPORT AREA, INCLUDING FAIRFIELD, MILFORD AND BRIDGEPORT. A SPECIMEN COLLECTION RV WAS DEPLOYED TO VARIOUS COMMUNITY CENTERS IN BRIDGEPORT TO IMPROVE ACCESS TO TESTING, PARTICULARLY FOR UNDERSERVED POPULATIONS.JUNE 9 MARKED THE FIRST ANNIVERSARY OF THE INTEGRATION OF THE FORMER MILFORD HOSPITAL INTO BRIDGEPORT HOSPITAL AND YALE NEW HAVEN HEALTH SYSTEM. THE MILFORD CAMPUS PLAYED A KEY ROLE IN CARING FOR NON-COVID-19 PATIENTS AND INCREASING CAPACITY AT THE BRIDGEPORT CAMPUS FOR COVID-POSITIVE PATIENTS SINCE MARCH 14.IN SEPTEMBER, YALE NEW HAVEN HEALTH'S NORTHEAST MEDICAL GROUP (NEMG) OPENED A NEW MULTISPECIALTY CENTER AT 1152 KINGS HIGHWAY CUTOFF IN FAIRFIELD. THE NEW 25,000-SQUARE-FOOT FACILITY INCLUDES 45 EXAM ROOMS AND THREE PROCEDURE ROOMS FOR SOME 30 MEDICAL SPECIALISTS. THE CENTER ALSO HOUSES A BLOOD DRAW STATION AND X-RAY SERVICES. ALL PROVIDERS AND SERVICES ARE AFFILIATED WITH BRIDGEPORT HOSPITAL AND YALE NEW HAVEN HEALTH.BRIDGEPORT HOSPITAL JOINED THE AGE-FRIENDLY HEALTH SYSTEMS INITIATIVE, A MOVEMENT TO IMPROVE HEALTH CARE FOR OLDER ADULTS, CONTRIBUTING TO A GOAL OF 20 PERCENT OF U.S. HOSPITALS AND HEALTH SYSTEMS BECOMING AGE-FRIENDLY BY 2020. BRIDGEPORT HOSPITAL IS ONE OF MORE THAN 100 HEALTH SYSTEMS WORKING TO MAKE CARE FOR OLDER ADULTS EVEN MORE TAILORED TO PATIENTS' GOALS AND PREFERENCES AND CONSISTENTLY OF HIGH QUALITY.BRIDGEPORT HOSPITAL WAS AMONG THE FIRST HOSPITALS IN THE NORTHEAST, AND THE FIRST IN YALE NEW HAVEN HEALTH SYSTEM, TO OFFER PASTEURIZED DONOR HUMAN MILK (PDHM) TO WELL BABIES. PDHM IS SUPPLIED BY MOTHERS' MILK BANK NORTHEAST FOR INFANTS WHEN A MOTHER'S OWN MILK IS NOT SUFFICIENTLY AVAILABLE. SCREENING OF BREAST MILK DONORS IS SIMILAR TO BLOOD DONOR SCREENING, AND INCLUDES A HEALTH HISTORY, PHYSICIAN APPROVAL AND BLOOD TESTS. FOR ADDED SAFETY, THE MILK IS PASTEURIZED, AND THEN TESTED BY AN INDEPENDENT LAB. BRIDGEPORT HOSPITAL LAUNCHED AN ENHANCED STROKE CENTER, EXPANDING SERVICES FOR FAIRFIELD COUNTY RESIDENTS WHO CAN RECEIVE IMMEDIATE ON-SITE STROKE CARE, AND BRINGING CUTTING-EDGE NEUROSURGICAL PROCEDURES TO BRIDGEPORT. THE CENTER INCLUDES WORLD-CLASS NEUROSURGEONS FROM ACROSS YALE NEW HAVEN HEALTH, A TELESTROKE PROGRAM AND ADVANCED PROCEDURES THAT CAN REVERSE STROKE SYMPTOMS AND SAVE LIVES.TELESTROKE ALLOWS BRIDGEPORT HOSPITAL CAREGIVERS TO PARTNER WITH THE ENTIRE YALE NEW HAVEN HEALTH STROKE TEAM TO ENHANCE EFFICIENCY IN THE CARE OF STROKE PATIENTS WHO MIGHT REQUIRE INTER-ARTERIAL THERAPIES. IT ALSO HELPS ENSURE CONSISTENCY OF CARE ACROSS ALL YNHHS DELIVERY NETWORKS. THE MILFORD CAMPUS OF BRIDGEPORT HOSPITAL HAD THE TECHNOLOGY BEFORE IT BECAME PART OF BRIDGEPORT HOSPITAL. THE WOUND HEALING CENTER AT BRIDGEPORT HOSPITAL'S MILFORD CAMPUS ADDED TWO NEW SINGLE-PERSON HYPERBARIC OXYGEN THERAPY (HBOT) CHAMBERS. HBOT IS A MEDICAL TREATMENT IN WHICH PATIENTS BREATHE 100 PERCENT PURE OXYGEN AT AN INCREASED PRESSURE INSIDE AN OXYGEN CHAMBER TO PROMOTE THE HEALING OF CERTAIN TYPES OF WOUNDS. THE NEW HBOT CHAMBERS INCLUDE FEATURES THAT IMPROVE PATIENT COMFORT. BRIDGEPORT HOSPITAL MAINTAINED ITS RECOGNITION AS A HEALTHCARE EQUALITY LEADER BY THE HUMAN RIGHTS CAMPAIGN. ORGANIZATIONS DESIGNATED AS LEADERS IN LGBTQ HEALTHCARE EQUALITY ARE RECOGNIZED FOR IMPLEMENTING LGBTQ-INCLUSIVE POLICIES AND PRACTICES IN FOUR AREAS: PATIENT-CENTERED CARE, PATIENT SERVICES AND SUPPORT, FULLY INCLUSIVE EMPLOYEE BENEFITS AND POLICIES, AND PATIENT AND COMMUNITY ENGAGEMENT.BRIDGEPORT HOSPITAL HAS EARNED PLATINUM-LEVEL RECOGNITION FOR PARTICIPATION IN THE WORKPLACE PARTNERSHIP FOR LIFE (WPFL) HOSPITAL ORGAN DONATION CAMPAIGN, WHICH AIMS TO INCREASE ORGAN, EYE AND TISSUE DONOR REGISTRATIONS. BRIDGEPORT HOSPITAL WAS RECOGNIZED FOR EDUCATING STAFF, PATIENTS, VISITORS AND COMMUNITIES ABOUT THE CRITICAL NEED FOR ORGAN, EYE AND TISSUE DONATION, AND OFFERING OPPORTUNITIES TO REGISTER AS DONORS. FOOD INSECURITY IS A LONG-STANDING ISSUE IN THE BRIDGEPORT AREA AND THE NEED FOR FOOD INCREASED OVER THE COURSE OF THE COVID-19 PANDEMIC. BRIDGEPORT HOSPITAL HAS PROVIDED ACCESS TO A MONTHLY MOBILE FOOD PANTRY SINCE MAY 2019 IN PARTNERSHIP WITH THE CONNECTICUT FOOD BANK. NEARLY 2,000 FAMILIES HAVE BEEN SERVED BY MONTHLY MOBILE PANTRY VISITS, AND COUNTING. THE HOSPITAL ALSO PARTNERED WITH THE BRIDGEPORT FARMERS MARKET COLLABORATIVE TO HELP MAKE HEALTHY FOOD ACCESSIBLE TO THE COMMUNITY BY HOSTING A SEASONAL FARM STAND AT ITS BRIDGEPORT AND MILFORD CAMPUSES. FARM STAND CUSTOMERS HAVE THE ABILITY TO DOUBLE THEIR SNAP (SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM) DOLLARS TOWARD THE PURCHASE OF FRESH PRODUCE. EMPLOYEES DONATED HUNDREDS OF ITEMS TO SCHOOL SUPPLY DRIVES AT THE BRIDGEPORT AND MILFORD CAMPUSES AND PARK AVENUE MEDICAL CENTER. THE SUPPLIES, RANGING FROM NOTEBOOKS TO PENCILS, MARKERS AND BACKPACKS, WENT TO HALL SCHOOL IN BRIDGEPORT AND MILFORD SCHOOLS. THROUGHOUT 2020, IN ADDITION TO MANAGING THE EMERGENT NEEDS OF PATIENTS, STAFF AND COMMUNITY, BRIDGEPORT HOSPITAL DEMONSTRATED A STRONG COMMITMENT TO PATIENT CARE, CLINICAL QUALITY, PATIENT SAFETY AND SOUND FINANCIAL STEWARDSHIP TO THE PEOPLE AND COMMUNITIES IT SERVES. 671417070 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 341 0 3903 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 9 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X VERNETTE D GRAY 2036889585 789 HOWARD AVENUE NEW HAVEN CT 06519 GAYLE CAPOZZALO FORMER TRUSTEE 0.00 0.00 X 0 1545056 0 VINCENT PETRINI TRUSTEE 6.00 34.00 X 122479 694045 299029 PAMELA SCAGLIARINI SECRETARY 40.00 0.00 X 792975 0 302000 MICHAEL IVY INTERIM CEO/TRUSTEE 7.00 33.00 X X 155338 791672 117349 WILLIAM JENNINGS FORMER TRUSTEE 0.00 0.00 X 0 1013152 0 ROCKMAN FERRIGNO PHYSICIAN 40.00 0.00 X 735327 0 38618 CAROLYN SALSGIVER SR. VP STRATEGY & BUSINESS 8.00 32.00 X 107279 429115 221396 FRANCISCO GARRIDO PHYSICIAN 40.00 0.00 X 684774 0 37166 EUGENE COLUCCI CFO/TREASURER 18.00 22.00 X 289415 353730 43859 RYAN O'CONNELL VP OF PERFORMANCE & RISK 25.00 15.00 X 213726 356955 41763 JONATHAN MAISEL PHYSICIAN 40.00 0.00 X 505396 0 43344 MARYELLEN KOSTURKO SR. VP PATIENT CARE 40.00 0.00 X 479974 0 30221 THOMAS LAMONTE PHYSICIAN 40.00 0.00 X 403446 0 47514 GUILLERMO KATIGBAK PHYSICIAN 40.00 0.00 X 402894 0 43341 GINA CALDER VP OF AMBULATORY SERVICES 40.00 0.00 X 325828 0 26718 MARC LOMBARDI ASSISTANT SECRETARY 5.00 35.00 X 37549 275364 38569 MARY CHRISTOFFERSEN VP OF NURSING 40.00 0.00 X 304897 0 37910 ANNE DIAMOND PRESIDENT/TRUSTEE 32.00 8.00 X X 124693 31173 16870 JOHN FALCONI CHAIRMAN/TRUSTEE 1.00 2.00 X X 0 0 0 RONALD NOREN VICE CHAIRMAN/TRUSTEE 1.00 0.00 X X 0 0 0 GARY ZIMMERMAN VICE CHAIRMAN/TRUSTEE 1.00 0.00 X X 0 0 0 ADRIENNE HOUEL TRUSTEE 1.00 0.00 X 0 0 0 THOMAS LENCI TRUSTEE 1.00 0.00 X 0 0 0 KENNETH LIPOW TRUSTEE 1.00 0.00 X 0 0 0 FRED MCKINNEY TRUSTEE 1.00 0.00 X 0 0 0 RICHARD MEISENHEIMER TRUSTEE 1.00 2.00 X 0 0 0 MEREDITH REUBEN TRUSTEE 1.00 1.00 X 0 0 0 ED RODRIGUEZ TRUSTEE 1.00 0.00 X 0 0 0 JEFFREY TENGEL TRUSTEE 1.00 0.00 X 0 0 0 TITO VASQUEZ TRUSTEE 1.00 0.00 X 0 0 0 5685990 5490262 1385667 429 1 1 0 VIZIENT INC 290 E JOHN CARPENTER FREEWAY IRVING TX 75062 HEALTHCARE PERFORMANCE SERVICE 3454245 UNIVERSAL PROTECTION SERVICE LP PO BOX 828854 PHILADELPHIA PA 191828854 SECURITY SERVICE 2363264 UNITEX TEXTILE RENTAL INC 155 SOUTH