2016-08-13T07:46:52-05:00 2015-09-30 440160260 BKD 1201 Walnut Suite 1700 Kansas City MO 64106 990 2014-10-01 060646768 The Hospital of Central Connecticut HOSP 8602245900 100 Grand Street New Britain CT 06050 Renata Cook VP Finance 8602245900 2016-08-13 1 Mike Engle P00482834 8162216300 2014 2016-09-27 15:27:22Z Lucille Janatka 100 Grand Street New Britain CT 06050 367709693 0 X www.thocc.org X 1893 CT The Hospital of Central Connecticut is dedicated to fostering, sustaining and improving the health status of the people in the communities we serve. 15 14 2998 330 1599110 -950320 4733130 2811645 368172882 347569184 11085482 13920206 1158948 1181353 385150442 365482388 0 0 0 0 193538562 187451694 36934 30358 641076 164311775 166165158 357887271 353647210 27263171 11835178 501255592 483663185 273140311 252355024 228115281 231308161 X The Hospital of Central Connecticut is dedicated to fostering, sustaining and improving the health status of the people in the communities we serve. 0 0 18367979 44451355 Emergency Department: For Fiscal Year 2015 (FY15), there were approximately 140 Full-time employees (FTEs) in the Emergency Department for both Southington and New Britain Campuses. Our ER team is committed to delivering quality medical care with high patient safety in a timely, efficient and professional manner while also exceeding the needs of our patients and private physicians. Trends in Emergency Department Volumes: This year our total patient visits for both campuses combined was over 103,808. This was a decrease of 1,496 patients or 1.4% from the previous year. The volumes were approximately 86,000 and 17,000 at the New Britain and Southington campuses respectively. The Department continues to manage staffing levels, based on census levels and trends to meet the demands of our patient volumes. 14919829 44756787 Radiology Department: Radiology derived information is an inextricable component of our patients' care continuum. From screening exams to acute interventionary imaging, radiographic technology continued to evolve in 2015. There were over 151,000 imaging exams performed at the New Britain and Southington campuses. Of these, more than 80% were performed on Outpatients. There was a 4.9% overall decline in imaging exams in FY15 versus the prior year's due to the combined economic influences and judicious applications of imaging and radiation exposure. Management continues to manage and review satellite offices volume and staffing levels in a continuous form to stay financially responsible to the organization and community. 14973557 28018867 Laboratory: Our Laboratory/Drawing Stations serve the greater New Britain area and its surrounding neighboring towns such as Bristol, Kensington, Plainville, etc. The Laboratory/Drawing Stations tested 1,357,319, of those tests, 92,243 were from our drawing stations (which saw a decrease of 2% over prior year). Our laboratory tested 343,873 units for our Inpatients and 877,984 for Outpatients (the outpatient tests were approximately 65% of total units). As a partner in the community, HOCC has positioned itself throughout the greater New Britain area in order to be convenient to our patients and family members. Our organization continues to review sites that we currently operate and potential new sites to address patient and family experience/satisfaction and convenience. 268791707 223085450 Other routine services such as inpatient and outpatient medical and surgical, maternity, newborn, psychiatric and pediatric and anciliary services provided to patients. 268791707 223085450 317053072 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 1 247 0 1 2998 1 1 1 0 0 0 0 0 0 0 0 0 X 15 14 0 0 1 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 CT X Carolyn Freiheit 8602245900 389 John Downey Drive New Britain CT 06051 Letterio Asciuto MD Director 2.00 X 0 0 0 Josephe Harrison MD Director 2.00 X 0 0 0 Jason Howey Director 2.00 X 0 0 0 Steven Basche Director 2.00 X 0 0 0 Paul Czepiga Director 2.00 X 0 0 0 Irfan Chughtai MD Director 2.00 X 0 0 0 Nadine Francis-West Director 2.00 X 0 0 0 George Springer Jr Director 2.00 X 0 0 0 Carl Grant Director 2.00 X 0 0 0 Bruce Koeppen MD Director 2.00 X 0 0 0 John Rathgeber Director 2.00 X 0 0 0 John Redmond MD Director 2.00 X 0 0 0 John Dillaway Thru 615 Director 2.00 X 0 0 0 Marie Gustin PHD Thru 615 Director 2.00 X 0 0 0 Frank Miller Thru 615 Director 2.00 X 0 0 0 Akella Sarma MD Thru 615 Director 2.00 X 0 0 0 William Weber Thru 615 Director 2.00 X 0 0 0 Lindsley Wellman Thru 615 Director 2.00 X 0 0 0 Joseph Voelker Chair 3.00 X X 0 0 0 Denise McNair Vice Chair 3.00 X X 0 0 0 Lucille Janatka President/Director 30.00 30.00 X X 0 3295845 107940 Carolyn Freiheit VP, Finance 30.00 30.00 X 0 267639 25014 Margaret Marchak Secretary 3.00 X 0 541910 108761 Steven Hanks MD Sr. VP, Medical Affairs 60.00 X 0 1266987 61233 Catherine Stevens VP, Patient Care 30.00 30.00 X 0 262718 47387 Mary Morgan VP, Human Resources 30.00 30.00 X 0 242040 34658 Justin Lundbye MD Chief of Cardiology 60.00 X 456313 0 44964 Jeffrey Finkelstein MD Chief of ER 60.00 X 1368611 0 104020 Michael Grey Chief of Medicine 60.00 X 526920 0 6295 James Flaherty MD Director, Surgical Oncolog 60.00 X 548773 0 126230 Haklai Lau MD Hospitalist 60.00 X 792810 0 31747 Clarence Silvia Former President & CEO 0.00 X 1719601 0 50455 Ralph Becker Former - CFO 0.00 X 0 385957 30904 5413028 6263096 779608 267 1 1 0 Downes Construction Company LLC 200 Stanley Street New Britain CT 06051 Construction 4443803 New England Mechanical Services Inc 166 Tunnel Road Vernon CT 06066 Mechanical Services 3088179 Bey Sell Construction Co of CT 387 East Main Street Wallingford CT 06492 Construction 2110782 Clinical Lab Partners LLC 129 Patricia M Genova Drive Newington CT 06111 Laboratory Services 1200192 Quest Diagnostics Inc 3 Giralda Farms Madison NJ 07940 Laboratory Services 1170663 203 2811645 2811645 Net Patient Service Revenue 622110 252167710 252167710 Laboratory Services 621500 87713775 86545639 1168136 Other Patient Services 622110 7687699 7687699 347569184 4174609 4174609 1502446 2227305 -724859 -724859 -724859 9745597 0 9745597 9745597 9745597 Dietary/Cafeteria 722210 1475238 1475238 Child Care 624410 430974 430974 1906212 365482388 338713349 1599110 22358284 1719601 1719601 140926939 126710194 13912872 303873 11938842 10702978 1206099 29765 23494029 21062016 2373441 58572 9372283 8402099 946817 23367 130327 130327 3077 3077 30358 30358 624795 624795 30393855 30390713 3142 60893 9920 50973 8316587 7694999 457074 164514 16490638 16293282 197356 6491028 5811353 679675 332105 156659 174984 462 647949 232691 415258 1836606 1792553 44053 21354347 17424851 3929496 19494512 18749108 721815 23589 3879856 352412 3527444 Medical Supplies 45996109 45996109 Equip. Rental & Maint. 6800910 2044511 4756399 Dietary Expense 1937548 1856042 81506 Misc. Expense 1227906 1224472 3434 146110 146110 353647210 317053072 35953062 641076 44302297 11771075 6142964 828010 3517458 2406253 40490596 41580130 5624397 6193421 2168888 2640940 458745637 266166241 174170445 192579396 17539370 15995215 2749826 3498949 204549351 206169796 501255592 483663185 24758070 26611040 5441998 5359983 1574774 1904129 241365469 218479872 273140311 252355024 X 178222406 185794465 26776206 23882792 23116669 21630904 228115281 231308161 501255592 483663185 X 11835178 -1963419 -6678879 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 130149040 23000000 -3233827 641958 149273255 121211981 250703 9453701 767345 130149040 141278334 1199865 12890385 215484 155153100 126491629 1007071 15195409 1415775 141278334 128449477 2086374 -2356272 1687950 126491629 0.92000 0.05000 0.03000 0 1 1 953194 5111813 6065007 7066214 291071515 150585717 147552012 200978 4003927 3669529 535376 875378 137012211 106524217 31363372 12450407 5386778 7063629 192579396 Other Receivable 18758380 Due from Affiliates 127161 SERP Plan Asset 4966447 Long Term Malpractice Rec 13098182 Bond - Intercompany 887713 Interest In Investments Held By Endowment 164739700 Funds Designed For Debt Service 3592213 206169796 Due to Third Parties 10957225 Pension Plan and Self Insurance Liability 118489088 Due to (From) Affiliates 4482675 Malpractice Liability 18704106 Inter Company Bond Debt - A 29950285 Inter Company Bond Debt - C 4544162 Inter Company Bond Debt - E 25688620 Inter Company Debt Equipment 1756248 Asset Retirement Obligation 1380150 Worker's Compensation 2527313 218479872 Part V, Line 4: The temporary and permanently restricted endowments are restricted according to the donor's requests. The other board designated endowments are intended to support the hospital's future needs in providing health care services to the community. 1 The Giving Collaborative LLC 53 Morgan Avenue East Haven CT 06512 Campaign for the new Cancer Center 0 0 30358 -30358 30358 -30358 1 1 X 1 X 250.000000000000 1 X 1 1 1 0 0 3703170 3703170 0.01050 99860590 62026107 37834483 0.10700 103563760 62026107 41537653 0.11750 1380094 241109 1138985 0.00320 12265402 2363002 9902400 0.02800 6412593 6412593 0.01810 225871 225871 0.00060 1345 1345 0.00000 20285305 2604111 17681194 0.04990 123849065 64630218 59218847 0.16740 0 5091859 0 85108297 86100954 -992657 X 1 1 1 Central CT Endoscopy Center LLC Endoscopy Services 0.06500 0.50000 1 1 The Hospital of Central Connecticut 100 Grand Street New Britain CT 06050 www.thocc.org 000052 X X X X New Britain General Hospital Campus and Bradley Memorial Hospital Campus The Hospital of Central Connecticut 1 0 0 1 X X X X X X X X X X 14 1 0 0 1 X See Part V X X 1 14 0 1 0 1 X 250.000000000000 400.000000000000 X X X X X 1 1 X X X X X 1 X hartfordhealthcare.org/patients-visitors/patients/billing-insurance X hartfordhealthcare.org/patients-visitors/patients/billing-insurance X hartfordhealthcare.org/patients-visitors/patients/billing-insurance X X X X X 1 X 0 X X X 1 X X 0 0 The Hospital of Central Connecticut Part V, Section B, Line 3j: The Hospital of Central Connecticut completed its last Community Health Needs Assessment in FY 2015. The study area for the survey effort is defined by 23 residential ZIP Codes in Connecticut. This assessment incorporated data from both quantitative and qualitative sources. Quantitative data input include primary research and secondary research. The survey instrument used for this study was based largely on the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS), as well as various other public health surveys and customized questions addressing gaps in indicator data relative to health promotion and disease prevention objectives and other recognized health issues. To ensure the best representation