2015-08-14T14:42:32-05:00 2014-09-30 350921680 CROWE HORWATH LLP 175 POWDER FOREST DRIVE SIMSBURY CT 06089 990 2013-10-01 060646710 MANCHESTER MEMORIAL HOSPITAL MANC 8606461222 71 HAYNES STREET MANCHESTER CT 06040 MICHAEL D VEILLETTE CHIEF FINANCIAL OFFICER 8606461222 2015-08-14 1 BETH A THURZ P00346435 8606789200 2013 2016-04-25 22:37:26Z PETER J KARL 71 HAYNES STREET MANCHESTER CT 06040 193724875 0 X WWW.ECHN.ORG X 1920 CT MANCHESTER MEMORIAL HOSPITAL IS A 249 BED HOSPITAL OFFERING VARIOUS HEALTHCARE SERVICES, INCLUDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO ALL MEMBERS OF THE COMMUNITY, INCLUDING THE INDIGENT AND UNDERSERVED. 18 12 1805 345 921833 -69384 3158530 6038927 181137247 180798739 2801853 4533864 913163 885580 188010793 192257110 14650 8600 0 0 111568140 109326548 0 0 0 77341310 76798781 188924100 186133929 -913307 6123181 174154774 161754391 136423034 136955974 37731740 24798417 X MANCHESTER MEMORIAL HOSPITAL IS A 249 BED HOSPITAL OFFERING VARIOUS HEALTHCARE SERVICES TO ALL MEMBERS OF THE COMMUNITY, INCLUDING THE INDIGENT AND UNDERSERVED. 0 0 24263258 16047583 INPATIENT SERVICES - MANCHESTER MEMORIAL HOSPITAL OFFERS COMPREHENSIVE MEDICAL SERVICES IN A 249 BED ACCUTE CARE COMMUNITY HOSPITAL, WITH A TOTAL OF 9,110 INPATIENTS TREATED IN FISCAL YEAR 2014. SERVICES ARE OFFERED TO THE COMMUNITY, REGARDLESS OF ANY INDIVIDUAL'S ABILITY TO PAY. 15913062 31187561 LABORATORY - WE ARE CAP ACCREDITED AND OFFER A WIDE RANGE OF CLINICAL TESTING PROCEDURES USING STATE-OF-THE-ART INSTRUMENTS TO PROVIDE TIMELY, ACCURATE RESULTS. OUR BOARD CERTIFIED PATHOLOGISTS UTILIZE STATE OF THE ART AUTOMATED EQUIPMENT PROVIDING RAPID TURNAROUND TIME, AND INTEGRATION OF TEST RESULTS WITH MEDICAL RECORDS. 12706301 33300224 EMERGENCY DEPARTMENT - EMERGENCY CARE IS OFFERED 24 HOURS PER DAY, AND PROVIDES NEEDED EMERGENCY MEDICAL CARE TO THE COMMUNITY, REGARDLESS OF ANY INDIVIDUAL'S ABILITY TO PAY. 96879540 8600 99341538 SEE SCHEDULE H, PART VI 96879540 8600 99341538 149762161 1 1 0 1 0 0 0 0 0 1 1 1 1 1 1 1 1 1 0 0 0 0 0 0 1 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 0 0 1 383 0 1 1805 1 1 1 0 0 0 0 0 0 0 0 0 X 18 12 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 CT X NICHOLAS JAMIESON 8606461222 320 MAIN STREET MANCHESTER CT 06040 DENNIS O'NEILL MD CHAIRMAN 1.00 4.00 X X 0 0 0 ROBIN MURDOCK MEGGERS VICE CHAIR 1.00 2.00 X X 0 0 0 MICHELE CONLON MD SECRETARY 1.00 2.00 X X 0 0 0 JOSEPH F JEAMEL JR TREASURER 1.00 2.00 X X 0 0 0 GORDON BRODIE MD TRUSTEE 1.00 2.00 X 0 0 0 THOMASINA CLEMONS TRUSTEE 1.00 2.00 X 0 0 0 ANTHONY DISTEFANO MD TRUSTEE 1.00 3.00 X 0 0 0 MILTON DOREMUS TRUSTEE 1.00 2.00 X 0 0 0 JOY DORIN TRUSTEE 1.00 2.00 X 0 0 0 DAVID GONCI TRUSTEE 1.00 2.00 X 0 0 0 REBECCA JANENDA TRUSTEE 1.00 2.00 X 0 0 0 LENORA WILLIAMS MD TRUSTEE 1.00 2.00 X 0 0 0 PETER J KARL PRESIDENT AND CEO 33.00 27.00 X X 1123212 0 122724 LOUISE ENGLAND TRUSTEE 1.00 3.00 X 0 0 0 DONALD GENOVESI TRUSTEE 1.00 2.00 X 0 0 0 KATHLEEN A O'NEILL TRUSTEE 1.00 3.00 X 0 0 0 KEITH J WOLFF TRUSTEE 1.00 2.00 X 0 0 0 ERIC KLOTER TRUSTEE 1.00 2.00 X 0 0 0 PAMELA LEWIS MD TRUSTEE 1.00 2.00 X 0 0 0 KEVIN G MURPHY EVP, TREASURER (THROUGH OCT 2013) 33.00 27.00 X 605651 0 26680 MICHAEL D VEILLETTE SVP, CHIEF FINANCIAL OFFICER 33.00 27.00 X 441275 0 58896 DEBORAH GOGLIETTINO SVP, HUMAN RESOURCES 33.00 27.00 X 350668 0 46611 DENNIS MCCONVILLE SVP, STRATEGIC PLANNING 33.00 27.00 X 325180 0 93680 DEBORAH PARKER EVP, CHIEF CLINICAL OFFICER 33.00 27.00 X 439801 0 58046 JOEL REICH MD SVP, MEDICAL AFFAIRS 33.00 27.00 X 522615 0 136948 CHARLES COVIN VP AND CIO (THROUGH NOV 2013) 33.00 27.00 X 158898 0 32253 LEONA CROSSKEY VP, QUALITY 33.00 27.00 X 177688 0 73043 ROBERT CARROLL MD MED DIR, EMERGENCY DEPARTMENT 33.00 27.00 X 449483 0 34371 JOYCE TICHY GENERAL COUNSEL 33.00 27.00 X 355681 0 28863 JAMES CASTELLONE MD ASST. MED DIR, EMERGENCY DEPT 60.00 X 379840 0 34371 ANDREAS BOJKO MD EMERGENCY DEPT PHYSICIAN 60.00 X 323486 0 90985 SCOTT BROWN MD DOCTOR 60.00 X 341301 0 33691 TAI TRAN MD EMERGENCY DEPT PHYSICIAN 60.00 X 312907 0 16954 THEODORE SHERRY MD EMERGENCY DEPT PHYSICIAN 60.00 X 365672 0 34285 6673358 0 922401 135 0 1 0 ALL-PHASE ENTERPRISES INC 191 WEST STAFFORD ROAD STAFFORD SPRINGS CT 06076 CONTRACTOR SERVICES 1363279 SODEXO 9801 WASHINGTON BLVD GAITHERSBURG MD 20878 DIETARY SERVICES 1323311 MED ASSETS INC PO BOX 405652 ATLANTA GA 30384 ENVIRONMENTAL SERVICES 1252058 GRIFFIN YORK & KRAUSE 121 RIVER FRONT DRIVE MANCHESTER NH 03102 ADVERTISING SERVICES 1179437 ARUP LABORATORIES INC PO BOX 27964 SALT LAKE CITY UT 84127 LABORATORY SERVICES 977151 42 250818 1642053 4146056 6038927 PATIENT SERVICE REVENUE 622110 172204267 172204267 OTHER HEALTHCARE REVENUE 621500 8594472 7672639 921833 180798739 838306 838306 548813 890267 -341454 -341454 -341454 3695558 0 3695558 3695558 3695558 70725 250818 182822 -112097 -112097 561984 394676 167308 167308 CAFETERIA REVENUE 722210 952311 952311 AUXILIARY REVENUE 900099 219512 219512 1171823 192257110 179876906 921833 5419444 8600 8600 3451504 3451504 80154792 60917642 19237150 3430948 2916306 514642 16682291 14179947 2502344 5607013 4765961 841052 129579 129579 130206 130206 103146 103146 5540530 3324318 2216212 100461 100461 592462 296231 296231 221174 110587 110587 3680705 3128599 552106 32122 27304 4818 159753 135790 23963 2589201 2589201 7116905 6049369 1067536 2149561 1827127 322434 