2018-08-14T09:00:51-05:00 2017-09-30 440160260 BKD LLP 1201 WALNUT SUITE 1700 KANSAS CITY MO 64106 990 2016-10-01 060250773 THE WILLIAM W BACKUS HOSPITAL WILL 8608898331 326 WASHINGTON STREET NORWICH CT 06360 ANTHONY MASTROIANNI VP, FINANCE 8608898331 2018-08-14 1 MICHAEL J ENGLE P00482834 8162216300 2016 2022-09-23 18:48:47Z DONNA HANDLEY 326 WASHINGTON STREET NORWICH CT 06360 364808623 0 X WWW.BACKUSHOSPITAL.ORG X 1891 CT THE WILLIAM W. BACKUS HOSPITAL DELIVERS AND COORDINATES A CONTINUUM OF HIGH-QUALITY HEALTH CARE THAT IS SENSITIVE TO THE NEEDS OF INDIVIDUALS IN EASTERN CONNECTICUT. THE HOSPITAL IS COMMITTED TO BEING RESPONSIVE AND ACCOUNTABLE TO THOSE FOR WHOSE BENEFIT IT EXISTS, AND TO IMPROVING THE HEALTH OF ITS COMMUNITIES. 11 8 1980 385 2305892 34996 512743 850343 308726062 344798102 8686222 15948934 1672123 -482262 319597150 361115117 149587 60026 0 0 139755080 135660651 0 0 276068 135932582 161168158 275837249 296888835 43759901 64226282 589761844 646918185 172757813 172966112 417004031 473952073 X THE WILLIAM W BACKUS HOSPITAL DELIVERS AND COORDINATES A CONTINUUM OF HIGH QUALITY HEALTH CARE THAT IS SENSITIVE TO THE NEEDS OF INDIVIDUALS IN EASTERN CONNECTICUT. THE HOSPITAL IS COMMITTED TO BEING RESPONSIVE AND ACCOUNTABLE TO THOSE FOR WHOSE BENEFIT IT EXISTS, AND TO IMPROVING THE HEALTH OF ITS COMMUNITIES. 0 0 107218197 114032732 INPATIENT-THE HOSPITAL HAS 233 LICENSED BEDS. DISCHARGES FOR FY 17 WERE 10,296 OF WHICH 7,711 MED/SURG AND ICU, 1,882 MATERNITY/NEWBORN AND 703 PSYCH. PATIENT DAYS TOTALED 46,248 OF WHICH 35,775 MED/SURG AND ICU, 4,323 MATERNITY/NEWBORN AND 6,150 PSYCH. OBSERVATION DISCHARGES WERE 2,715 AND OBSERVATION DAYS WERE 5,762. THE AVERAGE LENGTH OF STAY IS 4.49 DAYS. THERE WERE 2,148 INPATIENT SURGERIES PERFORMED. 96679589 60026 126236121 OUTPATIENT-FOR FISCAL 17, THE HOSPITAL HAD 430,375 OUTPATIENT VISITS. INCLUDED IN THOSE VISITS ARE 141,393 IMAGING EXAMS, 7,018 MRI EXAMINATIONS, 6,061 SAME DAY SURGICAL PROCEDURES, 7,547 PSYCHIATRIC CLINICAL VISITS, 10,240 PSYCHIATRIC PARTIAL HOSPITAL VISITS, 29,610 REHAB VISITS, 3,202 CARDIAC VISITS, 3,414 CHEMO VISITS, AND 3,007 GASTROINTESTINAL VISITS. 32012415 68146098 EMERGENCY DEPARTMENT-THE HOSPITAL HAS EMERGENCY DEPARTMENTS LOCATED IN NORWICH AND PLAINFIELD. FOR FISCAL 17, VISITS TOTALED 76,492 OF WHICH 6,415 WERE TRANSITIONED TO INPATIENT CARE. 23744878 36389176 OTHER PROGRAM SERVICES INCLUDE EHR REVENUE, PURCHASE DISCOUNTS, CONTRACT SERVICES AND OTHER MISCELLANEOUS INCOME. 23744878 36389176 259655079 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 137 0 1 1980 1 1 1 0 0 0 0 1 1 0 0 0 0 X 11 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 CT X X ANTHONY MASTROIANNI 8608898331 326 WASHINGTON STREET NORWICH CT 06360 MARY BARRY MD DIRECTOR 2.00 2.00 X 0 35089 2344 CARMEN CID DIRECTOR 2.00 2.00 X 0 0 0 CAROLYN DRESCHER DIRECTOR 2.00 2.00 X 0 0 0 KARLA FOX DIRECTOR (THRU JUNE 2017) 2.00 2.00 X 0 0 0 ANTHONY JOYCE DIRECTOR (THRU JUNE 2017) 2.00 2.00 X 0 0 0 STEPHEN LARCEN PHD DIRECTOR 2.00 2.00 X 0 62966 3955 STEVE LEE MD DIRECTOR 2.00 2.00 X 0 0 0 LYNN QUINTAL-HILL DIRECTOR 2.00 2.00 X 0 0 0 MARK TRAMONTOZZI MD DIRECTOR 2.00 2.00 X 0 0 0 JAMES WATSON MD DIRECTOR 2.00 2.00 X 0 0 0 DIANE WISHNAFSKI CHAIR 3.00 3.00 X X 0 0 0 DEBORAH MONAHAN VICE CHAIR 3.00 3.00 X X 0 0 0 BIMAL PATEL DIRECTOR/PRESIDENT 20.00 40.00 X X 0 648139 103528 ANTHONY MASTROIANNI VP FINANCE 30.00 30.00 X 0 268409 50315 DANIEL LOHR SENIOR VP/CFO (THRU DEC. 2016) 30.00 30.00 X 0 582635 128453 MARGARET MARCHAK CHIEF LEGAL OFFICER 0.00 