2014-08-13T08:51:41-05:00 2013-09-30 061533253 SASLOW LUFKIN & BUGGY LLP 175 POWDER FOREST DRIVE SIMSBURY CT 06089 990 2012-10-01 060647014 GRIFFIN HOSPITAL GRIF 2037327528 130 DIVISION STREET DERBY CT 06418 MARK O'NEILL 2037327528 2014-08-11 1 BETH THURZ P00346435 8606789200 2012 2015-11-30 17:44:51Z PATRICK S CHARMEL 130 DIVISION STREET DERBY CT 06418 131995459 0 X GRIFFINHEALTH.ORG X 1908 CT GRIFFIN HOSPITAL IS COMMITTED TO PROVIDING PERSONALIZED, HUMANISTIC, CONSUMER-DRIVEN HEALTH CARE IN A HEALING ENVIRONMENT. 22 18 1453 232 3312813 -960068 2234902 2231692 126387570 128990660 464000 320617 422129 452490 129508601 131995459 0 0 0 0 72639965 72402078 0 0 0 61258997 57266011 133898962 129668089 -4390361 2327370 129920217 119856922 159955862 133564097 -30035645 -13707175 X GRIFFIN HOSPITAL IS COMMITTED TO PROVIDING PERSONALIZED, HUMANISTIC, CONSUMER-DRIVEN HEALTH CARE IN A HEALING ENVIRONMENT; TO EMPOWERING INDIVIDUALS TO BE ACTIVELY INVOLVED IN DECISIONS AFFECTING THEIR CARE AND WELL-BEING THROUGH ACCESS TO INFORMATION AND EDUCATION; AND TO PROVIDING LEADERSHIP TO IMPROVE THE HEALTH OF THE COMMUNITY WE SERVE. 0 0 113144931 114088796 GRIFFIN HOSPITAL IS AN ACUTE CARE HOSPITAL PROVIDING MEDICAL CARE TO PATIENTS IN COMMUNITIES SERVED, INCLUDING SUBSIDIZED CARE, CHARITY CARE, AND EDUCATIONAL SERVICES TO HEALTH PROFESSIONALS TO HELP PREPARE THE NEXT GENERATION OF CAREGIVERS. 3542420 8237606 PROVIDE CANCER RELATED RADIOLOGY SERVICES TO THE COMMUNITY. 1982636 1876818 PROVIDE PSYCHIATRIC SERVICES TO THE COMMUNITY ON AN OUTPATIENT BASIS. 589683 1508490 PROVIDE HOSPICE SERVICES TO THE COMMUNITY. 589683 1508490 119259670 1 1 0 1 0 0 0 0 0 1 1 1 1 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 183 0 1 1453 1 1 1 0 0 0 0 0 0 0 0 0 X 22 18 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 1 1 1 CT X JAMES DOWNEY 2037327528 130 DIVISION STREET DERBY CT 06418 HENDRICKS DAVID 1.00 X 0 0 0 CHARMEL PATRICK 40.00 5.00 X X 487577 0 65392 BORIS GREGORY 1.00 X 0 0 0 DOBULER KENNETH 14.00 X 232023 0 47152 SCHWARTZ KENNETH 16.00 X 200262 0 67934 STUMPO BARBARA J 40.00 X X 179979 0 48122 ANDREANA JOSEPH 1.00 X 0 0 0 BALDYGA KENNETH 1.00 X 0 0 0 BETKOSKI JOHN W III 1.00 X X 0 0 0 DINARDO NANCY 1.00 X 0 0 0 FOX ROBERT A 1.00 X 0 0 0 JONES JEAN CRUM 1.00 X 0 0 0 KLARIDES THEMIS 1.00 X 0 0 0 LOGAN GEORGE S 1.00 X 0 0 0 OSAK FRANK M 1.00 X 0 0 0 MEZZO ROBERT 1.00 X 0 0 0 REISS ROBERT G 1.00 X 0 0 0 WEINER GERALD T 1.00 X 0 0 0 ZAPRZALKA JOHN J 1.00 X 0 0 0 SACZYNSKI SHELLY 1.00 X 0 0 0 BINGAMAN LARRY 1.00 X 0 0 0 PEARSON WM NEIL 1.00 X 0 0 0 MOYLAN JAMES J 40.00 X 248830 0 0 POWANDA WILLIAM 40.00 X 192757 0 49769 BERNS EDWARD 40.00 X 157815 0 52985 MARTIN KATHLEEN 40.00 X 155252 0 51790 DEEGAN MARGARET 40.00 X 213625 0 38716 SHEPARD SETH 40.00 X 193645 0 21483 FRAMPTON SUSAN 40.00 X 0 283241 46714 O'NEILL MARK 40.00 X 83160 0 10462 D'SOUSA SEEMA 30.00 X 205177 0 9576 HALSTEAD EDWARD 40.00 X 218803 0 75282 NAWAZ HAQ 40.00 X 277385 0 27997 SALABARRIA JAVIER 40.00 X 288852 0 23048 PAXTON HEATHER 40.00 X 201828 0 21456 3536970 283241 657878 72 0 1 0 HURON CONSULTING SERVICE 4795 PAYSPHERE CIRCLE CHICAGO IL 60674 CONSULTING SERVICE 2027291 UNIDINE CORPORATION 75 REMITTANCE DRIVE CHICAGO IL 60675 FOOD SERVICE 1675858 CONNECTICUT EMERGENCY MEDICINE SPECIALIS PO BOX 271618 WEST HARTFORD CT 06127 E.R. PHYSICIAN SERVICES 1357834 F & F MECHANICAL ENTERPRISES 2 DWIGHT STREET NORTH HAVEN CT 06473 CONSTRUCTION 534920 CARDIOLOGY ASSOC OF DERBY 130 DIVISION STREET DERBY CT 06418 PHYSICIAN SERVICES 391306 24 1802806 428886 2231692 PATIENT SERVICE REVENUE 622110 125805820 122526870 3278950 OTHER PROGRAM SERVICES 621500 3184840 3184840 128990660 266799 266799 418627 0 418627 418627 418627 53818 0 53818 53818 53818 PARTNERSHIP INCOME 900099 33863 33863 33863 131995459 125711710 3312813 739244 3372665 2225959 1146706 49865601 44879041 4986560 4951853 4456668 495185 10117788 9106009 1011779 4094171 3684754 409417 3279143 2951229 327914 259177 259177 256296 256296 9461837 8515653 946184 397456 397456 317785 286007 31778 371608 371608 329676 329676 190183 190183 4254018 4254018 6099345 6099345 3082676 2774408 308268 MEDICAL & DRUG SUPPLIES 16774433 16774433 RESEARCH GRANT EXPENSES 2291549 2062394 229155 DIETARY 1186475 1186475 8714354 8714354 129668089 119259670 10408419 0 8071213 5178405 12754987 14419423 852072 804168 2258893 2669266 149939077 94328204 59966718 55610873 6519819 10227164 15213004 16149279 24283511 14798344 129920217 119856922 28300556 25957546 40179 194930 51432599 48355712 80182528 59055909 159955862 133564097 X -38049002 -22179759 2203003 2641381 5810354 5831203 -30035645 -13707175 129920217 119856922 X 2327370 81689 13919411 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 0 0 0 0 0 0 0 0 1 14464 14464 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THE GRIFFIN HOSPITAL PAID FOR MEMBERSHIP DUES TO THE CONNECTICUT HOSPITAL ASSOCIATION FOR THE FISCAL YEAR ENDED 9/30/2013. $14,464 OF THE MEMBERSHIP DUES PAID WAS USED FOR LOBBYING ON ISSUES RELEVANT TO THE ORGANIZATION'S EXEMPT PURPOSE. 3249540 183001 23479 3409062 2932333 322207 5000 3249540 2953261 -1478 19450 2932333 2773278 124305 1337 2896246 2677652 97031 1405 2773278 0.63400 0.36600 1 0 4015091 4015091 73218689 36499924 36718765 72365111 57553954 14811157 340186 274326 65860 55610873 FIXED INCOME SECURITIES 5270018 F MARKETABLE EQUITY SECURITIES 4957146 F 10227164 LIMITED USE ASSETS - CURRENT 710605 F BOARD DESIGNATED INVESTMENTS 43179 F BENEFICIAL INTEREST IN TRUSTS 3670942 F UNDER INDENTURE AGREEMENT 4289166 F INVESTMENTS OF NET ASSETS OF AFFILIATES 7435387 C 16149279 OTHER RECEIVABLES 1739959 DUE FROM AFFILIATES 3659921 OTHER ASSETS & INSURANCE RECOVERABLE 8840778 THIRD PARTY 480486 DEFERRED REVENUE 77200 14798344 ACCRUED POST RETIREMENT - CURRENT 389000 ACCRUED POST RETIREMENT - NONCURRENT 7605700 PROFESSIONAL AND GENERAL LIABILITY 908285 MINIMUM PENSION LIABILITY 30640516 WORKERS COMPENSATION - LONG TERM 2317799 ACCRUED INTEREST PAYABLE 316307 OTHER LIABILITIES 15431054 RETIREMENT OBLIGATION 114445 CAPITAL LEASE - NET OF CURRENT 1221917 DUE TO AFFILIATES 110886 59055909 132077148 81689 81689 131995459 0 131995459 129668089 0 129668089 0 129668089 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE HOSPITAL'S ENDOWMENT FUNDS CONSIST OF DONOR RESTRICTED FUNDS TO BE INVESTED IN PERPETUITY TO PROVIDE A PERMANENT SOURCE OF INCOME. 1 1 1 X 250.000000000000 1 X 1 1 0 1 1 307 1477742 0 1477742 0.01140 11886 12780807 8827233 3953574 0.03050 110 160935 119507 41428 0.00030 12303 14419484 8946740 5472744 0.04220 46723 1026737 7210 1019527 0.00790 4539 7256619 5062395 2194224 0.01690 40995 21100488 21303418 -202930 0.00000 1247810 0 1247810 0.00960 2186 48878 0 48878 0.00040 94443 30680532 26373023 4307509 0.03480 106746 45100016 35319763 9780253 0.07700 1 723180 43184948 50292672 -7107724 X 1 1 1 1 GRIFFIN HOSPITAL

130 DIVISION STREET DERBY CT 06418

GRIFFINHEALTH.ORG X X X X X X X GRIFFIN HOSPITAL 1 1 X X X X X X X 12 1 0 1 X X X X X X X 0 0 1 1 250.000000000000 1 400.000000000000 1 X X X X X X X 1 1 X X X X X X 1 0 X X X X 1 X 0 0 PART I, LINE 3C: GRIFFIN HOSPITAL CRITERIA FOR DETERMINING ELIGIBILITY FOR FREE CARE OR DISCOUNTED CARE INCLUDE ELIGIBILITY REQUIREMENTS. ALL GUARANTORS WITH FAMILY INCOME EQUAL TO OR BELOW TWO HUNDRED PERCENT OF THE FEDERAL POVERTY STANDARD ADJUSTED FOR FAMILY SIZE SHALL BE DETERMINED TO BE INDIGENT PERSONS QUALIFYING FOR CHARITY SPONSORSHIP FOR THE FULL AMOUNT OF HOSPITAL CHARGES RELATED TO APPROPRIATE HOSPITAL-BASED MEDICAL SERVICES THAT ARE NOT COVERED BY PRIVATE OR PUBLIC THIRD-PARTY SPONSORSHIP. ALL GUARANTORS WITH FAMILY INCOME BETWEEN TWO HUNDRED ONE PERCENT (201%) AND FOUR HUNDRED PERCENT (400%) OF THE FEDERAL POVERTY STANDARD ADJUSTED FOR FAMILY SIZE SHALL BE DETERMINED TO BE INDIGENT PERSONS QUALIFYING FOR DISCOUNTS FROM CHARGES RELATED TO APPROPRIATE HOSPITAL BASED MEDICAL SERVICES IN ACCORDANCE WITH THE HOSPITAL'S SLIDING FEE SCHEDULE AND POLICIES REGARDING INDIVIDUAL FINANCIAL CIRCUMSTANCES BASED ON THE BELOW CRITERIA: A. ELIGIBILITY SHALL BE BASED ON FIANCIAL NEED AT THE TIME OF APPLICATION BY COMPARING TOTAL FAMILY INCOME WITH THE CURRENT FEDERAL POVERTY GUIDELINES. IF A FAMILY'S TOTAL INCOME IS GREATER THAN 100% OF THE FEDERAL POVERTY GUIDELINE FAMILY ASSETS, OTHER THAN EXEMPT ASSETS LISTED BELOW, MAY BE CONSIDERED AS A SOURCE OF PAYMENT. B. EXEMPT ASSETS (BASED ON MEDICARE EXEMPTED ASSETS) LISTED BELOW SHOULD NOT BE ADDED TO FAMILY WORTH FOR CHARITY REVIEW: I. FAMILY PRINICPAL RESIDENCE; II. NECESSARY MOTOR VEHICLES REQUIRED FOR EMPLOYMENT, REQUIRED FOR ACCESS TO TREATMENT, OR MODIFIED FOR OPERATION OR TRANSPORT OF A DISABLED PERSON; III. PERSONAL EFFECTS AND HOUSEHOLD GOODS; IV. RESOURCES NECESSARY FOR SELF-SUPPORT. ALL RESOURCES OF BOTH SPOUSES ARE CONSIDERED TOGETHER. C. CHARITY WILL BE ASSIGNED USING THE MOST RECENTLY PUBLISHED FEDERAL POVERTY STANDARDS AND EVALUATED ON THE ADJUSTED FAMILY INCOME AS EXPLAINED ABOVE FOR THOSE ABOVE 201% OF SUCH STANDARDS. D. DOCUMENTATION WILL BE REQUESTED AND IN MOST CASES WILL BE REQUIRED TO ESTABLISH ELIGIBILITY FOR CHARITY CARE. IN THE EVENT THAT THE GUARANTOR IS NOT ABLE TO PROVIDE THE DOCUMENTATION DESCRIBED ABOVE, THE HOSPITAL SHALL RELY UPON WRITTEN AND SIGNED STATEMENTS FROM THE GUARANTOR TO MAKE A FINAL DETERMINATION OF ELIGIBILITY FOR CLASSIFICATION AS AN INDIGENT PERSON. PART I, LINE 6A: GRIFFIN HOSPITAL DID PREPARE A COMMUNITY BENEFIT REPORT FOR YEAR ENDING 2013, WHICH WAS INCLUDED AS PART OF OUR ANNUAL REPORT. PART I, LINE 6B: GRIFFIN HOSPITAL POSTS ITS COMMUNITY BENEFIT REPORT AND INFORMATION ON THE HOSPITAL WEBSITE GRIFFINHEALTH.ORG. PART I, LINE 7: CHARITY CARE AND OTHER COMMUNITY BENEFITS WERE CALCULATED USING A COST ACCOUNTING SYSTEM OR COST TO CHARGE RATIO. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS AND ASSIGNS COSTS TO INDIVIDUAL SERVICES. PART III, LINE 4: SEE PAGE 11 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.PART III, LINE 2:GRIFFIN HOSPITAL BAD DEBT EXPENSE IS DETERMINED USING UNCOLLECTED ACCOUNTS NET OF ANY BAD DEBT RECOVERY MULTIPLIED BY THE COST TO CHARGE RATIO. GRIFFIN HOSPITAL HAS A WRITTEN POLICY ABOUT WHEN AND UNDER WHOSE AUTHORITY PATIENT DEBT IS ADVANCED FOR COLLECTION AND SHALL USE ITS BEST EFFORTS TO ENSURE THAT THE PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. CHARTIY APPROVAL WILL AFFECT ALL ACCOUNTS FOR WHICH THE APPROVED GUARANTOR IS RESPONSIBLE. THE APPROVED CHARITY PERCENTAGE WILL BE APPLIED TO ALL EXISTING ACCOUNTS WITH DEBIT BALANCES. ACCOUNTS MAY ALSO BE RETURNED FROM BAD DEBT STATUS IF FINANCIAL CIRCUMSTANCES WARRANT AND CHARITY MAY BE APPLIED. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FREE CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN IT'S ESTABLISHED AND CONTRACTUAL RATES. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS FREE CARE, THEY ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE.GRIFFIN HOSPITAL DOES NOT ATTRIBUTE ANY BAD DEBT TO COMMUNITY BENEFIT EXPENSE. UNCOLLECTED BALANCES ARE REVIEWED AT MANY STAGES TO DETERMINE IF THEY FALL UNDER UNINSURED OR FREE CARE ASSISTANCE. PART III, LINE 8: THE $7.107 MILLION MEDICARE SHORTFALL SHOULD BE CONSIDERED AS COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THIS YEAR MEDICARE ACCOUNTED FOR 5.5% OF HOSPITAL EXPENSES. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. PART III, LINE 9B: GRIFFIN HOSPITAL HAS A WRITTEN POLICY ABOUT WHEN AND UNDER WHOSE AUTHORITY PATIENT DEBT IS ADVANCED FOR COLLECTION AND SHALL USE ITS BEST EFFORTS TO ENSURE THE PATIENT AMOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. GRIFFIN WILL ENSURE THAT PRACTICES TO BE USED BY THEIR OUTSIDE COLLECTION AGENCIES WILL CONFORM TO THE STANDARDS SET FORTH IN THIS POLICY AND SHALL OBTAIN WRITTEN COMMITMENTS FROM SUCH AGENCIES AT TIME OF BILLING. GRIFFIN WILL PROVIDE TO ALL LOW INCOME UNINSURED PATIENTS THE SAME INFORMATION CONCERNING SERVICES AND CHARGES PROVIDED TO ALL OTHER PATIENTS WHO RECEIVE CARE AT THE HOSPITAL. FOR PATIENTS WHO HAVE AN APPLICATION PENDING DETERMINATION FOR EITHER GOVERNMENT SPONSORED COVERAGE OR FOR THE HOSPITAL'S OWN FINANCIAL ASSISTANCE PROGRAM, GRIFFIN WILL NOT KNOWINGLY SEND THAT PATIENT'S BILL TO A COLLECTION AGENCY. IF A PATIENT DOES NOT MAINTAIN THE AGREED UPON PAYMENT SCHEDULE THE AMOUNT WILL BE FORWARDED TO AN OUTSIDE COLLECTION AGENCY AT THE FULL REMAINING BALANCE. IF IT IS LATER DETERMINED BY THE GRIFFIN HOSPITAL OR OR A COLLECTION AGENCY ACTING ON BEHALF OF GRIFFIN HOSPITAL THAT THE PATIENT FINANCIAL CONDITIONS HAVE CHANGED AND THE PATIENT WAS UNABLE TO PAY THE OUTSTANDING ACCOUNT BALANCES AN OVERRIDE MAY BE APPLIED BY THE BUSINESS SERVICES DIRECTOR. THE UNCOLLECTED DEBT WILL BE TRANSFERRED TO UNINSURED OR FREE CARE ASSISTANCE BY THE SUPERVISOR AFTER REVIEW. GRIFFIN HOSPITAL PART V, SECTION B, LINE 3: REGIONAL COOPERATION ON HEALTH ISSUES - REGIONAL COOPERATION, THE LEADERSHIP OF GRIFFIN HOSPITAL ON COMMUNITY HEALTH IMPROVEMENT AND THE EFFECTIVENESS OF EFFORTS WAS POSITIVELY NOTED IN FOCUS GROUPS, FORUMS AND SURVEYS. OF PARTICULAR NOTE WAS THE VALLEY COUNCIL OF HEALTH AND HUMAN SERVICE ORGANIZATIONS (VCHHSO). GRIFFIN HOSPITAL WAS A LEADER IN ESTABLISHING THE VALLEY COUNCIL OF HEALTH AND HUMAN SERVICE ORGANIZATIONS WHICH HAS BECOME A MODEL FOR OTHER COMMUNITIES. THE VALLEY COUNCIL IS A COOPERATIVE VENTURE FOUNDED OVER TWENTY YEARS AGO LINKING APPROXIMATELY 50 NON-PROFIT HEALTH & HUMAN SERVICE PROVIDERS THROUGHOUT THE VALLEY. ITS MISSION IS TO IDENTIFY, PLAN, IMPLEMENT, AND COORDINATE A COMPREHENSIVE SYSTEM OF HUMAN SERVICE DELIVERY AND TO ADVOCATE FOR COMMUNITY-WIDE AND CULTURALLY DIVERSE PLANNING APPROACHES IN THE LARGER VALLEY COMMUNITY. DECISION MAKERS FROM EACH OF THE ACTIVE MEMBERS MEET MONTHLY. THE COUNCIL'S OBJECTIVES ARE TO: 1. ENGAGE IN PERIODIC ASSESSMENT AND IDENTIFICATION OF LOCAL SERVICE NEEDS, INCLUDING CLIENT INPUT. 2. COLLABORATIVELY EVALUATE CURRENT SERVICES, IDENTIFY GAPS, AND STRATEGIZE ON HOW TO FILL GAPS IN SERVICES. 3. SERVE AS THE PRIMARY PLANNING AND COORDINATING BODY FOR THE REGIONS' SERVICE PROVISION SYSTEM. 4. PROVIDE A PLACE FOR SUPPORT AND NETWORKING AMONG THE VALLEY HUMAN SERVICES COMMUNITY. 5. ADVOCATE FOR THE NEEDS OF LOCAL RESIDENTS AND FOR RESOURCES TO MEET THOSE NEEDS ON A LOCAL, STATE, AND FEDERAL LEVEL. 6. SEEK TO DEVELOP PARTNERSHIPS WITH OTHER COMMUNITY SYSTEMS (I.E. SCHOOLS, BUSINESSES, STATE AND LOCAL GOVERNMENTS, PUBLIC SAFETY) TO ENHANCE SERVICE DELIVERY. GRIFFIN REMAINS AN ACTIVE MEMBER OF THE COUNCIL. NOT ONLY IS GRIFFIN HOSPITAL A CONTINUING MEMBER, THE VALLEY PARISH NURSE PROGRAM AND THE YALE-GRIFFIN PREVENTION RESEARCH CENTER ALSO ARE MEMBERS. THE COMMUNITY ADVISORY COUNCIL ENGAGED THE PATIENTS AND THE COMMUNITY TO GET MEANINGFUL FEEDBACK ABOUT THE HOSPITAL'S SERVICES. THROUGHOUT ITS HISTORY, GRIFFIN'S MOST INNOVATIVE PROGRAMS HAVE BEEN DEVELOPED USING INSIGHTS GLEANED FROM PATIENTS AND FAMILY MEMBER FOCUS GROUPS. THE COMMUNITY ADVISORY COUNCIL WAS A NATURAL NEXT STEP FOR GRIFFIN AS A WAY TO SOLICIT THE PATIENT'S PERSPECTIVE OF CARE, PROGRAMS AND SERVICES AND TO IDENTIFY COMMUNITY NEEDS ON AN ONGOING BASIS.THE VALLEY CARES TASKFORCE BETH PATTON COMERFORD, MS, YALE-GRIFFIN PREVENTION RESEARCH CENTER (TASKFORCE CO-CHAIR) MARY S. NESCOTT, MPH, BIRMINGHAM GROUP HEALTH SERVICES, INC. (TASKFORCE CO-CHAIR) HEIDI ZAVATONE-VETH, PHD, VALLEY COUNCIL FOR HEALTH & HUMAN SERVICES (VALLEY COUNCIL COORDINATOR) KAREN N. SPARGO, MA, MPH, NAUGATUCK VALLEY HEALTH DISTRICT JESSE REYNOLDS, MS, (CURRENTLY YALE UNIVERSITY) ANN HARRISON, THE WORKPLACE, INC. (CURRENTLY WORKFORCE ALLIANCE). THE MATERIAL IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT WILL DOCUMENT GRIFFIN'S COMMITMENT TO THE SIX TOWN VALLEY COMMUNITIES THAT HAS BEEN ITS PRIMARY SERVICE AREA FOR OVER A CENTURY. MUCH OF THE RESEARCH REFERENCED AND USED IN THE CHNA HAS BEEN DONE OVER A TWO DECADE PERIOD OF TIME AND HAS BEEN A COLLABORATIVE EFFORT BETWEEN THE VALLEY COUNCIL OF HEALTH AND HUMAN SERVICE ORGANIZATIONS, GRIFFIN HOSPITAL AND THE YALE-GRIFFIN PREVENTION RESEARCH CENTER. GRIFFIN HOSPITAL PART V, SECTION B, LINE 5C: THE CHNA REPORT IS WIDELY AVAILABLE ON THE GRIFFIN HOSPITAL WEBSITE HTTP://WWW.GRIFFINHEALTH.ORG/ AND THE STATE OF CONNECTICUT'S WEBSITE HTTP://WWW.CT.GOV/DPH/CWP/. ALSO THE CHNA IS AVAILABLE AT THE FACILITY. GRIFFIN HOSPITAL PART V, SECTION B, LINE 7: GRIFFIN'S CHNA IDENTIFIED OUR COMMUNITY NEEDS AS AWARENESS OF HEALTH AND HUMAN SERVICES, TRANSPORTATION, OBESITY, PRIMARY CARE ACCESS, COMMUNITY POPULATION BASED MEDICAL ISSUES, CLINICAL SERVICES, SUBSTANCE ABUSE, PRE-NATAL CARE AND REGIONAL COOPERATION ON HEALTH ISSUES. GRIFFIN PLANS TO ADDRESS PRIORITY AREAS WITH IMPLEMENTATION PLANS ON ALL BUT ONE OF THE SUGGESTED NEEDS. THERE WAS A PERCEPTION THAT PRE-NATAL CARE WAS LOW AND THAT AN INTERVENTION WAS NEEDED. RESEARCH, HOWEVER, REVEALED THAT PRENATAL CARE FOR MOTHERS-TO-BE IN THE VALLEY WAS SIGNIFICANTLY BETTER WHEN COMPARED TO THE STATE AND NEW HAVEN COUNTY AS REPORTED BY THE CONNECTICUT DEPARTMENT OF PUBLIC HEALTH. BASED ON THE ACTUAL DATA THERE IS NO ACTION REQUIRED RELATED TO PRE-NATAL CARE. THE INFORMATION WILL BE WIDELY SHARED WITH HEALTH AND HUMAN SERVICE ORGANIZATIONS AND OTHER COMMUNITY LEADERS TO ENSURE THAT THERE IS INCREASED KNOWLEDGE OF THE VALLEY DATA AS COMPARED TO NEW HAVEN COUNTY AND THE STATE OF CONNECTICUT. PART VI, LINE 2: GRIFFIN HAS A HISTORY OF COMMUNITY SERVICE AND SOCIAL RESPONSIBILITY DATING BACK TO ITS FOUNDING 100 YEARS AGO, AND OF PROVIDING EDUCATIONAL, PREVENTION AND SCREENING PROGRAMS AND SERVICES. IN 1970, FUNDED BY A GRANT FROM THE KELLOGG FOUNDATION, GRIFFIN ESTABLISHED ONE OF THE FIRST HOSPITAL DEPARTMENTS OF COMMUNITY HEALTH IN THE COUNTRY TO FOCUS ON THE HEALTH AND SOCIAL NEEDS OF THE COMMUNITY IT SERVES. OVER THE PAST FIFTEEN YEARS, GRIFFIN'S REACH HAS BEEN EXPANDING INTO THE COMMUNITY. IN ADDITION TO PROVIDING HEALTH INFORMATION AND SERVICES TO THE PUBLIC AT THE HOSPITAL AND OTHER SATELLITE LOCATIONS, GRIFFIN TAKES THESE ACTIVITIES INTO THE COMMUNITIES WHERE PATIENTS LIVE AND WORK. BY OFFERING A VARIETY OF SUPPORT GROUPS, TRAINING SESSIONS, EDUCATIONAL PROGRAMS, AND OTHER COMMUNITY-BASED RESOUCES AND ACTIVITIES, AND COLLABORATING WITH OTHER NON-PROFIT ORGANIZATIONS AND GOVERNMENT ENTITIES, GRIFFIN HAS EXTENDED ITS MISSION FAR BEYOND THE HOSPITAL'S WALLS TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF PEOPLE OF ALL AGES. COMMUNITY LEADERSHIP RECOGNIZED THE NEED TO RESPOND TO THE CHANGING COMMUNITY DEMOGRAPHICS AND THE DIFFERENT SOCIOECONOMIC AND HEALTH NEEDS AND EXPECTATIONS OF THE MORE DIVERSE POPULATION. THREE MAJOR NEW STRUCTURES WERE CREATED. IN 1993, THE VALLEY COUNCIL OF HEALTH AND HUMAN SERVICE ORGANIZATION (VCHHSO) WAS FOUNDED. MORE THAN 55 ORGANIZATIONS THAT PROVIDE MOST OF THE HEALTH AND HUMAN SERVICES ARE MEMBERS. VCHHSO'S VISION IS A PROVIDER NETWORK THAT WORKS COLLABORATIVELY TO CREATE AN INTEGRATED HUMAN SERVICES DELIVERY SYSTEM THAT MEETS THE NEEDS OF ALL RESIDENTS. "HEALTHY VALLEY 2000", THE STATE'S FIRST HEALTHY COMMUNITY EFFORT, WAS LAUNCHED IN 1994. WITH FOUNDATION GRANT SUPPORT, THE NATIONAL CIVIC LEAGUE WAS ENGAGED TO GUIDE STAKEHOLDERS THROUGH THE PROCESS. THE VISION OF THE BROAD-BASED, VOLUNTEER INSPIRED AND MANAGED EFFORT WAS TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF THE COMMUNITY AND ITS RESIDENTS BY MAKING THE COMMUNITY A BETTER PLACE IN WHICH TO LIVE, WORK, SHOP, RAISE A FAMILY AND ENJOY LIFE. BASED ON RESEARCH, INCLUDING USE OF THE NATIONAL CIVIC LEAGUE INDEX, A S.W.O.T ANALYSIS, AND BRAINSTORMING, 175 STAKEHOLDERS IDENTIFIED ARTS & RECREATION, COMMUNITY INVOLVEMENT, ECONOMIC DEVELOPENT, EDUCATION AND HEALTH AS PRIORITIES. A TASK FORCE DEVELOPED A WORK PLAN FOR EACH OF THE PRIORITIES AND AN HONOR ROLE WAS DEVELOPED TO RECOGNIZE INITIATIVES UNDERTAKEN INDEPENDENTLY BY INDIVIDUALS OR ORGANIZATIONS RELATED TO THE IDENTIFIED PRIORITIES.THE BOARD ADOPTED STRATEGIC PLAN FOR THE 2010 - 2013 PERIODS, WHICH INCLUDED A PROVISION TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT AND ADOPT A STRATEGY TO MEET COMMUNITY HEALTH NEEDS IDENTIFIED IN THE ASSESSMENT. THE PROVISION INCLUDED OBTAINING INPUT FROM A BROADLY DIVERSE CROSS SECTION OF THE COMMUNITY THE HOSPITAL SERVES. IT ALSO INCLUDED THE POSTING OF THE ASSESSMENT ON THE CORPORATE SOCIAL RESPONSIBILITY SECTION OF THE HOSPITAL'S WEBSITE. PART VI, LINE 3: GRIFFIN HOSPITAL'S BUSINESS SERVICES OFFICE IS AVAILABLE TO HELP YOU UNDERSTAND YOUR BILL AND PAYMENT OPTIONS. IF YOU HAVE A QUESTION ABOUT A BILL YOU RECEIVED, OR YOU WOULD LIKE TO MEET WITH A FINANCIAL ADVISOR, PLEASE CALL THE BUSINESS OFFICE AT (203) 732-7360. GRIFFIN HOSPITAL MAINTAINS A PROFESSIONAL STAFF OF SPECIALISTS TO HELP YOU RESOLVE FINANCIAL PROBLEMS REGARDING YOUR BILL. A REPRESENTATIVE WILL BE ASSIGNED TO YOU WHO WILL HELP OBTAIN BILLING INSTRUCTIONS, ASSIST YOU IN COMPLETING FORMS AND ADVISE YOU OF YOUR FINANCIAL RESPONSIBILITY.POLICY & PROCEDURE: ANY PATIENT REQUESTING FINANCIAL ASSISTANCE IN PAYING THEIR GRIFFIN HOSPITAL BILL CAN APPLY FOR THE FREE CARE ASSISTANCE PROGRAM BY CONTACTING THE HOSPITAL'S FINANCIAL ADVISORY STAFF. THE FINANCIAL ADVISOR WILL BE CONTACTED BY THE PATIENT TO COMPLETE THE FREE CARE APPLICATION PROCESS. THE FINANCIAL ADVISOR WILL OBTAIN THE FOLLOWING INFORMATION FROM THE PATIENT IN ORDER TO COMPLETE THE FREE CARE APPLICATION: PATIENT'S W-2 FORM (TAX STATEMENT FROM PREVIOUS AND CURRENT YEAR); THREE CONSECUTIVE PAY STUBS FROM PATIENT'S CURRENT EMPLOYMENT; DEPENDENT INFORMATION (FAMILY SIZE); AND ANY OR ALL BANK AND CHECKING ACCOUNT STATEMENTS. THE FINANCIAL ADVISOR WILL REFER TO THE GRIFFIN HOSPITAL SLIDING SCALE. THIS IS BASED ON THE FEDERAL POVERTY INCOME GUIDELINES (SLIDING SCALE AVAILABLE UPON REQUEST). THE FINANCIAL ADVISOR WILL MAKE A DETERMINATION OF FREE CARE ELIGIBILITY STATUS. IF THE PATIENT QUALIFIES FOR FREE CARE ASSISTANCE, THE APPLICABLE DISCOUNT PERCENTAGE WILL BE APPLIED TO THE PATIENT'S ACCOUNT BALANCE. IF A PATIENT BALANCE REMAINS, THE FINANCIAL ADVISOR WILL PURSUE ONE OF THE FOLLOWING WITH THE PATIENT: REQUIRE PAYMENT IN FULL OR SET UP A MONTHLY PAYMENT ARRANGEMENT. IF THE PATIENT DOES NOT MAINTAIN THE AGREED UPON PAYMENT SCHEDULE, THE ACCOUNT WILL BE FORWARDED TO AN OUTSIDE COLLECTION AGENCY AT THE FULL REMAINING BALANCE. IF A PATIENT DOES NOT QUALIFY FOR FREE CARE ASSISTANCE, THE FINANCIAL ADVISOR WILL ATTEMPT TO: OBTAIN PAYMENT IN FULL OR SET UP A MONTHLY PAYMENT ARRANGEMENT. IF THE PATIENT DOES NOT MAINTAIN THE AGREED UPON PAYMENT SCHEDULE, THE ACCOUNT WILL BE FORWARDED TO AN OUTSIDE COLLECTION AGENCY AT THE FULL REMAINING BALANCE. IN SOME CASES, IT IS NECESSARY TO OVERRIDE THE POLICY GUIDELINES ON INCOME DUE TO "SPECIAL" CIRCUMSTANCE REQUIREMENTS, I.E., SOCIAL ADMITS, MAXED OUT DAYS, DECEASED PATIENTS. AN OVERRIDE CAN BE OBTAINED BY THE SUPERVISOR AND DIRECTOR OR CFO ALLOWING FOR CONSIDERATION OF ELIGIBILITY. THE COLLECTION SUPERVISOR WILL MAINTAIN ALL MONTHLY SPREADSHEETS THAT WILL IDENTIFY ALL FREE BED FUNDS, UNINSURED, AND FREE CARE ASSISTANCE ALLOCATED ON A MONTHLY BASIS. PART VI, LINE 4: GRIFFIN HOSPITAL, LICENSED BY THE STATE OF CONNECTICUT FOR 160 BEDS AND 15 BASSINETS, IS A GENERAL ACUTE CARE HOSPITAL SERVING A PRIMARY SERVICE AREA (PSA) OF SIX TOWNS: ANSONIA, BEACON FALLS, DERBY, OXFORD, SYMOUR AND SHELTON, CONNECTICUT. THE SIX TOWN REGION HAS COME TO BE KNOWN AS THE LOWER NAUGATUCK VALLEY. THE SIX TOWNS, WITH AN AREA OF A LITTLE MORE THAN 100 SQUARE MILES, HAVE A COMBINED POPULATION OF OVER 107,000 BASED ON CURRENT ESTIMATES.THE VALLEY'S DEMOGRAPHICS IN TERMS OF POPULATION BY AGE GROUP MIRROR THOSE OF THE STATE OF CONNECTICUT. THE VALLEY'S AFRICAN AMERICAN POPULATION IS 4% COMPARED TO 10.1% FOR THE STATE, AND THE HISPANIC POPULATION IS 6% COMPARED TO 13.4% FOR THE STATE. THE AFRICAN AMERICAN POPULATION IS CENTERED PRIMARILY IN ANSONIA (11.6%), AND THE HISPANIC POPULUATION IS CENTERED PRIMARILY IN ANSONIA (16.7%) AND DERBY (14.2%). POPULATION BY ETHNIC BACKGROUND REMAINS PRIMARILY ITALIAN - 23%, POLISH/RUSSIAN/UKRAINIAN - 17%, AND IRISH - 11%. THE AGE 65 AND OVER POPULATION IS 14% COMPARED TO THE STATE OF CONNECTICUT ALSO AT 14% IN 2010.MEDIAN HOUSEHOLD INCOME (2007-2011) IN ALL VALLEY TOWNS HAS BEEN INCREASING, BUT ANSONIA ($55,259) AND DERBY ($55,478) REMAIN ALMOST $15,000 BELOW THE STATE MEDIAN. THE REMAINING TOWNS, SEYMOUR ($65,036), BEACON FALLS ($70,228), SHELTON ($79,176), AND OXFORD ($95,710), WERE CLOSE TO OR CONSIDERABLY ABOVE THE CONNECTICUT MEDIAN ($68,055), AN INDICATION OF THE ECONOMIC DISPARITIES WITHIN THE VALLEY. THE NUMBER OF FOOD STAMP RECIPIENTS IN ANSONIA (2,998 - 16%) AND DERBY (1,612 - 12%) WERE HIGHER THAN THE CONNECTICUT RATE (10%). ALL OTHER TOWNS WERE CONSIDERABLY BELOW THE STATE RATE. THE OVERALL POVERTY RATE WAS THE HIGHEST IN THE VALLEY (YEAR 2009) IN DERBY (11.5%) AND ANSONIA (10.7%). ALL OTHER TOWNS WERE CONSIDERABLY BELOW THE STATE RATE (11.9%) WITH OXFORD THE LOWEST (2.1%). ANSONIA AND DERBY EXPERIENCED INSIGNIFICANT POPULATION DECLINES BETWEEN THE 2000 AND 2010 CENSUS. IN ALL OTHER TOWNS THE POPULATION GREW BETWEEN 4% AND 31% IN OXFORD WHICH WAS THE FASTEST GROWING TOWN IN THE STATE PERCENTAGE WISE. THE TOTAL VALLEY POPULATION IS PROJECTED TO BE 109,510 IN 2017 UP FROM THE CURRENT 107,000.UNDER 18 YEARS OLD: 23,701 (22%)ABOVE 65 YEARS OLD: 16,353 (15%)HISPANIC OR LATINO: 9,227 (9%)NON-HISPANIC WHITE: 88,855 (83%)NON-HISPANIC BLACK: 4,412 (4%)NON-HISPANIC ASIAN: 2,834 (3%)NON-HISPANIC OTHER: 1,638 (2%)BACHELOR'S DEGREE OR HIGHER: 20,565 (28%)NUMBER OF PEOPLE IN POVERTY: 5,831 (6%) PART VI, LINE 5: GRIFFIN HOSPITAL FURTHERS ITS EXEMPT PURPORSE BY PROMOTING THE HEALTH OF THE COMMUNITY THROUGH MANY PROGRAMS AND ASSOCIATIONS INCLUDING:-DEPARTMENT OF COMMUNITY OUTREACH AND PARISH NURSING- 5 EMPLOYEES WHO SUPPORT THE 75 VOLUNTEER PARISH NURSES AND 320 VOLUNTEERS WHO SERVE ON THE HEALTHCARE CABINETS OF THE CHURCHES.-THE MOBILE HEALTH RESOURCE CENTER- FOCUSES ON PREVENTATIVE HEALTH SERVICES AND PROVIDING HEALTH EDUCATION AND SCREENING SERVICES TO NEIGHBORHOODS, COMMUNITY EVENTS, HEALTH FAIRS, SHOPPING CENTERS AND BUSINESSES.-COMMUNITY OUTREACH SERVICES- IN FISCAL YEAR 2013, THE DEPARTMENT OF COMMUNITY OUTREACH AND THE VALLEY PARISH NURSE PROGRAM SERVED 39,054 PEOPLE. SERVICES INCLUDED 4,411 HEALTH SCREENINGS WHICH CONTRIBUTED TO 14,915 REFERRALS TO NEEDED SERVICES. IN ADDITION, 30,709 PEOPLE ATTEND 1,388 EDUCATIONAL PROGRAMS AND 3,540 PEOPLE WERE TRAINED IN CPR. THE PROGRAM ALSO PROVIDED AND PLACED AUTOMATED EXTERNAL DEFIBRILLATORS (AED'S) AT COMMUNITY SITES BRINGING THE TOTAL TO 67.-STARTING 6 YEARS AGO GRIFFIN HOSPITAL'S DEPARTMENT OF COMMUNITY OUTREACH AND PARISH NURSING JOINED WITH ANSONIA COMMUNITY ACTION, THE NON-PROFIT AGENCY PROVIDING SERVICES TO THE AFRICAN AMERICAN COMMUNITY, FOR AN OUTREACH PROGRAM TO PROVIDE FREE CHOLESTEROL, DIABETES, AND HYPERTENSION SCREENING AND HEALTH EDUCATION FOR PEOPLE WHO ARE 60 AND OLDER.-GREATER NAUGATUCK VALLEY SAFE KIDS CHAPTER- ESTABLISHED IN MARCH 2005 BY THE VALLEY PARISH NURSE PROGRAM. GRIFFIN HOSPITAL, THE VALLEY PARISH NURSE PROGRAM, THE VALLEY N.A.A.C.P., THE CITY OF ANSONIA AND THE COMMUNITY FOUNDATION OF GREATER NEW HAVEN SPONSORED THE ANNUAL COMMUNITY HEALTH AND SAFETY.-CERTIFIED CPR TRAINING CENTER- GRIFFIN HOSPITAL HAS BEEN A CERTIFIED COMMUNITY AMERICAN HEART ASSOCIATION CPR TRAINING CENTER SINCE 2006.-GRIFFIN BREAST HEALTH INITIATIVE- PROVIDES OUTREACH AND EDUCATION TO WOMEN, INCLUDING THE UNINSURED OR UNDERINSURED, ABOUT THE IMPORTANCE OF BREAST WELLNESS AND EARLY BREAST CANCER DETECTION, AND PROVIDES SCREENING MAMMOGRAMS TO WOMEN WHO MAY NOT BE ABLE TO AFFORD ONE.-VALLEY WOMEN'S HEALTH INITIATIVE-AED PLACEMENT AT PUBLIC SITES- THE GRIFFIN HOSPITAL VALLEY PARISH NURSE PROGRAM COORDINATED OBTAINING FUNDING FOR THE PURCHASE OF AED'S AND HAS PLACED 65 AED'S AT PUBLIC NON-PROFIT PUBLIC ACCESS DEFIBRILLATOR SITES IN THE COMMUNITY.-HOMELESS SHELTER FOOD BANK DONATIONS-PATIENT AND COMMUNITY SUPPORT GROUPS AND EDUCATIONAL MEETINGS-BY YOUR SIDE. CAREGIVER SUPPORT GROUP-BEREAVEMENT SUPPORT GROUP-BEREAVEMENT SUPPORT GROUP FOR PARENTS-THE WIDOW AND WIDOWER SUPPORT GROUPS-COPING WITH LOSS THROUGH THE HOLIDAYS-CIRCLE OF FRIENDS BREAST CANCER SUPPORT GROUP-GRIFFIN HOSPITAL DIABETES EDUCATION AND SUPPORT GROUP-FIBROMYALGIA SUPPORT GROUP-H.U.G.S (HELP UNLIMITED GRIFFIN SUPPORT)-MOM 2 MOM-NURSING MOMS-SLEEP APNEA SUPPORT GROUP-MULTIPLE SCLEROSIS SUPPORT GROUP -ALZHEIMER'S CAREGIVER SUPPORT GROUP-VALLEY HEART CLUB-SHARING HEARTS OF GRIFFIN HOSPITAL-LOOK GOOD...FEEL BETTER-ALL ABOUT BABY-BABY & ME FOR SIBLINGS-TO-BE-BABYSITTER TRAINING-BREASTFEEDING FOR BEGINNERS -EARLY PREGNANCY-GRAND PARENTING 101-LAMAZE REFRESHER-PREPARED CHILDBIRTH-TOT SAVER INFANT SAFETY & CPR-WEIGHT-LOSS SURGERY SEMINARS-MEDICATION MANAGEMENT PROGRAM-PARKINSON'S SUPPORT GROUP-SKILL TRAINING WORKSHOPS. REIKI, SOFT TOUCH, AND THERAPEUTIC TOUCH-GRIFFIN HOSPITAL COMMUNITY HEALTH RESOURCE CENTER PROVIDES AN ARRAY OF OUTREACH SERVICES IN THE COMMUNITY AND MAKES EXTENSIVE HEALTHCARE RESOURCES AVAILABLE TO THE PUBLIC ON THE MAIN CAMPUS. THE GRIFFIN HOSPITAL CHNA IS AVAILABLE FOR REVIEW AT THIS LOCATION IN THE HOSPITAL.-HEALTHY U PROGRAM/MINI-MED SCHOOL. EDUCATIONAL OFFERINGS AT THE HOSPITAL AND COMMUNITY SITES INCLUDING: ANATOMY, PHYSIOLOGY, PRIMARY CARE, CARDIOLOGY, ENDOCRINOLOGY, ORTHOPEDICS, PULMONARY DISEASE, GASTROENTEROLOGY, NEPHROLOGY, NEUROLOGY, ONCOLOGY, HEMATOLOGY, OTOLARYNGOLOGY, OPHTHALMOLOGY, GYNECOLOGY, UROLOGY, RHEUMATOLOGY, DERMATOLOGY, AND GENERAL SURGERY. HEALTHY U PROGAMS ARE FREE AND OPEN TO THE PUBLIC, AND FEATURE GRIFFIN HOSPITAL MEDICAL EXPERTS AND COMMUNITY PARTNERS WHO PROVIDE TRUSTED HEALTH INFORMATION AND ANSWERS TO QUESTIONS. -YALE-GRIFFIN PREVENTION RESEARCH CENTER (PRC). ESTABLISHED IN 1998, THE YALE-GRIFFIN PRC IS COLLABORATION BETWEEN YALE UNIVERSITY AND GRIFFIN HOSPITAL. ONE OF ONLY 35 SUCH CENTERS ACROSS THE COUNTRY, GRIFFIN'S IS THE ONLY ONE BASED AT A HOSPITAL. FUNDED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION, THE NATIONAL INSTITUTES OF HEALTH, FOUNDATIONS, AND PRIVATE INDUSTRY, THE PRC'S RESEARCH PORTFOLIO IS DIVERSE, WITH THE EMPHASIS ON COMMUNITY-BASED ISSUES. ITS MANY AREAS OF FOCUS ARE NUTRITION, PREVENTIVE CARDIOLOGY, AND PHYSICAL ACTIVITY. IT ALSO CONDUCTS RESEARCH ON COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM), CHRONIC DISEASE MANAGEMENT AND OBESITY PREVENTION. THE WORK OF THE PRC EXTENDS BEYOND THE GRIFFIN HOSPITAL SERVICE AREA TO INCLUDE PROGRAMS AND SERVICES IN BRIDGEPORT, NEW HAVEN AND HARTFORD, THE STATE'S 3 LARGEST CITIES.-YALE-GRIFFIN PRVENTION RESEARCH CENTER COMMUNITY HEALTH PROFILE. THE YALE-GRIFFIN PRC PRODUCES A BI-ANNUAL COMMUNITY HEALTH PROFILE FOR THE SIX TOWN REGION SERVED BY GRIFFIN HOSPITAL.-VALLEY COMMUNITY ASSESSMENT, RESEARCH & EDUCATION FOR SOLUTIONS (CARES). GRIFFIN HOSPITAL AND THE YALE-GRIFFIN PREVENTION RESEARCH CENTER SUPPORT A COLLABORATIVE INITIATIVE "VALLEY CARES", A COMMUNITY ASSESSMENT AND PLANNING EFFORT SPONSORED BY THE VALLEY COUNCIL OF HEALTH AND HUMAN SERVICE ORGANIZATIONS.-YALE-GRIFFIN PRC NUTRITION PROGRAM DETECTIVES PROGRAM. PROGRAM TO ADDRESS THE INCIDENCE OF CHILDHOOD OBESITY.-NUVAL NUTRITIONAL FOOD SCORING SYSTEM. INTRODUCED IN THE DERBY SHCOOL DISTRICT'S MIDDLE SCHOOL AND HIGH SCHOOL, SCHOOLS ON THE SAME CAMPUS WITH SIMILAR SNACKS AND MENUS. THE SCORING SYSTEM WILL BE APPLIED TO FOODS SERVED IN THE CAFETERIA AND VENDING MACHINES. THE GOAL IS TO INFORM STUDENTS ABOUT THE VARIATION IN NUTRITIONAL QUALITY AND THE RANGE OF SCORES WITHIN EACH FOOD CATEGORY TO GET THEM THINKING ABOUT THE POWER OF CHOICE, AND TO MAKE HEALTHIER FOOD CHOICES. THE PROJECT WILL BE EVALUATED BY ASSESSING CHANGES IN STUDENT'S ATTITUDES, KNOWLEDGE AND ABILITY TO MAKE POSITIVE CHOICES, ALONG WITH CHANGES IN FOOD PRODUCTS PURCHASED AT SCHOOL.-SCHOOL-BASED HEALTH CENTER. GRIFFIN HOSPITAL PERSONNEL, THE ANSONIA BOARD OF EDUCATION, AND ANSONIA HIGH SCHOOL STAFF WORKED COLLABORATIVELY TO CREATE THE CHARGER HEALTH CLINIC TO PROVIDE COMPREHENSIVE PHYSICAL AND MENTAL HEALTH SERVICES TO THE SCHOOL'S STUDENTS.-HEALTHY BEGINNINGS RETURN VISIT PROGRAM. GRIFFIN'S CHILDBIRTH CENTER NURSES ESTABLISHED A POST DISCHARGE FREE RETURN VISIT PROGRAM. PROBLEMS FROM LACTATION ISSUES, BLEEDING, JAUNDICE AND OTHERS ARE IDENTIFIED IN 20-30% OF MOTHERS AND BABIES, AND EDUCATION, CARE AND REFERRAL TO OTHER PRACTITIONERS OF SERVICES IS PROVIDED. -GO GREEN INITIATIVE. GRIFFIN'S PATIENT CENTERED CARE COUNCIL IN 2009 UNDERTOOK A NUMBER OF INITIATIVES TO PROMOTE SOCIAL RESPONSIBILITY TO THE COMMUNITY.-VOLUNTEER SERVICES DEPARTMENTS. WHILE GRIFFIN HOSPITAL'S VOLUNTEER FORCE OF 430 COMMUNITY RESIDENTS IS AN ESSENTIAL COMPONENT OF GRIFFIN'S CAREGIVER TEAM, THIS PROGRAM ALSO PROVIDES A SOCIAL EXPERIENCE THAT THE VOLUNTEERS ENJOY AND FONDLY LOOK FORWARD TO.-GRIFFIN HOSPITAL SENIOR MEALS CHOICE PROGRAM. IN PARTNERSHIP WITH TEAM, INC., THE COMMUNITY'S ANTI-POVERTY AGENCY, THE GRIFFIN HOSPITAL "SENIOR MEALS CHOICE" NUTRITION PROGRAM IS AVAILABLE TO INDIVIDUALS 60 YEARS OF AGE OR OLDER, OR THE SPOUSE OF AN ELIGIBLE INDIVIDUAL, REGARDLESS OF AGE. -VITAHLS (THE VALLEY INITIATIVE TO ADVANCE HEALTH AND LEARNING IN SHCOOLS). MISSION IS TO DEVELOP, IMPLEMENT, EVALUATE AND SUSTAIN A COMPREHENSIVE VALLEY-WIDE SCHOOL-BASED CHILDHOOD AND ADOLESCENT OBESITY PREVENTION PROGRAM THAT FOCUSES ON NUTRITION AND PHYSICAL ACTIVITY TO REDUCE THE PREVALENCE OF OBESITY AND TO PORMOTE HEALTH AND ACADEMIC READINESS IN STUDENTS PRE-K TO GRADE 12. -HIM (THE HEALTH INITIATIVE FOR MEN). LAUNCHED BY GRIFFIN HOSPITAL IN 2011 TO HELP INSPIRE MEN TO HAVE AN ANNUAL PHYSICAL AND RAISE AWARENESS ABOUT MEN'S HEALTH ISSUES, SUCH AS PROSTATE CANCER AND COLORECTAL CANCER.-WOMEN AND HEART DISEASE PROGRAM-WOMEN'S DAY OF HEALTH-AARP DRIVER SAFETY PROGRAM-FALL PREVENTIVE PROGRAM-CLOTHES CLOSET FOR BARIATRIC PATIENTS-CANCER BASICS 101: EVERYTHING YOU NEED TO KNOW-PASTORAL CARE & EDUCATION DEPARTMENT. OFFERS EXTENDED UNITS OF CLINICAL PASTORAL EDUCATION (CPE) FOR AREA CLERGY, SEMINARIANS AND LAY PERSONS. THE CPE FOR HEALTHCARE PROGRAM WILL PROVIDE NURSES AND OTHER CLINICAL STAFF WITH CLINICAL AND CLASSROOM TRAINING ON HOW TO INCLUDE SPIRITUALITY INTO THE CARE THEY PROVIDE.-JUNIOR ACHIEVEMENT (JA). 2 HOSPITAL MANAGEMENT MEMBERS PARTNERED WITH DERBY HIGH SCHOOL TO BRING THE JA PROGRAM TO AN ENTERPRISE MARKETING CLASS IN THE 2012-2013 SCHOOL YEAR. PART VI, LINE 6: N/A REPORTS FILED WITH STATES PART VI, LINE 7 CT STATE FILINGS OF COMMUNITY BENEFIT REPORT PART VI, LINE 7: AS PART OF THE ANNUAL REPORTING FILINGS GRIFFIN HOSPITAL SUBMITS THEIR IRS FORM 990 - COMMUNITY BENEFIT REPORT TO CT STATE OFFICE OF THE HEALTH CARE ADVOCATE.HTTP://WWW.CT.GOV/DPH/CWP/VIEW.ASP?A=3902&Q=538810 X X X 0 0 0 0 0 0 0 0 0 CHARMEL PATRICK 413851 0 72961 0 765 0 43935 0 21457 0 552969 0 0 0 DOBULER KENNETH 232023 0 0 0 0 0 47152 0 0 0 279175 0 0 0 SCHWARTZ KENNETH 171712 0 27785 0 765 0 53069 0 14865 0 268196 0 0 0 STUMPO BARBARA J 154917 0 24321 0 741 0 26666 0 21456 0 228101 0 0 0 MOYLAN JAMES J 48808 0 35600 0 164422 0 0 0 0 0 248830 0 0 0 POWANDA WILLIAM 167181 0 25350 0 226 0 34858 0 14911 0 242526 0 0 0 BERNS EDWARD 135160 0 22274 0 381 0 35265 0 17720 0 210800 0 0 0 MARTIN KATHLEEN 131983 0 22881 0 388 0 34070 0 17720 0 207042 0 0 0 DEEGAN MARGARET 182837 0 30023 0 765 0 17260 0 21456 0 252341 0 0 0 SHEPARD SETH 164706 0 28188 0 751 0 19503 0 1980 0 215128 0 0 0 FRAMPTON SUSAN 0 242704 0 40537 0 0 0 28994 0 17720 0 329955 0 0 D'SOUSA SEEMA 187713 0 17119 0 345 0 7379 0 2197 0 214753 0 0 0 HALSTEAD EDWARD 218038 0 0 0 765 0 53826 0 21456 0 294085 0 0 0 NAWAZ HAQ 209879 0 66741 0 765 0 13244 0 14753 0 305382 0 0 0 SALABARRIA JAVIER 288087 0 0 0 765 0 8320 0 14728 0 311900 0 0 0 PAXTON HEATHER 201165 0 0 0 663 0 0 0 21456 0 223284 0 0 0 A CHEFA SERIES B 060806186 2005-02-01 24800000 CONSTRUCTION OF NEW WING 0 0 0 B CHEFA SERIES C 060806186 2007-05-01 23125000 CONSTRUCTION OF NEW CANCER CENTER & RENOVATION OF EMERGENCY DEPARTMENT 0 0 0 A 25769812 24573303 435721 760791 1996 1 0 1 1 B 22982209 1406958 234306 1133492 20207453 2010 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 0 0 0 0 0 0 B 0 0 0 0 1 1 WACHOVIA BANK 2037.000000000000 0 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 GRIFFIN HOSPITAL IS A NON-STOCK CORPORATION THAT DOES NOT HAVE STOCKHOLDERS OR MEMBERS, BUT WHICH DOES HAVE A BOARD OF INCORPORATORS WHO SERVE AS REPRESENTATIVES OF THE COMMUNITY TO CARRY OUT THE EXEMPT AND CHARITABLE PURPOSES OF THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF TRUSTEES MAKES RECOMMENDATIONS TO THE INCORPORATORS OF THE HOSPITAL REGARDING NOMINATIONS OF MEMBERS OF THE COMMUNITY TO SERVE AS TRUSTEES. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS REVIEWED BY MANAGEMENT PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR ALL MEMBERS OF THE HOSPITAL BOARD, OFFICERS, DIRECTORS, AND KEY EMPLOYEES RECEIVE, SIGN, AND SUBMIT A CONFLICT OF INTEREST DISCLOSURE. THE DISCLOSURES ARE REVIEWED BY THE HOSPITAL BOARD AND DOCUMENTED IN THE MINUTES. ANY DISCLOSURE OF A CONFLICT PREVENTS THE INDIVIDUAL FROM INVOLVEMENT WITH OR PARTICIPATION IN SUBJECT MATTER THAT MIGHT AFFECT THE DISCLOSED CONFLICT. SUCH ACTIONS ARE DOCUMENTED IN BOARD MINUTES. ALL CONFLICTS ARE DISCLOSED TO BOARD MEMBERS AND CORPORATORS AT THE ANNUAL MEETING OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF OFFICERS AND KEY EMPLOYEES ARE REVIEWED ANNUALLY BY THE COMPENSATION COMMITTEE WHICH IS A SUBCOMMITTEE OF THE HOSPITAL BOARD. THIS COMMITTEE SETS THE COMPENSATION FOR THE CEO BASED ON INDUSTRY DATA. COMPENSATION OF OTHER OFFICERS AND DIRECTORS IS SET BY THE CEO IN CONJUNCTION WITH THE HUMAN RESOURCE DEPARTMENT. AGAIN INDUSTRY COMPENSATION DATA IS THE BASIS FOR DETERMINING THE APPROPRIATENESS OF COMPENSATION. THE CEO REVIEWS WITH THE COMPENSATION COMMITTEE ALL OFFICERS AND DIRECTORS IN THE FIRST QUARTER OF THE CALENDAR YEAR. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS ARE FILED WITH THE OFFICE OF HEALTH CARE ACCESS AND ARE AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: TRANSFERS BETWEEN AFFILIATES -3,563,164. MINIMUM PENSION LIABILITY ADJUSTMENT 14,637,527. CHANGE IN NET ASSETS OF AFFILIATE 471,884. CHANGE IN TEMPORARILY RESTRICTED NET ASSETS 438,379. CHANGE IN BENEFICIAL INTEREST IN TRUSTS 20,849. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 1,803,353. NET ASSETS RELEASED FROM RESTRICTION 110,583. FORM 990, PART XI, LINE 2C: THE BOARD OF TRUSTEES IS RESPONSIBLE FOR SELECTING AN INDEPENDENT AUDIT FIRM AND FOR OVERSEEING THE FINANCIAL STATEMENT PREPARATION PROCESS. THERE HAVE BEEN NO CHANGES IN THESE PROCEDURES SINCE THE PRIOR YEAR. GRIFFIN HEALTH SERVICES CORPORATION 130 DIVISION STREET DERBY CT 06418 222560257 HOLDING COMPANY CT 501(C)(3) 509(A)(3)(B)(I) N/A 0 GRIFFIN FACULTY PRACTICE PLAN INC 130 DIVISION STREET DERBY CT 06418 061463147 MEDICAL/EDUCATION CT 501(C)(3) 509(A)(2) GRIFFIN HOSPITAL 1 THE GRIFFIN HOSPITAL DEVELOPMENT FUND 130 DIVISION STREET DERBY CT 06418 222560254 FUND RAISING CT 501(C)(3) 509(A)(1) GRIFFIN HEALTH SERVICES CORPORATION 1 PLANETREE INC 130 DIVISION STREET DERBY CT 06418 061505284 EDUCATION CT 501(C)(3) 509(A)(2) GRIFFIN HEALTH SERVICES CORPORATION 1 GH VENTURES INC 130 DIVISION STREET DERBY CT 06418 222560247 RENTAL REAL ESTATE CT N/A C 1 HEALTHCARE ALLIANCE INSURANCE COMPANY LTD 171 ELGIN AVENUE GEORGETOWN CJ OFFSHORE CAPTIVE INSURANCE CJ N/A C 0 CT PRACTICE MANAGEMENT INC 130 DIVISION STREET DERBY CT 06418 061152819 INACTIVE CT N/A C 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 1 GRIFFIN HEALTH SERVICES CORP P 463062 ACTUAL CASH GH VENTURES INC P 436798 ACTUAL CASH GRIFFIN HOSPITAL DEVELOPMENT FUND S 500000 ACTUAL CASH PLANETREE INC P 1195401 ACTUAL CASH GRIFFIN HOSPITAL DEVELOPMENT FUND P 589211 ACTUAL CASH GRIFFIN FACULTY PRACTICE PLAN R 3471289 ACTUAL CASH