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
THE WATERBURY HOSPITAL
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
64 ROBBINS STREET
 
Room/suite
City or town, state or country, and ZIP + 4
WATERBURY, CT06708
D Employer identification number

06-0665979
E Telephone number

G Gross receipts $ 264,810,718
F Name and address of principal officer:
DARLENE STROMSTAD
64 ROBBINS STREET
WATERBURY,CT06708
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.WATERBURYHOSPITAL.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: 1951
M State of legal domicile: CT
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: WATERBURY HOSPITAL'S MISSION IS TO PROVIDE COMPASSIONATE HIGH QUALITY HEALTH CARE SERVICES THROUGH A FAMILY OF PROFESSIONALS AND SERVICES.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 16
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 12
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 2,227
6 Total number of volunteers (estimate if necessary) .... 6 282
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 3,727,068
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 100,724
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 6,580,621 5,432,131
9 Program service revenue (Part VIII, line 2g) ......... 229,011,318 231,768,719
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 2,513,080 3,389,996
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 3,650,743 5,501,666
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 241,755,762 246,092,512
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) 127,864,288 135,820,931
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet388,446    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 110,474,594 110,180,428
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 238,338,882 246,001,359
19 Revenue less expenses. Subtract line 18 from line 12...... 3,416,880 91,153
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 163,030,487 165,252,085
21 Total liabilities (Part X, line 26)............ 67,145,451 89,880,352
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 95,885,036 75,371,733
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: WATERBURY HOSPITAL'S MISSION IS TO PROVIDE COMPASSIONATE HIGH QUALITY HEALTH CARE SERVICES THROUGH A FAMILY OF PROFESSIONALS AND SERVICES.
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 $ 202,685,598 including grants of $   ) (Revenue $ 236,439,291 )
STATEMENT OF PURPOSEAS A NOT-FOR-PROFIT COMMUNITY HOSPITAL, WATERBURY HOSPITAL PROVIDES QUALITY HEALTH CARE TO ALL AREA INDIVIDUALS, REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, AGE, HANDICAP OR ABILITY TO PAY. HOWEVER, REIMBURSEMENT FOR SERVICES IS CRITICAL TO THE HOSPITAL'S STABILITY AND LONG-TERM OPERATION.SEE SCHEDULE O FOR CONTINUATION
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$ 202,685,598
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
Yes
 
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...... Click to see attachment
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................ Click to see attachment
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........................... Click to see attachment
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............... Click to see attachment
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 ......................... Click to see attachment
28a
Yes
 
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
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.. Click to see attachment
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
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
Yes
 
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
304
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
2,227
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
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
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
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
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
Yes
 
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
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
16
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
12
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
Yes
 
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
 
No
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
SCOTT BOWMAN
64 ROBBINS STREET
WATERBURY,CT06721
(203) 573-7333
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) JOHN H TOBIN
PRESIDENT
 40.00 X   X       509,465 0 285,873
(2) CARL CONTADINI
CHAIRMAN
 .30 X   X       0 0 0
(3) JACK KELLY
VICE CHAIR/SECRETARY
 .30 X   X       0 0 0
(4) DARLENE STROMSTAD
PRESIDENT/TREASURER
 40.00 X   X       0 0 0
(5) CARL SHERTER MD
CHIEF OF STAFF
 .30 X           0 0 0
(6) OJ BIZZOZERO JR MD
DIRECTOR
 .50 X           0 0 0
(7) RONALD D'ANDREA MD
DIRECTOR
 .20 X           0 0 0
(8) STEVEN L EISEN MD
DIRECTOR
 .30 X           166,295 54,988 217
(9) JAMES H GATLING PHD
DIRECTOR
 .40 X           0 0 0
(10) FREDERICK L LUEDKE
IMMEDIATE PAST CHAIRMAN
 .50 X           0 0 0
(11) PATRICIA MCKINLEY
DIRECTOR
 .40 X           0 0 0
(12) JOHN A MICHAELS
DIRECTOR
 .50 X           0 0 0
(13) DAVID J PIZZUTO MD
DIRECTOR
 .30 X           76,400 0 0
(14) WILLIAM J PIZZUTO PHD
DIRECTOR
 .90 X           0 0 0
(15) ANDREW K SKIPP
DIRECTOR
 .20 X           0 0 0
(16) AJ WASSERSTEIN
DIRECTOR
 .40 X           0 0 0
(17) MICHAEL A WILSON CPA MBA
DIRECTOR
 .20 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) DAVID W GRIFFIN ESQ
CHAIRMAN
 .60 X   X       0 0 0
(19) WILLIAM E SOLBERG
DIRECTOR
 .20 X           0 0 0
(20) COLLEEN SCOTT
VP FINANCE
 40.00     X       289,220 0 32,750
(21) MARY B PRYBYLO
VP PATIENT CARE SERVICES
 40.00     X       297,897 0 26,092
(22) STEVEN SCHNEIDER
VP MEDICAL SERVICES
 40.00     X       345,545 0 35,273
(23) MARY K MULSTON
VP HUMAN RESOURCES
 40.00     X       189,324 0 8,823
(24) MARYANNE VOLKRINGER
VP AFFILIATES & BUS DEV
 40.00     X       157,764 0 16,876
(25) MICHAEL CEMENO
CHIEF INFORMATION OFFICER
 40.00     X       0 0 0
(26) DIANE WOOLLEY
ACTING VP HUMAN RESOURCES
 40.00     X       142,826 0 19,903
(27) SANDRA IADAROLA
CHIEF NURSING OFFICER
 40.00     X       150,958 0 16,425
(28) THOMAS REINHARDT
MEDICAL DIRECTOR BEHAVIORAL HEALTH
 40.00         X   209,077 0 20,600
(29) DONALD EDWARDSON
MEDICAL DIRECTOR INPATIENT BH
 40.00         X   205,098 0 12,902
(30) KINSON LEE
PSYCHIATRIST
 40.00         X   197,920 0 24,064
(31) PETER PORRELLO
CHIEF MEDICAL INFORMATION OFFICER
 40.00         X   199,700 0 21,675
(32) SREEDEVI NAMPOOTHIRI
PSYCHIATRIST
 40.00         X   195,946 0 24,169
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 3,333,435 54,988 545,642
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet106
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
 