60.00 X 0 676177 131333 LESTER TEMPKIN VP OPERATIONS EAST REGION 30.00 30.00 X 0 308936 38333 CAROLYN TRANTALIS VP OPERATIONS EAST REGION 30.00 30.00 X 0 329504 57256 ROBERT SIDMAN MD VP MEDICAL AFFAIRS EAST REGION 30.00 30.00 X 0 514163 52683 GREGORY MAKOWSKI HHC LAB SERVICES 30.00 30.00 X 0 330039 21633 SERGIO CASILLAS MD PHYSICIAN 60.00 X 622426 0 38282 ZHENXIANG LIU MD PHYSICIAN 60.00 X 507401 0 37643 RICHARD GOULDING MD PHYSICIAN 60.00 X 360432 0 37765 WILLIAM HORGAN MD PHYSICIAN 60.00 X 376661 0 37765 NADER BAHADORY MD PHYSICIAN 60.00 X 448338 0 30533 DAVID WHITEHEAD FORMER DIRECTOR/PRESIDENT/EVP 0.00 60.00 X 0 885620 56363 2315258 4641677 828184 208 1 1 0 ALLIANCE HEALTHCARE SERVICES PO BOX 96485 CHICAGO IL 60693 MEDICAL SERVICES 2945412 HARTFORD HEALTHCARE LABORATORIES 80 SEYMOUR STREET HARTFORD CT 06102 LAB SERVICES 1711798 MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 30368 FOOD/TRANSPORT 1447216 LOCUMTENES PO BOX 405547 ATLANTA GA 30384 MEDICAL SERVICES 1109865 NORTH AMERICAN PARTNERS ANESTHESIA 68 SOUTH SERVICE RD MELVILLE NY 11747 MEDICAL SERVICES 864008 39 81180 769163 1388 850343 NET PATIENT REVENUE 624100 342498235 342498235 LAB COURIER SERVICE 621500 2299867 2299867 344798102 5311763 5311763 1709295 3288946 -1579651 -1579651 -1579651 10983420 2000 0 348249 10983420 -346249 10637171 10637171 28080 81180 56311 -28231 -28231 CAFETERIA 722320 1119595 1119595 6025 6025 1125620 361115117 342498235 2305892 15460647 50026 50026 10000 10000 108440928 98808908 9523496 108524 3853897 3511583 338457 3857 15968712 14550327 1402404 15981 7397114 6660265 728547 8302 65186 65186 20303 20303 23850 23850 1084370 1084370 11622681 11622681 227686 39381 155762 32543 2664937 1795800 794827 74310 17734250 10640550 7093700 5346552 4465363 881189 59453 43305 16148 364345 275684 88661 4030959 589365 3441594 12926108 6592315 6333793 12549535 11991450 558085 4840681 4840681 MEDICAL SUPPLIES 43955153 43955153 HOSPITAL PROVIDER TAX 19715655 19715655 PURCHASED SERVICES 15927831 12492239 3407555 28037 REPAIRS AND MAITENANCE 7182122 5461200 1720922 826501 458778 363209 4514 296888835 259655079 36957688 276068 2302732 29681835 46966017 2410144 64 0 37772680 40586735 7885 3822252 4056193 4061424 1700384 325071526 202958805 114328120 122112721 27637016 4840321 340919004 401607453 14919217 11944650 25003182 589761844 646918185 15572886 15553720 313087 1322594 1162798 155862333 155936507 172757813 172966112 X 404269648 459954493 4543173 5595523 8191210 8402057 417004031 473952073 589761844 646918185 X 64226282 38618171 -19356 -45877056 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 23850 0 0 23850 0 PART II-B, LINE 1: THE WILLIAM W. BACKUS HOSPITAL PAID ANNUAL DUES TO CONNECTICUT HOSPITAL ASSOCIATION (CHA). CHA CONDUCTS LOBBYING ACTIVITIES ON BEHALF OF ITS MEMBERS. CHA ALLOCATES A PORTION OF THEIR DUES AS LOBBYING EXPENSES. THE PORTION OF DUES ALLOCATED AS LOBBYING EXPENSES IS CALCULATED UNDER CURRENT MEDICARE RULES. CHA CONDUCTS LOBBING ACTIVITIES UNDER CURRENT MEDICARE RULES. THE ORGANIZATION OCCASIONALLY ASKS ITS EMPLOYEES TO VOLUNTEER THEIR TIME TO CONTACT STATE LEGISLATORS IN AN EFFORT TO LOBBY ON ITS BEHALF. THE TOTAL AMOUNT OF DUES ALLOCATED FOR LOBBYING EXPENSES FOR FY17 WAS $23,850. 7849631 555441 8405072 7465627 384004 7849631 7558064 -92437 7465627 7100798 459483 2217 7558064 6513852 591457 4511 7100798 0.68000 0.32000 0 1 1 5011878 5011878 10381267 122297550 79462415 53216402 63266122 37394077 25872045 116437587 86102313 30335274 7677122 7677122 122112721 INVESTMENT IN ENDOWMENT LLC 396412137 F ASSET HELD IN TRUST BY OTHERS 2649201 F INVESTMENT IN OTHER JOINT VENTURES 1806115 F INVESTMENT IMAGING JOINT VENTURE 740000 F 401607453 ACCRUED POST RETIREMENT EXPENSES 48168223 ACCRUED MALPRACTICE 5345032 OTHER LIABILITIES 19489857 TAX EXEMPT BONDS 75957092 HOSPITAL PROVIDER TAX 3758330 SERP LIABILITY 3217973 155936507 PART V, LINE 4: THE HOSPITAL HAS ADOPTED INVESTMENT AND SPENDING POLICIES FOR ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PREDICABLE STREAM OF FUNDING TO MISSION RELATED PROGRAMS, SUCH AS THOSE DESCRIBED IN PART III, LINES 4A-4D, WHILE SEEKING TO MAINTAIN PURCHASING POWER OF THE ENDOWMENT ASSETS. ENDOWMENT ASSETS INCLUDE THOSE ASSETS OF DONOR-RESTRICTED FUNDS THAT THE CORPORATION MUST HOLD IN PERPETUITY OR FOR A DONOR-SPECIFIC PERIOD(S). UNDER THIS POLICY, AS APPROVED BY THE BOARD OF DIRECTORS, 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. GOLF TOURNAMENT 74730 55530 19200 5470 14430 8855 1500 1865 SEDER GOLF TOURNAMENT 34530 25650 8880 2462 6727 10845 1500 2657 109260 81180 28080 7932 21157 19700 3000 4522 56311 -28231 1 1 1 X 250.000000000000 1 X 1 1 0 1 1 1136703 1136703 0.00380 70824281 42328692 28495589 0.09600 71960984 42328692 29632292 0.09980 465662 231 465431 0.00160 197785 197785 0.00070 3174719 3174719 0.01070 1500 1500 0.00000 3839666 231 3839435 0.01300 75800650 42328923 33471727 0.11280 54619 54619 0.00020 54619 54619 0.00020 0 6788033 0 73724873 85616627 -11891754 X 1 1 1 1 THE WILLIAM W BACKUS HOSPITAL 326 WASHINGTON STREET NORWICH CT 06360 BACKUSHOSPITAL.ORG 0037 X X X THE WILLIAM W BACKUS HOSPITAL 1 0 0 1 X X X X X X X X X 14 1 0 0 1 X SEE PART V X X 1 15 0 1 0 1 X 250.000000000000 400.000000000000 X X X X 1 1 X X X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X X 1 X 0 X X X X 1 X 0 0 THE WILLIAM W BACKUS HOSPITAL PART V, SECTION B, LINE 5: TO SOLICIT INPUT FROM KEY INFORMANTS AND INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY WAS ALSO IMPLEMENTED AS PART OF THIS PROCESS. THIS SURVEY WAS CONDUCTED FROM 12/1/14 THOUGH 12/21/14. THESE INDIVIDUALS INCLUDED PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS AND A VARIETY OF OTHER COMMUNITY LEADERS INCLUDING THE FOLLOWING: AMERICAN AMBULANCE SERVICE, INC. AMERICAN RED CROSS BLOOD SERVICES BACKUS HOSPITAL CATHOLIC CHARITIES GENERATIONS FAMILY HEALTH CENTER, INC. MOHEGAN TRIBE NORWICH ADULT EDUCATION / RELIANCE HOUSE, INC. ROSE CITY SENIOR CENTER SOUTHEASTERN REGIONAL ACTION COUNCIL ST. VINCENT DE PAUL PLACE NORWICH THREE RIVERS COMMUNITY COLLEGE NURSING PROGRAM TOWN OF WINDHAM TVCCA UNCAS HEALTH DISTRICT UNITED COMMUNITY AND FAMILY SERVICES WINDHAM HOSPITAL WINDHAM REGION NO FREEZE PROJECTPARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE OVERALL COMMUNITY. KEY INFORMANTS WERE CONTACTED BY EMAIL, INTRODUCING THE PURPOSE OF THE SURVEY AND PROVIDING A LINK TO TAKE THE SURVEY ONLINE. KEY INFORMANTS WERE ASKED TO RATE THE DEGREES TO WHICH VARIOUS HEALTH ISSUES WERE A PROBLEM IN THE HARTFORD REGION. FOLLOW-UP QUESTIONS ASKED THEM TO DESCRIBE WHY THEY IDENTIFIED AREAS AS SUCH, AND HOW THESE MIGHT BE BETTER ADDRESSED.AFTER REVIEWING THE COMMUNITY HEALTH NEEDS ASSESSMENT FINDINGS, THE COMMUNITY REPRESENTATIVES MET ON JUNE 11, 2015 TO DETERMINE THE HEALTH NEEDS TO BE PRIORITIZED FOR ACTION. DURING A DETAILED PRESENTATION OF THE CHNA FINDINGS, THE HOSPITAL USED AUDIENCE RESPONSE SYSTEM (ARS) TECHNOLOGIES TO LEAD STEERING COMMITTEE MEMBERS THROUGH A PROCESS OF UNDERSTANDING KEY LOCAL DATA FINDINGS (AREAS OF OPPORTUNITY) AND RANKING IDENTIFIED HEALTH ISSUES AGAINST THE FOLLOWING ESTABLISHED, UNIFORM CRITERIA: MAGNITUDE, IMPACT/SERIOUSNESS/FEASIBILITY, CONSEQUENCES OF INACTION. FROM THIS EXERCISE, THE AREAS OF OPPORTUNITY WERE PRIORITIZED AS FOLLOWS BY THE COMMITTEE: MENTAL HEALTH, NUTRITION, PHYSICAL ACTIVITY & WEIGHT STATUS, DIABETES, SUBSTANCE ABUSE, CANCER, HEART DISEASE AND STROKE.PART V, SECTION B, LINE 7AWWW.BACKUSHOSPITAL.ORG/ABOUT-US/COMMUNITY-OUTREACH/HEALTH-NEEDS-ASSESSMENT THE WILLIAM W BACKUS HOSPITAL PART V, SECTION B, LINE 7D: THE NEEDS ASSESSMENT WAS PUBLISHED IN MARCH 2015 AND IS AVAILABLE ON THE HOSPITAL'S WEBSITE. IN ADDITION, COPIES WERE MADE AVAILABLE TO OUR COMMUNITY PARTNERS. THE WILLIAM W BACKUS HOSPITAL PART V, SECTION B, LINE 11: IN ACKNOWLEDGING THE WIDE RANGE OF PRIORITY HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS, BACKUS HOSPITAL DETERMINED THAT IT COULD ONLY EFFECTIVELY FOCUS ON THOSE WHICH IT DEEMED MOST PRESSING, MOST UNDER-ADDRESSED, AND MOST WITHIN ITS ABILITY TO INFLUENCE:* NUTRITION* PHYSICAL ACTIVITY & WEIGHT (OBESITY)* CANCER* DIABETES* HEART DISEASE & STROKE* RESPIRATORY DISEASES* ACCESS TO CARE* ORAL HEALTH* DEMENTIA* ALZHEIMER'S DISEASE* MENTAL HEALTH & SUBSTANCE USE (INCLUDING TOBACCO USE).BACKUS HOSPITAL IS IMPLEMENTING INITIATIVES THAT WILL RESPOND TO THESE NEEDS. ADDITIONAL NEEDS IDENTIFIED AS "AREAS OF OPPORTUNITIES" WERE NOT DEEMED AS SIGNIFICANT NEEDS AND DID NOT RANK HIGHLY ENOUGH TO EARN A PRIORITIZED RANKING. AREAS OF OPPORTUNITIES, IDENTIFIED BUT NOT PRIORITIZED: * INFANT HEALTH AND FAMILY PLANNING * INJURY & VIOLENCE* POTENTIALLY DISABLING CONDITIONSINFANT HEALTH AND FAMILY PLANNING: BACKUS HOSPITAL HAS LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS FAMILY PLANNING AND INFANT HEALTH. OTHER COMMUNITY PARTNERS SUCH AS UCFS AND MADONNA PLACE HAVE INFRASTUCTURE AND PROGRAMS IN PLACE TO BETTER MEET THIS NEED.INJURY & VIOLENCE: BACKUS HOSPITAL BELIEVES THAT THIS PRIORITY AREA FALLS MORE WITHIN THE PURVIEW OF SAFE FUTURES, THE FORMER WOMEN'S SHELTER. BACKUS IS A COMMUNITY PARTNER AND HAS ARRANGED FOR SAFE FUTURES TO OPEN AN OFFICE IN THE MEDICAL OFFICE BUILDING, ADJOINING THE HOSPITAL. BACKUS HOSPITAL HAS LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS INJURY PREVENTION.POTENTIALLY DISABLING CONDITIONS: BACKUS HOSPITAL HAS LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS POTENTIALLY DISABLING CONDITIONS. THE WILLIAM W BACKUS HOSPITAL PART V, SECTION B, LINE 13H: FAMILY ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE ALSO INCLUDE FAMILY SIZE, EMPLOYMENT STATUS, FINANCIAL OBLIGATIONS, AND AMOUNT AND FREQUENCY OF HEALTH CARE EXPENSES. THE WILLIAM W BACKUS HOSPITAL PART V, SECTION B, LINE 15E: IN ADDITION, PATIENT MAY ASK A NURSE, PHYSICIAN, CHAPLAIN, OR STAFF MEMBER FROM PATIENT REGISTRATION, PATIENT FINANCIAL SERVICES, CASE COORDINATION, OR SOCIAL SERVICES ABOUT INITIATING THE FINANCIAL ASSISTANCE APPLICATION PROCESS.THE WILLIAM W BACKUS HOSPITAL:PART V, LINE 16A, FAP WEBSITE: HTTPS://BACKUSHOSPITAL.ORG/FOR-PATIENTS-FAMILIES/FINANCIAL- INSURANCE-INFO/FINANCIAL-COVERAGE/THE WILLIAM W BACKUS HOSPITAL:PART V, LINE 16B, FAP APPLICATION WEBSITE: HTTPS://BACKUSHOSPITAL.ORG/FOR-PATIENTS- FAMILIES/FINANCIAL-INSURANCE-INFO/FINANCIAL-COVERAGE/THE WILLIAM W BACKUS HOSPITAL:PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: HTTPS://BACKUSHOSPITAL.ORG/FOR-PATIENTS -FAMILIES/FINANCIAL-INSURANCE-INFO/FINANCIAL-COVERAGE/ THE WILLIAM W BACKUS HOSPITAL PART V, SECTION B, LINE 16J: PATIENTS ARE INFORMED DIRECTLY BY STAFF OF THE AVAILABILITY OF THE FINANCIAL ASSISTANCE POLICY. 10 1 - BACKUS OUTPATIENT CARE CENTER 111 SALEM TURNPIKE NORWICH CT 06360 OUTPATIENT SERVICES 2 - MEDICAL OFFICE BUILDING 330 WASHINGTON STREET NORWICH CT 06360 RADIATION THERAPY/LAB 3 - COLCHESTER BACKUS HEALTH CENTER 163 BROADWAY COLCHESTER CT 06415 RADIOLOGY/LAB/PRIMARY CARE 4 - MONTVILLE BACKUS HEALTH CARE 80 NORWICH/NEW LONDON TURNPIKE UNCASVILLE CT 06382 RADIOLOGY/LAB/PRIMARY CARE 5 - LEDYARD BACKUS HEALTH CENTER 2 LORENZ PARKWAY LEDYARD CT 06339 LAB/PRIMARY CARE 6 - FAMILY HEALTH CENTER AT CROSSROADS 196 PARKWAY SOUTH WATERFORD CT 06385 PRIMARY CARE/REHAB/ORTHOPEDICS 7 - INFECTIOUS DISEASE CLINIC 107 LAFAYETTE STREET NORWICH CT 06360 CLINIC 8 - NORTH STONINGTON BACKUS HEALTH CENTER 82 NORWICH-WESTERLY ROAD NORTH STONINGTON CT 06359 PRIMARY CARE 9 - PLAINFIELD MEDICAL OFFICE 584 NORWICH ROAD PLAINFIELD CT 06374 PHYSICIAN OFFICES/INFUSION CENTER 10 - PLAINFIELD EMERGENCY CENTER 582 NORWICH ROAD PLAINFIELD CT 06374 LAB/RADIOLOGY/EMERGENCY SERVICES PART I, LINE 3C: BACKUS HOSPITAL USED FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY. IN ADDITION, THE HOSPITAL TAKES INTO CONSIDERATION, MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS, AND OTHER FAMILY ELIGIBILITY CRITERIA SUCH AS FAMILY SIZE, EMPLOYMENT AND FINANCIAL OBLIGATIONS.PART I LINE 6A:THE ORGANIZATIONS SUBMITS QUARTERLY REPORTS TO THE CONNECTICUT HOSPITAL ASSOCIATION AND FORM 990 IS SUBMITTED TO THE CONNECTICUT OFFICE OF HEALTH CARE ACCESS (OHCA) ANNUALLY. PART I, LINE 7: THE ORGANIZATION UTILIZED AN OVERALL COST TO CHARGE RATIO (RCC), DEVELOPED FROM THE MEDICARE COST REPORT. TOTAL EXPENSE WAS ADJUSTED FOR: MEDICAID PROVIDER TAXES, DIRECTLY IDENTIFIED COMMUNITY BENEFIT EXPENSE AND COMMUNITY BUILDING EXPENSES. THIS COST TO CHARGE RATIO WAS USED TO CALCULATE COSTS FOR PART I LINES 7A & B. THE COSTS ASSOCIATED WITH THE ACTIVITIES REPORTED ON PART I LINE 7E WERE CAPTURED USING ACTUAL TIME MULTIPLIED BY AN AVERAGE SALARY RATE. THE COSTS ASSOCIATED WITH LINE 7H, WERE THE ACTUAL COSTS REPORTED IN THE ORGANIZATION'S GENERAL LEDGER LESS ANY INDUSTRY FUNDED STUDIES. THESE COSTS WERE REMOVED FROM THE CALCULATIONS TO AVOID DUPLICATION. COSTS REPORTED IN PART III, SECTION B6, WERE CALCULATED FROM THE MEDICARE COST REPORT AND REDUCED FOR MEDICARE COSTS PREVIOUSLY REPORTED IN PART I LINES 7F & G. PART II, COMMUNITY BUILDING ACTIVITIES: BACKUS HOSPITAL INTERACTS WITH THE COMMUNITY TO ADDRESS NEEDS AND FACILITATE APPROPRIATE RESPONSES. FOR FY 2017, BACKUS EXPENDED $54,619 ON COMMUNITY BUILDING ACTIVITIES. PART III, LINE 3: A PRE-BAD DEBT FINANCIAL ASSISTANCE SCREENING IS IN PLACE TO IDENTIFY PATIENTS THAT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. PRE-BAD DEBT ACCOUNTS THAT ARE IDENTIFIED AS MEETING THE REQUIREMENTS ARE ADJUSTED PRIOR TO BEING SENT TO BAD DEBT. THEREFORE, ANY BAD DEBT EXPENSE THAT COULD HAVE BEEN ATTRIBUTABLE TO CHARITY CARE AT THE END OF FY 2017 WOULD BE IMMATERIAL. PART III, LINE 4: PLEASE SEE THE TEXT OF THE FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE BEGINNING ON PAGE 22 OF THE AUDITED FINANCIAL STATEMENTS.THE FOOTNOTE IS ALSO APPLICABLE TO PART III LINE 2. PART III, LINE 8: THE ORGANIZATION'S MEDICARE COST REPORT WAS USED TO ACCUMULATE ACTUAL COSTS RELATED TO PART III SECTION B LINE 6. PART III, LINE 9B: THE FINANCIAL ASSISTANCE POLICY STATES:IN THE EVENT A PATIENT FAILS TO QUALIFY FOR FINANCIAL ASSISTANCE OR FAILS TO PAY THEIR PORTION OF DISCOUNTED CHARGES PURSUANT TO THIS POLICY, AND THE PATIENT DOES NOT PAY TIMELY THEIR OBLIGATIONS TO THE HOSPITAL, THE HOSPITAL RESERVES THE RIGHT TO BEGIN COLLECTION ACTIONS, INCLUDING BUT NOT LIMITED TO, IMPOSING WAGE GARNISHMENTS OR LEINS ON PRIMARY RESIDENCES, INSTITUTING LEGAL ACTION AND REPORTING THE MATTER TO ONE OR MORE CREDIT RATING AGENCIES. FOR THOSE PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THE HOSPITAL'S OUTSTANDING ACCOUNTS, THE HOSPITAL MAY OFFER EXTENDED PAYMENT PLANS TO ELIGIBLE PATIENTS, WILL NOT IMPOSE WAGE GARNISHMENTS OR LIENS ON PRIMARY RESIDENCES, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES AND WILL CEASE ALL COLLECTION EFFORTS.NO EXTRAORDINARY COLLECTION ACTIONS (ECA) WILL BE INITIATED DURING THE FIRST 120 DAYS FOLLOWING THE FIRST POST-DISCHARGE BILLING STATEMENT TO A VALID ADDRESS OR DURING THE TIME THAT PATIENT'S FINANCIAL ASSISTANCE APPLICATION IS PROCESSING. BEFORE INITIATING ANY ECA, A NOTICE WILL BE PROVIDED TO THE PATIENT 30 DAYS PRIOR TO INITIATING SUCH AN EVENT.IF THE PATIENT APPLIES FOR ASSISTANCE WITHIN 240 DAYS FROM THE FIRST NOTIFICATION OF THE SELF-PAY BALANCE, AND IS GRANTED ASSISTANCE, ANY ECA'S SUCH AS NEGATIVE REPORTING TO A CREDIT BUREAU OR LIENS THAT HAVE BEEN FILED WILL BE REMOVED. PART VI, LINE 2: BACKUS HOSPITAL USES EMERGENCY ROOM DATA TO TRACK INCREASES IN MEDICAL CONDITIONS SUCH AS FALLS, FLU, DRUG OVERDOSES, ETC. AND THE SAME APPROACH IS TAKEN IN OUR OUTPATIENT CLINICS. PERIODICALLY INFORMATION IS SURVEYED TO DETERMINE ADDITIONAL PATIENT NEEDS. INFORMATION IS ALSO TRACKED FROM OTHER ENTITIES SUCH AS AREA NON-PROFITS,GOVERNMENTAL AGENCIES AND PUBLIC SCHOOLS. PART VI, LINE 3: BACKUS HOSPITAL PROVIDES INFORMATION ABOUT ITS FINANCIAL ASSISTANCE POLICY AS FOLLOWS:(I) PROVIDE SIGNS REGARDING THIS POLICY AND WRITTEN PLAIN LANGUAGE SUMMARY INFORMATION DESCRIBING THE POLICY ALONG WITH FINANCIAL ASSISTANCE CONTACT INFORMATION IN THE EMERGENCY DEPARTMENT, LABOR AND DELIVERY AREAS AND OTHER PATIENT REGISTRATION AREAS;(II) PROVIDE TO EACH PATIENT WRITTEN PLAIN LANGUAGE SUMMARY INFORMATION DESCRIBING THE POLICY ALONG WITH FINANCIAL ASSISTANCE CONTACT INFORMATION IN ADMISSION, PATIENT REGISTRATION, DISCHARGE, BILLING AND COLLECTION WRITTEN COMMUNICATIONS;(III)MAKE PAPER COPIES OF THE POLICY, FINANCIAL ASSISTANCE APPLICATION, AND PLAIN LANGUAGE SUMMARY OF THE POLICY AVAILABLE UPON REQUEST AND WITHOUT CHARGE, BOTH BY MAIL AND IN PUBLIC LOCATIONS IN THE HOSPITAL FACILITY, INCLUDING THE EMERGENCY ROOM AND ADMISSION AREAS;(IV) POST THE POLICY, PLAIN LANGUAGE SUMMARY AND FINANCIAL ASSISTANCE APPLICATION ON THE WEBSITE WITH CLEAR LINKAGE TO SUCH DOCUMENTS ON THE HOSPITAL'S HOME PAGE;(V) EDUCATE ALL ADMISSION AND REGISTRATION PERSONNEL REGARDING THE POLICY SO THAT THEY CAN SERVE AS AN INFORMATIONAL RESOURCE TO PATIENTS REGARDING THE POLICY; AND (VI) INCLUDE THE TAG LINE "PLEASE ASK ABOUT OUR FINANCIAL ASSISTANCE POLICY" IN BACKUS WRITTEN PUBLICATIONS. PART VI, LINE 4: THE TOTAL POPULATION OF THE BACKUS HOSPITAL PRIMARY SERVICE AREA IS 275,166. 77% OF THE POPULATION IS WHITE WITH 5% BLACK. PEOPLE OF HISPANIC ORIGIN MAKE UP 8.9% AND 4% IS ASIAN. CHILDREN AGE 0-17 MAKE UP 21.8%, 18-64 64.3% AND SENIORS ACCOUNT FOR 13.9% OF THE POPULATION. THE POPULATION LIVING IN POVERTY IS 10% WITH THOSE LIVING BELOW 200% FPL IS 22.5%. 10.9% HAVE NO HIGH SCHOOL DIPLOMA.27% HAVE A BA OR HIGHER.THE REGION IS A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA. PART VI, LINE 5: A REGIONAL BOARD GOVERNS BACKUS, WINDHAM AND NATCHAUG HOSPITALS. THE BOARD IS RESPONSIBLE FOR MAINTAINING OUTSTANDING QUALITY SERVICES AND CREDENTIALS ITS MEDICAL STAFF. ALL OF THE DIRECTORS RESIDE IN OUR SERVICE AREA AND ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE HOSPITAL. PART VI, LINE 6: HARTFORD HEALTHCARE CORPORATION (HHC) IS ORGANIZED AS A SUPPORT ORGANIZATION TO GOVERN, MANAGE AND PROVIDE SUPPORT SERVICES TO ITS AFFILIATES. HHC, THROUGH ITS AFFILIATES INCLUDING THE WILLAM W BACKUS HOSPITAL, STRIVES TO IMPROVE HEALTH USING THE "TRIPLE AIM" MODEL: IMPROVING QUALITY AND EXPERIENCE OF CARE; IMPROVING HEALTH OF THE POPULATION (POPULATION HEALTH) AND REDUCING COSTS. HHC AND ITS AFFILIATES, INCLUDING ALL SUPPORTED ORGANIZATIONS, DEVELOP AND IMPLEMENT PROGRAMS TO IMPROVE THE HEALTH CARE IN OUR SOUTHERN NEW ENGLAND REGION. THIS INCLUDES INITIATIVES TO IMPROVE THE QUALITY AND ACCESSIBILITY OF HEALTH CARE, CREATE EFFICIENCY ON BOTH OUR INTERNAL OPERATIONS AND THE UTILIZATION OF HEALTH CARE, AND PROVIDE PATIENTS WITH THE MOST TECHNICALLY ADVANCED AND COMPASSIONATE COORDINATED CARE. IN ADDITION, HHC CONTINUES TO TAKE IMPORTANT STEPS TOWARD ACHIEVING ITS VISION OF BEING "NATIONALLY RESPECTED FOR EXCELLENCE IN PATIENT CARE AND MOST TRUSTED FOR PERSONALIZED, COORDINATED CARE".THE AFFILIATION WITH HHC CREATES A STRONG, INTEGRATED HEALTH CARE DELIVERY SYSTEM WITH A FULL CONTINUUM OF CARE ACROSS A BROADER GEOGRAPHIC AREA. THIS ALLOWS THE SMALL COMMUNITIES EASY AND EXPEDIENT ACCESS TO THE MORE EXTENSIVE AND SPECIALIZED SERVICES THE HOSPITAL IS ABLE TO OFFER. THIS INCLUDES CONTINUING EDUCATION OF HEALTH CARE PROFESSIONALS AT ALL THE AFFILIATED INSTITUTIONS THROUGH THE CENTER OF EDUCATION, SIMULATION AND INNOVATION LOCATED AT HARTFORD HOSPITAL. THE AFFILIATION FURTHER ENHANCES THE AFFILIATE'S ABILITIES TO SUPPORT THEIR MISSIONS, IDENTITY, AND RESPECTIVE COMMUNITY ROLES. THIS IS ACHIEVED THROUGH INTEGRATED PLANNING AND COMMUNICATION TO MEET THE CHANGING NEEDS OF THE REGION. THIS INCLUDES RESPONSIBLE DECISION MAKING AND APPROPRIATE SHARING OF SERVICES, RESOURCES AND TECHNOLOGIES, AS WELL AS CONTAINMENT STRATEGIES. PART VI, LINE 7, REPORTS FILED WITH STATES CT 1 CHAMBER OF COMMERCE OF SE CT 914 HARTFORD TPKE WATERFORD CT 06385 060475490 501C6 10870 SPONSORSHIPSPONSORSHIP PARAMEDIC PROGRAM SPONSORSHIP SPONSORSHIP SPONSORSHIP SPONSORSHIP SPONSORSHIP SPONSORSHIP SPONSORSHIP 0 1 SCHOLARSHIP 5 10000 PART I, LINE 2: DONATIONS MADE FOR LOCAL EVENTS, SUCH AS SPONSORSHIPS ARE TYPICALLY ATTENDED BY HOSPITAL EMPLOYEES. FIVE SCHOLARSHIPS IN THE AMOUNT OF $2,000 EACH ARE AWARDED TO STUDENTS WHO WILL ATTEND SCHOOL EITHER FOR NURSING OR IN THE MEDICAL FIELD. THE APPLICANTS ARE REVIEWED BY THE SCHOLARSHIP COMMITTEE OF THE AUXILIARY AND WINNERS ARE BASED ON ACADEMICS AS WELL AS COMMUNITY SERVICE. X 1 1 X X X X 0 1 0 0 0 0 0 1 0 BIMAL PATEL DIRECTOR/PRESIDENT 0 445963 0 185927 0 16249 0 91279 0 12249 0 751667 0 0 ANTHONY MASTROIANNI VP FINANCE 0 197286 0 70136 0 987 0 18550 0 31765 0 318724 0 0 DANIEL LOHR SENIOR VP/CFO (THRU DEC. 2016) 0 362355 0 114850 0 105430 0 92550 0 35903 0 711088 0 0 MARGARET MARCHAK CHIEF LEGAL OFFICER 0 453679 0 186949 0 35549 0 90285 0 41048 0 807510 0 0 LESTER TEMPKIN VP OPERATIONS EAST REGION 0 233271 0 69236 0 6429 0 18550 0 19783 0 347269 0 0 CAROLYN TRANTALIS VP OPERATIONS EAST REGION 0 237409 0 90860 0 1235 0 18550 0 38706 0 386760 0 0 ROBERT SIDMAN MD VP MEDICAL AFFAIRS EAST REGION 0 381747 0 130484 0 1932 0 18550 0 34133 0 566846 0 0 GREGORY MAKOWSKI HHC LAB SERVICES 0 253221 0 74449 0 2369 0 9275 0 12358 0 351672 0 0 SERGIO CASILLAS MD PHYSICIAN 511183 0 110626 0 617 0 18550 0 19732 0 660708 0 0 0 ZHENXIANG LIU MD PHYSICIAN 474690 0 32283 0 428 0 18550 0 19093 0 545044 0 0 0 RICHARD GOULDING MD PHYSICIAN 282850 0 77308 0 274 0 18550 0 19215 0 398197 0 0 0 WILLIAM HORGAN MD PHYSICIAN 297182 0 79060 0 419 0 18550 0 19215 0 414426 0 0 0 NADER BAHADORY MD PHYSICIAN 331224 0 115646 0 1468 0 18550 0 11983 0 478871 0 0 0 DAVID WHITEHEAD FORMER DIRECTOR/PRESIDENT/EVP 0 578564 0 222671 0 84385 0 18550 0 37813 0 941983 0 0 PART I, LINE 1A TAX INDEMNIFICATION AND GROSS-UP PAYMENTS TO INDIVIDUALS FOR BENEFITS WERE INCLUDED AS TAXABLE INCOME ON THEIR 2016 FORM W-2. PART 1, LINE 3: THE INDEPENDENT EXECUTIVE COMPENSATION COMMITTEE (COMMITTEE) OF THE BOARD OF DIRECTORS OF HARTFORD HEALTHCARE ON BEHALF OF BACKUS HOSPITAL 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 CEO, PRESIDENT, EXECUTIVE VICE PRESIDENT, SENIOR VICE PRESIDENT AND VICE PRESIDENT LEVELS THAT ARE REPORTED BY BACKUS 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 CHANE 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. 2016 SERP ACCRUALS MADE ON BEHALF OF THE FOLLOWING INDIVIDUALS: MR. BIMAL PATEL $58,694 MR. DAVID WHITEHEAD $75,587 MS. MARGARET MARCHAK $60,847 2016 SERP PAYOUTS WERE MADE ON BEHALF OF THE FOLLOWING INDIVIDUALS: MR. STEPHEN LARCEN $6,674 MR. DANIEL LOHR $74,000 MR. DAVID WHITEHEAD $34,339* *FOR THIS INDIVIDUAL, VESTING OCCURRED, CAUSING TAXABLE INCOME. A 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 6 HARTFORD HEALTHCARE CORPORATION, A NOT-FOR-PROFIT 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF THE WILLIAM W BACKUS HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF THE ORGANIZATION 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, AQUISITIONS, DISSOLUTIONS, ETC. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY HARTFORD HEALTHCARE'S STAFF ACCOUNTANT WITH OVERSIGHT FROM THE HARTFORD HEALTHCARE TAX DEPARTMENT. IT WAS THEN REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE FORM WAS THEN FORWARDED TO THE ORGANIZATION'S TOP MANAGEMENT INCLUDING THE REGIONAL VP OF FINANCE FOR REVIEW. THE FINAL FORM WAS PROVIDED TO THE ENTIRE BOARD PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE (IRS). ONCE THE ENTIRE PROCESS WAS COMPLETED, THE FORM WAS SIGNED BY THE REGIONAL VP OF FINANCE AND THEN FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE HOSPITAL'S 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 EXECUTIVE COMPLIANCE STEERING COMMITTEE ("ECSC") (THE COMMITTEE) WHICH INCLUDES REPRESENTATION FROM THE MEDICAL STAFF, THE LEGAL DEPARTMENT, HUMAN SERVICES, SUPPLY CHAIN MANAGEMENT AND COMPLIANCE. THE COMMITTEE ASSESSES AND MAY RECOMMEND THE CONFLICTING INTEREST EITHER BE (A) ELIMINATED FOR CONTINUED RELATIONSHIP WITH HHC/BACKUS, 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 BACKUS HOSPITAL, 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 BACKUS HOSPITAL, 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 ARE MADE BASED ON MARKET DATA ANALYSIS TO ENSURE APPROPRIATE COMPETITIVE POSITIONING WITHIN PARAMETERS OF COMPENSATION PHILOSOPHY; -THE CEO COMPENSATION IS 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 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 XI, LINE 9: CHANGE IN ASSETS HELD IN TRUST 177,438. CHANGE IN PENSION FUNDING 8,871,012. TRANSFER TO AFFILIATES -54,926,792. K-1 PASS-THROUGH INVESTMENTS 1,286. FORM 990, PART XII, LINE 3B: ALTHOUGH THE ORGANIZATION WAS NOT REQUIRED TO UNDERGO A-133 FEDERAL AUDIT, THE RESULTS WERE INCLUDED IN A CONSOLIDATED A-133 AUDIT PERFORMED AT THE PARENT LEVEL-HARTFORD HEALTHCARE CORPORATION. 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