2014-08-13T14:24:03-05:00 2013-09-30 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE SUITE 4000 Indianapolis IN 46204 990 2012-10-01 060646917 The Stamford Hospital % Kevin Gage STAM 2032761000 30 Shelburne Rd PO Box 9317 Suite Stamford CT 06902 Kevin Gage 2014-08-06 3176817000 2012 2015-11-30 17:44:51Z Kevin Gage CFO 30 Shelburne Road PO Box 9317 Stamford CT 06902 496004210 false X www.stamhealth.org X 1893 CT Our mission: Together with our physicians we provide a broad range of high quality health and wellness services focused on the needs of our communities. 14 12 2977 697 7421256 4983998 19419411 12066222 463409232 470829704 3440915 2785873 4739985 4619372 491009543 490301171 0 0 0 0 227287045 245135746 0 159575 3450033 211325027 206339187 438612072 451634508 52397471 38666663 798097565 797789880 637083779 589414476 161013786 208375404 Our mission: Together with our physicians we provide a broad range of high quality health and wellness services focused on the needs of our communities. false false 371947467 669559 470771708 IN ADDITION TO A 305 BED HOSPITAL FACILITY, THE STAMFORD HOSPITAL (TSH) OPERATES A 225,000 SQUARE FOOT AMBULATORY CARE CENTER (TULLYCENTER) ALSO IN STAMFORD, CT. KEY OPERATING STATISTICS FOR THE YEAR ENDED 9/30/2013 INCLUDE: ADULT AND PEDIATRIC INPATIENTS CARED FOR AND DISCHARGED 14,871; BABIES BORN 2,112; TOTAL INPATIENT DAYS OF CARE PROVIDED 71,656. PATIENTS SEEKING CARE IN THE STAMFORD HOSPITAL EMERGENCY ROOM: ADMITTED FOR INPATIENT TREATMENT 8,094; TREATED AND RELEASED 42,864; TREATED AT TULLY IMMEDIATE CARECENTER 24,863. SURGERIES PERFORMED AT THE HOSPITAL AND TULLY CENTER: 15,217. RADIATION THERAPY PROCEDURES PERFORMED: 64,358. 371947467 true true false true false false false false false true true false false true true false false true false false true false false true true false true true false false true true false false false false false false false true false false true false false false true true true true false false true 352 0 true 2977 true true true true BD false false false true true false false true false X 14 12 false false false false false false false true true false false true true true true true true true true false CT X Kevin Gage 2032761000 30 Shelburne Road Stamford CT 06902 Ernest N Abate 2.0 2.0 X 0 0 0 Jay Higham 2.0 2.0 X 0 0 0 Amy C Downer 2.0 2.0 X 0 0 0 Dr Rodrigo Acosta 2.0 40.0 X 0 411394 0 Michael Fedele 2.0 2.0 X 0 0 0 David Jahns 2.0 2.0 X 0 0 0 Maryann Keller-Chai 2.0 2.0 X 0 0 0 Brian Grissler 38.0 2.0 X X 1837162 0 36194 Edwin Ford 2.0 2.0 X 0 0 0 Dr Arthur Klein 2.0 2.0 X 0 0 0 Dr Charles Miner 2.0 2.0 X 0 0 0 Dr Neil Dreyer 2.0 2.0 X 0 0 0 Andrew Merrill 2.0 2.0 X 0 0 0 Charles Krause III 2.0 2.0 X 0 0 0 Darryl McCormick 38.0 2.0 X 496946 0 10997 David Smith 38.0 2.0 X 643134 0 38694 Kathleen Silard 38.0 2.0 X 777149 0 51103 Kevin Gage 38.0 2.0 X 730883 0 44506 Dr Sharon Kiely 38.0 0.0 X 706585 0 50131 Dr Michael Coady 38.0 0.0 X 1178784 0 24215 Dr Lance Bruck 38.0 2.0 X 768158 0 49153 Dr Steven Horowitz 38.0 0.0 X 594115 0 48516 Dr Li Poa 38.0 0.0 X 2600000 0 0 DR DAN DAVIS 38.0 0.0 X 564832 0 76168 10897748 411394 429677 475 false true false HEMATOLOGY ONCOLOGY P C 34 SHELBURNE RD Stamford CT 069023628 PHYS. FEES/ONCOLOGY 4734446 PATHOLOGY AND LABORATORY SERV LLC 11 RESEARCH DRIVE SUITE 4 WOODBRIDGE CT 065252348 Cytology labortatory 1131061 SPECIALIZED RECEIVABLES INC P O Box 12414 Newark NJ 071013514 Collections 1044749 ADELMAN SHEFF AND SMITH LLC 180 ADMIRAL COCHRANE DR Annapolis MD 21401 Legal 910541 ASHFORTH PROPERTIES CONSTRUCTION 707 Summer Street Stamford CT 069011026 Construction 767482 63 1365043 580529 10120650 375687 12066222 PATIENT REVENUE 621399 302996183 302996183 0 0 PHYSICIAN BILLING 621111 8324004 8324004 0 0 WELLNESS AND TRAINING 621410 3268631 3268631 0 0 MEDICARE/MEDICAID PAYMENT 621410 148890127 148890127 0 0 REFERENCE LAB INCOME 621511 7350759 0 7350759 0 470829704 1702398 1693476 8922 0 0 2955580 3901706 -946126 0 -946126 61575 -1007701 2615324 1531849 1083475 1083475 1083475 235695 1365043 269484 -33789 -33789 0 0 MANAGEMENT FEE INCOME 532000 1326761 1326761 0 0 CAFETERIA, COFFEE SHOP 722210 1613209 1613209 0 0 MEANINGFUL USE INCOME 621110 1961083 1961083 0 0 698234 698234 0 0 5599287 490301171 470771708 7421256 41985 X 0 0 0 0 0 0 0 0 4301667 657297 3644370 0 0 0 0 0 181114365 155307922 24891221 915222 19702774 16575938 3029566 97270 28003825 25441192 2482915 79718 12013115 10106630 1847178 59307 818110 818110 0 0 2130359 102580 2020680 7099 455101 0 455101 0 120584 0 120584 0 159575 159575 86999 0 86999 0 52713579 37174635 15437334 101610 3984893 140458 2339629 1504806 72775575 67698651 4994300 82624 5513654 -242565 5754536 1683 0 0 0 0 16336203 14648684 1598426 89093 505646 266237 160266 79143 0 0 0 0 390076 249927 61006 79143 87841 87841 0 0 0 0 0 0 23541169 23200851 340318 0 9812539 9812539 0 0 SUBSCRIPTIONS, DUES & MEMBER 2064620 679141 1366343 19136 STATE-FED TAXES 2047840 128529 1919311 0 LOSS ON LEASE OBLIGATIONS 1784311 0 1784311 0 SERVICE CONTRACTS 7946958 7880528 0 66430 3223130 1212342 1902614 108174 451634508 371947467 76237008 3450033 0 281828 74647 67845792 105669646 14776102 16814120 64792290 68025724 0 0 0 0 0 0 5408238 5564103 5037968 6075378 693155314 363575763 255279912 329579551 292893922 201535657 16718907 16033884 0 0 0 0 75062606 48417170 798097565 797789880 88929508 98044582 0 0 637796 510101 379572228 374738602 0 0 0 0 0 0 5024265 4443205 162919982 111677986 637083779 589414476 X 120894359 160465828 32086053 39876202 8033374 8033374 161013786 208375404 798097565 797789880 X 38666663 2536116 6158839 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false 0 false 0 false 0 true 120584 false 0 false 0 false 0 120584 false SCHEDULE C PART II B LINE 1F GRANTS THE HOSPITAL CONTRACTS LOBBYING FIRMS WHO LOBBY LEGISLATIVE ACTION ON BEHALF OF THE HOSPITAL AND THE HEALTHCARE INDUSTRY. ADDITIONALLY, THE HOSPITAL PAYS DUES TO ORGANIZATIONS THAT USE A PORTION OF THE DUES FOR HEALTHCARE LOBBYING EXPENSES. 40118983 8872941 1284155 2366947 47909132 26695222 16783195 1162352 4521786 40118983 27527319 3087737 -56132 3863702 26695222 28198000 2154945 874515 3700141 27527319 29311544 2687150 -864244 2936450 28198000 0.00000 0.16860 0.83140 false false 43860945 43860945 181925612 101844837 80080775 6714972 6714972 324572862 254237433 70335429 136080923 7493493 128587430 329579551 DONOR RESTRICTED FUNDS 18042243 INVESTMENT IN HEALTHSTAR 11898063 MISC. RECEIVABLE 7942939 DUE FROM AFFILIATES 4671729 DEBT ISSUANCE COSTS 4523506 ORGANIZATION COSTS 1289667 DEPOSITS 49023 48417170 0 CHARITABLE GIFT ANNUITY PAYABLE 51131 EST THIRD PART SETTLEMENTS 7393587 PENSION LIABILITY 59906883 DUE TO AFFILIATES 23659385 EST FOR PROFESSIONAL LIABILITY 10841317 LOSS ON LEASE OBLIGATION 9825683 111677986 X Schedule D, Part V, Line 4 The endowment consists of temporarily or permanently restricted contributions received with donor stipulations that limit the use of the donated assets. Temporarily restricted contributions are available for certain health care services as defined in the donor agreements. Permanently restricted net assets are restricted to investments to be held in perpetuity, the income from which is expendable to support health care services Central America and the Caribbean 0 1 Investments n/a 11898063 Central America and the Caribbean 0 1 Program Services malpractice insurance 9974500 0 2 0 2 21872563 21872563 false false true false false false X X X X X true Ghiorsi Sorrenti Inc 255 Madison Avenue Wykoff NJ 07481 campaign consultant false 8192627 144715 8047912 Michael Valentine 5 Southerland Road Savannah GA 31411 Campaign Advisor false 2000000 14864 1985136 10192627 159579 10033048 CT WALK, RUN &RIDE 807257 654632 152625 2763 3592 33398 DREAM BALL 607981 575861 32120 3133 95584 8451 1 185500 134550 50950 8738 50200 63625 1600738 1365043 235695 14634 149376 105474 269484 -33789 SCHEDULE G SUPPLEMENTAL INFORMATION PART I, LINE 2B (1), COL V THE AMOUNT OF $144,715 REPORTED INCLUDES $9,617 PAID TO DOUGLAS PICHA CONSULTING FOR THEIR SERVICES WITH THE SAME CAMPAIGN. true true X true X true X true true true false true false 24950547 14607372 10343175 0.02290 84615582 38166531 46449051 0.10280 606638 606638 0.00130 110172767 52773903 57398864 0.12700 14 18259 3461064 500786 2960278 0.00660 51600 51600 0.00010 2 182 379537 379537 0.00090 16 18441 3892201 500786 3391415 0.00760 16 18441 114064968 53274689 60790279 0.13460 1 160 161378 93562 67816 0.00020 1 160 161378 93562 67816 0.00020 true 48497654 0 83737062 105077849 -21340787 X true true 1 1 THE STAMFORD HOSPITAL

30 SHELBURNE RD STAMFORD CT 06902

X X X X THE STAMFORD HOSPITAL 1 true true 100 true 400. true X X X X X X true true X X X X X X true false true X false false Form 990, Schedule H, Part I, LINE 6 Disclosure Identifying Costs Supplemental Grant Funding to Optimus Health Care to operate clinics at 1351 Washington Blvd., Stamford, CT. Clinics include primary care, pediatrics, behavioral health as well as Stamford Hospital Specialty Clinics. Total expenses = $2,291,321. Form 990, Schedule H, Part I, Line 6b A COMMUNITY BENEFIT REPORT IS PREPARED FOR THE STATE OF CONNECTICUT; HOWEVER, THAT REPORT IS NOT MADE AVAILABLE TO THE PUBLIC. Form 990, Schedule H, Part II Community Building Activities TSH, through Ryan White grants, (Parts A and B), administered by Stamford CARES, employs an HIV Nurse Practitioner (DNP, APRN), Adherence Nurse (RN) Counselor, and a Dietician committed to providing HIV specialty primary care services. TSH works in partnership with the City of Stamford HIV Prevention Program and Stamford CARES, a program of Family Centers that provide HIV medical case management. The Hospital's HIV Nurse Practitioner and Adherence Nurse Counselor attended regular case management meetings with Stamford CARES' case managers and other local community services such as substance abuse rehabilitation, mental health, and housing support. TSH also provides office space and medical oversight of the program. Form 990, Schedule H, Part III, Line 4 Text of bad debt expense footnote ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. 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, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS 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 COPAYMENT 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. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. Form 990, Schedule H, Part III, Line 8 Treatment of Medicare Shortfall as Community Benefit TO THE EXTENT THERE IS A MEDICARE 'SHORTFALL', THE HOSPITAL HAS PROVIDED SERVICES AND IS REIMBURSED LESS THAN THE COST OF THOSE SERVICES. THIS TRANSFER OF VALUE BENEFITS THE PATIENT AND ARGUABLY (DIRECTLY AND INDIRECTLY) THE COMMUNITY IN WHICH THEY LIVE. Form 990, Schedule H, Part III, Line 8 Medicare Costing Methodology THE COSTING METHODOLOGY USED FOLLOWS THE METHODOLOGY OF THE MEDICARE COST REPORT. Form 990, Schedule H, Part III, Line 9b Application of Collection Practices Qualifying for Financial Assistance ALL COLLECTION EFFORTS CEASE AT ANY POINT IN THE PROCESS IF THE PATIENT APPLIES FOR FREE BED FUNDS OR FINANCIAL ASSISTANCE. Form 990, Schedule H, Part V, Section B, Line 3 We conducted dozens of interviews to engage the community in the needs assessment process. These interviews captured community perceptions on priority health issues, service gaps, and barriers to access, as well as suggested strategic initiatives to address these issues. In all, nearly 100 people were interviewed, including administrative and clinical staff from Stamford Hospital, representatives from local health and social service agencies, public health officers, other public and elected officials, representatives from advocacy organizations and foundations, members of the clergy, and community residents. We also administered community surveys to get feedback directly from the populations we serve. We mailed surveys to a randomly selected sample of 3,400 households in Lower Fairfield County. We intentionally oversampled the City of Stamford, and especially the low income residents (defined as households with annual household income below $50,000) within Stamford; these populations tend to be harder to reach and, as a result, are often excluded from community health assessment efforts. In total, 1,228 mail surveys were returned to us, a response rate of over 36%. To ensure input was received from low income, racial/ethnic minority, and other vulnerable populations, we also administered the survey through selected community venues, including community health fairs, primary care clinics, faith-based community organizations, and other community centers. The survey was conducted with the help of research assistants, Stamford Hospital volunteers, and volunteers from community organizations who served as translators for respondents who did not speak or read English. The result of this outreach was an additional 271 survey responses. Form 990, Schedule H, Part V, Section B, Line 7 Our Community Health Needs Assessment and Stamford Hospital Community Action Plan for Population Health and Prevention were approved by the Board of Directors in late September 2013. As a result, we were not able to execute any of our proposed community programs addressing the needs identified in our Community Health Needs Assessment during tax year 2013. Form 990, Schedule H, Part V, Section B, Line 20d The maximum amount charged to FAP eligible individuals is calculated based on federal poverty guidelines. Individual family income levels are compared to FPG and total charges are reduced from 100%-60% based on level of income. Form 990, Schedule H, Part VI Needs assessment The stamford hospital ("TSH' or 'hospital") partners with a number of nonprofit health and social services organizations that seek to benefit the community and improve the health and well-being of their clients. In addition, together with our physicians, the hospital works closely with the stamford department of health and social services ("stamford health dept.") to identify needs and develop programs, provide screenings, and promote dissemination of health information. With the stamford health department, TSH sponsored a joint city of stamford ('stamford') wide flu campaign, to promote the health of the community and reduce the number of flu-related hospitalizations and emergency department visits. The campaign included: a joint senior health fair/community projects; sharing vaccine supplies and redistribution to local providers in the event of a shortage; flu hotline; arrangements for vaccination of home bound individuals; and vaccination clinics at both the Stamford health department and TSH Tully Health Center. The hospital clinic was staffed with volunteers and per-diem nursing staff. In fy13, the hospital's outpatient component of this effort totaled 1,900 vaccinations. TSH works with the stamford health department's hiv prevention program and stamford cares, a program of family centers that provides hiv medical case management; includes participation in community health fairs and educational outreach efforts; provides hiv updates for aids service providers in the community; performs client home visits; and conducts monthly hiv positive women's support group. TSH partners with optimus health center (formerly bridgeport community health center), a federally qualified health care center, to create an integrated primary care delivery network for the medically underserved communities in stamford. The hospital provided supplemental support to optimus of $2.3 million in fy13 to ensure its continued viability. Community input and engagement to address childhood obesity is provided through a stamford city-wide task force lead by TSH. This effort focuses on prevention, advocacy, education, and treatment and is a city-wide collaboration that includes stamford public schools, the Stamford health department, early childhood educators, after school programs and community centers and community pediatricians and family medicine practitioners. TSH's kids' fans (kids' fitness and nutrition services) program, promoting physical activity and health conscious nutrition, is a cornerstone of this childhood obesity initiative. Another initiative representative of the collaborative efforts of TSH and community organizations is 'paint the town pink,' a community-wide breast cancer awareness program. 'Paint the town Pink' holds a month-long series of events in october of each year. The stamford hospital partners with a number of nonprofit health and social services organizations that seek to benefit the community and improve the health and well-being of their clients. In addition, together with our physician services ("stamford health dept.") to identify needs and develop programs, provide screenings, and promote dissemination of health information. Form 990, Schedule H, Part VI Patient education of eligibility for assistance THE STAMFORD HOSPITAL USES SEVERAL VENUES TO NOTIFY OUR PATIENTS OF THE AVAILABLE FINANCIAL OPTIONS. 1) SIGNS AND OR BROCHURES ARE DISPLAYED IN ENGLISH AND SPANISH IN THE FOLLOWING AREAS: * EMERGENCY ROOM WAITING ROOMS AND REGISTRATION WORKSTATIONS * IMMEDIATE CARE CENTER WAITING ROOM * PATIENT REGISTRATION AREAS ON THE MAIN CAMPUS AND TULLY CAMPUS * CASHIER'S OFFICE, OFFICES OF THE FINANCIAL COUNSELORS, RECEPTION AREA OF THE PATIENT BUSINESS SERVICES DEPARTMENT * ANCILLARY DEPARTMENTS * BROCHURES ARE ALSO AVAILABLE IN CREOLE AND POLISH. 2) THE HOSPITAL'S BILLING STATEMENTS INCLUDE AN INFORMATIONAL PAGE THAT IS PRINTED ON THE REVERSE SIDE OF THE STATEMENT OUTLINING THE FINANCIAL OPTIONS. 3) THE "ARE YOU UNINSURED NOTICE" IN ENGLISH AND SPANISH IS ATTACHED TO THE TRUE SELF PAY STATEMENTS. 4) STAFFING: * STAMFORD HOSPITAL HAS A FULL-TIME DSS ST OF CT OUTREACH WORKER ON THE HOSPITAL CAMPUS. * SOCIAL SERVICES DEPARTMENT * CASE MANAGEMENT DEPARTMENT * PATIENT REGISTRATION HAS ONE FULL TIME FINANCIAL COUNSELOR * PATIENT BUSINESS SERVICES HAS ONE BILINGUAL PATIENT ASSISTANCE COORDINATOR AND TWO FULL TIME BILINGUAL FINANCIAL COUNSELORS. * THE DSS OUTREACH WORKER AND A TSH FINANCIAL COUNSELOR HOLD EDUCATIONAL AND COUNSELING SESSIONS IN THE OPTIMUS AND STAMFORD HOSPITAL CLINICS ONCE PER WEEK. * HAND-OUTS ARE PROVIDED TO PATIENTS BY THE FINANCIAL COUNSELORS AT THE CLINICS AND THE COMMUNITY HEALTH CENTERS. * PATIENTS ARE SCREENED FOR FEDERAL OR STATE PROGRAMS, AND THE HOSPITALS FINANCIAL ASSISTANCE PROGRAM (FAP) BY THE SOCIAL WORKERS, * PATIENT ASSISTANCE COORDINATOR, FINANCIAL ASSISTANCE COUNSELORS, AND THE DSS LIAISON. 5) NOTIFICATIONS: PATIENTS RECEIVE APPROVAL OR DENIAL LETTERS AND, IF ELIGIBLE, FINANCIAL ASSISTANCE PROGRAM IDENTIFICATION CARDS. Form 990, Schedule H, Part VI Community information TSH provides a broad range of community outreach and educational services to residents of predominantly its primary service area (psa) and secondary service area (ssa) that include 12 communities in southern fairfield county, ct. The hospital's service area was developed through the strategic planning process and is defined in stamford health system, inc.'s strategic plan. The hospital's combined psa and ssa include an estimated 136,119 households with a total population of 361,760 residents. The psa includes the communities of stamford, darien, and rowayton, with an estimated 51,823 households and a total population of 141,892. Stamford comprises an estimated 45,196 households with a total population of 121,280. The ssa includes the communities of Greenwich, cos cob, riverside, old greenwich, new canaan, norwalk, westport, weston, and wilton, with an estimated 84,296 households and a total population of 219,868. For the psa, 24.4% of the population is estimated to be less than 18 years of age; 38.7% is 18-44; 24.5% is 45-64; and 12.4% is 65 years of age and older. The ssa has a slightly older age distribution with an estimated 25.3% of its population less than 18 years of age; 29.3% is 18-44; 30.8% is 45-64; and 14.6% 65 years of age and older. Regarding race/ethnicity, of the estimated population in the psa,65.6% of residents are white; 22.5% hispanic; 13% black; 7% Asian; and the remainder are multi-racial, native american, pacific islander, and other non-hispanic. Stamford is estimated to have a more racially diverse population than the psa and ssa with the black population representing 15.2% of its total population; the Hispanic population 25.8%; and asian population 7.8%. For the ssa, 83.8% of the total estimated population is white; 12% hispanic ; 5.9% black; 5.1% asian; and the remainder are multi-racial, native american, pacific islander, and other non-hispanic. Although in the psa an estimated 19.2% of total households have household incomes exceeding $200,000, stamford has areas with significant poverty. In comparison to the psa, stamford has only an estimated 14.6% of total households with household incomes exceeding $200,000, and 18.3% with household incomes less than $35,000, 28% with incomes less than $50,000. In the ssa, an estimated 27.3% of the total households have household incomes exceeding $200,000, while an estimated 16.7% have household incomes less than $35,000 and 24.3% less than $50,000. The estimated payor mix of the psa is predominantly commercial/private insurance (68.9%), followed by medicare (11.7%); medicaid (9.2%); self pay/uninsured (8.6%); and medicare dual eligible (1.6%). Compared to the psa, stamford has a higher estimated percentage of medicaid at 10.4% and self-pay/uninsured at 9.8%. For the ssa, the estimated payor mix is also primarily commercial/private insurance (74.8%), followed by medicare (12.6%); medicaid (5.7%); self-pay/uninsured (5.3%); and medicare dual eligible (1.6%). The hospital is Ryan White Title I & II HIV/AIDS: TSH, through Ryan White grants, (Parts A and B), administered by Stamford CARES, employs an HIV Nurse Practitioner (DNP, APRN) and Adherence Nurse (RN) Counselor and a Dietician committed to providing HIV specialty primary care services. TSH works in partnership with the City of Stamford HIV Prevention program and Stamford CARES, a program of Family Centers that provides HIV medical case management. The Hospital's HIV Nurse Practitioner and Adherence Nurse Counselor attend regular case management meetings with Stamford CARES case managers and other local community services such as substance abuse rehabilitation, mental health, and housing support. They collaborate with multidisciplinary community service providers on how to best serve each client's needs. TSH provides expertise and supports the west side neighborhood revitalization zone (WSNRZ), a community effort to improve the health, safety, infrastructure, and quality of life in the west side of stamford. Neighbors work side-by-side with local businesses, law enforcement, the hospital's housing partner, charter oak communities, inc. (formerly the stamford housing authority), and local elected and appointed officials. TSH in partnership with Charter Oak Communities, Inc., (formerly Stamford Housing Authority) established the Vita health and wellness district in the West Side. In partnership with the WSNRZ, the City of Stamford and support from U.S. Dept. of Housing and Urban Development (HUD), the Vita plan is intended to address the social determinants of health, including health and wellness, nutrition and access to nutritious food, active living and healthy lifestyles, workforce development, economic development and improving the hospital and community connections. In 2013, a community collaborative was formed to further strengthen our relationship with a multidisciplinary group of key stake holders throughout the community to improve health outcomes, address the findings of the community health needs assessment conducted by TSH in partnership with the City of Stamford health and social services department. Form 990, Schedule H, Part VI Promotion of community health The Stamford Hospital ("TSH" or the "hospital") provided a variety of programs that benefited the community. These programs included, for example, health screenings, immunization programs, social services and support counseling for patients and families, crisis intervention, community health education, and the donation of space for use by community groups. Health education programs provided by the Hospital for the benefit of the community included: smoking cessation; weight loss; stress management; and programs focused on such specific health factors or disease entities such as heart disease, breast cancer sleep disorders, arthritis, high cholesterol, cancer prevention, nutrition, stress management, circulatory problems, digestive disorders, pain management, sports injuries, and children's nutrition. TSH offered a Mini-Medical School, a free, six-week series of lectures by volunteer physicians focusing on common disease states and available treatments. Topics include anesthesiology, cancer, cardiology, gastroenterology, general anatomy, gynecology, infectious diseases, integrative medicine, medical decision-making, pulmonary medicine and orthopedics. In Spring and Fall of 2013 a total of 640 people attended the classes. Hospital staff provided services at community health fairs and served as speakers at various community groups on lifestyle/health improvement topics. In Fiscal Years 2012 and 2013, TSH participated in 149 community health events; conducted 9 screenings, with total attendance of 21,257. The events included health fairs at community centers, senior centers, religious institutions, and schools; physician presentations as well as career days, school tours and informational special events. Other highlights of community health education and outreach activities provided in FY2013 are as follows: Asthma Education: TSH conducted an event for the community with exhibits to educate and create an awareness and understanding of asthma. Topics included keeping asthma under control, utilizing a team approach in treating asthma, the role of allergies, and the future of asthma therapy. The Hospital also held educational events that focused on Pediatric asthma. Cancer: In 2013, Stamford Hospital's Carl & Dorothy Bennett Cancer Center continued to build on its reputation for delivering expert care in a warm, nurturing environment. A major achievement included the formation of the Cancer Center's own Patie and Family Advisory Council (PFAC), which is consistent with the Hospital's Plane tree philosophy of patient-centered care. With members that include staff, cancer survivors and caregivers, the goal of the PFAC is to continue to improve the care and services offered at the Bennett Cancer Center. Additionally, the Bennett Cancer Center teamed up with Oncology Rehab Partners to bring the STAR (Survivorship Training & Rehabilitation) Programs to its patients. STAR is a nationally recognized cancer survivorship program that focuses on helping survivors heal physically and emotionally. Physicians and staff began training in 2013; the program will be implemented in 2014. Cancer Outreach and Education: As required by the American College of Surgeons Commission on Cancer, a Cancer Committee oversees Stamford Hospital's cancer program, of which educational and outreach programs for the community and patients are a key component. Direct mail is used to remind women of the importance of screening for breast cancer. Paint the Town Pink, a community-wide breast cancer awareness program, held a month-long series of events in October. In addition, educational lectures offered through out the year for the community include topics focused on raising awareness about the dangers of sun exposure and risks for skin cancer, direct mail initiatives and programs to underscore the importance of screening and early detection of colorectal cancers, as well as education surrounding testicular and gynecologic cancers. Cancer outreach efforts also include anti-tobacco lectures and an Anti-Smoking Poster Contest for elementary school children. The Hospital offers Freedom From Smoking Quit for Good classes year-round. Nutrition programs, led by a registered dietitian, are offered through out the year. Form 990, Schedule H, Part VI Cancer Screenings/Mammography: Stamford Hospital's Mobile Wellness Center offered mammography screening to the community at no Cost to patients who are underinsured. The Mobile Mammography Program also offers mammography screenings to corporations. In FY13 2530 women received mammograms, of which 1062 were performed at no cost. To reach the underserved , the Hospital collaborated with Optimus Health Care ("Optimus"), a federally qualified health center, the Witness Project of CT, Planned Parenthood of CT, and the Hispanic Council of Greater Stamford. Outreach was targeted to underinsured and uninsured women of color, and assistance provided to address language barriers, navigate the healthcare system, and cope with fear. Other key 2013 accomplishments for the Bennett Cancer Center include: Stamford Hospital's Cancer Program was awarded the Gold Award by the American College of Surgeons Commission on Cancer . 100% of the outpatient nurses at the Bennett Cancer Center achieved Oncology Nursing Certification. The Medical Oncologists at the Bennett Cancer center were recognized by the Quality Oncology Practice Initiative (QOPI) Certification Program, an affiliate of the American Society of Clinical Oncology (ASCO). The QOPI Certification Program provides a three-year certification for outpatient hematology-oncology practices that meet the highest standards for quality cancer care. 6% of newly diagnosed patients were enrolled in Clinical Trials TSH Manager of Cancer Support Services at the Bennett Cancer Center, received the 2013 Oncology Social Worker of the Year Award from the Association of Oncology Social Work (AOSW). The prestigious award recognizes an oncology social worker who provides exemplary commitment to the delivery of compassionate patient care. Community-Based Clinical Care: The Hospital continues to employ the physicians and mid-level providers who work in the primary care centers. Optimus employs all other staff. The benefits of this transition are: 1) the creation of an integrated primary care delivery network for the medically underserved communities in Stamford; 2) access to federal programs to support the expansion of the primary care center's services to include pharmacy and dental; and 3) to ensure the availability of the primary care centers as ambulatory care training venues for the Hospital's residency programs. The Hospital provided supplemental support to Optimus of $2.3 million in FY 2013 to ensure its continued viability. Emergency Services and Education: Stamford's EMS Institute, a Department of TSH, provided emergency medical service (EMS) training to emergency medical technicians (EMTS), nurses, physicians, paramedics, and anyone in the public who is interested in learning these live-saving skills. The Hospital offered an Infant and Child Care class, and an adult cardio-pulmonary resuscitation ("CPR") and EMT-Basic course. TSH EMS Institute also collaborated with SEMS. Regarding disaster preparedness, the Hospital's staff worked with regional agencies to coordinate emergency plans and conducted joint simulation drills. Heart Disease Education: TSH provided education about risk factors and lifestyle behaviors that contribute to heart disease and stroke. The Hospital provided screenings for cardiovascular disease as part of its mobile coach. In addition, the Hospital supported community events addressing heart disease, including 397 cardiac risk assessment screenings at the Take Heart event in February, which is heart month. Presentations by physicians on women's heart health, controlling high blood pressure and stress, were also conducted throughout the year at businesses and community centers. Form 990, Schedule H, Part VI Nutrition/Weight Management Education/Fitness & Exercise: TSH Pediatrics integrates its childhood obesity prevention program, KIDS' FANS (Kids'Fitness and Nutrition Services), into community health education initiatives. KIDS' Fans promotes physical activity and health conscious nutrition through advocacy, education, intervention and treatment. Since 2008, 1,300 children have received 12 weeks of nutrition education and physical activity. The KIDS' FANS message is integrated into TSH community health education programs conducted at health fairs, schools and community centers. Education through cooking classes, restaurant engagement and healthy shopping activities at grocery stores and outreach to parent leader groups provide connections and linkages through the community. Chaired by Madhu Mathur, MD, MPH, a pediatrician board certified in obesity medicine, a city-wide, volunteer task force led by TSH focuses on prevention, advocacy, education, treatment, and research. This collaboration of 41 member organizations includes Stamford Public Schools, the City of Stamford Health and Social Services Department, ("Stamford Health Department"), early childhood educators, after school programs and community centers, community pediatricians and family medicine practicioners. Outreach/Senior Citizens: The Hospital provided on going support and speakers for senior women at the Yerwood Community Center; stroke risk assessments and screenings, with counseling; and lectures at community centers in Stamford, Darien and New Canaan, CT. Speakers focused on awareness about the risks of stroke and heart disease and congestive heart failure; provided education on healthy eating, diabetes and digestive disorders. TSH conducted over 550 free blood pressure screenings at senior centers in 2013. Form 990, Schedule H, Part VI Children and Youth with Special Health Care Needs: Medical home initiative covering southwest CT addresses the special healthcare needs of children and youth in the region, meeting their medical, social and emotional needs and provides linkages to community resources and family support networks. Families are provided assistance with care coordination, securing specialist appointments, transportation, and funding for medicines. In 2013, 1,778 children were served, 515 of whom were high complexity. Southwest PMHI is focused on prevention targeting obesity, mental health and promoting early literacy, working closely with the Stamford hospital-led KIDS' FANS (KIDS' Fitness and Nutrition services) Initiative. Ryan White Title I & II HIV/A IDS:TSH, through Ryan White grants, (Parts A and B), administered by Stamford CARES, employs an HIV Nurse Practitioner (APRN) and Adherence Nurse (RN) Counselor and a Dietician committed to providing HIV specialty primary care services. TSH works in partnership with the City of Stamford HIV Prevention program and Stamford CARES, a program of Family Centers that provides HIV medical case management. The Hospital's HIV Nurse Practitioner an Adherence Nurse Counselor attended regular case management meetings with Stamford CARES case managers and other local community services such as substance abuse rehabilitation, mental health, and housing support. They collaborate with multidisciplinary community service providers on how to best serve each client's needs. community services such as substance abuse rehabilitation, mental health, and housing support. They collaborate with multidisciplinary community service providers on how to best serve each client's needs. community services such as substance abuse rehabilitation, mental health, and housing support. They collaborate with multidisciplinary community service providers on how to best serve each client's needs. Form 990, Schedule H, Part VI State filing of community benefit report A community benefit report is prepared for the state of connecticut; however, that report is not made available to the public. X X true true X X X X X false false false false false false false false false Darryl McCormick 380148 0 102668 0 14130 0 0 0 10997 0 507943 0 0 0 David Smith 432272 0 100803 0 110059 0 0 0 38694 0 681828 0 0 0 Kathleen Silard 544902 0 142140 0 90107 0 12509 0 38594 0 828252 0 0 0 Kevin Gage 514227 0 135716 0 80940 0 15508 0 28998 0 775389 0 0 0 Dr Sharon Kiely 519990 0 137307 0 49288 0 12437 0 37694 0 756716 0 0 0 Dr Michael Coady 763288 0 338852 0 76644 0 13642 0 10573 0 1202999 0 0 0 Dr Lance Bruck 515452 0 239744 0 12962 0 13679 0 35474 0 817311 0 0 0 Dr Steven Horowitz 579924 0 0 0 14191 0 13272 0 35244 0 642631 0 0 0 Dr Rodrigo Acosta 0 383574 0 26000 0 1820 0 0 0 0 0 411394 0 0 Dr Li Poa 2600000 0 0 0 0 0 0 0 0 0 2600000 0 0 0 Brian Grissler 945941 0 345553 0 545668 0 0 0 36194 0 1873356 0 0 0 DR DAN DAVIS 564832 0 0 0 0 0 17000 0 59168 0 641000 0 0 0 Schedule J, Part I, Line 1a As per Company Policy, all noncash imputable benefits are to be processed in a grossed-up method with applicable wage and taxes reported on W2's for all employees. Housing allowances are provided to certain senior executives as part of their compensation. Schedule J Part 1 Line 3 IT IS THE POLICY OF THE STAMFORD HOSPITAL TO PAY EMPLOYEES FAIR AND COMPETITIVE WAGES. THE HOSPITAL HAS ADOPTED A WAGE AND SALARY PROGRAM TO ENSURE THAT ALL EMPLOYEES ARE PAID IN RELATION TO THE VALUE OF THE WORK THEY PERFORM. THIS PROGRAM IS REVIEWED ANNUALLY. EXECUTIVE COMPENSATION IS SUBJECT TO A MORE COMPREHENSIVE REVIEW, INCLUDING AN ANNUAL BENCHMARKING ANALYSIS AND BOARD-LEVEL APPROVAL PROCESS. Independent compensation consultants are used and compensation surveys are obtained from at least three sources. Once the Compensation is determined a written employment contract is obtained. Schedule J, Part I, Line 4a Dr. Andrew Snyder, SHIP President Last day of employment - 11/18/2011 Continuation of Salary - 15 months at base pay effective 11/18/2011 the last 7 1/2 months was offset by compensation earned by the employee. Schedule J, Part I, Line 4a Dr. Robert Debara Last day of employment - 3/20/13 Severence payments began - 6/07/13 to be paid over 16 months totaling $573,708. Schedule J, Part I, Line 4b The CEO received a payment of $342,746 from the supplemental executive retirement plan. Schedule J, Part I, Line 6b BONUSES ARE CALCULATED BASED ON VARIOUS PERFORMANCE FACTORS INCLUDING PRODUCTIVITY MEASURES AND FINANCIAL INDICATORS AS DEFINED BY CONTRACTUAL AGREEMENTS. TOTAL COMPENSATION IS REVIEWED TO ENSURE AMOUNTS DO NOT EXCEED FAIR MARKET VALUE AS DETERMINED BY EXTERNAL SURVEY DATA. EXCEED FAIR MARKET VALUE AS DETERMINED BY EXTERNAL SURVEY DATA. Schedule J, Part III Dr. Li Poa's compensation was a payout of his employment contract. A STATE OF CT HEALTH AND EDUCATION FAC AUTHORities 060806186 2077443P8 2010-05-27 133992115 SCHEDULE K, PART VI false false false B STATE OF CT HEALTH AND EDUCATION FAC AUTHORITIES 060806186 20774YKQ9 2012-06-20 254620769 CONSTRUCTION OF NEW HOSPITAL FACIL false false false A 0 0 133995069 0 0 0 2057323 0 0 24835260 107102468 0 2011 true false true true B 0 0 254620769 0 36350996 0 2935597 0 0 84670456 0 167014716 false false false A false false true true false 0 false false false true B false false true true false 0 false false false true A false false false false false false 0 false 0 false B false false false false false false 0 false 0 false true A false B true Schedule K, Part I, Line A 0 STATE OF CONNECTICUT HEALTH AND EDUCATIONAL FACILITIES AUTHORITY BONDS WERE ISSUED 5/27/10 TO: 1) REFUND THE 11/13/96, 03/24/99, 6/03/08 AND 05/28/09 BOND ISSUES AND COMMERCIAL LOANS. 2) FINANCE ROUTINE RENOVATIONS AND OTHER CAPITAL EXPENDITURES AND 3) FINANCE DEVELOPMENT AND CONSTRUCTION OF NEW HOSPITAL FACILITY Schedule K, Part II, Line 3 0 There is a $3,000 variance between the proceeds of issue and the issue price due to investment earnings. SHR1 LLC business relationship 38289 SHR1 LEASES SPACE TO STAMFORD false SCHEDULE L, PART IV BUSINESS TRANSACTIONS SHR1, LLC LEASES SPACE TO THE HOSPITAL. DOUGLAS MILNE, FORMER DIRECTOR IS A 50% OWNER OF THE COMPANY. MR. MILNE SOLD HIS INTEREST IN THE SHR1, LLC IN OCTOBER 2012. X 9 78187 Selling Price X 1 297500 FMV false true false Form 990, Part VI, Question 11 THE STAMFORD HOSPITAL HAS A COMPREHENSIVE REVIEW PROCESS IN PLACE RELATING TO THE REVIEW OF FORM 990. PRIOR TO FINALIZATION OF THE 990, MANAGEMENT PRESENTS THE DRAFT FORM 990 TO THE FULL BOARD OF DIRECTORS FOR REVIEW AND DISCUSSION. THE HOSPITAL'S EXTERNAL TAX ACCOUNTANTS ATTEND THIS MEETING WITH MANAGEMENT TO ADDRESS ANY SPECIFIC CONCERNS OR QUESTIONS. THIS REVIEW PROCEDURE HELPS TO ASSURE SOUND REPORTING AND COMPLIANCE WITH TAX LAW. Form 990, Part VI, Question 12c IT IS THE POLICY OF THE STAMFORD HOSPITAL TO PROHIBIT ITS EMPLOYEES AND OTHER ASSOCIATES FROM ENGAGING IN ANY ACTIVITY, PRACTICE, OR ACT WHICH CONFLICTS WITH, OR APPEARS TO CONFLICT WITH, THE INTERESTS OF THE STAMFORD HOSPITAL, OR ITS PATIENTS. EMPLOYEES ARE EXPECTED TO CONDUCT THE BUSINESS OF THE STAMFORD HOSPITAL TO THE BEST OF THEIR ABILITY AND FOR THE BENEFIT OF THE STAMFORD HOSPITAL AND ITS PATIENTS. THE POLICY ALSO REQUIRES BOARD MEMBERS, OFFICERS, SENIOR LEADERS, MEDICAL STAFF LEADERS, COMMITTEE MEMBERS AND OTHER INDIVIDUALS AS APPROPRIATE TO DISCLOSE ANY POTENTIAL CONFLICT OF INTEREST THEY OR THEIR IMMEDIATE FAMILY MAY HAVE ON AN ANNUAL BASIS. SURVEYS ARE DISTRIBUTED ANNUALLY AND TIMELY RECEIPT IS MONITORED BY THE HOSPITAL'S COMPLIANCE DEPARTMENT. Form 990, Part VI, Questions 15A & 15B IT IS THE POLICY OF THE STAMFORD HOSPITAL TO PAY EMPLOYEES FAIR AND COMPETITIVE WAGES. THE HOSPITAL HAS ADOPTED A WAGE AND SALARY PROGRAM TO ENSURE THAT ALL EMPLOYEES ARE PAID IN RELATION TO THE VALUE OF THE WORK THEY PERFORM. THIS PROGRAM IS REVIEWED ANNUALLY. EXECUTIVE COMPENSATION IS SUBJECT TO A MORE COMPREHENSIVE REVIEW, INCLUDING AN ANNUAL BENCHMARKING ANALYSIS AND BOARD-LEVEL APPROVAL PROCESS. Form 990, Part VI, Question 19 THE STAMFORD HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES 18,751,074 PHYSICIAN FEES 10,441,790 Intercompany Staffing fees 2,888,525 TEMP NURSING PERSONNEL 2,474,853 Other 1,438,733 CONSULTING SERVICE 711,481 DATA PROCESSING FEES 323,538 COLLECTION FEES 141,310 Archiving expense 3,332 Total 37,174,635 PART XI, LINE 5 RECONCILIATION OF NET ASSETS PENSION RELATED CHANGES OTHER THAN NET PERIODIC BENEFIT COST - 60,087,503 EQUITY TRANSFER TO SHIP - (53,928,664) TOTAL 6,158,839 36 GROVE ST NEW CANAAN LLC 30 Shelburne RD Stamford CT 06902 274941529 MED RENTALS CT 126873 5420950 TSH 24 GROVE ST NEW CANAAN LLC 30 Shelburne RD Stamford CT 06902 274941167 MED RENTALS CT -145626 850494 TSH Stamford Health System Inc 30 Shelburne RD Stamford CT 06902 222476636 HOSP PARENT CT 501 (C)(3) 11, Type I NA false The Stamford Hospital Foundation 30 Shelburne RD Stamford CT 06902 222478748 Fundraising CT 501 (C)(3) 9 SHS true Stamford Health Intergrated Practices 30 Shelburne RD Stamford CT 06902 271648289 Medical SVCS CT 501 (C)(3) 9 TSH true Miller Hall Medical Suites 166 W Broad Street Stamford CT 06904 061619978 Prof Office Bldg CT SHS C Corp 0 0 Stamford ObGYN Associates 30 Shelburne RD Stamford CT 06902 061330879 Obstetrical Care CT SHS C Corp 0 0 Healthstar Indemnity Co Limited FB PERRY BUILDING 40 CHURCH ST HAMILTON BD Self Insurance CT TSH C Corp 2438000 68461000 1.00000 Southwest Connecticut Radiology 30 Shelburne RD Stamford CT 06902 453801216 Radiology CT SHS S Corp false true false false false false false false false true false false false true true true true true Stamford Health Intergated Practices Inc b 53923664 book value Southwest Connecticut Radiology r 500000 cash value Southwest Connecticut Radiology s 1200000 cash value Healthstar Indemnity Company q 3064082 book value Healthstar Indemnity Company s 9974496 book value Stamford Health System Inc k 213418 book value Stamford Health System Inc s 100000 cash value Stamford Health System Inc p 1184639 book value Stamford Health System Inc o 65698 Book Value