2018-08-14T09:13:06-05:00 2017-09-30 346565596 Ernst & Young US LLP 200 Clarendon Street 44th Floor Boston MA 02116 990 2016-10-01 060646668 Hartford Hospital HART 8606966200 80 Seymour Street PO Box 5037 Hartford CT 061025037 MARK KEISE Authorized Signer 8606966282 2018-08-14 0 Jeanne Schuster P00743154 6172262000 2016 2022-09-23 18:48:47Z Bimal Patel 80 Seymour Street Hartford CT 06102 1390235282 0 X www.hartfordhospital.org X 1854 CT To improve the health and healing of the people and communities we serve. 14 10 7895 993 414929 -131842 15826083 36133750 1188662434 1314224290 11740094 32991272 5725536 2389680 1221954147 1385738992 111330 670565 0 0 503694863 568688773 0 0 1636506 671419865 731345970 1175226058 1300705308 46728089 85033684 1545015774 1661491895 988682194 889633542 556333580 771858353 X To improve the health and healing of the people and communities we serve. 0 0 218123506 226015812 At the completion of FY17, the Division of Cardiology was comprised of 15 full time faculty cardiologists, 1 per diem cardiologist, 6 full time hospitalists, and 1 doctoral-level researcher. Cardiology division members published 34 manuscripts (not including abstracts) in peer-reviewed journals in 2016/2017. Many of these articles were published in the top medical journals. Patient Care Activities:Cardiac Catheterization Laboratory:For FY17, there were 3,942 total cases performed in the Cardiac Catheterization Laboratory. Diagnostic Coronary procedures for FY17 were 3,575. The Catheterization Laboratory staff performed 257 Trans Aortic Valve Replacements in conjunction with cardiac surgery in the operating room. For FY17, 46.5% of all Cardiac Catherization Laboratory cases were elective, 40.9% Urgent, and 12.6% Emergent. Nuclear Cardiology:There were a total of 2,180 studies performed in the Non-Invasive Stress Laboratory at Hartford Hospital in FY17. This consisted of 40 cardiopulmonary stress tests, 435 exercise treadmill tests, 1,549 SPECT myocardial perfusion imaging studies, and 237 cardiac Positron Emission Tomography (PET) studies. The acquisition of a new SPECT/CT camera has allowed the laboratory to begin performing coronary artery calcium scores on a limited scale. This program is expected to be opened to all referring providers in 2018. In addition to the specialized PET cardiac viability studies and cardiac sarcoidosis studies, the laboratory began performing cardiac Technetium pyrophosphate studies (SPECT studies) for the diagnosis of cardiac amyloidosis.Advanced Heart Failure and Transplant Center:The Advanced Heart Failure (HF) Infusion Center continues to provide successful outpatient therapy for increasingly complex patients with decompensated HF. The infusion center is increasingly employed to transition patients successfully home from the hospital and in the management of our Bridge Clinic population needing "rescue" soon after discharge. Outpatient Private Cardiology Practices are more and more using the capabilities of the infusion center as an additional resource in the management of their chronic heart failure population. This multidisciplinary team has successfully prevented re-admission to the hospital while allowing patients to stay in the comfort of their own homes. Outpatient infusion therapy continues to grow in popularity as it is highly effective in stabilizing patients with acute HF syndrome and avoiding hospital readmission. Echocardiography:Hartford Hospital Echocardiography Lab performed 11,914 total studies/procedures during the year. The lab continued to provide robust support within and without Cardiology. New initiatives include the introduction of portable bedside echo in the cardiac intensive care unit. HH Heart Transplant Program (HHHTP):In FY17, the HHHTP performed 17 heart transplant operations. This is a 41.7 % increase over FY16. Morbidity and mortality remain well below all national standards and the program remains Medicare certified. In the United States, only 2,000+ heart transplants are performed annually related to this worldwide organ shortage. The HHHTP continues to use state-of-the-art AlloMap immunologic blood testing, thereby reducing the need for invasive endomyocardial biopsy in the surveillance and management of our patients.Preventive Cardiology: Preventive Cardiology includes Cholesterol Management, Low-Density Lipoprotein (LDL) Apheresis, Cardiovascular Sports Medicine Consultation and Cardiac Rehabilitation. The LDL Apheresis Cardiology Program continues to serve patients from Connecticut and Western Massachusetts. In FY17, there were 42 LDL apheresis procedures performed. There were 12,092 Cardiac Rehabilitation visits at all sites and the cholesterol management/sports cardiology program had 609 patient visits.Cardiac Intensive Care Unit:The Cardiac Intensive Care Unit (CICU) at Hartford Hospital is a 12-bed, open unit that provides care to patients presenting with acute coronary syndromes, advanced heart failure, advanced atrioventricular block, and cardiac arrest survivors. Our post-resuscitation hypothermia program has helped hundreds of patients improve their neurologic outcome after cardiac arrest. We are one of the largest intravascular hypothermia programs in the region. The Department has a total of 32 Registered Nurses and 10 full time Advanced Nurse Practitioners. The CICU is also one of the major teaching sites for the University of Connecticut Internal Medicine residency. 101599610 115362967 The Hartford HealthCare Cancer Institute is the charter member of the Memorial Sloan Kettering Cancer Alliance (MSK), the country's premier cancer center. What this means to patients: The Hartford HealthCare Cancer Institute's treatment standards are now aligned with MSK's. Patients have access to MSK's world-renowned clinical research trials and protocols. More than 50,000 patient visits are made annually to Hartford HealthCare Cancer Institute's Hartford campus. Helen and Harry Gray helped establish the Hartford Hospital cancer center through their generous philanthropy and continue to support its growth.Hartford HealthCare Cancer Institutes & Clinics:InstitutesThe Hartford HealthCare Cancer Institute at Hartford Hospital is a nationally-recognized center for the treatment of patients with cancer, and one of the largest of its kind in the Northeast United States. Located on the hospital campus is Bliss 5 (B5), a 26-bed acute medical oncology in-patient unit providing an intra-disciplinary team approach to oncology care for adults. The unit experiences a wide variety of cancer diagnoses including solid tumors to malignant and premalignant hematological disorders. Also, located in Avon, CT, is a beautiful and easy-to-reach facility that provides convenient access to residents of the Farmington Valley, Litchfield County and surrounding regions. Digital Mobile MammographyThrough Hartford Hospital's digital mobile mammography program, called "Take the Time", women who live in the Greater Hartford area have improved access to breast cancer screenings.Conditions & Treatments Cancer ImagingWe provide innovative treatment with the latest technology, including 3-D conformal radiation therapy, intensity modulated radiation therapy, high dose rate brachytherapy, stereotactic radiation therapy and radiosurgery.Clinical Interventional OncologyWe perform procedures offering minimally invasive, targeted treatment of cancer using image guidance to treat tumors and minimize possible injury to other body organs. Often used for patients whose cancer cannot be surgically removed or effectively treated with systemic chemotherapy.GynecologicalWe offer genetic counseling and testing for individuals at risk for specific hereditary cancers including breast, ovarian and colon cancer.Medical Oncology Medical oncologists are key players in the treatment of cancer patients with an array of modalities, from chemotherapy to targeted molecular therapies and other treatments through clinical research protocols.Pain & Symptom ControlWe offer support and care for hospitalized and ambulatory cancer patients with acute, chronic and other cancer pain issues. Our goal is to decrease the level of pain to restore a normal quality of life.PathologyOur facilities offer patients conventional and specialized pathology techniques to diagnose and stage cancerous tumors and support clinical