2015-08-12T21:24:09-05:00 2014-09-30 PricewaterhouseCoopers LLP 125 High Street Boston MA 02110 990 2013-10-01 060646704 Lawrence & Memorial Hospital % SETH VAN ESSENDELFT LAWR 8604420711 365 Montauk Avenue Suite New London CT 06320 SETH VAN ESSENDELFT VICE PRESIDENT/CFO 8604420711 2015-08-11 true ERIN COUTURE P01390592 8604420711 2013 2016-03-07 17:11:31Z BRUCE CUMMINGS 365 MONTAUK AVENUE NEW LONDON CT 06320 360381252 false X www.lmhospital.org X 1912 CT To improve the health of the region. 11 7 2648 359 2524951 -703047 813756 880130 318911102 345412898 7077778 9678721 2094550 2321513 328897186 358293262 0 0 0 0 187641751 192997162 108733 645 838522 124277351 155434308 312027835 348432115 16869351 9861147 393527817 394458671 194363317 226249224 199164500 168209447 X TO IMPROVE THE HEALTH OF THE REGION. false false 243616475 345020034 SEE SCHEDULE O 1155113 392864 EDUCATIONAL PROGRAMS 244771588 true true false true false false false false false true true false false true true false false true false false true false false false false false true true false false true true false false false false false false false false false false false false false false false true true true false false true 199 0 true 2648 true true true true NL false false false true true false false false false X 11 7 true false false false false false false true true false false true true true true true true true true false X X SETH VAN ESSENDELFT 8604420711 365 MONTAUK AVENUE New London CT 06320 X JAY E ALLEN DMD TREASURER AS OF 12/13 2.0 0.0 X X 0 0 0 ULYSSES B HAMMOND CHAIRMAN UNTIL 12/13 2.0 2.0 X X 0 0 0 CAROL O RIDGEWAY DIRECTOR 2.0 0.0 X 0 0 0 SCOTT D BATES VICE CHAIRMAN UNTIL 12/13 2.0 4.0 X X 0 0 0 MARY ELLEN JUKOSKI EDD VICE CHAIRMAN AS OF 12/13 2.0 0.0 X X 0 0 0 BRUCE D CUMMINGS PRESIDENT/CEO 27.25 12.75 X X 586388 0 111145 HENRY AMDUR MD PAST PRESIDENT, UNTIL 12/13 2.0 38.0 X X 0 379835 21384 DONALD J FELITTO MD DIRECTOR 2.0 4.0 X 27945 0 0 DAVID F REISFELD MD DIRECTOR 2.0 38.0 X 0 330927 33882 B MICHAEL RAUH JR TRE TO 12/13-DIR AS OF 12/13 2.0 0.0 X X 0 0 0 JAMES MITCHELL PHD SECRETARY AS OF 12/13 2.0 0.0 X X 0 0 0 GRANVILLE MORRIS CHAIRMAN AS OF 12/13 2.0 2.0 X X 0 0 0 SHARON ARNOLD DIRECTOR AS OF 12/13 2.0 0.0 X 0 0 0 NIALL J DUHIG MD DIRECTOR AS OF 12/13 2.0 0.0 X 58200 0 0 LUGENE INZANA VP/CFO UNTIL 2/14 24.0 16.0 X 339689 0 64510 MAUREEN ANDERSON ATTORNEY ASSISTANT SECRETARY 32.0 8.0 X 257757 0 53166 SETH VAN ESSENDELFT VP/CFO AS OF 8/14 24.0 16.0 X 0 0 0 JIM MOYLAN INTERIM VP/CFO 2/14 - 7/14 24.0 16.0 X 0 0 0 WILLIAM STANLEY VP DEV & COMMUNITY RELATIONS 16.0 24.0 X 189999 0 45549 DANIEL RISSI MD VP CHIEF MEDICAL OFFICER 32.0 8.0 X 382737 0 66098 KIMBERLY KALAJAINEN VP CHIEF INFORMATION OFFICER 34.0 6.0 X 218437 0 49105 CRISTA DURAND UNTIL 714 VP STRATEGIC PLANNING/MKTG 38.0 2.0 X 268409 0 54696 LAUREN WILLIAMS VP PATIENT CARE SERVICES 38.0 2.0 X 246661 0 39652 DONNA EPPS VP CHIEF HR OFFICER 38.0 2.0 X 197572 0 22449 CHRISTOPHER LEHRACH MD CHIEF TRANSFORMATION OFFICER 34.0 6.0 X 209144 0 22653 PAMELA KANE VP PHYSICIANS PRACTICE 0.0 40.0 X 223208 0 55161 GERALDINE RUFFA MD MEDICAL DIRECTOR, PHYSICIAN 40.0 0.0 X 233429 0 11216 PAUL CHAUSSE DIRECTOR OF REVENUE CYCLE 40.0 0.0 X 171598 0 19947 GARY CASS DIRECTOR HR/LABOR RELATIONS 40.0 0.0 X 169591 0 28852 WARREN B ROGERS DIRECTOR OF PHARMACY 40.0 0.0 X 163750 0 30610 3944514 710762 730075 163 false true false YANKEE REMODELER OF NEW LONDON 95 TRUMAN STREET NEW LONDON CT 06320 REMODELING COMPANY 1192000 TOTAL LAUNDRY COLLABORATIVE LLC 114 WOODLAND STREET HARTFORD CT 06105 LAUNDRY SERVICES 831187 NIXON PEABODY LLP ATTORNEYS AT LAW 100 SUMMER ST BOSTON MA 021102131 ATTORNEYS 2412538 INPATIENT CONSULTANTS OF NEW ENGLAN PO BOX 844929 LOS ANGELES CA 900844929 HOSPITALISTS 2189288 PRESIDIO NETWORKED SOLUTIONS GROUP PO BOX 677638 DALLAS TX 752677638 IT SERVICES 1393802 36 657996 222134 880130 NET PATIENT SERVICES 900099 318785233 318785233 LAB TESTING - ORR 900099 2524824 2524824 PARAMEDIC SERVICES 900099 2870412 2870412 OTHER PROGRAM SERVICE REVENUE 900099 21232429 21232429 345412898 9403082 127 9402955 0 0 1330836 1330836 0 1330836 1330836 2456992 -93363 2087990 369002 -93363 275639 275639 0 0 0 DINING ROOM 900099 990677 990677 990677 358293262 342888074 2524951 12000107 0 0 0 0 3740368 3515627 224741 0 138603250 105388782 32920573 293895 3687128 2734203 945300 7625 36722150 27231447 9414763 75940 10244266 7596673 2626408 21185 0 1972752 489146 1483606 2810 2810 0 645 645 424205 424205 5613434 5070746 542688 0 5482206 4114298 1332050 35858 4462189 915930 3534336 11923 0 6860579 2020308 4840271 332565 142214 190351 0 0 3542721 3542721 0 22635121 10884990 11749744 387 5568734 5568734 PURCHASED SVCS 32289846 9729980 22552741 7125 MEDICAL & SURGICAL 53303927 53003757 294244 5926 EQUIP RENTAL & MAINTENANCE 7520012 5316376 2203636 CONSULTING 3458663 184953 3273710 1964544 836330 974942 153272 348432115 244771588 102822005 838522 0 0 483541 7100538 20366 20366 32485521 35011996 0 0 0 0 304200 85520 5845470 6580752 2256097 2689506 426472926 265615130 161990209 160857796 149858150 148362925 6773578 6985614 0 0 0 0 33510685 26763658 393527817 394458671 37658612 41120923 0 0 0 0 88266954 111385992 0 0 0 0 0 0 0 0 68437751 73742309 194363317 226249224 X 171018998 138729444 22198248 23432028 5947254 6047975 199164500 168209447 393527817 394458671 X 9861147 1128066 -41944266 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 42350 42350 false false Lobbying Activities Schedule C, Part II-B, Line 1 The organization pays membership dues to the Connecticut Hospital Association and American Hospital Association which lobby on behalf of its member organizations. These lobbying activities are defined as associations communication with the federal and state governments to influence legislation. The Organization pays membership dues to member organizations which do engage in lobbying activities. Therefore, a portion of the dues is attributable to lobbying activities. 17922953 1382314 269234 48666 18987367 16251377 1952978 239701 41701 17922953 14398889 2146447 266733 27226 16251377 14741092 17500 324466 35237 14398889 14150668 1282741 652042 40275 14741092 0.85000 0.15000 false false 1464978 1464978 144195495 74047970 70147525 6714851 3502056 3212795 265024486 183101232 81923254 9073116 4963872 4109244 160857796 OTHER RECEIVABLES 20517048 DEBT SERVICE FUND 1304563 DEFERRED FINANCING COSTS 2315752 DUE FROM AFFILIATES 2064619 CONSTRUCTION FUND 561676 26763658 0 DUE TO THIRD PARTY AGENCIES 5165225 DEFERRED COMPENSATION 23825 SELF ASSURANCE RESERVES 3554817 ACCRUED POST RETIREMENT BENEFI 837437 ACCRUED PENSION 20197 ACCRUED 401K MATCH 856099 ACCRUED MIN PENSION LIABILITY 41478451 ASSET RETIREMENT OBLIGATION 509994 DUE TO L&M CORPORATION 2215430 DEFERRED FINANCING COST 2544115 MALPRACTICE INSURANCE 16536719 73742309 SCHEDULE D, PART V, LINE 4 THE ORGANIZATION'S ENDOWMENT FUNCTIONS TO SUPPORT AND PROVIDE INCOME FOR THE FURTHERANCE OF THE HEALTHCARE MISSION OF LAWRENCE & MEMORIAL HOSPITAL. SCHEDULE D, PART X LINE 2 THE ORGANIZATIONS FINANCIAL STATEMENTS DO NOT INCLUDE A FIN 48 DISCLOSURE. false Central America and the Caribbean Investments 39510772 39510772 39510772 false false true false false false true true X true X 250. true X true true true false false 2055 1053671 1053671 0.00300 25363 52916613 36972233 15944379 0.04580 785 1636597 1143472 493126 0.00140 28203 55606881 38115705 17491176 0.05020 51 8538 2136727 392864 1743863 0.00500 15 3823 1113320 3500 1109820 0.00320 8 6254 4719285 3011547 1707738 0.00490 2 466151 466151 0.00130 8 490 38481 38481 0.00010 84 19105 8473964 3407911 5066053 0.01450 84 47308 64080845 41523616 22557229 0.06470 2 752 42429 42429 0.00010 3 6982 6982 5 752 49411 49411 0.00010 true 12763924 382918 116008773 136596437 -20587664 X true true 1 1 LAWRENCE & MEMORIAL HOSPITAL 365 MONTAUK AVE NEW LONDON CT 06320 www.lmhospital.org 0047 X X X X LAWRENCE & MEMORIAL HOSPITAL 1 true X X X X X X X X 12 true false true X www.lmhospital.org X X X X X X false false true true 250. true 400. true X X X X true true X true false true X false false SCHEDULE H, PART V, SEC B, LINE 1j In addition to the Community Health Needs Assessment (CHNA) components listed, the L+M HOSPITAL CHNA report included analysis of the data in terms of strengths and opportunities for action. This analysis informed the creation of the Community Health Implementation Plan. SCHEDULE H, Part V, Section B, LINE 3: Upon completion of data collection and analysis, L+M Hospital convened a team of hospital and community representatives to a community health strategic planning session in May 2012. This session was facilitated by Holleran Consulting. The purpose of the strategic planning session was to share the results of the community health needs assessment, to discuss and prioritize community health needs, and to develop community health goals and strategies to guide the L+M Community Health Implementation Plan (CHIP). An asset mapping process was also undertaken in order to identify existing resources, services, and initiatives in the hospital service area. The following individuals comprised the planning team: Bruce Cummings, CEO, L+M Hospital Bill Stanley, VP Development/Community Relations, L+M Hospital Shraddha Patel, Director of Planning, L+M Hospital Sung Park, Outpatient Rehab Manager, L+M Hospital Mary Ann Nash, Nutrition Program Coordinator, L+M Hospital Drew Haffey, Manager, Therapeutic Fitness + Sports Medicine, L+M Hospital Trish Pugsley, Manager, Joslin Diabetes Center, L+M Hospital Alejandro Melendez-Cooper, Site Director, Community Health Center Jen Muggeo, Community Education, Ledge Light Health District Russell Melmed, Epidemiologist, Ledge Light Health District Stephanye Clarke, Health Program Coordinator, Ledge Light Health District Steve Smith, MD, Physician, Community Health Center Mary Lenzini, President, Visiting Nurse Association Jennifer O'Brien, Community Foundation of Southeastern Connecticut Dina Sears-Graves, VP of Community Investment, United Way Nancy Cowser, VP of Planning, United Community + Family Services Debra Pennuto-Muniz, Executive Director, Encuentros de Esperanza Michelle Devine, Executive Director, Southeastern Regional Action Council Rick Calvert, COO, Child + Family Agency JoAnn Eaccarino, Director-School Based Health Services, Child + Family Agency Michael Passero, President, New London City Council Jason Martin, Supervisor, Thames Valley Council for Community Action Tracee Reiser, Associate Dean for Community Learning, Connecticut College Jerry Lokken, Manager, Groton Parks + Recreation Fr. Michael Belt, Pastor, St. James Episcopal Chris Soto, New London Community Activist SCHEDULE H, Part V, Section B, LINE 5d: The CHNA report was released at a presentation open to the public on January 23, 2013. In attendance were community partners representing other non-profit organizations, business leaders, individuals representing the education sector, hospital staff, members of the press, and community members. SCHEDULE H, Part V, Section B, LINE 7: Due to resource constraints, some of the identified needs through the CHNA will not be addressed. In other cases, other organizations are taking the lead on an identified need and L+M Hospital is collaborating. A driving philosophy of L+M's community benefit efforts is to build on community resources, programs and services and to not duplicate them. As such, in examining each of the prioritized community health needs, existing community assets were identified before considering any new strategies that L+M might initiate and/or those to be continued. Where there is an existing community-based program addressing any of the prioritized needs, or due to resource limitations, L+M will work to support and build capacity of those programs rather than to create something new. There are three specific examples of areas where the data demonstrate that the L+M community is an outlier as compared to national benchmarks. The use of tobacco in the L+M service area, while having decreased, continues to exceed the Healthy People 2020 goal. L+M offers cessation support to employees presently. Although this indicator is directly linked to the priority area of cancer, due to resource limitations, L+M will not undertake programming intended for the wider community related to tobacco cessation. Similarly, although excessive drinking in adults over age 18 in New London County exceeds the national benchmark, and can be linked to cancer and mental health priority areas, L+M will support efforts led by community partners but will not take the lead in programming around this issue. For example, much work around substance abuse and addiction issues is being carried out by the Southeastern CT Regional Action Council, an entity established by the CT Legislature to assist communities in this area. Additionally, there are community partners receiving federal and state grant funds to address this area. L+M partners in these efforts but will not initiate new strategies. Last, the urban center of New London continues to demonstrate variance from state rates in births to teens and sexually transmitted infections. Although L+M will work to support community partners in addressing these issues, resource limitations will no longer allow L+M to play a leadership role. SCHEDULE H, Part V, Section B, LINE 20D: SEE EXPLANATION PROVIDED IN SCHEDULE H, PART I, LINE 3C SCHEDULE H, PART I, LINE 3C: It is the philosophy and policy of Lawrence & Memorial Hospital ("L+M HOSPITAL") that medically necessary health care services should be available to all individuals regardless of their ability to pay. Charity care applies to all uninsured patients (defined as earning less than 250% of the poverty guidelines) as described in 19a-673 of the Connecticut General Statutes. L+M HOSPITAL will meet or exceed the guidelines set-forth by the Connecticut Hospital Association ("CHA") on the Statewide Discount Policy for Uninsured Patients. Care will be provided free for those uninsured patients who request assistance and verify their annual income is less than 250% of the Federal Income Poverty Level ("FPL"). Liquid assets must not exceed $50,000 (Stocks, bonds, cash, 401, IRA, CD etc.) excluding primary residence and primary motor vehicle). Business assets, rental property, secondary residence, recreational vehicles and other such luxury items will be applied to the liquid assets. Care will be discounted on a sliding scale for self-pay patients who have no third party insurance to cover services with an annual income that is between 250% and 400% of the FPL and have assets less than $50,000, in accordance with the following: 251% - 300% = Cost of Charge 301% - 350% = 40% 351% - 400% = 30% SCHEDULE H, PART I, LINE 7: The amounts reported on Part I, Line 7 were calculated as direct, separately identifiable costs incurred by the Hospital plus an allocation of overhead. SCHEDULE H, Part II: L+M Hospital, with a mission to "Improve the Health of the Region," hews to the World Health Organization definition of health: "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." In addition to meeting an identified need in the community, L+M Hospital contributes to an overall healthy community and supports the hospital's role as good corporate citizen. This social impact is measured in terms of community vibrancy, and breadth and depth of community activities that enhance the quality of life in the region. The majority of the hospital's community building activities fall into the category of in-kind and financial support for partner non-profits also engaged in community development such as the disbursement of scholarships. We participate in economic development activities through the region's Chambers of Commerce. All of these activities have as their primary purpose to benefit the community and are carried out without remuneration. SCHEDULE H, PART III, LINES 2 AND 3: L+M HOSPITAL uses a cost reporting system to determine the bad debt expense. The amount of bad debt expense (at cost) reported on Part III, Line 2 is taken directly from the audited financial statements. The amount of bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy is calculated as 3% of the amount of bad debt (at cost) from the audited financial statements. The amount of 3% represents the bad debt amount that could have been qualified for charity care as this the percentage of gross revenue that is self paid. SCHEDULE H, PART III, LINE 8: The Medicare shortfall of ($20,587,664) reported in Part III, Line 7 was calculated based on cost reporting. The costing method was from the Medicare Cost report's own methodology of allocating cost by department and deriving a ratio of cost to charges. This amount should be treated as community benefit because the rates paid by Medicare do not accurately reflect the cost of care provided by L+M HOSPITAL. Accordingly, L+M HOSPITAL must subsidize the cost of care provided to Medicare beneficiaries with other revenues. SCHEDULE H, PART III, LINE 9B: IN ACCORDANCE WITH ITS WRITTEN CREDIT AND COLLECTION POLICY, L+M HOSPITAL WILL NOT PURSUE COLLECTION EFFORTS, DIRECTLY OR THROUGH COLLECTION AGENCIES, ON THE PORTION OF A PATIENT'S BILL FOR WHICH THAT PATIENT HAS ESTABLISHED ELIGIBILITY FOR CHARITY CARE. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: L&M Hospital employs a variety of strategies in gauging the health needs of the communities it serves. The most recent community health needs assessment (CHNA), covering the Lawrence + Memorial primary service area was conducted under the guidance of an outside expert. The assessment updates the last comprehensive CHNA and further analyzes health status as it relates to identified health care and public health issues in New London County. Methods included using scientifically valid data, comparative information, and input from local residents, providers and leaders. Indicators were computed from an extensive set of secondary health-related data. L+M Hospital reviews disease incidence and prevalence rates for the local community, state, and nation. Rates are collected from medical journals, the CT Department of Health, or national health resources such as the Kaiser Family Foundation or CDC. This analysis informs L+M on the health status of the community and is used to focus program and service development on areas of greatest concern. Information on community needs is also gathered through partnerships with other community organizations such as the United Way, the Ledge Light Health District, and other local non-profits. Periodic review of data and updating as appropriate is conducted. L+M Hospital completes a physician manpower study regularly. This study, conducted by an outside consultant, documents the demand for physicians by specialty based on physician-to-population ratios, the supply of physicians in the community, and the resultant gaps between demand and supply. The analysis informs L+M of deficiencies in physician supply and helps focus recruitment efforts to meet the demands of the community. All community benefit activities are regularly evaluated for impact and effectiveness and audited for compliance with the organization's community benefit policy. SCHEDULE H,PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: In accordance with its charity care policy, L+M HOSPITAL notifies patients of the availability of financial assistance using several methods. 1) Signage indicating the availability of charity care is posted in English and Spanish in Patient Accounts, Health Access Management and certain Clinical Areas. Summaries of the programs will also be available in those areas. 2) Patient Financial Advisors will attempt to visit all inpatients registered as self-pay patients. A summary explaining charity care will be given to the patient or guarantor when this visit occurs. 3) Patients with no insurance will receive an initial letter within one week of discharge informing them that L+M HOSPITAL considers them "insured" per the Connecticut General Statutes Section 19a-673. It is the responsibility of the patient to advise L+M HOSPITAL if they believe they qualify as "uninsured" (at or under 250% of the FPG). 4) A series of monthly statements will be sent following discharge. Each statement will remind the patient of the availability of charity care. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: Population size The communities that comprise the service area of Lawrence & Memorial include ten towns along the Connecticut shoreline between Rhode Island and the Connecticut River and inland to Salem, CT, with a total population of approximately 180,000 people year-round, increasing to 250,000 in the summer. Our communities represent a broad mix of urban, suburban, and rural areas. General Demographics The towns and cities in this area are very diverse, not only socio-economically but also in terms of race, ethnicity, faith tradition, resident transience, employment, health insurance status, and educational attainment. From 2000 to 2010, there was a slight overall growth in population with dramatic changes occurring in ethnic and racial composition of the local population; the percentage of Hispanics increased by 75.4%, African Americans increased by 16.9%, Native Americans increased by 0.7%, Asians increased by 124% and those who indicate "other" increased by 64%. Other increases have occurred in the Eastern European, and Haitian populations, among others, with local school districts reporting significant percentages of children who are English language learners (21.6 percent in New London, 11.5 percent in Norwich). Changes in the ethnic and racial makeup of County residents are impacting the burden of disease and demand for health services. According to the CDC Office of Minority Health & Health Equity (2012), race and ethnicity correlate with significant health disparities. Specifically, Hispanic/Latinos are at higher risk for asthma, diabetes, HIV/AIDS, cervical cancer, lack of prenatal care, and infant mortality. Blacks/African Americans are at higher risk for heart disease, hypertension, diabetes, and infant mortality. Both populations are also at higher risk for overweight/ obesity issues. Major Employers The region has transitioned from a largely defense industry-based economy to one that relies heavily upon employment in the service and trade sectors and in general has a higher percentage of persons employed in those sectors -with corresponding lower rates of pay- which is correlated with the lower per capita income and greater economic vulnerability. Major employers include the Mashantucket Pequot and Mohegan Tribes (Foxwoods Resort and Casino and Mohegan Sun Casino respectively), Pfizer Global Research and Development, educational institutions (Connecticut College, Mitchell College and the U.S. Coast Guard Academy), General Dynamics/Electric Boat, Dominion, and Lawrence + Memorial. There are Primary Social and Health Care Factors in the urban centers of the region, racial and ethnic health disparities, higher poverty and unemployment rates, lower levels of educational attainment, limited access to affordable housing and transportation, higher rates of death from chronic illness, and a greater likelihood of residents not having health insurance, all of which present particular challenges. Median household income in the L+M service area is far below that of the state, with African American and Hispanic families' incomes significantly lower than White families' incomes. The region includes one priority school district. Three of our communities have a greater percentage of children living in poverty than the state average of 26.1% - Groton 27.7%, New London 59.7% and Norwich 43.4% (children under 200% of the Federal Poverty Level 2006 - 2010, CT Voices for Children). The chronic disease burden is high throughout New London County with Norwich and New London having higher percentages with 3+ chronic conditions than other regions. New London and Norwich also have a higher percentage of people who self-identify as "Not Well" and, along with some outlying towns, have the least favorable indicators for chronic disease. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: L+M Hospital's community benefit programs and services forward the organizational mission "To Improve the Health of the Region" and align with the principles as set forth in the organization's community benefit policy. Those principles include: 1. Emphasis on programs to meet a significant unmet health need including efforts to identify and include vulnerable populations or those most at-risk as determined by risk factors which predispose those populations toward a higher incidence of disease and/or barriers to obtaining appropriate healthcare. 2. Emphasis on primary prevention and including at least one of three primary prevention strategies: health promotion, disease prevention, and health protection. Health promotion entails encouraging healthy lifestyles; disease prevention focuses on individuals identified as at-risk for health problems; health protection activities influence the environment to support healthy behaviors. 3. Programs should develop evidence-based links between clinical services and health improvement activities delivered both inside and outside the hospital. 4. Programs should focus on targeting charitable resources that mobilize and build capacity within existing community assets while minimizing duplication of effort. 5. Programs should emphasize collaboration with community stakeholders. As evidenced by the wide range of community benefit programs and services offered, L+M is engaged in meeting the identified health needs of the communities we serve. There is an organizational history of collecting data to determine how best to direct our resources and how to make the greatest impact in promoting community health. Our annual community benefit report publication describes a sampling of programs and the amount of investment that L+M makes in carrying out these programs. Community involvement in governance and advisory groups Community engagement in the planning, implementation and evaluation of L+M Hospital initiatives is of utmost importance. Consumers and stakeholder organizations participate in a range of activities so as to ensure that many perspectives are considered. One example of broad community involvement is in our facilitation of a multi-sector stakeholder collaborative to bring a community fitness center to our home community. The Reconnecting the Homeless Program engages in community collaboratives that provide important input for the program and emphasis is placed on hospital representative participation in other community organizations so as to provide opportunities to hear from our consumers. Lawrence + Memorial's Board of Directors is made up of community leaders who reside in the hospital's primary service area. These volunteers give countless hours of service to the hospital in their oversight role. They are involved in the strategic planning, in fundraising, and in general stewardship among other responsibilities. Our corporators are our community-liaisons and represent all sectors of our communities providing input and feedback regularly. Medical staff privileges are offered to all qualified physicians in the community. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: The entities of L+M Healthcare include L+M Hospital, the L+M Medical Group (LMPA, physician practices), The Visiting Nurse Association of Southeastern CT (VNASC), and Westerly Hospital (Rhode Island) each of which have a role in promoting the health of our communities. The L+M Hospital role is described in Question 5 above and Westerly Hospital operates in similar fashion: implementing community health improvement activities, providing opportunities for health professions students, ensuring access to care, promoting primary preventive care, providing subsidized health services and serving as a safety net provider. VNASC cares for everyone from the elderly who wish to remain in their homes for as long as they can and patients recovering from surgery or illness, to new mothers, schoolchildren, and the homeless using the most current medical advances and technologies in home healthcare, and strengthens community resources for everyone. LMPA, through its patient-centered medical home primary care and specialty practices provides diagnostic, therapeutic and preventive health care through physicians of Family Practice, Internal Medicine, Pediatrics, Dermatology, Endocrinology, General Surgery, Orthopedic Surgery, Neurosurgery, Breast and Reconstructive Surgery, Neurology, Rehabilitation Medicine, Obstetrics, Gynecology, Cardiology and Interventional Pain Management in multiple locations throughout southeastern CT and southwestern RI. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: L+M Hospital files its community benefit report in Connecticut only. The L+M Healthcare affiliated organization, Westerly Hospital, files reports in Rhode Island. OTHER INFORMATION: A MAJORITY OF L+M HOSPITAL'S TRUSTEES ARE MEMBERS OF THE COMMUNITY SERVED BY L+M HOSPITAL AND ARE NOT EMPLOYED BY L+M HOSPITAL NOR ARE THEY FAMILY MEMBERS OF PERSONS EMPLOYED BY L+M HOSPITAL. L+M HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY WHO WISH TO JOIN THE STAFF, CONSISTENT WITH THE SIZE AND NATURE OF ITS FACILITIES. EXCESS RECEIPTS FROM OPERATIONS ARE DEVOTED TO IMPROVEMENT OF FACILITIES, DEBT SERVICE, MEDICAL TRAINING AND RESEARCH. HEALTH ADVOCACY INITIATIVES L+M HOSPITAL IS INVOLVED IN HEALTH ADVOCACY INITIATIVES TO REDUCE UNINTENTIONAL INJURY TO CHILDREN, AND TO IMPROVE THE HEALTHCARE, PUBLIC HEALTH AND SOCIAL SERVICE SYSTEMS IN NEW LONDON COUNTY. OUR SAFE KIDS NEW LONDON COUNTY PROGRAM PLAYS A LEADERSHIP ROLE ON THE LOCAL, STATE AND NATIONAL LEVELS IN ADVOCATING FOR PUBLIC POLICIES THAT REDUCE INJURY RISK FOR CHILDREN. L+M HOSPITAL'S LEADERSHIP IN THE NEW LONDON COUNTY HEALTH COLLABORATIVE, AND PARTNERSHIP WITH OVER 12 OTHER ORGANIZATIONS INCLUDING BACKUS HOSPITAL, THREE HEALTH DEPARTMENTS, THREE FEDERALLY QUALIFIED HEALTH CENTERS, THE COUNTY ANTI-POVERTY AGENCY, TWO HOMECARE ORGANIZATIONS, AND THE COUNTY'S LARGEST CHILD ADVOCACY ORGANIZATION, HAS RESULTED IN THE COLLABORATIVE BEING LOOKED TO AS A VALUABLE RESOURCE FOR POLICY MAKERS. ADDITIONALLY, THE EFFORTS OF THE NEW LONDON COUNTY HEALTH COLLABORATIVE ARE HAVING AN IMPACT ON COMMUNITY HEALTH, INITIALLY IN THE AREA OF IMPROVED ACCESS TO CARE. X false true X X X X false true false false false false false true false BRUCE D CUMMINGS PRESIDENT/CEO 567106 0 0 19282 0 90112 0 21033 0 697533 0 0 0 HENRY AMDUR MD PAST PRESIDENT, UNTIL 12/13 0 277234 0 100621 0 1980 0 10000 0 11384 0 401219 0 0 LUGENE INZANA VP/CFO UNTIL 2/14 338447 0 0 0 1242 0 39749 0 24761 0 404199 0 0 0 WILLIAM STANLEY VP DEV & COMMUNITY RELATIONS 184059 0 0 0 5940 0 24087 0 21462 0 235548 0 0 0 MAUREEN ANDERSON ATTORNEY ASSISTANT SECRETARY 256947 0 0 0 810 0 29561 0 23605 0 310923 0 0 0 DANIEL RISSI MD VP CHIEF MEDICAL OFFICER 379173 0 0 0 3564 0 45065 0 21033 0 448835 0 0 0 KIMBERLY KALAJAINEN VP CHIEF INFORMATION OFFICER 214293 0 0 0 4144 0 25481 0 23624 0 267542 0 0 0 CRISTA DURAND UNTIL 714 VP STRATEGIC PLANNING/MKTG 267869 0 0 0 540 0 31875 0 22821 0 323105 0 0 0 LAUREN WILLIAMS VP PATIENT CARE SERVICES 244339 0 0 0 2322 0 28607 0 11045 0 286313 0 0 0 PAMELA KANE VP PHYSICIANS PRACTICE 222668 0 0 0 540 0 26950 0 28211 0 278369 0 0 0 DAVID F REISFELD MD DIRECTOR 0 292427 0 37210 0 1290 0 10000 0 23882 0 364809 0 0 GERALDINE RUFFA MD MEDICAL DIRECTOR, PHYSICIAN 231489 0 0 0 1940 0 10000 0 1216 0 244645 0 0 0 DONNA EPPS VP CHIEF HR OFFICER 188474 0 0 0 9098 0 22449 0 0 0 220021 0 0 0 PAUL CHAUSSE DIRECTOR OF REVENUE CYCLE 152304 0 18994 0 300 0 10000 0 9947 0 191545 0 0 0 GARY CASS DIRECTOR HR/LABOR RELATIONS 165696 0 85 0 3810 0 10000 0 18852 0 198443 0 0 0 CHRISTOPHER LEHRACH MD CHIEF TRANSFORMATION OFFICER 199958 0 0 0 9186 0 10000 0 12653 0 231797 0 0 0 WARREN B ROGERS DIRECTOR OF PHARMACY 141715 0 0 0 22035 0 5400 0 25210 0 194360 0 0 0 SCHEDULE J, PART I, LINE 1 WILLIAM STANLEY, VP OF DEVELOPMENT, HAS A NONTAXABLE MEMBERSHIP TO THE THAMES CLUB IN NEW LONDON. THE THAMES CLUB IS A SOCIAL CLUB THAT ALLOWS NETWORKING WITH POTENTIAL DONORS OR BOARD MEMBERS. NO PERSONAL USE IS ALLOWED AND ALL USE IS FOR BUSINESS PURPOSES. Bruce Cummings, President & CEO, authorizes William Stanley's membership in The Thames Club in his role as Vice President of Development & Community Relations of Lawrence & Memorial Hospital. In an effort to conduct business in the community and represent Lawrence & Memorial Hospital, The Thames Club provides an appropriate setting for meetings with Board Members and both current and potential donors. SCHEDULE J, PART I, LINE 4B LAWRENCE & MEMORIAL HOSPITAL ESTABLISHED A SECTION 457(F) SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR THE HOSPITAL'S SENIOR MANAGEMENT. AMOUNTS FOR BRUCE CUMMINGS ARE CREDITED TO THE RETIREMENT ACCOUNT IN MONTHLY INSTALLMENTS THROUGHOUT EACH PLAN YEAR. AMOUNTS FOR ALL OTHER MEMBERS OF SENIOR MANAGEMENT ARE CREDITED TO THE PLAN ANNUALLY. PLAN AMOUNTS WILL BE PAID ONLY IF CERTAIN CONDITIONS ARE MET, INCLUDING REMAINING EMPLOYED BY THE HOSPITAL THROUGH AGE 65, AS OUTLINED IN THE PLAN AGREEMENT. SECTION 457(F) CONTRIBUTIONS ARE REPORTED ON SCHEDULE J, PART II, COLUMN C. DURING 2013, SECTION 457(F) CONTRIBUTIONS WERE CREDITED TOWARDS THE PLAN AS FOLLOWS: BRUCE CUMMINGS - $80,112 DANIEL RISSI - $35,065 LUGENE INZANA - $29,749 CRISTA DURAND - $21,875 LAUREN WILLIAMS - $18,680 PAMELA KANE - $16,950 KIMBERLY KALAJAINEN - $15,481 WILLIAM STANLEY - $14,087 DONNA EPPS - $12,449 MAUREEN ANDERSON - $19,561 SCHEDULE J, PART I, LINE 7 L&M HOSPITAL HAS AN EXECUTIVE INCENTIVE PLAN. BONUSES ARE AWARDED UNDER THE PLAN BASED ON THE EXECUTIVE MEETING TEAM AND PERSONAL GOALS. THE PLAN ALSO INCLUDES A DISCRETIONARY COMPONENT. MEMBERS OF L&M HOSPITAL'S SENIOR MANAGEMENT TEAM (PRESIDENT & VICE PRESIDENTS) ARE ELIGIBLE FOR ANNUAL EXECUTIVE INCENTIVE PLAN AWARDS, BASED ON PRE-SET PERCENTAGES OF BASE SALARY TO EACH EXECUTIVE BASED ON THE HOSPITAL MEETING ITS FINANCIAL AND WORK-PLAN GOALS AS WELL AS THE EXECUTIVE MEETING PREDETERMINED INDIVIDUAL AND TEAM GOALS. IN THE CASE OF AN EXECUTIVE NOT MEETING ALL OF HIS OR HER PREDETERMINED GOALS, A PERCENTAGE OF THE ELIGIBLE TARGET AMOUNT MAY BE AWARDED. A CT HEFA FIXED RATE REV BONDS SERIES F 060806186 2011-09-15 61831040 SEE PART VI false false false B CT HEFA SERIES G 060806186 2013-10-10 30000000 SEE PART VI false false false C CT HEFA SERIES H 060806186 2013-05-05 21405000 SEE PART VI false false false A 8235000 0 61831040 0 0 0 1021749 0 0 0 60809291 0 2011 true false true true B 800000 0 30000000 0 0 0 299000 0 0 29139324 0 561676 2014 false false false true C 23209539 0 21405000 2247255 0 0 442716 0 0 0 18715029 0 true true true true A false false false false 0.00000 0.00000 0.00000 false false 0.00000 false false B false false false false 0 false false false false C false false false false 0 false false false false A false true false false false false 0 false 0 false false B false true false false false false 0 false 0 false false C false true false false true false 0 false 0 false false A false B false C false FORM 990, SCHEDULE K, PART I, COLUMN (F) NAME OF BOND: $58,940,000 FIXED RATE REV BONDS, SERIES F THE PROCEEDS OF THE SERIES F BONDS WERE USED TO REFUND THE OUTSTANDING AUTHORITY REVENUE BONDS, LAWRENCE & MEMORIAL HOSPITAL ISSUE, SERIES D (THE "SERIES D BONDS") AND TO FUND ALL OR A PORTION OF THE FOLLOWING CAPITAL PROJECTS: (1) REPLACEMENT OF A LINEAR ACCELERATOR ON THE MAIN CAMPUS OF THE HOSPITAL. (2) CAPITAL IMPROVEMENTS FOR INFRASTRUCTURE RENOVATION AND IMPROVEMENT ON THE MAIN CAMPUS, INCLUDING HEATING, VENTILATION, AND AIR CONDITIONING PROJECT. (3) REPLACEMENT OF A CATHETERIZATION LAB AND EQUIPMENT ON THE MAIN CAMPUS. (4) ACQUISITION OF APPROXIMATELY 100 ACRES OF LAND IN WATERFORD, CONNECTICUT FOR DEVELOPMENT OF A NEW CANCER CENTER. (5) ACQUISITION AND INSTALLATION OF MAGNETIC RESONANCE IMAGING (MRI) AND CT EQUIPMENT AT THE CROSSROADS FACILITY. NAME OF BOND: $29,200,000 PRIVATE PLACEMENT, SERIES G, ON OCTOBER 10, 2013 SERIES G WAS ISSUED IN A PRIVATE PLACEMENT OFFERING WITH BANK OF AMERICA-MERRILL LYNCH AND CHEFA WITH AN INTEREST RATE OF 3.20% UNTIL OCTOBER 1, 2023, WITH AN OPTION TO EXTEND AT A NEGOTIATED RATE WITH A MATURITY DATE OF JULY 1, 2038. THE PROJECT BEING FINANCED AND REFINANCED WITH THE PROCEEDS OF THE BONDS CONSISTS OF: (1) THE CONSTRUCTION AND EQUIPPING OF AN APPROXIMATELY 50,000 SQUARE FOOT COMMUNITY CANCER CENTER LOCATED AT 230 PARKWAY SOUTH, WATERFORD, CONNECTICUT. (2) THE RENOVATION AND EQUIPPING OF APPROXIMATELY 15,000 SQUARE FEET OF SPACE AT THE INSTITUTION'S MAIN CAMPUS FACILITY LOCATED AT 365 MONTAUK AVENUE, NEW LONDON, CONNECTICUT TO PROVIDE FOR A JOINT CENTER TO ACCOMMODATE POST-SURGICAL JOINT REPLACEMENT PATIENTS. (3) THE RENOVATION OF AN APPROXIMATELY 48,000-SQUARE FOOT, 3-STORY BUILDING LOCATED AT 194 HOWARD STREET, NEW LONDON, CONNECTICUT TO BE USED AS A MEDICAL OFFICE BUILDING (4) THE PAYING OF ALL OR A PORTION OF THE COSTS INCIDENTAL TO THE ISSUANCE OF THE BONDS, INCLUDING ISSUANCE COSTS OF THE BONDS AND ANY RESERVE FUNDS AS MAY BE NECESSARY TO SECURE THE BONDS. NAME OF BOND: $21,405,000 VARIABLE RATE DEMAND REV BOND, SERIES H, ON NOVEMBER 5,2013, SERIES H WAS ISSUED WITH A VARIABLE RATE AND A MATURITY DATE OF JULY 1, 2034. THIS BOND HAS A LETTER OF CREDIT GUARANTEED BY TD BANK. INTEREST ON THE SERIES H BONDS ACCRUES AT THE WEEKLY RATE AND IS PAYABLE ON THE FIRST BUSINESS DAY OF EACH MONTH COMMENCING JANUARY 1, 2014. THE SERIES H BONDS WERE ISSUED BY CHEFA TO REFINANCE SERIES E, WHICH REFUNDED 2004 ISSUE, WHICH REFUNDED 1998 ISSUE. OF AN APPROXIMATELY 50,000 SQUARE FOOT COMMUNITY CANCER CENTER LOCATED AT 230 PARKWAY SOUTH, WATERFORD, CONNECTICUT; (2) THE RENOVATION AND EQUIPPING OF APPROXIMATELY 15,000 SQUARE FEET OF SPACE AT THE INSTITUTION'S MAIN CAMPUS FACILITY LOCATED AT 365 MONTAUK AVENUE, NEW LONDON, CONNECTICUT TO PROVIDE FOR A JOINT CENTER TO ACCOMMODATE POST-SURGICAL JOINT REPLACEMENT PATIENTS; (3) THE RENOVATION OF AN APPROXIMATELY 48,000-SQUARE FOOT, 3-STORY BUILDING LOCATED AT 194 HOWARD STREET, NEW LONDON, CONNECTICUT TO BE USED AS A MEDICAL OFFICE BUILDING; AND (4) THE PAYING OF ALL OR A PORTION OF THE COSTS INCIDENTAL TO THE ISSUANCE OF THE BONDS, INCLUDING ISSUANCE COSTS OF THE BONDS AND ANY RESERVE FUNDS AS MAY BE NECESSARY TO SECURE THE BONDS. FORM 990, SCHEDULE K, PART III, LINE 9; PART IV, LINE 7; & PART V IN GENERAL, L&M HOSPITAL WORKS TO ENSURE POST ISSUANCE COMPLIANCE FOR ITS TAX-EXEMPT BONDS IN ACCORDANCE WITH BOND ISSUANCE DOCUMENTS. L&M HOSPITAL IS IN THE PROCESS OF DEVELOPING WRITTEN PROCEDURES FOR POST ISSUANCE COMPLIANCE FOR THE FOLLOWING: - TO ENSURE ALL NONQUALIFIED BONDS OF THE ISSUANCE ARE REMEDIATED IN ACCORDANCE WITH REQUIREMENTS OF REGULATIONS SECTIONS 1.141-12 & 1.145-2. - TO MONITOR THE REQUIREMENTS OF SECTION 148. - TO ENSURE THAT VIOLATIONS OF FEDERAL TAX REQUIREMENTS ARE TIMELY IDENTIFIED AND CORRECTED THROUGH THE VOLUNTARY CLOSING AGREEMENT PROGRAM IF SELF-REMEDIATION IS NOT AVAILABLE UNDER APPLICABLE REGULATIONS. Form 990, PART III, LINE 4A LAWRENCE & MEMORIAL HOSPITAL PROVIDES QUALITY MEDICAL CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF LAWRENCE & MEMORIAL HOSPITAL, WE RECOGNIZE THAT NOT ALL PERSONS HAVE THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES; AND, FURTHER, WE BELIEVE THAT A PART OF OUR MISSION IS TO CARE FOR THE MEDICALLY UNDER-SERVED IN OUR COMMUNITY WITH RESPECT TO PROVIDING HEALTH CARE SERVICES AND HEALTH CARE EDUCATION. IN KEEPING WITH OUR HOSPITAL'S MISSION OF "IMPROVING THE HEALTH OF OUR REGION" AND OUR COMMITMENT TO SERVE ALL MEMBERS OF ITS COMMUNITY, WE PROVIDE: - FREE CARE AND/OR SUBSIDIZED CARE. - CARE PROVIDED TO PERSONS COVERED BY GOVERNMENT PROGRAMS AT BELOW COST. - A BROAD RANGE OF HEALTH CARE ACTIVITIES, PROGRAMS AND SERVICES TO SUPPORT OUR COMMUNITY. - A SPECIAL COMMUNITY OUTREACH PROGRAM. THESE PROGRAMS WILL BE CONSIDERED WHERE THE NEED AND/OR AN INDIVIDUAL'S INABILITY TO PAY COEXIST. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, EMERGENCY RESPONSE PROGRAMS, COMMUNITY HEALTH SCREENINGS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, AND THE MEDICALLY UNDER-SERVED, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. DURING THE YEAR ENDED SEPTEMBER 30, 2014, LAWRENCE & MEMORIAL HOSPITAL SERVED 14,153 HOSPITALIZED PATIENTS AND 181,988 PATIENT VISITS THROUGH OUR AMBULATORY PROGRAMS. IN ADDITION, 86,353 EMERGENCY CASES CAME THROUGH OUR EMERGENCY FACILITIES IN NEW LONDON (50,457) AND GROTON (35,896). SAME DAY SURGERIES ACCOUNTED FOR 8,283 PROCEDURES. RECOGNIZING ITS MISSION TO THE COMMUNITY, LAWRENCE & MEMORIAL HOSPITAL PROVIDES CARE TO PERSONS COVERED BY FEDERAL AND STATE PROGRAMS AT OR BELOW COST. LAWRENCE & MEMORIAL HOSPITAL ALSO RECOGNIZES THE IMPORTANCE OF CHARITY CARE IN FULFILLING ITS MISSION TO THE ENTIRE COMMUNITY. CHARITY CARE IS ALSO PROVIDED THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR, BASED UPON ACTIVITIES AND SERVICES WHICH LAWRENCE & MEMORIAL HOSPITAL BELIEVES WILL SERVE A "BONA FIDE" COMMUNITY HEALTH CARE NEED. FORM 990, PART III, LINE 4B ======== LAWRENCE & MEMORIAL HOSPITAL BELIEVES THAT MOTIVATION THROUGH EDUCATION IS A STRONG FORCE IN HELPING INDIVIDUALS PREVENT ILLNESSES AND MAKE INFORMED CHOICES ABOUT THEIR BODIES AND WHAT HAPPENS TO THEM. OUR APPROACH PROVIDES ACCURATE HEALTH INFORMATION THROUGH A VARIETY OF PROGRAMMING EFFORTS SO CONSUMERS FEEL A PART OF THE DECISION-MAKING PROCESS AND HAVE AN ACTIVE ROLE IN THOSE DECISIONS. AS A RESULT, LAWRENCE & MEMORIAL REMAINS AMONG CONNECTICUT'S MOST PRO-ACTIVE HOSPITALS IN OFFERING DIVERSIFIED AND BROAD-BASED COMMUNITY HEALTH EDUCATION PROGRAMS. THESE PROGRAMMING EFFORTS INCLUDE COMMUNITY LECTURES AT THE HOSPITAL, CABLE TV ACCESS PROGRAMMING, RELIABLE HEALTH INFORMATION WITH OVER 2,500 HEALTH-RELATED ARTICLES ON THE HOSPITAL'S WEB SITE (WWW.LMHOSPITAL.ORG), TOURS, SUPPORT GROUPS, COMMUNITY EDUCATIONAL PROGRAMS, PUBLIC SERVICE ANNOUNCEMENTS AND SCREENING AND HEALTH FAIRS, INCLUDING ONSITE VISITS TO LARGE AND SMALL COMPANIES. LAWRENCE & MEMORIAL'S COMMUNITY OUTREACH PROGRAM HAS BEEN ABLE TO REACH A BROAD, CROSS-SECTION OF THE GREATER NEW LONDON COMMUNITY IN SOUTHEASTERN CONNECTICUT. THE COMMUNITY CONTRIBUTIONS ALSO INCLUDE SOME UNMENTIONED COMMUNITY BENEFITS SUCH AS: ADMINISTRATIVE AND FINANCIAL SUPPORT, OFFICE SPACE AND A LIBRARY OF ACCESSIBLE RESOURCES TO LEADERSHIP WITHIN THE VARIOUS FAITH COMMUNITIES IN OUR REGION. IN ADDITION, THERE ARE MANY COMMUNITY ORGANIZATIONS THAT WE SUPPORT AS PART OF BEING A GOOD NEIGHBOR AND TO RECOGNIZE THEIR EFFORTS IN OUR COMMUNITY. FORM 990, PART VI, LINE 2 DONALD FELITTO, MAUREEN ANDERSON, LUGENE INZANA, JIM MOYLAN, DANIEL RISSI, SETH VAN ESSENDELFT AND HENRY AMDUR SERVE ON THE BOARD OF L&M INDEMNITY, A RELATED ORGANIZATION. FORM 990, PART VI, LINE 11B WORKING WITH A PAID PREPARER, A FORM 990 IS PREPARED. L&M HOSPITAL'S FORM 990 IS THEN REVIEWED BY THE HOSPITAL'S INTERNAL MANAGEMENT. THE COMPLETED FORM 990 IS PROVIDED TO ALL MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO THE FORM BEING FILED WITH THE IRS. FORM 990, PART VI, LINE 12C L&M HOSPITAL REQUIRES ALL BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. QUESTIONNAIRES ARE COMPLETED ANNUALLY AND ARE REVIEWED BY L&M HOSPITAL'S GENERAL COUNSEL. ANY ACTUAL OR POTENTIAL CONFLICTS DISCLOSED ARE PRESENTED TO THE BOARD. APPROPRIATE CORRECTIVE ACTIONS ARE DECIDED ON A CASE BY CASE BASIS. FORM 990, PART VI, LINE 15 L&M HOSPITAL EXECUTIVE COMPENSATION COMMITTEE ANNUALLY REVIEWS THE SALARIES OF ITS EXECUTIVE MANAGEMENT. UTILIZING AN INDEPENDENT COMPENSATION CONSULTANT, THE EXECUTIVE COMPENSATION COMMITTEE APPROVES COMPENSATION. THE COMMITTEE'S DELIBERATIONS ARE REFLECTED IN ITS MINUTES. CEO'S COMPENSATION IS APPROVED BY THE FULL BOARD. FORM 990, PART VI, LINE 18 FORM 990 WILL ALSO BE MADE AVAILABLE THROUGH GUIDESTAR.ORG. FORM 990, PART VI, LINE 19 THE ORGANIZATION MAKES GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A ROBERT KELTNER, MD; NIALL DUHIG, MD AND DONALD FELITTO, MD ARE COMPENSATED AS MEDICAL STAFF AND NOT AS DIRECTORS. PART 990, PART IX, LINE 25 FUNDRAISING EXPENSES ARE REPORTED ON FORM 990, PART IX FOR LAWRENCE & MEMORIAL HOSPITAL (EIN 06-0646704). CONTRIBUTIONS ARE REPORTED ON THE FORMS 990 FOR BOTH LAWRENCE & MEMORIAL HOSPITAL (EIN 06-0646704) AND LAWRENCE & MEMORIAL CORPORATION (EIN 22-2553028). ADDITIONAL CONTRIBUTIONS IN THE AMOUNT OF $2,958,303 ARE REPORTED ON THE FORM 990 FOR LAWRENCE & MEMORIAL CORPORATION (EIN 22-2553028). FORM 990, PART XI, LINE 9 REALIZED GAINS -$369,002 PAYMENTS TO AFFILIATES -$37,512,133 CHANGE IN VALUE OF IRREVOCABLE TRUSTS $111,315 INCREASE IN FUNDS HELD IN TRUST BY OTHERS $100,721 CHANGE IN MINIMUM PENSION LIABILITY -$4,281,517 DONATED EQUIPMENT $6,350 _________ -$41,944,266 Lawrence & Memorial Corporation 365 Montauk Avenue New London CT 06320 222553028 Support CT 501(C)(3) 11 Type I NA false Lawrence & Memorial Foundation Inc 365 Montauk Avenue New London CT 06320 222553026 Fundraising CT 501(C)(3) PF L&M CORP true L&M Healthcare Inc 365 Montauk Avenue New London CT 06320 222553031 Healthcare CT 501(C)(3) 9 L&M CORP true Associated Specialists of SE CT 404 Thames Street Groton CT 06340 208006123 Phys Practice CT 501(C)(3) 11 Type I L&M HOSPITAL true Visiting Nurse Associate of SE CT 403 N Frontage Road Waterford CT 06385 060646616 Healthcare CT 501(C)(3) 9 L&M CORP true L&M Physician Association inc 365 Montauk Avenue new london CT 06320 271094375 healthcare CT 501(C)(3) 11 type i L&M CORP true LMW HEALTHCARE INC 25 WELLS ST WESTERLY RI 02879 460543230 HEALTHCARE RI 501(C)(3) 11 TYPE I L&M CORP true THE WESTERLY HOSPITAL FOUNDATION INC 25 WELLS STREET WESTERLY RI 02891 050508064 FUNDRAISING RI 501(C)(3) 11 TYPE I LMW HEALTH true L&M Systems Inc 365 Montauk Avenue New London CT 06320 222553037 Healthcare CT NA C true L&M Homecare Services Inc 365 Montauk Avenue New London CT 06320 061389272 Therapy CT NA C true L&M INDEMNITY PO BOX 1159 GRAND CAYMAN CAYMAN ISLANDS CJ KY1-1102 981021436 INSURANCE CJ NA C true CHARITABLE REMAINDER TRUSTS (3) SUPPORT CT L&M HOSPITAL TRUST true false true false false false false false false false true false false false false true true false false false L&M PHYSICIAN ASSOCIATION INC P 20865372 CASH LMW HEALTHCARE INC P 774443 CASH