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Hospital of Saint Raphael: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
Hospital of Saint Raphael (EIN 06-0653171)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-05
IRS object ID
201422179349300112
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-08-05T09:06:58-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN060653171EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Hospital of Saint RaphaelBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHOSPNameControl
Phone2037893940Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 Orchard Street Suite 204AddressLine1
CityNew HavenCity
StateCTState
ZIP Code06511ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJames R RudeName
TitleChief Financial OfficerTitle
Phone2037893575Phone
Date Signed2014-08-05DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJane Anne Lubin SzafranskNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1200 Orchard Street Suite 204AddressLine1
CityNew HavenCity
StateCTState
ZIP Code06511ZIPCode
FieldValueIRS element (for citing)
Gross Receipts0GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1907YearFormation
State Legal DomicileCTStateLegalDomicile
Activity Or Mission DescriptionNot for Profit HospitalActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees3976TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year5487195ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year443953259ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year293298InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year21174308OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year470908060TotalRevenuePriorYear
Total Revenue Current Year0TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year272875725SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year200064634OtherExpensePriorYear
Other Expenses Current Year0OtherExpensesCurrentYear
Total Expenses Prior Year472940359TotalExpensesPriorYear
Total Expenses Current Year0TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-2032299RevenuesLessExpensesPriorYear
Revenues Less Expenses CY0RevenuesLessExpensesCY
Total Assets BOY160560508TotalAssetsBOY
Total Assets EOY23200829TotalAssetsEOY
Total Liabilities BOY149059341TotalLiabilitiesBOY
Total Liabilities EOY22545821TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY11501167NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY655008NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionThe Hospital of Saint Raphael is a community teaching hospital and health care resource sponsored and guided by the values of the Sisters of Charity of Saint Elizabeth and of the Roman Catholic Church. The mission is to witness, share in, and promote excellence in the healing ministry of Jesus Christ. The Hospital is committed to preserving the dignity and well-being of each individual, and assuring that every person is treated according to the principles of charity and justice. The Hospital accepts the Gospel challenge that prompted their founders of the sponsoring congregation, Saint Vincent DePaul, Saint Elizabeth Ann Seton, and Mother Mary Xavier Mehegan by pledging every loving service in their power to reach out to those in need of services.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
DescriptionThe Hospital of Saint Raphael provided services to the poor and the medically underserved, as well as provided benefits to the broader community. The Hospital also provided services to other needy populations that may not qualify as poor but needed special services and support. Effective as of 12:01am September 12, 2012 the majority of the assets and the operations of the Hospital of Saint Raphael were sold to Yale-New Haven Hospital (a 966 bed not for profit hospital located in New Haven, Connecticut) and its parent company (Yale-New Haven Health Services Corporation), and active operations ceased. The company remains in existence to wind-up corporate affairs, which includes the collection of outstanding accounts receivable, payment of outstanding accounts payable and accrued expenses and the disposition of temporarily and permanently restricted net assets pending transfer as of September 30, 2013. The Attorney General of the State of Connecticut must review all restrictions on these net assets, with a cy-pres/equitable deviation action in Connecticut Superior Probate Court probable for some of these restricted amounts. While the expectation is that these funds will ultimately transition to Yale-New Haven Hospital, it is possible that some of these funds could be directed elsewhere.Description
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096358NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees3976NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Hospital of Saint Raphael Acctg DepBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2037893940TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1200 Orchard Street Suite 204AddressLine1
CityNew HavenCity
StateCTState
ZIP Code06511ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (46 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
M Joseph Canavan
Volunteer1.00X000
James M Carolan
Volunteer1.00X418600
Sister Teresa Confroy
Volunteer2.00X000
Ralph DeNatale MD
Volunteer0.50X8016700
James Farmer MD
Volunteer0.50X31649400
Sister Mary Kathleen Flanagan
Volunteer2.00X000
Paul Fortgang MD
Volunteer0.50X000
Michele Macauda
Volunteer0.50X000
Sister Mary Morley
Volunteer3.00X000
Edward J Mullen
Volunteer1.00X000
Most Reverend Peter Rosazza
Volunteer0.50X000
Sister Maureen Shaughnessy
Volunteer2.00X000
Kevin Twohig MD
Volunteer1.00X000
Sister Margaret Welch
Volunteer3.00X000
Janeanne Lubin-Szafranski
Chief Executive Officer40.00X060313419580X
James Rude
Chief Financial Officer40.00353112017827X
Susan Lipka
Director/Decision Support40.00176744017889X
Katherine Buckley
Director/Reimbursement40.0014495408119X
Caren Genovese
Director/Medical Affairs40.0015226003479X
Victor Cimino
IT Project Manager40.00129454019791X
Frank Jazab
IT Project Manager40.0012251708849X
Christopher M O'Connor
Former Chief Executive Off0.000196988716665X
Benedict Fernando MD
Former Volunteer Trustee0.001920000X
W Bruce Lundberg MD
Former Volunteer Trustee0.0014583100X
Lawrence E McManus
Former Chief Financial Officer0.0008979566821X
David W Benfer
Former Chief Executive Off0.0001529170X
Alan Kliger MD
Former Chief Medical Officer0.00082591312342X
Marshal Mandelkern MD
Former Chair/Psychiatry0.00030752014632X
Kim Samele
Former VP Surgical Services0.0004076948550X
Howard Shaw MD
Former Chair/Women and Children0.0004256172392X
Lucinda VonBeren
Former VP, Corporate Affairs0.00039279712001X
Joseph Bisson
Former VP Planning Services0.00041751415350X
Russ Braun MD
Former Chair/Emergency Medicine0.00053697721129X
John Burke
Former VP Information Services0.0005393271940X
Elizabeth Conrad
Former VP Human Resources0.00053604219258X
Thomas Donahue MD
Former Sec Chief/Cardiology0.00051401019004X
Peter Duffy
Former VP Facility Operations0.00040811618747X
John Fitzgerald
Former Asst VP Finance0.0034547207938X
Sister Joan Granville
Former VP Mission Services0.0003446417020X
Gary J Kaml MD
Former Chair/Surgery0.00379335014687X
Mary Kuncas
Former VP Patient Care Services0.0004827248920X
Andre Ghantous MD
Former Director/Cardiology0.00364595014931X
John Federico MD
Former Section Chief/Thoracic0.00383124013744X
Donald Kim MD
Former Director/SICU0.00349079013982X
Ernest Moritz MD
Former Associate Chair Medicine0.00263092015579X
Samuel Hahn MD
Former Sec Chief/Cardiology0.00373134013825X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4102750TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs9762786TotalReportableCompFrmRltdOrgs
Total Other Compensation374991TotalOtherCompensation
Number Individuals GT100 K168NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Cardinal Health
21377 Network PlaceChicagoIL60673Management15428802
Morrison Management
PO Box 102289AtlantaGA30368Dietary2814748
Rhode Island Blood Center
PO Box 9399ProvidenceRI02940Medical2784498
Yale University
PO Box 208087New HavenCT06511Medical2019023
Ropes Gray LLP
800 Boylston StreetBostonMA02199Professional Services1801434
FieldValueIRS element (for citing)
Number Of Contractors GT100 K59NumberOfContractorsGT100K

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY93375248BOY
EOY16005349EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY25007422BOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY16289043BOY
EOY84051EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY49580BOY
EOY0EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY556963BOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY24189707BOY
EOY6264580EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1092545BOY
EOY846849EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY160560508BOY
EOY23200829EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY48321015BOY
EOY22545821EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY100738326BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY149059341BOY
EOY22545821EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-6517301BOY
EOY-5609561EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY10301495BOY
EOY4833380EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY7716973BOY
EOY1431189EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY11501167BOY
EOY655008EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY160560508BOY
EOY23200829EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses0ReconcilationRevenueExpenses
Reconcilation Other Changes-10846159ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited0FSAudited
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance4004063BeginningOfYearBalance
Investment Earnings Or Losses22504InvestmentEarningsOrLosses
End Of Year Balance4026567EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance3446673BeginningOfYearBalance
Investment Earnings Or Losses557390InvestmentEarningsOrLosses
End Of Year Balance4004063EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3431456BeginningOfYearBalance
Investment Earnings Or Losses15217InvestmentEarningsOrLosses
End Of Year Balance3446673EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3122933BeginningOfYearBalance
Investment Earnings Or Losses308523InvestmentEarningsOrLosses
End Of Year Balance3431456EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3173968BeginningOfYearBalance
Investment Earnings Or Losses-51035InvestmentEarningsOrLosses
End Of Year Balance3122933EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs1EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Other Securities OtherSecurities (4 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
Cash863820F
Money Market Funds3214811F
CD's and Other1570161F
Mutual Funds615788F
FieldValueIRS element (for citing)
Total Of Book Value Securities6264580TotalOfBookValueSecurities

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDescription of Intended Use of Endowment Funds:Identifier
Return ReferencePart V, Line 4:ReturnReference
ExplanationThe Attorney General of the State of Connecticut is currently reviewing all restrictions on temporarily and permanently restricted net assets, with a cy-pres action in Connecticut Superior Court probable for some of these restricted amounts. While the expectation is that these funds will ultimately transition to Yale-New Haven Hospital, it is possible that some of these funds could be directed to another charity.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (31 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
James Farmer MD
Volunteer000031649400000316494000
Janeanne Lubin-Szafranski
Chief Executive Officer0308427015113101435760001958006227140124238
James Rude
Chief Financial Officer2186350880040464730001782703709390453540
Susan Lipka
Director/Decision Support166672010000072000178890194633050000
Katherine Buckley
Director/Reimbursement13188701300006700081190153073050000
Caren Genovese
Director/Medical Affairs1472000500006000034790155739050000
Christopher M O'Connor
Former Chief Executive Off05279510677909076402700016665019865520370442
Benedict Fernando MD
Former Volunteer Trustee0000192000000019200000
W Bruce Lundberg MD
Former Volunteer Trustee000014583100000145831000
Lawrence E McManus
Former Chief Financial Officer014571601529550599285000682109047770199309
David W Benfer
Former Chief Executive Off000001529170000015291700
Alan Kliger MD
Former Chief Medical Officer0342434028371601997630001234208382550199305
Marshal Mandelkern MD
Former Chair/Psychiatry0195942094596016982000146320322152072646
Kim Samele
Former VP Surgical Services024405107531408832900085500416244034279
Howard Shaw MD
Former Chair/Women and Children031462601090060198500023920428009054506
Lucinda VonBeren
Former VP, Corporate Affairs016911501160660107616000120010404798091657
Joseph Bisson
Former VP Planning Services017981101238030113900000153500432864091464
Russ Braun MD
Former Chair/Emergency Medicine0397173058765081039000211290558106058765
John Burke
Former VP Information Services02648130128962014555200019400541267095275
Elizabeth Conrad
Former VP Human Resources0266103013154101383980001925805553000105396
Thomas Donahue MD
Former Sec Chief/Cardiology03433220166904037840001900405330140106313
Peter Duffy
Former VP Facility Operations02047860894460113884000187470426863082268
John Fitzgerald
Former Asst VP Finance214764085440045268000793803534100440330
Sister Joan Granville
Former VP Mission Services017756607679109028400070200351661064431
Gary J Kaml MD
Former Chair/Surgery222441000156894000146870394022000
Mary Kuncas
Former VP Patient Care Services025319001093110120223000892004916440103355
Andre Ghantous MD
Former Director/Cardiology36379105000304000149310379526000
John Federico MD
Former Section Chief/Thoracic3572240255660334000137440396868000
Donald Kim MD
Former Director/SICU2571280917200231000139820363061000
Ernest Moritz MD
Former Associate Chair Medicine2616280001464000155790278671000
Samuel Hahn MD
Former Sec Chief/Cardiology372940000194000138250386959000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 1aTaxable housing and automobile allowances were provided to Christopher M. O'Connor (Saint Raphael Healthcare System, Inc. Chief Executive Officer through 9/11/12) under the terms of the individual's employment contract. Taxable housing and automobile allowances were provided to Lawrence E. McManus (Saint Raphael Healthcare System, Inc. Chief Operating Officer and Chief Financial Officer through 4/4/12) under the terms of the individual's employment contract. In addition, reimbursements (non-taxable) were made for the business use of a social club. Taxable automobile allowance is provided to Janeanne Lubin-Szafranski (Saint Raphael Healthcare System, Inc. Chief Executive Officer effective 9/12/12) under the terms of the individual's employment contract. Taxable housing and automobile allowances were provided to John Burke (Saint Raphael's Chief Information Officer through 9/11/12) under the terms of the individual's employment contract. Taxable automobile allowances were provided to other vice-president level executives under the terms of the individual's employment contract.
Part I, Lines 4a-bCertain Saint Raphael executives are eligible to receive severance payments upon termination of employment in certain circumstances. During calendar year 2012 severance payments made are reported as a component of the value reported in Schedule J Part II Column B (i) "Base Compensation" for the following individuals - Russ Braun, MD ($216,173), John Burke ($74,466), Elizabeth Conrad ($75,955), Peter Duffy ($52,230), Sister Joan Granville ($50,358), Kim Samele ($69,403). Certain Saint Raphael executives were eligible to receive payments for employment milestones during the finalization of the transaction to sell the majority of the assets and the operations of the System and its subsidiary corporations. Such payments made during calendar year 2012 are reported in Schedule J Part II Column B (iii)"Other Reportable Compensation" for the following individuals- Janeanne Lubin-Szafranski ($122,525), James Rude ($45,676), Christopher O'Connor ($740,875), Lawrence McManus ($570,105), Alan Kliger, MD ($188,180), Joseph Bisson ($100,363), John Burke ($104,544), Elizabeth Conrad ($106,635), Peter Duffy ($82,350), John Fitzgerald ($44,346), Sister Joan Granville ($70,700), Mary Kuncas ($100,636), Kim Samele ($49,439), Lucinda VonBeren ($94,090). Certain Saint Raphael executives were eligible to participate in a supplemental non-qualified retirement plan through a date in calendar year 2010. During calendar year 2012 no provision was made for participation in such plan. Vested amounts are reported as a component of the value reported in Schedule J Part II Column B (iii) "Other Reportable Compensation" for the following individuals- Janeanne Lubin-Szafranski ($12,576), Elizabeth Conrad ($8,216), Peter Duffy ($7,219), Mary Kuncas ($11,639), Marshall Mandelkern, MD ($12,391), Lucinda VonBeren ($5,909).
Part I, Line 7Certain Saint Raphael executives were eligible to earn incentive compensation based upon the achievement of Board of Trustee's- approved metrics. During calendar year 2012 payments were made for incentives related to fiscal year ended September 30, 2011 and are reported in Schedule J Part II Column B (ii) "Bonus and Incentive Compensation". Certain Hospital of Saint Raphael physician caregivers were eligible to earn incentive compensation based upon the achievement of approved productivity metrics. During calendar year 2012 payments were made for such incentives as reported in Schedule J Part II Column B (ii) "Bonus and Incentive Compensation" for the physician caregivers and amounts identified.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 6Hospital of Saint Raphael is a membership corporation and the sole Member of the Hospital is the Saint Raphael Healthcare System, Inc.
Form 990, Part VI, Section A, line 7aSaint Raphael Healthcare System, Inc. is the sole Member of the Hospital of Saint Raphael.
Form 990, Part VI, Section A, line 7bThe following rights and powers are reserved to the Membership of the Hospital's sole Member: >To acquire, alienate or convey the real property or endowment funds of the Hospital having a value of $3,000,000 or more, or to place a mortgage on such property or funds in the amount of $3,000,000 or more. >To dispose of all or substantially all of the physical assets of the Hospital and to approve the merger or consolidation of the Hospital. >To borrow money and issue evidences of indebtedness in connection with the activities of the Hospital in the amount $3,000,000 or more, if such borrowings are to secured by mortgage, pledge or other lien on the Hospital's real property or endowment funds. >To organize or direct the organization of any corporation or other entity in which the Hospital will be a member or shareholder or have an equity interest greater than $1,000,000. >To dispose of stock or other equity interest of a corporation or other entity controlled by the Hospital. >To elect the Trustees of the Hospital who do not serve in an ex officio capacity. >To fill any vacancy occurring on the Board of Trustees, other than ex officio positions. >To amend the Certificate of Incorporation and Bylaws of the Hospital. >To appoint or remove the President of the Hospital. >To exercise any right specifically reserved to them in the certificate of incorporation of a subsidiary corporation controlled by the Hospital.
Form 990, Part VI, Section B, line 11The governing body reviewed key elements of the 990 prior to submission.
Form 990, Part VI, Section B, line 12cOfficers, trustees and key employees are required to complete the conflict of interest questionaire on an annual basis. Results of the questionaire are reviewed annually by the audit committee.
Form 990, Part VI, Section B, line 15Compensation of the organization's chief executive officer is determined by the Compensation Committee of the Board of Trustees (utilizing an independent compensation consultant in conjunction with a compensation survey of the relevant marketplace). The Compensation Committee maintains minutes of its meetings. The Chief Executive Officer is employed with a written employment contract. Compensation of the organization's other officers and most of its key employees are also determined by the Compensation Committee of the Board of Trustees (utilizing an independent compensation consultant in conjunction with a compensation survey of the relevant marketplace). The Compensation Committee maintains minutes of its meetings.
Form 990, Part VI, Section C, line 19The organization makes its governing documents and conflict of interest policy available to the public upon request.
Form 990, Part VII, Section A, Line 1AHours related for volunteer trustees are the estimated hours per week that the volunteer trustees contribute to this and all other related exempt organizations, not necessarily equally but in the proportion required, for which they receive no compensation. Related exempt organizations include Saint Raphael Healthcare System, Inc. (06-1157542), Hospital of Saint Raphael (06-0653171), and Saint Regis Health Center, Inc. (06-1217867).
Form 990, Part XI, line 9:Net equity transfers to affiliates -182937. Contributions restricted to Special Purpose Fund 281491. Gains on restricted Net Assets 2011. Net assets released from restriction 15601. Change in interest in net assets of Saint Raphael Foundation, Inc. -12088439. Market value increase restricted net assets 35436. Excess of revenue over expenses during liquidation 1225762. Transfer of net assets to Yale-New Haven Hospital -135084.Changes in Net Assets or Fund Balances:
Form 990, Part VII, Line 1a, Column EAmounts reported for James Carolan reflect payments made to Withers Bergman, LLC in the normal and recurring course of Hospital of Saint Raphael business and are not related to the volunteer services provided by the trustee to the organization. Amounts reported for Ralph DeNatale, MD reflect payments made to Connecticut Vascular Center ($15,000) and the individual physician ($65,167). Certain of the amounts reported for the individual physician reflect payments made as a stipend for his role as President of the Hospital of Saint Raphael Medical Staff (responsibilities include participation as a Hospital trustee). Other payments made in the normal and recurring course of Hospital of Saint Raphael business. Amounts reported for James Farmer, MD reflect payments made to Anesthesia Associates in the normal and recurring course of Hospital of Saint Raphael business and are not related to the volunteer services provided by the trustee to the organization. Amounts reported for Benedict Fernando, MD include payments made to West Haven Medical Group in the normal and recurring course of Hospital of Saint Raphael business. Amounts reported for W. Bruce Lundberg, MD reflect payments made to Yale Cancer Center (formerly Medical Oncology and Hematology, acquired by Yale-New Haven Hospital on 1/1/12), in the normal and recurring course of Hospital of Saint Raphael business and are not related to the volunteer services provided by the trustee to the organization.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Saint Raphael Healthcare System Inc
200 Orchard Street Suite 204New HavenCT06511061157542Tax exempt holding companyCT501 (c) 311a0
Saint Raphael Foundation Inc
200 Orchard Street Suite 204New HavenCT06511510140710Fundraising FoundationCT501 (c) 311a0Saint Raphael Healthcare System Inc
Saint Regis Health Center Inc
200 Orchard Street Suite 204New HavenCT06511061217867Skilled Nursing FacilityCT501 (c) 330Saint Raphael Healthcare System Inc
Saint Raphael Healthcare System Affiliated Physicians Inc
200 Orchard Street Suite 204New HavenCT06511800522532Medical FoundationCT501 (c) 311a0Saint Raphael Healthcare System Inc
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Saint Raphael Healthcare System Inc
B2070677Cash Value
Saint Raphael Foundation Inc
C811049Cash Value
Saint Raphael Foundation Inc
B9293Cash Value
Saint Regis Health Center Inc
C656749cash Value
Saint Raphael Healthcare System Affiliated Physicians Inc
C429235cash Value