L&M PHYSICIAN ASSOCIATION INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- L&M PHYSICIAN ASSOCIATION INC (EIN 27-1094375)
- Tax period
- 2015-10-01 to 2016-09-30
- Filed
- 2017-08-14
- IRS object ID
- 201742269349301139
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-08-14T10:57:00-05:00 | ReturnTs |
| Tax Period End | 2016-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135565207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE FINANCIAL PLAZA 755 MAIN STREET | AddressLine1Txt |
| City | HARTFORD | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 06103 | 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 | 271094375 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | L&M PHYSICIAN ASSOCIATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | L&MP | BusinessNameControlTxt |
| Phone | 2036886088 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 365 MONTAUK AVENUE | AddressLine1Txt |
| City | NEW LONDON | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 06320 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRUCE CUMMINGS | PersonNm |
| Person Title | SR.VP FINANCE | PersonTitleTxt |
| Phone | 2036886088 | PhoneNum |
| Signature | 2017-08-14 | SignatureDt |
| Discuss With Paid Preparer | 0 | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MARY-EVELYN ANTONETTI | PreparerPersonNm |
| PTIN | P00431862 | PTIN |
| Phone | 8602976085 | 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 | SETH VAN ESSENDELFT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 365 MONTAUK AVENUE | AddressLine1Txt |
| City | NEW LONDON | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 06320 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $36,644,108 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2009 | FormationYr |
| Legal Domicile State | CT | LegalDomicileStateCd |
| Activity Or Mission | PROMOTES AND FURTHERS THE WELFARE, PROGRAMS AND ACTIVITIES OF LAWRENCE & MEMORIAL HOSPITAL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 1 | VotingMembersIndependentCnt |
| Total Employee | 470 | TotalEmployeeCnt |
| Total Volunteers | 1 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $38,034,174 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $36,607,298 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | -$8,205 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $38,034,174 | PYTotalRevenueAmt |
| CY Total Revenue | $36,599,093 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | 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 | $44,051,706 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $43,019,774 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $15,885,809 | PYOtherExpensesAmt |
| CY Other Expenses | $16,100,446 | CYOtherExpensesAmt |
| PY Total Expenses | $59,937,515 | PYTotalExpensesAmt |
| CY Total Expenses | $59,120,220 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$21,903,341 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$22,521,127 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,588,832 | TotalAssetsBOYAmt |
| Total Assets EOY | $9,204,166 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,347,580 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,972,213 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$2,758,748 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $231,953 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO BENEFIT THE HEALTH STATUS OF THE COMMUNITY SERVED BY THE HOSPITAL THROUGH INTEGRATING VARIOUS PHYSICIANS AND OTHER HEALTHCARE PROFESSIONALS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $52,375,834 | ExpenseAmt |
| Revenue | $36,607,298 | RevenueAmt |
| Desc | L&M PHYSICIAN ASSOCIATION, INC. SUPPORTS LAWRENCE & MEMORIAL HOSPITAL AND LMW HEALTHCARE'S COMMITMENT TO ADVANCE THE HEALTH AND WELL-BEING OF THE INDIVIDUALS IN THE HOSPITALS' SERVICE AREA (WHICH IS GREATER NEW LONDON, CT AND WESTERLY, RI) BY ENGAGING PHYSICIANS TO PROVIDE PHYSICIAN SERVICES TO THE HOSPITALS AND ORGANIZATIONS AFFILIATED WITH THE HOSPITALS FOR THE PURPOSE OF PRACTICING MEDICINE AND PROVIDING HEALTH CARE SERVICES AS A MEDICAL FOUNDATION. | Desc |
