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MIDDLESEX HOSPITAL: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
MIDDLESEX HOSPITAL (EIN 06-0646718)
Tax period
2018-10-01 to 2019-09-30
Filed
2020-07-21
IRS object ID
202032039349300003
Schema version
2018v3.1
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)
Return2020-07-21T06:31:21-05:00ReturnTs
Tax Period End2019-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN350921680PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CROWE LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1175 POWDER FOREST DRIVEAddressLine1Txt
CitySIMSBURYCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06089ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-10-01TaxPeriodBeginDt

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
Signature2020-07-21SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKRISTIN ANDERSONPreparerPersonNm
PTINP01231300PTIN
Phone8606789200PhoneNum
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-09-23 17:36:50ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1VINCENT CAPECE JRBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line128 CRESCENT STREETAddressLine1Txt
CityMIDDLETOWNCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06457ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$473,725,457GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MIDDLESEXHOSPITAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1895FormationYr
Legal Domicile StateCTLegalDomicileStateCd
Activity Or MissionMIDDLESEX 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 Body14VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee3430TotalEmployeeCnt
Total Volunteers531TotalVolunteersCnt
Total Gross UBI$3,170,035TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$4,475,172PYContributionsGrantsAmt
CY Contributions Grants$5,787,866CYContributionsGrantsAmt
PY Program Service Revenue$431,741,799PYProgramServiceRevenueAmt
CY Program Service Revenue$432,247,273CYProgramServiceRevenueAmt
PY Investment Income$7,819,509PYInvestmentIncomeAmt
CY Investment Income$9,557,248CYInvestmentIncomeAmt
PY Other Revenue$7,354,445PYOtherRevenueAmt
CY Other Revenue$5,078,880CYOtherRevenueAmt
PY Total Revenue$451,390,925PYTotalRevenueAmt
CY Total Revenue$452,671,267CYTotalRevenueAmt
PY Grants And Similar Paid$68,500PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$92,500CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$228,616,625PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$231,814,364CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$968,124CYTotalFundraisingExpenseAmt
PY Other Expenses$174,660,138PYOtherExpensesAmt
CY Other Expenses$178,097,893CYOtherExpensesAmt
PY Total Expenses$403,345,263PYTotalExpensesAmt
CY Total Expenses$410,004,757CYTotalExpensesAmt
PY Revenues Less Expenses$48,045,662PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$42,666,510CYRevenuesLessExpensesAmt
Total Assets BOY$508,825,625TotalAssetsBOYAmt
Total Assets EOY$528,880,049TotalAssetsEOYAmt
Total Liabilities BOY$151,444,638TotalLiabilitiesBOYAmt
Total Liabilities EOY$141,997,427TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$357,380,987NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$386,882,622NetAssetsOrFundBalancesEOYAmt
MissionMIDDLESEX HOSPITAL EXISTS TO PROVIDE THE SAFEST, HIGHEST-QUALITY HEALTH CARE AND THE BEST EXPERIENCE POSSIBLE FOR OUR COMMUNITY. 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 (CONTINUED ON SCHEDULE O)MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$365,506,325ExpenseAmt
Grant$92,500GrantAmt
Revenue$432,443,359RevenueAmt
DescIN THE FISCAL YEAR ENDING 9/30/2019, INPATIENT CARE REPRESENTED 13,087 DISCHARGES AND 53,851 PATIENT CARE DAYS. 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. 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 SERVICES 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$365,506,325TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (true)BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (true)BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document221IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee3430EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldCTStatesWhereCopyOfReturnIsFldCd
Own WebsiteYes (X)OwnWebsiteInd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SHANNON ST HILAIREBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8603586000PhoneNum