No
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
PRICE WATERHOUSE COOPERS LLC
PO BOX 7247-8001
PHILADELPHIA,PA191708001 		CONSULTING SERVICES 2,672,429
YALE UNIVERSITY SCHOOL OF MEDICINE
333 CEDAR STREET
NEW HAVEN,CT06510 		RESIDENCY PROGRAM SERVICE 2,265,285
ACCESS REHAB CENTERS LLC
22 TOMPKINS STREET
WATERBURY,CT06708 		REHAB THERAPY SERVICES 1,183,036
GREATER WATERBURY IMAGING CENTER
64 ROBBINS STREET
WATERBURY,CT06708 		IMAGING SERVICES 1,121,200
CARDIOLOGY ASSOCIATES OF WATERBURY
455 CHASE PARKWAY
WATERBURY,CT06708 		CARDIOLOGY SERVICES 994,787
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet56
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 234,545
d Related organizations...1d  
e Government grants (contributions)1e 4,709,075
f All other contributions, gifts, grants, and
similar amounts not included above1f 		488,511
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 5,432,131
Program Service Revenue Business Code
2a NET PATIENT SERVICE RE 624,100 224,072,647 224,072,647    
b CAW - NET PATIENT SERV 621,110 4,009,213 4,009,213    
c LAB SERVICE REVENUE 621,500 3,536,091   3,536,091  
d IMAGE REPAIRS & MAINTE 541,900 150,768   150,768  
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 231,768,719
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 2,207,300     2,207,300
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents 441,420  
b Less: rental expenses    
c Rental income or (loss) 441,420  
d Net rental income or (loss).......MediumBullet 441,420 441,420    
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 19,750,286 9,100
b Less: cost or other basis and sales expenses 18,576,690  
c Gain or (loss) 1,173,596 9,100
d Net gain or (loss)..........MediumBullet 1,182,696     1,182,696
8a Gross income from fundraising events (not including
$ 234,545
of contributions reported on line 1c). See Part IV, line 18 ...
a 70,701
b Less: direct expenses ...b 141,516
c Net income or (loss) from fundraising events..MediumBullet -70,815   -70,815
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 PARTNERSHIPS 900,099 2,059,441 2,059,441    
b CAW - OTHER INCOME 621,110 944,669 944,669    
c OTHER MISC INCOME 900,099 921,865 921,865    
d All other revenue .... 1,205,086 303,177 40,209 861,700
e Total. Add lines 11a–11d ......MediumBullet 5,131,061
12 Total revenue. See Instructions....MediumBullet 246,092,512 232,752,432 3,727,068 4,180,881
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 .... 3,314,965   3,314,965  
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 101,650,747 90,085,349 11,363,266 202,132
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 4,011,389 3,493,539 509,887 7,963
9 Other employee benefits ....... 18,803,706 16,166,035 2,599,845 37,826
10 Payroll taxes ........... 8,040,124 6,893,967 1,130,260 15,897
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 964,903 23,248 941,655  
c Accounting ........... 212,925   212,925  
d Lobbying ........... 72,512   72,512  
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ......        
g Other .......... 33,666,011 28,283,376 5,353,261 29,374
12 Advertising and promotion .... 889,177 40,697 845,220 3,260
13 Office expenses ....... 11,873,306 9,607,571 2,235,085 30,650
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 4,584,013 1,066,066 3,517,947  
17 Travel ............ 137,852 72,115 62,940 2,797
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 183,927 161,324 22,603  
20 Interest ........... 1,103,705   1,103,705  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 8,040,773   8,040,773  
23 Insurance .............. 5,307,790 5,307,790    
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 MEDICAL/SURGICAL SUPPLI 26,923,208 26,923,208    
b BAD DEBT 13,329,043 13,329,043    
c LOSS ON EXTINGUISHMENT 1,082,212   1,082,212  
d FOOD 1,012,440 998,678 11,562 2,200
e DUES AND SUBSCRIPTIONS 337,500 75,281 261,126 1,093
f All other expenses 459,131 158,311 245,566 55,254
25 Total functional expenses. Add lines 1 through 24f 246,001,359 202,685,598 42,927,315 388,446
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 ..........   1 445,086
2 Savings and temporary cash investments ....... 17,099,522 2 10,336,179
3 Pledges and grants receivable, net ......... 1,518,034 3 3,816,321
4 Accounts receivable, net ......... 27,165,931 4 23,027,509
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 ............. 133,333 7 0
8 Inventories for sale or use .............. 634,324 8 3,109,790
9 Prepaid expenses and deferred charges ............ 1,161,757 9 1,449,521
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 256,755,314
b Less: accumulated depreciation. ..... 10b 214,304,472 38,537,940 10c 42,450,842
11 Investments—publicly traded securities .......... 11,675,881 11 10,050,122
12 Investments—other securities. See Part IV, line 11 ...... 55,192,802 12 57,334,007
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ......... 0 14 200,500
15 Other assets. See Part IV, line 11 ........... 9,910,963 15 13,032,208
16 Total assets. Add lines 1 through 15 (must equal line 34)... 163,030,487 16 165,252,085
Liabilities 17 Accounts payable and accrued expenses . 25,350,669 17 34,927,900
18 Grants payable ..........   18  
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities .......... 19,007,716 20 25,630,879
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..... 22,787,066 25 29,321,573
26 Total liabilities. Add lines 17 through 25..... 67,145,451 26 89,880,352
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 ..... 45,216,062 27 28,763,004
28 Temporarily restricted net assets ..... 8,315,873 28 6,477,454
29 Permanently restricted net assets ..... 42,353,101 29 40,131,275
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 ..... 95,885,036 33 75,371,733
34 Total liabilities and net assets/fund balances ..... 163,030,487 34 165,252,085
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
246,092,512
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
246,001,359
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
91,153
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
95,885,036
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
-20,604,456
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
75,371,733
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
THE WATERBURY HOSPITAL
 
Employer identification number

06-0665979
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
THE WATERBURY HOSPITAL
 
Employer identification number

06-0665979
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
THE WATERBURY HOSPITAL
  		Employer identification number

06-0665979
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
THE WATERBURY HOSPITAL
  		Employer identification number

06-0665979
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
THE WATERBURY HOSPITAL
  		Employer identification number

06-0665979
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
THE WATERBURY HOSPITAL
 
