2014-02-24T14:27:28-06:00 2013-06-30 221478099 COHNREZNICK LLP 180 GLASTONBURY BOULEVARD GLASTONBURY CT 06033 990 2012-07-01 223160873 STAYWELL HEALTH CARE INC STAY 2037568021 80 PHOENIX AVENUE NO 201 WATERBURY CT 06702 DONALD J THOMPSON JR 2037568021 2014-02-24 1 P00852868 8606333000 2012 2015-11-30 17:44:51Z DONALD J THOMPSON JR 80 PHOENIX AVENUE WATERBURY CT 06702 13782914 0 X WWW.STAYWELLHEALTH.ORG X 1992 CT PROVIDE PRIMARY HEALTH CARE, DENTAL, MENTAL HEALTH, AND SOCIAL SERVICES, TO THE UNDERSERVED POPULATION OF THE GREATER WATERBURY COMMUNITY. 12 12 173 8 -992 -496 3403013 3873910 10505285 9578320 5589 4124 282089 146715 14195976 13603069 0 0 0 0 10780123 10365110 0 0 0 2836571 3162194 13616694 13527304 579282 75765 10017874 9616179 2609296 2131836 7408578 7484343 PROVIDE PRIMARY HEALTH CARE, DENTAL, MENTAL HEALTH, AND SOCIAL SERVICES, TO THE UNDERSERVED POPULATION OF THE GREATER WATERBURY COMMUNITY. 0 0 9490607 9705820 MEDICAL CLINIC, HEALTHY START, AND DENTAL CLINIC WHICH PROVIDE MEDICAL, PRENATAL, AND CHILDCARE FOR INNER CITY RESIDENTS AND UNINSURED RESIDENTS AND RESTORATIVE DENTAL CARE FOR INNER CITY CHILDREN. THE TOTAL NUMBER OF VISITS DURING FISCAL YEAR 2013 WAS 79,023. 9490607 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 72 0 1 173 1 1 1 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CT X LULE TRACEY 2037568021 80 PHOENIX AVENUE SUITE 201 WATERBURY CT 06702 MIGDALIA ROSARIO 2.00 X 0 0 0 MARK BRIGGS 2.00 X X 0 0 0 ANGIE MEDINA 2.00 X X 0 0 0 ARLENE M ARIAS LCSW 2.00 X 0 0 0 SANDRA J SOREL-LEDUC 2.00 X X 0 0 0 LAURIE LOUMINGOU 2.00 X 0 0 0 TYRONE WILLIAMSON 2.00 X 0 0 0 REV CHRISTOPHER KING 2.00 X 0 0 0 WALTER R MACHNICZ 2.00 X 0 0 0 CAROLYN A HIGHSMITH 2.00 X X 0 0 0 JUDY A ACOSTA 2.00 X 0 0 0 THOMAS JOHNSON 2.00 X 0 0 0 DONALD J THOMPSON JR 40.00 X 211393 0 73945 LULE TRACEY 40.00 X 169041 0 48483 SUNIL D'CUNHA 40.00 X 246555 0 56599 CHRISTINE BIANCHI 40.00 X 129412 0 30134 AMIT PATEL 40.00 X 196981 0 45610 MONIKA KAUL 40.00 X 137734 0 31804 ADNA SADIQ 40.00 X 146627 0 33732 LUIS LEON 40.00 X 148454 0 22673 RANTNEKER MANDAVA 37.30 X 134277 0 30704 1520474 0 373684 17 0 1 0 GEMINI DENTAL LABS 250 PORTER STREET SUITE 73 WATERTOWN CT 06795 DENTAL LAB SERVICES 115240 UNIVERSITY OF CT HEALTH CENTER FOR PEDIA 263 FARMINGTON AVE FARMINGTON CT 06488 PEDIATRIC DENTISTRY 104520 2 39576 12625 3050859 770850 768762 3873910 PATIENT SERVICE 621400 9159500 9159500 PHARMACY 446110 418820 418820 9578320 4124 4124 171244 172236 -992 -992 -992 6605 12625 7609 -1004 -1004 MEANINGFUL USE INCENTIVE 900099 127500 127500 OTHER REVENUE 900099 21211 21211 148711 13603069 9705820 -992 24331 910371 617334 293037 7469749 5065334 2404415 1320469 895427 425042 664521 450620 213901 10372 10372 34800 34800 15000 15000 921605 624952 296653 45747 31022 14725 35672 24190 11482 5371 5371 185935 164404 21531 49325 33448 15877 23635 16027 7608 56432 53664 2768 248600 207071 41529 28178 24745 3433 VACCINES 761812 761812 CLINIC SUPPLIES 412768 280270 132498 EQUIPMENT RENTAL AND MA 157168 110294 46874 OTHER 99171 82116 17055 70603 47877 22726 13527304 9490607 4036697 0 1856206 1147528 2004489 2257654 90449 240833 972010 849597 182467 177305 6838863 2324891 4551247 4513972 361006 429290 10017874 9616179 1337213 979848 8318 7653 171343 110101 1092422 1034234 2609296 2131836 X 5962355 5931961 1446223 1552382 7408578 7484343 10017874 9616179 75765 0 X X 0 1 X 1 1 1 X 3066787 3639556 3170165 3403013 3880515 17160036 3066787 3639556 3170165 3403013 3880515 17160036 17160036 6332 3860 8749 5589 4124 28654 3613 271 3884 5568 148711 154279 17346853 46319916 0.98920 0.99570 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 15000 0 0 15000 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: PAID $15,000 TO LEVIN, POWERS & BRENNAN LLC 384297 384297 5480337 1508587 3971750 974229 816304 157925 4513972 X 13782914 179845 179845 13603069 0 13603069 13707149 179845 179845 13527304 0 13527304 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE CORPORATION HAS NO UNRECOGNIZED TAX BENEFITS AT JUNE 30, 2013. THE CORPORATION'S U.S. FEDERAL AND STATE INFORMATION RETURNS PRIOR TO FISCAL YEAR 2010 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. IF THE CORPORATION HAS UNRELATED BUSINESS INCOME TAXES, IT RECOGNIZES INTEREST AND PENALTIES ASSOCIATED WITH ANY TAX MATTERS AS PART OF THE INCOME TAX PROVISION AND INCLUDE ACCRUED INTEREST AND PENALTIES WITH THE RELATED TAX LIABILITY IN THE STATEMENTS OF FINANCIAL POSITION. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENT EXPENSES 172,236. DIRECT FUNDRAISING EXPENSES 7,609. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENT EXPENSES 172,236. DIRECT FUNDRAISING EXPENSES 7,609. FUNDRAISING 19230 12625 6605 6500 189 600 320 19230 12625 6605 6500 189 600 320 7609 -1004 X X X 0 1 0 0 0 0 0 0 0 DONALD J THOMPSON JR 211393 0 0 0 0 0 25500 0 48445 0 285338 0 0 0 LULE TRACEY 169041 0 0 0 0 0 9250 0 39233 0 217524 0 0 0 SUNIL D'CUNHA 246555 0 0 0 0 0 0 0 56599 0 303154 0 0 0 CHRISTINE BIANCHI 129412 0 0 0 0 0 0 0 30134 0 159546 0 0 0 AMIT PATEL 196981 0 0 0 0 0 0 0 45610 0 242591 0 0 0 MONIKA KAUL 137734 0 0 0 0 0 0 0 31804 0 169538 0 0 0 ADNA SADIQ 146627 0 0 0 0 0 0 0 33732 0 180359 0 0 0 LUIS LEON 141704 0 6750 0 0 0 0 0 22673 0 171127 0 0 0 RANTNEKER MANDAVA 134277 0 0 0 0 0 0 0 30704 0 164981 0 0 0 PART I, LINE 4B DONALD J. THOMPSON, JR, 457 (F), $25,500 LULE TRACEY, 457 (F), $9,250 X 1 761812 X MISCELLANEOUS 6950 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE 990 WILL BE REVIEWED AND ACCEPTED BY THE BOARD BEFORE STAYWELL SUBMITS. FORM 990, PART VI, SECTION B, LINE 12C DONALD THOMPSON, CEO, MONITORS CONFLICT OF INTEREST POLICY BY REVIEWING AND ADDRESSING ANY POTENTIAL CONFLICTS AND FOLLOWING UP EACH YEAR FOR ANY CHANGES. FORM 990, PART VI, SECTION B, LINE 15 INFORMATION FROM NATIONAL AND STATEWIDE SURVEYS ARE USED AS CRITERIA TO DETERMINE THE SALARY OF THE CEO. THIS INFORMATION IS GIVEN TO THE PERSONNEL COMMITTEE FOR REVIEW. THE PERSONNEL COMMITTEE NEGOTIATES AND APPROVES THE SALARY OF THE CEO. FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C THERE HAVE BEEN NO CHANGES IN THE OVERSIGHT OR SELECTINO PROCESS DURING THE TAX YEAR.