THE CONNECTICUT HOSPICE INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- THE CONNECTICUT HOSPICE INC (EIN 06-0878822)
- Tax period
- 2013-10-01 to 2014-09-30
- Filed
- 2015-08-17
- IRS object ID
- 201532299349300858
- Schema version
- 2013v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-08-17T07:27:44-05:00 | ReturnTs |
| Tax Period End | 2014-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 061009205 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUM SHAPIRO & COMPANY PC CPA'S | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 29 S MAIN STREET PO BOX 272000 | AddressLine1 |
| City | WEST HARTFORD | City |
| State | CT | State |
| ZIP Code | 061272000 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 060878822 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE CONNECTICUT HOSPICE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CONN | BusinessNameControlTxt |
| Phone | 2033157500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DOUBLE BEACH ROAD | AddressLine1 |
| City | BRANFORD | City |
| State | CT | State |
| ZIP Code | 064054003 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | THOMAS MCGOVERN | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 2033157500 | PhoneNum |
| Signature | 2015-08-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ELIZABETH SOLECKI | PreparerPersonNm |
| PTIN | P00235171 | PTIN |
| Phone | 8605614000 | PhoneNum |
| Preparation | 2015-08-14 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | THOMAS MCGOVERN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DOUBLE BEACH ROAD | AddressLine1 |
| City | BRANFORD | City |
| State | CT | State |
| ZIP Code | 064054003 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $33,559,897 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HOSPICE.COM/CTHOSPICE | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1971 | FormationYr |
| Legal Domicile State | CT | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE ADULT AND PEDIATRIC CARE TO IRREVERSIBLY ILL PATIENTS AND THEIR FAMILIES AT HOME AND AT HOSPITAL-HOSPICE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 368 | TotalEmployeeCnt |
| Total Volunteers | 539 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,668,015 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,489,511 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $28,733,139 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $27,001,825 | CYProgramServiceRevenueAmt |
| PY Investment Income | $38,729 | PYInvestmentIncomeAmt |
| CY Investment Income | $86,543 | CYInvestmentIncomeAmt |
| PY Other Revenue | $89,774 | PYOtherRevenueAmt |
| CY Other Revenue | $76,807 | CYOtherRevenueAmt |
| PY Total Revenue | $31,529,657 | PYTotalRevenueAmt |
| CY Total Revenue | $30,654,686 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $17,567,105 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $16,561,438 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $254,213 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $15,476,208 | PYOtherExpensesAmt |
| CY Other Expenses | $14,146,275 | CYOtherExpensesAmt |
| PY Total Expenses | $33,043,313 | PYTotalExpensesAmt |
| CY Total Expenses | $30,707,713 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,513,656 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$53,027 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $21,530,709 | TotalAssetsBOYAmt |
| Total Assets EOY | $21,547,320 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,574,686 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,363,367 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $10,956,023 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $11,183,953 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDE ADULT AND PEDIATRIC CARE TO IRREVERSIBLY ILL PATIENTS AND THEIR FAMILIES AT HOME AND AT HOSPITAL-HOSPICE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $11,955,055 | ExpenseAmt |
| Revenue | $12,540,351 | RevenueAmt |
| Desc | PHYSICIAN DIRECTED PAIN AND SYMPTOM MANAGEMENT PROVIDED STATEWIDE TO PALLIATIVE HOSPITAL AND HOSPICE CARE ADULT AND PEDIATRIC PATIENTS AND THEIR FAMILIES | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $13,922,618 | ExpenseAmt |
| Revenue | $14,461,474 | RevenueAmt |
