MIDDLESEX HEALTH SYSTEM INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- MIDDLESEX HEALTH SYSTEM INC (EIN 22-2676137)
- Tax period
- 2009-10-01 to 2010-09-30
- Filed
- 2011-08-12
- IRS object ID
- 201122289349300627
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-08-12T11:25:37-05:00 | 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 | KPMG LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | One Financial Plaza | AddressLine1 |
| City | Hartford | City |
| State | CT | State |
| ZIP Code | 061032608 | 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 | 222676137 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDDLESEX HEALTH SYSTEM INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MIDD | NameControl |
| Phone | 8603586395 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 28 CRESCENT STREET | AddressLine1 |
| City | MIDDLETOWN | City |
| State | CT | State |
| ZIP Code | 06457 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SUSAN MARTIN | Name |
| Title | VP FINANCE TREASURER | Title |
| Date Signed | 2011-08-12 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8605223200 | 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 | VINCENT CAPECE - PRESIDENTCEO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 28 CRESCENT STREET | AddressLine1 |
| City | MIDDLETOWN | City |
| State | CT | State |
| ZIP Code | 06457 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 860928 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.MIDDLESEXHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1895 | YearFormation |
| State Legal Domicile | CT | StateLegalDomicile |
| Activity Or Mission Description | MIDDLESEX HEALTH SYSTEM'S MISSION IS TO PROVIDE FUNDRAISING FOR MIDDLESEX HOSPITAL, AN ACUTE CARE GENERAL HOSPITAL ESTABLISHED TO PROVIDE HIGH QUALITY INPATIENT AND OUTPATIENT HEALTH SERVICES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 6 | TotalNbrEmployees |
| Total Nbr Volunteers | 11 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 876018 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 860928 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 0 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 876018 | TotalRevenuePriorYear |
| Total Revenue Current Year | 860928 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 584029 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 628609 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 845449 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 291989 | OtherExpensePriorYear |
| Other Expenses Current Year | 232319 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 876018 | TotalExpensesPriorYear |
| Total Expenses Current Year | 860928 | TotalExpensesCurrentYear |
| Revenues Less Expenses CY | 0 | RevenuesLessExpensesCY |
| Total Assets BOY | 14591 | TotalAssetsBOY |
| Total Assets EOY | 14591 | TotalAssetsEOY |
| Total Liabilities BOY | 0 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 14591 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 14591 | NetAssetsOrFundBalancesEOY |
| Mission Description | MIDDLESEX HEALTH SYSTEM'S MISSION IS TO PROVIDE FUNDRAISING FOR MIDDLESEX HOSPITAL, AN ACUTE CARE GENERAL HOSPITAL ESTABLISHED TO PROVIDE HIGH QUALITY INPATIENT AND OUTPATIENT HEALTH SERVICES. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 0 | Expense |
| Revenue | 860928 | Revenue |
| Description | MIDDLESEX HEALTH SYSTEM, INC. MANAGES THE FUNDRAISING ACTIVITIES OF MIDDLESEX HOSPITAL. IT PROMOTES THE DEVELOPMENT OF COMPREHENSIVE HEALTHCARE RELATED SERVICES THROUGH MANAGEMENT OF FUNDRAISING ACTIVITIES. | Description |
| Total Program Service Expense | 0 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | false | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 6 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | CT | StatesWhereCopyOfReturnIsFiled |
| Own Website | X | OwnWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | SUSAN MARTIN | NamePerson |
| Telephone Number | 8603583005 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 28 CRESCENT STREET | AddressLine1 |
| City | MIDDLETOWN | City |
| State | CT | State |
| ZIP Code | 06457 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| NANCY D'OENCH | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| CHANDLER HOWARD | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| HUGH MACKENZIE | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| BRUCE MACMILLIAN | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| JAMES MATSCHULAT | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| JOHN RAFAL | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| ERIC THORNBURG | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| BARBARA WEISS | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| GARY WILLIS | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| ROBERT KIELY | ||||||||
| FORMER PRESIDENT /CEO | 1.0 | X | 0 | 1113319 | 200570 | X | ||
| DAVID BAGGISH MD | ||||||||
| CHIEF OF MEDICINE SECRETARY | 1.0 | X | 0 | 341602 | 4166 | X | ||
| R CHRISTOPHER SEATON | ||||||||
| CHAIRMAN | 1.0 | X | 0 | 0 | 0 | X | ||
| GEOFFREY HERTER MD | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | X | ||
| VINCENT CAPECE JR | ||||||||
| PRESIDENT/ CEO | 1.0 | X | 0 | 519404 | 92730 | X | ||
| SUSAN MARTIN | ||||||||
| VP FINANCE TREASURER | 1.0 | 0 | 333612 | 68469 | X | |||
| LAURA MARTINO | ||||||||
| VP MARKETING & DEVELOPMENT | 40.0 | 245977 | 0 | 45320 | X | |||
| BARBARA FERGIONE | ||||||||
| DIRECTOR, PHILANTHROPY | 40.0 | 118635 | 0 | 1089 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 364612 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2307937 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 412344 | TotalOtherCompensation |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | NA | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Of Contractor | AddressOfContractor |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Total Contributions | 0 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | FUNDRAISING | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 860928 | TotalRevenueColumn |
| Related Or Exempt Function Income | 860928 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 860928 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 0 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 0 | GrossIncomeFundraisingEvents |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Gaming | 0 | GrossIncomeGaming |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 860928 | TotalRevenueColumn |
| Related Or Exempt Function Income | 860928 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 227359 | Total |
| Fundraising | 227359 | Fundraising |
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 | 307029 | Total |
| Program Services | 0 | ProgramServices |
| Fundraising | 307029 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23410 | Total |
| Fundraising | 23410 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 39486 | Total |
| Fundraising | 39486 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31325 | Total |
| Fundraising | 31325 | 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 | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44484 | Total |
| Fundraising | 44484 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12026 | Total |
| Management And General | 12026 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 667 | Total |
| Fundraising | 667 | 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 | 2613 | Total |
| Management And General | 2613 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | FundraisingFundraising | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PURCHASED SERVICES | 155961 | 155961 | |
| DUES & SUBSCRIPTIONS | 840 | 840 | |
| MISCELLANEOUS EXPENSES | 15728 | 15728 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 860928 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 15479 | ManagementAndGeneral |
| Fundraising | 845449 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14591 | BOY |
| EOY | 14591 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14591 | BOY |
| EOY | 14591 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14591 | BOY |
| EOY | 14591 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14591 | BOY |
| EOY | 14591 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14591 | BOY |
| EOY | 14591 | 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 Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type2 | X | SupportingOrg509a3Type2 |
| Certification Checkbox | X | CertificationCheckbox |
| Written IRS Determination | X | WrittenIRSDetermination |
| Contrib By Controlling Individual | false | ContribByControllingIndividual |
| Contribution By Related Party | false | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | false | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation (2 entries)
| EINEIN | Type Of OrganizationTypeOfOrganization | Listed In Governing DocListedInGoverningDoc | AmountAmount |
|---|---|---|---|
| MIDDLESEX HOSPITAL | |||
| 060646718 | 03 | true | $0 |
| MIDDLESEX HEALTH SERVICES INC | |||
| 222676140 | 09 | true | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 2 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | true | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | true | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT KIELY | |||||||||||||
| 0 | 564888 | 0 | 190750 | 0 | 357681 | 0 | 198450 | 0 | 2120 | 0 | 1313889 | 0 | 0 |
| DAVID BAGGISH MD | |||||||||||||
| 0 | 331396 | 0 | 0 | 0 | 10206 | 0 | 0 | 0 | 4166 | 0 | 345768 | 0 | 0 |
| VINCENT CAPECE JR | |||||||||||||
| 0 | 344772 | 0 | 70500 | 0 | 104132 | 0 | 87500 | 0 | 5230 | 0 | 612134 | 0 | 0 |
| SUSAN MARTIN | |||||||||||||
| 0 | 272548 | 0 | 52000 | 0 | 9064 | 0 | 66000 | 0 | 2469 | 0 | 402081 | 0 | 0 |
| LAURA MARTINO | |||||||||||||
| 177884 | 0 | 37500 | 0 | 30593 | 0 | 43200 | 0 | 2120 | 0 | 291297 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| BENEFITS | PART I, LINE 1A | GROSS UP PAYMENTS - REPRESENTS THE FEDERAL AND STATE INCOME TAX PAID BY THE ORGANIZATION ON BEHALF OF THE INDIVIDUAL FOR CERTAIN NON-CASH BENEFITS PROVIDED. ONE EMPLOYEE NOTED ON FORM 990, PART VII, RECEIVED THIS BENEFIT. |
| ESTABLISH COMPENSATION | PART I, LINE 3 | MIDDLESEX HEALTH SYSTEM'S OFFICER SALARIES AND BENEFITS ARE PAID BY MIDDLESEX HOSPITAL. SALARIES AND BENEFITS ARE DETERMINED UNDER THE COMPENSATION POLICIES OF MIDDLESEX HOSPITAL WHICH INCLUDE THE USE OF A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, THE FORM 990 OF OTHER ORGANIZATIONS, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN | PART I, LINE 4B | ALTHOUGH THE BENEFIT IS NOT PAYABLE UNTIL RETIREMENT, THE NONQUALIFIED RETIREMENT PLAN BENEFIT ACCRUES ANNUALLY AND THE PLAN PROVIDES THAT A PARTICIPANT VESTS AFTER FIVE (5) YEARS OF SERVICE. THE AMOUNT OF THE VESTED BENEFIT IS CONSIDERED "INCOME" TO THE EXECUTIVE AS IT IS EARNED. THE INCOME IS REPORTED ON THE EXECUTIVE'S W-2 FORM AND IS TAXABLE. MIDDLESEX HOSPITAL SUPPLEMENTS THE EXECUTIVE'S INCOME TO PAY FOR THIS TAX CONSEQUENCE AS THE EARNED BENEFITS VEST. THE TOTAL OF THESE SUPPLEMENTAL PAYMENTS, CUMULATIVE WITH INTEREST, ARE OFFSET AGAINST THE NONQUALIFIED RETIREMENT PLAN BENEFIT AT THE TIME OF RETIREMENT. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NONQUALIFIED RETIREMENT PLAN. THE AMOUNTS REPORTED BELOW REPRESENT BENEFITS ACCRUED DURING 2008, NOT PAYABLE UNTIL RETIREMENT. ROBERT KIELY $179,642 VINCENT CAPECE, JR. $ 41,780 |
| COMPENSATION CONTINGENT ON REVENUE | PART I, LINE 5 A AND 5B | THERE ARE FOUR (4) BROAD CATEGORIES OF EXECUTIVE INCENTIVE GOALS: CLINICAL QUALITY AND PATIENT SATISFACTION (40%), FINANCIAL STRENGTH (30%), WORKPLACE ENVIRONMENT (15%), AND COMMUNITY BENEFIT/CHARITABLE MISSION EFFECTIVENESS (15%). WITHIN EACH CATEGORY ARE MORE SPECIFIC GOALS WHICH ARE DETERMINED FROM OUR OWN PAST EXPERIENCE AS WELL AS STATE AND NATIONAL BENCHMARK DATA. THE INCENTIVE COMPENSATION OF THE EXECUTIVE STAFF IS DETERMINED WITH REFERENCE TO PERFORMANCE RELATIVE TO THESE GOALS. |
| COMPENSATION | SCHEDULE J, PART II | BONUS & INCENTIVE COMPENSATION - COLUMN B(II) THE AMOUNTS REPORTED REPRESENT INCENTIVE COMPENSATION PAYMENTS MADE IN 2009. PAYMENTS INCLUDE AMOUNTS EARNED IN 2008 AND DEFERRED, WHERE APPLICABLE. DEFERRED COMPENSATION - COLUMN (C) THE DEFERRED COMPENSATION REPORTED IN COLUMN (C) REPRESENTS INCENTIVE COMPENSATION EARNED IN 2009 THAT WILL BE PAID AND INCLUDED IN TAXABLE WAGES IN A LATER YEAR. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| REVIEW PROCESS | FORM 990, PART VI, SECTION B, LINE 11A | DRAFT FORMS OF THE 990, INCLUDING REQUIRED SCHEDULES, ARE PROVIDED TO EACH BOARD MEMBER FOR REVIEW. MEMBERS REVIEW THE DOCUMENT AND DISCUSS IN DETAIL AT A BOARD MEETING. ANY QUESTIONS OR COMMENTS ARE PRESENTED TO EXECUTIVE MANAGEMENT PRIOR TO FILING. A COPY OF THE FINAL FORM 990 WILL BE PROVIDED TO THE BOARD PRIOR TO FILING WITH THE IRS VIA A WEB BASED COMMUNICATION PORTAL. |
| CONFLICT OF INTEREST POLICY | FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST FORMS ARE DISTRIBUTED ANNUALLY TO KEY EMPLOYEES, OFFICERS AND THE BOARD OF DIRECTORS. RESPONSES ARE RETURNED TO, TRACKED, AND REVIEWED BY THE COMPLIANCE OFFICER. INFORMATION REPORTED IS CONSIDERED PERSONAL AND CONFIDENTIAL AND ONLY DISCLOSED WHEN DEEMED NECESSARY TO PROTECT THE HOSPITAL AGAINST THE EFFECTS OF CONFLICTS OF INTEREST AND ONLY AFTER ADVISING THE REPORTING PERSON OF THE PROPOSED DISCLOSURE AND OF ITS EXTENT. MATERIAL CONFLICTS ARE REPORTED TO THE BOARDS AUDIT COMMITTEE FOR REVIEW AND DETERMINATION. IN ADDITION TO COMPLETING THE ANNUAL CONFLICT OF INTEREST FORM, BOARD MEMBERS MUST IMMEDIATELY DISCLOSE ANY INTEREST AND ALL MATERIAL FACTS TO THE BOARD OF DIRECTORS. THE BOARD THEN REVIEWS THE FACTS AND MAKES THE DETERMINATION AS TO WHETHER A SIGNIFICANT CONFLICT OF INTEREST EXISTS. IF SO, THE BOARD FOLLOWS DISABLING GUIDELINES TO DETERMINE IF THE BOARD MEMBER SHOULD BE ASKED TO RESIGN OR BE REMOVED. |
| COMPENSATION POLICY | FORM 990, PART VI, SECTION B, LINE 15B | MIDDLESEX HEALTH SYSTEM'S OFFICER SALARIES AND BENEFITS ARE PAID BY MIDDLESEX HOSPITAL. OFFICER SALARIES ARE DETERMINED UNDER THE COMPENSATION POLICIES OF MIDDLESEX HOSPITAL WHICH INCLUDE THE FOLLOWING: EXECUTIVE TEAM COMPENSATION IS REVIEWED ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD. THE COMMITTEE HAS A CHARTER AND A POLICY STATEMENT SETTING FORTH A PROCESS AND CERTAIN GUIDELINES FOR DETERMINING COMPENSATION. EXECUTIVES RECEIVE A BASE SALARY AND HAVE THE OPPORTUNITY FOR INCENTIVE COMPENSATION WITHIN A RANGE SET BY THE POLICY. FOLLOWING THE CLOSE OF EACH FISCAL YEAR, THE COMMITTEE RECEIVES A MARKET ANALYSIS FROM INDEPENDENT CONSULTANTS REGARDING COMPENSATION AT PEER GROUPS OF COMPARABLE HOSPITALS AND HEALTH SYSTEMS. POSITIONS WITHIN THE EXECUTIVE TEAM ARE COMPARED TO BENCHMARK POSITIONS WITHIN THIS MARKET DATA AND THEIR COMPENSATION IS COMPARED TO THE DATA BOTH WITH RESPECT TO CASH COMPENSATION AND TOTAL COMPENSATION INCLUDING FRINGE BENEFITS. THE CEO RECOMMENDS THE INCENTIVE AWARDS AND BASE SALARY ADJUSTMENTS TO THE COMPENSATION OF THE EXECUTIVES WHO REPORT TO HIM, AND THE COMMITTEE REVIEWS THOSE RECOMMENDATIONS, APPROVES OR MODIFIES THEM, AND ALSO DETERMINES ANY INCENTIVE AWARD AND BASE SALARY ADJUSTMENT FOR THE CEO. THE CONSULTANTS PROVIDE A WRITTEN OPINION ANNUALLY CONFIRMING THAT THE COMPENSATION OF THE EXECUTIVES, AS ADJUSTED BY THIS PROCESS, IS "REASONABLE" WITHIN APPLICABLE IRS GUIDELINES. KEY EMPLOYEE COMPENSATION IS SET FOLLOWING THE GUIDELINES SET FORTH IN THE HOSPITAL COMPENSATION POLICY. THE OBJECTIVE OF THIS POLICY IS TO PAY EMPLOYEES BASED UPON HOSPITAL NEED, THE PROPER EXTERNAL LABOR MARKET AND PERFORMANCE. |
| PUBLIC DISCLOSURE | FORM 990, PART VI, SECTION C, LINE 19 | MIDDLESEX HEALTH SYSTEM, INC. ("SYSTEM") IS A RELATED CORPORATION TO MIDDLESEX HOSPITAL. THE MIDDLESEX HEALTH SYSTEM MAINTAINS A QUALITY AND COMPLIANCE SECTION ON THE HOSPITAL'S WEBSITE, MIDDLESEXHOSPITAL.ORG. SYSTEM POSTS THE MOST CURRENT AUDITED FINANCIAL STATEMENTS AND FORM 990 WITH THOSE OF THE HOSPITAL AND OTHER AFFILIATES AS THEY BECOME AVAILABLE. THE CONFLICT OF INTEREST POLICY OF THE MIDDLESEX HEALTH SYSTEM IS ALSO POSTED ON THE WEBSITE IN THE FOR VENDORS AND SUPPLIERS SECTION. IN ADDITION, SYSTEM' FORM 990 IS AVAILABLE AT WWW.GUIDESTAR.ORG AND UPON REQUEST. |
| CONSOLIDATED AUDITED FINANCIAL STATEMENTS | FORM 990, PART IV, LINE 12 AND PART XI LINE 2 | MIDDLESEX HEALTH SYSTEM, INC.'S FINANCIAL STATEMENTS WERE AUDITED ON A CONSOLIDATED BASIS. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (3 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 |
|---|---|---|---|---|---|---|---|---|---|
| MIDDLESEX HOSPITAL | |||||||||
| 28 CRESCENT STREET | MIDDLETOWN | CT | 06457 | 060646718 | HEALTHCARE | CT | 501(C)(3) | 3 | NA |
| MIDDLESEX HEALTH SERVICES INC | |||||||||
| 28 CRESCENT STREET | MIDDLETOWN | CT | 06457 | 222676140 | HEALTHCARE | CT | 501(C)(3) | 9 | NA |
| MIDDLESEX HOSPITAL FOUNDATION INC | |||||||||
| 28 CRESCENT STREET | MIDDLETOWN | CT | 06457 | 273720822 | MSX HSP SUPP | CT | 501(C)(3) | 11B | NA |
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MIDDLESEX HEALTH RESOURCES INC | |||||||||||
| 28 CRESCENT STREET | MIDDLETOWN | CT | 06457 | 061089925 | HEALTHCARE | CT | MID HEALTH SYS | C CORP | 676361 | 3673396 | 1.00000 |
| INTEGRATED RESOURCES FOR MIDDLESEX AREA | |||||||||||
| 28 CRESCENT STREET | MIDDLETOWN | CT | 06457 | 061462230 | OUTPATIENT CARE | CT | MID HEALTH SYS | C CORP | 0 | 0 | 1.00000 |
| MHS PRIMARY CARE INC | |||||||||||
| 28 CRESCENT STREET | MIDDLETOWN | CT | 06457 | 061472743 | HEALTHCARE | CT | MID HEALTH SYS | C CORP | 9982588 | 3860344 | 1.00000 |
| 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 | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | 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 | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| MHS PRIMARY CARE INC | |
| B | 2466000 |
| MIDDLESEX HOSPITAL | |
| C | 2466000 |
| MIDDLESEX HOSPITAL | |
| P | 860900 |
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