2018-08-14T08:49:42-05:00 2017-09-30 990 2016-10-01 060966963 Natchaug Hospital Inc NATC 8604561311 189 Storrs Road Mansfield Center CT 06226 Paul Maloney VP of Finance 8604561311 2018-08-14 2016 2022-09-23 18:48:47Z Patricia Rehmer 189 Storrs Road Mansfield Center CT 06226 51951035 0 X WWW.NATCHAUG.ORG X 1954 CT The mission of Natchaug Hospital is to provide a continuum of accessible, community-based services for those living with psychiatric illness and chemical dependency or emotional and related educational disabilities, with a commitment to the dignity and privacy of those needing service, empowering them to participate in their own care, education and recovery. 11 8 633 21 0 0 167000 117000 51562855 51782498 22482 12428 18278 39109 51770615 51951035 0 0 0 0 38091993 38151135 0 0 146215 12631645 13819638 50723638 51970773 1046977 -19738 29148469 30036519 18099482 15861884 11048987 14174635 X The mission of Natchaug Hospital is to provide a continuum of accessible, community-based services for those living with psychiatric illness and chemical dependency or emotional and related educational disabilities, with a commitment to the dignity and privacy of those needing service, empowering them to participate in their own care, education and recovery. 0 0 21185446 21486224 Inpatient Treatment:Natchaug Hospital provides a full range of inpatient psychiatric and substance-abuse treatment for children, adolescents and adults at our 57-bed Mansfield Center facility. The highly qualified, experienced and dedicated professional staff of Natchaug Hospital provides expert care in a supportive, therapeutic setting - helping people regain their stability and return as soon as possible to their own homes. The hospital serves Medicare and Medicaid subscribers and provides care without regard to ability to pay.Intermediate Care (ICC):This is an acute level of care for a longer length of stay for persons living with prolonged and severe mental illness. Historically, people from Eastern Connecticut who were in need of an extended length of stay were referred to Cedarcrest Hospital in Newington. Natchaug Hospital ICC provides this much-needed care for persons from the Eastern Region, closer to the communities where they live and work.United Services and the Southeastern Mental Health Authority are the Local Mental Health Authorities (LMHA's) responsible for authorizing admission to the Intermediate Care Program. The above includes the authorization of Department of Mental Health and Addiction Services (DMHAS) funds to pay for care in the event the patient is medically indigent, has exhausted his/her Medicare benefit, or has no Medicare hospitalization coverage. Patients are most likely to be referred from Eastern Region hospital inpatient units when it becomes clear that the patient will not be able to safely return to the community following an acute care stay. Upon admission, each patient is assessed by a psychiatrist, a registered nurse and a primary therapist. A treatment plan is developed for each patient. The treatment team works closely with the patient, their family and community providers to develop a discharge plan and ensure that community supports are in place.In-Patient Treatment Programs:* Treats approximately 60 patients on a daily basis at the Mansfield locationInpatient Treatment includes:* Comprehensive bio-psycho-social assessment* Formulation of a treatment plan developed with the patient/family which may include the use of medications * Group therapy (a primary treatment approach)* Family therapy and individual therapy* Formulation of a discharge/aftercare plan* Case management servicesTypical patient experience: The majority of our patients arrive via ambulance through the ambulance entrance. All patients receive an initial assessment by a registered nurse and psychiatrist which is completed within 8 hours of admission. Patients are oriented to the unit, the milieu, and the schedule. Our patients are closely monitored for the first 24-48 hours, depending on presentation and symptoms. 