2017-08-14T15:23:36-05:00 2016-09-30 135565207 KPMG LLP 345 PARK AVENUE NEW YORK NY 101540102 990 2015-10-01 060646554 BRIDGEPORT HOSPITAL BRID 2036886088 267 GRANT STREET BRIDGEPORT CT 06610 JOHN SKELLY SR. VP AND TREASURER 2036886088 2017-08-14 0 ROBERT ROBINSON P00741489 2127589700 2015 2021-01-29 14:40:06Z JOHN SKELLY 267 GRANT ST BRIDGEPORT CT 06610 591385269 0 X WWW.BRIDGEPORTHOSPITAL.ORG X 1878 CT TO OPERATE AN ACUTE CARE HOSPITAL IN BRIDGEPORT, CONNECTICUT. 15 10 3106 332 1002307 -545637 2827511 3141705 466074249 472738316 744239 1170685 28760828 35186502 498406827 512237208 15000 5000 0 0 213856545 210410411 0 0 0 232570920 263087307 446442465 473502718 51964362 38734490 532166912 584917171 363602875 402692537 168564037 182224634 X TO OPERATE AN ACUTE CARE HOSPITAL IN BRIDGEPORT, CONNECTICUT FOR THE CARE AND TREATMENT OF PERSONS SUFFERING FROM DISEASE OR OTHER PHYSICAL OR MENTAL CONDITIONS WITHOUT REGARD TO RACE, COLOR, CREED, SEX, AGE OR ABILITY TO PAY. 0 0 382254346 5000 503075826 SCHEDULE OTHE HIGHLIGHT OF THE YEAR FOR BRIDGEPORT HOSPITAL WAS THE OPENING OF PARK AVENUE MEDICAL CENTER (PAMC) IN TRUMBULL OPENED IN MAY. PAMC COMBINED NEW AND EXISTING SERVICES ON A SINGLE CAMPUS, INCLUDING OUTPATIENT SURGERY AND GASTROENTEROLOGY SUITES, SPECIALTY PHYSICIAN OFFICES, A NORMA PFRIEM BREAST CENTER SATELLITE, AS WELL AS ANTENATAL TESTING, A LABORATORY DRAW STATION, OUTPATIENT RADIOLOGY, A YALE NEW HAVEN CHILDREN'S HOSPITAL SPECIALTY CENTER AND A SMILOW CANCER HOSPITAL CARE CENTER.ANOTHER NEW PROGRAM WAS THE TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVR) SURGERY PROGRAM WHICH BEGAN IN APRIL. TAVR IS AN EFFECTIVE HEART VALVE REPLACEMENT OPTION FOR OLDER OR HIGH-RISK PATIENTS NOT ELIGIBLE FOR SURGERY. THE ENHANCED RECOVERY AFTER SURGERY (ERAS) PROGRAM HAS INCREASED THE RECOVERY TIME FOR JOINT REPLACEMENT PATIENTS, DECREASED COMPLICATIONS AND SHORTENED THE AMOUNT OF TIME PATIENTS NEED TO STAY IN THE HOSPITAL.THE HOSPITAL EXPANDED ITS DIABETES PROGRAM IN THE PRIMARY CARE CENTER ON MILL HILL AVE. A NEW GERIATRIC INJURY INSTITUTE OPENED TO COORDINATE RESOURCES TO PREVENT FALLS AMONG OLDER PATIENTS. IN ADDITION, THE HOSPITAL OFFERED AN ENT SURGERY SERVICE FOR THE FIRST TIME, IMPROVING PATIENT ACCESS TO A HIGHER LEVEL OF EAR, NOSE AND THROAT CARE.IN ADDITION TO INVESTING IN ITS CLINICAL PROGRAMS, THE HOSPITAL ADDRESSED AGING BUILDING INFRASTRUCTURES AND FACILITY ENHANCEMENTS AND EXPANSIONS TO MEET GROWING PATIENT DEMAND. EAST TOWER 8 WAS RENOVATED TO ADD 19 MEDICAL/SURGICAL BEDS, THE PHARMACY WAS UPDATED AND THE EMERGENCY DEPARTMENT WAS RENOVATED. OTHER HOSPITAL INITIATIVES THIS YEAR REDUCED SERIOUS SAFETY EVENT RATES; IMPROVED EMPLOYEE ENGAGEMENT, DIVERSITY AND RECOGNITION; AND REALIZED OPERATIONAL AND COST EFFICIENCIES THROUGH CLINICAL REDESIGN INITIATIVES. 382254346 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 620 0 3106 1 1 1 0 0 0 0 0 0 0 0 0 X 15 10 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X DENIS DONEGAN 2036886088 789 HOWARD AVENUE NEW HAVEN CT 06519 NEWMAN MARSILIUS III CHAIRMAN/DIRECTOR 1.00 2.00 X X 0 0 0 GEORGE CARTER VICE CHAIRMAN/DIRECTOR 1.00 0.00 X X 0 0 0 JOHN FALCONI VICE CHAIRMAN/DIRECTOR 1.00 0.00 X X 0 0 0 RONALD NOREN VICE CHAIRMAN/DIRECTOR 1.00 0.00 X X 0 0 0 GARY ZIMMERMAN VICE CHAIRMAN/DIRECTOR 1.00 0.00 X X 27000 0 0 WILLIAM JENNINGS PRESIDENT & CEO/DIRECTOR 32.00 8.00 X X 908724 227181 317179 GAYLE CAPOZZALO DIRECTOR 1.00 39.00 X 0 1462558 38285 ED CASTILLO EFF 116 DIRECTOR 1.00 0.00 X 0 0 0 PETER HURST DIRECTOR 1.00 0.00 X 0 0 0 THOMAS LENCI DIRECTOR 1.00 0.00 X 0 0 0 MICK MAURER DIRECTOR 1.00 0.00 X 0 0 0 FRED MCKINNEY DIRECTOR 1.00 0.00 X 0 0 0 STEPHEN MARSHALKO THRU 1215 DIRECTOR 1.00 0.00 X 115438 0 0 DUNCAN O'BRIEN DIRECTOR 1.00 0.00 X 0 0 0 MEREDITH REUBEN DIRECTOR 1.00 1.00 X 0 0 0 EDDY RODRIGUEZ EFF 1115 DIRECTOR 1.00 0.00 X 0 0 0 JOHN SKELLY SR. VP & TREASURER 36.00 4.00 X 530492 58943 200850 PATRICK MCCABE THRU 916 SR. VP,& TREASURER 4.00 36.00 X 71782 646047 249847 PAMELA SCAGLIARINI COO & SEC. 39.00 1.00 X 505853 0 108905 MARC BRUNETTI SR. VP SUPPORT OPERATIONS 40.00 0.00 X 318239 0 47860 MICHAEL IVY SR. VP MEDICAL AFFAIRS 39.00 1.00 X 554492 0 33789 MARYELLEN KOSTURKO SR. VP PATIENT CARE 40.00 0.00 X 394646 0 28139 CAROLYN SALSGIVER SR. VP STRATEGY & BUSINESS 32.00 8.00 X 316380 79095 156693 MELISSA TURNER SR. VP HUMAN RESOURCE 20.00 20.00 X 205444 205444 147594 RYAN O'CONNELL VP OF PERFORMANCE & RISK 40.00 0.00 X 408806 0 27052 GINA CALDER EFF 916 VP OF AMBULATORY SERVICES 40.00 0.00 X 194922 0 18723 JENNIFER WILLCOX ASSISTANT SECRETARY 1.00 39.00 X 0 326626 33054 JONATHAN MAISEL PHYSICIAN 40.00 0.00 X 437613 0 44891 THOMAS LAMONTE PHYSICIAN 40.00 0.00 X 355263 0 44891 ROCKMAN FERRIGNO PHYSICIAN 40.00 0.00 X 539854 0 64017 GUILLERMO KATIGBAK PHYSICIAN 40.00 0.00 X 359444 0 39888 FRANCISCO GARRIDO PHYSICIAN 40.00 0.00 X 473599 0 27906 6717991 3005894 1629563 323 0 1 0 SHEPLEY BULFINCH RICHARDSON 2 SEAPORT LN BOSTON MA 02210 ARCHITECTURE SERVICE 2530807 UNITEX TEXTILE RENTAL 155 SOUTH TERRACE AVE MOUNT VERNON NY 10550 LAUNDRY/SERVICE 2393339 APOLLO SECURITY INTERNATIONAL 2150 BOSTON PROVIDENCE HWY WALPOLE MA 02081 SECURITY 2167824 NURSEFINDERS INC PO BOX 910738 DALLAS TX 753910738 STAFFING 1681368 DVA RENAL HEALTHCARE INC 30 COMMERCE RD STAMFORD CT 06902 MEDICAL/CLINICS 870237 86 3141705 3141705 INPATIENT REVENUE 621990 271171713 271171713 OUTPATIENT REVENUE 621990 200567237 200567237 LABORATORY SERVICES 621500 969086 969086 RADIOLOGY SERVICES 621500 30280 30280 472738316 224871 976 223895 1506891 8514 775047 6549 731844 1965 733809 1965 731844 79310279 2000 78366465 0 943814 2000 945814 945814 OTHER OPERATING INCOME 900099 18423678 18423678 PEDIATRIC ANCILLARY REVENUE 900099 9157255 9157255 CAFETERIA/VENDING OTHER OPERATING 900099 2553145 2553145 4318615 2756577 1562038 34452693 512237208 502076460 1002307 6016736 X 5000 5000 5955408 5955408 159418898 121346891 38072007 1350743 1141269 209474 32347085 24601734 7745351 11338277 8594730 2743547 84948 64393 20555 68115 51633 16482 539811 539811 125573261 106023834 19549427 6852136 5196617 1655519 13736352 10460467 3275885 603751 470926 132825 5480373 4131387 1348986 32443732 24593254 7850478 8529541 8367828 161713 MEDICAL SUPPLIES 59395929 59395929 YNHHS SYSTEM SUPPORT FE 5753914 4361627 1392287 PROPERTY TAX 1728046 1309907 418139 DUES, FEES AND MEMBERSH 891205 675558 215647 1406193 921551 484642 473502718 382254346 91248372 0 8000 8000 25960053 25240914 54662116 53543442 4348501 5720156 30123344 24942496 571332472 309517385 210821040 