2020-05-13T11:57:18-05:00 2019-06-30 350921680 Crowe LLP 175 Powder Forest Drive Simsbury CT 060897902 990 2018-07-01 222667260 Center for Hospice Care Southeast Connecticut Inc CENT 8608485699 227 Dunham Street Norwich CT 063606133 Mark Keise VP of Finance 8608485699 2020-05-13 1 Kristin Anderson P01231300 8606789200 199.231.28.240 2020-05-13 11:57:13 ED P 0EB4CE1ACD44DB279B6C2D9A8476B20948576B96 10032A75EE3B72951F53CBE1B3CD318C62DEE12D 2018 2021-01-29 14:40:06Z Rita Parisi 227 Dunham Street Norwich CT 06360 5313767 0 X www.Hospicesect.org X 1986 CT Health Care Services to the terminally ill. 4 0 93 108 0 0 1076449 359485 5248270 3843414 337936 209895 -23888 -27986 6638767 4384808 0 0 0 0 3729683 2983718 0 0 105612 1785429 1649662 5515112 4633380 1123655 -248572 11652567 11525857 992099 869777 10660468 10656080 Provide Health and Supportive Services to terminally ill individuals at their home or in a medical facility in Southeastern Connecticut. 0 0 3267442 3843414 Hospice Home Care is a program designed to care for terminally ill patients through the use of the Interdisciplinary Team, which includes Nurses, HHA's, MSW's, Medical Director, Clergy, Therapists, Pharmacists, Trained Volunteers, and Counselors. Care is provided in the person's place of residence, where ever that may be. Bereavement support is provided to the family for up to thirteen months after death. Home care visits - 1,782. Hospice patient days - 18,468. 3267442 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 62 0 1 93 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 0 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CT X David Baranik 8606962546 HHC Tax Dept 181 Patricia M Genova Newington CT 06111 Karen Neilan President (Thru 4/1/19) 1.00 X X 0 0 0 Maryann Fitzsimmons Vice President (Thru 4/1/19) 1.00 X X 0 0 0 James Bates Vice President (Thru 4/1/19) 1.00 X X 0 0 0 Edwin Lorah Treasurer (Thru 4/1/19) 1.00 X X 0 0 0 Megan Robinson PhD Secretary (Thru 4/1/19) 1.00 X X 0 0 0 Monica Farina RNMS Board Member (Thru 4/1/19) 1.00 X 0 0 0 Jeffrey Knapp Board Member (Thru 4/1/19) 1.00 X 0 0 0 Mark E Tramontozzi Board Member (Thru 4/1/19) 1.00 X 0 0 0 Lenny Winkler Board Member (Thru 4/1/19) 1.00 X 0 0 0 Donna Yother Board Member (Thru 4/1/19) 1.00 X 0 0 0 Lori Lindfors Board Member (Thru 4/1/19) 1.00 X 0 0 0 Lois F Geary Board Member (Thru 4/1/19) 1.00 X 0 0 0 William F Turner Board Member (Thru 4/1/19) 1.00 X 0 0 0 Brian McNamara Board Member (Thru 4/1/19) 1.00 X 0 0 0 Kimberly Fischburg Board Member (Thru 4/1/19) 1.00 X 0 0 0 Tracy Church Chair 2.00 58.00 X X 0 895011 70098 Charles L Johnson President 2.00 58.00 X X 0 1086334 162619 Rocco Orlando MD Secretary 2.00 58.00 X X 0 1019392 100318 Rita Parisi SVP, Community Network 2.00 58.00 X X 0 526582 66030 Carol Mahier President/CEO (Thru 4/1/19) 37.50 X 137483 0 10716 Arthur Labrie VP of Finance & Administration/CFO 37.50 X 120402 0 10423 Dawn McDermott Primary Care Nurse 37.50 X 106742 0 0 364627 3527319 420204 3 0 1 0 Reid & Reige PC One Financial Plaza Hartford CT 06103 Legal Services 148004 Enclara Pharmacia Inc PO Box 95000-7220 Philadelphia PA 19195 Pharmacy- Patients 146914 Mary Elizabeth Nursing Ctr 28 Broadway Mystic CT 06355 General In-Patient Care 113460 Lawrence & Memorial Hospital 365 Montauk Avenue New London CT 06320 General In-Patient Care 101812 4 106817 252668 359485 Patient Service Revenu 621610 3843414 3843414 3843414 161861 161861 949007 900973 48034 48034 48034 0 106817 27986 -27986 -27986 4384808 3843414 0 181909 X 240410 240410 2260849 1795299 377356 88194 260875 187256 73619 221584 159053 62531 148004 148004 56163 56163 478 478 35328 35328 757516 743963 13553 15354 580 14774 212771 149963 58943 3865 41882 41882 67326 47452 19874 111671 78170 33501 33007 33007 106015 74210 31805 34456 24285 10171 Dues and Subscriptions 21517 21517 Misc. 8174 7211 963 4633380 3267442 1260326 105612 75 75 3129867 3546885 9576 7948 434873 174720 0 0 0 124730 86783 3146762 1303331 1949445 1843431 6004001 5866015 11652567 11525857 374654 325474 17043 13049 600402 529800 0 1454 992099 869777 X 10069728 10075756 425895 415479 164845 164845 10660468 10656080 11652567 11525857 -248572 244184 0 X 1 X 0 1 0 X 468515 638333 1157805 276449 359485 2900587 468515 638333 1157805 276449 359485 2900587 717823 2182764 91697 103308 113907 128576 161861 599349 3499936 31465400 0.62370 0.64510 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 478 478 0 Part II-B, Line 1: During the year, the Organization paid membership dues to the Connecticut Association for HealthCare At Home. The Association notified the Organization that 5.0.