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
VINCENT CAPECE JR
PRESIDENT/CEO40.04.0Yes (X)Yes (X)$1,262,910$0$285,456
BRUCE S MACMILLIAN
CHAIRMAN1.03.0Yes (X)Yes (X)$0$0$0
CHANDLER J HOWARD
VICE CHAIRMAN1.03.0Yes (X)Yes (X)$0$0$0
JONATHAN D LEVINE MD
SECRETARY1.043.0Yes (X)Yes (X)$0$0$0
MARK D LORENZE MD
ASST SECRETARY1.00Yes (X)Yes (X)$0$0$0
GERALD P MIGLIACCIO
DIRECTOR1.04.0Yes (X)$0$0$0
JEAN M D'AQUILA
DIRECTOR1.04.0Yes (X)$0$0$0
DAVID C BENOIT
DIRECTOR1.03.0Yes (X)$0$0$0
JOHN J GAUTHIER
DIRECTOR1.03.0Yes (X)$0$0$0
ROBERT C HINTON
DIRECTOR1.03.0Yes (X)$0$0$0
DARRELL G PATASKA
DIRECTOR1.03.0Yes (X)$0$0$0
SABRA R PURTILL
DIRECTOR1.03.0Yes (X)$0$0$0
CHRISTINE H REPASY
DIRECTOR1.03.0Yes (X)$0$0$0
R CHRISTOPHER SEATON
DIRECTOR1.03.0Yes (X)$0$0$0
SUSAN MARTIN
VP FINANCE/TREASURER40.04.0Yes (X)$543,761$0$64,792
JESSE WAGNER MD
VP QUALITY AND PATIENT SAFETY40.00$592,191$0$102,535Yes (X)
JONATHAN BANKOFF
CHAIRMAN EMERGENCY MEDICINE40.00$435,580$0$45,997Yes (X)
RACHEL LOVINS
CHIEF DEPT OF MED40.00$415,195$0$48,847Yes (X)
DAVID GIUFFRIDA
VP FACILITIES AND SUPPORT SERVICES40.00$415,107$0$64,446Yes (X)
JACQUELYN CALAMARI
VP PATIENT CARE SERVICES/CNO40.00$393,485$0$46,344Yes (X)
EVAN JACKSON
VP STRATEGIC PLANNING AND CIO40.00$386,834$0$76,480Yes (X)
DONNA STRONESKI
VP HUMAN RESOURCES40.00$320,273$0$43,572Yes (X)
THEODORE HARTENSTEIN
MEDICAL DIRECTOR, UTILIZATION MANAGEMENT40.00$430,256$0$39,798Yes (X)
JEFFREY SHELTON
CHAIRMAN DEPT PSYCH40.00$418,548$0$32,973Yes (X)
MATTHEW DOLAN
Emergency Medicine MD40.00$411,201$0$18,357Yes (X)
BRIAN MCGUIRE
MEDICAL DIRECTOR ED40.00$407,889$0$48,214Yes (X)
DAVID ANTMAN
Emergency Medicine MD40.00$374,095$0$44,071Yes (X)
GREGORY NOKES
VP HUMAN RESOURCES40.00$155,781$0$161Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$6,963,106TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$962,043TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K410IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ACSYS INTERACTIVE
1577 NEW BRITAIN AVENUEFARMINGTONCT06032MARKETING$2,821,403
ARAMARK CORPORATION
66 OXFORD DRIVEFRANKLINMA02038DIETARY / HOUSEKEEPING$1,841,179
QUEST DIAGNOSTICS INC
2025 COLLECTION CENTER DRIVECHICAGOIL60693LABORATORY SERVICES$1,495,592
Cerner Corporation
PO Box 959156St LouisMO631959156Technology$1,408,731
GE Healthcare IITS
15727 Collections Center DriveChicagoIL60693Technology$1,243,658
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K76CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIIIYes (X)InfoInScheduleOPartVIIIInd
Federated Campaigns$34,964FederatedCampaignsAmt
Fundraising$233,399FundraisingAmt
Government Grants$3,745,065GovernmentGrantsAmt
All Other Contributions$1,774,438AllOtherContributionsAmt
Noncash Contributions$149,013NoncashContributionsAmt
Total Contributions$5,787,866TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Patient Revenues621110$426,551,142$426,551,142
Technical Lab621500$782,600$782,600
Specimen Lab621500$2,367,879$2,367,879
Joint Venture Program900009$2,545,652$2,545,652

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$432,247,273TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,505,576TotalRevenueColumnAmt
Exclusion$6,505,576ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$41,184TotalRevenueColumnAmt
Exclusion$41,184ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$1,014,560RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$828,040RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$186,520RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$186,520TotalRevenueColumnAmt
Exclusion$186,520ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$23,141,373SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$20,130,885SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$3,010,488SecuritiesAmt
Other$0OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,010,488TotalRevenueColumnAmt
Exclusion$3,010,488ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$95,265FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$233,399ContriRptFundraisingEventAmt
Fundraising Direct Expenses$95,265FundraisingDirectExpensesAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Cafeteria Revenue722210$1,526,239$1,526,239
Business ineruption proceeds900009$343,222$343,222

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,022,899TotalRevenueColumnAmt
Related Or Exempt Func Income$3,003,343RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$19,556UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$4,892,360OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$452,671,267TotalRevenueColumnAmt
Related Or Exempt Func Income$432,443,359RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$3,170,035UnrelatedBusinessRevenueAmt
Exclusion$11,270,007ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$92,500TotalAmt
Program Services$92,500ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$6,141,326TotalAmt
Program Services$5,613,870ProgramServicesAmt
Management And General$527,456ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$267,767TotalAmt
Program Services$267,767ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$188,643,712TotalAmt
Program Services$172,418,801ProgramServicesAmt
Management And General$16,224,911ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$9,397,584TotalAmt
Program Services$8,649,547ProgramServicesAmt
Management And General$748,037ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$13,690,463TotalAmt
Program Services$12,587,456ProgramServicesAmt
Management And General$1,103,007ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$13,673,512TotalAmt
Program Services$12,580,491ProgramServicesAmt
Management And General$1,093,021ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$7,394,141TotalAmt
Program Services$6,202,427ProgramServicesAmt
Management And General$223,590ManagementAndGeneralAmt
Fundraising$968,124FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$462,548TotalAmt
Management And General$462,548ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$194,658TotalAmt
Management And General$194,658ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$99,111TotalAmt
Management And General$99,111ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$168,722TotalAmt
Management And General$168,722ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$26,787,993TotalAmt
Program Services$21,690,435ProgramServicesAmt
Management And General$5,097,558ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$3,463,705TotalAmt
Program Services$82,615ProgramServicesAmt
Management And General$3,381,090ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$7,640,017TotalAmt
Program Services$5,375,909ProgramServicesAmt
Management And General$2,264,108ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$12,230,132TotalAmt
Program Services$7,454,870ProgramServicesAmt
Management And General$4,775,262ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$7,191,805TotalAmt
Program Services$4,599,876ProgramServicesAmt
Management And General$2,591,929ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,228,698TotalAmt
Program Services$959,601ProgramServicesAmt
Management And General$269,097ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$541,130TotalAmt
Program Services$486,287ProgramServicesAmt
Management And General$54,843ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,585,705TotalAmt
Program Services$1,585,705ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$23,518,580TotalAmt
Program Services$21,180,596ProgramServicesAmt
Management And General$2,337,984ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$3,053,876TotalAmt
Program Services$3,053,876ProgramServicesAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
Medical Supplies$42,066,093$42,066,093
State Hospital Tax$32,403,511$32,403,511

