THE CONNECTICUT HOSPICE INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
THE CONNECTICUT HOSPICE INC (EIN 06-0878822)
Tax period
2015-10-01 to 2016-09-30
Filed
2017-08-15
IRS object ID
201742279349303829
Schema version
2015v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2017-08-15T19:28:51-05:00ReturnTs
Tax Period End2016-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN061009205PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BLUM SHAPIRO & COMPANY PC CPA'SBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line129 S MAIN STREET PO BOX 272000AddressLine1Txt
CityWEST HARTFORDCityNm
State AbbreviationCTStateAbbreviationCd
ZIP061272000ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN060878822EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE CONNECTICUT HOSPICE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCONNBusinessNameControlTxt
Phone2033157500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 DOUBLE BEACH ROADAddressLine1Txt
CityBRANFORDCityNm
State AbbreviationCTStateAbbreviationCd
ZIP064054003ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTHOMAS MCGOVERNPersonNm
Person TitleCHIEF FINANCIAL OFFICERPersonTitleTxt
Phone2033157500PhoneNum
Signature2017-08-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonELIZABETH SOLECKIPreparerPersonNm
PTINP00235171PTIN
Phone8605614000PhoneNum
Preparation2017-08-15PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTHOMAS MCGOVERNPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 DOUBLE BEACH ROADAddressLine1Txt
CityBRANFORDCityNm
State AbbreviationCTStateAbbreviationCd
ZIP064054003ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$31,961,184GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.HOSPICE.COM/CTHOSPICEWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1971FormationYr
Legal Domicile StateCTLegalDomicileStateCd
Activity Or MissionPROVIDE ADULT AND PEDIATRIC CARE TO IRREVERSIBLY ILL PATIENTS AND THEIR FAMILIES AT HOME AND AT HOSPITAL-HOSPICE.ActivityOrMissionDesc
Voting Members Governing Body16VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee355TotalEmployeeCnt
Total Volunteers495TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,475,196PYContributionsGrantsAmt
CY Contributions Grants$1,907,017CYContributionsGrantsAmt
PY Program Service Revenue$28,269,537PYProgramServiceRevenueAmt
CY Program Service Revenue$27,036,579CYProgramServiceRevenueAmt
PY Investment Income$227,036PYInvestmentIncomeAmt
CY Investment Income$202,174CYInvestmentIncomeAmt
PY Other Revenue$68,979PYOtherRevenueAmt
CY Other Revenue$75,595CYOtherRevenueAmt
PY Total Revenue$31,040,748PYTotalRevenueAmt
CY Total Revenue$29,221,365CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$16,128,223PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$16,655,771CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$287,110CYTotalFundraisingExpenseAmt
PY Other Expenses$14,538,152PYOtherExpensesAmt
CY Other Expenses$13,962,632CYOtherExpensesAmt
PY Total Expenses$30,666,375PYTotalExpensesAmt
CY Total Expenses$30,618,403CYTotalExpensesAmt
PY Revenues Less Expenses$374,373PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,397,038CYRevenuesLessExpensesAmt
Total Assets BOY$23,504,617TotalAssetsBOYAmt
Total Assets EOY$22,355,772TotalAssetsEOYAmt
Total Liabilities BOY$12,492,160TotalLiabilitiesBOYAmt
Total Liabilities EOY$12,540,686TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$11,012,457NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$9,815,086NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE ADULT AND PEDIATRIC CARE TO IRREVERSIBLY ILL PATIENTS AND THEIR FAMILIES AT HOME AND AT HOSPITAL-HOSPICE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$12,888,504ExpenseAmt
Revenue$11,386,727RevenueAmt
DescPHYSICIAN DIRECTED PAIN AND SYMPTOM MANAGEMENT PROVIDED STATEWIDE TO PALLIATIVE HOSPITAL AND HOSPICE CARE ADULT AND PEDIATRIC PATIENTS AND THEIR FAMILIESDesc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$14,030,044ExpenseAmt
Revenue$15,649,852RevenueAmt
DescPHYSICIAN DIRECTED HOME MEDICAL AND HOSPICE CARE SERVICES TO ADULTS AND PEDIATRIC PATIENTS ON A STATEWIDE BASISDesc
FieldValueIRS element (for citing)
