2013-07-23T15:13:47-05:00 2012-09-30 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE SUITE 2600 INDIANAPOLIS IN 46204 990 2011-10-01 060669121 The New Milford Hospital Inc % KEVIN T MEADE NEWM 8602105365 21 ELM STREET NEW MILFORD CT 06776 DEBORAH WEYMOUTH 2013-07-23 3176817000 2011 2016-02-24 21:20:13Z STEVEN H ROSENBERG 24 HOSPITAL AVENUE DANBURY CT 06810 79437851 false X WWW.NEWMILFORDHOSPITAL.ORG X 1921 CT NEW MILFORD HOSPITAL IS AN ACUTE CARE FACILITY DEDICATED TO MAINTAINING AND IMPROVING THE HEALTHCARE OF MEMBERS OF THE COMMUNITY THAT IT SERVES. 12 9 718 100 867084 -638069 1152058 604222 92269157 78110901 64299 23243 486987 699485 93972501 79437851 0 0 0 0 54770792 45235474 0 0 0 39041456 39949499 93812248 85184973 160253 -5747122 70984854 66374764 40595858 45828861 30388996 20545903 X TO PROVIDE OUTSTANDING HEALTHCARE TO THE COMMUNITY WE SERVE THROUGH AN UNCOMPROMISING FOCUS ON CLINICAL QUALITY, COMPASSIONATE CARE, AND THE CREATION OF A MEDICAL "SAFE HAVEN" FOR OUR PATIENTS AND THEIR FAMILIES. false false 69310070 77283705 SEE SCHEDULE O 69310070 true true false true false false false false false false true true false true true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true false false true 45 0 true 718 true true true false false false false false false false false false X 12 9 true false false false true true true true true false false true true true true true true false true true true X X KEVIN T MEADE 8602105365 21 ELM STREET NEW MILFORD CT 06776 X JOHN M MURPHY MD 2.0 X X 0 1039775 62114 NEIL CULLIGAN MD 1.0 X 0 0 DAVID KRAMER MD 1.0 X 0 0 DAVID CYGANOWSKI 1.0 X X 0 0 ALPHONSE ALTORELLI MD 1.0 X 0 0 RICHARD G JABARA 1.0 X 0 0 ANTHEA DISNEY 1.0 X 0 0 JOSEPH D SKRZYPCZAK 1.0 X X 0 0 SPENCER HOULDIN 1.0 X 0 0 JOHN R PATRICK 2.0 X 0 0 BRIAN C WHITE 1.0 X 0 0 JAMES KENNEDY 3.0 X 0 0 JOHN MARTOCCI TO 1231 3.0 X X 0 0 JAY LENT TO 531 1.0 X 0 0 JOHN C CLINE TO 1231 1.0 X 0 0 STEVEN H ROSENBERG 2.0 X 0 677240 53042 DEBORAH WEYMOUTH 40.0 X 375896 857 DONNA KAPLANIS 2.0 X 0 222445 59652 THOMAS KOOBATIAN MD 40.0 X 329551 88076 9209 COURTNEY CHAMBERS MD 40.0 X 534799 11900 5851 PRASHANT RODRIGUES MD 40.0 X 426614 8261 JOSEPH BARGELLINI MD 40.0 X 241458 214640 7237 LEE ZARGER MD 40.0 X 188753 7931 MARYDALE DEBOR 40.0 X 183667 1921 DANA DIGGINS X 290992 649 2571730 2254076 216724 50 true true false UNIDINE PO BOX 60479 CHARLOTTE NC 28260 NUTRITIONAL 1013471 CONNECTICUT ONCOLOGY HEMATOLOGY 200 KENNEDY DRIVE TORRINGTON CT 06811 MEDICAL SERVICES 227733 SECURITAS SECURITY SERVICES 108 MILL PLAIN ROAD DANBURY CT 06811 SECURITY SERVICES 388289 PERSANTE SLEEP CARE 130 GAITHER DRIVE MOUNT LAUREL NJ 08054 SLEEP CTR MANAGEMENT 233750 RINALDI LINEN SERVICE 47 COMMONS COURT WATERBURY CT 06704 LAUNDRY SERVICES 176344 10 274468 329754 604222 PATIENT SERVICE REVENUE 621990 49181319 49181319 MEDICARE/MEDICAID 621990 28062498 28062498 NON-PATIENT LABORATORY 621500 867084 867084 78110901 23243 23243 0 0 39888 39888 39888 39888 0 0 0 0 CAFETERIA & VENDING 722210 325141 325141 OTHER REVENUE 900099 264910 264910 GIFT SHOP 452000 69546 69546 659597 79437851 77283705 867084 682840 X 0 0 0 0 540603 0 540603 0 0 32748766 26199013 6549753 0 3365456 2692365 673091 0 6539183 5231346 1307837 0 2041466 1633173 408293 0 0 0 0 0 249415 0 249415 0 164982 0 164982 0 32662 0 32662 0 0 0 18222227 14577782 3644445 0 1477 0 1477 0 1388583 1110866 277717 0 614370 491496 122874 0 0 0 0 0 1307237 1045790 261447 0 6110 4888 1222 0 0 80919 64735 16184 0 419014 419014 0 0 0 5526925 4421540 1105385 0 2587578 2070062 517516 0 DRUGS 4182182 4182182 0 0 SUPPLIES 2817898 2817898 0 0 ORTHO IMPLANTS & SUPPLY 2347920 2347920 0 0 85184973 69310070 15874903 0 8207651 3717748 2809717 0 0 0 10457444 8601320 0 0 0 0 450818 0 1944478 1645080 964220 782669 108192101 75751426 34745031 32440675 0 0 10309928 14710574 0 0 0 0 1095567 4476698 70984854 66374764 8845259 6745393 0 0 0 0 0 0 0 0 0 0 1924491 1508855 0 0 29826108 37574613 40595858 45828861 X 26176392 12487373 525763 3923984 3686841 4134546 30388996 20545903 70984854 66374764 X -5747122 -4095971 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false true 3 false false true 32430 false true 229 32662 false SCHEDULE C, PART II-B - DESCRIPTION OF LOBBYING ONLY STATE AND LOCAL OFFICIALS WERE LOBBIED DURING 2012. AS PART OF THIS MISCELLANEOUS OFFICE EXPENSE SUCH AS PHONE, COMPUTER SUPPLIES, REFRESHMENT ETC. WERE INCURRED AND WERE REFLECTED ON LINE 1I ACCORDINGLY. DIRECT CONTACT WITH LEGISLATORS TO OPPOSE MITIGATION BUDGET CUTS IN DECEMBER, WHICH WOULD FORCE THE CLOSURE OF PROGRAMMING FOR THE UN/UNDER INSURED AND AT-RISK POPULATION. 1145712 1145712 49484944 32904818 16580126 398484 394265 4219 56864547 42452343 14412204 298414 298414 32440675 INVESTMENT IN FOUNDATION 14710574 C 14710574 CSV OF LIFE INSURANCE 1338177 DEFERRED COMPENSATION 100798 MALPRACTICE TRUST 2913457 OTHER RECEIVABLES 117875 SECURITY DEPOSITS 6391 4476698 0 ACCRUED MALPRACTICE 4353356 ACCRUED PENSION 20895560 ACCRUED WORKERS COMP 489961 DUE TO RELATED PARTIES 8873224 DUE TO THIRD PARTIES 2461714 FIN 47 ACCRUED LIABILITY 400000 SERP LIABILITY 100798 37574613 true true true true true true false true true 1407572 1061883 345689 0.00410 8792666 6252206 2540460 0.02980 10200238 7314089 2886149 0.03390 93682 0 93682 0.00110 88855 0 88855 0.00100 1106275 673281 432994 0.00510 8295 0 8295 0.00010 1297107 673281 623826 0.00730 11497345 7987370 3509975 0.04120 true 1284279 166956 22923946 37280831 -14356885 X true true NEW MILFORD MRI JV MRI READING 1.00000 1 1 NEW MILFORD HOSPITAL INC

21 ELM STREET NEW MILFORD CT 06776

X X X X NEW MILFORD HOSPITAL INC 1 true true 400. true 600. true X X X X X X X true true X X X X X X true false true X false false 1 DANBURY HOSPITAL LAB CTR OF NEW MILFORD

120 PARK LANE NEW MILFORD CT 06776

DIAGNOSTIC PART III, LINE 4 - BAD DEBT EXPENSE IT IS THE POLICY OF THE HOSPITAL TO PROVIDE NECESSARY CARE TO ALL PERSONS SEEKING TREATMENT WITHOUT DISCRIMINATION ON THE GROUNDS OF AGE, RACE, CREED, NATIONAL ORIGIN OR ANY OTHER GROUNDS UNRELATED TO AN INDIVIDUAL'S NEED FOR THE SERVICE OR THE AVAILABILITY OF THE NEEDED SERVICE AT THE HOSPITAL. A PATIENT IS CLASSIFIED AS A CHARITY CARE PATIENT BY REFERENCE TO ESTABLISHED POLICIES OF THE HOSPITAL. ESSENTIALLY, THESE POLICIES DEFINE CHARITY SERVICES AS THOSE SERVICES FOR WHICH NO PAYMENT IS ANTICIPATED. IN ASSESSING A PATIENT'S INABILITY TO PAY, THE HOSPITAL UTILIZES THE GENERALLY RECOGNIZED FEDERAL POVERTY INCOME GUIDELINES, BUT ALSO INCLUDES CERTAIN CASES WHERE INCURRED CHARGES ARE SIGNIFICANT WHEN COMPARED TO A RESPONSIBLE PARTY'S INCOME AND THEIR COUNTABLE ASSETS. THOSE CHARGES ARE NOT INCLUDED IN NET PATIENT SERVICE. PART III, LINE 8 - EXPLANATION OF SHORTFALL AS COMMUNITY BENEFIT THE HOSPITAL'S MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT AS THE ORGANIZATION STRIVES TO PROVIDE AROUND THE CLOCK COVERAGE, IMPROVED PATIENT ACCESS, HIGHEST CLINICAL QUALITY AS WELL AS ADDRESSING THE NEEDS OF THE COMMUNITY BY OFFERING CRITICAL SERVICES TO OUR GEOGRAPHIC AREA. AS A RESULT, THE ORGANIZATION MUST BALANCE THE COST OF THESE PROGRAMS AGAINST THE CONTINUED DECREASING GOVERNMENT REIMBURSEMENT LEVELS, UNINSURED POPULATION AND COMMUNITY NEEDS. PART III, LINE 9B - PROVISIONS ON COLLECTION PRACTICES FOR QUALIFIED PATIENTS IT IS THE POLICY OF THE HOSPITAL TO PROVIDE "FINANCIAL ASSISTANCE" (EITHER FREE CARE OR REDUCED PATIENT OBLIGATION) TO PERSONS OR FAMILIES WHERE: (I) THERE IS LIMITED OR NO HEALTH INSURANCE AVAILABLE; (II) THE PATIENT FAILS TO QUALIFY FOR GOVERNMENTAL ASSISTANCE (FOR EXAMPLE MEDICARE OR MEDICAID); (III) THE PATIENT COOPERATES WITH THE HOSPITAL IN PROVIDING THE REQUESTED INFORMATION; (IV) THE PATIENT DEMONSTRATES FINANCIAL NEED; AND (V) THE HOSPITAL MAKES AN ADMINISTRATIVE DETERMINATION THAT FINANCIAL ASSISTANCE IS APPROPRIATE. AFTER THE HOSPITAL DETERMINES THAT A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL WILL DETERMINE THE AMOUNT OF FINANCIAL ASSISTANCE AVAILABLE TO THE PATIENT BY UTILIZING THE CHARITABLE ASSISTANCE GUIDELINES, WHICH ARE BASED UPON THE MOST RECENT FEDERAL POVERTY GUIDELINES. THE HOSPITAL SHALL REGULARLY REVIEW THIS FINANCIAL ASSISTANCE POLICY TO ENSURE THAT AT ALL TIMES IT: (I) REFLECTS THE PHILOSOPHY AND MISSION OF THE HOSPITAL; (II) EXPLAINS THE DECISION PROCESSES OF WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE AND IN WHAT AMOUNTS; AND (III) COMPLIES WITH ALL APPLICABLE STATE AND FEDERAL LAWS, RULES, AND REGULATIONS CONCERNING THE PROVISION OF FINANCIAL ASSISTANCE TO INDIGENT PATIENTS. CONSISTENT WITH THIS MISSION, THE HOSPITAL RECOGNIZES ITS OBLIGATION TO THE COMMUNITY IT SERVES TO PROVIDE FINANCIAL ASSISTANCE TO INDIGENT PERSONS WITHIN THE COMMUNITY. IN FURTHERANCE OF ITS CHARITABLE MISSION, THE HOSPITAL WILL PROVIDE BOTH (I) EMERGENCY TREATMENT TO ANY PERSON REQUIRING SUCH CARE; AND (II) ESSENTIAL, NON-EMERGENT CARE TO PATIENTS WHO ARE PERMANENT RESIDENTS OF ITS PRIMARY SERVICE AREA WHO MEET THE CONDITIONS AND CRITERIA SET FORTH IN THIS POLICY, WITHOUT REGARD TO THE PATIENTS' ABILITY TO PAY FOR SUCH CARE. ELECTIVE PROCEDURES GENERALLY WILL NOT BE CONSIDERED ESSENTIAL, NON-EMERGENT CARE AND USUALLY WILL NOT BE ELIGIBLE FOR FINANCIAL ASSISTANCE. THE HOSPITAL WILL COLLECT FROM INDIVIDUALS ON FINANCIAL ASSISTANCE IF THEY RECEIVED A PARTIAL CHARITABLE DISCOUNT. ALL PATIENTS CAN APPLY FOR CHARITABLE CARE ON BALANCES THEY FEEL THEY CANNOT AFFORD. PART V, LINE 13G - OTHER MEANS HOSPITAL FACILITY PUBLICIZED THE POLICY NEW MILFORD HOSPITAL HAS MESSAGES ON ALL STATEMENTS PROVIDING INFORMATION REGARDING HOW THE PATIENT CAN GET ASSISTANCE WITH THEIR HOSPITAL BILL. COUNSELORS ARE ALSO AVAILABLE TO PROVIDE FURTHER ASSISTANCE. PART VI, LINE 2 - NEEDS ASSESSMENT THE ORGANIZATION MONITORS AND REPORTS CMS INFORMATION. DATA INCLUDES BASIC DEMOGRAPHICS, ALONG WITH HEALTH ISSUE-SPECIFIC INFORMATION. ADDITIONALLY, WE SURVEY OUR CONSUMERS ON A REGULAR AND ONGOING BASIS FOR THEIR OPINIONS AND CONCERNS. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE THE HOSPITAL HAS MESSAGES ON ALL STATEMENTS PROVIDING INFORMATION REGARDING HOW THE PATIENT CAN GET ASSISTANCE WITH THEIR HOSPITAL BILL. ALSO SIGNS ARE POSTED THROUGHOUT THE HOSPITAL AND COUNSELORS ARE AVAILABLE TO PROVIDE FURTHER ASSISTANCE. ALL UNINSURED INPATIENTS ARE INTERVIEWED BY FINANCIAL COUNSELORS AND ASSESSED FOR ELIGIBILITY FOR ASSISTANCE PROGRAMS. THE HOSPITAL PROVIDES INFORMATIONAL HANDOUTS TO ALL UNINSURED PATIENTS AT THE TIME OF REGISTRATION WHICH REFERS THEM TO FINANCIAL COUNSELING IF THEY WOULD LIKE ASSISTANCE WITH THEIR BILLS. FURTHER, THE HOSPITAL MAILS NOTICES TO ALL SELF-PAY ACCOUNTS REFERRING THEM TO FINANCIAL COUNSELING IF THEY NEED ASSISTANCE. THE COLLECTION DEPARTMENT WILL ALSO REFER PATIENTS TO FINANCIAL COUNSELING WHEN A PATIENT INDICATES THAT THEY CANNOT AFFORD THEIR BALANCES; AND FINALLY, SCHEDULERS REFER UNINSURED PATIENTS TO FINANCIAL COUNSELING PRIOR TO THEIR TEST OR PROCEDURE. PART VI, LINE 4 - COMMUNITY INFORMATION THE HOSPITAL'S PRIMARY SERVICE AREA IS THE CITY OF NEW MILFORD AND SURROUNDING SUBURBAN TOWNS THAT MAKE UP CENTRAL LITCHFIELD COUNTY. THE REGION IS GENERALLY EMPLOYED AND WITH AVERAGE INCOMES. CONSTITUENTS ARE PREDOMINANTLY CAUCASIAN, SKEW SOMEWHAT OLDER THAN OTHER AREAS OF CT AND THE U.S. POVERTY LEVELS ARE BELOW OTHER AREAS. PART VI - COMMUNITY BUILDING ACTIVITIES NEW MILFORD HOSPITAL IS ACTIVELY ENGAGED WITH THE COMMUNITY THAT IT SERVES. WE PROVIDE COMMUNITY HEALTH IMPROVEMENT SERVICES, WORKFORCE DEVELOPMENT AND COALITION BUILDING ACTIVITIES TO LEARN ABOUT THE COMMUNITY HEALTH AND OTHER NEEDS. PART VI, LINE 5 - EXPLANATION OF HOW ORGANIZATION FURTHERS ITS EXEMPT PURPOSE DURING FISCAL YEAR 2012, NEW MILFORD HOSPITAL SERVED 2,288 INPATIENTS AND CARED FOR 68,689 OUTPATIENTS. IN ADDITION, 18,416 PATIENTS CAME THROUGH OUR EMERGENCY DEPARTMENT AND 2,288 ONE-DAY SURGERY PROCEDURES WERE PERFORMED. LED BY A TEAM OF SKILLED AND DEDICATED HEALTHCARE PROFESSIONALS, NEW MILFORD HOSPITAL'S COMMITMENT TO CLINICAL EXCELLENCE AND PATIENT SATISFACTION WERE RECOGNIZED BY NUMEROUS PRESTIGIOUS ORGANIZATIONS IN 2012. THE CREATION OF WESTERN CONNECTICUT HEALTH NETWORK, A HEALTHCARE DELIVERY SYSTEM THAT COMBINES THE RESOURCES AND EXPERTISE OF DANBURY HOSPITAL, NEW MILFORD HOSPITAL AND THEIR AFFILIATES, REPRESENTS A HISTORICAL ACHIEVEMENT. THIS AFFILIATION GIVES US AN OPPORTUNITY TO PROVIDE A HIGHER LEVEL OF CARE THROUGHOUT THE REGION IN THE MOST COST-EFFECTIVE MANNER WHILE MEETING THE CHALLENGES POSED BY HEALTHCARE REFORM HEAD ON. PROVIDING OUR PHYSICIANS AND MEDICAL TEAM WITH THE TECHNOLOGICAL ADVANCES THEY NEED TO SUCCEED REMAINS A PRIORITY. THE LINACC CANCER TREATMENT SYSTEM, 64 SLICE CT SCANNER, AND THE OPEN BORE MRI IMAGING SYSTEM, FOR EXAMPLE, OFFER PATIENTS A SOPHISTICATED LEVEL OF CARE RARELY AVAILABLE IN A COMMUNITY HOSPITAL. EVER MINDFUL OF IMPROVING THE PATIENT EXPERIENCE, THE HOSPITAL BUILDS UPON ITS ESTABLISHED HIGH LEVELS OF PATIENT SATISFACTION AND SERVICE EXCELLENCE THROUGH ITS AFFILIATION WITH "PLANETREE", A RECOGNIZED PHILOSOPHY IN PATIENT-CENTERED CARE. THE PARTNERSHIP FOCUSES IN IMPLEMENTING INNOVATIVE MODELS OF CARE THAT NURTURE THE MIND, BODY AND SPIRIT BY SUPPORTING PATIENTS, FAMILY MEMBERS AND STAFF ALIKE. KNOWLEDGE IS POWER WHEN IT COMES TO IMPROVING THE HEALTH AND WELLNESS OF PEOPLE OF ALL AGES IN CONNECTICUT AND NEW YORK. THAT'S THE MESSAGE BEHIND A NUMBER OF HOSPITAL INITIATIVES DESIGNED TO BUILD HEALTHY COMMUNITIES. PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM ROLES AND PROMOTION WESTERN CONNECTICUT HEALTH NETWORK, INC. (PARENT): WESTERN CONNECTICUT HEALTH NETWORK'S MISSION IS TO IMPROVE THE HEALTH AND WELL BEING OF THOSE WE SERVE, WHICH HELPS TO FURTHER THE HOSPITAL'S EXEMPT PURPOSE. DANBURY HOSPITAL DANBURY HOSPITAL PROVIDES MEDICAL SERVICES TO THE COMMUNITY REGARDLESS OF THE INDIVIDUAL'S ABILITY TO PAY. SERVICES INCLUDE ROUTINE INPATIENT ANCILLARY AND OUTPATIENT CARE IN SUPPORT OF THE HOSPITAL'S MISSION STATEMENT, TO IMPROVE THE HEALTH AND WELL BEING OF THOSE WE SERVE. FOR 2012, DANBURY HOSPITAL PROVIDED $13,969,782 IN CHARITY CARE. NEW MILFORD HOSPITAL: NEW MILFORD HOSPITAL'S MISSION IS TO PROVIDE OUTSTANDING HEALTH CARE TO THE COMMUNITIES THEY SERVE THROUGH AN UNCOMPROMISING FOCUS ON CLINICAL QUALITY, COMPASSIONATE SERVICE, AND THE CREATION OF A MEDICAL "SAFE HAVEN" FOR THEIR PATIENTS AND FAMILIES. FOR 2012, NEW MILFORD HOSPITAL PROVIDED $1,610,576 IN CHARITY CARE. WESTERN CONNECTICUT MEDICAL GROUP THE MISSION AT WESTERN CONNECTICUT MEDICAL GROUP IS TO PROVIDE SAFE, INNOVATIVE, CONVENIENT AND COORDINATED PRIMARY AND SPECIALTY HEALTH CARE IN THE COMMUNITIES THEY SERVE AND STRIVE TO BE AWARE OF AND RESPOND TO THEIR PATIENTS NEEDS. THEY SUPPORT A COMMITMENT TO ADVANCE THE HEALTH AND WELL-BEING OF INDIVIDUALS IN THEIR COMMUNITY BY DELIVERING QUALITY CARE, PARTICIPATING IN MEDI STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI CT, true true false false false true true false false JOHN M MURPHY MD 0 753982 0 280000 0 5793 0 22040 0 40074 0 1101889 0 0 STEVEN H ROSENBERG 0 504098 0 150000 0 23142 0 22040 0 31002 0 730282 0 0 DEBORAH WEYMOUTH 295120 80000 776 0 857 376753 0 DONNA KAPLANIS 0 180813 0 40000 0 1632 0 22040 0 37612 0 282097 0 0 THOMAS KOOBATIAN MD 328894 87692 0 0 657 384 0 0 8764 445 338315 88521 0 0 COURTNEY CHAMBERS MD 296192 11845 238607 0 0 55 0 0 5851 0 540650 11900 0 0 PRASHANT RODRIGUES MD 420107 0 6507 0 8261 434875 0 JOSEPH BARGELLINI MD 236058 213601 5400 0 0 1039 0 0 4764 2473 246222 217113 0 0 LEE ZARGER MD 187511 236 1006 0 7931 196684 0 MARYDALE DEBOR 70912 0 112755 0 1921 185588 0 DANA DIGGINS 34974 0 256018 0 649 291641 0 COMPENSATION INFORMATION PART I, LINE 4 - RECEIVED SEVERANCE, SUPPLEMENTAL NQ RETIREMENT, EQUITY-BASED COMPENSATION DANA DIGGINS RECEIVED SEVERANCE PAYMENTS OF $256,018. THE AGREEMENT WAS FOR A PERIOD OF ONE YEAR FROM TERMINATION. MARYDALE DEBOR RECEIVED SEVERANCE PAYMENTS OF $112,755. THE AGREEMENT WAS FOR A PERIOD OF ONE YEAR FROM TERMINATION. DURING THE FISCAL YEAR ENDING SEPTEMBER 30, 2012, DR. JOHN MURPHY, PRESIDENT AND CEO, AND STEVEN H. ROSENBERG, CFO WERE THE ONLY PARTICIPANTS OF A NEW SERP PLAN. NO PAYMENTS WERE MADE TO THEM. DUE TO A CAP IN THE DEFINED PENSION PLAN OF $190,000 THE SERP IS INTENDED TO GIVE SUPPLEMENTAL RETIREMENT BENEFITS TO KEY MEMBERS OF THE EXECUTIVE GROUP, WHOSE SALARY EXCEEDS THIS AMOUNT. THE SERP IS DESIGNED TO VEST KEY EXECUTIVES WITH AN INCENTIVE TO REMAIN WITH THE SYSTEM UNTIL THEY REACH RETIREMENT AGE. THE SERP IS NOT A QUALIFIED RETIREMENT PLAN AND THEREFORE IS SUBJECT TO CERTAIN TAX IMPLICATIONS UPON VESTING VS. THE TIME RETIREMENT PAYMENTS ARE MADE. THE EXPENSES FOR THE SERP COSTS ARE RECOGNIZED EACH ACCOUNTING PERIOD IN THREE SEGMENTS. THESE ARE: -PRIOR SERVICE COSTS THE ACTUAL PRESENT VALUE OF SERP BENEFITS FOR MEMBERS OF THE SERP GROUP AS COMPUTED ON THE DATE THE SERP IS IMPLEMENTED. THE INTANGIBLE ASSET IS AMORTIZED OVER THE ESTIMATED WORKING LIFE OF THE EXECUTIVES IN THE SERP PLAN. -CURRENT SERVICE COSTS THE CURRENT SERVICE COST (CSO) IS THE AMOUNT OF BENEFITS EARNED BY THE EMPLOYEE DURING THE CURRENT PERIOD. THE CSO IS CALCULATED AS THE DIFFERENCE IN THE ACTUARIAL PRESENT VALUE OF A LIFE ANNUITY, STARTING ON THE PROJECTED DATE OF RETIREMENT, DISCOUNTED TO THE BEGINNING OF THE PRESENT ACCOUNTING PERIOD; AND THE SAME ANNUITY DISCOUNTED TO THE END OF THE PRESENT ACCOUNTING PERIOD. -INTEREST COMPONENT EACH YEAR THE BEGINNING BALANCE IN THE UNFUNDED BENEFIT OBLIGATION IS CHARGED A DISCOUNTED INTEREST RATE. THE INTEREST COST (IMPLIED) IS THE INCREASE IN THE BENEFIT OBLIGATION DUE TO THE PASSAGE OF TIME. PART I, LINE 6 - COMPENSATION CONTINGENT ON NET EARNINGS OR RELATED ORGANIZATION SUMMARY OF EXECUTIVE INCENTIVE PLAN (EXCERPTS FROM) THE PLAN WILL BE ADMINISTERED SUBJECT TO THE BOARD POLICY ON EXECUTIVE COMPENSATION BY THE COMMITTEE ON GOVERNANCE SERVING AS THE EXECUTIVE COMPENSATION COMMITTEE (THE COMMITTEE) OF THE BOARD OF DIRECTORS OF WESTERN CONNECTICUT HEALTH NETWORK, INC. THE COMMITTEE MAY IN ITS SOLE DISCRETION INTERPRET THE PLAN, PRESCRIBE ANY RULES AND REGULATIONS NECESSARY OR APPROPRIATE FOR ADMINISTRATION OF THE PLAN, AND MAKE SUCH OTHER DETERMINATIONS AND TAKE SUCH ACTION AS IT DEEMS NECESSARY OR ADVISABLE. THE PLAN YEAR WILL BEGIN OCTOBER 1, 2011, AND END SEPTEMBER 30, 2012. THE MEASUREMENT PERIOD FOR AWARD PURPOSES WILL BE THE SAME. ELIGIBILITY TO PARTICIPATE IN THE PLAN WILL BE LIMITED TO THOSE WHO ARE IN POSITIONS IN WHICH THEIR DECISIONS, ACTIONS AND COUNSEL SIGNIFICANTLY AFFECT THE OPERATIONS OF WESTERN CONNECTICUT HEALTH NETWORK, INC. AND ITS SUBSIDIARIES, AS DETERMINED BY THE COMMITTEE AND WITH INPUT PROVIDED BY SENIOR MANAGEMENT. PRIOR TO THE START OF EACH PLAN YEAR, OR AS SOON AS PRACTICABLE THEREAFTER, THE COMMITTEE, WITH INPUT PROVIDED BY SENIOR MANAGEMENT, WILL DETERMINE WHICH ELIGIBLE INDIVIDUALS WILL PARTICIPATE IN THE PLAN WITH RESPECT TO SUCH PLAN YEAR AND THEY WILL BE LISTED ACCORDINGLY. IN DETERMINING WHICH ELIGIBLE INDIVIDUALS WILL PARTICIPATE, THE COMMITTEE WILL TAKE INTO ACCOUNT THE EXTENT TO WHICH ELIGIBLE INDIVIDUALS ARE IN POSITIONS IN WHICH THEIR DECISIONS, ACTIONS AND COUNSEL SIGNIFICANTLY AFFECT THE OVERALL PERFORMANCE OF WESTERN CONNECTICUT HEALTH NETWORK, INC. AND ITS AFFILIATES. TO BE CONSIDERED FOR PARTICIPATION, AN INDIVIDUAL MUST BE IN AN INCENTIVE ELIGIBLE POSITION FOR NO LESS THAN 6 MONTHS OF THE RESPECTIVE PLAN YEAR. INCENTIVE AWARDS WILL BE PRORATED AS APPROPRIATE TO REFLECT PARTIAL PLAN YEAR PARTICIPATION. ELIGIBLE INDIVIDUALS MUST BE EMPLOYED BY WESTERN CONNECTICUT HEALTH NETWORK, INC. AT THE TIME OF EXECUTIVE INCENTIVE AWARD DISTRIBUTION. THE COMMITTEE WILL ESTABLISH THE TARGET AWARD OPPORTUNITY (EXPRESSED AS A PERCENTAGE OF BASE SALARY) FOR EACH PARTICIPANT IN THE PLAN. THE TARGET AWARD IS THE AMOUNT PAID TO PARTICIPANTS FOR ACTUAL PERFORMANCE THAT MEETS EXPECTATIONS. TO RECOGNIZE A RANGE OF PERFORMANCE ABOVE THE "TARGET" LEVEL, PARTICIPANTS MAY EARN ONE-HALF TO ONE AND ONE-HALF TIMES THE TARGET AWARD OPPORTUNITIES BASED ON ACTUAL PERFORMANCE. A THRESHOLD OF PERFORMANCE MUST BE ACHIEVED IN ORDER FOR PARTICIPANTS TO EARN AWARDS. PRIOR TO THE BEGINNING OF EACH PLAN YEAR, OR AS SOON THEREAFTER AS PRACTICABLE, WEIGHTINGS FOR THE PERFORMANCE MEASURES INCLUDED IN THE PLAN WILL BE DETERMINED FOR EACH PARTICIPANT IN ACCORDANCE WITH THE NATURE OF EACH PARTICIPANT'S STATED GOALS AND RESPONSIBILITIES (I.E., ORGANIZATIONAL, FUNCTIONAL/INDIVIDUAL, ETC.). PRIOR TO THE BEGINNING OF EACH PLAN YEAR, OR AS SOON THEREAFTER AS PRACTICABLE, PERFORMANCE MEASURES AND PERFORMANCE LEVELS WILL BE ESTABLISHED FOR EACH PARTICIPANT IN THE PLAN. INCENTIVE AWARDS WILL BE MODIFIED OR ELIMINATED IF AT THE LEVEL OF PERFORMANCE SPECIFIED IN THE CIRCUIT BREAKER IS NOT ACHIEVED. THE CIRCUIT BREAKER WILL BE ESTABLISHED BY THE COMMITTEE PRIOR TO THE BEGINNING OF EACH FISCAL YEAR OR AS SOON THEREAFTER AS PRACTICABLE. IF EBITDA IS LESS THAN BASIC, FULL ELIMINATION OF INCENTIVE AWARD WILL OCCUR. NOTWITHSTANDING ANY OTHER PROVISION OF THE PLAN, INCENTIVE AWARDS CAN BE AFFECTED BY AN INDIVIDUAL MODIFIER (BASED ON INDIVIDUAL EXECUTIVE PERFORMANCE) AT THE LEVEL SPECIFIED IN THE PLAN. PART III - ADDITIONAL INFORMATION THE ORGANIZATION RELIED ON A RELATED ORGANIZATION, WESTERN CONNECTICUT HEALTH NETWORK, INC. WHICH USED THE FOLLOWING METHODS DESCRIBED BELOW TO ESTABLISH TOP MANAGEMENT'S COMPENSATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY BOARD OR COMPENSATION COMMITTEE PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A DURING 2012, NEW MILFORD HOSPITAL HAS EXPERIENCED MEANINGFUL CHANGE, DELIVERED LIFE-CHANGING EXPERIENCES, CONFRONTED SERIOUS ISSUES AND ACHIEVED SIGNIFICANT PROGRESS. WE ARE PROUD OF THE REMARKABLE PROGRESS WE HAVE MADE DURING A CHALLENGING AND ULTIMATELY REWARDING YEAR. AS WE CONTINUE TO CHART A NEW PATH TO THE FUTURE OF HEALTHCARE WE FOCUS ON THE REAL RESULTS THAT PEOPLE AND INVESTMENTS CAN CREATE. THE BEST HEALTHCARE COMES FROM COMBINING TOP MEDICAL CARE WITH A PERSONAL TOUCH PROVIDED BY OUR TEAM OF DEDICATED PROFESSIONALS. THAT'S HOW WE IMPROVE THE HEALTH OF OUR COMMUNITIES, ONE PERSON AT A TIME. WE LOOK AT 2012 AS A YEAR OF PROGRESS ON MANY FRONTS. WE ARE EXPANDING CANCER CARE, WOMEN'S HEALTH AND EMERGENCY SERVICES. WE HAVE INTEGRATED LABORATORY AND RADIOLOGY SERVICES TO OFFER MORE ACCESS AND IMPROVE EFFICIENCY. PROFESSIONAL COOPERATION BETWEEN OUR PHYSICIANS, SUPPORT STAFF AND HOSPITALS HAS NEVER BEEN STRONGER. OUR PLAN TO EXPAND THE EMERGENCY ROOM IN 2013 WILL ADD CAPACITY TO THIS AREA. ACCOUNTABLE CARE IS A DELIVERY CONCEPT THAT TIES PROVIDER REIMBURSEMENTS TO SPECIFIC QUALITY MEASURES, PATIENT SATISFACTION, EFFICIENCIES AND REDUCTIONS IN THE TOTAL COST OF CARE FOR A PARTICULAR POPULATION OF PATIENTS. AN ACCOUNTABLE CARE ORGANIZATION (ACO) IS DESIGNED TO REWARD IMPROVEMENTS IN HEALTHCARE QUALITY BY SHARING THE SAVINGS THAT RESULT FROM A MORE COMPREHENSIVE CONTINUUM OF CARE THAT YIELDS BETTER PATIENT OUTCOMES AT EVERY LEVEL OF INTERVENTION. AT THE SAME TIME, A HOSPITAL THAT FAILS TO MEET MINIMUM MEASURES IS PUT ON NOTICE THAT THEY WILL EVENTUALLY BE PENALIZED WITH REDUCED REIMBURSEMENTS IF THEY DO NOT IMPROVE IN A NUMBER OF AREAS. IN LATE 2011, THE ESTABLISHMENT OF ACOS BECAME AN IMPORTANT FEATURE OF THE AFFORDABLE CARE ACT WHEN THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) ISSUED A SET OF GUIDELINES FOR HEALTHCARE PROVIDERS LIKE DANBURY HOSPITAL. TO ADDRESS THE OVERALL GOAL TO IMPROVE HEALTHCARE QUALITY, CMS SPECIFIES FIVE DOMAINS BY WHICH THEY AND PROVIDER PARTICIPANTS CAN MONITOR PERFORMANCE QUALITY: - PATIENT/CAREGIVER EXPERIENCE - CARE COORDINATION - PATIENT SAFETY - PREVENTIVE HEALTH - CARE OF AT-RISK POPULATIONS INCLUDING THE FRAIL ELDERLY IN 2012, NEW MILFORD HOSPITAL ACTED WITH A PILOT PLAN TO MEET AND, WHERE POSSIBLE, EXCEED THESE GOALS. NEW MILFORD HOSPITAL STRIVES EVERY DAY TO PROTECT AND PROMOTE THE HEALTH AND WELLNESS OF EACH OF OUR PATIENTS AND TO PROVIDE ACCESS TO THE HIGHEST QUALITY CARE, REGARDLESS OF THEIR ABILITY TO PAY. WHETHER IT IS THROUGH CREATIVE PREVENTION PARTNERSHIPS, THE MANAGEMENT OF CHRONIC ILLNESSES, OR CONNECTING PATIENTS TO APPROPRIATE COMMUNITY SERVICES, WE ARE DEVOTED TO SERVING OUR NEIGHBORS IN NEED. WE ARE ESPECIALLY VIGILANT NOW DURING THESE DIFFICULT ECONOMIC TIMES, FOCUSING ON DISPARITIES IN CARE, OLDER ADULT HEALTH NEEDS, SUBSTANCE ABUSE AND MENTAL HEALTH AND IMPROVING AWARENESS OF HEALTH SERVICES AND SUPPORTS. MOREOVER, WE MUST PURSUE OUTREACH PROGRAMS THAT ADDRESS SUCH MAJOR HEALTH ISSUES AS HEART DISEASE AND CANCER. SOME OF OUR MOST EFFECTIVE HEALTH AND WELLNESS INITIATIVES ARE OFFERING A STABLE SAFETY NET OF MEDICAL ARE AND SUPPORT SERVICES FOR OUR MOST VULNERABLE AND AT-RISK NEIGHBORS LIVING WITH SERIOUS MENTAL HEALTH AND SUBSTANCE ABUSE ISSUES. ACHIEVEMENTS OF 2012 SHOW A NEW PICTURE EMERGING: A COORDINATED AND STRONG HEALTH CARE PARTNER THAT PRESERVES THE CARING SPIRIT OF A COMMUNITY HOSPITAL WITH A CONTEMPORARY OPERATION THAT REFLECTS THE BEST OF MODERN HEALTHCARE. AS WE APPROACH THE OPPORTUNITIES OF 2013, WE WILL CONTINUE TO INVEST IN OUR FUTURE TO HELP OUR COMMUNITIES EXPERIENCE THIS NEW PICTURE OF HEALTH. FAMILY AND BUSINESS RELATIONSHIPS FORM 990, PART VI, LINE 2 RICHARD JABARA AND JAMES KENNEDY, BOTH DIRECTORS OF NEW MILFORD HOSPITAL HAVE A BUSINESS RELATIONSHIP. DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINE 6 WESTERN CONNECTICUT HEALTH NETWORK, INC. IS THE SOLE MEMBER OF NEW MILFORD HOSPITAL. DESCRIPTION OF CLASSES OF PERSONS, NATURE OF RIGHTS, & VOTING RIGHTS FORM 990, PART VI, LINE 7A THE SOLE MEMBER SHALL BE RESPONSIBLE FOR ELECTING, AT THE ANNUAL MEETING OF THE MEMBERSHIP, THE MEMBERS OF THE BOARD OF DIRECTORS OF THE HOSPITAL TO SERVE FOR THREE YEAR TERMS AND UNTIL THEIR SUCCESSORS ARE ELECTED AND HAVE QUALIFIED. DECISIONS OF GOVERNING BODY SUBJECT TO APPROVAL FORM 990, PART VI, LINE 7B THE DUTIES AND RESPONSIBILITIES OF THE SOLE MEMBER SHALL INCLUDE, AMONG OTHERS, THE FOLLOWING: ELECTING AT THE ANNUAL MEETING OF THE MEMBERSHIP, THE MEMBERS OF THE BOARD OF DIRECTORS OF THE HOSPITAL TO SERVE FOR THREE YEAR TERMS AND UNTIL THEIR SUCCESSORS ARE ELECTED AND HAVE QUALIFIED: FILLING VACANCIES ON THE BOARD OF DIRECTORS, WHICH OCCUR BETWEEN ELECTIONS; REVIEWING, MAKING, AND APPROVING CHANGES IN THE BYLAWS; INSURING THAT THE OBJECTIVE, PURPOSES AND GOALS OF DANBURY HOSPITAL AS STATED IN THE CHARTER OF THE DANBURY HOSPITAL, INC. ARE PROPERLY AND EFFECTIVELY CARRIED OUT BY THE BOARD OF DIRECTORS; DELEGATING AS APPROPRIATE, TO THE BOARD OF DIRECTORS, POLICY-MAKING FUNCTIONS, THE SUPERVISION OF THE HOSPITAL'S OPERATIONS AND THE CONTROL OVER THE HOSPITAL'S ASSETS. FORM 990 REVIEW PROCESS FORM 990, PART VI, LINE 11B STEVEN ROSENBERG, CFO, WILL REVIEW THE 990 PRIOR TO IT BEING SENT TO THE IRS. A PRELIMINARY 990, IS PRESENTED TO THE AUDIT COMMITTEE IN JUNE, WHO REVIEWS IT ON BEHALF OF THE BOARD. E&Y IS ON HAND TO REVIEW THE 990 WITH THE AUDIT COMMITTEE AND ANSWER ANY QUESTIONS. PRIOR TO THE 990 BEING FILED WITH THE IRS, THE BOARD WILL GET A FULL AND ACCURATE COPY ON A SECURED WEBSITE FOR THEIR REVIEW. EXPLANATION OF MONITORING AND ENFORCEMENT OF CONFLICTS FORM 990, PART VI, LINE 12C BOARD MEMBERS AND SENIOR MANAGEMENT ARE COGNIZANT OF THE IMPORTANCE OF DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST AND WILL QUESTION POSSIBLE CONFLICTS IN VARIOUS BOARD MEETINGS. THE CHIEF COMPLIANCE OFFICER IS PART OF THE ROUTINE CONTRACTS REVIEW PROCESS AND WATCHES FOR POTENTIAL CONFLICTS WITH BOARD, MANAGEMENT AND STAFF. THE GENERAL COUNSEL WILL CONTINUALLY REQUEST THE INFORMATION UNTIL ALL RESPONSES ARE RECEIVED. THE AUDIT COMMITTEE REVIEWS AND EVALUATES EACH DISCLOSURE TO DETERMINE IF THERE IS A CONFLICT. A SUMMARY REPORT IS SHARED WITH THE FULL BOARD. THE COI POLICY BELOW NOTES WHAT IS TO OCCUR, WHEN THERE IS A CLEAR CONFLICT. CONFLICT OF INTEREST POLICY FOR DIRECTORS AND OFFICERS THE PURPOSE OF THIS POLICY IS TO ENSURE THAT THE DIRECTORS AND OFFICERS OF WESTERN CONNECTICUT HEALTH NETWORK, INC. (WCHN) (TOGETHER THE "REPRESENTATIVES" AND INDIVIDUALLY A "REPRESENTATIVE") ARE NOT PREVENTED FROM PERFORMING SERVICES ON BEHALF OF WCHN SOLELY BECAUSE OF POSSIBLE CONFLICTS OF INTEREST ON THEIR PART, AND THAT THE REPRESENTATIVES WILL BE ABLE TO GOVERN AND SERVE THE BEST INTERESTS OF WCHN BY EXERCISING THEIR BEST CARE, SKILL AND HONEST JUDGMENT ON ITS BEHALF. THIS POLICY RECOGNIZES THAT (1) MEMBERS OF THE BOARD OF DIRECTORS ARE OFTEN CHOSEN BECAUSE OF THEIR EXPERIENCE IN MATTERS RELEVANT TO THE OPERATION OF WCHN AND (2) THAT DIRECTORS AND OFFICERS MAY BE ASKED BY WCHN TO PARTICIPATE ON BEHALF OF WCHN AS A DIRECTOR OR OFFICER OF ANOTHER ORGANIZATION, TRADE ASSOCIATION, JOINT VENTURE AND NETWORK. ACCORDINGLY, ANOTHER OBJECTIVE OF THIS POLICY IS TO ENSURE THAT MEMBERS OF THE BOARD OF DIRECTORS AND OFFICERS ARE NOT DISQUALIFIED FROM PARTICIPATION IN WCHN GOVERNANCE BY VIRTUE OF THEIR AFFILIATIONS WITH OTHER INSTITUTIONS OR ENTITIES. NOTWITHSTANDING THE ABOVE, IT IS POSSIBLE THAT A REPRESENTATIVE MAY HAVE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST (1) BASED ON PERSONAL INTERESTS OR TRANSACTIONS OR (2) BY VIRTUE OF HIS OR HER RELATIONSHIP AS AN OWNER, CREDITOR, AGENT, OFFICER, DIRECTOR OR EMPLOYEE OF ANOTHER ENTITY. THE OBJECTIVES IDENTIFIED ABOVE WILL BE PROMOTED BY: (1) FULL DISCLOSURE BY DIRECTORS AND OFFICERS OF ALL PERSONAL AND OUTSIDE INTERESTS THAT MAY AFFECT OR BE AFFECTED BY WCHN'S OPERATIONS OR BY DECISIONS THAT THE REPRESENTATIVE MAKES ON WCHN'S BEHALF AND (2) ESTABLISHMENT OF GUIDELINES FOR DETERMINING WHEN ACTUAL AND POTENTIAL CONFLICTS OF INTEREST OCCUR AND OF PRINCIPLES AND PROCEDURES FOR ADDRESSING ACTUAL AND POTENTIAL CONFLICTS. EACH ACTUAL OR POTENTIAL CONFLICT OF INTEREST THAT IS DISCLOSED SHOULD BE CAREFULLY EXAMINED AND APPROPRIATE MEASURES PUT INTO PLACE TO MAINTAIN THE BALANCE BETWEEN ENSURING FAIR AND HONEST DELIBERATIONS AND ENCOURAGING PARTICIPATION OF QUALIFIED REPRESENTATIVES IN WCHN. THE BOARD OF DIRECTORS OF WCHN RECOGNIZES THE IMPORTANCE TO WCHN OF HAVING A CONSISTENT POLICY APPLICABLE TO THE DIRECTORS AND OFFICERS OF ALL CORPORATIONS WITHIN ITS SYSTEM. THIS POLICY THEREFORE APPLIES TO THE DIRECTORS AND OFFICERS OF WCHN AS WELL AS THE DIRECTORS AND OFFICERS OF DANBURY HOSPITAL, WESTERN CT HEALTH NETWORK FOUNDATION, INC., THE WESTERN CT HOME CARE, INC., REGIONAL HOSPICE OF WESTERN CONNECTICUT, WESTERN CT HEALTH NETWORK AFFILIATES, AND BUSINESS SYSTEMS, INC. AND THE BOARD OF EACH SUCH CORPORATION SHALL TAKE WHATEVER ACTION AS MAY BE NECESSARY TO INSURE THE EFFECTIVENESS OF THIS POLICY. VOTING. NO DIRECTOR HAVING A CONFLICT OF INTEREST ON ANY MATTER SHALL VOTE ON THAT MATTER OR BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING AT WHICH THE VOTE IS TAKEN, EVEN WHEN PERMITTED BY LAW. NO REPRESENTATIVE HAVING A CONFLICT OF INTEREST ON ANY MATTER SHALL USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER. NEED FOR RESIGNATION OR DECISION NOT TO APPOINT. IF THE BOARD OF DIRECTORS, IN ITS SOLE DISCRETION, DETERMINES THAT ANY REPRESENTATIVE HAS CONFLICTS OF INTEREST SUFFICIENT IN NUMBER AND/OR IMPORTANCE THAT THE EFFECTIVENESS OF SUCH REPRESENTATIVE ON BEHALF OF WCHN MAY BE SIGNIFICANTLY IMPAIRED, THE BOARD MAY ASK THE REPRESENTATIVE TO RESIGN. COMPENSATION REVIEW & APPROVAL PROCESS FOR CEO, EXEC. DIR., OR TOP MGMT FORM 990, PART VI, LINE 15A COMPENSATION OF CEO: IN ORDER TO ACHIEVE ITS MISSION AND ITS OVERALL PERFORMANCE OBJECTIVES, WESTERN CONNECTICUT HEALTH NETWORK, INC. EMPLOYS A PERFORMANCE-BASED TOTAL COMPENSATION PROGRAM FOR ITS SENIOR EXECUTIVES THAT IS MARKET COMPETITIVE, COMPLIANT WITH REGULATORY GUIDELINES, AND REPRESENTATIVE OF BEST PRACTICES. ELIGIBLE EXECUTIVES ARE GENERALLY DIRECT REPORTS OF THE CEO ALONG WITH OTHER EXECUTIVES DESIGNATED BY THE CEO. INCENTIVE COMPENSATION IS A CRITICAL ELEMENT OF TOTAL COMPENSATION. INCENTIVE COMPENSATION IS INTENDED TO ENCOURAGE AND REWARD EXECUTIVES FOR ACHIEVING OR SURPASSING SPECIFIC SHORT-TERM ORGANIZATIONAL PERFORMANCE OBJECTIVES. THE INCENTIVE PLAN SUPPORTS THE ACCOUNTABILITY AND RESULTS-ORIENTED AT WESTERN CONNECTICUT HEALTH NETWORK INC. RESULTING CASH COMPENSATION LEVELS WILL BE COMPETITIVE AND WITHIN THE LIMITS CONSIDERED REASONABLE WITH RESPECT TO THE TAXPAYER BILL OF RIGHTS. EXECUTIVES PARTICIPATE IN THE STANDARD BENEFIT PACKAGE APPLICABLE TO ALL WESTERN CONNECTICUT HEALTH NETWORK, INC. EMPLOYEES. THIS BENEFIT PACKAGE IS TARGETED AT THE 50TH PERCENTILE LEVEL FOR ALL EMPLOYERS. TO MEET WESTERN CONNECTICUT HEALTH NETWORK INC.'S TOTAL COMPENSATION OBJECTIVES FOR EXECUTIVES, THE FOLLOWING SURVEY SOURCES ARE USED FOR COMPARISON PURPOSES: -BLEND OF NATIONAL CONFIDENTIAL SOURCE, IHS, AND HAY GROUP POINTS HEALTHCARE DATA (WHERE DATA AVAILABLE), PLUS 15% GEOGRAPHIC DIFFERENTIAL. TITLE MATCH DATA CUTS SELECTED BASED ON REVENUE SIZE. -FOR PHYSICIAN EXECUTIVES, SURVEYS COVERING PHYSICIAN COMPENSATION IN ACCREDITED MEDICAL SCHOOLS (AAMC) ARE USED IN COMBINATION WITH PROPRIETARY SURVEYS COMPILED BY NATIONALLY KNOWN CONSULTING FIRM, SULLIVAN COTTER AND THE MEDICAL GROUP MANAGEMENT ASSOCIATION (MGMA). THE COMPENSATION CONSULTANT BENCHMARKS WESTERN CONNECTICUT HEALTH NETWORK, INC.'S EXECUTIVE POSITIONS BASED ON JOB DUTIES, SCOPE AND REPORTING RELATIONSHIPS. PREMIUMS MAY BE APPLIED TO MARKET DATA FOR CERTAIN POSITIONS TO REFLECT RESPONSIBILITIES THAT ARE IN ADDITION TO THOSE INCLUDED IN THE SURVEY POSITION MARKET MATCHES. WESTERN CONNECTICUT HEALTH NETWORK, INC. TARGETS CASH COMPENSATION AT MARKET COMPETITIVE LEVELS. BASE SALARY PLUS SHORT-TERM (ANNUAL) INCENTIVE AWARDS (TOTAL CASH) APPROXIMATE MARKET COMPETITIVE LEVELS FOR TOTAL CASH COMPENSATION. EXECUTIVE PERFORMANCE IS EXPECTED TO MEET OR EXCEED PREDETERMINED OPERATIONAL AND FINANCIAL METRICS. OTHER FACTORS, SUCH AS COMPETITIVE MARKET FORCES, JOB PERFORMANCE, UNIQUE QUALIFICATIONS, AND/OR INDIVIDUAL JOB RESPONSIBILITIES ARE ALSO CONSIDERED IN WESTERN CONNECTICUT HEALTH NETWORK, INC'S EXECUTIVE COMPENSATION DECISIONS. ROLES OF THE COMMITTEE ON GOVERNANCE AND KEY EXECUTIVES IN THE EXECUTIVE COMPENSATION PROCESS: - THE COMMITTEE ON GOVERNANCE IN CONSULTATION WITH THE CEO AND THE SVP HR SELECTS THE OUTSIDE COMPENSATION CONSULTANTS. THE CURRENT CONSULTANT IS THE HAY GROUP, WHOSE PURPOSE IS TO PROVIDE A VALID INDEPENDENT ASSESSMENT OF THE RELEVANT MARKET RATES AND PAY PRACTICES FOR HEALTHCARE EXECUTIVES, PHYSICIAN EXECUTIVES AND FOR PHYSICIANS IN GENERAL. - THE COMPENSATION CONSULTING FIRM COMPILES APPROPRIATE MARKET DATA, JOB EVALUATION AND RANKING INFORMATION FOR ALL EXECUTIVES AND PHYSICIANS OF THE ORGANIZATION, EXCLUDING THE CEO, AND WILL SUPPLY THIS MATERIAL TO THE CEO AND SVP HR FOR REVIEW AND AGREEMENT. ONCE THE REPORT IS FINAL IT WILL BE SUPPLIED TO THE COMMITTEE ON GOVERNANCE FOR THEIR CONSIDERATION AND ACCEPTANCE. -THE COMMITTEE ON GOVERNANCE DETERMINES THE CEO'S SALARY BASED ON OVERAL PERFORMANCE AND MARKET DATA SUPPLIED BY THE OUTSIDE MARKET CONSULTANT. THE LAST EXECUTIVE COMPENSATION EVALUATION BY AN OUTSIDE CONSULTANT WAS DONE IN NOVEMBER, 2011. THE LAST EXECUTIVE COMPENSATION EVALUATION BY AN OUTSIDE CONSULTANT WAS DONE IN NOVEMBER, 2011. COMPENSATION REVIEW & APPROVAL PROCESS FOR OFFICERS & KEY EMPLOYEES FORM 990, PART VI, LINE 15B COMPENSATION FOR OTHER OFFICERS AND KEY EMPLOYEES: IN ORDER TO ACHIEVE ITS MISSION AND ITS OVERALL PERFORMANCE OBJECTIVES, WESTERN CONNECTICUT HEALTH NETWORK, INC. EMPLOYS A PERFORMANCE-BASED TOTAL COMPENSATION PROGRAM FOR ITS SENIOR EXECUTIVES THAT IS MARKET COMPETITIVE, COMPLIANT WITH REGULATORY GUIDELINES, AND REPRESENTATIVE OF BEST PRACTICES. ELIGIBLE EXECUTIVES ARE GENERALLY DIRECT REPORTS OF THE CEO ALONG WITH OTHER EXECUTIVES DESIGNATED BY THE CEO. INCENTIVE COMPENSATION IS A CRITICAL ELEMENT OF TOTAL COMPENSATION. INCENTIVE COMPENSATION IS INTENDED TO ENCOURAGE AND REWARD EXECUTIVES FOR ACHIEVING OR SURPASSING SPECIFIC SHORT-TERM ORGANIZATIONAL PERFORMANCE OBJECTIVES. THE INCENTIVE PLAN SUPPORTS THE ACCOUNTABILITY AND RESULTS-ORIENTED AT WESTERN CONNECTICUT HEALTH NETWORK INC. RESULTING CASH COMPENSATION LEVELS WILL BE COMPETITIVE AND WITHIN THE LIMITS CONSIDERED REASONABLE WITH RESPECT TO THE TAXPAYER BILL OF RIGHTS. EXECUTIVES PARTICIPATE IN THE STANDARD BENEFIT PACKAGE APPLICABLE TO ALL WESTERN CONNECTICUT HEALTH NETWORK, INC. EMPLOYEES. THIS BENEFIT PACKAGE IS TARGETED AT THE 50TH PERCENTILE LEVEL FOR ALL EMPLOYERS. TO MEET WESTERN CONNECTICUT HEALTH NETWORK INC.'S TOTAL COMPENSATION OBJECTIVES FOR EXECUTIVES, THE FOLLOWING SURVEY SOURCES ARE USED FOR COMPARISON PURPOSES: -BLEND OF NATIONAL CONFIDENTIAL SOURCE, IHS, AND HAY GROUP POINTS HEALTHCARE DATA (WHERE DATA AVAILABLE), PLUS 15% GEOGRAPHIC DIFFERENTIAL. TITLE MATCH DATA CUTS SELECTED BASED ON REVENUE SIZE. -FOR PHYSICIAN EXECUTIVES, SURVEYS COVERING PHYSICIAN COMPENSATION IN ACCREDITED MEDICAL SCHOOLS (AAMC) ARE USED IN COMBINATION WITH PROPRIETARY SURVEYS COMPILED BY NATIONALLY KNOWN CONSULTING FIRM, SULLIVAN COTTER AND THE MEDICAL GROUP MANAGEMENT ASSOCIATION (MGMA). THE COMPENSATION CONSULTANT BENCHMARKS WESTERN CONNECTICUT HEALTH NETWORK, INC.'S EXECUTIVE POSITIONS BASED ON JOB DUTIES, SCOPE AND REPORTING RELATIONSHIPS. PREMIUMS MAY BE APPLIED TO MARKET DATA FOR CERTAIN POSITIONS TO REFLECT RESPONSIBILITIES THAT ARE IN ADDITION TO THOSE INCLUDED IN THE SURVEY POSITION MARKET MATCHES. WESTERN CONNECTICUT HEALTH NETWORK, INC. TARGETS CASH COMPENSATION MARKET COMPETITIVE LEVELS. BASE SALARY PLUS SHORT-TERM (ANNUAL) INCENTIVE AWARDS (TOTAL CASH) APPROXIMATE MARKET COMPETITIVE LEVELS FOR TOTAL CASH COMPENSATION. EXECUTIVE PERFORMANCE IS EXPECTED TO MEET OR EXCEED PREDETERMINED OPERATIONAL AND FINANCIAL METRICS. OTHER FACTORS, SUCH AS COMPETITIVE MARKET FORCES, JOB PERFORMANCE, UNIQUE QUALIFICATIONS, AND/OR INDIVIDUAL JOB RESPONSIBILITIES ARE ALSO CONSIDERED IN WESTERN CONNECTICUT HEALTH NETWORK, INC'S EXECUTIVE COMPENSATION DECISIONS. ROLES OF THE COMMITTEE ON GOVERNANCE AND KEY EXECUTIVES IN THE EXECUTIVE COMPENSATION PROCESS: - THE COMMITTEE ON GOVERNANCE IN CONSULTATION WITH THE CEO AND THE SVP HR SELECTS THE OUTSIDE COMPENSATION CONSULTANTS. THE CURRENT CONSULTANT IS THE HAY GROUP, WHOSE PURPOSE IS TO PROVIDE A VALID INDEPENDENT ASSESSMENT OF THE RELEVENT MARKET RATES AND PAY PRACTICES FOR HEALTHCARE EXECUTIVES, PHYSICIAN EXECUTIVES AND FOR PHYSICIANS IN GENERAL. - THE COMPENSATION CONSULTING FIRM COMPILES APPROPRIATE MARKET DATA, JOB EVALUATION AND RANKING INFORMATION FOR ALL EXECUTIVES AND PHYSICIANS OF THE ORGANIZATION, EXCLUDING THE CEO, AND WILL SUPPLY THIS MATERIAL TO THE CEO AND SVP HR FOR REVIEW AND AGREEMENT. ONCE THE REPORT IS FINAL IT WILL BE SUPPLIED TO THE COMMITTEE ON GOVERNANCE FOR THEIR CONSIDERATION AND ACCEPTANCE. -THE COMMITTEE ON GOVERNANCE DETERMINES THE CEO'S SALARY BASED ON OVERALL PERFORMANCE AND MARKET DATA SUPPLIED BY THE OUTSIDE MARKET CONSULTANT. THE LAST EXECUTIVE COMPENSATION EVALUATION BY AN OUTSIDE CONSULTANT WAS DONE IN NOVEMBER, 2011. OTHER ORGANIZATION DOCUMENTS PUBLICLY AVAILABLE FORM 990, PART VI, LINE 19 THE INFORMATION THAT HAS BEEN POSTED ON THE WESTERN CONNECTICUT HEALTH NETWORK, INC. WEBSITE FOR 2012 INCLUDES: THE MOST CURRENT AUDITED FINANCIAL STATEMENTS. ALSO INCLUDED IS THE CODE OF BUSINESS ETHICS, INFORMATION ABOUT OUR COMPLIANCE PROGRAM, AND A COPY OF OUR POLICY REGARDING PREVENTING OF FRAUD, WASTE AND ABUSE. ALL GOVERNING DOCUMENTS REQUIRED BY LAW ARE MADE AVAILABLE UPON REQUEST. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. ADDITIONAL OFFICER COMPENSATION INFORMATION FORM 990, PART VII FOR ALL OFFICERS AND THE TOP 5 EMPLOYEES, ALTHOUGH ONLY 40 HOURS IS NOTED TO REFLECT PAID HOURS, ACTUALLY WORKED HOURS EXCEEDED THIS AMOUNT. NOTE: ALL AMOUNTS IN COLUMN F, OF PART VII, "ESTIMATED AMOUNT OF OTHER COMPENSATION", REPRESENT BENEFITS, AND DO NOT REFLECT ANY COMPENSATION FOR WHICH THE AVERAGE AMOUNT OF TIME WORKED CAN BE REFLECTED. FUNDRAISING EXPENSES FORM 990, PART IX, COLUMN D ALTHOUGH CONTRIBUTIONS ARE REFLECTED ON LINE 1 OF PAGE 1 ON FORM 990, ALL FUNDRAISING EXPENSES WERE INCURRED BY THE NEW MILFORD HOSPITAL FOUNDATION. OTHER CHANGES IN NET ASSETS OR FUND BALANCES FORM 990, PART XI, LINE 5 CHANGE IN EQUITY INTEREST OF NMH FOUNDATION 4,600,388 CHANGE IN PENSION FUNDING OBLIGATIONS -7,274,255 ELIMINATION OF NMHRIJV, LLC -1,422,104 TOTAL -4,095,971 THE TAXPAYER'S FORM 5471 FILING REQUIREMENTS HAVE BEEN OR WILL BE SATISFIED BY DANBURY HOSPITAL, 24 HOSPITAL AVENUE, DANBURY, CT 06810, TIN: 06-0646597. DANBURY HOSPITAL HAS FILED OR WILL FILE THE FORM 5471 AND APPLICABLE SCHEDULES WITH THE IRS SERVICE CENTER, PHILADELPHIA, PA. TIN: 06-0646597. DANBURY HOSPITAL HAS FILED OR WILL FILE THE FORM 5471 AND APPLICABLE SCHEDULES WITH THE IRS SERVICE CENTER, PHILADELPHIA, PA. TIN: 06-0646597. DANBURY HOSPITAL HAS FILED OR WILL FILE THE FORM 5471 AND APPLICABLE SCHEDULES WITH THE IRS SERVICE CENTER, PHILADELPHIA, PA. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOHN M. MURPHY, MD TITLE:PRESIDENT & CEO HOURS:47 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:NEIL CULLIGAN, MD TITLE:DIRECTOR HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DAVID KRAMER, MD TITLE:DIRECTOR HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DAVID CYGANOWSKI TITLE:TREASURER HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ALPHONSE ALTORELLI, MD TITLE:DIRECTOR HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:RICHARD G. JABARA TITLE:DIRECTOR HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ANTHEA DISNEY TITLE:DIRECTOR HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOSEPH D. SKRZYPCZAK TITLE:SECRETARY HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SPENCER HOULDIN TITLE:DIRECTOR HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOHN R. PATRICK TITLE:DIRECTOR HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:BRIAN C. WHITE TITLE:DIRECTOR HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JAMES KENNEDY TITLE:CHAIR/VICE CHAIR HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOHN MARTOCCI (TO 12/31) TITLE:CHAIRMAN HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JAY LENT (TO 5/31) TITLE:DIRECTOR HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOHN C. CLINE (TO 12/31) TITLE:DIRECTOR HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:STEVEN H. ROSENBERG TITLE:CFO HOURS:46 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DONNA KAPLANIS TITLE:ASST. SECRETARY HOURS:46 NEW MILFORD HOSPITAL FOUNDATION 21 ELM STREET NEW MILFORD CT 06776 222515011 ADMIN CONTRIB CT 501(C)(3) 7 NMH true WESTERN CT HEALTH NETWORK INC 24 HOSPITAL AVENUE DANBURY CT 06810 222594977 PROGRAM DEVEL CT 501(C)(3) 11, TYPE 2 NA false WESTERN CT MEDICAL GROUP PC 14 RESEARCH DRIVE SUITE 201A BETHEL CT 06801 061137531 PHYSICIAN SVC CT 501(C)(3) 9 WCHN true WEST CT HEALTH NETWORK FOUNDATION 24 HOSPITAL AVENUE DANBURY CT 06810 237425557 ADMIN CONTRIB CT 501(C)(3) 7 WCHN true DANBURY HOSPITAL INC 24 HOSPITAL AVENUE DANBURY CT 06810 060646597 ACUTE CARE CT 501(C)(3) 3 WCHN true WESTERN CT HEALTH NETWORK AFFILIATES 95 LOCUST AVENUE DANBURY CT 06810 222594968 OP HLTHCR SVC CT 501(c)(3) 9 WCHN true WESTERN CT HOME CARE INC 4 LIBERTY STREET DANBURY CT 06810 060655138 HOME HLTHCARE CT 501(C)(3) 9 WCHN true NEW MILFORD MRI JV LLC 21 ELM STREET NEW MILFORD CT 06776 271877801 IMAGING SERVICES CT NMH RELATED 471841 0 false 0 true 1.00000 BUSINESS SYSTEMS INC 95 LOCUST AVENUE DANBURY CT 06810 061119262 PHARMACY CT NA C CORP 0 0 WEST CT HEALTH NETWORK INSURANCE CO 10 MAIN STREET PO BOX 1051 GT GRAND CAYMAN CJ 980438151 MALPRACTICE CJ NA C CORP 0 0 FOUNDATION FOR COMM HEALTHCARE 95 LOCUST AVENUE DANBURY CT 06810 061437131 INACTIVE CT NA C CORP 0 0 MEDICAL SERVICES OF DANBURY 24 HOSPITAL AVENUE DANBURY CT 06811 061635945 HEALTHCARE CT WCMG C CORP 0 0 true false true false false false true false false false false true false true true true true true NEW MILFORD HOSPITAL FOUNDATION C 274468 COST WESTERN CT MEDICAL GROUP PC L 6095603 COST WESTERN CT MEDICAL GROUP PC Q 6537654 COST DANBURY HOSPITAL INC Q 276250 COST DANBURY HOSPITAL INC L 824097 COST DANBURY HOSPITAL INC N 2773965 COST DANBURY HOSPITAL INC O 11176809 COST DANBURY HOSPITAL INC Q 1337258 COST DANBURY HOSPITAL INC R 9192629 COST