MEDICAL SUPPLIES/EQUIPM 28089792 28089792 ECHN ALLOCATION 10206118 6123671 4082447 PHYSICIAN FEES 9851497 9851497 DUE DILIGENCE 1490211 1266679 223532 4615358 4153540 461818 186133929 149762161 36371768 0 12239488 9361439 27182276 25099884 3245125 3873042 2316130 2357425 197198532 141480890 54574351 55717642 14768541 12613293 11580018 15240292 10780266 11172492 37468579 26318882 174154774 161754391 21391578 21842838 42014127 40768601 19189304 19344527 53828025 55000008 136423034 136955974 X 27759929 11344473 1392902 974762 8578909 12479182 37731740 24798417 174154774 161754391 X 6123181 -2551501 -16505003 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 38034 38034 0 PART II-B, LINE 1: THE CONNECTICUT HOSPITAL ASSOCIATION (CHA) HAS DETERMINED THAT FOR ITS FISCAL YEAR THAT $27,812 OF ITS MEMBERSHIP DUES FROM MANCHESTER MEMORIAL HOSPITAL WERE USED FOR LOBBYING PURPOSES. THE TOTAL LOBBYING PORTION FROM THE AMERICAN HOSPITAL ASSOCIATION (AHA) FOR MANCHESTER MEMORIAL HOSPITAL WAS $10,222. 10402048 34372 838838 1199 11274059 9747173 1854875 1200000 10402048 8023690 1723483 9747173 8100283 -76593 8023690 7537396 562887 8100283 0.84220 0.14140 0.01640 0 1 1 1429966 1429966 93173174 52705390 40467784 1687509 405054 1282455 97204134 87550148 9653986 3703749 820298 2883451 55717642 FUNDS HELD UNDER BOND INDENTURE 4151976 F BENEFICIAL INTEREST IN TRUST ASSETS 9599529 F FUNDS HELD IN TRUST FOR EST SELF INSURANCE LIAB 1488787 F 15240292 INTEREST IN NET ASSTS OF ECHN COMMUNITY HEALTHCARE FOUNDATION, INC. 7323190 F INVESTMENTS IN JOINT VENTURES 3849302 C 11172492 DUE FROM AFFILIATES 20255956 ESTIMATED SETTLEMENTS DUE FROM THIRD PARTY PAYERS 4139819 OTHER 1923107 26318882 CONDITIONAL RETIREMENT ASSET OBLIGATIONS 279796 OTHER CURRENT LIABILITIES 2653756 ESTIMATED SELF INSURANCE LIABILITIES 6835215 ACCRUED PENSION AND POST RETIREMENT BENEFITS 35620305 DUE TO AFFILIATES 5322021 DUE TO THIRD PARTY PAYERS 4285117 MARKET VALUE SWAP 3798 55000008 X 189545063 1405860 1405860 188139203 4117907 4117907 192257110 187052881 918952 918952 186133929 0 186133929 PART V, LINE 4: THE PRINCIPAL AND INCOME FROM THE UNRESTRICTED ENDOWMENT FUNDS AND THE INCOME FROM THE TERM ENDOWMENTS ARE FOR CAPITAL AND OPERATING NEEDS OF MANCHESTER MEMORIAL HOSPITAL. THE INCOME FROM THE PERMANENT ENDOWMENTS AND PRINCIPAL FROM THE TERM ENDOWMENTS ARE FOR THE USE OF MANCHESTER MEMORIAL HOSPITAL AS RESTRICTED BY THE DONORS. PART X, LINE 2: THE HOSPITAL ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH PROVISIONS OF FASB ASC 740, "INCOME TAXES," WHICH PROVIDES A FRAMEWORK FOR HOW COMPANIES SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE UNCERTAIN TAX POSITIONS IN THEIR FINANCIAL STATEMENTS. THE HOSPITAL MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE HOSPITAL DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2014 AND 2013. AS OF SEPTEMBER 30, 2014 AND 2013, THE HOSPITAL DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNCERTAIN TAX POSITIONS. THE HOSPITAL'S PRIOR THREE TAX YEARS ARE OPEN AND SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD - GIFT SHOP 394,676. NET RENTAL LOSS 341,454. NET ASSETS RELEASED FROM RESTRICTIONS FOR OPERATIONS 486,908. FUNDRAISING EVENT EXPENSES 182,822. PART XI, LINE 4B - OTHER ADJUSTMENTS: TEMPORARILY RESTRICTED CONTRIBUTIONS AND INVESTMENT INCOME 366,157. PERMAMENTLY RESTRICTED CONTRIBUTIONS AND INVESTMENT INCOME 3,751,750. PART XII, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD - GIFT SHOP 394,676. NET RENTAL LOSS 341,454. FUNDRAISING EVENT EXPENSES 182,822. HEALIUM BALL 321543 250818 70725 7500 65310 15550 94462 321543 250818 70725 7500 65310 15550 94462 182822 -112097 1 1 1 X 125.000000000000 1 X 1 0 1 1 1000 675395 97991 577404 0.00310 44576 35168336 27000727 8167609 0.04390 45576 35843731 27098718 8745013 0.04700 24 105167 1180159 80037 1100122 0.00590 13 446 3359486 1031481 2328005 0.01250 5 6075 6143894 3413247 2730647 0.01470 2 0 275691 0 275691 0.00150 11 13134 220298 19600 200698 0.00110 55 124822 11179528 4544365 6635163 0.03570 55 170398 47023259 31643083 15380176 0.08270 1 1543 1543 0.00000 4 1100 1688753 1547956 140797 0.00080 6 20884 20884 0.00010 1 5472 5472 0.00000 6 156 434535 309825 124710 0.00070 18 1256 2151187 1857781 293406 0.00160 1 5822470 2411263 48584349 53675235 -5090886 X 1 1 1 1 MANCHESTER MEMORIAL HOSPITAL 71 HAYNES STREET MANCHESTER CT 06040 00048 X X X X MANCHESTER MEMORIAL HOSPITAL 1 1 X X X X X X X X X 12 1 1 1 X WWW.ECHN.ORG X X X X X X 0 0 1 1 125.000000000000 1 400.000000000000 1 X X X 1 1 X X X X 1 0 1 X 0 0 MANCHESTER MEMORIAL HOSPITAL PART V, SECTION B, LINE 3: AS PART OF ITS CHNA, MMH INVITED COMMUNITY AGENCIES AND ORGANIZATIONS THROUGHOUT THE SERVICE AREA, REPRESENTING A VARIETY OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS, TO PARTICIPATE IN AN ONLINE SURVEY, WHICH ASKED QUESTIONS ABOUT WHAT THE INDIVIDUALS PERCEIVED TO BE HEALTHY AND UNHEALTHY ABOUT THE COMMUNITY, WHAT THEIR PERCEPTION IS OF MMH AND THE PROGRAMS AND SERVICES IT OFFERS, AND WHAT MMH CAN DO TO IMPROVE THE HEALTH AND QUALITY OF LIFE IN THE COMMUNITY. AGENCIES AND ORGANIZATIONS RESPONDING TO THE SURVEY INCLUDED THE DEPARTMENT OF PUBLIC HEALTH WIC PROGRAM, COMMUNITY CHILD GUIDANCE CLINIC, VERNON YOUTH SERVICES BUREAU, TOWN OF ELLINGTON HUMAN SERVICES, TOWN OF MANCHESTER HEALTH DEPARTMENT, TOWN OF ANDOVER ELDER SERVICES, MAPLE STREET SCHOOL IN VERNON, VERNON ADULT EDUCATION, INDIAN VALLEY YMCA, AND MARC, INC. MANCHESTER MEMORIAL HOSPITAL PART V, SECTION B, LINE 4: THE CHNA WAS CONDUCTED BY EASTERN CONNECTICUT HEALTH NETWORK, WHICH INCLUDES MANCHESTER MEMORIAL HOSPITAL AND ROCKVILLE GENERAL HOSPITAL. MANCHESTER MEMORIAL HOSPITAL PART V, SECTION B, LINE 5D: HTTP://WWW.ECHN.ORG/ABOUT-ECHN/COMMUNITY-BENEFIT-REPORTING.ASPX MANCHESTER MEMORIAL HOSPITAL PART V, SECTION B, LINE 7: AFTER REVIEWING THE CHNA DATA, THE OVERSIGHT COMMITTEE IDENTIFIED EIGHT HEALTH AREAS OF NEED (HEART DISEASE INCIDENCE, CANCER INCIDENCE, DIABETES INCIDENCE, ARTHRITIS INCIDENCE, ALZHEIMER'S DISEASE INCIDENCE, MULTIPLE SCLEROSIS INCIDENCE, SUBSTANCE ABUSE AND CHILDHOOD LEAD SCREENING), HOWEVER IT WAS DETERMINED THAT ALL NEEDS COULD NOT BE ADDRESSED BASED ON THE HOSPITAL'S ABILITY TO IMPACT THE NEEDS AND THE AVAILABILITY OF RESOURCES THAT EXIST TO ADDRESS THEM. THE FOLLOWING HEALTH NEEDS WERE IDENTIFIED AS THE HIGHEST PRIORITY: HEART DISEASE INCIDENCE, CANCER INCIDENCE, DIABETES INCIDENCE AND ARTHRITIS INCIDENCE.THE HOSPITAL WILL NOT ADDRESS THE FOLLOWING HEALTH NEEDS THAT WERE OUTLINED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT: ALZHEIMER'S DISEASE INCIDENCE, MULTIPLE SCLEROSIS INCIDENCE, SUBSTANCE ABUSE AND CHILDHOOD LEAD SCREENING. IN DISCUSSING AND PRIORITIZING ALL OF THE IDENTIFIED HEALTH NEEDS, THE OVERSIGHT COMMITTEE DETERMINED THAT THESE NEEDS WERE ALREADY BEING ADDRESSED BY OTHER HEALTHCARE AGENCIES AND PROVIDERS. ADDITIONALLY, SOME COMMUNITY NEEDS FALL OUTSIDE THE SCOPE OF THE EXPERTISE AND RESOURCES OF THE HOSPITAL. MANCHESTER MEMORIAL HOSPITAL PART V, SECTION B, LINE 12I: FAMILY SIZE IS USED WITH INCOME LEVEL. MANCHESTER MEMORIAL HOSPITAL PART V, SECTION B, LINE 20D: CHARGES ARE UNIFORMLY SET FOR ALL PATIENTS REGARDLESS OF PAYOR AND CHARITY CARE DISCOUNT IS APPLIED BASED ON INCOME. PART II, COMMUNITY BUILDING ACTIVITIES: MANCHESTER MEMORIAL HOSPITAL (MMH), AS PART OF EASTERN CONNECTICUT HEALTH NETWORK, PROMOTES THE HEALTH OF THE COMMUNITIES IT SERVES BY COMMITTING THE EXPERTISE AND RESOURCES OF THE ORGANIZATION TO A NUMBER OF COMMUNITY BUILDING ACTIVITIES THAT SUPPORT ASSOCIATIONS, BUSINESSES, PROGRAMS, INITIATIVES AND OTHER VALUABLE LOCAL COMMUNITY ASSETS. THROUGH GRANTS PROVIDED BY THE FEDERAL AND STATE GOVERNMENTS, MMH OFFERS FREE SUPPORT PROGRAMS TO CHILDREN AND THEIR FAMILIES TO PROMOTE POSITIVE FAMILY LIFE SKILLS AND CHILD DEVELOPMENT. IN FY 2014, THESE PROGRAMS BENEFITED 995 INDIVIDUALS WITH MMH PROVIDING NEARLY $133,000 OF IN-KIND RESOURCES AND SERVICES. OTHER COMMUNITY BUILDING ACTIVITIES INCLUDE SERVING ON THE BOARD AND EXECUTIVE COMMITTEE OF REGIONAL CHAMBERS OF COMMERCE IN SUPPORT OF THE LOCAL BUSINESS INDUSTRY; HOSTING ART EXHIBITS OF THE MANCHESTER ART ASSOCIATION; WORKING WITH THE MANCHESTER VETERANS COUNCIL TO HONOR VETERANS IN AN ANNUAL VETERANS DAY CEREMONY FOR THE COMMUNITY; PARTNERING WITH THE LOCAL SCHOOL SYSTEMS AND COLLEGES IN VARIOUS WORKFORCE DEVELOPMENT PROGRAMS; PROVIDING VOCATIONAL SERVICES TO RESIDENTS; SERVING ON THE AMERICAN HOSPITAL ASSOCIATION'S REGIONAL POLICY BOARD; THE DEPARTMENT OF PUBLIC HEALTH'S OFFICE OF EMERGENCY MEDICAL SERVICE MEDICAL ADVISORY COMMITTEE, THE CONNECTICUT EMS ADVISORY BOARD, THE CONNECTICUT EMS ADVISORY COMMITTEE, THE REGIONAL MEDICAL ADVISORY COMMITTEE, THE REGIONAL ED STANDARDS BOARD, THE STATE EMS EDUCATION AND TRAINING COMMITTEE, EMS CLINICAL COORDINATORS AND NUMEROUS COMMUNITY COALITIONS THAT ADDRESS ADOLESCENT BEHAVIORAL HEALTH CONCERNS. AS A RESULT OF THESE ACTIVITIES, THERE HAS BEEN IMPROVED COLLABORATION AMONG COMMUNITY PROVIDERS AND OTHERS INVOLVED IN PROVIDING SERVICES TO CHILDREN, ADOLESCENTS AND THEIR FAMILIES AND OTHER ADULTS. PART III, LINE 4: THE HOSPITAL PROVIDES FOR A PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND CO-PAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, THE HOSPITAL OFFERS A DISCOUNT OFF ITS STANDARD RATES FOR SERVICES PROVIDED. THE DIFFERENCE BETWEEN THE DISCOUNTED RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED UNCOLLECTIBLE. PART III, LINE 8: THE HOSPITAL PROVIDES QUALITY HEALTH CARE TO ALL, REGARDLESS OF THEIR ABILITY TO PAY. CHARITY CARE IS PROVIDED TO THOSE WHO ARE ELIGIBLE BASED ON MMH'S POLICY. MMH ALSO INCURS UNPAID COSTS FOR GOVERNMENT PROGRAMS BECAUSE REIMBURSEMENT IS NOT SUFFICIENT TO COVER COSTS ASSOCIATED WITH MEDICARE AND MEDICAID PATIENTS. THE ORGANIZATION'S MEDICARE COST REPORT WAS USED TO CALCULATE ACTUAL COSTS REPORTED ON PART III, LINE 6. THE ACCESS TO HEALTHCARE BY PATIENTS COVERED BY MEDICARE IS A FUNDAMENTAL PART OF THE HOSPITAL'S COMMUNITY BENEFIT PROGRAM. PART III, LINE 9B: INTERNAL AND EXTERNAL COLLECTION POLICIES AND PROCEDURES TAKE INTO ACCOUNT THE EXTENT TO WHICH A PATIENT IS QUALIFIED FOR CHARITY CARE OR DISCOUNTS. IN ADDITION, PATIENTS WHO QUALIFY FOR PARTIAL DISCOUNTS ARE REQUIRED TO MAKE A GOOD FAITH EFFORT TO HONOR PAYMENT AGREEMENTS WITH THE HOSPITAL, INCLUDING PAYMENT PLANS AND DISCOUNTED HOSPITAL BILLS. MMH IS COMMITTED TO WORKING WITH PATIENTS TO RESOLVE THEIR ACCOUNTS, AND AT ITS DISCRETION, MAY PROVIDE EXTENDED PAYMENT PLANS TO ELIGIBLE PATIENTS. MMH WILL NOT PURSUE LEGAL ACTION FOR NON-PAYMENT OF BILLS AGAINST CHARITY CARE PATIENTS WHO HAVE COOPERATED WITH THE HOSPITAL TO RESOLVE THEIR ACCOUNTS AND HAVE DEMONSTRATED THEIR INCOME AND/OR ASSETS ARE INSUFFICIENT TO PAY MEDICAL BILLS. PART VI, LINE 2: IN 2013, MMH COLLABORATED WITH ROCKVILLE GENERAL HOSPITAL, ALSO AN AFFILIATE OF ECHN, TO CONDUCT A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE GOALS OF THE ASSESSMENT WERE: TO IDENTIFY CURRENT AND FUTURE HEALTHCARE NEEDS IN THE COMMUNITY AND TO IMPROVE AND STRENGTHEN PROGRAMS AND SERVICES PROVIDED TO ADDRESS THEM.THE CHNA PROCESS WAS LED BY AN OVERSIGHT COMMITTEE THAT INCLUDED MEMBERS OF THE ORGANIZATION WITH ESTABLISHED RELATIONSHIPS WITH COMMUNITY GROUPS AND AGENCIES. DATA COLLECTED FOR THE CHNA INCLUDED: HEALTH, SOCIAL, AND DEMOGRAPHIC DATA SPECIFIC TO MMH'S SERVICE AREA OBTAINED FROM LOCAL PUBLIC HEALTH AGENCIES, NATIONAL HEALTH ASSOCIATIONS AND OTHER DATA SOURCES; HEALTH BEHAVIOR INFORMATION COLLECTED FROM 1,047 RESIDENTS WHO RESPONDED TO A COMMUNITY SURVEY; INPUT FROM 12 COMMUNITY STAKEHOLDERS FROM LOCAL ORGANIZATIONS INVESTED IN THE HEALTH OF UNDERSERVED POPULATIONS. ONCE ALL DATA WAS COLLECTED AND ANALYZED, THE OVERSIGHT COMMITTEE IDENTIFIED AND PRIORITIZED THE SERVICE AREA'S KEY HEALTH NEEDS AND DEVELOPED AN IMPLEMENTATION STRATEGY TO RESPOND TO THE NEEDS. PART VI, LINE 3: THE HOSPITAL COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE THROUGH NOTICES POSTED IN PUBLIC AREAS AROUND THE HOSPITAL, ON THE PATIENT BILLS, ON OUR WEBSITE, AND SELECTED PRE-SCHEDULED SERVICES TO ENSURE THAT THE FINANCIAL CAPACITY OF PEOPLE WHO NEED HEALTHCARE SERVICES DOES NOT PREVENT THEM FROM SEEKING OR RECEIVING CARE. PART VI, LINE 4: MANCHESTER MEMORIAL HOSPITAL, AS PART OF EASTERN CONNECTICUT HEALTH NETWORK, SERVES A 19-TOWN PRIMARY AND SECONDARY SERVICE AREA LOCATED EAST OF THE CONNECTICUT RIVER IN NORTHERN CONNECTICUT WITH MUNICIPALITIES IN HARTFORD, TOLLAND AND WINDHAM COUNTIES. THE PRIMARY SERVICE AREA INCLUDES ANY TOWN WHERE TOTAL INPATIENT AND NEWBORN DISCHARGES ARE GREATER THAN OR EQUAL TO 20 PERCENT AND INCLUDES THE TOWNS OF MANCHESTER, SOUTH WINDSOR, BOLTON, COVENTRY, ANDOVER, ELLINGTON, TOLLAND, VERNON/ROCKVILLE AND WILLINGTON. THE SECONDARY SERVICE AREA INCLUDES ANY TOWN WHERE TOTAL INPATIENT AND NEWBORN DISCHARGES ARE GREATER THAN OR EQUAL TO FIVE PERCENT AND LESS THAN 20 PERCENT AND INCLUDES THE TOWNS OF ASHFORD, SOMERS, STAFFORD, UNION, EAST HARTFORD, EAST WINDSOR, GLASTONBURY, HEBRON, COLUMBIA AND MANSFIELD. BASED ON DATA COLLECTED IN 2013, THE POPULATION OF THE ENTIRE SERVICE AREA IS 341,000; 49% MALE, 51% FEMALE. THE MEDIAN AGE OF RESIDENTS IS 39.5 YEARS WITH 33.3% OF THE POPULATION 50 YEARS OR OLDER. THE RACE OF THE RESIDENTS IS PREDOMINANTLY WHITE (80%) FOLLOWED BY BLACK/AFRICAN AMERICAN (8.3%), OTHER/MULTI-RACE (6.1%) AND ASIAN (5.3%). APPROXIMATELY 91.5% PERCENT OF THE POPULATION HAS A HIGH SCHOOL DEGREE AND 35.6% PERCENT HAVE A BACHELOR'S DEGREE OR HIGHER. THE MEDIAN HOUSEHOLD INCOME FOR THE SERVICE AREA IS $82,075 PER YEAR. JUST UNDER 8% OF HOUSEHOLDS HAVE ANNUAL INCOME AT THE FEDERAL POVERTY RATE. THE UNEMPLOYMENT RATE IS 7.4% AND THE AVERAGE HOUSEHOLD SIZE IS 2.61 PEOPLE. PART VI, LINE 5: COMMUNITY HEALTH EDUCATION INITIATIVES AND PROGRAMS ARE OFFERED TO THE COMMUNITY AND INCLUDE FREE COMMUNITY HEALTH EDUCATIONAL PROGRAMS, EDUCATION IN BETTER BEING (A FREE COMMUNITY WELLNESS MAGAZINE), PARTICIPATION IN COMMUNITY HEALTH FAIRS, THE DEVELOPMENT OF "FREEDOM FROM SMOKING" SMOKING CESSATION PROGRAM, NUTRITION COUNSELING SERVICES, INTEGRATIVE MEDICINE PROGRAMS FOR STRESS REDUCTION, A "HEART TALK" COMMUNITY PROGRAM FOR PEOPLE LIVING WITH HEART FAILURE, THE PROMOTION OF CARDIAC REHABILITATION SERVICES, FREE CANCER SCREENINGS, ONCOLOGY NURSE NAVIGATOR AND SURVIVORSHIP NAVIGATORS SERVICES, ANNUAL CANCER SURVIVORS DAY EVENT, REGULAR CANCER SUPPORT GROUP MEETINGS, CANCER CAREGIVER WORKSHOPS, DIABETES SELF-MANAGEMENT PROGRAM, NUTRITION COUNSELING FOR INDIVIDUALS ALREADY DIAGNOSED WITH DIABETES, FAMILY SUPPORT GROUPS FOR FAMILIES WHO ARE DEALING WITH BEHAVIORAL HEALTH OR ADDICTION ISSUES, WOMEN'S HEALTH PRESENTATIONS IN THE COMMUNITY, TEEN SMOKING PREVENTION LECTURES AT AREA SCHOOLS, AND OTHER LECTURE PRESENTATIONS. THE EDUCATION PROGRAMS INCLUDE EDUCATING THE PUBLIC ABOUT MANAGING LIFESTYLE BEHAVIORS THAT IMPACT DIET, BLOOD PRESSURE, CHOLESTEROL, WEIGHT, PHYSICAL ACTIVITY, STRESS, CANCER RISKS, DIABETES AND ARTHRITIS. PROGRAMS ALSO INCLUDED LACTATION CONSULTING SERVICES AND A GROCERY STORE TOUR TO EDUCATE RESIDENTS ABOUT HEALTHY SHOPPING HABITS. FREE HEALTH SCREENINGS INCLUDING DIABETIC FOOT CHECKS, MAMMOGRAMS, BLOOD PRESSURE, BONE DENSITY, GLUCOSE READINGS, INJURY SCREENINGS, VITAL SIGN CHECKS AND MEDICAL EXAMS ARE OFFERED IN THE COMMUNITY, TARGETING UNINSURED/UNDERINSURED POPULATIONS. HEALTHCARE SUPPORT SERVICES ARE PROVIDED BY THE HOSPITAL TO INCREASE ACCESS AND QUALITY OF CARE TO INDIVIDUALS IN NEED. EFFORTS INCLUDE FREE TRANSPORTATION TO BEHAVIORAL HEALTH PATIENTS, ASSISTANCE TO ENROLL IN PUBLIC PROGRAMS, REFERRALS TO SOCIAL SERVICES AND PHYSICIANS ACCEPTING MEDICAID OR OTHER GOVERNMENT PROGRAMS, AND FREE LIFELINE PERSONAL RESPONSE SYSTEM SERVICE. PARTNERING WITH LOCAL EDUCATIONAL INSTITUTIONS, MANCHESTER MEMORIAL HOSPITAL PROVIDES A CLINICAL SETTING FOR PHYSICIANS, NURSES, RADIOLOGIC TECHNICIANS, RESPIRATORY TECHNICIANS AND PHYSICAL THERAPISTS AND OTHERS FROM THE UNIVERSITY OF NEW ENGLAND COLLEGE OF OSTEOPATHIC MEDICINE, UNIVERSITY OF CONNECTICUT, MANCHESTER COMMUNITY COLLEGE, CENTRAL CONNECTICUT STATE UNIVERSITY, GOODWIN COLLEGE, CAPITAL COMMUNITY COLLEGE, ST. JOSEPH'S COLLEGE, QUINNIPIAC UNIVERSITY, UNIVERSITY OF HARTFORD, NAUGATUCK VALLEY COMMUNITY COLLEGE, CAMBRIDGE COLLEGE, SPRINGFIELD TECHNICAL COMMUNITY COLLEGE AND EASTERN CONNECTICUT STATE UNIVERSITY.SPECIFIC RESEARCH INITIATIVES CONDUCTED BY THE HOSPITAL INCLUDE MAINTENANCE OF A CANCER REGISTRY DATABASE AND AN INSTITUTIONAL REVIEW COMMITTEE. FINANCIAL AND IN-KIND SERVICES AND GOODS ARE DONATED TO COMMUNITY GROUPS AND OTHER NOT FOR PROFIT ORGANIZATIONS INCLUDING PATIENT MEALS, LOCAL FUNDRAISERS, FACILITY SPACE TO HOST BLOOD DRIVES AND HEALTH SUPPORT GROUPS ORGANIZATIONS' MEETINGS. PART VI, LINE 6: MANCHESTER MEMORIAL HOSPITAL (MMH) IS AN AFFILIATE OF EASTERN CONNECTICUT HEALTH NETWORK (ECHN), A HEALTH CARE SYSTEM SERVING 19 TOWNS IN EASTERN CONNECTICUT. THE ECHN NETWORK OF AFFILIATES INCLUDES:MANCHESTER MEMORIAL HOSPITAL, A COMMUNITY HOSPITAL LICENSED FOR 249 BEDS AND 34 BASSINETS, THAT OFFERS MEDICAL AND SURGICAL SERVICES, 24-HOUR EMERGENCY CARE, MEDICAL IMAGING, A MODERN FAMILY BIRTHING CENTER AND NEONATOLOGY SERVICES, REHABILITATION SERVICES, A CERTIFIED SLEEP DISORDERS CENTER, INTENSIVE CARE SUITES, A WOUND HEALING CENTER WITH HYPERBARIC THERAPY, HOSPICE CARE, DIABETES SELF-MANAGEMENT PROGRAM, CARDIAC & PULMONARY REHABILITATION, A COMPREHENSIVE RANGE OF ADOLESCENT AND ADULT INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES, NUTRITION COUNSELING, LABORATORY SERVICES, MEDICAL EDUCATION (FAMILY MEDICINE RESIDENCY & INTERNSHIP PROGRAM; UNECOM MEDICAL STUDENTS; AND CONTINUING EDUCATION) AND THE EASTERN CONNECTICUT CANER INSTITUTE AT THE JOHN A. DEQUATTRO CANCER CENTER.ROCKVILLE GENERAL HOSPITAL, A COMMUNITY HOSPITAL LICENSED FOR 102 BEDS, THAT OFFERS INPATIENT AND OUTPATIENT MEDICAL AND SURGICAL SERVICES, AMBULATORY (ONE-DAY) SURGERY, 24-HOUR EMERGENCY CARE, MEDICAL IMAGING, CARDIAC & PULMONARY REHABILITATION, PHYSICAL REHABILITATION, HOSPICE CARE, A MATERNITY CARE CENTER, OUTPATIENT ADOLESCENT BEHAVIORAL HEALTH SERVICES, AND LABRATORY SERVICES.WOODLAKE AT TOLLAND, A 130-BED LONG-TERM SKILLED NURSING CARE AND SHORT-TERM REHABILITATION FACILITY THAT OFFERS CUSTOMIZED REHABILITATION TREATMENT SERVICES INCLUDING JOINT REPLACEMENT REHABILITATION, ORTHOPEDIC POST-HOSPITAL CARE, STROKE/NEUROLOGICAL REHAB, POST MEDICAL/SURGICAL RECONDITIONING, PRE-DISCHARGE HOME EVALUATIONS, PATIENT AND FAMILY INSTRUCTION, AND PERSONALIZED, PROGRESSIVE, AND INTERDISCIPLINARY CARE PLANS.EASTERN CONNECTICUT MEDICAL PROFESSIONALS (ECMPF) FOUNDATION, INC., A MULTI-SPECIALTY PHYSICIAN GROUP PRACTICE THAT OFFERS A FULL RANGE OF HEALTHCARE SERVICES, INCLUDING PRIMARY AND SPECIALTY CARE IN THE TOWNS OF EAST HARTFORD, ELLINGTON, MANCHESTER, SOUTH WINDSOR, TOLLAND AND VERNON/ROCKVILLE. GLASTONBURY WELLNESS CENTER COMBINES FITNESS AND MEDICAL SERVICES UNDER ONE ROOF, INCLUDING PHYSICIAN PRACTICES, LABORATORY DRAW SERVICES, MEDICAL IMAGING DIAGNOSTIC SERVICES, AND REHABILITATION SERVICES.ECHN MEDICAL BUILDINGS AT EVERGREEN WALK (SOUTH WINDSOR):2400 TAMARACK AVENUE OCCUPANTS INCLUDE EVERGREEN ENDOSCOPY CENTER, CENTRAL CONNECTICUT GASTROENTEROLOGY, THE COLON & RECTAL SURGEONS OF GREATER HARTFORD, AND ECMP PRIMARY CARE PHYSICIANS, RHEUMATOLOGY PHYSICIANS, WALDEN BEHAVIORAL CARE EATING DISORDERS CLINIC, AND LABORATORY SERVICES. 2600 TAMARACK AVENUE INCLUDES THE WOMEN'S CENTER FOR WELLNESS, ECHN BREAST CARE COLLABORATIVE, AND THE OB/GYN GROUP OF EASTERN CONNECTICUT. 2800 TAMARACK AVENUE HOUSES EVERGREEN IMAGING CENTER, ECHN REHABILITATION SERVICES, A LABORATORY DRAW STATION, AND A SERIES OF MEDICAL PRACTICES (INCLUDING ORTHOPEDIC SURGERY, OPHTHALMOLOGY, AND OTOLARYNGOLOGY), CORPCARE, AND SOUTH WINDSOR URGENT CARE. ECHN MANCHESTER MEDICAL OFFICE BUILDINGS: 150 NORTH MAIN STREET OFFERS A VARIETY OF ADULT BEHAVIORAL HEALTH SERVICES. 130 HARTFORD ROAD, OFFERING PRIMARY CARE AND LABORATORY SERVICES.AN URGENT CARE CENTER LOCATED IN SOUTH WINDSOR.VISITING NURSE & HEALTH SERVICES OF CONNECTICUT, PROVIDES AT-HOME NURSING CARE AND HOSPICE CARE. ECHN HAS 392 PHYSICIANS (307 ACTIVE, 42 COURTESY, 15 CONSULTING, 28 PART-TIME), 77 ALLIED HEALTH PROFESSIONALS, 10 MEDICAL DEPARTMENTS AND 16 SERVICES AS WELL AS 15 UNIVERSITY OF NEW ENGLAND COLLEGE OF OSTEOPATHIC MEDICINE THIRD-YEAR MEDICAL STUDENTS AVAILABLE TO CARE FOR THE COMMUNITY. PART VI, LINE 7, REPORTS FILED WITH STATES CT SCHEDULE H, ADDITIONAL INFORMATION: MANCHESTER MEMORIAL HOSPITAL IS A NOT-FOR-PROFIT 249-BED ACUTE CARE HOSPITAL THAT PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR RESIDENTS OF MANCHESTER, CT AND SURROUNDING TOWNS. THE HOSPITAL IS A SUBSIDIARY OF EASTERN CONNECTICUT HEALTH NETWORK, INC., WHICH WAS FORMED IN 1995 BY A MERGER OF MMH CORP. AND ROCKVILLE AREA HEALTH SERVICES, INC. ECHN WAS ORGANIZED TO PROVIDE A BROADER HEALTH CARE SYSTEM FOR THE SURROUNDING COMMUNITIES WITH QUALITY MEDICAL CARE AT A REASONABLE COST AND TO FOSTER AN ENVIRONMENT CONDUCIVE TO HEALTH AND WELL BEING WHETHER IN THE HOME OR IN THE COMMUNITY.MANCHESTER MEMORIAL HOSPITAL PATIENTS NOT HAVING INSURANCE COVERING EMERGENCY OR OTHER MEDICALLY QUALIFIED CARE (UNINSURED PATIENTS), AS WELL AS UNDERINSURED PATIENTS, SUBJECT TO INCOME LIMITS AND FAMILY SIZE RECEIVE FREE OR DISCOUNTED CARE. MANCHESTER MEMORIAL HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. CHARGES FOR CARE PROVIDED TO PATIENTS ARE DETERMINED BY ESTABLISHED RATES, SUBJECT TO POSSIBLE ADJUSTMENTS OR DISCOUNTS FOR LOW INCOME PATIENTS; CONTRACTUAL DISCOUNTS, OR DISCOUNTS FOR PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICIES. CHARITY CARE FOR FY 2014 WAS $2,411,263 FOR 1,000 TOTAL APPROVED APPLICANTS. EXPENSES RELATED TO SERVICES PERFORMED FOR PATIENTS OF MANCHESTER MEMORIAL HOSPITAL CONTRIBUTE IMPORTANTLY TO ITS EXEMPT PURPOSE BECAUSE THE EXPENSES ARE INCURRED IN THE DIAGNOSIS, CURE, MITIGATION, TREATMENT AND PREVENTION OF DISEASE, AND FOR MEDICAL PURPOSES AFFECTING THE STRUCTURE OR FUNCTION OF THE HUMAN BODY.MANCHESTER MEMORIAL HOSPITAL PROVIDED NEEDED MEDICAL CARE TO THE COMMUNITY REGARDLESS OF ANY INDIVIDUAL'S ABILITY TO PAY. NINE THOUSAND ONE HUNDRED TEN (9,110) INPATIENTS WERE CARED FOR IN FY14 REPRESENTING 44,106 PATIENT DAYS. TWO HUNDRED FORTY FIVE THOUSAND SEVEN HUNDRED THIRTY-SEVEN (245,737) OUTPATIENT VISITS WERE RECORDED.INCLUDED IN THE 9,110 INPATIENTS WERE 5,896 GOVERNMENT RELATED PATIENTS. THE GOVERNMENT INPATIENTS FALL INTO THE FOLLOWING GROUPS:MEDICARE 2,876MEDICARE MANAGED CARE 808MEDICAID 2,180CHAMPUS 32TOTAL GOV PATIENTS 5,896TOTAL NON GOV PATIENTS 3,214TOTAL PATIENTS 9,110 INCLUDED IN THE 245,737 OUTPATIENT VISITS WERE 141,327 GOVERNMENT RELATED VISITS. THE VISITS ARE A PRODUCT OF GROSS REVENUE RELATIONSHIP TO TOTAL VISITS. THE GOVERNMENT VISITS FALL INTO THE FOLLOWING GROUPS: MEDICARE 75,076MEDICARE MANAGED CARE 26,447MEDICAID 38,882CHAMPUS 922TOTAL GOV PATIENTS 141,327TOTAL NON GOV PATIENTS 104,410TOTAL OUTPATIENT VISITS 245,737THE HOSPITAL PROVIDED UNCOMPENSATED CARE TO 44,576 MEDICAID PATIENTS FOR A NET COMMUNITY BENEFIT AMOUNT OF $8,168,000 AFTER MEDICAID REIMBURSEMENT. 1 SCHOLARSHIPS 8 8600 PART I, LINE 2: THE SCHOLARSHIPS ARE AWARED TO ECHN EMPLOYEES WISHING TO FURTHER THEIR NURSING EDUCATION OR BECOME A NURSE. THE PRIMARY PURPOSE IS TO PROVIDE FINANCIAL ASSISTANCE TO ECHN EMPLOYEES ENROLLED IN AN ACCREDITED NURSING PROGRAM THAT LEADS TO BECOMING A REGISTERED NURSE. FURTHERMORE, A PORTION OF THE FUNDS MAY BE AWARDED TO AN ECHN REGISTERED NURSE TO ASSIST THAT PERSON IN OBTAINING AN ADVANCED DEGREE. SCHOLARSHIPS ARE AWARDED BASED ON THE DETERMINATION OF A NURSING SCHOLARSHIP COMMITTEE. NURSING STUDENTS WHO NEED FINANCIAL ASSISTANCE TO COMPLETE THEIR EDUCATION AND WHO DEMONSTRATE SCHOLASTIC ABILITY AND PROFESSIONAL PROMISE ARE ELIGIBLE IF THEY ARE AN EMPLOYEE OF AN ECHN AFFILIATE, AT LEAST 20 HOURS PART-TIME OR FULL-TIME, FOR AT LEAST ONE YEAR; AND CURRENTLY ENROLLED IN AN ACCREDITED TRADITIONAL OR NON-TRADITIONAL NURSING PROGRAM. BACCALAUREATE APPLICANTS MUST HAVE COMPLETED THE 2ND YEAR OF A 4-YEAR PROGRAM AND ASSOCIATE DEGREE APPLICANTS MUST HAVE COMPLETED ALL PREREQUISITES AND BE ACCEPTED INTO A NURSING PROGRAM. IN MAKING THE AWARDS, THE COMMITTEE USES JOB PERFORMANCE EVALUATION AND RECOMMENDATION, GRADE POINT AVERAGE AND PROFESSIONAL GOALS. IN ADDITION, THE NUMBER OF CREDITS IN WHICH AN APPLICANT IS ENROLLED AND THE COST PER CREDIT IS FACTORED INTO ANY AWARD. IF AWARDED A SCHOLARSHIP, THE RECIPIENT AGREES TO MAINTAIN EMPLOYMENT, WHETHER FULL OR PART-TIME, AT AN AFFILIATE OF ECHN FOR A MINIMUM OF ONE YEAR. AWARDS ARE MAILED DIRECTLY TO THE EDUCATIONAL INSTITUTION. X X X X X 1 1 0 0 0 0 0 0 0 PETER J KARL PRESIDENT AND CEO 572400 0 550812 0 0 0 97575 0 25149 0 1245936 0 360237 0 KEVIN G MURPHY EVP, TREASURER (THROUGH OCT 2013) 347516 0 178255 0 79880 0 9505 0 17175 0 632331 0 154642 0 MICHAEL D VEILLETTE SVP, CHIEF FINANCIAL OFFICER 306037 0 135238 0 0 0 36975 0 21921 0 500171 0 58014 0 DEBORAH GOGLIETTINO SVP, HUMAN RESOURCES 222929 0 127739 0 0 0 29790 0 16821 0 397279 0 71339 0 DENNIS MCCONVILLE SVP, STRATEGIC PLANNING 207957 0 117223 0 0 0 82752 0 10928 0 418860 0 68020 0 DEBORAH PARKER EVP, CHIEF CLINICAL OFFICER 294718 0 145083 0 0 0 35251 0 22795 0 497847 0 73202 0 JOEL REICH MD SVP, MEDICAL AFFAIRS 338385 0 184230 0 0 0 119923 0 17025 0 659563 0 109131 0 CHARLES COVIN VP AND CIO (THROUGH NOV 2013) 151398 0 7500 0 0 0 20292 0 11961 0 191151 0 0 0 LEONA CROSSKEY VP, QUALITY 150246 0 27442 0 0 0 55175 0 17868 0 250731 0 0 0 ROBERT CARROLL MD MED DIR, EMERGENCY DEPARTMENT 376654 0 72829 0 0 0 12750 0 21621 0 483854 0 0 0 JOYCE TICHY GENERAL COUNSEL 257881 0 97800 0 0 0 7650 0 21213 0 384544 0 0 0 JAMES CASTELLONE MD ASST. MED DIR, EMERGENCY DEPT 332421 0 47419 0 0 0 12750 0 21621 0 414211 0 0 0 ANDREAS BOJKO MD EMERGENCY DEPT PHYSICIAN 319986 0 3500 0 0 0 69369 0 21616 0 414471 0 0 0 SCOTT BROWN MD DOCTOR 338801 0 2500 0 0 0 12059 0 21632 0 374992 0 0 0 TAI TRAN MD EMERGENCY DEPT PHYSICIAN 305407 0 7500 0 0 0 8639 0 8315 0 329861 0 0 0 THEODORE SHERRY MD EMERGENCY DEPT PHYSICIAN 362672 0 3000 0 0 0 12669 0 21616 0 399957 0 0 0 PART I, LINE 3 THE BOARD OF TRUSTEES (THE "BOARD") APPOINTS AN EXECUTIVE COMPENSATION COMMMITTEE (THE "COMMITTEE") AND HAS DELEGATED THE RESPONSIBILITY OF COMPLETING AN ANNUAL MARKET ANALYSIS OF THE CEO'S COMPENSATION AND OTHER SENIOR EXECUTIVES AND COMPLETION OF THE CEO'S ANNUAL PERFORMANCE REVIEW. THE EVALUATION OF THE CEO IS AN IMPORTANT RESPONSIBILITY OF THE BOARD AND IS CRITICAL TO THE GOVERNANCE RESPONSIBILITIES OF THE BOARD. THE EXECUTIVE COMPENSATION COMMITTEE SOLICITS FEEDBACK ABOUT THE PERFORMANCE OF THE CEO FROM EVERY ACTIVE BOARD MEMBER WHICH WHEN RECEIVED IS ANALYZED AND REVIEWED BY THE MEMBERS OF THE COMMITTEE. THE CEO COMPLETES A SELF-EVALUATION AND AN EVALUATION FOR ALL ELIGIBLE MEMBERS OF THE SENIOR LEADERSHIP TEAM, WHO COMPLETE BOTH A SELF-EVALUATION AND A PEER EVALUATION. THE RESULTS OF THE ASSESSMENTS COMPLETED BY MEMBERS OF THE SENIOR LEADERSHIP TEAM ARE REVIEWED BY THE CEO WHO DISCUSSES THE RESULTS WITH THE MEMBERS OF THE COMMITTEE ON AN ANNUAL BASIS. THE EXECUTIVE COMPENSATION COMMITTEE IN COLLABORATION WITH THE CEO EVALUATES AND APPROVES ORGANIZATIONAL PERFORMANCE OBJECTIVES BOTH ON AN ANNUAL AND LONG TERM BASIS AND FOCUSES ON THOSE GOALS WITH THE GREATEST IMPACT TO THE ORGANIZATION'S STRATEGY AND MISSION. THE COMMITTEE ENSURES AN ANNUAL REVIEW OF THE CEO'S PERFORMANCE IN RELATION TO THESE GOALS; REVIEWS THE TALLY SHEETS TO UNDERSTAND THE ECONOMICS OF THE EMPLOYEE BENEFITS; RETAINS AND ENSURES THE INDEPENDENCE OF ITS EXTERNAL CONSULTANTS AND ADVISORS AND INVOLVES RELEVANT ORGANIZATIONAL RESOURCES AS APPROPRIATE TO CARRY OUT ITS RESPONSIBILITIES. THE COMMITTEE ENSURES TRANSPARENCY AND DISCLOSURE TO THE BOARD BY PRESENTING THE RESULTS OF THE ANNUAL PERFORMANCE AND MARKET REVIEWS PROVIDING THE BOARD WITH THE OPPORTUNITY FOR FURTHER INPUT AND CONSIDERATION AND ASKING THAT THE BOARD TAKE ACTION ON THE RECOMMENDATION OF THE COMMITTEE IF THE RECOMMENDATION IS APPROPRIATE. THE BOARD HAS THE OPPORTUNITY TO CHANGE ANY RECOMMENDATIONS OF THE COMMITTEE IF IT SO DESIRES. MEMBERS OF THE BOARD AND OF THE COMMITTEE WHO MAY BE INTERESTED PARTIES ARE ASKED TO RECUSE THEMSELVES FROM ANY REQUIRED VOTES TO AVOID CONFLICTS OF INTEREST. THE COMMITTEE ENSURES THAT THE PROCESS MEETS COMPLIANCE STANDARDS. PART I, LINES 4A-B LINE 4A, SEVERANCE PAYMENT: KEVIN MURPHY - $79,880 LINE 4B, SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: PETER KARL - $84,825 MICHAEL VEILLETTE - $24,225 DEBORAH GOGLIETTINO - $17,625 DEBORAH PARKER - $22,501 DENNIS MCCONVILLE - $15,975 JOEL REICH - $25,845 PART I, QUESTIONS 5A, 5B, 6A AND 6B: THE ECHN EXECUTIVE INCENTIVE COMPENSATION PLAN IS A PLAN THAT HAS BEEN DEVELOPED, REVIEWED AND IS ANNUALLY APPROVED BY MEMBERS OF THE BOARD EXECUTIVE COMPENSATION COMMITTEE WITH CONSULTANT THIRD PARTY OVERSIGHT. THE PLAN ESTABLISHES GOALS IN 4 AREAS OF PERFORMANCE: SYSTEM-WIDE FINANCIAL PERFORMANCE BASED ON PROFIT FROM OPERATIONS, TWO QUALITY OUTCOMES IN CLINICAL CORE MEASURES AND PATIENT SATISFACTION AND AN INDIVIDUAL GOAL (WHICH HAS A SEPARATE MEASUREMENT FOR TEAM ASSESSMENT) FOR EACH MEMBER OF THE INCENTIVE PROGRAM. THERE IS NO EXECUTIVE COMPENSATION TIED TO THE REVENUES OF THE REPORTING ORGANIZATION OR OTHER RELATED ENTITIES. THERE IS EXECUTIVE COMPENSATION TIED TO THE NET EARNINGS (INCOME FROM OPERATIONS), AS NOTED IN THE PRIOR PARAGRAPH, HOWEVER IT IS ONE OF FOUR PERFORMANCE LEVERS THAT DETERMINE THE LEVEL OF COMPENSATION. THE AGGREGATE NET EARNINGS OF THE ECHN "SYSTEM" NOT ANY ONE REPORTING ORGANIZATION OR RELATED ENTITIES OF ECHN DETERMINE THIS COMPENSATION. SO TO CONCLUDE, THE ANSWER TO THESE 4 QUESTIONS IS "NO" WITH THE CLARIFICATION THAT IT IS THE PERFORMANCE OF THE ENTIRE SYSTEM AS A WHOLE THAT DETERMINES EXECUTIVE COMPENSATION, NOT ONE REPORTING ORGANIZATION OR A RELATED ENTITY. MEMBERS OF THE INCENTIVE PROGRAM INCLUDE THE FOLLOWING: POSITION TITLE - KEY EMPLOYEE NAME PRESIDENT AND CEO - PETER J. KARL SVP, CHIEF FINANCIAL OFFICER - MICHAEL D. VEILLETTE SVP, HUMAN RESOURCES - DEBORAH GOGLIETTINO SVP, STRATEGIC PLANNING - DENNIS MCCONVILLE SVP, CHIEF CLINICAL OFFICER - DEBORAH PARKER SVP, MEDICAL AFFAIRS - JOEL REICH, M.D. VP QUALITY - LEONA CROSSKEY MED. DIR. EMERGENCY DEPARTMENT - ROBERT CARROLL, M.D. PART II THE SALARY INFORMATION PROVIDED WITHIN SCHEDULE J REPRESENTS CALENDAR YEAR 2013 WAGES AND BENEFITS. AS COMPARED TO THE PRIOR YEAR RETURN, THE MAJOR CHANGES ARE: THE LONG TERM RETENTION BENEFIT REACHED MATURITY UPON THE COMPLETION OF THE FOUR YEAR VESTING PERIOD. THIS BENEFIT WAS PAID IN 2013 AND WAS FOR VESTING YEARS ENDED 9/30/10, 9/30/11, 9/30/12 AND 9/30/13. THREE OF THE FOUR VESTED YEARS WERE REPORTED AS DEFERRED INCOME IN PRIOR RETURNS ON SCHEDULE J LINE F (COMPENSATION REPORTED AS DEFERRED IN PRIOR FORM 990). IN CALENDAR YEAR 2013 WE IMPLEMENTED A FURLOUGH PROGRAM WHICH MEANT THAT EXECUTIVES RECEIVED AN UNPAID WEEK OF VACATION. THIS APPROXIMATED A 2% PAY REDUCTION. ANOTHER CHANGE TO PRIOR YEAR'S COMPENSATION IS THAT THE MONEY MATCH PROGRAM WAS REINSTATED IN CALENDAR YEAR 2013. A STATE OF CONNECTICUT HEALTH & EDL FACS AUTH REV SERIES C 060806186 20774UAZ8 2005-11-09 37579404 ADVANCE REFUND AND DEFEASE A PORTION OF THE SERIES 2000A BONDS (C) 0 0 0 B STATE OF CONNECTICUT HEALTH & EDL FACS AUTH REV SERIES D 060806186 NONEAVAIL 2009-05-14 15250000 WOODLAKE EXPANSION, EQUIPMENT PURCHASE, REFUNDING PRIOR ISSUE (SER D) 0 0 0 C STATE OF CONNECTICUT HEALTH & EDL FACS AUTH REV SERIES E 060806186 20774U5W1 2010-12-21 20145000 REDEEM PRIOR ISSUE AND FUND INTEREST RATE SWAP TERMINATION PAYMENTS 0 0 0 A 37579404 3556957 32759288 632013 631146 2006 0 1 1 1 B 15250000 9966919 305000 4978081 2009 1 0 1 1 C 20145000 1065002 17048821 402900 92225 1536052 2011 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 C 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 A 1 0 0 0 0 1 B 0 0 1 0 1 1 TD BANK 5.000000000000 1 1 0 0 1 C 0 1 0 0 1 0 0 0 1 A 1 B 1 C 1 SCHEDULE K, SUPPLEMENTAL INFORMATION: DATE OF LAST ARBITRAGE REBATE CALCULATION: SERIES C REBATE COMPUTATION WAS DONE 11/9/2010. THE HEDGE SWAP ARRANGEMENT FOR THE SERIES D ISSUE WAS TERMINATED IN MAY 2014. THE SERIES D ISSUE WAS REISSUED ON MAY 9, 2014 FOR $13,872,000. THIS REPRESENTED A REISSUANCE OF THE BONDS. NO PROCEEDS WERE REALIZED FROM THE DELIVERY OF THE ISSUE. THE SERIES C BONDS WERE ISSUED AFTER 12/31/02 TO REFUND BONDS ISSUED BEFORE 1/1/03. AS A RESULT, LINES 1 - 9 OF PART III ARE NOT REQUIRED TO BE COMPLETED. THE $1,536,052 ON LINE 11 COLUMN C REPRESENTS THE FEES TO TERMINATE THE HEDGES/SWAPS. DR DENNIS O'NEILL DR MICHELE CO SEE PART V SEE NOTE (1) 405912 SEE PART V ECPC CONTRACTS WITH ECHN, INC. TO PROVIDE PATHOLOGY SERVICES AND LAB MANAGEMENT SERVICES TO MMH AND RGH. ALL PAYMENTS MADE TO ECPC ARE FOR PURPOSES OF OPERATING THE BUSINESS AND MAINTAINING OPERATING CASHFLOW; PAYMENTS ARE NOT DIRECTLY TO ANY OF THE OWNERS. 0 KATHLEEN O'NEILL SEE PART V SEE NOTE (2) 0 SEE PART V 0 ANTHONY DISTEFANO MD SEE PART V SEE NOTE (3) 0 SEE PART V SALARY PAID TO LIZANNE DISTEFANO AS AN EMPLOYEE OF RGH. 0 WILSON VEGA SEE PART V SEE NOTE (4) 229776 SEE PART V CBS CONTRACTS WITH ECHN, INC. TO PROVIDE COPIER SERVICES TO MMH AND RGH. 0 SCHEDULE L, PART IV COLUMN (B) (1) MMH TRUSTEES EACH OWNING MORE THAN 5% OF EASTERN CONNECTICUT PATHOLOGY CONSULTANTS, PC (ECPC).(2) MMH TRUSTEE AND THE WIFE OF DR. DENNIS O'NEILL, TRUSTEE FOR ALL AFFILIATES, WHO HAS A REPORTABLE TRANSACTION AS NOTED ABOVE.(3) MMH TRUSTEE AND SPOUSE OF LIZANNE DISTEFANO, WHO IS EMPLOYED BY ROCKVILLE GENERAL HOSPITAL, A RELATED ENTITY TO MMH.(4) FORMER MMH TRUSTEE AND PRESIDENT OF CONNECTICUT BUSINESS SYSTEMS (CBS). SCHEDULE L, PART IV COLUMN (C) LINE 1: PAYMENT OF $405,912 FROM MMH IS TO ECPC AND NOT DIRECTLY TO ANY OF THE OWNERS OF ECPC.LINE 3: SALARY OF $19,191 PAID BY RGH. MMH DID NOT MAKE ANY PAYMENTS.LINE 4: PAYMENT OF $229,776 FROM MMH TO CBS AND NOT DIRECTLY TO WILSON VEGA. X 1 31767 COST 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 BOARD MEMBERS DENNIS O'NEILL AND MICHELE CONLON ARE BUSINESS PARTNERS. FORM 990, PART VI, SECTION A, LINE 6 ECHN IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A ECHN HAS THE AUTHORITY TO ELECT TRUSTEES AND OFFICERS AND APPOINT COMMITTEE MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B ECHN HAS VARIOUS POWERS INCLUDING BUT NOT LIMITED TO: APPROVING ALL OPERATING AND CAPITAL BUDGETS, CONTROLLING THE INVESTMENT OF FUNDS, LOCATION OF SERVICES, AGREEMENTS AND TRANSACTIONS, AFFILIATIONS, CHANGES, AMENDMENTS, OR RESTATEMENTS OF CERTIFICATES OF INCORPORATION AND BYLAWS, ADOPTING A SYSTEM-WIDE VISION AND STRATEGIC PLANS, AND APPROVING DEBT BORROWINGS. FORM 990, PART VI, SECTION B, LINE 11 PRIOR TO FILING THE 990, THE FOLLOWING STEPS ARE TAKEN: 1) THE ACCOUNTING MANAGER, TOGETHER WITH OTHER MEMBERS OF THE FINANCE DEPARTMENT, CONDUCT A REVIEW OF THE 990 ALONG WITH A REVIEW AND RECONCILIATION OF THE 990 TO THE AUDITED FINANCIAL STATEMENTS; 2) THE ACCOUNTING MANAGER CONDUCTS AN EXTENSIVE REVIEW AND DISCUSSION OF THE 990 WITH THE CPA FIRM THAT PREPARES THE RETURN; 3) AN ELECTRONIC COPY OF THE 990 IS MADE AVAILABLE TO THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES (THE GOVERNING BOARD), AND SENIOR MANAGEMENT OF THE ORGANIZATION, FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE CORPORATE COMPLIANCE/INTERNAL AUDIT DEPARTMENT PROVIDES TO OFFICERS, DIRECTORS, OR TRUSTEES AND KEY EMPLOYEES THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND DISCLOSURE STATEMENT. EACH INDIVIDUAL IS REQUIRED TO RETURN TO THE DEPARTMENT A SIGNED DOCUMENT, ACKNOWLEDGING RECEIPT OF THE POLICY AND DISCLOSURE STATEMENT AND DISCLOSE ANY INTERESTS THAT COULD GIVE RISE TO CONFLICTS. A SUMMARY OF THE DISCLOSURES IS SHARED WITH THE CHAIRMAN OF THE BOARD OF TRUSTEES AND WITH THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE OF THE BOARD. INDIVIDUALS WHO ARE IDENTIFIED AS HAVING A CONFLICT OF INTEREST ARE PROHIBITED FROM PARTICIPATING IN THE GOVERNING BODIES' DELIBERATIONS AND DECISIONS RELATED TO THE TRANSACTION. THE RETURNED STATEMENTS ARE RETAINED BY THE CORPORATE COMPLIANCE/INTERNAL AUDIT DEPARTMENT. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE TAKES THE FOLLOWING STEPS WITH AN INDEPENDENT COMPENSATION CONSULTANT (1) REVIEWS DATA RELATED TO CURRENT MARKET VALUES CONSISTENT FOR ORGANIZATION'S EXECUTIVES BY REVIEW OF COMPENSATION LEVELS AND PLANS CONSISTENT WITH HOSPITALS AND HEALTH SYSTEMS OF COMPARABLE SIZE AND LOCATION; (2) COMPLETES A REVIEW OF DATA ON CURRENT AND FUTURE PLANS FOR THE ORGANIZATION, INCLUDING STRUCTURE AND JOB DESCRIPTIONS; (3) REVIEWS AND APPROVES AND RECOMMENDS SALARY RANGES FOR EACH POSITION, ALONG WITH RELATED BENEFITS; (4) REVIEWS AND APPROVES A TIERED EXECUTIVE STRUCTURE WITH APPROPRIATE INCENTIVE OPPORTUNITY, BENEFITS AND COMPENSATION. THE LAST COMPENSATION REVIEW OCCURRED 12/18/2013. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION, WILL, UPON REQUEST, ALLOW FOR REVIEW OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND MOST RECENT ANNUAL AUDITED FINANCIAL STATEMENTS AT AN OFFICE OF THE ORGANIZATION. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST IN TRUSTS 148,523. CHANGE IN INTEREST RATE SWAP AGREEMENT 8,379. PENSION AND POSTRETIREMENT RELATED ADJUSTMENTS -5,366,133. NET TRANSFER FROM/(TO) AFFILIATES -11,295,772. FORM 990, PART XI, LINE 2C: THE ECHN AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THERE HAVE BEEN NO CHANGES IN THESE PROCESSES SINCE THE PRIOR YEAR. 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