research. Immunopathology and molecular laboratories with expertise in cytologic and histologic tissue review. Psycho-OncologyImproving quality of life, appreciating the intimate relationship between disease process and the existential nature of illness and providing care with dignity, integrity and compassion is provided to our patients by this department.Radiation OncologyWe offer optimal individually-tailored treatment plans for each patient designed by Radiation Oncology physicians and a multidisciplinary team of physicists, dosimetrists, engineers, radiation therapists, nurses, social workers and dietitians.Surgical OncologyWe offer a comprehensive multi-disciplinary surgical treatment for patients with cancer. Surgical sub-specialists provide state-of-the-art cancer care in conjunction with medical and radiation oncologists and other members of the oncology team.Hartford HealthCare Cancer Institute Departments & Services:Breast CancerOur Breast Cancer Program offers the best breast cancer treatments available nationwide and access to the very latest in breast cancer research - all within a supportive community hospital setting.Clinical ResearchThe nurses and clinical research associates of our Cancer Center Clinical Research Office are matched one-on-one with patients as Clinical Trial Navigators.GI CancerHartford Hospital is a leader in the care of digestive system cancers. A variety of specialists meet each week to tackle challenging patient issues.GU CancerPatients with urologic cancers (bladder, kidney, prostate or testicular cancer) find the most advanced surgical procedures and the latest medical treatments at Hartford Hospital's Genitourinary Cancer Program.Gynecologic CancerOur specialists in gynecologic cancers take a comprehensive approach to treating patients and keeping following generations healthy.Head & Neck CancerHartford Hospital's Head & Neck Cancer Program offers the most advanced treatment options for head and neck cancers.Hematologic CancerHartford Hospital offers patients leading-edge research and nationally-recognized hematopatholgy expertise.Melanoma & Skin CancerHartford Hospital's Melanoma & Skin Cancer Program brings together experts across many disciplines to treat both early and advanced melanoma and skin cancers.Neuro-OncologyHartford Hospital is one of the few in New England treating spinal cord tumors and brain tumors with leading edge technologies like stereotactic radiosurgery.Thoracic & Lung CancerThe Helen & Harry Gray Cancer Center is leading the Connecticut and Western Massachusetts region in advancing research, screening and treatment for lung cancer.Triology Stereotactic SystemThe Trilogy Stereotactic System from Varian Medical Systems at the Helen & Harry Gray Cancer Center is the first of its kind in Connecticut. Trilogy's "dynamic targeting" assures accurate beam positioning, while built-in CT diagnostic imaging pinpoints tumors with digital accuracy and positions them in the high-dose area despite any internal organ movement. 87536880 70531343 The Institute of Living (Hartford Hospital's Department of Psychiatry) is referred to as the IOL. The IOL strives to address enormous behavioral healthcare needs through the variety of clinical programs and services it provides. These programs includes research aimed at better understanding and treating mental illness through education of the community and through training programs aimed at producing the next generation of behavioral health clinicians.Total discharges for the year were 3,784. The number of adult day treatments was 7,824. The IOL treated 1,875 patients for Eating Disorder and 4,958 for Schizophrenia rehabilitation. A total of 1,171 patients received Geriatric day treatment, 3,634 received Professional Day Treatment, 2,052 received Extended Day Treatment, 6,466 received Child/Adolescent day treatment and 2,441 went through the Dialectical Behavioral Therapy (DBT) program. The average length of stay was 10 days, and the average daily census was 103.7. Hartford residents accounted for 48% of admissions and 50% of admissions were from other areas within the state; 2% were from other states.Patient care activities and program developments were guided by the IOL's internal goals for FY17. Highlights included a focus on continued growth in the Young Adult and Child and Adolescent Programs, growth and development of an outpatient Peripartum Mood Disorders Program and continued expansion of other initiatives. The IOL strives constantly to excel in clinical care, training and research and to address major mental health issues that afflict our community. Increasingly we are engaging as system partners within HHC's Behavioral Health Network (BHN). Together with our BHN partners, we are addressing the opioid addiction epidemic with the establishment of medication assisted treatment programs across our region. Through the Zero Suicide initiative, we are dramatically enhancing our approach to suicide prevention throughout the Behavioral Health Network. Recognizing the need to increase access and improve the quality of primary care, we are continuing to move clinicians into practices working alongside their primary care colleagues.The Institute of Living's Executive Quality Management Committee continues to oversee quality initiatives and activities. The committee collects and analyzes data to assess quality and safety outcomes of patient care. Results of performance indicators are reported semi-annually to the Hartford Hospital Quality Council and the Behavioral Health Network Quality Council. The IOL remains distinctive for its focus on training the mental health workforce of the future with three psychiatric residency programs, Psychology Internships and Post-Doctoral Programs and Training and Education Programs for virtually all other mental health specialists. The Department's translational research centers have generated over $80M in research funding over the past 16 years, supporting publications in the leading journals and presentation around the world. 771323460 670565 902548860 Hartford Hospital, founded in 1854, is one of the largest teaching hospitals and tertiary care centers in New England with perhaps the region's busiest surgery practice and has been training physicians for over 160 years. It is a member of Hartford HealthCare Corporation, a large, diversified health care system.The hospital is a regional referral center that provides high-quality care in all clinical disciplines. Among its divisions is The Institute of Living, a 114-bed mental health facility with a national and international reputation of excellence. Jefferson House, a 104-bed long-term care facility, is also part of Hartford Hospital. The hospital's active medical staff includes more than 1,000 physicians and dentists within 18 departments. It is an 867-bed hospital occupying a 65-acre campus in downtown Hartford and operating satellite facilities in Avon, Enfield, Glastonbury, Newington, West Hartford, Wethersfield, Windsor and South Windsor.In addition to above, the hospital provides services/programs including but not limited to the following:BariatricsBehavioral & Mental HealthBone & Joint InstituteCancer CareCardiology & Heart CareCedar Mountain CommonsCenter for Musculoskeletal HealthCritical CareCystic Fibrosis CenterDentalDiabetesEmergency ServicesEye CareEye SurgeryGastroenterologyHeadache CenterHearing & BalanceHerniasImaging ServicesIntegrative MedicineJefferson HouseLIFE STARLiver & HepatologyLung & PulmonaryMedical Weight LossMinimally Invasive SurgeryMovement Disorders CenterNeurosciencesPalliative CarePain TreatmentPediatricsPhysical RehabilitationPrimary Care & Family MedicineRobotic SurgerySenior ServicesSleep DisordersSpine CareStrokeSurgical Weight LossThoracic SurgeryTransplant ServicesTraumatologyUrology & KidneyVascularWomen's Health ServicesWound CareWeight Loss 771323460 670565 902548860 1178583456 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 1 0 0 0 1 0 1 1 1 1 1 0 0 0 0 0 1 0 1 1 0 0 0 0 1 1 1 0 0 1 565 0 1 7895 1 1 1 0 0 0 0 1 1 0 0 0 0 X 14 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 NH CT X Carol Wardell 8606966200 80 Seymour Street Hartford CT 061025037 Arnold Chase Director 2.00 X 0 0 0 Dariush Owlia MD Director 2.00 X 0 0 0 E Carol Polifroni Director 2.00 X 0 0 0 Eric Zachs Director 