Total Program Service Expenses$26,918,548TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan OutstandingYes (1)LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document18IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee355EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members16GoverningBodyVotingMembersCnt
Independent Voting Member15IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THOMAS MCGOVERNBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2033157500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 DOUBLE BEACH ROADAddressLine1Txt
CityBRANFORDCityNm
State AbbreviationCTStateAbbreviationCd
ZIP064054909ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
HON DANIEL COSGROVE
OFFICER EMERITUS0.000.00Yes (X)Yes (X)$0$0$0
WEN-JEN HWU MD PHD
DIRECTOR5.005.00Yes (X)$0$0$0
FREDERICK J MANCHESKI
OFFICER EMERITUS0.000.00Yes (X)Yes (X)$0$0$0
ANTHONY J DAROS
OFFICER AND DIRECTOR5.005.00Yes (X)Yes (X)$0$0$0
EUGENE MICHAEL
OFFICER AND DIRECTOR2.001.00Yes (X)Yes (X)$0$0$0
CHIEF WILLIAM FARRELL
DIRECTOR2.001.00Yes (X)$0$0$0
HON DONALD POGUE
DIRECTOR2.002.00Yes (X)$0$0$0
ARLENE M SAYERS
OFFICER AND DIRECTOR2.001.00Yes (X)Yes (X)$0$0$0
WAYNE O SOUTHWICK MD
OFFICER AND DIRECTOR1.001.00Yes (X)Yes (X)$0$0$0
JOHN P STACK CPA
DIRECTOR0.500.50Yes (X)$0$0$0
CAPTAIN KAYE WILLIAMS
OFFICER AND DIRECTOR3.003.00Yes (X)Yes (X)$0$0$0
MICHAEL MASSARO
DIRECTOR3.003.00Yes (X)$0$0$0
MRS NATALIE NIKKI O'NEIL
DIRECTOR1.001.00Yes (X)$0$0$0
GEORGE WALDRON
DIRECTOR2.001.00Yes (X)$0$0$0
THEODORE ZANKER MD
DIRECTOR2.002.00Yes (X)$0$0$0
PETER YARROW
DIRECTOR HONORARY0.200.20Yes (X)$0$0$0
MRS MARC A HURZELER
PRESIDENT & CEO65.0025.00Yes (X)Yes (X)$165,958$63,831$12,634
THOMAS MCGOVERN
CHIEF FINANCIAL OFFICER40.005.00Yes (X)$123,305$15,413$14,744
RONNY J KNIGHT
SENIOR VP REIMB/PLANNING43.002.00Yes (X)$168,253$7,826$10,978
JOSEPH SACCO SEE NOTE
MEDICAL DIRECTOR30.0010.00$178,445$59,482$18,826Yes (X)
DR ANTHONY COSCIA PT
PHYSICIAN20.004.00$117,323$23,465$7,322Yes (X)
JAMES PROTA
DIRECTOR OF PHARMACY35.005.00$115,950$16,564$17,129Yes (X)
MARY ANN FIEFFER
APRN25.0015.00$82,248$49,349$9,117Yes (X)
ANNE NUGENT
DIRECTOR OF NURSING40.005.00$117,667$14,708$5,543Yes (X)
SUSAN FLANNIGAN
VP OF HOME CARE32.008.00$126,706$31,676$10,383Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,195,855TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$282,314TotReportableCompRltdOrgAmt
Total Other Compensation$106,676TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K35IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
A&B HOMEHEALTH SOLUTIONS LLC
446A BLAKE STREET 3RD FLOORNEW HAVENCT06515HOME HEALTH AIDES$872,173
AAA NURSING CARE
3303 MAIN STREETSTRATFORDCT06614NURSING$514,548
EAST ROCK PHARMACY
767 ORANGE STREETNORTH HAVENCT06511SUPPLY AND DELIVERY OF DRUGS$376,668
ARCADIA HEALTH CARE
4639 MAIN STREETBRIDGEPORTCT06606HOME HEALTH AIDES$365,777
ABM JANITORIAL SERV NORTHEAST
PO BOX 1534NEW YORKNY100081534HOUSEKEEPING$333,413
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K14CntrctRcvdGreaterThan100KCnt
All Other Contributions$1,907,017AllOtherContributionsAmt
Total Contributions$1,907,017TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
HOME CARE REVENUE621610$15,649,852$15,649,852
INPATIENT REVENUE623000$11,386,727$11,386,727
FieldValueIRS element (for citing)
Total Program Service Revenue$27,036,579TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$172,773TotalRevenueColumnAmt
Exclusion$172,773ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$2,769,220SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$2,739,819SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$29,401SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$29,401TotalRevenueColumnAmt
Exclusion$29,401ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
FOOD SERVICE INCOME722210$53,644$53,644
OTHER900099$21,951$21,951
FieldValueIRS element (for citing)
Other Revenue Total$75,595OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$29,221,365TotalRevenueColumnAmt
Related Or Exempt Func Income$27,036,579RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$277,769ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$630,308TotalAmt
Program Services$206,751ProgramServicesAmt
Management And General$393,017ManagementAndGeneralAmt
Fundraising$30,540FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$13,273,304TotalAmt
Program Services$12,347,458ProgramServicesAmt
Management And General$771,440ManagementAndGeneralAmt
Fundraising$154,406FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$292,945TotalAmt
Program Services$263,651ProgramServicesAmt
Management And General$26,365ManagementAndGeneralAmt
Fundraising$2,929FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,222,145TotalAmt
Program Services$1,099,931ProgramServicesAmt
Management And General$109,993ManagementAndGeneralAmt
Fundraising$12,221FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,237,069TotalAmt
Program Services$1,113,361ProgramServicesAmt
Management And General$111,336ManagementAndGeneralAmt
Fundraising$12,372FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$4,000,000TotalAmt
Program Services$4,000,000ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$81,199TotalAmt
Management And General$81,199ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$123,200TotalAmt
Management And General$123,200ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,679,375TotalAmt
Program Services$2,184,227ProgramServicesAmt
Management And General$444,508ManagementAndGeneralAmt
Fundraising$50,640FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$9,913TotalAmt
Management And General$9,913ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,672,313TotalAmt
Program Services$2,993,670ProgramServicesAmt
Management And General$660,965ManagementAndGeneralAmt
Fundraising$17,678FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$825,083TotalAmt
Program Services$626,113ProgramServicesAmt
Management And General$198,970ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$261,421TotalAmt
Program Services$239,451ProgramServicesAmt
Management And General$21,924ManagementAndGeneralAmt
Fundraising$46FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$6,208TotalAmt
Management And General$6,208ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$67,939TotalAmt
Management And General$67,939ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$168,334TotalAmt
Program Services$57,144ProgramServicesAmt
Management And General$111,190ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$713,502TotalAmt
Program Services$597,006ProgramServicesAmt
Management And General$116,496ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
HOSPITALIZATION EXPENSE$613,960$613,960
HOUSEKEEPING$474,524$420,144$54,380
GROCERIES$168,888$155,681$13,207
OTHER$96,773$90,495$6,278

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$30,618,403TotalAmt
Program Services$26,918,548ProgramServicesAmt
Management And General$3,412,745ManagementAndGeneralAmt
Fundraising$287,110FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$143,991BOYAmt
EOY$141,992EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,860,146BOYAmt
EOY$1,658,893EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$198,755BOYAmt
EOY$213,532EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$3,626,687LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,558,036LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,197,541BOYAmt
EOY$1,068,651EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$6,430,200BOYAmt
EOY$4,368,246EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$13,673,984BOYAmt
EOY$14,904,458EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$23,504,617BOYAmt
EOY$22,355,772EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$7,078,681BOYAmt
EOY$7,075,822EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$433,332BOYAmt
EOY$341,508EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$2,286,887BOYAmt
EOY$2,421,442EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$2,651,852BOYAmt
EOY$2,681,699EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$41,408BOYAmt
EOY$20,215EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,492,160BOYAmt
EOY$12,540,686EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$8,883,320BOYAmt
EOY$7,481,020EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$960,745BOYAmt
EOY$965,674EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,168,392BOYAmt
EOY$1,368,392EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,012,457BOYAmt
EOY$9,815,086EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$23,504,617BOYAmt
EOY$22,355,772EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$1,397,038ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$199,667NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$100,750OtherActivitiesAmt
Total Lobbying Expenditures$100,750TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationTHE CONNECTICUT HOSPICE'S MISSION OF PROVIDING INTERDISCIPLINARY, QUALITY CARE, BOTH IN THE SPECIALTY HOSPITAL AND AT HOME, REQUIRES THE ONGOING APPLICATION OF STANDARDS THROUGH REGULATIONS AS IT RELATES TO HOSPICE AND PALLIATIVE CARE. IN PARTICULAR, WITH THE HOSPITAL'S RELOCATION, IT IS IMPORTANT TO ENABLE ALL CONNECTICUT PHYSICIANS THE OPPORTUNITY TO BE KNOWLEDGEABLE OF THE ENVIRONMENT OF CARE AND THESE STANDARDS.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,168,392BeginningYearBalanceAmt
Contributions$200,000ContributionsAmt
Investment Earnings Or Losses$111,868InvestmentEarningsOrLossesAmt
Other Expenditures$111,868OtherExpendituresAmt
End Year Balance$1,368,392EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$968,392BeginningYearBalanceAmt
Contributions$200,000ContributionsAmt
End Year Balance$1,168,392EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$768,392BeginningYearBalanceAmt
Contributions$200,000ContributionsAmt
Investment Earnings Or Losses$57,174InvestmentEarningsOrLossesAmt
Other Expenditures$57,174OtherExpendituresAmt
End Year Balance$968,392EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$568,392BeginningYearBalanceAmt
Contributions$200,000ContributionsAmt
Investment Earnings Or Losses$21,103InvestmentEarningsOrLossesAmt
Other Expenditures$21,103OtherExpendituresAmt
End Year Balance$768,392EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,628,392BeginningYearBalanceAmt
Contributions$220,000ContributionsAmt
Other Expenditures$1,280,000OtherExpendituresAmt
End Year Balance$568,392EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,626,687OtherCostOrOtherBasisAmt
Depreciation$2,558,036DepreciationAmt
Book Value$1,068,651BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,068,651TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
DUE FROM J.D. THOMPSON INSTITUTE, NET$12,461,333
OTHER CURRENT ASSETS$209,908
ASSETS HELD FOR SALE$332,200
DUE FROM THIRD PARTY$1,901,017
FieldValueIRS element (for citing)
Total Book Value Other Assets$14,904,458TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescLIABILITY UNDER CAPITAL LEASEDesc
Amt$20,215Amt
FieldValueIRS element (for citing)
Total Liability$20,215TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$29,421,032TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$199,667NetUnrealizedGainsInvstAmt
Revenue Not Reported$199,667RevenueNotReportedAmt
Revenue Subtotal$29,221,365RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$29,221,365TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$30,618,403TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$30,618,403ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$30,618,403TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART V, LINE 4:FormAndLineReferenceDesc
ExplanationTEMPORARY FUNDS ARE AVAILABLE TO SUPPORT OPERATIONS AND REPAYMENT OF LONG TERM DEBT. THE INCOME FROM PERMANENT FUNDS IS AVAILABLE TO SUPPORT HEALTH CARE SERVICES.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written Policy0WrittenPolicyInd
FPG Reference Free Care0FPGReferenceFreeCareInd
FPG Reference Discounted Care0FPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance Budget0FinancialAssistanceBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically Available0ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$449,140TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$449,140NetCommunityBenefitExpnsAmt
Total Expense0.01470TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,217,687TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,048,826DirectOffsettingRevenueAmt
Net Community Benefit Expns$168,861NetCommunityBenefitExpnsAmt
Total Expense0.00550TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,666,827TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,048,826DirectOffsettingRevenueAmt
Net Community Benefit Expns$618,001NetCommunityBenefitExpnsAmt
Total Expense0.02020TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$70,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$70,000NetCommunityBenefitExpnsAmt
Total Expense0.00230TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$70,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$70,000NetCommunityBenefitExpnsAmt
Total Expense0.00230TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,736,827TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,048,826DirectOffsettingRevenueAmt
Net Community Benefit Expns$688,001NetCommunityBenefitExpnsAmt
Total Expense0.02250TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$70,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$70,000NetCommunityBenefitExpnsAmt
Total Expense0.00230TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$70,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$70,000NetCommunityBenefitExpnsAmt
Total Expense0.00230TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$387,190BadDebtExpenseAmt
Reimbursed By Medicare$24,199,594ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$27,829,533CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$3,629,939MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn0FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

FieldValueIRS element (for citing)
Business Name Line11 NOT APPLICABLEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE CONNECTICUT HOSPICE INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 DOUBLE BEACH ROADAddressLine1Txt
CityBRANFORDCityNm
State AbbreviationCTStateAbbreviationCd
ZIP064054003ZIPCd
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
OtherHOSPITAL, SPECIAL, HOSPICEOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1THE CONNECTICUT HOSPICE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely Available0CHNAReportWidelyAvailableInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt13ImplementationStrategyAdptYr
Strategy Posted Website0StrategyPostedWebsiteInd
Strategy Attached0StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria Explained0EligCriteriaExplainedInd
Explained Basis0ExplainedBasisInd
App Financial Asst Expln0AppFinancialAsstExplnInd
Includes Publicity Measures0IncludesPublicityMeasuresInd
FAP Actions On Nonpayment0FAPActionsOnNonpaymentInd
Collection Activities0CollectionActivitiesInd
None MadeYes (X)NoneMadeInd
Nondis Emergency Care Policy0NondisEmergencyCarePolicyInd
No Emergency CareYes (X)NoEmergencyCareInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp

FieldValueIRS element (for citing)
Form And Line ReferencePART V, SECTION BFormAndLineReferenceDesc
ExplanationTHE CONNECTICUT HOSPICE, INC. ASSESSES THE HEALTHCARE NEEDS IN THE COMMUNITIES IT SERVES THROUGH PATIENT/FAMILY SATISFACTION SURVEYS, COMMUNITY PHYSICIAN FEEDBACK, HOSPITAL AND OTHER PATIENT CARE FACILITY COLLABORATION AND DIRECT COMMUNICATION WITH COMMUNITY LEADERSHIP.ExplanationTxt

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:THE HOSPITAL PROVIDES SERVICES BASED ON PATIENT NEED REGARDLESS OF INCOME OR ABILITY TO PAY.
PART IIA) PROVIDED OUTDOOR POOL FACILITY TO PROMOTE PHYSICAL WELLNESS TO COMMUNITYB) PROVIDED MEMORIAL SERVICES FOR EMOTIONAL SUPPORT TO COMMUNITYC) PROMOTED PUBLIC POLICY DISCOURSE ON INSTITUTIONAL RESEARCH USE OF MEDICINAL MARIJUANA FOR PAIN AND SYMPTOM RELIEF
PART III, LINE 4:FINANCIAL STATEMENTS DO NOT CONTAIN ANY REFERENCE TO BAD DEBTS IN THE FOOTNOTES TO THE FINANCIAL STATEMENTS. BAD DEBTS ARE RECORDED AT ACTUAL UNCOLLECTED REVENUE AS THE ESTIMATED COSTS.
PART III, LINE 8:ALL OF THE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. COSTING METHODOLOGY USED WAS COST TO CHARGE RATIO PER MEDICARE COST REPORT.
PART III, LINE 9B:THE ORGANIZATION HAS ESTABLISHED A WRITTEN POLICY STATING THAT CARE IS PROVIDED REGARDLESS OF ABILITY TO PAY. NO COLLECTION ACTIVITY IS PURSUED FOR INDIGENT PATIENTS IDENTIFIED AS SUCH BY LICENSED CLINICAL SOCIAL WORKERS. ALL PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE ARE EXCLUDED FROM COLLECTION ACTIVITIES.
PART VI, LINE 2THE HOSPITAL RESPONDS TO THE NEEDS OF ITS COMMUNITY PHYSICIANS AND REFERRING HOSPITALS.
PART VI, LINE 3PATIENTS AND THEIR FAMILIES ARE INFORMED OF ALL REIMBURSEMENT OPTIONS BOTH VERBALLY AND IN WRITING UPON ADMISSION.
PART VI, LINE 4ALL COMMUNITIES AND DEMOGRAPHIC CONSTITUENCIES ARE SERVED INCLUDING URBAN, RURAL AND SUBURBAN.
PART VI, LINE 5SEE PART II RESPONSE.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MRS MARC A HURZELER
PRESIDENT & CEO$165,958$63,831$0$0$0$0$4,875$1,875$4,249$1,635$175,082$67,341$0$0
THOMAS MCGOVERN
CHIEF FINANCIAL OFFICER$123,305$15,413$0$0$0$0$3,699$462$9,407$1,176$136,411$17,051$0$0
RONNY J KNIGHT
SENIOR VP REIMB/PLANNING$168,253$7,826$0$0$0$0$5,048$235$5,442$253$178,743$8,314$0$0
JOSEPH SACCO SEE NOTE
MEDICAL DIRECTOR$178,445$59,482$0$0$0$0$5,353$1,784$8,767$2,922$192,565$64,188$0$0
SUSAN FLANNIGAN
VP OF HOME CARE$126,706$31,676$0$0$0$0$3,801$950$4,506$1,126$135,013$33,752$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 4BCOMPENSATION AWARDED BUT NOT GIVEN TO THE PRESIDENT/CEO (DUE TO FINANCIAL CONDITION OF THE HOSPITAL). THE AVERAGE SALARY FOR THIS POSITION HAS BEEN $130,000. NO ACCUMULATED LIABILITY WAS GIVEN IN THE CURRENT YEAR.
PART II, LINE 4:THE EXECUTIVE EMPLOYEE'S STATED COMPENSATION REPRESENTS 9 MONTHS OF COMPENSATION. IF ANNUALIZED, THE COMPENSATION IS $330,000.

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp

FieldValueIRS element (for citing)
PersonF J MANCHESKIPersonNm
Relationship With OrgOFFICER AND DIRECTORRelationshipWithOrgTxt
Loan To OrganizationYes (X)LoanToOrganizationInd
Original Principal$800,000OriginalPrincipalAmt
Balance Due$341,508BalanceDueAmt
Default0DefaultInd
Board Or Committee ApprovalYes (1)BoardOrCommitteeApprovalInd
Written AgreementYes (1)WrittenAgreementInd
FieldValueIRS element (for citing)
Total Balance Due$341,508TotalBalanceDueAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 7AA NOMINATING COMMITTEE CONSISTING OF TWO MEMBERS OF THE BOARD OF DIRECTORS MAY ELECT A BOARD MEMBER.
FORM 990, PART VI, SECTION B, LINE 11THE RETURN IS PRESENTED AT A BOARD MEETING.
FORM 990, PART VI, SECTION B, LINE 12CTHE BOARD OF DIRECTORS REVIEWS THE ANNUAL ELIGIBILITY TEST OF ALL BOARD MEMBERS.
FORM 990, PART VI, SECTION B, LINE 15AA COMMITTEE OF TWO OR MORE DIRECTORS OF THE BOARD MEETS PERIODICALLY TO REVIEW THE PERFORMANCE AND COMPARABILITY DATA OF SIMILARLY SIZED HOSPITALS IN THE STATE OF CONNECTICUT. THEY DELIBERATE AND A FINAL DECISION IS MADE.
FORM 990, PART VI, SECTION C, LINE 19INFORMATION IS NOT AVAILABLE TO THE PUBLIC.
PART VIII, STATEMENT OF REVENUE, LINE 2DURING THE YEAR ENDED SEPTEMBER 30, 2016, THE ESTIMATED VALUE OF CONTRIBUTED SERVICES WAS $2,063,000.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1THE JOHN D THOMPSON HOSPICE INSTITUTE FOR EDUCATION TRAINING AND RESEARCHBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 DOUBLE BEACH ROADAddressLine1Txt
CityBRANFORDCityNm
State AbbreviationCTStateAbbreviationCd
ZIP064054003ZIPCd
FieldValueIRS element (for citing)
EIN061003712EIN
Primary ActivitiesPROGRAMS ON EDUCATION, TRAINING AND RESEARCH; MANAGEMENT SERVICESPrimaryActivitiesTxt
Legal Domicile StateCTLegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusBOX 9PublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
FACILITY LEASE
K$284,160OPERATING LEASE
MANAGEMENT SERVICES
M$4,000,000FAIR VALUE OF SERVICES

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