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$8,067,468TotalAmt
Program Services$6,154,092ProgramServicesAmt
Management And General$1,913,376ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$410,004,757TotalAmt
Program Services$365,506,325ProgramServicesAmt
Management And General$43,530,308ManagementAndGeneralAmt
Fundraising$968,124FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$27,632,430BOYAmt
EOY$40,883,855EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$32,477,000BOYAmt
EOY$14,759,476EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,174,131BOYAmt
EOY$1,981,000EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$48,017,606BOYAmt
EOY$48,355,523EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$1,049,892BOYAmt
EOY$1,224,315EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,275,731BOYAmt
EOY$1,315,139EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$5,256,310BOYAmt
EOY$5,007,515EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$594,654,766LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$372,845,984LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$201,848,824BOYAmt
EOY$221,808,782EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$176,743,045BOYAmt
EOY$179,344,862EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$612,800BOYAmt
EOY$545,933EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$12,737,856BOYAmt
EOY$13,653,649EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$508,825,625BOYAmt
EOY$528,880,049EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$64,537,203BOYAmt
EOY$58,756,565EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$1,010,749BOYAmt
EOY$964,337EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$43,542,482BOYAmt
EOY$42,361,422EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$42,354,204BOYAmt
EOY$39,915,103EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$151,444,638BOYAmt
EOY$141,997,427EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$339,115,292BOYAmt
EOY$368,990,166EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$10,328,569BOYAmt
EOY$9,887,659EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$7,937,126BOYAmt
EOY$8,004,797EOYAmt

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$357,380,987BOYAmt
EOY$386,882,622EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$508,825,625BOYAmt
EOY$528,880,049EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$42,666,510ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$2,014,000NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$11,150,875OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)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)
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$99,111OtherActivitiesAmt
Total Lobbying Expenditures$99,111TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITYFormAndLineReferenceDesc
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 $10,804 AND THE PORTION OF CHA DUES TOTALED $23,887. IN ADDITION, MIDDLESEX HOSPITAL CONTRACTED WITH TWO CONSULTANTS WHO PERFORMED LOBBYING ACTIVITIES. THOSE EXPENSES TOTALLED $64,420.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

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 Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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 Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

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

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$126,387,000BeginningYearBalanceAmt
Contributions$2,000ContributionsAmt
Investment Earnings Or Losses-$2,106,000InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$2,269,000OtherExpendituresAmt
End Year Balance$122,014,000EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.9075BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.0PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.0925TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,291,125OtherCostOrOtherBasisAmt
Book Value$13,291,125BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$331,194,229OtherCostOrOtherBasisAmt
Depreciation$187,817,844DepreciationAmt
Book Value$143,376,385BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,061,978OtherCostOrOtherBasisAmt
Depreciation$1,775,250DepreciationAmt
Book Value$286,728BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$218,930,206OtherCostOrOtherBasisAmt
Depreciation$179,559,994DepreciationAmt
Book Value$39,370,212BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$29,177,228OtherCostOrOtherBasisAmt
Depreciation$3,692,896DepreciationAmt
Book Value$25,484,332BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$221,808,782TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
ACCRUED RETIREMENT LIABILITIES$3,620,428
SELF INSURANCE LIABILITIES$24,535,749
ASSET RETIREMENT OBLIGATION$568,645
UNALLOCATED 3RD PARTY$10,848,297
OTHER$341,984
FieldValueIRS element (for citing)
Total Liability$39,915,103TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule D, Part V, Line 4 Intended uses of endowment fundsTHE 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 FY2019. 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.
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnoteThe 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, 2019 and 2018. 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, 2019 and 2018, 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$173,330GrossReceiptsEvent1Amt
Charitable Contri Event1$114,013CharitableContriEvent1Amt
Gross Revenue Event1$59,317GrossRevenueEvent1Amt
Cash Prizes Event1$0CashPrizesEvent1Amt
Non Cash Prizes Event1$0NonCashPrizesEvent1Amt
Rent Facility Costs Event1$57,523RentFacilityCostsEvent1Amt
Food And Beverage Event1$0FoodAndBeverageEvent1Amt
Entertainment Event1$0EntertainmentEvent1Amt
Other Direct Expenses Event1$1,795OtherDirectExpensesEvent1Amt
Event2Hospice GolfEvent2Nm
Gross Receipts Event2$78,282GrossReceiptsEvent2Amt
Charitable Contri Event2$55,040CharitableContriEvent2Amt
Gross Revenue Event2$23,242GrossRevenueEvent2Amt
Cash Prizes Event2$2,423CashPrizesEvent2Amt
Non Cash Prizes Event2$0NonCashPrizesEvent2Amt
Rent Facility Costs Event2$8,620RentFacilityCostsEvent2Amt
Food And Beverage Event2$10,134FoodAndBeverageEvent2Amt
Entertainment Event2$0EntertainmentEvent2Amt
Other Direct Expenses Event2$2,064OtherDirectExpensesEvent2Amt
Other Events Total2OtherEventsTotalCnt
Gross Receipts Other Events$77,052GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$64,346CharitableContriOtherEventsAmt
Gross Revenue Other Events$12,706GrossRevenueOtherEventsAmt
Cash Prizes Other Events$0CashPrizesOtherEventsAmt
Non Cash Prizes Other Events$0NonCashPrizesOtherEventsAmt
Rent Fclty Costs Other Events$0RentFcltyCostsOtherEventsAmt
Food And Beverage Other Events$0FoodAndBeverageOtherEventsAmt
Entertainment Other Events$0EntertainmentOtherEventsAmt
Oth Direct Expnss Other Events$12,706OthDirectExpnssOtherEventsAmt
Gross Receipts Total$328,664GrossReceiptsTotalAmt
Charitable Contributions Tot$233,399CharitableContributionsTotAmt
Gross Revenue Total Events$95,265GrossRevenueTotalEventsAmt
Cash Prizes Total Events$2,423CashPrizesTotalEventsAmt
Non Cash Prizes Total Events$0NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$66,143RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$10,134FoodAndBeverageTotalEventsAmt
Entertainment Total Events$0EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$16,565OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$95,265DirectExpenseSummaryEventsAmt
Net Income Summary$0NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

