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Norwalk Health Services Corporation: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
Norwalk Health Services Corporation (EIN 22-2577711)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-08-15
IRS object ID
201202289349302020
Schema version
2010v3.7
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-08-15T10:51:38-05:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line155 IVAN ALLEN BLVD SUITE 1000AddressLine1
CityATLANTACity
StateGAState
ZIP Code30308ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN222577711EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Norwalk Health Services CorporationBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlNORWNameControl
Phone2038522071Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line124 Stevens StreetAddressLine1
CityNorwalkCity
StateCTState
ZIP Code06850ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDANIEL DEBARBAName
TitlePRESIDENT & CEOTitle
Date Signed2012-08-14DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone4048748300Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDaniel DeBarbaNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line124 Stevens StreetAddressLine1
CityNorwalkCity
StateCTState
ZIP Code06850ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1744774GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.NORWALKHOSPITAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1985YearFormation
State Legal DomicileCTStateLegalDomicile
Activity Or Mission DescriptionTO SUPPORT THE MISSION OF NORWALK HOSPITAL ASSOCIATION.ActivityOrMissionDescription
Nbr Voting Members Governing Body22NbrVotingMembersGoverningBody
Nbr Independent Voting Members20NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers21TotalNbrVolunteers
Total Gross UBI745566TotalGrossUBI
Net Unrelated Business Txbl Income673387NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year551577InvestmentIncomePriorYear
Investment Income Current Year999208InvestmentIncomeCurrentYear
Other Revenue Prior Year859961OtherRevenuePriorYear
Other Revenue Current Year745566OtherRevenueCurrentYear
Total Revenue Prior Year1411538TotalRevenuePriorYear
Total Revenue Current Year1744774TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year436740OtherExpensePriorYear
Other Expenses Current Year362469OtherExpensesCurrentYear
Total Expenses Prior Year436740TotalExpensesPriorYear
Total Expenses Current Year362469TotalExpensesCurrentYear
Revenues Less Expenses Prior Year974798RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1382305RevenuesLessExpensesCY
Total Assets BOY30381263TotalAssetsBOY
Total Assets EOY28035863TotalAssetsEOY
Total Liabilities BOY324555TotalLiabilitiesBOY
Total Liabilities EOY628997TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY30056708NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY27406866NetAssetsOrFundBalancesEOY
Mission DescriptionTo support the mission of Norwalk Hospital Association.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense362469Expense
Grants0Grants
Revenue0Revenue
DescriptionNorwalk Health Services Corporation is the parent company of and provides support services for Norwalk Hospital Association, Norwalk Health Care, Inc., Norwalk Hospital Foundation and Fairfield County Medical Services, Inc.Description
Total Program Service Expense362469TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiestrueForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccounttrueForeignFinancialAccount
Name Of Foreign CountryBDNameOfForeignCountry
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Excess Business HoldingsfalseExcessBusinessHoldings
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members22NbrVotingGoverningBodyMembers
Number Independent Voting Members20NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicyfalseDocumentRetentionPolicy
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonToni HorneNamePerson
Telephone Number2038522071TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line124 Stevens StreetAddressLine1
CityNorwalkCity
StateCTState
ZIP Code06850ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationFormerFormer
Ervin Shames Chairman thru
12/31/10; Trustee as of 1/1/111.0XX000
Diane M Allison ESQ Vice chair
thru 12/31/10; chairman 1/1/112.0XX000
George P Bauer
Trustee as of 1/1/111.0X000
Andrew Whittingham
Treasurer1.0XX000
Joseph Mann
Secretary1.0XX000
Fred Afragola
Trustee1.0X000
Charles Augenbraun MD
Trustee (Leave of Absence)0.0X000
Barbara Butler
Trustee1.0X000
Daniel DeBarba
President and CEO1.0XX067078529920
Victor Liss
Trustee1.0X000
Michael Marks MD
Trustee (12/31/10)/Physician1.0X0708330
David Komansky
Trustee1.0X000
David Lehn
Trustee1.0X000
Gary Reiner
Trustee1.0X000
Roland Stichweh
Trustee1.0X000
William J Tamme trustee thru
12/31/10; Vice Chairman 1/1/112.0XX000
Richard Zelkowitz MD
Trustee1.0X000
Robert Ready
Trustee1.0X000
Thomas Ayoub trustee acting
Chairman OBGYN, chief of staff1.0X01408330
Maria Borges-Lopez
Trustee as of 1/1/111.0X000
Paul Gagne MD
Trustee as of 1/1/111.0X000
Mark Gudis
Trustee as of 1/1/111.0X000
Ed Kangas
Trustee as of 1/1/111.0X000
Ed Mahony
Trustee as of 1/1/111.0X000
Geoffrey Cole
FORMER PRESIDENT/CEO0124805246796X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2130503TotalReportableCompFrmRltdOrgs
Total Other Compensation76716TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

FieldValueIRS element (for citing)
Name PersonNoneNamePerson
FieldValueIRS element (for citing)
Address Of ContractorAddressOfContractor
FieldValueIRS element (for citing)
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Total Contributions0TotalContributions
Total Program Service Revenue0TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column999208TotalRevenueColumn
Exclusion$999,208ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionCAPTIVE INSURANCE INCOMEDescription
Total Revenue Column745566TotalRevenueColumn
Unrelated Business Revenue745566UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Other Revenue745566TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1744774TotalRevenueColumn
Unrelated Business Revenue745566UnrelatedBusinessRevenue
Exclusion$999,208ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total0Total

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total48000Total
Program Services48000ProgramServices

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total7469Total
Program Services7469ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Other Expenses OtherExpenses

FieldValueIRS element (for citing)
DescriptionTaxesDescription
Total307000Total
Program Services307000ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total362469Total
Program Services362469ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY32317BOY
EOY96219EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis1299968LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec275753LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1031684BOY
EOY1024215EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY22369800BOY
EOY20269811EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY6947462BOY
EOY6645618EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY30381263BOY
EOY28035863EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY279555BOY
EOY357365EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY45000BOY
EOY271632EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY324555BOY
EOY628997EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY23359028BOY
EOY21067108EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY6697680BOY
EOY6339758EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY30056708BOY
EOY27406866EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY30381263BOY
EOY28035863EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1382305ReconcilationRevenueExpenses
Reconcilation Other Changes-4032147ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type2XSupportingOrg509a3Type2
Certification CheckboxXCertificationCheckbox
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1Norwalk Hospital AssociationBusinessNameLine1
FieldValueIRS element (for citing)
EIN066068853EIN
Type Of Organization03TypeOfOrganization
Listed In Governing DoctrueListedInGoverningDoc
Amount$0Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis937642OtherCostOrOtherBasis
Book Value937642BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis362326OtherCostOrOtherBasis
Depreciation275753Depreciation
Book Value86573BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements
EquipmentEquipment

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis0OtherCostOrOtherBasis
Book Value0BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1024215TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
EQUITY IN UNCONSOLIDATED SUB305860
CHARITABLE REM AND LEAD TRUSTS6339758
FieldValueIRS element (for citing)
Total Book Value Other Assets6645618TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO AFFILIATEDescription
Amount$271,632Amount
FieldValueIRS element (for citing)
Total Of Amounts271632TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierFIN 48 FootnoteIdentifier
Return ReferenceSchedule D, Part X, Line 2ReturnReference
ExplanationThere was no fin 48/asc 740 footnote in the audited financial statements.Explanation

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable

FieldValueIRS element (for citing)
RegionCentral America and the CaribbeanRegion
Number Of Offices1NumberOfOffices
Number Of Employees0NumberOfEmployees
Type Of Activities ConductedProgram ServicesTypeOfActivitiesConducted
Specific Services ProvidedCaptive InsuranceSpecificServicesProvided
Total Expenditures9175257TotalExpenditures
FieldValueIRS element (for citing)
Subtotal Number Of Offices1SubtotalNumberOfOffices
Subtotal Number Of Employees0SubtotalNumberOfEmployees
Total Number Of Offices1TotalNumberOfOffices
Total Number Of Employees0TotalNumberOfEmployees
Subtotal Amount Spent9175257SubtotalAmountSpent
Total Amount Spent9175257TotalAmountSpent
Transfer To Foreign CorpfalseTransferToForeignCorp
Interest In Foreign TrustfalseInterestInForeignTrust
Own Foreign CorptrueOwnForeignCorp
Passive Foreign Invest CofalsePassiveForeignInvestCo
Foreign PartnershipfalseForeignPartnership
Boycott CountriesfalseBoycottCountries

Form990 Schedule F Part V Form990ScheduleFPartV

FieldValueIRS element (for citing)
IdentifierTotal Expenditure of the RegionIdentifier
Return ReferenceSchedule F, Part I, Line 3, Column (F)ReturnReference
ExplanationNorwalk Health Services Corporation (NHSC) maintains insurance coverage through Maple Street Indemnity Company, LTD(MSI), a related organization based in Bermuda. MSI uses the services of a managing agent in Bermuda to maintain all financial books and records for MSI information is reported to MSI in accordance with the requirements of the Bermuda monetary authority. Information received is converted to GAAP based financial reporting and included in the consolidated audit of NHSC.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Daniel DeBarba
04166380210000044147011025018895070070500
Geoffrey Cole
0202525010024709452800307670160290129484800

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSupplemental Compensation InformationIdentifier
Return ReferenceSchedule J, Part I, line 4aReturnReference
ExplanationGeoffrey Cole RECEIVED part of a two year severance arrangement based upon his COMPENSATION AT THE TIME OF TERMINATION. THE AMOUNT PAID during the year, $862,249, has BEEN INCLUDED IN SCHEDULE J, PART II, COLUMN B(III). Schedule J, Part I, Line 4B NORWALK HOSPITAL ASSOCIATION (NHA), A RELATED ORGANIZATION OF NORWALK HEALTH SERVICES CORPORATION (NHSC), HAS ESTABLISHED THE NORWALK HOSPITAL SENIOR DEFERRED COMPENSATION PLAN, PRIMARILY FOR THE PURPOSE OF PROVIDING A PROGRAM OF DEFERRED COMPENSATION FOR DANIEL DEBARBA, PRESIDENT AND CEO OF NHA AND NHSC. AMOUNTS PROMISED UNDER THE PLAN ARE BASED ON TARGETED RETIREMENT BENEFITS. THE PAYMENT OF BENEFITS UNDER THE PLAN IS SUBJECT TO VESTING, NO AMOUNTS WERE VESTED OR REPORTED AS TAXABLE INCOME ON MR DEBARBA'S 2010 W2.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF RELATIONSHIPSFORM 990, PART VI, LINE 2CERTAIN MEMBERS OF THE BOARD OF TRUSTEES OF NORWALK HEALTH SERVICES CORPORATION ALSO SERVE AS BOARD MEMBERS OF SWC CORPORATION AND MAPLE STREET INDEMNITY COMPANY LTD.
DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990FORM 990, PART VI, QUESTION 11BNORWALK HEALTH SERVICES CORPORATION (NHSC) FORM 990 IS PREPARED WITH THE ASSISTANCE OF ERNST AND YOUNG LLP AND REVIEWED BY NHSC'S INTERNAL MANAGEMENT. FOLLOWING THAT REVIEW, NHSC'S INTERNAL MANAGEMENT PRESENT THE FORM 990 TO THE AUDIT COMMITTEE FOR REVIEW AND COMMENT. THE COMPLETED 990 IS PROVIDED, via email, TO ALL MEMBERS OF THE BOARD OF TRUSTEES PRIOR TO THE FORM BEING FILED WITH THE IRS.
DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTERESTFORM 990, PART VI, QUESTION 12CMONITORING THE ORGANIZATION'S CONFLICT OF INTEREST POLICY PROVIDES THAT ANNUALLY, EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS SHALL SIGN A STATEMENT AFFIRMING THAT SUCH PERSON RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, READ AND UNDERSTANDS THE POLICY AND AGREES TO COMPLY WITH THE POLICY. ADDITIONALLY, THE SIGNED STATEMENT AFFIRMS THAT THE PERSON UNDERSTANDS NORWALK HEALTH SERVICES CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS, NORWALK HEALTH SERVICES CORPORATION MUST ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. ENFORCEMENT FAILURE TO COMPLY WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY SHALL CONSTITUTE GROUNDS FOR REMOVAL OF A PERSON COVERED BY THE POLICY AS A BOARD MEMBER OR BOARD COMMITTEE MEMBER, AND, IN THE CASE OF KEY MANAGEMENT PERSONNEL, TERMINATION OF EMPLOYMENT. WHO IS COVERED? THE ORGANIZATION'S CONFLICT OF INTEREST POLICY COVERS EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS. LEVEL OF DETERMINATION AND REVIEW OF CONFLICTS IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER PRESENTATION OF A POTENTIAL TRANSACTION OR ARRANGEMENT IS MADE BY AN INTERESTED PERSON, THE REMAINING DISINTERESTED BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. THE CHAIRPERSON OF THE GOVERNING BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE IF NORWALK HEALTH SERVICES CORPORATION CAN OBTAIN, WITH REASONABLE EFFORTS, A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTEREST, FOR ITS OWN BENEFIT AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DETERMINATION, THE GOVERNING BOARD OR COMMITTEE SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. RESTRICTIONS PLACED ON CONFLICTED PERSONS IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS.
WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICYFORM 990, PART VI, LINE 14NORWALK HEALTH SERVICES CORPORATION IS IN THE PROCESS OF DRAFTING A FORMAL WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY.
Offices & Positions for Which Process was Used, & Year Process was BegunForm 990, Part VI, Question 15aNORWALK HEALTH SERVICES CORPORATION (NHSC) DOES NOT RETAIN ANY COMPENSATED EMPLOYEES. THE OFFICERS AND TRUSTEES RECEIVING COMPENSATION ARE EMPLOYEES AND INDEPENDENT CONTRACTORS OF NORWALK HOSPITAL ASSOCIATION (NHA), A RELATED ORGANIZATION OF NHSC. THEREFORE, THEIR COMPENSATION AND BENEFITS ARE DETERMINED BY NHA.
Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen PublicForm 990, Part VI, Question 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE.
FORM 990, PART VIIHOURS DEVOTED TO RELATED ORGANIZATIONSTHE INDIVIDUALS LISTED BELOW WORKED THE FOLLOWING HOURS PER WEEK FOR A RELATED ORGANIZATION DURING THE FISCAL YEAR DANIEL DEBARBA 57 MICHAEL MARKS 52 ERVIN SHAMES 6 DIANE ALLISON 5 GEORGE BAUER 3 ANDREW WHITTINGHAM 3 JOSEPH MANN 2 FRED AFRAGOLA 4 BARBARA BUTLER 4 VICTOR LISS 5 DAVID KOMANSKY 2 DAVID LEHN 4 GARY REINER 3 ROLAND STICHWEH 3 WILLIAM TAMMEE 6 RICHARD ZELKOWITZ 3 THOMAS AYOUB 18 ROBERT READY 4 MARIA BORGES-LOPEZ 2 PAUL GAGNE 2 MARK GUDIS 2 ED KANGAS 2 ED MAHONY 3
OTHER CHANGES IN NET ASSETS OR FUND BALANCESPART XI, LINE 5TRANSFER TO NHA (1,914,723) NET UNREALIZED LOSSES INV. (1,013,938) DECREASE IN ASSETS HELD IN TRUST (357,920) MSI-MD INCOME (745,566) ------------ LINE 5 - CHANGES IN NET ASSETS (4,032,147)
COMPENSATION COMMITTEESCHEDULE J, PART I, LINE 3THE COMPENSATION COMMITTEE IS FROM NORWALK HEALTH SERVICES CORPORATION (NHSC) AS PER THE NHSC BYLAWS.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Norwalk Hospital Association
24 Stevens StreetNorwalkCT06850066068853Health SVCSCT501(C)(3)3NHSC
Norwalk Hospital Foundation Inc
24 Stevens StreetNorwalkCT06850222577707FundraisingCT501(C)(3)7NHSC
Fairfield County Medical ServicesInc
24 Stevens StreetNorwalkCT06850061522078Phy PRACTICECT501(C)(3)11bNHA
Norwalk Health Care Inc DBA Honey Hill
34 Midrocks DriveNorwalkCT06851222577722Nursing/RehabCT501(C)(3)9NHSC
Advanced Center for Rehab Medicine
24 Stevens StreetNorwalkCT06850061304799InactiveCT501(c)(3)11bNHSC

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryEINEINPrimary ActivityPrimaryActivityLegal Domicile Foreign CountryLegalDomicileForeignCountryType Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipAddress Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeLegal Domicile StateLegalDomicileState
Maple Street Indemnity Company Ltd
40 Church St PO Box HM 2062Hamilton HM HXBD980549862InsuranceBDC-Corp6800993362366161.00000
SWC Corporation
222577718Pharmacy SvcsC-Corp1115612313428641.0000024 Stevens StreetNorwalkCT06850CT
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Norwalk Hospital Association
q1914723
SWC Corporation
q2300000
Norwalk Hospital Association
r180000

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierTRANSACTION WITH RELATED ORGIdentifier
Return ReferencePART V, LINE 2ReturnReference
ExplanationNORWALK HOSPITAL ASSOCIATION - METHOD OF DETERMINING AMOUNT INVOLVED: Portion of purchase of NRMC (SWC 40% JV owner) by Norwalk Hospital - Represents SWC interest in NRMC prior to sale, after sale SWC has no value in investment - transferred to parent corporation (NHSC) then from parent corporation to Norwalk Hospital as goodwill SWC CORPORATION - METHOD OF DERERMINING AMOUNT INVOLVED: Transfer from Parent (NHSC) to SWC (100% owned by NHSC) to be used to pay off 40% of NRMC loan as part of the sale of NRMC to Norwalk HospitalExplanation