| Total Program Service Expenses | $52,375,834 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | 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 | 0 | OperateHospitalInd |
| 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 | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | 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 | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 470 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 1 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DENIS DONEGAN | PersonNm |
| Phone | 2036886088 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 789 HOWARD AVENUE | AddressLine1Txt |
| City | NEW HAVEN | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 06519 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| BRUCE CUMMINGS | |||||||||
| EX-OFFICIO/TRUSTEE | 1.00 | 39.00 | Yes (X) | Yes (X) | $0 | $639,099 | $50,765 | ||
| BRENDA APPLEGATE | |||||||||
| TREASURER/TRUSTEE | 40.00 | 0.00 | Yes (X) | Yes (X) | $190,547 | $0 | $41,113 | ||
| ANTHONY CARTER | |||||||||
| SECRETARY/TRUSTEE | 39.00 | 1.00 | Yes (X) | Yes (X) | $298,613 | $0 | $45,500 | ||
| JON GAUDIO | |||||||||
| CHAIRMAN/TRUSTEE | 37.00 | 3.00 | Yes (X) | Yes (X) | $615,938 | $0 | $70,551 | ||
| CHRISTOPHER LEHRACH | |||||||||
| PRESIDENT/TRUSTEE | 1.00 | 39.00 | Yes (X) | Yes (X) | $0 | $401,811 | $62,721 | ||
| PRESTON LAMBERTON TILL 1215 | |||||||||
| CHAIRMAN/TRUSTEE | 38.00 | 2.00 | Yes (X) | Yes (X) | $188,067 | $0 | $28,326 | ||
| PAUL BOURGUIGNON | |||||||||
| TRUSTEE | 40.00 | 0.00 | Yes (X) | $320,766 | $0 | $41,631 | |||
| AMIT KHANNA | |||||||||
| TRUSTEE | 40.00 | 0.00 | Yes (X) | $414,931 | $0 | $37,109 | |||
| CHRISTY STANAT | |||||||||
| TRUSTEE | 40.00 | 0.00 | Yes (X) | $334,438 | $0 | $28,465 | |||
| ANTONIO TOLEDO | |||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| BRIAN WILLIAMS | |||||||||
| TRUSTEE | 40.00 | 0.00 | Yes (X) | $152,760 | $0 | $31,174 | |||
| MAUREEN ANDERSON | |||||||||
| ASSISTANT SECRETARY | 1.00 | 39.00 | Yes (X) | $0 | $285,844 | $74,161 | |||
| SETH VAN ESSENDELFT | |||||||||
| SR. VP/CFO | 1.00 | 39.00 | Yes (X) | $0 | $374,982 | $48,016 | |||
| ROSHANAK BAGHERI | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $568,413 | $0 | $61,185 | Yes (X) | |||
| PATRICK DOHERTY | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $1,742,255 | $0 | $61,489 | Yes (X) | |||
| SEPEHR SAJJAD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $614,368 | $0 | $20,676 | Yes (X) | |||
| ADRIAN HAMBURGER | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $777,864 | $0 | $67,942 | Yes (X) | |||
| MICHAEL HARWOOD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $512,291 | $0 | $64,056 | Yes (X) | |||
| ROBERT CIOTOLA THRU 1214 | |||||||||
| FORMER TRUSTEE | 0.00 | 0.00 | $173,829 | $0 | $40,854 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $6,905,080 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,701,736 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $875,734 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 16 | 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 |
|---|---|---|---|---|---|
| BERKELEY RESEARCH GROUP LLC | |||||
| 220 POWELL STREET SUITE 1200 | EMERYVILLE | CA | 94608 | CONSULTING SERVICE | $995,564 |
| STAFF CARE INC | |||||
| 8840 CYPRESS WATERS BLVD 300 | COPPELL | TX | 75019 | STAFFING SERVICE | $267,230 |
| THERACOM LLC | |||||
| 9717 KEY WEST AVE | ROCKVILLE | MD | 20850 | DATA PROCESSING | $166,867 |
| DIVERSIFIED BUILDING SERVICES LLC | |||||
| 69 N TURNPIKE RD 2 | WALLINGFORD | CT | 06492 | CLEANING SERVICE | $149,915 |
| IPC HOSPITALISTS OF NEW ENGLAND PC | |||||
| 365 MONTAUK AVE | NEW LONDON | CT | 06320 | MEDICAL SERVICE | $149,910 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 621110 | $28,508,756 | $28,508,756 |
| PURCHASED SERVICES | 621110 | $8,098,542 | $8,098,542 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $36,607,298 | TotalProgramServiceRevenueAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $36,810 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $45,015 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$8,205 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$8,205 | TotalRevenueColumnAmt |
| Exclusion | -$8,205 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $36,599,093 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $36,607,298 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$8,205 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,264,704 | TotalAmt |
| Program Services | $2,986,502 | ProgramServicesAmt |
| Management And General | $278,202 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,139,040 | TotalAmt |
| Program Services | $30,315,096 | ProgramServicesAmt |
| Management And General | $2,823,944 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $859,198 | TotalAmt |
| Program Services | $785,981 | ProgramServicesAmt |
| Management And General | $73,217 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,777,970 | TotalAmt |
| Program Services | $3,456,030 | ProgramServicesAmt |
| Management And General | $321,940 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,978,862 | TotalAmt |
| Program Services | $1,810,233 | ProgramServicesAmt |
| Management And General | $168,629 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $111,359 | TotalAmt |
| Management And General | $111,359 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,393 | TotalAmt |
| Management And General | $27,393 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,879,330 | TotalAmt |
| Program Services | $3,546,736 | ProgramServicesAmt |
| Management And General | $332,594 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,449 | TotalAmt |
| Management And General | $11,449 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $414,535 | TotalAmt |
| Program Services | $378,951 | ProgramServicesAmt |
| Management And General | $35,584 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135,795 | TotalAmt |
| Management And General | $135,795 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,097,945 | TotalAmt |
| Program Services | $2,940,667 | ProgramServicesAmt |
| Management And General | $157,278 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $174,650 | TotalAmt |
| Program Services | $169,251 | ProgramServicesAmt |
| Management And General | $5,399 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $664,987 | TotalAmt |
| Program Services | $664,987 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,692,754 | TotalAmt |
| Program Services | $2,692,754 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PURCHASED SERVICES | $3,104,365 | $853,972 | $2,250,393 |
| MEDICAL & SURGICAL | $1,634,976 | $1,634,976 | $0 |
| EQUIPMENT RENTAL & MAIN | $65,933 | $64,746 | $1,187 |
| PACKAGE AND SHIPPING | $64,297 | $54,537 | $9,760 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,678 | TotalAmt |
| Program Services | $20,415 | ProgramServicesAmt |
| Management And General | $263 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,120,220 | TotalAmt |
| Program Services | $52,375,834 | ProgramServicesAmt |
| Management And General | $6,744,386 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,742,691 | BOYAmt |
| EOY | $383,055 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $997,949 | BOYAmt |
| EOY | $1,516,604 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $84,040 | BOYAmt |
| EOY | $51,075 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,453,821 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,835,034 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,040,689 | BOYAmt |
| EOY | $3,618,787 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,723,463 | BOYAmt |
| EOY | $3,634,645 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,588,832 | BOYAmt |
| EOY | $9,204,166 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $201,568 | BOYAmt |
| EOY | $1,001,084 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,146,012 | BOYAmt |
| EOY | $7,971,129 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,347,580 | BOYAmt |
| EOY | $8,972,213 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$2,758,748 | BOYAmt |
| EOY | $231,953 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$2,758,748 | BOYAmt |
| EOY | $231,953 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,588,832 | BOYAmt |