of the population surveyed, a telephone interview methodology - one that incorporates both landline and cell phone interviews - was employed. The sample design used for this effort consisted of a random sample of 798 individuals age 18 and older in the Hospital of Central CT service area. Because the study was part of a larger effort involving multiple regions and hospital service areas, the surveys were distributed among various strata. Once the interviews were completed, these were weighted in proportion to the actual population distribution so as to appropriately represent the Hartford Region as a whole.A variety of existing (secondary) data sources was consulted to complement the research quality of the Community Health Needs Assessment.Part V, Section B, Line 7ahttp://www.thocc.org/health-community/community-health-needs-assessment The Hospital of Central Connecticut Part V, Section B, Line 5: To solicit input from key informants, individuals who have a broad interest in the health of the community, an Online Key Informant Survey was also implemented as part of this process. These individuals included physicians, public health representatives, health professionals, social service providers and a variety of other community leaders including: Capital Community College Central Connecticut Health District Charter Oak Health Center Chrysalis Center, Inc. Community Health Services, Inc. Connecticut Association of Directors of Health Connecticut Children's Medical Center Connecticut Department of Public Health Connecticut State Colleges and Universities Connecticut State Medical Society FaithCare, Inc. Farmington Valley Health District Hartford Behavioral Health Hartford Food System, Inc. Hartford Foundation for Public Giving Hartford Gay and Lesbian Health Collective Hospital of Central CT Hartford Public Schools Hispanic Health Council Intercommunity, Inc. Legal Assistance Resource Center Malta House of Care Foundation Manchester Community College Manchester Health Department Manchester Public Schools Mental Health Association of Connecticut, Inc. Northern Connecticut Black Nurses Association South Windsor Human Services United Way Urban Alliance, Inc. West Hartford-Bloomfield Health District YWCA Participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall. Key informants were contacted by email, introducing the purpose of the survey and providing a link to take a survey online. Key informants were asked to rate the degrees to which various health issues were a problem in the Hartford Region. Follow-up questions asked them to describe why they identified areas as such, and how these might be better addressed. The Hospital of Central CT recognizes that it cannot measure all possible aspects of health in the community, nor can it adequately represent all possible populations of interest. In terms of content, the assessment was designed to provide a comprehensive and broad picture of the health of the overall community. The CHNA analysis and report yielded a wealth of information about the health status, behaviors and needs for our population. A distinct advantage of the primary quantitative (survey) research is the ability to segment findings by geographic, demographic and health characteristics to identify the primary and chronic disease needs and other health issues of vulnerable populations, such as uninsured persons, low-income persons, and racial/ethnic minority groups. For additional statistics about uninsured, low-income, and minority health needs please refer to the complete Community Health Needs Assessment report, which can be viewed online at: http://thocc.org/health-community/community-health-needs-assessment After reviewing the Community Health Needs Assessment findings, the community representatives met on June 10, 2015 to determine the health needs to be prioritized for action. During a detailed presentation of the CHNA findings, we used audience response system (ARS) technologies to lead steering committee members through a process of understanding key local data findings (Areas of Opportunity) and ranking identified health issues against the following established, uniform criteria: Magnitude, Impact/Seriousness/Feasibility, Consequences of Inaction. From this exercise, the areas of opportunity were prioritized as follows by the committee: Mental Health, Nutrition, Physical Activity & Weight Status, Diabetes, Substance Abuse, Cancer, Heart Disease and Stroke. The Hospital of Central Connecticut Part V, Section B, Line 7d: The needs assessment was published in March 2015 and is available on the hospital's website. In addition, copies were distributed to local non-profit organizations, colleges, churches, and state and local government representatives. These reports are also made available in waiting areas of the various departments within the hospital.Sch H Part V, Line 9:Although the approved implementation strategy date reflects 2014 tax year, the implementation strategy was approved in December 2015. The organization reports its data on a fiscal year basis. As a result, the current software prevents the disclosure of the 2015 date on the current Form. The correct date (2015) will be reflected on FY16 Form. The Hospital of Central Connecticut Part V, Section B, Line 11: As individual organizations begin to