2020-08-13T16:19:29-05:00 2019-09-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2018-10-01 454077626 DAY KIMBALL MEDICAL GROUP INC % PAUL A BEAUDOIN DAYK 8609286541 320 POMFRET STREET PUTNAM CT 06260 PAUL A BEAUDOIN CFO 2020-07-23 true Brian D Todd P00422601 4178658701 167.68.126.162 43032920202265000016 2020-08-13 P E047B250C43A9DFFF6EF145D98438216A51361AC AECC51588B8B05B8A6088E029F5570AF8FA04FA6 2018 2020-09-23 17:36:50Z ANNE DIAMOND 320 POMFRET STREET PUTNAM CT 06260 17541410 false X WWW.DAYKIMBALL.ORG X 2011 CT TO PROVIDE PHYSICIAN SERVICES TO INDIVIDUALS IN NEED OF MEDICAL CARE, INCLUDING PREVENTATIVE CARE, REGARDLESS OF ABILITY TO PAY. 9 2 194 8 0 0 0 17784372 17540893 324 517 0 0 17784696 17541410 0 0 0 0 19724660 20171299 0 0 0 5186763 5251679 24911423 25422978 -7126727 -7881568 1640131 1811032 2764128 2612158 -1123997 -801126 X TO PROVIDE PHYSICIAN SERVICES TO INDIVIDUALS IN NEED OF MEDICAL CARE, INCLUDING PREVENTATIVE CARE, REGARDLESS OF ABILITY TO PAY. SEE SCHEDULE O. true false 19532071 17540893 DAY KIMBALL MEDICAL GROUP TOGETHER WITH DAY KIMBALL HEALTHCARE PROVIDES A COMPREHENSIVE, INTEGRATED HEALTHCARE NETWORK OFFERING PRIMARY CARE AND OUTPATIENT VISITS AS WELL AS A MULTITUDE OF MEDICAL AND SURGICAL SPECIALTIES ALONG WITH LEADING-EDGE TECHNOLOGY AND SOPHISTICATED DIAGNOSTICS. OUR SERVICE AREA INCLUDES NORTHEAST CONNECTICUT AS WELL AS NEARBY MASSACHUSETTS AND RHODE ISLAND COMMUNITIES. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. 19532071 true false false false false false false false false false true false false false false false false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 22 0 true 194 true false false false false false false false false false false false false X 9 2 false true false false true true true true true false false false true true true true true true true false X PAUL A BEAUDOIN 8609286541 320 POMFRET STREET PUTNAM CT 06260 X JOHN GRAHAM MD V.P. MEDICAL AFFAIRS/CMO 1.0 40.0 X 0 274053 8250 DAVID MCCALLUM MD SECRETARY 40.0 1.0 X X 299367 6000 15072 RICHARD WILCON MD VICE PRESIDENT 40.0 1.0 X X 507159 22000 30356 JOSEPH ADILETTA CHAIR 1.0 2.0 X X 0 0 0 MICHAEL BAUM MD DIRECTOR 40.0 8.0 X 333948 26400 22508 SHAWN MCNERNEY DIRECTOR 1.0 1.0 X 0 0 0 ANNE DIAMOND PRESIDENT AND CEO 1.0 42.0 X X 0 455736 22106 TIMOTHY MONAHAN DIRECTOR 40.0 0.0 X 526882 0 9616 DANIEL O'NEILL DIRECTOR 40.0 0.0 X 311224 0 30167 PAUL BEAUDOIN V.P. FINANCE/CFO 1.0 42.0 X 0 346558 6475 MATTHEW ROY EXECUTIVE DIRECTOR 40.0 0.0 X 257048 0 16507 ANDREW MACKENZIE PHYSICIAN 40.0 1.0 X 496588 11000 4307 DAVID CANDOW PHYSICIAN 40.0 1.0 X 271448 11000 30050 PATHMANATHAN SUBAKEESAN PHYSICIAN 40.0 0.0 X 331132 0 8250 ERICA KESSELMAN PHYSICIAN 40.0 1.0 X 306720 7500 21930 LEE WESLER PHYSICIAN 40.0 0.0 X 307773 0 30167 3949289 1160247 255761 43 false true false WEATHERBY LOCUMS PO BOX 972633 DALLAS TX 753972633 LOCUMS - PHYSICIANS 215800 1 0 PATIENT SERVICE REVENUE 621110 16983269 16983269 OTHER REVENUE 900099 557624 557624 17540893 517 517 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17541410 17540893 517 0 0 0 0 2359854 2359854 0 15349177 11161790 4187387 264829 191271 73558 1146363 854299 292064 1051076 800788 250288 0 13431 13431 15000 15000 0 0 0 2336543 1780153 556390 0 373870 284842 89028 49726 37885 11841 0 989907 754185 235722 6201 4724 1477 0 2404 1832 572 0 0 26883 20481 6402 471220 359011 112209 MEDICAL SUPPLIES & DRUGS 775258 775258 RECRUITING & RETENTION 183163 139547 43616 REPAIRS & MAINTENANCE 7672 5845 1827 LICENSES, DUES, SUBSCRIPTIONS 401 306 95 25422978 19532071 5890907 0 221078 228990 0 0 0 0 1180266 1325418 0 0 0 0 0 0 132259 97158 1470 0 494379 334913 95523 159466 0 0 0 0 0 0 0 0 9535 0 1640131 1811032 2764128 2612158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2764128 2612158 X -1123997 -801126 0 0 0 0 -1123997 -801126 1640131 1811032 X -7881568 8204439 X false true X true false X 0 0 0 0 0 0 20367304 18536418 17430369 17784372 17540893 91659356 0 0 0 20367304 18536418 17430369 17784372 17540893 91659356 0 0 0 91659356 4737 1237 2639 324 517 9454 0 4737 1237 2639 324 517 9454 0 0 20372041 18537655 17433008 17784696 17541410 91668810 0.99990 0.99990 0.00010 0.00010 X 494379 334913 159466 159466 17541410 17541410 17541410 25422978 25422978 25422978 SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. X true true false false false false false false false false false JOHN GRAHAM MD V.P. MEDICAL AFFAIRS/CMO 0 272696 0 1000 0 357 0 8250 0 0 0 282303 0 0 DAVID MCCALLUM MD SECRETARY 273964 6000 25045 0 358 0 8250 0 6822 0 314439 6000 0 0 RICHARD WILCON MD VICE PRESIDENT 472277 22000 17162 0 17720 0 8250 0 22106 0 537515 22000 0 0 MICHAEL BAUM MD DIRECTOR 262076 26400 71330 0 542 0 8250 0 14258 0 356456 26400 0 0 PAUL BEAUDOIN V.P. FINANCE/CFO 0 306909 0 39249 0 400 0 88 0 6387 0 353033 0 0 ANNE DIAMOND PRESIDENT AND CEO 0 455159 0 0 0 577 0 0 0 22106 0 477842 0 0 TIMOTHY MONAHAN DIRECTOR 515503 0 10707 0 672 0 8250 0 1366 0 536498 0 0 0 DANIEL O'NEILL DIRECTOR 290926 0 19943 0 355 0 8250 0 21917 0 341391 0 0 0 ANDREW MACKENZIE PHYSICIAN 455885 11000 24793 0 15910 0 4307 0 0 0 500895 11000 0 0 DAVID CANDOW PHYSICIAN 243595 11000 27541 0 312 0 8133 0 21917 0 301498 11000 0 0 PATHMANATHAN SUBAKEESAN PHYSICIAN 330698 0 0 0 434 0 8250 0 0 0 339382 0 0 0 ERICA KESSELMAN PHYSICIAN 268912 7500 37491 0 317 0 8250 0 13680 0 328650 7500 0 0 LEE WESLER PHYSICIAN 283187 0 24216 0 370 0 8250 0 21917 0 337940 0 0 0 MATTHEW ROY EXECUTIVE DIRECTOR 236080 0 20666 0 302 0 2827 0 13680 0 273555 0 0 0 SCHEDULE J, PART I, LINE 1A HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: ANNE DIAMOND, CEO, RECEIVED A HOUSING ALLOWANCE. THE ALLOWANCE WAS TAXABLE IN THE YEAR RECEIVED. SCHEDULE J, PART I, LINE 3 COMPENSATION DETERMINATION: DAY KIMBALL HOSPITAL, A RELATED ORGANIZATION, USES AN INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE IN DETERMINATION THE COMPENSATION OF THE CEO. FORM 990, PART III, LINE 2 SIGNIFICANT PROGRAMS STARTED DURING THE FISCAL YEAR: DAY KIMBALL MEDICAL GROUP OPENED A WALK-IN CLINIC AT PLAINFIELD FACILITY IN JULY 2019 FOR THE TREATMENT OF NON-LIFE THREATENING LOW ACUITY HEALTH ISSUES. FORM 990, PART III, LINE 4A PROGRAM SERVICE ACTIVITY: PRACTICE AREAS REPRESENTED BY PHYSICIANS OF THE MEDICAL GROUP ENCOMPASS: -PEDIATRICS -INTERNAL MEDICINE -FAMILY MEDICINE -DERMATOLOGY -DIABETES MANAGEMENT -GENERAL SURGERY -INFECTIOUS DISEASE -OB/GYN -PULMONARY DISEASE FORM 990, PART VI, SECTION A, LINE 3 MANAGEMENT DUTIES: THE ORGANIZATION HAS ENTERED INTO A CONTRACT WITH DAY KIMBALL HEALTHCARE TO PROVIDE DAY-TO-DAY MANAGEMENT AND ADMINISTRATIVE DUTIES INCLUDING BUT NOT LIMITED TO PROVIDING FACILITIES, PERSONNEL, DIRECTION AND ADVICE, EQUIPMENT, FURNISHING AND SUPPLIES. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS: DAY KIMBALL HEALTHCARE, INC. IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A POWER TO ELECT THE GOVERNING BODY: DAY KIMBALL HEALTHCARE HAS THE AUTHORITY TO APPOINT AND REMOVE MEMBERS OF THE ORGANIZATION'S BOARD OF TRUSTEES AND OFFICERS. FORM 990, PART VI, SECTION A, LINE 7B GOVERNANCE DECISIONS SUBJECT TO APPROVAL OUTSIDE OF THE GOVERNING BODY: DAY KIMBALL HEALTHCARE, AS THE SOLE CORPORATE MEMBER, HAS THE AUTHORITY TO DETERMINE THE MISSION AND PURPOSE, APPROVE BUDGETS, HIRE AND TERMINATE PHYSICIAN EMPLOYEES, APPROVE THIRD PARTY CONTRACTS AND FINANCIAL COMMITMENTS IN EXCESS OF SPECIFIED AMOUNTS, APPROVE CHANGES TO THE BYLAWS OR ORGANIZING DOCUMENTS, APPROVE ANY MERGER, ACQUISITION, JOINT VENTURE OR DISSOLUTION AND OTHER POWERS AS LISTED IN THE BYLAWS OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B REVIEW OF FORM 990: THE FORM 990 IS REVIEWED BY PAUL A. BEAUDOIN, CFO, DAY KIMBALL HOSPITAL, PRIOR TO FILING. A COPY OF THE 990 IS MADE AVAILABLE TO ALL BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY REQUIRING BOARD MEMBERS, ADMINISTRATION, THE MEDICAL STAFF, AND ALL OTHER EMPLOYEES TO FILL OUT A CONFLICT OF INTEREST DISCLOSURE FORM ANNUALLY. IN THE EVENT A POTENTIAL CONFLICT OF INTEREST HAS A DIRECT IMPLICATION FOR PATIENT CARE, THE INSTITUTION MAY CONVENE AN ETHICS COMMITTEE MEETING TO ASSIST IN THE RESOLUTION OF THE ISSUE. IF AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST IS DISCLOSED, THE AFFECTED EMPLOYEE WILL REFRAIN FROM FURTHER PARTICIPATION IN MATTERS TO WHICH THE CONFLICT RELATES UNTIL THE QUESTION OF CONFLICT HAS BEEN RESOLVED. FORM 990, PART VI, SECTION B, LINES 15A & 15B COMPENSATION DETERMINATION: THE ORGANIZATION REVIEWS THE COMPENSATION OF THE CEO AND OTHER OFFICERS AND KEY EMPLOYEES ON A REGULAR BASIS. COMPENSATION ADJUSTMENTS ARE SUBJECT TO BOARD APPROVAL AND THE PROCESS AND CONCLUSIONS ARE DOCUMENTED IN THE BOARD MINUTES. THE COMPENSATION REVIEW INCLUDES AN ANALYSIS OF COMPARABILITY DATA. IN APRIL 2019, GALLAGHER GROUP PREPARED AN ANNUAL HOSPITAL WAGE SURVEY FOR THE CONNECTICUT, MASSACHUSETTS AND RHODE ISLAND HOSPITAL ASSOCIATIONS AVAILABLE FOR USE BY MEMBER HOSPITALS. THIS SURVEY WAS USED BY DAY KIMBALL HEALTHCARE IN THE COMPENSATION DETERMINATION PROCESS. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A COMPENSATION OF BOARD OF DIRECTORS: NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR DUTIES AS DIRECTORS. DIRECTORS WITH COMPENSATION LISTED ON PART VII ARE EITHER EMPLOYEES AND/OR INDEPENDENT CONTRACTORS OF THE FILING ORGANIZATION, OR EMPLOYEES AND/OR INDEPENDENT CONTRACTORS OF A RELATED ORGANIZATION, DAY KIMBALL HOSPITAL. THEY ARE COMPENSATED FOR THEIR DUTIES IN THE CAPACITY. FORM 990, PART XI, LINE 9 CHANGES IN NET ASSETS: $ 8,204,439 TRANSFER FROM AFFILIATE DAY KIMBALL HOMEMAKERS 320 POMFRET STREET PUTNAM CT 06260 061136893 HOMEMAKER CT 501(C)(3) 10 DK HLTHCR false DAY KIMBALL HEALTHCARE INC 320 POMFRET STREET PUTNAM CT 06260 060646599 HOSPITAL CT 501(C)(3) 3 NA false DAY KIMBALL HEALTHCARE FOUNDATION INC 309 POMFRET STREET PUTNAM CT 06260 833150493 SUPPORT CT 501(C)(3) 12A I DK HLTHCR false false false false false false false false false false false false false false false false false true false true