STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

MIDDLESEX HOSPITAL: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
MIDDLESEX HOSPITAL (EIN 06-0646718)
Tax period
2019-10-01 to 2020-09-30
Filed
2021-07-15
IRS object ID
202131969349301783
Schema version
2019v5.2
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)
Return2021-07-15T14:40:06-05:00ReturnTs
Tax Period End2020-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN111986323PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1MARCUM LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1555 LONG WHARF DRIVEAddressLine1Txt
CityNEW HAVENCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06511ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN060646718EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MIDDLESEX HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMIDDBusinessNameControlTxt
Phone8603586395PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line128 CRESCENT STREETAddressLine1Txt
CityMIDDLETOWNCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06457ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSUSAN MARTINPersonNm
Person TitleVP FINANCE & TREASURERPersonTitleTxt
Phone8603586395PhoneNum
Signature2021-07-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMARY ANTONETTIPreparerPersonNm
PTINP00431862PTIN
Phone2037819600PhoneNum
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerVINCENT CAPECE JRPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line128 CRESCENT STREETAddressLine1Txt
CityMIDDLETOWNCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06457ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$481,015,792GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MIDDLESEXHOSPITAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1895FormationYr
Legal Domicile StateCTLegalDomicileStateCd
Activity Or MissionA NON-PROFIT, ACUTE CARE, COMMUNITY HOSPITAL IN MIDDLETOWN, CT. (SEE SCHEDULE O)MIDDLESEX HOSPITAL IS COMMITTED TO PROVIDING HIGH QUALITY INPATIENT AND OUTPATIENT HEALTHCARE SERVICES. THE HOSPITAL RECOGNIZES COMMUNITY TRANSPARENCY AND INTEGRITY AS FUNDAMENTAL RESPONSIBILITIES.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee3602TotalEmployeeCnt
Total Volunteers480TotalVolunteersCnt
Total Gross UBI$2,279,374TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$80,244NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$5,787,866PYContributionsGrantsAmt
CY Contributions Grants$5,676,067CYContributionsGrantsAmt
PY Program Service Revenue$432,247,273PYProgramServiceRevenueAmt
CY Program Service Revenue$425,748,491CYProgramServiceRevenueAmt
PY Investment Income$9,557,248PYInvestmentIncomeAmt
CY Investment Income$7,476,106CYInvestmentIncomeAmt
PY Other Revenue$5,078,880PYOtherRevenueAmt
CY Other Revenue$5,916,024CYOtherRevenueAmt
PY Total Revenue$452,671,267PYTotalRevenueAmt
CY Total Revenue$444,816,688CYTotalRevenueAmt
PY Grants And Similar Paid$92,500PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$127,025CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$231,814,364PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$239,978,052CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$1,083,608CYTotalFundraisingExpenseAmt
PY Other Expenses$178,097,893PYOtherExpensesAmt
CY Other Expenses$179,130,254CYOtherExpensesAmt
PY Total Expenses$410,004,757PYTotalExpensesAmt
CY Total Expenses$419,235,331CYTotalExpensesAmt
PY Revenues Less Expenses$42,666,510PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$25,581,357CYRevenuesLessExpensesAmt
Total Assets BOY$528,880,049TotalAssetsBOYAmt
Total Assets EOY$619,190,364TotalAssetsEOYAmt
Total Liabilities BOY$141,997,427TotalLiabilitiesBOYAmt
Total Liabilities EOY$220,705,076TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$386,882,622NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$398,485,288NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionMIDDLESEX HOSPITAL EXISTS TO PROVIDE THE SAFEST, HIGHEST-QUALITY HEALTH CARE AND THE BEST EXPERIENCE POSSIBLE FOR OUR COMMUNITY. (CONTINUED ON SCHEDULE O)MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$372,874,584ExpenseAmt
Grant$127,025GrantAmt
Revenue$430,253,553RevenueAmt
DescIN MARCH OF 2020, MIDDLESEX HOSPITAL AS PART OF MIDDLESEX HEALTH'S COMMUNITY HEALTH AND WELL-BEING BASED WORK SHIFTED DRAMATICALLY TO ADDRESS THE COVID-19 PANDEMIC AND RESPOND TO COMMUNITY LEVEL NEEDS. MIDDLESEX HOSPITAL CONTINUES TO GO ABOVE AND BEYOND TO PROVIDE THE SAFEST POSSIBLE CARE TO ALL PATIENTS, WHETHER OR NOT THEIR ILLNESS IS RELATED TO THE CORONAVIRUS. MIDDLESEX HOSPITAL CONTINUES TO PROVIDE UPDATES AND ACCESS TO RESOURCES TO HELP MEMBERS OF THE COMMUNITY STAY SAFE AND HEALTHY DURING THESE CHALLENGING TIMES. ARMED WITH SKILLED STAFF, PROGRESSIVE DIAGNOSTIC TOOLS AND ADVANCED SURGICAL TECHNIQUES, THE HOSPITAL WAS WELL POSITIONED TO ENSURE A COMFORTABLE, SAFE ENVIRONMENT FOR EXCEPTIONAL MEDICAL TREATMENT AND RECOVERY. (CONTINUED ON SCHEDULE O)IN THE FISCAL YEAR ENDING 9/30/20, INPATIENT CARE REPRESENTED 12,004 DISCHARGES AND 51,259 PATIENT CARE DAYS. INPATIENT CARE FROM REGISTRATION THROUGH DISCHARGE IS CAREFULLY MANAGED TO EXCEED REGULATORY REQUIREMENTS AND ENSURE QUALITY, PATIENT SATISFACTION, AND BEST PRACTICE WITH EACH ASPECT OF THE INPATIENT EXPERIENCE, INCLUDING ALL ELEMENTS OF CARE FROM NURSING COMPETENCY AND COMPASSION, TO MEAL QUALITY, LAB AND DIAGNOSTIC TESTING, SAFE AND SECURE PHYSICAL SURROUNDINGS TO PATIENT EDUCATION. MIDDLESEX HOSPITAL, LICENSED FOR 275 BEDS AND 22 BASSINETS, PROVIDES ACUTE CARE FROM DEDICATED HEALTH CARE TEAMS WHICH INCLUDE SURGEONS, HOSPITALISTS, FAMILY PRACTITIONERS AND RESIDENTS, MEDICAL STAFF PHYSICIANS, MAGNET NURSES, PHYSICIAN ASSISTANTS, PATIENT CARE TECHNOLOGISTS, DIAGNOSTIC TECHNICIANS, PATHOLOGISTS, ADMINISTRATORS, ENVIRONMENTAL SERVICES, SECURITY, ENGINEERING AND A HOST OF OTHERS WORKING TOGETHER TO ENABLE THE ORGANIZATION'S SUCCESS.THE HOSPITAL UNITS INCLUDING INTENSIVE AND CRITICAL CARE, MEDICAL SURGICAL, ONCOLOGY, ORTHOPEDIC, PULMONOLOGY, VASCULAR AND CARDIOLOGY, GASTROINTESTINAL, MATERNITY, A 20-BED PSYCHIATRIC FLOOR, AND HOSPICE SERVICES SPECIALIZE IN THE SPECIFIC NEEDS OF THEIR PATIENTS AND ARE STAFFED TO ACCOMMODATE THE UNIQUE TREATMENT REQUIREMENTS OF EACH. ALL ANCILLARY SERVICS INCLUDING LABS, RADIOLOGY, FOOD SERVICES, PATHOLOGY, PHARMACY, MEDICAL TRANSCRIPTION AND INFORMATION SERVICES TOO ARE A PART OF THE HOSPITAL TEAM. PATIENT CARE IS DEVELOPED WITH FULL CONSIDERATION OF THE WHOLE INDIVIDUAL, AS THEY ARE ASSIGNED TO CONDITION SPECIFIC CARE PATHWAYS AND SERVICES TO SECURE BEST TREATMENT AND RECOVERY.Desc
Total Program Service Expenses$372,874,584TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
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 Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
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 BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntYes (1)BusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
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 Document267IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee3602EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
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 PymtYes (1)SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
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 ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldCTStatesWhereCopyOfReturnIsFldCd
Own WebsiteYes (X)OwnWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonSHANNON ST HILAIREPersonNm
Phone8603586000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line128 CRESCENT STREETAddressLine1Txt
CityMIDDLETOWNCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06457ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
VINCENT CAPECE JR
PRESIDENT/CEO40.004.00Yes (X)Yes (X)$1,312,797$0$301,961
BRUCE S MACMILLIAN
CHAIRMAN1.004.00Yes (X)Yes (X)$0$0$0
CHANDLER J HOWARD
VICE CHAIRMAN1.003.00Yes (X)Yes (X)$0$0$0
JONATHAN D LEVINE MD
SECRETARY1.004.00Yes (X)Yes (X)$0$0$0
MARK D LORENZE MD
ASST SECRETARY1.003.00Yes (X)Yes (X)$0$0$0
GERALD P MIGLIACCIO
DIRECTOR (RESIGNED 9/27/2020)1.004.00Yes (X)$0$0$0
JEAN M D'AQUILA
DIRECTOR1.004.00Yes (X)$0$0$0
DAVID C BENOIT
DIRECTOR1.003.00Yes (X)$0$0$0
JOHN J GAUTHIER
DIRECTOR1.003.00Yes (X)$0$0$0
ROBERT C HINTON
DIRECTOR1.003.00Yes (X)$0$0$0
DARRELL G PATASKA
DIRECTOR1.003.00Yes (X)$0$0$0
SABRA R PURTILL
DIRECTOR1.003.00Yes (X)$0$0$0
CHRISTINE H REPASY
DIRECTOR1.003.00Yes (X)$0$0$0
R CHRISTOPHER SEATON
DIRECTOR (RESIGNED 10/2/2019)1.003.00Yes (X)$0$0$0
GARY M WALLACE
DIRECTOR1.003.00Yes (X)$0$0$0
SUSAN MARTIN
VP FINANCE/TREASURER40.004.00Yes (X)$568,064$0$79,587
JESSE WAGNER MD
VP QUALITY AND PATIENT SAFETY40.000.00$647,910$0$118,001Yes (X)
JONATHAN BANKOFF
CHAIRMAN EMERGENCY MEDICINE40.000.00$439,018$0$57,733Yes (X)
RACHEL LOVINS
CHIEF DEPT OF MED (TO 11/2019)40.000.00$384,563$0$53,168Yes (X)
TODD BISHOP
CHIEF DEPT OF MED (FROM 2/2020)40.000.00$361,919$0$1,169Yes (X)
DAVID GIUFFRIDA
VP FACILITIES AND SUPPORT SERVICES40.000.00$424,410$0$78,231Yes (X)
JACQUELYN CALAMARI
VP PATIENT CARE SERVICES/CNO40.000.00$412,588$0$60,008Yes (X)
EVAN JACKSON
VP STRATEGIC PLANNING AND CIO40.000.00$439,138$0$89,883Yes (X)
DONNA STRONESKI
VP HUMAN RESOURCES40.000.00$343,719$0$60,591Yes (X)
THEODORE HARTENSTEIN
MEDICAL DIRECTOR, UTILIZATION MGMT40.000.00$531,725$0$55,081Yes (X)
JEFFREY SHELTON
CHAIRMAN DEPT PSYCH40.000.00$426,449$0$47,674Yes (X)
MATTHEW DOLAN
PHYSICIAN EMERGENCY DEPARTMENT40.000.00$390,334$0$36,523Yes (X)
BRIAN MCGUIRE
MEDICAL DIRECTOR ED40.000.00$405,696$0$62,385Yes (X)
UMA KASIREDDY
HOSPITALIST40.000.00$376,699$0$54,198Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$7,465,029TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$1,156,193TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K411IndivRcvdGreaterThan100KCnt
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
EPIC SYSTEMS
1979 MILKY WAYVERONAWI53593TECHNOLOGY$7,484,192
ACSYS INTERACTIVE
1577 NEW BRITAIN AVENUEFARMINGTONCT06032MARKETING$3,894,877
QUEST DIAGNOSTICS INC
PO BOX 844217BOSTONMA02284LABORATORY SERVICES$1,824,886
ARAMARK CORPORATION
66 OXFORD DRIVEFRANKLINMA02038DIETARY / HOUSEKEEPING$1,738,562
CERNER CORPORATION
PO BOX 959156ST LOUISMO63195TECHNOLOGY$1,627,493
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K88CntrctRcvdGreaterThan100KCnt
Federated Campaigns$30,444FederatedCampaignsAmt
Fundraising$114,420FundraisingAmt
Government Grants$2,811,704GovernmentGrantsAmt
All Other Contributions$2,719,499AllOtherContributionsAmt
Noncash Contributions$61,788NoncashContributionsAmt
Total Contributions$5,676,067TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SERVICE REVENUE622110$387,790,000$387,790,000
HHS PROVIDER RELIEF FUNDS624230$33,341,431$33,341,431
NET INCOME FROM JOINT VENTURES900099$2,355,686$2,355,686
SPECIMEN LAB621500$1,751,765$1,751,765
TECHNICAL LAB621500$509,609$509,609
FieldValueIRS element (for citing)
Total Program Service Revenue$425,748,491TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,479,853TotalRevenueColumnAmt
Exclusion$4,479,853ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$15,268TotalRevenueColumnAmt
Exclusion$15,268ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$959,233RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$828,646RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$130,587RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$130,587TotalRevenueColumnAmt
Exclusion$130,587ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$38,297,904SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$35,316,919SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$2,980,985SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,980,985TotalRevenueColumnAmt
Exclusion$2,980,985ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$53,840FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$114,420ContriRptFundraisingEventAmt
Fundraising Direct Expenses$53,539FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$301TotalRevenueColumnAmt
Exclusion$301ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
PURCHASE DISCOUNTS900099$1,545,930$1,545,930
CAFETERIA REVENUE722514$1,262,074$1,262,074

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,977,132TotalRevenueColumnAmt
Related Or Exempt Func Income$2,959,132RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$18,000UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Other Revenue Total$5,785,136OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$444,816,688TotalRevenueColumnAmt
Related Or Exempt Func Income$427,992,179RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$2,279,374UnrelatedBusinessRevenueAmt
Exclusion$8,869,068ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$127,025TotalAmt
Program Services$127,025ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$6,212,770TotalAmt
Program Services$4,970,216ProgramServicesAmt
Management And General$1,242,554ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$184,302TotalAmt
Program Services$184,302ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$195,565,428TotalAmt
Program Services$178,677,407ProgramServicesAmt
Management And General$16,888,021ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$10,265,463TotalAmt
Program Services$9,525,311ProgramServicesAmt
Management And General$740,152ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$13,870,604TotalAmt
Program Services$12,779,663ProgramServicesAmt
Management And General$1,090,941ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$13,879,485TotalAmt
Program Services$12,769,126ProgramServicesAmt
Management And General$1,110,359ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$2,184,612TotalAmt
Program Services$1,090,088ProgramServicesAmt
Management And General$10,916ManagementAndGeneralAmt
Fundraising$1,083,608FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$363,047TotalAmt
Management And General$363,047ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$208,659TotalAmt
Management And General$208,659ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$82,379TotalAmt
Management And General$82,379ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$189,516TotalAmt
Management And General$189,516ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$40,268,287TotalAmt
Program Services$34,130,736ProgramServicesAmt
Management And General$6,137,551ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$3,535,988TotalAmt
Program Services$96,729ProgramServicesAmt
Management And General$3,439,259ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$6,418,386TotalAmt
Program Services$4,262,358ProgramServicesAmt
Management And General$2,156,028ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$11,766,387TotalAmt
Program Services$7,091,079ProgramServicesAmt
Management And General$4,675,308ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$7,199,192TotalAmt
Program Services$3,543,870ProgramServicesAmt
Management And General$3,655,322ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$933,320TotalAmt
Program Services$865,241ProgramServicesAmt
Management And General$68,079ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$490,923TotalAmt
Program Services$382,889ProgramServicesAmt
Management And General$108,034ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,805,971TotalAmt
Program Services$1,805,971ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$25,546,822TotalAmt
Program Services$23,256,386ProgramServicesAmt
Management And General$2,290,436ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$5,318,531TotalAmt
Program Services$5,313,162ProgramServicesAmt
Management And General$5,369ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$42,377,982$42,377,469$513
STATE HOSPITAL TAX$22,780,640$22,780,640
FOOD$1,535,022$1,534,863$159
DUES$808,084$557,075$251,009

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$5,316,506TotalAmt
Program Services$4,752,978ProgramServicesAmt
Management And General$563,528ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$419,235,331TotalAmt
Program Services$372,874,584ProgramServicesAmt
Management And General$45,277,139ManagementAndGeneralAmt
Fundraising$1,083,608FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,207,961BOYAmt
EOY$1,966,108EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$54,435,370BOYAmt
EOY$121,960,697EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$723,554BOYAmt
EOY$670,785EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$47,631,969BOYAmt
EOY$47,401,339EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$559,092BOYAmt
EOY$446,155EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,315,139BOYAmt
EOY$2,013,908EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$5,007,515BOYAmt
EOY$3,329,192EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$639,377,615LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$397,978,570LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$221,808,782BOYAmt
EOY$241,399,045EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$179,344,860BOYAmt
EOY$187,471,988EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$545,933BOYAmt
EOY$488,467EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$16,299,874BOYAmt
EOY$12,042,680EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$528,880,049BOYAmt
EOY$619,190,364EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$58,756,565BOYAmt
EOY$69,518,795EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$964,337BOYAmt
EOY$732,577EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$39,417,721BOYAmt
EOY$35,653,781EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$2,943,701BOYAmt
EOY$32,976,505EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
EOY$6,000,000EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$39,915,103BOYAmt
EOY$75,823,418EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$141,997,427BOYAmt
EOY$220,705,076EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$368,990,166BOYAmt
EOY$379,050,203EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$17,892,456BOYAmt
EOY$19,435,085EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$386,882,622BOYAmt
EOY$398,485,288EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$528,880,049BOYAmt
EOY$619,190,364EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$25,581,357ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$5,836,000NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$19,814,691OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$82,379OtherActivitiesAmt
Total Lobbying Expenditures$82,379TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationMIDDLESEX HOSPITAL PAYS DUES TO BOTH THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE CONNECTICUT HOSPITAL ASSOCIATION (CHA). A PERCENTAGE OF THOSE DUES FUNDED LOBBYING ACTIVITIES DURING THE FISCAL YEAR. THE PORTION OF AHA DUES TOTALED $11,084 AND THE PORTION OF CHA DUES TOTALED $13,794. IN ADDITION, MIDDLESEX HOSPITAL CONTRACTED WITH TWO CONSULTANTS WHO PERFORMED LOBBYING ACTIVITIES. THOSE EXPENSES TOTALLED $57,501.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$128,949,000BeginningYearBalanceAmt
Investment Earnings Or Losses$11,014,000InvestmentEarningsOrLossesAmt
Other Expenditures$111,000OtherExpendituresAmt
End Year Balance$139,852,000EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$124,738,999BeginningYearBalanceAmt
Contributions$67,000ContributionsAmt
Investment Earnings Or Losses$3,977,000InvestmentEarningsOrLossesAmt
Other Expenditures-$166,001OtherExpendituresAmt
End Year Balance$128,949,000EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$118,528,000BeginningYearBalanceAmt
Contributions$505,000ContributionsAmt
Investment Earnings Or Losses$5,702,999InvestmentEarningsOrLossesAmt
Other Expenditures-$3,000OtherExpendituresAmt
End Year Balance$124,738,999EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$103,326,000BeginningYearBalanceAmt
Contributions$451,000ContributionsAmt
Investment Earnings Or Losses$14,480,000InvestmentEarningsOrLossesAmt
Other Expenditures-$271,000OtherExpendituresAmt
End Year Balance$118,528,000EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$122,014,000BeginningYearBalanceAmt
Investment Earnings Or Losses$10,726,000InvestmentEarningsOrLossesAmt
Other Expenditures$29,414,000OtherExpendituresAmt
End Year Balance$103,326,000EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.91000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.09000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,547,451OtherCostOrOtherBasisAmt
Book Value$14,547,451BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$347,739,489OtherCostOrOtherBasisAmt
Depreciation$204,372,287DepreciationAmt
Book Value$143,367,202BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,061,978OtherCostOrOtherBasisAmt
Depreciation$1,852,454DepreciationAmt
Book Value$209,524BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$269,611,497OtherCostOrOtherBasisAmt
Depreciation$190,022,108DepreciationAmt
Book Value$79,589,389BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,417,200OtherCostOrOtherBasisAmt
Depreciation$1,731,721DepreciationAmt
Book Value$3,685,479BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$241,399,045TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDescAmtAmt
THIRD PARTY ADVANCE REIMBURSEMENT$36,191,989
EST. SELF-INSURANCE LIABILITIES$23,497,289
ACCRUED RETIREMENT LIABILITIES$3,838,657
ASSET RETIREMENT OBLIGATION$568,645
THIRD-PARTY SETTLEMENTS$11,352,225
OTHER LIABILITIES$370,441
SECURITY DEPOSITS$4,172
FieldValueIRS element (for citing)
Total Liability$75,823,418TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE WITHOUT DONOR RESTRICTIONS RECORDED IN THE BOARD-DESIGNATED (QUASI-ENDOWMENT) FUNDS ARE ASSETS SET ASIDE BY THE BOARD FOR FUTURE UNSPECIFIED USES AND TO SUPPORT EDUCATION AND OTHER PROGRAMS OVER WHICH THE BOARD RETAINS CONTROL AND MAY, AT ITS DISCRETION, SUBSEQUENTLY USE FOR OTHER PURPOSES. PERMANENT ENDOWMENT FUNDS ARE ASSETS RECEIVED WITH THE DONOR STIPULATION THAT THE PRINCIPAL BE INVESTED IN PERPETUITY AND THAT ONLY THE INCOME EARNED THEREON IS AVAILABLE FOR SPECIFIC OR GENERAL SERVICES, SUCH AS FREE BED FUNDS AND SUPPORT OF HOSPITAL OPERATIONS. THESE ARE NOT IDENTIFIED ON THE AUDIT STATEMENTS IN THIS FASHION FOR FY2020. THEY ARE IN AS EITHER WITH OR WITHOUT DONOR RESTRICTIONS. TEMPORARILY RESTRICTED ENDOWMENT FUNDS ARE ASSETS RESTRICTED BY THE DONOR EITHER AS TO PURPOSE AND/OR AS TO TIME OF EXPENDITURE, SUCH AS EDUCATION, HEALTH SERVICES AND CAPITAL PURCHASES.
PART X, LINE 2:BELOW IS AN EXCERPT FROM FOOTNOTE 2 OF THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS FOR MIDDLESEX HEALTH SYSTEM, INC. AND SUBSIDIARIES. THE SYSTEM ACCOUNTS FOR UNCERTAIN TAX POSITIONS WITH PROVISIONS OF FASB ASC 740, "INCOME TAXES," WHICH PROVIDES A FRAMEWORK FOR HOW COMPANIES SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE UNCERTAIN TAX POSITIONS IN THEIR CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE SYSTEM DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2020 AND 2019. IT IS THE SYSTEM'S POLICY TO RECORD PENALTIES AND INTEREST ASSOCIATED WITH UNCERTAIN TAX PROVISIONS AS A COMPONENT OF OPERATING EXPENSES. AS OF SEPTEMBER 30, 2020 AND 2019, THE SYSTEM DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNCERTAIN TAX POSITIONS. THE SYSTEM'S PRIOR THREE TAX YEARS ARE OPEN AND SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1TPC GOLFEvent1Nm
Gross Receipts Event1$110,000GrossReceiptsEvent1Amt
Charitable Contri Event1$72,000CharitableContriEvent1Amt
Gross Revenue Event1$38,000GrossRevenueEvent1Amt
Rent Facility Costs Event1$37,463RentFacilityCostsEvent1Amt
Other Direct Expenses Event1$1,472OtherDirectExpensesEvent1Amt
Event2HOSPICE GOLFEvent2Nm
Gross Receipts Event2$58,260GrossReceiptsEvent2Amt
Charitable Contri Event2$42,420CharitableContriEvent2Amt
Gross Revenue Event2$15,840GrossRevenueEvent2Amt
Cash Prizes Event2$900CashPrizesEvent2Amt
Rent Facility Costs Event2$5,500RentFacilityCostsEvent2Amt
Food And Beverage Event2$7,747FoodAndBeverageEvent2Amt
Other Direct Expenses Event2$457OtherDirectExpensesEvent2Amt
Gross Receipts Total$168,260GrossReceiptsTotalAmt
Charitable Contributions Tot$114,420CharitableContributionsTotAmt
Gross Revenue Total Events$53,840GrossRevenueTotalEventsAmt
Cash Prizes Total Events$900CashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$42,963RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$7,747FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events$1,929OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$53,539DirectExpenseSummaryEventsAmt
Net Income Summary$301NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other500.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Persons Served2870PersonsServedCnt
Total Community Benefit Expns$7,875,756TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,141,887DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,733,869NetCommunityBenefitExpnsAmt
Total Expense0.00650TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Persons Served21708PersonsServedCnt
Total Community Benefit Expns$72,393,238TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$49,478,862DirectOffsettingRevenueAmt
Net Community Benefit Expns$22,914,376NetCommunityBenefitExpnsAmt
Total Expense0.05470TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Persons Served362PersonsServedCnt
Total Community Benefit Expns$557,502TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$301,043DirectOffsettingRevenueAmt
Net Community Benefit Expns$256,459NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Persons Served24940PersonsServedCnt
Total Community Benefit Expns$80,826,496TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$54,921,792DirectOffsettingRevenueAmt
Net Community Benefit Expns$25,904,704NetCommunityBenefitExpnsAmt
Total Expense0.06180TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Persons Served23255PersonsServedCnt
Total Community Benefit Expns$3,132,683TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$159,870DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,972,813NetCommunityBenefitExpnsAmt
Total Expense0.00710TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Persons Served1504PersonsServedCnt
Total Community Benefit Expns$12,624,300TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,185,076DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,439,224NetCommunityBenefitExpnsAmt
Total Expense0.02490TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Persons Served59696PersonsServedCnt
Total Community Benefit Expns$112,859,269TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$100,431,721DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,427,548NetCommunityBenefitExpnsAmt
Total Expense0.02960TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Persons Served151PersonsServedCnt
Total Community Benefit Expns$297,220TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$44,424DirectOffsettingRevenueAmt
Net Community Benefit Expns$252,796NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Persons Served1857PersonsServedCnt
Total Community Benefit Expns$275,056TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$275,056NetCommunityBenefitExpnsAmt
Total Expense0.00070TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Persons Served86463PersonsServedCnt
Total Community Benefit Expns$129,188,528TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$102,821,091DirectOffsettingRevenueAmt
Net Community Benefit Expns$26,367,437NetCommunityBenefitExpnsAmt
Total Expense0.06290TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Persons Served111403PersonsServedCnt
Total Community Benefit Expns$210,015,024TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$157,742,883DirectOffsettingRevenueAmt
Net Community Benefit Expns$52,272,141NetCommunityBenefitExpnsAmt
Total Expense0.12470TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$499TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$499NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Persons Served92262PersonsServedCnt
Total Community Benefit Expns$1,850,538TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,841,027DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,511NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Persons Served16PersonsServedCnt
Total Community Benefit Expns$2,371TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,371NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Persons Served2PersonsServedCnt
Total Community Benefit Expns$375TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$375NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Persons Served92280PersonsServedCnt
Total Community Benefit Expns$1,853,783TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,841,027DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,756NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$14,753,657BadDebtExpenseAmt
Bad Debt Expense Attributable$1,475,366BadDebtExpenseAttributableAmt
Reimbursed By Medicare$38,512,020ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$40,596,339CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$2,084,319MedicareSurplusOrShortfallAmt

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 Line1MIDDLESEX HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line128 CRESCENT STREETAddressLine1Txt
CityMIDDLETOWNCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06457ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.MIDDLESEXHEALTH.ORGWebsiteAddressTxt
State License000069StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Teaching HospitalYes (X)TeachingHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MIDDLESEX 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
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
OtherYes (X)OtherInd
CHNA Conducted18CHNAConductedYr
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 URLSEE STATEMENTOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt19ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSEE STATEMENTStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care500.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
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 URLSEE STATEMENTFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE STATEMENTFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE STATEMENTFAPSummaryOnWebsiteURLTxt
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
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
MIDDLESEX HOSPITALPART V, SECTION B, LINE 3J: IN ADDITION TO THE ELEMENTS SELECTED IN PART V, LINE 3, THE MIDDLESEX HEALTH 2019 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) EXAMINED HOW SOCIAL DETERMINANTS OF HEALTH AND HEALTH DISPARITIES IMPACT HEALTH OUTCOMES. THE REPORT CONTINUED TO RAISE AWARENESS ABOUT HEALTH-RELATED SOCIAL NEEDS, WELL-BEING AND QUALITY OF LIFE; HEALTH DISPARITIES; AND, VULNERABLE POPULATIONS. ACHIEVING HEALTH EQUITY THE ATTAINMENT OF THE HIGHEST LEVEL OF HEALTH FOR ALL PEOPLE STARTS WITH ASKING THE APPROPRIATE QUESTIONS RELATIVE TO DETERMINANTS OF HEALTH AND HOW THEY DISPROPORTIONATELY AFFECT CERTAIN GROUPS OF PEOPLE; NEXT STEPS INVOLVE ADDRESSING THE CONDITIONS THAT PREVENT THE REALIZATION OF GOOD HEALTH FOR THESE VULNERABLE OR MARGINALIZED GROUPS. THROUGH EXAMINATION OF THE INFLUENCE OF DETERMINANTS OF HEALTH, IT IS POSSIBLE TO DEVELOP STRATEGIES THAT ELIMINATE PERSISTENT AND PERVASIVE HEALTH DISPARITIES, PROMOTE HEALTH EQUITY, IMPROVE HEALTH OUTCOMES AND REDUCE FINANCIAL COST.
MIDDLESEX HOSPITALPART V, SECTION B, LINE 5: WHEN COMPLETING ITS 2019 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), MIDDLESEX HOSPITAL TOOK INTO ACCOUNT INPUT FROM REPRESENTATIVES OF ITS COMMUNITY SERVED, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. A COMMUNITY HEALTH NEEDS ASSESSMENT ADVISORY COMMITTEE WAS FORMED TO PROVIDE INPUT AND GUIDANCE THROUGHOUT THE PROCESS, INCLUDING REVIEW OF THE STUDY'S COMPONENTS; REVIEW AND INPUT ON THE KEY INFORMANT SURVEY; ASSISTANCE WITH SERVICE AREA-WIDE KEY INFORMANT SURVEY DISSEMINATION; REVIEW AND INPUT ON COMMUNITY RESOURCES AND ASSETS; AND FINAL STUDY REVIEW. THE ADVISORY COMMITTEE WAS COMPRISED OF STAKEHOLDERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING LOCAL HEALTH DEPARTMENTS, HEALTH CARE ORGANIZATIONS (INCLUDING MEDICAL AND BEHAVIORAL), COMMUNITY BASED ORGANIZATIONS, SCHOOLS, MUNICIPALITIES, FOUNDATIONS, ADVOCACY GROUPS, FAITH-BASED ORGANIZATIONS AND PUBLIC SAFETY. AN EFFORT WAS MADE TO ENSURE THAT MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS WERE REPRESENTED (SEE CHNA REPORT, APPENDIX - TABLE A1 - WHICH SETS FORTH REPRESENTED SECTORS/COMMUNITIES). TO CAPTURE BROAD COMMUNITY INPUT ON HEALTH NEEDS, SOCIAL DETERMINANTS OF HEALTH AND HEALTH EQUITY, MIDDLESEX HOSPITAL ADMINISTERED ITS KEY INFORMANT SURVEY THROUGH THE ONLINE SURVEYMONKEY FORMAT. A FOCUS ON SOCIAL DETERMINANTS OF HEALTH AND HEALTH EQUITY REMAINED AS INTEGRAL SECTIONS OF THE 2019 SURVEY. THE 14 QUESTION SURVEY WAS ADMINISTERED THROUGH THE ONLINE SURVEYMONKEY FORMAT AND INCLUDED TWO SEPARATE AND DISTINCT URLS FOR THE COMMUNITY AND MIDDLESEX HOSPITAL STAFF. SURVEYING STAFF WAS INCLUDED, AS THEY LIVE AND WORK IN THE HOSPITAL'S SERVICE AREA. THE SURVEYS WERE OPEN FOR COMPLETION FOR A FOUR WEEK TIME PERIOD. THE COMMUNITY E-SURVEY WAS EXTENSIVELY DISSEMINATED TO AN ARRAY OF SECTOR CONTACTS IN MIDDLETOWN, MIDDLESEX COUNTY AND THE PERIPHERY TOWNS OF MIDDLESEX HOSPITAL'S PRIMARY SERVICE AREA IN ORDER TO ENSURE RESPONSES FROM A WIDE RANGE OF REPRESENTATIVE COMMUNITY MEMBERS AND LEADERS WITH DIVERSE BACKGROUNDS, PERSPECTIVES AND FIRST-HAND KNOWLEDGE ABOUT THEIR COMMUNITIES. SECTORS INCLUDED ADVOCACY GROUPS, ALLIANCES/COALITIONS, THE BUSINESS COMMUNITY, EDUCATIONAL INSTITUTIONS, COMMUNITY BASED ORGANIZATIONS, COMMUNITY RESIDENTS, ELECTED OFFICIALS, FAITH-BASED ORGANIZATIONS, FOUNDATIONS, HEALTH CARE ORGANIZATIONS (INCLUDING MEDICAL AND BEHAVIORAL), LOCAL HEALTH DEPARTMENTS, MENTAL HEALTH ORGANIZATIONS, PRIMARY CARE/FAMILY MEDICINE PRACTICES, PUBLIC SAFETY ORGANIZATIONS (POLICE, FIRE, EMERGENCY MANAGEMENT), SOCIAL SERVICES, SUBSTANCE TREATMENT FACILITIES, AND YOUTH AND FAMILY SERVICES. COMMUNITY HEALTH NEEDS ASSESSMENT ADVISORY COMMITTEE MEMBERS WERE ASKED TO BROADLY SHARE THE COMMUNITY SURVEY LINK, AND ALL SURVEY RECIPIENTS WERE INVITED TO SHARE THE LINK WITH CO-WORKERS/COLLEAGUES, FRIENDS AND FAMILY OR ANYONE WHO LIVES OR WORKS IN MIDDLESEX COUNTY. THE SPECIFIC MIDDLESEX HOSPITAL E-SURVEY WAS SENT TO LEADERSHIP E-DISTRIBUTION LISTS (EXECUTIVE STAFF, DIRECTORS, MANAGERS, SUPERVISORS) WITH A REQUEST TO SHARE THE EXPLANATION OF PURPOSE AND SURVEY URL WITH INDIVIDUAL DEPARTMENTAL STAFF E-DISTRIBUTION LISTS. A TOTAL OF 427 SURVEYS WERE COMPLETED, WITH 239 COMPLETED BY THE COMMUNITY AND 188 COMPLETED BY MIDDLESEX HOSPITAL STAFF. THE COMMUNITY AND MIDDLESEX HOSPITAL RESPONSE RESULTS WERE ANALYZED SEPARATELY AND INCLUDED THROUGHOUT THE CHNA.
MIDDLESEX HOSPITALPART V, SECTION B, LINE 7D: MIDDLESEX HOSPITAL POSTED ITS 2019 CHNA ON ITS WEB-SITE (HTTPS://MIDDLESEXHEALTH.ORG/MIDDLESEX-AND-THE-COMMUNITY/SERVING-OUR-COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT) AND ELECTRONICALLY DISTRIBUTED IT THROUGH THE FOLLOWING DISSEMINATION CHANNELS: THE CHNA ADVISORY COMMITTEE; KEY INFORMANT COMMUNITY PARTNERS; COMMUNITY MEMBERS; AND EXISTING HOSPITAL-COMMUNITY BASED PARTNERSHIP DISTRIBUTION LISTS. RECIPIENTS WERE ENCOURAGED TO WIDELY SHARE THE ASSESSMENT. ELECTRONIC COPIES WERE ALSO DISTRIBUTED TO MIDDLESEX HOSPITAL LEADERSHIP, MANAGEMENT STAFF, MEDICAL STAFF, BOARD OF DIRECTORS, AND STAFF THROUGH INCLUSION IN MIDDLESEX HOSPITAL'S WEEKLY ELECTRONIC NEWSLETTER. HARD COPIES OF THE CHNA WERE HANDED OUT AT THE MIDDLESEX HEALTH CHNA IMPLEMENTATION STRATEGY COMMUNITY CONVERSATION (HELD ON JANUARY 28, 2020) AND WILL CONTINUE TO BE PROVIDED UPON REQUEST.
MIDDLESEX HOSPITALPART V, SECTION B, LINE 11: MIDDLESEX HEALTH COMPLETED ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2019, AND ITS CHNA IMPLEMENTATION STRATEGY WAS APPROVED BY MIDDLESEX HEALTH'S GOVERNING BODY ON FEBRUARY 7, 2020. TO ASSIST MIDDLESEX HEALTH IN PRIORITIZING THE SIGNIFICANT HEALTH AND HEALTH-RELATED NEEDS IDENTIFIED IN ITS MOST RECENTLY COMPLETED CHNA, A FACILITATED COMMUNITY CONVERSATION WAS HELD. THE COMMUNITY CONVERSATION FORMAT WAS SELECTED AS IT PROVIDES A PRACTICAL, PURPOSEFUL AND INTERACTIVE APPROACH. THE INVITATION TO THE EVENT WAS WIDELY DISSEMINATED TO AN ARRAY OF CONTACTS IN MIDDLETOWN, MIDDLESEX COUNTY AND THE PERIPHERY TOWNS OF MIDDLESEX HEALTH'S PRIMARY SERVICE AREA TO ENSURE PARTICIPATION BY COMMUNITY LEADERS, STAKEHOLDERS AND COMMUNITY MEMBERS WITH DIVERSE BACKGROUNDS, PERSPECTIVES AND FIRST-HAND KNOWLEDGE ABOUT THEIR COMMUNITIES. ATTENDEES REPRESENTED VARIOUS SECTORS INCLUDING ADVOCACY GROUPS, ALLIANCES/COALITIONS, EDUCATIONAL INSTITUTIONS, COMMUNITY BASED ORGANIZATIONS, COMMUNITY RESIDENTS, ELECTED OFFICIALS, FAITH-BASED ORGANIZATIONS, HEALTH CARE ORGANIZATIONS (INCLUDING MEDICAL AND BEHAVIORAL), LOCAL HEALTH DEPARTMENTS, MUNICIPAL AGENCIES, PUBLIC SAFETY ORGANIZATIONS (POLICE, EMERGENCY MANAGEMENT), SOCIAL SERVICES, STATE AGENCIES AND YOUTH AND FAMILY SERVICES. FACILITATORS WITH EXPERTISE IN COMMUNITY CONVERSATIONS LED THE ATTENDEES IN A PRIORITIZATION EXERCISE AND A DISCUSSION OF POTENTIAL STRATEGIES AND SOLUTIONS. PARTICIPANTS WERE ASKED TO CONSIDER THE IMPACTS OF SOCIAL DETERMINANTS OF HEALTH AND HEALTH DISPARITIES WHEN REVIEWING EACH HEALTH ISSUE. ONCE THE RANKING PROCESS WAS COMPLETED, THE RESULTS WERE TALLIED AND FIVE PRIORITY AREAS WERE DETERMINED. THE RESULTS OF THE COMMUNITY CONVERSATION SERVED AS A GUIDE FOR MIDDLESEX HEALTH'S SELECTION OF PRIORITY AREAS FOR ITS CHNA IMPLEMENTATION STRATEGY. THROUGH THIS PROCESS, THE FOLLOWING HEALTH TOPICS WERE SELECTED AS AREAS OF FOCUS FOR THE IMPLEMENTATION STRATEGY: 1) HEALTHY WEIGHT / OBESITY / DIABETES PREVENTION; 2) MENTAL HEALTH ADVERSE CHILDHOOD EXPERIENCES; 3) SUBSTANCE USE DISORDER OPIOIDS; AND 4) CANCER, WITH SOCIAL DETERMINANTS OF HEALTH AND HEALTH EQUITY AS ESSENTIAL COMPONENTS FOR EACH HEALTH AREA. WITH REGARD TO NEEDS THAT ARE NOT BEING ADDRESSED, MIDDLESEX HOSPITAL RECOGNIZES THAT IT CANNOT FOCUS ON EVERY HEALTH AND SOCIAL NEED IDENTIFIED IN ITS PREVIOUSLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT AND IS THEREFORE COMMITTED TO ALLOCATING RESOURCES AND IN-KIND TIME TO THE HIGHEST AREAS OF IDENTIFIED NEED AND/OR AREAS WITH GREATEST POTENTIAL FOR IMPACT AND FEASIBILITY (THE SELECTED PRIORITY AREAS). RESOURCE CONSTRAINTS PREVENT THE HOSPITAL FROM ADDRESSING EVERY NEED, AND IN MANY CASES, OTHER LOCAL COMMUNITY BASED ORGANIZATIONS MAY BE BETTER SUITED TO TAKE A LEADERSHIP ROLE IN IMPROVING CERTAIN HEALTH OUTCOMES. AS WITH OUR PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENTS, THE HOSPITAL WILL CONTINUE TO BE A WILLING PARTNER, WHEN ABLE, FOR INITIATIVES NOT RELATED TO ITS SELECTED CHNA IMPLEMENTATION STRATEGY PRIORITY AREAS.IN MARCH OF 2020, MIDDLESEX HEALTH'S COMMUNITY HEALTH AND WELL-BEING BASED WORK SHIFTED DRAMATICALLY TO ADDRESS THE COVID-19 PANDEMIC AND RESPOND TO COMMUNITY LEVEL NEEDS. MIDDLESEX HEALTH WAS A FOUNDING MEMBER OF THE MIDDLESEX COUNTY COVID-19 PEOPLE OF COLOR HEALTH INITIATIVE ("POC HEALTH INITIATIVE"), FORMED IN APRIL 2020 DUE TO THE ALARMING NATIONAL STATISTICS REGARDING DISPROPORTIONATE COVID-19 MORBIDITY AND MORTALITY OF BLACK, INDIGENOUS AND PEOPLE OF COLOR (BIPOC) INDIVIDUALS. SINCE INCEPTION, THE POC HEALTH INITIATIVE WORKED PROACTIVELY AND AGGRESSIVELY TO PREVENT THE SPREAD OF COVID-19 AMONG COMMUNITIES OF COLOR. THE COLLABORATIVE INCLUDES REPRESENTATIVES FROM THE MINISTERIAL HEALTH FELLOWSHIP; THE MIDDLETOWN MINISTERIAL ALLIANCE; THE MIDDLESEX COUNTY NAACP BRANCH; MIDDLESEX HEALTH; COMMUNITY HEALTH CENTER, INC.; THE MIDDLETOWN DEPARTMENT OF HEALTH; THE MIDDLETOWN COMMON COUNCIL; MIDDLETOWN PUBLIC SCHOOLS; THE MIDDLETOWN POLICE DEPARTMENT; MIDDLETOWN PARKS AND RECREATION; THE COMMUNITY FOUNDATION OF MIDDLESEX COUNTY; MIDDLESEX UNITED WAY; AND ST. VINCENT DE PAUL MIDDLETOWN. AT THE OUTSET OF THE ENDEAVOR, THE POC HEALTH INITIATIVE MEMBERS SECURED FUNDING AND IN-KIND DONATIONS FROM DONOR AGENCIES AND COMMUNITY MEMBERS FOR PHASE 1 OF ITS MITIGATION STRATEGY. BETWEEN THE MONTHS OF (APRIL 2020 - NOVEMBER 2020), 16,250 SURGICAL AND CLOTH MASKS WERE DISTRIBUTED AND 1,000 WELLNESS PACKAGES (INCLUDING COVID-19 EDUCATION AND RESOURCE MATERIALS IN ENGLISH AND SPANISH, CUSTOM-MADE EDUCATIONAL MAGNETS TO AFFIX EDUCATIONAL MATERIAL TO REFRIGERATORS, MASKS, KINSA SMART THERMOMETERS, HAND SANITIZER, SOAP, AND TARGETED GIFT CARDS TO COVER BASIC NEEDS) WERE PREPARED AND DISTRIBUTED. PHASE 2 (FEBRUARY 2021 - ON) BUILDS UPON PHASE 1 AND ADDS A CULTURALLY-SENSITIVE COVID-19 VACCINE EDUCATION COMMUNICATIONS PLAN TO THE SECOND ROUND OF 1,000 COVID-19 WELLNESS PACKAGES DISTRIBUTED TO BIPOC COMMUNITY MEMBERS. MIDDLESEX HEALTH PROVIDES EXTENSIVE IN-KIND SUPPORT TO THIS PROJECT, IN ADDITION TO GRANT WRITING TO SECURE FUNDING TO PURCHASE SUPPLIES; UNDERWRITING THE COST OF THE EDUCATIONAL MAGNETS; DEVELOPING THE CULTURALLY-SENSITIVE COVID-19 EDUCATIONAL MATERIALS FOR COVID-19 PREVENTION, SAFETY AND THE VACCINE - WHICH ALSO ADDRESSED COVID-19 VACCINE MYTHS AND MISINFORMATION; AND, UNDERWRITING THE COSTS OF MASS-QUANTITY COPYING OF THE EDUCATIONAL FLYERS. THE EDUCATIONAL INFORMATION PRODUCED BY MIDDLESEX HEALTH WAS ALSO USED FOR THE COVID-19 CRISIS COUNSELOR PROGRAM AND COVID-19 TRUSTED MESSENGERS PROGRAM DESCRIBED BELOW. IN 2020, MIDDLESEX HEALTH SECURED $628,392 IN GRANT FUNDING FOR COMMUNITY-LED PROGRAMS DEVELOPED TO ADDRESS BARRIERS TO HEALTH AND WELLNESS AND ADVANCE HEALTH EQUITY. THESE PROGRAMS, DESIGNED AND LED BY BIPOC COMMUNITY MEMBERS, INFUSED CAPITAL INTO THE COMMUNITY AND CREATED HEALTH-RELATED JOBS. EXAMPLES INCLUDE: 1) THE COVID-19 CRISIS COUNSELOR PROGRAM: ADMINISTERED BY THE MINISTERIAL HEALTH FELLOWSHIP AND FUNDED BY THE STATE OF CONNECTICUT DEPARTMENT OF MENTAL HEALTH AND ADDICTION SERVICES (DMHAS) BY WAY OF THE FEDERAL FEMA PROGRAM, DEPLOYED ELEVEN COVID-19 CRISIS COUNSELORS THROUGHOUT THE STATE OF CONNECTICUT TO PROVIDE INDIVIDUAL CRISIS COUNSELING; EDUCATION; ASSESSMENT, REFERRAL AND LINKAGE TO NEEDED COMMUNITY SUPPORTS AND RESOURCES IN RESPONSE TO THE PANDEMIC. THE TARGET POPULATION FOR THIS INITIATIVE WAS PEOPLE OF COLOR WHO WOULD BENEFIT FROM THESE SERVICES AND WERE LINKED TO CHURCHES OR COMMUNITIES IN THE TARGET GEOGRAPHIC LOCATIONS. ADDITIONAL CRISIS COUNSELOR DUTIES INCLUDED ASSISTING WITH COVID-19 VACCINE CAMPAIGNS ONCE THE VACCINE WAS MADE AVAILABLE TO THE PUBLIC AND ADDRESSING VACCINE CONFIDENCE CONCERNS WITHIN BIPOC COMMUNITIES. DURING THE CRISIS COUNSELOR ORIENTATIONS, MIDDLESEX HEALTH PROVIDED IN-DEPTH TRAINING ON COVID-19, INCLUDING MODULES ON PREVENTION, SAFETY, VACCINE AND MESSAGING; 2) THE COVID-19 TRUSTED MESSENGERS PROGRAM: ADMINISTERED BY THE MINISTERIAL HEALTH FELLOWSHIP AND FUNDED BY THE CONNECTICUT HEALTH FOUNDATION, THE GOAL OF THE TRUSTED MESSENGER MODEL WAS FOR TRUSTED MESSENGERS WHO LIVE, WORK AND WORSHIP IN THE COMMUNITIES THEY SERVE TO PROVIDE CULTURALLY-SENSITIVE COVID-19 SAFETY INFORMATION AND VACCINE EDUCATION IN A SUPPORTIVE ENVIRONMENT TO BIPOC COMMUNITY MEMBERS. THE INTENT OF THIS MODEL IS TO MITIGATE A WIDENING OF THE DISPROPORTIONATE IMPACT OF COVID-19 ON COMMUNITIES OF COLOR. PARTNERING WITH THE FAITH COMMUNITY IS INTEGRAL TO BUILDING TRUST, AS BLACK AND LATINX CHURCHES HAVE BEEN ENGAGED IN HEALTH MINISTRIES FOR DECADES, WITH CONGREGANTS AND COMMUNITY MEMBERS LOOKING TO THEIR HOUSES OF WORSHIP NOT ONLY AS PLACES OF HEALING AND REFUGE, BUT AS TRUSTED CHANNELS FOR RELIABLE HEALTH INFORMATION. THIS INITIATIVE ALSO ENGAGED MIDDLESEX COUNTY NAACP YOUTH COUNCIL MEMBERS AS TRUSTED MESSENGERS AND IN COVID-19 WELLNESS PACKAGE DISTRIBUTION.
MIDDLESEX HOSPITALPART V, SECTION B, LINE 13H: MIDDLESEX HOSPITAL'S SLIDING SCALE OUTLINES THE FACTORS THAT IT USES TO DETERMINE FINANCIAL ASSISTANCE DETERMINATIONS: THE FEDERAL POVERTY INCOME GUIDELINES AND NUMBER OF PERSONS IN HOUSEHOLD.
PART V, SECTION B, LINE 7A:HTTPS://MIDDLESEXHEALTH.ORG/MIDDLESEX-AND-THE-COMMUNITY/SERVING-OUR-COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
PART V, SECTION B, LINE 10A:HTTPS://MIDDLESEXHEALTH.ORG/MIDDLESEX-AND-THE-COMMUNITY/SERVING-OUR-COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
PART V, SECTION B, LINE 16A, FAP WEBSITE:HTTPS://MIDDLESEXHEALTH.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE-SERVICES
PART V, SECTION B, LINE 16B, FAP APPLICATION WEBSITE:HTTPS://MIDDLESEXHEALTH.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE-SERVICES
PART V, SECTION B, LINE 16C, FAP PLAIN LANGUANCE SUMMARY WEBSITE:HTTPS://MIDDLESEXHEALTH.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE-SERVICES
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line11 - MIDDLESEX HOSPITAL HOMECAREBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1770 SAYBROOK ROADAddressLine1Txt
CityMIDDLETOWNCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06457ZIPCd
FieldValueIRS element (for citing)
FacilityHOMECARE SERVICES, REHAB, HEART HEALTH, OTHER SERVICESFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:IN GENERAL, MIDDLESEX HOSPITAL ("THE HOSPITAL") USES FPG TO DETERMINE ELIGIBILITY. THERE ARE, HOWEVER, SPECIAL CIRCUMSTANCES (SUCH AS A CATASTROPHIC EVENT) WHICH MAY AFFECT A PATIENT'S ABILITY TO PAY. IN THIS CASE, THE HOSPITAL EVALUATES THE APPLICATION WITH CONSIDERATION GIVEN TO THE PATIENT'S CURRENT SITUATION. WITH SPECIAL CIRCUMSTANCES, IN ORDER TO MAXIMIZE THE AMOUNT OF FINANCIAL ASSISTANCE DISCOUNT, THE FPG THRESHOLD MAY BE IGNORED AND THE HOSPITAL MAY USE THE PATIENT'S ASSETS AND/OR TAX RETURN ITEMIZED DEDUCTIONS TO DETERMINE THE AMOUNT OF FINANCIAL ASSISTANCE.