parse out the information from the 2015 Community Health Needs Assessment, it is The Hospital of Central CT's goal that this will foster greater desire to embark on a community-wide community health improvement planning process. The Hospital of Central CT has expressed this intention to partnering organizations and is committed to being a productive member in this process as it evolves. Since the CHIP is still being developed and not required to be done until February of 2016 the actions that will be taken to address identified needs have not been finalized. In addition, formal collaboratives have been formed, and system-wide initiatives have been launched that address nutrition education such as our partnership with a statewide super market retailer. In acknowledging the wide range of priority health issues that emerged from the CHNA process, Hospital of Central CT determined that it could only effectively focus on those which it deemed most pressing, most under-addressed, and most within its ability to influence: * Nutrition, Physical Activity & Weight Status* Mental Health & Substance Abuse * Heart Disease/Stroke* Diabetes Other identified needs were:* Cancer * Substance Abuse * Respiratory Diseases * Infant Health & Family Planning * Dementias, Including Alzheimer's Disease * Injury & Violence * Sexually Transmitted Diseases * Chronic Kidney Disease * HIV/AIDS * Potentially Disabling Conditions In acknowledging the wide range of priority health issues that emerged from the CHNA process, Hospital of Central CT determined that it could only effectively focus on those which it deemed most pressing, most under-addressed, and most within its ability to influence. Health Priorities Not Chosen for Action:*Chronic Kidney Disease. THOCC believes that efforts outlined herein to improve and increase awareness of healthy lifestyles will have a positive impact on the detection of kidney disease and that we do not have the available resources to create a separate set of kidney-specific initiatives.*Dementia, including Alzheimer's Disease. THOCC believes that this priority area falls more within the purview of local organizations, such as the area Alzheimer's Resource Center. THOCC will support communication of these services.*Potentially Disabling Conductions. Those voting felt that more pressing health needs existed. Limited resources and lower priority excluded this as an area chosen for action*Respiratory Diseases. THOCC participates in a statewide asthma collaborative established by the CT Department of Public Health and The CT Hospital Association. THOCC will support the established initiatives from this collaborative.*Sexually Transmitted Diseases. THOCC believes that this priority area falls more within the purview of the community/district health departments and other community organizations. Limited resources and lower priority excluded this as an area chosen for action. The Hospital of Central Connecticut Part V, Section B, Line 13h: Family eligibility criteria for Financial Assistance also include family size, employment status, financial obligations, and amount and frequency of the health care expenses. The Hospital of Central Connecticut Part V, Section B, Line 15e: In addition, patients may ask a nurse, physician, chaplain, or staff member from Patient Registration, Patient Financial Services, Office of Professional Services, Case Coordination, or Social Services about initiating the Financial Assistance Application process. The Hospital of Central Connecticut Part V, Section B, Line 16i: Patients are informed directly by staff of the availability of the Financial Assistance Policy. The Hospital of Central Connecticut Part V, Section B, Line 22d: For FY15, the hospital did a computation to determine on average, insurance companies reimbursement for the types of services rendered. The average (discount) was offered to all self-pay patients without regards to financial ability. Patients who were unable to pay their bills were able to apply for financial assistance. Based upon factors including family size & income, patients were eligible to receive write-offs ranging between 25 - 100%.The Hospital Financial Assistance Policy (effective January 1, 2016) is compliant with IRS Code Sec. 501R. Per the Hospital's policy, no individual who is determined to be eligible for financial assistance will be charged more for emergency or other medically necessary care than the amount generally billed to individuals who have insurance covering such care. The basis to which any discount is applied is equivalent to the billed charges posted to a patient account minus any prior insurance payments and adjustments from the patient's insurance (if applicable). Starting January 1, 2016, the Hospital used the IRS 501R prescribed methodology to compute self-pay discount (AGB discount). Part V, Section B, Line 16 Financial Assistance Policy Website Availability The Hospital of Central Connecticut Part V, Section B, line 16a website: hartfordhealthcare.org/patients-visitors/patients/billing-insurance The Hospital of Central Connecticut Part V, Section B, line 16b website: hartfordhealthcare.org/patients-visitors/patients/billing-insurance The Hospital of Central Connecticut Part V, Section B, line 16c website: hartfordhealthcare.org/patients-visitors/patients/billing-insurance 