2013-08-14T08:30:05-05:00 2012-09-30 346565596 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE SUITE 2600 INDIANAPOLIS IN 46204 990 2011-10-01 060646659 GREENWICH HOSPITAL GREE 2038633000 5 PERRYRIDGE ROAD GREENWICH CT 06830 EUGENE COLUCCI 2038633000 2013-08-12 0 P00032493 3172807471 2011 2016-02-24 21:20:13Z FRANK CORVINO 5 PERRYRIDGE ROAD GREENWICH CT 06830 330753681 0 X WWW.GREENHOSP.ORG X 1903 CT TO PROVIDE HEALTHCARE SERVICES. 28 23 2057 0 8469550 0 7821256 6463170 297010149 304346157 173082 780845 13102688 14224269 318107175 325814441 228900 203950 0 0 170464251 159479999 0 0 1460981 138601239 156480443 309294390 316164392 8812785 9650049 419099368 441659828 152754147 172435619 266345221 269224209 X TO PROVIDE HEALTHCARE SERVICES. 0 0 221856077 203950 307900824 SEE SCHEDULE O GREENWICH HOSPITAL, FOUNDED IN 1903, IS A 206-BED COMMUNITY TEACHING HOSPITAL THAT HAS EVOLVED INTO A PROGRESSIVE REGIONAL HEALTHCARE CENTER, AVERAGING MORE THAN 13,000 INPATIENT DISCHARGES AND 2,300 BIRTHS A YEAR. THE HOSPITAL OFFERS A WIDE RANGE OF MEDICAL, SURGICAL, DIAGNOSTIC, INTEGRATIVE MEDICINE AND WELLNESS PROGRAMS, AS WELL AS MEDICAL INNOVATIONS FROM ROBOTIC SURGERY TO SOPHISTICATED DIAGNOSTIC IMAGING TO NATIONAL CLINICAL TRIALS. GREENWICH HOSPITAL SERVES FAIRFIELD, CONNECTICUT AND WESTCHESTER, NEW YORK COUNTIES. GREENWICH HOSPITAL, A MEMBER OF YALE NEW HAVEN HEALTH SYSTEM SINCE 1998, IS A LEADER IN SERVICE EXCELLENCE, CONSISTENTLY RANKING IN THE TOP FIVE PERCENT NATIONALLY FOR PATIENT SATISFACTION. THE MAIN CAMPUS INCLUDES THE HELMSLEY MEDICAL BUILDING AND WATSON PAVILION. OTHER SPECIALIZED SERVICES INCLUDE THE BENDHEIM CANCER AND BREAST CENTERS, ENDOSCOPY CENTER, LEONA M. AND HARRY B. HELMSLEY AMBULATORY MEDICAL CENTER, THE RICHARD R. PIVIROTTO CENTER FOR HEALTH LIVING AND THE GREENWICH HOSPITAL DIAGNOSTIC CENTER IN STAMFORD. DURING FISCAL YEAR (FY) 2012, GREENWICH HOSPITAL PROVIDED APPROXIMATELY $25.6 MILLION IN COMMUNITY BENEFITS. THIS FIGURE INCLUDES $19.2 MILLION DOLLARS IN CHARITY CARE AND UNDER REIMBURSED MEDICAID (AT COST), $2.8 MILLION IN HEALTH PROFESSIONS EDUCATION AND $3.1 MILLION IN COMMUNITY HEALTH IMPROVEMENT AND EDUCATION ACTIVITIES, SUBSIDIZED SERVICES, RESEARCH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS. AN ADDITIONAL $594,000 WAS PROVIDED IN THE AREA OF COMMUNITY BUILDING ACTIVITIES, WHICH INCLUDED SUPPORT FOR ECONOMIC DEVELOPMENT, ENVIRONMENTAL IMPROVEMENTS, WORKFORCE DEVELOPMENT, COALITION BUILDING AND PHYSICAL IMPROVEMENT AND HOUSING. GREENWICH HOSPITAL HAS INVESTED A SIGNIFICANT AMOUNT OF TIME, MONEY AND RESOURCES IN THE DEVELOPMENT AND IMPLEMENTATION OF PUBLIC HEALTH PROJECTS TO IMPROVE HEALTH AND INCREASE ACCESS. 221856077 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 0 1 1 0 0 0 0 0 0 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 1 1 1 0 0 1 378 0 1 2057 1 1 1 0 0 0 0 1 1 0 0 0 0 X 28 23 1 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 X EUGENE COLUCCI 2038633000 5 PERRYRIDGE ROAD GREENWICH CT 06830 X JAMES M MCTAGGART 1.00 X 0 0 0 ALAN BREED 1.00 X 0 0 0 FRANK A CORVINO 36.00 X X 1302649 144739 157265 ELIZABETH GALT 1.00 X X 0 0 0 NANCY BROWN 1.00 X 0 0 0 JOHN L TOWNSEND III 1.00 X X 0 0 0 DONALD J KIRK 1.00 X 0 0 0 DANIEL L MOSLEY 1.00 X X 0 0 0 GAYLE L CAPOZZALO 1.00 X 0 1217519 203569 BRUCE L WARWICK 1.00 X 0 0 0 ARTHUR C MARTINEZ 1.00 X 0 0 0 SHIRLEE HILTON 1.00 X 0 0 0 BARBARA B MILLER 1.00 X X 0 0 0 JACK MITCHELL 1.00 X 0 0 0 BRUCE MOLINELLI MD 1.00 X 0 0 0 MARGARET MOORE 1.00 X 0 0 0 RICHARD O'CONNELL 1.00 X 0 0 0 NANCY RAQUET 1.00 X 0 0 0 VENITA OSTERER 1.00 X 0 0 0 WILLIAM R BERKLEY JR 1.00 X 0 0 0 KEVIN A CONBOY MD 1.00 X 0 0 0 DAVID EVANS MD 1.00 X 0 0 0 LARRY THOMPSON 1.00 X 0 0 0 AILEEN HOUGHTON 1.00 X 0 0 0 RICHARD BRAUER MD 1.00 X 0 0 0 ANNE JUGE 1.00 X 0 0 0 JOHN SCHMELTZER III 1.00 X 0 0 0 JOHN TONER 1.00 X 0 0 0 EUGENE J COLUCCI 26.00 X 350710 198735 170444 QUINTON J FRIESEN 40.00 X 711018 0 96151 SUSAN BROWN 40.00 X 319986 0 50952 NANCY LEVITT-ROSENTHAL 40.00 X 404814 0 115449 MELISSA TURNER 25.00 X 178109 106865 114524 CHRISTINE BEECHNER 40.00 X 147230 0 33780 STEPHEN CARBERY 40.00 X 232493 0 50026 MARC KOSAK 40.00 X 224998 0 37300 GEORGE PAWLUSH 40.00 X 223756 0 40944 BRIAN DORAN MD 40.00 X 475665 0 36208 DEBORAH HODYS 40.00 X 351601 0 0 STEPHEN GRAY 40.00 X 560222 0 48573 VICKI ALTMEYER 40.00 X 513257 0 49140 RICHARD EISEN 40.00 X 516688 0 63063 ERIC DIAMOND 40.00 X 495933 0 54709 MARVIN LIPSCHUTZ MD 40.00 X 462331 0 29948 7471460 1667858 1352045 267 0 1 0 GREENWICH ULTRASOUND ASSOC 67 HOLLY HILL RD GREENWICH CT 06830 ULTRASOUND SERVICE 2405922 NURSEFINDERS INC 524 E LAMAR BLVD SUITE 300 ARLINGTON TX 76011 TRAVEL NURSES 1841558 MAKIARIS MEDIA SERVICES 101 CENTERPOINT DRIVE SUITE 101 MIDDLETOWN CT 06457 ADVERTISING 1335491 UNITEX TEXTILE RENTAL 161 S MAQUESTEW PARKWAY MOUNT VERNON NY 10550 LAUNDRY/UNIFORM 1283197 QUEST DIAGNOSTICS 3 GIRALDA FARMS MADISON NJ 07940 LAB SERVICES 657481 55 1400444 5062726 809960 6463170 OUTPATIENT PROGRAM SER 621400 176050980 176050980 INPATIENT PROGRAM SERV 612990 119825627 119825627 OUTREACH LAB 621500 8469550 8469550 304346157 1487498 1487498 927267 261438 665829 665829 665829 2616905 644636 3797400 170794 -1180495 473842 -706653 -706653 200950 1400444 709608 -508658 -508658 PATHOLOGY SERVICES 900099 3305109 3305109 IT MEANINGFUL USE INCO 900099 2042881 2042881 CLINIC SERVICES 900099 1768057 1768057 6951051 6951051 14067098 325814441 309943705 8469550 938016 203950 203950 6697034 6697034 114258964 94943501 18512085 803378 9341042 7873499 1400920 66623 21339073 17883003 3304750 151320 7843886 6517878 1270856 55152 227119 5336 221783 267875 267875 54970776 18679261 36197524 93991 27886869 17838139 9930213 118517 7184969 4749948 2281813 153208 355135 355135 18733002 10470025 8262977 MEDICAL SUPPLY EXPENSE 23717620 23717620 BAD DEBTS 14042325 14042325 0 0 REPAIRS & MAINTENANCE 7311652 4433084 2859776 18792 MISCELLANEOUS 1783101 143373 1639728 0 316164392 221856077 92847334 1460981 15123907 10425113 39399924 35615361 32433460 36588520 1333264 2267969 4419164 6940318 412193660 177303255 239538682 234890405 25579025 24091928 44908669 67023871 16363273 23816343 419099368 441659828 28928788 29052230 45005000 42645000 78820359 100738389 152754147 172435619 X 234530748 230689355 24575081 29998840 7239392 8536014 266345221 269224209 419099368 441659828 X 9650049 -6771061 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 1 500 0 0 0 0 1 45393 0 0 1 32540 78433 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THE AMOUNT REPORTED IN "OTHER ACTIVITIES" REPRESENTS A PORTION OF PROFESSIONAL DUES ATTRIBUTABLE TO LOBBYING DURING FY 2012. THE HEALTH SYSTEM OFFICIALS HAD MEETINGS AND CONTACTS WITH STATE GOVERNMENT OFFICIALS, INCLUDING STATE LEGISLATURES AND THEIR STAFF TO DISCUSS VARIOUS HEALTH CARE REFORM PROPOSALS. GREENWICH HOSPITAL IS PART OF A CONTROLLED GROUP WITH THE FOLLOWING LOBBYING EXPENSES: YALE-NEW HAVEN HOSPITAL EIN 06-0646652 $431,000 BRIDGEPORT HOSPITAL EIN 06-0646554 $ 95,474 64905000 100000 10512000 2664000 72853000 69106000 45000 -1833000 2413000 64905000 66856000 0 4816000 2566000 69106000 68156000 0 2401000 3701000 66856000 0.52180 0.29910 0.17910 1 0 6333484 6333484 224926124 224926124 19857101 5368080 14489021 157629703 171173525 -13543822 3447248 761650 2685598 234890405 OTHER SECURITIES 67023871 F 67023871 OTHER RECEIVABLES 5701034 DUE FROM PERRYRIDGE 2101437 PROPERTY HELD IN TRUST 2100000 EPIC SHARED PROJECT 11851760 THIRD PARTY PAYOR RECEIVABLE 2062112 23816343 DUE - 3RD PARTY & OTHER PAYORS 30706201 ESTIMATED LIABILITY - SELF INSURANCE 9452217 FORWARD INTEREST RATE SWAP 6416626 ACCRUED PENSION 54163345 100738389 325814441 316164392 9650049 7889008 -1555740 6333268 15983317 328542619 7889008 1425183 9314191 319228428 6586013 6586013 325814441 312559302 497204 497204 312062098 4102294 4102294 316164392 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ENDOWED FUNDS' INTENDED USE IS TO GENERATE INCOME TO SUPPORT GREENWICH HOSPITAL PROGRAM SERVICE FUNCTIONS AND OTHER OPERATIONS IN ACCORDANCE WITH THE GREENWICH HOSPITAL POOLED INVESTMENT POLICY. PART XI, LINE 8 - OTHER ADJUSTMENTS: INCOME FROM FOUNDATION RECOGNIZED ON SEPARATE RETURN 665,565. UNREALIZED GAIN ON INTEREST RATE SWAP -423,000. AUXILIARY CONTRIBUTIONS 550,000. NET ASSETS RELEASED FROM OPERATIONS 3,759,497. FUNDRAISING EXPENSES - INCLUDED IN NON-OPERATING REVENUE -1,924,631. OTHER EXPENSES - INCLUDED IN NON-OPERATING REVENUE -1,202,248. INTEREST & INVESTMENT INCOME FROM TEMP RESTRICTED -1,345,000. RECLASS FROM EXPENSE - GAIN ON SALE OF ASSETS -473,842. AUXILIARY REVENUE -1,420,216. AUXILIARY EXPENSES 975,414. RENTAL EXPENSES - RECLASS FROM EXPENSES TO REVENUE 261,675. RENTAL EXPENSES - RECLASS FROM EXPENSES TO REVENUE -261,675. CONTRIBUTIONS FROM TEMPORARILY RESTRICTED -4,318,000. SPECIAL EVENTS RECLASS TO INCOME 709,608. RECLASS - INCOME ON SALE OF ASSETS 473,842. SPECIAL EVENTS RECLASS TO INCOME -709,608. FUNDRAISING EXPENSES FROM NON-OPERATING REVENUE 1,924,631. MISCELLANEOUS EXPENSE FROM NON-OPERATING REVENUE 1,202,248. TOTAL TO SCHEDULE D, PART XI, LINE 8: -1,555,740. PART XII, LINE 2D - OTHER ADJUSTMENTS: INCOME FROM FOUNDATION RECOGNIZED ON SEPARATE RETURN 665,565. UNREALIZED GAIN ON INTEREST RATE SWAP -423,000. AUXILIARY CONTRIBUTIONS 550,000. NET ASSETS RELEASED FROM OPERATIONS 3,759,497. FUNDRAISING EXPENSES - INCLUDED IN NON-OPERATING REVENUE -1,924,631. OTHER EXPENSES - INCLUDED IN NON-OPERATING REVENUE -1,202,248. PART XII, LINE 4B - OTHER ADJUSTMENTS: INTEREST & INVESTMENT INCOME FROM TEMP RESTRICTED 1,235,977. RECLASS FROM EXPENSE - GAIN ON SALE OF ASSETS -706,653. AUXILIARY REVENUE 1,420,216. CONTRIBUTIONS FROM TEMPORARILY RESTRICTED 4,318,000. SPECIAL EVENTS RECLASS TO INCOME -709,608. RENTAL EXPENSES - RECLASS FROM EXPENSES TO REVENUE -261,437. RECLASS GAIN ON INTEREST RATE SWAP 1,289,518. PART XIII, LINE 2D - OTHER ADJUSTMENTS: RECLASS - GAIN ON SALE OF ASSETS -473,842. SPECIAL EVENTS RECLASS TO INCOME 709,608. RENTAL EXPENSES - RECLASS FROM EXPENSES TO REVENUE 261,438. PART XIII, LINE 4B - OTHER ADJUSTMENTS: AUXILIARY EXPENSES 975,414. FUNDRAISING EXPENSES FROM NON-OPERATING REVENUE 1,924,632. MISCELLANEOUS EXPENSE FROM NON-OPERATING REVENUE 1,202,248. GALA 1134644 1043644 91000 463285 UNDER THE STARS 244672 190522 54150 133823 1 222078 166278 55800 112501 1601394 1400444 200950 709609 709609 -508659 1 1 X 1 X 1 X 1 1 0 1 1 2453 8066000 0 8066000 0.02670 21500 19465362 8322423 11142939 0.03690 0 0 0 23953 27531362 8322423 19208939 0.06360 19 24381 966825 0 966825 0.00320 4 189 4011015 1236940 2774075 0.00920 3 3616 3939009 2489288 1449721 0.00480 1 0 359690 0 359690 0.00120 5 7443 291875 0 291875 0.00100 32 35629 9568414 3726228 5842186 0.01940 32 59582 37099776 12048651 25051125 0.08300 1 0 552604 0 552604 0.00180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1757 32655 0 32655 0.00010 0 0 0 0 1 587 8396 0 8396 0.00000 0 0 0 0 4 2344 593655 593655 0.00190 1 5177405 79599575 108256122 -28656547 X 1 1 1 NONE NONE 1 1 GREENWICH HOSPITAL

5 PERRYRIDGE ROAD GREENWICH CT 06830

X X X X X GREENWICH HOSPITAL 1 1 1 250.000000000000 1 400.000000000000 0 1 1 X 1 0 1 X 0 1 19 GREENWICH HOSPITAL DIAGNOSTIC CENT

2015 WEST MAIN ST STAMFORD CT 06902

DI / LAB BOYD CENTER FOR MEDICAL ONCOLOGY

15 VALLEY DRIVE GREENWICH CT 06831

CANCER CENTER GREENWICH HOSPITAL OUTPATIENT SURG

55 HOLLY HILL LANE GREENWICH CT 06830

HOSPITAL OUT-PATIENT SURGERY ENDOSCOPY CENTER OF GREENWICH HOSPITAL

500 WEST PUTNAM AVE GREENWICH CT 06830

HOSPITAL OUT-PATIENT ENDOSCOPY GREENWICH HOSPITAL OCCUPAT HEALTH

75 HOLLY HILL LANE GREENWICH CT 06830

OCC. HEALTH / WOMENS HEALTH / LAB GREENWICH HOSPITAL LAB

49 LAKE AVE 2ND FLOOR GREENWICH CT 06830

LAB BENHEIM LINEAR

78 LAFAYETTE PLACE GREENWICH CT 06830

RADIATION THERAPY GREENWICH HOSITAL LAB

90 MORGAN STREET 3RD FLOOR SUITE 302 STAMFORD CT 06905

LAB GREENWICH HOSPITAL LAB

106 NOROTON AVENUE DARIEN CT 06820

LAB GREENWICH HOSPITAL LAB

159 WEST PUTNAM AVE 2ND FLOOR GREENWICH CT 06830

LAB GREENWICH HOSPITAL LAB

4 DEERFIELD DRIVE 2ND FLOOR GREENWICH CT 06830

LAB GREENWICH HOSPITAL LAB

40 CROSS ST 3RD FLOOR SUITE 350 NORWALK CT 06851

LAB GREENWICH HOSPITAL LAB

148 EAST AVE SUITE 1F NORWALK CT 06851

LAB GREENWICH HOSPITAL INTEGRATIVE MED

35 RIVER ROAD COS COB CT 06807

INTEGRATIVE MEDICINE GREENWICH HOSPITAL LAB

1275 SUMMER STREET 3RD FLOOR STAMFORD CT 06905

LAB GREENWICH HOSPITAL LAB

225 MAIN ST SUITE 101 WESTPORT CT 06880

LAB GREENWICH HOSPITAL LAB

15 VALEY DRIVE SUITE 200 GREENWICH CT 06831

LAB GREENWICH HOSPITAL LAB

90 SOUTH RIDGE STREET RYE NY 10573

LAB BENDHEIM CANCER CENTER

77 LAFAYETTE PLACE GREENWICH CT 06830

CANCER/CARDIAC REHAB/DI/LAB PART I, LINE 7: THE HOSPITAL USES A COST ACCOUNTING SYSTEM, TSI, TO CALCULATE THE AMOUNTS PRESENTED IN PART I, LINE 7. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS. PART I, L7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $14,042,325. PART II: GREENWICH HOSPITAL (GH) IS ONE OF THE TOP FIVE EMPLOYERS IN GREENWICH WITH 1,809 EMPLOYEES IN 2012. THE HOSPITAL PROVIDES IN-KIND AND FINANCIAL SUPPORT FOR SEVERAL ECONOMIC INITIATIVES THROUGHOUT FAIRFIELD AND WESTCHESTER COUNTIES. MEMBERS OF THE HOSPITAL'S LEADERSHIP AND MANAGEMENT STAFF ALSO SUPPORT ECONOMIC DEVELOPMENT BY SERVING ON THE BOARDS OF THE GREENWICH CHAMBER OF COMMERCE AND THE PORT CHESTER-RYE BROOK-RYE TOWN CHAMBER OF COMMERCE.GREENWICH HOSPITAL ALONG WITH MANY OTHER HOSPITALS ACROSS THE COUNTRY UTILIZES THE COMMUNITY BENEFITS INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA) DATABASE DEVELOPED BY LYON SOFTWARE TO CATALOG ITS COMMUNITY BENEFIT AND COMMUNITY BUILDING ACTIVITIES AND THE GUIDELINES DEVELOPED BY THE CATHOLIC HOSPITAL ASSOCIATION (CHA) IN ORDER TO CATALOG THESE BENEFITS. THESE TWO ORGANIZATIONS HAVE WORKED TOGETHER FOR OVER TWENTY YEARS TO PROVIDE SUPPORT TO NON-FOR-PROFIT HOSPITALS TO DEVELOP AND SUSTAIN EFFECTIVE COMMUNITY BENEFIT PROGRAMS.THE MOST RECENT VERSION OF THE CHA GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFIT DEFINES COMMUNITY BUILDING ACTIVITIES AS PROGRAMS THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS AND ENVIRONMENTAL PROBLEMS. THESE ACTIVITIES ARE CATEGORIZED INTO EIGHT DISTINCT AREAS INCLUDING PHYSICAL IMPROVEMENT AND HOUSING, ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT, ENVIRONMENTAL IMPROVEMENTS, LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS, COALITION BUILDING, ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENTS, AND WORKFORCE DEVELOPMENT. WHILE GH'S VISION IS TO BE THE PREMIER REGIONAL HEALTH CARE PROVIDER, THE HOSPITAL IS INCREASINGLY AWARE OF HOW SOCIAL DETERMINANTS IMPACT THE HEALTH OF INDIVIDUALS AND COMMUNITIES. RESEARCH FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION AND HEALTH AND HUMAN SERVICES CLEARLY LINKS THE IMPACT OF ONE'S SOCIOECONOMIC STATUS TO ONE'S HEALTH. INCORPORATING ALL THE DATA AND RESEARCH THAT IS AVAILABLE ON LOCAL, REGIONAL AND FEDERAL LEVELS THE COMMUNITY BUILDING ACTIVITIES AT GREENWICH HOSPITAL ARE MULTI-PRONGED AND DIVERSE. THESE PROGRAMS ARE DEVELOPED AND IMPLEMENTED COLLABORATIVELY WITH OTHERS IN THE COMMUNITY TO ADDRESS COMMUNITY HEALTH NEEDS AND IMPROVE THE HEALTH OF ALL COMMUNITY MEMBERS.DURING FISCAL YEAR 2012, GREENWICH HOSPITAL PROVIDED NEARLY $594,000 IN FINANCIAL AND IN-KIND DONATIONS. THE HOSPITAL CONSIDERS THESE INVESTMENTS PART OF ITS OVERALL COMMITMENT OF BUILDING STRONGER NEIGHBORHOODS. EXAMPLES BELOW FOCUS ON THE AREAS OF REVITALIZING OUR NEIGHBORHOODS AND CREATING EDUCATIONAL OPPORTUNITIES.REVITALIZING OUR NEIGHBORHOODSONE OF SEVERAL COMMUNITY INITIATIVES UNDERTAKEN BY GREENWICH HOSPITAL IS GOD'S GREEN MARKET. THIS PROGRAM IS ADMINISTERED IN COLLABORATION WITH THE COUNCIL OF COMMUNITY SERVICES AND AREA CHURCHES TO PROVIDE FRESH VEGETABLES TO PARTICIPANTS IN PORT CHESTER'S FOUR FOOD PANTRIES AND SEVEN SOUP KITCHEN AND NUTRITION CENTERS. THE COUNCIL OF COMMUNITY SERVICES ORGANIZES VOLUNTEERS TO PLANT AND HARVEST THE CROPS. OVER THE PAST FIVE YEARS THE PROGRAM HAS PROVIDED THOUSANDS OF LOW-INCOME PORT CHESTER FAMILIES WITH FRESH VEGETABLES AND SPONSORS HEALTH EDUCATIONAL PROGRAMS THAT PROMOTE HEALTHIER EATING. THE HOSPITAL FUNDS THE INITIATIVE AND THE HOSPITAL'S DIETITIANS AND NURSES PROVIDED NUTRITION EDUCATION AND HEALTHY RECIPES IN BOTH ENGLISH AND SPANISH.GREENWICH HOSPITAL AND THE AARP CO-SPONSORED AN EDUCATIONAL DRIVING PROGRAM FOR OLDER ADULTS WITH APPROXIMATELY 267 WESTCHESTER AND FAIRFIELD COUNTY ADULTS ATTENDING THE PROGRAM. THE EDUCATIONAL DRIVING PROGRAM PROMOTES SAFETY AND IS INTENDED TO REDUCE ACCIDENT RATES AMONG DRIVERS AGE 55 AND OLDER. GREENWICH HOSPITAL WAS THE RECIPIENT OF A DONATION OF FUNDS TO DEVELOP A COMMUNITY FLOWER GARDEN ON ITS PROPERTY TO BE OPEN TO THE PUBLIC. VARIOUS COMMUNITY CEREMONIES AND CELEBRATIONS ARE CONDUCTED IN THE GARDEN INCLUDING CANCER SURVIVOR PROGRAMS AND THE TREE OF LIGHT PROGRAM. EACH WINTER, GREENWICH HOSPITAL PROVIDES A WARM CENTER FOR THE COMMUNITY IN ITS NOBLE CONFERENCE CENTER. THIS WARM CENTER IS AVAILABLE TO THOSE IN NEED DUE TO POWER OUTAGES, SNOW STORMS AND FREEZING TEMPERATURES. INCLUDED IN THE WARM CENTER ARE COTS, HOT BEVERAGES, HAND WARMERS AND MAGAZINES.CREATING EDUCATIONAL OPPORTUNITIES GREENWICH HOSPITAL THROUGH A JOINT EFFORT WITH HIGH SCHOOLS IN PORT CHESTER AND GREENWICH PROVIDED AN EDUCATIONAL PROGRAM INTRODUCING STUDENTS TO HEALTH CARE CAREER OPPORTUNITIES. A TOTAL OF 27 STUDENTS PARTICIPATED IN THE PROGRAM, WHICH IS AIMED AT EDUCATING AND INSPIRING STUDENTS TO PURSUE FULFILLING HEALTH CARE CAREERS. THE AFTER-SCHOOL PROGRAM WAS HELD OVER FOUR WEEKS AND INCLUDED A TOUR OF GREENWICH HOSPITAL AND ITS JOHN AND ANDREA FRANK SYN:APSE SIMULATION CENTER. THE SIMULATION CENTER OFFERS HANDS-ON TRAINING USING A HIGH-FIDELITY MANNEQUIN THAT CAN SPEAK AND RESPOND PHYSIOLOGICALLY TO MEDICATIONS AND TREATMENT. AS PART OF SUMMER EDUCATION PROGRAMS, 14 SUMMER INTERN STUDENTS FROM THE OPEN DOOR FAMILY MEDICAL CENTER IN PORT CHESTER, NY, AND 15 STUDENTS FROM COMMUNITY CENTERS, INC., (CCI) IN GREENWICH, SPENT THE DAY AT THE HOSPITAL LEARNING ABOUT VARIOUS HEALTH CARE CAREERS.GREENWICH HOSPITAL ALSO PROVIDED MIDDLE AND HIGH SCHOOL STUDENTS THE OPPORTUNITY TO GET AN IN-DEPTH LOOK INTO VARIOUS HEALTH CARE CAREERS THROUGH AN AFTER-SCHOOL PROGRAM SPONSORED IN PARTNERSHIP WITH THE BOY SCOUTS OF AMERICA'S GREENWICH CHAPTER. WHILE TOURING THE HOSPITAL, PARTICIPANTS LEARNED ABOUT A VARIETY OF HOSPITAL SETTINGS AND SPOKE WITH PROFESSIONALS IN THE MEDICAL FIELD. PART III, LINE 4: THE HOSPITAL'S COMMITMENT TO COMMUNITY SERVICE IS EVIDENCED BY SERVICES PROVIDED TO THE POOR AND BENEFITS PROVIDED TO THE BROADER COMMUNITY. SERVICES PROVIDED TO THE POOR INCLUDE SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTHCARE BECAUSE OF INADEQUATE RESOURCES AND/OR WHO ARE UNINSURED OR UNDERINSURED.THE HOSPITAL MAKES AVAILABLE FREE CARE PROGRAMS FOR QUALIFYING PATIENTS. IN ACCORDANCE WITH THE ESTABLISHED POLICIES OF THE HOSPITAL, DURING THE REGISTRATION, BILLING AND COLLECTION PROCESS A PATIENT'S ELIGIBILITY FOR FREE CARE FUNDS IS DETERMINED.FOR PATIENTS WHO WERE DETERMINED BY THE HOSPITAL TO HAVE THE ABILITY TO PAY BUT DID NOT, THE UNCOLLECTED AMOUNTS ARE BAD DEBT EXPENSE. FOR PATIENTS WHO DO NOT AVAIL THEMSELVES OF ANY FREE CARE PROGRAM AND WHOSE ABILITY TO PAY CANNOT BE DETERMINED BY THE HOSPITAL, CARE GIVEN BUT NOT PAID FOR, IS CLASSIFIED AS CHARITY CARE.TOGETHER, CHARITY CARE AND BAD DEBT EXPENSE REPRESENT UNCOMPENSATED CARE. THE ESTIMATED COST OF TOTAL UNCOMPENSATED CARE IS APPROXIMATELY $13.2 MILLION AND $13.0 MILLION FOR THE YEARS ENDED SEPTEMBER 30, 2012 AND 2011, RESPECTIVELY. THE ESTIMATED COST OF UNCOMPENSATED CARE IS DETERMINED BY THE HOSPITAL'S COST ACCOUNTING SYSTEM. THIS ANALYSIS CALCULATES THE ACTUAL PERCENTAGE OF ACCOUNTS WRITTEN OFF OR DESIGNATED AS BAD DEBT VS. CHARITY CARE WHILE TAKING INTO ACCOUNT THE TOTAL COSTS INCURRED BY THE HOSPITAL FOR EACH ACCOUNT ANALYZED.THE ESTIMATED COST OF CHARITY CARE PROVIDED WAS $8.1 MILLION AND $9.2 MILLION FOR THE YEARS ENDED SEPTEMBER 30, 2012 AND 2011, RESPECTIVELY. THE ESTIMATED COST OF CHARITY CARE IS DETERMINED BY THE HOSPITAL'S COST ACCOUNTING SYSTEM.FOR THE YEARS ENDED SEPTEMBER 30, 2012 AND 2011, BAD DEBT EXPENSE, AT CHARGES, WAS $14.0 MILLION AND $9.3 MILLION, RESPECTIVELY. THE BAD DEBT EXPENSE IS MULTIPLIED BY THE RATIO OF COST TO CHARGES FOR PURPOSES OF INCLUSION IN THE TOTAL UNCOMPENSATED CARE AMOUNT IDENTIFIED ABOVE.THE CONNECTICUT DISPROPORTIONATE SHARE HOSPITAL PROGRAM ("CDSHP") WAS ESTABLISHED TO PROVIDE FUNDS TO HOSPITALS FOR THE PROVISION OF UNCOMPENSATED CARE AND IS FUNDED, IN PART, BY A 1% ASSESSMENT ON HOSPITAL NET INPATIENT SERVICE REVENUE. DURING THE YEARS ENDED SEPTEMBER 30, 2012 AND 2011, THE HOSPITAL RECEIVED $4.6 MILLION AND $1.9 MILLION, RESPECTIVELY, IN CDSHP DISTRIBUTIONS, OF WHICH APPROXIMATELY $2.8 MILLION AND $1.3 MILLION WAS RELATED TO CHARITY CARE. THE HOSPITAL MADE PAYMENTS INTO THE CDSHP OF $12.1 MILLION AND $3.0 MILLION FOR THE YEARS ENDED SEPTEMBER 30, 2012 AND 2011, RESPECTIVELY, FOR THE 1% ASSESSMENT.ADDITIONALLY, THE HOSPITAL PROVIDES BENEFITS FOR THE BROADER COMMUNITY WHICH INCLUDES SERVICES PROVIDED TO OTHER NEEDY POPULATIONS THAT MAY NOT QUALIFY AS POOR BUT NEED SPECIAL SERVICES AND SUPPORT. BENEFITS INCLUDE THE COST OF HEALTH PROMOTION AND EDUCATION OF THE GENERAL COMMUNITY, INTERNS AND RESIDENTS, HEALTH SCREENINGS, AND MEDICAL RESEARCH. THE BENEFITS ARE PROVIDED THROUGH THE COMMUNITY HEALTH CENTERS, SOME OF WHICH SERVICE NON-ENGLISH SPEAKING RESIDENTS, DISABLED CHILDREN, AND VARIOUS COMMUNITY SUPPORT GROUPS. IN ADDITION TO THE QUANTIFIABLE SERVICES DEFINED ABOVE, THE HOSPITAL PROVIDES ADDITIONAL BENEFITS TO THE COMMUNITY THROUGH ITS ADVOCACY OF COMMUNITY SERVICE BY EMPLOYEES. THE HOSPITAL'S EMPLOYEES SERVE NUMEROUS ORGANIZATIONS THROUGH BOARD REPRESENTATION, MEMBERSHIP IN ASSOCIATIONS AND OTHER RELATED ACTIVITIES. THE HOSPITAL ALSO SOLICITS THE ASSISTANCE OF OTHER HEALTHCARE PROFESSIONALS TO PROVIDE THEIR SERVICES AT NO CHARGE THROUGH PARTICIPATION IN VARIOUS COMMUNITY SEMINARS AND TRAINING PROGRAMS.COSTING METHODOLOGY:IN ACCORDANCE WITH THE ESTABLISHED POLICIES OF THE HOSPITAL, DURING THE REGISTRATION, BILLING AND COLLECTION PROCESS A PATIENT'S ELIGIBILITY FOR FREE CARE FUNDS IS DETERMINED. FOR PATIENTS WHO WERE DETERMINED BY THE HOSPITAL TO HAVE THE ABILITY TO PAY BUT DID NOT, THE UNCOLLECTED AMOUNTS ARE BAD DEBT EXPENSE. THE HOSPITAL'S COST ACCOUNTING SYSTEM UTILIZES PATIENT-SPECIFIC DATA TO ACCUMULATE AND DERIVE COSTS RELATED TO THESE BAD DEBT ACCOUNTS. PART III, LINE 8: THE ENTIRE MEDICARE LOSS PRESENTED SHOULD BE TREATED AS A COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO MEDICARE BENEFICIARIES, IRS REVENUE RULING 69-545 INDICATES THAT HOSPITALS OPERATE FOR THE PROMOTION OF HEALTH IN THE COMMUNITY WHEN IT PROVIDES CARE TO PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, THE ORGANIZATION PROVIDES CARE TO MEDICARE PATIENTS REGARDLESS OF MEDICARE SHORTFALLS (REDUCING THE BURDEN ON THE GOVERNMENT), AND MANY OF THE MEDICARE PARTICIPANTS WOULD HAVE QUALIFIED FOR THE CHARITY CARE OR OTHER MEANS TESTED PROGRAMS ABSENT BEING ENROLLED IN THE MEDICARE PROGRAM. THE MEDICARE SHORTFALL REPORTED IS DETERMINED BY THE HOSPITAL'S COST ACCOUNTING SYSTEM, TSI. PART III, LINE 9B: IF AT ANY POINT IN THE DEBT COLLECTION PROCESS, THE HOSPITAL, INCLUDING ANY EMPLOYEE OR AGENT OF THE HOSPITAL, OR A COLLECTION AGENT ACTING ON BEHALF OF THE HOSPITAL, RECEIVES INFORMATION THAT A PATIENT IS ELIGIBLE FOR HOSPITAL BED FUNDS, FREE OR REDUCED PRICE HOSPITAL SERVICES, OR ANY OTHER PROGRAM WHICH WOULD RESULT IN THE ELIMINATION OF LIABILITY FOR THE DEBT OR REDUCTION IN THE AMOUNT OF SUCH LIABILITY, THE HOSPITAL OR COLLECTION AGENT WILL PROMPTLY DISCONTINUE COLLECTION EFFORTS AND, IF A COLLECTION AGENT, REFERS THE ACCOUNT BACK TO THE HOSPITAL FOR DETERMINATION OF ELIGIBILITY. THE COLLECTION EFFORT WILL NOT RESUME UNTIL SUCH DETERMINATION IS MADE. GREENWICH HOSPITAL PART V, SECTION B, LINE 19D: ALL PATIENTS ARE CHARGED STANDARD GROSS CHARGES. FAP ELIGIBLE INDIVIDUALS ARE CHARGED AT STANDARD GROSS CHARGES. AFTER A PATIENT IS GRANTED FREECARE, THEY WOULD NOT BE BILLED - THE CHARGES ARE ADJUSTED OFF THE ACCOUNT. GREENWICH HOSPITAL PART V, SECTION B, LINE 21: ALL PATIENTS ARE CHARGED STANDARD GROSS CHARGES. FAP ELIGIBLE INDIVIDUALS ARE CHARGED AT STANDARD GROSS CHARGES. AFTER A PATIENT IS GRANTED FREECARE, THEY WOULD NOT BE BILLED - THE CHARGES ARE ADJUSTED OFF THE ACCOUNT. PART VI, LINE 2: GREENWICH HOSPITAL (GH) IS A 206-BED (INCLUDING BASSINETS) REGIONAL HOSPITAL, SERVING FAIRFIELD COUNTY, CONNECTICUT AND WESTCHESTER COUNTY, NEW YORK. IT IS A MAJOR ACADEMIC AFFILIATE OF YALE UNIVERSITY SCHOOL OF MEDICINE AND A MEMBER OF THE YALE NEW HAVEN HEALTH SYSTEM. SINCE OPENING IN 1903, GREENWICH HOSPITAL HAS EVOLVED INTO A PROGRESSIVE MEDICAL CENTER AND TEACHING INSTITUTION WITH AN INTERNAL MEDICINE RESIDENCY. GREENWICH HOSPITAL REPRESENTS ALL MEDICAL SPECIALTIES AND OFFERS A WIDE RANGE OF MEDICAL, SURGICAL, DIAGNOSTIC AND WELLNESS PROGRAMS.GREENWICH HOSPITAL IS A COMMUNITY HOSPITAL DEDICATED TO PROVIDING QUALITY, VALUE DRIVEN HEALTH CARE. INDIVIDUALS WITHIN THE COMMUNITIES SERVED BY GREENWICH HOSPITAL ARE ASSURED ACCESS TO QUALITY HEALTH CARE REGARDLESS OF ABILITY TO PAY. GH HAS MADE A CONCERTED EFFORT TO REACH OUT TO ALL OF THOSE WHO REQUIRE HEALTH CARE SERVICES. THE COMMUNITIES THAT THE HOSPITAL SERVES IN FAIRFIELD COUNTY, CT AND WESTCHESTER COUNTY, NY REPRESENT A WIDE SPECTRUM OF SOCIOECONOMIC GROUPINGS. THE CLOSING OF TWO WESTCHESTER COUNTY HOSPITALS (UNITED HOSPITAL MEDICAL CENTER AND SAINT AGNES HOSPITAL) HAS HAD A PROFOUND EFFECT ON BOTH INCREASED VOLUME AND UNCOMPENSATED CARE AT THE HOSPITAL.THE GREENWICH HOSPITAL BOARD OF TRUSTEES IS DIRECTLY INVOLVED IN COMMUNITY BENEFITS THROUGH A SUBCOMMITTEE CALLED THE COMMUNITY ADVISORY COMMITTEE (CAC). A BOARD OF TRUSTEES MEMBER CHAIRS THE CAC, WHICH MEETS QUARTERLY TO DISCUSS THE COMMUNITY BENEFIT STRATEGY AS WELL AS SPECIFIC COMMUNITY OUTREACH ACTIVITIES BASED ON IDENTIFIED NEEDS. THE CAC INCLUDES 30 MEMBERS WHO REPRESENT A VARIETY OF COMMUNITY ORGANIZATIONS SUCH AS THE UNITED WAY, YMCA, YWCA, HOUSES OF WORSHIP, LOCAL MUNICIPAL HEALTH DEPARTMENTS, HISPANIC HEALTH COUNCIL, FAMILY CENTERS, NATIONAL ASSOCIATION FOR THE ADVANCEMENT OF COLORED PEOPLE, COUNCIL OF COMMUNITY SERVICES, HOUSING AUTHORITIES OF GREENWICH AND PORT CHESTER AND OTHER PRIVATE AND CORPORATE GROUPS. THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF GREENWICH HOSPITAL AND SEVERAL OTHER SENIOR LEVEL ADMINISTRATORS REGULARLY ATTEND CAC MEETINGS. THE CAC CHAIRMAN PROVIDES UPDATES ON COMMUNITY BENEFIT PROGRAMS AT BOARD OF TRUSTEES MEETINGS.THE CAC ESTABLISHED THE COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP (CHIP) IN 2003 TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. AS PART OF ITS CENTENNIAL CELEBRATION, THE HOSPITAL, UNDER THE DIRECTION OF CAC, CONDUCTED A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT. QUANTITATIVE DATA WERE COLLECTED THROUGH A 65 QUESTION CUSTOMIZED GENERAL POPULATION SURVEY. THREE THOUSAND SURVEYS WERE MAILED, AND ONE THOUSAND FOUR HUNDRED TWENTY-ONE SURVEYS WERE COMPLETED. THE SURVEY WAS ALSO TRANSLATED INTO SPANISH TO OBTAIN INFORMATION FROM THE GROWING LATINO COMMUNITY. QUALITATIVE DATA WERE COLLECTED THROUGH COMMUNITY DISCUSSION GROUPS TARGETING SPECIFIC AUDIENCES (MENTAL HEALTH PROVIDERS, SENIOR SERVICE PROVIDERS, SERVICE AGENCIES, ETC.). OVER 250 PEOPLE ATTENDED ONE OF THE TWENTY OPEN DISCUSSION GROUPS.THE CHIP AND THE CAC SET THE FOLLOWING GOALS FOLLOWING THE 2003 COMMUNITY HEALTH NEEDS ASSESSMENTS. THE TARGETS INCLUDED: A.EXPANDING DENTAL HEALTH SERVICES FOR THE UNINSUREDB.EXPANDING MENTAL HEALTH EDUCATIONAL PROGRAMS AND SERVICESC.INCREASING ACCESS TO SERVICES FOR VULNERABLE POPULATIONSD.PROVIDING TARGETED SERVICES TO PEOPLE WITH LOWER LEVELS OF HEALTH LITERACY (E.G., INDIVIDUALS FROM OTHER COUNTRIES, ETC.)E.CREATING A DIRECTORY OF COMMUNITY SERVICES AND PROGRAMSF.PROMOTING COLLABORATIVE OPPORTUNITIES AND ACTIVITIES BETWEEN HEALTHCARE PROVIDERS AND SERVICES. DATA COLLECTED THROUGH THE ASSESSMENT WERE REPORTED TO THE COMMUNITY THROUGH A HEALTH SUMMIT HELD AT THE LOCAL LIBRARY. OVER ONE HUNDRED PEOPLE ATTENDED THE EVENT. THE COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP (CHIP) CONTINUES TO MEET MONTHLY AND ADDRESSES HEALTH EDUCATION, HEALTH AND WELLNESS PROMOTION, AND ACCESS TO HEALTHCARE. THE MEMBERS OF THE CHIP ARE REPRESENTATIVES AND MEMBERS OF THE DEPARTMENT OF HEALTH, DEPARTMENT OF SOCIAL SERVICES, THE UNITED WAY, NUMEROUS SOCIAL SERVICES ORGANIZATIONS, BOARD OF EDUCATION, PTA, LEAGUE OF WOMEN'S VOTERS, GREENWICH HOUSING AUTHORITY, CHILD GUIDANCE CENTERS, GREENWICH POLICE DEPARTMENT, FAMILY CENTERS, INC., PATHWAYS AND INTERESTED COMMUNITY MEMBERS. THIS IS A VERY DIVERSE COLLABORATIVE GROUP COMPOSED OF PROFESSIONALS AND LAYPEOPLE THAT HAVE A VESTED INTEREST IN THE HEALTH OF THEIR COMMUNITIES.ATTAINING THE GOALS DEFINED BY THE NEEDS ASSESSMENT IS POSSIBLE THROUGH COLLABORATIVE EFFORTS AND RELATIONSHIPS THAT HAVE BEEN ESTABLISHED AND BUILT BETWEEN THE HOSPITAL AND COMMUNITY GROUPS. SOME OF THE OTHER COMMUNITY PARTNERS THAT PROVIDE NEEDS ASSESSMENT DATA AND INFORMATION THAT IS UTILIZED IN PLANNING HEALTH PROGRAMS TO MEET THE NEEDS OF THE COMMUNITY INCLUDE THE HISPANIC HEALTH COUNCIL, THE COUNCIL OF COMMUNITY SERVICES, THE LOCAL FEDERALLY QUALIFIED HEALTH CENTERS, MUNICIPAL DEPARTMENTS OF HEALTH, SCHOOLS, LIBRARIES, HOUSES OF WORSHIP, PARENT GROUPS, PTA, SENIOR SERVICES AND VARIOUS COMMUNITY SERVICE ORGANIZATIONS. THE HOSPITAL PROVIDES STAFF AND FINANCIAL SUPPORT FOR THE COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP WHICH CONDUCTS INFORMAL HEALTH ASSESSMENTS VIA THE COMMUNICATION AND REPORTING BY THE MEMBERS OF THE PARTNERSHIP. OVER THE LAST SEVERAL YEARS, THE CHIP HAS IMPLEMENTED OVER 75 HEALTH INITIATIVES THAT BENEFIT THE COMMUNITY. CHIP MEETINGS ARE HELD MONTHLY.DURING FY 2012, GREENWICH HOSPITAL INTERVIEWED VARIOUS CONSULTING FIRMS TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT AND ASSIST WITH THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES. A CONSULTING FIRM WAS ENGAGED IN LATE AUGUST AND A WORK PLAN DEVELOPED FOR FY 2013. THIS EFFORT WILL BUILD UPON EXISTING DATA AND ASSESSMENTS PROVIDED BY EXTERNAL AGENCIES AND ORGANIZATIONS THROUGH FOCUS GROUPS AND STAKEHOLDER INTERVIEWS. PART VI, LINE 3: PATIENTS WILL OBTAIN INFORMATION ON ELIGIBILITY FOR GOVERNMENT OR HOSPITAL PROGRAMS FROM INFORMATION DISTRIBUTED BY THE HOSPITAL. PATIENTS WILL BE ALERTED TO THE FINANCIAL ASSISTANCE PROGRAMS IN A NUMBER OF WAYS, INCLUDING NOTICES IN ENGLISH AND SPANISH POSTED IN APPROPRIATE LOCATIONS IN THE HOSPITAL, A SUMMARY OF FREE CARE AVAILABILITY AND INFORMATION ON HOW TO APPLY FOR FREE CARE (REFERRED TO AS THE "HOSPITAL'S NOTICE OF AVAILABILITY OF FUNDS"), INFORMATION DISTRIBUTED VIA MAIL AND / OR IN THE HOSPITAL'S ADMISSION PACKAGE, AND INFORMATION ON THE HOSPITAL'S WEB SITE. INFORMATION WILL ALSO BE PROVIDED WHEN DIRECT INQUIRIES ARE MADE TO GH. THERE IS ALSO ACCESS TO A TRANSLATION TELEPHONE.THE HOSPITAL WILL PROVIDE NOTICE AND INFORMATION IN A MANNER THAT (A) COMPLIES WITH THE REQUIREMENTS OF LAW, INCLUDING CONNECTICUT LAW CONCERNING HOSPITAL FUNDS, AND (B) IS DESIGNED TO MAKE INFORMATION EASILY AVAILABLE AND ACCESSIBLE TO ALL PATIENTS.ALL PATIENTS WILL HAVE ACCESS TO INFORMATION REGARDING ESTIMATED CHARGES FOR PARTICULAR SERVICES OR ACTUAL CHARGES FOR HOSPITAL SERVICES THAT HAVE BEEN PROVIDED. PART VI, LINE 4: GREENWICH HOSPITAL (GH) IS A 206-BED (INCLUDING BASSINETS) REGIONAL HOSPITAL, SERVING FAIRFIELD COUNTY, CONNECTICUT AND WESTCHESTER COUNTY, NEW YORK. IT IS A MAJOR ACADEMIC AFFILIATE OF YALE UNIVERSITY SCHOOL OF MEDICINE AND A MEMBER OF THE YALE NEW HAVEN HEALTH SYSTEM. SINCE OPENING IN 1903, GREENWICH HOSPITAL HAS EVOLVED INTO A PROGRESSIVE MEDICAL CENTER AND TEACHING INSTITUTION WITH AN INTERNAL MEDICINE RESIDENCY PROGRAM. GREENWICH HOSPITAL SERVES PATIENTS, THEIR FAMILIES AND THE COMMUNITY AT LARGE IN LOWER FAIRFIELD COUNTY AND WESTCHESTER COUNTY. THE PRIMARY GEOGRAPHIC AREA SERVED BY GREENWICH HOSPITAL INCLUDES THE CONNECTICUT TOWNS OF GREENWICH, DARIEN, NEW CANAAN AND STAMFORD AS WELL AS THE NEW YORK TOWNS OF PORT CHESTER, RYE, HARRISON, LARCHMONT AND MAMARONECK. APPROXIMATELY 29% OF HOUSEHOLDS HAVE INCOMES LESS THAN $50,000 WHILE 42% OF HOUSEHOLDS HAVE INCOMES BETWEEN $50,000 AND $150,000 AND THE REMAINING 29% OF HOUSEHOLDS HAVE INCOMES GREATER THAN $150,000. THE SECONDARY GEOGRAPHIC COVERAGE AREA OF THE HOSPITAL ENCOMPASSES A WIDE RANGE OF TOWNS INCLUDING NORWALK, WESTON, WESTPORT AND WILTON IN CONNECTICUT AND ARMONK, BEDFORD, HARTSDALE, KATONAH, MOUNT KISCO, MOUNT VERNON, NEW ROCHELLE, POUND RIDGE, PURCHASE, SCARSDALE, SOUTH SALEM, WEST HARRISON, AND WHITE PLAINS IN NEW YORK. SEVERAL NON-PROFIT HOSPITALS ARE LOCATED IN THE AREA INCLUDING STAMFORD HOSPITAL AND NORWALK HOSPITAL IN CONNECTICUT IN ADDITION TO WHITE PLAINS HOSPITAL, WESTCHESTER MEDICAL CENTER AND SOUND SHORE HOSPITAL IN NEW YORK. GREENWICH HOSPITAL REPRESENTS ALL MEDICAL SPECIALTIES AND OFFERS A WIDE RANGE OF MEDICAL, SURGICAL, DIAGNOSTIC AND WELLNESS PROGRAMS. IN FISCAL YEAR 2012, THERE WERE 43,587 VISITS TO THE HOSPITAL'S EMERGENCY DEPARTMENT OF WHICH 7,663 BECAME INPATIENTS AND 35,924 WERE OUTPATIENTS ONLY. IN THAT SAME FISCAL YEAR, THE HOSPITAL'S INPATIENT VOLUME CONSISTED OF A DIVERSE PAYER MIX WITH 6 PERCENT MEDICAID PATIENTS, 38 PERCENT MEDICARE PATIENTS, 53 PERCENT MANAGED CARE/COMMERCIAL PATIENTS AND 3 PERCENT SELF PAY OR OTHER PATIENTS. THE HIGH QUALITY OF CARE COUPLED WITH GREENWICH HOSPITAL'S CONVENIENT LOCATION, ARE SOME OF THE MANY REASONS PATIENTS CHOOSE TO BE TREATED HERE. PART VI, LINE 5: GREENWICH HOSPITAL, FOUNDED IN 1903, IS A 206-BED COMMUNITY TEACHING HOSPITAL THAT HAS EVOLVED INTO A PROGRESSIVE REGIONAL HEALTHCARE CENTER, AVERAGING MORE THAN 13,000 INPATIENT DISCHARGES AND 2,300 BIRTHS A YEAR. THE HOSPITAL OFFERS A WIDE RANGE OF MEDICAL, SURGICAL, DIAGNOSTIC, INTEGRATIVE MEDICINE AND WELLNESS PROGRAMS, AS WELL AS MEDICAL INNOVATIONS FROM ROBOTIC SURGERY TO SOPHISTICATED DIAGNOSTIC IMAGING TO NATIONAL CLINICAL TRIALS. IT IS A MAJOR ACADEMIC AFFILIATE OF YALE UNIVERSITY SCHOOL OF MEDICINE AND A MEMBER OF THE YALE NEW HAVEN HEALTH SYSTEM.THE STATE-OF-THE-ART MAIN CAMPUS INCLUDES THE HELMSLEY MEDICAL BUILDING AND WATSON PAVILION. OTHER SPECIALIZED SERVICES INCLUDE THE BENDHEIM CANCER AND BREAST CENTERS, ENDOSCOPY CENTER, LEONA M. AND HARRY B. HELMSLEY AMBULATORY MEDICAL CENTER, THE RICHARD R. PIVIROTTO CENTER FOR HEALTHY LIVING AND THE GREENWICH HOSPITAL DIAGNOSTIC CENTER IN STAMFORD.AS A COMMUNITY HEALTH CARE SERVICES PROVIDER, GREENWICH HOSPITAL REMAINS ATTENTIVE TO HEALTH AND WELL-BEING THROUGH EDUCATION, OUTREACH AND OTHER INNOVATIVE SERVICES. DURING FISCAL YEAR 2012, GREENWICH HOSPITAL MANAGED $25.1 MILLION IN FINANCIAL AND IN-KIND CONTRIBUTIONS THROUGH FIVE WIDE-RANGING PROGRAMS - GUARANTEEING ACCESS TO CARE; PROMOTING HEALTH AND WELLNESS; ADVANCING CAREERS IN HEALTH CARE; RESEARCH; AND CREATING HEALTHIER COMMUNITIES. A SIXTH CATEGORY, BUILDING STRONGER NEIGHBORHOODS, WAS PREVIOUSLY DISCUSSED IN RESPONSE TO QUESTION 5.GUARANTEEING ACCESS TO CAREGREENWICH HOSPITAL (GH) RECOGNIZES THAT SOME PATIENTS MAY BE UNINSURED, NOT HAVE ADEQUATE HEALTH INSURANCE OR OTHERWISE LACK THE RESOURCES TO PAY FOR HEALTH CARE. IN FY 2012, THE TOTAL COMMUNITY BENEFIT ASSOCIATED WITH GUARANTEEING ACCESS TO CARE WAS $20.6 MILLION. HONORING ITS MISSION AND ITS COMMITMENT TO THE COMMUNITY, THE HOSPITAL PARTICIPATES IN GOVERNMENT-SPONSORED PROGRAMS SUCH AS MEDICARE, MEDICAID, HUSKY, CHAMPUS AND TRICARE. DURING FY 2012, GH PROVIDED SERVICES FOR 21,500 MEDICAID BENEFICIARIES AT A TOTAL EXPENSE OF $11.1 MILLION (AT COST). ADDITIONALLY, THE HOSPITAL ASSISTED OVER 1,200 CONNECTICUT AND NEW YORK PATIENTS WITH MEDICAID APPLICATIONS AND MEDICAID ELIGIBILITY QUESTIONS DURING FY 2012. GH ALSO OFFERS A SLIDING SCALE OF DISCOUNTED FEES AND FREE CARE FOR ELIGIBLE PATIENTS. DURING FY 2012, THE HOSPITAL DELIVERED SUCH FINANCIAL ASSISTANCE SERVICES FOR AT A TOTAL EXPENSE OF $8.1 MILLION (AT COST). ALSO DURING FY 2012, HOSPITAL STAFF DISTRIBUTED NEARLY 2,000 APPLICATIONS FOR HOSPITAL FREE BED FUNDS THAT RESULTED IN FREE CARE OF NEARLY $1.8 MILLION. THE FUNDS WERE DONATED TO GREENWICH HOSPITAL BY INDIVIDUALS OR TRUSTS TO BE USED FOR FINANCIAL ASSISTANCE TO PATIENTS WHOM PAYMENT FOR THEIR HOSPITAL SERVICES WOULD BE A FINANCIAL HARDSHIP.GREENWICH HOSPITAL ALSO GUARANTEES ACCESS TO CARE BY PROVIDING CLINICAL PROGRAMS DESPITE A FINANCIAL LOSS SO SIGNIFICANT THAT NEGATIVE MARGINS REMAIN AFTER REMOVING THE EFFECTS OF FREE CARE, BAD DEBT AND UNDER-REIMBURSED MEDICAID. SUBSIDIZED HEALTH SERVICES INCLUDE THE OUTPATIENT CENTER'S MEDICAL (INCLUDING DIABETES) AND BEHAVIORAL HEALTH CLINICS. EACH YEAR, MORE THAN 5,000 ADULTS AND CHILDREN VISIT THE OUTPATIENT CENTER AND PEDIATRIC OUTPATIENT CENTER FOR DIAGNOSIS, TREATMENT AND PREVENTIVE CARE. GREENWICH HOSPITAL WAS ONCE AGAIN THE BENEFICIARY OF A GRANT FROM THE BREAST CANCER ALLIANCE TO PROVIDE FUNDING FOR FREE SCREENING AND DIAGNOSTIC MAMMOGRAM SERVICES FOR WOMEN WHO ARE UNINSURED OR UNDERINSURED. IN CALENDAR YEAR 2012, 191 UNINSURED WOMEN RECEIVED FREE SCREENING MAMMOGRAMS. AMONG THE WOMEN NEEDING FURTHER TESTING, 22 HAD FREE UNILATERAL DIAGNOSTIC MAMMOGRAMS, 7 HAD FREE BILATERAL DIAGNOSTIC MAMMOGRAMS AND 27 RECEIVED FREE ULTRASOUND EXAMINATIONS. IN ADDITION, 131 NEWLY DIAGNOSED BREAST CANCER PATIENTS RECEIVED EDUCATION RESOURCE NOTEBOOKS WITH INFORMATION ABOUT LOCAL SUPPORT AND CANCER RESOURCES THAT CAN PROVIDE ASSISTANCE.PROMOTING HEALTH AND WELLNESSDURING FY 2012, GREENWICH HOSPITAL PROVIDED $967,000 IN COMMUNITY HEALTH IMPROVEMENT SERVICES, INCLUDING HEALTH EDUCATION PROGRAM, SUPPORT GROUPS AND HEALTH FAIRS. EXAMPLES OF THESE IMPORTANT SERVICES AND PROGRAMS, MANY IN COLLABORATION WITH OTHER ORGANIZATIONS, ARE PROVIDED BELOW.THE HOSPITAL LED COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP, WHICH MEETS MONTHLY TO IDENTIFY COMMUNITY NEEDS AND IMPLEMENT HEALTH PROGRAMS ORGANIZED A HEALTH AND WELLNESS FAIR, WHICH WAS HELD AT THE HAMILTON AVENUE SCHOOL IN COLLABORATION WITH COMMUNITY PARTNERS, INCLUDING THE UNITED WAY, GREENWICH EMERGENCY MEDICAL SERVICE, GREENWICH POLICE DEPARTMENT, GREENWICH DEPARTMENT OF HEALTH, THE GREENWICH ALLIANCE, FAMILY CENTER AND THE HOUSING AUTHORITY OF THE TOWN OF GREENWICH. MORE THAN 300 PEOPLE RECEIVED FREE HEALTH SCREENINGS AND INFORMATION ON COMMUNITY RESOURCES. ANOTHER EVENT COORDINATED THROUGH THE COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP WAS, "NO KIDDING! ME, TOO!", HELD AT THE GREENWICH LIBRARY AND HOSTED BY JOE PANTOLIANO, EMMY-AWARD WINNING ACTOR, WRITER AND DIRECTOR. IN THIS DOCUMENTARY FILM, MR. PANTIOLIANO INTERVIEWS PEOPLE WHO ARE AFFECTED BY MENTAL ILLNESS. THE FILM WAS CREATED TO HELP REDUCE THE STIGMA OF MENTAL ILLNESS. FOLLOWING THE SHOWING, A PANEL OF MENTAL HEALTH PROVIDERS INCLUDING A PSYCHIATRIST FROM GREENWICH HOSPITAL, A PSYCHOLOGIST FROM GREENWICH HIGH SCHOOL, A FAMILY THERAPIST FROM THE CHILD GUIDANCE CENTER AND TWO YOUNG ADULTS AFFLICTED WITH MENTAL ILLNESS SHARED THEIR OWN BATTLES WITH THIS DISEASE. OVER 250 MEMBERS OF THE COMMUNITY ATTENDED THE EVENT. IN 2012, THROUGH THE COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP, GREENWICH HOSPITAL SPONSORED MENTAL HEALTH FIRST AID, A NATIONWIDE PUBLIC EDUCATION PROGRAM THAT HELPS PEOPLE IDENTIFY AND RESPOND TO SIGNS OF MENTAL ILLNESSES AND SUBSTANCE USE DISORDERS. THE 12-HOUR CERTIFICATE COURSE, WHICH WAS OFFERED IN PARTNERSHIP WITH THE TOWN OF GREENWICH, COVERS RISK FACTORS AND WARNING SIGNS OF MENTAL HEALTH PROBLEMS, AS WELL AS THEIR IMPACT AND COMMON TREATMENTS. IT HAS BENEFITED A VARIETY OF AUDIENCES, INCLUDING PRIMARY CARE PROFESSIONALS, EMPLOYERS AND BUSINESS LEADERS, FAITH COMMUNITIES, SCHOOL PERSONNEL AND EDUCATORS, NURSING HOME STAFF, VOLUNTEERS AND FAMILIES. THIRTY-TWO MEMBERS OF THE COMMUNITY ATTENDED THE TWO-DAY PROGRAM.AS THE HOSPITAL'S OUTREACH DEPARTMENT, COMMUNITY HEALTH AT GREENWICH HOSPITAL AND COMMUNITY HEALTH OF FAIRCHESTER ARE DEDICATED TO IMPROVING THE HEALTH STATUS OF COMMUNITIES IN CONNECTICUT AND NEW YORK. BOTH ENTITIES MAINTAIN A STRONG COMMUNITY PRESENCE THROUGH ITS NUMEROUS PARTNERSHIPS WITH THE YALE NEW HAVEN HEALTH SYSTEM, LOCAL AND REGIONAL COMMUNITY ORGANIZATIONS, SCHOOLS, GOVERNMENT AGENCIES, CORPORATIONS AND OTHER GREENWICH HOSPITAL DEPARTMENTS. CH@GH AND CHF SUPPORT THE HOSPITAL'S MISSION TO PROVIDE A FULL CONTINUUM OF CARE BY OFFERING INNOVATIVE HEALTH SCREENINGS, SPEAKERS, SUPPORT GROUPS, SCHOOL PROGRAMS, HEALTH EDUCATION AND WELLNESS PROGRAMS DESIGNED TO PROMOTE HEALTH AND INCREASE ACCESS TO HEALTHCARE SERVICES.GREENWICH HOSPITAL PARTICIPATED IN MORE THAN 36 HEALTH FAIRS REACHING AN ESTIMATED 10,000 PEOPLE AT VARIOUS COMMUNITY SITES WITH THE GOAL OF INCREASING PEOPLE'S KNOWLEDGE AND HEALTH LITERACY. THE FAIRS WERE HELD AT SCHOOLS, MULTI-HOUSING DEVELOPMENTS, HOUSES OF WORSHIP, PARKS, YOUTH AND SENIOR CENTERS IN WESTCHESTER AND FAIRFIELD COUNTIES. PARTICIPANTS RECEIVED INFORMATION AND EDUCATION ABOUT EXERCISE, HEALTHY HABITS/BEHAVIORS, HAND WASHING/HYGIENE, IMMUNIZATION, HEALTH SCREENINGS, SUN SAFETY, CHOLESTEROL, STROKE, WEIGHT MANAGEMENT, NUTRITION, BREAST SELF-EXAMS, SMOKING CESSATION AND MORE. HOSPITAL STAFF ALSO OFFERED FREE BLOOD PRESSURE AND METABOLIC SCREENINGS ALONG WITH EDUCATIONAL COUNSELING ON HEALTHY LIVING. THE HOSPITAL ALSO PROVIDED MORE THAN 200 INDIVIDUALS WITH INFORMATION FROM VENDORS SPECIALIZING IN DIABETIC CARE AND CONDUCTED FREE DIABETES-RELATED HEALTH SCREENINGS. THE GREENWICH DEPARTMENT OF HEALTH, THE GREENWICH COMMISSION ON AGING AND GREENWICH HOSPITAL SPONSORED AN ANNUAL SENIOR HEALTH, WHICH OFFERED FREE HEALTH EDUCATION, SCREENINGS AND RESOURCE REFERRALS TO MORE THAN 400 OLDER ADULTS. IN ADDITION, 62 FREE CHOLESTEROL SCREENINGS WERE CONDUCTED AT THE EVENT. COMMUNITY HEALTH OF FAIRCHESTER ALSO PARTICIPATED IN THE WESTCHESTER COUNTY SALUTE TO SENIORS PROGRAM IN WHITE PLAINS, WHICH DREW MORE THAN 500 AREA RESIDENTS.GREENWICH HOSPITAL THROUGH THE NURSE IS IN PROGRAM, PROVIDED FREE BLOOD PRESSURE SCREENINGS AND HEALTH COUNSELING TO 5,358 PEOPLE AT LOCAL LIBRARIES, YMCAS AND SENIOR CENTERS IN CONNECTICUT AND NEW YORK. AN ADDITIONAL 2,790 FREE BLOOD PRESSURE SCREENINGS WERE CONDUCTED AT OTHER COMMUNITY SITES. THE HOSPITAL'S PARISH NURSE PROGRAM, A PARTNERSHIP WITH THE FIRST CONGREGATIONAL CHURCH OF GREENWICH, PROVIDES MORE THAN 2,000 CHURCH MEMBERS WITH HEALTH EDUCATION PROGRAMS, SUPPORT GROUPS, FLU SHOTS AND SCREENINGS ALL CONDUCTED OR COORDINATED BY A REGISTERED NURSE. PART VI, LINE 5: DURING FY 2012, GREENWICH HOSPITAL RECEIVED VARIOUS AWARDS AND RECOGNITION INCLUDING: THE 2012 JOHN D. THOMPSON AWARD FOR "EXCELLENCE IN DELIVERY OF HEALTHCARE THROUGH THE USE OF DATA", BY THE CONNECTICUT HOSPITAL ASSOCIATION; A 2012 MERIT AWARD FROM THE U.S. ENVIRONMENTAL PROTECTION AGENCY FOR CREATING "HEALING RAIN GARDENS" THAT REDUCE POLLUTION AND PROMOTE A HEALTHY ENVIRONMENT FOR PATIENTS. IT WAS ONE OF JUST TWO NEW ENGLAND HOSPITALS TO BE HONORED WITH THE AWARD. THE HOSPITAL ALSO RECEIVED TWO AWARDS FROM THE CONNECTICUT QUALITY IMPROVEMENT AWARD PARTNERSHIP - GOLD AWARD FOR ITS MULTIMODAL ANALGESIC REGIME FOR JOINT REPLACEMENT SURGERY AND A SILVER AWARD FOR "IMPACT OF SUBTLE COGNITIVE DEFICITS ON READMISSIONS". GREENWICH HOSPITAL WAS ALSO RECOGNIZED WITH THE "GET WITH THE GUIDELINES" STROKE SILVER PLUS QUALITY ACHIEVEMENT AWARD FROM THE AMERICAN HEART ASSOCIATION / AMERICAN STROKE ASSOCIATION, WHICH RECOGNIZES THE HOSPITAL'S COMMITMENT TO IMPLEMENTING A HIGHER STANDARD OF STROKE CARE BY ENSURING THAT STROKE PATIENTS RECEIVE TREATMENT ACCORDING TO NATIONALLY ACCEPTED STANDARDS AND RECOMMENDATIONS.THE HOSPITAL'S SIMULATION CENTER ADDED ADDITIONAL TRAINING TOOLS IN FY 2012. THE YALE NEW HAVEN HEALTH SYSTEM SUPPORTED CENTER FEATURES A SIMULATED INPATIENT HOSPITAL ROOM AND REALISTIC, HIGH-FIDELITY "PATIENTS" THAT CAN BE PROGRAMMED TO BREATHE, SPEAK, BLINK, SWEAT, BLEED AND RESPOND PHYSIOLOGICALLY TO MEDICATIONS AND TREATMENT. THIS TYPE OF MEDICAL SIMULATION IS BENEFICIAL TO STAFF AND EDUCATORS AND IS AN INTEGRAL TOOL IN MEDICAL EDUCATION. IN FY 2012, AN INFANT MANNEQUIN WAS ADDED AND USED DURING MONTHLY PEDIATRIC SIMULATION DRILLS.GREENWICH HOSPITAL CONTINUED TO BE DEFINED BY ITS SERVICE EXCELLENCE ENVIRONMENT. IN JULY, THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) RELEASED THE NEXT SET OF HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (HCAHPS) RESULTS FOR THE TIME PERIOD OF OCTOBER 2010 TO SEPTEMBER 2011. HCAHPS IS THE SURVEY THAT MEASURES TEN AREAS OF INPATIENT PERCEPTIONS OF CARE. THE HOSPITAL SCORED WELL, WITH EIGHT MEASURES ABOVE THE NEW YORK AND CONNECTICUT AVERAGES AND SIX MEASURES ABOVE THE NATIONAL AVERAGE. AMONG ALL CONNECTICUT HOSPITALS, PATIENTS RATED GREENWICH HOSPITAL THE HIGHEST IN "OVERALL RATING:" AND "WILLINGNESS TO RECOMMEND TO OTHERS".YALE NEW HAVEN HEALTH SYSTEM WAS NAMED "MOST WIRED" BY HOSPITALS AND HEALTH NETWORKS. THE AWARD RECOGNIZES HEALTH SYSTEMS AND HOSPITALS AS BEING AMONG THE TOP HOSPITALS NATIONALLY TO HAVE INVESTED IN AND SUCCESSFULLY LEVERAGED LEADING-EDGE TECHNOLOGY IN THE AREAS OF SAFETY AND QUALITY, CUSTOMER SERVICE, PUBLIC HEALTH AND SAFETY, WORKFORCE MANAGEMENT AND BUSINESS PROCESSES. IN FY 2012, GREENWICH HOSPITAL BECAME THE FIRST YALE NEW HAVEN HEALTH SYSTEM HOSPITAL TO IMPLEMENT EPIC. THE EPIC SYSTEM ALLOWS CAREGIVERS TO PROVIDE ONE STANDARD OF CARE ACROSS THE SYSTEM THAT IS SAFER, MORE EFFECTIVE AND EFFICIENT, AND WILL IMPROVE PATIENT OUTCOMES. IN PREPARATION FOR "GO LIVE", HUNDREDS OF PHYSICIANS, NURSES, PHYSICIAN ASSISTANCES, PHARMACISTS, TECHNICIANS, THERAPISTS, NURSING ASSISTANTS, UNIT SECRETARIES, AND OTHERS PARTICIPATED IN MORE THAN 20,000 HOURS OF TRAINING. COMMUNITY MEMBERS UTILIZE GREENWICH HOSPITAL AS A VEHICLE TO CONNECT AND CONTRIBUTE TO INDIVIDUALS AND THE OVERALL COMMUNITY THROUGH PHILANTHROPY AND VOLUNTEERING. IN FY 2012, 754 ADULT AND JUNIOR VOLUNTEERS DEDICATED A TOTAL OF 63,300 SERVICE HOURS TO THE HOSPITAL. VOLUNTEERS WERE PLACED IN MANY PATIENTS AND NON PATIENT AREAS INCLUDING THE ED, PATIENT TRANSPORT/ESCORT, ONCOLOGY, SURGERY, PAIN MANAGEMENT, MATERNITY, NICU, HUMAN RESOURCES AND INFORMATION SERVICES. IN FY 2012, THE GREENWICH HOSPITAL AUXILIARY CONTINUED TO SUPPORT THE HOSPITAL'S EFFORTS AND THOSE OF THE COMMUNITY. EXAMPLES INCLUDE A THREE-YEAR FINANCIAL COMMITMENT BY THE AUXILIARY TO NORWALK COMMUNITY COLLEGE TO BUILD A STATE-OF-THE-ART NURSES TRAINING CENTER AND FOUR $1,000 SCHOLARSHIPS PROVIDED TO GREENWICH HIGH SCHOOL SENIORS PURSING STUDIES IN HEALTH CARE. PART VI, LINE 6: THE YALE NEW HAVEN HEALTH SYSTEM'S FUNDAMENTAL MISSION IS TO ENSURE THAT THE DELIVERY NETWORKS ASSOCIATED WITH THE SYSTEM PROMOTE THE HEALTH OF THE COMMUNITIES THEY SERVE AND ENSURE THAT ALL IN NEED HAVE ACCESS TO APPROPRIATE HEALTHCARE SERVICES. THE YALE NEW HAVEN HEALTH SYSTEM REQUIRES ITS HOSPITALS TO INCORPORATE PLANS TO PROMOTE HEALTHY COMMUNITIES WITHIN HOSPITAL EXISTING BUSINESS PLANS FOR WHICH THEY ARE HELD ACCOUNTABLE. IN ADDITION, REGULAR REPORTING ON COMMUNITY BENEFITS IS REQUIRED ON A QUARTERLY BASIS AND OBJECTIVES IN THE EXECUTIVES PERFORMANCE EVALUATION ARE ASSOCIATED WITH PROVIDING BENEFITS TO THE COMMUNITY. EACH DELIVERY NETWORK'S MISSION, VISION AND BUSINESS PLAN INCORPORATES THE CONCEPTS OF WORKING WITH ITS COMMUNITY TO IDENTIFY OPPORTUNITIES TO PROMOTE HEALTH, PROVIDE SERVICES THAT PROMOTE HEALTH AND PROVIDE CHARITY CARE AND FREE CARE TO THOSE THAT CANNOT AFFORD NECESSARY SERVICES. REPORTS FILED WITH STATES PART VI, LINE 7 CT 1 YWCA OF GREENWICH 259 E PUTNAM AVENUE GREENWICH CT 06830 060646992 C-3 11950 SUPPORT ORGANIZATION ED RANDALL'S FANS 4 A CURE 120 W 45TH ST FL17 NEW YORK NY 10036 061696245 C-3 5000 SUPPORT ORGANIZATION BREAST CANCER ALLIANCE 48 MAPLE AVENUE GREENWICH CT 06830 061453500 C-3 5000 SUPPORT ORGANIZATION AMERICAN CANCER SOCIETY 372 DANBURY ROAD WILTON CT 06897 131788491 C-3 10000 SUPPORT ORGANIZATION SACRED HEART UNIVERSITY 5151 PARK AVENUE FAIRFIELD CT 06825 060776644 C-3 5000 SUPPORT ORGANIZATION VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK NY 10573 133830232 C-3 5000 SUPPORT ORGANIZATION GREENWICH UNITED WAY 1 LAFAYETTE COURT GREENWICH CT 06830 060646578 C-3 1000 SUPPORT ORGANIZATION RED RIBBON FOUNDATION 270 GREENWICH AVENUE GREENWICH CT 06830 061427158 C-3 5000 SUPPORT ORGANIZATION STAMFORD HOSPITAL 166 W BROAD STREET STAMFORD CT 06904 060646917 C-3 6000 SUPPORT ORGANIZATION GEMS 111 E PUTNAM AVE RIVERSIDE CT 06878 222721171 C-3 91000 SUPPORT ORGANIZATION ONS FOUNDATION 6 GREENWICH OFFICE PARK GREENWICH CT 06831 261394760 C-3 50000 SUPPORT ORGANIZATION 11 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS - NONE OF THE AMOUNT REPORTED ON SCHEDULE I, PART II ARE GRANTS. THESE AMOUNTS ARE DONATIONS AND SPONSORSHIPS GIVEN TO ORGANIZATIONS TO ASSIST IN THE FURTHERANCE OF THEIR MISSION. X X X X X 0 1 0 0 0 0 0 1 0 FRANK A CORVINO 711944 79105 259250 28806 331455 36828 121723 13525 19815 2202 1444187 160466 402 45 GAYLE L CAPOZZALO 0 611828 0 225236 0 380455 0 140600 0 62969 0 1421088 0 0 EUGENE J COLUCCI 241268 136718 66789 37847 42653 24170 94741 53686 14053 7964 459504 260385 1395 791 QUINTON J FRIESEN 373815 0 101376 0 235827 0 73767 0 22384 0 807169 0 0 0 SUSAN BROWN 276379 0 43607 0 0 0 0 0 50952 0 370938 0 0 0 NANCY LEVITT-ROSENTHAL 291174 0 76828 0 36812 0 114178 0 1271 0 520263 0 11745 0 MELISSA TURNER 120414 72248 31886 19132 25809 15485 53968 32381 17609 10566 249686 149812 0 0 CHRISTINE BEECHNER 123897 0 16623 0 6710 0 0 0 33780 0 181010 0 3124 0 STEPHEN CARBERY 177320 0 33173 0 22000 0 0 0 50026 0 282519 0 0 0 MARC KOSAK 182152 0 29110 0 13736 0 0 0 37300 0 262298 0 2353 0 GEORGE PAWLUSH 162655 0 39101 0 22000 0 0 0 40944 0 264700 0 0 0 BRIAN DORAN MD 390948 0 68217 0 16500 0 0 0 36208 0 511873 0 11107 0 DEBORAH HODYS 284699 0 50402 0 16500 0 0 0 37175 0 388776 0 2424 0 STEPHEN GRAY 492898 0 47814 0 19510 0 0 0 48573 0 608795 0 17177 0 VICKI ALTMEYER 453215 0 38042 0 22000 0 0 0 49140 0 562397 0 2006 0 RICHARD EISEN 467023 0 28406 0 21259 0 0 0 63063 0 579751 0 0 0 ERIC DIAMOND 473933 0 0 0 22000 0 0 0 54709 0 550642 0 0 0 MARVIN LIPSCHUTZ MD 383139 0 75220 0 3972 0 0 0 29948 0 492279 0 0 0 PART I, LINE 4B PART I, LINE 4B: SEVERENCE NONQUALIFIED EQUITY-BASED EUGENE COLUCCI $0 $71,760 $0 NANCY LEVITT-ROSENTHAL $0 $54,272 $0 MELISSA TURNER $0 $40,416 $0 THE INDIVIDUALS LISTED ABOVE ARE PARTICIPANTS IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THESE ACCRUALS ARE INCLUDED IN THE AMOUNTS REPORTED IN PART II, COLUMN C (DEFERRED COMPENSATION) AND REPRESENTS BOTH THE REPORTING ENTITY'S AND RELATED ENTITY'S COMBINED AMOUNTS CONSISTENT WITH THE COMPENSATION REPORTING PER IRS INSTRUCTIONS. INDIVIDUALS LISTED BELOW BECAME VESTED IN BENEFITS VALUED AT THE AMOUNTS RESPECTIVELY REPORTED BELOW DURING THE REPORTING YEAR. INCLUDED IN SECTION II, COLUMN B (III) ARE AMOUNTS VESTED DURING THE 2011 CALENDAR YEAR THAT WERE RECOGNIZED AS TAXABLE EVENTS AND REPORTED IN THE INDIVIDUALS' 2011 CALENDAR YEAR FORM W-2S. FRANK CORVINO $ 261,824 QUINTON FRIESEN $ 173,947 GAYLE CAPOZZALO $ 294,699 VICKI ALTMEYER $ 17,772 RICHARD EISEN $ 8,630 STEPHEN GRAY $ 25,566 THE SUPPLEMENTAL RETIREMENT INCOME PLAN (SRIP) IS DESIGNED TO ENSURE THE PAYMENT OF A COMPETITIVE LEVEL OF RETIREMENT INCOME WHEN ADDED TO OTHER SOURCES OF RETIREMENT INCOME IN ORDER TO ATTRACT AND RETAIN KEY MANAGEMENT EMPLOYEES SERVING AS CORPORATE OFFICERS. THE PLAN PROVIDES SUPPLEMENTAL RETIREMENT INCOME THROUGH AN UNFUNDED, NONQUALIFIED DEFERRED COMPENSATION ARRANGEMENT UNDER SECTION 457(F) AND THROUGH A DEFERRED COMPENSATION PLAN UNDER SECTION 409A OF THE INTERNAL REVENUE CODE AND A MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES' PLAN UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (ERISA). PART I, LINE 7 THE SHORT TERM INCENTIVE PLAN (STIP) IS A VARIABLE COMPENSATION PLAN WHICH PROVIDES ONE-TIME PAYMENTS TO ELIGIBLE MEMBERS OF MANAGEMENT IN RECOGNITION OF THE ACCOMPLISHMENT OF KEY ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE OBJECTIVES. PERFORMANCE LEVELS ARE ESTABLISHED AND REVIEWED ANNUALLY AT THRESHOLD, TARGET AND MAXIMUM LEVELS, ACCORDING TO PLANNED "STRETCH" GOALS AND OBJECTIVES. INCENTIVE AWARD OPPORTUNITIES ARE ESTABLISHED ACCORDING TO MARKET PRACTICES BASED ON EACH ELIGIBLE POSITION'S RESPONSIBILITIES, PERFORMANCE AND LEVEL OF AUTHORITY. PERFORMANCE RELATIVE TO STIP AWARD OPPORTUNITIES INCORPORATES A BROAD SPECTRUM OF PRE-DEFINED FINANCIAL AND NON-FINANCIAL METRICS THAT ARE ALIGNED WITH ORGANIZATIONAL MISSION AND VALUES. SUPPLEMENTAL INFORMATION PART III THE INDIVIDUALS LISTED ABOVE ARE PARTICIPANTS IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THESE ACCRUALS ARE INCLUDED IN THE AMOUNTS REPORTED IN PART II, COLUMN C (DEFERRED COMPENSATION) AND REPRESENTS BOTH THE REPORTING ENTITY'S AND RELATED ENTITY'S COMBINED AMOUNTS CONSISTENT WITH THE COMPENSATION REPORTING PER IRS INSTRUCTIONS. INDIVIDUALS LISTED BELOW BECAME VESTED IN BENEFITS VALUED AT THE AMOUNTS RESPECTIVELY REPORTED BELOW DURING THE REPORTING YEAR. INCLUDED IN SECTION II, COLUMN B (III) ARE AMOUNTS VESTED DURING THE 2011 CALENDAR YEAR THAT WERE RECOGNIZED AS TAXABLE EVENTS AND REPORTED IN THE INDIVIDUALS' 2011 CALENDAR YEAR FORM W-2S. FRANK CORVINO $ 261,824 QUINTON FRIESEN $ 173,947 GAYLE CAPOZZALO $ 294,699 VICKI ALTMEYER $ 17,772 RICHARD EISEN $ 8,630 STEPHEN GRAY $ 25,566 THE SUPPLEMENTAL RETIREMENT INCOME PLAN (SRIP) IS DESIGNED TO ENSURE THE PAYMENT OF A COMPETITIVE LEVEL OF RETIREMENT INCOME WHEN ADDED TO OTHER SOURCES OF RETIREMENT INCOME IN ORDER TO ATTRACT AND RETAIN KEY MANAGEMENT EMPLOYEES SERVING AS CORPORATE OFFICERS. THE PLAN PROVIDES SUPPLEMENTAL RETIREMENT INCOME THROUGH AN UNFUNDED, NONQUALIFIED DEFERRED COMPENSATION ARRANGEMENT UNDER SECTION 457(F) AND THROUGH A DEFERRED COMPENSATION PLAN UNDER SECTION 409A OF THE INTERNAL REVENUE CODE AND A MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES' PLAN UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (ERISA). CHEFA 060806186 20774UYC3 2008-05-07 53630000 REFINANCE 4/3/2006 (SERIES B) BONDS 0 0 0 53630000 426060 2008 1 0 1 1 0 1 1 0 1 0 0.00770 0.01460 0.02230 1 1 1 0 0 0 0 X PART III, LINE 3C THE ORGANIZATION HAS IN-HOUSE LEGAL STAFF WHO PROVIDE ROUTINE REVIEW OF MANAGEMENT OR SERVICE CONTRACTS OR RESEARCH AGREEMENTS RELATING TO THE FINANCED PROPERTY TO ENSURE THAT SUCH AGREEMENTS ARE COMPLIANT WITH APPLICABLE SAFE HARBORS. IN-HOUSE COUNSEL CONSULT WITH THE HOSPITAL'S OUTSIDE BOND COUNSEL AS NEEDED, INCLUDING ON NON-ROUTINE ISSUES. SEE PART V 0 SCHEDULE L, PART V: ADDITIONAL INFORMATION - NAME OF INTERESTED PERSON: CENTURY FINANCIAL SERVICES, INC.OFFICER EUGENE COLUCCI IS AN OFFICER AND DIRECTOR OF CENTURY FINANCIAL SERVICES, INC.CENTURY FINANCIAL SERVICES, INC. PROVIDES BILLING AND COLLECTION SERVICES FOR THE HOSPITAL. A PORTION OF CENTURY FINANCIAL SERVICES, INC. IS OWNED, DIRECTLY OR INDIRECTLY, BY RELATED ORGANIZATIONS OF THE HOSPITAL.AMOUNT OF TRANSACTION: $445,068.00.NAME OF INTERESTED PERSON: ORTHOPAEDIC & NEUROSURGERY CENTER OF GREENWICH, LLCTRUSTEE PAUL APOSTOLIDES IS A MEMBER OF ORTHOPAEDIC & NEUROSURGERY SPECIALISTS, PC, WHICH IS A MEMBER OF ONS ASC, LLC. ONS ASC, LLC AND GREENWICH AMBULATORY SURGERY CENTER, LLC (AN AFFILIATE OF THE HOSPITAL) ARE EACH MEMBERS OF A JOINT VENTURE, ORTHOPAEDIC & NEUROSURGERY CENTER OF GREENWICH, LLC (THE "JOINT VENTURE"). PURSUANT TO AN AGREEMENT BETWEEN THE JOINT VENTURE AND THE HOSPITAL, THE JOINT VENTURE PAYS AN ANNUAL FEE TO THE HOSPITAL FOR THE USE OF FACILITIES, EQUIPMENT, SUPPLIES AND STAFF FOR THE CONDUCT OF THE JOINT VENTURE'S OPERATIONS.AMOUNT OF TRANSACTION: $1,346,196.91SOME OF THE ORGANIZATION'S CURRENT OFFICERS SERVE AS OFFICERS AND/OR DIRECTORS OF TAXABLE AFFILIATES WITHIN THE ORGANIZATIONS CORPORATE SYSTEM. THE ORGANIZATION ENGAGES IN BUSINESS TRANSACTIONS WITH SOME OF THESE TAXABLE AFFILIATES. THESE TRANSACTIONS HAVE BEEN REPORTED AND DISCLOSED ON SCHEDULE R. THEY ARE NOT BEING REPORTED AGAIN HERE BECAUSE THE INDIVIDUAL OFFICERS DO NOT HAVE PERSONAL FINANCIAL INTERESTS IN THE TAXABLE AFFILIATES AND SERVE ONLY AS A FUNCTION OF THEIR ROLES AT THE ORGANIZATION. X 9 5640 FAIR MARKET VALUE X 4828 FAIR MARKET VALUE X 99229 FAIR MARKET VALUE X 3 215781 FAIR MARKET VALUE X 114 34549 FAIR MARKET VALUE X VACACTION/AIR/CRUISE 34 150474 FAIR MARKET VALUE X ACQUARIUM 2 6393 FAIR MARKET VALUE X PHOTOGRAPHY 29 53550 FAIR MARKET VALUE X MISCELLANEOUS 330 239516 FAIR MARKET VALUE 0 1 0 FORM 990, PART VI, SECTION A, LINE 1 THE ORGANIZATION SOUGHT TO CONFIRM THE INDEPENDENCE OF EACH VOTING MEMBER OF ITS GOVERNING BODY BY REQUESTING THAT EACH SUCH VOTING MEMBER RESPOND TO A QUESTIONNAIRE CONTAINING THE PERTINENT INSTRUCTIONS AND DEFINITIONS AND DESIGNED TO ELICIT THE INFORMATION NECESSARY TO DETERMINE INDEPENDENCE. BASED ON RESPONSES TO THE QUESTIONNAIRES RECEIVED BY THE ORGANIZATION AND ANNUAL CONFLICTS OF INTEREST DISCLOSURES, THE ORGANIZATION WAS ABLE TO CONFIRM THAT 21 VOTING MEMBERS ARE INDEPENDENT. THE ORGANIZATION HAS NO REASON TO BELIEVE THAT THE REMAINING 2 VOTING MEMBERS ARE NOT INDEPENDENT. FORM 990, PART VI, SECTION A, LINE 2 TRUSTEE WILLIAM R. BERKLEY, JR. AND OFFICER/TRUSTEE FRANK A. CORVINO ARE BOARD MEMBERS OF THE SAME BUSINESS ENTITY. SOME OF THE ORGANIZATIONS CURRENT OFFICERS SERVE AS OFFICERS AND/OR DIRECTORS OF TAXABLE AFFILIATES WITHIN THE ORGANIZATION'S CORPORATE SYSTEM. THE INDIVIDUAL OFFICERS DO NOT HAVE PERSONAL FINANCIAL INTERESTS IN THOSE TAXABLE AFFILIATES AND SERVE ONLY AS A FUNCTION OF THEIR ROLES WITH THE ORGANIZATION. THE TAXABLE AFFILIATES FOR WHICH SOME OF THE ORGANIZATION'S OFFICERS SERVE ALSO AS OFFICERS AND/OR DIRECTORS INCLUDE: GREENWICH HEALTH SERVICES, INC.; GREENWICH PEDIATRIC SERVICES, P.C.; AND GREENWICH INTEGRATIVE MEDICINE, P.C. FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS: THE HOSPITAL IS A CONNECTICUT NON-STOCK CORPORATION. ITS SOLE MEMBER IS GREENWICH HEALTH CARE SERVICES, INC. ("GHCSI"), ITSELF A CONNECTICUT NON-STOCK CORPORATION DESCRIBED IN SECTION 501(C)(3) OF THE CODE. FORM 990, PART VI, SECTION A, LINE 7A ELECTION OF MEMBERS AND THEIR RIGHTS: YALE NEW HAVEN HEALTH SERVICES CORPORATION (YNHHS), THE SOLE MEMBER OF GHCSI (THE HOSPITAL'S SOLE MEMBER), HAS THE AUTHORITY TO DESIGNATE ONE REPRESENTATIVE OF YNHHS TO SERVE AS A TRUSTEE OF THE HOSPITAL AND APPROVE NOMINEES TO THE HOSPITAL'S BOARD OF TRUSTEES IN ACCORDANCE WITH THE HOSPITAL'S BYLAWS AND THAT CERTAIN SYSTEM AFFILIATION AGREEMENT (THE "AFFILIATION AGREEMENT") BY AND AMONG YNHHS, GHCSI AND THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS SUBJECT TO APPROVAL OF MEMBERS: THE HOSPITAL HAS RESERVED POWERS TO BOTH GHCSI AND YNHHS. GHCSI: GHCSI, IN ITS CAPACITY AS THE SOLE MEMBER OF THE HOSPITAL, HAS ONLY THOSE RIGHTS, POWERS AND PRIVILEGES REQUIRED BY LAW TO BE ACCORDED TO MEMBERS OF A NONSTOCK, NONPROFIT CORPORATION. YNHHS: IN ACCORDANCE WITH THE HOSPITAL'S BYLAWS AND THE AFFILIATION AGREEMENT, YNHHS HAS THE FOLLOWING RIGHTS, POWERS AND PRIVILEGES VIS-A-VIS THE HOSPITAL: (A)TO DESIGNATE ONE REPRESENTATIVE OF YNHHS TO SERVE AS A TRUSTEE OF THE HOSPITAL AT THE PLEASURE OF YNHHS, WHICH DESIGNEE SHALL BE A VOTING MEMBER OF THE EXECUTIVE OR ANY SIMILAR COMMITTEE OF THE HOSPITAL; (B)TO APPROVE THE NOMINEES TO THE BOARD OF TRUSTEES OF THE HOSPITAL IN ACCORDANCE WITH THE PROVISIONS OF SECTION 3.3 OF THE HOSPITAL BYLAWS AND SECTION 4.2 OF THE AFFILIATION AGREEMENT; (C)TO DIRECT THE HOSPITAL BOARD OF TRUSTEES TO REMOVE ANY HOSPITAL TRUSTEE IN ACCORDANCE WITH PROVISIONS OF THE HOSPITAL BYLAWS AND THE AFFILIATION AGREEMENT; (D)TO APPROVE THE HOSPITAL'S ANNUAL OPERATING AND CAPITAL BUDGETS AND STRATEGIC PLANS; AND (E)TO CONSENT TO (I) THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE HOSPITAL'S ASSETS, (II) ANY MERGER OR CONSOLIDATION INVOLVING THE HOSPITAL, (III)ANY CONTRACT TO MANAGE OR ADMINISTER THE HOSPITAL OR ANY SUBSTANTIAL PART OF THE BUSINESS OF THE HOSPITAL, (IV) ANY LIQUIDATION OR DISSOLUTION OF THE HOSPITAL OR FILING FOR BANKRUPTCY OR SIMILAR PROTECTION, OR (V) ANY CHANGE IN THE NAME OF THE HOSPITAL. FURTHER, IN ACCORDANCE WITH THE HOSPITAL BYLAWS, GHCSI AND YNHHS MUST EACH APPROVE ANY AMENDMENT TO THE HOSPITAL'S CERTIFICATE OF INCORPORATION OR BYLAWS. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S PROCESS TO REVIEW FORM 990: THE FORM 990 TAX RETURN AND ATTACHED SCHEDULES WERE PREPARED BY EMPLOYEES OF THE SYSTEM TAX DEPARTMENT. THE RETURN IS INITIALLY REVIEWED BY THE HOSPITAL DIRECTOR OF CORPORATE FINANCE. SUBSEQUENTLY, IT IS SENT TO ERNST & YOUNG US LLP FOR THEIR INITIAL REVIEW. AFTER ALL COMMENTS FROM THE ABOVE GROUPS ARE RECEIVED AND REVIEWED, THE RETURN IS THEN REVIEWED BY THE CHIEF FINANCIAL OFFICER OF THE HOSPITAL AND A FINAL VERSION OF THE RETURN IS SENT BACK TO ERNST & YOUNG US LLP FOR FINAL REVIEW. PRIOR TO FILING, THE ORGANIZATION MADE AVAILABLE A COMPLETE COPY OF THE RETURN TO THE BOARD OF TRUSTEES BY WEB PORTAL. FORM 990, PART VI, SECTION B, LINE 12C GREENWICH HOSPITAL IS COVERED UNDER THE YALE NEW HAVEN HEALTH SYSTEM CONFLICT OF INTEREST POLICY. THE YALE NEW HAVEN HEALTH SYSTEM CONFLICT OF INTEREST POLICY (CC:R-7) AND INDIVIDUAL ANNUAL DISCLOSURE FORM APPLIES TO A POOL OF EMPLOYEES, BOARD MEMBERS AND NON-BOARD MEMBERS SERVING ON BOARD COMMITTEES. THESE "COVERED INDIVIDUALS" ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT, UPON BEGINNING EMPLOYMENT OR OTHERWISE BECOMING A COVERED INDIVIDUAL AND ANNUALLY THEREAFTER. COVERED INDIVIDUALS ARE ALSO REQUIRED TO IMMEDIATELY REPORT MATERIAL CHANGES TO THEIR MOST RECENTLY COMPLETED DISCLOSURE STATEMENT. THESE DISCLOSURE STATEMENTS AND REPORTS ARE REVIEWED BY THE OFFICE OF PRIVACY AND CORPORATE COMPLIANCE AND/OR THE LEGAL AND RISK SERVICES DEPARTMENT TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. IF A POTENTIAL CONFLICT ARISES, THE PRESIDENT AND CEO WOULD CONSULT WITH THE BOARD CHAIRPERSON AND THE LEGAL AND RISK SERVICES DEPARTMENT AND TAKE ANY ACTIONS THAT HE DEEMS REQUIRED OR APPROPRIATE TO MANAGE OR RESOLVE A POTENTIAL CONFLICT OF INTEREST. FOR EXAMPLE, A VOTING BOARD OR COMMITTEE MEMBER WOULD BE REQUIRED TO RECUSE HIMSELF OR HERSELF FROM VOTING ON MATTERS RELATED TO THE POTENTIAL CONFLICT AND THE POTENTIAL CONFLICT WOULD BE DISCLOSED TO OTHER VOTING MEMBERS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION PROCESS FOR TOP OFFICIALS: THE TOP OFFICIAL IS AN EMPLOYEE OF YNHHS. THE EXECUTIVE COMPENSATION COMMITTEES OF GREENWICH HOSPITAL AND YNHHS STRIVE TO TAKE THE STEPS NECESSARY TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER FEDERAL TAX LAW. THE EXECUTIVE COMPENSATION COMMITTEES ARE RESPONSIBLE FOR (1) DETERMINING THE OVERALL TOTAL COMPENSATION STRATEGY FOR THEIR RESPECTIVE CORPORATE OFFICERS, (2) APPROVING ALL COMPENSATION AND BENEFITS DECISIONS FOR RESPECTIVE CORPORATE OFFICERS, AND (3) REPORTING SUCH ACTIONS TO THE FULL GREENWICH HOSPITAL AND YNHHS BOARDS ON AN ANNUAL BASIS. IN ADDITION, THE EXECUTIVE COMPENSATION COMMITTEES EXPRESSLY DETERMINE THE REASONABLENESS OF TOTAL COMPENSATION AND BENEFITS FOR ALL CORPORATE OFFICERS, AND ASSURES THAT ALL OFFICER COMPENSATION DECISIONS ARE MADE AFTER THOROUGH CONSIDERATION OF AND COMPARISON TO THE MARKET PRACTICES OF OTHER SIMILARLY SITUATED NOT-FOR-PROFIT HEALTHCARE EXECUTIVES IN COMPARABLE ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEES CONSIST OF BOARD MEMBERS WHO DO NOT HAVE MATERIAL FINANCIAL INTERESTS THAT COULD BE AFFECTED BY THE OFFICER COMPENSATION DECISIONS MADE BY THE COMMITTEES. THE COMPARABILITY DATA USED TO ASSIST THE EXECUTIVE COMPENSATION COMMITTEES IN THEIR COMPENSATION DELIBERATIONS ARE COMPILED BY AN INDEPENDENT,NATIONAL COMPENSATION CONSULTING FIRM THAT IS RETAINED BY AND REPORTS DIRECTLY TO THE EXECUTIVE COMPENSATION COMMITTEES. THE DATA COLLECTED BY THE CONSULTANT CONSISTS OF MARKET INFORMATION FOR EXECUTIVES IN FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS. THE DELIBERATIONS AND DECISIONS OF THE EXECUTIVE COMPENSATION COMMITTEES ARE CONTEMPORANEOUSLY DOCUMENTED, REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEES, AND PROVIDED TO THE BOARDS OF YNHHS AND THE HOSPITAL. COMPENSATION PROCESS FOR OFFICERS CERTAIN OFFICERS ARE EMPLOYEES OF YNHHS, OTHER OFFICERS ARE EMPLOYED DIRECTLY BY THE HOSPITAL. COMPENSATION DETERMINATIONS OF YNHHS EMPLOYEES ARE MADE BOTH BY THE COMPENSATION COMMITTEES AND BOARDS OF YNHHS AND THE HOSPITAL. COMPENSATION DETERMINATION OF THE HOSPITAL EMPLOYEES ARE MADE BY THE HOSPITAL'S COMPENSATION COMMITTEE AND BOARD. THE EXECUTIVE COMPENSATION COMMITTEES OF GREENWICH HOSPITAL AMD YNHHS STRIVE TO TAKE THE STEPS NECESSARY TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER FEDERAL TAX LAW. THE EXECUTIVE COMPENSATION COMMITTEES ARE RESPONSIBLE FOR (1) DETERMINING THE OVERALL TOTAL COMPENSATION STRATEGY FOR ALL THEIR RESPECTIVE CORPORATE OFFICERS, (2) APPROVING ALL COMPENSATION AND BENEFITS DECISIONS FOR CORPORATE OFFICERS, AND (3) REPORTING SUCH ACTIONS TO THE FULL GREENWICH HOSPITAL AND YNHHS BOARD ON AN ANNUAL BASIS, AS APPLICABLE. IN ADDITION, THE EXECUTIVE COMPENSATION COMMITTEES, AS APPLICABLE, EXPRESSLY DETERMINE THE REASONABLENESS OF TOTAL COMPENSATION AND BENEFITS FOR ALL CORPORATE OFFICERS, AND ASSURES THAT ALL OFFICER COMPENSATION DECISIONS ARE MADE AFTER THOROUGH CONSIDERATION OF AND COMPARISON TO THE MARKET PRACTICES OF OTHER SIMILARLY SITUATED NOT-FOR-PROFIT HEALTHCARE EXECUTIVES IN COMPARABLE ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEES CONSIST OF BOARD MEMBERS WHO DO NOT HAVE MATERIAL FINANCIAL INTERESTS THAT COULD BE AFFECTED BY THE OFFICER COMPENSATION DECISIONS MADE BY THE COMMITTEES. THE COMPARABILITY DATA USED TO ASSIST THE EXECUTIVE COMPENSATION COMMITTEES IN THEIR COMPENSATION DELIBERATIONS ARE COMPILED BY AN INDEPENDENT, NATIONAL COMPENSATION CONSULTING FIRM THAT IS RETAINED BY AND REPORTS DIRECTLY TO THE EXECUTIVE COMPENSATION COMMITTEES. THE DATA COLLECTED BY THE CONSULTANT CONSISTS OF MARKET INFORMATION FOR EXECUTIVES IN FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS. THE DELIBERATIONS AND DECISIONS OF THE EXECUTIVE COMPENSATION COMMITTEES ARE CONTEMPORANEOUSLY DOCUMENTED, REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEES, AND PROVIDED TO THE BOARDS OF YNHHS AND/OR THE HOSPITAL, AS APPLICABLE. FORM 990, PART VI, SECTION C, LINE 19 COPIES OF FORM 990, FORM 1023 AND AUDITED FINANCIAL STATEMENTS ARE MAINTAINED IN THE SYSTEM TAX DEPARTMENT. OTHER CORPORATE GOVERNING DOCUMENTS ARE MAINTAINED BY THE LEGAL AND RISK SERVICES DEPARTMENT. THE CONFLICT OF INTEREST POLICY, WHISTLEBLOWER POLICY, AND DOCUMENT RETENTION POLICY ARE AVAILABLE TO ALL EMPLOYEES ON THE CORPORATE INTERNAL WEBSITE. COPIES OF ALL DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, LINE 19 - GOVERNING DOCUMENTS DISCLOSURE EXPLANATION: COPIES OF FORM 990, FORM 1023 AND AUDITED FINANCIAL STATEMENTS ARE MAINTAINED IN THE SYSTEM TAX DEPARTMENT. OTHER CORPORATE GOVERNING DOCUMENTS ARE MAINTAINED BY THE LEGAL AND RISK SERVICES DEPARTMENT. THE CONFLICT OF INTEREST POLICY, WHISTLEBLOWER POLICY, AND DOCUMENT RETENTION POLICY ARE AVAILABLE TO ALL EMPLOYEES ON THE CORPORATE INTERNAL WEBSITE. COPIES OF ALL DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII - RELATED ORGANIZATIONS: OFFICERS WORK AN AVERAGE OF 40 HOURS A WEEK SPREAD FOR THE FILING ENTITY AND RELATED ENTITIES LISTED IN SCHEDULE R. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 5,068,000. PENSION ADJUSTMENT -8,397,000. AMORTIZATION -79,000. TRANSFERS TO AFFILIATES -6,615,000. TRANSFERS FROM AFFILIATES 700,000. ASSETS RELEASED FOR OPERATIONS -3,759,000. ASSETS RELEASED FOR NON-OPERATIONS -139,000. RESTRICTED CONTRIBUTIONS 4,318,000. REALIZED GAIN ON INVESTMENTS 1,345,000. CHANGE IN FOUNDATION NET ASSETS -5,441,000. CHANGE IN AUXILIARY NET ASSETS -105,524. MISCELLANEOUS 195. BOOK TO TAX ITEMS - SEE SCH D, PART XI, LINE 9 6,333,268. TOTAL TO FORM 990, PART XI, LINE 5: -6,771,061. DISCLOSURE STATEMENT RELATED TO FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN COPORATIONS, 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: YALE-NEW HAVEN HOSPITAL ADDRESS: 20 YORK STREET NEW HAVEN, CT 06504 IDENTIFYING NUMBER OF U.S. TAX RETURN WITH WHICH THE FORMS 5471 WERE OR WILL BE FILED: 06-0646652 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: OGDEN, UT 84201-0027 900 KING STREET ASSOCIATES LLC 5 PERRYRIDGE ROAD GREENWICH CT 06830 260805259 BUILDING OPERATIONS CT 0 0 GREENWICH HOSPITAL GREENWICH CLINICAL PATHOLOGY ASSOCIATES LLC 5 PERRYRIDGE ROAD GREENWICH CT 06830 262455578 HEALTHCARE CT 0 106885 GREENWICH HOSPITAL GREENWICH PATHLOGY ASSOCIATES LLC 5 PERRYRIDGE ROAD GREENWICH CT 06830 066140101 HEALTHCARE CT 0 620364 GREENWICH HOSPITAL BRIDGEPORT HOSPITAL 267 GRANT STREET BRIDGEPORT CT 06610 060646554 HEALTHCARE CT 501C3 LINE 3 BRIDGEPORT HOSP & HEALTHCARE SERVICES 1 BRIDGEPORT HOSPITAL & HEALTHCARE SERVICES 267 GRANT STREET BRIDGEPORT CT 06610 061066729 SYSTEM SUPPORT CT 501C3 LINE 11A, I YALE NEW HAVEN HEALTH SERVICES CORP 0 BRIDGEPORT HOSPITAL AUXILIARY INC 267 GRANT STREET 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