2.00 X 0 0 0 Alexia Cruz Director 2.00 X 0 0 0 Magdelena Rodriguez Director 2.00 X 0 0 0 Westley Thompson Director 2.00 X 0 0 0 James Loree Director 2.00 X 0 0 0 Matthew Saidel MD Director 2.00 X 100000 0 0 David Zwiener Director (Thru June 2017) 2.00 X 0 0 0 Stacy Nerenstone MD Director 2.00 X 0 0 0 Jeffry Nestler MD Director (Thru June 2017) 2.00 X 0 0 0 Yvette Melendez Director 60.00 X 203035 0 20052 Douglas Elliot Chair 3.00 X X 0 0 0 David McHale Vice Chair 3.00 X X 0 0 0 Stuart Markowitz MD President (Thru Sept 2017) 50.00 10.00 X X 0 802711 131045 Margaret Marchak Secretary & SVP/CLO, HHC 20.00 40.00 X 0 676177 131333 Gerald Boisvert SVP, Financial Operations 10.00 50.00 X 0 613557 111609 John Greene MD VP 0.00 60.00 X 0 660969 66715 Cheryl Ficara VP 0.00 60.00 X 0 434744 69236 Peter Fraser VP 0.00 60.00 X 0 398405 65470 Harold Schwartz MD VP 30.00 30.00 X 0 626947 78920 Barry Kriesberg VP 0.00 60.00 X 0 326010 47097 Carol Garlick VP 60.00 X 250877 0 47207 Orlando Kirton MD Dir. Surgery 60.00 X 949760 0 30859 Andrew Salner MD Chair Cancer Institute 60.00 X 599371 0 42380 Ajay Kumar MD Dir. Medicine 60.00 X 500515 0 64561 Kenneth Robinson MD Chair Emergency Medicine 60.00 X 493297 0 75598 Fred Tilden Jr MD Dir. ER Physician 60.00 X 424317 0 65254 Tracy Church Former - VP 0.00 60.00 X 0 898904 51653 Rocco Orlando Former - SVP 0.00 60.00 X 0 936263 74228 Richard Stys Former - VP 0.00 60.00 X 0 688074 48741 3521172 7062761 1221958 957 1 1 0 Gilbane Building Company 208A New London Turnpike Glastonbury CT 06033 Construction 56978715 University of CT Health Center 263 Farmington Avenue Farmington CT 06030 Medical Services 29069517 FIP Construction Inc 1536 New Britain Avenue Farmington CT 06032 Construction 19836193 Starling Physicians PC 1260 Silas Deane Highway Suite 102 Wethersfield CT 06109 Medical Services 6466255 Morrison Management SP Inc Acute Care 400 Northbridge Road Sandy Springs GA 30350 Food Services 6183939 140 46600 1477806 1152854 12470138 20986352 9579408 36133750 Net Patient Revenue 624100 1286585374 1286585374 Pharmacy 541700 27834894 27631689 203205 Ref. Testing / Lab 621500 836746 623725 213021 Inc. From Inv - Other 900003 -1032724 -1031427 -1297 1314224290 15300151 15300151 3646626 3829210 -182584 -182584 -182584 17691121 0 17691121 17691121 17691121 244652 1477806 667080 -422428 -422428 Cafeteria Income 722210 2994692 2994692 2994692 1385738992 1313809361 414929 35380952 611065 611065 59500 59500 257977 257977 459703742 434254427 24415042 1034273 28620988 28540578 16053 64357 48678822 48542061 27302 109459 31427244 31328387 19735 79122 55018 55018 69746 69746 1759081 1759081 82102979 82102979 231511 231511 17326481 14052058 3113835 160588 69537557 41814196 27723361 32085441 30080886 2004442 113 897346 865242 31273 831 902791 889596 13195 11557223 10634221 923002 98812633 70613620 28199013 49407259 42355240 7048066 3953 13843269 13843269 Medical Supplies 219767394 219767394 Hosp Provider/User Tax 64898783 64898783 Purchased Services 37408917 22812234 14474162 122521 Equipment & Ppty Maint 16273246 15289783 941837 41626 14409295 3468856 10920776 19663 1300705308 1178583456 120485346 1636506 27882914 46252635 389712 5250 8122824 8117414 165657106 159632654 17610739 25963735 8024071 9874631 1438798233 918972841 465129128 519825392 1119344 684172 692676241 790567930 763088 0 26288117 26396451 131352490 74171631 1545015774 1661491895 106466264 89092524 15043968 16383883 21937 9115790 867150025 775041345 988682194 889633542 X 180150912 335043921 152538908 178851034 223643760 257963398 556333580 771858353 1545015774 1661491895 X 85033684 78519937 51971153 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 0 0 0 0 0 1 69746 0 0 69746 0 Part II-B, Line 1: Hartford Hospital paid annual dues to Connecticut Hospital Association (CHA). CHA conducts lobbying activities on behalf of its members. CHA allocates a portion of their dues as lobbying expenses. The portion of dues allocated as lobbying expenses is calculated under current Medicare rules. CHA conducts lobbying activities under current Medicare rules. The Organization occasionally asks its employees to volunteer their time to contact state legislators in an effort to lobby on its behalf. The total amount of dues allocated for lobbying expenses for FY17 was $69,746. 0 168693523 9641000 21353000 4938000 194749523 159801523 635000 12775000 4518000 168693523 138546174 27936085 -2385301 4295435 159801523 131895671 1462396 8092554 2904447 138546174 119653630 4719250 11002959 3480169 131895671 0.50000 0.50000 0 1 1 29590384 29590384 790430071 478376712 312053359 618777778 440596129 178181649 519825392 Investment in Joint Ventures 2878898 F Investment in Endowment 627020840 F Funds Held in Trust 160592420 F Other Securities 75772 F 790567930 Accrued Post Retirement Expenses 11778137 Accrued Asbestos Costs 164329 Other Net Liabilities 84587121 Payable to HHC - Interco Bonds 405075391 Hospital Provider Tax 5825535 Accrued Post Retirement Expenses 216802083 Current Accrued Malpractice 11400548 Long Term Accrued Malpractice 35251540 Due from Affiliates 4156661 775041345 Part V, Line 4: The Hospital has adopted investment and spending policies for endowment assets that attempt to provide a predictable stream of funding to mission related programs such as those described in Part III, lines 4a-d while seeking to maintain purchasing power of the endowment assets. Endowment assets include those assets of donor-restricted funds that the Hospital must hold in perpetuity or for a donor-specific period(s). Under this policy, the endowment assets are invested in a manner that is intended to produce a real return, net of inflation and investment management costs, of at least 4% over the long term. Actual returns in any given year may vary from this amount. The Hospital's endowment consists of hundreds of individual funds established for a variety of purposes including but not limited to patient care, research and capital needs. Net assets associated with endowment funds are classified and reported based on the existence or absence of donor-imposed restrictions. East Asia and the Pacific 0 0 Program Service Research Activities 178172 Middle East and North Africa 0 0 Program Service Research Activities 50770 Europe 0 0 Program Service Research Activities 11345 North America 0 0 Program Service Insurance 13311 0 0 0 0 0 0 253598 0 253598 0 0 0 0 0 0 Sch F, Part 1, Line 3, Column F The transactions shown on Part I of Sch F are being reported on a cash basis. Black & Red Ball 1651293 1409643 241650 30076 222666 233861 124480 Spring Into Action 31385 28383 3002 5932 1 39780 39780 50065 1722458 1477806 244652 30076 228598 233861 174545 667080 -422428 1 1 X 1 X 250.000000000000 1 X 1 1 1 0 1 1 9420620 0 9420620 0.00720 231689359 170669236 61020123 0.04690 241109979 170669236 70440743 0.05410 2991309 1026660 1964649 0.00150 55107509 15167762 39939747 0.03070 8835249 5024997 3810252 0.00290 6524666 4676651 1848015 0.00140 23528648 15063984 8464664 0.00650 96987381 40960054 56027327 0.04300 338097360 211629290 126468070 0.09710 2629 0 2629 0.00000 2629 2629 0.00000 0 12487000 0 279730496 276768953 2961543 X 1 1 1 1 Hartford Hospital 80 Seymour Street Hartford CT 06102 hartfordhospital.org 0046 X X X X X Hartford Hospital 1 0 0 1 X X X X X X X X X 14 1 0 0 1 X See Part V X X 1 15 0 1 0 1 X 250.000000000000 400.000000000000 X X X X 1 1 X X X X X 1 X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X X X 1 X 0 X X X X 1 X 0 0 Hartford Hospital Part V, Section B, Line 5: To solicit input from key informants and individuals who have a broad interest in the health of the community, an Online Key Informant Survey was also implemented as part of this process. This survey was conducted from 12/1/2014 through 12/21/2014. These individuals included physicians, public health representatives, health professionals, social service providers and a variety of other community leaders including the following: CEO-Capital Workforce PartnersCEO-Community Health ServicesCEO-Community Renewal TeamCEO-CT Association of Human ServicesLocal Health Director-East Hartford Health DepartmentExecutive Director-Hartford Food SystemInterim Local Health Director-Hartford Health DepartmentCEO-Hartford Public LibraryCEO-Hispanic Health CouncilExecutive Director-Hockanum Valley Community CouncilLocal Health Director-Manchester Health DepartmentVice President-Metro Hartford AllianceCEO-United Way of Central & Northeastern CTCEO-Urban League of Greater HartfordLocal Health Dept. Director-Windsor Health DepartmentDirector-Windsor Social Services DepartmentVice President-United Way of CTChief Medical Directors-Hartford HospitalLocal Health Director-Farmington Valley Health DistrictExecutive Director-Southside Institutions Neighborhood Alliance (SINA)Vice President-Hartford Foundation for Public GivingSocial Service Organization-Greater Hartford Legal AidVice President-Saint Francis Hospital & Medical CenterCEO-Billings Forge Community WorksDirector Community Relations-Connecticut Children's Medical CenterExecutive Director-Hartford Gay & Lesbian CollectiveCEO-Intercommunity, Inc.Executive Director-CT Association of Directors of Health Social Service Organization-Reach CoalitionLocal Health Director-Central Connecticut Health DistrictSr. Vice President-Capital Region Education CouncilCEO-Charter Oak Health CenterExecutive Director-Faithcare, Inc.Social Service Organization-Legal Assistance Resource Center of CTCEO-Jewish FederationCEO-The Village for Families & ChildrenVice President-Connecticut Health FoundationLocal Health Director-North Central Health Regional Mental Health Board Director-North Hartford Promise ZoneCEO-Hartford Public SchoolsDirector-Department of Public Health, West Hartford/BloomfieldLocal Health Director-Department of Public Health, GlastonburyThrough this process, input was gathered from several individuals whose organizations work with low-income, minority populations (including African-Americans, American Indians, Asians, Bosnians, Eastern Europeans, ex-offenders, Hispanics, lesbian/gay/bisexual/transgender individuals, low-income residents, Middle Eastern peoples, mixed race individuals, multiple religion families, non-English speaking persons, refugee immigrants, undocumented immigrants, uninsured/underinsured persons, West Indian residents, women), or other medically underserved populations (including those with access and functional needs, African-Americans, Asians, children, deaf/hard of hearing persons, disabled individuals, the elderly, Hispanics, homeless persons, immigrants, lesbian/gays/bisexual/ transgender individuals, low-income residents, Medicaid/Medicare recipients, mentally ill persons, Native Americans, non-English speaking persons, people in rural areas, racial/ethnic minorities, single parents, those with substance abuse issues, undocumented immigrants, uninsured/ underinsured residents, veterans, young adults).Participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the overall community. Key informants were contacted by email, introducing the purpose of the survey and providing a link to take the survey online. Key informants were asked to rate the degrees to which various health issues were a problem in the Hartford Region. Follow-up questions asked them to describe why they identified areas as such, and how these might be better addressed. After reviewing the Community Health Needs Assessment findings, the community representatives met on June 10, 2015 to determine the health needs to be prioritized for action. During a detailed presentation of the CHNA findings, the hospital used audience response system (ARS) technologies to lead steering committee members through a process of understanding key local data findings (Area of Opportunity) and ranking identified health issues against the following established, uniform criteria: Magnitude, Impact/Seriousness/Feasibility, Consequences of Inaction. From this exercise, the areas of opportunity were prioritized as follows by the committee: Mental Health, Nutrition, Physical Activity & Weight Status, Diabetes, Substance Abuse, Cancer, Heart Disease and Stroke.Part V, Section B, Line 7ahttps://hartfordhospital.org/about-hh/community-outreach/community-health-needs-assessment Hartford Hospital Part V, Section B, Line 7d: The needs assessment was published in July 2015 and is available on the hospital's website. In addition, electronic copies are available upon request. Hartford Hospital Part V, Section B, Line 11: In acknowledging the wide range of priority health issues that emerged from the CHNA process, Hartford Hospital determined that it could only effectively focus on those which it deemed most pressing, most under-addressed, and most within its ability to influence: * Nutrition, Physical Activity & Weight* Diabetes* Mental Health* Heart Disease & Stroke* Cancer* Injury and ViolenceHartford Hospital continues to implement initiatives that will respond to these identified needs. Additional needs identified as "Areas of Opportunities" were not deemed as significant needs and did not rank highly enough to earn a prioritized ranking. However, in some areas such as Injury and Prevention and Dementia, major initiatives are never the less underway at Hartford Hospital. Areas of Opportunities identified but not prioritized:* Chronic Kidney Disease* Dementia, including Alzheimer's Disease* HIV/AIDS* Infant Health and Family Planning Health Needs Not Currently Prioritized:Chronic Kidney Disease:Hartford Hospital through its various departments and specialty designation as a Level 1 Trauma Center and acute care hospital treats many individuals with chronic kidney disease. We are one of two regional hospitals serving as a major transplant provider. We believe we are appropriately responding to this identified need. HIV/Aids:Hartford Hospital already responds to the needs of the community for those infected with HIV/Aids. We are responding to the needs of the underserved in the community and providing services through our Brownstone Clinic. Dementia/Alzheimer's Disease:Hartford Hospital does address this area of need through our identified gerontology services. Various strategies noted in our plan address cognitive wellness and are being addressed through our primary care efforts, including the underserved population. We believe that this approach is responding to the identified need. Infant Health & Family Planning:Family Planning is addressed through our Women's Health Center with particular focus on the underserved. Harford Hospital does not provide pediatric services. The Connecticut Children's Medical Center is on our campus and is solely dedicated to pediatric care. Hartford Hospital Part V, Section B, Line 13h: Family eligibility criteria for Financial Assistance also include family size, employment status, financial obligations, and amount and frequency of health care expenses. Hartford Hospital Part V, Section B, Line 15e: In addition, patients may ask a nurse, physician, chaplain, or staff member from Patient Registration, Patient Financial Services, Case Coordination, or Social Services about initiating the Financial Assistance Application process.Part V, Line 16a, FAP website:https://hartfordhospital.org/patients-and-visitors/for-patients/billing-insurance/financial-assistancePart V, Line 16b, FAP Application website:https://hartfordhospital.org/patients-and-visitors/for-patients/billing-insurance/financial-assistancePart V, Line 16c, FAP Plain Language Summary website:https://hartfordhospital.org/patients-and-visitors/for-patients/billing-insurance/financial-assistance Hartford Hospital Part V, Section B, Line 16j: Patients are informed directly by staff of the availability of the Financial Assistance Policy. 