Employer identification number

06-0665979
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
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) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  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) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -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          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots non-taxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
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? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
Yes
 
 
d
Mailings to members, legislators, or the public? .........................
Yes
 
 
e
Publications, or published or broadcast statements? .......................
Yes
 
 
f
Grants to other organizations for lobbying purposes? .......................
Yes
 
41,870
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
Yes
 
 
i
Other activities? If "Yes," describe in Part IV ..........................
Yes
 
30,642
j
Total. lines 1c through 1i ...................................
72,512
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
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
EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: A PORTION OF THE CT HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION FEES THAT ARE PAID BY THE WATERBURY HOSPITAL IS FOR LOBBYING ACTIVITIES.
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
THE WATERBURY HOSPITAL
 
Employer identification number

06-0665979
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 .... 51,457,624 49,308,865 50,479,712
b Contributions ........   20 10,560
c Investment earnings or losses ... -2,784,813 2,729,359 -512,662
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		229,936 580,620 668,745
f Administrative expenses ....      
g End of year balance ...... 48,442,875 51,457,624 49,308,865
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet5.400 %
b
Permanent endowment: SchDMd Bullet82.840 %
c
Term endowment: SchDMd Bullet11.760 %
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)
Yes
 
(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 .................   287,549 287,549
b Buildings ................   81,758,918 65,051,592 16,707,326
c Leasehold improvements ............   539,905 429,576 110,329
d Equipment ................   168,249,911 146,236,707 22,013,204
e Other .................   5,919,031 2,586,597 3,332,434
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 42,450,842
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) FUNDS HELD IN TRUST BY OTHERS 		37,339,264 F

(B) GREATER WATERBURY IMAGING CENTER 		5,745,591 F

(C) ACCESS REHAB CENTERS 		4,029,105 F

(D) IMAGING PARTNERS 		335,248 F

(E) ALLIANCE MEDICAL GROUP 		6,563,293 F

(F) CARDIOLOGY ASSOCIATES OF GREATER WATERBURY 		3,321,506 F



Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet 57,334,007
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
(1) CHEFA OBLIGATIONS DISCOUNT AND ISSUE EXPENSE, NET OF AMORTIZATION 360,656
(2) DUE FROM AFFILIATES 5,247,540
(3) ESCROW WITH CHEFA 3,958,301
(4) OTHER RECEIVABLES 3,240
(5) PREPAID & OTHER INVESTMENTS 604,385
(6) DUE FROM THIRD-PARTY REIMBURSEMENT AGENCIES 2,858,086



Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 13,032,208
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
LIABILITIES OF CONSOLIDATED AFFILIATES 5,429,509
RESERVE FOR WORKER'S COMP/MALPRACTICE LIAB. LOSS 6,947,153
NONCONTROLLING INTEREST 3,182,177
DEFERRED LIAB. ON GIFT ANNUITY 208,541
ASSET RETIREMENT OBLIGATION 2,716,459
CAPITAL LEASE LIABILITY 1,343,941
ACCRUED PENSION LIABILITY 6,989,553
DEFERRED LIAB. ON PLAN INVESTMENT FUND 13,796
DEFERRED LIAB. ON SERP 76,031
SWAP RATE LIABILITY 2,414,413
Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 29,321,573
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) .................... 1 246,092,512
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 246,001,359
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 91,153
4 Net unrealized gains (losses) on investments .......................... 4 -2,049,953
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7 -2,760,000
8 Other (Describe in Part XIV) ................................. 8 -15,794,503
9 Total adjustments (net). Add lines 4 - 8 ............................. 9 -20,604,456
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 -20,513,303
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 276,271,283
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a -2,049,953
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d 34,298,521
e Add lines 2a through 2d ..................... 2e 32,248,568
3 Subtract line 2e from line 1..................... 3 244,022,715
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 2,069,797
c Add lines 4a and 4b....................... 4c 2,069,797
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5 246,092,512
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 286,460,631
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 40,459,272
e Add lines 2a through 2d...................... 2e 40,459,272
3 Subtract line 2e from line 1..................... 3 246,001,359
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.) ...... 5 246,001,359
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 FUNDS ARE USED FOR FREE CARE AND GENERAL HOSPITAL OPERATIONS.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENU CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL IS ALSO EXEMPT FROM STATE INCOME TAXES. ACCESS, GWIC AND IMAGING PARTNERS LLC ARE PARTNERSHIPS. FOR TAX PURPOSES, THESE PARTNERSHIP ARE PASS-THROUGH ENTITIES. TAXATION DOES NOT OCCUR AT THE PARTNERSHIP LEVEL. ACCORDINGLY, NO PROVISION FOR TAXES IS INCLUDED. ALLIANCE MEDICAL IS TAX EXEMPT UNDER SECTION 501(C)(3) OF THE CODE. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2011, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES THE HOSPITAL IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS PRIOR TO 2008.
PART XI, LINE 8 - OTHER ADJUSTMENTS:   INCREASE IN FAIR VALUE OF FUNDS HELD IN TRUST BY OTHERS -2,221,826. ALLIANCE SUBSIDY -9,331,460. PENSION LIABILITY ADJUSTMENT -1,816,446. INTEREST RATE SWAP ADJUSTMENT -2,414,415. INCOME FROM WATERBURY GASTROENTEROLGY -10,356.
PART XII, LINE 2D - OTHER ADJUSTMENTS:   INCOME FROM CONSOLIDATED AFFILIATE 34,157,005. FUNDRAISING EXPENSE 141,516.
PART XII, LINE 4B - OTHER ADJUSTMENTS:   INVESTMENT INCOME FROM PARTNERSHIP 2,059,441. WATERBURY GASTROENTEROLOGY INCOME 10,356.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:   EXPENSE OF CONSOLIDATED AFFILIATE 40,317,756. FUNDRAISING EXPENSE 141,516.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE G
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,
or if the organization entered more than $15,000 on Form 990-EZ, line 6a.
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
THE WATERBURY HOSPITAL
 
