CHARLOTTE HUNGERFORD HOSPITAL: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- CHARLOTTE HUNGERFORD HOSPITAL (EIN 06-0646678)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-08-08
- IRS object ID
- 201442209349300104
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-08-08T08:11:28-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 061533253 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SASLOW LUFKIN & BUGGY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 175 POWDER FOREST DRIVE | AddressLine1 |
| City | SIMSBURY | City |
| State | CT | State |
| ZIP Code | 06089 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 060646678 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE CHARLOTTE HUNGERFORD HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CHAR | NameControl |
| Phone | 8604966728 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 540 LITCHFIELD STREET PO BOX 988 | AddressLine1 |
| City | TORRINGTON | City |
| State | CT | State |
| ZIP Code | 067900988 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SUSAN M SCHAPP | Name |
| Title | VP FINANCE/TREASURER | Title |
| Phone | 8604966728 | Phone |
| Date Signed | 2014-08-05 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | RICHARD BUGGY | Name |
| PTIN | P00512316 | PTIN |
| Phone | 8606789200 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | SUSAN M SCHAPP | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 540 LITCHFIELD STREET PO BOX 988 | AddressLine1 |
| City | TORRINGTON | City |
| State | CT | State |
| ZIP Code | 067900988 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 132715050 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.CHARLOTTEHUNGERFORD.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1917 | YearFormation |
| State Legal Domicile | CT | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE QUALITY, COMPASSIONATE AND COST EFFECTIVE HEALTHCARE TO THE COMMUNITY OF NORTHWESTERN CONNECTICUT. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 16 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1194 | TotalNbrEmployees |
| Total Nbr Volunteers | 185 | TotalNbrVolunteers |
| Total Gross UBI | 1212838 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -191695 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2991772 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 3015379 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 118802100 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 122017519 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2267570 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2463648 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 620288 | OtherRevenuePriorYear |
| Other Revenue Current Year | 381719 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 124681730 | TotalRevenuePriorYear |
| Total Revenue Current Year | 127878265 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 12000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 12000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 72583360 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 75560164 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 341307 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 49361413 | OtherExpensePriorYear |
| Other Expenses Current Year | 49401846 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 121956773 | TotalExpensesPriorYear |
| Total Expenses Current Year | 124974010 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2724957 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2904255 | RevenuesLessExpensesCY |
| Total Assets BOY | 126686772 | TotalAssetsBOY |
| Total Assets EOY | 132607623 | TotalAssetsEOY |
| Total Liabilities BOY | 64748035 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 47910218 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 61938737 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 84697405 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE CHARLOTTE HUNGERFORD HOSPITAL PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. OUR MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. IN KEEPING WITH THE HOSPITAL'S COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, FREE CARE AND/OR SUBSIDIZED CARE, CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST, HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY WILL BE CONSIDERED WHERE THE NEED AND/OR AN INDIVIDUAL'S INABILITY TO PAY COEXIST. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGAMS FOR THE ELDERLY, HANDICAPPED, THE MEDICALLY UNDERSERVED AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 110539750 | Expense |
| Grants | 12000 | Grants |
| Revenue | 120909002 | Revenue |
| Description | DURING FY 2013 THE HOSPITAL CONTRIBUTED OVER 18,000 HOURS TOWARD THE COMMON PURPOSE OF SERVICING THE HEALTHCARE NEEDS OF THE COMMUNITY. THE VALUE OF THIS CONTRIBUTION IS APPROXIMATELY $145,000, WHICH IS GIVEN BACK TO THE COMMUNITY THROUGH LOWER COSTS IN BOTH PATIENT SERVICES AND OTHER "WELLNESS" PROGRAMS. IN ADDITION THE HOSPITAL GRANTED CHARITY CARE IN THE AMOUNT OF $1,726,098 DURING FISCAL YEAR 2013. THE CHARLOTTE HUNGERFORD HOSPITAL RENDERED THE FOLLOWING SERVICES DURING FY 2013:INPATIENT SERVICES:DISCHARGES 6,533PATIENT DAYS 26,574 SPECIAL SERVICES: OPERATING ROOM CASES 4,145 AMBULATORY SURGERY CASES 3,283 ENDOSCOPY CASES 794 AMBULATORY MEDICAL CASES 2,597WOUND CARE CASES 4,936POST ANESTHESIA CARE UNIT CASES 2,566 DELIVERY ROOM DELIVERIES 452RESPIRATORY THERAPY TREATMENTS 40,178 PULMONARY REHAB TESTS 6,123PULMONARY FUNCTION LAB TESTS 1,631 CARDIO DIAGNOSTIC EXAMS 13,687EEG EXAMS 1,092PHYSICAL THERAPY TREATMENTS 32,047 CARDIAC REHAB TREATMENTS 3,146 SPEECH THERAPY TREATMENTS 663 OCCUPATIONAL THERAPY TREATMENTS 3,194 SLEEP STUDY TESTS 565 DIAGNOSTIC RADIOLOGY EXAMS 26,813 MAMMOGRAPHY EXAMS 9,246 NUCLEAR MEDICINE EXAMS 952ULTRASOUND EXAMS 8,696C.A.T. SCAN EXAMS 12,733 P.E.T. SCAN EXAMS 293 M.R.I. EXAMS 1,110SPECIAL PROCEDURES (RADIOLOGY) EXAMS 1,152 RADIATION THERAPY TREATMENTS 8,501LABORATORY TESTS 603,173 PSYCHIATRIC CLINIC VISITS 35,645 PHP-ADULT/ADOLESCENT VISITS 4,685 RENAL DIALYSIS VISITS 369 EMERGENCY DEPARTMENT VISITS 34,810 OUTPATIENT DIABETES PROGRAM VISITS 1,567 WALK IN CENTER VISITS 10,956 PROFESSIONAL SERVICE CONSULTS 132,553HUNGERFORD EMERGENCY MEDICAL CENTER: CARDIAC REHAB TREATMENTS 1,742 DIAGNOSTIC RADIOLOGY EXAMS 3,761 LABORATORY TESTS 18,381 EMERGENCY DEPARTMENT VISITS 6,162 PULMONARY REHAB TESTS 2,760 | Description |
| Total Program Service Expense | 110539750 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 207 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1194 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 16 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | CT | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUSAN M SCHAPP | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8604966728 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 540 LITCHFIELD STREET | AddressLine1 |
| City | TORRINGTON | City |
| State | CT | State |
| ZIP Code | 06790 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (27 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| EDWARD ARUM | ||||||||
| GOVERNOR | 2.50 | X | 0 | 0 | 0 | |||
| RICHARD DUTTON MD | ||||||||
| GOVERNOR | 1.00 | X | 0 | 0 | 0 | |||
| GLADYS CERRUTO | ||||||||
| GOVERNOR | 1.00 | X | 0 | 0 | 0 | |||
| DAVID J FRAUENHOFER | ||||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | X | ||
| JAMIE GREG | ||||||||
| GOVERNOR | 1.00 | X | 0 | 0 | 0 | |||
| KENDRICK HOM MD | ||||||||
| GOVERNOR | 60.00 | X | 277169 | 0 | 25339 | |||
| JOHN JANCO | ||||||||
| VICE CHAIRMAN | 2.50 | X | 0 | 0 | 0 | X | ||
| JOHN LAVIERI | ||||||||
| CHAIRMAN | 2.50 | X | 0 | 0 | 0 | X | ||
| DIANE LIBBY CPA | ||||||||
| GOVERNOR | 1.00 | X | 0 | 0 | 0 | |||
| JAMES O'LEARY | ||||||||
| GOVERNOR | 1.00 | X | 0 | 0 | 0 | |||
| EDWIN G BOOTH JR | ||||||||
| GOVERNOR | 1.00 | X | 0 | 0 | 0 | |||
| FRANK BUONOCORE JR | ||||||||
| GOVERNOR | 1.00 | X | 0 | 0 | 0 | |||
| STEPHANIE FOWLER MD | ||||||||
| GOVERNOR | 1.00 | X | 0 | 0 | 0 | |||
| MICHAEL PATTERSON | ||||||||
| GOVERNOR | 1.00 | X | 0 | 0 | 0 | |||
| CHARLES W RORABACK | ||||||||
| GOVERNOR | 1.00 | X | 0 | 0 | 0 | |||
| ANDREW SZCZEPENSKI MD | ||||||||
| GOVERNOR | 1.00 | X | 48564 | 0 | 4440 | |||
| DANIEL J MCINTYRE | ||||||||
| CEO/PRESIDENT | 60.00 | 382486 | 0 | 92729 | X | |||
| SUSAN M SCHAPP | ||||||||
| VP FINANCE/ TREASURER | 60.00 | 225452 | 0 | 103138 | X | |||
| JOHN J CAPOBIANCO | ||||||||
| VP OUT PATIENT SERVICES | 60.00 | 212043 | 0 | 113230 | X | |||
| MARK PRETE MD | ||||||||
| VP MEDICAL AFFAIRS | 60.00 | 326624 | 0 | 55108 | X | |||
| RAYMOND J ELLIOTT | ||||||||
| VP FACILITIES | 60.00 | 185519 | 0 | 61049 | X | |||
| BRIAN MATTIELLO | ||||||||
| VP HUMAN RESOURCES | 60.00 | 161067 | 0 | 21462 | X | |||
| ELZBIETA LACH-PASKO MD | ||||||||
| PATHOLOGIST | 60.00 | 393459 | 0 | 132225 | X | |||
| MUSTAFA UGURLU MD | ||||||||
| PHYSICIAN | 60.00 | 386073 | 0 | 47406 | X | |||
| TIMOTHY GOSTKOWSKI MD | ||||||||
| PHYSICIAN | 60.00 | 480418 | 0 | 68439 | X | |||
| WILLIAM MCGEEHIN MD | ||||||||
| PHYSICIAN | 60.00 | 429541 | 0 | 68468 | X | |||
| ROBERT KAHAN MD | ||||||||
| PHYSICIAN | 60.00 | 381129 | 0 | 34843 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3889544 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 827876 | TotalOtherCompensation |
| Number Individuals GT100 K | 50 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| ADULT & PEDIATRIC UROLOGY OF NW CONNECTI | |||||
| 538 LITCHFIELD STREET SUITE 102 | TORRINGTON | CT | 06790 | MEDICAL | 1455650 |
| BUILDING ONE FACILITY SERVICES | |||||
| 57 OZICK DRIVE SUITE A | DURHAM | CT | 06422 | CLEANING SERVICES | 1370633 |
| MAYO COLLABORATIVE SERVICES | |||||
| PO BOX 9146 | MINEAPOLIS | MN | 554809146 | LABORATORY TESTS | 1306027 |
| NWCT EMERGENCY SERVICES | |||||
| 80 S MAIN STREET | WEST HARTFORD | CT | 06107 | MEDICAL | 870492 |
| NEW MILFORD LAUNDRY | |||||
| 40 COMMONS COURT | WATERBURY | CT | 06704 | LAUNDRY/LINEN SERVICES | 460644 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 35 | NumberOfContractorsGT100K |
| Fundraising Events | 26533 | FundraisingEvents |
| Government Grants | 2626383 | GovernmentGrants |
| All Other Contributions | 362463 | AllOtherContributions |
| Total Contributions | 3015379 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| NET PATIENT REVENUE | 900099 | 105168170 | 105168170 | |
| LABORATORY SERVICES | 621500 | 11509377 | 10188647 | 1320730 |
| OTHER HOSPITAL SERVICES | 900099 | 5339972 | 5339972 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 122017519 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1616119 | TotalRevenueColumn |
| Exclusion | $1,616,119 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 594694 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 382481 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 212213 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 212213 | TotalRevenueColumn |
| Related Or Exempt Function Income | 212213 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 5159460 | Securities |
| Other | 1392 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 4313323 | Securities |
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 846137 | Securities |
| Other | 1392 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 847529 | TotalRevenueColumn |
| Exclusion | $847,529 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 145011 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 26533 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 42420 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 102591 | TotalRevenueColumn |
| Exclusion | $102,591 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 180295 | GrossSalesOfInventory |
| Cost Of Goods Sold | 98561 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 81734 | TotalRevenueColumn |
| Exclusion | $81,734 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| GAIN FROM EQUITY METHOD | 900001 | 93073 | $93,073 | |
