2019-08-15T13:52:37-05:00 2018-09-30 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 221 W PHILADELPHIA STREET SUITE 200 YORK PA 17401 990 2017-10-01 060646741 THE MILFORD HOSPITAL INC MILF 2038764000 300 SEASIDE AVENUE MILFORD CT 06460 LAURA SMITH CHIEF FINANCIAL OFFICER/VP FINANCE 2038764000 2019-08-14 1 KERRI N BOGDA P00760402 7178467000 96.89.178.154 2019-08-14 14:48:52 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 9D0D8DD59390B7764A3ECE0F40BBFE3618018605 2017 2019-02-21 02:37:17Z LAURA SMITH 300 SEASIDE AVENUE MILFORD CT 06460 67028653 0 X WWW.MILFORDHOSPITAL.ORG X 1942 CT TO EFFECTIVELY AND EFFICIENTLY PROVIDE HIGH QUALITY HEALTHCARE SERVICES. 20 19 780 298 1088145 0 724647 2383658 67150505 63853020 23260 5886 1675026 725505 69573438 66968069 1626767 1672876 0 0 39486244 31747095 0 0 0 28911986 36041028 70024997 69460999 -451559 -2492930 33517804 34051608 63631192 62509211 -30113388 -28457603 X THE MISSION OF MILFORD HOSPITAL IS TO EFFECTIVELY AND EFFICIENTLY PROVIDE HIGH QUALITY HEALTHCARE SERVICES IN A MODERN AND SAFE ENVIRONMENT, BY ANTICIPATING AND EXCEEDING THE NEEDS OF ALL OF OUR PATIENTS AND PHYSICIANS WITH EXCELLENCE, CONVENIENCE, AND COMPASSION. AS A COMMUNITY HEALTHCARE PROVIDER, MILFORD HOSPITAL IS COMMITTED TO REMAINING IN THE FOREFRONT OF THE CLINICAL, TECHNOLOGICAL, AND ELECTRONIC INFORMATION ADVANCES THAT MAKE THE CONTINUOUS DELIVERY OF HIGH QUALITY, COST EFFECTIVE HEALTHCARE SERVICE POSSIBLE. MILFORD HOSPITAL RECOGNIZES THAT THE QUALITY OF HUMAN RESOURCES - STAFF, PHYSICIANS, AND VOLUNTEERS - IS THE KEY TO CONTINUED SUCCESS AND, THEREFORE, STRIVES TO CREATE AN ENVIRONMENT OF TEAMWORK AND PARTICIPATION WHERE, THROUGH CONTINUOUS QUALITY IMPROVEMENT AND A FOCUS ON PATIENT SAFETY, PEOPLE PURSUE EXCELLENCE AND TAKE PRIDE IN THE QUALITY OF THEIR WORK IN THE ORGANIZATION. 0 0 61546557 1672876 63853020 MILFORD HOSPITAL PROVIDES HIGH-QUALITY HEALTHCARE SERVICES TO THE RESIDENTS OF MILFORD, WEST HAVEN, ORANGE AND STRATFORD, CONNECTICUT AND ITS SURROUNDING COMMUNITIES WITHOUT REGARD TO RACE, GENDER, CREED OR ABILITY TO PAY. AS A COMMUNITY HEALTHCARE PROVIDER, MILFORD HOSPITAL IS COMMITTED TO THOSE WE SERVE, BOTH PATIENTS AND NON-PATIENTS. OUR GOAL IS NOT ONLY TO PROVIDE QUALITY COMPASSIONATE CARE WHEN AN INDIVIDUAL ENTERS OUR HEALTHCARE INSTITUTION, BUT ALSO TO PROMOTE AND COMMUNICATE WELLNESS INFORMATION AND EDUCATION SO THAT FAMILIES INOUR AREA PREVENT ILLNESS AND CHRONIC DISEASE AND LEAD HEALTHIER LIVES.IN FY 2018, MILFORD HOSPITAL PROVIDED HEALTHCARE SERVICES TO 2,877 PATIENTS ON AN INPATIENT BASIS, 27,087 PATIENTS THROUGH THE EMERGENCY DEPARTMENT/WALK-IN CENTER, AND 1,218 PATIENTS IN OUR AMBULATORY SURGERY SUITE. IN ADDITION TO DIRECT PATIENT CARE, THE HOSPITAL PROVIDED EDUCATION, HEALTH SCREENINGS AND SUPPORT SERVICES TO OVER 8,500 INDIVIDUALS THROUGH A VARIETY OF MODALITIES INVOLVING PERSONAL INTERACTION. INDIRECTLY, VIA OUR WEBSITE ALONE, THE HOSPITAL PROVIDED INFORMATION TO MORE THAN 89,000 UNIQUE USERS FROM OUR SERVICE AREA AND BEYOND.IN SEPTEMBER 2013, IN ACCORDANCE WITH THE REQUIREMENTS SET FORTH IN THE AFFORDABLE CARE ACT, MILFORD HOSPITAL LED IT'S FIRST COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). DURING THE EARLY MONTHS OF FY 2014, AN IMPLEMENTATION STRATEGY WAS DEVELOPED AND ADOPTED TO GUIDE THE COMMUNITY BENEFIT INITIATIVES OF THE INSTITUTION. TO BOTH REMAIN IN COMPLIANCE WITH THE ACA, AS WELL AS, BECAUSE OF OUR ONGOING COMMITMENT TO THE HEALTH OF THE COMMUNITIES WE SERVE, MILFORD HOSPITAL PROUDLY JOINED THE HEALTHIER GREATER NEW HAVEN PARTNERSHIP TO COMPLETE OUR 2016 COMMUNITY HEALTH NEEDS ASSESSMENT. THIS COALITION IS AN EXCEPTIONAL TEAM THAT INCLUDES REPRESENTATION FROM 2 LOCAL HOSPITALS (MILFORD HOSPITAL AND YALE NEW HAVEN HOSPITAL), 16 PUBLIC HEALTH DEPARTMENTS AND NUMEROUS COMMUNITY ORGANIZATIONS. A MULTI YEAR, DATA DRIVEN PROCESS, THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT IS A STUDY WHICH EVALUATES THE HEALTH STATUS, BEHAVIORS AND NEEDS OF THE RESIDENTS IN THE GREATER NEW HAVEN AREA INCLUDING MILFORD AND SURROUNDING COMMUNITIES. ALSO INCLUDED IS A COMPREHENSIVE AND COLLABORATIVE COMMUNITY HEALTH IMPROVEMENT PLAN DESIGNED TO ADDRESS THE MAJOR UNMET NEEDS IN THE AREA. THE 2016 CHNA WAS MADE BROADLY, PUBLICLY AVAILABLE ON THE PARTNER HOSPITAL WEBSITES IN AUGUST OF 2016. AMONG OUR GOALS RELATIVE TO COMMUNITY BENEFITS IN FY 2016 WAS TO ADDRESS THE COMMON RISK FACTORS ASSOCIATED WITH AGING AS WELL AS CHRONIC AND INFECTIOUS DISEASES. IN DOING SO, THE HOSPITAL ESTABLISHED AN OBJECTIVE OF CONTINUING AND EXPANDING IT'S OFFERING OF COMMUNITY HEALTH AND WELLNESS PROGRAMS BOTH AT MILFORD HOSPITAL AND IN THE COMMUNITY.THESE PROGRAMS ARE OFFERED AT NO-CHARGE AND ARE DELIVERED BY HEALTH CARE PROFESSIONALS AND EDUCATORS AND INCLUDED THE FOLLOWING: HEART HEALTH, DIABETES MANAGEMENT, VASCULAR HEALTH, SKIN CANCER PREVENTION, RECOGNIZING THE SIGNS AND SYMPTOMS OF STROKES, COLORECTAL CANCER PREVENTION AND TREATMENT, END THE WEIGHT- NON-SURGICAL AND SURGICAL TECHNIQUES IN WEIGHT-LOSS, UNDERSTANDING AND TREATING GASTROINTESTINAL DISTURBANCES, ORTHOPEDIC CONDITIONS, SLEEP DISTURBANCES, WOUND CARE BASICS - UNDERSTANDING AND TREATING CHRONIC/NON-HEALING WOUNDS, STRESS REDUCTION, VEIN HEALTH, SENIOR HELP DESK - LINKING SENIORS WITH COMMUNITY RESOURCES, URGENT OR EMERGENCY - EVALUATING HEALTH CONDITIONS, AND PHYSICIAN TOWN HALL MEETING.ALSO AS PART OF ITS' OBJECTIVE TO INCREASE AWARENESS AND UNDERSTANDING OF HEALTHY LIFESTYLES, RISK FACTORS AND DISEASE PREVENTION, THE HOSPITAL CONTINUED TO CONDUCT FREE AND LOW COST HEALTH SCREENINGS. OFFERED ON A QUARTERLY BASIS, SCREENINGS ARE HELD BOTH IN THE HOSPITAL AND IN THE COMMUNITY. IN FY 2016, HEALTH SCREENINGS AND DISEASE PREVENTION INITIATIVES INCLUDED: BLOOD PRESSURE SCREENING, BLOOD SUGAR (DIABETES) SCREENING, CHOLESTEROL (TOTAL AND HDL) TESTING, PROSTATE CANCER SCREENING, INFLUENZA IMMUNIZATIONS, FOOT HEALTH SCREENINGS, PAD AND VASCULAR SCREENING, YOGA AND MEDITATION CLASSES.IN SEPTEMBER, 2016 MILFORD HOSPITAL SPONSORED "BOOMERS AND BEYOND" A SPECIAL EVENT AIMED AT LINKING THE AGING POPULATION WITH LOCAL RESOURCES TO MAINTAIN HEALTH AND WELLNESS. OVER 3,000 INDIVIDUALS ATTENDED THIS EVENT AND PARTICIPATED IN HEALTH SCREENINGS, LECTURES AND VISITED VENDORS PROVIDING EDUCATION, INFORMATION AND RESOURCES.IN ADDITION, MILFORD HOSPITAL WORKS WITH LOCAL BUSINESSES AND ORGANIZATIONS AS A WELLNESS PARTNER FOR THEIR EMPLOYEES. HEALTH SCREENINGS AND COUNSELING ARE PROVIDED OFF-SITE, IN THE WORK PLACE, AND INCLUDE, CHOLESTEROL, BLOOD PRESSURE, BLOOD SUGAR SCREENING AND NUTRITIONAL COUNSELING. THE FOLLOWING IS A LIST OUR CORPORATE/ORGANIZATIONAL PARTNERS: MILFORD SENIOR CENTER, CITY OF MILFORD, MILFORD POLICE DEPARTMENT, ALINABAL, INC., BIC CORPORATION, ADMINISTRATIVE BUILDING, AND BIC CORPORATION, MANUFACTURING PLANT.FOR COMMUNITY MEMBERS DIAGNOSED WITH, OR CARING FOR SOMEONE WITH, AN ILLNESS OR CHRONIC HEALTH CONDITION, A COMMUNITY NETWORK OF SUPPORT IS AVAILABLE AT MILFORD HOSPITAL. TO FOSTER UNDERSTANDING AND THE ABILITY TO COPE WITH ILLNESS AND CHRONIC HEALTH CONDITIONS THE HOSPITAL OFFERS THE FOLLOWING SUPPORT GROUPS ON A REGULARLY SCHEDULED BASIS: ALZHEIMER'S SUPPORT GROUP, MULTIPLE SCLEROSIS SUPPORT GROUP, LUPUS SUPPORT GROUP, AMPUTEE SUPPORT GROUP, BREAST CANCER SUPPORT GROUP, EPILEPSY SUPPORT GROUP, ESSENTIAL TREMORS SUPPORT GROUP, AND MILFORD EARLY LEARNING CENTER.WHILE MILFORD HOSPITAL TERMINATED ITS' MATERNITY SERVICE IN 2015, THE HOSPITAL DID MAINTAIN ITS' LONG-STANDING PARTNERSHIP WITH THE YOUNG PARENT PROGRAM (YPP) OF MILFORD THROUGH MOST OF FY 2016. THE YPP PROVIDES PARENTING AND PREGNANCY SERVICES TO TEENS AND YOUNG ADULTS WHICH PROMOTE POSITIVE BIRTH OUTCOMES, HEALTHY CHOICES, PREGNANCY PREVENTION AND RESPONSIBLE DECISION MAKING. THE HOSPITAL PROVIDES THE ORGANIZATION WITH OFFICE SPACE AND ALL ASSOCIATED OVERHEAD EXPENSES, CLERICAL SUPPORT AND MORE.THE FOLLOWING LIST IS INCLUSIVE OF SPECIAL EVENTS AND SERVICES THAT THE HOSPITAL OFFERS TO PATIENTS AND THE COMMUNITY. WHILE NOT ALL OF THE OFFERINGS ARE UNIQUE TO MILFORD HOSPITAL, THEY ARE, NONETHELESS, AVAILABLE AND OFFERED AS A RESOURCE, A SERVICE OR AN OPPORTUNITY TO SUPPORT OUR PATIENTS AND OUR COMMUNITY:- THE HOSPITAL HOSTS VARIETY OF HEALTH AND WELLNESS GROUPS AND PROGRAMS. OF THESE, SIX MEET MONTHLY. OTHERS MAY MEET LESS FREQUENTLY. EACH IS PROVIDED WITH MEETING SPACE, REFRESHMENTS AND ASSOCIATED COSTS AT NO CHARGE.- STAFF AND PHYSICIANS PARTICIPATE IN A LOCAL TELEVISION AND RADIO STATIONS AS GUEST EXPERTS/RESOURCES REGARDING HEALTH AND WELLNESS TOPICS.- THE HOSPITAL MAINTAINS A SPEAKERS BUREAU, WHICH PROVIDES PHYSICIANS AND MEMBERS OF THE HOSPITAL STAFF TO SPEAK TO LOCAL COMMUNITY ORGANIZATIONS ON A WIDE VARIETY OF TOPICS AT NO CHARGE.- MILFORD HOSPITAL HOSTS AN ANNUAL 5K "LIVE WELL" COMMUNITY EVENT. THIS EVENT OFFSETS THE COST ASSOCIATED WITH COMMUNITY PROGRAMMING AND HEALTH SCREENINGS OFFERED BY MILFORD HOSPITAL.- THE HOSPITAL SPONSORS RED CROSS BLOOD DRIVES THREE TO FOUR TIMES A YEAR IN PROVIDING, AUDITORIUM SPACE, VOLUNTEERS, REFRESHMENTS AND ASSISTANCE PROMOTING EACH DRIVE.- IN COMPLIANCE WITH THE CONSENT DECREE REGARDING THE HEARING IMPAIRED, MILFORD HOSPITAL PROVIDES VARIOUS ASSISTED LISTENING DEVICES FOR THE HARD OF HEARING, INTERPRETERS, AND TTY MACHINES FOR THE DEAF, FREE OF CHARGE FOR ANY PATIENT/COMPANION.- MILFORD HOSPITAL ALSO PROVIDES A LINGUISTIC SERVICE FOR NON-ENGLISH-SPEAKING PATIENTS. IF A LANGUAGE INTERPRETER MUST BE CALLED VIA A SPECIAL PHONE, THE COST OF THE CALL IS ASSUMED BY THE HOSPITAL.- MILFORD HOSPITAL OFFERS A "PHYSICIAN FINDER" TELEPHONE SERVICE FOR COMMUNITY RESIDENTS NEEDING A DOCTOR, AND PROVIDES A "DIRECTORY OF STAFF PHYSICIANS" WHICH LISTS THEIR SPECIALTY, PHONE NUMBER, AND ADDRESS.- HOSPITAL MEETING SPACE IS MADE AVAILABLE TO HEALTH RELATED AND OTHER NOT-FOR-PROFIT COMMUNITY GROUPS IN NEED OF A MEETING ROOM AT NO CHARGE.- THE HOSPITAL PROVIDES FREE MEDICARE/MEDICAID COUNSELING AND ASSISTANCE BY TRAINED HOSPITAL VOLUNTEERS. IN ADDITION, THE HOSPITAL HOSTED HEALTH CARE EXCHANGE ENROLLMENT AND INFORMATION SESSIONS IN COORDINATION WITH THE STATE OF CONNECTICUT.- CLINICAL STAFF INITIATED A FOLLOW-UP PROGRAM FOR CONGESTIVE HEART FAILURE PATIENTS TO PROVIDE EDUCATION AND CLINICAL SUPPORT.- THE HOSPITAL OFFERS COLLEGE AND POST GRADUATE STUDENTS TRAINING OPPORTUNITIES IN REGISTERED NURSING, LICENSED PRACTICAL NURSING, DIAGNOSTIC IMAGING, MEDICAL CODING SCIENCES, PHARMACY, LABORATORY SCIENCES, DIETETIC SERVICES, PUBLIC AND COMMUNITY HEALTH, ENVIRONMENT OF CARE -EMERGENCY PREPAREDNESS AND NURSING ASSISTANT. 61546557 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 1 0 0 0 0 0 0 1 0 1 1 1 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 49 0 780 1 1 1 0 0 0 0 0 0 0 0 0 X 20 19 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X LAURA SMITH CFOVP FINANCE 2038764231 300 SEASIDE AVENUE MILFORD CT 06460 SAMUEL BERGAMI JR CHAIR 1.00 4.30 X X 0 0 0 LOUIS D'AMATO VICE CHAIR 1.00 3.30 X X 0 0 0 RICHARD MEISENHEIMER TREASURER 1.00 5.30 X X 0 0 0 MICHAEL SAFFER ESQ SECRETARY 1.00 2.30 X X 0 0 0 JOSEPH PELACCIA PRESIDENT (UNTIL 6/18) 41.40 7.30 X X 713810 221721 22909 JAMES BEARD DIRECTOR 1.00 3.30 X 0 0 0 NANCY BENNETT DIRECTOR 1.00 1.30 X 0 0 0 ARMAND CANTAFIO DIRECTOR 1.00 0.30 X 0 0 0 LEO CARROLL ESQ DIRECTOR 1.00 0.30 X 0 0 0 BRADFORD GESLER DIRECTOR 1.00 1.30 X 0 0 0 ANN LOESCH DIRECTOR 0.20 0.10 X 0 0 0 CAROL MCINNIS DIRECTOR 0.20 0.10 X 0 0 0 LEN NAPOLI JR DIRECTOR 1.00 1.30 X 0 0 0 RAYMOND S OLIVER DIRECTOR 0.20 0.10 X 0 0 0 GARY OPIN DMD DIRECTOR 0.20 0.10 X 0 0 0 RONALD SILVERBERG DIRECTOR 0.20 0.10 X 0 0 0 JOY TOPAZIAN MOORE ESQ DIRECTOR 0.20 0.10 X 0 0 0 VIJAY CHHABRA MD MEDICAL STAFF REPRESENTATI 1.00 0.30 X 0 0 0 CLIFFORD KRAMER MD MEDICAL STAFF PRESIDENT 0.20 0.10 X 0 0 0 SUZANNE BELIVEAU AUXILIARY PRESIDENT 0.20 0.10 X 0 0 0 MARY JANE ROBBINS AUXILIARY CO-PRESIDENT (UNTIL 6/18) 0.20 0.10 X 0 0 0 GRAYCE MOWER AUXILIARY CO-PRESIDENT (UNTIL 6/18) 0.20 0.10 X 0 0 0 LATHA ALAPARTHI MD MED. STAFF PRES. (UNTIL 12/18) 1.00 0.30 X 0 0 0 LLOYD FRIEDMAN MD PRESIDENT & CEO 26.00 8.50 X X 949888 310746 26976 LAURA SMITH VP FINANCE & CFO 27.40 12.60 X 305100 140301 26976 MARK TONEY CHIEF RESTRUCTURING OFFICER 30.00 10.00 X 0 0 0 DR RESUL DALIPI PHYSICIAN 48.00 X 295235 0 26976 DR MICHAEL RUDOLPH PHYSICIAN 43.10 X 259511 0 26976 DR MAMTA PATEL PHYSICIAN 42.10 X 272175 0 24900 DR ANITHA KAMATH RAO PHYSICIAN 40.00 X 329316 0 26976 DR MAGDALEN MAURIELLO PHYSICIAN 42.34 X 326128 0 20450 3451163 672768 203139 67 0 1 0 SODEXO OPERATIONS LLC PO BOX 360170 PITTSBURGH PA 15251 FOOD SERVICE 639378 AFTERCARE PHYSICAL THERAPY SERVICES 4154 MADISON AVE TRUMBULL CT 06611 THERAPY SERVICES 619193 BISMARK CONSTRUCTION 100 BRIDGEPORT AVE MILFORD CT 06460 DESIGN/CONSTRUCTION SERVICES 472825 ACCELECARE WOUND CENTER INC PO BOX 671242 DALLAS TX 75267 WOUND SERVICES 420411 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 PHYSICIAN SERVICES 339502 17 67082 2314329 2247 2383658 PATIENT SERVICE REVENUE 624100 58172745 57512691 660054 INPATIENT REHAB REVENUE 624100 5680275 5680275 63853020 7392 7392 20842 28073 -7231 -7231 -7231 7911 9417 -1506 -1506 -1506 0 67082 23094 -23094 -23094 SERVICES TO RELATED PARTIES 900099 321316 321316 CAFETERIA 722210 208237 208237 SERVICES/LABS FOR MML 621500 106775 106775 119502 119502 755830 66968069 63192966 1088145 303300 X 1666876 1666876 6000 6000 1308939 1233955 74984 21206243 19991425 1214818 2441570 2184974 256596 4682575 4131199 551376 2107768 1821211 286557 734735 734735 81569 81569 295 295 7920758 4568230 3352528 35131 35131 505724 358658 147066 495192 10135 485057 1867703 1758341 109362 18140 4582 13558 11011 5807 5204 80205 80205 110945 96293 14652 1973500 1587532 385968 30709 30709 MEDICAL EXPENSES 10822926 10822926 MML/LAB SERVICE EXPENSE 6160526 6160526 BAD DEBT EXPENSE 4320597 4320597 INVENTORY SHRINKAGE 351352 351352 520010 465938 54072 69460999 61546557 7914442 0 735634 1465530 746147 232544 6470602 5305995 1167552 889979 442484 560618 56597798 38385743 17301940 18212055 1865017 1709092 1371930 100393 3416498 5575402 33517804 34051608 10574113 9141764 233407 599549 8000000 9600000 44823672 43167898 63631192 62509211 X -32039318 -29111996 1371930 100393 554000 554000 -30113388 -28457603 33517804 34051608 X -2492930 -13763 4162478 X 0 1 X 1 0 X 665310 -3480 110000 4343 547487 667177 3045 4912 665310 636486 35565 4874 667177 629510 6976 636486 724626 17634 112750 629510 1.00000 0 1 1 825066 825066 16127742 4848224 11279518 37433444 32937841 4495603 2211546 599678 1611868 18212055 DUE FROM AFFILIATES 314737 OTHER RECEIVABLES 138121 INSURED CLAIMS RECEIVABLE 5122544 5575402 ACCRUED PENSION 31242740 DUE TO THIRD PARTY 2119754 DEFERRED COMPENSATION 300403 DUE TO AFFILIATES 3781 OTHER ACCRUED BENEFITS 2345727 INSURED CLAIMS LIABILITIES 5242635 DEFERRED GRANT INCOME 632362 LEASES PAYABLE 1280496 43167898 66257500 -13763 1592923 1579160 64678340 2289729 2289729 66968069 64601715 -3479146 -3479146 68080861 1380138 1380138 69460999 PART V, LINE 4: TEMPORARILY RESTRICTED NET ASSETS ARE THOSE WHERE USE BY THE HOSPITAL HAS BEEN LIMITED BY DONORS TO A SPECIFIC TIME FRAME OR PURPOSE. PERMANENTLY RESTRICTED NET ASSETS ARE AMOUNTS TO BE MAINTAINED IN PERPETUITY, THE INCOME OF WHICH CAN BE USED FOR CAPITAL EXPENDITURES. PART XI, LINE 2D - OTHER ADJUSTMENTS: INVESTMENT FEES -295. CHANGE IN BENEFICIAL INTEREST IN MILFORD HOSPITAL FOUNDATION -1,271,537. PENSION LIABILITY ADJUSTMENT 4,244,598. ADDITIONAL BAD DEBT NETTED ON FINANCIALS -991,371. UBI EXPENSES NETTED WITH REVENUES ON FINANCIALS -388,472. PART XI, LINE 4B - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF ASSET -1,506. RELATED PARTY CONTRIBUTIONS NETTED WITH GRANTS ON THE FINANCIALS 2,314,329. FUNDRAISING EXPENSES -23,094. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF ASSET 1,506. RELATED PARTY CONTRIBUTIONS NETTED WITH GRANTS ON THE FINANCIALS -2,314,329. FUNDRAISING EXPENSES 23,094. RESERVE FOR DUE FROM AFFILIATE -1,189,417. PART XII, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT FEES 295. ADDITIONAL BAD DEBT NETTED ON FINANCIALS 991,371. UBI EXPENSES NETTED WITH REVENUES ON FINANCIALS 388,472. CELEBRATION OF TREES 28596 28596 5958 MOTHER'S DAY ROAD RACE 16405 16405 276 8172 10 22081 22081 3303 100 5285 67082 67082 276 3303 100 19415 23094 -23094 1 1 1 X 250.000000000000 1 X 1 1 0 1 1 44 70277 24414 45863 0.00070 10573 8584121 7494409 1089712 0.01670 10617 8654398 7518823 1135575 0.01740 17 1501 52907 300 52607 0.00080 3 153 296322 296322 0.00450 1 25 3183 3183 0.00000 6 68139 58393 58393 0.00090 27 69818 410805 300 410505 0.00620 27 80435 9065203 7519123 1546080 0.02360 1 3329226 25116145 40436266 -15320121 X 1 1 1 1 THE MILFORD HOSPITAL INC 300 SEASIDE AVENUE MILFORD CT 06460 WWW.MILFORDHOSPITAL.ORG 31 X X X WALK-IN CENTER A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 15 1 1 1 1 X HTTP://WWW.MILFORDHOSPITAL.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ X 1 15 1 HTTP://WWW.MILFORDHOSPITAL.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ 0 1 X 250.000000000000 400.000000000000 X X X X 1 1 X X X X 1 X WWW.MILFORDHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-INFORMATION/ X WWW.MILFORDHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-INFORMATION/ X WWW.MILFORDHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-INFORMATION/ X X X X X 1 X 0 X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: THE MILFORD HOSPITAL, INC. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: TO BOTH REMAIN IN COMPLIANCE WITH THE ACA, AS WELL AS, BECAUSE OF OUR ONGOING COMMITMENT TO THE HEALTH OF THE COMMUNITIES WE SERVE, MILFORD HOSPITAL PROUDLY JOINED THE HEALTHIER GREATER NEW HAVEN PARTNERSHIP TO COMPLETE OUR 2016 COMMUNITY HEALTH NEEDS ASSESSMENT. IN DEVELOPING AN IMPLEMENTATION STRATEGY AND COMMUNITY PLAN, THE HOSPITAL CONDUCTED FOCUS GROUPS WITH COMMUNITY MEMBERS. MEMBERS WERE REPRESENTATIVE OF KEY DEMOGRAPHIC AREAS INCLUDING THE AGING POPULATION AND PARENTS. THE HOSPITAL HELD A STRATEGIC PLANNING SESSION FOR OUR IMPLEMENTATION PLAN WITH THE FOLLOWING COMMUNITY LEADERS AND PROVIDERS:JOSEPH PELACCIA, MILFORD HOSPITAL, PRESIDENT AND CEOLAURA SMITH, MILFORD HOSPITAL, VICE PRESIDENT FINANCE AND CFODR. LLOYD FRIEDMAN, VICE PRESIDENT MEDICAL AFFAIRS AND COOKAREN KIPFER, MILFORD HOSPITAL, DIRECTOR OF COMMUNITY RELATIONSMARCY WINKEL, MILFORD HOSPITAL, DIRECTOR, SOCIAL SERVICESSENATOR GAYLE SLOSSBERG, STATE SENATORREP PAM STANESKI, STATE REPRESENTATIVE MILFORD/ORANGEREP CHARLES FERRARO, STATE REPRESENTATIVE MILFORD/ORANGE/WEST HAVENREP KIM ROSE, STATE REPRESENTATIVE MILFORDMAYOR BEN BLAKE, CITY OF MILFORDJOAN CAMPBELL, CITY OF MILFORD, DIRECTOR OF NURSING, HEALTH DEPARTMENTJOSEPH DEEPA, CITY OF MILFORD, DIRECTOR, HEALTH DEPARTMENTMAUREEN LILLIS, CITY OF WEST HAVEN HEALTH DEPARMENT, DIRECTORJULIE NASH, CITY OF MILFORD, ECONOMIC & COMMUNITY DEVELOPMENT DIRECTORELIZABETH FESER, CITY OF MILFORD, SUPERINTENDENT OF SCHOOLSDR. ANDREW CARLSON, CITY OF MILFORD, SCHOOL & COMMUNITY MEDICAL ADVISORDR. ROBERT LEWIS, CARDIOVASCULAR PHYSICIANS AND CONSULTANTS, CARDIOLOGISTBARBARA DEMAURO, BRIDGES, PRESIDENT AND CEOWENDY GIBBONS, MILFORD PREVENTION COUNCIL, DIRECTORJANICE JACKSON, MILFORD SENIOR CENTER, EXECUTIVE DIRECTORGARY JOHNSON, UNITED WAY OF MILFORD, EXECUTIVE DIRECTORPEGGY KELLY, MILFORD FAMILY RESOURCE CENTER, DIRECTORJOYCE LINDSAY, HOME CARE PLUS, DIRECTORAUGUSTA MUELLER, YNHH SYSTEM, DIRECTOR, COMMUNITY BENEFIT FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A: THE HOSPITAL'S CHNA WAS CONDUCTED WITH ONE OTHER HOSPITAL FACILITY - YALE NEW HAVEN HOSPITAL. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6B: THE HOSPITAL'S CHNA WAS CONDUCTED WITH THE PARTNERS OF HEALTHIER GREATER NEW HAVEN. ALL PARTNERS ARE AS FOLLOWS:CLIFFORD BEERS CLINICCOMMUNICARECT MENTAL HEALTH CENTERCORNELL SCOTT-HILL HEALTH CENTERFAIR HAVEN COMMUNITY HEALTH CENTERMILFORD HOSPITALNORTHEAST MEDICAL GROUPNEW HAVEN COMMUNITY MEDICAL GROUPPLANNED PARENTHOOD OF SOUTHERN NEW ENGLANDPROJECT ACCESS- NEW HAVENSCHOOL-BASED HEALTH CENTERSSOUTHERN CENTRAL CT CONSORTIUMYALE NEW HAVEN HEALTHYALE NEW HAVEN HOSPITALYALE MEDICAL GROUPYALE PEDIATRIC & INTERNAL MEDICINEEAST SHORE DISTRICT HEALTH DISTRICTGUILFORD HEALTH DEPARTMENTMADISON HEALTH DEPARTMENTMILFORD HEALTH DEPARTMENTNEW HAVEN HEALTH DEPARTMENTQUINNIPIACK VALLEY HEALTH DISTRICTWEST HAVEN HEALTH DEPARTMENTHOUSING AUTHORITY OF NEW HAVENNEW HAVEN COMMUNITY SERVICES ADMINISTRATIONNEW HAVEN PARKS, RECREATION AND TREESCENTRAL CT COAST YMCA AND ELM CITY, HAMDEN/ NORTH HAVEN SOUNDVIEW FAMILY AND WOODRUFF FAMILY YMCA LOCATIONSCOMMON GROUND HIGH SCHOOLDATA HAVENNEW HAVEN FAMILY ALLIANCENEW HAVEN HEALTHY STARTNEW HAVEN LAND TRUSTAMERICAN CANCER SOCIETYAMERICAN LUNG ASSOCIATIONCAIRCONNECTICUT HOSPITAL ASSOCIATIONCT ACADEMY OF NUTRITION AND DIETETICSNEW HAVEN FOOD POLICY COUNCILHEALTHY WEST HAVEN COLLABORATIVEMATCH COALITIONMILFORD PREVENTION COUNCILNEW HAVEN DENTAL ASSOCIATIONPROJECT SMILE CTPUTTING ON AIRSREGION 6 ASTHMA ADVISORY COUNCILTOBACCO-FREE NEW HAVEN COALITIONTRIGGERS BE GONENEW HAVEN PUBLIC SCHOOLS (DISTRICT WELLNESS COMMITTEE)SOUTHERN CT STATE UNIVERSITYYALE SCHOOL OF MEDICINE, PRIMARY CARE RESIDENCY PROGRAMYALE SCHOOL OF MEDICINE, SCHOLARS PROGRAMCOMMUNITY ALLIANCE FOR RESEARCH & ENGAGEMENT (CARE) AT THE YALE SCHOOL OF PUBLIC HEALTHCOMMUNITY FOUNDATION FOR GREATER NEW HAVENUNITED WAY OF GREATER NEW HAVENUNITED WAY OF MILFORDCT DENTAL HEALTH PARTNERSCT DEPARTMENT OF CORRECTIONSCT DEPARTMENT OF PUBLIC HEALTHCT DEPARTMENT OF SOCIAL SERVICESCT STATE DEPARTMENT OF EDUCATIONCT STATE DENTAL ASSOCIATIONACCESS HEALTH CTCOMMUNITY HEALTH NETWORKGREATER NEW HAVEN CHAMBER OF COMMERCELOGISTICARE FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11: THE MILFORD HOSPITAL IS ADDRESSING THREE MAIN PRIORITIES IDENTIFIED IN ITS MOST RECENT CHNA: ACCESS TO CARE, HEALTHY LIFESTYLES, & MENTAL HEALTH & SUBSTANCE ABUSE.THE FIRST PRIORITY IS TO PROVIDE ACCESS TO CARE BY ACHIEVING ACCESS TO INTEGRATED HEALTH SERVICES IN THE GREATER NEW HAVEN REGION. THE STRATEGIES FOR MEETING THIS GOAL ARE:- DECREASE THE NUMBER OF PEOPLE WHO ARE NEGATIVELY IMPACTED BY INSURANCE REDETERMINATION IN GREATER NEW HAVEN.- INCREASE THE NUMBER OF YOUNG ADULTS AND ADULTS THAT HAVE A PRIMARY CARE PROVIDER OR PLACE IN GREATER NEW HAVEN.- DECREASE THE NUMBER OF PATIENTS EXPRESSING DIFFICULTY IN ACCESSING HEALTH SERVICES DUE TO THE LACK OF NONEMERGENCY TRANSPORTATION.- INCREASE ADULTS ACCESSING DENTAL CARE IN GREATER NEW HAVEN.- INCREASE ACCESS TO SPECIALTY CARETHE SECOND PRIORITY IS HEALTHY LIFESTYLES BY REDUCING THE PREVALENCE AND BURDEN OF CHRONIC DISEASE THROUGH SUSTAINABLE, EVIDENCE-BASED EFFORTS. THE STRATEGIES FOR MEETING THIS GOAL ARE:- TO PROMOTE HEALTHY EATING IN GREATER NEW HAVEN.- TO PROMOTE PHYSICAL ACTIVITY IN GREATER NEW HAVEN.- TO ADVOCATE FOR CHANGE TO IMPROVE ACCESS TO HEALTHY FOOD, PHYSICAL ACTIVITY, AND ISSUES THAT IMPACT HEALTHY LIFESTYLES.- TO EDUCATE THE COMMUNITY ABOUT THE DANGERS OF ALL FORMS OF TOBACCO.- TO PROMOTE AND ENHANCE EVIDENCE-BASED APPROACHES FOR POPULATION-BASED ASTHMA CARE THAT SUPPORTS THE MEDICAL HOME AND COMMUNITY-WIDE EFFORTS.- TO PROMOTE FINANCIAL SUPPORT AND REIMBURSEMENT FOR EVIDENCE-BASED LEVELS OF COST-EFFECTIVE ASTHMA CARE AND REVISE PROCESSES AND POLICIES THAT RESULT IN EXCESS UTILIZATION OF HOSPITAL SERVICES.- IDENTIFY ADDITIONAL MEASURES/TABLES TO ADD TO THE CT ASTHMA SURVEILLANCE REPORT TO BETTER UNDERSTAND DISPARITIES AND OTHER VARIABLES AND SEEK TO FURTHER ALIGN THE CHIP WITH DPH'S STATE HEALTH IMPROVEMENT PLAN.- TO SUPPORT NEW HAVEN CITY TRANSFORMATION PLAN'S EFFORTS TO TARGET AREAS IDENTIFIED WITH HIGH CONCENTRATIONS OF CHILDREN WITH ASTHMA.THE THIRD PRIORITY IS MENTAL HEALTH AND SUBSTANCE ABUSE BY MAKING AL RESIDENTS FEEL SOCIALLY CONNECTED AN EMOTIONALLY SUPPORTED. THE STRATEGIES FOR MEETING THIS GOAL ARE:-CONTINUE TO PARTNER WITH THE SOUTH CENTRAL CT CONSORTIUM FOR INTEGRATED HEALTHCARE IMPROVEMENT IN ORDER TO ENABLE GREATER COORDINATION AMONG LOCAL MENTAL HEALTH AND HEALTH OUTCOMES FOR PATIENTS WITH COMPLEX MEDICAL AND/OR BEHAVIORAL HEALTH ILLNESSES.-SUPPORT CITY OF NEW HAVEN TRANSFORMATION COMMUNITY AND MENTAL HEALTH WORKGROUP PLAN.-INCREASE AWARENESS OF CURRENT SUBSTANCE USE AND MENTAL HEALTH ISSUES AMONG YOUTH TO LOCAL PROVIDERS.WHILE THE HOSPITAL IS FOCUSING ON THESE THREE MAIN PRIORITY AREAS, THERE ARE OTHER AREAS THAT HAVE BEEN IDENTIFIED THAT ARE CURRENTLY NOT BEING DIRECTLY ADDRESSED BY THE HOSPITAL. THE OTHER AREAS IDENTIFIED AS EMERGING ISSUES ARE: -LACK OF AFFORDABLE COMMUNITY ACTIVITIES, LACK OF COORDINATION OF AGENCIES, LACK OF AFFORDABLE INSURANCE, LACK OF SUFFICIENT TRANSPORTATION, ENVIRONMENT AND CLIMATE CHANGE, INCREASING AGING POPULATION, AND LIMITED FUNDING. PART I, LINE 7: THE CALCULATION OF THE HOSPITAL'S RCC WAS DERIVED FROM WORKSHEET 2 OF THE FORM 990 INSTRUCTIONS. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), IS $4,320,597. PART III, LINE 2: PATIENT ACCOUNTS RECEIVABLE RESULT FROM THE HEALTH CARE SERVICES PROVIDED BY THE HOSPITAL. ADDITIONS TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS RESULT FROM THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS. ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE AMOUNT OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN MEDICARE AND MEDICAID HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE RESULT FROM THE HEALTH CARE SERVICES PROVIDED BY THE HOSPITAL. ADDITIONS TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS RESULT FROM THE PROVISION FOR BAD DEBTS. ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE AMOUNT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN MEDICARE AND MEDICAID HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. SEE NOTE 2 FOR ADDITIONAL INFORMATION RELATIVE TO THIRD-PARTY PAYOR PROGRAMS.THE HOSPITAL'S PRIMARY CONCENTRATION OF CREDIT RISK IS PATIENT ACCOUNTS RECEIVABLE, WHICH CONSISTS OF AMOUNTS OWED BY VARIOUS GOVERNMENTAL AGENCIES, INSURANCE COMPANIES, AND PRIVATE PATIENTS. THE HOSPITAL MANAGES THE RECEIVABLES BY REGULARLY REVIEWING ITS PATIENT ACCOUNTS AND CONTRACTS, AND BY PROVIDING APPROPRIATE ALLOWANCES FOR DOUBTFUL AMOUNTS. SIGNIFICANT CONCENTRATIONS OF GROSS PATIENT ACCOUNTS RECEIVABLE, BEFORE ALLOWANCES FOR DOUBTFUL ACCOUNTS, INCLUDE 45% AND 51% FOR MEDICARE, AND 7% AND 5% FOR MEDICAID, FOR THE YEARS ENDED SEPTEMBER 30, 2018 AND 2017, RESPECTIVELY. PART III, LINE 8: THE HOSPITAL'S COSTS EXCEED REVENUE RECEIVED FROM CMS FOR MEDICARE PATIENTS BY APPROXIMATELY $15M. THE COSTS WERE DERIVED FROM THE MEDICARE COST REPORT. PART III, LINE 9B: THE HOSPITAL HAS POLICIES AND PROCEDURES TO ASSIST COLLECTION PERSONNEL IN DETERMINING A PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE WHO HAVE NO INSURANCE AND MEET SPECIFIC INCOME THRESHOLDS BASED ON THE POVERTY GUIDELINES. PART VI, LINE 2: IN ADDITION TO THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH GUIDES THE PLANNING AND IMPLEMENTATION OF HEALTH AND WELLNESS PROGRAMMING AND SERVICES, MILFORD HOSPITAL SURVEYS COMMUNITY ORGANIZATIONS, THE SCHOOL SYSTEMS AND THE LOCAL GOVERNMENT TO ASSESS THE HEALTH AND EDUCATIONAL NEEDS OF THE COMMUNITY. THIS IS DONE VIA COMMITTEE AND COALITION MEETINGS AND PARTNERSHIPS, AS WELL AS, INFORMAL AND FORMAL SURVEYS AND EVALUATIONS. PART VI, LINE 3: NOTIFICATION OF THE AVAILABILITY OF FINANCIAL ASSISTANCE IS POSTED BY THE HOSPITAL IN BOTH ENGLISH AND SPANISH IN THE FOLLOWING LOCATIONS: ADMITTING, EMERGENCY, BILLING AND CREDIT AND COLLECTIONS AND SOCIAL SERVICES DEPARTMENTS. FINANCIAL ASSISTANCE INFORMATION IS ALSO MADE PUBLICLY AVAILABLE ON THE MILFORD HOSPITAL WEBSITE. PART VI, LINE 4: MILFORD HOSPITAL SERVES THE COMMUNITY OF MILFORD, CT AND SEVERAL SURROUNDING COMMUNITIES. MILFORD IS A SMALL CITY OF 52,759 RESIDENTS LOCATED ON LONG ISLAND SOUND. THE ECONOMY IS DIVERSIFIED AND SUPPORTS MANUFACTURING, RETAIL, CORPORATE OFFICE AND SERVICE INDUSTRIES. THE MAJORITY OF THE POPULATION IDENTIFIES THEMSELVES AS WHITE (89.15%), HOWEVER, THE ASIAN AND HISPANIC POPULATIONS HAVE INCREASED RAPIDLY. MILFORD HAS AN OLDER POPULATION (16.3% OVER THE AGE OF 65), HIGHER THAN BOTH THE CONNECTICUT AND NATIONAL AVERAGES. CHILDREN AND YOUTH COMPRISE 20% OF THE POPULATION. THE ECONOMIC INDICATORS ARE MIXED. RESIDENTS HAVE EXPERIENCED FINANCIAL STRESS IN RECENT YEARS. THE SURROUNDING COMMUNITIES HAVE SIMILAR DEMOGRAPHIC PROFILES. PART VI, LINE 5: MILFORD HOSPITAL IS NOT ONLY THE HEALTHCARE PROVIDER FOR THE COMMUNITY, BUT ALSO A RESOURCE AND A PARTNER TO NUMEROUS COMMUNITY BOARDS, COALITIONS, PROGRAMS AND ORGANIZATIONS. IN ADDITION, THE HOSPITAL PROVIDES EMERGENCY PREPAREDNESS AND DISASTER PLANNING FOR THE ENTIRE COMMUNITY WHICH IT SERVES. COMMUNITY HEALTH AND WELLNESS PROGRAMS, HEALTH PROFESSIONAL EDUCATION AND HEALTH PROMOTION ACTIVITES ARE OFFERED TO THE COMMUNITY THROUGHOUT THE YEAR. OVER 10,000 PERSONS WERE SERVED VIA EDUCATIONAL OFFERINGS AND MORE THAN 100,000 PEOPLE WERE IMPACTED THROUGH HEALTH PROMOTION, EMERGENCY PLANNING AND OTHER ACTIVITIES. PART VI, LINE 6: THE MILFORD HOSPITAL IS A VOLUNTARY TAX-EXEMPT ACUTE CARE HOSPITAL INCORPORATED UNDER THE GENERAL STATUTES OF THE STATE OF CONNECTICUT. IT IS A SUBSIDIARY OF MILFORD HEALTH AND MEDICAL, INC. THE BOARD OF DIRECTORS OF THE HOSPITAL, APPOINTED BY THE PARENT, CONTROLS THE OPERATIONS OF THE HOSPITAL. ALSO, THE MILFORD HOSPITAL FOUNDATION, INC. IS A SUBSIDIARY OF THE PARENT, AND FUNCTIONS AS THE FUND-RAISING AFFILIATE FOR THE HOSPITAL.HOME CARE PLUS: GIVES SENIORS AND OTHERS THE OPPORTUNITY TO RECEIVE THEIR HEALTH CARE AT HOME. KEEPS PEOPLE OUT OF HOSPITALS AND CONVALESCENT HOMES FOR THOSE WHO DON'T NEED TO BE TREATED AS INPATIENT.TORRY CORP: PROVIDES AFFORDABLE RENTS TO PHYSICIANS AND OTHER HEALTH CARE PROVIDERS. PAYS TAXES TO THE FEDERAL GOV'T, STATE AND TOWN.SEABRIDGE CORP.: PROVIDES SERVICES TO HEALTH CARE PROVIDERS THAT ARE NOT TRADITIONALLY DELIVERED BY LOCAL NON PROFITS. PART VI, LINE 7, REPORTS FILED WITH STATES CT 1 MILFORD HEALTH & MEDICAL INC 300 SEASIDE AVENUE MILFORD CT 06460 222627346 501(C)(3) 622869 GENERAL OPERATING NEEDS HOME CARE PLUS INC PO BOX 161 MILFORD CT 06460 061044331 501(C)(3) 79615 GENERAL OPERATING NEEDS SEABRIDGE CORPORATION 300 SEASIDE AVENUE MILFORD CT 06460 222626962 36601 GENERAL OPERATING NEEDS MILFORD MEDICAL LABORATORY INC 300 SEASIDE AVENUE MILFORD CT 06460 066368893 14291 GENERAL OPERATING NEEDS TORRY CORPORATION 300 SEASIDE AVENUE MILFORD CT 06460 010724230 913500 GENERAL OPERATING NEEDS 2 3 SCHOLARSHIPS 7 6000 PART I, LINE 2: HOSPITAL ADMINISTATION MONITORS THE USE OF GRANT FUNDS BY REQUIRING A CAPITAL EQUIPMENT REQUEST (CER) AND A REQUEST FOR PAYMENT BE COMPLETED BEFORE FUNDS ARE RELEASED. ALL CERS MUST BE APPROVED BY THE CEO AND CFO OF THE HOSPITAL. THE REQUEST FOR PAYMENT IS APPROVED BY THE DIRECTOR OF THE FOUNDATION AND THE CFO OF THE HOSPITAL. IN ADDITION TO GRANT FUNDING, THE HOSPITAL PROVIDES SUPPORT TO RELATED ORGANIZATIONS. THIS SUPPORT IS MONITORED THROUGH COMMON MANAGEMENT. X X X X X 0 1 0 0 0 0 0 0 0 JOSEPH PELACCIA PRESIDENT (UNTIL 6/18) 708003 219917 0 0 5807 1804 6900 0 16009 0 736719 221721 0 0 LLOYD FRIEDMAN MD PRESIDENT & CEO 946851 309753 0 0 3037 993 6900 0 20076 0 976864 310746 0 0 LAURA SMITH VP FINANCE & CFO 304627 140084 0 0 473 217 6900 0 20076 0 332076 140301 0 0 DR RESUL DALIPI PHYSICIAN 294935 0 0 0 300 0 6900 0 20076 0 322211 0 0 0 DR MICHAEL RUDOLPH PHYSICIAN 258821 0 0 0 690 0 6900 0 20076 0 286487 0 0 0 DR MAMTA PATEL PHYSICIAN 271875 0 0 0 300 0 6900 0 18000 0 297075 0 0 0 DR ANITHA KAMATH RAO PHYSICIAN 329018 0 0 0 298 0 6900 0 20076 0 356292 0 0 0 DR MAGDALEN MAURIELLO PHYSICIAN 325546 0 0 0 582 0 6900 0 13550 0 346578 0 0 0 PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN IN CALENDAR YEAR 2017 AND DID NOT RECEIVE ANY DISTRIBUTIONS: LLOYD FRIEDMAN, VP OF MEDICAL AFFAIRS & COO LAURA SMITH, VP OF FINANCE & CFO JOSEPH PELACCIA PRESIDENT & CEO ADDITIONAL SERP PAYOUT DUE TO PRESIDENT & CEO X 233407 233407 0 1 1 LLOYD FRIEDMAN PRESIDENT & CEO ADDITIONAL SERP PAYOUT DUE TO PRESIDENT & CEO X 247144 247144 0 1 1 LAURA SMITH VP FINANCE & CFO ADDITIONAL SERP PAYOUT DUE TO OFFICER X 118998 118998 0 1 1 599549 MARIE LILLIS SPOUSE OF JOSEPH PELACCIA - PRESIDENT & CEO 78015 COMPENSATION 0 FORM 990, PART III, LINE 1 (CONTINUED) MILFORD HOSPITAL ENGAGES IN A WIDE RANGE OF HEALTH EDUCATIONAL ACTIVITIES DESIGNED TO MEET THE EDUCATIONAL NEEDS OF PATIENTS, STAFF, PHYSICIANS, AND THE COMMUNITY. FORM 990, PART III, LINE 4A (CONTINUED) - THE SOCIAL SERVICES DEPARTMENT OFFERS ASSISTANCE TO PATIENTS AND THEIR FAMILIES WITH COMPLETION OF TITLE-19 APPLICATIONS, CONSERVATOR APPLICATIONS, COMPLETION OF ADVANCED DIRECTIVES AND REFERRALS TO OTHER SOCIAL SERVICE AGENCIES. - CAB VOUCHERS ARE PROVIDED TO PATIENTS AND FAMILIES THROUGH THE SOCIAL SERVICE DEPARTMENT WHEN OTHER FORMS OF TRANSPORTATION ARE NOT AVAILABLE. THE HOSPITAL HAS ALSO COVERED THE COST OF AMBULANCE TRANSPORTATION FOR UNINSURED TITLE-19 PATIENTS GOING TO DMHAS FACILITIES. - THE SOCIAL SERVICES DEPARTMENT ALSO MAINTAINS A FUND TO PROVIDE ASSISTANCE TO PATIENTS AS NEEDED; I.E., COVER COST OF PRESCRIPTIONS, TRANSPORTATION ETC. - ADMINISTRATION AND DEPARTMENT LEADERSHIP RESPOND TO REQUESTS FOR SPEAKERS AT VARIOUS COMMUNITY FORUMS AND ORGANIZATIONS (INCLUDING SCHOOL GROUPS, CIVIC ORGANIZATIONS, SENIOR PROGRAMS ETC.) - MILFORD HOSPITAL ADMINISTRATION AND DEPARTMENT LEADERSHIP MAINTAIN PROFESSIONAL AFFILIATIONS WITH, AND STRONGLY SUPPORT, LOCAL ORGANIZATIONS THROUGH PARTICIPATION ON BOARDS, ADVISORY COMMITTEE, AND COUNCILS OF THE FOLLOWING: ALZHEIMERS ASSOCIATION OF CONNECTICUT, AMERICAN CANCER SOCIETY, AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES, AMERICAN HEART ASSOCIATION, AMERICAN LUNG ASSOCIATION, AMERICAN RED CROSS, BRIDGES - A COMMUNITY SUPPORT AGENCY, CITY OF MILFORD HEALTH AND WELLNESS COUNCIL, CONNECTICUT ASSOCIATION OF RESPIRATORY CARE, CONNECTICUT COLLEGE OF HEALTH CARE EXECUTIVES, CONNECTICUT HOSPITAL ASSOCIATION, CONNECTICUT LEAGUE FOR NURSING, CONNECTICUT ORGANIZATION FOR NURSE EXECUTIVES, CONNECTICUT TUBERCULOSIS ADVISORY COMMITTEE, CONNECTICUT YANKEE COUNCIL - BOY SCOUTS OF AMERICA, HEALTHCARE HUMAN RESOURCES ASSOCIATION, KIDS COUNT 12345, MILFORD CHAMBER OF COMMERCE, MILFORD MAYORS YOUTH FORUM, MILFORD - ORANGE YMCA, MILFORD PREVENTION COUNCIL, NEW HAVEN TUBERCULOSIS COALITION, PARTNERSHIP FOR GREATER NEW HAVEN, RAPE CRISIS CENTER, SOCIAL SERVICES NETWORK OF MILFORD, STATE REGIONAL PSYCHIATRIC COMMITTEE, UNITED WAY OF MILFORD, WOODRUFF FAMILY YMCA, AND YOUNG PARENT PROGRAM. THE ACTIVITIES AS OUTLINED ABOVE ARE REFLECTIVE OF THE STRONG COMMITMENT BY MILFORD HOSPITAL AND ITS STAFF TO THE WELL-BEING OF THE COMMUNITIES WE SERVE. THE FUTURE OF HOSPITAL HEALTH CARE DEPENDS AS MUCH ON THE SUCCESSFUL PREVENTION OF ILLNESS AS DOES THE TREATMENT. OUR INVESTMENT IN COMMUNITY EDUCATION, SPECIAL OUTREACH PROGRAMS, HEALTHCARE SEMINARS, AND MEMBERSHIPS IN INDEPENDENT HEALTH ORGANIZATIONS, ALL CONTRIBUTE TOWARD THE OVERALL WELFARE OF OUR CITIZENRY. FORM 990, PART VI, SECTION A, LINE 2 BOARD MEMBERS JOSEPH PELACCIA, SAMUEL BERGAMI, JR., LOUIS D'AMATO, JAMES BEARD, LEO CARROLL, AND CAROL MCINNIS ARE ALSO BOARD MEMBERS OF THE MILFORD BANK. BOARD MEMBER, RAY OLIVER, RENTS OFFICE SPACE TO BOARD MEMBER, LEO CAROLL'S LAW FIRM. BOARD MEMBERS, LEO CARROLL AND JOY TOPAZIAN MOORE ARE PARTNERS IN THE SAME LAW FIRM. BOARD MEMBER, NANCY BENNETT, OWNS A BOAT YARD THAT PROVIDES SERVICES TO BOARD MEMBER, RAY OLIVER. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY MANAGEMENT OF THE MILFORD HOSPITAL AND SENT BY SECURE E-MAIL TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST QUESTIONNAIRES ARE SENT TO OFFICERS, DIRECTORS, AND KEY EMPLOYEES ANNUALLY. THE COMPLETED QUESTIONNAIRES ARE REVIEWED BY THE PRESIDENT. WHENEVER THE BOARD OR BOARD COMMITTEE OF THE ORGANIZATION IS CONSIDERING A TRANSACTION OR ARRANGEMENT WITH AN ORGANIZATION, ENTITY, OR INDIVIDUAL IN WHICH A PERSON COVERED BY THE POLICY OR HIS OR HER FAMILY MAY BE AN INTERESTED PERSON: 1. THE INTERESTED PERSON MUST DISCLOSE THE FINANCIAL INTEREST AND ALL MATERIAL FACTS TO THE BOARD OR BOARD COMMITTEE SO THAT IT MAY CONSIDER WHETHER THERE IS A CONFLICT OF INTEREST; 2. IF APPROPRIATE, THE BOARD MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT; 3. THE BOARD CHAIR, THE BOARD COMMITTEE OR THE BOARD SHALL DIRECT THE INTERESTED PERSON TO LEAVE THE MEETING DURING DISCUSSION OF THE FINANCIAL INTEREST AND POTENTIAL CONFLICT. THE INTERESTED PERSON MAY MAKE A STATEMENT OR ANSWER ANY QUESTIONS ON THE MATTER BEFORE LEAVING AND MAY BE CALLED BACK TO ANSWER ADDITIONAL QUESTIONS; 4. THE INTERESTED PERSON WILL NOT VOTE ON THE MATTER; AND 5. IN ORDER TO APPROVE THE TRANSACTION, THE BOARD OR BOARD COMMITTEE MUST FIRST FIND, BY A MAJORITY VOTE OF THE BOARD MEMBERS THEN IN OFFICE, WITHOUT COUNTING THE VOTE OF THE INTERESTED PERSON, THAT THE PROPOSED TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF THE ORGANIZATION, THAT THE PROPOSED TRANSACTION IS FAIR AND REASONABLE, AND, AFTER REASONABLE INVESTIGATION, THAT THE ORGANIZATION CANNOT OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE COMPENSATION OF ALL OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. DECISIONS REGARDING COMPENSATION ARE DOCUMENTED IN THE COMMITTEE MEETING MINUTES. THE ORGANIZATION USES A COMPENSATION COMMITTEE, THE FORM 990 OF OTHER ORGANIZATIONS, WRITTEN EMPLOYMENT CONTRACTS, AND COMPENSATION SURVEYS OR STUDIES IN ITS PROCESS FOR DETERMINING COMPENSATION FOR OFFICERS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE KEPT IN THE PRESIDENT'S OFFICE AND ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,030,777. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,030,777. CONSULTANTS: PROGRAM SERVICE EXPENSES 267,361. MANAGEMENT AND GENERAL EXPENSES 1,977,914. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,245,275. SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 2,695,578. MANAGEMENT AND GENERAL EXPENSES 840,610. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,536,188. EQUIPMENT REPAIR FEES: PROGRAM SERVICE EXPENSES 255,333. MANAGEMENT AND GENERAL EXPENSES 24,077. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 279,410. LANDSCAPING: PROGRAM SERVICE EXPENSES 21,871. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,871. TEMPORARY HELP: PROGRAM SERVICE EXPENSES 46,598. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 46,598. OUTSIDE LAB FEES: PROGRAM SERVICE EXPENSES 250,712. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 250,712. BANK FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 69,052. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 69,052. DATA PROCESSING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 11,658. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,658. BILLING & COLLECTIONS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 429,217. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 429,217. FORM 990, PART XI, LINE 9: PENSION LIABILITY ADJUSTMENT 4,244,598. CHANGE IN BENEFICIAL INTEREST IN MILFORD HOSPITAL FOUNDATION -1,271,537. RESERVE FOR DUE FROM AFFILIATE 1,189,417. MILFORD HEALTH & MEDICAL INC 300 SEASIDE AVENUE MILFORD CT 06460 222627346 SUPPORTING ORGANIZATION CT 501(C)(3) LINE 12B, II N/A 0 MILFORD HEALTH CARE SERVICES INC 300 SEASIDE AVENUE MILFORD CT 06460 222627353 HEALTH CARE SERVICES CT 501(C)(3) PF MILFORD HEALTH & MEDICAL INC 0 MILFORD HOSPITAL FOUNDATION INC 300 SEASIDE AVENUE MILFORD CT 06460 222627350 FUNDRAISING CT 501(C)(3) PF MILFORD HEALTH & MEDICAL INC 0 HOME CARE PLUS INC PO BOX 161 MILFORD CT 06460 061044331 HOME HEALTH SERVICES CT 501(C)(3) LINE 10 MILFORD HEALTH & MEDICAL INC 0 SEABRIDGE CORPORATION 300 SEASIDE AVENUE MILFORD CT 06460 222626962 OTHER MEDICAL SERVICES CT N/A C 0 MILFORD MEDICAL LABORATORY INC 300 SEASIDE AVENUE MILFORD CT 06460 066368893 LABORATORY SERVICES CT N/A C 0 TORRY CORPORATION 300 SEASIDE AVENUE MILFORD CT 06460 010724230 RENTAL REAL ESTATE CT N/A C 0 SEASIDE INDEMNITY ALLIANCE LTD 300 SEASIDE AVENUE MILFORD CT 06460 LIABILITY INSURANCE CJ N/A C 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1