2018-08-13T10:03:51-05:00 2017-09-30 990 2016-10-01 454456939 Hartford HealthCare Medical Group Inc HART 8606966200 1290 Silas Deane Highway 2nd Floor Wethersfield CT 06109 Vincent DiBattista President 8605455000 2018-08-13 2016 2022-09-23 18:48:47Z X Vincent DiBattista 80 Seymour Street Hartford CT 06102 141111740 0 X www.hartfordhealthcaremedicalgroup.com X 2012 CT The Mission of Hartford HealthCare Medical Group is to put the patients first, provide coordinated quality care and value, exceed the expectations of patients, providers, staff and the community that it serves. 4 0 1311 0 0 0 0 0 124582209 140775450 0 -22464 0 319442 124582209 141072428 0 0 0 0 131003438 153748965 0 0 0 61851167 64748985 192854605 218497950 -68272396 -77425522 33298170 54415848 31471612 47724259 1826558 6691589 X The Mission of Hartford HealthCare Medical Group is to put patients first, provide coordinated quality care and value, and exceed the expectations of patients, providers, staff and the community that it serves. 0 0 65373366 48777501 The Primary Care program has 67 physicians and 49 advanced practitioners who provide primary care to a wide region within central and eastern Connecticut. Physicians have privileges at Hartford Hospital, Hospital of Central Connecticut, MidState Medical Center, Windham Community Memorial Hospital and Backus Hospital. The practices saw 375,894 patient visits in 2017. Our providers are credentialed in both internal and family medicine, with a commitment to providing sick visits within 24 hours. 23450666 17030776 The Urological Surgery practice has 19 surgeons and 5 advanced practitioners who provide care at the following HHC affiliated entities: Hartford Hospital, Hospital of Central Connecticut and MidState Medical Center. The group is active in teaching medical students and residents through Hartford Hospital and UCONN. The group saw 75,986 patient visits in 2017.The Urology providers have expertise in a wide range of areas that are involved in the diagnosis and treatment, including bladder disease, incontinence and voiding dysfunction, prostate cancer diagnosis, treatment and after care, female urology and pediatric urology. Minimally invasive surgical options are available, including robotic surgery. Providers' areas of expertise also include: - Stone Disease - Diagnosis and treatment including Lithotripsy - Male Sexual Function - Diagnosis and treatment - Urologic Oncology - Diagnosis and treatment of Kidney, Bladder and Prostate Cancer - Vasectomy and Vasectomy Reversal - Sexually Transmitted Disease - Diagnosis and treatment - Benign Prostatic Hyperplasia (BPH) 10503649 7873133 The Cardio Thoracic practice has 7 surgeons and 5 advanced practitioners who provide care at Hartford Hospital and UCONN Health Center. The group saw 5,075 visits in 2017.Our cardiovascular surgeons were the first in Connecticut to integrate the latest advancements in robotics and computer technology during surgical procedures. The Department of Cardiovascular Surgery is a team of experienced and dedicated surgeons who offer a full range of sophisticated cardiac surgical services in the following areas: - Coronary Artery Bypass Surgery, including: beating heart bypass (off pump), robotic assisted, minimally invasive approaches.- Heart Valve Surgery, including: mitral valve replacement, aortic valve replacement, minimally invasive approaches.- Surgery for Advanced Heart Failure, including: heart transplantation, ventricular assist devices/mechanical circulatory support, high risk coronary artery bypass, valve repair or replacement, and left ventricular reconstruction.- Complex Aortic Surgery, including: aortic root, ascending aorta, aortic arch and dorsal aortic replacement, endovascular (stent graft), thoracic and abdominal aortic repair.- Cardiac Arrhythmia Surgery, including: pacemakers and defibrillators, maze procedure for atrial fibrillation.- General Thoracic surgery, including: minimally invasive lung surgery (VATS, Robotic), Esophageal surgery.- Peripheral Vascular Surgery, including: Endovascular (stent graft) abdominal aneurysm repair, peripheral artery bypass, carotid artery surgery.- Bloodless Medicine and Surgery. 95531418 67094040 Hartford HealthCare Medical Group (HHCMG) is a multi-specialty group encompassing physicians in more than 30 specialties in convenient offices across Central and Eastern Connecticut. In addition to clinical practice, our doctors are teachers and researchers, always looking for ways to improve the quality of care and bring innovations to their patients.HHCMG is one of the largest practices in Connecticut with numerous locations throughout Connecticut and over 250 physicians and advanced practitioners. HHCMG offer Primary Care, Urgent Care and Walk-in services. We are a member of Hartford HealthCare and are affiliated with some of the region's top hospitals including Hartford Hospital, The Hospital of Central Connecticut, MidState Medical Center, Windham Hospital, and Backus Hospital. ServicesIn addition to above, HHCMG offers the following services/programs: Bariatric Surgery, Breast Surgery and Breast Care, Cardiac Surgery, Cardiology, Colorectal Surgery, Endocrinology, Diabetes & Metabolism, Family Medicine, General Surgery, Geriatrics, Hand Surgery, Hematology & Oncology, Hepatbiliary Surgery & Pancreatic, Internal Medicine, Internal Medicine/Pediatrics, Occupational Medicine, Oral Maxillofacial Surgery, Orthopedic Surgery, Otolaryngology and Allergy (Ear, Nose, Throat, Allergy), Neurosurgery, Neurology, Peripheral Vascular Surgery, Plastic & Reconstructive Surgery, Podiatric Surgery, Pulmonology, Rheumatology, Sports Medicine, Surgical Oncology, Transplant Surgery, Vascular & Endovascular Surgery, Urgent Care, and Urology. 95531418 67094040 194859099 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 146 0 1 1311 1 0 0 0 0 0 0 0 0 0 0 X 4 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Ellen Liquindoli 8605457188 1290 Silas Deane Highway Wethersfield CT 06109 Jeffrey Flaks Director 2.00 60.00 X 0 1747704 56687 Jeffrey Cohen MD Director 60.00 X 790752 0 65452 Cynthia Heller MD Director 60.00 X 362829 0 18168 Vincent DiBattista Director, President 2.00 60.00 X X 0 489385 100582 Robert Hagberg MD Chair, Dept. Cardiac Surgery 60.00 X 1055150 0 49802 Charles Castiglione MD Plastic Surgeon 60.00 X 999679 0 57187 Brendan Kilroy MD Neurosurgeon 60.00 X 923010 0 54533 Jonathan Hammond MD Cardiothoracic Surgeon 60.00 X 919724 0 53145 Paul Vignati MD Colorectal Surgeon 60.00 X 879175 0 49735 James Watkins Former Officer 0.00 60.00 X 0 443117 58739 5930319 2680206 564030 355 1 1 0 J Morrissey & Company Inc 289 Broad Street Windsor CT 06095 Staffing Services 2664076 OR&L Construction 2 Summit Place Branford CT 06405 Contracting Services 498530 The Casle Corporation 200 Fisher Drive Avon CT 06001 Contracting Services 359936 MUSA CHS Physicians (MARSH) PO Box 310380 Des Moines IA 50311 Prof Liab Insurance 339145 Cardon Healthcare Holdings LLC PO BOX 4950 The Woodlands TX 77387 Outreach Services 318972 17 Net Patient Care 624100 140775450 140775450 140775450 319442 0 319442 319442 319442 16848 39312 -22464 -22464 -22464 141072428 140775450 0 296978 828817 828817 129180050 119101635 10078415 10824959 9985798 839161 4535390 4183802 351588 8379749 7608750 770999 7202 7202 1071640 1071640 291742 33397 258345 2621161 1892321 728840 7441445 4474676 2966769 13287680 12169026 1118654 543665 383949 159716 431114 385206 45908 11765048 8429586 3335462 3000375 1656171 1344204 7540604 7540604 Medical Supplies 11043317 11043317 Purchased Services 4328242 2788611 1539631 Dues, Subs & Licenses 828308 800181 28127 Repairs & Maintenance 315324 291822 23502 232118 189790 42328 218497950 194859099 23638851 0 2460080 3006586 10385899 12482863 251782 251782 494243 533394 24979869 9057116 12239220 15922753 7466946 22218470 33298170 54415848 14999109 24101714 16472503 23622545 31471612 47724259 X 1826558 6691589 1826558 6691589 33298170 54415848 X -77425522 82290553 X 0 1 X 1 0 X 78276707 109744661 111508014 124582209 140775450 564887041 78276707 109744661 111508014 124582209 140775450 564887041 0 0 0 564887041 319442 319442 319442 319442 78276707 109744661 111508014 124582209 141094892 565206483 X 5939761 1762530 4177231 11684568 7294586 4389982 7355540 7355540 15922753 Security Deposits 76784 Malpractice Insurance 14691203 SERP Asset 4869564 Due from Affiliates 2580919 22218470 Accrued Pension Plan 4869564 Other Liabilities - IBNR 3733899 Accrued Malpractice Insurance 14691204 Patient Refunds 327878 23622545 South Asia 0 0 Program Services Indexing Services 111439 0 0 0 0 0 0 111439 0 111439 1 0 0 0 0 0 Sch F, Part II, Line 1 The Indexing Services are being reported on a cash basis. X 1 1 0 1 0 0 0 0 0 1 0 Jeffrey Flaks Director 0 824819 0 659551 0 263334 0 21200 0 35487 0 1804391 0 80266 Jeffrey Cohen MD Director 592857 0 158510 0 39385 0 18550 0 46902 0 856204 0 0 0 Cynthia Heller MD Director 286315 0 72732 0 3782 0 0 0 18168 0 380997 0 0 0 Vincent DiBattista Director, President 0 363372 0 120698 0 5315 0 65956 0 34626 0 589967 0 0 Robert Hagberg MD Chair, Dept. Cardiac Surgery 911506 0 90000 0 53644 0 18550 0 31252 0 1104952 0 0 0 Charles Castiglione MD Plastic Surgeon 948355 0 0 0 51324 0 18550 0 38637 0 1056866 0 0 0 Brendan Kilroy MD Neurosurgeon 886289 0 0 0 36721 0 18550 0 35983 0 977543 0 0 0 Jonathan Hammond MD Cardiothoracic Surgeon 615038 0 264291 0 40395 0 18550 0 34595 0 972869 0 0 0 Paul Vignati MD Colorectal Surgeon 839498 0 0 0 39677 0 18550 0 31185 0 928910 0 0 0 James Watkins Former Officer 0 336021 0 105319 0 1777 0 18550 0 40189 0 501856 0 0 Part I, Line 1b Tax indemnification and gross-up payments to individuals for benefits were included as taxable income on their 2016 Form W-2. Part I, Line 3 The Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare on behalf of Hartford HealthCare Medical Group, 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 CEO, President, Executive Vice President, Senior Vice President and Vice President levels that are reported by Hartford HealthCare Medical Group, Inc. 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. 2016 SERP Accruals were made on behalf of the following individuals: Jeffrey Flaks $200,439 Vincent DiBattista $47,406 2016 SERP Payout was made on behalf of the following individual: Jeffrey Flaks $98,710* *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 1 The organization does not have any independent board members as all board members are compensated for their service to the organization either by the organization itself or by a related organization - Hartford HealthCare. The Foundation is a member of an integrated healthcare delivery system which includes multiple tax-exempt hospitals that have community boards. Form 990, Part VI, Section A, line 6 Hartford HealthCare Medical Group, Inc. is organized as a non-stock not for profit entity. Hartford HealthCare Corporation is the sole member. 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, 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 forwarded to the Director 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 of the Organization and then filed with the IRS. Form 990, Part VI, Section B, line 12c The Hartford HealthCare Medical Group'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/HHCMG, 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 Hartford HealthCare Medical Group 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 Hartford HealthCare Medical Group, 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 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 18 The Organization's Form 990, Form 1023 and its attachments are available for public inspection at the organization's address upon request. Form 990, Part VI, Section C, line 19 The Organization's 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: Transfer from Affiliate 82,291,000. Rounding -447. 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