PART I, LINE 7:FOR PART 1, LINE 7 SECTIONS (A) FINANCIAL ASSISTANCE AT COST, (B) MEDICAID, (C) COSTS OF OTHER MEANS-TESTED GOVERNMENT PROGRAMS, PORTIONS OF (F) HEALTH PROFESSIONS EDUCATION, AND (G) SUBSIDIZED HEALTH SERVICES, THE COSTING METHODOLOGY USED IS A HYBRID COST ACCOUNTING/MEDICARE COST-TO-CHARGE RATIO CALCULATION. THE PERCENTAGES ARE DERIVED FROM THE MOST CURRENT MEDICARE COST REPORT AND APPLIED BY CHARGE LINE APPROPRIATELY. INDIRECT COSTS WERE APPLIED TO SUBSIDIZED HEALTH SERVICES. THE MEDICARE COST REPORT DOES NOT ADDRESS ALL AREAS OF THE HOSPITAL IN THE SAME DETAIL, BUT DOES ACCURATELY ADDRESS INPATIENT AND OUTPATIENT, HOMECARE AND TO AN EXTENT PHYSICIAN SERVICES. SECTIONS (E) COMMUNITY HEALTH IMPROVEMENT; PORTIONS OF (F) HEALTH PROFESSIONS EDUCATION, (H) RESEARCH, AND (I) CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS ARE COMPRISED (EXCEPT FOR CASH DONATIONS AND IN-KIND MATERIAL DONATIONS) OF 1) SUPPLY EXPENSES; 2) PURCHASED SERVICES; AND 3) THE DIRECT SALARY COSTS FOR HOSPITAL STAFF WHOSE TIME WAS COMPENSATED BY THE HOSPITAL FOR TIME SPENT PARTICIPATING IN ACTIVITIES THAT QUALIFY AS COMMUNITY BENEFITS PLUS THE CURRENT FISCAL YEAR FRINGE BENEFIT RATE. IN ADDITION TO SUBSIDIZED SERVICES, INDIRECT COSTS WERE APPLIED TO A SMALL SELECTION OF SALARIES AND SERVICES UNDER COMMUNITY HEALTH IMPROVEMENT, RESEARCH, AND COMMUNITY BENEFIT OPERATIONS, BUT NOT BROADLY ACROSS ALL COMMUNITY BENEFIT ACTIVITY ENTRIES.
PART I, LINE 7G:MIDDLESEX HOSPITAL INCLUDES ITS FAMILY MEDICINE GROUP AS A SUBSIDIZED SERVICE. FOR FY20, 10,528 UNIQUE INDIVIDUALS WERE SERVED WITH A TOTAL HOSPITAL SUBSIDY OF $975,782. MIDDLESEX COUNTY HAS BEEN DESIGNATED BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) TO BE A MEDICALLY UNDERSERVED AREA EXPERIENCING A SHORTAGE OF SELECT HEALTH SERVICES WHICH INCLUDE TOO FEW PRIMARY CARE PROVIDERS. IN ADDITION, HRSA REPORTS HEALTH PROFESSIONAL SHORTAGE AREAS (HPSAS) FOR PRIMARY CARE (MIDDLETOWN SERVICE AREA; LOW INCOME POPULATION), MENTAL HEALTH (MIDDLESEX COUNTY; HIGH NEED GEOGRAPHIC) AND DENTAL HEALTH (CENTRAL MIDDLETOWN; LOW INCOME POPULATION). MIDDLESEX HOSPITAL'S FAMILY MEDICINE GROUP FILLS A VITAL COMMUNITY HEALTH NEED BY PROVIDING ACCESS TO PRIMARY CARE SERVICES.DURING FY19, HHS DISTRIBUTED PROVIDER RELIEF FUNDS TO PREVENT, PREPARE FOR, AND RESPOND TO CORONAVIRUS. THE FUNDS MAY BE UTILIZED FOR COVID-19 RELATED EXPENSES OR FOR LOST REVENUE. AS OF SEPTEMBER 30, 2020, THE WORLD IS STILL IN THE MIDST OF THE COVID-19 CRISIS. MIDDLESEX HOSPITAL ESTIMATES THE SUBSIDIZED SERVICES ON PART I, LINE 7G TO HAVE A NET COMMUNITY BENEFIT EXPENSE OF $18,809,306 BEFORE THE APPLICATION OF HHS PROVIDER RELIEF FUNDS. THE HOSPITAL ESTIMATES THAT $6,381,758 OF HHS PROVIDER RELIEF FUNDS MAY BE USED TO OFFSET SOME OF THE LOSSES IN THESE DEPARTMENTS. THEREFORE, THIS AMOUNT INCREASED THE AMOUNT OF DIRECT OFFSETTING REVENUE IN PART I, LINE 7G COLUMN D AND ONLY $12,427,548 OF NET COMMUNITY BENEFIT EXPENSE WAS REPORTED IN COLUMN E.
PART II, COMMUNITY BUILDING ACTIVITIES:THE MAJORITY OF MIDDLESEX HOSPITAL'S COMMUNITY BASED HEALTH IMPROVEMENT WORK IS CAPTURED UNDER COMMUNITY BENEFIT CATEGORIES. THE HOSPITAL'S PARTICIPATION IN COMMUNITY BUILDING ACTIVITIES, HOWEVER, HAS A VITAL ROLE IN CONTINUING TO PROMOTE THE HEALTH, WELL-BEING AND SAFETY FOR RESIDENTS IN ITS SERVICE AREA. THE HOSPITAL OFFERS ITS RESOURCES AND EXPERTISE TO SUPPORT AND STRENGTHEN COMMUNITY ASSETS IN A VARIETY OF WAYS THAT FALL UNDER THE SCOPE OF COMMUNITY BUILDING. STAFF MEMBERS ARE HIGHLY PARTICIPATIVE IN COMMUNITY PARTNERSHIPS AND COALITIONS, THE SUCCESS OF WHICH ARE GREATLY ENHANCED BY HOSPITAL COLLABORATION - MANY COMMUNITY INITIATIVES WOULD NOT BE AS EFFECTIVE WITHOUT THE HOSPITAL'S ADMINISTRATIVE AND CLINICAL STAFF IN-KIND INVOLVEMENT, SUPPORT AND EXPERTISE.THE CRITICAL ROLE OF THE NOT-FOR-PROFIT HOSPITAL AS A SAFETY NET AND ANCHOR HEALTHCARE INSTITUTION HAS NEVER BEEN MORE APPARENT THAN DURING THE COVID-19 PANDEMIC THAT COMMENCED IN THE UNITED STATES IN THE EARLY MONTHS OF 2020. IN RESPONSE TO THE COVID-19 PUBLIC HEALTH EMERGENCY, MIDDLESEX HEALTH QUICKLY ASSEMBLED ITS COVID-19 COMMAND CENTER UNDER THE LEADERSHIP OF ITS ENVIRONMENTAL SAFETY & EMERGENCY PREPAREDNESS DEPARTMENT AND WENT INTO IMMEDIATE RESPONSE MODE TO ENSURE IT WAS FULLY EQUIPPED TO ADDRESS THE COVID-19 NEEDS OF THE COMMUNITY WHILE IMPLEMENTING AND MAINTAINING COVID-19 SAFETY PROTOCOLS WITHIN THE HOSPITAL'S WALLS TO ENSURE THAT MIDDLESEX HEALTH WAS 1) READY AND ABLE TO TREAT THE COVID-19 PATIENTS WHO CAME TO THE HOSPITAL AND 2) KEEP ITS NON-COVID-19 PATIENTS SAFE FROM THE VIRUS. COMMAND CENTER ACTIVITIES INCLUDED: 1) ONGOING COORDINATION AND PLANNING WITH THE CITY OF MIDDLETOWN EMERGENCY MANAGEMENT TEAM, THE CITY OF MIDDLETOWN DIRECTOR OF HEALTH, OTHER MUNICIPALITIES AND HEALTH DIRECTORS IN THE HOSPITAL'S SERVICE AREA, COMMUNITY BASED ORGANIZATIONS, STATE LEVEL EMERGENCY RESPONSE TEAMS, AND THE CONNECTICUT HOSPITAL ASSOCIATION EMERGENCY RESPONSE COLLABORATIVE; 2) SUPPLY CHAIN MANAGEMENT AND MONITORING; 3) DEVELOPING COVID-19 SPECIFIC POLICIES AND PROTOCOLS; 4) PROVIDING SUPPORT, EXPERT CONSULTATION AND RESOURCES BOTH INTERNALLY AND EXTERNALLY; 5) TRACKING AND REPORTING COVID-19 CENSUS DATA TO THE CONNECTICUT HOSPITAL ASSOCIATION, STATE OF CONNECTICUT AND FEDERAL AGENCIES; 6) PATIENT SURGE PLANNING; AMONG MANY OTHER VITAL FUNCTIONS. MIDDLESEX HEALTH'S COMMAND CENTER COSTS TOTALLED $1,841,027 FOR FY20, WHICH INCLUDE SIGNIFICANT STAFF TIME AND ADDITIONAL DIRECT EXPENSES. WHILE THIS TOTAL COST HAS BEEN OFFSET BY A GRANT FROM THE STATE OF CONNECTICUT, IT SIGNIFIES THE EXTENSIVE UNDERTAKING BY MIDDLESEX HEALTH TO RESPOND TO THE COVID-19 PANDEMIC IN ORDER TO TREAT ITS COVID-19 PATIENTS AND ALL ITS OTHER PATIENTS NEEDING MEDICAL CARE.PART II, COMMUNITY BUILDING ACTIVITIES, COLUMN (D), DIRECT OFFSETTING REVENUE:DURING FY20, MIDDLESEX HOSPITAL SET UP A MOBILE COMMAND CENTER RELATING TO THE COVID-19 CRISIS. INCLUDED IN REVENUE FROM COMMUNITY BUILDING ACTIVITIES IN PART II, LINE 3 WAS $1,841,027 OF RELIEF FUNDS FROM THE STATE OF CONNECTICUT THAT WAS RECEIVED SUBSEQUENT TO YEAR END. AT SEPTEMBER 30, 2020, THE HOSPITAL DID NOT ACCRUE THIS AMOUNT INTO THE AUDITED FINANCIAL STATEMENTS AS THE CERTAINTY OF RECEIVING THE FUNDS WAS NOT KNOWN. DURING MARCH OF 2021, THE HOSPITAL WAS REIMBURSED BY THE STATE FOR THEIR EMERGENCY COMMAND CENTER. THIS AMOUNT WAS INCLUDED IN THE CURRENT YEAR AS IT ACCURATELY REFLECTS THE REIMBURSEMENT OF THE EXPENSES.
PART III, LINE 2:THE BAD DEBT EXPENSE AMOUNT IN PART III, LINE 2 IS BASED ON CHARGES AND TIED TO THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS. THE HOSPITAL ACCOUNTS FOR DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS IN DETERMINING BAD DEBT EXPENSE BY REDUCING BAD DEBT BY RECOVERIES ON THE HOSPITAL'S FINANCIALS.
PART III, LINE 3:THE HOSPITAL ESTIMATES THAT 10% OF ITS BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THE HOSPITAL HAS A WELL-ESTABLISHED PROCESS WITH ITS THIRD PARTY AGENCIES TO CAPTURE AS MANY PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE AS POSSIBLE AND AWARDS FINANCIAL ASSISTANCE TO THOSE PATIENTS IN COLLECTIONS WHO ARE KNOWN TO QUALIFY. ONCE IN COLLECTIONS, THERE ARE TWO METHODS WHICH ENABLE PATIENTS TO RECEIVE FINANCIAL ASSISTANCE AWARDS: 1) PATIENTS EITHER COMPLETE A FINANCIAL ASSISTANCE APPLICATION, MEET ELIGIBILITY CRITERIA AND ARE APPROVED; OR 2) THE THIRD PARTY ORGANIZATIONS THAT WORK ON BEHALF OF THE HOSPITAL TO COLLECT BALANCES SCREEN FOR FINANCIAL ASSISTANCE ELIGIBILITY. IN ORDER TO ENSURE THAT ALL PATIENTS IN COLLECTIONS ARE AWARE OF FINANCIAL ASSISTANCE AVAILABILITY, THE HOSPITAL REQUIRES THIRD PARTY ORGANIZATIONS TO FOLLOW THE HOSPITAL'S POLICIES REGARDING PATIENT NOTIFICATION ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. WITHIN THE POLICY THERE IS A PROVISION WHEREBY COLLECTION AGENCIES, USING GUIDELINES SET FORTH BY THE HOSPITAL, ASSIST THE HOSPITAL IN IDENTIFYING PATIENTS WHO DO NOT HAVE A MEANS TO PAY FOR SERVICES AND THEREFORE QUALIFY FOR THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM WHILE THESE PATIENTS HAVE NOT GONE THROUGH THE FORMAL APPLICATION PROCESS, THEY MEET THE ELIGIBILITY GUIDELINES FOR FINANCIAL ASSISTANCE AS DEFINED BY THE HOSPITAL. THESE PATIENTS ARE THEN TRANSFERRED AND INCLUDED UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE UMBRELLA. WHILE THIS PROCESS CAPTURES THE MAJORITY OF THOSE WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL RECOGNIZES IT WILL STILL HAVE A POPULATION OF PATIENTS WHO COULD POTENTIALLY QUALIFY FOR FINANCIAL ASSISTANCE AND DO NOT RECEIVE AWARDS THOSE WHO ARE UNCOOPERATIVE, UNRESPONSIVE OR HAVE MOVED AWAY. BAD DEBT DOLLARS ARE NOT INCLUDED IN ANY OF THE HOSPITAL'S PROGRAMMATIC COMMUNITY BENEFIT VALUES AND, WHILE NOTED, ARE NOT INCLUDED IN THE HOSPITAL'S COMMUNITY BENEFIT TOTALS IN ANY HOSPITAL COMMUNITY BENEFIT PUBLICATION.
PART III, LINE 4:THE HOSPITAL ESTIMATES A RESERVE FOR UNCOLLECTIBLE ACCOUNTS AGAINST ITS PATIENT ACCOUNTS RECEIVABLES. WHEN BAD DEBTS ARE IDENTIFIED, THEY ARE ACCOUNTED FOR AS A COMPONENT OF THE NET PATIENT REVENUE PROVISION FOR BAD DEBTS NET OF RECOVERIES. PAGE 14 OF THE MIDDLESEX HEALTH SYSTEM'S CONSOLIDATED FY20 AUDITED FINANCIAL STATEMENT STATES: THE SYSTEM DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON ITS HISTORICAL COLLECTION EXPERIENCE FROM THAT CATEGORY OF PAYOR.
PART III, LINE 8:THE MEDICARE COST REPORT IS THE COSTING METHODOLOGY SYSTEM USED TO DETERMINE THE AMOUNT REPORTED ON PART III, LINES 5 AND 6. THE HOSPITAL UTILIZES WORKSHEET 6 FOUND IN THE FORM 990 INSTRUCTIONS FOR SCHEDULE H TO CALCULATE ITS SUBSIDIZED SERVICES. THE INSTRUCTIONS STATE THAT "THE FINANCIAL LOSS IS MEASURED AFTER REMOVING LOSSES, MEASURED BY COST, ASSOCIATED WITH BAD DEBT, CHARITY CARE, MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS". GIVEN THAT WORKSHEET 6 DOESN'T SUGGEST REMOVING LOSSES ASSOCIATED WITH MEDICARE, A PORTION OF MEDICARE IS INCLUDED IN THE HOSPITAL'S SUBSIDIZED SERVICE CALCULATIONS. SO AS NOT TO DOUBLE COUNT MEDICARE VALUES IN PART III, SECTION B, LINES 5 AND 6, THE PORTION OF MEDICARE SHORTFALL INCLUDED IN OUR SUBSIDIZED SERVICES CALCULATIONS HAS BEEN SUBTRACTED FROM THE MEDICARE REVENUE AND COSTS DERIVED FROM THE MEDICARE COST REPORT. THE VALUES INDICATED IN PART III, LINES 5 AND 6 ARE THEREFORE WHAT REMAINS AFTER THE MEDICARE REVENUE AND COSTS INCLUDED IN THE SUBSIDIZED SERVICES CALCULATIONS HAS BEEN SUBTRACTED OUT. GIVEN THIS, THE RESULTING VALUES (PART III, LINES 5, 6 AND 7) WOULD NEED TO BE COMBINED WITH THE MEDICARE REVENUE/COSTS INCLUDED IN OUR SUBSIDIZED SERVICES TO GET THE FULL OVERVIEW OF MEDICARE REVENUE, COSTS AND ANY REMAINING SHORTFALL OR SURPLUS.WE AGREE WITH THE CURRENT SUBSIDIZED SERVICES CALCULATION METHODOLOGY THAT ALLOWS THE INCLUSION OF MEDICARE DOLLARS AS THE MEDICARE POPULATION COMPRISES AN IMPORTANT SEGMENT OF THOSE RECEIVING SUBSIDIZED SERVICES CARE. THE HOSPITAL TREATS ALL MEDICARE PATIENTS EQUALLY AND DOES NOT DISCRIMINATE AGAINST LOWER-MARGIN YIELDING SERVICES. AS A NOT-FOR-PROFIT HOSPITAL, MIDDLESEX HOSPITAL IS THE SAFETY-NET IN THE COMMUNITY FOR ALL MEDICARE PATIENTS, REGARDLESS OF LEVEL OF MEDICARE COVERAGE AND REGARDLESS IF A SURPLUS OR DEFICIT RESULTS. THIS OPEN ACCESS FOR MEDICARE PATIENTS PROMOTES ACCESS TO CARE, A FUNDAMENTAL TENET OF THE HOSPITAL'S COMMUNITY BENEFIT PROGRAM.THERE REMAINS A DISPROPORTIONATE PERCENTAGE OF OLDER ADULTS IN MIDDLESEX COUNTY WHEN COMPARED TO STATE AVERAGES. MIDDLESEX HEALTH'S 2019 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOUND THAT, WHEN EXTRACTING THE AGE 65+ POPULATION, MIDDLESEX COUNTY (18.4%) EXCEEDS CONNECTICUT (16.0%), (CONNECTICUT DATA COLLABORATIVE, 2013-2017) AND THE MAJORITY OF THE TOWNS IN MIDDLESEX HEALTH'S SERVICE AREA CONTINUE TO HAVE A GREATER CONCENTRATION OF OLDER ADULTS WHEN COMPARED TO CONNECTICUT. THE TOWNS OF COLCHESTER, MIDDLETOWN AND EAST HAMPTON FALL BELOW THE STATE AVERAGE OF 16.0%. MARLBOROUGH, EAST HADDAM, AND DURHAM ARE ON PAR WITH THE STATE AVERAGE, WHILE MIDDLEFIELD, CROMWELL, CLINTON, DEEP RIVER, HADDAM, PORTLAND, KILLINGWORTH, WESTBROOK, CHESTER, OLD SAYBROOK, OLD LYME, ESSEX AND LYME CONSIDERABLY EXCEED THE STATE AVERAGE WITH A RANGE OF 18.5%-32.4% AGE 65+ (CONNECTICUT DATA COLLABORATIVE, 2013-2017). THE TREND OF A DISPROPORTIONATELY HIGHER 65+ OLDER ADULT POPULATION IN THE MAJORITY OF TOWNS IN MIDDLESEX HEALTH'S SERVICE AREA WHEN COMPARED TO THE STATE AVERAGE CONTINUES TO BE EVIDENT FOR POPULATION PROJECTIONS FOR 2020, 2030, AND 2040. FOR 2020, EXCLUDING MIDDLETOWN AND COLCHESTER (AT 14.3% AND 15.2%), THE EXPECTED GROWTH FOR AGE 65+ RANGES FROM 17.3% TO 30.0% IN THE REMAINING SEVENTEEN TOWNS IN MIDDLESEX HEALTH'S SERVICE AREA COMPARED TO 16.1% FOR CONNECTICUT. FOR 2030, EXCLUDING MIDDLETOWN (AT 14.9%), THE EXPECTED GROWTH FOR AGE 65+ RANGES FROM 19.5% TO 34.9% FOR THE REMAINING EIGHTEEN TOWNS IN MIDDLESEX HEALTH'S SERVICE AREA COMPARED TO 17.9% FOR CONNECTICUT. FOR 2040, EXCLUDING MIDDLETOWN (AT 13.9%), THE EXPECTED GROWTH FOR AGE 65+ RANGES FROM 18.5% TO 36.4% IN THE REMAINING EIGHTEEN TOWNS IN MIDDLESEX HEALTH'S SERVICE AREA COMPARED TO 17.3% FOR CONNECTICUT (CONNECTICUT STATE DATA CENTER, 2015-2040 PROJECTIONS). AS MIDDLESEX COUNTY HAS A DISPROPORTIONATE LEVEL OF COMMUNITY MEMBERS AGE 65+ WHEN COMPARED TO STATE AVERAGES, THE SHORTFALL THAT THE HOSPITAL EXPERIENCES IN PROVIDING CRITICAL HEALTHCARE SERVICES TO THE MEDICARE POPULATION SHOULD BE CONSIDERED A COMMUNITY BENEFIT WITHIN THE HOSPITAL'S SUBSIDIZED SERVICES, WHICH THOSE AGE 65+ ALSO RELY HEAVILY ON FOR CARE. THE HOSPITAL FILLS A HEALTHCARE DELIVERY GAP FOR MEDICARE PATIENTS, ONE WHICH WOULD BE DETRIMENTAL TO THE COMMUNITY IF THE HOSPITAL WAS NOT PRESENT.
PART III, LINE 9B:MIDDLESEX HOSPITAL HAS A WRITTEN DEBT COLLECTION POLICY. THE POLICY STATES THAT PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE WILL BE RESPONSIBLE FOR PAYING ANY BALANCE REMAINING AFTER THE FINANCIAL ASSISTANCE ALLOWANCE HAS BEEN APPLIED (THAT IS, IF 100% FINANCIAL ASSISTANCE HAS NOT BEEN AWARDED). THE POLICY ALSO OUTLINES THE PROCESS FOR PAYING OUTSTANDING BALANCES SHOULD THE PATIENT BE FOUND TO HAVE THE MEANS TO PAY A PARTIAL AMOUNT AFTER THE HOSPITAL'S FINANCIAL ASSISTANCE DETERMINATION CRITERIA HAS BEEN APPLIED. FOR SUCH BALANCES, THE HOSPITAL WILL NOTIFY THE PATIENT OF HIS/HER LIABILITY. IF PAYMENT IS NOT MADE, THE POLICY STATES THAT THE HOSPITAL WILL USE APPROPRIATE METHODS TO PURSUE COLLECTION, WHICH MAY INCLUDE COLLECTIONS AGENCIES. THIS PRACTICE IS BROADLY UTILIZED FOR ALL PATIENTS WITH OUTSTANDING BALANCES. THE HOSPITAL MAKES EVERY EFFORT TO ENSURE THAT ALL PATIENTS KNOW PAYMENT PLANS ARE AVAILABLE FOR ANY BALANCE, INCLUDING THOSE PATIENTS WHO HAVE A BALANCE LEFT OVER AFTER A FINANCIAL ASSISTANCE AWARD HAS BEEN APPLIED. IN ORDER TO CAPTURE THE PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE, THE HOSPITAL HAS PROVISIONS IN ITS COLLECTION POLICY. IN THE CASE WHERE PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE DO NOT COMPLETE A FINANCIAL ASSISTANCE APPLICATION AND ARE PLACED INTO COLLECTIONS, THE THIRD PARTY ORGANIZATIONS THAT WORK ON BEHALF OF THE HOSPITAL TO COLLECT BALANCES SCREEN FOR FINANCIAL ASSISTANCE ELIGIBILITY. THE THIRD PARTY ORGANIZATIONS FOLLOW HOSPITAL POLICY BY ALERTING ALL PATIENTS IN COLLECTIONS TO THE AVAILABILITY OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. WITHIN THE HOSPITAL'S COLLECTION POLICY THERE IS A PROVISION WHEREBY COLLECTION AGENCIES, USING GUIDELINES SET FORTH BY THE HOSPITAL, ASSIST THE HOSPITAL IN IDENTIFYING PATIENTS WHO DO NOT HAVE A MEANS TO PAY FOR SERVICES AND THEREFORE QUALIFY FOR THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM WHILE THESE PATIENTS HAVE NOT GONE THROUGH THE FORMAL APPLICATION PROCESS, THEY MEET THE ELIGIBILITY GUIDELINES FOR FINANCIAL ASSISTANCE AS DEFINED BY THE HOSPITAL. THESE PATIENTS ARE THEN TRANSFERRED AND INCLUDED UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE UMBRELLA. THIS PROCESS WAS PUT IN PLACE BY THE HOSPITAL IN ORDER TO CAPTURE AS MANY PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE AS POSSIBLE.
PART VI, LINE 2:SINCE THE INCEPTION OF MIDDLESEX HEALTH'S COMMUNITY BENEFIT POLICY IN 2007, AND PRIOR TO THE MANDATE OF THE AFFORDABLE CARE ACT, CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN ORDER TO PRIORITIZE SPECIFIC COMMUNITY BENEFIT INITIATIVES HAS BEEN A CORE ELEMENT OF THE HOSPITAL'S COMMUNITY BENEFIT PROGRAM. IN ADDITION TO COMPLETING A CHNA, THE HOSPITAL ASSESSES THE NEEDS OF THE COMMUNITIES IT SERVICES ON AN ON-GOING BASIS THROUGH A VARIETY OF METHODS. EXAMPLES INCLUDE UNDERSTANDING THE LOCAL AND STATE-WIDE NEEDS DERIVED FROM: 1) PARTICIPATION IN COMMUNITY HEALTHCARE COALITIONS AND BOARDS, WHICH INCLUDE STRATEGIC PLANNING THAT IS RESPONSIVE TO COMMUNITY NEED; 2) PARTICIPATION IN THE LEADERSHIP TEAM OF THE GREATER MIDDLETOWN HEALTH ENHANCEMENT COMMUNITY (GMHEC), A PLACE-BASED INITIATIVE THAT SUPPORTS LONG-TERM, COLLABORATIVE, AND CROSS-SECTOR EFFORTS TO IMPROVE COMMUNITY HEALTH AND WELL-BEING THROUGH BROAD, SYSTEMIC CHANGE BY BUILDING HEALTHY AND EQUITABLE COMMUNITIES THAT ACTIVELY WORK TOGETHER TO PREVENT THE DEVELOPMENT OF DISEASE; 3) PARTICIPATION IN THE STATE'S HOSPITAL ASSOCIATION POPULATION AND COMMUNITY HEALTH INITIATIVES BASED ON STATE-WIDE AND LOCAL COMMUNITY HEALTH ISSUES; 4) ANY REAL-TIME COMMUNITY BASED INPUT, FEED-BACK, RECOMMENDATIONS AND SUGGESTIONS; AND 5) CONTINUOUS ASSESSMENT AND ADJUSTMENTS, WHEN NECESSARY, OF THE HOSPITAL'S COMMUNITY BENEFIT PROGRAMS THROUGH SURVEYS AND PATIENT/PARTICIPANT FEED-BACK. HAVING A STRONG PRESENCE IN COMMUNITY COALITIONS AND PARTNERSHIPS, IN ADDITION TO BEING RESPONSIVE TO THE NEEDS EXPRESSED BY OUR COMMUNITY RESIDENTS, ALLOWS MIDDLESEX HOSPITAL TO CONTINUALLY ASSESS THE HEALTHCARE NEEDS OF OUR COMMUNITY IN BETWEEN COMMUNITY HEALTH NEEDS ASSESSMENT CYCLES.
PART VI, LINE 3:GREAT CONCERN IS TAKEN TO ENSURE THAT PATIENTS ARE APPRISED OF THE AVAILABILITY OF FEDERAL/STATE/LOCAL GOVERNMENT PROGRAMS AND THE HOSPITAL'S FINANCIAL ASSISTANCE PLAN. NOTICE OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM IS DISPLAYED CONSPICUOUSLY IN ENGLISH AND SPANISH AT THE ENTRY OF EACH FACILITY AND AT ALL PATIENT REGISTRATION POINTS. THE NOTIFICATION INCLUDES AN OVERVIEW OF THE HOSPITAL'S FINANCIAL AID PROGRAM; THE AVAILABILITY OF FREE BED FUNDS AND OTHER FINANCIAL ASSISTANCE; SLIDING SCALE; AND FINANCIAL COUNSELOR CONTACT INFORMATION. AT THE TIME OF REGISTRATION, HOSPITAL ACCESS STAFF REVIEWS THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM AND ASKS THE PATIENT IF HE/SHE WOULD LIKE A FINANCIAL ASSISTANCE PACKAGE. BUILT INTO THE REGISTRATION DATABASE IS A REQUIRED FINANCIAL ASSISTANCE FIELD WHICH MUST BE COMPLETED AS PART OF THE ADMISSIONS PROCESS. ONCE THE PATIENT EXPRESSES THE DESIRE TO RECEIVE A FINANCIAL ASSISTANCE PACKAGE, PAPERWORK WITH PATIENT NAME AND MEDICAL RECORD IS AUTOMATICALLY PRINTED AT THE REGISTRATION STATION AND HANDED TO THE PATIENT. OTHER METHODS OF COMMUNICATION TO INCREASE AWARENESS REGARDING THE FINANCIAL ASSISTANCE AND FREE BED FUND PROGRAM INCLUDE 1) A FINANCIAL ASSISTANCE BROCHURE THAT AIDS PATIENTS IN THE PROCESS, ANSWERS KEY QUESTIONS AND PROVIDES EASY ACCESS FOR HELP (AVAILABLE AT MULTIPLE HOSPITAL DEPARTMENTS AND LOCATIONS, INCLUDING KIOSKS AT EVERY HOSPITAL ENTRY POINT); 2) A SEPARATE AND DISTINCT FINANCIAL ASSISTANCE SERVICES SECTION ON THE HOSPITAL'S WEB-SITE (HTTPS://MIDDLESEXHEALTH.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE-SERVICES) WHICH INCLUDES APPLICATION, INSTRUCTIONS, AND SLIDING SCALE; 3) INCLUSION OF FINANCIAL ASSISTANCE INFORMATION IN THE HOSPITAL'S INPATIENT ADMISSIONS BOOKLET; 4) NOTICE OF THE PROGRAM AND FINANCIAL COUNSELOR CONTACT INFORMATION ON EVERY BILLING STATEMENT; 5) NOTIFICATION AT DISCHARGE; AND 6) A LETTER OUTLINING THE PROGRAM SENT TO EVERY SELF-PAY PATIENT FOLLOWING DISCHARGE. THE HOSPITAL HAS A TEAM OF FINANCIAL COUNSELORS WHO ARE AVAILABLE TO ASSIST THE PATIENT THROUGH THE APPLICATION PROCESS EITHER BY PHONE OR VISIT. THE ROLE OF THE COUNSELORS IS TO HELP PATIENTS NAVIGATE THE HOSPITAL'S FINANCIAL ASSISTANCE PROCESS AND TO AID IN APPLICATION FOR MEDICAID/STATE PROGRAMS. ALL COUNSELORS RECEIVE DEPARTMENTAL TRAINING ON THE IMPORTANCE OF ASSISTING PATIENTS IN NEED OF STATE/GOVERNMENTAL OR HOSPITAL FINANCIAL ASSISTANCE, THE HOSPITAL'S FINANCIAL ASSISTANCE PROTOCOLS, SYSTEMS, NEW PROGRAM ENHANCEMENTS, AND HOW TO PROVIDE SUPPORT AND FOLLOW-UP FOR MEDICAID/STATE ENROLLMENT. THE HOSPITAL'S SOCIAL WORKERS ALSO ASSIST PATIENTS WITH COMPLETION OF HOSPITAL FINANCIAL ASSISTANCE APPLICATIONS AS WELL AS MEDICAID/STATE APPLICATIONS. AN IMPORTANT ADDITION TO MIDDLESEX HOSPITAL'S FINANCIAL ASSISTANCE PROCESS HAS BEEN THE DEVELOPMENT OF THE FINANCIAL ASSISTANCE WORKGROUP SEVERAL YEARS AGO. WORKGROUP TASKS INCLUDE: INCREASING AWARENESS REGARDING FINANCIAL ASSISTANCE AVAILABILITY; CONTINUOUS MONITORING OF APPROPRIATENESS, FEASIBILITY AND ACCESSIBILITY OF THE HOSPITAL'S FINANCIAL ASSISTANCE PRACTICES; AND A COMPREHENSIVE COMMUNICATIONS STRATEGY FOR INCREASING AWARENESS FOR FINANCIAL ASSISTANCE. IN FY20, MIDDLESEX HOSPITAL GRANTED $2,733,869 OF FINANCIAL ASSISTANCE TO 2,870 UNIQUE RECIPIENTS AND ABSORBED $23,170,834 IN UNPAID COSTS OF MEDICAID (TOTAL OF MEDICAID INCLUDING MANAGED CARE AND LIA), SERVING 22,070 INDIVIDUALS.
PART VI, LINE 4:MIDDLESEX HOSPITAL IS THE SOLE HOSPITAL PROVIDER IN ITS SERVICE AREA, WHICH INCLUDES THE LARGE GEOGRAPHIC AREA OF MIDDLESEX COUNTY AND SURROUNDING TOWNS. IT ENCOMPASSES 24 MUNICIPALITIES, INCLUDING THE 15 TOWNS OF MIDDLESEX COUNTY. MIDDLESEX HOSPITAL HEALTH'S SERVICE AREA INCLUDES TWENTY-FOUR MUNICIPALITIES. THERE ARE NINETEEN TOWNS IN ITS PRIMARY SERVICE AREA: CHESTER, CLINTON, CROMWELL, DEEP RIVER, DURHAM, EAST HADDAM, EAST HAMPTON, ESSEX, HADDAM, KILLINGWORTH, MIDDLEFIELD, MIDDLETOWN, OLD SAYBROOK, PORTLAND, AND WESTBROOK (THE FIFTEEN TOWNS OF MIDDLESEX COUNTY) AND COLCHESTER, LYME, MARLBOROUGH AND OLD LYME; AND, FIVE TOWNS IN ITS SECONDARY SERVICE AREA: GUILFORD, HEBRON, MADISON, MERIDEN, AND ROCKY HILL. BY LAND AREA, MIDDLESEX COUNTY (369 SQUARE MILES) IS THE SMALLEST COUNTY OF THE EIGHT COUNTIES IN CONNECTICUT, AND IS THE SIXTH IN POPULATION SIZE (CONNECTICUT DATA COLLABORATIVE, 2017). MUNICIPALITY SIZES BY LAND MASS VARY THROUGHOUT THE COUNTY, FROM 54 SQUARE MILES (EAST HADDAM) TO 10 SQUARE MILES (ESSEX), WITH MIDDLETOWN HAVING 41 SQUARE MILES OF LAND AREA. THE CITY OF MIDDLETOWN (ZIP CODE 06457) IS CENTRALLY LOCATED 16 MILES SOUTH OF HARTFORD. THE POPULATION IN MIDDLETOWN IS ECONOMICALLY AND RACIALLY/ETHNICALLY MORE DIVERSE WHEN COMPARED TO OTHER MUNICIPALITIES IN MIDDLESEX COUNTY AND IS ONE OF THE FEW COMMUNITIES IN CONNECTICUT TO INCLUDE URBAN, SUBURBAN, AND RURAL CHARACTERISTICS. THE DATA THAT FOLLOWS IS PER MIDDLESEX HEALTH'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT (2019). OF THE TOTAL STATE OF CONNECTICUT POPULATION (3,588,184), 4.6% (163,410) RESIDE IN MIDDLESEX COUNTY. WITH A POPULATION OF 46,478 (CONNECTICUT DATA COLLABORATIVE, 2017), MIDDLETOWN IS THE LARGEST MUNICIPALITY IN MIDDLESEX COUNTY. THE REMAINING TOWNS IN MIDDLESEX HEALTH'S PRIMARY SERVICE AREA FALL INTO THREE POPULATION RANGES: COLCHESTER, CROMWELL, CLINTON, EAST HAMPTON AND OLD SAYBROOK HAVE POPULATIONS BETWEEN 10,000 AND 16,100; PORTLAND, EAST HADDAM, HADDAM, OLD LYME, DURHAM, WESTBROOK, ESSEX, KILLINGWORTH, AND MARLBOROUGH HAVE POPULATIONS BETWEEN 5,000 AND 9,999; AND CHESTER, DEEP RIVER, MIDDLEFIELD, AND LYME HAVE POPULATIONS LESS THAN 5,000. THE CONNECTICUT OFFICE OF RURAL HEALTH (CT-ORH) DEFINES RURAL AS ALL TOWNS WITH A POPULATION CENSUS OF 10,000 OR LESS AND A POPULATION DENSITY OF 500 OR LESS PEOPLE PER SQUARE MILE. BASED ON THIS METRIC, THE TOWNS OF CHESTER, DEEP RIVER, DURHAM, EAST HADDAM, HADDAM, KILLINGWORTH, LYME, MARLBOROUGH, MIDDLEFIELD, OLD LYME, PORTLAND, AND WESTBROOK ARE CONSIDERED RURAL.FOR THE AGE DISTRIBUTIONS, MIDDLESEX COUNTY IS BELOW STATE AVERAGES IN THE 0-44 AGE CATEGORIES AND HAS A HIGHER PERCENTAGE OF RESIDENTS IN THE 45-54, 55-64, 65-74, 75-84, AND 85+ AGE RANGES WHEN COMPARED TO THE STATE. WHEN EXTRACTING AGE 65+, MIDDLESEX COUNTY (18.4%) EXCEEDS CONNECTICUT (16.0%), AND THE MAJORITY OF THE TOWNS IN MIDDLESEX HEALTH'S SERVICE AREA CONTINUE TO HAVE A GREATER CONCENTRATION OF OLDER ADULTS WHEN COMPARED TO CONNECTICUT. THE TOWNS OF COLCHESTER, MIDDLETOWN AND EAST HAMPTON FALL BELOW THE STATE AVERAGE OF 16.0%. MARLBOROUGH, EAST HADDAM, AND DURHAM ARE ON PAR WITH THE STATE AVERAGE, WHILE MIDDLEFIELD, CROMWELL, CLINTON, DEEP RIVER, HADDAM, PORTLAND, KILLINGWORTH, WESTBROOK, CHESTER, OLD SAYBROOK, OLD LYME, ESSEX AND LYME CONSIDERABLY EXCEED THE STATE AVERAGE WITH A RANGE OF 18.5%-32.4% AGE 65+ (CONNECTICUT DATA COLLABORATIVE, 2013-2017).MIDDLETOWN HAS A MORE DIVERSE DEMOGRAPHIC RELATIVE TO THE OTHER TOWNS IN MIDDLESEX COUNTY AND RESEMBLES CONNECTICUT EXCEPT IN THE HISPANIC OR LATINO CATEGORY, WHERE MIDDLETOWN HAS A SMALLER POPULATION. MIDDLESEX COUNTY'S RACE AND HISPANIC OR LATINO ORIGIN COMPOSITION IS 83.7% WHITE, NON-HISPANIC; 5.5% BLACK OR AFRICAN AMERICAN, NON-HISPANIC; 6.4% HISPANIC OR LATINO; 3.2% ASIAN, NON-HISPANIC; 2.1% TWO OR MORE RACES, NON-HISPANIC (U.S. CENSUS QUICK FACTS 2017; VINTAGE 2018 POPULATION ESTIMATES PROGRAM). MIDDLETOWN'S RACE AND HISPANIC OR LATINO ORIGIN COMPOSITION IS 69.5%% WHITE, NON-HISPANIC; 13.6% BLACK OR AFRICAN AMERICAN, NON-HISPANIC; 9.2% HISPANIC OR LATINO; 5.6% ASIAN, NON-HISPANIC; 2.9% TWO OR MORE RACES, NON-HISPANIC (U.S. CENSUS QUICK FACTS 2017; VINTAGE 2018 POPULATION ESTIMATES PROGRAM).THE MEDIAN HOUSEHOLD INCOME IN MIDDLESEX COUNTY ($81,673) IS HIGHER THAN THE STATE OF CONNECTICUT AVERAGE ($73,781) [CONNECTICUT DATA COLLABORATIVE, 2017]. THERE IS A SIGNIFICANT RANGE BETWEEN THE TOWNS IN MIDDLESEX COUNTY, WITH MIDDLETOWN AT THE LOWER BOUND ($63,914) AND DURHAM AT THE HIGHEST LEVEL ($116,232) [CONNECTICUT DATA COLLABORATIVE, 2017]. THERE ARE SIGNIFICANT MEDIAN HOUSEHOLD INCOME DISPARITIES AMONG THE BLACK OR AFRICAN AMERICAN ALONE ($44,554 FOR MIDDLETOWN AND $47,642 FOR MIDDLESEX COUNTY) AND HISPANIC OR LATINO POPULATIONS ($47,313 FOR MIDDLETOWN AND $71,131 FOR MIDDLESEX COUNTY) WHEN COMPARED TO WHITE ALONE NOT HISPANIC OR LATINO ($69,509 FOR MIDDLETOWN AND $84,402 FOR MIDDLESEX COUNTY) [CONNECTICUT DATA COLLABORATIVE, 2013-2017]. FOR POVERTY STATUS, MIDDLETOWN'S TOTAL (11.3%) AND UNDER 18 (15.5%) POVERTY RATES EXCEED CONNECTICUT'S RATE OF 10.1% AND 13.5% RESPECTIVELY (CONNECTICUT DATA COLLABORATIVE, 2013-2017), WITH THE TOWNS OF CLINTON, COLCHESTER, CROMWELL, DEEP RIVER, MIDDLEFIELD AND PORTLAND EXPERIENCING INCREASED POVERTY STATUS FOR THE UNDER 18 CATEGORY RELATIVE TO THE OTHER TOWNS IN MIDDLESEX HOSPITAL'S SERVICE AREA. TOTAL AND UNDER 18 POVERTY RATES ARE SIGNIFICANTLY MORE PRONOUNCED AMONG THE BLACK OR AFRICAN AMERICAN ALONE (TOTAL: 20.3% FOR MIDDLETOWN AND 17.8% FOR MIDDLESEX COUNTY & UNDER 18: 30.0% FOR MIDDLETOWN AND 26.9% FOR MIDDLESEX COUNTY) AND HISPANIC OR LATINO POPULATIONS (TOTAL: 25.1% FOR MIDDLETOWN AND 17.4% FOR MIDDLESEX COUNTY & UNDER 18: 27.9% FOR MIDDLETOWN AND 23.0% FOR MIDDLESEX COUNTY) WHEN COMPARED TO WHITE ALONE NOT HISPANIC OR LATINO (TOTAL: 8.0% FOR MIDDLETOWN AND 5.9% FOR MIDDLESEX COUNTY & UNDER 18: 10.0% FOR MIDDLETOWN AND 5.6% FOR MIDDLESEX COUNTY) [CONNECTICUT DATA COLLABORATIVE, 2013-2017].THE EDUCATIONAL ATTAINMENT FOR MIDDLESEX COUNTY MIRRORS CONNECTICUT, EXCEPT IN THE OUTER BOUNDS (PERCENT OF NO HIGH SCHOOL DIPLOMA AND PERCENT OF BACHELOR'S DEGREE OR HIGHER) FOR MIDDLESEX COUNTY WHICH INDICATE SOMEWHAT BETTER RATES WHEN BENCHMARKED AGAINST CONNECTICUT (AMERICAN COMMUNITY SURVEY (ACS) 5-YEAR; DATAHAVEN ANALYSIS 2017). THE UNEMPLOYMENT RATES FOR THE TOWNS IN MIDDLESEX HEATH'S SERVICE AREA ARE LOWER THAN CONNECTICUT'S AVERAGE OF 4.1% (CONNECTICUT DATA COLLABORATIVE, 2018), EXCEPT FOR MIDDLETOWN, WHICH MIRRORS THE STATE RATE. WHILE THE MAJORITY OF TOWNS IN MIDDLESEX HEALTH'S SERVICE AREA EXPERIENCE A LOWER HOUSING COST-BURDEN RATE (HOUSEHOLDS THAT SPEND AT LEAST 30% OF THEIR ANNUAL HOUSEHOLD INCOME ON HOUSING COSTS) WHEN COMPARED TO CONNECTICUT (40.7%), THE PERCENTAGE OF HOUSEHOLDS IN THE TOWNS THAT ARE COST-BURDENED IS HIGH, RANGING FROM 26.9% - 35.8%. THE TOWNS OF MIDDLETOWN AND WESTBROOK COMPARE TO CONNECTICUT, WHILE CLINTON, LYME, DEEP RIVER AND OLD SAYBROOK EXCEED THE STATE AVERAGE WITH A RANGE OF 43.3% - 47.9% EXPERIENCING HOUSING COST-BURDEN (CONNECTICUT DATA COLLABORATIVE, 2013-2017).ALL TOWNS IN MIDDLESEX HEALTH'S SERVICE AREA HAVE A LOWER UNINSURED RATE WHEN COMPARED TO CONNECTICUT (6.4%), EXCEPT CLINTON (8.1%), DEEP RIVER (8.1%) AND WESTBROOK (6.9%). DEEP RIVER IS THE ONLY TOWN IN MIDDLESEX HEALTH'S SERVICE AREA THAT HAS A SLIGHTLY LOWER PRIVATE INSURANCE RATE WHEN COMPARED TO CONNECTICUT. ALL TOWNS IN MIDDLESEX HEALTH'S SERVICE AREA HAVE A LOWER PERCENTAGE OF PUBLIC HEALTH INSURANCE WHEN COMPARED TO CONNECTICUT (33.4%), EXCEPT OLD SAYBROOK (41.6%), LYME (40.1%), OLD LYME (37.2%), ESSEX (36.7%) AND CHESTER (35.3%), WHICH IS LIKELY DUE TO HIGHER MEDICARE ENROLLMENT GIVEN THE AGE DISTRIBUTION OF THOSE TOWNS (CONNECTICUT DATA COLLABORATIVE, 2013-2017).IN 2020, THE PERCENT OF HOSPITAL DISCHARGES FOR MEDICAID/SAGA/UNINSURED COMBINED WERE: 21% INPATIENT; 14% OUTPATIENT; 29% EMERGENCY DEPARTMENT NON-ADMISSION; AND, FOR THE FOLLOWING SERVICES: 36% NEWBORN; 46% INPATIENT PSYCHIATRY; 13% OUTPATIENT SURGERY AND 14% OTHER OUTPATIENT SERVICES. MIDDLESEX COUNTY HAS BEEN DESIGNATED BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) TO BE A MEDICALLY UNDERSERVED AREA EXPERIENCING A SHORTAGE OF SELECT HEALTH SERVICES WHICH INCLUDE A LACK OF ACCESS TO PRIMARY CARE SERVICES.
PART VI, LINE 5:AS MIDDLESEX HOSPITAL IS A COMMUNITY HOSPITAL, INVOLVING COMMUNITY MEMBERS IN KEY FUNCTIONS HAS ALWAYS BEEN A PRIORITY. MIDDLESEX HOSPITAL'S BOARD IS COMPRISED MAINLY OF COMMUNITY MEMBERS WHO ARE NEITHER EMPLOYEES, FAMILY MEMBERS NOR CONTRACTORS OF THE ORGANIZATION, BUT ARE LONG-TERM RESIDENTS WHOSE PRIMARY INTEREST IS THE HEALTH AND WELL-BEING OF THE COMMUNITY AT LARGE. MIDDLESEX HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY BASED ON THE HOSPITAL'S CURRENT AND PROJECTED PATIENT CARE, TEACHING AND RESEARCH NEEDS, AND OVERALL COMMUNITY NEED. MEDICAL STAFF INPUT AND PARTICIPATION IS HIGHLY VALUED BY THE HOSPITAL AS EVIDENCED BY INCLUSION IN THE HOSPITAL'S MEDICAL EXECUTIVE COMMITTEE, THE MEDICAL STAFF COUNCIL AND COUNTLESS OTHER WORKING COMMITTEES. MIDDLESEX HOSPITAL HAS A FORMAL PROCESS FOR ALLOCATION OF SURPLUS FUNDS; A MULTIDISCIPLINARY CAPITAL BUDGETING COMMITTEE MEETS AND SETS PRIORITIES FOR INVESTMENTS IN PATIENT CARE, EDUCATION AND RESEARCH, AND PHYSICAL STRUCTURE. THE APPROACH TAKES INTO CONSIDERATION PATIENT, COMMUNITY AND STAFF NEEDS. EACH YEAR THE HOSPITAL ALLOCATES A PORTION OF SURPLUS FUNDING TO A WIDE ARRAY OF COMMUNITY BENEFIT PROGRAMS AND SERVICE LINES, INCLUDING SUBSTANTIAL HEALTH AND WELLNESS ACTIVITIES AND INITIATIVES, SUBSIDIZED SERVICES, MEDICAL EDUCATION, RESEARCH AND HEALTH ASSESSMENT COSTS. CONTINUOUS DEDICATION TO THE COMMUNITIES IT SERVES REMAINS THE HALLMARK OF MIDDLESEX HOSPITAL'S VISION, MISSION, AND STRATEGIC PLANNING. AMBITIOUS COMMUNITY BENEFIT GOALS, THE INCORPORATION OF COMMUNITY BENEFIT INTO ANNUAL ORGANIZATIONAL PLANNING, AND THE PROVISION OF COMMUNITY BENEFIT PROGRAMS THAT TARGET THE COMMUNITY'S MOST VULNERABLE AND AT-RISK POPULATIONS HAS ALLOWED THE HOSPITAL TO PUT A FORMAL STRUCTURE AROUND ITS FUNDAMENTAL PURPOSE. THE HOSPITAL'S COMMUNITY BENEFIT TOTAL FOR FY20 WAS $58,653,898 (EXCLUDING COMMUNITY BUILDING) WITH 111,403 SERVED (EXCLUDING COMMUNITY BUILDING). IN THE LATTER HALF OF MIDDLESEX HEALTH'S FISCAL YEAR 2020 (MARCH 2020 - SEPTEMBER 2020), SOME OF ITS COMMUNITY BENEFIT PROGRAMS WERE CANCELLED DUE TO THE COVID-19 PANDEMIC, PARTICULARLY ON-SITE LEARNING OPPORTUNITIES FOR STUDENTS. MIDDLESEX HEALTH WAS ABLE TO PIVOT IN MOST CASES BY TRANSITIONING THEIR PROGRAMS TO THE VIRTUAL PLATFORM, MOST NOTABLY ITS SUPPORT GROUPS AND OTHER HEALTH-BASED EDUCATIONAL INITIATIVES. THE FOLLOWING IS AN OVERVIEW OF THE HOSPITAL'S COMMUNITY BENEFIT PROGRAM: COMMUNITY HEALTH IMPROVEMENT SERVICES: THE HOSPITAL UNDERWRITES A VAST RANGE OF COMMUNITY HEALTH EDUCATION AND HEALTH IMPROVEMENT PROGRAMS, NONE OF WHICH ARE DEVELOPED FOR MARKETING PURPOSES, ALL OF WHICH ARE SUPPORTED AS A MEANS OF FULFILLING THE HOSPITAL'S MISSION TO SERVE ITS COMMUNITY. ALMOST 100% OF THE TIME THESE SERVICES ARE OFFERED FREE OF CHARGE; IN THE RARE INSTANCE WHERE A NOMINAL FEE IS ASSESSED THE COST OF PROVIDING THE SERVICE IS NOT COVERED. COMMUNITY HEALTH EDUCATION IS PROVIDED TO THE COMMUNITY AT LARGE. SOME OF THE PROGRAMS REPRESENT ONE TIME EVENTS, HOWEVER MOST ARE ONGOING AND OVER THE YEARS HAVE BECOME ENTRENCHED IN THE COMMUNITY AS A SOURCE OF SUPPORT AND CONTINUED EDUCATION FOR A HEALTHFUL FUTURE. EXAMPLES OF COMMUNITY HEALTH IMPROVEMENT SERVICES INCLUDE (BUT ARE NOT LIMITED TO): 1) HEALTH EDUCATION (COMMUNITY EDUCATION PRESENTATIONS; HEALTH AND WELLNESS EVENTS/HEALTH FAIRS; SUPPORT GROUPS; LARGE SCALE CANCER AWARENESS AND EDUCATIONAL EVENTS; AND THE AVAILABILITY OF HEALTH LITERATURE); 2) COMMUNITY-BASED CLINICAL SERVICES (CLINICS AND SCREENINGS; ANNUAL FLU SHOTS; BLOOD PRESSURE CLINICS); AND 3) HEALTHCARE SUPPORT SERVICES OFFERED TO INCREASE ACCESS AND QUALITY OF CARE TO INDIVIDUALS, ESPECIALLY THOSE LIVING IN POVERTY AND/OR OTHER VULNERABLE POPULATIONS (CENTER FOR CHRONIC CARE MANAGEMENT DISEASE MANAGEMENT OUTPATIENT PROGRAMS FOR ADULT ASTHMA; CHILD ASTHMA; DIABETES EDUCATION AND DISEASE MANAGEMENT; MEDICAL NUTRITION THERAPY; SMOKING CESSATION; CHRONIC HEART FAILURE; AND CHILDHOOD WEIGHT MANAGEMENT). IN FY20, THE HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT SERVICES SERVED 23,255 INDIVIDUALS AT A TOTAL COST OF $2,833,263 TO THE HOSPITAL. HEALTH PROFESSIONS EDUCATION: HELPING TO PREPARE FUTURE HEALTH CARE PROFESSIONALS IS A LONG-STANDING COMMITMENT OF MIDDLESEX HOSPITAL AND DISTINGUISHING CHARACTERISTIC THAT CONSTITUTES A SIGNIFICANT COMMUNITY BENEFIT. THE HOSPITAL'S FAMILY MEDICINE RESIDENCY PROGRAM GRADUATES FAMILY PRACTICE PHYSICIANS, MANY OF WHOM CONTINUE TO PRACTICE IN THE MIDDLESEX COUNTY AREA AFTER THEIR TRAINING IS COMPLETE. THIS IS ESPECIALLY IMPORTANT GIVEN THAT MIDDLESEX COUNTY HAS BEEN DESIGNATED BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) TO BE A MEDICALLY UNDERSERVED AREA (MUA) EXPERIENCING A SHORTAGE OF SELECT HEALTH SERVICES WHICH INCLUDES TOO FEW PRIMARY CARE PROVIDERS. IN ADDITION, HRSA REPORTS THAT MIDDLESEX COUNTY IS A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) FOR PRIMARY MEDICAL CARE. THE HOSPITAL ALSO WELCOMES MEDICAL AND NURSING STUDENT INTERNS AND PROVIDES ON-SITE TRAINING DURING CLINICAL ROTATIONS. NURSING STUDENTS FROM LOCAL COLLEGES AND PROGRAMS RECEIVE HANDS-ON MENTORSHIP IN THE MAJORITY OF CLINICAL SERVICE LINES YEAR-ROUND. OTHER HEALTHCARE PROFESSIONAL EDUCATION INCLUDES THE HOSPITAL'S RADIOLOGY SCHOOL (WHICH OPERATES AT A LOSS FOR THE HOSPITAL) AND CLINICAL/NON-CLINICAL EDUCATIONAL STUDENT TRAINING IN MULTIPLE FIELDS. IN FY20, THE HOSPITAL'S HEALTH PROFESSIONS EDUCATION CATEGORY SERVED 1,504 INDIVIDUALS AT A TOTAL COST OF $10,439,224 TO THE HOSPITAL. SUBSIDIZED HEALTH SERVICES: THE HOSPITAL'S SUBSIDIZED HEALTH SERVICES REPRESENT A SIGNIFICANT PORTION OF MIDDLESEX HOSPITAL'S ANNUAL COMMUNITY BENEFIT AGGREGATE FINANCIALS AND NUMBERS SERVED. SUBSIDIZED SERVICES ARE PARTICULAR CLINICAL PROGRAMS PROVIDED TO THE COMMUNITY DESPITE A FINANCIAL LOSS, WITH NEGATIVE MARGINS REMAINING AFTER SPECIFIC DOLLARS (FINANCIAL ASSISTANCE AND BAD DEBT) AND SHORTFALLS (MEDICAID) ARE REMOVED. IN ORDER TO QUALIFY AS A SUBSIDIZED SERVICE, THE PROGRAM MUST MEET CERTAIN HEALTH DELIVERY CRITERIA; MEET AN IDENTIFIED NEED IN THE COMMUNITY; AND WOULD BECOME UNAVAILABLE OR THE RESPONSIBILITY OF A GOVERNMENTAL OR ANOTHER NOT-FOR-PROFIT AGENCY TO PROVIDE IF THE HOSPITAL DISCONTINUED THE SERVICE. MIDDLESEX HOSPITAL'S SUBSIDIZED SERVICES INCLUDE FAMILY PRACTICE SERVICES, BEHAVIORAL HEALTH (INPATIENT AND OUTPATIENT), HOMECARE, EMERGENCY DEPARTMENT, PARAMEDICS, HOSPICE, DIABETES EDUCATION, AMBULATORY INFUSION, CARDIAC REHAB, PULMONARY REHAB AND WOUND CARE. IN FY20 THE HOSPITAL'S SUBSIDIZED SERVICES SERVED 59,696 PEOPLE WITH A TOTAL COST OF $18,809,306 TO THE HOSPITAL. RESEARCH: MIDDLESEX HOSPITAL CONDUCTS RESEARCH IN THE DOMAINS OF CLINICAL AND COMMUNITY HEALTH. CLINICAL EXAMPLES INCLUDE NATIONAL TRIALS BY THE HOSPITAL'S CANCER CENTER FOR BREAST, LUNG, PROSTATE, COLORECTAL, AMONG OTHERS. FOR FY20, THE HOSPITAL'S ASSOCIATED COSTS FOR ALL (NON-INDUSTRY) RESEARCH PROJECTS TOTALED $252,796 AND SERVED 151 INDIVIDUALS. FINANCIAL AND IN-KIND CONTRIBUTIONS: MIDDLESEX HOSPITAL SUPPORTS THE COMMUNITY IN THE FORM OF FINANCIAL AND IN-KIND CONTRIBUTIONS. THE HOSPITAL'S MAIN CAMPUS AND SATELLITE LOCATIONS MAKE MEETING SPACE AVAILABLE, FREE-OF-CHARGE AND ON AN ON-GOING BASIS, FOR MANY COMMUNITY GROUPS THAT WOULD OTHERWISE STRUGGLE TO PAY FOR SPACE. IN ADDITION, EACH YEAR THE HOSPITAL MAKES SUBSTANTIAL CASH DONATIONS TO CAREFULLY SELECTED MISSION-DRIVEN COMMUNITY ORGANIZATIONS THROUGHOUT ITS SERVICE AREA. THE HOSPITAL'S FY20 SUPPORT FOR FINANCIAL AND IN-KIND CONTRIBUTIONS TOTALED $275,056, SERVING 1,857 INDIVIDUALS. COMMUNITY BENEFIT OPERATIONS: COMMUNITY BENEFIT OPERATIONS INCLUDE ACTIVITIES AND COSTS ASSOCIATED WITH COMMUNITY BENEFIT STRATEGIC PLANNING, ADMINISTRATION, ANNUAL GOAL ATTAINMENT, AND COMMUNITY HEALTH NEEDS ASSESSMENT PRODUCTION AND IMPLEMENTATION. MIDDLESEX HOSPITAL HAS A DEDICATED DIRECTOR OF COMMUNITY BENEFIT AND A REPORTING STRUCTURE THAT OVERSEES COMMUNITY BENEFIT PLANNING AND OPERATIONS. OUTSIDE OF ON-GOING COMMUNITY BENEFIT ACTIVITIES, KEY COMPONENTS OF THE HOSPITAL'S COMMUNITY BENEFIT PROGRAM IS CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT AND DEVELOPING A CHNA IMPLEMENTATION STRATEGY EVERY THREE TAXABLE YEARS, ENSURING THAT THE CHNA IMPLEMENTATION STRATEGY GOALS ARE ADDRESSED THROUGH COLLABORATION WITH COMMUNITY PARTNERS, AND FOCUSING ON HEALTH EQUITY AND HEALTH-RELATED SOCIAL NEEDS. THE HOSPITAL'S FY20 COMMUNITY BENEFIT OPERATIONS EXPENSE TOTALED $139,550.
PART VI, LINE 6:THE ORGANIZATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM. MIDDLESEX HEALTH IS A FULLY COMPREHENSIVE NETWORK OF EXPERT HEALTH CARE PROVIDERS THAT HAS CONVENIENT LOCATIONS THROUGHOUT CENTRAL CONNECTICUT AND THE SHORELINE. MEMBERS OF THE COMMUNITY ARE ALWAYS CLOSE TO CARE FOR EVERY FAMILY MEMBER AT EVERY AGE. MIDDLESEX HEALTH PROVIDES THE BEST CARE POSSIBLE FOR JUST ABOUT ALL YOUR HEALTH AND WELLNESS NEEDS.THE ORGANIZATIONS INCLUDED IN THE AFFILIATED HEALTH CARE SYSTEM ARE AS FOLLOWS:MIDDLESEX HOSPITAL - A NON-PROFIT, ACUTE CARE, COMMUNITY HOSPITAL IN MIDDLETOWN, CT.MIDDLESEX HEALTH SERVICES - PROVIDES HIGH QUALITY ASSISTED LIVING SERVICES TO THE COMMUNITY.MHS PRIMARY CARE - PROVIDES PATIENT-CENTERED COMPASSIONATE CARE TO ALL MEMBERS OF THE COMMUNITY.MIDDLESEX HOSPITAL FOUNDATION - SUPPORTS MIDDLESEX HOSPITAL.MIDDLESEX HEALTH SYSTEM - PARENT OF AND PROVIDES FUNDRAISING SERVICES FOR MIDDLESEX HOSPITAL.
PART VI, LINE 7, REPORTS FILED WITH STATESCT
PART VI, LINE 7, STATE FILING OF COMMUNITY BENEFIT REPORT:UNDER THE CONNECTICUT GENERAL STATUTES 19A-127K, HOSPITALS THAT HAVE A COMMUNITY BENEFIT PROGRAM IN PLACE, AS SPECIFIED BY THE STATUTE, ARE REQUIRED TO REPORT BIENNIALLY TO THE STATE OF CT. THIS BIENNIAL COMMUNITY BENEFIT REPORTING IS CURRENTLY UNDER THE AUSPICES OF THE STATE OF CONNECTICUT'S OFFICE OF HEALTH STRATEGY. AS MIDDLESEX HOSPITAL MEETS THE STATUTE AS HAVING A COMMUNITY BENEFIT PROGRAM IN PLACE, IT REPORTS BIENNIALLY TO THE STATE OF CT'S OFFICE OF HEALTH STRATEGY.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
COMMUNITY FOUNDATION OF MIDDLESEX COUNTY
211 SOUTH MAIN STREETMIDDLETOWNCT06457061477711501(C)(3)$5,000GENERAL SUPPORT
MIDDLESEX CHAMBER OF COMMERCE
393 MAIN STREETMIDDLETOWNCT06457060452410501(C)(3)$54,775GENERAL SUPPORT
EUGENE O'NEILL THEATER
305 GREAT NECK ROADWATERFORDCT06385066070900501(C)(3)$22,500GENERAL SUPPORT
JEWISH FEDERATION OF GREATER NEW HAVEN
360 AMITY ROADWOODBRIDGECT06525060647025501(C)(3)$5,000GENERAL SUPPORT
FRIENDS OF LONG HILL ESTATE
421 WADSWORTH STREETMIDDLETOWNCT06457061546991501(C)(3)$5,000GENERAL SUPPORT
TRAVELERS CHAMPIONSHIP
90 STATE HOUSE SQUARE 11TH FLOORHARTFORDCT06103421684133$19,250FAN ZONE EXPO SUPPORT
VARSITY COMMUNICATIONS INC
5720 204TH ST SUITE 100LYNNWOODWA98036911430177$15,5002020 CT GOLF SHOW SPONSOR
FieldValueIRS element (for citing)
Total501c3 Org5Total501c3OrgCnt
Total Other Org2TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE PUBLIC RELATIONS DEPARTMENT HAS A POLICY REGARDING WHICH ORGANIZATIONS THEY ARE WILLING TO PARTNER WITH AND GIVE GRANTS OR ASSISTANCE. THEN ONCE THE GRANT OR ASSISTANCE IS AWARDED THE PUBLIC RELATIONS DEPARTMENT WORKS CLOSELY WITH EACH OF THE ORGANIZATIONS TO ENSURE THAT THE GRANT OR ASSISTANCE IS USED FOR THE INTENDED PURPOSES. THIS IS DONE BY CONTACT AND ATTENDANCE AT THE SPONSORED EVENTS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsYes (X)TravelForCompanionsInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Personal ServicesYes (X)PersonalServicesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
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 (15 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
VINCENT CAPECE JR
PRESIDENT/CEO$761,042$0$300,000$0$251,755$0$269,924$0$32,037$0$1,614,758$0$228,238$0
SUSAN MARTIN
VP FINANCE/TREASURER$431,447$0$110,500$0$26,117$0$56,412$0$23,175$0$647,651$0$17,485$0
JESSE WAGNER MD
VP QUALITY AND PATIENT SAFETY$484,299$0$110,600$0$53,011$0$86,404$0$31,597$0$765,911$0$43,590$0
JONATHAN BANKOFF
CHAIRMAN EMERGENCY MEDICINE$413,228$0$25,500$0$290$0$27,816$0$29,917$0$496,751$0$0$0
RACHEL LOVINS
CHIEF DEPT OF MED (TO 11/2019)$368,264$0$15,661$0$638$0$30,616$0$22,552$0$437,731$0$0$0
TODD BISHOP
CHIEF DEPT OF MED (FROM 2/2020)$255,187$0$106,442$0$290$0$0$0$1,169$0$363,088$0$0$0
DAVID GIUFFRIDA
VP FACILITIES AND SUPPORT SERVICES$308,042$0$81,000$0$35,368$0$64,410$0$13,821$0$502,641$0$30,468$0
JACQUELYN CALAMARI
VP PATIENT CARE SERVICES/CNO$298,244$0$77,500$0$36,844$0$38,924$0$21,084$0$472,596$0$30,140$0
EVAN JACKSON
VP STRATEGIC PLANNING AND CIO$337,623$0$74,000$0$27,515$0$59,541$0$30,342$0$529,021$0$22,943$0
DONNA STRONESKI
VP HUMAN RESOURCES$268,393$0$70,500$0$4,826$0$55,952$0$4,639$0$404,310$0$0$0
THEODORE HARTENSTEIN
MEDICAL DIRECTOR, UTILIZATION MGMT$502,435$0$29,000$0$290$0$18,321$0$36,760$0$586,806$0$0$0
JEFFREY SHELTON
CHAIRMAN DEPT PSYCH$386,112$0$39,885$0$452$0$25,062$0$22,612$0$474,123$0$0$0
MATTHEW DOLAN
PHYSICIAN EMERGENCY DEPARTMENT$281,095$0$109,007$0$232$0$10,735$0$25,788$0$426,857$0$0$0
BRIAN MCGUIRE
MEDICAL DIRECTOR ED$302,896$0$102,366$0$434$0$29,818$0$32,567$0$468,081$0$0$0
UMA KASIREDDY
HOSPITALIST$317,280$0$59,129$0$290$0$24,281$0$29,917$0$430,897$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1ATRAVEL FOR COMPANIONS - THE COMPANY'S POLICY FOR SPOUSAL OR "SIGNIFICANT OTHER" TRAVEL IN CERTAIN INSTANCES RELATED TO BUSINESS ACTIVITIES AND PRESCRIBES THE PROPER TAX TREATMENT OF THAT BENEFIT. THIS BENEFIT IS TREATED AS TAXABLE COMPENSATION, WHEN APPLICABLE. THESE BENEFITS WERE PROVIDED TO THE FOLLOWING INDIVIDUALS: EVAN JACKSON SUSAN MARTIN VINCENT CAPECE JESSE WAGNER, MD SOCIAL CLUB DUES - REPRESENTS A CORPORATE MEMBERSHIP AT A GOLF CLUB USED FOR VARIOUS BUSINESS PURPOSES. THE ASSOCIATED COST IS INCLUDED IN THE TAXABLE COMPENSATION OF THE EXECUTIVE STAFF MEMBER ACCORDING TO IRS RULES AND REGULATIONS. THIS BENEFIT WAS PROVIDED TO THE FOLLOWING INDIVIDUAL: VINCENT CAPECE PERSONAL SERVICES - REPRESENTS TAX PLANNING AND/OR TAX PERSONAL SERVICES. PREPARATION FEES FOR ONE MEMBER OF THE EXECUTIVE STAFF. THIS BENEFIT WAS TREATED AS TAXABLE COMPENSATION. THIS BENEFIT WAS PROVIDED TO THE FOLLOWING INDIVIDUAL: EVAN JACKSON
PART I, LINE 4BTHE FOLLOWING INDIVIDUALS RECEIVED COMPENSATION FROM A SERP, WHICH WAS INCLUDED IN PART II, COLUMN B(III) AND COLUMN F: VINCENT CAPECE = $228,238 SUSAN MARTIN = $17,485 JESSE WAGNER, MD = $43,590 DAVID GIUFFRIDA = $30,468 JACQUELYN CALAMARI = $30,140 EVAN JACKSON = $22,943 SERP CONTRIBUTIONS WERE MADE FOR THE FOLLOWING INDIVIDUALS AND ARE INCLUDED IN PART II, COLUMN C: VINCENT CAPECE = $231,000 SUSAN MARTIN = $17,488 JESSE WAGNER, MD = $47,480 DAVID GIUFFRIDA = $31,040 EVAN JACKSON = $34,610 DONNA STRONESKI = $27,070
PART II, COLUM (B)(II) - BONUS & INCENTIVE COMPENSATION:THE AMOUNTS REPRESENT INCENTIVE COMPENSATION PAYMENTS MADE IN CALENDAR YEAR 2019. PAYMENTS INCLUDE AMOUNTS EARNED IN 2018 AND DEFERRED, WHERE APPLICABLE.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
CHEFA - SERIES N
A06080618620774YAW72011-07-26$33,803,383REFINANCE H&IYes (1)00
CHEFA - SERIES O
B06080618620774YWD52015-05-19$19,491,965REFINANCE L BONDS000
CHEFA - SERIES P
C0608061862016-06-10$9,683,000REFINANCE M BONDS000
CHEFA - SERIES Q
D0608061862017-11-21$9,069,272REFINANCE N BONDS000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtBond DefeasedBondDefeasedAmtTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndRefunding EscrowRefundingEscrowAmt
A$19,270,000$7,600,000$33,524,650$537,971$32,987,0792011Yes (1)0Yes (1)Yes (1)
B$3,110,000$19,491,965$388,960$19,103,01020150Yes (1)Yes (1)Yes (1)
C$3,713,030$10,347,540$193,660$10,153,88020160Yes (1)Yes (1)Yes (1)
D$514,782$10,351,063$197,183$1,285,1910Yes (1)0Yes (1)$8,868,689

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceBBondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A000Yes (1)0000Yes (1)
B000Yes (1)0000Yes (1)
C0Yes (1)000000Yes (1)
D0Yes (1)000000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)
CYes (1)
DYes (1)

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
DATE REBATE COMPUTATION PERFORMEDISSUER NAME: CHEFA - SERIES N DATE THE REBATE COMPUTATION WAS PERFORMED: 07/26/2016 ISSUER NAME: CHEFA - SERIES O DATE THE REBATE COMPUTATION WAS PERFORMED: 05/19/2020
SCHEDULE K, PART II, LINE 3:SERIES P BONDS (COLUMN C) AND SERIES Q BONDS (COLUMN D) - THE DIFFERENCE BETWEEN THE ISSUE PRICE AND THE TOTAL PROCEEDS IS INVESTMENT EARNINGS.
SCHEDULE K, PART II, LINE 11:THE AMOUNT INCLUDED IN PART II, LINE 11, OTHER SPENT PROCEEDS FOR THE SERIES N BONDS (COLUMN A) WAS USED TO REFUND THE CHEFA SERIES H & I BONDS DATED OCTOBER 9, 1997. THE AMOUNT INCLUDED IN PART II, LINE 11, OTHER SPENT PROCEEDS FOR THE SERIES O BONDS (COLUMN B) WAS USED TO REFUND THE CHEFA SERIES L BONDS DATED DECEMBER 7, 2006. THE AMOUNT INCLUDED IN PART II, LINE 11, OTHER SPENT PROCEEDS FOR THE SERIES P BONDS (COLUMN C) WAS USED TO REFUND THE CHEFA SERIES M BONDS DATED DECEMBER 7, 2006. THE AMOUNT INCLUDED IN PART II, LINE 11, OTHER SPENT PROCEEDS FOR THE SERIES Q BONDS (COLUMN D) WAS USED TO PARTIALLY REFUND THE CHEFA SERIES N BONDS DATED JULY 26, 2011.
SCHEDULE K, PART III, LINE 3:SERIES O BONDS (COLUMN B) AND SERIES P BONDS (COLUMN C) - THE ORGANIZATION HAS DETERMINED THAT ALL MANAGEMENT/SERVICE CONTRACTS MEET THE SAFE HARBOR UNDER REV. PROC. 2017-13, 2017-6 I.R.B. 787.
SCHEDULE K, PART VI, SUPPLEMENTAL INFORMATION:SERIES N BONDS (COLUMN A) WERE SPLIT BETWEEN MIDDLESEX HEALTH SERVICES AND MIDDLESEX HOSPITAL, WHICH ISSUED $5,637,382 AND $33,803,383, RESEPECTIVELY. SERIES Q BONDS (COLUMN D) WERE SPLIT BETWEEN MIDDLESEX HEALTH SERVICES AND MIDDLESEX HOSPITAL, WHICH ISSUED $2,529,728 AND $9,069,272, RESEPECTIVELY.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
DAVID GIUFFRIDA
KEY EMPLOYEE$905,045SEE PART V0
DAVID GIUFFRIDA
KEY EMPLOYEE$15,960SEE PART V0
JACQUELYN CALAMARI
KEY EMPLOYEE$139,626SEE PART V0
JESSE WAGNER MD
KEY EMPLOYEE$44,677SEE PART V0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS:FormAndLineReferenceDesc
Explanation(A) NAME OF INTERESTED PERSON: DAVID GIUFFRIDA(D) DESCRIPTION OF TRANSACTION: MIDDLESEX HOSPITAL HAS AN INDEPENDENT CONTRACTOR ARRANGEMENT WITH GUIFFRIDA ELECTRIC, CO., WHICH IS MORE THAN 35% OWNED BY A FAMILY MEMBER OF DAVID GIUFFRIDA.(A) NAME OF INTERESTED PERSON: DAVID GIUFFRIDA(D) DESCRIPTION OF TRANSACTION: MIDDLESEX HOSPITAL HAS AN INDEPENDENT CONTRACTOR ARRANGEMENT WITH GUIFFRIDA ENGINEERING, WHICH IS MORE THAN 35% OWNED BY A FAMILY MEMBER OF DAVID GIUFFRIDA.(A) NAME OF INTERESTED PERSON: JACQUELYN CALAMARI(D) DESCRIPTION OF TRANSACTION: MIDDLESEX HOSPITAL HAS AN EMPLOYMENT ARRANGEMENT WITH ANNE CALAMARI, LCSW COORDINATOR, WHO IS A FAMILY MEMBER OF JACQUELYN CALAMARI.(A) NAME OF INTERESTED PERSON: JESSE WAGNER, MD(D) DESCRIPTION OF TRANSACTION: MIDDLESEX HOSPITAL HAS AN EMPLOYMENT ARRANGEMENT WITH RUTH WAGNER, REGISTERED NURSE, WHO IS A FAMILY MEMBER OF JESSE WAGNER, MD.ExplanationTxt

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution4ContributionCnt
Noncash Contributions Rpt F990$61,788NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt

Other Non Cash Contri Table OtherNonCashContriTableGrp

FieldValueIRS element (for citing)
DescCOVID-19 SUPPLY DONATIONSDesc
Contribution0ContributionCnt
Noncash Contributions Rpt F990$0NoncashContributionsRptF990Amt
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (1)ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, COLUMN (B):FormAndLineReferenceDesc
ExplanationTHE NUMBER IN COLUMN B IS THE NUMBER OF CONTRIBUTIONS. SCHEDULE M, PART I, LINE 25: DURING THE FISCAL YEAR THE HOSPITAL RECEIVED DONATIONS OF COVID-19 SUPPLIES INCLUDING SURGICAL MASKS, FACESHIELDS, RESPIRATOR MASKS, GOWNS, FOOD AND HAND SANITIZER. THE VALUE OF THESE DONATIONS WERE NOT INCLUDED IN THE AUDITED FINANCIAL STATEMENTS. THE HOSPITAL ESTIMATES THEY RECEIVED 17 DIFFERENT CONTRIBUTORS WITH A VALUE OF APPROXIMATELY $95,000.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION:MIDDLESEX HOSPITAL IS AN ACUTE CARE GENERAL HOSPITAL SERVING THE RESIDENTS OF MIDDLESEX COUNTY AND VARIOUS SURROUNDING COMMUNITIES PROVIDING SELECTED HIGH-QUALITY INPATIENT AND OUTPATIENT HEALTH SERVICES. THE HOSPITAL MAINTAINS FORMAL RELATIONSHIPS WITH SPECIALIZED PROVIDERS TO ASSURE COORDINATION OF CARE WHEN SERVICES ARE NOT LOCALLY AVAILABLE. AN INTEGRAL PART OF THE CORE PROGRAMS, SPANNING THEIR TRADITIONAL DIAGNOSTIC AND TREATMENT SERVICES, ARE THE SCORES OF SPECIAL PROGRAMS OFFERED TO THE COMMUNITIES SERVED, MANY OF WHICH FOCUS ON THE DISADVANTAGED AND UNDERSERVED, THOSE SPECIAL POPULATIONS SUCH AS MINORITIES, OLDER PERSONS, PERSONS LIVING IN POVERTY WITH DISABILITIES, CHRONICALLY MENTALLY ILL PERSONS, AND OTHER DISENFRANCHISED PERSONS. MANY OTHER SPECIAL PROGRAMS WITH A FOCUS TO REACH OUT TO ALL MEMBERS OF THE COMMUNITY REGARDLESS OF ECONOMIC CONDITION OR SOCIAL STATUS RESPOND TO PUBLIC HEALTH NEEDS AND INVOLVE EDUCATION OR RESEARCH THAT IMPROVES OVERALL COMMUNITY HEALTH. ALL OF THESE SPECIAL PROGRAMS ARE OFFERED FREE OF CHARGE OR OFFERED AT A RATE THAT IS CONSIDERABLY LESS THAN THE COST OF PROVIDING THEM.
FORM 990, PART VI, SECTION A, LINE 6THE SOLE MEMBER OF THE HOSPITAL IS MIDDLESEX HEALTH SYSTEM, INC.
FORM 990, PART VI, SECTION A, LINE 7ATHE SOLE MEMBER, MIDDLESEX HEALTH SYSTEM, INC. HAS THE RIGHT TO ANNUALLY ELECT THE BOARD OF DIRECTORS OF THE HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7BTHE SOLE MEMBER, MIDDLESEX HEALTH SYSTEM, INC., HAS ALL RIGHTS CONFERRED BY LAW, THE CERTIFICATE OF INCORPORATION AND MIDDLESEX HOSPITAL BY-LAWS, BY VOTE OF ITS BOARD OF DIRECTORS, ITS PRESIDENT, OR BY OR THROUGH ANY OTHER PERSON(S) DESIGNATED BY ITS BOARD OF DIRECTORS IN ITS BEHALF.
FORM 990, PART VI, SECTION B, LINE 11BA DRAFT COPY OF THE FORM 990 IS PROVIDED TO EACH BOARD MEMBER FOR THEIR REVIEW AND CHANGES FROM PRIOR YEAR ARE HIGHLIGHTED. ANY QUESTIONS OR COMMENTS THEY HAVE ARE PRESENTED TO EXECUTIVE MANAGEMENT. A COMPLETE COPY OF THE FINAL FORM 990 IS PROVIDED TO ALL MEMBERS OF THE BOARD PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CCONFLICT OF INTEREST FORMS ARE DISTRIBUTED ANNUALLY TO KEY EMPLOYEES, OFFICERS, AND THE BOARD OF DIRECTORS. RESPONSES ARE RETURNED TO, TRACKED, AND REVIEWED BY THE SYSTEM COMPLIANCE OFFICER. MATERIAL CONFLICTS ARE REPORTED TO THE AUDIT COMMITTEE FOR REVIEW AND DETERMINATION. IN ADDITION TO COMPLETING THE ANNUAL CONFLICT OF INTEREST FORM, BOARD MEMBERS MUST IMMEDIATELY DISCLOSE ANY INTEREST AND ALL MATERIAL FACTS TO THE BOARD OF DIRECTORS, AS THEY OCCUR. THE BOARD THEN REVIEWS THE FACTS AND MAKES THE DETERMINATION AS TO WHETHER A SIGNIFICANT CONFLICT OF INTEREST EXISTS. IF SO, THE BOARD FOLLOWS DISABLING GUIDELINES TO DETERMINE IF THE BOARD MEMBER SHOULD BE ASKED TO RESIGN OR BE REMOVED.
FORM 990, PART VI, SECTION B, LINE 15THE COMPENSATION OF THE PRESIDENT/CEO IS REVIEWED ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE. THE COMMITTEE HAS A CHARTER AND A POLICY STATEMENT SETTING FORTH A PROCESS AND CERTAIN GUIDELINES FOR DETERMINING COMPENSATION, WHICH INCLUDES A BASE SALARY AND AN INCENTIVE COMPENSATION WITHIN A RANGE SET BY THE POLICY. FOLLOWING THE CLOSE OF EACH FISCAL YEAR, THE COMMITTEE RECEIVES MARKET ANALYSIS FROM AN INDEPENDENT CONSULTANT REGARDING COMPENSATION AT PEER GROUPS OF COMPARABLE HOSPITALS AND HEALTH SYSTEMS. COMPENSATION IS COMPARED TO BENCHMARKS WITH RESPECT TO CASH COMPENSATION AND TOTAL COMPENSATION INCLUDING FRINGE BENEFITS. THE INDEPENDENT CONSULTANT PROVIDES A WRITTEN OPINION ANNUALLY CONFIRMING THAT THE COMPENSATION AS ADJUSTED BY THIS PROCESS, IS "REASONABLE" WITHIN APPLICABLE IRS GUIDELINES. THE COMPENSATION IS APPROVED BY THE COMMITTEE AND DOCUMENTED IN THE MINUTES. THE LAST COMPENSATION REVIEW OCCURRED 12/2019. THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS REVIEWED ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE WHICH HAS A CHARTER AND A POLICY STATEMENT SETTING FORTH A PROCESS AND CERTAIN GUIDELINES FOR DETERMINING COMPENSATION, WHICH INCLUDES A BASE SALARY AND THE OPPORTUNITY FOR INCENTIVE COMPENSATION WITHIN A RANGE SET BY THE POLICY. FOLLOWING THE CLOSE OF EACH FISCAL YEAR, THE COMMITTEE RECEIVES MARKET ANALYSIS FROM AN INDEPENDENT CONSULTANT REGARDING COMPENSATION AT PEER GROUPS OF COMPARABLE HOSPITALS AND HEALTH SYSTEMS. POSITIONS WITHIN THE EXECUTIVE TEAM ARE COMPARED TO BENCHMARK POSITIONS BOTH WITH RESPECT TO CASH COMPENSATION AND TOTAL COMPENSATION INCLUDING FRINGE BENEFITS. THE CEO RECOMMENDS THE INCENTIVE AWARDS AND BASE SALARY ADJUSTMENTS TO THE COMPENSATION OF THE EXECUTIVES WHO REPORT TO HIM, AND THE COMMITTEE REVIEWS THOSE RECOMMENDATIONS, AND APPROVES OR MODIFIES THEM. THE CONSULTANT PROVIDES A WRITTEN OPINION ANNUALLY CONFIRMING THAT THE COMPENSATION OF THE EXECUTIVES, AS ADJUSTED BY THIS PROCESS, IS "REASONABLE" WITHIN APPLICABLE IRS GUIDELINES. THE COMPENSATION OF THESE OTHER OFFICERS AND KEY EMPLOYEES IS APPROVED BY THE COMMITTEE AND DOCUMENTED IN THE MINUTES. THE LAST COMPENSATION REVIEW OCCURRED 12/2019.
FORM 990, PART VI, SECTION C, LINE 19MIDDLESEX HOSPITAL MAINTAINS A QUALITY AND COMPLIANCE SECTION ON ITS WEBSITE, MIDDLESEXHOSPITAL.ORG. THE HOSPITAL POSTS THE MOST CURRENT AUDITED FINANCIAL STATEMENTS AND FORM 990 WITH THOSE OF OTHER AFFILIATES AS THEY BECOME AVAILABLE, AS WELL AS STATEMENTS AND FORMS FROM AT LEAST TWO PREVIOUS FISCAL YEARS. THE HOSPITAL'S CONFLICT OF INTEREST POLICY IS ALSO POSTED ON THE WEBSITE IN THE VENDORS AND SUPPLIERS SECTION. IN ADDITION, THE ORGANIZATION'S FORM 990 IS AVAILABLE AT WWW.GUIDESTAR.ORG AND UPON REQUEST.
FORM 990, PART XI, LINE 9:TRANSFER (TO) / FROM MIDDLESEX HEALTH SYSTEM, INC. -18,728,227. CHANGE IN ASSETS HELD IN TRUST 115,000. CHANGE IN TEMP RESTRICTED NET ASSETS -1,201,464.
FORM 990, PART XII, LINE 2C:THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
MIDDLESEX HEALTH SYSTEM INC
28 CRESCENT STREETMIDDLETOWNCT06457222676137SUPPORTCT501(C)(3)LINE 12B, IIN/A0
MIDDLESEX HEALTH SERVICES INC
28 CRESCENT STREETMIDDLETOWNCT06457222676140ASSISTED LIVINGCT501(C)(3)LINE 100MIDDLESEX HEALTH SYSTEM INC
MIDDLESEX HOSPITAL FOUNDATION INC
28 CRESCENT STREETMIDDLETOWNCT06457273720822SUPPORTCT501(C)(3)LINE 12B, IIYes (1)MIDDLESEX HOSPITAL
MHS PRIMARY CARE INC
28 CRESCENT STREETMIDDLETOWNCT06457061472743HEALTHCARECT501(C)(3)LINE 100MIDDLESEX HEALTH SYSTEM INC

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
MIDDLESEX HEALTH RESOURCES INC
28 CRESCENT STREETMIDDLETOWNCT06457061089925RENTAL REAL ESTATECTN/AC0
INTEGRATED RESOURCES FOR THE MIDDLESEX AREA LLC
28 CRESCENT STREETMIDDLETOWNCT06457061462230OUTPATIENT CARECTN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
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 OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd