MIDDLESEX HOSPITAL: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization: MIDDLESEX HOSPITAL (EIN 06-0646718)
Tax period: 2017-10-01 to 2018-09-30
Filed: 2019-07-15
IRS object ID: 201941969349301354
Schema version: 2017v2.2
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule G
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2019-07-15T11:30:30-05:00	ReturnTs
Tax Period End	2018-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	350921680	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	CROWE LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	175 POWDER FOREST DRIVE	AddressLine1Txt
City	SIMSBURY	CityNm
State Abbreviation	CT	StateAbbreviationCd
ZIP	06089	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2017-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	060646718	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Middlesex Hospital	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	MIDD	BusinessNameControlTxt
Phone	8603586395	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	28 CRESCENT STREET	AddressLine1Txt
City	MIDDLETOWN	CityNm
State Abbreviation	CT	StateAbbreviationCd
ZIP	06457	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	SUSAN MARTIN	PersonNm
Person Title	VP FINANCE & TREASURER	PersonTitleTxt
Signature	2019-07-15	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	KRISTIN ANDERSON	PreparerPersonNm
PTIN	P01231300	PTIN
Phone	8606789200	PhoneNum

Field	Value	IRS element (for citing)
Tax	2017	TaxYr
Build TS	2019-02-21 02:37:17Z	BuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	VINCENT CAPECE JR	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	28 CRESCENT STREET	AddressLine1Txt
City	MIDDLETOWN	CityNm
State Abbreviation	CT	StateAbbreviationCd
ZIP	06457	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$483,499,805	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.MIDDLESEXHOSPITAL.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1895	FormationYr
Legal Domicile State	CT	LegalDomicileStateCd
Activity Or Mission	MIDDLESEX 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 Body	14	VotingMembersGoverningBodyCnt
Voting Members Independent	12	VotingMembersIndependentCnt
Total Employee	3370	TotalEmployeeCnt
Total Volunteers	601	TotalVolunteersCnt
Total Gross UBI	$3,166,235	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$509,857	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$4,322,258	PYContributionsGrantsAmt
CY Contributions Grants	$4,475,172	CYContributionsGrantsAmt
PY Program Service Revenue	$387,851,692	PYProgramServiceRevenueAmt
CY Program Service Revenue	$431,741,799	CYProgramServiceRevenueAmt
PY Investment Income	$15,675,644	PYInvestmentIncomeAmt
CY Investment Income	$7,819,509	CYInvestmentIncomeAmt
PY Other Revenue	$8,262,728	PYOtherRevenueAmt
CY Other Revenue	$7,354,445	CYOtherRevenueAmt
PY Total Revenue	$416,112,322	PYTotalRevenueAmt
CY Total Revenue	$451,390,925	CYTotalRevenueAmt
PY Grants And Similar Paid	$82,000	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$68,500	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$211,215,055	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$228,616,625	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$972,933	CYTotalFundraisingExpenseAmt
PY Other Expenses	$164,209,342	PYOtherExpensesAmt
CY Other Expenses	$174,660,138	CYOtherExpensesAmt
PY Total Expenses	$375,506,397	PYTotalExpensesAmt
CY Total Expenses	$403,345,263	CYTotalExpensesAmt
PY Revenues Less Expenses	$40,605,925	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$48,045,662	CYRevenuesLessExpensesAmt
Total Assets BOY	$471,471,154	TotalAssetsBOYAmt
Total Assets EOY	$508,825,625	TotalAssetsEOYAmt
Total Liabilities BOY	$153,499,090	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$151,444,638	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$317,972,064	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$357,380,987	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	MIDDLESEX 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 Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$160,737,373	ExpenseAmt
Grant	$68,500	GrantAmt
Revenue	$174,061,460	RevenueAmt
Desc	IN THE FISCAL YEAR ENDING 9/30/2018, INPATIENT CARE REPRESENTED 13,270 DISCHARGES AND 54,035 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

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$56,949,675	ExpenseAmt
Revenue	$84,342,068	RevenueAmt
Desc	MIDDLESEX HOSPITAL EMERGENCY DEPARTMENT DELIVERS CARE AT THE WHALEN EMERGENCY CENTER AT THE HOSPITAL'S MAIN CAMPUS AS WELL AS TWO SATELLITE SITES LOCATED AT THE SHORELINE MEDICAL CENTER IN WESTBROOK AND THE MIDDLESEX HOSPITAL MEDICAL CENTER IN MARLBOROUGH. THE EMERGENCY DEPARTMENT TREAT AND RELEASE VISITS FOR THE FISCAL YEAR ENDING 9/30/2018 WERE 77,222. IN EACH, EMERGENCY CARE IS DEPLOYED BY EXPERT, BOARD-CERTIFIED EMERGENCY MEDICINE DOCTORS AND SPECIFICALLY TRAINED PHYSICIAN ASSISTANTS, NURSES, PATIENT CARE TECHNICIANS AND OTHER SUPPORT PERSONNEL. EMERGENCY CARE IS PROVIDED 24 HOURS A DAY, 7 DAYS A WEEK. THE DEPARTMENTS ARE SUPPORTED BY A BROAD SPECTRUM OF DIAGNOSTIC CAPABILITIES AND SOPHISTICATED INFORMATION SYSTEMS. IN ADDITION TO EMERGENCY CARE THERE ARE ALSO ISOLATION AND DECONTAMINATION AREAS IN THE EMERGENCY DEPARTMENT AND A HELIPAD ON SITE FOR LIFE STAR MEDICAL HELICOPTER TRANSPORTS. MIDDLESEX HOSPITAL IS COMMITTED TO PROVIDING THE HIGHEST STANDARD OF CARE FOR BOTH THE PHYSICAL AND BEHAVIORAL HEALTH NEEDS OF OUR PSYCHIATRIC PATIENTS. THE EMERGENCY DEPARTMENT AT THE HOSPITAL HOUSES AN EIGHT BED EMERGENCY DEPARTMENT CRISIS UNIT. TREATMENT IS PROVIDED REGARDLESS OF THE PATIENT'S BACKGROUND OR STATUS. ED SERVICES ARE STAFFED WITH CLINICAL PERSONNEL SPECIFICALLY TRAINED TO CARE FOR THE UNIQUE NEEDS OF THEIR PATIENTS (PSYCHIATRISTS, STAFF NURSES, PATIENT CARE TECHNICIANS/MENTAL HEALTH WORKERS, SECRETARIES, NURSE EDUCATOR, SOCIAL WORKERS, COTAS, OT AND OTHERS). TOGETHER THE STAFF PARTNERS WITH HOSPITAL STAFF AND COMMUNITY RESOURCES TO DEVELOP THE BEST CARE PLAN FOR PATIENTS THROUGHOUT THEIR STAY IN THE HOSPITAL AND UPON DISCHARGE. IN FY 18, THE EMERGENCY ROOM ACTIVITY ACCOUNTED FOR 77,222 EMERGENCY DEPARTMENT VISITS. DEMAND CONTINUES TO RISE AND THE SERVICES PROVIDED CONTINUE TO BE RECOGNIZED FOR CONTINUOUS PATIENT SATISFACTION IN PARTICULAR AS A RECIPIENT OF THE PRESS GANEY SUMMIT AWARD FOR ACHIEVING A 99% CUSTOMER SATISFACTION RATING FOR TWELVE CONSECUTIVE YEARS.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$19,983,770	ExpenseAmt
Revenue	$13,236,757	RevenueAmt
Desc	THE HOSPITAL'S HOMECARE DEPARTMENT MAKES OVER 92,000 REVENUE GENERATING VISITS A YEAR TO COMMUNITY RESIDENTS. HOMECARE IS STAFFED WITH SPECIALTY NURSES, HOME HEALTH AIDES, PHYSICAL THERAPISTS, OCCUPATIONAL THERAPISTS, SPEECH THERAPISTS, MEDICAL SOCIAL WORKERS AND NUTRITIONISTS TO MEET THE PHYSICAL AND BEHAVIORAL HEALTH NEEDS OF PATIENTS CARED FOR IN THEIR HOMES AND OUTSIDE THE HOSPITAL SETTING. HOMECARE SERVICES INCLUDE: SPECIALIZED CARDIAC CARE; INCLUDING TELE MONITORING AND THE HEART SMART PROGRAM (A MULTIDISCIPLINARY PROGRAM WHICH INCLUDES THE FULL SPECTRUM CARDIAC SELF MANAGEMENT SUPPORT AND CLINICAL CARE), FULL SPECTRUM GERIATRIC CARE, INFUSION THERAPIES, LIFELINE SERVICES, AND A SIGNIFICANT RANGE OF RESPIRATORY, PULMONARY AND MEDICAL REHABILITATION SERVICES AS WELL AS PROVIDING OUTPATIENT HOSPICE AND PALLIATIVE SERVICES THROUGHOUT THE COMMUNITY. THE HOMECARE DEPARTMENT GENEROUSLY PROVIDES COMMUNITY HEALTH SERVICES INCLUDING FLU SHOTS, HEALTH FAIRS, AND COORDINATION OF LINKAGES WITH MEALS ON WHEELS, TRANSPORTATION, ADULT DAY CARE AND OTHER SERVICES ON CONTRACT WITH LOCAL ORGANIZATIONS.	Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

