2013-08-14T14:02:59-05:00 2012-09-30 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE SUITE 2600 Indianapolis IN 46204 990 2011-10-01 060646917 The Stamford Hospital % KEVIN GAGE CFO STAM 2032761000 30 Shelburne Rd PO Box 9317 Stamford CT 06904 KEVIN GAGE 2013-07-29 3176817000 2011 2016-02-24 21:20:13Z Kevin Gage CFO 30 Shelburne Rd PO Box 9317 Stamford CT 06902 498631475 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. 16 13 2958 680 5894223 3821779 5656742 19419411 485857948 463409232 1229027 3440915 2454910 4739985 495198627 491009543 0 0 0 0 221586026 227287045 0 0 3215292 236025215 211325027 457611241 438612072 37587386 52397471 475861907 798097565 340662907 637083779 135199000 161013786 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 352075615 2291321 465060898 IN ADDITION TO A 305 BED HOSPITAL FACILITY, THE STAMFORD HOSPITAL (TSH) OPERATES A 225,000 SQUARE FOOT AMBULATORY CARE CENTER (TULLY CENTER) ALSO IN STAMFORD, CT. KEY OPERATING STATISTICS FOR THE YEAR ENDED 9/30/2012 INCLUDE: ADULT AND PEDIATRIC INPATIENTS CARED FOR AND DISCHARGED 14,294; BABIES BORN 1,968; TOTAL INPATIENT DAYS OF CARE PROVIDED 70,911. PATIENTS SEEKING CARE IN THE STAMFORD HOSPITAL EMERGENCY ROOM: ADMITTED FOR INPATIENT TREATMENT 7,642; TREATED AND RELEASED 43,189; TREATED AT TULLY IMMEDIATE CARE CENTER 22,555. SURGERIES PERFORMED AT THE HOSPITAL AND TULLY CENTER: 16,803. RADIATION THERAPY PROCEDURES PERFORMED: 62,043. 352075615 true true false true false false false false false true true false false true true false false true false false false false false false 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 320 0 true 2958 true true true true BD false false false true true false false true false X 16 13 false false false false false false false true true false false true true true true true true true true false CT X KEVIN GAGE CFO 2032761000 30 SHELBURNE RD Stamford CT 06902 X Brian Grissler 37.5 X X 1829715 0 30336 Douglas Milne III 2.0 X 0 0 0 Edwin Ford 2.0 X 0 0 0 Dr Arthur Klein 2.0 X 0 0 0 Dr Charles Miner 2.0 X 0 0 0 Dr Neil Dreyer 2.0 X 0 108264 21000 Andrew Merrill 2.0 X 0 0 0 Charles Krause III 2.0 X 0 0 0 David R Nissen 2.0 X 0 0 0 Elliot S Jaffe 2.0 X 0 0 0 Ernest N Abate 2.0 X 0 0 0 Jay Higham 2.0 X 0 0 0 Amy C Downer 2.0 X 0 0 0 Suzanne B Peters 2.0 X 0 0 0 Dr Rodrigo Acosta 2.0 X 0 480111 31670 Michael Fedele 2.0 X 0 0 0 Darryl McCormick 37.5 X 461456 0 73495 David Smith 37.5 X 639948 0 92577 Kathleen Silard 37.5 X 659720 0 100173 Kevin Gage 37.5 X 649788 0 94596 Dr Sharon Kiely 37.5 X 610663 0 84305 Dr Michael Coady 37.5 X 1095854 0 20438 Dr Lance Bruck 37.5 X 566685 0 42586 Dr Steven Horowitz 37.5 X 550209 0 42586 Dr Timothy Hall TERM 63011 37.5 X 801254 0 38970 Dr Andrew Snyder 37.5 X 725174 0 66330 Dr John Rodis 0.0 X 443589 0 130132 9034055 588375 869194 421 true true false HEMATOLOGY ONCOLOGY PC 34 SHELBURNE RD STAMFORD CT 069023628 PHYS. FEES/ONCOLOGY 4016119 ASHFORTH PROPERTIES CONSTRUCTION 707 SUMMER ST STAMFORD CT 069011026 CIP VENDOR 2095100 SPECIALIZED RECEIVABLES INC DBA PO BOX 12414 NEWARK NJ 071013514 COLLECTIONS 1016611 PATHOLOGY AND LABORATORY SERV LLC 11 RESEARCH DRIVE SUITE 4 WOODBRIDGE CT 065252348 CYTOLOGY LABORATORY 897276 MMODAL SERVICES LTD PO BOX 102467 ATLANTA GA 30368 TRANSCRIPTION SVCS 855793 52 1424597 747880 17246934 41879 19419411 PATIENT REVENUE 621400 293844863 293844863 PHYSICIAN BILLING 621110 11170423 11170423 WELLNESS AND TRAINING 621400 3343100 3343100 MEDICARE/MEDICAID PAYMENTS 621400 148890127 148890127 REF LAB INCOME 621500 6160719 6160719 463409232 1536929 1535666 1263 0 0 2811317 4351775 -1540458 -1540458 -267759 -1272699 4893643 5830 2995487 1898156 5830 1903986 1903986 278394 274670 3724 3724 0 0 MANAGEMENT FEES 532000 649876 649876 CAFETERIA AND COFFEE SHOP 722210 1488056 1488056 Meaningful Use 621110 3002938 3002938 1135849 1135849 6276719 491009543 465060898 5894223 635011 0 0 0 0 4045351 582313 3463038 0 172985775 148030319 24109714 845742 19935090 16734945 3104908 95237 18761040 15749364 2922048 89628 11559789 9704117 1800447 55225 767967 767932 35 1577839 45635 1511297 20907 368933 368933 108363 108363 0 51990 51990 49790120 34576355 14987916 225849 3113091 87500 1874737 1150854 74001544 70305175 3608496 87873 5629941 -59660 5689601 0 16042047 13977968 1935396 128683 488384 247553 172196 68635 0 380729 234350 77744 68635 169226 169226 0 24874427 24099520 590272 184635 6901732 6901732 TAXES 1798482 247510 1550972 SUBSCRIPTIONS, DUES & MEMBERSH 1675570 627586 1042913 5071 Loss on Lease Obligation 12724857 12724857 SERVICE CONTRACTS 8264383 8231576 -37844 70651 2595402 814599 1663136 117667 438612072 352075615 83321165 3215292 151382 281828 80541399 67845792 608061 14776102 58871844 64792290 0 0 0 0 0 0 5243405 5408238 3608897 5037968 594041910 338761998 242513845 255279912 15674580 292893922 18094444 16718907 0 0 0 0 50554050 75062606 475861907 798097565 71075513 88929508 0 0 806805 637796 129662012 379572228 0 0 0 0 0 0 5380916 5024265 133737661 162919982 340662907 637083779 X 108503626 120894359 18662000 32086053 8033374 8033374 135199000 161013786 475861907 798097565 X 52397471 -26582685 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 108363 false false false 108363 false Schedule C, Supplemental Information Schedule C Part II-B, Line 1F 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. 26695222 16783195 1162352 4521786 40118983 27527319 3087737 -56132 3863702 26695222 28198000 2154945 874515 3700141 27527319 29311544 2687150 -864244 2936450 28198000 0.20140 0.79860 false false 0 43483477 43483477 0 177407242 93980547 83426695 0 6712752 3813566 2899186 0 313065865 238131317 74934548 0 53372574 2836568 50536006 255279912 MISCELLANEOUS RECEIVABLE 9237113 DONOR RESTRICTED FUNDS 18042243 INVESTMENT IN HEALTHSTAR 11898063 DUE FROM AFFILIATES 29856617 DEBT ISSUANCE COSTS 4819880 DEPOSITS 49023 ORGANIZATION COSTS 1159667 75062606 0 EST THIRD PART SETTLEMENTS 11221213 PENSION LIABILITY 109173605 DUE TO AFFILIATES 22852637 EST FOR PROFESSIONAL LIABILITY 10204924 LOSS ON LEASE OBLIGATION 9322690 CHARITY GIFT ANNUITY PAYABLE 144913 162919982 WALK,RUN & RIDE 806214 658294 147920 3797 32260 DREAM BALL 629697 606393 23304 723 108230 5376 2 215160 159910 55250 7366 52600 61705 1651071 1424597 226474 11886 160830 99341 272057 -45583 true true X true X true X true true true false true false 26367737 22747614 3620123 0.00830 56658124 36819909 19838215 0.04520 2291321 0 2291321 0.00520 85317182 59567523 25749659 0.05870 16 23257 1319435 171161 1148274 0.00260 1 0 51600 0 51600 0.00010 3 160 991757 0 991757 0.00230 20 23417 2362792 171161 2191631 0.00500 20 23417 87679974 59738684 27941290 0.06370 2 260 578443 578443 0.00130 2 260 578443 578443 0.00130 false 14102613 298975 81921723 104838090 -22916367 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 SCHEDULE H, SUPPLEMENTAL INFORMATION PART I, LINE 6A EXPLANATION A COMMUNITY BENEFIT REPORT IS PREPARED FOR THE STATE OF CONNECTICUT; HOWEVER, THAT REPORT IS NOT MADE AVAILABLE TO THE PUBLIC. PART III, LINE 4 EXPLANATION 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. PART III, LINE 8 EXPLANATION 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. THE COSTING METHODOLOGY USED FOLLOWS THE METHODOLOGY OF THE MEDICARE COST REPORT. PART III, LINE 9B EXPLANATION ALL COLLECTION EFFORTS CEASE AT ANY POINT IN THE PROCESS IF THE PATIENT APPLIES FOR FREE BED FUNDS OR FINANCIAL ASSISTANCE. PART V, LINE 19D MAXIMUM AMOUNTS CHARGED ARE BASED INDIVIDUALS INCOME LEVELS AND/OR ASSETS AND HOLDINGS. COMPLETE CHARITY CARE IS PROVIDED FOR INDIVIDUALS WITH INCOME THAT IS BELOW FEDERAL POVERTY GUIDELINES. NEEDS ASSESSMENT THE STAMFORD HOSPITAL ("SH" 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 HEALTH DEPARTMENT (SHD) TO IDENTIFY NEEDS AND DEVELOP PROGRAMS, PROVIDE SCREENINGS, AND PROMOTE DISSEMINATION OF HEALTH INFORMATION. WITH THE SHD, SH SPONSORED A JOINT CITY-WIDE IMMUNIZATION CAMPAIGN TO REDUCE THE NUMBER OF FLU-RELATED HOSPITALIZATIONS AND EMERGENCY DEPARTMENT VISITS. THE CAMPAIGN INCLUDED: A JOINT SENIOR HEALTH FAIR/COMMUNITY PROJECTS; A COMMON ELECTRONIC DATABASE; SHARED VACCINE SUPPLIES AND REDISTRIBUTION TO LOCAL PROVIDERS; FLU HOTLINE; ARRANGEMENTS FOR VACCINATION OF HOMEBOUND INDIVIDUALS; AND VACCINATION CLINICS AT BOTH THE STAMFORD HEALTH DEPT, AND HOSPITAL STAFFED WITH VOLUNTEERS AND CROSS-OVERSTAFFING. IN FY12, THE HOSPITAL'S OUTPATIENT COMPONENT OF THIS EFFORT TOTALED 2,109 VACCINATIONS. SH COLLABORATES WITH THE STAMFORD HEALTH DEPARTMENT'S HIV PREVENTION PROGRAM AND STAMFORD CARES, A PROGRAM OF FAMILY CENTERS THAT PROVIDE HIV MEDICAL CASE MANAGEMENT. ALSO, THIS COLLABORATION 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 A MONTHLY HIV- POSITIVE WOMEN SUPPORT GROUP. SH PARTNERS WITH OPTIMUS HEALTH CARE (FORMERLY BRIDGEPORT COMMUNITY HEALTH CENTER), A FEDERALLY QUALIFIED HEALTH CARE CENTER, TO CREATE AN INTEGRATED PRIMARY CARE DELIVERY NETWORK FOR THE MEDICALLY UNDERSERVED IN STAMFORD. THE HOSPITAL PROVIDED SUPPLEMENTAL SUPPORT TO OPTIMUS OF $2,291,321 IN FY12 TO ENSURE ITS CONTINUED VIABILITY. COMMUNITY INPUT TO PREVENT CHILDHOOD OBESITY IS PROVIDED THROUGH A STAMFORD CITY-WIDE TASK FORCE LEAD BY SH. THIS EFFORT FOCUSES ON PREVENTION, ADVOCACY, TREATMENT, AND RESEARCH, AND IS A CITY-WIDE COLLABORATION THAT INCLUDES THE STAMFORD PUBLIC SCHOOLS, THE STAMFORD HEALTH DEPARTMENT, EARLY CHILDHOOD AND AFTER-SCHOOL PROVIDERS AND EDUCATORS, AS WELL AS COMMUNITY PEDIATRICIANS AND FAMILY MEDICINE PRACTITIONERS. SH'S KIDS FANS PROGRAM (KIDS' FITNESS AND NUTRITION SERVICES) PROMOTES PHYSICAL ACTIVITY AND HEALTH-CONSCIOUS NUTRITION, A CORNERSTONE OF THIS CHILDHOOD OBESITY INITIATIVE. KIDS FANS RECEIVED THE 2010 CONNECTICUT HOSPITAL ASSOCIATION/ CONNECTICUT DEPARTMENT OF PUBLIC HEALTH COMMUNITY SERVICE AWARD WHICH RECOGNIZES HOSPITALS THAT MAKE AN OUTSTANDING CONTRIBUTION TO ITS COMMUNITY. SH WAS HONORED FOR TACKLING THE SERIOUS ISSUE OF CHILDHOOD OBESITY IN SOUTHWESTERN CT. SH'S DOMESTIC VIOLENCE MEDICAL ADVOCACY PROGRAM ENCOMPASSES A COMPREHENSIVE APPROACH. THE MEDICAL ADVOCACY PROGRAM MEETS ONCE A MONTH; THE COMMITTEE IS COMPRISED OF PHYSICIANS, NURSES, SOCIAL WORKERS, CASE MANAGERS, SECURITY PERSONNEL, HUMAN RESOURCES STAFF OF THE DOMESTIC VIOLENCE CRISIS CENTER, THE STAMFORD POLICE DEPARTMENT SPECIAL VICTIMS UNIT AND STAMFORD EMERGENCY MEDICAL SERVICES. ACCOMPLISHMENTS INCLUDE: EDUCATIONAL PROGRAMS AND OUTREACH; OVER 995 SH EMPLOYEES COMPLETED TRAINING IN THE IDENTIFICATION AND MANAGEMENT OF VICTIMS OF ABUSE TRAINING MODULE; ADMISSIONS DATA BASES FOR INPATIENTS AND EMERGENCY ROOM PATIENTS WERE UPGRADED TO INCLUDE QUESTIONS FOR ASSESSING ALL PATIENTS 13 YEARS AND OLDER FOR EXPOSURE TO INTIMATE PARTNER VIOLENCE; AND A SCORE CARD WAS DEVELOPED TO TRACK THE NUMBER OF PATIENTS REFERRED FOR SERVICES AS WELL AS THE NUMBER OF POLICE CALLS RELATED TO DOMESTIC VIOLENCE. OUR CENTER FOR INTEGRATED MEDICINE AND WELLNESS AT THE TULLY HEALTH CENTER WORKS CLOSELY WITH THE SH BREAST CENTER AND OPTIMUS FAMILY MEDICINE CENTER (AN FQHC); IN FY2012 THE CENTER TREATED 50 PATIENTS WHO WERE UNINSURED; THE PROGRAM SERVED THOSE PATIENTS WHO WERE APPROVED TO RECEIVE A STAMFORD HOSPITAL FINANCIAL ASSISTANCE PROGRAM CARD. SH ALSO PROVIDES SUPPORT FOR THE PARENT LEADERSHIP TRAINING INSTITUTE (PLTI), A 20-WEEK PROGRAM FOR PARENTS AND THEIR CHILDREN. PARENTS LEARN HOW TO BECOME ADVOCATES FOR THEIR CHILDREN IN THE SCHOOLS, THE VALUE OF CIVIC ENGAGEMENT AND PARENTING SKILLS FOCUSED ON HEALTHY DEVELOPMENT. SH ACTIVELY SUPPORTS THE WEST SIDE NEIGHBORHOOD REVITALIZATION ZONE, A COMMUNITY-LED EFFORT TO IMPROVE THE HEALTH, SAFETY, INFRASTRUCTURE, AND QUALITY OF LIFE IN THE NEIGHBORHOOD, WHICH HAS EXPERIENCED CRIME AND ECONOMIC DECLINE. SH PROVIDED FUNDING AND STAFF EXPERTISE TO THIS GRASSROOTS ORGANIZATION WHERE NEIGHBORS WORK SIDE-BY-SIDE WITH LOCAL BUSINESSES, LAW ENFORCEMENT, THE HOSPITAL'S HOUSING PARTNER, CHARTER OAK COMMUNITIES, INC.(COC, FORMERLY THE STAMFORD HOUSING AUTHORITY), AND LOCAL ELECTED AND APPOINTED OFFICIALS. THE HOSPITAL AND COC ARE WORKING IN PARTNERSHIP TO ACHIEVE COMMON GOALS FOR THE REVITALIZATION OF THE WEST SIDE NEIGHBORHOOD. THE INITIATIVE, KNOWN AS VITA, HAS ALREADY ESTABLISHED THE NEIGHBORHOOD AS A HEALTH & WELLNESS DISTRICT; RECENT ACCOMPLISHMENTS INCLUDE FAIRGATE FARM, WHICH ENJOYED A SUCCESSFUL SECOND YEAR WITH PRODUCTIVITY MORE THAN TRIPLING OUTPUT IN 2012. THE FARM PROVIDES OPPORTUNITIES FOR YOUTH AND ADULTS TO LEARN ABOUT PLANTING, HARVESTING AND NUTRITION AND HEALTHY COOKING. PARTICIPANTS INCLUDE VOLUNTEERS FROM THE BOYS & GIRLS CLUB AND YMCA AS WELL AS LOCAL RESIDENTS AND BUSINESSES. THE VITA HEALTH & WELLNESS DISTRICT ALSO HOSTS THE FAIRGATE HEALTH CENTER, A PARTNERSHIP WITH OPTIMUS HEALTH CARE AND COC. SH PARTNERED WITH NORWALK COMMUNITY COLLEGE, OPTIMUS AND CT APPLESEED ON AN INITIATIVE TO IMPROVE CARE TEAMS AND LEVERAGE TECHNOLOGY TO INCREASE ACCESS AND QUALITY OF CARE FOR SAFETY NET POPULATIONS. THE CT TELEHEALTH AND WORKFORCE PARTNERSHIP COMPLETED A TELEHEALTH STUDY WITH OPTIMUS PATIENTS WHICH HAS INCREASED PATIENTS' ABILITY TO SELF-MANAGE CHRONIC DISEASE AND BETTER TRACK, COORDINATE AND MANAGE CARE. THE INITIATIVE ALSO UPGRADED THE FRONTLINE WORKERS THROUGH TRAINING AND DEVELOPMENT OF EMERGING CARE TEAM MODELS DRIVEN IN PART BY THE AFFORDABLE CARE ACT. THE RESULTS HAVE BEEN PROMISING AND PLANS ARE IN DEVELOPMENT TO SEEK FUNDING TO EXPAND THE PROGRAM. 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 SH 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. COMMUNITY INFORMATION SH 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 A COMPREHENSIVE STRATEGIC PLANNING PROCESS AND IS DEFINED IN STAMFORD HEALTH SYSTEM, INC.'S STRATEGIC PLAN. THE HOSPITAL'S COMBINED PSA AND SSA INCLUDE AN ESTIMATED 135,511 HOUSEHOLDS WITH A TOTAL POPULATION OF 361,418 RESIDENTS. THE PSA INCLUDES THE COMMUNITIES OF STAMFORD, DARIEN, AND ROWAYTON, WITH AN ESTIMATED 54,392 HOUSEHOLDS AND A TOTAL POPULATION OF 143,122. STAMFORD COMPRISES AN ESTIMATED 46,195 HOUSEHOLDS WITH A TOTAL POPULATION OF 119,294. THE SSA INCLUDES THE COMMUNITIES OF GREENWICH, COS COB, RIVERSIDE, OLD GREENWICH, NEW CANAAN, NORWALK, WESTPORT, WESTON, AND WILTON, WITH AN ESTIMATED 81,119 HOUSEHOLDS AND A TOTAL POPULATION OF 218,296. FOR THE PSA, 24% OF THE POPULATION IS ESTIMATED TO BE LESS THAN 18 YEARS OF AGE; 34.7% IS 18-44; 27.8% IS 45-64; AND 13.5% IS 65 YEARS OF AGE AND OLDER. THE SSA HAS A SLIGHTLY OLDER AGE DISTRIBUTION WITH AN ESTIMATED 25.7% OF ITS POPULATION LESS THAN 18 YEARS OF AGE; 29.2% IS 18-44; 30.7% IS 45-64; AND 14.4% 65 YEARS OF AGE AND OLDER. REGARDING RACE/ETHNICITY, OF THE ESTIMATED POPULATION IN THE PSA, 60.0% OF RESIDENTS ARE WHITE; 20.5% HISPANIC; 10.7% BLACK; 6.3% 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 12.6% OF ITS TOTAL POPULATION; THE HISPANIC POPULATION 23.9%; AND ASIAN POPULATION 7.0%. FOR THE SSA, 75.6% OF THE TOTAL ESTIMATED POPULATION IS WHITE; 11.9% HISPANIC; 6.0% BLACK;4.6% ASIAN; AND THE REMAINDER ARE MULTI-RACIAL, NATIVE AMERICAN, PACIFIC ISLANDER, AND OTHER NON-HISPANIC. ALTHOUGH IN THE PSA AN ESTIMATED 26.4% 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 12.0% OF TOTAL HOUSEHOLDS WITH HOUSEHOLD INCOMES EXCEEDING $200,000, AND 19.3% WITH HOUSEHOLD INCOMES LESS THAN $30,000, and 26.3% WITH LESS THAN $40,000. IN THE SSA, AN ESTIMATED 27.9% OF THE TOTAL HOUSEHOLDS HAVE HOUSEHOLD INCOMES EXCEEDING $200,000, WHILE AN ESTIMATED 11.8% HAVE HOUSEHOLD INCOMES LESS THAN $30,000 AND 16.9% LESS THAN $40,000. 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%). PROMOTION OF COMMUNITY HEALTH DURING FY 2012: THE STAMFORD HOSPITAL ("SH" OR THE "HOSPITAL") PROVIDED A VARIETY OF PROGRAMS THAT BENEFITED THE COMMUNITY. THESE PROGRAMS INCLUDED, FOR EXAMPLE, HEALTH EDUCATION PROGRAMS, FREE AND/OR DISCOUNTED EQUIPMENT AND SERVICES, HEALTH SCREENINGS, IMMUNIZATION PROGRAMS, SOCIAL SERVICES AND SUPPORT COUNSELING FOR PATIENTS AND FAMILIES AND CRISIS INTERVENTION. 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. HOSPITAL STAFF PROVIDED SERVICES AT COMMUNITY HEALTH FAIRS AND SERVED AS SPEAKERS AT VARIOUS COMMUNITY GROUPS ON LIFESTYLE/HEALTH IMPROVEMENT TOPICS. IN FISCAL YEAR 2012, SH PARTICIPATED IN MORE THAN 150 HEALTH FAIRS, PHYSICIAN PRESENTATIONS AND SPECIAL EVENTS FOR A TOTAL OF MORE THAN 20,285 PARTICIPANTS. IN FY2012, SH CONDUCTED OVER 10,802 SCREENINGS IN THE COMMUNITY. HIGHLIGHTS OF COMMUNITY HEALTH EDUCATION AND OUTREACH ACTIVITIES PROVIDED IN FY2 012 ARE AS FOLLOWS: ASTHMA EDUCATION: SH CONDUCTED EVENTS 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 EDUCATION: AS REQUIRED BY THE AMERICAN COLLEGE OF SURGEONS COMMISSION ON CANCER, A CANCER COMMITTEE OVERSEES SH'S CANCER PROGRAM, OF WHICH EDUCATIONAL AND OUTREACH PROGRAMS FOR THE COMMUNITY AND PATIENTS ARE A KEY COMPONENT. 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 THROUGHOUT THE YEAR FOR THE COMMUNITY INCLUDE TOPICS FOCUSED ON RAISING AWARENESS ABOUT THE DANGERS OF SUN EXPOSURE AND RISKS FOR SKIN CANCER, PROGRAMS TO UNDERSCORE THE IMPORTANCE OF SCREENING AND EARLY DETECTION OF COLORECTAL CANCERS, AS WELL AS EDUCATION SURROUNDING GYNECOLOGIC AND PROSTATE CANCERS. CANCER OUTREACH EFFORTS ALSO INCLUDE ANTI-TOBACCO LECTURES AND AN ANTI-SMOKING POSTER CONTEST FOR ELEMENTARY SCHOOL CHILDREN. IN CONJUNCTION WITH THE AMERICAN CANCER SOCIETY, THE HOSPITAL OFFERS FREEDOM FROM SMOKING-QUIT FOR GOOD CLASSES YEAR-ROUND. NUTRITION PROGRAMS, LED BY REGISTERED DIETITIANS, ARE OFFERED THROUGHOUT THE YEAR. CANCER SCREENINGS/MAMMOGRAPHY CANCER SCREENINGS/MAMMOGRAPHY: SH OFFERED MAMMOGRAPHY SCREENING TO THE COMMUNITY AT NO COST TO THE PATIENT IF THEY HAD NO INSURANCE OR WERE UNDERINSURED. EACH YEAR, OVER 2,000 WOMEN ARE SCREENED. IN FY12, 2,200 PATIENTS RECEIVED MAMMOGRAMS, OF WHICH 1,200 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. TO REACH THE UNDERSERVED, SH ALSO COLLABORATED WITH CHARTER OAK COMMUNITIES, HAITIAN CHURCH OF STAMFORD, NEIGHBORS LINK, YERWOOD CENTER, AND HELD PUBLIC SCREENING EVENTS AT WAL-MART, WALGREENS, SHOP RITE, FIRST CONGREGATIONAL CHURCH OF STAMFORD, CANCER CARE, AND THE AMERICAN CANCER SOCIETY. OUTREACH WAS TARGETED TO REDUCE BARRIERS TO SCREENING BY CONNECTING WOMEN WHO ARE UNINSURED, LOW INCOME, NEW IMMIGRANTS, BLACK AND HISPANIC AND OVER 40 YEARS OF AGE. SH ADDRESSED LANGUAGE BARRIERS, HOW TO NAVIGATE THE HEALTHCARE SYSTEM, AND THE REDUCTION OF FEAR OF THE EXAM. 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 CENTERS' 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 $2,291,321 IN FY 2012 TO ENSURE ITS CONTINUED VIABILITY. EMERGENCY SERVICES AND EDUCATION: STAMFORD'S EMS INSTITUTE, A DEPARTMENT OF SH, 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. THE SH EMS INSTITUTE ALSO COLLABORATED WITH STAMFORD EMERGENCY MEDICAL SERVICES (SEMS). REGARDING DISASTER PREPAREDNESS, THE HOSPITAL'S STAFF WORKED WITH REGIONAL AGENCIES TO COORDINATE EMERGENCY PLANS AND CONDUCTED JOINT SIMULATION DRILLS. HEART DISEASE EDUCATION: SH 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 CARDIAC RISK ASSESSMENT SCREENINGS DURING HEART MONTH IN FEBRUARY, AS WELL AS SUPPORT AND PROMOTION OF THE AMERICAN HEART ASSOCIATION'S GO RED INITIATIVE. 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. MORE THAN 40 MEMBERS OF THE HOSPITAL AND MEDICAL STAFF TOOK LEAD ROLES IN PLANNING, CONDUCTING AND TRAINING FOR THE HANDS FOR LIFE STAMFORD 2012 EVENT. 5,141 INDIVIDUALS RECEIVED LIFE-SAVING TRAINING, SETTING A NEW NATIONAL RECORD FOR HANDS-ONLY CPR; AND A WORLD RECORD FOR AUTOMATED EXTERNAL DEFIBRILLATOR TRAINING (5,141). NUTRITION/WEIGHT MANAGEMENT EDUCATION/FITNESS & EXERCISE - PEDIATRICS: SH CONTINUES TO INCORPORATE ITS CHILDHOOD OBESITY PREVENTION PROGRAM, KIDS' FANS (KIDS' FITNESS AND NUTRITION SERVICES), INTO ITS HEALTH PROMOTION INITIATIVES. KIDS' FANS PROMOTES PHYSICAL ACTIVITY AND HEALTH CONSCIOUS NUTRITION AND USES THE PREVENTIVE HEALTH MESSAGE OF 5-2-1-0: FOR EACH DAY, 5 FRUITS AND VEGETABLES, 2 HOURS OR LESS OF SCREEN TIME, 1 HOUR OR MORE OF PHYSICAL ACTIVITY, AND 0 SUGAR-SWEETENED BEVERAGES. CHAIRED BY SH'S PEDIATRICIAN MADHU MATHUR, MD, MPH, THIS CHILDHOOD OBESITY EFFORT FOCUSES ON PREVENTION, ADVOCACY, TREATMENT, AND RESEARCH, AND IS A CITY-WIDE COLLABORATION THAT NOW INCLUDES STAMFORD PUBLIC SCHOOLS, THE CITY OF STAMFORD HEALTH AND SOCIAL SERVICES DEPARTMENT ("STAMFORD HEALTH DEPT."), EARLY CHILDHOOD EDUCATORS, AND COMMUNITY PEDIATRICIANS AND FAMILY MEDICINE PRACTITIONERS. OUTREACH/SENIOR CITIZENS: THE HOSPITAL PROVIDED ONGOING 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. SH CONDUCTED OVER 550 FREE BLOOD PRESSURE SCREENINGS AT SENIOR CENTERS IN FY 2012. PEDIATRIC MEDICAL HOME INITIATIVE OF SOUTHWESTERN CT: MEDICAL HOME INITIATIVE, SOUTHWEST CT SERVES CHILDREN AND YOUTH WITH SPECIAL HEALTHCARE NEEDS. FAMILIES ARE PROVIDED ASSISTANCE WITH CARE COORDINATION, PROVIDING SPECIALISTS APPOINTMENTS AND REFERRALS TO COMMUNITY RESOURCES AND FAMILY SUPPORT NETWORKS. IN ADDITION TO PROVIDING CARE COORDINATION, SOUTHWEST MHI IS FOCUSED ON PREVENTION WORKING WITH THE CHILDHOOD BLUEPRINT AND THE KIDS' FANS (KIDS FITNESS AND NUTRITION SERVICES) INITIATIVE. 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. STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI CT, X X true true X X X X true true false false false false true false false Brian Grissler 935335 0 338223 0 556157 0 0 0 30336 0 1860051 0 30336 0 Darryl McCormick 347816 0 100193 0 13447 0 65307 0 8188 0 534951 0 0 0 David Smith 397837 0 110201 0 131910 0 59741 0 32836 0 732525 0 0 0 Kathleen Silard 485287 0 138500 0 35933 0 67337 0 32836 0 759893 0 0 0 Kevin Gage 477405 0 132241 0 40142 0 70042 0 24554 0 744384 0 0 0 Dr Sharon Kiely 463012 0 119301 0 28350 0 51469 0 32836 0 694968 0 0 0 Dr Michael Coady 720192 0 285879 0 89783 0 12250 0 8188 0 1116292 0 0 0 Dr Lance Bruck 493375 0 60000 0 13310 0 12250 0 30336 0 609271 0 0 0 Dr Steven Horowitz 541684 0 0 0 8525 0 12250 0 30336 0 592795 0 0 0 Dr Timothy Hall TERM 63011 296562 0 35000 0 469692 0 9800 0 29170 0 840224 0 0 0 Dr John Rodis 301098 0 0 0 142491 0 115012 0 15120 0 573721 0 0 0 Dr Andrew Snyder 332431 0 72231 0 320512 0 46106 0 20224 0 791504 0 0 0 Dr Rodrigo Acosta 0 364420 0 114982 0 709 0 0 0 31670 0 511781 0 0 Supplemental Compensation Information SCHEDULE J, PART I, LINE 1A TAX INDEMNIFICATION AND GROSS-UP PAYMENTS ARE GIVEN TO CERTAIN EMPLOYEES. ALL BENEFITS ARE TREATED AS TAXABLE COMPENSATION AS REQUIRED. A HOUSING ALLOWANCE IS PROVIDED TO A SENIOR EXECUTIVE, AS PART OF HIS/HER 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. 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 MONTHS WAS OFFSET BY COMPENSATION EARNED BY THE EMPLOYEE. TIMOTHY HALL, CHAIR DEPARTMENT OF SURGERY LAST DAY OF EMPLOYMENT - 6/30/11 RECEIVED SEVERANCE OF $308,785 SCHEDULE J, PART I, LINE 4B SHS PROVIDES SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAMS TO THREE FORMER OFFICERS: PATRICK COLANGELO - FORMER PRESIDENT, $113,898 PHILIP CUSANO - FORMER TREASURER, $390,919 RONALD TURNBULL - FORMER COO, $126,401 SCHEDULE J, PART I, LINE 6B BONUSES ARE CALCUALTED 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. STATE OF CT HEALTH AND EDUCATION FAC AUTHORITIES 060806186 2077443P8 2010-05-27 133992115 PLEASE SEE SCHEDULE O false false false STATE OF CT HEALTH AND EDUCATION FAC AUTHORITIES 060806186 20774YKQ9 2012-06-20 254620769 CONSTRUCT NEW HOSP FACILITY false false false 0 0 133995069 0 0 0 2057323 0 0 24835260 107102468 0 2011 true false true true 0 0 254620769 0 36350996 0 2935597 0 0 7866205 0 243818967 false false false false false true true false 0.00000 0.00000 0.00000 true false false true true false 0 true false false false 0 false 0 false false false false false 0 false 0 false false SHR1 LLC Business Relationship 459473 PLEASE SEE SCH L, PART V false SCHEDULE L SUPPLEMENTAL INFORMATION SCHEDULE L, PART IV, COLUMN D SHR1, LLC LEASES SPACE TO THE HOSPITAL. DOUGLAS MILNE, DIRECTOR IS 50% OWNER OF SHR1, LLC. X 8 41879 cost/selling price false true false Form 990, Supplemental Information 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 TO THE BOARD OF DIRECTORS FOR FINAL 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 ENSURE SOUND REPORTING AND COMPLIANCE WITH TAX LAW. PART VI, QUESTION 12C IT IS THE POLICY OF 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 HOSPITAL OR ITS PATIENTS. EMPLOYEES ARE EXPECTED TO CONDUCT THE BUSINESS OF THE HOSPITAL TO THE BEST OF THEIR ABILITY AND FOR THE BENEFIT OF THE 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. PART VI, QUESTION 15A AND 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 HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. PART XI, LINE 5 RECONCILIATION OF NET ASSETS PENSION RELATED CHANGES OTHER THAN NET PERIODIC BENEFIT COST - (27,878,685) OTHER - 1,295,315 TOTAL - 26,582,685 SCHEDULE K, PART I 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 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Brian Grissler TITLE:President and CEO HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Douglas Milne, III TITLE:Director HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Edwin Ford TITLE:Chairman HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dr. Arthur Klein TITLE:Director HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dr. Charles Miner TITLE:Director HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dr. Neil Dreyer TITLE:Director HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Andrew Merrill TITLE:Director HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Charles Krause, III TITLE:Director HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:David R. Nissen TITLE:Director HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Elliot S. Jaffe TITLE:Director HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Ernest N. Abate TITLE:Director HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Jay Higham TITLE:Director HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Amy C. Downer TITLE:Director HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Suzanne B. Peters TITLE:Director HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dr. Rodrigo Acosta TITLE:Physician HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Michael Fedele TITLE:Director HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Darryl McCormick TITLE:Assistant Secretary HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:David Smith TITLE:Assistant Secretary HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Kathleen Silard TITLE:Assistant Secretary HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Kevin Gage TITLE:Treasurer HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dr. Sharon Kiely TITLE:Sr. VP, Medical Services HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dr. Michael Coady TITLE:Chief Cardiac Surgeon HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dr. Lance Bruck TITLE:Chair, Department of OB/GYN HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dr. Steven Horowitz TITLE:Chief, Divion of Cardiology HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dr. Timothy Hall (TERM 6/30/11) TITLE:Chair, Department of Surgery HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dr. Andrew Snyder TITLE:VP, Ambulatory Services HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dr. John Rodis TITLE:Sr. VP, Medical Services HOURS: 36 Grove Street New Canaan LLC 30 Shelburne Rd Stamford CT 06904 274941529 MED RENTALS CT -376875 0 TSH 24 Grove Street New Canaan LLC 30 Shelburne Rd Stamford CT 06904 274941167 MED RENTALS CT -63651 0 TSH Stamford Health System 30 Shelburne Rd Stamford CT 06904 222476636 Hosp Parent CT 501(c)(3) 11, TYPE I NA false The Stamford Hospital Foundation 30 Shelburne Rd Stamford CT 06904 222478748 Fundraising CT 501(c)(3) 9 SHS true Stamford Health Intergrated Practices 30 Shelburne Rd Stamford CT 06904 271648289 Medical Svcs CT 501(c)(3) 9 TSH true Cont Care Retirement Comm of Gr Stamford 30 Shelburne Rd Stamford CT 06904 061402215 Retiremt Ctr CT 501(c)(3) 9 SHS 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 06904 061330879 Obstetrical Care CT SHS C corp 0 0 Fairfield County Surgical Specialists 30 Shelburne Rd Stamford CT 06904 205234062 Surgical Services CT SHS C corp 0 0 Premier Medical Group 230 Weschester Ave Harrison NY 10604 263467761 ORTHO/REHAB CARE NY SHIP S corp 0 0 Southwest Connecticut Radiology LLC 30 Shelburne Rd Stamford CT 06904 453801216 Radiology CT SHS S Corp Healthstar Indemnity Co Limited FB PERRY BUILDING 40 CHURCH ST HAMILTON BERMUDA BD Self-Insurance BD TSH C corp 2282000 73631000 1.00000 false false false true false false false false true true false false false true true true true true STAMFORD HEALTH SYSTEM J 361416 BOOK VALUE STAMFORD HEALTH SYSTEM N 65698 BOOK VALUE STAMFORD HEALTH SYSTEM R 679817 BOOK VALUE STAMFORD HEALTH SYSTEM Q 1005718 BOOK VALUE STAMFORD HEALTH INTERGRATED PRACTICES D 13952405 CASH VALUE STAMFORD HEALTH INTERGRATED PRACTICES I 214556 CASH VALUE STAMFORD HEALTH INTERGRATED PRACTICES N 1967650 BOOK VALUE STAMFORD HEALTH INTERGRATED PRACTICES R 2196756 BOOK VALUE STAMFORD HEALTH INTERGRATED PRACTICES Q 4414469 BOOK VALUE SOUTHWEST CONNECTICUT RADIOLOGY 520236 CASH VALUE STAMFORD OBGYN D 94945 CASH VALUE STAMFORD OBGYN N 150708 BOOK VALUE HEALTHSTAR INDEMNITY COMPANY P 996619 BOOK VALUE HEALTHSTAR INDEMNITY COMPANY Q 8315370 BOOK VALUE