2013-08-13T11:18:51-05:00 2012-09-30 060903326 WHITTLESEY & HADLEY PC 147 CHARTER OAK AVE HARTFORD CT 061065100 990 2011-10-01 060646710 MANCHESTER MEMORIAL HOSPITAL MANC 8606461222 71 HAYNES STREET MANCHESTER CT 06040 MICHAEL D VEILLETTE 8606461222 2013-08-13 ROBERT W MCCALL P00592560 8605223111 2011 2016-02-24 21:20:13Z MICHAEL D VEILLETTE 71 HAYNES STREET MANCHESTER CT 06040 194135015 0 X WWW.ECHN.ORG X 1920 CT MANCHESTER MEMORIAL HOSPITAL IS A 249 BED HOSPITAL OFFERING VARIOUS HEALTHCARE SERVICES TO ALL MEMBERS OF THE COMMUNITY, INCLUDING THE INDIGENT AND UNDERSERVED. ALSO SEE STATEMENTS 7, 17 AND 18. 22 20 1798 319 932627 -54809 2874889 4217696 174362885 188389725 659792 671876 1129978 855718 179027544 194135015 28611 24438 0 0 99361014 106417075 0 0 0 73726563 77776479 173116188 184217992 5911356 9917023 148034488 170071385 135892846 155065612 12141642 15005773 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 22360599 15730496 INPATIENT SERVICES - MANCHESTER MEMORIAL HOSPITAL OFFERS COMPREHENSIVE MEDICAL SERVICES IN A 249 BED ACCUTE CARE COMMUNITY HOSPITAL, WITH A TOTAL OF 8,832 INPATIENTS TREATED IN FISCAL YEAR 2012. SERVICES ARE OFFERED TO THE COMMUNITY, REGARDLESS OF ANY INDIVIDUALS ABILITY TO PAY 14832233 30834082 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 UTITLIZE STATE OF THE ART AUTOMATED EQUIPMENT PROVIDING RAPID TURNAROUND TIME, AND INTEGRATION OF TEST RESULTS WITH MEDICAL RECORDS. 13322742 32214661 EMERGENCY DEPARTMENT - EMERGENCY CARE IS OFFERED 24 HOURS PER DAY, AND PROVIDES NEEDED EMERGENCY MEDICAL CARE TO THE COMMUNITY, REGARDLESS OF ANY INDIVIDUALS ABILITY TO PAY. 95264904 24438 108552033 SEE SCHEDULE H, PART VI 95264904 24438 108552033 145780478 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 1 330 0 1 1798 1 1 1 0 0 0 0 0 0 0 X 22 20 1 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X JAMES RAY 8606461222 71 HAYNES STREET MANCHESTER CT 06040 DENNIS O'NEILL MD 1.00 X X 0 0 0 ROBIN MURDOCK MEGGERS 1.00 X X 0 0 0 MICHELE CONLON MD 1.00 X X 0 0 0 CRAIG LAPPEN 1.00 X X 0 0 0 PAUL BERTE 1.00 X 0 0 0 GORON BRODIE MD 1.00 X 0 0 0 GLORIA BROOKS 1.00 X 0 0 0 THOMASINA CLEMONS 1.00 X 0 0 0 ANTHONY DISTEFANO MD 1.00 X 0 0 0 MILTON DOREMUS 1.00 X 0 0 0 JOY DORIN 1.00 X 0 0 0 DAVID ENGELSON 1.00 X 0 0 0 DAVID GONCI 1.00 X 0 0 0 JEFFREY HEIDTMAN 1.00 X 0 0 0 REBECCA JANENDA 1.00 X 0 0 0 JOSEPH JEAMEL JR 1.00 X 0 0 0 CLAUDIO MILITE MD 1.00 X 0 0 0 PETER MULLIGAN 1.00 X 0 0 0 ROSEMARIE PAPA 1.00 X 0 0 0 THOMAS SCANLON 1.00 X 0 0 0 WILSON VEGA 1.00 X 0 0 0 LENORA WILLIAMS MD 1.00 X 0 0 0 PETER J KARL 37.50 X 766216 0 125567 KEVIN G MURPHY 37.50 X 435547 0 77082 MICHAEL D VEILLETTE 37.50 X 301364 0 51959 DEBORAH GOGLIETTINO 37.50 X 281288 0 47022 DENNIS MCCONVILLE 37.50 X 258851 0 37601 DEBORAH PARKER 37.50 X 267792 0 51529 JOEL REICH MD 37.50 X 388378 0 49746 CHARLES COVIN 37.50 X 208398 0 20047 LEONA CROSSKEY 37.50 X 183913 0 23753 KATHLEEN SIMS 37.50 X 211111 0 31762 ROBERT CARROLL MD 37.50 X 388212 0 37540 CAROLYN MCKENNA 37.50 X 107944 0 8609 JAMES A CASTELLONE MD 37.50 X 