2017-08-15T14:09:25-05:00 2016-09-30 061009205 BLUM SHAPIRO & COMPANY PC CPA'S 29 S MAIN STREET PO BOX 272000 WEST HARTFORD CT 061272000 990 2015-10-01 061003712 THE JOHN D THOMPSON HOSPICE INSTITUTE FOR EDUCATION TRAINING AND RESEARCH JOHN 2033157500 100 DOUBLE BEACH ROAD BRANFORD CT 064054003 THOMAS MCGOVERN CHIEF FINANCIAL OFFICER 2033157500 2017-08-15 1 ELIZABETH SOLECKI P00235171 8605614000 2017-08-14 2015 2021-01-29 14:40:06Z THOMAS MCGOVERN 100 DOUBLE BEACH ROAD BRANFORD CT 064054003 4330275 0 X WWW.HOSPICE.COM X 1978 CT TO EXTEND THE PRINCIPLES OF PALLIATIVE CARE AND HOSPICE SERVICES INTO THE MAINSTREAM OF MEDICAL PRACTICE AND EDUCATION REGIONALLY, NATIONALLY AND INTERNATIONALLY THROUGH EDUCATION, TRAINING AND RESEARCH. 16 15 1 3 0 0 45815 41057 5017385 4005058 0 0 284160 284160 5347360 4330275 0 0 0 0 2948310 2910294 0 0 10146 2571972 2721898 5520282 5632192 -172922 -1301917 20231401 19691641 11699178 12461335 8532223 7230306 TO EXTEND THE PRINCIPLES OF PALLIATIVE CARE AND HOSPICE SERVICES INTO THE MAINSTREAM OF MEDICAL PRACTICE AND EDUCATION REGIONALLY, NATIONALLY AND INTERNATIONALLY THROUGH EDUCATION, TRAINING AND RESEARCH. 0 0 1667554 5058 THE INSTITUTE OFFERS PROGRAMS ON EDUCATION, TRAINING AND RESEARCH PERTAINING TO THE CARE OF ADULT AND PEDIATRIC PATIENTS WITH IRREVERSIBLE ILLNESSES AND THEIR FAMILIES. 3488535 4000000 PROVIDING MANAGEMENT SERVICES AND FACILITIES TO CT HOSPICE. 5156089 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 X 16 15 0 0 0 0 0 1 0 1 1 0 0 0 1 1 1 1 0 1 0 0 CT X MR THOMAS MCGOVERN 2033157500 100 DOUBLE BEACH ROAD BRANFORD CT 064054909 HON DANIEL COSGROVE OFFICER EMERITUS 0.00 0.00 X X 0 0 0 ANTHONY J DAROS OFFICER AND DIRECTOR 5.00 5.00 X X 0 0 0 WEN-JEN HWU MD PHD DIRECTOR 5.00 5.00 X 0 0 0 FREDERICK J MANCHESKI OFFICER EMERITUS 0.00 0.00 X X 0 0 0 EUGENE MICHAEL OFFICER AND DIRECTOR 1.00 2.00 X X 0 0 0 CHIEF WILLIAM FARRELL DIRECTOR 1.00 2.00 X 0 0 0 HON DONALD POGUE DIRECTOR 2.00 2.00 X 0 0 0 ARLENE M SAYERS OFFICER AND DIRECTOR 1.00 2.00 X X 0 0 0 WAYNE O SOUTHWICK MD OFFICER AND DIRECTOR 1.00 1.00 X X 0 0 0 JOHN P STACK CPA DIRECTOR 0.50 0.50 X 0 0 0 CAPTAIN KAYE WILLIAMS OFFICER AND DIRECTOR 3.00 3.00 X X 0 0 0 MICHAEL MASSARO DIRECTOR 3.00 3.00 X 0 0 0 MRS NATALIE NIKKI O'NEIL DIRECTOR 1.00 1.00 X 0 0 0 GEORGE WALDRON DIRECTOR 1.00 2.00 X 0 0 0 THEODORE ZANKER MD DIRECTOR 2.00 2.00 X 0 0 0 PETER YARROW DIRECTOR HONORARY 0.20 0.20 X 0 0 0 MRS MARC A HURZELER PRESIDENT & CEO 25.00 65.00 X X 63831 165958 12634 THOMAS MCGOVERN CHIEF FINACIAL OFFICER 5.00 40.00 X 15413 123305 14744 RONNY J KNIGHT SENIOR VP REIMB/PLANNING 2.00 43.00 X 7826 168253 10978 JOSEPH SACCO SEE NOTE MEDICAL DIRECTOR 10.00 30.00 X 59482 178445 18826 DR ANTHONY COSCIA PT PHYSICIAN 4.00 20.00 X 23465 117323 7322 MARY ANN FIEFFER APRN 15.00 25.00 X 49349 82248 9117 JAMES PROTA DIRECTOR OF PHARMACY 5.00 35.00 X 16564 115950 17129 SUSAN FLANNIGAN VP OF HOME CARE 8.00 32.00 X 31676 126706 9663 ANNE NUGENT DIRECTOR OF NURSING 5.00 40.00 X 14708 117667 5543 282314 1195855 105956 0 0 1 0 0 41057 41057 LEASE AND MGT SERVICES 532000 4000000 4000000 EDUCATIONAL 611600 5058 5058 4005058 284160 0 284160 284160 284160 4330275 4005058 0 284160 X 144489 58519 75824 10146 2424506 2302871 121635 341299 305944 35355 1516144 1348628 167516 37943 20567 17376 5674 5674 573209 573209 NON MEDICAL INTERCOMPAN 584789 536538 48251 NON MEDICAL GENERAL EXP 4139 4139 5632192 5156089 465957 10146 16640 43769 500000 500000 28345538 9197666 19714761 19147872 20231401 19691641 11699178 12461335 11699178 12461335 X 8032223 6730306 500000 500000 8532223 7230306 20231401 19691641 -1301917 0 X 0 1 X 1 0 X 58732 68898 47275 45815 41057 261777 4007641 4513030 4500272 5017385 4005058 22043386 4066373 4581928 4547547 5063200 4046115 22305163 0 0 0 22305163 284160 284160 284160 284160 284160 1420800 284160 284160 284160 284160 284160 1420800 4350533 4866088 4831707 5347360 4330275 23725963 0.94010 0.94030 0.05990 0.05970 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 PART II-B, LINE 1: THE JOHN D. THOMPSON HOSPICE INSTITUTE FOR EDUCATION, TRAINING AND RESEARCH'S MISSION IS TO EDUCATE AND TRAIN CAREGIVERS AND CONDUCT RESEARCH. THIS REQUIRES THE ONGOING DEVELOPMENT OF REGULATIONS THAT WOULD SUPPORT THIS EFFORT. IN PARTICULAR, WITH THE RELOCATION OF THE INSTITUTE, ALTHOUGH WITHIN THE SAME PROVINCE, IT IS IMPORTANT TO MAINTAIN THESE STANDARDS. 6433345 6433345 21364826 8650299 12714527 547367 547367 0 19147872 DUE TO CT HOSPICE, NET 12461335 12461335 4330275 0 4330275 0 4330275 5632192 0 5632192 0 5632192 X X X X 0 1 0 0 0 0 0 0 0 MRS MARC A HURZELER PRESIDENT & CEO 63831 165958 0 0 0 0 1875 4875 1635 4249 67341 175082 0 0 THOMAS MCGOVERN CHIEF FINACIAL OFFICER 15413 123305 0 0 0 0 462 3699 1176 9407 17051 136411 0 0 RONNY J KNIGHT SENIOR VP REIMB/PLANNING 7826 168253 0 0 0 0 235 5048 253 5442 8314 178743 0 0 JOSEPH SACCO SEE NOTE MEDICAL DIRECTOR 59482 178445 0 0 0 0 1784 5353 2922 8767 64188 192565 0 0 SUSAN FLANNIGAN VP OF HOME CARE 31676 126706 0 0 0 0 950 3081 1126 4506 33752 134293 0 0 PART I, LINE 4B COMPENSATION RELATED TO THE RELATED ORGANIZATIONS BUT NOT GIVEN DUE TO THE FINANCIAL CONDITIONS OF THE ORGANIZATIONS. PART II, LINE 4: THE EXECUTIVE EMPLOYEE'S STATED COMPENSATION REPRESENTS 9 MONTHS OF COMPENSATION. IF ANNUALIZED, THE COMPENSATION IS $330,000. FORM 990, PART VI, SECTION A, LINE 7A A NOMINATING COMMITTEE CONSISTING OF TWO MEMBERS OF THE BOARD OF DIRECTORS MAY ELECT A BOARD MEMBER. FORM 990, PART VI, SECTION B, LINE 11 THE RETURN IS PRESENTED AT A BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS REVIEWS THE ANNUAL ELIGIBILITY TEST OF ALL BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 15A A COMMITTEE OF TWO OR MORE DIRECTORS OF THE BOARD MEETS PERIODICALLY TO REVIEW THE PERFORMANCE AND THE COMPARABILITY DATA OF SIMILARLY SIZED HOSPITALS IN THE STATE OF CONNECTICUT. THEY DELIBERATE AND A FINAL DECISION IS MADE. FORM 990, PART VI, SECTION C, LINE 19 INFORMATION IS NOT AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 1,348,628. MANAGEMENT AND GENERAL EXPENSES 167,516. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,516,144. THE CONNECTICUT HOSPICE INC 100 DOUBLE BEACH ROAD BRANFORD CT 064054003 060878822 TEACHING PALLIATIVE HOSPITAL AND HOSPICE CARE CT 501(C)(3) BOX 3 N/A 0 0 0 0 0 1 0 0 0 0 1 0 1 0 1 0 0 0 0 0 RENTAL INCOME J 284160 OPERATING LEASE MANAGEMENT SERVICES L 4000000 FAIR VALUE OF SERVICES