3 New Britain MRI Limited Partnership 100 Grand Street New Britain CT 06050 Magnetic Resonance Imaging Services Central Connecticut Endoscopy Center 440 New Britain Avenue Plainville CT 06062 Endoscopy Services HHC Southington Surgery Center 81 Meriden Avenue Southington CT 06489 Surgery Center Part I, Line 3c: The Hospital of Central Connecticut uses Federal Poverty Guidelines (FPG) to determine eligibility. In addition to the FPG, the hospital also utilizes other eligibility criteria, such as asset level, medical indigence and insurance status. Part I, Line 7: The organization utilized an overall cost to charge ratio, (RCC), developed from the Medicare Cost Report. Total expense was adjusted for: medicaid provider taxes, directly identified community benefit expense and community building expenses. This cost to charge ratio was used to calculate costs for Part I lines 7a, b, & g. The costs associated with the activities reported on Part I, Line 7e were captured using actual time multiplied by an average salary rate. The costs associated with Line 7h, were the actual costs reported in the organization's general ledger less any industry funded studies. These costs were removed from the calculations above to avoid duplication. Costs reported in Part III, Section B6, were calculated from the Medicare cost report and reduced for Medicare costs previously reported on Part I Lines 7f and g. Part I, Line 7g: Physician clinic costs were included in the Subsidized Health Services cost calculations. Part II, Community Building Activities: In 2015, The Hospital of Central Connecticut did not conduct any community building activities and primarily focused on both community health programs and health professions education. Part III, Line 2: The Hospital has established estimates based on information presently available of amounts due to or from Medicare, Medicaid, and third-party payers for adjustments to current and prior year payment rates, based on industry-wide and Hospital-specific data. Such amounts are included in the accompanying consolidated balance sheets. Part III, Line 3: A pre-bad debt financial assistance screening is in place to identify patients that may be eligible for financial assistance. Pre-bad debt accounts that are identified as meeting the requirements are adjusted prior to being sent to bad debt. Therefore, any bad debt expense that could have been attributable to charity care at the end of FY 2015 would be immaterial. Part III, Line 4: Please see the text of the footnote that describes bad debt expense beginning on page 16 - 19 of the Audited Financial Statement. Part III, Line 8: Providing for those in need, including Medicare patients and serving all patients regardless of their ability to pay is an essential part of the organization's mission. The Hospital serves all patients without regard to any payment shortfall. The Organization's Medicare Cost Report was used to accumulate actual costs related to Part III, Section B, Line 6. Part III, Line 9b: The Financial Assistance Policy states: In the event a patient fails to qualify for Financial Assistance or fails to timely pay his or her portion of discounted charges pursuant to this Policy, The Hospital of Central Connecticut reserves the right to institute and pursue Extraordinary Collection Actions (ECA) and remedies such as imposing wage garnishments or filing liens on primary or secondary residences, bank or investment accounts, or other assets, instituting and prosecuting legal actions and reporting the matter to one or more credit rating agencies. For those patients who qualify for Financial Assistance and who, in The Hospital of Central Connecticut's sole determination, are cooperating in good faith to resolve the outstanding accounts, The Hospital of Central Connecticut may offer extended payment plans. For patients who meet the terms of the payment plan The Hospital of Central Connecticut will not impose wage garnishments or liens on primary residences, and will not send unpaid bills that are part of the payment plan to outside collection agencies.No ECA will be initiated during the first 120 days following the first post-discharge billing statement to a valid address or during the time that patient's Financial Assistance Application is processing. Before initiating any ECA, a notice will be provided to the patient 30 days prior to initiating such event.If the patient applies for assistance within 240 days from the first notification of the self-pay balance, and is granted assistance, any ECA's such as negative reporting to a credit bureau or liens that have been filed will be removed. Part VI, Line 2: The Hospital of Central Connecticut assesses the health care needs of the communities it serves in several manners. HOCC has recently conducted a community needs assessment of the population within its service area in order to ascertain the prevalent health care needs. The assessment identified chronic diseases, defined the population cohorts most at risk and segregated needs based on socioeconomic and mental status. Within these stratifications, HOCC looked to identify the barriers to receiving appropriate care such as lack of transportation, program capacity, mobility issues, mental status, age, and language. The Hospital will be partnering with