362270 0 25356 SCOTT BROWN MD 37.50 X 322837 0 35344 ANDREAS J BOJKO MD 37.50 X 338649 0 28352 ENOCH DARKO MD 37.50 X 327441 0 10861 THEODORE SHERRY MD 37.50 X 344520 0 35715 5494731 0 697845 130 1 1 0 GRIFFIN YORK & KRAUSE 121 RIVER FRONT DRIVE MANCHESTER NH 03102 MARKETING, ADVERTISING 1106514 ROBINSON & COLE 280 TRUMBULL STREET HARTFORD CT 06103 LEGAL 629827 HEALOGICS WOUND CARE & HYPERBARIC SERVIC 3087 MOMENTUM PLACE CHICAGO IL 60689 WOUND SERVICES 405824 EASTERN CONNECTICUT PATHOLOGY CONSULTANT 11 RESEARCH DRIVE WOODBRIDGE CT 06525 PATHOLOGY SERVICES 396199 SIEMENS HEALTHCARE DIAGNOSTICS PO BOX 121102 DALLAS TX 75312 MEDICAL SERVICES 384488 5 1323383 2894313 4217696 PATIENT SERVICES REVEN 621500 175217566 175217566 OTHER HEALTHCARE REVEN 621500 12993276 12060649 932627 AUXILIARY REVENUE 900099 178883 178883 188389725 671876 671876 412808 0 412808 412808 412808 389853 0 389853 389853 CAFETERIA REVENUE 722210 921694 921694 NON OPERATING GAIN/LOS 621500 -868637 -868637 53057 194135015 187331272 932627 1653420 24438 24438 3806878 3806878 77742946 59084639 18658307 4753221 4040238 712983 14690562 12486978 2203584 5423468 4609948 813520 204755 204755 23785 23785 506027 506027 10009105 6005463 4003642 90573 90573 759106 379553 379553 246796 123398 123398 3735144 3174872 560272 52404 44543 7861 245212 208430 36782 2714044 2714044 6896812 5862290 1034522 4705033 3999278 705755 MEDICAL SUPPLIES/EQUIPM 22368010 22368010 ECHN ALLOCATION 9503532 5702119 3801413 PHYSICIAN FEES 7189666 7189666 BAD DEBT EXPENSE 6382307 6382307 2144168 1380264 763904 184217992 145780478 38437514 0 10880738 6414688 24700329 26534856 2591833 2660785 1380569 2028449 194911016 143593394 52084498 51317622 15241294 18295109 41155227 62819876 148034488 170071385 15698846 17702182 44485118 43201382 15190769 18870010 60518113 75292038 135892846 155065612 X 3473307 4925515 988702 1905069 7679633 8175189 12141642 15005773 148034488 170071385 X 9917023 -7052891 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 24395 24395 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THE CONNECTICUT HOSPITAL ASSOCIATION (CHA) HAS DETERMINED THAT FOR ITS FISCAL YEAR ENDING APRIL 30,2012 THAT 9% OF ITS MEMBERSHIP DUES WERE USED FOR LOBBYING PURPOSES. THE TOTAL LOBBYING PORTION FROM CHA FOR MANCHESTER MEMORIAL HOSPITAL INC. WAS $13,787. THE AMERICAN HOSPITAL ASSOCIATION (AHA) HAS INDICATED THAT 24% OF 2012 DUES WERE USED FOR LOBBYING PURPOSES.THE TOTAL LOBBYING PORTION FROM AHA FOR MANCHESTER MEMORIAL HOSPITAL INC. WAS $10,608. 8023690 1723483 9747173 8100283 -76593 8023690 7537396 562887 8100283 7346972 190424 7537396 0.76000 0.16000 0.08000 0 1 1 1429966 1429966 91147363 48804122 42343241 1744348 220444 1523904 98163305 94568828 3594477 2426034 2426034 51317622 ASSETS LIMITED-INVESTMENTS HELD IN TRUST FOR EST SELF INS LIAB 1856635 ASSETS LIMITED-INVSTMENTS HELD UNDER BOND INDENTURES 8040554 DUE FROM AFFILIATES 32445168 ESTIMATED SETTLEMENTS DUE FROM THIRD PARTY PAYORS 3549365 INTEREST IN NA OF ECHN COMMUNITY HEALTH CARE FOUNDATION 6199192 INVESTMENT IN JOINT VENTURES 3565975 OTHER, NET 1866509 BENEFICIAL INTEREST IN TRUST ASSETS 5296478 62819876 CONDITIONAL RETIREMENT ASSET OBLIGATIONS 272109 OTHER CURRENT LIABILITIES 2426820 EST SELF INSURANCE LIABILITIES 9814802 ACCRUED PENSION AND OTHER POST RETIREMENT BENEFITS LONG TERM 60203932 DUE TO AFFILIATED ENTITIES 818583 ESTIMATED SETTLEMENT DUE TO THRID PARTIES 1343126 MARKET VALUE SWAP 412666 75292038 194135015 184217992 9917023 3707084 -10759975 -7052891 2864132 187310132 3707084 -10759975 -7052891 194363023 -228008 -228008 194135015 184446001 228008 228008 184217993 0 184217993 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: 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. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: 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, 2012 AND 2011. AS OF SEPTEMBER 30, 2012 AND 2011, THE HOSPITAL DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNCERTAIN TAX POSITIONS. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN BENEFICIAL INTEREST IN TRUSTS 495,556. NET CHANGE IN INTERST RATE SWAP AGREEMENT -123,039. TRANSFERS TO/FROM AFFILIATES, NET 2,244,135. PENSION AND POSTRETIREMENT RELATED ADJUSTMENTS -13,376,627. TOTAL TO SCHEDULE D, PART XI, LINE 8: -10,759,975. PART XII, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN BENFICIAL INTEREST IN TRUST ASSETS 495,556. NET CHANGE IN INTEREST RATE SWAP AGREEMENT -123,039. TRANSFERS TO/FROM AFFILIATES, NET 2,244,135. PENSION AND POSTRETIREMENT RELATED ADJUSTMENTS -13,376,627. PART XII, LINE 4B - OTHER ADJUSTMENTS: COST OF GOODS SOLD - GIFT SHOP -228,008. PART XIII, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD - GIFT SHOP 228,008. 1 1 1 X 125.000000000000 1 X 1 0 1 1 2467 1615082 12435 1602647 0.01100 43688 27823160 21601566 6221594 0.04270 46155 29438242 21614001 7824241 0.05370 29 100282 648391 135 648256 0.00440 10 269 667026 0 667026 0.00460 1 193 3096426 1908336 1188090 0.00820 2 0 252042 0 252042 0.00170 12 16989 182563 150 182413 0.00130 54 117733 4846448 1908621 2937827 0.02020 54 163888 34284690 23522622 10762068 0.07390 3 12 1472 1472 0.00000 5 1726 1321424 1321424 0.00910 1 9303 9303 0.00010 3 420 420 0.00000 221 2632 2632 0.00000 12 1959 1335251 1335251 0.00920 1 6382307 4954240 45795230 53784911 -7989681 X 1 1 1 NORTHEAST REGIONAL RADIATION ONCOLOGY NETWORK INC ONCOLOGY SERVICES 0.25000 2 TOLLAND IMAGING CENTER MEDICAL IMAGING SERVICES 0.35000 3 EVERGREEN ENDOSCOPY CENTER ENDOSCOPY SERVICES 0.50000 4 EVERGREEN IMAGING CENTER LLC MEDICAL IMAGING SERVICES 0.50000 5 MEDICAL PRACTICE PARTNERS MANAGEMENT SERVICES 0.50000 1 1 MANCHESTER MEMORIAL HOSPTIAL

71 HAYNES STREET MANCHESTER CT 06040

X X X X MANCHESTER MEMORIAL HOSPITAL 1 1 1 125.000000000000 1 400.000000000000 1 X X X 1 1 X X X X 1 0 1 X 0 0 PART II: AS PART OF EASTERN CONNECTICUT HEALTH NETWORK, MANCHESTER MEMORIAL HOSPITAL (MMH) 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 PRENATAL INDIVIDUALS AND PARENTS TO PROMOTE POSITIVE FAMILY LIFE SKILLS AND CHILD DEVELOPMENT. IN FY 2012, THESE PROGRAMS BENEFITED 1,533 INDIVIDUALS WITH MMH PROVIDING NEARLY $94,000 IN IN-KIND RESOURCES AND SERVICES. OTHER COMMUNITY BUILDING ACTIVITIES INCLUDESERVING ON THE BOARD AND EXECUTIVE COMMITTEE OF REGIONAL CHAMBERS OF COMMERCE IN SUPPORT OF THE LOCAL BUSINESS INDUSTRY, CREATING WORK EXPERIENCES FOR ADULTS WITH SPECIAL NEEDS THROUGH THE MANCHESTERPUPIL PERSONNEL SERVICES PROGRAM; 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 SYSTEM AND MANCHESTER COMMUNITY COLLEGE IN VARIOUSWORKFORCE DEVELOPMENT PROGRAMS; PARTICIPATING IN THE CONNECTICUT COMMUNITY COLLEGES REGIONAL ECONOMIC SUMMIT, DISCUSSING REGIONAL BUSINESS DEVELOPMENT AND ECONOMIC GROWTH; VOLUNTEER EFFORTS TO REDUCE ENVIRONMENTAL HAZARDS ALONG THE HOCKANUM RIVER; SERVING ON THE DEPARTMENT OF PUBLIC HEALTHS OFFICE OF EMERGENCY MEDICAL SERVICE MEDICAL ADVISORY COMMITTEE AND NUMEROUS COMMUNITY COALITIONS THAT ADDRESS ADOLESCENT BEHAVIORAL HEALTH CONCERNS; AND SUPPORTING THE CHARITABLE EFFORTS OF THEMANCHESTER CHAPTER OF UNICO. MANCHESTER MEMORIAL HOSPITAL PART V, SECTION B, LINE 11H: FAMILY SIZE IS USED WITH INCOME LEVEL. MANCHESTER MEMORIAL HOSPITAL PART V, SECTION B, LINE 19D: CHARGES ARE UNIFORMALY SET FOR ALL PATIENTS REGARDLESS OF PAYOR, AND CHARITY CARE DISCOUNT IS APPLIED BASED ON INCOME. PART VI, LINE 2: MANCHESTER MEMORIAL HOSPITAL, AS PART OF THE EASTERN CONNECTICUT HEALTH NETWORK, CONDUCTS A REGULAR COMMUNITY HEALTH NEEDS ASSESSMENT TO GATHER CURRENT STATISTICS AND QUALITATIVE INPUT TO DETERMINE THE KEY HEALTH ISSUES FACING RESIDENTS OF ITS 19-TOWN SERVICE AREA. THE ASSESSMENT IS COMPRISED OF TWO RESEARCH COMPONENTS: 1. A SECONDARY DATA PROFILE, WHICH COLLECTS DATA FROM COMMUNITY, CIVIC AND SOCIAL SERVICE AGENCIES TO DEPICT THE DEMOGRAPHICS, MORBIDITY AND MORTALITY STATISTICS AND HEALTH INDICATORSWITHIN THE SERVICES AREA. 2, PRIMARY STATISTICAL RESEARCH USING THE CENTER FOR DISEASE CONTROL AND PREVENTION (CDC) BEHAVIOR RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) TOOL.THE MOST RECENT ASSESSMENT WAS CONDUCTED IN 2010 AND IDENTIFIED SPECIFIC AREAS OF NEED, WHICH HAVE BEEN USED TO DEVELOP TARGETED COMMUNITY BENEFIT AND EDUCATION PROGRAMS AND INITIATIVES THROUGHOUT THE ORGANIZATION.WITH THE SUPPORT OF A COMMUNITY PROGRAM ADVISORY COMMITTEE, CONSISTING OF MEDICAL STAFF LEADERSHIP AND ECHN ADMINISTRATION, THE ORGANIZATIONS COMMUNITY BENEFIT & EDUCATION DEPARTMENT EVALUATES, COORDINATES AND IMPLEMENTS PROGRAMS TO ADDRESS THESE NEEDS. EFFORTS INCLUDE FREE HEALTH EDUCATION LECTURES PRESENTED BY THE MEDICAL STAFF, HEALTH SCREENINGS, HEALTH FAIR PARTICIPATION, AND SUPPORT GROUPS.COMMUNITY HEALTH NEEDS ARE ALSO IDENTIFIED THROUGH REGULAR SOLICITATION OF THE GENERAL PUBLIC AND THE MEDICAL COMMUNITY TO IDENTIFY PERTINENT HEALTH NEEDS THEY FEEL NEED TO BE ADDRESSED. PART VI, LINE 4: MANCHESTER MEMORIAL HOSPITAL, PART OF THE EASTERN CONNECTICUT HEALTH NETWORK, PRIMARILY SERVES THE FOLLOWING TOWNS LOCATED EAST OF THE CONNECTICUT RIVER IN NORTHERN CONNECTICUT: MANCHESTER, SOUTH WINDSOR, BOLTON, COVENTRY, ANDOVER, ELLINGTON, TOLLAND, VERNON, WILLINGTON. ITS SECONDARY SERVICE AREA INCLUDES THE TOWNS OF ASHFORD, SOMERS, STAFFORD, UNION, EAST HARTFORD, EAST WINDSOR, GLASTONBURY, HEBRON, COLUMBIA AND MANSFIELD. THE SERVICE AREAS CONTAIN MUNICIPALITIES IN HARTFORD, TOLLAND AND WINDHAM COUNTIES.BASED ON DATA COLLECTED IN 2010, THE POPULATION OF THE MMH/ECHN SERVICE AREA IS OVER 328,000; 49 PERCENT MALE, 51 PERCENT FEMALE. RESIDENTS BETWEEN 45 AND 64 YEARS OF AGE REPRESENT THE HIGHEST PERCENTAGE OF THE POPULATION (28%), FOLLOWED BY RESIDENTS BETWEEN 25 AND 44 YEARS OF AGE (26%) AND OVER THE AGE OF 65 YEARS OF AGE (18%). THE RACE OF THE RESIDENTS IS PREDOMINANTLY WHITE (83%) FOLLOWED BY BLACK/AFRICAN AMERICAN (7.5) AND HISPANIC OR LATINO (7%).EIGHTY-SEVEN PERCENT OF THE POPULATION AGE 25 AND OVER HAVE A HIGH SCHOOL DEGREE AND 32 PERCENT HAVE A BACHELORS DEGREE OR HIGHER. THE MEDIAN HOUSEHOLD INCOME FOR THE SERVICE AREA IS $71,280.SEVEN PERCENT OF HOUSEHOLDS HAVE ANNUAL INCOME LESS THAN $15,000.THE UNEMPLOYMENT RATE IS 2.6%. PART VI, LINE 5: COMMUNITY HEALTH EDUCATION INITIATIVES/PROGRAMS ARE OFFERED TO THE COMMUNITY AND INCLUDE LECTURE PRESENTATIONS, DEVELOPMENT AND DISTRIBUTION OF A WELLNESS MAGAZINE TO MORE THAN 150,000 HOUSEHOLDS IN THE SERVICE AREA, DEMONSTRATIONS, AND HEALTH FAIR PARTICIPATION. AREAS OF PARTICULAR FOCUS INCLUDE:ARTHRITIS, BREAST HEALTH, CARDIOVASCULAR DISEASE, CHOLESTEROL AWARENESS, COLORECTAL CANCER, DIABETES, HYPERTENSION AWARENESS, LYME DISEASE AND PRE-NATAL CARE, WHICH WERE IDENTIFIED AS AREAS OF NEED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED IN 2010. NEARLY 95,000 PEOPLE BENEFITTED FROM THESE SERVICES IN FY 12.FREE HEALTH SCREENINGS INCLUDING DIABETIC FOOT CHECKS, PROSTATE AND SKIN CANCER SCREENINGS, MAMMOGRAMS, BLOOD PRESSURE, BONE DENSITY, GLUCOSE READINGS, INJURY SCREENINGS, VITAL SIGN CHECKS AND MEDICAL EXAMS ARE OFFERED IN THE COMMUNITY. TARGETING UNINSURED/UNDERINSURED POPULATIONS, 316 PEOPLE BENEFITTED FROM THESE SERVICES IN FY 12.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, FREE LIFELINE PERSONAL RESPONSE SYSTEM SERVICE. 5,173 PEOPLE BENEFITTED FROM THESE EFFORTS IN FY 12.PARTNERING WITH LOCAL EDUCATIONAL INSTITUTIONS, MANCHESTER MEMORIAL HOSPITAL PROVIDES A CLINICAL SETTING FOR PHYSICIANS, NURSES, RADIOLOGIC TECHNICIANS, RESPIRATORY TECHNICIANS AND PHYSICAL THERAPISTS AND OTHERSFROM THE UNIVERSITY OF NEW ENGLAND COLLEGE OF OSTEOPATHIC MEDICINE, UNIVERSITY OF CONNECTICUT, MANCHESTER COMMUNITY COLLEGE, CENTRAL CONNECTICUT STATE UNIVERSITY, CAMBRIDGE COLLEGE, GOODWIN COLLEGE, CAPITAL COMMUNITY COLLEGE, SPRINGFIELD TECHNICAL COMMUNITY COLLEGE, ST. JOSEPHS COLLEGE, QUINNIPIAC UNIVERSITY, UNIVERSITY OF HARTFORD AND SACRED HEART UNIVERSITY.SPECIFIC RESEARCH INITIATIVES CONDUCTED BY THE HOSPITAL INCLUDE MAINTENANCE OF 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 FIVE BLOOD DRIVES AND 20 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:MMH, 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, AND THE EASTERN CONNECTICUT CANCER INSTITUTE AT THE JOHN A. DEQUATTRO CANCER CENTER.ROCKVILLE GENERAL HOSPITAL, A COMMUNITY HOSPITAL LICENSED FOR 102 BEDS, THAT OFFERS MEDICAL AND SURGICAL SERVICES, 24-HOUR EMERGENCY CARE, MEDICAL IMAGING, CARDIAC & PULMONARY REHABILITATION, PHYSICAL REHABILITATION, HOSPICE CARE, A MATERNITY CARE CENTER FOR UNINSURED WOMEN, OUTPATIENT ADOLESCENT BEHAVIORAL HEALTH SERVICES, AND LABORATORY SERVICES.WOODLAKE AT TOLLAND SKILLED NURSING & REHABILITATION CENTER, A 130-BED LONG-TERM SKILLED NURSING CARE AND SHORT-TERM REHABILITATION FACILITY. CUSTOMIZED REHABILITATION TREATMENT SERVICES INCLUDE JOINT REPLACEMENT REHABILITATION, ORTHOPEDIC POST-HOSPITAL CARE, STROKE/NEUROLOGICAL REHAB, POSTMEDICAL/SURGICAL RECONDITIONING, AND PERSONALIZED, PROGRESSIVE, AND INTERDISCIPLINARY CARE SERVICES.EASTERN CONNECTICUT MEDICAL PROFESSIONALS (ECMP) FOUNDATION, INC., A MULTI-SPECIALTY PHYSICIAN GROUP PRACTICE THAT OFFERS A FULL RANGE OF HEALTHCARE SERVICES, INCLUDING PRIMARY AND SPECIALTY CARE IN THE TOWNSOF EAST HARTFORD, ELLINGTON, MANCHESTER, SOMERS, 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, RHEUMATOLOGY PHYSICIANS, WALDEN BEHAVIORAL CARE EATINGDISORDERS CLINIC, AND LABORATORY SERVICES. 2600 TAMARACK AVENUE INCLUDES THE WOMENS 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 DRAWSTATION, AND A SERIES OF MEDICAL PRACTICES, INCLUDING ORTHOPEDIC SURGERY, OTOLARYNGOLOGY (ENT), AND GENERAL SURGERY, CORPCARE, AND SOUTH WINDSOR URGENT CARE.ECHN MANCHESTER MEDICAL OFFICE BUILDINGS: 150 NORTH MAIN STREET OFFERS A VARIETY OF BEHAVIORAL HEALTH SERVICES.VISITING NURSE & HEALTH SERVICES OF CONNECTICUT, PROVIDES AT-HOME NURSING CARE AND HOSPICE CARE. ECHN HAS 432 PHYSICIANS (317 ACTIVE, 65 COURTESY, 12 CONSULTING, 38 PART-TIME), 83 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. 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 2012 WAS $4,954,240, FOR 2,467 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 INDIVIDUALS ABILITY TO PAY. EIGHT THOUSAND EIGHT HUNDRED THREE ONE (8,831) INPATIENTS WERE CARED FOR IN FY12 REPRESENTING 43,475 PATIENT DAYS. TWO HUNDRED FIFTY ONE THOUSAND SIX HUNDRED FORTY (251,640) OUTPATIENT VISITS WERE RECORDED.INCLUDED IN THE 8,831 INPATIENTS WERE 5,763 GOVERNMENT RELATED PATIENTS. THE GOVERNMENT INPATIENTS FALL INTO THE FOLLOWING GROUPS:MEDICARE 2,898MEDICARE MANAGED CARE 639MEDICAID 1,794MEDICAID MANAGED CARE 204CHAMPUS 228TOTAL GOV PATIENTS 5,763TOTAL NON GOV PATIENTS 3,068TOTAL PATIENTS 8,831 INCLUDED IN THE 251,640 OUTPATIENT VISITS THE FOLLOWING WERE GOVERNMENT RELATED. THE VISITS ARE A PRODUCT OF GROSS REVENUE RELATIONSHIP TO TOTAL VISITS.MEDICARE 81,022MEDICARE MANAGED CARE 22,493MEDICAID 31,850MEDICAID MANAGED CARE 5,049CHAMPUS 4,149TOTAL GOV PATIENTS 144,563TOTAL NON GOV PATIENTS 107,077TOTAL OUTPATIENT VISITS 251,640THE HOSPITAL PROVIDED UNCOMPENSATED CARE TO 43,668 MEDICAID PATIENTS FOR A NET COMMUNITY BENEFIT AMOUNT OF $6,221,594 AFTER MEDICAID REIMBURSEMENT. ADDITIONAL INFORMATION REGARDING PROGRAMS FOR THE COMMUNITY AT MMH: COMMUNITY HEALTH IMPROVEMENT SERVICES (A) COMMUNITY HEALTH EDUCATION (A1) 94,793 $ 368,043 COMMUNITY BASED CLINICAL SERVICES (A2) 316 $ 6,816 HEALTH CARE SUPPORT SERVICES (A3) 5,173 $ 134,853**** COMMUNITY HEALTH IMPROVEMENT SERVICES 100,282 $ 509,712HEALTH PROFESSIONS EDUCATION (B) PHYSICIANS/MEDICAL STUDENTS (B1) 18 $ 240,782 NURSES/NURSING STUDENTS (B2) 158 $ 374,311 OTHER HEALTH PROFESSIONAL EDUCATION (B3) 93 $ 51,933**** HEALTH PROFESSIONS EDUCATION 269 $ 667,026SUBSIDIZED HEALTH SERVICES (C) NEONATAL INTENSIVE CARE (C2) 193 $1,188,090**** SUBSIDIZED HEALTH SERVICES 193 $1,188,090RESEARCH (D) OTHER RESEARCH (D3) 0 $ 252,042**** RESEARCH 0 $ 252,042FINANCIAL AND IN-KIND CONTRIBUTIONS (E) CASH DONATIONS (E1) 0 $ 19,221 GRANTS (E2) 200 $ 3,201 IN-KIND DONATIONS (E3) 16,789 $ 159,991**** FINANCIAL AND IN-KIND CONTRIBUTIONS 16,989 $ 182,413COMMUNITY BUILDING ACTIVITIES (F) ECONOMIC DEVELOPMENT (F2) 12 $ 1,472 COMMUNITY SUPPORT (F3) 1,726 $1,321,424 COALITION BUILDING (F6) 0 $ 9,303 COMMUNITY HEALTH IMPROVEMENT ADVOCACY (F7) 0 $ 420 WORKFORCE DEVELOPMENT (F8) 221 $ 2,632**** COMMUNITY BUILDING ACTIVITIES 1,959 $1,335,251COMMUNITY BENEFIT OPERATIONS (G) DEDICATED STAFF (G1) 0 $ 138,544**** COMMUNITY BENEFIT OPERATIONS 0 $ 138,544FINANCIAL ASSISTANCE FINANCIAL ASSISTANCE 2,467 $1,602,647**** FINANCIAL ASSISTANCE 2,467 $1,602,647GOVERNMENT SPONSORED HEALTH CARE MEDICAID 43,688 $6,221,594**** GOVERNMENT SPONSORED HEALTH CARE 43,688 $6,221,594TOTALS - COMMUNITY BENEFIT 165,847 $12,097,319GRAND TOTALS 165,847 $12,097,319 REPORTS FILED WITH STATES PART VI, LINE 7 CT 1 SCHOLARSHIPS 15 24438 N/A N/A THE SCHOLARSHIPS ARE AWARDED 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 0 1 0 0 0 1 1 0 0 PETER J KARL 560216 0 206000 0 0 0 103459 0 22108 0 891783 0 0 0 KEVIN G MURPHY 351064 0 84483 0 0 0 52124 0 24958 0 512629 0 0 0 MICHAEL D VEILLETTE 233486 0 67878 0 0 0 32701 0 19258 0 353323 0 0 0 DEBORAH GOGLIETTINO 232603 0 48685 0 0 0 31939 0 15083 0 328310 0 0 0 DENNIS MCCONVILLE 207451 0 51400 0 0 0 22062 0 15539 0 296452 0 0 0 DEBORAH PARKER 220350 0 47442 0 0 0 30078 0 21451 0 319321 0 0 0 JOEL REICH MD 323358 0 65020 0 0 0 34478 0 15268 0 438124 0 0 0 CHARLES COVIN 179710 0 28688 0 0 0 5548 0 14499 0 228445 0 0 0 LEONA CROSSKEY 153009 0 30904 0 0 0 4875 0 18878 0 207666 0 0 0 KATHLEEN SIMS 181487 0 29624 0 0 0 11978 0 19784 0 242873 0 0 0 ROBERT CARROLL MD 383712 0 4500 0 0 0 17738 0 19802 0 425752 0 0 0 CAROLYN MCKENNA 62142 0 45802 0 0 0 1585 0 7024 0 116553 0 0 0 JAMES A CASTELLONE MD 276455 0 85815 0 0 0 16458 0 8898 0 387626 0 0 0 SCOTT BROWN MD 245842 0 76995 0 0 0 15548 0 19796 0 358181 0 0 0 ANDREAS J BOJKO MD 256258 0 82391 0 0 0 8556 0 19796 0 367001 0 0 0 ENOCH DARKO MD 259432 0 68009 0 0 0 7350 0 3511 0 338302 0 0 0 THEODORE SHERRY MD 244336 0 100184 0 0 0 15918 0 19797 0 380235 0 0 0 PART I, LINE 3 THE BOARD OF TRUSTEES (THE "BOARD") APPOINTS AN EXECUTIVE COMPENSATION COMMITTEE (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, LINE 4B PETER KARL - $77,249 KEVIN MURPHY - $35,201 MICHAEL VEILLETTE - $17,626 DEBORAH GOGLIETTINO - $17,625 DEBORAH PARKER - $15,814 DENNIS MCCONVILLE - $15,421 JOEL REICH - $24,383 PART I, LINE 6 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 FOR EACH MEMBER OF THE INCENTIVE PROGRAM MEMBERS OF THE INCENTIVE PROGRAM INCLUDE THE FOLLOWING: POSITION TITLE - KEY EMPLOYEE NAME PRESIDENT AND CEO - PETER J. KARL EVP, TREASURER - KEVIN G. MURPHY SVP, CHIEF FINANCIAL OFFICER - MICHAEL D. VEILLETTE SVP, HUMAN RESOURCES - DEBORAH GOGLIETTINO SVP, STRATEGIC PLANNING - DENNIS MCCONVILLE SVP, PATIENT CARE SERVICES - DEBORAH PARKER SVP, MEDICAL AFFAIRS - JOEL REICH, M.D. VP AND CIO - CHARLES COVIN VP QUALITY - LEONA CROSSKEY VP, OPERATIONS - KATHERINE SIMS MED. DIR. EMERGENCY DEPARTMENT - ROBERT CARROLL, M.D. 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. 0 0 0 STATE OF CONNECTICUT HEALTH & EDL FACS AUTH REV SERIES D 060806186 NONEAVAIL 2009-05-14 15250000 WOODLAKE EXPANSION, EQUIPMENT PURCHASE, PRIOR ISSUE REFUND. 0 0 0 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 37579404 3556957 32759288 632013 631146 2006 0 1 1 1 15250000 9966919 305000 4978081 2009 1 0 1 1 20145000 1065002 17048821 402900 92225 1536052 2011 1 0 1 1 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 1 0 1 1 TD BANK 5.000000000000 0 0 0 0 1 0 1 0 0 0 1 DR MICHELE CONLON MMH TRUSTEE OWNING MORE THAN 5% OF P.C.; 20% SHARE 388976 ECPC, PC PROVIDES PATHOLOGY SERVICES AND LAB MANAGEMENT SERVICES TO MMH; PAYMENTS REPORTED REPRESENT TOTAL BY MMH. 0 DR DENNIS O'NEILL MMH TRUSTEE OWNING MORE THAN 5% OF P.C.; 20% SHARE 388976 ECPC, PC PROVIDES PATHOLOGY SERVICES AND LAB MANAGEMENT SERVICES TO MMH; PAYMENTS REPORTED REPRESENT TOTAL BY MMH. 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 7A CORPORATORS HAVE THE AUTHORITY TO ELECT BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B CORPORATORS HAVE THE AUTHORITY TO VOTE ON SIGNIFICANT ISSUES. FORM 990, PART VI, SECTION B, LINE 11 PRIOR TO THE FILING THE 990, THE FOLLOWING STEPS ARE TAKEN: 1) THE DIRECTOR OF ACCOUNTING AND TAXATION, TOGETHER WITH OTHER MEMBERS OF THE FINANCE DEPARTMENT, CONDUCT A REVIEW OF THE 990 ALONG WITH A REVIEW AND RECONCILATION OF THE 990 TO THE AUDITED FINANCIAL STATEMENTS; 2) DIRECTOR OF ACCOUNTING AND TAXATION 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, AND 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 IN 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 RECOMMEND SALARY RANGES FOR EACH POSITION, ALONG WITH RELATED BENEFITS; (4) REVIEWS AND APPROVES A TIERED EXECUTIVE STRUCTURE WITH APPROPRIATE INCENTIVE OPPORTUNITY, BENEFITS, AND COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION, WILL, UPON REQUEST, ALLOW FOR REVIEW OF OUR GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND MOST RECENT ANNUAL AUDITED FINANCIAL STATEMENTS AT AN OFFICE OF THE ORGANIZATION. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 3,707,084. CHANGE IN BENEFICIAL INTEREST IN TRUSTS 495,556. NET CHANGE IN INTERST RATE SWAP AGREEMENT -123,039. TRANSFERS TO/FROM AFFILIATES, NET 2,244,135. PENSION AND POSTRETIREMENT RELATED ADJUSTMENTS -13,376,627. TOTAL TO FORM 990, PART XI, LINE 5: -7,052,891. 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