| EOY | $9,204,166 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$22,521,127 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $25,511,828 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | 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 | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | L&M HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 060646704 | EIN |
| Organization Type | 3 | OrganizationTypeCd |
| Governing Document Listed | Yes (1) | GoverningDocumentListedInd |
| Support | $0 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | 0 | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | 0 | OperateBenefitNonSuprtOrgInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART IV, SECTION B, LINE 1 | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION'S SUPPORTED ORGANIZATION IS LAWRENCE & MEMORIAL HOSPITAL ("L&M HOSPITAL OR THE HOSPITAL"). THE HOSPITAL'S PARENT, LAWRENCE & MEMORIAL CORPORATION (THE "CORPORATION OR THE "SYSTEM PARENT"), HAS THE RIGHT TO APPOINT THE BOARD OF DIRECTORS OF THE ORGANIZATION. THE SYSTEM PARENT OVERSEES A COMPREHENSIVE AND INTEGRATED HEALTH CARE DELIVERY SYSTEM OPERATED BY THE SYSTEM'S AFFILIATED ENTITIES, INCLUDING THE HOSPITAL AND THE ORGANIZATION. THE SYSTEM PARENT IS ALSO A SUPPORTING ORGANIZATION TO THE HOSPITAL. IN ADDITION, THE MAJORITY OF THE ORGANIZATION'S OFFICERS ARE ALSO OFFICERS OR KEY EMPLOYEES OF THE HOSPITAL. THEREFORE, THE HOSPITAL, THROUGH ITS PARENT AND THROUGH ITS EMPLOYEES, IS ABLE TO EFFECTIVELY OPERATE, SUPERVISE AND CONTROL THE ORGANIZATION'S ACTIVITIES. EFFECTIVE AS OF SEPTEMBER 8, 2016, LAWRENCE + MEMORIAL CORPORATION AFFILIATED WITH THE YALE NEW HAVEN HEALTH SYSTEM, AND YALE NEW HAVEN HEALTH SERVICES CORPORATION BECAME THE SOLE MEMBER OF LAWRENCE + MEMORIAL CORPORATION. | ExplanationTxt |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,332,390 | OtherCostOrOtherBasisAmt |
| Depreciation | $621,325 | DepreciationAmt |
| Book Value | $711,065 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,121,431 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,213,709 | DepreciationAmt |
| Book Value | $2,907,722 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,618,787 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER NOTES & LOANS RECEIVABLE | Desc |
| Book Value | $3,634,645 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $3,634,645 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| RESERVE ACCOUNTS | $4,635,005 |
| SALARIES, WAGES, P/R TAXES | $3,330,580 |
| DUE TO THIRD PARTY | $5,544 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $7,971,129 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D,PART X, LINE 2 | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS DO NOT INCLUDE A FIN 48 FOOTNOTE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | 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 (18 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRUCE CUMMINGS | ||||||||||||||
| EX-OFFICIO/TRUSTEE | $0 | $505,747 | $0 | $0 | $0 | $133,352 | $0 | $10,600 | $0 | $40,165 | $0 | $689,864 | $0 | $0 |
| BRENDA APPLEGATE | ||||||||||||||
| TREASURER/TRUSTEE | $149,007 | $0 | $33,560 | $0 | $7,980 | $0 | $7,155 | $0 | $33,958 | $0 | $231,660 | $0 | $0 | $0 |
| ANTHONY CARTER | ||||||||||||||
| SECRETARY/TRUSTEE | $297,923 | $0 | $0 | $0 | $690 | $0 | $10,600 | $0 | $34,900 | $0 | $344,113 | $0 | $0 | $0 |
| JON GAUDIO | ||||||||||||||
| CHAIRMAN/TRUSTEE | $324,334 | $0 | $276,226 | $0 | $15,378 | $0 | $10,600 | $0 | $59,951 | $0 | $686,489 | $0 | $0 | $0 |
| CHRISTOPHER LEHRACH | ||||||||||||||
| PRESIDENT/TRUSTEE | $0 | $382,176 | $0 | $0 | $0 | $19,635 | $0 | $10,600 | $0 | $52,121 | $0 | $464,532 | $0 | $0 |
| PRESTON LAMBERTON TILL 1215 | ||||||||||||||
| CHAIRMAN/TRUSTEE | $131,219 | $0 | $46,318 | $0 | $10,530 | $0 | $5,150 | $0 | $23,176 | $0 | $216,393 | $0 | $0 | $0 |
| PAUL BOURGUIGNON | ||||||||||||||
| TRUSTEE | $257,446 | $0 | $51,480 | $0 | $11,840 | $0 | $10,600 | $0 | $31,031 | $0 | $362,397 | $0 | $0 | $0 |
| AMIT KHANNA | ||||||||||||||
| TRUSTEE | $254,393 | $0 | $142,238 | $0 | $18,300 | $0 | $10,600 | $0 | $26,509 | $0 | $452,040 | $0 | $0 | $0 |
| CHRISTY STANAT | ||||||||||||||
| TRUSTEE | $316,729 | $0 | $0 | $0 | $17,709 | $0 | $10,600 | $0 | $17,865 | $0 | $362,903 | $0 | $0 | $0 |
| BRIAN WILLIAMS | ||||||||||||||
| TRUSTEE | $102,758 | $0 | $31,357 | $0 | $18,645 | $0 | $6,890 | $0 | $24,284 | $0 | $183,934 | $0 | $0 | $0 |
| MAUREEN ANDERSON | ||||||||||||||
| ASSISTANT SECRETARY | $0 | $269,134 | $0 | $0 | $0 | $16,710 | $0 | $10,600 | $0 | $63,561 | $0 | $360,005 | $0 | $0 |
| SETH VAN ESSENDELFT | ||||||||||||||
| SR. VP/CFO | $0 | $356,172 | $0 | $0 | $0 | $18,810 | $0 | $10,600 | $0 | $37,416 | $0 | $422,998 | $0 | $0 |
| ROSHANAK BAGHERI | ||||||||||||||
| PHYSICIAN | $308,348 | $0 | $236,119 | $0 | $23,946 | $0 | $10,600 | $0 | $50,585 | $0 | $629,598 | $0 | $0 | $0 |
| PATRICK DOHERTY | ||||||||||||||
| PHYSICIAN | $730,709 | $0 | $994,761 | $0 | $16,785 | $0 | $5,863 | $0 | $55,626 | $0 | $1,803,744 | $0 | $0 | $0 |
| SEPEHR SAJJAD | ||||||||||||||
| PHYSICIAN | $532,243 | $0 | $68,199 | $0 | $13,926 | $0 | $3,028 | $0 | $17,648 | $0 | $635,044 | $0 | $0 | $0 |
| ADRIAN HAMBURGER | ||||||||||||||
| PHYSICIAN | $311,287 | $0 | $450,917 | $0 | $15,660 | $0 | $10,600 | $0 | $57,342 | $0 | $845,806 | $0 | $0 | $0 |
| MICHAEL HARWOOD | ||||||||||||||
| PHYSICIAN | $259,388 | $0 | $235,933 | $0 | $16,970 | $0 | $10,600 | $0 | $53,456 | $0 | $576,347 | $0 | $0 | $0 |
| ROBERT CIOTOLA THRU 1214 | ||||||||||||||
| FORMER TRUSTEE | $127,023 | $0 | $21,968 | $0 | $24,838 | $0 | $7,421 | $0 | $33,433 | $0 | $214,683 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | LAWRENCE + MEMORIAL HOSPITAL, INC., A RELATED ORGANIZATION'S EXECUTIVE COMPENSATION COMMITTEE ANNUALLY REVIEWS THE SALARIES OF ITS EXECUTIVE MANAGEMENT AND KEY EMPLOYEES. UTILIZING INDEPENDENT COMPENSATION CONSULTANTS, THE EXECUTIVE COMPENSATION COMMITTEE MAKES ITS RECOMMENDATIONS. |
| PART I, LINE 4B | LAWRENCE & MEMORIAL HOSPITAL (A RELATED ORGANIZATION) ESTABLISHED A SECTION 457(F) SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR THE HOSPITAL'S SENIOR MANAGEMENT. AMOUNTS FOR BRUCE CUMMINGS ARE CREDITED TO THE RETIREMENT ACCOUNT IN MONTHLY INSTALLMENTS THROUGHOUT EACH PLAN YEAR. PLAN AMOUNTS FOR ALL OTHER MEMBERS OF SENIOR MANAGEMENT ARE CREDITED TO THE PLAN ANNUALLY. PLAN AMOUNTS WILL BE PAID ONLY IF CERTAIN CONDITIONS ARE MET, INCLUDING REMAINING EMPLOYED BY THE HOSPITAL THROUGH AGE 65, AS OUTLINED IN THE PLAN AGREEMENT. SECTION 457 (F) CONTRIBUTIONS ARE PAID OUT AND REPORTED ON THEIR W-2'S. DURING 2015, SECTION 457(F) CONTRIBUTIONS WERE CREDITED TOWARDS THE PLAN AS FOLLOWS: BRUCE CUMMINGS $86,945 |
| PART I, LINE 7 | BONUSES ARE PROVIDED AT THE DISCRETION OF SENIOR MANAGEMENT. THE CALCULATION IS BASED ON A RELATIVE VALUE UNIT PRODUCTIVITY MODEL AND OTHER PERFORMANCE MEASURES. |
| SCHEDULE J, PART II | BOARD MEMBERS ROBERT CIOTOLA, MD, JON GAUDIO, MD, BRENDA APPLEGATE, MD, CRISTY STANAT, MD, BRIAN WILLIAMS, MD, R. PRESTON LAMBERTON MD, H. ANTHONY CARTER MD, AMIT KHANNA, MD AND PAUL BOURGUIGNON MD, RECEIVE COMPENSATION FROM THE ORGANIZATION FOR THEIR SERVICES AS PHYSICIANS, NOT AS BOARD MEMBERS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI | PART I, LINE 4 & PART VI, LINE 1B NUMBER OF INDEPENDENT VOTING MEMBERS OF THE GOVERNING BODY THE ORGANIZATION SOUGHT TO CONFIRM THE INDEPENDENCE OF EACH VOTING MEMBER OF ITS GOVERNING BODY BY REQUESTING THAT EACH SUCH VOTING MEMBER RESPOND TO A QUESTIONNAIRE CONTAINING THE PERTINENT INSTRUCTIONS AND DEFINITIONS AND DESIGNED TO ELICIT THE INFORMATION NECESSARY TO DETERMINE INDEPENDENCE. BASED ON RESPONSES TO THE QUESTIONNAIRES RECEIVED BY THE ORGANIZATION AND ANNUAL CONFLICTS OF INTEREST DISCLOSURES, THE ORGANIZATION WAS ABLE TO CONFIRM THAT ONE (1) VOTING MEMBER IS INDEPENDENT. THE ORGANIZATION IS A RELATED ORGANIZATION OF LAWRENCE + MEMORIAL CORPORATION. PURSUANT TO ITS BYLAWS, THE ORGANIZATION'S EXECUTIVE DIRECTOR AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF LAWRENCE + MEMORIAL CORPORATION SERVE AS EX-OFFICIO MEMBERS OF THE BOARD OF TRUSTEES OF THE ORGANIZATION. ALL OTHER DIRECTORS ARE APPOINTED BY LAWRENCE + MEMORIAL CORPORATION. THE ORGANIZATION'S BYLAWS FURTHER REQUIRE THAT AT LEAST HALF OF THE DIRECTORS BE PHYSICIANS, WHO ARE TYPICALLY EMPLOYED BY THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 2 | BUSINESS RELATIONSHIPS BETWEEN OFFICERS, DIRECTORS, TRUSTEES, OR KEY EMPLOYEES THE ORGANIZATION'S CURRENT OFFICERS AND/OR TRUSTEES SERVE AS OFFICERS AND/OR DIRECTORS OF TAXABLE AFFILIATES WITHIN THE ORGANIZATION'S CORPORATE SYSTEM OR JOINT VENTURES IN WHICH THE ORGANIZATION'S CORPORATE SYSTEM HAS AN OWNERSHIP INTEREST. THE INDIVIDUAL OFFICERS DO NOT HAVE PERSONAL FINANCIAL INTERESTS IN THE TAXABLE AFFILIATE AND SERVE ONLY AS A FUNCTION OF THEIR ROLES WITH THE ORGANIZATION OR WITHIN THE ORGANIZATION'S CORPORATE SYSTEM. |
| FORM 990, PART VI, SECTION A, LINE 4 | EFFECTIVE SEPTEMBER 8, 2016, LAWRENCE + MEMORIAL CORPORATION ("LMC") AND ITS RELATED ORGANIZATIONS BECAME AFFILIATED WITH THE YALE NEW HAVEN HEALTH SYSTEM PURSUANT TO THE TERMS OF AN AFFILIATION AGREEMENT BETWEEN LMC AND YALE NEW HAVEN HEALTH SERVICES CORPORATION ("YNHHSC") DATED AS OF JULY 17, 2015 (THE "AFFILIATION AGREEMENT"). AS A RESULT OF THE CLOSING OF THE AFFILIATION TRANSACTION, YNHHSC BECAME THE SOLE MEMBER OF LMC. ADDITIONALLY, THE CERTIFICATES OF INCORPORATION AND BYLAWS OF LMC AND ITS SUBSIDIARIES LAWRENCE + MEMORIAL HOSPITAL, LMW HEALTHCARE, INC., L+M PHYSICIAN ASSOCIATION, INC. AND VISITING NURSE ASSOCIATION OF SOUTHEASTERN CONNECTICUT, INC. WERE REVISED AS AGREED UPON IN THE AFFILIATION AGREEMENT TO REFLECT YNHHSC AS THE ULTIMATE CORPORATE PARENT AND DESCRIBE THE RETAINED POWERS AND OF YNHHSC CONSISTENT WITH ITS OTHER AFFILIATED ENTITIES. |
| FORM 990, PART VI, SECTION A, LINE 6 | L&M CORPORATION IS THE SOLE CORPORATE MEMBER OF L&M PHYSICIAN ASSOCIATION, INC. (LMPA). |
| FORM 990, PART VI, SECTION A, LINE 7A | THE LMPA BOARD MEMBERS ARE ELECTED BY THE BOARD OF L&M CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE SOLE MEMBER OF THE ORGANIZATION HAS THE POWER TO ACCEPT OR REJECT THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE ORGANIZATION; AND TO APPROVE, UPON RECOMMENDATION OF THE BOARD, SIGNIFICANT FUNDRAISING PROGRAMS AND SALE OR DISPOSITION OF ANY ASSETS AND THE INCURRING OF INDEBTEDNESS IN SPECIFIC SITUATIONS. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PREPARED BY THE ORGANIZATION AND REVIEWED BY THE EXTERNAL TAX CONSULTANTS. A DRAFT OF THE RETURN IS PROVIDED TO MANAGEMENT FOR REVIEW. ANY NECESSARY CHANGES ARE MADE PRIOR TO THE FINAL REVIEW AND SIGNING OF THE RETURN BY THE ORGANIZATION'S INDEPENDENT TAX CONSULTANTS. THE FINAL FORM 990 IS PROVIDED TO THE BOARD PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | LMPA REQUIRES ALL BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. QUESTIONNAIRES ARE COMPLETED ANNUALLY AND ARE REVIEWED BY L&M HOSPITAL'S GENERAL COUNSEL. ANY ACTUAL OR POTENTIAL CONFLICTS DISCLOSED ARE PRESENTED TO THE BOARD. APPROPRIATE CORRECTIVE ACTIONS ARE DECIDED ON A CASE BY CASE BASIS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE OFFICERS COMPENSATION AND BENEFITS REPORTED IN PART VII ARE DETERMINED BY L&M HOSPITAL. L&M HOSPITAL EXECUTIVE COMPENSATION COMMITTEE ANNUALLY REVIEWS THE SALARIES OF ITS EXECUTIVE MANAGEMENT AND KEY EMPLOYEES. UTILIZING INDEPENDENT COMPENSATION CONSULTANTS THE EXECUTIVE COMPENSATION COMMITTEE MAKES ITS RECOMMENDATIONS. THE COMMITTEE'S DELIBERATIONS ARE REFLECTED IN ITS MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL DOCUMENTS AVAILABLE UPON REQUEST. |
| PART VII SECTION A. | ROBERT CIOTOLA LEFT THE BOARD AS OF 12/2014. HOWEVER, HE WAS COMPENSATED FOR BEING AN EMPLOYEE IN L& M PHYSICIAN ASSOCIATION, INC. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (23 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ASSOCIATED SPECIALISTS OF SOUTHEASTERN CONNECTICUT INC | |||||||||||
| 365 MONTAUK AVENUE | NEW LONDON | CT | 06320 | 208006123 | HEALTHCARE SERVICES | CT | 501C3 | LINE 11A, I | LAWRENCE MEMORIAL HOSPITAL INC | Yes (1) | |
| BRIDGEPORT HOSPITAL | |||||||||||
| 267 GRANT STREET | BRIDGEPORT | CT | 06610 | 060646554 | HEALTHCARE SERVICES | CT | 501C3 | LINE 3 | YALE NEW HAVEN HEALTH SERVICES CORP | 0 | |
| BRIDGEPORT HOSPITAL AUXILIARY INC | |||||||||||
| 267 GRANT STREET | BRIDGEPORT | CT | 06610 | 066042500 | SYSTEM SUPPORT SERVICES | CT | 501C3 | LINE 11A, I | BRIDGEPORT HOSPITAL | Yes (1) | |
| BRIDGEPORT HOSPITAL FOUNDATION INC | |||||||||||
| 267 GRANT STREET | BRIDGEPORT | CT | 06610 | 222908698 | SYSTEM SUPPORT SERVICES | CT | 501C3 | LINE 7 | BRIDGEPORT HOSPITAL | Yes (1) | |
| BRIDGEPORT HOSPITAL FRIENDS OF PEDIATRICS INC | |||||||||||
| 120 COLUMBINE DRIVE | TRUMBULL | CT | 06611 | 066048427 | SYSTEM SUPPORT SERVICES | CT | 501C3 | LINE 11A, I | YALE NEW HAVEN HOSPITAL | Yes (1) | |
| GREENWICH HEALTH CARE SERVICES INC - MERGED WITH GH 5122016 | |||||||||||
| 5 PERRYRIDGE ROAD | GREENWICH | CT | 06830 | 222593399 | SYSTEM SUPPORT SERVICES | CT | 501C3 | LINE 11B, II | YALE NEW HAVEN HEALTH SERVICES CORP | 0 | |
| GREENWICH HOSPITAL | |||||||||||
| 5 PERRYRIDGE ROAD | GREENWICH | CT | 06830 | 060646659 | HEALTHCARE SERVICES | CT | 501C3 | LINE 3 | SEE SCHEDULE R PART VII | 0 | |
| LAWRENCE MEMORIAL CORPORATION | |||||||||||
| 365 MONTAUK AVENUE | NEW LONDON | CT | 06320 | 222553028 | PROMOTE HEALTHCARE | CT | 501C3 | LINE 9 | YALE NEW HAVEN HEALTH SERVICES CORP | 0 | |
| LAWRENCE AND MEMORIAL FOUNDATION INC | |||||||||||
| 365 MONTAUK AVENUE | NEW LONDON | CT | 06320 | 222553026 | FUNDRAISING SERVICES | CT | 501C3 | PF | LAWRENCE MEMORIAL CORPORATION | Yes (1) | |
| LAWRENCE MEMORIAL HOSPITAL INC | |||||||||||
| 365 MONTAUK AVENUE | NEW LONDON | CT | 06320 | 060646704 | HEALTHCARE SERVICES | CT | 501C3 | LINE 3 | LAWRENCE MEMORIAL CORPORATION | Yes (1) | |
| LMW HEALTHCARE INC | |||||||||||
| 365 MONTAUK AVENUE | NEW HAVEN | CT | 06320 | 460543230 | HEALTHCARE SERVICES | RI | 501C3 | LINE 3 | LAWRENCE MEMORIAL CORPORATION | Yes (1) | |
| NORTHEAST MEDICAL GROUP INC | |||||||||||
| 99 HAWLEY LANE | STRATFORD | CT | 06614 | 061330992 | HEALTHCARE SERVICES | CT | 501C3 | LINE 9 | YALE NEW HAVEN HEALTH SERVICES CORP | 0 | |
| NORTHEAST MEDICAL GROUP PLLC | |||||||||||
| 99 HAWLEY LANE | STRATFORD | CT | 06614 | 352380180 | HEALTHCARE SERVICES | CT | 501C3 | LINE 11A, I | NORTHEAST MEDICAL GROUP INC | Yes (1) | |
| PERRYRIDGE CORPORATION | |||||||||||
| 5 PERRYRIDGE ROAD | GREENWICH | CT | 06830 | 061207316 | SYSTEM SUPPORT SERVICES | CT | 501C3 | LINE 11B, II | SEE SCHEDULE R PART VII | Yes (1) | |
| SOUTHERN CONNECTICUT HEALTH SYSTEM PROPERTIES INC | |||||||||||
| 267 GRANT STREET | BRIDGEPORT | CT | 06610 | 061297708 | TITLE HOLDING | CT | 501C2 | BRIDGEPORT HOSPITAL | Yes (1) | ||
| THE GREENWICH HOSPITAL ENDOWMENT FUND INC | |||||||||||
| 5 PERRYRIDGE ROAD | GREENWICH | CT | 06830 | 061526642 | SYSTEM SUPPORT SERVICES | CT | 501C3 | LINE 11B, II | SEE SCHEDULE R PART VII | Yes (1) | |
| THE WESTERLY HOSPITAL FOUNDATION INC | |||||||||||
| 25 WELLS STREET | WESTERLY | RI | 02891 | 050508064 | FUNDRAISING SERVICES | RI | 501C3 | LINE 11A, I | LMW HEALTHCARE INC | Yes (1) | |
| VISITING NURSE ASSOCIATION OF SOUTHEREASTERN CONNECTICUT INC | |||||||||||
| 403 NORTH FRONTAGE ROAD | WATERFORD | CT | 06385 | 060646616 | HOME HEALTHCARE SERVICES | CT | 501C3 | LINE 9 | LAWRENCE MEMORIAL CORPORATION | Yes (1) | |
| WESTERLY HOSPITAL AUXILIARY INC | |||||||||||
| 25 WELLS STREET | WESTERLY | RI | 02891 | 222507181 | FUNDRAISING ACTIVITIES | RI | 501C3 | LINE 11C, III-FI | LMW HEALTHCARE INC | Yes (1) | |
| YALE NEW HAVEN HEALTH SERVICES CORP | |||||||||||
| 789 HOWARD AVE | NEW HAVEN | CT | 06519 | 222529464 | SYSTEM SUPPORT SERVICES | CT | 501C3 | LINE 11A, I | 0 | N/A | |
| YALE NEW HAVEN HOSPITAL | |||||||||||
| 20 YORK STREET | NEW HAVEN | CT | 06504 | 060646652 | HEALTHCARE SERVICES | CT | 501C3 | LINE 3 | YALE NEW HAVEN HEALTH SERVICES CORP | 0 | |
| YALE-NEW HAVEN CARE CONTINUUM CORP | |||||||||||
| 789 HOWARD AVE | NEW HAVEN | CT | 06519 | 455235566 | NURSING HOME | CT | 501C3 | LINE 3 | YALE NEW HAVEN HOSPITAL | Yes (1) | |
| L&M HEALTHCARE INC | |||||||||||
| 365 MONTAUK AVENUE | NEW LONDON | CT | 06320 | 222553031 | SYSTEM SUPPORT SERVICES | CT | 501C3 | LINE 11A, I | LAWRENCE MEMORIAL CORPORATION | Yes (1) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| SHORELINE SURGERY CENTER LLC | |||||||
| 111 GOOSE LANE | GUILFORD | CT | 06437 | 900110459 | HEALTHCARE SERVICES | CT | N/A |
| SSC II LLC | |||||||
| 111 GOOSE LANE | GUILFORD | CT | 06437 | 261709382 | HEALTHCARE SERVICES | CT | N/A |
| ORTHOPAEDIC & NEUROSURGERY CENTER | |||||||
| 55 HOLLY HILL LANE | GREENWICH | CT | 06830 | 273477197 | HEALTHCARE SERVICES | CT | N/A |
| TOTAL HEALTH CONNECTICUT LLC | |||||||
| 789 HOWARD AVENUE | NEW HAVEN | CT | 06519 | 474070024 | HEALTHCARE SERVICES | CT | N/A |
| YALE NEW HAVEN HEALTH SYSTEM INVESTMENT | |||||||
| 20 YORK STREET | NEW HAVEN | CT | 06510 | 271374301 | INVESTMENT | DE | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (15 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 | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| YNHHS-MSO INC | |||||||||||||
| 789 HOWARD AVE | NEW HAVEN | CT | 06519 | 061467717 | MANAGEMENT SERVICES | CT | N/A | C | Yes (1) | ||||
| YALE NEW HAVEN AMBULATORY SERVICES | |||||||||||||
| 40 TEMPLE STREET | NEW HAVEN | CT | 06510 | 061398526 | HEALTHCARE SERVICES | CT | N/A | C | Yes (1) | ||||
| MEDICAL CENTER REALTY INC | |||||||||||||
| 50 YORK STREET | NEW HAVEN | CT | 06511 | 061110858 | RENTAL SERVICES | CT | N/A | C | Yes (1) | ||||
| GREENWICH FERTILITY & IVF PC | |||||||||||||
| 5 PERRYRIDGE ROAD | GREENWICH | CT | 06830 | 300145464 | HEALTHCARE SERVICES | CT | N/A | C | Yes (1) | ||||
| YORK ENTERPRISES INC | |||||||||||||
| 50 YORK STREET | NEW HAVEN | CT | 06511 | 061110937 | TITLE HOLDING | CT | N/A | C | Yes (1) | ||||
| YNHH-PHYSICIANS CORP | |||||||||||||
| 789 HOWARD AVE | NEW HAVEN | CT | 06519 | 061202305 | ADMINISTRATIVE SERVICES | CT | N/A | C | Yes (1) | ||||
| MEDICAL CENTER PHARMACY INC | |||||||||||||
| 50 YORK STREET | NEW HAVEN | CT | 06511 | 061087673 | PHARMACY | CT | N/A | C | Yes (1) | ||||
| GREENWICH OCCUPATIONAL HEALTH SERVICES OF NY PC | |||||||||||||
| 5 PERRYRIDGE ROAD | GREENWICH | CT | 06830 | 061540101 | HEALTHCARE SERVICES | NY | N/A | C | Yes (1) | ||||
| GREENWICH OCCUPATIONAL HEALTH SERVICES OF NEW JERSEY | |||||||||||||
| 5 PERRYRIDGE ROAD | GREENWICH | CT | 06830 | 453833883 | HEALTHCARE SERVICES | NJ | N/A | C | Yes (1) | ||||
| PRIMARYNET OF CONNECTICUT INC- TERMINATED 93016 | |||||||||||||
| 789 HOWARD AVE | NEW HAVEN | CT | 06519 | 061463534 | HEALTHCARE SERVICES | CT | N/A | C | Yes (1) | ||||
| CENTURY FINANCIAL SERVICES INC | |||||||||||||
| 23 MAIDEN LANE | NORTH HAVEN | CT | 06473 | 061110797 | DEBT COLLECTION SERVICES | CT | N/A | C | Yes (1) | ||||
| CENTURY MANAGEMENT SERVICES INC | |||||||||||||
| 23 MAIDEN LANE | NORTH HAVEN | CT | 06473 | 061303173 | RECEIVABLE MANAGEMENT SERVICES | CT | N/A | C | Yes (1) | ||||
| L & M SYSTEMS INC | |||||||||||||
| 365 MONTAUK AVENUE | NEW LONDON | CT | 06320 | 222553037 | HEALTHCARE RELATED SERVICES | CT | N/A | C | Yes (1) | ||||
| L&M HOME CARE SERVICES INC | |||||||||||||
| 365 MONTAUK AVENUE | NEW LONDON | CT | 06320 | 061389272 | HOME THERAPY | CT | N/A | C | Yes (1) | ||||
| LAWRENCE & MEMORIAL INDEMNITY COMPANY LTD | |||||||||||||
| 981021436 | INSURANCE | N/A | C | Yes (1) | PO BOX 1159 KY1-1102 | GRAND CAYMAN | CJ | CJ | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | 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 | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| LAWRENCE MEMORIAL HOSPITAL INC | ||
| S | $25,511,828 | CASH |
| LMW HEALTHCARE INC | ||
| S | $3,741,000 | CASH |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II, IDENTIFICATION OF RELATED TAX-EXEMPT ORGANIZATION: | FormAndLineReferenceDesc |
| Explanation | NAME OF RELATED ORGANIZATION: GREENWICH HOSPITAL DIRECT CONTROLLING ENTITY: GREENWICH HEALTH CARE SERVICES, INC. THROUGH 5/12/16, AFTER YALE NEW HAVEN HEALTH SERVICES CORPORATION. NAME OF RELATED ORGANIZATION: PERRYRIDGE CORPORATION DIRECT CONTROLLING ENTITY: GREENWICH HEALTH CARE SERVICES, INC. THROUGH 5/12/16, AFTER GREENWICH HOSPTIAL. NAME OF RELATED ORGANIZATION: THE GREENWICH HOSPITAL ENDOWMENT FUND INC DIRECT CONTROLLING ENTITY: GREENWICH HEALTH CARE SERVICES, INC. THROUGH 5/12/16, AFTER GREENWICH HOSPTIAL. | ExplanationTxt |
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