STAMFORD HEALTH MEDICAL GROUP INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: STAMFORD HEALTH MEDICAL GROUP INC (EIN 27-1648289)
Tax period: 2010-10-01 to 2011-09-30
Filed: 2012-08-16
IRS object ID: 201212299349300706
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
Form 990
Schedule A
Schedule D
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-08-16T08:26:16-05:00	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 SUITE 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	271648289	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	STAMFORD HEALTH INTEGRATED PRACTICES INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	STAM	NameControl
Phone	2032761000	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	30 Shelburne Road	AddressLine1
City	Stamford	City
State	CT	State
ZIP Code	069049317	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Dr Lance Bruck	Name
Title	President & CEO	Title
Date Signed	2012-08-15	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)
Name Of Principal Officer Person	Dr Lance Bruck	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	30 Shelburne Rd P O Box 9317	AddressLine1
City	Stamford	City
State	CT	State
ZIP Code	06902	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	8834031	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	N/A	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	2009	YearFormation
State Legal Domicile	CT	StateLegalDomicile
Activity Or Mission Description	Supports the provision of physician services and other health practitioner services to residents of the communities served by Stamford Hospital and affiliated organizations.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	6	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	0	NbrIndependentVotingMembers
Total Nbr Employees	192	TotalNbrEmployees
Total Nbr Volunteers	0	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	0	ContributionsGrantsPriorYear
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	0	ProgramServiceRevenuePriorYear
Program Service Revenue CY	8821031	ProgramServiceRevenueCY
Investment Income Prior Year	0	InvestmentIncomePriorYear
Investment Income Current Year	0	InvestmentIncomeCurrentYear
Other Revenue Prior Year	0	OtherRevenuePriorYear
Other Revenue Current Year	13000	OtherRevenueCurrentYear
Total Revenue Prior Year	0	TotalRevenuePriorYear
Total Revenue Current Year	8834031	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	555743	SalariesEtcPriorYear
Salaries Etc Current Year	10891941	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	412257	OtherExpensePriorYear
Other Expenses Current Year	6300642	OtherExpensesCurrentYear
Total Expenses Prior Year	968000	TotalExpensesPriorYear
Total Expenses Current Year	17192583	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-968000	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-8358552	RevenuesLessExpensesCY
Total Assets BOY	340438	TotalAssetsBOY
Total Assets EOY	6472566	TotalAssetsEOY
Total Liabilities BOY	135907	TotalLiabilitiesBOY
Total Liabilities EOY	14563317	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	204531	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	-8090751	NetAssetsOrFundBalancesEOY
Mission Description	Support the Stamford Health System (SHS), Stamford Hospital and affiliated organizations by employing physicians and other health practitioners and providing and supporting the provision of physician services and other health practitioner services to residents of the communities served by SHS, the Hospital and their affiliates.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	7683402	Expense
Grants	0	Grants
Revenue	8834031	Revenue
Description	Stamford Health Integrated Practices Inc. (SHIP) provides a comprehensive array of management services in support of physician practices.	Description
Total Program Service Expense	7683402	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	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	true	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	54	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	192	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
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	6	NbrVotingGoverningBodyMembers
Number Independent Voting Members	0	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	true	MembersOrStockholders
Election Of Board Members	true	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
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	KEVIN GAGE CFO	NamePerson
Telephone Number	2032761000	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	30 SHELBURNE RD	AddressLine1
City	Stamford	City
State	CT	State
ZIP Code	06902	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Highest Compensated EmployeeHighestCompensatedEmployee
Dr Angelo Mallozzi
Director	2.0	X	480137	0	31570
Dr Kevin Miller
Director	2.0	X	315869	0	19717
Dr Craig Tifford
Director	2.0	X	705658	0	0
Dr Craig Olin
Treasurer	2.0		612566	0	27054	X
Dr Andrew Snyder
President & CEO	2.0		0	716174	66330	X
DR LANCE BRUCK
SECRETARY	2.0		0	566685	42586	X
Dr Rodrigo Acosta
Physician	40.0		480111	0	31670		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	2594341	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	1282859	TotalReportableCompFrmRltdOrgs
Total Other Compensation	218927	TotalOtherCompensation
Number Individuals GT100 K	32	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
ADELMAN SHEFF AND SMITH LLC
180 ADMIRAL COCHRANE DR	ANNAPOLIS	MD	21401	LEGAL	113188
ASHFORTH PROPERTIES CONSTRUCTION
707 SUMMER ST	STAMFORD	CT	069011026	CIP VENDOR	482588
COASTAL CARE MEDICAL MANAGEMENT
10 DAVOL SQUARE SUITE 400	PROVIDENCE	RI	02903	BILLING SERVICES	305707
SYED H REZA MD
345 MAIN AVE	NORWALK	CT	06851	PHYSICIAN FEES	176565

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	7	NumberOfContractorsGT100K
Total Contributions	0	TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Medicare/Medicaid Payments	621400	889579	889579
Physician Billing	621110	7919726	7919726
Abstracts	621110	11726	11726

Field	Value	IRS element (for citing)
Total Program Service Revenue	8821031	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

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	13000	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	0	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	13000	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	13000	TotalRevenueColumn
Exclusion	$13,000	ExclusionAmount

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

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Field	Value	IRS element (for citing)
Total Other Revenue	0	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	8834031	TotalRevenueColumn
Related Or Exempt Function Income	8821031	RelatedOrExemptFunctionIncome
Exclusion	$13,000	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	2755792	Total
Program Services	612093	ProgramServices
Management And General	2143699	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	6708290	Total
Program Services	2143699	ProgramServices
Management And General	4564591	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	6464	Total
Program Services	6464	ProgramServices

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	796296	Total
Program Services	780342	ProgramServices
Management And General	15954	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	625099	Total
Program Services	619853	ProgramServices
Management And General	5246	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	353533	Total
Program Services	299750	ProgramServices
Management And General	53783	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	230415	Total
Program Services	64	ProgramServices
Management And General	230351	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	12000	Total
Management And General	12000	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	2111353	Total
Program Services	381616	ProgramServices
Management And General	1729737	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	89877	Total
Program Services	270	ProgramServices
Management And General	89607	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	901574	Total
Program Services	745337	ProgramServices
Management And General	156237	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	0	Total

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	976480	Total
Program Services	924595	ProgramServices
Management And General	51885	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	28172	Total
Program Services	15349	ProgramServices
Management And General	12823	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	0	Total

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	1036637	Total
Program Services	684180	ProgramServices
Management And General	352457	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	372099	Total
Program Services	372099	ProgramServices

Other Expenses OtherExpenses

Field	Value	IRS element (for citing)
Description	All other expenses	Description
Total	188502	Total
Program Services	97691	ProgramServices
Management And General	90811	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	17192583	Total
Program Services	7683402	ProgramServices
Management And General	9509181	ManagementAndGeneral
Fundraising	0	Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	14763	BOY
EOY	1318489	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	2352053	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	55738	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	2060927	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	446999	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	325675	BOY
EOY	1613928	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
EOY	1132358	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	340438	BOY
EOY	6472566	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	115552	BOY
EOY	2274453	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	20355	BOY
EOY	12288864	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	135907	BOY
EOY	14563317	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	204531	BOY
EOY	-8090751	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	204531	BOY
EOY	-8090751	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	340438	BOY
EOY	6472566	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	-8358552	ReconcilationRevenueExpenses
Reconcilation Other Changes	63270	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	0	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	0	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	0	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	0	CurrentTaxYearMinus1Year
Current Tax Year	0	CurrentTaxYear
Total	0	Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	0	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	0	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	0	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	0	CurrentTaxYearMinus1Year
Current Tax Year	8834031	CurrentTaxYear
Total	8834031	Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	0	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	0	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	0	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	0	CurrentTaxYearMinus1Year
Current Tax Year	0	CurrentTaxYear
Total	0	Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	0	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	0	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	0	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	0	CurrentTaxYearMinus1Year
Current Tax Year	0	CurrentTaxYear
Total	0	Total

Total509 Total509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	0	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	0	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	0	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	0	CurrentTaxYearMinus1Year
Current Tax Year	8834031	CurrentTaxYear
Total	8834031	Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	0	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	0	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	0	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	0	CurrentTaxYearMinus1Year
Current Tax Year	0	CurrentTaxYear
Total	0	Total

Amts From Subst Contributors AmtsFromSubstContributors

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	0	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	0	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	0	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	0	CurrentTaxYearMinus1Year
Current Tax Year	0	CurrentTaxYear
Total	0	Total

Support From DQ Ps Etc SupportFromDQPsEtc

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	0	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	0	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	0	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	0	CurrentTaxYearMinus1Year
Current Tax Year	0	CurrentTaxYear
Total	0	Total

Field	Value	IRS element (for citing)
Public Support Total509	8834031	PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	0	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	0	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	0	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	0	CurrentTaxYearMinus1Year
Current Tax Year	13000	CurrentTaxYear
Total	13000	Total

Investment Income And UBTI InvestmentIncomeAndUBTI

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	0	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	0	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	0	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	0	CurrentTaxYearMinus1Year
Current Tax Year	13000	CurrentTaxYear
Total	13000	Total

Net Income From Other UBI NetIncomeFromOtherUBI

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	0	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	0	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	0	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	0	CurrentTaxYearMinus1Year
Current Tax Year	0	CurrentTaxYear
Total	0	Total

Other Income509 OtherIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	0	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	0	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	0	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	0	CurrentTaxYearMinus1Year
Current Tax Year	0	CurrentTaxYear
Total	0	Total

Total Support Total TotalSupportTotal

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	0	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	0	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	0	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	0	CurrentTaxYearMinus1Year
Current Tax Year	8847031	CurrentTaxYear
Total	8847031	Total

Field	Value	IRS element (for citing)
Public Support Percentage509	0.99853	PublicSupportPercentage509
Prior Year Support Percentage	0.00000	PriorYearSupportPercentage
Investment Income Percentage	0.00147	InvestmentIncomePercentage
Prior Yr Invest Income Percentage	0.00000	PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509	X	ThirtyThreePercntTestsCY509

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	602664	OtherCostOrOtherBasis
Depreciation	0	Depreciation
Book Value	602664	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1275441	OtherCostOrOtherBasis
Depreciation	387004	Depreciation
Book Value	888437	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	182822	OtherCostOrOtherBasis
Depreciation	59995	Depreciation
Book Value	122827	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	1613928	TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescription	Book ValueBookValue
DEPOSITS	13101
DUE FROM AFFILIATES	1119257

Field	Value	IRS element (for citing)
Total Book Value Other Assets	1132358	TotalBookValueOtherAssets
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	DUE TO AFFILIATES	Description
Amount	$12,288,864	Amount

Field	Value	IRS element (for citing)
Total Of Amounts	12288864	TotalOfAmounts

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Payments	X	IdemnificationGrossUpPayments
Written Policy Re T And E Expenses	true	WrittenPolicyReTAndEExpenses
Substantiation Required	true	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Form990 Of Other Organizations	X	Form990OfOtherOrganizations
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
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	false	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	false	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 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
Dr Angelo Mallozzi
363830	0	114982	0	1325	0	0	0	31570	0	511707	0	0	0
Dr Craig Olin
478792	0	133301	0	473	0	0	0	27054	0	639620	0	0	0
Dr Rodrigo Acosta
364420	0	114982	0	709	0	0	0	31670	0	511781	0	0	0
Dr Kevin Miller
285825	0	29613	0	431	0	0	0	19717	0	335586	0	0	0
Dr Craig Tifford
679408	0	26250	0	0	0	0	0		0	705658	0	0	0
Dr Andrew Snyder
0	323431	0	72231	0	320512	0	46106	0	20224	0	782504	0	0
DR LANCE BRUCK
0	493375	0	60000	0	13310	0	12250	0	30336	0	609271	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII

Field	Value	IRS element (for citing)
Identifier	Supplemental Compensation Information	Identifier
Return Reference	SCHEDULE J, PART 1A	ReturnReference
Explanation	Tax indemnification and gross-up payments and are given to certain employees. All benefits are treated as taxable compensation as required. Bonus are calculated and paid based on a percentage of revenue as defined by a contractual agreement.	Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
FORM 990, SUPPLEMENTAL INFORMATION	FORM 990, PART VI, QUESTION 6	THE STAMFORD HEALTH INTEGRATED PRACTICES, INC. ("SHIP") IS A CONNECTICUT NONSTOCK CORPORATION. SHIP HAS TWO CLASSES OF MEMBERS. CLASS A MEMBERS ARE THE PHYSICIANS EMPLOYED BY SHIP. THE CLASS B MEMBER IS THE STAMFORD HOSPITAL. FORM 990, PART VI, QUESTION 7A THE BOARD OF DIRECTORS SHALL TOTAL SIX MEMBERS. THE INITIAL BOARD WAS SELECTED BY THE INCORPORATOR, AND THEREAFTER THE BOARD WILL BE ELECTED AS FOLLOWS: (A) EIGHT MEMBERS OF THE BOARD OF DIRECTORS SHALL BE ELECTED BY THE CLASS A MEMBERS, SUBJECT TO THE APPROVAL OF THE CLASS B MEMBER, AND (B) ONE MEMBER OF THE BOARD OF DIRECTORS SHALL BE APPOINTED BY THE CLASS B MEMBER. FORM 990, PART VI, QUESTION 7B ALL POWERS OF SHIP SHALL BE EXERCISED BY AND UNDER THE AUTHORITY OF THE BOARD OF DIRECTORS, EXCEPT THAT THE CLASS B MEMBER SHALL HAVE THE SOLE AUTHORITY TO AMEND THE BYLAWS OF SHIP AND SELECT THE AUDITORS OF SHIP. FORM 990, PART VI, QUESTION 11 THE STAMFORD HEALTH INTEGRATED PRACTICES, INC. (SHIP) HAS A COMPREHENSIVE REVIEW PROCESS IN PLACE RELATING TO THE REVIEW OF FORM 990. PRIOR TO FINALIZATION OF THE 990, MANAGEMENT PROVIDES THE DRAFT FORM 990 TO THE BOARD OF DIRECTORS. THE HOSPITAL'S EXTERNAL TAX ACCOUNTANTS ADDRESS ANY SPECIFIC CONCERNS OR QUESTIONS WITH MANAGEMENT AND THE BOARD. THIS REVIEW PROCEDURE HELPS TO ASSURE SOUND REPORTING AND COMPLIANCE WITH TAX LAW. FORM 990, PART VI, QUESTION 12 SHIP AS A WHOLLY OWNED SUBSIDIARY OF STAMFORD HOSPITAL FOLLOWS THE HOSPITAL'S CONFLICT OF INTEREST POLICY. IT IS THE POLICY 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 ORGANIZATION. EMPLOYEES ARE EXPECTED TO CONDUCT THE BUSINESS OF THE SHIP TO THE BEST OF THEIR ABILITY AND FOR THE BENEFIT OF THE SHIP AND IT'S 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. FORM 990, PART VI, QUESTIONS 15A & 15B IT IS THE POLICY OF THE SHIP TO PAY EMPLOYEES FAIR AND COMPETITIVE WAGES. SHIP 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. FORM 990, PART VI, QUESTION 19 SHIP MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 5 RECONCILIATION OF NET ASSETS EQUITY TRANSFER FROM STAMFORD HEALTH SYSTEM - $63,270
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Dr. Kevin Miller TITLE:Director HOURS:40
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Dr. Craig Tifford TITLE:Director HOURS:40
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Dr. Andrew Snyder TITLE:President & CEO HOURS:40
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:DR. LANCE BRUCK TITLE:SECRETARY HOURS:38

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	Fairfield County OBGYN Assoc	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	PO Box 11580	AddressLine1
City	Trumbull	City
State	CT	State
ZIP Code	06111	ZIPCode

Field	Value	IRS element (for citing)
EIN	830352099	EIN
Primary Activities	Obstetrl care	PrimaryActivities
Legal Domicile State	CT	LegalDomicileState
Total Income	0	TotalIncome
EOY Assets	0	EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	SHIP	BusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII (4 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
Stamford Health System
30 Shelburne Rd	Stamford	CT	06904	222476636	Hosp Parent	CT	501(c)(3)	11, TYPE I	NA
The Stamford Hospital Foundation
30 Shelburne Rd	Stamford	CT	06904	222478748	Fundraising	CT	501(c)(3)	9	SHS
Cont Care Retirement Comm of Gr Stamford
30 Shelburne Rd	Stamford	CT	06904	061402215	Retiremt Ctr	CT	501(c)(3)	9	SHS
The Stamford Hospital
30 Shelburne Rd	Stamford	CT	06904	060646917	Hospital	CT	501(c)(3)	3	SHS

Form990 Schedule R Part IV Form990ScheduleRPartIV (6 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	Legal Domicile Foreign CountryLegalDomicileForeignCountry
Miller Hall Medical Suites
166 W Broad Street	Stamford	CT	06904	061619978	PROF OFFICE BLDG	CT	SHS	C CORP	0	0	0.00000
Stamford ObGyn Associates
30 Shelburne Rd	Stamford	CT	06904	061330879	Obstetrical Care	CT	SHS	C CORP	0	0	0.00000
Premier Medical Group
230 Weschester Ave	Harrison	NY	10604	263467761	ORTHO/REHAB CARE	NY	SHS	C corp	0	0	0.00000
Fairfield County Primary Care
30 Shelburne Rd	Stamford	CT	06904	262903051	PRIM URGENT CARE	CT	SHS	C corp	0	0	0.00000
Healthstar Indemnity Co Limited
					Self-Insurance		TSH	C corp	0	0	0.00000	BD
Fairfield County Surgical Specialists
30 Shelburne Rd	Stamford	CT	06904	205234062	Surgical Services	CT	SHS	C corp	0	0	0.00000

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	false	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	false	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	true	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	false	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	true	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	false	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	false	PerformOfServicesByOtherOrgs
Sharing Of Facilities	false	SharingOfFacilities
Sharing Of Paid Employees	true	SharingOfPaidEmployees
Reimbursement Paid To Other Org	true	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	true	OtherTransferToOtherOrg
Other Transfer From Other Org	true	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (14 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved
Fairfield County OBGYN Assoc
C	110335
FAIRFIELD COUNTY PRIMARY CARE
C	1139333
FAIRFIELD COUNTY PRIMARY CARE
C	950000
Fairfield County Surgical Specialists
C	123828
PREMIER MEDICAL GROUP
C	71137
PREMIER MEDICAL GROUP
O	375366
PREMIER MEDICAL GROUP
Q	3044059
PREMIER MEDICAL GROUP
R	1745000
STAMFORD HEALTH SYSTEM
C	1519051
STAMFORD HEALTH SYSTEM
J	141285
STAMFORD HEALTH SYSTEM
R	2131900
STAMFORD HOSPITAL
C	1167796
STAMFORD HOSPITAL
N	353532
STAMFORD OBGYN ASSOCIATES
H	212100