% of their dues were indirectly attributable to lobbying expenses. 164845 164845 164845 164845 159845 5000 164845 159845 159845 159845 159845 1.00000 0 0 531245 531245 2039871 806660 1233211 476335 403610 72725 99311 93061 6250 1843431 Due From Affiliate 1454 1454 X 4523380 244184 244184 4279196 105612 105612 4384808 4527768 0 4527768 105612 105612 4633380 Part V, Line 4: The Organization has adopted investment and spending policies for Endowment assets that attempt to provide a predictable stream of funding to mission related programs such as those described in Part III, lines 4a-d while seeking to maintain purchasing power of the endowment assets. Endowment assets include those assets of donor-restricted funds that the Organization must hold in perpetuity or for a donor-specific period(s). Under this policy, the endowment assets are invested in a manner that is intended to produce a real return, net of inflation and investment management costs, of at least 4% over the long term. Actual returns in any given year may vary from this amount. The Organizations Endowment consists of hundreds of individual funds established for a variety of purposes including but not limited to patient care, research and capital needs. Net assets associated with Endowment funds are classified and reported based on the existence or absence of donor-imposed restrictions. Part X, Line 2: The Agency accounts for uncertain tax positions in accordance with certain provisions of FASB ASC 740, "Income Taxes," which provides a framework for how companies should recognize, measure, present and disclose uncertain tax positions in their financial statements. Under FASB ASC 740, the Agency may recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. The tax benefits recognized in the financial statements from such position are measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. TheAgency does not have any uncertain tax positions as of June 30, 2019 and 2018. As of June 30, 2019and 2018, the Agency did not record any penalties or interest associated with uncertain tax positions. The Agency would recognize interest and/or penalties related to income tax matters in income tax expense. The Agency's prior three tax years are open and subject to examination. Part XI, Line 4b - Other Adjustments: Fundraising Expense Included in Revenue 105,612. Part XII, Line 4b - Other Adjustments: Fundraising Expenses Included in Net Revenue 105,612. Regatta 49181 49181 4950 2324 1000 7195 Walk-A-Thon 24050 24050 4175 1 33586 33586 417 595 7330 106817 106817 5367 2919 1000 18700 27986 -27986 0 1 0 0 0 0 0 1 0 Tracy Church Chair 0 527724 0 279630 0 87657 0 19250 0 50848 0 965109 0 0 Charles L Johnson President 0 640066 0 357729 0 88539 0 106613 0 56006 0 1248953 0 0 Rocco Orlando MD Secretary 0 598617 0 274050 0 146725 0 35750 0 64568 0 1119710 0 0 Rita Parisi SVP, Community Network 0 334314 0 143158 0 49110 0 33000 0 33030 0 592612 0 0 Part I, Line 3 The Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare on behalf of the Center for Hospice Care Southeast Connecticut Inc., hires an outside consultant, Integrated Healthcare Strategies, a division of Gallagher Benefit Services, Inc., to determine best practices in governing executive compensation. Please refer to compensation narrative reported on Schedule O. Part I, Line 4b Hartford Healthcare Corporation, a related organization, maintains a 457(f) Supplemental Executive Retirement Plan (SERP). Participants include certain officers and key employees at the President, Executive Vice President, Senior Vice President and Vice President levels that are reported by Hartford Hospital on its Form 990, Part VII. Contributions are made by Hartford HealthCare Corporation to the plan based on a percentage of the participant's compensation. Participants vest in the plan at the earlier of reaching age 55 and having 5 years of service, death, disability, involuntary separation without reasonable cause, upon reaching age 65 or the occurence of a change in control. Each participant ceases to be eligible for further contributions by Hartford HealthCare Corporation on the date of the participant's separation from service. Participants receive a one-time lump sum payment of the accumulated amount during the 30-day period following the participant's separation from service. 