Field	Value	IRS element (for citing)
Expense	$119,934,271	ExpenseAmt
Revenue	$162,648,568	RevenueAmt
Desc	OTHER SERVICES INCORPORATE A WIDE RANGE OF CARE PROVIDED TO PATIENTS THAT ARE NOT SPECIFICALLY CAPTURED IN THE THREE LARGEST CATEGORIES. THIS DESIGNATION ACCOUNTS FOR APPROXIMATELY 550,000 VISITS. THESE SERVICES INCLUDE CARE PROVIDED AT THE CANCER CENTER SUCH AS DIAGNOSTIC TESTING, TREATMENT AND SUCH SUPPORTS AS ALTERNATIVE MEDICINE THERAPIES/INTEGRATIVE MEDICINES, AND HEREDITARY RISK ASSESSMENTS. PHYSICAL MEDICINE AND REHABILITATION SERVICES ALSO ARE FOLDED INTO THIS GROUPING. SERVICES ARE AVAILABLE AT MULTIPLE LOCATIONS WHICH OFFER COMPREHENSIVE REHABILITATION AND OCCUPATIONAL MEDICINE AND PHYSICAL THERAPY (INCLUDING HAND THERAPY) SERVICES. CARE IS DELIVERED BY EXPERIENCED, HIGHLY-QUALIFIED STAFF, WITH ADVANCED TRAINING IN PHYSICAL AND OCCUPATIONAL THERAPY, SPEECH LANGUAGE PATHOLOGY AND RELATED FIELDS. IN EACH CLINICAL CASE, PATIENTS ARE EVALUATED AND RECEIVE A UNIQUE TREATMENT PLAN, WHICH INCLUDES DESIRED GOALS, ANTICIPATED OUTCOMES AND THE TIME FRAME NECESSARY TO ACHIEVE CLINICALLY OPTIMAL RESULTS. ADDITIONAL SERVICES ARE AVAILABLE BY THE WOUND AND SKIN TEAM AT MIDDLESEX HOSPITAL. THE MULTIDISCIPLINARY TEAM PROVIDES TREATMENT WHICH FOCUSES ON CLINICAL WOUND, OSTOMY AND SKIN ISSUES. THE HOSPITAL HAS CAREFUL AND ONGOING SERVICES FOR INDIVIDUALS WITH CHRONIC DISEASES. A SAMPLING OF SUCH PROGRAMS INCLUDE PULMONARY REHABILITATION SERVICES WHICH PROVIDE RESPIRATORY THERAPY AND CARE FOR PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AS WELL AS DIABETES EDUCATION AND MEDICAL NUTRITION THERAPY AT THE CENTER FOR CHRONIC CARE MANAGEMENT PROVIDED TO INDIVIDUALS WITH A NEW DIAGNOSIS AND UNCONTROLLED DIABETES. MANY BEHAVIORAL HEALTH SERVICES ARE PROVIDED TO PATIENTS IN THE OUTPATIENT SETTING IN ADDITION TO COUNSELING AND SUPPORT GROUPS. PROGRAMS INCLUDE THE DAY TREATMENT PROGRAM (INTENSIVE OUTPATIENT SERVICES FOR ADULTS, GERIATRIC PATIENTS, AND DUALLY-DIAGNOSED PATIENTS), SERVICES AT THE OUTPATIENT CENTER FOR BEHAVIORAL HEALTH (PSYCHOTHERAPY AND MEDICATION MANAGEMENT FOR ADULTS) AND THE FAMILY ADVOCACY PROGRAM (MENTAL HEALTH TREATMENT FOR PATIENTS UNDER 18 YEARS OLD AND THEIR FAMILIES). IN FISCAL YEAR ENDING 9/30/2018, THERE WERE 7,524 REVENUE GENERATING AMBULATORY SURGERY CASES FROM ENDOSCOPY/COLONOSCOPY TO ORTHOPEDIC AND OTHER OUTPATIENT PROCEDURES. AMBULATORY OR OUTPATIENT SURGERY IS PERFORMED AT MIDDLESEX HOSPITAL AND THE MIDDLESEX OUTPATIENT CENTER.	Desc

Field	Value	IRS element (for citing)
Total Other Prog Srvc Expense	$119,934,271	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue	$162,648,568	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$357,605,089	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	Yes (true)	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	Yes (true)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	Yes (true)	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	150	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	3370	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	Yes (true)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (true)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	Yes (true)	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	14	GoverningBodyVotingMembersCnt
Independent Voting Member	12	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	CT	StatesWhereCopyOfReturnIsFldCd
Own Website	Yes (X)	OwnWebsiteInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SHANNON ST HILAIRE	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	8603586000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	28 CRESCENT STREET	AddressLine1Txt
City	MIDDLETOWN	CityNm
State Abbreviation	CT	StateAbbreviationCd
ZIP	06457	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
VINCENT CAPECE JR
PRESIDENT/CEO	40.0	4.0	Yes (X)	Yes (X)	$1,179,432	$0	$524,571
BRUCE S MACMILLIAN
CHAIR	1.0	3.0	Yes (X)	Yes (X)	$0	$0	$0
DAVID BAGGISH MD
SECRETARY & CHIEF DEPT OF MEDICINE	40.0	3.0	Yes (X)	Yes (X)	$33,839	$0	$2,548
JONATHAN D LEVINE MD
ASST SECRETARY	1.0	2.0	Yes (X)	Yes (X)	$0	$0	$0
CHANDLER J HOWARD
VICE CHAIR	1.0	2.0	Yes (X)	Yes (X)	$0	$0	$0
CAROL P WALLACE
DIRECTOR	1.0	3.0	Yes (X)		$0	$0	$0
GERALD P MIGLIACCIO
DIRECTOR	1.0	3.0	Yes (X)		$0	$0	$0
GREGORY B BUTLER
DIRECTOR	1.0	2.0	Yes (X)		$0	$0	$0
JEAN M D'AQUILA
DIRECTOR	1.0	2.0	Yes (X)		$0	$0	$0
DARRELL G PATASKA
DIRECTOR	1.0	2.0	Yes (X)		$0	$0	$0
R CHRISTOPHER SEATON
DIRECTOR	1.0	2.0	Yes (X)		$0	$0	$0
JOHN J GAUTHIER
DIRECTOR	1.0	2.0	Yes (X)		$0	$0	$0
SABRA R PURTILL
DIRECTOR	1.0	2.0	Yes (X)		$0	$0	$0
CHRISTINE H REPASSY
DIRECTOR	1.0	2.0	Yes (X)		$0	$0	$0
SUSAN MARTIN
VP FINANCE/TREASURER	40.0	4.0		Yes (X)	$429,982	$0	$159,122
JESSE WAGNER MD
VP QUALITY AND PATIENT SAFETY	40.0	1.0			$547,070	$0	$185,467	Yes (X)
JACQUELYN CALAMARI
VP PATIENT CARE SERVICES/CNO	40.0	0			$379,185	$0	$111,484	Yes (X)
EVAN JACKSON
VP STRATEGIC PLANNING AND CIO	40.0	0			$301,623	$0	$123,204	Yes (X)
DAVID GIUFFRIDA
VP FACILITIES AND SUPPORT SERVICES	40.0	0			$384,783	$0	$139,571	Yes (X)
DONNA STRONESKI
VP HUMAN RESOURCES	40.0	0			$246,280	$0	$37,190	Yes (X)
GREGORY NOKES
VP Human Resources	40.0	0			$432,591	$0	$124,267	Yes (X)
JONATHAN BANKOFF
CHAIRMAN EMERGENCY MEDICINE	40.0	0			$422,052	$0	$60,343	Yes (X)
RACHEL LOVINS
CHIEF DEPT OF MED	40.0	0			$403,691	$0	$60,465	Yes (X)
DAVID COSENTINO
PHYSICIAN EMERGENCY DEPARTMENT	40.0	0			$352,863	$0	$62,856		Yes (X)
BRIAN MCGUIRE
MEDICAL DIRECTOR ED	40.0	0			$356,344	$0	$56,412		Yes (X)
MARIO CAPUZZI
MEDICAL DIRECTOR ED	40.0	0			$359,652	$0	$58,210		Yes (X)
JEFFREY SHELTON
CHAIRMAN DEPT PSYCH	40.0	0			$389,910	$0	$44,754		Yes (X)
THEODORE HARTENSTEIN
MEDICAL DIRECTOR, UTILIZATION MANAGEMENT	40.0	0			$403,310	$0	$53,280		Yes (X)
MICHAEL SAXE
CHAIRMAN EMERGENCY MEDICINE	0.0	0			$206,274	$0	$20,331			Yes (X)
ARTHUR MCDOWELL
FORMER VP CLINICAL AFFAIRS	40.0	0			$203,856	$0	$1,600			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$7,032,738	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,825,675	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	362	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
ACSYS INTERACTIVE
1577 NEW BRITAIN AVENUE	FARMINGTON	CT	06032	MARKETING	$2,683,634
ARAMARK CORPORATION
66 OXFORD DRIVE	FRANKLIN	MA	02038	DIETARY / HOUSEKEEPING	$1,673,221
QUEST DIAGNOSTICS INC
2025 COLLECTION CENTER DRIVE	CHICAGO	IL	60693	LABORATORY SERVICES	$1,528,768
GE Healthcare IITS
15727 Collections Center Drive	Chicago	IL	60693	Technology	$1,162,859
Cerner Corporation
PO Box 959156	St Louis	MO	631959156	Technology	$982,308

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	70	CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIII	Yes (X)	InfoInScheduleOPartVIIIInd
Federated Campaigns	$30,446	FederatedCampaignsAmt
Fundraising	$177,217	FundraisingAmt
Government Grants	$2,094,122	GovernmentGrantsAmt
All Other Contributions	$2,173,387	AllOtherContributionsAmt
Noncash Contributions	$47,845	NoncashContributionsAmt
Total Contributions	$4,475,172	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICES	621110	$426,013,729	$426,013,729
SPECIMEN LAB	621500	$2,348,189		$2,348,189
TECHNICAL LABORATORY	621500	$798,203		$798,203
JOINT VENTURE PROGRAM REVENUE	900009	$2,581,678	$2,581,678

