2016-08-15T11:07:10-05:00 2015-09-30 ERNST & YOUNG US LLP 200 CLARENDON STREET BOSTON MA 021165072 990 2014-10-01 060646597 Danbury Hospital % MARY JO PAWLAK DANB 2037397000 24 Hospital Avenue Danbury CT 068106099 STEVEN H ROSENBERG SVP/CFO 2037397000 2016-08-09 true Mike A Cincotta P01595811 6172662000 2014 2016-09-27 15:27:22Z Daniel DeBarba Jr 24 Hospital Avenue Danbury CT 06810 695533868 false X www.danburyhospital.org X 1885 CT To enhance through medical care,education and research the health and well being of individuals in Danbury, CT and surrounding communities in partnership with those we serve. 9 8 3666 378 5663696 -371649 23605157 14913270 507620940 598482181 4087630 4838153 3515639 1601785 538829366 619835389 0 0 0 0 239374097 280914729 0 0 0 261253127 343750186 500627224 624664915 38202142 -4829526 838062311 836823101 348768773 360086728 489293538 476736373 X To improve the health of every person we serve through the efficient delivery of excellent, innovative and compassionate care. false false 196329911 158301807 SEE SCHEDULE O 154180970 171576114 SEE SCHEDULE O 82328536 77426210 SEE SCHEDULE O 98288751 191491715 531128168 true true false true false false false false false false true true false true true false false true false true true false false false false false true true false false true true false false false false false false false false false true false false false false false true true true false false true 639 0 true 3666 true true true true CJ false false false false false false false false X 9 8 true false false false true true true true true false false true false false false true true false X MARY JO PAWLAK 2037397000 24 HOSPITAL AVENUE Danbury CT 068106099 X John M MurphyMD Pres/CEO, WCHN 40.0 9.0 X X 1402828 0 51844 Neil Culligan MD Director 1.0 1.0 X 0 0 0 David Kramer MD Director (To 1/1) 1.0 1.0 X 0 0 0 D Cyganowski Director 1.0 1.0 X 0 0 0 Richard G Jabara Director 1.0 4.0 X 0 0 0 Anthea Disney Director 1.0 1.0 X 0 0 0 Joseph D Skrzypczak Secretary 1.0 3.0 X X 0 0 0 Spencer Houldin Director 1.0 3.0 X 0 0 0 Brian C White Director 1.0 3.0 X 0 0 0 James Kennedy Chairman 3.0 5.0 X X 0 0 0 Steven H Rosenberg SVP/CFO, WCHN 40.0 17.0 X 779114 0 42729 Daniel DeBarba Jr Exec VP/Pres-DH 35.0 12.0 X 966102 93142 57347 Donna Kaplanis Ass't Secretary 40.0 8.0 X 252835 0 51331 Matthew A Miller MD SVP & Chief Medical Officer 40.0 4.0 X 308356 361965 45992 Moreen O Donahue Sr VP/Chief Nurse Officer,WCHN 40.0 1.0 X 446933 0 50720 Michael Daglio Chief Oper Officer (To 11/2) 5.0 43.0 X 550572 0 44866 Morris Gross VP of Facilities/Real Estate 40.0 2.0 X 360940 6180 51603 Kathleen A Dematteo Chief Infor.Officer, WCHN 40.0 0.0 X 475193 0 32274 Patrick C Minicus VP of Finance 20.0 22.0 X 476177 73323 50314 James Varrone VP Supply Chain 36.0 4.0 X 0 185641 30014 Lisa Schmittgall SRVP Strategy-WCHN (To 12/31) 40.0 1.0 X 724800 38261 31469 Debra Carragher VP of Operations 40.0 0.0 X 325179 0 16137 Carolyn McKenna Sr VP/Gen'l Coun 40.0 0.0 X 471111 0 37202 Ramin Ahmadi MD Dir. of Educ./Res. 40.0 0.0 X 330757 0 42127 Dawn Myles SRV,Qual/Pat. Sfty 40.0 0.0 X 334356 0 22081 Ruth Gregory Director of Materials Dist 40.0 0.0 X 162028 0 26328 Joseph Campbell Chief Audit Compl. Officer 40.0 0.0 X 291737 0 50466 Phyllis F Zappala Sr. VP of Human Resource 40.0 0.0 X 269485 0 35718 8928503 758512 770562 594 true true false TOWERS WATSON PENNSYLVANIA PO BOX 8500 PHILADELPHIA PA 191787482 CONSULTANTS 1359311 ROBINSON COLE LLP 280 TRUMBULL STREET HARTFORD CT 06103 ATTORNEYS 1548372 DANBURY RADIOLOGICAL ASSOCIATES PO BOX 417407 BOSTON MA 02241 RADIOLOGY SERVICES 927782 E4 SERVICES LLC 60 NORTH CAROLINA AVE SINKING SPRING PA 19608 ITG CONSULTANTS 1029292 PRICE WATERHOUSE COOPERS LLC PO BOX 7247 PHILADELPHIA PA 19170 CONSULTANTS 1899925 52 11877473 2730032 305765 14913270 ANCILLARY SERVICE 621400 297090886 297090886 MEDICARE/MEDICAID PAY'TS 621990 253818157 253818157 ROUTINE PATIENT 621990 37037912 37037912 CONTRACT LAB 621500 4928198 4928198 RENTAL INC.-AFFL. EXEMPT 532000 2512565 2512565 3094463 3094463 598482181 3637036 3637036 73109 73109 0 910968 178610 732358 0 732358 11229 721129 76030605 150500 74992138 60959 1038467 89541 1128008 1128008 0 0 465750 466772 -1022 -1022 NUTRITION AND DIETARY 561000 372148 372148 OTHER PATIENT SERVICES 900099 302436 302436 ADMINISTRATIVE SERVICES 561000 181496 181496 14369 14369 870449 619835389 593867648 5663696 5390775 0 0 0 0 6573840 1740254 4833586 0 218210682 179674676 38536006 9306626 7663076 1643550 29978262 24684101 5294161 16845319 13870436 2974883 195167 195167 2643881 2643881 501452 501452 172312 141882 30430 0 269287 269287 104940344 86407879 18532465 1262780 1039773 223007 7793028 6416779 1376249 17279133 14227638 3051495 0 14072076 11586947 2485129 637526 524939 112587 0 291082 239677 51405 7515245 7515245 0 45346522 37338326 8008196 10671352 10110640 560712 MEDICAL SUPPLIES 91868331 91868331 STATE OF CT HOSPITAL TAX 24402044 24402044 EQUIPMENT RENT AND MAINT. 9683926 7973745 1710181 PROFESSIONAL MEMBERSHIP 2847778 2344860 502918 1356920 1356920 624664915 531128168 93536747 0 39492 87296 46694493 21119887 0 0 63595267 76938200 0 0 0 0 2476284 0 10027585 10950142 3728278 4185867 846418674 452257825 351669715 394160849 204327199 64573120 0 102260022 0 0 0 0 155503998 162547718 838062311 836823101 67327475 75819734 0 0 3183583 2565628 246700000 244850000 0 0 0 0 0 0 0 0 31557715 36851366 348768773 360086728 X 412096873 406109696 47726160 36051363 29470505 34575314 489293538 476736373 838062311 836823101 X -4829526 -6685508 -1042131 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED true true false true 42 false true 76895 true 94902 false true 473 172312 false Schedule C, Part II-B - Description of Lobbying Activity Dues were paid to CHA in the amount of $390,877, of which 15.43% of this amount or $60,312 were expended on lobbying. AHA dues of $72,733 had 22.80% or $16,583 expended on lobbying activities. Both amounts are reflected on 1f. Only state and local officials were lobbied during 2015. As part of this miscellaneous office expense such as phone, computer supplies, refreshment etc. were incurred and were reflected on line #1i accordingly. Direct contact with legislators and state leaders were lobbied in support of maintaining patient access to essential services for both the uninsured and under insured. 4992068 4992068 508885933 234589427 274296506 9549698 3938712 5610986 306225446 213729686 92495760 16765529 16765529 394160849 COMMON COLLECTIVE FUNDS 77271753 F HARD TO VALUE FUNDS 24988269 F 102260022 457B ASSET 898100 BOND ESCROW FUND 1868178 BOND ISSUANCE COST 3192086 BULK ACCOUNTS NET OF RESERVE 684627 CSV ON OFFICER'S LIFE POLICY 1806700 DUE FROM RELATED PARTIES 6402385 INTEREST IN WCHN FOUNDATION 92379063 INVESTMENT IN WCHIC, LTD. 53694168 MORRISON DEPOSIT 96418 OTHER RECEIVABLES 1525993 162547718 0 457B LIABILITY 898100 ASSET RETIREMENT OBLIGATION 411783 DUE TO 3RD PARTIES 18231699 MALPRACTICE TRUST FUND RESERVE 10246000 RESERVE FOR WORKERS COMPENSATION 7063784 36851366 Central America and the Caribbean 1 1 Program Services Malpractice Ins. Central America and the Caribbean 1 1 Investments Malpractice Ins. 53694168 Central America and the Caribbean 1 1 Program Services Malpractice Ins. 10080158 3 3 3 3 63774326 63774326 true false true false true false Schedule F, Part I, Line 3f - Method of Accounting All information for Part I, Line 3, column (f) is accounted for on the audited financial statements on the accrual basis. true true X true X 400. true X 600. true true true false true true 12551226 1547976 11003250 0.01760 82775 98753200 46712575 52040625 0.08330 82775 111304426 48260551 63043875 0.10090 310 239099 297710 80578 217132 0.00030 40 239 21006755 7249420 13757335 0.02200 21 9645 2854080 1813934 1040146 0.00170 1 126 2329841 583095 1746746 0.00280 372 249109 26488386 9727027 16761359 0.02680 372 331884 137792812 57987578 79805234 0.12770 2 355 355 1 152 152 47 9169 9169 3 4697 4697 53 14373 14373 true 7709381 1431402 209181129 264752197 -55571068 X true true 2 1 Danbury Hospital 24 Hospital Avenue Danbury CT 06810 www.danburyhospital.org 0039 X X X X X 2 New Milford Hospital Campus 21 Elm Street New Milford CT 06776 www.newmilfordhospital.org 0039 X X X Danbury Hospital 1 false false true X X X X X X X X X 13 true true true true X SEE PART V, SECTION C X SEE PART V, SECTION C X true 13 true SEE PART V, SECTION C false false true X 400. 600. X X X X true true X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X true X false X X X X true X X false false New Milford Hospital Campus 2 false true true X X X X X X X X X 13 true true true true X SEE PART V, SECTION C X SEE PART V, SECTION C X true 13 true SEE PART V, SECTION C false false true X 400. 600. X X X X true true X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X true X false X X X X true X X false false Part V, Line 5 - Account input from persons who represent the community Facility: Danbury Hospital Danbury Hospital in conducting its most recent CHNA in 2012 (completed and approved in 2013), developed effective strategies to improve community health involve active collaboration and commitment among health providers, public and community health agencies, educators, work sites, community and faith-based organizations and groups, and the public they serve. The hospital collaborates with community partners for assessment of community health needs and action planning. Danbury Hospital, and its New Milford Hospital Campus, participated in the development of a Community Report Card for the Housatonic Valley Region, a 10-district municipality that includes Danbury and New Milford, CT. The other eight towns are Bridgewater, Bethel, Brookfield, New Fairfield, Newtown, Redding, Ridgefield and Sherman, CT, all towns within the primary service area of both hospitals. Developing a plan for health improvement in our region involves collective action by and sharing of expertise and resources across agencies and organizations in both the public and private sectors. Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted needs Assessment Facility: Danbury Hospital Danbury Hospital, and its New Milford Hospital Campus, participated in the development of a Community Report Card for the Housatonic Valley Region, a 10-district municipality that includes Danbury and New Milford, CT. Part V, Line 6b - CHNA Conducted by Orgnizations Other Than Hospital Facility: Danbury Hospital As noted in Part VI, Line #2, Needs Assessment narrative, the CHNA was conducted with various community organizations participating in the Community Forum at Danbury Hospital and its New Milford Hospital Campus. Part V, Line 2 - Acquistion Of Facility Placed In Service Facility: New Milford Hospital Campus On October 1, 2014 (the merger date), Danbury Hospital (the Hospital) received a single provider license to include The New Milford Hospital Incorporated (New Milford Hospital). As a result, New Milford Hospital merged with the Hospital and the operations of New Milford Hospital became a campus of Danbury Hospital effective October 1, 2014. The Hospital will operate as one licensed facility with two campuses. Part V, Line 5 - Account Input from Person Who Represent the Community Facility: New Milford Hospital Campus New Milford Hospital Campus in conducting its most recent CHNA in 2012 (completed and approved in 2013), developed effective strategies to improve community health involve active collaboration and commitment among health providers, public and community health agencies, educators, work sites, community and faith-based organizations and groups, and the public they serve. The hospital collaborates with community partners for assessment of community health needs and action planning. New Milford Hospital and Danbury Hospital Campuses participated in the development of a Community Report Card for the Housatonic Valley Region, a 10-district municipality that includes Danbury and New Milford, CT. The other eight towns are Bridgewater, Bethel, Brookfield, New Fairfield, Newtown, Redding, Ridgefield and Sherman, CT, all towns within the primary service area of both hospitals. Developing a plan for health improvement in our region involves collective action by and sharing of expertise and resources across agencies and organizations in both the public and private sectors. Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted needs assessment Facility: New Milford Hospital Campus New Milford Hospital and Danbury Hospital Campuses participated in the development of a Community Report Card for the Housatonic Valley Region, a 10-district municipality that includes Danbury and New Milford, CT. that includes Danbury and New Milford, CT. Part V, Line 6b - CHNA Conducted by Orgnizations Other Than Hospital Facility: New Milford Hospital Campus As noted in Part VI, Line #2, Needs Assessment narrative, the CHNA was conducted with various community organizations participating in the Community Forum at Danbury Hospital and its New Milford Hospital Campus. Hospital and its New Milford Hospital Campus. Part V, Line 7A - URL Facility: DANBURY HOSPITAL http://www.danburyhospital.org/about-us/about-danbury-hospital/community-b enefit Part V, Line 7A - URL Facility: NEW MILFORD HOSPITAL http://www.newmilfordhospital.org/about-us/about-us/community-benefit Part V, Line 7B - URL Facility: DANBURY HOSPITAL http://www.chime.org/advocacy/community-health/ Part V, Line 7B - URL Facility: NEW MILFORD HOSPITAL http://www.chime.org/advocacy/community-health/ Part V, Line 10A - URL Facility: DANBURY HOSPITAL http://www.danburyhospital.org/about-us/about-danbury-hospital/community-b enefit Part V, Line 10A - URL Facility: NEW MILFORD HOSPITAL http://www.newmilfordhospital.org/about-us/about-us/community-benefit Part V, Line 16A - URL Facility: DANBURY HOSPITAL http://www.danburyhospital.org/patient-and-visitors-info/billing Part V, Line 16A - URL Facility: NEW MILFORD HOSPITAL http://www.newmilfordhospital.org/patient-and-visitors-info/billing Part V, Line 16B - URL Facility: DANBURY HOSPITAL http://www.danburyhospital.org/patient-and-visitors-info/billing Part V, Line 16B - URL Facility: NEW MILFORD HOSPITAL http://www.newmilfordhospital.org/patient-and-visitors-info/billing Part V, Line 16C - URL Facility: DANBURY HOSPITAL http://www.danburyhospital.org/patient-and-visitors-info/billing Part V, Line 16C - URL Facility: NEW MILFORD HOSPITAL http://www.newmilfordhospital.org/patient-and-visitors-info/billing Part V, Line 16i - Other Means Hospital Facility Publicized the Policy Facility: Danbury Hospital Danbury Hospital has messages on all statements providing information regarding how the patient can get assistance with their hospital bill. Counselors are also available to provide further assistance. available to provide further assistance. Part V, Line 16i - Other Means Hospital Facility Publicized the Policy Facility: New Milford Hospital Campus New Milford Hospital Campus has messages on all statements providing information regarding how the patient can get assistance with their hospital bill. Counselors are also available to provide further assistance. Part V, Line 22d - Other Billing Determination of Individuals Without Insurance Facility: Danbury Hospital Danbury Hospital intends to be in compliance with the regulations regarding the maximum amounts that can be charged to FAP-eligible individuals for emergency and other medical necessary care by the effective date (10/1/2016). Part V, Line 22d - Other Billing Determination of Individuals Without Insurance Facility: New Milford Hospital Campus New Milford Hospital intends to be in compliance with the regulations regarding the maximum amounts that can be charged to FAP-eligible individuals for emergency and other medical necessary care by the effective date (10/1/2016). 23 Danbury Hospital Ridgefield Surg Ctr 901 Ethan Allen Highway Ridgefield CT 06877 Outpatient Surgical Center Breast Imaging Center 20 Germantown Road Danbury CT 06810 Diagnostic Main Street Rehabilitation Center 235 Main Street Danbury CT 06810 Rehabilitation Siefert & Ford Community Health Ctr 70 Main Street Danbury CT 06810 Outpatient-Physician Clinic Danbury Hospital Sleep Lab II 25 Lake Avenue-Extension Danbury CT 06810 Diagnostic Comm Ctr for Behaviorial Health 152 West Street Danbury CT 06810 Outpatient-Physician Clinic Southbury Cardiovascular Diagnostics 22 Old Waterbury Road Southbury CT 06488 Diagnostic Pulmonary Services 33 Germantown Road Danbury CT 06810 Diagnostic The Anticoagulation Center 41 Germantown Road Danbury CT 06810 Diagnostic Physical Medicine Center of Southbury 22 Old Waterbury Road Suite 101 Southbury CT 06488 Outpatient-Physician Clinic New Milford Hospital Behavorial Healt 23 Poplar Street New Milford CT 06776 Outpatient-Physician Clinic Danbury Hospital Laboratory 79 Sandpit Road Danbury CT 06810 Diagnostic Center for Child & Adol Treat 152 West Street Danbury CT 06810 Outpatient-Physician Clinic Danbury Hospital Laboratory Center NM 120 Park Lane Suite A201 New Milford CT 06776 Diagnostic Danbury Hospital Southbury Laboratory 22 Old Waterbury Road Suite 101 Southbury CT 06488 Diagnostic Danbury Hospital Lab Ctr in Brookfield 60 Old New Milford Road Unit 1C Brookfield CT 06804 Diagnostic Danbury Hospital Diabetes Education Ct 41 Germantown Road Danbury CT 06810 Education Center Ridgefield Specimen Collection Facili 10 South Street Ridgefield CT 06877 Diagnostic Bethel Laboratory 68 Stony Hill Road Bethel CT 06801 Diagnostic Newtown Laboratory 14-18 Church Hill Road Newtown CT 06470 Diagnostic Kenosia Lab 51-53 Kenosia Avenue Danbury CT 06810 Diagnostic Danbury Hospital Research Institute 131 West Street Danbury CT 06813 Diagnostic New Milford Integrated Medicine Prgm 30 Elm Street New Milford CT 06776 Outpatient-Physician Clinic SCHEDULE H, PART I, LINE 3C Annual income and liquid assets are combined to determine eligibility. If family income limit for eligibility is between 400% and 500% then 50% will be taken off based on a sliding scale. If the income limit for eligibility is between 500% and 600% then 100% will be taken off based on a sliding scale. SCHEDULE H, PART I, LINE 6A Part I, Line 6a & 6b: The Community Benefit report is reported on a Network basis. It contains the organization's community benefit programs and services' descriptions and financial data. The form is made available to the public on the Office of Health Care Access' website: http://www.ct.gov/dph/lib/dph/ohca/hospitalfillings/2012/irs990/danby990_h ospital_2012.pdf SCHEDULE H, PART 1, LINE #7 Charity Care At Cost Percentage: Total Gross Patient charges written off to charity (Income Statement) * Patient Cost to Charge % (see below) = Total Community Benefit Expense Total Community Benefit Expenses - Revenue from Uncompensated Care Pools and programs (DHS * % of cost of uncompensated care shown on the OCHA Schedule 500) = Net community benefits expenses Net community benefits expenses / total expenses = % of total expenses Ratio Cost To Charge Calculation Total Operating Expenses - non-patient care activities, medicaid provider tax, total community benefit expense and total community building expense = Adjusted Patient Care Cost. Adjusted Patient Care Cost divided by Gross Patient Charges= Ratio of patient care costs to charges. SCHEDULE H, PART I, LINE 7G Part I, Line 7g - Costs Associated With Physicans Clinics There are no physician clinics included in this amount. SCHEDULE H, PART III, LINE #2 The ratio of cost to charges is applied to the bad debt expense on the audited financial statements. SCHEDULE H, PART III, LINE #3 It is the policy of the Hospital to provide necessary care to all persons seeking treatment without discrimination on the grounds of age, race, creed, national origin or any other grounds unrelated to an individual's need for the service or the availability of the needed service at the Hospital. A patient is classified as a charity care patient by reference to established policies of the Hospital. Essentially, these policies define charity services as those services for which no payment is anticipated. In assessing a patient's inability to pay, the Hospital utilizes the generally recognized federal poverty income guidelines, but also includes certain cases where incurred charges are significant when compared to a responsible party's income and their countable assets. Those charges are not included in net patient service revenue for financial reporting purposes. Because the hospital is not paid for these services, they are considered to be community benefit. When private pay patients are sent to the collection agency their account is considered to be a bad debt. Subsequently, Medicaid may be granted for some of those patients. At that time those accounts would become charity care or a community benefit. SCHEDULE H, PART III, LINE #4 The Hospital's estimation of the allowance for uncollectible accounts is based primarily upon the type and age of the patient accounts receivable and the effectiveness of the Hospital's collection efforts. The Hospital's policy is to reserve a portion of all self-pay receivables, including amounts due from the uninsured and amounts related to co-payments and deductibles, as these charges are recorded. On a monthly basis, the Hospital reviews its accounts receivable balances and various analytics to support the basis for its estimates. These efforts primarily consist of reviewing the following: Historical write-off and collection experience using a hindsight or look-back approach; Revenue and volume trends by payor, particularly the self-pay components; Changes in the aging and payor mix of accounts receivable, including increased focus on accounts due from the uninsured and accounts that represent co-payments and deductibles due from patients; Cash collections as a percentage of net patient revenue less the provision for uncollectible accounts; and Trending of days revenue in accounts receivable The amount of the allowance for uncollectible accounts is based upon management's assessment of historical and expected net collections, business and economic conditions, trends in Medicare and Medicaid health care coverage, and other collection indicators. The Hospital regularly performs hindsight procedures to evaluate historical write-off and collection experience throughout the year to assist in determining the reasonableness of its process for estimating the allowance for uncollectible accounts. The Hospital's primary concentration of credit risk is patient accounts receivable, which consists of amounts owed by various governmental agencies, insurance companies and private patients. The Hospital manages the receivables by regularly reviewing its patient accounts and contracts, and by providing appropriate allowances for uncollectible amounts. Significant concentrations of gross patient accounts receivable include 30%, 13% and 57% and 37%, 13% and 50% for Medicare, Medicaid and non-government payors, respectively, at September 30, 2015 and 2014, respectively. SCHEDULE H, PART III, LINE #8 Danbury Hospital's Medicare shortfall should be treated as a community benefit as the organization strives to provide 24/7 coverage, improved patient access, highest clinical quality as well as addressing the needs of the community by offering critical services to our geographic area. As a result, the organization must balance the cost of these programs against the continued decreasing government reimbursement levels, uninsured population and community needs. A cost accounting system is used to calculate the shortfall, which is Medicare Net Patient Revenue less applicable costs. SCHEDULE H, PART III, LINE 9B It is the policy of Danbury Hospital to provide "Financial Assistance" (either free care or reduced patient obligations) to persons or families where: (i) there is limited or no health insurance available; (ii) the patient fails to qualify for governmental assistance (for example Medicare or Medicaid); (iii) the patient cooperates with the Hospital in providing the requested information; (iv) the patient demonstrates financial need; and (v) Danbury Hospital makes an administrative determination that Financial Assistance is appropriate. After the Hospital determines that a patient is eligible for Financial Assistance, the Hospital will determine the amount of Financial Assistance available to the patient by utilizing the Charitable Assistance Guidelines, which are based upon the most recent federal poverty guidelines. Danbury Hospital shall regularly review this Financial Assistance Policy to ensure that at all times it: (i) reflects the philosophy and mission of the Hospital; (ii) explains the decision processes of who may be eligible for Financial Assistance and in what amounts; and (iii) complies with all applicable state and federal laws, rules, and regulations concerning the provision of financial assistance to indigent patients. Consistent with this mission, Danbury Hospital recognizes its obligation to the community it serves to provide financial assistance to indigent persons within the community. In furtherance of its charitable mission, Danbury Hospital will provide both (i) emergency treatment to any person requiring such care; and (ii) essential, non-emergent care to patients who are permanent residents of its primary service area who meet the conditions and criteria set forth in this Policy, without regard to the patients' ability to pay for such care. Elective procedures generally will not be considered essential, non-emergent care and usually will not be eligible for Financial Assistance. Danbury Hospital will collect from individuals on financial assistance if they received a partial charitable discount. All patients can apply for charitable care on balances they feel that they cannot afford. SCHEDULE H, PART V 14 Diagnostic Centers 6 Outpatient Physician Clinics 1 Outpatient Surgical Center 1 Rehabilitation Center 1 Education Center SCHEDULE H, PART VI, LINE 2 Needs Assessment: The Community Forum held in 2014 was attended by 37 community stakeholders from the Housatonic Valley Region (HVR). This included representatives from 5 Health Departments/Districts (Danbury, New Milford, Bethel, Newtown, and Pomperaug), Western CT Health Network, Danbury EMS, the Bethel Visiting Nurse Association, the United Way of Western CT, the Regional YMCA, the Housatonic Valley Coalition Against Substance Abuse, the Mid-Western CT Council on Alcoholism, the AmerCares Free Clinic, the CIFC Community Health Center, Doctor's Express Urgent Care Center, the Regional Educational Service Center, the Danbury Fire Department, the New Milford Senior Center, and the Peter and Carmen Lucia Buck Foundation. Two community health conversations were held with key community stakeholders in October 2012 - (Danbury and New Milford, CT) to ensure accessibility by key stakeholders throughout the region. Attendees included a total of 52 representatives from hospitals; community health centers; school-based health centers; Visiting Nurse Associations/Services; municipal health, education, social service, senior centers and fire departments; non-profit organizations; and a legislator's office. Geographically, all 10 HVR municipalities were represented either directly or through regional agencies and organizations. The participation and insights of community leaders and agencies/organizations who provide direct programs and services for the low income/minority members of the community was important to the data collection and assessment process. The Western CT Health Network (of which Danbury Hospital is a part) conducted a Physician Resource Assessment to evaluate the supply of health care providers within its combined service area towns. This is done to document community need for health care providers, and to develop a plan to meet the health care needs of the community served. Through Western CT Health Network's annual Planning Process, an environmental assessment is conducted to identify health care gaps and needs of the service area community brought about by local and national trends in economic, legislative, demographic, health care industry and other environmental factors. These forces are considered and incorporated in meeting the health care needs of the community by helping to frame the priorities, goals and initiatives of Western CT Health Network's long range and annual strategic plans. SCHEDULE H, PART VI, LINE 3 part vi- PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE The Hospital has messages on all statements providing information regarding how the patient can get assistance with their hospital bill. Also signs are posted throughout the hospital and counselors are available to provide further assistance. All uninsured inpatients are interviewed by financial counselors and assessed for eligibility for assistance programs. The hospital provides informational handouts to all uninsured patients at the time of registration which refers them to financial counseling if they would like assistance with their bills. Further, the hospital mails notices to all self-pay accounts referring them to financial counseling if they need assistance. The collection department will also refer patients to financial counseling when a patient indicates that they cannot afford their balances; and finally, schedulers refer uninsured patients to financial counseling prior to their test or procedure. The policy and applications for assistance are also available on line. SCHEDULE H, PART VI, LINE 4 PART VI - COMMUNITY INFORMATION Community Information: Danbury Hospital and the New Milford Hospital Campus serves an area with a population of about 280,000 people. The Primary Service Area includes Bethel, Bridgewater, Brookfield, Danbury, New Fairfield, New Milford, Newtown, Ridgefield, and Southbury (in CT), and the Secondary Service Area includes Kent, Redding, Roxbury, Sherman, Washington, Wingdale, and Woodbury (in CT) and Brewster, North Salem, Patterson, and Pawling (in NY). This service area is comprised of a densely populated core of the urban/suburban City of Danbury surrounded by moderately affluent residential and rural towns. Danbury is also listed as a Medically Underserved Area, or MUA. Danbury has a median household income of $65,981 and a poverty rate of 11.1%,while New Milford has a household income of $49,575 and a poverty rate of 15.6%. The overall uninsured population rate for the state is estimated to be 3.8%. Although the population of the primary and secondary service areas is expected to remain virtually level from 2010 to 2020, the cohort aged 65 and over is expected to increase by 2.78% in Danbury and 4.05% in New Milford, while the age 20-44 age cohort is forecast to slightly increase at 0.68% in Danbury and decrease by 1.13% in New Milford over the same time period. SCHEDULE H, PART II: Community Building Activities Relates to Line #6, Coalition Building, totaling $9,169: Western Connecticut Health Network (WCHN) participates as a member of a regional collaborative representing the Housatonic Valley Region and ten municipalities. A Steering Committee comprised of health care providers, community-based providers, and local government agencies meets no less than twice a year to oversee a community health improvement plan (CHIP) that was developed utilizing data from a report card and previous community conversations. Four priority health indicators (PHI) are being addressed through a work group structure that includes a designated leader who convenes the group to further develop and refine their action plans. Community stakeholders participated in an April 2014 community forum facilitated by the Center for Health Schools & Communities @ Education Connection. Overall, data obtained from the conversations provided high quality information to frame the beginning of a community health improvement change process in the region. 1. Prevention and Education of Most Prevalent Chronic Diseases/Health Conditions: Obesity, Type 2 diabetes, and hypertension were identified as the most prevalent health conditions in the community. The PHI team goals are to increase healthy eating options, enhance access to physical activities, and promote a universal healthy lifestyle. In July 2014, the PHI team received the YMCA Diabetes Prevention Program Grant which was used to fund their diabetes prevention program. The program began in October 2014, and through December 2015 10 classes had been conducted (average class size of 5.4 participants, average age of 59 years, and 75% of the referrals were from physician offices). Participants exceeded the targeted weight loss goal of 7% (achieved 10.4%) which was supported by consistent program participation, physical activity and food tracker completion. The team also participated in National Walk Day, which garnered over 150 people from the Housatonic Valley Region and formation of 3 community walking groups. The Coalition for Healthy Kids is piloting a "Walking School Bus" program with a local school to encourage physical activity. A wellness campaign building on the "5, 2, 1, 0 Let's Go" messaging was implemented and the "Know Your Numbers" campaign tracked 338 individuals with blood pressure monitoring. 2. Improving Access/Utilization to Substance Abuse and Mental Health Services: Mental health issues and substance abuse continue to be prevalent issues in the community. This PHI team is collaborating with 12 Local Prevention Councils, the CT Prevention Framework, and other entities to increase outreach efforts. Their goals are to identify gaps in services and access, provide education, and increase awareness regarding services and programs. There is awareness to vulnerable target groups in need of enhanced services and supports, such as the homeless population and youth. The team worked to improve education and information dissemination, and supported integration of a "question-persuade-refer" model for suicide prevention. Areas of focus targeted prescription drug use, support for community "drop boxes" , opiate use, underage drinking, and behavioral health initiates in primary care practices. 3. Improve Assessment and Service Planning to Senior Health: Senior citizens, particularly homebound elderly and immigrants, are in need of assessment and service planning to address their health, housing, and social support needs. The main goal is to increase awareness, services, and education for senior health. This team is supporting and collaborating with the Aging in Place initiatives funded by the Peter and Carmen Lucia Buck Foundation, which includes the "Safe at Home" program that delivers home safety items to seniors. Efforts continue to move the Danbury community as a "livable" community and to share learnings with adjacent communities. 4. Improve Awareness and Utilization of Existing Health and Social Programs/Services: This team focused on enhancing awareness and utilization of existing programs and services in the community, including support of Infoline 2-1-1 and 5 Health Access CT Assistor sites by target populations. It also established a partnership with FamilyWize to provide promotional materials for distribution to health providers and key community sites. The individual CHIP Steering Committee members, including WCHN, support the importance of shared commitment and responsibility in development and execution of its recommended action plans for health improvement. To the best of the organization's knowledge, all prevalent issues in the community are being addressed. Relates to Line #2, Economic Development, Line #3, Community Support and Line #7, Community Health Improvement Advocacy totaling $5,204: Part II: Community Health Improvement Advocacy: Largely state and local elected officials and agency heads were lobbied in support of maintaining patient access to essential services for the uninsured and under insured. As part of this effort, miscellaneous expenses are noted in Schedule C, Part II-B 1i. SCHEDULE H, PART VI, LINE 5 Promotion of community health. Danbury Hospital served approximately 239,099 persons through over 310 health events. One of the highest impact outreach activities includes approximately 187,000 individuals served through Health Talk. Health Talk which airs twice a week focuses on disease prevention, new treatments in pulmonary, embolism atrial fibrillation, pediatric asthma, heart health, colon cancer, exercise and wellness talks, to name a few examples. Over 50% of the Board Members are independent and do not get paid by Danbury Hospital. Danbury Hospital also has an open medical staff. Surplus funds are