37 1 - Eye Center - Newington 505 Willard Avenue Newington CT 06111 Eye Center 2 - West Hartford Surgery Center 65 Memorial Road Suite 500 West Hartford CT 06107 General Cardiology, Integrative Medicine 3 - Hartford Hospital Wellness Center 65 Memorial Road West Hartford CT 06107 Wellness Center 4 - The Sleep Center 1260 Silas Dean Hwy Wethersfield CT 06109 Sleep Lab 5 - Helen & Harry Gray Cancer Center 80 Fisher Drive Avon CT 06001 Cancer Center 6 - Hartford Hospital Rehab Network 1025 Silas Deane Highway Wethersfield CT 06109 Rehabilitation Department 7 - Hartford Hospital Rehab Network 85 Seymour Street Suite 604 Hartford CT 06106 Rehabilitation Department 8 - Hartford Hospital Rehab Network 100 Hazard Avenue Enfield CT 06082 Rehabilitation Department 9 - Hartford Hospital Rehab Network 1064 East Main Street Meriden CT 06450 Rehabilitation Department 10 - Hartford Hospital Rehab Network 1559 Sullivan Avenue South Windsor CT 06074 Rehabilitation Department 11 - Hartford Hospital Sleep Lab 533 Cottage Grove Road Bloomfield CT 06002 Sleep Lab 12 - Hartford Hospital Rehab Network 330 Western Boulevard Glastonbury CT 06033 Rehabilitation Department 13 - Hartford Hospital Rehab Network 334 North Main Street West Hartford CT 06117 Rehabilitation Department 14 - Hartford Hospital Rehab Network 445 South Main Street West Hartford CT 06110 Rehabilitation Department 15 - Hartford Hospital Rehab Network 65 Memorial Road West Hartford CT 06107 Rehabilitation Department 16 - Avon Family Wellness Center 339 West Main Street Avon CT 06001 Wellness Center 17 - Hartford Hospital Rehab Network 1060 Day Hill Road Windsor CT 06095 Rehabilitation Department 18 - Hartford Hospital Rehab Network 100 Simsbury Road Avon CT 06001 Rehabilitation Department 19 - Enfield Family Wellness Center 100 Hazard Avenue Enfield CT 06082 Wellness Center 20 - Hartford Hospital Rehab Network 230 North Main Street Manchester CT 06042 Rehabilitation Department 21 - South Windsor Family Wellness Center 1559 Sullivan Avenue South Windsor CT 06074 Wellness Center 22 - Hartford Hospital Rehab Network 406 Farmington Avenue 2nd Floor Farmington CT 06030 Rehabilitation Department 23 - Hartford Hospital Rehab Network 85 Barnes Road Suite 300 Wallingford CT 06492 Rehabilitation Department 24 - Hartford Hospital Rehab Network 18 East Granby Road Granby CT 06035 Rehabilitation Department 25 - Family Health Center 35 Talcottville Road Vernon CT 06066 Wellness Center 26 - Hartford Hospital Rehab Network 35 Talcottville Road Vernon CT 06066 Rehabilitation Department 27 - Farmington Cardiac Rehabilitation 11 South Road Suite 260 Farmington CT 06032 Cardiac Rehabilitation Program 28 - Glastonbury Endoscopy Center LLC 300 Western Boulevard Glastonbury CT 06033 Endoscopy Center, Education Center 29 - Glastonbury Surgery Center 195 Eastern Boulevard Glastonbury CT 06033 Surgery Center 30 - Hart Hosp Healthcare - Glastonbury 330 Western Boulevard Glastonbury CT 06033 Rehabilitation, Wellness Center 31 - Hart Hosp Healthcare - Glastonbury 704 Hebron Avenue Glastonbury CT 06033 Wellness Center 32 - Hartford Hospital Rehab Network 2 Northwestern Drive Bloomfield CT 06002 Rehabilitation Department 33 - Hart Hosp Healthcare - Wethersfield 1260 Silas Dean Hwy Wethersfield CT 06109 Education Center 34 - Glastonbury Wellness Center 628 Hebron Avenue Glastonbury CT 06033 Wellness Center 35 - Hartford Hosp Healthcare - Windsor 1060 Day Hill Road Windsor CT 06095 Education Center 36 - Avon Healthcare Center 100 Simsbury Road Avon CT 06001 Nuclear Cardiology, Education Center 37 - Hartford Hospital Rehab Network 335 Westbourne Parkway Hartford CT 06112 Rehabilitation Department Part I, Line 3c: Hartford Hospital used Federal Poverty Guidelines to determine eligibility. In addition, the hospital takes into consideration, medical indigency, insurance status, underinsurance status and other family eligibility criteria such as family size, employment and financial obligations.Part I, Line 6a:The Organization submits quarterly reports to Connecticut Hospital Association and Form 990 is submitted to the Connecticut Office of Health Care Access (OHCA) annually. Part I, Line 7: The organization utilized an overall cost to charge ratio, (RCC), developed from the Medicare Cost Report. Total expense was adjusted for: medicaid provider taxes, directly identified community benefit expense and community building expenses. This cost to charge ratio was used to calculate costs for Part I lines 7a, b, & g. The costs associated with the activities reported on Part I, Line 7e were captured using actual time multiplied by an average salary rate. The costs associated with Line 7h, were the actual costs reported in the organization's general ledger less any industry funded studies. These costs were removed from the calculations above to avoid duplication. Costs reported in Part III, Section B6, were calculated from the Medicare cost report and reduced for Medicare costs previously reported on Part I Lines 7f and g. Part I, Line 7g: No physician clinic costs were included in the Subsidized Health Services cost calculations. Part II, Community Building Activities: Hartford Hospital (HH) interacts with the community to address needs and facilitate appropriate responses. For FY17, HH expended $2,629 on community building activities. Part III, Line 3: A pre-bad debt financial assistance screening is in place to identify patients that may be eligible for financial assistance. Pre-bad debt accounts that are identified as meeting the requirements are adjusted prior to being sent to bad debt. Therefore, any bad debt expense that could have been attributable to charity care at the end of FY 2017 would be immaterial. Part III, Line 4: Please see the text of the footnote that describes bad debt expense beginning on page 22 of the Audited Financial Statement. The Footnote is also applicable Part III,Line 2. Part III, Line 8: The organization's Medicare Cost Report was used to accumulate actual costs related to Part III, Section B, Line 6. Part III, Line 9b: The Financial Assistance Policy states: In the event a patient fails to qualify for Financial Assistance or fails to pay their portion of discounted charges pursuant to this Policy, and the patient does not pay timely their obligations to Hartford Hospital, the Hospital reserves the right to begin collection actions, including but not limited to, imposing wage garnishments or liens on primary residences, instituting legal action and reporting the matter to one or more credit rating agencies. For those patients that qualify for Financial Assistance and who are cooperating in good faith to resolve the Hospital's outstanding accounts, the Hospital may offer extended payment plans to eligible patients, will not impose wage garnishments or liens on primary residences, will not send unpaid bills to outside collection agencies and will cease all collection efforts. No Extraordinary Collection Actions (ECA) will be initiated during the first 120 days following the first post-discharge billing statement to a valid address or during the time that patient's Financial Assistance Application is processing. Before initiating any ECA, a notice will be provided to the patient 30 days prior to initiating such event.If the patient applies for assistance within 240 days from the first notification of the self-pay balance, and is granted assistance, any ECA's such as negative reporting to a credit bureau or liens that have been filed will be removed. Part VI, Line 2: Hartford Hospital uses Emergency Room data to track increases in medical conditions such as falls, flu, drug overdoses, etc. and the same approach is taken in our outpatient clinics. Periodically information is surveyed to determine additional patients needs. Information is also tracked from other entities such as local area non-profits, government agencies and public schools. Part VI, Line 3: Hartford Hospital provides information about its Financial Assistance Policy as follows: (i) provide signs regarding this Policy and written plain language summary information describing the Policy along with Financial Assistance contact information in the Emergency Department, Labor and Delivery areas and other patient registration areas; (ii) provide to each patient written plain language summary information describing the Policy along with Financial Assistance contact information in admission, patient registration, discharge, billing and collection written communications; (iii) make paper copies of the Policy, financial assistance application, and plain language summary of the Policy available upon request and without charge, both by mail and in public locations in the hospital facility, including the emergency room (if any) and admissions areas; (iv) post the Policy, plain language summary and financial assistance application on the website with clear linkage to such documents on the HH's home page; (v) educate all admission and registration personnel regarding the Policy so that they can serve as an informational resource to patients regarding the Policy; and (vi) include the tag line "Please ask about our Financial Assistance Policy" in HH written publications. Part VI, Line 4: Hartford Hospital is located in the capital of the State of Connecticut. The Hartford Region encompasses 734.9 square miles and houses a total population of approximately 1,064,363 residents. According to latest census estimates, Hartford County is predominantly urban, with 94.6% of the population living in areas designated as urban. In Hartford County, 22.7% of the population are infants, children or adolescents (age 0-17); another 62.6% are age 18 to 64, while 14.6% are age 65 and older. In looking at race independent of ethnicity (Hispanic or Latino origin), approximately 65% of residents of Hartford County are White, 13% are Black, just over 15% of Hartford County residents are Hispanic or Latino and 4% are Asian.The latest census estimate shows 12% of the Hartford County population living below the federal poverty level. In all, 24.5% of Hartford County residents (an estimated 212,802 individuals) live below 200% of the federal poverty level. Additionally, 15.8% of Hartford County children age 0-17 live below the 200% poverty threshold. Among the Hartford County population age 25 and older, 12.3% do not have a high school education. There is one other acute care hospital in Hartford, as well as one in a suburb and two smaller acute care hospitals in nearby towns. Part VI, Line 5: The majority of Hartford Hospital's governing board is comprised of persons who either reside or work in its primary service area, and they are neither employees nor contractors of the Hospital.Hartford Hospital extends medical staff privileges to all qualified physicians in its community. The Hospital has partnered with the City of Hartford Department of Health and Human Services and the Hispanic Health Center to provide health services to the underserved in the community. In addition, the Hospital participates in research projects with the Hispanic Health Council to improve community health and well-being.The Hospital has contracted to use the services of an organization to assist its patients in determining eligibility and applying for state and federal means-tested programs, as well as for the Hospital's Financial Assistance Program.As a tertiary health center, teaching hospital and Level 1 Trauma Center, Hartford Hospital provides specialized services not available at most other hospitals. These services are provided regardless of a patient's ability to pay. The hospital uses its surplus funds to provide additional benefits to its patients and the community it serves as detailed in Schedule O. Part VI, Line 6: Hartford HealthCare Corporation (HHC) is organized as a support organization to govern, manage and provide support services to its affiliates. HHC, through its affiliates including Hartford Hospital, strives to improve health using the "Triple Aim" model: improving quality and experience of care; improving health of the population (population health) and reducing costs. HHC and its affiliates including all supported organizations, develop and implement programs to improve the future of health care in our Southern New England region. This includes initiatives to improve the quality and accessibility of health care; create efficiency on both our internal operations and the utilization of health care; and provide patients with the most technically advanced and compassionate coordinated care. In addition, HHC continues to take important steps toward achieving its vision of being "nationally respected for excellence in patient care and most trusted for personalized, coordinated care".The affiliation with HHC creates a strong, integrated health care delivery system with a full continuum of care across a broader geographic area. This allows small communities easy and expedient access to the more extensive and specialized services the larger hospitals are able to offer. This includes continuing education of health care professionals at all the affiliated institutions through the Center of Education, Simulation and Innovation located at Hartford Hospital.The affiliation further enhances the affiliates' abilities to support their missions, identity, and respective community roles. This is achieved through integrated planning and communication to meet the changing needs of the region. This includes responsible decision making and appropriate sharing of services, resources and technologies, as well as cost containment strategies. Part VI, Line 7, Reports Filed With States CT 1 Free to Breathe 1 Point Place Suite 200 Madison WI 53719 450505050 501(c)(3) 5000 FMV Free to Breathe merged with The Lung Cancer Research Foundation on 09/30/2017. The Lung Cancer Research Foundation focus is supporting lung cancer research. Their mission is to improve lung cancer outcomes by funding research for the prevention, diagnosis, treatment and cure of lung cancer. Hartford Youth Scholars 129 Allen Place Hartford CT 06106 203495171 501(c)(3) 5000 FMV Hartford Youth Scholars (HYS) is committed to ensuring that deserving students from Hartford succeed in high school and college so they can achieve even more in the neighborhoods they return to in the years that follow. HYS prepares highly motivated middle school students for a rigorous high school education; assists them in gaining acceptance and financial assistance at top college preparatory schools; and supports them through the college application process, college experience, and beyond. Compass 55 Airport Road Suite 201 Hartford CT 06114 311768549 501(c)(3) 10000 FMV Community Benefit Grant was awarded to Compass who works to reengage youth in their school, family and community, help youth and their families navigate challenging social and economic obstacles, partners in promoting the safety, wellness and academic success of youth, inspires and empower youth to pursue and contribute to a brighter future. Connecticut Rivers Council Inc Boy Scouts of America 60 Darlin Street East Hartford CT 06108 060662110 501(c)(3) 12315 FMV The Connecticut Rivers Council is one of New England's largest private youth-serving organizations; the Connecticut Rivers Council delivers Scouting programs that develop character, citizenship, fitness, and leadership skills to more than 20,000 youth and nearly 7,000 adult volunteers in 127 cities and towns in Connecticut. The Boy Scouts of America collaborates with hundreds of churches, school affiliated groups and other community organizations that organize and operate local Scout groups. It is the mission of the Boy Scouts of America and the Connecticut Rivers Council to prepare young people to make ethical and moral choices over their lifetimes by instilling in them the values of the Scout oath and law. American Cancer Society 825 Brook Street Rocky Hill CT 06067 131788491 501(c)(3) 18750 FMV The American Cancer Society's mission is to save lives, celebrate lives, and lead the fight for a world without cancer. Their goal is to promote healthy lifestyles to help you prevent cancer, research cancer and its causes to find more answers and better treatments, fight for lifesaving policy changes and provide everything from emotional support to the latest cancer information for those who have been touched by cancer. TheaterWorks 233 Pearl Street Hartford CT 06103 061172413 501(c)(3) 25000 FMV TheaterWorks produces high quality, contemporary theater that is relevant to our audiences, engages a diverse community, and provides insight into the human experience. Connecticut Science Center 250 Columbus Boulevard Hartford CT 06103 061538101 501(c)(3) 35000 FMV The Connecticut Science Center is dedicated to inspiring lifelong learning through interactive and innovative experiences that explore our changing world through science.They strive to create an engaging and sustainable science center that serves families and schools and has a significant impact on student and adult learning in Connecticut. They seek to develop the minds of future thinkers and inventors who will compete in the ever-expanding global marketplace for technology and innovation. And they endeavor to create a Connecticut workforce that meets the projected growth of jobs in science-related fields. Hartford Promise 750 Main Street Suite 1108-1 Hartford CT 06103 810924703 501(c)(3) 500000 FMV Hartford Promise is a Large Scale College Scholarship Fund and College Success Program for Hartford Public School Students. Their goal is to provide Hartford students the financial resources, support services, and key relationships that lead to college success. Hockanum Valley Community Council Inc 29 Naek Road Suite 5A Vernon CT 06066 060864311 501(c)(3) 5000 FMV Sponsorship to assist in the organization's mission to provide food to the HVCC Food Pantry, Dial-A-Ride transportation services, senior services and mental health counseling to those whom may be suffering from emotional disorders. 