Hospital of Saint Raphael: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- Hospital of Saint Raphael (EIN 06-0653171)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-08-14
- IRS object ID
- 201332269349302008
- 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 N
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-14T11:56:33-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 060653171 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Hospital of Saint Raphael | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HOSP | NameControl |
| Phone | 2037893940 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 Orchard Street Suite 204 | AddressLine1 |
| City | New Haven | City |
| State | CT | State |
| ZIP Code | 06511 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | James R Rude | Name |
| Title | Chief Financial Officer | Title |
| Phone | 2037893575 | Phone |
| Date Signed | 2013-08-14 | DateSigned |
| 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) |
|---|---|---|
| Address Change | X | AddressChange |
| Name Of Principal Officer Person | Jane Anne Lubin Szafransk | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 Orchard Street Suite 204 | AddressLine1 |
| City | New Haven | City |
| State | CT | State |
| ZIP Code | 06511 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 471827245 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1907 | YearFormation |
| State Legal Domicile | CT | StateLegalDomicile |
| Activity Or Mission Description | Not for Profit Hospital | ActivityOrMissionDescription |
| Termination Or Contraction | X | TerminationOrContraction |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 4286 | TotalNbrEmployees |
| Total Nbr Volunteers | 700 | TotalNbrVolunteers |
| Total Gross UBI | 6131130 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 5555754 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 5487195 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 477956801 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 443953259 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 304901 | InvestmentIncomePriorYear |
| Investment Income Current Year | 293298 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 22106354 | OtherRevenuePriorYear |
| Other Revenue Current Year | 21174308 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 505923810 | TotalRevenuePriorYear |
| Total Revenue Current Year | 470908060 | 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 | 284957442 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 272875725 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 216793388 | OtherExpensePriorYear |
| Other Expenses Current Year | 200064634 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 501750830 | TotalExpensesPriorYear |
| Total Expenses Current Year | 472940359 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 4172980 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -2032299 | RevenuesLessExpensesCY |
| Total Assets BOY | 277047305 | TotalAssetsBOY |
| Total Assets EOY | 160560508 | TotalAssetsEOY |
| Total Liabilities BOY | 323551576 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 149059341 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -46504271 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 11501167 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | The Hospital of Saint Raphael is a community teaching hospital and health care resource sponsored and guided by the values of the Sisters of Charity of Saint Elizabeth and of the Roman Catholic Church. The mission is to witness, share in, and promote excellence in the healing ministry of Jesus Christ. The Hospital is committed to preserving the dignity and well-being of each individual, and assuring that every person is treated according to the principles of charity and justice. The Hospital accepts the Gospel challenge that prompted their founders of the sponsoring congregation, Saint Vincent DePaul, Saint Elizabeth Ann Seton, and Mother Mary Xavier Mehegan by pledging every loving service in their power to reach out to those in need of services. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 1 | SignificantChange |
| Expense | 420696443 | Expense |
| Revenue | 458996437 | Revenue |
| Description | The Hospital of Saint Raphael provides services to the poor and the medically underserved, as well as providing benefits to the broader community. The Hospital also provides services to other needy populations that may not qualify as poor but need special services and support. These include the cost of health promotion, health screening and education of the general community. Total discharges for the year were 19,941, Emergency Room Visits 55,528, Patient days 102,666, Inpatient Surgical Procedures 5,367 and Ambulatory Surgery 8,811. | Description |
| Total Program Service Expense | 420696443 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 0 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 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 | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 1 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 365 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 4286 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 1 | ForeignFinancialAccount |
| Name Of Foreign Country | BD | NameOfForeignCountry |
| 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 |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | 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 | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Hospital of Saint Raphael Acctg Dep | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2037893940 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 Orchard Street Suite 204 | AddressLine1 |
| City | New Haven | City |
| State | CT | State |
| ZIP Code | 06511 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (48 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 | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| Vincent Calarco | |||||||||
| Volunteer | 3.30 | X | 0 | 0 | 0 | ||||
| M Joseph Canavan | |||||||||
| Volunteer | 5.00 | X | 0 | 0 | 0 | ||||
| James M Carolan | |||||||||
| Volunteer | 3.00 | X | 7327 | 0 | 0 | ||||
| Sister Teresa Confroy | |||||||||
| Volunteer | 8.00 | X | 0 | 0 | 0 | ||||
| Ralph DeNatale MD | |||||||||
| Volunteer | 5.00 | X | 126033 | 0 | 0 | ||||
| James Farmer MD | |||||||||
| Volunteer | 3.00 | X | 403872 | 0 | 0 | ||||
| Sister Mary Kathleen Flanagan | |||||||||
| Volunteer | 2.50 | X | 0 | 0 | 0 | ||||
| Paul Fortgang MD | |||||||||
| Volunteer | 2.00 | X | 0 | 0 | 0 | ||||
| Rev Bonita Grubbs | |||||||||
| Volunteer | 3.00 | X | 0 | 0 | 0 | ||||
| W Bruce Lundberg MD | |||||||||
| Volunteer | 4.00 | X | 276832 | 0 | 0 | ||||
| Michele Macauda | |||||||||
| Volunteer | 2.00 | X | 0 | 0 | 0 | ||||
| Linda Masci | |||||||||
| Volunteer | 3.00 | X | 0 | 0 | 0 | ||||
| Sister Mary Morley | |||||||||
| Volunteer | 8.50 | X | 0 | 0 | 0 | ||||
| Sister Rosemary Moynihan | |||||||||
| Volunteer | 6.00 | X | 0 | 0 | 0 | ||||
| Edward J Mullen | |||||||||
| Volunteer | 1.00 | X | 0 | 0 | 0 | ||||
| Christopher M O'Connor | |||||||||
| Chief Executive Officer to 9/11/12 | 40.00 | X | 0 | 959577 | 392713 | X | |||
| Most Reverend Peter Rosazza | |||||||||
| Volunteer | 1.50 | X | 0 | 0 | 0 | ||||
| Sister Maureen Shaughnessy | |||||||||
| Volunteer | 6.00 | X | 0 | 0 | 0 | ||||
| James P Torgerson | |||||||||
| Volunteer | 2.00 | X | 0 | 0 | 0 | ||||
| Kevin Twohig MD | |||||||||
| Volunteer | 3.00 | X | 0 | 0 | 0 | ||||
| Sister Margaret Welch | |||||||||
| Volunteer | 6.50 | X | 0 | 0 | 0 | ||||
| Janeanne Lubin-Szafranski | |||||||||
| Chief Executive Officer begin 9/12/12 | 40.00 | X | 0 | 406168 | 131241 | X | |||
| Alan Kliger MD | |||||||||
| Chief Medical Officer to 09/11/12 | 40.00 | 0 | 609368 | 215761 | X | ||||
| Lawrence E McManus | |||||||||
| Chief Financial Officer to 4/4/12 | 40.00 | 0 | 704640 | 219781 | X | ||||
| James Rude | |||||||||
| Chief Financial Officer begin 9/12/12 | 40.00 | 219080 | 0 | 62821 | X | ||||
| Joseph Bisson | |||||||||
| VP, Planning Services | 40.00 | 0 | 244275 | 111940 | X | ||||
| Russ Braun MD | |||||||||
| Chair/Emergency Med | 40.00 | 0 | 544457 | 78719 | X | ||||
| John Burke | |||||||||
| VP Information Services | 40.00 | 0 | 317960 | 97862 | X | ||||
| Elizabeth Conrad | |||||||||
| VP, Human Resources | 40.00 | 0 | 342760 | 116628 | X | ||||
| Thomas DonahueMD | |||||||||
| Sec Chief/Cardiology | 40.00 | 0 | 465762 | 131788 | X | ||||
| Peter Duffy | |||||||||
| VP, Facility Operations | 40.00 | 0 | 265818 | 94172 | X | ||||
| John Fitzgerald | |||||||||
| Asst Vice President Finance | 40.00 | 214839 | 0 | 51973 | X | ||||
| Sister Joan Granville | |||||||||
| VP, Mission Services | 20.00 | 0 | 257685 | 71731 | X | ||||
| W Scott Helton MD | |||||||||
| Former Chair/Surgery | 0.00 | 0 | 161091 | 3670 | X | ||||
| Gary J Kaml MD | |||||||||
| Chair/Surgery | 40.00 | 430419 | 0 | 19583 | X | ||||
| Mary Kuncas | |||||||||
| VP Patient Care Service | 40.00 | 0 | 332835 | 100615 | X | ||||
| Marshal Mandelkern MD | |||||||||
| Chair/Psychiatry | 40.00 | 0 | 347184 | 79764 | X | ||||
| Kim Samele | |||||||||
| VP Surgical Services | 40.00 | 0 | 182908 | 43179 | X | ||||
| Howard Shaw MD | |||||||||
| Chair/Women and Children | 40.00 | 0 | 344738 | 57212 | X | ||||
| Lucinda VonBeren | |||||||||
| VP, Corporate Affairs | 40.00 | 0 | 301785 | 101675 | X | ||||
| Andre Ghantous MD | |||||||||
| Director/Cardiology | 40.00 | 493397 | 0 | 18946 | X | ||||
| John Federico MD | |||||||||
| Section Chief/Thoracic | 40.00 | 533228 | 0 | 18325 | X | ||||
| Donald Kim MD | |||||||||
| Director/SICU | 40.00 | 472379 | 0 | 18651 | X | ||||
| Ernest Moritz MD | |||||||||
| Associate Chair Medicine | 40.00 | 362030 | 0 | 21130 | X | ||||
| Samuel Hahn MD | |||||||||
| Sec Chief/Cardiology | 40.00 | 509333 | 0 | 18438 | X | ||||
| Benedict Fernando MD | |||||||||
| Former Volunteer Trustee | 0.00 | 73419 | 0 | 0 | X | ||||
| Charles Hollander MD | |||||||||
| Former Chief Medical Officer | 0.00 | 0 | 209251 | 0 | X | ||||
| David W Benfer | |||||||||
| Former Chief Executive Officer | 0.00 | 0 | 193261 | 0 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 4122188 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 7191523 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 2278318 | TotalOtherCompensation |
| Number Individuals GT100 K | 469 | NumberIndividualsGT100K |
| Formers Listed | 1 | 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 |
|---|---|---|---|---|---|
| Cardinal Health | |||||
| 21377 Network Place | Chicago | IL | 60673 | Management | 20450068 |
| Rhode Island Blood Center | |||||
| PO Box 9399 | Providence | RI | 02940 | Medical | 4283811 |
| Morrison Management | |||||
| PO Box 102289 | Atlanta | GA | 30368 | Dietary | 3728856 |
| Yale University | |||||
| PO Box 208087 | New Haven | CT | 06511 | Medical | 2485570 |
| Saint Raphael MRI | |||||
| PO Box 9651 | New Haven | CT | 06511 | MRI Service | 1729674 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 58 | NumberOfContractorsGT100K |
| All Other Contributions | 5487195 | AllOtherContributions |
| Total Contributions | 5487195 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Net Patient Services | Description |
| Business Code | 621500 | BusinessCode |
| Total Revenue Column | 443953259 | TotalRevenueColumn |
| Related Or Exempt Function Income | 440574125 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 3379134 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 443953259 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 312483 | TotalRevenueColumn |
| Exclusion | $312,483 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 900000 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 919185 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -19185 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -19185 | TotalRevenueColumn |
| Exclusion | -$19,185 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Unrelated Business RevenueUnrelatedBusinessRevenue | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| Physician Premiums | 524298 | 2232000 | 2232000 | |
| Yankee Alliance | 561499 | 519996 | 519996 | |
| Auxiliary | 453220 | -65993 | -65993 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 18488305 | TotalRevenueColumn |
| Related Or Exempt Function Income | 18488305 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 21174308 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 470908060 | TotalRevenueColumn |
| Related Or Exempt Function Income | 458996437 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 6131130 | UnrelatedBusinessRevenue |
| Exclusion | $293,298 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5346102 | Total |
| Program Services | 1202206 | ProgramServices |
| Management And General | 4143896 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 212540205 | Total |
| Program Services | 190222234 | ProgramServices |
| Management And General | 22317971 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5061321 | Total |
| Program Services | 4446633 | ProgramServices |
| Management And General | 614688 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34270635 | Total |
| Program Services | 30108533 | ProgramServices |
| Management And General | 4162102 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15657462 | Total |
| Program Services | 13755894 | ProgramServices |
| Management And General | 1901568 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 228721 | Total |
| Program Services | 200943 | ProgramServices |
| Management And General | 27778 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 600637 | Total |
| Program Services | 527691 | ProgramServices |
| Management And General | 72946 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 386134 | Total |
| Program Services | 339239 | ProgramServices |
| Management And General | 46895 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2463 | Total |
| Program Services | 2164 | ProgramServices |
| Management And General | 299 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28170961 | Total |
| Program Services | 24749652 | ProgramServices |
| Management And General | 3421309 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 961455 | Total |
| Program Services | 844688 | ProgramServices |
| Management And General | 116767 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 87596781 | Total |
| Program Services | 76958323 | ProgramServices |
| Management And General | 10638458 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6307675 | Total |
| Program Services | 5541620 | ProgramServices |
| Management And General | 766055 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11755712 | Total |
| Program Services | 10328004 | ProgramServices |
| Management And General | 1427708 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 690381 | Total |
| Program Services | 606536 | ProgramServices |
| Management And General | 83845 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 671841 | Total |
| Program Services | 590247 | ProgramServices |
| Management And General | 81594 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2279689 | Total |
| Program Services | 2002825 | ProgramServices |
| Management And General | 276864 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13175681 | Total |
| Program Services | 11575520 | ProgramServices |
| Management And General | 1600161 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4471143 | Total |
| Program Services | 3928131 | ProgramServices |
| Management And General | 543012 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| Pharmacy | 18591441 | 18591441 |
| Bad debts - net | 13531774 | 13531774 |
| Malpractice Insurance | 5592278 | 5592278 |
| Red Cross charges | 3586206 | 3586206 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1463661 | Total |
| Program Services | 1463661 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 472940359 | Total |
| Program Services | 420696443 | ProgramServices |
| Management And General | 52243916 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26894270 | BOY |
| EOY | 93375248 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42793002 | BOY |
| EOY | 25007422 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2253020 | BOY |
| EOY | 16289043 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7423719 | BOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6898002 | BOY |
| EOY | 49580 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 0 | LandBuildingsEquipmentBasis |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 91355080 | BOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 43743670 | BOY |
| EOY | 556963 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41651039 | BOY |
| EOY | 24189707 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14035503 | BOY |
| EOY | 1092545 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 277047305 | BOY |
| EOY | 160560508 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 61485997 | BOY |
| EOY | 48321015 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 660619 | BOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 261404960 | BOY |
| EOY | 100738326 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 323551576 | BOY |
| EOY | 149059341 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -77285560 | BOY |
| EOY | -6517301 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19690868 | BOY |
| EOY | 10301495 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11090421 | BOY |
| EOY | 7716973 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -46504271 | BOY |
| EOY | 11501167 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 277047305 | BOY |
| EOY | 160560508 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -2032299 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 60037737 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 1 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 1 | GrantsOtherOrganizations |
| Grants Other Organizations | $109,600 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | 1 | DirectContactLegislators |
| Direct Contact Legislators | $7,012 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $2,709 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 119321 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Explanation of Lobbying Activities: | Identifier |
| Return Reference | Part II-B, Line 1: | ReturnReference |
| Explanation | The majority of lobbying by Saint Raphael employees takes place at the state and federal levels. During fiscal 2012, state law required Saint Raphael to register as a state lobbyist as well (as its Chief Executive Officer, its Chief Financial Officer, the Executive Director of Saint Regis Health Center and its Director of Community and Government Relations). These four individuals met with elected officials, sent correspondence, and educated the Saint Raphael community about proposed legislation. Occasionally, other Saint Raphael employees may be asked to write to their legislators about proposed healthcare legislation. These combined efforts constitue Saint Raphael's direct lobbying efforts. Other lobbying activites include: dues paid to a national coalition to influence Medicare reimbursement; background and research work completed by Saint Raphael employees and a legal firm concerning a variety of federal issues; and a lobbying contract with a federal lobbying firm. The Hospital is also a member of several trade associations, and periodically participates in their lobbying efforts since a portion of the dues paid to these groups (American Hospital Association, Catholic Health Association, Association of American Medical Colleges, Premier, Connecticut Hospital Association, and Connecticut Catholic Hospital Council) may be used for lobbying efforts. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3446673 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 557390 | InvestmentEarningsOrLosses |
| End Of Year Balance | 4004063 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3431456 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 15217 | InvestmentEarningsOrLosses |
| End Of Year Balance | 3446673 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3122933 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 308523 | InvestmentEarningsOrLosses |
| End Of Year Balance | 3431456 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3173968 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -51035 | InvestmentEarningsOrLosses |
| End Of Year Balance | 3122933 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (3 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| Cash | 1125555 | F |
| Money Market Funds | 9401688 | F |
| CD's and Other | 13662464 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 24189707 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Post retirement Medical Costs | $1,608,486 |
| Accrued Pension - Defined Benefit Plan | $99,128,041 |
| Self Insurance - Workers Compensation | $1,799 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 100738326 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | Footnote to financial statements that reports the organization's liability for uncertain tax positions under FIN 48: Based on status of tax matters as of September 30, 2011, there were no disclosures in the footnotes to the organization's financial statements related to uncertain tax positions under FIN 48. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| 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 | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1108 | PersonsServed |
| Total Community Benefit Expense | 787194 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 787194 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00170 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 83080 | PersonsServed |
| Total Community Benefit Expense | 68513648 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 53750182 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 14763466 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03120 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 84188 | PersonsServed |
| Total Community Benefit Expense | 69300842 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 53750182 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 15550660 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03290 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 6 | NumberOfActivitiesOrPrograms |
| Persons Served | 6447 | PersonsServed |
| Total Community Benefit Expense | 219567 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5522 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 214045 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 1570 | PersonsServed |
| Total Community Benefit Expense | 39424067 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 25715162 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 13708905 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02900 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 9071 | PersonsServed |
| Total Community Benefit Expense | 11905214 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12033908 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -128694 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 2869 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2869 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 3571 | PersonsServed |
| Total Community Benefit Expense | 144712 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 144712 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 15 | NumberOfActivitiesOrPrograms |
| Persons Served | 20659 | PersonsServed |
| Total Community Benefit Expense | 51696429 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 37754592 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 13941837 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02980 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 15 | NumberOfActivitiesOrPrograms |
| Persons Served | 104847 | PersonsServed |
| Total Community Benefit Expense | 120997271 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 91504774 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 29492497 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06270 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 19337 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 19337 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 628 | PersonsServed |
| Total Community Building Expense | 1931 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1931 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 40 | PersonsServed |
| Total Community Building Expense | 1334 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1334 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 9042 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 9042 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 668 | PersonsServed |
| Total Community Building Expense | 31644 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 31644 | NetCommunityBuildingExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $4,755,065 | BadDebtExpenseAmount |
| Amount Attributable To | 2848759 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 180638638 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 214072521 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -33433883 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV (3 entries)
| Description Ent Primary ActivityDescriptionEntPrimaryActivity | Organization Profit Or OwnershipOrganizationProfitOrOwnership | Physicans Profit Or OwnershipPhysicansProfitOrOwnership |
|---|---|---|
| 1 CT CK Leasing LLC | ||
| Cyberkife stereotactic radiosurgery system. | 0.49090 | 0.13640 |
| 2 Health CT LLC | ||
| Provides comprehensive health care through hospital provider network. | 0.15800 | |
| 3 Yankee Alliance LLC | ||
| Hospital supply chain management. | 0.11110 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | Hospital of Saint Raphael | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1450 Chapel Street | AddressLine1 |
| City | New Haven | City |
| State | CT | State |
| ZIP Code | 06511 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Teaching Hospital | X | TeachingHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | 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 |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Permit Lien On Residence | X | PermitLienOnResidence |
| Permit Body Attachment | X | PermitBodyAttachment |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Lien On Residence | X | LienOnResidence |
| Body Attachment | X | BodyAttachment |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| Part II: The Hospital of Saint Raphael's community building activities include: the HOPE Program which provides basic job skills training to members of the community in order to assist them in finding employment and improving their overall quality of life; Disaster Preparedness - the Disaster Preparedness Committee works with local agencies (police, fire, etc.) to coordinate activities and prepare our staff in the event that a local disaster would occur; the maintenance of two Hospital parks and an "adopted" site within the neighborhood for community use; and periodic street patrols within the neighborhood promoting security and safety. | ||
| Part III, Line 4: The Hospital is committed to the community by providing services to the poor and the medically underserved, as well as providing benefits to the broader community. Focused on providing nondiscriminatory treatment of all patients, the Hospital fosters universal access to emergency care regardless of ability to pay. The Hospital grants credit without collateral to its patients, most of who are local residents and are insured under third-party payer arrangements. Services provided to the poor and the medically underserved include services provided to persons who cannot afford healthcare due to lack of resources, lack of insurance, or both. The Hospital considers care provided for which no payment was received from the patient or their insurer as uncompensated care. Uncompensated care is composed of free care provided, charity care provided, and bad debt expense. The Hospital makes available free care and financial assistance programs for qualifying patients. In accordance with established policies, during the registration, billing, and collection processes, a patient's eligibility for free care and financial assistance is determined. For patients who were determined to have the ability to pay but did not, the Hospital provision for uncollectible accounts is bad debt expense. | ||
| Part III, Line 8: The Medicare shortfall should be considered a part of the community benefit provided by the Hospital. Medicare patients who receive care at the Hospital are primarily local residents. They receive the same quality care as Medicaid and charity care patients.The costs reported on line 6 were estimated using a cost to charge ratio, which was derived by comparing total routine costs to total charges. | ||
| Part III, Line 9b: Whenever it is determined that the patient qualifies for Charity Care, a Patient Accounts Representative will adjust the balance by the appropriate amount, and the residual balance (if any) will become the patient's responsibility. | ||
| Part V, Section B, Line 19d: A patient's annual family income must be greater than 250% and is less than or equal to 400% of the current year's Federal Poverty Guidelines in order to be eligible for partial financial assistance. Partial financial assistance means the patient will be charged only the cost of services rather than the hospital's published charges. | N/A | |
| Part VI, Line 2: The Hospital of Saint Raphael community benefit programs have been designed to meet the long standing needs of individuals living in our services area. The Hospital utilizes data from local, regional, state, and federal resources to develop and expand our community benefit program. Examples of these informational sources include Connecticut Department of Public Health - 2009 Connecticut Health Disparities Report, CDC Behavioral Risk Factors Surveillance System, DATA Haven of South Central CT - Community Data Well Being Indicators, and the Community Alliance for Research and Engagement at the School of Public Health- Yale University /2009 CARE Neighborhood Health Survey Results. | ||
| Part VI, Line 3: The Hospital of Saint Raphael is committed to providing quality healthcare that is affordable and accessible to all, regardless of their ability to pay. To ensure that cost will not be a barrier to our community, we provide financial assistance coordinators who work closely with our patients to apply for eligible financial assistance programs, including assistance from our charitable resources. In addition there are brochures and signage in two languages indicating that financial assistance is available to qualified patients and their families. | ||
| Part VI, Line 4: The Hospital of Saint Raphael is a 511-bed community teaching hospital located in New Haven. The Hospital of Saint Raphael's Service Area consists of the 22 towns which surround New Haven. The Service Area has a population of approximately 863,000. Average household income for the entire service area in 2012 was determined to be approximately $63,000. The City of New Haven demographics include a population of approximately 131,000 in 49,000 households. Average household income approximates $39,000 and per capita income approximates $23,000. | ||
| Part VI, Line 5: In addition to the community building activities identified in Part VI, line 5 and the quantified free or discounted health services identified in Part I, Charity Care and Certain Other Community Benefits at Cost, the Hospital of Saint Raphael provides the following community benefits: Community Health Improvement Services - provides free and discounted services, such as screenings, lectures, health fairs, support groups, consultations, and referrals to outside agencies, aimed toward improving the health of the community; Health Professions Education - in addition to our medical interns and residents program, we provide a training site for high school and college students who are interested in pursing other degrees within the medical industry; and Financial and In-Kind Contributions - we financially support other community organizations through sponsorships and in-kind donations via time spent by staff volunteering in the community. | ||
| Part VI, Line 6: Saint Raphael Healthcare System affiliated organizations include Saint Regis Nursing Home, Inc., d/b/a The Sister Anne Virginie Grimes Health Center and DePaul Health Services Corporation, both of which operate healthcare organizations that complement the care given at the Hospital of Saint Raphael. Our healthcare providing organizations are supported through the fund raising efforts of The Saint Raphael Foundation, Inc., the One for All Fund, and the Saint Raphael Auxiliary. These affiliated organizations share the Hospital's mission to witness, share in, and promote excellence in the healing ministry of Jesus Christ. The Saint Raphael Healthcare System and its affiliates are committed to preserving the dignity and well-being of each individual, and assuring that every person is treated according to the principles of charity and justice. | ||
| CT | Reports Filed With States | Part VI, Line 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Housing Allowance Or Residence | X | HousingAllowanceOrResidence |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | 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 | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (30 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| James Farmer MD | |||||||||||||
| 0 | 0 | 0 | 0 | 403872 | 0 | 0 | 0 | 0 | 0 | 403872 | 0 | 0 | 0 |
| W Bruce Lundberg MD | |||||||||||||
| 0 | 0 | 0 | 0 | 276832 | 0 | 0 | 0 | 0 | 0 | 276832 | 0 | 0 | 0 |
| Christopher M O'Connor | |||||||||||||
| 0 | 661339 | 0 | 270000 | 0 | 28238 | 0 | 370442 | 0 | 22271 | 0 | 1352290 | 0 | 270000 |
| Janeanne Lubin-Szafranski | |||||||||||||
| 0 | 298893 | 0 | 61530 | 0 | 45745 | 0 | 111662 | 0 | 19579 | 0 | 537409 | 0 | 61530 |
| Alan Kliger MD | |||||||||||||
| 0 | 461763 | 0 | 130000 | 0 | 17605 | 0 | 199305 | 0 | 16456 | 0 | 825129 | 0 | 130000 |
| Lawrence E McManus | |||||||||||||
| 0 | 458902 | 0 | 175000 | 0 | 70738 | 0 | 199305 | 0 | 20476 | 0 | 924421 | 0 | 175000 |
| James Rude | |||||||||||||
| 198320 | 0 | 20157 | 0 | 603 | 0 | 45354 | 0 | 17467 | 0 | 281901 | 0 | 20157 | 0 |
| Joseph Bisson | |||||||||||||
| 0 | 242761 | 0 | 0 | 0 | 1514 | 0 | 91464 | 0 | 20476 | 0 | 356215 | 0 | 0 |
| Russ Braun MD | |||||||||||||
| 0 | 387440 | 0 | 0 | 0 | 157017 | 0 | 58765 | 0 | 19954 | 0 | 623176 | 0 | 0 |
| John Burke | |||||||||||||
| 0 | 256540 | 0 | 35002 | 0 | 26418 | 0 | 95275 | 0 | 2587 | 0 | 415822 | 0 | 35002 |
| Elizabeth Conrad | |||||||||||||
| 0 | 258051 | 0 | 53550 | 0 | 31159 | 0 | 97180 | 0 | 19448 | 0 | 459388 | 0 | 53550 |
| Thomas DonahueMD | |||||||||||||
| 0 | 462902 | 0 | 0 | 0 | 2860 | 0 | 106313 | 0 | 25475 | 0 | 597550 | 0 | 0 |
| Peter Duffy | |||||||||||||
| 0 | 198729 | 0 | 39139 | 0 | 27950 | 0 | 75049 | 0 | 19123 | 0 | 359990 | 0 | 39139 |
| John Fitzgerald | |||||||||||||
| 194152 | 0 | 19570 | 0 | 1117 | 0 | 44033 | 0 | 7940 | 0 | 266812 | 0 | 19570 | 0 |
| Sister Joan Granville | |||||||||||||
| 0 | 171631 | 0 | 31700 | 0 | 54354 | 0 | 64431 | 0 | 7300 | 0 | 329416 | 0 | 31700 |
| W Scott Helton MD | |||||||||||||
| 0 | 55970 | 0 | 75000 | 0 | 30121 | 0 | 0 | 0 | 3670 | 0 | 164761 | 0 | 75000 |
| Gary J Kaml MD | |||||||||||||
| 430239 | 0 | 0 | 0 | 180 | 0 | 0 | 0 | 19583 | 0 | 450002 | 0 | 0 | 0 |
| Mary Kuncas | |||||||||||||
| 0 | 245453 | 0 | 45124 | 0 | 42258 | 0 | 91716 | 0 | 8899 | 0 | 433450 | 0 | 45124 |
| Marshal Mandelkern MD | |||||||||||||
| 0 | 263422 | 0 | 51675 | 0 | 32087 | 0 | 60255 | 0 | 19509 | 0 | 426948 | 0 | 51675 |
| Kim Samele | |||||||||||||
| 0 | 182589 | 0 | 0 | 0 | 319 | 0 | 34279 | 0 | 8900 | 0 | 226087 | 0 | 0 |
| Howard Shaw MD | |||||||||||||
| 0 | 342509 | 0 | 0 | 0 | 2229 | 0 | 54506 | 0 | 2706 | 0 | 401950 | 0 | 0 |
| Lucinda VonBeren | |||||||||||||
| 0 | 228250 | 0 | 47250 | 0 | 26285 | 0 | 85748 | 0 | 15927 | 0 | 403460 | 0 | 47250 |
| Andre Ghantous MD | |||||||||||||
| 492977 | 0 | 0 | 0 | 420 | 0 | 0 | 0 | 18946 | 0 | 512343 | 0 | 0 | 0 |
| John Federico MD | |||||||||||||
| 439366 | 0 | 93448 | 0 | 414 | 0 | 0 | 0 | 18325 | 0 | 551553 | 0 | 0 | 0 |
| Donald Kim MD | |||||||||||||
| 348154 | 0 | 123905 | 0 | 320 | 0 | 0 | 0 | 18651 | 0 | 491030 | 0 | 0 | 0 |
| Ernest Moritz MD | |||||||||||||
| 352892 | 0 | 7700 | 0 | 1438 | 0 | 0 | 0 | 21130 | 0 | 383160 | 0 | 0 | 0 |
| Samuel Hahn MD | |||||||||||||
| 506753 | 0 | 2400 | 0 | 180 | 0 | 0 | 0 | 18438 | 0 | 527771 | 0 | 0 | 0 |
| Benedict Fernando MD | |||||||||||||
| 0 | 0 | 0 | 0 | 73419 | 0 | 0 | 0 | 0 | 0 | 73419 | 0 | 0 | 0 |
| Charles Hollander MD | |||||||||||||
| 0 | 204976 | 0 | 0 | 0 | 4275 | 0 | 0 | 0 | 0 | 0 | 209251 | 0 | 0 |
| David W Benfer | |||||||||||||
| 0 | 47306 | 0 | 0 | 0 | 145955 | 0 | 0 | 0 | 0 | 0 | 193261 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Part I, Line 1a | Taxable housing and automobile allowances are provided to Christopher M. O'Connor (Saint Raphael Healthcare System, Inc. Chief Executive Officer through 9/11/12) under the terms of the individual's employment contract. Taxable housing and automobile allowances are provided to Lawrence E. McManus (Saint Raphael Healthcare System, Inc. Chief Operating Officer and Chief Financial Officer through 4/4/12) under the terms of the individual's employment contract. In addition, reimbursements (non-taxable) are made for the business use of a social club. Taxable automobile allowance is provided to Janeanne Lubin-Szafranski (Saint Raphael Healthcare System, Inc. Chief Executive Officer effective 9/12/12) under the terms of the individual's employment contract. Taxable housing and automobile allowances are provided to John Burke (Saint Raphael's Chief Information Officer through 9/11/12) under the terms of the individual's employment contract. Taxable automobile allowances are provided to other vice-president level executives under the terms of the individual's employment contract. |
| Part I, Line 4b | Certain Saint Raphael executives were eligible to participate in a supplemental non-qualified retirement plan through a date in calendar year 2010. During calendar year 2011 no provision was made for participation in such plan. Vested amounts are reported as a component of the value reported in Schedule J Part II Column B (iii) "Other Reportable Compensation" for the following individuals- Lawrence E. McManus ($41,578), Alan Kliger, MD ($8), Janeanne Lubin-Szafranski ($34,659), Elizabeth Conrad ($22,644), Peter Duffy ($19,895), Sister Joan Granville ($42,390), Mary Kuncas ($31,608), Marshall Mandelkern, MD ($25,241), Lucinda VonBeren ($16,283). |
| Part I, Line 7 | Certain Saint Raphael executives are eligible to earn incentive compensation based upon the achievement of Board of Trustee's- approved metrics. During calendar year 2011 payments were made for incentives related to fiscal year ended September 30, 2010 and are reported in Schedule J Part II Column B (ii) "Bonus and Incentive Compensation". During fiscal year 2011 provision was made for incentives related to the fiscal year ended September 30, 2011; such provision is reported in Schedule J as a component of Part II Column C "Deferred Compensation" for the following individuals- Christopher M. O'Connor ($370,442), Lawrence E. McManus ($199,305), Alan Kliger, MD ($199,305), Janeanne Lubin-Szafranski ($111,662), James Rude ($45,354), Joseph Bisson ($91,464), Russ Braun, MD ($58,765), John Burke ($95,275), Elizabeth Conrad ($97,180), Thomas Donohue, MD ($106,313), Peter Duffy ($75,049), John Fitzgerald ($44,033), Sister Joan Granville ($64,431), Mary Kuncas ($91,716), Marshall Mandelkern, MD ($60,255), Kim Samele ($34,279), Howard Shaw, MD ($54,508), Lucinda VonBeren ($85,748). Certain Hospital of Saint Raphael physician caregivers are eligible to earn incentive compensation based upon the achievement of approved productivity metrics. During calendar year 2011 payments were made for such incentives as reported in Schedule J Part II Column B (ii) "Bonus and Incentive Compensation" for the physician caregivers and amounts identified. |
Schedule N IRS990ScheduleN
Disposition Table DispositionTable (7 entries)
| Description Of AssetDescriptionOfAsset | Date Of DistributionDateOfDistribution | FMV Of AssetFMVOfAsset | Method Of FMV DeterminationMethodOfFMVDetermination | EINEIN | Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | IRC SectionIRCSection |
|---|---|---|---|---|---|---|---|---|---|
| Yale-New Haven Hospital | |||||||||
| Cash | 2012-09-12 | 3400000 | Net Book Value as of 09/11/12 | 060646652 | 20 York Street | New Haven | CT | 06504 | 501(3)c |
| Yale-New Haven Hospital | |||||||||
| Inventory | 2012-09-12 | 7426862 | Net Book Value as of 09/11/12 | 060646652 | 20 York Street | New Haven | CT | 06504 | 501(3)c |
| Yale-New Haven Hospital | |||||||||
| Land | 2012-09-12 | 985500 | Net Book Value as of 09/11/12 | 060646652 | 20 York Street | New Haven | CT | 06504 | 501(3)c |
| Yale-New Haven Hospital | |||||||||
| Property, Plant and Equipment | 2012-09-12 | 85287614 | Net Book Value as of 09/11/12 | 060646652 | 20 York Street | New Haven | CT | 06504 | 501(3)c |
| Yale-New Haven Hospital | |||||||||
| Investment - Cyberknife Partnership | 2012-09-12 | 226821 | Net Book Value as of 09/11/12 | 060646652 | 20 York Street | New Haven | CT | 06504 | 501(3)c |
| Yale-New Haven Hospital | |||||||||
| Lukan Indemnity Co. Assets | 2012-09-12 | 33787352 | Net Book Value as of 09/11/12 | 060646652 | 20 York Street | New Haven | CT | 06504 | 501(3)c |
| Yale-New Haven Hospital | |||||||||
| Net Due From Third Parties | 2012-09-12 | 2360882 | Net Book Value as of 09/11/12 | 060646652 | 20 York Street | New Haven | CT | 06504 | 501(3)c |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor2 | 1 | DirectorOfSuccessor2 |
| Employee Of Successor2 | 1 | EmployeeOfSuccessor2 |
| Owner Of Successor2 | 0 | OwnerOfSuccessor2 |
| Receive Compensation2 | 1 | ReceiveCompensation2 |
Form990 Schedule N Part III Form990ScheduleNPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | Part II, Line 2e: Part 1 Line 2a. Vincent Calarco, Linda Masci, Sister Rosemary Moynihan and James Torgerson (Saint Raphael Healthcare System, Inc. trustees through September 11, 2012) have become trustees of the transferee organization as of September 12, 2012.Part I Line 2b. Christopher M. O'Connor, Alan Kliger MD, Thomas Donohue MD, Marshall Mandelkern MD, Howard Shaw MD, Lucinda VonBeren, Andre Ghantous MD, John Federico MD, Donald Kim MD, Ernest Moritz MD, and Samuel Hahn MD became employees of the transferee organization as of September 12, 2012.Part I Line 2d. Christopher M. O'Connor, Lawrence E. McManus, Janeanne Lubin-Szafranski, Joe Bisson, John Burke, Elizabeth Conrad, Peter Duffy, Sister Joan Granville, Mary Kuncas, Kim Samele, Lucinda VonBeren, John Fitzgerald and James Rude received Board of Trustee's approved retention payments for continuous employment through September 11, 2012 from Saint Raphael's. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Changes in Program Services | Form 990, Part III, line 3 | Effective as of 12:01am September 12, 2012, the majority of the assets and the operations of the Hospital of Saint Raphael were sold to Yale-New Haven Hospital (a 966-bed not-for-profit hospital located in New Haven, Connecticut) and its parent company (Yale-New Haven Health Services Corporation), and active operations ceased. The company remains in existence to wind-up corporate affairs, which includes the collection of outstanding accounts receivable and the payment of outstanding accounts payable & accrued expenses as of September 30, 2012. Wind-up activities for Hospital of Saint Raphael also include the disposition of temporarily and permanently restricted net assets pending transfer as of September 30, 2012. The Attorney General of the State of Connecticut must review all restrictions on these net assets, with a cy-pres action in Connecticut Superior Court probable for some of these restricted amounts. While the expectation is that these funds will ultimately transition to Yale-New Haven Hospital, it is possible that some of these funds could be directed to another charity. |
| Form 990, Part VI, Section A, line 6 | Hospital of Saint Raphael is a membership corporation and the sole Member of the Hospital is the Saint Raphael Healthcare System, Inc. | |
| Form 990, Part VI, Section A, line 7a | Saint Raphael Healthcare System, Inc. is the sole Member of the Hospital of Saint Raphael. | |
| Form 990, Part VI, Section A, line 7b | The following rights and powers are reserved to the Membership of the Hospital's sole Member: >To acquire, alienate or convey the real property or endowment funds of the Hospital having a value of $3,000,000 or more, or to place a mortgage on such property or funds in the amount of $3,000,000 or more. >To dispose of all or substantially all of the physical assets of the Hospital and to approve the merger or consolidation of the Hospital. >To borrow money and issue evidences of indebtedness in connection with the activities of the Hospital in the amount $3,000,000 or more, if such borrowings are to secured by mortgage, pledge or other lien on the Hospital's real property or endowment funds. >To organize or direct the organization of any corporation or other entity in which the Hospital will be a member or shareholder or have an equity interest greater than $1,000,000. >To dispose of stock or other equity interest of a corporation or other entity controlled by the Hospital. >To elect the Trustees of the Hospital who do not serve in an ex officio capacity. >To fill any vacancy occurring on the Board of Trustees, other than ex officio positions. >To amend the Certificate of Incorporation and Bylaws of the Hospital. >To appoint or remove the President of the Hospital. >To exercise any right specifically reserved to them in the certificate of incorporation of a subsidiary corporation controlled by the Hospital. | |
| Form 990, Part VI, Section B, line 11 | The governing body reviewed key elements of the 990 prior to submission. | |
| Form 990, Part VI, Section B, line 12c | Officers, trustees and key employees are required to complete the conflict of interest questionaire on an annual basis. Results of the questionaire are reviewed annually by the audit committee. | |
| Form 990, Part VI, Section B, line 15 | Compensation of the organization's chief executive officer is determined by the Compensation Committee of the Board of Trustees (utilizing an independent compensation consultant in conjunction with a compensation survey of the relevant marketplace). The Compensation Committee maintains minutes of its meetings. The Chief Executive Officer is employed with a written employment contract. Compensation of the organization's other officers and most of its key employees are also determined by the Compensation Committee of the Board of Trustees (utilizing an independent compensation consultant in conjunction with a compensation survey of the relevant marketplace). The Compensation Committee maintains minutes of its meetings. | |
| Form 990, Part VI, Section C, line 19 | The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. | |
| Changes in Net Assets or Fund Balances: | Form 990, Part XI, line 5: | Net unrealized gains on investments: 695617. Net equity transfers to affiliates 5487848. Contributions restricted to Special Purpose Fund 3433484. Gains on restricted Net Assets 484659. Net assets released from restriction -5728047. Change in interest in net assets of Saint Raphael Foundation, Inc. -9254665. Decrease in Minimum Pension Liability 45266000. Debt Defeasance -6878725. Transfer of Caritas investment 4683496. Gain on affiliation transaction 21848070. Total to Form 990, Part XI, Line 5: 60037737. |
| Form 990, Part VII, Line 1a, Column E | Amounts reported for James Carolan reflect payments made to Withers Bergman, LLC in the normal and recurring course of Hospital of Saint Raphael business and are not related to the volunteer services provided by the trustee to the organization. Amounts reported for Ralph DeNatale, MD reflect payments made to Connecticut Vascular Center ($35,200) and the individual physician ($90,833). Certain of the amounts reported for the individual physician reflect payments made as a stipend for his role as President of the Hospital of Saint Raphael Medical Staff (responsibilities include participation as a Hospital trustee). Other payments made in the normal and recurring course of Hospital of Saint Raphael business. Amounts reported for James Farmer, MD reflect payments made to Anesthesia Associates in the normal and recurring course of Hospital of Saint Raphael business and are not related to the volunteer services provided by the trustee to the organization. Amounts reported for W. Bruce Lundberg, MD reflect payments made to Medical Oncology and Hematology in the normal and recurring course of Hospital of Saint Raphael business and are not related to the volunteer services provided by the trustee to the organization. Amounts reported for Benedict Fernando, MD include payments made to West Haven Medical Group as a stipend for his role as President of the Hospital of Saint Raphael Medical Staff (responsibilities include participation as a Hospital trustee). Other payments made in the normal and recurring course of Hospital of Saint Raphael business. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lukan Indemnity Co Ltd | BusinessNameLine1 |
Address Foreign AddressForeign
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | FB Perry Building 40 Church Street | AddressLine1 |
| City | Hamilton | City |
| Province Or State | Hamilton | ProvinceOrState |
| Country | BD | Country |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 060653171 | EIN |
| Primary Activities | Direct and reinsurance malpractice | PrimaryActivities |
| Legal Domicile Foreign Country | BD | LegalDomicileForeignCountry |
| Total Income | 3454859 | TotalIncome |
| EOY Assets | 0 | EOYAssets |
Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|
| Saint Raphael Healthcare System Inc | ||||||||||
| 200 Orchard Street Suite 204 | New Haven | CT | 06511 | 061157542 | Tax exempt holding company | CT | 501 (c) 3 | 11a | 0 | |
| Caritas Insurance Company LTD | ||||||||||
| 30 Main Street Suite 330 | Burlington | VT | 05401 | 030322238 | Insurance | VT | 501 (c) 3 | 11a | 0 | Hospital of Saint Raphael |
| Saint Raphael Foundation Inc | ||||||||||
| 200 Orchard Street Suite 204 | New Haven | CT | 06511 | 510140710 | Fundraising Foundation | CT | 501 (c) 3 | 11a | 0 | Saint Raphael Healthcare System Inc |
| Saint Regis Health Center Inc | ||||||||||
| 200 Orchard Street Suite 204 | New Haven | CT | 06511 | 061217867 | Skilled Nursing Facility | CT | 501 (c) 3 | 3 | 0 | Saint Raphael Healthcare System Inc |
| DePaul Health Services Corp | ||||||||||
| 200 Orchard Street Suite 204 | New Haven | CT | 06511 | 061157544 | Tax exempt holding company | CT | 501 (c) 3 | 11a | 0 | Saint Raphael Healthcare System Inc |
| Hospital of Saint Raphael One for All Fund | ||||||||||
| 200 Orchard Street Suite 204 | New Haven | CT | 06511 | 222505062 | Fundraising Organization | CT | 501 (c) 3 | 11a | 0 | Hospital of Saint Raphael |
| VNA Services Inc | ||||||||||
| 200 Orchard Street Suite 204 | New Haven | CT | 06511 | 060646709 | Provision of healthcare services to patients in their homes | CT | 501 (c) 3 | 9 | 0 | DePaul Health Services Corporation |
| Saint Raphael Healthcare System Affiliated Physicians Inc | ||||||||||
| 200 Orchard Street Suite 204 | New Haven | CT | 06511 | 800522532 | Medical Foundation | CT | 501 (c) 3 | 11a | 0 | Saint Raphael Healthcare System Inc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | 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 | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (13 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Saint Raphael Healthcare System Inc | ||
| L | 2203409 | Cost Basis |
| Saint Raphael Healthcare System Inc | ||
| I | 23702 | FMV of Services |
| Saint Raphael Healthcare System Inc | ||
| C | 1385000 | Cash Value |
| Saint Raphael Healthcare System Inc | ||
| B | 2748515 | Cash Value |
| Caritas Insurance Company LTD | ||
| L | 1422131 | FMV of Services |
| Saint Raphael Foundation Inc | ||
| C | 7810332 | Cash Value |
| Saint Regis Health Center Inc | ||
| I | 28402 | FMV of Services |
| Saint Regis Health Center Inc | ||
| K | 1421988 | FMV of Services |
| Saint Regis Health Center Inc | ||
| J | 17041 | FMV of Services |
| Saint Regis Health Center Inc | ||
| B | 240847 | Cost Basis |
| VNA Services Inc | ||
| R | 654665 | FMV of Property |
| Saint Raphael Healthcare System Affiliated Physicians Inc | ||
| K | 8108908 | FMV of Services |
| Caritas Insurance Company LTD | ||
| C | 1500000 | Cash Value |