NUVANCE HEALTH MEDICAL PRACTICE CT INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- NUVANCE HEALTH MEDICAL PRACTICE CT INC (EIN 06-1137531)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-08-10
- IRS object ID
- 201212239349300101
- Schema version
- 2010v3.7
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-10T06:48:04-05:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 MONUMENT CIRCLE STE 2600 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46204 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 061137531 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WESTERN CONNECTICUT MEDICAL GROUP PC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | WEST | NameControl |
| Phone | 2037397294 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14 RESEARCH DRIVE | AddressLine1 |
| City | BETHEL | City |
| State | CT | State |
| ZIP Code | 06801 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | PATRICK BRODERICK | Name |
| Title | PRESIDENT | Title |
| Date Signed | 2012-08-09 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3176817000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | X | AddressChange |
| Name Of Principal Officer Person | Patrick Broderick | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 95 LOCUST AVENUE | AddressLine1 |
| City | DANBURY | City |
| State | CT | State |
| ZIP Code | 06810 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 138978872 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.westernconnecticutmedicalgroup.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1985 | YearFormation |
| State Legal Domicile | CT | StateLegalDomicile |
| Activity Or Mission Description | PLEASE SEE ATTACHMENT 1 | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | NbrIndependentVotingMembers |
| Total Nbr Employees | 830 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | -6049 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -31509 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 131101845 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 138533899 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 17977 | InvestmentIncomePriorYear |
| Investment Income Current Year | 3746 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 304833 | OtherRevenuePriorYear |
| Other Revenue Current Year | 126474 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 131424655 | TotalRevenuePriorYear |
| Total Revenue Current Year | 138664119 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 109233555 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 122544363 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 26993840 | OtherExpensePriorYear |
| Other Expenses Current Year | 29951876 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 136227395 | TotalExpensesPriorYear |
| Total Expenses Current Year | 152496239 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -4802740 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -13832120 | RevenuesLessExpensesCY |
| Total Assets BOY | 24242470 | TotalAssetsBOY |
| Total Assets EOY | 26257390 | TotalAssetsEOY |
| Total Liabilities BOY | 25575074 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 15775787 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -1332604 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 10481603 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | the mission is to provide safe, innovative, convenient and coordinated primary and specialty health care in the communities we serve and strive to be aware of and respond to our patients NEEDS. We support a commitment to advance the health and wellbeing of people in our community by delivering quality care participating in medical research and medical residency programs and the provision of medical services to patients. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 54784081 | Expense |
| Revenue | 49458625 | Revenue |
| Description | MEDICINE SUBSPECIALTY - 13 Locations serving areas in Western Connecticut 93,710 patients during fiscal year 2011 109,772 visits during fiscal year 2011 484,348 - Adjusted for Charity Care in FY 2011 | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 29301439 | Expense |
| Revenue | 24820968 | Revenue |
| Description | PRIMARY CARE- 10 Locations serving areas in Western Connecticut and Eastern New York 90,224 patients during fiscal year 2011 90,795 visits during fiscal year 2011 20,203 - Adjusted for Charity Care in FY 2011 | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 20341003 | Expense |
| Revenue | 20096375 | Revenue |
| Description | ANESTHESIOLOGY- 3 Locations serving areas in Western Connecticut 23,134 patients during fiscal year 2011 210,302 - Adjusted for charity care in FY 2011 | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 33798697 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 44290454 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 138225220 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 563 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 830 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 0 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | true | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | CT | StatesWhereCopyOfReturnIsFiled |
| States Where Copy Of Return Is Filed | NY | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | COLLEEN SCOTT | NamePerson |
| Telephone Number | 2037397294 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14 RESEARCH DRIVE SUITE 201A | AddressLine1 |
| City | bethel | City |
| State | CT | State |
| ZIP Code | 06804 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (16 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| PATRICK BRODERICK | |||||||
| PHYSICIAN/PRESIDENT | 50.0 | X | X | 469771 | 0 | 7070 | |
| MATTHEW MILLER | |||||||
| PHYSICIAN/BOD | 2.0 | X | 555802 | 0 | 81647 | ||
| CHARLES HERRICK | |||||||
| PHYSICIAN/BOD | 50.0 | X | 392584 | 0 | 32213 | ||
| PIERRE SALDINGER | |||||||
| PHYSICIAN/SECRETARY | 50.0 | X | X | 663870 | 0 | 7996 | |
| RAMON KRANWINKEL | |||||||
| PHYSICIAN/BOD | 50.0 | X | 589197 | 0 | 40744 | ||
| MARTIN SERRINS | |||||||
| PHYSICIAN/VP | 50.0 | X | X | 623634 | 0 | 29016 | |
| PATRICIA TIETJEN | |||||||
| PHYSICIAN/BOD | 50.0 | X | 578457 | 0 | 23206 | ||
| RAUL ARGUELLO | |||||||
| PHYSICIAN/BOD | 50.0 | X | 357970 | 0 | 21620 | ||
| SHOHREH SHAHABI | |||||||
| OB/GYN PHYSICIAN/BOD | 50.0 | X | 602904 | 0 | 11541 | ||
| DOUG MAGAZU | |||||||
| CFO | 50.0 | X | 236848 | 0 | 16764 | ||
| EDWARD KUSHMEREK | |||||||
| EXECUTIVE DIRECTOR | 50.0 | X | 289986 | 0 | 25789 | ||
| ALAN DIETZEK | |||||||
| SURGEON | 50.0 | 997694 | 0 | 46933 | X | ||
| HAL WASSERMAN | |||||||
| IC CARDIOLOGY | 50.0 | 705866 | 0 | 26933 | X | ||
| CARY PASSIK | |||||||
| CARDIOLOGIST | 50.0 | 766809 | 0 | 44733 | X | ||
| KARL KULIKOWSKI | |||||||
| ANESTHESIOLOGIST | 50.0 | 597895 | 0 | 22807 | X | ||
| WINSTON SHIH | |||||||
| PHYSICIAN | 50.0 | 590860 | 0 | 28160 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 9020147 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 467172 | TotalOtherCompensation |
| Number Individuals GT100 K | 240 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| ALLSCRIPTS | |||||
| 8529 SIX FORKS ROAD | RALEIGH | NC | 27615 | COMPUTER SERVICES | 2304739 |
| WOMENS HEALTH SERVICES | |||||
| 90 LOCUST AVE | DANBURY | CT | 06810 | PHYSCIAN FEES | 485333 |
| PREMIER GROUP | |||||
| 6 STONY HILL RoaD SUITE 200 | BETHEL | CT | 06801 | STAFFING | 230337 |
| ACCURATE ANSWER | |||||
| 16 SADDLE RIDGE Road | NEW MILFORD | CT | 06776 | ANSWERING SERVICES | 196414 |
| BB COMMERCIAL CLEANING SRVC | |||||
| 36 TAMARACK AVE | DANBURY | CT | 06811 | CLEANING SERVICES | 171238 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 10 | NumberOfContractorsGT100K |
| Total Contributions | 0 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MEDICAL REVENUE | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 138533899 | TotalRevenueColumn |
| Related Or Exempt Function Income | 138533899 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 138533899 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3746 | TotalRevenueColumn |
| Exclusion | $3,746 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 304642 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 304642 | Real |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 4062 | GrossSalesOfInventory |
| Cost Of Goods Sold | 10111 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -6049 | TotalRevenueColumn |
| Unrelated Business Revenue | -6049 | UnrelatedBusinessRevenue |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| REIMBURSE PROVIDER TESTIMONY | 621610 | 43405 | 43405 |
| MEDICAL RECORDS | 900003 | 89118 | 89118 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 132523 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 138664119 | TotalRevenueColumn |
| Related Or Exempt Function Income | 138666422 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | -6049 | UnrelatedBusinessRevenue |
| Exclusion | $3,746 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8735511 | Total |
| Program Services | 8308932 | ProgramServices |
| Management And General | 426579 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 103053453 | Total |
| Program Services | 99190795 | ProgramServices |
| Management And General | 3862658 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6057144 | Total |
| Program Services | 5739765 | ProgramServices |
| Management And General | 317379 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4698255 | Total |
| Program Services | 3657888 | ProgramServices |
| Management And General | 1040367 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 235046 | Total |
| Management And General | 235046 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 172144 | Total |
| Management And General | 172144 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8067294 | Total |
| Program Services | 2251485 | ProgramServices |
| Management And General | 5815809 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3120537 | Total |
| Program Services | 3007131 | ProgramServices |
| Management And General | 113406 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 189019 | Total |
| Program Services | 166141 | ProgramServices |
| Management And General | 22878 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5149563 | Total |
| Program Services | 4525602 | ProgramServices |
| Management And General | 623961 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 429812 | Total |
| Program Services | 401736 | ProgramServices |
| Management And General | 28076 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49870 | Total |
| Program Services | 49870 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1279271 | Total |
| Program Services | 995776 | ProgramServices |
| Management And General | 283495 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3659795 | Total |
| Program Services | 3192833 | ProgramServices |
| Management And General | 466962 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT | 5256573 | 5256573 | |
| MEMBERSHIP DUES | 504392 | 468275 | 36117 |
| MAINTENANCE CONTRACTS | 373899 | 21109 | 352790 |
| BOOKS AND PERIODICALS | 108189 | 84143 | 24046 |
| REPAIRS/MAINTENANCE | 104546 | 100776 | 3770 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1251926 | Total |
| Program Services | 806390 | ProgramServices |
| Management And General | 445536 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 152496239 | Total |
| Program Services | 138225220 | ProgramServices |
| Management And General | 14271019 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5257 | BOY |
| EOY | 5594 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3583516 | BOY |
| EOY | 3208288 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10614681 | BOY |
| EOY | 6609543 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 186591 | BOY |
| EOY | 243785 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 119335 | BOY |
| EOY | 177699 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 16142714 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 7709054 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6254429 | BOY |
| EOY | 8433660 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 191177 | BOY |
| EOY | 148891 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3287484 | BOY |
| EOY | 7429930 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24242470 | BOY |
| EOY | 26257390 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8836272 | BOY |
| EOY | 13741545 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 763426 | BOY |
| EOY | 1042268 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 917010 | BOY |
| EOY | 697874 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15058366 | BOY |
| EOY | 294100 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25575074 | BOY |
| EOY | 15775787 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Do Not Follow SFAS117 | X | DoNotFollowSFAS117 |
Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1000 | BOY |
| EOY | 1000 | EOY |
Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -1333604 | BOY |
| EOY | 10480603 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -1332604 | BOY |
| EOY | 10481603 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24242470 | BOY |
| EOY | 26257390 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -13832120 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 25646327 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 143640 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 160329 | CurrentTaxYearMinus3Years |
| Total | 303969 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 109544284 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 116231509 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 121548488 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 131374921 | CurrentTaxYearMinus1Year |
| Current Tax Year | 138666422 | CurrentTaxYear |
| Total | 617365624 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 109687924 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 116391838 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 121548488 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 131374921 | CurrentTaxYearMinus1Year |
| Current Tax Year | 138666422 | CurrentTaxYear |
| Total | 617669593 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 617669593 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 429692 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 488325 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 457479 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 358176 | CurrentTaxYearMinus1Year |
| Current Tax Year | 308388 | CurrentTaxYear |
| Total | 2042060 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 429692 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 488325 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 457479 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 358176 | CurrentTaxYearMinus1Year |
| Current Tax Year | 308388 | CurrentTaxYear |
| Total | 2042060 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 110117616 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 116880163 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 122005967 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 131733097 | CurrentTaxYearMinus1Year |
| Current Tax Year | 138974810 | CurrentTaxYear |
| Total | 619711653 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99670 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99632 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00330 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00368 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | true | MailingsMembers |
| Mailings Members | $9,923 | MailingsMembersAmount |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 9923 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
| Form4720 Filed4912 Tax | false | Form4720Filed4912Tax |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PART II-B, LINE 1D-MAILINGS TO MEMBERS, LEGISLATORS, OR the PUBLIC | Identifier |
| Explanation | THE DOLLARS RELATED TO LOBBYING ACTIVITIES REPRESENTS APPROXIMATELY 1.9% OF THE TOTAL MEMBERSHIP DUES EXPENDITURES. ALL LOBBYING DOLLARS ARE A PORTION OF MEMBERSHIP DUES PAID. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Land | Land | |
| Buildings | Buildings |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 280724 | OtherCostOrOtherBasis |
| Depreciation | 235856 | Depreciation |
| Book Value | 44868 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5835082 | OtherCostOrOtherBasis |
| Depreciation | 2563051 | Depreciation |
| Book Value | 3272031 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10026908 | OtherCostOrOtherBasis |
| Depreciation | 4910147 | Depreciation |
| Book Value | 5116761 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 8433660 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (7 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| 457B ASSET | 5200013 |
| CASH VALUE LIFE INSURANCE | 1008912 |
| DANBURY HOSPITAL RECEIVABLE | 47899 |
| DHCC RECEIVABLE | 13925 |
| NEW MILFORD RECEIVABLE | 1101688 |
| MISCELLANEOUS RECEIVABLE | 15120 |
| SOUTHBURY RENT RECEIVABLE | 42373 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 7429930 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | I/C DANBURY HOSPITAL | Description |
| Amount | $294,100 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 294100 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PART X- FIN 48 FOOTNOTE | Identifier |
| Explanation | There is no FIN 48 (asc 740) footnote in the audited financial statements. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | X | IndependentConsultant |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | true | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (16 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PATRICK BRODERICK | |||||||||||||
| 346376 | 0 | 120544 | 0 | 2851 | 0 | 0 | 0 | 7070 | 0 | 476841 | 0 | 0 | 0 |
| MATTHEW MILLER | |||||||||||||
| 422561 | 0 | 125000 | 0 | 8241 | 0 | 60540 | 0 | 21107 | 0 | 637449 | 0 | 0 | 0 |
| DOUG MAGAZU | |||||||||||||
| 201336 | 0 | 35000 | 0 | 512 | 0 | 16500 | 0 | 264 | 0 | 253612 | 0 | 0 | 0 |
| CHARLES HERRICK | |||||||||||||
| 315637 | 0 | 75000 | 0 | 1947 | 0 | 22000 | 0 | 10213 | 0 | 424797 | 0 | 0 | 0 |
| PIERRE SALDINGER | |||||||||||||
| 541434 | 0 | 120000 | 0 | 2436 | 0 | 0 | 0 | 7996 | 0 | 671866 | 0 | 0 | 0 |
| RAMON KRANWINKEL | |||||||||||||
| 468606 | 0 | 90000 | 0 | 30591 | 0 | 38500 | 0 | 2244 | 0 | 629941 | 0 | 0 | 0 |
| MARTIN SERRINS | |||||||||||||
| 497334 | 0 | 120000 | 0 | 6300 | 0 | 22000 | 0 | 7016 | 0 | 652650 | 0 | 0 | 0 |
| PATRICIA TIETJEN | |||||||||||||
| 474644 | 0 | 100000 | 0 | 3813 | 0 | 22000 | 0 | 1206 | 0 | 601663 | 0 | 0 | 0 |
| RAUL ARGUELLO | |||||||||||||
| 286630 | 0 | 70000 | 0 | 1340 | 0 | 16500 | 0 | 5120 | 0 | 379590 | 0 | 0 | 0 |
| ALAN DIETZEK | |||||||||||||
| 763107 | 0 | 227852 | 0 | 6735 | 0 | 38500 | 0 | 8433 | 0 | 1044627 | 0 | 0 | 0 |
| EDWARD KUSHMEREK | |||||||||||||
| 247061 | 0 | 40000 | 0 | 2925 | 0 | 22000 | 0 | 3789 | 0 | 315775 | 0 | 0 | 0 |
| HAL WASSERMAN | |||||||||||||
| 591494 | 0 | 109320 | 0 | 5052 | 0 | 22000 | 0 | 4933 | 0 | 732799 | 0 | 0 | 0 |
| CARY PASSIK | |||||||||||||
| 629042 | 0 | 132683 | 0 | 5084 | 0 | 37300 | 0 | 7433 | 0 | 811542 | 0 | 0 | 0 |
| SHOHREH SHAHABI | |||||||||||||
| 470636 | 0 | 130000 | 0 | 2268 | 0 | 7000 | 0 | 4541 | 0 | 614445 | 0 | 0 | 0 |
| KARL KULIKOWSKI | |||||||||||||
| 535933 | 0 | 60655 | 0 | 1307 | 0 | 16500 | 0 | 6307 | 0 | 620702 | 0 | 0 | 0 |
| WINSTON SHIH | |||||||||||||
| 371990 | 0 | 215973 | 0 | 2897 | 0 | 22000 | 0 | 6160 | 0 | 619020 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PART I, LINE 6 | Identifier |
| Return Reference | Compensation Contingent on Net Earnings or Related Organization | ReturnReference |
| Explanation | The Plan will be administered subject to the Board policy on Executive Compensation by the Committee on Governance serving as the Executive Compensation Committee (the Committee) of the Board of Directors of Western Connecticut Health Network, Inc. (WCHN). The Committee may in its sole discretion interpret the Plan, prescribe any rules and regulations necessary or appropriate for administration of the Plan and make such other determinations and take such actions as it deems necessary or advisable. The Plan year will begin October 1, 2010 and end September 30, 2011. The measurement period for award purposes will be the same. Eligibility to participate in the Plan will be limited to those who are in positions in which their decisions, actions, and counsel significantly affect the operations of WCHN and its subsidiaries, as determined by the Committee and with input provided by senior management. Prior to the start of each Plan year, or as soon as practicable thereafter, the Committee, with input provided by senior management, will determine which eligible individuals will participate in the Plan with respect to such Plan year and they will be listed accordingly. In determining which eligible individuals will participate, the Committee will take in to account the extent to which eligible individuals are in positions in which their decisions, actions and counsel significantly affect the overall performance of WCHN and its affiliates. To be considered for participation, an individual must be in an incentive eligible position for no less than 6 months of the respective Plan year. Incentive awards will be prorated as appropriate to reflect partial Plan year participation. Eligible individuals must be employed by WCHN at the time of executive incentive award distribution. The Committee will establish the target award opportunity (expressed as a percentage of base salary) for each participant in the Plan. The target award is the amount paid to participants for actual performance that meets expectations. To recognize a range of performance above the "target" level, participants may earn one-half to one and one-half times the target award opportunities based on actual performance. A threshold of performance must be achieved in order for participants to earn awards. Prior to the beginning of each Plan year, or as soon thereafter as practicable, weighting for the performance measures included in the Plan will be determined for each participant in accordance with the nature of each participant's stated goals and responsibilities (i.e. organizational, functional/individual, etc.). Prior to the beginning of each Plan year, or as soon thereafter as practicable, performance measures and performance levels will be established for each participant in the Plan. Incentive awards will be modified or eliminated if at the level of performance specified in the circuit breaker is not achieved. The circuit breaker will be established by the Committee prior to the beginning of each fiscal year or as soon thereafter as practicable. If EBITA is less than basic, full elimination of incentive award will occur. Notwithstanding, any other provision of the Plan, incentive awards can be affected by an individual modifier (based on individual executive performance) at the level specified in the Plan. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SUPPLEMENTAL INFORMATION | Identifier |
| Explanation | Form 990, Part I, Line 3 INDEPENDENT TRUSTEES There are no independent trustees due to compensation paid to trustees for their services as physicians rather than for their board service. However, the organization is part of an integrated health care delivery system of entities which have community boards which are responsible for certain oversight and policy decisions. Form 990, Part III, Line 4d OTHER PROGRAM SERVICES All other program services include Surgery, OBGYN, Pediatrics, Psychology, Pathology, and Administration. Form 990, Part VI, Line 4 SIGNIFICANT CHANGES TO ITS GOVERNING DOCUMENTS The Articles of Amendment were already provided to the IRS and were filed previously. The organization had a name change from Danbury Office of Physician Services, P.C. to Western Connecticut Medical Group, P.C. Form 990, Part VI, Line 6 EXPLANATION OF CLASSES OF MEMBERS OR SHAREHOLDER Western Connecticut Medical Group is a stock corporation with stock issued to its physician membership. Form 990, Part VI, line 7a ELECTION OF MEMBERS OF THE GOVERNING BODY The Board of Trustees are automatic appointments based on their specific positions as full-time salaried POSITIONS at the Hospital and therefore, Trustees are not elected to the Board. Form 990, Part VI, Line 7b APPROVALS BY MEMBERS, STOCKHOLDERS, OR OTHER PERSONS The by-laws require that the Members must vote to approve, amend, alter or repeal the corporation's by-laws. Form 990 Part VI, Line 11B FORM 990 REVIEW PROCESS The organization provides a copy of the completed 990 forms to the Audit Committee for review. The forms are reviewed by the Chief Financial Officer, president, and Executive Director. ernst & young conducts a review of the return for completeness and accuracy. Form 990 Part VI, Line 12c EXPLANATION OF MONITORING AND ENFORCEMENT OF CONFLICTS The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy by requiring all physicians and Management to sign a conflict of interest disclosure. The documents are then reviewed by the compliance committee. If the board or committee has reasonable cause to believe that a representative has failed to disclose a personal or outside interest that could constitute a conflict of interest, it shall inform the representative of the basis for that belief and give the Representative an opportunity to explain the alleged failure to disclose. If, after hearing that response of the Representative and making such further investigation as may be warranted in the circumstances, the Board or committee determines that the Representatives has in fact failed to disclose a personal or outside interest that could constitute a conflict of interest, the Board shall take appropriate disciplinary and corrective action. DISCIPLINARY ACTION MAY RESULT IN TERMINATION OF EMPLOYMENT OR THE REFUSAL OF WESTERN CONNECTICUT MEDICAL GROUP TO DEFEND THE EMPLOYEE WITH A MATTER THAT WAS NOT DISCLOSED BUT OTHERWISE MAY HAVE BEEN ELIGIBLE TO BE DEFENDED BY WESTERN CONNECTICUT MEDICAL GROUP. Form 990, Part VI, Lines 15A AND 15B COMPENSATION REVIEW & APPROVAL PROCESS FOR OFFICERS & KEY EMPLOYEES Compensation for the Executive Director and CFO positions, Edward Kusmerek and Douglas Magazu, respectively, are reviewed and based on outside market data from a third party vendor. The review was last performed in 2009 while searching for a candidate to fill the Executive Director Position. Compensation is further reviewed by the Human Resources Department and the WCMG Board of Directors. Form 990, Part VI, Line 19 OTHER ORGANIZATION DOCUMENTS PUBLICLY AVAILABLE The organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request. Certain documents are also available on the Network's web site. Form 990, Part VII Hours Explanation Matthew A. Miller, MD is paid by Western Connecticut Medical Group for the services he provides to a related organization. Form 990, Part XI, Line 5 Other Changes in net assets or fund balances Other Changes in net assets or fund balances includes a $25,646,327 transfer from Danbury Hospital. The taxpayer's Form 5471 filing requirements have been or will be satisfied by Danbury Hospital, 24 Hospital Avenue, Danbury, CT 06810, TIN: 06-0646597, the majority shareholder of Western Connecticut Healthcare Insurance Co., Ltd. Danbury Hospital has filed or will file the Form 5471 and applicable schedules with the IRS. | Explanation |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| DANBURY HOSPITAL | |||||||||
| 24 HOSPITAL AVE | DANBURY | CT | 06801 | 060646597 | acute care | CT | 501(C)(3) | 3 | WCTHN |
| WESTERN CONNECTICUT HEALTH NETWORK INC | |||||||||
| 24 HOSPITAL AVE | DANBURY | CT | 06810 | 222594977 | PROGRAM DEVLP | CT | 501(C)(3) | 11 TYPE 2 | NA |
| WESTERN CT HEALTH NETWORK AFFILIATES | |||||||||
| 95 LOCUST AVE | DANBURY | CT | 06801 | 222594968 | OUTPATIENT | CT | 501(C)(3) | 9 | WCTHN |
| WESTERN CONNECTICUT HEALTH NETWORK FNDN | |||||||||
| 24 Hospital Ave | DANBURY | CT | 06801 | 237425557 | ADMIN CONTRIB | CT | 501(C)(3) | 7 | WCTHN |
| WESTERN CONNECTICUT HOMECARE INC | |||||||||
| 4 Liberty Street | DANBURY | CT | 06810 | 060655138 | HOME HLTHCRE | CT | 501(C)(3) | 9 | WCTHN |
| REGIONAL HOSPICE OF WESTERN CONNECTICUT | |||||||||
| 405 MAIN STREET | DANBURY | CT | 06810 | 061178847 | PATIENT CARE | CT | 501(C)(3) | 7 | WCTHN |
| NEW MILFORD HOSPITAL | |||||||||
| 21 ELM STREET | DANBURY | CT | 06776 | 060669121 | ACUTE CARE | CT | 501(C)(3) | 3 | WCTHN |
| NEW MILFORD HOSPITAL FOUNDATION | |||||||||
| 21 ELM ST | NEW MILFORD | CT | 06776 | 222515011 | ADMIN CONTRIB | CT | 501(C)(3) | 7 | NM HOSPITAL |
| NEW MILFORD VISITING NURSES ASSOCIATION | |||||||||
| 68 PARK LANE RD | NEW MILFORD | CT | 06776 | 060653153 | HOME CARE | CT | 501(C)(3) | 9 | NM HOSPITAL |
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | Code VCodeVAmount | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NEW MILFORD MRI | ||||||||||||||
| 21 ELM ST | NEW MILFORD | CT | 06810 | 271877801 | IMAGING SVC | CT | NA | N/A | 0 | 0 | false | $0 | false | 0.00000 |
| RIDGEFIELD SURGical | ||||||||||||||
| 901 ETHAN ALLEN | RIDGEFIELD | CT | 06877 | 222594977 | HEALTH CARE | CT | NA | N/A | 0 | 0 | false | $0 | false | 0.00000 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | Province Or StateAddressForeign/ProvinceOrState | CountryAddressForeign/Country | Postal CodeAddressForeign/PostalCode | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MEDICAL SERVICES OF DANBURY | |||||||||||||||||
| 24 HOSPITAL AVE | DANBURY | CT | 06811 | 061635945 | HEALTHCARE | CT | WCMG | C CORP | 0 | 0 | 1.00000 | ||||||
| BUSINESS SYSTEMS INC | |||||||||||||||||
| 95 LOCUST AVENUE | DANBURY | CT | 06810 | 061119262 | PHARMACY | CT | NA | C CORP | 0 | 0 | 0.00000 | ||||||
| WESTERN CT HEALTHCARE INSURANCE COMPANY | |||||||||||||||||
| 980438151 | MALPRACTICE | NA | C CORP | 0 | 0 | 0.00000 | 10 MAIN STREET | GRAND CAYMAN | CAYMAN ISLANDS | CJ | 1051 | CJ | |||||
| FOUNDATION FOR COMMUNITY HEALTHCARE | |||||||||||||||||
| 95 LOCUST AVE | DANBURY | CT | 06810 | 061437131 | INACTIVE | CT | NA | C CORP | 0 | 0 | 0.00000 | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | true | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (8 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| DANBURY HOSPITAL | |
| J | 1621484 |
| DANBURY HOSPITAL | |
| C | 25646327 |
| DANBURY HOSPITAL | |
| J | 129886 |
| DANBURY HOSPITAL | |
| I | 668473 |
| DANBURY HOSPITAL | |
| K | 40419665 |
| DANBURY HOSPITAL | |
| N | 2193042 |
| DANBURY HOSPITAL | |
| O | 376132 |
| DANBURY HOSPITAL | |
| R | 46735661 |