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

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other500DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Persons Served4235PersonsServedCnt
Total Community Benefit Expns$7,251,941TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,454,888DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,797,053NetCommunityBenefitExpnsAmt
Total Expense0.0068TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Persons Served19376PersonsServedCnt
Total Community Benefit Expns$84,214,474TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$56,149,381DirectOffsettingRevenueAmt
Net Community Benefit Expns$28,065,093NetCommunityBenefitExpnsAmt
Total Expense0.0685TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Persons Served388PersonsServedCnt
Total Community Benefit Expns$1,056,335TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$783,466DirectOffsettingRevenueAmt
Net Community Benefit Expns$272,869NetCommunityBenefitExpnsAmt
Total Expense0.0007TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served23999PersonsServedCnt
Total Community Benefit Expns$92,522,750TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$61,387,735DirectOffsettingRevenueAmt
Net Community Benefit Expns$31,135,015NetCommunityBenefitExpnsAmt
Total Expense0.0759TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Persons Served14961PersonsServedCnt
Total Community Benefit Expns$6,870,932TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$316,577DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,554,355NetCommunityBenefitExpnsAmt
Total Expense0.0160TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Persons Served1396PersonsServedCnt
Total Community Benefit Expns$13,768,991TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,153,269DirectOffsettingRevenueAmt
Net Community Benefit Expns$11,615,722NetCommunityBenefitExpnsAmt
Total Expense0.0283TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Persons Served32406PersonsServedCnt
Total Community Benefit Expns$46,861,660TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$35,408,830DirectOffsettingRevenueAmt
Net Community Benefit Expns$11,452,830NetCommunityBenefitExpnsAmt
Total Expense0.0279TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Persons Served31PersonsServedCnt
Total Community Benefit Expns$360,672TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,771DirectOffsettingRevenueAmt
Net Community Benefit Expns$343,901NetCommunityBenefitExpnsAmt
Total Expense0.0008TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Persons Served3528PersonsServedCnt
Total Community Benefit Expns$318,202TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,800DirectOffsettingRevenueAmt
Net Community Benefit Expns$316,402NetCommunityBenefitExpnsAmt
Total Expense0.0008TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served52322PersonsServedCnt
Total Community Benefit Expns$68,180,457TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$37,897,247DirectOffsettingRevenueAmt
Net Community Benefit Expns$30,283,210NetCommunityBenefitExpnsAmt
Total Expense0.0739TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served76321PersonsServedCnt
Total Community Benefit Expns$160,703,207TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$99,284,982DirectOffsettingRevenueAmt
Net Community Benefit Expns$61,418,225NetCommunityBenefitExpnsAmt
Total Expense0.1498TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,614TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,614NetCommunityBenefitExpnsAmt
Total Expense0.0000TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Persons Served18PersonsServedCnt
Total Community Benefit Expns$126,526TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$24,700DirectOffsettingRevenueAmt
Net Community Benefit Expns$101,826NetCommunityBenefitExpnsAmt
Total Expense0.0002TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Persons Served31PersonsServedCnt
Total Community Benefit Expns$567TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$567NetCommunityBenefitExpnsAmt
Total Expense0.0000TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Persons Served40PersonsServedCnt
Total Community Benefit Expns$62TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$62NetCommunityBenefitExpnsAmt
Total Expense0.0000TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served89PersonsServedCnt
Total Community Benefit Expns$130,769TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$24,700DirectOffsettingRevenueAmt
Net Community Benefit Expns$106,069NetCommunityBenefitExpnsAmt
Total Expense0.0003TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$17,273,230BadDebtExpenseAmt
Bad Debt Expense Attributable$1,727,323BadDebtExpenseAttributableAmt
Reimbursed By Medicare$38,612,666ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$45,808,120CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$7,195,454MedicareSurplusOrShortfallAmt