9012698 7680024 Joshua Centers: The Joshua Centers provides various treatment programs including:Partial Hospital Program (PHP): The Partial Hospital Program provides four hours of intensive psychiatric support daily for up to five days per week. This is a morning program for adults and an after-school program for children and adolescents. The program can eliminate the need for a hospital stay, and/or help with the transition back to home and regular school after a period of inpatient care.Intensive Outpatient Program (IOP): The Intensive Outpatient Program is somewhat less intense than the PHP, providing three hours of intensive treatment each day for up to five days each week. This program is offered both in the morning and during the evening for adults and after-school for children and adolescents. The IOP program is designed to help continue progress with behavioral health stabilization and recovery.Extended Day Treatment (EDT):This special program, partially funded by the Connecticut Department of Children, supports children and adolescents who have emotional or behavioral health issues that put them at risk of needing psychiatric residential or inpatient care. The Extended Day Treatment program is particularly helpful for children with special needs who are in foster care.Child & Adolescent Treatment Programs:* Treat about 250 children and adolescents daily in all programs/locations* May prevent hospitalization* Aids in transition back to the community following hospitalization* Transportation to Partial Hospital Program, Intensive Outpatient Program and Extended Day Program: Most of this transportation is provided by Natchaug Hospital staff, driving the Hospital vans that pick up patients from their school or home. * Average length of stay in PHP/IOP program, 6 - 8 weeks; EDT and Intensive In-Home Child & Adolescent Psychiatric Services, 6 months.Joshua Program treatment services include: * Comprehensive bio-psycho-social assessment* Group Therapy (the primary treatment approach)* Family and individual therapy* Medication management* Occupational and creative rehabilitation therapy* Comprehensive aftercare/discharge planningPartial Hospital Program (PHP): four hours of treatment for up to five days per week Intensive Outpatient program (IOP): three hours of treatment up to five days per week Extended Day Treatment (EDT) is a specialized therapeutic after-school support program that provides structured groups for three hours a day up to five days per week to learn and practice social skills such as group interaction, listening, cooperative leisure activities. Intensive In-Home Child & Adolescent Psychiatric Services(IICAPS): developed and monitored by the Yale University Child Study Center, provides in home services 2-3 times per week to help meet the needs of families with children with persistent psychiatric disorders. Client referral to a Child/Adolescent Treatment Program:* Referred from an inpatient program in Connecticut* Community providers (Child & Family Services; United Children & Families; Emergency Rooms)* School systems* Private providers (community psychiatrists or therapists)* Family and friendsIn a treatment day, clients arrive after being picked up from their school (or home) in one of Natchaug Hospital vans and will attend four groups in PHP and three groups in IOP. Groups include a psychotherapy group, educational groups and an activity group. The activity group is led by a Mental Health Worker or a CRS Staff member; all other groups are led by a masters level clinician. Education groups might include managing emotions, dangers of substance abuse, handling relationships, etc. 7928835 7835099 Education: Natchaug provides various educational programs such as:Clinical Day Treatment School Programs (CDT):Natchaug's clinical day treatment programs, which are approved by the Connecticut Department of Education, offer special education services to students in grades 1 - 12, whose social, emotional or behavioral health problems prevent them from functioning successfully in a regular school environment. Each student's individual academic and clinical treatment plan is designed to address their special needs and return them to their regular schools as soon as possible. Natchaug Hospital schools operate in Enfield, Danielson, Mansfield, Norwich, and Windham. Natchaug is also the contracted operator of a school for the Town of Norwich. Natchaug Hospital's Board of Directors serves a number of functions similar to a Board of Education, with responsibilities for the oversight and the implementation of certain State statutes and Federal legislation.Natchaug Hospital School Programs:* Each school day, an average of 200 students attend Natchaug Hospital's school programs* Approved by the Connecticut Department of Education * Inpatient School, Journey House School, Clinical Day Treatment School in six sites Students come to the Inpatient School on an emergency basis, and for non-educational reasons; school staff determines if the student receives special education services, and if there is an Individual Education Plan (IEP) to be implemented. Students come to the Journey House School on a planned basis and for non-educational reasons. Each student's school files are evaluated for proper placement in school. Girls who receive special education, Section 504, and regular education all are educated at the Journey School. Students come to the six CDT sites via a Planning and Placement Team (PPT) Meeting from their home school district. They may be placed on a diagnostic basis with PPT meetings every two weeks while psychiatric, psychological and educational assessments are performed. Students also may enter the program already receiving special education services with an IEP (Individualized Education Plan) in place. Students at the Hickory Street School are placed by the Norwich Board of Education. All students are identified as special education and have an IEP in place. Transportation to all day school programs is provided by the Local Education Authority (LEA) that placed the student; however, transportation during the school day for field trips is often provided using Natchaug vans with school staff driving; sometimes school field trips are transported by outside vendors. Description of typical day:A typical day in the Inpatient and Journey House School is a five-hour day that covers all academic areas, including electives of Art and PE. A typical day in the CDT schools is similar to any traditional school day, with academic subjects in addition to psycho-educational groups led by school clinicians. 6328887 14781151 Natchaug Hospital is eastern Connecticut's leading provider of mental health and addiction services for children, adolescents and adults. Founded in 1954, Natchaug Hospital provides a wide range of mental health and addiction treatment services for children, adolescents and adults in eastern Connecticut. Natchaug offers inpatient services, including one of only six pediatric inpatient units in the state of Connecticut, residential treatment for court-involved teenage girls, clinical day treatment schools, and ambulatory services through its 10-site network of care.In addition to above, Natchaug provides the following services/programs:Child Services Adolescent ServicesYoung Adult ServicesAdult ServicesAlcohol AbuseOlder Adults ProgramAttention Deficit Hyperactivity Disorder Evaluations Autism Spectrum Disorder EvaluationsPsychological ServicesSchoolsExtended Day TreatmentInpatient TreatmentIntensive In-Home Child and Adolescent Psychiatric Services (IICAPS)Intensive Outpatient TreatmentJoshua Center ProgramsJourney House ProgramPartial HospitalizationResidential Treatment ProgramMedication Assisted Treatment Close to Home (MATCH) 6328887 14781151 44455866 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 75 0 1 633 1 0 0 0 0 0 0 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 0 CT X Paul V Maloney VP Finance Behavioral Health Network 8604561311 189 Storrs Road Mansfield Center CT 06226 James Watson MD Director 1.00 2.00 X 0 0 0 Mary Barry MD Director 1.00 2.00 X 0 35089 2344 Lynne Quintal-Hill Director 1.00 2.00 X 0 0 0 Mark Tramontozzi MD Director 1.00 2.00 X 0 0 0 Carmen Cid Director 1.00 2.00 X 0 0 0 Carolyn Drescher Director 1.00 2.00 X 0 0 0 Stephen Larcen Director 2.00 60.00 X 0 62966 3955 Karla Fox Director (Thru June 2017) 1.00 2.00 X 0 0 0 Anthony Joyce Director (Thru June 2017) 1.00 2.00 X 0 0 0 Steve Lee MD Director 1.00 2.00 X 0 0 0 Diane Wishnafski Director & Chair 3.00 6.00 X X 0 0 0 Deborah Monahan Director & Vice Chair 3.00 6.00 X X 0 0 0 Bimal Patel Director 2.00 60.00 X 0 648140 103527 Margaret Marchak Secretary 1.00 59.00 X 0 676177 131333 Patricia Rehmer President BHN 30.00 30.00 X 0 429052 74316 Paul Maloney VP, Finance 30.00 30.00 X 0 282802 45883 Deborah Weidner MD VP, Safety and Quality 30.00 30.00 X 521505 0 47269 Harold Schwartz MD VP, Psychiatrist in Chief 30.00 30.00 X 0 626947 78920 James O'Dea VP, Operations 30.00 30.00 X 0 284475 47172 Pamela Shuman Associate Medical Director 60.00 0.00 X 294477 0 43030 Paul Weigle Associate Medical Director 60.00 0.00 X 283775 0 51931 Jonathan Raub Associate Medical Director 60.00 0.00 X 259907 0 52702 Tiwalola Kolawole Psychiatric Attending 60.00 0.00 X 233176 0 35256 Gengyun Wen Psychiatric Attending 60.00 0.00 X 225980 0 40485 David Whitehead Former President 0.00 0.00 X 0 885620 56363 1818820 3931268 814486 37 1 1 0 Locumtenenscom LLC 2655 Northwinds Parkway Alpharetta GA 30009 Staffing Services 467917 Morrison Mgmt Specialists Inc 5801 Peachtree Dunwoody Rd Atlanta GA 30342 Food and Nutrition Services 451386 Rose Construction 348 Orchard Hill Road Promfret Center CT 06259 Construction Services 381990 Girard Ford 450 West Thames Street Norwich CT 06360 Automobile Repair Services 188270 Lifespan Psychiatry LLC 23 Indian Hill Road Redding CT 06896 Psychiatric Services 155760 9 117000 117000 Net Patient Revenue 624100 51782498 51782498 51782498 12428 12428 39109 0 39109 39109 39109 51951035 51782498 0 51537 473124 473124 28016260 25941916 1968747 105597 3091186 2877571 213615 4324288 4017382 298828 8078 2246277 2088082 150609 7586 4753 4753 2381262 2381262 16879 16879 482574 221685 258040 2849 3263040 1962125 1300915 1433504 1409728 23776 71797 55610 15986 201 38463 13407 25056 109535 109535 2739742 1419729 1320013 827295 45859 781436 442129 442129 Purchased Services 1071830 736758 318588 16484 Medical Supplies 499392 499392 Repairs & Maintenance 348086 338144 9942 Dues & licenses 83752 4782 78850 120 5605 305 5300 51970773 44455866 7368692 146215 4600075 6983142 188949 12155303 10729712 174644 135350 251610 203761 22697301 11552458 11257369 11144843 50022 11133 61155 1482 0 646831 589607 29148469 30036519 9298547 3135111 1955075 1789589 6845860 10937184 18099482 15861884 X 10576206 13604783 422781 519830 50000 50022 11048987 14174635 29148469 30036519 X -19738 3145386 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 4753 0 0 4753 0 Part II-B, Line 1: Natchaug 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 lobbying activities under current Medicare rules. The total amount of dues allocated for lobbying expenses for FY17 was $4,753. 440040 440040 14155203 6332134 7823069 2325315 980739 1344576 4975487 4239585 735902 801256 801256 11144843 Due To Affiliates 7005811 Professional Liability 423637 Accrued Post Retirement Expenses 3183353 Accrued Malpractice 324383 10937184 1 1 X 1 X 250.000000000000 1 X 1 1 1 0 1 1 120558 0 120558 0.00230 17617871 13315616 4302255 0.08280 16961075 16590297 370778 0.00710 34699504 29905913 4793591 0.09220 560089 122564 437525 0.00840 360534 0 360534 0.00690 54772 20 54752 0.00110 0 0 23006 0 23006 0.00040 998401 122584 875817 0.01680 35697905 30028497 5669408 0.10900 25374 25374 0.00050 25374 25374 0.00050 0 1608000 0 3260729 3718430 -457701 X 1 1 1 1 Natchaug Hospital 189 Storrs Rd PO Box 260 Mansfield Center CT 06250 www.natchaug.org H0003 X Natchaug Hospital Inc 1 0 0 1 X X X X X X X X X 14 1 0 0 1 X See Part V 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 Natchaug Hospital, Inc. Part V, Section B, Line 5: To solicit input from key informants, 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 12/1/2014 through 12/21/2014. 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 Berlin Senior Center Boys and Girls Club of Meriden Bristol Community Organization Bristol Burlington Health District Calendar House Southington Senior Center Capital Community College Catholic Charities Central Connecticut Health District Central Connecticut Senior Health Services Central Connecticut Senior Health Services Chamber of Commerce of Eastern Connecticut Charter Oak Health Center Chrysalis Center, Inc. Community Health Center, Inc. Community Health Services, Inc. Connecticut Association for Community Action Connecticut Association of Directors of Health Connecticut Children's Medical Center Connecticut Department of Public Health Connecticut State Colleges and Universities Connecticut State Medical Society Eastern Highlands Health District FaithCare, Inc. Farmington Valley Health District Generations Family Health Center, Inc. Girls Incorporated of Meriden Greater New Britain Chamber of Commerce Hartford Behavioral Health Hartford Food System, Inc. Hartford Foundation for Public Giving Hartford Gay and Lesbian Health Collective Hartford Hospital Hartford Public Schools Hispanic Health Council Intercommunity, Inc. LCS Legal Assistance Resource Center Malta House of Care Foundation Manchester Community College Manchester Health Department Manchester Public Schools Mental Health Association of Connecticut, Inc. Meriden Senior Center Meriden Wallingford Chrysalis, Inc. MHT Christians in Action Mohegan Tribe Northeast District Department of Health Northern Connecticut Black Nurses Association Norwich Adult Education Quinnipiac Chamber of Commerce Reliance House, Inc. Rose City Senior Center South Central CT Substance Abuse Council South Windsor Human Services Southeastern Regional Action Council Southington Library Southington Public Schools St. Vincent de Paul Place Norwich Three Rivers Community College Nursing Program Town of Windham TVCCA Participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall. Key informants were contacted by email, introducing the purpose of the survey and providing a link to take a 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, we 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 7a:https://natchaug.org/health-wellness/community-health-needs-assessment Natchaug Hospital, Inc. 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 distributed to local non-profit organizations, colleges, churches, and state and local government representatives. These reports are also made available in waiting areas of the various departments within the hospital. Natchaug Hospital, Inc. Part V, Section B, Line 11: In acknowledging the wide range of priority health issues that emerged from the CHNA process, Natchaug 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: * Access to Health Services * Mental Health & Mental Disorders* Substance Abuse Areas of Opportunity, Identified but not Prioritized:Nutrition, Physical Activity & Weight Status:Natchaug has limited resources, services and expertise available to address these issues.Infant Health & Family Planning:As a mental and behavioral health hospital, Natchaug has no resources for addressing these issues. Other community organizations have infrastructure and programs in place to better meet this need. Limited resources excluded this as an area chosen for action. Injury & Violence Prevention:Natchaug has limited resources, services and expertise available to address injury and violence prevention. Other community organizations have infrastructure and programs in place to better meet this need. Limited resources excluded this as an area chosen for action.Cancer:Since Natchaug is not an acute care hospital, it does not have appropriate health services to address this issue. Immunization & Infectious Diseases:Since Natchaug is not an acute care hospital, it does not have appropriate health services to address this issue. Diabetes:Since Natchaug is not an acute care hospital, it does not have appropriate health services to address this issue.Dementias including Alzheimer's Disease:Natchaug has limited resources, services and expertise available to address these issues.Respiratory:Since Natchaug is not an acute care hospital it does not have appropriate health services to address this issue.Potentially Disabling Conditions:Since Natchaug is not an acute care hospital it does not have appropriate health services to address this issue.Chronic Kidney Disease:Since Natchaug is not an acute care hospital, it does not have appropriate health services to address this issue.Heart Disease:Since Natchaug is not an acute care hospital, it does not have appropriate health services to address this issue. Natchaug Hospital, Inc. 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 the health care expenses. Natchaug Hospital, Inc. Part V, Section B, Line 15e: In addition, patients may ask a nurse, physician, chaplain, or staff member from Patient Registration, Patient Financial Services, Office of Professional Services, Case Coordination, or Social Services about initiating the Financial Assistance Application process.Part V, Section B, Line 16a: FAP Website:natchaug.org/patients-caregivers/billing-insurance/financial-assistance Part V, Section B, Line 16b: FAP Application Website:natchaug.org/patients-caregivers/billing-insurance/financial-assistancePart V, Section B, Line 16c: FAP Plain Language Summary:natchaug.org/patients-caregivers/billing-insurance/financial-assistance Natchaug Hospital, Inc. Part V, Section B, Line 16j: Patients are informed directly by staff of the availability of the Financial Assistance Policy. 15 1 - Care Plus 1353 Gold Star Highway Groton CT 06340 Day Treatment Center 2 - Clinical Day Treatment Windham 345 Jackson Street Willimantic CT 06226 Day Treatment Center 3 - Hickory Street School 201 Hickory Street Norwich CT 06360 Day Treatment Center 4 - Joshua Center - Northeast 934 North Main Street Danielson CT 06239 Day Treatment Center 5 - Joshua Center - Enfield 72 Shaker Road Suite 7 Enfield CT 06082 Day Treatment Center 6 - Joshua Center - Mansfield Center 189 Storrs Road Mansfield Center CT 06250 Day Treatment Center 7 - Journey House 189 Storrs Road Mansfield Center CT 06250 Day Treatment Center 8 - Quinebaug Day Treatment Center 11 Dog Hill Road Dayville CT 06241 Day Treatment Center 9 - Rivereast Day Treatment Center 428 Hartford Tpke Vernon CT 06066 Day Treatment Center 10 - Sachem House 189 Storrs Road Mansfield Center CT 06250 Day Treatment Center 11 - Thames Valley Clinical Day Programs 11A Stott Avenue Norwich CT 06360 Day Treatment Center 12 - Joshua Center Shoreline 5 Research Parkway Old Saybrook CT 06475 Day Treatment Center 13 - Joshua Center Thames Valley 11A Stott Avenue Norwich CT 06360 Day Treatment Center 14 - Deborah Tennant-Zinewicz School 30 Case Street Norwich CT 06360 School/ Treatment Center 15 - Joshua Center - Montville 20 Maple Avenue Uncasville CT 06382 Day Treatment Center Part I, Line 3c: Natchaug 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 Organization submits quarterly reports to 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, & g. 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 above to avoid duplication. Costs reported in Part III, Section B6, were calculated from the Medicare Cost Report and reduced for medicare costs previously reported on Part I Lines 7f and g. Part I, Line 7g: No physician clinic costs were included in the Subsidized Health Services cost calculations. Part II, Community Building Activities: To reduce economic impact of untreated mental illness and improve the quality of life for those living with this disease (and the communities in which they live) Natchaug Hospital pursues opportunities to increase awareness of the symptoms of mental illness, increase awareness that mental illness is a treatable disease, achieve a reduction in the stigma associated with mental illness (which is the largest barrier to treatment), and increase awareness of behavioral health treatment resources. The amount spent on Community Building activities for FY17 was $25,374. 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 Statement. The footnote is also applicable to Part III, Line 2. Part III, Line 8: Providing care for those in need, including Medicare and Medicaid patients, and serving all patients regardless of ability to pay is an essential part of the community benefit standard, as well as our mission in our community. We serve these patients without regard to the payment shortfall. Therefore Medicare shortfall should be considered Community Benefit. The organization used cost to charge ratio as determined by Medicare Cost report. Part III, Line 9b: Natchaug Hospital has adopted the Financial Assistance Policy of its Parent Company, Hartford HealthCare Corporation. The following is included in the Financial Assistance Policy: 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 Natchaug Hospital, the Hospital reserves the right to begin collection actions, including but not limited to, imposing wage garnishments or liens 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 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 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: Natchaug Hospital periodically canvases our Social Work/Case Management staff as to what they are seeing and hearing about as they work with patients. We also track requests from other entities such as area non-profits, local government agencies and public schools. These requests often reflect growing needs and issues in our community. Data from health needs assessments conducted by Backus Hospital, Lawrence & Memorial Hospital, the United Way and regional health districts is also reviewed. Needs are also assessed by tracking waiting lists for admission to programs. Part VI, Line 3: Natchaug 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 (if any) and admissions areas; (iv) post the Policy, plain language summary and financial assistance application on the website with clear linkage to such documents on the Natchaug 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 Natchaug written publications. Additionally, Natchaug employs three Financial Counselors who meet with patients to review payment options or process financial assistance applications. Part VI, Line 4: Natchaug Hospital admits residents of, on average, 150 of Connecticut's 169 towns and resident of six states around the country each year. Natchaug Hospital's primary service area is comprised of 62 towns, predominantly east of the Connecticut River, which together represent approximately half the state's land area. Natchaug Hospital's clients represent urban, suburban and rural areas. Based on the 2015 census, the total population of the Natchaug Hospital service area is 1,603,049. 22.1% are age 0-17, 63.6% are age 18-64 and 14.3% are seniors. Whites make up 79.5%, Black 9.1%, Hispanics 11.6% and all other races combined is 8.6%.The population in poverty is 10.0% with the population living below 200% FPL is 22.4%. Those with no High School Diploma (Age 25+) is 10.9%.Admissions reflect the demographics and prevalence of behavioral health illnesses of the region: for FY 2017, admissions were composed of 46% female, 52% male, 2% unknown, 4% American Indian or Alaskan Native, .3% Asian, 3.6% African American, 39.3% Caucasian, 53.9% unknown. 66% of clients were age 18 or older, 22% were between 13 and 17 years of age, 12% were ages 4 to 12. The majority of Natchaug Hospital clients are financially stressed, as measured by the number of students meeting Federal free/reduced lunch criteria and the number of clients overall who are uninsured or participating in a public support plan such as HUSKY, Medicaid or Medicare.The region is a federally-designated medically underserved area. Part VI, Line 5: A Regional Board governs Natchaug, Windham, and Backus 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, family members, nor contractors of the Hospital. Natchaug Hospital staff actively contribute to the community. For example, Natchaug Hospital's Director of Pharmacy serves on the Experiential Education Advisory Board of UConn's School of Pharmacy, staffs a Migrant Farmers Clinic, serves on the Accreditation Council for Pharmacy Education, and more; a Program Director serves on the Eastern Connecticut Chamber of Commerce's Health Advisory Committee and as a Chamber Trustee; two Natchaug staff serve on their local Boards of Education; at least three Program Directors serve their region's Systems of Care; and the Human Services Advisory Board for the Mansfield Town Council includes a representative from Natchaug. Many professionals are continuing to benefit from Natchaug Hospital's Speaker's Bureau program which offers trainings on behavioral health topics for professionals working with school age youth (school nurses, guidance counselors, teachers, etc), for free. The goals of this community outreach are to 1) help identify treatable behavioral health conditions as early as possible and 2) to improve awareness of effective classroom. The Speakers Bureau makes Natchaug staff experts more accessible to the community. Schools, community groups, businesses and others can request a Natchaug expert to provide training, lead a school assembly or serve on a panel for free. 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 Natchaug 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 future of 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 small communities easy and expedient access to the more extensive and specialized services the larger hospitals are 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 affiliates' 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 cost containment strategies. Part VI, Line 7, Reports Filed With States CT X 1 1 0 1 0 0 0 0 0 1 0 Bimal Patel Director 0 445964 0 185926 0 16250 0 91278 0 12249 0 751667 0 0 Margaret Marchak Secretary 0 453679 0 186949 0 35549 0 90285 0 41048 0 807510 0 0 Patricia Rehmer President BHN 0 309407 0 115166 0 4479 0 59625 0 14691 0 503368 0 0 Paul Maloney VP, Finance 0 210785 0 70083 0 1934 0 34450 0 11433 0 328685 0 0 Deborah Weidner MD VP, Safety and Quality 364302 0 155282 0 1921 0 18550 0 28719 0 568774 0 0 0 Harold Schwartz MD VP, Psychiatrist in Chief 0 476878 0 117198 0 32871 0 34450 0 44470 0 705867 0 0 James O'Dea VP, Operations 0 217822 0 64584 0 2069 0 14765 0 32407 0 331647 0 0 Pamela Shuman Associate Medical Director 253043 0 37943 0 3491 0 18550 0 24480 0 337507 0 0 0 Paul Weigle Associate Medical Director 242228 0 36274 0 5273 0 18550 0 33381 0 335706 0 0 0 Jonathan Raub Associate Medical Director 237674 0 20544 0 1689 0 18550 0 34152 0 312609 0 0 0 Tiwalola Kolawole Psychiatric Attending 220772 0 12000 0 404 0 16625 0 18631 0 268432 0 0 0 Gengyun Wen Psychiatric Attending 212947 0 8450 0 4583 0 16318 0 24167 0 266465 0 0 0 David Whitehead Former President 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 I, Line 3 The Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare on behalf of Natchaug Hospital, 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 Natchaug Hospital, 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 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 were made on behalf of the following individuals: Bimal Patel $58,694 David Whitehead $75,587 Margaret Marchak $60,847 Patricia Rehmer $41,075 2016 SERP Payout was made on behalf of the following individual: Stephen Larcen $6,674 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 Natchaug Hospital 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 reviewed by an independent accounting firm. It was then forwarded to the organization's top management including 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 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/Natchaug Hospital, 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 Natchaug Hospital, 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 Natchaug Hospital, 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 Hospital's Form 990, Form 1023 and its attachments are available upon request. Form 990, Part VI, Section C, line 19 The Hospital'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: Change In Retirement & Pension Fund Obligation 3,145,386. Form 990, Part XII, Line 2c: 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. Hartford Hospital 80 Seymour Street Hartford CT 06102 060646668 Health Services CT 501 (c) (3) 3 Hartford HealthCare Corp 1 Windham Community Memorial Hospital 112 Mansfield Avenue Willimantic CT 06226 060646966 Health Services CT 501 (c) (3) 3 Hartford HealthCare Corp 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 Health Services CT 501 (c) (3) 3 Hartford HealthCare Corp 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 Hartford HealthCare At Home Inc 1290 Silas Deane Hwy Suite 4B Wethersfield CT 06109 060646938 Home Healthcare CT 501 (c) (3) 7 Hartford HealthCare Corp 1 Rushford Center Inc 883 Paddock Avenue Meriden CT 06450 060932875 Substance Abuse Healthcare Services CT 501 (c) (3) 7 Hartford HealthCare Corp 1 Hartford Hospital Auxiliary co Hartford Hospital 80 Seymour Street Hartford CT 06115 066040747 Fundraising CT 501 (c) (3) 12 (b) Hartford Hospital 1 1 1 Hartford HealthCare Independence Home 1290 Silas Deane Hwy Suite 4B Wethersfield CT 06109 061161422 Home Healthcare CT 501 (c) (3) 10 Hartford HealthCare Corp 1 WCMH Women's Auxiliary Inc 112 Mansfield Avenue Willimantic CT 06226 060677728 Fundraising CT 501 (c) (3) 12 (a) Windham Community Memorial Hospital 1 The Hospital of Central CT and Bradley Memorial 100 Grand Street New Britain CT 06050 060646768 Health Services CT 501 (c) (3) 3 Hartford HealthCare Corp 1 Hartford HealthCare Senior Services Inc 45 Meriden Avenue Southington CT 06489 222635676 Sub-Acute & Long Term Healthcare CT 501 (c) (3) 10 Hartford HealthCare Corp 1 Hartford HealthCare Endowment LLC 80 Seymour Street Hartford CT 06102 454181103 Investment Managment CT 501 (c) (3) 12 (a) Hartford HealthCare Corp 1 The Orchards of Southington 34 Hobart Street Southington CT 06489 061490803 Residential Services for Senior Citizens CT 501 (c) (3) 10 Hartford HealthCare Senior Services Inc 1 Rushford Foundation Inc 883 Paddock Avenue Meriden CT 06450 061432692 Supporting 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 MidState Medical Center Auxiliary 435 Lewis Avenue Meriden CT 06451 066063082 Fundraising CT 501 (c) (3) 12(a) MidState Medical Center 1 Hartford HealthCare Medical Group Inc 80 Seymour Street Hartford CT 06102 454456939 Medical Services CT 501 (c) (3) 10 Hartford HealthCare Corp 1 Hartford HealthCare ACO Inc 1290 Silas Deane Hwy 2nd Floor Wethersfield CT 06109 460886367 Government Contracts CT 501 (c) (3) 7 Hartford HealthCare Medical Group Inc 1 Backus Corporation 326 Washington Street Norwich CT 06360 222757608 Support CT 501 (c) (3) 12(b) Hartford HealthCare Corp 1 The William W Backus Hospital 326 Washington Street Norwich CT 06360 060250773 Hospital CT 501 (c) (3) 3 Hartford HealthCare Corp 1 Backus HealthCare Inc 326 Washington Street Norwich CT 06360 222481794 Support Services CT 501 (c) (3) 12(a) Hartford HealthCare Corp 1 Caring for Colleagues Employee Crisis Fund 100 Grand Street New Britain CT 06052 264469178 Employee Fund CT 501 (c) (3) 7 Hartford HealthCare Corp 1 Connecticut Health Systems Inc 80 Seymour Street Hartford CT 06102 222779421 Coordination of Health Delivery CT 501 (c) (3) 12 (c) Hartford HealthCare Corp 1 New Britain MRI Limited Partnership 100 Grand Street New Britain CT 06050 061271349 Magnetic Resonance Imaging CT N/A Omni Home Health Services E CT LLC 12 Case Street 317 Norwich CT 06360 061458837 Home Health Care CT N/A Ambulance Service of Manchester LLC POBox 300 Manchester CT 06450 061557358 Ambulatory Services CT N/A Glastonbury Endoscopy Center LLC 300 Western Blvd Suite B 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 Connecticut Imaging Partners LLC 111 Founders Plaza East Hartford CT 06108 134298940 Imaging Services CT N/A HHC Southington Surgery Center 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 Willmington DE 19808 815112698 Urgent Care Services DE N/A Wallingford Endoscopy Center LLC 85 Seymour Suite Suite 100 Hartford CT 06106 824601730 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 FB Perry Bld 40 Church St Hamilton 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 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 Hartford Physician Hospital Organization Inc 80 Seymour Street Hartford CT 06102 222785918 Physician & Hospital Support CT N/A C 1 Aetna Ambulance Service Inc PO BOX 1150 Manchester CT 06045 060795431 Ambulance Services CT N/A C 1 Metro Wheelchair Service Inc PO BOX 300 Manchester CT 06045 060878432 Wheelchair Services CT N/A C 1 WWB Corporation 326 Washington Street Norwich CT 06360 061094836 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 112 Mansfield Avenue Willimantic CT 06226 061090041 Condo Association CT N/A C 1 Midstate Medical Group PC 435 Lewis Avenue Meriden CT 06450 204327968 Medical Services CT N/A C 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 1 1 The William W Backus Hospital A 54823 FMV The William W Backus Hospital L 420307 FMV The William W Backus Hospital P 85575 FMV The William W Backus Hospital R 567671 FMV The William W Backus Hospital S 545894 FMV Rushford Center Inc L 397150 FMV Rushford Center Inc M 342202 FMV Windham Community Memorial Hospital L 136774 FMV Hartford Hospital L 66108 FMV Hartford Hospital M 106425 FMV Hartford Hospital O 105385 FMV Hartford Hospital P 54345 FMV Hartford Hospital S 86844 FMV