used to provide innovative technology to clinical care in addition to expanding our service area. PART VI-AFFILIATED HEALTH CARE SYSTEM ROLES AND PROMOTION Western Connecticut Health Network (WCHN) is an integrated health care delivery system comprised of three community hospitals and their affiliated entities. In addition to Norwalk Hospital, Danbury Hospital and its New Milford Hospital Campus, the continuum of care includes a large medical group, home health care services, a nationally renowned biomedical research institute, the WCHN and Norwalk Hospital Foundations, and other related affiliates (the Network). WCHN's mission is to improve the health of every person we serve through the efficient delivery of excellent, innovative and compassionate care. For 2015, WCHN provided approximately $19,826,631 in total charity care. Danbury Hospital, its New Milford Hospital Campus and Norwalk Hospital provide medical services to the community regardless of the individual's ability to pay. Services include routine inpatient ancillary and outpatient care in support of the Network's mission statement, as noted above, For 2015, charity care was provided in the following amounts: Norwalk Hospital, $7,649,926, Danbury Hospital and its New Milford Hospital Campus, approximately $11,003,250. Western Connecticut Medical Group/Norwalk Hospital Physicians & Surgeons: The mission of Western Connecticut Medical Group is to provide safe, innovative, convenient and coordinated primary and specialty health care in the communities they serve and strive to be aware of and respond to their patients'needs. They support a commitment to advance the health and well-being of individuals in their community by delivering quality care, participating in medical research and medical residency programs and the provision of medical services to patients. For 2015, WCMG/NHP&S provided approximately $1,023,000 in charity care. Western Connecticut Health Network Foundation Inc.'s mission is to raise funds, reinvest and administer these funds and make distributions to Danbury Hospital and its New Milford Hospital Campus and other Danbury not-for-profit health care affiliates. Norwalk Hospital Foundation's mission is to raise funds, reinvest and administer these funds and make distributions to Norwalk Hospital and other not-for-profit Norwalk Hospital affiliates. Western Connecticut Health Network Affiliates principal purpose is to provide outpatient health care services in various locations and also provide ambulance services to Danbury and surrounding towns, while serving those that cannot afford the care. Western Connecticut Home Care, Inc. (WCHC) provides state of the art clinical services ranging from pediatric patients to the elderly utilizing best practice in home care to meet the needs of their patients. For 2015, WCHC provided approximately $91,000 in charity care. Eastern New York Medical Services (ENYMS): The mission at ENYMS is to provide safe, innovative, convenient and coordinated primary and gastroenterology health care in the communities we serve and strive to be aware of and respond to our patients' needs. SCHEDULE H, PART VI, Line 7 CT. true true false false false true true false false John M MurphyMD Pres/CEO, WCHN 949990 0 450000 0 2838 0 12750 0 39094 0 1454672 0 0 0 Steven H Rosenberg SVP/CFO, WCHN 557258 0 200000 0 21856 0 12750 0 29979 0 821843 0 0 0 Daniel DeBarba Jr Exec VP/Pres-DH 637084 19466 310000 0 19018 73676 12750 4197 40400 0 1019252 97339 0 0 Donna Kaplanis Ass't Secretary 193923 0 40000 0 18912 0 24188 0 27143 0 304166 0 0 0 Matthew A Miller MD SVP & Chief Medical Officer 126404 168034 175000 175000 6952 18931 12750 12750 9343 11149 330449 385864 0 0 Moreen O Donahue Sr VP/Chief Nurse Officer,WCHN 339737 0 100000 0 7196 0 20400 0 30320 0 497653 0 0 0 Michael Daglio Chief Oper Officer (To 11/2) 404582 0 145000 0 990 0 15300 0 29566 0 595438 0 0 0 Morris Gross VP of Facilities/Real Estate 255758 0 100000 0 5182 6180 25500 0 26103 0 412543 6180 0 0 Kathleen A Dematteo Chief Infor.Officer, WCHN 343359 0 110461 0 21373 0 22950 0 9324 0 507467 0 0 0 Patrick C Minicus VP of Finance 375651 45622 100000 0 526 27701 0 2376 45461 2477 521638 78176 0 0 James Varrone VP Supply Chain 0 159641 0 26000 0 0 0 9019 0 20995 0 215655 0 0 Lisa Schmittgall SRVP Strategy-WCHN (To 12/31) 384629 38097 339262 0 909 164 0 1722 27824 1923 752624 41906 0 0 Debra Carragher VP of Operations 249594 0 75000 0 585 0 12750 0 3387 0 341316 0 0 0 Carolyn McKenna Sr VP/Gen'l Coun 344800 0 125000 0 1311 0 12750 0 24452 0 508313 0 0 0 Ramin Ahmadi MD Dir. of Educ./Res. 259797 0 70000 0 960 0 12750 0 29377 0 372884 0 0 0 Dawn Myles SRV,Qual/Pat. Sfty 253756 0 80000 0 600 0 17850 0 4231 0 356437 0 0 0 Ruth Gregory Director of Materials Dist 143679 0 17050 0 1299 0 15978 0 10350 0 188356 0 0 0 Joseph Campbell Chief Audit Compl. Officer 229337 0 60000 0 2400 0 22950 0 27516 0 342203 0 0 0 Phyllis F Zappala Sr. VP of Human Resource 264230 0 0 0 5255 0 22950 0 12768 0 305203 0 0 0 SCHEDULE J, PART I, LINE #4 Severance: During the fiscal year ending September 30, 2015, Lisa Schmittgall received $597,184 in severance payments. A severance benefit of one and a half (1 ) years of compensation was paid in a lump sum within 60 days of the termination date of December 31, 2014. Supplemental Executive Retirement Plans: Western Connecticut Health Network (WCHN) established three separate Supplemental Executive Retirement Plans (SERP). These plans provide supplemental retirement benefits to key members of the executive group. Under the agreements for SERP Plans #1 and #2, amounts promised to eligible executives are based on targeted retirement benefits and the payment of benefits is subject to vesting. The benefits at the vested age are provided in the form of an actuarial equivalent lump sum plus a tax gross-up amount to the participants. WCHN has on its books an accrual for the participants of the SERP, which is maintained solely for accounting purposes and is unfunded. SERP Plan #1 - During the fiscal year ending September 30, 2015, Dr. Matthew Miller, Chief Medical Officer and Phyllis Zappala, former Senior VP of Human Resources were the only participants. Under the terms of SERP Plan #1, a payment of $350,006 was made to Phyllis Zappala during the year. SERP Plan #2 - During the fiscal year ending September 30, 2015, no payments were made to either, Dr. John Murphy, President/CEO of WCHN and Steven H. Rosenberg, CFO of WCHN, participants of SERP Plan #2. SERP Plan #3 - Earnings and losses on the investments selected by participants of SERP Plan #3 are added to the balance of the account. During the fiscal year ending September 30, 2015, no payments were made to either Daniel DeBarba, Jr., Executive VP/President of Danbury Hospital and Michael Daglio, Chief Operating Officer, participants of SERP #3. SCHEDULE J, PART I, LINE #6 Summary of Executive Incentive Plan The Plan is administered by the Executive Compensation Committee (the Committee) of Western Connecticut Health Network,Inc.(WCHN). Eligibility to participate in the Plan is limited to those exempt executives employed by WCHN and its subsidiaries (the Network) during the Plan year who are in positions in which their decisions, actions and counsel significantly affect the operations of the Network. The Committee, with input provided by senior management of the Network will determine which eligible executive employees of the Network will participate in the Plan. Prior to the beginning of each Plan year, or as soon thereafter as practicable, the Committee will establish target and maximum award opportunity for the participant, in the appropriate tier in the Plan, along with a team scorecard of Plan measures. Soon after the close of the Plan Year, actual organization and individual performance and results will be measured and assessed in comparison to published goals and expectations established for such Plan Year. Recommendations for individual incentive awards will be prepared and submitted to the Committee for evaluation and approval. Notwithstanding any other provision of the Plan, at the discretion of the Committee, awards may not be paid under the Plan for any Plan Year if the level of performance specified in one or more Network level "Circuit Breaker Goals" is not achieved during the Plan Year. SCHEDULE J, PART III, ADDITIONAL INFORMATION The organization relied on a related organization, Western Connecticut Health Network, Inc. which used the following methods described below to establish top management's compensation: -Compensation committee. -Independent compensation. -Written employment contract. -Compensation survey or study. -Approval by board or compensation committee. A CHEFA RevBondsSeries H 060806186 20774UCL7 2006-03-16 40924665 See Part VI for purpose false false false B CHEFA (WCHN) Series M 060806186 20774U8A6 2011-07-13 45523137 See Part VI for purpose false false false C CHEFA (WCHN) Series N 060806186 20774YEJ2 2011-11-22 40735995 See Part VI for purpose false false false D CHEFA (WCHN) Series O 060806186 2015-05-08 122120000 See Part VI for purpose false false false A 1945000 0 42742900 0 2237472 0 606787 828469 0 39070172 0 0 2007 false false true true B 0 0 45576281 0 7328241 0 908228 0 0 37339812 0 0 2014 false false true true C 2795000 0 40735995 0 0 0 749768 0 0 0 39986227 0 2011 true false true true D 0 0 122120000 0 0 0 797294 0 0 0 121322706 0 2015 true false true true A false true true true false 0.00010 0.00010 false false false true B false false false false 0 false false false true C 0 D false false false false 0 false false false true A false false false true false false 0 false 0 false true B false true false false true false 0 false 0 false true C false true false false false false 0 false 0 false true D false true false false true false 0 false 0 false true A true B true C true D true SCHEDULE K, ADDITIONAL INFORMATION Series H Bonds ($41,560,000): Proceeds from the sales of Series H Bonds were used, together with other monies available to 1) finance a portion of the costs of the Series H project, 2) to fund capitalized interest, if any on the Series H Bonds, and 3) to pay certain costs of issuance and bond insurance premiums incurred in connection with the issuance of Series H Bonds. Series M Bonds ($46,030,000): Series M Bonds were issued concurrently in 2011 with Series L bonds and were used to fund the planning, design, acquisition, construction, equipping and furnishing of Danbury Hospital's new patient tower, expansion of a parking garage, capital improvements and to fund capitalized interest. Series N Bonds ($39,880,000): Series N Bonds mature serially from July 1, 2014 to July 1, 2029. The proceeds were used to refund Danbury Hospital's Series G Bonds which were issued on September 29, 1999. Series O Bonds ($122,120,000): Series O Bonds mature serially from July 1, 2022 to July 1, 2041. The proceeds were used to refund Danbury Hospital's Series K and Series L Bonds which were fully redeemed as of September 30, 2015. Part II, Line #3 includes investment earnings of $1,818,235 for Series H Bonds. Part II, Line #3 includes investment earnings of $53,144 for Series M Bonds. Part IV, Line #2c The date that the rebate computation was performed was March, 2014 for Series H Bonds. Kaufman Hall Associates See Part V 397546 Consulting Firm false Schedule L, Part IV, Col (c) During the year the following transactions are at arm's length, entered into the ordinary course of business and in compliance with the Organization's Conflict of Interest Policy: David M. Cyganowski, a director at Danbury Hospital is a shareholder of Kaufman Hall & Associates, Inc., which provides financial and forecasting services. FORM 990, PART VII (ADDT'L INFORMATION) For those officers and top 5 employees, for which only 40 hours is noted to reflect paid hours, actual hours worked exceeded this amount. Note: All amounts in column F, of Part VII,"Estimated Amount of Other Compensation", represent benefits, and do not reflect any compensation for which the average amount of time worked can be reflected. FORM 990, PART IX, COLUMN D ALTHOUGH CONTRIBUTIONS ARE REFLECTED ON LINE #1 OF PAGE #1 ON FORM 990, ALL FUNDRAISING EXPENSES WERE INCURRED BY THE WESTERN CONNECTICUT HEALTH NETWORK FOUNDATION, INC. Form 990, Part VI, Line 7A The sole member shall be responsible for electing, at the annual meeting of the membership, the members of the Board of Directors of the Hospital to serve for three year terms and until their successors are elected and have qualified. Form 990, Part III On October 1, 2014 (the merger date), Danbury Hospital (the Hospital) received a single provider license to include The New Milford Hospital Incorporated (New Milford Hospital). As a result, New Milford Hospital merged with the Hospital and the operations of New Milford Hospital became a campus of Danbury Hospital effective October 1, 2014. The Hospital will operate as one licensed facility with two campuses. Form 990, Part VI, Section B, 12A, 13 and 14 The policies exist at the parent level, which are followed by each entity and are approved by the parent board, but not each individual board. This excludes the record retention policy, which is approved only by the parent audit committee. Form 990, Part III - PROGRAM SERVICE, Line 4A MEDICAL SERVICE LINE Danbury Hospital's Medical Service Line consists of the following services: Inpatient Cases: Gastrointestinal 1,925 Infectious Disease 1,199 Internal Medicine 651 Neurology Medicine 509 Renal/Urology Medicine 802 Pulmonary Medicine 1,435 All Other Inpatient 1,917 Outpatient Service Line Cases: O/P Medicine 9,685 O/P Medicine Comm. Clinic 31,667 O/P Medical Oncology 10,448 O/P Pulmonary Medicine 5,125 DIGESTIVE DISEASES: Our Digestive Disease Center is staffed by renowned fellowship-trained gastroenterologists. We use advanced diagnostic and treatment technology in a compassionate and supportive manner. The following services are provided: Ablation therapy for Barrett's esophagus, Colon cancer screening, Colonoscopy, Cryotherapy, Endoscopy, Endoscopic ultrasound and fine-needle aspiration,, Lactose tolerance testing, LINX Reflux Management System for treatment of GERD, Wireless capsule endoscopy and Laparoscopic fundoplication for GERD. INFECTIOUS DISEASE: Danbury Hospital's infectious disease specialists treat the full range of infectious diseases, including conditions caused by living organisms (bacteria, viruses, fungi and parasites), HIV, and related conditions, Lyme disease, chronic and wound-related infection, and travel-related infection. Our doctors have expertise in the proper use of antibiotics and other anti-infective medicines to treat disease and also collaborate with primary care doctors, specialists and surgeons to provide individualized treatment for each patient. INTERNAL MEDICINE: Whatever your medical needs, Danbury Hospital provides expert care in the warm, focused and personal manner you deserve. Specialists in primary care, our family medicine physicians treat infants, children and adults of all ages. Services include preventive medicine (including vaccines and immunizations), diagnosis and treatment of chronic and acute illnesses and injuries, and coordination of specialty care. Our family physicians are trained to provide medical care for patients ranging in age from pediatrics through adult and geriatrics. NEUROLOGY AND STROKE: We offer expertise in treatment of neurological disorders, including stroke, epilepsy, headache, Parkinson's disease, Alzheimer's disease and Vertigo. One of the nation's first hospitals to earn primary stroke center accreditation from the Joint Commission, we have been regularly recognized by the Connecticut Department of Public Health for consistently demonstrating the ability to rapidly diagnose and treat stroke. Committed to remaining on the forefront of rapid and effective stroke care, we continue to incorporate the latest effective treatments. UROLOGY: Our expert urologists treat conditions such as: -Female urologic disorders, including urinary incontinence and voiding dysfunction -Infertility -Kidney, bladder, prostate and testicular cancer -Kidney stones -Male sexual difficulties -Prostate cancer -Urinary tract infections -Vasectomy and vasectomy reversal Procedures we perform include: -Extracorporeal shock wave lithotripsy for kidney stones -Laparoscopic nephrectomy -Minimally invasive photo-vaporization of the prostate -Minimally invasive surgical treatment for female incontinence -Pyeloplasty PULMONOLOGY: We offer outstanding diagnosis, treatment and care for patients with all types of pulmonary conditions. We perform specialized services, such as cardiopulmonary exercise testing to measure degree of fitness and aid in the assessment of shortness of breath; specific diagnostic asthma testing; and testing to determine the need for supplemental oxygen for everyday living and air travel. All programs are administered consistent with Danbury Hospital's financial assistance policy. Form 990, Part III - PROGRAM SERVICE, Line 4B SURGERY SERVICE LINE Inpatient Cases: Major Joint Replacement 1,078 Trauma Surgery 568 Minor GI Surgery 267 General Surgery 325 Urology Surgery 158 Colon/Bowel Surgery 236 Obesity Surgery 164 Spinal Surgery 398 All Other Inpatient Surgery 571 Outpatient Service Line Cases: Abdomen GI Surgery 1,426 Breast Surgery-Non Plastic 260 Endoscopy 12,933 Misc. General Surgery 3,765 Oral Surgery 111 Opthamology 766 Urology 988 Pain Injection Procedures 701 Head/Neck Surgery 1,139 Plastic Surgery 1,071 All Other Outpatient Surgery 1,342 GENERAL SURGERY: Danbury Hospital's surgeons are continually recognized for their experience, excellent outcomes, and expertise in minimally invasive surgical techniques. Here are just some of the awards we've been privileged to receive: -Intersocietal Accreditation Commission's Vein Center Accreditation for the Vascular Surgical Service (2015) -Participant, Institute for Healthcare Improvements International Joint Replacement Learning Community (2014) -Member, Institute for Healthcare Improvement's International Joint Replacement Learning Community (2015) -Joint Commission Top Performer, America's Improving Quality and Safety (2014/13) -Top 100 Community Value Leadership Award for providing high-quality, high-value service at an appropriate cost, from Cleverly and Associates (2014) -Top 100 Great Community Hospitals from Becker's Hospital Review (2012) -Recertification, Joint Commission Disease Specific Certification in Hip Arthroplasty, Knee Arthroplasty and Spine Surgery (2015) -The Center for Weight Loss Surgery has been named the Comprehensive Center with the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) (2015 - 2018) -A Bariatric Center for Excellence under The Clinical Science Institute (CSI) of Optum (2015) -Recipient of The Aetna Institute of Quality Bariatric Designation (2015) At Danbury Hospital our expert surgeons excel at using advanced technology to perform minimally invasive procedures, allowing patients to undergo surgery with less pain, shorter hospital stays, and quicker recovery periods. Surgeons use very small incisions, meaning less trauma to the body, less blood loss, smaller scars and a lower need for pain medication. Our surgeons have been recognized for excellence in laparoscopic techniques performed in many surgical specialties including weight loss, colorectal, and general surgical procedures. For robotic surgery, we use the latest, most advanced robotic technology available, the da Vinci surgical system. We are committed to staying at the forefront of innovation, equipping our surgeons with sophisticated technology so they can offer innovative surgical procedures here in our community. Our da Vinci surgical system gives surgeons better visualization and tools that improve dexterity. With more control they can operate with greater precision. Our doctors use this advanced technology to perform a wide range of procedures, including single-incision robotic surgery. As a Level II Trauma Center, Danbury Hospital's team of board certified surgeons provide immediate, 24/7 care for acute and life-threatening injuries to children and adults. ORTHOPEDIC SURGERY: Our Center for Advanced Orthopedic and Spine Care has earned the "Center of Excellence" designation from the Joint Commission for providing comprehensive, multidisciplinary care, including hip, knee, shoulder, and ankle replacement. Our Danbury Hospital orthopedic surgeons offer a wide array of joint replacement procedures. Our continuum of care includes: -A care coordinator who provides education and guidance every step of the way, pre-op through your rehabilitation. -Pre-admission testing in our dedicated unit, designed to meet the unique needs of joint replacement patients and families. Services include individualized patient education, nursing and anesthesia assessments, and collaboration with you on planning a pain management program for your surgical recovery. -Dedicated orthopedic operating rooms and clinical support staff. -A comfortable orthopedic recovery unit with physician assistants, nursing and rehabilitation staff specially trained to care for total joint replacement patients. -Advanced, digital diagnostic imaging technology. -Acute in-hospital therapy -Outpatient physical and occupational -Access to home care services with Western Connecticut Home Care (formerly DVNA). DIGESTIVE DISEASE: Our expert general and digestive disease surgeons specialize in major and minor surgical procedures of the abdomen, digestive tract, endocrine system, breasts, skin and blood vessels. UROLOGIC SURGERY: Danbury Hospital urologists are known nationally for innovation. Procedures performed include: Extracorporeal shock wave lithotripsy for kidney stones; Laparoscopic nephrectomy, Minimally invasive photo-vaporization of the prostate; Minimally invasive surgical treatment for female incontinence and Pyeloplasty. Danbury 990, Part VI, Line #2 Richard Jabara and James Kennedy, both directors of Danbury Hospital have a business relationship. 990, Part VI, Line #6 Western Connecticut Health Network, Inc. is the sole member of Danbury Hospital. 990, Part VI, Line #7B Certain fundamental decisions to be undertaken by the Hospital require the approval of the Member. a) The actions listed below, taken for the Hospital or in its capacity voting as a shareholder or member of a subsidiary ("Danbury Subsidiary") shall not require approval by the Board and are reserved solely to the Member: -The amendment of the Hospital's bylaws; -The election or removal of a director; -Approval of investment policies; -Approval of the adoption of or amendment to any qualified or any non-qualified benefit plan; -Approval of the adoption of or any amendment to the policies and procedures governing a) indemnification of directors and officers of the Hospital or any Danbury Subsidiary; b) conflicts or dualities of interest; c) accounting and investment standards and practices and d) such other policies the Member may determine; -Approval of system-wide quality, performance and credentialing standards and procedures to which the Hospital or any Danbury Subsidiary is expected to adhere; and -Approval of regulatory compliance and methodology for physician compensation arrangements. The actions listed below, taken for the Hospital or in its capacity voting as a shareholder or member of a Danbury Subsidiary, which require approval of the Board, must also be approved by the Member: -The election and removal of a director of a Danbury Subsidiary; -The election of the officers of the Hospital; -Approval of all operating and capital budgets of the Hospital and Danbury Subsidiary; -Approval of any amendment or restatement of the Hospital's certificate of incorporation, bylaws, or operating agreement of any Danbury Subsidiary; -Approval of any sale, lease, exchange, or other disposition of all or substantially all the property or assets of the Hospital or any Danbury Subsidiary; -Approval of the creation of any corporation of which the Hospital or a Danbury Subsidiary is the sole or controlling member or sole or controlling shareholder; the merger or consolidation of the Hospital or any Danbury Subsidiary with another corporation;and the reorganization, liquidation or dissolution of the Hospital or any Danbury Subsidiary; -Approval of any loans by the Hospital or any Danbury Subsidiary,or the incurring of any indebtedness, secured or unsecured, which exceeds two million dollars ($2.0 million) or which has a term longer than one year; -Approval of unbudgeted expenditures in excess of two million dollars ($2.0 million) or any increase in any approved annual operating or capital budget. -Approval of any agreement or transaction of the Hospital or any Danbury Subsidary involving an amount greater than two million dollars ($2.0 million)with another individual or entity; -Approval of the affiliation of the Hospital or any Danbury Subsidiary with any other entity for the purposes of the joint conduct of business; -Creation of any committee which shall have the authority to act on behalf of the Board or on behalf of any Danbury Subsidiary; -Approval of any conveyance of, or the granting of mortgages or trusts on any real property assets of the Hospital or of any Danbury Subsidiary; -Approval of the strategic plan of the Hospital and of any Danbury Subsidiary; and -Approval of any commencement, cessation, location, relocation or consolidation of significant clinical services provided by the Hospital or any Danbury Subsidiary. 990, Part VI, Line 11B Steven Rosenberg, SVP/CFO of Western Connecticut Health Network, Inc., will review the 990 prior to it being sent to the IRS. A preliminary 990, is presented to the Audit Committee in June, who reviews it on behalf of the Board. E&Y is on hand to review the 990 with the Audit Committee and answer any questions. Prior to the 990 being filed with the IRS, the Board will receive a full and accurate copy on a secured website for their review. 990, Part VI, Line 12C The Organization's Process for Monitoring and Enforcing Conflicts of Interest The Western Connecticut Health Network and its affiliates' (The Network) Conflict of Interest Policy provides that annually, its Representatives shall sign a statement affirming that they disclosed all potential conflicts, as documented in the Conflict of Interest Policy. In addition, General Counsel is part of the routine contracts review process and watches for potential conflicts with any of The Network's Representatives. Who Is Covered By the Policy The Network's Conflict of Interest Policy covers each director, officer and manager of The Network, also referred to as "Representatives". Level At Which Determinations of Whether There Is a Conflict In connection with any actual or possible conflict of interest, an interested person must disclose the facts of the conflict. The Compliance Officer and the Audit Committee review and evaluate each disclosure to determine if there is a conflict of interest. After presentation of a potential transaction or arrangement is made by an interested person, the remaining disinterested Board or Committee members shall decide if a conflict of interest exist. Level That Reviews and Determines What To Do If There Is a Conflict After exercising due diligence the full Board would determine what actions should be taken for all conflicts by Officers and Directors. Any conflicts occurring by a manager are reviewed by the Compliance Committee to determine what further action should be taken. Restrictions on The Conflicted Person No director having a conflict of interest on any matter shall vote on that matter or be counted in determining the quorum for the meeting at which the vote is taken, even when permitted by law. No Representative having a conflict of interest on any matter shall use his or her personal influence on the matter. If the Board of Directors, in its sole discretion, determines that any Representative has conflicts of interest sufficient in number and/or importance that the effectiveness of such individual on behalf of The Network may be significantly impaired, the Board may ask the individual to resign. Part V, Line 15B Compensation for Other Officers and Key Employees: In order to achieve its mission and its overall performance objectives, Western Connecticut Health Network, Inc. employs a performance-based total compensation program for its senior executives that is market competitive, compliant with regulatory guidelines, and representative of best practices. Eligible executives are generally direct reports of the CEO along with other executives designated by the CEO. To meet Western Connecticut Health Network Inc.'s total compensation objectives for executives, the following survey sources are used for comparison purposes: -Blend of national Confidential Source, IHS, and Hay Group points, health care data (where data available), plus 15% geographic differential. Title match data cuts selected based on revenue size. -For Physician executives, surveys covering physician compensation in accredited medical schools (AAMC) are used in combination with proprietary surveys compiled by nationally known consulting firm, Sullivan Cotter and the Medical Group Management Association (MGMA). Western Connecticut Health Network, Inc. targets cash compensation at market competitive levels. Base salary plus short-term (annual) incentive awards (total cash) approximate market competitive levels for total cash compensation. Executive performance is expected to meet or exceed predetermined operational and financial metrics. Other factors, such as competitive market forces, job performance, unique qualifications, and/or individual job responsibilities are also considered in Western Connecticut Health Network, Inc's executive compensation decisions. Roles of the Compensation Committee and Key Executives in the Executive Compensation Process - The Compensation Committee in consultation with the CEO and the SVP Human Resources (HR) selects the outside compensation consultants. The current consultant is the Hay Group, whose purpose is to provide a valid independent assessment of the relevant market rates and pay practices for health care executives, physician executives and for physicians in general. - The compensation consulting firm compiles appropriate market data, job evaluation and ranking information for all executives and physicians of the organization, excluding the CEO, and will supply this material to the CEO and SVP HR for review and agreement. Once the report is final, it will be supplied to the Compensation Committee for their consideration and acceptance. -The Compensation Committee determines the CEO's salary based on overall performance and market data supplied by the outside compensation consultant. The last executive compensation evaluation by an outside consultant was done in December, 2015. 990, Part VI, Line #19 The information that has been posted on Danbury Hospital's website for 2014 includes: The Code of Business Ethics, information about our Compliance Program, and a copy of our policy regarding Preventing of Fraud, Waste and Abuse. All governing documents required by law and the financial statements are made available upon request. The conflict of interest policy is available upon request. Form 990, Part VII (Comments Attached) NEIL CULLIGAN, MD A stipend was paid to Neil Culligan, MD, a director, during the year for stroke program directorship and Chief of Neurology. It was not reflected in Part VII as compensation, since it was in box #6 rather than box #7 of the 1099. DAVID KRAMER, MD (TO 1/1) David Kramer was a director to January 1, 2015. MIKE DAGLIO (TO 11/2) Mike Daglio was Chief Operating Officer of Danbury Hospital until November 2, 2014, when he became the President of Norwalk Hospital. LISA SCHMITTGALL (TO 12/31) Lisa Schmittgall's employment was terminated on December 31, 2014. Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances CAPTIVE UBI . . . . . . . . . . . . . . . . . . . . . . . $ -14,369. CHANGE IN EQUITY INTEREST OF WCHNIC. . . . . . . . . . . . 13,329,262. CHANGE IN INVESTMENT OF WHNF. . . . . . . . . . . . . . . .-16,094,946. EQUITY TRANSFER TO WCHN-W/O OF INTERCOMPANY. . . . . . . . -19,356,313. EQUITY TRANSFER TO WCMG-W/O OF INTERCOMPANY. . . . . . . . -13,034,066. NMH NET ASSETS TRFD TO DH. . . . . . . . . . . . . . . . . .34,128,301. ______________________ Total $ -1,042,131. FORM 990 PART IX LINE 11G DESCRIPTION:HEALTHCARE PROFESSIONALS TOTAL FEES:74824188 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:30116156 West CT Health Network Affiliates 95 Locust Avenue Danbury CT 06810 222594968 OP HLTHCR SVC CT 501(C)(3) 9 WCHN true Western CT Health Network Inc 24 Hospital Avenue danbury CT 06810 222594977 PROGRAM DEVLP CT 501(C)(3) 11, TYPE 2 NA false West CT Health Network Foundation 24 Hospital Avenue Danbury CT 06810 237425557 ADMIN CONTRIB CT 501(C)(3) 7 WCHN true Western CT Home Care Inc 4 Liberty Street Danbury CT 06810 060655138 HOME HLTHCARE CT 501(C)(3) 9 WCHN true Western CT Medical Group Inc 14 Research Drive Suite 201A Bethel CT 06801 061137531 PHYSICIAN SVC CT 501(C)(3) 9 WCHN true Eastern NY Medical Services PC 14 Research Drive Suite 201A Bethel CT 06810 455431389 PHYSICIAN SVC NY 501(C)(3) 9 WCHN true The Norwalk Hospital Association 24 Stevens Street Norwalk CT 06850 066068853 HEALTH SVCS CT 501 (C) (3) 3 NHSC true Norwalk Hospital Phys and Surgeons 24 Stevens Street Norwalk CT 06850 061522078 PHYSICIAN SVC CT 501 (C) (3) 11, TYPE 2 NHSC true Norwalk Health Care Inc 24 Stevens Street Norwalk CT 06850 222577722 INACTIVE CT 501 (C) (3) 9 NHSC true Norwalk Hospital Foundation 34 Maple Street Norwalk CT 06850 222577708 ADMIN CONTRIB CT 501 (C) (3) 7 NHSC true Advanced Ctr for Rehab Medicine 24 Stevens Street Norwalk CT 06850 061304799 INACTIVE CT 501 (C) (3) 11, TYPE 2 NHSC true New Milford MRI 21 Elm Street New Milford CT 06776 271877801 INACTIVE CT NMH N/A 0 0 false 0 false Norwalk Surgery 40 Cross Street Norwalk CT 06851 272394942 SURGERY CENTER CT NH RELATED 0 0 false 0 false West CT Health Network Insur 23 Lime Tree Bay PO Box 105 Grand Cayman CJ 980438151 MALPRCTICE CJ DH C CORP 23409419 132830968 1.00000 true Medical Services of Danbury 24 Hospital Avenue Danbury CT 06811 061635945 INACTIVE CT WCMG C CORP 0 0 true SWC Corporation 24 Stevens Street Norwalk CT 06850 222577718 PHARMACY CT NHSC C CORP 0 0 true false true true false false false false false true true true true true false true false true true true West CT Health Network Affiliates j 104356 COST West CT Health Network Affiliates l 357015 COST West CT Health Network Affiliates m 477289 COST West CT Health Network Affiliates o 154934 COST West CT Health Network Affiliates q 5906776 COST West CT Health Network Affiliates s 6324920 COST West CT Health Network Foundation c 11877473 cost West CT Health Network Foundation j 81493 cost West CT Health Network Foundation k 56258 cost West CT Health Network Foundation o 1966467 cost West CT Health Network Foundation q 1848190 cost West CT Health Network Foundation s 8701234 cost Western CT Home Care Inc l 154967 cost Western CT Home Care Inc o 147394 cost Western CT Home Care Inc q 859175 cost Western CT Home Care Inc r 250000 cost Western CT Home Care Inc s 1194306 cost Western CT Medical Group Inc b 13034066 cost Western CT Medical Group Inc i 97726 cost Western CT Medical Group Inc j 2319887 cost Western CT Medical Group Inc l 4028047 cost Western CT Medical Group Inc m 67706087 cost Western CT Medical Group Inc o 962897 cost Western CT Medical Group Inc q 75038541 cost Western CT Medical Group Inc s 1622201 cost Eastern NY Medical Services PC q 169718 cost The Norwalk Hospital Association i 1012175 cost The Norwalk Hospital Association j 416543 cost The Norwalk Hospital Association l 5792729 cost The Norwalk Hospital Association o 9606088 cost The Norwalk Hospital Association q 11936824 cost The Norwalk Hospital Association s 24191633 cost Norwalk Hospital Phys and Surgeons o 127264 cost Norwalk Hospital Phys and Surgeons q 670239 cost Norwalk Hospital Phys and Surgeons s 783006 cost West CT Health Network Insur Co LTD q 10981551 cost West CT Health Network Insur Co LTD r 13106977 cost West CT Health Network Insur Co LTD s 10910500 cost SWC Corporation o 128029 Cost SWC Corporation q 105949 cost SWC Corporation r 214835 cost Schedule R, Part III - Partnership Full Name, Address, FEIN New Milford MRI JV, LLC 27-1877801 21 Elm Street New Milford, CT 06776 Norwalk Surgery Center, LLC 27-2394942 40 Cross Street, #120 Norwalk, CT 06851