MIDDLESEX HOSPITAL: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization: MIDDLESEX HOSPITAL (EIN 06-0646718)
Tax period: 2022-10-01 to 2023-09-30
Filed: 2024-08-07
IRS object ID: 202442209349301439
Schema version: 2022v5.0
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 M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2024-08-07T14:52:00-05:00	ReturnTs
Tax Period End	2023-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	111986323	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	MARCUM LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	555 LONG WHARF DRIVE	AddressLine1Txt
City	NEW HAVEN	CityNm
State Abbreviation	CT	StateAbbreviationCd
ZIP	06511	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2022-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	060646718	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MIDDLESEX HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	MIDD	BusinessNameControlTxt
Phone	8603586395	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	28 CRESCENT STREET	AddressLine1Txt
City	MIDDLETOWN	CityNm
State Abbreviation	CT	StateAbbreviationCd
ZIP	06457	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	SUSAN MARTIN	PersonNm
Person Title	VP FINANCE & TREASURER	PersonTitleTxt
Phone	8603586395	PhoneNum
Signature	2024-08-01	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	0	IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	MARY ANTONETTI	PreparerPersonNm
PTIN	P00431862	PTIN
Phone	2037819600	PhoneNum
Preparation	2024-08-01	PreparationDt

Field	Value	IRS element (for citing)
Tax	2022	TaxYr
Build TS	2024-08-08 14:25:15Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	VINCENT CAPECE JR	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	28 CRESCENT STREET	AddressLine1Txt
City	MIDDLETOWN	CityNm
State Abbreviation	CT	StateAbbreviationCd
ZIP	06457	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$557,942,376	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.MIDDLESEXHOSPITAL.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1895	FormationYr
Legal Domicile State	CT	LegalDomicileStateCd
Activity Or Mission	A NON-PROFIT, ACUTE CARE, COMMUNITY HOSPITAL IN MIDDLETOWN, CT. (SEE SCHEDULE O)MIDDLESEX HOSPITAL IS COMMITTED TO PROVIDING HIGH QUALITY INPATIENT AND OUTPATIENT HEALTHCARE SERVICES. THE HOSPITAL RECOGNIZES COMMUNITY TRANSPARENCY AND INTEGRITY AS FUNDAMENTAL RESPONSIBILITIES.	ActivityOrMissionDesc
Voting Members Governing Body	12	VotingMembersGoverningBodyCnt
Voting Members Independent	11	VotingMembersIndependentCnt
Total Employee	3628	TotalEmployeeCnt
Total Volunteers	320	TotalVolunteersCnt
Total Gross UBI	$868,641	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$7,720	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$14,664,845	PYContributionsGrantsAmt
CY Contributions Grants	$5,932,612	CYContributionsGrantsAmt
PY Program Service Revenue	$451,862,643	PYProgramServiceRevenueAmt
CY Program Service Revenue	$486,141,966	CYProgramServiceRevenueAmt
PY Investment Income	$7,895,630	PYInvestmentIncomeAmt
CY Investment Income	$11,470,240	CYInvestmentIncomeAmt
PY Other Revenue	$10,048,100	PYOtherRevenueAmt
CY Other Revenue	$9,094,420	CYOtherRevenueAmt
PY Total Revenue	$484,471,218	PYTotalRevenueAmt
CY Total Revenue	$512,639,238	CYTotalRevenueAmt
PY Grants And Similar Paid	$144,225	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$150,290	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$256,723,633	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$270,526,465	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$994,467	CYTotalFundraisingExpenseAmt
PY Other Expenses	$198,914,614	PYOtherExpensesAmt
CY Other Expenses	$215,035,177	CYOtherExpensesAmt
PY Total Expenses	$455,782,472	PYTotalExpensesAmt
CY Total Expenses	$485,711,932	CYTotalExpensesAmt
PY Revenues Less Expenses	$28,688,746	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$26,927,306	CYRevenuesLessExpensesAmt
Total Assets BOY	$546,749,767	TotalAssetsBOYAmt
Total Assets EOY	$557,504,992	TotalAssetsEOYAmt
Total Liabilities BOY	$151,860,206	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$148,816,360	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$394,889,561	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$408,688,632	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	MIDDLESEX HOSPITAL EXISTS TO PROVIDE THE SAFEST, HIGHEST-QUALITY HEALTH CARE AND THE BEST EXPERIENCE POSSIBLE FOR OUR COMMUNITY. (CONTINUED ON SCHEDULE O)	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$432,848,109	ExpenseAmt
Grant	$150,290	GrantAmt
Revenue	$493,275,454	RevenueAmt
Desc	IN MARCH OF 2020, MIDDLESEX HOSPITAL AS PART OF MIDDLESEX HEALTH'S COMMUNITY HEALTH AND WELL-BEING BASED WORK SHIFTED DRAMATICALLY TO ADDRESS THE COVID-19 PANDEMIC AND RESPOND TO COMMUNITY LEVEL NEEDS. MIDDLESEX HOSPITAL CONTINUES TO GO ABOVE AND BEYOND TO PROVIDE THE SAFEST POSSIBLE CARE TO ALL PATIENTS, WHETHER OR NOT THEIR ILLNESS IS RELATED TO THE CORONAVIRUS. MIDDLESEX HOSPITAL CONTINUES TO PROVIDE UPDATES AND ACCESS TO RESOURCES TO HELP MEMBERS OF THE COMMUNITY STAY SAFE AND HEALTHY DURING THESE CHALLENGING TIMES. ARMED WITH SKILLED STAFF, PROGRESSIVE DIAGNOSTIC TOOLS AND ADVANCED SURGICAL TECHNIQUES, THE HOSPITAL WAS WELL POSITIONED TO ENSURE A COMFORTABLE, SAFE ENVIRONMENT FOR EXCEPTIONAL MEDICAL TREATMENT AND RECOVERY. (CONTINUED ON SCHEDULE O)IN THE FISCAL YEAR ENDING 9/30/23, INPATIENT CARE REPRESENTED 11,412 DISCHARGES AND 51,957 PATIENT CARE DAYS. INPATIENT CARE FROM REGISTRATION THROUGH DISCHARGE IS CAREFULLY MANAGED TO EXCEED REGULATORY REQUIREMENTS AND ENSURE QUALITY, PATIENT SATISFACTION, AND BEST PRACTICE WITH EACH ASPECT OF THE INPATIENT EXPERIENCE, INCLUDING ALL ELEMENTS OF CARE FROM NURSING COMPETENCY AND COMPASSION, TO MEAL QUALITY, LAB AND DIAGNOSTIC TESTING, SAFE AND SECURE PHYSICAL SURROUNDINGS TO PATIENT EDUCATION. MIDDLESEX HOSPITAL, LICENSED FOR 275 BEDS AND 22 BASSINETS, PROVIDES ACUTE CARE FROM DEDICATED HEALTH CARE TEAMS WHICH INCLUDE SURGEONS, HOSPITALISTS, FAMILY PRACTITIONERS AND RESIDENTS, MEDICAL STAFF PHYSICIANS, MAGNET NURSES, PHYSICIAN ASSISTANTS, PATIENT CARE TECHNOLOGISTS, DIAGNOSTIC TECHNICIANS, PATHOLOGISTS, ADMINISTRATORS, ENVIRONMENTAL SERVICES, SECURITY, ENGINEERING AND A HOST OF OTHERS WORKING TOGETHER TO ENABLE THE ORGANIZATION'S SUCCESS.THE HOSPITAL UNITS INCLUDING INTENSIVE AND CRITICAL CARE, MEDICAL SURGICAL, ONCOLOGY, ORTHOPEDIC, PULMONOLOGY, VASCULAR AND CARDIOLOGY, GASTROINTESTINAL, MATERNITY, A 20-BED PSYCHIATRIC FLOOR, AND HOSPICE SERVICES SPECIALIZE IN THE SPECIFIC NEEDS OF THEIR PATIENTS AND ARE STAFFED TO ACCOMMODATE THE UNIQUE TREATMENT REQUIREMENTS OF EACH. ALL ANCILLARY SERVICES INCLUDING LABS, RADIOLOGY, FOOD SERVICES, PATHOLOGY, PHARMACY, MEDICAL TRANSCRIPTION AND INFORMATION SERVICES TOO ARE A PART OF THE HOSPITAL TEAM. PATIENT CARE IS DEVELOPED WITH FULL CONSIDERATION OF THE WHOLE INDIVIDUAL, AS THEY ARE ASSIGNED TO CONDITION SPECIFIC CARE PATHWAYS AND SERVICES TO SECURE BEST TREATMENT AND RECOVERY.	Desc
Total Program Service Expenses	$432,848,109	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (1)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	Yes (1)	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	Yes (1)	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	Yes (1)	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	0	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	270	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	3628	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	Yes (1)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (1)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	Yes (1)	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	12	GoverningBodyVotingMembersCnt
Independent Voting Member	11	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (1)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	CT	StatesWhereCopyOfReturnIsFldCd
Own Website	Yes (X)	OwnWebsiteInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	SHANNON ST HILAIRE	PersonNm
Phone	8603586000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	28 CRESCENT STREET	AddressLine1Txt
City	MIDDLETOWN	CityNm
State Abbreviation	CT	StateAbbreviationCd
ZIP	06457	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
VINCENT CAPECE JR
PRESIDENT/CEO	40.00	4.00	Yes (X)	Yes (X)	$1,361,746	$0	$312,709
DAVID C BENOIT
DIRECTOR	1.00	3.00	Yes (X)		$0	$0	$0
JEAN M D'AQUILA
DIRECTOR	1.00	4.00	Yes (X)		$0	$0	$0
JOHN J GAUTHIER
DIRECTOR	1.00	3.00	Yes (X)		$0	$0	$0
ROBERT C HINTON
DIRECTOR	1.00	3.00	Yes (X)		$0	$0	$0
CHANDLER J HOWARD
VICE CHAIRMAN	1.00	3.00	Yes (X)	Yes (X)	$0	$0	$0
JONATHAN D LEVINE MD
SECRETARY	1.00	4.00	Yes (X)	Yes (X)	$0	$0	$0
MARK D LORENZE MD
ASST SECRETARY	1.00	3.00	Yes (X)	Yes (X)	$0	$0	$0
BRUCE S MACMILLIAN
DIRECTOR (LEFT 9/30/23)	1.00	4.00	Yes (X)		$0	$0	$0
DARRELL G PATASKA
CHAIRMAN	1.00	3.00	Yes (X)	Yes (X)	$0	$0	$0
CHRISTINE H REPASY
DIRECTOR	1.00	3.00	Yes (X)		$0	$0	$0
GARY M WALLACE
DIRECTOR	1.00	3.00	Yes (X)		$0	$0	$0
MARK BERTOLAMI
DIRECTOR	1.00	3.00	Yes (X)		$0	$0	$0
SUSAN MARTIN
VP FINANCE/TREASURER	40.00	4.00		Yes (X)	$514,497	$0	$69,174
JONATHAN BANKOFF
CHAIRMAN EMERGENCY MEDICINE	40.00	0.00			$492,992	$0	$52,539	Yes (X)
TODD BISCHOP
CHIEF DEPT OF MED	40.00	0.00			$430,306	$0	$20,718	Yes (X)
DAVID GIUFFRIDA
VP OPERATIONS	40.00	0.00			$482,551	$0	$74,639	Yes (X)
EVAN JACKSON
VP & CIO	40.00	0.00			$500,649	$0	$94,522	Yes (X)
DONNA STRONESKI
VP HUMAN RESOURCES	40.00	0.00			$419,307	$0	$60,269	Yes (X)
DAVID COSENTINO
VP QUALITY & PATIENT SAFETY	40.00	0.00			$519,150	$0	$101,024	Yes (X)
KELLY HAECKEL
VP PATIENT CARE SERVICES/CNO	40.00	0.00			$346,868	$0	$79,265	Yes (X)
LAURA MARTINO
VP MARKETING& DEVELOPMENT(TO 12/22)	30.00	10.00			$0	$403,325	$42,510	Yes (X)
LELAND MCKENNA JOINED 123
VP PLANNING & EXTERNAL AFFAIRS	40.00	0.00			$163,259	$0	$14,402	Yes (X)
JUSTIN DREW JOINED 123
VP AMBULATORY & CLINICAL SERVICES	40.00	0.00			$195,364	$0	$15,235	Yes (X)
JEFFREY SHELTON
CHAIRMAN DEPT PSYCH	40.00	0.00			$449,224	$0	$40,870		Yes (X)
THEODORE HARTENSTEIN
MED DIRECTOR, UTILIZATION MGMT	40.00	0.00			$525,816	$0	$52,239		Yes (X)
JUSTIN GORALNIK
PULMONOLOGIST	40.00	0.00			$414,281	$0	$29,469		Yes (X)
RICARDO PEREZ
PULMONOLOGIST	40.00	0.00			$443,025	$0	$46,439		Yes (X)
BRIAN MCGUIRE
MEDICAL DIRECTOR ED	40.00	0.00			$421,188	$0	$54,717		Yes (X)
JESSE WAGNER MD
HOSPITALIST	40.00	0.00			$276,824	$0	$14,868			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$7,957,047	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$403,325	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,175,608	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	597	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
EPIC SYSTEMS
1979 MILKY WAY	VERONA	WI	53593	TECHNOLOGY SERVICES	$4,387,512
MEDICAL SOLUTIONS
PO BOX 310737	DES MOINES	IA	50331	TEMPORARY LABOR SERVICES	$2,875,235
MEDIATELY LLC
525 S FLAGLER DRIVE SUITE 300	WEST PALM BEACH	FL	33401	MARKETING	$2,407,737
ARAMARK CORPORATION
66 OXFORD DRIVE	FRANKLIN	MA	02038	DIETARY / HOUSEKEEPING SERVICES	$2,229,338
QUEST DIAGNOSTICS INC
PO BOX 844217	BOSTON	MA	02284	LABORATORY SERVICES	$2,189,774

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	110	CntrctRcvdGreaterThan100KCnt
Federated Campaigns	$245	FederatedCampaignsAmt
Fundraising	$215,791	FundraisingAmt
Government Grants	$3,252,734	GovernmentGrantsAmt
All Other Contributions	$2,463,842	AllOtherContributionsAmt
Noncash Contributions	$289,499	NoncashContributionsAmt
Total Contributions	$5,932,612	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SERVICE REVENUE	621400	$482,613,663	$482,613,663
NET INCOME FROM JOINT VENTURES	900003	$2,685,337	$2,685,337
SPECIMEN LAB	621500	$842,966		$842,966

Field	Value	IRS element (for citing)
Total Program Service Revenue	$486,141,966	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$6,765,922	TotalRevenueColumnAmt
Exclusion	$6,765,922	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$23,255	TotalRevenueColumnAmt
Exclusion	$23,255	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$932,872	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$917,598	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$15,274	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$15,274	TotalRevenueColumnAmt
Exclusion	$15,274	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$48,970,135	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$44,289,072	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$4,681,063	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$4,681,063	TotalRevenueColumnAmt
Exclusion	$4,681,063	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$140,275	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$215,791	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$95,585	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$44,690	TotalRevenueColumnAmt
Exclusion	$44,690	ExclusionAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$13,440	GamingGrossIncomeAmt
Gaming Direct Expenses	$883	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$12,557	TotalRevenueColumnAmt
Exclusion	$12,557	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
PURCHASE DISCOUNTS	900003	$2,100,465	$2,100,465
CAFETERIA REVENUE	722514	$1,019,770		$1,019,770
IN-SYSTEM BILLING MANAGEMENT FEES	900003	$731,376	$731,376

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,170,288	TotalRevenueColumnAmt
Related Or Exempt Func Income	$5,144,613	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$25,675	UnrelatedBusinessRevenueAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$9,021,899	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$512,639,238	TotalRevenueColumnAmt
Related Or Exempt Func Income	$493,275,454	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$868,641	UnrelatedBusinessRevenueAmt
Exclusion	$12,562,531	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$150,290	TotalAmt
Program Services	$150,290	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$7,760,451	TotalAmt
Program Services	$6,208,362	ProgramServicesAmt
Management And General	$1,552,089	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$331,909	TotalAmt
Program Services	$331,909	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$212,192,362	TotalAmt
Program Services	$196,426,469	ProgramServicesAmt
Management And General	$15,765,893	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$11,624,235	TotalAmt
Program Services	$10,782,765	ProgramServicesAmt
Management And General	$841,470	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$22,945,583	TotalAmt
Program Services	$21,117,898	ProgramServicesAmt
Management And General	$1,827,685	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$15,671,925	TotalAmt
Program Services	$14,418,171	ProgramServicesAmt
Management And General	$1,253,754	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$2,027,844	TotalAmt
Program Services	$1,016,102	ProgramServicesAmt
Management And General	$17,275	ManagementAndGeneralAmt
Fundraising	$994,467	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$507,050	TotalAmt
Management And General	$507,050	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$230,773	TotalAmt
Management And General	$230,773	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$147,605	TotalAmt
Management And General	$147,605	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$212,027	TotalAmt
Management And General	$212,027	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$40,762,969	TotalAmt
Program Services	$34,647,235	ProgramServicesAmt
Management And General	$6,115,734	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$3,688,247	TotalAmt
Program Services	$60,435	ProgramServicesAmt
Management And General	$3,627,812	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$6,013,956	TotalAmt
Program Services	$5,723,135	ProgramServicesAmt
Management And General	$290,821	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$26,493,029	TotalAmt
Program Services	$15,935,787	ProgramServicesAmt
Management And General	$10,557,242	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$8,423,468	TotalAmt
Program Services	$4,638,161	ProgramServicesAmt
Management And General	$3,785,307	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$1,196,026	TotalAmt
Program Services	$1,081,163	ProgramServicesAmt
Management And General	$114,863	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$627,695	TotalAmt
Program Services	$513,160	ProgramServicesAmt
Management And General	$114,535	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$853,853	TotalAmt
Program Services	$853,853	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$27,609,032	TotalAmt
Program Services	$24,250,856	ProgramServicesAmt
Management And General	$3,358,176	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$4,939,193	TotalAmt
Program Services	$4,939,193	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$55,891,517	$55,872,851	$18,666
STATE HOSPITAL TAX	$30,132,931	$30,132,931
FOOD	$1,697,015	$1,695,793	$1,222
DUES & LICENSES	$713,198	$120,836	$592,362

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,867,749	TotalAmt
Program Services	$1,930,754	ProgramServicesAmt
Management And General	$936,995	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$485,711,932	TotalAmt
Program Services	$432,848,109	ProgramServicesAmt
Management And General	$51,869,356	ManagementAndGeneralAmt
Fundraising	$994,467	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$1,469,491	BOYAmt
EOY	$1,831,470	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$59,909,758	BOYAmt
EOY	$53,706,556	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$983,766	BOYAmt
EOY	$1,619,641	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$52,748,169	BOYAmt
EOY	$54,929,290	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$290,449	BOYAmt
EOY	$129,187	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$2,214,886	BOYAmt
EOY	$2,088,722	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$5,053,112	BOYAmt
EOY	$6,274,581	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$595,292,053	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$368,119,801	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$223,492,244	BOYAmt
EOY	$227,172,252	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$176,083,352	BOYAmt
EOY	$187,162,423	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$373,533	BOYAmt
EOY	$316,067	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$24,131,007	BOYAmt
EOY	$22,274,803	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$546,749,767	BOYAmt
EOY	$557,504,992	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$62,331,084	BOYAmt
EOY	$64,573,412	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$214,483	BOYAmt
EOY	$132,420	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$28,318,221	BOYAmt
EOY	$24,740,230	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$3,539,332	BOYAmt
EOY	$1,996,879	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$57,457,086	BOYAmt
EOY	$57,373,419	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$151,860,206	BOYAmt
EOY	$148,816,360	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$376,762,460	BOYAmt
EOY	$388,767,615	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$18,127,101	BOYAmt
EOY	$19,921,017	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$394,889,561	BOYAmt
EOY	$408,688,632	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$546,749,767	BOYAmt
EOY	$557,504,992	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$26,927,306	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$9,311,217	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$22,439,452	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	Yes (1)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (1)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

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

Contributor US Address ContributorUSAddress

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)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$147,605	OtherActivitiesAmt
Total Lobbying Expenditures	$147,605	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	MIDDLESEX HOSPITAL PAYS DUES TO BOTH THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE CONNECTICUT HOSPITAL ASSOCIATION (CHA). A PERCENTAGE OF THOSE DUES FUNDED LOBBYING ACTIVITIES DURING THE FISCAL YEAR. THE PORTION OF AHA DUES TOTALED $13,561 AND THE PORTION OF CHA DUES TOTALED $68,628. IN ADDITION, MIDDLESEX HOSPITAL CONTRACTED WITH TWO CONSULTANTS WHO PERFORMED LOBBYING ACTIVITIES. THOSE EXPENSES TOTALED $65,416.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$138,207,000	BeginningYearBalanceAmt
Contributions	$77,000	ContributionsAmt
Investment Earnings Or Losses	$17,164,000	InvestmentEarningsOrLossesAmt
Other Expenditures	$135,000	OtherExpendituresAmt
End Year Balance	$155,313,000	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$167,025,000	BeginningYearBalanceAmt
Contributions	$99,000	ContributionsAmt
Investment Earnings Or Losses	-$28,415,000	InvestmentEarningsOrLossesAmt
Other Expenditures	$502,000	OtherExpendituresAmt
End Year Balance	$138,207,000	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$139,852,000	BeginningYearBalanceAmt
Contributions	$140,000	ContributionsAmt
Investment Earnings Or Losses	$27,444,000	InvestmentEarningsOrLossesAmt
Other Expenditures	$411,000	OtherExpendituresAmt
End Year Balance	$167,025,000	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$128,949,000	BeginningYearBalanceAmt
Investment Earnings Or Losses	$11,014,000	InvestmentEarningsOrLossesAmt
Other Expenditures	$111,000	OtherExpendituresAmt
End Year Balance	$139,852,000	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$124,738,999	BeginningYearBalanceAmt
Contributions	$67,000	ContributionsAmt
Investment Earnings Or Losses	$3,977,000	InvestmentEarningsOrLossesAmt
Other Expenditures	-$166,001	OtherExpendituresAmt
End Year Balance	$128,949,000	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.92000	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.00000	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.08000	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$14,571,462	OtherCostOrOtherBasisAmt
Book Value	$14,571,462	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$363,494,786	OtherCostOrOtherBasisAmt
Depreciation	$234,102,097	DepreciationAmt
Book Value	$129,392,689	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,020,646	OtherCostOrOtherBasisAmt
Depreciation	$2,246,751	DepreciationAmt
Book Value	$1,773,895	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$207,565,593	OtherCostOrOtherBasisAmt
Depreciation	$128,422,189	DepreciationAmt
Book Value	$79,143,404	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$5,639,566	OtherCostOrOtherBasisAmt
Depreciation	$3,348,764	DepreciationAmt
Book Value	$2,290,802	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$227,172,252	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (9 entries)

DescDesc	AmtAmt
EST. SELF-INSURANCE LIABILITIES	$29,974,974
ACCRUED RETIREMENT LIABILITIES	$3,553,364
ASSET RETIREMENT OBLIGATION	$633,750
THIRD-PARTY SETTLEMENTS	$11,894,498
OTHER LIABILITIES	$270,265
SECURITY DEPOSITS	$4,172
DUE TO RELATED PARTIES	$4,255
HOME CARE	$9,511
OPERATING LEASE LIABILITIES	$11,028,630

Field	Value	IRS element (for citing)
Total Liability	$57,373,419	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART V, LINE 4:

THE WITHOUT DONOR RESTRICTIONS RECORDED IN THE BOARD-DESIGNATED (QUASI-ENDOWMENT) FUNDS ARE ASSETS SET ASIDE BY THE BOARD FOR FUTURE UNSPECIFIED USES AND TO SUPPORT EDUCATION AND OTHER PROGRAMS OVER WHICH THE BOARD RETAINS CONTROL AND MAY, AT ITS DISCRETION, SUBSEQUENTLY USE FOR OTHER PURPOSES. PERMANENT ENDOWMENT FUNDS ARE ASSETS RECEIVED WITH THE DONOR STIPULATION THAT THE PRINCIPAL BE INVESTED IN PERPETUITY AND THAT ONLY THE INCOME EARNED THEREON IS AVAILABLE FOR SPECIFIC OR GENERAL SERVICES, SUCH AS FREE BED FUNDS AND SUPPORT OF HOSPITAL OPERATIONS. THESE ARE NOT IDENTIFIED ON THE AUDIT STATEMENTS IN THIS FASHION FOR FY2023. THEY ARE IN AS EITHER WITH OR WITHOUT DONOR RESTRICTIONS. TEMPORARILY RESTRICTED ENDOWMENT FUNDS ARE ASSETS RESTRICTED BY THE DONOR EITHER AS TO PURPOSE AND/OR AS TO TIME OF EXPENDITURE, SUCH AS EDUCATION, HEALTH SERVICES AND CAPITAL PURCHASES.

PART X, LINE 2:

BELOW IS AN EXCERPT FROM FOOTNOTE 2 OF THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS FOR MIDDLESEX HEALTH SYSTEM, INC. AND SUBSIDIARIES. THE SYSTEM ACCOUNTS FOR UNCERTAIN TAX POSITIONS WITH PROVISIONS OF FASB ASC 740, "INCOME TAXES," WHICH PROVIDES A FRAMEWORK FOR HOW COMPANIES SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE UNCERTAIN TAX POSITIONS IN THEIR CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE SYSTEM DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2023 AND 2022. IT IS THE SYSTEM'S POLICY TO RECORD PENALTIES AND INTEREST ASSOCIATED WITH UNCERTAIN TAX PROVISIONS AS A COMPONENT OF OPERATING EXPENSES. AS OF SEPTEMBER 30, 2023 AND 2022, THE SYSTEM DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNCERTAIN TAX POSITIONS. THE SYSTEM'S PRIOR THREE TAX YEARS ARE OPEN AND SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	TPC GOLF	Event1Nm
Gross Receipts Event1	$179,120	GrossReceiptsEvent1Amt
Charitable Contri Event1	$117,920	CharitableContriEvent1Amt
Gross Revenue Event1	$61,200	GrossRevenueEvent1Amt
Rent Facility Costs Event1	$36,627	RentFacilityCostsEvent1Amt
Food And Beverage Event1	$18,636	FoodAndBeverageEvent1Amt
Other Direct Expenses Event1	$7,332	OtherDirectExpensesEvent1Amt
Event2	HOSPICE GOLF	Event2Nm
Gross Receipts Event2	$100,346	GrossReceiptsEvent2Amt
Charitable Contri Event2	$75,146	CharitableContriEvent2Amt
Gross Revenue Event2	$25,200	GrossRevenueEvent2Amt
Cash Prizes Event2	$1,174	CashPrizesEvent2Amt
Non Cash Prizes Event2	$1,640	NonCashPrizesEvent2Amt
Rent Facility Costs Event2	$8,436	RentFacilityCostsEvent2Amt
Food And Beverage Event2	$12,981	FoodAndBeverageEvent2Amt
Other Direct Expenses Event2	$1,221	OtherDirectExpensesEvent2Amt
Other Events Total	2	OtherEventsTotalCnt
Gross Receipts Other Events	$76,600	GrossReceiptsOtherEventsAmt
Charitable Contri Other Events	$22,725	CharitableContriOtherEventsAmt
Gross Revenue Other Events	$53,875	GrossRevenueOtherEventsAmt
Non Cash Prizes Other Events	$2,805	NonCashPrizesOtherEventsAmt
Food And Beverage Other Events	$240	FoodAndBeverageOtherEventsAmt
Entertainment Other Events	$150	EntertainmentOtherEventsAmt
Oth Direct Expnss Other Events	$4,343	OthDirectExpnssOtherEventsAmt
Gross Receipts Total	$356,066	GrossReceiptsTotalAmt
Charitable Contributions Tot	$215,791	CharitableContributionsTotAmt
Gross Revenue Total Events	$140,275	GrossRevenueTotalEventsAmt
Cash Prizes Total Events	$1,174	CashPrizesTotalEventsAmt
Non Cash Prizes Total Events	$4,445	NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$45,063	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$31,857	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$150	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$12,896	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$95,585	DirectExpenseSummaryEventsAmt
Net Income Summary	$44,690	NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Discounted Care Other	500.000000000000	DiscountedCareOtherPct

Field	Value	IRS element (for citing)
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Persons Served	1143	PersonsServedCnt
Total Community Benefit Expns	$5,709,372	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,157,592	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,551,780	NetCommunityBenefitExpnsAmt
Total Expense	0.00320	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Persons Served	23980	PersonsServedCnt
Total Community Benefit Expns	$105,725,684	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$71,999,622	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$33,726,062	NetCommunityBenefitExpnsAmt
Total Expense	0.06940	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Persons Served	25123	PersonsServedCnt
Total Community Benefit Expns	$111,435,056	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$76,157,214	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$35,277,842	NetCommunityBenefitExpnsAmt
Total Expense	0.07260	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Persons Served	26009	PersonsServedCnt
Total Community Benefit Expns	$2,260,282	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$107,842	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,152,440	NetCommunityBenefitExpnsAmt
Total Expense	0.00440	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Persons Served	731	PersonsServedCnt
Total Community Benefit Expns	$14,020,107	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,072,500	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,947,607	NetCommunityBenefitExpnsAmt
Total Expense	0.02250	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Persons Served	24364	PersonsServedCnt
Total Community Benefit Expns	$65,540,892	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$43,604,442	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$21,936,450	NetCommunityBenefitExpnsAmt
Total Expense	0.04520	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Persons Served	68	PersonsServedCnt
Total Community Benefit Expns	$246,104	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$246,104	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Persons Served	627	PersonsServedCnt
Total Community Benefit Expns	$256,728	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,725	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$253,003	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Persons Served	51799	PersonsServedCnt
Total Community Benefit Expns	$82,324,113	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$46,788,509	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$35,535,604	NetCommunityBenefitExpnsAmt
Total Expense	0.07310	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Persons Served	76922	PersonsServedCnt
Total Community Benefit Expns	$193,759,169	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$122,945,723	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$70,813,446	NetCommunityBenefitExpnsAmt
Total Expense	0.14570	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$21,737	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$21,737	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Persons Served	30	PersonsServedCnt
Total Community Benefit Expns	$132,836	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$132,836	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Persons Served	108	PersonsServedCnt
Total Community Benefit Expns	$29,239	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$29,239	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Persons Served	138	PersonsServedCnt
Total Community Benefit Expns	$183,812	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$183,812	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReportedInd
Bad Debt Expense	$21,818,497	BadDebtExpenseAmt
Bad Debt Expense Attributable	$2,181,850	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$46,564,607	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$45,213,477	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$1,351,130	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MIDDLESEX HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	28 CRESCENT STREET	AddressLine1Txt
City	MIDDLETOWN	CityNm
State Abbreviation	CT	StateAbbreviationCd
ZIP	06457	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.MIDDLESEXHEALTH.ORG	WebsiteAddressTxt
State License	000069	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Teaching Hospital	Yes (X)	TeachingHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	MIDDLESEX HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
Other	Yes (X)	OtherInd
CHNA Conducted	22	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	0	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	0	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE STATEMENT	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	23	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	SEE STATEMENT	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	100.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	500.000000000000	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE STATEMENT	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE STATEMENT	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE STATEMENT	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
None Made	Yes (X)	NoneMadeInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
MIDDLESEX HOSPITAL	PART V, SECTION B, LINE 3J: IN ADDITION TO THE ELEMENTS SELECTED IN PART V, LINE 3, MIDDLESEX HOSPITAL'S MOST RECENTLY COMPLETED (2022) COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) EXAMINED HOW SOCIAL DETERMINANTS OF HEALTH AND HEALTH DISPARITIES IMPACT HEALTH OUTCOMES. THE REPORT CONTINUED TO RAISE AWARENESS ABOUT HEALTH-RELATED SOCIAL NEEDS, WELL-BEING AND QUALITY OF LIFE, HEALTH DISPARITIES, AND VULNERABLE POPULATIONS. ACHIEVING HEALTH EQUITY - THE ATTAINMENT OF THE HIGHEST LEVEL OF HEALTH FOR ALL PEOPLE - STARTS WITH ASKING THE APPROPRIATE QUESTIONS RELATIVE TO DETERMINANTS OF HEALTH AND HOW THEY DISPROPORTIONATELY AFFECT CERTAIN GROUPS OF PEOPLE; NEXT STEPS INVOLVE ADDRESSING THE CONDITIONS THAT PREVENT THE REALIZATION OF GOOD HEALTH FOR THESE VULNERABLE OR MARGINALIZED GROUPS. THROUGH EXAMINATION OF THE INFLUENCE OF DETERMINANTS OF HEALTH, IT IS POSSIBLE TO DEVELOP STRATEGIES THAT ELIMINATE PERSISTENT AND PERVASIVE HEALTH DISPARITIES, PROMOTE HEALTH EQUITY, IMPROVE HEALTH OUTCOMES, AND REDUCE FINANCIAL COST.
MIDDLESEX HOSPITAL	PART V, SECTION B, LINE 5: IN COMPLETING ITS MOST RECENT (2022) COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), MIDDLESEX HOSPITAL TOOK INTO ACCOUNT INPUT FROM REPRESENTATIVES OF ITS COMMUNITY SERVED, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. A COMMUNITY HEALTH NEEDS ASSESSMENT ADVISORY COMMITTEE WAS FORMED TO PROVIDE INPUT AND GUIDANCE, INCLUDING REVIEW OF THE STUDY'S DATA COMPONENTS; REVIEW AND INPUT ON THE MIDDLESEX HEALTH CHNA COMMUNITY SURVEY; ASSISTANCE WITH SERVICE AREA-WIDE COMMUNITY SURVEY DISSEMINATION; AND REVIEW AND INPUT ON COMMUNITY RESOURCES AND ASSETS. THE ADVISORY COMMITTEE WAS COMPRISED OF STAKEHOLDERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING LOCAL HEALTH DEPARTMENTS, HEALTH CARE ORGANIZATIONS (INCLUDING MEDICAL AND BEHAVIORAL), COMMUNITY-BASED ORGANIZATIONS, FAITH-BASED ORGANIZATIONS, ADVOCACY GROUPS, SUPPORT PROFESSIONALS EMBEDDED IN THE COMMUNITY (I.E., COMMUNITY HEALTH WORKERS, DOULAS, RECOVERY COACHES, ETC.) AND COMMUNITY MEMBERS TO ENSURE COMMUNITY VOICE WAS REPRESENTED. TO CAPTURE BROAD COMMUNITY INPUT ON HEALTH NEEDS, SOCIAL DETERMINANTS OF HEALTH AND HEALTH EQUITY, MIDDLESEX HOSPITAL ADMINISTERED A COMMUNITY SURVEY FOR ITS CHNA. SURVEY TOPIC AREAS INCLUDED KEY HEALTH ISSUES AND HEALTH BEHAVIORS, HEALTH CARE ACCESS, AND SOCIAL DETERMINANTS OF HEALTH. QUESTIONS RELATED TO COVID-19 WERE ADDED. ALL THE SURVEY RESPONSE OPTIONS WERE POSED IN QUANTITATIVE FORM THROUGH LIKERT SCALES. A QUALITATIVE OPEN-ENDED TEXT BOX WAS PROVIDED AT THE END OF THE SURVEY TO ALLOW FOR COMMENTS. THE EIGHT-QUESTION SURVEY (FIVE FOCUSED QUESTIONS, TWO DEMOGRAPHIC QUESTIONS AND AN OPTION TO ADD COMMENTS) WAS ADMINISTERED ELECTRONICALLY THROUGH THE ONLINE SURVEYMONKEY FORMAT. TO ENSURE RESPONSES FROM A WIDE RANGE OF REPRESENTATIVE COMMUNITY MEMBERS AND LEADERS WITH DIVERSE BACKGROUNDS, PERSPECTIVES AND FIRST-HAND KNOWLEDGE ABOUT THEIR COMMUNITIES, THE SURVEY WAS EXTENSIVELY DISSEMINATED TO AN ARRAY OF SECTOR CONTACTS; FORWARDED TO MULTIPLE COLLABORATIVE E-DISTRIBUTION LISTS; POSTED ON WEBSITES AND SOCIAL MEDIA PLATFORMS; AND INCLUDED IN E-NEWSLETTERS THROUGHOUT MIDDLETOWN, MIDDLESEX COUNTY AND THE PERIPHERY TOWNS OF MIDDLESEX HEALTH'S SERVICE AREA. SECTORS INCLUDED ADVOCACY GROUPS, ALLIANCES/COALITIONS, THE BUSINESS COMMUNITY, EDUCATIONAL INSTITUTIONS, COMMUNITY-BASED ORGANIZATIONS, COMMUNITY RESIDENTS, ELECTED OFFICIALS, MUNICIPAL STAFF, FAITH-BASED ORGANIZATIONS, FOUNDATIONS, HEALTH CARE ORGANIZATIONS (INCLUDING MEDICAL AND BEHAVIORAL), LOCAL HEALTH DEPARTMENTS, MENTAL HEALTH ORGANIZATIONS, SUBSTANCE TREATMENT FACILITIES, AND YOUTH AND FAMILY SERVICES. COMMUNITY HEALTH NEEDS ASSESSMENT ADVISORY COMMITTEE MEMBERS WERE ASKED TO BROADLY SHARE THE COMMUNITY SURVEY LINK, AND ALL SURVEY RECIPIENTS WERE INVITED TO SHARE THE LINK WITH COWORKERS, FRIENDS AND FAMILY OR ANYONE WHO LIVES OR WORKS IN MIDDLESEX COUNTY. A TOTAL OF 204 SURVEYS WERE COMPLETED AND RESPONSE RESULTS ARE INCLUDED IN THE MIDDLESEX HEALTH CHNA COMMUNITY SURVEY SECTION OF THE CHNA.
MIDDLESEX HOSPITAL	PART V, SECTION B, LINE 7D: MIDDLESEX HOSPITAL POSTED ITS MOST RECENTLY COMPLETED CHNA (2022) ON ITS WEB-SITE (HTTPS://MIDDLESEXHEALTH.ORG/MIDDLESEX-AND-THE-COMMUNITY/SERVING-OUR-COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT) AND ELECTRONICALLY DISTRIBUTED IT THROUGH THE FOLLOWING DISSEMINATION CHANNELS: THE CHNA ADVISORY COMMITTEE; COMMUNITY MEMBERS; AND EXISTING HOSPITAL-COMMUNITY BASED PARTNERSHIP DISTRIBUTION LISTS. RECIPIENTS WERE ENCOURAGED TO WIDELY SHARE THE ASSESSMENT. PAPER COPIES OF THE CHNA WERE AND WILL CONTINUE TO BE PROVIDED UPON REQUEST.
MIDDLESEX HOSPITAL	PART V, SECTION B, LINE 11: MIDDLESEX HOSPITAL COMPLETED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2022, AND ITS CHNA IMPLEMENTATION STRATEGY WAS APPROVED BY MIDDLESEX HEALTH'S GOVERNING BODY IN FEBRUARY 2023. A FACILITATED COMMUNITY CONVERSATION WAS HELD TO REVIEW, PRIORITIZE, AND DISCUSS STRATEGIES AND SOLUTIONS FOR THE SIGNIFICANT HEALTH AND HEALTH-RELATED NEEDS IDENTIFIED IN MIDDLESEX HEALTH'S 2022 COMMUNITY HEALTH NEEDS ASSESSMENT, THEREBY INFORMING MIDDLESEX HEALTH'S CHNA IMPLEMENTATION STRATEGY. THE RESULTS OF THE COMMUNITY CONVERSATION SERVED AS A GUIDE FOR MIDDLESEX HEALTH'S SELECTION OF PRIORITY AREAS FOR ITS CHNA IMPLEMENTATION STRATEGY. THROUGH THIS PROCESS, THE FOLLOWING HEALTH TOPICS WERE SELECTED AS AREAS OF FOCUS FOR THE IMPLEMENTATION STRATEGY: 1) MENTAL HEALTH - ALL AGES; 2) SUBSTANCE USE ISSUES; 3) HEALTHY AGING; 4) MATERNAL CHILD HEALTH; AND 5) CHRONIC DISEASES, WITH SOCIAL DETERMINANTS OF HEALTH, HEALTH EQUITY AND THE IMPACTS OF COVID-19 AS ESSENTIAL COMPONENTS FOR EACH HEALTH AREA. WITH REGARD TO NEEDS THAT ARE NOT BEING ADDRESSED, MIDDLESEX HOSPITAL RECOGNIZES THAT IT CANNOT FOCUS ON EVERY HEALTH AND SOCIAL NEED IDENTIFIED IN MOST CURRENT COMMUNITY HEALTH NEEDS ASSESSMENT AND IS THEREFORE COMMITTED TO ALLOCATING RESOURCES AND IN-KIND TIME TO THE HIGHEST AREAS OF IDENTIFIED NEED AND/OR AREAS WITH GREATEST POTENTIAL FOR IMPACT AND FEASIBILITY (THE SELECTED PRIORITY AREAS). RESOURCE CONSTRAINTS PREVENT THE HOSPITAL FROM ADDRESSING EVERY NEED, AND IN MANY CASES, OTHER LOCAL COMMUNITY BASED ORGANIZATIONS MAY BE BETTER SUITED TO TAKE A LEADERSHIP ROLE IN IMPROVING CERTAIN HEALTH OUTCOMES. AS WITH OUR PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENTS, THE HOSPITAL WILL CONTINUE TO BE A WILLING PARTNER, WHEN ABLE, FOR INITIATIVES NOT RELATED TO ITS SELECTED CHNA IMPLEMENTATION STRATEGY PRIORITY AREAS.EXAMPLES OF MIDDLESEX HEALTH'S INVOLVEMENT IN ADDRESSING IDENTIFIED PRIORITY AREAS ARE OUTLINED BELOW. IN ALL EXAMPLES, A CENTRAL TENET OF THE WORK IS ADVANCING HEALTH EQUITY THROUGH INCLUSION AND INTENTIONALITY AND ALL WORK IS GUIDED BY COMMUNITY VOICE. IN RESPONSE TO THE OPIOID EPIDEMIC AND THE SIGNIFICANT UPWARD TREND SPECIFICALLY FOR FENTANYL INVOLVEMENT FOR ACCIDENTAL DRUG-RELATED DEATHS IN MIDDLESEX HEALTH'S SERVICE AREA DUE TO "ANY OPIOID", MIDDLESEX HEALTH IS A FOUNDING MEMBER OF THE GREATER MIDDLETOWN OPIOIDS TASK FORCE ("TASK FORCE"). THE TASK FORCE IS COMPOSED OF MORE THAN 35 AGENCIES, AND HAS A DISTRIBUTION LIST OF MORE THAN 100 MEMBERS. PARTNER AGENCIES INCLUDE MUNICIPALITIES, HEALTH DEPARTMENTS, POLICE AND FIRE DEPARTMENTS, HEALTH CARE ORGANIZATIONS, PARAMEDIC AND AMBULANCE SERVICES, BEHAVIORAL HEALTH SERVICES, TREATMENT AND RECOVERY SERVICES, HARM REDUCTION SERVICES, FAITH-BASED SERVICES, SCHOOLS AND COLLEGES AND COMMUNITY-BASED ORGANIZATIONS. THE TASK FORCE AIMS TO ENGAGE THE GREATER MIDDLETOWN COMMUNITY IN WORKING TOGETHER TO PROMOTE OPIOID AWARENESS, EDUCATION, PREVENTION, HARM REDUCTION AND ACCESS TO TREATMENT THEREBY REDUCING OPIOID-RELATED OVERDOSES AND DEATH. IT ALSO STRIVES TO BUILD A HEALTHY, SAFE AND DRUG-FREE COMMUNITY, AND TO DEVELOP A COMMUNITY THAT WORKS TOGETHER TO PREVENT AND HELP PEOPLE EXPERIENCING OPIOID USE CHALLENGES. THE TASK FORCE CREATED WORK GROUPS TO ADDRESS PRIORITY AREAS, WHICH INCLUDE RESOURCE AWARENESS, ACCESS TO TREATMENT; EDUCATION AND PREVENTION AND INTERVENTION / HARM REDUCTION. ACCOMPLISHMENTS INCLUDE: 1) CREATION OF A 40-PAGE RESOURCE GUIDE THAT PROVIDES IMPORTANT INFORMATION THAT ADDRESSES A NUMBER OF CONCERNS RELATED TO OPIOID USE - FROM INFORMATION ABOUT WITHDRAWAL MANAGEMENT AND INPATIENT OR RESIDENTIAL TREATMENT TO INFORMATION ABOUT RECOVERY COACHES AND SUPPORT GROUPS; 2) COLLABORATION WITH THE VILLAGE FOR FAMILIES & CHILDREN TO BRING A RECOVERY VEHICLE PROGRAM TO MIDDLETOWN ONCE A WEEK THAT OFFERS SUPPORT TO INDIVIDUALS IMPACTED BY OPIOID USE BY PROVIDING PEER SUPPORT, CASE MANAGEMENT, HARM REDUCTION RESOURCES AND CONNECTION TO TREATMENT; 3) A HARM-REDUCTION LEAVE-BEHIND KIT INITIATIVE; AND 4) DEVELOPMENT OF A STRATEGY FOR THE CITY OF MIDDLETOWN OPIOIDS SETTLEMENT FUNDS.MIDDLESEX HEALTH IS AN INTEGRAL MEMBER OF THE GREATER MIDDLETOWN HEALTH ENHANCEMENT COMMUNITY COALITION ("GMHEC"). THE GMHEC'S OBJECTIVE IS TO BE A PLACE-BASED INITIATIVE THAT ADVANCES HEALTH EQUITY, SUPPORTS LONG-TERM, COLLABORATIVE AND CROSS-SECTOR EFFORTS TO IMPROVE COMMUNITY HEALTH AND WELL-BEING THROUGH BROAD, SYSTEMIC CHANGE. ITS GOAL IS TO BUILD HEALTHY AND EQUITABLE COMMUNITIES THAT ACTIVELY WORK TOGETHER TO PREVENT THE DEVELOPMENT OF DISEASE. THE COALITION ENGAGES IN INITIATIVES THAT ADVANCE HEALTH EQUITY, IMPROVE THE SOCIAL, ECONOMIC AND PHYSICAL CONDITIONS WITHIN COMMUNITIES THAT ENABLE INDIVIDUALS AND FAMILIES TO MEET BASIC NEEDS, ACHIEVE THEIR HEALTH AND WELL-BEING GOALS AND THRIVE THROUGHOUT THEIR LIVES. THE COALITION HAS A 90+ PERSON DISTRIBUTION LIST AND IS MADE UP OF 35+ DIFFERENT AGENCIES AND INCLUDES COMMUNITY MEMBERS. CENTERING COMMUNITY VOICE IS CRITICAL TO THE COALITION'S PURPOSE, WHICH ENSURES THAT PRIORITY AREAS AND PROGRAMS ARE DEVELOPED IN RESPONSE TO COMMUNITY DESIRES AND NEEDS. THROUGH ITS EXTENSIVE DISTRIBUTION LIST, THE GMHEC IS ABLE TO SHARE INFORMATION ABOUT UPCOMING COMMUNITY HEALTH AND WELL-BEING EVENTS, WHICH HELPS TO INCREASE ATTENDANCE AT THESE EVENTS. MIDDLESEX HEALTH STAFF MEMBERS ARE PART OF GMHEC LEADERSHIP TEAM AND PROVIDE ADMINISTRATIVE AND GRANT WRITING SUPPORT. WITH A STRONG AND COLLABORATIVE STRUCTURE IN PLACE, THE COALITION CONTINUES TO BUILD PARTNERSHIPS, STRENGTHEN COMMUNITY ENGAGEMENT, AND DEVELOP PROGRAMS THAT RESPOND TO IDENTIFIED HEALTH AND WELL-BEING NEEDS.MIDDLESEX HEALTH ALSO PARTICIPATES IN THE GMAHEC'S NUTRITIOUS FOODS SUBCOMMITTEE ("SUBCOMMITTEE") WHICH WAS FORMED TO FULFILL A COMMUNITY NEED FOR MORE EQUITABLE AND SUSTAINABLE ACCESS TO FRESH, NUTRITIOUS FOODS. A MIDDLESEX HEALTH STAFF MEMBER CO-CHAIRS THE HEC NUTRITIOUS FOODS SUBCOMMITTEE. THE SUBCOMMITTEE RECOGNIZES THAT 1) FOOD INSECURITY IS AN ISSUE IN OUR COMMUNITY; 2) THE BENEFITS OF NUTRITIOUS FOODS TO ADDRESS CHRONIC DISEASE PREVENTION AND MANAGEMENT; 3) THE POTENTIAL TO LEVERAGE MULTIPLE COMMUNITY ASSETS TO CREATE SUSTAINABLE, EQUITABLE ACCESS TO HEALTHY FOOD; AND 4) THAT FOOD (GROWING, PREPARING, EATING) IS A POWERFUL VEHICLE FOR COMMUNITY CONNECTION AND WELL-BEING. THROUGH LISTENING SESSIONS AND COMMUNITY SURVEYING THE SUBCOMMITTEE LEARNED THAT ACCESS TO HEALTHY FRUITS AND VEGETABLES WAS A BARRIER FOR MANY IN THE GREATER MIDDLETOWN COMMUNITY AND GROWING ONE'S OWN VEGETABLES WAS A PREFERRED SOLUTION. IN RESPONSE, THE SUBCOMMITTEE HAS A STARTER PLANT INITIATIVES. AS GROWING ONE'S OWN VEGETABLES IS ASSOCIATED WITH GREATER FRUIT AND VEGETABLE INTAKE (ALAIMO, 2023), CONTAINER PLANTING IS A WAY TO GET PEOPLE ENGAGED AND INTERESTED IN HOME VEGETABLE GARDENING. STARTER PLANTS FEATURING VEGETABLES PREFERRED BY THE COMMUNITY (CHERRY TOMATOES, KALE, CALLALOO, CABBAGE, EGGPLANT, PEPPERS) ARE DISTRIBUTED AT COMMUNITY EVENTS ALONG WITH NUTRITIOUS FOODS EDUCATIONAL MATERIAL AVAILABLE IN ENGLISH AND SPANISH. THE SUBCOMMITTEE HAS STARTED TO PLAN FOR A HYDROPONIC GROWING INITIATIVE WHICH IT PLANS TO PILOT. MIDDLESEX HEALTH HAS PARTNERED WITH THE MINISTERIAL HEALTH FELLOWSHIP'S ("MHF") PREGNANT WITH POSSIBILITIES ("PWP") PROGRAM TO ADDRESS PERINATAL HEALTH DISPARITIES FOR BIRTHING PEOPLE OF COLOR. STRIKING RACIAL AND ETHNIC DISPARITIES EXIST IN THE UNITED STATES FOR PREGNANCY AND BIRTH OUTCOMES. BLACK AND AMERICAN INDIAN/ALASKA NATIVE WOMEN ARE 2-3 TIMES MORE LIKELY TO DIE FROM A PREGNANCY-RELATED CAUSE THAN WHITE WOMEN (CDC, 2007-2016). FOR INFANT MORTALITY, BABIES BORN TO BLACK BIRTHING PEOPLE IN CONNECTICUT ARE MORE THAN 4 TIMES AS LIKELY TO DIE BEFORE THEIR FIRST BIRTHDAY THAN BABIES BORN TO WHITE BIRTHING PEOPLE (CT HEALTH FOUNDATION, 2020). PWP IS A COMMUNITY-BASED PROGRAM THAT PROVIDES DOULA SERVICES IN ORDER TO ADDRESS THE SIGNIFICANT DISPARITIES IN PERINATAL OUTCOMES AMONG BIRTHING PEOPLE OF COLOR AND THEIR BABIES. MHF DOULAS ARE EMBEDDED IN THE MIDDLETOWN COMMUNITY. PROVIDING DOULA SUPPORT FOR A BIRTH IS EVIDENCE-BASED CARE AND PWP IS DESIGNED TO BENEFIT PREGNANT PERSONS AND THEIR HEALTHCARE PROVIDERS. WHAT MAKES THE PWP PROGRAM UNIQUE IS THAT PWP PROVIDES PROFESSIONALS WHO ARE TRAINED AND CERTIFIED AS BOTH DOULAS AND COMMUNITY HEALTH WORKERS. AND, DOULA SUPPORT IS PROVIDED BEFORE, DURING AND UP TO ONE YEAR AFTER DELIVERY. THERE IS NO COST FOR PARTICIPATION IN THE PWP PROGRAM.
MIDDLESEX HOSPITAL	PART V, SECTION B, LINE 13H: MIDDLESEX HOSPITAL'S SLIDING SCALE OUTLINES THE FACTORS THAT IT USES TO DETERMINE FINANCIAL ASSISTANCE DETERMINATIONS: THE FEDERAL POVERTY INCOME GUIDELINES AND NUMBER OF PERSONS IN HOUSEHOLD.
PART V, SECTION B, LINE 7A:	HTTPS://MIDDLESEXHEALTH.ORG/MIDDLESEX-AND-THE-COMMUNITY/SERVING-OUR-COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
PART V, SECTION B, LINE 10A:	HTTPS://MIDDLESEXHEALTH.ORG/MIDDLESEX-AND-THE-COMMUNITY/SERVING-OUR-COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
PART V, SECTION B, LINE 16A, FAP WEBSITE:	HTTPS://MIDDLESEXHEALTH.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE-SERVICES
PART V, SECTION B, LINE 16B, FAP APPLICATION WEBSITE:	HTTPS://MIDDLESEXHEALTH.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE-SERVICES
PART V, SECTION B, LINE 16C, FAP PLAIN LANGUANCE SUMMARY WEBSITE:	HTTPS://MIDDLESEXHEALTH.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE-SERVICES
PART V, SECTION B, LINE 20A:	WRITTEN NOTICE ABOUT UPCOMING ECAS WAS NOT REQUIRED BECAUSE THE ORGANIZATION DID NOT PURSUE ANY EXTRAORDINARY COLLECTION ACTION'S DURING THE YEAR. IF AN ECA WAS PURSUED IN THE FUTURE, PROPER NOTICE WOULD BE GIVEN.

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	1 - MIDDLESEX HOSPITAL HOMECARE	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	770 SAYBROOK ROAD	AddressLine1Txt
City	MIDDLETOWN	CityNm
State Abbreviation	CT	StateAbbreviationCd
ZIP	06457	ZIPCd

Field	Value	IRS element (for citing)
Facility	HOMECARE SERVICES, REHAB, HEART HEALTH, OTHER SERVICES	FacilityTxt

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C:	IN GENERAL, MIDDLESEX HOSPITAL ("THE HOSPITAL") USES FPG TO DETERMINE ELIGIBILITY. THERE ARE, HOWEVER, SPECIAL CIRCUMSTANCES (SUCH AS A CATASTROPHIC EVENT) WHICH MAY AFFECT A PATIENT'S ABILITY TO PAY. IN THIS CASE, THE HOSPITAL EVALUATES THE APPLICATION WITH CONSIDERATION GIVEN TO THE PATIENT'S CURRENT SITUATION. WITH SPECIAL CIRCUMSTANCES, IN ORDER TO MAXIMIZE THE AMOUNT OF FINANCIAL ASSISTANCE DISCOUNT, THE FPG THRESHOLD MAY BE IGNORED AND THE HOSPITAL MAY USE THE PATIENT'S ASSETS AND/OR TAX RETURN ITEMIZED DEDUCTIONS TO DETERMINE THE AMOUNT OF FINANCIAL ASSISTANCE.
PART I, LINE 7:	FOR PART 1, LINE 7 SECTIONS (A) FINANCIAL ASSISTANCE AT COST, (B) MEDICAID, (C) COSTS OF OTHER MEANS-TESTED GOVERNMENT PROGRAMS, PORTIONS OF (F) HEALTH PROFESSIONS EDUCATION, AND (G) SUBSIDIZED HEALTH SERVICES, THE COSTING METHODOLOGY USED IS A HYBRID COST ACCOUNTING/MEDICARE COST-TO-CHARGE RATIO CALCULATION. THE PERCENTAGES ARE DERIVED FROM THE MOST CURRENT MEDICARE COST REPORT AND APPLIED BY CHARGE LINE APPROPRIATELY. INDIRECT COSTS WERE APPLIED TO SUBSIDIZED HEALTH SERVICES. THE MEDICARE COST REPORT DOES NOT ADDRESS ALL AREAS OF THE HOSPITAL IN THE SAME DETAIL, BUT DOES ACCURATELY ADDRESS INPATIENT AND OUTPATIENT, HOMECARE AND TO AN EXTENT PHYSICIAN SERVICES. SECTIONS (E) COMMUNITY HEALTH IMPROVEMENT; PORTIONS OF (F) HEALTH PROFESSIONS EDUCATION, (H) RESEARCH, AND (I) CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS ARE COMPRISED (EXCEPT FOR CASH DONATIONS AND IN-KIND MATERIAL DONATIONS) OF 1) SUPPLY EXPENSES; 2) PURCHASED SERVICES; AND 3) THE DIRECT SALARY COSTS FOR HOSPITAL STAFF WHOSE TIME WAS COMPENSATED BY THE HOSPITAL FOR TIME SPENT PARTICIPATING IN ACTIVITIES THAT QUALIFY AS COMMUNITY BENEFITS PLUS THE CURRENT FISCAL YEAR FRINGE BENEFIT RATE. IN ADDITION TO SUBSIDIZED SERVICES, INDIRECT COSTS WERE APPLIED TO A SMALL SELECTION OF SALARIES AND SERVICES UNDER COMMUNITY HEALTH IMPROVEMENT, RESEARCH, AND COMMUNITY BENEFIT OPERATIONS, BUT NOT BROADLY ACROSS ALL COMMUNITY BENEFIT ACTIVITY ENTRIES.
PART I, LINE 7G:	MIDDLESEX HOSPITAL INCLUDES ITS FAMILY MEDICINE GROUP AS A SUBSIDIZED SERVICE. FOR FY23, 7,988 UNIQUE INDIVIDUALS WERE SERVED WITH A TOTAL HOSPITAL SUBSIDY OF $777,261. MIDDLESEX COUNTY HAS BEEN DESIGNATED BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) TO BE A MEDICALLY UNDERSERVED AREA EXPERIENCING A SHORTAGE OF SELECT HEALTH SERVICES WHICH INCLUDE TOO FEW PRIMARY CARE PROVIDERS. IN ADDITION, HRSA REPORTS HEALTH PROFESSIONAL SHORTAGE AREAS (HPSAS) FOR PRIMARY CARE (MIDDLETOWN SERVICE AREA; LOW INCOME POPULATION), MENTAL HEALTH (MIDDLESEX COUNTY; HIGH NEED GEOGRAPHIC) AND DENTAL HEALTH (CENTRAL MIDDLETOWN; LOW INCOME POPULATION). MIDDLESEX HOSPITAL'S FAMILY MEDICINE GROUP FILLS A VITAL COMMUNITY HEALTH NEED BY PROVIDING ACCESS TO PRIMARY CARE SERVICES.
PART II, COMMUNITY BUILDING ACTIVITIES:	THE MAJORITY OF MIDDLESEX HOSPITAL'S COMMUNITY BASED HEALTH IMPROVEMENT WORK IS CAPTURED UNDER COMMUNITY BENEFIT CATEGORIES. THE HOSPITAL'S PARTICIPATION IN COMMUNITY BUILDING ACTIVITIES, HOWEVER, HAS A VITAL ROLE IN CONTINUING TO PROMOTE THE HEALTH, WELL-BEING AND SAFETY FOR RESIDENTS IN ITS SERVICE AREA. THE HOSPITAL OFFERS ITS RESOURCES AND EXPERTISE TO SUPPORT AND STRENGTHEN COMMUNITY ASSETS IN A VARIETY OF WAYS THAT FALL UNDER THE SCOPE OF COMMUNITY BUILDING. STAFF MEMBERS PARTICIPATE IN MULTIPLE COMMUNITY PARTNERSHIPS AND COALITIONS, THE SUCCESS OF WHICH ARE GREATLY ENHANCED BY HOSPITAL COLLABORATION - MANY COMMUNITY INITIATIVES WOULD NOT BE AS EFFECTIVE WITHOUT THE HOSPITAL'S ADMINISTRATIVE AND CLINICAL STAFF IN-KIND INVOLVEMENT, SUPPORT AND EXPERTISE.TO FURTHER ITS COMMITMENT TO DIVERSITY, EQUITY AND INCLUSION TO ADDRESS DISPARITIES IN HEALTH CARE, MIDDLESEX HEALTH OFFERS THE MIDDLESEX HEALTH MEDICAL EXPLORERS PROGRAM (WORKFORCE DEVELOPMENT) TO ADDRESS THE LACK OF RACIAL AND ETHNIC REPRESENTATION IN HEALTHCARE. BLACK, INDIGENOUS AND LATINO/A/E INDIVIDUALS ARE EXTREMELY UNDERREPRESENTED IN HEALTHCARE PROFESSIONS IN THE UNITED STATES, WHICH CONTRIBUTES TO HEALTH DISPARITIES FOR PEOPLE OF COLOR. IT IS WELL DOCUMENTED THAT THE LACK OF DIVERSITY IN THE HEALTHCARE WORKFORCE HAS A NEGATIVE EFFECT ON PATIENTS OF COLOR. FOSTERING A DIVERSE AND INCLUSIVE WORKFORCE IS CRITICAL TO IMPROVING TRUST AMONG PATIENT-PROVIDER RELATIONSHIPS, INCREASING ACCESS TO CARE AND IMPROVING HEALTHCARE QUALITY AND OUTCOMES AMONG PEOPLE OF COLOR. THE PROGRAM'S OBJECTIVE IS TO CREATE A HEALTHCARE EDUCATIONAL PIPELINE BY INTRODUCING BLACK, INDIGENOUS, AND LATINO/A STUDENTS TO A VARIETY OF HEALTH CARE PROFESSIONS THROUGH AN ENGAGED INTERACTIVE LEARNING EXPERIENCE. THE MEDICAL EXPLORERS PROGRAM OCCURS ONCE A YEAR FROM JANUARY - MAY. THE MONTHLY SESSIONS ARE VIRTUAL TO ALLOW FOR MAXIMUM STUDENT PARTICIPATION AND GEOGRAPHIC REACH BY REDUCING TRAVEL TIME AND THE NEED FOR TRANSPORTATION. TO BE ELIGIBLE FOR THE PROGRAM, STUDENTS MUST BE IN GRADES 7 - 12 OR RECENT HIGH SCHOOL GRADUATES AND IDENTIFY AS BLACK, INDIGENOUS AND LATINO/A/E. THE MEDICAL EXPLORERS ARE GUIDED THROUGH A SIMULATED PATIENT CASE AS IT MOVES ALONG THE HOSPITAL SYSTEM. TO MODEL A VARIETY OF PROFESSIONS, MIDDLESEX HEALTH STAFF IDENTIFYING AS PEOPLE OF COLOR ARE THE FEATURED SPEAKERS. STUDENTS LEARN ABOUT THE SPECIFICS OF EACH HIGHLIGHTED PROFESSION, THE SPEAKER'S PATHWAY TO THAT PROFESSION, AND THE SPEAKER'S CLINICAL EXPERTISE REGARDING THE CASE. ON-SITE EXPERIENCES INCLUDE A TOUR OF THE HOSPITAL WHERE MEDICAL EXPLORERS GET TO MEET STAFF AND EXPERIENCE VARIOUS CLINICAL DEPARTMENTS AND A CELEBRATION WHERE CERTIFICATES OF COMPLETION ARE AWARDED. THE HOSPITAL'S FY23 COMMUNITY BUILDING EXPENSE TOTALED $183,812, SERVING 138 INDIVIDUALS.
PART III, LINE 2:	DUE TO THE ADOPTION OF ASC NO 2014-09 CONTRACTS WITH CUSTOMERS (TOPIC 606) BAD DEBT EXPENSE IS NO LONGER REPORTED ON THE AUDITED FINANCIAL STATEMENT. RATHER IT IS TREATED AS A PRICE CONCESSION. THE BAD DEBT EXPENSE FOR FY23 WAS $21,818,497.
PART III, LINE 3:	THE HOSPITAL ESTIMATES THAT 10% OF ITS BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THE HOSPITAL HAS A WELL-ESTABLISHED PROCESS WITH ITS THIRD PARTY AGENCIES TO CAPTURE AS MANY PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE AS POSSIBLE AND AWARDS FINANCIAL ASSISTANCE TO THOSE PATIENTS IN COLLECTIONS WHO ARE KNOWN TO QUALIFY. ONCE IN COLLECTIONS, THERE ARE TWO METHODS WHICH ENABLE PATIENTS TO RECEIVE FINANCIAL ASSISTANCE AWARDS: 1) PATIENTS EITHER COMPLETE A FINANCIAL ASSISTANCE APPLICATION, MEET ELIGIBILITY CRITERIA AND ARE APPROVED; OR 2) THE THIRD PARTY ORGANIZATIONS THAT WORK ON BEHALF OF THE HOSPITAL TO COLLECT BALANCES SCREEN FOR FINANCIAL ASSISTANCE ELIGIBILITY. IN ORDER TO ENSURE THAT ALL PATIENTS IN COLLECTIONS ARE AWARE OF FINANCIAL ASSISTANCE AVAILABILITY, THE HOSPITAL REQUIRES THIRD PARTY ORGANIZATIONS TO FOLLOW THE HOSPITAL'S POLICIES REGARDING PATIENT NOTIFICATION ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. WITHIN THE POLICY THERE IS A PROVISION WHEREBY COLLECTION AGENCIES, USING GUIDELINES SET FORTH BY THE HOSPITAL, ASSIST THE HOSPITAL IN IDENTIFYING PATIENTS WHO DO NOT HAVE A MEANS TO PAY FOR SERVICES AND THEREFORE QUALIFY FOR THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM - WHILE THESE PATIENTS HAVE NOT GONE THROUGH THE FORMAL APPLICATION PROCESS, THEY MEET THE ELIGIBILITY GUIDELINES FOR FINANCIAL ASSISTANCE AS DEFINED BY THE HOSPITAL. THESE PATIENTS ARE THEN TRANSFERRED AND INCLUDED UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE UMBRELLA. WHILE THIS PROCESS CAPTURES THE MAJORITY OF THOSE WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL RECOGNIZES IT WILL STILL HAVE A POPULATION OF PATIENTS WHO COULD POTENTIALLY QUALIFY FOR FINANCIAL ASSISTANCE AND DO NOT RECEIVE AWARDS - THOSE WHO ARE UNRESPONSIVE OR HAVE MOVED AWAY. BAD DEBT DOLLARS ARE NOT INCLUDED IN ANY OF THE HOSPITAL'S PROGRAMMATIC COMMUNITY BENEFIT VALUES AND, WHILE NOTED, ARE NOT INCLUDED IN THE HOSPITAL'S COMMUNITY BENEFIT TOTALS IN ANY HOSPITAL COMMUNITY BENEFIT PUBLICATION.
PART III, LINE 4:	THE HOSPITAL ESTIMATES A RESERVE FOR UNCOLLECTIBLE ACCOUNTS AGAINST ITS PATIENT ACCOUNTS RECEIVABLES. WHEN BAD DEBTS ARE IDENTIFIED, THEY ARE ACCOUNTED FOR AS A COMPONENT OF THE NET PATIENT REVENUE PROVISION FOR BAD DEBTS NET OF RECOVERIES. PAGE 14 OF THE MIDDLESEX HEALTH SYSTEM'S CONSOLIDATED FY23 AUDITED FINANCIAL STATEMENT STATES: THE SYSTEM DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON ITS HISTORICAL COLLECTION EXPERIENCE FROM THAT CATEGORY OF PAYOR.
PART III, LINE 8:	THE MEDICARE COST REPORT IS THE COSTING METHODOLOGY SYSTEM USED TO DETERMINE THE AMOUNT REPORTED ON PART III, LINES 5 AND 6. THE HOSPITAL UTILIZES WORKSHEET 6 FOUND IN THE FORM 990 INSTRUCTIONS FOR SCHEDULE H TO CALCULATE ITS SUBSIDIZED SERVICES. THE INSTRUCTIONS STATE THAT "THE FINANCIAL LOSS IS MEASURED AFTER REMOVING LOSSES, MEASURED BY COST, ASSOCIATED WITH BAD DEBT, CHARITY CARE, MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS". GIVEN THAT WORKSHEET 6 DOESN'T SUGGEST REMOVING LOSSES ASSOCIATED WITH MEDICARE, A PORTION OF MEDICARE IS INCLUDED IN THE HOSPITAL'S SUBSIDIZED SERVICE CALCULATIONS. SO AS NOT TO DOUBLE COUNT MEDICARE VALUES IN PART III, SECTION B, LINES 5 AND 6, THE PORTION OF MEDICARE SHORTFALL INCLUDED IN OUR SUBSIDIZED SERVICES CALCULATIONS HAS BEEN SUBTRACTED FROM THE MEDICARE REVENUE AND COSTS DERIVED FROM THE MEDICARE COST REPORT. THE VALUES INDICATED IN PART III, LINES 5 AND 6 ARE THEREFORE WHAT REMAINS AFTER THE MEDICARE REVENUE AND COSTS INCLUDED IN THE SUBSIDIZED SERVICES CALCULATIONS HAS BEEN SUBTRACTED OUT. GIVEN THIS, THE RESULTING VALUES (PART III, LINES 5, 6 AND 7) WOULD NEED TO BE COMBINED WITH THE MEDICARE REVENUE/COSTS INCLUDED IN OUR SUBSIDIZED SERVICES TO GET THE FULL OVERVIEW OF MEDICARE REVENUE, COSTS AND ANY REMAINING SHORTFALL OR SURPLUS. WE AGREE WITH THE CURRENT SUBSIDIZED SERVICES CALCULATION METHODOLOGY THAT ALLOWS THE INCLUSION OF MEDICARE DOLLARS AS THE MEDICARE POPULATION COMPRISES AN IMPORTANT SEGMENT OF THOSE RECEIVING SUBSIDIZED SERVICES CARE. THE HOSPITAL TREATS ALL MEDICARE PATIENTS EQUALLY AND DOES NOT DISCRIMINATE AGAINST LOWER-MARGIN YIELDING SERVICES. AS A NOT-FOR-PROFIT HOSPITAL, MIDDLESEX HOSPITAL IS THE SAFETY-NET IN THE COMMUNITY FOR ALL MEDICARE PATIENTS, REGARDLESS OF LEVEL OF MEDICARE COVERAGE AND REGARDLESS IF A SURPLUS OR DEFICIT RESULTS. THIS OPEN ACCESS FOR MEDICARE PATIENTS PROMOTES ACCESS TO CARE, A FUNDAMENTAL TENET OF THE HOSPITAL'S COMMUNITY BENEFIT PROGRAM.THERE REMAINS A DISPROPORTIONATE PERCENTAGE OF OLDER ADULTS IN MIDDLESEX COUNTY WHEN COMPARED TO STATE AVERAGES. MIDDLESEX HOSPITAL'S MOST RECENTLY COMPLETED (2022) COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOUND THAT, WHEN EXTRACTING THE AGE 65+ POPULATION, MIDDLESEX COUNTY (19.0%) EXCEEDS CONNECTICUT (17.2%), AND THE MAJORITY OF THE TOWNS IN MIDDLESEX HEALTH'S SERVICE AREA CONTINUE TO HAVE A GREATER CONCENTRATION OF OLDER ADULTS WHEN COMPARED TO CONNECTICUT. THE TOWNS OF COLCHESTER, MARLBOROUGH AND MIDDLETOWN FALL BELOW THE STATE AVERAGE OF 17.2%. PORTLAND IS ON PAR WITH THE STATE AVERAGE, WHILE CHESTER, CLINTON, CROMWELL, DEEP RIVER, DURHAM, EAST HADDAM, EAST HAMPTON, HADDAM, KILLINGWORTH, AND MIDDLEFIELD EXCEED THE STATE AVERAGE WITH AN AGE 65+ RANGE OF 19.1%-24.8%, AND ESSEX, LYME, OLD LYME, OLD SAYBROOK, AND WESTBROOK CONSIDERABLY EXCEED THE STATE AVERAGE WITH AN AGE 65+ RANGE OF 26.2%-30.9% (CT DATA COLLABORATIVE, 2016-2020). THE TREND OF A DISPROPORTIONATELY HIGHER 65+ OLDER ADULT POPULATION IN THE MAJORITY OF TOWNS IN MIDDLESEX HEALTH'S SERVICE AREA WHEN COMPARED TO THE STATE AVERAGE CONTINUES TO BE EVIDENT FOR POPULATION PROJECTIONS FOR 2030. EXCLUDING MIDDLETOWN (AT 14.9%), THE EXPECTED GROWTH FOR AGE 65+ BY 2030 RANGES FROM 19.5% TO 34.9% IN THE REMAINING 18 TOWNS IN MIDDLESEX HEALTH'S SERVICE AREA COMPARED TO 17.9% FOR CONNECTICUT (CT DATA COLLABORATIVE, AGE 65+ POPULATION PROJECTIONS, 2030). AS MIDDLESEX COUNTY HAS A DISPROPORTIONATE LEVEL OF COMMUNITY MEMBERS AGE 65+ WHEN COMPARED TO STATE AVERAGES, THE SHORTFALL THAT THE HOSPITAL EXPERIENCES IN PROVIDING CRITICAL HEALTHCARE SERVICES TO THE MEDICARE POPULATION SHOULD BE CONSIDERED A COMMUNITY BENEFIT WITHIN THE HOSPITAL'S SUBSIDIZED SERVICES, WHICH THOSE AGE 65+ ALSO RELY HEAVILY ON FOR CARE. THE HOSPITAL FILLS A HEALTHCARE DELIVERY GAP FOR MEDICARE PATIENTS, ONE WHICH WOULD BE DETRIMENTAL TO THE COMMUNITY IF THE HOSPITAL WAS NOT PRESENT.
PART III, LINE 9B:	MIDDLESEX HOSPITAL HAS A WRITTEN DEBT COLLECTION POLICY. THE POLICY STATES THAT PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE WILL BE RESPONSIBLE FOR PAYING ANY BALANCE REMAINING AFTER THE FINANCIAL ASSISTANCE ALLOWANCE HAS BEEN APPLIED (THAT IS, IF 100% FINANCIAL ASSISTANCE HAS NOT BEEN AWARDED). THE POLICY ALSO OUTLINES THE PROCESS FOR PAYING OUTSTANDING BALANCES SHOULD THE PATIENT BE FOUND TO HAVE THE MEANS TO PAY A PARTIAL AMOUNT AFTER THE HOSPITAL'S FINANCIAL ASSISTANCE DETERMINATION CRITERIA HAS BEEN APPLIED. FOR SUCH BALANCES, THE HOSPITAL WILL NOTIFY THE PATIENT OF HIS/HER LIABILITY. IF PAYMENT IS NOT MADE, THE POLICY STATES THAT THE HOSPITAL WILL USE APPROPRIATE METHODS TO PURSUE COLLECTION, WHICH MAY INCLUDE COLLECTIONS AGENCIES. THIS PRACTICE IS BROADLY UTILIZED FOR ALL PATIENTS WITH OUTSTANDING BALANCES. THE HOSPITAL MAKES EVERY EFFORT TO ENSURE THAT ALL PATIENTS KNOW PAYMENT PLANS ARE AVAILABLE FOR ANY BALANCE, INCLUDING THOSE PATIENTS WHO HAVE A BALANCE LEFT OVER AFTER A FINANCIAL ASSISTANCE AWARD HAS BEEN APPLIED. IN ORDER TO CAPTURE THE PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE, THE HOSPITAL HAS PROVISIONS IN ITS COLLECTION POLICY. IN THE CASE WHERE PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE DO NOT COMPLETE A FINANCIAL ASSISTANCE APPLICATION AND ARE PLACED INTO COLLECTIONS, THE THIRD PARTY ORGANIZATIONS THAT WORK ON BEHALF OF THE HOSPITAL TO COLLECT BALANCES SCREEN FOR FINANCIAL ASSISTANCE ELIGIBILITY. THE THIRD PARTY ORGANIZATIONS FOLLOW HOSPITAL POLICY BY ALERTING ALL PATIENTS IN COLLECTIONS TO THE AVAILABILITY OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. WITHIN THE HOSPITAL'S COLLECTION POLICY THERE IS A PROVISION WHEREBY COLLECTION AGENCIES, USING GUIDELINES SET FORTH BY THE HOSPITAL, ASSIST THE HOSPITAL IN IDENTIFYING PATIENTS WHO DO NOT HAVE A MEANS TO PAY FOR SERVICES AND THEREFORE QUALIFY FOR THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM WHILE THESE PATIENTS HAVE NOT GONE THROUGH THE FORMAL APPLICATION PROCESS, THEY MEET THE ELIGIBILITY GUIDELINES FOR FINANCIAL ASSISTANCE AS DEFINED BY THE HOSPITAL. THESE PATIENTS ARE THEN TRANSFERRED AND INCLUDED UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE UMBRELLA. THIS PROCESS WAS PUT IN PLACE BY THE HOSPITAL IN ORDER TO CAPTURE AS MANY PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE AS POSSIBLE.
PART VI, LINE 2:	SINCE THE INCEPTION OF MIDDLESEX HEALTH'S COMMUNITY BENEFIT POLICY IN 2007, AND PRIOR TO THE MANDATE OF THE AFFORDABLE CARE ACT, CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN ORDER TO PRIORITIZE SPECIFIC COMMUNITY BENEFIT INITIATIVES HAS BEEN A CORE ELEMENT OF THE HOSPITAL'S COMMUNITY BENEFIT PROGRAM. IN ADDITION TO COMPLETING A CHNA, THE HOSPITAL ASSESSES THE NEEDS OF THE COMMUNITIES IT SERVICES ON AN ON-GOING BASIS THROUGH A VARIETY OF METHODS. EXAMPLES INCLUDE UNDERSTANDING THE LOCAL AND STATE-WIDE NEEDS DERIVED FROM: 1) PARTICIPATION IN COMMUNITY HEALTHCARE COALITIONS AND BOARDS, WHICH INCLUDE STRATEGIC PLANNING THAT IS RESPONSIVE TO COMMUNITY NEED; 2) PARTICIPATION IN THE LEADERSHIP TEAM OF THE GREATER MIDDLETOWN HEALTH ENHANCEMENT COMMUNITY (GMHEC) COALITION, A PLACE-BASED INITIATIVE THAT SUPPORTS LONG-TERM, COLLABORATIVE, AND CROSS-SECTOR EFFORTS TO IMPROVE COMMUNITY HEALTH AND WELL-BEING THROUGH BROAD, SYSTEMIC CHANGE BY BUILDING HEALTHY AND EQUITABLE COMMUNITIES THAT ACTIVELY WORK TOGETHER TO PREVENT THE DEVELOPMENT OF DISEASE; 3) PARTICIPATION IN THE STATE'S HOSPITAL ASSOCIATION POPULATION AND COMMUNITY HEALTH INITIATIVES BASED ON STATE-WIDE AND LOCAL COMMUNITY HEALTH ISSUES; 4) ANY REAL-TIME COMMUNITY BASED INPUT, FEED-BACK, RECOMMENDATIONS AND SUGGESTIONS; AND 5) CONTINUOUS ASSESSMENT AND ADJUSTMENTS, WHEN NECESSARY, OF THE HOSPITAL'S COMMUNITY BENEFIT PROGRAMS THROUGH SURVEYS AND PATIENT/PARTICIPANT FEED-BACK. HAVING A STRONG PRESENCE IN COMMUNITY COALITIONS AND PARTNERSHIPS, IN ADDITION TO BEING RESPONSIVE TO THE NEEDS EXPRESSED BY OUR COMMUNITY RESIDENTS, ALLOWS MIDDLESEX HOSPITAL TO CONTINUALLY ASSESS THE HEALTHCARE NEEDS OF OUR COMMUNITY IN BETWEEN COMMUNITY HEALTH NEEDS ASSESSMENT CYCLES.
PART VI, LINE 3:	GREAT CONCERN IS TAKEN TO ENSURE THAT PATIENTS ARE APPRISED OF THE AVAILABILITY OF FEDERAL/STATE/LOCAL GOVERNMENT PROGRAMS AND THE HOSPITAL'S FINANCIAL ASSISTANCE PLAN. NOTICE OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM IS DISPLAYED CONSPICUOUSLY IN ENGLISH AND SPANISH AT THE ENTRY OF EACH FACILITY AND AT ALL PATIENT REGISTRATION POINTS. THE NOTIFICATION INCLUDES AN OVERVIEW OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM; THE AVAILABILITY OF FREE BED FUNDS AND OTHER FINANCIAL ASSISTANCE; SLIDING SCALE; AND FINANCIAL COUNSELOR CONTACT INFORMATION. AT THE TIME OF REGISTRATION, HOSPITAL ACCESS STAFF REVIEWS THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM AND ASKS PATIENTS IF THEY WOULD LIKE A FINANCIAL ASSISTANCE PACKAGE. BUILT INTO THE REGISTRATION DATABASE IS A REQUIRED FINANCIAL ASSISTANCE FIELD WHICH MUST BE COMPLETED AS PART OF THE ADMISSIONS PROCESS. ONCE THE PATIENT EXPRESSES THE DESIRE TO RECEIVE A FINANCIAL ASSISTANCE PACKAGE, PAPERWORK WITH PATIENT NAME AND MEDICAL RECORD IS AUTOMATICALLY PRINTED AT THE REGISTRATION STATION AND HANDED TO THE PATIENT. OTHER METHODS OF COMMUNICATION TO INCREASE AWARENESS REGARDING THE FINANCIAL ASSISTANCE AND FREE BED FUND PROGRAM INCLUDE 1) A FINANCIAL ASSISTANCE BROCHURE THAT AIDS PATIENTS IN THE PROCESS, ANSWERS KEY QUESTIONS AND PROVIDES EASY ACCESS FOR HELP (AVAILABLE AT MULTIPLE HOSPITAL DEPARTMENTS AND LOCATIONS, INCLUDING KIOSKS AT EVERY HOSPITAL ENTRY POINT); 2) A SEPARATE AND DISTINCT FINANCIAL ASSISTANCE SERVICES SECTION ON THE HOSPITAL'S WEB-SITE (HTTPS://MIDDLESEXHEALTH.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE-SERVICES) WHICH INCLUDES APPLICATION, INSTRUCTIONS, AND SLIDING SCALE; 3) INCLUSION OF FINANCIAL ASSISTANCE INFORMATION IN THE HOSPITAL'S INPATIENT ADMISSIONS BOOKLET; 4) NOTICE OF THE PROGRAM AND FINANCIAL COUNSELOR CONTACT INFORMATION ON EVERY BILLING STATEMENT; 5) NOTIFICATION AT DISCHARGE; AND 6) A LETTER OUTLINING THE PROGRAM SENT TO EVERY SELF-PAY PATIENT FOLLOWING DISCHARGE. MIDDLESEX HEALTH'S FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN THE TOP 15 LANGUAGES IN ITS SERVICE AREA AND THIS AVAILABILITY IS COMMUNICATED ON THE BACK OF THE STATEMENT IN EACH LANGUAGE.THE HOSPITAL HAS A TEAM OF FINANCIAL COUNSELORS WHO ARE AVAILABLE TO ASSIST PATIENTS THROUGH THE APPLICATION PROCESS EITHER BY PHONE OR VISIT. THE ROLE OF THE COUNSELORS IS TO HELP PATIENTS NAVIGATE THE HOSPITAL'S FINANCIAL ASSISTANCE PROCESS AND TO AID IN APPLICATION FOR MEDICAID/STATE PROGRAMS. ALL COUNSELORS RECEIVE DEPARTMENTAL TRAINING ON THE IMPORTANCE OF ASSISTING PATIENTS IN NEED OF STATE/GOVERNMENTAL OR HOSPITAL FINANCIAL ASSISTANCE, THE HOSPITAL'S FINANCIAL ASSISTANCE PROTOCOLS, SYSTEMS, NEW PROGRAM ENHANCEMENTS, AND HOW TO PROVIDE SUPPORT AND FOLLOW-UP FOR MEDICAID/STATE ENROLLMENT. THE HOSPITAL'S SOCIAL WORKERS ALSO ASSIST PATIENTS WITH COMPLETION OF HOSPITAL FINANCIAL ASSISTANCE APPLICATIONS AS WELL AS MEDICAID/STATE APPLICATIONS.IN FY23, MIDDLESEX HOSPITAL GRANTED $1,551,780 IN FINANCIAL ASSISTANCE TO 1,143 UNIQUE RECIPIENTS AND ABSORBED $33,726,063 IN UNPAID COSTS OF MEDICAID, SERVING 23,980 INDIVIDUALS.
PART VI, LINE 4:	MIDDLESEX HOSPITAL IS THE SOLE HOSPITAL PROVIDER IN ITS SERVICE AREA, WHICH INCLUDES THE LARGE GEOGRAPHIC AREA OF MIDDLESEX COUNTY AND SURROUNDING TOWNS. IT ENCOMPASSES 24 MUNICIPALITIES, INCLUDING THE 15 TOWNS OF MIDDLESEX COUNTY. THERE ARE NINETEEN TOWNS IN ITS PRIMARY SERVICE AREA: CHESTER, CLINTON, CROMWELL, DEEP RIVER, DURHAM, EAST HADDAM, EAST HAMPTON, ESSEX, HADDAM, KILLINGWORTH, MIDDLEFIELD, MIDDLETOWN, OLD SAYBROOK, PORTLAND, AND WESTBROOK (THE FIFTEEN TOWNS OF MIDDLESEX COUNTY) AND COLCHESTER, LYME, MARLBOROUGH AND OLD LYME; AND, FIVE TOWNS IN ITS SECONDARY SERVICE AREA: GUILFORD, HEBRON, MADISON, MERIDEN, AND ROCKY HILL. BY LAND AREA, MIDDLESEX COUNTY (369.3 SQUARE MILES) IS THE SMALLEST COUNTY OF THE EIGHT COUNTIES IN CONNECTICUT AND IS THE SIXTH IN POPULATION SIZE (U.S. CENSUS, 2020). MUNICIPALITY SIZES BY LAND MASS VARY THROUGHOUT THE COUNTY, FROM 10.40 SQUARE MILES (ESSEX) TO 54.25 SQUARE MILES (EAST HADDAM) WITH MIDDLETOWN HAVING 41.02 SQUARE MILES OF LAND AREA. THE CITY OF MIDDLETOWN (ZIP CODE 06457) IS CENTRALLY LOCATED 16 MILES SOUTH OF HARTFORD. THE POPULATION IN MIDDLETOWN IS ECONOMICALLY AND RACIALLY / ETHNICALLY MORE DIVERSE WHEN COMPARED TO OTHER MUNICIPALITIES IN MIDDLESEX COUNTY AND IS ONE OF THE FEW COMMUNITIES IN CONNECTICUT TO INCLUDE URBAN, SUBURBAN, AND RURAL CHARACTERISTICS. THE DATA THAT FOLLOWS IS PER MIDDLESEX HEALTH'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT (2022).OF THE TOTAL STATE OF CONNECTICUT POPULATION (3,605,597), 4.6% (164,759) RESIDE IN MIDDLESEX COUNTY (U.S. CENSUS, 2021). WITH A POPULATION OF 47,108 (U.S. CENSUS, 2021), MIDDLETOWN IS THE LARGEST MUNICIPALITY IN MIDDLESEX COUNTY. THE REMAINING TOWNS IN MIDDLESEX HEALTH'S PRIMARY SERVICE AREA FALL INTO THREE POPULATION RANGES. COLCHESTER, CROMWELL, CLINTON, EAST HAMPTON AND OLD SAYBROOK HAVE POPULATIONS BETWEEN 10,000 AND 15,600. PORTLAND, EAST HADDAM, HADDAM, OLD LYME, DURHAM, WESTBROOK, ESSEX, KILLINGWORTH AND MARLBOROUGH HAVE POPULATIONS BETWEEN 5,000 AND 9,999. DEEP RIVER, MIDDLEFIELD, CHESTER AND LYME HAVE POPULATIONS LESS THAN 5,000. THE CONNECTICUT OFFICE OF RURAL HEALTH (CT-ORH) DEFINES RURAL AS ALL TOWNS WITH A POPULATION CENSUS OF 10,000 OR LESS AND A POPULATION DENSITY OF 500 OR LESS PEOPLE PER SQUARE MILE. BASED ON THIS METRIC, THE TOWNS OF CHESTER, DEEP RIVER, DURHAM, EAST HADDAM, HADDAM, KILLINGWORTH, LYME, MARLBOROUGH, MIDDLEFIELD, OLD LYME AND WESTBROOK ARE CONSIDERED RURAL. FOR THE AGE DISTRIBUTIONS, MIDDLESEX COUNTY IS LOWER THAN THE STATE AVERAGE IN THE 0-19 AND 20-44 AGE GROUPS AND EXCEEDS THE STATE AVERAGE IN THE 45-64 AND 65+ AGE GROUPS. MIDDLETOWN IS LOWER THAN THE STATE AVERAGE IN THE 0-19 AGE GROUP, IS SIGNIFICANTLY HIGHER THAN THE STATE AVERAGE IN THE 20-44 AGE GROUP AND LOWER THAN THE STATE AVERAGE IN THE 45-64 AND 65+ AGE GROUPS. WHEN EXTRACTING AGE 65+, MIDDLESEX COUNTY (19.0%) EXCEEDS CONNECTICUT (17.2%), AND THE MAJORITY OF THE TOWNS IN MIDDLESEX HEALTH'S SERVICE AREA CONTINUE TO HAVE A GREATER CONCENTRATION OF OLDER ADULTS WHEN COMPARED TO CONNECTICUT. THE TOWNS OF COLCHESTER, MARLBOROUGH AND MIDDLETOWN FALL BELOW THE STATE AVERAGE OF 17.2%. PORTLAND IS ON PAR WITH THE STATE AVERAGE, WHILE CHESTER, CLINTON, CROMWELL, DEEP RIVER, DURHAM, EAST HADDAM, EAST HAMPTON, HADDAM, KILLINGWORTH, AND MIDDLEFIELD EXCEED THE STATE AVERAGE WITH AN AGE 65+ RANGE OF 19.1%-24.8%, AND ESSEX, LYME, OLD LYME, OLD SAYBROOK, AND WESTBROOK CONSIDERABLY EXCEED THE STATE AVERAGE WITH AN AGE 65+ RANGE OF 26.2%-30.9% (CT DATA COLLABORATIVE, 2016-2020).MIDDLETOWN HAS A MORE DIVERSE RACIAL / ETHNIC DEMOGRAPHIC RELATIVE TO THE OTHER TOWNS IN MIDDLESEX COUNTY AND RESEMBLES CONNECTICUT EXCEPT IN THE HISPANIC OR LATINO CATEGORY, WHERE MIDDLETOWN HAS A SMALLER POPULATION. MIDDLESEX COUNTY'S RACE AND HISPANIC OR LATINO ORIGIN COMPOSITION IS 82.4% WHITE, NON-HISPANIC; 6% BLACK OR AFRICAN AMERICAN, NON-HISPANIC; 7.1% HISPANIC OR LATINO; 3.3% ASIAN, NON-HISPANIC; 2.2% TWO OR MORE RACES, NON-HISPANIC (U.S. CENSUS QUICK FACTS 2021). MIDDLETOWN'S RACE AND HISPANIC OR LATINO ORIGIN COMPOSITION IS 66.8% WHITE, NON-HISPANIC; 15.8% BLACK OR AFRICAN AMERICAN, NON-HISPANIC; 10.3% HISPANIC OR LATINO; 6% ASIAN, NON-HISPANIC; 4.2% TWO OR MORE RACES, NON-HISPANIC (U.S. CENSUS QUICK FACTS 2021).THE MEDIAN HOUSEHOLD INCOME PER TOWN IN MIDDLESEX HEALTH'S SERVICE AREA RANGES FROM $62,022 (MIDDLETOWN) TO $130,635 (DURHAM) AND ALL TOWNS EXCEPT MIDDLETOWN, MIDDLEFIELD AND WESTBROOK EXCEED CONNECTICUT'S MEDIAN INCOME OF $79,855 (CONNECTICUT DATA COLLABORATIVE, 2016-2020). THERE ARE SIGNIFICANT MEDIAN HOUSEHOLD INCOME DISPARITIES WHEN DATA POINTS ARE DISAGGREGATED BY RACE AND ETHNICITY AND COMPARED TO WHITE ALONE NOT HISPANIC OR LATINO. IN MIDDLETOWN, WHITE HOUSEHOLDS EARN 1.6 TIMES MORE THAN BLACK HOUSEHOLDS AND 1.8 TIMES MORE THAN HISPANIC OR LATINO HOUSEHOLDS. IN MIDDLESEX COUNTY, WHITE HOUSEHOLDS EARN 1.8 TIMES MORE THAN BLACK HOUSEHOLDS AND 1.6 TIMES MORE THAN HISPANIC OR LATINO HOUSEHOLDS. WHILE THE GAP IS NARROWER, WHITE HOUSEHOLDS EARN 1.1 TIMES MORE (MIDDLETOWN) AND 1.4 TIMES MORE (MIDDLESEX COUNTY) THAN ASIAN HOUSEHOLDS. FOR POVERTY STATUS, THE TOTAL POVERTY RATE FOR MIDDLETOWN AT 12.3% EXCEEDS THE STATE OF CONNECTICUT AT 9.8%. THE TOTAL POVERTY RATES FOR MIDDLEFIELD (8.5%) AND MARLBOROUGH (8.4%) EXCEED THE MIDDLESEX COUNTY TOTAL POVERTY RATE OF 7.1%. THE UNDER 18 POVERTY RATE FOR MIDDLETOWN AT 16.1% EXCEEDS THE STATE OF CONNECTICUT AT 13.0%. THE UNDER 18 POVERTY RATES FOR THE TOWNS OF COLCHESTER (11.6%), PORTLAND (10.9%), MIDDLEFIELD (9.3%) AND EAST HAMPTON (8.7%) EXCEED THE MIDDLESEX COUNTY UNDER 18 POVERTY RATE OF 8.3% (CONNECTICUT DATA COLLABORATIVE, 2016-2020; MIDDLESEX COUNTY: U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES 2016-2020).POVERTY RATES ARE SIGNIFICANTLY MORE PRONOUNCED AMONG BLACK OR AFRICAN AMERICAN ALONE, HISPANIC OR LATINO, AND TWO OR MORE RACES POPULATIONS IN MIDDLETOWN AND MIDDLESEX COUNTY WHEN COMPARED TO WHITE ALONE NOT HISPANIC OR LATINO FOR THE TOTAL AND UNDER 18 CATEGORIES. BLACK OR AFRICAN AMERICAN ALONE RESIDENTS ARE 2.5 TIMES MORE LIKELY (MIDDLETOWN) AND 3.2 TIMES MORE LIKELY (MIDDLESEX COUNTY) TO EXPERIENCE POVERTY WHEN COMPARED TO WHITE ALONE NOT HISPANIC OR LATINO RESIDENTS. HISPANIC OR LATINO RESIDENTS ARE 4.1 TIMES MORE LIKELY (MIDDLETOWN) AND 3.8 TIMES MORE LIKELY (MIDDLESEX COUNTY) TO EXPERIENCE POVERTY WHEN COMPARED TO WHITE ALONE NOT HISPANIC OR LATINO RESIDENTS. ASIAN ALONE RESIDENTS ARE 1.2 TIMES MORE LIKELY (MIDDLETOWN) AND 2 TIMES MORE LIKELY (MIDDLESEX COUNTY) TO EXPERIENCE POVERTY WHEN COMPARED TO WHITE ALONE NOT HISPANIC OR LATINO RESIDENTS. RESIDENTS WITH TWO OR MORE RACES ARE 2.7 TIMES MORE LIKELY (MIDDLETOWN) AND 3.1 TIMES MORE LIKELY (MIDDLESEX COUNTY) TO EXPERIENCE POVERTY WHEN COMPARED TO WHITE ALONE NOT HISPANIC OR LATINO RESIDENTS (CONNECTICUT DATA COLLABORATIVE, 2016-2020; MIDDLESEX COUNTY: CONNECTICUT DATA COLLABORATIVE, 2015-2019). UNDER AGE 18 BLACK OR AFRICAN AMERICAN ALONE YOUTH ARE 2.9 TIMES MORE LIKELY (MIDDLETOWN) AND 5.5 TIMES MORE LIKELY (MIDDLESEX COUNTY) TO EXPERIENCE POVERTY WHEN COMPARED TO UNDER 18 AGE WHITE ALONE NOT HISPANIC OR LATINO YOUTH. UNDER AGE 18 HISPANIC OR LATINO YOUTH ARE 5.1 TIMES MORE LIKELY (MIDDLETOWN) AND 5.8 TIMES MORE LIKELY (MIDDLESEX COUNTY) TO EXPERIENCE POVERTY WHEN COMPARED TO UNDER AGE 18 WHITE ALONE NOT HISPANIC OR LATINO YOUTH. UNDER AGE 18 YOUTH WITH TWO OR MORE RACES ARE 2.1 TIMES MORE LIKELY (MIDDLETOWN) AND 2.3 TIMES MORE LIKELY (MIDDLESEX COUNTY) TO EXPERIENCE POVERTY WHEN COMPARED TO UNDER AGE 18 YOUTH WHITE ALONE NOT HISPANIC OR LATINO YOUTH (CONNECTICUT DATA COLLABORATIVE, 2016-2020; MIDDLESEX COUNTY: CONNECTICUT DATA COLLABORATIVE, 2015-2019).THE COVID-19 PANDEMIC HAD A PROFOUND IMPACT ON THE UNEMPLOYMENT RATE IN CONNECTICUT. IN FEBRUARY 2020, JUST PRIOR TO THE COVID-19 LOCKDOWN, THE UNEMPLOYMENT RATE IN CONNECTICUT WAS 3.4%. BY JUNE 2020, IT HAD MORE THAN TRIPLED TO 11.1%. AS OF JUNE 2021, THE UNEMPLOYMENT RATE IN CONNECTICUT WAS STILL HIGH AT 6.7% AND EXPERIENCED A DOWNWARD TREND AS OF JUNE 2022 AT 4% (CT DEPARTMENT OF LABOR, 2022). WHILE THE MAJORITY OF TOWNS IN MIDDLESEX HEALTH'S SERVICE AREA EXPERIENCE A LOWER HOUSING COST-BURDEN RATE (HOUSEHOLDS THAT SPEND AT LEAST 30% OF THEIR ANNUAL HOUSEHOLD INCOME ON HOUSING COSTS) WHEN COMPARED TO CONNECTICUT (39.6%), FOR THIS COHORT, THE PERCENTAGE OF HOUSEHOLDS IN THE TOWNS THAT ARE COST-BURDENED IS HIGH, RANGING FROM 22% - 37.8%. THE TOWNS OF CLINTON, LYME, AND MIDDLETOWN COMPARE TO CONNECTICUT, WHILE CHESTER, OLD SAYBROOK, AND WESTBROOK EXCEED THE STATE AVERAGE WITH A RANGE OF 41.2% - 43.6% EXPERIENCING HOUSING COST-BURDEN (CONNECTICUT DATA COLLABORATIVE, 2015-2019).(CONTINUED AT END)
PART VI, LINE 5:	AS MIDDLESEX HOSPITAL IS A COMMUNITY HOSPITAL, INVOLVING COMMUNITY MEMBERS IN KEY FUNCTIONS HAS ALWAYS BEEN A PRIORITY. MIDDLESEX HOSPITAL'S BOARD IS COMPRISED MAINLY OF COMMUNITY MEMBERS WHO ARE NEITHER EMPLOYEES, FAMILY MEMBERS NOR CONTRACTORS OF THE ORGANIZATION, BUT ARE LONG-TERM RESIDENTS WHOSE PRIMARY INTEREST IS THE HEALTH AND WELL-BEING OF THE COMMUNITY AT LARGE. MIDDLESEX HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY BASED ON THE HOSPITAL'S CURRENT AND PROJECTED PATIENT CARE, TEACHING AND RESEARCH NEEDS, AND OVERALL COMMUNITY NEED. MEDICAL STAFF INPUT AND PARTICIPATION IS HIGHLY VALUED BY THE HOSPITAL AS EVIDENCED BY INCLUSION IN THE HOSPITAL'S MEDICAL EXECUTIVE COMMITTEE, THE MEDICAL STAFF COUNCIL AND COUNTLESS OTHER WORKING COMMITTEES. MIDDLESEX HOSPITAL HAS A FORMAL PROCESS FOR ALLOCATION OF SURPLUS FUNDS; A MULTIDISCIPLINARY CAPITAL BUDGETING COMMITTEE MEETS AND SETS PRIORITIES FOR INVESTMENTS IN PATIENT CARE, EDUCATION AND RESEARCH, AND PHYSICAL STRUCTURE. THE APPROACH TAKES INTO CONSIDERATION PATIENT, COMMUNITY AND STAFF NEEDS. EACH YEAR THE HOSPITAL ALLOCATES A PORTION OF SURPLUS FUNDING TO A WIDE ARRAY OF COMMUNITY BENEFIT PROGRAMS AND SERVICE LINES, INCLUDING SUBSTANTIAL HEALTH AND WELLNESS ACTIVITIES AND INITIATIVES, SUBSIDIZED SERVICES, MEDICAL EDUCATION, RESEARCH AND HEALTH ASSESSMENT COSTS. CONTINUOUS DEDICATION TO THE COMMUNITIES IT SERVES REMAINS THE HALLMARK OF MIDDLESEX HOSPITAL'S VISION, MISSION, AND STRATEGIC PLANNING. AMBITIOUS COMMUNITY BENEFIT GOALS, THE INCORPORATION OF COMMUNITY BENEFIT INTO ANNUAL ORGANIZATIONAL PLANNING, AND THE PROVISION OF COMMUNITY BENEFIT PROGRAMS THAT TARGET THE COMMUNITY'S MOST VULNERABLE AND AT-RISK POPULATIONS HAS ALLOWED THE HOSPITAL TO PUT A FORMAL STRUCTURE AROUND ITS FUNDAMENTAL PURPOSE. THE HOSPITAL'S COMMUNITY BENEFIT TOTAL FOR FY23 WAS $70,813,447 (EXCLUDING COMMUNITY BUILDING) WITH 76,922 SERVED (EXCLUDING COMMUNITY BUILDING). THE FOLLOWING IS AN OVERVIEW OF THE HOSPITAL'S COMMUNITY BENEFIT PROGRAM: COMMUNITY HEALTH IMPROVEMENT SERVICES: THE HOSPITAL UNDERWRITES A VAST RANGE OF COMMUNITY HEALTH EDUCATION AND HEALTH IMPROVEMENT PROGRAMS, NONE OF WHICH ARE DEVELOPED FOR MARKETING PURPOSES, ALL OF WHICH ARE SUPPORTED AS A MEANS OF FULFILLING THE HOSPITAL'S MISSION TO SERVE ITS COMMUNITY. 100% OF THE TIME THESE SERVICES ARE OFFERED FREE OF CHARGE (IN THE RARE INSTANCE WHERE A NOMINAL FEE IS ASSESSED THE COST OF PROVIDING THE SERVICE IS NOT COVERED). COMMUNITY HEALTH EDUCATION IS PROVIDED TO THE COMMUNITY AT LARGE. SOME OF THE PROGRAMS REPRESENT ONE TIME EVENTS, HOWEVER MOST ARE ONGOING AND OVER THE YEARS HAVE BECOME ENTRENCHED IN THE COMMUNITY AS A SOURCE OF SUPPORT AND CONTINUED EDUCATION FOR A HEALTHFUL FUTURE. EXAMPLES OF COMMUNITY HEALTH IMPROVEMENT SERVICES INCLUDE (BUT ARE NOT LIMITED TO): 1) HEALTH EDUCATION (COMMUNITY EDUCATION PRESENTATIONS; HEALTH AND WELLNESS EVENTS/HEALTH FAIRS; SUPPORT GROUPS; LARGE SCALE CANCER AWARENESS AND EDUCATIONAL EVENTS; AND THE AVAILABILITY OF HEALTH LITERATURE); 2) COMMUNITY-BASED CLINICAL SERVICES (CLINICS AND SCREENINGS; ANNUAL FLU SHOTS; BLOOD PRESSURE CLINICS); AND 3) HEALTHCARE SUPPORT SERVICES OFFERED TO INCREASE ACCESS AND QUALITY OF CARE TO INDIVIDUALS, ESPECIALLY THOSE LIVING IN POVERTY AND / OR OTHER VULNERABLE POPULATIONS. IN FY23, THE HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT SERVICES SERVED 25,909 INDIVIDUALS AT A TOTAL COST OF $1,981,721 TO THE HOSPITAL. HEALTH PROFESSIONS EDUCATION: HELPING TO PREPARE FUTURE HEALTH CARE PROFESSIONALS IS A LONG-STANDING COMMITMENT OF MIDDLESEX HOSPITAL AND DISTINGUISHING CHARACTERISTIC THAT CONSTITUTES A SIGNIFICANT COMMUNITY BENEFIT. THE HOSPITAL'S FAMILY MEDICINE RESIDENCY PROGRAM GRADUATES FAMILY PRACTICE PHYSICIANS, MANY OF WHOM CONTINUE TO PRACTICE IN THE MIDDLESEX COUNTY AREA AFTER THEIR TRAINING IS COMPLETE. THIS IS ESPECIALLY IMPORTANT GIVEN THAT MIDDLESEX COUNTY HAS BEEN DESIGNATED BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) TO BE A MEDICALLY UNDERSERVED AREA (MUA) EXPERIENCING A SHORTAGE OF SELECT HEALTH SERVICES WHICH INCLUDES TOO FEW PRIMARY CARE PROVIDERS. IN ADDITION, HRSA REPORTS THAT MIDDLESEX COUNTY IS A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) FOR PRIMARY MEDICAL CARE. THE HOSPITAL ALSO WELCOMES MEDICAL AND NURSING STUDENT INTERNS AND PROVIDES ON-SITE TRAINING DURING CLINICAL ROTATIONS. NURSING STUDENTS FROM LOCAL COLLEGES AND PROGRAMS RECEIVE HANDS-ON MENTORSHIP IN THE MAJORITY OF CLINICAL SERVICE LINES YEAR-ROUND. OTHER HEALTHCARE PROFESSIONAL EDUCATION INCLUDES THE HOSPITAL'S RADIOLOGY SCHOOL (WHICH OPERATES AT A LOSS FOR THE HOSPITAL) AND CLINICAL/NON-CLINICAL EDUCATIONAL STUDENT TRAINING IN MULTIPLE FIELDS. IN FY23, THE HOSPITAL'S HEALTH PROFESSIONS EDUCATION CATEGORY SERVED 731 INDIVIDUALS AT A TOTAL COST OF $10,947,607 TO THE HOSPITAL. SUBSIDIZED HEALTH SERVICES: THE HOSPITAL'S SUBSIDIZED HEALTH SERVICES REPRESENT A SIGNIFICANT PORTION OF MIDDLESEX HOSPITAL'S ANNUAL COMMUNITY BENEFIT AGGREGATE FINANCIALS AND NUMBERS SERVED. SUBSIDIZED SERVICES ARE PARTICULAR CLINICAL PROGRAMS PROVIDED TO THE COMMUNITY DESPITE A FINANCIAL LOSS, WITH NEGATIVE MARGINS REMAINING AFTER SPECIFIC DOLLARS (FINANCIAL ASSISTANCE AND BAD DEBT) AND SHORTFALLS (MEDICAID) ARE REMOVED. IN ORDER TO QUALIFY AS A SUBSIDIZED SERVICE, THE PROGRAM MUST MEET CERTAIN HEALTH DELIVERY CRITERIA; MEET AN IDENTIFIED NEED IN THE COMMUNITY; AND WOULD BECOME UNAVAILABLE OR THE RESPONSIBILITY OF A GOVERNMENTAL OR ANOTHER NOT-FOR-PROFIT AGENCY TO PROVIDE IF THE HOSPITAL DISCONTINUED THE SERVICE. MIDDLESEX HOSPITAL'S SUBSIDIZED SERVICES INCLUDE FAMILY PRACTICE SERVICES, BEHAVIORAL HEALTH (INPATIENT AND OUTPATIENT), HOMECARE, PARAMEDICS, HOSPICE, CENTER FOR CHRONIC CARE MANAGEMENT DISEASE MANAGEMENT OUTPATIENT PROGRAMS (ADULT ASTHMA; CHILD ASTHMA; DIABETES EDUCATION AND DISEASE MANAGEMENT; MEDICAL NUTRITION THERAPY; SMOKING CESSATION; CHRONIC HEART FAILURE; AND CHILDHOOD WEIGHT MANAGEMENT); WIC (SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS, AND CHILDREN) AMBULATORY INFUSION, CARDIAC REHAB, AND WOUND CARE. IN FY23 THE HOSPITAL'S SUBSIDIZED SERVICES SERVED 24,364 PEOPLE WITH A TOTAL COST OF $21,936,450 TO THE HOSPITAL. RESEARCH: MIDDLESEX HOSPITAL CONDUCTS RESEARCH IN THE DOMAINS OF CLINICAL AND COMMUNITY HEALTH. CLINICAL EXAMPLES INCLUDE NATIONAL TRIALS BY THE HOSPITAL'S CANCER CENTER. FOR FY23, THE HOSPITAL'S ASSOCIATED COSTS FOR ALL (NON-INDUSTRY) RESEARCH PROJECTS TOTALED $246,104 AND SERVED 68 INDIVIDUALS. FINANCIAL AND IN-KIND CONTRIBUTIONS: MIDDLESEX HOSPITAL SUPPORTS THE COMMUNITY IN THE FORM OF FINANCIAL AND IN-KIND CONTRIBUTIONS. EACH YEAR THE HOSPITAL MAKES SUBSTANTIAL CASH DONATIONS TO CAREFULLY SELECTED MISSION-DRIVEN COMMUNITY ORGANIZATIONS THROUGHOUT ITS SERVICE AREA. THE HOSPITAL'S FY23 SUPPORT FOR FINANCIAL AND IN-KIND CONTRIBUTIONS TOTALED $253,003, SERVING 627 INDIVIDUALS. COMMUNITY BENEFIT OPERATIONS: COMMUNITY BENEFIT OPERATIONS INCLUDE ACTIVITIES AND COSTS ASSOCIATED WITH COMMUNITY BENEFIT STRATEGIC PLANNING, ADMINISTRATION, ANNUAL GOAL ATTAINMENT, AND COMMUNITY HEALTH NEEDS ASSESSMENT (AND CHNA IMPLEMENTATION STRATEGY) PRODUCTION AND IMPLEMENTATION. MIDDLESEX HOSPITAL HAS A DEDICATED DIRECTOR OF COMMUNITY HEALTH IMPROVEMENT WHO OVERSEES THE HOSPITAL'S COMMUNITY BENEFIT PROGRAM AND A REPORTING STRUCTURE THAT OVERSEES COMMUNITY BENEFIT PLANNING AND OPERATIONS. OUTSIDE OF ON-GOING COMMUNITY BENEFIT ACTIVITIES, KEY COMPONENTS OF THE HOSPITAL'S COMMUNITY BENEFIT PROGRAM IS CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT AND DEVELOPING A CHNA IMPLEMENTATION STRATEGY EVERY THREE TAXABLE YEARS, ENSURING THAT THE CHNA IMPLEMENTATION STRATEGY GOALS ARE ADDRESSED THROUGH COLLABORATION WITH COMMUNITY PARTNERS, AND FOCUSING ON HEALTH EQUITY AND HEALTH-RELATED SOCIAL NEEDS. THE HOSPITAL'S FY23 COMMUNITY BENEFIT OPERATIONS EXPENSE TOTALED $170,719, SERVING 100 INDIVIDUALS.
PART VI, LINE 6:	THE ORGANIZATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM. MIDDLESEX HEALTH IS A FULLY COMPREHENSIVE NETWORK OF EXPERT HEALTH CARE PROVIDERS THAT HAS CONVENIENT LOCATIONS THROUGHOUT CENTRAL CONNECTICUT AND THE SHORELINE. MEMBERS OF THE COMMUNITY ARE ALWAYS CLOSE TO CARE FOR EVERY FAMILY MEMBER AT EVERY AGE. MIDDLESEX HEALTH PROVIDES THE BEST CARE POSSIBLE FOR JUST ABOUT ALL ITS COMMUNITY MEMBERS' HEALTH AND WELLNESS NEEDS. THE ORGANIZATIONS INCLUDED IN THE AFFILIATED HEALTH CARE SYSTEM ARE AS FOLLOWS: MIDDLESEX HOSPITAL - A NON-PROFIT, ACUTE CARE, COMMUNITY HOSPITAL IN MIDDLETOWN, CT MIDDLESEX HEALTH SERVICES - PROVIDING INTEGRATIVE MEDICINE SERVICES TO THE COMMUNITY. MHS PRIMARY CARE - PROVIDES PATIENT-CENTERED, COMPASSIONATE CARE TO ALL MEMBERS OF THE COMMUNITY. MIDDLESEX HOSPITAL FOUNDATION - SUPPORTS MIDDLESEX HOSPITAL. MIDDLESEX HEALTH SYSTEM - PARENT OF AND PROVIDES FUNDRAISING SERVICES FOR MIDDLESEX HOSPITAL. MIDDLESEX HEALTH RESOURCES - OWNS AND MANAGES CERTAIN REAL ESTATE. DURING 2022, TRANSFERRED ALL REAL ESTATE TO OTHER ENTITIES WITHIN THE SYSTEMINTEGRATED RESOURCES FOR THE MIDDLESEX AREA, LLC - CURRENTLY INACTIVE
PART VI, LINE 7, STATE FILING OF COMMUNITY BENEFIT REPORT:	CONNECTICUT GENERAL STATUTES 19A-127K REQUIRES THAT ON OR AFTER JANUARY 1, 2023, EACH HOSPITAL IN CONNECTICUT SUBMIT ANNUAL COMMUNITY BENEFIT PROGRAM REPORTING TO THE CONNECTICUT OFFICE OF HEALTH STRATEGY. AS MIDDLESEX HOSPITAL MEETS THE STATUTE AS HAVING A COMMUNITY BENEFIT PROGRAM IN PLACE, IT REPORTS ANNUALLY TO THE STATE OF CONNECTICUT'S OFFICE OF HEALTH STRATEGY.
PART VI, QUESTION 4 - COMMUNITY INFORMATION (CONTINUED):	FOR HEALTH INSURANCE STATUS, UNDER AGE 18, ALL TOWNS IN MIDDLESEX HEALTH'S SERVICE AREA HAVE A LOWER UNINSURED RATE WHEN COMPARED TO CONNECTICUT (3.0%), EXCEPT CLINTON (3.4%), ESSEX (4.9%) AND OLD LYME (4.7%) [CONNECTICUT DATA COLLABORATIVE, FROM THE AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES 2015-2019]. FOR HEALTH INSURANCE STATUS, AGES 18-64, ALL TOWNS IN MIDDLESEX HEALTH'S SERVICE AREA HAVE A LOWER UNINSURED RATE WHEN COMPARED TO CONNECTICUT (7.5%), EXCEPT DEEP RIVER (12.8%) [CONNECTICUT DATA COLLABORATIVE, FROM THE AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES 2015-2019]. FOR HEALTH INSURANCE STATUS, AGES 65+, ALL TOWNS IN MIDDLESEX HEALTH'S SERVICE AREA HAVE A LOWER UNINSURED RATE WHEN COMPARED TO CONNECTICUT (0.6%), EXCEPT DEEP RIVER (1.0%) AND KILLINGWORTH (2.9%) [CONNECTICUT DATA COLLABORATIVE, FROM THE AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES 2015-2019]. IN 2023, THE PERCENT OF HOSPITAL DISCHARGES FOR MEDICAID/SAGA/UNINSURED COMBINED WERE: 20% INPATIENT; 15% OUTPATIENT; 28% EMERGENCY DEPARTMENT NON-ADMISSION; AND, FOR THE FOLLOWING SERVICES: 38% MATERNITY; 42% NEWBORN; 48% INPATIENT PSYCHIATRY; 13% OUTPATIENT SURGERY AND 15% OTHER OUTPATIENT SERVICES. MIDDLESEX COUNTY HAS BEEN DESIGNATED BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) TO BE A MEDICALLY UNDERSERVED AREA EXPERIENCING A SHORTAGE OF SELECT HEALTH SERVICES WHICH INCLUDE TOO FEW PRIMARY CARE PROVIDERS. IN ADDITION, HRSA REPORTS HEALTH PROFESSIONAL SHORTAGE AREAS (HPSAS) FOR PRIMARY CARE (MIDDLETOWN SERVICE AREA; LOW INCOME POPULATION), MENTAL HEALTH (MIDDLESEX COUNTY; HIGH NEED GEOGRAPHIC) AND DENTAL HEALTH (CENTRAL MIDDLETOWN; LOW INCOME POPULATION).

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Purpose Of GrantPurposeOfGrantTxt
MIDDLESEX CHAMBER OF COMMERCE
393 MAIN STREET	MIDDLETOWN	CT	06457	060452410	501(C)(6)	$49,750	$0	GENERAL SUPPORT
COMMUNITY FOUNDATION OF MIDDLESEX COUNTY
211 SOUTH MAIN STREET	MIDDLETOWN	CT	06457	061477711	501(C)(3)	$10,000	$0	GENERAL SUPPORT
VARSITY COMMUNICATIONS INC
5720 204TH ST SUITE 100	LYNNWOOD	WA	98036	911430177		$15,500	$0	2023 GOLF SHOW SPONSORSHIP
TRAVELERS CHAMPIONSHIP
90 STATE HOUSE SQUARE 11TH FLOOR	HARTFORD	CT	06103	421684133		$10,040	$0	GENERAL SUPPORT
CONNECTICUT STATE GOLF ASSOCIATION
35 COLD SPRING ROAD SUITE 212	ROCKY HILL	CT	06067	222587856	501(C)(3)	$50,000	$0	SPONSORSHIP FOR THE CT SENIOR MATCHPLAY CHAMPIONSHIP

Field	Value	IRS element (for citing)
Total501c3 Org	2	Total501c3OrgCnt
Total Other Org	3	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	THE PUBLIC RELATIONS DEPARTMENT HAS A POLICY REGARDING WHICH ORGANIZATIONS THEY ARE WILLING TO PARTNER WITH AND GIVE GRANTS OR ASSISTANCE. THEN ONCE THE GRANT OR ASSISTANCE IS AWARDED THE PUBLIC RELATIONS DEPARTMENT WORKS CLOSELY WITH EACH OF THE ORGANIZATIONS TO ENSURE THAT THE GRANT OR ASSISTANCE IS USED FOR THE INTENDED PURPOSES. THIS IS DONE BY CONTACT AND ATTENDANCE AT THE SPONSORED EVENTS.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (1)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Form990 Of Other Organizations	Yes (X)	Form990OfOtherOrganizationsInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
VINCENT CAPECE JR
PRESIDENT/CEO	$829,309	$0	$185,400	$0	$347,037	$0	$279,400	$0	$33,309	$0	$1,674,455	$0	$310,507	$0
DAVID COSENTINO
VP QUALITY & PATIENT SAFETY	$446,249	$0	$66,300	$0	$6,601	$0	$69,930	$0	$31,094	$0	$620,174	$0	$0	$0
EVAN JACKSON
VP & CIO	$389,234	$0	$58,300	$0	$53,115	$0	$61,350	$0	$33,172	$0	$595,171	$0	$46,711	$0
SUSAN MARTIN
VP FINANCE/TREASURER	$472,809	$0	$0	$0	$41,688	$0	$43,880	$0	$25,294	$0	$583,671	$0	$23,866	$0
THEODORE HARTENSTEIN
MED DIRECTOR, UTILIZATION MGMT	$507,866	$0	$17,500	$0	$450	$0	$18,300	$0	$33,939	$0	$578,055	$0	$0	$0
DAVID GIUFFRIDA
VP OPERATIONS	$354,047	$0	$79,000	$0	$49,504	$0	$60,300	$0	$14,339	$0	$557,190	$0	$40,784	$0
JONATHAN BANKOFF
CHAIRMAN EMERGENCY MEDICINE	$469,292	$0	$23,250	$0	$450	$0	$21,350	$0	$31,189	$0	$545,531	$0	$0	$0
JEFFREY SHELTON
CHAIRMAN DEPT PSYCH	$430,774	$0	$18,000	$0	$450	$0	$18,300	$0	$22,570	$0	$490,094	$0	$0	$0
RICARDO PEREZ
PULMONOLOGIST	$340,073	$0	$102,682	$0	$270	$0	$15,250	$0	$31,189	$0	$489,464	$0	$0	$0
DONNA STRONESKI
VP HUMAN RESOURCES	$311,943	$0	$63,500	$0	$43,864	$0	$56,030	$0	$4,239	$0	$479,576	$0	$36,535	$0
BRIAN MCGUIRE
MEDICAL DIRECTOR ED	$314,860	$0	$105,878	$0	$450	$0	$20,778	$0	$33,939	$0	$475,905	$0	$0	$0
TODD BISCHOP
CHIEF DEPT OF MED	$390,496	$0	$39,360	$0	$450	$0	$18,300	$0	$2,418	$0	$451,024	$0	$0	$0
LAURA MARTINO
VP MARKETING& DEVELOPMENT(TO 12/22)	$0	$340,143	$0	$51,000	$0	$12,182	$0	$19,320	$0	$23,190	$0	$445,835	$0	$0
JUSTIN GORALNIK
PULMONOLOGIST	$324,711	$0	$89,300	$0	$270	$0	$15,250	$0	$14,219	$0	$443,750	$0	$0	$0
KELLY HAECKEL
VP PATIENT CARE SERVICES/CNO	$300,204	$0	$43,000	$0	$3,664	$0	$48,900	$0	$30,365	$0	$426,133	$0	$0	$0
JESSE WAGNER MD
HOSPITALIST	$211,123	$0	$1,620	$0	$64,081	$0	$14,868	$0	$0	$0	$291,692	$0	$64,081	$0
JUSTIN DREW JOINED 123
VP AMBULATORY & CLINICAL SERVICES	$174,115	$0	$21,204	$0	$45	$0	$12,784	$0	$2,451	$0	$210,599	$0	$0	$0
LELAND MCKENNA JOINED 123
VP PLANNING & EXTERNAL AFFAIRS	$150,229	$0	$13,000	$0	$30	$0	$8,087	$0	$6,315	$0	$177,661	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 1A	SOCIAL CLUB DUES - REPRESENTS A CORPORATE MEMBERSHIP AT A GOLF CLUB USED FOR VARIOUS BUSINESS PURPOSES. THE ASSOCIATED COST IS INCLUDED IN THE TAXABLE COMPENSATION OF THE EXECUTIVE STAFF MEMBER ACCORDING TO IRS RULES AND REGULATIONS. THIS BENEFIT WAS PROVIDED TO THE FOLLOWING INDIVIDUAL: VINCENT CAPECE
PART I, LINE 4B	THE FOLLOWING INDIVIDUALS RECEIVED COMPENSATION FROM A SERP, WHICH WAS INCLUDED IN PART II, COLUMN B(III) AND COLUMN F: VINCENT CAPECE = $310,507 SUSAN MARTIN = $23,866 JESSE WAGNER, MD = $64,081 DAVID GIUFFRIDA = $40,784 EVAN JACKSON = $46,711 DONNA STRONESKI = $36,535 SERP CONTRIBUTIONS WERE MADE FOR THE FOLLOWING INDIVIDUALS AND ARE INCLUDED IN PART II, COLUMN C: VINCENT CAPECE = $255,000 DAVID CONSENTINO = $45,530 DAVID GIUFFRIDA = $35,900 KELLY HAECKEL = $30,600 EVAN JACKSON = $40,000 SUSAN MARTIN = $19,480 DONNA STRONESKI = $31,630
PART II, COLUMN (B)(II) - BONUS & INCENTIVE COMPENSATION:	THE AMOUNTS REPRESENT INCENTIVE COMPENSATION PAYMENTS MADE IN CALENDAR YEAR 2022. PAYMENTS INCLUDE AMOUNTS EARNED IN 2021 AND DEFERRED, WHERE APPLICABLE.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
CHEFA - SERIES O
A	060806186	20774YWD5	2015-05-19	$19,491,965	REFINANCE L BONDS	0	0	0
CHEFA - SERIES P
B	060806186		2016-06-10	$9,683,000	REFINANCE M BONDS	0	0	0
CHEFA - SERIES Q
C	060806186		2017-11-21	$11,599,000	REFINANCE N BONDS	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$5,245,000	$19,491,965	$388,960	$19,103,010	2015	Yes (1)	Yes (1)	Yes (1)
B	$6,333,992	$10,347,540	$193,660	$10,153,880	2016	Yes (1)	Yes (1)	Yes (1)
C	$3,625,462	$11,599,000	$231,980	$11,367,020	2021	Yes (1)	Yes (1)	Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Any Research AgreementsAnyResearchAgreementsInd	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	0	0	0	0	0	0	Yes (1)
B	0	0	0	0	0	0	Yes (1)
C	0	0	0	0	0	0	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCd	No Rebate DueNoRebateDueInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A	Yes (1)	Yes (1)
B	Yes (1)	Yes (1)
C	Yes (1)	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)
C	Yes (1)

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
DATE REBATE COMPUTATION PERFORMED	ISSUER NAME: CHEFA - SERIES O DATE THE REBATE COMPUTATION WAS PERFORMED: 05/19/2020 ISSUER NAME: CHEFA - SERIES P DATE THE REBATE COMPUTATION WAS PERFORMED: 06/10/2021 ISSUER NAME: CHEFA - SERIES Q DATE THE REBATE COMPUTATION WAS PERFORMED: 11/21/2022
SCHEDULE K, PART II, LINE 3:	SERIES P BONDS (COLUMN B) AND SERIES Q BONDS (COLUMN C) - THE DIFFERENCE BETWEEN THE ISSUE PRICE AND THE TOTAL PROCEEDS IS INVESTMENT EARNINGS.
SCHEDULE K, PART II, LINE 11:	THE AMOUNT INCLUDED IN PART II, LINE 11, OTHER SPENT PROCEEDS FOR THE SERIES O BONDS (COLUMN A) WAS USED TO REFUND THE CHEFA SERIES L BONDS DATED DECEMBER 7, 2006. THE AMOUNT INCLUDED IN PART II, LINE 11, OTHER SPENT PROCEEDS FOR THE SERIES P BONDS (COLUMN B) WAS USED TO REFUND THE CHEFA SERIES M BONDS DATED DECEMBER 7, 2006. THE AMOUNT INCLUDED IN PART II, LINE 11, OTHER SPENT PROCEEDS FOR THE SERIES Q BONDS (COLUMN C) WAS USED TO PARTIALLY REFUND THE CHEFA SERIES N BONDS DATED JULY 26, 2011. IN ADDITION, $736 WAS A PREPAYMENT OF INTEREST.
SCHEDULE K, PART III, LINE 3:	SERIES O BONDS (COLUMN A) AND SERIES P BONDS (COLUMN B) - THE ORGANIZATION HAS DETERMINED THAT ALL MANAGEMENT/SERVICE CONTRACTS MEET THE SAFE HARBOR UNDER REV. PROC. 2017-13, 2017-6 I.R.B. 787.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (13 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
DAVID GIUFFRIDA
KEY EMPLOYEE	$558,146	SEE PART V	0
JESSE WAGNER MD
KEY EMPLOYEE	$76,868	SEE PART V	0
DAVID COSENTINO
KEY EMPLOYEE	$255,041	SEE PART V	0
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$4,387,512	INDEPENDENT CONTRACTOR ARRANGEMENT	0
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$2,229,338	INDEPENDENT CONTRACTOR ARRANGEMENT	0
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$1,158,901	INDEPENDENT CONTRACTOR ARRANGEMENT	0
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$650,342	INDEPENDENT CONTRACTOR ARRANGEMENT	0
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$520,321	INDEPENDENT CONTRACTOR ARRANGEMENT	0
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$338,298	INDEPENDENT CONTRACTOR ARRANGEMENT	0
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$328,328	INDEPENDENT CONTRACTOR ARRANGEMENT	0
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$308,930	INDEPENDENT CONTRACTOR ARRANGEMENT	0
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$297,842	INDEPENDENT CONTRACTOR ARRANGEMENT	0
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$280,876	INDEPENDENT CONTRACTOR ARRANGEMENT	0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS:	FormAndLineReferenceDesc
Explanation	(A) NAME OF INTERESTED PERSON: DAVID GIUFFRIDA(D) DESCRIPTION OF TRANSACTION: MIDDLESEX HOSPITAL HAS AN INDEPENDENT CONTRACTOR ARRANGEMENT WITH GUIFFRIDA ELECTRIC, CO., WHICH IS MORE THAN 35% OWNED BY A FAMILY MEMBER OF DAVID GIUFFRIDA.(A) NAME OF INTERESTED PERSON: JESSE WAGNER, MD(D) DESCRIPTION OF TRANSACTION: MIDDLESEX HOSPITAL HAS AN EMPLOYMENT ARRANGEMENT WITH RUTH WAGNER, REGISTERED NURSE, WHO IS A FAMILY MEMBER OF JESSE WAGNER, MD.(A) NAME OF INTERESTED PERSON: DAVID COSENTINO(D) DESCRIPTION OF TRANSACTION: MIDDLESEX HOSPITAL HAS AN EMPLOYMENT ARRANGEMENT WITH MEGAN COSENTINO, WHO IS A FAMILY MEMBER OF DAVID COSENTINO.	ExplanationTxt

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	10	ContributionCnt
Noncash Contributions Rpt F990	$289,499	NoncashContributionsRptF990Amt
Method Of Determining Revenues	FMV	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Form8283 Received	0	Form8283ReceivedCnt
Any Property That Must Be Held	0	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	Yes (1)	ReviewProcessUnusualNCGiftsInd
Third Parties Used	0	ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, COLUMN (B):	FormAndLineReferenceDesc
Explanation	THE NUMBER IN COLUMN B IS THE NUMBER OF CONTRIBUTIONS.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION:	MIDDLESEX HOSPITAL IS AN ACUTE CARE GENERAL HOSPITAL SERVING THE RESIDENTS OF MIDDLESEX COUNTY AND VARIOUS SURROUNDING COMMUNITIES PROVIDING SELECTED HIGH-QUALITY INPATIENT AND OUTPATIENT HEALTH SERVICES. THE HOSPITAL MAINTAINS FORMAL RELATIONSHIPS WITH SPECIALIZED PROVIDERS TO ASSURE COORDINATION OF CARE WHEN SERVICES ARE NOT LOCALLY AVAILABLE. AN INTEGRAL PART OF THE CORE PROGRAMS, SPANNING THEIR TRADITIONAL DIAGNOSTIC AND TREATMENT SERVICES, ARE THE SCORES OF SPECIAL PROGRAMS OFFERED TO THE COMMUNITIES SERVED, MANY OF WHICH FOCUS ON THE DISADVANTAGED AND UNDERSERVED, THOSE SPECIAL POPULATIONS SUCH AS MINORITIES, OLDER PERSONS, PERSONS LIVING IN POVERTY WITH DISABILITIES, CHRONICALLY MENTALLY ILL PERSONS, AND OTHER DISENFRANCHISED PERSONS. MANY OTHER SPECIAL PROGRAMS WITH A FOCUS TO REACH OUT TO ALL MEMBERS OF THE COMMUNITY REGARDLESS OF ECONOMIC CONDITION OR SOCIAL STATUS RESPOND TO PUBLIC HEALTH NEEDS AND INVOLVE EDUCATION OR RESEARCH THAT IMPROVES OVERALL COMMUNITY HEALTH. ALL OF THESE SPECIAL PROGRAMS ARE OFFERED FREE OF CHARGE OR OFFERED AT A RATE THAT IS CONSIDERABLY LESS THAN THE COST OF PROVIDING THEM.
FORM 990, PART VI, SECTION A, LINE 6	THE SOLE MEMBER OF THE HOSPITAL IS MIDDLESEX HEALTH SYSTEM, INC.
FORM 990, PART VI, SECTION A, LINE 7A	THE SOLE MEMBER, MIDDLESEX HEALTH SYSTEM, INC. HAS THE RIGHT TO ANNUALLY ELECT THE BOARD OF DIRECTORS OF THE HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7B	THE SOLE MEMBER, MIDDLESEX HEALTH SYSTEM, INC., HAS ALL RIGHTS CONFERRED BY LAW, THE CERTIFICATE OF INCORPORATION AND MIDDLESEX HOSPITAL BY-LAWS, BY VOTE OF ITS BOARD OF DIRECTORS, ITS PRESIDENT, OR BY OR THROUGH ANY OTHER PERSON(S) DESIGNATED BY ITS BOARD OF DIRECTORS IN ITS BEHALF.
FORM 990, PART VI, SECTION B, LINE 11B	A DRAFT COPY OF THE FORM 990 IS PROVIDED TO EACH BOARD MEMBER FOR THEIR REVIEW AND CHANGES FROM PRIOR YEAR ARE HIGHLIGHTED. ANY QUESTIONS OR COMMENTS THEY HAVE ARE PRESENTED TO EXECUTIVE MANAGEMENT. A COMPLETE COPY OF THE FINAL FORM 990 IS PROVIDED TO ALL MEMBERS OF THE BOARD PRIOR TO FILING.
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 SYSTEM COMPLIANCE OFFICER. MATERIAL CONFLICTS ARE REPORTED TO THE 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, AS THEY OCCUR. 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.
FORM 990, PART VI, SECTION B, LINE 15	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 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. THE LAST COMPENSATION REVIEW OCCURRED 12/2022.
FORM 990, PART VI, SECTION C, LINE 19	MIDDLESEX HOSPITAL MAINTAINS A QUALITY AND COMPLIANCE SECTION ON ITS WEBSITE, MIDDLESEXHOSPITAL.ORG. THE HOSPITAL POSTS THE MOST CURRENT AUDITED FINANCIAL STATEMENTS AND FORM 990 WITH THOSE OF OTHER AFFILIATES AS THEY BECOME AVAILABLE, AS WELL AS STATEMENTS AND FORMS FROM AT LEAST TWO PREVIOUS FISCAL YEARS. THE HOSPITAL'S CONFLICT OF INTEREST POLICY IS ALSO POSTED ON THE WEBSITE IN THE VENDORS AND SUPPLIERS SECTION. IN ADDITION, THE ORGANIZATION'S FORM 990 IS AVAILABLE AT WWW.GUIDESTAR.ORG AND UPON REQUEST.
FORM 990, PART XI, LINE 9:	TRANSFER (TO) / FROM MIDDLESEX HEALTH SERVICES, INC. 28,475. TRANSFER (TO) / FROM MIDDLESEX HEALTH SYSTEM, INC. -638,991. TRANSFER (TO) / FROM MHS PRIMARY CARE -21,126,179. TRANSFER (TO) / FROM RESOURCES -8,757. CHANGE IN ASSETS HELD IN TRUST 198,000. CHANGE IN TEMP RESTRICTED NET ASSETS -892,000.
FORM 990, PART XII, LINE 2C:	THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
FORM 990, PART XII, LINE 3B:	MIDDLESEX HOSPITAL DOES NOT HAVE A SEPARATE AUDIT PERFORMED UNDER THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133. MIDDLESEX HOSPITAL IS INCLUDED IN THE A-133 AUDIT PERFORMED FOR MIDDLESEX HEALTH SYSTEM FOR PURPOSES OF THE A-133 AUDIT. THE RELEVANT ACTIVITIES AND EXPENDITURES OF MIDDLESEX HOSPITAL ARE REVIEWED AND THE RESULTS ARE INCLUDED IN THE SINGLE A-133 AUDIT REPORT FOR MIDDLESEX HEALTH SYSTEM.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
MIDDLESEX HEALTH SYSTEM INC
28 CRESCENT STREET	MIDDLETOWN	CT	06457	222676137	SUPPORT	CT	501(C)(3)	LINE 12B, II	N/A	0
MIDDLESEX HEALTH SERVICES INC
28 CRESCENT STREET	MIDDLETOWN	CT	06457	222676140	HEALTHCARE	CT	501(C)(3)	LINE 10		0	MIDDLESEX HEALTH SYSTEM INC
MIDDLESEX HOSPITAL FOUNDATION INC
28 CRESCENT STREET	MIDDLETOWN	CT	06457	273720822	SUPPORT	CT	501(C)(3)	LINE 12B, II		Yes (1)	MIDDLESEX HOSPITAL
MHS PRIMARY CARE INC
28 CRESCENT STREET	MIDDLETOWN	CT	06457	061472743	HEALTHCARE	CT	501(C)(3)	LINE 10		0	MIDDLESEX HEALTH SYSTEM INC

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd
MIDDLESEX HEALTH RESOURCES INC
28 CRESCENT STREET	MIDDLETOWN	CT	06457	061089925	RENTAL REAL ESTATE	CT	N/A	C	0
INTEGRATED RESOURCES FOR THE MIDDLESEX AREA LLC
28 CRESCENT STREET	MIDDLETOWN	CT	06457	061462230	OUTPATIENT CARE	CT	N/A	C	0

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	0	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (1)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	0	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd