Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 10-01-2010 and ending 09-30-2011
BCheck if applicable:
CName of organization
GAYLORD HOSPITAL INC
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
PO BOX 400 GAYLORD FARM ROAD
 
Room/suite
City or town, state or country, and ZIP + 4
WALLINGFORD, CT06492
D Employer identification number

06-0646649
E Telephone number

G Gross receipts $ 933,435,567
F Name and address of principal officer:
JANINE L EPRIGHT
PO BOX 400 GAYLORD FARM ROAD
WALLINGFORD,CT06492
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.GAYLORD.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1991
M State of legal domicile: CT
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO PRESERVE & ENHANCE A PERSON'S HEALTH & FUNCTION
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 24
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 22
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 860
6 Total number of volunteers (estimate if necessary) .... 6 47
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 1,886,776 1,047,821
9 Program service revenue (Part VIII, line 2g) ......... 67,358,336 66,776,439
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 564,409 687,530
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 705,593 507,037
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 70,515,114 69,018,827
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 44,815,517 46,209,984
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet638,760    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 25,945,555 24,571,590
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 70,761,072 70,781,574
19 Revenue less expenses. Subtract line 18 from line 12...... -245,958 -1,762,747
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 93,186,921 87,088,723
21 Total liabilities (Part X, line 26)............ 50,988,173 51,976,811
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 42,198,748 35,111,912
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: TO PRESERVE AND ENHANCE A PERSON'S HEALTH AND FUNCTION
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 54,357,451 including grants of $   ) (Revenue $ 66,776,439 )
GAYLORD HOSPITAL IS A LONG-TERM ACUTE CARE HOSPITAL (LTACH) THAT SPECIALIZES IN THE CARE AND TREATMENT OF PEOPLE WITH MEDICALLY COMPLEX CONDITIONS, REHABILITATION NEEDS AND SLEEP MEDICINE DISORDERS. WHAT STARTED OUT AS A TUBERCULOSIS SANATORIUM CREATED BY THE NEW HAVEN COUNTY ANTI-TUBERCULOSIS ASSOCIATION IN 1902 HAS GROWN FROM SIX BUILDINGS AND A HALF DOZEN PATIENTS INTO A 137-BED, PRIVATE, NOT-FOR-PROFIT HOSPITAL ON 500 ACRES IN WALLINGFORD, CONNECTICUT. TODAY, GAYLORD HOSPITAL ADMITS MORE THAN 1,300 INPATIENTS AND 50,000 OUTPATIENT VISITS EACH YEAR AND OFFERS THE COMMUNITY MANY PROGRAMS THAT ADDRESS THEIR CONTINUING HEALTH CARE NEEDS. GAYLORD OFFERS SLEEP MEDICINE SERVICES IN GLASTONBURY, GUILFORD, NORTH HAVEN AND TRUMBULL. SLEEP MEDICINE EDUCATION AND RESEARCH IS COORDINATED THROUGH THE WALLINGFORD CAMPUS. OUTPATIENT THERAPY SERVICES ARE LOCATED IN NORTH HAVEN AND WALLINGFORD. LICENSED BY THE STATE OF CONNECTICUT AS A CHRONIC DISEASE HOSPITAL, GAYLORD HOSPITAL DRAWS PATIENTS FROM THROUGHOUT THE STATE AS WELL AS SOUTHERN NEW ENGLAND AND NEW YORK. AS A NOT-FOR-PROFIT ORGANIZATION, GAYLORD HOSPITAL IS COMMITTED TO DEVELOPING AND IMPLEMENTING COMMUNITY-BASED INITIATIVES DESIGNED TO PROMOTE HEALTH AND WELLNESS AMONG RESIDENTS.GAYLORD HOSPITAL ALSO SUPPORTS THE REGION'S ECONOMY AS THE THIRD LARGEST EMPLOYER IN WALLINGFORD, OPERATING WITH A STAFF OF APPROXIMATELY 687 FULL-TIME, PART-TIME AND PER-DIEM EMPLOYEES. GAYLORD HOSPITAL IS ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS. ITS INPATIENT REHABILITATION PROGRAM IS ACCREDITED BY THE COMMISSION FOR ACCREDITATION OF REHABILITATION FACILITIES. GAYLORD ALSO IS AFFILIATED WITH THE YALE UNIVERSITY SCHOOL OF MEDICINE AND THE UNIVERSITY OF CONNECTICUT SCHOOL OF MEDICINE.MISSION STATEMENT:GAYLORD HOSPITAL'S MISSION IS TO PRESERVE AND ENHANCE A PERSON'S HEALTH AND FUNCTION. THE ROLE OF THE HOSPITAL IN CONNECTICUT:GAYLORD HOSPITAL FULFILLS A UNIQUE PLACE IN THE HEALTH CARE CONTINUUM. THE HOSPITAL'S 137 LICENSED BEDS REPRESENT A SIGNIFICANT PART OF THE REHABILITATION, LONG-TERM ACUTE AND CHRONIC DISEASE HOSPITAL CAPACITY EXISTING IN THE STATE. GAYLORD FILLS THE GAP BETWEEN THE ACUTE CARE HOSPITAL AND OTHER TERTIARY LEVELS OF CARE SUCH AS THE SKILLED NURSING FACILITY, HOME CARE AGENCY OR ASSISTED LIVING CENTER. BY PROVIDING A HOSPITAL LEVEL OF CARE, GAYLORD OFFERS 24-HOUR MEDICAL, NURSING AND RESPIRATORY STAFF COVERAGE. THEREFORE, IT PROVIDES DIAGNOSTIC AND TREATMENT RESOURCES AT THE HOSPITAL LEVEL OF CARE, BUT WITH THE OPTION OF LONGER LENGTH OF STAY (25 DAYS OR MORE) AND AT LESS COST THAN AN ACUTE CARE HOSPITAL. (SEE DISCUSSION UNDER "MARKET SHARE" HEREIN.)MORE THAN 90 PERCENT OF THE HOSPITAL'S INPATIENT ADMISSIONS ARE FROM ACUTE CARE HOSPITALS. MOST OUTPATIENT THERAPY VISITS ARE DRIVEN BY PHYSICIAN REFERRALS, AS ARE SLEEP MEDICINE EVALUATIONS AND STUDIES.PROGRAM BACKGROUND AND KEY SERVICES:PATIENTS ADMITTED TO GAYLORD FOR INPATIENT SERVICES MAY TAKE ADVANTAGE OF THE MEDICAL DIVISION OR THE REHABILITATION DIVISION, DEPENDING ON THEIR INDIVIDUAL NEEDS. THE MEDICAL DIVISION CONSISTS OF THE MEDICALLY COMPLEX PROGRAM FOR PATIENTS WITH SERIOUS MEDICAL ISSUES DUE TO ILLNESS OR INJURY REQUIRING 24-HOUR MEDICAL AND NURSING SUPERVISION; THE VENTILATOR CARE PROGRAM FOR THE CARE AND WEANING OF PATIENTS FROM VENTILATORS, AND THE PULMONARY PROGRAM FOR THOSE WITH CHRONIC RESPIRATORY INSUFFICIENCY.THE REHABILITATION DIVISION ADDRESSES THE NEEDS OF PATIENTS AFTER EXPERIENCING ACUTE ACCIDENTS OR ILLNESSES THAT MAY LEAVE THEM DISABLED IN SOME WAY. THE HOSPITAL'S MAJOR PROGRAMS ARE IN BRAIN INJURY, NEUROLOGICAL REHABILITATION, ORTHOPEDICS, SPINAL CORD INJURY AND STROKE.PARTNERING WITH BOSTON MEDICAL CENTER, THE SPINAL CORD INJURY PROGRAM HAS BECOME DESIGNATED BY THE U.S. NATIONAL INSTITUTE ON DISABILITY AND REHABILITATION RESEARCH (NIDRR) AS A MODEL SYSTEM OF CARE FOR SPINAL CORD INJURY. ONLY 17 HEALTH CARE ORGANIZATIONS IN THE COUNTRY HAVE THIS DESIGNATION. GAYLORD CURRENTLY IS INVOLVED IN SPINAL CORD INJURY-RELATED CARE AND RESEARCH AS THE NEW ENGLAND REGIONAL SPINAL CORD INJURY CENTER (NERSCIC) AT GAYLORD. GAYLORD HOSPITAL, WORKING WITH MYOMO, INC., IS A PREMIER DEMONSTRATION PARTNER IN THE E100 NEUROROBOTIC SYSTEM, WHICH IS NEW MEDICAL DEVICE TECHNOLOGY DESIGNED TO HELP STROKE SURVIVORS REGAIN USE OF PARTIALLY PARALYZED LIMBS. THE TECHNOLOGY IS AVAILABLE TO PATIENTS IN BOTH INPATIENT AND OUTPATIENT SETTINGS AT GAYLORD.A KEY PROGRAM FOR PEOPLE WITH ACQUIRED BRAIN INJURY IS THE LOUIS D. TRAURIG TRANSITIONAL LIVING CENTER, A FREESTANDING, EIGHT-BED HOUSE ON THE MAIN CAMPUS THAT OFFERS THEM THE OPPORTUNITY TO PRACTICE PROBLEM-SOLVING TECHNIQUES AND ENHANCE SOCIAL SKILLS IN A SUPERVISED SETTING THROUGH PEER INTERACTION WHILE CONTINUING TO RECEIVE PHYSICIAN, NURSING AND THERAPY SERVICES. THE TRANSITIONAL LIVING CENTER IS THE ONLY FACILITY OF ITS KIND IN CONNECTICUT. IT IS LICENSED BY THE CONNECTICUT STATE DEPARTMENT OF PUBLIC HEALTH AND ADDICTION SERVICES.GAYLORD'S CONTINUUM OF CARE FOR PATIENTS IS EXTENDED THROUGH OUTPATIENT PHYSICIAN AND THERAPY SERVICES. IMPROVING ACCESSIBILITY TO OUTPATIENT REHABILITATION REMAINS ONE OF THE HOSPITAL'S PRIORITIES, WHICH IS WHY GAYLORD OFFERS STATE RESIDENTS TWO LOCATIONS FOR THERAPY SERVICES IN NORTH HAVEN AND WALLINGFORD. COLLECTIVELY, MORE THAN 40 CLINICAL SERVICES ENHANCE THE HOSPITAL'S OUTPATIENT TREATMENT PROGRAMS. GAYLORD ANSWERS CONNECTICUT'S NEED FOR SLEEP MEDICINE SERVICES AS THE LARGEST SINGLE PROVIDER IN THE STATE. ACCREDITED BY THE AMERICAN ACADEMY OF SLEEP MEDICINE, GAYLORD SLEEP MEDICINE INCLUDES A STAFF OF PHYSICIANS WHO ARE BOARD-CERTIFIED IN SLEEP MEDICINE AS WELL AS THE SPECIALTIES OF NEUROLOGY, PEDIATRICS, PULMONARY MEDICINE, CRITICAL CARE MEDICINE, AND INTERNAL MEDICINE. THE HOSPITAL OFFERS CONSULTATIVE AND DIAGNOSTIC SERVICES AT CENTERS IN GLASTONBURY, GUILFORD, NORTH HAVEN AND TRUMBULL. OUR WALLINGFORD OFFICE, LOCATED AT THE HOSPITAL'S MAIN CAMPUS, HOUSES GAYLORD'S SLEEP RESEARCH AND EDUCATION PROGRAM.PROFESSIONAL AND COMMUNITY EDUCATION:GAYLORD FOCUSES ON COMMUNITY RELATIONSHIPS TO PROMOTE WELLNESS AND ADVANCE HEALTH CARE THROUGH EDUCATION, RESEARCH AND IMPROVEMENT OF CLINICAL PRACTICE. EMPLOYEES ARE ACTIVELY ENGAGED IN COMMUNITY AND PROFESSIONAL ORGANIZATIONS. MORE THAN 340 STUDENTS PARTICIPATED IN ALMOST 2,440 HOURS OF EDUCATIONAL PROGRAMMING AT GAYLORD IN AREAS SUCH AS MEDICAL SERVICES, NURSING, PSYCHOLOGY, SOCIAL WORK, PHARMACY, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH AND LANGUAGE THERAPY, THERAPEUTIC RECREATION, RESPIRATORY THERAPY AND NUTRITION. WEEKLY MEDICAL AND REHABILITATION ROUNDS AT GAYLORD PROVIDED HEALTH CARE PROFESSIONALS AND LAY PEOPLE WITH DIVERSE TOPICS RELATED TO TIMELY TOPICS IN MEDICINE AND REHABILITATION. TWELVE ONE-HOUR PROGRAMS GRANTING CONTINUING MEDICAL EDUCATION CREDITS WERE PRESENTED BY STAFF AND GUEST LECTURERS. THE TOPICS FOCUSED ON DIAGNOSES AND TREATMENT OPTIONS IN SPINAL CORD INJURY, PULMONARY DISORDERS AND VENTILATOR WEANING, BRAIN INJURY, STROKE AND WOUND CARE.GAYLORD STAFF MEMBERS HAVE BEEN PUBLISHED IN VARIOUS MEDIA, PRIMARILY IN MEDICAL JOURNALS RELATED TO THEIR SPECIALTY. GAYLORD STAFF ALSO INTRODUCED THE HOSPITAL AND AN OVERVIEW OF ITS SERVICES TO APPROXIMATELY 72 HIGH SCHOOL STUDENTS TO EDUCATE THEM ABOUT CAREERS IN HEALTH CARE AND THE BENEFITS OFFERED TO PATIENTS.PATIENT AND FAMILY EDUCATION AND SUPPORT:THE CHALLENGES THAT ARE EXPERIENCED BY PEOPLE AFTER ILLNESS OR INJURY OFTEN REQUIRE UNDERSTANDING, ONGOING SUPPORT AND THE BEST SERVICES POSSIBLE. GAYLORD PROVIDES SOCIAL SERVICE, CASE MANAGEMENT, CHAPLAIN SERVICES AND PSYCHOLOGY SERVICES AS PART OF OUR STANDARD OF CARE. PATIENT AND FAMILY EDUCATION ALSO INCLUDES ONGOING INSTRUCTIONAL CLASSES FOR INPATIENTS AND THEIR FAMILIES AS WELL AS REGULARLY SCHEDULED, DIAGNOSIS-RELATED SUPPORT GROUPS.OTHER FORMS OF PATIENT AND FAMILY EDUCATION INCLUDE: - PATIENT AND FAMILY EDUCATION GUIDES ARE AVAILABLE TO PEOPLE WITH BRAIN INJURY, DIABETES, MULTIPLE SCLEROSIS, SPINAL CORD INJURY AND STROKE - A LIBRARY AND RESOURCE CENTER WITH A FULL-TIME MEDICAL LIBRARIAN - VALUE-ADDED SERVICES (FOR WHICH GAYLORD IS NOT REIMBURSED) INCLUDE: - THERAPEUTIC RECREATION AND SPORTS ACTIVITIES FOR THOSE WITH PHYSICAL DISABILITIES - SOCIAL WORK AND CASE MANAGEMENT TO GAYLORD'S TRANSITIONAL LIVING PROGRAM RESIDENTSSEE CONTINUATION OF DESCRIPTION.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 54,357,451
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. ..... Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..
21
 
No
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III.....
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I......
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II...........................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III...............
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV...................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV..
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule MClick to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............ Click to see attachment
30
Yes
 
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I........................... Click to see attachment
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
 
No
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
97
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
860
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletCJ
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
24
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
22
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
JANINE EPRIGHT
GAYLORD FARM ROAD
WALLINGFORD,CT06492
(203) 284-2800
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) JAMES J CULLEN
PRESIDENT & CEO
 40.00 X   X       452,480 0 23,833
(2) MICHAEL HOBEN
DIRECTOR
 1.00 X           0 0 0
(3) DONNA J CRANDLEY
DIRECTOR
 1.00 X           0 0 0
(4) ROBERT J LYONS JR
DIRECTOR
 1.00 X           0 0 0
(5) JEFFREY A STEIN
SECRETARY/DIRECTOR
 1.00 X           0 0 0
(6) DIANA WAKERLEY
DIRECTOR
 1.00 X           0 0 0
(7) KAREN A SCAPPATICCI
DIRECTOR
 1.00 X           0 0 0
(8) EDWARD H CANTOR ESQ
TREASURER/DIRECTOR
 1.00 X   X       0 0 0
(9) GARY L CARTER
VICE CHAIR/DIRECTOR
 1.00 X   X       0 0 0
(10) PETER DECKERS MD
DIRECTOR
 1.00 X           0 0 0
(11) JAMES MONIELLO
DIRECTOR
 1.00 X           0 0 0
(12) WILLIAM J SIMIONE JR
CHAIR/DIRECTOR
 1.00 X   X       0 0 0
(13) HORATIO W YEUNG PHD
DIRECTOR
 1.00 X           0 0 0
(14) KIM HEALY
DIRECTOR
 1.00 X           0 0 0
(15) ROBERT J MOBECK
DIRECTOR
 1.00 X           0 0 0
(16) JAMES FLINT MD
DIRECTOR
 1.00 X           0 0 0
(17) CAROL MILNE
DIRECTOR
 1.00 X           0 0 0
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) EDWARD O'CONNOR PHD
DIRECTOR
 1.00 X           0 0 0
(19) ETHAN WEINER MD
DIRECTOR
 1.00 X           0 0 0
(20) LUIS TEBA
VP & CMO
 40.00 X   X       270,074 0 13,735
(21) JON T WALWORTH
DIRECTOR
 1.00 X           0 0 0
(22) THOMAS BALCEZAK MD
DIRECTOR
 1.00 X           0 0 0
(23) EMILY LITTMAN PHD
DIRECTOR
 1.00 X           0 0 0
(24) JANINE EPRIGHT
VP & CFO
 40.00     X       251,197 0 16,509
(25) CHARLOTTE HYATT
VP & INPATIENT DIRECTOR
 40.00       X     164,426 0 7,122
(26) JACQUELINE A EPRIGHT
OUTPATIENT DIRECTOR
 40.00       X     153,074 0 16,392
(27) DR KEITH DIXON
PHYSICIAN/MEDICAL DIRECTOR SLEEP
 40.00         X   210,679 0 7,024
(28) DR MEIR KRYGER
PHYSICIAN SLEEP RESEARCH
 40.00         X   315,366 0 18,390
(29) DR DAVID ROSENBLUM
PHYSICIAN/MEDICAL DIRECTOR
 40.00         X   255,322 0 16,630
(30) DR ALYSE SICKLICK
PHYSICIAN/INPATIENT
 36.00         X   202,545 0 16,081
(31) DR ROCHELLE TURETSKY
PHYSICIAN/SLEEP
 40.00         X   189,184 0 1,297
(32) ANDREA GELZER MD
FORMER KEY EMPLOYEE
 40.00           X 328,433 0 3,605
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 2,792,780 0 140,618
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet42
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
HMP OF NEW HAVEN COUNTY LLC
4535 DRESSLER RD NW
CANTON,OH44718 		PHYSICIAN SERVICES 966,670
SLEEP HEALTH CENTERS LLC
300 ROSEWOOD DRIVE
DANVERS,MA01923 		MANAGEMENT SERVICES 265,677
MURPHY SECURITY SERVICES
PO BOX 356
NEW BRITAIN,CT06050 		HOSPITAL SECURITY 257,741
GAYLORD WELLNESS ASSOCIATES LLC
200 FISHER DRIVE
AVON,CT06001 		RENT 220,059
SHIPMAN & GOODWIN LLP
ONE CONSTITUTION PLAZA
HARTFORD,CT06103 		LEGAL SERVICES 184,711
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet13
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		1,047,821
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 1,047,821
Program Service Revenue Business Code
2a PATIENT SERVICE REV. 624,310 66,776,439 66,776,439    
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 66,776,439
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 546,700     546,700
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents 245,017  
b Less: rental expenses    
c Rental income or (loss) 245,017  
d Net rental income or (loss).......MediumBullet 245,017     245,017
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 864,557,570  
b Less: cost or other basis and sales expenses 864,416,740  
c Gain or (loss) 140,830  
d Net gain or (loss)..........MediumBullet 140,830     140,830
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a NET ASSETS RELEASED FR 624,310 145,235     145,235
b OTHER OPERATING REVENU 624,310 116,785     116,785
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 262,020
12 Total revenue. See Instructions....MediumBullet 69,018,827 66,776,439 0 1,194,567
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21    
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 1,492,785   1,492,785  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 35,369,858 31,467,466 3,468,579 433,813
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 963,041 822,262 129,348 11,431
9 Other employee benefits ....... 5,781,054 4,900,214 818,035 62,805
10 Payroll taxes ........... 2,603,246 2,223,909 348,970 30,367
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 198,870   198,870  
c Accounting ........... 141,038   141,038  
d Lobbying ........... 79,555   79,555  
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ......        
g Other .......... 7,576,764 5,661,826 1,869,214 45,724
12 Advertising and promotion .... 369,910   367,128 2,782
13 Office expenses ....... 1,231,391 641,587 544,813 44,991
14 Information technology ...... 423,405   423,405  
15 Royalties ..        
16 Occupancy ........... 1,968,306 1,539,871 428,435  
17 Travel ............ 137,551 119,537 13,642 4,372
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 78,997 54,580 22,669 1,748
20 Interest ........... 912,116   912,116  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 3,825,731   3,825,731  
23 Insurance .............. 1,093,292 800,959 292,333  
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a DRUGS 2,775,547 2,775,547    
b GENERAL MEDICAL SUPPLIE 1,957,076 1,957,076    
c RENTAL EQUIPMENT 846,485 771,219 75,266  
d RECRUITING FEES/HELP WA 376,597 331,405 45,192  
e BAD DEBTS 344,715   344,715  
f All other expenses 234,244 289,993 -56,476 727
25 Total functional expenses. Add lines 1 through 24f 70,781,574 54,357,451 15,785,363 638,760
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 2,183,087 1 487,626
2 Savings and temporary cash investments .......   2  
3 Pledges and grants receivable, net ......... 689,220 3 696,762
4 Accounts receivable, net ......... 9,115,849 4 10,001,815
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use ..............   8  
9 Prepaid expenses and deferred charges ............ 565,740 9 1,021,320
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 93,344,498
b Less: accumulated depreciation. ..... 10b 51,406,912 44,202,592 10c 41,937,586
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ...... 32,127,644 12 28,972,002
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 4,302,789 15 3,971,612
16 Total assets. Add lines 1 through 15 (must equal line 34)... 93,186,921 16 87,088,723
Liabilities 17 Accounts payable and accrued expenses . 23,529,688 17 26,067,233
18 Grants payable ..........   18  
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities .......... 19,775,000 20 19,135,000
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 7,683,485 25 6,774,578
26 Total liabilities. Add lines 17 through 25..... 50,988,173 26 51,976,811
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 24,748,041 27 18,625,933
28 Temporarily restricted net assets ..... 1,781,818 28 1,207,234
29 Permanently restricted net assets ..... 15,668,889 29 15,278,745
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 42,198,748 33 35,111,912
34 Total liabilities and net assets/fund balances ..... 93,186,921 34 87,088,723
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
69,018,827
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
70,781,574
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
-1,762,747
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
42,198,748
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
-5,324,089
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
35,111,912
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
Yes
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
GAYLORD HOSPITAL INC
 
Employer identification number

06-0646649
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
GAYLORD HOSPITAL INC
 
Employer identification number

06-0646649
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
GAYLORD HOSPITAL INC
  		Employer identification number

06-0646649
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
GAYLORD HOSPITAL INC
  		Employer identification number

06-0646649
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
GAYLORD HOSPITAL INC
  		Employer identification number

06-0646649
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
GAYLORD HOSPITAL INC
 
Employer identification number

06-0646649
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities ....................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2010

Schedule C (Form 990 or 990-EZ) 2010
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check Click to see attachment
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
Organization's
Totals 		(b) Affiliated Group
Totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ...... 0 0
b Total lobbying expenditures to influence a legislative body (direct lobbying) ....... 79,555 79,555
c Total lobbying expenditures (add lines 1a and 1b) ................... 79,555 79,555
d Other exempt purpose expenditures ........................ 54,277,896 54,277,896
e Total exempt purpose expenditures (add lines 1c and 1d) ............... 54,357,451 54,357,451
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		 1,000,000 1,000,000
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) ................. 250,000 250,000
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................ 0 0
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................ 0 0
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) Total
             
2a Lobbying non-taxable amount 1,000,000 1,000,000 1,000,000 1,000,000 4,000,000
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		        6,000,000
             
c Total lobbying expenditures 21,814 37,000 136,337 79,555 274,706
             
d Grassroots non-taxable amount 250,000 250,000 250,000 250,000 1,000,000
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		         1,500,000
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2010


Schedule C (Form 990 or 990-EZ) 2010
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
 
c
Media advertisements? ....................................
 
 
 
d
Mailings to members, legislators, or the public? .........................
 
 
 
e
Publications, or published or broadcast statements? .......................
 
 
 
f
Grants to other organizations for lobbying purposes? .......................
 
 
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
 
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
 
 
i
Other activities? If "Yes," describe in Part IV ..........................
 
 
 
j
Total. lines 1c through 1i ...................................
 
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
 
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
GAYLORD HOSPITAL INC
 
Employer identification number

06-0646649
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 21,959,224 21,181,655 32,790,054
b Contributions ........ 29,320 514,253 124,588
c Investment earnings or losses ... -734,869 2,429,752 -137,889
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		2,030,629 2,166,436 -1,651,192
f Administrative expenses ....      
g End of year balance ...... 19,223,046 21,959,224 31,125,561
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet72.000 %
b
Permanent endowment: SchDMd Bullet28.000 %
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   1,911,843 1,911,843
b Buildings ................   56,381,815 25,552,749 30,829,066
c Leasehold improvements ............   2,815,981 1,010,393 1,805,588
d Equipment ................   32,234,859 24,843,770 7,391,089
e Other .................        
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 41,937,586
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
(3)Other
(A) OTHER MARKETABLE SECURITIES 		2,366,019 F

(B) MARKETABLE EQUITY SECURITITES 		5,164,432 F

(C) MUTUAL FUNDS 		11,692,595 F

(D) BENEFICIAL INTEREST IN TRUSTS HELD BY OTHERS 		9,748,956 F





Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet 28,972,002
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
DUE TO THIRD PARTY 246,805
CAPITAL LEASE OBLIGATIONS 416,044
INTEREST RATE SWAP LIABILITIES 4,155,222
LEASE ABANDONMENT OBLIGATIONS 106,507
LINE OF CREDIT 450,000
TERM LOAN PROMISSORY NOTE 1,400,000



Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 6,774,578
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 69,018,827
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 70,781,574
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 -1,762,747
4 Net unrealized gains (losses) on investments .......................... 4 -1,279,169
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8 -4,044,920
9 Total adjustments (net). Add lines 4 - 8 ............................. 9 -5,324,089
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 -7,086,836
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 69,018,827
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e 0
3 Subtract line 2e from line 1..................... 3 69,018,827
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b  
c Add lines 4a and 4b....................... 4c 0
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5 69,018,827
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 71,295,071
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d 513,497
e Add lines 2a through 2d...................... 2e 513,497
3 Subtract line 2e from line 1..................... 3 70,781,574
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c 0
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5 70,781,574
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ENDOWMENT CONSISTS OF MULTIPLE FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE ENDOWMENT INCLUDES BOTH DONOR-RESTRICTED ENDOWMENT FUNDS AND FUNDS DESIGNATED BY THE BOARD OF DIRECTORS TO FUNCTION AS ENDOWMENTS. THE TEMPORARILY RESTRICTED NET ASSETS ARE AVAILABLE FOR HEALTH CARE SERVICES SUCH AS PATIENT SPECIAL NEEDS, AS WELL AS OTHER RESTRICTED PURPOSES AND CAPITAL CAMPAIGNS. THE PERMANENTLY RESTRICTED NET ASSETS ARE RESTRICTED FOR THE PURPOSES OF INVESTMENTS TO BE HELD IN PERPETUITY, THE INCOME OF WHICH IS EXPENDABLE TO SUPPORT PATIENT SPECIAL NEEDS AND OTHER SERVICES; AND FOR THE BENEFICIAL INTEREST IN TRUSTS HELD BY OTHERS, THE INCOME OF WHICH IS EXPENDABLE TO SUPPORT OTHER HEALTH CARE SERVICES.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ASSOCIATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS WITH PROVISIONS OF FASB ASC 740, "INCOME TAXES" WHICH PROVIDE A FRAMEWORK FOR HOW COMPANIES SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE UNCERTAIN TAX POSITIONS IN THEIR CONSOLIDATED FINANCIAL STATEMENTS. THE ASSOCIATION 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 ASSOCIATION DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2011 AND 2010. AS OF SEPTEMBER 30, 2011 AND 2010, THE ASSOCIATION DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNCERTAIN TAX POSITIONS. THE ASSOCIATION'S PRIOR THREE TAX YEARS ARE OPEN AND SUBJECT TO EXAMINIATION BY THE INTERNAL REVENUE SERVICE.
PART XI, LINE 8 - OTHER ADJUSTMENTS:   PENSION RELATED CHANGES -3,183,532. GAINS (LOSSES) ON TRUST -419,464. NET ASSETS RELEASED FROM RESTRICTIONS -145,235. CHANGES IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT -508,193. LOSS ON EQUITY INVESTMENTS -5,304. RESTRICTED CONTRIBUTIONS 216,808.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:   LOSS ON EQUITY INVESTMENTS 5,304. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT 508,193.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
GAYLORD HOSPITAL INC
 
