2017-08-15T17:46:56-05:00 2016-09-30 111986323 Marcum LLP 53 State Street Boston MA 02109 990 2015-10-01 060646710 MANCHESTER MEMORIAL HOSPITAL MANC 8606461222 71 HAYNES STREET MANCHESTER CT 06040 robert a schwartz md President 8606461222 2017-08-15 1 DOUGLAS FARRINGTON P00370668 6178075000 2017-08-15 2015 2021-01-29 14:40:06Z robert A Schwartz MD 71 HAYNES STREET MANCHESTER CT 06040 190695125 0 X WWW.ECHN.ORG X 1920 CT MANCHESTER MEMORIAL HOSPITAL IS A 249 BED HOSPITAL OFFERING VARIOUS HEALTHCARE SERVICES, INCLUDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO ALL MEMBERS OF THE COMMUNITY, INCLUDING THE INDIGENT AND UNDERSERVED. 11 6 1868 312 1060110 0 3601518 1779359 182971978 186598236 175414 187875 905846 884060 187654756 189449530 0 0 0 0 107278932 109185144 0 0 0 73490775 96743124 180769707 205928268 6885049 -16478738 156302485 116969731 141297026 121465741 15005459 -4496010 MANCHESTER MEMORIAL HOSPITAL IS A 249 BED HOSPITAL OFFERING VARIOUS HEALTHCARE SERVICES TO ALLMEMBERS OF THE COMMUNITY, INCLUDING THE INDIGENT AND UNDERSERVED. 0 0 34448137 28453228 INPATIENT SERVICES -MANCHESTER MEMORIAL HOSPITAL OFFERS COMPREHENSIVE MEDICAL SERVICES IN A 249 BED ACCUTE CARE COMMUNITY HOSPITAL, WITH A TOTAL OF 9,442 INPATIENTS TREATED IN FISCAL YEAR 2016. SERVICES ARE OFFERED TO THE COMMUNITY, REGARDLESS OF ANY INDIVIDUAL'S ABILITY TO PAY. 15628954 32837730 LABORATORY - WE ARE CAP ACCREDITED AND OFFER A WIDE RANGE OF CLINICAL TESTING PROCEDURES USING STATE-OF-THE-ART INSTRUMENTS TO PROVIDE TIMELY, ACCURATE RESULTS. OUR BOARD CERTIFIED PATHOLOGISTS UTILIZE STATE OF THE ART AUTOMATED EQUIPMENT PROVIDING RAPID TURNAROUND TIME, AND INTEGRATION OF TEST RESULTS WITH MEDICAL RECORDS. 11381317 32200151 EMERGENCY DEPARTMENT -EMERGENCY CARE IS OFFERED 24 HOURS PER DAY, AND PROVIDES NEEDED EMERGENCY MEDICAL CARE TO THE COMMUNITY, REGARDLESS OF ANY INDIVIDUAL'S ABILITY TO PAY. 104974356 104974356 166432764 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 381 0 1 1868 1 1 1 0 0 0 0 0 0 0 0 0 X 11 6 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 CT X NICHOLAS JAMIESON 8606461222 320 MAIN STREET MANCHESTER CT 06040 Dennis O'Neill MD Chairman 1.00 4.00 X X 0 0 0 Joy Dorin Vice Chair 1.00 2.00 X X 0 0 0 Michele Conlon MD Secretary 1.00 2.00 X X 0 0 0 Donald Genovesi Treasurer 1.00 2.00 X X 0 0 0 Thomasina Clemons Trustee 1.00 2.00 X 0 0 0 Anthony DiStefano MD Trustee 1.00 2.00 X 0 0 0 David Gonci Trustee 1.00 2.00 X 0 0 0 Eric Kloter Trustee 1.00 4.00 X 0 0 0 Kathleen A O'Neill Trustee 1.00 4.00 X 0 0 0 Maher Suede Trustee 1.00 2.00 X 0 0 0 Peter J Karl President and CEO 33.00 28.00 X X 866048 0 23743 Michael D Veillette Senior Vice President, Chief Financial Officer 33.00 28.00 X 495281 0 23743 Dennis McConville Senior Vice President, Strategic Planning 33.00 28.00 X 357372 0 9272 Joel Reich MD Senior Vice President, Medical Affairs 33.00 28.00 X 487147 0 17694 Mary Powers SVP, PATIENT CARE SERVICES 1.00 60.00 X 0 259352 9316 Robert Carroll MD Medical Director, Emergency Department 33.00 28.00 X 557457 0 23743 Joyce Tichy General Counsel 33.00 28.00 X 423800 0 23743 James Castellone MD Asst. Medical Director, Emergency Dept. 60.00 X 436954 0 2365 Andreas Bojko MD Emergency Department Physician 60.00 X 366011 0 23300 Enoch Darko MD Doctor 60.00 X 364673 0 10985 Osman Qureshi Emergency Department Physician 60.00 X 519032 0 23300 Theodore Sherry MD Emergency Department Physician 60.00 X 395038 0 23300 Deborah Parker Executive Vice President, Chief Clinical Officer 33.00 28.00 X 226407 0 1655 Deborah Gogliettino Senior Vice President, Human Resouces 33.00 28.00 X 141600 0 1159 5636820 259352 217318 141 1 1 0 SOUND PHYSICIANS PO BOX 742936 LOS ANGELES CA 900742936 Physician Services 2180681 STANDARD BUILDERS INC 52 HOLMES ROAD NEWINGTON CT 061111708 Construction 1248736 ARUP LABORATORIESINC PO BOX 27964 SALT LAKE CITY UT 84127 Lab Services 1244937 THE ADVISORY BOARD COMPANY PO BOX 79461 BALTIMORE MD 212790461 Consulting Services 1042023 SODEXO OPERATIONS LLC BOX 360170 PITTSBURGH PA 152516170 Food/Dietary Services 849768 46 67192 1545665 166502 12809 1779359 Patient Service Revenue 622110 180464278 180464278 Other Healthcare revenue 621500 6133958 5073848 1060110 186598236 187875 187875 645843 901413 -255570 -255570 -255570 28138 67192 107881 -79743 -79743 433016 236301 196715 196715 Cafeteria Revenue 722210 864346 864346 Auxiliary Revenue 900099 158312 158312 1022658 189449530 185538126 1060110 1071935 3665930 3665930 76461648 58691324 17770324 5117647 4350000 767647 18621131 15827961 2793170 5318788 4520970 797818 194959 194959 33971 33971 167293 167293 5565340 3339204 2226136 9405 9405 624586 312293 312293 227634 113817 113817 3243553 2757020 486533 51434 43719 7715 146427 124463 21964 2266813 2266813 7601674 6132202 1469472 6931552 5891819 1039733 Medical Supplies 31617839 31617839 bad debts expense 10662336 10662336 Physician Fees Total 9966849 9966849 Other Total 8145049 4242289 3902760 9286410 5571846 3714564 205928268 166432764 39495504 0 5266042 1270241 25143982 17615410 4086699 4155414 1678056 1302449 205230876 154099076 53573130 51131800 10975532 1598908 14376307 10668497 12938262 5196060 28264475 24030952 156302485 116969731 21650353 19700529 39467798 0 18619620 8713031 61559255 93052181 141297026 121465741 X 2829380 -16517740 494603 3678 11681476 12018052 15005459 -4496010 156302485 116969731 X -16478738 75659 -3098389 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 34946 34946 0 Part II-B, Line 1: THE CONNECTICUT HOSPITAL ASSOCIATION (CHA) HAS DETERMINED FOR ITS FISCAL YEAR THAT $24,909 OF THE MEMBERSHIP DUES FROM MANCHESTER MEMORIAL HOSPITAL WERE USED FOR LOBBYING PURPOSES. THE AMERICAN HOSPITAL ASSOCIATION (AHA) HAS DETERMINED FOR ITS FISCAL YEAR THAT $10,037 OF THE MEMBERSHIP DUES FROM MANCHESTER MEMORIAL HOSPITAL WERE USED FOR LOBBYING PURPOSES. 9641876 27657 8066419 4206 1598908 11274059 8869 1636638 4414 9641876 10402048 34372 838838 1199 11274059 9747173 1854875 1200000 10402048 8023690 1723483 9747173 0.00240 0.99760 0 1 1 1429966 1429966 96864788 56853377 40011411 1687509 589774 1097735 103566153 95835627 7730526 1682460 820298 862162 51131800 BENEFICIAL INTEREST IN TRUST ASSETS 9138026 F FUNDS HELD IN TRUST ESTIMATED SELF INSURANCE LIABILITIES 1530471 F 10668497 DUE FROM AFFILIATES 21796666 ESTIMATED SETTLEMENTS DUE FROM THIRD PARTY PAYERS 1655707 OTHER ASSETS 578579 24030952 CONDITIONAL RETIREMENT ASSET OBLIGATIONS 279796 OTHER CURRENT LIABILITIES 2665214 ESTIMATED SELF INSURANCE LIABILITIES 11726152 ACCRUED PENSION AND POST RETIREMENT BENEFITS 52224357 DUE TO AFFILIATES 4731866 ESTIMATED SETTLEMENTS DUE TO THIRD PARTY PAYERS 3033355 ADVANCE ON SALE 18391441 93052181 X 190554852 1054890 1054890 189499962 -50432 -50432 189449530 206528020 599752 599752 205928268 0 205928268 Part V, Line 4: THE PRINCIPAL AND INCOME FROM THE UNRESTRICTED ENDOWMENT FUNDS AND THE INCOME FROM THE TERM ENDOWMENTS ARE FOR CAPITAL AND OPERATING NEEDS OF MANCHESTER MEMORIAL HOSPITAL. THE INCOME FROM THE PERMANENT ENDOWMENTS AND PRINCIPAL FROM THE TERM ENDOWMENTS ARE FOR THE USE OF MANCHESTER MEMORIAL HOSPITAL AS RESTRICTED BY THE DONORS. Part X, Line 2: THE NETWORK ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH PROVISIONS OF FASB ASC 740, "INCOME TAXES," WHICH PROVIDES A FRAMEWORK FOR HOW COMPANIES SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE UNCERTAIN TAX POSITIONS IN THEIR CONSOLIDATED FINANCIAL STATEMENTS. THE NETWORK MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE NETWORK DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2016 AND 2015. THE NETWORK'S POLICY IS TO INCLUDE PENALTIES AND INTEREST AS A COMPONENT OF INCOME TAX EXPENSE, WHEN APPLICABLE. AS OF SEPTEMBER 30, 2016 AND 2015, THE NETWORK DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNCERTAIN TAX POSITIONS. GENERALLY, THE NETWORK'S PRIOR THREE TAX YEARS ARE OPEN AND SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. Part XI, Line 2d - Other Adjustments: COST OF GOODS SOLD -GIFT SHOP 236,301. NET ASSETS RELEASED FROM RESTRICTIONS USED FOR OPERATION 455,138. NET RENT LOSS 255,570. FUNDRAISING EXPENSES 107,881. Part XI, Line 4b - Other Adjustments: TEMPORARILY RESTRICTED CONTRIBUTIONS AND INVESTMENT INCOME -50,432. Part XII, Line 2d - Other Adjustments: COST OF GOODS SOLD -GIFT SHOP 236,301. NET RENTAL EXPENSE 255,570. FUNDRAISING EXPENSES 107,881. CT ILLUMINITE EVENT 95330 67192 28138 22000 39798 8417 37666 95330 67192 28138 22000 39798 8417 37666 107881 -79743 1 1 X 1 X 125.000000000000 1 X 1 1 0 1 1 921 630629 124885 505744 0.00250 48272 40119405 28434151 11685254 0.05670 49193 40750034 28559036 12190998 0.05920 23 101145 1149610 101446 1048164 0.00510 12 886 4047240 1564402 2482838 0.01210 4 2023 6775614 4222252 2553362 0.01240 1 34815 34815 0.00020 9 11976 184659 3550 181109 0.00090 49 116030 12191938 5891650 6300288 0.03070 49 165223 52941972 34450686 18491286 0.08990 4 686 1721322 1583377 137945 0.00070 2 42683 42683 0.00020 3 19 372127 309060 63067 0.00030 9 705 2136132 1892437 243695 0.00120 1 10662336 2300726 44891042 56200916 -11309874 X 1 1 1 1 MANCHESTER MEMORIAL HOSPITAL 71 HAYNES STREET MANCHESTER CT 06040 WWW.ECHN.ORG STATE LICENSE NO.: 0048 X X X X MANCHESTER MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X X 15 1 1 0 1 X see supplemental information X 1 15 1 http://www.echn.org/filemanager/userfiles/pdfs/2016_PRC_CHNA_Report__Manch 0 0 1 X 125.000000000000 400.000000000000 X X 1 1 X X X X 1 X www.echn.org X www.echn.org X www.echn.org X X X X X 1 0 X X X X 1 X 0 0 MANCHESTER MEMORIAL HOSPITAL Part V, Section B, Line 5: The assessments incorporate data from both quantitative and qualitative sources. Quantitative data input includes primary research (phone surveys) and secondary research (vital statistics and other existing health-related data); these quantitative components allow for comparison to benchmark data at the state and national levels. Qualitative data input includes primary research gathered through an online key informant survey (OKIS).The Community Health Needs Assessment was sponsored by a collaboration of community partners and relied on information provided by: public health and vital statistics data a variety of existing (secondary) data data representing the most recent BRFSS (Behavioral Risk Factor Surveillance System) prevalence and trends data (published online by the Centers for Disease Control and Prevention) state-wide risk factor data nationwide risk factor data Healthy People 2020 which provides science-based, 10-year national objectives for improving the health of all Americans phone surveys (based on the Centers for Disease Control Behavioral Risk Factor Surveillance Survey) And online key informant surveys.The participants for the online surveys included input from physicians and other health providers, public health experts, social service representatives, and community leaders. For a full listing of participating agencies, please reference the 2016 CHNA for Manchester Memorial Hospital or the 2016 CHNA for Rockville General Hospital. MANCHESTER MEMORIAL HOSPITAL Part V, Section B, Line 6a: FACILITY NAME: MANCHESTER MEMORIAL HOSPITALDESCRIPTION:THE CHNA WAS CONDUCTED BY EASTERN CONNECTICUT HEALTH NETWORK,WHICH INCLUDES MANCHESTER MEMORIAL HOSPITAL AND ROCKVILLEGENERAL HOSPITAL. MANCHESTER MEMORIAL HOSPITAL Part V, Section B, Line 11: FACILITY NAME: MANCHESTER MEMORIAL HOSPITALDESCRIPTION:I. Access to Healthcare Services:Strategy #1: Build the capacity of ECMPF primary care offices to provide primary and preventive healthcare services with at least 2 providers.Strategy #2: Expand the number of Family Practice Residents trained at ECHN from 25 residents per year to 33 and actively recruit graduates to practice locally. Strategy #3: Ensure that ECHN's hospital and home health care management programs as well as the ECHN hospitalist practitioners provide effective transitions of care for patients treated at ECHN facilities with an emphasis on communication with primary care physicians. II. Cancer Strategy 1: Colon Cancer - Colorectal screening and education Develop a marketing campaign for Colon Cancer Awareness Month each year to create awareness Hold a colonoscopy screening event to promote screenings, educate the community Promote the Open Access Program offered by local physicians at Evergreen Endoscopy Center that makes convenient appointments easier to obtain for screeningsStrategy 2: Lung Cancer - Promote and educate community on ECHN's Low Dose CT Screening Program Maintain ECHN's ACR accreditation as a Designated Cancer Screening Center Develop marketing and promotional material to create awareness of the need for screening and the community resources available Provide education to community and physicians through presence at health fairs and by hosting community education lecturesStrategy 3: Prostate Cancer - Host a Prostate Screening Event Determine eligibility and process to adhere to national standard of prostate screenings Collaborate with local physicians and health care workers to hold event Market and promote a prostate cancer screening eventStrategy #1: Educate women about the importance of preventative and screening services and lifestyle changes: Develop and coordinate educational lectures and seminars which will be offered to the community Publish information in ECHN's Better Being newsletter regarding health screenings, educational programs and lectures Participate in health fairs and community events Coordinate with ECHN providers to present educational programs and lectures related to women's health, diabetes and heart diseaseStrategy #2: Build community relationships to increase awareness of the ECHN Early Detection Program: The Community Health Navigator will engage and collaborate with community partners in order to provide education on program benefits and services available The Community Health Navigator will provide written material, in both English and Spanish, to community partners and providers detailing services available, and contact information for eligibilityStrategy 1: Freedom From Smoking: Provide program at least 3 times a year Advertise program through Better Being and with community partners Increase number of facilitators to 2 Provide program at multiple locationsStrategy 2: Offer smoking prevention presentation to public and private schools: Contact schools with 6th grade classes offering presentations Participate in health fairs at high schools and vocational schoolsStrategy 3: Provide CEU program to community primary care physicians: Provide education regarding available smoking prevention and cessation programsStrategy 4: Participate in health fairs: Provide material on nicotine addiction Provide material on Freedom From SmokingStrategy 1: Offer support to cancer survivors Established process to identify patients who have completed cancer therapy and provide patients with summary care plan which includes cancer diagnosis, stage and treatment receivedStrategy 2: Educate cancer survivors on managing lifestyle behaviors after treatment completion Survivorship care plan will also include road map for recommended follow up care Educate and encourage lifestyle changes to reduce cancer recurrence and/or improve quality of lifeIII. Heart Disease & StrokeStrategy #1: Provide education for cardiovascular disease risk factors and behavior modification Produce multi-year plan to improve health and reduce risky behaviors of our ECHN employees and families Provide community education lecture(s) on the signs and symptoms of stroke and heart attack, the early recognition of symptoms and importance of seeking immediate medical care Promote nutrition counseling services offered by local supermarkets and community centers to promote healthy diets Promote physical fitness activities/programs available in the community including fitness centers, cardiac rehabilitation programs, schools, parks and recreation programs Participate in community health fairs throughout service area where blood pressure, cholesterol, body fat composition analysis and education resources will be offeredStrategy #2: Promote the Freedom From Smoking cessation program Offer behavioral counseling on the short and long term physiologic benefits and quality of life benefits from smoking cessation Provide education about FDA approved smoking cessation medications Promote available smoking cessation programs to physicians in the community and hospitals as an option for patients who smokeStrategy #3: Promote cardiac rehabilitation Promote cardiac rehabilitation services to restore people who have had a heart condition or heart surgery to the highest possible physiological, emotional, social, and vocational levelIV. Infant Health & Family PlanningThis strategy will focus on the service areas of Manchester and Vernon Strategy #1: Improve access to care and education Continue family planning education sessions/tours Encourage the use of the Maternity Care Center (MCC) at Rockville General Hospital Provide information through ECHN digital boards, Readiness Committees, ECHN social media and ECHN Website Continue to publicize educational opportunities through Better Being magazine Continue the distribution of ECHN prenatal folders through the community practices that contain comprehensive topical informationStrategy #2: Increase preconception and first trimester pregnancy education Encourage regular ECHN birth class attendance Provide information through ECHN digital boards, Readiness Committees, ECHN social media and Website Pursue the development of a preconception and an early pregnancy class offering MANCHESTER MEMORIAL HOSPITAL Part V, Section B, Line 13h: DESCRIPTION:FAMILY SIZE IS USED WITH INCOME LEVEL. MANCHESTER MEMORIAL HOSPITAL Part V, Section B, Line 16i: DESCRIPTION:THE HOSPITAL COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE THROUGH NOTICES POSTED IN PUBLIC AREAS AROUND THE HOSPITAL, ON THE PATIENT BILLS, ON OUR WEBSITE, AND FOR SELECTED PRE-SCHEDULED SERVICES TO ENSURE THAT THE FINANCIAL CAPACITY OF PEOPLE WHO NEED HEALTH CARE SERVICES DOES NOT PREVENT THEM FROM SEEKING OR RECEIVING CARE. MANCHESTER MEMORIAL HOSPITAL Part V, Section B, Line 22d: DESCRIPTION:PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL NOT BE CHARGED MORETHAN THE AMOUNT GENERALLY BILLED TO PATIENTS WITH INSURANCE FOREMERGENCY OR OTHER MEDICALLY NECESSARY CARE. SCHEDULE H, PART II DESCRIBE HOW BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY:MANCHESTER MEMORIAL HOSPITAL (MMH), AS PART OF EASTERN CONNECTICUT HEALTH NETWORK, PROMOTES THE HEALTH OF THE COMMUNITIES IT SERVES BY COMMITTING THE EXPERTISE AND RESOURCES OFTHE ORGANIZATION TO A NUMBER OF COMMUNITY BUILDING ACTIVITIES THAT SUPPORT ASSOCIATIONS, BUSINESSES, PROGRAMS, INITIATIVES AND OTHER VALUABLE LOCAL COMMUNITY ASSETS. THROUGH GRANTS PROVIDEd BY THE FEDERAL AND STATE GOVERNMENTS, MMH OFFERS FREE SUPPORT PROGRAMS TO CHILDREN AND THEIR FAMILIES TO PROMOTE POSITIVE FAMILY LIFE SKILLS AND CHILD DEVELOPMENT. IN FY 2016, THESE PROGRAMS BENEFITED 581 INDIVIDUALS WITH MMH PROVIDING OVER $117,000 OF IN-KIND RESOURCES AND SERVICES. OTHER COMMUNITY BUILDING ACTIVITIES PERFORMED IN FY 2016 INCLUDE PARTICIPATION IN REGIONAL EXERCISES TO EVALUATE THE READINESS OF THE HOSPITAL'S EMERGENCY PREPAREDNESSCAPABILITIES; PARTICIPATION IN THE BABY FRIENDLY PRACTICES STATEWIDE COLLABORATIVE AND THE STATEWIDE CPQC INITIATIVE; SERVING ON THE BOARD AND EXECUTIVE COMMITTEE OF REGIONAL CHAMBERS OF COMMERCE IN SUPPORT OF THE LOCAL BUSINESS INDUSTRY; HOSTING ART EXHIBITS OFTHE MANCHESTER ART ASSOCIATION; WORKING WITH THE MANCHESTER VETERANS COUNCIL TO HONOR VETERANS IN AN ANNUAL VETERANS DAY CEREMONY FOR THE COMMUNITY; PARTNERING WITH THE LOCAL SCHOOL SYSTEMS AND COLLEGES IN VARIOUS WORKFORCE DEVELOPMENT PROGRAMS; ATTENDING SCHOOL READINESS COUNCIL MEETINGS; PROVIDING VOCATIONAL SERVICES AND EMPLOYMENT ASSISTANCE TO RESIDENTS; SERVING ON THE AMERICAN HOSPITAL ASSOCIATION'S REGIONAL POLICY BOARD; AND SERVING ON THE DEPARTMENT OF PUBLIC HEALTH'S OFFICE OF EMERGENCY MEDICAL SERVICE MEDICAL ADVISORY COMMITTEE, THE CONNECTICUT EMS ADVISORY BOARD, THE CONNECTICUT EMS ADVISORY COMMITTEE, THE REGIONAL MEDICAL ADVISORY COMMITTEE, THE REGIONAL ED STANDARDS BOARD, THE STATE EMS EDUCATION AND TRAINING COMMITTEE, AND EMS CLINICAL COORDINATORS. AS A RESULT OF THESEACTIVITIES, THERE HAS BEEN IMPROVED COLLABORATION AMONG COMMUNITY PROVIDERS AND OTHERS INVOLVED IN PROVIDING SERVICES TO CHILDREN, ADOLESCENTS AND THEIR FAMILIES AND OTHER ADULTS. SCHEDULE H, PART III, LINE 2 METHODOLOGY USED TO ESTIMATE BAD DEBT:THE NETWORK PROVIDES FOR A PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE NETWORK ANALYZES CONTRACTUALLY DUEAMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITHDEDUCTIBLE AND CO-PAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE NETWORK RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THEBASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, THE NETWORK OFFERS A DISCOUNT OFF ITS STANDARD RATES FOR SERVICES PROVIDED. THE DIFFERENCE BETWEEN THE DISCOUNTED RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED UNCOLLECTIBLE. SCHEDULE H, PART III, LINE 4 FOOTNOTE IN ORGANIZATION'S FINANCIAL STATEMENTS DESCRIBING BAD DEBT:the Network provided for a provision for bad debts. For receivables associated with services provided to patients who have third-party coverage, the Network analyzed contractually due amounts and provided an allowance for doubtful accounts (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payer has not yet paid, or for payers who were known to be having financial difficulties that makethe realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and co-payment balances due for which third-party coverage existed for part of the bill), the Network recorded a significant provision for bad debts in the period of service on the basis of its past experience, which indicated that many patients were unable or unwilling to pay the portion of their bill for which they were financially responsible. For uninsured patients that did not qualify for financial assistance, the Network offered a discount off its standard rates for services provided. The difference between the discounted rates and the amounts actually collected after all reasonable collection efforts have been exhausted is written off against the allowance for doubtful accounts in the period they were determined uncollectible. SCHEDULE H, PART III, LINE 8 DESCRIBE EXTENT ANY SHORTFALL FROM LINE 7 TREATED AS COMMUNITY BENEFIT AND COSTING METHOD USED:THE HOSPITAL PROVIDES QUALITY HEALTH CARE TO ALL, REGARDLESS OF THEIR ABILITY TO PAY. CHARITY CARE IS PROVIDED TO THOSE WHO ARE ELIGIBLE BASED ON MMH'S POLICY. MMH ALSO INCURS UNPAID COSTS FORGOVERNMENT PROGRAMS BECAUSE REIMBURSEMENT IS NOT SUFFICIENT TO COVER COSTS ASSOCIATED WITH MEDICARE AND MEDICAID PATIENTS. THE ORGANIZATION'S MEDICARE COST REPORT WAS USED TO CALCULATE ACTUAL COSTS REPORTED ON PART III, LINE 6. THE ACCESS TO HEALTHCARE BY PATIENTS COVERED BY MEDICARE IS A FUNDAMENTAL PART OF THE HOSPITAL'S COMMUNITY BENEFIT PROGRAM. SCHEDULE H, PART III, LINE 9B DID COLLECTION POLICY CONTAIN PROVISIONS ON COLLECTION PRACTICES FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR ASSISTANCE:INTERNAL AND EXTERNAL COLLECTION POLICIES AND PROCEDURES TAKE INTO ACCOUNT THE EXTENT TO WHICH A PATIENT IS QUALIFIED FOR CHARITY CARE OR DISCOUNTS. IN ADDITION, PATIENTS WHO QUALIFY FOR PARTIAL DISCOUNTS ARE REQUIRED TO MAKE A GOOD FAITH EFFORT TO HONOR PAYMENT AGREEMENTS WITH THE HOSPITAL, INCLUDING PAYMENT PLANS AND DISCOUNTED HOSPITAL BILLS. MMH IS COMMITTED TO WORKING WITH PATIENTS TO RESOLVE THEIR ACCOUNTS, AND AT ITS DISCRETION, MAY PROVIDE EXTENDED PAYMENT PLANS TO ELIGIBLE PATIENTS. MMH WILL NOT PURSUE LEGAL ACTION FOR NON-PAYMENT OF BILLS AGAINST CHARITY CARE PATIENTS WHO HAVE COOPERATED WITH THE HOSPITAL TO RESOLVE THEIR ACCOUNTS AND HAVE DEMONSTRATED THEIR INCOME AND/OR ASSETS ARE INSUFFICIENT TO PAY MEDICAL BILLS. Part VI, Line 2: In 2016, MMH collaborated with Rockville General Hospital, also an affiliate of ECHN, to conduct a comprehensive community health needs assessment (CHNA). The CHNA was a systematic, data-driven approach to determining the health status, behaviors and needs of residents in the service area of Manchester Memorial Hospital. Subsequently, the information was used to inform decisions and guide efforts to improve community health and wellness.The CHNA provides information so that communities may identify issues of greatest concern and decide to commit resources to those areas, thereby making the greatest possible impact on community health status. The CHNA will serve as a tool toward reaching three basic goals: To improve residents' health status, increase their life spans, and elevate their overall quality of life. A healthy community is not only one where its residents suffer little from physical and mental illness, but also one where its residents enjoy a high quality of life. To reduce the health disparities among residents. By gathering demographic information along with health status and behavior data, it will be possible to identify population segments that are most at-risk for various diseases and injuries. Intervention plans aimed at targeting these individuals may then be developed to combat some of the socio-economic factors which have historically had a negative impact on residents' health. To increase accessibility to preventive services for all community residents. More accessible preventive services will prove beneficial in accomplishing the first goal (improving health status, increasing life spans, and elevating the quality of life), as well as lowering the costs associated with caring for late-stage diseases resulting from a lack of preventive care.This assessment was conducted on behalf of the Eastern Connecticut Health Network and Manchester Memorial Hospital by Professional Research Consultants, Inc. (PRC). PRC is a nationally recognized healthcare consulting firm with extensive experience conducting Community Health Needs Assessments such as this in hundreds of communities across the United States since 1994. Part VI, Line 3: THE HOSPITAL COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE THROUGH NOTICES POSTED IN PUBLIC AREAS AROUND THE HOSPITAL, ON THE PATIENT BILLS, ON OUR WEBSITE, AND SELECTED PRE-SCHEDULED SERVICES TO ENSURE THAT THE FINANCIAL CAPACITY OF PEOPLE WHO NEED HEALTHCARE SERVICES DOES NOT PREVENT THEM FROM SEEKING OR RECEIVING CARE. Part VI, Line 4: ECHN's community, as defined for the purposes of the Community Health Needs Assessment, included each of the residential Zip Codes that comprise the hospital's town location including 06040 and 06042 for Manchester Memorial Hospital and 06066 for Rockville General Hospital. This community definition was determined because the majority of ECHN's patients originate from these areas for use of our hospital services.Demographics of the CommunityThe population of Manchester Memorial Hospital's service area is estimated at 58,253 people. It is predominantly non-Hispanic White (71.4%), but also has substantial African America (12.3%) and Hispanic (12%) populations. Part VI, Line 5: o Community health education initiatives/programs are offered to the community and include lecture presentations; development and distribution of a wellness magazine to more than 150,000 households in the service area; and demonstrations and health fair participation. Examples of programs are o Lecture presentations, such as Coffee & Conversation: Breast Health Screening; Ending Obesity: Step by Step; Nutritional Needs During Pregnancy; Pre-diabetes, Let's Take Action!; and Embracing Wellness in the Midst of Cancer. o A Freedom from Smoking Program that is facilitated by an ALA Certified Health are Professional and includes eight 1- to 2-hour sessions over 7 weeks, the 4th session being Quit Day. The sessions is provided at the worksite or other location, daytime or evening.o Lunch and learn programs which are free workshops for cancer patients and their caregivers. o Presentations on women's health issues made in the community about breast cancer, preventative/screening recommendations, bone density exams, and free screening programs. In 2016, these presentations were made at the Manchester Area Conference of Churches, East Hartford Senior Center, Manchester Community College Health Information Table, Mobile Foodshare, Manchester Town Health Fair, Crossroads Annual Health Fair, South Windsor Wapping Fair, Town of Hartford CT Health I-Team Fair, 9th Annual Thinking of You Community Fair, and the Office of Migration, Refugee, and Immigration Services at Catholic Charities of Hartford. o The promotion and support of breastfeeding through breastfeeding classes, peer mentor programs, a new mother's support group, and lactation consultants. Other examples of community benefit include integrative medicine programs for stress reduction, a "heart talk" community program for people living with heart failure, regular cancer support group meetings, cancer caregiver workshops, diabetes self-management program, nutrition counseling for individuals already diagnosed with diabetes, family support groups for families who are dealing with behavioral health or addiction issues, teen smoking prevention lectures at area schools, and other lecture presentations. Over 97,000 people benefitted from these initiatives and programs in FY 16. Free health screenings including diabetic foot checks, lung cancer screening, mammograms, heart disease screenings, blood pressure, bone density, pap test and cervical cancer screenings, and vital sign checks are offered to the community. For example, blood pressure screenings were done during Wear Red Day; breast cancer and education screenings were done at Pink Ribbon Day; a Mammos and Mimosas event; and at a Big Y Breast Cancer awareness event. Targeting uninsured/underinsured populations, 124 people benefitted from all these services in FY 16. Healthcare support services are provided by the hospital to increase access and quality of care to individuals in need. Efforts include free transportation to behavioral health patients, assistance to enroll in public programs, referrals to social services, and help in finding physicians who accept Medicaid or other government programs. Nurse navigation services help patients and their loved ones navigate through the healthcare system, finding support and resources to manage symptoms, get a second opinion, schedule tests and treatment, find homecare services and coordinate care. A social worker who serves as a survivorship navigator is available to provide supportive counseling and assistance in locating resources to help with finances, disability, medical insurance, advance directives and post treatment survivorship care planning. Three thousand eight hundred fifty-four (3,854) people benefitted from these efforts in FY 16. Partnering with local educational institutions, Manchester Memorial Hospital provides a clinical setting for physicians and interns, medical students, nursing students, radiologic technicians, phlebotomy students, respiratory technicians, dietetic interns, pharmacy students, physical therapists and others from the University of New England College of Osteopathic Medicine, University of Connecticut, Manchester Community College, Goodwin College, Capital Community College, University of St. Joseph, Southern CT State University, Asnuntuck Community College, Naugatuck Valley Community College, and the University of Hartford. Presentations are also given to local groups on new emergency management services guidelines and updates, EMT education, paramedic skills training, regional skills validations, Narcan and CPAP training. Health services which are subsidized by the hospital include neonatal services, diabetes self-management, dialysis services and the behavioral health clinic. Specific research initiatives conducted by the hospital include an Institutional Review Committee, which has the primary responsibility to protect the rights and welfare of research subjects and to approve all research studies in accordance with federal regulations. The hospital also maintains a cancer registry and datebase. Financial and in-kind services and goods are donated to community groups and other not for profit organizations, including patient meals, local fundraisers, facility space to host blood drives, conference rooms for health support groups organizations' meetings, and for oncology clinical research. For example, the hospital provides free meeting space for the ACOA Support Group Adult Children of Alcoholics, Al-Anon, Alcoholics Anonymous, Not So Typical Autism Support Group, Brain Injury Alliance of CT Support Group, Narcotics Anonymous, Family Support Night, Older Adults Recovery & Support Group, ECHN Prostate Cancer Support Group, and Sweet Talk - Diabetes Support Group. The expertise and resources of the organization are dedicated to a number of community building activities that support associations, businesses, programs, initiatives and other valuable local community assets. o Through grants provided by the federal and state governments, MMH offers free support programs to prenatal individuals and parents to promote positive family life skills and child development. In FY 2016, these programs benefited 581 individuals with MMH providing over $117,000 in in-kind resources and services. Other community building activities performed in FY 2016 include participation in regional exercises to evaluate the readiness of the hospital's emergency preparedness capabilities; participation in the Baby Friendly Practices Statewide Collaborative and the statewide CPQC Initiative; serving on the Board and Executive Committee of regional Chambers of Commerce in support of the local business industry; hosting art exhibits of the Manchester Art Association; working with the Manchester Veterans Council to honor veterans in an annual Veterans Day ceremony for the community; partnering with the local school systems and colleges in various workforce development programs; attending School Readiness Council meetings; providing vocational services and employment assistance to residents; serving on the American Hospital Association's Regional Policy Board; and serving on the Department of Public Health's Office of Emergency Medical Service Medical Advisory Committee, the Connecticut EMS Advisory Board, the Connecticut EMS Advisory Committee, the Regional Medical Advisory Committee, the Regional ED Standards Board, the State EMS Education and Training Committee, and EMS Clinical Coordinators. Part VI, Line 6: MANCHESTER MEMORIAL HOSPITAL (MMH) IS AN AFFILIATE OF EASTERN CONNECTICUT HEALTH NETWORK (ECHN), A HEALTH CARE SYSTEM SERVING 19 TOWNS IN EASTERN CONNECTICUT. THE ECHN NETWORK OF AFFILIATESINCLUDES:MANCHESTER MEMORIAL HOSPITAL, A COMMUNITY HOSPITAL LICENSED FOR 249 BEDS AND 34 BASSINETS, THAT OFFERS MEDICAL AND SURGICAL SERVICES, 24-HOUR EMERGENCY CARE, MEDICAL IMAGING, A MODERN FAMILY BIRTHING CENTER AND NEONATOLOGY SERVICES, REHABILITATION SERVICES, ACERTIFIED SLEEP DISORDERS CENTER, INTENSIVE CARE SUITES, A WOUND HEALING CENTER WITH HYPERBARIC THERAPY, HOSPICE CARE, DIABETES SELF-MANAGEMENT PROGRAM, CARDIAC &PULMONARY REHABILITATION, A COMPREHENSIVE RANGE OF ADOLESCENT AND ADULT INPATIENT ANDOUTPATIENT BEHAVIORAL HEALTH SERVICES, NUTRITION COUNSELING, LABORATORY SERVICES, MEDICAL EDUCATION (FAMILY MEDICINE RESIDENCY & INTERNSHIP PROGRAM; UNECOM MEDICAL STUDENTS; AND CONTINUING EDUCATION) AND THE EASTERN CQNNECTiCUT CANER INSTITUTE AT THE JOHNA. DEQUATTRO CANCER CENTER.ROCKVILLE GENERAL HOSPITAL, A COMMUNITY HOSPITAL LICENSED FOR 102 BEDS, THAT OFFERS INPATIENT AND OUTPATIENT MEDICAL AND SURGICAL SERVICES, AMBULATORY (ONE-DAY) SURGERY, 24-HOUR EMERGENCY CARE, MEDICAL IMAGING, CARDIAC &PULMONARY REHABILITATION, PHYSICAL REHABILITATION, HOSPICE CARE, A MATERNITY CARE CENTER, OUTPATIENT ADOLESCENT BEHAVIORAL HEALTH SERVICES, AND LABRATORY SERVICES.WOODLAKE AT TOLLAND, A 130-BED LONG-TERM SKILLED NURSING CARE AND SHORT-TERM REHABILITATION FACILITY THAT OFFERS CUSTOMIZED REHABILITATION TREATMENT SERVICES INCLUDING JOINT REPLACEMENT REHABILITATION, ORTHOPEDIC POST-HOSPITAL CARE, STROKE/NEUROLOGICALREHAB, POST MEDICAL/SURGICAL RECONDITIONING, PRE-DISCHARGE HOME EVALUATIONS, PATIENT AND FAMILY INSTRUCTION, AND PERSONALIZED, PROGRESSIVE, AND INTERDISCIPLINARY CARE PLANS.EASTERN CONNECTICUT MEDICAL PROFESSIONALS FOUNDATION, INC. (ECMPF), A MULTI-SPECIALTY PHYSICIAN GROUP PRACTICE THAT OFFERS A FULL RANGE OF HEALTHCARE SERVICES, INCLUDING PRIMARY AND SPECIALTY CARE IN THE TOWNS OF EAST HARTFORD, ELLINGTON, MANCHESTER, SOUTH WINDSOR,TOLLAND AND VERNON/ROCKVILLE. GLASTONBURY WELLNESS CENTER COMBINES FITNESS AND MEDICAL SERVICES UNDER ONE ROOF, INCLUDING PHYSICIAN PRACTICES, LABORATORY DRAW SERVICES, MEDICAL IMAGING DIAGNOSTIC SERVICES, AND REHABILITATION SERVICES.ECHN MEDICAL BUILDINGS AT EVERGREEN WALK (SOUTH WINDSOR): 2400 TAMARACK AVENUE OCCUPANTS INCLUDE EVERGREEN ENDOSCOPY CENTER, CENTRAL CONNECTICUT GASTROENTEROLOGY, THE COLON & RECTAL SURGEONS OF GREATER HARTFORD, ECMPF PRIMARY CARE PHYSICIANS, RHEUMATOLOGY PHYSICIANS, WALDEN BEHAVIORAL CARE EATING DISORDERS CLINIC, ACCLAIM BEHAVIORAL SERVICES, LLC, AND LABORATORY SERVICES.2600 TAMARACK AVENUE INCLUDES THE WOMEN'S CENTER FOR WELLNESS, ECHN BREAST CARE COLLABORATIVE, AND THE OB/GYN GROUP OF EASTERN CONNECTICUT. THE CONFERENCE ROOM IS USED FOR COMMUNITY PROGRAMS.2800 TAMARACK AVENUE HOUSES EVERGREEN IMAGING CENTER, ECHN REHABILITATION SERVICES, A LABORATORY DRAW STATION, AND A SERIES OF MEDICAL PRACTICES (INCLUDING ORTHOPEDIC SURGERY, OPHTHALMOLOGY, AND OTOLARYNGOLOGY), CORPCARE, AND SOUTH WINDSOR URGENT CARE. 353 Main Street, Manchester houses Digestive Heath Specialists of Eastern CT, LLC and a gastroenterologist. 945 Main Street, Manchester houses digestive health physicians. 460 Hartford Turnpike, Vernon, includes an endocrinologist and Davita DialysisECHN MANCHESTER MEDICAL OFFICE BUILDINGS: 150 NORTH MAIN STREET OFFERS A VARIETY OF ADULT BEHAVIORAL HEALTH SERVICES. 130 HARTFORD ROAD, OFFERS PRIMARY CARE AND LABORATORY SERVICES. VISITING NURSE &HEALTH SERVICES OF CONNECTICUT, PROVIDES AT-HOME NURSING CARE AND HOSPICE CARE.ECHN HAS 388 PHYSICIANS (305 ACTIVE, 34 COURTESY, 16 CONSULTING, 33 PART-TIME), 105 ALLIED HEALTH PROFESSIONALS, 10 MEDICAL DEPARTMENTS AND 16 SERVICES AS WELL AS 18 UNIVERSITY OF NEW ENGLAND COLLEGE OF OSTEOPATHIC MEDICINE THIRD-YEAR MEDICAL STUDENTS AVAILABLE TO CAREFOR THE COMMUNITY. IN ADDITION, ECHN HAS 87 ELECTIVE STUDENTS FROM VARIOUS UNIVERSITIES WHO COME FOR ONE ROTATION PER YEAR. ADDITIONAL INFORMATION MANCHESTER MEMORIAL HOSPITAL IS A NOT-FOR-PROFIT 249-BED ACUTE CARE HOSPITAL THAT PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR RESIDENTS OF MANCHESTER, CT AND SURROUNDING TOWNS. THE HOSPITAL IS A SUBSIDIARY OF EASTERN CONNECTICUT HEALTH NETWORK,INC., WHICH WAS FORMED IN 1995 BY A MERGER OF MMH CORP. AND ROCKVILLE AREA HEALTH SERVICES, INC. ECHN WAS ORGANIZED TO PROVIDE A BROADER HEALTH CARE SYSTEM FOR THE SURROUNDING COMMUNITIES WITH QUALITY MEDICAL CARE AT A REASONABLE COST AND TO FOSTER AN ENVIRONMENT CONDUCIVE TO HEALTH AND WELL BEING WHETHER IN THE HOME OR IN THE COMMUNITY.MANCHESTER MEMORIAL HOSPITAL PATIENTS NOT HAVING INSURANCE COVERING EMERGENCY OR OTHER MEDICALLY QUALIFIED CARE (UNINSURED PATIENTS), AS WELL AS UNDERINSURED PATIENTS, SUBJECT TO INCOME LIMITS AND FAMILY SIZE RECEIVE FREE OR DISCOUNTED CARE. MANCHESTER MEMORIAL HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. CHARGES FOR CARE PROVIDED TO PATIENTS ARE DETERMINED BY ESTABLISHED RATES, SUBJECT TO POSSIBLE ADJUSTMENTS OR DISCOUNTS FOR LOW INCOME PATIENTS; CONTRACTUAL DISCOUNTS, OR DISCOUNTS FOR PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICIES. CHARITY CARE FOR FY 2016 WAS $2,300,726 FOR 921 TOTAL APPROVED APPLICANTS. EXPENSES RELATED TO SERVICES PERFORMED FOR PATIENTS OF MANCHESTER MEMORIAL HOSPITAL CONTRIBUTE IMPORTANTLY TO ITS EXEMPT PURPOSE BECAUSE THE EXPENSES ARE INCURRED IN THE DIAGNOSIS, CURE, MITIGATION, TREATMENT AND PREVENTION OF DISEASE, AND FOR MEDICAL PURPOSES AFFECTING THE STRUCTURE OR FUNCTION OF THE HUMAN BODY. MANCHESTER MEMORIAL HOSPITAL PROVIDED NEEDED MEDICAL CARE TO THE COMMUNITY REGARDLESS OF ANY INDIVIDUAL'S ABILITY TO PAY. 9,442 INPATIENTS WERE CARED FOR IN FY16 REPRESENTING 44,775 PATIENT DAYS.198,558 OUTPATIENT VISITS WERE RECORDED.INCLUDED IN THE 9,442 INPATIENTS WERE 6,107 GOVERNMENT RELATEDPATIENTS. THE GOVERNMENT INPATIENTS FALL INTO THE FOLLOWING GROUPS.MEDICARE... 2,547MEDICARE MANAGED CARE... 929MEDICAID...2,586CHAMPUS...45TOTAL GOV PATIENTS... 6,107INCLUDED IN THE 198,558 OUTPATIENT VISITS WERE 119,886 GOVERNMENTRELATED VISITS. THE VISITS ARE A PRODUCT OF GROSS REVENUERELATIONSHIP TO TOTAL VISITS. THE GOVERNMENT VISITS FALL INTO THEFOLLOWING GROUPS.MEDICARE...65,893MEDICARE MANAGED CARE...28,122MEDICAID...25,125CHAMPUS...746TOTAL GOV PATIENTS...119,886THE HOSPITAL PROVIDED UNCOMPENSATED CARE TO 48,272 MEDICAIDPATIENTS FOR A NET COMMUNITY BENEFIT AMOUNT OF $11,685,255 AFTERMEDICAID REIMBURSEMENT. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: CT X X X X X 0 1 0 0 0 0 0 0 0 Peter J Karl President and CEO 607548 0 258500 0 0 0 0 0 23743 0 889791 0 0 0 Michael D Veillette Senior Vice President, Chief Financi 364031 0 131250 0 0 0 0 0 23743 0 519024 0 0 0 Dennis McConville Senior Vice President, Strategic Pla 226122 0 131250 0 0 0 0 0 9272 0 366644 0 0 0 Joel Reich MD Senior Vice President, Medical Affai 355897 0 131250 0 0 0 0 0 17694 0 504841 0 0 0 Mary Powers SVP, PATIENT CARE SERVICES 0 244352 0 15000 0 0 0 0 0 9316 0 268668 0 0 Robert Carroll MD Medical Director, Emergency Departme 410665 0 146792 0 0 0 0 0 23743 0 581200 0 0 0 Joyce Tichy General Counsel 292550 0 131250 0 0 0 0 0 23743 0 447543 0 0 0 James Castellone MD Asst. Medical Director, Emergency De 353054 0 83900 0 0 0 0 0 2365 0 439319 0 0 0 Andreas Bojko MD Emergency Department Physician 366011 0 0 0 0 0 0 0 23300 0 389311 0 0 0 Enoch Darko MD Doctor 364673 0 0 0 0 0 0 0 10985 0 375658 0 0 0 Osman Qureshi Emergency Department Physician 468072 0 50960 0 0 0 0 0 23300 0 542332 0 0 0 Theodore Sherry MD Emergency Department Physician 395038 0 0 0 0 0 0 0 23300 0 418338 0 0 0 Deborah Parker Executive Vice President, Chief Clin 126407 0 100000 0 0 0 0 0 1655 0 228062 0 0 0 Deborah Gogliettino Senior Vice President, Human Resouce 141600 0 0 0 0 0 0 0 1159 0 142759 0 0 0 SCHEDULE J, PART I, LINE 3 ARRANGEMENT USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: THE BOARD OF TRUSTEES (THE "BOARD") APPOINTS AN EXECUTIVE COMPENSATION COMMMITTEE (THE "COMMITTEE") AND HAS DELEGATED THE RESPONSIBILITY OF COMPLETING AN ANNUAL MARKET ANALYSIS OF THE CEO'S COMPENSATION AND OTHER SENIOR EXECUTIVES AND COMPLETION OF THE CEO'S ANNUAL PERFORMANCE REVIEW. THE EVALUATION OF THE CEO IS AN IMPORTANT RESPONSIBILITY OF THE BOARD AND IS CRITICAL TO THE GOVERNANCE RESPONSIBILITIES OF THE BOARD. THE EXECUTIVE COMPENSATION COMMITTEE SOLICITS FEEDBACK ABOUT THE PERFORMANCE OF THE CEO FROM EVERY ACTIVE BOARD MEMBER WHICH WHEN RECEIVED IS ANALYZED AND REVIEWED BY THE MEMBERS OF THE COMMITTEE. THE CEO COMPLETES A SELF-EVALUATION AND AN EVALUATION FOR ALL ELIGIBLE MEMBERS OF THE SENIOR LEADERSHIP TEAM, WHO COMPLETE BOTH A SELF-EVALUATION AND A PEER EVALUATION. THE RESULTS OF THE ASSESSMENTS COMPLETED BY MEMBERS OF THE SENIOR LEADERSHIP TEAM ARE REVIEWED BY THE CEO WHO DISCUSSES THE RESULTS WITH THE MEMBERS OF THE COMMITTEE ON AN ANNUAL BASIS. THE EXECUTIVE COMPENSATION COMMITTEE IN COLLABORATION WITH THE CEO EVALUATES AND APPROVES ORGANIZATIONAL PERFORMANCE OBJECTIVES BOTH ON AN ANNUAL AND LONG TERM BASIS AND FOCUSES ON THOSE GOALS WITH THE GREATEST IMPACT TO THE ORGANIZATION'S STRATEGY AND MISSION. THE COMMITTEE ENSURES AN ANNUAL REVIEW OF THE CEO'S PERFORMANCE IN RELATION TO THESE GOALS; REVIEWS THE TALLY SHEETS TO UNDERSTAND THE ECONOMICS OF THE EMPLOYEE BENEFITS; RETAINS AND ENSURES THE INDEPENDENCE OF ITS EXTERNAL CONSULTANTS AND ADVISORS AND INVOLVES RELEVANT ORGANIZATIONAL RESOURCES AS APPROPRIATE TO CARRY OUT ITS RESPONSIBILITIES. THE COMMITTEE ENSURES TRANSPARENCY AND DISCLOSURE TO THE BOARD BY PRESENTING THE RESULTS OF THE ANNUAL PERFORMANCE AND MARKET REVIEWS PROVIDING THE BOARD WITH THE OPPORTUNITY FOR FURTHER INPUT AND CONSIDERATION AND ASKING THAT THE BOARD TAKE ACTION ON THE RECOMMENDATION OF THE COMMITTEE IF THE RECOMMENDATION IS APPROPRIATE. THE BOARD HAS THE OPPORTUNITY TO CHANGE ANY RECOMMENDATIONS OF THE COMMITTEE IF IT SO DESIRES. MEMBERS OF THE BOARD AND OF THE COMMITTEE WHO MAY BE INTERESTED PARTIES ARE ASKED TO RECUSE THEMSELVES FROM ANY REQUIRED VOTES TO AVOID CONFLICTS OF INTEREST. THE COMMITTEE ENSURES THAT THE PROCESS MEETS COMPLIANCE STANDARDS. SCHEDULE J, PART I, LINE 5 THE ECHN EXECUTIVE INCENTIVE COMPENSATION PLAN IS A PLAN THAT HAS BEEN DEVELOPED, REVIEWED AND IS ANNUALLY APPROVED BY MEMBERS OF THE BOARD EXECUTIVE COMPENSATION COMMITTEE WITH CONSULTANT THIRD PARTY OVERSIGHT. THE PLAN ESTABLISHES GOALS IN 4 AREAS OF PERFORMANCE: SYSTEM-WIDE FINANCIAL PERFORMANCE BASED ON PROFIT FROM OPERATIONS, TWO QUALITY OUTCOMES IN CLINICAL CORE MEASURES AND PATIENT SATISFACTION AND AN INDIVIDUAL GOAL (WHICH HAS A SEPARATE MEASUREMENT FOR TEAM ASSESSMENT) FOR EACH MEMBER OF THE INCENTIVE PROGRAM. THERE IS NO EXECUTIVE COMPENSATION TIED TO THE REVENUES OF THE REPORTING ORGANIZATION OR OTHER RELATED ENTITIES. THERE IS EXECUTIVE COMPENSATION TIED TO THE NET EARNINGS (INCOME FROM OPERATIONS), AS NOTED IN THE PRIOR PARAGRAPH, HOWEVER IT IS ONE OF FOUR PERFORMANCE LEVERS THAT DETERMINE THE LEVEL OF COMPENSATION. THE AGGREGATE NET EARNINGS OF THE ECHN "SYSTEM NOT ANY ONE REPORTING ORGANIZATION OR RELATED ENTITIES OF ECHN DETERMINE THIS COMPENSATION. SO TO CONCLUDE, THE ANSWER TO THESE 4 QUESTIONS IS "NO" WITH THE CLARIFICATION THAT IT IS THE PERFORMANCE OF THE ENTIRE SYSTEM AS A WHOLE THAT DETERMINES EXECUTIVE COMPENSATION, NOT ONE REPORTING ORGANIZATION OR A RELATED ENTITY. MEMBERS OF THE INCENTIVE PROGRAM INCLUDE THE FOLLOWING: POSITION TITLE -KEY EMPLOYEE NAME PRESIDENT AND CEO -PETER J. KARL SVP, CHIEF FINANCIAL OFFICER -MICHAEL D. VEILLETTE SVP, HUMAN RESOURCES -DEBORAH GOGLIElTINO SVP, STRATEGIC PLANNING DENNIS MCCONVILLE SVP, CHIEF CLINICAL OFFICER -DEBORAH PARKER SVP, MEDICAL AFFAIRS -JOEL REICH, M.D. SVP, GENERAL COUNSEL -JOYCE TICHY Addendum for calendar year 2015: The ECHN Board of Trustees and the Board Compensation Committee replaced the executive short term incentive compensation program with a retention (or "stay") program pertaining to key senior ECHN executives. The purpose of this change was to ensure that the Prospect Medical Holdings (PMH) acquisition process be successfully executed through the closing date, and help provide a smooth transition of ownership. The move to this program and away from the short term incentive compensation structure was approved by the ECHN Board, as recommended by the Compensation Committee in the latter part of calendar year 2013. This decision was driven by the acquisition process and the Board's concern around executive departure. SCHEDULE J, PART II THE SALARY INFORMATION PROVIDED WITHIN SCHEDULE J REPRESENTS CALENDAR YEAR 2015 WAGES AND BENEFITS. Dr Dennis O'Neill Dr Michele Co Drs. O'Neill & Conlon MMH TRUSTEES, EACH OWN MORE THAN 5% OF ECPC. 416666 ECHN, INC. CONTRACTS WITH EASTERN CONNECTICUT PATHOLOGY CONSULTANTS, PC (ECPC), TO PROVIDE PATHOLOGY SERVICES AND LAB MANAGEMENT SERVICES TO MMH AND RGH. ALL PAYMENTS MADE TO ECPC ARE FOR PURPOSES OF OPERATING THE BUSINESS AND MAINTAINING OPERATING CASHFLOW. PAYMENTS ARE NOT DIRECTLY TO ANY OF THE OWNERS. 0 Kathleen O'Neill MMH TRUSTEE AND wife OF DR. DENNIS O'NEILL, TRUSTEE FOR ALL AFFILIates 0 ECHN TRUSTEE AND THE WIFE OF DR. DENNIS O'NEILL, TRUSTEE FOR ALL AFFILIATES, WHO HAS A REPORTABLE TRANSACTION AS NOTED ABOVE. 0 Anthony DiStefano MD MMH TRUSTEE AND SPOUSE OF LIZANNE DISTEFANO, RGH EMPLOYEE 0 LIZANNE DISTEFANO, SPOUSE, IS EMPLOYED BY ROCKVILLE GENERAL HOSPITAL (RGH), AN AFFILIATE OF ECHN. SALARY PAID TO LIZANNE DISTEFANO AS AN EMPLOYEE OF RGH. SALARY OF $22,469 WAS PAID BY RGH. 0 Wilson Vega Former MMH trustee and president of Connecticut Business Systems (CBS) 198613 CBS contracts with ECHN, Inc. to provide copier services to MMH and RGH. Payment of $198,613 from MMH to CBS and not directly to Wilson Vega. 0 Form 990, Part VI, Section A, line 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS: DENNIS O'NEILL AND MICHELE CONLON -BUSINESS RELATIONSHIP KATHLEEN O'NEILL AND DENNIS O'NEILL -FAMILY RELATIONSHIP. Form 990, Part VI, Section A, line 6 CLASSES OF MEMBERS OR STOCKHOLDERS: ECHN IS THE SOLE MEMBER OF THE ORGANIZATION. Form 990, Part VI, Section A, line 7a MEMBERS OR STOCKHOLDERS ELECTING MEMBERS OF GOVERNING BODY: ECHN HAS THE AUTHORITY TO ELECT TRUSTEES AND OFFICERS AND APPOINT COMMITTEE MEMBERS. Form 990, Part VI, Section A, line 7b DECISIONS REQUIRING APPROVAL BY MEMBERS OR STOCKHOLDERS: ECHN HAS VARIOUS POWERS INCLUDING BUT NOT LIMITED TO: APPROVING ALL OPERATING AND CAPITAL BUDGETS, CONTROLLING THE INVESTMENT OF FUNDS, LOCATION OF SERVICES, AGREEMENTS AND TRANSACTIONS, AFFILIATIONS, CHANGES, AMENDMENTS, OR RESTATEMENTS OF CERTIFICATES OF INCORPORATION AND BYLAWS, ADOPTING A SYSTEM-WIDE VISION AND STRATEGIC PLANS, AND APPROVING DEBT BORROWINGS. Form 990, Part VI, Section B, line 11 REVIEW OF FORM 990 BY GOVERNING BODY: PRIOR TO FILING THE 990, THE FOLLOWING STEPS ARE TAKEN: 1) THE ACCOUNTING MANAGER, TOGETHER WITH OTHER MEMBERS OF THE FINANCE DEPARTMENT, CONDUCT A REVIEW OF THE 990 ALONG WITH A REVIEW AND RECONCILIATION OF THE 990 TO THE AUDITED FINANCIAL STATEMENTS; 2) THE ACCOUNTING MANAGER CONDUCTS AN EXTENSIVE REVIEW AND DISCUSSION OF THE 990 WITH THE CPA FIRM THAT PREPARES THE RETURN; 3) AN ELECTRONIC COPY OF THE 990 IS MADE AVAILABLE TO THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES (THE GOVERNING BOARD), AND SENIOR MANAGEMENT OF THE ORGANIZATION, FOR REVIEW. Form 990, Part VI, Section B, line 12c ANNUALLY, THE CORPORATE COMPLIANCE/INTERNAL AUDIT DEPARTMENT PROVIDES TO OFFICERS, DIRECTORS, OR TRUSTEES AND KEY EMPLOYEES THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND DISCLOSURE STATEMENT. EACH INDIVIDUAL IS REQUIRED TO RETURN TO THE DEPARTMENT A SIGNED DOCUMENT, ACKNOWLEDGING RECEIPT OF THE POLICY AND DISCLOSURE STATEMENT AND DISCLOSE ANY INTERESTS THAT COULD GIVE RISE TO CONFLICTS. A SUMMARY OF THE DISCLOSURES IS SHARED WITH THE CHAIRMAN OF THE BOARD OF TRUSTEES AND WITH THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE OF THE BOARD. INDIVIDUALS WHO ARE IDENTIFIED AS HAVING A CONFLICT OF INTEREST ARE PROHIBITED FROM PARTICIPATING IN THE GOVERNING BODIES' DELIBERATIONS AND DECISIONS RELATED TO THE TRANSACTION. THE RETURNED STATEMENTS ARE RETAINED BY THE CORPORATE COMPLIANCE/INTERNAL AUDIT DEPARTMENT Form 990, Part VI, Section B, line 15 THE COMPENSATION COMMITTEE TAKES THE FOLLOWING STEPS WITH AN INDEPENDENT COMPENSATION CONSULTANT (1) REVIEWS DATA RELATED TO CURRENT MARKET VALUES CONSISTENT FOR ORGANIZATION'S EXECUTIVES BY REVIEW OF COMPENSATION LEVELS AND PLANS CONSISTENT WITH HOSPITALS AND HEALTH SYSTEMS OF COMPARABLE SIZE AND LOCATION; (2) COMPLETES A REVIEW OF DATA ON CURRENT AND FUTURE PLANS FOR THE ORGANIZATION, INCLUDING STRUCTURE AND JOB DESCRIPTIONS; (3) REVIEWS AND APPROVES AND RECOMMENDS SALARY RANGES FOR EACH POSITION, ALONG WITH RELATED BENEFITS; (4) REVIEWS AND APPROVES A TIERED EXECUTIVE STRUCTURE WITH APPROPRIATE INCENTIVE OPPORTUNITY, BENEFITS AND COMPENSATION. THE LAST COMPENSATION REVIEW OCCURRED 3/19/2015. Form 990, Part VI, Section C, line 19 THE ORGANIZATION, WILL, UPON REQUEST, ALLOW FOR REVIEW OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND MOST RECENT ANNUAL AUDITED FINANCIAL STATEMENTS AT AN OFFICE OF THE ORGANIZATION. Form 990, Part XI, line 9: Change in Beneficial Interest in Trust Assets 336,576. Change in interest rate swap agreement -8,164. Pension and Postretirement related adjustments -2,461,749. Net transfers from/(to) affiliates -965,052. VISITING NURSE & HEALTH SERVICES OF CT INC 8 KEYNOTE DRIVE VERNON CT 06066 060645795 HOME HEALTHCARE SERVICES CT 501(c)(3) Line 9 echn 1 EASTERN CONNECTICUT HEALTH NETWORK INC 71 HAYNES STREET MANCHESTER CT 06040 222546079 Integrated health care system parent Co CT 501(c)(3) 11 type iii-fi 0 ROCKVILLE GENERAL HOSPITAL INC 31 UNION STREET Rockville CT 06066 060653151 Hospital CT 501(c)(3) Line 3 ECHN 1 ECHN ELDERCARE SERVICES INC 26 SHENIPSIT LAKE ROAD Tolland CT 06084 061149193 Skilled Nursing Facility CT 501(c)(3) Line 9 ECHN 1 EASTERN CONNECTICUT MEDICAL PROFESSIONAL FOUNDATION iNc 71 HAYNES STREET MANCHESTER CT 06040 222546078 Physician Services CT 501(c)(3) Line 3 ECHN 1 ECHN COMMUNITY HEALTHCARE FOUNDATION INC 71 HAYNES STREET MANCHESTER CT 06040 222546080 Fundraising/Support CT 501(c)(3) Line 7 ECHN 1 MEDICAL PRACTICE PARTNERS LLC PO BOX 3830 vernon CT 06066 271498877 BILLING AND PRACTICE MANAGEMENT SERVICES CT N/A 0 0 ECHN ENTERPRISES INC 71 HAYNES STREET MANCHESTER CT 06040 222546828 real estate holding CT N/A C 1 HAYNES STREET PROPERTY MANAGEMENT LLC 71 HAYNES STREET MANCHESTER CT 06040 222546028 REAL ESTATE PROPERTY MANAGEMENT CT N/A C 1 CONNECTICUT HEALTHCARE INSURANCE COMPANY PO BOX 1109 cayman islands CJ 980623043 CAPTIVE INSURANCE CJ N/A C 1 ECHN CORPORATE SERVICES 71 HAYNES STREET MANCHESTER CT 06040 271596320 BILLING AND OTHER PRACTICE MANAGEMENT SERVICES CT N/A C 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 1 1 0 Eastern CT Medical Professionals Foundation J 385096 market value Haynes Street Property Management K 174728 market value Eastern CT Medical Professionals Foundation K 105368 market value Eastern CT Health Network L 45008 cost Eastern CT Health Network M 20891594 cost ECHN ElderCare Services Inc Q 1763513 cash transfer ECHN Community HealthCare Foundation Inc Q 1967934 cash transfer VISITING NURSE &HEALTH SERVICES OF CT INC Q 20354899 cash transfer Eastern CT Medical Professionals Foundation R 4215218 cash transfer ECHN Community HealthCare Foundation Inc M 63769 COST