TERRACE AVE MOUNT VERNON NY 10550 LAUNDRY/SERVICE 2355915 TOBIN CARBERRY O'MALLEY 43 BROAD STREET NEW LONDON CT 06320 LAW SERVICE 1381456 DVA RENAL HEALTHCARE INC 30 COMMERCE RD STAMFORD CT 06902 MEDICARE/CLINICS 1132980 78 4866840 70090164 745 74957004 INPATIENT REVENUE 621990 336462608 336462608 OUTPATIENT REVENUE 621990 258649595 258649595 LABORATORY SERVICES 621500 400700 400700 MGMT SVC - NEPC 621500 122645 122645 SESSION LEASE 621500 48738 48738 595684286 2181754 -245 2181999 7738976 823578 6915398 6915398 6915398 61742034 60506541 1235493 1235493 1235493 OTHER OPERATING INCOME 900099 34209555 34209555 PEDIATRIC ANCILLARY 900099 10100136 10100136 CAFETERIA/VENDING OTHE 900099 2149967 2149967 2541962 2541962 49001620 729975555 639421894 571838 15024819 X 4400 4400 540246 540246 3374697 337470 3037227 237560889 207805115 29755774 1964090 1710996 253094 37222854 32426289 4796565 16529980 14399914 2130066 207478 180742 26736 4635 4038 597 98002 98002 254080017 234829798 19250219 1766467 1538839 227628 8495038 7375712 1119326 23228864 20235575 2993289 641935 559214 82721 7424691 6467940 956751 9128779 7952438 1176341 33141206 28870605 4270601 12180563 10610966 1569597 MEDICAL SUPPLIES 90819086 90819086 PROPERTY TAX 3738477 3256734 481743 BOOKS/LICENSES 1457678 1269841 187837 SALES TAX 82597 71953 10644 58724 51157 7567 743751393 671417070 72334323 0 41412288 94573567 73092763 68908171 7068902 8481077 17448135 24963934 685584650 367281475 322916617 318303175 49007507 54677427 31745126 21145428 75743386 75743386 128177935 186913601 746612659 853709766 75358933 90535067 20106591 16997766 94609822 91570473 224427501 322330553 414502847 521433859 X 266043405 264654534 66066407 67621373 332109812 332275907 746612659 853709766 X -13775838 2097450 11844483 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 500 0 0 1 47952 0 1 49550 98002 0 PART II-B, LINE 1: THE AMOUNT REPORTED IN "OTHER ACTIVITIES" REPRESENTS A PORTION OF PROFESSIONAL DUES ATTRIBUTABLE TO LOBBYING DURING FY 2020. ALSO, THE HEALTH SYSTEM OFFICIALS HAD MEETINGS AND CONTACTS WITH STATE GOVERNMENT OFFICIALS, INCLUDING STATE LEGISLATORS AND THEIR STAFF TO DISCUSS VARIOUS HEALTH CARE REFORM PROPOSALS. BRIDGEPORT HOSPITAL IS PART OF AN AFFILIATED GROUP WITH THE FOLLOWING LOBBYING EXPENSES: YALE NEW HAVEN HOSPITAL EIN 06-0646652 $ 453,814 GREENWICH HOSPITAL EIN 06-0646659 $ 68,805 LAWRENCE + MEMORIAL HOSPITAL EIN 06-0646704 $ 65,560 NORTHEAST MEDICAL GROUP EIN 06-1330992 $ 32,337 LMW HEALTHCARE, INC. EIN 46-0543230 $ 24,657 0 26207000 1837794 1316978 26727816 26628000 654000 1075000 26207000 26140000 2087000 1599000 26628000 24648000 2453000 961000 26140000 23226000 2106000 684000 24648000 0.09560 0.20230 0.70210 0 0 43338313 43338313 305719434 110941694 194777740 28319645 27622915 696730 297081086 228716866 68364220 11126172 11126172 318303175 OTHER RECEIVABLES 4281982 INTEREST IN BRIDGEPORT HOSPITAL FOUNDATION,INC. 98199320 INTEREST IN BRIDGEPORT HOSPITAL AUXILIARY 484099 INTEREST IN CENTURY FINANCIAL SERVICES 749328 INTEREST IN BRIDGEPORT HOSPITAL FRIEMDS OF PEDIATRICS 2998623 THIRD PARTY RECEIVABLES 406972 RIGHT OF USE ASSET 27811277 PROFESSIONAL LIABILITIES INSURANCE RECOVERIES RECEIVABLES 51982000 186913601 SELF INSURANCE 42320646 ASSET RETIREMENT OBLIGATIONS 56889563 PENSION OBLIGATION 85663325 THIRD PARTY PAYABLE 32951209 DUE TO AFFILIATES 30340090 LEASE LIABILITY LTO 22183720 MALPRACTICE GROSS LIABILITY 51982000 322330553 X PART V, LINE 4: INTENDED USES FOR ENDOWMENT FUNDS THE ENDOWED FUNDS' INTENDED USE IS TO GENERATE INCOME TO SUPPORT BRIDGEPORT HOSPITAL PROGRAM SERVICE FUNCTIONS AND OTHER OPERATIONS IN ACCORDANCE WITH THE BRIDGEPORT HOSPITAL POOLED INVESTMENT POLICY, INCLUDING TO PROVIDE FREE CARE, ALL IN ACCORDANCE WITH AND BASED ON DONORS' WISHES. PART X, LINE 2: BRIDGEPORT HOSPITAL IS INCLUDED IN THE CONSOLIDATED YALE NEW HAVEN HEALTH CORPORATION AND SUBSIDIARIES AUDITED FINANCIAL STATEMENTS. FOLLOWING IS THE FOOTNOTE FROM THE CONSOLIDATED FINANCIAL STATEMENTS: MOST ENTITIES WITHIN THE SYSTEM ARE NOT FOR PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE CODE, AND ARE GENERALLY EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. PROVISIONS FOR INCOME TAXES AND DEFERRED TAXES, WHICH ARE NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS, HAVE BEEN MADE FOR THE TAXABLE ENTITIES LISTED ABOVE UNDER THE DESCRIPTION OF THE SYSTEM. U.S. GAAP REQUIRES THE SYSTEM TO EVALUATE TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN THE COURSE OF PREPARING THE SYSTEM'S TAX RETURNS TO DETERMINE WHETHER THE TAX POSITIONS ARE "MORE LIKELY THAN NOT" OF BEING SUSTAINED BY THE APPLICABLE TAX AUTHORITY BASED UPON THE TECHNICAL MERITS OF THE POSITION. THE SYSTEM RECOGNIZES THE EFFECT OF TAX POSITIONS ONLY IF THEY ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. THIS EVALUATION HAD NO IMPACT ON THE OPERATIONS OF THE SYSTEM AS OF AND FOR THE YEARS ENDED SEPTEMBER 30, 2020 AND 2019. 1 1 1 X 250.000000000000 1 X 550.000000000000 1 1 1 0 1 1 25458 66551556 35905154 30646402 0.04120 110040 164051641 103476973 60574668 0.08140 0 0 0 135498 230603197 139382127 91221070 0.12260 14 7791 2355841 317171 2038670 0.00270 3 223 9040353 0 9040353 0.01220 2 8104 10787077 9538324 1248753 0.00170 0 0 0 0 3 53026 254422 0 254422 0.00030 22 69144 22437693 9855495 12582198 0.01690 22 204642 253040890 149237622 103803268 0.13950 1 0 6250 0 6250 0.00000 0 0 0 0 2 535 7934 0 7934 0.00000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 4330 0 4330 0.00000 4 535 18514 18514 0.00000 1 19092076 223451377 265690450 -42239073 X 1 1 1 NONE NONE 1 1 BRIDGEPORT HOSPITAL 267 GRANT STREET BRIDGEPORT CT 06610 WWW.BRIDGEPORTHOSPITAL.ORG 0040 X X X X X BRIDGEPORT HOSPITAL 1 0 0 1 X X X X X X X X X X 18 1 1 1 1 X SEE PART V SUPPLEMENTAL INFORMATION X SEE PART V SUPPLEMENTAL INFORMATION X 1 18 1 SEE PART V SUPPLEMENTAL INFORMATION 0 1 X 250.000000000000 550.000000000000 X X X X X 1 1 X X X 1 X SEE PART V X SEE PART V X SEE PART V X X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION A: THIS STATE LICENSE FOR THE HOSPITAL LOCATION LISTED IN SCHEDULE H, PART V, SECTION A, ALSO COVERS VARIOUS SATELLITE LOCATIONS OPERATED UNDER AND EXPRESSLY LISTED ON THE SAME STATE HOSPITAL LICENSE. BRIDGEPORT HOSPITAL PART V, SECTION B, LINE 5: COMMUNITY ENGAGEMENT AND FEEDBACK WERE AN INTEGRAL PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. BRIDGEPORT HOSPITAL, THROUGH THE HEALTH IMPROVEMENT ALLIANCE, SOUGHT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL THROUGH FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WITH COMMUNITY MEMBERS AND COMMUNITY STAKEHOLDERS, AS WELL AS INCLUSION OF BOTH COMMUNITY PARTNERS AND AREA RESIDENTS IN THE PRIORITIZATION AND IMPLEMENTATION PLANNING PROCESS. PUBLIC HEALTH AND HEALTH CARE PROFESSIONALS SHARED KNOWLEDGE AND EXPERTISE ABOUT HEALTH ISSUES, WHILE LEADERS AND REPRESENTATIVES OF NON-PROFIT AND COMMUNITY-BASED ORGANIZATIONS PROVIDED INSIGHT ON THE COMMUNITY SERVED BY BRIDGEPORT HOSPITAL, INCLUDING MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITY POPULATIONS. BRIDGEPORT HOSPITAL PART V, SECTION B, LINE 6A: ST. VINCENT'S MEDICAL CENTER, ALSO LOCATED IN BRIDGEPORT, IS PART OF THE HEALTH IMPROVEMENT ALLIANCE, WHICH CONDUCTED THE COMMUNITY