2014-08-14T12:32:58-05:00 2013-09-30 346565596 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE SUITE 4000 INDIANAPOLIS IN 46204 990 2012-10-01 060646554 BRIDGEPORT HOSPITAL BRID 2036886679 267 GRANT STREET BRIDGEPORT CT 06610 PATRICK MCCABE 2036886679 2014-08-07 0 CHRISTOPHER B BOGGS P00032493 3176817000 2012 2015-11-30 17:44:51Z PATRICK MCCABE 267 GRANT ST BRIDGEPORT CT 06610 463067825 0 X WWW.BRIDGEPORTHOSPITAL.ORG X 1878 CT TO OPERATE AN ACUTE CARE HOSPITAL IN BRIDGEPORT, CONNECTICUT. 18 14 2898 296 584088 34355 2774608 3168483 420615529 418827196 1616983 1109678 13972534 19795595 438979654 442900952 11000 25000 0 0 198130576 200565110 0 0 0 210631559 212005256 408773135 412595366 30206519 30305586 389784478 437250967 266526575 264449007 123257903 172801960 X TO OPERATE AN ACUTE CARE HOSPITAL IN BRIDGEPORT, CONNECTICUT FOR THE CARE AND TREATMENT OF PERSONS SUFFERING FROM DISEASE OR OTHER PHYSICAL OR MENTAL CONDITIONS WITHOUT REGARD TO RACE,COLOR, CREED, SEX, AGE OR ABILITY TO PAY. 0 0 342975096 25000 438306261 SCHEDULE OBRIDGEPORT HOSPITAL, FOUNDED IN 1878, IS A 383-BED URBAN TEACHING HOSPITAL SERVING NEARLY 18,500 INPATIENTS AND MORE THAN 240,000 OUTPATIENT ENCOUNTERS IN 2013. A MEMBER OF THE YALE NEW HAVEN HEALTH SYSTEM SINCE 1996, BRIDGEPORT HOSPITAL IS THE SITE OF THE CONNECTICUT BURN CENTER; THE JOEL E. SMILOW HEART INSTITUTE THE NORMA F. PFRIEM CANCER INSTITUTE AND BREAST CARE CENTER, THE WOMEN'S CARE CENTER, CENTER FOR WOUND HEALING & HYPERBARIC MEDICINE, AND AHLBIN CENTERS FOR REHABILITATION MEDICINE. BRIDGEPORT HOSPITAL IS ALSO HOME TO THE SECOND INPATIENT CAMPUS OF YALE-NEW HAVEN CHILDREN'S HOSPITAL.DURING FISCAL YEAR 2013, BRIDGEPORT HOSPITAL PROVIDED APPROXIMATELY $71.8 MILLION DOLLARS IN COMMUNITY BENEFITS. THIS FIGURE INCLUDES $47.3 MILLION DOLLARS IN CHARITY CARE (AT COST) AND UNDER REIMBURSED MEDICAID (AT COST), $19.5 MILLION IN HEALTH PROFESSIONS EDUCATION, AND OVER $4.9 MILLION IN COMMUNITY HEALTH IMPROVEMENT AND EDUCATION ACTIVITIES, SUBSIDIZED SERVICES, RESEARCH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS. AN ADDITIONAL $91,000 DOLLARS WAS PROVIDED IN THE AREA OF COMMUNITY BUILDING ACTIVITIES, WHICH INCLUDED SUPPORT FOR ECONOMIC DEVELOPMENT, ENVIRONMENTAL IMPROVEMENTS, WORKFORCE DEVELOPMENT, ADVOCACY AND COALITION BUILDING. BRIDGEPORT HOSPITAL HAS INVESTED A SIGNIFICANT AMOUNT OF TIME AND RESOURCES IN THE DEVELOPMENT AND IMPLEMENTATION OF PUBLIC HEALTH PROJECTS TO IMPROVE HEALTH AND INCREASE ACCESS. 342975096 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 0 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 890 0 2898 1 1 1 0 0 0 0 0 0 0 0 0 X 18 14 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X MICHAEL KRAHN 2036886679 789 HOWARD AVENUE NEW HAVEN CT 06519 MEREDITH B REUBEN 1.00 4.00 X X 0 0 0 PETER F HURST 1.00 3.00 X X 0 0 0 GEORGE P CARTER 1.00 3.00 X X 0 0 0 RICHARD HOYT 1.00 3.00 X X 0 0 0 HOWARD TAUBIN 1.00 3.00 X X 0 0 0 NEWMAN M MARSILIUS III 1.00 3.00 X X 0 0 0 WILLIAM M JENNINGS 26.00 14.00 X X 567422 305534 253206 GAYLE L CAPOZZALO 4.00 36.00 X 114652 1031872 161371 JOHN FALCONI 1.00 3.00 X 0 0 0 RUSSELL FUCHS 1.00 3.00 X 0 0 0 JANET M HANSEN 1.00 3.00 X 0 0 0 MICK MAURER 1.00 3.00 X 0 0 0 STEPHEN MARSHALKO 1.00 3.00 X 105329 0 0 PATRICIA L MCDERMOTTTHRU 813 1.00 3.00 X 0 0 0 FRED MCKINNEY 1.00 3.00 X 0 0 0 RONALD B NOREN 1.00 4.00 X 0 0 0 DUNCAN M O'BRIEN JR 1.00 3.00 X 0 0 0 PETER TORTORA 1.00 3.00 X 0 0 0 GARY ZIMMERMAN 1.00 3.00 X 27300 0 0 MICHAEL IVY 38.00 2.00 X 383830 0 47436 MARYELLEN KOSTURKO 39.00 1.00 X 315002 0 34139 CAROLYN SALSGIVER 38.00 2.00 X 341984 0 132425 MELISSA TURNER 20.00 20.00 X 165513 165513 110916 PATRICK MCCABE 18.00 22.00 X 259551 317224 174067 MARC BRUNETTI 39.00 1.00 X 224316 0 56310 RYAN O'CONNELL 1.00 39.00 X 0 267102 44679 PATRICK SCHMINCKE 39.00 1.00 X 215860 0 41958 JOHN SKELLY 38.00 2.00 X 562297 0 164783 NORMAN G ROTH 32.00 8.00 X 580966 145241 181493 MICHAEL WERDMANN 40.00 0.00 X 364180 0 33019 JONATHAN MAISEL 40.00 0.00 X 349002 0 46027 ROCKMAN FERRIGNO 40.00 0.00 X 298090 0 38048 THOMAS LAMONTE 40.00 0.00 X 323154 0 46558 GUILLERMO KATIGBAK 40.00 0.00 X 314016 0 44299 JOSEPH JANELL132012 0.00 0.00 X 600241 0 10823 ROBERT J TREFRY THRU 92010 0.00 0.00 X 301062 0 0 BRUCE MCDONALD THRU 9272012 0.00 0.00 X 0 508422 59550 6413767 2740908 1681107 272 1 1 0 UNITEX TEXTILE RENTAL 155 SOUTH TERRACE AVE MOUNT VERNON NY 10550 LAUNDRY/SERVICE 2374793 SECURITAS SECURITY SERVICES PO BOX 409412 ATLANTA GA 30384 SECURITY 2196109 NURSEFINDERS INC PO BOX 910738 DALLAS TX 753910738 MEDICAL SERVICE 2016768 GE HEALTHCARE INC PO BOX 96483 CHICAGO IL 60693 MEDICAL SERVICE 1919592 NOVAMED 30 NUTMEG DRIVE TRUMBULL CT 06611 BIOMEDICAL SVC 1854128 160 3168483 3168483 INPATIENT REVENUE 621990 241403196 241403196 OUTPATIENT REVENUE 621990 176839912 176839912 LABORATORY SERVICES 621500 490111 490111 RESEARCH SERVICES 541700 93977 93977 418827196 289212 289212 1183128 866598 316530 316530 316530 20112991 7750 19300275 0 812716 7750 820466 820466 PEDIATRIC ANCILLARY REVENUE 900099 9568831 9568831 CAFETERIA/VENDING OTHER OPERATING 900099 4146829 4146829 IT MEANINGFUL USE 900099 3586737 3586737 2176668 2176668 19479065 442900952 437722173 584088 1426208 X 25000 25000 4538305 4538305 148546265 120383026 28163239 1232841 981925 250916 35299015 28541216 6757799 10948684 8720331 2228353 1546536 1231774 314762 419577 334182 85395 113213 113213 89358065 76874031 12484034 9446547 7522193 1924354 19385468 15447895 3937573 541617 422461 119156 1665007 1326133 338874 22793664 18154538 4639126 1028085 878339 149746 MEDICAL SUPPLIES 47722105 47722105 OTHER PROFESSIONAL FEES 10443592 8312951 2130641 YNHHS SYSTEM SUPPORT FE 5032091 4007925 1024166 OTHER MISC EXPENSES 877008 675471 201537 1632681 1300387 332294 412595366 342975096 69620270 0 8000 8000 29560746 30118829 42982977 51432238 3617848 4271378 25463841 52164171 428109618 285401858 127935771 142707760 11742894 24738696 39304780 29927000 109167621 101882895 389784478 437250967 41239465 48244843 40298906 37740706 10946983 18666198 174041221 159797260 266526575 264449007 X 74553766 123039209 28832421 28974601 19871716 20788150 123257903 172801960 389784478 437250967 X 30305586 2764711 16473759 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 1 500 0 0 0 0 1 67156 0 0 1 45557 113213 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THE AMOUNT REPORTED IN "OTHER ACTIVITIES" REPRESENTS A PORTION OF PROFESSIONAL DUES ATTRIBUTABLE TO LOBBYING DURING 2013. THE HEALTH SYSTEM OFFICIALS HAD MEETINGS AND CONTACTS WITH STATE GOVERNMENT OFFICIALS, INCLUDING STATE LEGISLATURES AND THEIR STAFF TO DISCUSS VARIOUS HEALTH CARE REFORM PROPOSALS. BRIDGEPORT HOSPITAL HAS CERTAIN STAFF MEMBERS THAT LOBBY ON BEHALF OF THE HOSPITAL ON VARIOUS HEALTHCARE ISSUES. BRIDGEPORT HOSPITAL IS PART OF A CONTROLLED GROUP WITH THE FOLLOWING LOBBYING EXPENSES: YALE NEW HAVEN HOSPITAL EIN 06-0646652 $ 537,753 GREENWICH HOSPITAL EIN 06-0646659 $ 89,757 37606000 3504000 2097000 -1347000 41860000 34442000 874000 2394000 -104000 37606000 32083000 1805000 1209000 -655000 34442000 26634000 5076000 1260000 -887000 32083000 28740000 1551000 -2608000 -1049000 26634000 0.50000 0.50000 0 0 1654817 1654817 121185522 100682894 20502628 132121153 69995619 62125534 153670845 114723345 38947500 19477281 19477281 142707760 HEDGE FUNDS 559000 F YALE ENDOWMENT POOL 29368000 F 29927000 DUE FROM AFFILIATES 617316 DEFERRED ISSUANCE COSTS 862487 INTEREST IN FOUNDATION, INC. 60013562 OTHER RECEIVABLES 1517790 THIRD PARTY RECEIVABLES 6152666 PROFESSIONAL LIABILITIES INSURANCE RECOVERIES RECEIVABLES 32719074 101882895 SELF INSURANCE 17306787 ASSET RETIREMENT OBLIGATIONS 12076027 PENSION OBLIGATION 36719602 THIRD PARTY PAYABLE 17846949 DUE TO AFFILIATES 18128821 MALPRACTICE GROSS LIABILITY 32719074 NOTES PAYABLE 25000000 159797260 445680480 6141230 6141230 439539250 3361703 3361703 442900953 409233663 866598 866598 408367065 4228301 4228301 412595366 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: INTENDED USES FOR ENDOWMENT FUNDS THE ENDOWED FUNDS' INTENDED USE IS TO GENERATE INCOME TO SUPPORT BRIDGEPORT HOSPITAL PROGRAM SERVICE FUNCTIONS AND OTHER OPERATIONS IN ACCORDANCE WITH THE BRIDGEPORT HOSPITAL POOLED INVESTMENT POLICY, TO PROVIDE FREE CARE BASED ON DONORS WISHES. PART XI, LINE 2D - OTHER ADJUSTMENTS: NET CHANGE IN INTEREST IN BHF 1,034,710. RECLASS BHF INVESTMENT INCOME TO CHANGE IN NET ASSETS 1,824,880. RECLASS OTHER OPERATING INCOME RESTRICTED FUNDS TO CHANGE IN NET ASSETS 3,282,339. RECLASS SERP ASSET GAIN/LOSS TO CHANGE IN NET ASSETS -699. PART XI, LINE 4B - OTHER ADJUSTMENTS: RECLASS CONTRIBUTION 3,168,483. RECLASS NET RENTAL INCOME AND EXPENSE 193,220. PART XII, LINE 2D - OTHER ADJUSTMENTS: RECLASS RENTAL EXPENSE 866,598. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECLASS CONTRIBUTION 3,168,483. RECLASS NET RENTAL INCOME 1,059,818. 1 1 X 1 X 250.000000000000 1 X 1 1 0 1 1 3254 33330420 17694420 15636000 0.03790 95439 108275000 76585000 31690000 0.07680 98693 141605420 94279420 47326000 0.11470 9 3311 734338 0 734338 0.00180 4 221 27870462 8324521 19545941 0.04740 2 6906 13278849 9684770 3594079 0.00870 2 0 458122 0 458122 0.00110 2 39052 107386 0 107386 0.00030 19 49490 42449157 18009291 24439866 0.05930 19 148183 184054577 112288711 71765866 0.17400 1 0 12500 0 12500 0.00000 1 0 23832 0 23832 0.00010 3 728 49511 0 49511 0.00010 651 0 651 0.00000 1 0 1 1 4491 0 4491 0.00000 7 729 90985 90985 0.00020 1 5929000 157024642 147414597 9610045 X 1 1 1 NONE NONE 1 1 BRIDGEPORT HOSPITAL

267 GRANT STREET BRIDGEPORT CT 06610

WWW.BRIDGEPORTHOSPITAL.ORG X X X X X N/A BRIDGEPORT HOSPITAL 1 1 X X X X X X X X X 12 1 1 1 X X X X X X X X X X 0 0 1 1 250.000000000000 1 400.000000000000 1 X X 1 1 X X X X X X 1 0 X X X X 1 X 0 0 27 BH CENTER FOR SLEEP MEDICINE

1070 MAIN STREET BRIDGEPORT CT 06604

SLEEP CENTER NORMA PFRIEM BREAST CARE CENTER

111 BEACH ROAD FAIRFIELD CT 06824

CANCER/DI/WELLNESS/WOMENS HEALTH BH BLOOD DRAW

125 KINGS HIGHWAY NORTH WESTPORT CT 06880

LAB BRIDGEPORT HOSPITAL OUTPATIENT CARD

1305 POST ROAD FAIRFIELD CT 06824

CARDIAC REHAB/CARDIAC TESTING/LAB WOUND CAREHYPERBARIC CHAMBER

141 MILL HILL AVENUE BRIDGEPORT CT 06610

WOUND CARE/HYPERBARIC OXYGEN CHILD FIRST PROGRAM

1470 BARNUM AVENUE STRATFORD CT 06614

CHILDREN PROGRAM BRIDGEPORT HOSPITAL BLOOD DRAW STATION

15 CORPORATE DRIVE TRUMBULL CT 06611

LAB BH BLOOD DRAW

1825 BARNUM AVENUE STRATFORD CT 06614

LAB BRIDGEPORT HOSPITAL OUTPATIENT CARD

25 GERMANTOWN ROAD DANBURY CT 06810

CARDIAC TESTING BH OUTPATIENT RADIOLOGY MRI

2595 MAIN STREET STRATFORD CT 06615

RADIOLOGY MRI NEWG AHLBIN CENTER REHAB

2600 POST ROAD SOUTHPORT CT 06824

OCC HEALTH/PT/REHAB/LAB AHLBIN REHABILITATION CENTER

2750 RESERVOIR AVENUE TRUMBULL CT 06611

OCC HEALTH/PT/REHAB NEMG MILL HILL SURGICAL ASSOCIATES

2909 MAIN STREET STRATFORD CT 06614

SURGICAL SERVICES BRIDGEPORT HOSPITAL OUTPATIENT CARD

30 PROSPECT STREET RIDGEFIELD CT 06877

CARDIAC TESTING BH BLOOD DRAW

3115 MAIN STREET STRATFORD CT 06614

LAB AHLBIN REHABILITATION CENTER

3585 MAIN STREET STRATFORD CT 06614

OCC HEALTH/PT/REHAB AHLBIN CENTER REHAB

4 CORPORATE DRIVE SHELTON CT 06484

OCC HEALTH/PT/REHAB BH OUTPATIENT RADIOLOGY

425 POST ROAD FAIRFIELD CT 06824

RADIOLOGY BRIDGEPORT PODIATRY CENTER

4695 MAIN STREET BRIDGEPORT CT 06606

PODIATRY CENTER BH OUTPATIENT RADIOLOGY

4699 MAIN STREET BRIDGEPORT CT 06606

RADIOLOGY BH BLOOD DRAW

4775 MAIN STREET BRIDGEPORT CT 06610

LAB CENTER FOR GERIATRICS

55 ARMORY ROAD STRATFORD CT 06614

GERIATRICS RADIATION THERAPY CENTER

5520 PARK AVENUE TRUMBULL CT 06611

LAB AHLBIN REHABILITATION CENTER

80 FERRY BOULEVARD STRATFORD CT 06614

REHAB THE HUNTINGTON WALK-IN MEDICAL CENTER

887 BRIDGEPORT AVENUE SHELTON CT 06484

URGENT CARE/LAB CENTER FOR GERIATRICS

95 ARMORY ROAD STRATFORD CT 06614

GERIATRICS CARDIAC SPECIALISTS

999 SILVER LANE TRUMBULL CT 06611

CARDIAC TESTING PART I, LINE 7: COSTING METHODOLOGY EXPLANATION:THE HOSPITAL USES A COST ACCOUNTING SYSTEM, TSI, TO CALCULATE THE AMOUNTS PRESENTED IN PART I, LINE 7. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS. PART II - COMMUNITY BUILDING ACTIVITIES BRIDGEPORT HOSPITAL IS THE LARGEST PRIVATE EMPLOYER IN BRIDGEPORT WITH 2,512 EMPLOYEES IN 2013. THE HOSPITAL HAS TAKEN A LEADERSHIP ROLE IN IMPROVING THE HEALTH IN THE COMMUNITY IT SERVES BY PROVIDING IN-KIND AND FINANCIAL SUPPORT FOR INITIATIVES THROUGHOUT THE GREATER BRIDGEPORT AREA. MEMBERS OF THE HOSPITAL'S LEADERSHIP AND MANAGEMENT STAFF ALSO SUPPORT ECONOMIC DEVELOPMENT BY SERVING ON THE BOARDS OF THE BRIDGEPORT REGIONAL BUSINESS COUNCIL, BRIDGEPORT CHAMBER OF COMMERCE, AREA ROTARY CLUBS AND NON-PROFIT CULTURAL VENUES. THROUGH THESE ORGANIZATIONS, BRIDGEPORT HOSPITAL ADVOCATES FOR AND FACILITATES INCREASED ECONOMIC DEVELOPMENT FOR THE AREA. BRIDGEPORT HOSPITAL, ALONG WITH MANY OTHER HOSPITALS ACROSS THE COUNTRY, UTILIZES THE COMMUNITY BENEFITS INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA) DATABASE DEVELOPED BY LYON SOFTWARE TO CATALOG ITS COMMUNITY BENEFIT AND COMMUNITY BUILDING ACTIVITIES AND THE GUIDELINES DEVELOPED BY THE CATHOLIC HOSPITAL ASSOCIATION (CHA) IN ORDER TO CATALOG THESE BENEFITS. THESE TWO ORGANIZATIONS HAVE WORKED TOGETHER FOR OVER TWENTY YEARS TO PROVIDE SUPPORT TO NON-FOR-PROFIT HOSPITALS TO DEVELOP AND SUSTAIN EFFECTIVE COMMUNITY BENEFIT PROGRAMS.THE MOST RECENT VERSION OF THE CHA GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFIT DEFINES COMMUNITY BUILDING ACTIVITIES AS PROGRAMS THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS AND ENVIRONMENTAL PROBLEMS. THESE ACTIVITIES ARE CATEGORIZED INTO EIGHT DISTINCT AREAS INCLUDING PHYSICAL IMPROVEMENT AND HOUSING, ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT ENVIRONMENTAL IMPROVEMENTS, LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS, COALITION BUILDING, ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENTS, AND WORKFORCE DEVELOPMENT. BRIDGEPORT HOSPITAL'S VISION IS TO BE THE PREFERRED HEALTHCARE PROVIDER IN THE REGION, AND AS SUCH, THE HOSPITAL IS INCREASINGLY AWARE OF HOW SOCIAL DETERMINANTS IMPACT THE HEALTH OF INDIVIDUALS AND COMMUNITIES. A PERSON'S HEALTH AND CHANCES OF BECOMING SICK AND DYING EARLY ARE GREATLY INFLUENCED BY POWERFUL SOCIAL FACTORS SUCH AS EDUCATION, INCOME, NUTRITION, HOUSING AND NEIGHBORHOODS. DURING FISCAL YEAR 2013, BRIDGEPORT HOSPITAL PROVIDED $91,000 IN FINANCIAL AND IN-KIND DONATIONS TO SUPPORT JOB TRAINING, ECONOMIC DEVELOPMENT AND OTHER ESSENTIAL SERVICES. THE HOSPITAL CONSIDERS THESE INVESTMENTS PART OF ITS OVERALL COMMITMENT OF BUILDING STRONGER NEIGHBORHOODS. EXAMPLES BELOW FOCUS ON THE AREAS OF REVITALIZING OUR NEIGHBORHOODS AND CREATING EDUCATIONAL OPPORTUNITIES.REVITALIZING OUR NEIGHBORHOODSSEVERAL YEARS AGO, THE CITY OF BRIDGEPORT ORGANIZED NEIGHBORHOOD REVITALIZATION ZONES (NRZS) IN ORDER TO EXPAND AND IMPROVE BUSINESS AND HOUSING IN LOW-TO-MODERATE INCOME NEIGHBORHOODS OR AREAS WITHIN NEIGHBORHOODS. THE NRZS RECEIVED TECHNICAL ASSISTANCE FROM THE CITY AND OUTSIDE CONSULTANTS, AND ENGAGES NEIGHBORHOOD RESIDENTS, NON-PROFITS, BUSINESSES AND FAITH-BASED ORGANIZATIONS TO MEET AND FORM STAKEHOLDER GROUPS. THESE GROUPS IDENTIFY THE PRIORITIES AND NEEDS OF THE NEIGHBORHOODS AND ARE ELIGIBLE TO BORROW STATE MONEY TO PURCHASE BLIGHTED PROPERTIES OR OFFER LOW-INTEREST LOANS TO QUALIFYING BUSINESSES FOR FACADE IMPROVEMENTS. HOSPITAL LEADERSHIP HAS BEEN ACTIVELY ENGAGED IN THE NRZ PROCESS FROM THE ONSET WITH REPRESENTATIVES SERVING ON COMMITTEES ORGANIZED IN THE CITY'S EAST END, EAST SID AND MILL HILL NEIGHBORHOODS, WHICH ARE LOCATED NEAR THE HOSPITAL. SEVERAL YEARS AGO, PRIOR TO THE CITY'S EFFORT TO DEVELOP AN NRZ IN IN THE MILL HILL NEIGHBORHOOD, THE HOSPITAL CREATED WHAT IS NOW CALLED THE BRIDGEPORT HOSPITAL COMMUNITY PARTNERSHIP. THIS UNIQUE PROGRAM WAS DEVELOPED TO IMPLEMENT MEASURABLE AND SUSTAINABLE QUALITY-OF-LIFE ENHANCEMENTS IN THE NEIGHBORHOODS DIRECTLY SURROUNDING THE HOSPITAL. OVER 900 NEIGHBORHOOD RESIDENTS RECEIVE INVITATIONS TO ATTEND THE HOSPITAL-SPONSORED MEETINGS WHERE RESIDENTS IDENTIFY ISSUES OR CONCERNS RELATED TO THEIR NEIGHBORHOOD. THESE CONCERNS, WHICH RUN THE GAMUT OF FIXING STREET LIGHTS TO INCREASING POLICE PRESENCE, ARE ADDRESSED BY THE CITY OF BRIDGEPORT WITH FACILITATION SUPPORT BY THE HOSPITAL.THE HOSPITAL PROVIDES ANNUAL OPERATIONAL SUPPORT TO THE EAST END COMMUNITY COUNCIL, A GROUP OF COMMUNITY RESIDENTS, BUSINESS, CIVIC, RELIGIOUS LEADERS AND COMMUNITY POLICE OFFICERS. THE EAST END COMMUNITY COUNCIL WORKS COLLABORATIVELY TO ENHANCE THE QUALITY OF LIFE IN THE NEIGHBORHOOD THROUGH VARIOUS INITIATIVES INCLUDING SAFE STREETS, FOOD PANTRIES, ANNUAL TOY DRIVES AND A LITTLE LEAGUE TEAM.BRIDGEPORT HOSPITAL, ALONG WITH OTHER AREA BUSINESSES, IS A FOUNDING MEMBER OF THE SEAVIEW AVENUE BUSINESS ALLIANCE. THE SEAVIEW AVENUE BUSINESS ALLIANCE IS A NON-PROFIT ORGANIZATION DEDICATED TO