Employer identification number

06-0665979
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.
(a) Event #1

GALA
(event type) 		(b) Event #2

GOLF TOURNAMENT
(event type) 		(c) Other Events

1
(total number) 		(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 155,945 109,687 39,614 305,246
2 Less: Charitable
contributions . . . 		118,145 89,527 26,873 234,545
3 Gross income (line 1
minus line 2) . . . 		37,800 20,160 12,741 70,701
VerticalDirectExpenses 4 Cash prizes . . .        
5 Non-cash prizes . .     895 895
6 Rent/facility costs . . 37,840 25,362 13,025 76,227
7 Food and beverages . .        
8 Entertainment . . .        
9 Other direct expenses . 45,516 11,605 7,273 64,394
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 141,516
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow -70,815
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (Add col. (a) through col. (c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
 
 
 
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," Explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," Explain:
 
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ...........................
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 3
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
 
b
An outside facility ........................
13b
 
14
Provide the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)
Identifier ReturnReference Explanation
Schedule G (Form 990 or 990-EZ) 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
THE WATERBURY HOSPITAL
 
Employer identification number

06-0665979
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
Yes
 
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
Yes
 
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
 
No
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
 
No
6b
If "Yes," does the organization make it available to the public? ..............
6b
 
 
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) .. 		    936,076 132,653 803,423 0.330 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		  34,265 33,166,260 23,136,942 10,029,318 4.080 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....   10,808 18,742,851 11,635,577 7,107,274 2.890 %
dTotal Charity Care and
Means-Tested Government Programs ..... 		  45,073 52,845,187 34,905,172 17,940,015 7.300 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		57 30,230 13,748,776 861,005 12,887,771 5.240 %
f Health professions education
(from Worksheet 5) .. 		42 8,096 19,518,720 7,763,955 11,754,765 4.780 %
g Subsidized health services
(from Worksheet 6) .. 		5 8,827 14,693,462 10,670,895 4,022,567 1.640 %
h Research (from Worksheet 7) 8 283 116,911 0 116,911 0.050 %
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		7 61,972 628,343 215,639 412,704 0.170 %
jTotal Other Benefits ... 119 109,408 48,706,212 19,511,494 29,194,718 11.880 %
kTotal. Add lines 7d and 7j. .. 119 154,481 101,551,399 54,416,666 47,134,733 19.180 %
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 0 0 0 0    
2 Economic development 0 0 0 0    
3 Community support 7 397 25,772 0 25,772 0.010 %
4 Environmental improvements 3 0 4,839 0 4,839 0 %
5 Leadership development and training for community members 10 641 235,950 3,160 232,790 0.090 %
6 Coalition building 14 557 151,134 0 151,134 0.060 %
7 Community health improvement advocacy 0 0 0 0    
8 Workforce development 0 0 0 0    
9 Other 1 0 44,988 0 44,988 0.020 %
10 Total 35 1,595 462,683 3,160 459,523 0.180 %
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
3,038,674
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
 
