WILLIAM W BACKUS HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: WILLIAM W BACKUS HOSPITAL (EIN 06-0250773)
Tax period: 2011-10-01 to 2012-09-30
Filed: 2013-08-06
IRS object ID: 201302189349301450
Schema version: 2011v1.5
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 K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-08-06T14:14:25-05:00	Timestamp
Tax Period End Date	2012-09-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BKD LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	1201 Walnut Suite 1700	AddressLine1
City	Kansas City	City
State	MO	State
ZIP Code	641062246	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-10-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	060250773	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	THE WILLIAM W BACKUS HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
In Care Of Name	% DANIEL E LOHR	InCareOfName
Name Control	WILL	NameControl
Phone	8608898331	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	326 WASHINGTON STREET	AddressLine1
City	NORWICH	City
State	CT	State
ZIP Code	06360	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	DANIEL E LOHR	Name
Title	CFO	Title
Date Signed	2013-08-15	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	Jim Still	Name
Phone	8162216300	Phone

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	DAVID WHITEHEAD	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	326 WASHINGTON STREET	AddressLine1
City	NORWICH	City
State	CT	State
ZIP Code	06360	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	314928667	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.BACKUSHOSPITAL.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1891	YearFormation
State Legal Domicile	CT	StateLegalDomicile
Activity Or Mission Description	BACKUS HOSPITAL DELIVERS AND COORDINATES A CONTINUUM OF HIGH-QUALITY HEALTHCARE THAT IS SENSITIVE TO THE NEEDS OF INDIVIDUALS IN EASTERN CONNECTICUT.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	14	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	9	NbrIndependentVotingMembers
Total Nbr Employees	2063	TotalNbrEmployees
Total Nbr Volunteers	484	TotalNbrVolunteers
Total Gross UBI	2161879	TotalGrossUBI
Net Unrelated Business Txbl Income	69663	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	1296004	ContributionsGrantsPriorYear
Contributions Grants Current Year	1179014	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	271933218	ProgramServiceRevenuePriorYear
Program Service Revenue CY	285997171	ProgramServiceRevenueCY
Investment Income Prior Year	5938478	InvestmentIncomePriorYear
Investment Income Current Year	4525194	InvestmentIncomeCurrentYear
Other Revenue Prior Year	1609862	OtherRevenuePriorYear
Other Revenue Current Year	1628784	OtherRevenueCurrentYear
Total Revenue Prior Year	280777562	TotalRevenuePriorYear
Total Revenue Current Year	293330163	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	692681	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	752684	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	135892894	SalariesEtcPriorYear
Salaries Etc Current Year	146148497	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	325071	TotalFundrsngExpCurrentYear
Other Expense Prior Year	113381675	OtherExpensePriorYear
Other Expenses Current Year	115188670	OtherExpensesCurrentYear
Total Expenses Prior Year	249967250	TotalExpensesPriorYear
Total Expenses Current Year	262089851	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	30810312	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	31240312	RevenuesLessExpensesCY
Total Assets BOY	358349465	TotalAssetsBOY
Total Assets EOY	393284501	TotalAssetsEOY
Total Liabilities BOY	195793905	TotalLiabilitiesBOY
Total Liabilities EOY	195088980	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	162555560	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	198195521	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	SEE SCHEDULE O	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	210491948	Expense
Grants	752684	Grants
Revenue	287011997	Revenue
Description	IN FISCAL YEAR 2011, BACKUS HOSPITAL HAD 10,974 ADMISSIONS, 68,102 EMERGENCY DEPARTMENT VISITS, AND 440,605 OUTPATIENT VISITS. THE HOSPITAL DELIVERED 919 BABIES AND 6,968 SAME DAY SURGICAL PROCEDURES. BACKUS PERFORMED 122,132 OUTPATIENT IMAGING EXAMS, 7,707 MRI EXAMINATIONS, 9,443 PSYCHIATRIC CLINICAL VISITS, AND 7,914 PSYCHIATRIC PARTIAL HOSPITAL VISITS.	Description
Total Program Service Expense	210491948	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	true	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	true	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	true	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	true	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	true	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	true	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	true	TaxExemptBonds
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	true	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	true	RelatedOrgControlledEntity
Transaction Related Entity	true	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	156	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	2063	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	true	UnrelatedBusinessIncome
Form990-T Filed	true	Form990-TFiled
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	true	QuidProQuoContributions
Quid Pro Quo Disclosure	true	QuidProQuoDisclosure
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	14	NbrVotingGoverningBodyMembers
Number Independent Voting Members	9	NumberIndependentVotingMembers
Family Or Business Relationship	true	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	true	MembersOrStockholders
Election Of Board Members	true	ElectionOfBoardMembers
Decisions Subject To Approval	true	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	true	InvestmentInJointVenture
Written Policy Or Procedure	false	WrittenPolicyOrProcedure
Other Website	X	OtherWebsite
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	DANIEL E LOHR	NamePerson
Telephone Number	8608898331	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	326 WASHINGTON STREET	AddressLine1
City	NORWICH	City
State	CT	State
ZIP Code	06360	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee	FormerFormer
DAVID WHITEHEAD
TRUSTEE/PRESIDENT/CEO	40.0	X	X	762221	0	43852
ROBERT RAMSDELL
TRUSTEE/TREASURER	6.0	X	X
JOSEPH FATONE
TRUSTEE/SECRETARY	6.0	X	X
ANTHONY JOYCE
TRUSTEE/VICE CHAIRMAN	6.0	X	X
JOHN F BILDA
TRUSTEE	2.0	X
ELIZABETH CONWAY
TRUSTEE	2.0	X
BERT A COPPOTELLI MD
TRUSTEE	2.0	X
PETER MANERI
TRUSTEE	2.0	X
DEBORAH MONAHAN
TRUSTEE	2.0	X
LYNNE QUINTAL-HILL
TRUSTEE	2.0	X
MARK TRAMONTOZZI MD
TRUSTEE	12.25	X		53700		0
STEPHEN T BRIGGS MD
TRUSTEE	2.0	X
PAUL MAXFIELD
TRUSTEE	2.0	X
DONNA ROMITO DO
TRUSTEE	2.0	X
DANIEL E LOHR
SENIOR VP/CFO	40.0		X	514728		37462
PETER SHEA
SENIOR VP/MEDICAL DIRECTOR	40.0			492797		36733	X
SERGIO CASILLAS MD
PHYSICIAN	40.0			496355		14287		X
ROBERT SIDMAN MD
PHYSICIAN	40.0			409425		36502		X
MARK TOUSIGNANT MD
PHYSICIAN	40.0			335264		36733		X
JUAN ESCALON MD
PHYSICIAN	40.0			346171		36733		X
WILLIAM HORGAN MD
PHYSICIAN	40.0			322581		33135		X
THOMAS P PIPICELLI
FORMER PRESIDENT	0.0			3777778		37462			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	7511020	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	312899	TotalOtherCompensation
Number Individuals GT100 K	139	NumberIndividualsGT100K
Formers Listed	true	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Description Of ServicesDescriptionOfServices	CompensationCompensation
EXECUTIVE HEALTH RESOURCES
CONSULTING	799847
ALLIANCE HEALTHCARE SERVICES
MEDICAL SERVICES	3204696
HURON CONSULTING GROUP
CONSULTING	3308146
YALE NH HOSPITAL
MEDICAL SERVICES	2255899
NAVIN HAFTY ASSOCIATES
CONSULTING	571116

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	35	NumberOfContractorsGT100K
Fundraising Events	95705	FundraisingEvents
Related Organizations	3225	RelatedOrganizations
Government Grants	614920	GovernmentGrants
All Other Contributions	465164	AllOtherContributions
Noncash Contributions	3179	NoncashContributions
Total Contributions	1179014	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
Inpatient	900099	126151493	126151493
Outpatient	900099	108882771	108882771
Emergency Department	900099	45998119	45998119
Lab courier service	621500	2187372		2187372
E.H.R. REVENUE	722320	2777416	2777416

Field	Value	IRS element (for citing)
Total Program Service Revenue	285997171	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	3731395	TotalRevenueColumn
Exclusion	$3,731,395	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	1025860	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	2126333	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	-1100473	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	-1100473	TotalRevenueColumn
Unrelated Business Revenue	-50079	UnrelatedBusinessRevenue
Exclusion	-$1,050,394	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	19678400	Securities
Other	184772	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	18855065	Securities
Other	214308	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	823335	Securities
Other	-29536	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	793799	TotalRevenueColumn
Exclusion	$793,799	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	32160	GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events	95705	CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses	49496	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	-17336	TotalRevenueColumn
Exclusion	-$17,336	ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	469919	GrossSalesOfInventory
Cost Of Goods Sold	353302	CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	116617	TotalRevenueColumn
Exclusion	$116,617	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
Cafeteria	624410	1166526	$1,166,526
Child care	900099	398545	$398,545
OTHER MISC REVENUE	900099	1064905		1040319	24586

Field	Value	IRS element (for citing)
Total Other Revenue	2629976	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	293330163	TotalRevenueColumn
Related Or Exempt Function Income	284850118	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	2161879	UnrelatedBusinessRevenue
Exclusion	$5,139,152	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	740184	Total
Program Services	740184	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	12500	Total
Program Services	12500	ProgramServices

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	5580387	Total
Program Services	587917	ProgramServices
Management And General	4992470	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	108559950	Total
Program Services	97665139	ProgramServices
Management And General	10798732	ManagementAndGeneral
Fundraising	96079	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	9850231	Total
Program Services	8865208	ProgramServices
Management And General	985023	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	13862551	Total
Program Services	12476296	ProgramServices
Management And General	1386255	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	8295378	Total
Program Services	7465840	ProgramServices
Management And General	829538	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	2167582	Total
Management And General	2167582	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	415616	Total
Management And General	415616	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	51213	Total
Management And General	51213	ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	132898	Total
Management And General	132898	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	20320485	Total
Program Services	15235141	ProgramServices
Management And General	5084844	ManagementAndGeneral
Fundraising	500	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	188256	Total
Program Services	166829	ProgramServices
Fundraising	21427	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	6060614	Total
Program Services	4152449	ProgramServices
Management And General	1905902	ManagementAndGeneral
Fundraising	2263	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	3398561	Total
Program Services	353216	ProgramServices
Management And General	3045345	ManagementAndGeneral

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	5578019	Total
Program Services	553635	ProgramServices
Management And General	5024384	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	255725	Total
Program Services	108125	ProgramServices
Management And General	147600	ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	31175	Total
Program Services	5560	ProgramServices
Management And General	25560	ManagementAndGeneral
Fundraising	55	Fundraising

Interest Interest

Field	Value	IRS element (for citing)
Total	3008114	Total
Management And General	3008114	ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	16954609	Total
Program Services	8344451	ProgramServices
Management And General	8610158	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	1720586	Total
Program Services	1295901	ProgramServices
Management And General	424685	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
MEDICAL SUPPLIES	34428304	34428304
BAD DEBT	7950269	7949694	575
MAINTENANCE/SERVICE CONTRACT	5345541	3840244	1505297
LAB EXPENSES	4338527	4338527

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	2842576	Total
Program Services	1906788	ProgramServices
Management And General	731041	ManagementAndGeneral
Fundraising	204747	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	262089851	Total
Program Services	210491948	ProgramServices
Management And General	51272832	ManagementAndGeneral
Fundraising	325071	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	2802148	BOY
EOY	3816199	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	90659933	BOY
EOY	103907072	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	101211	BOY
EOY	31723	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	32373122	BOY
EOY	32015340	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	100023	BOY
EOY	74517	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	3757730	BOY
EOY	3602936	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	4493355	BOY
EOY	5066915	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	240354654	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	149000168	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	89983664	BOY
EOY	91354486	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	133516829	BOY
EOY	147043829	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	12632	BOY
EOY	12632	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	548818	BOY
EOY	6358852	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	358349465	BOY
EOY	393284501	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	22318404	BOY
EOY	23583670	EOY

Grants Payable GrantsPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	61230000	BOY
EOY	59265000	EOY

Escrow Account Liability EscrowAccountLiability

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Loans From Officers Directors LoansFromOfficersDirectors

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	1183176	BOY
EOY	1126557	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	111062325	BOY
EOY	111113753	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	195793905	BOY
EOY	195088980	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	153706889	BOY
EOY	187548862	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1399547	BOY
EOY	2890743	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	7449124	BOY
EOY	7755916	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	162555560	BOY
EOY	198195521	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	358349465	BOY
EOY	393284501	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	31240312	ReconcilationRevenueExpenses
Reconcilation Other Changes	4399649	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Both	X	FinancialStatementBoth
Federal Grant Audit Required	false	FederalGrantAuditRequired

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)
Total Grassroots Lobbying		TotalGrassrootsLobbying
Total Direct Lobbying		TotalDirectLobbying
Total Lobbying Expenditures		TotalLobbyingExpenditures
Other Exempt Purpose Expenditures		OtherExemptPurposeExpenditures
Total Exempt Purpose Expenditures		TotalExemptPurposeExpenditures
Lobbying Nontaxable		LobbyingNontaxableAmount
Grassroots Nontaxable		GrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non Tx		TotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying Nontx		TotLobbyExpendMnsLobbyingNontx
Volunteers	false	Volunteers
Paid Staff Or Management	false	PaidStaffOrManagement
Media Advertisements	false	MediaAdvertisements
Mailings Members	false	MailingsMembers
Publications Or Broadcast	false	PublicationsOrBroadcast
Grants Other Organizations	true	GrantsOtherOrganizations
Grants Other Organizations	$51,213	GrantsOtherOrganizationsAmount
Direct Contact Legislators	false	DirectContactLegislators
Rallies Demonstrations	false	RalliesDemonstrations
Other Activities	false	OtherActivities
Total Lobbying Expenditures IIB	51213	TotalLobbyingExpendituresIIB
Not Described In501c3	false	NotDescribedIn501c3

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amts		ArtPublicExhibitionAmts
Held Works Of Art Amts		HeldWorksOfArtAmts

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	5396859	BeginningOfYearBalance
Investment Earnings Or Losses	5226	InvestmentEarningsOrLosses
Administrative Expenses	5226	AdministrativeExpenses
End Of Year Balance	5396859	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	5320786	BeginningOfYearBalance
Contributions	5000	Contributions
Investment Earnings Or Losses	76505	InvestmentEarningsOrLosses
Grants Or Scholarships	0	GrantsOrScholarships
Other Expenditures	0	OtherExpenditures
Administrative Expenses	5432	AdministrativeExpenses
End Of Year Balance	5396859	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	4841631	BeginningOfYearBalance
Contributions	358064	Contributions
Investment Earnings Or Losses	505259	InvestmentEarningsOrLosses
Grants Or Scholarships	0	GrantsOrScholarships
Other Expenditures	378271	OtherExpenditures
Administrative Expenses	5897	AdministrativeExpenses
End Of Year Balance	5320786	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	3871631	BeginningOfYearBalance
Contributions	970000	Contributions
Investment Earnings Or Losses	142089	InvestmentEarningsOrLosses
Grants Or Scholarships	0	GrantsOrScholarships
Other Expenditures	135254	OtherExpenditures
Administrative Expenses	6835	AdministrativeExpenses
End Of Year Balance	4841631	EndOfYearBalance

Field	Value	IRS element (for citing)
Permanent Endowment EOY Balance	1.00000	PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	false	EndowmentsHeldByRelatedOrgs

Land Land

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	0	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	2229795	OtherCostOrOtherBasis
Book Value	2229795	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	10381267	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	46448280	OtherCostOrOtherBasis
Depreciation	33861382	Depreciation
Book Value	22968165	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	80846314	OtherCostOrOtherBasis
Depreciation	45668172	Depreciation
Book Value	35178142	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	98659140	OtherCostOrOtherBasis
Depreciation	69428410	Depreciation
Book Value	29230730	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1747654	OtherCostOrOtherBasis
Book Value	1747654	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	91354486	TotalOfBookValueLandBuildings
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescription	AmountAmount
Tax exempt bond premium, net	$667,276
Due to 3rd parties	$18,193,420
Employee related obligations	$75,571,071
Self-insured prof liability	$9,685,357
Capital lease obligations	$6,344,367
Other liabilities	$652,262

Field	Value	IRS element (for citing)
Total Of Amounts	111113753	TotalOfAmounts
Total Revenue	293330163	TotalRevenue
Total Expenses	262089851	TotalExpenses
Excess Or Deficit For Year	31240312	ExcessOrDeficitForYear
Net Unrealized GL On Investments	10067106	NetUnrealizedGLOnInvestments
Investment Expenses	-365321	InvestmentExpenses
Other	-$5,302,136	OtherAmount
Total Adjustments	4399649	TotalAdjustments
Excess Or Deficit Per FS	35639961	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	305112306	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	10067106	NetUnrealizedGainsInvestments
Revenue Not Rptd F990	10067106	RevenueNotRptdF990
Revenue Subtotal	295045200	RevenueSubtotal
Investment Expenses Not Included	365321	InvestmentExpensesNotIncluded
Other Revenues Not Included	-2080358	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	-1715037	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	293330163	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	264141267	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	2205365	OtherExpensesIncluded
Expenses Not Rptd F990	2205365	ExpensesNotRptdF990
Expenses Subtotal	261935902	ExpensesSubtotal
Other Expenses Not Included	153949	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	153949	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	262089851	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (7 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ENDOWMENT FUNDS	SCHEDULE D, PART V, LINE 4	THE PERMANENTLY RESTRICTED ENDOWMENT FUNDS ARE MEANT TO PROVIDE LONG-TERM SUPPORT FOR CAPITAL AND OPERATING PROGRAMS FOR THE HOSPITAL IN ACCORDANCE WITH THE DONOR'S WISHES.
UNCERTAIN TAX POSITIONS DISCLOSURE	SCHEDULE D, PART X, LINE 2	ASC 740-10, Uncertain Tax Positions, prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. This interpretation also provides guidance on derecognition, classification, interest and penalties, accounting in interim periods, and disclosure requirements for uncertain tax positions. Management has evaluated the implications of ASC 740-10 and determined that its impact on the financial statements is not significant.
RECONCILIATION OF CHANGE IN NET ASSETS	SCHEDULE D, PART XI, LINE 8	K-1 LOSS 892 TRANSFER TO AFFILIATES (1,248,123) INCREASE IN NET ASSETS HELD IN TRUST 306,792 CHANGE IN PENSION FUNDING (4,361,697) ------------ TOTAL $(5,302,136)
RECONCILIATION OF REVENUE- OTHER ADJUSTMENTS	SCHEDULE D, PART XII, LINE 2D
RECONCILIATION OF REVENUES- OTHER ADJUSTMENTS	SCHEDULE D, PART XII, LINE 4B	AUXILIARY INCOME 125,899 K-1 LOSS ( 892) LOSS ON FIXED ASSETS ( 29,536) RENTAL EXPENSE (2,126,333) TEMPORARILY RESTRICTED INCOME ( 49,496) ------------ TOTAL $(2,080,358)
RECONCILIATION OF EXPENSES- OTHER ADJUSTMENTS	SCHEDULE D, PART XIII, LINE 2D	RENTAL EXPENSE 2,126,333 GOLF TOURNAMENT EXPENSE 49,496 LOSS ON FIXED ASSETS 29,536 ---------- TOTAL $2,205,365
RECONCILIATION OF EXPENSES- OTHER ADJUSTMENTS	SCHEDULE D, PART XIII, LINE 4B	AUXILIARY EXPENSE $ 153,949

Schedule G IRS990ScheduleG

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	GOLF TOURNAMENT	NameOfEvent1
Gross Receipts Event1	90515	GrossReceiptsEvent1
Charitable Contributions Event1	67715	CharitableContributionsEvent1
Gross Revenue Event1	22800	GrossRevenueEvent1
Cash Prizes Event1	0	CashPrizesEvent1
Non Cash Prizes Event1	5136	NonCashPrizesEvent1
Rent Facility Costs Event1	20118	RentFacilityCostsEvent1
Food And Beverage Event1	3265	FoodAndBeverageEvent1
Entertainment Event1	0	EntertainmentEvent1
Other Direct Expenses Event1	11609	OtherDirectExpensesEvent1
Name Of Event2	SEDER GOLF	NameOfEvent2
Gross Receipts Event2	37350	GrossReceiptsEvent2
Charitable Contributions Event2	27990	CharitableContributionsEvent2
Gross Revenue Event2	9360	GrossRevenueEvent2
Cash Prizes Event2	0	CashPrizesEvent2
Non Cash Prizes Event2	1560	NonCashPrizesEvent2
Rent Facility Costs Event2	4680	RentFacilityCostsEvent2
Food And Beverage Event2	0	FoodAndBeverageEvent2
Entertainment Event2	0	EntertainmentEvent2
Other Direct Expenses Event2	3128	OtherDirectExpensesEvent2
Total Number Of Other Events	0	TotalNumberOfOtherEvents
Gross Receipts Other Events	0	GrossReceiptsOtherEvents
Charitable Contrib Other Events	0	CharitableContribOtherEvents
Gross Revenue Other Events	0	GrossRevenueOtherEvents
Cash Prizes Other Events	0	CashPrizesOtherEvents
Non Cash Prizes Other Events	0	NonCashPrizesOtherEvents
Rent Facility Costs Other Events	0	RentFacilityCostsOtherEvents
Food And Beverage Other Events	0	FoodAndBeverageOtherEvents
Entertainment Other Events	0	EntertainmentOtherEvents
Other Direct Expenses Other Events	0	OtherDirectExpensesOtherEvents
Gross Receipts Total	127865	GrossReceiptsTotal
Charitable Contributions Total	95705	CharitableContributionsTotal
Gross Revenue Total Events	32160	GrossRevenueTotalEvents
Cash Prizes Total Events	0	CashPrizesTotalEvents
Non Cash Prizes Total Events	6696	NonCashPrizesTotalEvents
Rent Facility Costs Total Events	24798	RentFacilityCostsTotalEvents
Food And Beverage Total Events	3265	FoodAndBeverageTotalEvents
Entertainment Total Events	0	EntertainmentTotalEvents
Other Direct Expenses Total Events	14737	OtherDirectExpensesTotalEvents
Direct Expense Summary Events	49496	DirectExpenseSummaryEvents
Net Income Summary	-17336	NetIncomeSummary

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
FPG Reference Free Care	true	FPGReferenceFreeCare

Other Percentage OtherPercentage

Field	Value	IRS element (for citing)
Other	X	Other
Free Other Percentage	250.	FreeOtherPercentage

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	true	FPGReferenceDiscountedCare
Pcent400	X	Pcent400
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	true	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	false	ExpensesExceededBudget
Annual Community Benefit Report	false	AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	3313006	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1038468	DirectOffsettingRevenue
Net Community Benefit Expense	2274538	NetCommunityBenefitExpense
Percent Of Total Expense	0.00900	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	55952799	TotalCommunityBenefitExpense
Direct Offsetting Revenue	39553595	DirectOffsettingRevenue
Net Community Benefit Expense	16399204	NetCommunityBenefitExpense
Percent Of Total Expense	0.06450	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	59265805	TotalCommunityBenefitExpense
Direct Offsetting Revenue	40592063	DirectOffsettingRevenue
Net Community Benefit Expense	18673742	NetCommunityBenefitExpense
Percent Of Total Expense	0.07350	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	96	NumberOfActivitiesOrPrograms
Persons Served	41062	PersonsServed
Total Community Benefit Expense	658308	TotalCommunityBenefitExpense
Direct Offsetting Revenue	12340	DirectOffsettingRevenue
Net Community Benefit Expense	645968	NetCommunityBenefitExpense
Percent Of Total Expense	0.00250	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	17	NumberOfActivitiesOrPrograms
Persons Served	4531	PersonsServed
Total Community Benefit Expense	275274	TotalCommunityBenefitExpense
Direct Offsetting Revenue	2250	DirectOffsettingRevenue
Net Community Benefit Expense	273024	NetCommunityBenefitExpense
Percent Of Total Expense	0.00110	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Persons Served	22476	PersonsServed
Total Community Benefit Expense	5140665	TotalCommunityBenefitExpense
Net Community Benefit Expense	5140665	NetCommunityBenefitExpense
Percent Of Total Expense	0.02020	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Total Community Benefit Expense	24431	TotalCommunityBenefitExpense
Net Community Benefit Expense	24431	NetCommunityBenefitExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	22	NumberOfActivitiesOrPrograms
Persons Served	23	PersonsServed
Total Community Benefit Expense	669064	TotalCommunityBenefitExpense
Net Community Benefit Expense	669064	NetCommunityBenefitExpense
Percent Of Total Expense	0.00260	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	136	NumberOfActivitiesOrPrograms
Persons Served	68092	PersonsServed
Total Community Benefit Expense	6767742	TotalCommunityBenefitExpense
Direct Offsetting Revenue	14590	DirectOffsettingRevenue
Net Community Benefit Expense	6753152	NetCommunityBenefitExpense
Percent Of Total Expense	0.02650	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	136	NumberOfActivitiesOrPrograms
Persons Served	68092	PersonsServed
Total Community Benefit Expense	66033547	TotalCommunityBenefitExpense
Direct Offsetting Revenue	40606653	DirectOffsettingRevenue
Net Community Benefit Expense	25426894	NetCommunityBenefitExpense
Percent Of Total Expense	0.10000	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	8	NumberOfActivitiesOrPrograms
Total Community Building Expense	69051	TotalCommunityBuildingExpense
Net Community Building Expense	69051	NetCommunityBuildingExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Leadership Development LeadershipDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Total Community Building Expense	1848	TotalCommunityBuildingExpense
Net Community Building Expense	1848	NetCommunityBuildingExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Total Community Building Expense	18320	TotalCommunityBuildingExpense
Net Community Building Expense	18320	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Total Community Building Expense	510	TotalCommunityBuildingExpense
Net Community Building Expense	510	NetCommunityBuildingExpense

Other Other

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Total Community Building Expense	100	TotalCommunityBuildingExpense
Net Community Building Expense	100	NetCommunityBuildingExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	13	NumberOfActivitiesOrPrograms
Total Community Building Expense	89829	TotalCommunityBuildingExpense
Net Community Building Expense	89829	NetCommunityBuildingExpense
Percent Of Total Expense	0.00040	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReported
Bad Debt Expense	$3,308,653	BadDebtExpenseAmount
Amount Attributable To	3143316	AmountAttributableTo
Amount Reimbursed By Medicare	62914770	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	90995950	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-28081180	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Other	X	Other

Field	Value	IRS element (for citing)
Written Debt Collection Policy	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	WILLIAM W BACKUS HOSPITAL	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	326 WASHINGTON ST	AddressLine1
City	NORWICH	City
State	CT	State
ZIP Code	06360	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	WILLIAM W BACKUS HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
Eligibility Criteria Explained	true	EligibilityCriteriaExplained
Uses FPG Free	true	UsesFPGFree
FPG Free Percent	250.	FPGFreePercent
Uses FPG Discounted	true	UsesFPGDiscounted
FPG Discount Percent	400.	FPGDiscountPercent
Explains Basis	true	ExplainsBasis
Income Level	X	IncomeLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Uninsured Discount	X	UninsuredDiscount
Medicaid Medicare	X	MedicaidMedicare
State Regulation	X	StateRegulation
Explains Application Method	true	ExplainsApplicationMethod
Includes Publicity Measures	true	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Attached To Invoices	X	AttachedToInvoices
Posted In Admission Office	X	PostedInAdmissionOffice
Available On Request	X	AvailableOnRequest
Actions On Nonpayment	true	ActionsOnNonpayment
Collection Activities	false	CollectionActivities
Nondiscrim Emergency Care Policy	true	NondiscrimEmergencyCarePolicy
Average Negotiated Rates	X	AverageNegotiatedRates
Amounts Generally Billed	false	AmountsGenerallyBilled
Gross Charges	false	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	11	NumberOfOtherFacilities

Other Facilities OtherFacilities (11 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
BACKUS OUTPATIENT CARE CENTER
111 SALEM TURNPIKE	NORWICH	CT	06360	OUTPATIENT SERVICES
MEDICAL OFFICE BUILDING
330 WASHINGTON STREET	NORWICH	CT	06360	RADIATION THERAPY/LAB
COLCHESTER BACKUS HEALTH CENTER
163 BROADWAY	COLCHESTER	CT	06415	RADIOLOGY/LAB/PRIMARY CARE
MONTVILLE BACKUS HEALTH CARE
80 NORWICH/NEW LONDON TURNPIKE	UNCASVILLE	CT	06382	RADIOLOGY/LAB/PRIMARY CARE
PAIN MANAGEMENT
112 LAFAYETTE STREET	NORWICH	CT	06360	PAIN MANAGEMENT CLINIC
LEDYARD BACKUS HEALTH CENTER
743 COLONEL LEDYARD HWY	LEDYARD	CT	06339	LAB/PRIMARY CARE
JEWETT CITY PATIENT SERVICE CENTER
70 MAIN STREET	JEWETT CITY	CT	06351	LAB
INFECTIOUS DISEASE CLINIC
107 LAFAYETTE STREET	NORWICH	CT	06360	CLINIC
NORTH STONINGTON BACKUS HEALTH CENTER
82 NORWICH-WESTERLY ROAD	NORTH STONINGTON	CT	06359	PRIMARY CARE
NORWICHTOWN BACKUS PATIENT SERVICE CNTR
55 TOWN STREET	NORWICH	CT	06360	LAB
PLAINFIELD EMERGENCY CENTER
582 NORWICH ROAD	PLAINFIELD	CT	06374	LAB/RADIOLOGY/EMERGENCY SRVCS

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST	SCHEDULE H, PART I, LINE 7	FROM OCTOBER 2011 THROUGH SEPTEMBER OF 2012 THE WILLIAM W. BACKUS HOSPITAL SUPPORTED 146 PROGRAMS THAT SERVED 68,101 PEOPLE, TOTALING A COMMUNITY BENEFIT OF $6,859,351. PROGRAMS IMPROVED THE HEALTH AND WELLNESS OF THE COMMUNITY, ADDRESSING STRATEGIC COMMUNITY HEALTH PRIORITY AREAS. SUCH PRIORITY HEALTH AREAS INCLUDE REDUCING OBESITY, AUTISM, DRUG AND ALCOHOL USE, AND INCREASING ACCESS TO HEALTH CARE. PROGRAMS ALSO INCLUDED CLINICAL SERVICES PROVIDED BY THE HOSPITAL AT A FINANCIAL LOSS (SUBSIDIZED SERVICES). THESE SERVICES, IF DISCONTINUED, WOULD NOT BE AVAILABLE TO THE COMMUNITY OR WOULD FALL TO ANOTHER NOT-FOR-PROFIT OR GOVERNMENT AGENCY TO PROVIDE. HEALTH PROFESSIONAL EDUCATION WAS ALSO ENHANCED, THROUGH MENTORSHIPS, INTERNING OPPORTUNITIES, AND STUDENT ROTATIONS THROUGH THE FACILITY. THE HOSPITAL ALSO SUPPORTED COMMUNITY PARTNERSHIPS THROUGH CASH AND IN-KIND DONATIONS. SUCH SUPPORT INCLUDED ASSISTING A LOCAL FEDERALLY-QUALIFIED LOOK-ALIKE IN SUSTAINING A GYNECOLOGY SERVICES PROGRAM FOR UNDERSERVED AND UNINSURED WOMEN, AS WELL AS DONATING A BUILDING TO ESTABLISH A SATELLITE FQHC FACILITY TO PROVIDE PRIMARY CARE IN AN UNDERSERVED COMMUNITY. LASTLY, THE HOSPITAL COMMITTED RESOURCES TO FINDING "NOT-FOR-PROFIT" RESEARCH OPPORTUNITIES (IN OTHER WORDS, THOSE RESEARCH OPPORTUNITIES IN WHICH THE HOSPITAL HAS NO FINANCIAL INCENTIVE) TO HELP IMPROVE CLINICAL CARE AVAILABLE TO THE RESIDENTS OF EASTERN CONNECTICUT. SCHEDULE H, PART I, LINE 7 THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THE COLUMN IS $7,950,269. SCHEDULE H, PART I LINE 7 THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE WAS COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2.
COMMUNITY BUILDING ACTIVITIES	SCHEDULE H, PART II	Backus Hospital conducts and sponsors 10 support groups that provide ongoing education and counseling for a wide array of health-related issues, from infant child loss to cancer. Hospital employees volunteer their service on dozens of community not-for-profit organizations, many of which has healthcare as a primary or major focus. Examples include THE HEALTH CARE COUNCIL OF EASTERN CONNECTICUT, THE FOUNDATION OF THREE RIVERS COMMUNITY COLLEGE (WHICH PROVIDEDS FUNDING FOR NURSING STUDENT EDUCATION AND EQUIPMENT), THE REGION'S NON-PROFIT HOSPICE ORGANIZATION, THE NORWHICH CHAMBER OF COMMERCE HEALTH CARE COMMITTEE, UNITED WAY OF SOUTHEASTERN CONNECTICUT (WHICH PROVIDES FUNDING FOR MANY REGIONAL HUMAN SERVICES, INCLUDING THOSE THAT ARE HEALTH-RELATED); AS WELL AS SERVICE AND BOARD MEMBERSHIPS ON THE REGION'S TWO FEDERALLY QUALIFIED HEALTH CENTERS. Additionally, Backus personnel volunteer on other boards and organizations that advance the quality of life and economic well-being of the region, including the local library, family support and social service organizations, the regional Chamber of Commerce, numerous civic and governmental bodies, and various volunteer fire companies and ambulance services. Members of the administrative staff routinely submit government testimony on behalf of regional not-for-profit health-related organizations, and provide research and advocacy for the healthcare access.
BAD DEBT EXPENSE	SCHEDULE H, PART III, LINES 4, 8 AND 9B	THE HOSPITAL PROVIDES SERVICES WITHOUT CHARGE, OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES, TO PATIENTS WHO MEET THE CRITERIA OF ITS CHARITY CARE POLICY. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO BE CHARITY CARE, SUCH SERVICES ARE NOT REPORTED AS NET REVENUE. THE HOSPITAL'S CHARITY CARE POLICY UTILIZES THE GENERALLY RECOGNIZED POVERTY INCOME LEVELS FOR THE STATE. FOR PATIENTS WHO DO NOT APPLY OR DO NOT QUALIFY, THE UNCOLLECTED AMOUNTS ARE RECOGNIZED AS BAD DEBT EXPENSE. ESTIMATED COST OF BAD DEBT IS BASED ON THE RATIO OF COST TO CHARGES AS DETERMINED BY HOSPITAL SPECIFIC DATA.
MEDICARE SHORTFALL	SCHEDULE H, PART III, LINE 8	THE MEDICARE SHORTFALL WAS NOT INCLUDED IN THE COMMUNITY BENEFIT COST. THE COSTING METHODOLOGY CONSISTED OF INFORMATION FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM AS WELL AS COSTS FROM THE MEDICARE COST REPORT.
COLLECTION POLICY	SCHEDULE H, PART III, LINE 9B	IN THE SELF-PAY POLICY, SECTION II, B STATES THAT THE MEDICAL BUREAU OF ECONOMICS ("MBE") RECEIVES A WEEKLY LIST OF PATIENTS WHO WERE SENT FINANCIAL ASSISTANCE APPLICATIONS FROM BACKUS STAFF. THIS INFORMATION IS FROM THE PATIENT ACCOUNTS OR FINANCIAL COUNSELING DEPARTMENTS. MBE'S COLLECTION ACTIVITY ON THESE PATIENTS IS HALTED UNTIL IT HAS BEEN DETERMINED IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UNDER THE HOSPTIAL'S POLICY, BY THE HOSPITAL FINANCIAL COUNSELING UNIT. COLLECTION ACTION IS ONLY RESUMED ONCE IT IS DETERMINED THE PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE.
AVAILABILITY OF FINANCIAL ASSISTANCE	SCHEDULE H, PART V, LINES 13G, 17E	THE WILLIAM W. BACKUS HOSPITAL PROVIDES FINANCIAL ASSISTANCE FOR CERTAIN QUALIFIED PATIENTS WHO ARE UNABLE TO PAY ALL OR PART OF THEIR BILL FOR INPATIENT, OUTPATIENT, AND EMERGENCY SERVICES RENDERED AT THE HOSPITAL. IF YOU ARE COPING WITH A FINANCIAL HARDSHIP AND ARE FACING DEBTS OWED TO THE WILLIAM W. BACKUS HOSPITAL, FINANCIAL ASSISTANCE SUCH AS FREE CARE OR A SLIDING SCALE DISCOUNT MAY BE AVAILABE TO YOU. THE FINANCIAL COUNSELING PROCESS WILL INDICATE WHAT OPTIONS EXIST TO ASSIST YOU WITH YOUR OUTSTANDING BALANCE. FINANCIAL ASSISTANCE APPLIES TO BACKUS HOSPITAL BILLS ONLY. IT DOES NOT APPLY TO RADIOLOGISTS, PATHOLOGISTS, ANESTHESIOLOGISTS OR OTHER PROFESSIONAL SERVICES INVOLVED IN YOUR CARE THAT ARE BILLED SEPARATELY. TO APPLY PLEASE SUBMIT THE ATTACHED APPLICATION FOR FINANCIAL ASSISTANCE AND THE FOLLOWING VERIFICATIONS OF INCOME INFORMATION: - Most recent Federal tax return and W-2 - Most recent 3 payroll checks - Copies of unemployment checks - Copies of any pension, alimony, child support or other sources of income - Copies of Social Security earnings, if any - Any other pertinent information. Proof of income or earnings is required with application or the application will not be considered. Please allow 3 to 4 weeks for processing time; you will be notified by mail of the outcome of your application. If you have any questions please contact Customer Service: Monday thru Friday, 9:00 am to 4:00 pm (860) 823-6394 / Fax: (860) 892-6902. Further, as detailed in the Hospitals Bad Debt Write Off Policy, a series of statements, all indicating the availability of financial assistance (per the letter described previously) are sent out prior to collecting on the open account. The bad-debt collections and write off policy is described below: I Self Pay Accounts Collection Process (Accounts that do not qualify for MBE outsource) A Initial letter is sent 5 days after discharge. B Statement #1 is sent 30 days later. C Statement # 2 is sent 30 days later. D Precollect Letter is sent 15 days later (by Medconn). E Account will be written off to bad debt 45 days later. II Self Pay balances after insurance (Accounts that do not qualify for MBE outsource) A Statement # 1 is sent 15 day after account goes to self pay. B Statement # 2 is sent 30 days later. C Statement # 3 is sent 21 days later. D Precollect Letter is sent 21 days later. E Account will be written off to bad debt 45 days later. III All final billed accounts with self-pay balances only will be outsourced to Medical Bureau of Economics (MBE). (refer to Self Pay Collections policy) A Statement # 1 is sent at placement with MBE. (5 days after discharge) B Statement # 2 is sent 30 days later. C Statement # 3 is sent 30 days later. D Final Statement sent 15 days later. E Account closed and returned to WWBH for bad debt process 45 days later 1 Accounts with balances of $1000 or more. a. If time permits the staff will attempt to contact the patient to attempt to determine if they may qualify for free bed funds, charity care or a payment contract. b. If the patient may qualify, and application is sent and the account is not sent to bad debt, pending a response within 14 days. If no response is received the account will be sent to bad debt in the next weekly processing cycle. C. THE ACCOUNT WILL BE PLACED ON "BAD DEBT HOLD". A NOTE IS PLACED ON THE ACCOUNT INDICATING THE APPLICATION FOR FREE BED AND CHARITY CARE. d. A reminder will be set up to review the account in 14 days. If the application is received the hold will be removed and the account will be processed according to the free Bed/charity care policy. If the patient does not qualify, the hold will be removed and the account will go to bad debt in the next weekly processing cycle. If the application is not received back in 14 days the hold will be removed and the account will go to bad debt in the next weekly processing cycle. e. If time permits the staff will attempt to process the accounts through Passport One/SSI to determine if Medicaid coverage has been established for the patient. If so, the account will be updated and Medicaid billed. updated and Medicaid billed.
COMMUNITY HEALTH NEEDS ASSESSMENT	SCHEDULE H, PART V, SECTION B	(a) In addition to conducting its own research, Backus Hospital collaborates with local and regional health care organizations to determine the need for health-related programs and services. (b) In 2010, the Hospital commissioned a comprehensive community health needs assessment conducted by Holleran, a professional research firm. The assessment consisted of 1,109 BRFSS telephone surveys which were conducted throughout the Hospital's service region (both New London and Windham Counties). The assessment also included a detailed analysis of secondary data sources, as well as two comprehensive focus groups to gain qualitative data on identified priority health areas. The needs assessment was presented and distributed, and can be accessed at www.backushospital.org/healthsurvey. Subsequently the Hospital has developed a Community Needs Strategic Plan which identifies and outlines top priority health needs as determined by the needs assessment. Priority health areas include obesity and overweight, autism, smoking, alcohol and substance abuse, mental health, chronic lower respiratory diseases, and access to healthcare. This plan has guided Hospital's outreach efforts for the last two fiscal years. A second needs assessment was undertaken in the fourth quarter of FY 2012 to measure the Hospital's progress, and augment existing research. Based on the Holleran survey, the Hospital partnered with United Way of Southeastern Connecticut to create the New London County Food Policy Council, which is using the data to address obesity and other food-related issues, as well as Norwich Technical High School, to focus on adolescent health issues such as self-esteem, depression, and substance abuse. (c) The hospital identifies health problems in the community through indicators and measures of health risk, disease prevalence, disease management and outcomes using sources such as birth and mortality records, census data, Behavioral Risk Factor Survey data, Robert Wood Johnson County Health Rankings, and other datasets. Priority areas were ranked utilizing a methodology which determined the severity of the problem and the Hospital's ability to impact it. (d) The hospital partners with two regional Federally Qualified Health Centers ("FQHC") - United Community and Family Services, and Generations Healthcare. Managers from the hospital and FQHCs meet to determine unmet community needs to develop educational, outreach and preventative health programs to meet these needs. (e) The hospital conducts follow-up surveys with all participants in its free educational programs. The surveys assess participants' satisfaction with the program, and solicit information about other needs.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	SCHEDULE H, PART VI, LINE 3	(a) Notification about charitable care and assistance programs is available at all registration areas, on and off the main hospital campus, in waiting areas, in the patient handbook, on our website, on prominently placed signs (in English and Spanish). Additionally, Care Management Social Workers meet with patients, family, clergy and others as appropriate to discuss assistance programs and services that may be available. In addition to the complete Financial Assistance Policy and Application for Financial Assistance, here is the information included on the Hospitals website: Financial Assistance Backus Hospital provides financial assistance programs for certain qualified patients who are unable to pay all or part of their bill for inpatient, outpatient and emergency services rendered at the Hospital. If you are coping with a financial hardship, and are facing debts owed to Backus Hospital, financial assistance may be available to you. Income Verification Backus requests income information from the applicant. Verification of reported income should be included within the application package. Appropriate verification sources include: - Most recent Federal tax return and W-2 - Most recent 3 payroll checks - Copies of unemployment checks - Copies of any pension, alimony, child support or other sources of income - Copies of Social Security earnings, if any - Any other pertinent information If the applicant has no income a statement detailing the current method of support will be accepted. Proof of income or earnings is required with application or the application will not be considered. Financial Assistance Options The level of financial assistance that you may be eligible to receive will be based upon the criteria defined in the Financial Assistance Policy. The William W. Backus Hospital considers Financial Assistance awards on a case-by-case basis. Please contact us if you have questions regarding eligibility. Financially Indigent Financially Indigent is defined as an individual whose total gross annual income is less than or equal to 250% of the Federal Poverty Guidelines (FPG). Patients at or below 250% FPG are eligible for a 100% discount off of their outstanding balances. Individuals above 250% up to 400% FPG are eligible for a discount based on their total gross annual income. Medically Indigent Backus Hospital considers an individual to be Medically Indigent if their total annual gross income is above 400% FPG and their outstanding medical obligations are greater than 50% of their total annual gross income. These individuals may be eligible for a discount separate from traditional financial assistance. Please refer to the Financial Assistance Policy for details regarding eligibility and the discount schedule. MEDICALLY INDIGENT IS DEFINED BY THE IRS AS: 'Persons whom the organization has determined are unable to pay some or all of their medical bills because their medical bills exceed a certain percentage of their family or household income or assets (for example, due to catastrophic costs or conditions), even though they have income or assets that otherwise exceed the generally applicable eligibility requirements for free or discounted care under the organizations financial assistance policy.' Backus Hospital treats each application individually. If you have any questions about your specific situation, please contact our customer service representatives at 860-889-8331, ext. 2917, Monday through Friday from 7:30 am to 4 pm. Financial Assistance Letter The William W. Backus Hospital provides financial assistance for certain qualified patients who are unable to pay all or part of their bill for inpatient, outpatient and emergency services rendered at the hospital. If you are coping with a financial hardship and are facing debts owed to The William W. Backus Hospital, financial assistance such as free care or a sliding scale discount may be available to you. The financial counseling process will indicate what options exist to assist you with your outstanding balance. Financial assistance applies to Backus Hospital bills only. It does not apply to Radiologists, Pathologists, Anesthesiologists or other professional services involved in your care that are billed separately. Frequently Asked Questions 1. DOES THE HOSPITAL HAVE A FINANCIAL ASSISTANCE POLICY? The William W. Backus Hospital does have a written financial assistance policy that defines the discount structure and programs available to qualifying patients. The William W. Backus Hospital bases all financial assistance on the most current Federal Poverty Guidelines (FPG), which are based on the gross income and household size. Backus grants 100% charity care to those applicants whose gross household income is at or below 250% FPG. A sliding discount is available to those patients who have gross income up to 400% FPG. Currently, the Federal government defines 100% of poverty as an individual earning a gross income of $10,890 per year. The William W. Backus Hospital Financial Assistance Policy grants 100% Charity Care to a family of one earning up to $21,780 per year, or 250% FPG. Income thresholds increase relative to household size. A discount is available for applicants earning up to 400% FPG. 2. WHAT SERVICES DOES THE FINANCIAL ASSISTANCE POLICY COVER? The William W. Backus Hospitals Financial Assistance Policy covers services rendered at the William W. Backus Hospital, including inpatient, emergency, and outpatient procedures. Financial assistance may not be granted for some procedures, such as elective procedures or some special situations, such as that of an individual who is eligible for insurance but has refused to apply or funds are available through another source for payment (i.e. settlements, State Funded programs). Financial assistance applies to Backus Hospital bills only. It does not apply to Radiologists, Pathologists, Anesthesiologists or other professional services involved in your care that are billed separately. 3. DOES THE HOSPITAL PROVIDE PERSONNEL TO HELP WITH APPLICATIONS AND TO ANSWER QUESTIONS? The William W. Backus Hospital employs Financial Counselors to help patients apply for Financial Assistance, Medicaid, and other State health programs. The Hospital also has resources to help with applications for State Nutritional Assistance Programs (SNAP) and pharmacy assistance programs. Financial Counselors can help to determine appropriate referrals to these resources. The William W. Backus Hospital provides language translation via Cyracom and MARTTI Language Lines. 4. DOES THE HOSPITAL COMMUNICATE THE AVAILABILITY OF FINANCIAL ASSISTANCE TO THE COMMUNITY? The William W. Backus Hospital believes it is important to communicate the availability of financial assistance to the communities it serves. Therefore, a notice of the availability of financial assistance is included with the paper bill sent to the patients home, is posted in all main registration areas, is available on the Hospitals website, and upon request of Hospital staff or representatives. 5. DOES THE HOSPITAL EVER DENY CARE BASED ON INABILITY TO PAY? The William W. Backus Hospital will never delay or deny emergency care or necessary services due to an inability to pay. 6. DOES THE HOSPITAL HAVE A PROGRAM FOR PATIENTS WHO DONT QUALIFY FOR TRADITIONAL FINANCIAL ASSISTANCE BUT INCUR CATASTROPHIC MEDICAL DEBTS? The Hospital has a written policy that covers Catastrophic Financial Assistance for the Medically Indigent. The policy is included in the financial assistance policy, is available on the website, and upon request. (b) The hospital provides two Access to Care Specialists (both first and second shift) in its Emergency Departments and two health centers, who provides free insurance eligibility screenings to uninsured clients seeking care. The Specialists work with uninsured patients to connect them with a primary medical home, so they can receive preventative care, rather than using costly emergency services for illnesses that are not medical emergencies. Significant one-on-one follow-up is provided through phone calls or letters to make appointments to screen patients and help them fill out applications for HUSKY or Charter Oak applications. uninsured patients to connect them with a primary medical home, so they can receive preventative care, rather than using costly emergency services for illnesses that are not medical emergencies. Significant one-on-one follow-up is provided through phone calls or letters to make appointments to screen patients and help them fill out applications for HUSKY or Charter Oak applications.
COMMUNITY INFORMATION	SCHEDULE H, PART VI, LINE 4	The William W. Backus Hospital is located in Norwich, 45 minutes southeast of Hartford. In the past decade, the region has undergone major economic changes, due to the operation of two Native American-owned casinos both among the largest casinos in the world. These gambling and entertainment venues bring bringing an average of 40,000 visitors into the region each day. The casinos are the largest employers, and are experiencing layoffs and cutbacks as the economy continues to decline. The hospitals primary service area has an estimated population of about 118,000. The secondary service area consists of larger communities, such as New London and Groton, and smaller lower-density rural communities. The total population of the secondary service area is about 123,000. The service areas contain municipalities in New London and Windham Counties. The fastest growing segment of the regions population is the elderly. For the last decennial census, the regions elderly population grew at 10 times the rate of growth for the total population. The regions lack of affordable housing began to emerge as a critical issue even before the economic downturn. Homelessness is a growing concern, as the number of mortgage foreclosures grow. Further, the 2012 Robert Wood Johnson County Health Rankings reported that in New London and Windham Counties between 12-15% of children are living in poverty, and 31-32% are living in single parent households. Unemployment in the regional labor market (per the 2012 Robert Wood Johnson County Health Ranking) stands at 8.7-10.3% in New London and Windham Counties, hovering around state average of 9.1%, and well above the national average of 5.4%.
PROMOTION OF COMMUNITY HEALTH	SCHEDULE H, PART VI, LINE 5	a) The hospital is governed by a volunteer community Board of Directors/Trustees. These individuals represent an array of professions and backgrounds. B) THE HOSPITAL HAS 110 CORPORATORS - VOLUNTEER MEMEBERS CHOSEN FROM ALL THE COMMUNITIES IN OUR PRIMARY AND SECONDARY service areas. In addition to their official capacity as nominators of Board members, the Corporators serve as the hospitals eyes and ears throughout its service area. C) THE HOSPITAL OWNS AND OPERATES A MOBILE HEALTH RESOURCE CENTER - a 40-foot van that travels to various locations in eastern Connecticut offering health education, counseling, and screenings. The van makes regularly scheduled stops at senior citizens centers, soup kitchens, elderly housing complexes and homeless shelters. Not-for-profit groups are encouraged to request the van and its services at their functions or offices. d) The hospital provides individuals who do not identify as having a primary medical home with a follow up visit post discharge from to become link these individuals with a primary care physician in the community. This is facilitated through the My Health Direct program, a web-based tool that allows hospital staff to access blocked appointments for physicians in the community. From 10/1/11 to 9/30/12 the Hospital linked 582 individuals with primary care. e) The hospital provides free community prostate screenings, diabetes education, backpack safety, HIV education/testing, blood pressure tests, skin cancer screenings, nutrition education and many others services. f) The hospital provides a comprehensive medical library, which is open to all staff. The library has subscriptions to hundreds of major scientific and clinical journals, as well as an on-staff librarian to help with specific research requests. g) The hospital provides free website access to complete and current medical information to answer clinical questions, through UpToDate.com, a peer-reviewed online medical reference. UpToDate covers more than 7,400 topics in 13 medical specialties and includes more than 76,000 pages of text, graphics, links to Medline abstracts, more than 254,000 references, and a drug database. h) The hospital provides free medication cards to help patients keep track of their current medications, and its pharmacists offer free regular medication reviews to check for possible interactions and expired medications. i) The hospital offers free wireless internet (wi-fi) use throughout the campus, and provides free computer use to visitors. j) The hospital publishes a monthly consumer health magazine. The publication contains information about health issues and trends, a calendar of free healthcare education and screenings, and contact information for healthcare providers. 44,000 copies are distributed monthly. publication contains information about health issues and trends, a calendar of free healthcare education and screenings, and contact information for healthcare providers. 44,000 copies are distributed monthly.
STATE FILING OF COMMUNITY BENEFIT REPORT	SCHEDULE H, PART VI, LINE 7	THE HOSPITAL FILES A COMMUNITY BENEFIT REPORT WITH THE CONNECTICUT OFFICE OF THE HEALTH ADVOCATE ("OHA").

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	true	RecordsMaintained

Recipient Table RecipientTable (7 entries)

EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant	Amount Of Non Cash AssistanceAmountOfNonCashAssistance	Method Of ValuationMethodOfValuation	Description Of Non Cash AssistanceDescriptionOfNonCashAssistance
HOSPICE OF SE CONNECTICUT
222667260	501(C)(3)	8500	SPONSORSHIP
AMERICAN HEART ASSOC
135613797	501(C)(3)	7500	SPONSORSHIP
UNITED COMMUNITY & FAMILY SERVICES
060653142	501(C)(3)	200000	WOMEN'S HEALTH
CHAMBER OF COMMERCE
060475490	501(C)(6)	6500	SPONSORSHIP
THREE RIVERS COLLEGE
237303151	501(C)(3)	16000	SPONSORSHIP
BROADWAY KIDS
		5100	SPONSORSHIP
UNITED COMMUNITY & FAMILY SERVICES
060653142	501(C)(3)		PRIMARY CARE	410000	APPRAISAL	BUILDING

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	5	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	2	TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

Field	Value	IRS element (for citing)
Type Of Grant	SCHOLARSHIPS	TypeOfGrant
Number Of Recipients	5	NumberOfRecipients
Amount Of Cash Grant	12500	AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	Procedures for Monitoring the use of grant funds in the U.S.	Identifier
Return Reference	SCHEDULE I, PART I, LINE 2	ReturnReference
Explanation	DONATIONS MADE FOR LOCAL EVENTS, SUCH AS SPONSORSHIPS, ARE TYPICALLY ATTENDED BY HOSPITAL EMPLOYEES. FIVE SCHOLARSHIPS IN THE AMOUNT OF $2,500 EACH ARE AWARDED TO STUDENTS WHO WILL ATTEND SCHOOL EITHER FOR NURSING OR IN THE MEDICAL FIELD. THE APPLICANTS ARE REVIEWED BY THE SCHOLARSHIP COMMITTEE OF THE AUXILIARY AND WINNERS ARE CHOSEN BASED ON ACADEMICS AS WELL AS COMMUNITY SERVICE.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Payments	X	IdemnificationGrossUpPayments
Written Policy Re T And E Expenses	false	WrittenPolicyReTAndEExpenses
Substantiation Required	true	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	false	SeverancePayment
Supplemental Nonqual Retire Plan	true	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	false	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	false	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	false	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	true	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

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
DAVID WHITEHEAD
740686	0	0	0	21535	0	20580	0	23272	0	806073	0
DANIEL E LOHR
491649		0		23079		20580		16882		552190
PETER SHEA
491146		0		1651		13230		23503		529530
SERGIO CASILLAS MD
378355		118000		0		13230		1057		510642
ROBERT SIDMAN MD
296400		96525		16500		13230		23272		445927
MARK TOUSIGNANT MD
265264		70000		0		13230		23503		371997
JUAN ESCALON MD
341282		0		4889		13230		23503		382904
THOMAS P PIPICELLI
608153		0		3169625		20580		16882		3815240		2782763
WILLIAM HORGAN MD
252291		58890		11400		9632		23503		355716

Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
GROSS-UP PAYMENTS	SCHEDULE J, PART I, LINE 1A	THE FORMER PRESIDENT RECEIVED GROSS-UP PAYMENTS ON SELECTED EXPENSES. THEY WERE PROPERLY INCLUDED IN HIS W-2 WAGES.
SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN	SCHEDULE J, PART I, LINE 4B	DAVID WHITEHEAD, DANIEL E LOHR AND PETER SHEA PARTICIPATE IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN, HOWEVER THERE WERE NO ACCRUALS OR CONTRIBUTIONS THAT WERE MADE TO THE PLAN DURING THE REPORTING PERIOD.
NON-FIXED PAYMENTS	SCHEDULE J, PART I, LINE 7	BASE COMPENSATION FOR EXECUTIVES IS APPROVED BASED ON THE CRITERIA LISTED IN PART I, LINE 3, HOWEVER A PORTION OF THAT IS HELD BACK AND SUBSEQUENTLY DISTRIBUTED BASED ON EVALUATION OF THE INDIVIDUALS PERFORMANCE AND ACCOMPLISHMENT OF THE GOALS SET AT THE BEGINNING OF THE YEAR BY AN INDEPENDENT COMPENSATION COMMITTEE. PHYSICIAN BONUSES ARE BASED ON MEETING PREESTABLISHED GOALS.
RETIREMENT AND OTHER DEFERRED COMPENSATION EXPLANATION	SCHEDULE J, PART II, COLUMN C	COMPENSATION IS REPORTED ON THE FORM 990 IN THE YEAR THE COMPENSATION IS EARNED BY OR AWARDED TO AN INDIVIDUAL, EVEN IF THE COMPENSATION IS NOT PAID TO THE INDIVIDUAL, IS NOT FULLY VESTED, OR IS SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. IF COMPENSATION IS EARNED OR AWARDED IN ONE YEAR BUT PAID IN A LATER YEAR, THEN THE COMPENSATION IS GENERALLY REPORTED A SECOND TIME ON THE FORM 990 IN THE YEAR THE COMPENSATION IS PAID TO THE INDIVIDUAL. AS A RESULT OF THE REPORTING REQUIREMENT, AN ORGANIZATION COULD BE REQUIRED TO REPORT THE SAME COMPENSATION ON FORM 990 IN TWO DIFFERENT YEARS.
ADDITIONAL INFORMATION	SCHEDULE J, PART II, LINE 10	THOMAS PIPICELLI'S COMPENSATION INCLUDES AMOUNTS ESTABLISHED AND PAID PURSUANT TO AN EMPLOYMENT AGREEMENT DATED DECEMBER 15, 2008, UNDER WHICH EMPLOYEE'S EMPLOYMENT WOULD TERMINATE ON DECEMBER 31, 2011. THE AMOUNT OF COMPENSATION RECOGNIZED THE EMPLOYEE'S DECADES-LONG SERVICE TO THE ORGANIZATION AS PRESIDENT AND CEO, AND HIS SERVICES IN TRANSITIONING TO THE ORGANIZATION'S CURRENT MANAGEMENT TEAM.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEIN	CUSIP NumberCUSIPNumber	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer	Pool FinancingPoolFinancing
STATE OF CT HEALTH & EDUCATIONAL FACILITIES
060806186	20774LSV3	2005-08-10	28992719	SEE SCHEDULE K, PART V	false	false	false
STATE OF CT HEALTH & EDUCATIONAL FACILITIES
060806186	20774UC86	2008-07-02	30168922	SEE SCHEDULE K, PART V	false	false	false

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Amount RetiredAmountRetired	Amount Bond DefeasedAmountBondDefeased	Total ProceedsTotalProceeds	Amount In Reserve FundAmountInReserveFund	Capitalized InterestCapitalizedInterest	Refunding EscrowRefundingEscrow	Issuance Costs From ProceedsIssuanceCostsFromProceeds	Credit EnhancementCreditEnhancement	Working Capital ExpendituresWorkingCapitalExpenditures	Capital ExpendituresCapitalExpenditures	Other Spent ProceedsOtherSpentProceeds	Amount UnspentAmountUnspent	Year Of Subst CompletionYearOfSubstCompletion	Current RefundingCurrentRefunding	Advance RefundingAdvanceRefunding	Final Allocation MadeFinalAllocationMade	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
3535000	0	28992719	755086	0	16750062	369723	583673	0	10514252	19923	0	2008	false	true	true	true
2850000	0	30168922	0	0	30100000	68922	0	0	0	0	0	2008	true	false	true	true

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedProperty	Any Lease ArrangementsAnyLeaseArrangements	Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Any Research AgreementsAnyResearchAgreements	Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers	Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI	Total Private Business UseTotalPrivateBusinessUse	Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
false	false	false	false	0.00000	0.00000	0.00000	true
false	false	false	false	0.00000	0.00000	0.00000	true

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiled	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Business Name Line1NameOfGICProvider/BusinessNameLine1	Gross Proceeds InvestedGrossProceedsInvested	Exception To RebateExceptionToRebate	Term Of HedgeTermOfHedge	Superintegrated HedgeSuperintegratedHedge	Hedge TerminatedHedgeTerminated	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC
0
false	false	false	0	false	false
UBS AG
true	true	true	0	false	false	29.9	false	false	false

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Field	Value	IRS element (for citing)
Name Person	SEE SCHEDULE L PART V	NamePerson

Form990 Schedule L Part V Form990ScheduleLPartV

Field	Value	IRS element (for citing)
Identifier	BUSINESS TRANSACTION INVOLVING INTERESTED PERSONS	Identifier
Return Reference	SCHEDULE L, PART IV	ReturnReference
Explanation	(B) DAVID WHITEHEAD, DANIEL E LOHR, AND PETER SHEA ARE OFFICERS, TRUSTEES, DIRECTORS AND/OR KEY EMPLOYEES OF THE WILLIAM W. BACKUS HOSPITAL(WWBH) AND CONNCARE, INC.(CI) (C)/(D)$3,375,000 REIMBURSEMENTS PAID BY CI TO WWBH $ 96,142 PERFORMANCE OF SERVICES BY WWHBH FOR CI $ 367,717 LEASED PROPERTY (E) NO (B) DAVID WHITEHEAD AND DANIEL LOHR ARE OFFICERS OF THE WILLIAM W BACKUS HOSPITAL AND WWB, INC. (C)/(D)$8,017,000 REIMBURSEMENTS PAID BY WWB TO WWBH (E) NO (B) DAVID WHITEHEAD AND DANIEL LOHR ARE OFFICERS OF THE WILLIAM W BACKUS HOSPITAL AND OMNI HOME HEALTH. (C)/(D)$120,000 ACCOUNTING AND MANAGEMENT FEES PAID BY OMNI TO WWBH $ 5,263 PERFORMANCE OF SERVICES BY WWBH FOR OMNI	Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (27 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ORGANIZATION'S MISSION	FORM 990, PART I, LINE 1 & PART III, LINE 1	THE WILLIAM W. BACKUS HOSPITAL DELIVERS AND COORDINATES A CONTINUUM OF HIGH QUALITY HEALTH CARE THAT IS SENSITIVE TO THE NEEDS OF INDIVIDUALS IN EASTERN CONNECTICUT. THE HOSPITAL IS COMMITTED TO BEING RESPONSIVE AND ACCOUNTABLE TO THOSE FOR WHOSE BENEFIT IT EXISTS, AND TO IMPROVING THE HEALTH OF ITS COMMUNITIES.
INDEPENDENT VOTING MEMBERS	FORM 990, PART VI, SECTION A, LINE 1B	THE TAXPAYER IS REPORTING SEVERAL MEMBERS OF THE BOARD OF DIRECTORS AS NOT BEING INDEPENDENT, EVEN THOUGH THEY DO NOT MEET ANY OF THE DEFINITIONS FROM THE 990 INSTRUCTIONS FOR DETERMINING INDEPENDENT DIRECTORS. HOWEVER, THEY DO HAVE PRIVILEGES AT THE HOSPITAL WHICH IS WHY THE HOSPITAL CONSIDERS THEM NOT INDEPENDENT. BUSINESS RELATIONSHIPS FORM 990, PART VI, SECTION A, LINE 2 DAVID WHITEHEAD AND DANIEL E LOHR HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER. THEY SERVE AS AN OFFICER OR DIRECTOR FOR CONNCARE, INC., WWB CORPORATION, AND BACKUS HOME HEALTH WHICH ARE RELATED FOR PROFIT COMPANIES.
MEMBERS	FORM 990, PART VI, SECTION A, LINE 6	BACKUS CORPORATION, A NOT-FOR-PROFIT, 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF THE WILLIAM W. BACKUS HOSPITAL.
MEMBERS WHO MAY ELECT THE GOVERNING BODY	FORM 990, PART VI, SECTION A, LINE 7A	BACKUS CORPORATION, BEING THE SOLE MEMBER OF THE WILLIAM W. BACKUS HOSPITAL, HAS THE RIGHT TO ELECT ALL THE BOARD OF TRUSTEES.
DECISIONS SUBJECT TO APPROVAL OF MEMBERS	FORM 990, PART VI, SECTION A, LINE 7B	THE ADMINISTRATIVE POWERS OF THE HOSPITAL SHALL BE VESTED IN THE BOARD OF TRUSTEES WHO SHALL HAVE CHARGE, CONTROL AND MANAGEMENT OF THE PROPERTY, AFFAIRS AND FUNDS OF THE HOSPITAL, SHALL BE RESPONSIBLE FOR THE DELIVERY AND MAINTENANCE OF QUALITY PATIENT CARE, THE PROMOTION OF QUALITY IMPROVEMENT, OVERSIGHT OF RISK MANAGEMENT ACTIVITIES, AND WHICH SHALL HAVE THE POWER AND AUTHORITY TO DO AND PERFOM ALL ACTS AND FUNCTIONS NOT INCONSISTENT WITH THE BYLAWS. THE BOARD OF TRUSTEES SHALL MAKE ALL POLICIES AND RULES THAT GOVERN THE HOSPITAL AND SHALL PROVIDE FOR THE ABILITY OF HOSPITAL LEADERSHIP TO ESTABLISH AND IMPLEMENT POLICIES AND TO PROVIDE NECESSARY RESOURCES.
990 REVIEW PROCESS	FORM 990, PART VI, SECTION B, LINE 11B	THE 990 IS PREPARED BY THE ACCOUNTING STAFF AND THEN REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE 990 IS THEN REVIEWED BY THE CFO AND ANY QUESTIONS OR CONCERNS THE CFO MAY HAVE ARE ADDRESSED. THE FINANCE COMMITTEE OF THE BOARD WILL THEN REVIEW THE 990 AND ANY QUESTIONS OR CONCERNS THE FINANCE COMMITTEE HAVE ARE ADDRESSED. THE FINAL FORM 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING.
CONFLICT OF INTEREST POLICY	FORM 990, PART VI, SECTION B, LINE 12C	ALL TRUSTEES, OFFICERS, AND KEY EMPLOYEES OF THE HOSPITAL SHALL COMPLETE AND SIGN A DISCLOSURE STATEMENT. THE STATEMENT WILL INCLUDE AN ITEMIZATION AND DESCRIPTION OF ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST AND ALL MATERIAL FACTS RELATED THERETO FOR SUCH TRUSTEE, OFFICER, OR KEY EMPLOYEE BY VIRTUE OF HIS OR HER ACTIVITIES OR THE ACTIVITIES OF RELATED PERSONS. TRUSTEES, OFFICERS, AND KEY EMPLOYEES ARE URGED TO BE INCLUSIVE IN THIS DISCLOSURE OF POTENTIAL AND ACTUAL CONFLICTS OF INTEREST IS ESSENTIAL TO ENSURING DISCUSSION OF CONFLICT. DISCLOSURE STATEMENTS SHALL BE RETURNED TO THE CORPORATE COMPLIANCE OFFICER. ALL DISCLOSURES MADE WILL BE REVIEWED BY THE COMPLIANCE OFFICER, UNDER THE DIRECTION OF THE CHAIR AND THE PRESIDENT, WHO SHALL EXERCISE GOOD FAITH JUDGEMENT AS TO WHETHER A CONFLICT EXISTS. THE CHAIR AND THE PRESIDENT SHALL BE RESPONSIBLE FOR MONITORING TRANSACTIONS OR ARRANGMENTS IN WHICH A TRUSTEE, OFFICER, OR KEY EMPLOYEE MAY HAVE A CONFLICT OF INTEREST AND FOR ASSURING THAT THE TRUSTEE, OFFICER, OR KEY EMPLOYEE SERVES THE HOSPITAL'S BEST INTERESTS. THE COMPLIANCE OFFICER, THE CHAIR AND/OR PRESIDENT MAY CONSULT WITH ANY TRUSTEE, OFFICER, OR KEY EMPLOYEE AND OBTAIN INFORMATION NECESSARY FOR AN ORDINARILY PRUDENT PERSON TO MAKE A JUDGMENT AS TO WHETHER A CONFLICT EXISTS AND EACH TRUSTEE, OFFICER, AND KEY EMPLOYEE SHALL COOPERATE WITH SUCH REQUESTS. THE COMPLIANCE OFFICER, THE CHAIR, AND/OR THE PRESIDENT SHALL PROVIDE GUIDANCE TO THE TRUSTEE, OFFICER, OR KEY EMPLOYEE AND TO THE BOARD OF TRUSTEES AS TO THE APPRORIATE COURSE OF ACTION. WHEN DEEMED PRUDENT BY THE CHAIR OR THE PRESIDENT, THE CHAIR AND THE PRESIDENT SHALL SEEK THE ADVICE AND APPROVAL OF THE FULL BOARD OF TRUSTEES OR GOVERNANCE COMMITTEE IN DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS AND THAT THE TRUSTEE, OFFICER, OR KEY EMPLOYEE SERVES THE HOSPITAL'S BEST INTERESTS. IF, AFTER COMPLETING AND SIGNING THE ANNUAL DISCLOSURE STATEMENT, AN ACTUAL OR POTENTIAL CONFLICT ARISES, THE TRUSTEE, OFFICER, OR KEY EMPLOYEE WITH THE CONFLICT SHALL PROMPTLY NOTIFY THE COMPLIANCE OFFICER IN WRITING. TRUSTEES, OFFICERS, AND KEY EMPLOYEES WHO HAVE DECLARED OR HAVE BEEN DEEMED TO HAVE A CONFLICT OF INTEREST MUST REFRAIN FROM CONSIDERATION OF PROPOSED TRANSACTIONS OR ARRANGMENTS, UNLESS FOR SPECIAL REASON THE BOARD OF TRUSTEES REQUESTS INFORMATION OR INTERPRETATIONS.
COMPENSATION REVIEW	FORM 990, PART VI, SECTION B, LINES 15A & B	A PERFORMANCE REVIEW COMMITTEE CONSISTING OF INDEPENDENT BOARD MEMBERS REVIEWS THE PERFORMANCE OF THE SENIOR MANAGEMENT TEAM. COMPENSATION IS BASED ON THE RESULTS OF THESE REVIEWS. THE COMMITTEE ALSO TAKES INTO CONSIDERATION INFORMATION FROM COMPENSATION SURVEYS.
JOINT VENTURES	FORM 990, PART VI, SECTION B, LINE 16B	ALL NEW VENTURES ARE REVIEWED BY OUTSIDE COUNSEL AND PRESENTED TO THE BOARD FOR REVIEW AND APPROVAL.
AVAILABILITY OF DOCUMENTS	FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. PLEASE CONTACT DANIEL E LOHR AT 326 WASHINGTON STREET, NORWICH, CT, 06360, ABOUT INSPECTING THE ORGANIZATION'S DOCUMENTS.
OTHER CHANGES IN NET ASSETS	FORM 990, PART XI, LINE 5	K-1 GAIN 892 TRANSFER TO AFFILIATE (1,248,123) INCREASE IN ASSETS HELD IN TRUST 306,792 CHANGE IN PENSION FUNDING (4,361,697) UNREALIZED GAIN 10,067,106 INVESTMENT EXPENSES (365,321) ------------ TOTAL $ 4,399,649
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:DAVID WHITEHEAD TITLE:TRUSTEE/PRESIDENT/CEO HOURS:7
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:ROBERT RAMSDELL TITLE:TRUSTEE/TREASURER HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:JOSEPH FATONE TITLE:TRUSTEE/SECRETARY HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:ANTHONY JOYCE TITLE:TRUSTEE/VICE CHAIRMAN HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:JOHN F BILDA TITLE:TRUSTEE HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:ELIZABETH CONWAY TITLE:TRUSTEE HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:BERT A COPPOTELLI, MD TITLE:TRUSTEE HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:PETER MANERI TITLE:TRUSTEE HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:DEBORAH MONAHAN TITLE:TRUSTEE HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:LYNNE QUINTAL-HILL TITLE:TRUSTEE HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:MARK TRAMONTOZZI, MD TITLE:TRUSTEE HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:STEPHEN T BRIGGS, MD TITLE:TRUSTEE HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:PAUL MAXFIELD TITLE:TRUSTEE HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:DONNA ROMITO, DO TITLE:TRUSTEE HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:DANIEL E LOHR TITLE:SENIOR VP/CFO HOURS:9
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:THOMAS P PIPICELLI TITLE:FORMER PRESIDENT HOURS:10

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg
BACKUS HEALTH CARE INC
326 WASHINGTON ST	NORWICH	CT	06360	222481794	SUPPORT	CT	501(C)(3)	11A	BACKUS CORP	true
BACKUS CORPORATION
326 WASHINGTON ST	NORWICH	CT	06360	222757608	SUPPORT	CT	501(C)(3)	11B	NA	false

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	OMNI HOME HEALTH	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	NORWICH CT 06360	AddressLine1
City	NORWICH	City
State	CT	State
ZIP Code	06360	ZIPCode

Field	Value	IRS element (for citing)
EIN	061458837	EIN
Primary Activity	HOME HEALTH CARE	PrimaryActivity
Legal Domicile State	CT	LegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Type Of EntityTypeOfEntity	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Percentage OwnershipPercentageOwnership
WWB CORPORATION
326 WASHINGTON ST	NORWICH	CT	06360	061094836	HOLDING COMPANY	CT	NA	C-CORP
CONNCARE INC
326 WASHINGTON ST	NORWICH	CT	06360	061387598	HEALTH CARE SRVCS	CT	NA	C CORP
BACKUS MEDICAL CENTER CONDO ASSOC INC
330 WASHINGTON ST	NORWICH	CT	06360	061542647	CONDO ASSOCIATION	CT	NA	C-CORP	0	0	0.65000

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	false	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	true	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	false	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	false	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	true	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	false	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	true	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	false	PerformOfServicesByOtherOrgs
Sharing Of Facilities	false	SharingOfFacilities
Sharing Of Paid Employees	true	SharingOfPaidEmployees
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	true	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	false	OtherTransferToOtherOrg
Other Transfer From Other Org	false	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
CONNCARE INC
I	367717	COST
OMNI HOME HEALTH
K	125263	COST
CONNCARE INC
K	96142	COST
CONNCARE INC
P	3375000	COST
WWB INC
P	8017000	COST