| Desc | PHYSICIAN DIRECTED HOME MEDICAL AND HOSPICE CARE SERVICES TO ADULTS AND PEDIATRIC PATIENTS ON A STATEWIDE BASIS | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $25,877,673 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 19 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 368 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THOMAS MCGOVERN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2033157500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DOUBLE BEACH ROAD | AddressLine1 |
| City | BRANFORD | City |
| State | CT | State |
| ZIP Code | 064054909 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| HON DANIEL COSGROVE | |||||||||
| OFFICER AND DIRECTOR | 5.00 | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| WEN-JEN HWU MD PHD | |||||||||
| DIRECTOR | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| FREDERICK J MANCHESKI | |||||||||
| OFFICER AND DIRECTOR | 5.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ANTHONY J DAROS | |||||||||
| OFFICER AND DIRECTOR | 5.00 | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| EUGENE MICHAEL | |||||||||
| DIRECTOR | 3.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT PARKER | |||||||||
| DIRECTOR | 0.30 | 0.30 | Yes (X) | $0 | $0 | $0 | |||
| HON DONALD POGUE | |||||||||
| DIRECTOR | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ARLENE M SAYERS | |||||||||
| OFFICER AND DIRECTOR | 15.00 | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| WAYNE O SOUTHWICK MD | |||||||||
| OFFICER AND DIRECTOR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JOHN P STACK CPA | |||||||||
| DIRECTOR | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| CAPTAIN KAYE WILLIAMS | |||||||||
| OFFICER AND DIRECTOR | 3.00 | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| PETER YARROW | |||||||||
| DIRECTOR HONORARY | 0.20 | 0.20 | Yes (X) | $0 | $0 | $0 | |||
| MRS MARC A HURZELER | |||||||||
| PRESIDENT & CEO | 65.00 | 25.00 | Yes (X) | Yes (X) | $165,732 | $63,743 | $14,257 | ||
| SANDRA J KLIMAS | |||||||||
| SR VP OF CLINICAL SERVICES | 35.00 | 5.00 | Yes (X) | $94,460 | $13,494 | $10,836 | |||
| RONNY J KNIGHT | |||||||||
| SENIOR VP REIMB/PLANNING | 43.00 | 2.00 | Yes (X) | $141,900 | $6,600 | $11,709 | |||
| THOMAS MCGOVERN | |||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | 5.00 | Yes (X) | $160,728 | $20,091 | $19,395 | |||
| DR JOSEPH ANDREWS | |||||||||
| CHIEF MEDICAL OFFICER | 35.00 | 10.00 | $173,091 | $49,455 | $7,774 | Yes (X) | |||
| ANDREA PETERSON | |||||||||
| ASSISTANT MEDICAL DIRECTOR | 35.00 | 10.00 | $158,847 | $45,385 | $24,804 | Yes (X) | |||
| DR ANTHONY COSCIA PT | |||||||||
| PHYSICIAN | 20.00 | 4.00 | $115,493 | $23,099 | $17,956 | Yes (X) | |||
| JAMES PROTA | |||||||||
| DIRECTOR OF PHARMACY | 35.00 | 5.00 | $104,996 | $14,999 | $21,985 | Yes (X) | |||
| JOANNE LITEVICH | |||||||||
| PHARMACIST | 40.00 | 0.00 | $114,733 | $0 | $21,594 | Yes (X) | |||
| SYLVIA VANHEERDEN | |||||||||
| CHIEF OF QUALITY ASSURANCE | 32.00 | 8.00 | $103,927 | $25,982 | $11,138 | Yes (X) | |||
| MARY ANN FIEFFER | |||||||||
| DIRECTOR OF CLINICAL EDUCATION | 25.00 | 15.00 | $82,895 | $49,737 | $17,729 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,416,802 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $312,585 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $179,177 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 11 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| A&B HOMEHEALTH SOLUTIONS LLC | |||||
| 446A BLAKE STREET 3RD FLOOR | NEW HAVEN | CT | 06515 | HOME HEALTH AIDES | $876,642 |
| ARCADIA HEALTH CARE | |||||
| 4639 MAIN STREET | BRIDGEPORT | CT | 06606 | HOME HEALTH AIDES | $604,479 |
| PEQUOT PHARMACEUTICAL NETWORK | |||||
| 1 ANNIE GEORGE DRIVE | MASHANTUCKET | CT | 063390049 | PHARMACEUTICAL DISTR | $584,455 |
| AAA NURSING CARE LLC | |||||
| 3303 MAIN STREET | STRATFORD | CT | 06614 | HOME HEALTH AIDES | $333,383 |
| ABM JANITORIAL SERV NORTHEAST | |||||
| PO BOX 1534 | NEW YORK | NY | 100081534 | HOUSEKEEPING | $324,458 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 19 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $3,489,511 | AllOtherContributionsAmt |
| Total Contributions | $3,489,511 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| HOME CARE REVENUE | 621610 | $14,461,474 | $14,461,474 |
| INPATIENT REVENUE | 623000 | $12,540,351 | $12,540,351 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $27,001,825 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $146,502 | TotalRevenueColumnAmt |
| Exclusion | $146,502 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,845,252 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,905,211 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$59,959 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$59,959 | TotalRevenueColumnAmt |
| Exclusion | -$59,959 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| FOOD SERVICE INCOME | 722210 | $49,698 | $49,698 |
| OTHER | 900099 | $27,109 | $27,109 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $76,807 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $30,654,686 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $27,001,825 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $163,350 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $780,682 | TotalAmt |
| Program Services | $349,497 | ProgramServicesAmt |
| Management And General | $412,902 | ManagementAndGeneralAmt |
| Fundraising | $18,283 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,163,749 | TotalAmt |
| Program Services | $11,304,047 | ProgramServicesAmt |
| Management And General | $1,718,963 | ManagementAndGeneralAmt |
| Fundraising | $140,739 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $177,980 | TotalAmt |
| Program Services | $149,503 | ProgramServicesAmt |
| Management And General | $26,697 | ManagementAndGeneralAmt |
| Fundraising | $1,780 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,223,647 | TotalAmt |
| Program Services | $1,027,864 | ProgramServicesAmt |
| Management And General | $183,547 | ManagementAndGeneralAmt |
| Fundraising | $12,236 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,215,380 | TotalAmt |
| Program Services | $1,020,919 | ProgramServicesAmt |
| Management And General | $182,307 | ManagementAndGeneralAmt |
| Fundraising | $12,154 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,500,000 | TotalAmt |
| Program Services | $4,500,000 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,016 | TotalAmt |
| Management And General | $108,016 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,698 | TotalAmt |
| Management And General | $158,698 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,023,084 | TotalAmt |
| Program Services | $2,351,959 | ProgramServicesAmt |
| Management And General | $625,174 | ManagementAndGeneralAmt |
| Fundraising | $45,951 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,589 | TotalAmt |
| Management And General | $3,589 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,004,885 | TotalAmt |
| Program Services | $2,456,493 | ProgramServicesAmt |
| Management And General | $531,743 | ManagementAndGeneralAmt |
| Fundraising | $16,649 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,074 | TotalAmt |
| Management And General | $3,074 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $744,865 | TotalAmt |
| Program Services | $551,541 | ProgramServicesAmt |
| Management And General | $193,324 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $268,233 | TotalAmt |
| Program Services | $246,246 | ProgramServicesAmt |
| Management And General | $21,823 | ManagementAndGeneralAmt |
| Fundraising | $164 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,734 | TotalAmt |
| Program Services | $1,129 | ProgramServicesAmt |
| Management And General | $4,605 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,794 | TotalAmt |
| Management And General | $71,794 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,325 | TotalAmt |
| Management And General | $147,325 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $758,964 | TotalAmt |
| Program Services | $696,349 | ProgramServicesAmt |
| Management And General | $62,615 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| HOSPITALIZATION EXPENSE | $599,835 | $599,835 | ||
| HOUSEKEEPING | $460,323 | $428,791 | $31,532 | |
| GROCERIES | $162,721 | $149,703 | $13,018 | |
| OTHER | $125,135 | $43,797 | $75,081 | $6,257 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,707,713 | TotalAmt |
| Program Services | $25,877,673 | ProgramServicesAmt |
| Management And General | $4,575,827 | ManagementAndGeneralAmt |
| Fundraising | $254,213 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $449,195 | BOYAmt |
| EOY | $1,066,312 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,379,145 | BOYAmt |
| EOY | $963,167 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $208,043 | BOYAmt |
| EOY | $203,907 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,596,791 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,369,987 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $835,648 | BOYAmt |
| EOY | $1,226,804 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,170,260 | BOYAmt |
| EOY | $5,074,177 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,488,418 | BOYAmt |
| EOY | $13,012,953 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,530,709 | BOYAmt |
| EOY | $21,547,320 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,751,909 | BOYAmt |
| EOY | $6,239,159 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $416,980 | BOYAmt |
| EOY | $425,156 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,169,151 | BOYAmt |
| EOY | $2,321,778 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $154,515 | BOYAmt |
| EOY | $1,315,232 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $82,131 | BOYAmt |
| EOY | $62,042 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,574,686 | BOYAmt |
| EOY | $10,363,367 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,039,435 | BOYAmt |
| EOY | $9,254,070 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,148,196 | BOYAmt |
| EOY | $961,491 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $768,392 | BOYAmt |
| EOY | $968,392 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,956,023 | BOYAmt |
| EOY | $11,183,953 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,530,709 | BOYAmt |
| EOY | $21,547,320 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$53,027 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $280,957 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $100,658 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $100,658 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE CONNECTICUT HOSPICE'S MISSION OF PROVIDING INTERDISCIPLINARY, QUALITY CARE, BOTH IN THE SPECIALTY HOSPITAL AND AT HOME, REQUIRES THE ONGOING APPLICATION OF STANDARDS THROUGH REGULATIONS AS IT RELATES TO HOSPICE AND PALLIATIVE CARE. IN PARTICULAR, WITH THE HOSPITAL'S RELOCATION, IT IS IMPORTANT TO ENABLE ALL CONNECTICUT PHYSICIANS THE OPPORTUNITY TO BE KNOWLEDGEABLE OF THE ENVIRONMENT OF CARE AND THESE STANDARDS. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $768,392 | BeginningYearBalanceAmt |
| Contributions | $200,000 | ContributionsAmt |
| Investment Earnings Or Losses | $57,174 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $57,174 | OtherExpendituresAmt |
| End Year Balance | $968,392 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $568,392 | BeginningYearBalanceAmt |
| Contributions | $200,000 | ContributionsAmt |
| Investment Earnings Or Losses | $21,103 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $21,103 | OtherExpendituresAmt |
| End Year Balance | $768,392 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,628,392 | BeginningYearBalanceAmt |
| Contributions | $220,000 | ContributionsAmt |
| Other Expenditures | $1,280,000 | OtherExpendituresAmt |
| End Year Balance | $568,392 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,408,392 | BeginningYearBalanceAmt |
| Contributions | $220,000 | ContributionsAmt |
| Investment Earnings Or Losses | $14,073 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $14,073 | OtherExpendituresAmt |
| End Year Balance | $1,628,392 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,228,392 | BeginningYearBalanceAmt |
| Contributions | $180,000 | ContributionsAmt |
| Investment Earnings Or Losses | $90,304 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $90,304 | OtherExpendituresAmt |
| End Year Balance | $1,408,392 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,596,791 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,369,987 | DepreciationAmt |
| Book Value | $1,226,804 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,226,804 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM J.D. THOMPSON INSTITUTE, NET | $12,053,592 |
| OTHER CURRENT ASSETS | $194,355 |
| ASSETS HELD FOR SALE | $332,200 |
| DUE FROM THIRD PARTY | $432,806 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $13,012,953 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | LIABILITY UNDER CAPITAL LEASE | Desc |
| Amt | $62,042 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $62,042 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $30,935,643 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $280,957 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $280,957 | RevenueNotReportedAmt |
| Revenue Subtotal | $30,654,686 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $30,654,686 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $30,707,713 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $30,707,713 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $30,707,713 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, LINE 4: | FormAndLineReferenceDesc |
| Explanation | TEMPORARY FUNDS ARE AVAILABLE TO SUPPORT OPERATIONS AND REPAYMENT OF LONG TERM DEBT. THE INCOME FROM PERMANENT FUNDS IS AVAILABLE TO SUPPORT HEALTH CARE SERVICES. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | 0 | WrittenPolicyInd |
| FPG Reference Free Care | 0 | FPGReferenceFreeCareInd |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | 0 | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | 0 | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $164,522 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $164,522 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00540 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,038,773 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $919,445 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $119,328 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,203,295 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $919,445 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $283,850 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00930 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $20,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $20,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,223,295 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $919,445 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $303,850 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $145,595 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $23,850,762 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $27,428,838 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$3,578,076 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | 0 | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 NOT APPLICABLE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE CONNECTICUT HOSPICE INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DOUBLE BEACH ROAD | AddressLine1 |
| City | BRANFORD | City |
| State | CT | State |
| ZIP Code | 064054003 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Other | HOSPITAL, SPECIAL, HOSPICE | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE CONNECTICUT HOSPICE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | 0 | CHNAReportWidelyAvailableInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | Yes (1) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | 0 | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | 0 | FPGUsedDeterEligFreeCareInd |
| FPG Used Determ Elig Dscnt Care | 0 | FPGUsedDetermEligDscntCareInd |
| Explained Basis | 0 | ExplainedBasisInd |
| App Financial Asst Expln | 0 | AppFinancialAsstExplnInd |
| Includes Publicity Measures | 0 | IncludesPublicityMeasuresInd |
| FAP Actions On Nonpayment | 0 | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Nondis Emergency Care Policy | 0 | NondisEmergencyCarePolicyInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, SECTION B | FormAndLineReferenceDesc |
| Explanation | THE CONNECTICUT HOSPICE, INC. ASSESSES THE HEALTHCARE NEEDS IN THE COMMUNITIES IT SERVES THROUGH PATIENT/FAMILY SATISFACTION SURVEYS, COMMUNITY PHYSICIAN FEEDBACK, HOSPITAL AND OTHER PATIENT CARE FACILITY COLLABORATION AND DIRECT COMMUNICATION WITH COMMUNITY LEADERSHIP. | ExplanationTxt |
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | THE HOSPITAL PROVIDES SERVICES BASED ON PATIENT NEED REGARDLESS OF INCOME OR ABILITY TO PAY. |
| PART II | A) PROVIDED OUTDOOR POOL FACILITY TO PROMOTE PHYSICAL WELLNESS TO COMMUNITYB) PROVIDED MEMORIAL SERVICES FOR EMOTIONAL SUPPORT TO COMMUNITYC) PROMOTED PUBLIC POLICY DISCOURSE ON INSTITUTIONAL RESEARCH USE OF MEDICINAL MARIJUANA FOR PAIN AND SYMPTOM RELIEF |
| PART III, LINE 4: | FINANCIAL STATEMENTS DO NOT CONTAIN ANY REFERENCE TO BAD DEBTS IN THE FOOTNOTES TO THE FINANCIAL STATEMENTS. BAD DEBTS ARE RECORDED AT ACTUAL UNCOLLECTED REVENUE AS THE ESTIMATED COSTS. |
| PART III, LINE 8: | NONE OF THE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. |
| PART III, LINE 9B: | THE ORGANIZATION HAS ESTABLISHED A WRITTEN POLICY STATING THAT CARE IS PROVIDED REGARDLESS OF ABILITY TO PAY. NO COLLECTION ACTIVITY IS PURSUED FOR INDIGENT PATIENTS IDENTIFIED AS SUCH BY LICENSED CLINICAL SOCIAL WORKERS. |
| PART VI, LINE 2 | THE HOSPITAL RESPONDS TO THE NEEDS OF ITS COMMUNITY PHYSICIANS AND REFERRING HOSPITALS. |
| PART VI, LINE 3 | PATIENTS AND THEIR FAMILIES ARE INFORMED OF ALL REIMBURSEMENT OPTIONS BOTH VERBALLY AND IN WRITING UPON ADMISSION. |
| PART VI, LINE 4 | ALL COMMUNITIES AND DEMOGRAPHIC CONSTITUENCIES ARE SERVED INCLUDING URBAN, RURAL AND SUBURBAN. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MRS MARC A HURZELER | ||||||||||||||
| PRESIDENT & CEO | $165,732 | $63,743 | $0 | $0 | $0 | $0 | $4,647 | $1,787 | $5,650 | $2,173 | $176,029 | $67,703 | $0 | $0 |
| RONNY J KNIGHT | ||||||||||||||
| SENIOR VP REIMB/PLANNING | $141,900 | $6,600 | $0 | $0 | $0 | $0 | $4,257 | $198 | $6,932 | $322 | $153,089 | $7,120 | $0 | $0 |
| THOMAS MCGOVERN | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $160,728 | $20,091 | $0 | $0 | $0 | $0 | $4,822 | $603 | $12,418 | $1,552 | $177,968 | $22,246 | $0 | $0 |
| DR JOSEPH ANDREWS | ||||||||||||||
| CHIEF MEDICAL OFFICER | $173,091 | $49,455 | $0 | $0 | $0 | $0 | $0 | $0 | $6,046 | $1,728 | $179,137 | $51,183 | $0 | $0 |
| ANDREA PETERSON | ||||||||||||||
| ASSISTANT MEDICAL DIRECTOR | $158,847 | $45,385 | $0 | $0 | $0 | $0 | $4,765 | $1,362 | $14,527 | $4,150 | $178,139 | $50,897 | $0 | $0 |
| DR ANTHONY COSCIA PT | ||||||||||||||
| PHYSICIAN | $115,493 | $23,099 | $0 | $0 | $0 | $0 | $3,465 | $693 | $11,498 | $2,300 | $130,456 | $26,092 | $0 | $0 |
| MARY ANN FIEFFER | ||||||||||||||
| DIRECTOR OF CLINICAL EDUCATION | $82,895 | $49,737 | $0 | $0 | $0 | $0 | $2,487 | $1,492 | $8,594 | $5,156 | $93,976 | $56,385 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | COMPENSATION AWARDED BUT NOT GIVEN TO THE PRESIDENT/CEO (DUE TO FINANCIAL CONDITION OF THE HOSPITAL). THE AVERAGE SALARY FOR THIS POSITION HAS BEEN $130,000. NO ACCUMULATED LIABILITY WAS GIVEN IN THE CURRENT YEAR. | ExplanationTxt |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | F J MANCHESKI | PersonNm |
| Relationship With Org | OFFICER AND DIRECTOR | RelationshipWithOrgTxt |
| Loan To Organization | Yes (X) | LoanToOrganizationInd |
| Original Principal | $800,000 | OriginalPrincipalAmt |
| Balance Due | $425,156 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $425,156 | TotalBalanceDueAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 7A | A NOMINATING COMMITTEE CONSISTING OF FOUR MEMBERS OF THE BOARD OF DIRECTORS MAY ELECT A BOARD MEMBER. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE RETURN IS PRESENTED AT A BOARD MEETING PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS THE ANNUAL ELIGIBILITY TEST OF ALL BOARD MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 15A | A COMMITTEE OF TWO OR MORE DIRECTORS OF THE BOARD MEETS PERIODICALLY TO REVIEW THE PERFORMANCE AND COMPARABILITY DATA OF SIMILARLY SIZED HOSPITALS IN THE STATE OF CONNECTICUT. THEY DELIBERATE AND A FINAL DECISION IS MADE. |
| FORM 990, PART VI, SECTION C, LINE 19 | INFORMATION IS NOT AVAILABLE TO THE PUBLIC. |
| PART VIII, STATEMENT OF REVENUE, LINE 2 | DURING THE YEAR ENDED SEPTEMBER 30, 2014, THE ESTIMATED VALUE OF CONTRIBUTED SERVICES WAS $2,092,000. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE JOHN D THOMPSON HOSPICE INSTITUTE FOR EDUCATION TRAINING AND RESEARCH | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DOUBLE BEACH ROAD | AddressLine1 |
| City | BRANFORD | City |
| State | CT | State |
| ZIP Code | 064054003 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 061003712 | EIN |
| Primary Activities | PROGRAMS ON EDUCATION, TRAINING AND RESEARCH; MANAGEMENT SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | CT | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | BOX 9 | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| FACILITY LEASE | ||
| K | $284,160 | OPERATING LEASE |
| MANAGEMENT SERVICES | ||
| M | $4,500,000 | FAIR VALUE OF SERVICES |
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