2016-08-15T11:07:10-05:00 2015-09-30 ERNST & YOUNG US LLP 200 CLARENDON STREET BOSTON MA 021165072 990 2014-10-01 066068853 THE NORWALK HOSPITAL ASSOCIATION % TONI HORNE CONTROLLER NORW 2038522000 24 STEVENS STREET NORWALK CT 06850 STEVEN H ROSENBERG SVP & CFO 2038522000 2016-08-10 true MIKE A CINCOTTA P01595811 6172662000 2014 2016-09-27 15:27:22Z MICHAEL DAGLIO EFF 112015 24 STEVENS STREET NORWALK CT 06850 381125196 false X NORWALKHOSPITAL.ORG X 1893 CT THE MISSION OF NORWALK HOSPITAL IS TO IMPROVE THE HEALTH OF EVERY PERSON WE SERVE THROUGH THE EFFICIENT DELIVERY OF EXCELLENT, INNOVATIVE AND COMPASSIONATE CARE. 19 17 2124 425 2533393 -1312655 3133943 3369032 332314811 365394458 1594693 3203481 3329326 5768162 340372773 377735133 7666306 16234828 0 0 168179279 176528299 0 0 0 131459491 161645152 307305076 354408279 33067697 23326854 609496496 639545087 296336288 289830942 313160208 349714145 X SEE SCHEDULE O false false 95783710 94617299 SEE SCHEDULE O 73869179 75022433 SEE SCHEDULE O 35141996 35910224 SEE SCHEDULE O 101464528 16234828 159844502 306259413 true true false true false false false false false false true false true true true false false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false false true true true false false true 362 0 true 2124 true true true false false false false false false false false false X 19 17 true false false false true true true true true false false true true true true true true false true true false X TONI HORNE CONTROLLER 2038522000 14 RESEARCH DRIVE BETHEL CT 06801 X DIANE ALLLISON CHAIRMAN THRU 12/31/14 2.0 0.0 X X 0 0 0 FRED AFRAGOLA SECRETARY 2.0 1.0 X X 0 0 0 THOMAS AYOUB MD TRUSTEE 18.0 1.0 X 85000 0 0 GEORGE BAUER TRUSTEE 2.0 2.0 X 0 0 0 MARIA BORGES-LOPEZ TRUSTEE THRU 12/31/14 2.0 0.0 X 0 0 0 BARBARA BUTLER SECRETARY 2.0 1.0 X X 0 0 0 DANIEL DEBARBA PRESIDENT THRU 12/31/14 5.0 42.0 X X 93142 966102 57347 HOWARD EISON MD TRUSTEE 2.0 3.0 X 0 0 0 PAUL GAGNE TRUSTEE 2.0 1.0 X 0 0 0 MARK GUDIS TREASURER 2.0 0.0 X X 0 0 0 ED KANGAS VICE CHAIRMAN THRU 12/31/14 2.0 0.0 X X 0 0 0 DAVID KOMANSKY TRUSTEE 2.0 0.0 X 0 0 0 DAVID LEHN ESQ TRUSTEE 2.0 1.0 X 0 0 0 VICTOR LISS TRUSTEE 2.0 6.0 X 0 0 0 ED MAHONY CHAIRMAN 5.0 2.0 X X 0 0 0 MICHAEL DAGLIO PRESIDENT EFF 1/1/2015 40.0 8.0 X X 0 550572 44866 ROBERT READY TRUSTEE THRU 6/3/15 2.0 2.0 X 0 0 0 GARY REINER TRUSTEE 2.0 0.0 X 0 0 0 AMY SCHAFRANN TRUSTEE 2.0 1.0 X 0 0 0 ERVIN SHAMES TRUSTEE 2.0 4.0 X 0 0 0 ANDREW WHITTINGHAM VICE CHAIR 4.0 1.0 X X 0 0 0 RICHARD ZELKOWITZ MD TRUSTEE 2.0 0.0 X 0 0 0 RICHARD JABARA TRUSTEE EFF 1/1/15 2.0 3.0 X 0 0 0 JOSEPH D SKRZYPCZAK TRUSTEE 1/1/15 2.0 2.0 X 0 0 0 JAMES KENNEDY TRUSTEE THRU 12/31/14 2.0 6.0 X 0 0 0 JOHN MURPHY MD CEO THRU 12/31/14 2.0 47.0 X X 0 1402828 51844 STEVEN ROSENBERG CFO/TREASURER 5.0 52.0 X 0 779114 42729 ANTHONY ACETO VICE PRESIDENT HUMAN RESOURCES 40.0 0.0 X 663210 123225 22398 RENEE MAURIELLO VP NURSING & PATIENT CARE 40.0 0.0 X 404823 0 31695 JAMES HAYNES VP OPERATIONS 40.0 0.0 X 295852 0 32344 JAMES VARRONE VP SUPPLY CHAIN 4.0 36.0 X 185641 0 30014 PATRICK MINICUS VICE PRESIDENT FINANCE 20.0 22.0 X 73323 476177 50314 BRIAN MCGOVERN MD PHYSICIAN 40.0 0.0 X 567803 0 34819 ARI PERKINS MD PHYSICIAN 40.0 0.0 X 496472 0 33890 JASON FISCHEL MD PHYSICIAN 40.0 0.0 X 467233 0 31695 ROBERT CAPODANNO MD PHYSICIAN 40.0 0.0 X 460953 0 34326 ARTHUR STRICHMAN MD PHYSICIAN 40.0 0.0 X 426931 0 33819 4220383 4298018 532100 351 false true false MORRISON MANAGEMENT SPECIALISTS INC PO BOX 102289 ATLANTA GA 30342 FOOD SERVICE 3549077 NORWALK RADIOLOGY CONSULTANTS PC 148 EAST AVENUE NORWALK CT 06851 PHYSICIANS-RADIOLOGY 1648207 DONALD MURPHY DBA MURPHY SECURITY PO BOX 356 NEW BRITAIN CT 06051 SECURITY SERVICES 1271638 CARDIOLOGY ASSOCIATES OF FAIRFELD C 40 CROSS STREET 200 NORWALK CT 06851 CARDIOLOGY SERVICES 1157304 RIGHTSOURCING INC PO BOX 9695 UNIONDALE NY 11555 STAFFING SERVICES 1068729 51 1491840 1877192 3369032 NET PATIENT SERVICE REV 621400 353131612 353131612 NORWALK SURGERY CENTER JV 900099 3771481 3771481 LAB SERVICES REVENUE 621500 2533393 2533393 OTHER MEDICAL SERVICES 900099 1256951 1256951 MEANINGFUL USE 900099 615509 615509 4085512 4085512 365394458 3203481 3203481 0 0 4045948 3202053 843895 0 843895 843895 0 0 0 411705 188010 223695 223695 GAIN EXTINGUISHMENT LTD 900099 2625073 2625073 CAFETERIA/VENDING 900099 1902727 1902727 PARKING 900099 172772 172772 4700572 377735133 362861065 2533393 8971643 X 16234828 16234828 0 0 0 973476 0 973476 0 0 0 0 0 134845496 116635573 18209923 3187081 2851864 335217 28192202 24967727 3224475 9330044 8248856 1081188 0 1135518 1135518 436004 436004 109385 109385 0 0 45180271 35311440 9868831 108856 63144 45712 2190486 1280939 909547 7513674 6466639 1047035 0 16925459 12864095 4061364 602358 526992 75366 0 22388 20896 1492 2308056 2308056 0 20264153 14286615 5977538 7524433 7498540 25893 MEDICAL SUPPLIES 20742860 20742860 PHARMACY 15448764 15448764 HOSPITAL TAX 14644001 14644001 RADIOLOGY & LAB SUPPLIES 3208657 3208657 3279829 2648927 630902 354408279 306259413 48148866 0 74550518 43468380 0 0 0 0 40426872 44469740 0 0 0 0 812885 61725 1774961 2725505 1172206 1688811 618421330 349245363 244452830 269175967 125266668 123434544 2002502 7411876 47837445 98322402 0 0 71199609 48786137 609496496 639545087 60551105 51194090 0 0 0 0 119435000 114265000 0 0 0 0 0 0 0 0 116350183 124371852 296336288 289830942 X 265968153 280584110 37730403 59661583 9461652 9468452 313160208 349714145 609496496 639545087 X 23326854 -4976964 18204047 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED true true false true 25 false true 52159 true 56917 false true 284 109385 false SCHEDULE C PART II B - DESCRIPTION OF LOBBYING ACTIVITY LARGELY STATE AND LOCAL ELECTED OFFICIALS AND AGENCY HEADS WERE LOBBIED IN SUPPORT OF MAINTAINING PATIENT ACCESS TO ESSENTIAL SERVICES FOR THE UNINSURED AND UNDERSERVED. A PART OF THIS EFFORT, LOBBYISTS AND STAFF TIME ARE INCLUDED IN 1G AND MISCELLANEOUS EXPENSES ARE NOTED IN 1I. DUES WERE PAID TO CONNECTICUT HOSPITAL ASSOCIATION (CHA)IN THE AMOUNT OF $266,330 DURING FISCAL 2015. CHA HAS DETERMINED THAT FOR CHA'S FISCAL YEAR ENDING APRIL 30, 2015, 15.43% OF ITS MEMBERSHIP DUES WERE EXPENDED ON ACTIVITIES THAT MEET THE MEDICARE DEFINITION OF UNALLOWABLE LOBBYING (THOSE ACTIVITIES THAT ARE DIRECTLY RELATED TO COMMUNICATIONS WITH LEGISLATORS OR ACTIONS ON SPECIFIC LEGISLATIVE BILLS). CHA CONTINUES TO INVEST RESOURCES ON ADVOCACY EFFORTS AND GOVERNMENTAL INTERACTIONS THAT ARE SUPPORTED BY DUES AND NOT CONSIDERED UNALLOWABLE. DUES WERE PAID TO AMERICAN HOSPITAL ASSOCIATION (AHA) IN THE AMOUNT OF $46,351 DURING FISCAL 2015. AHA HAD DETERMINED THAT 22.8% OF ITS MEMBERSHIP DUES FOR CALENDAR 2014, WERE EXPENDED ON ACTIVITIES THAT MEET THE MEDICARE DEFINITION OF UNALLOWABLE LOBBYING. AHA CONTINUES TO INVEST RESOURCES ON A BROAD RANGE OF ADVOCACY AND REPRESENTATION INITIATIVES TO HELP THE FIELD UNDERSTAND AND RESPOND TO THE LEGISLATIVE AND REGULATORY CHANGES ON THE HORIZON AND TO SUPPORT HOSPITALS AS THEY STRIVE TO DELIVER AN EVER-HIGHER QUALITY OF CARE IN THE FACE OF CHANGES. MANY OF THESE ACTIVITIES WENT WELL BEYOND THE SCOPE OF THE NARROW DEFINITION OF LOBBYING ACTIVITIES CAPTURED IN THE LOBBYING % NUMBER. 26000000 26000000 218919327 110137723 108781604 10821049 4406644 6414405 274547426 233164665 41382761 88133528 1536331 86597197 269175967 BEN INT IN NORWALK HOSPITAL FD 98322402 F 98322402 457 PLAN ASSET 733228 CONSTRUCTION FUND/COST ISSUE 9027862 DUE FROM AFFILIATES 50088 INTEREST FROM CHAR REM TRUST 7555786 MALPRACTICE RECEIVABLE 28829397 MALPRACTICE TRUST 327 OTHER RECEIVABLES 2589449 48786137 0 457 PLAN LIABILITY 733228 ACCRUED PENSION LIABILITY 39558605 ASSET RETIREMENT OBLIGATION 9034409 DEBT FAIR VALUE ADJUSTMENT 1087014 DUE TO AFFILIATES 7983075 DUE TO THIRD PARTIES 27894498 INTEREST RATE SWAP 418466 LEASE - CURRENT AND LONG TERM 1780315 LONG TERM DISABILITY RESERVE 1754161 MALPRACTICE PAYABLE 28829397 MALPRACTICE RESERVE 2573254 WORKERS COMP RESERVE 2725430 124371852 SCHEDULE D PART V LINE 4 - INTENDED USE OF ENDOWMENT FUNDS NORWALK HOSPITAL FOUNDATION, INC. (NHF) MANAGES THE FUNDRAISING FOR NORWALK HOSPITAL ASSOCIATION. THE INCOME GENERATED ON THE PERMANENTLY ENDOWED FUNDS HELD BY NHF ARE USED TO SUPPORT THE CAPITAL AND OPERATING NEEDS OF NORWALK HOSPITAL AS DESIGNATED BY THE DONOR, IF APPLICABLE. DURING FISCAL 2015 ENDOWMENT INCOME WAS USED TO SUPPORT NURSING EDUCATION AND SCHOLARSHIPS, DEPARTMENT OF MEDICINE GRAND ROUNDS, GIFT SHOP STAFF AND CANCER SERVICES. true true X true X true X true true false true true 10525694 2875768 7649926 0.02160 63146400 42460809 20685591 0.05840 73672094 45336577 28335517 0.08000 359344 35 359309 0.00100 10472372 4870466 5601906 0.01580 2695415 1519035 1176380 0.00330 13527131 6389536 7137595 0.02010 87199225 51726113 35473112 0.10010 91488 12628 12628 10635 1367925 1367925 0.00390 102123 1380553 1380553 0.00390 false 4311968 1925725 102903351 133715577 -30812226 X true true NORWALK SURGERY CTR AMBULATORY SURGERY CENTER 0.63210 0.32070 1 1 NORWALK HOSPITAL 24 STEVENS STREET NORWALK CT 06850 NORWALKHOSPITAL.ORG X X X X NORWALK HOSPITAL 1 false false true X X X X X X X X X 13 true false true true X WWW.NORWALKHOSPITAL.ORG X SEE PART VI X true 13 true SEE SCHEDULE O false false true X 200. 400. X X true true X X X true X NORWALKHOSPITAL.ORG X NORWALKHOSPITAL.ORG X NORWALKHOSPITAL.ORG X X X X true X false X X X X true X X false false PART V, LINE 5 - ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY FACILITY: NORWALK HOSPITAL IN CONDUCTING ITS MOST RECENT CHNA IN 2012 (COMPLETED AND APPROVED IN 2013), NORWALK HOSPITAL AND THE NORWALK HEALTH DEPARTMENT ENGAGED IN A COLLABORATIVE COMMUNITY PLANNING PROCESS TO IMPROVE THE HEALTH OF THE GREATER NORWALK AREA RESIDENTS INCLUDING NORWALK, NEW CANAAN, WESTPORT, WESTON, WILTON, DARIEN, AND FAIRFIELD. THE INITIATIVE INCLUDED A COMMUNITY HEALTH ASSESSMENT (CHA) TO IDENTIFY THE HEALTH-RELATED STRENGTHS AND NEEDS OF THE AREA AND A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) TO IDENTIFY PRIORITIES, GOALS, AND IMPLEMENT AND COORDINATE STRATEGIES TO ADDRESS THESE PRIORITY ISSUES ACROSS THE REGION. FINDINGS FROM THE CHA IDENTIFIED OBESITY, MENTAL HEALTH AND SUBSTANCE ABUSE AS PRIORITIES FOR THE AREA. THE COMMUNITY HEALTH ASSESSMENT WAS GUIDED BY A PARTICIPATORY, COLLABORATIVE APPROACH, WHICH EXAMINED HEALTH IN ITS BROADEST SENSE. THIS PROCESS INCLUDED INTEGRATING EXISTING DATA REGARDING SOCIAL, ECONOMIC, AND HEALTH INDICATORS IN THE REGION WITH QUALITATIVE INFORMATION FROM 15 FOCUS GROUPS WITH COMMUNITY RESIDENTS AND SERVICE PROVIDERS AND 17 INTERVIEWS WITH COMMUNITY STAKEHOLDERS. FOCUS GROUPS AND INTERVIEWS WERE CONDUCTED WITH INDIVIDUALS FROM THE 7 MUNICIPALITIES THAT COMPRISE THE GREATER NORWALK AREA, WITH INDIVIDUALS REPRESENTING YOUTH; THE HISPANIC AND AFRICAN AMERICAN COMMUNITIES; INDIVIDUALS RECEIVING SERVICES FROM A FEDERALLY-QUALIFIED HEALTH CENTER; SOCIAL SERVICE, HEALTH CARE, AND MENTAL HEALTH PROVIDERS; BUSINESSES; HOUSING; LAW ENFORCEMENT; AND THE LOCAL GOVERNMENT. THIS QUALITATIVE ASSESSMENT PROCESS ENGAGED OVER 200 INDIVIDUALS. PART V, LINE 6B - CHNA CONDUCTED BY ORGANIZATIONS OTHER THAN THE HOSPITAL FACILITY: NORWALK HOSPITAL NORWALK HEALTH DEPARTMENT PART V, LINE 11 - EXPLANATION OF NEEDS NOT ADDRESSED AND REASONS WHY FACILITY: NORWALK HOSPITAL TO THE BEST OF THE ORGANIZATION'S KNOWLEDGE, ALL PREVALENT ISSUES IN THE COMMUNITY ARE BEING ADDRESSED THROUGH THE 2012 CHIP. ANY NEEDS NOT BEING ADDRESSED ARE THOSE THAT NORWALK HOSPITAL DOES NOT HAVE THE FUNDS OR CONTROL OVER, SUCH AS HOUSING OR ENVIRONMENTAL HEALTH. IN ORDER TO ADDRESS THE SIGNIFICANT NEEDS IDENTIFIED IN THE CHNA, A COMMUNITY HEALTH IMPROVEMENT TASK FORCE WAS CREATED OF OVER 100 COMMUNITY RESIDENTS AND PROFESSIONALS REPRESENTING VARIOUS ORGANIZATIONS. THEY IDENTIFIED MENTAL HEALTH, OBESITY AND SUBSTANCE ABUSE AS THE MAIN PRIORITIES TO ADDRESS. THEY CREATED THE 2012 COMMUNITY HEALTH IMPROVEMENT PLAN WHICH DETAILS SPECIFIC GOALS AND METRICS FOR EACH IDENTIFIED NEED, AND COMMUNITY BENEFIT PROGRAMS THAT WOULD HELP ACHIEVE THESE GOALS. THE NARRATIVES FOR PART I, LINE 7E AND PART II COMMUNITY BUILDING ACTIVITIES DESCRIBE ACTIONS TAKEN TO ADDRESS THE NEEDS IDENTIFIED IN THE 2012 CHNA. PART V LINE 22 - OTHER BILLING DETERMINATION OF INDIVIDUALS WITHOUT INS FACILITY: NORWALK HOSPITAL NORWALK HOSPITAL INTENDS TO BE IN COMPLIANCE WITH THE REGULATIONS REGARDING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY AND OTHER MEDICAL NECESSARY CARE BY THE EFFECTIVE DATE (10/1/16). 11 NORWALK HOSPITAL OUTPATIENT REHAB SVCS 520 WEST AVENUE NORWALK CT 06850 OUTPATIENT REHABILITATION FACILITY NORWALK HOSPITAL OUTPATIENT REHAB SVCS 40 CROSS STREET SUITE 110 NORWALK CT 06851 OUTPATIENT SERVICES NORWALK HOSPITAL SLEEP DISORDER CENTER 520 WEST AVENUE NORWALK CT 06850 SLEEP DISORDER SERVICES NORWALK HOSP RADIOLOGY & MAMMOGRAPHY CTR 148 EAST AVENUE SUITE 1R NORWALK CT 06851 RADIOLOGY AND MAMMOGRAPHY CENTER NORWALK HOSPITAL NEW CANAAN RADIOLOGY 28-30 EAST AVENUE NORWALK CT 06840 RADIOLOGY SERVICES NORWALK HOSPITAL WESTPORT RADIOLOGY 728 POST ROAD EAST WESTPORT CT 06880 RADIOLOGY SERVICES NEW CANAAN BLOOD COLLECTION CENTER 25-30 EAST AVENUE NEW CANAAN CT 06840 BLOOD COLLECTION WESTPORT BLOOD COLLECTION CENTER 728 POST ROAD EAST WESTPORT CT 06880 BLOOD COLLECTION NORWALK BLOOD COLLECTION CENTER 40 CROSS STREET NORWALK CT 06851 BLOOD COLLECTION NORWALK BLOOD COLLECTION CENTER 148 EAST AVENUE NORWALK CT 06851 BLOOD COLLECTION NORWALK SURGERY CENTER LLC 40 CROSS STREET NORWALK CT 06851 AMBULATORY SURGERY CENTER PART I, LINE 7G - COSTS ASSOCIATED WITH PHYSICIANS CLINICS SUBSIDIZED HEALTH SERVICES LINE G - NORWALK HOSPITAL RECEIVES A DHMAS GRANT FROM THE STATE OF CONNECTICUT FOR THE OUTPATIENT PSYCHIATRIC CLINIC. THESE DOLLARS HELP OFFSET THE SHORTFALL FROM UNDER OR UNINSURED PATIENTS. PART III, LINE 2 - METHODOLOGY USED TO ESTIMATE BAD DEBT EXPENSE BAD DEBT EXPENSE IS A FUNCTION OF ACTUAL BAD DEBT WRITE-OFFS AND ESTIMATED BAD DEBTS FOR BALANCES STILL IN ACCOUNTS RECEIVABLE (AR) AS OF THE MEASUREMENT DATE. THE HOSPITAL CALCULATES THE ESTIMATED BAD DEBTS IN AR BY COMPUTING HISTORICAL PAYMENT % BY PAYOR, SERVICE TYPE AND BY ACCOUNT AGE AND APPLIES THOSE PERCENTAGES ADJUSTED FOR PRICE INCREASE TO CURRENT AR. PART III, LINE 3 METHODOLOGY OF EST AMOUNT & RATIONALE FOR INC COM BENEFIT THE PERCENT OF CHARITY CARE APPLICATIONS UNDER NORWALK HOSPITAL'S FINANCIAL ASSISTANCE POLICY THAT RESULTED IN A DISCOUNT WAS 44.66%. WE APPLIED THIS % TO OUR BAD DEBT EXPENSE OF $4,311,968 TO ARRIVE AT OUR ESTIMATE OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER NORWALK HOSPITAL'S FINANCIAL ASSISTANCE POLICY OF $1,925,725. PART III, LINE 4 - BAD DEBT EXPENSE PATIENT ACCOUNTS RECEIVABLE RESULT FROM THE HEALTH CARE SERVICES PROVIDED BY THE HOSPITAL. ADDITIONS TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS RESULT FROM THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS. ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE HOSPITAL'S ESTIMATION OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED PRIMARILY UPON THE TYPE AND AGE OF THE PATIENT ACCOUNTS RECEIVABLE AND THE EFFECTIVENESS OF THE HOSPITAL'S COLLECTION EFFORTS. THE HOSPITAL'S POLICY IS TO RESERVE A PORTION OF ALL SELF-PAY RECEIVABLES, INCLUDING AMOUNTS DUE FROM THE UNINSURED AND AMOUNTS RELATED TO CO-PAYMENTS AND DEDUCTIBLES, AS THESE CHARGES ARE RECORDED. ON A MONTHLY BASIS, THE HOSPITAL REVIEWS ITS ACCOUNTS RECEIVABLE BALANCES AND VARIOUS ANALYTICS TO SUPPORT THE BASIS FOR ITS ESTIMATES. THESE EFFORTS PRIMARILY CONSIST OF REVIEWING THE FOLLOWING: HISTORICAL WRITE-OFF AND COLLECTION EXPERIENCE USING A HINDSIGHT OR LOOK-BACK APPROACH; REVENUE AND VOLUME TRENDS BY PAYOR, PARTICULARLY THE SELF-PAY COMPONENTS; CHANGES IN THE AGING AND PAYOR MIX OF ACCOUNTS RECEIVABLE, INCLUDING INCREASED FOCUS ON ACCOUNTS DUE FROM THE UNINSURED AND ACCOUNTS THAT REPRESENT CO-PAYMENTS AND DEDUCTIBLES DUE FROM PATIENTS; CASH COLLECTIONS AS A PERCENTAGE OF NET PATIENT REVENUE LESS THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS; AND TRENDING OF DAYS REVENUE IN ACCOUNTS RECEIVABLE. THE HOSPITAL REGULARLY PERFORMS HINDSIGHT PROCEDURES TO EVALUATE HISTORICAL WRITE-OFF AND COLLECTION EXPERIENCE THROUGHOUT THE YEAR TO ASSIST IN DETERMINING THE REASONABLENESS OF ITS PROCESS FOR ESTIMATING THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. PART III, LINE 8 - EXPLANATION OF SHORTFALL AS COMMUNITY BENEFIT ALL HOSPITALS MUST RECORD PROFITS IN ORDER TO GENERATE THE CAPITAL NEEDED TO INVEST IN FACILITIES AND SERVICES. SERVICES THAT RESPOND TO PUBLIC HEALTH NEEDS PROVIDED TO MEDICARE PATIENTS AT NORWALK HOSPITAL GENERATE NEGATIVE MARGINS AVERAGING AROUND 25% OF COST. IT IS POSSIBLE THAT SOME OF THESE SERVICES WOULD BE DISCONTINUED IF THE DECISION WAS MADE ON A PURELY FINANCIAL BASIS. FOR THIS REASON, IT WOULD BE APPROPRIATE TO CONSIDER THE MEDICARE PAYMENT SHORTFALL A COMMUNITY BENEFIT. THE MEDICARE ALLOWABLE COSTS OF CARE ON PART III, LINE 6 WERE COMPUTED USING THE COST TO CHARGE RATIO FROM THE MEDICARE COST REPORT MULTIPLIED AGAINST MEDICARE CHARGES. PART III, LINE 9B - PROVISIONS ON COLLECT PRACTICES FOR QUALIFIED PATIENTS NORWALK HOSPITAL COLLECTION PRACTICES CONSIST PRIMARILY OF BILLING NOTICES AND FOLLOW UP COURTESY CALLS. THE PATIENT IS NOTIFIED OF THE FINANCIAL ASSISTANCE PROGRAM WITH EACH WRITTEN NOTIFICATION AND AT EACH POINT OF SERVICE. NOTIFICATION IS SHARED BY POSTINGS AND VERBAL NOTIFICATION AT THE TIME THE PROCEDURE IS SCHEDULED. IF AT ANY TIME DURING THE COLLECTION PROCESS A PATIENT WOULD LIKE TO PARTICIPATE IN THE FINANCIAL ASSISTANCE PROGRAM COLLECTION ACTIVITY CEASES. THE PATIENT IS THEN SENT AN APPLICATION AND WORKS WITH THE FINANCIAL COUNSELING TEAM FOR APPROVAL OF FULL OR PARTIAL DISCOUNT. PART VI - NEEDS ASSESSMENT IN 2012 (COMPLETED AND APPROVED IN 2013) NORWALK HOSPITAL AND THE NORWALK HEALTH DEPARTMENT ENGAGED IN A COLLABORATIVE COMMUNITY PLANNING PROCESS TO IMPROVE THE HEALTH OF THE GREATER NORWALK AREA RESIDENTS. THE INITIATIVE INCLUDED A CHA TO IDENTIFY THE HEALTH-RELATED STRENGTHS AND NEEDS OF THE AREA AND A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) TO IDENTIFY THE PRIORITIES, GOALS AND IMPLEMENT AND COORDINATE STRATEGIES CHA WAS GUIDED BY A COLLABORATIVE APPROACH, WHICH INCLUDED INTEGRATING EXISTING HEALTH INDICATORS, SOCIAL AND ECONOMIC DATA WITH QUALITATIVE INFORMATION FROM COMMUNITY RESIDENTS AND STAKEHOLDERS. FOCUS GROUPS AND INTERVIEWS WERE CONDUCTED WITH PARTICIPATION FROM YOUTH, ETHNIC COMMUNITIES, SOCIAL SERVICES, HEALTH CARE PROVIDER BUSINESSES, LAW ENFORCEMENT AND LOCAL GOVERNMENT AGENCIES. FOR EXAMPLE, MID-FAIRFIELD CHILD GUIDANCE CENTER PARTICIPATED IN THESE FOCUS GROUPS AND INTERVIEWS. THROUGH THE PROCESS, THEY WERE ABLE TO IDENTIFY MENTAL HEALTH/SUBSTANCE ABUSE AS A PRIORITY NEED. THEY ALSO PROVIDED DATA AND INPUT ON BARRIERS AND CHALLENGES TO ACCESS AND QUALITY CARE FOR CHILDREN IN THE AREA, AS WELL AS STRATEGIES ON HOW TO ENHANCE TREATMENT AND CARE. IN ADDITION TO THE CHNAS REPORTED IN PART V, SECTION B, THE WESTERN CT HEALTH NETWORK (OF WHICH NORWALK HOSPITAL IS A PART) CONDUCTED A PHYSICIAN RESOURCE ASSESSMENT TO EVALUATE THE SUPPLY OF HEALTHCARE PROVIDERS WITHIN ITS COMBINED SERVICE AREA TOWNS. THIS IS DONE TO DOCUMENT COMMUNITY NEED FOR HEALTHCARE PROVIDERS, AND TO DEVELOP A PLAN TO MEET THE HEALTHCARE NEEDS OF THE COMMUNITY SERVED. THROUGH WESTERN CT HEALTH NETWORK'S ANNUAL PLANNING PROCESS, AN ENVIRONMENTAL ASSESSMENT IS CONDUCTED TO IDENTIFY HEALTHCARE GAPS AND NEEDS OF THE SERVICE AREA COMMUNITY BROUGHT ABOUT BY LOCAL AND NATIONAL TRENDS IN ECONOMIC, LEGISLATIVE, DEMOGRAPHIC, HEALTHCARE INDUSTRY AND OTHER ENVIRONMENTAL FACTORS. THESE FORCES ARE INCORPORATED IN MEETING THE HEALTHCARE NEEDS OF THE COMMUNITY BY HELPING TO FRAME THE PRIORITIES, GOALS AND INITIATIVES OF WESTERN CT HEALTH NETWORK'S LONG RANGE AND ANNUAL STRATEGIC PLANS. PART VI - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE THE PATIENT IS NOTIFIED OF THE FINANCIAL ASSISTANCE PROGRAM (FAP) WITH EACH WRITTEN NOTIFICATION AND AT EACH POINT OF SERVICE. NOTIFICATION IS SHARED BY POSTINGS AND VERBAL NOTIFICATION AT THE TIME THE PROCEDURE IS SCHEDULED. THE FACILITY ALSO EMPLOYS FINANCIAL COUNSELORS TO FACILITATE PATIENT EDUCATION REGARDING ALL PROGRAMS AVAILABLE TO INCLUDE STATE, LOCAL AND INTERNAL. IF AT ANY TIME IN THE COLLECTION PROCESS A PATIENT WOULD LIKE TO PARTICIPATE IN THE FAP, COLLECTION ACTIVITY CEASES. THE PATIENT IS THEN SENT AN APPLICATION AND WORKS WITH THE FINANCIAL COUNSELING TEAM FOR APPROVAL OF FULL OR PARTIAL DISCOUNT. PART VI - COMMUNITY INFORMATION NORWALK HOSPITAL SERVES AN AREA WITH A POPULATION OF ABOUT 280,000 PEOPLE. THE PRIMARY SERVICE AREA INCLUDES NORWALK, NEW CANAAN, WESTPORT, WESTON, AND WILTON, CT, AND THE SECONDARY SERVICE AREA INCLUDES FAIRFIELD, DARIEN, REDDING, RIDGEFIELD (IN FAIRFIELD COUNTY, CT) AND SOUTH SALEM (IN WESTCHESTER COUNTY, NY). THIS SERVICE AREA IS COMPRISED OF A DENSELY POPULATED CORE OF THE URBAN/SUBURBAN CITY OF NORWALK SURROUNDED BY PREDOMINANTLY AFFLUENT RESIDENTIAL TOWNS. NO OTHER GENERAL MEDICAL/SURGICAL HOSPITALS ARE LOCATED IN THIS SERVICE AREA. THIS AREA IS HOME TO A DIVERSE SOCIO-ECONOMIC POPULATION, FROM THE AFFLUENT TO THE MEDICALLY UNDER SERVED; CENTRAL NORWALK IS LISTED AS A MEDICALLY UNDER SERVED AREA (OR MUA). NORWALK HAS A MEDIAN HOUSEHOLD INCOME OF $76,051 AND A POVERTY RATE OF 8.1%. THE UNINSURED POPULATION RATE IS ESTIMATED TO BE 3.8%. ALTHOUGH THE POPULATION OF THE PRIMARY AND SECONDARY SERVICE AREAS IS EXPECTED TO REMAIN VIRTUALLY LEVEL FROM 2010 TO 2020, THE COHORT AGED 65 AND OVER IS EXPECTED TO INCREASE BY 2.36%, WHILE THE AGE 20-44 AGE COHORT IS FORECAST TO SLIGHTLY INCREASE AT 0.06% OVER THE SAME TIME PERIOD. PART VI - COMMUNITY BUILDING ACTIVITIES PART II: COMMUNITY BUILDING ACTIVITIES: OBESITY/HEALTHY LIFESTYLES: THROUGH INITIATIVES LED BY THE OBESITY/HEALTHY LIFESTYLES INITIATIVE COMMITTEE, PREVENT AND REDUCE OBESITY IN THE COMMUNITY BY PROMOTING HEALTHY LIFESTYLES. THIS WAS DONE THROUGH FOUR PROGRAMS IN 2015: WALK TO SCHOOL DAY; NORWALKER WALKING ROUTES; HEALTHY RESTAURANT INITIATIVE; MOVE MORE TOOLKIT. OBJECTIVE 2.1: INCREASE THE NUMBER OF CHILDREN AND ADULTS WHO MEET PHYSICAL ACTIVITY GUIDELINES, AND OBJECTIVE 2.2: INCREASE ACCESS TO AND CONSUMPTION OF HEALTHY AND AFFORDABLE FOODS THROUGHOUT THE REGION. INITIATIVES TAKEN: TO COMBAT OBESITY, THE GREATER NORWALK HEALTHY LIFESTYLES WORK GROUP WAS FORMED. THE WORK GROUP IS A COALITION OF ORGANIZATIONS, AGENCIES, AND COMMUNITY MEMBERS FROM THE GREATER NORWALK AREA. THE MISSION OF THE WORK GROUP IS TO REDUCE AND PREVENT OBESITY AND CHRONIC DISEASE IN THE COMMUNITY BY PROMOTING HEALTHY LIFESTYLES. TWO WALK TO SCHOOL DAY EVENTS WERE PLANNED THIS YEAR IN COLLABORATION WITH NORWALK DEPARTMENT OF HEALTH, SACRED HEART UNIVERSITY EXERCISE SCIENCE STUDENTS, CITY OFFICIALS, AND THE PUBLIC SCHOOL SYSTEMS OF NORWALK, WESTPORT, AND NEW CANAAN. FORTY AREA SCHOOL SYSTEMS THROUGHOUT OUR CATCHMENT AREA WERE CONTACTED AND PROVIDED A TOOL KIT CONTAINING INFORMATION ON HOW TO CONDUCT A WALK TO SCHOOL DAY EVENT. ON OCTOBER 9, 2013, A TOTAL OF 90 STUDENTS AND FAMILY MEMBERS PARTICIPATED ON THE FIRST WALK TO SCHOOL DAY EVENT. THE SECOND EVENT, CONDUCTED ON MAY 2, 2014, ATTRACTED MORE THAN 350 STUDENTS FROM AREA ELEMENTARY AND MIDDLE SCHOOLS, FAMILY MEMBERS, INCLUDING SCHOOL STAFF, AND CITY OFFICIALS. EVENTS HELD IN OCTOBER 2014 AND MAY 2015 HAD MORE THAN 1,000 PARTICIPANTS FROM FOUR AREA SCHOOLS INCLUDING FOX RUN AND COLUMBUS MAGNET ELEMENTARY SCHOOLS IN NORWALK, SOUTH SCHOOL IN NEW CANAAN AND KINGS HIGHWAY ELEMENTARY SCHOOL IN WESTPORT. BOTH EVENTS IN FISCAL 2015 GENERATED $1,253 IN COMMUNITY BENEFIT EXPENSE. WITH THE OBJECTIVE TO INCREASE PHYSICAL ACTIVITY AMONG COMMUNITY MEMBERS AND THOSE WORKING WITHIN THE COMMUNITY, THE NORWALKER NEIGHBORHOOD WALKING PROJECT WAS DEVELOPED. THE PROJECT PLAN IDENTIFIED SIXTEEN NEIGHBORHOODS IN NORWALK AND MAPPED OUT WALKING ROUTES IN EACH. THE 44 WALKING ROUTES HAVE BEEN AUDITED, UTILIZING THE CENTER FOR DISEASE CONTROL AND PREVENTION WALKABILITY AUDIT TOOL. AS A RESULT OF THE AUDIT, SEVERAL ROUTES ARE BEING UPDATED AND REDESIGNED TO ACCOMMODATE CHANGES IN GEOGRAPHICAL AREA DESIGN, SAFETY AND ACCESSIBILITY. THE GREATER NORWALK HEALTHY RESTAURANT INITIATIVE (HRI) WAS DEVELOPED TO HELP MEET THE GOAL OF INCREASING ACCESS TO AND CONSUMPTION OF HEALTHY AND AFFORDABLE FOODS. THIS HEALTHY RESTAURANT PROGRAM WILL HELP RESTAURANTS IN THE GREATER NORWALK AREA HIGHLIGHT HEALTHY MENU OPTIONS TO DINERS OF ALL AGES. THE PROGRAM IS VOLUNTARY FOR RESTAURANT OWNERS, AND THUS FAR MORE THAN 40 AREA RESTAURANT ESTABLISHMENTS HAVE SHOWN INTEREST IN THE PROGRAM AND PARTICIPATED IN DISCUSSIONS AND/OR GUIDED FOCUS GROUPS. RESTAURANTS RANGE FROM FAST FOOD CHAINS, CATERERS AND DINERS TO FINE DINING ESTABLISHMENTS. THE PROGRAM IS DESIGNED TO CONNECT RESTAURANT OWNERS TO THE HRI PROGRAM COORDINATOR AND REGISTERED DIETITIAN (RD) WHO WILL WORK WITH THE RESTAURANT TO ASSESS A CURRENT MENU OPTION AND HELP DEVELOP HEALTHY ENTREES. ONCE A MEAL(S) MEETS THE ESTABLISHED NUTRITIONAL CRITERIA (DEVELOPED BASED ON NUTRITIONAL RECOMMENDATIONS FOR BOTH ADULTS AND CHILDREN) IT WILL BE HIGHLIGHTED AS A HEALTHY MENU OPTION ON THE MENU AND THE RESTAURANT WILL BE DESIGNATED AS A "HEALTHY RESTAURANT" PARTICIPATING IN HRI. AREA DIRECTORS OF HEALTH AND SANITARIANS HAVE COLLABORATED WITH THE WORKGROUP TO ESTABLISH DETAILS OF THE PROGRAM AND PROVIDE INSIGHT ON COLLABORATING FOR MANAGEMENT AND OVERSIGHT OF THE PROGRAM. RECRUITMENT FOR INTERESTED RESTAURANTS WILL BEGIN IN MARCH 2016. THE HRI GENERATED $3,404 IN COMMUNITY BENEFIT EXPENSE. THE PHYSICAL ACTIVITY WORKGROUP IS CONDUCTING RESEARCH OF PUBLIC HEALTH GUIDELINES, IMPACT OF ACADEMICS, RESOURCES AND NATIONAL RECOMMENDATIONS TO GUIDE THE DEVELOPMENT OF A MOVE MORE TOOLKIT TO ENHANCE PHYSICAL ACTIVITY AMONG PRE-SCHOOL, ELEMENTARY, MIDDLE AND HIGH SCHOOL STUDENTS. MEMBERS OF THE BOARD OF EDUCATION, SCHOOL NURSES AND EDUCATORS ARE BEING CONSULTED TO OBTAIN GUIDANCE. THE COMPREHENSIVE GUIDE WILL PROVIDE SIMPLE, YET SPECIFIC STRATEGIES TO INCORPORATE MORE PHYSICAL ACTIVITY INTO THE DAY. COALITION BUILDING: NORWALK HOSPITAL PROVIDED $9,601 IN EMS & PARAMEDIC COVERAGE AT THE 2015 OYSTER FESTIVAL AND EMS AMBULANCE TOURS FOR THE COMMUNITY AND ELEMENTARY SCHOOLS. THEY ALSO PROVIDED $19,498 IN DONATIONS/SPONSORSHIPS TO VARIOUS ORGANIZATIONS, SUCH AS AMERICAN LUNG ASSOCIATION AND THE WOMEN'S BUSINESS DEVELOPMENT COUNCIL. COMMUNITY HEALTH IMPROVEMENT ADVOCACY: LARGELY STATE AND LOCAL ELECTED OFFICIALS AND AGENCY HEADS WERE LOBBIED IN SUPPORT OF MAINTAINING PATIENT ACCESS TO ESSENTIAL SERVICES FOR THE UNINSURED AND UNDERINSURED. THE TOTAL ADVOCACY INVESTMENT FOR FISCAL 2015 IS $54,231. FOR FISCAL 2015 NORWALK HOSPITAL PROVIDED $1,350,000 IN SUPPORT TO NORWALK COMMUNITY HEALTH CENTER. PART VI - EXPLANATION OF HOW ORGANIZATION FURTHERS IT EXEMPT PURPOSE SCHEDULE H - PART I, LINE 7E - COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS - OBESITY/HEALTHY LIFESTYLES: THROUGH INITIATIVES LED BY THE OBESITY/HEALTHY LIFESTYLES INITIATIVE COMMITTEE, PREVENT AND REDUCE OBESITY IN THE COMMUNITY BY PROMOTING HEALTHY LIFESTYLES. ONE INITIATIVE WAS PROJECT LEAN. PROJECT LEAN (LEARNING WITH ENERGY FROM ACTIVITY AND NUTRITION) IS AN INNOVATIVE, COMMUNITY-WIDE PROGRAM COLLABORATIVE BETWEEN NORWALK HOSPITAL, NORWALK HEALTH DEPARTMENT, JEFFERSON, KENDALL, MARVIN, BROOKSIDE, TRACEY AND SILVERMINE ELEMENTARY SCHOOLS, AND PEPPERIDGE FARM, INC. WHICH IS DESIGNED TO ACTIVELY ENGAGE APPROXIMATELY 1,000 ELEMENTARY SCHOOL CHILDREN WITH A HANDS-ON INTERACTIVE CURRICULUM TO COMBAT CHILDHOOD OBESITY. PROJECT LEAN'S GOAL IS TO IMPROVE ATTITUDES, INCREASE KNOWLEDGE, AND KEEP BODY MASS INDEX AT OR BELOW THE CENTER FOR DISEASE CONTROL AND PREVENTION AVERAGE GAINS THROUGH NUTRITION EDUCATION AND INCREASED ACTIVITY. THE AIM IS TO IMPROVE THE OVERALL HEALTH OF THE STUDENTS THROUGH HEALTHY NUTRITION AND EXERCISE WITH THE GOAL TO MAKE A SUSTAINABLE DIFFERENCE IN THEIR LIVES. APPROXIMATELY 1,100 STUDENTS IN SIX CITY ELEMENTARY SCHOOLS HAVE DEMONSTRATED (THROUGH SURVEY MEASURES) INCREASED KNOWLEDGE ABOUT NUTRITION AND POSITIVE BEHAVIOR CHANGES. MENTAL HEALTH AND SUBSTANCE ABUSE: THROUGH INITIATIVES LED BY THE MENTAL HEALTH/SUBSTANCE ABUSE INITIATIVE COMMITTEE, PROVIDE EDUCATION ON AND ACCESS TO QUALITY MENTAL HEALTH AND SUBSTANCE ABUSE PREVENTION, INTERVENTION AND TREATMENT SERVICES ACROSS THE LIFE SPAN. OBJECTIVE 1.1: INCREASE PROVIDERS' AND COMMUNITY MEMBERS' AWARENESS AND USE OF QUALITY MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES AND EDUCATIONAL RESOURCES FOR PREVENTION, INTERVENTION, TREATMENT AND RECOVERY. INITIATIVE TAKEN: REGIONAL DATABASE FOR MENTAL HEALTH/SUBSTANCE ABUSE: IN COLLABORATION WITH FAMILY & CHILDREN'S AGENCY, MID-FAIRFIELD CHILD GUIDANCE CENTER AND THE NORWALK HEALTHY FAMILY COLLABORATIVE (WHICH COMPRISES MORE THAN 25 AREA ORGANIZATIONS INCLUDING THE NORWALK HEALTH DEPARTMENT), A REGIONAL ASSESSMENT OF EXISTING MENTAL HEALTH AND SUBSTANCE ABUSE RESOURCES AVAILABLE TO CHILDREN AND ADULTS WAS CONDUCTED OVER THE COURSE OF A YEAR. AFTER VERIFYING AND CROSS-REFERENCING EACH RESOURCE, A COMPREHENSIVE DATABASE WAS COMPILED. THE RESOURCE GUIDE IS UPDATED ON A REGULAR BASIS AND COMMUNITY AGENCIES ARE ENCOURAGED TO SELF-REPORT AND UPDATE ANY CHANGES RELATED TO THEIR AGENCY AND/OR SERVICES. OBJECTIVE 1.2: ENHANCE LOCAL AND REGIONAL PARTNERSHIPS TO IMPROVE ACCESS TO TIMELY, COMPREHENSIVE, AND COORDINATED SERVICES FOR DIVERSE POPULATIONS ACROSS THE LIFESPAN. INITIATIVE TAKEN: IN APRIL 2014, NORWALK HOSPITAL LAUNCHED A COMMUNITY CARE TEAM (CCT) WITH THE GOAL OF TARGETING MENTAL HEALTH AND SUBSTANCE ABUSE POPULATIONS. THIS HAS ALLOWED US TO DELIVER ENHANCED CARE TO INDIVIDUALS WITH COMPLEX MEDICAL AND PSYCHOSOCIAL CHALLENGES BY PROVIDING WRAP AROUND SERVICES TO INDIVIDUALS WITH HOUSING INSTABILITY SUFFERING FROM MENTAL HEALTH AND/OR SUBSTANCE ABUSE ISSUES OR SERIOUS MEDICAL CONDITIONS. AS OF SEPTEMBER 30, 2015, THE GREATER NORWALK CCT DEVELOPED INDIVIDUALIZED CARE PLANS FOR 170 INDIVIDUALS. THE CCT HAS ENABLED NORWALK HOSPITAL TO BREAK DOWN EXISTING SILOS BY INCREASING COMMUNICATION AND COLLABORATION AMONG COMMUNITY PROVIDERS, IMPROVE PATIENT ENGAGEMENT TO APPROPRIATE SERVICES,AND DECREASE PATIENT TURN-OVER IN COMMUNITY PROGRAMS WITH A 27% DECREASE IN INAPPROPRIATE ED UTILIZATION. APPROXIMATELY, 40 PATIENTS HAVE BEEN SUCCESSFULLY LINKED TO HOUSING AND THE MAJORITIES HAVE BEEN REFERRED TO SUPPORT SERVICES. THE SUCCESS OF THE GREATER NORWALK CCT HAS ENABLED EXPANSION OF THE PROGRAM ACROSS OUR NETWORK OF HOSPITALS. INITIATIVE TAKEN: NORWALK HOSPITAL'S BEHAVIORAL HEALTH SPECIALISTS ESTABLISHED A COLLABORATIVE RELATIONSHIP WITH PRACTITIONERS FROM THE NORWALK COMMUNITY HEALTH CENTER (A FEDERALLY QUALIFIED HEALTH CLINIC, FQHC) TO INCORPORATE BEHAVIORAL HEALTH CONSULTATIONS AND ANALYSIS INTO PRIMARY CARE VISITS. ALL PATIENTS AGED 14 YEARS AND OLDER ARE ROUTINELY ASSESSED FOR SUBSTANCE ABUSE/MISUSE DISORDERS AT EACH OFFICE VISIT USING SBIRT (SCREENING, BRIEF INTERVENTION AND REFERRAL TO TREATMENT) TECHNIQUE. THE BEHAVIORAL HEALTH SPECIALISTS WORK IN CONJUNCTION WITH THE PRIMARY CARE PROVIDER AND WILL SEE AND ASSESS THE PATIENT AT THE TIME OF THE OFFICE VISIT AND WHEN APPROPRIATE, MAKE RECOMMENDATIONS TO THE PATIENT OR PHYSICIAN. THIS PRACTICE ALLOWS FOR ENHANCED COLLABORATIVE PLANNING, SERVICE DELIVERY, RESOURCE SHARING ANT THE ABILITY TO ADDRESS BEHAVIORAL HEALTH ISSUES EARLY. UTILIZING THE SBIRT TECHNIQUE SPECIFICALLY ALLOW EARLIER IMPLEMENTATION, INTERVENTION AND ACTIVE INVOLVEMENT FROM EMERGENCY SERVICES WHEN APPROPRIATE. OBJECTIVE 1.3: REDUCE FINANCIAL BARRIERS TO TREATMENT. THE STRATEGY FOR THIS IS TO CONVENE PAYERS IN ACO/PHO (ACCOUNTABLE CARE ORGANIZATION/PHYSICIAN HOSPITAL ORGANIZATION) TO ADDRESS REIMBURSEMENT ISSUES AROUND MENTAL HEALTH AND SUBSTANCE ABUSE. INITIATIVE TAKEN: THE WESTERN CONNECTICUT HEALTH NETWORK, WHICH INCLUDES NORWALK HOSPITAL, IS PARTICIPATING IN MULTIPLE PROGRAMS AND INITIATIVES THAT ADDRESS THE NEEDS OF ITS MOST VULNERABLE CITIZENS. IN JANUARY OF 2015, WCHN WAS ACCEPTED INTO CMS MEDICARE SHARED SAVINGS PROGRAM (MSSP) AS AN ACCOUNTABLE CARE ORGANIZATION (ACO). THE ACO IS STRUCTURED TO ENHANCE CARE SERVICES TO MEDICARES SENIORS AND PEOPLE WHO ARE DUAL ELIGIBLE. PROGRAMS UNDER THE ACO INCLUDE CARE MANAGEMENT AND CARE TRANSITIONS FOR THOSE INDIVIDUALS WHO ARE IDENTIFIED AS HAVING GREATER HEALTHCARE OR PSYCHOSOCIAL NEEDS, PROMOTION OF PREVENTATIVE SERVICES FOR THOSE WITH GAPS IN CARE AND CLINICAL PROTOCOLS TO DECREASE VARIATION IN HOW CARE IS DELIVERED. THE EXPECTATION IS THAT THROUGH THESE EFFORTS WE WILL BE ABLE TO MEET THE TENETS OF THE TRIPLE AIM, BETTER CARE FOR POPULATIONS, INCREASE PATIENT SATISFACTION AND AT LOWER COSTS. ANOTHER FOCUS IN OUR ORGANIZATION IS ON THE COMMUNITY CARE TEAMS. THE NORWALK COMMUNITY CARE TEAM (CCT) IS A COLLECTIVE OF PARTIES FROM THE NORWALK COMMUNITY WORKING TOGETHER TO IMPROVE OUTCOMES FOR VULNERABLE POPULATIONS INCLUDING THOSE WHO ARE CHRONICALLY PHYSICALLY AND/OR MENTALLY ILL, HOMELESS OR ABUSING SUBSTANCES. THE GOAL IS TO IMPROVE CARE, INCREASE COMMUNITY SAFETY AND REDUCE COSTS BY DEVELOPING WRAP AROUND SERVICES THROUGH MULTI-AGENCY PARTNERSHIP. THE NORWALK COMMUNITY CARE TEAM, INITIATED IN FEBRUARY 2014 AS AN OUTCOME OF THE NORWALK COMMUNITY HEALTH ASSESSMENT, PROVIDES DEDICATED LEADERSHIP FROM NORWALK HOSPITAL AND BRINGS TOGETHER A WIDELY DIVERSE GROUP OF COMMUNITY AGENCIES. THE NORWALK SUPER-USER TEAM WAS DEVELOPED TO AUGMENT THE CCT AND FOCUSES SPECIFICALLY ON EMERGENCY DEPARTMENT OVER-UTILIZATION. THIS TEAM BEGAN MEETING IN OCTOBER 2014 AND HAS REPRESENTATIVES FROM EMERGENCY MEDICINE INCLUDING THE DEPARTMENT CHAIR, PSYCHIATRY, CASE MANAGEMENT AND POPULATION HEALTH. TO DATE, THE NORWALK CCT AND SUPER-USER TEAM HAVE SERVED MORE THAN 200 INDIVIDUALS LINKING THEM TO HOUSING AND SOCIAL, MEDICAL AND PSYCHIATRIC SERVICES THEREBY IMPROVING QUALITY OF CARE AND REDUCING ED VISITS BY 30 AND 23% RESPECTIVELY. THE TARGET POPULATION FOR THESE PROGRAMS INCLUDES THOSE WHO ARE HOMELESS AND/OR HIGH EMERGENCY DEPARTMENT VISITORS. THOUGH SUCCESSFUL, THERE IS STILL MUCH WORK TO BE DONE. THE 83 MEMBERS OF THE SUPER-USER TEAM VISITED THE ED MORE THAN 1300 TIMES IN FY15. PART VI - AFFILIATED HEALTHCARE SYSTEM ROLES AND PROMOTION WESTERN CONNECTICUT HEALTH NETWORK (WCHN) IS AN INTEGRATED HEALTH CARE DELIVERY SYSTEM COMPRISED OF THREE COMMUNITY HOSPITALS AND THEIR AFFILIATED ENTITIES. IN ADDITION TO DANBURY, NEW MILFORD AND NORWALK HOSPITALS, THE CONTINUUM OF CARE INCLUDES A LARGE MEDICAL GROUP, HOME HEALTH CARE SERVICES, A NATIONALLY RENOWNED BIOMEDICAL RESEARCH INSTITUTE, THE WCHN AND NORWALK HOSPITAL FOUNDATIONS, AND OTHER RELATED AFFILIATES. WCHN'S MISSION IS TO IMPROVE THE HEALTH OF EVERY PERSON WE SERVE THROUGH THE EFFICIENT DELIVERY OF EXCELLENT, INNOVATIVE AND COMPASSIONATE CARE. FOR 2015, WCHN PROVIDED $19,826,631 IN TOTAL CHARITY CARE. DANBURY, NEW MILFORD AND NORWALK HOSPITALS PROVIDE MEDICAL SERVICES TO THE COMMUNITY REGARDLESS OF THE INDIVIDUAL'S ABILITY TO PAY. SERVICES INCLUDE ROUTINE INPATIENT ANCILLARY AND OUTPATIENT CARE IN SUPPORT OF THE HOSPITAL'S MISSION STATEMENT, TO IMPROVE THE HEALTH AND WELL-BEING OF THOSE WE SERVE. FOR 2015, WCHN PROVIDED CHARITY CARE IN THE FOLLOWING AMOUNTS: NORWALK HOSPITAL $7,649,926, DANBURY HOSPITAL INCLUDING THE NEW MILFORD HOSPITAL CAMPUS $11,003,250. WESTERN CONNECTICUT MEDICAL GROUP/NORWALK HOSPITAL PHYSICIANS & SURGEONS: THE MISSION OF WESTERN CONNECTICUT MEDICAL GROUP IS TO PROVIDE SAFE, INNOVATIVE, CONVENIENT AND COORDINATED PRIMARY AND SPECIALTY HEALTH CARE IN THE COMMUNITIES THEY SERVE AND STRIVE TO BE AWARE OF AND RESPOND TO THEIR PATIENTS' NEEDS. THEY SUPPORT A COMMITMENT TO ADVANCE THE HEALTH AND WELL-BEING OF INDIVIDUALS IN THEIR COMMUNITY BY DELIVERING QUALITY CARE, PARTICIPATING IN MEDICAL RESEARCH AND MEDICAL RESIDENCY PROGRAMS AND THE PROVISION OF MEDICAL SERVICES TO PATIENTS. WESTERN CONNECTICUT HEALTH NETWORK FOUNDATION INC'S MISSION IS TO RAISE FUNDS, REINVEST AND ADMINISTER THESE FUNDS AND MAKE DISTRIBUTIONS TO DANBURY HOSPITAL AND OTHER NOT-FOR-PROFIT HEALTH CARE AFFILIATES. FOR 2015, WCMG/NHP&S PROVIDED $1,023,000 IN CHARITY CARE. WESTERN CONNECTICUT HEALTH NETWORK AFFILIATES PRINCIPAL PURPOSE IS TO PROVIDE OUTPATIENT HEALTH CARE SERVICES IN VARIOUS LOCATIONS AND ALSO PROVIDE AMBULANCE SERVICES TO DANBURY AND SURROUNDING TOWNS, WHILE SERVING THOSE THAT CANNOT AFFORD THE CARE. FOR 2015, WCHN AFFILIATES PROVIDED $ IN CHARITY CARE. WESTERN CONNECTICUT HOME CARE, INC. (WCHC) PROVIDES STATE OF THE ART CLINICAL SERVICES RANGING FROM PEDIATRIC PATIENTS TO THE ELDERLY UTILIZING BEST PRACTICE IN HOME CARE TO MEET THE NEEDS OF THEIR PATIENTS. FOR 2015, WCHC PROVIDED $91,000 IN CHARITY CARE. EASTERN NEW YORK MEDICAL SERVICES (ENYMS) WAS FORMED IN APRIL, 2013. THE MISSION AT ENYMS IS TO PROVIDE SAFE, INNOVATIVE, CONVENIENT AND COORDINATED PRIMARY AND GASTRO HEALTH CARE IN THE COMMUNITIES WE SERVE AND STRIVE TO BE AWARE OF AND RESPOND TO OUR PATIENTS' NEEDS. PART VI - STATES WHERE COMMUNITY BENEFIT REPORT FILED CT ADDITIONAL INFORMATION PART I, LINE 7E - PROMOTION OF COMMUNITY HEALTH. IN ORDER TO PROMOTE THE HEALTH OF THE COMMUNITY, NORWALK HOSPITAL IS RESPONSIBLE FOR COORDINATING THE SERVICES OF THE HOSPITAL WITH THOSE OF OTHER HEALTH, EDUCATION, AND SOCIAL SERVICES IN THE COMMUNITY. THESE SERVICES ARE PROMOTED IN ORDER TO OPTIMIZE THE AVAILABILITY OF A FULL SCOPE OF SERVICES IN A COST-EFFECTIVE MANNER. IN FY15, NORWALK HOSPITAL SERVED OVER 1.6 MILLION PERSONS THROUGH OVER 400 COMMUNITY HEALTH EVENTS AND SPONSORSHIPS. HOSPITAL STAFF AND AFFILIATED PHYSICIANS PARTICIPATED IN HEALTH FAIRS, COMMUNITY EDUCATION LECTURES AND SCREENINGS WITH COMMUNITY ORGANIZATIONS. NORWALK HOSPITAL OFFERS PROGRAMS AND FINANCIAL SUPPORT TO THE CITY OF NORWALK AND SURROUNDING AREAS. EXAMPLES INCLUDE THE NORWALK COMMUNITY HEALTH CENTER (A FQHC) AND PROGRAM SUPPORT TO AMERICARES CLINIC (ALSO A FQHC). NORWALK HOSPITAL SUB-SPECIALTY CLINICS ARE ALSO STAFFED BY VOLUNTEER ATTENDING PHYSICIANS FOR UNDER SERVED PATIENTS. SCHEDULE H - PART I, LINE 7F - HEALTH PROFESSIONAL EDUCATION. NORWALK HOSPITAL HAS AN ACGME ACCREDITED MEDICAL RESIDENCY PROGRAM PARTNERED WITH YALE UNIVERSITY SCHOOL OF MEDICINE. APPROXIMATELY 61 RESIDENTS AND FELLOWS ROTATE IN THE MEDICINE, RADIOLOGY, GASTROENTEROLOGY, PULMONARY OR SLEEP PROGRAMS. THE ASSOCIATED COSTS AND REVENUES ARE DERIVED FROM THE MEDICARE COST REPORT. PART II: COMMUNITY HEALTH IMPROVEMENT ADVOCACY: LARGELY STATE AND LOCAL ELECTED OFFICIALS AND AGENCY HEADS WERE LOBBIED IN SUPPORT OF MAINTAINING PATIENT ACCESS TO ESSENTIAL SERVICES FOR THE UNINSURED AND UNDER INSURED. PART V LINE 5 - THE MOST RECENTLY COMPLETED CHNA WAS MADE AVAILABLE ON: A) NORWALK HOSPITAL'S WEBSITE: WWW.NORWALKHEALTH.ORG, B) ON THE CT HOSPITAL ASSOCIATION'S WEBSITE: HTTP://WWW.CHIME.ORG/ADVOCACY/COMMUNITY-HEALTH/ ON THE CITY OF NORWALK WEBSITE:WWW.NORWALKCT.ORG/DOCUMENTCENTER/VIEW/4397 AND ON THE NORWALK HEALTH DEPARTMENT'S WEBSITE: HTTP://WWW.CT.GOV/DPH/LIB/DPH/OHCA/COMMUNITY_NEEDS_ASSESSMENT/CHNA/2014/NO RWALK_HOSPITAL.PDF C) IS AVAILABLE UPON REQUEST FROM THE HOSPITAL FACILITY. C) IS AVAILABLE UPON REQUEST FROM THE HOSPITAL FACILITY. true NORWALK HOS PHYS & SURGEONS 24 STEVENS STREET NORWALK CT 06850 061522078 501(C)(3) 4736991 0 STRATEGIC SUPPORT WESTERN CT MEDICAL GROUP 14 RESEARCH DRIVE BETHEL CT 06801 061137531 501(C)(3) 11497837 0 STRATEGIC SUPPORT 2 PART I, LINE 2 - PROCEDURE FOR MONITORING USE OF GRANTS FUNDS IN US FUNDS ARE PROVIDED TO NORWALK HOSPITAL PHYSICIANS & SURGEONS, INC. AND WESTERN CONNECTICUT MEDICAL GROUP, INC. RELATED 501(C)(3) ORGANIZATIONS TO SUPPORT THE OPERATING LOSSES OF HOSPITAL BASED PHYSICIAN PRACTICES, AS THEY SUPPORT THE MISSION OF NORWALK HOSPITAL. NORWALK HOSPITAL PHYSICIANS & SURGEONS, INC. AND WESTERN CONNECTICUT MEDICAL GROUP, INC. ARE SUBJECT TO THE SAME POLICIES AND PROCEDURES AS NORWALK HOSPITAL ASSOCIATION. NORWALK HOSPITAL'S ACCOUNTING STAFF PROCESSES PAYROLL, PAYABLE, GENERAL LEDGER AND FINANCIAL STATEMENTS FOR NORWALK HOSPITAL PHYSICIANS & SURGEONS. MONTHLY RESULTS ARE PRESENTED TO THE NORWALK HOSPITAL FINANCE COMMITTEE FOR REVIEW. true true false false false true true false false DANIEL DEBARBA PRESIDENT THRU 12/31/14 19466 637084 0 310000 73676 19018 4197 12750 0 40400 97339 1019252 0 0 MICHAEL DAGLIO PRESIDENT EFF 1/1/2015 0 404582 0 145000 0 990 0 15300 0 29566 0 595438 0 0 JOHN MURPHY MD CEO THRU 12/31/14 0 949990 0 450000 0 2838 0 12750 0 39094 0 1454672 0 0 STEVEN ROSENBERG CFO/TREASURER 0 573258 0 200000 0 5856 0 12750 0 29979 0 821843 0 0 ANTHONY ACETO VICE PRESIDENT HUMAN RESOURCES 172622 123225 110235 0 380353 0 11862 0 10536 0 685608 123225 0 0 RENEE MAURIELLO VP NURSING & PATIENT CARE 317991 0 75000 0 11832 0 11700 0 19995 0 436518 0 0 0 JAMES HAYNES VP OPERATIONS 222066 0 57500 0 16286 0 11549 0 20795 0 328196 0 0 0 JAMES VARRONE VP SUPPLY CHAIN 159641 0 26000 0 0 0 9019 0 20995 0 215655 0 0 0 PATRICK MINICUS VICE PRESIDENT FINANCE 45622 375651 0 100000 27701 526 2376 0 2477 45461 78176 521638 0 0 BRIAN MCGOVERN MD PHYSICIAN 258715 0 286637 0 22451 0 12324 0 22495 0 602622 0 0 0 ARI PERKINS MD PHYSICIAN 345425 0 144946 0 6101 0 11395 0 22495 0 530362 0 0 0 JASON FISCHEL MD PHYSICIAN 260807 0 205749 0 677 0 11700 0 19995 0 498928 0 0 0 ROBERT CAPODANNO MD PHYSICIAN 248004 0 202751 0 10198 0 11831 0 22495 0 495279 0 0 0 ARTHUR STRICHMAN MD PHYSICIAN 235318 0 168527 0 23086 0 12324 0 21495 0 460750 0 0 0 PART I, LINE 4 - RECEIVED SEVERANCE, SUPPL NQ RETIRE, EQUITY BASED COMP ANTHONY ACETO RECEIVED SEVERANCE PAYMENTS TOTALING $314,956. SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS: WESTERN CONNECTICUT HEALTH NETWORK (WCHN) HAS ESTABLISHED THREE SEPARATE SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS (SERP). THESE PLANS PROVIDE SUPPLEMENTAL RETIREMENT BENEFITS TO KEY MEMBERS OF THE EXECUTIVE GROUP. UNDER THE AGREEMENTS FOR SERP PLANS #1 AND #2, AMOUNTS PROMISED TO ELIGIBLE EXECUTIVES ARE BASED ON TARGETED RETIREMENT BENEFITS AND THE PAYMENT OF BENEFITS IS SUBJECT TO VESTING. THE BENEFITS AT THE VESTED AGE ARE PROVIDED IN THE FORM OF AN ACTUARIAL EQUIVALENT LUMP SUM PLUS TAX GROSS-UP AMOUNT TO THE PARTICIPANTS. WCHN HAS ON ITS BOOKS AN ACCRUAL FOR THE PARTICIPANTS OF THE SERP, WHICH IS MAINTAINED SOLELY FOR ACCOUNTING PURPOSES AND IS UNFUNDED. SERP PLAN #1 - NONE OF THE INDIVIDUALS LISTED ON SCHEDULE J, PART II PARTICIPATED IN THIS PLAN DURING THE YEAR. SERP PLAN #2 - DURING THE FISCAL YEAR ENDING SEPTEMBER 30, 2015 NO PAYMENTS WERE MADE TO EITHER DR. JOHN MURPHY, PRESIDENT/CEO OF WCHN AND STEVEN H. ROSENBERG, CFO OF WCHN, PARTICIPANTS OF SERP PLAN #2. SERP PLAN #3 - EARNINGS AND LOSSES ON THE INVESTMENTS SELECTED BY PARTICIPANTS OF SERP PLAN #3 ARE ADDED TO THE BALANCE OF THE ACCOUNT. DURING THE FISCAL YEAR ENDING SEPTEMBER 30, 2015, NOT PAYMENTS WERE MADE TO DANIEL DEBARBA JR., EXECUTIVE VP/PRESIDENT OF DANBURY HOSPITAL AND MICHAEL DAGLIO, CHIEF OPERATING OFFICER/PRESIDENT NORWALK HOSPITAL, PARTICIPANTS OF SERP PLAN #3. PART I, LINE 6 - COMPENSATION CONTINGENT ON NET EARNINGS OF RELATED ORGS SUMMARY OF EXECUTIVE INCENTIVE PLAN THE PLAN IS ADMINISTERED BY THE EXECUTIVE COMPENSATION COMMITTEE (THE COMMITTEE) OF WESTERN CONNECTICUT HEALTH NETWORK, INC. (WHCN) ELIGIBILITY TO PARTICIPATE IN THE PLAN IS LIMITED TO THOSE EXEMPT EXECUTIVES EMPLOYED BY WCHN AND ITS SUBSIDIARIES (THE NETWORK) DURING THE PLAN YEAR WHO ARE IN POSITIONS IN WHICH THEIR DECISIONS, ACTIONS AND COUNSEL SIGNIFICANTLY AFFECT THE OPERATIONS OF THE NETWORK. THE COMMITTEE, WITH INPUT PROVIDED BY SENIOR MANAGEMENT OF THE NETWORK WILL DETERMINE WHICH ELIGIBLE EXECUTIVE EMPLOYEES OF THE NETWORK WILL PARTICIPATE IN THE PLAN. PRIOR TO THE BEGINNING OF EACH PLAN YEAR, OR AS SOON THEREAFTER AS PRACTICABLE, THE COMMITTEE WILL ESTABLISH TARGET AND MAXIMUM AWARD OPPORTUNITY FOR THE PARTICIPANTS, IN THE APPROPRIATE TIER IN THE PLAN, ALONG WITH A TEAM SCORECARD OF PLAN MEASURES. SOON AFTER THE CLOSE OF THE PLAN YEAR, ACTUAL ORGANIZATION AND INDIVIDUAL PERFORMANCE AND RESULTS WILL BE MEASURED AND ASSESSED IN COMPARISON TO PUBLISHED GOALS AND EXPECTATIONS ESTABLISHED FOR SUCH PLAN YEAR. RECOMMENDATIONS FOR INDIVIDUAL INCENTIVE AWARDS WILL BE PREPARED AND SUBMITTED TO THE COMMITTEE FOR EVALUATION AND APPROVAL. NOTWITHSTANDING ANY OTHER PROVISION OF THE PLAN, AT THE DISCRETION OF THE COMMITTEE, AWARDS MAY NOT BE PAID UNDER THE PLAN FOR ANY PLAN YEAR IF THE LEVEL OF PERFORMANCE SPECIFIED IN ONE OR MORE NETWORK LEVEL "CIRCUIT BREAKER GOALS" IS NOT ACHIEVED DURING THE PLAN YEAR. PART III - ADDITIONAL INFORMATION THE ORGANIZATION RELIED ON RELATED ORGANIZATIONS, WESTERN CONNECTICUT HEALTH NETWORK, INC. WHICH USED THE FOLLOWING METHODS DESCRIBED BELOW TO ESTABLISH TOP MANAGEMENT'S COMPENSATION: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -WRITTEN EMPLOYMENT CONTRACT -COMPENSATION SURVEY OR STUDY -APPROVAL BY BOARD OR COMPENSATION COMMITTEE A ST OF CT HLTH & EDUC FAC 060806186 2010-12-09 46840000 SEE PART VI false false false B ST OF CT HLTH & EDUC FAC 060806186 2012-12-07 82000000 SEE PART VI false false false A 12805000 0 46844821 0 1010853 0 829268 0 463600 44541100 0 0 2013 false false true true B 0 0 82012048 0 0 0 639886 0 0 72629368 0 8742793 2017 false false false true A false true false false false 0.01570 0.00460 0.02030 false false false true B false false false true false 0 false false false true A false true false false false false 0 false 0 false false B false true false false true true PEOPLES UNITED BANK 12. false false false 0 false false A true B true ADDITIONAL INFORMATION PART I - BOND ISSUE, (A) ISSUER NAME - A CHEFA SERIES G,H AND I STATE OF CONNECTICUT HEALTH AND EDUCATIONAL FACILITIES AUTHORITY PART I - BOND ISSUE, (A) ISSUER NAME - B CHEFA SERIES J - STATE OF CONNECTICUT HEALTH AND EDUCATIONAL FACILITIES AUTHORITY PART I - BOND ISSUE, (F) DESCRIPTION OF PURPOSE - A CHEFA SERIES G,H AND I - THE PROCEEDS OF THE BOND WERE USED FOR CONSTRUCTION OF A PARKING GARAGE AND FOR THE PURCHASE OF OTHER CAPITAL EQUIPMENT. PART I - BOND ISSUE, (F) DESCRIPTION OF PURPOSE - B CHEFA SERIES J THE PROCEEDS OF THE BOND ARE BEING USED FOR CONSTRUCTION OF AN AMBULATORY PAVILION AND FOR THE PURCHASE OF OTHER CAPITAL EQUIPMENT. PART II - PROCEEDS, A CHEFA SERIES G, H AND I - TOTAL PROCEEDS OF ISSUE INCLUDES INTEREST INCOME OF $4,821 RECEIVED ON THE CONSTRUCTION FUND, COST OF ISSUANCE FUND AND CAPITALIZED INTEREST FUND. PART II - PROCEEDS, B CHEFA SERIES J - TOTAL PROCEEDS OF ISSUE INCLUDES INTEREST INCOME OF $12,048 RECEIVED ON THE CONSTRUCTION FUND AND COST OF ISSUANCE FUND. PART III - PRIVATE BUSINESS USE - A CHEFA SERIES G,H AND I - PRIVATE BUSINESS USE IS BASED ON PHYSICIAN RESERVED SPACES IN FINANCED PARKING GARAGE. THESE RESERVED SPACES ARE USED BY BOTH EMPLOYEES AND ATTENDING PHYSICIANS VISITING HOSPITAL PATIENTS TO FURTHER THE HOSPITAL'S MISSION. PART III - PRIVATE BUSINESS USE - B CHEFA SERIES J - NO PRIVATE BUSINESS USE IN FISCAL 2015 - THE PORTION OF THE PAVILION COMPLETE AND OCCUPIED DOES NOT INCLUDE ANY PRIVATE BUSINESS USE. A PORTION OF THE CANCER CENTER WHICH WILL BE LOCATED IN THE NEW PAVILION WILL BE DEDICATED TO CANCER RESEARCH ONCE THE PAVILION IS COMPLETE AND OPERATIONAL. THE FUNDING OF THE PAVILION WILL INCLUDE $30,000,000 OF PHILANTHROPY AND APPROXIMATELY $2,300,000 OF WORKING CAPITAL. THESE AMOUNTS WILL BE ALLOCATED TO THE PORTION OF THE PAVILION THAT WILL BE USED BY OUTSIDE ENTITIES. PART III, LINE 9 POST ISSUANCE COMPLIANCE - NONQUALIFIED BONDS EFFECTIVE 1/1/2014, WESTERN CONNECTICUT HEALTH NETWORK (WCHN) BECAME THE SOLE CORPORATE MEMBER OF NORWALK HEALTH SERVICES CORPORATION AND A CORPORATE AFFILIATION WAS COMPLETED. NORWALK HEALTH SERVICES CORPORATION AND ALL SUBSIDIARIES ARE COVERED UNDER THE POLICIES OF WCHN AND AS SUCH, THE TAX EXEMPT DEBT POLICY APPLIES TO NORWALK HOSPITAL AS OF 1/1/2014. PART IV - ARBITRAGE LINE 4B - NAME OF PROVIDER - CHEFA SERIES J - PEOPLE'S UNITED BANK PART V - PROCEDURES TO UNDERTAKE CORRECTIVE ACTION EFFECTIVE 1/1/2014, WESTERN CONNECTICUT HEALTH NETWORK (WCHN) BECAME THE SOLE CORPORATE MEMBER OF NORWALK HEALTH SERVICES CORPORATION AND A CORPORATE AFFILIATION WAS COMPLETED. NORWALK HEALTH SERVICES CORPORATION AND ALL SUBSIDIARIES ARE COVERED UNDER THE POLICIES OF WCHN AND AS SUCH, THE TAX EXEMPT DEBT POLICY APPLIES TO NORWALK HOSPITAL AS OF 1/1/2014. JOINT VENTURE POLICY FORM 990, PART VI, SECTION B, LINE 16B WHILE A WRITTEN POLICY HAS NOT BEEN ADOPTED REGARDING THE EVALUATION OF PARTICIPATION IN JOINT VENTURES, MANAGEMENT FOLLOWS A PROCEDURE IN WHICH ALL POSSIBLE JOINT VENTURE ARRANGEMENTS ARE EVALUATED UNDER APPLICABLE FEDERAL TAX LAWS. MANAGEMENT UTILIZED THE SERVICES OF APPROPRIATE CONSULTANTS AND LEGAL COUNSEL TO EVALUATE EACH JOINT VENTURE OPPORTUNITY. THIS EVALUATION ALSO INCLUDES AN ANALYSIS OF HOW THE JOINT VENTURE WILL FURTHER THE HOSPITAL'S MISSION. THE HOSPITAL HAS TAKEN ALL APPROPRIATE STEPS TO SAFEGUARD ITS TAX EXEMPT STATUS WITH RESPECTS TO ALL JOINT VENTURE ARRANGEMENTS. JOINT VENTURE ARRANGEMENTS ARE APPROVED BY THE BOARD OF TRUSTEES. OFFICERS AND TRUSTEES FORM 990, PART VII DANIEL DEBARBA WAS PRESIDENT OF NORWALK HOSPITAL, DANBURY HOSPITAL AND NEW MILFORD HOSPITAL THRU 11/30/2014. EFFECTIVE 12/1/2014 HE IS PRESIDENT OF DANBURY HOSPITAL ONLY. BOARD TERM EXPIRED 12/31/2014. ED MAHONY - VICE CHAIRMAN AND TRUSTEE THRU 12/31/2014, CHAIRMAN AND TRUSTEE EFFECTIVE 1/1/2015 ANDREW WHITTINGHAM - TRUSTEE ONLY THRU 12/31/2014, VICE CHAIRMAN AND TRUSTEE EFFECTIVE 1/1/2015 MARK GUDIS - TREASURER AND TRUSTEE THRU 12/31/2014, TRUSTEE ONLY EFFECTIVE 1/1/2015 THOMAS AYOUB, MD - TRUSTEE AND CHIEF OF STAFF, COMPENSATION RECEIVED IS FOR SERVICES AS CHIEF OF STAFF OF NORWALK HOSPITAL FOR THOSE OFFICERS AND TOP 5 EMPLOYEES, FOR WHICH ONLY 40 HOURS IS NOTED TO REFLECT PAID HOURS, ACTUAL HOURS WORKED EXCEEDED THIS AMOUNT. NOTE - ALL AMOUNT IN COLUMN F, OF PART VII, "ESTIMATED AMOUNT OF OTHER COMPENSATION", REPRESENT BENEFITS, AND DO NOT REFLECT ANY COMPENSATION FOR WHICH THE AVERAGE AMOUNT OF TIME WORK CAN BE REFLECTED. SCHEDULE H PART V LINE 10A URL IMPLEMENTATION STRATEGY MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY TO MEET THE SIGNIFICANT COMMUNITY HEALTH NEEDS CAN BE FOUND AT: HTTP://WWW.NORWALKHOSPITAL.ORG/ABOUT-US/ABOUT-NORWALK-HOSPITAL/ COMMUNITY-BENEFIT TITLED GREATER NORWALK CHA CHIP REPORT DECEMBER 2012 FORM 990 - ADDITIONAL DBAS 24 STEVENS STREET, NORWALK, CT 06850 FORM 990, PART III, LINE 1 - ORGANIZATION MISSION THE MISSION OF NORWALK HOSPITAL IS TO IMPROVE THE HEALTH OF EVERY PERSON WE SERVE THROUGH THE EFFICIENT DELIVERY OF EXCELLENT, INNOVATIVE AND COMPASSIONATE CARE. VISION 2020: WESTERN CONNECTICUT HEALTH NETWORK (WCHN) OF WHICH NORWALK HOSPITAL IS A MEMBER, WILL BE THE PREFERRED PARTNER IN HEALTH AND PROVIDER OF CARE FOR THE COMMUNITIES WE SERVE AND WILL BE AMONG THE MOST RESPECTED COMMUNITY HEALTHCARE SYSTEMS IN THE NATION. VALUES: OUR VALUES REFLECT WHO WE ARE AS AN ORGANIZATION. THEY PROVIDE CLEAR GUIDANCE AS TO BEHAVIOR EXPECTATIONS AND MOTIVATE US BY PROMOTING A SENSE OF BELONGS AND PRIDE. WE ARE ALL ACCOUNTABLE FOR LIVING UP TO AND DEMONSTRATING THESE VALUES IN OUR DAY-TO-DAY ACTIONS: * EXCELLENCE - WE DELIVER THE HIGHEST QUALITY CARE AND SERVICE AND SURPASS ESTABLISH STANDARDS THROUGH A CONTINUOUS FOCUS ON IMPROVEMENT, INNOVATION AND EDUCATION. * INTEGRITY - WE APPROACH OUR WORK WITH THE HIGHEST STANDARDS OF OPENNESS, HONESTY AND ETHICAL BEHAVIOR, WITH FREEDOM FROM ANY INAPPROPRIATE INFLUENCE OR MOTIVE. * COMPASSION - WE SERVE OTHERS WITH EMPATHY AND A DESIRE TO ALLEVIATE THEIR SUFFERING WHILE HONORING EACH INDIVIDUAL'S DIGNITY AND PRIVACY. * TEAMWORK - WE WORK TOGETHER IN A COOPERATIVE, COORDINATED AND SUPPORTIVE ENVIRONMENT THAT PLACES THE TEAM'S OR ORGANIZATION'S GOALS AHEAD OF INDIVIDUAL GOALS. * FISCAL RESPONSIBILITY - WE ACHIEVE OUR MISSION THROUGH EFFICIENT AND EFFECTIVE USE OF OUR RESOURCES AND PERSONAL ACCOUNTABILITY FOR ENSURING FINANCIAL INTEGRITY AND PERFORMANCE. FORM 990, PART III, LINE 4A - PROGRAM SERVICE ACCOMPLISHMENTS MEDICINE SERVICE LINE: NORWALK HOSPITAL'S MEDICINE SERVICE LINE CONSISTS OF THE FOLLOWING SERVICES: INPATIENT DISCHARGES: GASTROINTESTINAL 1,151 INFECTIOUS DISEASE 1,081 INTERNAL MEDICINE 754 NEUROLOGY MEDICAL 353 PULMONARY MEDICINE 914 ALL OTHER 1,049 OUTPATIENT SERVICE LINE VOLUME: O/P MEDICINE 5,600 O/P MEDICINE COMMUNITY CLINIC 3,963 O/P MEDICAL ONCOLOGY 2,476 O/P PULMONARY MEDICINE 5,492 OUR DIGESTIVE DISEASE CENTER IS STAFFED BY RENOWNED FELLOWSHIP-TRAINED GASTROENTEROLOGISTS. WE USE ADVANCED DIAGNOSTIC AND TREATMENT TECHNOLOGY IN A COMPASSIONATE AND SUPPORTIVE MANNER. THE FOLLOWING SERVICES ARE PROVIDED: ABLATION THERAPY FOR BARRETT'S ESOPHAGUS, RADIOFREQUENCY ABLATION, COLON CANCER SCREENING, COLONOSCOPY, THIRD EYE RETROSCOPIC, CRYOTHERAPY, DOUBLE BALLOON-ASSISTED ENTEROSCOPY, ENDOSCOPY, ENDOSCOPIC MUCOSAL RESECTION, ENDOSCOPIC ULTRASOUND AND FINE-NEEDLE ASPIRATION, ESOPHAGEL MANOMETRY AND PH TESTING, LACTOSE TOLERANCE TESTING, LINX REFLUX MANAGEMENT SYSTEM FOR TREATMENT OF GERD, WIRELESS CAPSULE ENDOSCOPY AND LAPAROSCOPIC FUNDOPLICATION FOR GERD. NORWALK HOSPITAL'S INFECTIOUS DISEASE SPECIALISTS TREAT THE FULL RANGE OF INFECTIOUS DISEASES, INCLUDING CONDITIONS CAUSED BY LIVING ORGANISMS (BACTERIA, VIRUSES, FUNGI AND PARASITES), HIV, AND RELATED CONDITIONS, LYME DISEASE, CHRONIC AND WOUND-RELATED INFECTION, AND TRAVEL-RELATED INFECTION. OUR DOCTORS HAVE EXPERTISE IN THE PROPER USE OF ANTIBIOTICS AND OTHER ANTI-INFECTIVE MEDICINES TO TREAT DISEASE AND ALSO COLLABORATE WITH PRIMARY CARE DOCTORS, SPECIALISTS AND SURGEONS TO PROVIDE INDIVIDUALIZED TREATMENT FOR EACH PATIENT. WE OFFER EXPERTISE IN TREATMENT OF NEUROLOGICAL DISORDERS, INCLUDING STOKE, EPILEPSY, HEADACHE, PARKINSON'S DISEASE, ALZHEIMER'S DISEASE AND VERTIGO. ONE OF THE NATION'S FIRST HOSPITALS TO EARN PRIMARY STROKE CENTER ACCREDITATION FROM THE JOINT COMMISSION, WE HAVE BEEN REGULARLY RECOGNIZED BY THE CONNECTICUT DEPARTMENT OF PUBLIC HEALTH FOR CONSISTENTLY DEMONSTRATING THE ABILITY TO RAPIDLY DIAGNOSE AND TREAT STROKE. COMMITTED TO REMAINING ON THE FOREFRONT OF RAPID AND EFFECTIVE STROKE CARE, WE CONTINUE TO INCORPORATE THE LATEST EFFECTIVE TREATMENTS. WE OFFER OUTSTANDING DIAGNOSIS, TREATMENT AND CARE FOR PATIENTS WITH ALL TYPES OF PULMONARY CONDITIONS. WE PERFORM SPECIALIZED SERVICES, SUCH AS CARDIOPULMONARY EXERCISE TESTING TO MEASURE DEGREE OF FITNESS AND AID IN THE ASSESSMENT OF SHORTNESS OF BREATH; SPECIFIC DIAGNOSTIC ASTHMA TESTING; AND TESTING TO DETERMINE THE NEED FOR SUPPLEMENTAL OXYGEN FOR EVERYDAY LIVING AND AIR TRAVEL. ALL PROGRAMS ARE ADMINISTERED CONSISTENT WITH NORWALK HOSPITAL'S FINANCIAL ASSISTANCE POLICY. FORM 990, PART III, LINE 4B - PROGRAM SERVICE ACCOMPLISHMENTS SURGERY SERVICE LINE: NORWALK HOSPITAL'S SURGERY SERVICE LINE CONSISTS OF THE FOLLOWING SERVICES: INPATIENT DISCHARGES: MAJOR JOINT REPLACEMENT 399 TRAUMA SURGERY 354 MINOR GI SURGERY 191 GENERAL SURGERY 158 UROLOGY SURGERY 122 COLON/BOWEL SURGERY 168 OBESITY SURGERY 129 SPINAL SURGERY 131 ALL OTHER INPATIENT SURGERY 361 OUTPATIENT SERVICE LINE VOLUME: ABDOMEN GI SURGERY 545 BREAST SURGERY-NON PLASTIC 450 ENDOSCOPY 6,312 MISC GENERAL SURGERY 992 ORTHO SURGERY 521 UROLOGY 298 PAIN INJECTION PROCEDURES 569 OTOLARY HEAD NECK SURGERY 136 PLASTIC SURGERY 198 ALL OTHER OUTPATIENT SURGERY 724 NORWALK HOSPITAL OFFERS A JOINT REPLACEMENT CENTER, ONE OF OUR CENTERS OF EXCELLENCE. WE OFFER COMPREHENSIVE, MULTIDISCIPLINARY, PERSONALIZED JOINT REPLACEMENT CARE INCLUDING TOTAL HIP REPLACEMENT, TOTAL KNEE REPLACEMENT AND TOTAL SHOULDER REPLACEMENT. AS A LEVEL II TRAUMA CENTER, NORWALK HOSPITAL'S TEAM OF BOARD CERTIFIED SURGEONS PROVIDE IMMEDIATE, 24/7 CARE FOR ACUTE AND LIFE-THREATENING INJURIES TO CHILDREN AND ADULTS. OUR EXPERT GENERAL AND DIGESTIVE DISEASE SURGEONS SPECIALIZE IN MAJOR AND MINOR SURGICAL PROCEDURES OF THE ABDOMEN, DIGESTIVE TRACT, ENDOCRINE SYSTEM, BREASTS, SKIN AND BLOOD VESSELS. NORWALK HOSPITAL UROLOGISTS ARE KNOWN NATIONALLY FOR INNOVATION. PROCEDURES PERFORMED INCLUDE: EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY FOR KIDNEY STONES; LAPAROSCOPIC NEPHRECTOMY, MINIMALLY INVASIVE PHOTO-VAPORIZATION OF THE PROSTATE; MINIMALLY INVASIVE SURGICAL TREATMENT FOR FEMALE INCONTINENCE AND PYELOPLASTY. KNOWN FOR EXCELLENCE AND EXPERTISE, OUR COLON AND RECTAL SURGEONS PERFORM MORE ROBOTIC COLORECTAL SURGERIES THAN ANY OTHER HOSPITAL IN FAIRFIELD COUNTY. CERTIFIED BY THE AMERICAN BOARD OF COLON AND RECTAL SURGEONS, OUR COLORECTAL SURGEONS PROVIDE ADVANCED, INNOVATIVE, PERSONALIZED CARE FOR A WIDE RANGE OF CONDITIONS. OUR SURGEONS ARE EXPERTS IN THE SURGICAL MANAGEMENT OF COLON AND RECTAL CANCER; CROHN'S DISEASE; DIVERTICULITIS, AND ULCERATIVE COLITIS. THE SURGICAL WEIGHT LOSS CENTER IS NATIONALLY ACCREDITED. WE OFFER SEVERAL TYPES OF BARIATRIC SURGERY INCLUDING: LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING; SINGLE INCISION GASTRIC BANDING; LAPAROSCOPIC GASTRIC SLEEVE, LAPAROSCOPIC GASTRIC BYPASS, REVISIONAL BARIATRIC SURGERY AND ROBOTIC BARIATRIC SURGERY. BOARD-CERTIFIED NEUROSURGEONS DIAGNOSE AND TREAT DISORDERS THAT AFFECT ANY PORTION OF THE NERVOUS SYSTEM, INCLUDING THE BRAIN, SPINAL CORD AND PERIPHERAL NERVES. CONDITIONS INCLUDE BRAIN ANEURYSMS, CEREBRAL ANEURYSMS, CHRONIC SUBDURAL HEMATOMA, COMA, CONCUSSIONS, DEGENERATIVE DISC DISEASE, DISC HERNIATION, EPILEPSY, HEAD TRAUMA, SCOLIOSIS, SEIZURES, SPINAL COMPRESSION FRACTURES, SPINAL CORD INJURY, SPINAL CORD TUMORS, STENOSIS, STROKE, AND TORTICOLLIS. ALL PROGRAMS ARE ADMINISTERED CONSISTENT WITH NORWALK HOSPITAL'S FINANCIAL ASSISTANCE POLICY. FORM 990, PART III, LINE 4C - PROGRAM SERVICE ACCOMPLISHMENTS WOMEN AND CHILDREN'S SERVICE LINE: NORWALK HOSPITAL'S WOMEN'S AND CHILDREN'S DERIVE LINE CONSISTS OF THE FOLLOWING SERVICES: INPATIENT DISCHARGES: ANTE/POST-PARTUM 76 C SECTION DELIVERIES 492 GYN ONCOLOGY 33 GYNECOLOGY 73 VAGINAL DELIVERIES 845 NICU 242 NURSERY 1,128 PEDIATRIC MEDICAL 302 PEDIATRIC SURGERY 30 OUTPATIENT SERVICE LINE VOLUME: GYNECOLOGY 773 ULTRASOUND TESTING 2,849 OBSERVATION 804 PEDIATRIC OP PROCEDURES 4 PEDIATRIC OBSERVATION 548 OUR WOMENS AND CHILDREN'S SERVICES FEATURES A TOP NOTCH TEAM OF OBSTETRICIANS, GYNECOLOGIST, PEDIATRICIANS, CERTIFIED MIDWIVES, PEDIATRIC HOSPITALISTS, NEONATOLOGISTS, PEDIATRIC SPECIALISTS, PHYSICIAN ASSISTANTS AND NURSES. OUR OBSTETRICIANS AND CERTIFIED NURSE MIDWIVES DELIVER BABIES IN THE HOSPITAL'S MODERN, HOME-LIKE CHILD BIRTH CENTER. THE CENTER FEATURES IN-SUITE AMENITIES, INCLUDING PRIVATE ROOMS, MASSAGE THERAPY FOR INFANTS AND MOTHERS AND WIRELESS INTERNET ACCESS. IN ADDITION ADVANCES, MINIMALLY INVASIVE ROBOTIC SURGERY FOR SEVERAL GYNECOLOGIC PROCEDURES, INCLUDING HYSTERECTOMIES, FIBROID REMOVAL, VAGINAL PROLAPSE CORRECTION, TO STOP MENORRHAGIA AND TO TREAT CERTAIN FORMS OF CERVICAL AND UTERINE CANCERS, ARE AVAILABLE AT THE HOSPITAL. THE NORWALK HOSPITAL PEDIATRIC SERVICES INCLUDE THE JEFFREY PETER BAUER NEWBORN INTENSIVE CARE UNIT (NICU), PEDIATRIC INPATIENT CARE, PEDIATRIC SUBSPECIALTY CARE, AND THE PEDIATRIC DEVELOPMENT THERAPY CENTER. ALL PROGRAMS ARE ADMINISTERED CONSISTENT WITH NORWALK HOSPITAL'S FINANCIAL ASSISTANCE POLICY. FORM 990, PART III, LINE 4D - OTHER PROGRAM SERVICES DESCRIPTION OTHER PROGRAM SERVICES INCLUDE: EMERGENCY SERVICES - NORWALK HOSPITAL PROVIDES A COMPREHENSIVE RANGE OF HIGH-QUALITY EMERGENCY MEDICAL SERVICES, FOR THE MOST CRITICALLY ILL AND INJURED PATIENTS, FROM PRE-HOSPITAL EMS/PARAMEDIC SERVICES TO AN EMERGENCY DEPARTMENT FEATURING A LEVEL II TRAUMA CENTER TO A NATIONALLY RECOGNIZED CRITICAL CARE UNIT. OUR EMERGENCY DEPARTMENT FEATURES MODERN LIFESAVING TECHNOLOGY AND IS STAFFED BY BOARD-CERTIFIED PHYSICIANS AND EXPERIENCED NURSES WITH ADVANCED SKILLS. FOR PATIENTS EXPERIENCING A STROKE, NORWALK HOSPITAL IS CERTIFIED AS A STROKE CENTER BY THE JOINT COMMISSION. FOR PATIENTS EXPERIENCING AN ACUTE HEART ATTACK, NORWALK HOSPITAL IS CERTIFIED AS A PRIMARY ANGIOPLASTY CENTER. ONCE IDENTIFIED AS A CANDIDATE BY EMS OR BY THE EMERGENCY PHYSICIAN, A CRITICAL PATHWAY ENSURES THE RAPID EVALUATION OF THE PATIENT AND MOVEMENT TO THE CARDIAC CATH LAB FOR DEFINITIVE CARE TO MINIMIZE LONG-TERM CONSEQUENCES. NORWALK HOSPITAL'S CRITICAL CARE UNIT HAS BEEN NATIONALLY RECOGNIZED FOR THE EXEMPLARY LEVEL OF CARE PROVIDED. THE UNIT'S NURSES HAVE BEEN AWARDED THE BEACON AWARD FOR CRITICAL CARE EXCELLENCE BY THE AMERICAN ASSOCIATION OF CRITICAL CARE NURSES THREE TIMES. THE EMERGENCY DEPARTMENT HAD 36,759 TREATED AND RELEASED VISITS 9/30/2015. CARDIOVASCULAR SERVICES - NORWALK HOSPITAL OFFERS A PREMIER CARDIOVASCULAR PROGRAM TO MEET THE NEEDS OF PATIENTS WITH CARDIAC AND VASCULAR PROBLEMS. LED BY A SPECIALIST TEAM OF CARDIOLOGISTS, INTERVENTIONAL CARDIOLOGISTS AND VASCULAR SURGEONS, THIS PROGRAM HAS ACHIEVED WIDE ACCLAIM FOR PROVIDING LEADING-EDGE PREVENTION, DIAGNOSIS, TREATMENT AND REHABILITATION OF CARDIOVASCULAR DISEASE. ONE OF NORWALK HOSPITAL'S SIGNATURE CLINICAL SERVICES, OUR CARDIOVASCULAR PROGRAM OFFERS OUTSTANDING INPATIENT AND OUTPATIENT CARE FOR THOSE SUFFERING A HEART ATTACK OR FROM HEART DISEASE, CONGESTIVE HEART FAILURE, ANGINA, ATHEROSCLEROSIS, AND VASCULAR CONDITIONS, INCLUDING AORTIC ANEURYSMS, CAROTID ARTERY STENOSIS, DEEP VEIN THROMBOSIS AND PERIPHERAL ARTERY DISEASE. ADDITIONALLY, THE HOSPITAL HAS ON STAFF SEVERAL INTERVENTIONAL CARDIOLOGISTS WHO PERFORM DIAGNOSTIC CARDIAC CATHERIZATIONS AND EMERGENCY CARDIAC ANGIOPLASTY AMONG OTHER INVASIVE PROCEDURES. OUR CARDIAC REHABILITATION PROGRAM HELPS CARDIAC PATIENTS LIVE LIFE TO THE FULLEST AND IS ACCREDITED BY THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION FOR PROVIDING THE HIGHEST STANDARD OF CARE. CARDIOVASCULAR SERVICES HAD 1,37 INPATIENT DISCHARGES; 4,743 OUTPATIENT VOLUME FOR THE FISCAL YEAR ENDED 9/30/2015. PSYCHIATRY - NORWALK HOSPITAL PROVIDES INPATIENT PSYCHIATRIC SERVICES FOR ADULT AND GERIATRIC PATIENTS. THE 20 BED UNIT PROVIDES INDIVIDUALIZED CARE FOR PATIENTS WITH ACUTE PSYCHIATRIC ILLNESS, COMPLEX MEDICAL-PSYCHIATRIC ILLNESS OR A NEED FOR DUAL-DIAGNOSIS DETOXIFICATION. NORWALK HOSPITAL ALSO PROVIDES AN INTENSIVE OUTPATIENT PROGRAM, OFFERING BOTH INDIVIDUAL TREATMENT AND GROUP THERAPY. PSYCHIATRY HAD INPATIENT DISCHARGES OF 537 AND 9,523 BILLED MONTHS FOR THE FISCAL YEAR ENDED 9/30/2015. RADIOLOGY - NORWALK HOSPITAL OFFERS A VARIETY OF RADIOLOGY SERVICES INCLUDING, CT, PET/CT, CT LUNG SCREENING, VIRTUAL COLONOGRAPHY, MRI AND OPEN MRI, ULTRASOUND, BONE DENSITY MEASUREMENT/OSTEOPOROSIS SCREENING, GENERAL X-RAY, DIGITAL MAMMOGRAPHY, DIGITAL BREAST TOMOSYNTHESIS, BREAST MRI AND ULTRASOUND, STEREOTACTIC, MRI-GUIDED AND ULTRASOUND GUIDED BREAST BIOPSY, NUCLEAR MEDICINE, INTERVENTIONAL RADIOLOGY, CANCER SCREENING, STEREOTACTIC RADIOSURGERY, INTENSITY-MODULATED RADIATION THERAPY (IMRT) AND PROSTATE CANCER TREATMENT WITH RADIOACTIVE SEEDS. RADIOLOGY SERVICES PERFORMED 66,068 PROCEDURES FOR THE FISCAL YEAR ENDED 9/30/2015. PATHOLOGY AND LABORATORY MEDICINE - THE DEPARTMENT OF PATHOLOGY AND LABORATORY MEDICINE IS FULLY ACCREDITED BY THE COLLEGE OF AMERICAN PATHOLOGISTS. THE DEPARTMENT PROVIDES COMPREHENSIVE ANATOMIC AND CLINICAL PATHOLOGY TESTING SERVICES INCLUDING: BLOOD BANK & TRANSFUSION SERVICES, CLINICAL CHEMISTRY, MICROBIOLOGY, CYTOLOGY, HEMATOLOGY/COAGULATION/URINALYSIS, IMMUNOLOGY AND FLOW CYTOMETRY, SURGICAL PATHOLOGY, AUTOPSY SERVICE, CYTOGENETIC AND MOLECULAR DIAGNOSTICS AND BLOOD COLLECTION. THE PATHOLOGY AND LABORATORY DEPARTMENT PERFORM APPROXIMATELY, 1.5 MILLION TESTS EVERY YEAR, UTILIZING THE LATEST TECHNOLOGY IN ROBOTIC AUTOMATION AND BARCODE SPECIMEN TRACKING. FORM 990, PART VI, LINE 2 BUSINESS OR FAMILY RELATIONSHIP OF OFFICERS, DIRECTORS, ETC. A BUSINESS RELATIONSHIP EXISTS BETWEEN FRED AFRAGOLA, VICTOR LISS AND GEORGE BAUER A BUSINESS RELATIONSHIP EXISTS BETWEEN RICHARD JABARA AND ERVIN SHAMES FORM 990, PART VI, LINE 6 EXPLANATION OF CLASSES OF MEMBERS OR SHAREHOLDERS AS OF SEPTEMBER 30, 2014 NORWALK HEALTH SERVICES CORPORATION, INC. (NHSC) IS THE SOLE MEMBER OF NORWALK HOSPITAL ASSOCIATION (NHA) AND APPOINTS NHA'S TRUSTEES. ON OCTOBER 1, 2014 NHSC MERGED INTO WESTERN CONNECTICUT HEALTH NETWORK (WCHN), WCHN BECAME THE SOLE CORPORATE MEMBER OF NHA. FORM 990, PART VI, LINE 7A HOW MEMBERS OR SHAREHOLDERS ELECT GOVERNING BODY THE SOLE MEMBER SHALL BE RESPONSIBLE FOR ELECTING, AT THE ANNUAL MEETING OF THE MEMBERSHIP, THE MEMBERS OF THE BOARD OF TRUSTEES OF THE HOSPITAL TO SERVE FOR THREE YEAR TERMS AND UNTIL THEIR SUCCESSORS ARE ELECTED AND HAVE QUALIFIED. FORM 990, PART VI,LINE 7B DECISIONS OF GOVERNING BODY APPROVAL OF MEMBERS OR SHAREHOLDERS CERTAIN FUNDAMENTAL DECISIONS TO BE UNDERTAKEN BY THE HOSPITAL REQUIRE APPROVAL OF THE MEMBER. FORM 990, PART VI, LINE 11B FORM 990 REVIEW PROCESS STEVEN ROSENBERG, CFO OF WCHN, WILL REVIEW THE 990 PRIOR TO IT BEING SENT TO THE IRS. A PRELIMINARY 990, IS PRESENTED TO THE AUDIT COMMITTEE IN JUNE, WHO REVIEWS IT ON BEHALF OF THE BOARD. E&Y IS ON HAND TO REVIEW THE 990 WITH THE AUDIT COMMITTEE AND ANSWER ANY QUESTIONS. PRIOR TO THE 990 BEING FILED WITH THE IRS, THE BOARD WILL RECEIVE A FULL AND ACCURATE COPY ON A SECURED WEBSITE FOR THEIR REVIEW. FORM 990,PART VI, LINE 12C EXPLANATION OF MONITORING AND ENFORCEMENT OF CONFLICTS THE ORGANIZATION'S PROCESS FOR MONITORING AND ENFORCING CONFLICTS OF INTEREST THE WESTERN CONNECTICUT HEALTH NETWORK AND ITS AFFILIATES' (THE NETWORK) CONFLICT OF INTEREST POLICY PROVIDES THAT ANNUALLY, ITS REPRESENTATIVES SHALL SIGN A STATEMENT AFFIRMING THAT THEY DISCLOSED ALL POTENTIAL CONFLICTS, AS DOCUMENTED IN THE CONFLICT OF INTEREST POLICY. IN ADDITION, GENERAL COUNSEL IS PART OF THE ROUTINE CONTRACTS REVIEW PROCESS AND WATCHES FOR POTENTIAL CONFLICTS WITH ANY OF THE NETWORK'S REPRESENTATIVES. WHO IS COVERED BY THE POLICY THE NETWORK'S CONFLICT OF INTEREST POLICY COVERS EACH DIRECTOR, OFFICER AND MANAGER OF THE NETWORK, ALSO REFERRED TO AS "REPRESENTATIVES". LEVEL AT WHICH DETERMINATIONS OF WHETHER THERE IS A CONFLICT IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE FACTS OF THE CONFLICT. THE COMPLIANCE OFFICER AND THE AUDIT COMMITTEE REVIEW AND EVALUATE EACH DISCLOSURE TO DETERMINE IF THERE IS A CONFLICT OF INTEREST. AFTER PRESENTATION OF A POTENTIAL TRANSACTION OR ARRANGEMENT IS MADE BY AN INTERESTED PERSON, THE REMAINING DISINTERESTED BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXIST. LEVEL THAT REVIEWS AND DETERMINES WHAT TO DO IF THERE IS A CONFLICT AFTER EXERCISING DUE DILIGENCE THE FULL BOARD WOULD DETERMINE WHAT ACTIONS SHOULD BE TAKEN FOR ALL CONFLICTS BY OFFICERS AND DIRECTORS. ANY CONFLICTS OCCURRING BY A MANAGER ARE REVIEWED BY THE COMPLIANCE COMMITTEE TO DETERMINE WHAT FURTHER ACTION SHOULD BE TAKEN. RESTRICTIONS ON THE CONFLICTED PERSON NO DIRECTOR HAVING A CONFLICT OF INTEREST ON ANY MATTER SHALL VOTE ON THAT MATTER OR BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING AT WHICH THE VOTE IS TAKEN, EVEN WHEN PERMITTED BY LAW. NO REPRESENTATIVE HAVING A CONFLICT OF INTEREST ON ANY MATTER SHALL USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER. IF THE BOARD OF DIRECTORS, IN ITS SOLE DISCRETION, DETERMINES THAT ANY REPRESENTATIVE HAS CONFLICTS OF INTEREST SUFFICIENT IN NUMBER AND/OR IMPORTANCE THAT THE EFFECTIVENESS OF SUCH INDIVIDUAL ON BEHALF OF THE NETWORK MAY BE SIGNIFICANTLY IMPAIRED, THE BOARD MAY ASK THE INDIVIDUAL TO RESIGN. FORM 990,PART VI, LINE 15B COMPENSATION REVIEW & APPROVAL PROCESS- OFFICERS & KEY EMPLOYEES COMPENSATION OF CEO: IN ORDER TO ACHIEVE ITS MISSION AND ITS OVERALL PERFORMANCE OBJECTIVES, WESTERN CONNECTICUT HEALTH NETWORK, INC. EMPLOYS A PERFORMANCE-BASED TOTAL COMPENSATION PROGRAM FOR ITS SENIOR EXECUTIVES THAT IS MARKET COMPETITIVE, COMPLIANT WITH REGULATORY GUIDELINES, AND REPRESENTATIVE OF BEST PRACTICES. ELIGIBLE EXECUTIVES ARE GENERALLY DIRECT REPORTS OF THE CEO ALONG WITH OTHER EXECUTIVES DESIGNATED BY THE CEO. TO MEET WESTERN CONNECTICUT HEALTH NETWORK INC.'S TOTAL COMPENSATION OBJECTIVES FOR EXECUTIVES, THE FOLLOWING SURVEY SOURCES ARE USED FOR COMPARISON PURPOSES: -BLEND OF NATIONAL CONFIDENTIAL SOURCE, IHS, AND HAY GROUP POINTS, HEALTHCARE DATA (WHERE DATA AVAILABLE), PLUS 15% GEOGRAPHIC DIFFERENTIAL. TITLE MATCH DATA CUTS SELECTED BASED ON REVENUE SIZE. -FOR PHYSICIAN EXECUTIVES, SURVEYS COVERING PHYSICIAN COMPENSATION IN ACCREDITED MEDICAL SCHOOLS (AAMC) ARE USED IN COMBINATION WITH PROPRIETARY SURVEYS COMPILED BY NATIONALLY KNOWN CONSULTING FIRM, SULLIVAN COTTER AND THE MEDICAL GROUP MANAGEMENT ASSOCIATION (MGMA). WESTERN CONNECTICUT HEALTH NETWORK, INC. TARGETS CASH COMPENSATION AT MARKET COMPETITIVE LEVELS. BASE SALARY PLUS SHORT-TERM (ANNUAL) INCENTIVE AWARDS (TOTAL CASH) APPROXIMATE MARKET COMPETITIVE LEVELS FOR TOTAL CASH COMPENSATION. EXECUTIVE PERFORMANCE IS EXPECTED TO MEET OR EXCEED PREDETERMINED OPERATIONAL AND FINANCIAL METRICS. OTHER FACTORS, SUCH AS COMPETITIVE MARKET FORCES, JOB PERFORMANCE, UNIQUE QUALIFICATIONS, AND/OR INDIVIDUAL JOB RESPONSIBILITIES ARE ALSO CONSIDERED IN WESTERN CONNECTICUT HEALTH NETWORK, INC'S EXECUTIVE COMPENSATION DECISIONS. ROLES OF THE COMPENSATION COMMITTEE AND KEY EXECUTIVES IN THE EXECUTIVE COMPENSATION PROCESS - THE COMPENSATION COMMITTEE IN CONSULTATION WITH THE CEO AND THE SVP HUMAN RESOURCES (HR) SELECTS THE OUTSIDE COMPENSATION CONSULTANTS. THE CURRENT CONSULTANT IS THE HAY GROUP, WHOSE PURPOSE IS TO PROVIDE A VALID INDEPENDENT ASSESSMENT OF THE RELEVENT MARKET RATES AND PAY PRACTICES FOR HEALTHCARE EXECUTIVES, PHYSICIAN EXECUTIVES AND FOR PHYSICIANS IN GENERAL. - THE COMPENSATION CONSULTING FIRM COMPILES APPROPRIATE MARKET DATA, JOB EVALUATION AND RANKING INFORMATION FOR ALL EXECUTIVES AND PHYSICIANS OF THE ORGANIZATION, EXCLUDING THE CEO, AND WILL SUPPLY THIS MATERIAL TO THE CEO AND SVP HR FOR REVIEW AND AGREEMENT. ONCE THE REPORT IS FINAL, IT WILL BE SUPPLIED TO THE COMPENSATION COMMITTEE FOR THEIR CONSIDERATION AND ACCEPTANCE. -THE COMPENSATION COMMITTEE DETERMINES THE CEO'S SALARY BASED ON OVERALL PERFORMANCE AND MARKET DATA SUPPLIED BY THE OUTSIDE COMPENSATION CONSULTANT. THE LAST EXECUTIVE COMPENSATION EVALUATION BY AN OUTSIDE CONSULTANT WAS DONE IN DECEMBER, 2015. COMPENSATION FOR OTHER OFFICERS AND KEY EMPLOYEES: COMPENSATION REVIEW AND APPROVAL PROCESS IS IDENTICAL TO THE PROCESS FOR THE CEO AND EXECUTIVES. FORM 990, PART VI LINE 19 OTHER ORGANIZATION DOCUMENTS PUBLICLY AVAILABLE ALL GOVERNING DOCUMENTS REQUIRED BY LAW AND THE FINANCIAL STATEMENTS ARE MADE AVAILABLE BY REQUEST. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES CHANGE IN INTEREST RATE SWAP $ -2,928,568 CHANGE IN PENSION OBLIGATION -28,544,535 DECREASE IN BEN INT CHARITABLE REMAINDER TRUST -452,051 INCREASE BEN INTEREST IN NHF - PERM RESTRICTED 6,800 INCREASE BEN INTEREST IN NHF - TEMP RESTRICTED 22,383,231 INCREASE BEN INTEREST IN NHF - UNRESTRICTED 28,094,926 NET ASSET TRANSFER NORWALK HOSP PHYSICIANS & SURG -776,179 NET UNRESTRICTED CHANGES IN JOINT VENTURE 3,911,974 NORWALK SURGERY CENTER / JOINT VENTURE INCOME -3,771,482 TRANSFER FROM NORWALK HEALTH CARE, INC 270,131 TRANSFER FROM NORWALK HOSPITAL FOUNDATION 9,800 ------------ TOTAL $ 18,204,047 ------------ FORM 990 PART IX LINE 11G DESCRIPTION:AGENCY & TEMP HELP TOTAL FEES:1996594 FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTION EXPENSE TOTAL FEES:1878207 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT MANAGEMENT TOTAL FEES:9383073 FORM 990 PART IX LINE 11G DESCRIPTION:CORPORATE DEPTS ALLOCATIONS TOTAL FEES:5336947 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER TOTAL FEES:664455 FORM 990 PART IX LINE 11G DESCRIPTION:OUTSIDE SERVICES TOTAL FEES:4963673 FORM 990 PART IX LINE 11G DESCRIPTION:PATIENT CARE & ADMIN SERVICES TOTAL FEES:6496272 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES TOTAL FEES:8103372 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES - CONSULTING TOTAL FEES:2332523 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES - PHARMACY TOTAL FEES:4025155 NORWALK HOSPITAL PHYSICIANS & SURG 24 STEVENS STREET NORWALK CT 06850 061522078 PHYS PRACTICE CT 501(C)(3) 11 TYPE 2 NHA true NORWALK HEALTH CARE INC 24 STEVENS STREET NORWALK CT 06850 222577722 INACTIVE CT 501(C)(3) 9 WCHN INC true NORWALK HOSPITAL FOUNDATION INC 24 STEVENS STREET NORWALK CT 06850 252577708 FUNDRAISING CT 501(C)(3) 7 NHA true ADVANCED CENTER FOR REHABILITATION 24 STEVENS STREET NORWALK CT 06850 061304799 INACTIVE CT 501(C)(3) 11 TYPE 2 NHSC true DANBURY HOSPITAL 24 HOSPITAL AVENUE DANBURY CT 06810 060646597 ACUTE CARE CT 501(C)(3) 3 WCHN true WESTERN CONNECTICUT HEALTH NETWORK 24 HOSPITAL AVENUE DANBURY CT 06810 222594977 PRGM DEVELOP CT 501(C)(3) 11 TYPE 2 NA false WESTERN CT HEALTH NETWORK AFFILIATES 24 HOSPITAL AVENUE DANBURY CT 06810 222594968 OUTPATIENT CT 501(C)(3) 9 WCHN true WESTERN CT HEALTH NETWORK FOUNDATION 24 HOSPITAL AVENUE DANBURY CT 06810 237425557 ADMIN CONTRIB CT 501(C)(3) 7 WCHN true WESTERN CONNECTICUT HOME CARE INC 4 LIBERTY STREET DANBURY CT 06810 060655138 HOME HLTHCARE CT 501(C)(3) 9 WCHN true WESTERN CT MEDICAL GROUP INC 14 RESEARCH DRIVE SUITE 201A BETHEL CT 06801 061137531 PHYS PRACTICE CT 501(C)(3) 9 WCHN true EASTERN NY MEDICAL SERVICES PC 14 RESEARCH DRIVE SUITE 201A BETHEL CT 06801 455431389 PHYS PRACTICE NY 501(C)(3) 9 WCHN true NORWALK SURGERY 40 CROSS STREET NORWALK CT 06850 272394942 SURGERY CENTER CT NONE RELATED 3771480 5116985 false false 0.63210 NEW MILFORD MRI 21 ELM STREET NEW MILFORD CT 06776 271877801 INACTIVE CT NMH 0 0 false false 0.00000 SWC CORPORATION 24 STEVENS STREET NORWALK CT 06850 222577718 PHARMACY CT WCHN C CORP 0 0 true MEDICAL SERVICES OF DANBURY 24 HOSPITAL AVENUE DANBURY CT 06811 061635945 HEALTHCARE CT WCMG C CORP 0 0 true WESTERN CT HEALTH NETWORK INSU 23 LIME TREE BAY PO BOX 105 GRAND CAYMAN CJ 980438151 CAPTIVE INSURANCE CJ DANBURY HOSP C CORP 0 0 true false false true false false false false false true true true true true false true true true true true NORWALK HOSPITAL PHYSICIANS & SURGEONS J 572070 FMV NORWALK HOSPITAL PHYSICIANS & SURGEONS M 6997971 FMV NORWALK HOSPITAL PHYSICIANS & SURGEONS O 653149 FMV NORWALK HOSPITAL PHYSICIANS & SURGEONS Q 1679608 FMV NORWALK HOSPITAL PHYSICIANS & SURGEONS R 7000000 FMV NORWALK HOSPITAL PHYSICIANS & SURGEONS S 331625 FMV NORWALK HOSPITAL FOUNDATION INC C 1501640 FMV NORWALK HOSPITAL FOUNDATION INC J 43200 FMV NORWALK HOSPITAL FOUNDATION INC L 65160 FMV NORWALK HOSPITAL FOUNDATION INC O 137801 FMV NORWALK HOSPITAL FOUNDATION INC Q 149928 FMV NORWALK HOSPITAL FOUNDATION INC S 1979495 FMV DANBURY HOSPITAL I 1012175 FMV DANBURY HOSPITAL K 416543 FMV DANBURY HOSPITAL M 5792729 FMV DANBURY HOSPITAL O 9606088 FMV DANBURY HOSPITAL P 11936824 FMV DANBURY HOSPITAL R 24191633 FMV WESTERN CONNECTICUT HEALTH NETWORK INC O 218400 FMV WESTERN CT HEALTH NETWORK AFFILIATES O 111664 FMV WESTERN CT HEALTH NETWORK AFFILIATES S 111494 FMV WESTERN CT MEDICAL GROUP INC J 822787 FMV WESTERN CT MEDICAL GROUP INC M 15733128 FMV WESTERN CT MEDICAL GROUP INC O 506681 FMV WESTERN CT MEDICAL GROUP INC Q 43582 FMV WESTERN CT MEDICAL GROUP INC R 12827178 FMV SWC CORPORATION J 28532 FMV SWC CORPORATION L 138000 FMV SWC CORPORATION M 3576421 FMV SWC CORPORATION Q 243766 FMV SWC CORPORATION R 2899913 FMV WESTERN CT HEALTH NETWORK INSURANCE CO R 8027439 FMV PART III - PARTNERSHIP FULL NAME, ADDRESS, FEIN NORWALK SURGERY CENTER, LLC 27-2394942 40 CROSS STREET NORWALK, CT 06850 NEW MILFORD MRI JV, LLC 27-1877801 21 ELM STREET NEW MILFORD, CT 06776