2012-08-15T11:05:15-05:00 2011-09-30 ERNST & YOUNG US LLP 55 IVAN ALLEN BLVD SUITE 1000 ATLANTA GA 30308 990 2010-10-01 222577722 Norwalk Health Care dba Honey Hill Rehab & Nursing Center NORW 2038479686 34 MIDROCKS DRIVE NORWALK CT 06851 DANIEL DEBARBA 2012-08-14 4048748300 2010 2016-02-24 21:20:13Z HONEY HILL REHABILITATION & NURSING Daniel Debarba 24 Stevens Street Norwalk CT 06850 22710126 false X WWW.NORWALKHEALTH.ORG X 1985 CT TO OFFER ITS RESIDENTS QUALITY SERVICE AND PROGRAMS IN AN ENVIRONMENT WHICH AFFIRMS THE HIGHEST PRINCIPLES OF HUMAN DIGNITY. X 9 8 211 35 0 0 0 0 15987091 16229072 1614 -1742083 13081 10608 16001786 14497597 0 0 0 0 8885923 8506309 0 0 0 7599084 7813733 16485007 16320042 -483221 -1822445 11132002 10050764 11184058 11924156 -52056 -1873392 X TO OFFER ITS RESIDENTS QUALITY SERVICE AND PROGRAMS IN AN ENVIRONMENT WHICH AFFIRMS THE HIGHEST PRINCIPLES OF HUMAN DIGNITY. false true 14048095 0 16229072 REHABILITATION & NURSING CARE - NORWALK HEALTH CARE, INC. (DBA HONEY HILL REHABILITATION & NURSING CENTER) IS A 150 BED SKILLED NURSING CARE FACILITY PROVIDING SUB ACUTE AND REHABILITATION SERVICES. HONEY HILL SERVES PATIENTS WITH THE FOLLOWING NEEDS: CEREBRAL VASCULAR ACCIDENT; ELECTIVE JOINT REPLACEMENTS (HIP, KNEE, SHOULDER & ELBOW); HIP FRACTURES, PULMONARY CONDITIONS SUCH AS PNEUMONIA, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, PULMONARY FIBROSIS & EMPHYSEMA. TOTAL PATIENT DAYS = 48,780. PERCENTAGE OCCUPANCY = 89.10%. AVERAGE DAILY CENSUS = 134. PAYOR MIX: MEDICAID = 62.66%, MEDICARE = 28.47%, PRIVATE & OTHER = 8.87%. 14048095 true false false false false false false false false true false false false true false false true false false false false false false false false false false false true false false false false false false false false false false false true false true true true false false true 10 0 true 211 true false false false false false false false false false false X 9 8 true false false false true true false true true false false true true true true true false false false false X TONI HORNE 2038522071 24 STEVENS STREET NORWALK CT 06850 X Daniel DeBarba 2.0 X X 0 670785 29920 Ervin Shames 1.0 X 0 0 0 Frank N Zullo Esq 1.0 X 0 0 0 Carol Bauer 1.0 X 0 0 0 Barbara Butler 1.0 X 0 0 0 Victor Liss 1.0 X 0 0 0 Michael Marks Physician 1.0 X 0 70833 0 Robert Ready 1.0 X 0 0 0 William Stephanak 1.0 X 0 0 0 Nicole Tobin 1.0 X 0 0 0 Arthur Santilli 50.0 X 0 261042 25420 Deborah Quare 45.0 X 107622 0 15949 Judith Perry 49.0 X 107271 0 5991 Kathleen Yuckienuz 47.0 X 102432 0 638 Geoffrey Cole 0.0 X 0 1248052 46796 317325 2250712 124714 3 true true false NORWALK HOSPITAL ASSOCIATION 24 Stevens Street NORWALK CT 06850 THERAPY/MGT/LAB/LAUN 1592710 THE NURSE NETWORK PO Box 982 SOUTHINGTON CT 06489 NURSING 441495 MORRISON MANAGEMENT SPECIALISTS INC PO Box 102289 ATLANTA GA 303682289 DIETARY MANAGEMENT 442010 READY NURSE STAFFING SERVICES 1080 ELM ST SUITE 201 ROCKY HILL CT 06067 NURSING 229870 DURANT NICHOLS HOUSTON 1057 BROAD ST BRIDGEPORT CT 066010351 LEGAL 195014 6 0 NURSING & REHABILITATION CARE 623000 16229072 16229072 16229072 0 4446 4446 0 616000 5850000 619146 7593383 -3146 -1743383 -1746529 -1746529 0 0 0 BARBER & BEAUTY INCOME 812900 1346 1346 GIFT SHOP 453220 3378 3378 All other revenue 900099 5884 5884 10608 14497597 16229072 0 -1731475 0 0 0 0 0 0 6370798 5902414 468384 0 1589919 1473060 116859 545592 505491 40101 585000 585000 203520 203520 0 0 0 0 1763986 1336343 427643 0 1262997 1123894 139103 21062 21062 0 882154 774796 107358 2306 2306 0 0 402000 402000 0 419375 366903 52472 107814 107814 BAD DEBT 415000 415000 DIETARY 883161 883161 PHYSICAL THERAPY 449753 449753 OCCUPATIONAL THERAPY 280960 280960 INHALATION/OXYGEN SUPPLIES 77517 77517 57128 56803 325 16320042 14048095 2271947 0 833664 6408446 1410699 1032349 33626 0 428394 700000 6451323 0 1929700 1864654 44596 45315 11132002 10050764 1076050 1281954 8335000 7805000 1773008 2837202 11184058 11924156 X -52056 -1873392 -52056 -1873392 11132002 10050764 X -1822445 1109 X false true true X false X 14044048 14722190 14632956 15987091 16229072 75615357 14044048 14722190 14632956 15987091 16229072 75615357 75615357 97499 125881 25815 1614 1300 252109 97499 125881 25815 1614 1300 252109 9367 14136 8736 13081 10608 55928 14150914 14862207 14667507 16001786 16240980 75923394 0.99594 0.99513 0.00332 0.00426 X Other income includes Barber & Beauty, Guest Trays & Gift Shop Revenue. 0 0 0 0 due to third party agencies 115108 Due to affiliates 1991232 Accrued Interest payable 96083 Workers Comp Reserve 428349 Malpractice Reserve 83069 Other Liabilities 123361 2837202 FIN 48 Footnote Schedule D, Part X, Line 2 The Organization's financial statements do not contain a footnote concerning uncertain tax positions under FIN 48. true true false false false false false false false Daniel DeBarba 0 416638 0 210000 0 44147 0 11025 0 18895 0 700705 0 0 Arthur Santilli 0 187892 0 60750 0 12400 0 11025 0 14395 0 286462 0 0 Geoffrey Cole 0 202525 0 100247 0 945280 0 30767 0 16029 0 1294848 0 0 Supplemental Compensation Information Schedule J, Part I, Line 1a TAX GROSS-UP PAYMENTS ARE PROVIDED ON TAXABLE BENEFITS IN ACCORDANCE WITH THE NORWALK HOSPITAL ASSOCIATION'S SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, DESCRIBED BELOW IN RESPONSE TO LINE 4B. ADDITIONALLY, TAX GROSS UP PAYMENTS ARE PROVIDED FOR TAXABLE MOVING EXPENSES AND ON THE TAXATION OF THE FORMER CEO'S PERSONAL USE OF A HOSPITAL-OWNED AUTOMOBILE PRIOR TO HIS TERMINATION AS CEO(FOR CALENDAR YEAR 2010 ONLY). ALL TAX GROSS-UP PAYMENTS ARE TREATED AS TAXABLE COMPENSATION TO THE INDIVIDUALS RECEIVING SUCH PAYMENTS. Supplemental Compensation Information Schedule J, Part I, Line 4a Geoffrey 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). Supplemental Compensation Information Schedule J, Part I, Line 4b NORWALK HOSPITAL ASSOCIATION (NHA), A RELATED ORGANIZATION OF NORWALK HEALTH CARE (NHC), HAS ESTABLISHED THE NORWALK HOSPITAL SENIOR EXECUTIVE DEFERRED COMPENSATION PLAN, PRIMARILY FOR THE PURPOSE OF PROVIDING A PROGRAM OF DEFERRED COMPENSATION FOR DANIEL DERBARBA, PRESIDENT AND CEO OF NHA. AMOUNTS PROMISED UNDER THE PLAN ARE BASED ON A TARGETED RETIREMENT BENEFIT. 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 W-2. All Real and Personal Property 2011-09-30 5850000 Arms length negotiation 452573283 Aurora Health Management 8227 clove Dr Ste 309 Millersville MD 21108 Millersville MD 21108 Corporation false false false false Cessation of Services Form 990, Part III, Line 3 On September 30, 2011 Norwalk Health Care, Inc. closed on the sale of the nursing home business for a sales price of $5,850,000. An escrow for $700,000 was established for a three year period for indemnification obligations under the Medicare & Medicaid programs and such escrow was recorded as other Assets. A loss of $1,743,383 was recorded on the sale. The outstanding debt of Norwalk Health Care, Inc. as of September 30, 2011 of $7,805,000 was defeased and repaid to bondholders on November 15, 2011. Description of Relationships FORM 990, PART VI, LINE 2 CERTAIN NORWALK HEALTH CARE, INC. BOARD MEMBERS ALSO SERVE ON THE BOARD OF SWC CORPORATION, AND MAPLE STREET INDEMNITY COMPANY LTD. The organization's members or stockholders Form 990, Part VI, Line 6 The sole member of Norwalk Health Care is Norwalk Health Services Corporation. Members, Stockholders, or other persons who may elect one or more members Form 990, Part VI, Line 7a The officers of NHC are appointed by the Governance Committee of NHSC. Up to 14 members of the Board are appointed by NHSC. Describe the Process used by Management &/or Governing Body to Review 990 Form 990, Part VI, Line 11B NORWALK HEALTH CARE, INC.'S (NHC) FORM 990 IS PREPARED WITH THE ASSISTANCE OF ERNST & YOUNG AND REVIEWED BY NORWALK HOSPITAL'S MANAGEMENT. FOLLOWING THAT REVIEW THE FORM 990 IS PRESENTED TO THE AUDIT COMMITTEE OF NORWALK HOSPITAL ASSOCIATION FOR REVIEW AND COMMENT. THE COMPLETED FORM 990 IS PROVIDED, via email, TO ALL MEMBERS OF THE BOARD OF Directors OF NORWALK HEALTH SERVICES CORPORATION PRIOR TO THE FORM BEING FILED WITH THE IRS. Description of Process to Monitor Transactions for Conflicts of Interest FORM 990, PART VI, LINE 12C MONITORING 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 Care IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS, Norwalk Health Care 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 Care 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. Document Retention Policy Form 990, Part VI, Line 14 NORWALK HEALTH CARE IS IN THE PROCESS OF DRAFTING A FORMAL WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY. Offices & Positions for Which Process was Used, & Year Process was Begun Form 990, Part VI, Line 15a NORWALK HEALTH CARE (NHC) DOES NOT COMPENSATE ANY OFFICERS OR ITS EXECUTIVE DIRECTOR. THE OFFICER AND EXECUTIVE DIRECTOR RECEIVING COMPENSATION ARE COMPENSATED BY NORWALK HOSPITAL ASSOCIATION (NHA), A RELATED ORGANIZATION OF NHC. THEREFORE, THEIR COMPENSATION AND BENEFITS ARE DETERMINED BY NHA. Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen Public FORM 990, PART VI, LINE 19 NORWALK HEALTH CARE, INC. MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC ONLY UPON REQUEST. THE CONFLICT OF INTEREST POLICY IS AVAILABLE THROUGH NORWALK HEALTH SERVICES CORPORATION UPON REQUEST. Changes in Net Assets or Other Fund Balances Form 990, Part XI, Line 5 Transfers from Norwalk Hospital Foundation, Inc. $ 719 Net Unrealized gains on investments $ 390 ------- Total Line 5 $ 1,109 Compensation Committee Schedule J, Part I, Line 3 THE COMPENSATION COMMITTEE IS FROM NORWALK HEALTH SERVICES CORPORATION (NHSC) AS PER THE NHSC BYLAWS. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Daniel DeBarba TITLE:President and Chairman HOURS:56 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Ervin Shames TITLE:Director HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Frank N. Zullo, Esq TITLE:Director HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Barbara Butler TITLE:Director HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Victor Liss TITLE:Director HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Michael Marks, Physician; TITLE:Director until 12/31/2010 HOURS:53 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Robert Ready TITLE:Director HOURS:4 Norwalk Hospital Association 24 Stevens Street Norwalk CT 06850 066068853 health svcs CT 501(C)(3) 3 nhsc Fairfield County Medical Services Inc 24 Stevens Street Norwalk CT 06850 061522078 phys practice CT 501(c)(3) 11B nha Norwalk Health Services Corporation 24 Stevens Street Norwalk CT 06850 222577711 support svcs CT 501(c)(3) 11B NA Norwalk Hospital Foundation Inc 34 Maple Street Norwalk CT 06850 222377707 fundraising CT 501(c)(3) 7 nhsc Advanced Center for Rehab Medicine 24 Stevens Street Norwalk CT 06850 061304799 Inactive CT 501(c)(3) 11B NHSC Maple Street Indemnity Company Ltd 40 Church Street PO Box HM 2062 Hamilton HM HX BD 980549862 Captive Insurance BD NHSC C-Corp 0 0 0.00000 SWC Corporation 24 Stevens Street Norwalk CT 06850 222577718 Pharmacy CT NHSC C-Corp 0 0 0.00000 false false true false false false false false false false false true false false true false true false NORWALK HOSPITAL ASSOCIATION L 1580698 NORWALK HOSPITAL ASSOCIATION O 551936 NORWALK HOSPITAL ASSOCIATION Q 288302