MIDSTATE MEDICAL CENTER: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- MIDSTATE MEDICAL CENTER (EIN 06-0646715)
- Tax period
- 2015-10-01 to 2016-09-30
- Filed
- 2017-08-10
- IRS object ID
- 201702229349301500
- Schema version
- 2015v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-08-10T12:55:54-05:00 | ReturnTs |
| Tax Period End | 2016-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 346565596 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Ernst & Young US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 Clarendon Street 44th Floor | AddressLine1Txt |
| City | Boston | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02216 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 060646715 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MidState Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MIDS | BusinessNameControlTxt |
| Phone | 8606966282 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 435 Lewis Avenue | AddressLine1Txt |
| City | Meriden | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 06451 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mark Keise | PersonNm |
| Person Title | VP, Finance | PersonTitleTxt |
| Phone | 8606966282 | PhoneNum |
| Signature | 2017-08-10 | SignatureDt |
| Discuss With Paid Preparer | 0 | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Jeanne Schuster | PreparerPersonNm |
| PTIN | P00743154 | PTIN |
| Phone | 6172262000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Lucille Janatka | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 435 Lewis Ave | AddressLine1Txt |
| City | Meriden | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 06451 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $239,159,457 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MIDSTATEMEDICAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1885 | FormationYr |
| Legal Domicile State | CT | LegalDomicileStateCd |
| Activity Or Mission | The mission of MidState Medical Center is to improve the health and healing of the people and communities we serve. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 1219 | TotalEmployeeCnt |
| Total Volunteers | 213 | TotalVolunteersCnt |
| Total Gross UBI | $302,993 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $583,828 | PYContributionsGrantsAmt |
| CY Contributions Grants | $318,672 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $225,478,397 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $231,338,268 | CYProgramServiceRevenueAmt |
| PY Investment Income | $5,130,630 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,031,455 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,554,348 | PYOtherRevenueAmt |
| CY Other Revenue | $5,471,062 | CYOtherRevenueAmt |
| PY Total Revenue | $232,747,203 | PYTotalRevenueAmt |
| CY Total Revenue | $239,159,457 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,300 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $85,408,367 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $80,452,372 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $131,113 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $125,768,115 | PYOtherExpensesAmt |
| CY Other Expenses | $136,473,663 | CYOtherExpensesAmt |
| PY Total Expenses | $211,178,782 | PYTotalExpensesAmt |
| CY Total Expenses | $216,926,035 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $21,568,421 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $22,233,422 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $271,884,855 | TotalAssetsBOYAmt |
| Total Assets EOY | $275,954,166 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $182,402,633 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $187,895,638 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $89,482,222 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $88,058,528 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The mission of Midstate Medical Center is to improve the health and healing of the people and communities we serve. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $31,998,578 | ExpenseAmt |
| Revenue | $27,218,340 | RevenueAmt |
| Desc | Oncology Services at MidState Medical Center is a multi-discipline service line consisting of radiation oncology, medical oncology, support services and surgical services. Each patient seeking care for an oncological based health need is treated in a state of the art facility with physicians, nurses and support staff from MidState Medical Center collaborating with our 4 other Hartford HealthCare partners. This collaboration operates in the form of cancer conferences and disease management teams through which a single standard of care is delivered at the highest quality. The oncology program at MidState Medical Center strives to provide compassionate, high-quality care to all of its patients, regardless of their financial ability to pay for services. We provide a medical social worker who helps patients find the financial resources and assists in alleviating the stress that often accompanies a cancer diagnosis. We also provide an onsite genetics counselor and a high risk program. There is an on-site full time nurse navigator to provide support and guidance through the patient's treatment, from diagnosis to survivorship. In March 2015, the lung screening trial and study closed, it provided screening to 500 patients. We have continued to provide the lung screening program to the community and work closely with the physicians to educate on smoking prevention and cessation. The Hartford HealthCare Cancer Institute at MidState received formal certification from the American Society of Clinical Oncology for maintaining the highest standards of quality and evidence-based cancer care.Cancer Conferences:Our multidisciplinary approach to cancer care is highlighted through the cancer conferences in which patient's diagnosis and disease are discussed confidentially across the various disciplines. Imaging, pathology, medical and radiation oncology as well as surgery provide expertise to guide treatment options and plan the care needed to meet the standards of care outlined by the National Comprehensive Cancer Network (NCCN) guidelines. Accreditation:The breast program leadership was restructured to align with Hartford HealthCare Cancer Institute's structure and achieved re-accreditation in November 2015. Our cancer program continues to meet the standards of the American College of Surgeons Commission on Cancer and operates under the direction of the cancer committee which meets quarterly. Community Outreach:MidState Medical Center's cancer program has a robust community outreach program providing several opportunities for patients, caregivers and the community to participate at no cost. A few of these programs include: outreach to the Hispanic community, survivorship programs, integrative therapies and support groups. Through a grant, we were able to add an additional part-time outreach coordinator that will help facilitate programs, education and various other opportunities to establish support groups. Additionally, we provide cancer screenings that include: head and neck, skin, and breast screenings. Education is also provided during the screening sessions. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $28,305,332 | ExpenseAmt |
| Revenue | $33,692,388 | RevenueAmt |
| Desc | The Emergency Department (ED) at MidState Medical Center strives to provide compassionate, high-quality care to all of its patients, regardless of their financial ability to pay for services. In April, we implemented Epic, our system wide electronic medical record. In fiscal year 2016 we continued to focus on our patients' experience by working to decrease overall length of stay for discharged patients in the ED. This is the total time a patient spends in the ED. We have improved our length of stay in the department from an average of 296 minutes to 163 minutes for patients who are treated and released; this is a 45% improvement. Overall, the total number of ED visits for FY 2016 was 51,903; this is a 10.1% decrease from FY15. 11% of our patients were admitted to MidState Medical Center as inpatients. Approximately 25% of all Emergency Department patients arrived by ambulance. The percentage of patients who left without being seen was 3.7%. Emergency Medicine Physicians (EMP):We continue our relationship with Emergency Medicine Physicians (EMP) to provide Physician and Physician Assistant staffing to care for the ED patients. EMP focuses on patient satisfaction, medical staff satisfaction and providing exceptional emergency care. Partnerships: The MidState ED does not work alone in providing excellent care to those it serves. The ED continues to provide ongoing education to local EMS providers, including the Wallingford Fire Department, Hunter's Ambulance and the Meriden Fire Department. The ED continues to build its relationship with the Meriden Police Department and work more collaboratively in situations when emergency care intersects with law enforcement matters by participating in a joint educational training session. The MidState ED also partners with Hartford Hospital's LifeStar helicopter program to deliver lifesaving care to critically ill patients that need a higher level of care than what MidState can provide. Senior Emergency Care Services:We identified a need to improve the transition of care for the senior population that is over 65; this group of patients' accounts for 22% of our ED visits annually. Our goal is to provide seniors with the services needed to maintain independence and overall health and well-being. During FY 16 we continued the process of screening all patients 65 and older to identify patients at risk, and match resources to their needs. Community Outreach:The staff of the ED are committed to community service and enriching the lives of others. In FY 2016, the ED participated in the in collecting food for area food banks. Our staff participated in a community program "adopt a family" for the holiday season. As a group we embraced this challenge to provide for those less fortunate. Our adopted family was overwhelmed the outpouring of gifts and the generosity of our staff. Patient Satisfaction:For FY 2016, our focus continued on a patient's Likelihood to Recommend the MidState ED. For this measure our scores were in the 25th percentile. This piece of customer satisfaction, what our patients are telling their friends in the community, influences an individual's choice when needing emergency care. This is an area we will be continuing to focus on for FY 17, and should show improvement as we improve overall length of stay. Education:In FY 2016, the MidState ED continued to play a critical role in staff education integrating best practices treatment and protocols for the care of our patients. We developed and implemented a specific graduate nurse program for those looking to begin their career in the ED. We have encouraged our RN staff to become certified "emergency nurses", and active members of the Emergency Nursing Association. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $20,177,032 | ExpenseAmt |
| Revenue | $28,710,660 | RevenueAmt |
| Desc | For patients in Central Connecticut, The Digestive Health Center at MidState is a comprehensive resource for the prevention, diagnosis and treatment of a full range of gastrointestinal disorders that affect the esophagus, stomach, small intestine and colon. The staff provides top notch care to all of our patients and work well together to provide a seamless transition from pre-procedure to procedure room and home. Our staff ensures that each patient has a visit that is as pleasant and comfortable as possible. We care for inpatients as well as an outpatient population. Along with providing upper endoscopies and colonoscopies we provide radiofrequency ablation for patients with high grade Barrett's Esophagus, and ERCP (endoscopic retrograde cholangiopancreatogram). Pulmonologist's frequent our department as we continue to care for patients having Bronchoscope procedures. Overall we saw a total of 10,861 cases for fiscal year 2016 an increase of 196 cases from the previous year. This year only 32 of our patients were admitted post procedure. Digestive Health Center Physicians:We continue to maintain and improve our relationships with both the Connecticut GI and Gastroenterology Specialists physicians. Another one of our physicians spoke to over 150 GI nurses and associates at the 2015 Fall Conference for the Connecticut GI Nurses and Associates addressing Current challenges in Crohn's and Colitis care. DHC works in collaboration with the Anesthesia department to provide the same level of care to our patients 24 hours a day, seven days a week whether we are in the actual Digestive Health area or traveling to the ER, ICU or OR areas.Electronic Health Record:We have been using an electronic health record for over 12 years in DHC. The MD and Multicare (nursing) records interface between the MD and nursing records to provide seamless charting from pre, intra and post care. To be current with "The Joint" recommendations, we also have electronic medication reconciliations. We are now in the process of converting to the EPIC system, working feverishly towards a GoLive date of April 2016. We will be the first hospital in the Hartford Healthcare System to implement the EPIC go live. Patient Satisfaction: Our Endoscopy unit has continued to maintain consistently high press ganey scores. We monitor monthly Likelihood or recommending center and for FY2016 averaged 95.1%. Our "Overall care received" average for the year was 95.2 and our "wait time prior to procedure was 90.6%. Our unit goal was to maintain a >85 score on "Response to concerns and complaints and the staff well exceeded that with a score of 94. Presently, we have 3 GI certified nurses. Community Outreach:March is Colorectal Cancer Awareness month and in the spirit of sharing knowledge, the Digestive Health Center staff presented to our "MidState family" information on colon cancer screening. In May 2015, staff from DHC spoke at the Wallingford Senior Center Health Fair on GI Diseases. Additionally, RNs spoke at the Meriden Senior center and at local congregations. Two of our nurses taught at the "Hands On" ERCP course in October 2015. Over 45 GI health professionals took advantage of this regionally recognized course. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $113,504,655 | ExpenseAmt |
| Revenue | $144,157,049 | RevenueAmt |
| Desc | In towns across central Connecticut, MidState Medical Center is committed and focused on efforts to promote health and wellness in the communities the hospital serves. In addition to the programs referred to above, the hospital provides services/programs including but not limited to the following: Behavioral & Mental Health Cardiology & Heart Care Dermatology Diabetes & Endocrinology Digestive Health Ear, Nose, & Throat Emergency Services Epilepsy Center Home Care Headache Center Hospice Care Imaging Services Lab Services LIFE STAR Lung & Pulmonary MATCH Maternity Movement Disorders Center Neurosciences Neurosurgery Orthopedics Pain Treatment Pediatrics Physical Rehabilitation Primary Care & Family Medicine Senior Services Sleep Disorders Sports Medicine Stroke Center Surgical Weight Loss Transplant Services Urgent Care Urology & Kidney Women's Health Wound Care | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $113,504,655 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $144,157,049 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $193,985,597 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (1) | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 142 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1219 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CT | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Carol Wardell | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8606966200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 181 Patricia M Genova Drive | AddressLine1Txt |
| City | Newington | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 06111 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Letterio Asciuto MD | ||||||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| Steven Basche | ||||||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| Paul Czepiga | ||||||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| Nadine Francis-West | ||||||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| Carl Grant | ||||||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| Joseph Harrison MD | ||||||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| John Redmond MD | ||||||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| Jason Howey | ||||||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| Irfan Chughtai MD | ||||||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| Bruce Koeppen MD | ||||||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| John Rathgeber | ||||||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| George Springer Jr Esq | ||||||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| Joseph Voelker | ||||||||||
| Chair | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||||
| Denise McNair | ||||||||||
| Vice Chair | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||||
| Lucille Janatka | ||||||||||
| President/CEO | 30.00 | Yes (X) | $0 | $777,836 | $79,868 | Yes (X) | 30.00 | |||
| Margaret Marchak | ||||||||||
| Secretary | 3.00 | $0 | $660,302 | $141,415 | Yes (X) | 57.00 | ||||
| Carolyn Freiheit | ||||||||||
| VP | 30.00 | $0 | $274,587 | $19,719 | Yes (X) | 30.00 | ||||
| Catherine Stevens | ||||||||||
| VP | 0.00 | $0 | $266,162 | $58,207 | 60.00 | Yes (X) | ||||
| Jonathan Velez MD | ||||||||||
| VP | 5.00 | $0 | $472,365 | $70,593 | 55.00 | Yes (X) | ||||
| Timothy Pratt | ||||||||||
| Hospitalist | 60.00 | $334,812 | $0 | $47,359 | Yes (X) | |||||
| Walter Kupson III | ||||||||||
| Medical Director | 60.00 | $319,538 | $0 | $71,099 | Yes (X) | |||||
| Adwoa Nyanin MD | ||||||||||
| Hospitalist | 60.00 | $317,482 | $0 | $49,636 | Yes (X) | |||||
| Cindy Russo | ||||||||||
| SVP | 60.00 | $313,646 | $0 | $63,669 | Yes (X) | |||||
| Yin Fei Hung | ||||||||||
| Hospitalist | 60.00 | $312,909 | $0 | $36,884 | Yes (X) | |||||
| John Greene MD | ||||||||||
| Former VP | 0.00 | $0 | $592,869 | $77,945 | 60.00 | Yes (X) | ||||
| Steven Hanks | ||||||||||
| Former VP | 0.00 | $0 | $1,669,882 | $47,270 | 60.00 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,598,387 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,714,003 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $763,664 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 135 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Emergency Medical Physicians | |||||
| PO Box 848317 | Boston | MA | 02284 | Medical Services | $719,712 |
| CFM Construction Corp | |||||
| 150 Sycamore Street | Glastonbury | CT | 06033 | Construction | $672,096 |
| Origin Incorporated | |||||
| 1800 SW 1st Suite 510 | Portland | OR | 97201 | Staffing Services | $216,202 |
| Diversified Clinical Services | |||||
| PO Box 551187 | Jacksonville | FL | 32255 | Medical Services | $189,611 |
| Comprehensive Orthopaedics | |||||
| 85 Barnes Road | Wallingford | CT | 06492 | Medical Services | $148,280 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 12 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $30,878 | FederatedCampaignsAmt |
| Related Organizations | $24,000 | RelatedOrganizationsAmt |
| All Other Contributions | $263,794 | AllOtherContributionsAmt |
| Total Contributions | $318,672 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Patient Care | 624100 | $231,148,675 | $231,148,675 | |
| Ref. Testing & Fees | 621500 | $187,306 | $135,336 | $51,970 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,287 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $2,287 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $231,338,268 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,077,387 | TotalRevenueColumnAmt |
| Exclusion | $1,077,387 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,522,706 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,522,706 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,522,706 | TotalRevenueColumnAmt |
| Exclusion | $2,522,706 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $838,758 | SecuritiesAmt |
| Other | $115,310 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $838,758 | SecuritiesAmt |
| Other | $115,310 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $954,068 | TotalRevenueColumnAmt |
| Exclusion | $954,068 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| Income-Pass Thru Entity | 900003 | $2,440,169 | $2,191,433 | $248,736 | |
| Cafeteria Income | 722210 | $508,187 | $508,187 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,948,356 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $239,159,457 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $233,475,444 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $302,993 | UnrelatedBusinessRevenueAmt |
| Exclusion | $5,062,348 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,732,689 | TotalAmt |
| Program Services | $1,072,209 | ProgramServicesAmt |
| Management And General | $660,480 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,780,849 | TotalAmt |
| Program Services | $59,879,566 | ProgramServicesAmt |
| Management And General | $1,855,012 | ManagementAndGeneralAmt |
| Fundraising | $46,271 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,243,489 | TotalAmt |
| Program Services | $3,112,666 | ProgramServicesAmt |
| Management And General | $128,460 | ManagementAndGeneralAmt |
| Fundraising | $2,363 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,342,966 | TotalAmt |
| Program Services | $8,966,125 | ProgramServicesAmt |
| Management And General | $370,034 | ManagementAndGeneralAmt |
| Fundraising | $6,807 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,352,379 | TotalAmt |
| Program Services | $4,176,829 | ProgramServicesAmt |
| Management And General | $172,379 | ManagementAndGeneralAmt |
| Fundraising | $3,171 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,573 | TotalAmt |
| Management And General | $28,573 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,334 | TotalAmt |
| Management And General | $69,334 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,839 | TotalAmt |
| Management And General | $28,839 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $277,354 | TotalAmt |
| Program Services | $277,354 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,843,746 | TotalAmt |
| Program Services | $18,843,746 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,925 | TotalAmt |
| Management And General | $46,925 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,604,233 | TotalAmt |
| Program Services | $1,835,571 | ProgramServicesAmt |
| Management And General | $757,721 | ManagementAndGeneralAmt |
| Fundraising | $10,941 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,092,222 | TotalAmt |
| Program Services | $7,814,419 | ProgramServicesAmt |
| Management And General | $4,277,803 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,789,253 | TotalAmt |
| Program Services | $4,084,695 | ProgramServicesAmt |
| Management And General | $2,704,526 | ManagementAndGeneralAmt |
| Fundraising | $32 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,830 | TotalAmt |
| Program Services | $37,801 | ProgramServicesAmt |
| Management And General | $14,548 | ManagementAndGeneralAmt |
| Fundraising | $481 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $182,279 | TotalAmt |
| Program Services | $125,958 | ProgramServicesAmt |
| Management And General | $56,197 | ManagementAndGeneralAmt |
| Fundraising | $124 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,913,863 | TotalAmt |
| Program Services | $3,913,863 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,273,938 | TotalAmt |
| Program Services | $14,884,036 | ProgramServicesAmt |
| Management And General | $2,389,902 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,375,368 | TotalAmt |
| Program Services | $4,947,294 | ProgramServicesAmt |
| Management And General | $6,416,119 | ManagementAndGeneralAmt |
| Fundraising | $11,955 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,954,377 | TotalAmt |
| Program Services | $2,929,119 | ProgramServicesAmt |
| Management And General | $25,258 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Medical Supplies | $35,623,487 | $35,623,487 | ||
| Hospital Provider/User | $13,489,166 | $13,489,166 | ||
| Purchased Services | $7,274,227 | $6,329,539 | $909,990 | $34,698 |
| Repairs & Maintenance | $2,872,526 | $1,446,823 | $1,411,623 | $14,080 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $681,123 | TotalAmt |
| Program Services | $195,331 | ProgramServicesAmt |
| Management And General | $485,602 | ManagementAndGeneralAmt |
| Fundraising | $190 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $216,926,035 | TotalAmt |
| Program Services | $193,985,597 | ProgramServicesAmt |
| Management And General | $22,809,325 | ManagementAndGeneralAmt |
| Fundraising | $131,113 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,808,350 | BOYAmt |
| EOY | $8,914,251 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,093 | BOYAmt |
| EOY | $31,099 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,565,335 | BOYAmt |
| EOY | $28,903,534 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,846,758 | BOYAmt |
| EOY | $3,234,698 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,656,273 | BOYAmt |
| EOY | $2,998,000 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $269,981,451 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $168,655,639 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $109,733,241 | BOYAmt |
| EOY | $101,325,812 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,172,907 | BOYAmt |
| EOY | $18,923,085 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $66,102,603 | BOYAmt |
| EOY | $74,071,053 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,961,295 | BOYAmt |
| EOY | $37,552,634 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $271,884,855 | BOYAmt |
| EOY | $275,954,166 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,273,929 | BOYAmt |
| EOY | $11,775,795 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $164,128,704 | BOYAmt |
| EOY | $176,119,843 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $182,402,633 | BOYAmt |
| EOY | $187,895,638 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,575,241 | BOYAmt |
| EOY | $70,508,214 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,488,431 | BOYAmt |
| EOY | $2,580,173 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,418,550 | BOYAmt |
| EOY | $14,970,141 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $89,482,222 | BOYAmt |
| EOY | $88,058,528 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $271,884,855 | BOYAmt |
| EOY | $275,954,166 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $22,233,422 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $6,231,895 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$29,889,011 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $28,839 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $28,839 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | MidState Medical Center (MMC) is a member of Connecticut Hospital Association (CHA). CHA engages in lobbying activities on behalf of all their members. Efforts mainly include lobbying activities that are directly related to communications with legislators or actions on specific legislative bills on healthcare matters. CHA allocates portion of its dues as lobbying expenses. The total amount of dues allocated for lobbying purpose in FY16 was $28,839. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $16,445,639 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $796,000 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $17,241,639 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $16,586,328 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$140,689 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $16,445,639 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $15,855,675 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $785,129 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $54,476 | OtherExpendituresAmt |
| End Year Balance | $16,586,328 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $14,919,840 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,155,553 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $219,718 | OtherExpendituresAmt |
| End Year Balance | $15,855,675 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $12,501,553 | BeginningYearBalanceAmt |
| Contributions | $240,834 | ContributionsAmt |
| Investment Earnings Or Losses | $2,534,968 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $272,520 | OtherExpendituresAmt |
| Administrative Expenses | $84,995 | AdministrativeExpensesAmt |
| End Year Balance | $14,919,840 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.90000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.05000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.05000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,250,000 | OtherCostOrOtherBasisAmt |
| Book Value | $1,250,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $114,621,976 | OtherCostOrOtherBasisAmt |
| Depreciation | $48,465,536 | DepreciationAmt |
| Book Value | $66,156,440 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,283,537 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,197,573 | DepreciationAmt |
| Book Value | $2,085,964 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $142,237,450 | OtherCostOrOtherBasisAmt |
| Depreciation | $113,992,530 | DepreciationAmt |
| Book Value | $28,244,920 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,588,488 | OtherCostOrOtherBasisAmt |
| Book Value | $3,588,488 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $101,325,812 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| Other Investments | $3,058,090 | F |
| Funds Held in Trust | $15,864,995 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $18,923,085 | TotalBookValueSecuritiesAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Investment in Endowment LLC | Desc |
| Book Value | $74,071,053 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $74,071,053 | TotalBookValueProgramRltdAmt |
Other Assets Org OtherAssetsOrgGrp (6 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Funds Held In Trust | $15,566,521 |
| Amortizable Bond Issue Costs | $1,081,267 |
| Funds Designated for Debt Service | $6,307,694 |
| Security Deposits | $9,000 |
| Insurance Receivable | $14,490,935 |
| Other Non Current Assets | $97,217 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $37,552,634 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (8 entries)
| DescDesc | AmtAmt |
|---|---|
| Accrued Post Retirement Expenses | $64,555,584 |
| IBNR Malpractice Reserve | $2,646,864 |
| Other Liabilities | $1,879,294 |
| Long Term Debt - Intercompany | $85,145,173 |
| Accrued Malpractice Claims | $15,296,759 |
| Due to Affiliates | $2,021,369 |
| Hospital Provider Tax | $3,609,297 |
| General Reserve | $965,503 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $176,119,843 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part V, Line 4: | FormAndLineReferenceDesc |
| Explanation | Midstate Medical Center (the Medical Center) has adopted investment and spending policies for endowment assets that attempt to provide a predictable stream of funding to programs supported by its endowment while seeking to maintain purchasing power of the endowment assets. The Medical Center's spending policy is that investment income and realized gains and losses associated with the endowments are appropriated for spending every year, and unrealized gains and losses are reinvested back in to the endowment as accumulated earnings. Endowment assets include those assets of donor-restricted funds as well as board designated funds that the Medical Center must hold in perpetuity or for donor-specific period(s). The Medical Center's endowment consists of approximately 100 individual funds established for a variety of purposes. The endowment includes both donor-restricted endowment funds and funds designated by the Board of Directors to function as endowments. Net assets associated with endowment funds, including funds designated by the Board of Directors to function as endowments, are classified and reported based on the existence or absence of donor-imposed restrictions. The income generated by the funds are used mainly for capital purchases. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 250.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,868,753 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,868,753 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00860 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $88,115,141 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $61,706,367 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $26,408,774 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12170 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $89,983,894 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $61,706,367 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $28,277,527 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13030 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $367,689 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $367,689 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $975,144 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $522,489 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $452,655 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00210 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,372 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,372 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,344,205 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $522,489 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $821,716 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00380 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $91,328,099 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $62,228,856 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $29,099,243 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13410 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,747 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,747 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,747 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,747 | NetCommunityBenefitExpnsAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,744,000 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $55,891,415 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $60,636,616 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$4,745,201 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Midstate Medical Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 435 Lewis Avenue | AddressLine1Txt |
| City | Meriden | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 06451 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | midstatemedical.org | WebsiteAddressTxt |
| State License | 0070 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MidState Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 14 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Part V | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | 0 | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (1) | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 250.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See Part V | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Part V | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Part V | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MidState Medical Center | Part V, Section B, Line 5: To solicit input from key participants and individuals who have a broad interest in the health of the community, an Online Key Participant Survey was also implemented as part of this process. These individuals included physicians, public health representatives, health professionals, social service providers and a variety of other community leaders including the following: Berlin Senior Center Boys and Girls Club of Meriden Bristol Community Organization Bristol-Burlington Health District Calendar House Southington Senior Center Central Connecticut Senior Health Services Community Health Center, Inc. Connecticut Association for Community Action Girls Incorporated of Meriden Greater New Britain Chamber of Commerce Meriden Senior Center Meriden-Wallingford Chrysalis, Inc. MHT Christians in Action MidState Medical Center Quinnipiac Chamber of Commerce South Central CT Substance Abuse Council Southington Library Southington Public Schools The Hospital of Central Connecticut United Way Wallingford Health Department Wallingford Senior Center Women and Families Center YMCA Participants 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 participants were contacted by email, introducing the purpose of the survey and providing a link to take the survey online. Key participants were asked to rate the degrees to which various health issues were a problem in the Central 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 10, 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 7ahttps://midstatemedical.org/about/community-outreach/community-health-needs-assessment |
| MidState Medical Center | Part V, Section B, Line 7d: The needs assessment was published in July 2015 and is available on the hospital's website. In addition, electronic copies are available upon request. |
| MidState Medical Center | Part V, Section B, Line 11: In acknowledging the wide range of priority health issues that emerged from the CHNA process, MidState Medical Center 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 Status* Mental Health & Substance Abuse * Heart Disease/Stroke* Diabetes* Cancer Additional needs identified as "Areas of Opportunity" were not deemed as significant and did not rank highly enough to earn a prioritized ranking.Areas of Opportunity, identified but not prioritized:* Substance Abuse * Infant Health & Family Planning * Injury & Violence * Potentially Disabling Conditions * Sexually Transmitted Diseases * HIV/AIDS * Chronic Kidney Disease Chronic Kidney Disease:MMC believes that efforts outlined herein to improve and increase awareness of healthy lifestyles will have a positive impact on the detection of kidney disease and that we do not have the available resources to create a separate set of kidney-specific initiatives.Dementia, including Alzheimer's Disease:MMC believes that this priority area falls more within the purview of local organizations, such as the area Alzheimer's Resource Center. MMC will support communication of these services. Potentially Disabling Conductions:Those voting felt that more pressing health needs existed. Limited resources and lower priority excluded this as an area chosen for action.Respiratory Diseases:MMC participates in a statewide asthma collaborative established by the CT Department of Public Health and The CT Hospital Association. MMC will support the established initiatives from this collaborative.Sexually Transmitted Diseases:MMC believes that this priority area falls more within the purview of the community/district health departments and other community organizations. Limited resources and lower priority excluded this as an area chosen for action.HIV/AIDS:MMC believes that this priority area falls more within the purview of the community/district health departments and other community organizations. Limited resources and lower priority excluded this as an area chosen for action.Infant Health & Family Planning:MMC has limited resources, services, and expertise to address these issues. Other community organizations have infrastructure and programs in place to better address these needs. Limited resources excluded this as an area chosen for action.Injury & Violence Prevention:MMC believes that this priority area falls more within the purview of the community/district health departments and other community organizations. Limited resources and lower priority excluded this as an area chosen for action. |
| MidState Medical Center | 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. |
| MidState Medical Center | Part V, Section B, Line 15e: In addition, patient may ask nurse, physician, chaplain, or staff member from Patient Registration, Patient Financial Services, Case Coordination, or Social Services about initiating the Financial Assistance Application process.Part V, Line 16a, FAP website:https://midstatemedical.org/patients-visitors/billing-insurance /financial-assistancePart V, Line 16b, FAP Application website:https://midstatemedical.org/patients-visitors/billing-insurance /financial-assistancePart V, Line 16c, FAP Plain Language Summary website:https://midstatemedical.org/patients-visitors/billing-insurance /financial-assistance |
| MidState Medical Center | Part V, Section B, Line 16i: Patients are informed directly by staff of the availability of the Financial Assistance Policy. |
| MidState Medical Center | Part V, Section B, Line 22d: For uninsured patients, published rates are reduced by the percentage defined by the IRS as the amounts generally billed using a "look back" retrospective calculation to calculate the amount allowed by governmental (Medicare and Medicaid) and commerically insured patients. This percentage is updated on an annual basis. The annual calculation methodiology and the percentages are located in Appendex A of the Hospital's Financial Assistance Policy.Underinsured patients will not be billed more than amounts generally billed (AGB) to insured patients. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - Mediquick-Midstate Medical Center | ||||
| 61 Pomeroy Avenue | Meriden | CT | 06450 | Urgent Care Center |
| 2 - Mediquick-Midstate Medical Center | ||||
| 680 South Main Street | Cheshire | CT | 06410 | Urgent Care Center |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | Midstate Medical Center used the Federal Poverty Guidelines to determine eligibility. In addition, the hospital takes into consideration, medical indigency, insurance status, underinsurance status, and other family eligibiity criteria such as family size, employment and financial obligations.Part I, Line 6aThe 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 the RCC derived from the FY 2016 Medicare cost report which already incorporates or is net of non-patient care costs (i.e. bad debt, non-patient care, etc.). The ratio was further reduced to incorporate the directly identified community 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. 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 7g. |
| Part I, Line 7g: | No physician clinic costs were included in the subsidized Health Services cost calculations. |
| Part II, Community Building Activities: | MidState coordinates a Community Vision group that interacts with the community to address needs and facilitate responses to identified needs. Through Community Vision, MidState has collaborated with the United Way of Meriden and Wallingford to address food collection and distribution for the needy while also conducting semi-annual food collections within the hospital for distribution to those in need. More specifically, MidState is involved in a Choice Neighborhood program in collaboration with the housing authority, health department, Children's First initiative and other health and human service providers. This program is targeted on high risk neighborhoods and downtown area in order to respond with extended services to families who reside in a targeted segment of the community. MidState representatives also serve on a housing coalition that addresses the need for housing and shelter in its primary service area. Since basic needs, such as food and housing, are tied to health status, MidState's participation in these initiatives alongside the United Way has been important and beneficial to the community the hospital serves.Since the mid-1990s, MidState has had a close-knit relationship with nearby John Barry Elementary School which has provided opportunities for staff to adopt classrooms and enrich the academic experience of students through read-a-loud days and other classroom activities, as well as promote tailored education to students on important health topics including the signs and symptoms of stroke. By educating students on disease risk factors at an early age, it is the hope that their knowledge base will increase, they will share information with their families and perhaps recognize a health problem in a loved one. For FY16, the MidState Medical Center expended $4,747 on community building activities as reported on Part II of schedule H.Part III, Line 2:The Hospital has established estimates based on information presently available of amounts due to or from Medicare, Medicaid, and third-party payers for adjustments to current and prior year payment rates, based on industry-wide and Hospital-specific data. Such amounts are included in the accompanying consolidated balance sheets. |
| 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 as charity care 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 2016 would be immaterial. |
| Part III, Line 4: | Please see the text of the footnote that describes bad debt expense beginning on pages 20 of the Audited Financial Statement. The Footnote is also applicable to Part III, Line 2. |
| Part III, Line 8: | Providing for those in need, including Medicare patients and serving all patients regardless of their ability to pay is an essential part of the organization's mission. The hospital serves all patients without regard to any payment shortfall. Therefore the Medicare shortfall should be considered to be a community benefit. The organization Medicare Cost Report was used to accumulate actual costs related to Part III, Section B, Line 6. |
| Part III, Line 9b: | MidState Medical Center has adopted the Financial Assistance Policy of its Parent Company, Hartford HealthCare Corporation. The following is included in the Financial Assistance Policy: For those patients that qualify for financial assistance and for whom in the System's sole determination are cooperating in good faith to resolve the System's outstanding accounts, the Systems' facilities 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 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: | MidState Medical Center uses Emergency Room data to track increases in medical conditions such as falls, flu, drug overdoses, etc. The same approach is taken in our outpatient clinics. We periodically canvas 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. |
| Part VI, Line 3: | MidState Medical Center will provide 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 my mail and in public locations in the hospital facility, including the emergency room 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 MidState'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 MidState written publications. |
| Part VI, Line 4: | MidState Medical Center is located in central Connecticut. Its primary service area has a total population of 178,551 people. Of those, 21% are under the age of 18, 63% 18 to 64 and 16% are seniors. The racial makeup is 77% White, 5% Black, 14% Hispanic and 3% Asian. Females make up 51% of the populations and males account for 49%. There are about 5,000 veterans in the service area. 8% of the population lives below the poverty level. Approximately 26% speak a language other than English at home. 32% have a Bachelor's degree or higher. |
| Part VI, Line 5: | The mission of MidState Medical Center is to improve the health and healing of the people and communities we serve. MidState is committed and focused on efforts to promote health and wellness.The majority of MidState Medical Center's regional governing board is comprised of persons who either reside or work in its primary service area, and they are neither employees nor contractors of the Hospital.MidState Medical Center extends medical staff privileges to all qualified physicians in its community. The Hospital/Medical Center has partnered with the Community Health Center to provide health services to the underserved in the community. In addition, MidState participates in Community Vision to improve community health and well-being.MidState has contracted to use the services of an organization to assist its patients in determining eligibility and applying for state and federal means tested programs such as Medicare and Medicaid, as well as for the MidState Medical Center Financial Assistance Program. Additionally, the MidState Emergency Department and satellite MediQuick Urgent Care facilities provide medical care regardless of patients' ability to pay for services. In towns across central Connecticut, MidState Medical Center is committed and focused on efforts to promote health and wellness in the communities the hospital serves. Each year, MidState makes a concerted effort to go above and beyond its call to the community. Our physicians, nurses, and staff reach out to thousands of individuals every year through health-related programs and special events. Additionally, MidState has partnered with various community organizations to improve the quality of life of its residents. These include key opinion leaders, faith communities, business leaders, government officals, and a variety of social service organizations. Senior Emergency Care ServicesIn May 2013, with an eye on the health needs of our aging population, MidState began offering a newer, innovative approach to caring for seniors in its Emergency Department. When a patient 65+ comes to our Emergency Department, they are not just treated for the ailment that brought them to the hospital. A multi disciplinary team also performs a special assessment to guage the patient's status and whether they may have medication issues, be a fall risk or suffer from ailments like dementia and depression. The hope is to identify follow up care before the condition worsens. When patients leave our Emergency Department, we make sure they are transitioning home or to another care setting smoothly by developing individualized care plans following discharge, making follow up appointments. |
| 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 MidState Medical Center, 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. The Strategic Planning and Community Benefit Committee of the HHC Board of Directors ensures the oversight for these services by each hospital community. HHC and its affiliates, including all supporting 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 that 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 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | 0 | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | 0 | SubstantiationRequiredInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Lucille Janatka | ||||||||||||||
| President/CEO | $0 | $572,147 | $0 | $180,278 | $0 | $25,411 | $0 | $21,200 | $0 | $58,668 | $0 | $857,704 | $0 | $0 |
| Margaret Marchak | ||||||||||||||
| Secretary | $0 | $463,399 | $0 | $166,749 | $0 | $30,154 | $0 | $93,339 | $0 | $48,076 | $0 | $801,717 | $0 | $0 |
| Carolyn Freiheit | ||||||||||||||
| VP | $0 | $223,041 | $0 | $50,824 | $0 | $722 | $0 | $0 | $0 | $19,719 | $0 | $294,306 | $0 | $0 |
| Catherine Stevens | ||||||||||||||
| VP | $0 | $221,905 | $0 | $43,124 | $0 | $1,133 | $0 | $21,200 | $0 | $37,007 | $0 | $324,369 | $0 | $0 |
| Jonathan Velez MD | ||||||||||||||
| VP | $0 | $364,066 | $0 | $105,198 | $0 | $3,101 | $0 | $31,970 | $0 | $38,623 | $0 | $542,958 | $0 | $0 |
| Timothy Pratt | ||||||||||||||
| Hospitalist | $276,422 | $0 | $58,100 | $0 | $290 | $0 | $26,660 | $0 | $20,699 | $0 | $382,171 | $0 | $0 | $0 |
| Walter Kupson III | ||||||||||||||
| Medical Director | $300,343 | $0 | $18,842 | $0 | $353 | $0 | $25,511 | $0 | $45,588 | $0 | $390,637 | $0 | $0 | $0 |
| Adwoa Nyanin MD | ||||||||||||||
| Hospitalist | $283,588 | $0 | $33,560 | $0 | $334 | $0 | $25,098 | $0 | $24,538 | $0 | $367,118 | $0 | $0 | $0 |
| Cindy Russo | ||||||||||||||
| SVP | $267,157 | $0 | $45,458 | $0 | $1,031 | $0 | $25,158 | $0 | $38,511 | $0 | $377,315 | $0 | $0 | $0 |
| Yin Fei Hung | ||||||||||||||
| Hospitalist | $292,659 | $0 | $20,250 | $0 | $0 | $0 | $25,000 | $0 | $11,884 | $0 | $349,793 | $0 | $0 | $0 |
| John Greene MD | ||||||||||||||
| Former VP | $0 | $470,432 | $0 | $87,091 | $0 | $35,346 | $0 | $39,200 | $0 | $38,745 | $0 | $670,814 | $0 | $0 |
| Steven Hanks | ||||||||||||||
| Former VP | $0 | $298,957 | $0 | $0 | $0 | $1,370,925 | $0 | $0 | $0 | $47,270 | $0 | $1,717,152 | $0 | $593,863 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 1a | Tax indemnification and gross-up payments to individuals for benefits were included as taxable income on their 2015 W-2. |
| Part I, Line 3 | Hartford HealthCare Executive Compensation Committee approves CEO and other Executive compensation. See detailed explanation on Sch O as references to Form 990, Part VI, Section B, Line 15. |
| Part I, Lines 4a-b | Hartford Healthcare Corporation, a related organization, maintains a 457(f) Supplemental Executive Retirement Plan (SERP). Participants include certain officers and key employees at the President, Executive Vice President, Senior Vice President and Vice President levels that are reported by Midstate Medical Center on 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 or upon reaching age 65. 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. 2015 SERP accrual made on behalf of the following individual: Ms. Margaret Marchak $56,789 Severance payment made on behalf of the following individual: Steven Hanks, MD (VP) in the amount of $775,451 |
| 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 for management that contribute to 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. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | See Part V | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | See Part V | RelationshipDescriptionTxt |
| Transaction | See Part V | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part IV | FormAndLineReferenceDesc |
| Explanation | (a) Name of Interested Person: John Redmond, MD(b) Relationship between Interested Person and Organization: Director(c) Amount of Transactions: $40,785(d) Description of Transaction: Dr. John Redmond is a Board member of Hartford HealthCare's Cental Region. The Region consists of MidState Medical Center, Hospital of Central Connecticut & Rushford Center Inc. Dr. Redmond is the President of the Medical Staff at MidState Medical Center. He is also an officer of Eye Health Professionals, PC. The PC was paid $40,785 for Dr Redmond's services.(e) Sharing of Organization Revenues? = No | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | MidState Medical Center 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 board. |
| Form 990, Part VI, Section A, line 7b | The sole member of the organization has the right to review, approve, disapprove or deny fundamental transactions such as mergers, acquisitions, dissolutions, etc. |
| Form 990, Part VI, Section B, line 11 | 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 HHC Conflict of Interest Committee (the Committee) which includes representation from the Medical Staff, the Legal Department, Human Resources, Supply Chain Management and Compliance. The Committee assesses and may recommend the conflicting interest either be (a) eliminated for a continued relationship with HHC/MMC, 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 MidState Medical Center, 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: - Use of an Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare, on behalf of MidState Medical Center, 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 data analysis to ensure appropriate competitive positioning within parameters of compensation philosophy - The CEO compensation is reviewed by the Committee based on comparative market information and organizational performance - All changes are reviewed and approved by the Executive Compensation Committee The CEO compensation determination process 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, 990T and 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 Hospital's address. |
| Form 990, Part XI, line 9: | K-1 Income (Pass Thru Entities) -248,736. Transfer to affiliated entity -11,897,520. Change in pension and post-retirement funding obligation -18,389,001. Change in unrealized gains and losses on investments 94,654. Change in unrealized gains and losses on funds held in trust by others 551,591. Rounding 1. |
| FORM 990 PART XII LINE 3A & B | 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. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MidState MSO LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 435 Lewis Avenue | AddressLine1Txt |
| City | Meriden | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 06451 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 204312072 | EIN |
| Primary Activities | Management Services | PrimaryActivitiesTxt |
| Legal Domicile State | CT | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MidState Medical Center | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (26 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Hartford Hospital | |||||||||||
| 80 Seymour Street | Hartford | CT | 06102 | 060646668 | Healthcare Services | CT | 501(C)(3) | 3 | Hartford HealthCare Corporation | Yes (1) | |
| Hartford HealthCare Corp | |||||||||||
| One State Street Suite 19 | Hartford | CT | 06103 | 222672834 | Support and Management Services to Hartford Hospital and Affiliates | CT | 501(C)(3) | 11(c) | 0 | N/A | |
| Windham Community Memorial Hospital | |||||||||||
| 112 Mansfield Avenue | Willimantic | CT | 06226 | 060646966 | Healthcare Services | CT | 501(C)(3) | 3 | Hartford HealthCare Corporation | Yes (1) | |
| Windham Hospital Foundation Inc | |||||||||||
| 112 Mansfield Avenue | Willimantic | CT | 06226 | 562546632 | Supporting Organization | CT | 501(C)(3) | 11(a) | Windham Community Memorial Hospital | Yes (1) | |
| Natchaug Hospital Inc | |||||||||||
| 189 Storrs Road | Mansfield Center | CT | 06226 | 060966963 | Behavioral Health | CT | 501(C)(3) | 3 | Hartford HealthCare Corporation | Yes (1) | |
| Hartford HealthCare At HomeInc | |||||||||||
| 1290 Silas Deane Hwy Suite 4B | Wethersfield | CT | 06109 | 060646938 | Home Health Care | CT | 501(C)(3) | 7 | Hartford HealthCare Corporation | Yes (1) | |
| Rushford Center Inc | |||||||||||
| 883 Paddock Avenue | Meriden | CT | 06450 | 060932875 | Substance Abuse Health Care Services | CT | 501(C)(3) | 7 | Hartford HealthCare Corporation | Yes (1) | |
| Hartford Hospital Auxiliary co Hartford Hospital | |||||||||||
| 80 Seymour Street | Hartford | CT | 06102 | 066040747 | Fundraising | CT | 501(C)(3) | 11(c) | Hartford Hospital | Yes (1) | |
| Connecticut Health System Inc | |||||||||||
| 80 Seymour Street | Hartford | CT | 06102 | 222779421 | Coordination of Health Delivery | CT | 501(C)(3) | 11(c) | Hartford HealthCare Corporation | Yes (1) | |
| HHC Independence at Home Inc | |||||||||||
| 1290 Silas Deane Hwy Suite 4B | Wethersfield | CT | 06109 | 061161422 | Home Health Care | CT | 501(C)(3) | 9 | Hartford HealthCare At Home Inc | Yes (1) | |
| MidState Medical Center Auxiliary | |||||||||||
| 435 Lewis Avenue | Meriden | CT | 06451 | 066063082 | Fundraising | CT | 501(C)(3) | 11(a) | MidState Medical Center | Yes (1) | |
| WCMH Women's Auxiliary Inc | |||||||||||
| 112 Mansfield Avenue | Willimantic | CT | 06226 | 060677728 | Fundraising | CT | 501(C)(3) | 11(a) | Windham Community Memorial Hospital | Yes (1) | |
| The Hospital of Central CT | |||||||||||
| 100 Grand Street | New Britain | CT | 06050 | 060646768 | Healthcare Services | CT | 501(C)(3) | 3 | Hartford HealthCare Corporation | Yes (1) | |
| Hartford HealthCare Senior Services Inc | |||||||||||
| 45 Meride Avenue | Southington | CT | 06489 | 222635676 | Sub-Acute & Long Term Healthcare | CT | 501(C)(3) | 9 | Hartford HealthCare Corporation | Yes (1) | |
| Bradley Health Services | |||||||||||
| 100 Grand Street | New Britain | CT | 06050 | 061367014 | Healthcare Services | CT | 501(C)(3) | 9 | Hartford HealthCare Corporation | Yes (1) | |
| The Orchards of Southington | |||||||||||
| 34 Hobart Street | Southington | CT | 06489 | 061490803 | Residential Services for Senior Citizens | CT | 501(C)(3) | 9 | Hartford HealthCare Senior Services Inc | Yes (1) | |
| Mulberry Gardens of SouthingtonLLC | |||||||||||
| 58 Mulberry Street | Plantsville | CT | 06479 | 820586577 | Assisted Living & Adult Day Care Facility | CT | 501(C)(3) | 9 | Hartford HealthCare Senior Services Inc | Yes (1) | |
| HHC PhysiciansCare Inc | |||||||||||
| 80 Seymour Street | Hartford | CT | 06102 | 454456939 | Medical Services | CT | 501(C)(3) | 9 | Hartford HealthCare Corporation | Yes (1) | |
| Hartford HealthCare Accountable Care Org Inc | |||||||||||
| 1290 Silas Deane Hwy | Wethersfield | CT | 06109 | 460886367 | Government Contracts | CT | 501(C)(3) | 7 | HHC PhysiciansCare Inc | Yes (1) | |
| Hartford HealthCare Corp Group (VEBA) | |||||||||||
| 777 Main Street | Hartford | CT | 06102 | 266671355 | Medical Benefits Trust | CT | 501(C)(9) | N/A | Hartford HealthCare Corporation | Yes (1) | |
| Backus Corporation | |||||||||||
| 326 Washington Street | Norwich | CT | 06360 | 222757608 | Supporting Organization | CT | 501(C)(3) | 11(b) | Hartford HealthCare Corporation | Yes (1) | |
| The William W Backus Hospital | |||||||||||
| 326 Washington Street | Norwich | CT | 06360 | 060250773 | Healthcare Services | CT | 501(C)(3) | 3 | Hartford HealthCare Corporation | Yes (1) | |
| Backus HealthCare Inc | |||||||||||
| 326 Washington Street | Norwich | CT | 06360 | 222481794 | Supporting Organization | CT | 501(C)(3) | 11(a) | Hartford HealthCare Corporation | Yes (1) | |
| Rushford Foundation Inc | |||||||||||
| 883 Paddock Avenue | Meriden | CT | 06450 | 061432692 | Supporting Organization | CT | 501(C)(3) | 11(a) | Rushford Center Inc | Yes (1) | |
| Caring for Colleagues Employee Crisis Fund | |||||||||||
| 100 Grand Street | New Britain | CT | 06052 | 264469178 | Employee Fund | CT | 501(C)(3) | 7 | Hartford HealthCare Corporation | Yes (1) | |
| Hartford HealthCare Endowment LLC | |||||||||||
| 80 Seymour Street | Hartford | CT | 06102 | 454181103 | Endowment Management | CT | 501(C)(3) | 11(a) | Hartford HealthCare Corporation | Yes (1) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Omni Home Health Services E CT LLC | |||||||||||||
| 12 Case Street 317 | Norwich | CT | 06360 | 061458837 | Home Health Care | CT | N/A | ||||||
| New Britain MRI Limited Partnership | |||||||||||||
| 100 Grand Street | New Britain | CT | 06050 | 061271349 | Magnetic Resonance Imaging | CT | N/A | ||||||
| Hartford HealthCare Endowment LLC | |||||||||||||
| 80 Seymour Street | Hartford | CT | 06102 | 454181103 | Endowment Management | CT | N/A | Investment | 0 | 0 | |||
| Ambulance Service of Manchester LLC | |||||||||||||
| PO Box 300 | Manchester | CT | 06450 | 061557358 | Ambulatory Services | CT | N/A | ||||||
| Connecticut Imaging Partners LLC | |||||||||||||
| 111 Founders Plaza | East Hartford | CT | 06108 | 134298940 | Imaging 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 | Affilate Support Services | CT | N/A | ||||||
| Med-East Assoc LLC | |||||||||||||
| 1703 West Main Street | Willimantic | CT | 06226 | 061469575 | Outpatient Care Clinic | CT | N/A | ||||||
| HHC Southington Surgery Center LLC | |||||||||||||
| 100 Avon Meadow Lane | Avon | CT | 06001 | 465500829 | Surgery Services | CT | N/A | Related | 0 | 0 | $1,634,391 | $470,675 | 0.25000 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (16 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HHMOB Corporation & Subsidiaries | |||||||||||||||||
| 80 Seymour Street | Hartford | CT | 06102 | 061140244 | Real Estate & Parking | CT | N/A | C | Yes (1) | ||||||||
| Hartford HealthCare Indemnity Services LTD | |||||||||||||||||
| Captive Insurance | N/A | C | Yes (1) | 40 Church Street | Hamilton | BD | BD | ||||||||||
| Windham Health Services Inc | |||||||||||||||||
| 112 Mansfield Avenue | Willimantic | CT | 06226 | 061461101 | Home Health Care | CT | N/A | C | Yes (1) | ||||||||
| Windham Physician Hospital Organization | |||||||||||||||||
| 112 Mansfield Avenue | Willimantic | CT | 06226 | 061441614 | Medical Services | CT | N/A | C | Yes (1) | ||||||||
| Windham Family Medical Services PC | |||||||||||||||||
| 112 Mansfield Avenue | Willimantic | CT | 06226 | 061491649 | Medical Services | CT | N/A | C | Yes (1) | ||||||||
| CenConn Services Inc | |||||||||||||||||
| 100 Grand Street | New Britain | CT | 06050 | 222836001 | Investment Management | CT | N/A | C | Yes (1) | ||||||||
| MidState Medical Group PC | |||||||||||||||||
| 435 Lewis Avenue | Meriden | CT | 06450 | 204327968 | Medical Services | CT | N/A | C | Yes (1) | ||||||||
| Hartford Physician Services PC | |||||||||||||||||
| 80 Seymour Street | Hartford | CT | 06102 | 061254082 | Medical Services | CT | N/A | C | Yes (1) | ||||||||
| Meriden Imaging Center | |||||||||||||||||
| 101 North Plains Indusrial Park | Meriden | CT | 06429 | 061541468 | Imaging | CT | S | Yes (1) | MidState Medical Center | $248,450 | $3,072,578 | 0.80000 | |||||
| Hartford Physician Hospital Organization Inc | |||||||||||||||||
| 80 Seymour Street | Hartford | CT | 06102 | 222785918 | Physician & Hospital Support | CT | N/A | C | Yes (1) | ||||||||
| Aetna Ambulance Service Inc | |||||||||||||||||
| PO Box 1150 | Manchester | CT | 06045 | 060795431 | Ambulance Services | CT | N/A | C | Yes (1) | ||||||||
| Metro Wheelchair Service Inc | |||||||||||||||||
| PO Box 300 | Manchester | CT | 06045 | 060878432 | Wheelchair Services | CT | N/A | C | Yes (1) | ||||||||
| WWB Corporation | |||||||||||||||||
| 326 Washington Street | Norwich | CT | 06360 | 061094836 | Holding Company | CT | N/A | C | Yes (1) | ||||||||
| ConnCare Inc | |||||||||||||||||
| 326 Washington Street | Norwich | CT | 06360 | 061387598 | Healthcare Services | CT | N/A | C | Yes (1) | ||||||||
| Backus Medical Center Condo Assoc Inc | |||||||||||||||||
| 330 Washington Street | Norwich | CT | 06360 | 061542647 | Condo Association | CT | N/A | C | Yes (1) | ||||||||
| Windham Professional Office Condominium Association Inc | |||||||||||||||||
| 112 Mansfield Avenue | Willimantic | CT | 06226 | 061090041 | Condo Association | CT | N/A | C | Yes (1) | ||||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (11 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Hartford Hospital | ||
| M | $538,090 | FMV |
| Hartford Hospital | ||
| O | $207,315 | FMV |
| Hartford Hospital | ||
| P | $315,078 | FMV |
| Hartford Hospital | ||
| R | $595,062 | FMV |
| Hartford Hospital | ||
| A | $3,266 | FMV |
| Hartford HealthCare Rehabiliation Network | ||
| Q | $205,457 | FMV |
| Hartford HealthCare Rehabiliation Network | ||
| L | $1,047,057 | FMV |
| HHC PhysiciansCare Inc | ||
| A | $735,459 | FMV |
| HHC PhysiciansCare Inc | ||
| O | $275,728 | FMV |
| The Hospital of Central Connecticut | ||
| A | $42,953 | FMV |
| Rushford Center Inc | ||
| P | $459,030 | FMV |
Comments