CHARLOTTE HUNGERFORD HOSPITAL: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- CHARLOTTE HUNGERFORD HOSPITAL (EIN 06-0646678)
- Tax period
- 2013-10-01 to 2014-09-30
- Filed
- 2015-06-30
- IRS object ID
- 201531819349300808
- Schema version
- 2013v4.0
- 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 L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-06-30T10:36:27-05:00 | ReturnTs |
| Tax Period End | 2014-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 061533253 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SASLOW LUFKIN & BUGGY LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 175 POWDER FOREST DRIVE | AddressLine1 |
| City | SIMSBURY | City |
| State | CT | State |
| ZIP Code | 06089 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 060646678 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE CHARLOTTE HUNGERFORD HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHAR | BusinessNameControlTxt |
| Phone | 8604966728 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 540 LITCHFIELD STREET PO BOX 988 | AddressLine1 |
| City | TORRINGTON | City |
| State | CT | State |
| ZIP Code | 067900988 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SUSAN M SCHAPP | PersonNm |
| Person Title | VP FINANCE/TREASURER | PersonTitleTxt |
| Phone | 8604966728 | PhoneNum |
| Signature | 2015-06-30 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | 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 | 2013 | TaxYr |
| Build TS | 2016-04-25 22:37:26Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SUSAN M SCHAPP | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 540 LITCHFIELD STREET PO BOX 988 | AddressLine1 |
| City | TORRINGTON | City |
| State | CT | State |
| ZIP Code | 067900988 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $134,126,705 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CHARLOTTEHUNGERFORD.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1917 | FormationYr |
| Legal Domicile State | CT | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE QUALITY, COMPASSIONATE AND COST EFFECTIVE HEALTHCARE TO THE COMMUNITY OF NORTHWESTERN CONNECTICUT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 1253 | TotalEmployeeCnt |
| Total Volunteers | 185 | TotalVolunteersCnt |
| Total Gross UBI | $980,924 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,015,379 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,170,907 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $122,017,519 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $118,627,892 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,463,648 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,182,192 | CYInvestmentIncomeAmt |
| PY Other Revenue | $381,719 | PYOtherRevenueAmt |
| CY Other Revenue | $479,250 | CYOtherRevenueAmt |
| PY Total Revenue | $127,878,265 | PYTotalRevenueAmt |
| CY Total Revenue | $125,460,241 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $12,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $12,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $75,560,164 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $73,040,987 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $345,306 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $49,401,846 | PYOtherExpensesAmt |
| CY Other Expenses | $49,026,972 | CYOtherExpensesAmt |
| PY Total Expenses | $124,974,010 | PYTotalExpensesAmt |
| CY Total Expenses | $122,079,959 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,904,255 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,380,282 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $132,607,623 | TotalAssetsBOYAmt |
| Total Assets EOY | $137,043,425 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $47,910,218 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $52,361,370 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $84,697,405 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $84,682,055 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE CHARLOTTE HUNGERFORD HOSPITAL PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. OUR MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. IN KEEPING WITH THE HOSPITAL'S COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, FREE CARE AND/OR SUBSIDIZED CARE, CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST, HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY WILL BE CONSIDERED WHERE THE NEED AND/OR AN INDIVIDUAL'S INABILITY TO PAY COEXIST. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGAMS FOR THE ELDERLY, HANDICAPPED, THE MEDICALLY UNDERSERVED AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $107,818,668 | ExpenseAmt |
| Grant | $12,000 | GrantAmt |
| Revenue | $117,870,688 | RevenueAmt |
| Desc | DURING FY 2014 THE HOSPITAL CONTRIBUTED OVER 15,000 HOURS TOWARD THE COMMON PURPOSE OF SERVICING THE HEALTHCARE NEEDS OF THE COMMUNITY. THE VALUE OF THIS CONTRIBUTION IS APPROXIMATELY $125,000, WHICH IS GIVEN BACK TO THE COMMUNITY THROUGH LOWER COSTS IN BOTH PATIENT SERVICES AND OTHER "WELLNESS" PROGRAMS. IN ADDITION THE HOSPITAL GRANTED CHARITY CARE IN THE AMOUNT OF $1,349,407 DURING FISCAL YEAR 2014. THE CHARLOTTE HUNGERFORD HOSPITAL RENDERED THE FOLLOWING SERVICES DURING FY 2014:INPATIENT SERVICES:DISCHARGES 6,106PATIENT DAYS 25,604 SPECIAL SERVICES: OPERATING ROOM CASES 4,011 AMBULATORY SURGERY CASES 3,245 ENDOSCOPY CASES 981 AMBULATORY MEDICAL CASES 2,808WOUND CARE CASES 6,522POST ANESTHESIA CARE UNIT CASES 2,401 DELIVERY ROOM DELIVERIES 444RESPIRATORY THERAPY TREATMENTS 35,824 PULMONARY REHAB TESTS 5,691PULMONARY FUNCTION LAB TESTS 1,434 CARDIO DIAGNOSTIC EXAMS 13,415EEG EXAMS 186PHYSICAL THERAPY TREATMENTS 35,268 CARDIAC REHAB TREATMENTS 3,298 SPEECH THERAPY TREATMENTS 765 OCCUPATIONAL THERAPY TREATMENTS 3,759 SLEEP STUDY TESTS 516 DIAGNOSTIC RADIOLOGY EXAMS 25,786MAMMOGRAPHY EXAMS 8,923 NUCLEAR MEDICINE EXAMS 801ULTRASOUND EXAMS 9,028C.A.T. SCAN EXAMS 12,932P.E.T. SCAN EXAMS 276M.R.I. EXAMS 1,359SPECIAL PROCEDURES (RADIOLOGY) EXAMS 1,243RADIATION THERAPY TREATMENTS 8,266LABORATORY TESTS 571,488 PSYCHIATRIC CLINIC VISITS 34,954 PHP-ADULT/ADOLESCENT VISITS 4,677 RENAL DIALYSIS VISITS 302 EMERGENCY DEPARTMENT VISITS 34,363OUTPATIENT DIABETES PROGRAM VISITS 1,699WALK IN CENTER VISITS 11,890PROFESSIONAL SERVICE CONSULTS 126,787HUNGERFORD EMERGENCY MEDICAL CENTER: CARDIAC REHAB TREATMENTS 1,551DIAGNOSTIC RADIOLOGY EXAMS 3,741 LABORATORY TESTS 17,877EMERGENCY DEPARTMENT VISITS 6,361PULMONARY REHAB TESTS 2,246 | Desc |
| Total Program Service Expenses | $107,818,668 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 216 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1253 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | CT | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUSAN M SCHAPP | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8604966728 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 540 LITCHFIELD STREET | AddressLine1 |
| City | TORRINGTON | City |
| State | CT | State |
| ZIP Code | 06790 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| EDWARD ARUM | ||||||||
| GOVERNOR | 2.50 | Yes (X) | $0 | $0 | $0 | |||
| RICHARD DUTTON MD | ||||||||
| GOVERNOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| GLADYS CERRUTO | ||||||||
| GOVERNOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVID J FRAUENHOFER | ||||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JAMIE GREG | ||||||||
| GOVERNOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KENDRICK HOM MD | ||||||||
| GOVERNOR | 40.00 | Yes (X) | $275,710 | $0 | $33,960 | |||
| JOHN JANCO | ||||||||
| CHAIRMAN | 2.50 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JOHN LAVIERI | ||||||||
| GOVERNOR | 2.50 | Yes (X) | $0 | $0 | $0 | |||
| DIANE LIBBY CPA | ||||||||
| VICE CHAIRMAN | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JAMES O'LEARY | ||||||||
| GOVERNOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| EDWIN G BOOTH JR | ||||||||
| GOVERNOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| FRANK BUONOCORE JR | ||||||||
| GOVERNOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| STEPHANIE FOWLER MD | ||||||||
| GOVERNOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL PATTERSON | ||||||||
| GOVERNOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CHARLES W RORABACK | ||||||||
| GOVERNOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ANDREW SZCZEPENSKI MD | ||||||||
| GOVERNOR | 10.00 | Yes (X) | $43,045 | $0 | $4,108 | |||
| DANIEL J MCINTYRE | ||||||||
| CEO/PRESIDENT | 60.00 | $446,903 | $0 | $83,619 | Yes (X) | |||
| SUSAN M SCHAPP | ||||||||
| VP FINANCE/ TREASURER | 60.00 | $269,327 | $0 | $50,496 | Yes (X) | |||
| JOHN J CAPOBIANCO | ||||||||
| VP OUT PATIENT SERVICES | 60.00 | $241,956 | $0 | $44,778 | Yes (X) | |||
| MARK PRETE MD | ||||||||
| VP MEDICAL AFFAIRS | 60.00 | $311,896 | $0 | $59,231 | Yes (X) | |||
| RAYMOND J ELLIOTT | ||||||||
| VP FACILITIES | 60.00 | $165,636 | $0 | $40,397 | Yes (X) | |||
| BRIAN MATTIELLO | ||||||||
| VP HUMAN RESOURCES | 60.00 | $188,193 | $0 | $21,961 | Yes (X) | |||
| ELZBIETA LACH-PASKO MD | ||||||||
| PATHOLOGIST | 60.00 | $393,156 | $0 | $53,166 | Yes (X) | |||
| MUSTAFA UGURLU MD | ||||||||
| PHYSICIAN | 60.00 | $490,960 | $0 | $55,528 | Yes (X) | |||
| TIMOTHY GOSTKOWSKI MD | ||||||||
| PHYSICIAN | 60.00 | $612,210 | $0 | $68,166 | Yes (X) | |||
| WILLIAM MCGEEHIN MD | ||||||||
| PHYSICIAN | 60.00 | $584,900 | $0 | $65,973 | Yes (X) | |||
| DAVID FRECCERO MD | ||||||||
| PHYSICIAN | 60.00 | $532,006 | $0 | $52,663 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,555,898 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $634,046 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 50 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ADULT & PEDIATRIC UROLOGY OF NW CONNECTI | |||||
| 538 LITCHFIELD STREET SUITE 102 | TORRINGTON | CT | 06790 | MEDICAL | $1,454,570 |
| BUILDING ONE FACILITY SERVICES | |||||
| 57 OZICK DRIVE SUITE A | DURHAM | CT | 06422 | CLEANING SERVICES | $1,290,327 |
| MAYO COLLABORATIVE SERVICES | |||||
| PO BOX 9146 | MINEAPOLIS | MN | 554809146 | LABORATORY TESTS | $943,485 |
| NEW MILFORD LAUNDRY | |||||
| 40 COMMONS COURT | WATERBURY | CT | 06704 | LAUNDRY/LINEN SERVICES | $507,855 |
| PROGRESSIVE PAVING & CONSTRUCTION LLC | |||||
| PO BOX 160 | GOSHEN | CT | 06756 | PAVING / CONSTRUCTION | $503,410 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 28 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $19,933 | FundraisingAmt |
| Government Grants | $2,047,945 | GovernmentGrantsAmt |
| All Other Contributions | $1,103,029 | AllOtherContributionsAmt |
| Total Contributions | $3,170,907 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT REVENUE | 900099 | $104,184,584 | $104,184,584 | |
| LABORATORY SERVICES | 621500 | $10,437,466 | $9,465,157 | $972,309 |
| OTHER HOSPITAL SERVICES | 900099 | $4,005,842 | $4,005,842 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $118,627,892 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,587,620 | TotalRevenueColumnAmt |
| Exclusion | $1,587,620 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $573,597 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $358,492 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $215,105 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $215,105 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $215,105 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,755,404 | SecuritiesAmt |
| Other | $2,006,529 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $6,460,129 | SecuritiesAmt |
| Other | $1,707,232 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,295,275 | SecuritiesAmt |
| Other | $299,297 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,594,572 | TotalRevenueColumnAmt |
| Exclusion | $1,594,572 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $123,545 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $19,933 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $44,242 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $79,303 | TotalRevenueColumnAmt |
| Exclusion | $79,303 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $206,597 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $96,369 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $110,228 | TotalRevenueColumnAmt |
| Exclusion | $110,228 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| GAIN FROM EQUITY METHOD | 900001 | $65,999 | $65,999 | |
| MEDCONN | 561499 | $8,615 | $8,615 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $74,614 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $125,460,241 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $117,870,688 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $980,924 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,437,722 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,000 | TotalAmt |
| Program Services | $12,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,322,016 | TotalAmt |
| Program Services | $1,741,512 | ProgramServicesAmt |
| Management And General | $580,504 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,934,381 | TotalAmt |
| Program Services | $50,878,266 | ProgramServicesAmt |
| Management And General | $5,882,224 | ManagementAndGeneralAmt |
| Fundraising | $173,891 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,417,762 | TotalAmt |
| Program Services | $3,034,978 | ProgramServicesAmt |
| Management And General | $372,754 | ManagementAndGeneralAmt |
| Fundraising | $10,030 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,517,466 | TotalAmt |
| Program Services | $5,787,520 | ProgramServicesAmt |
| Management And General | $710,820 | ManagementAndGeneralAmt |
| Fundraising | $19,126 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,849,362 | TotalAmt |
| Program Services | $3,418,240 | ProgramServicesAmt |
| Management And General | $419,826 | ManagementAndGeneralAmt |
| Fundraising | $11,296 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,099,731 | TotalAmt |
| Program Services | $6,304,572 | ProgramServicesAmt |
| Management And General | $774,324 | ManagementAndGeneralAmt |
| Fundraising | $20,835 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $350,198 | TotalAmt |
| Program Services | $310,976 | ProgramServicesAmt |
| Management And General | $38,194 | ManagementAndGeneralAmt |
| Fundraising | $1,028 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,200 | TotalAmt |
| Program Services | $105,850 | ProgramServicesAmt |
| Management And General | $13,000 | ManagementAndGeneralAmt |
| Fundraising | $350 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,248,543 | TotalAmt |
| Program Services | $6,436,718 | ProgramServicesAmt |
| Management And General | $790,554 | ManagementAndGeneralAmt |
| Fundraising | $21,271 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $524,329 | TotalAmt |
| Program Services | $465,605 | ProgramServicesAmt |
| Management And General | $57,185 | ManagementAndGeneralAmt |
| Fundraising | $1,539 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $366,847 | TotalAmt |
| Program Services | $325,760 | ProgramServicesAmt |
| Management And General | $40,010 | ManagementAndGeneralAmt |
| Fundraising | $1,077 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,656,884 | TotalAmt |
| Program Services | $1,471,316 | ProgramServicesAmt |
| Management And General | $180,706 | ManagementAndGeneralAmt |
| Fundraising | $4,862 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,364,241 | TotalAmt |
| Program Services | $2,987,451 | ProgramServicesAmt |
| Management And General | $366,917 | ManagementAndGeneralAmt |
| Fundraising | $9,873 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,278 | TotalAmt |
| Program Services | $25,999 | ProgramServicesAmt |
| Management And General | $3,193 | ManagementAndGeneralAmt |
| Fundraising | $86 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,651 | TotalAmt |
| Program Services | $13,898 | ProgramServicesAmt |
| Management And General | $1,707 | ManagementAndGeneralAmt |
| Fundraising | $46 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,899,420 | TotalAmt |
| Program Services | $5,238,695 | ProgramServicesAmt |
| Management And General | $643,413 | ManagementAndGeneralAmt |
| Fundraising | $17,312 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,997,755 | TotalAmt |
| Program Services | $1,774,009 | ProgramServicesAmt |
| Management And General | $217,883 | ManagementAndGeneralAmt |
| Fundraising | $5,863 | FundraisingAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| SUPPLIES | $15,955,239 | $14,168,279 | $1,740,139 | $46,821 |
| PHYSICIAN FEES | $4,330,528 | $3,247,896 | $1,082,632 | $0 |
| HOSPITAL AUXILIARY EXPE | $69,128 | $69,128 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $122,079,959 | TotalAmt |
| Program Services | $107,818,668 | ProgramServicesAmt |
| Management And General | $13,915,985 | ManagementAndGeneralAmt |
| Fundraising | $345,306 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,643 | BOYAmt |
| EOY | $110,649 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,014,949 | BOYAmt |
| EOY | $7,236,836 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,857 | BOYAmt |
| EOY | $14,891 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,504,471 | BOYAmt |
| EOY | $13,152,579 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,119,166 | BOYAmt |
| EOY | $1,999,800 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,512,549 | BOYAmt |
| EOY | $1,264,076 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $155,625,189 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $116,385,088 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,869,779 | BOYAmt |
| EOY | $39,240,101 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $66,334,495 | BOYAmt |
| EOY | $69,582,179 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,150,714 | BOYAmt |
| EOY | $4,442,314 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $132,607,623 | BOYAmt |
| EOY | $137,043,425 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,483,194 | BOYAmt |
| EOY | $11,740,332 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $298,993 | BOYAmt |
| EOY | $516,546 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,219,468 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,908,563 | BOYAmt |
| EOY | $40,104,492 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,910,218 | BOYAmt |
| EOY | $52,361,370 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,261,338 | BOYAmt |
| EOY | $59,513,314 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,334,379 | BOYAmt |
| EOY | $3,526,938 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,101,688 | BOYAmt |
| EOY | $21,641,803 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $84,697,405 | BOYAmt |
| EOY | $84,682,055 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $132,607,623 | BOYAmt |
| EOY | $137,043,425 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,380,282 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $4,658,208 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$8,053,840 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $22,332 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $22,332 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL IS A MEMBER OF THE CONNECTICUT HOSPITAL ASSOCIATION. $22,332 REPRESENTS THE PORTION OF DUES PAID TO THE ASSOCIATION WHICH WERE USED FOR LOBBYING PURPOSES. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $60,160,777 | BeginningYearBalanceAmt |
| Contributions | $253,117 | ContributionsAmt |
| Investment Earnings Or Losses | $5,411,408 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $3,269,043 | OtherExpendituresAmt |
| End Year Balance | $62,556,259 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $53,165,045 | BeginningYearBalanceAmt |
| Contributions | $243,732 | ContributionsAmt |
| Investment Earnings Or Losses | $7,106,906 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $354,906 | OtherExpendituresAmt |
| End Year Balance | $60,160,777 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $46,929,816 | BeginningYearBalanceAmt |
| Contributions | $239,485 | ContributionsAmt |
| Investment Earnings Or Losses | $6,103,897 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $108,153 | OtherExpendituresAmt |
| End Year Balance | $53,165,045 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $49,273,746 | BeginningYearBalanceAmt |
| Contributions | $186,977 | ContributionsAmt |
| Investment Earnings Or Losses | -$2,264,127 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $266,780 | OtherExpendituresAmt |
| End Year Balance | $46,929,816 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $45,533,758 | BeginningYearBalanceAmt |
| Contributions | $690,138 | ContributionsAmt |
| Investment Earnings Or Losses | $3,824,302 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $774,452 | OtherExpendituresAmt |
| End Year Balance | $49,273,746 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.59800 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.34600 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.05600 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $155,467 | OtherCostOrOtherBasisAmt |
| Book Value | $155,467 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $82,924,326 | OtherCostOrOtherBasisAmt |
| Depreciation | $57,153,527 | DepreciationAmt |
| Book Value | $25,770,799 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $65,768,005 | OtherCostOrOtherBasisAmt |
| Depreciation | $54,733,312 | DepreciationAmt |
| Book Value | $11,034,693 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,777,391 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,498,249 | DepreciationAmt |
| Book Value | $2,279,142 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $39,240,101 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED AMOUNTS DUE TO THIRD PARTY REIMBURSEMENT AGENCIES | $4,348,984 |
| MISCELLANEOUS CURRENT LIABILITIES | $198,980 |
| ESTIMATED SELF-INSURANCE LIABILITIES | $3,971,340 |
| ACCRUED PENSION LIABILITY | $27,865,188 |
| PENSION CONTRIBUTION - CURRENT YEAR | $3,720,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $40,104,492 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $125,021,877 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $125,021,877 | RevenueSubtotalAmt |
| Other Revenues Not Included | $438,364 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $438,364 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $125,460,241 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $121,998,831 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $121,998,831 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $81,128 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $81,128 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $122,079,959 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE ENDOWMENT FUNDS WILL BE USED PRIMARILY FOR CAPITAL PURCHASES, INDIGENT CARE AND OTHER USES AS APPROVED BY THE BOARD IN ACCORDANCE WITH DONOR RESTRICTIONS. |
| PART X, LINE 2: | THE HOSPITAL ACCOUNTS FOR UNCERTAIN TAX POSITIONS WITH PROVISIONS OF FASB ASC 740, "INCOME TAXES" WHICH PROVIDES A FRAMEWORK FOR HOW COMPANIES SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE UNCERTAIN TAX POSITIONS IN THEIR FINANCIAL STATEMENTS. THE HOSPITAL 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 HOSPITAL DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2014 AND 2013. AS OF SEPTEMBER 30, 2014 AND 2013, THE HOSPITAL DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNCERTAIN TAX POSITIONS. THE HOSPITAL'S PRIOR THREE TAX YEARS ARE OPEN AND SUBJECT TO EXAMINATION. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | TEMPORARY RESTRICTED ACTIVITY 335,640. AUXILIARY REVENUE 102,724. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | AUXILIARY EXPENSES 81,128. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF TOURNAMENT | NameOfEvent1Amt |
| Gross Receipts Event1 | $95,680 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $95,680 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $5,436 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $25,252 | RentFacilityCostsEvent1Amt |
| Name Of Event2 | DINNER DANCE | NameOfEvent2Amt |
| Gross Receipts Event2 | $27,865 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $27,865 | GrossRevenueEvent2Amt |
| Rent Facility Costs Event2 | $13,554 | RentFacilityCostsEvent2Amt |
| Other Events Total | 6 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $19,933 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $19,933 | CharitableContriOtherEventsAmt |
| Gross Receipts Total | $143,478 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $19,933 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $123,545 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $5,436 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $38,806 | RentFcltyCostsTotalEventsAmt |
| Direct Expense Summary Events | $44,242 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $79,303 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1736 | PersonsServedCnt |
| Total Community Benefit Expns | $1,311,527 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,311,527 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01070 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 46250 | PersonsServedCnt |
| Total Community Benefit Expns | $28,577,031 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,909,855 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,667,176 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05460 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 595 | PersonsServedCnt |
| Total Community Benefit Expns | $276,706 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $111,323 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $165,383 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 48581 | PersonsServedCnt |
| Total Community Benefit Expns | $30,165,264 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $22,021,178 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,144,086 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06670 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 11 | ActivitiesOrProgramsCnt |
| Persons Served | 6264 | PersonsServedCnt |
| Total Community Benefit Expns | $269,597 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $269,597 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 413 | PersonsServedCnt |
| Total Community Benefit Expns | $3,985 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,985 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 74408 | PersonsServedCnt |
| Total Community Benefit Expns | $29,371,764 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $26,682,171 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,689,593 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02200 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 1492 | PersonsServedCnt |
| Total Community Benefit Expns | $9,933 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $9,933 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 15 | ActivitiesOrProgramsCnt |
| Persons Served | 82577 | PersonsServedCnt |
| Total Community Benefit Expns | $29,655,279 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $26,682,171 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,973,108 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02430 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 15 | ActivitiesOrProgramsCnt |
| Persons Served | 131158 | PersonsServedCnt |
| Total Community Benefit Expns | $59,820,543 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $48,703,349 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,117,194 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09100 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,699,503 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $43,633,893 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $48,228,139 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$4,594,246 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (4 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Org Profit Or OwnershipOrgProfitOrOwnershipPct | Ofcr Etc Profit Or OwnershipOfcrEtcProfitOrOwnershipPct | Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct |
|---|---|---|---|
| 1 ADVANCED MEDICAL IMAGING OF NORTHWEST CT LLC | |||
| IMAGING CENTER | 0.50000 | 0.00000 | 0.50000 |
| 2 MEDCONN COLLECTION AGENCY LLC | |||
| PATIENT COLLECTION AGENCY | 0.33370 | 0.00000 | 0.00000 |
| 3 UROLOGY CENTER OF NW CT | |||
| UROLOGY CENTER | 0.62500 | 0.00000 | 0.37500 |
| 4 LITCHFIELD COUNTY HEALTHCARE SERVICE CORP | |||
| PHYSICIANS PRACTICE | 1.00000 | 0.00000 | 0.00000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | CHARLOTTE HUNGERFORD HOSPITAL | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 540 LITCHFIELD STRRET | AddressLine1 |
| City | TORRINGTON | City |
| State | CT | State |
| ZIP Code | 06790 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.CHARLOTTEHUNGERFORD.ORG | WebsiteAddressTxt |
| State License | 0042 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Emergency Room Other | Yes (X) | EmergencyRoomOtherInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHARLOTTE HUNGERFORD HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| 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 |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.CHARLOTTEHUNGERFORD.ORG | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | 0 | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Attached To Invoice | Yes (X) | AttachedToInvoiceInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Provided On Admission | Yes (X) | ProvidedOnAdmissionInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Lien On Residence | Yes (X) | PermitLienOnResidenceInd |
| Collection Activities | Yes (1) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| Liens On Residences | Yes (X) | LiensOnResidencesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| CHARLOTTE HUNGERFORD HOSPITAL | PART V, SECTION B, LINE 3: THE STUDY WAS CONDUCTED BY THE CENTER FOR HEALTHY SCHOOLS AND COMMUNITIES AT EDUCATION CONNECTION IN LITCHFIELD, CT. THE STEERING COMMITTEE INCLUDED THE FOLLOWING INDIVIDUALS AND ORGANIZATIONS: JIM ROKOS, DIRECTOR OF HEALTH, TORRINGTON AREA HEALTH DISTRICT; LESLIE POLITO, ASSISTANT DIRECTOR OF HEALTH, TORRINGTON AREA HEALTH DISTRICT; SHARON MCCOY, PROJECT DIRECTOR, TORRINGTON AREA HEALTH DISTRICT; STEPHANIE BARKSDALE, EXECUTIVE DIRECTOR, UNITED WAY OF NORTHWEST CONNECTICUT; GREG BRISCO, CHIEF EXECUTIVE OFFICER, NORTHWEST CONNECTICUT YMCA; BRIAN MATTIELLO, V.P. FOR ORGANIZATIONAL DEVELOPMENT, CHARLOTTE HUNGERFORD HOSPITAL; DANIEL BAROODY, DIRECTOR OF HEALTH, TOWN OF SHARON; MIKE CRESPAN, DIRECTOR OF HEALTH, NEW MILFORD HEALTH DEPARTMENT; DONNA CULBERT, DIRECTOR OF HEALTH, NEWTOWN HEALTH DISTRICT; JENNIFER KERTANIS, DIRECTOR OF HEALTH, FARMINGTON VALLEY HEALTH DISTRICT; NEAL LUSTIG, DIRECTOR OF HEALTH, POMPERAUG HEALTH DISTRICT; MARY BEVAN, DIRECTOR, CENTER FOR HEALTHY SCHOOLS AND COMMUNITIES EDUCATION CONNECTION; JIM HUTCHISON, COMMUNITY HEALTH COORDINATOR, SHARON HOSPITAL; ANDREA RYNN, DIRECTOR OF PUBLIC AND GOVERNMENT RELATIONS, WESTERN CT HEALTH NETWORK; MARY WINAR, PROJECTS COORDINATOR, CONNECTICUT OFFICE OF RURAL HEALTH. |
| CHARLOTTE HUNGERFORD HOSPITAL | PART V, SECTION B, LINE 7: NOT ALL NEEDS HAVE BEEN ADDRESSED SINCE THE ASSESSMENT WAS IN YEAR TWO OF A FIVE YEAR PLAN WITH A CONTINUED EFFORT TO REFINE ASSESSMENTS. |
| CHARLOTTE HUNGERFORD HOSPITAL | PART V, SECTION B, LINE 20D: CONNECTICUT STATE LAW (LOONEY BILL) REQUIRES THE HOSPITAL TO ADJUST THE PATIENT'S BALANCE EQUAL TO THE COST OF PROVIDING THE CARE. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 13 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (13 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| NORTHWEST CONNECTICUT MEDICAL WALK IN | ||||
| 1598 EAST MAIN STREET | TORRINGTON | CT | 06790 | WALK IN MEDICAL CLINIC |
| THE HUNGERFORD CENTER | ||||
| 780 LITCHFIELD STREET | TORRINGTON | CT | 06790 | CARDIAC AND PULMONARY REHAB SERVICES |
| THE CENTER FOR CANCER CARE | ||||
| 200 KENNEDY DRIVE | TORRINGTON | CT | 06790 | CANCER TREATMENT CENTER |
| HUNGERFORD DIAGNOSTIC CENTER | ||||
| 220 KENNEDY DRIVE | TORRINGTON | CT | 06790 | RADIOLOGY SERVICES |
| THE CENTER FOR YOUTH AND FAMILIES | ||||
| 50 LITCHFIELD STREET | TORRINGTON | CT | 06790 | PSYCH SERVICES FOR CHILDREN AND FAMILIES |
| WINSTED BEHAVIORAL HEALTH CENTER | ||||
| 294 MAIN STREET | WINSTED | CT | 06098 | PSYCH SERVICES |
| SURGICAL ASSOCIATES OF CHH | ||||
| 538 LITCHFIELD STREET | TORRINGTON | CT | 06790 | SURGICAL PHYSICIANS PRACTICE |
| NEUROLOGY PBC | ||||
| 780 LITCHFIELD STREET | TORRINGTON | CT | 06790 | NEUROLOGY PHYSICIANS PRACTICE |
| CHH PRIMARY CARE | ||||
| 780 LITCHFIELD STREET | TORRINGTON | CT | 06790 | PRIMARY CARE PHYSICIANS PRACTICE |
| CHH CARDIOVASCULAR MEDICINE SERVICE | ||||
| 1215 NEW LITCHFIELD STREET | TORRINGTON | CT | 06790 | CARDIOVASCULAR PHYSICIANS PRACTICE |
| CHH WOUND CARE AND HYPERBARIC MEDICINE | ||||
| 7 FELICITY LANE | TORRINGTON | CT | 06790 | WOUND CARE PHYSICIANS PRACTICE |
| CHH UROLOGY MEDICINE | ||||
| 538 LITCHFIELD STREET | TORRINGTON | CT | 06790 | ADULT AND PEDIATRIC UROLOGY PHYSICIANS PRACTICE |
| HUNGERFORD EMERGENCY AND MEDICAL CARE | ||||
| 115 SPENCER STREET | WINSTED | CT | 06098 | EMERGENCY SERVICES |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | CARE WILL BE PROVIDED FREE FOR THOSE WHO QUALIFY AS UNINSURED AND VERIFICATION HAS DETERMINED THAT THEIR ANNUAL INCOME IS LESS THAN 200% OF THE FEDERAL INCOME POVERTY LEVEL. CARE WILL BE PROVIDED AT HOSPITAL COST, AS ESTABLISHED BY THE OFFICE OF HEALTH CARE ACCESS (OCHA), FOR THOSE UNINSURED PATIENTS WHO REQUEST ASSISTANCE AND VERIFICATION HAS DETERMINED THAT THEIR ANNUAL INCOME IS BETWEEN 200% AND 250% OF THE FPL. CARE WILL BE DISCOUNTED BY 30% FOR THOSE UNISURED PATIENTS WHO REQUEST ASSISTANCE AND VERIFICATION HAS DETERMINED THAT THEIR ANNUAL INCOME IS BETWEEN 250% AND 400% OF THE FPL. THE HOSPITAL WILL ALSO CONSIDER THE TOTAL MEDICAL EXPENSES FACED BY THE FAMILY AND THE FAMILY'S ABILITY TO PAY FOR THOSE EXPENSES, AND WILL CONSIDER OFFERING GREATER ASSISTANCE WHEN POSSIBLE TO THOSE FAMILIES FACING CATASTROPHIC MEDICAL EXPENSES. |
| PART I, LINE 7: | A COST TO CHARGE RATIO BASED ON CHARITY CARE CHARGES AND EXPENSES. |
| PART III, LINE 4: | IN JULY 2011, THE FASB ISSUED ASU 2011-07, "HEALTH CARE ENTITIES (TOPIC 954): PRESENTATION AND DISCLOSURE OF PATIENT SERVICE REVENUE, PROVISION OF BAD DEBTS, AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTH CARE ENTITIES." THIS GUIDANCE ESTABLISHES ACCOUNTING AND DISCLOSURE REQUIREMENTS FOR HEALTH CARE ENTITIES THAT RECOGNIZE SIGNIFICANT AMOUNTS OF PATIENT SERVICE REVENUES AT THE TIME SERVICES ARE RENDERED EVEN THOUGH THE ENTITY DOES NOT ASSESS A PATIENT'S ABILITY TO PAY. SPECIFICALLY, THE GUIDANCE REQUIRES THAT HEALTH CARE ENTITIES PRESENT BAD DEBT EXPENSE ASSOCIATED WITH NET PATIENT SERVICE REVENUES AS AN OFFSET TO NET PATIENT SERVICE REVENUES WITHIN THE STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS. ADDITIONALLY, THE GUIDANCE REQUIRES ENHANCED DISCLOSURE OF THE POLICIES FOR RECOGNIZING REVENUE AND ASSESSING BAD DEBTS, AS WELL AS QUALITATIVE AND QUANTITATIVE INFORMATION ABOUT CHANGES IN THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE GUIDANCE REQUIRES RETROSPECTIVE APPLICATION TO ALL PRIOR PERIODS PRESENTED. THIS GUIDANCE BECAME EFFECTIVE FOR THE HOSPITAL BEGINNING ON OCTOBER 1, 2012. THE ADOPTION OF THIS GUIDANCE HAD NO IMPACT ON THE HOSPITAL'S OPERATING INCOME IN THE STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS, BUT RESULTED IN ADDITIONAL DISCLOSURES IN NOTE 3. ALL PERIODS INCLUDED HAVE BEEN PRESENTED IN ACCORDANCE WITH THE PROVISIONS OF ASU 2011-07.IT IS AN INHERENT PART OF THE HOSPITAL'S MISSION TO PROVIDE NECESSARY MEDICAL CARE FREE OF CHARGE, OR AT A DISCOUNT, TO INDIVIDUALS WITHOUT INSURANCE OR OTHER MEANS OF PAYING FOR SUCH CARE. AS THE AMOUNTS DETERMINED TO QUALIFY FOR CHARITY CARE ARE NOT PURSUED FOR COLLECTION, THEY ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE. PATIENTS WHO WOULD OTHERWISE QUALIFY FOR CHARITY CARE BUT WHO DO NOT PROVIDE ADEQUATE INFORMATION WOULD BE CHARACTERIZED AS BAD DEBT AND INCLUDED IN THE PROVISION FOR BAD DEBTS.PART III, LINE 2: COSTING METHODOLOGY USED - THE HOSPITAL USES A MODEL CONSISTING OF OUR ACCOUNTS RECEIVABLE BALANCE DIVIDED INTO EIGHT AGING CATEGORIES AS FOLLOWS: 0-30 DAYS, 31-60 DAYS, 61-90 DAYS, 91-120 DAYS, 121-210 DAYS, 211-365 DAYS, AND GREATER THAN 365 DAYS. A PERCENTAGE IS THEN ASSIGNED TO EACH AGING BUCKET BASED ON AGE, WITH A HIGHER PERCENTAGE ASSIGNED AS THE DAYS OUTSTANDING INCREASES. THE RESULTING CALCULATION IS USED TO COMPARE WITH THE RESERVE AND A MONTHLY ADJUSTMENT IS MADE TO DETERMINE THE EXPENSE. ANNUALLY, THIS CALCULATION IS COMPARED TO AN AUDIT OF THE BAD DEBT RESERVES TO DETERMINE IF ANY ADJUSTMENTS ARE REQUIRED. |
| PART III, LINE 8: | THE MEDICARE SHORTFALL IS NOT TREATED AS COMMUNITY BENEFIT. THE MEDICARE ALLLOWABLE COSTS OF CARE ARE DERIVED DIRECTLY FROM THE MEDICARE COST REPORT. |
| PART III, LINE 9B: | THE HOSPITAL ATTEMPTS TO HAVE INDIVIDUALS FILL OUT ALL PAPER WORK REQUIRED FOR CHARITY CARE. IF THE PERSON IS NOT CAPABLE OF DOING THIS OR IS KNOWN TO BE UNABLE TO DO THIS (SUCH AS A KNOWN HOMELESS PERSON), THEN THE FINANCIAL ASSISTANCE COMMITTEE WILL ADJUST THE ACCOUNT TO CHARITY CARE AND IT WILL NOT BE REPORTED AS BAD DEBT. IF THE ACCOUNT HAS BEEN REPORTED AS BAD DEBT AND INFORMATION COMES FORTH INDICATING AN INABILITY TO PAY, THEN THE ACCOUNT WOULD BE REMOVED FROM BAD DEBT AND MOVED TO CHARITY CARE. |
| PART VI, LINE 2: | THE HOSPITAL OFFERS FREE HEALTH SCREENINGS, FREE HEALTH EDUCATION AND LECTURES AT VARIOUS COMMUNITY EVENTS INCLUDING FAIRS, EXPOS, PRIVATE COMPANIES, PUBLIC MUNICIPALITIES, AND PUBLIC GATHERINGS. THESE EVENTS PROVIDE A FORUM FOR RECEIVING INFORMATION AND INPUT FROM THE COMMUNITY. |
| PART VI, LINE 3: | THE HOSPITAL COUNSELS ALL SELF PAY PATIENTS BY PROVIDING A MEETING WITH A FINANCIAL COUNSELOR OR SOCIAL WORKER. ALL STATEMENTS DISTRIBUTED TO PATIENTS INCLUDE FINANCIAL COUNSELING INFORMATION. SIGNS ARE POSTED THROUGHOUT THE HOSPITAL, INCLUDING THE EMERGENCY ROOM, WHICH STATE CHARITY CARE POLICIES AND FINANCIAL ASSISTANCE INFORMATION. |
| PART VI, LINE 4: | THE CHARLOTTE HUNGERFORD HOSPITAL IS LOCATED IN TORRINGTON, CONNECTICUT, AND SERVES AS A REGIONAL HEALTH CARE RESOURCE FOR 100,000 RESIDENTS OF LITCHFIELD COUNTY AND NORTHWEST CONNECTICUT. RECENT ASSESSMENTS FROM THE AREA THAT THE HOSPITAL SERVES HAS FOUND THE FOLLOWING: - THE COUNTY HAS BECOME MORE RACIALLY AND ETHNICALLY DIVERSE. - THE COUNTY HAS THE HIGHEST PROPORTION OF RESIDENTS AGES 50+ IN THE STATE. - AREA RATES OF OBESITY AND CURRENT SMOKING EXCEED THE STATE AVERAGE. - STUDENTS IN NEARLY HALF OF THE AREA'S SCHOOL DISTRICTS SCORED BELOW THE STATE AVERAGE IN STANDARDIZED PHYSICAL FITNESS TESTS. - NEARLY ONE IN FOUR COUNTY RESIDENTS HAS HYPERTENSION. - NEARLY 40% HAVE BEEN TOLD BY THEIR HEALTH PROFESSIONAL THAT THEY HAVE HIGH CHOLESTEROL. - THE COUNTY HAS A RATIO OF ONE PRIMARY CARE PHYSICIAN TO EVERY 1,123 RESIDENTS. THIS WELL BELOW BOTH STATE AND NATIONAL BENCHMARKS. |
| PART VI, LINE 5: | ALL BOARD OF DIRECTORS MEMBERS RESIDE IN THE COMMUNITY SERVED BY THE CHARLOTTE HUNGERFORD HOSPITAL. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS WHO APPLY FOR SUCH PRIVILEGES. THE HOSPITAL ESTABLISHES AN ANNUAL CAPITAL BUDGET TO ADD OR REPLACE PATIENT CARE EQUIPMENT AND FACILITIES. MEDICAL EDUCATION IS PROVIDED TO PHYSICIANS THROUGH CONFERENCES ON A MONTHLY BASIS. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | CT |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | HEALTHCARE SCHOLARSHIPS | GrantTypeTxt |
| Recipient | 12 | RecipientCnt |
| Cash Grant | $12,000 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART IV | FormAndLineReferenceDesc |
| Explanation | THE CHARLOTTE HUNGERFORD HOSPITAL AUXILIARY AWARDS SCHOLARSHIPS IN THE AMOUNT OF $1,000 EACH TO STUDENTS PURSUING HEALTHCARE EDUCATION. THE STUDENTS MUST LIVE IN THE AREA SERVED BY THE HOSPITAL. THEY MUST ALSO PROVIDE EVIDENCE OF ACCEPTANCE INTO A COLLEGE PROGRAM OR THEIR CURRENT GRADES IN COLLEGE. APPLICANTS MUST SUBMIT LETTERS OF RECOMMENDATION FROM THEIR TEACHERS AND ALSO FROM NON-FAMILY PERSONS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KENDRICK HOM MD | ||||||||||||||
| GOVERNOR | $275,710 | $0 | $0 | $0 | $0 | $0 | $7,650 | $0 | $26,310 | $0 | $309,670 | $0 | $0 | $0 |
| DANIEL J MCINTYRE | ||||||||||||||
| CEO/PRESIDENT | $446,903 | $0 | $0 | $0 | $0 | $0 | $40,973 | $0 | $42,646 | $0 | $530,522 | $0 | $0 | $0 |
| SUSAN M SCHAPP | ||||||||||||||
| VP FINANCE/ TREASURER | $269,327 | $0 | $0 | $0 | $0 | $0 | $24,795 | $0 | $25,701 | $0 | $319,823 | $0 | $0 | $0 |
| JOHN J CAPOBIANCO | ||||||||||||||
| VP OUT PATIENT SERVICES | $241,956 | $0 | $0 | $0 | $0 | $0 | $21,689 | $0 | $23,089 | $0 | $286,734 | $0 | $0 | $0 |
| MARK PRETE MD | ||||||||||||||
| VP MEDICAL AFFAIRS | $311,896 | $0 | $0 | $0 | $0 | $0 | $29,468 | $0 | $29,763 | $0 | $371,127 | $0 | $0 | $0 |
| RAYMOND J ELLIOTT | ||||||||||||||
| VP FACILITIES | $165,636 | $0 | $0 | $0 | $0 | $0 | $24,591 | $0 | $15,806 | $0 | $206,033 | $0 | $0 | $0 |
| BRIAN MATTIELLO | ||||||||||||||
| VP HUMAN RESOURCES | $188,193 | $0 | $0 | $0 | $0 | $0 | $4,003 | $0 | $17,958 | $0 | $210,154 | $0 | $0 | $0 |
| ELZBIETA LACH-PASKO MD | ||||||||||||||
| PATHOLOGIST | $393,156 | $0 | $0 | $0 | $0 | $0 | $15,649 | $0 | $37,517 | $0 | $446,322 | $0 | $0 | $0 |
| MUSTAFA UGURLU MD | ||||||||||||||
| PHYSICIAN | $490,960 | $0 | $0 | $0 | $0 | $0 | $8,678 | $0 | $46,850 | $0 | $546,488 | $0 | $0 | $0 |
| TIMOTHY GOSTKOWSKI MD | ||||||||||||||
| PHYSICIAN | $612,210 | $0 | $0 | $0 | $0 | $0 | $9,745 | $0 | $58,421 | $0 | $680,376 | $0 | $0 | $0 |
| WILLIAM MCGEEHIN MD | ||||||||||||||
| PHYSICIAN | $584,900 | $0 | $0 | $0 | $0 | $0 | $10,159 | $0 | $55,814 | $0 | $650,873 | $0 | $0 | $0 |
| DAVID FRECCERO MD | ||||||||||||||
| PHYSICIAN | $532,006 | $0 | $0 | $0 | $0 | $0 | $1,896 | $0 | $50,767 | $0 | $584,669 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| MARK PRETE MD | |||
| KEY EMPLOYEE | $543,761 | PARTNER IN NWCT EMERGENCY MEDICINE P.C. WHICH PROVIDES EMERGENCY ROOM SERVICES TO THE HOSPITAL. | 0 |
| DIANE LIBBY CPA | |||
| GOVERNOR | $6,100 | PARTNER IN ADAMS SAMARTINO & CO, P.C. WHICH PROVIDES ACCOUNTING SERVICES TO CHARLOTTE HUNGERFORD HOSPITAL. | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY OF FORM 990 IS DISTRIBUTED TO THE BOARD OF DIRECTORS BEFORE IT IS FILED WITH THE IRS. THIS ENABLES THE BOARD TO ASK QUESTIONS, AND TO APPROVE THE DISCLOSURES MADE IN THE RETURN. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE HOSPITAL DISTRIBUTES A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY TO ITS BOARD OF DIRECTORS, ALL MANAGEMENT PERSONNEL, AND PURCHASING AGENTS. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION FOR SENIOR STAFF IS DETERMINED USING THE FOLLOWING STEPS: - A MARKET SURVEY BASED ON CT HOSPITAL ASSOCIATION IS USED AS A STARTING POINT. - ADJUSTMENTS ARE THEN MADE BASED ON THE CANDIDATE'S CURRENT SALARY AND PRIOR EXPERIENCE. - THE COMPENSATION FIGURE IS THEN PRESENTED TO THE BOARD OF DIRECTORS FOR APPROVAL. THE LAST COMPENSATION REVIEW OCCURRED IN AUGUST 2014. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND ANNUAL REPORT AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | PENSION RELATED CHANGES OTHER THAN NET PERIODIC PENSION COSTS -7,784,797. NET ASSETS RELEASED FROM RESTRICTIONS -269,043. |
| FORM 990, PART XI, LINE 2C: | THE HOSPITAL'S AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THESE FUNCTIONS AND PROCESSES HAVE NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ADVANCED MEDICAL IMAGING OF NW CT LLC | |||||||||||||
| 57 COMMERCIAL BLVD | TORRINGTON | CT | 06790 | 061594854 | MAGNETIC RESONANCE IMAGING | CT | N/A | RELATED | $5,336,553 | $283,055 | 0 | 0 | 0.50000 |
| UROLOGY CENTER OF NW CT LLC | |||||||||||||
| 538 LITCHFIELD STREET | TORRINGTON | CT | 06790 | 582674029 | EQUIPMENT RENTAL | CT | N/A | RELATED | $55,137 | $51,422 | 0 | 0 | 0.62500 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LITCHFIELD COUNTY HEALTHCARE SERVICE CORPORATION | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 540 LITCHFIELD STREET | AddressLine1 |
| City | TORRINGTON | City |
| State | CT | State |
| ZIP Code | 06790 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 061227655 | EIN |
| Primary Activities | MANAGEMENT SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | CT | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE CHARLOTTE HUNGERFORD HOSPTIAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Share Of EOY Assets | $505 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| ADVANCED MEDICAL IMAGING OF NW CT LLC | ||
| S | $528,000 | ACTUAL |
| UROLOGY CENTER OF NW CT LLC | ||
| K | $106,846 | ACTUAL |