Employer identification number

06-0646649
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
 
No
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
 
No
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
 
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
 
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) .. 		  11 53,299 0 53,299 0.080 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		    9,762,397 7,251,510 2,510,887 3.550 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....            
dTotal Charity Care and
Means-Tested Government Programs ..... 		  11 9,815,696 7,251,510 2,564,186 3.630 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		18   3,540 0 3,540 0.010 %
f Health professions education
(from Worksheet 5) .. 		222 340 74,515 0 74,515 0.110 %
g Subsidized health services
(from Worksheet 6) .. 		           
h Research (from Worksheet 7)            
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		    19,369 0 19,369 0.030 %
jTotal Other Benefits ... 240 340 97,424   97,424 0.150 %
kTotal. Add lines 7d and 7j. .. 240 351 9,913,120 7,251,510 2,661,610 3.780 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support 880 45,768 153,703 0 153,703 0.220 %
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building 65 2,000 7,260 0 7,260 0.010 %
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total 945 47,768 160,963   160,963 0.230 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense (at cost).....
2
344,715
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
0
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
27,913,507
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
27,865,715
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
47,792
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
11 NORTH HAVEN FITNESS & WELLNESS LLC
  		FITNESS CENTER 50.000 % 0 % 0 %
22 GAYLORD SLEEP HEALTH CENTER INC
  		SLEEP DME 50.000 % 0 % 0 %
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 GAYLORD HOSPITAL INC
PO BOX 400
WALLINGFORD,CT06492 		X               LONG TERM ACUTE CARE HOSPITAL/OUTPATIENT CLINIC/SLEEP SERVICES
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:GAYLORD HOSPITAL INC
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1   No
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for free care: 250.000000000000%
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10   No
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14 Yes  
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16 Yes  
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18   No
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 7
Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?  
Name and address Type of Facility (Describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
    PART II: AS A SPECIALTY HOSPITAL, GAYLORD RESPONDS TO THE NEEDS OF THE COMMUNITY BASED ON THE EXPERTISE AND RESOURCES IT MAINTAINS. THESE ACTIVITIES FOCUS ON MEDICAL REHABILITATION, THERAPY SERVICES, REHABILITATION NURSING, AND COMMUNITY GOODWILL ENDEAVORS (SUCH AS MONETARY DONATIONS TO CHARITABLE COMMUNITY CAUSES AND VOLUNTEER INVOLVEMENT IN COMMUNITY ACTIVITIES DESIGNED TO PROMOTE WELLNESS OR CAUSES FOR UNDERSERVED POPULATIONS). OVERALL, 48,108 INDIVIDUALS WERE SERVED IN DIRECT COMMUNITY BUILDING ACTIVITIES.
    PART III, LINE 4: BAD DEBT IS RECORDED AT NET VALUE (AMOUNT COLLECTIBLE FROM THE PAYER). CHARITY CARE IS BROKEN OUT TO ANOTHER SECTION AND NO ACCOUNTS ELIGIBLE FOR CHARITY CARE UNDER HOSPITAL POLICY ARE INCLUDED IN THE BAD DEBT NUMBER. MONTHLY, MANAGEMENT REVIEWS ACCOUNTS RECEIVABLE FOR UNCOLLECTIBLE AMOUNTS AND RECORDS AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON SPECIFICALLY IDENTIFIED ACCOUNTS, AS WELL AS AN AMOUNT FOR EXPECTED BAD DEBT BASED ON HISTORICAL LOSSES.
    PART III, LINE 9B: HOSPITAL PRACTICE IS TO CONTACT THE PATIENT PRIOR TO COLLECTIONS OR WRITE OFF OF ANY OUTSTANDING RECEIVABLE AMOUNT AND INQUIRE AGAIN WHETHER THEY WOULD LIKE TO APPLY OR THINK THEY QUALIFY FOR FREE CARE UNDER OUR HOSPITAL POLICY. IF AFTER REVIEW THE PATIENT QUALIFIES, THEN THE AMOUNT WOULD BE ADJUSTED AS CHARITY CARE; IF NOT, THE DEBT WOULD GO TO COLLECTIONS AND FOLLOW THE COLLECTION/BAD DEBT POLICY FROM THERE.
GAYLORD HOSPITAL, INC.   PART V, SECTION B, LINE 15E: THE HOSPITALS POLICIES FOR BILLING AND COLLECTIONS DO NOT ADDRESS THE PROCESS FOR COLLECTING LATE OR BAD DEBT. IT STOPS WITH THE DEFINITIONS OF HOW NOTIFICATION OF DEBT WILL BE COMMUNICATED AND REFERENCES THE FREE CARE POLICY FOR THOSE WHO QUALIFY.
GAYLORD HOSPITAL, INC.   PART V, SECTION B, LINE 16E: THE HOSPITAL HAS ENGAGED A THIRD PARTY COLLECTION AGENCY TO HELP US RESOLVE THE COLLECTION OF BAD DEBTS.
    PART VI, LINE 3: GAYLORD HOSPITAL INFORMS PATIENTS AND THEIR FAMILIES ABOUT FINANCIAL ASSISTANCE AND THE CHARITY CARE POLICY DURING THE REFERRAL AND ADMISSION PROCESS FOR ALL SERVICES. INFORMATION IS POSTED THROUGHOUT THE HOSPITAL AND ITS SATELLITE LOCATIONS, AS WELL AS ON THE HOSPITAL'S WEBSITE AND IN THE PATIENT HANDBOOK.
    PART VI, LINE 4: GAYLORD HOSPITAL, AS A REFERRAL HOSPITAL AND ONE OF ONLY TWO LONG-TERM ACUTE CARE HOSPITALS IN CONNECTICUT, PRIMARILY SERVES RESIDENTS OF THE STATE BUT ALSO ADMITS PATIENTS FROM NEIGHBORING STATES AS WELL. THE HOSPITAL'S PRIMARY SERVICE AREA TOWNS INCLUDE MERIDEN, NEW HAVEN, WALLINGFORD, AND WATERBURY. THE SECONDARY SERVICE AREA TOWNS ARE CHESHIRE, HAMDEN, MIDDLETOWN, NAUGATUCK, NORTH HAVEN, AND WEST HAVEN. THESE TOWNS REPRESENT APPROXIMATELY HALF OF THE HOSPITAL'S DISCHARGES. THE MAJORITY OF PATIENTS ARE AGE 62 OR OLDER, WITH SLIGHTLY MORE PERCENTAGE OF MEN THAN WOMEN. GAYLORD DOES NOT INCLUDE VERIFICATION OF RACIAL BACKGROUND IN ITS ADMISSIONS PROCESS.
    PART VI, LINE 6: GAYLORD WELLNESS LECTURE SERIES: A HEALTH CARE LECTURE SERIES IS PRESENTED BY HOSPITAL STAFF TO THE COMMUNITY AT NO CHARGE. IN 2010-2011, GAYLORD STAFF CONDUCTED 3 PRESENTATIONS, SERVING 120 PEOPLE WITHIN THE COMMUNITIES. THE HOSPITAL ASSUMED THE COST OF ADVERTISING THESE FREE COMMUNITY EVENTS, AT $10,800.WOUNDED WARRIOR DISABLED SPORTS PROJECT: WORKING WITH THE WOUNDED WARRIOR DISABLED SPORTS PROJECT, GAYLORD PARTNERED WITH DISABLED SPORTS USA TO CREATE A FOUR-DAY EVENT FOR WOUNDED WAR VETERANS OF CONFLICTS IN IRAQ AND AFGHANISTAN. STAFF FROM ALL AREAS OF THE HOSPITAL (MEDICAL, CLINICAL, ADMINISTRATIVE, SUPPORT SERVICES) WORKED WITH THESE ORGANIZATIONS TO BRING VETERANS AND THEIR FAMILIES TO CONNECTICUT FOR A LONG WEEKEND WHERE THEY WERE INTRODUCED TO ADAPTIVE WATER SPORTS AND CAMARADERIE. TWELVE EMPLOYEES ON THE COMMITTEE DEVOTED 230 HOURS IN PLANNING AND ORGANIZING, PLUS 30 PEOPLE VOLUNTEERED FOR THE FOUR-DAY EVENT CONTRIBUTING 816 HOURS OF TIME. TWENTY-FIVE INJURED WAR VETERANS AND 17 GUESTS WERE SERVED THROUGH THIS PROJECT.COMMUNITY NOT-FOR-PROFIT MEETING SPACE:GAYLORD OPENS ITS MEETING ROOMS TO AREA NOT-FOR-PROFIT ORGANIZATIONS IN NEED OF MEETING SPACE AT NO COST TO THE VISITING ORGANIZATION. PRIORITY IS GIVEN TO ORGANIZATIONS WITH A HEALTH CARE FOCUS. DURING 2010-2011, GAYLORD WELCOMED 30 GROUPS WHO MET 312 TIMES. THE HOSPITAL ALSO PROVIDED STAFF RESOURCES TO SET UP AND CLEAN UP FOR EACH MEETING, AT A TOTAL ESTIMATE OF 300 MAN HOURS. BASED ON ESTIMATED ATTENDANCE, 180 PEOPLE HAVE BEEN SERVED IN THIS ACTIVITY.HEALTH SCREENINGS:GAYLORD SPONSORED 5 SEPARATE HEALTH SCREENINGS, WHICH CONSISTED OF 3 FALL SCREENINGS, ONE HEARING SCREENING AND ONE BLOOD PRESSURE SCREENING, AT AREA SENIOR CENTERS PROVIDING 44 HOURS OF STAFF TIME AND SERVING APPROXIMATELY 172 PEOPLE.AMERICAN RED CROSS BLOOD DRIVES:THE HOSPITAL WORKED WITH THE AMERICAN RED CROSS TO SPONSOR ONE BLOOD DRIVE. THE HOSPITAL DONATED SPACE TO THE AMERICAN RED CROSS FOR THE DRIVE, AND SUPPLIED EMPLOYEE VOLUNTEERS TO HELP COORDINATE AND MANAGE THE ACTIVITY. A TOTAL OF 45 EMPLOYEES PARTICIPATED, DONATING 64.50 HOURS OF TIME. SINCE THE AMERICAN RED CROSS ESTIMATES THAT ONE UNIT OF BLOOD CAN SAVE UP TO THREE LIVES, IT IS ESTIMATED THAT GAYLORD EMPLOYEES HAD THE POTENTIAL TO SERVE 135 PEOPLE.WALLINGFORD EMERGENCY SHELTER:THE SHELTER OFFERS A SAFE, SUPERVISED OVERNIGHT SETTING FOR THE AREA'S HOMELESS FROM LATE FALL THROUGH WINTER. THE SHELTER ALSO PROVIDES A HEALTHY DINNER AND BREAKFAST TO CLIENTS, WHO ALSO INCLUDE THE AREA'S POOR AND INDIGENT POPULATION. FORTY-FIVE EMPLOYEES REPORTED THEIR PARTICIPATION IN THIS ACTIVITY OVER 82 HOURS, SERVING APPROXIMATELY 400 PEOPLE.SUPPORT GROUPS:GAYLORD HOSPITAL OFFERS TWO 12-STEP GROUPS FREE USE OF MEETING SPACE TO CONDUCT SUPPORT GROUPS THROUGHOUT THE YEAR. SINCE THESE GROUPS ARE ANONYMOUS, WITHOUT ATTENDANCE RECORDS, IT IS ESTIMATED THAT BASED ON 104 MEETINGS THROUGHOUT THE YEAR, THAT APPROXIMATELY 60 PEOPLE ARE SERVED THROUGH THIS PROGRAM, WITH THE HOSPITAL PROVIDING APPROXIMATELY 100 MAN HOURS IN HUMAN RESOURCES TO PREPARE THE MEETING SPACE.THE HOSPITAL ALSO SPONSORS FIVE SUPPORT GROUPS THAT ARE OPEN TO THE COMMUNITY, SERVING THOSE WITH SPINAL CORD INJURY, STROKE, TRAUMATIC BRAIN INJURY AND PULMONARY ISSUES. MOST MEET MONTHLY IN HOSPITAL MEETING SPACE. APPROXIMATELY 120 PEOPLE ARE SERVED IN THESE ACTIVITIES.
Schedule H (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
GAYLORD HOSPITAL INC
 
Employer identification number

06-0646649
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) JAMES J CULLEN (i)
(ii)		 421,227
0 		31,253
0 		0
0 		0
0 		23,833
0 		476,313
0 		0
0
(2) LUIS TEBA (i)
(ii)		 270,074
0 		0
0 		0
0 		0
0 		13,735
0 		283,809
0 		0
0
(3) JANINE EPRIGHT (i)
(ii)		 251,197
0 		0
0 		0
0 		0
0 		16,509
0 		267,706
0 		0
0
(4) CHARLOTTE HYATT (i)
(ii)		 164,426
0 		0
0 		0
0 		0
0 		7,122
0 		171,548
0 		0
0
(5) JACQUELINE A EPRIGHT (i)
(ii)		 153,074
0 		0
0 		0
0 		0
0 		16,392
0 		169,466
0 		0
0
(6) DR KEITH DIXON (i)
(ii)		 210,679
0 		0
0 		0
0 		0
0 		7,024
0 		217,703
0 		0
0
(7) DR MEIR KRYGER (i)
(ii)		 315,366
0 		0
0 		0
0 		0
0 		18,390
0 		333,756
0 		0
0
(8) DR DAVID ROSENBLUM (i)
(ii)		 255,322
0 		0
0 		0
0 		0
0 		16,630
0 		271,952
0 		0
0
(9) DR ALYSE SICKLICK (i)
(ii)		 202,545
0 		0
0 		0
0 		0
0 		16,081
0 		218,626
0 		0
0
(10) DR ROCHELLE TURETSKY (i)
(ii)		 189,184
0 		0
0 		0
0 		0
0 		1,297
0 		190,481
0 		0
0
(11) ANDREA GELZER MD (i)
(ii)		 308,433
0 		20,000
0 		0
0 		0
0 		3,605
0 		332,038
0 		0
0





Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
SUPPLEMENTAL INFORMATION PART III PART 1 - LINE 4B (FROM ALL RELATED ORGANIZATIONS): JAMES J. CULLEN - SERP CONTRIBUTION - $221,441
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
GAYLORD HOSPITAL INC
 
Employer identification number
06-0646649
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A STATE OF CONNECTICUT HEALTH AND EDUCATIONAL FACILITIES AUTHORITY (CHEFA)
  		06-0806186 20774UNQ4 04-01-2007 21,530,000 CONSTRUCTION OF A 36-BED ADDITION X     X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . .        
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 21,530,000      
4 Gross proceeds in reserve funds . .        
5 Capitalized interest from proceeds.        
6 Proceeds in refunding escrow. . . . .        
7 Issuance costs from proceeds . . . 449,233      
8 Credit enhancement from proceeds.        
9 Working capital expenditures from proceeds . .        
10 Capital expenditures from proceeds . .        
11 Other spent proceeds . .        
12 Other unspent proceeds. . .        
13 Year of substantial completion . . . 2008
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue?   X            
15 Were the bonds issued as part of an advance refunding issue? X              
16 Has the final allocation of proceeds been made? . . X              
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X              
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X            
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .   X            
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use?   X            
b Are there any research agreements that may result in private business use of bond-financed property? . .   X            
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? .   X            
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0 %      
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet 0 %      
6 Total of lines 4 and 5 . . .. . . . . . 0 %      
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X              
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X            
2 Is the bond issue a variable rate issue? X              
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X            
b Name of provider .  
  		 
  		 
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .                
e Was a hedge terminated? .                
4a Were gross proceeds invested in a GIC? .   X            
b Name of provider .  
  		 
  		 
  		 
 
c Term of GIC . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? .                
5 Were any gross proceeds invested beyond an available temporary period? .   X            
6 Did the bond issue qualify for an exception to rebate? . . .   X            
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (Form 990) 2010

Additional Data


Software ID:  
Software Version:  

SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
NonCash Contributions
Right pointing arrow large imageComplete if the organization answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
GAYLORD HOSPITAL INC
 
Employer identification number

06-0646649
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of Contributions or items contributed 		(c)
Contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		X 3,700 FMV
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded .        
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles ..... X 1 10,000 COST
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( GIFT CERTIFICATES & MISC ) X 85 22,009 COST
26 Other Right pointing arrow large image ( FOOD ) X 24 60,915 COST
27 Other Right pointing arrow large image ( EQUIPMENT ) X 9 55,053 COST
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell non-cash
contributions? ............................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report revenues in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) 2010
Schedule M (Form 990) 2010
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33. Also complete this part for any additional information.
Identifier Return Reference Explanation
Schedule M (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
GAYLORD HOSPITAL INC
 
Employer identification number

06-0646649
Identifier Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 6   THE HOSPITAL HAS ONE CLASS OF MEMBERS. THERE IS ONE SOLE MEMBER OF THE HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7A   THERE IS ONE SOLE MEMBER OF THE HOSPITAL. THE MEMBER HAS THE POWER TO ELECT THE BOARD OF DIRECTORS OF THE HOSPITAL. THE MEMBER HAS OTHER RIGHTS, POWERS AND PRIVILEGES USUALLY OR BY LAW ACCORDED TO THE MEMBERS OF A NONSTOCK NON-PROFIT CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11   A MEETING IS HELD PRIOR TO FILING, WITH THE AUDIT COMMITTEE OF THE BOARD AND SENIOR MANAGEMENT IN ORDER TO REVIEW THE 990 RETURNS. AFTER REVIEW, THE COMMITTEE REPORTS BACK TO THE FULL BOARD AND REVIEWS THE 990 WITH THEM. THE FULL BOARD THEN VOTES TO ACCEPT OR AMEND.
  FORM 990, PART VI, SECTION B, LINE 12C ANY CONFLICT OF INTEREST SITUATION MUST BE DISCLOSED TO THE BOARD OF DIRECTORS OF THE ASSOCIATION OR THE COMPLIANCE OFFICER IMMEDIATELY AND SUCH DIRECTOR, OFFICER OR EMPLOYEE WITH A CONFLICT OF INTEREST WILL BE REQUIRED TO REFRAIN FROM PARTICIPATING IN ANY DISCUSSION OR ACTION CONCERNING SUCH CONFLICTED SITUATION.
  FORM 990, PART VI, SECTION B, LINE 15 GAYLORD HAS CONTRACTED WITH TOWERS PERRIN TO PERFORM A TOTAL COMPENSATION REVIEW OF THREE KEY POSITIONS IN SENIOR MANAGEMENT: THE CEO, THE CFO AND THE CMO AND USE ONLY SOUTHERN NEW ENGLAND SURVEY DATA FOR THE VICE PRESIDENT OF CLINICAL SERVICES, THE VICE PRESIDENT OF HUMAN RESOURCES, THE VICE PRESIDENT OF DEVELOPMENT AND THE VICE PRESIDENT OF MARKETING/PUBLIC RELATIONS. THIS PROCESS WILL BE DONE ANNUALLY FOR THE AFOREMENTIONED POSITIONS. A REPORT WILL BE MADE BY THE VICE PRESIDENT OF HUMAN RESOURCES TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS ANNUALLY FOR THEIR ENDORSEMENT. THE LAST COMPENSATION REVIEW OCCURRED DURING THE SPRING/SUMMER OF 2011.
  FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -1,279,169. PENSION RELATED CHANGES -3,183,532. GAINS (LOSSES) ON TRUST -419,464. NET ASSETS RELEASED FROM RESTRICTIONS -145,235. CHANGES IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT -508,193. LOSS ON EQUITY INVESTMENTS -5,304. RESTRICTED CONTRIBUTIONS 216,808. TOTAL TO FORM 990, PART XI, LINE 5: -5,324,089.
  FORM 990, PART XI, LINE 2C THE AUDIT COMMITTEE IS RESPONSIBLE FOR REVIEWING WITH THE INDEPENDENT AUDITORS THE SCOPE OF THEIR EXAMINATION, WITH PARTICULAR EMPHASIS ON THE AREAS TO WHICH THE COMMITTEE BELIEVES SPECIAL ATTENTION SHOULD BE DIRECTED; AND SHALL REVIEW, AND IMPLEMENT AS REQUIRED, THE ANNUAL FINANCIAL AUDIT AND MANAGEMENT RECOMMENDATIONS OF THE INDEPENDENT AUDITORS. THE COMMITTEE SHALL ACQUAINT ITSELF WITH THE QUALITY AND DEPTH OF STAFFING OF THE CORPORATION'S ACCOUNTING AND FINANCIAL FUNCTIONS AND OF THE INTERNAL CONTROL SYSTEMS. THE COMMITTEE SHALL EVALUATE THE PERFORMANCE OF THE INDEPENDENT AUDITORS AND SHALL MAKE RECOMMENDATIONS, ANNUALLY OR WITH GREATER FREQUENCY AS NECESSARY, TO THE BOARD OF DIRECTORS ON THE ANNUAL SELECTION OF THE INDEPENDENT AUDITING FIRM OR ON ANY OTHER AUDIT MATTERS. THE AUDIT OVERSIGHT PROCESS AND SELECTION PROCESS OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED SINCE THE PREVIOUS YEAR.
CONTINUATION OF PROGRAM SERVICES DESCRIPTION FORM 990, PART III, LINE 4A GAYLORD OFFERS LOW-COST PROGRAMS SUCH AS A COMMUNITY AQUATICS PROGRAM AND A FITNESS PROGRAM FOR PEOPLE WITH DISABILITIES TO PROMOTE HEALTH AND WELLNESS. ASSISTIVE TECHNOLOGY EVALUATIONS ARE AVAILABLE, AS IS OUTPATIENT NUTRITIONAL COUNSELING. UNDERSCORING THE IMPORTANCE OF PATIENT AND FAMILY EDUCATION, GAYLORD SPONSORS SUPPORT GROUPS SUCH AS: ADULT CHILDREN OF ALCOHOLICS, AL-ANON, ALCOHOLICS ANONYMOUS AND NARCOTICS ANONYMOUS GROUPS; THE PEER SUPPORT PROGRAM FOR PEOPLE WITH SPINAL CORD INJURY; STROKE SUPPORT GROUP; BRAIN INJURY PATIENT AND FAMILY SUPPORT GROUP; BETTER BREATHERS GROUP. GAYLORD EMPLOYEES REPORT A TOTAL OF 100 HOURS SPENT IN THE COORDINATION, COUNSELING AND SUPPORT OF THESE GROUPS. ADDITIONAL HOSPITAL-FUNDED ACTIVITIES INCLUDE: SERVICES (INTERPRETERS, TTY'S, ASSISTIVE LISTENING DEVICES, VOLUME-CONTROLLED TELEPHONES AND CAPTIONED TV) FOR INDIVIDUALS WHO ARE DEAF OR HEARING IMPAIRED; INTERPRETER SERVICES FOR NON-ENGLISH-SPEAKING PATIENTS AND FAMILIES; CULTURAL AWARENESS AND DIVERSITY EDUCATION; HEALTH LITERACY AWARENESS AND PROMOTION; COMMUNITY RE-ENTRY SERVICES, AND A PATIENT ADVOCACY PROGRAM. GAYLORD MAKES A COMMITMENT TO PROMOTE ACCESSIBILITY OF ALL SERVICES FOR PEOPLE WITH DISABILITIES INCLUDING APPROPRIATE EQUIPMENT FOR INDIVIDUALS WHO HAVE BARIATRIC NEEDS. ACCESSIBILITY ASSESSMENTS HAVE ALSO BEEN OFFERED TO CHURCHES AND PUBLIC BUILDINGS. FINANCIAL AND VOLUNTEER CONTRIBUTIONS GAYLORD EMPLOYEES MADE CONTRIBUTIONS OF TIME AND MONEY TO HOSPITAL-SPONSORED PROGRAMS AND COMMUNITY ENDEAVORS. GAYLORD EMPLOYEES CONTRIBUTED OVER $74,681 TO THE ANNUAL APPEAL - A VOLUNTARY GIVING PROGRAM TO WHICH EMPLOYEES DESIGNATE WHERE THEIR FUNDS ARE USED WITHIN THE HOSPITAL. THE ANNUAL GAYLORD GOLF CLASSIC TOURNAMENT, HELD EVERY JUNE, NETTED $66,477 AFTER EXPENSES. THE PROCEEDS SUPPORT THE HOSPITAL'S THERAPEUTIC RECREATION DEPARTMENT PROGRAM. THE HOSPITAL ALSO JOINED FORCES WITH HARTFORD'S AMERICAN HOCKEY LEAGUE TEAM IN A FUNDRAISING EVENT TO SUPPORT INPATIENT THERAPY SERVICES. THE EVENT RAISED ALMOST $32,747 FOR PATIENT CARE. THE HOSPITAL ENCOURAGES EMPLOYEES TO PARTICIPATE IN VOLUNTEER OPPORTUNITIES THAT BENEFIT THE COMMUNITY, AND SPONSORS A NUMBER OF GROUP ACTIVITIES THAT HELP CONNECT THE HOSPITAL AND ITS STAFF WITH CAUSES IDENTIFIED AS COMMUNITY NEED. MORE THAN 94 HOURS OF GAYLORD VOLUNTEER TIME IS GIVEN YEARLY TO PREPARE AND SERVE MEALS AT THE WALLINGFORD EMERGENCY SHELTER, WITH SEVEN EMPLOYEES REPORTING PARTICIPATION. STAFF ALSO CONTRIBUTED MORE THAN 250 TOYS TO THE "WE ARE THE CHILDREN" HOLIDAY TOY DRIVE CAMPAIGN IN CONNECTICUT AND REPRESENTED GAYLORD WITHIN THE COMMUNITY THROUGH VOLUNTEER ENDEAVORS RANGING FROM THE GREATER NEW HAVEN HEART WALK, WALLINGFORD ADOPT-A-ROAD PROGRAM, AND RELAY FOR LIFE. EMPLOYEES REPORTED RAISING, COLLECTIVELY, $12,000 FOR THE GREATER NEW HAVEN HEART WALK AND $2,500 FOR THE AMERICAN CANCER SOCIETY RELAY FOR LIFE. THE IMPACT OF HOSPITAL VOLUNTEERS IS OUTSTANDING; 47 VOLUNTEERS GAVE OVER 9,730 HOURS TO GAYLORD, WHICH IS EQUIVALENT TO 4.7 FULL-TIME EMPLOYEES. CONTRIBUTIONS FROM HOSPITAL SUPPORTERS AND EMPLOYEES TO THE GOFF MEMORIAL SPECIAL NEEDS FUND TOTALED $9,204; APPROXIMATELY $14,625 OF THIS FUND WAS USED TO HELP MULTIPLE INDIVIDUALS MEET THE CHALLENGES OF AN INDEPENDENT LIFE. ITEMS MADE AVAILABLE THROUGH THE FUND INCLUDED: TUB BENCHES, MEDICAL SUPPLIES AND SERVICES, ADAPTIVE EQUIPMENT, CLOTHING, PERSONAL CARE ITEMS, FOOD AND TRANSPORT DEVICES SUCH AS WHEELCHAIRS AND WALKERS. INSURANCE COUNSELING WAS MADE AVAILABLE TO ASSIST INDIVIDUALS IN APPLYING FOR BENEFITS. IN ADDITION, GAYLORD PROVIDED QUALITY, FREE UNCOMPENSATED CARE THROUGH THE "FREE BED FUND" IN THE AMOUNT OF $53,299. GAYLORD PROVIDED OFFICE SPACE AND FINANCIAL CONTRIBUTIONS TO THE NATIONAL SPINAL CORD INJURY ASSOCIATION, CT CHAPTER THROUGH DUES, EXPENSES FOR PEER VISITORS AND CONTRIBUTIONS TO THEIR FUNDRAISERS. THE HOSPITAL'S COMMUNITY RELATIONS COMMITTEE MAKES REGULAR CONTRIBUTIONS TO COMMUNITY-BASED, NONPROFIT ORGANIZATIONS AND HEALTH-RELATED CAUSES SUCH AS RELAY FOR LIFE, THE BRAIN INJURY ASSOCIATION OF CONNECTICUT, PROJECT GRADUATIONS, AND LOCAL SOFTBALL AND LITTLE LEAGUE TEAMS. FINANCIAL SUPPORT TOTALED APPROXIMATELY $10,000. COMMUNITY HEALTH AND WELLNESS GAYLORD EMPLOYEES DEVOTED OVER 3,000 HOURS TO A NUMBER OF HEALTH AND WELLNESS RELATED ACTIVITIES FOR THE COMMUNITY INCLUDING: THE GAYLORD WELLNESS CENTER LECTURE SERIES (PRESENTATIONS DEALING WITH TOPICS SUCH AS SLEEP DISORDERS, PHYSICAL THERAPY, LYMPHEDEMA, STRESS MANAGEMENT, SPORTS-RELATED INJURIES, FALLS INJURY PREVENTION, HEARING LOSS, OBESITY AND CURRENT TREATMENTS IN STROKE.) THREE LECTURES ON FALLS INJURY PREVENTION TO AREA SENIOR CITIZENS. ADMINISTERING FREE HEARING SCREENINGS TO CHILDREN AND ADULTS. DONATING MORE THAN 130 HOURS OF EMPLOYEE TIME TO DEVELOP AND ADMINISTER A WELLNESS PROGRAM THAT PROMOTED HEALTHY LIFESTYLES FOR EMPLOYEES. DEVOTING 90 HOURS TO THE AMERICAN CANCER SOCIETY AND 200 HOURS TO THE GREATER NEW HAVEN HEART WALK. A COMMUNITY PROGRAM, THINKFIRST, IS A TRAUMA PREVENTION PROGRAM AIMED AT SCHOOL-AGED CHILDREN FROM ELEMENTARY THROUGH HIGH SCHOOL. THE PROGRAM WAS RECEIVED BY FIVE SCHOOLS IN THE STATE, REACHING APPROXIMATELY 250 STUDENTS RANGING IN AGES FROM 12 THROUGH 18. THE PROGRAM USES A "NO-PREACHING" METHOD AND INCLUDES REAL-LIFE STORIES WITH INDIVIDUALS WHO HAVE EXPERIENCED EITHER A BRAIN INJURY OR SPINAL CORD INJURY IN THE PRESENTATIONS TO EDUCATE STUDENTS ABOUT THE REALITY OF TRAUMATIC INJURIES. ADVOCACY GAYLORD BELONGS TO TWO TRADE ORGANIZATIONS: THE NATIONAL ASSOCIATION OF LONG TERM HOSPITALS (NALTH) AND THE AMERICAN MEDICAL REHABILITATION PROVIDERS ASSOCIATION (AMRPA). THE ORGANIZATIONS ADDRESS ISSUES THAT COULD INFLUENCE LEGISLATION AFFECTING ACCESS TO CARE. SEVERAL MEMBERS OF SENIOR MANAGEMENT PARTICIPATED ON COMMITTEES AND ATTENDED MEETINGS. TAKING A LEADERSHIP ROLE IN THE ADVOCACY OF PEOPLE WITH DISABILITIES, INDIVIDUAL STAFF MEMBERS HOLD OFFICES OR BOARD POSITIONS WITH ADVOCACY GROUPS SUCH AS THE BRAIN INJURY ASSOCIATION OF CONNECTICUT AND THE NATIONAL SPINAL CORD INJURY ASSOCIATION-CONNECTICUT CHAPTER. STAFF CONTRIBUTED APPROXIMATELY 15 HOURS OF VOLUNTEER TIME RELATED TO THESE ROLES. OTHER SUPPORT SERVICES AND SPONSORED EVENTS GAYLORD HELD A NUMBER OF EVENTS DESIGNED TO INCREASE AWARENESS OF DISABILITY (SUCH AS AN EXHIBITION OF PATIENT ART WORK AND A GOLF TOURNAMENT FOR PEOPLE WITH DISABILITIES), OR TO MEET A DESIGNATED COMMUNITY NEED (SUCH AS A HOSPITAL-SPONSORED HOLIDAY PARTY FOR UNDERPRIVILEGED CHILDREN FROM NEIGHBORING TOWNS, ONE ON-SITE BLOOD DRIVE WITH THE AMERICAN RED CROSS.) CREATING OPPORTUNITIES FOR PEOPLE WITH DISABILITIES TO MAXIMIZE THEIR INDIVIDUAL FUNCTIONALITY LIES IN THE HOSPITAL'S MISSION. GAYLORD'S THERAPEUTIC RECREATION DEPARTMENT SPONSORED A NUMBER OF DISCOVERY NIGHT SESSIONS DESIGNED TO INTRODUCE PEOPLE WITH DISABILITIES TO ADAPTIVE SPORTING ACTIVITIES, INCLUDING WHEELCHAIR TENNIS, SKIING, SCUBA DIVING, SAILING, HORSEBACK RIDING, WATERSKIING, HAND CYCLING AND KAYAKING. GAYLORD CONTINUED TO HOST ARCHERY CLINICS, GOLF CLINICS, AND A WHEELCHAIR TENNIS TOURNAMENT. WORKING WITH THE WOUNDED WARRIOR DISABLED SPORTS PROJECT, GAYLORD PARTNERED WITH DISABLED SPORTS USA TO CREATE A FOUR-DAY EVENT FOR WOUNDED WAR VETERANS OF CONFLICTS IN IRAQ AND AFGHANISTAN. STAFF FROM ALL AREAS OF THE HOSPITAL-MEDICAL, CLINICAL, ADMINISTRATIVE, SUPPORT SERVICES-WORKED WITH THESE ORGANIZATIONS TO BRING VETERANS AND THEIR FAMILIES TO CONNECTICUT FOR A LONG WEEKEND WHERE THEY WERE INTRODUCED TO ADAPTIVE WATER SPORTS AND CAMARADERIE. TWELVE EMPLOYEES ON THE COMMITTEE DEVOTED 230 HOURS IN PLANNING AND ORGANIZING, PLUS 30 PEOPLE VOLUNTEERED, CONTRIBUTING 816 HOURS OF ON SITE SUPPORT OVER THE 4 DAY EVENT; 25 WAR VETERANS WERE SERVED IN THIS ACTIVITY. CONCLUSION THE HOSPITAL IS COMMITTED TO SUPPORTING THE DESIGNATED HEALTH NEEDS OF THE COMMUNITY THROUGH THE EXPERTISE AND TIME OF ITS STAFF AS WELL AS THROUGH MONETARY DONATIONS. IN TOTAL, 295 EMPLOYEES REPORTED DONATING 4,500 HOURS OF TIME TO A HOST OF COMMUNITY- AND HOSPITAL-SPONSORED ACTIVITIES DESIGNED TO IMPROVE THE HEALTH AND FUNCTION OF PEOPLE SERVED. MANY EMPLOYEES ALSO VOLUNTEERED THEIR TIME TO PERSONAL OR COMMUNITY-BASED CAUSES SUCH AS THE BOY SCOUTS AND GIRL SCOUTS OF AMERICA, LOCAL CHURCHES AND SYNAGOGUES, AREA SCHOOLS, ANIMAL RESCUE MISSIONS, INTERNATIONAL 4H YOUTH EXCHANGE ASSOCIATION, SPECIAL OLYMPICS, AND THE MARCH OF DIMES.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
GAYLORD HOSPITAL INC
 
Employer identification number

06-0646649
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity

















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) GAYLORD FARM REHABILITATION CENTER INC

PO BOX 400 GAYLORD FARM ROAD

WALLINGFORD,CT06492
06-1432065 		RESIDENTIAL CARE HOME CT 501(C)(3) 3 GAYLORD FARM ASSOCIATION INC
 
 
No
(2) GAYLORD RESEARCH INSTITUTE INC

PO BOX 400 GAYLORD FARM ROAD

WALLINGFORD,CT06492
06-1460112 		RESEARCH ORGANIZATION CT 501(C)(3) 4 GAYLORD FARM ASSOCIATION INC
 
 
No
(3) THE GAYLORD FOUNDATION INC

PO BOX 400 GAYLORD FARM ROAD

WALLINGFORD,CT06492
06-1521864 		SUPPORTING CORPORATION CT 501(C)(3) 11 GAYLORD FARM ASSOCIATION INC
 
 
No
(4) GAYLORD FARM ASSOCIATION INC

PO BOX 400 GAYLORD FARM ROAD

WALLINGFORD,CT06492
06-1302029 		SUPPORTING CORPORATION CT 501(C)(3) 11 N/A
 
No






For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) NORTH HAVEN FITNESS & WELLNESS LLC

PO BOX 400 400 GAYLORD FARM ROAD
WALLINGFORD,CT06492
20-1637848 		FITNESS CENTER CT  
RELATED -118,629 486,566   No     No 50.000 %
(2) GAYLORD SLEEP HEALTH CENTERS LLC

300 ROSE WOOD DRIVE
DANVERS,MA01923
27-1698160 		CPAP EQUIPMENT SALES CT  
RELATED 113,325 100,562   No     No 50.000 %










Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) FARM PROPERTIES
PO BOX 400 400 GAYLORD FARM ROAD
WALLINGFORD,CT06492
06-1301584 		PROPERTY DEVELOPMENT CT GAYLORD FARM ASSOCIATION INC
  		C      
(2) GAYLORD RISK SOLUTIONS LTD
PO BOX 400 400 GAYLORD FARM ROAD
WALLINGFORD,CT06492
98-0561423 		INSURANCE PROVIDER CJ GAYLORD FARM ASSOCIATION INC
  		C      










Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) NORTH HAVEN FITNESS & WELLNESS LLC

 B 30,601 ACTUAL AMOUNT
(2) GAYLORD FARM REHABILITATION CENTER INC

 N 597,339 ACTUAL AMOUNT
(3) GAYLORD FARM REHABILITATION CENTER INC

 M 132,360 ACTUAL AMOUNT
(4) GAYLORD FARM REHABILITATION CENTER INC

 R 418,907 ACTUAL AMOUNT
(5)
(6)
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


Software ID:  
Software Version:  






TY 2010 AffiliatedGroupSchedule
Name:
GAYLORD HOSPITAL INC
EIN: 06-0646649
Affiliated Group Business Name:
GAYLORD FARM REHABILITATION CENTER INC
 
Address. Either US or Foreign Type:
PO BOX 400 GAYLORD FARM ROAD
WALLINGFORD, CT06492    
EIN:
06-1432065
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
0
Total Exempt Purpose Expenditures:
0
Lobbying Nontaxable Amount:
0
Grassroots Nontaxable Amount:
0
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
GAYLORD RESEARCH INSTITUTE INC
 
Address. Either US or Foreign Type:
PO BOX 400 GAYLORD FARM ROAD
WALLINGFORD, CT06492    
EIN:
06-1460112
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
0
Total Exempt Purpose Expenditures:
0
Lobbying Nontaxable Amount:
0
Grassroots Nontaxable Amount:
0
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0