LAWRENCE AND MEMORIAL HOSPITAL INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
LAWRENCE AND MEMORIAL HOSPITAL INC (EIN 06-0646704)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-08-15
IRS object ID
201242289349300729
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

FieldValueIRS element (for citing)
Timestamp2012-08-15T12:02:54-05:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PricewaterhouseCoopers LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1125 High StreetAddressLine1
CityBostonCity
StateMAState
ZIP Code02110ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN060646704EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Lawrence & Memorial HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlLAWRNameControl
Phone8604420711Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1365 Montauk AvenueAddressLine1
CityNew LondonCity
StateCTState
ZIP Code06320ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLugene InzanaName
TitleVP Chief Financial OfficerTitle
Date Signed2012-08-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NamePRICEWATERHOUSECOOPERS LLPName
Phone6175305000Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonBRUCE CUMMINGSNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1365 MONTAUK AVENUEAddressLine1
CityNEW LONDONCity
StateCTState
ZIP Code06320ZIPCode
FieldValueIRS element (for citing)
Gross Receipts347313810GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.lmhospital.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1912YearFormation
State Legal DomicileCTStateLegalDomicile
Activity Or Mission DescriptionTo improve the health of the region.ActivityOrMissionDescription
Nbr Voting Members Governing Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees2723TotalNbrEmployees
Total Nbr Volunteers408TotalNbrVolunteers
Total Gross UBI3200871TotalGrossUBI
Net Unrelated Business Txbl Income-367008NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year960530ContributionsGrantsPriorYear
Contributions Grants Current Year937909ContributionsGrantsCurrentYear
Program Service Revenue Prior Year318197093ProgramServiceRevenuePriorYear
Program Service Revenue CY331763213ProgramServiceRevenueCY
Investment Income Prior Year634461InvestmentIncomePriorYear
Investment Income Current Year7251547InvestmentIncomeCurrentYear
Other Revenue Prior Year1826256OtherRevenuePriorYear
Other Revenue Current Year1980952OtherRevenueCurrentYear
Total Revenue Prior Year321618340TotalRevenuePriorYear
Total Revenue Current Year341933621TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year174218799SalariesEtcPriorYear
Salaries Etc Current Year182672132SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year210142TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY199040TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year1165588TotalFundrsngExpCurrentYear
Other Expense Prior Year125219995OtherExpensePriorYear
Other Expenses Current Year131486920OtherExpensesCurrentYear
Total Expenses Prior Year299648936TotalExpensesPriorYear
Total Expenses Current Year314358092TotalExpensesCurrentYear
Revenues Less Expenses Prior Year21969404RevenuesLessExpensesPriorYear
Revenues Less Expenses CY27575529RevenuesLessExpensesCY
Total Assets BOY338671812TotalAssetsBOY
Total Assets EOY353189046TotalAssetsEOY
Total Liabilities BOY177055134TotalLiabilitiesBOY
Total Liabilities EOY187408373TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY161616678NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY165780673NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO IMPROVE THE HEALTH OF THE REGION.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense236419137Expense
Revenue331726730Revenue
DescriptionSEE SCHEDULE ODescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense915318Expense
Revenue36483Revenue
DescriptionEDUCATIONAL PROGRAMSDescription
FieldValueIRS element (for citing)
Total Program Service Expense237334455TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiestrueForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingtrueProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096242NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees2723NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members20NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonLUGENE INZANANamePerson
Telephone Number8604420711TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1365 MONTAUK AVENUEAddressLine1
CityNew LondonCity
StateCTState
ZIP Code06320ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (34 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
John E Allen DMD
Director2.0X000
Timothy D Bates
Director2.0X000
L James Carroll CPA
Director2.0X000
Ulysses B Hammond
CHAIRMAN2.0X000
R Alan Hunter
Director2.0X000
Robert Keltner MD
Director2.0X8221900
Maralynn Malerba
Secretary2.0X000
Granville Morris
Vice Chairman2.0X000
Leon Olivier
Director2.0X000
Toni Hoover PhD
Director2.0X000
Fred Conti
Treasurer2.0X000
Kathy Steamer
Director2.0X000
Carol Ridgeway
Director2.0X000
Scott D Bates
Director2.0X000
Mary Ellen Jukoski
Director2.0X000
Daniel P O'Shea
Director2.0X000
MARY ANN D BENTZ
PRES. MED. STAFF40.0X1075000
Bruce D Cummings
President / CEO35.25X654172048240X
Henry Amdur MD
President, Medical Staff2.0X165006470792000X
Donald Felitto MD
VP of Medical Staff40.0X1080000X
Lugene Inzana
VP Chief Financial Officer32.0345517033418X
Peter Fraser
VP Chief HR Officer UNTIL 6/1140.0228459033076X
William Stanley
VP Dev & Community Relations40.0206857028454X
Maureen Anderson
VP of General Counsel40.0260691030104X
Daniel Rissi
VP Chief Medical Officer34.0398160024315X
Kimberly Kalajainen
VP Chief Information Officer38.0215780032204X
Crista Durand
VP Strategic Planning/Mktg40.0278216027862X
Lauren Williams
VP Patient Care Services40.0252410016261X
PAMELA KANE
VP PHYSICIANS PRACTICE0.0145444017188X
Michael Alper
Medical Director/Physician40.0262138026164X
Richard Papatonio
Emergency Room Physician40.027231409800X
Ashok Maheshwari
Emergency Room Physician40.0252304030918X
Robert Gianfrocco
Emergency Room Physician40.0263912030104X
GARTH BALLANTYNE
CHAIRMAN DEPT OF SURGERY40.0499232010933X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4804381TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs47079TotalReportableCompFrmRltdOrgs
Total Other Compensation401041TotalOtherCompensation
Number Individuals GT100 K164NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
IPC HOSPITALISTS OF NEW ENGLAND PC
PO BOX 92284LOS ANGELESCA90009HOSPITALISTS1286001
Eastern CT Cardiology
196 Parkway South Suite 103WATERFORDCT06385MEDICAL DOCTORS1013120
Phoenix Medcom Inc
10 Meadow Sweet RoadCORTLANDT MANORNY10567Transcription Srvc699671
Anesthesia Associates of New London
365 Montauk AvenueNEW LONDONCT06365Anesthesiologists686294
Pathology Consultants of New London
365 MONTAUK AVENUENEW LONDONCT06365Medical Consultants442244
FieldValueIRS element (for citing)
Number Of Contractors GT100 K22NumberOfContractorsGT100K
Government Grants706176GovernmentGrants
All Other Contributions231733AllOtherContributions
Total Contributions937909TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
NET PATIENT SERVICES900099318813210318813210
LAB TESTING - ORR90009928658002865800
EMPLOYEE ASSISTANCE PROGRAM900099335071335071
PARAMEDIC SERVICES90009924561012456101
OTHER PROGRAM SERVICE REVENUE90009972930317293031
FieldValueIRS element (for citing)
Total Program Service Revenue331763213TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column6486532TotalRevenueColumn
Exclusion$6,486,532ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real951266Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real951266Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column951266TotalRevenueColumn
Exclusion$951,266ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities6119429Securities
Other25775Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities5380189Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities739240Securities
Other25775Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column765015TotalRevenueColumn
Exclusion$765,015ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionDINING ROOMDescription
Business Code900099BusinessCode
Total Revenue Column1029686TotalRevenueColumn
Exclusion$1,029,686ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue1029686TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column341933621TotalRevenueColumn
Related Or Exempt Function Income328562342RelatedOrExemptFunctionIncome
Unrelated Business Revenue3200871UnrelatedBusinessRevenue
Exclusion$9,232,499ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total3010036Total
Management And General2798614ManagementAndGeneral
Fundraising211422Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total138155614Total
Program Services108255222ProgramServices
Management And General29673549ManagementAndGeneral
Fundraising226843Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4302812Total
Program Services3304632ProgramServices
Management And General991255ManagementAndGeneral
Fundraising6925Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total27171453Total
Program Services20868134ProgramServices
Management And General6259591ManagementAndGeneral
Fundraising43728Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total10032217Total
Program Services7704912ProgramServices
Management And General2311160ManagementAndGeneral
Fundraising16145Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1207625Total
Program Services1200ProgramServices
Management And General1206425ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total199040Total
Fundraising199040Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total4182448Total
Program Services3650511ProgramServices
Management And General531937ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total8263210Total
Program Services6567212ProgramServices
Management And General1650756ManagementAndGeneral
Fundraising45242Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total3122765Total
Program Services577904ProgramServices
Management And General2540028ManagementAndGeneral
Fundraising4833Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4402073Total
Program Services109636ProgramServices
Management And General4292437ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total785229Total
Program Services303247ProgramServices
Management And General479124ManagementAndGeneral
Fundraising2858Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total2212181Total
Program Services2212181ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total17199566Total
Program Services10396501ProgramServices
Management And General6802652ManagementAndGeneral
Fundraising413Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total4575599Total
Program Services4575599ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
PURCHASED SVCS1893147985671361031980744536
MEDICAL & SURGICAL39150096388580072869845105
EQUIP RENTAL & MAINTENANCE931608768009932515094
BAD DEBTS1386521013865210
CONSULTING204888423362200547620046

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2224468Total
Program Services692856ProgramServices
Management And General1193160ManagementAndGeneral
Fundraising338452Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total314358092Total
Program Services237334455ProgramServices
Management And General75858049ManagementAndGeneral
Fundraising1165588Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY29181327BOY
EOY40113126EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY46092BOY
EOY20328EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY28474179BOY
EOY28744360EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY763155BOY
EOY574684EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3796086BOY
EOY4528017EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1624613BOY
EOY1739804EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis331391770LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec210414909LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY109171110BOY
EOY120976861EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY133522673BOY
EOY131544880EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY5876049BOY
EOY5607933EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY26216528BOY
EOY19339053EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY338671812BOY
EOY353189046EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY33333570BOY
EOY34792940EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY65987539BOY
EOY82335373EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY77734025BOY
EOY70280060EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY177055134BOY
EOY187408373EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY137717053BOY
EOY142478037EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY18249300BOY
EOY17792779EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY5650325BOY
EOY5509857EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY161616678BOY
EOY165780673EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY338671812BOY
EOY353189046EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses27575529ReconcilationRevenueExpenses
Reconcilation Other Changes-23411534ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$30,437OtherActivitiesAmount
Total Lobbying Expenditures IIB30437TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierLobbying ActivitiesIdentifier
Return ReferenceSchedule C, Part II-B, Line 1ReturnReference
ExplanationThe organization pays membership dues to the Connecticut Hospital Association which lobbies on behalf of its member organizations. These lobbying activities are defined as CHA staff communication with the federal and state governments to influence legislation. The Organization pays membership dues to member organizations which may engage in lobbying activities. therefore, a portion of the dues may be attributable to lobbying activities.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance14741092BeginningOfYearBalance
Investment Earnings Or Losses17500InvestmentEarningsOrLosses
Other Expenditures324466OtherExpenditures
Administrative Expenses35237AdministrativeExpenses
End Of Year Balance14398889EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance14150668BeginningOfYearBalance
Investment Earnings Or Losses1282741InvestmentEarningsOrLosses
Other Expenditures652042OtherExpenditures
Administrative Expenses40275AdministrativeExpenses
End Of Year Balance14741092EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance14857509BeginningOfYearBalance
Investment Earnings Or Losses-154454InvestmentEarningsOrLosses
Other Expenditures539291OtherExpenditures
Administrative Expenses13096AdministrativeExpenses
End Of Year Balance14150668EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.84000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.16000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.00000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis301884OtherCostOrOtherBasis
Book Value301884BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis105661471OtherCostOrOtherBasis
Depreciation63052576Depreciation
Book Value42608895BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis5784899OtherCostOrOtherBasis
Depreciation1701613Depreciation
Book Value4083286BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis203329727OtherCostOrOtherBasis
Depreciation141506116Depreciation
Book Value61823611BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis16313789OtherCostOrOtherBasis
Depreciation4154604Depreciation
Book Value12159185BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings120976861TotalOfBookValueLandBuildings

Other Assets OtherAssets (6 entries)

DescriptionDescriptionBook ValueBookValue
OTHER RECEIVABLES3173599
DEBT SERVICE FUND1109892
DEBT SERVICE RESERVE FUND2247370
DEFERRED FINANCING COSTS1938833
DUE FROM AFFILIATES2441664
CONSTRUCTION FUND8427695
FieldValueIRS element (for citing)
Total Book Value Other Assets19339053TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (10 entries)

DescriptionDescriptionAmountAmount
DUE TO THIRD PARTY AGENCIES$7,838,088
DEFERRED COMPENSATION$94,554
SELF ASSURANCE RESERVES$13,768,365
ACCRUED POST RETIREMENT BENEFIT$1,281,454
ACCRUED PENSION$8,800,979
ACCRUED 401K MATCH$870,698
ACCRUED MIN PENSION LIABILITY$32,375,536
ASSET RETIREMENT OBLIGATION$445,355
DUE TO L&M CORPORATION$1,913,991
DEFERRED FINANCING COST$2,891,040
FieldValueIRS element (for citing)
Total Of Amounts70280060TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierSCHEDULE D, PART V, LINE 4Identifier
Return ReferenceTHE ORGANIZATION'S ENDOWMENT FUNCTIONS TO SUPPORT AND PROVIDE INCOME FORReturnReference
ExplanationTHE FURTHERANCE OF THE HEALTHCARE MISSION OF LAWRENCE & MEMORIAL HOSPITAL.Explanation

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable

FieldValueIRS element (for citing)
RegionCentral America and the CaribbeanRegion
Type Of Activities ConductedInvestmentsTypeOfActivitiesConducted
Total Expenditures33839206TotalExpenditures
FieldValueIRS element (for citing)
Subtotal Amount Spent33839206SubtotalAmountSpent
Total Amount Spent33839206TotalAmountSpent
Transfer To Foreign CorptrueTransferToForeignCorp
Interest In Foreign TrustfalseInterestInForeignTrust
Own Foreign CorptrueOwnForeignCorp
Passive Foreign Invest CofalsePassiveForeignInvestCo
Foreign PartnershipfalseForeignPartnership
Boycott CountriesfalseBoycottCountries

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsXMailSolicitations
Email SolicitationsXEmailSolicitations
Phone SolicitationsXPhoneSolicitations
In Person SolicitationsXInPersonSolicitations
Solicitation Of Non Govt GrantsXSolicitationOfNonGovtGrants
Solicitation Of Govt GrantsXSolicitationOfGovtGrants
Special Fundraising EventsXSpecialFundraisingEvents
Agreement Ref FundraisingtrueAgreementRefFundraising

Fundraiser Activity Information FundraiserActivityInformation

FieldValueIRS element (for citing)
Name Of IndividualGhiorsi Sorrenti IncNameOfIndividual
ActivityCapital CampaignActivity
Fundraiser Control Of FundsfalseFundraiserControlOfFunds
Amount Retained By Contractor199040AmountRetainedByContractor
FieldValueIRS element (for citing)
Total Retained By Contractors199040TotalRetainedByContractors
Licensed StatesCTLicensedStates

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage250.FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense1339418TotalCommunityBenefitExpense
Net Community Benefit Expense1339418NetCommunityBenefitExpense
Percent Of Total Expense0.00450PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense46031668TotalCommunityBenefitExpense
Direct Offsetting Revenue39928036DirectOffsettingRevenue
Net Community Benefit Expense6103632NetCommunityBenefitExpense
Percent Of Total Expense0.02030PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense808721TotalCommunityBenefitExpense
Direct Offsetting Revenue585829DirectOffsettingRevenue
Net Community Benefit Expense222892NetCommunityBenefitExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense48179807TotalCommunityBenefitExpense
Direct Offsetting Revenue40513865DirectOffsettingRevenue
Net Community Benefit Expense7665942NetCommunityBenefitExpense
Percent Of Total Expense0.02550PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Persons Served64242PersonsServed
Total Community Benefit Expense1762186TotalCommunityBenefitExpense
Direct Offsetting Revenue36483DirectOffsettingRevenue
Net Community Benefit Expense1725703NetCommunityBenefitExpense
Percent Of Total Expense0.00570PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Persons Served2200PersonsServed
Total Community Benefit Expense947757TotalCommunityBenefitExpense
Direct Offsetting Revenue150DirectOffsettingRevenue
Net Community Benefit Expense947607NetCommunityBenefitExpense
Percent Of Total Expense0.00320PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Persons Served2927PersonsServed
Total Community Benefit Expense1725774TotalCommunityBenefitExpense
Direct Offsetting Revenue2456101DirectOffsettingRevenue
Net Community Benefit Expense-730327NetCommunityBenefitExpense
Percent Of Total Expense0.00240PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Persons Served406PersonsServed
Total Community Benefit Expense9950TotalCommunityBenefitExpense
Net Community Benefit Expense9950NetCommunityBenefitExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Persons Served1845PersonsServed
Total Community Benefit Expense144978TotalCommunityBenefitExpense
Direct Offsetting Revenue1000DirectOffsettingRevenue
Net Community Benefit Expense143978NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Persons Served71620PersonsServed
Total Community Benefit Expense4590645TotalCommunityBenefitExpense
Direct Offsetting Revenue2493734DirectOffsettingRevenue
Net Community Benefit Expense2096911NetCommunityBenefitExpense
Percent Of Total Expense0.00700PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Persons Served71620PersonsServed
Total Community Benefit Expense52770452TotalCommunityBenefitExpense
Direct Offsetting Revenue43007599DirectOffsettingRevenue
Net Community Benefit Expense9762853NetCommunityBenefitExpense
Percent Of Total Expense0.03250PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Building Expense89405TotalCommunityBuildingExpense
Direct Offsetting Revenue1700DirectOffsettingRevenue
Net Community Building Expense87705NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Persons Served340PersonsServed
Total Community Building Expense107282TotalCommunityBuildingExpense
Net Community Building Expense107282NetCommunityBuildingExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Persons Served64PersonsServed
Total Community Building Expense1012TotalCommunityBuildingExpense
Net Community Building Expense1012NetCommunityBuildingExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Persons Served16PersonsServed
Total Community Building Expense153TotalCommunityBuildingExpense
Net Community Building Expense153NetCommunityBuildingExpense

Total Total

FieldValueIRS element (for citing)
Persons Served420PersonsServed
Total Community Building Expense197852TotalCommunityBuildingExpense
Direct Offsetting Revenue1700DirectOffsettingRevenue
Net Community Building Expense196152NetCommunityBuildingExpense
Percent Of Total Expense0.00070PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$13,865,210BadDebtExpenseAmount
Amount Attributable To277304AmountAttributableTo
Amount Reimbursed By Medicare99961314AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare121370981CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-21409667MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Lawrence & Memorial HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1365 Montauk AvenueAddressLine1
CityNew LondonCity
StateCTState
ZIP Code06320ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours
Er OtherXErOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Lawrence & Memorial HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
SCHEDULE H, PART I, LINE 3C:It is the philosophy and policy of Lawrence & Memorial Hospital (the "Hospital") that medically necessary health care services should be available to all individuals regardless of their ability to pay. Charity care applies to all uninsured patients (defined as earning less than 250% of the poverty guidelines) as described in 19a-673 of the Connecticut General Statutes. The Hospital will meet or exceed the guidelines set-forth by the Connecticut Hospital Association ("CHA") on the Statewide Discount Policy for Uninsured Patients. Care will be provided free for those uninsured patients who request assistance and verify their annual income is less than 250% of the Federal Income Poverty Level ("FPL"). Liquid assets must not exceed $50,000 (Stocks, bonds, cash, 401, IRA, CD etc.) excluding primary residence and primary motor vehicle). Business assets, rental property, secondary residence, recreational vehicles and other such luxury items will be applied to the liquid assets. Care will be discounted on a sliding scale for self-pay patients who have no third party insurance to cover services with an annual income that is between 250% and 400% of the FPL and have assets less than $50,000, in accordance with the following: 251% - 300% = Cost of Charge 301% - 350% = 40% 351% - 400% = 30%
SCHEDULE H, PART I, LINE 7:The amounts reported on Part I, Line 7 were calculated as direct, separately identifiable costs incurred by the Hospital plus an allocation of overhead. PART I, LINE 7, COLUMN F THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $13,865,210.
SCHEDULE H, PART III, LINE 4:The Hospital uses a cost reporting system to determine the bad debt expense. The amount of bad debt expense (at cost) reported on Part III, Line 2 is taken directly from the audited financial statements. The amount of bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy is calculated as 2% of the amount of bad debt (at cost) from the audited financial statements. The amount of 2% represents the bad debt amount that could have been qualified for charity care as this the percentage of gross revenue that is self paid.
SCHEDULE H, PART III, LINE 8:The Medicare shortfall of ($21,409,667) reported in Part III, Line 7 was calculated based on cost reporting. This amount should be treated as community benefit because the rates paid by Medicare do not accurately reflect the cost of care provided by the Hospital. Accordingly, the Hospital must subsidize the cost of care provided to Medicare beneficiaries with other revenues.
SCHEDULE H, PART III, LINE 9B:In accordance with its written credit and collection policy, the Hospital will not pursue collection efforts, directly or through collection agencies, on the portion of a patient's bill for which that patient has established eligibility for charity care.
SCHEDULE H, PART VI, LINE 2The Hospital employs a variety of strategies in conducting community health needs assessments. The most recent comprehensive assessment, covering the entire New London County and completed as a collaborative effort with several partner organizations, was conducted under the guidance of an outside expert. Those partner organizations included the County's two hospitals, all three Federally Qualified Health Centers, the New London County Medical Society, all full-time public health organizations (three), the County's Community Action Agency and a number of other important health care organizations who formed the Assessment Oversight Committee and informed the process from design to implementation to reporting. The assessment identified the most important health care and public health issues in New London County using scientifically valid data, comparative information, and input from local residents, providers and leaders. Indicators were computed from an extensive set of secondary health-related data and a random sample community household telephone survey. This study is currently being updated. The Hospital reviews disease incidence and prevalence rates for the local community, state, and nation. Rates are collected from medical journals, the Connecticut Department of Health, or national health resources such as the Kaiser Family Foundation or Centers for Disease Control. This analysis informs the Hospital on the health status of the community and is used to focus program and service development on areas of greatest concern. Information on community needs is also gathered through partnerships with other community organizations such as the United Way, the Ledge Light Health District, and other local non-profits. Periodic review of data and updating as appropriate is conducted. The Hospital completes a physician manpower study regularly. This study, conducted by an outside consultant, documents the demand for physicians by specialty based on physician-to-population ratios, the supply of physicians in the community, and the resultant gaps between demand and supply. The analysis informs the Hospital of deficiencies in physician supply and helps focus recruitment efforts to meet the demands of the community. All community benefit activities are regularly evaluated for impact and effectiveness and audited for compliance with the organization's community benefit policy.NEEDS ASSESSMENT:
SCHEDULE H, PART VI, LINE 3In accordance with its charity care policy, the Hospital notifies patients of the availability of financial assistance using several methods. 1) Signage indicating the availability of charity care is posted in English and Spanish in Patient Accounts, Health Access Management and certain Clinical Areas. Summaries of the programs will also be available in those areas. 2) Patient Financial Advisors will attempt to visit all inpatients registered as self-pay patients. A summary explaining charity care will be given to the patient or guarantor when this visit occurs. 3) Patients with no insurance will receive an initial letter within one week of discharge informing them that the hospital considers them "insured" per the Connecticut General Statues Section 19a-673. It is the responsibility of the patient to advise the hospital if they believe they qualify as "uninsured" (at or under 250% of the FPG). 4) A series of monthly statements will be sent following discharge. Each statement will remind the patient of the availability of charity care.PATIENT EDUCATION OF ELGIBILITY FOR ASSISTANCE:
SCHEDULE H, PART VI, LINE 4Population size The communities that comprise the service area of the Hospital include ten towns along the Connecticut shoreline between Rhode Island and the Connecticut River and inland to Salem, CT, with a total population of approximately 180,000 people year-round, increasing to 250,000 in the summer. Our communities represent a broad mix of urban, suburban, and rural areas. General Demographics The towns and cities in this area are very diverse, not only socio-economically but also in terms of race, ethnicity, faith tradition, resident transience, employment, health insurance status, and educational attainment. From 2000 to 2010, there was a slight overall growth in population in new London county with dramatic changes occurring in ethnic and racial composition of the local population; the percentage of Hispanics increased by 75.49%, African Americans increased by 16.99%, Native Americans increased by 0.72%, Asian/Hawaiian/Pacific Islanders increased by 19.2%, those who indicate "other" increased by 63.9% and those indicating two or more races increased by 44.3%. Other increases have occurred in the Eastern European and Haitian populations, among others, with local school districts reporting significant percentages of children from homes where English is not the primary language. Changes in the ethnic and racial makeup of County residents over time will impact the burden of disease and demand for health services. Major Employers The region has transitioned from a largely defense industry-based economy to one that relies heavily upon employment in the service and trade sectors and in general has a higher percentage of persons employed in those sectors -with corresponding lower rates of pay- which is correlated with the lower per capita income and greater economic vulnerability. Major employers include the Mashantucket Pequot and Mohegan Tribes (Foxwoods Resort and Casino and Mohegan Sun Casino respectively), Pfizer Global Research and Development, educational institutions (Connecticut College, Mitchell College and the U.S. Coast Guard Academy), General Dynamics/Electric Boat, Dominion, and Lawrence & Memorial. Primary Social and Health Care Factors In the urban centers of the region, racial and ethnic health disparities, higher poverty and unemployment rates, lower levels of educational attainment, limited access to affordable housing and transportation, higher rates of death from chronic illness, and a greater likelihood of residents not having health insurance, all of which present particular challenges. Median household income in the Hospital service area is far below that of the state, with African American and Hispanic families' incomes significantly lower than White families' incomes. The region includes one priority school district in which families speak over 30 different languages and approximately 40% of children change schools each year. Two of our communities have a greater percentage of children living in poverty than the state average of 24%. The chronic disease burden is high throughout New London County with Norwich and New London having higher percentages with 3+ chronic conditions than other regions. These two communities also have a higher percentage of people who self-identify as "Not Well" and, along with some outlying towns, have the least favorable indicators for chronic disease.COMMUNITY INFORMATION:
SCHEDULE H, PART VI, LINE 5In addition to meeting an identified need in the community, the Hospital's community building activities contribute to an overall healthy community and support the Hospital's role as good corporate citizen. This social impact is measured in terms of community vibrancy, and breadth and depth of community activities that enhance quality of life in the region. These activities are not included elsewhere on the Schedule H. The majority of the Hospital's community building activities fall into the category of coalition building, in which we are engaged with a broad range of community partners in improving community health in the areas of parish nursing, teen pregnancy prevention, access to care, and reduction of chronic disease. Additionally, we are engaged in community support activities such as support for local faith community leaders, disaster preparedness activities that go beyond what is required by regulation, health-related career development activities, and support for partner non-profits also engaged in community development such as the disbursement of scholarships. In the area of leadership development and training for community members, we provide training for professionals in injury prevention strategies, and health career leadership development and workforce development. We participate in economic development activities through the region's Chamber of Commerce. Community health improvement advocacy includes promotion of injury prevention policy changes and support for improved access to healthcare. All of these activities have as their primary purpose to benefit the community and are carried out without remuneration.PROMOTION OF COMMUNITY HEALTH:
OTHER INFORMATION:A majority of the Hospital's trustees are members of the community served by the Hospital and are not employed by the Hospital nor are they family members of persons employed by the Hospital. The Hospital extends medical staff privileges to all qualified physicians in the community who wish to join the staff, consistent with the size and nature of its facilities. Excess receipts from operations are devoted to improvement of facilities, debt service, medical training and research. The Hospital's community benefit programs and services align with the principles as set forth in the organization's community benefit policy. Those principles include: 1. Emphasis on programs to meet a significant unmet health need including efforts to identify and include vulnerable populations or those most at-risk as determined by risk factors which predispose those populations toward a higher incidence of disease and/or barriers to obtaining appropriate healthcare. 2. Emphasis on primary prevention and including at least one of three primary prevention strategies: health promotion, disease prevention, and health protection. Health promotion entails encouraging healthy lifestyles; disease prevention focuses on individuals identified as at-risk for health problems; health protection activities influence the environment to support healthy behaviors. 3. Programs should develop evidence-based links between clinical services and health improvement activities delivered both inside and outside the hospital. 4. Programs should focus on targeting charitable resources that mobilize and build capacity within existing community assets while minimizing duplication of effort. 5. Programs should emphasis collaboration with community stakeholders. Community involvement in governance and advisory groups Community engagement in the planning, implementation and evaluation of the Hospital's initiatives is of utmost importance. Consumers and stakeholder organizations participate in a range of activities so as to ensure that many perspectives are considered. One example of broad community involvement is in our most recent community health needs assessment study, which was led by a multi-member stakeholder group representing the communities we serve. The study methodology included a language appropriate household survey and key informant interviews. Additionally, our community-based programs each have advisory groups, including the Faith in Action Network (parish nursing), Safe Kids New London County (injury prevention), Teen Pregnancy Prevention Task Force. The Reconnecting the Homeless Program engages in community collaboratives that provide important input for the program and emphasis is placed on hospital representative participation in other community organizations so as to provide opportunities to hear from our consumers. The Hospital's Board of Directors is made up of community leaders who reside in the hospital's primary service area. These volunteers give countless hours of service to the hospital in their oversight role. They are involved in the strategic planning, in fundraising, and in general stewardship among other responsibilities. Our corporators are our community-liaisons and represent all sectors of our communities providing input and feedback regularly. Medical staff privileges are offered to all qualified physicians in the community. Health advocacy initiatives The Hospital is involved in health advocacy initiatives to reduce unintentional injury to children, and to improve the healthcare, public health and social service systems in New London County. Our Safe Kids New London County program plays a leadership role on the local, state and national levels in advocating for public policies that reduce injury risk for children. The Hospital's leadership in the New London County Health collaborative, and partnership with over 12 other organizations including Backus Hospital, three health departments, three Federally Qualified Health Centers, the county anti-poverty agency, two homecare organizations, and the county's largest child advocacy organization, has resulted in the collaborative being looked to as a valuable resource for policy makers. Additionally, the efforts of the New London County Health Collaborative are having an impact on community health, initially in the area of improved access to care.
STATE FILING OF COMMUNITY BENEFIT REPORTCT,990 SCHEDULE H, PART VI

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensesfalseWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (16 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Bruce D Cummings
522740077543053889040852073880702412000
Henry Amdur MD
16500647079000000020001650064907900
Lugene Inzana
3042700404370810098000236180378935000
Peter Fraser
20505401867504730094580236180261535000
William Stanley
167550023780015527081500203040235311000
Maureen Anderson
2362260239350530098000203040290795000
Daniel Rissi
35100704483102322098000145150422475000
Kimberly Kalajainen
19172601607207982086440235600247984000
Crista Durand
2446010330750540075580203040306078000
Lauren Williams
2248740252140232209002072590268671000
PAMELA KANE
1350700100000374031310140570162632000
Michael Alper
2608480001290093440168200288302000
Richard Papatonio
270299000201509800000282114000
Ashok Maheshwari
2510140001290098000211180283222000
Robert Gianfrocco
263612000300098000203040294016000
GARTH BALLANTYNE
4485870500000645000109330510165000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSCHEDULE J, PART I, LINES 1A and 1BIdentifier
Return ReferenceWILLIAM STANLEY, VP OF DEVELOPMENT, HAS A NONTAXABLE MEMBERSHIP TO THEReturnReference
ExplanationTHAMES CLUB IN NEW LONDON. THE THAMES CLUB IS A SOCIAL CLUB THAT ALLOWS NETWORKING WITH POTENTIAL DONORS OR BOARD MEMBERS. Bruce Cummings, President & CEO, authorizes William Stanley's membership in The Thames Club in his role as Vice President of Development & Community Relations of Lawrence & Memorial Hospital. In an effort to conduct business in the community and represent Lawrence & Memorial Hospital, The Thames Club provides an appropriate setting for meetings with Board Members and both current and potential donors. SCHEDULE J, PART I, LINE 4B LAWRENCE & MEMORIAL HOSPITAL ESTABLISHED A SECTION 457(F) CEO SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR THE HOSPITAL'S PRESIDENT AND CHIEF EXECUTIVE OFFICER, BRUCE D. CUMMINGS. AMOUNTS ARE CREDITED TO THE RETIREMENT ACCOUNT IN MONTHLY INSTALLMENTS THROUGHOUT EACH PLAN YEAR. PLAN AMOUNTS WILL BE PAID ONLY IF CERTAIN CONDITIONS ARE MET, INCLUDING REMAINING EMPLOYED BY THE HOSPITAL THROUGH AGE 65, AS OUTLINED IN THE PLAN AGREEMENT. DURING 2010, SECTION 457(F) CONTRIBUTIONS OF $67,280 WERE CREDITED TOWARDS THE PLAN. SCHEDULE J, PART I, LINE 7 L&M HOSPITAL HAS AN EXECUTIVE INCENTIVE PLAN. BONUSES ARE AWARDED UNDER THE PLAN BASED ON THE EXECUTIVE MEETING TEAM AND PERSONAL GOALS. THE PLAN ALSO INCLUDES A DISCRETIONARY COMPONENT. MEMBERS OF L&M HOSPITAL'S SENIOR MANAGEMENT TEAM (PRESIDENT & VICE PRESIDENTS) ARE ELIGIBLE FOR ANNUAL EXECUTIVE INCENTIVE PLAN AWARDS, BASED ON PRE-SET PERCENTAGES OF BASE SALARY TO EACH EXECUTIVE BASED ON THE HOSPITAL MEETING ITS FINANCIAL AND WORK-PLAN GOALS AS WELL AS THE EXECUTIVE MEETING PREDETERMINED INDIVIDUAL AND TEAM GOALS. IN THE CASE OF AN EXECUTIVE NOT MEETING ALL OF THEIR PREDETERMINED GOALS, A PERCENTAGE OF THE ELIGIBLE TARGET AMOUNT MAY BE AWARDED.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
CT HEFA VAR RATE DEMAND REV BONDS SERIES E
06080618620774LS892008-01-1622990000SEE SCHEDULE Ofalsefalsefalse
CT HEFA FIXED RATE REV BONDS SERIES F
060806186VARIOUS002011-09-1561831040SEE SCHEDULE Ofalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindCapitalized InterestCapitalizedInterestAmount UnspentAmountUnspent
229900000000022990000truefalsetruetrue
61831040010217490035523497truefalsefalsetrue025285794

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Bond Counsel Routinely EngagedtrueBondCounselRoutinelyEngaged
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Post Issuance Compliance ProcdrstruePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
falsetruefalsefalsefalsetrue
falsefalsefalsefalsefalsefalse

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Northeast Utilities
Board Member/Director1219512Utilities Servicesfalse
BLUECROSS BLUESHIELD
SECRETARY'S IN LAW IS CEO1295693INSURANCE PREMIUMSfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, PART III, LINE 4LAWRENCE & MEMORIAL HOSPITAL PROVIDES QUALITY MEDICAL CARE REGARDLESS OFRACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF LAWRENCE & MEMORIAL HOSPITAL, WE RECOGNIZE THAT NOT ALL PERSONS HAVE THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES; AND, FURTHER, WE BELIEVE THAT A PART OF OUR MISSION IS TO CARE FOR THE MEDICALLY UNDER-SERVED IN OUR COMMUNITY WITH RESPECT TO PROVIDING HEALTH CARE SERVICES AND HEALTH CARE EDUCATION. IN KEEPING WITH OUR HOSPITAL'S MISSION OF "IMPROVING THE HEALTH OF OUR REGION" AND OUR COMMITMENT TO SERVE ALL MEMBERS OF ITS COMMUNITY, WE PROVIDE: -FREE CARE AND/OR SUBSIDIZED CARE. -CARE PROVIDED TO PERSONS COVERED BY GOVERNMENT PROGRAMS AT BELOW COST. -A BROAD RANGE OF HEALTH CARE ACTIVITIES, PROGRAMS AND SERVICES TO SUPPORT OUR COMMUNITY. -A SPECIAL COMMUNITY OUTREACH PROGRAM. THESE PROGRAMS WILL BE CONSIDERED WHERE THE NEED AND/OR AN INDIVIDUAL'S INABILITY TO PAY COEXIST. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, EMERGENCY RESPONSE PROGRAMS, COMMUNITY HEALTH SCREENINGS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, AND THE MEDICALLY UNDER-SERVED, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. DURING THE YEAR ENDED SEPTEMBER 30, 2011, LAWRENCE & MEMORIAL HOSPITAL SERVED 15,342 HOSPITALIZED PATIENTS AND 184,608 PATIENT VISITS THROUGH OUR AMBULATORY PROGRAMS. IN ADDITION, 84,175 EMERGENCY CASES CAME THROUGH OUR EMERGENCY FACILITIES IN NEW LONDON (47,625) AND GROTON (36,550). SAME DAY SURGERIES ACCOUNTED FOR 7,224 PROCEDURES. RECOGNIZING ITS MISSION TO THE COMMUNITY, LAWRENCE & MEMORIAL HOSPITAL PROVIDES CARE TO PERSONS COVERED BY FEDERAL AND STATE PROGRAMS AT OR BELOW COST. PATIENTS WHO WERE COVERED BY MEDICARE AND MEDICAID RECEIVED COMPREHENSIVE CARE TO THE EXTENT THAT THE HOSPITAL WAS REIMBURSED APPROXIMATELY $24.1 MILLION IN PAYMENTS BELOW THE ACTUAL COST OF THE SERVICES PROVIDED. LAWRENCE & MEMORIAL HOSPITAL ALSO RECOGNIZES CHARITY CARE IN FULFILLING ITS MISSION TO THE ENTIRE COMMUNITY. IN FY 11, OUR CHARITY CARE PROVIDED TO UNINSURED PATIENTS TOTALED $1.5 MILLION. IN ADDITION, LAWRENCE & MEMORIAL HOSPITAL EXPERIENCED A BAD DEBT EXPENSE OF $13.8 MILLION FROM CARE PROVIDED TO PATIENTS, THE COST OF WHICH WAS ULTIMATELY NON-COLLECTIBLE. CHARITY CARE IS ALSO PROVIDED THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR, BASED UPON ACTIVITIES AND SERVICES WHICH LAWRENCE & MEMORIAL HOSPITAL BELIEVES WILL SERVE A "BONA FIDE" COMMUNITY HEALTH CARE NEED. OVERVIEW ======== LAWRENCE & MEMORIAL HOSPITAL BELIEVES THAT MOTIVATION THROUGH EDUCATION IS A STRONG FORCE IN HELPING INDIVIDUALS PREVENT ILLNESSES AND MAKE INFORMED CHOICES ABOUT THEIR BODIES AND WHAT HAPPENS TO THEM. OUR APPROACH PROVIDES ACCURATE HEALTH INFORMATION THROUGH A VARIETY OF PROGRAMMING EFFORTS SO CONSUMERS FEEL A PART OF THE DECISION-MAKING PROCESS AND HAVE AN ACTIVE ROLE IN THOSE DECISIONS. AS A RESULT, LAWRENCE & MEMORIAL REMAINS AMONG CONNECTICUT'S MOST PRO-ACTIVE HOSPITALS IN OFFERING DIVERSIFIED AND BROAD-BASED COMMUNITY HEALTH EDUCATION PROGRAMS. THESE PROGRAMMING EFFORTS INCLUDE COMMUNITY LECTURES AT THE HOSPITAL, CABLE TV ACCESS PROGRAMMING, RELIABLE HEALTH INFORMATION WITH OVER 2,500 HEALTH-RELATED STORIES ON THE HOSPITAL'S WEB SITE (WWW.LMHOSPITAL.ORG), TOURS, SUPPORT GROUPS, COMMUNITY EDUCATIONAL PROGRAMS, PUBLIC SERVICE ANNOUNCEMENTS AND SCREENING AND HEALTH FAIRS, INCLUDING ONSITE VISITS TO LARGE AND SMALL COMPANIES. LAWRENCE & MEMORIAL'S COMMUNITY OUTREACH PROGRAM HAS BEEN ABLE TO REACH A BROAD, CROSS-SECTION OF THE GREATER NEW LONDON COMMUNITY IN SOUTHEASTERN CONNECTICUT. THE COMMUNITY CONTRIBUTIONS ALSO INCLUDE SOME UNMENTIONED COMMUNITY BENEFITS SUCH AS: ADMINISTRATIVE AND FINANCIAL SUPPORT, OFFICE SPACE AND A LIBRARY OF ACCESSIBLE RESOURCES TO LEADERSHIP WITHIN THE VARIOUS FAITH COMMUNITIES IN OUR REGION. IN ADDITION, THERE ARE MANY COMMUNITY ORGANIZATIONS THAT WE SUPPORT AS PART OF BEING A GOOD NEIGHBOR AND TO RECOGNIZE THEIR EFFORTS IN OUR COMMUNITY.
Form 990, Part VI, Line 2Board members Jim Carroll and Alan Hunter are brothers in law.GRANVILLE MORRIS AND LEON OLIVER ARE BOTH BOARD MEMBERS ON THE ESSEX FINANCIAL SERVICES. DANIEL RISSI, DONALD FELITTO, R. ALAN HUNTER, MAUREEN ANDERSON AND HENRY AMDUR SERVE ON THE BOARD OF L&M INDEMNITY, A RELATED ORGANIZATION. Form 990, Part VI, Line 11A WORKING WITH A PAID PREPARER, A FORM 990 IS PREPARED. L&M HOSPITAL'S FORM 990 IS THEN REVIEWED BY THE HOSPITAL'S INTERNAL MANAGEMENT. THE COMPLETED FORM 990 IS PROVIDED TO ALL MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO THE FORM BEING FILED WITH THE IRS. Form 990, Part VI, Line 12 L&M Hospital requires all board members, officers, and key employees to complete a conflict of interest questionnaire. Questionnaires are completed annually and are reviewed by L&M Hospital's general counsel. Any actual or potential conflicts disclosed are presented to the board. Appropriate corrective actions are decided on a case by case basis. Form 990, Part VI, Line 15 L&M Hospital Executive compensation committee annually reviews the salaries of its executive management. Utilizing an independent compensation consultant, the Executive compensation committee approves compensation. The committee's deliberations are reflected in its minutes. CEO's compensation is approved by the full board. Form 990, Part VI, Line 19 The organization makes governing documents, conflict of interest policy, and financial statements available upon request. Form 990, Part VII, Section A HENRY AMDUR, MD IS COMPENSATED FOR SERVICES PROVIDED TO THE HOSPITAL AS AN INDEPENDENT CONTRACTOR. MARY ANN D. BENTZ, MD AND DONALD FELITTO ARE COMPENSATED AS MEDICAL STAFF AND NOT AS DIRECTORS. ROBERT KELTNER IS COMPENSATED NOT AS MEDICAL STAFF OR AS DIRECTOR BUT HE IS COMPENSATED FOR SPECIALIZED ICU SERVICES AND SEVERAL OTHER SPECIALIZED SERVICES. FORM 990, PART VII THE FOLLOWING INDIVIDUALS DEVOTED TIME TO RELATED ORGANIZATIONS. LAWRENCE & MEMORIAL CORPORATION: BRUCE D. CUMMINGS - 2 HOURS/WEEK LUGENE INZANA - 2 HOURS/WEEK EACH DIRECTOR DEVOTES 2 HOURS/WEEK VISITING NURSE ASSOCIATION OF SOUTHEASTERN CONNECTICUT: BRUCE D. CUMMINGS - 0.5 HOUR/WEEK L&M SYSTEMS, INC.: BRUCE D. CUMMINGS - 0.25 HOUR/WEEK ASSOCIATED SPECIALISTS OF SOUTHEASTERN CONNECTICUT: BRUCE D. CUMMINGS - 2 HOURS/WEEK LUGENE INZANA - 2 HOURS/WEEK DANIEL RISSI - 2 HOURS/WEEK KIMBERLY KALAJAINEN - 2 HOURS/WEEK HENRY AMDUR - 8 HOURS/WEEK PAMELA KANE - 20 HOURS/WEEK L&M PHYSICIAN ASSOCIATION, INC.: DANIEL RISSI - 2 HOURS/WEEK LUGENE INZANA - 2 HOURS/WEEK PAMELA KANE - 20 HOURS/WEEK L&M INDEMNITY: DANIEL RISSI - 2 HOURS/WEEK DONALD FELITTO - 2 HOURS/WEEK R. ALAN HUNTER - 2 HOURS/WEEK MAUREEN ANDERSON - 2 HOURS/WEEK HENRY AMDUR - 2 HOURS/WEEK Form 990, Part IX, Line 25 FUNDRAISING EXPENSES ARE REPORTED ON THE FORM 990 FOR LAWRENCE & MEMORIAL HOSPITAL (EIN 06-0646704). CONTRIBUTIONS ARE REPORTED ON THE FORMS 990 FOR BOTH LAWRENCE & MEMORIAL HOSPITAL (EIN 06-0646704) AND LAWRENCE & MEMORIAL CORPORATION (EIN 22-2553028). FORM 990, PART XI, LINE 5 UNREALIZED LOSSES -$6,568,670 PAYMENTS TO AFFILIATES -$22,389,887 CHANGE IN VALUE OF IRREVOCABLE TRUSTS -$152,473 DECREASE IN FUNDS HELD IN TRUST BY OTHERS -$140,467 CHANGE IN MINIMUM PENSION LIABILITY $5,839,963 ____________ -$23,411,534 Form 990, Schedule K, Part I, column (f) Name of Bond: $22,990,000 Var. Rate Demand Rev, Bds. Lawrence & Memorial Hosp. Issue, Series E refunded 2004 issue, which refunded 1998 issue. NAME of Bond: $58,940,000 Fixed Rate Rev Bonds, Series F THE PROCEEDS OF THE SERIES F BONDS WILL BE USED TO REFUND THE OUTSTANDING AUTHORITY REVENUE BONDS, LAWRENCE & MEMORIAL HOSPITAL ISSUE, SERIES D (THE "SERIES D BONDS") AND TO FUND ALL OR A PORTION OF THE FOLLOWING CAPITAL PROJECTS: (1) REPLACEMENT OF A LINEAR ACCELERATOR ON THE MAIN CAMPUS OF THE HOSPITAL. (2) CAPITAL IMPROVEMENTS FOR INFRASTRUCTURE RENOVATION AND IMPROVEMENT ON THE MAIN CAMPUS, INCLUDING HEATING, VENTILATION, AND AIR CONDITIONING PROJECT. (3) REPLACEMENT OF A CATHETERIZATION LAB AND EQUIPMENT ON THE MAIN CAMPUS. (4) ACQUISITION OF APPROXIMATELY 100 ACRES OF LAND IN WATERFORD, CONNECTICUT FOR DEVELOPMENT OF A NEW CANCER CENTER. (5) ACQUISITION AND INSTALLATION OF MAGNETIC RESONANCE IMAGING (MRI) AND CT EQUIPMENT AT THE CROSSROADS FACILITY.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Lawrence & Memorial Corporation
365 Montauk AvenueNew LondonCT06320222553028SupportCT501(c)(3)11 Type INA
Lawrence & Memorial Foundation Inc
365 Montauk AvenueNew LondonCT06320222553026FundraisingCT501(c)(3)PFL&M CORP
L&M Healthcare Inc
365 Montauk AvenueNew LondonCT06320222553031HealthcareCT501(c)(3)9L&M CORP
Associated Specialists of SE CT
404 Thames StreetGrotonCT06340208006123Phys PracticeCT501(c)(3)11 Type IL&M HOSPITAL
Visiting Nurse Associate of SE CT
403 N Frontage RoadWaterfordCT06385060646616HealthcareCT501(c)(3)9L&M CORP
L&M Physician Association inc
365 Montauk Avenuenew londonCT06320271094375healthcareCT501(c)(3)11 type il&M Hospital

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryPostal CodeAddressForeign/PostalCodeLegal Domicile Foreign CountryLegalDomicileForeignCountry
L&M Systems Inc
365 Montauk AvenueNew LondonCT06320222553037HealthcareCTNAC001.00000
L&M Homecare Services Inc
365 Montauk AvenueNew LondonCT06320061389272TherapyCTNAC001.00000
L&M INDEMNITY
981021436INSURANCENAC001.00000PO BOX 1159GRAND CAYMANCAYMAN ISLANDSCJKY1-1102CJ
CHARITABLE REMAINDER TRUSTS (3)
SUPPORTCTL&M HOSPITALTRUST
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgtruePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
ASSOCIATED SPECIALISTS OF SE CT
B8809661
ASSOCIATED SPECIALISTS OF SE CT
I690741
ASSOCIATED SPECIALISTS OF SE CT
N2314761
ASSOCIATED SPECIALISTS OF SE CT
O35122016

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