HEALTH NEEDS ASSESSMENT. BRIDGEPORT HOSPITAL PART V, SECTION B, LINE 6B: YES, THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS SPEARHEADED, FUNDED, AND MANAGED BY THE HEALTH IMPROVEMENT ALLIANCE, WHICH INCLUDES BRIDGEPORT HOSPITAL, ST. VINCENT'S MEDICAL CENTER, CITY OF BRIDGEPORT DEPARTMENT OF HEALTH AND SOCIAL SERVICES, FAIRFIELD HEALTH DEPARTMENT, MONROE HEALTH DEPARTMENT, TRUMBULL HEALTH DEPARTMENT, STRATFORD HEALTH DEPARTMENT, OPTIMUS HEALTHCARE, SOUTHWEST COMMUNITY HEALTH CENTER, AMERICARES FREE CLINIC OF BRIDGEPORT, LLC. THE ORGANIZATIONS ARE REPRESENTATIVE OF THOSE IN THE COMMUNITY WHO SERVE UNDERSERVED, LOW-INCOME, AND HARD TO REACH POPULATIONS. REPRESENTATIVES FROM THESE ORGANIZATIONS PROVIDE REGULAR INPUT AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPROVEMENT PLAN IMPLEMENTATION PROCESS BY ROUTINELY ATTENDING MONTHLY COALITION MEETINGS, PROVIDING FEEDBACK AND GUIDANCE AT EACH STAGE OF THE CHNA PROCESS, IDENTIFYING SPECIFIC POPULATIONS FOR COMMUNITY CONVERSATIONS, RESPONDING TO KEY INFORMANT SURVEYS, ATTENDING COMMUNITY FORUMS AND PRIORITIZATION SESSIONS, AND BY BEING VALUED COMMUNITY PARTNERS.THE HEALTH IMPROVEMENT ALLIANCE FORMERLY THE PRIMARY CARE ACTION GROUP WAS FOUNDED IN 2003 WITH THE MISSION TO IMPROVE THE HEALTH OF THE COMMUNITY. HIA'S VISION IS TO WORK TOGETHER AS A COALITION TO IDENTIFY, PRIORITIZE, AND MEASURABLY IMPROVE THE HEALTH OF THEIR COMMUNITY THROUGH HEALTH CARE PREVENTION, EDUCATION, AND SERVICES. TO DEVELOP A SHARED VISION AND PLAN FOR THE COMMUNITY AND HELP SUSTAIN LASTING CHANGE, THE PCAG ASSESSMENT AND PLANNING PROCESS AIMED TO ENGAGE AGENCIES, ORGANIZATIONS, AND RESIDENTS IN THE AREA THROUGH PARTICIPATORY AND COLLABORATIVE APPROACHES.PART V, SECTION B, LINE 7A - HOSPITAL FACILITY'S WEBSITE HTTPS://WWW.BRIDGEPORTHOSPITAL.ORG/ABOUT/COMMUNITY/HEALTH-NEEDS-ASSESSMENT.ASPXPART V, SECTION B, LINE 7B - OTHER WEBSITES (LIST URL):HTTPS://STVINCENTS.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT; HTTPS://WWW.TRUMBULL-CT.GOV/DOCUMENTCENTER/VIEW/3468/2019-CHNA-IMPLEMENTATION-PLAN-PDF?BIDID=; HTTPS://FAIRFIELDCT.ORG/HEALTHDATA; HTTP://WWW.TOWNOFSTRATFORD.COM/HEALTH/DATA; HTTP://WWW.MONROECT.ORG/HEALTH PART V, SECTION B, LINE 10A:HTTPS://WWW.BRIDGEPORTHOSPITAL.ORG/ABOUT/COMMUNITY/HEALTH-NEEDS-ASSESSMENT.ASPX BRIDGEPORT HOSPITAL PART V, SECTION B, LINE 11: IN FEBRUARY 2019, HEALTH IMPROVEMENT ALLIANCE MEMBERS AND THEIR COMMUNITY PARTNERS (INCLUDING THOSE WITH PUBLIC HEALTH DEPARTMENTS AND / OR KNOWLEDGE, INFORMATION, OR EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY OR MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS) REVIEWED THE PRIMARY AND SECONDARY CHNA DATA AND DETERMINED, BY GROUP CONSENSUS, THAT THE 2016 PRIORITIES WOULD BE MAINTAINED MOVING FORWARD FOR THE 2019 CHNA. IN 2019, CONCURRENT WITH THE COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPROVEMENT PLAN PROCESS, HIA RESTRUCTURED ITS TASK FORCES TO FOCUS ON THREE PRIORITY AREAS: HEALTHY LIFESTYLES, BEHAVIORAL HEALTH AND ACCESS TO CARE. AS PART OF THE CHNA ENGAGEMENT PROCESS, HEALTH EQUITY SOLUTIONS (HES) WORKED WITH HIA TO DEVELOP A PROCESS TO PRIORITIZE HEALTH ISSUES FOR THE GREATER BRIDGEPORT REGION. FOLLOWING DATA COLLECTION FROM THE 2018 DATAHAVEN COMMUNITY WELLBEING SURVEY, KEY INFORMANT INTERVIEWS, AND COMMUNITY CONVERSATIONS, EACH OF THE THREE HIA TASK FORCES MET WITH HEALTH EQUITY SOLUTIONS TO PRIORITIZE HEALTH ISSUES, DEVELOP MEASURABLE GOALS, SET INDICATORS, AND IDENTIFY STRATEGIES AND ACTIONS FOR EACH PRIORITY. BASED ON THE FEEDBACK FROM THE PRIORITIZATION SESSIONS, COMMUNITY HEALTH IMPROVEMENT PLANS (CHIPS) WERE DEVELOPED FOR EACH OF THE THREE PRIORITY AREAS. THESE FOCUS AREAS WILL BE ADDRESSED THROUGH A SOCIAL DETERMINANTS OF HEALTH LENS.BRIDGEPORT HOSPITAL RECOGNIZES THAT PARTNERSHIPS WITH COMMUNITY AGENCIES HAVE THE BROADEST REACH TO IMPROVE COMMUNITY HEALTH ISSUES. AS SUCH, THE HOSPITAL IS PROVIDING FACILITATION SUPPORT FOR THE IMPLEMENTATION OF THE COMMUNITY-WIDE HEALTH IMPROVEMENT PLAN THAT WILL FOCUS ON ALL THREE AREAS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (HEALTHY LIFESTYLES, AND BEHAVIORAL HEALTH AND ACCESS TO CARE). BRIDGEPORT HOSPITAL FOLLOWED THE SAME PROCESS DETAILED ABOVE WITHIN ITS OWN FACILITY AND DEVELOPED A COMMUNITY HEALTH IMPROVEMENT PLAN OUTLINING SPECIFIC GOALS, OBJECTIVES AND STRATEGIES TO PURSUE FOR THE NEXT THREE-YEAR CYCLE. PROGRESS ON BOTH PLANS WILL BE MONITORED REGULARLY USING A MONITORING TOOL DEVELOPED TO TRACK THE SPECIFIC GOALS, OBJECTIVES, AND STRATEGIES IDENTIFIED IN EACH AREA. THE HOSPITAL BEGAN IMPLEMENTING ITS IMPLEMENTATION STRATEGIES IN FY 2020. THIS INCLUDED LEADING THE HEALTH IMPROVEMENT ALLIANCE IN THE HEALTH ENHANCEMENT COMMUNITY GRANT OPPORTUNITY FROM THE CONNECTICUT DEPARTMENT OF PUBLIC HEALTH. THE HEALTH ENHANCEMENT COMMUNITY INITIATIVE IS A PARTNERSHIP BETWEEN THE STATE OF CONNECTICUT AND PARTICIPANT COMMUNITIES THAT FOCUSES ON IMPROVING COMMUNITY HEALTH BY WORKING ALONGSIDE COMMUNITY MEMBERS TO ADDRESS ISSUES AIMED TO ALLEVIATE ROOT CAUSES AND PREVENT PEOPLE FROM GETTING SICK IN THE FIRST PLACE.IN MARCH 2020, ALL EFFORTS SHIFTED TO ADDRESS THE COVID-19 PANDEMIC IN OUR COMMUNITY. YALE NEW HAVEN HOSPITAL, AS PART OF YALE NEW HAVEN HEALTH SWIFTLY CONVERTED HOSPITAL SPACE TO COVID-19 UNITS, ASSEMBLED DRIVE-THROUGH SPECIMEN COLLECTION SITES AND MOBILE TESTING UNITS, CREATED ONSITE SPECIMEN TESTING CAPABILITIES, INSTITUTED NEW TREATMENT AND MEDICATION THERAPIES, LAUNCHED EMPLOYEE WELLNESS INITIATIVES AND PROCURED NEARLY IMPOSSIBLE-TO-FIND RESOURCES FROM PPE TO VENTILATORS TO MEDICATIONS. BRIDGEPORT HOSPITAL PART V, SECTION B, LINE 13H: THESE PROGRAMS COVER MEDICALLY NECESSARY CARE ONLY.PART V, SECTION B, LINE 16A, 16B AND 16C:HTTPS://WWW.BRIDGEPORTHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE.ASPX SCHEDULE H, PART V, SECTION D THE FACILITY LOCATIONS LISTED IN SCHEDULE H, PART V, SECTION D, INCLUDE OFF-CAMPUS OUTPATIENT HEALTH CARE FACILITIES THAT BRIDGEPORT HOSPITAL OPERATED DURING THE TAX YEAR UNDER ITS STATE HOSPITAL LICENSE.PART V, SECTION B, LINE 3J:QUANTITATIVE AND QUALITATIVE DATA WERE COLLECTED AND REVIEWED THROUGHOUT THE CHNA PROCESS. SECONDARY DATA SOURCES INCLUDED, BUT WERE NOT LIMITED TO, THE U.S. CENSUS, U.S. BUREAU OF LABOR STATISTICS, CENTERS FOR DISEASE CONTROL AND PREVENTION, STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH, CONNECTICUT HEALTH INFORMATION MANAGEMENT EXCHANGE (CHIME), AS WELL AS LOCAL ORGANIZATIONS AND AGENCIES. TYPES OF DATA INCLUDED VITAL STATISTICS BASED ON BIRTH AND DEATH RECORDS. IN ADDITION, HIA PARTNERED WITH DATAHAVEN AND, IN PART, SPONSORED THE 2018 DATAHAVEN COMMUNITY WELLBEING SURVEY, HIRED HEALTH EQUITY SOLUTIONS TO CONDUCT COMMUNITY CONVERSATIONS IN THE GREATER BRIDGEPORT REGION, WORKED WITH THE YALE SCHOOL OF PUBLIC HEALTH STUDENT CONSULTING GROUP TO CONDUCT AND LATER ANALYZE KEY INFORMANT SURVEYS, AND A STUDENT PRACTICUM TEAM ALSO FROM THE YALE SCHOOL OF PUBLIC HEALTH TO IDENTIFY COMMUNITY RESOURCES. HEALTH OUTCOMES AND RISK FACTORS RELATED TO CHRONIC DISEASE, MENTAL HEALTH AND SUBSTANCE ABUSE, MORTALITY AND MORBIDITY INCLUDE SELF-REPORTED HEALTH STATUS, NEIGHBORHOOD ENVIRONMENTS AND FINANCIAL STRESS. KEY FINDINGS FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR THE GREATER BRIDGEPORT REGION INCLUDE HEALTH OUTCOMES AND FINDINGS AS THEY RELATE TO THE TOP THREE HEALTH PRIORITIES THAT WERE SELECTED FOR ACTION PLANNING AT A REGIONAL LEVEL: HEALTHY LIFESTYLES, ACCESS TO CARE AND BEHAVIORAL HEALTH. SIGNIFICANT HEALTH ISSUES IDENTIFIED INCLUDE OBESITY RATES, MEDICAL CONDITIONS AND COMPLICATIONS FROM OBESITY (E.G. HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, DIABETES, HEART DISEASE, ETC.), SMOKING (INCLUDING E-CIGARETTE) PREVALENCE RATES, COMMUNITY NEED FOR MENTAL HEALTH SERVICES, AND SUPPORT, FINANCIAL STRESS, CHALLENGES RELATED TO ACCESS TO MEDICAL CARE AND TYPE OF INSURANCE COVERAGE LEADING TO FEELINGS OF DISCRIMINATION. 12 1 - BRIDGEPORT HOSPITAL 40 COMMERCE PARK MILFORD CT 06460 DRAW STATION 2 - BRIDGEPORT HOSPITAL 887 BRIDGEPORT AVENUE SHELTON CT 06484 DIAGNOSTIC RADIOLOGY, DRAW STATION 3 - BRIDGEPORT HOSPITAL 15 CORPORATE DRIVE TRUMBULL CT 06611 DRAW STATION 4 - BRIDGEPORT HOSPITAL 111 BEACH ROAD FAIRFIELD CT 06824 GENETICS 5 - BRIDGEPORT HOSPITAL 1070 MAIN STREET BRIDGEPORT CT 06610 SLEEP MEDICINE 6 - BRIDGEPORT HOSPITAL 1825 BARNUM AVENUE STRATFORD CT 06614 DRAW STATION 7 - BRIDGEPORT HOSPITAL 129 KINGS HIGHWAY NORTH WESTPORT CT 06883 DRAW STATION 8 - BRIDGEPORT HOSPITAL 849 BOSTON POST ROAD SUITE 204 MILFORD CT 06460 DRAW STATION 9 - BRIDGEPORT HOSPITAL 267 GRANT STREET BRIDGEPORT CT 06610 NORMA PFRIEM BREAST CENTER, YNHH CHILDREN'S HOSPITAL OF BH. BLOOD DRAW 10 - BRIDGEPORT HOSPITAL 1152 KINGS HIGHWAY CUTOFF FAIRFIELD CT 06824 DRAW STATION 11 - BRIDGEPORT HOSPITAL 327 RIVERSIDE AVENUE WESTPORT CT 06880 DRAW STATION 12 - BRIDGEPORT HOSPITAL 223 MILL HILL AVENUE BRIDGEPORT CT 06610 VACCINE AND COVID TESTING PART I, LINE 3C: THE FINANCIAL ASSISTANCE POLICY PROVIDES THAT THE PATIENT MUST SUBMIT A FINANCIAL ASSISTANCE APPLICATION. PART I, LINE 7: THE HOSPITAL USES A COST ACCOUNTING SYSTEM, STRATAJAZZ, TO CALCULATE THE AMOUNTS PRESENTED IN PART I, LINE 7. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS. PART II, COMMUNITY BUILDING ACTIVITIES: BRIDGEPORT HOSPITAL, ALONG WITH MANY OTHER HOSPITALS ACROSS THE COUNTRY, UTILIZES THE COMMUNITY BENEFITS INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA) DATABASE DEVELOPED BY LYON SOFTWARE TO CATALOG ITS COMMUNITY BENEFIT AND COMMUNITY BUILDING ACTIVITIES AND THE GUIDELINES DEVELOPED BY THE CATHOLIC HOSPITAL ASSOCIATION (CHA) IN ORDER TO CATALOG THESE BENEFITS. THESE TWO ORGANIZATIONS HAVE WORKED TOGETHER FOR OVER 30 YEARS TO PROVIDE SUPPORT TO NON-FOR-PROFIT HOSPITALS TO DEVELOP AND SUSTAIN EFFECTIVE COMMUNITY BENEFIT PROGRAMS.THE MOST RECENT VERSION OF THE CHA GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFIT DEFINES COMMUNITY BUILDING ACTIVITIES AS PROGRAMS THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS AND ENVIRONMENTAL PROBLEMS. THESE ACTIVITIES ARE CATEGORIZED INTO EIGHT DISTINCT AREAS INCLUDING PHYSICAL IMPROVEMENT AND HOUSING, ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT, ENVIRONMENTAL IMPROVEMENTS, LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS, COALITION BUILDING, ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENTS, AND WORKFORCE DEVELOPMENT. BRIDGEPORT HOSPITAL IS INCREASINGLY AWARE OF HOW SOCIAL DETERMINANTS IMPACT THE HEALTH OF INDIVIDUALS AND COMMUNITIES. A PERSON'S HEALTH AND CHANCES OF BECOMING SICK AND DYING EARLY ARE GREATLY INFLUENCED BY POWERFUL SOCIAL FACTORS SUCH AS EDUCATION, INCOME, NUTRITION, HOUSING AND NEIGHBORHOODS. DURING FISCAL YEAR 2020, BRIDGEPORT HOSPITAL PROVIDED $18,514 IN FINANCIAL AND IN-KIND DONATIONS TO SUPPORT JOB TRAINING, ECONOMIC DEVELOPMENT AND OTHER ESSENTIAL SERVICES. THE HOSPITAL CONSIDERS THESE INVESTMENTS PART OF ITS OVERALL COMMITMENT OF BUILDING STRONGER NEIGHBORHOODS. EXAMPLES BELOW FOCUS ON THE AREAS OF REVITALIZING OUR NEIGHBORHOODS AND CREATING EDUCATIONAL OPPORTUNITIES.REVITALIZING OUR NEIGHBORHOODSSEVERAL YEARS AGO, THE CITY OF BRIDGEPORT ORGANIZED NEIGHBORHOOD REVITALIZATION ZONES (NRZS) IN ORDER TO EXPAND AND IMPROVE BUSINESS AND HOUSING IN LOW-TO-MODERATE INCOME NEIGHBORHOODS OR AREAS WITHIN NEIGHBORHOODS. THE NRZS RECEIVE TECHNICAL ASSISTANCE FROM THE CITY AND OUTSIDE CONSULTANTS, AND ENGAGE NEIGHBORHOOD RESIDENTS, NON-PROFITS, BUSINESSES AND FAITH-BASED ORGANIZATIONS TO MEET AND FORM STAKEHOLDER GROUPS. THESE GROUPS IDENTIFY THE PRIORITIES AND NEEDS OF THE NEIGHBORHOODS AND ARE ELIGIBLE TO BORROW STATE MONEY TO PURCHASE BLIGHTED PROPERTIES OR OFFER LOW-INTEREST LOANS TO QUALIFYING BUSINESSES FOR FACADE IMPROVEMENTS. HOSPITAL LEADERSHIP HAS BEEN ACTIVELY ENGAGED IN THE NRZ PROCESS FROM THE ONSET WITH REPRESENTATIVES SERVING ON COMMITTEES ORGANIZED IN THE CITY'S EAST END, EAST SIDE AND MILL HILL NEIGHBORHOODS, WHICH ARE LOCATED NEAR THE HOSPITAL. BRIDGEPORT HOSPITAL, ALONG WITH OTHER AREA BUSINESSES, IS A FOUNDING MEMBER OF THE SEAVIEW AVENUE BUSINESS ALLIANCE. THE SEAVIEW AVENUE BUSINESS ALLIANCE IS A NON-PROFIT ORGANIZATION DEDICATED TO IMPROVING STREETSCAPES AND IMPROVING THE AREA ALONG THE SEAVIEW AVENUE CORRIDOR. THE ORGANIZATION ALSO PROVIDES ANNUAL SCHOLARSHIPS TO STUDENTS GRADUATING FROM HARDING HIGH SCHOOL WHO PLAN TO ATTEND COLLEGE. THE HOSPITAL PROVIDE ONGOING FINANCIAL AND IN-KIND SUPPORT FOR THESE EFFORTS.CREATING EDUCATIONAL OPPORTUNITIESHIGHER EDUCATIONAL ATTAINMENT IS ASSOCIATED WITH BETTER HEALTH STATUS AND LONGER LIFE. FOR EXAMPLE, ADULTS AGED 25-50 YEARS WHO HAVE A COLLEGE DEGREE WILL ON AVERAGE LIVE FIVE YEARS LONGER THAN THOSE WITH LESS THAN A HIGH SCHOOL EDUCATION. A SCHOOL SUPPLY DRIVE WAS HELD AT THE HOSPITAL FOR STUDENTS AT THE HALL ELEMENTARY SCHOOL, LOCATED IN THE MILL HILL NEIGHBORHOOD OF BRIDGEPORT. HOSPITAL EMPLOYEES CONTRIBUTED HUNDREDS OF ITEMS RANGING FROM PENS AND PENCILS TO NOTEBOOKS, BACKPACKS AND OTHER ITEMS TO HELP ASSIST OVER 300 STUDENTS TO BEGIN THEIR SCHOOL YEAR. AS MENTIONED IN THE PREVIOUS SECTION, BRIDGEPORT HOSPITAL, THROUGH THE SEAVIEW AVENUE BUSINESS ALLIANCE, PROVIDED SCHOLARSHIPS TO SENIORS FROM HARDING HIGH SCHOOL WHO WILL BE ATTENDING COLLEGE. THE HOSPITAL IS ALSO A MEMBER OF THE BRIDGEPORT CHILD ADVOCACY COALITION, WHICH IS A COALITION OF ORGANIZATIONS, PARENTS AND OTHER CONCERNED INDIVIDUALS COMMITTED TO IMPROVING THE WELL-BEING OF BRIDGEPORT'S CHILDREN THROUGH RESEARCH, ADVOCACY, COMMUNITY EDUCATION AND MOBILIZATION. PART III, LINE 2: IN ACCORDANCE WITH THE ESTABLISHED POLICIES OF THE HOSPITAL, DURING THE REGISTRATION, BILLING AND COLLECTION PROCESS A PATIENT'S ELIGIBILITY FOR FREE CARE FUNDS IS DETERMINED. FOR PATIENTS WHO WERE DETERMINED BY THE HOSPITAL TO HAVE THE ABILITY TO PAY BUT DID NOT, THE UNCOLLECTED AMOUNTS ARE BAD DEBT EXPENSE. THE HOSPITAL'S COST ACCOUNTING SYSTEM UTILIZES PATIENT-SPECIFIC DATA TO ACCUMULATE AND DERIVE COSTS RELATED TO THESE BAD DEBT ACCOUNTS.DUE TO THE ADOPTION OF ASU NO. 2014-09 REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606) BAD DEBT EXPENSE IS NO LONGER REPORTED ON THE AUDITED FINANCIAL STATEMENTS. RATHER IT IS TREATED AS A PRICE CONCESSION. BAD DEBT IS DETERMINED IF THERE WAS AN ADVERSE EVENT THAT PREVENTED A PATIENT FROM BEING ABLE TO PAY THE EXPECTED AMOUNT. FOR THE PATIENTS WHO WERE DETERMINED BY THE HOSPITAL TO HAVE THE ABILITY TO PAY UNCOLLECTED AMOUNTS BUT DID NOT, THESE UNCOLLECTED AMOUNTS ARE TREATED AS IMPLICIT PRICE CONCESSIONS. THE HOSPITAL IS REPORTING BOTH BAD DEBT AND IMPLICIT PRICE CONCESSIONS ON SCHEDULE H, PART III, LINE 2. PART III, LINE 3: THE ORGANIZATION DOES NOT CURRENTLY HAVE A METHODOLOGY TO ACCURATELY QUANTIFY OR ESTIMATE THE AMOUNT OF BAD DEBT EXPENSE THAT WOULD BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PART III, LINE 4: BRIDGEPORT HOSPITAL IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS FOR YALE NEW HAVEN HEALTH SERVICES CORPORATION (YNHHSC). THE CONSOLIDATED FINANCIAL STATEMENTS FOR YNHHSC INCLUDES THE FOLLOWING FOOTNOTE REGARDING UNCOMPENSATED CARE AND COMMUNITY BENEFIT EXPENSE ON PAGE 20:THE SYSTEM'S COMMITMENT TO COMMUNITY SERVICE IS EVIDENCED BY SERVICES PROVIDED TO THE POOR AND BENEFITS PROVIDED TO THE BROADER COMMUNITY. SERVICES PROVIDED TO THE POOR INCLUDE SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTHCARE BECAUSE OF INADEQUATE RESOURCES, AND/OR WHO ARE UNINSURED OR UNDERINSURED.THE SYSTEM PROVIDES FREE CARE PROGRAMS FOR QUALIFYING PATIENTS. IN ACCORDANCE WITH THE ESTABLISHED POLICIES OF THE SYSTEM, DURING THE REGISTRATION, BILLING, AND COLLECTION PROCESS, A PATIENT'S ELIGIBILITY FOR FREE CARE FUNDS IS DETERMINED. FOR PATIENTS WHO WERE DETERMINED BY THE SYSTEM TO HAVE THE ABILITY TO PAY BUT DID NOT, THE UNCOLLECTED AMOUNTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS. FOR PATIENTS WHO DO NOT AVAIL THEMSELVES OF ANY FREE CARE PROGRAM, AND WHOSE ABILITY TO PAY CANNOT BE DETERMINED BY THE SYSTEM, CARE GIVEN BUT NOT PAID FOR IS CLASSIFIED AS CHARITY CARE.TOGETHER, CHARITY CARE AND FREE CARE REPRESENT UNCOMPENSATED CARE. THE ESTIMATED COST OF TOTAL UNCOMPENSATED CARE IS APPROXIMATELY $102.0 MILLION AND $88.9 MILLION FOR THE YEARS ENDED SEPTEMBER 30, 2020 AND 2019, RESPECTIVELY. THE ESTIMATED COST OF UNCOMPENSATED CARE IS BASED ON THE RATIO OF COST TO CHARGES, AS DETERMINED BY CLAIMS ACTIVITY.THE ALLOCATION BETWEEN IMPLICIT PRICE CONCESSION AND CHARITY CARE IS DETERMINED BASED ON MANAGEMENT'S ANALYSIS ON THE PREVIOUS 12 MONTHS OF HOSPITAL DATA. THIS ANALYSIS CALCULATES THE ACTUAL PERCENTAGE OF ACCOUNTS WRITTEN OFF OR DESIGNATED AS IMPLICIT PRICE CONCESSIONS VERSUS CHARITY CARE WHILE TAKING INTO ACCOUNT THE TOTAL COSTS INCURRED BY THE SYSTEM FOR EACH ACCOUNT ANALYZED.THE CONNECTICUT DISPROPORTIONATE SHARE HOSPITAL PROGRAM (CDSHP) WAS ESTABLISHED TO PROVIDE FUNDS TO HOSPITALS FOR THE PROVISION OF UNCOMPENSATED CARE AND IS FUNDED, IN PART, BY AN ASSESSMENT ON HOSPITAL NET PATIENT SERVICE REVENUE. THE SYSTEM MADE PAYMENTS INTO THE CDSHP OF $330.7 MILLION AND $333.1 MILLION FOR THE YEARS ENDED SEPTEMBER 30, 2020 AND 2019, RESPECTIVELY, FOR THE ASSESSMENT.DURING THE YEARS ENDED SEPTEMBER 30, 2020 AND 2019, THE SYSTEM RECEIVED $184.4 MILLION AND $155.1 MILLION, RESPECTIVELY, IN CDSHP DISTRIBUTIONS, OF WHICH APPROXIMATELY $108.0 MILLION AND 92.0 MILLION WAS RELATED TO CHARITY CARE. THESE ARE RECORDED IN NET PATIENT SERVICE REVENUE.ADDITIONALLY, THE SYSTEM PROVIDES BENEFITS FOR THE BROADER COMMUNITY, WHICH INCLUDES SERVICES PROVIDED TO OTHER NEEDY POPULATIONS THAT MAY NOT QUALIFY AS POOR BUT NEED SPECIAL SERVICES AND SUPPORT. BENEFITS INCLUDE THE COST OF HEALTH PROMOTION AND EDUCATION OF THE GENERAL COMMUNITY, INTERNS AND RESIDENTS, HEALTH SCREENINGS, AND MEDICAL RESEARCH. THE BENEFITS ARE PROVIDED THROUGH THE COMMUNITY HEALTH CENTERS, SOME OF WHICH SERVICE NON ENGLISH SPEAKING RESIDENTS, DISABLED CHILDREN, AND VARIOUS COMMUNITY SUPPORT GROUPS. THE SYSTEM VOLUNTARILY ASSISTS WITH THE DIRECT FUNDING OF SEVERAL CITY OF NEW HAVEN PROGRAMS, INCLUDING AN ECONOMIC DEVELOPMENT PROGRAM AND A YOUTH INITIATIVE PROGRAM.IN ADDITION TO THE QUANTIFIABLE SERVICES DEFINED ABOVE, THE SYSTEM PROVIDES BENEFITS TO THE COMMUNITY THROUGH ITS ADVOCACY OF COMMUNITY SERVICE BY EMPLOYEES. THE SYSTEM'S EMPLOYEES SERVE NUMEROUS ORGANIZATIONS THROUGH BOARD REPRESENTATION, MEMBERSHIP IN ASSOCIATIONS AND OTHER RELATED ACTIVITIES. THE SYSTEM ALSO SOLICITS THE ASSISTANCE OF OTHER HEALTHCARE PROFESSIONALS TO PROVIDE THEIR SERVICES AT NO CHARGE THROUGH PARTICIPATION IN VARIOUS COMMUNITY SEMINARS AND TRAINING PROGRAMS. PART III, LINE 8: THE ENTIRE MEDICARE LOSS PRESENTED SHOULD BE TREATED AS A COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO MEDICARE BENEFICIARIES, IRS REVENUE RULING 69-545 INDICATES THAT HOSPITALS OPERATE FOR THE PROMOTION OF HEALTH IN THE COMMUNITY WHEN IT PROVIDES CARE TO PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, THE HOSPITAL PROVIDES CARE TO MEDICARE PATIENTS REGARDLESS OF MEDICARE SHORTFALLS (REDUCING THE BURDEN ON THE GOVERNMENT), AND MANY OF THE MEDICARE PARTICIPANTS WOULD HAVE QUALIFIED FOR THE CHARITY CARE OR OTHER MEANS TESTED PROGRAMS ABSENT BEING ENROLLED IN THE MEDICARE PROGRAM. THE MEDICARE SHORTFALL REPORTED IS DETERMINED BY THE HOSPITAL'S COST ACCOUNTING SYSTEM, STRATAJAZZ. PART III, LINE 9B: IT IS THE HOSPITAL'S POLICY TO TREAT ALL PATIENTS EQUITABLY WITH RESPECT AND COMPASSION, FROM THE BEDSIDE TO THE BILLING OFFICE. THE HOSPITAL WILL PURSUE PATIENT ACCOUNTS, DIRECTLY AND THROUGH ITS COLLECTION AGENTS, FAIRLY AND CONSISTENTLY TAKING INTO CONSIDERATION DEMONSTRATED FINANCIAL NEED. AS PART OF ITS COLLECTION PROCESS, THE HOSPITAL WILL MAKE REASONABLE EFFORTS TO DETERMINE IF AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER ITS FINANCIAL ASSISTANCE POLICY. IN THE EVENT A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL WILL NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTION AS DEFINED BY LAW AND HOSPITAL POLICY. PART VI, LINE 2: COMMUNITY NEEDS ARE ROUTINELY REVIEWED AND ADDRESSED AS PART OF THE OPERATIONS AND SERVICE LINE TEAMS AT BRIDGEPORT HOSPITAL. THESE MULTI-DISCIPLINARY GROUPS PROVIDE ANALYSIS AND INSIGHT INTO PATIENT UTILIZATION TRENDS ACROSS OUR DELIVERY OF CARE AND ARE REVIEWED IN TANDEM WITH CARE MANAGEMENT AND PATIENT SATISFACTION RESULTS AND OTHER COMMUNITY FEEDBACK. COUPLED WITH THE COMMUNITY NEEDS ASSESSMENT, THIS INFORMATION ASSISTS WITH THE DEVELOPMENT OF NEW INITIATIVES, PARTNERSHIPS, PROGRAMS AND SERVICES TO BENEFIT OUR COMMUNITY. PART VI, LINE 3: BRIDGEPORT HOSPITAL INFORMS INDIVIDUALS ABOUT ITS FINANCIAL ASSISTANCE PROGRAMS ON ITS WEBSITE, THROUGH VISIBLE POSTINGS AND COMMUNICATIONS AT POINTS OF REGISTRATION AND FRONT LINE ACCESS. THE FINANCIAL ASSISTANCE POLICY, APPLICATION AND SUMMARY ARE AVAILABLE ON REQUEST WITHOUT CHARGE BY MAIL, INCLUDING AT ADMITTING DEPARTMENT. FURTHER, PATIENTS RECEIVE A SUMMARY OF FINANCIAL ASSISTANCE PROGRAMS, INCLUDING ELIGIBILITY REQUIREMENTS THROUGH A FIRST STATEMENT MAILER AS PART OF THE BILLING PROCESS. THESE COMMUNICATIONS INCLUDE TELEPHONE NUMBERS AND POINT OF CONTACT FOR INDIVIDUALS TO VISIT OR CALL. THE HOSPITAL HAS RESOURCES TO ASSIST PATIENTS WITH STATE OF CONNECTICUT MEDICAID APPLICATIONS. PART VI, LINE 4: TO DEFINE COMMUNITY FOR CHNA PURPOSES, THIS GREATER BRIDGEPORT COMMUNITY HEALTH NEEDS ASSESSMENT USES A GEOGRAPHIC APPROACH FOCUSING ON SIX TOWNS WITHIN FAIRFIELD COUNTY, CT: BRIDGEPORT, EASTON, FAIRFIELD, MONROE, STRATFORD, AND TRUMBULL. THESE COMMUNITIES ARE SERVED BY BOTH BRIDGEPORT HOSPITAL AND ST. VINCENT'S MEDICAL CENTER REPRESENTING AT LEAST 75% OF TOTAL DISCHARGES AND DO NOT OVERLAP WITH CHNA AREAS IDENTIFIED BY OTHER ACUTE CARE HOSPITALS AND/OR COLLABORATIONS. UPON DEFINING THE GEOGRAPHIC AREA AND POPULATION SERVED IN GREATER BRIDGEPORT, HIA WAS DILIGENT TO ENSURE THAT NO GROUPS, ESPECIALLY MINORITY, LOW-INCOME OR MEDICALLY UNDER-SERVED, WERE EXCLUDED.NUMEROUS FACTORS ARE ASSOCIATED WITH THE HEALTH OF A COMMUNITY INCLUDING WHAT RESOURCES AND SERVICES ARE AVAILABLE AS WELL AS WHO LIVES IN THE COMMUNITY. WHILE INDIVIDUAL CHARACTERISTICS SUCH AS AGE, GENDER, RACE, AND ETHNICITY HAVE AN IMPACT ON PEOPLE'S HEALTH, THE DISTRIBUTION OF THESE CHARACTERISTICS ACROSS A COMMUNITY IS ALSO CRITICALLY IMPORTANT AND CAN AFFECT THE NUMBER AND TYPE OF SERVICES AND RESOURCES AVAILABLE. THE GREATER BRIDGEPORT AREA HAS A TOTAL POPULATION OF 330,000. THE TYPICAL BRIDGEPORT RESIDENT IS 34 YEARS OLD, BUT MOST TOWNS IN THE REGION HAVE A MEDIAN AGE THAT IS AT LEAST 10 YEARS HIGHER THAN THAT. THE POPULATION OF OLDER ADULTS IS PROJECTED TO GROW SIGNIFICANTLY THROUGHOUT THE REGION OVER THE NEXT 20 YEARS. THE TOWNS IN THE REGION VARY DRAMATICALLY IN TERMS OF THEIR RACIAL AND ETHNIC COMPOSITION. THE COMMUNITIES OF EASTON, FAIRFIELD, MONROE AND TRUMBULL ARE OVER 80% WHITE AND STRATFORD IS TWO-THIRDS WHITE. BY CONTRAST, CLOSE TO 80% OF BRIDGEPORT'S POPULATION IS NON-WHITE; HISPANICS AND AFRICAN-AMERICANS EACH COMPRISE MORE THAN ONE THIRD OF BRIDGEPORT'S RESIDENTS. BRIDGEPORT BENEFITS FROM HIGH RATES OF IMMIGRATION, BUT ABOUT 23 PERCENT OF ITS POPULATION STRUGGLES WITH LOW ENGLISH PROFICIENCY, ABOUT TWICE THE RATE OF CONNECTICUT OVERALL (8 PERCENT).INCOME AND POVERTY ARE CLOSELY CONNECTED TO HEALTH OUTCOMES. A HIGHER INCOME MAKES IT EASIER TO LIVE IN A SAFE NEIGHBORHOOD WITH GOOD SCHOOLS AND MANY RECREATIONAL OPPORTUNITIES. HIGHER WAGE EARNERS ARE BETTER ABLE TO BUY MEDICAL INSURANCE AND MEDICAL CARE, PURCHASE NUTRITIOUS FOODS, AND OBTAIN QUALITY CHILD CARE THAN THOSE EARNING LOWER WAGES. COMMUNITIES WHERE RESIDENTS HAVE LOWER INCOME LEVELS HAVE BEEN SHOWN TO HAVE HIGHER RATES OF ASTHMA, DIABETES, AND HEART DISEASE, AND LOWER LIFE EXPECTANCIES. THERE ARE WIDE GAPS IN MEDIAN HOUSEHOLD INCOME RATES WITHIN THE GREATER BRIDGEPORT REGION. THE TOWNS OF EASTON, FAIRFIELD, MONROE, AND TRUMBULL ARE AFFLUENT WITH MEDIAN INCOMES SUBSTANTIALLY HIGHER THAN NATIONAL AND STATE AVERAGES. STRATFORD, WHICH HAS A LONG HISTORY AS AN INDUSTRIAL TOWN, WAS DESCRIBED BY RESIDENTS AS BLUE COLLAR AND MIDDLE CLASS. BRIDGEPORT HAS A HIGH POVERTY RATE AND A LOWER MEDIAN INCOME THAT BOTH STATE AND NATIONAL AVERAGES, AND CERTAIN NEIGHBORHOODS SUCH AS THE EAST END HAVE RATES OF CONCENTRATED POVERTY AND OTHER CONDITIONS THAT RANK THEM AMONG THE MOST ECONOMICALLY-DISADVANTAGED NEIGHBORHOODS IN THE NORTHEAST US. ONLY 18% OF BRIDGEPORT ADULTS AGE 25 AND OVER HAVE A COLLEGE DEGREE OR HIGHER, LESS THAN HALF THE RATE FOR THE STATE; STRATFORD ALSO FALLS BELOW THE STATE RATE WITH ONLY 33% OF THE RESIDENTS HAVING A COLLEGE DEGREE OR HIGHER. THE PROPORTION OF RESIDENTS WITH A COLLEGE DEGREE OR HIGHER IN EASTON, FAIRFIELD, MONROE AND TRUMBULL IS GREATER THAN THAT OF THE STATE, WITH FAIRFIELD'S ADULTS HAVING A COLLEGE EDUCATIONAL ATTAINMENT RATE OF 63%. PART VI, LINE 5: AS A COMMUNITY HEALTH CARE SERVICES PROVIDER, BRIDGEPORT HOSPITAL REMAINS ATTENTIVE TO HEALTH AND WELL-BEING THROUGH EDUCATION, OUTREACH AND OTHER INNOVATIVE SERVICES. DURING FISCAL YEAR 2020, BRIDGEPORT HOSPITAL PROVIDED $103.8 MILLION IN COMMUNITY BENEFITS THROUGH FINANCIAL AND IN-KIND CONTRIBUTIONS IN FIVE WIDE-RANGING PROGRAMS GUARANTEEING ACCESS TO CARE; PROMOTING HEALTH AND WELLNESS; ADVANCING CAREERS IN HEALTH CARE; RESEARCH; AND CREATING HEALTHIER COMMUNITIES. BRIDGEPORT HOSPITAL ALSO CONTRIBUTES TO THE COMMUNITY IN WAYS THAT ARE NOT QUANTIFIED AS PART OF COMMUNITY BENEFITS AND SERVES AS AN IMPORTANT COMMUNITY RESOURCE. THIS INCLUDES HAVING A COMMUNITY-BASED BOARD OF TRUSTEES WITH MANY MEMBERS RESIDING OR WORKING IN THE AREA SERVED BY THE HOSPITAL. THE HOSPITAL ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY. IN FISCAL YEAR 2020 THERE WERE A TOTAL OF 1,812 MEMBERS OF THE BRIDGEPORT HOSPITAL MEDICAL STAFF. BRIDGEPORT HOSPITAL, FOUNDED IN 1878, IS A 501-BED URBAN TEACHING HOSPITAL SERVING 21,686 INPATIENTS AND 360,391 OUTPATIENT ENCOUNTERS IN 2020. BRIDGEPORT HOSPITAL IS ONE OF THE LARGEST PRIVATE EMPLOYERS IN BRIDGEPORT WITH 3,395 EMPLOYEES IN 2020. PART VI, LINE 6: THE YALE NEW HAVEN HEALTH SYSTEM'S FUNDAMENTAL MISSION IS TO ENSURE THAT THE DELIVERY NETWORKS SUCH AS BRIDGEPORT HOSPITAL ASSOCIATED WITH THE SYSTEM PROMOTE THE HEALTH OF THE COMMUNITIES THEY SERVE AND ENSURE THAT ALL PATIENTS HAVE ACCESS TO APPROPRIATE HEALTHCARE SERVICES. THE YALE NEW HAVEN HEALTH SYSTEM REQUIRES ITS HOSPITALS TO INCORPORATE PLANS TO PROMOTE HEALTHY COMMUNITIES WITHIN THE HOSPITAL'S EXISTING BUSINESS PLANS AND IMPLEMENTATION STRATEGIES FOR WHICH THEY ARE HELD ACCOUNTABLE. IN ADDITION, REGULAR REPORTING ON COMMUNITY BENEFITS IS REQUIRED ON A QUARTERLY BASIS. PART VI, LINE 7, REPORTS FILED WITH STATES CT 1 TAXI TRANSPORTATION VOUCHERS 1413 35341 FMV A TAXI VOUCHER PROGRAM OFFERS TAXI CAB SERVICES AT REDUCED RATES FOR ELIGIBLE PATIENTS. CARE COORDINATION 247 412905 UBER TRANSPORTATION 6382 92000 PART I, LINE 2: BRIDGEPORT HOSPITAL ("BH") CARRIES OUT DUE DILIGENCE IN PROVIDING MONETARY ASSISTANCE ONLY TO QUALIFYING 501(C)(3) ORGANIZATIONS THAT COMPLEMENT ITS MISSION OR SUPPORT THE GREATER GOOD IN THE COMMUNITIES SERVED. BH VERIFIES EACH ORGANIZATION'S EIN AS LISTED ON IRS FORM W-9 THAT HAS BEEN SUBMITTED TO BH. ASSISTANCE DONATED BY BH TO THESE QUALIFYING ORGANIZATIONS IS NOT OUTCOMES-BASED AND IS GIVEN IN SUPPORT OF AN INDIVIDUAL ORGANIZATION'S FUNDRAISING EVENTS OR IN SUPPORT OF DIRECT SERVICES. BH MAINTAINS FULL AND COMPLETE RECORDS OF ALL MONETARY ASSISTANCE PROVIDED, HOWEVER DOES NOT MONITOR SPECIFIC FUNDS. NO GRANTS WERE MADE IN FY2020. 0 1 0 0 0 0 0 1 0 GAYLE CAPOZZALO FORMER TRUSTEE 0 9755 0 226553 0 1308748 0 0 0 0 0 1545056 0 453750 VINCENT PETRINI TRUSTEE 81954 464405 29333 166221 11192 63419 42592 241357 2262 12818 167333 948220 0 0 PAMELA SCAGLIARINI SECRETARY 517235 0 196103 0 79637 0 282120 0 19880 0 1094975 0 0 0 MICHAEL IVY INTERIM CEO/TRUSTEE 113916 580566 31363 159840 10059 51266 16014 81613 3235 16487 174587 889772 0 0 WILLIAM JENNINGS FORMER TRUSTEE 0 0 0 328536 0 684616 0 0 0 0 0 1013152 0 227427 ROCKMAN FERRIGNO PHYSICIAN 652159 0 29048 0 54120 0 21396 0 17222 0 773945 0 12979 0 CAROLYN SALSGIVER SR. VP STRATEGY & BUSINESS 73921 295684 23587 94349 9771 39082 40128 160513 4151 16604 151558 606232 0 0 FRANCISCO GARRIDO PHYSICIAN 667944 0 16174 0 656 0 18754 0 18412 0 721940 0 0 0 EUGENE COLUCCI CFO/TREASURER 219575 268370 54340 66416 15500 18944 13535 16542 6202 7580 309152 377852 0 0 RYAN O'CONNELL VP OF PERFORMANCE & RISK 156755 261806 48567 81114 8404 14035 7701 12863 7939 13260 229366 383078 0 0 JONATHAN MAISEL PHYSICIAN 491475 0 11131 0 2790 0 30400 0 12944 0 548740 0 0 0 MARYELLEN KOSTURKO SR. VP PATIENT CARE 375612 0 98121 0 6241 0 29108 0 1113 0 510195 0 0 0 THOMAS LAMONTE PHYSICIAN 391696 0 9008 0 2742 0 30400 0 17114 0 450960 0 0 0 GUILLERMO KATIGBAK PHYSICIAN 391202 0 8950 0 2742 0 30400 0 12941 0 446235 0 0 0 GINA CALDER VP OF AMBULATORY SERVICES 268885 0 54443 0 2500 0 19844 0 6874 0 352546 0 0 0 MARC LOMBARDI ASSISTANT SECRETARY 29742 218112 5403 39623 2404 17629 2269 16636 2360 17304 42178 309304 0 0 MARY CHRISTOFFERSEN VP OF NURSING 250562 0 53760 0 575 0 25170 0 12740 0 342807 0 0 0 ANNE DIAMOND PRESIDENT/TRUSTEE 63696 15924 60000 15000 997 249 12923 3231 573 143 138189 34547 0 0 PART I, LINE 3 THE FILING ORGANIZATION DOES NOT HAVE AND/OR COMPENSATE ITS OWN CEO/EXECUTIVE DIRECTOR. THESE POSITIONS ARE FILLED BY EMPLOYEES OF A RELATED ORGANIZATION(S) AND COMPENSATED THROUGH THE RESPECTIVE RELATED ORGANIZATION(S). THE METHOD(S) USED BY THE RELATED ORGANIZATION(S) FOR DETERMINING COMPENSATION FOR THESE INDIVIDUALS ARE: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B THE INDIVIDUALS LISTED BELOW ARE PARTICIPANTS IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THESE ACCRUALS ARE INCLUDED IN THE AMOUNTS REPORTED IN PART II, COLUMN C (DEFERRED COMPENSATION) AND REPRESENTS BOTH THE REPORTING ENTITY'S AND RELATED ENTITY'S COMBINED AMOUNTS CONSISTENT WITH THE COMPENSATION REPORTING PER IRS INSTRUCTIONS. SEVERANCE NONQUALIFIED EQUITY-BASED VINCENT PETRINI - $176,247 - PAMELA SCAGLIARINI - 171,720 - CAROLYN SALSGIVER - 121,241 - ANNE DIAMOND - 16,154 - THE FORMER OFFICER BELOW RECEIVED PAYMENT THROUGHOUT THE YEAR FROM THE NONQUALIFIED PLAN. THE FOLLOWING PAYMENT WAS MADE DIRECTLY TO HER FROM THE RABBI TRUST: GAYLE CAPOZZALO 113,613 THE SUPPLEMENTAL RETIREMENT INCOME PLAN (SRIP) / EXECUTIVE DEFERRED COMPENSATION ACCOUNT PLAN (EDCAP) ARE DESIGNED TO ENSURE THE PAYMENT OF A COMPETITIVE LEVEL OF RETIREMENT INCOME WHEN ADDED TO OTHER SOURCES OF RETIREMENT INCOME IN ORDER TO ATTRACT AND RETAIN KEY MANAGEMENT EMPLOYEES SERVING AS CORPORATE OFFICERS. THE PLAN PROVIDES SUPPLEMENTAL RETIREMENT INCOME THROUGH AN UNFUNDED, NONQUALIFIED DEFERRED COMPENSATION ARRANGEMENT UNDER SECTION 457(F) AND THROUGH A DEFERRED COMPENSATION PLAN UNDER SECTION 409A OF THE INTERNAL REVENUE CODE AND A MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES' PLAN UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (ERISA). PART I, LINE 7 NON-FIXED PAYMENTS PROVIDED THE SHORT TERM INCENTIVE PLAN IS A VARIABLE COMPENSATION PLAN WHICH PROVIDES ONE-TIME PAYMENTS TO ELIGIBLE MEMBERS OF MANAGEMENT IN RECOGNITION OF THE ACCOMPLISHMENT OF KEY ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE OBJECTIVES. PERFORMANCE LEVELS ARE ESTABLISHED AND REVIEWED ANNUALLY AT THRESHOLD, TARGET AND MAXIMUM LEVELS, ACCORDING TO PLANNED "STRETCH" GOALS AND OBJECTIVES. INCENTIVE AWARD OPPORTUNITIES ARE ESTABLISHED ACCORDING TO MARKET PRACTICES BASED ON EACH ELIGIBLE POSITION'S RESPONSIBILITIES, PERFORMANCE AND LEVEL OF AUTHORITY. PERFORMANCE RELATIVE TO STIP AWARD OPPORTUNITIES INCORPORATES A BROAD SPECTRUM OF PRE-DEFINED FINANCIAL AND NON-FINANCIAL METRICS THAT ARE ALIGNED WITH ORGANIZATIONAL MISSION AND VALUES. A CHEFA- SERIES D 060806186 20774YJE8 2012-05-31 40467946 REFINANCING A & C ISSUED 92 & 95 0 0 0 A 19750000 40467953 775780 39692173 2012 1 0 1 1 A 0 0 1 1 0 0 0 0 1 A 0 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CHEFA- SERIES D DATE THE REBATE COMPUTATION WAS PERFORMED: 05/31/2017 PART III - PRIVATE BUSINESS USE THIS SECTION IS NOT REQUIRED TO BE COMPLETED AS THE BOND REFUNDED PRE-2003 BOND ISSUANCES. PART III, LINE 3C THE ORGANIZATION IS A MEMBER OF THE YALE NEW HAVEN HEALTH OBLIGATED GROUP ("YNHHS"). YNHHS HAS IN-HOUSE LEGAL COUNSEL STAFF WHO REVIEW MANAGEMENT, OR SERVICE CONTRACTS AND RESEARCH AGREEMENTS RELATING TO THE FINANCED PROPERTY TO ENSURE THAT SUCH AGREEMENTS ARE COMPLIANT WITH APPLICABLE SAFE HARBORS. IN-HOUSE COUNSEL CONSULTS WITH THE HOSPITAL'S OUTSIDE BOND COUNSEL AS NEEDED, INCLUDING ON NON-ROUTINE ISSUES. EBP SUPPLY SOLUTIONS SEE SCHEDULE O 369991 SEE PART V 0 CONNECTICUT NEUROSURGICAL SPECIALISTS PC SEE SCHEDULE O 138707 SEE PART V 0 PART IV, COLUMN D NAME OF INTERESTED PERSON: EBP SUPPLY SOLUTIONSTRUSTEE MEREDITH REUBEN IS THE SOLE STOCKHOLDER AND CHIEF EXECUTIVE OFFICER OF EBP SUPPLY SOLUTIONS, INC. AFTER PERFORMING AN OBJECTIVE REVIEW PROCESS, WHICH INCLUDED A COMPARISON TO COMPETITIVE ALTERNATIVES AVAILABLE IN THE MARKETPLACE AND IN WHICH MS. REUBEN WAS NOT INVOLVED, THE HOSPITAL PURCHASED JANITORIAL AND FOOD SERVICE SUPPLIES AND SERVICES FROM EBP SUPPLY SOLUTIONS, INC.AMOUNT OF TRANSACTION: $369,990.81NAME OF INTERESTED PERSON: CONNECTICUT NEUROSURGICAL SPECIALISTS, P.C. TRUSTEE KENNETH LIPOW, MD IS THE SOLE OWNER OF CONNECTICUT NEUROSURGICAL SPECIALISTS, P.C. AMOUNT OF TRANSACTION: $138,706.65 (MEDICAL SERVICES: $115,082.13; RENT: $23,624.52) FORM 990, PART VI PART I, LINE 4 & PART VI, LINE 1B NUMBER OF INDEPENDENT VOTING MEMBERS OF THE GOVERNING BODY THE ORGANIZATION SOUGHT TO CONFIRM THE INDEPENDENCE OF EACH VOTING MEMBER OF ITS GOVERNING BODY BY REQUESTING THAT EACH SUCH VOTING MEMBER RESPOND TO A QUESTIONNAIRE CONTAINING THE PERTINENT INSTRUCTIONS AND DEFINITIONS AND DESIGNED TO ELICIT THE INFORMATION NECESSARY TO DETERMINE INDEPENDENCE. IN THE EVENT THAT THE ORGANIZATION DOES NOT RECEIVE A RESPONSE FROM ANY SUCH VOTING MEMBER, THE ORGANIZATION REVIEWS OTHER INFORMATION KNOWN TO IT REGARDING THE VOTING MEMBER AND MAKES A REASONABLE ASSESSMENT OF INDEPENDENCE BASED ON THAT INFORMATION. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIPS BETWEEN OFFICERS, DIRECTORS, TRUSTEES, OR KEY EMPLOYEES CERTAIN OF THE ORGANIZATION'S CURRENT OFFICERS AND/OR TRUSTEES MAY SERVE AS OFFICERS AND/OR DIRECTORS OF TAX-EXEMPT AND TAXABLE AFFILIATES WITHIN THE ORGANIZATION'S CORPORATE SYSTEM OR JOINT VENTURES IN WHICH THE ORGANIZATION'S CORPORATE SYSTEM HAS AN OWNERSHIP INTEREST. THE INDIVIDUAL OFFICERS AND/OR TRUSTEES DO NOT HAVE PERSONAL FINANCIAL INTERESTS IN SUCH AFFILIATES AND SERVE ONLY AS A FUNCTION OF THEIR ROLES WITH THE ORGANIZATION OR WITHIN THE ORGANIZATION'S CORPORATE SYSTEM. FORM 990, PART VI, SECTION A, LINE 6 THE ENTITY IS A CONNECTICUT NON-STOCK CORPORATION. ITS SOLE MEMBER OF BRIDGEPORT HOSPITAL IS YALE NEW HAVEN HEALTH SERVICES CORPORATION ("YNHHS"), ITSELF A CONNECTICUT NON-STOCK CORPORATION EXEMPT FROM FEDERAL INCOME TAX AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. FORM 990, PART VI, SECTION A, LINE 7A YNHHS HAS THE AUTHORITY TO DESIGNATE ONE REPRESENTATIVE OF YNHHS TO SERVE AS A TRUSTEE OF THE HOSPITAL AND FURTHER TO APPROVE NOMINEES TO THE HOSPITAL'S BOARD OF TRUSTEES IN ACCORDANCE WITH THE HOSPITAL'S BYLAWS. FORM 990, PART VI, SECTION A, LINE 7B THE YALE NEW HAVEN HEALTH SERVICES CORPORATION, AS THE ENTITY'S SOLE MEMBER, HAS THE RIGHTS, POWERS AND PRIVILEGES SET FORTH IN THE HOSPITAL'S BYLAWS, INCLUDING, IN PART, THE AUTHORITY TO APPROVE THE NOMINEES TO THE HOSPITAL'S BOARD OF TRUSTEES, AMENDMENTS TO THE GOVERNING DOCUMENTS, OPERATING AND CAPITAL BUDGETS, INITIATION OF MAJOR NEW PROGRAMS AND CLINICAL SERVICES OR THE DISCONTINUATION OR CONSOLIDATION OF SUCH PROGRAMS, CERTAIN FUNDAMENTAL CORPORATION TRANSACTIONS, AND THE ISSUANCE AND INCURRENCE OF INDEBTEDNESS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 TAX RETURN AND ATTACHED SCHEDULES WERE PREPARED BY EMPLOYEES OF THE YNHHS TAX DEPARTMENT. THE RETURN IS INITIALLY REVIEWED BY THE EXECUTIVE DIRECTOR OF CORPORATE FINANCE. SUBSEQUENTLY, IT IS SENT TO KPMG LLP FOR THEIR INITIAL REVIEW. AFTER ALL COMMENTS FROM THE ABOVE GROUPS ARE RECEIVED AND REVIEWED, THE RETURN IS THEN REVIEWED BY THE CHIEF FINANCIAL OFFICER