IMPROVING STREETSCAPES AND IMPROVING THE AREA ALONG THE SEAVIEW AVENUE CORRIDOR. THE ORGANIZATION ALSO PROVIDES ANNUAL SCHOLARSHIPS TO STUDENTS GRADUATING FROM HARDING HIGH SCHOOL WHO PLAN TO ATTEND COLLEGE. IN 2013, THE HOSPITAL PROVIDED FINANCIAL AND IN-KIND SUPPORT FOR THESE EFFORTS.CREATING EDUCATIONAL OPPORTUNITIESHIGHER EDUCATIONAL ATTAINMENT IS ASSOCIATED WITH BETTER HEALTH STATUS AND LONGER LIFE. FOR EXAMPLE, ADULTS AGED 25-50 YEARS WHO HAVE A COLLEGE DEGREE WILL ON AVERAGE LIVE FIVE YEARS LONGER THAN THOSE WITH LESS THAN A HIGH SCHOOL EDUCATION. ACCORDING TO THE BRIDGEPORT CHILD ADVOCACY COALITION, ONLY 70% OF BRIDGEPORT'S GRADUATING CLASS OF 2010 WENT ON TO POST-SECONDARY EDUCATION, COMPARED TO 86% STATEWIDE. RESULTS FROM THE CONNECTICUT MASTERY TEST CONSISTENTLY DEMONSTRATE AN ACHIEVEMENT GAP BETWEEN BRIDGEPORT YOUTH AND THEIR STATEWIDE PEERS. IN RESPONSE TO THESE STATISTICS, BRIDGEPORT HOSPITAL SUPPORTED A VARIETY OF EDUCATIONAL PROGRAMS IN 2013.REFLECTING ITS STRONG COMMITMENT TO THE BRIDGEPORT COMMUNITY AND SUPPORT OF EDUCATION, BRIDGEPORT HOSPITAL CONTINUED MENTORING AND CAREER EXPLORATION OPPORTUNITIES DURING THE YEAR. EXAMPLES INCLUDE A PHARMACY INTERNSHIP WITH STRATFORD HIGH SCHOOL AND PARTICIPATION IN CAREER DAY AT COLUMBUS ELEMENTARY SCHOOL AND HARDING HIGH SCHOOL, BOTH OF WHICH ARE LOCATED IN BRIDGEPORT. A SCHOOL SUPPLY DRIVE WAS HELD AT THE HOSPITAL FOR STUDENTS AT THE HALL ELEMENTARY SCHOOL, LOCATED IN THE MILL HILL NEIGHBORHOOD OF BRIDGEPORT. HOSPITAL EMPLOYEES CONTRIBUTED NOTEBOOKS, BINDERS, BACKPACKS, RULERS, PACKAGES OF PAPER, CRAYONS AND PENCILS AND OTHER ITEMS TO HELP ASSIST THE 350 STUDENTS TO BEGIN THEIR SCHOOL YEAR. AS MENTIONED IN THE PREVIOUS SECTION, BRIDGEPORT HOSPITAL, THROUGH THE SEAVIEW AVENUE BUSINESS ALLIANCE, PROVIDED SCHOLARSHIPS TO SENIORS FROM HARDING HIGH SCHOOL WHO WILL BE ATTENDING COLLEGE. THE HOSPITAL IS ALSO A MEMBER OF THE BRIDGEPORT CHILD ADVOCACY COALITION, WHICH IS A COALITION OF ORGANIZATIONS, PARENTS AND OTHER CONCERNED INDIVIDUALS COMMITTED TO IMPROVING THE WELL-BEING OF BRIDGEPORT'S CHILDREN THROUGH RESEARCH, ADVOCACY, COMMUNITY EDUCATION AND MOBILIZATION. PART III, LINE 4: FOOTNOTE FROM AUDITED FINANCIAL STATEMENTS:UNCOMPENSATED CARE AND COMMUNITY BENEFIT EXPENSETHE HOSPITAL'S COMMITMENT TO COMMUNITY SERVICE IS EVIDENCED BY SERVICES PROVIDED TO THE POOR AND BENEFITS PROVIDED TO THE BROADER COMMUNITY. SERVICES PROVIDED TO THE POOR INCLUDE SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTHCARE BECAUSE OF INADEQUATE RESOURCES AND/OR WHO ARE UNINSURED OR UNDERINSURED.THE HOSPITAL MAKES AVAILABLE FREE CARE PROGRAMS FOR QUALIFYING PATIENTS. IN ACCORDANCE WITH THE ESTABLISHED POLICIES OF THE HOSPITAL, DURING THE REGISTRATION, BILLING AND COLLECTION PROCESS A PATIENT'S ELIGIBILITY FOR FREE CARE FUNDS IS DETERMINED. FOR PATIENTS WHO WERE DETERMINED BY THE HOSPITAL TO HAVE THE ABILITY TO PAY BUT DID NOT, THE UNCOLLECTED AMOUNTS ARE BAD DEBT EXPENSE. FOR PATIENTS WHO DO NOT AVAIL THEMSELVES OF ANY FREE CARE PROGRAM AND WHOSE ABILITY TO PAY CANNOT BE DETERMINED BY THE HOSPITAL, CARE GIVEN BUT NOT PAID FOR, IS CLASSIFIED AS CHARITY CARE.TOGETHER, CHARITY CARE AND BAD DEBT EXPENSE REPRESENT UNCOMPENSATED CARE. THE ESTIMATED COST OF TOTAL UNCOMPENSATED CARE IS APPROXIMATELY $22.3 MILLION AND $17.7 MILLION FOR THE YEARS ENDED SEPTEMBER 30, 2013 AND 2012, RESPECTIVELY. THE ESTIMATED COST OF UNCOMPENSATED CARE IS BASED ON THE RATIO OF COST TO CHARGES, AS DETERMINED BY CLAIMS ACTIVITY. THE ALLOCATION BETWEEN BAD DEBT AND CHARITY CARE IS DETERMINED BASED ON MANAGEMENT'S ANALYSIS ON THE PREVIOUS 12 MONTHS OF HOSPITAL DATA. THIS ANALYSIS CALCULATES THE ACTUAL PERCENTAGE OF ACCOUNTS WRITTEN OFF OR DESIGNATED AS BAD DEBT VS. CHARITY CARE WHILE TAKING INTO ACCOUNT THE TOTAL COSTS INCURRED BY THE HOSPITAL FOR EACH ACCOUNT ANALYZED.THE ESTIMATED COST OF CHARITY CARE PROVIDED WAS $16.4 MILLION AND $11.2 MILLION FOR THE YEARS ENDED SEPTEMBER 30, 2013 AND 2012, RESPECTIVELY. THE ESTIMATED COST OF CHARITY CARE IS ESTIMATED USING THE RATIO OF COST TO GROSS CHARGES APPLIED TO THE GROSS UNCOMPENSATED COST ASSOCIATED WITH PROVIDING CHARITY CARE.FOR THE YEARS ENDED SEPTEMBER 30, 2013 AND 2012, BAD DEBT EXPENSE, AT CHARGES, WAS $15.0 MILLION AND $16.6 MILLION, RESPECTIVELY. FOR THE YEARS ENDED SEPTEMBER 30, 2013 AND 2012, BAD DEBT EXPENSE, AT COST, WAS $5.9 MILLION AND $6.6 MILLION, RESPECTIVELY. THE BAD DEBT EXPENSE IS MULTIPLIED BY THE RATIO OF COST TO CHARGES FOR PURPOSES OF INCLUSION IN THE TOTAL UNCOMPENSATED CARE AMOUNT IDENTIFIED ABOVE.THE CONNECTICUT DISPROPORTIONATE SHARE HOSPITAL PROGRAM (CDSHP) WAS ESTABLISHED TO PROVIDE FUNDS TO HOSPITALS FOR THE PROVISION OF UNCOMPENSATED CARE AND IS FUNDED, IN PART, BY A 1% ASSESSMENT ON HOSPITAL NET INPATIENT SERVICE REVENUE. DURING THE YEARS ENDED SEPTEMBER 30, 2013 AND 2012, THE HOSPITAL RECEIVED $17.7 MILLION AND $20.0 MILLION, RESPECTIVELY, IN DISTRIBUTIONS FROM CDSHP, OF WHICH APPROXIMATELY $12.6 MILLION WAS RELATED TO CHARITY CARE. THE HOSPITAL MADE PAYMENTS INTO CDSHP OF $16.9 MILLION AND $16.9 MILLION FOR THE YEARS ENDED SEPTEMBER 30, 2013 AND 2012, RESPECTIVELY, FOR THE 1% ASSESSMENT.ADDITIONALLY, THE HOSPITAL PROVIDES BENEFITS FOR THE BROADER COMMUNITY WHICH INCLUDES SERVICES PROVIDED TO OTHER NEEDY POPULATIONS THAT MAY NOT QUALIFY AS POOR BUT NEED SPECIAL SERVICES AND SUPPORT. BENEFITS INCLUDE THE COST OF HEALTH PROMOTION AND EDUCATION OF THE GENERAL COMMUNITY, INTERNS AND RESIDENTS, HEALTH SCREENINGS, AND MEDICAL RESEARCH. THE BENEFITS ARE PROVIDED THROUGH THE COMMUNITY HEALTH CENTERS, SOME OF WHICH SERVICE NON-ENGLISH SPEAKING RESIDENTS, DISABLED CHILDREN, AND VARIOUS COMMUNITY SUPPORT GROUPS. THE HOSPITAL VOLUNTARILY ASSISTS WITH THE DIRECT FUNDING OF SEVERAL CITY OF BRIDGEPORT PROGRAMS, INCLUDING AN ECONOMIC DEVELOPMENT PROGRAM AND A YOUTH INITIATIVE PROGRAM.IN ADDITION TO THE QUANTIFIABLE SERVICES DEFINED ABOVE, THE HOSPITAL PROVIDES ADDITIONAL BENEFITS TO THE COMMUNITY THROUGH ITS ADVOCACY OF COMMUNITY SERVICE BY EMPLOYEES. THE HOSPITAL'S EMPLOYEES SERVE NUMEROUS ORGANIZATIONS THROUGH BOARD REPRESENTATION, MEMBERSHIP IN ASSOCIATIONS AND OTHER RELATED ACTIVITIES. THE HOSPITAL ALSO SOLICITS THE ASSISTANCE OF OTHER HEALTHCARE PROFESSIONALS TO PROVIDE THEIR SERVICES AT NO CHARGE THROUGH PARTICIPATION IN VARIOUS COMMUNITY SEMINARS AND TRAINING PROGRAMS. PART III, LINE 9B: COLLECTION PRACTICES EXPLANATION:IF, AT ANY TIME, THE HOSPITAL OR A COLLECTION AGENCY OR LAW FIRM, RECEIVES INFORMATION THAT A PATIENT IS OR MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER ONE OF THESE PROGRAMS OR UNDER ANY GOVERNMENTAL OR OTHER PROGRAM, THE HOSPITAL, COLLECTION AGENCY, OR LAW FIRM SHALL, CONSISTENT WITH CONNECTICUT LAW, CEASE COLLECTION EFFORTS UNTIL THE HOSPITAL DETERMINES THE PATIENT'S ELIGIBILITY FOR ASSISTANCE. PART III, LINE 2 - THE METHODOLOGY USED BY THE ORGANIZATION TO ESTIMATE IN ACCORDANCE WITH THE ESTABLISHED POLICIES OF THE HOSPITAL, DURING THE REGISTRATION, BILLING AND COLLECTION PROCESS A PATIENT'S ELIGIBILITY FOR FREE CARE FUNDS IS DETERMINED. FOR PATIENTS WHO WERE DETERMINED BY THE HOSPITAL TO HAVE THE ABILITY TO PAY BUT DID NOT, THE UNCOLLECTED AMOUNTS ARE BAD DEBT EXPENSE. THE HOSPITAL'S COST ACCOUNTING SYSTEM UTILIZES PATIENT-SPECIFIC DATA TO ACCUMULATE AND DERIVE COSTS RELATED TO THESE BAD DEBT ACCOUNTS. BRIDGEPORT HOSPITAL PART