2017-08-14T14:59:13-05:00 2016-09-30 135565207 KPMG LLP 345 PARK AVENUE NEW YORK NY 10154 990 2015-10-01 060646659 GREENWICH HOSPITAL GREE 2038633000 5 PERRYRIDGE ROAD GREENWICH CT 06830 EUGENE COLUCCI SR VP 2038633000 2017-08-14 0 ROBERT ROBINSON P00741489 2127589700 2015 2021-01-29 14:40:06Z NORMAN ROTH 5 PERRYRIDGE ROAD GREENWICH CT 06830 384548082 0 X WWW.GREENWICHHOSPITAL.ORG X 1903 CT TO PROVIDE HEALTHCARE SERVICES. 24 18 2054 715 6233549 0 8402281 8177500 340737212 357650227 5155848 3723754 11612471 12039232 365907812 381590713 397291 381724 0 0 164159732 151119718 0 0 3205124 167474118 199007428 332031141 350508870 33876671 31081843 494263689 521735219 143652158 174820369 350611531 346914850 X TO PROVIDE HEALTHCARE SERVICES. 0 0 250367210 381724 367999947 SEE SCHEDULE O 250367210 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 1 493 0 2054 1 1 1 0 0 0 0 1 1 0 0 0 0 X 24 18 1 0 1 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 X DENIS DONEGAN 2036886088 789 HOWARD AVENUE NEW HAVEN CT 06519 PAUL J APOSTOLIDES TRUSTEE 1.00 1.00 X 0 0 0 WILLIAM BERKLEY TRUSTEE 1.00 1.00 X 0 0 0 ALAN BREED TRUSTEE 1.00 2.00 X 0 0 0 NANCY BROWN TRUSTEE (END 10/15) 1.00 1.00 X 0 0 0 PETER DAPUZZO TRUSTEE 1.00 2.00 X 0 0 0 MARC GABELLI TRUSTEE (START 3/16) 1.00 2.00 X 0 0 0 ELIZABETH GALT TRUSTEE AND SECRETARY 1.00 1.00 X X 0 0 0 ANNE JUGE TRUSTEE AND TREASURER 1.00 2.00 X X 0 0 0 ROBIN KANAREK TRUSTEE 1.00 1.00 X 0 0 0 DONALD KIRK TRUSTEE (END 10/15) 1.00 1.00 X 0 0 0 SALLY LOCHNER TRUSTEE (END 9/16) 1.00 1.00 X 0 0 0 ARTHUR MARTINEZ TRUSTEE AND CO CHAIR 1.00 3.00 X X 0 0 0 BARBARA MILLER TRUSTEE AND CO-VICE CHAIR 1.00 2.00 X X 0 0 0 AMY MINELLA TRUSTEE 1.00 2.00 X 0 0 0 JACK MITCHELL TRUSTEE 1.00 1.00 X 0 0 0 DANIEL L MOSLEY TRUSTEE (END 9/16) 1.00 3.00 X 0 0 0 CHRISTOPHER O'CONNOR TRUSTEE 1.00 39.00 X 0 1210574 388215 VENITA OSTERER TRUSTEE (END 9/16) 1.00 1.00 X 0 0 0 THOMAS PELLECHI TRUSTEE 1.00 1.00 X 0 0 0 CHRISTINE RANDOLPH TRUSTEE (START 9/16) 1.00 1.00 X 0 0 0 NORMAN ROTH TRUSTEE AND PRESIDENT 32.00 8.00 X X 861657 215411 113148 JIM SABETTA TRUSTEE 39.00 1.00 X 380664 0 75858 JOHN SCHMELTZER III TRUSTEE (END 9/16) 1.00 1.00 X 0 0 0 JOHN TOWNSEND III TRUSTEE AND CO CHAIR 1.00 4.00 X X 0 0 0 BRUCE WARWICK TRUSTEE (END 9/16) 1.00 1.00 X 0 0 0 FELICE ZWAS TRUSTEE 1.00 1.00 X 0 0 0 CHRISTINE BEECHNER VP 39.00 1.00 X 172504 0 40486 SUSAN BROWN SENIOR VP 39.00 1.00 X 387981 0 58492 EUGENE COLUCCI SENIOR VP 36.00 4.00 X 550066 61119 208733 DEBORAH HODYS VP 39.00 1.00 X 477880 0 42764 MARC KOSAK VP 39.00 1.00 X 310854 0 45460 NANCY LEVITT-ROSENTHAL SENIOR VP (END 11/15) 32.00 8.00 X 353088 88273 154114 SPIKE LIPSCHUTZ MD VP 39.00 1.00 X 497461 0 41933 DANA MARNANE VP (START 10/15) 39.00 1.00 X 185018 0 16146 MELISSA TURNER SENIOR VP 20.00 20.00 X 205444 205444 147594 JIM WRIGHT VP (START 10/15) 39.00 1.00 X 184325 0 10258 VICKI ALTMEYER DIRECTOR OF PATHOLOGY 40.00 0.00 X 592666 0 56786 DOROTHY BLACKMUN PATHOLOGIST 40.00 0.00 X 466307 0 35927 RICHARD EISEN DIRECTOR OF PATHOLOGY 40.00 0.00 X 430572 0 22977 ILEANA GREEN PATHOLOGIST 40.00 0.00 X 447694 0 20459 STEPHEN JONES CHIEF SAFETY OFFICER/DIRECTOR 40.00 0.00 X 388191 0 62225 FRANK CORVINO FORMER OFFICER (12/14) 0.00 0.00 X 0 915327 3640 BRIAN DORAN FORMER OFFICER (9/15) 0.00 0.00 X 337794 0 26684 7230166 2696148 1571899 299 1 1 0 GREENWICH ULTRASOUND ASSOC 67 HOLLY HILL RD GREENWICH CT 06830 ULTRASOUND SERVICE 3237657 UNITEX TEXTILE RENTAL 161 SOUTH MACQESTEN PARKWAY MOUNT VERNON NY 10550 UNIFORM LAUNDERING 1320219 CENTURY MANAGEMENT SERVICES 23 MAIDEN LANE NORTH HAVEN CT 06473 DEBT COLLECTION 1061019 QUEST DIAGNOSTIC 15 CAMPUS BOULEVARD NEWTOWN SQUARE PA 19073 MEDICAL COMPLIANCE 1034258 NURSEFINDERS 524 EAST LAMAR BLVD SUITE 300 ARLINGTON TX 76011 RECRUITING 730147 55 1127929 163571 6886000 705517 8177500 OUTPATIENT PROGRAM SERVICES 621400 194130011 194130011 INPATIENT PROGRAM SERVICES 612990 152942803 152942803 OUTREACH LAB 621500 6233413 6233413 PATHOLOGY PATIENT REVENUE 621500 4344000 4344000 357650227 530134 136 529998 1854416 141088 1713328 1713328 1713328 4821825 489868 2118073 0 2703752 489868 3193620 3193620 144125 1127929 698208 -554083 -554083 PATHOLOGY SERVICES 900099 2640233 2640233 IVF SERVICE INCOME 900099 1918839 1918839 CLINIC SERVICES 900099 1007573 1007573 5313342 4783075 530267 10879987 381590713 361766534 6233549 5413130 X 381724 381724 8262268 8262268 114815470 88256442 24866978 1692050 3025214 2762970 262244 16452202 12726933 3219134 506135 8564564 6238318 2206645 119601 4519161 3360942 1158219 566762 366060 126148 74554 233013 173294 59719 79202 79202 75465976 55973402 19281204 211370 5939632 4172548 1437907 329177 8929549 6640989 2288560 13705324 9990312 3442775 272237 529825 394036 135789 350866 260942 89924 18696127 6535073 12161054 2706069 2012529 693540 PHARMACEUTICAL SUPPLIES 28200757 20973166 7227591 0 MEDICAL SUPPLY EXPENSE 27388015 20368722 7019293 0 EDUCATION & OTHER EMPL 6527643 4854669 1672974 0 OTHER PATHOLOGY EXPENSE 4344000 3231000 1113000 0 825507 613937 211570 350508870 250367210 96936536 3205124 24997890 13091369 74483889 120083800 38149419 38130498 1636165 1962864 6244397 5157662 477813225 249895877 215976202 227917348 9085610 7067871 88158568 68101913 35531549 40221894 494263689 521735219 31776164 38248735 35105000 32070314 76770994 104501320 143652158 174820369 X 298677899 292116010 41782451 44533260 10151181 10265580 350611531 346914850 494263689 521735219 X 31081843 1631000 -36409524 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 500 0 0 1 40940 0 1 79202 120642 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. GREENWICH HOSPITAL IS PART OF A CONTROLLED GROUP WITH THE FOLLOWING LOBBYING EXPENSES: YALE-NEW HAVEN HOSPITAL EIN 06-0646652 $1,099,541 BRIDGEPORT HOSPITAL EIN 06-0646554 $ 596,691 NORTHEAST MEDICAL GROUP EIN 06-1330992 $ 42,892 LAWRENCE + MEMORIAL HOSPITAL EIN 06-0646704 $ 97,147 LMW HEALTHCARE, INC. EIN 46-0543230 $ 66,063 83683000 464000 6271000 4236000 86182000 87493000 388000 -783000 3415000 83683000 78904000 925000 10828000 3164000 87493000 72853000 125000 8395000 2469000 78904000 64905000 100000 10512000 2664000 72853000 0.51910 0.27730 0.20360 0 1 1 6333484 6333484 229891330 86297511 143593819 27435228 11492983 15942245 204960359 152105383 52854976 9192824 9192824 227917348 OTHER SECURITIES 68101913 F 68101913 OTHER RECEIVABLES 33442456 EPIC SHARED PROJECT 6779438 40221894 DUE-3RD PARTY & OTHER PAYORS 12935284 EST LIABILITY-SELF INSURANCE 21880343 FORWARD INTEREST RATE SWAP 4148322 ACCRUED PENSION 64829371 OTHER ACCRUED EXPENSES AND CURRENT LIAB. 708000 104501320 X PART V, LINE 4: THE ENDOWED FUNDS' INTENDED USE IS TO GENERATE INCOME TO SUPPORT GREENWICH HOSPITAL PROGRAM SERVICE FUNCTIONS AND OTHER OPERATIONS IN ACCORDANCE WITH THE GREENWICH HOSPITAL POOLED INVESTMENT POLICY. PART X, LINE 2: THE CONSOLIDATED FINANCIAL STATEMENTS OF GREENWICH HOSPITAL AND SUBSIDIARIES INCLUDE THE FOLLOWING FIN48 DISCLOSURE: GH AND ITS SUBSIDIARIES, WITH THE EXCEPTION OF GASC, 900 KING STREET ASSOCIATES, LLC, GREENWICH CLINICAL PATHOLOGY ASSOCIATES, LLC AND GREENWICH PATHOLOGY ASSOCIATES, LLC ARE CONNECTICUT NONSTOCK CORPORATIONS GENERALLY EXEMPT FROM FEDERAL AND STATE INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE CODE. AS QUALIFYING LIMITED LIABILITY COMPANIES, GASC, 900 KING STREET ASSOCIATES, GREENWICH CLINICAL PATHOLOGY ASSOCIATES, LLC AND GREENWICH PATHOLOGY ASSOCIATES, LLC ARE TREATED AS DISREGARDED ENTITIES FOR FEDERAL AND CONNECTICUT STATE TAX PURPOSES. ACCORDINGLY, GASC, 900 KING STREET ASSOCIATES, LLC, GREENWICH CLINICAL PATHOLOGY ASSOCIATED, LLC AND GREENWICH PATHOLOGY ASSOCIATES, LLC ARE SUBJECT TO CONNECTICUT BUSINESS ENTITY TAX OF $250 ANNUALLY, AFTER WHICH ITS NET INCOME OR LOSS PASSES THROUGH TO GH. UNDER U.S. GAAP, GH AND SUBSIDIARIES ARE REQUIRED TO EVALUATE TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN THE COURSE OF PREPARING GH AND SUBSIDIARIES'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. GH AND SUBSIDIARIES 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 GH OR ANY SUBSIDIARIES AS OF AND FOR THE YEAR ENDED SEPTEMBER 30, 2016. GALA 912058 852733 59325 93721 78604 9250 237698 UNDER THE STARS 270037 215737 54300 29376 66363 1200 58558 1 89959 59459 30500 58253 5000 2500 57685 1272054 1127929 144125 181350 149967 12950 353941 698208 -554083 1 1 X 1 X 250.000000000000 0 1 1 1 0 1 1 14582 27867852 923887 26943965 0.07690 26816 28239863 13993849 14246014 0.04060 0 0 41398 56107715 14917736 41189979 0.11750 12 14323 745902 0 745902 0.00210 4 185 4960667 1230199 3730468 0.01060 2 9554 5579566 3490999 2088567 0.00600 0 0 0 0 4 889 158515 0 158515 0.00050 22 24951 11444650 4721198 6723452 0.01920 22 66349 67552365 19638934 47913431 0.13670 1 0 259963 0 259963 0.00070 1 0 1492 0 1492 0.00000 0 0 0 0 0 0 0 0 0 0 0 0 2 270 25747 0 25747 0.00010 0 0 0 0 1 14 3956 0 3956 0.00000 0 0 0 0 5 284 291158 291158 0.00080 1 15919399 100225729 134595154 -34369425 X 1 1 1 NONE NONE 1 1 GREENWICH HOSPITAL 5 PERRYRIDGE ROAD GREENWICH CT 06830 WWW.GREENWICHHOSPITAL.ORG 0045 X X X X X GREENWICH HOSPITAL 1 0 0 1 X X X X X X X X X 15 1 0 1 1 X SEE PART V X SEE PART V X 1 15 1 SEE PART V 0 0 1 X 250.000000000000 X X X X 1 1 X X X 1 X SEE PART V X SEE PART V X SEE PART V 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. GREENWICH HOSPITAL PART V, SECTION B, LINE 5: COMMUNITY ENGAGEMENT AND FEEDBACK WERE AN INTEGRAL PART OF THE CHNA PROCESS. GREENWICH HOSPITAL SOUGHT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL THROUGH FOCUS GROUPS WITH COMMUNITY MEMBERS, KEY INFORMANT INTERVIEWS WITH COMMUNITY STAKEHOLDERS, AND INCLUSION OF COMMUNITY PARTNERS 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 GREENWICH HOSPITAL, INCLUDING MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITY POPULATIONS. GREENWICH HOSPITAL PART V, SECTION B, LINE 6B: THE GREENWICH HOSPITAL BOARD OF TRUSTEES IS DIRECTLY INVOLVED IN THE CHNA THROUGH A SUBCOMMITTEE CALLED THE COMMUNITY ADVISORY COMMITTEE. THE COMMUNITY ADVISORY COMMITTEE INCLUDES 30 MEMBERS WHO REPRESENT A VARIETY OF COMMUNITY ORGANIZATIONS SUCH AS THE UNITED WAY, YMCA, YWCA, HOUSES OF WORSHIP, LOCAL MUNICIPAL HEALTH DEPARTMENTS, HISPANIC HEALTH COUNCIL, FAMILY CENTERS, INC., YOUTH AND SENIOR SERVICES REPRESENTATIVES, NATIONAL ASSOCIATION FOR THE ADVANCEMENT OF COLORED PEOPLE, HOUSING AUTHORITIES OF GREENWICH AND PORT CHESTER, CHAMBER OF COMMERCE, FEDERALLY QUALIFIED HEALTH CENTERS, GREENWICH EMERGENCY MEDICAL SERVICES AND OTHER PRIVATE AND CORPORATE GROUPS. IN 2003, THE COMMUNITY ADVISORY COUNCIL ESTABLISHED THE GREENWICH COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP TO ASSIST WITH MEETING THE HEALTH NEEDS OF THE GREENWICH COMMUNITY. GREENWICH COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP MEMBERS INCLUDE REPRESENTATIVES FROM TOWN OF GREENWICH DEPARTMENT OF HEALTH, DEPARTMENT OF SOCIAL SERVICES, THE UNITED WAY, BOARD OF EDUCATION, PTA, GREENWICH LIBRARY, LEAGUE OF WOMEN'S VOTERS, HOUSING AUTHORITY OF GREENWICH, CHILD GUIDANCE CENTERS, GREENWICH POLICE DEPARTMENT, FAMILY CENTERS, INC., PATHWAYS, YMCA, YWCA, COMMUNITIES 4 ACTION, LOWER FAIRFIELD REGIONAL ACTION COUNCIL SOUTHWEST REGIONAL MENTAL HEALTH BOARD, NATIONAL ALLIANCE ON MENTAL ILLNESS, GREENWICH EMERGENCY MEDICAL SERVICES, SENIOR AND YOUTH REPRESENTATIVES (BOYS & GIRLS CLUB, GREENWICH ADULT DAY CARE), GREENWICH ALLIANCE FOR EDUCATION AND NUMEROUS INTERESTED COMMUNITY MEMBERS.IN NEW YORK, GREENWICH HOSPITAL COLLABORATES WITH THE COUNCIL OF COMMUNITY SERVICES OF PORT CHESTER, RYE BROOK, AND RYE TOWN TO PROVIDE COMMUNITY HEALTH OUTREACH ACTIVITIES. SCHEDULE H, PART V, SEC B, LINE 7A AND 10A:HTTPS://WWW.GREENWICHHOSPITAL.ORG/ABOUT/COMMUNITY/COMMUNITY-HEALTH/NEEDS-ASSESSMENT.ASPXSCHEDULE H, PART V, SEC B, LINE 7B: HTTP://WWW.CT.GOV/DPH/LIB/DPH/OHCA/COMMUNITY_NEEDS_ASSESSMENT/CHNA/2016/2016_GREENWICH_HOSPITAL.PDF; HTTP://WWW.CTDATAHAVEN.ORG/DATA-RESOURCES/FAIRFIELD-COUNTY-COMMUNITY-WELLBEING-INDEX-GREATER-GREENWICH-CHNA-CHAPTER GREENWICH HOSPITAL PART V, SECTION B, LINE 11: IN MARCH 2016, COALITION MEMBERS, LOCAL HEALTH DEPARTMENTS, AND COMMUNITY PARTNERS (INCLUDING THOSE WITH 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. PARTICIPANTS DETERMINED THAT THE CANCER FOCUS AREA WOULD BE INCLUDED WITH STRATEGIES AND ACTION STEPS OUTLINES IN THE HEALTHY LIFESTYLES PRIORITY AREA IN 2016. THE COALITIONS, GREENWICH HOSPITAL AND THE HEALTH DEPARTMENTS CONFIRMED THAT THERE WAS A NEED TO CONTINUE WORKING IN THE 2013 FOCUS AREAS AS THESE WERE STILL THE TOP HEALTH PRIORITY AREAS IN THE REGION. ALL PRIMARY AND SECONDARY DATA THAT WAS COLLECTED, ANALYZED AND REVIEWED SUPPORTED THE CONTINUATION OF 2013 PRIORITY AREAS: HEALTHY LIFESTYLES, ACCESS TO CARE AND MENTAL AND BEHAVIORAL HEALTH. TO LEARN MORE ABOUT HOW GREENWICH HOSPITAL AND ITS COMMUNITY PARTNERS ARE MEETING THESE NEEDS PLEASE REVIEW THE GREENWICH COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP & COUNCIL OF COMMUNITY SERVICES' 2016 GREATER GREENWICH REGION GREENWICH HOSPITAL COLLABORATIVE COMMUNITY HEALTH ASSESSMENT AND IMPLEMENTATION STRATEGIES.GREENWICH 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. GREENWICH HOSPITAL PART V, SECTION B, LINE 13H: THESE PROGRAMS COVER MEDICALLY NECESSARY CARE ONLY. GREENWICH 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 B, LINE 16A, 16B AND 16C: HTTPS://WWW.GREENWICHHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE.ASPXSCHEDULE H, PART V, SECTION D:THE FACILITY LOCATIONS LISTED IN SCHEDULE H, PART V, SECTION D, INCLUDE OFF-CAMPUS OUTPATIENT HEALTH CARE FACILITIES THAT GREENWICH HOSPITAL OPERATED DURING THE TAX YEAR UNDER ITS STATE HOSPITAL LICENSE. 17 1 - PHYSICAL MEDICINE & REHAB CENTER 2015 WEST MAIN STREET STAMFORD CT 06902 DIAGNOSTIC; LAB; REHAB 2 - AMBULATORY SURGICAL CENTER 55 HOLLY HILL LANE GREENWICH CT 06830 OUTPATIENT FACILITY 3 - GREENWICH HOSPITAL HOME CARE 500 WEST PUTNAM AVENUE GREENWICH CT 06831 HOME CARE 4 - GREENWICH HOSPITAL LAB 49 LAKE AVENUE GREENWICH CT 06830 BLOOD DRAW CENTER 5 - GREENWICH HOSPITAL LAB 90 MORGAN STREET STAMFORD CT 06905 BLOOD DRAW CENTER 6 - HOSPITAL OUTPATIENT MEDICAL ONCOLOGY LA 15 VALLEY DRIVE GREENWICH CT 06831 CANCER CENTER; BLOOD DRAW 7 - GREENWICH HOSPITAL LAB 159 WEST PUTNAM AVENUE GREENWICH CT 06831 BLOOD DRAW CENTER 8 - GREENWICH HOSPITAL OCCUP HEALTH 75 HOLLY HILL LANE GREENWICH CT 06830 OCC HEALTH; WOMEN'S HEALTH; LAB 9 - GREENWICH HOSPITAL LAB 40 CROSS STREET NORWALK CT 06850 BLOOD DRAW CENTER 10 - GREENWICH HOSPITAL LAB 90 SOUTH RIDGE STREET RYE BROOK NY 10573 BLOOD DRAW CENTER 11 - GREENWICH HOSPITAL LAB 1275 SUMMER STREET STAMFORD CT 06902 BLOOD DRAW CENTER 12 - GREENWICH HOSPITAL LAB 4 DEERFIELD DRIVE GREENWICH CT 06830 BLOOD DRAW CENTER 13 - GREENWICH HOSPITAL LAB 31 RIVER ROAD GREENWICH CT 06830 BLOOD DRAW CENTER 14 - GREENWICH HOSPITAL LAB 106 NOROTON AVENUE DARIEN CT 06820 BLOOD DRAW CENTER 15 - GREENWICH HOSPITAL LAB 148 EAST AVENUE NORWALK CT 06850 BLOOD DRAW CENTER 16 - GREENWICH HOSPITAL OUTPATIENT 260 LONG RIDGE ROAD STAMFORD CT 06902 MEDICAL FACILITY 17 - GREENWICH HOSPITAL MEDICAL CENTER 35 RIVER ROAD COS COB CT 06807 INTEGRATIVE MEDICINE PART I, LINE 3C: THE FINANCIAL ASSISTANCE POLICY PROVIDES THAT THE PATIENT MUST SUBMIT A FINANCIAL ASSISTANCE APPLICATION. PART I, LINE 7: GREENWICH HOSPITAL ("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: GREENWICH HOSPITAL ALONG WITH MANY OTHER HOSPITALS ACROSS THE COUNTRY UTILIZES THE COMMUNITY BENEFITS INVENTORY FOR SOCIAL ACCOUNTABILITY 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, AND ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENTS, AND WORKFORCE DEVELOPMENT. DURING FISCAL YEAR 2016, GREENWICH HOSPITAL PROVIDED $291,158 IN FINANCIAL AND IN-KIND DONATIONS IN THE AREA OF COMMUNITY BUILDING ACTIVITIES. 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 NEIGHBORHOODSONE OF SEVERAL COMMUNITY INITIATIVES UNDERTAKEN BY GREENWICH HOSPITAL TO ENHANCE ACCESS TO HEALTHY, AFFORDABLE FOOD IS COMMUNITY GARDENS. THIS PROGRAM IS ADMINISTERED IN COLLABORATION WITH THE COUNCIL OF COMMUNITY SERVICES, PORT CHESTER SCHOOLS AND AREA CHURCHES TO PROVIDE FRESH VEGETABLES TO PARTICIPANTS IN PORT CHESTER'S FOUR FOOD PANTRIES, SEVEN SOUP KITCHENS AND NUTRITION CENTERS. THE COUNCIL OF COMMUNITY SERVICES ORGANIZES VOLUNTEERS TO PLANT AND HARVEST THE CROPS. OVER THE PAST SEVERAL YEARS, THE PROGRAM HAS PROVIDED THOUSANDS OF LOW-INCOME PORT CHESTER FAMILIES WITH FRESH VEGETABLES. THE COMMUNITY GARDENS ENCOURAGE HEALTHY EATING HABITS, ENCOURAGE CHILDREN TO TRY NEW VEGETABLES, CONNECT CHILDREN TO NATURE AND THE ENVIRONMENT, AIM TO PREVENT CHILDHOOD OBESITY, AND PROMOTE PHYSICAL ACTIVITY WHILE ENCOURAGING NEW WAYS OF LEARNING AND PROMOTING HEALTH EDUCATION. THE HOSPITAL PROVIDES IN-KIND SUPPORT FOR THE INITIATIVE.TO SUPPORT DRIVING SAFETY, GREENWICH HOSPITAL AND THE AARP CO-SPONSORED AN EDUCATIONAL DRIVING PROGRAM FOR OLDER ADULTS WITH APPROXIMATELY 350 WESTCHESTER AND FAIRFIELD COUNTY ADULTS ATTENDING THE PROGRAM. THE EDUCATIONAL DRIVING PROGRAM PROMOTES SAFETY AND IS INTENDED TO REDUCE ACCIDENT RATES AMONG DRIVERS AGE 55 AND OLDER. GREENWICH HOSPITAL WAS ALSO THE RECIPIENT OF A DONATION OF FUNDS TO DEVELOP A COMMUNITY FLOWER GARDEN ON ITS PROPERTY TO BE OPEN TO THE PUBLIC. RECENT STUDIES HAVE PROVEN THE HEALTH AND WELLNESS BENEFITS ASSOCIATED WITH BEING IN NATURE. VARIOUS COMMUNITY CEREMONIES AND CELEBRATIONS ARE CONDUCTED IN THE GARDEN INCLUDING CANCER SURVIVOR PROGRAMS AND THE TREE OF LIGHT PROGRAM. CREATING EDUCATIONAL OPPORTUNITIES HIGHER 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. TO ENCOURAGE THE PURSUIT OF HIGHER EDUCATION, GREENWICH HOSPITAL SPONSORED SEVERAL PROGRAMS TO INTRODUCE MIDDLE AND HIGH SCHOOL STUDENTS TO POTENTIAL HEALTH CARE CAREERS. GREENWICH HOSPITAL, THROUGH A JOINT EFFORT WITH HIGH SCHOOLS IN PORT CHESTER AND GREENWICH, PROVIDED AN EDUCATIONAL PROGRAM INTRODUCING STUDENTS TO HEALTH CARE CAREER OPPORTUNITIES. A TOTAL OF 17 STUDENTS PARTICIPATED IN THE PROGRAM, WHICH IS AIMED AT EDUCATING AND INSPIRING STUDENTS TO PURSUE FULFILLING HEALTH CARE CAREERS. 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 HEALTHCARE BECAUSE OF INADEQUATE RESOURCES AND/OR WHO ARE UNINSURED OR UNDERINSURED.THE HOSPITAL MAKES AVAILABLE 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 PROVISION FOR BAD DEBT REPRESENT UNCOMPENSATED CARE. THE ESTIMATED COST OF TOTAL UNCOMPENSATED CARE IS APPROXIMATELY $13.9 MILLION AND $12.3 MILLION FOR THE YEARS ENDED SEPTEMBER 30, 2016 AND 2015, RESPECTIVELY. THE ESTIMATED COST OF UNCOMPENSATED CARE IS BASED ON THE HOSPITAL'S COST ACCOUNTING SYSTEM. THIS ANALYSIS CALCULATES THE ACTUAL PERCENTAGE OF ACCOUNTS WRITTEN OFF OR DESIGNATED AS BAD DEBT VS. 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 $8.5 MILLION AND $7.7 MILLION FOR THE YEARS ENDED SEPTEMBER 30, 2016 AND 2015, RESPECTIVELY. THE ESTIMATED COST OF CHARITY CARE IS DETERMINED BY THE HOSPITAL'S COST ACCOUNTING SYSTEM.FOR THE YEARS ENDED SEPTEMBER 30, 2016 AND 2015, PROVISION FOR BAD DEBT, AT CHARGES, WAS APPROXIMATELY $16.2 MILLION AND $12.5 MILLION, RESPECTIVELY. FOR THE YEARS ENDED SEPTEMBER 30, 2016 AND 2015, BAD DEBT EXPENSE, AT COST, WAS APPROXIMATELY $5.4 MILLION AND $4.6 MILLION, RESPECTIVELY. THE PROVISION FOR BAD DEBT 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 AN ASSESSMENT ON HOSPITAL NET PATIENT SERVICE REVENUE. DURING THE YEARS ENDED SEPTEMBER 30, 2016 AND 2015, GH RECEIVED APPROXIMATELY $0.9 MILLION AND $0.4 MILLION, RESPECTIVELY, IN CDSHP DISTRIBUTIONS, OF WHICH APPROXIMATELY $0.6 MILLION WAS RELATED TO CHARITY CARE. GH MADE PAYMENTS INTO THE CDSHP OF $19.5 MILLION AND $14.0 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 COMMUNITY HEALTH SERVICES, SOME OF WHICH SERVICE NON ENGLISH SPEAKING RESIDENTS, DISABLED CHILDREN AND VARIOUS COMMUNITY SUPPORT GROUPS.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 8: THE ENTIRE MEDICARE LOSS PRESENTED SHOULD BE TREATED AS A COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO MEDICARE BENEFICIARIES, IRS REVENUE RULING 69-545 INDICATES THAT HOSPITALS OPERATE FOR THE PROMOTION OF HEALTH IN THE COMMUNITY WHEN IT PROVIDES CARE TO PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, THE HOSPITAL PROVIDES CARE TO MEDICARE PATIENTS REGARDLESS OF MEDICARE SHORTFALLS (REDUCING THE BURDEN ON THE GOVERNMENT), AND MANY OF THE MEDICARE PARTICIPANTS WOULD HAVE QUALIFIED FOR THE CHARITY CARE OR OTHER MEANS TESTED PROGRAMS ABSENT BEING ENROLLED IN THE MEDICARE PROGRAM. THE MEDICARE SHORTFALL REPORTED IS DETERMINED BY THE HOSPITAL'S COST ACCOUNTING SYSTEM, STRATAJAZZ. 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 GREENWICH HOSPITAL. THESE MULTI-DISCIPLINARY GROUPS PROVIDE ANALYSIS AND INSIGHT INTO PATIENT UTILIZATION TRENDS ACROSS THE 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: GREENWICH 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 PROCESS. 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: GREENWICH HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT EFFORTS ARE SPECIFICALLY FOCUSED IN THE TOWNS WHERE THE HOSPITAL IS ENGAGED WITH COMMUNITY PARTNERS. THIS GEOGRAPHIC AREA INCLUDES THE TOWN OF GREENWICH, CONNECTICUT AND THE FOLLOWING TOWNS LOCATED IN THE STATE OF NEW YORK: ARMONK, BEDFORD, LARCHMONT, MAMARONECK, POUND RIDGE, PORT CHESTER / RYE BROOK, AND RYE. THE GREATER GREENWICH REGION HAS A POPULATION OF 173,202. THE MEDIAN AGE FOR BOTH THE POPULATION OF GREENWICH AND ALL NEW YORK STATE AREAS ARE HIGHER THAN THE STATE AS A WHOLE; BY CONTRAST, PORT CHESTER VILLAGE HAS A MEDIAN AGE OF 35.9 WHICH IS LOWER THAN THE STATE AVERAGE OF 40.3. THE TOWNS IN THE REGION VARY DRAMATICALLY IN TERMS OF THEIR RACIAL AND ETHNIC COMPOSITION. GREENWICH AND THE NEW YORK STATE AREAS (EXCLUDING PORT CHESTER VILLAGE) ARE CLOSE TO 80% WHITE AND 10% HISPANIC. BY CONTRAST, PORT CHESTER VILLAGE IS 30% WHITE AND 61% HISPANIC. THERE ARE WIDE GAPS IN MEDIAN HOUSEHOLD INCOME RATES FOR THE GREATER GREENWICH REGION ($125,567), FAIRFIELD COUNTY ($83,163), AND CONNECTICUT ($69,899). THE WIDEST GAP IS FOUND BETWEEN GREENWICH ($135,528) AND PORT CHESTER VILLAGE ($60,141). THE PROPORTION OF RESIDENTS IN THE GREATER GREENWICH REGION WITH A COLLEGE DEGREE OR HIGHER (60%) IS GREATER THAN THAT OF THE STATE OVERALL (37%) AND FAIRFIELD COUNTY (45%). ONLY 21% OF PORT CHESTER VILLAGE ADULTS HAVE A COLLEGE DEGREE OR HIGHER, COMPARED TO 66% OF GREENWICH ADULTS. PART VI, LINE 5: AS A COMMUNITY HEALTH CARE SERVICES PROVIDER, GREENWICH HOSPITAL REMAINS ATTENTIVE TO HEALTH AND WELL-BEING THROUGH EDUCATION, OUTREACH AND OTHER INNOVATIVE SERVICES. DURING FISCAL YEAR 2016, GREENWICH HOSPITAL PROVIDED $51.5 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.GREENWICH 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 OF THE BOARD MEMBERS RESIDING OR WORKING IN THE TOWN OF GREENWICH AND OTHER MUNICIPALITIES 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 804 MEMBERS OF THE GREENWICH HOSPITAL MEDICAL STAFF. GREENWICH HOSPITAL, FOUNDED IN 1903, IS A 206-BED COMMUNITY TEACHING HOSPITAL THAT HAS EVOLVED INTO A PROGRESSIVE REGIONAL HEALTHCARE CENTER, WITH MORE THAN 13,077 INPATIENT DISCHARGES AND 280,635 OUTPATIENT ENCOUNTERS LAST YEAR. THE HOSPITAL OFFERS A WIDE RANGE OF MEDICAL, SURGICAL, DIAGNOSTIC AND WELLNESS PROGRAMS. GREENWICH HOSPITAL IS ONE OF THE TOP FIVE EMPLOYERS IN GREENWICH WITH 1,848 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 1 AMERICAN CANCER SOCIETY 372 DANBURY ROAD WILTON CT 06897 131788491 501(C)(3) 16000 SUPPORT ORGANIZATION BREAST CANCER ALLIANCE 48 MAPLE AVENUE GREENWICH CT 06830 061453500 501(C)(3) 55000 SUPPORT ORGANIZATION GLOBAL LYME ALLIANCE 222 RAILROAD AVENUE STE 2B GREENWICH CT 06830 061559393 501(C)(3) 7500 SUPPORT ORGANIZATION GEMS 111 E PUTNAM AVENUE RIVERSIDE CT 06878 222721171 501(C)(3) 83417 SUPPORT ORGANIZATION HEALTH ASSISTANCE INTERVENTION 1210 MILL STREET EAST BERLIN CT 06023 510642913 501(C)(3) 15000 SUPPORT ORGANIZATION ONS FOUNDATION 6 GREENWICH OFFICE PARK GREENWICH CT 06831 261394760 501(C)(3) 57500 SUPPORT ORGANIZATION UNITED WAY OF GREENWICH ONE LAFAYETTE COURT GREENWICH CT 06830 060646578 501(C)(3) 10000 SUPPORT ORGANIZATION YALE UNIVERSITY PO BOX 208239 NEW HAVEN CT 06520 060646973 501(C)(3) 10000 SUPPORT ORGANIZATION YMCA - RYE 21 LOCUST AVENUE RYE NY 10580 131740515 501(C)(3) 10000 SUPPORT ORGANIZATION YWCA OF GREENWICH 259 E PUTNAM AVENUE GREENWICH CT 06830 060646992 501(C)(3) 26000 SUPPORT ORGANIZATION 10 0 PART I, LINE 2: NONE OF THE AMOUNTS REPORTED ON SCHEDULE I, PART II ARE GRANTS. THESE AMOUNTS ARE DONATIONS AND SPONSORSHIPS GIVEN TO ORGANIZATIONS TO ASSIST IN THE FURTHERANCE OF THEIR CHARITABLE MISSION. GREENWICH HOSPITAL ("GH") CARRIES OUT DUE DILIGENCE IN PROVIDING MONETARY ASSISTANCE ONLY TO QUALIFYING 501(C)3 ORGANIZATIONS THAT COMPLEMENT ITS MISSION OR SUPPORT THE GREATER GOOD IN THE COMMUNITIES SERVED. GH VERIFIES EACH ORGANIZATION'S EIN AS LISTED ON IRS FORM W-9 THAT HAS BEEN SUBMITTED TO GH. ASSISTANCE DONATED BY GH TO THESE QUALIFYING ORGANIZATIONS IS NOT OUTCOMES-BASED AND IS GIVEN IN SUPPORT OF AN INDIVIDUAL ORGANIZATION'S FUNDRAISING EVENTS OR IN SUPPORT OF DIRECT SERVICES. GH MAINTAINS FULL AND COMPLETE RECORDS OF ALL MONETARY ASSISTANCE PROVIDED, HOWEVER DOES NOT MONITOR SPECIFIC FUNDS. X X X X X 0 1 0 0 0 0 0 1 0 CHRISTOPHER O'CONNOR TRUSTEE 0 822935 0 283340 0 104299 0 358561 0 29654 0 1598789 0 0 NORMAN ROTH TRUSTEE AND PRESIDENT 504044 126011 150828 37704 206785 51696 64600 16150 25918 6480 952175 238041 0 0 JIM SABETTA TRUSTEE 332445 0 22239 0 25980 0 39344 0 36514 0 456522 0 0 0 CHRISTINE BEECHNER VP 149360 0 5148 0 17996 0 15321 0 25165 0 212990 0 1279 0 SUSAN BROWN SENIOR VP 326316 0 53604 0 8061 0 39344 0 19148 0 446473 0 0 0 EUGENE COLUCCI SENIOR VP 384134 42682 99981 11109 65951 7328 166578 18509 21282 2364 737926 81992 0 0 DEBORAH HODYS VP 351021 0 89596 0 37263 0 18044 0 24720 0 520644 0 0 0 MARC KOSAK VP 246248 0 41849 0 22757 0 20481 0 24979 0 356314 0 0 0 NANCY LEVITT-ROSENTHAL SENIOR VP (END 11/15) 253266 63317 66587 16647 33235 8309 114661 28665 8630 2158 476379 119096 0 0 SPIKE LIPSCHUTZ MD VP 402323 0 58589 0 36549 0 16470 0 25463 0 539394 0 0 0 DANA MARNANE VP (START 10/15) 147694 0 15888 0 21436 0 10506 0 5640 0 201164 0 0 0 MELISSA TURNER SENIOR VP 139049 139049 38036 38036 28359 28359 61505 61504 12292 12293 279241 279241 0 0 JIM WRIGHT VP (START 10/15) 157875 0 0 0 26450 0 5351 0 4907 0 194583 0 0 0 VICKI ALTMEYER DIRECTOR OF PATHOLOGY 500922 0 63847 0 27897 0 39344 0 17442 0 649452 0 8973 0 DOROTHY BLACKMUN PATHOLOGIST 446490 0 0 0 19817 0 18039 0 17888 0 502234 0 0 0 RICHARD EISEN DIRECTOR OF PATHOLOGY 412835 0 0 0 17737 0 0 0 22977 0 453549 0 39763 0 ILEANA GREEN PATHOLOGIST 422572 0 0 0 25122 0 7999 0 12460 0 468153 0 0 0 STEPHEN JONES CHIEF SAFETY OFFICER/DIRECTOR 347163 0 16719 0 24309 0 39344 0 22881 0 450416 0 1410 0 FRANK CORVINO FORMER OFFICER (12/14) 0 214763 0 287758 0 412806 0 3640 0 0 0 918967 0 404000 BRIAN DORAN FORMER OFFICER (9/15) 34887 0 69919 0 232988 0 22639 0 4045 0 364478 0 249679 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 CHRISTOPHER O'CONNOR $0 $198,811 $0 EUGENE COLUCCI 0 99,337 $0 NANCY LEVITT-ROSENTHAL 0 74,576 $0 MELISSA TURNER 0 69,659 $0 INDIVIDUALS LISTED BELOW BECAME VESTED IN BENEFITS VALUED AT THE AMOUNTS RESPECTIVELY REPORTED BELOW DURING THE REPORTING YEAR. INCLUDED IN SECTION II, COLUMN B (III) ARE AMOUNTS VESTED DURING THE 2015 CALENDAR YEAR THAT WERE RECOGNIZED AS TAXABLE EVENTS AND REPORTED IN THE INDIVIDUALS' 2015 CALENDAR YEAR FORM W-2. BRIAN DORAN $214,691 NORMAN ROTH 178,599 THE FOLLOWING FORMER OFFICERS RECEIVED A PAYMENT FROM A NONQUALIFIED PLAN. THIS AMOUNT IS INCLUDED IN SECTION II, COLUMN B (III) THE FOLLOWING PAYMENT WAS MADE DIRECTLY TO HIM FROM THE RABBI TRUST: QUINTON FRIESEN $127,684 FRANK CORVINO 63,668 THE SUPPLEMENTAL RETIREMENT INCOME PLAN (SRIP) 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 THE SHORT TERM INCENTIVE PLAN (STIP) 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 2008 - SERIES C 060806186 20774UYC3 2008-05-07 53630000 REFINANCE SERIES 2006B 0 0 0 A 21200000 53631315 477687 72256 53091372 2008 1 0 1 1 A 0 1 1 0 1 0 0.01860 0.00310 0.02170 0 0 0 A 0 0 1 1 1 0 0 0 1 A 0 SCHEDULE K SUPPLENTAL INFORMATION REFINANCE ISSUANCE DATE 4/6/2006 PART III, LINE 3C THE ORGANIZATION HAS IN-HOUSE LEGAL STAFF WHO PROVIDE ROUTINE REVIEW OF MANAGEMENT OR SERVICE CONTRACTS OR RESEARCH AGREEMENTS RELATING TO THE FINANCED PROPERTY TO ENSURE THAT SUCH AGREEMENTS ARE COMPLIANT WITH APPLICABLE SAFE HARBORS. IN-HOUSE COUNSEL CONSULT WITH THE HOSPITAL'S OUTSIDE BOND COUNSEL AS NEEDED, INCLUDING ON NON-ROUTINE ISSUES. PART III, LINE 9 & PART V THE ORGANIZATION HAS POLICIES AND PROCEDURES IN PLACE TO ENSURE COMPLIANCE WITH FEDERAL TAX LAW, AND TO TIMELY IDENTIFY NONCOMPLIANCE. IN THE EVENT OF NON-COMPLIANCE THE ORGANIZATION WOULD INVOLVE ITS LEGAL COUNSEL TO ADVISE REGARDING APPROPRIATE REMEDIATION. SCHEDULE K, PART IV, ARBITRAGE, LINE 2C ISSUER NAME: CHEFA 2008 - SERIES C DATE THE REBATE COMPUTATION WAS PERFORMED: 06/30/2009 & 06/30/2014 0 SUBST CONTR #35 VENDOR 200078 DEBT COLLECTION 0 SUBST CONTR #134 VENDOR 237805 MEDICAL SERVICES 0 X 4 50600 FAIR MARKET VALUE X 154900 FAIR MARKET VALUE X 4 70308 FAIR MARKET VALUE X 3 7480 FAIR MARKET VALUE X 2 163571 FAIR MARKET VALUE X MISCELLANEOUS 587 136243 FAIR MARKET VALUE X VACACTION/ENTERTAINENT 24 100140 FAIR MARKET VALUE X PHOTOGRAPHY 8 22275 FAIR MARKET VALUE 0 1 0 PART I, COLUMN (B): THE ORGANIZATION IS REPORTING IN PART I, COLUMN (B), THE NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART III, LINE 4A A MEMBER OF YALE NEW HAVEN HEALTH SINCE 1998, GREENWICH HOSPITAL BROUGHT HIGH QUALITY, COST-EFFECTIVE CARE TO THOUSANDS OF RESIDENTS OF CONNECTICUT AND NEW YORK LAST YEAR. THE HOSPITAL INCREASED VOLUME IN TARGETED SERVICES, EXPANDED ACCESS AND REACH, AND IMPROVED PATIENT SAFETY AND QUALITY DURING THE YEAR. FIFTY-TWO NEW PHYSICIANS JOINED THE MEDICAL STAFF, INCLUDING SPECIALISTS IN HYPERBARIC MEDICINE, SLEEP DISORDERS AND PAIN MANAGEMENT. SAFETY AND QUALITY OF CARE REMAINED THE TOP PRIORITY. IN JULY 2016, GREENWICH HOSPITAL RECEIVED THE PRESTIGIOUS MAGNET DESIGNATION FROM THE AMERICAN NURSES CREDENTIALING CENTER (ANCC), PLACING IT AMONG APPROXIMATELY 7 PERCENT OF THE MORE THAN 5,600 HOSPITALS NATIONWIDE, AND ONE OF ONLY SIX IN CONNECTICUT. MAGNET DESIGNATION, THE HIGHEST HONOR OF NURSING EXCELLENCE ANY HOSPITAL CAN ACHIEVE, RECOGNIZES QUALITY PATIENT CARE, NURSING EXCELLENCE AND INNOVATIONS IN PROFESSIONAL PRACTICE. THE HOSPITAL RECEIVED THE JOINT COMMISSION'S GOLD SEAL OF APPROVAL FOR ADHERING TO STRICT STANDARDS FOR EXCELLENCE AND SAFETY IN SPINAL FUSION AND TOTAL HIP AND KNEE REPLACEMENT. THE HOSPITAL ALSO RECEIVED THE AMERICAN HEART ASSOCIATION AND AMERICAN STROKE ASSOCIATION QUALITY ACHIEVEMENT AWARD FOR ITS HIGHER STROKE CARE STANDARD; THE WOMEN'S CHOICE AWARD FOR PATIENT SAFETY AND AN "A" SAFETY RATING FROM THE LEAPFROG GROUP. THE HOSPITAL OPENED ITS LARGEST, MOST COMPREHENSIVE OUTPATIENT SITE IN SEPTEMBER. THE LONG RIDGE MEDICAL CENTER, A NEW OUTPATIENT CENTER AT 260 LONG RIDGE ROAD IN STAMFORD IN AUGUST. THIS VENTURE, WHICH WAS A COLLABORATION WITH NORTHEAST MEDICAL GROUP'S PRIMARY CARE PHYSICIANS AND YALE MEDICINE'S CENTER FOR MUSCULOSKELETAL CARE, WAS THE HOSPITAL'S. LONG RIDGE OFFERS SERVICES IN REHABILITATION, LABORATORY, RADIOLOGY, RHEUMATOLOGY AND NEUROLOGY INFUSION. ADDITIONALLY, THE HOSPITAL OPENED A FULL-SERVICE VASCULAR IMAGING CENTER FOR EVALUATION OF VENOUS AND ARTERIAL VASCULAR DISEASES, AS WELL AS THE YALE NEW HAVEN HEALTH WOMEN'S CARDIOVASCULAR CENTER AT 15 VALLEY DRIVE IN GREENWICH. THE HOSPITAL ALSO UNVEILED THE TRUEBEAM RADIATION THERAPY SYSTEM, THE LATEST TECHNOLOGY AVAILABLE TO TREAT CANCER ANYWHERE IN THE BODY, INCLUDING LUNG, BREAST, PROSTATE AND HEAD AND NECK REGION. THE NEW LINEAR ACCELERATOR ZEROES IN ON MOVING TARGETS QUICKLY AND ACCURATELY, LEADING TO SHORTER TREATMENT TIMES. 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 SEVENTEEN (17) VOTING MEMBERS ARE INDEPENDENT. BASED ON OTHER INFORMATION KNOWN TO THE ORGANIZATION, THE ORGANIZATION HAS NO REASON TO BELIEVE THAT THE REMAINING ONE (1) VOTING MEMBER IS NOT INDEPENDENT. FORM 990, PART VI, SECTION A, LINE 2 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 THE HOSPITAL AMENDED ITS CORPORATE BYLAWS ON MAY 12, 2016 TO REFLECT THE MERGER OF ITS PARENT COMPANY, GREENWICH HEALTH CARE SERVICES, INC. INTO THE HOSPITAL AND FURTHER TO INCORPORATE AN AFFIRMATION OF ITS AFFILIATION AGREEMENT WITH YALE NEW HAVEN HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS: THE HOSPITAL IS A CONNECTICUT NON-STOCK CORPORATION. ITS SOLE MEMBER IS YALE NEW HAVEN HEALTH SERVICES CORPORATION ("YNHHS"), ITSELF A CONNECTICUT NON-STOCK CORPORATION DESCRIBED IN SECTION 501(C)(3) OF THE CODE. FORM 990, PART VI, SECTION A, LINE 7A ELECTION OF MEMBERS AND THEIR RIGHTS: YNHHS HAS THE AUTHORITY TO DESIGNATE ONE REPRESENTATIVE OF YNHHS TO SERVE AS A TRUSTEE OF THE HOSPITAL AND APPROVE NOMINEES TO THE HOSPITAL'S BOARD OF TRUSTEES IN ACCORDANCE WITH THE HOSPITAL'S BYLAWS AND THAT CERTAIN SYSTEM AFFILIATION AGREEMENT (THE "AFFILIATION AGREEMENT") BY AND AMONG YNHHS AND THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS SUBJECT TO APPROVAL OF MEMBERS: THE HOSPITAL HAS RESERVED POWERS TO YNHHS. YNHHS: IN ACCORDANCE WITH THE HOSPITAL'S BYLAWS AND THE AFFILIATION AGREEMENT, YNHHS HAS THE FOLLOWING RIGHTS, POWERS AND PRIVILEGES VIS-A-VIS THE HOSPITAL: (A)TO DESIGNATE ONE REPRESENTATIVE OF YNHHS TO SERVE AS A TRUSTEE OF THE HOSPITAL AT THE PLEASURE OF YNHHS, WHICH DESIGNEE SHALL BE A VOTING MEMBER OF THE EXECUTIVE OR ANY SIMILAR COMMITTEE OF THE HOSPITAL; (B)TO APPROVE THE NOMINEES TO THE BOARD OF TRUSTEES OF THE HOSPITAL IN ACCORDANCE WITH THE PROVISIONS OF SECTION 3.3 OF THE HOSPITAL BYLAWS AND SECTION 4.2 OF THE AFFILIATION AGREEMENT; (C)TO DIRECT THE HOSPITAL BOARD OF TRUSTEES TO REMOVE ANY HOSPITAL TRUSTEE IN ACCORDANCE WITH PROVISIONS OF THE HOSPITAL BYLAWS AND THE AFFILIATION AGREEMENT; (D)TO APPROVE THE HOSPITAL'S ANNUAL OPERATING AND CAPITAL BUDGETS AND STRATEGIC PLANS; AND (E)TO CONSENT TO (I) THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE HOSPITAL'S ASSETS, (II) ANY MERGER OR CONSOLIDATION INVOLVING THE HOSPITAL, (III)ANY CONTRACT TO MANAGE OR ADMINISTER THE HOSPITAL OR ANY SUBSTANTIAL PART OF THE BUSINESS OF THE HOSPITAL, (IV) ANY LIQUIDATION OR DISSOLUTION OF THE HOSPITAL OR FILING FOR BANKRUPTCY OR SIMILAR PROTECTION, OR (V) ANY CHANGE IN THE NAME OF THE HOSPITAL. FURTHER, IN ACCORDANCE WITH THE HOSPITAL BYLAWS, YNHHS MUST EACH APPROVE ANY AMENDMENT TO THE HOSPITAL'S CERTIFICATE OF INCORPORATION OR BYLAWS. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S PROCESS TO REVIEW FORM 990: THE FORM 990 TAX RETURN AND ATTACHED SCHEDULES WERE PREPARED BY EMPLOYEES OF THE SYSTEM TAX DEPARTMENT. THE RETURN IS INITIALLY REVIEWED BY THE HOSPITAL DIRECTOR OF CORPORATE FINANCE. SUBSEQUENTLY, IT IS SENT TO KPMG LLP FOR THEIR INITIAL REVIEW. AFTER ALL COMMENTS FROM THE ABOVE GROUPS ARE RECEIVED AND REVIEWED, THE RETURN IS THEN REVIEWED BY THE CHIEF FINANCIAL OFFICER OF THE HOSPITAL AND A FINAL VERSION OF THE RETURN IS SENT BACK TO KPMG US LLP FOR FINAL REVIEW. PRIOR TO FILING, THE ORGANIZATION MADE AVAILABLE A COMPLETE COPY OF THE RETURN TO THE BOARD OF TRUSTEES BY WEB PORTAL. FORM 990, PART VI, SECTION B, LINE 12C GREENWICH HOSPITAL IS COVERED UNDER THE YALE NEW HAVEN HEALTH SYSTEM 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 HE 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 COMPENSATION PROCESS FOR TOP OFFICIALS: THE TOP OFFICIAL IS AN EMPLOYEE OF YNHHS. THE EXECUTIVE COMPENSATION COMMITTEES OF GREENWICH HOSPITAL AND YNHHS STRIVE TO TAKE THE STEPS NECESSARY TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER FEDERAL TAX LAW. THE EXECUTIVE COMPENSATION COMMITTEES ARE RESPONSIBLE FOR (1) DETERMINING THE OVERALL TOTAL COMPENSATION STRATEGY FOR THEIR RESPECTIVE CORPORATE OFFICERS, (2) APPROVING ALL COMPENSATION AND BENEFITS DECISIONS FOR RESPECTIVE CORPORATE OFFICERS, AND (3) REPORTING SUCH ACTIONS TO THE FULL GREENWICH HOSPITAL AND YNHHS BOARDS ON AN ANNUAL BASIS. IN ADDITION, THE EXECUTIVE COMPENSATION COMMITTEES EXPRESSLY DETERMINE 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 EXECUTIVE COMPENSATION COMMITTEES CONSIST OF BOARD MEMBERS WHO DO NOT HAVE MATERIAL FINANCIAL INTERESTS THAT COULD BE AFFECTED BY THE OFFICER COMPENSATION DECISIONS MADE BY THE COMMITTEES. THE COMPARABILITY DATA USED TO ASSIST THE EXECUTIVE COMPENSATION COMMITTEES IN THEIR COMPENSATION DELIBERATIONS ARE COMPILED BY AN INDEPENDENT,NATIONAL COMPENSATION CONSULTING FIRM THAT IS RETAINED BY AND REPORTS DIRECTLY TO THE EXECUTIVE COMPENSATION COMMITTEES. 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 EXECUTIVE COMPENSATION COMMITTEES ARE CONTEMPORANEOUSLY DOCUMENTED, REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEES, AND PROVIDED TO THE BOARDS OF YNHHS AND THE HOSPITAL. FORM 990, PART VI, SECTION B, LINE 15B: COMPENSATION PROCESS FOR OFFICERS CERTAIN OFFICERS ARE EMPLOYEES OF YNHHS, OTHER OFFICERS ARE EMPLOYED DIRECTLY BY THE HOSPITAL. COMPENSATION DETERMINATIONS OF YNHHS EMPLOYEES ARE MADE BOTH BY THE COMPENSATION COMMITTEES AND BOARDS OF YNHHS AND THE HOSPITAL. COMPENSATION DETERMINATION OF THE HOSPITAL EMPLOYEES ARE MADE BY THE HOSPITAL'S COMPENSATION COMMITTEE AND BOARD. THE EXECUTIVE COMPENSATION COMMITTEES OF GREENWICH HOSPITAL AMD YNHHS STRIVE TO TAKE THE STEPS NECESSARY TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER FEDERAL TAX LAW. THE EXECUTIVE COMPENSATION COMMITTEES ARE RESPONSIBLE FOR (1) DETERMINING THE OVERALL TOTAL COMPENSATION STRATEGY FOR ALL THEIR RESPECTIVE CORPORATE OFFICERS, (2) APPROVING ALL COMPENSATION AND BENEFITS DECISIONS FOR CORPORATE OFFICERS, AND (3) REPORTING SUCH ACTIONS TO THE FULL GREENWICH HOSPITAL AND YNHHS BOARD ON AN ANNUAL BASIS, AS APPLICABLE. IN ADDITION, THE EXECUTIVE COMPENSATION COMMITTEES, AS APPLICABLE, EXPRESSLY DETERMINE 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 EXECUTIVE COMPENSATION COMMITTEES CONSIST OF BOARD MEMBERS WHO DO NOT HAVE MATERIAL FINANCIAL INTERESTS THAT COULD BE AFFECTED BY THE OFFICER COMPENSATION DECISIONS MADE BY THE COMMITTEES. THE COMPARABILITY DATA USED TO ASSIST THE EXECUTIVE COMPENSATION COMMITTEES IN THEIR COMPENSATION DELIBERATIONS ARE COMPILED BY AN INDEPENDENT, NATIONAL COMPENSATION CONSULTING FIRM THAT IS RETAINED BY AND REPORTS DIRECTLY TO THE EXECUTIVE COMPENSATION COMMITTEES. 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 EXECUTIVE COMPENSATION COMMITTEES ARE CONTEMPORANEOUSLY DOCUMENTED, REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEES, AND PROVIDED TO THE BOARDS OF YNHHS AND/OR THE HOSPITAL, AS APPLICABLE. 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 LAUNDERING SERVICE: PROGRAM SERVICE EXPENSES 837,284. MANAGEMENT AND GENERAL EXPENSES 288,538. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,125,822. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 44,545,246. MANAGEMENT AND GENERAL EXPENSES 15,342,931. FUNDRAISING EXPENSES 211,370. TOTAL EXPENSES 60,099,547. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 10,590,872. MANAGEMENT AND GENERAL EXPENSES 3,649,735. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,240,607. FORM 990, PART XI, LINE 9: PENSION ADJUSTMENT -26,976,000. AMORTIZATION 1,121,000. TRANSFERS TO AFFILIATES -12,360,000. CHANGE IN FOUNDATION NET ASSETS 1,497,342. CHANGE IN AUXILIARY NET ASSETS -488,995. 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GREENWICH HEALTH CARE SERVICES, INC. THROUGH 5/12/2016, AFTER YALE NEW HAVEN HEALTH SERVICES CORPORATION. NAME OF RELATED ORGANIZATION: PERRYRIDGE CORPORATION DIRECT CONTROLLING ENTITY: GREENWICH HEALTH CARE SERVICES, INC. THROUGH 5/12/2016, AFTER YALE NEW HAVEN HEALTH SERVICES CORPORATION. NAME OF RELATED ORGANIZATION: THE GREENWICH HOSPITAL ENDOWMENT FUND INC DIRECT CONTROLLING ENTITY: GREENWICH HEALTH CARE SERVICES, INC. THROUGH 5/12/2016, AFTER YALE NEW HAVEN HEALTH SERVICES CORPORATION.