2021-02-15T14:41:03-06:00 2020-09-30 390859910 BAKER TILLY US LLP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2019-10-01 222627346 MILFORD HEALTH & MEDICAL INC MILF 2033011634 300 SEASIDE AVENUE MILFORD CT 06460 LAURA SMITH CHIEF FINANCIAL OFFICER/VP FINANCE 2033011634 2021-02-13 1 KERRI N BOGDA CPA P00760402 7177404863 2019 2022-09-23 18:48:47Z LAURA SMITH 300 SEASIDE AVENUE MILFORD CT 06460 3 0 X N/A X 1987 CT TO EFFECTIVELY AND EFFICIENTLY PROVIDE HIGH QUALITY HEALTHCARE SERVICES. 3 3 0 0 0 0 1900859 0 0 0 172517 3 0 0 2073376 3 0 0 0 0 0 0 0 0 0 468834 831046 468834 831046 1604542 -831043 10930162 2871241 6959944 2871241 3970218 0 TO EFFECTIVELY AND EFFICIENTLY PROVIDE HIGH QUALITY HEALTHCARE SERVICES. 0 0 0 0 0 EFFECTIVE JUNE 9, 2019, THE HOSPITAL SOLD SUBSTANTIALLY ALL ASSETS AND TRANSFERRED CERTAIN LIABILITIES USED IN OR INCIDENTAL TO THE CONDUCT OF THE BUSINESS TO YALE-NEW HAVEN HEALTH SERVICES CORPORATION AND BRIDGEPORT HOSPITAL ("THE BUYER"), AND THIS REPORTING ENTITY WILL NO LONGER OPERATE. THE OPERATIONS OF THIS REPORTING ENTITY, HOWEVER, WILL CONTINUE UNDER THE CONTROL OF THE BUYER, WHICH IS UNRELATED TO THE COMPANY. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 15 0 0 0 1 CJ 0 0 0 0 0 0 0 0 0 0 X 3 3 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X LAURA SMITH CFOVP FINANCE 2033011634 300 SEASIDE AVENUE MILFORD CT 06460 LAURA SMITH VP FINANCE & CFO 2.00 38.00 X 0 89896 14769 MARK TONEY PRESIDENT/CEO/CRO 10.00 30.00 X 0 0 0 SAMUEL S BERGAMI JR CHAIR 1.00 2.00 X X 0 0 0 LOUIS D'AMATO VICE CHAIR (UNTIL 11/2019) 1.00 1.00 X X 0 0 0 RICHARD MEISENHEIMER TREASURER (UNTIL 11/2019) 1.00 1.00 X X 0 0 0 MICHAEL SAFFER ESQ SECRETARY (UNTIL 11/2019) 1.00 1.00 X X 0 0 0 NANCY BENNETT DIRECTOR 1.00 1.00 X 0 0 0 ARMAND CANTAFIO DIRECTOR 1.00 1.00 X 0 0 0 JAMES BEARD DIRECTOR (UNTIL 11/2019) 1.00 1.00 X 0 0 0 LEO CARROLL ESQ DIRECTOR (UNTIL 11/2019) 1.00 1.00 X 0 0 0 BRADFORD GESLER DIRECTOR (UNTIL 11/2019) 1.00 1.00 X 0 0 0 LEN NAPOLI JR DIRECTOR (UNTIL 11/2019) 1.00 1.00 X 0 0 0 ANN LOESCH DIRECTOR (UNTIL 11/2019) 0.50 0.50 X 0 0 0 CAROL MCINNIS DIRECTOR (UNTIL 11/2019) 0.50 0.50 X 0 0 0 RAYMOND S OLIVER DIRECTOR (UNTIL 11/2019) 0.50 0.50 X 0 0 0 GARY OPIN DMD DIRECTOR (UNTIL 11/2019) 0.50 0.50 X 0 0 0 RONALD SILVERBERG DIRECTOR (UNTIL 11/2019) 0.50 0.50 X 0 0 0 JOY TOPAZIAN MOORE ESQ DIRECTOR (UNTIL 11/2019) 0.50 0.50 X 0 0 0 VIJAY CHHABRA MD MEDICAL STAFF PRESIDENT (UNTIL 11/2019) 0.50 1.00 X 0 0 0 SUZANNE BELIVEAU AUXILIARY PRESIDENT (UNTIL 11/2019) 0.50 0.50 X 0 0 0 ROBERT LEWIS MD NON-VOTING MEDICAL STAFF REPRESENTATIVE (UNTIL 11/2019) 0.50 0.50 X 0 0 0 0 89896 14769 0 0 0 0 TONEYKORF PARTNERS LLC 1595-14 NORTH CENTRAL AVE VALLEY STREAM NY 11580 CONSULTING/REORGANIZATION SERVICES 472505 CARMODY TORRANCE 50 LEAVENWORTH STREET WATERBURY CT 06721 LEGAL SERVICES 224737 NORTON ROSE FULBRIGHT US LLP PO BOX 122613 DALLAS TX 75312 LEGAL SERVICES 180948 BAKER TILLY VIRCHOW KRAUSE LLP PO BOX 78975 MILWAUKEE WI 53278 ACCOUNTING SERVICES 118168 4 3 3 3 0 0 3 X 248430 248430 208740 208740 351904 351904 4752 4752 TAXES 17220 17220 831046 0 831046 0 6959944 2871241 3970218 0 10930162 2871241 6959944 2871241 6959944 2871241 X 3970218 0 3970218 0 10930162 2871241 X -831043 -3139175 X 0 0 0 X X X 1 THE MILFORD HOSPITAL INC 060646741 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 PART IV, SECTION A, LINE 1: MILFORD HEALTH & MEDICAL'S BYLAWS STATE THAT IT SUPPORTS THE MILFORD HOSPITAL AND "OTHER SIMILARLY TAX-EXEMPT ORGANIZATIONS". 0 DUE TO YALE 2871241 2871241 FORM 990, PART V, LINE 2: MILFORD HEALTH & MEDICAL DOES NOT HAVE ANY OF ITS OWN EMPLOYEES PROVIDING SERVICES TO THE ORGANIZATION. THE ORGANIZATION DOES NOT FILE ITS OWN FORM W-3. THE EMPLOYEES PROVIDING SERVICES TO MILFORD HEALTH & MEDICAL ARE EMPLOYED BY THE MILFORD HOSPITAL, A RELATED TAX-EXEMPT ENTITY. THESE EMPLOYEES RECEIVE A W-2 FROM THE MILFORD HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY MANAGEMENT OF THE MILFORD HOSPITAL AND SENT BY SECURE E-MAIL TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C PRIOR TO THE SALE OF ASSETS, CONFLICT OF INTEREST QUESTIONNAIRES ARE SENT TO OFFICERS, DIRECTORS, AND KEY EMPLOYEES ANNUALLY. THE COMPLETED QUESTIONNAIRES WERE REVIEWED BY THE PRESIDENT. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION DOES NOT DIRECTLY EMPLOY TOP MANAGEMENT OFFICIALS OR ANY OFFICERS OR KEY EMPLOYEES. THE OFFICERS LISTED IN PART VII ARE EMPLOYED BY MILFORD HOSPITAL AND ARE SUBJECT TO THE COMPENSATION PROCESS IN PLACE BY THAT ENTITY. THE HOSPITAL BOARD OF DIRECTORS APPROVES THE COMPENSATION OF OFFICERS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND THE FINANCIAL STATEMENTS WERE KEPT IN A SECURED OFFICE AND ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G CONSULTANTS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 341,728. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 341,728. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 10,176. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,176. FORM 990, PART XI, LINE 9: NET CHANGE IN VALUE OF INVESTMENT IN SIAC -3,970,218. ADJUSTMENT TO DUE TO AFFILIATE 831,043. THE MILFORD HOSPITAL INC 300 SEASIDE AVENUE MILFORD CT 06460 060646741 HOSPITAL SERVICES CT 501(C)(3) LINE 3 MILFORD HEALTH & MEDICAL INC 1 MILFORD HEALTH CARE SERVICES INC 300 SEASIDE AVENUE MILFORD CT 06460 222627353 HEALTH CARE SERVICES CT 501(C)(3) PF MILFORD HEALTH & MEDICAL INC 1 MILFORD HOSPITAL FOUNDATION INC 300 SEASIDE AVENUE MILFORD CT 06460 222627350 FUNDRAISING CT 501(C)(3) PF MILFORD HEALTH & MEDICAL INC 1 SEABRIDGE CORPORATION 300 SEASIDE AVENUE MILFORD CT 06460 222626962 OTHER MEDICAL SERVICES CT MILFORD HEALTH & MEDICAL INC C 1.00000 1 MILFORD MEDICAL LABORATORY INC 300 SEASIDE AVENUE MILFORD CT 06460 066368893 LAB SERVICES CT MILFORD HEALTH & MEDICAL INC C 1.00000 1 TORRY CORPORATION 300 SEASIDE AVENUE MILFORD CT 06460 010724230 RENTAL REAL ESTATE CT MILFORD HEALTH & MEDICAL INC C 1.00000 1 SEASIDE INDEMNITY ALLIANCE LTD 300 SEASIDE AVENUE MILFORD CT 06460 LIABILITY INSURANCE CJ MILFORD HEALTH & MEDICAL INC C 1.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 SEASIDE INDEMNITY ALLIANCE LTD R 2436524 CASH TRANSFER