261815087 47488705 43101642 37554124 37554124 17217110 17217110 103983919 115774200 532166912 584917171 49162515 57740327 32238597 64918517 68525740 104669657 213676023 175364036 363602875 402692537 X 110842796 116789276 34845554 42302088 22875687 23133270 168564037 182224634 532166912 584917171 X 38734490 2884409 -27958303 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 1 500 0 0 0 0 1 56381 0 1 539810 596691 0 PART II-B, LINE 1: THE AMOUNT REPORTED IN "OTHER ACTIVITIES" REPRESENTS A PORTION OF PROFESSIONAL DUES ATTRIBUTABLE TO LOBBYING DURING FY 2016. ALSO, THE HEALTH SYSTEM OFFICIALS HAD MEETINGS AND CONTACTS WITH STATE GOVERNMENT OFFICIALS,INCLUDING STATE LEGISLATORS AND THEIR STAFF TO DISCUSS VARIOUS HEALTH CARE REFORM PROPOSALS. BRIDGEPORT HOSPITAL IS PART OF A CONTROLLED GROUP WITH THE FOLLOWING LOBBYING EXPENSES: YALE NEW HAVEN HOSPITAL EIN 06-0646652 $1,099,541 NORTHEAST MEDICAL GROUP EIN 06-1330992 $ 42,892 GREENWICH HOSPITAL EIN 06-0646659 $ 120,642 LAWRENCE + MEMORIAL HOSPITAL EIN 06-0646704 $ 97,147 LMW HEALTHCARE, INC. EIN 46-0543230 $ 66,063 0 23226000 0 2106000 684000 24648000 23470000 0 634000 878000 23226000 41860000 2176000 2969000 4297000 42708000 37606000 3504000 2097000 -1347000 41860000 34442000 874000 2394000 -104000 37606000 0.78000 0.22000 0 0 1654817 1654817 225045406 104058156 120987250 33596055 2304652 31291403 294170859 203154577 91016282 16865335 16865335 261815087 HEDGE FUNDS 365550 F YALE ENDOWMENT POOL 37188574 F 37554124 OTHER RECEIVABLES 732140 INTEREST IN BRIDGEPORT HOSPITAL FOUNDATION,INC. 79597109 INTEREST IN BRIDGEPORT HOSPITAL AUXILIARY 446105 INTEREST IN CENTURY FINANCIAL SERVICES 853214 DUE FROM AFFILIATES 7018372 THIRD PARTY RECEIVABLES 748260 PROFESSIONAL LIABILITIES INSURANCE RECOVERIES RECEIVABLES 26379000 115774200 SELF INSURANCE 23226657 ASSET RETIREMENT OBLIGATIONS 10537517 PENSION OBLIGATION 77643567 THIRD PARTY PAYABLE 27808668 DUE TO AFFILIATES 9768627 MALPRACTICE GROSS LIABILITY 26379000 175364036 X PART V, LINE 4: INTENDED USES FOR ENDOWMENT FUNDS THE ENDOWED FUNDS' INTENDED USE IS TO GENERATE INCOME TO SUPPORT BRIDGEPORT HOSPITAL PROGRAM SERVICE FUNCTIONS AND OTHER OPERATIONS IN ACCORDANCE WITH THE BRIDGEPORT HOSPITAL POOLED INVESTMENT POLICY, INCLUDING TO PROVIDE FREE CARE, ALL IN ACCORDANCE WITH BASED ON DONORS' WISHES. PART X, LINE 2: THE CONSOLIDATED FINANCIAL STATEMENTS OF BRIDGEPORT HOSPITAL AND SUBSIDIARIES INCLUDE THE FOOTNOTE AS FOLLOWS: THE BRIDGEPORT HOSPITAL AND THE BRIDGEPORT HOSPITAL FOUNDATION, INC. ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND ARE GENERALLY EXEMPT FROM FEDERAL AND STATE INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. PROPERTIES IS A TAX-EXEMPT ORGANIZATION GENERALLY EXEMPT FROM FEDERAL AND STATE INCOME TAXES PURSUANT TO SECTION 501(C)(2) OF THE CODE. U.S. GAAP REQUIRES THE HOSPITAL AND THE FOUNDATION TO EVALUATE TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN THE COURSE OF PREPARING THE HOSPITAL'S AND THE FOUNDATION'S TAX RETURNS TO DETERMINE WHETHER THE TAX POSITIONS ARE "MORE LIKELY THAN NOT" OF BEING SUSTAINED BY THE APPLICABLE TAX AUTHORITY BASED UPON THE TECHNICAL MERITS OF THE POSITION. THE HOSPITAL AND THE FOUNDATION RECOGNIZE THE EFFECT OF TAX POSITIONS ONLY IF THEY ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. THIS EVALUATION HAD NO IMPACT ON THE OPERATIONS OF THE HOSPITAL OR THE FOUNDATION AS OF AND FOR THE YEAR ENDED SEPTEMBER 30, 2016. 1 1 X 1 X 250.000000000000 0 1 1 1 0 1 1 20742 43996000 16066000 27930000 0.05900 119905 126988000 93850000 33138000 0.07000 0 0 0 140647 170984000 109916000 61068000 0.12900 10 2347 624454 15000 609454 0.00130 3 179 23942655 8403313 15539342 0.03280 1 1291 10866198 9073360 1792838 0.00380 0 0 0 0 2 27740 92763 0 92763 0.00020 16 31557 35526070 17491673 18034397 0.03810 16 172204 206510070 127407673 79102397 0.16710 1 0 12500 0 12500 0.00000 1 0 2300 0 2300 0.00000 2 0 13950 0 13950 0.00000 0 0 0 0 0 0 0 0 1 0 1069 0 1069 0.00000 0 0 0 0 1 0 285 0 285 0.00000 0 0 0 0 6 30104 30104 1 15691920 177932878 173284093 4648785 X 1 1 1 NONE NONE 1 1 BRIDGEPORT HOSPITAL 267 GRANT STREET BRIDGEPORT CT 06610 WWW.BRIDGEPORTHOSPITAL.ORG 0040 X X X X X BRIDGEPORT HOSPITAL 1 0 0 1 X X X X X X X X X 15 1 1 1 1 X SEE PART V SUPPLEMENTAL INFORMATION X SEE PART V SUPPLEMENTAL INFORMATION X 1 15 1 SEE PART V SUPPLEMENTAL INFORMATION 0 0 1 X 250.000000000000 X X X X 1 1 X X X 1 X HTTPS://WWW.BRIDGEPORTHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINA X HTTPS://WWW.BRIDGEPORTHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINA X HTTPS://WWW.BRIDGEPORTHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINA X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION A: THIS STATE LICENSE FOR THE HOSPITAL LOCATION LISTED IN SCHEDULE H, PART V, SECTION A, ALSO COVERS VARIOUS SATELLITE LOCATIONS OPERATED UNDER AND EXPRESSLY LISTED ON THE SAME STATE HOSPITAL LICENSE. BRIDGEPORT HOSPITAL PART V, SECTION B, LINE 5: COMMUNITY ENGAGEMENT AND FEEDBACK WERE AN INTEGRAL PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. BRIDGEPORT HOSPITAL, THROUGH THE PRIMARY CARE ACTION GROUP, SOUGHT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL THROUGH FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WITH COMMUNITY MEMBERS AND COMMUNITY STAKEHOLDERS, AS WELL AS INCLUSION OF BOTH COMMUNITY PARTNERS AND AREA RESIDENTS IN THE PRIORITIZATION AND IMPLEMENTATION PLANNING PROCESS. PUBLIC HEALTH AND HEALTH CARE PROFESSIONALS SHARED KNOWLEDGE AND EXPERTISE ABOUT HEALTH ISSUES, WHILE LEADERS AND REPRESENTATIVES OF NON-PROFIT AND COMMUNITY-BASED ORGANIZATIONS PROVIDED INSIGHT ON THE COMMUNITY SERVED BY BRIDGEPORT HOSPITAL, INCLUDING MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITY POPULATIONS. BRIDGEPORT HOSPITAL PART V, SECTION B, LINE 6A: ST. VINCENT'S MEDICAL CENTER, A MEMBER OF ASCENSION HEALTH SYSTEM, ALSO LOCATED IN BRIDGEPORT, IS PART OF THE PRIMARY CARE ACTION GROUP, WHICH CONDUCTED THE COMMUNITY HEALTH NEEDS ASSESSMENT. BRIDGEPORT HOSPITAL PART V, SECTION B, LINE 6B: THE CHNA FOR THE GREATER BRIDGEPORT REGION, WHICH SERVES AS THE CHNA FOR BRIDGEPORT HOSPITAL, WAS CONDUCTED IN COLLABORATION WITH THE PRIMARY CARE ACTION GROUP. PRIMARY CARE ACTION GROUP MEMBERS IN ADDITION TO BRIDGEPORT HOSPITAL AND ST. VINCENT'S MEDICAL CENTER INCLUDE BUT ARE NOT LIMITED TO THE CITY OF BRIDGEPORT DEPARTMENT OF HEALTH AND SOCIAL SERVICES, FAIRFIELD HEALTH DEPARTMENT, MONROE HEALTH DEPARTMENT, TRUMBULL HEALTH DEPARTMENT, STRATFORD HEALTH DEPARTMENT, OPTIMUS HEALTHCARE, SOUTHWEST COMMUNITY HEALTH CENTER, AMERICARES FREE CLINIC OF BRIDGEPORT, LLC. PART V, SECTION B, LINE 7A - HOSPITAL FACILITY'S WEBSITE URL: HTTPS://WWW.BRIDGEPORTHOSPITAL.ORG/ABOUT/COMMUNITY/HEALTH-NEEDS-ASSESSMENT.ASPXPART V, SECTION B, LINE 7B - OTHER WEBSITES (LIST URL):HTTP://WWW.CT.GOV/DPH/LIB/DPH/OHCA/COMMUNITY_NEEDS_ASSESSMENT/CHNA/2016/2016_BRIDGEPORT_HOSPITAL.PDF; HTTP://CTDATAHAVEN.ORG/DATA-RESOURCES/FAIRFIELD-COUNTY-COMMUNITY-WELLBEING-INDEX-GREATER-BRIDGEPORT-PCAG-CHNA-CHAPTER; HTTP://WWW.MONROECT.ORG/FILESTORAGE/343/351/4478/DATAHAVEN_CHIP_CHA_2016_AND_PCAG_REVISED_10_7_16.PDF; HTTP://WWW.TOWNOFSTRATFORD.COM/HEALTHDATA; HTTP://WWW.BRIDGEPORTCT.GOV/FILESTORAGE/89019/95959/2016_PCAG_CHA_%26_CHIP.PDF; HTTP://WWW.STVINCENTS.ORG/COMMUNITY-WELLNESS; PART V, SECTION B, LINE 10A:HTTPS://WWW.BRIDGEPORTHOSPITAL.ORG/ABOUT/COMMUNITY/HEALTH-NEEDS-ASSESSMENT.ASPX BRIDGEPORT HOSPITAL PART V, SECTION B, LINE 11: IN MARCH 2016, PCAG MEMBERS AND THEIR COMMUNITY PARTNERS (INCLUDING THOSE WITH PUBLIC HEALTH DEPARTMENTS AND / OR KNOWLEDGE, INFORMATION, OR EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY OR MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS) REVIEWED THE PRIMARY AND SECONDARY CHNA DATA AND DETERMINED, BY GROUP CONSENSUS, THAT THE 2013 PRIORITIES WOULD BE MAINTAINED MOVING FORWARD FOR THE 2016 CHNA (ACCESS TO CARE, HEALTHY LIFESTYLES, CARDIAC & DIABETES, AND MENTAL HEALTH & SUBSTANCE ABUSE.). PCAG, HEALTH DEPARTMENTS, AND HOSPITALS CONFIRMED THAT THERE WAS A NEED TO CONTINUE WORKING IN THE 2013 FOCUS AREAS AS THESE WERE STILL THE TOP HEALTH PRIORITY AREAS. ALL PRIMARY AND SECONDARY DATA THAT WAS COLLECTED, ANALYZED AND REVIEWED SUPPORTED THE CONTINUATION OF THE 2013 PRIORITY AREAS. TO LEARN MORE ABOUT HOW BRIDGEPORT HOSPITAL AND ITS COMMUNITY PARTNERS ARE MEETING THESE NEEDS PLEASE REVIEW THE PRIMARY CARE ACTION GROUP'S 2016 GREATER BRIDGEPORT REGION BRIDGEPORT HOSPITAL AND ST. VINCENT'S MEDICAL CENTER COLLABORATIVE COMMUNITY HEALTH ASSESSMENT AND IMPLEMENTATION PLAN.BRIDGEPORT HOSPITAL RECOGNIZES THAT PARTNERSHIPS WITH COMMUNITY AGENCIES HAVE THE BROADEST REACH TO IMPROVE COMMUNITY HEALTH ISSUES. AS SUCH, THE HOSPITAL IS PROVIDING FACILITATION SUPPORT FOR THE IMPLEMENTATION OF THE COMMUNITY-WIDE HEALTH IMPROVEMENT PLAN THAT WILL FOCUS ON ALL FOUR AREAS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. BRIDGEPORT HOSPITAL PART V, SECTION B, LINE 13H: THESE PROGRAMS COVER MEDICALLY NECESSARY CARE ONLY. BRIDGEPORT HOSPITAL PART V, SECTION B, LINE 22D: THE MAXIMUM AMOUNT CHARGED TO FAP-ELIGIBLE PATIENTS IS THE AMOUNT GENERAL BILLED TO INDIVIDUALS WHO HAVE INSURANCE COVERING THE CARE AT ISSUE (AGB). AGB IS CALCULATED ANNUALLY USING THE "LOOK BACK METHOD AND BASED ON MEDICARE FEE-FOR-SERVICE RATES, INCLUDING MEDICARE BENEFICIARY COST-SHARING AMOUNTS AND ALL PRIVATE HEALTH INSURERS THAT PAY CLAIMS TO THE HOSPITAL FOR THE PRIOR FISCAL YEAR. SCHEDULE H, PART V, SECTION D THE FACILITY LOCATIONS LISTED IN SCHEDULE H, PART V, SECTION D, INCLUDE OFF-CAMPUS OUTPATIENT HEALTH CARE FACILITIES THAT BRIDGEPORT HOSPITAL OPERATED DURING THE TAX YEAR UNDER ITS STATE HOSPITAL LICENSE. 27 1 - NORMA F PFRIEM CANCER INSTITUTE 5520 PARK AVENUE TRUMBULL CT 06611 ONCOLOGY RADIOLOGY; LAB; PERINATAL/ATU 2 - CARDIAC DIAGNOSTIC TESTING 1305 POST ROAD FAIRFIELD CT 06824 CARDIAC SERVICES; DIAGNOSTIC TESTING 3 - OUTPATIENT RADIOLOGY 4699 MAIN STREET BRIDGEPORT CT 06610 RADIOLOGY; OUTPATIENT 4 - BRIDGEPORT HOSPITAL REHABILITATION 226 MILL HILL AVENUE BRIDGEPORT CT 06610 REHABILITATION 5 - CARDIAC DIAGNOSTIC TESTING 999 SILVER LANE TRUMBULL CT 06611 CARDIAC SERVICES 6 - OUTPATIENT RADIOLOGY 425 POST ROAD FAIRFIELD CT 06824 RADIOLOGY 7 - CARDIAC DIAGNOSTIC TESTING 25 GERMANTOWN ROAD DANBURY CT 06810 CARDIAC SERVICES 8 - FAIRFIELD URGENT CARE CENTER 309 STILLSON ROAD FAIRFIELD CT 06824 MEDICAL OFFICE 9 - OUTPATIENT RADIOLOGY 2909 MAIN STREET STRATFORD CT 06614 RADIOLOGY 10 - REACH AT BH 305 BOSTON AVENUE STRATFORD CT 06614 VARIOUS MEDICAL SERVICES 11 - CARDIAC DIAGNOSTIC TESTING 20 COMMERCE PARK MILFORD CT 06460 CARDIAC SERVICES; DIAGNOSTIC TESTING 12 - AHLBIN REHAB CENTER-STRATFORD 3585 MAIN STREET STRATFORD CT 06614 PHYSICAL THERAPY 13 - OUTPATIENT RADIOLOGY 2595 MAIN STREET STRATFORD CT 06614 RADIOLOGY; OUTPATIENT 14 - BRIDGEPORT HOSPITAL LAB 4 CORPORATE DRIVE SHELTON CT 06484 BLOOD DRAW CENTER 15 - AHLBIN REHAB CENTER-SOUTHPORT 2600 POST ROAD SOUTHPORT CT 06890 PHYSICAL THERAPY; DRAW STATION 16 - CARDIAC DIAGNOSTIC TESTING 30 PROSPECT STREET RIDGEFIELD CT 06877 CARDIAC SERVICES; DIAGNOSTIC TESTING 17 - BRIDGEPORT HOSPITAL LAB 40 COMMERCE PARK MILFORD CT 06460 BLOOD DRAW CENTER 18 - BLOOD DRAW STATION 887 BRIDGEPORT AVENUE SHELTON CT 06484 BLOOD DRAW CENTER 19 - AHLBIN PHYSICAL THERAPY 2750 RESERVOIR AVE TRUMBULL CT 06611 REHABILITATION 20 - IVY BROOK MEDICAL CENTER 2 IVY BROOK ROAD SHELTON CT 06484 CARDIAC SERVICES; DIAGNOSTIC TESTING 21 - BRIDGEPORT HOSPITAL LAB 15 CORPORATE DRIVE TRUMBULL CT 06611 BLOOD DRAW CENTER 22 - BRIDGEPORT HOSPITAL LAB 3115 MAIN STREET STRATFORD CT 06614 BLOOD DRAW CENTER 23 - NORMA PFRIEM BREAST CENTER 111 BEACH ROAD FAIRFIELD CT 06824 CANCER CENTER 24 - SLEEP STUDY CENTER 1070 MAIN STREET BRIDGEPORT CT 06610 SLEEP CENTER 25 - OUTPATIENT RADIOLOGY 2660 MAIN STREET BRIDGEPORT CT 06606 OUTPATIENT RADIOLOGY 26 - CENTER FOR GERIATRICS 95 ARMORY ROAD STRATFORD CT 06614 ELDER CARE 27 - CARDIAC DIAGNOSTIC TESTING 300 SEYMOUR AVENUE DERBY CT 06418 CARDIAC SERVICES; DIAGNOSTIC TESTING PART I, LINE 3C: THE FINANCIAL ASSISTANCE POLICY PROVIDES THAT THE PATIENT MUST SUBMIT A FINANCIAL ASSISTANCE APPLICATION. PART I, LINE 7: THE HOSPITAL USES A COST ACCOUNTING SYSTEM, STRATAJAZZ, TO CALCULATE THE AMOUNTS PRESENTED IN PART I, LINE 7. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS. PART II, COMMUNITY BUILDING ACTIVITIES: BRIDGEPORT HOSPITAL, ALONG WITH MANY OTHER HOSPITALS ACROSS THE COUNTRY, UTILIZES THE COMMUNITY BENEFITS INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA) DATABASE DEVELOPED BY LYON SOFTWARE TO CATALOG ITS COMMUNITY BENEFIT AND COMMUNITY BUILDING ACTIVITIES AND THE GUIDELINES DEVELOPED BY THE CATHOLIC HOSPITAL ASSOCIATION (CHA) IN ORDER TO CATALOG THESE BENEFITS. THESE TWO ORGANIZATIONS HAVE WORKED TOGETHER FOR OVER TWENTY YEARS TO PROVIDE SUPPORT TO NON-FOR-PROFIT HOSPITALS TO DEVELOP AND SUSTAIN EFFECTIVE COMMUNITY BENEFIT PROGRAMS.THE MOST RECENT VERSION OF THE CHA GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFIT DEFINES COMMUNITY BUILDING ACTIVITIES AS PROGRAMS THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS AND ENVIRONMENTAL PROBLEMS. THESE ACTIVITIES ARE CATEGORIZED INTO EIGHT DISTINCT AREAS INCLUDING PHYSICAL IMPROVEMENT AND HOUSING, ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT, ENVIRONMENTAL IMPROVEMENTS, LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS, COALITION BUILDING, ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENTS, AND WORKFORCE DEVELOPMENT. BRIDGEPORT HOSPITAL IS INCREASINGLY AWARE OF HOW SOCIAL DETERMINANTS IMPACT THE HEALTH OF INDIVIDUALS AND COMMUNITIES. A PERSON'S HEALTH AND CHANCES OF BECOMING SICK AND DYING EARLY ARE GREATLY INFLUENCED BY POWERFUL SOCIAL FACTORS SUCH AS EDUCATION, INCOME, NUTRITION, HOUSING AND NEIGHBORHOODS. DURING FISCAL YEAR 2016, BRIDGEPORT HOSPITAL PROVIDED $30,104 IN FINANCIAL AND IN-KIND DONATIONS TO SUPPORT JOB TRAINING, ECONOMIC DEVELOPMENT AND OTHER ESSENTIAL SERVICES. THE HOSPITAL CONSIDERS THESE INVESTMENTS PART OF ITS OVERALL COMMITMENT OF BUILDING STRONGER NEIGHBORHOODS. EXAMPLES BELOW FOCUS ON THE AREAS OF REVITALIZING OUR NEIGHBORHOODS AND CREATING EDUCATIONAL OPPORTUNITIES.REVITALIZING OUR NEIGHBORHOODSSEVERAL YEARS AGO, THE CITY OF BRIDGEPORT ORGANIZED NEIGHBORHOOD REVITALIZATION ZONES (NRZS) IN ORDER TO EXPAND AND IMPROVE BUSINESS AND HOUSING IN LOW-TO-MODERATE INCOME NEIGHBORHOODS OR AREAS WITHIN NEIGHBORHOODS. THE NRZS RECEIVE TECHNICAL ASSISTANCE FROM THE CITY AND OUTSIDE CONSULTANTS, AND ENGAGE NEIGHBORHOOD RESIDENTS, NON-PROFITS, BUSINESSES AND FAITH-BASED ORGANIZATIONS TO MEET AND FORM STAKEHOLDER GROUPS. THESE GROUPS IDENTIFY THE PRIORITIES AND NEEDS OF THE NEIGHBORHOODS AND ARE ELIGIBLE TO BORROW STATE MONEY TO PURCHASE BLIGHTED PROPERTIES OR OFFER LOW-INTEREST LOANS TO QUALIFYING BUSINESSES FOR FACADE IMPROVEMENTS. HOSPITAL LEADERSHIP HAS BEEN ACTIVELY ENGAGED IN THE NRZ PROCESS FROM THE ONSET WITH REPRESENTATIVES SERVING ON COMMITTEES ORGANIZED IN THE CITY'S EAST END, EAST SIDE AND MILL HILL NEIGHBORHOODS, WHICH ARE LOCATED NEAR THE HOSPITAL. THE HOSPITAL PROVIDES ANNUAL OPERATIONAL SUPPORT TO THE EAST END COMMUNITY COUNCIL, A GROUP OF COMMUNITY RESIDENTS, BUSINESS, CIVIC, RELIGIOUS LEADERS AND COMMUNITY POLICE OFFICERS. THE EAST END COMMUNITY COUNCIL WORKS COLLABORATIVELY TO ENHANCE THE QUALITY OF LIFE IN THE NEIGHBORHOOD THROUGH VARIOUS INITIATIVES INCLUDING SAFE STREETS, FOOD PANTRIES, ANNUAL TOY DRIVES AND A LITTLE LEAGUE TEAM.AS PART OF A SUSTAINABILITY PROGRAM AIMED AT ADDRESSING FOOD INSECURITY WITHIN THE CITY OF BRIDGEPORT, BRIDGEPORT HOSPITAL AND ROCK AND WRAP IT UP! TEAMED UP TO RECOVER FOOD THAT HAS BEEN PREPARED BUT NOT SERVED FROM THE HOSPITAL AND DONATE IT TO THE BRIDGEPORT RESCUE MISSION. OVER 375 POUNDS OF FOOD WAS DONATED IN 2016. BRIDGEPORT HOSPITAL, ALONG WITH OTHER AREA BUSINESSES, IS A FOUNDING MEMBER OF THE SEAVIEW AVENUE BUSINESS ALLIANCE. THE SEAVIEW AVENUE BUSINESS ALLIANCE IS A NON-PROFIT ORGANIZATION DEDICATED TO IMPROVING STREETSCAPES AND IMPROVING THE AREA ALONG THE SEAVIEW AVENUE CORRIDOR. THE ORGANIZATION ALSO PROVIDES ANNUAL SCHOLARSHIPS TO STUDENTS GRADUATING FROM HARDING HIGH SCHOOL WHO PLAN TO ATTEND COLLEGE. IN 2016, THE HOSPITAL PROVIDED FINANCIAL AND IN-KIND SUPPORT FOR THESE EFFORTS.CREATING EDUCATIONAL OPPORTUNITIESHIGHER EDUCATIONAL ATTAINMENT IS ASSOCIATED WITH BETTER HEALTH STATUS AND LONGER LIFE. FOR EXAMPLE, ADULTS AGED 25-50 YEARS WHO HAVE A COLLEGE DEGREE WILL ON AVERAGE LIVE FIVE YEARS LONGER THAN THOSE WITH LESS THAN A HIGH SCHOOL EDUCATION. A SCHOOL SUPPLY DRIVE WAS HELD AT THE HOSPITAL FOR STUDENTS AT THE HALL ELEMENTARY SCHOOL, LOCATED IN THE MILL HILL NEIGHBORHOOD OF BRIDGEPORT. HOSPITAL EMPLOYEES CONTRIBUTED MORE THAN 800 ITEMS RANGING FROM PENS AND PENCILS TO NOTEBOOKS, BACKPACKS AND OTHER ITEMS TO HELP ASSIST THE 262 STUDENTS TO BEGIN THEIR SCHOOL YEAR. BRIDGEPORT HOSPITAL STAFF ALSO COLLABORATED WITH HALL ELEMENTARY SCHOOL AND OTHERS FOR THE ANNUAL "MOCK TRIAL" THROUGH THE HOSPITAL'S LEGAL & RISK MANAGEMENT DEPARTMENT, WHICH PROVIDES STUDENTS AN OPPORTUNITY TO PARTICIPATE IN AN ACTUAL TRIAL AT THE FEDERAL COURTHOUSE COMPLETE WITH A SUPERIOR COURT JUDGE. AS MENTIONED IN THE PREVIOUS SECTION, BRIDGEPORT HOSPITAL, THROUGH THE SEAVIEW AVENUE BUSINESS ALLIANCE, PROVIDED SCHOLARSHIPS TO SENIORS FROM HARDING HIGH SCHOOL WHO WILL BE ATTENDING COLLEGE. THE HOSPITAL IS ALSO A MEMBER OF THE BRIDGEPORT CHILD ADVOCACY COALITION, WHICH IS A COALITION OF ORGANIZATIONS, PARENTS AND OTHER CONCERNED INDIVIDUALS COMMITTED TO IMPROVING THE WELL-BEING OF BRIDGEPORT'S CHILDREN THROUGH RESEARCH, ADVOCACY, COMMUNITY EDUCATION AND MOBILIZATION. PART III, LINE 2: IN ACCORDANCE WITH THE ESTABLISHED POLICIES OF THE HOSPITAL, DURING THE REGISTRATION, BILLING AND COLLECTION PROCESS A PATIENT'S ELIGIBILITY FOR FREE CARE FUNDS IS DETERMINED. FOR PATIENTS WHO WERE DETERMINED BY THE HOSPITAL TO HAVE THE ABILITY TO PAY BUT DID NOT, THE UNCOLLECTED AMOUNTS ARE BAD DEBT EXPENSE. THE HOSPITAL'S COST ACCOUNTING SYSTEM UTILIZES PATIENT-SPECIFIC DATA TO ACCUMULATE AND DERIVE COSTS RELATED TO THESE BAD DEBT ACCOUNTS. PART III, LINE 3: THE ORGANIZATION DOES NOT CURRENTLY HAVE A METHODOLOGY TO ACCURATELY QUANTIFY OR ESTIMATE THE AMOUNT OF BAD DEBT EXPENSE THAT WOULD BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PART III, LINE 4: THE HOSPITAL'S COMMITMENT TO COMMUNITY SERVICE IS EVIDENCED BY SERVICES PROVIDED TO THE POOR AND BENEFITS PROVIDED TO THE BROADER COMMUNITY. SERVICES PROVIDED TO THE POOR INCLUDE SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTH CARE BECAUSE OF INADEQUATE RESOURCES AND/OR WHO ARE UNINSURED OR UNDERINSURED.THE HOSPITAL PROVIDES FREE CARE PROGRAMS FOR QUALIFYING PATIENTS. IN ACCORDANCE WITH THE ESTABLISHED POLICIES OF THE HOSPITAL, DURING THE REGISTRATION, BILLING, AND COLLECTION PROCESS A PATIENT'S ELIGIBILITY FOR FREE CARE FUNDS IS DETERMINED. FOR PATIENTS WHO WERE DETERMINED BY THE HOSPITAL TO HAVE THE ABILITY TO PAY BUT DID NOT, THE UNCOLLECTED AMOUNTS ARE BAD DEBT EXPENSE. FOR PATIENTS WHO DO NOT AVAIL THEMSELVES OF ANY FREE CARE PROGRAM AND WHOSE ABILITY TO PAY CANNOT BE DETERMINED BY THE HOSPITAL, CARE GIVEN BUT NOT PAID FOR IS CLASSIFIED AS CHARITY CARE.TOGETHER, CHARITY CARE AND THE PROVISION FOR BAD DEBTS REPRESENT UNCOMPENSATED CARE. THE ESTIMATED COST OF TOTAL UNCOMPENSATED CARE IS APPROXIMATELY $27.0 MILLION AND $24.8 MILLION FOR THE YEARS ENDED SEPTEMBER 30, 2016 AND 2015, RESPECTIVELY. THE ESTIMATED COST OF UNCOMPENSATED CARE IS BASED ON THE RATIO OF COST TO CHARGES, AS DETERMINED BY CLAIMS ACTIVITY. THE ESTIMATED COST OF CHARITY CARE IS BASED ON THE RATIO OF COST TO CHARGES. THE ALLOCATION BETWEEN BAD DEBT AND CHARITY CARE IS DETERMINED BASED ON MANAGEMENT'S ANALYSIS ON THE PREVIOUS 12 MONTHS OF HOSPITAL DATA. THIS ANALYSIS CALCULATES THE ACTUAL PERCENTAGE OF ACCOUNTS WRITTEN OFF OR DESIGNATED AS BAD DEBT VERSUS CHARITY CARE WHILE TAKING INTO ACCOUNT THE TOTAL COSTS INCURRED BY THE HOSPITAL FOR EACH ACCOUNT ANALYZED.THE ESTIMATED COST OF CHARITY CARE AND FREE CARE PROVIDED WAS APPROXIMATELY $19.1 MILLION AND $17.3 MILLION FOR THE YEARS ENDED SEPTEMBER 30, 2016 AND 2015, RESPECTIVELY. THE ESTIMATED COST OF CHARITY CARE IS BASED ON THE RATIO OF COST TO CHARGES, AS DETERMINED BY HOSPITAL SPECIFIC DATA.FOR THE YEARS ENDED SEPTEMBER 30, 2016 AND 2015, THE PROVISION FOR BAD DEBTS, AT CHARGES, WAS APPROXIMATELY $15.7 MILLION AND $15.4 MILLION, RESPECTIVELY. FOR THE YEARS ENDED SEPTEMBER 30, 2016 AND 2015, THE PROVISION FOR BAD DEBTS, AT COST, WAS APPROXIMATELY $7.9 MILLION AND $7.5 MILLION, RESPECTIVELY. THE BAD DEBT EXPENSE IS MULTIPLIED BY THE RATIO OF COST TO CHARGES FOR PURPOSES OF INCLUSION IN THE TOTAL UNCOMPENSATED CARE AMOUNT IDENTIFIED ABOVE.THE CONNECTICUT DISPROPORTIONATE SHARE HOSPITAL PROGRAM (CDSHP) WAS ESTABLISHED TO PROVIDE FUNDS TO HOSPITALS FOR THE PROVISION OF UNCOMPENSATED CARE AND IS FUNDED, IN PART, BY A 1% ASSESSMENT ON HOSPITAL NET INPATIENT SERVICE REVENUE. DURING THE YEARS ENDED SEPTEMBER 30, 2016 AND 2015, THE HOSPITAL RECEIVED APPROXIMATELY $16.1 MILLION AND $4.9 MILLION, RESPECTIVELY, IN CDSHP DISTRIBUTIONS, OF WHICH APPROXIMATELY $11.4 MILLION AND $3.4 MILLION, RESPECTIVELY, RELATED TO CHARITY CARE. THE HOSPITAL MADE PAYMENTS INTO CDSHP OF APPROXIMATELY $25.8 MILLION AND $19.1 MILLION FOR THE YEARS ENDED SEPTEMBER 30, 2016 AND 2015, RESPECTIVELY, FOR THE 1% ASSESSMENT. THESE ARE RECORDED IN NET PATIENT SERVICE REVENUE.ADDITIONALLY, THE HOSPITAL PROVIDES BENEFITS FOR THE BROADER COMMUNITY, WHICH INCLUDES SERVICES PROVIDED TO OTHER NEEDY POPULATIONS THAT MAY NOT QUALIFY AS POOR BUT NEED SPECIAL SERVICES AND SUPPORT. BENEFITS INCLUDE THE COST OF HEALTH PROMOTION AND EDUCATION OF THE GENERAL COMMUNITY, INTERNS AND RESIDENTS, HEALTH SCREENINGS, AND MEDICAL RESEARCH. THE BENEFITS ARE PROVIDED THROUGH THE COMMUNITY HEALTH CENTERS, SOME OF WHICH SERVICE NON ENGLISH SPEAKING RESIDENTS, DISABLED CHILDREN, AND VARIOUS COMMUNITY SUPPORT GROUPS. THE HOSPITAL VOLUNTARILY ASSISTS WITH THE DIRECT FUNDING OF SEVERAL CITY OF BRIDGEPORT PROGRAMS, INCLUDING AN ECONOMIC DEVELOPMENT PROGRAM AND A YOUTH INITIATIVE PROGRAM.IN ADDITION TO THE QUANTIFIABLE SERVICES DEFINED ABOVE, THE HOSPITAL PROVIDES ADDITIONAL BENEFITS TO THE COMMUNITY THROUGH ITS ADVOCACY OF COMMUNITY SERVICE BY EMPLOYEES. THE HOSPITAL'S EMPLOYEES SERVE NUMEROUS ORGANIZATIONS THROUGH BOARD REPRESENTATION, MEMBERSHIP IN ASSOCIATIONS, AND OTHER RELATED ACTIVITIES. THE HOSPITAL ALSO SOLICITS THE ASSISTANCE OF OTHER HEALTH CARE PROFESSIONALS TO PROVIDE THEIR SERVICES AT NO CHARGE THROUGH PARTICIPATION IN VARIOUS COMMUNITY SEMINARS AND TRAINING PROGRAMS. PART III, LINE 9B: IT IS THE HOSPITAL'S POLICY TO TREAT ALL PATIENTS EQUITABLY WITH RESPECT AND COMPASSION, FROM THE BEDSIDE TO THE BILLING OFFICE. THE HOSPITAL WILL PURSUE PATIENT ACCOUNTS, DIRECTLY AND THROUGH ITS COLLECTION AGENTS, FAIRLY AND CONSISTENTLY TAKING INTO CONSIDERATION DEMONSTRATED FINANCIAL NEED. AS PART OF ITS COLLECTION PROCESS, THE HOSPITAL WILL MAKE REASONABLE EFFORTS TO DETERMINE IF AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER ITS FINANCIAL ASSISTANCE POLICY. IN THE EVENT A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL WILL NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTION AS DEFINED BY LAW AND HOSPITAL POLICY. PART VI, LINE 2: COMMUNITY NEEDS ARE ROUTINELY REVIEWED AND ADDRESSED AS PART OF THE OPERATIONS AND SERVICE LINE TEAMS AT BRIDGEPORT HOSPITAL. THESE MULTI-DISCIPLINARY GROUPS PROVIDE ANALYSIS AND INSIGHT INTO PATIENT UTILIZATION TRENDS ACROSS OUR DELIVERY OF CARE AND ARE REVIEWED IN TANDEM WITH CARE MANAGEMENT AND PATIENT SATISFACTION RESULTS AND OTHER COMMUNITY FEEDBACK. COUPLED WITH THE RECENTLY COMPLETED COMMUNITY NEEDS ASSESSMENT, THIS INFORMATION ASSISTS WITH THE DEVELOPMENT OF NEW INITIATIVES, PARTNERSHIPS, PROGRAMS AND SERVICES TO BENEFIT OUR COMMUNITY. PART VI, LINE 3: BRIDGEPORT HOSPITAL INFORMS INDIVIDUALS ABOUT ITS FINANCIAL ASSISTANCE PROGRAMS ON ITS WEBSITE, THROUGH VISIBLE POSTINGS AND COMMUNICATIONS AT POINTS OF REGISTRATION AND FRONT LINE ACCESS. THE FINANCIAL ASSISTANCE POLICY, APPLICATION AND SUMMARY ARE AVAILABLE ON REQUEST WITHOUT CHARGE BY MAIL, INCLUDING AT ADMITTING DEPARTMENT. FURTHER, PATIENTS RECEIVE A SUMMARY OF FINANCIAL ASSISTANCE PROGRAMS, INCLUDING ELIGIBILITY REQUIREMENTS THROUGH A FIRST STATEMENT MAILER AS PART OF THE BILLING PROVES. THESE COMMUNICATIONS INCLUDE TELEPHONE NUMBERS AND POINT OF CONTACT FOR INDIVIDUALS TO VISIT OR CALL. THE HOSPITAL HAS RESOURCES TO ASSIST PATIENTS WITH STATE OF CONNECTICUT MEDICAID APPLICATIONS. PART VI, LINE 4: BRIDGEPORT HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT EFFORTS ARE SPECIFICALLY FOCUSED IN TOWNS WHERE THE HOSPITAL IS ENGAGED WITH COMMUNITY PARTNERS THROUGH THE PRIMARY CARE ACTION GROUP. THIS GEOGRAPHIC AREA INCLUDES BRIDGEPORT, EASTON, FAIRFIELD, MONROE, STRATFORD, AND TRUMBULL. THE GREATER BRIDGEPORT REGION HAS A POPULATION OF 323,231. BRIDGEPORT, CONNECTICUT'S LARGEST CITY COMPRISES 45% OF THE REGION'S POPULATION. THE MEDIAN AGE OF THE AREA IS 40.3 YEARS, WHICH IS HIGHER THAN THE STATE AS A WHOLE, EXCEPT FOR THE CITY OF BRIDGEPORT. BRIDGEPORT'S MEDIAN AGE IS LOWER AT 32.8 YEARS. THE TOWNS IN THE REGION VARY DRAMATICALLY IN TERMS OF THEIR RACIAL AND ETHNIC COMPOSITION. THE COMMUNITIES OF EASTON, FAIRFIELD, MONROE AND TRUMBULL ARE OVER 80% WHITE AND STRATFORD IS OVER TWO-THIRDS WHITE. BY CONTRAST, CLOSE TO 80% OF BRIDGEPORT'S POPULATION IS NON-WHITE; HISPANICS AND AFRICAN-AMERICAN'S EACH COMPRISE MORE THAN ONE THIRD OF BRIDGEPORT'S RESIDENTS.THERE ARE WIDE GAPS IN MEDIAN HOUSEHOLD INCOME RATES WITHIN THE GREATER BRIDGEPORT REGION. THE TOWNS OF EASTON, FAIRFIELD, MONROE, AND TRUMBULL ARE AFFLUENT WITH MEDIAN INCOMES SUBSTANTIALLY HIGHER THAN NATIONAL AND STATE AVERAGES. STRATFORD, WHICH HAS A LONG HISTORY AS AN INDUSTRIAL TOWN, WAS DESCRIBED BY RESIDENTS AS BLUE COLLAR AND MIDDLE CLASS. BRIDGEPORT HAS A HIGH POVERTY RATE AND A LOWER MEDIAN INCOME THAT BOTH STATE AND NATIONAL AVERAGES; IT IS AMONG ONE OF THE POOREST CITIES IN THE COUNTRY. THE PROPORTION OF RESIDENTS WITH A COLLEGE DEGREE OR HIGHER IN EASTON, FAIRFIELD, MONROE AND TRUMBULL IS GREATER THAN THAT OF THE STATE OVERALL AT 37%. ONLY 16% OF BRIDGEPORT ADULTS HAVE A COLLEGE DEGREE OR HIGHER, LESS THAN HALF THE RATE FOR THE STATE; STRATFORD ALSO FALLS BELOW THE STATE RATE WITH ONLY 31% OF THE RESIDENTS HAVING A COLLEGE DEGREE OR HIGHER. PART VI, LINE 5: AS A COMMUNITY HEALTH CARE SERVICES PROVIDER, BRIDGEPORT HOSPITAL REMAINS ATTENTIVE TO HEALTH AND WELL-BEING THROUGH EDUCATION, OUTREACH AND OTHER INNOVATIVE SERVICES. DURING FISCAL YEAR 2016, BRIDGEPORT HOSPITAL PROVIDED $80.1 MILLION IN COMMUNITY BENEFITS THROUGH FINANCIAL AND IN-KIND CONTRIBUTIONS IN FIVE WIDE-RANGING PROGRAMS - GUARANTEEING ACCESS TO CARE; PROMOTING HEALTH AND WELLNESS; ADVANCING CAREERS IN HEALTH CARE; RESEARCH; AND CREATING HEALTHIER COMMUNITIES. BRIDGEPORT HOSPITAL ALSO CONTRIBUTES TO THE COMMUNITY IN WAYS THAT ARE NOT QUANTIFIED AS PART OF COMMUNITY BENEFITS AND SERVES AS AN IMPORTANT COMMUNITY RESOURCE. THIS INCLUDES HAVING A COMMUNITY-BASED BOARD OF TRUSTEES WITH MANY MEMBERS RESIDING OR WORKING IN THE AREA SERVED BY THE HOSPITAL. THE HOSPITAL ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY. IN FISCAL YEAR 2016 THERE WERE A TOTAL OF 1,163 MEMBERS OF THE BRIDGEPORT HOSPITAL MEDICAL STAFF. BRIDGEPORT HOSPITAL, FOUNDED IN 1878, IS A 383-BED URBAN TEACHING HOSPITAL SERVING 20,657 INPATIENTS AND MORE THAN 294,320 OUTPATIENT ENCOUNTERS IN 2016. BRIDGEPORT HOSPITAL IS ONE OF THE LARGEST PRIVATE EMPLOYERS IN BRIDGEPORT WITH 2,659 EMPLOYEES IN 2016. PART VI, LINE 6: THE YALE NEW HAVEN HEALTH SYSTEM'S FUNDAMENTAL MISSION IS TO ENSURE THAT THE DELIVERY NETWORKS ASSOCIATED WITH THE SYSTEM PROMOTE THE HEALTH OF THE COMMUNITIES THEY SERVE AND ENSURE THAT ALL PATIENTS HAVE ACCESS TO APPROPRIATE HEALTHCARE SERVICES. THE YALE NEW HAVEN HEALTH SYSTEM REQUIRES ITS HOSPITALS TO INCORPORATE PLANS TO PROMOTE HEALTHY COMMUNITIES WITHIN THE HOSPITAL'S EXISTING BUSINESS PLANS FOR WHICH THEY ARE HELD ACCOUNTABLE. IN ADDITION, REGULAR REPORTING ON COMMUNITY BENEFITS IS REQUIRED ON A QUARTERLY BASIS. PART VI, LINE 7, REPORTS FILED WITH STATES CT X X X X X 0 1 0 0 0 0 0 1 0 WILLIAM JENNINGS PRESIDENT & CEO/DIRECTOR 626366 156592 195328 48832 87030 21757 239273 59819 14470 3617 1162467 290617 15048 3762 GAYLE CAPOZZALO DIRECTOR 0 713269 0 274705 0 474584 0 23550 0 14735 0 1500843 0 12135 JOHN SKELLY SR. VP & TREASURER 374440 41604 91583 10176 64469 7163 160625 17847 20140 2238 711257 79028 0 0 PATRICK MCCABE THRU 916 SR. VP,& TREASURER 48559 437031 16239 146155 6984 62861 22843 205591 2141 19272 96766 870910 0 0 PAMELA SCAGLIARINI COO & SEC. 375952 0 73408 0 56493 0 88210 0 20695 0 614758 0 519 0 MARC BRUNETTI SR. VP SUPPORT OPERATIONS 255837 0 44402 0 18000 0 24559 0 23301 0 366099 0 0 0 MICHAEL IVY SR. VP MEDICAL AFFAIRS 426159 0 98933 0 29400 0 10400 0 23389 0 588281 0 0 0 MARYELLEN KOSTURKO SR. VP PATIENT CARE 305754 0 65492 0 23400 0 23704 0 4435 0 422785 0 0 0 CAROLYN SALSGIVER SR. VP STRATEGY & BUSINESS 217376 54344 58138 14535 40866 10216 105323 26331 20031 5008 441734 110434 0 0 MELISSA TURNER SR. VP HUMAN RESOURCE 139049 139049 38036 38036 28359 28359 61505 61504 12292 12293 279241 279241 0 0 RYAN O'CONNELL VP OF PERFORMANCE & RISK 337739 0 48867 0 22200 0 10400 0 16652 0 435858 0 0 0 GINA CALDER EFF 916 VP OF AMBULATORY SERVICES 162426 0 14496 0 18000 0 13676 0 5047 0 213645 0 0 0 JENNIFER WILLCOX ASSISTANT SECRETARY 0 239057 0 49448 0 38121 0 17659 0 15395 0 359680 0 9839 JONATHAN MAISEL PHYSICIAN 403925 0 10177 0 23511 0 26150 0 18741 0 482504 0 0 0 THOMAS LAMONTE PHYSICIAN 322703 0 8377 0 24183 0 26150 0 18741 0 400154 0 0 0 ROCKMAN FERRIGNO PHYSICIAN 486425 0 35687 0 17742 0 15394 0 48623 0 603871 0 0 0 GUILLERMO KATIGBAK PHYSICIAN 332373 0 8575 0 18496 0 26150 0 13738 0 399332 0 0 0 FRANCISCO GARRIDO PHYSICIAN 447167 0 8967 0 17465 0 12654 0 15252 0 501505 0 0 0 PART I, LINE 4B THE INDIVIDUALS LISTED BELOW ARE PARTICIPANTS IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THESE ACCRUALS ARE INCLUDED IN THE AMOUNTS REPORTED IN PART II, COLUMN C (DEFERRED COMPENSATION) AND REPRESENTS BOTH THE REPORTING ENTITY'S AND RELATED ENTITY'S COMBINED AMOUNTS CONSISTENT WITH THE COMPENSATION REPORTING PER IRS INSTRUCTIONS. SEVERANCE NONQUALIFIED EQUITY-BASED WILLIAM M. JENNINGS $0 $180,742 $0 PATRICK MCCABE 0 121,484 0 JOHN SKELLY 0 96,527 0 MELLISSA TURNER 0 69,659 0 CAROLYN SALSGIVER 0 65,210 0 PAMELA SCAGLIARINI 0 22,537 0 INDIVIDUAL LISTED BELOW BECAME VESTED IN BENEFITS VALUED AT THE AMOUNT RESPECTIVELY REPORTED DURING THE REPORTING YEAR. INCLUDED IN SECTION II, COLUMN B (III) IS AMOUNT VESTED DURING THE 2015 CALENDAR YEAR THAT WAS RECOGNIZED AS TAXABLE EVENTS AND REPORTED IN THE INDIVIDUAL' 2015 CALENDAR YEAR FORM W-2. GAYLE CAPOZZALO $ 380,628 THE SUPPLEMENTAL RETIREMENT PLAN IS DESIGNED TO ENSURE THE PAYMENT OF A COMPETITIVE LEVEL OF RETIREMENT INCOME WHEN ADDED TO OTHER SOURCES OF RETIREMENT INCOME IN ORDER TO ATTRACT AND RETAIN KEY MANAGEMENT EMPLOYEES SERVING AS CORPORATE OFFICERS. THE PLAN PROVIDES SUPPLEMENTAL RETIREMENT INCOME THROUGH AN UNFUNDED, NONQUALIFIED DEFERRED COMPENSATION ARRANGEMENT UNDER SECTION 457(F) AND THROUGH A DEFERRED COMPENSATION PLAN UNDER SECTION 409A OF THE INTERNAL REVENUE CODE AND A MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES' PLAN UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (ERISA). PART I, LINE 7 NON-FIXED PAYMENTS PROVIDED THE SHORT TERM INCENTIVE PLAN IS A VARIABLE COMPENSATION PLAN WHICH PROVIDES ONE-TIME PAYMENTS TO ELIGIBLE MEMBERS OF MANAGEMENT IN RECOGNITION OF THE ACCOMPLISHMENT OF KEY ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE OBJECTIVES. PERFORMANCE LEVELS ARE ESTABLISHED AND REVIEWED ANNUALLY AT THRESHOLD, TARGET AND MAXIMUM LEVELS, ACCORDING TO PLANNED "STRETCH" GOALS AND OBJECTIVES. INCENTIVE AWARD OPPORTUNITIES ARE ESTABLISHED ACCORDING TO MARKET PRACTICES BASED ON EACH ELIGIBLE POSITION'S RESPONSIBILITIES, PERFORMANCE AND LEVEL OF AUTHORITY. PERFORMANCE RELATIVE TO STIP AWARD OPPORTUNITIES INCORPORATES A BROAD SPECTRUM OF PRE-DEFINED FINANCIAL AND NON-FINANCIAL METRICS THAT ARE ALIGNED WITH ORGANIZATIONAL MISSION AND VALUES. A CHEFA- SERIES D 060806186 20774YJE8 2012-05-31 40467946 REFINANCING A & C ISSUED 92 & 95 0 0 0 A 9015000 40467953 775780 39692173 2012 1 0 1 1 A 0 1 1 0 0 0 0 0 1 A 0 PART III - PRIVATE BUSINESS USE THIS SECTION IS NOT REQUIRED TO BE COMPLETED AS THE BOND REFUNDED PRE-2003 BOND ISSUANCES. SEE PART V SEE PART V SEE PART V 1 8468 0 CONNECTICUT NEUROSURGICAL SPECIALISTS PC SEE SCHEDULE O 487581 SEE PART V 0 EBP SUPPLY SOLUTIONS SEE SCHEDULE O 268177 SEE PART V 0 PART I EXCESS BENEFIT TRANSACTIONS (A)NAME OF DISQUALIFIED PERSON:CONNECTICUT NEUROSURGICAL SPECIALISTS, P.C. (CNS)/DRS. KENNETH LIPOW AND GARY ZIMMERMAN(B)RELATIONSHIP BETWEEN DISQUALIFIED PERSON AND ORGANIZATION: CNS RENTS SPACE FROM THE HOSPITAL AND PROVIDES MEDICAL SERVICES TO THE HOSPITAL. CNS' OBLIGATIONS UNDER THE LEASE WERE GUARANTEED BY DRS. LIPOW AND ZIMMERMAN.(C)DESCRIPTION OF TRANSACTION: THERE WERE CERTAIN AMOUNTS DUE TO AND FROM CNS AND THE HOSPITAL THAT WERE NOT TIMELY PAID AND/OR PAID AT WHAT WAS LATER DETERMINED TO BE LESS THAN FAIR MARKET VALUE. THE ISSUE WAS DISCOVERED AND SELF CORRECTED. REASONABLE STEPS HAVE BEEN TAKEN TO MITIGATE ANY FUTURE OCCURANCE.PART I, LINE 2A REQUEST FOR ABATEMENT HAS BEEN OR WILL BE FILED BY THE DISQUALIFIED PERSONS. THE ORGANIZATION BELIEVES THAT NO ORGANIZATION MANAGER PARTICIPATED IN THE TRANSACTION KNOWING THAT IT WAS AN EXCESS BENEFIT TRANSACTION. PART IV, COLUMN D BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONSNAME OF INTERESTED PERSON: CONNECTICUT NEUROSURGICAL SPECIALISTS, P.C.TRUSTEE GARY ZIMMERMAN, M.D., IS A GREATER THAN 35% OWNER OF CONNECTICUT NEUROSURGICAL SPECIALISTS, P.C. CONNECTICUT NEUROSURGICAL SPECIALISTS, P.C. RENTS SPACE FROM THE HOSPITAL AND PROVIDES MEDICAL SERVICES TO THE HOSPITAL.AMOUNT OF TRANSACTION: $409,152 (MEDICAL SERVICES) AND $78,429 (RENTAL PAYMENTS FROM CNS TO THE HOSPITAL) NAME OF INTERESTED PERSON: EBP SUPPLY SOLUTIONSTRUSTEE MEREDITH REUBEN IS THE SOLE STOCKHOLDER AND CHIEF EXECUTIVE OFFICER OF EBP SUPPLY SOLUTIONS, INC. AFTER PERFORMING AN OBJECTIVE REVIEW PROCESS, WHICH INCLUDED A COMPARISON TO COMPETITIVE ALTERNATIVES AVAILABLE IN THE MARKETPLACE AND IN WHICH MS. REUBEN WAS NOT INVOLVED, THE HOSPITAL PURCHASED JANITORIAL AND FOOD SERVICE SUPPLIES AND SERVICES FROM EBP SUPPLY SOLUTIONS, INC.AMOUNT OF TRANSACTION: $268,177 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 TEN (10) VOTING MEMBERS ARE INDEPENDENT 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 6 THE SOLE MEMBER OF BRIDGEPORT HOSPITAL IS YALE NEW HAVEN HEALTH SERVICES CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE HOSPITAL NOMINATES INDIVIDUALS TO SERVE ON THE HOSPITAL'S BOARD FOR APPROVAL BY ITS SOLE MEMBER, YALE NEW HAVEN HEALTH SERVICES CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER, YALE NEW HAVEN HEALTH SERVICES CORPORATION, HAS THE RIGHT TO ELECT THE BOARD OF DIRECTORS OF THE ORGANIZATION, AND(ON THE RECOMMENDATION OF THE BOARD OF DIRECTORS) THE FOLLOWING ADDITIONAL RIGHTS TO APPROVE OPERATING, CASH FLOW AND CAPITAL BUDGETS; TO APPROVE GRADUATE AND UNDERGRADUATE MEDICAL EDUCATION ARRANGEMENTS; TO APPROVE MAJOR NEW CLINICAL PROGRAMS AND SERVICES AND CONTINUATION OF SAME; APPROVAL OF STRATEGIC PLANS; AND ADOPTION OF SAFETY AND QUALITY ASSESSMENT POLICIES THAT DO NOT CONFORM WITH SYSTEM POLICIES; TO APPROVE THE MERGER, CONSOLIDATION, DISSOLUTION OR THE SALE OF ALL OR SUBSTANTIALLY ALL THE ORGANIZATION'S ASSETS; TO AMEND THE CERTIFICATE OF INCORPORATION AND BYLAWS OF THE ORGANIZATION, TO APPROVE THE EXECUTION OF LONG-TERM OR MATERIAL AGREEMENTS.YALE NEW HAVEN HEALTH SERVICES CORPORATION RETAINS THE FOLLOWING DIRECT AUTHORITY: ADOPTION OF BUDGETARY TARGETS, INDEBTEDNESS, MANAGEMENT AND CONTROL OF LIQUID ASSETS, APPOINTMENT OF THE INDEPENDENT AUDITOR AND APPOINTMENT OF THE CEO. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 TAX RETURN AND ATTACHED SCHEDULES WERE PREPARED BY EMPLOYEES OF THE SYSTEM TAX DEPARTMENT. THE RETURN IS INITIALLY REVIEWED BY THE EXECUTIVE DIRECTOR/DIRECTOR OF FINANCE. SUBSEQUENTLY IT IS SENT TO KPMG LLP FOR THEIR INITIAL REVIEW. AFTER ALL COMMENTS FROM THE ABOVE GROUP ARE CLEARED, THE RETURN IS THEN REVIEWED BY THE CHIEF FINANCIAL OFFICER OF THE ENTITY AND A FINAL VERSION OF THE RETURN IS SENT BACK TO KPMG LLP FOR FINAL REVIEW. PRIOR TO FILING, THE ORGANIZATION MADE AVAILABLE A COMPLETE COPY OF THE RETURN TO THE BOARD OF DIRECTORS VIA A WEB PORTAL. FORM 990, PART VI, SECTION B, LINE 12C BRIDGEPORT HOSPITAL IS COVERED UNDER THE YALE NEW HAVEN HEALTH SERVICES CORP. CONFLICT OF INTEREST POLICY. THE YALE NEW HAVEN HEALTH SYSTEM CONFLICT OF INTEREST POLICY (CC:R-7) AND INDIVIDUAL ANNUAL DISCLOSURE FORM APPLIES TO A POOL OF EMPLOYEES, BOARD MEMBERS AND NON-BOARD MEMBERS SERVING ON BOARD COMMITTEES. THESE "COVERED INDIVIDUALS" ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT, UPON BEGINNING EMPLOYMENT OR OTHERWISE BECOMING A COVERED INDIVIDUAL AND ANNUALLY THEREAFTER. COVERED INDIVIDUALS ARE ALSO REQUIRED TO IMMEDIATELY REPORT MATERIAL CHANGES TO THEIR MOST RECENTLY COMPLETED DISCLOSURE STATEMENT. THESE DISCLOSURE STATEMENTS AND REPORTS ARE REVIEWED BY THE OFFICE OF PRIVACY AND CORPORATE COMPLIANCE AND/OR THE LEGAL AND RISK SERVICES DEPARTMENT TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. IF A POTENTIAL CONFLICT ARISES, THE PRESIDENT AND CEO WOULD CONSULT WITH THE BOARD CHAIRPERSON AND THE LEGAL AND RISK SERVICES DEPARTMENT AND TAKE ANY ACTIONS THAT SHE DEEMS REQUIRED OR APPROPRIATE TO MANAGE OR RESOLVE A POTENTIAL CONFLICT OF INTEREST. FOR EXAMPLE, A VOTING BOARD OR COMMITTEE MEMBER WOULD BE REQUIRED TO RECUSE HIMSELF OR HERSELF FROM VOTING ON MATTERS RELATED TO THE POTENTIAL CONFLICT AND THE POTENTIAL CONFLICT WOULD BE DISCLOSED TO OTHER VOTING MEMBERS. FORM 990, PART VI, SECTION B, LINE 15 LINE 15A - COMPENSATION PROCESS FOR TOP OFFICIAL AND LINE 15B - COMPENSATION PROCESS FOR OTHER OFFICERS OR KEY EMPLOYEES: THE MANAGEMENT AFFAIRS COMMITTEE OF BRIDGEPORT HOSPITAL STRIVES TO TAKE THE STEPS NECESSARY TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER FEDERAL TAX LAW. THE MANAGEMENT AFFAIRS COMMITTEE IS AUTHORIZED UNDER THE BRIDGEPORT HOSPITAL BYLAWS AND IS RESPONSIBLE FOR (1) DETERMINING THE OVERALL TOTAL COMPENSATION STRATEGY FOR ALL CORPORATE OFFICERS, (2) APPROVING ALL COMPENSATION AND BENEFITS DECISIONS FOR CORPORATE OFFICERS, AND (3) REPORTING SUCH ACTIONS TO THE FULL BRIDGEPORT HOSPITAL BOARD ON AN ANNUAL BASIS. IN ADDITION, THE MANAGEMENT AFFAIRS COMMITTEE EXPRESSLY DETERMINES THE REASONABLENESS OF TOTAL COMPENSATION AND BENEFITS FOR ALL CORPORATE OFFICERS, AND ASSURES THAT ALL OFFICER COMPENSATION DECISIONS ARE MADE AFTER THOROUGH CONSIDERATION OF AND COMPARISON TO THE MARKET PRACTICES OF OTHER SIMILARLY SITUATED NOT-FOR-PROFIT HEALTHCARE EXECUTIVES IN COMPARABLE ORGANIZATIONS. THE MANAGEMENT AFFAIRS COMMITTEE CONSISTS OF BOARD MEMBERS WHO DO NOT HAVE MATERIAL FINANCIAL INTERESTS THAT COULD BE AFFECTED BY THE OFFICER COMPENSATION DECISIONS MADE BY THE COMMITTEE. THE COMPARABILITY DATA USED TO ASSIST THE MANAGEMENT AFFAIRS COMMITTEE IN ITS COMPENSATION DELIBERATIONS ARE COMPILED BY AN INDEPENDENT, NATIONAL COMPENSATION CONSULTING FIRM THAT IS RETAINED BY AND REPORTS DIRECTLY TO THE MANAGEMENT AFFAIRS COMMITTEE. THE DATA COLLECTED BY THE CONSULTANT CONSISTS OF MARKET INFORMATION FOR EXECUTIVES IN FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS. THE DELIBERATIONS AND DECISIONS OF THE MANAGEMENT AFFAIRS COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED, REVIEWED AND APPROVED BY THE MANAGEMENT AFFAIRS COMMITTEE, AND PROVIDED TO THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 COPIES OF FORM 990, FORM 1023 (IF AVAILABLE) AND AUDITED FINANCIAL STATEMENTS ARE MAINTAINED IN THE SYSTEM TAX DEPARTMENT. OTHER CORPORATE GOVERNING DOCUMENTS ARE MAINTAINED BY THE LEGAL AND RISK SERVICES DEPARTMENT. THE CONFLICT OF INTEREST POLICY, WHISTLEBLOWER POLICY, AND DOCUMENT RETENTION POLICY ARE AVAILABLE TO ALL EMPLOYEES ON THE CORPORATE INTERNAL WEBSITE. COPIES OF ALL DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 62,352,799. MANAGEMENT AND GENERAL EXPENSES 16,733,626. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 79,086,425. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 34,798,072. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 34,798,072. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 8,872,963. MANAGEMENT AND GENERAL EXPENSES 2,815,801. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,688,764. FORM 990, PART XI, LINE 9: OTHER NON OPERATING INCOME ADJUSTMENT 315,162. NET CHANGE OF INTEREST IN BHF 522,500. NET ASSETS RELEASE FROM RESTRICTION - BHF 2,126,210. RECLASS BHF INVESTMENT INCOME TO CHANGE OF NET ASSETS 2,320,370. RECLASS REALIZED INVESTMENT FROM TEMP RESTRICTED TO P/L -229,821. INCREASE IN UNRESTRICTED NET ASSETS -40,727,724. INCREASE IN TEMP RESTRICTED NET ASSETS 7,458,000. INCREASE IN PERM RESTRICTED NET ASSETS 257,000. GREENWICH HOSPITAL 5 PERRYRIDGE ROAD GREENWICH CT 06830 060646659 HEALTHCARE SERVICES CT 501C3 LINE 3 SEE SCHEDULE R PART VII 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 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 1 SOUTHERN CONNECTICUT HEALTH SYSTEM PROPERTIES INC 267 GRANT STREET BRIDGEPORT CT 06610 061297708 TITLE HOLDING CT 501C2 BRIDGEPORT HOSPITAL 1 BRIDGEPORT HOSPITAL AUXILIARY INC 267 GRANT STREET BRIDGEPORT CT 06610 066042500 SYSTEM SUPPORT SERVICES CT 501C3 LINE 11A, I BRIDGEPORT HOSPITAL 1 BRIDGEPORT HOSPITAL FOUNDATION INC 267 GRANT STREET BRIDGEPORT CT 06610 222908698 SYSTEM SUPPORT SERVICES CT 501C3 LINE 7 BRIDGEPORT HOSPITAL 1 NORTHEAST MEDICAL GROUP INC 99 HAWLEY LANE STRATFORD CT 06614 061330992 HEALTHCARE SERVICES CT 501C3 LINE 9 YALE NEW HAVEN HEALTH SERVICES CORP 1 NORTHEAST MEDICAL GROUP PLLC 99 HAWLEY LANE STRATFORD CT 06614 352380180 HEALTHCARE SERVICES CT 501C3 LINE 11A, I NORTHEAST MEDICAL GROUP INC 1 YALE NEW HAVEN HOSPITAL 20 YORK STREET NEW HAVEN CT 06504 060646652 HEALTHCARE SERVICES CT 501C3 LINE 3 YALE NEW HAVEN HEALTH SERVICES CORP 1 YALE-NEW HAVEN CARE CONTINUUM CORP 789 HOWARD AVE NEW HAVEN CT 06519 455235566 NURSING HOME CT 501C3 LINE 3 YALE NEW HAVEN HOSPITAL 1 YALE NEW HAVEN HEALTH SERVICES CORP 789 HOWARD AVE NEW HAVEN CT 06519 222529464 SYSTEM SUPPORT SERVICES CT 501C3 LINE 11A, I N/A 0 PERRYRIDGE CORPORATION 5 PERRYRIDGE ROAD GREENWICH CT 06830 061207316 SYSTEM SUPPORT SERVICES CT 501C3 LINE 11B, II SEE SCHEDULE R PART VII 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 1 LAWRENCE MEMORIAL COPRORATION 365 MONTAUK AVENUE NEW LONDON CT 06320 222553028 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LMW HEALTHCARE INC 1 LAWRENCE MEMORIAL FOUNDATION INC 365 MONTAUK AVENUE NEW LONDON CT 06320 222553026 FUNDRAISING SERVICES CT 501C3 PF LAWRENCE MEMORIAL COPRORATION 1 WESTERLY HOSPITAL AUXILIARY INC 25 WELLS ST WESTERLY RI 02891 222507181 FUNDRAISING ACTIVITIES RI 501C3 LINE 11C, III-FI LMW HEALTHCARE INC 1 L&M HEALTHCARE INC 365 MONTAUK AVENUE NEW LONDON CT 06320 222553031 SYSTEM SUPPORT SERVICES CT 501C3 LINE 11A, I LAWRENCE MEMORIAL COPRORATION 1 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 789 HOWARD AVENUE NEW HAVEN CT 06519 271374301 INVESTMENT DE N/A YNHHS-MSO INC 789 HOWARD AVE NEW HAVEN CT 06519 061467717 MANAGEMENT SERVICES CT N/A C 1 YALE NEW HAVEN AMBULATORY SERVICES 40 TEMPLE STREET NEW HAVEN CT 06510 061398526 HEALTHCARE SERVICES CT N/A C 1 MEDICAL CENTER REALTY INC 50 YORK STREET NEW HAVEN CT 06511 061110858 RENTAL SERVICES CT N/A C 1 GREENWICH FERTILITY & IVF PC 5 PERRYRIDGE ROAD GREENWICH CT 06830 300145464 HEALTHCARE SERVICES CT N/A C 1 YORK ENTERPRISES INC 50 YORK STREET NEW HAVEN CT 06511 061110937 TITLE HOLDING CT N/A C 1 YNHH-PHYSICIANS CORP 789 HOWARD AVE NEW HAVEN CT 06519 061202305 ADMINISTRATIVE SERVICES CT N/A C 1 MEDICAL CENTER PHARMACY INC 50 YORK STREET NEW HAVEN CT 06511 061087673 PHARMACY CT N/A C 1 GREENWICH OCCUPATIONAL HEALTH SERVICES OF NY PC 5 PERRYRIDGE ROAD GREENWICH CT 06830 061540101 HEALTHCARE SERVICES NY N/A C 1 GREENWICH OCCUPATIONAL HEALTH SERVICES OF NEW JERSEY 5 PERRYRIDGE ROAD GREENWICH CT 06830 453833883 HEALTHCARE SERVICES NJ N/A C 1 PRIMARYNET OF CONNECTICUT INC- TERMINATED 93016 789 HOWARD AVE NEW HAVEN CT 06519 061463534 HEALTHCARE SERVICES CT N/A C 1 CENTURY FINANCIAL SERVICES INC 23 MAIDEN LANE NORTH HAVEN CT 06473 061110797 DEBT COLLECTION SERVICES CT N/A C 1 CENTURY MANAGEMENT SERVICES INC 23 MAIDEN LANE NORTH HAVEN CT 06473 061303173 RECEIVABLE MANAGEMENT SERVICES CT N/A C 1 L&M SYSTEMS INC 365 MONTAUK AVENUE NEW LONDON CT 06320 222553037 HEALTHCARE RELATED SERVICES CT N/A C 1 L&M HOME CARE SERVICES INC 365 MONTAUK AVENUE NEW LONDON CT 06320 061389272 HOME THERAPY CT N/A C 1 LAWRENCE & MEMORIAL INDEMNITY COMPANY LTD PO BOX 1159 KY1-1102 GRAND CAYMAN CJ 981021436 INSURANCE CJ N/A C 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 YALE NEW HAVEN HEALTH SERVICES CORPORATION P 79217925 TRANSACTION REVIEW YALE NEW HAVEN HEALTH SERVICES CORPORATION M 77416962 COMPARABLE MARKET VALUE BRIDGEPORT HOSPITAL FOUNDATION INC Q 2854000 TRANSACTION REVIEW BRIDGEPORT HOSPITAL FOUNDATION INC L 1302285 TRANSACTION REVIEW YALE NEW HAVEN HEALTH SERVICES CORPORATION L 11098363 COMPARABLE MARKET VALUE YALE NEW HAVEN HEALTH SERVICES CORPORATION Q 5292353 TRANSACTION REVIEW NORTHEAST MEDICAL GROUP INC R 466140 CASH BRIDGEPORT HOSPITAL AUXILIARY INC S 446105 TRANSACTION REVIEW BRIDGEPORT HOSPITAL AUXILIARY INC C 89570 TRANSACTION REVIEW BRIDGEPORT HOSPITAL FOUNDATION INC S 5410452 CASH PART II (F), DIRECT CONTROLLING ENTITY OF TAX-EXEMPT ORGANIZATIONS: 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.