2019-08-12T14:32:51-05:00 2018-09-30 350921680 CROWE LLP 175 POWDER FOREST DRIVE SIMSBURY CT 06089 990 2017-10-01 061466555 Bristol Hospital Multi-Specialty Group Inc BRIS 8605853469 240 Main Street Bristol CT 06010 Richard Braam Vice President & CFO 2019-08-12 true KRISTIN ANDERSON P01231300 8606789200 2017 2019-02-21 02:37:17Z Kurt Barwis 240 Main Street Bristol CT 06010 30178956 false X WWW.BRISTOLHOSPITAL.ORG X 2011 CT TO PROVIDE HIGH QUALITY, SUSTAINABLE, PATIENT-CENTERED HEALTH CARE IN THE COMMUNITY AND RESPOND TO THE EVOLVING HEALTH CARE NEEDS OF THE COMMUNITY. 8 2 303 2 0 0 6527055 6675013 21059892 23494343 -18151 0 9600 9600 27578396 30178956 0 0 0 0 27185545 28425762 0 0 0 5684419 6162495 32869964 34588257 -5291568 -4409301 3046535 4050946 2800291 2651893 246244 1399053 TO PROVIDE ACCESSIBLE, HIGH QUALITY, SUSTAINABLE, PATIENT-CENTERED HEALTH CARE IN THE COMMUNITY, AND TO RESPOND TO THE EVOLVING HEALTH CARE NEEDS OF THE COMMUNITY. false false 31991061 0 23494343 THE BRISTOL HOSPITAL MULTISPECIALTY GROUP WAS FORMED TO DELIVER A FULL RANGE OF HEALTH AND SPECIALTY CARE SERVICES AT CONVENIENT LOCATIONS THROUGHOUT BRISTOL, CONNECTICUT AND THE SURROUNDING TOWNS TO PROVIDE ACCESSIBLE, HIGH QUALITY, EVIDENCE-BASED, STATE-OF THE-ART, COST-EFFECTIVE, COMPASSIONATE AND PATIENT-CENTERED HEALTH CARE IN THE COMMUNITIES SERVED BY BRISTOL HOSPITAL; TO RESPOND APPROPRIATELY TO EVOLVING COMMUNITY HEALTH CARE NEEDS AND TO CHANGES IN TECHNOLOGY AND THE HEALTH CARE SYSTEM; AND TO ASSURE A SUSTAINABLE LEGACY OF HEALTH CARE SERVICE EXCELLENCE IN THOSE COMMUNITIES. SUCH SERVICES WILL BE AVAILABLE TO ALL PERSONS, WITHOUT REGARD TO THEIR ABILITY TO PAY FOR SUCH SERVICES, AND TO OPERATE AT ALL TIMES IN FURTHERANCE OF THE TAX-EXEMPT CHARITABLE MISSIONS OF BRISTOL HOSPITAL AND HEALTH CARE GROUP, INC. THE ORGANIZATION'S PHYSICIANS PROVIDE FREQUENT COMMUNITY WIDE EDUCATION SUCH AS SEMINARS, ARTICLES IN THE LOCAL NEWSPAPERS, AND SESSIONS AT THE SENIOR CENTERS AND SCHOOLS. THESE COMMUNITY EVENTS ALSO PROVIDE THE PUBLIC THE OPPORTUNITY TO INTERACT WITH THE PHYSICIANS AT NO COST. 31991061 true true false false false false false false false true false false false true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 41 0 true 303 true false false false false false false true false false false X 8 2 false false false false true true true true true false false true true true true true true false false false X Patricia Levandoski 8605853680 240 Main Street Bristol CT 06010 KURT BARWIS PRESIDENT & CEO 8.0 69.0 X X 0 559736 34820 LIRAN BLUM MD Chairman of the Board 40.0 8.0 X X 412117 0 22031 VIJAY JOSHI MD SECRETARY 40.0 8.0 X X 231394 0 0 JOHN LODOVICO JR TREASURER 2.0 10.0 X X 0 0 0 JOHN FRAZIER MD PAST SECRETARY 30.0 0 X X 228659 0 0 DOUGLAS DEVNEW JR Director 2.0 10.0 X 0 0 0 RAINER BAGDASARIAN MD DIRECTOR 40.0 0 X 417838 0 23460 DAVID RUBINS MD DIRECTOR 40.0 0 X 793535 0 18036 Richard Braam VP of Finance/ CFO 40.0 82.0 X 0 110569 6240 EDWARD HENRY Executive Director 40.0 80.0 X 0 222716 18019 CHRISTOPHER BETZ Physician 40.0 0 X 593626 0 0 Makram Gedeon MD PHYSICIAN 40.0 0 X 474478 0 8613 VANESSA MALIT MD Physician 40.0 0 X 464793 0 750 ASHISH UPADHYAY Physician 40.0 0 X 659322 0 0 RICHARD ZWEIG MD PHYSICIAN 40.0 0 X 528743 0 17931 4804505 893021 149900 72 false true false Saint Francis Medical Group Inc 1000 Asylum Ave Hartford CT 06105 Physician Services 254880 Weatherby Locums Inc PO Box 972633 Dallas TX 753972633 Physician Services 180798 2 6675013 6675013 PATIENT SERVICE REVENUE, NET 621110 23470964 23470964 Other Revenue 900099 23379 23379 0 0 0 0 23494343 9600 0 9600 0 9600 9600 0 0 0 0 0 0 0 30178956 23494343 0 9600 0 0 1997437 1719137 278300 24465559 22911616 1553943 694412 511082 183330 1268354 1177015 91339 59728 35812 23916 2250 2250 779987 660491 119496 0 9126 9126 434140 324529 109611 649811 546775 103036 1463547 1413232 50315 279294 251615 27679 1589446 1561588 27858 MEDICAL SUPPLIES 357349 357349 DRUGS 452682 452682 EMPLOYEE PHYSICALS 22754 18304 4450 62381 40708 21673 0 34588257 31991061 2597196 0 83278 112296 1566797 2530150 0 0 0 0 339331 277603 3033125 1966351 1026923 1066774 0 0 30206 64123 3046535 4050946 2719651 2375924 0 0 80640 275969 2800291 2651893 X 246244 1399053 246244 1399053 3046535 4050946 X -4409301 5562110 X false true X true false X 6627818 7153741 9955477 6527055 6675013 36939104 15484840 17927068 20359948 21059892 23494343 98326091 0 0 0 22112658 25080809 30315425 27586947 30169356 135265195 6627818 7153741 9955477 6527055 6675013 36939104 0 0 0 0 0 0 6627818 7153741 9955477 6527055 6675013 36939104 98326091 9600 9600 19200 0 0 0 0 9600 9600 19200 0 0 0 0 0 0 0 22112658 25080809 30315425 27596547 30178956 135284395 0.7268 0.7165 0.0001 0.0001 X 572432 223976 348456 2402515 1705503 697012 58178 36872 21306 1066774 ACCRUED WORKER'S COMPENSATION 269507 CAPITAL LEASE 6462 275969 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote The Corporation 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 financial statements. The Corporation 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 Corporation does not have any uncertain tax positions as September 30, 2018 and 2017. It is the Corporation's policy to record penalties and interest associated with uncertain tax provisions as a component of operating expenses. As of September 30, 2018 and 2017, the Corporation did not record any penalties or interest associated with uncertain tax positions. The Corporation's prior three tax years are open and subject to examination by the Internal Revenue Service. The corporation does not exempt the total amount of unrecognized tax benefits to significantly change in the next twelve months. false true false false false false false false true true KURT BARWIS PRESIDENT & CEO 0 496682 0 39417 0 23637 0 18000 0 16820 0 594556 0 0 LIRAN BLUM MD Chairman of the Board 354669 0 57448 0 0 0 0 0 22031 0 434148 0 0 0 VIJAY JOSHI MD SECRETARY 226890 0 4505 0 0 0 0 0 0 0 231394 0 0 0 JOHN FRAZIER MD PAST SECRETARY 224328 0 4331 0 0 0 0 0 0 0 228659 0 0 0 RAINER BAGDASARIAN MD DIRECTOR 383706 0 34132 0 0 0 0 0 23460 0 441298 0 0 0 DAVID RUBINS MD DIRECTOR 678246 0 115289 0 0 0 0 0 18036 0 811571 0 0 0 EDWARD HENRY Executive Director 0 210296 0 12420 0 0 0 0 0 18019 0 240735 0 0 CHRISTOPHER BETZ Physician 515384 0 78242 0 0 0 0 0 0 0 593626 0 0 0 Makram Gedeon MD PHYSICIAN 464589 0 9889 0 0 0 0 0 8613 0 483091 0 0 0 VANESSA MALIT MD Physician 451992 0 12801 0 0 0 0 0 750 0 465543 0 0 0 ASHISH UPADHYAY Physician 650105 0 9217 0 0 0 0 0 0 0 659322 0 0 0 RICHARD ZWEIG MD PHYSICIAN 519158 0 9585 0 0 0 0 0 17931 0 546674 0 0 0 Schedule J, Part I, Line 3 The organization's CEO, Kurt Barwis, is compenated by a related organization, Bristol Hospital, Inc. which uses the following methods to establish his compensation: Compensation Committee, Independent Compensation Consultant, Compensation Survey or Study, and Approval by the Board or Compensation Committee. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan KURT BARWIS, BOARD MEMBER, PARTICIPATES IN THE 457(F) DEFINED CONTRIBUTION PLAN OF RELATED ORGANIZATION, BRISTOL HOSPITAL INC. AMOUNT DEFERRED IN CALENDAR YEAR 2017 WAS $18,000 AND IS INCLUDED ON SCHEDULE J, COLUMN D. Schedule J, Part I, Line 8 Payments on contract that is subject to the initial contract exception AMOUNTS WERE PAID BY A RELATED ORGANIZATION (BRISTOL HOSPITAL) TO KURT BARWIS PURSUANT TO A CONTRACT WITH THE HOSPITAL THAT WAS SUBJECT TO THE INITIAL CONTRACT EXCEPTION DESCRIBED IN REGS. SECTION 53.4958-4(A)(3). THE HOSPITAL FOLLOWED THE REBUTTABLE PRESUMPTION PROCEDURE DESCRIBED IN REGS. SECTION 53.4958-6(C). Form 990, Part VI, Line 15 The organization's CEO, Kurt Barwis, the organization's Executive Director, Edward Henry, and the organization's CFO, Richard Braam, are compensated by a related organization, Bristol Hospital, Inc. In accordance with IRS instructions, Part VI, Lines 15a and 15b are therefore marked No. However, the related organization, Bristol Hospital, Inc., used a process for determining compensation of these individuals which included review and approval of independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. This process last occurred on November 30, 2017. Other officers of the organization, Liran Blum, Chairman of the Board, and Vijay Joshi, Secretary, receive compensation from the organization for their services as physicians. Form 990, Part VI, Line 6 Classes of members or stockholders The organization has a sole member, which is Bristol Hospital and Health Care Group, Inc. The member has the right to elect the members of the governing body, approve significant decisions of the governing body, and receive the organization's net assets upon the organization's dissolution. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body The organization has a sole member, and there are no classes of members. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders Certain decisions, considered "Major Actions" require the approval of the sole member, Bristol Hospital and Health Care Group, Inc. These actions include the adoption of the organization's annual budget, as well as other major actions. The sole member has full voting rights. Form 990, Part VI, Line 11b Review of form 990 by governing body A COMPLETED 990 IS PROVIDED TO EACH BOARD MEMBER BEFORE IT IS FILED. THIS PROVIDES AN OPPORTUNITY FOR MEMBERS TO ASK QUESTIONS AND FOLLOW UP WITH THE FINANCE TEAM REGARDING ANY ISSUES OR CONCERNS. THE 990 IS ALSO REVIEWED INTERNALLY BY MEMBERS OF THE FINANCE AND MANAGEMENT TEAMS. Form 990, Part VI, Line 12c Conflict of interest policy The parent organization, Bristol Hospital and Health Care Group, has three conflict of interest policies - one for the Board of Directors and Committee Members, one for Non-Medical Staff Employees, and one for Medical Staff Members. Board of Directors and Committee Members Each of the above listed persons receives, reads and signs a statement once annually agreeing to comply with the Conflict of Interest Policy. If any actual, apparent or potential conflict of interest arises, the person shall make full disclosure of such actual, apparent or potential conflict of interest, within fifteen (15) days of the time that such conflict is discovered, or at least once annually at the commencement of each calendar year, with regular written updates to accord with any change in circumstances. The Governance Committee reviews all such disclosures to determine whether an actual, apparent or potential conflict of interest exists. Decisions pertaining to actual, apparent or potential conflicts of interests shall be made by the Governance Committee. The Corporate Compliance Officer (CCO) shall be available to the Governance Committee upon request. In the event that it determines that an apparent or potential conflict of interest exits, the Governance Committee shall institute a reasonable compliance management plan including periodic reviews of relationships or activities of any person or relative. Any changes or modifications in such relationships or activities shall be periodically reviewed and evaluated by the Governance Committee. Non-Medical Staff Employees Same process as outlined above with one exception: The oversight, review and determinations of disclosures are made by the CCO. The Bristol Health Executive Leadership Group (ELG) shall be available to the CCO upon request. Medical Staff Members Medical Staff Members complete Conflict of Interest disclosure statements during the initial credentialing process and subsequently every two years during the re-credentialing process. Any new relationships that arise in the interim deemed to be a potential conflict must be disclosed in a timely manner. Disclosures are reviewed and determinations are made by the Executive Committee of the Medical Staff (ECMS). The CCO is a member of this committee. In the event that the ECMS determines that an apparent or potential conflict of interest exits, a reasonable compliance management plan including periodic reviews of relationships or activities of any person or relative will be instituted. Any changes or modifications in such relationships or activities shall be periodically reviewed and evaluated by the ECMS. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part XI, Line 9 Other changes in net assets or fund balances TRANSFER FROM BRISTOL HOSPITAL AND HEALTH CARE GROUP - 5562110; BRISTOL HOSPITAL INC 41 BREWSTER ROAD BRISTOL CT 06010 060646559 SHORT-TERM ACUTE CARE COMMUNITY HOSPITAL CT 501(c)(3) 3 BRISTOL HOSPITAL AND HEALTH CARE GROUP false BRISTOL HOSPITAL AND HEALTH CARE GROUP INC 41 BREWSTER ROAD BRISTOL CT 06010 222577726 HEALTHCARE PARENT COMPANY CT 501(c)(3) Type II NA false BRISTOL HOSPITAL DEVELOPMENT FOUNDATION INC 41 BREWSTER ROAD BRISTOL CT 06010 222577740 FUNDRAISING CT 501(c)(3) 7 BRISTOL HOSPITAL AND HEALTH CARE GROUP false BRISTOL HEALTH CARE INC 400 NORTH MAIN STREET BRISTOL CT 06010 222577731 NURSING HOME CT 501(c)(3) 9 BRISTOL HOSPITAL AND HEALTH CARE GROUP false BRISTOL HOME CARE AND HOSPICE AGENCY INC 41 BREWSTER ROAD BRISTOL CT 06101 821663577 HOME CARE AND HOSPICE CT 501(c)(3) 10 BRISTOL HOSPITAL AND HEALTH CARE GROUP false BRISTOL HOSPITAL EMS LLC 41 Brewster Road BRISTOL CT 06010 061547648 EMERGENCY MEDICAL SERVICES CT BRISTOL HOSPITAL AND HEALTH CARE GROUP C Corporation 0 0 false false false true false false false false false false false true false false false true false false false true IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS CORP OR TRUST NAME OF RELATED ORGANIZATION: BRISTOL HOSPITAL EMS, LLC DIRECT CONTROLLING ENTITY: BRISTOL HOSPITAL AND HEALTH CARE GROUP