2018 SERP Accruals were made on behalf of the following individuals: Charles Johnson $87,363 2018 SERP Payouts were made on behalf of the following individuals: Tracy Church $22,476* Rocco Orlando $24,390* Rita Parisi $13,128* *For these individuals, vesting occurred, causing taxable income. This portion of the vested amount was used to pay the associated tax liability. The remaining balance was deposited into the employee SERP account. Part I, Line 7 Hartford HealthCare Corporation, a related organization, has a Compensation At Risk Plan that encourages and rewards achievements of significant functional goals. These goals contribute to the organization's strategic and financial direction. The plan utilizes market practice alignment to ensure competitive recruitment and retention. Awards are based on CEO and/or Hartford HealthCare Corporation's Compensation Committee discretionary assessment of overall organization performance and individual contribution to results. Form 990, Part VI, Section A, line 4 Effective April 1, 2019, the Board of Directors approved an Amendment and Restatement of the Corporation's Certificate of Incorporation in the manner required by Sections 33-1140 to 33-1147 of the Connecticut General Statutes, and by the Certificate of Incorporation. The Restate Certificate includes the following substantive amendments: 1. The Certificate of Incorporation is Amended and Restated in its entirety. 2. The Amended and Restated Certificate of Incorporation consolidates all Amendments made simutaneously with or prior to filing of this Certificate into a single document. The organization's governing documents are available upon request. Form 990, Part VI, Section A, line 6 Center for Hospice Care Southeast Connecticut, Inc., is organized as a non-stock not for profit entity. Hartford HealthCare At Home Inc. is the sole member. Form 990, Part VI, Section A, line 7a The sole member of the orpanization has the authority to approve/remove members of the governing body. Form 990, Part VI, Section A, line 7b The sole member of the organization has the right to review, approve, disapprove and deny significant transactions such as mergers, acquisitions, dissolutions, etc. Form 990, Part VI, Section B, line 11b The Form 990 was prepared by Hartford HealthCare's Tax Department. It was then reviewed by an independent accounting firm. It was then forwarded to the VP of Finance for review. The final Form was provided to the entire Board prior to submission to the Internal Revenue Services (IRS). Once the entire review process was completed, the Form was signed by the President/CEO and then filed with the IRS. Form 990, Part VI, Section B, line 12c The Management board has adopted the policy of the member, Hartford HealthCare Corporation (HHC). HHC's Conflict of Interest Policy (Policy) requires all Covered Individuals, including board members and officers, to provide a disclosure of relationships that create or have the appearance of creating a conflict of interest or commitment. The Policy requires updates if changes in circumstances arise during the year that either (a) create a new potential conflict of interest or commitment or (b) change or eliminate a conflict of interest or commitment previously disclosed. Conflict of Interest disclosure statements are maintained by the HHC Office of Compliance and Integrity (OCI). Employee disclosures are reviewed by OCI in collaboration with the Covered Individuals' supervisor when deemed appropriate, to determine if there is a potential conflict. Oversight review of employee disclosures is provided by the Conflict of Interest Committee ("COIC") (the Committee) which includes representation from the Medical Staff, the Legal Department, Human Resources, Finance Administration, Management and Compliance. The Committee assesses and may recommend the conflicting interest either be (a) eliminated for a continued relationship with HHC/Center for Hospice Care Southeast Connecticut Inc., or, (b) managed through a management plan. Board member disclosures are reported to the HHC Nominating and Governance Committee for determinations of conflicts and the management of them, where applicable. Form 990, Part VI, Section B, line 15 The Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare on behalf of Hospice Care Southeast Connecticut Inc., hires an outside consultant, Integrated Healthcare Strategies, a division of Gallagher Benefit Services, Inc., to determine best practices in governing executive compensation. The following steps were taken: - The use of an Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare, on behalf of Center for Hospice Care Southeast Connecticut Inc., established and regularly reviews Executive Compensation Philosophy; - The Committee regularly reviews scope and depth of positions taking into account complexity and the financial impact and accountability of all "disqualified persons; - National peer groups are selected for comparative purposes based on organizational size, operating revenue, geography and other relevant factors; - Analysis of current total compensation versus market is performed by independent third party compensation consulting firm and is then reviewed by the committee; - Recommendations made based on market data analysis to ensure appropriate competitive positioning within parameters of compensation philosophy; - The CEO compensation reviewed by the Committee and is based on comparative market information and organizational performance; - All changes are reviewed and approved by the Executive Compensation Committee; The compensation determination process for the CEO is reviewed on an annual basis. All other executive compensation is regularly reviewed for scope and depth of positions taking into account complexity and the financial impact and accountability. Form 990, Part VI, Section C, line 18 The Organizations Form 990, 990T and form 1023 and its attachments are available upon request. Form 990, Part VI, Section C, line 19 The Organizations Financial Statements, Governing Documents and the Conflict of Interest Policy are available for inspection upon request at the Organization's address. Form 990, Part IX, line 11g Medical Professional: Program service expenses 743,963. Management and general expenses 0. Fundraising expenses 13,553. Total expenses 757,516. Connecticut Health System Inc 80 Seymour Street Hartford CT 06102 222779421 Coordination of Health Care Delivery CT 501(C)(3) 12(c) Hartford HealthCare Corporation 1 Hartford HealthCare Corporation One State Street Suite 19 Hartford CT 06103 222672834 Support and Management Services to Hartford Hospital and Affiliates CT 501(C)(3) 12(c) N/A 0 Windham Community Memorial Hospital 112 Mansfield Avenue Willimantic CT 06226 060646966 Healthcare Services CT 501(C)(3) 3 Hartford HealthCare Corporation 1 Windham Hospital Foundation Inc 112 Mansfield Avenue Willimantic CT 06226 562546632 Supporting Organization CT 501(C)(3) 12(a) Windham Community Memorial Hospital 1 MidState Medical Center 435 Lewis Avenue Meriden CT 06451 060646715 Healthcare Services CT 501(C)(3) 3 Hartford HealthCare Corporation 1 Natchaug Hospital Inc 189 Storrs Road Mansfield Ctr CT 06226 060966963 Behavioral Health CT 501(C)(3) 3 Hartford HealthCare Corporation 1 Hartford HealthCare At HomeInc 1290 Silas Deane Hwy Suite 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CT 501(C)(3) 10 Hartford HealthCare Senior Services Inc 1 Rushford Foundation Inc 883 Paddock Avenue Meriden CT 06450 061432692 Support Organization CT 501(C)(3) 12(a) Rushford Center Inc 1 Mulberry Gardens of Southington LLC 58 Mulberry Street Plantsville CT 06479 820586577 Assisted Living & Adult Day Care Facility CT 501(C)(3) 10 Hartford HealthCare Senior Services Inc 1 Windham Community Memorial Hospital Women's Auxiliary Inc 112 Mansfield Avenue Willimantic CT 06226 060677728 Fundraising CT 501(C)(3) Line 12a, I Windham Community Memorial Hospital 1 MidState Medical Center Auxiliary 435 Lewis Avenue Meriden CT 06451 066063082 Fundraising CT 501(C)(3) Line 12a, I MidState Medical Center 1 Hartford HealthCare Medical Group Inc 1290 Silas Deane Hwy Wethersfield CT 06109 454456939 Medical Services CT 501(C)(3) Line 10 Hartford HealthCare Corporation 1 Hartford HealthCare Accountable Care Org Inc 1290 Silas Deane Hwy Wethersfield CT 06109 460886367 Government Contracts CT 501(C)(3) Line 7 Hartford HealthCare Medical Group Inc 1 The William W Backus Hospital 326 Washington Street Norwich CT 06360 060250773 Hospital CT 501(C)(3) Line 3 Hartford HealthCare Corporation 1 Backus HealthCare Inc 326 Washington Street Norwich CT 06360 222481794 Support Organization CT 501(C)(3) Line 12a, I Hartford HealthCare Corporation 1 Caring for Colleagues Employee Crisis Fund 100 Grand Street New Britain CT 06052 264469178 Employee Fund CT 501(C)(3) Line 7 Hartford HealthCare Corporation 1 Hartford Healthcare Endowment LLC 80 Seymour Street Hartford CT 06102 454181103 Investment Management CT 501(C)(3) Line 12a, I Hartford HealthCare Corporation 1 The Charlotte Hungerford Hospital 540 Litchfield Street PO Box 988 Torrington CT 06790 060646678 Healthcare Services CT 501(C)(3) Line 3 Hartford HealthCare Corporation 1 VNA Management Corporation Inc 765 Fairfield Avenue Bridgeport CT 06604 061246818 Supporting Organization CT 501(C)(3) Line 10 Hartford HealthCare At Home Inc 1 Partners in Care 40 Lindeman Road Trumbull CT 06611 061142867 Home Healthcare CT 501(C)(3) Line 10 Hartford HealthCare At Home Inc 1 Visiting Nurse Services of CT Inc 765 Fairfield Avenue Bridgeport CT 06604 060665196 Home Healthcare CT 501(C)(3) Line 10 Hartford HealthCare At Home Inc 1 Hartford Hospital 80 Seymour Street PO Box 5037 Hartford CT 06102 060646668 Healthcare Services CT 501(C)(3) Line 3 Hartford HealthCare Corporation 1 VNA Corporation Inc 765 Fairfield Avenue Bridgeport CT 06604 061142892 Supporting Organization CT 501(C)(3) Line 12a, I Hartford HealthCare At Home Inc 1 New Britain MRI Limited Partnership 100 Grand Street New Britain CT 06050 061271349 Magnetic Resonance Imaging CT N/A Ambulance Service of Manchester LLC PO Box 300 Manchester CT 06450 061557358 Ambulatory Services CT N/A Connecticut Imaging Partners LLC 111 Founders Plaza East Hartford CT 06108 134298940 Imaging Service CT N/A Glastonbury Endoscopy Center LLC 300 Western Boulevard Glastonbury CT 06033 261721234 Endoscopy Services CT N/A Glastonbury Surgery Center LLC 195 Eastern Boulevard Glastonbury CT 06033 262600828 Surgery Services CT N/A Hartford - Middlesex Clinical System LLC 80 Seymour Street Hartford CT 06110 061543605 Affiliate Support Services CT N/A Med-East Assoc LLC 1703 West Main Street Willimantic CT 06226 061469575 Outpatient Care Clinic CT N/A HHC Southington Surgery Center LLC 100 Avon Meadow Lane Avon CT 06001 465500829 Surgery Services CT N/A Constitution Surgery Center East LLC 174 Cross Road Waterford CT 06385 061574704 Surgery Services CT N/A CT GI Endoscopy Center LLC 4 Northwestern Drive Bloomfield CT 06002 061573358 GI Services CT N/A HHC Hartford Surgery Center LLC 100 Avon Meadow Lane Avon CT 06001 812637261 Surgery Services CT N/A HHC Urgent Care Go Health LLC 2711 Centerville Road Suite 400 Wilmington DE 19808 815112698 Urgent Care Services DE N/A Wallingford Endoscopy Center LLC 85 Seymour Street Suite 1000 Hartford CT 06106 824601730 Endoscopy Services CT N/A Advanced Medical Imaging of NW CT LLC 57 Commerical Blvd Torrington CT 06790 061594854 Magnetic Resonance Imaging CT N/A Central Connecticut Endoscopy Center 440 New Britain Avenue Plainville CT 06062 141855010 Endoscopy Services CT N/A The Endoscopy Center of Northwest Connecticut LLC 245 Alvord Park Road Torrington CT 06790 061609993 Endoscopy Services CT N/A HHMOB Corporation 80 Seymour Street Hartford CT 06102 061140244 Real Estate & Parking CT N/A C 1 Hartford HealthCare Indemnity Services Ltd FB Perry Bld 40 Church St BD Captive Insurance BD N/A C 1 CenConn Services Inc 100 Grand Street New Britain CT 06050 222836001 Holding Company CT N/A C 1 MidState Medical Group PC 435 Lewis Avenue Meriden CT 06450 204327968 Medical Services CT N/A C 1 Hartford Physician Services PC 80 Seymour Street Hartford CT 06102 061254082 Medical Services CT N/A C 1 Meriden Imaging Center 101 North Plains Industrial Road Meriden CT 06429 061541468 Imaging CT N/A S 1 Aetna Ambulance Service Inc POBOX 1150 Manchester CT 06045 060795431 Ambulance Services CT N/A C 1 Metro Wheelchair Service Inc POBOX 300 Manchester CT 06045 060878432 Wheelchair Services CT N/A C 1 WWB Corporation 326 Washington Street Norwich CT 06360 061094838 Holding Company CT N/A C 1 ConnCare Inc 326 Washington Street Norwich CT 06360 061387598 Health Care Services CT N/A C 1 Backus Medical Center Condo Assoc Inc 330 Washington Street Norwich CT 06360 061542647 Condo Association CT N/A C 1 Windham Professional Office Condominium Association Inc 112 Mansfield Avenue Willimantic CT 06226 061090041 Condo Association CT N/A C 1 Litchfield County Healthcare Service Corporation 540 Litchfield Street Torrington CT 06790 061227655 Management Services CT N/A C 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0