STRATEGY STUDIO / PUBLIC DATA EXPLORER

SILVER HILL HOSPITAL INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
SILVER HILL HOSPITAL INC (EIN 06-0655139)
Tax period
2020-03-01 to 2021-02-28
Filed
2022-01-18
IRS object ID
202240189349301324
Schema version
2020v4.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-01-18T14:25:14-06:00ReturnTs
Tax Period End2021-02-28TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN135565207PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1345 PARK AVENUEAddressLine1Txt
CityNEW YORKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP101540102ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-03-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN060655139EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SILVER HILL HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSILVBusinessNameControlTxt
Phone2038012230PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1208 VALLEY ROADAddressLine1Txt
CityNEW CANAANCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06840ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonANDREW GERBER MD PHDPersonNm
Person TitlePRESIDENT & MEDICAL DIRECTORPersonTitleTxt
Phone2038012230PhoneNum
Signature2022-01-18SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstANDREWPersonFirstNm
Person LastGERBER MD PHDPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonEVAN SEEKAMPPreparerPersonNm
PTINP01907071PTIN
Phone2127589700PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerANDREW GERBER MD PHDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1208 VALLEY ROADAddressLine1Txt
CityNEW CANAANCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06840ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$40,046,739GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.SILVERHILLHOSPITAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1934FormationYr
Legal Domicile StateCTLegalDomicileStateCd
Activity Or MissionTO PROVIDE OUR PATIENTS WITH THE BEST AVAILABLE TREATMENT OF MENTAL ILLNESS. SEE SCHEDULE O.THE MISSION OF SILVER HILL HOSPITAL IS TO PROVIDE OUR PATIENTS WITH THEBEST AVAILABLE TREATMENT OF MENTAL ILLNESS AND ADDICTION; AND TO OFFERCONTINUING SUPPORT, COUNSELING AND EDUCATION TO OUR PATIENTS AND THEIRFAMILIES IN EVERY PHASE OF ILLNESS AND RECOVERY.ActivityOrMissionDesc
Voting Members Governing Body18VotingMembersGoverningBodyCnt
Voting Members Independent17VotingMembersIndependentCnt
Total Employee440TotalEmployeeCnt
Total Volunteers51TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,721,421PYContributionsGrantsAmt
CY Contributions Grants$2,957,859CYContributionsGrantsAmt
PY Program Service Revenue$39,843,475PYProgramServiceRevenueAmt
CY Program Service Revenue$32,177,334CYProgramServiceRevenueAmt
PY Investment Income$707,199PYInvestmentIncomeAmt
CY Investment Income$436,115CYInvestmentIncomeAmt
PY Other Revenue$478,497PYOtherRevenueAmt
CY Other Revenue$1,501,487CYOtherRevenueAmt
PY Total Revenue$42,750,592PYTotalRevenueAmt
CY Total Revenue$37,072,795CYTotalRevenueAmt
PY Grants And Similar Paid$20,623PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$49,795CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$26,682,618PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$24,813,640CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$989,264CYTotalFundraisingExpenseAmt
PY Other Expenses$16,700,345PYOtherExpensesAmt
CY Other Expenses$15,643,672CYOtherExpensesAmt
PY Total Expenses$43,403,586PYTotalExpensesAmt
CY Total Expenses$40,507,107CYTotalExpensesAmt
PY Revenues Less Expenses-$652,994PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$3,434,312CYRevenuesLessExpensesAmt
Total Assets BOY$64,709,400TotalAssetsBOYAmt
Total Assets EOY$69,964,996TotalAssetsEOYAmt
Total Liabilities BOY$10,525,216TotalLiabilitiesBOYAmt
Total Liabilities EOY$17,225,243TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$54,184,184NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$52,739,753NetAssetsOrFundBalancesEOYAmt
MissionTHE MISSION OF THE HOSPITAL IS TO PROVIDE OUR PATIENTS WITH THE BEST AVAILABLE TREATMENT OF MENTAL HEALTH AND ADDICTION; AND TO OFFER CONTINUING SUPPORT, COUNSELING AND EDUCATION TO OUR PATIENTS AND THEIR FAMILIES IN EVERY PHASE OF ILLNESS AND RECOVERY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$11,810,933ExpenseAmt
Grant$0GrantAmt
Revenue$10,188,570RevenueAmt
DescINPATIENT 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 676 INPATIENTS DURING FISCAL YEAR 2021.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$11,382,314ExpenseAmt
Grant$49,795GrantAmt
Revenue$19,726,892RevenueAmt
