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Hospital of Saint Raphael: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
Hospital of Saint Raphael (EIN 06-0653171)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-08-15
IRS object ID
201142289349301914
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)
Timestamp2011-08-15T14:51:25-05:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN060653171EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Hospital of Saint RaphaelBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHOSPNameControl
Phone2037893000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11450 Chapel StreetAddressLine1
CityNew HavenCity
StateCTState
ZIP Code06511ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJames R RudeName
TitleAssist Vice President FinanceTitle
Phone2037893575Phone
Date Signed2011-08-16DateSigned
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonChristopher M O'ConnorNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11450 Chapel StreetAddressLine1
CityNew HavenCity
StateCTState
ZIP Code06511ZIPCode
FieldValueIRS element (for citing)
Gross Receipts497082892GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitesrhs.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1907YearFormation
State Legal DomicileCTStateLegalDomicile
Activity Or Mission DescriptionNot for Profit HospitalActivityOrMissionDescription
Nbr Voting Members Governing Body22NbrVotingMembersGoverningBody
Nbr Independent Voting Members17NbrIndependentVotingMembers
Total Nbr Employees4327TotalNbrEmployees
Total Nbr Volunteers700TotalNbrVolunteers
Total Gross UBI6044284TotalGrossUBI
Net Unrelated Business Txbl Income-1949973NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year3913464ContributionsGrantsPriorYear
Contributions Grants Current Year3635690ContributionsGrantsCurrentYear
Program Service Revenue Prior Year458581236ProgramServiceRevenuePriorYear
Program Service Revenue CY471037065ProgramServiceRevenueCY
Investment Income Prior Year-752848InvestmentIncomePriorYear
Investment Income Current Year233861InvestmentIncomeCurrentYear
Other Revenue Prior Year15648933OtherRevenuePriorYear
Other Revenue Current Year20426376OtherRevenueCurrentYear
Total Revenue Prior Year477390785TotalRevenuePriorYear
Total Revenue Current Year495332992TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year271231119SalariesEtcPriorYear
Salaries Etc Current Year280314635SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year217859792OtherExpensePriorYear
Other Expenses Current Year215195197OtherExpensesCurrentYear
Total Expenses Prior Year489090911TotalExpensesPriorYear
Total Expenses Current Year495509832TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-11700126RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-176840RevenuesLessExpensesCY
Total Assets BOY285638091TotalAssetsBOY
Total Assets EOY283518684TotalAssetsEOY
Total Liabilities BOY315078439TotalLiabilitiesBOY
Total Liabilities EOY291639962TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-29440348NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-8121278NetAssetsOrFundBalancesEOY
Mission DescriptionThe Hospital of Saint Raphael is a community teaching hospital and health care resource sponsored and guided by the values of the Sisters of Charity of Saint Elizabeth and of the Roman Catholic Church. The mission is to witness, share in, and promote excellence in the healing ministry of Jesus Christ. The Hospital is committed to preserving the dignity and well-being of each individual, and assuring that every person is treated according to the principles of charity and justice. The Hospital accepts the Gospel challenge that prompted their founders of the sponsoring congregation, Saint Vincent DePaul, Saint Elizabeth Ann Seton, and Mother Mary Xavier Mehegan by pledging every loving service in their power to reach out to those in need of services.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense443364936Expense
Revenue485419157Revenue
DescriptionThe Hospital of Saint Raphael provides services to the poor and the medically underserved, as well as providing benefits to the broader community. The Hospital also provides services to other needy populations that may not qualify as poor but need special services and support. These include the cost of health promotion, health screening and education of the general community. Total discharges for the year were 24,479, Emergency Room Visits 53,801, Patient days 124,818, Clinic Visits 104,041, Inpatient Surgical Procedures 6,946 and Ambulatory Surgery 10,192.Description
Total Program Service Expense443364936TotalProgramServiceExpense
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 Stmt0IndependentAuditFinancialStmt
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 Individuals0GrantsToIndividuals
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 Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096264NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees4327NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account1ForeignFinancialAccount
Name Of Foreign CountryBDNameOfForeignCountry
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 Members22NbrVotingGoverningBodyMembers
Number Independent Voting Members17NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
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 Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Hospital of Saint Raphael Acctg DepBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2037893505TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11450 Chapel StreetAddressLine1
CityNew HavenCity
StateCTState
ZIP Code06511ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (46 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Vincent Calarco
Volunteer3.30X000
M Joseph Canavan
Volunteer5.00X000
James M Carolan
Volunteer3.00X000
Sister Teresa Confroy
Volunteer8.00X000
Ralph DeNatale MD
Volunteer5.00X1851000
Benedict Fernando MD
Volunteer3.00X8420400
Sister Mary Kathleen Flanagan
Volunteer2.50X000
Paul Fortgang MD
Volunteer2.00X000
Rev Bonita Grubbs
Volunteer3.00X100000
Bruce Lundberg MD
Volunteer4.00X20833300
Michele Macauda
Volunteer2.00X000
Linda Masci
Volunteer3.00X000
Larry McCurdy
Volunteer5.00X000
Sister Mary Morley
Volunteer8.50X000
Edward J Mullen
Volunteer1.00X000
Christopher M O'Connor
Chief Executive Officer40.00X014983922187X
Most Reverend Peter Rosazza
Volunteer1.50X000
Sister Maureen Shaughnessy
Volunteer6.00X000
James P Torgerson
Volunteer2.00X000
Kevin Twohig MD
Volunteer3.00X000
Sister Margaret Welch
Volunteer6.50X000
Prescott Wiske MD
Volunteer3.00X53000
Alan Kliger MD
Chief Medical Officer40.000692480138669X
Lawrence E McManus
Chief Financial Officer40.000436370215820X
Charles Hollander MD
Chief Medical Officer40.000491771232009X
John Burke
VP Information Services40.0002032450X
Elizabeth Conrad
VP, Human Resources40.00023687674577X
Peter Duffy
VP, Facility Operations40.00020859767083X
Sister Joan Granville
VP, Mission Services20.00017523950331X
W Scott Helton MD
Chair/Surgery40.000556288166286X
John Fitzgerald
Asst Vice President40.0012338103872X
Mary Kuncas
VP Patient Care Service40.00026529783141X
Janeanne Lubin-Szafranski
VP, General Counsel40.00031146189756X
James Rude
Asst Vice President Finance40.00187520036116X
Ronald Thomas MD
Chair/Emergency Med40.000530123130380X
Keith Williams MD
Chair/OB GYN40.000459382138130X
Marshal Mandelkern MD
Chair/Psychiatry40.00021025362078X
Lucinda VonBeren
VP, Corporate Affairs40.00017146155143X
Harish Gundluru MD
Dept of Med Physician40.00505423024822X
John Federico MD
Section Chief/Thoracic40.00494110029322X
Donald Kim MD
Director/SICU40.00440568029649X
Adam Waltman MD
ER Physician40.00424546019753X
Thomas DonahueMD
Sec Chief/Cardiology40.00405088034649X
Christopher McLaughlin MD
Former Volunteer Trustee0.001836700X
David Reynolds
Former Volunteer Trustee0.007118200X
David W Benfer
Former Chief Executive Officer0.0002711447674425X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2859381TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs7810129TotalReportableCompFrmRltdOrgs
Total Other Compensation2374326TotalOtherCompensation
Number Individuals GT100 K433NumberIndividualsGT100K
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
Cardinal Health
21377 Network PlaceChicagoIL60673Management20310284
Morrison Management
PO Box 102289AtlantaGA30368Dietary3400120
Yale University
PO Box 208087New HavenCT06511Medical1841514
Yale New Haven Hospital
20 York StreetNew HavenCT06511Medical1732666
Murphy Security Service LLC
PO Box 356New BritainCT06050Security1437398
FieldValueIRS element (for citing)
Number Of Contractors GT100 K42NumberOfContractorsGT100K
All Other Contributions3635690AllOtherContributions
Total Contributions3635690TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNet Patient ServicesDescription
Business Code621500BusinessCode
Total Revenue Column471037065TotalRevenueColumn
Related Or Exempt Function Income467842812RelatedOrExemptFunctionIncome
Unrelated Business Revenue3194253UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Program Service Revenue471037065TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column227511TotalRevenueColumn
Exclusion$227,511ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1756250Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1749900Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities6350Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column6350TotalRevenueColumn
Exclusion$6,350ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Physician Premiums52429828499612849961
Auxiliary4532203847338473
Advertising5111207070

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column17537872TotalRevenueColumn
Related Or Exempt Function Income17537872RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue20426376TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column495332992TotalRevenueColumn
Related Or Exempt Function Income485419157RelatedOrExemptFunctionIncome
Unrelated Business Revenue6044284UnrelatedBusinessRevenue
Exclusion$233,861ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total5265734Total
Program Services4642511ProgramServices
Management And General623223ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total221731213Total
Program Services195488328ProgramServices
Management And General26242885ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total8823381Total
Program Services7779094ProgramServices
Management And General1044287ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total29320133Total
Program Services25849964ProgramServices
Management And General3470169ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total15174174Total
Program Services13378242ProgramServices
Management And General1795932ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total202022Total
Program Services178112ProgramServices
Management And General23910ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total408676Total
Program Services360307ProgramServices
Management And General48369ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total383822Total
Program Services338395ProgramServices
Management And General45427ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total74265Total
Program Services65475ProgramServices
Management And General8790ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total28239450Total
Program Services24897185ProgramServices
Management And General3342265ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total893674Total
Program Services787904ProgramServices
Management And General105770ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total89806341Total
Program Services79177357ProgramServices
Management And General10628984ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total4911694Total
Program Services4330373ProgramServices
Management And General581321ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total13009964Total
Program Services11470176ProgramServices
Management And General1539788ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total777342Total
Program Services685340ProgramServices
Management And General92002ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total594548Total
Program Services524181ProgramServices
Management And General70367ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2902286Total
Program Services2558787ProgramServices
Management And General343499ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total14606590Total
Program Services12877834ProgramServices
Management And General1728756ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total3457004Total
Program Services3047852ProgramServices
Management And General409152ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
Bad debts - net2467099724670997
Pharmacy1957983019579830
Malpractice Insurance52900045290004
Red Cross charges38242843824284
Laundry and Linen15624041562404

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total495509832Total
Program Services443364936ProgramServices
Management And General52144896ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY21204104BOY
EOY12582506EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY53665511BOY
EOY46474066EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY2113213BOY
EOY2681453EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY7866688BOY
EOY7913605EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3917694BOY
EOY9995656EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis434645276LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec340443184LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY100116892BOY
EOY94202092EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY24357546BOY
EOY39974541EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY55546778BOY
EOY45843443EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY16849665BOY
EOY23851322EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY285638091BOY
EOY283518684EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY58631602BOY
EOY56144302EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY3187103BOY
EOY1946643EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY253259734BOY
EOY233549017EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY315078439BOY
EOY291639962EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-57824407BOY
EOY-38810360EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY15697222BOY
EOY17619759EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY12686837BOY
EOY13069323EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-29440348BOY
EOY-8121278EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY285638091BOY
EOY283518684EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
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)
Volunteers1Volunteers
Paid Staff Or Management1PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators1DirectContactLegislators
Direct Contact Legislators$13,797DirectContactLegislatorsAmount
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$168,184OtherActivitiesAmount
Total Lobbying Expenditures IIB181981TotalLobbyingExpendituresIIB
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 majority of lobbying by Saint Raphael employees takes place at the state and federal levels. During fiscal 2010, state law required Saint Raphael to register as a state lobbyist as well (as its Chief Executive Officer, its Chief Financial Officer, the Executive Director of Saint Regis Health Center and its Director of Community and Government Relations). These four individuals met with elected officials, sent correspondence, and educated the Saint Raphael community about proposed legislation. Occasionally, other Saint Raphael employees may be asked to write to their legislators about proposed healthcare legislation. These combined efforts constitue Saint Raphael's direct lobbying efforts. Other lobbying activites include: dues paid to a national coalition to influence Medicare reimbursement; background and research work completed by Saint Raphael employees and a legal firm concerning a variety of federal issues; and a lobbying contract with a federal lobbying firm. The Hospital is also a memeber of several trade associations, and periodically participates in their lobbying efforts since a portion of the dues paid to these groups (American Hospital Association, Catholic Health Association, Association of American Medical Colleges, Premier, Connecticut Hospital Association, and Connecticut Catholic Hospital Council) may be used for lobbying efforts.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance3122933BeginningOfYearBalance
Investment Earnings Or Losses308523InvestmentEarningsOrLosses
End Of Year Balance3431456EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance3173968BeginningOfYearBalance
Investment Earnings Or Losses-51035InvestmentEarningsOrLosses
End Of Year Balance3122933EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis5952401OtherCostOrOtherBasis
Book Value5952401BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis178290649OtherCostOrOtherBasis
Depreciation117123512Depreciation
Book Value61167137BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis45999749OtherCostOrOtherBasis
Depreciation44985986Depreciation
Book Value1013763BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis204402477OtherCostOrOtherBasis
Depreciation178333686Depreciation
Book Value26068791BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings94202092TotalOfBookValueLandBuildings

Other Securities OtherSecurities (4 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
Mutual Funds3473244F
Cash5895023F
Money Market Funds14228272F
CD's and Other22246904F
FieldValueIRS element (for citing)
Total Of Book Value Securities45843443TotalOfBookValueSecurities

Other Assets OtherAssets (8 entries)

DescriptionDescriptionBook ValueBookValue
Due from Affiliates13312504
Deferred financing costs1787565
Investment in Caritas4350000
Long Term Investments2188026
Cash Surrender Value of life insurance123876
Investment Cyberknife239353
Investment Yankee Alliance421111
SERP Deposit1428887
FieldValueIRS element (for citing)
Total Book Value Other Assets23851322TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (9 entries)

DescriptionDescriptionAmountAmount
Current Portion of Long Term Debt$70,804,456
Interest Payable$372,878
Post retirement Medical Costs$17,960,951
Accrued Pension - Defined Benefit Plan$96,264,582
Self Insurance - Workers Compensation$6,428,801
Outstanding Malpractice Losses Payable$12,668,293
Malpractice IBNR Costs$16,276,422
Third party payables$5,811,921
Other Long term liabilities$6,960,713
FieldValueIRS element (for citing)
Total Of Amounts233549017TotalOfAmounts
Total Revenue495332992TotalRevenue
Total Expenses495509832TotalExpenses
Excess Or Deficit For Year-176840ExcessOrDeficitForYear
Net Unrealized GL On Investments1463133NetUnrealizedGLOnInvestments
Other$20,032,777OtherAmount
Total Adjustments21495910TotalAdjustments
Excess Or Deficit Per FS21319070ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt497081436TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments1865409NetUnrealizedGainsInvestments
Revenue Not Rptd F9901865409RevenueNotRptdF990
Revenue Subtotal495216027RevenueSubtotal
Investment Expenses Not Included74265InvestmentExpensesNotIncluded
Other Revenues Not Included42700OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt116965RevenueNotRptdOnFinStmt
Total Revenue Per Form990495332992TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt495405896TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal495405896ExpensesSubtotal
Investment Expenses Not Included274265InvestmentExpensesNotIncluded2
Other Expenses Not Included29671OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt103936ExpensesNotRptdOnFinStmt
Total Expenses Per Form990495509832TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierExplanationExplanation
Part XI, Line 8 - Other Adjustments:Equity Transfer from DePaul Health Services Corporation: 1300000. Contributions restricted to Special Purpose Fund: 3428450. Gains on restricted Net Assets: 10286. Net assets released from restriction: -3635688. Change in interest in net assets of Saint Raphael Foundation, Inc.: -157961. Decrease in Minimum Pension Liability: -24291000. Net Equity Transfer from Saint Raphael Foundation, Inc.: 2119438. Net Equity Transfer from Xavier Corporation, Inc.: 264252. Post retirement Plan Curtailment Gain: 40995000.
Part XII, Line 4b - Other Adjustments:Elimination/reclass Subsidiary activity: 42700.
Part XIII, Line 4b - Other Adjustments:Elimination/reclass Subsidiary activity: 29671.
Footnote to financial statements that reports the organization's liability for uncertain tax positions under FIN 48: Based on status of tax matters as of September 30, 2010, there were no disclosures in the footnotes to the organization's financial statements related to uncertain tax positions under FIN 48.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage250.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
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 Served1940PersonsServed
Total Community Benefit Expense1972169TotalCommunityBenefitExpense
Direct Offsetting Revenue845043DirectOffsettingRevenue
Net Community Benefit Expense1127126NetCommunityBenefitExpense
Percent Of Total Expense0.00240PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Persons Served73651PersonsServed
Total Community Benefit Expense51202966TotalCommunityBenefitExpense
Direct Offsetting Revenue41286022DirectOffsettingRevenue
Net Community Benefit Expense9916944NetCommunityBenefitExpense
Percent Of Total Expense0.02110PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Persons Served12415PersonsServed
Total Community Benefit Expense8695611TotalCommunityBenefitExpense
Direct Offsetting Revenue3263426DirectOffsettingRevenue
Net Community Benefit Expense5432185NetCommunityBenefitExpense
Percent Of Total Expense0.01150PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Persons Served88006PersonsServed
Total Community Benefit Expense61870746TotalCommunityBenefitExpense
Direct Offsetting Revenue45394491DirectOffsettingRevenue
Net Community Benefit Expense16476255NetCommunityBenefitExpense
Percent Of Total Expense0.03500PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs6NumberOfActivitiesOrPrograms
Persons Served20318PersonsServed
Total Community Benefit Expense584364TotalCommunityBenefitExpense
Direct Offsetting Revenue21610DirectOffsettingRevenue
Net Community Benefit Expense562754NetCommunityBenefitExpense
Percent Of Total Expense0.00120PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Persons Served7182PersonsServed
Total Community Benefit Expense40701608TotalCommunityBenefitExpense
Direct Offsetting Revenue27807052DirectOffsettingRevenue
Net Community Benefit Expense12894556NetCommunityBenefitExpense
Percent Of Total Expense0.02740PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served30PersonsServed
Total Community Benefit Expense5056TotalCommunityBenefitExpense
Net Community Benefit Expense5056NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served821PersonsServed
Total Community Benefit Expense56233TotalCommunityBenefitExpense
Direct Offsetting Revenue100DirectOffsettingRevenue
Net Community Benefit Expense56133NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served1560PersonsServed
Total Community Benefit Expense447585TotalCommunityBenefitExpense
Net Community Benefit Expense447585NetCommunityBenefitExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs16NumberOfActivitiesOrPrograms
Persons Served29911PersonsServed
Total Community Benefit Expense41794846TotalCommunityBenefitExpense
Direct Offsetting Revenue27828762DirectOffsettingRevenue
Net Community Benefit Expense13966084NetCommunityBenefitExpense
Percent Of Total Expense0.02970PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs16NumberOfActivitiesOrPrograms
Persons Served117917PersonsServed
Total Community Benefit Expense103665592TotalCommunityBenefitExpense
Direct Offsetting Revenue73223253DirectOffsettingRevenue
Net Community Benefit Expense30442339NetCommunityBenefitExpense
Percent Of Total Expense0.06470PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense31200TotalCommunityBuildingExpense
Net Community Building Expense31200NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense704TotalCommunityBuildingExpense
Net Community Building Expense704NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served506PersonsServed
Total Community Building Expense40911TotalCommunityBuildingExpense
Net Community Building Expense40911NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense18036TotalCommunityBuildingExpense
Net Community Building Expense18036NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served50PersonsServed
Total Community Building Expense840TotalCommunityBuildingExpense
Net Community Building Expense840NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served20PersonsServed
Total Community Building Expense2933TotalCommunityBuildingExpense
Net Community Building Expense2933NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense192TotalCommunityBuildingExpense
Net Community Building Expense192NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served241PersonsServed
Total Community Building Expense184686TotalCommunityBuildingExpense
Direct Offsetting Revenue15000DirectOffsettingRevenue
Net Community Building Expense169686NetCommunityBuildingExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs8NumberOfActivitiesOrPrograms
Persons Served817PersonsServed
Total Community Building Expense279502TotalCommunityBuildingExpense
Direct Offsetting Revenue15000DirectOffsettingRevenue
Net Community Building Expense264502NetCommunityBuildingExpense
Percent Of Total Expense0.00060PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$9,027,118BadDebtExpenseAmount
Amount Attributable To6382172AmountAttributableTo
Amount Reimbursed By Medicare195304320AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare226690732CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-31386412MedicareSurplusOrShortfall

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 (3 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
CT CK Leasing LLC
Cyberkife stereotactic radiosurgery system.0.490900.13640
Health CT LLC
Provides comprehensive health care through hospital provider network.0.15800
Yankee Alliance LLC
Hospital supply chain management.0.11110

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

FieldValueIRS element (for citing)
Business Name Line1Hospital of Saint RaphaelBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11450 Chapel StreetAddressLine1
CityNew HavenCity
StateCTState
ZIP Code06511ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Bad Debt FootnotePart III, Line 4: The Hospital is committed to the community by providing services to the poor and the medically underserved, as well as providing benefits to the broader community. Focused on providing nondiscriminatory treatment of all patients, the Hospital fosters universal access to emergency care regardless of ability to pay. The Hospital grants credit without collateral to its patients, most of who are local residents and are insured under third-party payer arrangements. Services provided to the poor and the medically underserved include services provided to persons who cannot afford healthcare due to lack of resources, lack of insurance, or both. The Hospital considers care provided for which no payment was received from the patient or their insurer as uncompensated care. Uncompensated care is composed of free care provided, charity car provided, and bad debt expense. The Hospital makes available free care and financial assistance programs for qualifying patients. In accordance with established policies, during the registration, billing, and collection processes, a patients eligibility for free care and financial assistance is determined. For patients who were determined to have the ability to pay but did not, the Hospital provision for uncollectible accounts is bad debt expense.BadDebtFootnote
Shortfall As Community BenefitPart III, Line 8: The Medicare shortfall should be considered a part of the community benefit provided by the Hospital. Medicare patients who receive care at the Hospital are primarily local residents. They receive the same quality care as Medicaid and charity care patients.The costs reported on line 6 were estimated using a cost to charge ratio, which was derived by comparing total routine costs to total charges.ShortfallAsCommunityBenefit
Debt Collection PolicyPart III, Line 9b: Whenever it is determined that the patient qualifies for Charity Care, a Patient Accounts Representative will adjust the balance by the appropriate amount, and the residual balance (if any) will become the patients responsibility.DebtCollectionPolicy
Needs AssessmentPart VI, Line 2: The Hospital of Saint Raphael community benefit programs have been designed to meet the long standing needs of individuals living in our services area. The Hospital utilizes data from local, regional, state, and federal resources to develop and expand our community benefit program. Examples of these informational sources include Connecticut Department of Public Health 2009 Connecticut Health Disparities Report, CDC Behavioral Risk Factors Surveillance System, DATA Haven of South Central CT Community Data Well Being Indicators, and the Community Alliance for Research and Engagement at the School of Public Health- Yale University /2009 CARE Neighborhood Health Survey Results.NeedsAssessment
Patient Education AssistancePart VI, Line 3: The Hospital of Saint Raphael is committed to providing quality healthcare that is affordable and accessible to all, regardless of their ability to pay. To ensure that cost will not be a barrier to our community, we provide financial assistance coordinators who work closely with our patients to apply for eligible financial assistance programs, including assistance from our charitable resources. In addition there are brochures and signage in two languages indicating that financial assistance is available to qualified patients and their families.PatientEducationAssistance
Community InformationPart VI, Line 4: The Hospital of Saint Raphael is a 511-bed community teaching hospital located in New Haven. The Hospital of Saint Raphael's Service Area consists of the 22 towns which surround New Haven. The Service Area has a population of approximately 700,000. Average household income for the entire service area in 2010 was determined to be approximately $82,000. The City of New Haven demographics include a population of approximately 124,000, in 48,000 households. Average household income is $47,193 and per capita income is $16,393 with an unemployment rate of >10%.CommunityInformation
Community Building ActivitiesPart VI, Line 5: The Hospital of Saint Raphael's community building activities include: the HOPE Program which provides basic job skills training to members of the community in order to assist them in finding employment and improving their overall quality of life; Disaster Preparedness - the Disaster Preparedness Committee works with local agencies (police, fire, etc) to coordinate activities and prepare our staff in the event that a local disaster would occur; the maintenance of two Hospital parks and an adopted site within the neighborhood for community use; and periodic street patrols within the neighborhood promoting security and safety.CommunityBuildingActivities
Other InformationPart VI, Line 6: In addition to the community building activities identified in Part VI, line 5 and the quantified free or discounted health services identified in Part I, Charity Care and Certain Other Community Benefits at Cost, the Hospital of Saint Raphael provides the following community benefits: Community Health Improvement Services - provides free and discounted services, such as screenings, lectures, health fairs, support groups, consultations, and referrals to outside agencies, aimed toward improving the health of the community; Health Professions Education - in addition to our medical interns and residents program, we provide a training site for high school and college students who are interested in pursing other degrees within the medical industry; and Financial and In-Kind Contributions - we financially support other community organizations through sponsorships and in-kind donations via time spent by staff volunteering in the community.OtherInformation
Affiliated Health Care SystemPart VI, Line 7: Saint Raphael Healthcare System affiliated organizations include Saint Regis Nursing Home, Inc., d/b/a The Sister Anne Virginie Grimes Health Center and DePaul Health Services Corporation, both of which operate healthcare organizations that complement the care given at the Hospital of Saint Raphael. Our healthcare providing organizations are supported through the fund raising efforts of The Saint Raphael Foundation, Inc., the One for All Fund, and the Saint Raphael Auxiliary. These affiliated organizations share the Hospitals mission to witness, share in, and promote excellence in the healing ministry of Jesus Christ. The Saint Raphael Healthcare System and its affiliates are committed to preserving the dignity and well-being of each individual, and assuring that every person is treated according to the principles of charity and justice.AffiliatedHealthCareSystem
Reports Filed With StatesCTReportsFiledWithStates

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
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 Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (25 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
Bruce Lundberg MD
000020833300000208333000
Christopher M O'Connor
0142217000762209577012610017202600
Alan Kliger MD
0413759000278721012501601365308311490277451
Lawrence E McManus
0410653000257170198888016932065219000
Charles Hollander MD
038835500010341602156170163920723780095863
John Burke
000002032450000020324500
Elizabeth Conrad
022149300015383058152016425031145308776
Peter Duffy
019454400014053051094015989027568007445
Sister Joan Granville
0168080000715904401206319022557000
W Scott Helton MD
04901640006612401467020195840722574065330
Mary Kuncas
0238113000271840692410139000348438020044
Janeanne Lubin-Szafranski
0244201000672600729770167790401217060467
James Rude
1869480005720214520146640223636000
Ronald Thomas MD
04877930004233001087730216070660503036953
Keith Williams MD
0413628000457540129773083570597512045329
Marshal Mandelkern MD
02079550002298047034015044027233100
Lucinda VonBeren
015897800012483041493013650022660405760
Harish Gundluru MD
4591020230000233210105610142610530245000
John Federico MD
3417240760530763330147000146220523432000
Donald Kim MD
2412360995000998320147000149490470217000
Adam Waltman MD
351296036541036709013633061200444299000
Thomas DonahueMD
4046060004820147000199490439737000
Christopher McLaughlin MD
0000183670000018367000
David Reynolds
7118200000000071182000
David W Benfer
050021400022112330656615017810033858720855727

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 1aTaxable housing and automobile allowances are provided to Christopher M. O'Connor (current Saint Raphael Healthcare System Inc. Chief Executive Officer) under the terms of the individual's employment contract. Taxable housing and automobile allowances are provided to Lawrence E. McManus (Saint Raphael Healthcare System, Inc. Chief Financial Officer) under the terms of the individual's employment arrangement. In addition, reimbursements (non-taxable) are made for the business use of a social club. Taxable housing and automobile allowances are provided to John Burke (Saint Raphael Healthcare System, Inc. Chief Information Officer) under the terms of the individual's employment arrangement. A taxable automobile allowance is provided to Saint Raphael Healthcare System, Inc.'s Vice Presidents. Certain payments to David W. Benfer (former Saint Raphael Healthcare System, Inc. Chief Executive Officer) are for gross-up payments (taxable) under the terms of the individual's employment arrangement. In addition, reimbursements (non-taxable) are made for the business use of a social club.
Part I, Line 4b:The chief executive officer, chief financial officer, chief medical officer and key employees at the vice presidential/ clinical chairperson level are eligible to participate in a supplemental non-qualified retirement plan. During calendar 2009 payments were made under a terminated plan; such amounts are reported as a component of the value reported in Schedule J Part II Column (B)(iii) Other Reportable Compensation for the persons and amounts identified in Schedule J Part II Column (F) Compensation Reported in Prior Form 990. Also during calendar year 2009 provision was made for participation in another such plan; these amounts are reported as a component of the value reported in Schedule J Part II Column (C) Deferred Compensation for the following individuals- Alan Kliger, MD ($70,745), Lawrence E. McManus ($41,538), Elizabeth Conrad ($22,623), Peter Duffy ($19,877), Sister Joan Granville ($17,064), W. Scott Helton MD ($84,302), Mary Kuncas ($31,578), Janeanne Lubin-Szafranski ($34,626), Marshal Mandelkern MD ($21,258) Ronald Thomas MD ($58,752), Keith Williams MD ($74,996), Lucinda VonBeren ($16,268) David Benfer ($641,915) Charles Hollander MD ($50,917).
Part I, Line 7The chief executive officer, chief financial officer, chief medical officer and key employees at the vice presidential/ clinical chairperson level are eligible to earn incentive compensation based upon the achievement of Board of Trustees' approved metrics. During calendar year 2009 no payments were made for incentives related to fiscal year ended September 30, 2008. During fiscal year 2009 provision was made for incentives related to fiscal year ended September 30, 2009; such provision is reported in Schedule J as a component of Part II Column (C) "Deferred Compensation" for the following individuals - Alan Kliger MD ($39,571), Lawrence E. McManus ($150,000), Elizabeth Conrad ($21,760), Peter Duffy ($19,119), Sister Joan Granville ($16,414), Scott Helton MD ($47,700), Mary Kuncas ($23,365), Janeanne Lubin-Szafranski ($23,791), Marshal Mandelkern ($15,231), James Rude ($10,000), Ronald Thomas MD ($35,321), Keith Williams ($40,077), Lucinda Von Beren ($15,648), Charles Hollander ($150,000). Certain Hospital of Saint Raphael physician caregivers are elibigle to earn incentive compensation based upon the achievement of approved productivity metrics. During calendar year 2009 payments were made for such incentives as reported in Schedule J Part II Column (B) (ii) "Bonus and Incentive Compensation" for the persons and amounts identified.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuer
State of Connecticut Health and Educational Faciliaites Authority
06080618620774LY252004-12-1627599152See Schedule O below.00
State of Connecticut Health and Educational Faciliaites Authority
06080618620774LY332004-12-1625366864See Schedule O below.00

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundIssuance Costs From ProceedsIssuanceCostsFromProceedsCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
27599152151627619053821011
253668644653301011

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
000000
000000

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
000000
000000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section A, line 6Hospital of Saint Raphael is a membership corporation and the sole Member of the Hospital is the Saint Raphael Healthcare System, Inc.
Form 990, Part VI, Section A, line 7aSaint Raphael Healthcare System, Inc. is the sole Member of the Hospital of Saint Raphael.
Form 990, Part VI, Section A, line 7bThe following rights and powers are reserved to the Membership of the Hospital's sole Member: >To acquire, alienate or convey the real property or endowment funds of the Hospital having a value of $3,000,000 or more, or to place a mortgage on such property or funds in the amount of $3,000,000 or more. >To dispose of all or substantially all of the physical assets of the Hospital and to approve the merger or consolidation of the Hospital. >To borrow money and issue evidences of indebtedness in connection with the activities of the Hospital in the amount $3,000,000 or more, if such borrowings are to secured by mortgage, pledge or other lien on the Hospital's real property or endowment funds. >To organize or direct the organization of any corporation or other entity in which the Hospital will be a member or shareholder or have an equity interest greater than $1,000,000. >To dispose of stock or other equity interest of a corporation or other entity controlled by the Hospital. >To elect the Trustees of the Hospital who do not serve in an ex officio capacity. >To fill any vacancy occurring on the Board of Trustees, other than ex officio positions. >To amend the Certificate of Incorporation and Bylaws of the Hospital. >To appoint or remove the President of the Hospital. >To exercise any right specifically reserved to them in the certificate of incorporation of a subsidiary corporation controlled by the Hospital.
Form 990, Part VI, Section B, line 11The governing body reviewed key elements of the 990 prior to submission.
Form 990, Part VI, Section B, line 12cOfficers, trustees and key employees are required to complete the conflict of interest questionaire on an annual basis. Results of the questionaire are reviewed annually by the audit committee.
Form 990, Part VI, Section B, line 15Compensation of the organization's chief executive officer is determined by the Compensation Committee of the Board of Trustees (utilizing an independent compensation consultant in conjunction with a compensation survey of the relevant marketplace). The Compensation Committee maintains minutes of its meetings. The Chief Executive Officer is employed with a written employment contract. Compensation of the organization's other officers and most of its key employees are also determined by the Compensation Committee of the Board of Trustees (utilizing an independent compensation consultant in conjunction with a compensation survey of the relevant marketplace). The Compensation Committee maintains minutes of its meetings.
Form 990, Part VI, Section C, line 19The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.
Part 1 Column F Purpose Series L Refinance State of Connecticut Health and Educational Facilities Authority, Hospital of Saint Raphael Issue Series D and E (dated 4/1/1991), Series G (dated 1/1/1992) and Series F (dated 11/1/1993).
Part 1 Column F PUrpose Series M Refinance State of Connecticut Health and Educational Facilities Authority, Hospital of Saint Raphael Issue Series J and K (dated 1/8/1998) and fund a portion of the construction and renovation costs of a facilities upgrade at Saint Regis Health Center, Inc.
Schedule K, Part I, Bond Issues:On December 16, 2004 the Hospital of Saint Raphael, through the State of Connecticut Health and Educational Facilities Authority issued Series L Revenue Bonds in the amount of $29,525,000 and Series M Revenue Bonds in the amount of $30,420,000. A portion of the proceeds were allocated for use by Saint Regis Health Center, Inc. The totals reported on Schedule K are net of these amounts.
Form 990, Part VII, Line 1a, Column FAmounts reported for Ralph De Natale, MD reflect payments made to Connecticut Vascular Center in the normal and recurring course of Hospital of Saint Raphael business and are not related to the volunteer services provided by the trustee to the organization. Amounts reported for Benedict Fernando, MD include payments made to West Haven Medical Group as a stipend for his role as president of the Hospital of Saint Raphael Medical Staff. The medical staff president's responsibilities include participation as a Hospital trustee. Amounts reported for Rev. Bonita Grubbs reflect payments made to Christain Community Action in the normal and recurring course of Hospital of Saint Raphael business and are not related to the volunteer services provided by the trustee to the organization. Amounts reported for Bruce Lundberg, MD reflect payments made to Medical Oncology and Hematology in the normal and recurring course of Hospital of Saint Raphael business and are not related to the volunteer services provided by the trustee to the organization. Amounts reported for David Reynolds reflect payments made to Withers Bergman, LLC in the normal and recurring course of Hospital of Saint Raphael business and are not related to the volunteer services provided by the trustee to the organization. Amounts reported for Prescott Wiske, MD reflect payments made to Cardiology Associates of New Haven in the normal and recurring course of Hospital of Saint Raphael business and are not related to the volunteer services provided by the trustee to the organization. Amounts reported to Christopher McLaughlin, MD reflect payments made to his medical professional corporation (General Surgery PC) as a stipend in his former role as president of the Hospital of Saint Raphael Medical Staff.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Lukan Indemnity Co LtdBusinessNameLine1

Address Foreign AddressForeign

FieldValueIRS element (for citing)
Address Line1FB Perry Building 40 Church StreetAddressLine1
CityHamiltonCity
Province Or StateHamiltonProvinceOrState
CountryBDCountry
FieldValueIRS element (for citing)
EIN060653171EIN
Primary ActivitiesDirect and reinsurance malpracticePrimaryActivities
Legal Domicile Foreign CountryBDLegalDomicileForeignCountry
Total Income3732150TotalIncome
EOY Assets34395932EOYAssets

Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Saint Raphael Healthcare System Inc
659 George StreetNew HavenCT06511061157542Tax exempt holding companyCT501 (c) 311a
Caritas Insurance Company LTD
30 Main Street Suite 330BurlingtonVT05401030322238InsuranceVT501 (c) 311aHospital of Saint Raphael
Saint Raphael Foundation Inc
1450 Chapel StreetNew HavenCT06511510140710Fundraising FoundationCT501 (c) 311aSaint Raphael Healthcare System Inc
Saint Regis Health Center Inc
1354 Chapel StreetNew HavenCT06511061217867Skilled Nursing FacilityCT501 (c) 33Saint Raphael Healthcare System Inc
DePaul Health Services Corp
659 George StreetNew HavenCT06511061157544Tax exempt holding companyCT501 (c) 311aSaint Raphael Healthcare System Inc
Hospital of Saint Raphael One for All Fund
1450 Chapel StreetNew HavenCT06511222505062Fundraising OrganizationCT501 (c) 311aHospital of Saint Raphael
VNA Services Inc
1100 Sherman AvenueHamdenCT06518060646709Provision of healthcare services to patients in their homesCT501 (c) 39DePaul Health Services Corporation
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
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 Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (12 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Saint Raphael Healthcare System Inc
L2328925
Saint Raphael Healthcare System Inc
I25000
Saint Raphael Healthcare System Inc
C1300000
Caritas Insurance Company LTD
L1300000
Saint Raphael Healthcare System Inc
B326039
Saint Raphael Foundation Inc
C2492441
Saint Regis Health Center Inc
I30036
Saint Regis Health Center Inc
K931986
Saint Regis Health Center Inc
J18024
VNA Services Inc
P390000
Saint Raphael Healthcare System Inc
C264247
Saint Regis Health Center Inc
B46951