CHARLOTTE HUNGERFORD HOSPITAL: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- CHARLOTTE HUNGERFORD HOSPITAL (EIN 06-0646678)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-08-09
- IRS object ID
- 201212229349300201
- 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 G
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-09T06:32:46-05:00 | 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 | 060646678 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE CHARLOTTE HUNGERFORD HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CHAR | NameControl |
| Phone | 8604966728 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 540 LITCHFIELD STREET PO BOX 988 | AddressLine1 |
| City | TORRINGTON | City |
| State | CT | State |
| ZIP Code | 067900988 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SUSAN M SCHAPP | Name |
| Title | VP FINANCE/TREASURER | Title |
| Phone | 8604966728 | Phone |
| Date Signed | 2012-08-01 | 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 | SUSAN M SCHAPP | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 540 LITCHFIELD STREET PO BOX 988 | AddressLine1 |
| City | TORRINGTON | City |
| State | CT | State |
| ZIP Code | 067900988 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 123412885 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.CHARLOTTESWEB.HUNGERFORD.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1917 | YearFormation |
| State Legal Domicile | CT | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE QUALITY, COMPASSIONATE AND COST EFFECTIVE HEALTHCARE TO THE COMMUNITY OF NORTHWESTERN CONNECTICUT. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 15 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1091 | TotalNbrEmployees |
| Total Nbr Volunteers | 170 | TotalNbrVolunteers |
| Total Gross UBI | 1852626 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -73576 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 3509677 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 3090679 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 105888350 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 111675220 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2066888 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1535589 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 607983 | OtherRevenuePriorYear |
| Other Revenue Current Year | 481119 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 112072898 | TotalRevenuePriorYear |
| Total Revenue Current Year | 116782607 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 12000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 12000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 65975270 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 69100340 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 408098 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 43904798 | OtherExpensePriorYear |
| Other Expenses Current Year | 44844632 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 109892068 | TotalExpensesPriorYear |
| Total Expenses Current Year | 113956972 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2180830 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2825635 | RevenuesLessExpensesCY |
| Total Assets BOY | 117822296 | TotalAssetsBOY |
| Total Assets EOY | 118964048 | TotalAssetsEOY |
| Total Liabilities BOY | 59139886 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 52846422 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 58682410 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 66117626 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE CHARLOTTE HUNGERFORD HOSPITAL PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. OUR MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. IN KEEPING WITH THE HOSPITAL'S COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, FREE CARE AND/OR SUBSIDIZED CARE, CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST, HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY WILL BE CONSIDERED WHERE THE NEED AND/OR AN INDIVIDUAL'S INABILITY TO PAY COEXIST. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGAMS FOR THE ELDERLY, HANDICAPPED, THE MEDICALLY UNDERSERVED AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 104362471 | Expense |
| Grants | 12000 | Grants |
| Revenue | 110099324 | Revenue |
| Description | DURING FY 2011 THE HOSPITAL CONTRIBUTED OVER 17,000 HOURS TOWARD THE COMMON PURPOSE OF SERVICING THE HEALTHCARE NEEDS OF THE COMMUNITY. THE VALUE OF THIS CONTRIBUTION IS APPROXIMATELY $141,000, WHICH IS GIVEN BACK TO THE COMMUNITY THOUGH LOWER COSTS IN BOTH PATIENT SERVICES AND OTHER "WELLNESS" PROGRAMS. IN ADDITION THE HOSPITAL GRANTED CHARITY CARE IN THE AMOUNT OF $1,726,098 DURING FISCAL YEAR 2011. THE CHARLOTTE HUNGERFORD HOSPITAL RENDERED THE FOLLOWING SERVICES DURING FY 2011:INPATIENT SERVICES:DISCHARGES 6,512PATIENT DAYS 27,425 SPECIAL SERVICES: OPERATING ROOM CASES 4,025 AMBULATORY SURGERY CASES 3,244 ENDOSCOPY CASES 951 AMBULATORY MEDICAL CASES 2,790 POST ANESTHESIA CARE UNIT CASES 2,503 DELIVERY ROOM DELIVERIES 367RESPIRATORY THERAPY TREATMENTS 39,353 PULMONARY REHAB TESTS 4,329PULMONARY FUNCTION LAB TESTS 1,745 CARDIO DIAGNOSTIC EXAMS 13,440EEG EXAMS 2,060PHYSICAL THERAPY TREATMENTS 27,403 CARDIAC REHAB TREATMENTS 3,381 SPEECH THERAPY TREATMENTS 568 OCCUPATIONAL THERAPY TREATMENTS 3,468 SLEEP STUDY TESTS 641 DIAGNOSTIC RADIOLOGY EXAMS 30,404 MAMMOGRAPHY EXAMS 9,595 NUCLEAR MEDICINE EXAMS 1,181 ULTRASOUND EXAMS 8,805 C.A.T. SCAN EXAMS 12,918 P.E.T. SCAN EXAMS 57 M.R.I. EXAMS 957 SPECIAL PROCEDURES (RADIOLOGY) EXAMS 1,259 RADIATION THERAPY TREATMENTS 8,175 LABORATORY TESTS 647,799 PSYCHIATRIC CLINIC VISITS 35,193 PHP-ADULT/ADOLESCENT VISITS 4,618 RENAL DIALYSIS VISITS 360 EMERGENCY DEPARTMENT VISITS 33,109 EMERGENCY DEPARTMENT PHYSICIAN VISITS 4,836 OUTPATIENT DIABETES PROGRAM VISITS 1,556 WALK IN CENTER BLOOD DRAWING VISITS 825 WALK IN CENTER VISITS 11,961 HOSPITALIST CONSULTS 18,756WINSTED HEALTH CENTER: CARDIAC REHAB TREATMENTS 1,441 DIAGNOSTIC RADIOLOGY EXAMS 4,090 LABORATORY TESTS 21,104 EMERGENCY DEPARTMENT VISITS 6,426 EMERGENCY DEPARTMENT PHYSICIAN VISITS 576 PULMONARY REHAB TESTS 2,095 | Description |
| Total Program Service Expense | 104362471 | 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 | 0 | 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 | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 201 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1091 | 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 | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 15 | 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 |
| States Where Copy Of Return Is Filed | CT | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUSAN M SCHAPP | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8604966728 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 540 LITCHFIELD STREET | AddressLine1 |
| City | TORRINGTON | City |
| State | CT | State |
| ZIP Code | 06790 | 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 |
|---|---|---|---|---|---|---|---|---|
| EDWARD ARUM | ||||||||
| GOVERNOR | 2.50 | X | 0 | 0 | 0 | |||
| RICHARD DUTTON MD | ||||||||
| GOVERNOR | 1.00 | X | 0 | 0 | 0 | |||
| GLADYS CERRUTO | ||||||||
| GOVERNOR | 1.00 | X | 0 | 0 | 0 | |||
| DAVID J FRAUENHOFER | ||||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | X | ||
| JAMIE GREG | ||||||||
| GOVERNOR | 1.00 | X | 0 | 0 | 0 | |||
| PAUL GROSSMAN | ||||||||
| GOVERNOR | 1.00 | X | 0 | 0 | 0 | |||
| KENDRICK HOM MD | ||||||||
| GOVERNOR | 1.00 | X | 0 | 0 | 0 | |||
| JOHN JANCO | ||||||||
| VICE CHAIRMAN | 2.50 | X | 0 | 0 | 0 | X | ||
| NANCY SULLIVAN HODKOSKI | ||||||||
| GOVERNOR | 1.00 | X | 0 | 0 | 0 | |||
| JOHN LAVIERI | ||||||||
| CHAIRMAN | 2.50 | X | 0 | 0 | 0 | X | ||
| DIANE LIBBY CPA | ||||||||
| GOVERNOR | 1.00 | X | 0 | 0 | 0 | |||
| MARVIN MASKOVSKY | ||||||||
| GOVERNOR | 1.00 | X | 0 | 0 | 0 | |||
| JAMES O'LEARY | ||||||||
| GOVERNOR | 1.00 | X | 0 | 0 | 0 | |||
| CHARLES W RORABACK | ||||||||
| GOVERNOR | 1.00 | X | 0 | 0 | 0 | |||
| ALFRED J FINN MD | ||||||||
| GOVERNOR | 1.00 | X | 0 | 0 | 0 | |||
| DANIEL J MCINTYRE | ||||||||
| CEO/PRESIDENT | 60.00 | 361716 | 0 | 88408 | X | |||
| SUSAN M SCHAPP | ||||||||
| VP FINANCE/ TREASURER | 60.00 | 155580 | 0 | 35604 | X | |||
| JOHN J CAPOBIANCO | ||||||||
| VP OUT PATIENT SERVICES | 60.00 | 196967 | 0 | 41939 | X | |||
| MARK PRETE MD | ||||||||
| VP MEDICAL AFFAIRS | 60.00 | 317143 | 0 | 113323 | X | |||
| RAYMOND J ELLIOTT | ||||||||
| VICE PRESIDENT HUMAN RESOU | 60.00 | 167462 | 0 | 53487 | X | |||
| STEVEN SINGER MD | ||||||||
| PHYSICIAN | 60.00 | 265613 | 0 | 63987 | X | |||
| ELZBIETA LACH-PASKO MD | ||||||||
| PATHOLOGIST | 60.00 | 396162 | 0 | 56773 | X | |||
| ROBERTA MELTZER MD | ||||||||
| PHYSICIAN | 60.00 | 185417 | 0 | 59974 | X | |||
| WILLIAM POLITO MD | ||||||||
| PHYSICIAN | 60.00 | 248264 | 0 | 50606 | X | |||
| ASHOK DUBEY MD | ||||||||
| PHYSICIAN | 60.00 | 262659 | 0 | 27404 | X | |||
| MUSTAFA UGURLU MD | ||||||||
| PHYSICIAN | 60.00 | 307766 | 0 | 37229 | X | |||
| TIMOTHY GOSTKOWSKI MD | ||||||||
| PHYSICIAN | 60.00 | 432715 | 0 | 45147 | X | |||
| RAHUL MAGAVI MD | ||||||||
| PHYSICIAN | 60.00 | 219986 | 0 | 25472 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3517450 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 699353 | TotalOtherCompensation |
| Number Individuals GT100 K | 62 | NumberIndividualsGT100K |
| Formers Listed | 0 | 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 |
|---|---|---|---|---|---|
| MAYO COLLABORATIVE SERVICES | |||||
| PO BOX 9146 | MINEAPOLIS | MN | 554809146 | LABORATORY TESTS | 1220602 |
| PORTAL HEALTHCARE SOLUTIONS LLC | |||||
| 5885 TRINITY PARKWAY SUITE 210 | CENTERVILLE | VA | 20120 | TRANSCRIPTION SERVICES | 440034 |
| NWCT EMERGENCY SERVICES | |||||
| 80 S MAIN STREET | WEST HARTFORD | CT | 06107 | MEDICAL | 433682 |
| NEW MILFORD LAUNDRY | |||||
| 40 COMMONS COURT | WATERBURY | CT | 06704 | LAUNDRY/LINEN SERVICES | 423332 |
| O'BRIEN TANSKI & YOUNG LLP | |||||
| CITY PLACE II ASYLUM STREET | HARTFORD | CT | 061033402 | LEGAL | 379161 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 27 | NumberOfContractorsGT100K |
| Fundraising Events | 40333 | FundraisingEvents |
| Government Grants | 2179225 | GovernmentGrants |
| All Other Contributions | 871121 | AllOtherContributions |
| Total Contributions | 3090679 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| NET PATIENT REVENUE | 900099 | 96917507 | 96917507 | |
| LABORATORY SERVICES | 621500 | 12662210 | 10792223 | 1869987 |
| OTHER HOSPITAL SERVICE | 900099 | 2095503 | 2095503 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 111675220 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 962023 | TotalRevenueColumn |
| Exclusion | $962,023 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 678361 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 384270 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 294091 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 294091 | TotalRevenueColumn |
| Related Or Exempt Function Income | 294091 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 6727788 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 6150851 | Securities |
| Other | 3371 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 576937 | Securities |
| Other | -3371 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 573566 | TotalRevenueColumn |
| Exclusion | $573,566 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 84460 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 40333 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 26960 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 57500 | TotalRevenueColumn |
| Exclusion | $57,500 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 102657 | GrossSalesOfInventory |
| Cost Of Goods Sold | 64826 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 37831 | TotalRevenueColumn |
| Exclusion | $37,831 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| GAIN FROM EQUITY METHO | 900001 | 109058 | $109,058 | |
| MEDCONN | 561499 | -17361 | -17361 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 91697 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 116782607 | TotalRevenueColumn |
| Related Or Exempt Function Income | 110099324 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1852626 | UnrelatedBusinessRevenue |
| Exclusion | $1,739,978 | ExclusionAmount |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12000 | Total |
| Program Services | 12000 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2366975 | Total |
| Program Services | 1775231 | ProgramServices |
| Management And General | 591744 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50920700 | Total |
| Program Services | 47054740 | ProgramServices |
| Management And General | 3668749 | ManagementAndGeneral |
| Fundraising | 197211 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6298777 | Total |
| Program Services | 5771862 | ProgramServices |
| Management And General | 503604 | ManagementAndGeneral |
| Fundraising | 23311 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5924465 | Total |
| Program Services | 5428862 | ProgramServices |
| Management And General | 473677 | ManagementAndGeneral |
| Fundraising | 21926 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3589423 | Total |
| Program Services | 3289155 | ProgramServices |
| Management And General | 286984 | ManagementAndGeneral |
| Fundraising | 13284 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1489460 | Total |
| Program Services | 1364862 | ProgramServices |
| Management And General | 119086 | ManagementAndGeneral |
| Fundraising | 5512 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 341697 | Total |
| Program Services | 313112 | ProgramServices |
| Management And General | 27320 | ManagementAndGeneral |
| Fundraising | 1265 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 122256 | Total |
| Program Services | 112029 | ProgramServices |
| Management And General | 9775 | ManagementAndGeneral |
| Fundraising | 452 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9622651 | Total |
| Program Services | 8817682 | ProgramServices |
| Management And General | 769357 | ManagementAndGeneral |
| Fundraising | 35612 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 599251 | Total |
| Program Services | 549121 | ProgramServices |
| Management And General | 47912 | ManagementAndGeneral |
| Fundraising | 2218 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 392716 | Total |
| Program Services | 359864 | ProgramServices |
| Management And General | 31399 | ManagementAndGeneral |
| Fundraising | 1453 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1392657 | Total |
| Program Services | 1276156 | ProgramServices |
| Management And General | 111347 | ManagementAndGeneral |
| Fundraising | 5154 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2184180 | Total |
| Program Services | 2001466 | ProgramServices |
| Management And General | 174631 | ManagementAndGeneral |
| Fundraising | 8083 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 164123 | Total |
| Program Services | 150394 | ProgramServices |
| Management And General | 13122 | ManagementAndGeneral |
| Fundraising | 607 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 308286 | Total |
| Program Services | 282497 | ProgramServices |
| Management And General | 24648 | ManagementAndGeneral |
| Fundraising | 1141 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6178081 | Total |
| Program Services | 5661263 | ProgramServices |
| Management And General | 493954 | ManagementAndGeneral |
| Fundraising | 22864 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2375290 | Total |
| Program Services | 2176588 | ProgramServices |
| Management And General | 189911 | ManagementAndGeneral |
| Fundraising | 8791 | Fundraising |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| SUPPLIES | 16000092 | 14661628 | 1279250 | 59214 |
| PROVISION FOR BAD DEBT | 2129955 | 2129955 | ||
| PHYSICIAN FEES | 1479732 | 1109799 | 369933 | |
| HOSPITAL AUXILIARY EXPE | 64205 | 64205 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 113956972 | Total |
| Program Services | 104362471 | ProgramServices |
| Management And General | 9186403 | ManagementAndGeneral |
| Fundraising | 408098 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4615 | BOY |
| EOY | 35278 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5577511 | BOY |
| EOY | 8542940 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 282069 | BOY |
| EOY | 169438 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9573985 | BOY |
| EOY | 11144539 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1902704 | BOY |
| EOY | 2009008 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1678690 | BOY |
| EOY | 1051648 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 142473071 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 102496652 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41562230 | BOY |
| EOY | 39976419 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 54362578 | BOY |
| EOY | 51701434 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2877914 | BOY |
| EOY | 4333344 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 117822296 | BOY |
| EOY | 118964048 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7460667 | BOY |
| EOY | 8948843 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 128582 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3475000 | BOY |
| EOY | 2355000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3880641 | BOY |
| EOY | 3610528 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44323578 | BOY |
| EOY | 37803469 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 59139886 | BOY |
| EOY | 52846422 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39309707 | BOY |
| EOY | 47173941 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3000453 | BOY |
| EOY | 2830655 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16372250 | BOY |
| EOY | 16113030 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58682410 | BOY |
| EOY | 66117626 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 117822296 | BOY |
| EOY | 118964048 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 2825635 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 4609581 | 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 | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Total Lobbying Expenditures IIB | 0 | TotalLobbyingExpendituresIIB |
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 PAID DUES TO THE CONNECTICUT HOSPITAL ASSOCIATION. SOME PORTION OF THESE DUES MAY HAVE BEEN USED FOR LOBBYING EXPENSES ON BEHALF OF ITS' MEMBERS. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 49273746 | BeginningOfYearBalance |
| Contributions | 186977 | Contributions |
| Investment Earnings Or Losses | -2264127 | InvestmentEarningsOrLosses |
| Other Expenditures | 266780 | OtherExpenditures |
| End Of Year Balance | 46929816 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 45533758 | BeginningOfYearBalance |
| Contributions | 690138 | Contributions |
| Investment Earnings Or Losses | 3824302 | InvestmentEarningsOrLosses |
| Other Expenditures | 774452 | OtherExpenditures |
| End Of Year Balance | 49273746 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 47240328 | BeginningOfYearBalance |
| Contributions | 1043719 | Contributions |
| Investment Earnings Or Losses | -1532480 | InvestmentEarningsOrLosses |
| Other Expenditures | 1217809 | OtherExpenditures |
| End Of Year Balance | 45533758 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.59680 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.34330 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.05990 | 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 | 155467 | OtherCostOrOtherBasis |
| Book Value | 155467 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 77970871 | OtherCostOrOtherBasis |
| Depreciation | 47969112 | Depreciation |
| Book Value | 30001759 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 58753563 | OtherCostOrOtherBasis |
| Depreciation | 50349826 | Depreciation |
| Book Value | 8403737 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5593170 | OtherCostOrOtherBasis |
| Depreciation | 4177714 | Depreciation |
| Book Value | 1415456 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 39976419 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (5 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| INVESTMENTS HELD IN TRUST FOR ESTIMATED SELF-INSURANCE LIABILITIES | 3726581 | F |
| UNDER BOND INDENTURE AGREEMENT-HELD BY OTHERS | 288839 | F |
| BENEFICIAL INTEREST IN ASSETS HELD IN TRUST BY OTHERS | 12360649 | F |
| LONG-TERM INVESTMENTS | 28762329 | F |
| DONOR RESTRICTED ASSETS | 6563036 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 51701434 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (5 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ESTIMATED AMOUNTS DUE TO THIRD PARTY REIMBURSEMENT AGENCIES | $1,693,818 |
| MISCELLANEOUS CURRENT LIABILITIES | $91,711 |
| ESTIMATED SELF-INSURANCE LIABILITIES | $2,631,693 |
| ACCRUED PENSION LIABILITY | $26,422,971 |
| PENSION CONTRIBUTION - CURRENT PORTION | $6,963,276 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 37803469 | TotalOfAmounts |
| Total Revenue | 116782607 | TotalRevenue |
| Total Expenses | 113956972 | TotalExpenses |
| Excess Or Deficit For Year | 2825635 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -2203969 | NetUnrealizedGLOnInvestments |
| Other | $6,813,550 | OtherAmount |
| Total Adjustments | 4609581 | TotalAdjustments |
| Excess Or Deficit Per FS | 7435216 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 116540216 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 116540216 | RevenueSubtotal |
| Other Revenues Not Included | 242391 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 242391 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 116782607 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 113880767 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 113880767 | ExpensesSubtotal |
| Other Expenses Not Included | 76205 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 76205 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 113956972 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | THE ENDOWMENT FUNDS WILL BE USED PRIMARILY FOR CAPITAL PURCHASES, INDIGENT CARE AND OTHER USES AS APPROVED BY THE BOARD IN ACCORDANCE WITH DONOR RESTRICTIONS. |
| 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 OF SEPTEMBER 30, 2011 AND 2010. 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. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | PENSION RELATED CHANGES OTHER THAN NET PERIODIC PENSION COSTS 6,880,330. NET ASSETS RELEASED FROM RESTRICTIONS -266,780. NET ASSETS RELEASED FOR PROPERTY, PLANT & EQUIPMENT 200,000. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | TEMPORARY RESTRICTED ACTIVITY 175,236. AUXILIARY REVENUE 67,155. | |
| PART XIII, LINE 4B - OTHER ADJUSTMENTS: | AUXILIARY EXPENSES 76,205. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF TOURNAMENT | NameOfEvent1 |
| Gross Receipts Event1 | 84460 | GrossReceiptsEvent1 |
| Gross Revenue Event1 | 84460 | GrossRevenueEvent1 |
| Non Cash Prizes Event1 | 3947 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 21709 | RentFacilityCostsEvent1 |
| Other Direct Expenses Event1 | 1304 | OtherDirectExpensesEvent1 |
| Name Of Event2 | FASHION SHOW | NameOfEvent2 |
| Gross Receipts Event2 | 8481 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 8481 | CharitableContributionsEvent2 |
| Total Number Of Other Events | 13 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 31852 | GrossReceiptsOtherEvents |
| Charitable Contrib Other Events | 31852 | CharitableContribOtherEvents |
| Gross Receipts Total | 124793 | GrossReceiptsTotal |
| Charitable Contributions Total | 40333 | CharitableContributionsTotal |
| Gross Revenue Total Events | 84460 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 3947 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 21709 | RentFacilityCostsTotalEvents |
| Other Direct Expenses Total Events | 1304 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 26960 | DirectExpenseSummaryEvents |
| Net Income Summary | 57500 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1798 | PersonsServed |
| Total Community Benefit Expense | 971403 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 52637 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 918766 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00810 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 41050 | PersonsServed |
| Total Community Benefit Expense | 22835171 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 18685833 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4149338 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03640 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 2119 | PersonsServed |
| Total Community Benefit Expense | 1016466 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 760257 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 256209 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00220 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 44967 | PersonsServed |
| Total Community Benefit Expense | 24823040 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 19498727 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5324313 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04670 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 8 | NumberOfActivitiesOrPrograms |
| Persons Served | 1044 | PersonsServed |
| Total Community Benefit Expense | 25008 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 25008 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 12 | PersonsServed |
| Total Community Benefit Expense | 12000 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 12000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 17887605 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 16040031 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1847574 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01620 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 8 | NumberOfActivitiesOrPrograms |
| Persons Served | 1056 | PersonsServed |
| Total Community Benefit Expense | 17924613 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 16040031 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1884582 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01650 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 8 | NumberOfActivitiesOrPrograms |
| Persons Served | 46023 | PersonsServed |
| Total Community Benefit Expense | 42747653 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 35538758 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7208895 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06320 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $2,129,955 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 39876326 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 38075589 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 1800737 | 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 (4 entries)
| Description Ent Primary ActivityDescriptionEntPrimaryActivity | Organization Profit Or OwnershipOrganizationProfitOrOwnership | Officers Etc Profit Or OwnershipOfficersEtcProfitOrOwnership | Physicans Profit Or OwnershipPhysicansProfitOrOwnership |
|---|---|---|---|
| 1 ADVANCED MEDICAL IMAGING OF NORTHWEST CT LLC | |||
| IMAGING CENTER | 0.50000 | 0.00000 | 0.50000 |
| 2 MEDCONN COLLECTION AGENCY LLC | |||
| PATIENT COLLECTION AGENCY | 0.20000 | 0.00000 | 0.00000 |
| 4 UROLOGY CENTER OF NW CT | |||
| UROLOGY CENTER | 0.62500 | 0.00000 | 0.37500 |
| 5 LITCHFIELD COUNTY HEALTHCARE SERVICE CORP | |||
| PHYSICIANS PRACTICE | 1.00000 | 0.00000 | 0.00000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 2 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)
| Facility NumberFacilityNumber | Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Er24 HoursEr24Hours | Er OtherErOther |
|---|---|---|---|---|---|---|---|---|
| CHARLOTTE HUNGERFORD HOSPITAL | ||||||||
| 1 | 540 LITCHFIELD STRRET | TORRINGTON | CT | 06790 | X | X | X | X |
| HUNGERFORD EMERGENCY MEDICAL CENTER | ||||||||
| 2 | 115 SPENCER STREET | WINSTED | CT | 06098 | X | |||
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (2 entries)
| Hospital Facility NumberHospitalFacilityNumber | CHNA ConductedCHNAConducted | Community DefinitionCommunityDefinition | Community DemographicsCommunityDemographics | How Data ObtainedHowDataObtained | Community Health NeedsCommunityHealthNeeds | Other Health IssuesOtherHealthIssues | Identifying ProcessIdentifyingProcess | Consulting ProcessConsultingProcess | Information GapsInformationGaps | Needs Assessment ConductedNeedsAssessmentConducted | Take Into AccountTakeIntoAccount | Other FacilitiesOtherFacilities | CHNA Widely AvailableCHNAWidelyAvailable | Own WebsiteOwnWebsite | On RequestOnRequest | Other MethodOtherMethod | Adopt Implement StrategyAdoptImplementStrategy | Execute Implement StrategyExecuteImplementStrategy | Develop Community PlanDevelopCommunityPlan | Participate Community PlanParticipateCommunityPlan | Include Operational PlansIncludeOperationalPlans | Prioritize Health NeedsPrioritizeHealthNeeds | Prioritize ServicesPrioritizeServices | All Needs AddressedAllNeedsAddressed | Eligibility Criteria ExplainedEligibilityCriteriaExplained | Uses FPG FreeUsesFPGFree | FPG Free PercentFPGFreePercent | Uses FPG DiscountedUsesFPGDiscounted | FPG Discount PercentFPGDiscountPercent | Explains BasisExplainsBasis | Income LevelIncomeLevel | Uninsured DiscountUninsuredDiscount | Explains Application MethodExplainsApplicationMethod | Includes Publicity MeasuresIncludesPublicityMeasures | Attached To InvoicesAttachedToInvoices | Posted In Emergency RoomPostedInEmergencyRoom | Posted In Admission OfficePostedInAdmissionOffice | Provided On AdmissionProvidedOnAdmission | Available On RequestAvailableOnRequest | Actions On NonpaymentActionsOnNonpayment | Permit Report To Credit AgencyPermitReportToCreditAgency | Permit Lien On ResidencePermitLienOnResidence | Collection ActivitiesCollectionActivities | Report To Credit AgencyReportToCreditAgency | Lien On ResidenceLienOnResidence | Notify Upon AdmissionNotifyUponAdmission | Notified All PatientsNotifiedAllPatients | Documented DeterminationDocumentedDetermination | Nondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicy | Used Other MethodUsedOtherMethod | Amounts Generally BilledAmountsGenerallyBilled | Gross ChargesGrossCharges |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHARLOTTE HUNGERFORD HOSPITAL | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| 1 | 1 | X | X | X | X | X | X | X | X | 10 | 1 | 0 | 1 | X | X | X | X | X | X | X | X | X | X | 0 | 1 | 1 | 200.000000000000 | 1 | 250.000000000000 | 1 | X | X | 1 | 1 | X | X | X | X | X | 1 | X | X | 1 | X | X | X | X | X | 1 | X | 0 | 0 |
| HUNGERFORD EMERGENCY MEDICAL CENTER | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| 2 | 1 | X | X | X | X | X | X | X | X | 10 | 1 | 0 | 1 | X | X | X | X | X | X | X | X | X | X | 0 | 1 | 1 | 200.000000000000 | 1 | 250.000000000000 | 1 | X | X | 1 | 1 | X | X | X | X | X | 1 | X | X | 1 | X | X | X | X | X | 1 | X | 0 | 0 |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 11 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (11 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| NORTHWEST CONNECTICUT MEDICAL WALK IN | ||||
| 1598 EAST MAIN STREET | TORRINGTON | CT | 06790 | WALK IN MEDICAL CLINIC |
| THE HUNGERFORD CENTER | ||||
| 780 LITCHFIELD STREET | TORRINGTON | CT | 06790 | CARDIAC AND PULMONARY REHAB SERVICES |
| THE CENTER FOR CANCER CARE | ||||
| 200 KENNEDY DRIVE | TORRINGTON | CT | 06790 | CANCER TREATMENT CENTER |
| HUNGERFORD DIAGNOSTIC CENTER | ||||
| 220 KENNEDY DRIVE | TORRINGTON | CT | 06790 | RADIOLOGY SERVICES |
| THE CENTER FOR YOUTH AND FAMILIES | ||||
| 1061 EAST MAIN STREET | TORRINGTON | CT | 06790 | PSYCH SERVICES FOR CHILDREN AND FAMILIES |
| BRIDGES EXTENDED DAY PROGRAM | ||||
| 28 SAINT JOHN PLACE | TORRINGTON | CT | 06790 | CHILD GUIDANCE CLINIC |
| WINSTED BEHAVIORAL HEALTH CENTER | ||||
| 294 MAIN STREET | WINSTED | CT | 06098 | PSYCH SERVICES |
| SURGICAL ASSOCIATES OF CHH | ||||
| 538 LITCHFIELD STREET | TORRINGTON | CT | 06790 | SURGICAL PHYSICIANS PRACTICE |
| NEUROLOGY PBC | ||||
| 780 LITCHFIELD STREET | TORRINGTON | CT | 06790 | NEUROLOGY PHYSICIANS PRACTICE |
| CHH PRIMARY CARE | ||||
| 780 LITCHFIELD STREET | TORRINGTON | CT | 06790 | PRIMARY CARE PHYSICIANS PRACTICE |
| CHH CARDIOVASCULAR MEDICINE SERVICE | ||||
| 1215 NEW LITCHFIELD STREET | TORRINGTON | CT | 06790 | CARDIOVASCULAR PHYSICIANS PRACTICE |
Form990 Schedule H Part VI Form990ScheduleHPartVI (18 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 3C: CARE WILL BE PROVIDED FREE FOR THOSE UNINSURED WHO QUALIFY AS UNINSURED AND VERIFICATION HAS DETERMINED THAT THEIR ANNUAL INCOME IS LESS THAN 200% OF THE FEDERAL INCOME POVERTY LEVEL. CARE WILL BE PROVIDED AT HOSPITAL COST, AS ESTABLISHED BY THE OFFICE OF HEALTH CARE ACCESS (OCHA), FOR THOSE UNINSURED PATIENTS WHO REQUEST ASSISTANCE AND VERIFICATION HAS DETERMINED THAT THEIR ANNUAL INCOME IS BETWEEN 200% AND 250% OF THE FPL. CARE WILL BE DISCOUNTED BY 30% FOR THOSE UNISURED PATIENTS WHO REQUEST ASSISTANCE AND VERIFICATION HAS DETERMINED THAT THEIR ANNUAL INCOME IS BETWEEN 250% AND 400% OF THE FPL. THE HOSPITAL WILL ALSO CONSIDER THE TOTAL MEDICAL EXPENSES FACED BY THE FAMILY AND THE FAMILY'S ABILITY TO PAY FOR THOSE EXPENSES, AND WILL CONSIDER OFFERING GREATER ASSISTANCE WHEN POSSIBLE TO THOSE FAMILIES FACING CATASTROPHIC MEDICAL EXPENSES. | ||
| PART I, LINE 7: A COST TO CHARGE RATIO BASED ON CHARITY CARE CHARGES AND EXPENSES. | ||
| PART III, LINE 4: THE RATIONALE FOR REPORTING BAD DEBT EXPENSE DIRECTLY FROM THE TRIAL BALANCE IS THAT ACCOUNTS HAVE ALREADY BEEN DISCOUNTED PRIOR TO BEING CLASSIFIED AS A BAD DEBT EXPENSE. | ||
| PART III, LINE 8: THE REPORTED AMOUNTS FOR MEDICARE REVENUE RECEIVED AND MEDICARE COSTS ARE DERIVED DIRECTLY FROM THE MEDICARE COST REPORT. | ||
| PART III, LINE 9B: THE HOSPITAL ATTEMPTS TO HAVE INDIVIDUALS FILL OUT ALL PAPER WORK REQUIRED FOR CHARITY CARE. IF THE PERSON IS NOT CAPABLE OF DOING THIS OR IS KNOWN TO BE UNABLE TO DO THIS (SUCH AS A KNOWN HOMELESS PERSON), THEN THE FINANCIAL ASSISTANCE COMMITTEE WILL ADJUST THE ACCOUNT TO CHARITY CARE AND IT WILL NOT BE REPORTED AS BAD DEBT. IF AN ACCOUNT HAS BEEN REPORTED AS BAD DEBT AND INFORMATION COMES FORTH INDICATING AN INABILITY TO PAY, THEN THE ACCOUNT WOULD BE REMOVED FROM BAD DEBT AND MOVED TO CHARITY CARE. | ||
| PART V, SECTION B, LINE 3: A CONSULTANT WAS ENGAGED TO CONDUCT A COMMUNITY PERCEPTION SURVEY. IN ADDITION TO THIS THE MEDICAL STAFF, BOARD OF DIRECTORS, AND EMPLOYEES WERE SURVEYED FOR THEIR INPUT INTO THE PROCESS. | CHARLOTTE HUNGERFORD HOSPITAL | |
| PART V, SECTION B, LINE 3: A CONSULTANT WAS ENGAGED TO CONDUCT A COMMUNITY PERCEPTION SURVEY. IN ADDITION TO THIS THE MEDICAL STAFF, BOARD OF DIRECTORS, AND EMPLOYEES WERE SURVEYED FOR THEIR INPUT INTO THE PROCESS. | HUNGERFORD EMERGENCY MEDICAL CENTER | |
| PART V, SECTION B, LINE 5C: IN ADDITION TO THE GENERAL PUBLIC, THE NEEDS ASSESSMENT IS MADE AVAILABLE TO THE MEDICAL STAFF, BOARD OF DIRECTORS, AND EMPLOYEES. | CHARLOTTE HUNGERFORD HOSPITAL | |
| PART V, SECTION B, LINE 5C: IN ADDITION TO THE GENERAL PUBLIC, THE NEEDS ASSESSMENT IS MADE AVAILABLE TO THE MEDICAL STAFF, BOARD OF DIRECTORS, AND EMPLOYEES. | HUNGERFORD EMERGENCY MEDICAL CENTER | |
| PART V, SECTION B, LINE 7: NOT ALL NEEDS HAVE BEEN ADDRESSED SINCE THE ASSESSMENT WAS IN YEAR ONE OF A FIVE YEAR PLAN WITH A CONTINUED EFFORT TO REFINE ASSESSMENTS. | CHARLOTTE HUNGERFORD HOSPITAL | |
| PART V, SECTION B, LINE 7: NOT ALL NEEDS HAVE BEEN ADDRESSED SINCE THE ASSESSMENT WAS IN YEAR ONE OF A FIVE YEAR PLAN WITH A CONTINUED EFFORT TO REFINE ASSESSMENTS. | HUNGERFORD EMERGENCY MEDICAL CENTER | |
| PART V, SECTION B, LINE 19D: CONNECTICUT STATE LAW (LOONEY BILL) REQUIRES THE HOSPITAL TO ADJUST THE PATIENTS BALANCE EQUAL TO THE COST OF PROVIDING THE CARE. | CHARLOTTE HUNGERFORD HOSPITAL | |
| PART V, SECTION B, LINE 19D: CONNECTICUT STATE LAW (LOONEY BILL) REQUIRES THE HOSPITAL TO ADJUST THE PATIENTS BALANCE EQUAL TO THE COST OF PROVIDING THE CARE. | HUNGERFORD EMERGENCY MEDICAL CENTER | |
| PART VI, LINE 2: THE HOSPITAL OFFERS FREE HEALTH SCREENINGS, FREE HEALTH EDUCATION AND LECTURES AT VARIOUS COMMUNITY EVENTS INCLUDING FAIRS, EXPOS, PRIVATE COMPANIES, PUBLIC MUNICIPALITIES, AND PUBLIC GATHERINGS. THIS HELPS THE COMMUNITY ASSESS THEIR MEDICAL NEEDS. IN ADDITION TO THE ABOVE ITEMS, THE HOSPITAL DISTRIBUTES FREE MEDICAL SUMMARY CARDS WHICH ALLOW PATIENTS TO TRACK THEIR MEDICATIONS. | ||
| PART VI, LINE 3: THE HOSPITAL COUNSELS ALL SELF PAY PATIENTS EITHER BY MEETING WITH A FINANCIAL COUNSELOR OR IF HE OR SHE IS AN INPATIENT, MEETING WITH A SOCIAL WORKER. ALL STATEMENTS RECEIVED BY PATIENTS INCLUDE FINANCIAL COUNSELING INFORMATION. SIGNS ARE POSTED THROUGHOUT THE HOSPITAL INCLUDING IN THE EMERGENCY ROOM WHICH STATE THE CHARITY CARE POLICIES AND FINANCIAL ASSISTANCE INFORMATION. | ||
| PART VI, LINE 4: THE CHARLOTTE HUNGERFORD HOSPITAL IS A 109 BED, GENERAL ACUTE CARE HOSPITAL LOCATED IN TORRINGTON, CONNECTICUT, SERVING A TWELVE TOWN PRIMARY SERVICE AREA COMPRISED OF APPROXIMATELY 100,000 PERSONS. | ||
| PART VI, LINE 6: ALL BOARD OF DIRECTORS MEMBERS RESIDE IN THE COMMUNITY SERVED BY THE CHARLOTTE HUNGERFORD HOSPITAL AND ARE NOT EMPLOYEES OF THE HOSPITAL NOR ARE THEY INDEPENDENT CONTRACTORS DOING BUSINESS WITH THE HOSPITAL. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS WHO APPLY FOR SUCH PRIVILEGES. THE HOSPITAL ESTABLISHES AN ANNUAL CAPITAL BUDGET TO ADD OR REPLACE PATIENT CARE EQUIPMENT AND FACILITIES. MEDICAL EDUCATION IS PROVIDED TO PHYSICIANS THROUGH CONFERENCES ON A MONTHLY BASIS. | ||
| CT | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | HEALTHCARE SCHOLARSHIPS | TypeOfGrant |
| Number Of Recipients | 12 | NumberOfRecipients |
| Amount Of Cash Grant | 12000 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | OTHER INFORMATION: | Identifier |
| Return Reference | PART IV: | ReturnReference |
| Explanation | THE CHARLOTTE HUNGERFORD HOSPITAL AUXILIARY AWARDS SCHOLARSHIPS IN THE AMOUNT OF $1,000 EACH TO STUDENTS PURSUING HEALTHCARE EDUCATIONS. THE STUDENTS MUST LIVE IN THE AREA SERVED BY THE HOSPITAL. THEY MUST ALSO PROVIDE EVIDENCE OF HAVING BEEN ACCEPTED INTO A COLLEGE PROGRAM OR THEIR CURRENT GRADES IN COLLEGE. RECIPIENTS OF THE SCHOLARSHIPS MUST SUBMIT LETTERS OF RECOMMENDATION FROM THEIR TEACHERS AND ALSO FROM NON-FAMILY PERSONS. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (13 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DANIEL J MCINTYRE | |||||||||||||
| 361716 | 0 | 0 | 0 | 0 | 0 | 50669 | 0 | 37739 | 0 | 450124 | 0 | 0 | 0 |
| SUSAN M SCHAPP | |||||||||||||
| 155580 | 0 | 0 | 0 | 0 | 0 | 19372 | 0 | 16232 | 0 | 191184 | 0 | 0 | 0 |
| JOHN J CAPOBIANCO | |||||||||||||
| 196967 | 0 | 0 | 0 | 0 | 0 | 21389 | 0 | 20550 | 0 | 238906 | 0 | 0 | 0 |
| MARK PRETE MD | |||||||||||||
| 317143 | 0 | 0 | 0 | 0 | 0 | 80234 | 0 | 33089 | 0 | 430466 | 0 | 0 | 0 |
| RAYMOND J ELLIOTT | |||||||||||||
| 167462 | 0 | 0 | 0 | 0 | 0 | 36015 | 0 | 17472 | 0 | 220949 | 0 | 0 | 0 |
| STEVEN SINGER MD | |||||||||||||
| 265613 | 0 | 0 | 0 | 0 | 0 | 36275 | 0 | 27712 | 0 | 329600 | 0 | 0 | 0 |
| ELZBIETA LACH-PASKO MD | |||||||||||||
| 396162 | 0 | 0 | 0 | 0 | 0 | 15440 | 0 | 41333 | 0 | 452935 | 0 | 0 | 0 |
| ROBERTA MELTZER MD | |||||||||||||
| 185417 | 0 | 0 | 0 | 0 | 0 | 40629 | 0 | 19345 | 0 | 245391 | 0 | 0 | 0 |
| WILLIAM POLITO MD | |||||||||||||
| 248264 | 0 | 0 | 0 | 0 | 0 | 24704 | 0 | 25902 | 0 | 298870 | 0 | 0 | 0 |
| ASHOK DUBEY MD | |||||||||||||
| 262659 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 27404 | 0 | 290063 | 0 | 0 | 0 |
| MUSTAFA UGURLU MD | |||||||||||||
| 307766 | 0 | 0 | 0 | 0 | 0 | 5119 | 0 | 32110 | 0 | 344995 | 0 | 0 | 0 |
| TIMOTHY GOSTKOWSKI MD | |||||||||||||
| 432715 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 45147 | 0 | 477862 | 0 | 0 | 0 |
| RAHUL MAGAVI MD | |||||||||||||
| 219986 | 0 | 0 | 0 | 0 | 0 | 2520 | 0 | 22952 | 0 | 245458 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY OF FORM 990 IS DISTRIBUTED TO THE BOARD OF DIRECTORS BEFORE IT IS FILED WITH THE IRS. THIS ENABLES THE BOARD TO ASK QUESTIONS, AND TO APPROVE THE DISCLOSURES MADE IN THE RETURN. | |
| THE HOSPITAL DISTRIBUTES A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY TO ITS BOARD OF DIRECTORS, ALL MANAGEMENT PERSONNEL, AND PURCHASING AGENTS. | FORM 990, PART VI, SECTION B, LINE 12C | |
| COMPENSATION FOR SENIOR STAFF IS DETERMINED USING THE FOLLOWING STEPS: - A MARKET SURVEY BASED ON CT HOSPITAL ASSOCIATION IS USED AS A STARTING POINT. - ADJUSTMENTS ARE THEN MADE BASED ON THE CANDIDATE'S CURRENT SALARY AND PRIOR EXPERIENCE. - THE COMPENSATION FIGURE IS THEN PRESENTED TO THE BOARD OF DIRECTORS FOR APPROVAL. | FORM 990, PART VI, SECTION B, LINE 15 | |
| THE HOSPITAL MAKES ITS GOVERNING POLICIES AVAILABLE TO THE PUBLIC UPON REQUEST. A CONFLICT OF INTEREST QUESTIONNAIRE IS DISTRIBUTED TO THE BOARD OF DIRECTORS, ALL MANAGEMENT PERSONNEL, AND THE PURCHASING AGENTS FOR THE HOSPITAL. AN ANNUAL REPORT OF THE OPERATIONS OF THE HOSPITAL INCLUDING FINANCIAL INFORMATION IS PUBLISHED EACH YEAR AND IS AVAILABLE TO THE PUBLIC. | FORM 990, PART VI, SECTION C, LINE 19 | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET UNREALIZED LOSSES ON INVESTMENTS: -2,203,969. PENSION RELATED CHANGES OTHER THAN NET PERIODIC PENSION COSTS 6,880,330. NET ASSETS RELEASED FROM RESTRICTIONS -266,780. NET ASSETS RELEASED FOR PROPERTY, PLANT & EQUIPMENT 200,000. TOTAL TO FORM 990, PART XI, LINE 5: 4,609,581. | FORM 990, PART XI, LINE 5: |
| THE HOSPITAL'S AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THESE FUNCTIONS AND PROCESSES HAVE NOT CHANGED FROM THE PRIOR YEAR. | FORM 990, PART XI, LINE 2C: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ADVANCED MEDICAL IMAGING OF NW CT LLC | ||||||||||||
| 57 COMMERCIAL BLVD | TORRINGTON | CT | 06790 | 061594854 | MAGNETIC RESONANCE IMAGING | CT | N/A | RELATED | 666744 | 274067 | 0 | 0 |
| UROLOGY CENTER OF NW CT LLC | ||||||||||||
| 538 LITCHFIELD STREET | TORRINGTON | CT | 06790 | 582674029 | EQUIPMENT RENTAL | CT | N/A | RELATED | 48301 | 24208 | 0 | 0 |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LITCHFIELD COUNTY HEALTHCARE SERVICE CORPORATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 540 LITCHFIELD STREET | AddressLine1 |
| City | TORRINGTON | City |
| State | CT | State |
| ZIP Code | 06790 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 061227655 | EIN |
| Primary Activity | MANAGEMENT SERVICES | PrimaryActivity |
| Legal Domicile State | CT | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE CHARLOTTE HUNGERFORD HOSPTIAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Share Of EOY Assets | 505 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | 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 | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADVANCED MEDICAL IMAGING OF NW CT LLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | R | TransactionType |
| Amount Involved | 680000 | AmountInvolved |
| Method Of Amt Determination | ACTUAL | MethodOfAmtDetermination |