other community organizations to address some of the most prevalent needs identified. HOCC also analyzed claims based data to understand what medical diagnoses and surgical procedures are attributed to its local population in order to plan for program growth and/or capacity. Another method HOCC employs is through continuous contact and collaboration with local community groups. These groups often identify medical services that are needed in the community that HOCC ought to address. Part VI, Line 3: The patients are educated about Financial Assistance by the signage and Financial Assistance summary hand out available in the following departments at the hospital, Admitting, Patient Accounts, Emergency Department, Behavioral Health, and Social Services. Financial Assistance education is also provided on the back of the hospital's monthly statement, by our outside vendors, and collection agencies. Part VI, Line 4: The Hospital of Central Connecticut (HOCC) serves primarily the communities located in greater New Britain and the surrounding towns including Berlin, Plainville and Southington, with some coverage of Bristol, Burlington, Cheshire, Cromwell, Farmington, Meriden, Newington, West Hartford and Wolcott. The total population in HOCC's service area is 464,998 as defined by CERC town profiles for 2014. The most prominent race is Caucasian at about 84% of the total population which has been declining as the Hispanic population has grown to approximately 15% of the total 13 town primary and sub-service areas. Within HOCC's primary service area of Berlin, Plainville, New Britain and Southington, the Hispanic population counts for 16%. The population in HOCC's service area is older than the US and CT as a whole with approximately 16% in the over 65 category in some of the primary towns. The median household income in HOCC's communities varies significantly averaging $72,000 with 23.5% of NB's population living beneath the federal poverty level. Part VI, Line 5: The Hospital of Central Connecticut (HOCC) is responsive to the community by having a completely open medical staff and a board of trustees with diverse membership that reflects the community at large. HOCC is a Disproportionate Share Hospital with one of the highest rates of Medicaid patients in the state. The organization provides space for the Medicare Choices program to help community members select the Medicare programs that are best for them. The organization has a full graduate medical education program for physician training with UCONN, and also provides training for nursing and allied health students, including a specialty echosonographer program. HOCC is a major sponsor of the New Britain Health Academy, a program that exposes local high school students to careers in the healthcare field. Presented in partnership with other community organizations, the Academy offers students an opportunity to learn about the types of jobs available, and facilitates contact with healthcare professionals who can guide program participants. In FY 2015, HOCC continues to support a community service organization fair where area not-for-profit organizations are invited to the hospital to share with HOCC's community about their mission and purpose. In addition, various hospital staff members and departments support community events on an ongoing basis, as well as frequent monetary and in-kind donations to area organizations in need.HOCC also participates in the Medical Legal Partnership Program. This program recognizes that there are many issues that may affect children and families seeking health care, that are not specifically healthcare related. These include landlord/tenant and housing issues. The program helps healthcare providers direct families to resources that can assist with these issues. Among our outreach services is our Mothers Offering Mothers Support (M.O.M.S.) program, a weekly support program for mothers 21 years old and under. Program leaders are women who were also young mothers and are now helping others. In addition, The Hospital of Central Connecticut has a program in which indigent patients who are being discharged from the hospital and who do not have prescription drug coverage, receive dosages of their prescribed medications to help them recover and comply with treatment guidelines as well as reduce readmission rates. Part VI, Line 6: Hartford Healthcare Corporation (HHC) is organized as a supporting organization to govern, manage and provide support services to its affiliates. HHC, through its affiliates including The Hospital of Central Connecticut, strives to improve health using the "Triple Aim" model: improving quality and experience of care; improving health of the population (population health) and reducing costs. The Strategic Planning and Community Benefit Committee of the HHC Board of Directors ensures the oversight for these services by each hospital community. HHC and its affiliates including all supporting organizations, develop and implement programs to improve the future of health care in our Southern New England region. This includes initiatives to improve the quality and accessibility of health care; create efficiency on both our internal operations and the utilization of health care; and provide patients with the most technically advanced and compassionate coordinated care. In addition, HHC continues to take important steps toward achieving its vision of being "nationally respected for excellence in patient care and most trusted for personalized, coordinated care".HHC affiliation creates a strong, integrated health care delivery system with a full continuum of care across a broader geographic area. This allows small communities easy and expedient access to the more extensive and specialized services the larger hospitals are able to offer. This includes continuing education of health care professionals at all the affiliated institutions through the Center of Education, Simulation and Innovation located at Hartford Hospital, the largest of the system hospitals.The affiliation further enhances the affiliates abilities to support their missions, identity, and respective community roles. This is achieved through integrated planning and communication to meet the changing needs of the region. This includes responsible decision making and appropriate sharing of services, resources and technologies, as well as cost containment strategies.Additionally, the hospital is affiliated with several other non hospital charitable organizations. These organizations provide significant benefits to the community. These benefits are not reported in the Community Benefit data provided by the hospital. Part VI, Line 7, Reports Filed With States CT X 1 1 1 1 0 0 0 0 0 1 0 Lucille Janatka President/Director 0 560112 0 128700 0 2607033 0 20800 0 87140 0 3403785 0 2575769 Carolyn Freiheit VP, Finance 0 222058 0 33605 0 11976 0 8068 0 16946 0 292653 0 0 Margaret Marchak Secretary 0 432566 0 101007 0 8337 0 72165 0 36596 0 650671 0 0 Steven Hanks MD Sr. VP, Medical Affairs 0 559245 0 77262 0 630480 0 20252 0 40981 0 1328220 0 595590 Catherine Stevens VP, Patient Care 0 225924 0 33429 0 3365 0 20800 0 26587 0 310105 0 0 Mary Morgan VP, Human Resources 0 198366 0 30550 0 13124 0 7409 0 27249 0 276698 0 0 Justin Lundbye MD Chief of Cardiology 436012 0 20301 0 0 0 27900 0 17064 0 501277 0 0 0 Jeffrey Finkelstein MD Chief of ER 576841 0 34741 0 757029 0 81755 0 22265 0 1472631 0 380924 0 Michael Grey Chief of Medicine 96080 0 0 0 430840 0 5943 0 352 0 533215 0 371176 0 James Flaherty MD Director, Surgical Oncolog 424398 0 107669 0 16706 0 110400 0 15830 0 675003 0 0 0 Haklai Lau MD Hospitalist 200824 0 447218 0 144768 0 10400 0 21347 0 824557 0 0 0 Clarence Silvia Former President & CEO 171983 0 25901 0 1521717 0 49890 0 565 0 1770056 0 197657 0 Ralph Becker Former - CFO 0 23987 0 0 0 361970 0 5200 0 25704 0 416861 0 0 Part I, Line 1a Tax Idemnification and gross-up payments to certain individuals for benefits were included as taxable income on their 2014 Form W-2. Part I, Line 3 The Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare Corporation, on behalf of The Hospital of Central Connecticut, hires an outside consultant, Integrated Healthcare Strategies, a division of Gallagher Benefit Services, Inc., to determine best practices in governing executive compensation. Please refer to schedule O for more details. Part I, Lines 4a-b Hartford HealthCare Corporation, a related organization, maintains a 457(f) plan. Participants include certain officers and key employees at the President, Executive Vice President, Senior Vice President and Vice President levels that are reported by The Hospital of Central Connecticut on Form 990, Part VII. Contributions are made by Hartford HealthCare Corporation to the plan based on the percentage of the participant's compensation. Participants vest in the plan at the earlier of reaching age 55 and having 5 years of service, death, disability, involuntary separation without resonable cause or upon reaching age 65. Each participant ceases to be eligible for further contributions by Hartford HealthCare Corporation on the date of the participant's separation from service. Participants receive a one-time lump sum payment of the accumulated amount during the 30-day period following the participant's separation from service. 2014 SERP Accruals made on behalf of the following individuals: Clarence Silvia $28,226 Jeffrey Finkelstein $50,585 James Flaherty $100,000 Justin Lundbye $17,500 2014 SERP Payouts made on behalf of the following individuals: Steven Hanks $595,590 Lucille Janatka $2,575,769 Clarence Silvia $197,657 Jeffrey Finkelstein $380,924 Michael Grey $371,176 2014 Severance Payouts made on behalf of the following individuals: Clarence Silvia $1,213,838 Ralph Becker $305,000 Part I, Line 7 Hartford HealthCare Organization, a related organization, has an At Risk Plan that encourages and rewards achievements of significant functional goals for management that contibute to organization(s) strategic and financial direction. The Plan utilizes market practice alignment to ensure competitive recruitment and retention. Awards are based on CEO and/or Hartford HealthCare Corporation's Compensation Committee discretionary assessment of overall organization performance and individual contribution to results. X 1 200 FMV X 1620 FMV X 6574 FMV X Auction Items 45 12157 FMV X Gift Cards 34 5774 Face Value X Event Tickets 19 2819 Face Value 0 0 1 0 Part I, Column (b): The information reported in column (b) represents the number of contributions. Form 990, Part VI, Section A, line 4 The Corporation amended its Certificate of Incorporation in Fiscal Year 2015. The Amended and Restated Certificate of Incorporation includes the following substantive amendments: 1. The Corporation's purposes have been revised but are consistent with its charitable purposes. 2. The board's role was revised to focus on quality in health care. 3. Section 12 relating to the indemnification of directors, officers, and committee members of the Corporation has been revised consistent with Connecticut Law. The Organizations' governing documents are available upon request. Form 990, Part VI, Section A, line 6 The Hospital of Central Connecticut is organized as a non-stock not-for-profit entity. Hartford HealthCare Corporation is the sole member. Form 990, Part VI, Section A, line 7a The sole member of the organization has the authority to approve/remove members of the governing body. Form 990, Part VI, Section A, line 7b The sole member of the organization has the right to review, approve, disapprove and deny significant transactions such as mergers, acquisitions, dissolutions etc. Form 990, Part VI, Section B, line 11 The Form 990 was prepared by Hartford HealthCare's Tax Department. It was then reviewed by an independent accounting firm. It was then forwarded to the organization's top management including the VP of Finance for review. The final Form was provided to the entire Board prior to submission to the Internal Revenue Services (IRS). Once the entire review process was completed, the Form was signed by the VP of Finance and then filed with the IRS. Form 990, Part VI, Section B, line 12c The hospital's board has adopted the policy of the member, Hartford HealthCare Corporation (HHC). HHC's Conflict of Interest Policy (Policy) requires all Covered Individuals, including board members and officers, to provide a disclosure of relationships that create or have the appearance of creating a conflict of interest or commitment. The Policy requires updates if changes in circumstances arise during the year that either (a) create a new potential conflict of interest or commitment or (b) change or eliminate a conflict of interest or commitment previously disclosed. Conflict of Interest disclosure statements are maintained by the HHC Office of Compliance, Audit & Privacy (OCAP). Employee disclosures are reviewed by OCAP in collaboration with the Covered Individuals' supervisor when deemed appropriate, to determine if there is a potential conflict. Oversight review of employee disclosures is provided by the HHC Conflict of Interest Committee (the Committee) which includes representation from the Medical Staff, the Legal Department, Human Resources, Supply Chain Management and Compliance. The Committee assesses and may recommend the conflicting interest either be (a) eliminated for a continued relationship with HHC, or (b) managed through a management plan. Board member disclosures are reported to the HHC Nominating and Governance Committee for determinations of conflicts and the management of them, where applicable. Form 990, Part VI, Section B, line 15 The Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare on behalf of The Hospital of Central Connecituct, hires an outside consultant, Integrated Healthcare Strategies, a division on Gallagher Benefit Services Inc., to determine best practices in governing executive compensation. The following steps were taken: - Use of an Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare, on behalf of The Hospital of Central Connecticut, established and regularly reviews Executive Compensation Philosophy. - The Committee regularly reviews scope and depth of positions taking into account complexity and the financial impact and accountability of all "disqualified persons". - National peer group selected for comparative purposes based on organizational size, operating revenue, geography and other relevant factors. - Analysis of current total compensation versus market performed by independent third party compensation consulting firm, reviewed by the committee. - Recommendations made based on data analysis to ensure appropriate competitive positioning within parameters of compensation philosophy. - The CEO compensation is reviewed by Committee based on comparative market information and organizational performance. - All changes reviewed and approved by Executive Compensation Committee. The CEO compensation determination process is reviewed on an annual basis. All other executive compensation is regularly reviewed for scope and depth of positions taking into account complexity and the financial impact and accountability. Form 990, Part VI, Section C, line 18 The Hospital's Form 990, 990T and form 1023 and its attachments are available upon request. Form 990, Part VI, Section C, line 19 The Hospital's Financial Statements, Governing Documents and the Conflict of Interest Policy are available for inspection upon request at the Hospital's address. Form 990, Part XI, line 9: Change In Pension Funding Obligation 16,805,766. Transfer to Affiliate -10,966,613. Change In Funds Held In Trust -1,485,764. CCHA Asset Transfer 4,070,218. Adjustment To Report Actual K-1 From Endowment, LLC -13,930,809. Other Changes -18,172. Net Assets Released From Restrictions for Operations -1,153,505. 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