2021-08-12T10:20:33-05:00 2020-09-30 990 2019-10-01 454456939 Hartford HealthCare Medical Group Inc HART 8606966200 1290 Silas Deane Highway 2nd Floor Wethersfield CT 06109 Mark Keise Authorized Signer 8606966282 2021-08-12 2019 2022-09-23 18:48:47Z Cynthia Heller 1290 Silas Deane Highway 2nd Floor Wethersfield CT 06109 203401421 0 X www.hartfordhealthcaremedicalgroup.com X 2012 CT The Mission of Hartford HealthCare Medical Group is to put the patients first, provide coordinated quality care and value, exceed the expectations of patients, providers, staff and the community that it serves. 4 0 2850 0 0 0 167417 169219 286593882 202677404 -27724 -47905 594898 554798 287328473 203353516 0 0 0 0 205482096 94826430 0 0 0 81729623 108512489 287211719 203338919 116754 14597 96736126 153642839 69325452 115898745 27410674 37744094 X The Mission of Hartford HealthCare Medical Group is to put patients first, provide coordinated quality care and value, and exceed the expectations of patients, providers, staff and the community that it serves. 0 0 8191791 4935495 The Primary Care program under Hartford HealthCare Medical Group has 106 physicians and 104 advanced practitioners who provide primary care across the State of Connecticut. Physicians have privileges at Hartford Hospital, Hospital of Central Connecticut, MidState Medical Center, Windham Community Memorial Hospital, Backus Hospital, Charlotte Hungerford Hospital and SVMC Holdings, Inc. The practices saw 595,917 patient visits in 2020. Our providers are credentialed in both internal and family medicine, with a commitment to providing sick visits within 24 hours. Within our Hartford HealthCare Medical Group Primary Care practices, our largest practices from a financial standpoint are our primary care practices in Wethersfield, South Windsor and our Occupational Medicine practices which are located in various locations across Connecticut. 173923250 197741909 Hartford HealthCare Medical Group (HHCMG) is a multi-specialty group encompassing providers located throughout the state of Connecticut. In addition to clinical practice, our doctors are teachers and researchers, always looking for ways to improve the quality of care and bring innovations to their patients.Hartford HealthCare Medical Group has more than 400 primary care providers located throughout the state of Connecticut. HHCMG offers Primary Care, Urgent Care and Walk-in services. We are a member of Hartford HealthCare and are affiliated with some of the region's top hospitals including Hartford Hospital, The Hospital of Central Connecticut, MidState Medical Center, Windham Hospital, Backus Hospital, Charlotte Hungerford Hospital and St. Vincent Medical Center. 173923250 197741909 182115041 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 183 0 1 2850 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X David Baranick 8606962546 181 Patricia M Genova Drive Newington CT 06111 Sabet Hashim MD Physician 60.00 X 1793459 0 81614 Michael Daglio Director 30.00 30.00 X 0 1058682 182125 Robert Hagberg MD Chair Dept Cardiac Surgery 60.00 X 1147617 0 73721 Brendan Killory MD Neurosurgeon 60.00 X 1134758 0 72140 Edward Hannoush MD General Surgeon 60.00 X 1117413 0 73465 Paul Schwartz MD Neurosurgeon 60.00 X 1034738 0 68345 Jeffrey Cohen MD Chair 30.00 30.00 X X 0 945213 89922 Vincent DiBattista Former Director & President 0.00 0.00 X 0 815533 136336 Mark Prete Vice Chair & President 30.00 30.00 X X 528976 0 42270 Cynthia Heller Director 30.00 30.00 X 416551 0 58209 David Baranik VP, Finance 30.00 30.00 X 0 329847 70289 Mark Vye VP, Specialty Care Ops. 30.00 30.00 X 318124 0 59969 Susan Barrett VP, Primary Care Ops. 30.00 30.00 X 321266 0 36231 Carla Nunziante VP, Growth & Acquisitions 30.00 30.00 X 258079 0 63029 Ellen Liquindoli VP, Finance (Thru 2/2020) 30.00 30.00 X 0 280375 35721 Diana Caffarena Chief Oper. Officer (Thru 2/2020) 30.00 30.00 X 250176 0 31067 8321157 3429650 1174453 728 1 1 0 Locumtenens Holdings LLC PO Box 405547 Atlanta GA 30384 Staffing Services 4681042 CDW LLC 300 North Milwuakee Avenue Vernon Hills IL 60061 Information Technology Services 1482814 Propicius BioSolutions LLC 10 Jordan Lane Unionville CT 06085 Staffing Services 1183172 J Morrissey & Company Inc 289 Broad Street Windsor CT 06095 Staffing Services 1146018 FIP Construction Inc 1536 New Britain Ave Farmington CT 06032 Construction Services 803259 35 169219 169219 Net Patient Care 624100 202677404 202677404 202677404 554798 0 554798 554798 554798 47905 -47905 -47905 -47905 203353516 202677404 0 506893 X 1312436 835074 477362 76732577 68182020 8550557 5964862 5274872 689990 5677931 5021132 656799 5138624 4447988 690636 128864 128864 23592562 23592562 20147 20147 4440354 4021250 419104 2505932 1478500 1027432 25717944 24703602 1014342 829373 657420 171953 370096 349493 20603 26937838 19791026 7146812 2565095 2424108 140987 1960918 1960918 Medical Supplies 16526345 16526345 Dues, Subs & Licenses 1427215 1403471 23744 Repairs & Maintenance 1404575 1385942 18633 Misc Expense 40233 36130 4103 44998 3041 41957 203338919 182115041 21223878 0 9703523 8164511 15619836 15644465 2005917 2705933 542177 3226623 39316629 9872568 27800399 29444061 41064274 94457246 96736126 153642839 22957690 14580624 46367762 101318121 69325452 115898745 X 27408874 37741794 1800 2300 27410674 37744094 96736126 153642839 X 14597 10318823 X 0 1 X 1 1 1 X 163246 167417 169219 499882 124582209 140775450 269528557 286593882 202677403 1024157501 124582209 140775450 269691803 286761299 202846622 1024657383 0 0 0 1024657383 319442 570809 594898 554798 2039947 319442 570809 594898 554798 2039947 124582209 141094892 270262612 287356197 203401420 1026697330 0.99800 0.99840 0.00200 0.00160 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 10811349 3555050 7256299 9590990 6317518 3273472 18914290 18914290 29444061 Security Deposits 124066 Malpractice Insurance 27601533 SERP Asset 15413792 Due from Affiliates 3702770 Other Assets - Operating Lease 47615085 94457246 Accrued Pension Plan 15413792 Other Liabilities - Opearting Lease 55146772 Accrued Malpractice Insurance 27601533 Patient Refunds 3156024 101318121 South Asia 0 0 Program Services Indexing Services 37939 0 0 0 0 0 0 37939 0 37939 0 0 0 0 0 0 Part III Accounting Method: Sch F, Part II, Line 1 The indexing services are being reorted on cash basis. 0 1 0 0 0 0 0 1 0 Sabet Hashim MD Physician 1291195 0 500550 0 1714 0 19600 0 62014 0 1875073 0 0 0 Michael Daglio Director 0 733234 0 319459 0 5989 0 122154 0 59971 0 1240807 0 0 Robert Hagberg MD Chair Dept Cardiac Surgery 957204 0 150550 0 39863 0 19600 0 54121 0 1221338 0 0 0 Brendan Killory MD Neurosurgeon 1098592 0 550 0 35616 0 19600 0 52540 0 1206898 0 0 0 Edward Hannoush MD General Surgeon 1105372 0 550 0 11491 0 19600 0 53865 0 1190878 0 0 0 Paul Schwartz MD Neurosurgeon 822462 0 211724 0 552 0 19600 0 48745 0 1103083 0 0 0 Jeffrey Cohen MD Chair 0 634152 0 243711 0 67350 0 19600 0 70322 0 1035135 0 0 Vincent DiBattista Former Director & President 0 513422 0 242714 0 59397 0 87533 0 48803 0 951869 0 0 Mark Prete Vice Chair & President 400000 0 123036 0 5940 0 19600 0 22670 0 571246 0 0 0 Cynthia Heller Director 318535 0 95023 0 2993 0 19600 0 38609 0 474760 0 0 0 David Baranik VP, Finance 0 256992 0 69291 0 3564 0 19600 0 50689 0 400136 0 0 Mark Vye VP, Specialty Care Ops. 248618 0 68236 0 1270 0 19600 0 40369 0 378093 0 0 0 Susan Barrett VP, Primary Care Ops. 251161 0 67783 0 2322 0 19600 0 16631 0 357497 0 0 0 Carla Nunziante VP, Growth & Acquisitions 198391 0 58659 0 1029 0 18882 0 44147 0 321108 0 0 0 Ellen Liquindoli VP, Finance (Thru 2/2020) 0 217945 0 61417 0 1013 0 18710 0 17011 0 316096 0 0 Diana Caffarena Chief Oper. Officer (Thru 2/2020) 197651 0 52114 0 411 0 17521 0 13546 0 281243 0 0 0 Part I, Line 3 The Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare on behalf of Hartford HealthCare Medical Group, Inc., hires an outside consultant, Human Resources and Compensation Consulting Practice of Gallagher to determine best practices in governing executive compensation. Please refer to compensation narrative reported on Schedule O. Part I, Line 4b Hartford Healthcare Corporation, a related organization, maintains a 457(f) Supplemental Executive Retirement Plan (SERP). Participants include certain officers and key employees at the President & CEO, Executive Vice President and Senior Vice President levels that are reported by Hartford HealthCare Medical Group, Inc. on its Form 990, Part VII. Contributions are made by Hartford HealthCare Corporation to the plan based on a percentage of the participant's compensation. Participants vest in the plan at the earlier of reaching age 55 and having 5 years of service, death, disability, involuntary separation without reasonable cause, upon reaching age 65 or the occurrence of a change in control. Each participant ceases to be eligible for further contributions by Hartford Healthcare Corporation on the date of the participant's separation from service. Participants receive a one-time lump sum payment of the accumulated amount during the 30-day period following the participant's separation from service. 2019 SERP Accruals were made on behalf of the following individuals: Vincent DiBattista $67,933 Michael Daglio $102,554 Part I, Line 7 Hartford HealthCare Corporation, a related organization, has a Compensation At Risk Plan that encourages and rewards achievements of significant functional goals. These goals contribute to the organization's strategic and financial direction. The plan utilizes market practice alignment to ensure competitive recruitment and retention. Awards are based on CEO and/or Hartford HealthCare Corporation's Compensation Committee discretionary assessment of overall organization performance and individual contribution to results. Form 990, Part VI, Section A, line 1 The organization does not have any independent board members as all board members are compensated for their service to the organization either by the organization itself or by a related organization - HHC. The Foundation is a member of an integrated healthcare delivery system which includes multiple tax-exempt hospitals that have community boards. Form 990, Part VI, Section A, line 6 Hartford HealthCare Medical Group, Inc. is organized as a non-stock not for profit entity. Hartford HealthCare Corporation is the sole member. Form 990, Part VI, Section A, line 7a The sole member of the organization has the authority to approve/remove members of the governing body. Form 990, Part VI, Section A, line 7b The sole member of the organization has the right to review, approve, disapprove and deny significant transactions such as mergers, acquisitions, dissolutions etc. Form 990, Part VI, Section B, line 11b The Form 990 was prepared by Hartford HealthCare's Tax Department. The Form was then forwarded to the VP of Finance for review. The final Form was provided to the entire Board prior to submission to the Internal Revenue Services (IRS). Once the entire review process was completed, the Form was signed and then filed with the IRS. Form 990, Part VI, Section B, line 12c The organization's board has adopted the policy of the member, Hartford HealthCare Corporation (HHC). HHC's Conflict of Interest Policy (Policy) requires all covered individuals, including board members and officers, to provide a disclosure of relationships that create or have the appearance of creating a conflict of interest or commitment. The Policy requires updates if changes in circumstances arise during the year that either (a) create a new potential conflict of interest or commitment or (b) change or eliminate a conflict of interest or commitment previously disclosed. Conflict of interest disclosure statements are maintained by the HHC Office of Compliance and Integrity (OCI). Employee disclosures are reviewed by OCI in collaboration with the Covered Individuals' supervisor when deemed appropriate, to determine if there is a potential conflict. Oversight review of employee disclosures is provided by the HHC Conflict of Interest Committee. The Conflict of Interest Committee assesses and may recommend the conflicting interest either be (a) eliminated for continued relationship with HHC/HHC Affiliate, or, (b) managed through a management plan. Oversight review of physician disclosures is provided by the HHC Physician Conflict Resolution Committee. The Physician Conflict Resolution Committee assesses and may recommend the conflicting interest either be (a) eliminated for continued relationship with HHC/HHC Affiliate, or, (b) managed through a management plan. Board member disclosures are reported to the HHC Nominating and Governance Committee for determinations of conflicts and the management of them, where applicable. Form 990, Part VI, Section B, line 15 The Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare on behalf of Hartford HealthCare Medical Group, Inc., hires an outside consultant, Human Resources and Compensation Consulting Practice of Gallagher to determine best practices in governing executive compensation. The following steps were taken: - The use of an Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare, on behalf of Hartford HealthCare Medical Group, Inc., established and regularly reviews Executive Compensation Philosophy; - The Committee regularly reviews scope and depth of positions taking into account complexity and the financial impact and accountability of all "disqualified persons; - National peer groups are selected for comparative purposes based on organizational size, operating revenue, geography and other relevant factors; - Analysis of current total compensation versus market is performed by independent third party compensation consulting firm and is then reviewed by the committee; - Recommendations are made based on market data analysis to ensure appropriate competitive positioning within parameters of compensation philosophy; -The CEO compensation is reviewed by the Committee and is based on comparative market information and organizational performance; - All changes are reviewed and approved by the Executive Compensation Committee; The compensation determination process for the CEO is reviewed on an annual basis. All other executive compensation is regularly reviewed for scope and depth of positions taking into account complexity and the financial impact and accountability. Form 990, Part VI, Section C, line 18 The Organization's Form 990, Form 990-T, Form 1023 and its attachments are available for public inspection at the organization's address upon request. Form 990, Part VI, Section C, line 19 The Organization's Financial Statements, Governing Documents and the Conflict of Interest Policy are available for inspection upon request at the Organization's address. Form 990, Part IX, line 11g Medical Professional Fees: Program service expenses 23,592,562. Management and general expenses 0. Fundraising expenses 0. Total expenses 23,592,562. Form 990, Part XI, line 9: Transfer to Affiliated Entities 10,318,823. 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Partnership 100 Grand Street New Britain CT 06050 061271349 Magnetic resonance imaging CT N/A Rocky Hill Surgery Center LLC 1111 Cromwell Avenue Building 1 Rocky Hill CT 06067 833096156 Surgery Svcs CT N/A The Endoscopy Center of Northwest Connecticut LLC 245 Alvord Park Road Torrington CT 06790 061609993 Endoscopy Svcs CT N/A Wallingford Endoscopy Center LLC 85 Seymour Street Suite 1000 Hartford CT 06106 824601730 Endoscopy Svcs CT N/A Aetna Ambulance Service Inc PO Box 1150 Manchester CT 06045 060795431 Ambulance Services CT N/A C 1 Backus Medical Center Condo Assoc Inc 330 Washington Street Norwich CT 06360 061542647 Condo Association CT N/A C 1 CenConn Services Inc 100 Grand Street New Britain CT 06050 222836001 Billing Services CT N/A C 1 ConnCare Inc 326 Washington Street Norwich CT 06360 061387598 Health Care Services CT N/A C 1 HHMOB Corporation 80 Seymour Street PO Box 5037 Hartford CT 06102 061140244 Real Estate & Parking CT N/A C 1 Hartford HealthCare Indemnity Services Ltd 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