2012-08-14T14:51:40-05:00 2011-09-30 KPMG LLP One Financial Plaza Hartford CT 061032608 990 2010-10-01 222676137 MIDDLESEX HEALTH SYSTEM INC MIDD 8603586395 28 CRESCENT STREET MIDDLETOWN CT 06457 SUSAN MARTIN 2012-08-14 8605223200 2010 2016-02-24 21:20:13Z VINCENT CAPECE - PRESIDENTCEO 28 CRESCENT STREET MIDDLETOWN CT 06457 874104 false X WWW.MIDDLESEXHOSPITAL.ORG X 1895 CT MIDDLESEX HEALTH SYSTEM'S MISSION IS TO PROVIDE FUNDRAISING FOR MIDDLESEX HOSPITAL, AN ACUTE CARE GENERAL HOSPITAL ESTABLISHED TO PROVIDE HIGH QUALITY INPATIENT AND OUTPATIENT HEALTH SERVICES. 13 9 6 11 0 0 0 0 860928 874104 0 0 0 0 860928 874104 0 0 0 0 628609 645192 0 0 858268 232319 228912 860928 874104 0 14591 14591 0 0 14591 14591 MIDDLESEX HEALTH SYSTEM'S MISSION IS TO PROVIDE FUNDRAISING FOR MIDDLESEX HOSPITAL, AN ACUTE CARE GENERAL HOSPITAL ESTABLISHED TO PROVIDE HIGH QUALITY INPATIENT AND OUTPATIENT HEALTH SERVICES. false false 0 874104 MIDDLESEX HEALTH SYSTEM, INC. MANAGES THE FUNDRAISING ACTIVITIES OF OF MIDDLESEX HOSPITAL. IT PROMOTES THE DEVELOPMENT OF COMPREHENSIVE HEALTHCARE RELATED SERVICES THROUGH MANAGEMENT OF FUNDRAISING ACTIVITIES. 0 true false false false false false false false false false false false false false false false true false false false false false false false false false false false true false false false false false false false false false false false false false true true false false true 0 0 true 6 true false false false false false false false false false false false X 13 9 false false false false false false false true true false false true true true true true true true true false CT X X SUSAN MARTIN 8603583005 28 CRESCENT STREET MIDDLETOWN CT 06457 X NANCY D'OENCH 1.0 X 0 0 0 CHANDLER HOWARD 1.0 X 0 0 0 HUGH MACKENZIE 1.0 X 0 0 0 BRUCE MACMILLIAN 1.0 X 0 0 0 JAMES MATSCHULAT 1.0 X 0 0 0 JOHN RAFAL 1.0 X 0 0 0 ERIC THORNBURG 1.0 X 0 0 0 BARBARA WEISS 1.0 X 0 0 0 GARY WILLIS 1.0 X X 0 0 0 DAVID BAGGISH MD 1.0 X X 0 340218 11827 R CHRISTOPHER SEATON 1.0 X X 0 0 0 GEOFFREY HERTER MD 1.0 X X 0 0 0 VINCENT CAPECE JR 1.0 X X 0 722515 181489 SUSAN MARTIN 1.0 X 0 380618 71166 LAURA MARTINO 40.0 X 295906 0 40256 BARBARA FERGIONE 40.0 X 121045 0 2438 ROBERT KIELY 0.0 X 0 1725232 2250 416951 3168583 309426 2 true true false NA 0 0 FUNDRAISING 900099 874104 874104 874104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 874104 874104 0 0 0 0 0 0 244052 244052 0 305769 0 305769 24054 24054 40516 40516 30801 30801 0 0 0 0 0 0 0 0 40062 40062 0 0 12159 12159 340 340 0 2529 2529 0 0 0 0 PURCHASED SERVICES 159895 159895 DUES & SUBSCRIPTIONS 1148 1148 MISCELLANEOUS EXPENSES 12779 12779 874104 0 15836 858268 14591 14591 14591 14591 0 0 0 0 X 14591 14591 14591 14591 14591 14591 0 0 X false true true X false X X X X false false false MIDDLESEX HOSPITAL 060646718 03 true 0 MIDDLESEX HEALTH SERVICES INC 222676140 04 true 0 2 0 X true true X X X X X false true false true true false false false false DAVID BAGGISH MD 0 331597 0 6353 0 2268 0 6353 0 5474 0 352045 0 0 VINCENT CAPECE JR 0 400022 0 87500 0 234993 0 175000 0 6489 0 904004 0 87500 SUSAN MARTIN 0 301345 0 66000 0 13273 0 67500 0 3666 0 451784 0 66000 LAURA MARTINO 183760 0 43200 0 68946 0 39000 0 1256 0 336162 0 43200 0 ROBERT KIELY 0 398142 0 198450 0 1128640 0 0 0 2250 0 1727482 0 198450 BENEFITS PART I, LINE 1A GROSS UP PAYMENTS - REPRESENTS THE FEDERAL AND STATE INCOME TAX PAID BY THE ORGANIZATION ON BEHALF OF THE INDIVIDUAL FOR CERTAIN NON-CASH BENEFITS PROVIDED. ONE EMPLOYEE NOTED ON FORM 990, PART VII, RECEIVED THIS BENEFIT. ESTABLISH COMPENSATION PART I, LINE 3 MIDDLESEX HEALTH SYSTEM'S OFFICER SALARIES AND BENEFITS ARE PAID BY MIDDLESEX HOSPITAL. SALARIES AND BENEFITS ARE DETERMINED UNDER THE COMPENSATION POLICIES OF MIDDLESEX HOSPITAL WHICH INCLUDE THE USE OF A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, THE FORM 990 OF OTHER ORGANIZATIONS, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN PART I, LINE 4B ALTHOUGH THE BENEFIT IS NOT PAYABLE UNTIL RETIREMENT, THE NONQUALIFIED RETIREMENT PLAN BENEFIT ACCRUES ANNUALLY AND THE PLAN PROVIDES THAT A PARTICIPANT VESTS AFTER FIVE (5) YEARS OF SERVICE. THE AMOUNT OF THE VESTED BENEFIT IS CONSIDERED "INCOME" TO THE EXECUTIVE AS IT IS EARNED. THE INCOME IS REPORTED ON THE EXECUTIVE'S W-2 FORM AND IS TAXABLE. MIDDLESEX HOSPITAL SUPPLEMENTS THE EXECUTIVE'S INCOME TO PAY FOR THIS TAX CONSEQUENCE AS THE EARNED BENEFITS VEST. THE TOTAL OF THESE SUPPLEMENTAL PAYMENTS, CUMULATIVE WITH INTEREST, ARE OFFSET AGAINST THE NONQUALIFIED RETIREMENT PLAN BENEFIT AT THE TIME OF RETIREMENT. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NONQUALIFIED RETIREMENT PLAN. THE AMOUNTS REPORTED BELOW REPRESENT BENEFITS ACCRUED DURING 2010, NOT PAYABLE UNTIL RETIREMENT. ROBERT KIELY $981,611 VINCENT CAPECE, JR. $115,357 LAURA MARTINO $ 36,329 COMPENSATION CONTINGENT ON REVENUE PART I, LINE 5 A AND 5B THERE ARE FOUR (4) BROAD CATEGORIES OF EXECUTIVE INCENTIVE GOALS: CLINICAL QUALITY AND PATIENT SATISFACTION (40%), FINANCIAL STRENGTH (30%), WORKPLACE ENVIRONMENT (15%), AND COMMUNITY BENEFIT/CHARITABLE MISSION EFFECTIVENESS (15%). WITHIN EACH CATEGORY ARE MORE SPECIFIC GOALS WHICH ARE DETERMINED FROM OUR OWN PAST EXPERIENCE AS WELL AS STATE AND NATIONAL BENCHMARK DATA. THE INCENTIVE COMPENSATION OF THE EXECUTIVE STAFF IS DETERMINED WITH REFERENCE TO PERFORMANCE RELATIVE TO THESE GOALS. COMPENSATION SCHEDULE J, PART II BONUS & INCENTIVE COMPENSATION - COLUMN B(II) THE AMOUNTS REPORTED REPRESENT INCENTIVE COMPENSATION PAYMENTS MADE IN CALENDAR YEAR 2010. PAYMENTS INCLUDE AMOUNTS EARNED IN 2009 AND DEFERRED, WHERE APPLICABLE. DEFERRED COMPENSATION - COLUMN (C) THE DEFERRED COMPENSATION REPORTED IN COLUMN (C) REPRESENTS INCENTIVE COMPENSATION EARNED IN 2010 THAT WILL BE PAID AND INCLUDED IN TAXABLE WAGES IN A LATER YEAR. REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11A DRAFT FORMS OF THE 990, INCLUDING REQUIRED SCHEDULES, ARE PROVIDED TO EACH BOARD MEMBER FOR REVIEW. MEMBERS REVIEW THE DOCUMENT AND DISCUSS IN DETAIL AT A BOARD MEETING. ANY QUESTIONS OR COMMENTS ARE PRESENTED TO EXECUTIVE MANAGEMENT PRIOR TO FILING. A COPY OF THE FINAL FORM 990 WILL BE PROVIDED TO THE BOARD PRIOR TO FILING WITH THE IRS VIA A WEB BASED COMMUNICATION PORTAL. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST FORMS ARE DISTRIBUTED ANNUALLY TO KEY EMPLOYEES, OFFICERS AND THE BOARD OF DIRECTORS. RESPONSES ARE RETURNED TO, TRACKED, AND REVIEWED BY THE COMPLIANCE OFFICER. INFORMATION REPORTED IS CONSIDERED PERSONAL AND CONFIDENTIAL AND ONLY DISCLOSED WHEN DEEMED NECESSARY TO PROTECT THE HOSPITAL AGAINST THE EFFECTS OF CONFLICTS OF INTEREST AND ONLY AFTER ADVISING THE REPORTING PERSON OF THE PROPOSED DISCLOSURE AND OF ITS EXTENT. MATERIAL CONFLICTS ARE REPORTED TO THE BOARDS AUDIT COMMITTEE FOR REVIEW AND DETERMINATION. IN ADDITION TO COMPLETING THE ANNUAL CONFLICT OF INTEREST FORM, BOARD MEMBERS MUST IMMEDIATELY DISCLOSE ANY INTEREST AND ALL MATERIAL FACTS TO THE BOARD OF DIRECTORS. THE BOARD THEN REVIEWS THE FACTS AND MAKES THE DETERMINATION AS TO WHETHER A SIGNIFICANT CONFLICT OF INTEREST EXISTS. IF SO, THE BOARD FOLLOWS DISABLING GUIDELINES TO DETERMINE IF THE BOARD MEMBER SHOULD BE ASKED TO RESIGN OR BE REMOVED. COMPENSATION POLICY FORM 990, PART VI, SECTION B, LINE 15B MIDDLESEX HEALTH SYSTEM'S OFFICER SALARIES AND BENEFITS ARE PAID BY MIDDLESEX HOSPITAL. OFFICER SALARIES ARE DETERMINED UNDER THE COMPENSATION POLICIES OF MIDDLESEX HOSPITAL WHICH INCLUDE THE FOLLOWING: EXECUTIVE TEAM COMPENSATION IS REVIEWED ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD. THE COMMITTEE HAS A CHARTER AND A POLICY STATEMENT SETTING FORTH A PROCESS AND CERTAIN GUIDELINES FOR DETERMINING COMPENSATION. EXECUTIVES RECEIVE A BASE SALARY AND HAVE THE OPPORTUNITY FOR INCENTIVE COMPENSATION WITHIN A RANGE SET BY THE POLICY. FOLLOWING THE CLOSE OF EACH FISCAL YEAR, THE COMMITTEE RECEIVES A MARKET ANALYSIS FROM INDEPENDENT CONSULTANTS REGARDING COMPENSATION AT PEER GROUPS OF COMPARABLE HOSPITALS AND HEALTH SYSTEMS. POSITIONS WITHIN THE EXECUTIVE TEAM ARE COMPARED TO BENCHMARK POSITIONS WITHIN THIS MARKET DATA AND THEIR COMPENSATION IS COMPARED TO THE DATA BOTH WITH RESPECT TO CASH COMPENSATION AND TOTAL COMPENSATION INCLUDING FRINGE BENEFITS. THE CEO RECOMMENDS THE INCENTIVE AWARDS AND BASE SALARY ADJUSTMENTS TO THE COMPENSATION OF THE EXECUTIVES WHO REPORT TO HIM, AND THE COMMITTEE REVIEWS THOSE RECOMMENDATIONS, APPROVES OR MODIFIES THEM, AND ALSO DETERMINES ANY INCENTIVE AWARD AND BASE SALARY ADJUSTMENT FOR THE CEO. THE CONSULTANTS PROVIDE A WRITTEN OPINION ANNUALLY CONFIRMING THAT THE COMPENSATION OF THE EXECUTIVES, AS ADJUSTED BY THIS PROCESS, IS "REASONABLE" WITHIN APPLICABLE IRS GUIDELINES. KEY EMPLOYEE COMPENSATION IS SET FOLLOWING THE GUIDELINES SET FORTH IN THE HOSPITAL COMPENSATION POLICY. THE OBJECTIVE OF THIS POLICY IS TO PAY EMPLOYEES BASED UPON HOSPITAL NEED, THE PROPER EXTERNAL LABOR MARKET AND PERFORMANCE. PUBLIC DISCLOSURE FORM 990, PART VI, SECTION C, LINE 19 MIDDLESEX HEALTH SYSTEM, INC. ("SYSTEM") IS A RELATED CORPORATION TO MIDDLESEX HOSPITAL. THE MIDDLESEX HEALTH SYSTEM MAINTAINS A QUALITY AND COMPLIANCE SECTION ON THE HOSPITAL'S WEBSITE, MIDDLESEXHOSPITAL.ORG. SYSTEM POSTS THE MOST CURRENT AUDITED FINANCIAL STATEMENTS AND FORM 990 WITH THOSE OF THE HOSPITAL AND OTHER AFFILIATES AS THEY BECOME AVAILABLE. THE CONFLICT OF INTEREST POLICY OF THE MIDDLESEX HEALTH SYSTEM IS ALSO POSTED ON THE WEBSITE IN THE FOR VENDORS AND SUPPLIERS SECTION. IN ADDITION, SYSTEM' FORM 990 IS AVAILABLE AT WWW.GUIDESTAR.ORG AND UPON REQUEST. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:NANCY D'OENCH TITLE:DIRECTOR HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:CHANDLER HOWARD TITLE:DIRECTOR HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:HUGH MACKENZIE TITLE:DIRECTOR HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:BRUCE MACMILLIAN TITLE:DIRECTOR HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JAMES MATSCHULAT TITLE:DIRECTOR HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOHN RAFAL TITLE:DIRECTOR HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ERIC THORNBURG TITLE:DIRECTOR HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:BARBARA WEISS TITLE:DIRECTOR HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:GARY WILLIS TITLE:VICE CHAIRMAN HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DAVID BAGGISH MD TITLE:CHIEF OF MEDICINE SECRETARY HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:R CHRISTOPHER SEATON TITLE:CHAIRMAN HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:GEOFFREY HERTER MD TITLE:ASSISTANT SECRETARY HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:VINCENT CAPECE JR TITLE:PRESIDENT/ CEO HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SUSAN MARTIN TITLE:VP FINANCE TREASURER HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ROBERT KIELY TITLE:FORMER PRESIDENT /CEO HOURS: MIDDLESEX HOSPITAL 28 CRESCENT STREET MIDDLETOWN CT 06457 060646718 HEALTHCARE CT 501(C)(3) 3 MSX HLTH SYS MIDDLESEX HEALTH SERVICES INC 28 CRESCENT STREET MIDDLETOWN CT 06457 222676140 HEALTHCARE CT 501(C)(3) 9 MSX HLTH SYS MIDDLESEX HOSPITAL FOUNDATION INC 28 CRESCENT STREET MIDDLETOWN CT 06457 273720822 MSX HSP SUPP CT 501(C)(3) 11B MSX HOSPITAL MIDDLESEX HEALTH RESOURCES INC 28 CRESCENT STREET MIDDLETOWN CT 06457 061089925 HEALTHCARE CT MID HEALTH SYS C Corp 1553111 4190847 1.00000 INTEGRATED RESOURCES FOR MIDDLESEX AREA 28 CRESCENT STREET MIDDLETOWN CT 06457 061462230 OUTPATIENT CARE CT MID HEALTH SYS C Corp 0 0 1.00000 MHS PRIMARY CARE INC 28 CRESCENT STREET MIDDLETOWN CT 06457 061472743 HEALTHCARE CT MID HEALTH SYS C Corp 10471053 3807340 1.00000 false true true false false false false false false false true false true true false true false false MHS PRIMARY CARE INC B 3398000 MIDDLESEX HOSPITAL C 3398000 MIDDLESEX HOSPITAL P 874100