9 0 Hazel Vail Awards 11 30500 Sons and Daughters Scholarship Awards 29 29000 Part I, Line 2: Upon issuing the grant, the hospital attaches a letter that restricts the use of the funds for a specific purpose. All of the grants are made to public charities to assist in funding their exempt programs. Therefore, extensive monitoring of the use of these funds by these entities is not warranted. Schedule I, Part III Once recipients are determined, the funds are sent directly to the institutions and not to individuals. Required qualifications The Sons and Daughters/Hazel Vail Scholarships are available to children of Hartford Hospital employees who meet eligibility requirements. The applicant must be financially dependent on the employee by being claimed on either parent's tax return. The applicant must be enrolled as a full-time student in an Accredited Undergraduate Program. The applicant must be the son or daughter (biological, adopted, stepchild, or legal ward) of a Hartford Hospital employee (full-time or part-time, budgeted to work at least 24 hours per week). The dependent of a Hartford Hospital employee who is also employed at Hartford Hospital is eligible to apply if they are budgeted to work less than 24 hours per week at Hartford Hospital. Applicant must have a verifiable GPA of 3.0 or higher to apply. Applicants are chosen on 1 criteria. 1. GPA (must be at least a 3.0 or higher to apply) X 0 1 1 1 0 0 0 0 0 1 0 Yvette Melendez Director 135957 0 0 0 67078 0 8778 0 11274 0 223087 0 0 0 Stuart Markowitz MD President (Thru Sept 2017) 0 549957 0 208864 0 43890 0 90196 0 40849 0 933756 0 0 Margaret Marchak Secretary & SVP/CLO, HHC 0 453679 0 186949 0 35549 0 90285 0 41048 0 807510 0 0 Gerald Boisvert SVP, Financial Operations 0 421729 0 162087 0 29741 0 74588 0 37021 0 725166 0 0 John Greene MD VP 0 475784 0 132165 0 53020 0 18550 0 48165 0 727684 0 0 Cheryl Ficara VP 0 328664 0 82536 0 23544 0 34450 0 34786 0 503980 0 0 Peter Fraser VP 0 307820 0 77249 0 13336 0 27244 0 38226 0 463875 0 0 Harold Schwartz MD VP 0 476878 0 117198 0 32871 0 34450 0 44470 0 705867 0 0 Barry Kriesberg VP 0 276365 0 45584 0 4061 0 18550 0 28547 0 373107 0 0 Carol Garlick VP 204537 0 44213 0 2127 0 30139 0 17068 0 298084 0 0 0 Orlando Kirton MD Dir. Surgery 342683 0 0 0 607077 0 13250 0 17609 0 980619 0 217549 0 Andrew Salner MD Chair Cancer Institute 574986 0 0 0 24385 0 18550 0 23830 0 641751 0 0 0 Ajay Kumar MD Dir. Medicine 449555 0 25000 0 25960 0 32348 0 32213 0 565076 0 0 0 Kenneth Robinson MD Chair Emergency Medicine 461636 0 9798 0 21863 0 45965 0 29633 0 568895 0 0 0 Fred Tilden Jr MD Dir. ER Physician 376896 0 36415 0 11006 0 35923 0 29331 0 489571 0 0 0 Tracy Church Former - VP 0 423528 0 174765 0 300611 0 18550 0 33103 0 950557 0 189038 Rocco Orlando Former - SVP 0 557951 0 210173 0 168139 0 34450 0 39778 0 1010491 0 0 Richard Stys Former - VP 0 432815 0 169095 0 86164 0 18550 0 30191 0 736815 0 0 Part I, Line 1b Tax indemnification and gross-up payments to individuals for benefits were included as taxable income on their 2016 Form W-2. Part I, Line 3 The Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare on behalf of Hartford Hospital, hires an outside consultant, Integrated Healthcare Strategies, a division of Gallagher Benefit Services, Inc., to determine best practices in governing executive compensation. Please refer to compensation narrative reported on Schedule O. Part I, Lines 4a-b In 2016, Orlando Kirton (Key Employee) received a lump sum severance payment in the amount of $351,158. In 2016, Yvette Melendez received a Severance payment in the amount of $63,157. Hartford Healthcare Corporation, a related organization, maintains a 457(f) Supplemental Executive Retirement Plan (SERP). Participants include certain officers and key employees at the President, Executive Vice President, Senior Vice President and Vice President levels that are reported by Hartford Hospital on its Form 990, Part VII. Contributions are made by Hartford HealthCare Corporation to the plan based on a percentage of the participant's compensation. Participants vest in the plan at the earlier of reaching age 55 and having 5 years of service, death, disability, involuntary separation without reasonable cause, upon reaching age 65 or the occurence of a change in control. Each participant ceases to be eligible for further contributions by Hartford HealthCare Corporation on the date of the participant's separation from service. Participants receive a one-time lump sum payment of the accumulated amount during the 30-day period following the participant's separation from service. 2016 SERP Accruals were made on behalf of the following individuals: Margaret Marchak $60,847 Richard Stys $56,672 Rocco Orlando $72,449 Stuart Markowitz $71,646 Tracy Church $272,183 2016 SERP Payouts were made on behalf of the following individuals: Orlando Kirton $217,549 Tracy Church $130,674* Richard Stys $23,423* Rocco Orlando $33,648* *For these individuals, vesting occurred, causing taxable income. A portion of the vested amount was used to pay the associated tax liability. The remaining balance was deposited into the employee SERP account. Part I, Line 7 Hartford HealthCare Corporation, a related organization, has a Compensation At Risk Plan that encourages and rewards achievements of significant functional goals. These goals contribute to the organization's strategic and financial direction. The plan utilizes market practice alignment to ensure competitive recruitment and retention. Awards are based on CEO and/or Hartford HealthCare Corporation's Compensation Committee discretionary assessment of overall organization performance and individual contribution to results. See Part V See Part V See Part V 0 Schedule L, Part IV (a)Name of Person: Stacy Nerenstone(b)Relationship Between Interested Person and Organization: Board Member(c)Amount of Transactions: $2,519,671(d)Description of Transaction: Dr. Stacey Nerenstone is the President of the Medical Staff at Harford Hospital. Therefore, she is also ex-officio of the Board for the lenght of her 2 year term as the President of the Medical Staff. Dr. Nerenstone is also an Executive of Oncology Associates PC. Effective May 2017, Hartford Hospital executed a purchase service agreement for three Oncology Associates PC locations. For FY17, the Hospital paid the PC $2,186,530 for Professional Services rendered and made a partial payment of $333,141 for the aquisiton of the PC. Total payments between the Hospital and the PC for FY17 was $2,519,671.(e)Sharing of Organization's Revenue? No X 62 9579408 FMV 0 0 1 0 Form 990, Part VI, Section A, line 6 Hartford Hospital is organized as a non-stock not for profit entity. Hartford HealthCare Corporation is the sole member. Form 990, Part VI, Section A, line 7a The sole member of the organization has the authority to approve/remove members of the governing body. Form 990, Part VI, Section A, line 7b The sole member of the organization has the right to review, approve, disapprove and deny significant transactions such as mergers, acquisitions, dissolutions etc. Form 990, Part VI, Section B, line 11b The Form 990 was prepared by Hartford HealthCare's Tax Department. It was then reviewed by an independent accounting firm. It was then forwarded to the organization's top management including the VP of Finance for review. The final Form was provided to the entire Board prior to submission to the Internal Revenue Services (IRS). Once the entire review process was completed, the Form was signed by the VP of Finance and then filed with the IRS. Form 990, Part VI, Section B, line 12c The hospital's board has adopted the policy of the member, Hartford HealthCare Corporation (HHC). HHC's Conflict of Interest Policy (Policy) requires all Covered Individuals, including board members and officers, to provide a disclosure of relationships that create or have the appearance of creating a conflict of interest or commitment. The Policy requires updates if changes in circumstances arise during the year that either (a) create a new potential conflict of interest or commitment or (b) change or eliminate a conflict of interest or commitment previously disclosed. Conflict of Interest disclosure statements are maintained by the HHC Office of Compliance and Integrity (OCI). Employee disclosures are reviewed by OCI in collaboration with the Covered Individuals' supervisor when deemed appropriate, to determine if there is a potential conflict. Oversight review of employee disclosures is provided by the Executive Compliance Steering Committee ("ECSC") (the Committee) which includes representation from the Medical Staff, the Legal Department, Human Services, Supply Chain Management and Compliance. The Committee assesses and may recommend the conflicting interest either be (a) eliminated for a continued relationship with HHC/HH, or, (b) managed through a management plan. Board member disclosures are reported to the HHC Nominating and Governance Committee for determinations of conflicts and the management of them, where applicable. Form 990, Part VI, Section B, line 15 The Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare on behalf of Hartford Hospital, hires an outside consultant, Integrated Healthcare Strategies, a division of Gallagher Benefit Services, Inc., to determine best practices in governing executive compensation. The following steps were taken: - The use of an Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare, on behalf of Hartford Hospital, established and regularly reviews Executive Compensation Philosophy; - The Committee regularly reviews scope and depth of positions taking into account complexity and the financial impact and accountability of all "disqualified persons; - National peer groups are selected for comparative purposes based on organizational size, operating revenue, geography and other relevant factors; - Analysis of current total compensation versus market is performed by independent third party compensation consulting firm and is then reviewed by the committee; - Recommendations made based on market data analysis to ensure appropriate competitive positioning within parameters of compensation philosophy; - The CEO compensation reviewed by the Committee and is based on comparative market information and organizational performance; - All changes are reviewed and approved by the Executive Compensation Committee; The compensation determination process for the CEO is reviewed on an annual basis. All other executive compensation is regularly reviewed for scope and depth of positions taking into account complexity and the financial impact and accountability. Form 990, Part VI, Section C, line 18 The Hospital's Form 990, 990T and form 1023 and its attachments are available upon request. Form 990, Part VI, Section C, line 19 The Hospital's Financial Statements, Governing Documents and the Conflict of Interest Policy are available for inspection upon request at the Organization's address. Form 990, Part XI, line 9: Transfer to Affiliated Entity -20,778,000. Change in Pension and Post-Retirement Funding Obligation 79,856,000. Rounding -847. Net Unrestricted Other Changes in Joint Ventures -7,106,000. Connecticut Health System Inc 80 Seymour Street Hartford CT 06102 222779421 Coordination of Health Care Delivery CT 501(C)(3) 12 (c) N/A 1 Hartford HealthCare Corporation One State Street Suite 19 Hartford CT 06103 222672834 Support and Management Services to Hartford Hospital and Affiliates CT 501(C)(3) 12 (c) N/A 0 Windham Community Memorial Hospital 112 Mansfield Avenue Willimantic CT 06226 060646966 Healthcare Services CT 501(C)(3) 3 Hartford HealthCare Corporation 1 Windham Hospital Foundation Inc 112 Mansfield Avenue Willimantic CT 06226 562546632 Supporting Organization CT 501(C)(3) 12 (a) Windham Community Memorial Hospital 1 MidState Medical Center 435 Lewis Avenue Meriden CT 06451 060646715 Healthcare Services CT 501(C)(3) 3 Hartford HealthCare Corporation 1 Natchaug Hospital Inc 189 Storrs Road Mansfield Center CT 06226 060966963 Behavioral Health CT 501(C)(3) 3 Hartford HealthCare Corporation 1 Hartford HealthCare At HomeInc 1290 Silas Deane Hwy Suite 4B Wethersfield CT 06109 060646938 Home Healthcare CT 501(C)(3) 7 Hartford HealthCare Corporation 1 Rushford Center Inc 883 Paddock Avenue Meriden CT 06450 060932875 Substance Abuse Healthcare Services CT 501(C)(3) 7 Hartford HealthCare Corporation 1 HHC Independence at Home Inc 1290 Silas Deane Hwy Suite 4B Wethersfield CT 06109 061161422 Home Healthcare CT 501(C)(3) 10 Hartford HealthCare At Home Inc 1 Hartford Hospital Auxiliary co Hartford Hospital 80 Seymour Street Hartford CT 06115 066040747 Fundraising CT 501(C)(3) 12 (b) Hartford Hospital 1 The Hospital of Central CT and Bradley Memorial 100 Grand Street New Britain CT 06050 060646768 Healthcare Services CT 501(C)(3) 3 Hartford HealthCare Corporation 1 Hartford HealthCare Senior Services Inc 45 Meriden Avenue Southington CT 06489 222635676 Sub-Acute & Long Term Healthcare CT 501(C)(3) 10 Hartford HealthCare Corporation 1 The Orchards of Southington 34 Hobart Street Southington CT 06489 061490803 Residential Services for Senior Care CT 501(C)(3) 10 Hartford HealthCare Senior Services Inc 1 Rushford Foundation Inc 883 Paddock Avenue Meriden CT 06450 061432692 Support Organization CT 501(C)(3) 12 (a) Rushford Center Inc 1 Mulberry Gardens of Southington LLC 58 Mulberry Street Plantsville CT 06479 820586577 Assisted Living & Adult Day Care Facility CT 501(C)(3) 10 Hartford HealthCare Senior Services Inc 1 Windham Community Memorial Hospital Women's Auxiliary Inc 112 Mansfield Avenue Willimantic CT 06226 060677728 Fundraising CT 501(C)(3) 12 (a) Windham Community Memorial Hospital 1 MidState Medical Center Auxiliary 435 Lewis Avenue Meriden CT 06451 066063082 Fundraising CT 501(C)(3) 12 (a) MidState Medical Center 1 Hartford HealthCare Medical Group Inc 1290 Silas Deane Hwy Wethersfield CT 06109 454456939 Medical Services CT 501(C)(3) 10 Hartford HealthCare Corporation 1 Hartford HealthCare Accountable Care Org Inc 1290 Silas Deane Hwy Wethersfield CT 06109 460886367 Government Contracts CT 501(C)(3) 7 Hartford HealthCare Medical Group Inc 1 Backus Corporation 326 Washington Street Norwich CT 06360 222757608 Support Organization CT 501(C)(3) 12 (b) Hartford HealthCare Corporation 1 The William W Backus Hospital 326 Washington Street Norwich CT 06360 060250773 Hospital CT 501(C)(3) 3 Hartford HealthCare Corporation 1 Backus HealthCare Inc 326 Washington Street Norwich CT 06360 222481794 Support Organization CT 501(C)(3) 12 (a) Hartford HealthCare Corporation 1 Caring for Colleagues Employee Crisis Fund 100 Grand Street New Britain CT 06052 264469178 Employee Fund CT 501(C)(3) 7 Hartford HealthCare Corporation 1 Hartford Healthcare Endowment LLC 80 Seymour Street Hartford CT 06102 454181103 Investment Management CT 501(C)(3) 12 (a) Hartford HealthCare Corporation 1 New Britain MRI Limited Partnership 100 Grand Street New Britain CT 06050 061271349 Magnetic Resonance Imaging CT N/A Omni Home Health Services E CT LLC 12 Case Street - 317 Norwich CT 06360 061458837 Backus Home Health Care CT N/A Ambulance Service of Manchester LLC PO Box 300 Manchester CT 06450 061557358 Ambulatory Services CT N/A Connecticut Imaging Partners LLC 111 Founders Plaza East Hartford CT 06108 134298940 Imaging Service CT N/A Unrelated 902239 1468983 0 0 0.51000 Glastonbury Endoscopy Center LLC 300 Western Boulevard Glastonbury CT 06033 261721234 Endoscopy Services CT N/A Related 1164113 632631 0 0 0.51000 Glastonbury Surgery Center LLC 195 Eastern Boulevard Glastonbury CT 06033 262600828 Surgery Services CT N/A Related 5011385 1556218 0 0 0.51000 Hartford - Middlesex Clinical System LLC 80 Seymour Street Hartford CT 06110 061543605 Affiliate Support Services CT N/A Unrelated -10 0 0 0.50000 Med-East Assoc LLC 1703 West Main Street Willimantic CT 06226 061469575 Outpatient Care Clinic CT N/A HHC Southington Surgery Center LLC 100 Avon Meadow Lane Avon CT 06001 465500829 Surgery Services CT N/A Constitution Surgery Center East LLC 174 Cross Road Waterford CT 06385 Surgery Services CT N/A CT GI Endoscopy Center LLC 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