2018-08-13T17:00:07-05:00 2017-09-30 350921680 CROWE LLP 175 Powder Forest Drive Simsbury CT 060897902 990 2016-10-01 060646678 The Charlotte Hungerford Hospital CHAR 8604966728 540 LITCHFIELD STREET PO BOX 988 TORRINGTON CT 067900988 SUSAN M SCHAPP VP FINANCE/TREASURER 2018-08-13 true KRISTIN ANDERSON P01231300 8606789200 2016 2022-09-23 18:48:47Z SUSAN M SCHAPP 540 LITCHFIELD STREET PO BOX 988 TORRINGTON CT 067900988 134433555 false X WWW.CHARLOTTEHUNGERFORD.ORG X 1917 CT TO PROVIDE QUALITY, COMPASSIONATE AND COST EFFECTIVE HEALTHCARE TO THE COMMUNITY OF NORTHWESTERN CONNECTICUT. 16 16 1182 158 964566 -81207 3407167 2636637 113594092 116969824 3373388 2091058 443813 250415 120818460 121947934 13000 12000 0 69849166 69031643 0 345023 55493992 56099026 125356158 125142669 -4537698 -3194735 143816112 149068856 87951626 81120257 55864486 67948599 THE CHARLOTTE HUNGERFORD HOSPITAL PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. OUR MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO WITH THE HOSPITAL'S COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, FREE CARE AND/OR SUBSIDIZED CARE, CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST, HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY WILL BE CONSIDERED WHERE THE NEED AND/OR AN INDIVIDUAL'S INABILITY TO PAY COEXIST. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGAMS FOR THE ELDERLY, HANDICAPPED, THE MEDICALLY UNDERSERVED AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. false false 109517742 12000 116162845 During FY 2017, the hospital has contributed over 13,000 hours toward the common purpose of servicing the healthcare of the community. The value of this contribution is approximately $134,000, which is given back to the community through lower costs in both patient services and other "wellness" programs. The Charlotte Hungerford Hospital rendered the following services during FY 2017. INPATIENT SERVICES: Discharges 5,557 Patient Days 23,600 SPECIAL SERVICES: Ambulatory Medical Cases 2,360 Ambulatory Surgery Cases 2,657 C.A.T. Scan Exams 15,537 Cardiac Rehab Treatments 3,263 Cardio Diagnostic Exams 11,620 Delivery Room Deliveries 384 Diagnostic Radiology Exams 23,357 EEG Exams 375 Emergency Department Visits 32,736 Endoscopy Cases 959 Laboratory Tests 529,519 M.R.I. Exams 1,482 Mammograpy Exams 8,975 Nuclear Medicine Exams 721 Occupational Therapy Treatments 4,604 Operating Room Cases 3,426 P.E.T. Scan Exams 339 Partial Hospitalization 4,628 Physical Therapy Treatments 37,362 Post Anesthesia Care Unit Cases 1,832 Professional Service Consults 131,310 Psychiatric Clinic Visits 35,763 Pulmonary Function Lab Tests 1,586 Pulmonary Rehab Tests 4,572 Radiation Therapy Treatments 6,566 Renal Dialysis Visits 256 Respiratory Therapy Treatments 37,653 Sleep Study Tests 584 Special Procedures (Radiology) Exams 1,449 Speech Therapy Treatments 701 Ultrasound Exams 9,166 Walk In Center Visits 14,823 Wound Care Cases 5,564 Hungerford Emergency Medical Center Cardiac Rehab Visits 1,497 Diagnostic Radiology Exams 3,205 Emergency Department Visits 5,763 Laboratory Tests 15,671 Pulmonary Rehab Tests 1,516 109517742 true true false true false false false false false true true true false false true true true false false false false false false false true false true true false true true true false false false false false false false false false false false false false false false true false false false true 234 0 true 1182 true true true false false false false false false false false false X 16 16 false false false false false false false true true false false true true true true true false false false true true CT X SUSAN M SCHAPP 8604966728 540 LITCHFIELD STREET TORRINGTON CT 06790 James O'Leary Governor 2.0 X 0 0 0 Edward Arum Governor 2.0 X 0 0 0 Jeff Borghesi Governor 2.0 X 0 0 0 Debra Brandt Governor 2.0 X 0 0 0 Frank Buonocore Jr Governor 2.0 X 0 0 0 Gladys Cerruto Governor 2.0 X 0 0 0 Richard Dutton MD Governor 2.0 X 0 0 0 Stephanie Fowler MD Governor 2.0 X 0 0 0 Kenrick Hom MD Governor 2.0 X 0 0 0 Jamie Gregg Governor 2.0 X 0 0 0 Maria Countant Skinner Governor 2.0 X 0 0 0 John N Lavieri Governor 2.0 X 0 0 0 Charles W Roraback Governor 2.0 X 0 0 0 Douglas O'Connell Governor 2.0 X 0 0 0 Edwin G Booth Governor 2.0 X 0 0 0 Michael Patterson Governor 2.0 X 0 0 0 Mark Prete MD VP Medical Affairs through October 2016 50.0 X 241117 0 32436 Susan M Schapp VP Finanace 50.0 X 296619 0 68423 John J Capobianco VP OP Services 50.0 X 272355 0 68911 Brian Mattiello VP Human Resources 50.0 X 239721 0 36351 John Janco Chairman 4.0 X 0 0 0 David J Frauenhofer Secretary 2.0 X 0 0 0 Daniel J McIntyre CEO / President 50.0 X 461474 0 110068 Diane Libby CPA Vice Chairman 4.0 X 0 0 0 Timothy Gostkowski MD Physician 40.0 X 484792 0 72372 William McGeehin MD Physician 40.0 X 465826 0 70033 Ofer Sagiv MD Physician 40.0 X 348446 0 50059 Robert Kahan MD Physician 40.0 X 345528 0 49514 Carie Wolfberg MD Physician 40.0 X 342248 0 49089 3498126 0 607256 78 false true true Quest Diagnostics Inc 12436 Collections Center Drive Chicago IL 606932436 Laboratory services/tests 5125793 Saint Francis Medical Group 114 Woodland Street Hartford CT 06105 Medical 2384070 PAC Group LLC 126 South Main St Suite 200 Torrington CT 06790 Construction management 1956785 Morrison Health Care Inc PO Box 102289 Atlanta GA 303682289 Food services 1733811 Adult & Pediatric Urology of NWCT PC 538 Litchfield St Torrington CT 06790 Urology services 1654002 45 695 92171 2282032 261739 2636637 NET PATIENT REVENUE 900099 105772063 105772063 LABORATORY SERVICES 621500 8772618 7849739 922879 OTHER HOSPITAL SERVICES 900099 2425143 2425143 0 0 0 0 116969824 1820401 1820401 488067 372167 115900 0 115900 115900 12213276 50761 11934600 58780 278676 -8019 270657 270657 42170 92171 42170 0 0 159417 77904 81513 81513 INCOME FROM JOINT VENTURES 900001 11315 11315 MEDCONN 561499 41687 41687 0 0 0 0 53002 121947934 116162845 964566 2183886 12000 12000 1430967 1073225 357742 54713704 48588915 5957542 167247 1792097 1585180 201579 5338 7312958 6468595 822579 21784 3781917 3345252 425399 11266 9819883 8686068 1104563 29252 283032 250353 31836 843 131445 116268 14785 392 5823313 5150946 655020 17347 339901 300656 38232 1013 341452 302028 38407 1017 1782978 1577113 200554 5311 3173686 2807248 356984 9454 19025 16828 2140 57 87175 77109 9806 260 6565841 5807741 738541 19559 2423739 2143891 272628 7220 SUPPLIES 16000581 14153135 1799783 47663 PHYSICIAN FEES 9007138 6755354 2251784 HOSPITAL AUXILIARY EXPENSE 75339 75339 Non-operating expenses 224498 224498 0 0 0 0 125142669 109517742 15279904 345023 106274 80299 6646122 6352512 12967654 13819471 0 0 0 2067977 2143657 962403 922535 159005621 112467347 42444100 46538274 56530223 53021573 20312336 24621630 0 1779023 1568905 143816112 149068856 12311129 12425298 141819 218302 12675000 11874876 62823678 56601781 87951626 81120257 X 28888801 36147205 2910968 3427383 24064717 28374011 55864486 67948599 143816112 149068856 X -3194735 3781428 11497420 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 15318 15318 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY The hospital paid dues to the Connecticut Hospital Association. $15,318 represents the portion of these dues used for lobbying expenses on behalf of its' members. Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY The hospital paid dues to the Connecticut Hospital Association. $15,318 represents the portion of these dues used for lobbying expenses on behalf of its' members. 24064717 4624213 314919 28374011 23396887 1839701 1171871 24064717 21641803 0 2554961 0 799877 0 23396887 20101688 0 3608194 0 2068079 0 21641803 17620532 0 2762341 0 281185 0 20101688 0.0 1.0 0.0 false false 155467 155467 91142829 64434002 26708827 42284038 31063660 11220378 25423287 16969685 8453602 46538274 held in trust by others 24621630 F 24621630 ESTIMATED AMOUNTS DUE TO THIRD PARTY REIMBURSEMENT AGENCIES 5063750 MISCELLANEOUS CURRENT LIABILITIES 339745 ESTIMATED SELF-INSURANCE LIABILITIES 5485703 ACCRUED PENSION LIABILITY 45712583 56601781 X 129969342 3781428 4331404 8112832 121856510 91424 91424 121947934 117867204 -7188126 -7188126 125055330 87339 87339 125142669 Schedule D, Part V, Line 4 Intended uses of endowment funds THE ENDOWMENT FUNDS ARE USED PRIMARILY FOR CAPITAL PURCHASES, INDIGENT CARE AND OTHER USES AS APPROVED BY THE BOARD IN ACCORDANCE WITH DONOR RESTRICTIONS. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE HOSPITAL ACCOUNTS FOR UNCERTAIN TAX POSITIONS WITH 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. THE HOSPITAL 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 HOSPITAL DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2017 OR 2016. AS OF SEPTEMBER 30, 2017 OR 2016, THE HOSPITAL DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNCERTAIN TAX POSITIONS. THE HOSPITAL WOULD RECOGNIZE INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE. THE HOSPITAL'S PRIOR THREE TAX YEARS ARE OPEN AND SUBJECT TO EXAMINATION. Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990 Change in beneficial interest in assets - 4309294 Contributions from CHH Auxiliary - 22110 Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements Auxiliary Income - 99221 Auxiliary Fashion Show Expense - -7797 Schedule D, Part XII, Line 2(d) Other expenses in audited financial statements not in form 990 Pension related changes - -7188126 Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statements Auxiliary expenses - 95136 Auxiliary fashion show expense - -7797 Golf Tournament 108566 74193 34373 321 20210 12882 200 760 ANNIVERSARY GALA 10198 10198 0 2 15577 7780 7797 7797 134341 92171 42170 321 20210 12882 200 8557 42170 0 true true X true X true X true true false true true 2005 835790 54944 780846 0.0062 45621 31916949 20219939 11697010 0.0935 0 0.0 0 47626 32752739 20274883 12477856 0.0997 9 4059 68579 68579 0.0005 1 67 244 244 0.0000 5 78057 16350347 13517719 2832628 0.0226 0 0 0 0 0 0.0 2 2660 3557 3557 0.0000 17 84843 16422727 13517719 2905008 0.0232 17 132469 49175466 33792602 15382864 0.1229 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 true 2559232 40324869 44470442 -4145573 X true true ADVANCED MEDICAL IMAGING OF NORTHWEST CT LLC IMAGING CENTER 0.5 0.5 UROLOGY CENTER OF NW CT UROLOGY CENTER 0.625 0.375 1 1 CHARLOTTE HUNGERFORD HOSPITAL 540 LITCHFIELD STREET TORRINGTON CT 06790 WWW.CHARLOTTEHUNGERFORD.ORG 0042 X X X X CHARLOTTE HUNGERFORD HOSPITAL 1 false false true X X X X X X X X X 15 true false false true X https://www.charlottehungerford.org/about-us/community-health-assessment/ X true 14 false false false true X 200.0 400.0 X X X X true true X X X true X https://www.charlottehungerford.org/billing/financial-assistance-billing/ X https://www.charlottehungerford.org/billing/financial-assistance-billing/ X https://www.charlottehungerford.org/billing/financial-assistance-billing/ X X X X X X true X false X X X X true false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Charlotte Hungerford Hospital:. THE STUDY WAS CONDUCTED BY THE CENTER FOR HEALTHY SCHOOLS AND COMMUNITIES AT EDUCATION CONNECTION IN LITCHFIELD, CT. THE STEERING COMMITTEE INCLUDED THE FOLLOWING INDIVIDUALS AND ORGANIZATIONS: Joanne Borduas, BSN, MSN, MBA, Chief Executive Officer, Community Health and Wellness Center, Heather Cappabianca, RN, MHA, Director, CT Office of Rural Health, Coordinator, NCCC, Allied Health, Stephanie K. Fowler, M.D., Charlotte Hungerford Hospital Board of Governors, Ruthann Horvay, Director, Winsted Family Resource Center, Winchester Public Schools, John N. Lavieri, President, Sterling Engineering, Tim J. LeBouthillier, Director of Public Relations, Charlotte Hungerford Hospital, Brian E. Mattiello, VP for Organizational Development, Charlotte Hungerford Hospital, Thomas Narducci, LCSW, Administrative Director, Outpatient Behavioral Health, Charlotte Hungerford Hospital, Leslie Polito, BSN, RN, Public Health Nurse, Torrington Area Health District, Frank R. Vanoni, M.D., Community resident/Former member CHH staff. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Charlotte Hungerford Hospital. Brian Mattiello from CHH will provide a bullet point summary for this section. 0 NORTHWEST CONNECTICUT MEDICAL WALK IN 1598 EAST MAIN STREET TORRINGTON CT 06790 WALK IN MEDICAL CLINIC THE HUNGERFORD CENTER 780 LITCHFIELD STREET TORRINGTON CT 06790 CARDIAC AND PULMONARY REHAB SERVICES THE CENTER FOR CANCER CARE 200 KENNEDY DRIVE TORRINGTON CT 06790 CANCER TREATMENT CENTER HUNGERFORD DIAGNOSTIC CENTER 220 KENNEDY DRIVE TORRINGTON CT 06790 RADIOLOGY SERVICES THE CENTER FOR YOUTH AND FAMILIES 50 LITCHFIELD STREET TORRINGTON CT 06790 PSYCH SERVICES FOR CHILDREN AND FAMILIES WINSTED BEHAVIORAL HEALTH CENTER 294 MAIN STREET WINSTED CT 06098 PSYCH SERVICES SURGICAL ASSOCIATES OF CHH 538 LITCHFIELD STREET TORRINGTON CT 06790 SURGICAL PHYSICIANS PRACTICE NEUROLOGY PBC 780 LITCHFIELD STREET TORRINGTON CT 06790 NEUROLOGY PHYSICIANS PRACTICE CHH PRIMARY CARE 780 LITCHFIELD STREET TORRINGTON CT 06790 PRIMARY CARE PHYSICIANS PRACTICE CHH CARDIOVASCULAR MEDICINE SERVICE 1215 NEW LITCHFIELD STREET TORRINGTON CT 06790 CARDIOVASCULAR PHYSICIANS PRACTICE CHH WOUND CARE AND HYPERBARIC MEDICINE 7 FELICITY LANE TORRINGTON CT 06790 WOUND CARE PHYSICIANS PRACTICE CHH UROLOGY MEDICINE 538 LITCHFIELD STREET TORRINGTON CT 06790 ADULT AND PEDIATRIC UROLOGY PHYSICIANS PRACTICE HUNGERFORD EMERGENCY AND MEDICAL CARE 115 SPENCER STREET WINSTED CT 06098 EMERGENCY SERVICES Schedule H, Part I, Line 3c CRITERIA USED TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE CARE WILL BE PROVIDED FREE FOR THOSE WHO QUALIFY AS UNINSURED AND VERIFICATION HAS DETERMINED THAT THEIR ANNUAL INCOME IS LESS THAN 200% OF THE FEDERAL INCOME POVERTY LEVEL. CARE WILL BE PROVIDED AT HOSPITAL COST, AS ESTABLISHED BY THE OFFICE OF HEALTH CARE ACCESS (OCHA), FOR THOSE UNINSURED PATIENTS WHO REQUEST ASSISTANCE AND VERIFICATION HAS DETERMINED THAT THEIR ANNUAL INCOME IS BETWEEN 200% AND 250% OF THE FPL. CARE WILL BE DISCOUNTED BY 30% FOR THOSE UNISURED PATIENTS WHO REQUEST ASSISTANCE AND VERIFICATION HAS DETERMINED THAT THEIR ANNUAL INCOME IS BETWEEN 250% AND 400% OF THE FPL. THE HOSPITAL WILL ALSO CONSIDER THE TOTAL MEDICALEXPENSES FACED BY THE FAMILY AND THE FAMILY'S ABILITY TO PAY FOR THOSE EXPENSES, AND WILL CONSIDER OFFERING GREATER ASSISTANCE WHEN POSSIBLE TO THOSE FAMILIES FACING CATASTROPHIC MEDICAL EXPENSES. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance A cost to charge ratio based on charity care charges and expenses. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount COSTING METHODOLOGY USED - THE HOSPITAL USES A MODEL CONSISTING OF OUR ACCOUNTS RECEIVABLE BALANCE DIVIDED INTO EIGHT AGING CATEGORIES AS FOLLOWS: 0-30 DAYS, 31-60 DAYS, 61-90 DAYS, 91-120 DAYS, 121-210 DAYS, 211-365 DAYS, AND GREATER THAN 365 DAYS. A PERCENTAGE IS THEN ASSIGNED TO EACH AGING BUCKET BASED ON AGE, WITH A HIGHER PERCENTAGE ASSIGNED AS THE DAYS OUTSTANDING INCREASES. THE RESULTING CALCULATION IS USED TO COMPARE WITH THE RESERVE AND A MONTHLY ADJUSTMENT IS MADE TO DETERMINE THE EXPENSE. ANNUALLY, THIS CALCULATION IS COMPARED TO AN AUDIT OF THE BAD DEBT RESERVES TO DETERMINE IF ANY ADJUSTMENTS ARE REQUIRED. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE IS NOTE 3 ON PAGE 14 OF THE ATTACHED FINANCIAL STATEMENTS. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs EXPLANATION: THE MEDICARE SHORTFALL IS NOT TREATED AS COMMUNITY BENEFIT. THE MEDICARE ALLLOWABLE COSTS OF CARE ARE DERIVED DIRECTLY FROM THE MEDICARE COST REPORT. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance THE HOSPITAL ATTEMPTS TO HAVE INDIVIDUALS FILL OUT ALL PAPER WORK REQUIRED FOR CHARITY CARE. IF THE PERSON IS NOT CAPABLE OF DOING THIS OR IS KNOWN TO BE UNABLE TO DO THIS (SUCH AS A KNOWN HOMELESS PERSON), THEN THE FINANCIAL ASSISTANCE COMMITTEE WILL ADJUST THE ACCOUNT TO CHARITY CARE AND IT WILL NOT BE REPORTED AS BAD DEBT. IF THE ACCOUNT HAS BEEN REPORTED AS BAD DEBT AND INFORMATION COMES FORTH INDICATING AN INABILITY TO PAY, THEN THE ACCOUNT WOULD BE REMOVED FROM BAD DEBT AND MOVED TO CHARITY CARE. Schedule H, Part V, Section B, Line 16a FAP website - CHARLOTTE HUNGERFORD HOSPITAL: Line 16a URL: https://www.charlottehungerford.org/billing/financial-assistance-billing/; Schedule H, Part V, Section B, Line 16b FAP Application website - CHARLOTTE HUNGERFORD HOSPITAL: Line 16b URL: https://www.charlottehungerford.org/billing/financial-assistance-billing/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - CHARLOTTE HUNGERFORD HOSPITAL: Line 16c URL: https://www.charlottehungerford.org/billing/financial-assistance-billing/; Schedule H, Part VI, Line 2 Needs assessment THE HOSPITAL OFFERS FREE HEALTH SCREENINGS, FREE HEALTH EDUCATION AND LECTURES AT VARIOUS COMMUNITY EVENTS INCLUDING FAIRS, EXPOS, PRIVATE COMPANIES, PUBLIC MUNICIPALITIES, AND PUBLIC GATHERINGS. THESE EVENTS PROVIDE A FORUM FOR RECEIVING INFORMATION AND INPUT FROM THE COMMUNITY. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance THE HOSPITAL COUNSELS SELF PAY PATIENTS BY PROVIDING A MEETING WITH A FINANCIAL COUNSELOR OR SOCIAL WORKER. ALL STATEMENTS DISTRIBUTED TO PATIENTS INCLUDE FINANCIAL COUNSELING INFORMATION. SIGNS ARE POSTED THROUGHOUT THE HOSPITAL, INCLUDING THE EMERGENCY ROOM, WHICH STATE CHARITY CARE POLICIES AND FINANCIAL ASSISTANCE INFORMATION. The hospital employs two full-time certified financial application counselors. Schedule H, Part VI, Line 4 Community information The Charlotte Hungerford Hospital (CHH) is located in the northwest part of Connecticut (Litchfield County) in the town of Torrington. The service area of the hospital is comprised of thirteen towns with a total population of approximately 100,000 people. In recent years, the area is becoming more racially and ethnically diverse. In the past decade, the number of White residents increased at a slower rate compared to African American, Asian, and Hispanic residents. The local population is also aging, and has a lower percentage of persons under age 18 and a higher percentage of persons age 65 and older than in the state. This is evident in the high percentage of Medicare and Medicaid revenue (approximately 70%) the hospital receives as part of its operations. Of the 13 service area towns served by CHH, the towns of Torrington (11%) and Cornwall (12%) had the highest poverty levels. Both towns were above the state average of 10%. In terms of educational achievement, the overall county average for high school completion of 96% exceeded the state average of 89%. Lower levels of achievement are found in the towns of Torrington and Winchester. Both of these towns also have higher poverty rates and lower median household incomes than other towns served by the hospital. The school districts in these two towns had the highest percentage of students eligible for free or reduced meals with Torrington at 47% and Winchester at 61%.The vast majority of county residents speak English (91%) with 9% having a primary language other than English and 3% speaking English less than "very well". In terms of services provided to communities, Torrington generates 52% of hospital charges with 12% generated from Winsted. Schedule H, Part VI, Line 5 Promotion of community health All board of directors members reside in the community served by the Charlotte Hungerford Hospital. The hospital extends medical staff privileges to all providers who meet the qualification standards and requirements set forth in the Charlotte Hungerford Hospital medical staff by-laws. Schedule H, Part VI, Line 7 State filing of community benefit report CT true HEALTHCARE SCHOLARSHIPS 12 12000 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. THE CHARLOTTE HUNGERFORD HOSPITAL AUXILIARY AWARDS SCHOLARSHIPS IN THE AMOUNT OF $1,000 EACH TO STUDENTS PURSUING HEALTHCARE EDUCATION. THE STUDENTS MUST LIVE IN THE AREA SERVED BY THE HOSPITAL. THEY MUST ALSO PROVIDE EVIDENCE OF ACCEPTANCE INTO A COLLEGE PROGRAM OR THEIR CURRENT GRADES IN COLLEGE. APPLICANTS MUST SUBMIT LETTERS OF RECOMMENDATION FROM THEIR TEACHERS AND ALSO FROM NON-FAMILY PERSONS. X X false false false false false false false false false Mark Prete MD VP Medical Affairs through October 2016 241117 0 0 0 0 0 32436 0 0 0 273553 0 0 0 Susan M Schapp VP Finanace 296619 0 0 0 0 0 28769 0 39654 0 365042 0 0 0 John J Capobianco VP OP Services 272355 0 0 0 0 0 32501 0 36410 0 341266 0 0 0 Brian Mattiello VP Human Resources 239721 0 0 0 0 0 4304 0 32047 0 276072 0 0 0 Daniel J McIntyre CEO / President 461474 0 0 0 0 0 48375 0 61693 0 571542 0 0 0 Timothy Gostkowski MD Physician 432169 0 52623 0 0 0 7562 0 64810 0 557164 0 0 0 William McGeehin MD Physician 416551 0 49275 0 0 0 7759 0 62274 0 535859 0 0 0 Ofer Sagiv MD Physician 322924 0 25522 0 0 0 3477 0 46582 0 398505 0 0 0 Robert Kahan MD Physician 289834 0 55694 0 0 0 3322 0 46192 0 395042 0 0 0 Carie Wolfberg MD Physician 300804 0 41444 0 0 0 3335 0 45754 0 391337 0 0 0 A THE STATE OF CONNECTICUT HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 060806186 000000000 13000000 To expand the hospital's emergency department and relocate their cardio diagnostics department. false false false A 0 0 13062101 0 0 0 172784 0 0 7258891 5630426 false false false true A false false false false 0.0 0.0 0.0 false false false A false true false false false false false false false A false Schedule K, Part I DIFFERENCE BETWEEN ISSUE PRICE IN PART I AND PART II The difference between the Issues Price in Part I and the Total Proceeds in Part III is $62,101 which is investment earnings. Schedule K, Part III, Line 9 PROCEDURES OF THE ORGANIZATION The hospital follows the procedures outlined in the bond document to ensure all of the proceeds are used for qualified uses, and employs an individual to oversee the project financed by the bond issue. Form 990, Part VI, Line 15a COMPENSATION FOR THE CEO IS DETERMINED USING THE FOLLOWING STEPS: - A MARKET SURVEY BASED ON CT HOSPITAL ASSOCIATION - ADJUSTMENTS BASED ON THE CANDIDATE'S CURRENT SALARY AND PRIOR EXPERIENCE - REVIEW AND APPROVAL BY THE BOARD OF DIRECTORS THE LAST COMPENSATION REVIEW OCCURRED IN AUGUST 2016. Form 990, Part VI, Line 15b COMPENSATION FOR OFFICERS AND KEY EMPLOYEES IS DETERMINED USING THE FOLLOWING STEPS: - A MARKET SURVEY BASED ON CT HOSPITAL ASSOCIATION - ADJUSTMENTS BASED ON THE CANDIDATE'S CURRENT SALARY AND PRIOR EXPERIENCE. - REVIEW AND APPROVAL BY THE BOARD OF DIRECTORS THE LAST COMPENSATION REVIEW OCCURRED IN AUGUST 2016. Form 990, Part VI, Line 11b Review of form 990 by governing body A COPY OF FORM 990 IS DISTRIBUTED TO THE BOARD OF DIRECTORS BEFORE IT IS FILED WITH THE IRS. THIS ENABLES THE BOARD TO ASK QUESTIONS, AND TO APPROVE THE DISCLOSURES MADE IN THE RETURN. Form 990, Part VI, Line 12c Conflict of interest policy THE HOSPITAL DISTRIBUTES A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY TO ITS BOARD OF DIRECTORS, ALL MANAGEMENT PERSONNEL, AND PURCHASING AGENTS. Form 990, Part VI, Line 19 Required documents available to the public THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND ANNUAL REPORT AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part XI, Line 9 Other changes in net assets or fund balances Pension related changes other than net periodic pension costs - 7188126; Change in beneficial interest in assets held in trust by others - 4309294; FORM 990, PART III, LINE 4A PROGRAM SERVICE DESCRIPTION Operating Room Cases 3,617 Ambulatory Surgery Cases 2,892 Endoscopy Cases 1,023 Ambulatory Medical Cases 2,457 Wound Care Cases 6,837 Post Anesthesia Care Unit Cases 2,054 Delivery Room Deliveries 0 Respiratory Therapy Treatments 35,037 Pulmonary Rehab Tests 4,807 Pulmonary Function Lab Tests 1,764 Cardio Diagnostic Exams 12,315 EEG Exams 513 Physical Therapy Treatments 38,800 Cardiac Rehab Treatments 3,286 Speech Therapy Treatments 668 Occupational Therapy Treatments 3,952 Sleep Study Tests 591 Diagnostic Radiology Exams 23,917 Mammograpy Exams 8,922 Nuclear Medicine Exams 754 Ultrasound Exams 9,300 C.A.T. Scan Exams 14,637 P.E.T. Scan Exams 195 M.R.I. Exams 1,483 Special Procedures (Radiology) Exams 1,278 Radiation Therapy Treatments 7,721 Laboratory Tests 520,319 Psychiatric Clinic Visits 39,184 PHP-Adult / Adolescent Visits 4,545 Renal Dialysis Visits 293 Emergency Department Visits 34,412 Walk In Center Visits 13,285 Professional Service Consults 125,530 Hungerford Emergency Medical Center Cardiac Rehab Visits 1,697 Diagnostic Radiology Exams 3,450 Emergency Department Visits 6,011 Laboratory Tests 16,326 Pulmonary Rehab Tests 2,075 ADVANCED MEDICAL IMAGING OF NW CT LLC 57 COMMERCIAL BLVD TORRINGTON CT 06790 061594854 MAGNETIC RESONANCE IMAGING CT NA Related 725284 277685 false false 0.5 UROLOGY CENTER OF NW CT LLC - 538 LITCHFIELD STREET TORRINGTON CT 06790 582674029 EQUIPMENT RENTAL CT NA Related 30812 0 false false 0.625 LITCHFIELD COUNTY HEALTHCARE SERVICE CORPORATION 540 LITCHFIELD STREET TORRINGTON CT 06790 061227655 MANAGEMENT SERVICES CT THE CHARLOTTE HUNGERFORD HOSPITAL C Corporation 0 505 1 true false false false false false false false false false false false false false false false false false false true