2011-08-15T12:34:19-05:00 2010-09-30 PricewaterhouseCoopers LLP 125 High Street Boston MA 02110 990 2009-10-01 222577707 NORWALK HOSPITAL FOUNDATION NORW 2038522000 34 MAPLE STREET NORWALK CT 06856 DANIEL DEBARBA 2038523273 2011-08-12 6175305000 2011-08-11 2009 2016-02-24 21:20:13Z MARY G FRANCO 34 MAPLE STREET NORWALK CT 06856 15254112 false X WWW.NORWALKHOSPITAL.ORG X 1985 CT THE NORWALK HOSPITAL FOUNDATION GENERATES PHILANTHROPY AND AWARENESS TO SUPPORT NORWALK HOSPITAL IN BEING A LEADER IN ADVANCED MEDICAL CARE IN THE REGION. 26 24 0 300 0 0 6145403 6989124 0 0 811494 688861 -155628 -132726 6801269 7545259 5322488 3088251 0 0 1236266 1411108 70709 60603 943554 1995065 3669289 8624528 8229251 -1823259 -683992 28786654 29487813 61277 459025 28725377 29028788 THE NORWALK HOSPITAL FOUNDATION GENERATES PHILANTHROPY AND AWARENESS TO SUPPORT NORWALK HOSPITAL IN BEING A LEADER IN ADVANCED MEDICAL CARE IN THE REGION. GIFTS TO NORWALK HOSPITAL FOUNDATION SUPPORT WORLD CLASS MEDICAL CARE TO MEET THE HIGHEST LEVEL PATIENT EXPECTATIONS INCLUDING THE FOLLOWING INITIATIVES: PROVIDING QUALITY COMPASSIONATE PATIENT-CENTERED CARE FOR ALL PATIENTS; BUILDING STATE-OF-THE-ART FACILITIES WITH INNOVATIVE NEW TECHNOLOGIES AND EQUIPMENT; DEVELOPING AND PROVIDING PROGRESSIVE EDUCATIONAL PROGRAMS TO ASSURE MEDICAL PERSONNEL ARE UP-TO-DATE ON THE MOST RECENT TREATMENTS AND QUALITY OF CARE; ATTRACTING AND RETAINING THE BEST, THE BRIGHTEST, AND THE MOST DEDICATED PHYSICIANS, NURSES AND OTHER MEDICAL STAFF; AND LEADING RELEVANT RESEARCH IN KEY AREAS IN MEDICINE AND SURGERY. false false 3020060 0 PATIENT CARE & OTHER PROGRAMS - FOUNDATION FUNDS WERE USED TO SUPPORT A VARIETY OF PATIENT CARE PROGRAMS INCLUDING INTEGRATIVE MEDICINE, NURSING DOCUMENTATION AND INDIVIDUAL AND GROUP THERAPY FOR CANCER PATIENTS. INTEREST FROM ENDOWMENTS AND OTHER RESTRICTED FUNDS SUPPORT SEVERAL KEY POSITIONS INCLUDING THE CHAIRS OF PEDIATRICS AND PSYCHIATRY, PEDIATRIC HOSPITALISTS, THE SMILOW FAMILY BREAST HEALTH DIRECTOR AND THE GRACE COLE JONES GIFT SHOP MANAGER. 1628906 1594038 0 FACILITIES, EQUIPMENT & TECHNOLOGY - IN 2010, FOUNDATION FUNDS SUPPORTED THE MASTER FACILITY PLAN INCLUDING THE DESIGN AND ENABLING PROJECTS FOR THE NEW PARKING GARAGE AT NORWALK HOSPITAL. CONSTRUCTION OF THE NEW GARAGE IS SCHEDULED FOR JANUARY 2011 WITH COMPLETION ANTICIPATED IN MARCH 2012. FUNDS SUPPORTED THE RENOVATION AND UPGRADE OF THE PEDIATRIC PATIENT CARE ROOMS INCLUDING PAINT, CARPET, FIXTURES AND WINDOW TREATMENTS IN EACH ROOM AS WELL AS COMMON AREAS. IN ADDITION, FUNDS WERE USED TO PURCHASE NEW EMERGENCY ROOM STRETCHERS, REPLACE A NEONATAL TRANSPORT ISOLETTE, PURCHASE A NEW AMBULANCE, PURCHASE NEW BIPAP EQUIPMENT AND REPLACE REHABILITATION EQUIPMENT TO NAME A FEW, AMONG OTHER FACILITIES ENHANCEMENTS AND UPGRADES. 255445 65500 0 EDUCATION, TRAINING, & RESEARCH - NORWALK HOSPITAL FOUNDATION SUPPORTS A VARIETY OF LEARNING OPPORTUNITIES FOR EMPLOYEES AS WELL AS SCHOLARSHIPS FOR STUDENTS PURSUING DEGREES IN NURSING AND HEALTHCARE. TWENTY SCHOLARSHIPS WERE AWARDED TO STUDENTS ENROLLED IN NURSING PROGRAMS AT LOCAL COLLEGES AND UNIVERSITIES. FUNDS WERE ALSO USED TO SUPPORT TRAINING FOR MEDICAL RESIDENTS, SPIRITUAL CARE PROVIDERS, SURGICAL SIMULATION, LABOR AND DELIVERY NURSES, PULMONARY AND CRITICAL CARE NURSES, AND RESPIRATORY THERAPISTS AMONG OTHERS. IN ADDITION, FOUNDATION FUNDS SUPPORTED MEDICAL GRAND ROUNDS LECTURES, LIBRARY SERVICES, AND PRINTED EDUCATIONAL MATERIALS. AS A COMMUNITY TEACHING HOSPITAL, RESEARCH IS A KEY ELEMENT IN ATTRACTING NEW RESIDENTS, FELLOWS AND PHYSICIANS AS WELL AS TO CONTINUOUSLY IMPROVE MEDICAL CARE AND SERVICES FOR PATIENTS IN THE COMMUNITY. FOUNDATION SUPPORT ENABLED NORWALK HOSPITAL'S WHITTINGHAM CANCER CENTER TO CONTINUE ITS ROBUST CLINICAL RESEARCH TRIAL PROGRAM. IN 2010, RESEARCH TRIALS WERE CONDUCTED IN BREAST, COLON, HEAD AND NECK, LUNG, OVARIAN, AND HEMATOLOGY AMONG OTHERS. 1428713 1428713 0 TRANSFR UNRSTRCTD FUNDS TO NORWALK HOSPITAL ASSOC. 1428713 1428713 0 6333124 true true false false false false false false true true false true false false false false false true true false false true true true false false false false false false false false true false false false false true true false false true 6 0 true 0 false false false false false false false false false 26 24 true false false false true true false true true false false false true true true true false false X TONI HORNE 2038522071 34 MAPLE STREET NORWALK CT 06856 X MARY G FRANCO 40.0 X X 0 372908 41477 FREDERICK R AFRAGOLA 1.0 X X 0 0 0 PATSY R BRESCIA 1.0 X 0 0 0 ROBERT CIOFFI 1.0 X X 0 0 0 GEOFFREY COLE 1.0 X 0 884538 52704 MARIANNE W CREW 1.0 X 0 0 0 HOWARD EISON MD 1.0 X 0 0 0 JAMES F GUTHRIE MD 1.0 X 0 0 0 SHEILA J KEIN 1.0 X 0 0 0 DAVID M LEHN 2.0 X X 0 0 0 KATHLEEN MCSHANE 1.0 X 0 0 0 ROBERT B OBERNIER 1.0 X 0 0 0 LUNSFORD RICHARDSON JR 1.0 X 0 0 0 CORNELIUS T RYAN 1.0 X 0 0 0 AMY SCHAFRANN 2.0 X X 0 0 0 ERVIN R SHAMES 2.0 X 0 0 0 LUISA URIARTE 1.0 X 0 0 0 JOHN M WILSON JR MD 1.0 X 0 0 0 RICHARD ZELKOWITZ MD 1.0 X 0 0 0 FRANK N ZULLO ESQ 1.0 X 0 0 0 DIANE ALLISON ESQ 1.0 X 0 0 0 DANIEL DEBARBA 1.0 X 0 559945 26675 LEONARD DINARDO 1.0 X 0 0 0 JILL HANAU 1.0 X 0 0 0 PHILIP MORRIS 1.0 X 0 0 0 ALISON SCAVONE 1.0 X 0 0 0 PETER THORNER 1.0 X 0 0 0 LISA FERRARO 40.0 X 0 184605 25342 0 2001996 146198 0 false true false 0 544785 1428713 5015626 92973 6989124 0 622717 622717 0 0 0 0 7607071 7540927 66144 66144 66144 35200 544785 167926 -132726 -132726 0 0 0 0 0 7545259 0 0 556135 3022751 3022751 65500 65500 0 0 503336 257502 245834 0 625550 335395 290155 0 213553 111413 102140 68669 36812 31857 0 950 950 65160 65160 0 60603 60603 0 68156 6518 61638 0 85518 23985 61533 58661 58661 0 43200 43200 3604 3604 0 0 0 0 23160 23160 0 PATIENT CARE & OTHER PROGRAMS 3020060 3020060 EDUCATION, TRAINING & RESEARCH 189945 189945 FACILITIES, EQUIPMENT & TECH 34868 34868 DONOR RECOGNITION 21524 21524 DUES/MEMBERSHIP 22505 22505 31978 22369 9609 8229251 6333124 952573 943554 430161 392798 328535 428540 131033 131033 23160 27796301 27891739 208497 774736 28786654 29487813 2073 477 163025 59204 295523 61277 459025 X 0 0 19381735 19600080 9343642 9428708 28725377 29028788 28786654 29487813 X false true true X X 7763802 3558867 7254995 6145403 6989124 31712191 7763802 3558867 7254995 6145403 6989124 31712191 8862905 22849286 1582472 1254003 1069340 845570 622717 5374102 37086293 569634 0.61611 0.59544 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 9343642 85066 9428708 9338472 5170 9343642 0.00000 1.00000 0.00000 false false 0 131033 131033 0 0 0 DUE TO AFFILIATES 295523 295523 SCHEDULE D, PART V, LINE 4: NORWALK HOSPITAL FOUNDATION'S ENDOWED FUNDS ARE USED TO SUPPORT THE GENERAL CAPITAL AND OPERATING EXPENSES OF NORWALK HOSPITAL, SCHOLARSHIPS AND PERSONNEL. SCHEDULE D, PART X, LINE 2: THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE CONCERNING UNCERTAIN TAX POSITIONS UNDER FIN 48. X X X X X X true RUOTOLO ASSOCIATES INC CAMPAIGN STUDY false 0 60603 0 0 60603 0 CT GALA 118200 118200 117246 CANCER CTR WALK 301446 301446 1450 25398 5 160339 125139 35200 22375 1457 579985 544785 35200 23825 144101 167926 -132726 true NORWALK HOSPITAL ASSOCIATION 24 STEVENS STREET NORWALK CT 06850 066068853 3022751 1 0 STUDENT SCHOLARSHIPS 20 66500 SCHEDULE I, PART I, LINE 2: NORWALK HOSPITAL FOUNDATION SCHOLARSHIP COMMITTEE UTILIZES AN APPLICATION FORM LISTING ALL OF THE SCHOLARSHIPS AVAILABLE FROM THE FOUNDATION. APPLICATIONS ARE DISTRIBUTED THROUGHOUT NORWALK HOSPITAL AS WELL AS TO THE FINANCIAL AID OFFICES AND NURSING DEPARTMENTS AT LOCAL COLLEGES AND UNIVERSITIES AND GUIDANCE OFFICES AT LOCAL HIGH SCHOOLS. THE SCHOLARSHIP APPLICATION IS ALSO AVAILABLE ELECTRONICALLY ON THE NORWALK HOSPITAL FOUNDATION WEBSITE. COMPLETED SCHOLARSHIP APPLICATIONS ARE DUE TO THE FOUNDATION OFFICE BY THE END OF MAY. THE SCHOLARSHIP APPLICATIONS ARE REVIEWED BY A SCHOLARSHIP COMMITTEE, WHICH IS COMPRISED OF ONE NURSING DIRECTOR, ONE NURSE MANAGER, LEGAL COUNSEL, A HUMAN RESOURCES REPRESENTATIVE, A FOUNDATION BOARD MEMBER, THE FOUNDATION'S DIRECTOR OF DEVELOPMENT AND THE FUNDS MANAGER. APPLICATIONS ARE RATED ON ACADEMIC SUCCESS, FINANCIAL NEED, AND ESSAY COMPONENTS. THE SCHOLARSHIP COMMITTEE MEETS IN JUNE TO DISCUSS APPLICATION EVALUATIONS AND DETERMINE SCHOLARSHIP AWARDS. SCHOLARSHIPS ARE PAID DIRECTLY TO THE EDUCATIONAL INSTITUTION WITH HALF THE SCHOLARSHIP APPLIED TO THE STUDENT'S ACCOUNT IN THE FALL AND THE OTHER HALF APPLIED FOR THE SPRING SEMESTER. false true false false false false false false false MARY G FRANCO 0 248331 0 104811 0 19766 0 27127 0 14350 0 414385 0 0 GEOFFREY COLE 0 601346 0 270000 0 13192 0 33354 0 19350 0 937242 0 0 LISA FERRARO 0 169649 0 14612 0 344 0 11330 0 14012 0 209947 0 0 DANIEL DEBARBA 0 358704 0 183200 0 18041 0 11025 0 15650 0 586620 0 0 SCHEDULE J, PART I, LINE 4B: NORWALK HOSPITAL ASSOCIATION (NHA), A RELATED ORGANIZATION OF NORWALK HOSPITAL FOUNDATION (NHF), HAS ESTABLISHED THE NORWALK HOSPITAL SENIOR EXECUTIVE DEFERRED COMPENSATION PLAN, PRIMARILY FOR THE PURPOSE OF PROVIDING A PROGRAM OF DEFERRED COMPENSATION FOR GEOFFREY COLE, A TRUSTEE OF NHF AND PRESIDENT & CEO OF NHA UP TO 4/10/2010 AND DANIEL DEBARBA, A TRUSTEE OF NHF AND PRESIDENT & CEO OF NHA AS OF 4/12/2010. 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. COLE'S AND MR. DEBARBA'S 2009 W-2. X 7 92973 COST/SELLING PRICE false true true SCHEDULE M, PART I, COLUMN (B): NORWALK HOSPITAL FOUNDATION IS REPORTING SEVEN (7) DONORS WHO CONTRIBUTED STOCK. SCHEDULE M, PART I, LINE 32B: NORWALK HOSPITAL FOUNDATION USES A THIRD PARTY TO SELL NONCASH CONTRIBUTIONS OF STOCK. FORM 990, PART I, LINE 19: REVENUE LESS EXPENSES REFLECTS TRANSFERS OF ACCUMULATED FUNDS FROM THE NORWALK HOSPITAL FOUNDATION TO THE NORWALK HOSPITAL TOTALING $6,593,721. FISCAL YEAR 2010 CONTRIBUTIONS AND OPERATIONAL EXPENSES FOR THE FOUNDATION WERE AS FOLLOWS: REVENUE: $6,234,000 EXPENSES: $1,803,000 REVENUE LESS EXPENSES: $4,431,000 FORM 990, PART VI, LINE 2; PART VII; & PART IX, LINES 5-10: NORWALK HOSPITAL FOUNDATION DOES NOT HAVE ANY DIRECT EMPLOYEES. NORWALK HOSPITAL ASSOCIATION IS THE DESIGNATED COMMON PAYMASTER FOR THE INDIVIDUALS REPORTED IN FORM 990, PART VII, AND SCHEDULE J. COMPENSATION REPORTED IN PART IX OF THIS RETURN REPRESENTS AN ALLOCATION OF SALARIES AND BENEFITS PAID BY NORWALK HOSPITAL ASSOCIATION. NORWALK HOSPITAL FOUNDATION REIMBURSES NORWALK HOSPITAL ASSOCIATION FOR THESE EXPENSES. FORM 990, PART VI, LINE 2: FRANK ZULLO, ESQ. AND DIANE ALLISON ESQ. HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, LINES 6 & 7: NORWALK HEALTH SERVICES CORPORATION, INC. IS THE SOLE MEMBER OF NORWALK HOSPITAL FOUNDATION AND APPOINTS NORWALK HOSPITAL FOUNDATION'S BOARD OF DIRECTORS. FORM 990, PART VI, LINE 11 & 11A: NORWALK HOSPITAL FOUNDATION'S FORM 990 IS PREPARED WITH THE ASSISTANCE OF PRICEWATERHOUSECOOPERS AND REVIEWED BY NHF'S INTERNAL MANAGEMENT. FOLLOWING THAT REVIEW, NORWALK HOSPITAL FOUNDATION'S INTERNAL MANAGEMENT PRESENTS THE FORM 990 TO THE AUDIT COMMITTEE FOR REVIEW & COMMENT. THE COMPLETED FORM 990 EXCLUDING THE SCHEDULE OF CONTRIBUTIONS, SCHEDULE B, IS PROVIDED TO ALL MEMBERS OF THE BOARD PRIOR TO THE FORM BEING FILED WITH THE IRS. MANAGEMENT HAS DECIDED NOT TO DISTRIBUTE SCHEDULE B TO THE BOARD DUE TO THE SENSITIVITY TO DONOR IDENTITY AND CONTRIBUTIONS. FORM 990, PART VI, LINE 12C: OFFICERS, TRUSTEES, KEY EMPLOYEES, AND MANAGERS ARE SURVEYED ANNUALLY REGARDING INTERESTS THAT PRESENT POTENTIAL CONFLICTS. RESPONSES ARE SCREENED FOR POTENTIAL CONFLICTS, INDIVIDUALS ARE INTERVIEWED AS NECESSARY, AND SURVEY RESULTS ARE SHARED WITH THE CEO. INDIVIDUALS ARE REQUIRED TO DISCLOSE POTENTIAL CONFLICTS AT ANY MEETING OR DURING ANY DISCUSSION WHICH MAY BE AFFECTED BY THE POTENTIAL CONFLICT, AND THE INDIVIDUAL IS REQUIRED TO RECUSE HIMSELF/HERSELF ACCORDINGLY. FORM 990, PART VI, LINE 14: NORWALK HOSPITAL FOUNDATION IS IN THE PROCESS OF DRAFTING A FORMAL WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY. FORM 990, PART VI, LINE 15: NORWALK HOSPITAL FOUNDATION DOES NOT COMPENSATE ANY OFFICERS OR KEY EMPLOYEES. THE OFFICERS AND KEY EMPLOYEES RECEIVING COMPENSATION ARE COMPENSATED BY NORWALK HOSPITAL ASSOCIATION (NHA). THEREFORE, THEIR COMPENSATION AND BENEFITS ARE DETERMINED BY NHA. FORM 990, PART VI, LINE 19: NORWALK HOSPITAL FOUNDATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE CONFLICT OF INTEREST POLICY IS AVAILABLE THROUGH NORWALK HEALTH SERVICES CORPORATION UPON REQUEST. FORM 990, PART VII, SECTION A: THE INDIVIDUALS LISTED BELOW WORKED THE FOLLOWING HOURS PER WEEK FOR A RELATED ORGANIZATION DURING THE FISCAL YEAR: GEOFFREY COLE - 46 HOURS/WEEK DANIEL DEBARBA - 47 HOURS/WEEK ERVIN SHAMES - 8 HOURS/WEEK DIANE ALLISON - 8 HOURS/WEEK FRED AFGRAGOLA - 4 HOURS/WEEK MARIANNE CREW - 3 HOURS/WEEK DAVID LEHN - 3 HOURS/WEEK ROBERT OBERNIER - 3 HOURS/WEEK RICHARD ZELKOWITZ - 3 HOURS/WEEK FRANK ZULLO - 1 HOUR/WEEK SCHEDULE G, PART II, LINE 9: THE NET INCOME EVENT RESULTS IN SCHEDULE G, LINE 9 ARE ADJUSTED FOR CHARITABLE CONTRIBUTIONS. WHEN CHARITABLE CONTRIBUTIONS ARE CONSIDERED IN THE TOTAL AMOUNT THE ORGANIZATION RAISED FOR THE EVENT, THE NET RESULTS ARE CALCULATED AS DONATIONS LESS EXPENSES. CANCER CTR WALK OTHER EVENTS (5) DONATIONS: $301,446 $160,339 EXPENSES: ($26,848) ($23,832) NET PROFIT: $274,598 136,507 GALA EVENTS HAVE BEEN TRADITIONALLY HELD IN THE FALL, AND REVENUES AND EXPENSES WERE NOT BEING ACCRUED BY FISCAL YEAR. FOR EXAMPLE, SOME OF THE RESULTS OF THE GALA HELD ON OCTOBER 3, 2009 (IN FISCAL YEAR ENDING 9/30/2010) WERE RECORDED IN PRIOR FISCAL YEAR ENDING 9/30/2009. ADDITOINAL REVENUE FROM THE EVENT HELD OCTOBER 3, 2009 WAS REFLECTED IN FY2010: 10/03/2009 GALA TOTAL REVENUE: $530,100 TOTAL EXPENSES: ($210,060) NET PROFIT: $320,040 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-ii NHA NORWALK HEALTH CARE INC DBA HONEY HILL 34 MIDROCKS DRIVE NORWALK CT 06851 222577722 NURSING/REHAB CT 501(C)(3) 9 NHSC NORWALK HEALTH SERVICES CORP INC 24 STEVENS STREET NORWALK CT 06850 222577711 SUPPORT SVCS CT 501(C)(3) 11b-ii NA ADVANCED CENTER FOR REHAB MEDICINE 24 STEVENS STREET NORWALK CT 06850 061304799 INACTIVE CT 501(C)(3) 11b-ii NHSC MAPLE STREET INDEMNITY COMPANY LTD 980549862 CAPTIVE INSUR 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 true true false false false false false false true false true false false true false true false NORWALK HOSPITAL ASSOCIATION B 6238562 FAIRFIELD COUNTY MEDICAL SERVICES INC B 150000 NORWALK HEALTH CARE INC B 44532 NORWALK HOSPITAL ASSOCIATION C 1428713 NORWALK HOSPITAL ASSOCIATION J 43200 NORWALK HOSPITAL ASSOCIATION L 65160 NORWALK HOSPITAL ASSOCIATION O 1489732 NORWALK HOSPTIAL ASSOCIATION Q 5666000