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Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part V, Section B, Line 3EThe significant health needs are a prioritized description of the significant health needs of the community and identified through the CHNA.
Schedule H, Part V, Section B, Line 3 Facility , 1Facility , 1 - MIDDLESEX HOSPITAL. 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.
Schedule H, Part V, Section B, Line 5 Facility , 1Facility , 1 - MIDDLESEX HOSPITAL. 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.
Schedule H, Part V, Section B, Line 7 Facility , 1Facility , 1 - MIDDLESEX HOSPITAL. 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.
Schedule H, Part V, Section B, Line 11 Facility , 1Facility , 1 - MIDDLESEX HOSPITAL. Middlesex Hospital's 2016 CHNA Implementation Strategy had four broad priority areas (mental health, substance abuse, aging population, and asthma), and each had specific goals. The actions taken to address the significant health needs identified in the Hospital's previous CHNA (2016) include: Goal 1) Mental Health: Goal 1.1 Improve access to mental health services through interprofessional collaborative practice. To achieve this goal, Middlesex Health implemented an evidence-based integrated care model for mental health treatment within the primary care setting. Mental health clinicians, who are primarily Licensed Clinical Social Workers, are embedded in select primary care offices within the Middlesex Health system. Patients can be referred to therapy within the primary care practice where they receive psychotherapy to address a myriad of issues including depression, anxiety, grief, and trauma. Immediate warm hand-offs between primary care providers and mental health providers can also occur after the primary care visit. The embedded mental health clinicians consult with a staff psychiatrist on a weekly basis to review cases. Goal 1.2 Provide specialized mental health treatment for high risk populations. Action steps included 1) developing the service where, through assessment and intervention, young adults are able to regain and sustain functioning, and remain safe and healthy; 2) renovation of office space in order to accommodate the expansion; and 3) hiring psychiatrists specializing in young adult care. Goal 2) Substance Abuse: Goal 2.1 Develop a treatment program for high-risk patients experiencing severe alcohol use disorders. In order to accomplish this goal, an inpatient unit dedicated solely to patients experiencing acute alcohol withdrawal requiring medical care was created. The unit was identified, protocols were established and staff education was provided. Results have been highly positive, including: 1) no patients requiring transfer to the intensive care unit (ICU) during program launch (compared to a 40% ICU transfer prior to program launch); 2) improved patient satisfaction; 3) increased patient engagement in outpatient care after discharge; 4) increased staff satisfaction; and 5) reduction in staff and patient injuries. Goal 2.2 A) Develop and launch an opioid awareness campaign; B) Increase access to naloxone for patients at high risk for opioid overdose. In November 2017, Middlesex Health piloted a naloxone kit distribution program in its Middletown emergency department (ED) where the ED and pharmacy staff collaborated to develop a naloxone kit distribution policy and pathway. In early 2019, through a grant partnership between the Connecticut Hospital Association and the Department of Mental Health and Addiction Services (DMHAS), Middlesex Health elected to participate in this opportunity and expanded its pilot program of offering Narcan to-go kits to all its ED sites. Middlesex Health is also involved in the DMHAS-funded "How Can We Help?" initiative, a partnership between the Ministerial Health Fellowship, Columbus House and Middlesex Health which provides recovery coach services to survivors of an opioid overdose, individuals at-risk of an opioid overdose, individuals struggling with opioid use, and families of those struggling with opioid use. Goal 3) Aging Population. Design and implement interventions to promote healthy aging in place and improve outcomes for the aging population. The GOT Care! (Geriatrics Outreach and Training with Care) pilot program was successfully completed in June of 2017, followed by a period of required reporting and journal article development to broadly disseminate the model of care and successful outcomes. Program design continues to be underway through 1) assessment of existing geriatric service capacity as well as organizational strengths and barriers; 2) data review from a doctoral dissertation which evaluated GOT Care! outcomes; 3) collaboration with a health care economist to conduct a cost/benefit analysis; and 4) development of a strategic plan to guide the process of designing an interprofessional practice geriatric service line, starting with the in-home comprehensive geriatric assessment. Goal 4) Asthma. Improve asthma outcomes by meeting the Connecticut Asthma Initiative goals. In 2016, the Middlesex County Asthma Coalition was formed, with Middlesex Health serving as administrative lead under its Center for Chronic Care Management. The objective of the coalition is to work collaboratively to address areas of identified asthma need with a focus on those who are most at-risk. An initial area of focus was increasing the use of asthma action plans and promoting patient education techniques for asthma management. Since August 2018, the Connecticut River Area Health District, the Connecticut Department of Public Health and Middlesex Health have been partnering on the Putting in Airs initiative, an asthma home visiting program for children and adults in the defined service area who have poorly controlled asthma. 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.
Schedule H, Part V, Section B, Line 13 Facility , 1Facility , 1 - MIDDLESEX HOSPITAL. 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.
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Supplemental Information Detail SupplementalInformationDetail (21 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part I, Line 3c Criteria used for determining eligibility for free or discounted careIn 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.
Schedule H, Part VI, Line 6 Affiliated health care systemn/a. Middlesex Hospital is not part of an affiliated health care system.
Schedule H, Part VI, Line 7 Additional Information - State filing community benefit reportUnder 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 H, Part V, Section B, Line 4 The tax year the hospital facility last conducted a CHNAThe last CHNA report was approved by the board on 9/27/19 (tax year 2018); certain updates to the report were made and approved by the board on 11/22/19.
Schedule H, Part V, Section B, Line 8 Adoption of Implementation StrategyMiddlesex Hospital's most recent Implementation Strategy (that relates to Middlesex Hospital's 2019 CHNA) was adopted after the end of the tax year in which its most recent CHNA was completed, but before the 15th day of the fifth month after the end of the tax year in which the CHNA was conducted. This Implementation Strategy was adopted by the board on February 7, 2020.
Schedule H, Part I, Line 7g Subsidized Health ServicesMiddlesex Hospital includes its Family Medicine Group as a subsidized service. For FY19, 10,500 unique individuals were served with a total Hospital subsidy of $297,650. 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.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistanceFor 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.
Schedule H, Part II Community Building ActivitiesThe majority of Middlesex Hospital's community based community benefit work is captured under non-community building 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 programs 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. In FY19 the Hospital's Community Building Activities totaled $106,069 and served 89 individuals. Examples include (but are not limited to): 1) Disaster Readiness where the Hospital plays a pivotal role by working in collaboration with key community partners to ensure the safety of the community at large during a potential disaster. To prepare for disasters, the Hospital often participates in community disaster preparation and emergency management committees; regular collaborative community education and drills; and hosts yearly radiation drills for the staff of a local nuclear power plant. In addition, the Hospital purchases and stock-piles large quantities of extensive pandemic supplies to be used should a community-wide disaster occur. Included in this stock-pile are medications for infectious disease and chemical exposure curatives. The majority of the value of the supplies, space utilization and costs associated to monitor and replenish pandemic products (within expiration dates) are absorbed by the Hospital. 2) Workforce Development: the Hospital's Shoreline Medical Center (SMC) has well-developed educational programs for local students interested in medical careers. Shortages of certain trained medical professionals such as nurses and radiologic technologists served as the impetus for starting these programs. Examples of these educational programs include: a) SMC Career Day - an experiential learning event where high school students interact with staff members from a variety of clinical fields and participate in interactive mock demonstrations/simulations, and b) SMC World of Work - an educational experience for middle schools students where students learn about specific healthcare fields and the education required for each specialty. Students also receive demonstrations on health care modalities.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amountThe 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.
Schedule H, Part III, Line 3 Bad Debt Expense MethodologyThe 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.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnoteThe 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 16 of the Middlesex Health System's Consolidated FY19 Audited Financial Statement states: For receivables associated with self-pay patients which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill, the Hospital records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between discounted rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costsThe 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.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistanceMiddlesex 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.
Schedule H, Part V, Section B, Line 16a FAP website- MIDDLESEX HOSPITAL: Line 16a URL: https://middlesexhospital.org/patients-and-visitors/financial-assistance-services;
Schedule H, Part V, Section B, Line 16b FAP Application website- MIDDLESEX HOSPITAL: Line 16b URL: https://middlesexhospital.org/patients-and-visitors/financial-assistance-services;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website- MIDDLESEX HOSPITAL: Line 16c URL: https://middlesexhospital.org/patients-and-visitors/financial-assistance-services;
Schedule H, Part VI, Line 2 Needs assessmentSince 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 state's Hospital Association population and community health initiatives based on state-wide and local community health issues; 3) any real-time community based input, feed-back, recommendations and suggestions; and 4) 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.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistanceGreat 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 FY19, Middlesex Hospital granted $2,797,053 of financial assistance to 4,235 unique recipients and absorbed $28,337,962 in unpaid costs of Medicaid (total of Medicaid including managed care and LIA), serving 19,764 individuals.
Schedule H, Part VI, Line 4 Community informationMiddlesex 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. 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 2019, the percent of hospital discharges for Medicaid/SAGA/Uninsured combined were: 18.5% inpatient; 14% outpatient; 31% Emergency Department non-admission; and, for the following services: 40% newborn; 44% 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.
Schedule H, Part VI, Line 5 Promotion of community healthAs 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 FY19 was $61,418,225 (excluding Community Building) with 76,321 served (excluding Community Building). 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 FY19, the Hospital's Community Health Improvement Services served 14,961 individuals at a total cost of $6,301,720 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 FY19, the Hospital's Health Professions Education category served 1,396 individuals at a total cost of $11,615,722 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, Paramedics, Hospice, Diabetes Education, and Wound Care. In FY19 the Hospital's subsidized services served 32,406 people with a total cost of $11,452,830 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 FY19, the Hospital's associated costs for all (non-industry) research projects totaled $343,901 and served 31 individuals. Financial and In-Kind Contributions: Middlesex Hospital supports the community in the form of financial and in-kind contributions. The Hospital's in-kind contributions include equipment, food, linens and medical supplies that are donated both locally and globally. Other in-kind donations include cafeteria discounts for YMCA residents and staff coordination of community support drives. 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 FY19 support for financial and in-kind contributions totaled $316,402, serving 3,528 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 FY19 Community Benefit Operations expense totaled $252,635.
Schedule H, Part VI, Line 7 State filing of community benefit reportCT

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)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 County Chamber of Commerce Inc
393 Main StreetMiddletownCT06457060452410501(c)(6)$48,000General Support
Florida Hospital Association RESEARCH AND EDUCATION FOUNDATION
307 Park Lake CircleOrlandoFL32803596151162501(c)(3)$10,000General Support
HEALTH ASSISTANCE INTERVENTION EDUCATION NETWORK FOR CONNECTICUT
1210 Mill StreetEast BerlinCT06023510642913501(c)(3)$5,000General Support
Eugene O'Neill Theater
305 Great Neck RoadWaterfordCT06385066070900501(c)(3)$14,500General Support
Friends of Long Hill Estate
421 Wadsworth StreetMiddletownCT06457061546991501(c)(3)$5,000general support
Connecticut River Museum
67 Main StreetEssexCT06426237417579501(c)(3)$5,000General Support
FieldValueIRS element (for citing)
Total501c3 Org6Total501c3OrgCnt
Total Other Org1TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule I, Part I, Line 2 Procedures for monitoring use of grant funds.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 (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)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 PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

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$730,342$0$253,050$0$279,518$0$244,671$0$40,785$0$1,548,366$0$251,283$0
SUSAN MARTIN
VP FINANCE/TREASURER$408,504$0$98,000$0$37,257$0$35,817$0$28,975$0$608,553$0$18,197$0
GREGORY NOKES
VP HUMAN RESOURCES$29,301$0$80,000$0$46,480$0$0$0$161$0$155,942$0$27,980$0
JESSE WAGNER MD
VP QUALITY AND PATIENT SAFETY$414,146$0$113,150$0$64,895$0$64,760$0$37,775$0$694,726$0$46,395$0
JONATHAN BANKOFF
CHAIRMAN EMERGENCY MEDICINE$397,830$0$37,750$0$0$0$16,085$0$29,912$0$481,577$0$0$0
RACHEL LOVINS
CHIEF DEPT OF MED$366,118$0$47,000$0$2,077$0$16,200$0$32,647$0$464,042$0$0$0
DAVID GIUFFRIDA
VP FACILITIES AND SUPPORT SERVICES$280,087$0$87,000$0$48,020$0$47,995$0$16,451$0$479,553$0$29,520$0
JACQUELYN CALAMARI
VP PATIENT CARE SERVICES/CNO$278,233$0$68,000$0$47,252$0$21,600$0$24,744$0$439,829$0$29,260$0
EVAN JACKSON
VP STRATEGIC PLANNING AND CIO$289,302$0$77,000$0$20,532$0$44,272$0$32,208$0$463,314$0$0$0
DONNA STRONESKI
VP HUMAN RESOURCES$258,273$0$62,000$0$0$0$38,030$0$5,542$0$363,845$0$0$0
THEODORE HARTENSTEIN
MEDICAL DIRECTOR, UTILIZATION MANAGEMENT$390,256$0$40,000$0$0$0$8,143$0$31,655$0$470,054$0$0$0
JEFFREY SHELTON
CHAIRMAN DEPT PSYCH$365,048$0$53,500$0$0$0$11,159$0$21,814$0$451,521$0$0$0
MATTHEW DOLAN
Emergency Medicine MD$335,926$0$75,275$0$0$0$5,400$0$12,957$0$429,558$0$0$0
BRIAN MCGUIRE
MEDICAL DIRECTOR ED$284,725$0$104,664$0$18,500$0$15,702$0$32,512$0$456,103$0$0$0
DAVID ANTMAN
Emergency Medicine MD$287,341$0$86,754$0$0$0$12,980$0$31,091$0$418,166$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 1a Travel for companionsTRAVEL FOR COMPANIONS - THE HOSPITAL'S POLICY PROVIDES 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. EVAN JACKSON SUSAN MARTIN VINCENT CAPECE
Schedule J, Part I, Line 1a Health or social club dues or initiation feesSOCIAL 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 (VINCENT CAPECE) ACCORDING TO IRS RULES AND REGULATIONS.
Schedule J, Part I, Line 1a Personal servicesREPRESENTS TAX PLANNING AND/OR TAX PERSONAL SERVICES - PREPARATION FEES FOR ONE MEMBER OF THE EXECUTIVE STAFF. THIS BENEFIT WAS TREATED AS TAXABLE COMPENSATION. EVAN JACKSON

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
STATE OF CT HEALTH & EDUCATIONAL FACILITIES AUTH
A06080618620774YAW72011-07-26$33,803,383SERIES N REFINANCE 10/9/1997 (SERIES H & I)Yes (true)falsefalse
State of CT Health & Educational Facilities Authority
B06080618620774YWD52015-05-19$19,491,965SERIES O Refinance 12/7/2006 (Series L)falsefalsefalse
STATE OF CT HEALTH & EDUCATIONAL FACILITES AUTHORITY
C0608061860000000002016-06-10$9,683,000SERIES P REFINANCE 6/10/2016 (SERIES M)falsefalsefalse
STATE OF CT HEALTH & EDUCATIONAL FACILITIES AUTH
D0608061860000000002017-11-21$9,069,272SERIES Q REFINANCE 10/26/2010 (SERIES N)falsefalsefalse

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtBond DefeasedBondDefeasedAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtCapitalized InterestCapitalizedInterestAmtRefunding EscrowRefundingEscrowAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCredit EnhancementCreditEnhancementAmtWorking Capital ExpendituresWorkingCapitalExpendituresAmtCapital ExpendituresCapitalExpendituresAmtOther Spent ProceedsOtherSpentProceedsAmtUnspentUnspentAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$16,740,000$7,600,000$33,803,651$0$0$0$537,971$0$0$0$33,265,690$02011Yes (true)falseYes (true)Yes (true)
B$2,455,000$0$19,491,965$0$0$0$388,960$0$0$0$19,103,010$02015falseYes (true)Yes (true)Yes (true)
C$2,693,767$0$9,683,000$0$0$0$193,660$0$0$0$9,489,340$02016falseYes (true)Yes (true)Yes (true)
D$322,611$0$9,366,990$0$8,397,800$181,425$0$0$0$788,341$0falseYes (true)falseYes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCdTotal Private Business UseTotalPrivateBusinessUsePctOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0.0
B0.0falsefalsefalsefalse0.00.0falsefalseYes (true)
C0.0
D0.0

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
AfalsefalsefalseYes (true)falsefalsefalsefalseYes (true)
BfalseYes (true)falsefalsefalsefalsefalsefalseYes (true)
CfalseYes (true)falsefalsefalsefalsefalsefalseYes (true)
DfalseYes (true)falsefalsefalsefalsefalsefalseYes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

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

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule K, Part II, Line 3 COLUMN A and Column D BondsTHE DIFFERENCE BETWEEN THE ISSUE PRICE AND THE TOTAL PROCEEDS IS investment earnings.
Schedule K, Part III Column B and Column C BondsThe 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 InformationSeries N bonds were split between Middlesex Health Services which issued $5,637,382 and Middlesex Hospital which issued $33,803,383.
Schedule K, Part VI Supplemental InformationSeries Q bonds were split between Middlesex Health Services which issued $2,529,728 and Middlesex Hospital which issued $9,069,272.
Schedule K, Part IV, Line 2c COLUMN AIssuer name: STATE OF CT HEALTH & EDUCATIONAL FACILITIES AUTH. The calculation for computing no rebate due was performed on 07/26/2016

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
ANNE CALAMARI - LCSW COORDINATOR
FAMILY MEMBER of J. CALAMARI$136,004Employment Arrangementfalse
GUIFFRIDA ELECTRIC CO
Entity more than 35% owned by FAMILY MEMBER of D. GUIFFRIDA, a key employee$1,052,011Indpendent Contractor Arrangementfalse
Ruth Wagner - Registered Nurse
Family Member of J Wagner, a key employee$84,407Employment Arrangementfalse

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule L, Part IV RELATED PARTIESFormAndLineReferenceDesc
ExplanationANNE CALAMARI, LCSW COORDINATOR, IS THE DAUGHTER OF JACQUELYN CALAMARI, VP NURSING. ANNE CALAMARI'S WAGES FOR 10/01/18 TO 09/30/19 TOTALED $136,004. COS GIUFFRIDA AND GIULIO GIUFFRIDA, FATHER AND UNCLE OF DAVID GIUFFRIDA, RESPECTIVELY, ARE OWNERS OF GIUFFRIDA ELECTRIC. GUIFFRIDA ELECTRIC PROVIDES ELECTRICAL CONTRACTING SERVICES TO MIDDLESEX HOSPITAL SINCE 1970. AMOUNTS PAID BY THE HOSPITAL FOR SERVICES RENDERED DURING FY19 TOTALED $1,052,011. RUTH WAGNER, CCU REGISTERED NURSE, IS THE WIFE OF JESSE WAGNER, VP QUALITY & SAFETY. RUTH WAGNER'S WAGES FOR 10/01/18 TO 09/30/19 TOTALED $84,407.ExplanationTxt

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution4ContributionCnt
Noncash Contributions Rpt F990$149,013NoncashContributionsRptF990Amt
Method Of Determining RevenuesOther - Selling PriceMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (true)ReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule M, Part I Explanations of reporting method for number of contributionsFormAndLineReferenceDesc
ExplanationSecurities - Publicly traded - Reporting on count of donorsExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, Line 1 ORGANIZATION'S MISSIONRELATIONSHIPS 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, Line 2 Family/business relationships amongst interested personsJEAN D'AQUILA & CHANDLER HOWARD - Business relationship, VINCENT CAPECE & CHANDLER HOWARD - Business relationship
Form 990, Part VI, Line 6 Classes of members or stockholdersTHE SOLE MEMBER OF THE HOSPITAL IS MIDDLESEX HEALTH SYSTEM, INC.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyTHE SOLE MEMBER, MIDDLESEX HEALTH SYSTEM, INC. HAS THE RIGHT TO ANNUALLY ELECT THE BOARD OF DIRECTORS OF THE HOSPITAL.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersTHE 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 ON ITS BEHALF.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyA 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, Line 12c Conflict of interest policyCONFLICT OF INTEREST FORMS ARE DISTRIBUTED ANNUALLY TO KEY EMPLOYEES, OFFICERS AND THE BOARD OF DIRECTORS. RESPONSES ARE RETURNED TO, TRACKED, AND REVIEWED BY THE 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, Line 15a Process to establish compensation of top management officialTHE 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 AND INCENTIVE COMPENSATION WITHIN A RANGE SET BY THE POLICY. FOLLOWING THE CLOSE OF EACH FISCAL YEAR, THE COMMITTEE RECEIVES MARKET ANALYSIS FROM AND 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 12/2018.
Form 990, Part VI, Line 15b Process to establish compensation of other employeesTHE 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 12/2018.
Form 990, Part VI, Line 19 Required documents available to the publicMIDDLESEX 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 VIII, Line 11d Other Miscellaneous Revenueall Other Revenue - Total Revenue: 3022899, Related or Exempt Function Revenue: 3003343, Unrelated Business Revenue: 19556, Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesEXPENDITURES FROM RESTRICTED FUNDS - -1284000; Transfer to System - -10698000; Transfer from Resources - 260000; Transfer from Primary Care - 496000; Change in Assets Held in Trust - 75125;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
MIDDLESEX HEALTH SYSTEM INC
28 CRESCENT STREETMIDDLETOWNCT06457222676137SUPPORTCT501(c)(3)Type IINAfalse
MIDDLESEX HEALTH SERVICES INC
28 CRESCENT STREETMIDDLETOWNCT06457222676140ASST. LIVINGCT501(c)(3)10MIDDLESEX HEALTH SYSTEMfalse
MIDDLESEX HOSPITAL FOUNDATION
28 CRESCENT STREETMIDDLETOWNCT06457273720822SUPPORTCT501(c)(3)Type IIMIDDLESEX HOSPITALYes (true)
MHS PRIMARY CARE INC
28 CRESCENT STREETMIDDLETOWNCT06457061472743HEALTHCARECT501(c)(3)Type IIMIDDLESEX HEALTH SYSTEMfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
MIDDLESEX HEALTH RESOURCES INC
28 CRESCENT STREETMIDDLETOWNCT06457061089925HEALTHCARECTMIDDLESEX HEALTH SYSTEMC Corporationfalse
INTEGRATED RESOURCES FOR THE MIDDLESEX AREA LLC
28 CRESCENT STREETMIDDLETOWNCT06457061462230OUTPATIENT CARECTMIDDLESEX HEALTH SYSTEMC Corporationfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd