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LEGACY MMH INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
LEGACY MMH INC (EIN 06-0646710)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-08-12
IRS object ID
201132289349301598
Schema version
2009v1.7
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)
Timestamp2011-08-12T14:42:26-05:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Whittlesey & Hadley PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1147 Charter Oak AveAddressLine1
CityHartfordCity
StateCTState
ZIP Code061065100ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN060646710EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Manchester Memorial HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMANCNameControl
Phone8606461222Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line171 Haynes StreetAddressLine1
CityManchesterCity
StateCTState
ZIP Code06040ZIPCode

Officer Officer

FieldValueIRS element (for citing)
Namekevin g murphyName
Titletreasurer&evp network/business devTitle
Phone8606461222Phone
Date Signed2011-08-12DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone8605223111Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line171 Haynes StreetAddressLine1
CityManchesterCity
StateCTState
ZIP Code06040ZIPCode
FieldValueIRS element (for citing)
Gross Receipts176594243GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.ECHN.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1920YearFormation
State Legal DomicileCTStateLegalDomicile
Activity Or Mission DescriptionManchester Memorial Hospital is a 249 bed hospital offering various healthcare services to all members of the community, including the indigent and underserved. Also see statements 7, 17 and 18.ActivityOrMissionDescription
Nbr Voting Members Governing Body25NbrVotingMembersGoverningBody
Nbr Independent Voting Members25NbrIndependentVotingMembers
Total Nbr Employees1803TotalNbrEmployees
Total Nbr Volunteers333TotalNbrVolunteers
Total Gross UBI997493TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1527316ContributionsGrantsPriorYear
Contributions Grants Current Year2600993ContributionsGrantsCurrentYear
Program Service Revenue Prior Year171940989ProgramServiceRevenuePriorYear
Program Service Revenue CY171957808ProgramServiceRevenueCY
Investment Income Prior Year87292InvestmentIncomePriorYear
Investment Income Current Year110669InvestmentIncomeCurrentYear
Other Revenue Prior Year1479660OtherRevenuePriorYear
Other Revenue Current Year1768150OtherRevenueCurrentYear
Total Revenue Prior Year175035257TotalRevenuePriorYear
Total Revenue Current Year176437620TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year22928GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY17376GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year95491679SalariesEtcPriorYear
Salaries Etc Current Year96106838SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year74338340OtherExpensePriorYear
Other Expenses Current Year73953911OtherExpensesCurrentYear
Total Expenses Prior Year169852947TotalExpensesPriorYear
Total Expenses Current Year170078125TotalExpensesCurrentYear
Revenues Less Expenses Prior Year5182310RevenuesLessExpensesPriorYear
Revenues Less Expenses CY6359495RevenuesLessExpensesCY
Total Assets BOY150608374TotalAssetsBOY
Total Assets EOY150642268TotalAssetsEOY
Total Liabilities BOY128680507TotalLiabilitiesBOY
Total Liabilities EOY135450881TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY21927867NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY15191387NetAssetsOrFundBalancesEOY
Mission DescriptionManchester Memorial Hospital is a 249 bed hospital offering various healthcare services to all members of the community, including the indigent and underserved.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense11966422Expense
Revenue17665150Revenue
DescriptionOperating Room - Manchester Memorial Hospital offers comprehensive inpatient and outpatient medical and surgical services including robotic surgery. Manchester Memorial Hospital was the first hospital in eastern Connecticut to introduce the daVinci S HD (High Definition) Surgical System, a minimally-invasive surgical system manufactured by Intuitive Surgical Inc.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense8837507Expense
Revenue43547745Revenue
DescriptionEmergency Care The hospital offers 24 hour emergency care. The hospital provides needed medical care to the community regardless of any individuals ability to pay.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense1389213Expense
Revenue33504929Revenue
DescriptionImaging Services The hospital also offers a wide range of imaging diagnostic and treatment services. Diagnostic testing and treatment include x-rays, CT, MRI, PET, ultrasound, nuclear medicine, mammography.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense112497729Expense
Revenue71592924Revenue
DescriptionSee Schedule H, Part VIDescription
FieldValueIRS element (for citing)
Total Of Other Program Service Exp112497729TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev71592924TotalOfOtherProgramServiceRev
Total Program Service Expense134690871TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096160NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1803NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Form8899 Filed0Form8899Filed
Form1098 C Filed0Form1098CFiled
Nbr Voting Governing Body Members25NbrVotingGoverningBodyMembers
Number Independent Voting Members25NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1James RayBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8606461222TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1James Ray 71 Haynes StreetAddressLine1
CityManchesterCity
StateCTState
ZIP Code06040ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (42 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeFormerFormerHighest Compensated EmployeeHighestCompensatedEmployee
Jeffrey P Heidtman
CHAIRPERSON1.00XX000
Dennis G O'Neill md
VICE CHAIRPERSON1.00XX000
Rebecca Janenda
Secretary1.00XX000
Craig S Lappen
TREASURER1.00X000
Leona Crosskey
VP Quality28.0001367880X
Paul A Berte esq
Trustee1.00X000
Gordon L Brodie md
Trustee1.00X000
Gloria Brooks
Trustee1.00X000
THOMASINA CLEMONS
Trustee1.00X000
Michele Conlon md
Trustee1.00X000
Milton A Doremus
Trustee1.00X000
Joy Dorin
Trustee1.00X000
Anthony J DiStefano
Trustee1.00X000
David ENGELSON
Trustee1.00X000
Howard E Fitts
Trustee1.00X000
DAVID GONCI
Trustee1.00X000
Harriet Haslett
Trustee1.00X000
JOSEPH JAMAEL JR
TRUSTEE1.00X000
Joyce Jordan
Trustee1.00X000
CLAUDIO MILITE MD
TRUSTEE1.00X000
Peter K Mulligan
Trustee1.00X000
Robin S Murdock-Meggers
Trustee1.00X000
Rosemarie N Papa
TRUSTEE1.00X000
BARBARA PHILLIPS MD
TRUSTEE1.00X000
Lenora S Williams
Trustee1.00X000
Peter J Karl
President & CEO28.00XX70120300
Kevin Murphy
Treasurer&EVP Network/Bu28.00X432643057325
Joel Reich MD
SVP Medical Affairs28.00400319040407X
Charles Covin
SVP Chief Information Of28.0021164700X
Deborah Gogliettino
SVP Human Resources28.0024510300X
dennis mcconville
SVP Strategic Planning28.0026214800X
deborah parker
SVP Patient Care Service28.0024963200X
Kathleen Sims
VP Operations28.0020627300X
Michael Veilette
SVP Finance & Info Servi28.0020799200X
Carolyn M McKenna Esq
former KEY EMPLOYEE28.00257604038522X
Andrew Beck
former KEY EMPLOYEE28.0016982500X
SONDRA DELLARIPA
former KEY EMPLOYEE28.0011955000X
Robert Carroll MD
Doctor40.00369917026698X
James Castellone MD
doctor40.00321384026246X
Scott Brown MD
doctor40.00296015023488X
THEODORE SHERRY MD
doctor40.00302930024485X
ANDREAS J BOJKO MD
DOCTOR40.00301210017271X
FieldValueIRS element (for citing)
Total Reportable Comp From Org5055395TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation254442TotalOtherCompensation
Number Individuals GT100 K123NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
AMERICAN RED CROSS NHQ
PO Box 33093NEWARKNJ071880093BLOOD/PLATELET SUPPLIER1142644
GRIFFIN YORK & KRAUSE
121 RIVER FRONT DRIVEMANCHESTERNH99999ADVERTISING895425
ROBINSON AND COLE
280 TRUMBULL STREETHARTFORDCT061033597LEGAL772524
DELOITTE & TOUCHE LLP
PO Box 7247-8001HamdenCT06517Audit services297939
PROMETHEUS LABRATORIES INC
PO Box 7738SANF FRANCISCOCA94120laboratory services270498
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Government Grants1293246GovernmentGrants
All Other Contributions1307747AllOtherContributions
Total Contributions2600993TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Patient Services Reven621500166310748166310748
Other Healthcare Reven6215005484516997493$4,487,023
Auxiliary Revenue900099162544$162,544
FieldValueIRS element (for citing)
Total Program Service Revenue171957808TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column110669TotalRevenueColumn
Exclusion$110,669ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real757952Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real757952Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column757952TotalRevenueColumn
Exclusion$757,952ExclusionAmount
FieldValueIRS element (for citing)
Gross Sales Of Inventory276459GrossSalesOfInventory
Cost Of Goods Sold156623CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column119836TotalRevenueColumn
Exclusion$119,836ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionCafeteria RevenueDescription
Business Code722210BusinessCode
Total Revenue Column890362TotalRevenueColumn
Exclusion$890,362ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue890362TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column176437620TotalRevenueColumn
Related Or Exempt Function Income166310748RelatedOrExemptFunctionIncome
Unrelated Business Revenue997493UnrelatedBusinessRevenue
Exclusion$6,528,386ExclusionAmount

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total17376Total
Program Services17376ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2611133Total
Management And General2611133ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total72505221Total
Program Services59487292ProgramServices
Management And General13017929ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total16067932Total
Program Services12724763ProgramServices
Management And General3343169ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4922552Total
Program Services3898343ProgramServices
Management And General1024209ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total204402Total
Program Services161873ProgramServices
Management And General42529ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total94107Total
Program Services74527ProgramServices
Management And General19580ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total3619Total
Program Services2866ProgramServices
Management And General753ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total155946Total
Program Services123499ProgramServices
Management And General32447ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total56370Total
Program Services44641ProgramServices
Management And General11729ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2455299Total
Program Services1944438ProgramServices
Management And General510861ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3825218Total
Program Services3825218ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total49083Total
Program Services38871ProgramServices
Management And General10212ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total118606Total
Program Services93928ProgramServices
Management And General24678ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2528633Total
Program Services2528633ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total7666028Total
Program Services7666028ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total2290570Total
Program Services1813983ProgramServices
Management And General476587ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Medical Supplies2208871022088710
ECHN Allocation102992355149629784273
BAD dEBT eXPENSE67125996712599
Outside/Purchased Servi629547049856051309865
Physician Fees59346135934613

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total3175403Total
Program Services8103ProgramServices
Management And General3167300ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total170078125Total
Program Services134690871ProgramServices
Management And General35387254ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY10660990BOY
EOY6996083EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY24557822BOY
EOY24506769EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2215756BOY
EOY2570091EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY486845BOY
EOY1489763EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis182733340LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec130971357LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY54573162BOY
EOY51761983EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY11200340BOY
EOY11950774EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY46913459BOY
EOY51366805EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY150608374BOY
EOY150642268EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY17435198BOY
EOY16747968EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY34190272BOY
EOY33272900EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY22857203BOY
EOY20995782EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY54197834BOY
EOY64434231EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY128680507BOY
EOY135450881EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY12898050BOY
EOY5363698EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1262823BOY
EOY1904133EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY7766994BOY
EOY7923556EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY21927867BOY
EOY15191387EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY150608374BOY
EOY150642268EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$22,884OtherActivitiesAmount
Total Lobbying Expenditures IIB22884TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B, Line 1i:Identifier
Return ReferenceExplanation of Other Lobbying Activities:ReturnReference
ExplanationThe Connecticut Hospital Association (CHA) has determined that for its fiscal year ending April 30,2010 that 7.63% of its membership dues were used for lobbying purposes. The total lobbying portion from CHA for Manchester Memorial Hospital Inc. was $12,932. The American Hospital Association (AHA) has indicated that 23.76% of 2009 dues were used for lobbying purposes.The total lobbying portion from AHA for Manchester Memorial Hospital Inc. was $9,952.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance7249986BeginningOfYearBalance
Contributions123623Contributions
Investment Earnings Or Losses562999InvestmentEarningsOrLosses
End Of Year Balance7936608EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance7082968BeginningOfYearBalance
Investment Earnings Or Losses167018InvestmentEarningsOrLosses
End Of Year Balance7249986EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.79000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.20000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.01000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis92986683OtherCostOrOtherBasis
Depreciation66719486Depreciation
Book Value26267197BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis15994611OtherCostOrOtherBasis
Depreciation11476398Depreciation
Book Value4518213BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis73552965OtherCostOrOtherBasis
Depreciation52775473Depreciation
Book Value20777492BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis199081OtherCostOrOtherBasis
Book Value199081BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings51761983TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
Mutual Funds6905928F
Beneficial Interest in Trust Assets5044846F
FieldValueIRS element (for citing)
Total Of Book Value Securities11950774TotalOfBookValueSecurities

Other Assets OtherAssets (9 entries)

DescriptionDescriptionBook ValueBookValue
Due from affiliates24151431
Other, net2458502
Current portion of assets whose use is limited694111
Interest in net access of ECHN Community Health Care Foundation, Inc4852903
Assets whose use is limited-board designed investments8564485
Assets whose use is limited-investments held in trust for est, self ins liab2651750
Investment in Joint Ventures3825778
Estimated settlements due from third party payors906337
Assets whose use is limited-invstmnts held under bond indentures3261508
FieldValueIRS element (for citing)
Total Book Value Other Assets51366805TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
Conditional retirement asset obligations$260,265
other current liabilities$6,944,195
Estimated self insurance liabilities$2,344,478
Accrued pension and other post retirement benefits,net of current portion$39,765,402
Due to affiliated entities$14,838,492
estimated settlement due to thrid parties$281,399
FieldValueIRS element (for citing)
Total Of Amounts64434231TotalOfAmounts
Total Revenue176437620TotalRevenue
Total Expenses170078125TotalExpenses
Excess Or Deficit For Year6359495ExcessOrDeficitForYear
Net Unrealized GL On Investments957677NetUnrealizedGLOnInvestments
Other-$14,053,652OtherAmount
Total Adjustments-13095975TotalAdjustments
Excess Or Deficit Per FS-6736480ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt177716687TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments957677NetUnrealizedGainsInvestments
Other Revenues100773OtherRevenues
Revenue Not Rptd F9901058450RevenueNotRptdF990
Revenue Subtotal176658237RevenueSubtotal
Other Revenues Not Included-220617OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-220617RevenueNotRptdOnFinStmt
Total Revenue Per Form990176437620TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt170234748TotExpensesEtcAuditedFinclStmt
Other Expenses Included156623OtherExpensesIncluded
Expenses Not Rptd F990156623ExpensesNotRptdF990
Expenses Subtotal170078125ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990170078125TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part V, Line 4:Description of Intended Use of Endowment Funds:The principal and income from the unrestricted endowment funds and the income from the term endowments are for capital and operating needs of Manchester Memorial Hospital. The income from the permanent endowments and principal from the term endowments are for the use of Manchester Memorial Hospital as restricted by the donors.
Part X:Description of Uncertain Tax Positions Under FIN 48:The Hospital accounts for uncertain tax positions in accordance 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, 2010 and 2009. As of September 30, 2010 and 2009, the Hospital did not record any penalties or interest associated with uncertain tax positions.
Part XI, Line 8 - Other Adjustments:Equity transfer to ECHN Health Services per AFS: -5024696. Change in accrued pension and post retirement (AFS): -9183064. Change in Beneficial interest in Trust Assets AFS (Permanent): 156562. Transfers to affiliates, Net (AFS - Unrestricted): 43741. Net loss on interest rate swap: -61076. Transfers from affiliates, Net (AFS - Temp Restricted): 14881. TOTAL OTHER ADJUSTMENTS -14,053,652: 0.
Part XII, Line 2d - Other Adjustments:Temporarily restricted net assets - net assets released from restriction: 100773.
Part XII, Line 4b - Other Adjustments:temporarily restricted net assets - Change in net assets of ECHN foundation: 762013. Temporarily restricted net assets - Investment income: 16121. cost of goods sold: -156623. Non operating income, net: -842128.
Part XIII, Line 2d - Other Adjustments:cost of goods sold: 156623.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Persons Served673PersonsServed
Total Community Benefit Expense818600TotalCommunityBenefitExpense
Direct Offsetting Revenue10824DirectOffsettingRevenue
Net Community Benefit Expense807776NetCommunityBenefitExpense
Percent Of Total Expense0.00470PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Persons Served40760PersonsServed
Total Community Benefit Expense22471398TotalCommunityBenefitExpense
Direct Offsetting Revenue17284291DirectOffsettingRevenue
Net Community Benefit Expense5187107NetCommunityBenefitExpense
Percent Of Total Expense0.03050PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Persons Served41433PersonsServed
Total Community Benefit Expense23289998TotalCommunityBenefitExpense
Direct Offsetting Revenue17295115DirectOffsettingRevenue
Net Community Benefit Expense5994883NetCommunityBenefitExpense
Percent Of Total Expense0.03520PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs32NumberOfActivitiesOrPrograms
Persons Served93704PersonsServed
Total Community Benefit Expense524841TotalCommunityBenefitExpense
Direct Offsetting Revenue1946DirectOffsettingRevenue
Net Community Benefit Expense522895NetCommunityBenefitExpense
Percent Of Total Expense0.00310PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs13NumberOfActivitiesOrPrograms
Persons Served366PersonsServed
Total Community Benefit Expense489160TotalCommunityBenefitExpense
Direct Offsetting Revenue1150DirectOffsettingRevenue
Net Community Benefit Expense488010NetCommunityBenefitExpense
Percent Of Total Expense0.00290PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served175PersonsServed
Total Community Benefit Expense2572860TotalCommunityBenefitExpense
Direct Offsetting Revenue986168DirectOffsettingRevenue
Net Community Benefit Expense1586692NetCommunityBenefitExpense
Percent Of Total Expense0.00930PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense39233TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense39233NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs12NumberOfActivitiesOrPrograms
Persons Served10989PersonsServed
Total Community Benefit Expense182916TotalCommunityBenefitExpense
Direct Offsetting Revenue160DirectOffsettingRevenue
Net Community Benefit Expense182756NetCommunityBenefitExpense
Percent Of Total Expense0.00110PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs59NumberOfActivitiesOrPrograms
Persons Served105234PersonsServed
Total Community Benefit Expense3809010TotalCommunityBenefitExpense
Direct Offsetting Revenue989424DirectOffsettingRevenue
Net Community Benefit Expense2819586NetCommunityBenefitExpense
Percent Of Total Expense0.01660PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs59NumberOfActivitiesOrPrograms
Persons Served146667PersonsServed
Total Community Benefit Expense27099008TotalCommunityBenefitExpense
Direct Offsetting Revenue18284539DirectOffsettingRevenue
Net Community Benefit Expense8814469NetCommunityBenefitExpense
Percent Of Total Expense0.05180PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense3469TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense3469NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served78PersonsServed
Total Community Building Expense2917TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense2917NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs6NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense12121TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense12121NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense1931TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense1931NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs9NumberOfActivitiesOrPrograms
Persons Served591PersonsServed
Total Community Building Expense6870TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense6870NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs19NumberOfActivitiesOrPrograms
Persons Served669PersonsServed
Total Community Building Expense27308TotalCommunityBuildingExpense
Net Community Building Expense27308NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$6,712,599BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare48494330AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare54224999CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-5730669MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (5 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnership
NORTHEAST REGIONAL RADIATION ONCOLOGY NETWORK INC
ONCOLOGY SERVICES0.25000
TOLLAND IMAGING CENTER
MEDICAL IMAGING SERVICES0.35000
EVERGREEN ENDOSCOPY CENTER
ENDOSCOPY SERVICES0.50000
EVERGREEN IMAGING CENTER LLC
MEDICAL IMAGING SERVICES0.50000
MEDICAL PRACTICE PARTNERS
MANAGEMENT SERVICES0.50000

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

FieldValueIRS element (for citing)
Business Name Line1Manchester Memorial HosptialBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line171 Haynes StreetAddressLine1
CityManchesterCity
StateCTState
ZIP Code06040ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
General ExplanationManchester Memorial Hospital is a not-for-profit 249-bed acute care hospital that provides inpatient, outpatient and emergency care services for residents of Manchester, CT and surrounding towns. The Hospital is a subsidiary of Eastern Connecticut Health Network, Inc., which was formed in 1995 by a merger of MMH Corp. and Rockville Area Health Services, Inc. ECHN was organized to provide a broader health care system for the surrounding communities with quality medical care at a reasonable cost and to foster an environment conducive to health and well being whether in the home or in the community.Manchester Memorial Hospital provides care to patients who meet certain criteria under its charity care policies without charge or at amounts less than its established and contractual rates. Manchester Memorial Hospital does not pursue collection of amounts determined to qualify as charity care; such as, these amounts are not reported as revenue. Charity care for FY 2010 was $2,236,613, for 673 total approved applicants.Expenses related to services performed for patients of Manchester Memorial Hospital contribute importantly to its exempt purpose because the expenses are incurred in the diagnosis, cure, mitigation, treatment and prevention of disease, and for medical purposes affecting the structure or function of the human body.Manchester Memorial Hospital provided needed medical care to the community regardless of any individual's ability to pay. Nine thousand one hundred nine (9,109) inpatients were cared for in FY10 representing 44,935 patient days. Two hundred thirty nine thousand four hundred eighty six (239,486) outpatient visits were recorded.Included in the 9,109 inpatients were 5,459 government related patients. The government inpatients fall into the following groups.Medicare 3,205Medicare Managed Care 569Medicaid 452Medicaid Managed Care 843Saga 356Champus 34Total Gov Patients 5,459Total Non Gov Patients 3,650Total Patients 9,109 Included in the 239,486 outpatient visits the following were government related. The visits are a product of gross revenue relationship to total visits.Medicare 79,220Medicare Managed Care 17,495Medicaid 5,756Medicaid Managed Care 18,843Saga 5,435Champus 889Total Gov Patients 126,638Total Non Gov Patients 111,848Total Outpatient Visits 239,486The Hospital provided uncompensated care to 40,760 Medicaid patients for a net community benefit amount of $5,187,107 after Medicaid reimbursement. Additional information regarding programs for the Community at MMH: PersonsCommunity Benefit Services Benefit Served Community Health Improvement Services Community Health Education $ 347,268 90,726 Community Based Clinical Services $ 11,783 766 Health Care Support Services $ 41,083 2,212Total $ 400,134 93,704 Health Professions Education Physicians/Medical Students $ 37,746 42 Nurses/Nursing Students $ 374,634 213 Other Health Professional Education $ 75,630 111Total $ 488,010 366 Subsidized Health Services Neonatal Intensive Care $1,586,692 175 Emergency and Trauma Services 148 0Total $1,586,840 175 Total Research $ 39,233 0Financial and In-Kind Contributions Cash Donations $ 2,210 0 In-Kind Donations $180,546 10,989Total $182,756 10,989 Community Building Activities Economic Development $ 3,469 0 Community Support $ 2,917 78 Coalition Building $ 12,121 0 Community Health Improvement Advocacy $ 1,931 0 Workforce Development $ 6,870 591Total $ 27,308 669 Community Benefit Operations Dedicated Staff $ 62,313 0 Cummunity Needs/Health Assets Assessmnt $ 60,448 0Total $ 122,761 0 Grand Total $2,847,042 105,903 Financial Services Detail Persons Benefit ServedTraditional Charity Care $ 807,776 673Unpaid Costs of Medicaid $5,187,107 40,760Total Community Benefit $8,841,925 147,336GeneralExplanation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantSCHOLARSHIPSTypeOfGrant
Number Of Recipients17NumberOfRecipients
Amount Of Cash Grant17376AmountOfCashGrant
Method Of ValuationN/AMethodOfValuation
Description Of Non Cash AssistanceN/ADescriptionOfNonCashAssistance

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierOther Information:Identifier
Return ReferencePart IV:ReturnReference
ExplanationThe scholarships are awarded to ECHN employees wishing to further their nursing education or become a nurse. The primary purpose is to provide financial assistance to ECHN employees enrolled in an accredited nursing program that leads to becoming a Registered Nurse. Furthermore, a portion of the funds may be awarded to an ECHN Registered Nurse to assist that person in obtaining an advanced degree. Scholarships are awarded based on the determination of a nursing scholarship committee. Nursing students who need financial assistance to complete their education and who demonstrate scholastic ability and professional promise are eligible if they are an employee of an ECHN affiliate, at least 20 hours part- or full-time, for at least one year; and currently enrolled in an accredited traditional or non-traditional nursing program. Baccalaureate applicants must have completed the 2nd year of a 4-year program and associate degree applicants must have completed all prerequisites and be accepted into a nursing program. In making the awards, the committee uses job performance evaluation and recommendation, grade point average and professional goals. In addition, the number of credits in which an applicant is enrolled and the cost per credit is factored into any award. If awarded a scholarship, the recipient agrees to maintain employment, whether full or part-time, at an affiliate of ECHN for a minimum of one year. Awards are mailed directly to the educational institution.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs1CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (17 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
Peter J Karl
495535020000405664014700081296079719905259020
Kevin Murphy
33031501016300698014583042742048996803244820
Joel Reich MD
3161960825950152806195034212044072603002390
Charles Covin
1753470363000005009010982022763801587350
Deborah Gogliettino
19378304910002220013774024791028366801838270
dennis mcconville
2109880489500221004989024749029188601966110
deborah parker
19805105021301368013189025104028792501872240
Kathleen Sims
17223303404000013552010982023080701547050
Michael Veilette
17721203078000011453010982023042701559940
Carolyn M McKenna Esq
20302705175002827012985025537029612601932030
Andrew Beck
1401050297200000010982018080701273690
SONDRA DELLARIPA
97422022128000001098201305320896630
Robert Carroll MD
36991700000157160109820396615000
James Castellone MD
32138400000152640109820347630000
Scott Brown MD
29601500000125060109820319503000
THEODORE SHERRY MD
30293000000135030109820327415000
ANDREAS J BOJKO MD
3012100000062890109820318481000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 4aPETER KARL - $71,219 KEVIN MURPHY - $33,877 CAROLYN MCKENNA - $15,525 DEBORAH PARKER - $15,064 JOEL REICH - $24,778 DEBORAH GOGLIETTINO - $14,730 DENNIS MCCONVILLE - $14,685
Part I, Line 6The ECHN Executive Incentive Compensation Plan is a plan that has been developed, reviewed and is annually approved by members of the Board Executive Compensation Committee with consultant third party oversight. The plan establishes goals in 4 areas of performance: System- Wide Financial Performance based on profit from operations, two quality outcomes in clinical core measures and patient satisfaction and an individual goal for each member of the incentive program Members of the incentive program include the following: Position Title - Key Employee Name President and CEO - Peter J. Karl Senior Vice President and CFO - Kevin Murphy Vice President and CIO - Charles Covin Vice President Quality - Leona Crosskey Senior Vice President, Human Resources - Deb Gogliettino Senior Vice President, Strategic Planning - Dennis McConville Senior Vice President, Legal Counsel - Carolyn McKenna Senior Vice President, Patient Care Services - Deborah Parker Senior Vice President, Medical Affairs - Joel Reich, M.D. Vice President, Operations - Katherine Sims Vice President, Long Term Care - Richard Slutsky Vice President, Finance - Michael Veillette

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuer
State of cONNECTICUT HEALTH & EDL FACS AUTH REV SERIES B
06080618620774LS972004-07-2120000000Finance additions and renovations and purchased of equipment for RGH and MMH00
State of cONNECTICUT HEALTH & EDL FACS AUTH REV SERIES C
060806186207744a282005-11-0937579404Advance refund and defease a portion of the Series 2000A bonds.00
State of cONNECTICUT HEALTH & EDL FACS AUTH REV SERIES D
060806186NoneAvail2009-05-1415250000Woodlake expansion, equipment purchase, prior issue refund.00

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Total ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindAmount In Reserve FundAmountInReserveFundAmount DefeasedAmountDefeased
200000004931411950685920040011
37579404126315920060111355695732759288
152500003050004978081200910119966919

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
000000.000000.000000.000001
000000.000000.000000.000001
000000.000000.000000.000001

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebateTerm Of HedgeTermOfHedge
(no name)
010001
(no name)
000001
TD BANK
0110015.000000000000

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
O'NEILL DENNIS
Executive, Governance, Compensation, Finance, Health Services, ECPHO576914President of Eastern Connecticut Pathology Consultants (ECPC) which provides laboratory management services by contract to ECHN0
BRODIE GORDON MD
Executive, PA&I, Planning, ECPHO818292Partner in Practice Management Advisors0
CONLON MICHELLE MD
Executive, Governance, MEC576914Partner, Eastern CT Pathology Consultants which has contract with ECHN to provide pathology services0
dISTEFANO ANTHONY MD
Health Services, PA&I, MEC195000Owner and Bd Member of Continental Connecticut Lithotripsy, LLC, which provides services to ECHN.0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section B, line 11PRIOR TO THE FILING THE 990, THE FOLLOWING STEPS ARE TAKEN: 1) THE DIRECTOR OF ACCOUNTING AND TAXATION CONDUCTS AN EXTENSIVE REVIEW OF THE 990 WITH THE CPA FIRM THAT PREPARES THE RETURN, ALONG WITH OTHER MEMBERS OF THE FINANCE DEPARTMENT ALSO REVIEW THE RETURN. 2) AN ELECTRONIC COPY OF THE 990 IS MADE AVAILABLE TO THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES (THE GOVERNING BOARD) AND THE COMMITTEE MEMBERS ARE REQUESTED TO REVIEW THE 990; ALONG WITH A DISCUSSION OF THE PREPARATION OF THE 990 AT A COMMITTEE MEETING. 3) A DISCUSSION OF THE 990 PREPARATION AND ITS KEY COMPONENTS IS HELD AT A FULL BOARD OF TRUSTEES MEETING AND AN ELECTRONIC COPY OF THE 990 IS MADE AVAILABLE TO THE BOARD OF TRUSTEES. PRESENT AT BOTH OF THESE MEETINGS ARE THE OFFICERS (CEO, CFO) AND SENIOR MANAGEMENT OF THE ORGANIZATION.
Form 990, Part VI, Section B, line 12cAnnually, the Corporate Compliance/Internal Audit department provides to Officers, Directors, or Trustees and key employees the Organization's Conflict of Interest Policy and Disclosure Statement, and each individual is required to return to the Department, a signed document, acknowledging receipt of the Policy and Disclosure statement and disclose any interests that could give rise to conflicts. A summary of the disclosures is shared with the Chairman of the Board of Trustees and with the Audit and Corporate Compliance Committee of the Board. Individuals who are identified as having a conflict of interest are prohibited in participating in the governing bodies deliberations and decisions related to the transaction. The returned statements are retained by the Corporate Compliance/Internal Audit department.
Form 990, Part VI, Section B, line 15The compensation committee takes the following steps with an independent compensation consultant (1) Reviews data related to current market values consistent for organization's executives by review of compensation levels and plans consistent with hospitals and health systems of comparable size and location; (2) Completes a review of data on current and future plans for the organization, including structure and job descriptions; (3) Reviews and approves and recommend salary ranges for each position, along with related benefits; (4) Reviews and approves a tiered executive structure with appropriate incentive opportunity, benefits, and compensation.
Form 990, Part VI, Section C, line 19The organization, will, upon request, allow for review of our Governing documents, conflict of interest policy, and most recent Annual Audited Financial statements at an office of the organization.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNABusiness Name Line1DirectControllingEntityName/BusinessNameLine1
EASTERN CONNECTICUT HEALTH NETWORK INC
71 haynes streetmanchesterCT06040222546079INTEGRATED HEALTH CARE SYSTEMCT501(c)3170(b)(1)(A)N/A
Rockville General Hospital
31 Union StreetRockvilleCT06066060653151The provision of health careCT501(c)3170(b)(1)(A)EASTERN CONNECTICUT HEALTH NETWORK INC
ECHN Wellness Services Inc
2800 Tamarack AvenueSouth WindsorCT06074061360082The provision of health careCT501(c)3170(b)(1)(A)EASTERN CONNECTICUT HEALTH NETWORK INC
echn community healthcare foundation inc
71 haynes streetmanchesterCT06040222546080FUNDRAISINGCT501(c)3170(b)(1)(A)EASTERN CONNECTICUT HEALTH NETWORK INC
echn eldercare services inc
26 shenipsit lake roadtollandCT06084061149193The provision of health careCT501(c)3170(b)(1)(A)EASTERN CONNECTICUT HEALTH NETWORK INC
echn health services
71 haynes streetManchesterCT06040222546079The provision of health careCT501(c)3170(b)(1)(A)EASTERN CONNECTICUT HEALTH NETWORK INC

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
echn enterprises inc
71 Haynes StreetMANCHESTERCT06040222546828Real estate holdingCTEastern Connecticut Health Network Inc
haynes street property management LLC
71 Haynes StreetMANCHESTERCT06040222546028real estate property managementCTechn enterprises inc
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
EASTERN CONNECTICUT HEALTH NETWORK INC
N8544022
EASTERN CONNECTICUT HEALTH NETWORK INC
O6956988