2014-08-14T08:03:12-05:00 2013-09-30 861065772 Deloitte Tax LLP 111 Monument Circle Suite 2000 Indianapolis IN 46204 990 2012-10-01 800458769 St Vincent's Multispecialty Group Inc STVI 2035765524 2800 Main Street Bridgeport CT 066064201 John C Gleckler 2035765524 2014-08-14 1 Jeffrey D Frank P00287234 3174648600 2012 2015-11-30 17:44:51Z Roger Poitras 2800 Main Street Bridgeport CT 066064201 47430503 0 X N/A X 2010 CT Address the wellness, prevention, and healthcare needs of the Bridgeport community. 10 0 282 0 0 0 0 0 40016132 47408590 5547 21913 700604 0 40722283 47430503 0 0 0 0 34007801 38975312 0 0 0 10994160 22297999 45001961 61273311 -4279678 -13842808 7527303 6720754 10771944 23818121 -3244641 -17097367 X St. Vincent's Multispecialty Group provides professional medical services to patients in Bridgeport, Connecticut and surrounding communities through a network of employed primary care physicians, hospital based providers, and specialists. 0 0 59055913 47408590 Professional Service Revenue from professional medical services provided to patients in Bridgeport, Connecticut and other communities in lower Fairfield County Connecticut through a network of employed primary care physicians, hospital based providers, and specialists. Employed primary care physicians and other specialists provide services at (1) private practice offices located in the community and within St. Vincent's Medical Center, (2) a Family Health Clinic in Bridgeport, Connecticut that serves the poor and uninsured and is owned and operated by St. Vincent's Medical Center, and (3) Immediate Health Care Centers owned and operated by St. Vincent's Medical Center located in Bridgeport, Fairfield, Monroe, and Shelton, Connecticut. Employed hospital-based providers provide services in St. Vincent's Medical Center departments pursuant to a professional services agreement between St. Vincent's Medical Center and St. Vincent's Multispecialty Group, Inc. Hospital-based providers include hospitalists, intensivists, psychiatrists, emergency services, and rehabilitation. 59055913 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 55 0 1 282 1 0 0 0 0 0 0 0 0 0 0 0 X 10 0 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X John C Gleckler 2035766000 2800 Main Street Bridgeport CT 066064201 Roger Poitras 40.00 0.00 X X 349480 0 35610 John Gleckler 5.00 35.00 X X 0 680492 74331 Peter Struzzi 1.00 39.00 X X 0 439131 40636 Sheila Cooperman MD 40.00 0.00 X 244070 0 14852 Michael V Herman MD 1.00 1.00 X 64155 0 0 Frank Illuzzi MD 1.00 39.00 X 549176 0 56523 Corina Marcu MD 40.00 0.00 X 282023 0 41421 Frank Scifo MD 40.00 0.00 X 0 276525 33654 Dawn Moser 40.00 0.00 X 183265 0 67937 Stuart Marcus MD 5.00 35.00 X 0 940743 45725 Susan L Davis RN EdD 5.00 35.00 X X 0 1453449 955587 Rafael Squitieri MD 40.00 0.00 X 664810 0 50045 Albert DiMeo MD 40.00 0.00 X 682958 0 45045 Ahmad Fotovat MD 40.00 0.00 X 472384 0 42397 Kathleen Harper MD 40.00 0.00 X 646038 0 52366 Edward Kosinski MD 40.00 0.00 X 766072 0 36161 4904431 3790340 1592290 112 0 1 0 Cardiology Associates of Fairfield Count 1177 Summer Street Stamford CT 06905 Physician Services 3988115 Medi-Claim Services Inc dba Medistar 12 Cambridge Drive Trumbull CT 06611 Medical Billing 1271056 Vista Staffing Solutions Inc File 50834 Los Angeles CA 900740834 Physician Services 456680 3 Professional Svc. Rev. 621100 47408590 47408590 47408590 21913 21913 47430503 47408590 0 21913 X 1119965 705997 413968 32938173 32325019 613154 1040592 1010023 30569 2085749 2024532 61217 1790833 1738225 52608 117153 117153 6204 6204 3678 3589 89 12186325 11468369 717956 5310 3230 2080 844401 780398 64003 225600 225600 2135825 2076337 59488 16331 9670 6661 1801 1801 437286 424929 12357 1142121 1140621 1500 Corporate Allocations 3634972 3634972 Supplies 932916 912617 20299 Licenses, Dues, and Sub 321416 291685 29731 Restructuring expenses 154116 154116 132544 124183 8361 61273311 59055913 2217398 0 370523 72175 1723016 3106182 3975433 123649 165537 2416814 568872 1385019 1847942 600000 755614 218914 -95947 7527303 6720754 3983946 3861375 6787998 19956746 10771944 23818121 X -3244641 -17097367 -3244641 -17097367 7527303 6720754 X -13842808 -19952 10033 X 0 1 X 1 0 X X X 0 0 0 St Vincent's Medical Center 060646886 3 - Hospital 1 1 1 29350000 1 29350000 0 0 0 0 0 0 0 0 1 3678 3678 0 Explanation of Lobbying Activities: Part II-B, Line 1: Lobbying expenses represent the portion of dues paid to the Connecticut State Medical Society and the Fairfield County Medical Association that are specifically allocable to lobbying. St. Vincent's Multispecialty Group does not participate in or intervene in (including the publishing or distributiing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. 804090 285671 518419 1048562 283201 765361 564162 564162 1847942 Due to St. Vincent's Medical Center 16640003 Defined Contribution Liability 573767 Accrued Pension 527688 Accrued Professional Liability 139483 Professional Liability IBNR 1000805 Notes Payable 1075000 19956746 X Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: The Medical Center, the Multispecialty Group, and the College are tax-exempt organizations under Internal Revenue Code Section 501(c) (3) and their related income is exempt from federal income tax under Section 501(a). The Medical Center accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. 0 1 0 0 0 0 0 0 0 Roger Poitras 260098 0 79665 0 9717 0 5463 0 30147 0 385090 0 0 0 John Gleckler 0 399588 0 263851 0 17053 0 40108 0 34223 0 754823 0 0 Peter Struzzi 0 326390 0 101018 0 11723 0 10000 0 30636 0 479767 0 0 Sheila Cooperman MD 233726 0 8999 0 1345 0 10748 0 4104 0 258922 0 0 0 Frank Illuzzi MD 446890 0 87660 0 14626 0 19290 0 37233 0 605699 0 0 0 Corina Marcu MD 273540 0 8256 0 227 0 10798 0 30623 0 323444 0 0 0 Frank Scifo MD 0 254833 0 10836 0 10856 0 11250 0 22404 0 310179 0 0 Dawn Moser 182109 0 500 0 656 0 55503 0 12434 0 251202 0 0 0 Stuart Marcus MD 0 582773 0 354014 0 3956 0 11250 0 34475 0 986468 0 0 Susan L Davis RN EdD 0 807402 0 599993 0 46054 0 921992 0 33595 0 2409036 0 104681 Rafael Squitieri MD 651801 0 10182 0 2827 0 11250 0 38795 0 714855 0 0 0 Albert DiMeo MD 636150 0 45573 0 1235 0 11250 0 33795 0 728003 0 0 0 Ahmad Fotovat MD 439871 0 29226 0 3287 0 11250 0 31147 0 514781 0 0 0 Kathleen Harper MD 392583 0 226526 0 26929 0 37583 0 14783 0 698404 0 0 0 Edward Kosinski MD 431402 0 328594 0 6076 0 5000 0 31161 0 802233 0 0 0 Part I, Line 3 The President/CEO compensation, along with the compensation of all other executives of the Health System, is established annually by the St. Vincent's Health Services Executive Compensation Committee (the Compensation Committee). The Compensation Committee uses an external national firm for an independent compensation comparison based on well recognized and established guidelines. Recommended compensation is discussed and approved by the Compensation Committee and is sent to the Multispecialty Board for final approval. Part I, Line 4b Susan L. Davis participates in a 457f plan. During calendar year 2012, Ms. Davis received $900,188 in elective deferred compensation under the plan. She received payments from the plan of $104,681. Supplemental Information Part III Schedule J, Part II: Compensation for Susan L. Davis, John C. Gleckler, Stuart Marcus, Frank Illuzi, Frank Scifo, and Peter Struzzi is paid by St. Vincent's Medical Center, the parent of St. Vincent's Multispecialty Group, Inc. Compensation for Susan L. Davis is paid by St. Vincent's Medical Center on behalf of St. Vincent's Health Services Corp, and all of its related organizations, including St. Vincent's Multispecialty Group, Inc. The compensation Dr. Davis receives is for her role as the President/CEO of St. Vincent's Health Services and as an Ascension Ministry Market Leader for the NY/CT market, which includes four other health systems. In July 2012, Dr. Davis assumed additional responsibilities as the Ministry Market Leader for the entire Florida and Alabama market area. A portion of Dr. Davis' compensation and benefits are allocated to that market. None of Dr. Davis's compensation is allocated to St. Vincent's Multispecialty Group, nor is there any compensation for her role as a Board member of St. Vincent's Multispecialty Group. Compensation for John C. Gleckler is paid by St. Vincent's Medical Center on behalf of St. Vincent's Health Services Corp, and all of its related organizations, including St. Vincent's Multispecialty Group. The compensation Mr. Gleckler receives is for his role as the Senior Vice President and Chief Financial Officer of St. Vincent's Health Services. None of Mr. Gleckler's compensation is allocated to St. Vincent's Multispecialty Group. Compensation for Stuart Marcus, M.D. is paid by St. Vincent's Medical Center, the parent organization of St. Vincent's Multispecialty Group. The compensation Dr. Marcus receives is for his role as President of St. Vincent's Medical Center. None of Dr. Marcus's compensation is allocated to St. Vincent's Multispecialty Group. The compensation Frank Illuzzi, Frank Scifo and Peter Struzzi receive is for their roles at St. Vincent's Medical Center. None of their compensation is allocated to St. Vincent's Multispecialty Group. Form 990, Part VI, Section A, line 2 Many of the persons listed on Part VII have a "business relationship" with each other by virtue of sitting on the board of or being employed by related St. Vincent Health Services entities. Form 990, Part VI, Section A, line 6 St. Vincent's Multispecialty Group, Inc. has a single corporate member, St. Vincent's Medical Center. Form 990, Part VI, Section A, line 7a St. Vincent's Multispecialty Group, Inc. has a single corporate member, St. Vincent's Medical Center, who has the ability to elect members to the governing body of St. Vincent's Multispecialty Group, Inc. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to St. Vincent's Multispecialty Group, Inc. financial information or corporation as a whole are subject to approval by its sole corporate member, St. Vincent's Medical Center. Form 990, Part VI, Section B, line 11 Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Management presents the Form to the Board, or a designated committee, to review and answer any questions. Prior to filing the return, all Board Members are provided the Form 990 and management team members are available to answer any Board Members' questions. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee meeting will decide if conflict of interest exist. Each director, principal officer, and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Section B, line 15 In determining compensation of the organization's CEO, the process, performed by St. Vincent's Health Services Corp, a related organization of St. Vincent's Multispecialty Group, included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The St. Vincent's Health Services Executive Compensation Committee reviewed and approved the compensation. In the review of the compensation, the CEO was compared to individuals at other organizations in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the minutes. The individual was not present when her compensation was decided. In determining compensation of other officers or key employees of the organization, the process, performed by St. Vincent's Health Services Corp, a related organization of St. Vincent's Multispecialty Group, Inc., included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. St. Vincent's Health Services Executive Compensation Committee reviewed and approved the compensation. In the review of the compensation, the other officers or key employees of the organization were compared to individuals at other organizations in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. Form 990, Part VI, Section C, line 19 The organization will provide any documents open to public inspection upon request. Other Fees Form 990, Part IX, line 11g Contract Labor Physicians and Other: Program service expenses 9,527,632. Management and general expenses 600,816. Fundraising expenses 0. Total expenses 10,128,448. Purchased Services Billing Transcriptionists: Program service expenses 1,875,371. Management and general expenses 19,348. Fundraising expenses 0. Total expenses 1,894,719. Consulting and recruiting: Program service expenses 65,366. Management and general expenses 97,792. Fundraising expenses 0. Total expenses 163,158. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: Change in FASB Liability 72,389. Change in Pension Plan Liability -62,356. Ascension Health PO Box 45998 St Louis MO 63145 311662309 National Health System MO Section 501(c)(3) Schedule A, Line 11a Ascension Health Alliance 0 St Vincent's Health Services Corp 2800 Main Street Bridgeport CT 06606 222558134 System Parent CT Section 501(c)(3) Schedule A, Line 11a Ascension Health 0 St Vincent's Medical Center 2800 Main Street Bridgeport CT 06606 060646886 Hospital CT Section 501(c)(3) Schedule A, Line 3 St Vincent's Health Services Corp 0 St Vincent's Medical Center Foundation Inc 2800 Main Street Bridgeport CT 06606 222558132 Fundraising CT Section 501(c)(3) Schedule A, Line 7 St Vincent's Health Services Corp 0 St Vincent's Special Needs Center Inc 95 Merritt Boulevard Trumbull CT 06611 060702617 Programs for Special Needs Individuals CT Section 501(c)(3) Schedule A, Line 9 St Vincent's Health Services Corp 0 Hall-Brooke Behavioral Health Services Inc 47 Long Lots Road Westport CT 06880 060813283 Behavioral Health Services CT Section 501(c)(3) Schedule A, Line 9 St Vincent's Health Services Corp 0 St Vincent's College 2800 Main Street Bridgeport CT 06606 061331677 College of Health Sciences CT Section 501(c)(3) Schedule A, Line 2 St Vincent's Medical Center 1 St Vincent's Development Inc 95 Merritt Boulevard Trumbull CT 06611 222554128 Real Estate Holdings CT Section 501(c)(25) N/A St Vincent's Health Services Corp 0 Vincentures Inc 95 Merritt Boulevard Trumbull CT 06611 061211417 Inactive CT N/A C 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 St Vincent's Development Corporation P 248878 Actual Amount Paid St Vincent's Medical Center S 29350000 Amount Transferred Ascension Health P 830234 Actual Amount Paid