V, SECTION B, LINE 3: COMMUNITY ENGAGEMENT AND FEEDBACK WERE AN INTEGRAL PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. BRIDGEPORT HOSPITAL, THROUGH THE PRIMARY CARE ACTION GROUP, SOUGHT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL THROUGH FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WITH COMMUNITY MEMBERS AND COMMUNITY STAKEHOLDERS, AS WELL AS INCLUSION OF AT LEAST EIGHTY COMMUNITY PARTNERS AND RESIDENTS IN THE PRIORITIZATION AND IMPLEMENTATION PLANNING PROCESS. PUBLIC HEALTH AND HEALTH CARE PROFESSIONALS SHARED KNOWLEDGE AND EXPERTISE ABOUT HEALTH ISSUES, WHILE LEADERS AND REPRESENTATIVES OF NON-PROFIT AND COMMUNITY-BASED ORGANIZATIONS PROVIDED INSIGHT ON THE COMMUNITY SERVED BY BRIDGEPORT HOSPITAL, INCLUDING MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITY POPULATIONS. BRIDGEPORT HOSPITAL PART V, SECTION B, LINE 4: ST. VINCENT'S MEDICAL CENTER, A MEMBER OF ASCENSION HEALTH SYSTEM, ALSO LOCATED IN BRIDGEPORT IS PART OF THE PRIMARY CARE ACTION GROUP, WHICH CONDUCTED THE COMMUNITY HEALTH NEEDS ASSESSMENT. BRIDGEPORT HOSPITAL PART V, SECTION B, LINE 7: BASED ON THE FEEDBACK FROM COMMUNITY PARTNERS INCLUDING HEALTH PROVIDERS, PUBLIC HEALTH EXPERTS, HEALTH AND HUMAN SERVICE AGENCIES, AND OTHER COMMUNITY REPRESENTATIVES, FOUR HEALTH ISSUES WERE PRIORITIZED: CARDIOVASCULAR DISEASE AND DIABETES, OBESITY, MENTAL HEALTH AND SUBSTANCE ABUSE AND ACCESS TO CARE. BRIDGEPORT HOSPITAL PLANS TO FOCUS ITS COMMUNITY HEALTH IMPROVEMENT EFFORTS ON ALL FOUR OF THESE AREAS. AREAS IDENTIFIED AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT NOT BEING ADDRESSED AS A RESULT OF A PRIORITIZATION PROCESS INCLUDE ABILITY TO CARE FOR THE ELDERLY, ASTHMA, CANCER, DENTAL / ORAL HEALTH, ENVIRONMENTAL ISSUES / CONTAMINATED LANDS, PRENATAL CARE, SEXUAL HEALTH, TOBACCO, TRANSPORTATION AND VIOLENCE.BRIDGEPORT HOSPITAL RECOGNIZES THAT PARTNERSHIPS WITH COMMUNITY AGENCIES HAVE THE BROADEST REACH TO IMPROVE COMMUNITY HEALTH ISSUES. AS SUCH, THE HOSPITAL IS PROVIDING FACILITATION SUPPORT FOR THE IMPLEMENTATION OF THE COMMUNITY-WIDE HEALTH IMPROVEMENT PLAN THAT WILL FOCUS ON ALL FOUR AREAS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. BRIDGEPORT HOSPITAL PART V, SECTION B, LINE 14G: THE FINANCIAL ASSISTANCE PROGRAM WHICH SUMMARIZES THE FINANCIAL ASSISTANCE POLICY WAS POSTED ON THE HOSPITAL FACILITY'S WEBSITE. THE FINANCIAL ASSISTANCE POLICY WILL BE POSTED ON THE WEBSITE UPON FILING THE FY 2013 TAX FILING. BRIDGEPORT HOSPITAL PART V, SECTION B, LINE 20D: PRIOR TO BECOMING FAP-ELIGIBLE, ALL INDIVIDUALS ARE CHARGED STANDARD GROSS CHARGES. AFTER AN INDIVIDUAL IS DEEMED TO BE FAP-ELIGIBLE, ANY DISCOUNTS OR FREE CARE ASSISTANCE DISCOUNTS ARE APPLIED IN ACCORDANCE WITH THE FAP PROGRAM THE INDIVIDUAL QUALIFIES FOR. THE DISCOUNTS ARE ADJUSTED OFF THE PATIENT'S ACCOUNT WHICH IS ALSO REFLECTED IN THE INDIVIDUAL'S BILLING. PART VI, LINE 2 - NEEDS ASSESSMENT: COMMUNITY NEEDS ARE ROUTINELY REVIEWED AND ADDRESSED AS PART OF THE OPERATIONS AND SERVICE LINE TEAMS AT BRIDGEPORT HOSPITAL. THESE MULTI-DISCIPLINARY GROUPS PROVIDE ANALYSIS AND INSIGHT INTO PATIENT UTILIZATION TRENDS ACROSS OUR DELIVERY OF CARE AND ARE REVIEWED IN TANDEM WITH CARE MANAGEMENT AND PATIENT SATISFACTION RESULTS AND OTHER COMMUNITY FEEDBACK. COUPLED WITH THE RECENTLY COMPLETED COMMUNITY NEEDS ASSESSMENT, THIS INFORMATION ASSISTS WITH THE DEVELOPMENT OF NEW INITIATIVES, PARTNERSHIPS, PROGRAMS AND SERVICES TO BENEFIT OUR COMMUNITY. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGILE FOR ASSISTANCE THE BRIDGEPORT HOSPITAL FREE CARE PROGRAM IS OFFERED THROUGH THE FOLLOWING CHANNELS: THE BRIDGEPORT HOSPITAL WEB SITE, NEWSPAPER ADVERTISEMENTS, THROUGH A FIRST STATEMENT MAILER SENT TO THE PATIENT, THROUGH THE HOSPITAL'S FRONT ACCESS/REGISTRATION AREAS ON VISIBLE POSTINGS AND COMMUNICATIONS, VISIBLE POSTINGS AND VERBAL COMMUNICATIONS MADE IN THE VIA BILLING AND COLLECTION LINES; AND THROUGH THE FREE CARE DEPARTMENT. IF A PATIENT INQUIRIES ABOUT FREE CARE OR NEEDS FINANCIAL ASSISTANCE, AN APPLICATION IS EITHER SENT OR HANDED TO THE PATIENT TO COMPLETE. INSTRUCTIONS AND INCOME GUIDELINES ACCOMPANY THE APPLICATION IN THE PACKAGE. APPOINTMENTS ARE ALSO AVAILABLE TO ASSIST WITH THE APPLICATION PROCESS AND THE AGENCY AND FREE CARE COORDINATORS ARE READILY AVAILABLE EVERY FOURTH MONDAY OF EACH MONTH. IN ADDITION TO THE UNRESTRICTED FREE CARE PROGRAM, THERE ARE ALSO RESTRICTED AND NOMINATED BED FUNDS THAT PATIENTS CAN APPLY FOR IF THEY MEET THE FREE CARE GUIDELINES. FREE CARE ALSO INCORPORATES THE DISCOUNTED CARE PROGRAM. THE DISCOUNTED CARE PROGRAM IS OFFERED TO PATIENTS WHO HAVE NO INSURANCE AND DO NOT WISH TO APPLY FOR A VALID STATE DENIAL. ELIGIBILITY IS BASED ON FAMILY SIZE AND INCOME. IF A PATIENT WISHING TO PARTICIPATE MEETS ALL ELIGIBILITY REQUIREMENTS AND GUIDELINES THEN AN APPROVAL LETTER IS SENT TO THE PATIENT. IF A PATIENT IS MISSING INFORMATION OR DENIED, A LETTER TO THAT EFFECT IS SENT TO THE PATIENT WITH AN EXPLANATION OF WHAT IS NEEDED IN ORDER TO PROCESS AN APPEAL. FREE CARE ELIGIBILITY IS VALID FOR SIX MONTHS FROM THE APPROVAL DATE ON THE LETTER AND DISCOUNTED CARE ELIGIBILITY IS VALID FOR ONE YEAR FROM APPROVAL DATE INDICATED ON LETTER. ANY VISITS BY THE PATIENT TO THE HOSPITAL DURING THIS ELIGIBILITY PERIOD WILL BE TRACKED AND WRITTEN-OFF TO THE APPROPRIATE ALLOWANCE CODE. PART VI, LINE 4 - COMMUNITY INFORMATION: BRIDGEPORT HOSPITAL'S LOCAL GEOGRAPHIC AREA IS COMPRISED OF EIGHT CITIES AND TOWNS ALONG THE SOUTHWEST COAST OF CT, INCLUDING BRIDGEPORT, EASTON, FAIRFIELD, MILFORD, MONROE, SHELTON, STRATFORD AND TRUMBULL. THE HOSPITAL ITSELF IS LOCATED IN BRIDGEPORT, WHICH IS THE MOST POPULOUS CITY IN CONNECTICUT, AND THE FIFTH LARGEST CITY IN NEW ENGLAND. LOCATED IN FAIRFIELD COUNTY, THE CITY HAS AN ESTIMATED POPULATION OF 143,412. THE CITY IS THE CORE OF THE GREATER BRIDGEPORT AREA, WHICH ITSELF IS CONSIDERED PART OF THE LABOR MARKET AREA FOR NEW YORK CITY. THE MEDIAN HOUSEHOLD INCOME FOR BRIDGEPORT IS $40,947, WHICH IS $28,296 BELOW THE STATE OF CONNECTICUT MEDIAN HOUSEHOLD INCOME OF $69,243 AND $41,611 BELOW THE MEDIAN HOUSEHOLD INCOME OF $82,558 IN FAIRFIELD COUNTY. ABOUT 21.9% OF THE POPULATION OF BRIDGEPORT LIVES BELOW THE FEDERAL POVERTY LEVEL VERSUS 9.5% FOR THE WHOLE STATE. BRIDGEPORT HAS A HIGH PROPORTION OF UNDERINSURED OR UNINSURED PATIENTS, WHILE THE SURROUNDING TOWNS ARE SOME OF THE MOST AFFLUENT TOWNS IN THE COUNTRY, WHICH CREATES AN URBAN/SUBURBAN DIVIDE IN THE AREA. NEARLY A THIRD OF THE INPATIENTS AT BRIDGEPORT HOSPITAL, 5,763 PATIENTS (31% OF TOTAL) WERE MEDICAID OR UNINSURED IN FISCAL YEAR 2013. THE HOSPITAL IS A DISPROPORTIONATE SHARE HOSPITAL, AND ALSO QUALIFIES FOR 340B PHARMACY PRICING.THE BRIDGEPORT HOSPITAL EMERGENCY ROOM PROVIDES A HEALTH CARE SAFETY NET FOR THOUSANDS OF PEOPLE EACH YEAR BY SERVING AS THE PRIMARY CARE PROVIDER FOR UNINSURED AND UNDERINSURED PATIENTS. IN FISCAL YEAR 2013, THE TOTAL NUMBER OF EMERGENCY ROOM VISITS WERE 79,799 INCLUDING BOTH TREATED AND ADMITTED AND TREATED AND DISCHARGED PATIENTS. THE TREATED AND DISCHARGED PATIENTS MAKE UP 86 PERCENT OF THE TOTAL WITH 7,734 (11%) OF THOSE PATIENTS IDENTIFIED AS NOT HAVING INSURANCE AND ANOTHER 36,763 (54%) IDENTIFIED AS MEDICAID BENEFICIARIES. BRIDGEPORT HOSPITAL, ST. VINCENT'S MEDICAL CENTER AND MILFORD HOSPITAL ARE THE THREE ACUTE CARE HOSPITALS LOCATED IN THE LOCAL SERVICE AREA. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH BRIDGEPORT HOSPITAL, FOUNDED IN 1878, IS A 383-BED URBAN TEACHING HOSPITAL SERVING NEARLY 18,500 INPATIENTS AND MORE THAN 240,000 OUTPATIENT ENCOUNTERS IN 2013. A MEMBER OF THE YALE NEW HAVEN HEALTH SYSTEM SINCE 1996, BRIDGEPORT HOSPITAL IS THE SITE OF THE CONNECTICUT BURN CENTER; THE JOEL E. SMILOW HEART INSTITUTE THE NORMA F. PFRIEM CANCER INSTITUTE AND BREAST CARE CENTER, THE WOMENS CARE CENTER, CENTER FOR WOUND HEALING & HYPERBARIC MEDICINE, AND AHLBIN CENTERS FOR REHABILITATION MEDICINE. BRIDGEPORT HOSPITAL IS ALSO HOME TO THE SECOND INPATIENT CAMPUS OF YALE-NEW HAVEN CHILDREN'S HOSPITAL.EVERY YEAR, AS PART OF ITS MISSION TO PROVIDE PATIENT CARE, TEACHING, RESEARCH AND COMMUNITY SERVICE, BRIDGEPORT HOSPITAL SPONSORS, DEVELOPS, PARTICIPATES IN AND FINANCIALLY SUPPORTS A WIDE VARIETY OF COMMUNITY-BASED PROGRAMS AND SERVICES. DURING FISCAL YEAR 2013, BRIDGEPORT HOSPITAL PROVIDED $71.8 MILLION IN FINANCIAL AND IN-KIND CONTRIBUTIONS THROUGH FIVE WIDE-RANGING PROGRAMS GUARANTEEING ACCESS TO CARE; PROMOTING HEALTH AND WELLNESS; ADVANCING CAREERS IN HEALTH CARE; RESEARCH; AND CREATING HEALTHIER COMMUNITIES. A SIXTH CATEGORY, BUILDING STRONGER NEIGHBORHOODS, WAS PREVIOUSLY DISCUSSED IN PART II.GUARANTEEING ACCESS TO CARE.BRIDGEPORT HOSPITAL RECOGNIZES THAT SOME PATIENTS MAY BE UNINSURED, NOT HAVE ADEQUATE HEALTH INSURANCE OR OTHERWISE LACK THE RESOURCES TO PAY FOR HEALTH CARE. IN FISCAL YEAR 2013, THE TOTAL COMMUNITY BENEFIT ASSOCIATED WITH GUARANTEEING ACCESS TO CARE WAS $50.9 MILLION. HONORING ITS MISSION AND COMMITMENT TO THE COMMUNITY, THE HOSPITAL PARTICIPATES IN GOVERNMENT-SPONSORED PROGRAMS SUCH AS MEDICARE, MEDICAID, HUSKY, CHAMPUS AND TRICARE. DURING FISCAL YEAR 2013, BRIDGEPORT HOSPITAL PROVIDED INPATIENT AND OUTPATIENT SERVICES FOR 95,439 MEDICAID BENEFICIARIES AT A TOTAL EXPENSE OF $31.7 MILLION (AT COST). BRIDGEPORT HOSPITAL ALSO OFFERS A SLIDING SCALE OF DISCOUNTED FEES AND FREE CARE FOR ELIGIBLE PATIENTS. DURING FISCAL YEAR 2013, THE HOSPITAL DELIVERED SUCH FINANCIAL ASSISTANCE SERVICES FOR AT A TOTAL EXPENSE OF $15.6 MILLION (AT COST). IN ADDITION, THE HOSPITAL EMPLOYS AN OUTPATIENT ACCOUNT ADVOCATE WHO IS BASED IN ITS PRIMARY CARE CLINIC. THIS RESOURCE IS DEDICATED TO ASSISTING PATIENTS IN THE PRIMARY CARE CLINIC TO ENROLL IN PUBLIC ASSISTANCE PROGRAMS. LAST YEAR, OVER 150 INDIVIDUALS WERE ASSISTED WITH ALL ASPECTS OF THE ENROLLMENT PROCESS INCLUDING PRE-SCREENING AND APPLICATION REVIEW. THE HOSPITAL ALSO CONTINUED TO FUND AN ONSITE STATE DEPARTMENT OF SOCIAL SERVICES WORKER TO ASSIST PATIENTS TO APPLY FOR STATE HEALTH INSURANCE PROGRAMS. BRIDGEPORT HOSPITAL ALSO GUARANTEES ACCESS TO CARE BY PROVIDING CLINICAL PROGRAMS DESPITE A FINANCIAL LOSS SO SIGNIFICANT THAT NEGATIVE MARGINS REMAIN AFTER REMOVING THE EFFECTS OF FREE CARE, BAD DEBT AND UNDER-REIMBURSED MEDICAID. SUBSIDIZED HEALTH SERVICES INCLUDE OUTPATIENT PSYCHIATRIC PROGRAMS FOR CHILDREN AND ADOLESCENTS AND THE PRIMARY CARE CLINIC. TOTAL VISITS FOR THESE ESSENTIAL SERVICES BY INDIVIDUALS SEEKING DIAGNOSIS, TREATMENT AND PREVENTIVE CARE ARE OVER 28,600 ANNUALLY. THE NORMA F. PFRIEM BREAST CARE CENTER'S UNDERSERVED PROGRAM PROVIDED FREE MEDICAL, SCREENING AND DIAGNOSTIC SERVICES TO OVER 1,000 UNINSURED AND UNDERINSURED WOMEN DURING THE YEAR. THE HOSPITAL'S COMMUNITY ASSISTANCE PROGRAM ASSISTS UNINSURED AND UNDERSERVED PATIENTS TO OBTAIN EXPENSIVE PRESCRIPTION MEDICATION AND THERAPIES FOR A VARIETY OF CONDITIONS THROUGH EXISTING PHARMACEUTICAL ASSISTANCE PROGRAMS. A FULL-TIME DEDICATED COORDINATOR FOR THE PROGRAM ASSISTED 128 PATIENTS IN THE COMMUNITY IN FISCAL YEAR 2013, ACHIEVING AN OUT-OF-POCKET COST SAVINGS FOR THESE PATIENTS OF NEARLY $1.3 MILLION. IN FISCAL YEAR 2013 OVER 185 PATIENTS RECEIVED FREE ORAL MEDICATIONS AND SELF-INJECTIONS THROUGH THE CARE COORDINATION PROGRAM WITH BRIDGEPORT HOSPITAL AND BRIDGEPORT PHARMACY. THIS PROGRAM PROVIDED ASSISTANCE TO UNINSURED AND UNDERINSURED PATIENTS WITH PRESCRIPTIONS THROUGH BRIDGEPORT PHARMACY. THE ESTIMATED VALUE OF THE DRUGS WAS $51,551. THROUGH THE PRIMARY CARE ACTION GROUP, BRIDGEPORT HOSPITAL ALSO CONTINUED TO REFER UNINSURED AND LOW INCOME RESIDENTS IN THE GREATER BRIDGEPORT AREA TO THE DISPENSARY OF HOPE. THE DISPENSARY, WHICH OPENED IN 2011, IS AN INITIATIVE DEVELOPED BY THE PRIMARY CARE ACTION GROUP THAT PROVIDES PRESCRIPTION MEDICATIONS AT NO COST. AS PART OF ITS ONGOING COMMITMENT AND SUPPORT, THE HOSPITAL ALSO DONATES UNUSED MEDICATIONS TO THE DISPENSARY OF HOPE.PROMOTING HEALTH AND WELLNESSDURING FISCAL YEAR 2013, BRIDGEPORT HOSPITAL PROVIDED $734,000 IN COMMUNITY HEALTH IMPROVEMENT SERVICES, INCLUDING HEALTH EDUCATION PROGRAMS, SUPPORT GROUPS AND HEALTH FAIRS. EXAMPLES OF THESE IMPORTANT SERVICES AND PROGRAMS ARE PROVIDED BELOW.THE CHILD FIRST PROGRAM, THE BRIDGEPORT HOSPITAL-BASED EARLY INTERVENTION PROGRAM FOR AT-RISK CHILDREN, WAS DESIGNATED AS ONE OF ONLY NINE EVIDENCE-BASED HOME VISITING MODELS FOR MATERNAL, INFANT AND EARLY CHILDHOOD CARE BY THE U.S. HEALTH RESOURCES AND SERVICES ADMINISTRATION FOR CHILDREN AND FAMILIES. IN ADDITION, THANKS TO A MAJOR GRANT FROM THE ROBERT WOOD JOHNSON FOUNDATION AND LOCAL SUPPORTING ORGANIZATIONS, CHILD FIRST HAS EXPANDED FROM THE BRIDGEPORT AREA TO FIVE OTHER METROPOLITAN AREAS IN CONNECTICUT: HARTFORD, NEW HAVEN, NEW LONDON, NORWALK AND WATERBURY. CHILD FIRST INTENDS TO REPLICATE THE MODEL IN AT LEAST TWO OTHER STATES BY 2015.THE HOSPITAL OFFERS THE NURTURING CONNECTIONS PARENTING PROGRAM FOR FIRST-TIME PARENTS WHO LIVE IN BRIDGEPORT. THE SUPPORT PROGRAM FOCUSES ON INFANT HEALTH AND GOOD PARENTING, AND COVERS A VARIETY OF DEVELOPMENTAL NEWBORN SUBJECTS SUCH AS ESTABLISHING ROUTINES, WAYS TO PROMOTE DEVELOPMENT IN NEWBORNS BRAIN, EYE, AND MOTOR AREAS AND PROPER NUTRITION. THE PROGRAM ALSO HELPS TO CONNECT FAMILIES WITH HELPFUL COMMUNITY RESOURCES.THE ONCOLOGY SOCIAL WORKER IN THE NORMA F. PFRIEM CANCER INSTITUTE ASSISTED OVER 300 PATIENTS WITH REQUESTS FOR REFERRALS OR ASSISTANCE FROM OUTSIDE AGENCIES. THESE REQUESTS WERE FOR A VARIETY OF COMMUNITY RESOURCES INCLUDING TRANSPORTATION,FINANCIAL ASSISTANCE, SUPPORT SERVICES AND HEAD COVERINGS. THROUGH THESE REFERRALS, INDIVIDUALS RECEIVED OVER $25,000 IN FINANCIAL GRANTS FROM ORGANIZATIONS SUCH AS THE AMERICAN CANCER SOCIETY, CANCER CARE, CONNECTICUT SPORTS FOUNDATION AGAINST CANCER, LEUKEMIA AND LYMPHOMA SOCIETY, NATIONAL BRAIN TUMOR ASSOCIATION, CHAIN FUND, BREAST CANCER EMERGENCY FUND AND TAKE A SWING AGAINST CANCER. THE HOSPITAL SPONSORS FREE SUPPORT GROUPS FOR PATIENTS RECOVERING FROM CANCER, HEART DISEASE, LUNG DISEASE, STROKE AND OTHER CONDITIONS. MORE THAN 200 PEOPLE PARTICIPATED IN THESE GROUPS DURING FY 2013. NEARLY 800 PEOPLE ATTENDED FREE HOSPITAL-SPONSORED HEALTH LECTURES AND AWARENESS EVENTS ON TOPICS SUCH AS BACK PAIN, CARDIOVASCULAR HEALTH, CONGESTION, DEMENTIA AND HIP OR KNEE PAIN. THE SIXTH ANNUAL "CELEBRATE LIFE" CANCER SURVIVORS' EVENT AT THE CONNECTICUT BEARDSLEY ZOO IN JUNE ATTRACTED MORE THAN 600 PEOPLE AND PROVIDED INFORMATION ABOUT CANCER PREVENTION AND TREATMENT. BRIDGEPORT HOSPITAL PROVIDED FREE BLOOD PRESSURE SCREENINGS AND INFORMATION AT SENIOR CENTERS LOCATED IN BRIDGEPORT, FAIRFIELD, SHELTON AND STRATFORD TO NEARLY 600 PEOPLE. ADVANCING CAREERS IN HEALTH CAREAS A MAJOR ACADEMIC AFFILIATE OF THE YALE SCHOOL OF MEDICINE, BRIDGEPORT HOSPITAL PROVIDES A SIGNIFICANT AMOUNT OF HEALTH PROFESSIONS EDUCATION ON AN ANNUAL BASIS. THIS INCLUDES GRADUATE AND INDIRECT MEDICAL EDUCATION IN THE AREA OF RESIDENCY AND FELLOWSHIP EDUCATION FOR PHYSICIANS / MEDICAL STUDENTS, THE BRIDGEPORT HOSPITAL SCHOOL OF NURSING INCLUDING A STUDENT REGISTERED NURSE ANESTHETIST PROGRAM, ALLIED HEALTH EDUCATION, RADIOLOGY RESIDENCY PROGRAM, PASTORAL CARE RESIDENCY PROGRAM AND A PHARMACY PROGRAM. IN ADDITION, THE HOSPITAL PROVIDES A CLINICAL SETTING FOR UNDERGRADUATE TRAINING TO STUDENTS ENROLLED IN VARIOUS ALLIED HEALTH FIELDS INCLUDING NURSING, LABORATORY AND RADIOLOGY. IN 2013, THE COST TO BRIDGEPORT HOSPITAL TO PROVIDE FUNDING FOR HEALTHCARE TRAINING AND EDUCATION PROGRAMS WAS MORE THAN $19.5 MILLION, AND BENEFITED 220 INDIVIDUALS.A TOTAL OF 86 STUDENTS GRADUATED FROM THE BRIDGEPORT HOSPITAL SCHOOL OF NURSING (43 IN THE 15-MONTH ACCELERATED PROGRAM AND 43 IN THE TRADITIONAL TWO-YEAR PROGRAM). MOST GRADUATES ACCEPTED NURSING POSITIONS AT THE HOSPITAL. A TOTAL OF 12 NURSES GRADUATED WITH MASTERS DEGREES FROM THE JOINT BRIDGEPORT HOSPITAL-FAIRFIELD UNIVERSITY NURSE ANESTHESIA PROGRAM. THE BRIDGEPORT HOSPITAL SCHOOL OF NURSING SURGICAL TECHNOLOGY PROGRAM HAD 16 GRADUATES AND 38 PEOPLE COMPLETED THE SCHOOL'S STERILE PROCESSING TECHNICIAN COURSE.DURING 2013, THE HOSPITAL PROVIDED A CLINICAL SETTING FOR UNDERGRADUATE TRAINING TO 120 STUDENTS ENROLLED IN PROGRAMS FOR NURSING, LABORATORY TECHNICIANS, RADIOLOGY TECHNICIANS, PHYSICAL AND OCCUPATIONAL THERAPY, AND DIETARY PROFESSIONALS. BRIDGEPORT HOSPITAL HAS LONG STANDING PART VI, LINE 6 - AFFILIATED HEALTH CARE INFORMATION THE YALE NEW HAVEN HEALTH SYSTEM'S FUNDAMENTAL MISSION IS TO ENSURE THAT THE DELIVERY NETWORKS ASSOCIATED WITH THE SYSTEM PROMOTE THE HEALTH OF THE COMMUNITIES THEY SERVE AND ENSURE THAT ALL PATIENTS HAVE ACCESS TO APPROPRIATE HEALTHCARE SERVICES. THE YALE NEW HAVEN HEALTH SYSTEM REQUIRES ITS HOSPITALS TO INCORPORATE PLANS TO PROMOTE HEALTHY COMMUNITIES WITHIN THE HOSPITAL'S EXISTING BUSINESS PLANS FOR WHICH THEY ARE HELD ACCOUNTABLE. IN ADDITION, REGULAR REPORTING ON COMMUNITY BENEFITS IS REQUIRED ON A QUARTERLY BASIS. PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT:CONNECTICUT 0 EAST END COMMUNITY COUNCIL INC 1149 STRATFORD AVE BRIDGEPORT CT 06607 061614075 501(C)(3) 5000 SUPPORT MISSION LOVE CHRISTIAN ACADEMY 729 UNION AVENUE BRIDGEPORT CT 06607 061448782 501(C)(3) 5000 SUPPORT MISSION P T BARNUM FOUNDATION INC 1070 MAIN ST BRIDGEPORT CT 06604 222655681 501(C)(3) 15000 SUPPORT MISSION 3 0 PART I LINE 2 - DESCRIBE THE ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANT FUND NONE OF THE AMOUNTS REPORTED ON SCHEDULE I, PART II ARE GRANTS. THESE AMOUNTS ARE DONATIONS AND SPONSORSHIPS GIVEN TO ORGANIZATIONS TO ASSIST IN THE FURTHERANCE OF THEIR CHARITABLE MISSION. X X X X X 0 1 0 0 0 0 0 1 0 WILLIAM M JENNINGS 385887 207785 129984 69991 51551 27758 138343 74493 26241 14129 732006 394156 0 0 GAYLE L CAPOZZALO 63222 569000 24782 223038 26648 239834 14320 128880 1817 16354 130789 1177106 0 0 MICHAEL IVY 318118 0 41810 0 23902 0 16364 0 31072 0 431266 0 0 0 MARYELLEN KOSTURKO 249202 0 48800 0 17000 0 23269 0 10870 0 349141 0 0 0 CAROLYN SALSGIVER 232639 0 64418 0 44927 0 101673 0 30752 0 474409 0 0 0 MELISSA TURNER 113172 113172 30769 30769 21572 21572 42409 42409 13049 13049 220971 220971 0 0 PATRICK MCCABE 178816 218551 60469 73905 20266 24768 60547 74001 17781 21738 337879 412963 0 0 MARC BRUNETTI 189664 0 23680 0 10972 0 18309 0 38001 0 280626 0 0 0 RYAN O'CONNELL 0 252631 0 3000 0 11471 0 13832 0 30847 0 311781 0 0 PATRICK SCHMINCKE 182432 0 23680 0 9748 0 12917 0 29041 0 257818 0 0 0 JOHN SKELLY 397192 0 99212 0 65893 0 142259 0 22524 0 727080 0 6060 0 NORMAN G ROTH 385779 96444 139579 34895 55608 13902 131014 32754 14180 3545 726160 181540 0 0 MICHAEL WERDMANN 337792 0 0 0 26388 0 17500 0 15519 0 397199 0 0 0 JONATHAN MAISEL 288962 0 37540 0 22500 0 24808 0 21219 0 395029 0 0 0 ROCKMAN FERRIGNO 275558 0 5532 0 17000 0 16490 0 21558 0 336138 0 0 0 THOMAS LAMONTE 302702 0 6065 0 14387 0 25000 0 21558 0 369712 0 0 0 GUILLERMO KATIGBAK 286527 0 10942 0 16547 0 22500 0 21799 0 358315 0 0 0 JOSEPH JANELL132012 79273 0 74850 0 446118 0 10823 0 0 0 611064 0 90346 0 ROBERT J TREFRY THRU 92010 0 0 0 0 301062 0 0 0 0 0 301062 0 237188 0 BRUCE MCDONALD THRU 9272012 0 358028 0 124614 0 25780 0 26627 0 32923 0 567972 0 0 PART I, LINE 4B PART I, LINE 4 - SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS: SEVERANCE NONQUALIFIED EQUITY-BASED PATRICK MCCABE $0 $65,125 $0 JOSEPH JANELL $0 $10,466 $0 WILLIAM M. JENNINGS $0 $95,633 $0 MELLISSA TURNER $0 $37,518 $0 JOHN SKELLY $0 $63,959 $0 NORMAN ROTH $0 $84,668 $0 CAROLYN SALSGIVER $0 $41,473 $0 THE INDIVIDUALS LISTED ABOVE ARE PARTICIPANTS IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THESE ACCRUALS ARE INCLUDED IN THE AMOUNTS REPORTED IN PART II, COLUMN C (DEFERRED COMPENSATION) AND REPRESENTS BOTH THE REPORTING ENTITY'S AND RELATED ENTITY'S COMBINED AMOUNTS CONSISTENT WITH THE COMPENSATION REPORTING PER IRS INSTRUCTIONS. INDIVIDUAL LISTED BELOW BECAME VESTED IN BENEFIT VALUED AT THE AMOUNT RESPECTIVELY REPORTED DURING THE REPORTING YEAR. INCLUDED IN SECTION II, COLUMN B (III) IS AMOUNT VESTED DURING THE 2012 CALENDAR YEAR THAT WAS RECOGNIZED AS TAXABLE EVENT AND REPORTED IN THE INDIVIDUAL'S 2012 CALENDAR YEAR FORM W-2. GAYLE CAPOZZALO $ 185,042 TWO FORMER OFFICERS, ROBERT TREFRY AND JOSEPH JANNEL, RECEIVED PAYMENTS FROM THE NONQUALIFIED PLAN. THESE AMOUNTS ARE NOT INCLUDED IN COLUMN B OR C. THE FOLLOWING PAYMENTS WERE MADE DIRECTLY TO THEM FROM THE RABBI TRUST: ROBERT TREFRY $216,182 JOSEPH JANELL 30,585 THE SUPPLEMENTAL RETIREMENT PLAN IS DESIGNED TO ENSURE THE PAYMENT OF A COMPETITIVE LEVEL OF RETIREMENT INCOME WHEN ADDED TO OTHER SOURCES OF RETIREMENT INCOME IN ORDER TO ATTRACT AND RETAIN KEY MANAGEMENT EMPLOYEES SERVING AS CORPORATE OFFICERS. THE PLAN PROVIDES SUPPLEMENTAL RETIREMENT INCOME THROUGH AN UNFUNDED, NONQUALIFIED DEFERRED COMPENSATION ARRANGEMENT UNDER SECTION 457(F) AND THROUGH A DEFERRED COMPENSATION PLAN UNDER SECTION 409A OF THE INTERNAL REVENUE CODE AND A MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES' PLAN UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (ERISA). PART I, LINE 7 PART I, LINE 7: NON-FIXED PAYMENTS PROVIDED THE SHORT TERM INCENTIVE PLAN IS A VARIABLE COMPENSATION PLAN WHICH PROVIDES ONE-TIME PAYMENTS TO ELIGIBLE MEMBERS OF MANAGEMENT IN RECOGNITION OF THE ACCOMPLISHMENT OF KEY ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE OBJECTIVES. PERFORMANCE LEVELS ARE ESTABLISHED AND REVIEWED ANNUALLY AT THRESHOLD, TARGET AND MAXIMUM LEVELS, ACCORDING TO PLANNED "STRETCH" GOALS AND OBJECTIVES. INCENTIVE AWARD OPPORTUNITIES ARE ESTABLISHED ACCORDING TO MARKET PRACTICES BASED ON EACH ELIGIBLE POSITION'S RESPONSIBILITIES, PERFORMANCE AND LEVEL OF AUTHORITY. PERFORMANCE RELATIVE TO STIP AWARD OPPORTUNITIES INCORPORATES A BROAD SPECTRUM OF PRE-DEFINED FINANCIAL AND NON-FINANCIAL METRICS THAT ARE ALIGNED WITH ORGANIZATIONAL MISSION AND VALUES. A CHEFA 060806186 20774YJE8 2012-05-31 40467946 REFINANCING A & C ISSUED 92 & 95 0 0 0 A 40467946 781263 39686683 2012 1 0 1 1 A 0 1 1 0 0 0 0 0 1 A 1 CENTURY FINANCIAL SVC INC SEE SCHEDULE O 289148 SEE PART V 0 EASTERN BAG & PAPER GROUP SEE SCHEDULE O 131039 SEE PART V 0 PART IV, COLUMN D BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS NAME OF INTERESTED PERSON: CENTURY FINANCIAL SERVICES, INC.OFFICER PATRICK MCCABE IS AN OFFICER AND DIRECTOR OF CENTURY FINANCIAL SERVICES, INC.CENTURY FINANCIAL SERVICES, INC. PROVIDES BILLING AND COLLECTION SERVICES FOR THE HOSPITAL. CENTURY FINANCIAL SERVICES, INC. IS PARTIALLY OWNED BY THE HOSPITAL'S CORPORATE PARENT, BRIDGEPORT HOSPITAL AND HEALTHCARE SERVICES, INC.AMOUNT OF TRANSACTION: $289,147.56.NAME OF INTERESTED PERSON: EASTERN BAG AND PAPER GROUPTRUSTEE MEREDITH REUBEN IS THE SOLE STOCKHOLDER AND CEO OF EBP SUPPLY SOLUTIONS. AFTER PERFORMING AN OBJECTIVE REVIEW PROCESS, WHICH INCLUDED A COMPARISON TO COMPETITIVE ALTERNATIVES AVAILABLE IN THE MARKETPLACE AND IN WHICH MS. REUBEN WAS NOT INVOLVED, THE HOSPITAL PURCHASED JANITORIAL AND FOOD SERVICE SUPPLIES AND SERVICES FROM EBP SUPPLY SOLUTIONS.AMOUNT OF TRANSACTION: $131,039.06. FORM 990, PART VI PART I, LINE 4 & PART VI, LINE 1B NUMBER OF INDEPENDENT VOTING MEMBERS OF THE GOVERNING BODY THE ORGANIZATION SOUGHT TO CONFIRM THE INDEPENDENCE OF EACH VOTING MEMBER OF ITS GOVERNING BODY BY REQUESTING THAT EACH SUCH VOTING MEMBER RESPOND TO A QUESTIONNAIRE CONTAINING THE PERTINENT INSTRUCTIONS AND DEFINITIONS AND DESIGNED TO ELICIT THE INFORMATION NECESSARY TO DETERMINE INDEPENDENCE. BASED ON RESPONSES TO THE QUESTIONNAIRES RECEIVED BY THE ORGANIZATION AND ANNUAL CONFLICTS OF INTEREST DISCLOSURES, THE ORGANIZATION WAS ABLE TO CONFIRM THAT 14 VOTING MEMBERS ARE INDEPENDENT. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIPS BETWEEN OFFICERS, DIRECTORS, TRUSTEES, OR KEY EMPLOYEES: TRUSTEES GEORGE P. CARTER, JANET M. HANSEN, AND RICHARD M. HOYT ARE BOARD MEMBERS OF THE SAME BUSINESS ENTITY. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF BRIDGEPORT HOSPITAL IS BRIDGEPORT HOSPITAL & HEALTHCARE SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 7A THE HOSPITAL IS GOVERNED BY ITS BOARD OF DIRECTORS, WHICH ELECTS THE PERSONS TO SERVE ON SUCH BOARD OF DIRECTORS FORM 990, PART VI, SECTION A, LINE 7B BRIDGEPORT HOSPITAL & HEALTHCARE SERVICES, INC. SHALL HAVE THE FOLLOWING RIGHTS, POWERS AND PRIVILEGES: A)TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS, PROGRAMS AND EXPENDITURES REQUIRING CERTIFICATE OF NEED APPROVAL BY APPROPRIATE GOVERNMENTAL BODIES, AND PLANS THAT MATERIALLY AFFECT THE GROWTH, OPERATING AND DEVELOPMENT OF THE HOSPITAL. B)TO VOTE UPON ALL MATTERS ON WHICH MEMBERS ARE ENTITLED TO VOTE UNDER THE CONNECTICUT REVISED NONSTOCK CORPORATION ACT, AS AMENDED, SUPPLEMENTED OR OTHERWISE MODIFIED FROM TIME TO TIME C)TO ELECT AND REMOVE THE DIRECTORS AND NON-VOTING PHYSICIAN DIRECTORS IN ACCORDANCE WITH THE PROVISIONS BY THESE BYLAWS. D)TO ELECT AND REMOVE THE OFFICERS AND THE HOSPITAL IN ACCORDANCE WITH THE PROVISIONS OF THE BYLAWS E)TO ACT ON ANY OTHER MATTERS ON WHICH ACTION BY MEMBERS IS REQUIRED OR PERMITTED BY THESE BYLAWS FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 TAX RETURN AND ATTACHED SCHEDULES WERE PREPARED BY EMPLOYEES OF THE SYSTEM TAX DEPARTMENT. THE RETURN IS INITIALLY REVIEWED BY THE ADMINISTRATIVE DIRECTOR OF FINANCE. SUBSEQUENTLY IT IS SENT TO ERNST & YOUNG US, LLP FOR THEIR INITIAL REVIEW. AFTER ALL COMMENTS FROM THE ABOVE GROUP ARE CLEARED, THE RETURN IS THEN REVIEWED BY THE CHIEF FINANCIAL OFFICER OF THE ENTITY AND A FINAL VERSION OF THE RETURN IS SENT BACK TO ERNST & YOUNG US, LLP FOR FINAL REVIEW. PRIOR TO FILING, THE ORGANIZATION MADE AVAILABLE A COMPLETE COPY OF THE RETURN TO THE BOARD OF DIRECTORS VIA A WEB PORTAL. FORM 990, PART VI, SECTION B, LINE 12C BRIDGEPORT HOSPITAL IS COVERED UNDER THE YALE NEW HAVEN HEALTH SERVICES CORP. CONFLICT OF INTEREST POLICY. THE YALE NEW HAVEN HEALTH SYSTEM CONFLICT OF INTEREST POLICY (CC:R-7) AND INDIVIDUAL ANNUAL DISCLOSURE FORM APPLIES TO A POOL OF EMPLOYEES, BOARD MEMBERS AND NON-BOARD MEMBERS SERVING ON BOARD COMMITTEES. THESE "COVERED INDIVIDUALS" ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT, UPON BEGINNING EMPLOYMENT OR OTHERWISE BECOMING A COVERED INDIVIDUAL AND ANNUALLY THEREAFTER. COVERED INDIVIDUALS ARE ALSO REQUIRED TO IMMEDIATELY REPORT MATERIAL CHANGES TO THEIR MOST RECENTLY COMPLETED DISCLOSURE STATEMENT. THESE DISCLOSURE STATEMENTS AND REPORTS ARE REVIEWED BY THE OFFICE OF PRIVACY AND CORPORATE COMPLIANCE AND/OR THE LEGAL AND RISK SERVICES DEPARTMENT TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. IF A POTENTIAL CONFLICT ARISES, THE PRESIDENT AND CEO WOULD CONSULT WITH THE BOARD CHAIRPERSON AND THE LEGAL AND RISK SERVICES DEPARTMENT AND TAKE ANY ACTIONS THAT SHE DEEMS REQUIRED OR APPROPRIATE TO MANAGE OR RESOLVE A POTENTIAL CONFLICT OF INTEREST. FOR EXAMPLE, A VOTING BOARD OR COMMITTEE MEMBER WOULD BE REQUIRED TO RECUSE HIMSELF OR HERSELF FROM VOTING ON MATTERS RELATED TO THE POTENTIAL CONFLICT AND THE POTENTIAL CONFLICT WOULD BE DISCLOSED TO OTHER VOTING MEMBERS. FORM 990, PART VI, SECTION B, LINE 15 LINE 15A - COMPENSATION PROCESS FOR TOP OFFICIAL: THE MANAGEMENT AFFAIRS COMMITTEE OF BRIDGEPORT HOSPITAL STRIVES TO TAKE THE STEPS NECESSARY TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER FEDERAL TAX LAW. THE MANAGEMENT AFFAIRS COMMITTEE IS AUTHORIZED UNDER THE BRIDGEPORT HOSPITAL BYLAWS AND IS RESPONSIBLE FOR (1) DETERMINING THE OVERALL TOTAL COMPENSATION STRATEGY FOR ALL CORPORATE OFFICERS, (2) APPROVING ALL COMPENSATION AND BENEFITS DECISIONS FOR CORPORATE OFFICERS, AND (3) REPORTING SUCH ACTIONS TO THE FULL BRIDGEPORT HOSPITAL BOARD ON AN ANNUAL BASIS. IN ADDITION, THE MANAGEMENT AFFAIRS COMMITTEE EXPRESSLY DETERMINES THE REASONABLENESS OF TOTAL COMPENSATION AND BENEFITS FOR ALL CORPORATE OFFICERS, AND ASSURES THAT ALL OFFICER COMPENSATION DECISIONS ARE MADE AFTER THOROUGH CONSIDERATION OF AND COMPARISON TO THE MARKET PRACTICES OF OTHER SIMILARLY SITUATED NOT-FOR-PROFIT HEALTHCARE EXECUTIVES IN COMPARABLE ORGANIZATIONS. THE MANAGEMENT AFFAIRS COMMITTEE CONSISTS OF BOARD MEMBERS WHO DO NOT HAVE MATERIAL FINANCIAL INTERESTS THAT COULD BE AFFECTED BY THE OFFICER COMPENSATION DECISIONS MADE BY THE COMMITTEE. THE COMPARABILITY DATA USED TO ASSIST THE MANAGEMENT AFFAIRS COMMITTEE IN ITS COMPENSATION DELIBERATIONS ARE COMPILED BY AN INDEPENDENT, NATIONAL COMPENSATION CONSULTING FIRM THAT IS RETAINED BY AND REPORTS DIRECTLY TO THE MANAGEMENT AFFAIRS COMMITTEE. THE DATA COLLECTED BY THE CONSULTANT CONSISTS OF MARKET INFORMATION FOR EXECUTIVES IN FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS. THE DELIBERATIONS AND DECISIONS OF THE MANAGEMENT AFFAIRS COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED, REVIEWED AND APPROVED BY THE MANAGEMENT AFFAIRS COMMITTEE, AND PROVIDED TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 15: LINE 15B - COMPENSATION PROCESS FOR OTHER OFFICERS OR KEY EMPLOYEES: THE MANAGEMENT AFFAIRS COMMITTEE OF BRIDGEPORT HOSPITAL STRIVES TO TAKE THE STEPS NECESSARY TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER FEDERAL TAX LAW. THE MANAGEMENT AFFAIRS COMMITTEE IS AUTHORIZED UNDER THE BRIDGEPORT HOSPITAL BYLAWS AND IS RESPONSIBLE FOR (1) DETERMINING THE OVERALL TOTAL COMPENSATION STRATEGY FOR ALL CORPORATE OFFICERS, (2) APPROVING ALL COMPENSATION AND BENEFITS DECISIONS FOR CORPORATE OFFICERS, AND (3) REPORTING SUCH ACTIONS TO THE FULL BRIDGEPORT HOSPITAL BOARD ON AN ANNUAL BASIS. IN ADDITION, THE MANAGEMENT AFFAIRS COMMITTEE EXPRESSLY DETERMINES THE REASONABLENESS OF TOTAL COMPENSATION AND BENEFITS FOR ALL CORPORATE OFFICERS, AND ASSURES THAT ALL OFFICER COMPENSATION DECISIONS ARE MADE AFTER THOROUGH CONSIDERATION OF AND COMPARISON TO THE MARKET PRACTICES OF OTHER SIMILARLY SITUATED NOT-FOR-PROFIT HEALTHCARE EXECUTIVES IN COMPARABLE ORGANIZATIONS. THE MANAGEMENT AFFAIRS COMMITTEE CONSISTS OF BOARD MEMBERS WHO DO NOT HAVE MATERIAL FINANCIAL INTERESTS THAT COULD BE AFFECTED BY THE OFFICER COMPENSATION DECISIONS MADE BY THE COMMITTEE. THE COMPARABILITY DATA USED TO ASSIST THE MANAGEMENT AFFAIRS COMMITTEE IN ITS COMPENSATION DELIBERATIONS ARE COMPILED BY AN INDEPENDENT, NATIONAL COMPENSATION CONSULTING FIRM THAT IS RETAINED BY AND REPORTS DIRECTLY TO THE MANAGEMENT AFFAIRS COMMITTEE. THE DATA COLLECTED BY THE CONSULTANT CONSISTS OF MARKET INFORMATION FOR EXECUTIVES IN FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS. THE DELIBERATIONS AND DECISIONS OF THE MANAGEMENT AFFAIRS COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED, REVIEWED AND APPROVED BY THE MANAGEMENT AFFAIRS COMMITTEE, AND PROVIDED TO THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 FORM 990, PART VI, SECTION C, LINE 19: COPIES OF FORM 990, FORM 1023 AND AUDITED FINANCIAL STATEMENTS ARE MAINTAINED IN THE SYSTEM TAX DEPARTMENT. OTHER CORPORATE GOVERNING DOCUMENTS ARE MAINTAINED BY THE LEGAL AND RISK SERVICES DEPARTMENT. THE CONFLICT OF INTEREST POLICY, WHISTLEBLOWER POLICY, AND DOCUMENT RETENTION POLICY ARE AVAILABLE TO ALL EMPLOYEES ON THE CORPORATE INTERNAL WEBSITE. COPIES OF ALL DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. OTHER FEES FORM 990, PART IX, LINE 11G PHURCHASE SERVICES: PROGRAM SERVICE EXPENSES 54,407,386. MANAGEMENT AND GENERAL EXPENSES 12,484,034. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 66,891,420. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 22,466,645. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,466,645. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: NET CHANGE IN INTEREST IN BRIDGEPORT HOSPITAL FOUNDATION 1,659,000. DECREASE IN TEMP RESTRICTED NET ASSETS -188,000. INCREASE IN PERM RESTRICTED NET ASSETS 916,000. TRANSFER FROM YALE NEW HAVEN HEALTH 900,000. TRANSFER FROM BRIDGEPORT HOSPITAL FOUNDATION 444,409. NET ASSETS RELEASED FROM CAPITAL ACQUISITIONS 879,000. PENSION LIABILITY ADJUSTMENT 22,810,000. TRANSFER FROM BRIDGEPORT HOSPITAL & BRIDGEPORT HOSPITAL HEALTH SERVICES -12,995,000. NET CHANGE IN INTEREST IN BHF 3,282,339. RECLASS BHF INVESTMENT INCOME TO CHANGE IN NET ASSETS 1,824,880. RECLASS SERP ASSETS G/L -699. E-FUND ADJUSTMENT -3,058,170. GREENWICH HOSPITAL 5 PERRYRIDGE ROAD GREENWICH CT 06830 060646659 HEALTHCARE CT 501C3 LINE 3 GREENWICH HEALTH CARE SERVICES INC 1 GREENWICH HEALTH CARE SERVICES INC 5 PERRYRIDGE ROAD GREENWICH CT 06830 222593399 SYSTEM SUPPORT CT 501C3 LINE 11B, II YALE NEW HAVEN HEALTH SERVICES CORP 0 THE GREENWICH HOSPITAL ENDOWMENT FUND INC 5 PERRYRIDGE ROAD GREENWICH CT 06830 061526642 SYSTEM SUPPORT CT 501C3 LINE 11B, II GREENWICH HEALTH CARE SERVICES INC 1 BRIDGEPORT HOSPITAL & HEALTHCARE SERVICES 267 GRANT STREET BRIDGEPORT CT 06610 061066729 SYSTEM SUPPORT CT 501C3 LINE 11A, I YALE NEW HAVEN HEALTH SERVICES CORP 0 SCHS PROPERTIES INC 267 GRANT STREET BRIDGEPORT CT 06610 061297708 TITLE HOLDING CT 501C2 BRIDGEPORT HOSP & HEALTHCARE SERVICES 1 BRIDGEPORT HOSPITAL AUXILIARY INC 267 GRANT STREET BRIDGEPORT CT 06610 066042500 SYSTEM SUPPORT CT 501C3 LINE 11A, I BRIDGEPORT HOSP & HEALTHCARE SERVICES 1 BRIDGEPORT HOSPITAL FOUNDATION INC 267 GRANT STREET BRIDGEPORT CT 06610 222908698 SYSTEM SUPPORT CT 501C3 LINE 7 BRIDGEPORT HOSP & HEALTHCARE SERVICES 1 NORMA F PFREIM BREAST CANCER INC 111 BEACH ROAD FAIRFIELD CT 06430 060567752 HEALTHCARE CT 501C3 LINE 11A, I BRIDGEPORT HOSPITAL 1 NORTHEAST MEDICAL GROUP INC 226 MILL HILL AVENUE BRIDGEPORT CT 06610 061330992 HEALTHCARE CT 501C3 LINE 9 YALE NEW HAVEN HEALTH SERVICES CORP 1 NORTHEAST MEDICAL GROUP PLLC 226 MILL HILL AVENUE BRIDGEPORT CT 06610 352380180 HEALTHCARE CT 501C3 LINE 11A, I NORTHEAST MEDICAL GROUP INC 1 YNH NETWORK CORP 789 HOWARD AVE NEW HAVEN CT 06519 061513687 SYSTEM SUPPORT CT 501C3 LINE 11A, I YALE NEW HAVEN HEALTH SERVICES CORP 0 YALE-NEW HAVEN HOSPITAL 20 YORK STREET NEW HAVEN CT 06504 060646652 HEALTHCARE CT 501C3 LINE 3 YNH NETWORK CORP 1 YALE-NEW HAVEN CARE CONTINUUM CORP 789 HOWARD AVE NEW HAVEN CT 06519 455235566 NURSING HOME CT 501C3 LINE 3 YNH NETWORK CORP 1 CARITAS INSURANCE 30 MAIN STREET BURLINGTON VT 05401 030322238 INSURANCE VT 501C3 LINE 11A, I YALE NEW HAVEN HOSPITAL 1 YALE NEW HAVEN HEALTH SERVICES CORP 789 HOWARD AVE NEW HAVEN CT 06519 222529464 SYSTEM SUPPORT CT 501C3 LINE 11A, I N/A 0 PERRYRIDGE CORPORATION 5 PERRYRIDGE ROAD GREENWICH CT 06830 061207316 SYSTEM SUPPORT CT 501C3 LINE 11B, II GREENWICH HOSP & HEALTHCARE SERVICES CORP 1 BRIDGEPORT HOSPITAL FRIENDS OF PEDIATRICS INC 120 COLUMBINE DRIVE TRUMBULL CT 06611 066048427 SYSTEM SUPPORT CT 501C3 LINE 11A, I YALE-NEW HAVEN HOSPITAL 1 SHORELINE SURGERY CENTER LLC 60 TEMPLE STREET NEW HAVEN CT 06510 900110459 HEALTHCARE CT N/A SSC II LLC 111 GOOSE LANE GUILFORD CT 06437 261709382 HEALTHCARE CT N/A ORTHOPAEDIC & NEUROSURGERY CENTER 55 HOLLY HILL LANE GREENWICH CT 06830 273477197 HEALTHCARE CT N/A YNHHS-MSO INC 789 HOWARD AVE NEW HAVEN CT 06519 061467717 MANAGEMENT SERVICES CT N/A C 1 YALE NEW HAVEN AMBULATORY SERVICES 40 TEMPLE STREET NEW HAVEN CT 06510 061398526 HEALTHCARE CT N/A C 1 QUINNIPIAC MEDICAL PC 789 HOWARD AVE NEW HAVEN CT 06519 061405531 HEALTHCARE CT N/A C 1 MEDICAL CENTER REALTY 50 YORK STREET NEW HAVEN CT 06511 061110858 RENTAL CT N/A C 1 YNH GERIATRIC SERVICES PC 789 HOWARD AVE NEW HAVEN CT 06519 061561581 HEALTHCARE CT N/A C 1 YNH MEDICAL SERVICES PC 789 HOWARD AVE NEW HAVEN CT 06519 061561583 HEALTHCARE CT N/A C 1 CHC PHYSICIANS PC 789 HOWARD AVE NEW HAVEN CT 06519 061436530 HEALTHCARE CT N/A C 1 GREENWICH HEALTH SERVICES INC 5 PERRYRIDGE ROAD GREENWICH CT 06830 061233643 HEALTHCARE CT N/A C 1 GREENWICH PEDIATRIC SERVICES PC 5 PERRYRIDGE ROAD GREENWICH CT 06830 743054409 HEALTHCARE CT N/A C 1 GREENWICH INTEGRATIVE MEDICINE 5 PERRYRIDGE ROAD GREENWICH CT 06830 260236411 HEALTHCARE CT N/A C 1 GREENWICH FERTILITY & IVF PC 5 PERRYRIDGE ROAD GREENWICH CT 06830 300145464 HEALTHCARE CT N/A C 1 YORK ENTERPRISES INC 50 YORK STREET NEW HAVEN CT 06511 061110937 TITLE HOLDING CT N/A C 1 YNHH-PHYSICIANS CORP 789 HOWARD AVE NEW HAVEN CT 06519 061202305 ADMINISTRATIVE SERVICES CT N/A C 1 MEDICAL CENTER PHARMACY 50 YORK STREET NEW HAVEN CT 06511 061087673 PHARMACY CT N/A C 1 GREENWICH OCCUPATIONAL HEALTH SERVICES INC 5 PERRYRIDGE ROAD GREENWICH CT 06830 061540101 HEALTHCARE NY N/A C 1 LUKAN INDEMNITY COMPANY 58 PAR-LA-VALLIS RD HAMILTON BERMUDA BD 060646652 INSURANCE BD N/A C 1 GREENWICH OCCUPATIONAL HEALTH SERVICES OF NEW JERSEY 5 PERRYRIDGE ROAD GREENWICH CT 06830 453833883 HEALTHCARE NJ N/A C 1 PRIMARYNET OF CONNECTICUT INC 789 HOWARD AVE NEW HAVEN CT 06519 061463534 HEALTHCARE CT N/A C 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 YALE NEW HAVEN SERVICES CORPORATION P 292330 TRANSACTION REVIEW YALE NEW HAVEN SERVICES CORPORATION M 71006331 COMPARABLE MARKET VALUE BRIDGEPORT HOSPITAL FOUNDATION INC Q 1239262 TRANSACTION REVIEW BRIDGEPORT HOSPITAL FOUNDATION INC L 2131843 TRANSACTION REVIEW BRIDGEPORT HOSPITAL AND HEALTHCARE R 12995015 CASH