2021-08-12T09:45:48-05:00 2020-09-30 346565596 Ernst & Young US LLP 370 17th Street 4800 Denver CO 80202 990 2019-10-01 060646966 Windham Community Memorial Hospital Inc WIND 8604566821 112 Mansfield Avenue Willimantic CT 06226 Mark Keise VP, Finance 8604566821 2021-08-12 0 Sarah Arnold P01868655 7209314000 2019 2022-09-23 18:48:47Z Donna Handley 112 Mansfield Avenue Willimantic CT 06226 121530109 0 X www.windhamhospital.org X 1908 CT The mission of Windham Community Memorial Hospital is to offer comprehensive services in an environment where innovation and teaching are integral to care; where we are proud to serve patients and one another; where meeting the challenge of complex medical needs is viewed as a defining competency; and where quality and safety of care are a constant. 10 5 709 150 7577 0 657229 586112 108144618 119676305 375428 257410 768145 534856 109945420 121054683 0 0 0 0 43192878 48338731 0 0 69916 63473794 68973175 106666672 117311906 3278748 3742777 60017455 68084533 105617852 113382102 -45600397 -45297569 X The mission of Windham Community Memorial Hospital is to offer comprehensive services in an environment where innovation and teaching are integral to care; where we are proud to serve patients and one another; where meeting the challenge of complex medical needs is viewed as a defining competency; and where quality and safety of care are a constant. 0 0 13463553 14850225 Bone & Joint (Orthopedics):The Orthopedics Department at Windham Hospital offers a full range of services to the communities it serves. As a member of Hartford HealthCare Corporation's network, the hospital has access to the integrated health network's recognized expertise, ongoing research studies that evaluate new treatments and one of the nation's top training centers for robot-assisted surgery. At the completion of the fiscal year, the Division of Orthopedics had 10,600 cases with an average length of stay of 2.6 days.Orthopedics services provided by the hospital include:Advanced ImagingOur radiology services target disorders of the bones, joints and soft tissues, including:MRIMulti-slice CTNuclear ScintigraphMinimally-invasive needle biopsies under image guidance using ultrasound, fluoroscope or CTSpinal injectionsWindham surgeons utilize the Robotic Arm Interactive Orthopedic System (RIO) which allows them to personalize partial and total joint replacement surgery more accurately than with conventional instruments.Mako Technology:Mako is a treatment option if you have early to mid-stage degeneration of your hip or knee. With smaller incisions, the robotic arm-assisted technology allows the surgeon to more precisely place your implant for faster recovery and more effective results. This technology is available at Windham.In addition, the Hospital also serves patients with issues in the following areas:Hand & Upper ExtremityHipKneeOsteoporosisShoulderSpineSports MedicineTotal Replacements 14846977 12725304 Hartford HealthCare Cancer Institute:Hartford HealthCare is Connecticut's most comprehensive healthcare network. Our fully integrated health system includes a tertiary-care teaching hospital, an acute-care community teaching hospital, an acute-care hospital and trauma center, two community hospitals. The Hartford HealthCare Cancer Institute encompasses comprehensive cancer centers at six hospitals across Connecticut Hartford Hospital, The Hospital of Central Connecticut, Backus Hospital, Midstate Medical Center, Windham Hospital, Charlotte Hungerford Hospital and St Vincent's Medical Center (SVMC). Collectively, the cancer programs within the Cancer Institute treat more than 5,000 new cancer patients per year while caring for tens of thousands of existing patients, offering a full range of innovative, evidence-based and personalized treatments designed to meet the needs of each individual patient. Our innovative Institute approach is unlike any other in the state and is among the most highly regarded in the nation. Through our Institute, which is organized around a specific disease and not necessarily location, we can apply best practices throughout our system so that patients receive the same high standards of care no matter where they live or which Hartford HealthCare cancer center they choose. For all of our patients, a dedicated team of oncologists, surgeons, radiologists, pathologists, nurses, clinical researchers, technicians and others collaborate to provide the exact course of care they need. The Institute's multidisciplinary disease management teams meet and collaborate regularly to lend expertise and insight on numerous cancer types, translating into exceptional coordinated care. The Institute's accomplished, fellowship-trained physicians are nationally recognized for their level of sophisticated care in areas such as radiation oncology, medical oncology and surgical oncology. Patients are also cared for in an environment that emphasizes compassion and personal connections, with a team of trained nurse navigators who provide guidance and support to patients and families, from diagnosis to recovery. The Institute also boasts a thriving survivorship program. In 2013, the Hartford HealthCare Cancer Institute became the first community-based cancer program to become a member of the Memorial Sloan Kettering Cancer Alliance, establishing a relationship with one of the world's premier cancer centers. The Institute's membership in the Alliance provides patients in Connecticut access to the most advanced, leading-edge treatments available anywhere. In 2017, the Institute was accredited as a network by the American College of Surgeons Commission on Cancer, one of a select few institutes nationwide to be recognized as a system, rather than individual cancer centers. For patients coming through our doors with a cancer diagnosis, that means three things: standardized care, more options and more hope.More than four years after the Hartford HealthCare Cancer Institute became the charter member of the Memorial Sloan Kettering (MSK) Cancer Alliance, cancer patients now have unprecedented access to the world's most advanced clinical trials. And more than ever before, physicians, nurses, pharmacists and researchers are working collaboratively to implement cancer treatment standards and protocols developed at MSK, the premier cancer treatment center in the country. This distinctive cancer care and clinical research partnership means the Hartford HealthCare Cancer Institute brings the most innovative, evidence-based cancer care directly into community settings.During FY20, the Institute was impacted by COVID-19. As a result, the number of patients/cases that were treated was significantly reduced. For FY20, the approximate number of cases was as follows:Hartford Hospital - 2,893Hospital of Central Connecticut - 826Backus Hospital - 819Midstate Medical Center - 469Windham Hospital - 188Charlotte Hungerford Hospital - 257SVMC - 427The five most common types of cancer diagnosed by teams of specialists at the Hartford HealthCare Cancer Institute are cancers of the bladder, breast, colon, lung and prostate. Each patient has a unique scenario requiring a personalized plan.Approximately 1,307 Breast Cancer cases were treated across the system as follows:Hartford Hospital - 579Hospital of Central Connecticut - 173Backus Hospital - 227Midstate Medical Center - 125Windham Hospital - 66Charlotte Hungerford Hospital - 51SVMC - 86Approximately 720 Lung Cancer cases were treated across the system as follows:Hartford Hospital - 322Hospital of Central Connecticut - 95Backus Hospital - 19Midstate Medical Center - 53Windham Hospital - 42Charlotte Hungerford Hospital - 20SVMC - 69Approximately 653 Prostate Cancer cases were treated across the system as follows:Hartford Hospital - 315Hospital of Central Connecticut - 92Backus Hospital - 71Midstate Medical Center - 59Windham Hospital - 13Charlotte Hungerford Hospital - 53SVMC - 50 Approximately 346 Bladder Cancer cases were treated across the system as follows:Hartford Hospital - 185Hospital of Central Connecticut - 57Backus Hospital - 34Midstate Medical Center - 33 Windham Hospital - 10Charlotte Hungerford Hospital - 20SVMC - 7Approximately 314 Colon Cancer cases were treated across the system as follows:Hartford Hospital - 130Hospital of Central Connecticut - 38Backus Hospital - 41Midstate Medical Center - 30Windham Hospital - 10Charlotte Hungerford Hospital - 29SVMC - 36Today, Hartford HealthCare is creating a better future for healthcare in Connecticut and beyond. We are a community of caregivers engaged in developing a coordinated, consistent high standard of care. We use research and education as partners in care delivery. We create and engage in meaningful alliances to enhance access to services. We invest in technology and training to develop new pathways to improve the timeliness, efficiency and accuracy of our services. 12553289 11792531 Gastroenterology:Committed to excellence in quality and service for the region, Windham boasts a state-of-the-art Emergency Department that consistently ranks in the highest percentiles of customer satisfaction. The hospital also offers convenient and modern satellite services including two Physical Therapy and Rehabilitation Clinics and a Center for Women's Health offering mammography, bone density, and integrative health. The medical staff brings specialties and diagnostic disciplines in the areas of Surgery, Orthopedics and Sports Medicine, Obstetrics and Gynecology, Critical Care, Diagnostic and Interventional Radiology, Oncology, Endocrinology, Cardiology, Gastroenterology (GI), Neurology, Nephrology, Sleep Medicine, and Pain Management. The hospital is committed to providing its patients with up-to-date treatment options for gastroenterological disorders with the sole purpose of improving quality of life.Gastroenterologists at Windham hospital perform many specialized tests, such as endoscopy, to diagnose or treat diseases. When necessary, they may consult with surgeons. Gastroenterologists further specialize in treating people in certain age groups, such as pediatric gastroenterologists, who only treat children.During FY20, the hospital GI department had one Gastroenterology surgeon and three general surgeons. The department had 5,338 cases with an average length of stay of 3.4 days. 66715027 80308245 Committed to excellence in quality and service for the region, Windham Community Memorial Hospital boasts a state-of-the-art Emergency Department that consistently ranks in the highest percentiles of customer satisfaction. The Hospital also offers convenient and modern satellite services including two Physical Therapy and Rehabilitation Clinics and a Center for Women's Health offering mammography, bone density, and integrative health.There are on-campus support services for patients of Windham Community Memorial Hospital including a Cardiac Rehabilitation Center and Lipid Clinic, Pulmonary Rehabilitation and Pain Management Services. Community education is an important component of Windham Community Memorial Hospital's vision to improve the health of the community. To achieve this goal - diabetes education, childbirth education, integrative health services, cancer support groups, and ongoing community health forums are offered. In addition to the programs referred to above, the Hospital provides services/programs including but not limited to the following:Cardiology ServicesDiabetes & EndocrinologyEmergency CareFamily & Primary CareHeadache CenterHospital MedicineImaging & RadiologyIntegrative HealthMedical Weight LossMovement DisordersNeuroscience InstituteOrthopedicsPain ManagementParamedic ProgramPhysical TherapyPulmonary & Respiratory ServicesSenior ServicesSleep MedicineSpine CareSurgical Weight LossUrologyWomen's HealthWound Care & Surgical ClinicSupport Services 66715027 80308245 107578846 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 85 0 1 709 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 5 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 CT X Anthony Mastroianni 8604566821 112 Mansfield Avenue Willimantic CT 06226 David Whitehead Former Director & President 0.00 60.00 X 0 1157035 72930 Bimal Patel Former Director & President 0.00 60.00 X 0 1001936 136854 Margaret Marchak Thru 620 Secretary 2.00 58.00 X 0 850753 77083 Donna Handley Director, SVP HHC & President 20.00 40.00 X X 0 715935 71531 Robert Sidman MD VP, Medical Affairs 30.00 30.00 X 0 564347 70695 David Mack CLO 30.00 30.00 X 0 470090 37908 Kismatkumar Detroja MD Physician 60.00 0.00 X 461837 0 36614 Lester Temkin VP, Operations 30.00 30.00 X 0 440032 50398 Julian Munoz MD Physician 60.00 0.00 X 400783 0 42765 Thomas Vaccarelli Former VP, Facilities 0.00 60.00 X 0 370513 68286 Melisha Cumberland MD Physician 60.00 0.00 X 359465 0 35562 Gregory Makowski Former VP, HHC Lab Service 0.00 60.00 X 0 353796 37828 Jennifer Bellino Assoc. Chief Hospitalist 60.00 0.00 X 329255 0 53087 Anthony Mastroianni VP, Finance 30.00 30.00 X 0 308567 59786 Mark Tramontozzi MD Director 1.00 59.00 X 0 306335 49189 Laura Currie VP, Pat. Care Services 30.00 30.00 X 0 283358 54226 Karin Grann Nurse Practitioner 60.00 0.00 X 249003 0 29772 Matthew Kaufman VP, Operations 30.00 30.00 X 0 234456 35936 Mary Barry MD Chair 2.00 58.00 X X 4000 191768 17338 Gregory Shangold MD Director 1.00 2.00 X 43846 27450 3473 David Coletti MD Director 1.00 2.00 X 0 70473 0 Carmen Cid Director 1.00 2.00 X 0 0 0 Anthony Joyce III Director 1.00 2.00 X 0 0 0 Carina Vora DDS Director 1.00 2.00 X 0 0 0 James Watson MD Thru 1219 Director 1.00 2.00 X 0 0 0 Diane Wishnafski Thru 620 Director and Chair 1.00 2.00 X X 0 0 0 Henry Beck Vice Chair 2.00 4.00 X X 0 0 0 Stephen Larcen MD Director 2.00 4.00 X 0 0 0 1848189 7346844 1041261 60 1 1 0 Origin Incorporated 1800 SW 1St Suite 510 Portland OR 97201 Staffing Services 1846438 Morrison Management Specialist 400 Northridge Road Sandy Springs GA 30350 Food Services 606821 Anesthesia Associates of Willimantic PC 1185 Main Street Willimantic CT 06226 Medical Services 541856 MedPartners Locum Tenens Inc PO Box 740478 Atlanta GA 30374 Staffing Services 531854 Connecticut Children's Specialty Group 282 Washington Street Hartford CT 06106 Medical Services 518149 29 586112 586112 Inpatient and Outpatient Revenue 621400 119391368 119391368 Cafeteria Revenue 722210 277360 277360 Income From JV 900003 7577 7577 119676305 375711 375711 873582 338726 534856 534856 534856 3841 14558 41372 95328 -37531 -80770 -118301 -118301 121054683 119668728 7577 792266 X 36154 36154 38572941 35669644 2851083 52214 1354706 1252740 100132 1834 5759934 5326397 425740 7797 2614996 2392894 218108 3994 407 407 7567 7567 2323 2323 16918796 16918796 1488199 1257002 228733 2464 6224823 3548149 2676674 2016942 1875367 141575 30888 27965 2923 49766 31492 16661 1613 1289743 799641 490102 10294488 9882708 411780 3758083 2478352 1279731 783075 783075 Medical Supplies 19113608 19113608 Purchased Services 3245907 2579794 666113 Repairs & Maintenance 2708036 2696441 11595 Hospital Provider Tax 796917 796917 243607 111710 131897 117311906 107578846 9663144 69916 3580826 8254093 8446959 10194717 1345101 1732407 773229 751158 110537362 76113995 36472297 34423367 60465 59043 7929842 8556012 1408736 4113736 60017455 68084533 7788200 9482582 10778759 11334946 205586 86845307 92564574 105617852 113382102 X -53889245 -54123578 8288848 8826009 -45600397 -45297569 60017455 68084533 X 3742777 -753926 -2686023 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 0 0 0 0 0 1 7567 0 0 7567 0 Part II-B, Line 1: Windham Community Memorial Hospital paid annual dues to Connecticut Hospital Association (CHA). CHA conducts lobbying activities on behalf of its members. CHA allocates a portion of their dues as lobbying expenses. The portion of dues allocated as lobbying expenses is calculated under current Medicare rules. CHA conducts lobbying activities under current Medicare rules. In addition,the Organization occasionally asks its employees to volunteer their time to contact state legislators in an effort to lobby on its behalf. The total amount of all dues allocated for lobbying expenses for FY20 was $7,567. 2867147 230000 3097147 2795147 72000 2867147 2608147 187000 2795147 2256147 352000 2608147 2088147 168000 2256147 0.00000 0.42000 0.58000 0 1 1 77645 77645 65931794 41879499 24052295 1268328 993861 274467 40207787 33240635 6967152 3051808 3051808 34423367 Assets Held In Trust 5189410 C Invest. Endowment - TEMP 1805293 C Invest. Endowment - PERM 1226513 C Investment in Others JV 215205 C Investment in Endowment 119591 C 8556012 Due From Affiliates 2160870 Malpractice Insurance Claims 1080208 Other Assets 745262 SERP Assets 127396 4113736 Accrued Post Retirement Pension 48773545 LT Debt HHC - Interco. Bonds 25478094 Other Liabilities 15657721 Hospital Provider User Fee 1642288 Accrued Malpractice 885531 SERP Liability 127395 92564574 Part V, Line 4: The Hospital has adopted investment and spending policies for Endowment assets that attempt to provide a predictable stream of funding to mission related programs such as those described in Part III, lines 4a-d while seeking to maintain purchasing power of the endowment assets. Endowment assets include those assets of donor-restricted funds that the Hospital must hold in perpetuity or for a donor-specific period(s). Under this policy, as approved by the Board of Directors, the Endowment assets are invested in a manner that is intended to produce a real return, net of inflation and investment management costs, of a least 4% over the long term. Actual returns in any given year may vary from this amount. The Hospital's Endowment consists of hundreds of individual funds established for a variety of purposes. Net assets associated with Endowment funds are classified and reported based on the existence or absence of donor-imposed restrictions. The income generated by the funds are used mainly for capital expenses. 1 1 1 X 250.000000000000 1 X 1 1 1 0 0 933694 933694 0.00800 23894547 19445048 4449499 0.03790 24828241 19445048 5383193 0.04590 214609 3780 210829 0.00180 217674 217674 0.00190 482422 174116 308306 0.00260 6917 6917 0.00010 921622 177896 743726 0.00640 25749863 19622944 6126919 0.05230 0 4398412 13642997 20642215 -6999218 X 1 1 1 1 Windham Community Memorial Hospital 112 Mansfield Avenue Willimantic CT 06226 www.wcmh.org 0061 X X X Windham Community Memorial Hospital 1 0 0 1 X X X X X X X X X 17 1 1 0 1 X See Part V, Page 8 X X 1 17 1 See Part V, Page 8 0 1 X 250.000000000000 400.000000000000 X X X X 1 1 X X X X X 1 X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X X X 1 X 0 X X X X 1 X 0 0 Windham Community Memorial Hospital Part V, Section B, Line 5: To solicit input from key informants and individuals who have broad interest in the health of the community, the Hospital performed surveys, community forums, focus groups and interviews with key informants. The key informants were selected by community leader(s) or liaison(s). Additionally, focus groups were used to identify any other resource. Focus group was conducted on February 14, 2018. Community forums, and individual key informant interviews were conducted between February and May 2018.Key informants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the overall community. They were asked to rate the degrees to which various health issues were of concern in the Eastern Region. Follow up questions were asked to describe why they identified areas as such, and how these might be better addressed. The key informants included Physicians, public health representatives, health professionals, social service providers and a variety of other community leaders including the following:Center for Healthy AgingConnecticut Legal ServicesEastern Connecticut Health Insurance Program (ECHIP)Eastern Connecticut Workforce BoardEastern Highlands Health DistrictGenerationsMansfield Youth ServicesNCDHDNortheast District Department of HealthSt. Joseph's LivingTown of MansfieldUConn Student Health ServicesUnited Services, Inc.Willimantic DCF officeWillimantic Fire DepartmentWillimantic PoliceWindham HospitalWindham Public SchoolsWindham Region Transit District The 2018 CHNA took a close look at social determinants of health such as poverty, housing, transportation, education, fresh food availability, and neighborhood safety. Social determinants of health have become a national priority for identifying and addressing health disparities, and Windham Hospital is committed to addressing these disparities through the Community Health Improvement Plan that will follow this Assessment. Through this process, input was gathered from individuals whose organizations can provide information for the following data elements: * Medically Underserved Areas* Health Professional Shortage Areas* Demographics* Ethnicity Distributions* Median Household Incomes* Homeownership Rates* Poverty Metrics* Unemployment Rates* Educational Metrics* Children in Poverty and Single Parent Households* Linguistically Isolated Populations* Uninsured Population Estimates* Clinical Provider Ratios* Physical Environment Metrics* Crime Rates* General Health Status Indicators* Cancer Prevalence and Screening Indicators* Cardiovascular Disease* Respiratory Disease* Diabetes* Infectious Diseases* Sexually Transmitted Diseases* Births and Prenatal Care* Health Behaviors* Benchmark Metrics (HealthyPeople 2020) Windham Community Memorial Hospital Part V, Section B, Line 6a: Natchaug Hospital.Part V, Section B, Line 7a:https://windhamhospital.org/about-us/community-health-needs-assessment Windham Community Memorial Hospital Part V, Section B, Line 7d: The needs assessment was published in June 2018 and is available on the Hospital's website. In addition, electronic copies are available upon request.Part V, Section B, Line 10:https://windhamhospital.org/about-us/community-health-needs-assessment Windham Community Memorial Hospital Part V, Section B, Line 11: In acknowledging the wide range of priority health issues that emerged from the 2018 CHNA process, the community representatives met on May 16, 2018 to determine the health needs that will be prioritized for action. The review of the identified needs were followed by a wide ranging discussion, after which the representatives were asked to rank each of the needs.Based on data analysis, surveys, focus groups, and interviews performed, the top community health needs and priorities for the Windham Hospital focus area are listed below:Transportation:Transportation was identified as a top social determinant issue in Windham service area. Community members can't get to appointments, including specialists that are far away.* Local transit municipal grant funding is inadequate and requires capping services* No Medicaid funds available* Dial A Ride has a 30 mile radius* Med Cab can't bring kids with them, which is a big issue for many families * EMS fills the gaps and is over stressed with transportation issuesAccess to Care:* Leads to overuse of the ED* Need for bilingual health counselors in community organizations* Need for more smoking cessation programs and awareness* Access to dental care, many have to leave the area* Need for community educational events as part of preventive care* Lack of women's health services and postpartum servicesSubstance Abuse:* Improvements have been made in the last few years* Willimantic continues to be challenged with the stigma of heroin availability and use* The number of drug exposed infants is very high in the areaMental Health:* Undocumented citizens not seeking or accepting care for fear of losing other services* The stigma of mental health difficult to overcome* School based healthcare is the only place that black and Latino males seek behavioral health assistance* Availability of services for children* Home behavioral health services can be 6 - 8 weeks on the waiting list* Need for more providers and more screening servicesAccess to Healthy Food:* High density and proportionality of fast food in the area* Schools have high BMI, poor nutrition, and need for more education and dedicated community dietician* The high cost of healthy food and need for more voucher programs and increasing focus on food donationIn the region, geographically Windham and Killingly/Plainfield scored significantly worse in physical and mental health indicators. In addition, Windham, Killingly/Plainfield, and Brooklyn/Hampton/Canterbury all had higher than state average rates in the following chronic conditions: asthma, arthritis, and diabetes.Lack of coordination among and between providers and community based organizations limits the overall effectiveness of the programs and the funding that is going to help serve the populations most in need. The results were then grouped into 3 Areas of Concern that were addressed in Community Health Improvement Plan (CHIP):1. Enhance Coordination of Services. This category includes Access to Care and Transportation. CHIP addressed this need in the following manner:a.Evaluate and use information exchange portal resources, linking healthcare providers with community based organizationsb. Improve IT resources to enable community focus and better measurement of outcomesc. Develop a playbook for infrastructure, dashboard of health, governance, and community workflowsd. Enable dynamic and up-to-date asset mappinge. Develop innovation network for learning, research, co-creation, and rapid knowledge dissemination (bi-directional communication platform)f. Implement new or increased use of Community Health Workers (CHW)g. Evaluate and use adaptive technology (e.g., geo-fencing, GIS mapping, artificial intelligence, biometric risk assessment, Epic tie-ins)2. Promote Healthy Behaviors and Lifestyle. This category includes Access to Healthy Food and Poor Physical and Mental Health. CHIP addresses this need in the following manner:a. Screen for healthy food need identification in community population and provide assessment at points of care b. Enhance Promotion and Marketing, including adopting 5-2-1-0 initiative, at schools, workplaces, public spaces, faith communities, and healthcare events c. Provide voucher/prescription programs for fruits and vegetablesd. Promote and improve healthy food donation e. Further partnerships with food pantries/banks and food providers and suppliersf. Create more access points for healthy foodsg. Develop urban gardens, community gardens, hospital campus gardens, farmer's markets (fresh food)h. Evaluate and use mobile food programsi. Create and support food policy councils3. Improve community Behavioral Health. This category includes Mental Health and Substance Abuse. CHIP addresses this need in the following manner: a. Embed behavioral health services in primary care (ongoing)b. Recruit more mental health providers, with focus on community outpatient services (e.g., family therapists)c. Implement Recovery Coach program in EDd. Provide more depression screeninge. Further Mental Health First Aid training and grow community behavioral health training at the local levelf. Enhance services in virtual mental health, including tele-psychiatry Windham Community Memorial Hospital Part V, Section B, Line 13h: Family eligibility criteria for Financial Assistance also include family size, employment status, financial obligations, and amount and frequency of health care expenses. Windham Community Memorial Hospital Part V, Section B, Line 15e: In addition, patients may ask a nurse, physician, chaplain, or staff member from Patient Registration, Patient Financial Services, Case Coordination, or Social Services about initiating the Financial Assistance Application process.Part V, Line 16a, FAP website:https://windhamhospital.org/patients-visitors/for-patients/financial-assistancePart V, Line 16b, FAP Application website:https://windhamhospital.org/patients-visitors/for-patients/financial-assistancePart V, Line 16c, FAP Plain Language Summary website:https://windhamhospital.org/patients-visitors/for-patients/financial-assistance Windham Community Memorial Hospital Part V, Section B, Line 16j: Patients are informed directly by staff of the availability of the Financial Assistance Policy. 6 1 - Windham Middle School Health Center 123 Quarry Street Willimantic CT 06226 In-Depth Health and Mental Health Assessment 2 - Windham High School Wellness Center 355 High Street Willimantic CT 06226 In-Depth Health and Mental Health Assessment 3 - Charles H Barrows STEM Academy 141 Tuckie Road North Windham CT 06256 School Based Health Center 4 - Windham Hospital Family Health Center 5 Founders Avenue Suite 201 Willimantic CT 06226 Patient Rehabilitation 5 - The Center for Women's Health 7 Ledgebrook Drive Mansfield CT 06250 Women's Health Services 6 - Storrs Physical Therapy Clinic 1244 Storrs Road Mansfield CT 06250 Patient Rehabilitation Part I, Line 3c: The Organization uses Federal Poverty Guidelines (FPG) to determine eligibility. In addition to the FPG, the Hospital also utilizes other eligibility criteria, such as asset level, medical indigence and insurance status. Part I, Line 6a:Although the Organization does not prepare a formal Community Benefit Report, it submits a quarterly report to The Connecticut Hospital Association and Form 990 is submitted to the Connecticut Office of Health Strategy (OHS) annually. Part I, Line 7: The Organization utilized an overall cost to charge ratio, (RCC), developed from the Medicare Cost Report. Total expense was adjusted for: medicaid provider taxes, directly identified community benefit expense and community building expenses. This cost to charge ratio was used to calculate costs for Part I lines 7a, b & g. The costs associated with the activities reported on Part I, Line 7e were captured using actual time multiplied by an average salary rate. The costs associated with Line 7h, were the actual costs reported in the organization's general ledger less any industry funded studies. These costs were removed from the calculations above to avoid duplication. Costs reported in Part III, Section B6, were calculated from the Medicare cost report and reduced for Medicare costs previously reported on Part I Lines 7f and g. Part I, Line 7g: No physician clinic costs were included in the Subsidized Health Services cost calculations. Part III, Line 3: A pre-bad debt financial assistance screening was put in place to identify patients that may be eligible for financial assistance. Pre-bad debt accounts that are identified as meeting the requirements are adjusted as charity care prior to being sent to bad debt. Therefore, any bad debt expense that could have been attributable to charity care at the end of FY20 would be immaterial. Part III, Line 4: Please see the text of the footnote that describes bad debt expense beginning on page 30 of the Audited Financial Statement. Part III, Line 8: Cost Reports were used to report Medicare allowable costs. Medicare defines allowable costs as those appropriate and helpful in developing and maintaining the operation of patient care facilities and activities. It specifically excludes certain costs that are not directly related to patient care. The hospital incurs additional expense related to the provision of care to Medicare patients that Medicare has deemed non-allowable. This additional expense includes costs of physician services (emergency on-call fees, Hospitalist Programs, recruitment, etc.), advertising costs, cafeteria costs for meals sold to visitors, etc. The Hospital attempts to collect coinsurance and deductibles from Medicare beneficiaries. To the extent collection efforts are unsuccessful, Medicare reimburses the hospital at 65% of unpaid amounts. The table reconciles the shortfall or surplus from Line 7 to the actual surplus or shortfall. The additional costs were allocated to Medicare based upon Medicare's percentage of total allowable costs. The unpaid coinsurance/deductibles were estimated using historical collection results. Any shortfall amounts have not been treated as Community Benefits. Part III, Line 9b: The Windham Community Memorial Hospital has adopted the Financial Assistance Policy of its Parent Company, Hartford HealthCare Corporation. The following is included in the Financial Assistance Policy: Patients who are deemed ineligible for financial assistance or who receive a partial discount and do not pay their bills may be subject to the following Extraordinary Collection Action (ECAs):*Wage Garnishments*Liens on primary and secondary residences, bank or investment accounts, or other assets*Legal actions and reporting the matter to one or more credit rating agencies*Other ECAs not listed aboveIf an individual has not submitted an application within the first 120 days from the date on which Hartford HealthCare first issues its first, post-discharge billing statement, then Hartford HealthCare may begin engaging in the ECAs described above.ECAs may begin after the first 120 days from the date on which Hartford HealthCare issues its first, post-discharge billing statement. If the patient applies for assistance within 240 days from the first notification of the self-pay balance, and is granted assistance, Hartford HealthCare will take all reasonable available measures to remove any collection actions such as negative reporting to a credit bureau or liens that have been filed.Before Hartford HealthCare initiates any collection actions, it will issue a written notice to the last known address of record for the patient (or his/her family) that describes the specific collection activities it intends to initiate (or resume), provides a deadline after which such action(s) will be initiated (or resumed), and includes a plain language summary of this Policy. ECAs can begin no sooner than 30 days from the date written notice is transmitted. Patients who are ineligible for financial assistance, or qualify for partial financial assistance and who are cooperating in good faith to resolve the outstanding accounts, may be offered extended payment plans. No further collection action will be taken as long as the patient continues to meet the terms of the payment plan. Part VI, Line 2: A variety of methods are used to assess needs for programs that we offer to the community. Informal methods to assess needs include feedback from Advisory Councils and support groups. We coordinate closely with the federally qualified health center in Willimantic, which serves the healthcare needs of low income residents, as well as numerous other organizations including the public schools, other non profit organizations, senior centers, and government agencies in our region. Secondary data from other organizations is also utilized to take advantage of other resources such as the United Way, Eastern Highlands Health District, Visiting Nurses, and partner organizations. Part VI, Line 3: Windham Community Memorial Hospital provides information about its Financial Assistance Policy as follows:(1) Provides signage, brochures and/or a written plain language summary describing the policy along with financial assistance contact information in the emergency department, labor and delivery areas, discharge paperwork, other patient registration/admission areas, as well as in billing and collection communication.(2) Makes paper copies of the policy, financial assistance application, and plain language summary of the policy available upon request and without charge, by mail.(3) Posts the policy, plain language summary and financial assistance application on the website with clear linkage to such documents on the Hartford HealthCare and each affiliated hospital's home page.(4) Educates all admission and registration personnel, financial counselors, billing and collection specialists and social workers regarding the policy so that they can serve as an informational resource to patients.(5) Includes the tag line "Please ask about our Financial Assistance Policy" in applicable Hartford HealthCare written publications. Part VI, Line 4: Windham Community Memorial Hospital services Eastern Connecticut. In 2018, The total population is 152,842. 73.7% of the population is White with 5.5% Black. People of Hispanic origin make up 12.8% and 7.9% are identified as other. Children age 0-17 make up 18.6%, 18-64 make up 66.8% and seniors account for 14.6% of the population. The population living in poverty is 11.2%. Windham County has an 8.4% unemployment rate. 9.6% do not have a high school diploma and 16.9% do have a Bachelor's Degree.The region is a federally designated as medically underserved area. Part VI, Line 5: Windham Community Memorial Hospital was formed to serve its community in 1933 and has been an important resource for nearly 87 years. A regional board governs Windham, Backus, and Natchaug Hospitals. The Board is responsible for maintaining outstanding quality services and credentials its medical staff. All of the Directors reside in our service area and are neither employees, family members, nor contractors of the Hospital. The Windham Hospital Foundation, a related organization, raises funds to assure that the latest advancements in technology are available to our patients, as well as a range of community benefit programs that are not funded by other sources. We are a true community resource as we offer space for other community groups to meet at no charge, bring together other health providers for health fairs and educational sessions for the community, and encourage the involvement of our staff on various boards and councils that promote the overall health of the community. Part VI, Line 6: Hartford Healthcare Corporation (HHC) is organized as a support organization to govern, manage and provide support services to its affiliates. HHC, through its affiliates including Windham Community Memorial Hospital, strives to improve health using the "Triple Aim" model: improving quality and experience of care; improving health of the population (population health) and reducing costs. HHC and its affiliates including all supported organizations, develop and implement programs to improve the future of health care in our Southern New England region. This includes initiatives to improve the quality and accessibility of health care; create efficiency on both our internal operations and the utilization of health care; and provide patients with the most technically advanced and compassionate coordinated care. In addition, HHC continues to take important steps toward achieving its vision of being "nationally respected for excellence in patient care and most trusted for personalized, coordinated care. The affiliation with HHC creates a strong, integrated health care delivery system with a full continuum of care across a broader geographic area. This allows small communities easy and expedient access to the more extensive and specialized services the larger hospitals are able to offer. This includes continuing education of health care professionals at all the affiliated institutions through the Center of Education, Simulation and Innovation located at Hartford Hospital.The affiliation further enhances the affiliates' abilities to support their missions, identity, and respective community roles. This is achieved through integrated planning and communication to meet the changing needs of the region. This includes responsible decision making and appropriate sharing of services, resources and technologies, as well as cost containment strategies. Part VI, Line 7, Reports Filed With States CT 1 1 0 0 0 0 0 1 0 David Whitehead Former Director & President 0 640738 0 394623 0 121674 0 19600 0 53330 0 1229965 0 0 Bimal Patel Former Director & President 0 651398 0 330898 0 19640 0 107840 0 29014 0 1138790 0 0 Margaret Marchak Thru 620 Secretary 0 503824 0 259612 0 87317 0 19600 0 57483 0 927836 0 0 Donna Handley Director, SVP HHC & President 0 439144 0 207260 0 69531 0 19600 0 51931 0 787466 0 0 Robert Sidman MD VP, Medical Affairs 0 402892 0 157446 0 4009 0 19600 0 51095 0 635042 0 0 David Mack CLO 0 327019 0 142033 0 1038 0 19600 0 18308 0 507998 0 0 Kismatkumar Detroja MD Physician 412490 0 45035 0 4312 0 19600 0 17014 0 498451 0 0 0 Lester Temkin VP, Operations 0 202459 0 0 0 237573 0 14637 0 35761 0 490430 0 0 Julian Munoz MD Physician 355146 0 41344 0 4293 0 19600 0 23165 0 443548 0 0 0 Thomas Vaccarelli Former VP, Facilities 0 263861 0 104118 0 2534 0 25200 0 43086 0 438799 0 0 Melisha Cumberland MD Physician 314870 0 41332 0 3263 0 19600 0 15962 0 395027 0 0 0 Gregory Makowski Former VP, HHC Lab Service 0 269246 0 80686 0 3864 0 19600 0 18228 0 391624 0 0 Jennifer Bellino Assoc. Chief Hospitalist 308761 0 20134 0 360 0 19600 0 33487 0 382342 0 0 0 Anthony Mastroianni VP, Finance 0 220099 0 86359 0 2109 0 19600 0 40186 0 368353 0 0 Mark Tramontozzi MD Director 0 304201 0 550 0 1584 0 17458 0 31731 0 355524 0 0 Laura Currie VP, Pat. Care Services 0 211121 0 71212 0 1025 0 19512 0 34714 0 337584 0 0 Karin Grann Nurse Practitioner 222037 0 26732 0 234 0 17414 0 12358 0 278775 0 0 0 Matthew Kaufman VP, Operations 0 176669 0 57538 0 249 0 16514 0 19422 0 270392 0 0 Mary Barry MD Chair 0 183634 0 150 4000 7984 0 6433 0 10905 4000 209106 0 0 Part I, Line 3 The Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare, on behalf of Windham Community Memorial Hospital, hires an outside consultant, Human Resources and Compensation Consulting Practice of Gallagher, to determine best practices in governing executive compensation. Please refer to compensation narrative reported on Schedule O. Part I, Lines 4a-b Hartford Healthcare Corporation, a related organization, maintains a 457(f) Supplemental Executive Retirement Plan (SERP). Participants include certain officers and key employees at the President & CEO, Executive Vice President and Senior Vice President levels that are reported by Windham Community Memorial Hospital on its Form 990, Part VII. Contributions are made by Hartford HealthCare Corporation to the plan based on a percentage of the participant's compensation. Participants vest in the plan at the earlier of reaching age 55 and having 5 years of service, death, disability, involuntary separation without reasonable cause, upon reaching age 65 or the occurrence of a change in control. Each participant ceases to be eligible for further contributions by Hartford Healthcare Corporation on the date of the participant's separation from service. Participants receive a one-time lump sum payment of the accumulated amount during the 30-day period following the participant's separation from service. In 2019, Lester Temkin received a lump sum severance payment in the amount of $230,377. 2019 SERP accrual was made on behalf of the following individual: Bimal Patel $88,240 2019 SERP Payouts were made on behalf of the following individuals: David Whitehead $28,528* Margaret Marchak $21,554* Donna Handley $18,721* *For these individuals, vesting occurred, causing taxable income. This portion of the vested amount was used to pay the associated tax liability. The remaining balance was deposited into the employee SERP account. Part I, Line 7 Hartford HealthCare Corporation, a related organization, has a Compensation At Risk Plan that encourages and rewards achievements of significant functional goals. These goals contribute to the organization's strategic and financial direction. The plan utilizes market practice alignment to ensure competitive recruitment and retention. Awards are based on President & CEO and/or Hartford HealthCare Corporation's Compensation Committee discretionary assessment of overall organization performance and individual contribution to results. Robert Sidman Key Employee 994341 Dr. Sidman is the Vice President of Medical Affairs at the East Region which includes Windham Community Memorial Hospital (WCMH). In addition, Dr. Sidman provides medical professional services to WCMH and other affiliated entities in its Emergency Department (ED). The ED is staffed by Northeast Emergency Medicine Specialists (NEMS), a local group of doctors. His services are provided to the hospital through NEMS. Total transaction between NEMS and Hartford Healthcare System for FY20 was $994,341. 0 Form 990, Part VI, Section A, line 6 Windham Community Memorial Hospital is organized as a non-stock not for profit entity. Hartford HealthCare Corporation is the sole member. Form 990, Part VI, Section A, line 7a The sole member of the organization has the authority to approve/remove members of the governing body. Form 990, Part VI, Section A, line 7b The sole member of the organization has the right to review, approve, disapprove and deny significant transactions such as mergers, acquisitions, dissolutions etc. Form 990, Part VI, Section B, line 11b The Form 990 was prepared by Hartford HealthCare's Tax Department. It was then reviewed by an independent accounting firm. It was then forwarded to the VP of Finance for review. The final Form was provided to the entire Board prior to submission to the Internal Revenue Services (IRS). Once the entire review process was completed, the Form was signed by the VP of Finance and then filed with the IRS. Form 990, Part VI, Section B, line 12c The hospital's board has adopted the policy of the member, Hartford HealthCare Corporation (HHC). HHC's Conflict of Interest Policy (Policy) requires all covered individuals, including board members and officers, to provide a disclosure of relationships that create or have the appearance of creating a conflict of interest or commitment. The Policy requires updates if changes in circumstances arise during the year that either (a) create a new potential conflict of interest or commitment or (b) change or eliminate a conflict of interest or commitment previously disclosed. Conflict of interest disclosure statements are maintained by the HHC Office of Compliance and Integrity (OCI). Employee disclosures are reviewed by OCI in collaboration with the Covered Individuals' supervisor when deemed appropriate, to determine if there is a potential conflict. Oversight review of employee disclosures is provided by the HHC Conflict of Interest Committee. The Conflict of Interest Committee assesses and may recommend the conflicting interest either be (a) eliminated for continued relationship with HHC/HHC Affiliate, or, (b) managed through a management plan. Oversight review of physician disclosures is provided by the HHC Physician Conflict Resolution Committee. The Physician Conflict Resolution Committee assesses and may recommend the conflicting interest either be (a) eliminated for continued relationship with HHC/HHC Affiliate, or, (b) managed through a management plan. Board member disclosures are reported to the HHC Nominating and Governance Committee for determinations of conflicts and the management of them, where applicable. Form 990, Part VI, Section B, line 15 The Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare on behalf of Windham Community Memorial Hospital, hires an outside consultant, Human Resources and Compensation Consulting Practice of Gallagher to determine best practices in governing executive compensation. The following steps were taken: - The use of an Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare, on behalf of Windham Community Memorial Hospital, established and regularly reviews Executive Compensation Philosophy; - The Committee regularly reviews scope and depth of positions taking into account complexity and the financial impact and accountability of all "disqualified persons; - National peer groups are selected for comparative purposes based on organizational size, operating revenue, geography and other relevant factors; - Analysis of current total compensation versus market is performed by independent third party compensation consulting firm and is then reviewed by the committee; - Recommendations are made based on market data analysis to ensure appropriate competitive positioning within parameters of compensation philosophy; - The President & CEO compensation is reviewed by the Committee and is based on comparative market information and organizational performance; - All changes are reviewed and approved by the Executive Compensation Committee; The compensation determination process for the President & CEO is reviewed on an annual basis. All other executive compensation is regularly reviewed for scope and depth of positions taking into account complexity and the financial impact and accountability. Form 990, Part VI, Section C, line 18 The Hospital's Form 990, 990T and form 1023 and its attachments are available upon request. Form 990, Part VI, Section C, line 19 The Hospital's Financial Statements, Governing Documents and the Conflict of Interest Policy are available for inspection upon request at the Organization's address. Form 990, Part IX, line 11g Medical Professional Fees: Program service expenses 16,918,796. Management and general expenses 0. Fundraising expenses 0. Total expenses 16,918,796. Form 990, Part XI, line 9: Change In Pension and Post-Retirement Funding Status Obligation -4,894,470. Transfer to Affiliated Entities 2,216,024. K-1 Income (Loss) Pass Thru Entities -7,577. Form 990, Part XII, Line 3b: Although the Organization was not required to undergo the A-133 Federal Audit, the results were included in a consolidated A-133 Audit performed at the parent level Hartford HealthCare Corporation. 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