2013-08-14T12:23:07-05:00 2012-09-30 061533253 SASLOW LUFKIN & BUGGY LLP TEN TOWER LANE AVON CT 06001 990 2011-10-01 060646768 THE HOSPITAL OF CENTRAL CONNECTICUT HOSP 8602245900 100 GRAND STREET NEW BRITAIN CT 06050 CAROLYN FREIHEIT 8602245900 2013-08-13 1 Beth Thurz P00346435 8606789200 2011 2016-02-24 21:20:13Z CLARENCE J SILVIA 100 GRAND STREET NEW BRITAIN CT 06050 413414557 0 X WWW.THOCC.ORG X 1893 CT HCC'S MISSION IS TO FOSTER, SUSTAIN AND IMPROVE THE HEALTH STATUS OF THE PEOPLE IN THE COMMUNITIES WE SERVE. 15 10 3188 429 3757270 0 2983328 2046849 388490564 402498584 1783908 3942956 2826098 3003727 396083898 411492116 0 0 0 0 205409513 208286192 17800 22034 677397 163198089 181270682 368625402 389578908 27458496 21913208 374049690 400333621 208172025 264813382 165877665 135520239 X THE HOSPITAL OF CENTRAL CONNECTICUT ("HCC") REFLECTS THE COMBINED TALENT, RESOURCES, AND CAPABILITIES OF NEW BRITAIN GENERAL HOSPITAL AND BRADLEY MEMORIAL HOSPITAL. IT IS A 414-BED ACUTE CARE TEACHING HOSPITAL AFFILIATED WITH THE UNIVERSITY OF CONNECTICUT SCHOOL OF MEDICINE AND SERVES AS THE PRIMARY REFERRAL CENTER FOR THE CENTRAL CONNECTICUT REGION, SERVING A POPULATION OF 250,000. AS A FULL-SERVICE HOSPITAL, THE HOSPITAL OF CENTRAL CONNECTICUT OFFERS MANY CLINICAL SERVICES THAT ARE RECOGNIZED FOR THEIR COMPREHENSIVENESS AND EXCELLENCE. THEY INCLUDE: THE GEORGE BRAY CANCER CENTER; THE WOLFSON PALLIATIVE CARE PROGRAM; THE JOSLIN CENTER FOR DIABETES AT THE HOSPITAL OF CENTRAL CONNECTICUT; THE WOUND CARE CENTER; THE FAMILY BIRTHPLACE; CRITICAL CARE SERVICES, AND THE SLEEP DISORDERS CENTER. 1 0 33858587 79761089 THE INPATIENT MEDICAL, SURGICAL AND INTENSIVE CARE SERVICES AREAS SERVED 15,964 WITH TOTAL PATIENT DAYS OF 64,024. 70% AND 59% OF THE NEW BRITAIN AND SOUTHINGTON COMMUNITY NEEDS ARE RESPECTIVELY MET WITH THESE SERVICES. THE AREAS OF SPECIALTY INCLUDE STROKE SERVICES, BARIATRIC CARE, JOINT REPLACEMENT AND DIABETES. 20892282 45753705 TOTAL PATIENT VISITS FOR BOTH EMERGENCY ROOMS WERE OVER 110,000. THIS WAS AN INCREASE OF 1,142 PATIENTS OR 1% FROM THE PREVIOUS YEAR. THE VOLUMES WERE APPROXIMATELY 91,192 AND 19,004 AT THE NBG AND BRADLEY MEMORIAL CAMPUSES RESPECTIVELY. CONTINUED WORK ON STAFFING, STAFFING PATTERNS AND IMPROVEMENTS IN WORK FLOW TO MEET DEMAND AND INCREASED VOLUME. QUALITY INDICATORS FOR THE EMERGENCY ROOM, CONTINUE TO IMPROVE IN THE AREAS TO LEFT WITHOUT BEING SEEN RATES, TIME UNTIL SEEN BY CLINICIAN, BOARDING TIMES AND PATIENT SATISFACTION. CONTINUED INCREASES IN VOLUME, AVAILABLE SPECIALISTS, AND ACUITY OF PATIENTS CHALLENGE THE LEADERSHIP. 17015149 52088354 RADIOLOGY-DERIVED INFORMATION IS AN INEXTRICABLE COMPONENT OF OUR PATIENTS' CARE CONTINUUM. FROM SCREENING EXAMS, TO ACUTE INTERVENTIONARY IMAGINING, RADIOGRAPHIC TECHNOLOGY CONTINUED TO EVOLVE IN 2012. OVER 161,000 IMAGING EXAMS WERE PERFORMED AT THE NEW BRITAIN AND BRADLEY MEMORIAL CAMPUSES. OF THESE, MORE THAN 76% WERE PERFORMED ON OUTPATIENTS. WHILE THERE WAS A 1.8% OVERALL DECLINE IN IMAGING EXAMS IN FY2012 V. THE PRIOR YEAR, THE DECLINE IS LESS THAN PUBLISHED DECLINES IN PRIMARY CARE AND SELECT SPECIALTY OFFICE VISITS - THE REFERRAL SOURCES FOR IMAGING STUDIES. THAT REFERRAL SOURCE DECLINE, COMBINED WITH ECONOMIC INFLUENCES AND JUDICIOUS APPLICATION OF IMAGING (AND RADIATION EXPOSURE), COMBINE TO ACCOUNT FOR THE DECREASE EXAM VOLUME. 274034156 221427356 OTHER ROUTINE SERVICES SUCH AS LABORATORY, MATERNITY, NEWBORN, PSYCHIATRIC AND PEDIATRIC AND ANCILLARY SERVICES PROVIDED TO PATIENTS. 274034156 221427356 345800174 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 0 1 1 0 0 1 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 328 0 1 3188 1 1 1 1 CA BD EI 0 0 0 0 0 0 0 0 X 15 10 1 1 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 CT X CAROLYN FREIHEIT 8602245900 389 JOHN DOWNEY DRIVE NEW BRITAIN CT 060512924 X CLARENCE J SILVIA 50.00 X X 775131 0 716236 JOHN W ANDREOLI JR MD 1.50 X 47000 0 0 FRANK R MILLER 2.00 X 0 0 0 MARIE S GUSTIN PHD 2.00 X 0 0 0 LINDSLEY WELLMAN 1.70 X 0 0 0 JOHN E DILLAWAY 2.50 X X 0 0 0 JOHN S MANNING 2.50 X 0 0 0 JOHN J PATRICK JR 1.00 X X 0 0 0 ROBERT A LAPKIN MD 1.50 X 132342 0 0 WILLIAM W WEBER 1.50 X X 0 0 0 LETTERIO ASCIUTO MD 1.50 X 20000 0 0 REV THOMAS A MILLS JR 2.00 X 0 0 0 ELLIOT JOSEPH 1.00 X 0 1651290 175301 THOMAS MARCHOZZI 1.00 X 0 690977 62526 JOSEPH HARRISON 1.50 X 0 0 0 AKELLA SARMA MD 1.00 X 0 0 0 JOSEPH VOELKER 1.00 X 0 0 0 BRIAN A ROGOZ 50.00 X 787124 0 56764 STEVEN D HANKS MD 50.00 X 603858 0 135607 ELIZABETH A LYNCH 50.00 X 343705 0 80476 JOYCE HAWRYLIK 40.00 X 63138 0 21857 STEVEN A GODFREY 50.00 X 247752 0 76929 NANCY KROEBER 50.00 X 186170 0 98835 DENISE PETERSON 50.00 X 219216 0 26751 RALPH BECKER 50.00 X 0 372077 84855 MARY MORGAN 50.00 X 116172 0 4770 THOMAS VACCARELLI 50.00 X 163621 0 21311 JEFFREY A FINKELSTEIN MD 50.00 X 422695 0 99392 MICHAEL BALKUNAS MD 50.00 X 345896 0 92908 MICHAEL GREY MD 50.00 X 391191 0 57942 JAMES L MASSI MD 50.00 X 319608 0 586 FRANCIS H PINTO 50.00 X 226171 0 81130 ELIZABETH SCHLAFF 50.00 X 200080 0 54203 HAKLAI P LAU MD 50.00 X 475286 0 12744 JAMES F FLAHERTY 50.00 X 377241 0 114511 MICHELLE MCDADE 50.00 X 360574 0 31197 DAVID BUONO 50.00 X 363044 0 40800 ERIC HOBERT 50.00 X 344451 0 14070 MAUREEN FITZSIMMONS 50.00 X 354721 0 5445 7886187 2714344 2167146 238 1 1 0 CERNER CORPORATION 2702 ROCKCREEK PARKWAY KANSAS CITY MO 64117 INFORMATION SYSTEMS 9954450 UCONN HEALTH CENTER FARMINGTON AVE FARMINGTON CT 060301915 RESIDENT SERVICES 5565979 MRI OF NEW BRITAIN 40 HART ST NEW BRITAIN CT 06050 MRI SERVICES 3465720 KNAUS BUILDERS 150 PRODUCTION COURT NEW BRITAIN CT 06051 CONSTRUCTION SERVICES 2626629 CENTRAL CT SPORTS MEDICINE CENTER 15 MASSIRIO DRIVE SUITE 104 BERLIN CT 06037 PHYSICAL THERAPY SERVICES 1874710 119 161331 1119729 765789 2046849 PATIENT SERVICE REVENU 900099 351211262 351211262 LABORATORY SERVICES 621500 42317724 38685292 3632432 OTHER PATIENT SERVICE 900099 8969598 8969598 402498584 3389351 3389351 1468419 1111412 357007 357007 -8985 365992 827233 221146 22324 472450 804909 -251304 553605 553605 129420 161331 98457 30963 30963 397487 217798 179689 179689 DIETARY/ CAFETERIA 722210 1725420 1725420 CHILD CARE INCOME 624410 442575 30102 412473 OUTSIDE SERVICES 518210 268073 164352 103721 2436068 411492116 399030504 3757270 6657493 7181097 7181097 159463423 149363933 9667846 431644 8021414 7992081 29333 22505171 20546136 1959035 11115087 10229148 863296 22643 4615508 3826256 789252 351166 199614 151552 409431 409431 22034 22034 32476536 26941315 5535221 1153828 956523 197305 64705674 61918551 2787123 15729082 13039409 2689673 8624942 6975867 1649075 798501 661957 136544 244459 202657 41802 1724038 1428973 295065 19353058 12934165 6418893 5586377 4630348 956029 BAD DEBT 17293190 17293190 DIETARY 2932413 2430647 501766 STRAT INITIATIVE 1505196 1247807 257389 COLLECTION EXPENSE 1182002 979880 202122 2585281 2001717 382488 201076 389578908 345800174 43101337 677397 X 17548741 27607790 48945018 48473300 65580 31917 5642776 5998294 4287847 3609849 425063092 274632798 152765070 150430294 128888836 143400598 8643214 7530923 7262608 13250656 374049690 400333621 23363595 24789697 434859 572719 35743805 35743805 6983052 4122249 141646714 199584912 208172025 264813382 X 129061862 93712366 16726765 20015125 20089038 21792748 165877665 135520239 374049690 400333621 X 21913208 -52270634 X X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 39984 0 0 0 39984 0 Explanation of Lobbying Activities: Part II-B, Line 1: CENTRAL CT HEALTH ALLIANCE, THE PARENT COMPANY OF THE HOSPITAL OF CENTRAL CONNECTICUT, ENGAGED THE FIRM OF KOZAK & SALINA TO LOBBY ON ITS BEHALF. PAYMENT MADE TO KOZAK & SALINA DURING THE FISCAL YEAR WAS $34,500. ADDITIONALLY, THE HOSPITAL OF CENTRAL CONNECTICUT IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND THE CONNECTICUT HOSPITAL ASSOCIATION WHO ENGAGE IN LOBBYING AND ADVOCACY EFFORTS ON BEHALF OF ITS MEMBERS. 126491630 1007071 15195409 1415775 141278335 128449477 2086374 -2356272 1687950 126491629 115483988 2672254 11693366 1400131 128449477 110529502 2235178 4211109 1491801 115483988 0.71630 0.15430 0.12940 1 0 1052227 5042999 6095226 7246519 222728057 124538345 105436231 200978 4259827 2508828 1951977 475691 174565305 143104244 31936752 9491489 4481381 5010108 150430294 FUNDS HELD IN TRUST BY OTHERS 15192304 F MUTUAL FUNDS 119210648 F CURRENT ASSETS WHOSE USE IS LIMITED 2397202 F PERMANENTLY RESTRICTED INVESTMENTS 6600444 F 143400598 DUE TO THIRD PARTIES 15270456 PENSION PLAN AND SELF INSURANCE LIABILITY 164366024 ACCRUED COMPENSATION 14266850 DUE TO (FROM) AFFILIATES 1644937 OTHER LIABILITIES 4036645 199584912 411492116 389578908 21913208 11243022 -63513656 -52270634 -30357426 411452869 1799503 1799503 409653366 1838750 1838750 411492116 389521493 0 389521493 57415 57415 389578908 Description of Intended Use of Endowment Funds: Part V, Line 4: THE TEMPORARY AND PERMANENTLY RESTRICTED ENDOWMENTS ARE RESTRICTED BASED ON THE DONOR'S REQUEST. THE OTHER BOARD DESIGNATED ENDOWMENTS ARE INTENDED TO SUPPORT THE HOSPITAL'S FUTURE NEEDS IN PROVIDING HEALTH CARE SERVICES TO THE COMMUNITY. Part XI, Line 8 - Other Adjustments: CHANGE IN ASSETS HELD IN TRUST BY OTHERS 1,703,710. PENSION CHANGES OTHER THAN NET PERIODIC BENEFIT COSTS -65,083,998. CHANGE IN BEGINNING BALANCE OF AUXILIARY NET WORTH 131. LOSS ON INVESTMENT IN AFFILIATE -133,499. Total to Schedule D, Part XI, Line 8: -63,513,656. Part XII, Line 2d - Other Adjustments: NET ASSETS RELEASED FROM RESTRICTIONS USED FOR OPERATIONS 1,559,503. AUXILIARY CONTRIBUTION 240,000. Part XII, Line 4b - Other Adjustments: CONTRIBUTIONS 882,719. AUXILIARY SPECIAL EVENTS- GOLF TOURNAMENT AND BALL 161,331. AUXILIARY GIFT STORE INCOME 179,689. AUXILIARY CONTRIBUTIONS 30,963. INVESTMENT INCOME- TEMP RESTRICTED 584,048. Part XIII, Line 4b - Other Adjustments: AUXILIARY EXPENSES 57,415. Central America and the Caribbean 0 0 Investment/ Insurance 5267875 0 0 0 0 0 0 5267875 0 5267875 1 0 1 0 0 0 1 THE GIVING COLLABORATIVE LLC 53 Morgan Avenue East Haven CT 06512 FEASIBILITY STUDY FOR NEW CANCER CENTER CAMPAIGN 0 0 22034 -22034 22034 -22034 GOLF TOURNAMENTS 118690 75190 43500 0 7747 10569 10269 0 2675 CHRYSANTHEMUM BALL 141450 76500 64950 0 562 0 41337 3500 7911 1 30611 9641 20970 0 558 12192 0 250 887 290751 161331 129420 8867 22761 51606 3750 11473 98457 30963 1 1 X 1 X 250.000000000000 1 X 1 1 1 0 0 2470777 616305 1854472 0.00500 84338826 72939503 11399323 0.03060 0 0 86809603 73555808 13253795 0.03560 61 22120 1618812 28178 1590634 0.00430 18 941 10917841 2743515 8174326 0.02200 945602 0 945602 0.00250 1 0 334513 0 334513 0.00090 7 100 61120 0 61120 0.00020 87 23161 13877888 2771693 11106195 0.02990 87 23161 100687491 76327501 24359990 0.06550 0 0 0 0 6162 0 6162 0.00000 0 0 0 0 0 0 0 0 0 0 0 0 6162 6162 0 5363741 0 90143353 97193439 -7050086 X 1 0 2 New Britain MRI LP Magnetic Resonance Imaging 0.43000 3 Central CT Endoscopy Center LLC Endoscopy Services 0.06500 0.50000 6 New Britain Alliance Occupational Health Occupational Health Services 1.00000 7 Central CT Sports Medicine LLC Sports Medicine Provider 0.50000 1 1 The Hospital of Central Connecticut

100 Grand Steet New Britain CT 06050

X X X X New Britain General Hospital campus and Bradley Memorial Hospital Campus Hospital of Central Connecticut 1 1 1 250.000000000000 1 400.000000000000 0 1 1 X X X X X 1 0 1 X 0 0 4 New Britain MRI Limited Partnership

100 Grand Street New Britain CT 06050

Magnetic Resonance Imaging Services Central Connecticut Endoscopy Center

440 New Britain Avenue Plainville CT 06062

Endoscopy Services New Britain Occupational Health

440 New Britain Avenue Plainville CT 06062

Occupational Health Services (100% ownership at 9/30/12) Central Connecticut Sports Medicine Cent

15 Massirio Drive Berlin CT 06037

Sports Medicine Provider/Rehabilitation Facility Part I, Line 3c: HCC uses Federal Poverty Guidelines to determine eligibility. Part I, Line 7: Charity care is at Cost. Cost to charge ratio was derived from Worksheet 2, Ratio of Patient Care Cost to Charges. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 17293190. Part I, Line 6a: The Hospital of Central Connecticut does not prepare an annual community benefit report. Part III, Line 4: There is no Footnote for Bad Debt Expense included in the Financial Statements. Part III, Line 8: The costing methodology used for bad debt expense was based on the Financial Services - Calculation of Ratio of Patient Care Costs to Charges worksheet, which is provided in the Lyon's CBISA Online (Community Benefits) software program. Hospital of Central Connecticut Part V, Section B, Line 19d: The Hospital of Central Connecticut is in the process of adopting 501(r) Regulations. Once the regulations are final the Hospital will be in compliance. Part VI, Line 2: In FY 2012/TY 2011, The Hospital of Central Connecticut began a Community Health Needs Assessment partnering with The Hospital for Special Care and including the towns of New Britain, Berlin, Plainville, Southington, Newington and Bristol. As of Sept. 30, 2012 the CHNA was not yet complete. It is anticipated that secondary data collection and analysis as well as Key Informant Interviews and Focus Groups will be completed as of December 2012, and a report will then be generated. During FY13/TY12 the hospital will develop and enact its Implementation Plan. Part VI, Line 3: The patients are educated about Financial Assistance by the signage and Financial Assistance summary hand out available in the following departments at the hospital, Admitting, Patient Accounts, Emergency Department, Behavioral Health, and Social Services. Financial Assistance education is also provided on the back of the hospital's monthly statement, by our outside vendors, and collection agencies. Part VI, Line 4: The Hospital of Central Connecticut (HCC) serves primarily the communities located in greater New Britain and the surrounding towns including Berlin, Plainville and Southington, with some coverage of Bristol, Burlington, Cheshire, Cromwell, Farmington, Meriden, Newington and West Hartford. The total population in HCC's service area is 441,300 as defined by CERC town profiles for 2010. The most prominent race is Caucasian at about 84% of the total population which has been declining as the Hispanic population has grown to approximately 12% of the total 12 town primary and sub-service areas. Within HCC's primary service area of Berlin, Plainville, New Britain and Southington, the Hispanic population counts for 16%. The population in HCC's service area is older than the US and CT as a whole with approximately 16% in the over 65 category in some of the primary towns. The median household income in HCC's communities varies significantly, averaging $72,000 with 18.7% of NB's population living beneath the federal poverty level. Part VI, Line 5: The Hospital of Central Connecticut (HCC) is responsive to the community by having a completely open medical staff and a board of trustees with diverse membership that reflects the community at large. HCC is a Disproportionate Share Hospital with one of the highest rates of Medicaid patients in the state. We provide space for the Medicare Choices program to help community members select the Medicare programs that are best for them. We have a full graduate medical education program for physician training with UCONN, and also provide training for nursing and allied health students, including a specialty echosonographer program. HCC is a major sponsor of the New Britain Health Academy, a program that exposes local high school students to careers in the healthcare field. Presented in partnership with other community organizations, the Academy offers students an opportunity to learn about the types of jobs available, and facilitates contact with healthcare professionals who can guide program participants. As we have in the past, in FY 2012 we sponsored a community service organization fair where area not for profits are invited to the hospital to share with HCC'S community about their mission and purpose. In addition, various hospital staff members and departments support community events on an ongoing basis, as well as frequent monetary and in kind donations to area organizations in need.On a related note, HCC also participates in the Medical Legal Partnership Program. This program recognizes that there are many issues that may affect children and families seeking health care that are not specifically healthcare problems. These include landlord tenant and housing issues. The program helps healthcare providers to direct families to resources that can assist with these issues. Among our outreach services is our Mothers Offering Mothers Support (M.O.M.S.) program, a weekly support program for mothers 21 years old and under. Program leaders are women who were also young mothers and now are helping others. And, The Hospital of Central Connecticut has a program in which indigent patients who are being discharged from the hospital who do not have prescription drug coverage receive dosages of their prescribed medications to help them recover and comply with treatment guidelines and to reduce readmission rates. Part VI, Line 6: The Hospital of Central Connecticut is an Affiliate of Hartford Healthcare Corporation (HHC). HHC strives to provide compassionate care designed to deliver the necessary health services needed by the community. The Strategic Planning and Community Benefit Committee of the HHC Board of Directors ensures the oversight for these services by each hospital community. In addition, HHC continues to take important steps toward achieving its vision of being "nationally respected for excellence in patient care and most trusted for personalized, coordinated care." HHC affiliation creates a strong integrated health care delivery system with a full continuum of care across a broader geographic area. This allows the small communities easy and expedient access to the more extensive and specialized services the larger hospitals are able to offer. This includes continuing education of health care professionals at all the affiliated institutions through the Center of Education, Simulation and Innovation located at Hartford Hospital, the largest of the system hospitals. The affiliation further enhances the hospitals' abilities to support their missions, identity, and respective community roles. This is achieved through integrated planning and communication to meet the changing needs of the region. This includes responsible decision making and appropriate sharing of services, resources and technologies, as well as cost containment strategies. X 1 1 X X X X X 1 1 0 0 0 1 0 0 0 CLARENCE J SILVIA 604839 0 151000 0 19292 0 701603 0 14633 0 1491367 0 0 0 ELLIOT JOSEPH 0 1058368 0 486360 0 106562 0 130564 0 44737 0 1826591 0 0 THOMAS MARCHOZZI 0 497032 0 173443 0 20502 0 36100 0 26426 0 753503 0 0 BRIAN A ROGOZ 219142 0 41369 0 526613 0 53300 0 3464 0 843888 0 0 0 STEVEN D HANKS MD 483454 0 61133 0 59271 0 132901 0 2706 0 739465 0 0 0 ELIZABETH A LYNCH 267407 0 28147 0 48151 0 63698 0 16778 0 424181 0 0 0 STEVEN A GODFREY 188787 0 20236 0 38729 0 74159 0 2770 0 324681 0 10847 0 NANCY KROEBER 157169 0 19038 0 9963 0 96927 0 1908 0 285005 0 0 0 DENISE PETERSON 195781 0 23435 0 0 0 24743 0 2008 0 245967 0 0 0 RALPH BECKER 0 297588 0 48750 0 25739 0 59375 0 25480 0 456932 0 0 THOMAS VACCARELLI 145497 0 4689 0 13435 0 18605 0 2706 0 184932 0 0 0 JEFFREY A FINKELSTEIN MD 353689 0 57960 0 11046 0 87929 0 11463 0 522087 0 0 0 MICHAEL BALKUNAS MD 312603 0 33293 0 0 0 82010 0 10898 0 438804 0 0 0 MICHAEL GREY MD 317568 0 62829 0 10794 0 50292 0 7650 0 449133 0 0 0 JAMES L MASSI MD 280759 0 29049 0 9800 0 586 0 0 0 320194 0 0 0 FRANCIS H PINTO 189788 0 5983 0 30400 0 63055 0 18075 0 307301 0 0 0 ELIZABETH SCHLAFF 180736 0 5769 0 13575 0 49737 0 4466 0 254283 0 0 0 HAKLAI P LAU MD 218515 0 155963 0 100808 0 9800 0 2944 0 488030 0 0 0 JAMES F FLAHERTY 369501 0 7740 0 0 0 109012 0 5499 0 491752 0 0 0 MICHELLE MCDADE 264559 0 91290 0 4725 0 9800 0 21397 0 391771 0 0 0 DAVID BUONO 298198 0 51486 0 13360 0 38792 0 2008 0 403844 0 0 0 ERIC HOBERT 279448 0 48463 0 16540 0 9800 0 4270 0 358521 0 0 0 MAUREEN FITZSIMMONS 85209 0 0 0 269512 0 4020 0 1425 0 360166 0 0 0 Part I, Line 1a "GROSS-UPS" ARE PAID ON THE PORTION OF THE SPLIT DOLLAR ANNUALLY REPORTED ON THE CEO'S W-2. ALSO, THE DISCRETIONARY BONUS PAID TO ALL ELIGIBLE EMPLOYEES WAS GROSSED UP. Part I, Lines 4a-b MAUREEN FITZSIMMONS WAS PAID SEVERANCE OF $255,764 UPON TERMINATION OF HER EMPLOYMENT WITH THE HOSPITAL DURING THE REPORTING YEAR. THERE WERE NO SPECIFIED TERMS OR CONDITIONS ASSOCIATED WITH THIS SEVERANCE PAYMENT. NONQUALIFIED RETIREMENT PLANS (SERP) HAVE BEEN ESTABLISHED FOR CERTAIN EMPLOYEES, WHICH ARE MAINTAINED PRIMARILY FOR THE PURPOSE OF PROVIDING DEFERRED COMPENSATION FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES WITHIN THE MEANING OF SECTIONS 201(2), 301(A) (3) AND 401(A)(1) OF ERISA. PAYMENTS FROM SUCH PLANS DURING THE YEAR ARE AS FOLLOWS: STEVE GODFREY - $10,847 ELIZABETH LYNCH - $16,734 BRIAN A. ROGOZ - $72,401 A NONQUALIFIED RETIREMENT PLAN (SERP) HAS BEEN ESTABLISHED TO PROVIDE A SUPPLEMENTAL RETIREMENT BENEFIT TO CLARENCE SILVIA UPON CERTAIN TERMINATION EVENTS OR UPON DISABILITY, DEATH OR ATTAINMENT OF AGE 65 WHILE EMPLOYED. THE PLAN IS INTENDED TO BE "A PLAN WHICH IS UNFUNDED AND IS MAINTAINED BY AN EMPLOYER PRIMARILY FOR THE PURPOSE OF PROVIDING DEFERRED COMPENSATION FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES" WITHIN THE MEANING OF SECTIONS 201(2), 301(A) (3) AND 401(A)(1) OF ERISA, AND SHALL BE INTERPRETED AND ADMINISTERED IN A MANNER CONSISTENT THEREWITH. AMOUNT OF BENEFIT: THE SUPPLEMENTAL RETIREMENT BENEFIT PAYABLE TO THE PARTICIPANT SHALL BE (A) MINUS (B) MINUS (C) WHERE: (A) IS THE LUMP SUM ACTUARIAL EQUIVALENT OF A SINGLE LIFE ANNUITY EQUAL TO THE EXCESS OF 60% OF HIS AVERAGE ANNUAL EARNINGS OVER THE SUM OF THE ACTUARIAL EQUIVALENT SINGLE LIFE ANNUITY BENEFIT, AS DETERMINED AS OF HIS NORMAL RETIREMENT DATE, ACCRUED UNDER THE QUALIFIED PLAN, ONE-HALF OF HIS SOCIAL SECURITY BENEFIT PAYABLE AT HIS NORMAL RETIREMENT DATE AND THE ACTUARIAL EQUIVALENT SINGLE LIFE ANNUITY BENEFIT, DETERMINED AS OF HIS NORMAL RETIREMENT DATE, ACCRUED AND VESTED UNDER ANY QUALIFIED RETIREMENT PLAN OF ANY FORMER EMPLOYER. (B) IS THE NET CASH SURRENDER VALUE, AS OF HIS NORMAL RETIREMENT DATE, OF ALL SPLIT DOLLAR LIFE INSURANCE POLICIES INSURING THE PARTICIPANT'S LIFE WITH RESPECT TO WHICH THE EMPLOYER HAS PAID SOME OR ALL OF THE PREMIUMS THEREON AND WITH RESPECT TO WHICH THE EMPLOYER HAS A COLLATERAL ASSIGNMENT INTEREST. (C) IS THE ACTUARIAL EQUIVALENT OF THE VALUE OF ANY BENEFIT PAID HEREUNDER TO THE PARTICIPANT THERE WAS NO PAYMENT FROM THE PLAN DURING THE YEAR. Part I, Line 6 THE MANAGEMENT INCENTIVE PLAN'S TRIGGER FOR PAYMENT ELIGIBILITY IS THE ORGANIZATION'S OPERATING MARGIN, AFTER WHICH SPECIFIC DEPARTMENTAL PERFORMANCE GOALS MUST BE MET. THE MAXIMUM BONUS AMOUNT IS UP TO 12% OF BASE SALARY. THE OFFICERS ARE ALSO ELIGIBLE FOR A SIMILAR INCENTIVE PLAN FOR WHICH THE TRIGGER IS THE ORGANIZATION'S OPERATING MARGIN, FOLLOWED BY THE NECESSARY ATTAINMENT OF ORGANIZATIONAL GOALS. THIS PLAN HAS A TARGET PAYOUT OF 12.5% FOR VICE PRESIDENTS AND PHYSICIAN CHIEFS AND A 15% TARGET PAYOUT FOR THE CHIEF MEDICAL OFFICER. X 50 FMV X 7787 FMV X 1 324050 DPH VACCINE GRANT X GIFT CARDS & CERTIFICATES 13 1170 FACE VALUE X TICKETS TO EVENTS 2 135 FACE VALUE X AUCTION ITEMS 45 14718 FAIR MARKET VALUE 0 0 0 0 New Program Services Form 990, Part III, line 2 HCC UNDERTOOK VARIOUS PROGRAM ENHANCEMENTS IN SEVERAL CATEGORIES IN ORDER TO BETTER MEET THE NEEDS OF OUR COMMUNITY. THEY ARE AS FOLLOWS: CLINICAL TECHNOLOGY: ENHANCED ITS MINIMALLY INVASIVE ROBOTIC PROGRAMS TO INCLUDE MORE SPECIALTIES LIKE ENT. EMPLOYED MEDICAL CARDIOLOGISTS TO ADDRESS THE INCREASED DEMAND FOR CARDIOVASCULAR SERVICES. FACILITY IMPROVEMENTS: OPENED SATELLITE PRIMARY CARE OFFICES AND ENDOCRINOLOGY IN THE TOWN OF SOUTHINGTON TO BETTER MEET THE NEEDS OF THAT COMMUNITY. Form 990, Part VI, Section A, line 2 A BOARD MEMBER IS A "TRANSITION PARTNER" IN A LAW FIRM THAT DOES WORK FOR THE HOSPITAL OF CENTRAL CONNECTICUT. ALSO SEVERAL PHYSICIAN BOARD MEMBERS HAVE MEDICAL DIRECTOR CONTRACTS WITH THE HOSPITAL OF CENTRAL CONNECTICUT. ONE PHYSICIAN BOARD MEMBER IS A PRINCIPAL IN AN ENDOSCOPY CENTER THAT IS A JOINT VENTURE WITH THE HOSPITAL OF CENTRAL CONNECTICUT. Form 990, Part VI, Section A, line 3 MANAGEMENT SERVICES HAVE BEEN OUTSOURCED FOR PHYSICAL THERAPY, ENVIRONMENTAL SERVICES, MRI AT BRADLEY AND PHARMACY FOR PART OF FY2012. Form 990, Part VI, Section A, line 6 THE ORGANIZATION HAS A SINGLE MEMBER, NAMELY, CENTRAL CONNECTICUT HEALTH ALLIANCE, INC. Form 990, Part VI, Section A, line 7a The Member shall have such rights, powers and responsibilities as are accorded to members under the Act, under the Certificate of Incorporation and under these Bylaws; provided, however, that HHC shall, as the parent company of the Corporation's Member, have the reserved rights and powers set forth in Article 3 hereof. Form 990, Part VI, Section A, line 7b CCHA's authority is subject to the Parent Company, Hartford HealthCare. See amended bylaws article 3, section 3.2. Form 990, Part VI, Section B, line 11 THE BOARD RECEIVES THE 990 AND COMMENTS ARE INCORPORATED INTO THE RETURN. Form 990, Part VI, Section B, line 12c ANNUAL DISCLOSURES ARE COMPLETED AND SENT TO HARTFORD HEALTHCARE OFFICE OF COMPLIANCE, AUDIT & PRIVACY FOR REVIEW. Form 990, Part VI, Section B, line 15 IN FEBRUARY 2011, THE HOSPITAL OF CENTRAL CONNECTICUT AFFILIATED WITH HARTFORD HEALTHCARE. AT THAT TIME, THE EXECUTIVE COMPENSATION COMMITTEE OF HARTFORD HEALTHCARE ASSUMED RESPONSIBILITY FOR THE COMPETITIVE ASSESSMENT AND APPROVAL OF THE TOTAL COMPENSATION OF THE HOSPITAL OF CENTRAL CONNECTICUT'S PRESIDENT AND CEO. WITH THE EXCEPTION OF THE PRESIDENT AND CEO, THE HOSPITAL OF CENTRAL CONNECTICUT ENGAGES AN EXECUTIVE COMPENSATION CONSULTING FIRM TO CONDUCT A COMPETITIVE ASSESSMENT OF TOTAL COMPENSATION FOR OFFICERS AND PHYSICIAN CHIEFS (INCLUDING CASH COMPENSATION AND EXECUTIVE BENEFITS) AND TO VALIDATE THE REASONABLENESS OF SUCH COMPENSATION. THIS ASSESSMENT IS CONDUCTED EVERY OTHER YEAR. SULLIVAN AND COTTER COMPLETED THEIR MOST RECENT ASSESSMENT IN NOVEMBER 2010. WHEN DETERMINING COMPENSATION FOR THE HOSPITAL'S DEPARTMENT HEADS, RELEVANT MARKET DATA IS COLLECTED FROM A NUMBER OF SOURCES TO ASSURE THAT EACH INCUMBENT IS PAID COMPETITIVELY. SOURCES INCLUDE THE CONNECTICUT HOSPITAL ASSOCIATION SALARY SURVEY PREPARED BY OLNEY/HRADVANTAGE, MERCER'S INTEGRATED HEALTH NETWORKS SURVEY, INTEGRATED HEALTHCARE STRATEGIES NATIONAL HEALTHCARE LEADERSHIP COMPENSATION SURVEY AND SULLIVAN AND COTTER'S SURVEY OF MANAGER AND EXECUTIVE COMPENSATION IN HOSPITALS AND HEALTH SYSTEMS. SURVEY DATA IS CONSIDERED BY STATE, REGION, AND SIZE OF HOSPITAL. THE PERFORMANCE OF EACH DEPARTMENT HEAD AND AVAILABLE MONIES ARE OTHER FACTORS IN THE DELIBERATION PROCESS. AFTER COLLATING AND ANALYZING ALL RELEVANT DATA, A RECOMMENDATION AS TO APPROPRIATE SALARY IS MADE BY HUMAN RESOURCES MANAGEMENT. THE ADMINISTRATIVE ADVISOR OF EACH DEPARTMENT HEAD THEN CONSIDERS THE RECOMMENDATIONS AND APPROVES OR REVISES THE FIGURES BASED ON THE INFORMATION PRESENTED. Form 990, Part VI, Section C, line 19 Governing documents, conflict of interest policy and financial statements aren't made available to the public. FORM 990, PART VII, COMPENSATION OF OFFICERS, DIRECTORS: A. DR. ANDREOLI- COMPENSATION PROVIDED FOR PROVISION OF PROFESSIONAL SERVICES AS OB/GYN SITE DIRECTOR RESIDENCY PROGRAM AT THE HOSPITAL OF CENTRAL CONNECTICUT (HCC). B. DR. ASCIUTO- COMPENSATION PROVIDED FOR PROVISION OF PROFESSIONAL SERVICES AS ASSOCIATE CHIEF OF MEDICAL STAFF, BRADLEY MEMORIAL CAMPUS OF HCC. C. DR. LAPKIN- COMPENSATION PROVIDED FOR PROFESSIONAL SERVICES AS CHIEF OF STAFF AND MEDICAL DIRECTOR OF THE DIALYSIS UNIT AT HCC. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 11,243,022. CHANGE IN ASSETS HELD IN TRUST BY OTHERS 1,703,710. PENSION CHANGES OTHER THAN NET PERIODIC BENEFIT COSTS -65,083,998. CHANGE IN BEGINNING BALANCE OF AUXILIARY NET WORTH 131. LOSS ON INVESTMENT IN AFFILIATE -133,499. Total to Form 990, Part XI, Line 5: -52,270,634. FORM 990, Part XII, Line 2C: Oversight committee is of Hartford Healthcare since the affiliation on February 1, 2011. Form 990, Part III, Line 1 (continued): The Hospital of Central Connecticut at Bradley Memorial, founded in 1938, is an acute care hospital located at 81 Meriden Avenue, Southington, Connecticut. It provides a wide range of inpatient and outpatient services to a geographic area centered on the town of Southington. The Bradley Memorial Campus is licensed for 84 beds. Maternity services are not provided, therefore, there are no bassinets. It currently staffs 30 beds. The beds are divided into 27 medical and surgical beds and 3 ICU beds. Inpatient: The Bradley Memorial campus offers inpatient care in general medicine and surgery and various specialties, including but not limited to cardiology, physical medicine, radiology, 24-hour emergency care, neurosurgery and intensive care. Outpatient: The campus provides ambulatory surgery, cardiac testing and rehabilitation, physical medicine, respiratory therapy and other types of outpatient services, as well as Women's Center, Diagnostic services, including lab testing and radiology and Wound Care Center. Both campuses provide a wide array of medical services. Since operating under a single license, patients can receive services offered at either campus without any interruption. Patients are also offered continuity of care since the clinical oversight of each service is shared between campuses. 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