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
73,963,013
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
82,298,203
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-8,335,190
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 %
1
2
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 THE WATERBURY HOSPITAL
64 ROBBINS STREET
WATERBURY,CT06708 		X X   X     X    
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:NA
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    
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    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
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    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
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    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
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    
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    
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    
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    
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    
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 I, LINE 3C: N/A
    PART II: AS THE LARGEST PRIVATE EMPLOYER IN THE CITY OF WATERBURY, WATERBURY HOSPITAL (WH) UNDERSTANDS ITS ROLE AS A LEADER IN THE COMMUNITY. MANY OF OUR PROGRAMS ARE SPECIFICALLY TARGETED AT STRENGTHENING THE WELFARE AND AWARENESS OF THE CITIZENS WITHIN OUR COMMUNITY. FROM EDUCATING WATERBURY'S YOUTH ABOUT HEALTHCARE CAREERS TO OFFERING SUPPORT GROUPS TO FAMILIES WHO HAVE LOST LOVED ONES, WATERBURY HOSPITAL REMAINS COMMITTED TO MAKING THE GREATER WATERBURY AREA A STRONGER, MORE PROSPEROUS COMMUNITY.KEY PROGRAMS: YOUTH PIPELINE INITIATIVES: SINCE THE YOUTH PIPELINE INITIATIVES WERE ESTABLISHED IN 2001 AS A PARTNERSHIP BETWEEN WATERBURY HOSPITAL AND WATERBURY PUBLIC SCHOOLS, ITS MISSION HAS REMAINED THE SAME: TO CLOSE THE ACHIEVEMENT GAP FOR MINORITY AND ECONOMICALLY DISADVANTAGED STUDENTS IN WATERBURY SO THEY CAN MATRICULATE AND COMPETE NATIONALLY FOR PLACEMENT IN POST-SECONDARY EDUCATION PROGRAMS IN PREPARATION FOR HEALTH CAREERS. WATERBURY HOSPITAL HAS REMAINED DEDICATED TO ENHANCING AND ENRICHING THE LIVES OF WATERBURY'S YOUTH. WE TAKE PRIDE IN HELPING STUDENTS REALIZE THEIR POTENTIAL AS THEY EMBARK ON THEIR ACADEMIC AND PERSONAL JOURNEYS. TO THIS END, DURING 2011, WATERBURY HOSPITAL CONTINUED TO PROVIDE OVER 600 STUDENTS AND PARENTS IN GREATER WATERBURY WITH UNIQUE EDUCATIONAL PROGRAMS THAT WILL ENHANCE THE OVERALL WELFARE OF OUR COMMUNITY.THE YOUTH PIPELINE INITIATIVES ARE A MULTIFACETED SERIES WITH FIVE FOCUS AREAS DURING 2011, INCLUDING: - PROVIDING EARLY ACQUAINTANCE WITH CAREERS IN HEALTH (PEACH) - SINCE ITS INCEPTION IN 2004, WATERBURY HOSPITAL'S PROVIDING EARLY ACQUAINTANCE WITH CAREERS IN HEALTH (PEACH) PROGRAM HAS WORKED WITH ADMINISTRATORS, TEACHERS, AND STUDENTS AT WATERBURY'S NORTH END MIDDLE SCHOOL AND WEST SIDE MIDDLE SCHOOL TO ADDRESS PROJECTED SHORTAGES OF HEALTHCARE WORKERS AND TO CLOSE THE ACHIEVEMENT GAP FOR STUDENTS IN WATERBURY PUBLIC SCHOOLS. THROUGH THE PEACH PROGRAM, STUDENTS ENGAGE WITH HEALTHCARE WORKERS IN A NON-EMERGENCY SETTING AND ARE INFORMED OF THE VARIETY OF HEALTHCARE CAREER OPPORTUNITIES AVAILABLE IN OUR COMMUNITY. EACH SPRING, OVER 100 SEVENTH GRADERS FROM WATERBURY TAKE PART IN A DAY-LONG PEACH TOUR AT WATERBURY HOSPITAL, DURING WHICH THEY VISIT AT LEAST SIX HOSPITAL DEPARTMENTS AND COMPLETE HANDS-ON LEARNING ACTIVITIES WITH HOSPITAL STAFF. ANNUALLY, WATERBURY HOSPITAL ALSO OFFERS ITS PEACH SPRING BREAK EXPLORATION CAMP, IN WHICH 20 MIDDLE SCHOOL STUDENTS FROM WATERBURY TAKE PART IN SHADOWING AND HANDS-ON LEARNING ACTIVITIES AT THE HOSPITAL AND ARE CPR CERTIFIED . - 9TH GRADE MENTORING - FOR THE PAST SIX YEARS, DOZENS OF WATERBURY HOSPITAL EMPLOYEES HAVE SERVED AS MENTORS AT WATERBURY'S WILBY HIGH SCHOOL. WATERBURY HOSPITAL'S MENTORS VOLUNTEER FOR ONE HOUR PER WEEK FOR 25 TO 30 WEEKS PER SCHOOL YEAR TO GUIDE STUDENTS AS THEY SET ACADEMIC AND PERSONAL GOALS FOR HIGH SCHOOL AND BEYOND. IN 2011, FIFTEEN WATERBURY HOSPITAL STAFF MEMBERS WORKED WITH A TOTAL OF 200 STUDENTS FOR OVER 500 HOURS. - PARENT LEADERSHIP TRAINING INSTITUTE (PLTI) - IN 2011, SIXTEEN INDIVIDUALS FROM GREATER WATERBURY SUCCESSFULLY COMPLETED WATERBURY'S PLTI, A 20-WEEK CURRICULUM TEACHING LEADERSHIP AND ADVOCACY SKILLS. WATERBURY HOSPITAL HAS HOSTED THE WATERBURY PLTI SINCE 2000, AND THE PROGRAM HAS TRAINED AND GRADUATED OVER 150 AREA PARENTS. PLTI'S CORE MISSION IS TO IMPART LEADERSHIP AND ADVOCACY SKILLS TO PARENTS WHILE SIMULTANEOUSLY EDUCATING THEM ABOUT VOLUNTEERISM, CIVIC LIFE, AND THE PROCESS BY WHICH STATE AND LOCAL GOVERNMENTS ENACT AND CHANGE LAWS. EACH PARTICIPANT COMPLETES AND IMPLEMENTS A COMMUNITY PROJECT; EXAMPLE PROJECTS FROM 2011 INCLUDE "BRIDGE THE GAP" (TO CLOSE THE ACHIEVEMENT GAP FOR STUDENTS) AND "ALL DAY WEE CARE" (A 24-HOUR LEARNING CENTER TO BETTER CHILDREN AND THE COMMUNITY). - WH SUMMER BRIDGE PROGRAM - DURING THE SUMMER OF 2011, TWENTY-SIX STUDENTS FROM WATERBURY, GRADES 6-11, PARTICIPATED IN THE WH SUMMER BRIDGE PROGRAM, WHICH PROVIDED THE STUDENTS WITH ACADEMIC PREPARATION, SUCH AS SAT MATH AND SAT ENGLISH REVIEW, JOB READINESS ACTIVITIES, AND JOB SHADOWING THROUGHOUT THE HOSPITAL. IN ORDER TO INCREASE THE PROGRAM'S DIVERSITY, A HANDFUL OF PROGRAM SLOTS WERE ALLOCATED FOR STUDENTS OF WATERBURY HOSPITAL EMPLOYEES. BY THE END OF THE PROGRAM, STUDENTS: - LEARNED 360 NEW SAT VOCABULARY WORDS; - COMPLETED 11 HOURS OF ALGEBRA AND GEOMETRY REVIEW; - READ LORD OF THE FLIES AND WORKED ON A JOURNAL; - COMPLETED A PHOTOGRAPHY SELF-PORTRAIT, WHICH THEY CONTRIBUTED TO THE CLASS PHOTO BOOK; - COMPLETED MOCK JOB APPLICATIONS AND JOB INTERVIEWS WITH THE HOSPITAL'S HUMAN RESOURCES CONSULTANTS; - LEARNED MICROSOFT OFFICE AND ADOBE PHOTOSHOP FROM WH'S INFORMATION SERVICES TRAINER; AND - SHADOWED WH CLINICIANS IN GASTROENTEROLOGY, TRAUMA, RADIOLOGY, ELECTROENCEPHALOGRAPHY, AND EMERGENCY DEPARTMENTS.SUPPORT GROUPS - DURING 2011, WATERBURY HOSPITAL HOSTED SEVERAL SUPPORT GROUPS FOR ITS PATIENTS AND THEIR FAMILIES, INCLUDING: - SHARE, A SUPPORT GROUP RUN BY THE FAMILY BIRTHING CENTER FOR PARENTS WHO HAVE LOST A BABY; - BEHAVIORAL HEALTH'S PARENT AND SIBLING SUPPORT GROUP, WHICH OFFERS EMOTIONAL ASSISTANCE TO FAMILIES WHO HAVE CHILDREN IN TREATMENT; AND - ALCOHOLICS ANONYMOUS, WHICH MEETS WEEKLY THROUGHOUT THE YEAR AND IS COORDINATED BY OUR BEHAVIORAL HEALTH DEPARTMENT.
    PART III, LINE 4: THE HOSPITAL ACCEPTS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. A PATIENT IS CLASSIFIED AS A CHARITY PATIENT BY REFERENCE TO THE ESTABLISHED POLICIES OF THE HOSPITAL. ESSENTIALLY, THESE POLICIES DEFINE CHARITY SERVICES AS THOSE SERVICES FOR WHICH NO PAYMENT IS POSSIBLE. IN ASSESSING A PATIENT'S INABILITY TO PAY, THE HOSPITAL UTILIZES THE GENERALLY RECOGNIZED FEDERAL POVERTY INCOME LEVELS, BUT ALSO INCLUDES CERTAIN CASES WHERE INCURRED CHARGES ARE SIGNIFICANT WHEN COMPARED TO INCOMES AND ASSETS. THESE CHARGES ARE NOT INCLUDED IN NET PATIENT SERVICE REVENUES FOR FINANCIAL REPORTING PURPOSES.
    PART III, LINE 8: COSTING METHODOLOGY USED TO COMPUTE THE MEDICARE SHORTFALL AND ANY ASSOCIATED COMMUNITY BENEFIT IS A COMBINATION OF THE AMOUNT REPORTED ON LINE 7 AS WELL AS THE HEALTH PROFESSION EDUCATION LINE. A TOTAL SHORTFALL OF $8,335,190 WAS DERIVED FROM THE 2011 MEDICARE COST REPORT USING AN AHA APPROVED FORM FOR SCHEDULE H WORKSHEET B PPS AND IPF HOSPITALS AND $11,754,765 FROM THE HEALTH PROFESSIONS EDUCATION CALCULATION FOR A TOTAL OF $20,089,955. ALL OF THIS SHORTFALL SHOULD BE REPORTED AS A COMMUNITY BENEFIT. THE HOSPITAL COST ACCOUNTING SYSTEM SHOWS A SHORTFALL FROM ALL MEDICARE PROGRAMS (INCLUDING MANAGED MEDICARE) OF $16,746,853 (NET OF BAD DEBT AND FREE CARE).
    PART III, LINE 9B: WE HAVE SEVERAL CREDIT AND COLLECTION PROGRAMS GOVERNING PATIENTS WHO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE; PROMPT PAY DISCOUNT; SLIDING SCALE; PAYMENT ARRANGEMENTS; CHARITY CARE AND FREE BED FUNDS. ANY PATIENT EXPRESSING DIFFICULTY PAYING A BALANCE IS ENTITLED TO APPLY FOR FINANCIAL COUNSELING ASSISTANCE. CUSTOMER SERVICE REPRESENTATIVES WORK WITH THE PATIENTS TO DETERMINE PROGRAM QUALIFICATION BASED ON THE COMPLETION OF A FINANCIAL APPLICATION. CASES ARE PREPARED AND PRESENTED TO THE PATIENT ASSISTANCE COMMITTEE. APPROVED CASES WILL BE EITHER FULLY OR PARTIALLY WRITTEN OFF TO FREE BED FUNDS OR CHARITY CARE.
    PART VI, LINE 2: WATERBURY HOSPITAL WORKS CLOSELY WITH LOCAL HEALTHCARE PROVIDERS AND COMMUNITY-BASED ORGANIZATIONS TO IDENTIFY HEALTHCARE NEEDS FOR UNDERSERVED PATIENTS THROUGHOUT THE WATERBURY COMMUNITY. THROUGH THESE COLLABORATIONS, WATERBURY HOSPITAL WORKS TO DEVELOP KEY PROGRAMMING FOR THE CITY'S VULNERABLE POPULATIONS, INCLUDING: THE WATERBURY HOSPITAL INFECTIOUS DISEASE CLINIC, WHICH PROVIDES COMPREHENSIVE HIV CARE TO 500 PEOPLE LIVING WITH HIV/AIDS; THE WATERBURY HEALTH ACCESS PROGRAM, WHICH PROVIDES COMPREHENSIVE CASE MANAGEMENT SERVICES TO OVER 3,000 UNINSURED AND UNDERINSURED PATIENTS ANNUALLY; AND THE WATERBURY HOSPITAL CHASE DIABETES DISEASE MANAGEMENT CLINIC, WHICH PROVIDES >150 DIABETICS WITH SELF-MANAGEMENT SKILLS AND CLINICAL CARE. WATERBURY HOSPITAL BEGAN WORKING ON ITS COMMUNITY HEALTH NEEDS ASSESSMENT DURING FY 2012 IN COLLABORATION WITH ST. MARY'S HOSPITAL, THE WATERBURY HEALTH DEPARTMENT, CONNECTICUT COMMUNITY FOUNDATION, STAYWELL HEALTH CENTER (FQHC), AND THE UNITED WAY OF GREATER WATERBURY. IN THE PAST, WE HAVE COLLABORATED WITH THESE ORGANIZATIONS TO COMPLETE COMMUNITY NEEDS ASSESSMENTS, THE MOST RECENT OF WHICH WAS COMPLETED BY THE UNITED WAY OF GREATER WATERBURY IN 2007.
    PART VI, LINE 3: WE HAVE SIGNAGE, PT HANDBOOK, STATEMENT BACKERS & HANDOUTS THAT INFORM PATIENTS OF FREE BED FUNDS ETC. THE HOSPITAL ACCEPTS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. A PATIENT IS CLASSIFIED AS A CHARITY PATIENT BY REFERENCE TO THE ESTABLISHED POLICIES OF THE HOSPITAL. ESSENTIALLY, THESE POLICIES DEFINE CHARITY SERVICES AS THOSE SERVICES FOR WHICH NO PAYMENT IS POSSIBLE. IN ASSESSING A PATIENT'S INABILITY TO PAY, THE HOSPITAL UTILIZES THE GENERALLY RECOGNIZED POVERTY INCOME LEVELS FOR THE STATE, BUT ALSO INCLUDES CERTAIN CASES WHERE INCURRED CHARGES ARE SIGNIFICANT WHEN COMPARED TO INCOMES. THESE CHARGES ARE NOT INCLUDED IN NET PATIENT SERVICE REVENUES FOR FINANCIAL REPORTING PURPOSES.
    PART VI, LINE 4: LOCATED IN A CITY OF 107,000 RESIDENTS, WATERBURY HOSPITAL IS CENTRALLY LOCATED IN WESTERN CONNECTICUT. IT IS ONE OF TWO HOSPITALS THAT SERVES THE CITY OF WATERBURY AND ITS SURROUNDING TOWNS, INCLUDING BEACON FALLS, BETHLEHEM, CHESHIRE, MIDDLEBURY, NAUGATUCK, PROSPECT, SOUTHBURY, THOMASTON, WATERTOWN, WOLCOTT, AND WOODBURY. OVERALL, THE CITY OF WATERBURY LAGS BEHIND THE STATE OF CONNECTICUT AND THE U.S. IN KEY MEASURABLE STATISTICS, AS SEEN IN TABLE 1, BELOW:TABLE 1: SELECTED CENSUS DATA, 2005-2009 ACS, WATERBURY, CT, & U.S. WATERBURY CT U.S.MEDIAN HOUSEHOLD INCOME: $39,832 $67,721 $51,425PER CAPITA MONEY INCOME: $21,222 $36,468 $27,041% PERSONS BELOW POVERTY: 20.3% 8.7% 13.5%% HOUSEHOLDS MARRIED COUPLE FAMILY: 35.4% 51.0% 49.7%% OF OWNER-OCCUPIED HOMES: 49.7% 69.5% 66.9%% FOREIGN-BORN PERSONS: 14.2% 12.8% 12.4%% LANGUAGE NOT ENGLISH SPOKEN AT HOME, AGE 5+: 29.1% 19.7% 19.6%% HOUSEHOLDS WITH NO VEHICLE: 16.8% 8.3% 8.8%% MALE: 47.0% 48.8% 49.3%% FEMALE 53.0% 51.2% 50.7%% CAUCASIAN: 50.0% 74.0% 65.8%% AFRICAN-AMERICAN: 16.5% 9.1% 12.1%% HISPANIC: 28.2% 11.6% 15.1%% HIGH SCHOOL GRADUATES OR HIGHER: 79.4% 88.2% 84.6%% BACHELOR'S DEGREE OR HIGHER: 16.2% 35.1% 27.5%% OF PERSONS AGE 62 & OVER: 15.7% 16.5% 15.3%UNEMPLOYMENT RATE, APRIL 2012: 10.2% 7.7% 8.1%INFANT MORTALITY PER 1,000 RESIDENTS: 9.83 6.2 6.8CRIME RATE (VIOLENT & PROPERTY) PER 100,000 RESIDENTS (2009): 5,423 2,646 3,466WATERBURY WAS ONCE A ROBUST MANUFACTURING CENTER. HOWEVER, OVER THE PAST 25 YEARS, THE INDUSTRIAL BASE THAT WAS THE CENTER OF WATERBURY'S ECONOMY FOR MOST OF THE 20TH CENTURY DWINDLED, LEAVING MANY UNEMPLOYED. ALTHOUGH THERE ARE JOBS AVAILABLE IN HEALTHCARE AND SERVICE SECTORS, HIGH UNEMPLOYMENT REMAINS A THREAT FOR MANY INDIVIDUALS IN THE GREATER WATERBURY AREA. THE CITY OF WATERBURY IS ALSO DESIGNATED A FEDERAL MUA (MEDICALLY UNDERSERVED AREA) AND HPSA (HEALTH PROFESSIONAL SHORTAGE AREA) FOR PRIMARY CARE, MENTAL HEALTH, AND DENTAL CARE.
    PART VI, LINE 6: REALIZING THE DIVERSE NEEDS OF RESIDENTS IN OUR COMMUNITY, WATERBURY HOSPITAL REMAINS DEDICATED TO PROVIDING COMPREHENSIVE HEALTH SERVICES TO ENSURE EVERY INDIVIDUAL HAS ACCESS TO APPROPRIATE, QUALITY HEALTHCARE. DURING 2011, WATERBURY HOSPITAL'S SPECTRUM OF SERVICES CONTINUED TO HAVE A POSITIVE IMPACT ON THE WELFARE OF WATERBURY'S CITIZENS. TO REMAIN CONSISTENT WITH WATERBURY HOSPITAL'S MISSION, MANY OF OUR SERVICES ARE TARGETED FOR VULNERABLE MEMBERS OF OUR COMMUNITY, INCLUDING THOSE WHO ARE UNINSURED OR UNDERINSURED.KEY PROGRAMS: WATERBURY HEALTH ACCESS PROGRAM: WATERBURY HOSPITAL IS AWARE OF THE ECONOMIC NEEDS MANY PATIENTS IN OUR COMMUNITY, AND, AS A RESULT, WE REMAIN COMMITTED TO THE WATERBURY HEALTH ACCESS PROGRAM. FOUNDED IN 2003 AS A PARTNERSHIP BETWEEN WATERBURY HOSPITAL, ST. MARY'S HOSPITAL, STAYWELL HEALTH CENTER (FQHC), AND THE WATERBURY HEALTH DEPARTMENT, THE WATERBURY HEALTH ACCESS PROGRAM IMPROVES ACCESS TO HIGH-QUALITY MEDICAL CARE BY PROVIDING COMPREHENSIVE CASE MANAGEMENT, PHARMACY ASSISTANCE, AND ACCESS TO PRIMARY AND SUB-SPECIALTY MEDICAL CARE FOR THE UNINSURED AND UNDERINSURED RESIDENTS OF THE GREATER WATERBURY REGION. DURING 2011, THE WATERBURY HEALTH ACCESS PROGRAM SAW OVER 3,600 ACTIVE CLIENTS. ADDITIONALLY, DURING WATERBURY HOSPITAL'S FY 2011, WATERBURY HOSPITAL PROVIDED $397,785 WORTH OF DONATED SERVICES TO