2021-08-12T10:21:22-05:00 2020-09-30 ERNST & YOUNG US LLP 1 MANHATTAN WEST NEW YORK NY 10001 990 2019-10-01 271648289 STAMFORD HEALTH MEDICAL GROUP INC % MICHAEL VEILLETTE STAM 2032767447 One Hospital Plaza PO Box 9317 STAMFORD CT 06904 MICHAEL VEILLETTE SVP/CFO 2032761000 2021-08-10 true NICOLE M SOKOLOWSKI P01683199 2127733000 2019 2022-09-23 18:48:47Z MICHAEL VEILLETTE ONE HOSPITAL PLAZA Stamford CT 06904 87008699 false X www.stamfordhealth.org/shmg/ X 2009 CT SUPPORTS THE PROVISION OF PHYSICIAN serVICES AND OTHER HEALTH PRACTITIONER SERVICES TO THE RESIDENTS OF the COMMUNITIES SERVED BY STAMFORD HOSPITAL AFFILIATED ORGANIZATIONS. 8 0 672 0 0 0 0 1395300 68573429 71932499 0 0 12399571 13680900 80973000 87008699 0 0 0 0 90397405 98637038 0 0 0 34538595 36651433 124936000 135288471 -43963000 -48279772 36789077 80733069 27520037 80926099 9269040 -193030 SUPPORTS THE PROVISION OF PHYSICIAN SERVICES AND OTHER HEALTH PRACTITIONER SERVICES TO THE RESIDENTS OF THE COMMUNITIES SERVED BY STAMFORD HOSPITAL AND AFFILIATED ORGANIZATIONS. false false 105044149 1395300 84381814 STAMFORD HEALTH MEDICAL GROUP INC. PROVIDES A COMPREHENSIVE ARRAY OF MANAGEMENT SERVICES IN SUPPORT OF PHYSICIAN PRACTICES. 105044149 true false false false false false false false false false true false false true true false false true false false false false false false false false false false false true false false false false false false false false false false false false false true true true false false true 89 0 true 672 true false false false false false false false false false false false false X 8 0 false false false false true true true true true false false true true true true true true true true false X MICHAEL VEILLETTE 2032761000 ONE HOSPITAL PLAZA Stamford CT 06904 Rodrigo Acosta MD President & Chairman 38.0 2.0 X X 897387 0 53635 William Symons MD Physician 38.0 2.0 X 892369 0 26985 Arghiris Barbadimos MD Physician 38.0 2.0 X 832906 0 27469 John Dowdle MD Physician Director 38.0 2.0 X 775811 0 54857 Andrea Douglas MD Physician 38.0 2.0 X 765039 0 45978 Charles Rosenstein MD Physician 38.0 2.0 X 766175 0 31385 Craig Olin MD Physician Director 38.0 2.0 X 744831 0 23847 Scott Weiss MD Physician 38.0 2.0 X 716398 0 27197 Michael Ebright MD Physician Director 38.0 2.0 X 622303 0 26197 William Hines MD Chief Medical Officer 38.0 2.0 X 462517 0 51985 Gerald B Rakos MD Physician Director (STX) 2.0 38.0 X 467716 0 4635 Ben Wade Sr. VP Strategy & Marketing 2.0 38.0 X 0 449342 17720 Elizabeth Longmore Chief Operating Officer 38.0 2.0 X 377960 0 0 Joseph Costanzo MD Physician Treasurer 38.0 2.0 X X 331211 0 44523 Allison Ostroff MD Physician Director 38.0 2.0 X 324911 0 24697 Ann Williams MD Physician Director 38.0 2.0 X 302184 0 33176 Fortrella Cummings Former Officer - CFO 0.0 0.0 X 171737 0 0 Kevin Gage Former Treasurer/CFO 2.0 38.0 X 123537 0 0 Jonathan Immordino SHMG CFO 38.0 2.0 X 47019 0 5288 Michael Veillette CFO, SVP - FINANCE 2.0 38.0 X 0 0 0 9622011 449342 499574 170 true true false PULMONARY ASSOCIATES OF STAMFORD 29 HOSPITAL PLAZA SUITE 505 STAMFORD CT 06902 PHYSICIAN FEES 3400375 ECLINICALWORKS LLC PO BOX 847950 BOSTON MA 02284 CAP/SYSTEM & SUPPORT 1506857 KPMG LLP PO BOX 120511 DALLAS TX 753120511 INTERNAL AUDIT SRVCS 648552 COLLIERS INTERNATIONAL CT LLC 666 FIFTH AVENUE NEW YORK NY 10103 PROPERTY MANAGEMENT 185628 Physicians For Womens's Health LLC 22 Waterville Rd AVON CT 06001 PHYSICIAN SERVICES 120000 6 1395300 1395300 MEDICARE 621110 24413872 24413872 PHYSICIAN BILLING 621110 47518627 47518627 71932499 0 0 0 1231585 1231585 0 1231585 1231585 0 0 0 0 0 0 0 0 0 0 INTERCOMPANY STAFFING REIMBURSEMENTS 900099 12344558 12344558 MEDICAL RECORDS ABSTRACTS 900099 25804 25804 RETAIL SALES 900099 75424 75424 3529 3529 12449315 87008699 84381814 1231585 0 0 0 0 6258565 4680883 1577682 0 78929906 67023388 11906518 0 9256147 5320186 3935961 4192420 3631798 560622 213998 213998 284107 284107 78158 78158 0 0 0 10269145 5647535 4621610 739281 4892 734389 2244932 676997 1567935 29840 14675 15165 0 9673028 8446206 1226822 76937 76937 0 0 0 0 3538488 2826863 711625 2377708 2358531 19177 MEDICAL EXPENSES 3748144 3748144 SERVICE CONTRACTS 2788385 148039 2640346 NON-COLLEGE EDUCATION 547719 484709 63010 LICENSE FEES 7531 4120 3411 34032 27183 6849 135288471 105044149 30244322 0 0 0 5492794 5511821 0 0 8163906 9119157 0 0 0 0 0 0 0 0 395797 381371 36011207 16752108 22269301 19259099 0 0 0 0 0 0 0 0 467279 46461621 36789077 80733069 16635489 25852364 0 0 3190205 131691 0 0 0 0 0 0 0 0 0 0 7694343 54942044 27520037 80926099 X 9269040 -193030 0 0 9269040 -193030 36789077 80733069 X -48279772 38817702 X false true X true false X 0 0 0 0 1395300 1395300 57926345 62529436 72410927 79674194 84277057 356817959 0 0 0 57926345 62529436 72410927 79674194 85672357 358213259 0 0 0 358213259 468558 737161 1147767 1213143 1231585 4798214 0 468558 737161 1147767 1213143 1231585 4798214 0 78077 111972 75306 85663 104757 455775 58472980 63378569 73634000 80973000 87008699 363467248 0.98555 0.98730 0.01320 0.01130 X 23924620 9406083 14518537 11730079 7346025 4384054 356508 356508 19259099 OPERATING LEASE ASSETS, NET 45890428 INVENTORY 526707 DEPOSITS 44486 46461621 0 DUE TO AFFILIATES - SHI 8425152 OPERATING LEASE LIABILITY 45865103 OTHER LONG TERM LIABILITIES 651789 54942044 X true true X X X X X true false false false false false false false false William Symons MD Physician 891229 0 0 1140 0 19000 0 7985 0 919354 0 0 0 Rodrigo Acosta MD President & Chairman 657538 126233 0 113616 0 43000 0 10635 0 951022 0 0 0 Arghiris Barbadimos MD Physician 779870 45512 0 7524 0 22000 0 5469 0 860375 0 0 0 John Dowdle MD Physician Director 770139 770 0 4902 0 44000 0 10857 0 830668 0 0 0 Andrea Douglas MD Physician 763899 0 0 1140 0 38000 0 7978 0 811017 0 0 0 Charles Rosenstein MD Physician 759065 1566 0 5544 0 23400 0 7985 0 797560 0 0 0 Craig Olin MD Physician Director 520921 221978 0 1932 0 13000 0 10847 0 768678 0 0 0 Scott Weiss MD Physician 715262 0 0 1136 0 19000 0 8197 0 743595 0 0 0 Michael Ebright MD Physician Director 571817 48776 0 1710 0 18000 0 8197 0 648500 0 0 0 William Hines MD Chief Medical Officer 401723 46583 0 14211 0 44000 0 7985 0 514502 0 0 0 Elizabeth Longmore Chief Operating Officer 347952 0 0 30008 0 16800 0 8197 0 402957 0 0 0 Joseph Costanzo MD Physician Treasurer 325111 1856 0 4244 0 23200 0 21323 0 375734 0 0 0 Allison Ostroff MD Physician Director 324161 0 0 750 0 14000 0 10697 0 349608 0 0 0 Ann Williams MD Physician Director 298500 0 0 3684 0 25000 0 8176 0 335360 0 0 0 Fortrella Cummings Former Officer - CFO 0 0 0 171737 0 0 0 0 0 171737 0 0 0 Ben Wade Sr. VP Strategy & Marketing 0 364813 0 43391 0 41138 0 12788 0 4932 0 467062 0 0 Gerald B Rakos MD Physician Director (STX) 428893 38823 0 0 0 2400 0 2235 0 472351 0 0 0 Kevin Gage Former Treasurer/CFO 0 62451 0 61086 0 0 0 0 0 123537 0 0 0 SCHEDULE J, PART I, LINE 1A President & Chairman - RODRIGO ACOSTA Taxable Gross Up Payment - $5,547 CFO - ELIZABETH LONGMORE: TAXABLE GROSS UP PAYMENT - $13,165 HOUSING PAYMENT: $11,240 SR. VP STRATEGY & MARKETING - BEN WADE TAXABLE GROSS UP PAYMENT - $1,920 GROSS-UP PAYMENTS, PER POLICY, ARE PROCESSED ON ALL TAXABLE BENEFITS. HOUSING IS PAID FOR ELIZABETH LONGMORE, CFO. SCHEDULE J, PART I, LINE 4A CHIEF FINANCIAL OFFICER - FORTRELLA CUMMINGS SEVERANCE PAYMENT: $171,737 FORM 990, PART VI, LINE 6 STAMFORD HEALTH MEDICAL GROUP ('SHMG') IS A CONNECTICUT NONSTOCK CORPORATION. SHMG HAS TWO CLASSES OF MEMBERS. CLASS A MEMBERS ARE THE PHYSICIANS EMPLOYED BY SHMG. THE CLASS B MEMBER IS THE STAMFORD HOSPITAL. FORM 990, PART VI, LINE 7A THE BOARD OF DIRECTORS SHALL TOTAL EIGHT MEMBERS. THE INITIAL BOARD WAS SELECTED BY THE INCORPORATOR, AND THEREAFTER THE BOARD WILL BE ELECTED AS FOLLOWS: (A) SEVEN MEMBERS OF THE BOARD OF DIRECTORS SHALL BE ELECTED BY THE CLASS A MEMBERS, SUBJECT TO THE APPROVAL OF THE CLASS B MEMBER, AND (B) ONE MEMBER OF THE BOARD OF DIRECTORS SHALL BE APPOINTED BY THE CLASS B MEMBER. FORM 990, PART VI, LINE 7B ALL POWERS OF SHMG SHALL BE EXERCISED BY AND UNDER THE AUTHORITY OF THE BOARD OF DIRECTORS, EXCEPT THAT THE CLASS B MEMBER SHALL HAVE THE SOLE AUTHORITY TO AMEND THE BYLAWS OF SHMG AND SELECT THE AUDITORS OF SHMG. FORM 990, PART VI, LINE 11B STAMFORD HEALTH MEDICAL GROUP (SHMG) HAS A COMPREHENSIVE REVIEW PROCESS IN PLACE RELATING TO THE REVIEW OF FORM 990. PRIOR TO FINALIZATION OF THE 990, MANAGEMENT PROVIDES THE DRAFT OF THE FORM 990 TO THE BOARD OF DIRECTORS. SHMG'S EXTERNAL TAX ACCOUNTANTS ADDRESS ANY SPECIFIC CONCERNS OR QUESTIONS WITH MANAGEMENT AND THE BOARD. THIS REVIEW PROCEDURE HELPS TO ASSURE SOUND REPORTING AND COMPLIANCE WITH TAX LAW. FORM 990, PART VI, LINE 12C SHMG, AS A WHOLLY OWNED SUBSIDIARY OF THE STAMFORD HOSPITAL, FOLLOWS THE HOSPITAL'S CONFLICT OF INTEREST POLICY. IT IS THE POLICY TO PROHIBIT ITS EMPLOYEES AND OTHER ASSOCIATES FROM ENGAGING IN ANY ACTIVITY, PRACTICE, OR ACT WHICH CONFLICTS WITH, OR APPEARS TO CONFLICT WITH, THE INTERESTS OF THE ORGANIZATION. EMPLOYEES ARE EXPECTED TO CONDUCT THE BUSINESS OF SHMG TO THE BEST OF THEIR ABILITY AND FOR THE BENEFIT OF SHMG AND ITS PATIENTS. THE POLICY ALSO REQUIRES BOARD MEMBERS, OFFICERS, SENIOR LEADERS, MEDICAL STAFF LEADERS, COMMITTEE MEMBERS AND OTHER INDIVIDUALS AS APPROPRIATE TO DISCLOSE ANY POTENTIAL CONFLICT OF INTEREST THEY OR THEIR IMMEDIATE FAMILY MAY HAVE ON AN ANNUAL BASIS. SURVEYS ARE DISTRIBUTED ANNUALLY AND TIMELY RECEIPT IS MONITORED BY THE HOSPITAL'S COMPLIANCE DEPARTMENT. FORM 990, PART VI, LINES 15A & 15B IT IS THE POLICY OF SHMG TO PAY EMPLOYEES FAIR AND COMPETITIVE WAGES. SHMG HAS ADOPTED A WAGE AND SALARY PROGRAM TO ENSURE THAT ALL EMPLOYEES ARE PAID IN RELATION TO THE VALUE OF THE WORK THEY PERFORM. THIS PROGRAM IS REVIEWED ANNUALLY. EXECUTIVE COMPENSATION IS SUBJECT TO A MORE COMPREHENSIVE REVIEW, INCLUDING AN ANNUAL BENCHMARKING ANALYSIS. FORM 990, PART VI, LINE 19 SHMG MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9 EQUITY TRANSFER FROM STAMFORD HOSPITAL DEBT FORGIVENESS $38,817,702 TOTAL $38,817,702 STAMFORD HEALTH INC ONE HOSPITAL PLZ PO BOX 9317 STAMFORD CT 06904 222476636 PARENT CT 501(c)(3) 12A na false THE STAMFORD HOSPITAL FOUNDATION ONE HOSPITAL PLZ PO BOX 9317 STAMFORD CT 06904 222478748 FUNDRAISING CT 501(c)(3) 10 SHI true THE STAMFORD HOSPITAL ONE HOSPITAL PLZ PO BOX 9317 STAMFORD CT 06904 060646917 HOSPITAL CT 501(c)(3) 3 SHI true false false false false false false false false false true true false false false true false false false true Stamford Health Inc k 730810 Book Value The Stamford Hospital k 1055108 Book Value The Stamford Hospital j 1237639 Book Value The Stamford Hospital o 232752 Book Value The Stamford Hospital s 38817702 Book Value