WILLIAM W BACKUS HOSPITAL: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- WILLIAM W BACKUS HOSPITAL (EIN 06-0250773)
- Tax period
- 2009-10-01 to 2010-09-30
- Filed
- 2011-08-15
- IRS object ID
- 201112279349300841
- Schema version
- 2009v1.7
- 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 B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-08-15T10:10:37-04:00 | Timestamp |
| Tax Period End Date | 2010-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1201 Walnut Suite 1700 | AddressLine1 |
| City | Kansas City | City |
| State | MO | State |
| ZIP Code | 641062246 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 060250773 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE WILLIAM W BACKUS HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | WILL | NameControl |
| Phone | 8608898331 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 326 WASHINGTON STREET | AddressLine1 |
| City | NORWICH | City |
| State | CT | State |
| ZIP Code | 06360 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DANIEL E LOHR | Name |
| Title | CFO | Title |
| Date Signed | 2011-07-01 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Michael J Engle | Name |
| Phone | 8162216300 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DAVID WHITEHEAD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 326 WASHINGTON STREET | AddressLine1 |
| City | NORWICH | City |
| State | CT | State |
| ZIP Code | 06360 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 300631393 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.BACKUSHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1891 | YearFormation |
| State Legal Domicile | CT | StateLegalDomicile |
| Activity Or Mission Description | BACKUS HOSPITAL DELIVERS AND COORDINATES A CONTINUUM OF HIGH-QUALITY HEALTHCARE THAT IS SENSITIVE TO THE NEEDS OF INDIVIDUALS IN EASTERN CONNECTICUT. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 2116 | TotalNbrEmployees |
| Total Nbr Volunteers | 464 | TotalNbrVolunteers |
| Total Gross UBI | 2933580 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 537401 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 713612 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1527754 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 259652271 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 270048715 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -2455678 | InvestmentIncomePriorYear |
| Investment Income Current Year | 3471412 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 2668006 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1774538 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 260578211 | TotalRevenuePriorYear |
| Total Revenue Current Year | 276822419 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 83063 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 81360 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 139676198 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 136363855 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 302487 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 110950609 | OtherExpensePriorYear |
| Other Expenses Current Year | 124070814 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 250709870 | TotalExpensesPriorYear |
| Total Expenses Current Year | 260516029 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 9868341 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 16306390 | RevenuesLessExpensesCY |
| Total Assets BOY | 312498408 | TotalAssetsBOY |
| Total Assets EOY | 335457576 | TotalAssetsEOY |
| Total Liabilities BOY | 199488251 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 176145231 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 113010157 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 159312345 | NetAssetsOrFundBalancesEOY |
| Mission Description | SEE SCHEDULE O | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 204994874 | Expense |
| Grants | 81360 | Grants |
| Revenue | 270016974 | Revenue |
| Description | IN FISCAL YEAR 2010, BACKUS HOSPITAL HAD 11,210 ADMISSIONS, 65,561 EMERGENCY DEPARTMENT VISITS, AND 449,993 OUTPATIENT VISITS. THE HOSPITAL PERFORMED 954 BIRTHS AND 7,453 SAME DAY SURGICAL PROCEDURES. BACKUS PERFORMED 124,214 IMAGING EXAMS, 9,365 MRI EXAMINATIONS, 12,550 PSYCHIATRIC CLINICAL VISITS, AND 9,629 PSYCHIATRIC PARTIAL HOSPITAL VISITS. | Description |
| Total Program Service Expense | 204994874 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | true | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | true | 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 | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | true | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| 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 | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | true | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 171 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 2116 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | true | QuidProQuoContributions |
| Quid Pro Quo Disclosure | true | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | 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 | true | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DANIEL E LOHR | NamePerson |
| Telephone Number | 8608898331 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 326 WASHINGTON STREET | AddressLine1 |
| City | NORWICH | City |
| State | CT | State |
| ZIP Code | 06360 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (23 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| DAVID WHITEHEAD | |||||||||
| TRUSTEE/PRESIDENT/CEO | 40.0 | X | X | 444582 | 0 | 31487 | |||
| PETER V DISCH | |||||||||
| TRUSTEE/CHAIRMAN | 6.0 | X | X | 0 | 0 | 0 | |||
| ROBERT RAMSDELL | |||||||||
| TRUSTEE/VICE CHAIRMAN | 6.0 | X | X | 0 | 0 | 0 | |||
| JOSEPH FATONE | |||||||||
| TRUSTEE/SECRETARY | 6.0 | X | X | 0 | 0 | 0 | |||
| ANTHONY JOYCE | |||||||||
| TRUSTEE/TREASURER | 6.0 | X | X | 0 | 0 | 0 | |||
| JOHN F BILDA | |||||||||
| TRUSTEE | 2.0 | X | 0 | 0 | 0 | ||||
| STEPHEN T BRIGGS MD | |||||||||
| TRUSTEE | 2.0 | X | 0 | 0 | 0 | ||||
| ELIZABETH CONWAY | |||||||||
| TRUSTEE | 2.0 | X | 0 | 0 | 0 | ||||
| BERT A COPPOTELLI MD | |||||||||
| TRUSTEE | 2.0 | X | 0 | 0 | 0 | ||||
| GRACE JONES PHD | |||||||||
| TRUSTEE | 2.0 | X | 0 | 0 | 0 | ||||
| DEBORAH MONAHAN | |||||||||
| TRUSTEE | 2.0 | X | 0 | 0 | 0 | ||||
| TODD POSTLER | |||||||||
| TRUSTEE | 2.0 | X | 0 | 0 | 0 | ||||
| PATRICIA STUART MD | |||||||||
| TRUSTEE | 2.0 | X | 0 | 0 | 0 | ||||
| DANIEL E LOHR | |||||||||
| SENIOR VP/CFO | 40.0 | X | 475709 | 0 | 45011 | ||||
| MARK SANTAMARIA | |||||||||
| SENIOR VP/COO | 40.0 | 356517 | 0 | 36124 | X | ||||
| PETER SHEA | |||||||||
| SENIOR VP/MEDICAL DIRECTOR | 40.0 | 373516 | 0 | 41942 | X | ||||
| SERGIO CASILLAS MD | |||||||||
| PHYSICIAN | 40.0 | 449616 | 0 | 1487 | X | ||||
| ROBERT SIDMAN MD | |||||||||
| PHYSICIAN | 40.0 | 391426 | 0 | 44725 | X | ||||
| VICTOR ALEXANDER MD | |||||||||
| PHYSICIAN | 40.0 | 355752 | 0 | 43612 | X | ||||
| JUAN ESCALON MD | |||||||||
| PHYSICIAN | 40.0 | 333361 | 0 | 38188 | X | ||||
| DANIEL FAGNANT MD | |||||||||
| PHYSICIAN | 40.0 | 321984 | 0 | 32624 | X | ||||
| THOMAS P PIPICELLI | |||||||||
| FORMER PRESIDENT | 0.0 | 780953 | 0 | 2215956 | X | ||||
| DAVID KALLA MD | |||||||||
| CHAIR-SURGICAL SERVICES | 24.0 | 146845 | 0 | 20385 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 4430261 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 2551541 | TotalOtherCompensation |
| Number Individuals GT100 K | 122 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|
| WELLSPRING PARTNERS | |
| CONSULTING | 1800000 |
| NAVIN HAFTY ASSOC INC | |
| CONSULTING | 1334060 |
| NORWICH ANESTHESIA ASSOCIATES | |
| MEDICAL SERVICES | 1010404 |
| DAVITA INC | |
| MEDICAL SERVICES | 489183 |
| NUANCE TRANSCRIPTION SERV | |
| PURCHASE SERVICE | 474027 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 22 | NumberOfContractorsGT100K |
| Fundraising Events | 60555 | FundraisingEvents |
| Related Organizations | 1975 | RelatedOrganizations |
| Government Grants | 733844 | GovernmentGrants |
| All Other Contributions | 731380 | AllOtherContributions |
| Noncash Contributions | 4279 | NoncashContributions |
| Total Contributions | 1527754 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| Inpatient | 900099 | 122215357 | 122215357 | |
| Outpatient | 900099 | 101199201 | 101199201 | |
| Emergency Department | 900099 | 43668836 | 43668836 | |
| Lab courier service | 621500 | 2965321 | 2965321 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 270048715 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2756478 | TotalRevenueColumn |
| Exclusion | $2,756,478 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1102133 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1700268 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -598135 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -598135 | TotalRevenueColumn |
| Unrelated Business Revenue | -31741 | UnrelatedBusinessRevenue |
| Exclusion | -$566,394 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 22420233 | Securities |
| Other | 35314 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 21588538 | Securities |
| Other | 152075 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 831695 | Securities |
| Other | -116761 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 714934 | TotalRevenueColumn |
| Exclusion | $714,934 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 21600 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 60555 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 39669 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -18069 | TotalRevenueColumn |
| Exclusion | -$18,069 | ExclusionAmount |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 454393 | GrossSalesOfInventory |
| Cost Of Goods Sold | 328424 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 125969 | TotalRevenueColumn |
| Exclusion | $125,969 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| Cafeteria | 722320 | 1062901 | $1,062,901 |
| Child care | 624410 | 355497 | $355,497 |
| Purchase discounts | 900099 | 351343 | $351,343 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 495032 | TotalRevenueColumn |
| Exclusion | $495,032 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2264773 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 276822419 | TotalRevenueColumn |
| Related Or Exempt Function Income | 267083394 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 2933580 | UnrelatedBusinessRevenue |
| Exclusion | $5,277,691 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71310 | Total |
| Program Services | 71310 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10050 | Total |
| Program Services | 10050 | ProgramServices |
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 | 2181240 | Total |
| Program Services | 754683 | ProgramServices |
| Management And General | 1426557 | 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 | 106997786 | Total |
| Program Services | 94808378 | ProgramServices |
| Management And General | 12080025 | ManagementAndGeneral |
| Fundraising | 109383 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8074896 | Total |
| Program Services | 7186657 | ProgramServices |
| Management And General | 879984 | ManagementAndGeneral |
| Fundraising | 8255 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11219641 | Total |
| Program Services | 9985480 | ProgramServices |
| Management And General | 1222691 | ManagementAndGeneral |
| Fundraising | 11470 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7890292 | Total |
| Program Services | 7022361 | ProgramServices |
| Management And General | 859865 | ManagementAndGeneral |
| Fundraising | 8066 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1680899 | Total |
| Management And General | 1680899 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 158816 | Total |
| Management And General | 155716 | ManagementAndGeneral |
| Fundraising | 3100 | Fundraising |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 45452 | Total |
| Management And General | 45452 | ManagementAndGeneral |
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 | 100126 | Total |
| Management And General | 100126 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24551685 | Total |
| Program Services | 11339853 | ProgramServices |
| Management And General | 13206462 | ManagementAndGeneral |
| Fundraising | 5370 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 154483 | Total |
| Program Services | 113318 | ProgramServices |
| Fundraising | 41165 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38437945 | Total |
| Program Services | 37476425 | ProgramServices |
| Management And General | 956630 | ManagementAndGeneral |
| Fundraising | 4890 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2883395 | Total |
| Program Services | 445156 | ProgramServices |
| Management And General | 2438239 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5293268 | Total |
| Program Services | 678507 | ProgramServices |
| Management And General | 4610362 | ManagementAndGeneral |
| Fundraising | 4399 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 189952 | Total |
| Program Services | 85375 | ProgramServices |
| Management And General | 104412 | ManagementAndGeneral |
| Fundraising | 165 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49237 | Total |
| Program Services | 37797 | ProgramServices |
| Management And General | 11350 | ManagementAndGeneral |
| Fundraising | 90 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2933786 | Total |
| Management And General | 2933786 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16651550 | Total |
| Program Services | 8014259 | ProgramServices |
| Management And General | 8637291 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3163927 | Total |
| Program Services | 2443084 | ProgramServices |
| Management And General | 720843 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| LAB EXPENSES | 4142880 | 4142880 | ||
| FOOD/DIETARY | 1151732 | 1044352 | 107380 | |
| MAINTENANCE/SERVICE CONTRACTS | 4974557 | 3859576 | 1110659 | 4322 |
| EDUCATION | 419229 | 347946 | 71113 | 170 |
| BAD DEBT | 14409876 | 14409876 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2678019 | Total |
| Program Services | 717551 | ProgramServices |
| Management And General | 1858826 | ManagementAndGeneral |
| Fundraising | 101642 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 260516029 | Total |
| Program Services | 204994874 | ProgramServices |
| Management And General | 55218668 | ManagementAndGeneral |
| Fundraising | 302487 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1537978 | BOY |
| EOY | 4239212 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 56399972 | BOY |
| EOY | 68235460 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 185866 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36111295 | BOY |
| EOY | 30758941 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 203437 | BOY |
| EOY | 153242 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3292014 | BOY |
| EOY | 3844330 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3925993 | BOY |
| EOY | 4267569 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 231891916 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 132769529 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 98131132 | BOY |
| EOY | 99122387 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 67243895 | BOY |
| EOY | 123615211 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41160106 | BOY |
| EOY | 12632 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 270843 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4221743 | BOY |
| EOY | 1022726 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 312498408 | BOY |
| EOY | 335457576 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25902374 | BOY |
| EOY | 25301642 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 64950000 | BOY |
| EOY | 63125000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 1236586 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 108635877 | BOY |
| EOY | 86482003 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 199488251 | BOY |
| EOY | 176145231 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 102700895 | BOY |
| EOY | 147735382 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3447432 | BOY |
| EOY | 4101543 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6861830 | BOY |
| EOY | 7475420 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 113010157 | BOY |
| EOY | 159312345 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 312498408 | BOY |
| EOY | 335457576 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | true | GrantsOtherOrganizations |
| Grants Other Organizations | $45,452 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | true | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 45452 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4841631 | BeginningOfYearBalance |
| Contributions | 358064 | Contributions |
| Investment Earnings Or Losses | 505259 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 0 | GrantsOrScholarships |
| Other Expenditures | 378271 | OtherExpenditures |
| Administrative Expenses | 5897 | AdministrativeExpenses |
| End Of Year Balance | 5320786 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3871631 | BeginningOfYearBalance |
| Contributions | 970000 | Contributions |
| Investment Earnings Or Losses | 142089 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 0 | GrantsOrScholarships |
| Other Expenditures | 135254 | OtherExpenditures |
| Administrative Expenses | 6835 | AdministrativeExpenses |
| End Of Year Balance | 4841631 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2229795 | OtherCostOrOtherBasis |
| Book Value | 2229795 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 10381267 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 41471084 | OtherCostOrOtherBasis |
| Depreciation | 31068453 | Depreciation |
| Book Value | 20783898 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 76545346 | OtherCostOrOtherBasis |
| Depreciation | 33327779 | Depreciation |
| Book Value | 43217567 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 100633618 | OtherCostOrOtherBasis |
| Depreciation | 68373297 | Depreciation |
| Book Value | 32260321 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 630806 | OtherCostOrOtherBasis |
| Book Value | 630806 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 99122387 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (6 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Tax exempt bond premium, net | $757,072 |
| DUE TO 3RD PARTY REIMB AGENCIES | $15,381,854 |
| Employee related obligations | $57,973,203 |
| Self-insured prof liability | $10,514,332 |
| Capital lease obligations | $1,505,864 |
| Other liabilities | $349,678 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 86482003 | TotalOfAmounts |
| Total Revenue | 276822419 | TotalRevenue |
| Total Expenses | 260516029 | TotalExpenses |
| Excess Or Deficit For Year | 16306390 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 3742481 | NetUnrealizedGLOnInvestments |
| Investment Expenses | -180767 | InvestmentExpenses |
| Other | $26,434,084 | OtherAmount |
| Total Adjustments | 29995798 | TotalAdjustments |
| Excess Or Deficit Per FS | 46302188 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 281364313 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 3742481 | NetUnrealizedGainsInvestments |
| Other Revenues | 39669 | OtherRevenues |
| Revenue Not Rptd F990 | 3782150 | RevenueNotRptdF990 |
| Revenue Subtotal | 277582163 | RevenueSubtotal |
| Investment Expenses Not Included | 180767 | InvestmentExpensesNotIncluded |
| Other Revenues Not Included | -940511 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -759744 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 276822419 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 262219045 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 1856698 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 1856698 | ExpensesNotRptdF990 |
| Expenses Subtotal | 260362347 | ExpensesSubtotal |
| Other Expenses Not Included | 153682 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 153682 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 260516029 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (7 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ENDOWMENT FUNDS | SCHEDULE D, PART V, LINE 4 | THE PERMANENTLY RESTRICTED ENDOWMENT FUNDS ARE MEANT TO PROVIDE LONG-TERM SUPPORT FOR CAPITAL AND OPERATING PROGRAMS FOR THE HOSPITAL IN ACCORDANCE WITH THE DONOR'S WISHES. |
| UNCERTAIN TAX POSITIONS DISCLOSURE | SCHEDULE D, PART X, LINE 2 | ASC 740-10, Uncertain Tax Positions, prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. This interpretation also provides guidance on derecognition, classification, interest and penalties, accounting in interim periods, and disclosure requirements for uncertain tax positions. Management has evaluated the implications of ASC 740-10 and determined that its impact on the financial statements is not significant. |
| RECONCILIATION OF CHANGE IN NET ASSETS | SCHEDULE D, PART XI, LINE 8 | K-1 GAIN AND INTEREST (2,316) TRANSFER TO AFFILIATES (73,056) MERGER OF PROPERTIES 1,402,938 INCREASE IN NET ASSETS HELD IN TRUST 134,435 CHANGE IN PENSION FUNDING 24,972,083 ------------ 26,434,084 |
| RECONCILIATION OF REVENUE- OTHER ADJUSTMENTS | SCHEDULE D, PART XII, LINE 2D | GOLF TOURNAMENT EXPENSES 39,669 |
| RECONCILIATION OF REVENUES- OTHER ADJUSTMENTS | SCHEDULE D, PART XII, LINE 4B | AUXILIARY INCOME 134,420 K-1 GAIN & INTEREST 2,316 LOSS ON FIXED ASSETS (116,761) RENTAL EXPENSE (1,700,268) TEMPORARILY RESTRICTED INCOME 739,782 ----------- (940,511) |
| RECONCILIATION OF EXPENSES- OTHER ADJUSTMENTS | SCHEDULE D, PART XIII, LINE 2D | RENTAL EXPENSE 1,700,268 GOLF TOURNAMENT EXPENSE 39,669 LOSS ON FIXED ASSETS 116,761 ----------- 1,856,698 |
| RECONCILIATION OF EXPENSES- OTHER ADJUSTMENTS | SCHEDULE D, PART XIII, LINE 4B | AUXILIARY EXPENSE 153,682 |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF TOURNAMENT | NameOfEvent1 |
| Gross Receipts Event1 | 82155 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 60555 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 21600 | GrossRevenueEvent1 |
| Cash Prizes Event1 | 0 | CashPrizesEvent1 |
| Non Cash Prizes Event1 | 6857 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 15351 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 3411 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 0 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 14050 | OtherDirectExpensesEvent1 |
| Total Number Of Other Events | 0 | TotalNumberOfOtherEvents |
| Gross Receipts Total | 82155 | GrossReceiptsTotal |
| Charitable Contributions Total | 60555 | CharitableContributionsTotal |
| Gross Revenue Total Events | 21600 | GrossRevenueTotalEvents |
| Cash Prizes Total Events | 0 | CashPrizesTotalEvents |
| Non Cash Prizes Total Events | 6857 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 15351 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 3411 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 0 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 14050 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 39669 | DirectExpenseSummaryEvents |
| Net Income Summary | -18069 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 250. | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent350 | X | Pcent350 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2830076 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 279376 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2550700 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01040 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 41910575 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 24570741 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 17339834 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07050 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 44740651 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 24850117 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 19890534 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08090 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 42452 | PersonsServed |
| Total Community Benefit Expense | 642190 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11960 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 630230 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00260 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1058 | PersonsServed |
| Total Community Benefit Expense | 193795 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 140 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 193655 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 13512 | PersonsServed |
| Total Community Benefit Expense | 16458860 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12178716 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4280144 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01740 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 121 | PersonsServed |
| Total Community Benefit Expense | 29967 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 29967 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 46017 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 46017 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 57143 | PersonsServed |
| Total Community Benefit Expense | 17370829 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12190816 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5180013 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02110 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 57143 | PersonsServed |
| Total Community Benefit Expense | 62111480 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 37040933 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 25070547 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10200 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 14538 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 14538 | NetCommunityBuildingExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 6099 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 6099 | NetCommunityBuildingExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 7588 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 7588 | NetCommunityBuildingExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 28225 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 28225 | NetCommunityBuildingExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $6,451,301 | BadDebtExpenseAmount |
| Amount Attributable To | 2193451 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 53432655 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 70236869 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -16804214 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | X | CostAccountingSystem |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV (11 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|
| WILLIAM W BACKUS HOSPITAL | |||||||
| 326 WASHINGTON ST | NORWICH | CT | 06360 | X | X | X | |
| BACKUS OUTPATIENT CARE CENTER | |||||||
| 111 SALEM TURNPIKE | NORWICH | CT | 06360 | OUTPATIENT SERVICES | |||
| BACKUS OUTPATIENT CENTER | |||||||
| 12/19 CASE STREET | NORWICH | CT | 06360 | LAB/X-RAY/ MAMMOGRAPHY | |||
| COLCHESTER BACKUS HEALTH CENTER | |||||||
| 163 BROADWAY | COLCHESTER | CT | 06415 | RADIOLOGY/LAB/ PRIMARY CARE | |||
| MONTVILLE BACKUS HEALTH CENTER | |||||||
| 80 NORWICH-NEW LONDON TPKE | UNCASVILLE | CT | 06382 | RADIOLOGY/LAB/ PRIMARY CARE | |||
| JEWETT CITY PATIENT SERVICE CENTER | |||||||
| 70 MAIN STREET | JEWETT CITY | CT | 06351 | LAB | |||
| PLAINFIELD BACKUS PATIENT SERVICE CENTER | |||||||
| 122 PLAINFIELD ROAD | MOSSUP | CT | 06354 | LAB/X-RAY/ PRIMARY CARE | |||
| PAIN MANAGEMENT | |||||||
| 112 LAFAYETTE STREET | NORWICH | CT | 06360 | PAIN MANAGEMENT | |||
| INFECTIOUS DISEASE CLINIC | |||||||
| 107 LAFAYETTE STREET | NORWICH | CT | 06360 | CLINIC | |||
| MEDICAL OFFICE BUILDING | |||||||
| 330 WASHINGTON STREET | NORWICH | CT | 06360 | LAB/RADIATION THERAPY | |||
| LEDYARD BACKUS HEALTH CENTER | |||||||
| 743 COLONEL LEDYARD HWY | LEDYARD | CT | 06339 | LAB/PRIMARY CARE | |||
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense Expln | THE 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 $14,409,876. | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | THE HOSPITAL PROVIDES SERVICES WITHOUT CHARGE, OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES, TO PATIENTS WHO MEET THE CRITERIA OF ITS CHARITY CARE POLICY. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO BE CHARITY CARE, SUCH SERVICES ARE NOT REPORTED AS NET REVENUE. THE HOSPITAL'S CHARITY CARE POLICY UTILIZES THE GENERALLY RECOGNIZED POVERTY INCOME LEVELS FOR THE STATE. FOR PATIENTS WHO DO NOT APPLY OR DO NOT QUALIFY, THE UNCOLLECTED AMOUNTS ARE RECOGNIZED AS BAD DEBT EXPENSE. ESTIMATED COST OF BAD DEBT IS BASED ON THE RATIO OF COST TO CHARGES AS DETERMINED BY HOSPITAL SPECIFIC DATA. | BadDebtFootnote |
| Shortfall As Community Benefit | THE MEDICARE SHORTFALL WAS NOT INCLUDED IN THE COMMUNITY BENEFIT COST. THE COSTING METHODOLOGY CONSISTED OF INFORMATION FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM AS WELL AS COSTS FROM THE MEDICARE COST REPORT. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO BE CHARITY CARE. | DebtCollectionPolicy |
| Needs Assessment | (A) IN ADDITION TO CONDUCTING ITS OWN RESEARCH, BACKUS HOSPITAL COLLABORATES WITH LOCAL AND REGIONAL HEALTH CARE ORGANIZATIONS TO DETERMINE THE NEED FOR HEALTH-RELATED PROGRAMS AND SERVICES. (B) THE HOSPITAL COMMISSIONED A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED BY HOLLERAN, A PROFESSIONAL RESEARCH FIRM. THE ASSESSMENT CONSISTED OF 1,109 BRFSS TELEPHONE SURVEYS WHICH WERE CONDUCTED THROUGHOUT THE HOSPITAL'S SERVICE REGION (BOTH NEW LONDON AND WINDHAM COUNTIES). THE ASSESSMENT ALSO INCLUDED A DETAILED ANALYSIS OF SECONDARY DATA SOURCES, AS WELL AS TWO COMPREHENSIVE FOCUS GROUPS TO GAIN QUALITATIVE DATA ON IDENTIFIED PRIORITY HEALTH AREAS. THE NEEDS ASSESSMENT WAS PRESENTED AND DISTRIBUTED, AND CAN BE ACCESSED AT WWW.BACKUSHOSPITAL.ORG/HEALTHSURVEY SUBSEQUENTLY THE HOSPITAL HAS DEVELOPED A COMMUNITY NEEDS STRATEGIC PLAN WHICH IDENTIFIES AND OUTLINES TOP PRIORITY HEALTH NEEDS AS DETERMINED BY THE NEEDS ASSESSMENT. PRIORITY HEALTH AREAS INCLUDE OBESITY AND OVERWEIGHT, AUTISM, SMOKING, ALCOHOL AND SUBSTANCE ABUSE, MENTAL HEALTH, CHRONIC LOWER RESPIRATORY DISEASES, AND ACCESS TO HEALTHCARE. THIS PLAN WILL GUIDE THE HOSPITAL'S OUTREACH EFFORTS OVER THE NEXT THREE FISCAL YEARS, AT WHICH TIME A SECOND NEEDS ASSESSMENT WILL BE CONDUCTED TO MEASURE THE HOSPITAL'S PROGRESS. BASED ON THE HOLLERAN SURVEY, THE HOSPITAL PARTNERED WITH THE UNITED WAY OF SOUTHEASTERN CONNECTICUT TO CREATE THE NEW LONDON COUNTY FOOD POLICY COUNCIL, WHICH IS USING THE DATA TO ADDRESS OBESITY AND OTHER FOOD-RELATED ISSUES. (C) THE HOSPITAL INDENTIFIES HEALTH PROBLEMS IN THE COMMUNITY THROUGH INDICATORS AND MEASURES OF HEALTH RISK, DISEASE PREVALENCE, DISEASE MANAGEMENT AND OUTCOMES USING SOURCES SUCH AS BIRTH AND MORTALITY RECORDS, CENSUS DATA, HOSPITAL DISCHARGE RECORDS, CANCER REGISTERY DATA, BEHAVIORAL RISK FACTOR SURVEY DATA, AND OTHER DATASETS. (D) THE HOSPITAL PARTNERS WITH TWO REGIONAL FEDERALLY QUALIFIED HEALTH CENTERS-UNITED COMMUNITY AND FAMILY SERVICES, AND GENERATIONS HEALTHCARE. CASE MANAGERS FROM THE HOSPITAL MEET TO DETERMINE UNMET COMMUNITY NEEDS TO DEVELOP EDUCATIONAL, OUTREACH AND PREVENTATIVE HEALTH PROGRAMS TO MEET THESE NEEDS. (E) THE HOSPITAL CONDUCTS FOLLOW-UP SURVEYS WITH ALL PARTICIPANTS IN ITS FREE EDUCATIONAL PROGRAMS. THE SURVEYS ASSESS PARTICIPANTS SATISFACTION WITH THE PROGRAM, AND SOLICIT INFORMATION ABOUT OTHER NEEDS. | NeedsAssessment |
| Patient Education Assistance | (A) NOTIFICATION ABOUT CHARITABLE CARE AND ASSISTANCE PROGRAMS IS AVAILABLE AT ALL REGISTRATION AREAS, ON AND OFF THE MAIN HOSPITAL CAMPUS, IN WAITING AREAS, IN THE PATIENT HANDBOOK, ON OUR WEBSITE, AND ON PROMINENTLY PLACED SIGNS (IN ENGLISH AND SPANISH). ADDITIONALLY, CARE MANAGEMENT SOCIAL WORKERS MEET WITH PATIENTS, FAMILY, CLERGY AND OTHERS AS APPROPRIATE TO DISCUSS ASSISTANCE PROGRAMS AND SERVICES THAT MAY BE AVAILABLE. HERE IS THE INFORMATION FROM OUR WEBSITE: IF YOU DO NOT HAVE HEALTH INSURANCE AND ARE ELIGIBLE FOR A GOVERNMENT SPONSORED HEALTH PROGRAM, OUR ACCESS TO CARE STAFF AT BACKUS HOSPITAL IS AVAILABLE TO HELP YOU THROUGH THE APPLICATION PROCESS. IF YOU QUALIFY, PROGRAMS SUCH AS HUSKY, T-19, AND SAGA MAY HELP YOU WITH ACCESS TO HEALTHCARE AND OTHER VITAL SERVICES FOR YOURSELF AND YOUR FAMILY. IF YOU ARE UNINSURED, AND DO NOT QUALIFY FOR A GOVERNMENT SPONSORED INSURANCE PROGRAM YOU MAY BE ELIGIBLE FOR FREE OR DISCOUNTED SERVICES FROM BACKUS HOSPITAL DEPENDING ON YOUR INCOME LEVEL AND CIRCUMSTANCES. IN ADDITION, EXTENDED PAYMENT PLANS ARE AVAILABLE TO PATIENTS WHO QUALIFY FOR PAYMENT ASSISTANCE AND WHO ARE MAKING GOOD-FAITH EFFORTS TO PAY THEIR BILL. TO GET HELP ENROLLING IN A GOVERNMENT SPONSORED INSURANCE PROGRAM OR TO APPLY FOR CHARITABLE CARE FROM BACKUS HOSPITAL, PLEASE CALL OUR ADVOCATE FOR CHARITABLE CARE AT (860) 889-8331, EXT. 3831 OR CUSTOMER SERVICE AT (860) 823-6394. OUR STAFF WILL WORK WITH YOU TO COMPLETE AN APPLICATION WHICH MUST BE RETURNED WITH INCOME AND RESOURCES INFORMATION. WE LOOK FORWARD TO WORKING WITH YOU TO IMPROVE ACCESS TO CARE FOR YOU AND YOUR FAMILY. (B) THE HOSPITAL PROVIDES TWO ACCESS TO CARE SPECIALISTS (BOTH FIRST AND SECOND SHIFT) IN ITS EMERGENCY DEPARTMENT, WHO PROVIDES FREE INSURANCE ELIGIBILITY SCREENINGS TO UNINSURED CLIENTS SEEKING CARE. THE SPECIALIST WORKS WITH UNINSURED PATIENTS TO CONNECT THEM WITH A PRIMARY MEDICAL HOME, SO THEY CAN RECEIVE PREVENTATIVE CARE, RATHER THAN USING COSTLY EMERGENCY SERVICES FOR ILLNESSES THAT ARE NOT MEDICAL EMERGENCIES. SIGNIFICANT ONE-ON-ONE FOLLOW-UP IS PROVIDED THROUGH PHONE CALLS OR LETTERS TO MAKE APPOINTMENTS TO SCREEN PATIENTS AND HELP THEM FILL OUT APPLICATIONS FOR HUSKY OR STATE ADMINISTRATED GENERAL ASSISTANCE. | PatientEducationAssistance |
| Community Information | THE WILLIAM W. BACKUS HOSPITAL IS LOCATED IN NORWICH, 45 MINUTES SOUTHEAST OF HARTFORD. IN THE PAST DECADE, THE REGION HAS UNDERGONE MAJOR ECONOMIC CHANGES, DUE TO THE OPERATION OF TWO NATIVE AMERICAN-OWNED CASINOS - BOTH AMONG THE LARGEST CASINOS IN THE WORLD. THESE GAMBLING AND ENTERTAINMENT VENUES BRING AN AVERAGE OF 40,000 VISITORS INTO THE REGION EACH DAY. THE CASINOS ARE THE LARGEST EMPLOYERS, AND ARE EXPERIENCING LAYOFFS AND CUTBACKS AS THE ECONOMY CONTINUES TO DECLINE. THE HOSPITAL'S PRIMARY SERVICE AREA HAS AN ESIMATED POPULATION OF ABOUT 118,000. THE SECONDARY SERVICE AREA CONSISTS OF LARGER COMMUNITIES, SUCH AS NEW LONDON AND GROTON, AND SMALLER LOWER-DENSITY RURAL COMMUNITIES. THE TOTAL POPULATION OF THE SECONDARY SERVICE AREA IS ABOUT 123,000. THE SERVICE AREAS CONTAIN MUNICIPALITIES IN NEW LONDON AND WINDHAM COUNTIES. THE FASTEST GROWING SEGMENT OF THE REGION'S POPULATION IS THE ELDERLY. FOR THE LAST DECENNIAL CENSUS, THE REGION'S ELDERLY POPULATION GREW AT 10 TIMES THE RATE OF GROWTH FOR THE TOTAL POPULATION. THE REGION'S LACK OF AFFORDABLE HOUSING BEGAN TO EMERGE AS A CRITICAL ISSUE EVEN BEFORE THE ECONOMIC DOWNTURN. HOMELESSNESS IS A GROWING CONCERN, AS THE NUMBER OF MORTGAGE FORECLOSURES GROW. UNEMPLOYEMENT IN THE REGIONAL LABOR MARKET (LATEST AVAILABILITY; MAY 2009) STANDS AT 11.7%, WELL ABOVE THE STATE AVERAGE OF 8.0%. THE REGION ALSO DISPLAYED A SUDDEN EROSION IN ITS HOUSING MARKET. HOME PRICES SANK 12.5% FROM MAY 2008 TO MAY 2009 (THE MOST RECENT DATA AVAILABLE), AND NEW HOUSING PERMITS PLUNGED BY ALMOST TWO-THIRDS - THE WORST RECORD ON BOTH SCORES OF ANY REGION IN THE STATE. SALES OF SINGLE-FAMILY HOMES FELL 18.5% FROM MAY 2008 TO MAY 2009. STATE. SALES OF SINGLE-FAMILY HOMES FELL 18.5% FROM MAY 2008 TO MAY 2009. | CommunityInformation |
| Community Building Activities | BACKUS HOSPITAL CONDUCTS AND SPONSORS 9 SUPPORT GROUPS THAT PROVIDE ONGOING EDUCATION AND COUNSELING FOR A WIDE ARRAY OF HEALTH-RELATED ISSUES, FROM INFANT CHILD LOSS TO CANCER. HOSPITAL EMPLOYEES VOLUNTEER THEIR SERVICE ON DOZENS OF COMMUNITY NOT-FOR-PROFIT ORGANIZATIONS, MANY OF WHICH HAS HEALTHCARE AS A PRIMARY OR MAJOR FOCUS. EXAMPLES INCLUDE THE NEW LONDON COUNTY HEALTHCARE COLLABORATIVE, THE HEALTH CARE COUNCIL OF EASTERN CONNECTICUT, THE FOUNDATION OF THREE RIVERS COMMUNITY COLLEGE (WHICH PROVIDES FUNDING FOR NURSING STUDENT EDUCATION AND EQUIPMENT), THE REGION'S NON-PROFIT HOSPICE ORGANIZATION, UNITED WAY OF SOUTHEASTERN CONNECTICUT (WHICH PROVIDES FUNDING FOR MANY REGIONAL HUMAN SERVICES, INCLUDING THOSE THAT ARE HEALTH RELATED); AS WELL AS SERVICE AND BOARD MEMBERSHIPS ON THE REGION'S TWO FEDERALLY QUALIFIED HEALTH CENTERS. ADDITIONALLY, BACKUS PERSONNEL VOLUNTEER ON OTHER BOARDS AND ORGANIZATIONS THAT ADVANCE THE QUALITY OF LIFE AND ECONOMIC WELL-BEING OF THE REGION, INCLUDING THE LOCAL LIBRARY, THE REGIONAL CHAMBER OF COMMERCE, NUMEROUS CIVIC AND GOVERNMENTAL BODIES, AND VARIOUS VOLUNTEER FIRE COMPANIES AND AMBULANCE SERVICES. THE HOSPITAL REGULARLY HOSTS COMMUNITY FORUMS ON HEALTH-RELATED ISSUES, AND WAS A KEY COMMUNITY CONVENER FOR A MULTI-AGENCY EFFORT TO EQUIP ALL LOCAL SCHOOLS WITH AUTOMATED EXTERNAL DEFIBRILLATORS. THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT, AND ITS FINDINGS OF THE PREVELANCE OF OBESITY AS A HEALTH CONCERN, WAS THE CATALYST TO FORMING NEW LONDON COUNTY FOOD POLICY COUNCIL IN PARTNERSHIP WITH THE UNITED WAY. MEMBERS OF THE ADMINISTRATIVE STAFF ROUTINELY SUBMIT GOVERNMENT TESTIMONY ON BEHALF OF REGIONAL NOT-FOR-PROFIT HEALTH-RELATED ORGANIZATIONS, AND PROVIDE RESEARCH AND ADVOCACY FOR THE HEALTHCARE ACCESS. | CommunityBuildingActivities |
| Other Information | (A) THE HOSPITAL IS GOVERNED BY A VOLUNTEER COMMUNITY BOARD OF DIRECTORS/TRUSTEES. THESE INDIVIDUALS REPRESENT AN ARRAY OF PROFESSIONS AND BACKGROUNDS. (B) THE HOSPITAL HAS 110 CORPORATORS - VOLUNTEER MEMBERS CHOSEN FROM ALL THE COMMUNITIES IN OUR PRIMARY AND SECONDARY SERVICE AREAS. IN ADDITION TO THEIR OFFICIAL CAPACITY AS NOMINATORS OF BOARD MEMBERS, THE CORPORATORS SERVE AS THE HOSPITAL'S EYES AND EARS THROUGHOUT ITS SERVICE AREA. (C) THE HOSPITAL OWNS AND OPERATES A MOBILE HEALTH RESOURCE CENTER - A 40-FOOT VAN THAT TRAVELS TO VARIOUS LOCATIONS IN EASTERN CONNECTICUT OFFERING HEALTH EDUCATION, COUNSELING, AND SCREENINGS. THE VAN MAKES REGULARLY SCHEDULED STOPS AT SENIOR CITIZENS CENTERS, SOUP KITCHENS, ELDERLY HOUSING COMPLEXES AND HOMELESS SHELTERS. NOT-FOR-PROFIT GROUPS ARE ENCOURAGED TO REQUEST THE VAN AND ITS SERVICES AT THEIR FUNCTIONS OR OFFICES. (D) THE HOSPITAL PROVIDES INDIVIDUALS WHO DO NOT IDENTIFY AS HAVING A PRIMARY MEDICAL HOME WITH A FOLLOW UP VISIT POST DISCHARGE TO LINK THESE INDIVIDUALS WITH A PRIMARY CARE PHYSICIAN IN THE COMMUNITY. THIS IS FACILITATED THROUGH MY HEALTH DIRECT PROGRAM, A WEB-BASED TOOL THAT ALLOWS HOSPITAL STAFF TO ACCESS BLOCKED APPOINTMENTS FOR PHYSICIANS IN THE COMMUNITY. FROM 10/1/09 TO 9/30/10, THE HOSPITAL LINKED 398 INDIVIDUALS WITH PRIMARY CARE. (E)THE HOSPITAL PROVIDES FREE COMMUNITY CHOLESTEROL SCREENINGS, DIABETES EDUCATION, BACKPACK SAFETY, HIV EDUCATION/TESTING, BLOOD PRESSURE TESTS, SKIN CANCER SCREENINGS, NUTRITION EDUCATION AND MANY OTHER SERVICES. (F) THE HOPSITAL PROVIDES FREE WEBSITE ACCESS TO COMPLETE AND CURRENT MEDICAL INFORMATION TO ANSWER THEIR CLINICAL QUESTIONS, THROUGH UPTODATE.COM, A PEER-REVIEWED ONLINE MEDICAL REFERENCE. UPTODATE COVERS MORE THAN 7,400 TOPICS IN 13 MEDICAL SPECIALTIES AND INCLUDES MORE THAN 76,000 PAGES OF TEXT, GRAPHICS, LINKS TO MEDLINE ABSTRACTS, MORE THAN 254,000 REFERENCES, AND A DRUG DATABASE. (G) THE HOSPITAL PROVIDES FREE MEDICATION CARDS TO HELP PATIENTS KEEP TRACK OF THEIR CURRENT MEDICATIONS, AND ITS PHARMACISTS OFFER FREE REGULAR MEDICATION REVIEWS TO CHECK FOR POSSIBLE INTERACTIONS AND EXPIRED MEDICATIONS. (H) THE HOSPITAL OFFERS FREE WIRELESS INTERENT (WI-FI) USE THROUGHOUT THE CAMPUS, AND PROVIDES FREE COMPUTER USE TO VISITORS. (I) THE HOSPITAL PUBLISHES A MONTHLY CONSUMER HEALTH MAGAZINE. THE PUBLICATION CONTAINS INFORMATION ABOUT HEALTH ISSUES AND TRENDS, A CALENDAR OF FREE HEALTHCARE EDUCATION AND SCREENINGS, AND CONTACT INFORMATION FOR HEALTHCARE PROVIDERS. 44,000 COPIES ARE DISTRIBUTED MONTHLY. | OtherInformation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable (4 entries)
| EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|
| HOSPICE OF SE CONNECTICUT | |||
| 222667260 | 501( C)(3) | 8500 | CORPORATE BENEFACTOR |
| CHAMBER OF COMMERCE OF SE CT | |||
| 060475490 | 501( C)(6) | 5405 | SPONSORSHIP |
| COMMUNITY FOUNDATION OF THE TRICOUNTY AREA | |||
| 222897455 | 501( C)(3) | 10000 | DEFRIBULATORS |
| AMERICAN HEART ASSOC | |||
| 135613797 | 501( C)(3) | 15000 | SPONSORSHIP |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 3 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 1 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | SCHOLARSHIPS | TypeOfGrant |
| Number Of Recipients | 3 | NumberOfRecipients |
| Amount Of Cash Grant | 10050 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedures for Monitoring the use of grant funds in the U.S. | Identifier |
| Return Reference | Schedule I, Part I, Line 2. | ReturnReference |
| Explanation | DONATIONS MADE FOR LOCAL EVENTS, SUCH AS THE RELAY FOR LIFE AND HEALTH FAIRS, ARE TYPICALLY ATTENDED BY HOSPITAL EMPLOYEES. THREE SCHOLARSHIPS IN THE AMOUNT OF $3,350 EACH ARE AWARDED TO STUDENTS WHO WILL ATTEND SCHOOL EITHER FOR NURSING OR IN THE MEDICAL FIELD. THE APPLICANTS ARE REVIEWED BY THE SCHOLARSHIP COMMITTEE OF THE AUXILIARY AND WINNERS ARE CHOSEN BASED ON ACADEMICS AS WELL AS COMMUNITY SERVICE. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Written Policy Re T And E Expenses | false | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | 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 | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (11 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID WHITEHEAD | |||||||||||||
| 375897 | 0 | 60000 | 0 | 8685 | 0 | 10234 | 0 | 21253 | 0 | 476069 | 0 | 0 | 0 |
| DANIEL E LOHR | |||||||||||||
| 332246 | 0 | 120000 | 0 | 23463 | 0 | 29715 | 0 | 15296 | 0 | 520720 | 0 | 0 | 0 |
| THOMAS P PIPICELLI | |||||||||||||
| 744737 | 0 | 0 | 0 | 36216 | 0 | 2200661 | 0 | 15295 | 0 | 2996909 | 0 | 0 | 0 |
| MARK SANTAMARIA | |||||||||||||
| 304261 | 0 | 45000 | 0 | 7256 | 0 | 14871 | 0 | 21253 | 0 | 392641 | 0 | 0 | 0 |
| PETER SHEA | |||||||||||||
| 344723 | 0 | 25000 | 0 | 3793 | 0 | 20689 | 0 | 21253 | 0 | 415458 | 0 | 0 | 0 |
| DAVID KALLA MD | |||||||||||||
| 146486 | 0 | 0 | 0 | 359 | 0 | 0 | 0 | 20385 | 0 | 167230 | 0 | 0 | 0 |
| SERGIO CASILLAS MD | |||||||||||||
| 449616 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1487 | 0 | 451103 | 0 | 0 | 0 |
| ROBERT SIDMAN MD | |||||||||||||
| 298320 | 0 | 93106 | 0 | 0 | 0 | 23392 | 0 | 21333 | 0 | 436151 | 0 | 0 | 0 |
| VICTOR ALEXANDER MD | |||||||||||||
| 288091 | 0 | 67661 | 0 | 0 | 0 | 22309 | 0 | 21303 | 0 | 399364 | 0 | 0 | 0 |
| JUAN ESCALON MD | |||||||||||||
| 333361 | 0 | 0 | 0 | 0 | 0 | 16500 | 0 | 21688 | 0 | 371549 | 0 | 0 | 0 |
| DANIEL FAGNANT MD | |||||||||||||
| 253908 | 0 | 68076 | 0 | 0 | 0 | 11464 | 0 | 21160 | 0 | 354608 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| GROSS-UP PAYMENTS | SCHEDULE J, PART I, LINE 1A | THE FORMER PRESIDENT RECEIVED GROSS-UP PAYMENTS ON SELECTED EXPENSES PROPERLY INCLUDED IN HIS W-2 WAGES. |
| SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS | SCHEDULE J, PART I, LINE 4B | DAVID WHITEHEAD, DANIEL E LOHR AND PETER SHEA PARTICIPATE IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN, HOWEVER THERE WERE NO ACCRUALS OR CONTRIBUTIONS THAT WERE MADE TO THE PLAN DURING THE REPORTING PERIOD. THOMAS P PIPICELLI $2,160,980 |
| NON-FIXED PAYMENTS | SCHEDULE J, PART 1, LINE 7 | BONUSES ARE BASED ON THE EVALUATION OF AN INDIVIDUAL'S PERFORMANCE AND ACCOMPLISHMENT OF GOALS SET AT THE BEGINNING OF THE YEAR BY AN INDEPENDENT COMPENSATION COMMITTEE. |
| RETIREMENT AND OTHER DEFERRED COMPENSATION EXPLANATION | SCHEDULE J, PART II, COLUMN C | COMPENSATION IS REPORTED ON THE FORM 990 IN THE YEAR THE COMPENSATION IS EARNED BY OR AWARDED TO AN INDIVIDUAL, EVEN IF THE COMPENSATION IS NOT PAID TO THE INDIVIDUAL, IS NOT FULLY VESTED, OR IS SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. IF COMPENSATION IS EARNED OR AWARDED IN ONE YEAR BUT PAID IN A LATER YEAR, THEN THE COMPENSATION IS GENERALLY REPORTED A SECOND TIME ON THE FORM 990 IN THE YEAR THE COMPENSATION IS PAID TO THE INDIVIDUAL. AS A RESULT OF THE REPORTING REQUIREMENT, AN ORGANIZATION COULD BE REQUIRED TO REPORT THE SAME COMPENSATION ON FORM 990 IN TWO DIFFERENT YEARS. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer |
|---|---|---|---|---|---|---|
| STATE OF CT HEALTH & EDUCATIONAL FACILITIES | ||||||
| 060806186 | 20774LSV3 | 2005-08-10 | 28992719 | SEE SCHEDULE O | false | false |
| STATE OF CT HEALTH & EDUCATIONAL FACILITIES | ||||||
| 060806186 | 20774UC86 | 2008-07-02 | 30168922 | SEE SCHEDULE O | false | false |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Amount DefeasedAmountDefeased | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|---|
| 28992719 | 775086 | 16750062 | 369723 | 10514252 | 2008 | false | true | true | true |
| 30168922 | 0 | 30100000 | 68922 | 0 | 2008 | true | false | true | true |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|---|
| false | false | false | false | true | 0.00000 | 0.00000 | 0.00000 | true |
| false | false | false | false | true | 0.00000 | 0.00000 | 0.00000 | true |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate | Term Of HedgeTermOfHedge | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC |
|---|---|---|---|---|---|---|
| (no name) | ||||||
| false | false | false | false | false | ||
| UBS AG | ||||||
| true | true | true | false | false | 29.9 | false |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | SEE SCHEDULE O | NamePerson |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (13 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990, PART I, LINE 1 & PART III, LINE 1 | THE WILLIAM W. BACKUS HOSPITAL DELIVERS AND COORDINATES A CONTINUUM OF HIGH QUALITY HEALTH CARE THAT IS SENSITIVE TO THE NEEDS OF INDIVIDUALS IN EASTERN CONNECTICUT. THE HOSPITAL IS COMMITTED TO BEING RESPONSIVE AND ACCOUNTABLE TO THOSE FOR WHOSE BENEFIT IT EXISTS, AND TO IMPROVING THE HEALTH OF ITS COMMUNITIES. |
| BUSINESS RELATIONSHIPS | FORM 990, PART VI, SECTION A, LINE 2 | DAVID WHITEHEAD, DANIEL E LOHR, PETER V DISCH AND PETER SHEA HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER. THEY SERVE AS AN OFFICER OR DIRECTOR FOR CONNCARE, INC. OR WWB CORPORATION, WHICH ARE RELATED FOR PROFIT COMPANIES. |
| MEMBERS | FORM 990, PART VI, SECTION A, LINE 6 | BACKUS CORPORATION, A NOT-FOR-PROFIT, 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF THE WILLIAM W. BACKUS HOSPITAL. |
| MEMBERS WHO MAY ELECT THE GOVERNING BODY | FORM 990, PART VI, SECTION A, LINE 7A | BACKUS CORPORATION, BEING THE SOLE MEMBER OF THE WILLIAM W. BACKUS HOSPITAL, HAS THE RIGHT TO ELECT ALL THE BOARD OF TRUSTEES. |
| DECISIONS SUBJECT TO APPROVAL OF MEMBERS | FORM 990, PART VI, SECTION A, LINE 7B | THE ADMINISTRATIVE POWERS OF THE HOSPITAL SHALL BE VESTED IN THE BOARD OF TRUSTEES WHO SHALL HAVE CHARGE, CONTROL AND MANAGEMENT OF THE PROPERTY, AFFAIRS AND FUNDS OF THE HOSPITAL, SHALL BE RESPONSIBLE FOR THE DELIVERY AND MAINTENANCE OF QUALITY PATIENT CARE, THE PROMOTION OF QUALITY IMPROVEMENT, OVERSIGHT OF RISK MANAGEMENT ACTIVITIES, AND WHICH SHALL HAVE THE POWER AND AUTHORITY TO DO AND PERFOM ALL ACTS AND FUNCTIONS NOT INCONSISTENT WITH THE BYLAWS. THE BOARD OF TRUSTEES SHALL MAKE ALL POLICIES AND RULES THAT GOVERN THE HOSPITAL AND SHALL PROVIDE FOR THE ABILITY OF HOSPITAL LEADERSHIP TO ESTABLISH AND IMPLEMENT POLICIES AND TO PROVIDE NECESSARY RESOURCES. |
| 990 REVIEW PROCESS | FORM 990, PART VI, SECTION B, LINE 11A | THE 990 IS PREPARED BY THE ACCOUNTING STAFF AND THEN REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE 990 IS THEN REVIEWED BY THE CFO AND ANY QUESTIONS OR CONCERNS THE CFO MAY HAVE ARE ADDRESSED. THE FINANCE COMMITTEE OF THE BOARD WILL THEN REVIEW THE 990 AND ANY QUESTIONS OR CONCERNS THE FINANCE COMMITTEE HAVE ARE ADDRESSED. THE FINAL FORM 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING. |
| CONFLICT OF INTEREST POLICY | FORM 990, PART VI, SECTION B, LINE 12C | ALL TRUSTEES, OFFICERS, AND KEY EMPLOYEES OF THE HOSPITAL SHALL COMPLETE AND SIGN A DISCLOSURE STATEMENT. THE STATEMENT WILL INCLUDE AN ITEMIZATION AND DESCRIPTION OF ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST AND ALL MATERIAL FACTS RELATED THERETO FOR SUCH TRUSTEE, OFFICER, OR KEY EMPLOYEE BY VIRTUE OF HIS OR HER ACTIVITIES OR THE ACTIVITIES OF RELATED PERSONS. TRUSTEES, OFFICERS, AND KEY EMPLOYEES ARE URGED TO BE INCLUSIVE IN THIS DISCLOSURE OF POTENTIAL AND ACTUAL CONFLICTS OF INTEREST IS ESSENTIAL TO ENSURING DISCUSSION OF CONFLICT. DISCLOSURE STATEMENTS SHALL BE RETURNED TO THE CORPORATE COMPLIANCE OFFICER. ALL DISCLOSURES MADE WILL BE REVIEWED BY THE COMPLIANCE OFFICER, UNDER THE DIRECTION OF THE CHAIR AND THE PRESIDENT, WHO SHALL EXERCISE GOOD FAITH JUDGEMENT AS TO WHETHER A CONFLICT EXISTS. THE CHAIR AND THE PRESIDENT SHALL BE RESPONSIBLE FOR MONITORING TRANSACTIONS OR ARRANGMENTS IN WHICH A TRUSTEE, OFFICER, OR KEY EMPLOYEE MAY HAVE A CONFLICT OF INTEREST AND FOR ASSURING THAT THE TRUSTEE, OFFICER, OR KEY EMPLOYEE SERVES THE HOSPITAL'S BEST INTERESTS. THE COMPLIANCE OFFICER, THE CHAIR AND/OR PRESIDENT MAY CONSULT WITH ANY TRUSTEE, OFFICER, OR KEY EMPLOYEE AND OBTAIN INFORMATION NECESSARY FOR AN ORDINARILY PRUDENT PERSON TO MAKE A JUDGMENT AS TO WHETHER A CONFLICT EXISTS AND EACH TRUSTEE, OFFICER, AND KEY EMPLOYEE SHALL COOPERATE WITH SUCH REQUESTS. THE COMPLIANCE OFFICER, THE CHAIR, AND/OR THE PRESIDENT SHALL PROVIDE GUIDANCE TO THE TRUSTEE, OFFICER, OR KEY EMPLOYEE AND TO THE BOARD OF TRUSTEES AS TO THE APPRORIATE COURSE OF ACTION. WHEN DEEMED PRUDENT BY THE CHAIR OR THE PRESIDENT, THE CHAIR AND THE PRESIDENT SHALL SEEK THE ADVICE AND APPROVAL OF THE FULL BOARD OF TRUSTEES OR GOVERNANCE COMMITTEE IN DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS AND THAT THE TRUSTEE, OFFICER, OR KEY EMPLOYEE SERVES THE HOSPITAL'S BEST INTERESTS. IF, AFTER COMPLETING AND SIGNING THE ANNUAL DISCLOSURE STATEMENT, AN ACTUAL OR POTENTIAL CONFLICT ARISES, THE TRUSTEE, OFFICER, OR KEY EMPLOYEE WITH THE CONFLICT SHALL PROMPTLY NOTIFY THE COMPLIANCE OFFICER IN WRITING. TRUSTEES, OFFICERS, AND KEY EMPLOYEES WHO HAVE DECLARED OR HAVE BEEN DEEMED TO HAVE A CONFLICT OF INTEREST MUST REFRAIN FROM CONSIDERATION OF PROPOSED TRANSACTIONS OR ARRANGMENTS, UNLESS FOR SPECIAL REASON THE BOARD OF TRUSTEES REQUESTS INFORMATION OR INTERPRETATIONS. |
| COMPENSATION REVIEW | FORM 990, PART VI, SECTION B, LINES 15A & B | A PERFORMANCE REVIEW COMMITTEE CONSISTING OF INDEPENDENT BOARD MEMBERS REVIEWS THE PERFORMANCE OF THE SENIOR MANAGEMENT TEAM. COMPENSATION IS BASED ON THE RESULTS OF THESE REVIEWS. THE COMMITTEE ALSO TAKES INTO CONSIDERATION INFORMATION FROM COMPENSATION SURVEYS. |
| JOINT VENTURES | FORM 990, PART VI, SECTION B, LINE 16B | ALL NEW VENTURES ARE REVIEWED BY OUTSIDE COUNSEL AND PRESENTED TO THE BOARD FOR REVIEW AND APPROVAL. |
| AVAILABILITY OF DOCUMENTS | FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. PLEASE CONTACT DANIEL E LOHR AT 326 WASHINGTON STREET, NORWICH, CT, 06360, ABOUT INSPECTING THE ORGANIZATION'S DOCUMENTS. |
| AVERAGE HOURS WORKED FOR RELATED ORGANIZATIONS | FORM 990, PART VII, SECTION A, LINE 1A | AVG HOURS WORKED FOR RELATED ORGANIZATIONS ---------------------- DAVID WHITEHEAD 14 DANIEL E LOHR 18 PETER V DISCH 1.25 ROBERT RAMSDELL 1 JOSEPH FATONE 1 ANTHONY JOYCE 1 JOHN F BILDA 1 STEPHEN T BRIGGS, MD 1 ELIZABETH CONWAY 1 BERT A COPPOTELLI, MD 1 GRACE JONES, PHD 1 DEBORAH MONAHAN 1 TODD POSTLER 1 PATRICIA STUART, MD 1 PETER SHEA .25 THOMAS P PIPICELLI 10 |
| TAX-EXEMPT BONDS | SCHEDULE K, PART I | A-(F)- ADVANCE REFUND SERIES D/ FINANCE A PORTION OF THE COST OF THE PROJECT. B-(F)- CONSTRUCTION, RENNOVATION, AND IMPROVEMENTS TO THE FACILITY PURSUANT TO THE FACILITY MASTER PLAN |
| BUSINESS TRANSACTION INVOLVING INTERESTED PERSONS | SCHEDULE L, PART IV | TRANSACTION 1 (A) CONNCARE, INC. (B) DAVID WHITEHEAD, DANIEL E LOHR, PETER V DISCH AND PETER SHEA ARE OFFICERS, TRUSTEES, DIRECTORS AND/OR KEY EMPLOYEES OF THE WILLIAM W. BACKUS HOSPITAL(WWBH) AND CONNCARE, INC. (CI) (C)/(D) $4,327,890 REIMBURSEMENTS PAID BY CI TO WWBH $ 133,914 PERFORMANCE OF SERVICES BY WWBH FOR CI $ 214,184 LEASE FACILITIES AND EQUIPMENT TO CI BY WWBH $ 71,348 TRANSFER OF ASSETS TO CI FROM WWBH (E) NO |
Schedule R IRS990ScheduleR
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 | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|
| BACKUS FOUNDATION INC | ||||||||||
| 326 WASHINGTON ST | NORWICH | CT | 06360 | 222481795 | FUNDRAISING | CT | 501( C)(3) | 7 | NA | |
| BACKUS HEALTHCARE INC | ||||||||||
| 326 WASHINGTON ST | NORWICH | CT | 06360 | 222481794 | SUPPORT | CT | 501( C)(3) | PF | NA | |
| BACKUS PROPERTIES INC | ||||||||||
| 326 WASHINGTON ST | NORWICH | CT | 06360 | 222767730 | TITLE HOLDING | CT | 501( C)(2) | NA | ||
| BACKUS CORPORATION | ||||||||||
| 326 WASHINGTON ST | NORWICH | CT | 06360 | 222757608 | SUPPORT | CT | 501( C)(3) | 11b | N/A | |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OMNI HOME HEALTH SERVICES OF EASTERN CT | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | NORWICH CT 06360 | AddressLine1 |
| City | NORWICH | City |
| State | CT | State |
| ZIP Code | 06360 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 061458837 | EIN |
| Primary Activity | HOME HEALTH CARE | PrimaryActivity |
| Legal Domicile State | CT | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | N/A | PredominantIncomeType |
| Share Of Total Income | 0 | ShareOfTotalIncome |
| Share Of EOY Assets | 0 | ShareOfEOYAssets |
| Code V | $0 | CodeVAmount |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WWB CORPORATION | |||||||||||
| 326 WASHINGTON ST | NORWICH | CT | 06360 | 061094838 | HOLDING COMPANY | CT | NA | C CORP | 0 | 0 | 0.00000 |
| CONNCARE INC | |||||||||||
| 326 WASHINGTON ST | NORWICH | CT | 06360 | 061387598 | HEALTH CARE SRVCS | CT | NA | C CORP | 0 | 0 | 0.00000 |
| BACKUS MEDICAL CENTER CONDO ASSOC INC | |||||||||||
| 330 WASHINGTON ST | NORWICH | CT | 06360 | 061542647 | CONDO ASSOCIATION | CT | NA | C CORP | 0 | 0 | 0.69000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | true | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BACKUS PROPERTIES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | R | TransactionType |
| Amount Involved | 1402938 | AmountInvolved |
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