2016-08-12T15:33:14-05:00 2015-09-30 KPMG LLP One Financial Plaza Hartford CT 061032608 990 2014-10-01 060646844 ST MARY'S HOSPITAL INC % KYLE JURCZYK STMA 2037096111 56 FRANKLIN STREET WATERBURY CT 067061281 CHAD WABLE PRESIDENT AND CEO 2037096111 2016-08-12 true KPMG LLP P00431862 8605223200 2014 2016-09-27 15:27:22Z CHAD WABLE 56 FRANKLIN STREET WATERBURY CT 067061281 279871789 false 0928 X WWW.STMH.ORG X 1907 CT SAINT MARY'S HOSPITAL PROVIDES EXCELLENT HEALTHCARE IN A SPIRITUALLY ENRICHED ENVIRONMENT TO IMPROVE THE HEALTH OF OUR COMMUNITY. 20 15 1930 173 871593 -2564679 1607114 2576451 248807341 260100707 4893950 3042838 7471863 7040929 262780268 272760925 0 0 0 0 109911511 116354894 0 0 0 127849647 134590128 237761158 250945022 25019110 21815903 187153109 183715192 140389197 138551489 46763912 45163703 X SAINT MARY'S HEALTH SYSTEM PROVIDES EXCELLENT HEALTHCARE IN A SPIRITUALLY ENRICHED ENVIRONMENT TO IMPROVE THE HEALTH OF OUR COMMUNITY. SEE SCHEDULE O. false false 96094234 137756272 INPATIENT SAINT MARY'S REMAINS COMMITTED TO PROVIDING THE HIGHEST QUALITY CARE FOR OUR PATIENTS. THE HOSPITAL PROVIDED INPATIENT TREATMENT FOR 11,900 INPATIENTS IN 2015. PLEASE SEE SCHEDULE O FOR ADDITIONAL INFORMATION ABOUT SAINT MARY'S INPATIENT SERVICES PROGRAM. 94467377 127129953 OUTPATIENT SAINT MARY'S HEALTH SYSTEM EXTENDS FROM WATERBURY TO WOLCOTT, NAUGATUCK, SOUTHBURY AND PROSPECT. IN 2015, 232,468 PATIENTS CHOSE SAINT MARY'S FOR OUTPATIENT CARE. PLEASE SEE SCHEDULE O FOR ADDITIONAL INFORMATION ABOUT THE OUTPATIENT SERVICES PROGRAM. 190561611 true true false true false false false false false true true true false false true true false true false false false false false false false false true true false false true false false false false false false true true false false false false true true true true false false true 164 0 true 1930 true true true false false false false false false false false false X 20 15 false false false false false true true true true false false true true true true true true true true true true CT X KYLE JURCZYK 2037096111 56 FRANKLIN STREET WATERBURY CT 067061281 X CHAD WABLE PRESIDENT AND CEO 40.0 10.0 X X 663360 0 176010 JOSEPH CARLSON II TREASURER 4.0 4.0 X X 0 0 0 REV MONSIGNOR JAMES COLEMAN VICE CHAIRMAN 1.0 4.0 X X 0 0 0 STEPHEN R GRIFFIN ESQ SECRETARY 4.0 4.0 X X 0 0 0 S MARK ALBINI MD DIRECTOR 1.0 2.0 X 49000 0 0 GARRETT CASEY DIRECTOR 4.0 2.0 X 0 0 0 SISTER DOLORES LAHR DIRECTOR 2.0 2.0 X 0 0 0 JOSEPH MENGACCI ESQ DIRECTOR 4.0 2.0 X 0 0 0 MICHAEL O'BRIEN DIRECTOR 1.0 1.0 X 0 0 0 ROBERT ROSCOE DIRECTOR 1.0 1.0 X 0 0 0 JAMES C SMITH DIRECTOR 4.0 1.0 X 0 0 0 CHRISTINE SULLIVAN ESQ DIRECTOR 1.0 4.0 X 0 0 0 JAMES UBERTI MD DIRECTOR 1.0 40.0 X 0 198234 7807 MICHAEL KARNASIEWICZ MD DIRECTOR 1.0 1.0 X 0 0 0 ROBERT MAZAIKA CHAIRMAN 2.0 2.0 X X 0 0 0 ERIC ALBERT DIRECTOR 1.0 1.0 X 0 0 0 ROBERT GUMBARDO MD DIRECTOR 4.0 2.0 X 72000 0 0 ANGELA MATTIE DIRECTOR 1.0 1.0 X 0 0 0 RICHARD PUGH DIRECTOR 1.0 1.0 X 0 0 0 FELIX RODRIQUEZ DIRECTOR 1.0 1.0 X 0 0 0 LAURA ST JOHN DIRECTOR 1.0 1.0 X 0 0 0 RALPH BECKER CFO 40.0 0.0 X 311982 0 42634 CHARLES FLINN COO 40.0 0.0 X 297457 0 25457 MICHAEL NOVAK VP OPERATIONS 40.0 0.0 X 284763 0 41417 M CLARK KEARNEY VP HUMAN RESOURCES 40.0 0.0 X 247415 0 37209 JOSEPH CONNOLLY CHIEF MARKETING OFFICER 40.0 0.0 X 206758 0 38346 STEPHEN SCHNEIDER MD CMO 40.0 10.0 X 440872 0 49249 JAMES TUCKER VP AND CHIEF NURSING OFFICER 40.0 0.0 X 187037 0 31645 GEORGE SEMKO DIR. REV. CYCLE (THRU 11/14) 40.0 0.0 X 171550 0 30852 ELIZABETH BOZZUTO VP SURGICAL SERVICES 40.0 0.0 X 337584 0 37257 3269778 198234 517883 137 true true false SODEXHO INC AFFILIATES PO BOX 905374 CHARLOTTE NC 28290 HOSPITAL MGMT SVCS 2880932 MIDDLE CT EMERGENCY PHYSICIANS 1000 RIVER ROAD SUITE 100 CONSHOHOCKEN PA 19428 EMERGENCY ROOM SVCS 2165608 PRECYSE SOLUTIONS LLC PO BOX 11407 BIRMINGHAM AL 35246 CONTRACT LABOR SVCS 3748746 XTEND HEALTHCARE 500 WEST MAIN STREET SUITE 14 HENDERSONVILLE TN 37075 CONTRACT LABOR SVCS 1206376 ANTHELIO ONE FINANCIAL CENTER BOSTON MA 02111 HOSP MGMT/IT HOSTING 2083930 55 X 555243 657692 1363516 2576451 NET PATIENT REVENUE 900099 260100707 260100707 260100707 3286385 5395 3286385 0 0 1413213 1413213 0 1413213 24000 1389213 6867317 7082878 27986 -215561 -27986 -243547 -243547 0 0 0 CAFETERIA & DIETARY 900099 1220795 1220795 MEANINGFUL USE 900099 2067577 2067577 PHYSICIAN MALPRACTICE PREMIUMS 571927 571927 1767417 1497146 270271 5627716 272760925 264886225 871593 4432051 X 0 0 0 0 3784290 1892145 1892145 48073 48073 85511982 72878114 12633868 8476511 7105035 1371476 11859086 9945804 1913282 6674952 5594963 1079989 0 434351 131088 303263 283801 70950 212851 124545 124545 0 0 34904613 21491287 13413326 1045654 784240 261414 8321703 5695404 2626299 0 0 14025648 8315378 5710270 204681 122809 81872 0 244601 146761 97840 962852 240713 722139 0 10804660 2701165 8103495 4135030 2481018 1654012 MEDICAL SUPPLIES 41889763 37700787 4188976 BAD DEBT 8179905 8179905 CONSULTING 2311896 1387138 924758 DUES AND SUBSCRIPTIONS 851940 664864 187076 5864485 3032043 2832442 250945022 190561611 60383411 0 X 24610433 13310208 16948 17133 95342 42586 26815465 28547867 0 0 0 0 -121001 3610061 3644672 3701277 2489313 3439691 205415024 139993715 59767598 65421309 20802742 20283883 48928064 45341177 0 0 0 0 103533 0 187153109 183715192 34904423 39988745 0 0 0 0 19509799 0 0 0 0 0 0 13500000 0 0 85974975 85062744 140389197 138551489 X 27668208 27410639 2414574 1921975 16681130 15831089 46763912 45163703 187153109 183715192 X 21815903 -23416112 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true false true 141245 141245 false false SCHEDULE C - PART II-B - LINE 1I - OTHER ACTIVITIES $1,287 - THE CATHOLIC HEALTH ASSOCATION - ANNUAL MEMBERSHIP DUES $90,000 - LEGAL FEES RELATED TO LOBBYING $33,258 - CONNECTICUT HOSPITAL ASSOCIATION - PORTION OF MEMBERSHIP DUES EXPENDED ON LOBBYING $16,700 - COMPENSATION OF CHIEF MARKETING OFFICER ATTRIBUTABLE TO LOBBYING (APPROXIMATELY 7% OF OFFICER TIME SPENT ON LOBBYING ACTIVITIES) TOTAL OTHER LOBBYING ACTIVITIES: $141,245 17138000 83000 -248000 733000 16240000 16630000 1264000 756000 17138000 15567000 1768000 705000 16630000 13783000 2426000 642000 15567000 14500000 -64000 653000 13783000 0.00000 0.02580 0.97420 true 7385828 7385828 68062303 49991739 18070564 129051155 89618489 39432666 915738 383487 532251 65421309 4908243 F DONOR & HELD IN TRUST BY OTHER 14763715 F MISCELLANEOUS FUNDS 5588 F INVESTMENTS IN JOINT VENTURES 25663631 F 45341177 0 DUE TO REIMBURSEMENT AGENCIES 727351 SELF INSURANCE LIABILITY 3041043 PENSION LIABILITY 74894579 OTHER 931463 CAPITAL LEASE 88770 RAC AND OTHER RESERVES 3070361 ASBESTOS LIABILITY 1219863 WORKERS COMPENSATION RESERVE 1089314 85062744 X SCHEDULE D, PART V, LINE 4 THE INTENDED USE OF THE ENDOWMENT FUNDS IS TO USE THE INCOME GENERATED TO SUPPORT THE MISSION OF THE HOSPITAL. THE HOSPITAL ADOPTED INVESTMENT AND SPENDING POLICIES FOR ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO PROGRAMS SUPPORTED BY ITS ENDOWMENT WHILE SEEKING TO MAINTAIN THE PURCHASING POWER OF THE ENDOWMENT ASSETS. THE HOSPITAL FOLLOWS A POLICY OF SPENDING AN AMOUNT THAT APPROXIMATES THE INVESTMENT INCOME EARNED, IN ADDITION TO SPECIFIC PURCHASES OF CAPITAL EQUIPMENT. ACCORDINGLY, THE HOSPITAL EXPECTS ITS SPENDING POLICY WILL ALLOW ITS ENDOWMENT FUNDS TO BE MAINTAINED IN PERPETUITY BY GROWING AT A RATE AT LEAST EQUAL TO THE PLANNED PAYOUTS. ADDITIONAL REAL ENDOWMENT GROWTH WILL BE PROVIDED THROUGH NEW GIFTS AND ANY EXCESS INVESTMENT RETURN. SCHEDULE D, PART X, LINE 2 THE HOSPITAL IS A TAX-EXEMPT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS GENERALLY EXEMPT FROM INCOME TAXES. THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS HAVE BEEN PREPARED ON THE BASIS THAT ITS TAX-EXEMPT STATUS WILL BE MAINTAINED. The Hospital recognizes the effect of income tax positions only if those positions are more likely than not of being sustained. Recognized income tax positions are measured at the largest amount of benefit that is greater than fifty percent likely to be realized upon settlement. Changes in recognition in measurement are reflected in the period in which the change in judgment occurs. The Hospital did not recognize the effect of any income tax positions in either 2015 or 2014. true true true X 200. true X true true true false true true 1118560 46668 1071892 0.00440 72826441 53891622 18934819 0.07770 73945001 53938290 20006711 0.08210 200781 200781 0.00080 14488876 9512041 4976835 0.02040 3658923 1219820 2439103 0.01000 76697 76697 0.00030 18425277 10731861 7693416 0.03150 92370278 64670151 27700127 0.11360 202 202 169504 169504 169706 169706 true 3082905 2158033 94305076 86782623 7522453 X true true H L CANCER CTR OUTPATIENT CANCER TREATMENT 0.50000 HEART CTR OF FW CARDIAC SERVICES MSO 0.50000 SM INDEMNITY GROUP INSURANCE COMPANY 1.00000 FRANKLIN MEDICAL PRIMARY CARE PHYSICIAN PRACT 1.00000 DIAGNOSTIC IMAGING OUTPATIENT IMAGING CENTER 0.60000 NAUGATUCK VALLEY MRI MAGNETIC IMAGING 0.48000 0.52000 SM PHYSICIAN PTRS ACCOUNTABLE CARE ORG. 1.00000 1 1 SAINT MARY'S HOSPITAL INCORPORATED 56 FRANKLIN STREET WATERBURY CT 06706 X X X X SAINT MARY'S HOSPITAL INCORPORATED 1 false false true X X X X X X X X X 12 true true true true X WWW.STMH.ORG/ABOUT/CHNA X true 12 true WWW.STMH.ORG/ABOUT/CHNA false false true X 200. 400. X X X X true true X X X true X WWW.STMH.ORG X WWW.STMH.ORG X WWW.STMH.ORG X X X X X true X false X X X X true X false false PART V, SECTION B, LINE 5 SAINT MARY'S CONTRACTED WITH HOLLERAN, AN INDEPENDENT RESEARCH AND CONSULTING FIRM LOCATED IN LANCASTER, PENNSYLVANIA, TO CONDUCT RESEARCH IN SUPPORT OF THE CHNA. THE CHNA INCLUDED BOTH QUALITATIVE AND QUANTITATIVE DATA COLLECTION METHODS. QUALITATIVE DATA WERE COLLECTED THROUGH BOTH A KEY INFORMANT ONLINE SURVEY AND SIX FOCUS GROUPS. TWO HUNDRED FIVE COMMUNITY LEADERS, PARTNERS AND HEALTH CARE PROVIDERS PARTICIPATED IN THE ONLINE KEY INFORMANT SURVEY. TWO FOCUS GROUPS WITH HEALTHCARE PROVIDERS WERE HELD AT EACH OF THE HOSPITALS; 24 HEALTH CARE PROVIDERS PARTICIPATED. FOUR FOCUS GROUPS WERE HELD AT NEIGHBORHOOD ASSOCIATIONS IN WATERBURY; 33 LOCAL RESIDENTS PARTICIPATED. QUANTITATIVE DATA WERE COLLECTED THROUGH A STATISTICAL HOUSEHOLD TELEPHONE SURVEY OF 1,100 PEOPLE IN THE SAINT MARY'S SERVICE AREA. THE STATISTICAL HOUSEHOLD SURVEY WAS BASED ON THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) STUDY DEVELOPED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC). THE SURVEY ASSESSED INDICATORS SUCH AS GENERAL HEALTH STATUS, PREVENTION ACTIVITIES (SCREENINGS, ETC.) AND RISK BEHAVIORS (ALCOHOL USE, ETC.). THE RESULTS WERE EXAMINED BY A VARIETY OF DEMOGRAPHIC INDICATORS INCLUDING AGE AND GENDER. SPECIAL ATTENTION WAS GIVEN TO IDENTIFYING THE NEEDS OF UNDERSERVED INDIVIDUALS, INCLUDING LOW-INCOME, MINORITY, AND CHRONIC CONDITION POPULATIONS IN THE SAINT MARY'S SERVICE AREA. IN ADDITION TO THE HOUSEHOLD SURVEY, SECONDARY DATA WERE ALSO ANALYZED AS PART OF THE CHNA. PART V, SECTION B, LINE 11 ON JUNE 18, 2013, THE PARTNERSHIP HELD A PRIORITIZATION SESSION THAT INCLUDED 40 INDIVIDUALS REPRESENTING LOCAL HEALTH AND HUMAN SERVICE AGENCIES, AREA NON-PROFIT ORGANIZATIONS, HEALTH PROVIDERS AND PUBLIC HEALTH REPRESENTATIVES. THE OBJECTIVES OF THE PRIORITIZATION SESSION WERE TO REVIEW THE RECENTLY COMPILED COMMUNITY HEALTH DATA AND HIGHLIGHT KEY RESEARCH FINDINGS; TO GATHER FEEDBACK FROM THE COMMUNITY REPRESENTATIVES; AND TO PRIORITIZE THE COMMUNITY HEALTH NEEDS BASED ON SELECTED CRITERIA. ATTENDEES VOTED ON THE TOP FOUR PRIORITY AREAS. THE SELECTED PRIORITIES ARE (1) ACCESS TO CARE; (2) MENTAL HEALTH AND SUBSTANCE ABUSE; (3) CHRONIC DISEASES - OBESITY, DIABETES, HEART DISEASE AND ASTHMA; AND (4) SMOKING. SAINT MARY'S HAS AN ANNUAL STRATEGIC PLANNING PROCESS THAT IDENTIFIES UNMET COMMUNITY NEEDS WHILE DEPLOYING STRATEGIES TO ADDRESS THESE UNMET COMMUNITY NEEDS AND IMPROVE OUR OVERALL COMMUNITY BENEFIT. SAINT MARY'S ALSO WORKS CLOSELY WITH MANY LOCAL CHARITABLE COMMUNITY SERVICE ORGANIZATIONS TO BOTH IDENTIFY AND ADDRESS COMMUNITY NEEDS. SAINT MARY'S HOSPITAL (SMH) INDIVIDUAL COMMUNITY BENEFIT PROGRAMS HAVE BEEN DESIGNED TO MEET THE LONG-STANDING NEEDS OF INDIVIDUALS LIVING IN THE SERVICE AREA. TO IDENTIFY NEED, SMH HAS RELIED ON EXISTING LOCAL AND REGIONAL NEEDS ASSESSMENTS INCLUDING: UNITED WAY OF GREATER WATERBURY'S COMMUNITY STATUS REPORT (2014); UNITED WAY'S TEN-YEAR PLAN TO END HOMELESSNESS (2014); THE CENTERS FOR DISEASE CONTROL AND PREVENTION BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (2014); CONNECTICUT DEPARTMENT OF PUBLIC HEALTH STATE HEALTH ASSESSMENT (2014); AND THE CONNECTICUT HEALTH CARE SURVEY (2014) BY THE CONNECTICUT HEALTH FOUNDATION. IN ADDITION, THE HOSPITAL USES CONNECTICUT HOSPITAL ASSOCIATION (CHA) ONLINE TOOLS WHICH INCLUDE THE CHIME DECISION SUPPORT TOOL AND CHIME MAPS TO UNDERSTAND SERVICE AREA NEEDS. THE HOSPITAL USES THE CENSUS BUREAU DATABASES AS WELL AS DEMOGRAPHIC REPORTS AVAILABLE THROUGH CLARITAS DATABASES. PART V, SECTION B, LINE 6A & 6B BETWEEN 2012 AND 2013, SAINT MARY'S CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). SAINT MARY'S REACHED OUT TO LOCAL ORGANIZATIONS AND FORMED THE GREATER WATERBURY HEALTH IMPROVEMENT PARTNERSHIP (THE PARTNERSHIP). THE PARTNERSHIP INCLUDES LOCAL NON-PROFIT ORGANIZATIONS (SAINT MARY'S HOSPITAL, WATERBURY HOSPITAL, THE WATERBURY DEPARTMENT OF HEALTH, UNITED WAY OF GREATER WATERBURY, STAYWELL HEALTH CENTER, AND THE CONNECTICUT COMMUNITY FOUNDATION). PARTNERSHIP MEMBERS EACH CONTRIBUTED FINANCIAL RESOURCES TO CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENT. PART V, SECTION B, LINE 22D FREE CARE IS PROVIDED FOR UNINSURED INDIVIDUALS WHOSE INCOME IS BELOW 200% OF THE FEDERAL POVERTY INCOME LEVELS. FOR SELF-PAY ACCOUNTS WHOSE INCOME ARE BETWEEN 200% AND 400% OF THE FEDERAL POVERTY INCOME LEVELS, SMH WILL REDUCE THEIR BILL BY SLIDING SCALE DISCOUNT FOR AN ADDITIONAL CHARITY CARE REDUCTION OF 25% OFF OF THEIR REMAINING ACCOUNT(S) BALANCE(S)FOR A TOTAL DISCOUNT OF UP TO 65%. 9 NAUGATUCK VALLEY SURGICAL CENTER 160 ROBBINS STREET SUITE 1 WATERBURY CT 06708 SURGICAL CENTER THE HAROLD LEEVER CANCER CENTER 1075 CHASE PARKWAY WATERBURY CT 06708 CANCER CENTER SAINT MARY'S MEDICAL IMAGING CENTER 475 CHASE PARKWAY WATERBURY CT 06708 MRI SERVICES SLEEP DISORDER CENTER 1312 WEST MAIN STREET WATERBURY CT 06708 SLEEP CARE OCCPUATION HEALTH & DIAG CENTER 146 HIGHLAND AVENUE WATERBURY CT 06708 OCCUPATIONAL HEALTH, OCCUPATIONAL THERAPY, PHYSICAL THERAPY HEART CENTER OF GREATER WATERBURY 1075 CHASE PARKWAY WATERBURY CT 06708 CARDIAC CARE ST MARY'S HOSP URGENT CARE - NAUGATUCK 799 NEW HAVEN ROAD NAUGATUCK CT 06770 LAB, RADIOLOGY, URGENT CARE ST MARY'S HOSP URGENT CARE - WOLCOTT 503 WOLCOTT ROAD WOLCOTT CT 06716 LAB, RADIOLOGY, URGENT CARE ST MARY'S MEDICAL ONCOLOGY CENTER 1075 CHASE PARKWAY WATERBURY CT 06708 ONCOLOGY PART I, LINE 6A SAINT MARY'S HOSPITAL COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") DURING THE FISCAL YEAR ENDED 9/30/2013. THE CHNA IS ACCESSIBLE ON THE SAINT MARY'S WEBSITE AT WWW.STMH.ORG. PART I, LINE 7A MANY PATIENTS WITHOUT INSURANCE DO NOT COMPLETE THE APPLICATION FOR CHARITY CARE. THE HOSPITAL, UPON PERFORMING A CREDIT CHECK, MAKES A DETERMINATION WHETHER THE PATIENT WOULD HAVE QUALIFIED FOR THE CHARITY CARE. PART I, LINE 7, COLUMN F THE PERCENT OF TOTAL EXPENSE IN PART 1, LINE 7, COLUMN (F) IS CALCULATED BY DIVIDING COLUMN (E), NET COMMUNITY BENEFIT EXPENSE, BY TOTAL EXPENSE. THE BAD DEBT EXPENSE OF $8,179,905 WAS SUBTRACTED FROM THE TOTAL EXPENSE VALUE USED TO CALCULATE THE PERCENTAGES IN PART 1, LINE 7, COLUMN (F). PART I, LINE 7 FOR PART 1, LINE 7 SECTIONS (A) CHARITY CARE AT COST, (B) UNREIMBURSED MEDICAID, (C) UNREIMBURSED COSTS-OTHER MEANS-TESTED GOVERNMENT PROGRAMS THE COSTING METHODOLOGY USED WAS THE COST-TO-CHARGE RATIO USING THE INCOME STATEMENT METHOD. THE COST-TO-CHARGE RATIO WAS DERIVED FROM THE YEAR-END GENERAL LEDGER, CALCULATED BY DIVIDING GROSS EXPENSE (LESS BAD DEBT) MINUS OTHER OPERATING REVENUE BY GROSS PATIENT CHARGES AND APPLIED BY CHARGE LINE APPROPRIATELY. SECTIONS (E) COMMUNITY HEALTH IMPROVEMENT; PORTIONS OF (F) HEALTH PROFESSIONS EDUCATION, (G) SUBSIDIZED HEALTH SERVICES, (H) RESEARCH, AND (I) CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS ARE COMPRISED (EXCEPT FOR CASH DONATIONS AND IN-KIND MATERIAL DONATIONS) OF 1) SUPPLY EXPENSES; 2) PURCHASED SERVICES; 3) TUITION WAIVERS; AND 4) THE DIRECT SALARY COSTS FOR STAFF COMPENSATED BY THE HOSPITAL AND SPENT TIME PARTICIPATING IN ACTIVITIES THAT QUALIFY AS COMMUNITY BENEFITS. THE INTERN, RESIDENT AND FELLOW PORTION OF SECTION (F) HEALTH PROFESSIONS EDUCATION ALSO INCLUDES THE SALARIES, FRINGE BENEFITS AND OTHER EXPENSES OF THE RESIDENCY PROGRAM DERIVED FROM THE GENERAL LEDGER. INDIRECT COSTS WERE ALSO APPLIED. THE COST ACCOUNTING METHODOLOGY WAS USED TO DETERMINE NET COMMUNITY BENEFIT EXPENSE FOR (G) SUBSIDIZED HEALTH SERVICES, WHICH INCLUDE IP AND OP PSYCHIATRY SERVICE LINES AND SERIES/RECURRING. PART III, LINE 4 THE FINANCIAL STATEMENTS DO NOT HAVE A FOOTNOTE FOR BAD DEBT EXPENSE BUT BELOW IS THE FOOTNOTE FOR THE ALLOWANCE FOR BAD DEBTS. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER THEIR FINANCIAL ASSISTANCE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN THEIR ESTABLISHED RATES. BECAUSE THE HOSPITAL DOES NOT ANTICIPATE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. THE HOSPITAL GRANTS CREDIT WITHOUT COLLATERAL TO PATIENTS, MOST OF WHOM ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD-PARTY ARRANGEMENTS. ADDITIONS TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS ARE MADE BY MEANS OF THE FOR BAD DEBTS. ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE AND SUBSEQUENT RECOVERIES ARE ADDED. THE AMOUNT OF THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. PART III, SECTION A: LINES 2 & 3 THE HOSPITAL USED A COST TO CHARGE RATIO TO CALCULATE THE AMOUNTS RECORDED IN LINES 2 AND 3. WE REASONABLY ESTIMATED THE AMOUNT OF BAD DEBTS THAT WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY, IF THE PATIENTS WOULD HAVE APPLIED OR PROVIDED SUFFICIENT INFORMATION. WE DID NOT INCLUDE THIS AMOUNT IN THE COMMUNITY BENEFIT. PART III, LINE 8 THERE IS NO SHORTFALL REPORTED IN LINE 7, THEREFORE, WE DID NOT INCLUDE IN COMMUNITY BENEFIT. WE UTILIZED THE COST TO CHARGE RATIO TO ESTIMATE THE MEDICARE ALLOWABLE COSTS OF CARE. PART III, LINE 9B A PATIENT MAY REQUEST CHARITY CARE AT ANY TIME IN THE BILLING AND COLLECTION PROCESS. IF THE HOSPITAL, ITS COLLECTION AGENT, OR ITS ATTORNEY BECOMES AWARE THAT THE PATIENT OR GUARANTOR REQUESTS CHARITY CARE, THE COLLECTION PROCESS WILL BE PROMPTLY DISCONTINUED WHILE THE ELIGIBILITY STATUS OF THE PATIENT OR GUARANTOR REQUESTING ASSISTANCE IS DETERMINED. WHENEVER IT IS DETERMINED THAT THE PATIENT QUALIFIES FOR CHARITY CARE, THE FINANCIAL COUNSELOR WILL ADJUST THE BALANCE BY THE APPROPRIATE AMOUNT, AND ANY RESULTING BALANCE WILL BECOME THE PATIENT'S RESPONSIBILITY. PART VI, LINE 3 THERE ARE BROCHURES AND SIGNAGE IN FOUR LANGUAGES INDICATING THAT FINANCIAL ASSISTANCE IS AVAILABLE TO QUALIFIED PATIENTS AND THEIR FAMILIES. SIGNAGE IS LOCATED IN REGISTRATION, EMERGENCY DEPARTMENT, ALL SOCIAL SERVICES DEPARTMENTS, CASHIER'S OFFICE, PATIENT FINANCIAL SERVICES AND THE LOBBY. THE SIGNAGE EXPLAINS THE POLICY AND HOW TO APPLY. IN ADDITION, FINANCIAL COUNSELORS ARE AVAILABLE TO MEET WITH INDIVIDUAL PATIENTS TO ASSIST DURING THE PROCESS. ALL FAMILIES OF ELIGIBLE CHILDREN, REGARDLESS OF INCOME, RECEIVE CARE COORDINATION SERVICES IN PARTNERSHIP WITH THEIR CHILD'S MEDICAL HOME UNDER THE SAINT MARY'S PROGRAM. FAMILY AND COMMUNITY REFERRALS, DIRECT SERVICES, ADVOCACY AND LINKS TO PARENT SUPPORT SERVICES ARE ALSO PROVIDED. A LIMITED NUMBER OF FAMILIES RECEIVE RESPITE AND CAMP FUNDS. UNINSURED OR UNDERINSURED FAMILIES WHO FALL WITHIN THE TITLE V EXTENDED SERVICE FUNDS ELIGIBILITY GUIDELINES CAN ALSO BENEFIT FROM PAYMENT FOR EXTENDED SERVICES (I.E. DURABLE MEDICAL EQUIPMENT, PRESCRIPTIONS, SPECIALTY VISITS, THERAPIES AND SPECIAL NUTRITIONAL FORMULAS). PATIENT FINANCIAL AID SAINT MARY'S HOSPITAL PROVIDES FINANCIAL ASSISTANCE TO PATIENTS WHO QUALIFY FOR THE HOSPITAL'S "BED FUND" OR OTHER FINANCIAL ASSISTANCE PROGRAMS. IF A PATIENT IS UNINSURED OR OTHERWISE UNABLE TO PAY HIS OR HER MEDICAL BILLS, HE OR SHE MAY QUALIFY FOR THE HOSPITAL BED FUND. IN ORDER TO QUALIFY, A PATIENT MUST MEET CERTAIN CRITERIA, INCLUDING HAVING A HOUSEHOLD INCOME AT OR BELOW 400% OF THE FEDERAL POVERTY LIMITS. IF A PATIENT QUALIFIES FOR THE "BED FUND," OR ANY OTHER FINANCIAL ASSISTANCE PROGRAMS, THE PATIENT WILL BE NOTIFIED WITHIN THIRTY (30) DAYS OF RECEIPT OF APPLICATION. IF A PATIENT'S APPLICATION IS DENIED, AN EXPLANATION WILL BE PROVIDED. THE PATIENT MAY REAPPLY AT ANY TIME AND THE APPLICATION WILL BE REASSESSED BASED ON THE AVAILABILITY OF ADDITIONAL FUNDS OR A CHANGE IN THE PATIENT'S FINANCIAL STATUS. PART VI, LINE 4 SAINT MARY'S TOTAL SERVICE AREA IS COMPRISED OF 35 ZIP CODES, WHICH INCLUDE THE CITY OF WATERBURY AND 17 SURROUNDING TOWNS. THE PRIMARY SERVICE AREA (WHICH INCLUDES WATERBURY, NAUGATUCK, PROSPECT AND WOLCOTT, CT) HAS A POPULATION OF APPROXIMATELY 168,000. THE SECONDARY SERVICE AREA HAS A POPULATION OF APPROXIMATELY 153,000. THE MAJORITY OF SAINT MARY'S HOSPITAL PATIENTS LIVE IN THE CITY OF WATERBURY WHICH IS PARTICULARLY ECONOMICALLY DISTRESSED. THE MEDIAN HOUSEHOLD INCOME IS $41,136, WHICH IS SIGNIFICANTLY LESS THAN THE OVERALL SERVICE AREA, WHICH IS APPROXIMATELY $70,000. THE UNEMPLOYMENT RATE IN THE CITY OF WATERBURY IN SEPTEMBER 2015 WAS 10.7%. THIS IS HIGHER THAN THE STATE OF CONNECTICUT UNEMPLOYMENT RATE OF 6.6% APPROXIMATELY 31.6% OF THE POPULATION IN WATERBURY SPEAKS A LANGUAGE OTHER THAN ENGLISH IN THE HOME. THIS IS HIGHER THAN THE STATE OF CONNECTICUT WHERE 20.8% OF THE POPULATION SPEAKS A LANGUAGE OTHER THAN ENGLISH IN THE HOME. IN ADDITION, 24.2% OF FAMILIES IN WATERBURY HAVE POVERTY STATUS COMPARED TO 10.5% IN CONNECTICUT. CENTRAL WATERBURY HAS BEEN DESIGNATED A MEDICALLY UNDERSERVED AREA (MUA) AND MEDICALLY UNDERSERVED POPULATION (MUP) BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA). HRSA HAS ALSO DESIGNATED CENTRAL WATERBURY AS A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) FOR PRIMARY MEDICAL CARE, DENTAL CARE AND MENTAL HEALTH. PART II AND PART VI, LINE 5 SMH'S COMMUNITY BUILDING ACTIVITIES INCLUDE THE FOLLOWING: DISASTER PREPAREDNESS; CONTRIBUTIONS TO THE WATERBURY ELIMINATES LEAD HAZARDS PROGRAM; HEALTH CARE ADVOCACY; A VARIETY OF WORKFORCE DEVELOPMENT INITIATIVES INCLUDING LECTURES TO ADDRESS HEALTHCARE WORKFORCE SHORTAGES, RECRUITING MINORITIES AND DIVERSE LANGUAGES, AND SPEAKING TO YOUTH ABOUT CAREERS IN HEALTHCARE; PARTICIPATION IN THE CONNECTICUT HOSPITAL ASSOCIATION'S DIVERSITY COLLABORATIVE; UNITED WAY DAY OF CARING; AND PUBLIC LANDSCAPE ENHANCEMENT AMONG OTHERS. THESE ACTIVITIES PROMOTE HEALTH IN MANY WAYS. THE EFFORTS OF OUR DISASTER PREPAREDNESS COMMITTEE ABOVE AND BEYOND WHAT IS REQUIRED OF THEM HELPS TO PREPARE OUR STAFF AND COORDINATE PLANS WITH OTHER LOCAL AGENCIES (FIRE, POLICE, ETC) IN THE EVENT THAT A LOCAL DISASTER WOULD OCCUR. THE WATERBURY ELIMINATES LEAD HAZARDS PROGRAM COLLABORATES WITH OTHER LOCAL AGENCIES TO IDENTIFY LEAD HAZARDS IN THE COMMUNITY AND EDUCATE AND TREAT INDIVIDUALS IN AN EFFORT TO PREVENT LEAD HAZARDS THROUGHOUT THE COMMUNITY. A VARIETY OF SMH STAFF ADVOCATE FOR HEALTHCARE REFORM BOTH LOCALLY AND AT THE STATE LEVEL IN AN EFFORT TO IMPROVE ACCESS TO HEALTHCARE AND PUBLIC HEALTH. THE VARIOUS WORKFORCE DEVELOPMENT INITIATIVES ASSURE ACCESS TO HEALTHCARE SERVICES IN OUR COMMUNITY WHILE MAINTAINING HUMAN RESOURCES. BOTH THE UNITED WAY DAY OF CARING AND PUBLIC LANDSCAPE ENHANCEMENT CLEAN UP OUR COMMUNITIES TO PROVIDE A SAFE AND HEALTHY ENVIRONMENT FOR EVERYONE TO WORK, PLAY AND LIVE. PART II AND PART VI, LINE 5 SAINT MARY'S HOSPITAL OFFERS A VARIETY OF FREE PROGRAMS AND SERVICES THAT ARE SUBSIDIZED BY THE HOSPITAL. FROM MEDICAL AND SURGICAL SERVICES FOR THE UNINSURED AND UNDERINSURED TO HEALTH EDUCATION, SUPPORT GROUPS AND COMMUNITY OUTREACH PROGRAMS, SAINT MARY'S PLAYS AN INTEGRAL ROLE IN THE COMMUNITY WHILE RESPONDING TO THE UNIQUE HEALTHCARE NEEDS OF THE RESIDENTS OF GREATER WATERBURY. AN EXAMPLE OF ONE OF THE SEVERAL SAINT MARY'S MANY COMMUNITY BENEFIT SERVICES INCLUDE THE EARLY DETECTION PROGRAM FOR BREAST, CERVICAL, AND COLORECTAL CANCER. AS THE ONLY HOSPITAL IN WATERBURY OFFERING THIS PROGRAM, IT HAS ASSISTED AND SCREENED MORE THAN 3,200 UNINSURED OR UNDERINSURED WOMEN AND MEN SINCE THE PROGRAM BEGAN IN 1995. PATIENTS RECEIVE FREE SCREENING AND DIAGNOSTIC SERVICES AND WORK DIRECTLY WITH A BILINGUAL NURSE CASE MANAGER TO ADDRESS BARRIERS TO CARE IF FACED WITH A HIGH RISK OR CANCER DIAGNOSIS. TO DATE, 76 WOMEN HAVE BEEN DIAGNOSED WITH BREAST OR CERVICAL CANCER THROUGH OUR PROGRAM. THESE WOMEN HAVE RECEIVED APPROPRIATE AND TIMELY FOLLOW-UP CARE AND TREATMENT. AFTER ALMOST TWO DECADES OF SERVICE, THE EARLY DETECTION PROGRAM CONTINUES TO IMPACT THE LIVES OF WOMEN AND THEIR FAMILIES. THE PROGRAM IS OFFERED THROUGH THE SAINT MARY'S FAMILY HEALTH CENTER. OTHER EXAMPLES OF SAINT MARY'S COMMUNITY BENEFIT PROGRAMS AND SERVICES INCLUDE SUPPORT GROUPS THAT ARE HOSTED AND SUPPORTED BY THE HOSPITAL. THE BARIATRIC SUPPORT GROUP AT SAINT MARY'S IS HELD ON A MONTHLY BASIS AND TYPICALLY ASSISTS 40 PATIENTS PER MONTH TO PROVIDE PROFESSIONAL, COMPASSIONATE SUPPORT BEFORE, DURING AND AFTER PATIENTS WEIGHT LOSS SURGERY. IN ADDITION, SAINT MARY'S HAS JOINED THE SPIRIT OF WOMEN NETWORK, A NATIONAL ORGANIZATION WHICH ENGAGES, EDUCATES, AND MOTIVATES WOMEN TO TAKE ACTION FOR BETTER HEALTH FOR THEMSELVES AND THEIR FAMILIES THROUGH INSPIRING EXPERIENCES, EVENTS, AND HEALTHCARE COMMUNICATIONS. IN THE 2015 FISCAL YEAR, MORE THAN 900 WOMEN ATTENDED 3 EVENTS THAT WERE HELD AT LOCAL COMMUNITY VENUES. ONE OF THE PROGRAMS THAT HAS HAD AN INCREDIBLE IMPACT IS CALLED "THE PUMP CLUB," A INITIATIVE STARTED BY THE AMERICAN COLLEGE OF CARDIOLOGY'S PATIENT NAVIGATOR PROGRAM. THIS PROGRAM HELPS CARDIAC PATIENTS OVERCOME CHALLENGES IN THE WEEKS FOLLOWING THEIR HOSPITAL DISCHARGE AND HELPS THEM AVOID READMISSION. PUMP CLUB MEMBERS COME TO THE HOSPITAL FOR POST-DISCHARGE EDUCATION, HELP MANAGING THEIR MEDICATIONS, IV THERAPY, AND OTHER TREATMENT. DURING EACH VISIT, THE STAFF GO BEYOND THE CLINICAL NEEDS OF PATIENTS TO ADDRESS THEIR SOCIOECONOMIC NEEDS AND ELIMINATE BARRIERS TO CARE. WITHOUT THE PUMP CLUB, MANY PATIENTS WOULD STRUGGLE TO MANAGE THEIR HEART FAILURE AND INEVITABLY SEEK CARE IN THE EMERGENCY DEPARTMENT. WITH OVER 60 MEMBERS, THE TEAM HAS ESTABLISHED AND MAINTAINS A FRAMEWORK TO KEEP ITS MEMBERS AS HEALTHY AND STABLE AS POSSIBLE.IN ADDITION TO THESE PROGRAMS SAINT MARY'S ALSO HAS SUCCESSFUL PARTNERSHIPS WITH OTHER COMMUNITY ORGANIZATIONS SUCH AS THE GREATER WATERBURY UNITED WAY, WELLMORE BEHAVIORAL HEALTH FOR CHILDREN AND FAMILIES, AND THE MORRIS FOUNDATION, WHICH OFFERS TREATMENT, PREVENTION, EDUCATION, AND RECOVERY SUPPORT FOR INDIVIDUALS WITH SUBSTANCE ABUSE AND BEHAVIORAL HEALTH ISSUES. THE HOSPITAL HAS ALSO FORGED COLLABORATIONS TO BRING WORLD-CLASS HEALTHCARE SERVICES TO THE COMMUNITY THROUGH: - THE HAROLD LEEVER REGIONAL CANCER CENTER, A FREESTANDING 40,000-SQUARE-FOOT FACILITY DEDICATED TO OUTPATIENT CANCER CARE, WHICH IS A JOINT VENTURE PARTNERSHIP BETWEEN SAINT MARY'S HOSPITAL AND WATERBURY HOSPITAL; THE HEART CENTER OF GREATER WATERBURY, WHICH PROVIDES ADVANCED CARDIAC SERVICES, INCLUDING ANGIOPLASTY AND OPEN HEART SURGERY, THROUGH A PARTNERSHIP BETWEEN SAINT MARY'S HOSPITAL, WATERBURY HOSPITAL AND THE UNIVERSITY OF CONNECTICUT HEALTH CENTER/JOHN DEMPSEY HOSPITAL. EXTENDING ITS REACH. IN THE PAST, SAINT MARY'S FAMILY HEALTH CENTER HAS BEEN RECOGNIZED BY THE CONNECTICUT LEGISLATURE, STATE CHILD ADVOCACY GROUPS AND THE NATIONAL INITIATIVE FOR CHILD HEALTHCARE QUALITY AS A LEADER AND MODEL PRACTICE IN THE CARE OF CHILDREN WITH SPECIAL HEALTHCARE NEEDS BASED ON ITS "MEDICAL HOME" MODEL OF CARE. FORMALLY KNOWN AS THE NORTHWEST REGIONAL MEDICAL HOME SUPPORT CENTER, THIS HOSPITAL-BASED PROGRAM PROVIDES ASSISTANCE TO CAREGIVERS OF CHILDREN WITH SPECIAL HEALTHCARE NEEDS AND HAS EXPANDED TO FIVE LOCATIONS: SAINT MARY'S CHILDREN'S FAMILY HEALTH CENTER, LITCHFIELD COUNTY PEDIATRICS IN TORRINGTON, PEDIATRIC ASSOCIATES OF WESTERN, CT, PEDIATRIC ASSOCIATES OF CT AND THE MEDICAL/PEDIATRICS RESIDENCY TRAINING PROGRAM OPERATED JOINTLY BY SAINT MARY'S HOSPITAL AND YALE-NEW HAVEN HOSPITAL. THE PROGRAM PROVIDES: O CARE COORDINATION O FAMILY SUPPORT O ADVOCACY O TITLE V FUNDS O BENEFITS COORDINATION WORKING WITH CAREGIVERS, THE "MEDICAL HOME" PROGRAM HELPS CREATE CUSTOMIZED CARE PLANS AND BRINGS TOGETHER RESOURCES THAT FAMILIES WITH CHILDREN OF SPECIAL NEEDS DEPEND UPON. THE PROGRAM PARTNERS WITH PEDIATRIC CARE PROVIDERS TO MEET THE DIVERSE NEEDS OF CAREGIVERS AND FAMILIES OF CHILDREN WITH SPECIAL HEALTHCARE NEEDS. WORKING THROUGH REHABILITATION AND SCHOOL SERVICES, COMMUNITY AGENCIES AND DEPARTMENT OF SOCIAL SERVICES, THE PROGRAM ESTABLISHES TRANSITION PLANS FOR CHILDREN LEAVING THE PROGRAM AT AGE 21. THE UNITED STATES MATERNAL AND CHILD HEALTH BUREAU DEFINES CHILDREN WITH SPECIAL HEALTHCARE NEEDS (CSHCN) AS THOSE WHO HAVE OR ARE AT INCREASED RISK FOR: CHRONIC PHYSICAL, DEVELOPMENTAL, BEHAVIORAL OR EMOTION CONDITIONS (EXPECTED TO LAST AT LEAST A YEAR); AND THOSE WHO REQUIRE HEALTH AND RELATED SERVICES OF A TYPE OR AMOUNT BEYOND THAT REQUIRED BY CHILDREN GENERALLY. EIGHTEEN PERCENT OF CHILDREN IN THE UNITED STATES ARE INCLUDED IN THAT DEFINITION. IN ADDITION TO THE COMMUNITY BUILDING ACTIVITIES IDENTIFIED IN RESPONSE TO QUESTION 5 AND THE QUANTIFIED FREE OR DISCOUNTED HEALTH SERVICES IDENTIFIED IN THE REPORTED CHARITY CARE FIGURES, SMH PROVIDES OTHER COMMUNITY BENEFITS. EXAMPLES INCLUDE SCREENINGS, LECTURES, HEALTH FAIRS, SUPPORT GROUPS, CONSULTATIONS, REFERRALS TO OUTSIDE AGENCIES AND OTHERS. HEALTH PROFESSIONS EDUCATION: SMH IS A TEACHING HOSPITAL AND IS COMMITTED TO PREPARING FUTURE HEALTHCARE PROFESSIONALS. THIS CATEGORY REPRESENTS THE MAJORITY OF SMH'S COMMUNITY BENEFIT ACTIVITIES AND INCLUDES EFFORTS TO GENERATE INTEREST IN HEALTH PROFESSIONS AS WELL AS PROVIDING A CLINICAL SITE FOR MEDICAL STUDENTS, HIGH SCHOOL STUDENTS AND COLLEGES FOR STUDENTS WHO ARE PURSUING DEGREES AS NURSES, PHYSICIAN ASSISTANTS (PA), OCCUPATIONAL, SPEECH AND PHYSICAL THERAPISTS, DENTAL HYGIENISTS, RADIOLOGY TECHNOLOGISTS AND MORE. SUBSIDIZED SERVICES: SMH PROVIDES HEALTH SERVICES TO PATIENTS WITH NO INSURANCE OR STATE INSURANCE INCLUDING EMERGENCY SERVICES AND BEHAVIORAL HEALTH CLINICS. FINANCIAL AND IN-KIND CONTRIBUTIONS: SMH FINANCIALLY SUPPORTS OTHER COMMUNITY ORGANIZATIONS THROUGH SPONSORSHIPS AND IN-KIND DONATIONS VIA TIME SPENT BY STAFF IN THE COMMUNITY ON LOCAL BOARDS AND VOLUNTEERING TIME FOR LOCAL ORGANIZATIONS. COMMUNITY BENEFIT OPERATIONS: THE COSTS ASSOCIATED WITH PLANNING AND OPERATING COMMUNITY BENEFIT PROGRAMS ARE IN ITSELF A BENEFIT TO THE COMMUNITY. THIS CATEGORY ALSO INCLUDES COSTS ASSOCIATED WITH CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT AS WELL AS DEVELOPING AN IMPLEMENTATION STRATEGY. PART VI, LINE 6 SAINT MARY'S HOSPITAL PLAYS AN INDISPENSABLE ROLE IN THE HEALTHCARE DELIVERY SYSTEM FOR THE GREATER WATERBURY COMMUNITY AND THE TOWNS OF THE CENTRAL NAUGATUCK VALLEY. FOUNDED IN 1907 BY THE SISTERS OF SAINT JOSEPH OF CHAMBERY, SAINT MARY'S HAS BEEN THE CATHOLIC BEACON OF HEALING AND HOPE IN THE COMMUNITY FOR 100 YEARS. BUILT IN THE HEART OF THE CITY AND WITHIN CLOSE DISTANCE OF ITS ONCE-THRIVING BRASS MILLS SO THAT IT COULD RESPOND READILY TO INJURED WORKERS, THE HOSPITAL HAS EVOLVED INTO A DIVERSE HEALTH SYSTEM THAT TODAY PROVIDES A VARIETY OF HEALTHCARE, EDUCATIONAL, FINANCIAL AND OTHER BENEFITS TO THE PEOPLE IT SERVES. SMH AFFILIATED ORGANIZATIONS SHARE THE GOAL OF PROMOTING HEALTHY LIVING AND DISEASE DETECTION AND PREVENTION THROUGHOUT THE WATERBURY COMMUNITY. THE HEART CENTER OF GREATER WATERBURY IS A PARTNERSHIP ORGANIZATION WITH SOLE MEMBERS: SAINT MARY'S HOSPITAL AND WATERBURY HOSPITAL. THE HEART CENTER PROMOTES HEALTHY LIVING AND CARDIOVASCULAR DISEASE DETECTION THROUGH SUPPORT GROUPS, SCREENINGS, COMMUNITY HEALTH BOARD INVOLVEMENT, AND COMMUNITY EDUCATION. THE HAROLD LEEVER CANCER CENTER IS A PARTNERSHIP ORGANIZATION WITH SOLE MEMBERS: SAINT MARY'S HOSPITAL AND WATERBURY HOSPITAL. THE HAROLD LEEVER CANCER CENTER PROMOTES CANCER AWARENESS AND SUPPORT FOR PATIENTS THROUGH SUPPORT GROUPS, SCREENINGS AND COMMUNITY EDUCATION. SAINT MARY'S HOSPITAL FOUNDATION IS A 501(C)(3) WHOLLY OWNED SUBSIDIARY COMPANY OF SAINT MARY'S HEALTH SYSTEM. THE FOUNDATION SUPPORTS THE HOSPITAL'S MISSION BY RAISING MONEY TO BENEFIT A VARIETY OF COMMUNITY NEEDS. FRANKLIN MEDICAL GROUP IS A CAPTIVE PROFESSIONAL CORPORATION OF MULTI-SPECIALTY PHYSICIANS AFFILIATED WITH SAINT MARY'S HOSPITAL. THE MEDICAL GROUP OPERATES THE CHILDREN'S AND FAMILY HEALTH CENTER, DENTAL CLINIC AND A VARIETY OF CLINICS OFTEN BENEFITING THE UNINSURED POPULATION. IN ADDITION TO PATIENT CARE, PATIENTS BENEFIT FROM A VARIETY OF FREE OR DISCOUNTED SERVICES. PART VI, LINE 7 CT PART I, LINE 3C OUTSTANDING PATIENT ACCOUNT BALANCES LABELED AS SELF PAY, MAY BE SENT TO AN OUTSIDE VENDOR FOR CREDIT CHECKS. PATIENTS THAT MEET CERTAIN CRITERIA WILL BE WRITTEN OFF TO CHARITY CARE. X X X X true true false false false true false false false CHAD WABLE PRESIDENT AND CEO 548362 0 101719 0 13279 0 141457 0 34553 0 839370 0 0 0 JAMES UBERTI MD DIRECTOR 0 197494 0 0 0 740 0 3950 0 3857 0 206041 0 0 MICHAEL NOVAK VP OPERATIONS 239413 0 44936 0 414 0 11925 0 29492 0 326180 0 0 0 M CLARK KEARNEY VP HUMAN RESOURCES 208199 0 37943 0 1273 0 11133 0 26076 0 284624 0 0 0 JOSEPH CONNOLLY CHIEF MARKETING OFFICER 174073 0 32333 0 352 0 9304 0 29042 0 245104 0 0 0 STEPHEN SCHNEIDER MD CMO 372090 0 67594 0 1188 0 11925 0 37324 0 490121 0 0 0 ELIZABETH BOZZUTO VP SURGICAL SERVICES 292400 0 44254 0 930 0 11925 0 25332 0 374841 0 0 0 JAMES TUCKER VP AND CHIEF NURSING OFFICER 186687 0 0 0 350 0 3741 0 27904 0 218682 0 0 0 GEORGE SEMKO DIR. REV. CYCLE (THRU 11/14) 171229 0 0 0 321 0 9336 0 21516 0 202402 0 0 0 RALPH BECKER CFO 311091 0 0 0 891 0 11925 0 30709 0 354616 0 0 0 CHARLES FLINN COO 297254 0 0 0 203 0 8935 0 16522 0 322914 0 0 0 SCHEDULE J, PART I, LINE 4A ELIZABETH BOZZUTO'S EMPLOYMENT CONTRACT INCLUDED A PROVISION FOR SALARY CONTINUATION. FOR PURPOSES OF SCHEDULE J, THE AMOUNT IS INCLUDED IN OTHER REPORTABLE COMPENSATION IN COLUMN B(III). SCHEDULE J, PART I, LINE 4B CHAD WABLE PARTICIPATES IN A 457(F) DEFERRED COMPENSATION PLAN. THE AMOUNT OF 457(F) BENEFITS ACCRUED IS INCLUDED IN PART II, COLUMN C. SCHEDULE J, PART I, LINE 6A EACH SENIOR LEADER IS PROVIDED A BONUS BASED ON NET EARNINGS AND OTHER CORPORATE GOALS. THE BONUS IS CONTINGENT ON CORPORATE GOALS AND OBJECTIVES EACH YEAR. DURING FY2015, THERE WERE 5 OBJECTIVES: PEOPLE, SERVICE, QUALITY, FINANCE, AND GROWTH. THE BONUS IS COMPUTED ON A PERCENTAGE ALLOCATION FOR THE WEIGHT OF EACH OBJECTIVE WHICH IS DIFFERENT FOR EACH SENIOR LEADER BASED ON THEIR JOB FUNCTION. KIMBERLY ROSCOE SPOUSE OF BOARD MEMBER 48073 See Part V for Description false SCHEDULE L, PART IV KIMBERLY ROSCOE IS THE SPOUSE OF BOARD MEMBER ROBERT ROSCOE. DURING 2014, THE HOSPITAL PAID MRS. ROSCOE $48,073 IN TOTAL COMPENSATION, WHICH INCLUDES SALARY AND BENEFITS. PART IV, LINE 28C SMH HAS NO TRANSACTIONS TO REPORT BASED ON THE CURRENT INSTRUCTIONS. PART III, LINE 4A INPATIENT SERVICES SAINT MARY'S REMAINS COMMITTED TO PROVIDING THE HIGHEST QUALITY CARE FOR OUR PATIENTS. THE HOSPITAL PROVIDED INPATIENT TREATMENT FOR 11,900 INPATIENTS IN 2015, WITH AN AVERAGE LENGTH OF STAY OF 4.1 DAYS. SAINT MARY'S THREE LARGEST PROGRAMS ARE SURGERY, CARDIOLOGY AND MEDICINE. IN 2015, 868 PATIENTS CHOSE TO HAVE GENERAL SURGERY AT SAINT MARY'S, STAYING AT THE HOSPITAL FOR A TOTAL OF 4,660 DAYS AND GENERATED $15 MILLION IN REVENUE; 1,351 PATIENTS CHOSE SAINT MARY'S FOR CARDIAC CARE, STAYING IN THE HOSPITAL FOR A TOTAL OF 5,790 DAYS AND GENERATING $20 MILLION IN REVENUE; AND 4,349 PATIENTS RECEIVED INPATIENT MEDICAL CARE, STAYING IN THE HOSPITAL FOR A TOTAL OF 20,071 DAYS, AND GENERATING $42 MILLION IN REVENUE. AS THE HOSPITAL CONTINUES TO DISTINGUISH ITSELF AS A LEADING PROVIDER OF HEALTHCARE SERVICES IN THE REGION, IT HAS GARNERED RECOGNITION FROM STATE AND NATIONAL ORGANIZATIONS FOR PROVIDING OUTSTANDING PATIENT CARE. SAINT MARY'S HOSPITAL IS RANKED AS THE TOP-PERFORMING HOSPITAL IN CONNECTICUT FOR DELIVERING PERCUTANEOUS CORONARY INTERVENTION (PCI), A LIFE-SAVING PROCEDURE THAT OPENS THE BLOCKED ARTERIES OF HEART ATTACK PATIENTS. THE NATIONAL STANDARD STATES THAT PATIENTS SHOULD RECEIVE THIS PROCEDURE WITHIN 90 MINUTES OF ARRIVAL AT THE HOSPITAL. ACCORDING TO THE FEDERAL CENTERS FOR MEDICARE AND MEDICAID (CMS), 100 PERCENT OF PATIENTS WHO REQUIRE ANGIOPLASTY RECEIVE IT AT SAINT MARY'S WITHIN 90 MINUTES OF ARRIVAL. THIS RANKS SAINT MARY'S AS THE NUMBER ONE PERFORMING HOSPITAL IN CONNECTICUT, AND SIGNIFICANTLY AHEAD OF THE NATIONAL AVERAGE, WHICH IS 79 PERCENT OF PATIENTS BEING TREATED WITHIN 90 MINUTES. IN ADDITION, SAINT MARY'S IS THE FIRST HOSPITAL IN CONNECTICUT TO RECEIVE THE AMERICAN COLLEGE OF CARDIOLOGY'S NATIONAL CARDIOVASCULAR DATA REGISTRY (NCDR) ACTION REGISTRY-GET WITH THE GUIDELINES (GWTG) GOLD PERFORMANCE ACHIEVEMENT AWARD FOR. SAINT MARY'S IS ONE OF ONLY 78 HOSPITALS NATIONWIDE TO RECEIVE THE HONOR. THIS IS THE SECOND CONSECUTIVE YEAR THAT SAINT MARY'S HAS ACHIEVED THIS RECOGNITION, AND THE SEVENTH YEAR IN A ROW SAINT MARY'S HAS RECEIVED A GOLD AWARD FOR QUALITY CARDIAC CARE. SAINT MARY'S HAS BEEN NAMED ONE OF AMERICA'S BEST HOSPITALS FOR HEART CARE ACCORDING TO THE WOMEN'S CHOICE AWARD, A LEADING WOMEN'S CONSUMER ADVOCACY GROUP. THE HOSPITAL IS ONE OF 353 IN THE NATION-AND ONE OF JUST NINE IN CONNECTICUT-TO RECEIVE THE 2015 WOMEN'S CHOICE AWARD FOR HEART CARE. IN THE 2015 FISCAL YEAR, SAINT MARY'S ALSO ACHIEVED THE HIGHEST SCORES IN THEIR RESPECTIVE SIZE/GEOGRAPHIC GROUP EARNING THEM A SPOT ON THE CLEVERLY ASSOCIATES COMMUNITY VALUE 100 LIST FOR BEING A TOP VALUE HOSPITAL. IN ADDITION IN DECEMBER OF 2014, SAINT MARY'S WAS ONE OF ONLY 712 HOSPITALS IN THE UNITED STATES TO ACHIEVE THE TOP PERFORMER DISTINCTION TWO YEARS IN A ROW FROM THE JOINT COMMISSION. IN ADDITION, SAINT MARY'S IS A LEADER IN SURGICAL SERVICES. OUR PHYSICIANS PROVIDE BOTH IN-PATIENT AND OUT-PATIENT SURGERY IN THE AREAS OF GI, ONCOLOGY, THORACIC, VASCULAR, LAPAROSCOPY, TRAUMA, GYNECOLOGY, UROLOGY, NEUROSURGERY, ORTHOPEDICS, CARDIOTHORACIC, PLASTIC, BARIATRIC AND ENDOCRINE SURGERY AT SAINT MARY'S HOSPITAL. OUR EXPERIENCED SURGEONS PERFORM ADVANCED ROBOTIC-ASSISTED PROCEDURES UTILIZING TWO DAVINCI ROBOTIC SURGICAL SYSTEMS. THIS INNOVATIVE TECHNOLOGY IS BECOMING THE STANDARD OF CARE FOR MANY COMPLEX SURGICAL PROCEDURES WITH APPLICATIONS FOR GYNECOLOGIC, UROLOGIC, THORACIC, CARDIAC AND GENERAL SURGERY. AS THE LEADING PROVIDER OF SURGICAL SERVICES IN THE REGION, SAINT MARY'S IS COMMITTED TO PROVIDING THE HIGHEST QUALITY AND SUPERIOR SERVICE FOR OUR PATIENTS. DURING FISCAL YEAR 2015, SAINT MARY'S PERFORMED 617 SURGERIES USING THE DAVINCI ROBOTIC SURGICAL SYSTEMS. IN ADDITION, THE HOSPITAL OFFERS A COMPREHENSIVE SIX- YEAR TRAINING PROGRAM IN GENERAL SURGERY. SAINT MARY'S HOSPITAL IS COMMUNITY BASED AND BOASTS A CLOSE AFFILIATION TO YALE UNIVERSITY IN NEARBY NEW HAVEN, CONNECTICUT, AND THE UNIVERSITY OF CONNECTICUT IN FARMINGTON, CONNECTICUT. HISTORICALLY, NEARLY ONE HALF OF THE RESIDENTS COMPLETING THIS PROGRAM HAVE PURSUED FURTHER TRAINING IN CARDIOTHORACIC, COLON AND RECTAL, PLASTIC AND RECONSTRUCTIVE, SURGICAL ONCOLOGY, OR VASCULAR SURGERY. IN THE FISCAL YEAR 2015, THE HOSPITAL ADDED A NEW, FOUR-BED NEUROSPINE INTENSIVE CARE UNIT (NEUROICU) WHICH OFFICIALLY OPENED ON MAY 28, 2015. THIS NEW UNIT ALLOWS SAINT MARY'S TO CARE FOR PATIENTS WHO REQUIRE SPECIALIZED CARE FOLLOWING SURGICAL TREATMENT OF BRAIN TUMORS, HEAD TRAUMA, OR STROKES. THE NEUROICU FEATURES NEW, STATE-OF-THE-ART EQUIPMENT THAT ALLOWS SECOND-TO-SECOND MONITORING OF CRITICALLY-ILL PATIENTS. IN ADDITION, SAINT MARY'S HOSPITAL HAS BEEN RECOGNIZED BY ANTHEM BLUECROSS WITH A BLUE DISTINCTION CENTER DESIGNATION IN THE AREA OF BARIATRIC SURGERY. BLUE DISTINCTION CENTERS ARE NATIONALLY-DESIGNATED HEALTHCARE FACILITIES SHOWN TO DELIVER QUALITY SPECIALTY CARE BASED ON OBJECTIVE MEASURES THAT WERE DEVELOPED WITH INPUT FROM THE MEDICAL COMMUNITY FOR PATIENT SAFETY AND BETTER HEALTH OUTCOMES. AS A LEADER IN BARIATRIC SURGERY SAINT MARY'S GAINED ACCREDITATION BY THE AMERICAN COLLEGE OF SURGEONS (ACS) METABOLIC AND BARIATRIC SURGERY ACCREDITATION AND QUALITY IMPROVEMENT PROGRAM (MBSAQIP) AND THE AMERICAN SOCIETY FOR METABOLIC AND BARIATRIC SURGERY (ASMBS). THIS ACCREDITATION "FORMALLY ACKNOWLEDGES THE COMMITMENT TO PROVIDING AND SUPPORTING QUALITY IMPROVEMENT AND PATIENT SAFETY EFFORTS FOR METABOLIC AND BARIATRIC SURGERY PATIENTS. AS AN ACCREDITED PROGRAM SAINT MARY'S HAS DEMONSTRATED THAT THE CENTER MEETS THE NEEDS OF OUR PATIENTS BY PROVIDING MULTIDISCIPLINARY, HIGH-QUALITY, PATIENT-CENTERED CARE. PART III, LINE 4B SAINT MARY'S HEALTH SYSTEM EXTENDS FROM WATERBURY TO WOLCOTT, NAUGATUCK, SOUTHBURY AND PROSPECT. IN 2015, 232,468 PATIENTS CHOSE SAINT MARY'S FOR OUTPATIENT CARE. THE HEALTH SYSTEM'S TWO LARGEST PROGRAMS ARE ITS EMERGENCY DEPARTMENT, WHICH PROVIDED TREATMENT TO 63,488 PATIENTS IN 2015, GENERATING $28 MILLION IN REVENUE, AND AMBULATORY SURGERY. IN 2015, 14,206 PATIENTS CHOSE TO HAVE OUTPATIENT SURGERY AT SAINT MARY'S, GENERATING $46 MILLION IN REVENUE. OUTPATIENT SERVICES INCLUDE BUT ARE NOT LIMITED TO: MEDICAL IMAGING, BLOOD DRAW AND LAB SERVICES, CARDIAC AND PULMONARY REHABILITATION CLASSES, NUTRITIONAL COUNSELING AND EXPECTANT PARENT CLASSES. SAINT MARY'S SATELLITE FACILITIES INCLUDE HEALTH AND WELLNESS CENTERS PROVIDING CERTIFIED URGENT CARE CENTERS, BLOOD DRAW STATIONS AND X-RAY SERVICES IN NAUGATUCK, WATERBURY, AND WOLCOTT; OUTPATIENT REHABILITATION THERAPY OFFICES IN WATERBURY, WOLCOTT AND NAUGATUCK; OUTPATIENT SLEEP DISORDERS CENTERS IN WATERBURY AND WOLCOTT; THE BREAST & ONCOLOGY CENTERS IN SOUTHBURY AND PROSPECT, AND OCCUPATIONAL THERAPY IN WATERBURY. SAINT MARY'S HAS BEEN RECOGNIZED AT THE STATE AND NATIONAL LEVELS AS A DISTINGUISHED PROVIDER OF OUTPATIENT SERVICES. ONE ADDITION TO THE OUTPATIENT SERVICES INCLUDED THE LIONS LOW VISION CENTER WHICH IS ONE OF ONLY FIVE CENTERS IN CONNECTICUT AND THE ONLY CENTER OF ITS KIND IN GREATER WATERBURY. SPECIALISTS COLLABORATE WITH PATIENTS' EYE CARE PROFESSIONALS AND HELP PATIENTS MAKE THE MOST OF THEIR AVAILABLE VISION WITH EXERCISES, COMPENSATORY STRATEGIES, AND TRAINING WITH LOW VISION AIDES. SAINT MARY'S IS AMONG THE LARGEST AND BUSIEST EMERGENCY DEPARTMENTS IN THE STATE OF CONNECTICUT. IN FACT, WITH APPROXIMATELY 73,000 EMERGENCY VISITS PER YEAR, WE RANK AS THE 9TH BUSIEST IN THE STATE. THE SAINT MARY'S EMERGENCY DEPARTMENTS IS A CERTIFIED LEVEL 2 TRAUMA CENTER, AND ALL PHYSICIANS ARE BOARD CERTIFIED IN EMERGENCY MEDICINE. THE EMERGENCY DEPARTMENT PLAYS A CRITICAL ROLE IN HELPING SAINT MARY'S ACHIEVE ITS EXTRAORDINARY PERFORMANCE WITH DOOR-TO-BALLOON TIME, A MEASURE OF THE TIME IT TAKES A HEART ATTACK VICTIM TO HAVE HIS OR HER BLOCKED ARTERIES OPENED. SAINT MARY'S MEDIAN DOOR-TO-BALLOON TIME IS 60 MINUTES. SAINT MARY'S DOOR-TO-BALLOON TIME IS 30 MINUTES FASTER THAN NATIONAL GUIDELINES SET BY THE AMERICAN COLLEGE OF CARDIOLOGY FOR OPENING BLOCKED ARTERIES. THE DEPARTMENT ALSO PROVIDES AMBULATORY CARE SERVICES, WHICH ARE DESIGNED TO ACCOMMODATE NON-EMERGENT, LOWER ACUITY NEEDS. THIS UNIT CONTAINS A PEDIATRIC CENTER, WHICH IS STAFFED BY PEDIATRICIANS EACH AFTERNOON. FINALLY, THE EMERGENCY DEPARTMENT CONTAINS A DEDICATED BEHAVIORAL HEALTH AREA, SUPPORTED BY A PSYCHIATRIST, SOCIAL WORKER AND SPECIALIZED NURSES. THIS UNIT PROVIDES A MUCH NEEDED RESOURCE FOR SERVING OUR PATIENT POPULATION, AND HAS SEEN CONTINUED GROWTH AND INCREASE IN DEMAND. SAINT MARY'S CANCER PROGRAM WAS AWARDED A THREE-YEAR ACCREDITATION FROM THE AMERICAN COLLEGE OF SURGEONS' COMMISSION ON CANCER WITH COMMENDATION. ONLY 40 PERCENT OF ALL U.S. HOSPITALS SURVEYED BY THE COMMISSION ACHIEVE THIS LEVEL OF RECOGNITION. ACS ACCREDITATION ENSURES THAT PATIENTS WHO CHOOSE SAINT MARY'S FOR CANCER CARE HAVE ACCESS TO A COMPLETE RANGE OF STATE-OF-THE-ART SERVICES AND EQUIPMENT, A TEAM THAT COORDINATES THE BEST AVAILABLE TREATMENT OPTIONS, AND ACCESS TO CLINICAL TRIALS AND NEW TREATMENT OPTIONS, AS WELL AS EARLY DETECTION PROGRAMS, EDUCATION AND SUPPORT SERVICES. SAINT MARY'S WOUND HEALING CENTER IS STAFFED BY A SPECIALIZED TEAM OF PHYSICIANS, SURGEONS, NURSES AND TECHNICIANS, WHO COLLABORATE TO PRODUCE THE BEST POSSIBLE OUTCOMES. ON AVERAGE, 92.5 PERCENT OF PATIENTS WHO COME TO THE CENTER WITH CHRONIC WOUNDS THAT HAVE RESISTED TRADITIONAL TREATMENT ACHIEVE SUCCESSFUL RESULTS WITHIN 14 WEEKS. SPECIALIZED WOUND CARE ALSO HELPS PATIENTS WITH DIABETIC ULCERS, PRESSURE ULCERS, INFECTIONS AND COMPROMISED SKIN GRAFTS. IN ADDITION THE CENTER OFFERS HYPERBARIC OXYGEN THERAPY, WHICH IS PARTICULARLY EFFECTIVE FOR PATIENTS WHO SUFFER FROM RADIATION DAMAGE OR FACE THE POSSIBILITY OF AMPUTATION. PART III, LINE 1 BUILDING UPON A LEGACY OF CARING THE MISSION OF SAINT MARY'S HOSPITAL IS TO PROVIDE EXCELLENT HEALTHCARE SERVICES IN A SPIRITUALLY ENRICHED ENVIRONMENT TO IMPROVE THE HEALTH OF OUR COMMUNITY. SAINT MARY'S HOSPITAL PLAYS AN INDISPENSABLE ROLE IN THE HEALTHCARE DELIVERY SYSTEM FOR THE GREATER WATERBURY COMMUNITY AND THE TOWNS OF THE CENTRAL NAUGATUCK VALLEY. FOUNDED IN 1907 BY THE SISTERS OF SAINT JOSEPH OF CHAMBERY, SAINT MARY'S HAS BEEN THE CATHOLIC BEACON OF HEALING AND HOPE IN THE COMMUNITY FOR 100 YEARS. BUILT IN THE HEART OF THE CITY AND WITHIN CLOSE DISTANCE OF ITS ONCE-THRIVING BRASS MILLS SO THAT IT COULD RESPOND READILY TO INJURED WORKERS, THE HOSPITAL HAS EVOLVED INTO A DIVERSE HEALTH SYSTEM THAT TODAY PROVIDES A VARIETY OF HEALTHCARE, EDUCATIONAL, FINANCIAL AND OTHER BENEFITS TO THE PEOPLE IT SERVES. SAINT MARY'S EXISTS TO SERVE THE PEOPLE OF WATERBURY AND ITS SURROUNDING COMMUNITIES. PROVIDING HIGH QUALITY HEALTHCARE TO ALL WHO NEED IT, REGARDLESS OF ABILITY TO PAY, HAS BEEN CENTRAL TO ITS MISSION THROUGHOUT ITS EXISTENCE. ADAPTING TO MEET THE CHANGING NEEDS OF THE COMMUNITY, THE HOSPITAL IS MORE FOCUSED THAN EVER ON PRESERVING ACCESS TO APPROPRIATE HEALTHCARE AND PROVIDING EXCEPTIONAL QUALITY AND SERVICE TO PATIENTS AND THEIR FAMILIES. SAINT MARY'S HOSPITAL: - PROVIDES PRIMARY AND SPECIALTY CARE THROUGH ITS FAMILY HEALTH CENTER - PARTICIPATES IN MEDICAID, MEDICARE, SAGA, HUSKY A & B, CHARTER OAK AND/OR OTHER GOVERNMENT- SPONSORED HEALTHCARE PROGRAMS - SERVES ONE OF CONNECTICUT'S MOST CHALLENGING URBAN POPULATIONS, IN A DESIGNATED MEDICALLY UNDERSERVED AREA (MUA) - SPONSORS MEDICAL, SURGICAL, AND DENTAL RESIDENCY PROGRAMS TO PROVIDE PROFESSIONAL EDUCATION FOR PHYSICIANS IN TRAINING AND ENCOURAGE THE RETENTION OF PROVIDERS WHO WILL CHOOSE TO REMAIN IN ITS PRIMARY SERVICE AREA. THE CHALLENGES FACED BY SAINT MARY'S HOSPITAL ARE SIGNIFICANT, YET IT REMAINS FULLY DEDICATED TO FULFILLING ITS CORE MISSION. AS HAS BEEN THE CASE THROUGHOUT THE HOSPITAL'S HISTORY, ITS MISSION IS BROUGHT TO LIFE BY ITS TALENTED AND HARD WORKING EMPLOYEES, WHOSE INGENUITY AND PERSEVERANCE ENSURES THAT THE INDIVIDUAL AND COLLECTIVE NEEDS OF THE COMMUNITY ARE BEING MET. BUILDING UPON A LEGACY OF CARING THE MISSION OF SAINT MARY'S HOSPITAL IS TO PROVIDE EXCELLENT HEALTHCARE SERVICES IN A SPIRITUALLY ENRICHED ENVIRONMENT TO IMPROVE THE HEALTH OF OUR COMMUNITY. IT IS THE HOSPITAL'S VISION TO BECOME AN INTEGRATED NETWORK OF HEALTHCARE PROVIDERS CREATING EXCEPTIONAL VALUE FOR THOSE WE SERVE THROUGH TRUSTED PARTNERSHIPS THAT EMPOWER AND TRANSFORM LIVES. THE HOSPITAL'S STAFF, MEDICAL STAFF, BOARD OF DIRECTORS, FOUNDATION, AUXILIARY, AND VOLUNTEERS ARE ALSO UNITED BY THESE VALUES: -INTEGRITY - COMMITMENT TO DOING WHAT IS RIGHT - CARING - COMPASSIONATE APPROACH TO ADDRESSING THE HEALTHCARE NEEDS OF ALL PEOPLE - ACCOUNTABILITY - PERSONAL RESPONSIBILITY FOR THE PERFORMANCE OF SAINT MARY'S HEALTH SYSTEM - RESPECT - RESPECT FOR THE DIGNITY, WORTH, AND RIGHTS OF OTHERS - EXCELLENCE - WORKING TOGETHER IN PURSUIT OF SUPERIOR CLINICAL QUALITY AND SERVICE TO OTHERS PART VI, SECTION A, LINE 7A SAINT MARY'S HEALTH SYSTEM, INC. IS THE SOLE MEMBER OF SAINT MARY'S HOSPITAL, INC. AND APPOINTS THE BOARD OF DIRECTORS. 990 PART VI SECTION A LINE 7B PURSUANT TO THE PROVISIONS OF SECTION 33-1080(B) OF THE CONNECTICUT REVISED NON-STOCK CORPORATION ACT AND THE AMENDED AND RESTATED CERTIFICATE OF INCORPORATION OF THE CORPORATION, THERE SHALL BE RESERVED TO THE ARCHBISHOP OF THE HARTFORD ROMAN CATHOLIC ARCHDIOCESE OF HARTFORD (UNLESS SPECIFICALLY DELEGATED BY HIM) THE FOLLOWING RIGHTS AND POWERS: (A) TO APPROVE THE MISSION OR PURPOSE AND THE PHILOSOPHY OF THE CORPORATION AND OF ANY SAINT MARY'S SUBSIDIARIES. (B) TO APPROVE THE ACQUISITION, ALIENATION OR CONVEYANCE OF THE REAL PROPERTY OF THE CORPORATION THAT IS VALUED AT AN AMOUNT GREATER THAN THAT ESTABLISHED BY THE UNITED STATES CONFERENCE OF CATHOLIC BISHOPS PURSUANT TO CANON LAW OR TO PLACE A MORTGAGE ON SUCH PROPERTY OR TO BORROW FUNDS IN AMOUNTS GREATER THAN THOSE ESTABLISHED BY THE UNITED STATES CONFERENCE OF CATHOLIC BISHOPS PURSUANT TO CANON LAW, WHETHER IN A SINGLE TRANSACTION OR A SERIES OF RELATED TRANSACTIONS. (C)TO APPROVE THE DISPOSAL OF ALL OR SUBSTANTIALLY ALL OF THE PHYSICAL ASSETS OF THE CORPORATION AND TO APPROVE THE MERGER OR CONSOLIDATION OF THE CORPORATION. (D)TO APPROVE THE AMENDMENT OF THE CERTIFICATE OF INCORPORATION OR THE BYLAWS OF THE CORPORATION. PART VI, SECTION B, LINE 11A THE FORM 990 WAS DISTRIBUTED TO BOARD MEMBERS AND THE ORGANIZATION'S FINANCE COMMITEE FOR THEIR REVIEW PRIOR TO FILING TO ENSURE ACCURACY AND COMPLETENESS. A COMPLETE COPY OF THE ORGANIZATION'S FINAL FORM 990, INCLUDING ALL REQUIRED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, WAS PROVIDED TO EACH MEMBER OF THE BOARD BEFORE ITS FILING WITH THE IRS. PART VI - SECTION B - LINE 12C ANNUALLY, EACH DIRECTOR, OFFICER, AND BOARD COMMITTEE MEMBER OF SMHS AND ANY OF ITS AFFILIATES, AS APPROPRIATE, WILL SIGN A STATEMENT WHICH AFFIRMS THAT THE PERSON: 1) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; AND 3) HAS AGREED TO COMPLY WITH THE POLICY. THE STATEMENTS WILL BE DISTRIBUTED ANNUALLY BY THE COMPLIANCE OFFICER AND RETURNED TO THE CEO OR DELEGATED PERSON, WHERE THEY WILL BE RECORDED, REVIEWED, SUMMARIZED AND PRESENTED TO THE CHAIRPERSON OF THE BOARD, AS WELL AS TO THE AUDIT AND GOVERNANCE COMMITTEES, WHERE THEY EXISTS. CONFLICT OF INTEREST STATEMENTS WILL BE MAINTAINED FOR A MINIMUM OF SEVEN YEARS BY THE COMPLIANCE OFFICER. CONFLICT OF INTEREST FORMS PROVIDED BY OFFICERS, DIRECTORS AND BOARD COMMITTEE MEMBERS WILL BE FORWARDED TO THE COMPLIANCE OFFICER, ALONG WITH A STATEMENT OF IMPACT AS TO THE EFFECT OF THE CONFLICT OF INTEREST ON THE BUSINESS AND ANY ACTION TAKEN TO MINIMIZE THE EFFECT. THEY WILL BE MAINTAINED BY THE COMPLIANCE OFFICER FOR A MINIMUM OF SEVEN YEARS. PART VI - SECTION B - LINES 15A & 15B THE PROCESS FOR DETERMINING THE COMPENSATION OF THE HOSPITAL'S TOP MANAGEMENT OFFICIALS, INCLUDING THE CEO, ALL OFFICERS, AND KEY EMPLOYEES, MEET THE THREE REQUIREMENTS OF THE REBUTTABLE PRESUMPTION. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY THE ORGANIZATION'S EXECUTIVE COMPENSATION COMMITTEE. THE COMMITTEE IS APPOINTED BY THE BOARD OF DIRECTORS FOR THE PURPOSE OF ASSISTING THE BOARD TO FULFILL ITS RESPONSIBILY TO THE HOSPITAL AND THE COMMUNITY TO ENSURE THE COMPENSATION IS IN ACCORDANCE WITH THE HOSPITAL'S POLICIES. THE COMMITTEE IS COMPRISED OF SIX DIRECTORS WHO ARE INDEPENDENT OF MANAGEMENT AND THE HOSPITAL AND FREE OF ANY CONFLICTS OF INTEREST THAT WOULD INTERFERE WITH THEIR EXERCISE OF INDEPENDENT JUDGEMENT. PRIOR TO MAKING ANY COMPENSATION DECISIONS, THE EXECUTIVE COMPENSATION COMMITTEE OBTAINED AND RELIED UPON APPROPRIATE DATA AS TO COMPARABILITY. THE COMMITTEE CONTRACTS AN INDEPENDENT COMPENSATION CONSULTANT AND UTILIZES LOCAL AND NATIONAL COMPENSATION SURVERY'S TO SET COMPENSATION LEVELS. FINALLY, THE EXECUTIVE COMPENSATION COMMITTEE ADEQUATELY AND TIMELY DOCUMENTED THE BASIS FOR SETTING COMPENSATION CONCURRENTLY WITH THE MAKING OF THE DETERMINATION. PART VI, SECTION C, QUESTION 19 COPIES OF THE GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. PART XI, LINE 9 TRANSFERS TO AFFILIATES ($17,093,000) MINIMUM PENSIONS LIAB CHANGE ($ 2,773,000) CHANGE IN FOUNDATION INTEREST ($ 609,458) UNREALIZED GAIN/(LOSS) ($ 2,003,000) NET ADDITIONS TO ASSETS HELD IN TRUST ($ 933,000) OTHER ($ 4,654) TOTAL ($23,416,112) FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES TOTAL FEES:10970384 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTOR FEES TOTAL FEES:13413326 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER FEES TOTAL FEES:10520903 St Mary's Indemnity Company LLC 126 College Street Burlington VT 05401 060646844 Insurance VT 360000 32070000 ST Mary Hosp St Mary's Physician Partners LLC 56 Franklin Street Waterbury CT 06706 465760769 Account. Care CT -240000 75000 ST Mary Hosp St Mary's Health System Inc 56 Franklin Street Waterbury CT 06703 222528399 Holding Co. CT 501(c)(3) 11B NA false Saint Mary's Foundation 56 Franklin Street Waterbury CT 06703 222528400 Fundraising CT 501(c)(3) 7 ST Mary Hosp true Harold Leever Regional Cancer Center 1075 Chase Parkway Waterbury CT 06708 061548409 Treatment Ctr CT 501(c)(3) 3 ST Mary Hosp true Heart Center of Greater Waterbury Inc PO Box 2153 Waterbury CT 06722 830416893 Management CT 501(c)(3) 11A ST Mary Hosp true Diagnostic Imaging of Southbury LLC 385 Main Street South Southbury CT 06488 061487582 Imaging Cente CT NA RELATED 530000 10123800 false 0 true 0.60000 NAUGATUCK VALLEY MRI LLC 1389 WEST MAIN ST WATERBURY CT 06708 IMAGING CNTR CT NA RELATED 150000 2397000 false 0 true 0.78300 Franklin Medical Group PC 56 Franklin Street Waterbury CT 06706 061470493 Physician Off CT NA C Corp -16821000 6382000 1.00000 true true true true false false false false false false false true true true true false true false true Franklin Medical Group PC B 17093173 FMV Franklin Medical Group PC L 3376991 FMV Franklin Medical Group PC A 24000 FMV Diagnostic Imaging of Southbury LLC C 417000 FMV Naugatuck Valley MRI LLC C 117450 FMV Saint Mary's Hospital Foundation 555243 FMV