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$431,741,799	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$4,276,838	TotalRevenueColumnAmt
Exclusion	$4,276,838	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$19,418	TotalRevenueColumnAmt
Exclusion	$19,418	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$943,534	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$787,468	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$156,066	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$156,066	TotalRevenueColumnAmt
Exclusion	$156,066	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$34,753,062	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$31,229,809	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$3,523,253	SecuritiesAmt
Other	$0	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,523,253	TotalRevenueColumnAmt
Exclusion	$3,523,253	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$91,603	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$177,217	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$91,603	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Exclusion	$0	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
BUSINESS INTERRUPTION PROCEEDS	900009	$1,576,703	$1,576,703
CAFETERIA REVENUE	722210	$1,485,090		$1,485,090

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$4,136,586	TotalRevenueColumnAmt
Related Or Exempt Func Income	$4,116,743	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$19,843	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$7,198,379	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$451,390,925	TotalRevenueColumnAmt
Related Or Exempt Func Income	$434,288,853	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$3,166,235	UnrelatedBusinessRevenueAmt
Exclusion	$9,460,665	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$68,500	TotalAmt
Program Services	$68,500	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$5,843,528	TotalAmt
Program Services	$4,674,823	ProgramServicesAmt
Management And General	$1,168,705	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$356,308	TotalAmt
Program Services	$356,308	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$183,416,751	TotalAmt
Program Services	$167,629,999	ProgramServicesAmt
Management And General	$15,786,752	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$12,273,488	TotalAmt
Program Services	$11,182,631	ProgramServicesAmt
Management And General	$1,090,857	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$14,363,535	TotalAmt
Program Services	$13,205,534	ProgramServicesAmt
Management And General	$1,158,001	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$12,363,015	TotalAmt
Program Services	$11,248,089	ProgramServicesAmt
Management And General	$1,114,926	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$987,076	TotalAmt
Management And General	$987,076	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$214,077	TotalAmt
Management And General	$214,077	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$107,785	TotalAmt
Management And General	$107,785	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$151,270	TotalAmt
Management And General	$151,270	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$8,901,227	TotalAmt
Program Services	$6,988,845	ProgramServicesAmt
Management And General	$939,449	ManagementAndGeneralAmt
Fundraising	$972,933	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$2,986,718	TotalAmt
Program Services	$55,518	ProgramServicesAmt
Management And General	$2,931,200	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$7,129,198	TotalAmt
Program Services	$5,139,316	ProgramServicesAmt
Management And General	$1,989,882	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$8,937,288	TotalAmt
Program Services	$5,362,373	ProgramServicesAmt
Management And General	$3,574,915	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$7,352,926	TotalAmt
Program Services	$4,338,409	ProgramServicesAmt
Management And General	$3,014,517	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$1,274,046	TotalAmt
Program Services	$1,004,347	ProgramServicesAmt
Management And General	$269,699	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$692,457	TotalAmt
Program Services	$521,084	ProgramServicesAmt
Management And General	$171,373	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,465,321	TotalAmt
Program Services	$1,465,321	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$24,056,785	TotalAmt
Program Services	$21,778,315	ProgramServicesAmt
Management And General	$2,278,470	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$365,499	TotalAmt
Program Services	$365,499	ProgramServicesAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Medical Expenses	$41,505,389	$41,201,523	$303,866
Loss on Debt Refinance	$516,109		$516,109
State Net Patient Rev Tax	$35,520,618	$35,520,618

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$32,496,349	TotalAmt
Program Services	$25,498,037	ProgramServicesAmt
Management And General	$6,998,312	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$403,345,263	TotalAmt
Program Services	$357,605,089	ProgramServicesAmt
Management And General	$44,767,241	ManagementAndGeneralAmt
Fundraising	$972,933	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$21,872,000	BOYAmt
EOY	$27,632,430	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$31,640,000	BOYAmt
EOY	$32,477,000	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,298,687	BOYAmt
EOY	$1,174,131	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$43,649,483	BOYAmt
EOY	$48,017,606	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$1,417,799	BOYAmt
EOY	$1,049,892	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,184,536	BOYAmt
EOY	$1,275,731	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$5,788,868	BOYAmt
EOY	$5,256,310	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$550,540,160	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$348,691,336	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$192,561,299	BOYAmt
EOY	$201,848,824	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$157,563,000	BOYAmt
EOY	$176,743,045	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$730,182	BOYAmt
EOY	$612,800	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$13,765,300	BOYAmt
EOY	$12,737,856	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$471,471,154	BOYAmt
EOY	$508,825,625	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$49,993,272	BOYAmt
EOY	$64,537,203	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$756,215	BOYAmt
EOY	$1,010,749	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$47,119,672	BOYAmt
EOY	$43,542,482	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$55,629,931	BOYAmt
EOY	$42,354,204	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$153,499,090	BOYAmt
EOY	$151,444,638	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$299,976,946	BOYAmt
EOY	$339,115,292	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$10,563,781	BOYAmt
EOY	$10,328,569	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$7,431,337	BOYAmt
EOY	$7,937,126	EOYAmt

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$317,972,064	BOYAmt
EOY	$357,380,987	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$471,471,154	BOYAmt
EOY	$508,825,625	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$48,045,662	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$386,000	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$8,250,739	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$107,785	OtherActivitiesAmt
Total Lobbying Expenditures	$107,785	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY

MIDDLESEX 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 $10,605 AND THE PORTION OF CHA DUES TOTALED $35,740. IN ADDITION, MIDDLESEX HOSPITAL CONTRACTED WITH TWO CONSULTANTS WHO PERFORMED LOBBYING ACTIVITIES. THOSE EXPENSES TOTALLED $61,440.

Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$118,528,000	BeginningYearBalanceAmt
Contributions	$505,000	ContributionsAmt
Investment Earnings Or Losses	$5,703,000	InvestmentEarningsOrLossesAmt
Other Expenditures	-$3,000	OtherExpendituresAmt
End Year Balance	$124,739,000	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$103,326,000	BeginningYearBalanceAmt
Contributions	$451,000	ContributionsAmt
Investment Earnings Or Losses	$14,480,000	InvestmentEarningsOrLossesAmt
Other Expenditures	-$271,000	OtherExpendituresAmt
End Year Balance	$118,528,000	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$122,014,000	BeginningYearBalanceAmt
Investment Earnings Or Losses	$10,726,000	InvestmentEarningsOrLossesAmt
Other Expenditures	$29,414,000	OtherExpendituresAmt
End Year Balance	$103,326,000	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$126,387,000	BeginningYearBalanceAmt
Contributions	$2,000	ContributionsAmt
Investment Earnings Or Losses	-$2,106,000	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$2,269,000	OtherExpendituresAmt
End Year Balance	$122,014,000	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$114,787,000	BeginningYearBalanceAmt
Contributions	$229,000	ContributionsAmt
Investment Earnings Or Losses	$11,527,000	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$156,000	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$126,387,000	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.9065	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.0507	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.0428	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	false	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$13,403,490	OtherCostOrOtherBasisAmt
Book Value	$13,403,490	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$308,826,585	OtherCostOrOtherBasisAmt
Depreciation	$174,375,653	DepreciationAmt
Book Value	$134,450,932	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,061,978	OtherCostOrOtherBasisAmt
Depreciation	$1,698,046	DepreciationAmt
Book Value	$363,932	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$206,353,251	OtherCostOrOtherBasisAmt
Depreciation	$169,042,863	DepreciationAmt
Book Value	$37,310,388	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$19,894,856	OtherCostOrOtherBasisAmt
Depreciation	$3,574,774	DepreciationAmt
Book Value	$16,320,082	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$201,848,824	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDesc	AmtAmt
ACCRUED RETIREMENT LIABILITIES	$3,427,145
SELF INSURANCE LIABILITIES	$26,858,434
ASSET RETIREMENT OBLIGATION	$900,720
LEASE INCENTIVE OBLIGATION	$8,765
UNALLOCATED 3RD PARTY	$10,877,423
SECURITY DEPOSITS	$4,172
OTHER	$277,545

Field	Value	IRS element (for citing)
Total Liability	$42,354,204	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule D, Part V, Line 4 Intended uses of endowment funds

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. 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) footnote

THE 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, 2018 AND 2017. 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, 2018 AND 2017, 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

Field	Value	IRS element (for citing)
Event1	TPC Golf	Event1Nm
Gross Receipts Event1	$131,720	GrossReceiptsEvent1Amt
Charitable Contri Event1	$72,013	CharitableContriEvent1Amt
Gross Revenue Event1	$59,707	GrossRevenueEvent1Amt
Cash Prizes Event1	$2,993	CashPrizesEvent1Amt
Non Cash Prizes Event1	$0	NonCashPrizesEvent1Amt
Rent Facility Costs Event1	$55,486	RentFacilityCostsEvent1Amt
Food And Beverage Event1	$0	FoodAndBeverageEvent1Amt
Entertainment Event1	$0	EntertainmentEvent1Amt
Other Direct Expenses Event1	$1,228	OtherDirectExpensesEvent1Amt
Event2	Hospice Golf	Event2Nm
Gross Receipts Event2	$68,608	GrossReceiptsEvent2Amt
Charitable Contri Event2	$48,424	CharitableContriEvent2Amt
Gross Revenue Event2	$20,184	GrossRevenueEvent2Amt
Cash Prizes Event2	$2,740	CashPrizesEvent2Amt
Non Cash Prizes Event2	$0	NonCashPrizesEvent2Amt
Rent Facility Costs Event2	$7,740	RentFacilityCostsEvent2Amt
Food And Beverage Event2	$9,200	FoodAndBeverageEvent2Amt
Entertainment Event2	$0	EntertainmentEvent2Amt
Other Direct Expenses Event2	$504	OtherDirectExpensesEvent2Amt
Other Events Total	2	OtherEventsTotalCnt
Gross Receipts Other Events	$68,492	GrossReceiptsOtherEventsAmt
Charitable Contri Other Events	$56,780	CharitableContriOtherEventsAmt
Gross Revenue Other Events	$11,712	GrossRevenueOtherEventsAmt
Cash Prizes Other Events	$0	CashPrizesOtherEventsAmt
Non Cash Prizes Other Events	$0	NonCashPrizesOtherEventsAmt
Rent Fclty Costs Other Events	$0	RentFcltyCostsOtherEventsAmt
Food And Beverage Other Events	$0	FoodAndBeverageOtherEventsAmt
Entertainment Other Events	$0	EntertainmentOtherEventsAmt
Oth Direct Expnss Other Events	$11,712	OthDirectExpnssOtherEventsAmt
Gross Receipts Total	$268,820	GrossReceiptsTotalAmt
Charitable Contributions Tot	$177,217	CharitableContributionsTotAmt
Gross Revenue Total Events	$91,603	GrossRevenueTotalEventsAmt
Cash Prizes Total Events	$5,733	CashPrizesTotalEventsAmt
Non Cash Prizes Total Events	$0	NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$63,226	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$9,200	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$0	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$13,444	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$91,603	DirectExpenseSummaryEventsAmt
Net Income Summary	$0	NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Discounted Care Other	500	DiscountedCareOtherPct

Field	Value	IRS element (for citing)
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Persons Served	4235	PersonsServedCnt
Total Community Benefit Expns	$8,266,502	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,558,698	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,707,804	NetCommunityBenefitExpnsAmt
Total Expense	0.0042	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Persons Served	19173	PersonsServedCnt
Total Community Benefit Expns	$82,789,859	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$62,342,016	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$20,447,843	NetCommunityBenefitExpnsAmt
Total Expense	0.0507	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Persons Served	391	PersonsServedCnt
Total Community Benefit Expns	$877,085	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$707,853	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$169,232	NetCommunityBenefitExpnsAmt
Total Expense	0.0004	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	23799	PersonsServedCnt
Total Community Benefit Expns	$91,933,446	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$69,608,567	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$22,324,879	NetCommunityBenefitExpnsAmt
Total Expense	0.0553	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Persons Served	51196	PersonsServedCnt
Total Community Benefit Expns	$4,279,424	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$370,841	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,908,583	NetCommunityBenefitExpnsAmt
Total Expense	0.0097	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Persons Served	1717	PersonsServedCnt
Total Community Benefit Expns	$13,631,314	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,114,752	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$11,516,562	NetCommunityBenefitExpnsAmt
Total Expense	0.0286	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Persons Served	32379	PersonsServedCnt
Total Community Benefit Expns	$48,239,003	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$35,756,883	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$12,482,120	NetCommunityBenefitExpnsAmt
Total Expense	0.0309	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Persons Served	244	PersonsServedCnt
Total Community Benefit Expns	$396,138	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$52,025	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$344,113	NetCommunityBenefitExpnsAmt
Total Expense	0.0009	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Persons Served	3454	PersonsServedCnt
Total Community Benefit Expns	$318,684	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$900	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$317,784	NetCommunityBenefitExpnsAmt
Total Expense	0.0008	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	88990	PersonsServedCnt
Total Community Benefit Expns	$66,864,563	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$38,295,401	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$28,569,162	NetCommunityBenefitExpnsAmt
Total Expense	0.0708	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	112789	PersonsServedCnt
Total Community Benefit Expns	$158,798,009	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$107,903,968	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$50,894,041	NetCommunityBenefitExpnsAmt
Total Expense	0.1262	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$16,876	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$16,876	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$131,574	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$24,700	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$106,874	NetCommunityBenefitExpnsAmt
Total Expense	0.0003	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$564	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$564	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,998	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,998	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$153,012	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$24,700	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$128,312	NetCommunityBenefitExpnsAmt
Total Expense	0.0003	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$16,058,848	BadDebtExpenseAmt
Bad Debt Expense Attributable	$1,605,884	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$41,543,532	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$53,354,136	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$11,810,604	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MIDDLESEX HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	28 CRESCENT STREET	AddressLine1Txt
City	MIDDLETOWN	CityNm
State Abbreviation	CT	StateAbbreviationCd
ZIP	06457	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.MIDDLESEXHOSPITAL.ORG	WebsiteAddressTxt
State License	000069	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Teaching Hospital	Yes (X)	TeachingHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	MIDDLESEX HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Other	Yes (X)	OtherInd
CHNA Conducted	15	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	https://middlesexhealth.org/middlesex-and-the-community/serving-our-community/community-health-needs	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	16	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	https://middlesexhospital.org/middlesex-and-the-community/serving-our-community/community-health-nee	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.0	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	500.0	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	https://middlesexhospital.org/patients-and-visitors/financial-assistance-services	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	https://middlesexhospital.org/patients-and-visitors/financial-assistance-services	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	https://middlesexhospital.org/patients-and-visitors/financial-assistance-services	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 3 Facility , 1	Facility , 1 - MIDDLESEX HOSPITAL. In addition to the elements selected in Part V, line 3, the Middlesex Hospital 2016 Community Health Needs Assessment (CHNA) examined how social determinants of health and health disparities impact health outcomes. The report was used to raise awareness regarding how critical determinants influence health, 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. Middlesex Hospital will conduct its next community health needs assessment to be completed by September 30, 2019.
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - MIDDLESEX HOSPITAL. : Middlesex Hospital will conduct its next community health needs assessment to be completed by September 30, 2019. When completing its last Community Health Needs Assessment (CHNA) in 2016, Middlesex Hospital took into account input from representatives of its community served, including those with special knowledge of or expertise in public health. A participatory approach was utilized to create the 2016 CHNA through the following activities: 1) development of a CHNA Advisory Committee to provide guidance and insight; and 2) use of key informant surveys to promote diverse perspectives through community and clinical engagement. In addition to Hospital staff, CHNA Advisory Committee member organizations included: Middletown Health Department; Essex Health Department; Chatham Health District; Town of Killingworth Health Department; Durham Health Department; Connecticut River Area Health District; Middlesex County Branch of the NAACP; (FQHC) Community Health Center, Inc., Middletown; and the Middlesex County Substance Abuse Action Council. Advisory Committee development purposefully included organizations that represented low-income, medically underserved and minority populations. Advisory Committee participants provided key input and integral guidance to Middlesex Hospital throughout the CHNA process; members were engaged in a formal meeting during the assessment planning phase to review the study's overarching framework, planned data sources, list of potential stakeholders for key informant survey distribution, and to give suggestions and feedback on the key informant survey content and structure. In order to achieve county-based representation for the key informant survey, committee members provided additional contacts for the survey distribution list. Advisory Committee Members were given updates and kept informed by email regarding assessment status. Prior to finalization, the Advisory Committee was convened to review the CHNA draft and to offer comments and suggestions. The time-frame for completion of the CHNA, including community stakeholder input, was from early June 2016 - end of September 2016. To capture broad community input on health needs, social determinants of health and health equity, the Hospital administered its key informant survey through the online SurveyMonkey format. A total of 2,886 surveys were sent with a total of 438 completed for an overall response rate of 15.2%. Three discrete distribution channels were utilized: 1) Community: an extensive community contact list was developed, including representation from Middletown, Middlesex County and the periphery towns in the Middlesex Hospital service area. Sectors included elected officials (mayors, selectpersons, state legislators, etc.); local health departments; health care services (medical, dental, behavioral health, etc.); schools (public, private); colleges and universities; public safety (police, fire, emergency management); social services; youth and family services; other community services (senior care, veterans representation, etc.); faith-based organizations; community organizations and coalitions; the business community; and residents. Development of the community outreach distribution list included organizations that represented low-income, medically underserved and minority populations. 2) Middlesex Hospital/System Staff: the survey was sent to the Hospital's 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; and 3) Middlesex Hospital Medical Staff: surveys were sent to active medical staff and allied health professional staff through the Hospital's Medical Staff Office. In addition, through the prioritization process, the Hospital hosted a community forum to review the summary findings and themes of the assessment and to facilitate a prioritization dialogue. Participants included representatives from key community sectors and hospital departmental leadership; a total of 47 stakeholders attended. Presentation of the findings included primary and secondary data based on the following categories: demographic data; social determinants of health; health equity; health indicators; behavioral health indicators; key informant survey results; United Way 2-1-1 Connecticut system utilization; and a selection of DataHaven 2016 Wellbeing Survey results.
Schedule H, Part V, Section B, Line 7 Facility , 1	Facility , 1 - MIDDLESEX HOSPITAL. Middlesex Hospital will conduct its next community health needs assessment to be completed by September 30, 2019. For its last CHNA, conducted in 2016, in addition to posting it on the Hospital's web-site (https://middlesexhealth.org/middlesex-and-the-community/serving-our-community/community-health-needs-assessment) and making it available upon request, the Hospital electronically distributed its 2016 CHNA through the following dissemination channels: the CHNA Advisory Committee; key informant community partners; community members; the Middlesex Hospital medical staff; Hospital leadership, management staff, and board of directors; and, existing Hospital-community based partnership distribution lists. Other dissemination mechanisms included: a press release; the Hospital's weekly electronic newsletter Stat; a feature in the Hospital's community electronic newsletter, eVita; and presentations. Recipients were encouraged to widely share the assessment. During the dissemination process, CHNA hard copies were provided and will continue to be provided upon request.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - MIDDLESEX HOSPITAL. Based on the findings of the Middlesex Hospital's 2016 community health needs assessment (CHNA) and the CHNA community forum prioritization discussion hosted by the Hospital, the Hospital has selected four priority areas. Each priority has associated Goals, Actions, Anticipated Impact of Actions; Plans to Evaluate Actions; and Community Partners, as well as a focus on social determinants of health and health equity. The priority areas are as follows: 1a) Mental Health 1.1: Goal - Improve access to mental health services through interprofessional collaborative practice; Actions - Implement an evidence-based integrated model for mental health treatment within the primary care setting, including a focus on social determinants of health and health equity. 1b) Mental Health 1.2: Goal - Provide specialized mental health treatment for high risk populations; Actions - Plan, develop, and implement an early treatment intervention program for young adults with emerging mental illness and/or substance use disorders, including a focus on social determinants of health and health equity. 2a) Substance Abuse 2.1: Goal - Develop a treatment program for high-risk patients experiencing severe alcohol use disorders; Actions - Plan, develop, and implement targeted treatments to support patients gaining and sustaining sobriety utilizing evidence-based interventions, including a focus on social determinants of health and health equity; 2b) Substance Abuse 2.1: Goal - Develop and launch an opioid awareness campaign & Increase access of naloxone to patients at high risk for opioid overdose; Actions - Provide education to key community stakeholders & Provide patients brought to the emergency department following opioid overdose with naloxone. 3) Aging Population: Goal - Design and implement interventions to promote healthy aging in place and improve outcomes for the aging population; Actions - Develop an in-home comprehensive geriatric assessment and management service line using the HRSA funded GOT Care! (Geriatrics Outreach and Training with Care) program as a template. Coordinate care through an integrated and collaborative approach including a focus on social determinants of health and health equity. 4) Asthma: Goal - Improve asthma outcomes by meeting the Connecticut Asthma Initiative goals. Actions - Improve access and appropriate asthma care by partnering with the community; Enhance patient education techniques for asthma management; Advance progress toward health equity for asthma care and outcomes by focusing on social determinants of health; Develop a pediatric asthma pathway; and, Increase utilization of asthma action plans and enhance asthma action plan handoffs. Oversight of Middlesex Hospital's 2016 CHNA Implementation Strategy resides under Community Benefit, where Hospital staff collaborate with community agencies on the priority areas whenever possible and build evidence-based programs, where needed, with measurable, benchmarked results and the goal of achieving positive outcomes. In addition, the CHNA priority areas become the foundation for the Hospital's community benefit organizational goals. Middlesex Hospital will conduct its next community health needs assessment to be completed by September 30, 2019, which will be followed by prioritization of the findings and needs and the development of a community health needs assessment implementation strategy. Middlesex Hospital recognizes that it cannot focus on all the health needs identified in its 2016 CHNA. Given the significant resources and in-kind time needed to address health priority areas uncovered by a community health needs assessment, the Hospital engaged in a thorough process of data review and discussion to identify the areas of greatest need, impact potential and feasibility. For those areas of identified needs not addressed by the Hospital, its 2016 CHNA was widely disseminated to Middlesex County community agencies with the hope that the study would be used to initiate focus on CHNA findings that are outside the scope of the Hospital's selected priority areas. As many local community-based organizations are dedicated to meeting the needs of county residents, the Hospital realizes that these organizations may be better suited to take a leadership role in improving certain health outcomes. As with our previous community health needs assessment, the Hospital will continue to be a willing partner, when able, for initiatives not related to its selected CHNA priority areas.
Schedule H, Part V, Section B, Line 13 Facility , 1	Facility , 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.

