2021-08-12T10:30:30-05:00 2020-09-30 990 2019-10-01 222635676 HARTFORD HEALTHCARE SENIOR SERVICES INC HART 8606219559 45 MERIDEN AVENUE SOUTHINGTON CT 06489 Mark Keise Authorized Signer 8606966282 2021-08-12 2019 2022-09-23 18:48:47Z Rita Parisi 45 MERIDEN AVENUE SOUTHINGTON CT 06489 19144971 0 X www.hhcseniorservices.org X 1990 CT To provide sub-acute and long-term care services to a senior population. 4 0 375 25 0 0 63226 98644 19161110 18856360 160812 167167 6265 12878 19391413 19135049 0 2286 0 0 14035276 13620634 0 0 0 5351604 5305764 19386880 18928684 4533 206365 12542607 12831492 10079436 9968333 2463171 2863159 To provide and promote wellness and independence to ensure optimal quality of life for the people we serve. 0 0 15046601 2286 18956285 Hartford HealthCare Senior Services, Inc. is a licensed, 130-bed skilled nursing home facility, which provides room and board, nursing and physical therapy services to its residents in the community served. 15046601 1 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 34 0 1 375 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X David Baranik 8606962546 181 Patricia M Genova Dr Newington CT 06111 Charles Johnson President 1.00 59.00 X X 0 1116058 171445 Rocco Orlando MD Secretary 1.00 59.00 X X 0 1069112 99131 Tracy Church Chair 1.00 59.00 X X 0 1034529 73223 Rita Parisi SVP, Community Network 10.00 50.00 X X 0 566356 68897 David Baranik VP Finance 10.00 50.00 X 0 329847 70289 Lisa Connolly VP, Senior Services 60.00 X 0 287444 55693 William Kowalewski Executive Director 60.00 X 187396 0 19050 Julie Norko Director of Development 60.00 X 146588 0 46266 Sharon Robinson Managed Care Common Relati 60.00 X 157909 0 26295 Kathryn Mauriello Executive Director Assiste 60.00 X 155096 0 15850 Cirie Dorosh Director Nursing Services 60.00 X 103384 0 35844 750373 4403346 681983 7 0 1 0 CE Floyd Company Inc 135 South Road Bedford MA 01730 Maintenance Services 616445 Morrison Management Specialists Inc 400 Northridge Road Sandy Springs GA 30350 Food Services 490640 Crothall Healthcare Inc 13028 Collections Center Drive Chicago IL 60693 Transportation Services 109214 3 98644 98644 Net Patient Services 623000 18856360 18856360 18856360 99925 99925 22800 9922 12878 12878 12878 67242 0 67242 67242 67242 19135049 18956285 0 80120 2286 2286 10960669 8823459 2137210 252933 203614 49319 1613700 1299046 314654 793332 629835 163497 9069 9069 7081 7081 3456 3456 209388 209388 7474 418 7056 266603 60021 206582 554393 327092 227301 484626 371569 113057 13320 828 12492 12733 6282 6451 84953 52671 32282 810282 615814 194468 406228 211317 194911 60996 60996 Medical Supplies 788653 788653 Purchased Services 764617 623997 140620 Nursing Home User Fee 645503 645503 Repairs & Maintenance 129860 113332 16528 46529 480 46049 18928684 15046601 3882083 0 1163123 1389755 1341652 1234744 42472 42472 52137 51840 7873520 3423781 4743184 4449739 3885419 4231865 1314620 1431077 12542607 12831492 1732735 1849461 546006 677069 7800695 7441803 10079436 9968333 X 2388962 2795045 74209 68114 2463171 2863159 12542607 12831492 X 206365 180816 12807 X 0 1 X 1 0 X 55000 1080996 61306 63226 98644 1359172 20659273 19963227 20146526 19161110 18856360 98786496 20714273 21044223 20207832 19224336 18955004 100145668 0 11384524 10514562 71195 21970281 11384524 10514562 71195 21970281 78175387 52059 93135 318397 108374 112803 684768 52059 93135 318397 108374 112803 684768 20766332 21137358 20526229 19332710 19067807 100830436 0.77530 0.77930 0.00680 0.00610 X 3880225 283339 5501 4158063 3728888 158900 7563 3880225 3447550 293072 11734 3728888 2993196 466254 11900 3447550 2706052 298507 11363 2993196 0.97620 0.00180 0.02200 0 1 1 810000 810000 6190291 2714594 3475697 119019 119019 0 754210 590168 164042 4449739 Assets Held in Trust 5194 F Investment in Endowment LLC 4226671 F 4231865 Due from Affiliates 1304260 Long Term Workers Compensation 126817 1431077 Program Related Liability 549964 Payable to HHC - Interco Bonds 6891839 7441803 0 1 0 0 0 0 0 1 0 Charles Johnson President 0 785857 0 292257 0 37944 0 114560 0 56885 0 1287503 0 0 Rocco Orlando MD Secretary 0 690406 0 224494 0 154212 0 36400 0 62731 0 1168243 0 0 Tracy Church Chair 0 678989 0 252537 0 103003 0 19600 0 53623 0 1107752 0 0 Rita Parisi SVP, Community Network 0 389865 0 123624 0 52867 0 33600 0 35297 0 635253 0 0 David Baranik VP Finance 0 256992 0 69291 0 3564 0 19600 0 50689 0 400136 0 0 Lisa Connolly VP, Senior Services 0 207625 0 77854 0 1965 0 19154 0 36539 0 343137 0 0 William Kowalewski Executive Director 168773 0 17756 0 867 0 6549 0 12501 0 206446 0 0 0 Julie Norko Director of Development 126601 0 19740 0 247 0 5554 0 40712 0 192854 0 0 0 Sharon Robinson Managed Care Common Relati 136727 0 19949 0 1233 0 5613 0 20682 0 184204 0 0 0 Kathryn Mauriello Executive Director Assiste 135668 0 19273 0 155 0 4851 0 10999 0 170946 0 0 0 Part I, Line 3 The Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare on behalf of Hartford HealthCare Senior Services, Inc., hires an outside consultant, Human Resources and Compensation Consulting Practice of Gallagher to determine best practices in governing executive compensation. Please refer to compensation narrative reported on Schedule O. Part I, Line 4b Hartford Healthcare Corporation, a related organization, maintains a 457(f) Supplemental Executive Retirement Plan (SERP). Participants include certain officers and key employees at the President & CEO, Executive Vice President and Senior Vice President levels that are reported by Mulberry Gardens of Southington, LLC, 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 occurence of a chane in control. Each participant ceases to be eligible for further contributions by Hartford Healthcare Corporation on the date of the participant's separation from service. Participants receive a one-time lump sum payment of the accumulated amount during the 30-day period following the participant's separation from service. 2019 SERP Accrual was made on behalf of the following individual: Charles Johnson $94,960 2019 SERP Payouts were made on behalf of the following individuals: Tracy Church $34,741* Rocco Orlando $25,851* Rita Parisi $14,236* *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. Form 990, Part VI, Section A, line 1 The organization is governed by a management Board comprised of four employed individuals. These individuals are compensated for their services by Hartford HealthCare Corporation (HHC). HHC is the parent of an integrated healthcare delivery system which includes multiple tax-exempt hospitals that have community boards. Form 990, Part VI, Section A, line 6 Hartford HealthCare Senior Services, Inc. is organized as a non-stock not for profit entity. Hartford HealthCare Corporation is the sole member. Form 990, Part VI, Section A, line 7a The sole member of the organization has the authority to approve/remove members of the governing body. Form 990, Part VI, Section A, line 7b The sole member of the organization has the right to review, approve, disapprove and deny significant transactions such as mergers, acquisitions, dissolutions, etc. Form 990, Part VI, Section B, line 11b The Form 990 was prepared by Hartford HealthCare's Tax Department. 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 and then filed with the IRS. Form 990, Part VI, Section B, line 12c Hartford HealthCare Senior Services, Inc.'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 Rushford Foundation Inc., hires an outside consultant, Human Resources and Compensation Consulting Practice of Gallagher to determine best practices in governing executive compensation. The following steps were taken: - The use of an Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare, on behalf of Rushford Foundation Inc., established and regularly reviews Executive Compensation Philosophy; - The Committee regularly reviews scope and depth of positions taking into account complexity and the financial impact and accountability of all "disqualified persons; - National peer groups are selected for comparative purposes based on organizational size, operating revenue, geography and other relevant factors; - Analysis of current total compensation versus market is performed by independent third party compensation consulting firm and is then reviewed by the committee; - Recommendations are made based on market data analysis to ensure appropriate competitive positioning within parameters of compensation philosophy; -The 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 company's Form 990, Form 990-T, Form 1023 and its attachments are available upon request. Form 990, Part VI, Section C, line 19 The company'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 XI, line 9: Transfers to Afiliated Entity 12,807. Backus HealthCare Inc 326 Washington Street Norwich CT 06360 222481794 Supporting Organization CT 501(c)(3) 12 (a) Hartford HealthCare Corporation 1 Caring for Colleagues Employee Crisis Fund 100 Grand Street New Britian CT 06052 264469178 Employee Fund CT 501(c)(3) 7 Hartford HealthCare Corporation 1 Center for Hospice Care Southeast Connecticut Inc 227 Dunham Street Norwich CT 06360 222667260 Hospice CT 501(c)(3) 7 HHC Independence at Home 1 Connecticut Health System Inc 80 Seymour Street Hartford CT 06102 222779421 Coordination of Health Care Delivery CT 501(c)(3) 12 (c) Hartford HealthCare Corporation 1 Hartford HealthCare ACO Inc 1290 Silas Deane Hwy 2nd Floor Wethersfield CT 06109 460886367 Government Contracts CT 501(c)(3) 7 Hartford HealthCare Medical Group Inc 1 Hartford HealthCare At Home Inc 1290 Silas Deane Hwy Suite 4B Wethersfield CT 06109 060646938 Home Healthcare CT 501(c)(3) 10 Hartford HealthCare Corporation 1 Hartford HealthCare Corporation One State Street Suite 19 Hartford CT 06102 222672834 Support & Management Svcs. 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CT 06489 061490803 Residential Services for Senior Citizens CT 501(c)(3) 10 Hartford HealthCare Senior Services Inc 1 The William W Backus Hospital 326 Washington Street Norwich CT 06360 060250773 Hospital CT 501(c)(3) 3 Hartford HealthCare Corporation 1 Visiting Nurse Services of CT Inc 765 Fairfield Avenue Bridgeport CT 06604 060665196 Home Healthcare CT 501(c)(3) 10 Hartford HealthCare At Home Inc 1 WCMH Women's Auxiliary Inc 112 Mansfield Avenue Willimantic CT 06226 060677728 Fundraising CT 501(c)(3) 12 (a) Windham Community Memorial Hospital 1 Windham Community Memorial Hospital 112 Mansfield Avenue Willimantic CT 06226 060646966 Healthcare Services CT 501(c)(3) 3 Hartford HealthCare Corporation 1 Windham Hospital Foundation Inc 112 Mansfield Avenue Willimantic CT 06226 562546632 Supporting Organization CT 501(c)(3) 12 (a) Windham Community Memorial Hospital 1 Advanced Medical Imaging of NW CT LLC 57 Commercial Blvd Torrington CT 06790 061594854 Magnetic Resonance Imaging CT N/A 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