DescTHE 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 LIVING 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 579 TRANSITIONAL LIVING PATIENTS DURING FISCAL YEAR 2021.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$2,527,567ExpenseAmt
Grant$0GrantAmt
Revenue$3,727,974RevenueAmt
DescTHE 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 SIX WEEKS.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$25,720,814TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document177IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee440EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members18GoverningBodyVotingMembersCnt
Independent Voting Member17IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or Procedure0WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldCTStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MARTHA RENDEIRO ACCTG MGRBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2038012293PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1208 VALLEY RDAddressLine1Txt
CityNEW CANAANCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06840ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
ANDREW GERBER MD PH
PRESIDENT & MEDICAL DIRECTOR40.000.00Yes (X)Yes (X)$544,951$0$49,321
PETER ORTHWEIN
CHAIR EMERITUS & DIRECTOR1.000.00Yes (X)$0$0$0
LANCE LUNDBERG
CHAIR & DIRECTOR3.000.00Yes (X)Yes (X)$0$0$0
DEANN E MURPHY
CHAIR EMERITUS & DIRECTOR1.000.00Yes (X)$0$0$0
WARD F CLEARY ESQ
CHAIR EMERITUS & DIRECTOR1.000.00Yes (X)$0$0$0
LINDA AUTORE
CO-CHAIR & DIRECTOR3.000.00Yes (X)Yes (X)$0$0$0
RICHARD GANNON
TREASURER & DIRECTOR1.000.00Yes (X)$0$0$0
AMY BAUMAN
DIRECTOR1.000.00Yes (X)$0$0$0
RICHARD CANNING
DIRECTOR1.000.00Yes (X)Yes (X)$0$0$0
PETER FONAGY
DIRECTOR1.000.00Yes (X)$0$0$0
HENK J HARTONG JR
DIRECTOR1.000.00Yes (X)$0$0$0
DAVID HUNT
DIRECTOR1.000.00Yes (X)$0$0$0
JIM PERAKIS
SECRETARY & DIRECTOR1.000.00Yes (X)$0$0$0
DEBORAH SHABECOFF
DIRECTOR1.000.00Yes (X)$0$0$0
DAVID STIFELMAN START 520
DIRECTOR1.000.00Yes (X)$0$0$0
MICHEAL HOLMES
DIRECTOR1.000.00Yes (X)$0$0$0
CHERYL WIESENFELD
DIRECTOR1.000.00Yes (X)$0$0$0
SPERRY A DECEW END 0520
DIRECTOR1.000.00Yes (X)Yes (X)$0$0$0
TODD HOLLANDER
DIRECTOR1.000.00Yes (X)$0$0$0
DENNIS DOLAN ENDED 1220
CHIEF FINANCIAL OFFICER40.000.00Yes (X)$290,310$0$8,788
TIMOTHY DOUGHERTY START 0320
CHIEF ADVANCEMENT OFFICER40.000.00Yes (X)$288,916$0$55,261
LISA BENTON START 0920
CHIEF QUALITY OFFICER40.000.00Yes (X)$181,521$0$26,714
MICHAEL D GROAT
CHF CLINICAL OFFICER40.000.00$332,697$0$47,361Yes (X)
HOWARD WEINER MD
PHYSICIAN40.000.00$377,111$0$24,705Yes (X)
PETRA M PILGRIM
PHYSICIAN40.000.00$286,135$0$25,032Yes (X)
MARIE ANTOINETTE HANDLER
PHYSICIAN40.000.00$273,245$0$43,071Yes (X)
AMIR GARAKANI MD
PHYSICIAN40.000.00$257,547$0$19,440Yes (X)
ANRI KISSILENKO MD
PHYSICIAN40.000.00$233,636$0$54,282Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,066,069TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$353,975TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K44IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
UNIDINE CORPORATION
ONE GATEWAY CENTER SUTIE 751NEWTOWNMA02458FOOD SERVICES$1,762,690
MARSH USA INC
501 MERRITT 7NORWALKCT06851INSURANCE BROKER$1,365,864
YALE NEW HAVEN HOSPITAL
789 HOWARD AVENUENEW HAVENCT06519LAB SERVICES$717,814
PHARMACY & THERAPEUTICS CONS
393 CRESTWOOD DRCHESIRECT06410DRUGS$524,945
YALE UNIVERSITY SCHOOL OF MEDICINE
33 CEDAR STREETNEW HAVENCT06510HEALTH SERVICES$252,111
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K28CntrctRcvdGreaterThan100KCnt
Government Grants$796,909GovernmentGrantsAmt
All Other Contributions$2,160,950AllOtherContributionsAmt
Noncash Contributions$5,950NoncashContributionsAmt
Total Contributions$2,957,859TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
TRANSITIONAL LIVING623000$19,622,473$19,622,473
INPATIENT623000$8,826,886$8,826,886
OUTPATIENT623000$3,727,975$3,727,975
FieldValueIRS element (for citing)
Total Program Service Revenue$32,177,334TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$428,466TotalRevenueColumnAmt
Exclusion$428,466ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$149,231RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$188,049RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$38,818RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$38,818TotalRevenueColumnAmt
Exclusion-$38,818ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$2,790,064SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$2,782,415SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$7,649SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,649TotalRevenueColumnAmt
Exclusion$7,649ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$11,892GrossSalesOfInventoryAmt
Cost Of Goods Sold$3,480CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,412TotalRevenueColumnAmt
Exclusion$8,412ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
SH-YNHHS TLP-GAIN EQUITY INV900099$1,273,768$1,273,768
SCHOOL/TUTORING900099$87,915$87,915
GUEST MEALS900099$65,791$65,791

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$104,419TotalRevenueColumnAmt
Related Or Exempt Func Income$104,419RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,531,893OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$37,072,795TotalRevenueColumnAmt
Related Or Exempt Func Income$33,643,436RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$471,500ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$49,795TotalAmt
Program Services$49,795ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,591,784TotalAmt
Program Services$557,184ProgramServicesAmt
Management And General$683,696ManagementAndGeneralAmt
Fundraising$350,904FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$18,576,151TotalAmt
Program Services$14,073,205ProgramServicesAmt
Management And General$4,129,489ManagementAndGeneralAmt
Fundraising$373,457FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,226,104TotalAmt
Program Services$2,510,930ProgramServicesAmt
Management And General$649,162ManagementAndGeneralAmt
Fundraising$66,012FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,419,601TotalAmt
Program Services$1,178,269ProgramServicesAmt
Management And General$212,940ManagementAndGeneralAmt
Fundraising$28,392FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$727,903TotalAmt
Program Services$26,298ProgramServicesAmt
Management And General$701,605ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$116,944TotalAmt
Management And General$116,944ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$57,888TotalAmt
Management And General$57,888ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,098,313TotalAmt
Program Services$3,449,724ProgramServicesAmt
Management And General$565,584ManagementAndGeneralAmt
Fundraising$83,005FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$50,940TotalAmt
Program Services$49,775ProgramServicesAmt
Fundraising$1,165FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,751,781TotalAmt
Program Services$780,105ProgramServicesAmt
Management And General$1,938,123ManagementAndGeneralAmt
Fundraising$33,553FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$228,427TotalAmt
Program Services$13,200ProgramServicesAmt
Management And General$215,227ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$663,432TotalAmt
Program Services$229,806ProgramServicesAmt
Management And General$431,166ManagementAndGeneralAmt
Fundraising$2,460FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$58,085TotalAmt
Program Services$50,200ProgramServicesAmt
Management And General$5,665ManagementAndGeneralAmt
Fundraising$2,220FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$43,148TotalAmt
Program Services$32,409ProgramServicesAmt
Management And General$9,912ManagementAndGeneralAmt
Fundraising$827FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$6,428TotalAmt
Management And General$6,428ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,510,134TotalAmt
Program Services$1,973,302ProgramServicesAmt
Management And General$1,536,528ManagementAndGeneralAmt
Fundraising$304FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,232,181TotalAmt
Management And General$1,232,181ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
OTHER$1,303,664$520,835$743,397$39,432
CREDIT CARD FEES$492,536$2,179$482,824$7,533
MEDICATION$223,598$223,598
BAD DEBT EXPENSE$78,270$78,270

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$40,507,107TotalAmt
Program Services$25,720,814ProgramServicesAmt
Management And General$13,797,029ManagementAndGeneralAmt
Fundraising$989,264FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,900BOYAmt
EOY$1,900EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,958,271BOYAmt
EOY$6,407,500EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,376,341BOYAmt
EOY$1,782,341EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,137,705BOYAmt
EOY$2,827,614EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$108,787BOYAmt
EOY$100,445EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$996,042BOYAmt
EOY$601,486EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$80,309,792LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$39,885,750LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$43,192,503BOYAmt
EOY$40,424,042EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$11,549,765BOYAmt
EOY$14,187,108EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$1,145,192BOYAmt
EOY$2,405,216EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,242,894BOYAmt
EOY$1,227,344EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$64,709,400BOYAmt
EOY$69,964,996EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,310,728BOYAmt
EOY$4,657,731EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$3,523,145BOYAmt
EOY$3,394,689EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,691,343BOYAmt
EOY$9,172,823EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$10,525,216BOYAmt
EOY$17,225,243EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$50,715,103BOYAmt
EOY$48,152,213EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,469,081BOYAmt
EOY$4,587,540EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$54,184,184BOYAmt
EOY$52,739,753EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$64,709,400BOYAmt
EOY$69,964,996EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$3,434,312ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$2,262,881NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$273,000OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Incl Escrow Custodial Acct Liab0InclEscrowCustodialAcctLiabInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$213,000BeginningYearBalanceAmt
Investment Earnings Or Losses$7,619InvestmentEarningsOrLossesAmt
Other Expenditures$7,619OtherExpendituresAmt
End Year Balance$213,000EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$213,000BeginningYearBalanceAmt
Investment Earnings Or Losses$6,210InvestmentEarningsOrLossesAmt
Other Expenditures$6,210OtherExpendituresAmt
End Year Balance$213,000EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$245,559BeginningYearBalanceAmt
Investment Earnings Or Losses$1,894InvestmentEarningsOrLossesAmt
Other Expenditures$34,453OtherExpendituresAmt
End Year Balance$213,000EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$237,557BeginningYearBalanceAmt
Investment Earnings Or Losses$8,002InvestmentEarningsOrLossesAmt
End Year Balance$245,559EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$213,000BeginningYearBalanceAmt
Investment Earnings Or Losses$24,557InvestmentEarningsOrLossesAmt
End Year Balance$237,557EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,766,727OtherCostOrOtherBasisAmt
Book Value$1,766,727BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$54,126,939OtherCostOrOtherBasisAmt
Depreciation$25,728,552DepreciationAmt
Book Value$28,398,387BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,764,238OtherCostOrOtherBasisAmt
Depreciation$10,056,854DepreciationAmt
Book Value$3,707,384BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,651,888OtherCostOrOtherBasisAmt
Depreciation$4,100,344DepreciationAmt
Book Value$6,551,544BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$40,424,042TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
DUE TO PATIENTS AND THIRD PARTIES$2,297,756
PROFESSIONAL LIABILITY RESERVE$2,239,008
PAYCHECK PROTECTION PROGRAM LOAN$4,565,400
OTHER LIABILITIES$44,255
CAPITAL LEASES$26,404
FieldValueIRS element (for citing)
Total Liability$9,172,823TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$39,123,647TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$2,262,881NetUnrealizedGainsInvstAmt
Other Revenue-$78,270OtherRevenueAmt
Revenue Not Reported$2,184,611RevenueNotReportedAmt
Revenue Subtotal$36,939,036RevenueSubtotalAmt
Investment Expenses Not Incld$52,288InvestmentExpensesNotIncldAmt
Other Revenues Not Included$81,471OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$133,759RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$37,072,795TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$40,568,078TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$191,529OtherExpensesIncludedAmt
Expenses Not Reported$191,529ExpensesNotReportedAmt
Expenses Subtotal$40,376,549ExpensesSubtotalAmt
Investment Expenses Not Incld2$52,288InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$78,270OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$130,558ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$40,507,107TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:DONORS HAVE STIPULATED THAT ANY INCOME FROM THE ENOWMENT 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 FEBRUARY 28, 2021 AND FEBRUARY 29, 2020. THE HOSPITAL RECOGNIZES INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS WITHIN INTEREST. AS OF FEBRUARY 28, 2021 AND FEBRUARY 29, 2020, 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 DEBT -78,270.
PART XI, LINE 4B - OTHER ADJUSTMENTS:LITTLE SHOP INVENTORY EXPENSE -3,480. OTHER RENTAL EXPENSE -188,049. PLEDGE CONTRIBUTION ADJUSTMENTS 273,000.
PART XII, LINE 2D - OTHER ADJUSTMENTS:LITTLE SHOP INVENTORY EXPENSE 3,480. OTHER RENTAL EXPENSE 188,049.
PART XII, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT 78,270.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other600.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other900.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically Indigent0FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$270,900TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$270,900DirectOffsettingRevenueAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$270,900TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$270,900DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$65,918TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$65,918NetCommunityBenefitExpnsAmt
Total Expense0.00150TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$23,952TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$23,952NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,143,679TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,826,886DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,316,793NetCommunityBenefitExpnsAmt
Total Expense0.03090TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$26,800TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$26,800NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,260,349TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,826,886DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,433,463NetCommunityBenefitExpnsAmt
Total Expense0.03360TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,531,249TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,097,786DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,433,463NetCommunityBenefitExpnsAmt
Total Expense0.03360TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$78,270BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$469,370ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$37,292CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$432,078MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SILVER HILL HOSPITAL INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1208 VALLEY RDAddressLine1Txt
CityNEW CANAANCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06840ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.SILVERHILLHOSPITAL.ORGWebsiteAddressTxt
Licensed HospitalYes (X)LicensedHospitalInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1SILVER HILL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted19CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.SILVERHILLHOSPITAL.ORGOwnWebsiteURLTxt
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt20ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLWWW.SILVERHILLHOSPITAL.ORGStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care600.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care900.000000000000FPGFamilyIncmLmtDscntCarePct
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.SILVERHILLHOSPITAL.ORGFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.SILVERHILLHOSPITAL.ORGFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.SILVERHILLHOSPITAL.ORGFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
None MadeYes (X)NoneMadeInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back MedicareYes (X)LookBackMedicareInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SILVER HILL HOSPITALPART V, SECTION B, LINE 5: COMMUNITY ENGAGEMENT AND FEEDBACK WERE AN INTEGRAL PART OF THE CHNAPROCESS. SILVER HILL HOSPITAL SOUGHT COMMUNITY INPUT THROUGH KEYINFORMANT INTERVIEWS WITH COMMUNITY LEADERS AND PARTNERS. PUBLIC HEALTHAND HEALTH CARE PROFESSIONALS AS WELL AS LEADERS AND REPRESENTATIVES OFNON-PROFIT AND COMMUNITY-BASED ORGANIZATIONS SHARED KNOWLEDGE ABOUTMENTAL HEALTH AND SUBSTANCE ABUSE AND PROVIDED INSIGHT ON THE COMMUNITY,INCLUDING UNDERSERVED POPULATIONS. SEE APPENDIX C OF THE COMMUNITY NEEDSASSESSMENT FOR A LIST OF KEY INFORMANTS.THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM 49 KEY INFORMANTS, INCLUDINGPUBLIC HEALTH AND HEALTHCARE PROFESSIONALS, SOCIAL SERVICE PROVIDERS,NOT-PROFIT LEADERS, BUSINESS LEADERS, FAITH BASED ORGANIZATIONS AND OTHERCOMMUNITY LEADERS. PARTICIPANTS INCLUDED PUBLIC HEALTH ORGANIZATIONPROFESSIONALS, YOUTH AND SOCIAL SERVICE PROVIDERS, EDUCATION/SCHOOLSPECIALISTS, MENTAL HEALTH/SUBSTANCE ABUSE CLINICIANS, GOVERNMENTHOUSING/TRANSPORTATION AGENGIES, AND COMMUNITY MEMBERS.
SILVER HILL HOSPITALPART V, SECTION B, LINE 7D: THE HOSPITALS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE LOCATED AT HTTPS://SILVERHILLHOSPITAL.ORG/COMMUNITY/PUBLICATION/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/
SILVER HILL HOSPITALPART V, SECTION B, LINE 11: BASED ON FEEDBACK FROM COMMUNITY PARTNERS, INCLUDING MENTAL HEALTH ANDSUBSTANCE ABUSE PROVIDERS, PUBLIC HEALTH EXPERTS, SOCIAL SERVICEORGANIZATIONS, EDUCATION/SCHOOL ORGANIZATIONS, AND OTHER COMMUNITYREPRESENTATIVES, SILVER HILL HOSPITAL PLANS TO FOCUS COMMUNITY HEALTHIMPROVEMENT EFFORTS ON THE FOLLOWING PRIORITIES OVER THE NEXT THREE-YEARCYCLE: (1) SUBSTANCE MISUSE ISSUES INCLUDING ALCOHOL MISUSE; UNDERAGEDRINKING; VAPING; MARIJUANA, THC, AND CANNABINOIDS; (2) MENTAL HEALTHISSUES WITH A FOCUS ON DEPRESSION, ANXIETY, AND TRAUMA; (3) ADOLESCENTMENTAL HEALTH WITH A FOCUS ON DEPRESSION AND SUICIDALITY; (4) BARRIERS TOTREATMENT WITH A FOCUS ON NAVIGATING THE MENTAL HEALTHCARE SYSTEM ANDSTIGMA.THE HOSPITAL PLANS TO ADDRESS:(1) SUBSTANCE MISUSE ISSUES BY: (A) PARTNERING WITH COMMUNITYORGANIZATIONS TO DEVELOP AND DELIVER EDUCATIONAL PROGRAMMING; (B) HOSTINGMEDICAL GRAND ROUNDS TO ENHANCE CLINICIAN KNOWLEDGE AND UNDERSTANDINGREGARDING THESE ISSUES; (C) HOSTING AND SPONSORING TRAININGS ANDEDUCATIONAL SESSIONS FOR THE DEVELOPMENT OF PEER SUPPORT NETWORKS FORRECOVERY; (D) PROVIDING ACCESS TO SILVER HILL HOSPITAL PROGRAMS FOR THOSEREQUIRING INPATIENT, RESIDENTIAL, OR INTENSIVE OUTPATIENT TREATMENT; AND(E) OFFERING RECOVERY SUPPORT GROUPS THAT ARE OPEN TO THE COMMUNITY.(2) MENTAL HEALTH ISSUES WITH A FOCUS ON DEPRESSION, ANXIETY, AND TRAUMABY: (1) PARTNER WITH COMMUNITY ORGANIZATIONS TO DEVELOP AND DELIVEREDUCATIONAL PROGRAMMING BY: (A) HOSTING MEDICAL GRAND ROUNDS TO ENHANCECLINICIAN KNOWLEDGE AND UNDERSTANDING REGARDING THESE ISSUES; (B) HOSTINGAND SPONSORING TRAININGS AND EDUCATIONAL SESSIONS FOR THE DEVELOPMENT OFPEER SUPPORT NETWORKS; (C) DEVELOPING A TRAUMA FOCUSED TREATMENT TRACK(D) CONTINUING TO EXPAND OUTPATIENT DBT AND WOMEN'S IOP TO MEET COMMUNITYDEMAND; AND (E) PROVIDING ACCESS TO SILVER HILL HOSPITAL PROGRAMS FORTHOSE REQUIRING INPATIENT, RESIDENTIAL, OR INTENSIVE OUTPATIENT TREATMENT.(3) ADDRESS ADOLESCENT MENTAL HEALTH WITH A FOCUS ON DEPRESSION ANDSUICIDALITY. PARTNER WITH COMMUNITY ORGANIZATIONS TO DEVELOP AND DELIVEREDUCATIONAL PROGRAMMING BY: (A) HOSTING MEDICAL GRAND ROUNDS TO ENHANCECLINICIAN KNOWLEDGE AND UNDERSTANDING REGARDING THESE ISSUES; (B)EXPANDING ADOLESCENT IOP TO MEET COMMUNITY DEMAND; AND (C) CONTINUINGPARTICIPATION IN COMMUNITY EVENTS ON SUICIDE PREVENTION.(4) ADDRESS BARRIERS TO TREATMENT WITH A FOCUS ON NAVIGATING THE MENTALHEALTHCARE SYSTEM AND STIGMA BY: (A) INCREASING AWARENESS ANDUNDERSTANDING OF MENTAL HEALTH AND ADDICTION ISSUES THROUGH PARTICIPATIONIN EDUCATIONAL PROGRAMS, MENTAL HEALTH FAIRS AND WALKS, MEDIA INTERVIEWS,AND SOCIAL MEDIA; (B) CONTINUING TO IMPROVE ADMISSIONS RELATED PROCESSESTO OPTIMIZE PATIENT ACCESS; AND (C) CREATE A WEB-BASED AND PRINT GUIDE TOHELP PATIENTS AND FAMILIES NAVIGATE THE ADDICTION AND MENTAL HEALTHCARESYSTEMS.
SILVER HILL HOSPITALPART 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 AT HTTPS://SILVERHILLHOSPITAL.ORG/WP-CONTENT/UPLOADS/2020/10/FINANCIAL-ASSISTANCE-POLICY-AND-APPLICATION-REVISED-10-28-20.PDF.
SILVER HILL HOSPITALPART 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 FINANCIAL ABILITY TO PAY FOR SERVICES, MAY APPLY FOR FINANCIAL ASSISTANCE UPON ADMISSION INTO THE PROGRAM.
SILVER HILL HOSPITALPART 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 NECESSARYSERVICES. THE FULL TEXT VERSION OF THE HOSPITAL'S FINANCIAL ASSISTANCEPOLICY IS AVAILABLE ONLINE AT HTTPS://SILVERHILLHOSPITAL.ORG/WP-CONTENT/UPLOADS/2020/10/FINANCIAL-ASSISTANCE-POLICY-AND-APPLICATION-REVISED-10-28-20.PDF OR BY REQUESTINGA FREE COPY FROM THE HOSPITAL'S ADMISSIONS DEPARTMENT.

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:THE HOSPITAL USED A FPG OF 300% AS A FACTOR FOR DETERMINING ELIGIBILITYFOR PROVIDING DISCOUNTED CARE FOR MEDICALLY NECESSARY SERVICES. MEDICALLYNECESSARY SERVICES ARE DEFINED BY THE HOSPITAL AS INPATIENT SERVICES.THE HOSPITAL USED A FPG OF 600% AS A FACTOR FOR DETERMINING ELIGIBILITYFOR PROVIDING FREE CARE FOR TRANSITIONAL LIVING SERVICES (NON-INPATIENTSERVICES), AND A FPG OF 900% FOR DETERMINING ELIGIBILITY FOR PROVIDINGDISCOUNTED CARE FOR TRANSITIONAL LIVING SERVICES (NON-INPATIENTSERVICES).
PART I, LINE 7:A COST TO CHARGE RATIO, DERIVED FROM WORKSHEET 2 RATIO OF PATIENT CARECOST TO CHARGES, WAS USED TO DETERMINE FINANCIAL ASSISTANCE COSTS REPORTED. A COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 WAS USED TODETERMINE THE AMOUNT OF INPATIENT CARE THAT WAS SUBSIDIZED IN FISCAL YEAR2021. ALL OTHER EXPENSES ARE ACTUAL COSTS.TOTAL EXPENSES FROM PART IX, LINE 25 WERE REDUCED BY BAD DEBT EXPENSES OF$94,400 IN CALCULATING TOTAL EXPENSES FOR COLUMN (F). EXPENSES FROM ARELATED JOINT VENTURE WERE ALSO TAKEN INTO ACCOUNT FOR COLUMN (F).
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, LINE 2.
PART III, LINE 3:BAD DEBT EXPENSE IS MAINLY COMPRISED OF UNCOLLECTIBLE CO-PAYS AND DEDUCTIBLES FROM PATIENTS WITH INSURANCE. CO-INSUANCE AND DEDUCTIBLE BALANCES ARE EXCLUDED FROM THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.
PART III, LINE 4:EXCERPT FROM THE AUDITED FINANCIAL STATEMENT, FOOTNOTE 2 - NET PATIENT SERVICE REVENUE AND ACCOUNTS RECEIVABLE; AUDITED FINANCIAL STATEMENTS PAGE 16.PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PRIVATE PAYERS, THIRD-PARTY PAYERS, AND OTHERS FOR SERVICES RENDERED. THESE AMOUNTS ARE BASED ON HISTORICAL AND EXPECTED PRICE CONCESSIONS AND NET COLLECTIONS AS WELL AS AGING STATUS. BASED ON HISTORICAL EXPERIENCE, A PORTION OF THE HOSPITAL'S SELF-PAY PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE WILL BE UNABLE OR UNWILLING TO PAY FOR SERVICES PROVIDED. IMPLICIT PRICE CONCESSIONS ARE RECORDED AS A DIRECT REDUCTION TO NET PATIENT SERVICE REVENUE AND ARE BASED PRIMARILY ON HISTORICAL COLLECTION EXPERIENCE.
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:NEEDS ASSESSMENT: 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 39% OF THE PATIENT POPULATION IS FROM CONNECTICUT, 38% FROM NEW YORK, 23% FROM OTHER AREAS INCLUDING NEW JERSEY AND MASSACHUSETTS.
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 7STATE FILING OF COMMUNITY BENEFIT REPORT: DURING FISCAL YEAR ENDING 2021, THE HOSPITAL WAS NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT WITH THE STATE OF CONNECTICUT.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records Maintained0GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
NEW CANAAN POLICE DEPARTMENT
174 SOUTH AVENUENEW CANAANCT06840066002043GOVT$10,000DONATION
NEW CANAAN VOLUNTEER AMBULANCE
PO BOX 598NEW CANAANCT06840237300265GOVT$10,000DONATION
FieldValueIRS element (for citing)
Total501c3 Org0Total501c3OrgCnt
Total Other Org2TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PART I, LINES 1 AND 2FormAndLineReferenceDesc
ExplanationTHE AMOUNTS REPORTED ON SCHEDULE I ARE ASSISTANCE TO SUPPORT THE LOCAL VOLUNTEER AMBULANCE AND POLICE DEPARTMENT. DUE TO THE NATURE OF THIS PAYMENT TO A TRUSTED GRANTEE, ELIGIBILITY DETERMINATION AND POST-GRANT MONITORING IS NOT APPLICABLE.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Housing Allowance Or ResidenceYes (X)HousingAllowanceOrResidenceInd
Written Policy Ref T And E Expnss0WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ANDREW GERBER MD PH
PRESIDENT & MEDICAL DIRECTOR$544,764$0$0$0$187$0$19,500$0$29,821$0$594,272$0$0$0
HOWARD WEINER MD
PHYSICIAN$376,915$0$0$0$196$0$3,463$0$21,242$0$401,816$0$0$0
MICHAEL D GROAT
CHF CLINICAL OFFICER$291,341$0$0$0$41,356$0$17,921$0$29,440$0$380,058$0$0$0
TIMOTHY DOUGHERTY START 0320
CHIEF ADVANCEMENT OFFICER$288,629$0$0$0$287$0$25,440$0$29,821$0$344,177$0$0$0
MARIE ANTOINETTE HANDLER
PHYSICIAN$273,123$0$0$0$122$0$13,250$0$29,821$0$316,316$0$0$0
PETRA M PILGRIM
PHYSICIAN$286,023$0$0$0$112$0$14,447$0$10,585$0$311,167$0$0$0
DENNIS DOLAN ENDED 1220
CHIEF FINANCIAL OFFICER$289,457$0$0$0$853$0$0$0$8,788$0$299,098$0$0$0
ANRI KISSILENKO MD
PHYSICIAN$233,110$0$0$0$526$0$24,461$0$29,821$0$287,918$0$0$0
AMIR GARAKANI MD
PHYSICIAN$257,420$0$0$0$127$0$8,855$0$10,585$0$276,987$0$0$0
LISA BENTON START 0920
CHIEF QUALITY OFFICER$180,995$0$0$0$526$0$3,180$0$23,534$0$208,235$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 1AFormAndLineReferenceDesc
ExplanationTHE CHIEF CLINICAL OFFICER RECEIVED A HOUSING BENEFIT AS THE HOSPITAL DESIRED A CLINICIAN TO BE ON PREMISES. THE HOUSING BENEFIT OF $41,064 WAS INCLUDED IN TAXABLE COMPENSATION AND IS REPORTED IN SCHEDULE J, PART II, COLUMN B(III).ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3THE ORGANIZATION'S INTERIM CHIEF FINANCIAL OFFICER BECAME A FULL-TIME EMPLOYEE AS OF JANUARY 1, 2022.
FORM 990, PART VI, SECTION B, LINE 11B990 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 12CCOMPLIANCE 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 FISCAL 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 15COMPENSATION 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 FORMS 990 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 2020.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS AVAILABILITY THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON REQUEST.
FORM 990, PART IX, LINE 11GOTHER: PROGRAM SERVICE EXPENSES 3,449,724. MANAGEMENT AND GENERAL EXPENSES 565,584. FUNDRAISING EXPENSES 83,005. TOTAL EXPENSES 4,098,313.
FORM 990, PART XI, LINE 9:PLEDGE CONTRIBUTION ADJUSTMENTS -273,000.

Schedule R IRS990ScheduleR

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1SH-YNHHS TLPPBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1208 VALLEY RDAddressLine1Txt
CityNEW CANAANCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06840ZIPCd
FieldValueIRS element (for citing)
EIN843028517EIN
Primary ActivitiesHEALTHCARE SVCPrimaryActivitiesTxt
Legal Domicile StateCTLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SHHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Share Of Total Income$1,249,502ShareOfTotalIncomeAmt
Share Of EOY Assets$2,969,213ShareOfEOYAssetsAmt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing PartnerYes (1)GeneralOrManagingPartnerInd
Ownership0.75000OwnershipPct
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd