2024-11-15T09:17:49-06:00 2023-12-31 390859910 BAKER TILLY ADVISORY GROUP LP 66 HUDSON BLVD E SUITE 2200 NEW YORK NY 10001 990 2023-01-01 060655139 SILVER HILL HOSPITAL INC SILV 2038012230 208 VALLEY ROAD NEW CANAAN CT 06840 ANDREW GERBER MD PHD PRESIDENT & MEDICAL DIRECTOR 2038012230 2024-11-14 1 1 MARY-EVELYN ANTONETTI P00431862 2126976900 2024-11-13 2023 2024-10-15 13:58:12Z ANDREW GERBER MD PHD 208 VALLEY ROAD NEW CANAAN CT 06840 68237954 0 X WWW.SILVERHILLHOSPITAL.ORG X 1934 CT TO PROVIDE OUR PATIENTS WITH THE BEST AVAILABLE TREATMENT OF MENTAL ILLNESS. SEE SCHEDULE O. 13 12 509 128 0 0 5412854 5033101 46407550 53705606 2034390 569891 3293649 4702329 57148443 64010927 103553 168250 0 0 34699483 39304172 0 0 1815302 18304105 23475988 53107141 62948410 4041302 1062517 71199634 76430026 12697465 15244703 58502169 61185323 THE MISSION OF SILVER HILL HOSPITAL IS TO PROVIDE OUR PATIENTS WITH THE BEST AVAILABLE TREATMENT OF MENTAL ILLNESS AND ADDICTION; AND TO OFFER CONTINUING SUPPORT, COUNSELING AND EDUCATION TO OUR PATIENTS AND THEIR FAMILIES IN EVERY PHASE OF ILLNESS AND RECOVERY. 0 0 16967594 19769967 INPATIENT TREATMENT IS THE MOST INTENSIVE FORM OF CARE, INDICATED FOR A PHASE OF ILLNESS THAT REQUIRES A GREAT DEAL OF NURSING AND MEDICAL INTERVENTION. BECAUSE PATIENTS ARE USUALLY ACUTELY ILL DURING THIS PHASE OF CARE, OUR INPATIENT TREATMENT PLANS EMPHASIZE DIAGNOSTIC ASSESSMENT, SYMPTOM REDUCTION, AND STABILIZATION. THE HOSPITAL TREATED APPROXIMATELY 901 INPATIENTS DURING THE PERIOD OF 1/1/2023 TO 12/31/2023. 25572415 168250 34492613 THE HOSPITAL'S TRANSITIONAL LIVING PROGRAMS PROVIDE HIGHLY STRUCTURED INTENSIVE TREATMENT FOR PATIENTS WHO ARE READY FOR MORE PSYCHOLOGICAL AND BEHAVIORAL INTERVENTIONS. SET IN RESIDENTIAL, HOME-LIKE SETTINGS, THE TRANSITIONAL PROGRAMS HELP PATIENTS CONTINUE THEIR RECOVERY PROCESS UNTIL THEY ARE READY TO RETURN HOME FOR FURTHER COMMUNITY-BASED TREATMENTS. PATIENTS FOCUS ON DEVELOPING A PSYCHOLOGICAL UNDERSTANDING OF THEIR ILLNESS, OBTAINING INFORMATION ABOUT THEIR ILLNESS, AND DEVELOPING NEW BEHAVIORAL SKILLS TO MANAGE THEIR RECOVERY PROCESS. THE HOSPITAL TREATED APPROXIMATELY 751 TRANSITIONAL LIVING PATIENTS DURING THE PERIOD OF 1/1/2023 TO 12/31/2023. 3552679 4129901 THE HOSPITAL OFFERS SPECIALIZED INTENSIVE OUTPATIENT PROGRAMS (IOPS) FOR ADOLESCENTS AND ADULTS WHO ARE ABLE TO LIVE AT HOME AND DESIRE SUBSTANCE ABUSE TREATMENT AND/OR PSYCHOLOGICAL TREATMENT TO LIVE FULL AND INDEPENDENT LIVES. THE IOPS MEET THREE TIMES A WEEK FOR EIGHT WEEKS GUIDING INDIVIDUALS TOWARD FURTHER INDEPENDENCE. THE HOSPITAL TREATED APPROXIMATELY 740 PATIENTS DURING THE PERIOD OF 1/1/2023 TO 12/31/2023. 46092688 1 1 0 0 0 0 0 0 0 1 1 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 1 172 0 1 509 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 CT NY X MARINA ZINGER 2038013156 208 VALLEY ROAD NEW CANAAN CT 06840 ANDREW GERBER MD PHD PRESIDENT & MEDICAL DIRECTOR 40.00 X X 617856 0 55898 FRANCINE CONWAY DIRECTOR (FROM 5/2023) 1.00 X 0 0 0 BRUCE LEAVITT DIRECTOR (FROM 5/2023) 1.00 X 0 0 0 MICHAEL HOLMES DIRECTOR 1.00 X 0 0 0 RICHARD CANNING CHAIR 3.00 X X 0 0 0 DEBORAH SHABECOFF VICE CHAIR 1.00 X X 0 0 0 CHERYL WIESENFELD SECRETARY 1.00 X X 0 0 0 PETER FONAGY DIRECTOR 1.00 X 0 0 0 SUSAN SALICE DIRECTOR 1.00 X 0 0 0 PETER ORTHWEIN CHAIR EMERITUS 1.00 X X 0 0 0 WARD F CLEARY ESQ CHAIR EMERITUS 1.00 X X 0 0 0 LINDA AUTORE DIRECTOR 1.00 X 0 0 0 RICHARD GANNON DIRECTOR, TREASURER 1.00 X X 0 0 0 ROSS MARKELLO CHIEF FINANCIAL OFFICER (UNTIL 7/2023) 40.00 X 473949 0 49629 MICHAEL D GROAT PHD CHIEF CLINICAL OFFICER 40.00 X 430022 0 24868 TIMOTHY DOUGHERTY CHIEF ADVANCEMENT OFFICER 40.00 X 349900 0 60795 LISA BENTON CHIEF QUALITY OFFICER (UNTIL 12/2023) 40.00 X 305695 0 48867 IMMACULA CANN CHIEF NURSING OFFICER 40.00 X 274766 0 773 MARK JACK RUSS CHIEF MEDICAL OFFICER 40.00 X 265931 0 0 KRISTEN WOLFE CHIEF BUSINESS OFFICER (UNTIL 9/2023) 40.00 X 295522 0 40848 CHRISTY AHERNE CHIEF PEOPLE OFFICER 40.00 X 201458 0 20783 AYANA THOMAS CHIEF INFORMATION OFFICER (UNTIL 5/2023) 40.00 X 189888 0 19787 ANRI KISSILENKO PHYSICIAN 37.00 X 335615 0 31210 ELIZABETH ORTIZ-SCHWARTZ PHYSICIAN 34.90 X 328566 0 17450 BRENT ANTHONY PENQUE PHYSICIAN 56.00 X 470727 0 2635 PETRA M PILGRIM PHYSICIAN 33.80 X 325888 0 11350 GLORIA A LLOYD PHYSICIAN 36.90 X 314407 0 4691 5180190 0 389584 84 0 1 0 UNIDINE CORPORATION PO BOX 102289 ATLANTA GA 303682289 FOOD SERVICES 2741707 PAC GROUP 126 SOUTH MAIN STREET TORRINGTON CT 06790 CONSTRUCTION SERVICES 639156 LAUREN MUSE 78 EAST PUTNUM AVENUE COS COB CT 06807 INTERIOR DESIGNER 633030 SHIPMAN & GOODWIN LLP ONE CONSTITUTION PLAZA HARTFORD CT 06103 LEGAL SERVICES 612684 PHARMACY & THERAPEUTICS CONS PO BOX 487 CHESHIRE CT 06410 PHARMACEUTICAL SERVICES 523728 33 5033101 137060 5033101 TRANSITIONAL LIVING 623000 29796169 29796169 INPATIENT 623000 19769967 19769967 OUTPATIENT 623000 4139470 4139470 53705606 586841 586841 175897 269477 -93580 -93580 -93580 3925930 3942880 -16950 -16950 -16950 21046 14670 6376 6376 SH-YNHHS TL-GAIN EQUITY INVESTMEN 623000 3145496 3145496 NON-REFUNDABLE DEPOSITS 900099 675814 675814 WELLNESS 624100 123123 123123 845100 742442 102658 4789533 64010927 58392481 0 585345 168250 168250 3711234 1279082 1972434 459718 30718097 23897927 6058497 761673 2594796 1774000 778967 41829 2280045 1676968 524829 78248 785770 24509 761261 132414 132414 51621 4064 47557 5604349 4809378 656032 138939 314919 173302 9064 132553 5069000 2474691 2486577 107732 57491 660 56831 1229904 1145710 80748 3446 312927 201195 91330 20402 42005 12420 29035 550 3980193 3534488 444024 1681 2433795 2433795 BAD DEBTS 1574760 1574760 DIETARY PROVISIONS 892673 628779 242920 20974 CREDIT CARD FEES 718061 6668 711393 MEDICATION 276106 276106 62948410 46092688 15040420 1815302 1500 1500 3801044 4626077 1825309 3021793 9052763 12051634 145552 159011 787321 913066 91499287 50304341 41157900 41194946 7470109 4358367 6958136 10103632 71199634 76430026 2791593 3543470 125000 31967 9780872 11669266 12697465 15244703 X 55850329 55953627 2651840 5231696 58502169 61185323 71199634 76430026 1062517 1620637 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 413000 124787 12817 12817 537787 313000 100000 13564 13564 413000 213000 100000 29 29 313000 213000 7619 7619 213000 213000 6210 6210 213000 0.00000 1.00000 0.00000 0 0 1766721 1766721 57423145 31830441 25592704 17313516 12091151 5222365 14995905 6382749 8613156 41194946 THE SH-YNHHS TRANSITIONAL LIVING TREATMENT PROGRAM PARTNERSHIP 10103632 C 10103632 DUE TO PATIENTS AND THIRD PARTIES 3807950 PROFESSIONAL LIABILITY RESERVE 7795652 OTHER LIABILITIES 65664 11669266 X 64019853 1620637 -1574760 45877 63973976 51621 -14670 36951 64010927 61336699 14670 14670 61322029 51621 1574760 1626381 62948410 PART V, LINE 4: DONORS HAVE STIPULATED THAT ANY INCOME FROM THE ENDOWMENT FUNDS IS TO BE USED FOR ADOLESCENT AND CHEMICAL DEPENDENCY PROGRAMS. PART X, LINE 2: THE HOSPITAL IS QUALIFIED AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE), AND AS SUCH, NO PROVISION FOR INCOME TAXES HAS BEEN RECORDED. THE INTERNAL REVENUE SERVICE INFORMED THE HOSPITAL BY A LETTER DATED JUNE 23, 1937 THAT THE HOSPITAL'S OPERATIONS ARE DESIGNED IN ACCORDANCE WITH SUCH SECTION OF THE CODE. CERTAIN TRANSACTIONS COULD BE DEEMED "UNRELATED BUSINESS INCOME AND WOULD RESULT IN A TAX LIABILITY. MANAGEMENT REVIEWS TRANSACTIONS TO ESTIMATE POTENTIAL TAX LIABILITIES. THE HOSPITAL RECOGNIZES INCOME TAX POSITIONS WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINABLE BASED ON THE MERITS OF THE POSITION. MANAGEMENT HAS CONCLUDED THAT THERE ARE NO UNCERTAIN TAX POSITIONS THAT NEEDED TO BE RECORDED AT DECEMBER 31, 2023 AND 2022, RESPECTIVELY. THE HOSPITAL RECOGNIZES INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS WITHIN INTEREST. AS OF DECEMBER 31, 2023 AND 2022, THE HOSPITAL DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNCERTAIN TAX POSITIONS. THE HOSPITAL'S PRIOR THREE TAX YEARS ARE OPEN AND SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBTS -1,574,760. PART XI, LINE 4B - OTHER ADJUSTMENTS: LITTLE SHOP INVENTORY EXPENSE -14,670. PART XII, LINE 2D - OTHER ADJUSTMENTS: LITTLE SHOP INVENTORY EXPENSE 14,670. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DETS 1,574,760. 1 1 1 X 600.000000000000 1 X 900.000000000000 0 1 0 0 477320 477320 477320 477320 0 0.00000 274495 274495 0.00430 103313 103313 0.00160 14678439 12132115 2546324 0.03980 676482 102114 574368 0.00900 168250 168250 0.00260 15900979 12234229 3666750 0.05730 16378299 12711549 3666750 0.05730 1 485124 207711 95402 112309 X 1 1 1 1 SILVER HILL HOSPITAL 208 VALLEY ROAD NEW CANAAN CT 06840 WWW.SILVERHILLHOSPITAL.ORG H-0006 X SILVER HILL HOSPITAL 1 0 0 1 X X X X X X X X X 22 1 0 0 1 X WWW.SILVERHILLHOSPITAL.ORG 1 23 1 WWW.SILVERHILLHOSPITAL.ORG 0 1 X 600.000000000000 900.000000000000 X X 1 1 X X X 1 X WWW.SILVERHILLHOSPITAL.ORG X WWW.SILVERHILLHOSPITAL.ORG X WWW.SILVERHILLHOSPITAL.ORG X X X X X 1 X 0 X 1 X 0 0 SILVER HILL HOSPITAL PART V, SECTION B, LINE 5: COMMUNITY ENGAGEMENT AND FEEDBACK WERE AN INTEGRAL PART OF THE CHNA PROCESS. SILVER HILL HOSPITAL SOUGHT COMMUNITY INPUT THROUGH KEY INFORMANT INTERVIEWS WITH COMMUNITY LEADERS AND PARTNERS. PUBLIC HEALTH AND HEALTH CARE PROFESSIONALS AS WELL AS LEADERS AND REPRESENTATIVES OF NON-PROFIT AND COMMUNITY-BASED ORGANIZATIONS SHARED KNOWLEDGE ABOUT MENTAL HEALTH AND SUBSTANCE ABUSE AND PROVIDED INSIGHT ON THE COMMUNITY, INCLUDING UNDERSERVED POPULATIONS. SEE APPENDIX D OF THE COMMUNITY NEEDS ASSESSMENT FOR A LIST OF KEY INFORMANTS.THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM 20 KEY INFORMANTS, INCLUDING PUBLIC HEALTH AND HEALTHCARE PROFESSIONALS, SOCIAL SERVICE PROVIDERS, NOT-PROFIT LEADERS, BUSINESS LEADERS, FAITH BASED ORGANIZATIONS AND OTHER COMMUNITY LEADERS. PARTICIPANTS INCLUDED PUBLIC HEALTH ORGANIZATION PROFESSIONALS, YOUTH AND SOCIAL SERVICE PROVIDERS, EDUCATION/SCHOOL SPECIALISTS, MENTAL HEALTH/SUBSTANCE ABUSE CLINICIANS, GOVERNMENT HOUSING/TRANSPORTATION AGENGIES, AND COMMUNITY MEMBERS. SILVER HILL HOSPITAL PART V, SECTION B, LINE 11: BASED ON FEEDBACK FROM COMMUNITY PARTNERS, INCLUDING MENTAL HEALTH AND SUBSTANCE ABUSE PROVIDERS, PUBLIC HEALTH EXPERTS, SOCIAL SERVICE ORGANIZATIONS, EDUCATION/SCHOOL ORGANIZATIONS, AND OTHER COMMUNITY REPRESENTATIVES, SILVER HILL HOSPITAL PLANS TO FOCUS COMMUNITY HEALTH IMPROVEMENT EFFORTS ON THE FOLLOWING PRIORITIES OVER THE NEXT THREE-YEAR CYCLE: (1) MENTAL HEALTH AND SUBSTANCE ABUSE; (2) ADOLESCENT MENTAL HEALTH; (3) SUBSTANCE MISUSE; (4) ADULT MENTAL HEALTH.THE HOSPITAL PLANS TO ADDRESS:PRIORITIZED HEALTH ISSUE #1: ACCESSING MENTAL HEALTH AND SUBSTANCE ABUSE CARETHE GOAL IS TO ADDRESS ISSUES AROUND ACCESSING MENTAL HEALTH AND SUBSTANCE ABUSE CARE WITH A FOCUS ON AVAILABILITY OF SERVICES, NAVIGATING THE SYSTEM, AND STIGMA REDUCTION. THIS WILL BE DONE BY MEETING THE FOLLOWING OBJECTIVES:1) GROW THE CAPACITY OF THE NEW CANAAN URGENT ASSESSMENT PROGRAM THROUGH THE PARTICIPATION OF ADDITIONAL TOWNS2) EXPAND CAPACITY OF NEW OUTPATIENT SERVICES TREATING MOOD DISORDERS.3) PANEL WITH MEDICAID FOR IMPROVED ACCESS TO INPATIENT AND INTENSIVE OUTPATIENT SERVICES.4) COMPLETE HOSPITAL LICENSURE OF CURRENT TRANSITIONAL LIVING PROGRAMS AS RESIDENTIAL PROGRAMS FOR IMPROVED OUT OF NETWORK BENEFIT REIMBURSEMENT.5) PROMOTE AWARENESS AND UNDERSTANDING OF MENTAL HEALTH AND ADDICTION ISSUES THROUGH PARTICIPATION IN EDUCATIONAL PROGRAMS, MENTAL HEALTH FAIRS AND WALKS, MEDIA INTERVIEWS, AND SOCIAL MEDIA TO REDUCE STIGMA. PRIORITIZED HEALTH ISSUE #2: ADOLESCENT MENTAL HEALTHTHE GOAL IS TO ADDRESS ADOLESCENT MENTAL HEALTH WITH A FOCUS ON ANXIETY, DEPRESSION, AND SUICIDALITY. THIS WILL BE DONE BY MEETING THE FOLLOWING OBJECTIVES:1) INCREASE PARTNERSHIPS WITH FAIRFIELD COUNTY SCHOOL SYSTEMS ON THE URGENT ASSESSMENT PROGRAM2) INCREASE CAPACITY OF ADOLESCENT INTENSIVE OUTPATIENT PROGRAMS3) PARTNER WITH ALLIED COMMUNITY ORGANIZATIONS TO DEVELOP AND DELIVER PROGRAMMING FOCUSED ON EDUCATION, AWARENESS, AND SUICIDE PREVENTION.4) HOST MEDICAL GRAND ROUNDS TO INCREASE CLINICIAN KNOWLEDGE AND UNDERSTANDING OF THESE TOPICS. PRIORITIZED HEALTH ISSUE #3: SUBSTANCE MISUSETHE GOAL IS TO ADDRESS SUBSTANCE USE WITH A FOCUS ON ALCOHOL MISUSE; UNDERAGE SUBSTANCE USE; MARIJUANA, THC, AND CANNABINOIDS. THIS WILL BE DONE BY MEETING THE FOLLOWING OBJECTIVES:1. PARTNER WITH ALLIED COMMUNITY ORGANIZATIONS TO DEVELOP AND DELIVER PROGRAMMING FOCUSED ON EDUCATION, AWARENESS, AND ADVOCACY.2. HOST MEDICAL GRAND ROUNDS TO ENHANCE CLINICIAN KNOWLEDGE AND UNDERSTANDING ON THESE TOPICS.3. OFFER RECOVERY SUPPORT GROUPS THAT ARE OPEN TO THE COMMUNITY.4. PROVIDE ACCESS TO SILVER HILL HOSPITAL PROGRAMS FOR THOSE REQUIRING INPATIENT, RESIDENTIAL, OR INTENSIVE OUTPATIENT TREATMENT.5. EXPAND INTENSIVE OUTPATIENT SERVICES FOR ADULTS WITH SUBSTANCE USE DISORDERS.PRIORITIZED HEALTH ISSUE #4: ADULT MENTAL HEALTHTHE GOAL IS TO ADDRESS ADULT MENTAL HEALTH WITH A FOCUS ON ANXIETY, DEPRESSION, AND SUICIDALITY. THIS WILL BE DONE BY MEETING THE FOLLOWING OBJECTIVES:1. INCREASE CAPACITY OF THE URGENT ASSESSMENT PROGRAMSILVER HILL HOSPITAL KEY INFORMANT SURVEY DECEMBER 2022 PAGE 362. INCREASE TARGETED OUTREACH TO INDIVIDUAL ADULT POPULATIONS (E.G. YOUNG ADULTS, SENIOR CITIZENS, MOTHERS, PROFESSIONALS) ON THE URGENT ASSESSMENT PROGRAM3. OPEN KETAMINE CLINIC (EMPIRICALLY PROVEN MODALITY FOR THE TREATMENT OF MEDICATION RESISTANT DEPRESSION)4. INCREASE CAPACITY OF MOOD DISORDER AND WOMEN'S INTENSIVE OUTPATIENT PROGRAMS5. PARTNER WITH ALLIED COMMUNITY ORGANIZATIONS TO DEVELOP AND DELIVER PROGRAMMING FOCUSED ON EDUCATION, AWARENESS, AND SUICIDE PREVENTION.6. HOST MEDICAL GRAND ROUNDS TO INCREASE CLINICIAN KNOWLEDGE AND UNDERSTANDING OF THESE TOPICS. SILVER HILL HOSPITAL PART V, SECTION B, LINE 13H: SILVER HILL HOSPITAL, INC. OFFERS FINANCIAL ASSISTANCE, IN THE FORM OF REDUCED RATES, TO QUALIFYING PATIENTS RECEIVING EMERGENCY OR MEDICALLY NECESSARY SERVICES (I.E. INPATIENT LEVEL OF CARE). THE POLICY APPLIES TO PATIENTS THAT HAVE NO INSURANCE OR HAVE EXHAUSTED THEIR INSURANCE BENEFITS, AND HAVE INCOME OF LESS THAN 300% OF THE FEDERAL POVERTY GUIDELINES. COINSURANCE, COPAYMENTS AND DEDUCTIBLES ARE EXCLUDED FROM THE POLICY.THE HOSPITAL ALSO OFFERS FINANCIAL ASSISTANCE TO PATIENTS RECEIVING TREATMENT IN ITS TRANSITIONAL LIVING PROGRAMS. TRANSITION LIVING PROGRAM SERVICES ARE NOT CONSIDERED AN INPATIENT LEVEL OF CARE. TRANSITIONAL LIVING PATIENTS ARE ELIGIBLE FOR DISCOUNTED CARE IF THEY ARE CLINICALLY APPROPRIATE AND MOTIVATED FOR TREATMENT AND HAVE INCOME LEVELS EQUAL TO OR LESS THAN 900% OF THE FEDERAL POVERTY GUIDELINES.THIS POLICY IS AVAILABLE ATHTTPS://SILVERHILLHOSPITAL.ORG/RESOURCES SILVER HILL HOSPITAL PART V, SECTION B, LINE 16J: THE HOSPITAL MAINTAINS A FORMAL, WRITTEN FINANCIAL ASSISTANCE POLICY FOR ITS TRANSITIONAL LIVING PROGRAM. THE POLICY IS AVAILABLE UPON REQUEST. PATIENTS WHO DO NOT HAVE THE FINANCIALABILITY TO PAY FOR SERVICES, MAY APPLY FOR FINANCIAL ASSISTANCE UPON ADMISSION INTO THE PROGRAM. SILVER HILL HOSPITAL PART V, SECTION B, LINE 21D: IT IS THE POLICY OF THE HOSPITAL THAT PATIENTS ASSESSED TO BE SUFFERING FROM A BEHAVIORAL EMERGENCY MEDICAL CONDITION WILL BE ADMITTED, REGARDLESS OF THEIR INSURANCE STATUS OR ABILITY TO PAY, AS REQUIRED BY THE EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR ACT (EMTALA). SCHEDULE H, PART V, LINE 22 THE HOSPITAL OFFERS FINANCIAL ASSISTANCE, IN THE FORM OF REDUCED RATES, TO QUALIFYING PATIENTS RECEIVING EMERGENCY OR MEDICALLY NECESSARY SERVICES. THE FULL TEXT VERSION OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS AVAILABLE ONLINE AT:HTTPS://SILVERHILLHOSPITAL.ORG/RESOURCES PART I, LINE 3C: THE HOSPITAL USED A FPG OF 300% AS A FACTOR FOR DETERMINING ELIGIBILITY FOR PROVIDING DISCOUNTED CARE FOR MEDICALLY NECESSARY SERVICES. MEDICALLY NECESSARY SERVICES ARE DEFINED BY THE HOSPITAL AS INPATIENT SERVICES.THE HOSPITAL USED A FPG OF 600% AS A FACTOR FOR DETERMINING ELIGIBILITY FOR PROVIDING FREE CARE FOR TRANSITIONAL LIVING SERVICES (NON-INPATIENT SERVICES), AND A FPG OF 900% FOR DETERMINING ELIGIBILITY FOR PROVIDING DISCOUNTED CARE FOR TRANSITIONAL LIVING SERVICES (NON-INPATIENT SERVICES). PART I, LINE 7: A COST TO CHARGE RATIO, DERIVED FROM WORKSHEET 2 RATIO OF PATIENT CARE COST TO CHARGES, WAS USED TO DETERMINE FINANCE ASSISTANCE COSTS REPORTED. A COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 WAS USED TO DETERMINE THE AMOUNT OF INPATIENT CARE THAT WAS SUBSIDIZED IN THE TAX YEAR ENDING 12/31/2023. ALL OTHER EXPENSES REPORTED ARE ACTUAL COSTS. PART III, LINE 2: BAD DEBT EXPENSE IS ESTIMATED BASED ON HISTORICAL AND EXPECTED WRITE-OFFS AND NET COLLECTIONS, AS WELL AS AGING STATUS. A COST TO CHARGE RATIO FROM WORKSHEET 2 WAS APPLIED TO BAD DEBT EXPENSE REPORTED IN THE AUDITED FINANCIAL STATEMENTS IN ORDER TO DETERMINE THE BAD DEBT EXPENSE REPORTED ON PART III, SECTION A, LINE 2. THE BAD DEBT EXPENSE FOR INPATIENT SERVICES BEFORE APPLYING THE COST TO CHARGE RATIO TOTALLED $580,222. PART III, LINE 3: BAD DEBT EXPENSE IS MAINLY COMPRISED OF UNCOLLECTIBLE CO-PAYS AND DEDUCTIBLES FROM PATIENTS WITH INSURANCE. CO-INSURANCE AND DEDUCTIBLE BALANCES ARE EXCLUDED FROM THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. PART III, LINE 4: SEE FOOTNOTE 2 OF THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: N/A PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY STATES THE FOLLOWING: PATIENT ACCOUNTS WILL WORK WITH PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE TO DEVELOP A REASONABLE BUDGET/PAYMENT PLAN. DELINQUENT SELF-PAY BALANCES FOR PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE MAY BE SENT TO OUTSIDE COLLECTION AGENCIES; HOWEVER THE HOSPITAL WILL NOT PURSUE EXTRAORDINARY COLLECTION ACTIONS (ECA) AGAINST THESE PATIENTS. PART VI, LINE 2: IN ADDITION TO THE CHNA, THE SILVER HILL HOSPITAL STAFF ASSESSES THE NEED FOR ADDITIONAL PROGRAMMING BASED ON SERVICE AVAILABILITY FOR OUR DISCHARGING PATIENT POPULATION. THE HOSPITAL ALSO RECEIVES INPUT FROM COMMUNITY-BASED CLINICIANS TO IDENTIFY NEEDS WITHIN THE COMMUNITY. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: SOCIAL WORKERS HAVE A COMPREHENSIVE VIEW OF A PATIENT'S FINANCIAL AND SOCIAL SITUATION AND ARE KNOWLEDGEABLE ABOUT THE ELIGIBILITY CRITERIA FOR ENTITLEMENT PROGRAMS. IT IS THE ASSIGNED RESPONSIBILITY OF THE SOCIAL WORKER TO INFORM PATIENTS AND THEIR FAMILIES ABOUT ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS.PATIENTS WHO DO NOT HAVE THE FINANCIAL ABILITY TO PAY FOR SERVICES, ARE EDUCATED ABOUT SILVER HILL HOSPITAL'S FINANCIAL ASSISTANCE AND SCHOLARSHIP PROGRAMS BY A SPECIALLY TRAINED STAFF MEMBER. THE STAFF MEMBER PROVIDES PATIENTS AND THEIR FAMILIES WITH THE FINANCIAL GUIDELINES AND SUPPORTING DOCUMENTATION REQUIRED FOR OBTAINING FINANCIAL ASSISTANCE/ SCHOLARSHIPS. PART VI, LINE 4: COMMUNITY INFORMATION: APPROXIMATELY 31.2% OF THE PATIENT POPULATION IS FROM CONNECTICUT, 35.8% FROM NEW YORK AND 33% FROM OTHER AREAS. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH: SILVER HILL HOSPITAL FURTHERS ITS EXEMPT PURPOSE OF PROMOTING HEALTH OF THE COMMUNITY THROUGH A DIVERSE BOARD OF DIRECTORS WHOSE MEMBERS CONTRIBUTE THROUGH THEIR UNIQUE TALENTS AND RESOURCES TOWARD THE HOSPITAL'S MISSION OF HEALING AND THE CARE OF ITS PATIENTS. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM: N/A FORM 990, PART VI, LINE 7 STATE FILING OF THE COMMUNITY BENEFIT REPORT: DURING TAX YEAR ENDING 12/31/2023, THE HOSPITAL WAS NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT WITH THE STATE OF CONNECTICUT. FORM 990, PART VI, LINE 5: IN 2023, SILVER HILL HOSPITAL ESTABLISHED A BUSINESS AGREEMENT TO COLLABORATE WITH TETRICUS LABS FOR RESEARCH AND DEVELOPMENT ACTIVITIES RELATED TO WEB-BASED, PHONE-BASED, AND WEARABLE DEVICE ASSESSMENT OF PATIENT PREDICTORS OF TREATMENT RESPONSE. FUNDS FROM BOTH ORGANIZATIONS ARE SUPPORTING PRODUCT DEVELOPMENT AND RESEARCH, INCLUDING A RESEARCH STUDY APPROVED BY SILVER HILL HOSPITAL'S CONTRACT IRB (WCG) TITLED "FEASIBILITY OF MACHINE LEARNING-BASED ASSESSMENT IN A PSYCHIATRIC TREATMENT SETTING." STUDY ENROLLMENT LAUNCHED THE END OF 2023 AND HAS CONTINUED IN 2024 WITH OVER NEARLY 150 INPATIENT AND RESIDENTIAL PROGRAM PATIENTS HAVING ENROLLED. SEVERAL MODIFICATIONS WERE MADE TO THE DESIGN OF THE WEB-BASED ASSESSMENT INTERFACE AND ITS CONNECTION TO THE MOBILE/WEARABLE DEVICES USED BY PATIENTS DURING AND AFTER THEIR HOSPITAL STAY. PATIENTS COMPLETE MULTIPLE ASSESSMENTS OF THEIR PSYCHIATRIC SYMPTOMS, SLEEP, ACTIVITY, AND OTHER PSYCHOLOGICAL INDICATORS DURING TREATMENT AND FOR 1-YEAR AFTER DISCHARGE FROM SILVER HILL HOSPITAL.CLINICAL AND RESEARCH LEADERSHIP AT SILVER HILL HOSPITAL CONTRIBUTED SUBSTANTIALLY TO A GRANT SUBMITTED IN 2023 TO THE NATIONAL INSTITUTE ON ALCOHOLISM AND ALCOHOLISM (NIAAA) BY INVESTIGATORS AT NEW YORK UNIVERSITY (NYU) LANGONE HEALTH ("NEURAL MECHANISMS OF PSILOCYBIN-ASSISTED TREATMENT FOR ALCOHOL USE DISORDER, MICHAEL BOGENSCHUTZ, MD). THIS GRANT WAS FUNDED TO START IN 2024, AND SILVER HILL IS THE ONLY CLINICAL PERFORMANCE SITE. RESEARCH STAFF TO BE HIRED BY THE HOSPITAL WILL RECRUIT INTERESTED AND ELIGIBLE PATIENTS, FACILITATE STUDY CONSENT AND ASSESSMENTS, TRANSPORT PATIENTS TO NYC FOR ASSESSMENTS, AND CO-FACILITATE THERAPY SESSIONS. THIS 5-YEAR STUDY REPRESENTS THE FIRST FEDERALLY-FUNDED RESEARCH STUDY OCCURRING AT SILVER HILL. THE PROJECT EVALUATES BRAIN MECHANISMS THAT MAY UNDERLIE THE EFFICACY OF PSILOCYBIN FOR BEHAVIORAL HEALTH CONDITIONS AND WILL PROVIDE IMPORTANT DATA FOR FDA APPROVAL OF A TREATMENT THAT IS PROMISING AND THE FOCUS OF MUCH COMMUNITY ENTHUSIASM.IN ADDITION TO THESE FUNDED STUDIES AT THE HOSPITAL, THE SILVER HILL PATIENT EXPERIENCE AND CLINICAL STAFF ALSO PROVIDE INFORMATION OR FLYERS TO PATIENTS WHO MAY BE INTERESTED AND ELIGIBLE FOR RESEARCH PROJECTS CONDUCTED OFF-SITE BY AFFILIATED UNIVERSITIES. IN 2023, THIS INCLUDED TWO IRB-APPROVED, NIH-FUNDED RESEARCH PROJECTS TO PRINCIPAL INVESTIGATORS AT YALE SCHOOL OF MEDICINE ("BRAIN EMOTION CIRCUITRY-TARGETED SELF-MONITORY REGULATION THERAPY," HILARY BLUMBERG, MD); CHARACTERIZING CLINICAL AND PHARMACOLOGICAL NEUROIMAGING BIOMARKERS," YOUNGSUN CHO, MD, PHD). IN 2024, CLINICAL LEADERSHIP AT SILVER HILL'S TRAUMA-FOCUSED PROGRAM (TRIUMPH) BEGAN FACILITATING RECRUITMENT FOR A STUDY OF DISSOCIATIVE DISORDERS BEING CONDUCTED AT MCLEAN HOSPITAL ("EVALUATING THE NEUROBIOLOGICAL BASIS OF TRAUMATIC DISSOCIATION IN A CROSS-DIAGNOSTIC SAMPLE OF WOMEN WITH HISTORIES OF CHILDHOOD ABUSE AND NEGLECT," MILISSA KAUFMAN, MD, PHD).SILVER HILL HOSPITAL RESEARCH AND CLINICAL LEADERS ALSO SUPPORTED THE DEVELOPMENT OF A RESEARCH PROJECT BY ONE OF THE HOSPITAL'S COUNSELING STAFF AS PART OF HER MASTER'S THESIS AT CENTRAL CONNECTICUT STATE UNIVERSITY. THIS IRB-APPROVED STUDY RECRUITS MICHAEL'S HOUSE PROGRAM PATIENTS FOR A PROSPECTIVE ASSESSMENT OF PSYCHOSIS SYMPTOMS AND TREATMENT RESPONSE DURING THEIR TRANSITIONAL LIVING PROGRAM STAY ("DIFFERENTIAL RELATIONSHIP BETWEEN EXPRESSIVE & EXPERIENTIAL NEGATIVE SYMPTOMS, EMPATHY, AND SOCIAL FUNCTIONING IN SCHIZOPHRENIA AND THE THERAPEUTIC POTENTIAL ROLE OF OXYTOCIN," AMY REZENDE AND SILVIA CORBERO-LOPEZ, PHD). THIS RESEARCH WAS STIMULATED BY THE SIGNIFICANT AND INNOVATIVE WORK AND SCHOLARLY CONTRIBUTIONS OF DR. ROCCO MAROTTA TREATING PATIENTS SUFFERING FROM SCHIZOPHRENIA AS PART OF THE FUNDED CENTER FOR THE TREATMENT AND STUDY OF NEUROPSYCHIATRIC DISORDERS THAT HE DIRECTS. A NEW RESEARCH PROJECT IN THE COMING YEAR WILL EVALUATE OUTCOMES OF THE COMMUNITY RESILIENCE CAMPAIGN AT SILVER HILL HOSPITAL, A PSYCHOLOGICAL RESILIENCE PROGRAM DEVELOPED DURING THE COVID PANDEMIC AND DELIVERED TO VARIOUS COMMUNITY GROUPS WITH THE GOAL OF TEACHING EVIDENCE-BASED COPING SKILLS ("THE EFFECTIVENESS OF RESILIENCE TRAINING ON INDIVIDUAL ABILITY TO COPE WITH STRESS AND ADVERSITY," TERRA REED, MSN). 1 FRIENDS OF LAUREL HOUSE INC 1616 WASHINGTON BLVD STAMFORD CT 06902 061189773 501(C)(3) 62500 0 SPONSORSHIP-SUPPORTING RESOURCES TO RECOVERY GROUP FOR ADVANCEMENT OF PSYCHIATRY PO BOX 570218 DALLAS TX 75357 046040048 501(C)(3) 25000 0 FUNDING FOR A FELLOWSHIP, SUPPORTING PSYCHIATRY NEW CANAAN FIRE DEPARTMENT PO BOX 963 NEW CANAAN CT 06840 066062229 501(C)(3) 10000 0 LOCAL SERVICE PROVIDERS, SUPPORTING ELOPEMENTS AND PATIENT WELL BEING NEW CANAAN POLICE DEPARTMENT 174 SOUTH AVE NEW CANAAN CT 06840 066002043 GOVT 10000 0 LOCAL SERVICE PROVIDERS, SUPPORTING ELOPEMENTS AND PATIENT WELL BEING NEW CANNAAN VOLUNTEER AMBULANCE CORPORATION PO BOX 598 NEW CANAAN CT 06840 237300265 501(C)(3) 10000 0 LOCAL SERVICE PROVIDERS, SUPPORTING ELOPEMENTS AND PATIENT WELL BEING NEW CANAAN COMMUNITY FOUNDATION 111 CHERRY STREET NEW CANAAN CT 06840 060970466 501(C)(3) 50000 0 COMMUNITY BENEFIT FUND AND SCHOLARSHIPS TO STUDENTS STUDYING HEALTH CARE 6 0 PART I, LINE 2: A. THE AMOUNTS REPORTED ON SCHEDULE I ARE ASSISTANCE TO SUPPORT LOCAL GOVERNMENT DEPARTMENTS AND 501(C )(3) ORGANIZATIONS. DUE TO THE NATURE OF THESE PAYMENTS TO TRUSTEE GRANTEES, ELIGIBILITY DETERMINATION AND POST-GRANT MONITORING IS NOT APPLICABLE. X 0 1 X X X X 1 0 0 0 0 0 0 1 0 ANDREW GERBER MD PHD PRESIDENT & MEDICAL DIRECTOR 552955 0 64625 0 276 0 9341 0 46557 0 673754 0 0 0 ROSS MARKELLO CHIEF FINANCIAL OFFICER (UNTIL 7/202 250088 0 48000 0 175861 0 5077 0 44552 0 523578 0 0 0 BRENT ANTHONY PENQUE PHYSICIAN 313669 0 157058 0 0 0 2635 0 0 0 473362 0 0 0 MICHAEL D GROAT PHD CHIEF CLINICAL OFFICER 336322 0 38625 0 55075 0 7212 0 17656 0 454890 0 0 0 TIMOTHY DOUGHERTY CHIEF ADVANCEMENT OFFICER 299384 0 50000 0 516 0 7806 0 52989 0 410695 0 0 0 ANRI KISSILENKO PHYSICIAN 320354 0 15261 0 0 0 24106 0 7104 0 366825 0 0 0 LISA BENTON CHIEF QUALITY OFFICER (UNTIL 12/2023 271603 0 33300 0 792 0 9093 0 39774 0 354562 0 0 0 ELIZABETH ORTIZ-SCHWARTZ PHYSICIAN 316777 0 11789 0 0 0 6760 0 10690 0 346016 0 0 0 PETRA M PILGRIM PHYSICIAN 309206 0 16682 0 0 0 7984 0 3366 0 337238 0 0 0 KRISTEN WOLFE CHIEF BUSINESS OFFICER (UNTIL 9/2023 182443 0 31344 0 81735 0 5959 0 34889 0 336370 0 0 0 GLORIA A LLOYD PHYSICIAN 264307 0 50100 0 0 0 4691 0 0 0 319098 0 0 0 IMMACULA CANN CHIEF NURSING OFFICER 266450 0 7800 0 516 0 773 0 0 0 275539 0 0 0 MARK JACK RUSS CHIEF MEDICAL OFFICER 264505 0 0 0 1426 0 0 0 0 0 265931 0 0 0 CHRISTY AHERNE CHIEF PEOPLE OFFICER 201316 0 0 0 142 0 0 0 20783 0 222241 0 0 0 AYANA THOMAS CHIEF INFORMATION OFFICER (UNTIL 5/2 59822 0 19956 0 110110 0 1655 0 18132 0 209675 0 0 0 PART I, LINE 1B THE CHIEF CLINICAL OFFICER RECEIVED IMPUTED INCOME OF 54,804 RELATED TO RESIDENCE FOR PERSONAL USE WHICH IS RECORDED IN HIS BASE COMPENSATION. THE PAYMENT WAS INCLUDED IN TAXABLE COMPENSATION AND ARE REPORTED IN SCHEDULE J, PART II, COLUMN B(I). PART I, LINE 4A THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAY IN 2023: - ROSS MARKELLO $174,308 - AYANA THOMAS $109,979 - KRISTIN WOLFE $81,608 PART I, LINE 7 THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, CHIEF CLINICAL OFFICER, CHIEF BUSINESS OFFICER, CHIEF QUALITY OFFICER, CHIEF NURSING OFFICER, AND CHIEF INFORMATION OFFICER WERE ELIGIBLE FOR INCENTIVE COMPENSATION BASED ON THE ACHIEVEMENT OF PERFORMANCE GOALS ESTABLISHED AND APPROVED BY THE BOARD OF DIRECTORS. IN CALENDAR YEAR 2023, THE AFOREMENTIONED INDIVIDUALS RECEIVED COMPENSATION FOR ACHIEVEMENT OF INCENTIVE GOALS. THESE AMOUNTS ARE REPORTED IN SCHEDULE J, PART II, COLUMN (B)(II). X 7 137060 FMV 0 0 1 0 PART I, COLUMN (B): THE AMOUNT IN COLUMN (B) REPRESENTS THE NUMBER OF CONTRIBUTORS. FORM 990, PART 1, LINE 1 THE MISSION OF SILVER HILL HOSPITAL IS TO PROVIDE OUR PATIENTS WITH THE BEST AVAILABLE TREATMENT OF MENTAL ILLNESS AND ADDICTION; AND TO OFFER CONTINUING SUPPORT, COUNSELING AND EDUCATION TO OUR PATIENTS AND THEIR FAMILIES IN EVERY PHASE OF ILLNESS AND RECOVERY. FORM 990, PART VI, SECTION B, LINE 11B 990 REVIEW BY ORGANIZATION THE FORM 990 OF THE ORGANIZATION IS PREPARED BY THE FINANCE DEPARTMENT OF SILVER HILL HOSPITAL BASED ON THE BOOKS AND RECORDS OF THE ORGANIZATION. THE DRAFT RETURN AND ALL SUPPORTING DOCUMENTATION ARE PROVIDED TO THE ORGANIZATION'S INDEPENDENT ACCOUNTANTS FOR REVIEW AND FINAL PREPARATION OF THE RETURN. THE FINAL VERSION OF THE FORM 990 IS THEN REVIEWED BY THE INTERIM CFO AND PRESDIENT & MEDICAL DIRECTOR. THE FINAL VERSION OF THE FORM 990 IS PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY FOR THEIR REVIEW AND COMMENTS BEFORE FILING THE FORM WITH THE INTERNAL REVENUE SERVICES. FORM 990, PART VI, SECTION B, LINE 12C COMPLIANCE WITH CONFLICT OF INTEREST POLICY THE HOSPITAL REQUIRES THE BOARD OF DIRECTORS AND OFFICERS TO COMPLETE A NOTIFICATION OF COMPLIANCE QUESTIONNAIRE AT THE END OF EACH TAX YEAR. THE FINANCE DEPARTMENT REVIEWS THE QUESTIONNAIRES FOR DETERMINATION OF POTENTIAL CONFLICTS OF INTEREST. ANY POTENTIAL CONFLICTS OF INTEREST ARE MADE KNOWN TO THE BOARD FOR RESOLUTION. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION DETERMINATION EACH YEAR, OR WHEN OTHERWISE REQUIRED, THE BOARD OF DIRECTORS APPOINTS A COMPENSATION SUB-COMMITTEE OF INDEPENDENT DIRECTORS TO REVIEW THE COMPENSATION OF THE PRESIDENT AND MEDICAL DIRECTOR. THE SUB-COMMITTEE REVIEWS THE FORM 990'S OF SIMILAR ORGANIZATIONS AS WELL AS AMERICAN HOSPITAL ASSOCIATION SURVEYS, AND MAKES RECOMMENDATIONS TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. ANY DELIBERATIONS AND DECISIONS OF THE COMPENSATION SUB-COMMITTEE ARE DOCUMENTED IN THE MEETING MINUTES OF THE COMPENSATION SUB COMMITTEE. THE HOSPITAL ENGAGES A THIRD PARTY TO CONDUCT A SALARY SURVEY OF ALL OTHER HOSPITAL POSITIONS. THE SURVEY IS CONDUCTED EVERY TWO YEARS. THE MOST RECENT SURVEY WAS CONDUCTED IN 2021. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AVAILABILITY THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. SILVER HILL MANAGEMENT GROUP LLC 208 VALLEY ROAD NEW CANAAN CT 06840 922893646 MANAGEMENT COMPANY NY 0 0 SILVER HILL HOSPITAL THE SH-YNHHS TRANSITIONAL LIVING TREATMENT PROGRAM PARTNERSHIP 208 VALLEY ROAD NEW CANAAN CT 06840 843028517 HEALTHCARE SERVICES CT SILVER HILL HOSPITAL RELATED 3125345 11078084 0 1 0.75000 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1