2020-08-13T18:22:22-05:00 2019-09-30 990 2018-10-01 222635676 HARTFORD HEALTHCARE SENIOR SERVICES INC HART 8606219559 45 MERIDEN AVENUE SOUTHINGTON CT 06489 David Baranik VP Finance 8606219559 2020-08-13 199.231.27.235 2020-08-13 18:22:15 ED P AB8BD5A88D4BA927D2DA994192B6818756100B67 B528C7C86D3B360A0A6E3BCE3B7EF14312B9CEBE 2018 2020-11-06 18:47:13Z Rita Parisi 45 MERIDEN AVENUE SOUTHINGTON CT 06489 19407948 0 X www.hhcseniorservices.org X 1990 CT To provide sub-acute and long-term care services to a senior population. 4 0 358 50 0 0 61306 63226 20146526 19161110 277104 160812 22800 6265 20507736 19391413 100 0 0 0 13736531 14035276 0 0 0 8400527 5351604 22137158 19386880 -1629422 4533 11920928 12542607 9439299 10079436 2481629 2463171 To provide and promote wellness and independence to ensure optimal quality of life for the people we serve. 0 0 15193535 19161110 Hartford HealthCare Senior Services, Inc. is a licensed, 130-bed skilled nursing home facility, which provides room and board, nursing and physical therapy services to its residents in the community served. 15193535 1 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 32 0 1 358 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X David Baranik 8606962546 181 Patricia M Genova Dr Newington CT 06111 Tracy Church Chair 1.00 59.00 X X 0 895011 70098 Charles Johnson President 1.00 59.00 X X 0 1086335 162619 Rocco Orlando MD Secretary 1.00 59.00 X X 0 1019393 100318 Rita Parisi SVP, Community Network 10.00 50.00 X X 0 526582 66030 David Baranik VP Finance 10.00 50.00 X 0 323094 63504 Lisa Connolly VP, Community Network 60.00 X 0 281581 55197 William Kowalewski Executive Director 60.00 X 190794 0 12470 Sharon Robinson Managed Care Common Relati 60.00 X 153941 0 20469 Kathryn Mauriello Executive Director Assiste 60.00 X 149885 0 12059 Julie Norko Director of Development 60.00 X 143243 0 40378 Marjory Palladino Director of Nursing Servic 60.00 X 113608 0 10779 751471 4131996 613921 5 0 1 0 Morrison Management Specialists Inc 400 Northridge Road Sandy Springs GA 30350 Food Services 302174 1 63226 63226 Net Patient Services 623000 19161110 19161110 19161110 102109 102109 22800 16535 6265 6265 6265 58703 0 58703 58703 58703 19391413 19161110 0 167077 10735166 8759148 1976018 266276 217263 49013 2264216 1847443 416773 769618 618453 151165 5070 5070 7060 7060 4846 4846 196735 196735 22600 22600 336867 4128 332739 581088 348653 232435 408059 292311 115748 26863 19 26844 24626 3300 21326 118701 23740 94961 689455 392989 296466 415607 189891 225716 66738 66738 Medical Supplies 759180 759180 Nursing Home User Fee 747870 747870 Purchased Services 691045 558057 132988 Repairs & Maintenance 174807 166627 8180 74387 990 73397 19386880 15193535 4193345 0 1074607 1163123 1598751 1341652 42472 42472 62858 52137 7773622 3030438 4373556 4743184 3756400 3885419 1012284 1314620 11920928 12542607 1600247 1732735 459743 546006 7379309 7800695 9439299 10079436 X 2397356 2388962 79080 69016 5193 5193 2481629 2463171 11920928 12542607 X 4533 -22926 -65 X 0 1 X 1 0 X 564257 55000 1080996 61306 63226 1824785 19654568 20659273 19963227 20146526 19161110 99584704 20218825 20714273 21044223 20207832 19224336 101409489 0 11384524 10514562 21899086 11384524 10514562 21899086 79510403 51522 52059 93135 318397 108374 623487 51522 52059 93135 318397 108374 623487 20270347 20766332 21137358 20526229 19332710 102032976 0.77930 0.86910 0.00610 0.00550 X 3728888 158900 7563 3880225 3447550 293072 11734 3728888 2993196 466254 11900 3447550 2706052 298507 11363 2993196 2777673 -58670 12951 2706052 0.96990 0.00210 0.02800 0 1 1 1247835 1247835 5013576 2367215 2646361 119019 117060 1959 623876 546163 77713 769316 769316 4743184 Assets Held in Trust 5193 F Investment in Endowment LLC 3880226 F 3885419 Due from Affiliates 1146770 Long Term Workers Compensation 166068 Patient Refunds 1782 1314620 Program Related Liability 817218 Payable to HHC - Interco Bonds 6967734 Bond Billing 15743 7800695 0 1 0 0 0 0 0 1 0 Tracy Church Chair 0 527724 0 279630 0 87657 0 19250 0 50848 0 965109 0 0 Charles Johnson President 0 640066 0 357729 0 88540 0 106613 0 56006 0 1248954 0 0 Rocco Orlando MD Secretary 0 598617 0 274050 0 146726 0 35750 0 64568 0 1119711 0 0 Rita Parisi SVP, Community Network 0 334314 0 143158 0 49110 0 33000 0 33030 0 592612 0 0 David Baranik VP Finance 0 233595 0 71009 0 18490 0 19250 0 44254 0 386598 0 0 Lisa Connolly VP, Community Network 0 203564 0 76094 0 1923 0 18775 0 36422 0 336778 0 0 William Kowalewski Executive Director 165757 0 24203 0 834 0 0 0 12470 0 203264 0 0 0 Sharon Robinson Managed Care Common Relati 133407 0 19841 0 693 0 0 0 20469 0 174410 0 0 0 Kathryn Mauriello Executive Director Assiste 133008 0 16777 0 100 0 0 0 12059 0 161944 0 0 0 Julie Norko Director of Development 123371 0 19633 0 239 0 0 0 40378 0 183621 0 0 0 Part I, Line 3 The Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare on behalf of Hartford HealthCare Senior Services, Inc., hires an outside consultant, Human Resources and Compensation Consulting Practice of Gallagher to determine best practices in governing executive compensation. Please refer to compensation narrative reported on Schedule O. Part I, Line 4b Hartford Healthcare Corporation, a related organization, maintains a 457(f) Supplemental Executive Retirement Plan (SERP). Participants include certain officers and key employees at the President & CEO, Executive Vice President and Senior Vice President levels that are reported by Hartford HealthCare Senior Services, Inc. on its Form 990, Part VII. Contributions are made by Hartford HealthCare Corporation to the plan based on a percentage of the participant's compensation. Participants vest in the plan at the earlier of reaching age 55 and having 5 years of service, death, disability, involuntary separation without reasonable cause, upon reaching age 65 or the occurrence of a change in control. Each participant ceases to be eligible for further contributions by Hartford Healthcare Corporation on the date of the participant's separation from service. Participants receive a one-time lump sum payment of the accumulated amount during the 30-day period following the participant's separation from service. 2018 SERP Accruals were made on behalf of the following individual: Charles Johnson $87,363 2018 SERP Payouts were made on behalf of the following individuals: Tracy Church $22,476* Rocco Orlando $24,390* Rita Parisi $13,128* *For these individuals, vesting occurred, causing taxable income. This portion of the vested amount was used to pay the associated tax liability. The remaining balance was deposited into the employee SERP account. Part I, Line 7 Hartford HealthCare Corporation, a related organization, has a Compensation At Risk Plan that encourages and rewards achievements of significant functional goals. These goals contribute to the organization's strategic and financial direction. The plan utilizes market practice alignment to ensure competitive recruitment and retention. Awards are based on CEO and/or Hartford HealthCare Corporation's Compensation Committee discretionary assessment of overall organization performance and individual contribution to results. Form 990, Part VI, Section A, line 1 The organization is governed by a management Board comprised of four employed individuals. These individuals are compensated for their services by Hartford HealthCare Corporation (HHC). HHC is the parent of an integrated healthcare delivery system which includes multiple tax-exempt hospitals that have community boards. Form 990, Part VI, Section A, line 6 Hartford HealthCare Senior Services, Inc. is organized as a non-stock not for profit entity. Hartford HealthCare Corporation is the sole member. Form 990, Part VI, Section A, line 7a The sole member of the organization has the authority to approve/remove members of the governing body. Form 990, Part VI, Section A, line 7b The sole member of the organization has the right to review, approve, disapprove and deny significant transactions such as mergers, acquisitions, dissolutions, etc. Form 990, Part VI, Section B, line 11b The Form 990 was prepared by Hartford HealthCare's Tax Department. It was then forwarded to the VP of Finance for review. The final Form was provided to the entire Board prior to submission to the Internal Revenue Services (IRS). Once the entire review process was completed, the Form was signed by the VP of Finance and then filed with the IRS. Form 990, Part VI, Section B, line 12c Hartford HealthCare Senior Services, Inc.'s board has adopted the policy of the member, Hartford HealthCare Corporation (HHC). HHC's Conflict of Interest Policy (Policy) requires all covered individuals, including board members and officers, to provide a disclosure of relationships that create or have the appearance of creating a conflict of interest or commitment. The Policy requires updates if changes in circumstances arise during the year that either (a) create a new potential conflict of interest or commitment or (b) change or eliminate a conflict of interest or commitment previously disclosed. Conflict of interest disclosure statements are maintained by the HHC Office of Compliance and Integrity (OCI). Employee disclosures are reviewed by OCI in collaboration with the Covered Individuals' supervisor when deemed appropriate, to determine if there is a potential conflict. Oversight review of employee disclosures is provided by the Respective Network or Region Executive Leadership Team (ELT). The ELT assesses and may recommend the conflicting interest either be (a) eliminated for continued relationship with HHC/HHC Affiliate, or, (b) managed through a management plan. Board member disclosures are reported to the HHC Nominating and Governance Committee for determinations of conflicts and the management of them, where applicable. Form 990, Part VI, Section B, line 15 The Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare on behalf of Hartford HealthCare Senior Services, Inc., hires an outside consultant, Human Resources and Compensation Consulting Practice of Gallagher to determine best practices in governing executive compensation. The following steps were taken: - The use of an Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare, on behalf of Hartford HealthCare Senior Services, Inc., established and regularly reviews Executive Compensation Philosophy; - The Committee regularly reviews scope and depth of positions taking into account complexity and the financial impact and accountability of all "disqualified persons; - National peer groups are selected for comparative purposes based on organizational size, operating revenue, geography and other relevant factors; - Analysis of current total compensation versus market is performed by independent third party compensation consulting firm and is then reviewed by the committee; - Recommendations are made based on market data analysis to ensure appropriate competitive positioning within parameters of compensation philosophy; -The CEO compensation is reviewed by the Committee and is based on comparative market information and organizational performance; - All changes are reviewed and approved by the Executive Compensation Committee; The compensation determination process for the CEO is reviewed on an annual basis. All other executive compensation is regularly reviewed for scope and depth of positions taking into account complexity and the financial impact and accountability. Form 990, Part VI, Section C, line 18 The company's Form 990, Form 1023 and its attachments are available upon request. Form 990, Part VI, Section C, line 19 The company's Financial Statements, Governing Documents and the Conflict of Interest Policy are available for inspection upon request at the Organization's address. Form 990, Part XI, line 9: Rounding -65. 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Hartford Hospital O 101025 FMV Hartford Hospital R 218675 FMV Hartford Hospital S 431342 FMV The Hospital of Central Connecticut A 22800 FMV The Hospital of Central Connecticut P 92642 FMV