2016-08-15T15:01:58-05:00 2015-09-30 350921680 CROWE HORWATH LLP 175 POWDER FOREST DRIVE SIMSBURY CT 06089 990 2014-10-01 060653151 Rockville General Hospital ROCK 8606461222 31 UNION STREET ROCKVILLE CT 06066 MICHAEL D VEILLETTE CHIEF FINANCIAL OFFICER 2016-04-26 true BETH A THURZ P00346435 8606789200 2014 2016-09-27 15:27:22Z PETER J KARL 31 UNION STREET ROCKVILLE CT 06066 65735107 false X WWW.ECHN.ORG X 1921 CT ROCKVILLE GENERAL HOSPITAL IS A 102 BED HOSPITAL OFFERING VARIOUS HEALTHCARE SERVICES TO ALL MEMBERS OF THE COMMMUNITY, INCLUDING THE INDIGENT AND UNDERSERVED. 14 8 582 71 621671 192864 482157 318405 70852420 64638857 3398470 26701 298088 272326 75031135 65256289 0 0 0 0 41821049 40377767 0 0 0 30726037 29082443 72547086 69460210 2484049 -4203921 74786945 66202995 46452643 47324085 28334302 18878910 ROCKVILLE GENERAL HOSPITAL IS A 102 BED HOSPITAL OFFERING VARIOUS HEALTHCARE SERVICES TO ALL MEMBERS OF THE COMMMUNITY, INCLUDING THE INDIGENT AND UNDERSERVED. false false 13840564 4625562 INPATIENT SERVIES - ROCKVILLE GENERAL HOSPITAL OFFERS COMPREHENSIVE MEDICAL SERVICES IN A 102 BED ACUTE CARE COMMUNITY HOSPITAL, WITH A TOTAL OF 2,112 INPATIENTS TREATED IN FISCAL YEAR 2015. SERVICES ARE OFFERED TO THE COMMUNITY, REGARDLESS OF ANY INDIVIDUAL'S ABILITY TO PAY. 8202832 11293510 EMERGENCY DEPARTMENT - EMERGENCY CARE IS OFFERED 24 HOURS PER DAY, AND PROVIDES NEEDED EMERGENCY MEDICAL CARE TO THE COMMUNITY, REGARDLESS OF ANY INDIVIDUAL'S ABILITY TO PAY. 6774890 7472441 RADIOLOGY - A WIDE RANGE OF IMAGING DIAGNOSTIC AND TREATMENT SERVICES ARE OFFERED, INCLUDING X-RAYS, CT SCANS, MRI, PET, ULTRASOUND, NUCLEAR MEDICINE, AND MAMMOGRAPHY. 28949171 40625673 SEE SCHEDULE H, PART VI 28949171 40625673 57767457 true true false true false false false false false true true false true true true true false true false false false 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 156 0 true 582 true true true false false false false false false false false false X 14 8 true false false false true true true true true false false true true true true true true true true true true CT X NICHOLAS JAMIESON 8606461222 320 MAIN STREET MANCHESTER CT 06040 DENNIS G O'NEILL MD CHAIRMAN 1.00 4.00 X X 0 0 0 JOY W DORIN VICE CHAIR 1.00 2.00 X X 0 0 0 MICHELE B CONLON MD SECRETARY 1.00 2.00 X X 0 0 0 KEITH J WOLFF TREASURER 1.00 3.00 X X 0 0 0 PETER J KARL PRESIDENT AND CEO 13.00 50.00 X X 0 818446 112118 GORDON L BRODIE MD TRUSTEE 1.00 2.00 X 0 0 0 THOMASINA CLEMONS TRUSTEE 1.00 2.00 X 0 0 0 LOUISE C ENGLAND TRUSTEE 1.00 4.00 X 0 0 0 DONALD S GENOVESI TRUSTEE 1.00 2.00 X 0 0 0 DAVID H GONCI TRUSTEE 1.00 2.00 X 0 0 0 REBECCA D JANENDA TRUSTEE 1.00 2.00 X 0 0 0 ERIC L KLOTER TRUSTEE 1.00 4.00 X 0 0 0 PAMELA L LEWIS MD TRUSTEE/MEDICAL STAFF CHAIR 1.00 2.00 X 109375 0 0 KATHLEEN A O'NEILL TRUSTEE 1.00 3.00 X 0 0 0 MICHAEL D VEILLETTE SVP, CHIEF FINANCIAL OFFICER 13.00 48.00 X 0 356769 56127 MARY POWERS SVP, PATIENT CARE SERVICES 13.00 48.00 X 198620 0 10605 DEBORAH R GOGLIETTINO SVP, HUMAN RESOURCES (TERM 1/1/15) 13.00 48.00 X 0 269851 36023 DENNIS P MCCONVILLE SVP, STRATEGIC PLANNING 13.00 48.00 X 0 250585 29207 DEBORAH A PARKER EVP, CHIEF CLINICAL OFFICER (TERM 5/1/15) 13.00 48.00 X 0 332915 45347 JOEL REICH MD SVP, MEDICAL AFFAIRS 13.00 48.00 X 0 379130 45904 LEONA CROSSKEY VP, QUALITY (TERM 4/4/15) 13.00 48.00 X 0 145550 16271 ROBERT CARROLL MD MED DIR, EMERGENCY DEPARTMENT 13.00 48.00 X 0 373263 23763 JOYCE A TICHY GENERAL COUNSEL 13.00 48.00 X 0 316418 44083 DAVID NEUHAUS MEDICAL DIRECTOR 55.00 5.00 X 325860 0 5877 ALEXIS M CORDIANO URGENT CARE PHYSICIAN 60.00 0 X 256379 0 22964 ELLEN G NEUHAUS MEDICAL DIRECTOR 60.00 0 X 220703 0 26130 LINA HWANG URGENT CARE PHYSICIAN 60.00 0 X 207226 0 19648 JOHVONNE CLAYBOURNE URGENT CARE PHYSICIAN 60.00 0 X 199644 0 24518 1517807 3242927 518585 31 false true true SOUND INPATIENT PHYSICIANS INC PO BOX 742936 LOS ANGELES CA 900742936 PHYSICIAN SERVICES 817201 CONNECTICUT HOSPITAL ASSOCIATION PO BOX 90 WALLINGFORD CT 06492 VARIOUS SERVICES 573765 ROPES & GRAY LLP PO BOX 414265 BOSTON MA 022414265 LEGAL SERVICES 296823 STANDARD BUILDERS INC 52 HOLMES ROAD NEWINGTON CT 061111708 BUILDING SERVICES 276139 NORTHEASTERN PULMONARY ASSOCIATES LLC 27 NAEK ROAD UNIT 2 VERNON CT 06066 PHYSICIAN FEES 220000 14 198574 119831 318405 PATIENT SERVICE REVENUE 622110 63002481 63002481 OTHER HEALTHCARE REVENUE 621500 1636376 1014705 621671 0 0 0 0 64638857 26701 26701 524421 470209 54212 0 54212 54212 0 0 27316 8609 18707 18707 CAFETERIA REVENUE 722210 199407 199407 0 0 0 0 199407 65256289 64017186 621671 299027 1363760 1363760 29434779 25019562 4415217 647852 550674 97178 7256386 6167928 1088458 1674990 1423742 251248 90610 90610 1460205 876123 584082 0 40491 40491 192068 96034 96034 76640 38320 38320 1903960 1618366 285594 1994 1695 299 6481 5508 973 697473 697473 3138917 2668079 470838 842319 715971 126348 MEDICAL SUPPLIES 10181619 10181619 ECHN ALLOCATION 5154251 3092551 2061700 PHYSICIAN FEES 4133546 4133546 DUE DILIGENCE 534091 534091 627778 480266 147512 0 69460210 57767457 11692753 0 1772696 2130527 10900702 8279947 0 0 1325483 1266636 201349 209438 87446136 64443314 25700876 23002822 14606911 14583455 3392939 3132869 7088738 7286539 9797251 6310762 74786945 66202995 6181391 5623272 22968770 22342472 1368697 1044272 15933785 18314069 46452643 47324085 X 24211838 14969087 549043 537851 3573421 3371972 28334302 18878910 74786945 66202995 X -4203921 193 -5251664 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 20912 20912 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY THE CONNECTICUT HOSPITAL ASSOCIATION (CHA) HAS DETERMINED FOR ITS FISCAL YEAR THAT $16,600 OF ITS MEMBERSHIP DUES FROM ROCKVILLE GENERAL HOSPITAL WERE USED FOR LOBBYING PURPOSES. THE AMERICAN HOSPITAL ASSOCIATION (AHA) HAS DETERMINED FOR ITS FISCAL YEAR THAT $4,312 OF ITS MEMBERSHIP DUES FROM ROCKVILLE GENERAL HOSPITAL WERE USED FOR LOBBYING PURPOSES. 12538092 5697 17193 12526596 11605016 0 939011 0 0 5935 12538092 10707116 0 1197900 0 300000 0 11605016 9113580 0 1593536 0 0 0 10707116 9026890 0 86690 0 0 0 9113580 0.8742 0.0863 0.0395 false true true 644006 644006 46991728 30464623 16527105 1563538 730328 833210 37438952 32750194 4688758 807912 498169 309743 23002822 INTEREST IN NET ASSETS OF ECHN COMMUNITY HEALTHCARE FOUNDATION, INC. 3664214 F INVESTMENTS IN JOINT VENTURES 3622325 C 7286539 DUE FROM AFFILIATES 4623192 OTHER ASSETS 936314 ESTIMATED SETTLEMENTS DUE FROM THIRD PARTY PAYERS 751256 6310762 ESTIMATED SELF INSURANCE LIABILITIES 1939861 ACCRUED PENSION AND POST RETIREMENT BENEFITS 14001042 CONDITIONAL RETIREMENT ASSET OBLIGATONS 132211 ESTIMATED SETTLEMENTS DUE TO THIRD-PARTY PAYERS 1056682 OTHER CURRENT LIABILITIES 200005 DUE TO AFFILIATES 984268 18314069 X 65228254 58991 58991 65169263 87026 87026 65256289 69414607 8609 8609 69405998 54212 54212 69460210 Schedule D, Part V, Line 4 Intended uses of endowment funds THE PRINCIPAL AND INCOME FROM THE UNRESTRICTED ENDOWMENT FUNDS AND THE INCOME FROM THE TERM ENDOWMENTS ARE FOR CAPITAL AND OPERATING NEEDS OF ROCKVILLE GENERAL HOSPITAL. THE INCOME FROM THE PERMANENT ENDOWMENTS AND PRINCIPAL FROM THE TERM ENDOWMENTS ARE FOR THE USE OF ROCKVILLE GENERAL HOSPITAL AS RESTRICTED BY THE DONORS. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE NETWORK ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH PROVISIONS OF FASB ASC 740, "INCOME TAXES," WHICH PROVIDES A FRAMEWORK FOR HOW COMPANIES SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE UNCERTAIN TAX POSITIONS IN THEIR CONSOLIDATED FINANCIAL STATEMENTS. THE NETWORK MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE NETWORK DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2015 AND 2014. THE NETWORK'S POLICY IS TO INCLUDE PENALTIES AND INTEREST AS A COMPONENT OF INCOME TAX EXPENSE, WHEN APPLICABLE. AS OF SEPTEMBER 30, 2015 AND 2014, THE NETWORK DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNCERTAIN TAX POSITIONS. GENERALLY, THE NETWORK'S PRIOR THREE TAX YEARS ARE OPEN AND SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990 COST OF GOODS SOLD - GIFT SHOP - 8609 NET ASSETS RELEASED FROM RESTRICTIONS FOR OPERATIONS - 50382 Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements TEMPORARILY RESTRICTED CONTRIBUTIONS AND INVESTMENT INCOME - 32814 NET RENTAL INCOME - 54212 Schedule D, Part XII, Line 2(d) Other expenses in audited financial statements not in form 990 COST OF GOODS SOLD - GIFT SHOP - 8609 Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statements NET RENTAL INCOME - 54212 true true X true X 125 true X true true false true true 322 236019 0 236019 0.0034 15846 13449917 7523381 5926536 0.0853 0 0 0 0.0 0 16168 13685936 7523381 6162555 0.0887 13 40543 131842 668 131174 0.0019 10 239 356206 75289 280917 0.0040 4 1646 966987 363359 603628 0.0087 1 0 12493 0 12493 0.0002 3 421 15403 0 15403 0.0002 31 42849 1482931 439316 1043615 0.0150 31 59017 15168867 7962697 7206170 0.1037 0 0.0 0 0.0 2 39560 26510 13050 0.0002 0 0.0 0 0.0 0 0.0 1 1054 1054 0.0000 1 5 213 213 0.0000 0 0.0 4 5 40827 26510 14317 0.0002 true 3610628 797361 17726954 21782812 -4055858 X true true 1 1 ROCKVILLE GENERAL HOSPITAL www.echn.org 00036 X X X X ROCKVILLE GENERAL HOSPITAL 1 false false true X X X X X X X X X 12 true true false true X WWW.ECHN.ORG/ABOUT-ECHN/COMMUNITY-BENEFIT-REPORTING.ASPX X true 12 true WWW.ECHN.ORG/ABOUT-ECHN/COMMUNITY-BENEFIT-REPORTING.ASPX false false true X 1.25 4.0 X X true true X X X X true X www.echn.org X www.echn.org X www.echn.org X X X X X true false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - ROCKVILLE GENERAL HOSPITAL. AS PART OF ITS CHNA, RGH INVITED COMMUNITY AGENCIES AND ORGANIZATIONS THROUGHOUT THE SERVICE AREA, REPRESENTING A VARIETY OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS, TO PARTICIPATE IN AN ONLINE SURVEY, WHICH ASKED QUESTIONS ABOUT WHAT THE INDIVIDUALS PERCEIVED TO BE HEALTHY AND UNHEALTHY ABOUT THE COMMUNITY, WHAT THEIR PERCEPTION IS OF RGH AND THE PROGRAMS AND SERVICES IT OFFERS, AND WHAT RGH CAN DO TO IMPROVE THE HEALTH AND QUALITY OF LIFE IN THE COMMUNITY. AGENCIES AND ORGANIZATIONS RESPONDING TO THE SURVEY INCLUDED THE DEPARTMENT OF PUBLIC HEALTH WIC PROGRAM, COMMUNITY CHILD GUIDANCE CLINIC, VERNON YOUTH SERVICES BUREAU, TOWN OF ELLINGTON HUMAN SERVICES, TOWN OF MANCHESTER HEALTH DEPARTMENT, TOWN OF ANDOVER ELDER SERVICES, MAPLE STREET SCHOOL IN VERNON, VERNON ADULT EDUCATION, INDIAN VALLEY YMCA, AND MARC, INC. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - ROCKVILLE GENERAL HOSPITAL. THE CHNA WAS CONDUCTED BY EASTERN CONNECTICUT HEALTH NETWORK, WHICH INCLUDES MANCHESTER MEMORIAL HOSPITAL AND ROCKVILLE GENERAL HOSPITAL. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - ROCKVILLE GENERAL HOSPITAL. The strategies to address the health needs are as follows: I. Heart Disease 1. Educate the public about managing lifestyle behaviors that impact diet, blood pressure, cholesterol, weight, physical activity, and stress. (a.) Offer free community health educational programs (b.) Provide education in Better Being, community free wellness magazine (c.) Participate in community health fairs (d.) Develop "Freedom from Smoking" smoking cessation program (e.) Provide nutrition counseling services (f.) Offer integrative medicine programs for stress reduction 2. Provide information and services to individuals diagnosed with heart disease to help them best manage their symptoms (a.) Develop "Heart Talk" community program for people living with heart failure (b.) Promote Cardiac Rehabilitation services II. Cancer 1. Monitor reports of newly- diagnosed cancer cases in the service area using the National Cancer Center Data Base (NCDB) to identify significant changes, trends or abnormal activity. 2. Educate the public about managing lifestyle behaviors that impact cancer risks (a.) Free community health educational programs (b.) Articles in Better Being (c.) Health fair participation (d.) "Freedom from Smoking" smoking cessation program 3. Provide free screenings through the community and access to follow-up care 4. Offer comprehensive support programs for cancer survivors and caregivers (a.) Oncology Nurse Navigator and Survivorship Navigators services (b.) Annual Cancer Survivors Day event (c.) Regular support group meetings (d.) Cancer Caregiver Workshops III. Diabetes 1. Raise awareness of diabetes preventable risk factors and educate the public on ways to manage lifestyle behaviors that affect them including diet, weight and physical activity (a.) Free community health educational programs (b.) Articles in Better Being (c.) Health fair participation 2. Offer Diabetes Self-Management Program and Nutrition Counseling for individuals already diagnosed with diabetes. IV. Arthritis 1. Educate the public about ways to help prevent or slow the progression of arthritis and manage the symptoms of joint pain. (a.) Free community health educational programs (b.) Articles in Better Being (c.) Health fair participation 2. Offer free program to help individuals with arthritis prepare for hip or knee replacement surgery and achieve the best outcome. 3. Develop a comprehensive surgical spine program to support individuals experiencing chronic neck and back pain including symptom management and perioperative care. Community Collaboration An important component of these strategies will be collaboration with community resources including those currently available to respond to the health needs including: * Cornerstone Foundation * Eastern Highlands Health District * Hockanum Valley Community Council, Inc. * Johnson Health Network * Manchester Area Conferences of Churches * MARC, Inc. of Manchester * Natchaug Hospital * North Central Health Department * Town Departments of Health & Human Services * Town Departments of Social Services * Tri-Town Shelter Services * United Way NOT ALL THE NEEDS IDENTIFIED WILL BE ADDRESSED. AFTER REVIEWING THE CHNA DATA, THE OVERSIGHT COMMITTEE IDENTIFIED EIGHT HEALTH AREAS OF NEED: HEART DISEASE INCIDENCE, CANCER INCIDENCE, DIABETES INCIDENCE, ARTHRITIS INCIDENCE, ALZHEIMER'S DISEASE INCIDENCE, MULTIPLE SCLEROSIS INCIDENCE, SUBSTANCE ABUSE AND CHILDHOOD LEAD SCREENING. HOWEVER, IT WAS DETERMINED THAT ALL NEEDS COULD NOT BE ADDRESSED BASED ON THE HOSPITAL'S ABILITY TO IMPACT THE NEEDS AND THE AVAILABILITY OF RESOURCES THAT EXIST TO ADDRESS THEM. THE FOLLOWING HEALTH NEEDS WERE IDENTIFIED AS THE HIGHEST PRIORITY: HEART DISEASE INCIDENCE, CANCER INCIDENCE, DIABETES INCIDENCE AND ARTHRITIS INCIDENCE. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - ROCKVILLE GENERAL HOSPITAL. FAMILY SIZE IS USED WITH INCOME LEVEL. Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - ROCKVILLE GENERAL HOSPITAL. THE HOSPITAL COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE THROUGH NOTICES POSTED IN PUBLIC AREAS AROUND THE HOSPITAL SUCH AS THE EMERGENCY ROOM, WAITING ROOMS AND ADMISSION OFFICE, ON THE PATIENT BILLS, ON OUR WEBSITE, AND FOR SELECTED PRE-SCHEDULED SERVICES TO ENSURE THAT THE FINANCIAL CAPACITY OF THE PEOPLE WHO NEED HEALTH CARE SERVICES DOES NOT PREVENT THEM FROM SEEKING OR RECEIVING CARE. Schedule H, Part V, Section B, Line 22 Facility , 1 Facility , 1 - ROCKVILLE GENERAL HOSPITAL. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL NOT BE CHARGED MORE THAN THE AMOUNT GENERALLY BILLED TO PATIENTS WITH INSURANCE FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. 0 Schedule H, Part VI SCHEDULE H, ADDITIONAL INFORMATION The Rockville General Hospital, Inc. is a not-for-profit 102-bed acute care hospital that provides inpatient, outpatient and emergency care services for residents of Vernon-Rockville, CT and surrounding towns. The Hospital is a subsidiary of the Eastern Connecticut Health Network, Inc., which was formed in 1995 by a merger of MMH Corp. and Rockville Area Health Services, Inc. ECHN was organized to provide a broader health care system for the surrounding communities with quality medical care at a reasonable cost and to foster an environment conducive to health and well being whether in the home or in the community. Rockville General Hospital patients not having insurance covering emergency or other medically qualified care (uninsured patients), as well as underinsured patients, subject to income limits and family size receive free or discounted care. Rockville General Hospital does not pursue collection of amounts determined to qualify as charity care. Charges for care provided to patients are determined by established rates, subject to possible adjustments or discounts for low income patients; contractual discounts, or discounts for patients who meet certain criteria under its charity care policies. Charity care for FY 2015 was $797,361 for 322 approved applicants. Expenses related to services performed for patients of Rockville General Hospital contribute importantly to its exempt purpose because the expenses are incurred in the diagnosis, cure, mitigation, treatment and prevention of disease, and for medical purposes affecting the structure or function of the human body. Rockville General Hospital provided needed medical care to the community regardless of any individual's ability to pay. Two thousand one hundred twelve (2,112) inpatients were cared for in FY15 representing 9,873 patient days. One hundred twenty-four thousand two hundred sixty (124,260) outpatient visits were recorded. Included in the 2,112 inpatients were 1,703 government related patients. The government inpatients fall into the following groups. Medicare... 1,027 Medicare Managed Care... 401 Medicaid... 266 Champus... 9 Total Gov Patients... 1,703 Total Non Gov Patients... 409 Total Patients... 2,112 Included in the 124,260 outpatient visits were 60,732 government related visits. The visits are a product of gross revenue relationship to total visits. The government visits fall into the following groups. Medicare... 26,726 Medicare Managed Care... 10,673 Medicaid... 22,687 Champus... 646 Total Gov Patients... 60,732 Total Non Gov Patients... 63,528 Total Outpatient Visits... 124,260 The Hospital provided uncompensated care to 15,846 Medicaid patients for a net community benefit amount of $5,926,536 after Medicaid reimbursement. Schedule H, Part II Community Building Activities Rockville General Hospital (RGH), as part of Eastern Connecticut Health Network (ECHN), promotes the health of the communities it serves by committing the expertise and resources of the organization to a number of community building activities that support associations, businesses, programs, initiatives and other valuable local community assets. Community building activities include serving on the board and executive committee of regional chambers of commerce in support of the local business industry; partnering with the local school systems and colleges in various workforce development programs; serving on the Vernon School Readiness Council, the Cancer Community Outreach Committee and the American Hospital Association's Regional Policy Board; and numerous community coalitions that address adolescent behavioral health concerns. As a result of these activities, there has been improved collaboration among community providers and others involved in providing services to children, adolescents and their families and other adults. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount The Network provides for a provision for bad debts. For receivables associated with services provided to patients who have third-party coverage, the Network analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payer has not yet paid, or for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and co-payment balances due for which third-party coverage exists for part of the bill), the Network records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. For uninsured patients that do not qualify for financial assistance, the Network offers a discount off its standard rates for services provided. The difference between the discounted rates and the amounts actually collected after all reasonable collection efforts have been exhausted is written off against the allowance for doubtful accounts in the period they are determined uncollectible. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The Hospital provides for a provision for bad debts. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payer has not yet paid, or for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and co-payment balances due for which third-party coverage exists for part of the bill), the Hospital records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. For uninsured patients that do not qualify for financial assistance, the Hospital offers a discount off its standard rates for services provided. The difference between the discounted rates and the amounts actually collected after all reasonable collection efforts have been exhausted is written off against the allowance for doubtful accounts in the period they are determined uncollectible. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs The hospital provides quality health care to all, regardless of their ability to pay. Charity care is provided to those who are eligible based on RGH'S policy. The hospital also incurs unpaid costs for government programs because reimbursement is not sufficient to cover costs associated with Medicare and Medicaid patients. The organization's Medicare Cost Report was used to calculate actual costs reported on Part III, Line 6. The access to healthcare by patients covered by Medicare is a fundamental part of the hospital's community benefit program. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance Internal and external collection policies and procedures take into account the extent to which a patient is qualified for charity care or discounts. In addition, patients who qualify for partial discounts are required to make a good faith effort to honor payment agreements with ECHN, including payment plans and discounted hospital bills. RGH is committed to working with patients to resolve their accounts, and at its discretion, may provide extended payment plans to eligible patients. RGH will not pursue legal action for non-payment of bills against charity care patients who have cooperated with the hospital to resolve their accounts and have demonstrated their income and/or assets are insufficient to pay medical bills. Schedule H, Part V, Section B, Line 16a FAP website - ROCKVILLE GENERAL HOSPITAL: Line 16a URL: www.echn.org; Schedule H, Part V, Section B, Line 16b FAP Application website - ROCKVILLE GENERAL HOSPITAL: Line 16b URL: www.echn.org; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - ROCKVILLE GENERAL HOSPITAL: Line 16c URL: www.echn.org; Schedule H, Part VI, Line 2 Needs assessment IN 2013, RGH COLLABORATED WITH MANCHESTER MEMORIAL HOSPITAL, ALSO AN AFFILIATE OF ECHN, TO CONDUCT A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE GOALS OF THE ASSESSMENT WERE: TO IDENTIFY CURRENT AND FUTURE HEALTHCARE NEEDS IN THE COMMUNITY AND TO IMPROVE AND STRENGTHEN PROGRAMS AND SERVICES PROVIDED TO ADDRESS THEM. THE CHNA PROCESS WAS LED BY AN OVERSIGHT COMMITTEE THAT INCLUDED MEMBERS OF THE ORGANIZATION WITH ESTABLISHED RELATIONSHIPS WITH COMMUNITY GROUPS AND AGENCIES. DATA COLLECTED FOR THE CHNA INCLUDED: HEALTH, SOCIAL, AND DEMOGRAPHIC DATA SPECIFIC TO RGH'S SERVICE AREA OBTAINED FROM LOCAL PUBLIC HEALTH AGENCIES, NATIONAL HEALTH ASSOCIATIONS AND OTHER DATA SOURCES; HEALTH BEHAVIOR INFORMATION COLLECTED FROM 1,047 RESIDENTS WHO RESPONDED TO A COMMUNITY SURVEY; INPUT FROM 12 COMMUNITY STAKEHOLDERS FROM LOCAL ORGANIZATIONS INVESTED IN THE HEALTH OF UNDERSERVED POPULATIONS. ONCE ALL DATA WAS COLLECTED AND ANALYZED, THE OVERSIGHT COMMITTEE IDENTIFIED AND PRIORITIZED THE SERVICE AREA'S KEY HEALTH NEEDS AND DEVELOPED AN IMPLEMENTATION STRATEGY TO RESPOND TO THE NEEDS. IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT, MANAGEMENT HAS REGULAR MEETINGS WITH THE MEDICAL STAFF TO DISCUSS PATIENT NEEDS AND THE PROGRAMS OFFERED BY THE ORGANIZATION TO ADDRESS PATIENTS' NEEDS. IN ADDITION, A STRATEGIC PLANNING PROCESS IS CONDUCTED REGULARLY WHICH INCLUDES THE COLLECTION AND REVIEW OF MORTALITY DATA, THE UTILIZATION OF SERVICES AND PHYSICIAN STAFFING FOR THE COMMUNITIES SERVED BY THE HOSPITAL. FROM THE ANALYSIS OF THIS DATA, PLANS ARE MADE TO ADDRESS THE HEALTH NEEDS OF THE COMMUNITY. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance THE HOSPITAL COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE THROUGH NOTICES POSTED IN PUBLIC AREAS AROUND THE HOSPITAL, ON THE PATIENT BILLS, ON OUR WEBSITE, AND SELECTED PRE-SCHEDULED SERVICES TO ENSURE THAT THE FINANCIAL CAPACITY OF PEOPLE WHO NEED HEALTHCARE SERVICES DOES NOT PREVENT THEM FROM SEEKING OR RECEIVING CARE. Schedule H, Part VI, Line 4 Community information ROCKVILLE GENERAL HOSPITAL, PART OF EASTERN CONNECTICUT HEALTH NETWORK, SERVES A 19-TOWN PRIMARY AND SECONDARY SERVICE AREA LOCATED EAST OF THE CONNECTICUT RIVER IN NORTHERN CONNECTICUT WITH MUNICIPALITIES IN HARTFORD, TOLLAND AND WINDHAM COUNTIES. THE PRIMARY SERVICE AREA INCLUDES ANY TOWN WHERE TOTAL INPATIENT AND NEWBORN DISCHARGES ARE GREATER THAN OR EQUAL TO 20 PERCENT AND INCLUDES THE TOWNS OF MANCHESTER, SOUTH WINDSOR, BOLTON, COVENTRY, ANDOVER, ELLINGTON, TOLLAND, VERNON/ROCKVILLE AND WILLINGTON. THE SECONDARY SERVICE AREA INCLUDES ANY TOWN WHERE TOTAL INPATIENT AND NEWBORN DISCHARGES ARE GREATER THAN OR EQUAL TO FIVE PERCENT AND LESS THAN 20 PERCENT AND INCLUDES THE TOWNS OF ASHFORD, SOMERS, STAFFORD, UNION, EAST HARTFORD, EAST WINDSOR, GLASTONBURY, HEBRON, COLUMBIA AND MANSFIELD. BASED ON DATA COLLECTED IN 2013, THE POPULATION OF THE ENTIRE SERVICE AREA IS 341,000; 49% MALE, 51% FEMALE. THE MEDIAN AGE OF RESIDENTS IS 39.5 YEARS WITH 33.3% OF THE POPULATION 50 YEARS OR OLDER. THE RACE OF THE RESIDENTS IS PREDOMINANTLY WHITE (80%) FOLLOWED BY BLACK/AFRICAN AMERICAN (8.3%), OTHER/MULTI-RACE (6.1%) AND ASIAN (5.3%). APPROXIMATELY 91.5% PERCENT OF THE POPULATION HAS A HIGH SCHOOL DEGREE AND 35.6% PERCENT HAVE A BACHELOR'S DEGREE OR HIGHER. THE MEDIAN HOUSEHOLD INCOME FOR THE SERVICE AREA IS $82,075 PER YEAR. JUST UNDER 8% OF HOUSEHOLDS HAVE ANNUAL INCOME AT THE FEDERAL POVERTY RATE. THE UNEMPLOYMENT RATE IS 7.4% AND THE AVERAGE HOUSEHOLD SIZE IS 2.61 PEOPLE. Schedule H, Part VI, Line 5 Promotion of community health COMMUNITY HEALTH EDUCATION INITIATIVES AND PROGRAMS ARE OFFERED TO THE COMMUNITY AND INCLUDE FREE COMMUNITY HEALTH EDUCATIONAL PROGRAMS, EDUCATION IN BETTER BEING (A FREE COMMUNITY WELLNESS MAGAZINE), PARTICIPATION IN COMMUNITY HEALTH FAIRS, NUTRITION COUNSELING SERVICES, INTEGRATIVE MEDICINE PROGRAMS FOR STRESS REDUCTION, A "HEART TALK" COMMUNITY PROGRAM FOR PEOPLE LIVING WITH HEART FAILURE, THE PROMOTION OF CARDIAC REHABILITATION SERVICES, AND NUTRITION COUNSELING FOR INDIVIDUALS ALREADY DIAGNOSED WITH DIABETES. LECTURE PRESENTATIONS ARE MADE TO THE COMMUNITY ABOUT BREAST CANCER, PREVENTATIVE/SCREENING RECOMMENDATIONS, AND BONE DENSITY EXAMS. FOR EXAMPLE, PRESENTATIONS WERE MADE TO THE COMMUNITY ABOUT BREAST CANCER, PREVENTATIVE/SCREENING RECOMMENDATIONS, BONE DENSITY EXAMS, AND FREE SCREENING PROGRAMS. THESE PRESENTATIONS WERE MADE AT THE GREATER HARTFORD WOMEN'S CONFERENCE; A WOMEN AND YOUTH ADVISORY PANEL DISCUSSION AT MANCHESTER COMMUNITY COLLEGE; THE TOWN OF SOUTH WINDSOR HEALTH AND WELLNESS FAIR; TOWN OF VERNON EMPLOYEE HEALTH AND BENEFIT FAIR; THE TOWN OF MANCHESTER HEALTH AND SAFETY FAIR; CROSSROADS COMMUNITY CATHEDRAL CHURCH HEALTH FAIR; WOMEN TO WOMEN-A COMFORTABLE CONVERSATION; LET'S TALK MENOPAUSE PANEL COMMUNITY PROGRAM; THE VERNON CENTER MIDDLE SCHOOL; AND THE OFFICE OF MIGRATION, REFUGEE, AND IMMIGRATION SERVICES AT CATHOLIC CHARITIES OF HARTFORD. OTHER EDUCATION PROGRAMS INCLUDE EDUCATING THE PUBLIC ABOUT MANAGING LIFESTYLE BEHAVIORS THAT IMPACT DIET, BLOOD PRESSURE, CHOLESTEROL, WEIGHT, PHYSICAL ACTIVITY, STRESS, CANCER RISKS, DIABETES AND ARTHRITIS. FREE HEALTH SCREENINGS INCLUDING DIABETIC FOOT CHECKS, MAMMOGRAMS, HEART DISEASE SCREENINGS, BLOOD PRESSURE, BONE DENSITY, GLUCOSE READINGS, INJURY SCREENINGS, VITAL SIGN CHECKS, MASSAGE THERAPY AND MEDICAL EXAMS ARE OFFERED IN THE COMMUNITY, TARGETING UNINSURED/UNDERINSURED POPULATIONS. FOR EXAMPLE, BLOOD PRESSURE SCREENINGS WERE DONE AT THE AMERICAN HEART ASSOCIATION HEART WALK. RISK FACTOR SCREENINGS WERE DONE DURING WEAR RED DAY. HEALTHCARE SUPPORT SERVICES ARE PROVIDED BY THE HOSPITAL TO INCREASE ACCESS AND QUALITY OF CARE TO INDIVIDUALS IN NEED. EFFORTS INCLUDE ASSISTANCE TO ENROLL IN PUBLIC PROGRAMS, REFERRALS TO SOCIAL SERVICES, AND HELP IN FINDING PHYSICIANS ACCEPTING MEDICAID OR OTHER GOVERNMENT PROGRAMS. PARTNERING WITH LOCAL EDUCATIONAL INSTITUTIONS, ROCKVILLE GENERAL HOSPITAL PROVIDES A CLINICAL SETTING FOR PHYSICIANS AND INTERNS, MEDICAL STUDENTS, NURSING STUDENTS, RADIOLOGIC TECHNICIANS, PHLEBOTOMY STUDENTS, RESPIRATORY TECHNICIANS, DIETETIC INTERNS, PHARMACY STUDENTS, PHYSICAL THERAPISTS AND OTHERS FROM THE UNIVERSITY OF NEW ENGLAND COLLEGE OF OSTEOPATHIC MEDICINE, UNIVERSITY OF CONNECTICUT, MANCHESTER COMMUNITY COLLEGE, CENTRAL CONNECTICUT STATE UNIVERSITY, GOODWIN COLLEGE, CAPITAL COMMUNITY COLLEGE, SPRINGFIELD TECHNICAL COMMUNITY COLLEGE, UNIVERSITY OF ST. JOSEPH, QUINNIPIAC UNIVERSITY, ASNUNTUCK COMMUNITY COLLEGE, STONE ACADEMY, UNIVERSITY OF HARTFORD, AND EASTERN CONNECTICUT STATE UNIVERSITY. HEALTH SERVICES WHICH ARE SUBSIDIZED BY THE HOSPITAL INCLUDE THE EARLY DETECTION PROGRAM, THE MATERNITY CARE CENTER, DIALYSIS SERVICES, AND THE RYAN WHITE PART A PROGRAM. SPECIFIC RESEARCH INITIATIVES CONDUCTED BY THE HOSPITAL INCLUDE AN INSTITUTIONAL REVIEW COMMITTEE, WHICH PROTECTS THE RIGHTS AND WELFARE OF RESEARCH SUBJECTS AND APPROVES ALL RESEARCH STUDIES IN ACCORDANCE WITH FEDERAL REGULATIONS. THE HOSPITAL ALSO MAINTAINS A CANCER REGISTRY DATABASE. FINANCIAL AND IN-KIND SERVICES AND GOODS ARE DONATED TO COMMUNITY GROUPS AND OTHER NOT FOR PROFIT ORGANIZATIONS INCLUDING LOCAL FUNDRAISERS, FACILITY SPACE TO HOST BLOOD DRIVES AND HEALTH SUPPORT GROUPS ORGANIZATIONS' MEETINGS. FOR EXAMPLE, THE HOSPITAL PROVIDES FREE MEETING SPACE FOR COMPASSIONATE FRIENDS-PROVIDING GRIEF SUPPORT AFTER THE DEATH OF A CHILD, OVEREATERS ANONYMOUS, AND THE NORTH CENTRAL DISTRICT HEALTH DEPARTMENT. THE ORGANIZATION FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY, INCLUDING HAVING A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NOT EMPLOYEES OR INDEPENDENT CONTRACTORS, AND EXTENDING MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALISTS. Schedule H, Part VI, Line 6 Affiliated health care system ROCKVILLE GENERAL HOSPITAL (RGH) IS AN AFFILIATE OF EASTERN CONNECTICUT HEALTH NETWORK (ECHN), A HEALTH CARE SYSTEM SERVING 19 TOWNS IN EASTERN CONNECTICUT. THE ECHN NETWORK OF AFFILIATES INCLUDES: MANCHESTER MEMORIAL HOSPITAL, A COMMUNITY HOSPITAL LICENSED FOR 249 BEDS AND 34 BASSINETS, THAT OFFERS MEDICAL AND SURGICAL SERVICES, 24-HOUR EMERGENCY CARE, MEDICAL IMAGING, A MODERN FAMILY BIRTHING CENTER AND NEONATOLOGY SERVICES, REHABILITATION SERVICES, A CERTIFIED SLEEP DISORDERS CENTER, INTENSIVE CARE SUITES, A WOUND HEALING CENTER WITH HYPERBARIC THERAPY, HOSPICE CARE, DIABETES SELF-MANAGEMENT PROGRAM, CARDIAC & PULMONARY REHABILITATION, A COMPREHENSIVE RANGE OF ADOLESCENT AND ADULT INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES, NUTRITION COUNSELING, LABORATORY SERVICES, AND THE EASTERN CONNECTICUT CANCER INSTITUTE AT THE JOHN A. DEQUATTRO CANCER CENTER. ROCKVILLE GENERAL HOSPITAL, A COMMUNITY HOSPITAL LICENSED FOR 102 BEDS, THAT OFFERS MEDICAL AND SURGICAL SERVICES, 24-HOUR EMERGENCY CARE, MEDICAL IMAGING, CARDIAC & PULMONARY REHABILITATION, PHYSICAL REHABILITATION, HOSPICE CARE, A MATERNITY CARE CENTER FOR UNINSURED WOMEN, OUTPATIENT ADOLESCENT BEHAVIORAL HEALTH SERVICES, AND LABORATORY SERVICES. WOODLAKE AT TOLLAND IS A SKILLED NURSING & REHABILITATION CENTER, A 130-BED LONG-TERM SKILLED NURSING CARE AND SHORT-TERM REHABILITATION FACILITY. CUSTOMIZED REHABILITATION TREATMENT SERVICES INCLUDE JOINT REPLACEMENT REHABILITATION, ORTHOPEDIC POST-HOSPITAL CARE, STROKE/NEUROLOGICAL REHAB, POST MEDICAL/SURGICAL RECONDITIONING, AND PERSONALIZED, PROGRESSIVE, AND INTERDISCIPLINARY CARE SERVICES. EASTERN CONNECTICUT MEDICAL PROFESSIONALS FOUNDATION, INC. (ECMPF), A MULTI-SPECIALTY PHYSICIAN GROUP PRACTICE THAT OFFERS A FULL RANGE OF HEALTHCARE SERVICES, INCLUDING PRIMARY AND SPECIALTY CARE IN THE TOWNS OF EAST HARTFORD, ELLINGTON, MANCHESTER, SOMERS, SOUTH WINDSOR, TOLLAND AND VERNON/ROCKVILLE. GLASTONBURY WELLNESS CENTER COMBINES FITNESS AND MEDICAL SERVICES UNDER ONE ROOF, INCLUDING PHYSICIAN PRACTICES, LABORATORY DRAW SERVICES, MEDICAL IMAGING DIAGNOSTIC SERVICES, AND REHABILITATION SERVICES. ECHN MEDICAL BUILDINGS AT EVERGREEN WALK (SOUTH WINDSOR); 2400 TAMARACK AVENUE OCCUPANTS INCLUDE EVERGREEN ENDOSCOPY CENTER, CENTRAL CONNECTICUT GASTROENTEROLOGY, THE COLON & RECTAL SURGEONS OF GREATER HARTFORD, ECMPF PRIMARY CARE PHYSICIANS, RHEUMATOLOGY PHYSICIANS, WALDEN BEHAVIORAL CARE EATING DISORDERS CLINIC, LABORATORY SERVICES AND ACCLAIM BEHAVIORAL SERVICES, LLC. 2600 TAMARACK AVENUE INCLUDES THE WOMEN'S CENTER FOR WELLNESS, ECHN BREAST CARE COLLABORATIVE, AND THE OB/GYN GROUP OF EASTERN CONNECTICUT. THE CONFERENCE CENTER IS USED FOR COMMUNITY PROGRAMS. 2800 TAMARACK AVENUE HOUSES EVERGREEN IMAGING CENTER, ECHN REHABILITATION SERVICES, A LABORATORY DRAW STATION, A SERIES OF MEDICAL PRACTICES INCLUDING ORTHOPEDIC SURGERY, OTOLARYNGOLOGY (ENT), AND GENERAL SURGERY, CORPCARE, AND SOUTH WINDSOR URGENT CARE. ECHN MANCHESTER MEDICAL OFFICE BUILDINGS: 150 NORTH MAIN STREET OFFERS A VARIETY OF BEHAVIORAL HEALTH SERVICES. 130 HARTFORD ROAD OFFERS PRIMARY CARE AND LABORATORY SERVICES. VISITING NURSE & HEALTH SERVICES OF CONNECTICUT PROVIDES AT-HOME NURSING CARE AND HOSPICE CARE. ECHN HAS 391 PHYSICIANS (303 ACTIVE, 41 COURTESY, 13 CONSULTING, 34 PART-TIME), 92 ALLIED HEALTH PROFESSIONALS, 10 MEDICAL DEPARTMENTS AND 16 SERVICES AS WELL AS 15 UNIVERSITY OF NEW ENGLAND COLLEGE OF OSTEOPATHIC MEDICINE THIRD-YEAR MEDICAL STUDENTS AVAILABLE TO CARE FOR THE COMMUNITY. Schedule H, Part VI, Line 7 State filing of community benefit report CT X X X X X false true false false false false false false false PETER J KARL PRESIDENT AND CEO 0 568446 0 250000 0 0 0 90028 0 22090 0 930564 0 0 MICHAEL D VEILLETTE SVP, CHIEF FINANCIAL OFFICER 0 313019 0 43750 0 0 0 37264 0 18863 0 412896 0 0 MARY POWERS SVP, PATIENT CARE SERVICES 198620 0 0 0 0 0 3074 0 7531 0 209225 0 0 0 DEBORAH R GOGLIETTINO SVP, HUMAN RESOURCES (TERM 1/1/15) 0 226101 0 43750 0 0 0 21368 0 14655 0 305874 0 0 DENNIS P MCCONVILLE SVP, STRATEGIC PLANNING 0 206835 0 43750 0 0 0 19405 0 9802 0 279792 0 0 DEBORAH A PARKER EVP, CHIEF CLINICAL OFFICER (TERM 5/1/15) 0 332915 0 0 0 0 0 30235 0 15112 0 378262 0 0 JOEL REICH MD SVP, MEDICAL AFFAIRS 0 335380 0 43750 0 0 0 31045 0 14859 0 425034 0 0 LEONA CROSSKEY VP, QUALITY (TERM 4/4/15) 0 145550 0 0 0 0 0 2380 0 13891 0 161821 0 0 ROBERT CARROLL MD MED DIR, EMERGENCY DEPARTMENT 0 373263 0 0 0 0 0 5200 0 18563 0 397026 0 0 JOYCE A TICHY GENERAL COUNSEL 0 272668 0 43750 0 0 0 25520 0 18563 0 360501 0 0 DAVID NEUHAUS MEDICAL DIRECTOR 325860 0 0 0 0 0 4735 0 1142 0 331737 0 0 0 ALEXIS M CORDIANO URGENT CARE PHYSICIAN 256379 0 0 0 0 0 4401 0 18563 0 279343 0 0 0 ELLEN G NEUHAUS MEDICAL DIRECTOR 220703 0 0 0 0 0 3551 0 22579 0 246833 0 0 0 LINA HWANG URGENT CARE PHYSICIAN 207226 0 0 0 0 0 3561 0 16087 0 226874 0 0 0 JOHVONNE CLAYBOURNE URGENT CARE PHYSICIAN 199644 0 0 0 0 0 1939 0 22579 0 224162 0 0 0 Schedule J, Part I, Line 5 5A, 5B, 6A, 6B THE ECHN EXECUTIVE INCENTIVE COMPENSATION PLAN IS A PLAN THAT HAS BEEN DEVELOPED, REVIEWED AND IS ANNUALLY APPROVED BY MEMBERS OF THE BOARD EXECUTIVE COMPENSATION COMMITTEE WITH CONSULTANT THIRD PARTY OVERSIGHT. THE PLAN ESTABLISHES GOALS IN 4 AREAS OF PERFORMANCE: SYSTEM-WIDE FINANCIAL PERFORMANCE BASED ON PROFIT FROM OPERATIONS, TWO QUALITY OUTCOMES IN CLINICAL CORE MEASURES AND PATIENT SATISFACTION AND AN INDIVIDUAL GOAL (WHICH HAS A SEPARATE MEASUREMENT FOR TEAM ASSESSMENT) FOR EACH MEMBER OF THE INCENTIVE PROGRAM. THERE IS NO EXECUTIVE COMPENSATION TIED TO THE REVENUES OF THE REPORTING ORGANIZATION OR OTHER RELATED ENTITIES. THERE IS EXECUTIVE COMPENSATION TIED TO THE NET EARNINGS (INCOME FROM OPERATIONS), AS NOTED IN THE PRIOR PARAGRAPH, HOWEVER IT IS ONE OF FOUR PERFORMANCE LEVERS THAT DETERMINE THE LEVEL OF COMPENSATION. THE AGGREGATE NET EARNINGS OF THE ECHN "SYSTEM" NOT ANY ONE REPORTING ORGANIZATION OR RELATED ENTITIES OF ECHN DETERMINE THIS COMPENSATION. SO TO CONCLUDE, THE ANSWER TO THESE 4 QUESTIONS IS "NO" WITH THE CLARIFICATION THAT IT IS THE PERFORMANCE OF THE ENTIRE SYSTEM AS A WHOLE THAT DETERMINES EXECUTIVE COMPENSATION, NOT ONE REPORTING ORGANIZATION OR A RELATED ENTITY. MEMBERS OF THE INCENTIVE PROGRAM INCLUDE THE FOLLOWING: POSITION TITLE - KEY EMPLOYEE NAME PRESIDENT AND CEO - PETER J. KARL SVP, CHIEF FINANCIAL OFFICER - MICHAEL D. VEILLETTE SVP, HUMAN RESOURCES - DEBORAH GOGLIETTINO SVP, STRATEGIC PLANNING - DENNIS MCCONVILLE SVP, CHIEF CLINICAL OFFICER - DEBORAH PARKER SVP, MEDICAL AFFAIRS - JOEL REICH, M.D. SVP, GENERAL COUNSEL - JOYCE TICHY Schedule J, Part II SCH J, PART II THE SALARY INFORMATION PROVIDED WITHIN SCHEDULE J REPRESENTS CALENDAR YEAR 2014 WAGES AND BENEFITS. AS COMPARED TO THE PRIOR YEAR RETURN, THE MAJOR CHANGES ARE: THE LONG TERM RETENTION BENEFIT REACHED MATURITY IN 2013 UPON THE COMPLETION OF THE FOUR YEAR VESTING PERIOD. THIS BENEFIT WAS PAID IN 2013 AND WAS FOR VESTING YEARS ENDED 9/30/10, 9/30/11, 9/30/12 AND 9/30/13. THE FOUR VESTED YEARS WERE REPORTED AS DEFERRED INCOME IN PRIOR RETURNS ON SCHEDULE J - LINE F (COMPENSATION REPORTED AS DEFERRED IN PRIOR FORM 990). Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation THE BOARD OF TRUSTEES (THE "BOARD") APPOINTS AN EXECUTIVE COMPENSATION COMMITTEE (THE "COMMITTEE") AND HAS DELEGATED THE RESPONSIBILITY OF COMPLETING AN ANNUAL MARKET ANALYSIS OF THE CEO'S COMPENSATION AND OTHER SENIOR EXECUTIVES AND COMPLETION OF THE CEO'S ANNUAL PERFORMANCE REVIEW. THE EVALUATION OF THE CEO IS AN IMPORTANT RESPONSIBILITY OF THE BOARD AND IS CRITICAL TO THE GOVERNANCE RESPONSIBILITIES OF THE BOARD. THE EXECUTIVE COMPENSATION COMMITTEE SOLICITS FEEDBACK ABOUT THE PERFORMANCE OF THE CEO FROM EVERY ACTIVE BOARD MEMBER WHICH WHEN RECEIVED IS ANALYZED AND REVIEWED BY THE MEMBERS OF THE COMMITTEE. THE CEO COMPLETES A SELF EVALUATION AND AN EVALUATION FOR ALL ELIGIBLE MEMBERS OF THE SENIOR LEADERSHIP TEAM, WHO COMPLETE BOTH A SELF-EVALUATION AND A PEER EVALUATION. THE RESULTS OF THE ASSESSMENTS COMPLETED BY THE MEMBERS OF THE SENIOR LEADERSHIP TEAM ARE REVIEWED BY THE CEO WHO DISCUSSES THE RESULTS WITH THE MEMBERS OF THE COMMITTEE ON AN ANNUAL BASIS. THE EXECUTIVE COMPENSATION COMMITTEE IN COLLABORATION WITH THE CEO EVALUATES AND APPROVES ORGANIZATIONAL PERFORMANCE OBJECTIVES BOTH ON AN ANNUAL AND LONG TERM BASIS AND FOCUSES ON THOSE GOALS WITH THE GREATEST IMPACT TO THE ORGANIZATION'S STRATEGY AND MISSION. THE COMMITTEE ENSURES AN ANNUAL REVIEW OF THE CEO'S PERFORMANCE IN RELATION TO THESE GOALS; REVIEWS THE TALLY SHEETS TO UNDERSTAND THE ECONOMICS OF THE EMPLOYEE BENEFITS; RETAINS AND ENSURES THE INDEPENDENCE OF ITS EXTERNAL CONSULTANTS AND ADVISORS AND INVOLVES RELEVANT ORGANIZATIONAL RESOURCES AS APPROPRIATE TO CARRY OUT ITS RESPONSIBILITIES. THE COMMITTEE ENSURES TRANSPARENCY AND DISCLOSURE TO THE BOARD BY PRESENTING THE RESULTS OF THE ANNUAL PERFORMANCE AND MARKET REVIEWS PROVIDING THE BOARD WITH THE OPPORTUNITY FOR FURTHER INPUT AND CONSIDERATION AND ASKING THAT THE BOARD TAKE ACTION ON THE RECOMMENDATION OF THE COMMITTEE IF THE RECOMMENDATION IS APPROPRIATE. THE BOARD HAS THE OPPORTUNITY TO CHANGE ANY RECOMMENDATIONS OF THE COMMITTEE IF IT SO DESIRES. MEMBERS OF THE BOARD AND OF THE COMMITTEE WHO MAY BE INTERESTED PARTIES ARE ASKED TO RECUSE THEMSELVES FROM ANY REQUIRED VOTES TO AVOID CONFLICTS OF INTEREST. THE COMMITTEE ENSURES THAT THE PROCESS MEETS COMPLIANCE STANDARDS. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: PETER KARL - $84,825 MICHAEL VEILLETTE - $32,300 DEBORAH GOGLIETTINO - $17,663 DEBORAH PARKER - $25,035 DENNIS MCCONVILLE - $15,975 JOEL REICH - $25,845 JOYCE TICHY - $21,000 A STATE OF CONNECTICUT HEALTH & EDL FACS AUTH REV SERIES C 060806186 20774UAZ8 2005-11-09 37579404 ADVANCE REFUND AND DEFEASE A PORTION OF THE SERIES 2000A BONDS (C) false false false B STATE OF CONNECTICUT HEALTH & EDL FACS AUTH REV SERIES D 060806086 NONEAVAIL 2009-05-14 15250000 WOODLAKE EXPANSION, EQUIPMENT PURCHASE, REFUNDING PRIOR ISSUE (SER D) false false false C STATE OF CONNECTICUT HEALTH & EDL FACS AUTH REV SERIES E 060806186 20774U5W1 2010-12-21 20145000 REDEEM PRIOR ISSUE AND FUND INTEREST RATE SWAP TERMINATION PAYMENTS false false false A 0 0 37579404 3556957 0 32759288 632013 631146 0 0 0 0 2006 false true true true B 0 0 15250000 0 0 9966919 305000 0 0 4978081 0 0 2009 true false true true C 0 0 20145000 0 0 17048821 402900 92225 0 0 1536052 0 2011 true false true true A false false false false 0.0 0.0 0.0 false false B false false false false 0.0 0.0 0.0 false false C false false false false 0.0 0.0 0.0 false false A false false false true false false false false true B false false false true true true TD BANK 5.0 true true false false true C false false false true true false false false true A true B true C true Schedule K, Part III SUPPLEMENTAL INFORMATION THE HEDGE SWAP ARRANGEMENT FOR THE SERIES D ISSUE WAS TERMINATED IN MAY 2014. THE SERIES D ISSUE WAS REISSUED ON MARCH 11, 2015 FOR $13,615,000 AND REISSUED AGAIN ON JULY 31, 2015 FOR $13,477,000. THIS REPRESENTED A REISSUANCE OF THE BONDS. NO PROCEEDS WERE REALIZED FROM THE DELIVERY OF THIS ISSUE. THE SERIES C BONDS WERE ISSUED AFTER 12/31/02 TO REFUND BONDS ISSUED BEFORE 1/1/03. AS A RESULT, LINES 1 - 9 OF PART III ARE NOT REQUIRED TO BE COMPLETED. THE $1,536,052 ON LINE 11 COLUMN C REPRESENTS THE FEES TO TERMINATE THE HEDGES/SWAPS. $1,065,000 of the Series E bonds were called for redemption prior to maturity on October 3, 2011. Schedule K, Part IV, Line 2c Rebate Calculation Issuer name: STATE OF CONNECTICUT HEALTH & EDL FACS AUTH REV SERIES C The calculation for computing no rebate due was performed on 11/09/2014 Schedule K, Part IV, Line 2c Rebate Calculation Issuer name: STATE OF CONNECTICUT HEALTH & EDL FACS AUTH REV SERIES D The calculation for computing no rebate due was performed on 03/11/2015 Schedule K, Part IV, Line 2c Rebate Calculation Issuer name: STATE OF CONNECTICUT HEALTH & EDL FACS AUTH REV SERIES E The calculation for computing no rebate due was performed on 12/21/2014 DR DENNIS O'NEILL & DR MICHELE CONLON DRS. O'NEILL AND CONLON, RGH TRUSTEES, EACH OWN MORE THAN 5% OF ECPC. 208380 ECHN, INC. CONTRACTS WITH EASTERN CONNECTICUT PATHOLOGY CONSULTANTS, PC (ECPC), TO PROVIDE PATHOLOGY SERVICES AND LAB MANAGEMENT SERVICES TO MMH AND RGH. ALL PAYMENTS MADE TO ECPC ARE FOR PURPOSES OF OPERATING THE BUSINESS AND MAINTAINING OPERATING CASHFLOW. PAYMENTS ARE NOT DIRECTLY TO ANY OF THE OWNERS. false KATHLEEN O'NEILL RGH TRUSTEE AND FAMILY MEMBER OF DR. DENNIS O'NEILL, TRUSTEE FOR ALL AFFILIATES 0 ECHN trustee and the wife of Dr. Dennis O'Neill, trustee for all affiliates, who has a reportable transaction as noted above. false ANTHONY DISTEFANO MD FORMER RGH TRUSTEE AND SPOUSE OF LIZANNE DISTEFANO, RGH EMPLOYEE 17773 SALARY PAID TO LIZANNE DISTEFANO AS AN EMPLOYEE OF RGH. false WILSON VEGA FORMER RGH TRUSTEE AND PRESIDENT OF CONNECTICUT BUSINESS SYSTEMS (CBS). 130941 ECHN, INC. CONTRACTS WITH CBS TO PROVIDE COPIER SERVICES TO MMH AND RGH. false Form 990, Part III, Line 4d Description of other program services (Expenses $ 28,949,171 including grants of $)(Revenue $ 40,625,673) SEE SCHEDULE H, PART VI Form 990, Part VI, Line 2 Family/business relationships amongst interested persons BOARD MEMBERS DENNIS O'NEILL AND MICHELE CONLON - Business relationship, DENNIS O'NEILL AND KATHLEEN O'NEILL - Family relationship Form 990, Part VI, Line 6 Classes of members or stockholders ECHN IS THE SOLE MEMBER OF THE ORGANIZATION. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body ECHN HAS THE AUTHORITY TO ELECT TRUSTEES AND OFFICERS AND APPOINT COMMITTEE MEMBERS. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders ECHN HAS VARIOUS POWERS INCLUDING BUT NOT LIMITED TO: APPROVING ALL OPERATING AND CAPITAL BUDGETS, CONTROLLING THE INVESTMENT OF FUNDS, LOCATION OF SERVICES, AGREEMENTS AND TRANSACTIONS, AFFILIATIONS, CHANGES, AMENDMENTS, OR RESTATEMENTS OF CERTIFICATES OF INCORPORATION AND BYLAWS, ADOPTING A SYSTEM-WIDE VISION AND STRATEGIC PLANS, AND APPROVING DEBT BORROWINGS. Form 990, Part VI, Line 11b Review of form 990 by governing body PRIOR TO FILING THE 990, THE FOLLOWING STEPS ARE TAKEN: 1) THE ACCOUNTING MANAGER, TOGETHER WITH OTHER MEMBERS OF THE FINANCE DEPARTMENT, CONDUCT A REVIEW OF THE 990 ALONG WITH A REVIEW AND RECONCILIATION OF THE 990 TO THE AUDITED FINANCIAL STATEMENTS; 2) THE ACCOUNTING MANAGER CONDUCTS AN EXTENSIVE REVIEW AND DISCUSSION OF THE 990 WITH THE CPA FIRM THAT PREPARES THE RETURN; 3) AN ELECTRONIC COPY OF THE 990 IS MADE AVAILABLE TO THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES (THE GOVERNING BOARD), AND SENIOR MANAGEMENT OF THE ORGANIZATION, FOR REVIEW. Form 990, Part VI, Line 12c Conflict of interest policy ANNUALLY, THE CORPORATE COMPLIANCE/INTERNAL AUDIT DEPARTMENT PROVIDES TO OFFICERS, DIRECTORS, OR TRUSTEES AND KEY EMPLOYEES THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND DISCLOSURE STATEMENT. EACH INDIVIDUAL IS REQUIRED TO RETURN TO THE DEPARTMENT A SIGNED DOCUMENT, ACKNOWLEDGING RECEIPT OF THE POLICY AND DISCLOSURE STATEMENT AND DISCLOSE ANY INTERESTS THAT COULD GIVE RISE TO CONFLICTS. A SUMMARY OF THE DISCLOSURES IS SHARED WITH THE CHAIRMAN OF THE BOARD OF TRUSTEES AND WITH THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE OF THE BOARD. INDIVIDUALS WHO ARE IDENTIFIED AS HAVING A CONFLICT OF INTEREST ARE PROHIBITED FROM PARTICIPATING IN THE GOVERNING BODIES' DELIBERATIONS AND DECISIONS RELATED TO THE TRANSACTION. THE RETURNED STATEMENTS ARE RETAINED BY THE CORPORATE COMPLIANCE/INTERNAL AUDIT DEPARTMENT. Form 990, Part VI, Line 15a Process to establish compensation of top management official THE COMPENSATION COMMITTEE TAKES THE FOLLOWING STEPS WITH AN INDEPENDENT COMPENSATION CONSULTANT (1) REVIEWS DATA RELATED TO CURRENT MARKET VALUES CONSISTENT FOR ORGANIZATION'S EXECUTIVES BY REVIEW OF COMPENSATION LEVELS AND PLANS CONSISTENT WITH HOSPITALS AND HEALTH SYSTEMS OF COMPARABLE SIZE AND LOCATION; (2) COMPLETES A REVIEW OF DATA ON CURRENT AND FUTURE PLANS FOR THE ORGANIZATION, INCLUDING STRUCTURE AND JOB DESCRIPTIONS; (3) REVIEWS AND APPROVES AND RECOMMENDS SALARY RANGES FOR EACH POSITION, ALONG WITH RELATED BENEFITS; (4) REVIEWS AND APPROVES A TIERED EXECUTIVE STRUCTURE WITH APPROPRIATE INCENTIVE OPPORTUNITY, BENEFITS, AND COMPENSATION. THE LAST COMPENSATION REVIEW OCCURRED 3/19/2015. Form 990, Part VI, Line 15b Process to establish compensation of other employees THE COMPENSATION COMMITTEE TAKES THE FOLLOWING STEPS WITH AN INDEPENDENT COMPENSATION CONSULTANT (1) REVIEWS DATA RELATED TO CURRENT MARKET VALUES CONSISTENT FOR ORGANIZATION'S EXECUTIVES BY REVIEW OF COMPENSATION LEVELS AND PLANS CONSISTENT WITH HOSPITALS AND HEALTH SYSTEMS OF COMPARABLE SIZE AND LOCATION; (2) COMPLETES A REVIEW OF DATA ON CURRENT AND FUTURE PLANS FOR THE ORGANIZATION, INCLUDING STRUCTURE AND JOB DESCRIPTIONS; (3) REVIEWS AND APPROVES AND RECOMMENDS SALARY RANGES FOR EACH POSITION, ALONG WITH RELATED BENEFITS; (4) REVIEWS AND APPROVES A TIERED EXECUTIVE STRUCTURE WITH APPROPRIATE INCENTIVE OPPORTUNITY, BENEFITS, AND COMPENSATION. THE LAST COMPENSATION REVIEW OCCURRED 3/19/2015. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION, WILL, UPON REQUEST, ALLOW FOR REVIEW OF OUR GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND MOST RECENT AUDITED FINANCIAL STATEMENTS AT AN OFFICE OF THE ORGANIZATION. Form 990, Part XI, Line 9 Other changes in net assets or fund balances CHANGE IN BENEFICIAL INTEREST IN TRUST ASSETS - -201449; PENSION AND POSTRETIREMENT RELATED ADJUSTMENTS - -3208195; NET TRANSFER (TO)/FROM AFFILIATES - -1842020; EASTERN CONNECTICUT HEALTH NETWORK INC 71 HAYNES STREET MANCHESTER CT 06040 222546079 INTEGRATED HEALTHCARE SYSTEM PARENT CO CT 501(c)(3 Type III-FI NA false MANCHESTER MEMORIAL HOSPITAL 71 HAYNES STREET MANCHESTER CT 06040 060646710 HOSPITAL CT 501(c)(3 3 ECHN true ECHN COMMUNITY HEALTHCARE FOUNDATION INC 71 HAYNES STREET MANCHESTER CT 06040 222546080 FUNDRAISING/SUPPORT CT 501(c)(3 7 ECHN true ECHN ELDERCARE SERVICES INC 26 SHENIPSIT LAKE ROAD TOLLAND CT 06084 061149193 SKILLED NURSING ACTICITY CT 501(c)(3 9 ECHN true EASTERN CONNECTICUT MEDICAL PROFESSIONAL FOUNDATION INC 71 HAYNES STREET MANCHESTER CT 06040 222546078 PHYSICIAN SERVICES CT 501(c)(3 3 ECHN true VISITING NURSE & HEALTH SERVICES OF CT INC 8 KEYNOTE DRIVE VERNON CT 06066 060646795 HOME HEALTHCARE SERVICES CT 501(c)(3 9 ECHN true MEDICAL PRACTICE PARTNERS PO BOX 3830 VERNON CT 06066 271498877 BILLING AND PRACTICE MANAGEMENT SERVICES CT NA N/A ECHN ENTERPRISES INC 71 HAYNES STREET MANCHESTER CT 06040 222546828 REAL ESTATE HOLDING CT NA C Corporation true HAYNES STREET PROPERTY MANAGEMENT LLC 71 HAYNES STREET MANCHESTER CT 06040 222546028 REAL ESTATE PROPERTY MANAGEMENT CT NA C Corporation true ECHN CORPORATE SERVICES 71 HAYNES STREET MANCHESTER CT 06040 271596320 BILLING AND OTHER PRACTICE MANAGEMENT SERVICES CT NA C Corporation true CONNECTICUT HEALTHCARE INSURANCE COMPANY 980623043 CAPTIVE INSURANCE CJ NA C Corporation true false false false false false false false false false true false true true false false false true true false Eastern CT Medical Professionals Foundation J 63117 market value ECHN Community HealthCare Foundation Inc M 55236 Cost Eastern CT Health Network M 9206811 Cost ECHN ElderCare Services Inc Q 2871748 Cash transfer ECHN Community HealthCare Foundation Inc Q 118392 Cash transfer Eastern CT Medical Professionals Foundation R 1888111 Cash transfer