NATCHAUG HOSPITAL INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- NATCHAUG HOSPITAL INC (EIN 06-0966963)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-08-09
- IRS object ID
- 201312219349300331
- 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 H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-09T10:08:13-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 346565596 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Ernst & Young US LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 Ivan Allen Jr Blvd Suite 1000 | AddressLine1 |
| City | Atlanta | City |
| State | GA | State |
| ZIP Code | 30308 | 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 | 060966963 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Natchaug Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NATC | NameControl |
| Phone | 8604561311 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 189 Storrs Road | AddressLine1 |
| City | Mansfield Center | City |
| State | CT | State |
| ZIP Code | 06226 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | PAUL V MALONEY | Name |
| Title | CFO | Title |
| Phone | 8604561311 | Phone |
| Date Signed | 2013-08-09 | DateSigned |
| Authorize Third Party | 0 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Chad D Franks | Name |
| PTIN | P01071312 | PTIN |
| Phone | 4048748300 | 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 | Stephen W Larcen PHD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 189 Storrs Road | AddressLine1 |
| City | Mansfield Center | City |
| State | CT | State |
| ZIP Code | 06226 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 47430564 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.NATCHAUG.ORG | WebSite |
| Type Of Organization Other | X | TypeOfOrganizationOther |
| Year Formation | 1954 | YearFormation |
| State Legal Domicile | CT | StateLegalDomicile |
| Activity Or Mission Description | To provide inpatient and outpatient psychiatric healthcare services. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 663 | TotalNbrEmployees |
| Total Nbr Volunteers | 53 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 195250 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 132429 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 44920212 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 47287791 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 17780 | InvestmentIncomePriorYear |
| Investment Income Current Year | 10344 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 45133242 | TotalRevenuePriorYear |
| Total Revenue Current Year | 47430564 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 36405653 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 38561375 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 41848 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 9166667 | OtherExpensePriorYear |
| Other Expenses Current Year | 7850394 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 45572320 | TotalExpensesPriorYear |
| Total Expenses Current Year | 46411769 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -439078 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1018795 | RevenuesLessExpensesCY |
| Total Assets BOY | 17348692 | TotalAssetsBOY |
| Total Assets EOY | 19504685 | TotalAssetsEOY |
| Total Liabilities BOY | 9307210 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 11646884 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 8041482 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 7857801 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | To provide a continuum of accessible, community-based services for those living with psychiatric illness and chemical dependency or emotional and related educational disabilities, with a commitment to the dignity and privacy of those needing service, empowering them to participate in their own care, education and recovery. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 16690284 | Expense |
| Revenue | 17500833 | Revenue |
| Description | Inpatient TreatmentNatchaug Hospital provides a full range of inpatient psychiatric and substance-abuse treatment for children, adolescents and adults at our 57-bed Mansfield Center facility. The highly qualified, experienced and dedicated professional staff of Natchaug Hospital provides expert care in a supportive, therapeutic setting - helping people regain their stability and return as soon as possible to their own homes. The hospital serves Medicare and Medicaid subscribers and provides care without regard to ability to pay.Intermediate Care (ICC)An acute level of care for a longer length of stay for persons living with prolonged and severe mental illness. Historically, people from Eastern Connecticut who were in need of an extended length of stay were referred to Cedarcrest Hospital in Newington. Natchaug Hospital ICC provides this much-needed care for persons from the Eastern Region, closer to the communities where they live and work. United Services and the Southeastern Mental Health Authority are the Local Mental Health Authorities (LMHA's) responsible for authorizing admission to the Intermediate Care Program. The above includes the authorization of Department of Mental Health and Addiction Services (DMHAS) funds to pay for care in the event the patient is medically indigent, has exhausted his/her Medicare benefit, or has no Medicare hospitalization coverage. Patients are most likely to be referred from Eastern Region hospital inpatient units when it becomes clear that the patient will not be able to safely return to the community following an acute care stay. Upon admission, each patient is assessed by a psychiatrist, a registered nurse and a primary therapist, and a treatment plan is developed. The treatment team works closely with the client, their family and community providers to develop a discharge plan and ensure that community supports are in place.In-Patient Treatment Programs Treats 57 clients on a daily basis at the Mansfield location. Inpatient treatment includes: Comprehensive bio-psycho-social assessment Formulation of a treatment plan developed with the client/family which may include the use of medications Group therapy (a primary treatment approach) Family therapy and individual therapy Formulation of a discharge/aftercare plan Case management services Client referral to in-patient programs: Majority (over 80%) come from emergency rooms Self-referral via phone call or walk-in Referral from a Natchaug Program (PHP, IOP, school) Referral from community providersTypical client experience: The majority of our clients arrive via ambulance through the ambulance entrance. All clients receive an initial assessment by a registered nurse and psychiatrist which is completed within 8 hours of admission. Clients are oriented to the unit, the milieu, and the schedule. Our clients are closely monitored for the first 24-48 hours, depending on presentation and symptoms. Groups are scheduled from morning through evening. In addition, the clients meet with their Primary Therapist and Psychiatrist regularly.Contact with the family/guardian is during the admission process or within the following 48-72 hours. Family meetings are scheduled by the Primary Therapist. The clients on the child and adolescent units attend school in the building for 5 hours per day, with groups during the day, after school, and in the evening. Staffing pattern: Each inpatient unit is staffed 24-7 with: Registered NursesPsychiatristsMental Health Workers Licensed Practical Nurses (Adult Unit only) Also on the clinical treatment team are:Nurse Manager Licensed Primary TherapistsCase Manager (Adult Unit Only)Unit ClerkDieticianCertified Occupational Therapists (COTA)Occupational Therapist (OT)Family Practice Physician on site M-FInpatient Units: Adult rooms all semi-private plus one four-bed room. Child/Adolescent rooms are all private Units include group room space Meals are served in the dining roomOther points:Licensed by Connecticut Department of Public Health.Surveyed by Joint Commission under the Hospital StandardsSurveyed by the Center for Medicaid Services (federal program) | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 8243375 | Expense |
| Revenue | 8419516 | Revenue |
| Description | Joshua CentersPartial Hospital Program (PHP) The Partial Hospital Program provides four hours of intensive psychiatric support daily for up to five days per week. This is a morning program for adults and an after-school program for children and adolescents. The program can eliminate the need for a hospital stay, and/or help with the transition back to home and regular school after a period of inpatient care.Intensive Outpatient Program (IOP) The Intensive Outpatient Program is somewhat less intense than the PHP, providing three hours of intensive treatment each day for up to five days each week. This program is offered both in the morning and during the evening for adults, after-school for children and adolescents. The IOP program is designed to help continue progress with behavioral health stabilization and recovery.Extended Day Treatment (EDT)This special program, partially funded by the Connecticut Department of Children, supports children and adolescents who have emotional or behavioral health issues that put them at risk of needing psychiatric residential or inpatient care. The Extended Day Treatment program is particularly helpful for children with special needs who are in foster care.Child & Adolescent Treatment Programs:- Treat about 250 children and adolescents daily in all programs/locations- May prevent hospitalization- Aids in transition back to the community following hospitalization- Transportation to PHP, IOP & EDT: Most of this transportation is provided by Natchaug Hospital staff, driving the Hospital vans that pick up clients from their school or home. - Average length of stay in PHP/IOP program, 6 - 8 weeks; EDT and IICAPS, 6 months.Joshua Program treatment services include: - Comprehensive bio-psycho-social assessment- Group Therapy (the primary treatment approach)- Family and individual therapy- Medication management- Occupational and creative rehabilitation therapy- Comprehensive aftercare/discharge planningPartial Hospital Program (PHP): four hours of treatment for up to five days per week Intensive Outpatient program (IOP): three hours of treatment up to five days per week Extended Day Treatment (EDT) is a specialized therapeutic after-school support program that provides structured groups for three hours a day up to five days per week to learn and practice social skills such as group interaction, listening, cooperative leisure activities. Intensive In-Home Child & Adolescent Psychiatric Services(IICAPS): developed and monitored by the Yale University Child Study Center, provides in home services 2-3 times per week to help meet the needs of families with children with persistent psychiatric disorders. Client referral to a Child/Adolescent Treatment Program:- Referred from an inpatient program in Connecticut- Community providers (Child & Family Services; United Children & Families; Emergency Rooms)- School systems- Private providers (community psychiatrists or therapists)- Family and friendsTypical client experience in a Child/Adolescent Program:Initial referral phone call results in an intake appointment with a masters level clinician to complete a bio-psycho-social assessment. The client must be accompanied by their parent/guardian. After admission to the Program, the client/guardian meets with the psychiatrist/APRN for treatment planning and medication management.In a treatment day, clients arrive after being picked up from their school (or home) in one of Natchaug Hospital vans and will attend four groups in PHP and three groups in IOP. Groups include a psychotherapy group, educational groups and an activity group. The activity group is led by a Mental Health Worker or a CRS Staff member; all other groups are led by a masters level clinician. Education groups might include managing emotions; dangers of substance abuse; handling relationships, etc. Natchaug Hospital Group Levels: Psychotherapy/Process Group: is based on exploration and analysis of the interaction of a person's thoughts, feelings & beliefs and the group process for the purpose of facilitating an interpersonal change process and is led by a mental health professional with a graduate degree in a clinical discipline. Educational/Skills Group: Involves the acquisition of knowledge and/or skills, improved coping responses, or the sharing of experiences (such as Goals or Wrap-up Group). Group goals are to reduce stress, improve problem solving and learn new coping behaviors. This group is led by a staff member with documented training and/or experience in group leadership. The group includes: Registered Nurses, Certified Occupational Therapy Assistants, Mental Health Workers, Pharmacists, and Dieticians, CRS staff (music, art or recreational therapists).Leisure Activity Groups: involve the client/patient/student within a meeting/group format in order to practice the development of healthy social relationships. This may include a specific activity (art, music, games) planned with the goal of improving attention and/or social interactions; led by a staff member with the desire and supervisor-determined competency to lead a leisure activity group.Other points:Surveyed by Joint Commission using Behavioral Health Standards; PHP/IOP licensed by the Department of Public Health; EDT is licensed by the Department of Children & Families. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 9834494 | Expense |
| Revenue | 10967294 | Revenue |
| Description | EducationClinical Day Treatment School Programs (CDT)Natchaug's clinical day treatment programs, which are approved by the Connecticut Department of Education, offer special education services to students in grades 1 - 12 whose social, emotional or behavioral health problems prevent them from functioning successfully in a regular school environment. Each student's individual academic and clinical treatment plan is designed to address their special needs and return them to their regular schools as soon as possible. Natchaug Hospital schools operate in Enfield, Danielson, Mansfield, Norwich, Montville and Windham. Natchaug is also the contracted operator of two schools for the town of Norwich.Natchaug Hospital's Board of Directors serves a number of functions similar to a Board of Education, with responsibilities for the oversight and the implementation of certain State statutes and Federal legislation.Natchaug Hospital School Programs- Each school day, an average of 200 students attend Natchaug Hospital's school programs- Approved by the Connecticut Department of Education: Inpatient School Journey House School Clinical Day Treatment School in six sites - Natchaug contracts with the Norwich Public Schools to provide services located at: Deborah Tennant-Zinewicz Hickory Street SchoolStudents come to the Inpatient School on an emergency basis, and for non-educational reasons; school staff determines if the student receives special education services, and if there is an Individual Education Plan (IEP) to be implemented. Students come to the Journey House School on a planned basis and for non-educational reasons. Each student's school files are evaluated for proper placement in school. Girls who receive special education, Section 504, and regular education all are educated at the Journey School. Students come to the six CDT sites via a Planning and Placement Team (PPT) Meeting from their home school district. They may be placed on a diagnostic basis with PPT meetings every two weeks while psychiatric, psychological and educational assessments are performed. Students also may enter the program already receiving special education services with an IEP (Individualized Education Plan) in place.Students come to the Hickory Street School and DTZ School by placement by the Norwich Board of Education. All students are identified as special education and have an IEP in place.Transportation to all day school programs is provided by the Local Education Authority (LEA) that placed the student; however, transportation during the school day for field trips is often provided using Natchaug vans with school staff driving; sometimes school field trips are transported by outside vendors. Student Referral to the Inpatient and Journey Schools - Placement for non-educational reasons (inpatient or residential treatment admission)Student Referral to the six CDT sites - These are only made by the Local Education Authority (LEA), which is designated by the state to be the "town of nexus," which takes numerous requirements into consideration, such as where the parent resides. Referral to the Hickory and DTZ schools - These are only made by the Norwich Board of EducationDescription of typical day:A typical day in the Inpatient and Journey House School is a five-hour day that covers all academic areas, including electives of Art and PE. A typical day in the CDT schools is similar to any traditional school day, with academic subjects in addition to psycho-educational groups led by school clinicians. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 10196936 | Expense |
| Revenue | 10400148 | Revenue |
| Description | Natchaug Hospital provides inpatient acute behavioral health services for patients at its main site in Mansfield Center. Natchaug Hospital also operates a number of structured day programs providing partial hospital, intensive outpatient, extended day treatment, and outpatient services for persons with behavioral health and substance abuse treatment needs. These programs are provided at a variety of sites throughout eastern Connecticut. The Hospital also provides specialized residential treatment to adolescent girls in the care of the Connecticut Department of Children and Families. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 10196936 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 10400148 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 44965089 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 52 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 663 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Paul V Maloney | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8604561311 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 189 Storrs Road | AddressLine1 |
| City | Mansfield Center | City |
| State | CT | State |
| ZIP Code | 06226 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (29 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Colin K Rice | ||||||||
| Director (June 2012) | 2.00 | X | 0 | 0 | 0 | |||
| Antoinette Ellzey | ||||||||
| Director (June 2012) | 2.00 | X | 0 | 0 | 0 | |||
| Rev Laurence AM LaPointe | ||||||||
| Director (June 2012) | 2.00 | X | 0 | 0 | 0 | |||
| Harriotte W Wilson | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| William E Anderson Jr | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Edward S Sawicki MD | ||||||||
| Director (June 2012) | 2.00 | X | 0 | 0 | 0 | |||
| Carol A Wiggins PHD | ||||||||
| Chairman (June 2012) | 2.00 | X | 0 | 0 | 0 | |||
| Judith M Caracausa | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Pedro J Johnson | ||||||||
| Vice Chair | 2.00 | X | 0 | 0 | 0 | |||
| Karla Harbin Fox Esq | ||||||||
| Director (June 2012) | 2.00 | X | 0 | 0 | 0 | |||
| Stephen W Larcen PHD | ||||||||
| President & CEO | 40.00 | X | 0 | 467346 | 69180 | X | ||
| Kimberly A Colfer Esq | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Elizabeth B Ritter | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Dana R McGee Esq | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Nancy A Brouillet Esq | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| James E Watson MD | ||||||||
| Chairman | 2.00 | X | 0 | 0 | 0 | X | ||
| Michael G Pallein CPA | ||||||||
| Member-at-Large | 2.00 | X | 0 | 0 | 0 | |||
| Carolyn S Drescher | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Michael Kurland | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Michael C Nee MD | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Bernice Szafarek DMD | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| David Klein PHD | ||||||||
| VP & COO, Comm. Program | 40.00 | 169142 | 0 | 37367 | X | |||
| Paul Maloney | ||||||||
| CFO | 40.00 | 0 | 149772 | 29582 | X | |||
| Deborah Weidner | ||||||||
| CMO | 40.00 | 267841 | 0 | 32582 | X | |||
| Paul Weigle | ||||||||
| Psychiatrist | 40.00 | 172375 | 0 | 22604 | X | |||
| Jonathan L Chasen | ||||||||
| Psychiatrist | 40.00 | 217384 | 0 | 35544 | X | |||
| Pamela Shuman | ||||||||
| Psychiatrist | 40.00 | 193631 | 0 | 36751 | X | |||
| Teodora Andrei | ||||||||
| Psychiatrist | 40.00 | 217736 | 0 | 38293 | X | |||
| Paul G Pentz | ||||||||
| Psychiatrist | 40.00 | 177007 | 0 | 34207 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1415116 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 617118 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 336110 | TotalOtherCompensation |
| Number Individuals GT100 K | 30 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Aetna Insurance | |||||
| 25 Great Arrow Ave STE 23 | Buffalo | NY | 14207 | Insurance Services | 818690 |
| Staff Care Inc | |||||
| PO Box 281923 | Atlanta | GA | 30384 | Medical Services | 401870 |
| United Community & Family Services | |||||
| 34 East Town St | Norwich | CT | 06360 | Medical Services | 319571 |
| Mansfield Family Practice | |||||
| Mansfield Professional Park | Storrs | CT | 06268 | Medical Services | 218743 |
| Anthem Blue Cross Blue Shield | |||||
| 370 Bassett Road | North Haven | CT | 06473 | Insurance Services | 121322 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| All Other Contributions | 132429 | AllOtherContributions |
| Total Contributions | 132429 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Net Patient Revenue | Description |
| Business Code | 624100 | BusinessCode |
| Total Revenue Column | 47287791 | TotalRevenueColumn |
| Related Or Exempt Function Income | 47287791 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 47287791 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9844 | TotalRevenueColumn |
| Exclusion | $9,844 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 500 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 500 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 500 | TotalRevenueColumn |
| Exclusion | $500 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 47430564 | TotalRevenueColumn |
| Related Or Exempt Function Income | 47287791 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $10,344 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1528759 | Total |
| Program Services | 474658 | ProgramServices |
| Management And General | 1054101 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27908002 | Total |
| Program Services | 27885560 | ProgramServices |
| Fundraising | 22442 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1785386 | Total |
| Program Services | 1699657 | ProgramServices |
| Management And General | 84530 | ManagementAndGeneral |
| Fundraising | 1199 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5034042 | Total |
| Program Services | 4987349 | ProgramServices |
| Management And General | 42410 | ManagementAndGeneral |
| Fundraising | 4283 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2305186 | Total |
| Program Services | 2261698 | ProgramServices |
| Management And General | 41771 | ManagementAndGeneral |
| Fundraising | 1717 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 418741 | Total |
| Program Services | 418741 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 91700 | Total |
| Management And General | 91700 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71879 | Total |
| Management And General | 71879 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18441 | Total |
| Management And General | 18441 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1895848 | Total |
| Program Services | 1885789 | ProgramServices |
| Fundraising | 10059 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 53930 | Total |
| Program Services | 53930 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1930405 | Total |
| Program Services | 1928257 | ProgramServices |
| Fundraising | 2148 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 670302 | Total |
| Program Services | 670302 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 139790 | Total |
| Program Services | 139790 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 41772 | Total |
| Program Services | 41772 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 225786 | Total |
| Program Services | 225786 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 887474 | Total |
| Program Services | 887474 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 472702 | Total |
| Program Services | 472702 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| Medical Supplies | 524485 | 524485 |
| Repairs & Maintenance | 289735 | 289735 |
| Dues & Subscriptions | 88300 | 88300 |
| Education/Tech Training | 29104 | 29104 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46411769 | Total |
| Program Services | 44965089 | ProgramServices |
| Management And General | 1404832 | ManagementAndGeneral |
| Fundraising | 41848 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7250 | BOY |
| EOY | 8749 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 894437 | BOY |
| EOY | 1863528 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 241282 | BOY |
| EOY | 19168 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4253960 | BOY |
| EOY | 6058802 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 127971 | BOY |
| EOY | 121434 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 477762 | BOY |
| EOY | 137645 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 18278799 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 7143662 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11177564 | BOY |
| EOY | 11135137 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 53611 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 168466 | BOY |
| EOY | 106611 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17348692 | BOY |
| EOY | 19504685 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5723526 | BOY |
| EOY | 7999515 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3234650 | BOY |
| EOY | 2809866 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 349034 | BOY |
| EOY | 837503 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9307210 | BOY |
| EOY | 11646884 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7868019 | BOY |
| EOY | 7647801 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 173463 | BOY |
| EOY | 168000 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 42000 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8041482 | BOY |
| EOY | 7857801 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17348692 | BOY |
| EOY | 19504685 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1018795 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -1202476 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 1 | AccountantCompileOrReview |
| FS Audited | 0 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | 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) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 1 | DirectContactLegislators |
| Direct Contact Legislators | $18,441 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 0 | OtherActivities |
| Total Lobbying Expenditures IIB | 18441 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Explanation of Lobbying Activities: | Identifier |
| Return Reference | Part II-B, Line 1: | ReturnReference |
| Explanation | Natchaug Hospital paid Kenneth L. Przybysz LLC and Connecticut Hospital Association (CHA) for their lobbying efforts on behalf of the organization during the fiscal year. Both CHA and Mr. Przybysz lobbies Connecticut State Legislators in the interest of a group of specialty hospitals in the State of Connecticut. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 195897 | OtherCostOrOtherBasis |
| Book Value | 195897 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 13085151 | OtherCostOrOtherBasis |
| Depreciation | 4319938 | Depreciation |
| Book Value | 8765213 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1145517 | OtherCostOrOtherBasis |
| Depreciation | 240310 | Depreciation |
| Book Value | 905207 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2908705 | OtherCostOrOtherBasis |
| Depreciation | 1944566 | Depreciation |
| Book Value | 964139 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 943529 | OtherCostOrOtherBasis |
| Depreciation | 638848 | Depreciation |
| Book Value | 304681 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 11135137 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Due To Affiliates | $269,467 |
| Professional Liability | $568,036 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 837503 | TotalOfAmounts |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 250.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 201464 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 201464 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00430 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 14980067 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12097736 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2882331 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06210 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1892874 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1661564 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 231310 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00500 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 17074405 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13759300 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3315105 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07140 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 464464 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 464464 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01000 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 173130 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8000 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 165130 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00360 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 629508 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 629508 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01360 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 220786 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 220786 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00480 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1487888 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8000 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1479888 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03200 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 18562293 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13767300 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4794993 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10340 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $758,212 | BadDebtExpenseAmount |
| Amount Attributable To | 189553 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 3998115 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 4948303 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -950188 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| 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 | Natchaug Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 189 Storrs Rd PO Box 260 | AddressLine1 |
| City | Mansfield Center | City |
| State | CT | State |
| ZIP Code | 06250 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Natchaug Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 250.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 400.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Average Negotiated Rates | X | AverageNegotiatedRates |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 9 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (9 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| Care Plus | ||||
| 1353 Gold Star Highway | Center Groton | CT | 06340 | Day Treatment Center |
| Clinical Day Treatment Windham | ||||
| 345 Jackson Street | Willimantic | CT | 06226 | Day Treatment Center |
| Joshua Center-Northeast | ||||
| 934 North Main St | Danielson | CT | 06239 | Day Treatment Center |
| Joshua Center-Enfield | ||||
| 72 Shaker Road Suite 7 | Enfield | CT | 06082 | Day Treatment Center |
| Joshua Center-Montville | ||||
| 20 Maple Ave | Uncasville | CT | 06382 | Day Treatment Center |
| Quinebaug Day Treatment Center | ||||
| 320 Pomfret Street | Putnam | CT | 06260 | Day Treatment Center |
| Rivereast Day Treatment Center | ||||
| 428 Hartford Tpke | Vernon | CT | 06066 | Day Treatment Center |
| Thames Valley Clinical Day Program | ||||
| One Ohio Avenue | Norwich | CT | 06360 | Day Treatment Center |
| Joshua Center-Shoreline | ||||
| 5 Research Parkway | Old Saybrook | CT | 06475 | Day Treatment Center |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| Part I, Line 3c: Natchaug Hospital used Federal Poverty Guidelines to determine eligibility. | ||
| Part I, Line 7: The organization used cost to charge ratio as determined by the Medicare Cost Report. | ||
| Part I, Line 7g: No physician clinic costs were included in the Subsidized Health Services cost calculations. | ||
| Part I, L7 Col(f): The organization reported bad debt expense in accordance with Generally Accepted Accounting Principles (GAAP) Provision for Bad Debt ASU 2011-07. The provision require certain health care entities to present the provision for bad debts associated with patient services revenue as a deduction from patient service revenue rather than as an operating expense. | ||
| Part III, Line 4: For FY12 Natchaug Hospital, Inc., was not separately audited, however the parent entity Hartford HealthCare Corp. included Natchaug's financial results in its Consolidated Audited Financial Statement. The HHC's financial statements were provided in accordance with Generally Accepted Accounting Principles (GAAP). GAAP does not require a footnote for bad debt expenses, however, the charity care footnote reads as follows: "A patient is classified as a charity patient by reference to the established policies of the Hospital. Essentially, these policies define charity care services as those services for which no payment is anticipated. In assessing a patient's inability to pay, the Hospital utilizes the generally recognized poverty income levels for the State of Connecticut, but also includes certain cases where incurred charges are significant when compared to patients' incomes." In the event a patient fails to qualify for financial assistance or fails to pay their portion of discounted charges, and the patient does not pay timely their obligation to the Hospital, the Hospital reserves the right to institute and pursue collection actions and to pursue any remedies available at law or in equity, including but not limited to, imposing wage garnishments or filing and foreclosing on liens on primary residences or other assets, instituting and prosecuting legal actions and reporting the matter to one or more credit rating agencies. In the event the Hospital is unable to collect, the outstanding amounts are written off as bad debt. For those patients who qualify for financial assistance and are cooperating in good faith to resolve outstanding accounts, the Hospital may offer extended payment plans and will not impose collection efforts described above.For FY 2011, the amount reported on Part III, Line 3 was determined by reviewing the demographics as well as the insurance plans of the patients for whom accounts were written off as bad debt during the year and extrapolating likelihood that they would be eligible under the hospital's charity care program. For FY 2012, the hospital applied a ratio using the FY 2011 calculations. This ratio ( 25%) was applied to the current year bad debt expense to calculate the estimated amount for 2012.The hopsital received many incomplete Financial Assistance Package applications; if they were complete they would likely have counted as financial assistance. | ||
| Part III, Line 8: Providing care for those in need, including Medicare and Medicaid patients, and serving all patients regardless of ability to pay are an essential part of the community benefit standard, as well as our mission in our community. We serve these patients without regard to the payment shortfall. Therefore, Medicare shortfall should be considered a community benefit.The organization used a cost to charge ratio as determined by the Medicare Cost report. | ||
| Part III, Line 9b: The following is included in the Natchaug Hospital's Financial Assistance Policy: For those patients that qualify for financial assistance and who are cooperating in good faith to resolve the Hospital's outstanding accounts, the Hospital may offer extended payment plans to eligible patients, will not impose wage garnishments or liens on primary residences, will not send unpaid bills to outside collection agencies and will cease all collection efforts. | ||
| Part V, Section B, Line 13g: Policy is posted on internet | Natchaug Hospital, Inc. | |
| Part V, Section B, Line 19d: Part V, Section B, Linde 19b: Natchaug Hospital is in the process of adopting proposed 501r regulations. Once the regulations are final, the hospital will be in compliance. | Natchaug Hospital, Inc. | |
| Part VI, Line 2: In addition to the formal Windham County health needs assessment, Natchaug Hospital assesses data from the Connecticut Hospital Association (CHA) and providers throughout the state regarding bed availability and days in emergency departments while awaiting admission. Data from health needs assessments conducted by Backus Hospital, Lawrence & Memorial Hospital and the United Way is also reviewed. Needs are also assessed through Systems of Care meetings, and by tracking waiting lists for admission to programs. Natchaug utilizes all this data to respond to the needs of community served. | ||
| Part VI, Line 3: Natchaug informs and educates patients about their eligibility for financial assistance in a number of ways. Natchaug's financial assistance policy is available on the hospital's web site and signage is posted in admissions and waiting areas. The policy is also available upon request. Additionally, Natchaug employs three Financial Counselors who meet with patients to review payment options or process financial assistance applications. | ||
| Part VI, Line 4: Natchaug Hospital admits residents of, on average, 150 of Connecticut's 169 towns and six states each year. Natchaug Hospital's service area is comprised of 62 towns, primarily east of the Connecticut River, which together represent approximately half the State's land area. Natchaug Hospital's clients represent urban, suburban and rural areas. Admissions reflect the demographics and prevalence of behavioral health illnesses of the region: during FY 2012, admissions were composed of 54.5% female, 45.5% male; 1.04% American Indian or Alaskan Native, .38% Asian, 7.15% African American, 86.57 Caucasian, .05% Native Hawaiian, 4.8% other or unknown; 61.68% of clients were age 19 or older, 28.41% were between 12 and 18 years of age, 9.91% were age 4 to 11. The majority of Natchaug Hospital clients (approximately 76%) are financially stressed, as measured by the number of students meeting Federal free/reduced lunch criteria and the number of clients overall who are un insured or participating in a public support plan such as HUSKY, Medicaid or Medicare. | ||
| Part VI, Line 5: Natchaug Hospital staff actively contributes to the community. For example, Natchaug Hospital's Director of Pharmacy, Jose Scarpa, serves on the Experiential Education Advisory Board of UConn's School of Pharmacy, staffs a Migrant Farmers Clinic, serves on the Accreditation Council for Pharmacy Education, and more; Program Director Peter DeRosa serves on the Eastern Connecticut Chamber of Commerce's Health Advisory Committee and as a Chamber Trustee; Natchaug's Director of School Programs, Jill Bourbeau, serves as the Past President of CAPSEF, where she also sits on the Strategic Planning, Finance and Membership committees; Paul Kindall, Program Director of Natchaug's Enfield Joshua Center, serves on Healthy Enfield; two Natchaug staff serve on their local Boards of Education; at least three Program Directors serve their region's Systems of Care; and the Human Services Advisory Board for the Mansfield Town Council includes a representative from Natchaug.Natchaug Hospital provided seven Professional Development seminars on behavioral health topics for professionals working with school-age youth (school nurses, guidance counselors, teachers, etc), for free. The goals of these seminars are to 1) help identify treatable behavioral conditions as early as possible and 2) to improve awareness of effective classroom management of behaviorally-challenged youth.All members of the Board of Directors reside in our service area and are neither employees, family members, nor contractors of the Hospital. The Hospital extends medical staff privileges to all qualified physicians in its community. The Hospital uses its surplus funds to provide additional benefits to its patients and the community it serves. | ||
| Part VI, Line 6: Natchaug Hospital is an Affiliate of Hartford HealthCare Corporation (HHC). HHC strives to provide compassionate care designed to deliver the necessary health services needed by the community. The Strategic Planning and Community Benefit Committee of the HHC Board of Directors ensures the oversight for these services by each hospital community. In addition, HHC continues to take important steps toward achieving its vision of being "nationally respected for excellence in patient care and most trusted for personalized, coordinated care."HHC affiliation creates a strong integrated health care delivery system with a full continuum of care across a broader geographic area. This allows the small communities easy and expedient access to the more extensive and specialized services the larger hospitals are able to offer. This includes continuing education of health care professionals at all the affiliated institutions through the Center of Education, Simulation and Innovation located at Hartford Hospital, the largest of the system hospitals.The affiliation further enhances the hospitals' abilities to support their missions, identity, and respective community roles. This is achieved through integrated planning and communication to meet the changing needs of the region. This includes responsible decision making and appropriate sharing of services, resources and technologies, as well as cost containment strategies. | ||
| CT | Reports Filed With States | Part VI, Line 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (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 | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Stephen W Larcen PHD | |||||||||||||
| 0 | 338963 | 0 | 63228 | 0 | 65155 | 0 | 45900 | 0 | 23280 | 0 | 536526 | 0 | 0 |
| David Klein PHD | |||||||||||||
| 147974 | 0 | 21143 | 0 | 25 | 0 | 11109 | 0 | 26258 | 0 | 206509 | 0 | 0 | 0 |
| Paul Maloney | |||||||||||||
| 0 | 142905 | 0 | 6619 | 0 | 248 | 0 | 15271 | 0 | 14311 | 0 | 179354 | 0 | 0 |
| Deborah Weidner | |||||||||||||
| 258910 | 0 | 8906 | 0 | 25 | 0 | 12250 | 0 | 20332 | 0 | 300423 | 0 | 0 | 0 |
| Paul Weigle | |||||||||||||
| 160931 | 0 | 0 | 0 | 11444 | 0 | 0 | 0 | 22604 | 0 | 194979 | 0 | 0 | 0 |
| Jonathan L Chasen | |||||||||||||
| 211046 | 0 | 3422 | 0 | 2916 | 0 | 11526 | 0 | 24018 | 0 | 252928 | 0 | 0 | 0 |
| Pamela Shuman | |||||||||||||
| 189410 | 0 | 0 | 0 | 4221 | 0 | 9696 | 0 | 27055 | 0 | 230382 | 0 | 0 | 0 |
| Teodora Andrei | |||||||||||||
| 216611 | 0 | 1100 | 0 | 25 | 0 | 11100 | 0 | 27193 | 0 | 256029 | 0 | 0 | 0 |
| Paul G Pentz | |||||||||||||
| 176982 | 0 | 0 | 0 | 25 | 0 | 11038 | 0 | 23169 | 0 | 211214 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | See Part V | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | See Part V | Relationship |
| Amount Of Transaction | 154349 | AmountOfTransaction |
| Description Of Transaction | See Part V | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | Business Transactions Involving Interested Persons: | ReturnReference |
| Explanation | (a) Name of Person: William E. Anderson, Jr. (b) Relationship Between Interested Person and Organization: Director(c) Amount of Transactions: $154,349(d) Descrption of Transactions: Mr. Anderson is a board member at Natchaug Hospital. Mr. Anderson is currently an executive at the Savings Institute Bank & Trust. The bank does business with Windham Community Memorial Hospital and Natchaug Hospital. The Hospital paid the bank $154,349 for interest and principal payments on an outstanding loan.(e) Sharing of Organization's Revenue? No | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 1 | There were some board members whose term expired in June, 2012. As a result, they were not considered voting members at the end of the tax year. | |
| Form 990, Part VI, Section A, line 6 | Natchaug Hospital is organized as a non-stock not for profit entity. Hartford HealthCare Corporation is the sole member. | |
| Form 990, Part VI, Section A, line 7a | The sole member of the organization has the authority to approve/deny members of the governing body. | |
| Form 990, Part VI, Section A, line 7b | The sole member of the organization has the right to review, approve, disapprove and deny significant transactions such as mergers, acquisitions, dissolutions etc. | |
| Form 990, Part VI, Section B, line 11 | The Form 990 was prepared by Hartford HealthCare Corporation's Tax Department. It was then reviewed by an independent accounting firm. It was then forwarded to the organization's top management including the CFO for review. The Form was then made available to the board for review. Once the entire review process was completed, the form was signed by the CFO and then filed with the Internal Revenue Service. | |
| Form 990, Part VI, Section B, line 12c | The hospital's board has adopted the policy of the member, Hartford HealthCare Corporation (HHC). All directors, officers and senior management of the organization complete and sign a Conflict of Interest statement. The statement includes an itemization and description of any actual or potential conflict of interest and all material facts related thereto for such director, officer or senior manager by virtue of his or her activities or the activities of related persons. Directors, officers and senior managers are urged to be inclusive in this disclosure since the disclosure of potential and actual conflicts of interest is essential to ensuring discussion of the conflict. Conflict of Interest disclosure statements are returned to the HHC Office of Compliance, Audit & Privacy (OCAP). All disclosures are reviewed by OCAP under the direction of legal counsel and the HHC Executive Compliance Steering Committee (ECSC), who shall exercise good faith judgment as to whether a conflict exists. Legal counsel and the ECSC shall be responsible for monitoring transactions or arrangements in which a director, officer and senior management may have a conflict of interest and for assuring that the director, officer or senior management serves the hospital's best interests. OCAP, legal counsel and/or the ECSC may consult with any director, officer or senior manager and obtain information necessary for an ordinarily prudent person to make a judgment as to whether a conflict exists and each director, officer or senior manager shall cooperate with such requests. OCAP, legal counsel and/or the ECSC shall provide guidance to the director, officer or senior manager and to the board of directors as to the appropriate course of action. Legal counsel and the ECSC shall seek the advice and approval of the full Board of Directors in determining whether a conflict of interest exists and that the director, officer or senior manager serves the organization's best interests. When a conflict of interest is discovered, such director, officer or senior manager with the conflict will be required to refrain from participating in any discussion or action concerning such conflicted situation in accordance with policy. If, after completing and signing the annual disclosure statement, an actual or potential conflict arises, the director, officer or senior manager with the conflict shall promptly notify OCAP in writing. | |
| Form 990, Part VI, Section B, line 15b | The CEO and CFO scales are reviewed annually against surveys and reviewed and approved by the Hartford HealthCare Corporation Compensation Committee. These executives are compensated by Hartford Hospital, a related organization. Other executives are reviewed annually against market using Connecticut Hospital Association (CHA) data, Hartford Hospital (HH) data and appropriate published compensation surveys periodically and reviewed with the Hospital's independent Executive Committee of the Board annually. | |
| Form 990, Part VI, Section C, line 19 | Form 990 and Form 1023 and its attachments are available upon request. The Hospital's governing documents, financial statements and Conflict of Interest statements are also made available upon request. | |
| Form 990, Part XI, line 5: | Unrealized Pension Plan -1202476. Total to Form 990, Part XI, Line 5: -1202476. | Changes in Net Assets or Fund Balances: |
| Part XII, Lines 2 a & c | The organization's financial statement was not audited by an independent accounting firm. However, its operating results were including the the consolidated audited financial statement of the parent company. In addition, the parent organization has a committee that assumes responsibility for oversight of the audit of its financial statements. | |
| Form 990 Part VII, Column B | Certain employees listed on Part VII of Form 990 share their time between Natchaug Hospital and other related organizations. These are all full time employees that average 40-60 hours per week. Their hours and salaries are allocated between Hartford Hospital and Natchaug Hospital for expenditure purposes. | Average Hours Per Week |
| DISCLOSURE STATEMENT RELATED TO FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, FILED ON BEHALF OF THE TAXPAYER UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 5 FILER WITH RESPECT TO CERTAIN CONTROLLED FOREIGN CORPORATIONS (CFCS). THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE CFCS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. TAXPAYER NAME: HARTFORD HOSPITAL ADDRESS: 80 SEYMOUR STREET, PO BOX 5037 HARTFORD, CT 06102-5037 IDENTIFYING NUMBER OF U.S. TAX RETURN WITH WHICH THE FORMS 5471 WERE OR WILL BE FILED: 06-0646668 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED | Form 5471 Disclosure |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (25 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 | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Hartford Hospital | |||||||||||
| 80 Seymour Street | Hartford | CT | 06102 | 060646668 | Health Services | CT | 501 (c) (3) | 3 | Hartford HealthCare Corp | 1 | |
| Windham Community Memorial Hospital | |||||||||||
| 112 Mansfield Avenue | Willimantic | CT | 06226 | 060646966 | Health Services | CT | 501 (c) (3) | 3 | Hartford HealthCare Corp | 1 | |
| Windham Hospital Foundation Inc | |||||||||||
| 112 Mansfield Avenue | Willimantic | CT | 06226 | 562546632 | Supporting Organization | CT | 501 (c) (3) | 11 (a) | Windham Community Memorial Hospital | 1 | |
| Midstate Medical Center | |||||||||||
| 435 Lewis Avenue | Meriden | CT | 06451 | 060646715 | Health Services | CT | 501 (c) (3) | 3 | Hartford HealthCare Corp | 1 | |
| Hartford HealthCare Corp | |||||||||||
| 80 Seymour Street | Hartford | CT | 06102 | 222672834 | Support and Management Svcs. to Hartford Hospital and Affiliates | CT | 501 (c) (3) | 11 (c) | 1 | N/A | |
| VNA Health Care Inc | |||||||||||
| 103 Woodland Street | Hartford | CT | 06105 | 060646938 | Home Healthcare | CT | 501 (c) (3) | 7 | Hartford HealthCare Corp | 1 | |
| Rushford Center Inc | |||||||||||
| 883 Paddock Avenue | Meriden | CT | 06450 | 060932875 | Substance Abuse Healthcare Services | CT | 501 (c) (3) | 7 | Hartford HealthCare Corp | 1 | |
| Hartford Hospital Auxiliary co Hartford Hospital | |||||||||||
| 80 Seymour Street | Hartford | CT | 06115 | 066040747 | Fundraising | CT | 501 (c) (3) | 11 (c) | Hartford Hospital | 1 | |
| Connecticut Health System Inc | |||||||||||
| 80 Seymour Street | Hartford | CT | 06102 | 222779421 | Coordination of Health Delivery | CT | 501 (c) (3) | 11 (c) | 1 | N/A | |
| Institute of Living | |||||||||||
| 200 Retreat Avenue | Hartford | CT | 06106 | 060646683 | Psychiatric Services | CT | 501 (c) (3) | 11 (c) | Hartford Hospital | 1 | |
| VNA Resources Inc | |||||||||||
| 103 Woodland Street | Hartford | CT | 06105 | 061161422 | Home Healthcare | CT | 501 (c) (3) | 9 | VNA Health Care Inc | 1 | |
| The Hatch Hospital Corp | |||||||||||
| 112 Mansfield Avenue | Willimantic | CT | 06226 | 066076412 | Health Services | CT | 501 (c) (3) | 3 | Windham Community Memorial Hospital | 1 | |
| WCMH Women's Auxiliary Inc | |||||||||||
| 112 Mansfield Avenue | Willimantic | CT | 06226 | 060677728 | Fundraising | CT | 501 (c) (3) | 11 (a) | Windham Community Memorial Hospital | 1 | |
| The Hospital of Central CT and Bradley Memorial | |||||||||||
| 100 Grand Street | New Britain | CT | 06050 | 060646768 | Health Services | CT | 501 (c) (3) | 3 | Hartford HealthCare Corp | 1 | |
| Central CT Senior Health Svcs dba Southington Care | |||||||||||
| 45 Meriden Avenue | Southington | CT | 06489 | 222635676 | Sub-Acute & Long Term Healthcare | CT | 501 (c) (3) | 9 | Hartford HealthCare Corp | 1 | |
| Bradley Health Services | |||||||||||
| 100 Grand Street | New Britain | CT | 06050 | 061367014 | Health Services | CT | 501 (c) (3) | 9 | Hartford HealthCare Corp | 1 | |
| Central CT Health Alliance | |||||||||||
| 100 Grand Street | New Britain | CT | 06050 | 222785033 | Support and Management Svcs. to THOCC and Affiliates - Shell | CT | 501 (c) (3) | 11 (b) | Hartford HealthCare Corp | 1 | |
| (no name) | |||||||||||
| 1 | |||||||||||
| The Orchards of Southington | |||||||||||
| 34 Hobart Street | Southington | CT | 06489 | 061490803 | Residential Services for Senior Citizens | CT | 501 (c) (3) | 9 | Central CT Senior Health Services Inc | 1 | |
| Community Mental Health Affiliates | |||||||||||
| 270 John Downey Drive | New Britain | CT | 06051 | 060934544 | Mental Health & Substance Abuse Treatment Provider | CT | 501 (c) (3) | 7 | Hartford HealthCare Corp | 1 | |
| Mulberry Gardens of Southington LLC | |||||||||||
| 58 Mulberry Street | Plantsville | CT | 06479 | 820586577 | Assisted Living & Adult Day Care Facility | CT | 501 (c) (3) | 9 | Central Ct Senior Health Services Inc | 1 | |
| Midstate Medical Center Auxiliary | |||||||||||
| 435 Lewis Avenue | Meriden | CT | 06451 | 066063082 | Fundraising | CT | 501 (c) (3) | 3 | Midstate Medical Center | 1 | |
| HHC PhysiciansCare Inc | |||||||||||
| 80 Seymour Street | Hartford | CT | 06102 | 454456939 | Practice Medicine and Provide Health Care Services to the Public | CT | 501 (c) (3) | 9 | Hartford HealthCare Corp | 1 | |
| Hartford HealthCare Accountable Care Org Inc | |||||||||||
| 200 Retreat Avenue | Hartford | CT | 06102 | 460886367 | To Manage and Coordinate Care for Medicare Beneficiaries | CT | 501 (c) (3) | HHC PhysiciansCare Inc | 1 | ||
| Hartford HealthCare Corp Group (VEBA) | |||||||||||
| 777 Main Street | Hartford | CT | 06102 | 266671355 | To Provide Medical Benefits to Employees | CT | 501 (c) (9) | N/A | Hartford HealthCare Corp | 1 | |
Form990 Schedule R Part III Form990ScheduleRPartIII (10 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|
| Central CT Sports Medicine Ctr LLC | |||||||
| 15 Masairio Drive Suite 104 | Berlin | CT | 06037 | 223196509 | Physical Therapy | CT | N/A |
| New Britain MRI Limited Partnership | |||||||
| 100 Grand Street | New Britain | CT | 06050 | 061271349 | Magnetic Resonance Imaging | CT | N/A |
| New Britain Occupational Health Center LLC | |||||||
| 440 New Britain Avenue | Plainville | CT | 06062 | 061484904 | Occupational Healthcare | CT | N/A |
| Hartford HealthCare Endowment LLC | |||||||
| 80 Seymour Street | Hartford | CT | 06102 | 454181103 | Endowment Management | CT | N/A |
| Ambulance Service of Manchester LLC | |||||||
| 111 Founders Plaza | East Hartford | CT | 06108 | 061557358 | Ambulatory Services | CT | N/A |
| Glastonbury Endoscopy Center LLC | |||||||
| 300 Western Blvd Suite B | Glastonbury | CT | 06033 | 261721234 | Endoscopy Services | CT | N/A |
| Glastonbury Surgery Center LLC | |||||||
| 195 Eastern Boulevard | Glastonbury | CT | 06033 | 262600828 | Surgery Services | CT | N/A |
| Hartford-Middlesex Clinical System LLC | |||||||
| 80 Seymour Street | Hartford | CT | 06110 | 061543605 | Affiliate Support Services | CT | N/A |
| Med East Assoc LLC | |||||||
| 1703 West Main Street | Willimantic | CT | 06226 | 061469575 | Outpatient Care Clinic | CT | N/A |
| Connecticut Imaging Partners LLC | |||||||
| 111 Founders Plaza | East Hartford | CT | 06108 | 134298940 | Imaging Services | CT | N/A |
Form990 Schedule R Part IV Form990ScheduleRPartIV (10 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Address Line1AddressForeign/AddressLine1 | Province Or StateAddressForeign/ProvinceOrState | CountryAddressForeign/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HHMOB Corporation & Subsidiary | ||||||||||||
| 80 Seymour Street | Hartford | CT | 06102 | 061140244 | Real Estate Parking | CT | N/A | C | ||||
| CHS Insurance LTD | ||||||||||||
| Captive Insurance | N/A | C | 40 Church Street | Hamilton | BD | BD | ||||||
| Windham Health Services Inc | ||||||||||||
| 112 Mansfield Avenue | Willimantic | CT | 06226 | 061461101 | Home Healthcare | CT | N/A | C | ||||
| Windham Physician Hospital Organization | ||||||||||||
| 112 Mansfield Avenue | Willimantic | CT | 06226 | 061441614 | Medical Services | CT | N/A | C | ||||
| Windham Family Medical Services | ||||||||||||
| 112 Mansfield Avenue | Willimantic | CT | 06226 | 061491649 | Medical Services | CT | N/A | C | ||||
| CenConn Services Inc | ||||||||||||
| 100 Grand Street | New Britain | CT | 06050 | 222836001 | Investment Management | CT | N/A | C | ||||
| Grand Indemnity Co LTD FB Perry Building | ||||||||||||
| 980609499 | Professional Liability | N/A | C | 40 Church Street | Hamilton | BD | BD | |||||
| Hartford Physician Services PC | ||||||||||||
| 80 Seymour Street | Hartford | CT | 06102 | 061254082 | Medical Services | CT | N/A | C | ||||
| Meriden Imaging Center | ||||||||||||
| 101 North Plains Industrial Road | Meriden | CT | 06429 | 061541468 | Imaging | CT | N/A | S | ||||
| Hartford Physician Hospital Organization Inc | ||||||||||||
| 80 Seymour Street | Hartford | CT | 06102 | 222785918 | Physician & Hospital Support | CT | N/A | C | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Hartford Hospital | ||
| O | 139884 | FMV |
| Windham Community Memorial Hospital | ||
| L | 125092 | FMV |
| Windham Community Memorial Hospital | ||
| N | 202969 | FMV |
| Rushford Center Inc | ||
| N | 122640 | FMV |
| CHS Insurance Ltd | ||
| Q | 413129 | FMV |