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MIDDLESEX HOSPITAL HOMECARE	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	770 SAYBROOK ROAD	AddressLine1Txt
City	MIDDLETOWN	CityNm
State Abbreviation	CT	StateAbbreviationCd
ZIP	06457	ZIPCd

Field	Value	IRS element (for citing)
Facility	HOMECARE SERVICES, REHAB, HEART HEALTH, OTHER SERVICES	FacilityTxt

Supplemental Information Detail SupplementalInformationDetail (18 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 3c Criteria used for determining eligibility for free or discounted care	In 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 system	N/A. Middlesex Hospital is not part of an affiliated health care system.
Schedule H, Part VI, Line 7 Additional Information - State filing community benefit report	Under 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 I, Line 7g	Middlesex Hospital includes its Family Medicine Group as a subsidized service. For FY18, 10,314 unique individuals were served with a total Hospital subsidy of $500,399. 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 that Middlesex County is a Health Professional Shortage Area (HPSA) for primary medical care. Middlesex Hospital's Family Medicine Group fills a vital community health need by providing access to primary care services.
Schedule H, Part II Community Building Activities	The majority of Middlesex Hospital's community based community benefit work is captured under non-community building categories, which is narrow in scope. Middlesex 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 FY18 the Hospital's Community Building Activities totaled $128,312 and served 151 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. a) SMC Career Day is 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. b) SMC student learning experiences: SMC provides ongoing student learning experiences for local high school students where students are involved in patient rounds and are exposed to how diagnoses are made. c) SMC World of Work is 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 amount	The 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 Methodology	The 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 footnote	The 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 15 of the Middlesex Health System's Consolidated FY18 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 costs	The 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 is a disproportionate percentage of older adults in Middlesex County when compared to state averages. The Hospital's most recent (2016) community health needs assessment (CHNA) found that, when comparing state and national growth projections for persons age 65+ to local growth, every town in Middlesex County, except Middletown, considerably exceeds Connecticut and U.S. projections for 2020 and 2025 (Administration on Aging; Administration for Community Living; The Connecticut Data Collaborative and Connecticut's Legislative Commission on Aging). For 2020, excluding Middletown (at 16.4%), expected growth for age 65 and older ranges from 18.8% to 34.1% in the towns of Middlesex County compared to 17.5% for Connecticut and 16.3% for the U.S. For 2025, excluding Middletown (at 18.8%), expected growth for age 65 and older ranges from 22.6% to 38.9% in the towns of Middlesex County compared to 19.6% for Connecticut and 18.2% for the U.S. In Addition, the 2008, 2013 and 2016 Middlesex County CHNAs found older adults to be a priority area (access to care, health service utilization, lack of services, etc.). 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 assistance	Middlesex 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 and attorneys. 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 assessment	Since the inception of Middlesex Hospital'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 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 the 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 assistance	Great 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 data base 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 FY18, Middlesex Hospital granted $1,707,805 of financial assistance to 4,235 unique recipients and absorbed $20,617,075 in unpaid costs of Medicaid (total of Medicaid including managed care and LIA), serving 19,564 individuals.
Schedule H, Part VI, Line 4 Community information	Middlesex 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 (Middletown, Cromwell, Portland, East Hampton, East Haddam, Haddam, Middlefield, Durham, Killingworth, Chester, Deep River, Essex, Old Saybrook, Westbrook, Clinton) and 9 towns on Middlesex County's periphery (Rocky Hill, Glastonbury, Hebron, Marlborough, Colchester, Salem, Lyme/Old Lyme, Madison, Guilford). Middlesex County is 369 square miles, making it the smallest county by land area in Connecticut, and is the fifth in population size out of the eight Connecticut counties (TownCharts 2014). Municipality sizes vary throughout the county, from 10 square miles (Essex) to 54 square miles (East Haddam). Middletown has a geographic area of 41 square miles by land area. The periphery towns cover an additional 340 square miles. 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 2010 U.S. Census Data, the Middlesex County towns of Chester, Deep River, Durham, East Haddam, Haddam, Killingworth, Middlefield, Portland, Westbrook are considered rural, as well as the periphery town of Marlborough. Major employers include Middlesex Hospital, Wesleyan University, Middlesex Community College, Connecticut Valley Hospital, Pratt & Whitney, and the small business community. 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. Middletown is the largest municipality (47,424 persons) in Middlesex County (165,534 persons) [2014; CERC Town Profiles 2016]. Chester, Deep River and Middlefield have populations less than 5,000; Durham, East Haddam, Essex, Haddam, Killingworth, Portland, and Westbrook have populations between 5,000 and 9,999; Clinton, Cromwell, East Hampton and Old Saybrook have populations between 10,000 and 14,999 (2014; CERC Town Profiles 2016). The periphery towns in Middlesex Hospital's service area have a combined population of 141,516. Lyme and Salem have populations less than 5,000; Hebron, Old Lyme, and Marlborough have populations between 5,000 and 9,999; Colchester, Glastonbury, Guilford, Madison, and Rocky Hill have populations between 15,000 and 35,000 (2014; CERC Town Profiles 2016). Foreign born persons comprise 11% of the population in Middletown and 7.3% of Middlesex County compared to 13.7% of the state (2010-2014; U.S. Census Bureau QuickFacts). The median age in the towns in Middlesex County range from ages 37-53, with median age 37 in Middletown, 44 in Middlesex County, and 40 in the state of CT (2010-2014; CERC Town Profiles 2016). When comparing state and national growth projections for persons age 65+ to local growth every town in Middlesex County, except Middletown, considerably exceeds Connecticut and U.S. projections for 2020 and 2025 (Administration on Aging; Administration for Community Living; The Connecticut Data Collaborative and Connecticut's Legislative Commission on Aging). For 2020, excluding Middletown (at 16.4%), expected growth for age 65 and older ranges from 18.8% to 34.1% in the towns of Middlesex County compared to 17.5% for Connecticut and 16.3% for the U.S. For 2025, excluding Middletown (at 18.8%), expected growth for age 65 and older ranges from 22.6% to 38.9% in the towns of Middlesex County compared to 19.6% for Connecticut and 18.2% for the U.S. Middlesex County's race and Hispanic Origin composition is 84.4% white, non-Hispanic; 4.9% Black or African American, non-Hispanic; 5.9% Hispanic or Latino; 2.9% Asian, non-Hispanic; 1.6% two or more races, non-Hispanic; 0.2% other, non-Hispanic (U.S. Census 2013- 2017 5-Year Estimates). Middletown's race and Hispanic Origin composition is 69.5%% white, non-Hispanic; 13.0% Black or African American, non-Hispanic; 9.2% Hispanic or Latino; 5.6% Asian, non-Hispanic; 2.6% two or more races, non-Hispanic; 0.1% other, non-Hispanic (U.S. Census 2013- 2017 5-Year Estimates). The median household income in Middlesex County ($77,931) is higher than the state of Connecticut average ($69,899) [2010-2014; CERC Town Profile 2016 Report]. There is a significant range between the towns in Middlesex County, with Middletown at the lower bound ($61,373) and Durham at the highest level ($117,328) [2010-2014; CERC Town Profiles 2016]. Similar to the range of median household income in the towns throughout Middlesex County, there is a significant difference in poverty rate in Middletown (12.5%) when compared the rest of the county (6.9%) [2010-2014; CERC Town Profile 2016 Report]. Educational attainment in Middlesex County is: less than high school diploma - 7.9%; high school diploma, General Educational Development (GED) or equivalent: 21.4%; some college - 13.3%; associate's degree - 6.1%; bachelor's degree or higher: 39.8% (U.S. Census Bureau, American Community Survey 5-Year, 2010-2014). Unemployment in Middlesex County is 6.6% (U.S. Census Bureau, American Community Survey 5-Year, 2010-2014). Health insurance status (all income levels) in Middlesex County is: insured, ages <19: 97.2%; insured, ages 18 to 64 years: 93.6%; insured, ages 40 to 64 years: 94.8%; insured, ages 50 to 64 years: 95.1% (U.S. Census Bureau and the Small Area Health Insurance Estimates, 2014). In 2017, the percent of Hospital discharges for Medicaid/SAGA/Uninsured combined were: 17% inpatient; 14% outpatient; 31% Emergency Department non-admission; and, for the following services: 37% newborn; 38% inpatient psychiatry; 14% 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 too few primary care providers, high infant mortality, high poverty or a high elderly population. The Index of Medical Underservice includes the four variables of: ratio of primary medical care physicians per 1,000 population, infant mortality rate, percentage of the population with incomes below the poverty level, and percentage of the population age 65 or over.
Schedule H, Part VI, Line 5 Promotion of community health	As Middlesex Hospital is a community hospital, involving community members in key functions has always been a priority. The 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. The 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 FY17 was $69,221,996 (excluding Community Building) with 74,918 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 FY18, the Hospital's Community Health Improvement Services served 51,196 individuals at a total cost of $3,655,212 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 FY18, the Hospital's Health Professions Education category served 1,717 individuals at a total cost of $11,516,562 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, Cardiac Rehabilitation, Paramedics, Hospice, Diabetes Education, Wound Care and Pulmonary Rehabilitation. In FY18 the Hospital's subsidized services served 32,379 people with a total cost of $12,482,119 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 FY18, the Hospital's associated costs for all research projects totaled $344,113 and served 244 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 FY18 support for financial and in-kind contributions totaled $317,784, serving 3,454 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 FY18 Community Benefit Operations expense totaled $253,371.
Schedule H, Part VI, Line 7 State filing of community benefit report	CT

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
Community Foundation of Middlesex County
211 South Main Street	Middletown	CT	06457	061477711	501(c)(3)	$5,000	General Support
Friends of Long Hill Estate
421 Wadsworth Street	Middletown	CT	06457	061546991	501(c)(3)	$5,000	General Support
Eugene O'Neill Theater
305 Great Neck Rd	Waterford	CT	06385	066070900	501(c)(3)	$6,000	Corporate Gift
Middlesex Chamber of Commerce
393 Main Street	Middletown	CT	06457	060452410	501(c)(6)	$42,500	General Support
Florida Hospital Association
307 Park Lake Circle	Orlando	FL	32803	596151162	501(c)(3)	$10,000	General Support

Field	Value	IRS element (for citing)
Total501c3 Org	4	Total501c3OrgCnt
Total Other Org	1	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.	FormAndLineReferenceDesc
Explanation	EACH OF THE ORGANIZATIONS HAS A FORMAL PROCESS FOR ENSURING THE GRANT MONEY RECEIVED IS USED FOR APPROPRIATE PURPOSES VIA GRANT COMMITTEES.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Travel For Companions	Yes (X)	TravelForCompanionsInd
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Personal Services	Yes (X)	PersonalServicesInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Form990 Of Other Organizations	Yes (X)	Form990OfOtherOrganizationsInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
VINCENT CAPECE JR
PRESIDENT/CEO	$723,739	$0	$240,975	$0	$214,718	$0	$491,550	$0	$33,021	$0	$1,704,003	$0	$446,412	$0
SUSAN MARTIN
VP FINANCE/TREASURER	$413,367	$0	$0	$0	$16,615	$0	$136,080	$0	$23,042	$0	$589,104	$0	$15,669	$0
MICHAEL SAXE
CHAIRMAN EMERGENCY MEDICINE	$185,159	$0	$21,115	$0	$0	$0	$12,118	$0	$8,213	$0	$226,605	$0	$0	$0
ARTHUR MCDOWELL
FORMER VP CLINICAL AFFAIRS	$13,293	$0	$80,000	$0	$110,562	$0	$1,600	$0	$0	$0	$205,456	$0	$190,562	$0
JESSE WAGNER MD
VP QUALITY AND PATIENT SAFETY	$431,612	$0	$77,000	$0	$38,458	$0	$155,500	$0	$29,967	$0	$732,537	$0	$115,458	$0
JACQUELYN CALAMARI
VP PATIENT CARE SERVICES/CNO	$287,775	$0	$63,000	$0	$28,410	$0	$89,600	$0	$21,884	$0	$490,669	$0	$91,410	$0
EVAN JACKSON
VP STRATEGIC PLANNING AND CIO	$272,947	$0	$25,000	$0	$3,676	$0	$103,372	$0	$19,832	$0	$424,827	$0	$25,000	$0
DAVID GIUFFRIDA
VP FACILITIES AND SUPPORT SERVICES	$289,971	$0	$69,000	$0	$25,812	$0	$116,600	$0	$22,971	$0	$524,353	$0	$94,812	$0
DONNA STRONESKI
VP HUMAN RESOURCES	$221,030	$0	$25,250	$0	$0	$0	$13,944	$0	$23,246	$0	$283,470	$0	$0	$0
GREGORY NOKES
VP Human Resources	$336,303	$0	$62,000	$0	$34,287	$0	$101,600	$0	$22,667	$0	$556,858	$0	$95,820	$0
JONATHAN BANKOFF
CHAIRMAN EMERGENCY MEDICINE	$390,551	$0	$31,501	$0	$0	$0	$16,200	$0	$44,143	$0	$482,395	$0	$0	$0
RACHEL LOVINS
CHIEF DEPT OF MED	$372,190	$0	$31,501	$0	$0	$0	$16,200	$0	$44,265	$0	$464,156	$0	$0	$0
DAVID COSENTINO
PHYSICIAN EMERGENCY DEPARTMENT	$343,420	$0	$9,444	$0	$0	$0	$18,900	$0	$43,956	$0	$415,720	$0	$0	$0
BRIAN MCGUIRE
MEDICAL DIRECTOR ED	$347,605	$0	$8,739	$0	$0	$0	$12,269	$0	$44,143	$0	$412,756	$0	$0	$0
MARIO CAPUZZI
MEDICAL DIRECTOR ED	$351,234	$0	$8,418	$0	$0	$0	$15,788	$0	$42,421	$0	$417,862	$0	$0	$0
JEFFREY SHELTON
CHAIRMAN DEPT PSYCH	$358,410	$0	$31,500	$0	$0	$0	$12,412	$0	$32,342	$0	$434,664	$0	$0	$0
THEODORE HARTENSTEIN
MEDICAL DIRECTOR, UTILIZATION MANAGEMENT	$372,060	$0	$31,250	$0	$0	$0	$9,637	$0	$43,644	$0	$456,590	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, Part II, Column (B)(ii) BONUS & INCENTIVE COMPENSATION	THE AMOUNTS REPRESENT INCENTIVE COMPENSATION PAYMENTS MADE IN CALENDAR YEAR 2016. PAYMENTS INCLUDE AMOUNTS EARNED IN 2015 AND DEFERRED, WHERE APPLICABLE.
Schedule J, Part I, Line 1a Travel for companions	TRAVEL 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. GREGORY NOKES SUSAN MARTIN VINCENT CAPECE
Schedule J, Part I, Line 1a Health or social club dues or initiation fees	SOCIAL 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 services	REPRESENTS TAX PLANNING AND/OR TAX PERSONAL SERVICES - PREPARATION FEES FOR ONE MEMBER OF THE EXECUTIVE STAFF. THIS BENEFIT WAS TREATED AS TAXABLE COMPENSATION. GREGORY NOKES
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	NONQUALIFIED RETIREMENT BENEFITS ARE PROVIDED AS PART OF A COMPETITIVE TOTAL COMPENSATION PROGRAM AND TO ENCOURAGE RETENTION OF KEY EXECUTIVES. THE NONQUALIFIED RETIREMENT PLAN BENEFIT ACCRUES ANNUALLY AND EACH YEAR'S CONTRIBUTION VESTS AFTER THREE (3) YEARS OF SERVICE. THE AMOUNT OF THE VESTED BENEFITS IS CONSIDERED "INCOME" TO THE EXECUTIVE'S W-2 FORM AND IS TAXABLE. CERTAIN EXECUTIVES ALSO PARTICIPATE IN A FORMER PLAN, WHERE ACCRUALS CEASED IN 2010 AND THE VESTED BENEFITS WILL BE DISTRIBUTED ON TERMINATION OF EMPLOYMENT. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE NONQUALIFIED RETIREMENT PLAN. THE AMOUNTS REPORTED BELOW ARE THE SERP VESTED AMOUNTS PAID TO THE EMPLOYEE DURING CALENDAR YEAR 2017: ARTHUR MCDOWELL $ 110.562 SUSAN MARTIN $ 15,669 VINCENT CAPECE $ 205,437 JESSE WAGNER, MD $ 38,458 DAVID GIUFFRIDA $ 25,812 JACQUELYN CALAMARI $ 28,410 GREGORY NOKES $ 33,820 THE FOLLOWING PARTICIPANTS HAD FUNDS CONTRIBUTED TO THEIR SERP ACCOUNT IN 2017: DAVID GIUFFRIDA $ 28,700 VINCENT CAPECE $ 216,900 SUSAN MARTIN $ 16,480 JESSE WAGNER, MD $ 41,900 EVAN JACKSON $ 28,000

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
STATE OF CT HEALTH & EDUCATIONAL FACILITIES AUTH
A	060806186	20774YAW7	2011-07-26	$33,803,383	SERIES N REFINANCE 10/9/1997 (SERIES H & I)	Yes (true)	false	false
State of CT Health & Educational Facilities Authority
B	060806186	20774YWD5	2015-05-19	$19,491,965	SERIES O Refinance 12/7/2006 (Series L)	false	false	false
STATE OF CT HEALTH & EDUCATIONAL FACILITES AUTHORITY
C	060806186	000000000	2016-06-10	$9,683,000	SERIES P REFINANCE 6/10/2016 (SERIES M)	false	false	false
STATE OF CT HEALTH & EDUCATIONAL FACILITIES AUTH
D	060806186	000000000	2017-11-21	$9,069,272	SERIES Q REFINANCE 10/26/2010 (SERIES N)	false	false	false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	UnspentUnspentAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$14,325,000	$7,600,000	$33,803,651	$0	$0	$0	$537,971	$0	$0	$0	$33,265,690	$0	2011	false	Yes (true)	Yes (true)	Yes (true)
B	$1,815,000	$0	$19,491,965	$0	$0	$0	$388,960	$0	$0	$0	$19,103,010	$0	2015	false	Yes (true)	Yes (true)	Yes (true)
C	$1,820,113	$0	$9,683,000	$0	$0	$0	$193,660	$0	$0	$0	$9,489,340	$0	2016	false	Yes (true)	Yes (true)	Yes (true)
D	$144,144	$0	$8,749,618	$0	$0	$0	$173,985	$0	$0	$0	$8,524,713	$552	2018	false	Yes (true)	Yes (true)	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Any Research AgreementsAnyResearchAgreementsInd	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd
A	false	false	false	false	false	false	Yes (true)
B	false	false	Yes (true)	false	false	false	Yes (true)	false
C	false	false	Yes (true)	false	false	false	Yes (true)	false
D	false	false	false	false	false	false	Yes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A	false	false	false	Yes (true)	false	false	false	false	Yes (true)
B	false	Yes (true)	false	false	false	false	false	false	Yes (true)
C	false	Yes (true)	false	false	false	false	false	false	Yes (true)
D	false	Yes (true)	false	false	false	false	false	false	Yes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (true)
B	Yes (true)
C	Yes (true)
D	Yes (true)

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule K, Part II, Line 7 COLUMN A BOND	THIS AMOUNT WILL NOT TIE TO 8038 DUE TO ALLOCATION TO OBLIGATED GROUP.
Schedule K, Part II, Line 3 COLUMN A BOND	THE DIFFERENCE BETWEEN THE ISSUE PRICE AND THE TOTAL PROCEEDS IS INTEREST IN THE AMOUNT OF $268 FOR COLUMN A BOND.
Schedule K, Part II, Line 10 COLUMN A BOND	THIS AMOUNT WILL NOT TIE TO 8038 DUE TO ALLOCATION TO OBLIGATED GROUP.
Schedule K, Part III Column B and Column C Bonds	The 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 II, Line 11 COLUMN D BOND	THIS AMOUNT WILL NOT TIE TO 8038 DUE TO ALLOCATION TO OBLIGATED GROUP.
Schedule K, Part IV, Line 2c COLUMN A	Issuer 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 (5 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
ANNE CALAMARI - LCSW COORDINATOR
FAMILY MEMBER - J. CALAMARI	$107,731	WAGES/COMPENSATION RECEIVED	false
STEVE MCDOWELL - TRANSPORTATION AND LOGISTICS SUPERVISOR
FAMILY MEMBER - A. MCDOWELL	$105,319	WAGES/COMPENSATION RECEIVED	false
VICTORIA MCDOWELL - REGISTERED NURSE
FAMILY MEMBER - A. MCDOWELL	$62,995	WAGES/COMPENSATION RECEIVED	false
GUIFFRIDA ELECTRIC CO
FAMILY MEMBER - D. GUIFFRIDA	$377,391	PAYMENT FOR SERVICES RENDERED	false
Ruth Wagner - Registered Nurse
Family Member - J Wagner	$80,263	WAGES/COMPENSATION RECEIVED	false

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule L, Part IV RELATED PARTIES	FormAndLineReferenceDesc
Explanation	ANNE CALAMARI, LCSW COORDINATOR, IS THE DAUGHTER OF JACQUELYN CALAMARI, VP NURSING. ANNE CALAMARI'S WAGES FOR 10/01/17 TO 09/30/18 TOTALED $107,731. STEVE MCDOWELL, TRANSPORTATION AND LOGISTICS SUPERVISOR, IS THE BROTHER OF ARTHUR MCDOWELL, VICE PRESIDENT OF CLINICAL AFFAIRS. STEVE MCDOWELL'S WAGES FOR 10/01/17 TO 09/30/18 TOTALED $105,319. VICTORIA MCDOWELL, REGISTERED NURSE, IS THE SISTER-IN-LAW OF ARTHUR MCDOWELL, VICE PRESIDENT OF CLINICAL AFFAIRS. VICTORIA MCDOWELL'S WAGES FOR 10/01/17 TO 09/30/18 TOTALED $62,995. 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 FY18 TOTALED $377,391. RUTH WAGNER, CCU REGISTERED NURSE, IS THE WIFE OF JESSE WAGNER, VP QUALITY & SAFETY. RUTH WAGNER'S WAGES FOR 10/01/17 TO 09/30/18 TOTALED $80,263.	ExplanationTxt

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	6	ContributionCnt
Noncash Contributions Rpt F990	$47,845	NoncashContributionsRptF990Amt
Method Of Determining Revenues	Selling cost	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Form8283 Received	0	Form8283ReceivedCnt
Any Property That Must Be Held	false	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	Yes (true)	ReviewProcessUnusualNCGiftsInd
Third Parties Used	false	ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule M, Part I Explanations of reporting method for number of contributions	FormAndLineReferenceDesc
Explanation	Securities - Publicly traded - Reporting on count of donors	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part III, Line 1 ORGANIZATION'S MISSION	RELATIONSHIPS 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 III, Line 4d Description of other program services	(Expenses $ 119,934,271 including grants of $)(Revenue $ 162,648,568) OTHER SERVICES INCORPORATE A WIDE RANGE OF CARE PROVIDED TO PATIENTS THAT ARE NOT SPECIFICALLY CAPTURED IN THE THREE LARGEST CATEGORIES. THIS DESIGNATION ACCOUNTS FOR APPROXIMATELY 550,000 VISITS. THESE SERVICES INCLUDE CARE PROVIDED AT THE CANCER CENTER SUCH AS DIAGNOSTIC TESTING, TREATMENT AND SUCH SUPPORTS AS ALTERNATIVE MEDICINE THERAPIES/INTEGRATIVE MEDICINES, AND HEREDITARY RISK ASSESSMENTS. PHYSICAL MEDICINE AND REHABILITATION SERVICES ALSO ARE FOLDED INTO THIS GROUPING. SERVICES ARE AVAILABLE AT MULTIPLE LOCATIONS WHICH OFFER COMPREHENSIVE REHABILITATION AND OCCUPATIONAL MEDICINE AND PHYSICAL THERAPY (INCLUDING HAND THERAPY) SERVICES. CARE IS DELIVERED BY EXPERIENCED, HIGHLY-QUALIFIED STAFF, WITH ADVANCED TRAINING IN PHYSICAL AND OCCUPATIONAL THERAPY, SPEECH LANGUAGE PATHOLOGY AND RELATED FIELDS. IN EACH CLINICAL CASE, PATIENTS ARE EVALUATED AND RECEIVE A UNIQUE TREATMENT PLAN, WHICH INCLUDES DESIRED GOALS, ANTICIPATED OUTCOMES AND THE TIME FRAME NECESSARY TO ACHIEVE CLINICALLY OPTIMAL RESULTS. ADDITIONAL SERVICES ARE AVAILABLE BY THE WOUND AND SKIN TEAM AT MIDDLESEX HOSPITAL. THE MULTIDISCIPLINARY TEAM PROVIDES TREATMENT WHICH FOCUSES ON CLINICAL WOUND, OSTOMY AND SKIN ISSUES. THE HOSPITAL HAS CAREFUL AND ONGOING SERVICES FOR INDIVIDUALS WITH CHRONIC DISEASES. A SAMPLING OF SUCH PROGRAMS INCLUDE PULMONARY REHABILITATION SERVICES WHICH PROVIDE RESPIRATORY THERAPY AND CARE FOR PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AS WELL AS DIABETES EDUCATION AND MEDICAL NUTRITION THERAPY AT THE CENTER FOR CHRONIC CARE MANAGEMENT PROVIDED TO INDIVIDUALS WITH A NEW DIAGNOSIS AND UNCONTROLLED DIABETES. MANY BEHAVIORAL HEALTH SERVICES ARE PROVIDED TO PATIENTS IN THE OUTPATIENT SETTING IN ADDITION TO COUNSELING AND SUPPORT GROUPS. PROGRAMS INCLUDE THE DAY TREATMENT PROGRAM (INTENSIVE OUTPATIENT SERVICES FOR ADULTS, GERIATRIC PATIENTS, AND DUALLY-DIAGNOSED PATIENTS), SERVICES AT THE OUTPATIENT CENTER FOR BEHAVIORAL HEALTH (PSYCHOTHERAPY AND MEDICATION MANAGEMENT FOR ADULTS) AND THE FAMILY ADVOCACY PROGRAM (MENTAL HEALTH TREATMENT FOR PATIENTS UNDER 18 YEARS OLD AND THEIR FAMILIES). IN FISCAL YEAR ENDING 9/30/2018, THERE WERE 7,524 REVENUE GENERATING AMBULATORY SURGERY CASES FROM ENDOSCOPY/COLONOSCOPY TO ORTHOPEDIC AND OTHER OUTPATIENT PROCEDURES. AMBULATORY OR OUTPATIENT SURGERY IS PERFORMED AT MIDDLESEX HOSPITAL AND THE MIDDLESEX OUTPATIENT CENTER.
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons	CAROL WALLACE & ERIC THORNBURG - Business relationship, ERIC THORNBURG & CHANDLER HOWARD - Business relationship, JEAN D'AQUILA & CHANDLER HOWARD - Business relationship, VINCENT CAPECE & CHANDLER HOWARD - Business relationship, JEAN D'AQUILA & ERIC THORNBURG - Business relationship
Form 990, Part VI, Line 6 Classes of members or stockholders	THE SOLE MEMBER OF THE HOSPITAL SHALL BE MIDDLESEX HEALTH SYSTEM, INC., A CONNECTICUT NON-STOCK CORPORATION, OR ITS SUCCESSOR IN INTEREST ("SOLE MEMBER").
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	THE ANNUAL ELECTION OF THE BOARD OF DIRECTORS OF THE HOSPITAL BY THE DULY AUTHORIZED REPRESENTATIVE OF THE SOLE MEMBER SHALL BE DEEMED THE ANNUAL MEETING OF THE MEMBERSHIP OF THE HOSPITAL FOR ALL PURPOSES.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	THE SOLE MEMBER, MIDDLESEX HEALTH SYSTEM, INC., SHALL HAVE ALL OF THE MEMBERSHIP RIGHTS CONFERRED BY LAW, THE CERTIFICATE OF INCORPORATION OR THE 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. THE SECRETARY OF THE HOSPITAL SHALL PROVIDE APPROPRIATE NOTICES TO THE SOLE MEMBER AS REQUIRED BY LAW IN ADVANCE OF ACTIONS BEING REQUESTED OF THE SOLE MEMBER BY THE BOARD OF DIRECTORS OF THE HOSPITAL.
Form 990, Part VI, Line 11b Review of form 990 by governing body	DRAFT FORMS OF THE 990, INCLUDING REQUIRED SCHEDULES, ARE PROVIDED TO EACH BOARD MEMBER FOR REVIEW. MEMBERS REVIEW THE DOCUMENTS, HIGHLIGHT ANY SIGNIFICANT CHANGES AND ATTEST THEIR APPROVAL. ANY QUESTIONS OR COMMENTS ARE PRESENTED TO EXECUTIVE MANAGEMENT PRIOR TO FILING. A COPY OF THE FINAL FORM 990 WILL BE PROVIDED TO THE BOARD PRIOR TO FILING WITH THE IRS VIA A WEB BASED COMMUNICATION PORTAL.
Form 990, Part VI, Line 12c Conflict of interest policy	CONFLICT 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. INFORMATION REPORTED IS CONSIDERED PERSONAL AND CONFIDENTIAL AND ONLY DISCLOSED WHEN DEEMED NECESSARY TO PROTECT THE HOSPITAL AGAINST THE EFFECTS OF CONFLICTS OF INTEREST AND ONLY AFTER ADVISING THE REPORTING PERSON OF THE PROPOSED DISCLOSURE AND OF ITS EXTENT. MATERIAL CONFLICTS ARE REPORTED TO THE BOARD'S 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. 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 official	EXECUTIVE TEAM COMPENSATION IS REVIEWED ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD. THE COMMITTEE HAS A CHARTER AND A POLICY STATEMENT SETTING FORTH A PROCESS AND CERTAIN GUIDELINES FOR DETERMINING COMPENSATION. EXECUTIVES RECEIVE A BASE SALARY AND HAVE THE OPPORTUNITY FOR INCENTIVE COMPENSATION WITHIN A RANGE SET BY THE POLICY. FOLLOWING THE CLOSE OF EACH FISCAL YEAR, THE COMMITTEE RECEIVES A MARKET ANALYSIS FROM INDEPENDENT CONSULTANTS REGARDING COMPENSATION AT PEER GROUPS OF COMPARABLE HOSPITALS AND HEALTH SYSTEMS. POSITIONS WITHIN THE EXECUTIVE TEAM ARE COMPARED TO BENCHMARK POSITIONS WITHIN THIS MARKET DATA AND THEIR COMPENSATION IS COMPARED TO THE DATA 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, APPROVES OR MODIFIES THEM, AND ALSO DETERMINES ANY INCENTIVE AWARD AND BASE SALARY ADJUSTMENT FOR THE CEO. THE CONSULTANTS PROVIDE A WRITTEN OPINION ANNUALLY CONFIRMING THAT THE COMPENSATION OF THE EXECUTIVES, AS ADJUSTED BY THIS PROCESS, IS "REASONABLE" WITHIN APPLICABLE IRS GUIDELINES. THE LAST COMPENSATION REVIEW OCCURRED 12/2017.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	KEY EMPLOYEE COMPENSATION IS SET FOLLOWING THE GUIDELINES SET FORTH IN THE HOSPITAL COMPENSATION POLICY. THE OBJECTIVE OF THIS POLICY IS TO PAY EMPLOYEES BASED UPON HOSPITAL NEED, THE PROPER EXTERNAL LABOR MARKET AND PERFORMANCE. THE LAST COMPENSATION REVIEW OCCURRED 12/2017.
Form 990, Part VI, Line 19 Required documents available to the public	MIDDLESEX 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 Revenue	Parking Violation Fee Reimbursement - Total Revenue: 25, Related or Exempt Function Revenue: 25, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Accounting Fee Reimbursement - Total Revenue: 176532, Related or Exempt Function Revenue: 176532, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Vending Machine Income - Total Revenue: 5032, Related or Exempt Function Revenue: 5032, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Clerical - Total Revenue: 7735, Related or Exempt Function Revenue: 7735, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Laundry Income - Total Revenue: 19843, Related or Exempt Function Revenue: , Unrelated Business Revenue: 19843, Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Consulting Services - Total Revenue: 155978, Related or Exempt Function Revenue: 155978, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Energy Credit Rvenue - Total Revenue: 66339, Related or Exempt Function Revenue: 66339, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Miscellaneous Income - Total Revenue: 2702352, Related or Exempt Function Revenue: 2702352, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Purchase discounts - Total Revenue: 1002750, Related or Exempt Function Revenue: 1002750, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Change in Accumulated Pension Charges - 4217261; CAPITAL DISTRIBUTIONS TO RELATED ENTITIES - -11563000; EXPENDITURES FROM RESTRICTED FUNDS - -905000;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
MIDDLESEX HEALTH SYSTEM INC
28 CRESCENT STREET	MIDDLETOWN	CT	06457	222676137	SUPPORT	CT	501(c)(3)	Type II	NA	false
MIDDLESEX HEALTH SERVICES INC
28 CRESCENT STREET	MIDDLETOWN	CT	06457	222676140	ASST. LIVING	CT	501(c)(3)	9	MIDDLESEX HEALTH SYSTEM	false
MIDDLESEX HOSPITAL FOUNDATION
28 CRESCENT STREET	MIDDLETOWN	CT	06457	273720822	SUPPORT	CT	501(c)(3)	Type II	MIDDLESEX HOSPITAL	Yes (true)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd
MIDDLESEX HEALTH RESOURCES INC
28 CRESCENT STREET	MIDDLETOWN	CT	06457	061089925	HEALTHCARE	CT	MIDDLESEX HEALTH SYSTEM	C Corporation	false
INTEGRATED RESOURCES FOR THE MIDDLESEX AREA LLC
28 CRESCENT STREET	MIDDLETOWN	CT	06457	061462230	OUTPATIENT CARE	CT	MIDDLESEX HEALTH SYSTEM	C Corporation	false
MHS PRIMARY CARE INC
28 CRESCENT STREET	MIDDLETOWN	CT	06457	061472743	HEALTHCARE	CT	MIDDLESEX HEALTH SYSTEM	C Corporation	false

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (true)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd