2016-08-15T14:24:42-05:00 2015-09-30 061009205 BLUM SHAPIRO & COMPANY PC CPA'S 29 S MAIN STREET PO BOX 272000 WEST HARTFORD CT 061272000 990 2014-10-01 061003712 THE JOHN D THOMPSON HOSPICE INSTITUTE FOR EDUCATION TRAINING AND RESEARCH JOHN 2033157500 100 DOUBLE BEACH ROAD BRANFORD CT 064054003 THOMAS MCGOVERN CHIEF FINANCIAL OFFICER 2033157500 2016-08-15 1 ELIZABETH SOLECKI P00235171 8605614000 2016-08-15 2014 2017-02-10 21:41:12Z THOMAS MCGOVERN 100 DOUBLE BEACH ROAD BRANFORD CT 064054003 5347360 0 X WWW.HOSPICE.COM X 1978 CT TO EXTEND THE PRINCIPLES OF PALLIATIVE CARE AND HOSPICE SERVICES INTO THE MAINSTREAM OF MEDICAL PRACTICE AND EDUCATION REGIONALLY, NATIONALLY AND INTERNATIONALLY THROUGH EDUCATION, TRAINING AND RESEARCH. 15 14 1 18 0 0 47275 45815 4500272 5017385 0 0 284160 284160 4831707 5347360 0 0 0 0 3047375 2948310 0 0 10841 2048553 2571972 5095928 5520282 -264221 -172922 20761906 20231401 12056761 11699178 8705145 8532223 TO EXTEND THE PRINCIPLES OF PALLIATIVE CARE AND HOSPICE SERVICES INTO THE MAINSTREAM OF MEDICAL PRACTICE AND EDUCATION REGIONALLY, NATIONALLY AND INTERNATIONALLY THROUGH EDUCATION, TRAINING AND RESEARCH. 0 0 1882897 17385 THE INSTITUTE OFFERS PROGRAMS ON EDUCATION, TRAINING AND RESEARCH PERTAINING TO THE CARE OF ADULT AND PEDIATRIC PATIENTS WITH IRREVERSIBLE ILLNESSES AND THEIR FAMILIES. 3307935 5000000 PROVIDING MANAGEMENT SERVICES AND FACILITIES TO CT HOSPICE. 5190832 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 X 15 14 0 0 0 0 0 1 0 1 1 0 0 0 1 1 1 1 0 1 0 0 CT X MR THOMAS MCGOVERN 2033157500 100 DOUBLE BEACH ROAD BRANFORD CT 064054909 HON DANIEL COSGROVE OFFICER EMERITUS 0.00 0.00 X X 0 0 0 ANTHONY J DAROS OFFICER AND DIRECTOR 5.00 5.00 X X 0 0 0 WEN-JEN HWU MD PHD DIRECTOR 5.00 5.00 X 0 0 0 FREDERICK J MANCHESKI OFFICER EMERITUS 0.00 0.00 X X 0 0 0 EUGENE MICHAEL OFFICER AND DIRECTOR 1.00 2.00 X X 0 0 0 CHIEF WILLIAM FARRELL DIRECTOR 1.00 2.00 X 0 0 0 HON DONALD POGUE DIRECTOR 2.00 2.00 X 0 0 0 ARLENE M SAYERS OFFICER AND DIRECTOR 1.00 2.00 X X 0 0 0 WAYNE O SOUTHWICK MD OFFICER AND DIRECTOR 1.00 1.00 X X 0 0 0 JOHN P STACK CPA DIRECTOR 0.50 0.50 X 0 0 0 CAPTAIN KAYE WILLIAMS OFFICER AND DIRECTOR 3.00 3.00 X X 0 0 0 MICHAEL MASSARO DIRECTOR 3.00 3.00 X 0 0 0 MRS NATALIE NIKKI O'NEIL DIRECTOR 1.00 1.00 X 0 0 0 GEORGE WALDRON DIRECTOR 1.00 2.00 X 0 0 0 THEODORE ZANKER MD DIRECTOR 2.00 2.00 X 0 0 0 PETER YARROW DIRECTOR HONORARY 0.20 0.20 X 0 0 0 THOMAS MCGOVERN CHIEF FINACIAL OFFICER 5.00 40.00 X 16223 129782 13938 RONNY J KNIGHT SENIOR VP REIMB/PLANNING 2.00 43.00 X 8881 190947 8107 MRS MARC A HURZELER PRESIDENT & CEO 25.00 65.00 X X 63743 165732 8184 DR JOSEPH ANDREWS CHIEF MEDICAL OFFICER 10.00 35.00 X 47053 164684 5968 ANDREA PETERSON ASSISTANT MEDICAL DIRECTOR 10.00 35.00 X 32809 114831 9522 DR ANTHONY COSCIA PT PHYSICIAN 4.00 20.00 X 23099 115493 8184 SYLVIA VANHEERDEN CHIEF OF QUALITY ASSURANCE 8.00 32.00 X 25982 103927 11519 MARCEL BLANCHET CHIEF INFORMATION OFFICER 5.00 35.00 X 16100 112700 15722 JAMES PROTA DIRECTOR OF PHARMACY 5.00 35.00 X 14999 104996 19789 248889 1203092 100933 0 0 1 0 0 45815 45815 LEASE AND MGT SERVICES 532000 5000000 5000000 EDUCATIONAL 611600 17385 17385 5017385 284160 0 284160 284160 284160 5347360 5017385 0 284160 X 141023 64930 65252 10841 2485550 2418067 67483 321737 305650 16087 1245680 1119415 126265 49006 49006 6205 6205 576083 576083 NON MEDICAL INTERCOMPAN 691225 648023 43202 NON MEDICAL GENERAL EXP 3773 3453 320 5520282 5190832 318609 10841 31900 16640 500000 500000 28339218 8624457 20230006 19714761 20761906 20231401 3167 0 12053594 11699178 12056761 11699178 X 8205145 8032223 500000 500000 8705145 8532223 20761906 20231401 -172922 0 X 0 1 X 1 0 X 114089 58732 68898 47275 45815 334809 4017802 4007641 4513030 4500272 5017385 22056130 4131891 4066373 4581928 4547547 5063200 22390939 0 0 0 22390939 284160 284160 284160 284160 284160 1420800 284160 284160 284160 284160 284160 1420800 4416051 4350533 4866088 4831707 5347360 23811739 0.94030 0.93710 0.05970 0.06290 X 1 PART II-B, LINE 1: THE JOHN D. THOMPSON HOSPICE INSTITUTE FOR EDUCATION, TRAINING AND RESEARCH'S MISSION IS TO EDUCATE AND TRAIN CAREGIVERS AND CONDUCT RESEARCH. THIS REQUIRES THE ONGOING DEVELOPMENT OF REGULATIONS THAT WOULD SUPPORT THIS EFFORT. IN PARTICULAR, WITH THE RELOCATION OF THE INSTITUTE, ALTHOUGH WITHIN THE SAME PROVINCE, IT IS IMPORTANT TO MAINTAIN THESE STANDARDS. 6433345 6433345 21358506 8077090 13281416 547367 547367 0 19714761 DUE TO CT HOSPICE, NET 11699178 11699178 5347360 0 5347360 0 5347360 5520282 0 5520282 0 5520282 X X X X 0 1 0 0 0 0 0 0 0 THOMAS MCGOVERN CHIEF FINACIAL OFFICER 16223 129782 0 0 0 0 174 1394 1374 10996 17771 142172 0 0 RONNY J KNIGHT SENIOR VP REIMB/PLANNING 8881 190947 0 0 0 0 89 1909 272 5837 9242 198693 0 0 MRS MARC A HURZELER PRESIDENT & CEO 63743 165732 0 0 0 0 596 1549 1677 4362 66016 171643 0 0 DR JOSEPH ANDREWS CHIEF MEDICAL OFFICER 47053 164684 0 0 0 0 0 0 1326 4642 48379 169326 0 0 ANDREA PETERSON ASSISTANT MEDICAL DIRECTOR 32809 114831 0 0 0 0 328 1148 1788 6258 34925 122237 0 0 PART I, LINE 4B COMPENSATION RELATED TO THE RELATED ORGANIZATIONS BUT NOT GIVEN DUE TO THE FINANCIAL CONDITIONS OF THE ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 7A A NOMINATING COMMITTEE CONSISTING OF TWO MEMBERS OF THE BOARD OF DIRECTORS MAY ELECT A BOARD MEMBER. FORM 990, PART VI, SECTION B, LINE 11 THE RETURN IS PRESENTED AT A BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS REVIEWS THE ANNUAL ELIGIBILITY TEST OF ALL BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 15A A COMMITTEE OF TWO OR MORE DIRECTORS OF THE BOARD MEETS PERIODICALLY TO REVIEW THE PERFORMANCE AND THE 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 19 INFORMATION IS NOT AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 1,119,415. MANAGEMENT AND GENERAL EXPENSES 126,265. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,245,680. THE CONNECTICUT HOSPICE INC 100 DOUBLE BEACH ROAD BRANFORD CT 064054003 060878822 TEACHING PALLIATIVE HOSPITAL AND HOSPICE CARE CT 501(C)(3) BOX 3 N/A 0 0 0 0 0 1 0 0 0 0 1 0 1 0 1 0 0 0 0 0 RENTAL INCOME J 284160 OPERATING LEASE MANAGEMENT SERVICES M 5000000 FAIR VALUE OF SERVICES