| MEDCONN | 561499 | -107892 | -107892 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | -14819 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 127878265 | TotalRevenueColumn |
| Related Or Exempt Function Income | 120909002 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1212838 | UnrelatedBusinessRevenue |
| Exclusion | $2,741,046 | ExclusionAmount |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12000 | Total |
| Program Services | 12000 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1857323 | Total |
| Program Services | 1392992 | ProgramServices |
| Management And General | 464331 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 57493040 | Total |
| Program Services | 51408333 | ProgramServices |
| Management And General | 5916225 | ManagementAndGeneral |
| Fundraising | 168482 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5628302 | Total |
| Program Services | 5007245 | ProgramServices |
| Management And General | 605080 | ManagementAndGeneral |
| Fundraising | 15977 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6649991 | Total |
| Program Services | 5916195 | ProgramServices |
| Management And General | 714918 | ManagementAndGeneral |
| Fundraising | 18878 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3931508 | Total |
| Program Services | 3497684 | ProgramServices |
| Management And General | 422663 | ManagementAndGeneral |
| Fundraising | 11161 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3177905 | Total |
| Program Services | 2827238 | ProgramServices |
| Management And General | 341646 | ManagementAndGeneral |
| Fundraising | 9021 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 253533 | Total |
| Program Services | 225557 | ProgramServices |
| Management And General | 27256 | ManagementAndGeneral |
| Fundraising | 720 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 109008 | Total |
| Program Services | 96979 | ProgramServices |
| Management And General | 11719 | ManagementAndGeneral |
| Fundraising | 310 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10931016 | Total |
| Program Services | 9724829 | ProgramServices |
| Management And General | 1175156 | ManagementAndGeneral |
| Fundraising | 31031 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 539279 | Total |
| Program Services | 479772 | ProgramServices |
| Management And General | 57976 | ManagementAndGeneral |
| Fundraising | 1531 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 411337 | Total |
| Program Services | 365948 | ProgramServices |
| Management And General | 44221 | ManagementAndGeneral |
| Fundraising | 1168 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1411262 | Total |
| Program Services | 1255536 | ProgramServices |
| Management And General | 151720 | ManagementAndGeneral |
| Fundraising | 4006 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2090117 | Total |
| Program Services | 1859482 | ProgramServices |
| Management And General | 224702 | ManagementAndGeneral |
| Fundraising | 5933 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18135 | Total |
| Program Services | 16134 | ProgramServices |
| Management And General | 1950 | ManagementAndGeneral |
| Fundraising | 51 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 250825 | Total |
| Program Services | 223148 | ProgramServices |
| Management And General | 26965 | ManagementAndGeneral |
| Fundraising | 712 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6050075 | Total |
| Program Services | 5382477 | ProgramServices |
| Management And General | 650423 | ManagementAndGeneral |
| Fundraising | 17175 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2125573 | Total |
| Program Services | 1891026 | ProgramServices |
| Management And General | 228513 | ManagementAndGeneral |
| Fundraising | 6034 | Fundraising |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| SUPPLIES | 17302210 | 15392991 | 1860102 | 49117 |
| PHYSICIAN FEES | 4669548 | 3502161 | 1167387 | |
| HOSPITAL AUXILIARY EXPE | 62023 | 62023 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 124974010 | Total |
| Program Services | 110539750 | ProgramServices |
| Management And General | 14092953 | ManagementAndGeneral |
| Fundraising | 341307 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60839 | BOY |
| EOY | 64643 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9947626 | BOY |
| EOY | 9014949 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 88492 | BOY |
| EOY | 36857 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13441100 | BOY |
| EOY | 13504471 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2047381 | BOY |
| EOY | 2119166 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 979386 | BOY |
| EOY | 1512549 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 149504375 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 112634596 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37852787 | BOY |
| EOY | 36869779 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 59313706 | BOY |
| EOY | 66334495 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2955455 | BOY |
| EOY | 3150714 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 126686772 | BOY |
| EOY | 132607623 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9069553 | BOY |
| EOY | 11483194 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 147665 | BOY |
| EOY | 298993 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1200000 | BOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3421466 | BOY |
| EOY | 3219468 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50909351 | BOY |
| EOY | 32908563 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 64748035 | BOY |
| EOY | 47910218 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41061265 | BOY |
| EOY | 61261338 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3256943 | BOY |
| EOY | 3334379 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17620529 | BOY |
| EOY | 20101688 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 61938737 | BOY |
| EOY | 84697405 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 126686772 | BOY |
| EOY | 132607623 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 2904255 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 5754530 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 14099883 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Both | X | FinancialStatementBoth |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $13,492 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 13492 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | THE HOSPITAL IS A MEMBER OF THE CONNECTICUT HOSPITAL ASSOCIATION. $13,492 REPRESENTS THE PORTION OF DUES PAID TO THE ASSOCIATION WHICH WERE USED FOR LOBBYING PURPOSES. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 53165045 | BeginningOfYearBalance |
| Contributions | 243732 | Contributions |
| Investment Earnings Or Losses | 7106906 | InvestmentEarningsOrLosses |
| Other Expenditures | 354906 | OtherExpenditures |
| End Of Year Balance | 60160777 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 46929816 | BeginningOfYearBalance |
| Contributions | 239485 | Contributions |
| Investment Earnings Or Losses | 6103897 | InvestmentEarningsOrLosses |
| Other Expenditures | 108153 | OtherExpenditures |
| End Of Year Balance | 53165045 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 49273746 | BeginningOfYearBalance |
| Contributions | 186977 | Contributions |
| Investment Earnings Or Losses | -2264127 | InvestmentEarningsOrLosses |
| Other Expenditures | 266780 | OtherExpenditures |
| End Of Year Balance | 46929816 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 45533758 | BeginningOfYearBalance |
| Contributions | 690138 | Contributions |
| Investment Earnings Or Losses | 3824302 | InvestmentEarningsOrLosses |
| Other Expenditures | 774452 | OtherExpenditures |
| End Of Year Balance | 49273746 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 47240328 | BeginningOfYearBalance |
| Contributions | 1043719 | Contributions |
| Investment Earnings Or Losses | -1532480 | InvestmentEarningsOrLosses |
| Other Expenditures | 1217809 | OtherExpenditures |
| End Of Year Balance | 45533758 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.61080 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.33410 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.05510 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 155467 | OtherCostOrOtherBasis |
| Book Value | 155467 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 79680340 | OtherCostOrOtherBasis |
| Depreciation | 54026486 | Depreciation |
| Book Value | 25653854 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 62919428 | OtherCostOrOtherBasis |
| Depreciation | 54236704 | Depreciation |
| Book Value | 8682724 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6749140 | OtherCostOrOtherBasis |
| Depreciation | 4371406 | Depreciation |
| Book Value | 2377734 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 36869779 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (4 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| INVESTMENTS HELD IN TRUST FOR ESTIMATED SELF-INSURANCE LIABILITIES | 4175772 | F |
| BENEFICIAL INTEREST IN ASSETS HELD IN TRUST BY OTHERS | 16349307 | F |
| LONG-TERM INVESTMENTS | 38742293 | F |
| DONOR RESTRICTED ASSETS | 7067123 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 66334495 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (5 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ESTIMATED AMOUNTS DUE TO THIRD PARTY REIMBURSEMENT AGENCIES | $2,468,522 |
| MISCELLANEOUS CURRENT LIABILITIES | $181,897 |
| ESTIMATED SELF-INSURANCE LIABILITIES | $3,527,218 |
| ACCRUED PENSION LIABILITY | $23,133,018 |
| PENSION CONTRIBUTION - CURRENT YEAR | $3,597,908 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 32908563 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 127592905 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 127592905 | RevenueSubtotal |
| Other Revenues Not Included | 285360 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 285360 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 127878265 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 124899987 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 124899987 | ExpensesSubtotal |
| Other Expenses Not Included | 74023 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 74023 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 124974010 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | THE ENDOWMENT FUNDS WILL BE USED PRIMARILY FOR CAPITAL PURCHASES, INDIGENT CARE AND OTHER USES AS APPROVED BY THE BOARD IN ACCORDANCE WITH DONOR RESTRICTIONS. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | THE HOSPITAL ACCOUNTS FOR UNCERTAIN TAX POSITIONS WITH PROVISIONS OF FASB ASC 740, "INCOME TAXES" WHICH PROVIDES A FRAMEWORK FOR HOW COMPANIES SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE UNCERTAIN TAX POSITIONS IN THEIR FINANCIAL STATEMENTS. THE HOSPITAL MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE HOSPITAL DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2013 AND 2012. AS OF SEPTEMBER 30, 2013 AND 2012, THE HOSPITAL DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNCERTAIN TAX POSITIONS. THE HOSPITAL'S PRIOR THREE TAX YEARS ARE OPEN AND SUBJECT TO EXAMINATION. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | TEMPORARY RESTRICTED ACTIVITY 216,769. AUXILIARY REVENUE 68,591. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | AUXILIARY EXPENSES 74,023. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF TOURNAMENT | NameOfEvent1 |
| Gross Receipts Event1 | 107845 | GrossReceiptsEvent1 |
| Gross Revenue Event1 | 107845 | GrossRevenueEvent1 |
| Non Cash Prizes Event1 | 3532 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 25622 | RentFacilityCostsEvent1 |
| Name Of Event2 | DINNER DANCE | NameOfEvent2 |
| Gross Receipts Event2 | 37166 | GrossReceiptsEvent2 |
| Gross Revenue Event2 | 37166 | GrossRevenueEvent2 |
| Rent Facility Costs Event2 | 13266 | RentFacilityCostsEvent2 |
| Total Number Of Other Events | 8 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 26533 | GrossReceiptsOtherEvents |
| Charitable Contrib Other Events | 26533 | CharitableContribOtherEvents |
| Gross Receipts Total | 171544 | GrossReceiptsTotal |
| Charitable Contributions Total | 26533 | CharitableContributionsTotal |
| Gross Revenue Total Events | 145011 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 3532 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 38888 | RentFacilityCostsTotalEvents |
| Direct Expense Summary Events | 42420 | DirectExpenseSummaryEvents |
| Net Income Summary | 102591 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 3409 | PersonsServed |
| Total Community Benefit Expense | 1613688 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1613688 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01290 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 42458 | PersonsServed |
| Total Community Benefit Expense | 27835850 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 22094334 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5741516 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04590 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 637 | PersonsServed |
| Total Community Benefit Expense | 228156 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 152254 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 75902 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 46504 | PersonsServed |
| Total Community Benefit Expense | 29677694 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 22246588 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7431106 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05940 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 8 | NumberOfActivitiesOrPrograms |
| Persons Served | 4323 | PersonsServed |
| Total Community Benefit Expense | 37621 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 37621 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 55 | PersonsServed |
| Total Community Benefit Expense | 897 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 897 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 20242175 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 17246063 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2996112 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02400 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 1 | PersonsServed |
| Total Community Benefit Expense | 176 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 176 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 10 | NumberOfActivitiesOrPrograms |
| Persons Served | 4379 | PersonsServed |
| Total Community Benefit Expense | 20280869 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 17246063 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3034806 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02430 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 10 | NumberOfActivitiesOrPrograms |
| Persons Served | 50883 | PersonsServed |
| Total Community Benefit Expense | 49958563 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 39492651 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 10465912 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08370 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $3,378,061 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 43418966 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 46946867 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -3527901 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV (4 entries)
| Description Ent Primary ActivityDescriptionEntPrimaryActivity | Organization Profit Or OwnershipOrganizationProfitOrOwnership | Officers Etc Profit Or OwnershipOfficersEtcProfitOrOwnership | Physicans Profit Or OwnershipPhysicansProfitOrOwnership |
|---|---|---|---|
| 1 ADVANCED MEDICAL IMAGING OF NORTHWEST CT LLC | |||
| IMAGING CENTER | 0.50000 | 0.00000 | 0.50000 |
| 2 MEDCONN COLLECTION AGENCY LLC | |||
| PATIENT COLLECTION AGENCY | 0.25000 | 0.00000 | 0.00000 |
| 3 UROLOGY CENTER OF NW CT | |||
| UROLOGY CENTER | 0.62500 | 0.00000 | 0.37500 |
| 4 LITCHFIELD COUNTY HEALTHCARE SERVICE CORP | |||
| PHYSICIANS PRACTICE | 1.00000 | 0.00000 | 0.00000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 2 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)
| Facility NumberFacilityNumber | Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Er24 HoursEr24Hours | Er OtherErOther |
|---|---|---|---|---|---|---|---|---|
| CHARLOTTE HUNGERFORD HOSPITAL | ||||||||
| 1 | 540 LITCHFIELD STRRET | TORRINGTON | CT | 06790 | X | X | X | X |
| HUNGERFORD EMERGENCY MEDICAL CENTER | ||||||||
| 2 | 115 SPENCER STREET | WINSTED | CT | 06098 | X | |||
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (2 entries)
| Hospital Facility NumberHospitalFacilityNumber | CHNA ConductedCHNAConducted | Community DefinitionCommunityDefinition | Community DemographicsCommunityDemographics | How Data ObtainedHowDataObtained | Community Health NeedsCommunityHealthNeeds | Other Health IssuesOtherHealthIssues | Identifying ProcessIdentifyingProcess | Consulting ProcessConsultingProcess | Information GapsInformationGaps | Needs Assessment ConductedNeedsAssessmentConducted | Take Into AccountTakeIntoAccount | Other FacilitiesOtherFacilities | CHNA Widely AvailableCHNAWidelyAvailable | Own WebsiteOwnWebsite | On RequestOnRequest | Adopt Implement StrategyAdoptImplementStrategy | Execute Implement StrategyExecuteImplementStrategy | Develop Community PlanDevelopCommunityPlan | Participate Community PlanParticipateCommunityPlan | Include Operational PlansIncludeOperationalPlans | Prioritize Health NeedsPrioritizeHealthNeeds | Prioritize ServicesPrioritizeServices | All Needs AddressedAllNeedsAddressed | Organization Incur Excise TaxOrganizationIncurExciseTax | Eligibility Criteria ExplainedEligibilityCriteriaExplained | Uses FPG FreeUsesFPGFree | FPG Free PercentFPGFreePercent | Uses FPG DiscountedUsesFPGDiscounted | FPG Discount PercentFPGDiscountPercent | Explains BasisExplainsBasis | Income LevelIncomeLevel | Uninsured DiscountUninsuredDiscount | Explains Application MethodExplainsApplicationMethod | Includes Publicity MeasuresIncludesPublicityMeasures | Attached To InvoicesAttachedToInvoices | Posted In Emergency RoomPostedInEmergencyRoom | Posted In Admission OfficePostedInAdmissionOffice | Provided On AdmissionProvidedOnAdmission | Available On RequestAvailableOnRequest | Actions On NonpaymentActionsOnNonpayment | Permit Report To Credit AgencyPermitReportToCreditAgency | Permit Lien On ResidencePermitLienOnResidence | Collection ActivitiesCollectionActivities | Report To Credit AgencyReportToCreditAgency | Lien On ResidenceLienOnResidence | Notify Upon AdmissionNotifyUponAdmission | Notified All PatientsNotifiedAllPatients | Documented DeterminationDocumentedDetermination | Nondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicy | Used Other MethodUsedOtherMethod | Amounts Generally BilledAmountsGenerallyBilled | Gross ChargesGrossCharges | Other MethodOtherMethod |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHARLOTTE HUNGERFORD HOSPITAL | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| 1 | 1 | X | X | X | X | X | X | X | X | 12 | 1 | 0 | 1 | X | X | X | X | X | X | X | X | X | 0 | 0 | 1 | 1 | 200.000000000000 | 1 | 250.000000000000 | 1 | X | X | 1 | 1 | X | X | X | X | X | 1 | X | X | 1 | X | X | X | X | X | 1 | X | 0 | 0 | |
| HUNGERFORD EMERGENCY MEDICAL CENTER | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| 2 | 1 | X | X | X | X | X | X | X | X | 12 | 1 | 0 | 1 | X | X | X | X | X | X | X | X | X | 0 | 0 | 1 | 1 | 200.000000000000 | 1 | 250.000000000000 | 1 | X | X | 1 | 1 | X | X | X | X | X | 1 | X | X | 1 | X | X | X | X | X | 1 | X | 0 | 0 | X |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 13 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (13 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| NORTHWEST CONNECTICUT MEDICAL WALK IN | ||||
| 1598 EAST MAIN STREET | TORRINGTON | CT | 06790 | WALK IN MEDICAL CLINIC |
| THE HUNGERFORD CENTER | ||||
| 780 LITCHFIELD STREET | TORRINGTON | CT | 06790 | CARDIAC AND PULMONARY REHAB SERVICES |
| THE CENTER FOR CANCER CARE | ||||
| 200 KENNEDY DRIVE | TORRINGTON | CT | 06790 | CANCER TREATMENT CENTER |
| HUNGERFORD DIAGNOSTIC CENTER | ||||
| 220 KENNEDY DRIVE | TORRINGTON | CT | 06790 | RADIOLOGY SERVICES |
| THE CENTER FOR YOUTH AND FAMILIES | ||||
| 1061 EAST MAIN STREET | TORRINGTON | CT | 06790 | PSYCH SERVICES FOR CHILDREN AND FAMILIES |
| BRIDGES EXTENDED DAY PROGRAM | ||||
| 28 SAINT JOHN PLACE | TORRINGTON | CT | 06790 | CHILD GUIDANCE CLINIC |
| WINSTED BEHAVIORAL HEALTH CENTER | ||||
| 294 MAIN STREET | WINSTED | CT | 06098 | PSYCH SERVICES |
| SURGICAL ASSOCIATES OF CHH | ||||
| 538 LITCHFIELD STREET | TORRINGTON | CT | 06790 | SURGICAL PHYSICIANS PRACTICE |
| NEUROLOGY PBC | ||||
| 780 LITCHFIELD STREET | TORRINGTON | CT | 06790 | NEUROLOGY PHYSICIANS PRACTICE |
| CHH PRIMARY CARE | ||||
| 780 LITCHFIELD STREET | TORRINGTON | CT | 06790 | PRIMARY CARE PHYSICIANS PRACTICE |
| CHH CARDIOVASCULAR MEDICINE SERVICE | ||||
| 1215 NEW LITCHFIELD STREET | TORRINGTON | CT | 06790 | CARDIOVASCULAR PHYSICIANS PRACTICE |
| CHH WOUND CARE AND HYPERBARIC MEDICINE | ||||
| 7 FELICITY LANE | TORRINGTON | CT | 06790 | WOUND CARE PHYSICIANS PRACTICE |
| CHH UROLOGY MEDICINE | ||||
| 538 LITCHFIELD STREET | TORRINGTON | CT | 06790 | ADULT AND PEDIATRIC UROLOGY PHYSICIANS PRACTICE |
Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 3C: CARE WILL BE PROVIDED FREE FOR THOSE WHO QUALIFY AS UNINSURED AND VERIFICATION HAS DETERMINED THAT THEIR ANNUAL INCOME IS LESS THAN 200% OF THE FEDERAL INCOME POVERTY LEVEL. CARE WILL BE PROVIDED AT HOSPITAL COST, AS ESTABLISHED BY THE OFFICE OF HEALTH CARE ACCESS (OCHA), FOR THOSE UNINSURED PATIENTS WHO REQUEST ASSISTANCE AND VERIFICATION HAS DETERMINED THAT THEIR ANNUAL INCOME IS BETWEEN 200% AND 250% OF THE FPL. CARE WILL BE DISCOUNTED BY 30% FOR THOSE UNISURED PATIENTS WHO REQUEST ASSISTANCE AND VERIFICATION HAS DETERMINED THAT THEIR ANNUAL INCOME IS BETWEEN 250% AND 400% OF THE FPL. THE HOSPITAL WILL ALSO CONSIDER THE TOTAL MEDICAL EXPENSES FACED BY THE FAMILY AND THE FAMILY'S ABILITY TO PAY FOR THOSE EXPENSES, AND WILL CONSIDER OFFERING GREATER ASSISTANCE WHEN POSSIBLE TO THOSE FAMILIES FACING CATASTROPHIC MEDICAL EXPENSES. | ||
| PART I, LINE 7: A COST TO CHARGE RATIO BASED ON CHARITY CARE CHARGES AND EXPENSES. | ||
| PART III, LINE 4: IN JULY 2011, THE FASB ISSUED ASU 2011-07, "HEALTH CARE ENTITIES (TOPIC 954): PRESENTATION AND DISCLOSURE OF PATIENT SERVICE REVENUE, PROVISION OF BAD DEBTS, AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTH CARE ENTITIES." THIS GUIDANCE ESTABLISHES ACCOUNTING AND DISCLOSURE REQUIREMENTS FOR HEALTH CARE ENTITIES THAT RECOGNIZE SIGNIFICANT AMOUNTS OF PATIENT SERVICE REVENUES AT THE TIME SERVICES ARE RENDERED EVEN THOUGH THE ENTITY DOES NOT ASSESS A PATIENT'S ABILITY TO PAY. SPECIFICALLY, THE GUIDANCE REQUIRES THAT HEALTH CARE ENTITIES PRESENT BAD DEBT EXPENSE ASSOCIATED WITH NET PATIENT SERVICE REVENUES AS AN OFFSET TO NET PATIENT SERVICE REVENUES WITHIN THE STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS. ADDITIONALLY, THE GUIDANCE REQUIRES ENHANCED DISCLOSURE OF THE POLICIES FOR RECOGNIZING REVENUE AND ASSESSING BAD DEBTS, AS WELL AS QUALITATIVE AND QUANTITATIVE INFORMATION ABOUT CHANGES IN THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE GUIDANCE REQUIRES RETROSPECTIVE APPLICATION TO ALL PRIOR PERIODS PRESENTED. THIS GUIDANCE BECAME EFFECTIVE FOR THE HOSPITAL BEGINNING ON OCTOBER 1, 2012. THE ADOPTION OF THIS GUIDANCE HAD NO IMPACT ON THE HOSPITAL'S OPERATING INCOME IN THE STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS, BUT RESULTED IN ADDITIONAL DISCLOSURES IN NOTE 3. ALL PERIODS INCLUDED HAVE BEEN PRESENTED IN ACCORDANCE WITH THE PROVISIONS OF ASU 2011-07.IT IS AN INHERENT PART OF THE HOSPITAL'S MISSION TO PROVIDE NECESSARY MEDICAL CARE FREE OF CHARGE, OR AT A DISCOUNT, TO INDIVIDUALS WITHOUT INSURANCE OR OTHER MEANS OF PAYING FOR SUCH CARE. AS THE AMOUNTS DETERMINED TO QUALIFY FOR CHARITY CARE ARE NOT PURSUED FOR COLLECTION, THEY ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE. PATIENTS WHO WOULD OTHERWISE QUALIFY FOR CHARITY CARE BUT WHO DO NOT PROVIDE ADEQUATE INFORMATION WOULD BE CHARACTERIZED AS BAD DEBT AND INCLUDED IN THE PROVISION FOR BAD DEBTS.PART III, LINE 2: COSTING METHODOLOGY USED - THE HOSPITAL USES A MODEL CONSISTING OF OUR ACCOUNTS RECEIVABLE BALANCE DIVIDED INTO EIGHT AGING CATEGORIES AS FOLLOWS: 0-30 DAYS, 31-60 DAYS, 61-90 DAYS, 91-120 DAYS, 121-210 DAYS, 211-365 DAYS, AND GREATER THAN 365 DAYS. A PERCENTAGE IS THEN ASSIGNED TO EACH AGING BUCKET BASED ON AGE, WITH A HIGHER PERCENTAGE ASSIGNED AS THE DAYS OUTSTANDING INCREASES. THE RESULTING CALCULATION IS USED TO COMPARE WITH THE RESERVE AND A MONTHLY ADJUSTMENT IS MADE TO DETERMINE THE EXPENSE. ANNUALLY, THIS CALCULATION IS COMPARED TO AN AUDIT OF THE BAD DEBT RESERVES TO DETERMINE IF ANY ADJUSTMENTS ARE REQUIRED. | ||
| PART III, LINE 8: THE MEDICARE SHORTFALL IS NOT TREATED AS COMMUNITY BENEFIT. THE MEDICARE ALLLOWABLE COSTS OF CARE ARE DERIVED DIRECTLY FROM THE MEDICARE COST REPORT. | ||
| PART III, LINE 9B: THE HOSPITAL ATTEMPTS TO HAVE INDIVIDUALS FILL OUT ALL PAPER WORK REQUIRED FOR CHARITY CARE. IF THE PERSON IS NOT CAPABLE OF DOING THIS OR IS KNOWN TO BE UNABLE TO DO THIS (SUCH AS A KNOWN HOMELESS PERSON), THEN THE FINANCIAL ASSISTANCE COMMITTEE WILL ADJUST THE ACCOUNT TO CHARITY CARE AND IT WILL NOT BE REPORTED AS BAD DEBT. IF THE ACCOUNT HAS BEEN REPORTED AS BAD DEBT AND INFORMATION COMES FORTH INDICATING AN INABILITY TO PAY, THEN THE ACCOUNT WOULD BE REMOVED FROM BAD DEBT AND MOVED TO CHARITY CARE. | ||
| PART V, SECTION B, LINE 3: THE STUDY WAS CONDUCTED BY THE CENTER FOR HEALTHY SCHOOLS AND COMMUNITIES AT EDUCATION CONNECTION IN LITCHFIELD, CT. THE STEERING COMMITTEE INCLUDED THE FOLLOWING INDIVIDUALS AND ORGANIZATIONS: JIM ROKOS, DIRECTOR OF HEALTH, TORRINGTON AREA HEALTH DISTRICT; LESLIE POLITO, ASSISTANT DIRECTOR OF HEALTH, TORRINGTON AREA HEALTH DISTRICT; SHARON MCCOY, PROJECT DIRECTOR, TORRINGTON AREA HEALTH DISTRICT; STEPHANIE BARKSDALE, EXECUTIVE DIRECTOR, UNITED WAY OF NORTHWEST CONNECTICUT; GREG BRISCO, CHIEF EXECUTIVE OFFICER, NORTHWEST CONNECTICUT YMCA; BRIAN MATTIELLO, V.P. FOR ORGANIZATIONAL DEVELOPMENT, CHARLOTTE HUNGERFORD HOSPITAL; DANIEL BAROODY, DIRECTOR OF HEALTH, TOWN OF SHARON; MIKE CRESPAN, DIRECTOR OF HEALTH, NEW MILFORD HEALTH DEPARTMENT; DONNA CULBERT, DIRECTOR OF HEALTH, NEWTOWN HEALTH DISTRICT; JENNIFER KERTANIS, DIRECTOR OF HEALTH, FARMINGTON VALLEY HEALTH DISTRICT; NEAL LUSTIG, DIRECTOR OF HEALTH, POMPERAUG HEALTH DISTRICT; MARY BEVAN, DIRECTOR, CENTER FOR HEALTHY SCHOOLS AND COMMUNITIES EDUCATION CONNECTION; JIM HUTCHISON, COMMUNITY HEALTH COORDINATOR, SHARON HOSPITAL; ANDREA RYNN, DIRECTOR OF PUBLIC AND GOVERNMENT RELATIONS, WESTERN CT HEALTH NETWORK; MARY WINAR, PROJECTS COORDINATOR, CONNECTICUT OFFICE OF RURAL HEALTH. | CHARLOTTE HUNGERFORD HOSPITAL | |
| PART V, SECTION B, LINE 3: THE STUDY WAS CONDUCTED BY THE CENTER FOR HEALTHY SCHOOLS AND COMMUNITIES AT EDUCATION CONNECTION IN LITCHFIELD, CT. THE STEERING COMMITTEE INCLUDED THE FOLLOWING INDIVIDUALS AND ORGANIZATIONS: JIM ROKOS, DIRECTOR OF HEALTH, TORRINGTON AREA HEALTH DISTRICT; LESLIE POLITO, ASSISTANT DIRECTOR OF HEALTH, TORRINGTON AREA HEALTH DISTRICT; SHARON MCCOY, PROJECT DIRECTOR, TORRINGTON AREA HEALTH DISTRICT; STEPHANIE BARKSDALE, EXECUTIVE DIRECTOR, UNITED WAY OF NORTHWEST CONNECTICUT; GREG BRISCO, CHIEF EXECUTIVE OFFICER, NORTHWEST CONNECTICUT YMCA; BRIAN MATTIELLO, V.P. FOR ORGANIZATIONAL DEVELOPMENT, CHARLOTTE HUNGERFORD HOSPITAL; DANIEL BAROODY, DIRECTOR OF HEALTH, TOWN OF SHARON; MIKE CRESPAN, DIRECTOR OF HEALTH, NEW MILFORD HEALTH DEPARTMENT; DONNA CULBERT, DIRECTOR OF HEALTH, NEWTOWN HEALTH DISTRICT; JENNIFER KERTANIS, DIRECTOR OF HEALTH, FARMINGTON VALLEY HEALTH DISTRICT; NEAL LUSTIG, DIRECTOR OF HEALTH, POMPERAUG HEALTH DISTRICT; MARY BEVAN, DIRECTOR, CENTER FOR HEALTHY SCHOOLS AND COMMUNITIES EDUCATION CONNECTION; JIM HUTCHISON, COMMUNITY HEALTH COORDINATOR, SHARON HOSPITAL; ANDREA RYNN, DIRECTOR OF PUBLIC AND GOVERNMENT RELATIONS, WESTERN CT HEALTH NETWORK; MARY WINAR, PROJECTS COORDINATOR, CONNECTICUT OFFICE OF RURAL HEALTH. | HUNGERFORD EMERGENCY MEDICAL CENTER | |
| PART V, SECTION B, LINE 7: NOT ALL NEEDS HAVE BEEN ADDRESSED SINCE THE ASSESSMENT WAS IN YEAR TWO OF A FIVE YEAR PLAN WITH A CONTINUED EFFORT TO REFINE ASSESSMENTS. | CHARLOTTE HUNGERFORD HOSPITAL | |
| PART V, SECTION B, LINE 7: NOT ALL NEEDS HAVE BEEN ADDRESSED SINCE THE ASSESSMENT WAS CONDUCTED IN YEAR TWO OF A FIVE YEAR PLAN FOR CONTINUED EFFORT TO REFINE ASSESSMENTS. | HUNGERFORD EMERGENCY MEDICAL CENTER | |
| PART V, SECTION B, LINE 20D: CONNECTICUT STATE LAW (LOONEY BILL) REQUIRES THE HOSPITAL TO ADJUST THE PATIENT'S BALANCE EQUAL TO THE COST OF PROVIDING THE CARE. | CHARLOTTE HUNGERFORD HOSPITAL | |
| PART V, SECTION B, LINE 20D: CONNECTICUT STATE LAW (LOONEY BILL) REQUIRES THE HOSPITAL TO ADJUST THE PATIENT'S BALANCE EQUAL TO THE COST OF PROVIDING THE CARE. | HUNGERFORD EMERGENCY MEDICAL CENTER | |
| PART VI, LINE 2: THE HOSPITAL OFFERS FREE HEALTH SCREENINGS, FREE HEALTH EDUCATION AND LECTURES AT VARIOUS COMMUNITY EVENTS INCLUDING FAIRS, EXPOS, PRIVATE COMPANIES, PUBLIC MUNICIPALITIES, AND PUBLIC GATHERINGS. THESE EVENTS PROVIDE A FORUM FOR RECEIVING INFORMATION AND INPUT FROM THE COMMUNITY. | ||
| PART VI, LINE 3: THE HOSPITAL COUNSELS ALL SELF PAY PATIENTS BY PROVIDING A MEETING WITH A FINANCIAL COUNSELOR OR SOCIAL WORKER. ALL STATEMENTS DISTRIBUTED TO PATIENTS INCLUDE FINANCIAL COUNSELING INFORMATION. SIGNS ARE POSTED THROUGHOUT THE HOSPITAL, INCLUDING THE EMERGENCY ROOM, WHICH STATE CHARITY CARE POLICIES AND FINANCIAL ASSISTANCE INFORMATION. | ||
| PART VI, LINE 4: THE CHARLOTTE HUNGERFORD HOSPITAL IS LOCATED IN TORRINGTON, CONNECTICUT, AND SERVES AS A REGIONAL HEALTH CARE RESOURCE FOR 100,000 RESIDENTS OF LITCHFIELD COUNTY AND NORTHWEST CONNECTICUT. RECENT ASSESSMENTS FROM THE AREA THAT THE HOSPITAL SERVES HAS FOUND THE FOLLOWING: - THE COUNTY HAS BECOME MORE RACIALLY AND ETHNICALLY DIVERSE. - THE COUNTY HAS THE HIGHEST PROPORTION OF RESIDENTS AGES 50+ IN THE STATE. - AREA RATES OF OBESITY AND CURRENT SMOKING EXCEED THE STATE AVERAGE. - STUDENTS IN NEARLY HALF OF THE AREA'S SCHOOL DISTRICTS SCORED BELOW THE STATE AVERAGE IN STANDARDIZED PHYSICAL FITNESS TESTS. - NEARLY ONE IN FOUR COUNTY RESIDENTS HAS HYPERTENSION. - NEARLY 40% HAVE BEEN TOLD BY THEIR HEALTH PROFESSIONAL THAT THEY HAVE HIGH CHOLESTEROL. - THE COUNTY HAS A RATIO OF ONE PRIMARY CARE PHYSICIAN TO EVERY 1,123 RESIDENTS. THIS WELL BELOW BOTH STATE AND NATIONAL BENCHMARKS. | ||
| PART VI, LINE 5: ALL BOARD OF DIRECTORS MEMBERS RESIDE IN THE COMMUNITY SERVED BY THE CHARLOTTE HUNGERFORD HOSPITAL. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS WHO APPLY FOR SUCH PRIVILEGES. THE HOSPITAL ESTABLISHES AN ANNUAL CAPITAL BUDGET TO ADD OR REPLACE PATIENT CARE EQUIPMENT AND FACILITIES. MEDICAL EDUCATION IS PROVIDED TO PHYSICIANS THROUGH CONFERENCES ON A MONTHLY BASIS. | ||
| CT | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | HEALTHCARE SCHOLARSHIPS | TypeOfGrant |
| Number Of Recipients | 12 | NumberOfRecipients |
| Amount Of Cash Grant | 12000 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | THE CHARLOTTE HUNGERFORD HOSPITAL AUXILIARY AWARDS SCHOLARSHIPS IN THE AMOUNT OF $1,000 EACH TO STUDENTS PURSUING HEALTHCARE EDUCATION. THE STUDENTS MUST LIVE IN THE AREA SERVED BY THE HOSPITAL. THEY MUST ALSO PROVIDE EVIDENCE OF ACCEPTANCE INTO A COLLEGE PROGRAM OR THEIR CURRENT GRADES IN COLLEGE. APPLICANTS MUST SUBMIT LETTERS OF RECOMMENDATION FROM THEIR TEACHERS AND ALSO FROM NON-FAMILY PERSONS. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KENDRICK HOM MD | ||||||||||||||
| GOVERNOR | 277169 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 25339 | 0 | 302508 | 0 | 0 | 0 |
| DANIEL J MCINTYRE | ||||||||||||||
| CEO/PRESIDENT | 382486 | 0 | 0 | 0 | 0 | 0 | 57762 | 0 | 34967 | 0 | 475215 | 0 | 0 | 0 |
| SUSAN M SCHAPP | ||||||||||||||
| VP FINANCE/ TREASURER | 225452 | 0 | 0 | 0 | 0 | 0 | 82527 | 0 | 20611 | 0 | 328590 | 0 | 0 | 0 |
| JOHN J CAPOBIANCO | ||||||||||||||
| VP OUT PATIENT SERVICES | 212043 | 0 | 0 | 0 | 0 | 0 | 93845 | 0 | 19385 | 0 | 325273 | 0 | 0 | 0 |
| MARK PRETE MD | ||||||||||||||
| VP MEDICAL AFFAIRS | 326624 | 0 | 0 | 0 | 0 | 0 | 25247 | 0 | 29861 | 0 | 381732 | 0 | 0 | 0 |
| RAYMOND J ELLIOTT | ||||||||||||||
| VP FACILITIES | 185519 | 0 | 0 | 0 | 0 | 0 | 44089 | 0 | 16960 | 0 | 246568 | 0 | 0 | 0 |
| BRIAN MATTIELLO | ||||||||||||||
| VP HUMAN RESOURCES | 161067 | 0 | 0 | 0 | 0 | 0 | 6737 | 0 | 14725 | 0 | 182529 | 0 | 0 | 0 |
| ELZBIETA LACH-PASKO MD | ||||||||||||||
| PATHOLOGIST | 393459 | 0 | 0 | 0 | 0 | 0 | 96254 | 0 | 35971 | 0 | 525684 | 0 | 0 | 0 |
| MUSTAFA UGURLU MD | ||||||||||||||
| PHYSICIAN | 386073 | 0 | 0 | 0 | 0 | 0 | 12111 | 0 | 35295 | 0 | 433479 | 0 | 0 | 0 |
| TIMOTHY GOSTKOWSKI MD | ||||||||||||||
| PHYSICIAN | 480418 | 0 | 0 | 0 | 0 | 0 | 24518 | 0 | 43921 | 0 | 548857 | 0 | 0 | 0 |
| WILLIAM MCGEEHIN MD | ||||||||||||||
| PHYSICIAN | 429541 | 0 | 0 | 0 | 0 | 0 | 29199 | 0 | 39269 | 0 | 498009 | 0 | 0 | 0 |
| ROBERT KAHAN MD | ||||||||||||||
| PHYSICIAN | 381129 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 34843 | 0 | 415972 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| MARK PRETE MD | |||
| KEY EMPLOYEE | 134607 | PARTNER IN NWCT EMERGENCY MEDICINE P.C. WHICH PROVIDES EMERGENCY ROOM SERVICES TO THE HOSPITAL. | 0 |
| DIANE LIBBY CPA | |||
| GOVERNOR | 18000 | PARTNER IN ADAMS SAMARTINO & CO, P.C. WHICH PROVIDES ACCOUNTING SERVICES TO CHARLOTTE HUNGERFORD HOSPITAL. | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY OF FORM 990 IS DISTRIBUTED TO THE BOARD OF DIRECTORS BEFORE IT IS FILED WITH THE IRS. THIS ENABLES THE BOARD TO ASK QUESTIONS, AND TO APPROVE THE DISCLOSURES MADE IN THE RETURN. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE HOSPITAL DISTRIBUTES A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY TO ITS BOARD OF DIRECTORS, ALL MANAGEMENT PERSONNEL, AND PURCHASING AGENTS. | |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION FOR SENIOR STAFF IS DETERMINED USING THE FOLLOWING STEPS: - A MARKET SURVEY BASED ON CT HOSPITAL ASSOCIATION IS USED AS A STARTING POINT. - ADJUSTMENTS ARE THEN MADE BASED ON THE CANDIDATE'S CURRENT SALARY AND PRIOR EXPERIENCE. - THE COMPENSATION FIGURE IS THEN PRESENTED TO THE BOARD OF DIRECTORS FOR APPROVAL. THE LAST COMPENSATION REVIEW OCCURRED IN AUGUST 2013. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND ANNUAL REPORT AVAILABLE TO THE PUBLIC UPON REQUEST. | |
| FORM 990, PART XI, LINE 9: | PENSION RELATED CHANGES OTHER THAN NET PERIODIC PENSION COSTS 14,454,789. NET ASSETS RELEASED FROM RESTRICTIONS -354,906. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XI, LINE 2C: | THE HOSPITAL'S AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THESE FUNCTIONS AND PROCESSES HAVE NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ADVANCED MEDICAL IMAGING OF NW CT LLC | |||||||||||||
| 57 COMMERCIAL BLVD | TORRINGTON | CT | 06790 | 061594854 | MAGNETIC RESONANCE IMAGING | CT | N/A | RELATED | 665549 | 277403 | 0 | 0 | 0.50000 |
| UROLOGY CENTER OF NW CT LLC | |||||||||||||
| 538 LITCHFIELD STREET | TORRINGTON | CT | 06790 | 582674029 | EQUIPMENT RENTAL | CT | N/A | RELATED | 35721 | 27535 | 0 | 0 | 0.62500 |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LITCHFIELD COUNTY HEALTHCARE SERVICE CORPORATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 540 LITCHFIELD STREET | AddressLine1 |
| City | TORRINGTON | City |
| State | CT | State |
| ZIP Code | 06790 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 061227655 | EIN |
| Primary Activity | MANAGEMENT SERVICES | PrimaryActivity |
| Legal Domicile State | CT | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE CHARLOTTE HUNGERFORD HOSPTIAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Share Of EOY Assets | 505 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| ADVANCED MEDICAL IMAGING OF NW CT LLC | ||
| S | 651000 | ACTUAL |
| UROLOGY CENTER OF NW CT LLC | ||
| K | 115888 | ACTUAL |