OF THE HOSPITAL AND A FINAL VERSION OF THE RETURN IS SENT BACK TO KPMG LLP FOR FINAL REVIEW. PRIOR TO FILING, THE ORGANIZATION MADE AVAILABLE A COMPLETE COPY OF THE RETURN TO ITS BOARD OF TRUSTEES BY WEB PORTAL. FORM 990, PART VI, SECTION B, LINE 12C BRIDGEPORT HOSPITAL IS COVERED UNDER THE YALE NEW HAVEN HEALTH SYSTEM CONFLICT OF INTEREST POLICY APPROVED AND ADOPTED BY THE SYSTEM COMPLIANCE COMMITTEE, WHICH HAS BEEN DELEGATED THE AUTHORITY TO APPROVE AND ADOPT COMPLIANCE POLICIES ON BEHALF OF THE ENTITIES IN THE SYSTEM. THE YALE NEW HAVEN HEALTH SYSTEM CONFLICT OF INTEREST POLICY AND INDIVIDUAL ANNUAL DISCLOSURE FORM APPLIES TO A POOL OF EMPLOYEES, BOARD MEMBERS AND NON-BOARD MEMBERS SERVING ON BOARD COMMITTEES. THESE "COVERED INDIVIDUALS" ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT, UPON BEGINNING EMPLOYMENT OR OTHERWISE BECOMING A COVERED INDIVIDUAL AND ANNUALLY THEREAFTER. COVERED INDIVIDUALS ARE ALSO REQUIRED TO PROMPTLY REPORT CHANGES TO THEIR MOST RECENTLY COMPLETED DISCLOSURE STATEMENT. THESE DISCLOSURE STATEMENTS AND REPORTS ARE REVIEWED BY THE OFFICE OF PRIVACY AND CORPORATE COMPLIANCE AND/OR THE LEGAL AND RISK SERVICES DEPARTMENT TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. IF A POTENTIAL CONFLICT ARISES, THE PRESIDENT AND CEO WOULD CONSULT WITH THE BOARD CHAIRPERSON AND THE LEGAL AND RISK SERVICES DEPARTMENT TO DEVELOP A PLAN TO MITIGATE ANY ACTUAL CONFLICT OF INTEREST. FOR EXAMPLE, A VOTING BOARD OR COMMITTEE MEMBER WOULD BE REQUIRED TO RECUSE HIMSELF OR HERSELF FROM VOTING ON MATTERS WITH WHICH SHE OR HE HAD AN ACTUAL OR POTENTIAL CONFLICT AND THE ACTUAL OR POTENTIAL CONFLICT WOULD BE DISCLOSED TO OTHER VOTING MEMBERS. FORM 990, PART VI, SECTION B, LINE 15 FORM 990, PART VI, SECTION B, LINE 15A: COMPENSATION PROCESS FOR TOP OFFICIALS: THE TOP BRIDGEPORT HOSPITAL OFFICIAL IS AN EMPLOYEE OF YNHHS. THE YNHHS COMPENSATION AND LEADERSHIP DEVELOPMENT COMMITTEE (THE "YNHHS COMPENSATION COMMITTEE"), WHICH INCLUDES AN INDEPENDENT REPRESENTATIVE OF THE HOSPITAL, IS RESPONSIBLE FOR (1) DETERMINING THE OVERALL TOTAL COMPENSATION STRATEGY FOR YNHHS OFFICER-LEVEL EXECUTIVES, (2) APPROVING ALL COMPENSATION AND BENEFITS DECISIONS FOR YNHHS OFFICER-LEVEL EXECUTIVES, AND (3) REPORTING SUCH ACTIONS TO THE FULL YNHHS BOARD OF TRUSTEES ON AN ANNUAL BASIS. IN ADDITION, THE YNHHS COMPENSATION COMMITTEE EXPRESSLY DETERMINES THE REASONABLENESS OF TOTAL COMPENSATION AND BENEFITS FOR ALL YNHHS OFFICER-LEVEL EXECUTIVES, AND ASSURES THAT ALL OFFICER-LEVEL EXECUTIVE COMPENSATION DECISIONS ARE MADE AFTER THOROUGH CONSIDERATION OF AND COMPARISON TO THE MARKET PRACTICES OF OTHER SIMILARLY SITUATED ORGANIZATIONS. THE YNHHS COMPENSATION COMMITTEE CONSISTS OF TRUSTEES WHO DO NOT HAVE MATERIAL FINANCIAL INTERESTS THAT COULD BE AFFECTED BY THE OFFICER-LEVEL EXECUTIVE COMPENSATION DECISIONS MADE BY THE COMMITTEE. THE COMPARABILITY DATA USED TO ASSIST THE COMMITTEES IN ITS COMPENSATION DELIBERATIONS IS COMPILED BY AN INDEPENDENT, NATIONAL COMPENSATION CONSULTING FIRM THAT IS RETAINED BY AND REPORTS DIRECTLY TO THE YNHHS COMPENSATION COMMITTEE. THE DATA COLLECTED BY THE CONSULTANT CONSISTS OF MARKET INFORMATION FOR EXECUTIVES IN FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THE DELIBERATIONS AND DECISIONS OF THE YNHHS COMPENSATION COMMITTEE IS CONTEMPORANEOUSLY DOCUMENTED, REVIEWED AND APPROVED BY THE COMMITTEE, AND PROVIDED TO THE BOARD OF TRUSTEES OF YNHHS AND THE BRIDGEPORT HOSPITAL. FORM 990, PART VI, SECTION B, LINE 15B: COMPENSATION PROCESS FOR OFFICERS CERTAIN OFFICER-LEVEL EXECUTIVES ARE EMPLOYEES OF YNHHS, OTHER OFFICER-LEVEL EXECUTIVES ARE EMPLOYED DIRECTLY BY BRIDGEPORT HOSPITAL; COMPENSATION DETERMINATIONS OF YNHHS EMPLOYEES ARE MADE BY THE YNHHS COMPENSATION COMMITTEE. COMPENSATION OF OFFICER-LEVEL EXECUTIVES EMPLOYED DIRECTLY BY BRIDGEPORT HOSPITAL IS APPROVED BY THE BRIDGEPORT HOSPITAL'S COMPENSATION COMMITTEE AND BOARD OF TRUSTEES. FOR OFFICER-LEVEL EXECUTIVES EMPLOYED BY BRIDGEPORT HOSPITAL'S EXECUTIVE COMPENSATION COMMITTEES IS RESPONSIBLE FOR (1) DETERMINING THE OVERALL TOTAL COMPENSATION STRATEGY FOR ITS OFFICER-LEVEL EXECUTIVES, (2) APPROVING ALL COMPENSATION AND BENEFITS DECISIONS FOR OFFICER-LEVEL EXECUTIVES, AND (3) REPORTING SUCH ACTIONS TO THE FULL BOARD ON AN ANNUAL BASIS, AS APPLICABLE. IN ADDITION, THE EXECUTIVE COMPENSATION COMMITTEE EXPRESSLY DETERMINES THE REASONABLENESS OF TOTAL COMPENSATION AND BENEFITS FOR ALL OFFICER-LEVEL EXECUTIVES EMPLOYED BY BRIDGEPORT HOSPITAL, AND ASSURES THAT ALL OFFICER-LEVEL EXECUTIVE COMPENSATION DECISIONS ARE MADE AFTER THOROUGH CONSIDERATION OF AND COMPARISON TO THE MARKET PRACTICES OF OTHER SIMILARLY SITUATED ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEE CONSISTS OF BOARD MEMBERS WHO DO NOT HAVE MATERIAL FINANCIAL INTERESTS THAT COULD BE AFFECTED BY THE COMPENSATION DECISIONS MADE BY THE COMMITTEE. THE COMPARABILITY DATA USED TO ASSIST THE EXECUTIVE COMPENSATION COMMITTEE IN ITS COMPENSATION DELIBERATIONS ARE COMPILED BY AN INDEPENDENT, NATIONAL COMPENSATION CONSULTING FIRM THAT IS RETAINED BY AND REPORTS DIRECTLY TO THE EXECUTIVE COMPENSATION COMMITTEE. THE DATA COLLECTED BY THE CONSULTANT CONSISTS OF MARKET INFORMATION FOR EXECUTIVES IN FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THE DELIBERATIONS AND DECISIONS OF THE EXECUTIVE COMPENSATION COMMITTEES ARE CONTEMPORANEOUSLY DOCUMENTED, REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE, AND PROVIDED TO THE BRIDGEPORT HOSPITAL BOARD. FORM 990, PART VI, SECTION C, LINE 19 COPIES OF ALL DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 113,782,428. MANAGEMENT AND GENERAL EXPENSES 16,830,939. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 130,613,367. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 105,232,524. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 105,232,524. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 15,814,846. MANAGEMENT AND GENERAL EXPENSES 2,419,280. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,234,126. FORM 990, PART XI, LINE 9: INCREASE IN UNRESTRICTED NET ASSETS - PENSION LIABILITY 7,544,041. NET CHANGE IN INTEREST IN FOUNDATION 4,425,995. OTHER CHANGES -111,072. TRANSFERS TO BHA -14,481. BRIDGEPORT HOSPITAL AUXILIARY INC 267 GRANT STREET BRIDGEPORT CT 06610 066042500 SYSTEM SUPPORT SERVICES CT 501C3 LINE 12A, I SEE PART VII 1 BRIDGEPORT HOSPITAL FOUNDATION INC 267 GRANT STREET BRIDGEPORT CT 06610 222908698 SYSTEM SUPPORT SERVICES CT 501C3 LINE 7 BRIDGEPORT HOSPITAL 1 BRIDGEPORT HOSPITAL FRIENDS OF PEDIATRICS INC 120 COLUMBINE DRIVE TRUMBULL CT 06611 066048427 SYSTEM SUPPORT SERVICES CT 501C3 LINE 12A, I YALE NEW HAVEN HOSPITAL 1 GREENWICH HOSPITAL 5 PERRYRIDGE ROAD GREENWICH CT 06830 060646659 HEALTHCARE SERVICES CT 501C3 LINE 3 YALE NEW HAVEN HEALTH SERVICES CORP 1 HOME CARE PLUS INC 789 HOWARD AVE NEW HAVEN CT 06519 061044331 HOME HEALTHCARE SERVICES CT 501C3 LINE 10 YALE NEW HAVEN CARE CONTINUUM CORP 1 L&M HEALTHCARE INC 365 MONTAUK AVENUE NEW LONDON CT 06320 222553031 SYSTEM SUPPORT SERVICES CT 501C3 LINE 12A, I SEE PART VII 1 LAWRENCE MEMORIAL CORPORATION 365 MONTAUK AVENUE NEW LONDON CT 06320 222553028 PROMOTE HEALTHCARE CT 501C3 LINE 12A, I YALE NEW HAVEN HEALTH 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