BRISTOL HOSPITAL INCORPORATED: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- BRISTOL HOSPITAL INCORPORATED (EIN 06-0646559)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-08-15
- IRS object ID
- 201202289349301260
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-15T08:49:54-05:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SASLOW LUFKIN & BUGGY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | TEN TOWER LANE | AddressLine1 |
| City | AVON | City |
| State | CT | State |
| ZIP Code | 06001 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 060646559 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRISTOL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | BRIS | NameControl |
| Phone | 8605853000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | BREWSTER RD | AddressLine1 |
| City | BRISTOL | City |
| State | CT | State |
| ZIP Code | 06011 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | GEORGE W EIGHMY | Name |
| Title | VP & CFO | Title |
| Phone | 8605853000 | Phone |
| Date Signed | 2012-08-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BETH THURZ | Name |
| Phone | 8606789200 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | KURT BARWIS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | BREWSTER RD | AddressLine1 |
| City | BRISTOL | City |
| State | CT | State |
| ZIP Code | 06011 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 134512605 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.BRISTOLHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1920 | YearFormation |
| State Legal Domicile | CT | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE QUALITY HEALTHCARE SERVICES TO THE COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 17 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1343 | TotalNbrEmployees |
| Total Nbr Volunteers | 350 | TotalNbrVolunteers |
| Total Gross UBI | 1135597 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -742724 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1947224 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1812490 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 128738355 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 126737955 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 285251 | InvestmentIncomePriorYear |
| Investment Income Current Year | 516585 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 2531894 | OtherRevenuePriorYear |
| Other Revenue Current Year | 5445575 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 133502724 | TotalRevenuePriorYear |
| Total Revenue Current Year | 134512605 | 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 | 70523697 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 64766097 | 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 | 60463936 | OtherExpensePriorYear |
| Other Expenses Current Year | 67128430 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 130987633 | TotalExpensesPriorYear |
| Total Expenses Current Year | 131894527 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2515091 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2618078 | RevenuesLessExpensesCY |
| Total Assets BOY | 97645788 | TotalAssetsBOY |
| Total Assets EOY | 103125741 | TotalAssetsEOY |
| Total Liabilities BOY | 89425255 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 95110053 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 8220533 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 8015688 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | BRISTOL HOSPITAL IS COMMITTED TO PROVIDING THE BEST PATIENT EXPERIENCE IN THE REGION. OUR 134-BED, FULL-SERVICE HEALTH CARE INSTITUTION PROVIDES COMPREHENSIVE INPATIENT AND OUTPATIENT CARE FOR THE GREATER BRISTOL, CONNECTICUT AREA. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 113317317 | Expense |
| Revenue | 129958172 | Revenue |
| Description | AS A SHORT-TERM ACUTE CARE COMMUNITY HOSPITAL, BRISTOL HOSPITAL PROVIDES A BROAD SPECTRUM OF HEALTHCARE SERVICES TO ANY INDIVIDUAL REGARDLESS OF THE INDIVIDUAL'S ABILITY TO PAY. THE HOSPITAL PROVIDED MORE THAN $223,700 IN CHARITY CARE DURING THE OPERATING YEAR. THE HOSPITAL ALSO PROVIDES EDUCATION AND WELLNESS PROGRAMS TO THE COMMUNITY. THESE ACTIVITIES TYPICALLY REACH ABOUT 1,600 INDIVIDUALS PER QUARTER. THESE ACTIVITIES INCLUDE: WELLNESS CENTER - SPECIAL CENTER FOR EDUCATIONAL OUTREACH PROGRAMMING SERVING HUNDREDS OF INDIVIDUALS PER MONTH. - COMMUNITY HEALTH SCREENINGS - ONGOING FREE AND REDUCED PRICE SCREENINGS FOR MAMMOGRAMS, BLOOD PRESSURE, CHOLESTEROL, PROSTATE CANCER, SKIN CANCER AND A FLU CLINIC PROVIDING FREE FLU SHOTS IN THE FALL. - SPEAKERS BUREAU - A COMMUNITY SERVICE WHERE THE HOSPITAL PROVIDES SPEAKERS ON A VARIETY OF TOPICS TO SERVE THE COMMUNITY'S EDUCATIONAL NEEDS. - PERIODIC COMMUNITY SERVICE PROJECTS - THE HOSPITAL HAS SPONSORED TWO MAJOR OUTREACH EFFORTS, ONE TO PROMOTE EARLY DETECTION OF BREAST CANCER AND ONE TARGETED TO PREVENT COLON CANCER. BOTH PROGRAMS HAVE INCREASED THE COMMUNITY'S COMPLIANCE WITH THE RECOMMENDED CANCER SCREENINGS AND HAVE BEEN RECOGNIZED WITH STATE, REGIONAL AND NATIONAL AWARDS. | Description |
| Total Program Service Expense | 113317317 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| 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 | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | 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 | 1 | 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 | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 86 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1343 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 17 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | 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 | GEORGE EIGHMY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8605853000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | BREWSTER ROAD | AddressLine1 |
| City | BRISTOL | City |
| State | CT | State |
| ZIP Code | 06011 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (28 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 |
|---|---|---|---|---|---|---|---|---|---|
| KENNETH BENOIT MD | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| NANCY BLANCHETTE | |||||||||
| CHAIRMAN | 2.00 | X | 0 | 0 | 0 | X | |||
| MARK BLUM | |||||||||
| SECRETARY/TREASURER | 2.00 | X | 0 | 0 | 0 | X | |||
| BALA SHANMUGAM MD | |||||||||
| DIRECTOR | 2.00 | X | 4375 | 235565 | 2917 | ||||
| LESLIE KISH MD | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| MORRIS LAVIERO | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| JOHN J LEONE JR | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| GLENN HEISER | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| KURT BARWIS | |||||||||
| PRESIDENT & CEO | 60.00 | X | 586031 | 0 | 105220 | X | |||
| JOHN LODOVICO JR | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| MARIE O'BRIEN | |||||||||
| VICE CHAIRMAN | 2.00 | X | 0 | 0 | 0 | X | |||
| PETER VALERIO | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| KENNETH RHEE MD | |||||||||
| DIRECTOR | 40.00 | X | 71088 | 0 | 0 | ||||
| RICK ABBOTT | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| JACK ADLER MD | |||||||||
| VICE PRESIDENT OF THE MEDICAL STAFF | 2.00 | X | 0 | 0 | 0 | ||||
| DOUGLAS DEVNEW | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| DANIEL S SACCU | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| LEONARD BANCO MD | |||||||||
| CHIEF MEDICAL OFFICER | 40.00 | 370194 | 0 | 16946 | X | ||||
| JEANINE RECKDENWALD | |||||||||
| VP, HUMAN RESOURCES AND SUPPORT SERVICES | 40.00 | 177750 | 0 | 1738 | X | ||||
| DAVE RACKLIFF | |||||||||
| AVP INFORMATION TECHNOLOGY | 40.00 | 168188 | 0 | 18194 | X | ||||
| EVA WICKWIRE | |||||||||
| AVP / CHIEF DEVELOPMENT OFFICER | 40.00 | 151934 | 0 | 8082 | X | ||||
| SUE SYLVESTRE | |||||||||
| AVP PRACTICE MANAGEMENT | 40.00 | 167978 | 0 | 14467 | X | ||||
| MARC EDELMAN | |||||||||
| V.P. OPERATIONS | 40.00 | 202494 | 0 | 7747 | X | ||||
| JEFFREY SHELTON | |||||||||
| PHYSICIAN | 40.00 | 183365 | 0 | 13210 | X | ||||
| MARIE MARCIANO | |||||||||
| DIRECTOR OF DIAGNOSTICS | 40.00 | 129062 | 0 | 16942 | X | ||||
| LYNNE RAMER | |||||||||
| CLINICAL OPERATIONS DIRECTOR, PERIOPERATIVE | 40.00 | 127146 | 0 | 10756 | X | ||||
| DIANE BOUFFARD | |||||||||
| SYSTEM DIRECTOR, QUALITY | 40.00 | 128932 | 0 | 1066 | X | ||||
| PETER FREYTAG | |||||||||
| FORMER V.P. CFO | 40.00 | 392797 | 0 | 11148 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2861334 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 235565 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 228433 | TotalOtherCompensation |
| Number Individuals GT100 K | 32 | 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 |
|---|---|---|---|---|---|
| ALLIANCE HEALTHCARE SERVICES | |||||
| PO BOX 96485 | CHICAGO | IL | 603966485 | PET/CT SCANS | 362193 |
| HOSPITAL INTERNISTS OF BRISTOL LLC | |||||
| 3 MICHELLE LANE | MYSTIC | CT | 06355 | MEDICAL SERVICES | 255000 |
| TOTAL LAUNDRY COLLABORATIVE LLC | |||||
| 114 WOODLAND STREET | HARTFORD | CT | 06105 | LAUNDRY SERVICES | 237210 |
| DIALYSIS CTR OF NEWINGTON | |||||
| C/O DSD - NE REGIONAL OFFICE | BOSTON | MA | 022413696 | MEDICAL SERVICES | 195784 |
| BRISTOL PATHOLOGY CONSULTANTS PC | |||||
| PO BOX 1599 | HARTFORD | CT | 061441599 | MEDICAL CONSULT SERVICES | 187060 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 17 | NumberOfContractorsGT100K |
| Related Organizations | 402204 | RelatedOrganizations |
| Government Grants | 1410286 | GovernmentGrants |
| Noncash Contributions | 25338 | NoncashContributions |
| Total Contributions | 1812490 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| PATIENT SERVICE REVENU | 900099 | 125941019 | 124766502 | 1174517 |
| OCCUPATIONAL HEALTH RE | 621990 | 796936 | 796936 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 126737955 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 516585 | TotalRevenueColumn |
| Exclusion | $516,585 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 373912 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 373912 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 373912 | TotalRevenueColumn |
| Exclusion | $373,912 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| MISC. PROGRAM AND HEAL | 621990 | 2829132 | 2829132 | ||
| JOINT VENTURES | 900099 | 1526682 | 1565602 | -38920 | |
| CAFETERIA | 722210 | 402475 | $402,475 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 313374 | TotalRevenueColumn |
| Exclusion | $313,374 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 5071663 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 134512605 | TotalRevenueColumn |
| Related Or Exempt Function Income | 129958172 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1135597 | UnrelatedBusinessRevenue |
| Exclusion | $1,606,346 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1983916 | Total |
| Management And General | 1983916 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54522950 | Total |
| Program Services | 47134432 | ProgramServices |
| Management And General | 7388518 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3734851 | Total |
| Program Services | 2987881 | ProgramServices |
| Management And General | 746970 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 386890 | Total |
| Program Services | 309512 | ProgramServices |
| Management And General | 77378 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4137490 | Total |
| Program Services | 3309992 | ProgramServices |
| Management And General | 827498 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3798498 | Total |
| Management And General | 3798498 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 540268 | Total |
| Management And General | 540268 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 101881 | Total |
| Management And General | 101881 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 74353 | Total |
| Management And General | 74353 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4629882 | Total |
| Program Services | 3878259 | ProgramServices |
| Management And General | 751623 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1045838 | Total |
| Program Services | 1042509 | ProgramServices |
| Management And General | 3329 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14935494 | Total |
| Program Services | 14786139 | ProgramServices |
| Management And General | 149355 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1894085 | Total |
| Program Services | 1894085 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3456868 | Total |
| Program Services | 2972906 | ProgramServices |
| Management And General | 483962 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 204528 | Total |
| Program Services | 153396 | ProgramServices |
| Management And General | 51132 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34499 | Total |
| Management And General | 34499 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1833355 | Total |
| Program Services | 1833355 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5725556 | Total |
| Program Services | 5654038 | ProgramServices |
| Management And General | 71518 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7462558 | Total |
| Program Services | 5970046 | ProgramServices |
| Management And General | 1492512 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| BAD DEBT | 9847024 | 9847024 |
| MEDICAL SERVICES FEES | 6532866 | 6532866 |
| REPAIR AND MAINTENANCE | 1663662 | 1663662 |
| OTHER EXPENSES | 1448733 | 1448733 |
| COLLECTION FEES | 783031 | 783031 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1115451 | Total |
| Program Services | 1115451 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 131894527 | Total |
| Program Services | 113317317 | ProgramServices |
| Management And General | 18577210 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8286702 | BOY |
| EOY | 4272881 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 96165 | BOY |
| EOY | 96343 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15483112 | BOY |
| EOY | 20427829 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1439654 | BOY |
| EOY | 1696559 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2581093 | BOY |
| EOY | 2119071 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 139215994 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 99185736 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37000469 | BOY |
| EOY | 40030258 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12001102 | BOY |
| EOY | 11618379 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12654647 | BOY |
| EOY | 12513653 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5465804 | BOY |
| EOY | 5034092 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2637040 | BOY |
| EOY | 5316676 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 97645788 | BOY |
| EOY | 103125741 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23412362 | BOY |
| EOY | 29472454 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 607691 | BOY |
| EOY | 1186812 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25042967 | BOY |
| EOY | 24658242 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 312490 | BOY |
| EOY | 305407 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2749252 | BOY |
| EOY | 2351228 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37300493 | BOY |
| EOY | 37135910 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 89425255 | BOY |
| EOY | 95110053 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 755592 | BOY |
| EOY | 427122 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 800850 | BOY |
| EOY | 1021495 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6664091 | BOY |
| EOY | 6567071 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8220533 | BOY |
| EOY | 8015688 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 97645788 | BOY |
| EOY | 103125741 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 2618078 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -2822923 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| 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 | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 1 | DirectContactLegislators |
| Direct Contact Legislators | $4,629 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $69,725 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 74354 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF OTHER LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1I: | ReturnReference |
| Explanation | THE HOSPITAL IS A MEMBER OF THE CONNECTICUT HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. $20,024 REPRESENTS THE PORTION OF THE DUES PAID TO THESE ASSOCIATIONS WHICH WERE USED FOR LOBBYING PURPOSES. THE HOSPITAL ENGAGED CAMILLIERE, CLOUD & KENNEDY, A CONNECTICUT LOBBYING AND BUSINESS DEVELOPMENT FIRM, FOR CONSULTING SERVICES IN THE AMOUNT OF $49,700. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 12881077 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 40613 | InvestmentEarningsOrLosses |
| Other Expenditures | 185211 | OtherExpenditures |
| End Of Year Balance | 12736479 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 12016137 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 1587194 | InvestmentEarningsOrLosses |
| Other Expenditures | 722254 | OtherExpenditures |
| End Of Year Balance | 12881077 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 13256619 | BeginningOfYearBalance |
| Contributions | 570728 | Contributions |
| Investment Earnings Or Losses | -523731 | InvestmentEarningsOrLosses |
| Other Expenditures | 1287479 | OtherExpenditures |
| End Of Year Balance | 12016137 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.40400 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.51600 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.08000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1506976 | OtherCostOrOtherBasis |
| Book Value | 1506976 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 57576637 | OtherCostOrOtherBasis |
| Depreciation | 36232092 | Depreciation |
| Book Value | 21344545 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1006331 | OtherCostOrOtherBasis |
| Depreciation | 633794 | Depreciation |
| Book Value | 372537 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 76698658 | OtherCostOrOtherBasis |
| Depreciation | 60220582 | Depreciation |
| Book Value | 16478076 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2427392 | OtherCostOrOtherBasis |
| Depreciation | 2099268 | Depreciation |
| Book Value | 328124 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 40030258 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (5 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| FUNDS HELD FOR MALPRACTICE SELF-INSURANCE | 6406972 | F |
| ASSETS HELD IN TRUST BY OTHERS | 2743115 | F |
| FUNDS HELD UNDER BOND INDENTURE | 2506470 | F |
| DONOR RESTRICTED INVESTMENTS | 394142 | F |
| DEBT SERVICE FUND | 462954 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 12513653 | TotalOfBookValueSecurities |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| OTHER RECEIVABLES | 677818 |
| DUE FROM AFFILIATES | 2258921 |
| ESTIMATED SETTLEMENTS WITH THIRD-PARTY PAYERS | 2379937 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 5316676 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ACCRUED POSTRETIREMENT BENEFIT LIABILITY | $5,855,356 |
| LINE OF CREDIT | $3,541,944 |
| ASSET RETIREMENT OBLIGATIONS | $2,116,281 |
| ACCRUED PENSION LIABILITY | $25,622,329 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 37135910 | TotalOfAmounts |
| Total Revenue | 134512605 | TotalRevenue |
| Total Expenses | 131894527 | TotalExpenses |
| Excess Or Deficit For Year | 2618078 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -866399 | NetUnrealizedGLOnInvestments |
| Other | -$1,956,524 | OtherAmount |
| Total Adjustments | -2822923 | TotalAdjustments |
| Excess Or Deficit Per FS | -204845 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 134085063 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 134085063 | RevenueSubtotal |
| Other Revenues Not Included | 427542 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 427542 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 134512605 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 131894527 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 131894527 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 131894527 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | THE HOSPITAL'S ENDOWMENT CONSISTS OF MULTIPLE FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES, SUCH AS CAPITAL EXPENDITURES, OPERATING EXPENSES, AND OTHER SPECIFIED DONOR AND BOARD RESTRICTED USES. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | THE HOSPITAL ACCOUNTS FOR UNCERTAIN TAX POSITIONS WITH PROVISIONS OF FASB ASC 740, "INCOME TAXES" WHICH PROVIDES A FRAMEWORK FOR HOW COMPANIES SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE UNCERTAIN TAX POSITIONS IN THEIR FINANCIAL STATEMENTS. THE HOSPITAL MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE HOSPITAL DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AS SEPTEMBER 30, 2011 AND 2010. IT IS THE HOSPITAL'S POLICY TO RECORD PENALTIES AND INTEREST ASSOCIATED WITH UNCERTAIN TAX PROVISIONS AS A COMPONENT OF OPERATING EXPENSES. AS OF SEPTEMBER 30, 2011 AND 2010, THE HOSPITAL DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNCERTAIN TAX POSITIONS. THE HOSPITAL'S PRIOR THREE TAX YEARS ARE OPEN AND SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | DECREASE IN PERMANENTLY RESTRICTED NET ASSETS -97,020. TRANSFER TO BHMSG -825,477. PENSION CHANGES OTHER THAN NET PERIODIC BENEFIT COSTS -1,184,961. CHANGES IN POSTRETIREMENT HEALTH & WELFARE BENEFITS 278,391. CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 300,085. NONCASH VACCINE CONTRIBUTIONS -25,338. CONTRIBUTION FROM BRISTOL HOSPITAL DEVELOPMENT FOUNDATION -402,204. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | NONCASH VACCINE CONTRIBUTIONS 25,338. CONTRIBUTION FROM BRISTOL HOSPITAL DEVELOPMENT FOUNDATION 402,204. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent250 | X | Pcent250 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 809874 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 680000 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 129874 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00100 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 23270010 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 18924907 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4345103 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03290 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 24079884 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 19604907 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4474977 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03390 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 95660 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 95660 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 95660 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 95660 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 24175544 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 19604907 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4570637 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03460 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $3,306,197 | BadDebtExpenseAmount |
| Amount Attributable To | 826549 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 47069698 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 50538043 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -3468345 | 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 (7 entries)
| Description Ent Primary ActivityDescriptionEntPrimaryActivity | Organization Profit Or OwnershipOrganizationProfitOrOwnership | Officers Etc Profit Or OwnershipOfficersEtcProfitOrOwnership | Physicans Profit Or OwnershipPhysicansProfitOrOwnership |
|---|---|---|---|
| 1 BRISTOL MSO LLC | |||
| RADIOLOGY SERVICES | 0.50000 | ||
| 2 MEDWORKS LLC | |||
| REHAB & OCCUPATIONAL HEALTH | 0.50000 | 0.00000 | 0.00000 |
| 3 CT OCCUPATIONAL MEDICAL PARTNERS | |||
| OCCUPATIONAL HEALTH | 0.33000 | ||
| 4 MEDCONN COLLECTION AGENCY | |||
| COLLECTION SERVICES | 0.20000 | 0.00000 | 0.00000 |
| 6 TOTAL LAUNDRY COLLABORATIVE LLC | |||
| LAUNDRY SERVICES | 0.09000 | ||
| 7 CENTRAL CT ENDOSCOPY CENTER | |||
| MEDICAL SERVICES | 0.06500 | ||
| 8 HEALTH CT LLC | |||
| MEDICAL SERVICES | 0.05400 | 0.00000 | 0.00000 |
| 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 | BRISTOL HOSPITAL INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | BREWSTER ROAD | AddressLine1 |
| City | BRISTOL | City |
| State | CT | State |
| ZIP Code | 06010 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
| Er Other | X | ErOther |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRISTOL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 9 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (9 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| BRISTOL BEHAVIORAL HEALTH SERVICES | ||||
| 10 N MAIN STREET SUITE 210 | BRISTOL | CT | 06010 | BEHAVIORAL HEALTH |
| BRISTOL HOSPITAL CENTER FOR DIABETES | ||||
| 102 NORTH STREET | BRISTOL | CT | 06010 | DIABETES MEDICAL CARE AND EDUCATION |
| BRISTOL HOSPITAL COUNSELING CENTER | ||||
| 440-C NORTH MAIN STREET | BRISTOL | CT | 06010 | THERAPY AND COUNSELING |
| BRISTOL HOSPITAL WELLNESS CENTER | ||||
| 842 CLARK AVENUE | BRISTOL | CT | 06010 | MEDICAL AND FITNESS SERVICES |
| BRISTOL RADIOLOGY CENTER | ||||
| 25 COLLINS ROAD | BRISTOL | CT | 06010 | MAMMOGRAPHY AND MRI |
| MED HELP | ||||
| 539 FARMINGTON AVENUE | BRISTOL | CT | 06010 | URGENT CARE |
| MEDWORKS LLC | ||||
| 375 CEDAR STREET | NEWINGTON | CT | 06111 | OCCUPATIONAL HEALTH SERVICES |
| PARENT & CHILD CENTER - BRISTOL HOSPITA | ||||
| 9 PROSPECT STREET | BRISTOL | CT | 06010 | CHILDREN AND FAMILY SERVICES |
| REHAB DYNAMICS | ||||
| 975 FARMINGTON AVENUE | BRISTOL | CT | 06010 | PHYSICAL THERAPY AND SPORTS MEDICINE |
Form990 Schedule H Part VI Form990ScheduleHPartVI (8 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART III, LINE 8: THE CALCULATED MEDICARE SHORTFALL SHOULD BE CONSIDERED COMMUNITY BENEFIT BECAUSE IT REPRESENTS UNREIMBURSED COSTS FOR PATIENT SERVICES. THESE UNREIMBURSED COSTS ARE BRISTOL HOSPITAL EXPENSES THAT ULTIMATELY BENEFIT THE COMMUNITY BRISTOL HOSPITAL SERVICES. | ||
| PART III, LINE 9B: IT IS THE POLICY OF BRISTOL HOSPITAL TO PROVIDE EVERY PATIENT FROM THE COMMUNITY WE SERVE WITH MEDICALLY NECESSARY HEALTH SERVICES REGARDLESS OF THEIR ABILITY TO PAY. THE POLICY SETS SPECIFIC GUIDLINES FOR THE COLLECTION OF PATIENT PAYMENTS AND ESTABLISHES A HIERARCHY FOR PAYMENT METHODS THAT ARE BOTH FRIENDLY TO THE PATIENT AND BENEFICIAL TO THE HOSPITAL. PATIENTS WHO ARE UNABLE TO PAY THEIR LIABILITY ARE REFERRED TO A FINANCIAL COUNSELOR WHO WILL ASSESS THE PATIENT'S ELIGIBILITY FOR CHARITY CARE OR ALTERNATIVE FUNDING SOURCES. FUNDING SOURCES INCLUDE CHARITY CARE, OUTSIDE FINANCING, HOSPITAL PAYMENT PLANS, FEDERAL, STATE AND LOCAL PROGRAMS AND THE HOSPITAL FINANCIAL ASSISTANCE PROGRAM. | ||
| PART VI, LINE 2: HOSPITAL ASSESSMENT OF THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES IS A DYNAMIC PROCESS THAT INVOLVES ALL LEVELS OF HOSPITAL ADMINISTRATION, STAFF, THE BOARD OF DIRECTORS (BOD), AND MEDICAL STAFF. VARIOUS COMMITTEES AND GROUPS AT THE HOSPITAL MEET PERIODICALLY TO DISCUSS THE NEEDS OF THE COMMUNITY WE SERVE AS WELL AS THE RESOURCES AND SERVICES AVAILABLE AT THE HOSPITAL AND OTHER AGENCIES IN THE AREA. THE HOSPITAL IS REPRESENTED AT COMMUNITY LEVEL ORGANIZATIONS AND GROUPS THAT ARE ALSO INVOLVED WITH ASSESSMENT OF THE COMMUNITY NEEDS. HOSPITAL RESOURCES ARE FREQUENTLY CALLED UPON TO PARTICIPATE IN PROGRAMS AND PROJECTS PUT TOGETHER TO ADDRESS THOSE NEEDS. | ||
| PART VI, LINE 3: AT BRISTOL HOSPITAL, PATIENTS ARE NOTIFIED OF THEIR ABILITY TO DISCUSS FINANCIAL ASSISTANCE OPTIONS INCLUDING CHARITY CARE IN ALL OF THEIR BILLING STATEMENTS. THE HOSPITAL ENCOURAGES PATIENTS TO FIND OUT THEIR ELIGIBILITY FOR ASSISTANCE AND PROVIDES FINANCIAL COUNSELORS TO ASSIST PATIENTS IN APPLYING FOR CHARITY CARE.PATIENTS CAN CONTACT THE FINANCIAL ASSISTANCE DEPARTMENT WITHIN THE HOSPITAL AT 860-585-3878. THIS SUPPORT ALSO INCLUDES A REPRESENTATIVE THROUGH THE STATE OF CONNECTICUT (REPRESENTATIVE PAID BY BRISTOL HOSPITAL) SO WE ENSURE THAT ALL ASPECTS OF ASSISTANCE ARE PROVIDED FOR EACH PATIENT.THE FINANCIAL ASSISTANCE DEPARTMENT ALSO DISCUSSES GOVERNMENT BENEFITS WITH PATIENTS THAT THEY MAY BE ELIGIBLE FOR.CONTACT INFORMATION FOR OUR FINANCIAL COUNSELOR IS ALSO INCLUDED ON THE HOSPITAL WEBSITE FOR PATIENTS TO REFERENCE. THE HOSPITAL ALSO OFFERS MANY FREE PROGRAMS FOR THE UNINSURED INCLUDING FREE BLOOD PRESSURE CLINICS, SKIN CANCER SCREENING CLINICS AND SEMINARS TO PROVIDE PATIENTS ACCESS TO AS MUCH FREE HEALTH INFORMATION AS POSSIBLE. | ||
| PART VI, LINE 4: BRISTOL HOSPITAL IS COMMITTED TO PROVIDING THE BEST PATIENT EXPERIENCE IN THE REGION. OUR 134-BED, FULL-SERVICE HEALTH CARE INSTITUTION PROVIDES COMPREHENSIVE INPATIENT AND OUTPATIENT CARE FOR THE GREATER BRISTOL, CONNECTICUT AREA.BRISTOL IS A SUBURBAN CITY LOCATED IN HARTFORD COUNTY, CONNECTICUT, UNITED STATES 20 MILES SOUTHWEST OF HARTFORD. BRISTOL HAS A TOTAL AREA OF 26.8 SQUARE MILES AND A POPULATION OF APPROX 62K. IN BRISTOL, 84.2% OF THE PEOPLE SPEAK ENGLISH AND 4.8% OF PEOPLE SPEAK SPANISH. IN BRISTOL, 54.6% OF PEOPLE ARE MARRIED AND 92.2% OF RESIDENTS WERE BORN IN THE US.COMMUNITY INFORMATION:THE PRIMARY SERVICE AREA (PSA) FOR OUR HOSPITAL INCLUDES:BRISTOL (ZIP CODE 06010,06011)- 2011 CENSUS 62,078BURLINGTON (ZIP CODE 06013)- 2011 CENSUS- 10,011PLAINVILLE (ZIP CODE 06062)- 2011 CENSUS 17,767PLYMOUTH (ZIP CODE 06781,06782,06786)- 2011 CENSUS 12,605THE TOTAL POPULATION FROM THE 2011 CENSUS FOR OUR PSA IS- 102,461IN 2010, THE LATEST DATE DATA BECAME AVAILABLE AND THE FOLLOWING DATA POINTS WERE PROVIDED FOR THE FOLLOWING COMMUNITIES: BRISTOL:MEDIAN HOUSEHOLD INCOME: $58,537FAMILIES BELOW POVERTY LEVEL- 5.6%INDIVIDUALS BELOW POVERTY LEVEL- 7.7%RACE: WHITE- 87.6%, BLACK OR AFRICAN AMERICAN- 3.6%, AMERICAN INDIAN OR ALASKA NATIVE- 0.3%, ASIAN- 1.8%, OTHER RACE- 3.9%BURLINGTON: MEDIAN HOUSEHOLD INCOME: $116,419 FAMILIES BELOW POVERTY LEVEL- 1.2% INDIVIDUALS BELOW POVERTY LEVEL- 1.9% RACE: WHITE- 98%, BLACK OR AFRICAN AMERICAN- 0.2%,AMERICAN INDIAN OR ALASKA NATIVE- 0.1%, ASIAN- 1.2%PLAINVILLE: MEDIAN HOUSEHOLD INCOME: $62,440 FAMILIES BELOW POVERTY LEVEL- 4.1% INDIVIDUALS BELOW POVERTY LEVEL- 5.0% RACE: WHITE- 93.1%, BLACK OR AFRICAN AMERICAN- 2.5%, AMERICAN INDIAN OR ALASKA NATIVE- 0.3%, ASIAN- 1.3%, OTHER RACE- 0.6% PLYMOUTH: MEDIAN HOUSEHOLD INCOME: $70,132 FAMILIES BELOW POVERTY LEVEL- 2.9% INDIVIDUALS BELOW POVERTY LEVEL- 5.6% RACE: WHITE- 96.7%, BLACK OR AFRICAN AMERICAN- 0.5%, AMERICAN INDIAN OR ALASKA NATIVE- 0.3%, ASIAN- 0.6%, OTHER RACE- 0.7% THE SECONDARY SERVICE AREA (SSA) FOR OUR HOSPITAL INCLUDES:FARMINGTON (ZIP CODE 06085,06087)- 2011 CENSUS 6,058SOUTHINGTON (ZIP CODE 06489)- 2011 CENSUS 33,560WOLCOTT (ZIP CODE 06716)- 2011 CENSUS 17,458THOMASTON (ZIP CODE 06787)- 2011 CENSUS 8,512HARWINTON (ZIP CODE 06791)- 2011 CENSUS 5,938THE TOTAL POPULATION FROM THE 2011 CENSUS FOR OUR SSA IS- 71,526BOTH THE PSA (PRIMARY SERVICE AREA) AND SSA (SECONDARY SERVICE AREA) ARE PRIMARILY SUBURBAN AND RURAL AREAS BUT ALSO INCLUDE SOME URBAN AREAS AS WELL. SOME OF THE MAJOR HEALTH PROBLEMS PREVALENT IN OUR PSA ARE ASSOCIATED WITH BEHAVIORAL HEALTH, CHEMICAL DEPENDENCY, OBESITY, AND PULMONARY DISEASE. | ||
| PART VI, LINE 6: BRISTOL HOSPITAL TAKES GREAT PRIDE IN SERVING THE COMMUNITY. AS PART OF ITS MISSION, BRISTOL HOSPITAL INCORPORATES A BROAD ARRAY OF COMMUNITY OUTREACH AND WELLNESS ACTIVITIES, DELIVERING EDUCATIONAL MATERIAL AND COUNSELING, OFFERING FREE OR LOW COST HEALTH SCREENINGS AND HOSTING PATIENT AND FAMILY SUPPORT GROUPS. WE UNDERSTAND THE IMPORTANCE AND VALUE OF EMPHASIZING GOOD HEALTH, FITNESS, SAFETY AND THE PROMOTION OF EARLY DETECTION OF ILLNESS OR DISEASE. THEREFORE, ALL OF OUR OUTREACH EFFORTS REFLECT OUR STRONG DESIRE TO IMPROVE THE QUALITY OF LIFE FOR ALL WHO LIVE AND WORK IN THE COMMUNITIES WE SERVE. BRISTOL HOSPITAL PROVIDES FINANCIAL SUPPORT AND ACCESS TO APPROPRIATE CLINICAL CARE FOR SEVERAL LIFE-SAVING INITIATIVES, INCLUDING THE BRISTOL COMMUNITY BREAST HEALTH PROJECT AND THE COLON CANCER AWARENESS PROJECT OF GREATER BRISTOL, WHICH ALLOW US TO OFFER FREE BREAST, AND COLORECTAL CANCER SCREENINGS TO THOSE WHO, DUE TO INSURANCE OR INCOME FACTORS, MIGHT NOT OTHERWISE HAVE ACCESS TO THESE VALUABLE DIAGNOSTIC SCREENING SERVICES. THE EYE CARE PROJECT OF GREATER BRISTOL PROVIDES VITAL ACCESS TO SERVICES FOR THOSE SUFFERING FROM VISION IMPAIRMENT.AT BRISTOL HOSPITAL WE UNDERSTAND THE IMPORTANCE OF OUR ROLE AS AN EXEMPT HEALTHCARE PROVIDER TO THE COMMUNITY WE SERVICE. OUR LEADERSHIP TEAM IS COMMITTED TO PROVIDING OUTSTANDING PATIENT CARE AND PROMOTING THE HEALTH OF THE COMMUNITY. BRISTOL HOSPITAL ATTEMPTS TO PROMOTE OUR FREE AND NON-REVENUE GENERATING PROGRAMS IN A VARIETY OF WAYS. THREE TIMES A YEAR, THE HOSPITAL MAILS A "PATHWAYS TO YOUR HEALTH" CATALOG. THE CATALOG CONTAINS A LISTING OF PROGRAMS AVAILABLE TO THE GREATER BRISTOL COMMUNITY. THIS CATALOG IS MAILED TO OVER 60,000 RESIDENTS AND PROVIDES INFORMATION ON FREE HEALTH SCREENINGS, SUPPORT GROUPS, HEALTH EDUCATION, WELLNESS PROGRAMS, ETC. THE CATALOG IS ALSO INCLUDED ON OUR HOSPITAL WEBSITE TO PROVIDE INCREASED ACCESS TO PATIENTS. THE PATHWAYS CATALOG IS DELIVERED AND DISPLAYED IN EACH DEPARTMENT WITHIN THE HOSPITAL AND IS FREE FOR ALL PATIENTS TO TAKE. PROGRAMS ARE ALSO LISTED ON OUR WEBSITE UNDER AN "EVENTS" SECTION WHERE PATIENTS CAN REGISTER FOR FREE, DIRECTLY ONLINE. WE ALSO PROMOTE OUR PROGRAMS MONTHLY IN THE BRISTOL PRESS, BRISTOL OBSERVER, HARTFORD COURANT AND PLYMOUTH CONNECTION. WE SUBSCRIBE TO AN "ON-HOLD" SYSTEM FOR OUR PHONES WHICH ALLOWS US TO RECORD MESSAGES FOR PATIENTS WHEN THEY CALL THE HOSPITAL. MANY OF THESE MESSAGES ARE ABOUT FREE PROGRAMS AND SERVICES, HEALTH EDUCATION FACTS AND SERVICES TO THE COMMUNITY. | ||
| PART VI, LINE 7: N/A | ||
| CT | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 0 | 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 | 1 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BALA SHANMUGAM MD | |||||||||||||
| 0 | 218065 | 0 | 17500 | 4375 | 0 | 0 | 2917 | 0 | 0 | 4375 | 238482 | 0 | 0 |
| KURT BARWIS | |||||||||||||
| 429555 | 0 | 156476 | 0 | 0 | 0 | 86628 | 0 | 18592 | 0 | 691251 | 0 | 0 | 0 |
| LEONARD BANCO MD | |||||||||||||
| 293369 | 0 | 76825 | 0 | 0 | 0 | 2450 | 0 | 14496 | 0 | 387140 | 0 | 0 | 0 |
| JEANINE RECKDENWALD | |||||||||||||
| 146371 | 0 | 31379 | 0 | 0 | 0 | 807 | 0 | 931 | 0 | 179488 | 0 | 0 | 0 |
| DAVE RACKLIFF | |||||||||||||
| 144910 | 0 | 23278 | 0 | 0 | 0 | 1428 | 0 | 16766 | 0 | 186382 | 0 | 0 | 0 |
| EVA WICKWIRE | |||||||||||||
| 130206 | 0 | 21728 | 0 | 0 | 0 | 1248 | 0 | 6834 | 0 | 160016 | 0 | 0 | 0 |
| SUE SYLVESTRE | |||||||||||||
| 142547 | 0 | 25431 | 0 | 0 | 0 | 7615 | 0 | 6852 | 0 | 182445 | 0 | 0 | 0 |
| MARC EDELMAN | |||||||||||||
| 187094 | 0 | 15400 | 0 | 0 | 0 | 0 | 0 | 7747 | 0 | 210241 | 0 | 0 | 0 |
| JEFFREY SHELTON | |||||||||||||
| 178365 | 0 | 5000 | 0 | 0 | 0 | 0 | 0 | 13210 | 0 | 196575 | 0 | 0 | 0 |
| PETER FREYTAG | |||||||||||||
| 354363 | 0 | 38434 | 0 | 0 | 0 | 0 | 0 | 11148 | 0 | 403945 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1A | THE HOSPITAL PAID $5,382 IN GOLF CLUB MEMBERSHIP FEES FOR ITS PRESIDENT DURING FISCAL 2011. |
| PART I, LINE 4B | KURT BARWIS, PRESIDENT, PARTICIPATES IN THE HOSPITAL'S 457(F) DEFINED CONTRIBUTION PLAN. |
| PART I, LINE 6 | THE BASE COMPENSATION OF THE HOSPITAL'S PRESIDENT, KURT BARWIS, IS BASED IN PART ON THE NET EARNINGS OF THE HOSPITAL. |
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MORRIS LAVIERO | NamePerson |
| Purpose Of Loan | PURCHASE BUILDING | PurposeOfLoan |
| Loan To Organization | X | LoanToOrganization |
| Original Principal | $350,000 | OriginalPrincipalAmount |
| Balance Due | 305407 | BalanceDue |
| Default | 0 | Default |
| Approved By Board | 1 | ApprovedByBoard |
| Written Agreement | 1 | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 305407 | TotalBalanceDue |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSupplies
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 25338 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | REPORT FROM DHHS | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of8283 Received | 0 | NumberOf8283Received |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | A COMPLETED 990 IS PROVIDED TO EACH BOARD MEMBER PRIOR TO SUBMISSION. THIS PROVIDES AN OPPORTUNITY FOR MEMBERS TO ASK QUESTIONS, ADD COMMENTS, AND FOLLOW UP WITH THE FINANCE TEAM REGARDING ANY ISSUES OR CONCERNS. THE 990 IS ALSO REVIEWED INTERNALLY BY MEMBERS OF THE FINANCE AND MANAGEMENT TEAMS. | |
| ANNUALLY, ALL APPLICABLE PARTIES ARE REQUIRED TO RECEIVE AND SIGN A STATEMENT ACKNOWLEDGING THAT THEY HAVE READ, UNDERSTOOD AND AGREE TO COMPLY WITH THE CONFLICT OF INTEREST POLICY. | FORM 990, PART VI, SECTION B, LINE 12C | |
| THE EXECUTIVE COMPENSATION COMMITTEE IS AUTHORIZED UNDER THE BRISTOL HOSPITAL AND HEALTH CARE GROUP BYLAWS AND IS RESPONSIBLE FOR (1) DETERMINING THE OVERALL TOTAL COMPENSATION STRATEGY FOR ALL CORPORATE OFFICERS, (2) APPROVING ALL COMPENSATION AND BENEFITS DECISIONS FOR CORPORATE OFFICERS, AND (3) REPORTING SUCH ACTIONS TO THE FULL BRISTOL HOSPITAL AND HEALTH CARE GROUP BOARD ON AN ANNUAL BASIS. IN ADDITION, THE EXECUTIVE COMPENSATION COMMITTEE EXPRESSLY DETERMINES THE REASONABLENESS OF TOTAL COMPENSATION AND BENEFITS FOR ALL CORPORATE OFFICERS AND ASSURES THAT ALL OFFICER COMPENSATION DECISIONS ARE MADE AFTER THOROUGH CONSIDERATION OF AND COMPARISON TO THE MARKET PRACTICES OF OTHER SIMILARLY SITUATED NOT-FOR-PROFIT HEALTHCARE EXECUTIVES IN COMPARABLE ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEE CONSISTS OF BOARD MEMBERS WHO DO NOT HAVE MATERIAL FINANCIAL INTERESTS THAT COULD BE AFFECTED BY THE OFFICER COMPENSATION DECISIONS MADE BY THE COMMITTEE. THE COMPARABILITY DATA USED TO ASSIST THE EXECUTIVE COMPENSATION COMMITTEE IN ITS COMPENSATION DELIBERATIONS ARE COMPILED BY AN INDEPENDENT, NATIONAL COMPENSATION CONSULTING FIRM THAT IS RETAINED BY AND REPORTS DIRECTLY TO THE EXECUTIVE COMPENSATION COMMITTEE. THE DATA COLLECTED BY THE CONSULTANT CONSISTS OF MARKET INFORMATION FOR EXECUTIVES IN FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS. THE DELIBERATIONS AND DECISIONS OF THE EXECUTIVE COMPENSATION COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED, REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE AND PROVIDED TO THE BOARD ON AN ANNUAL BASIS. | FORM 990, PART VI, SECTION B, LINE 15 | |
| GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. | FORM 990, PART VI, SECTION C, LINE 19 | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET UNREALIZED LOSSES ON INVESTMENTS: -866,399. DECREASE IN PERMANENTLY RESTRICTED NET ASSETS -97,020. TRANSFER TO BHMSG -825,477. PENSION CHANGES OTHER THAN NET PERIODIC BENEFIT COSTS -1,184,961. CHANGES IN POSTRETIREMENT HEALTH & WELFARE BENEFITS 278,391. CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 300,085. NONCASH VACCINE CONTRIBUTIONS -25,338. CONTRIBUTION FROM BRISTOL HOSPITAL DEVELOPMENT FOUNDATION -402,204. TOTAL TO FORM 990, PART XI, LINE 5: -2,822,923. | FORM 990, PART XI, LINE 5: |
| THE HOSPITAL'S AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE PROCESSES OF OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAVE NOT CHANGED FROM THE PRIOR YEAR. | FORM 990, PART XI, LINE 2C: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HG PROPERTY HOLDINGS LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 41 BREWSTER RD | AddressLine1 |
| City | BRISTOL | City |
| State | CT | State |
| ZIP Code | 06010 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 272548373 | EIN |
| Primary Activities | REAL ESTATE | PrimaryActivities |
| Legal Domicile State | CT | LegalDomicileState |
| Total Income | 7500 | TotalIncome |
| EOY Assets | 276130 | EOYAssets |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRISTOL HOSPITAL INC | BusinessNameLine1 |
Form990 Schedule R Part II Form990ScheduleRPartII (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| BRISTOL HOSPITAL AND HEALTH CARE GROUP INC | ||||||||||
| BREWSTER ROAD | BRISTOL | CT | 06010 | 222577726 | HEALTHCARE PARENT COMPANY | CT | 501 (C) (3) | 11B, TYPE II | 0 | |
| BRISTOL HOSPITAL DEVELOPMENT FOUNDATION INC | ||||||||||
| BREWSTER ROAD | BRISTOL | CT | 06010 | 222577740 | FUNDRAISING | CT | 501 (C) (3) | 7 | 0 | BRISTOL HOSPITAL AND HEALTH CARE GROUP INC |
| BRISTOL HEALTH CARE INC | ||||||||||
| 400 NORTH MAIN STREET | BRISTOL | CT | 06010 | 222577731 | NURSING HOME | CT | 501 (C) (3) | 9 | 0 | BRISTOL HOSPITAL AND HEALTH CARE GROUP INC |
| BRISTOL HOSPITAL MULTISPECIALTY GROUP INC | ||||||||||
| BREWSTER ROAD | BRISTOL | CT | 06010 | 061466555 | HEALTHCARE SERVICES | CT | 501 (C) (3) | 9 | 0 | BRISTOL HOSPITAL AND HEALTH CARE GROUP INC |
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MEDWORKS LLC | ||||||||||||
| 375 EAST CEDAR STREET | NEWINGTON | CT | 06111 | 061490483 | REHAB & OCCUPATIONAL HEALTH | CT | RELATED | -62234 | 709 | 0 | 0 | 0.50000 |
| BRISTOL MSO LLC | ||||||||||||
| 25 COLLINS ROAD | BRISTOL | CT | 06010 | 061506024 | RADIOLOGY SERVICES | CT | RELATED | 435315 | 838425 | 0 | 0 | 0.50000 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|
| BRISTOL HOSPITAL EMS LLC | ||||||||
| PO BOX 977 | BRISTOL | CT | 06011 | 061547648 | EMERGENCY MEDICAL SERVICES | CT | BRISTOL HEALTH SERVICES INC | C |
| BRISTOL HEALTH SERVICES INC | ||||||||
| PO BOX 977 | BRISTOL | CT | 06011 | 203919173 | HOLDING COMPANY | CT | BRISTOL HOSPITAL AND HEALTH CARE GROUP INC | C |
| CENTRAL CONNECTICUT MEDICAL MANAGEMENT INC | ||||||||
| 200 MAIN STREET | BRISTOL | CT | 06011 | 222577728 | MANAGEMENT SERVICES | CT | BRISTOL HEALTH SERVICES INC | C |
| GREATER BRISTOL PRIMARY CARE GROUP PC | ||||||||
| 200 MAIN STREET | BRISTOL | CT | 06011 | 061466555 | PRIMARY CARE SERVICES | CT | C | |
| BRISTOL PSYCHIATRIC SERVICES PC | ||||||||
| 200 MAIN STREET | BRISTOL | CT | 06011 | 061511379 | PSYCHIATRIC SERVICES | CT | C | |
| MED-HELP PC | ||||||||
| 200 MAIN STREET | BRISTOL | CT | 06011 | 061484522 | URGENT CARE CENTER | CT | C | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | 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 | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (10 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| BRISTOL HOSPITAL EMS LLC | ||
| Q | 339223 | COST |
| BRISTOL HOSPITAL EMS LLC | ||
| N | 73592 | COST |
| BRISTOL HOSPTIAL MULTISPECIALTY GROUP | ||
| Q | 825477 | COST |
| BRISTOL HEALTH CARE | ||
| Q | 1325293 | COST |
| BRISTOL HEALTH CARE | ||
| N | 255276 | COST |
| BRISTOL HOSPITAL DEVELOPMENT FOUNDATION | ||
| N | 338064 | COST |
| BRISTOL HOSPITAL DEVELOPMENT FOUNDATION | ||
| L | 1115807 | COST |
| GREATER BRISTOL PRIMARY CARE GROUP INC | ||
| A | 217784 | COST |
| GREATER BRISTOL PRIMARY CARE GROUP INC | ||
| Q | 3963835 | COST |
| BRISTOL HOSPITAL DEVELOPMENT FOUNDATION | ||
| C | 402204 | COST |