WHAP PATIENTS.BEHAVIORAL HEALTH - WATERBURY HOSPITAL'S CENTER FOR BEHAVIORAL HEALTH IS ONE OF THE REGION'S LARGEST, PROVIDING COMPREHENSIVE INPATIENT AND OUTPATIENT SERVICES AND A VARIETY OF SUPPORT GROUPS. OUR BEHAVIORAL HEALTH DEPARTMENT BOASTS A CRISIS CENTER, WHICH PROVIDED SERVICES TO OVER 2,400 INDIVIDUALS DURING 2011. OTHER PROGRAMS INCLUDE HOMELESS OUTREACH, A RESPITE PROGRAM, A PARENT SUPPORT GROUP, A SIBLING SUPPORT GROUP, AND A MEDICAL TRANSPORTATION PROGRAM THAT BRINGS CHILDREN AND ADOLESCENTS TO THEIR OUTPATIENT THERAPY APPOINTMENTS AT WATERBURY HOSPITAL. BE WELL BUS - IN ORDER TO ENSURE THAT PATIENTS HAVE ACCESS TO MEDICAL APPOINTMENTS, AT THE HOSPITAL AND AT LOCAL PHYSICIANS' OFFICES, WATERBURY HOSPITAL'S BE WELL BUS PROVIDES TRANSPORTATION SERVICES TO PATIENTS FROM WATERBURY AND ELEVEN OF ITS SURROUNDING TOWNS. DURING 2011, THE BE WELL BUS COMPLETED OVER 4,400 TRANSPORTS TO AND FROM MEDICAL APPOINTMENTS. WATERBURY HOSPITAL HAS CONTRACTED WITH A TRANSPORTATION PROVIDER TO OFFER THE BUS SERVICE, AND ARE PROVIDERS PAY A SMALL FEE TO PARTICIPATE.HEART CENTER OF GREATER WATERBURY - FORMED IN COLLABORATION WITH SAINT MARY'S HOSPITAL, THE HEART CENTER OF GREATER WATERBURY PROVIDES DIVERSE MEDICAL SUPPORT INITIATIVES TO HELP EDUCATE RESIDENTS IN THE GREATER WATERBURY COMMUNITY ABOUT PERTINENT HEALTH AND WELLNESS ISSUES. THIS PAST YEAR, THE HEART CENTER CONDUCTED A SERIES OF HEALTH FAIRS AND VARIOUS HEALTH AND WELLNESS EDUCATION SESSIONS, INCLUDING "ASK THE NURSE," WHICH PROVIDES PATIENTS WITH COMPLIMENTARY BLOOD PRESSURE SCREENINGS AND HEALTH AWARENESS EDUCATION AND A "FREEDOM FROM SMOKING" SERIES TO HELP OUR RESIDENTS KICK THE HABIT. DURING 2011, THE HEART CENTER'S PROGRAMS SERVED OVER 3,800 RESIDENTS FROM THE GREATER WATERBURY AREA.FAMILY BIRTHING CENTER - PROVIDING A CHILD-CENTERED FOCUS, WATERBURY HOSPITAL'S FAMILY BIRTHING CENTER OFFERS EXPECTANT PARENTS A VARIETY OF CLASSES TO PREPARE THEM FOR THEIR BABY'S ARRIVAL. BETWEEN BREAST FEEDING, CHILDBIRTH, AND INFANT CARE CLASSES, OUR FAMILY BIRTHING CENTER PROVIDED VITAL INSTRUCTION TO OVER 170 PARENTS LAST YEAR. THANK GOD I'M FEMALE - FOR THE PAST 20 YEARS, WATERBURY HOSPITAL'S "THANK GOD I'M FEMALE" HAS SERVED AS AN ANNUAL WOMEN'S WELLNESS FORUM THAT FEATURES 40 EDUCATIONAL BOOTHS AND HEALTH-RELATED GIVEAWAYS. THE ULTIMATE GOAL OF THE FORUM IS TO EDUCATE ATTENDEES ABOUT STRESS, MENTAL WELL-BEING, HEART HEALTH, DIET, OSTEOPOROSIS AND BONE HEALTH, CHANGE OF LIFE, AND MORE. IN 2011, OVER 400 AREA RESIDENTS ATTENDED THE EVENT.EVERGREEN 50 CLUB - WATERBURY HOSPITAL'S EVERGREEN 50 CLUB IS AN ORGANIZATION COMPRISED OF OVER 15,000 MEMBERS OVER THE AGE OF 50. THE CLUB OFFERS WELLNESS PROGRAMMING, MEDICARE COUNSELING, AND HEALTH EDUCATION PRESENTATIONS ON A VARIETY OF TOPICS ARE PRESENTED BY HEALTH CARE PROFESSIONALS. PRESENTATION TOPICS INCLUDE: HOLISTIC HEALTH, VARICOSE VEIN TREATMENT, HEART DISEASE, SUMMER SKIN CARE, WEIGHT LOSS, BLOOD PRESSURE, BLADDER SCREENINGS, JOINT CARE AND REPLACEMENT, AND RESOLVING ADVERSE OUTCOMES WITH PATIENTS AND FAMILIES. ANNUALLY, THE EVERGREEN 50 CLUB HOSTS A HEALTH FAIR FOR ITS MEMBERS, WHICH PROVIDES FREE FLU SHOTS AND HEALTHCARE SCREENINGS. MEMBERS ALSO ENJOY COMPLIMENTARY PARKING AT WATERBURY HOSPITAL AND RECEIVE A NEWSLETTER THREE TIMES A YEAR WITH INFORMATION ABOUT STAYING HEALTHY AND THE COMMUNITY.YALE PRIMARY CARE RESEARCH DAY - THROUGH COLLABORATION WITH ST. MARY'S HOSPITAL IN WATERBURY, CT, WATERBURY HOSPITAL HOSTED ITS ANNUAL YALE PRIMARY CARE RESEARCH DAY. DURING THE DAY, PHYSICIANS AND MEDICAL STUDENTS PRESENT RESEARCH PROJECTS TO THE COMMUNITY. HIGH SCHOOL STUDENTS ARE ALSO ENCOURAGED TO PARTICIPATE IN THE ACTIVITIES.WATERBURY HOSPITAL INFECTIOUS DISEASE CLINIC (WHIC) - CURRENT SERVICES: THE WHIC OFFERS A COMPREHENSIVE "ONE-STOP SHOPPING" MODEL THAT PROVIDES PATIENTS WITH ON-SITE PRIMARY AND SPECIALTY SERVICES, MEDICAL CASE MANAGEMENT, INDIVIDUALIZED MEDICATION ADHERENCE SERVICES, MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES, NUTRITION COUNSELING, INDIVIDUALIZED HIV EDUCATION, LABORATORY TESTING, AND RADIOLOGY SERVICES. IN 2011, WHIC SERVED OVER 470 PEOPLE LIVING WITH HIV/AIDS. WHIC'S STAFF MEMBERS ACTIVELY PARTICIPATE IN STATEWIDE AND AREA COLLABORATIVES, SUCH AS THE CONNECTICUT HIV PLANNING CONSORTIUM (CHPC) AND THE RYAN WHITE PART A PLANNING COUNCIL, AND WHIC FACILITATES THE GREATER WATERBURY HIV CONSORTIUM. WHIC HAS A VERY ACTIVE CONSUMER ADVISORY GROUP (CAG), WHICH ORGANIZES SOCIAL AND TESTING EVENTS FOR THE COMMUNITY AND FACILITATES THE WATERBURY HOSPITAL PHOTOGRAPHY GROUP. THE WHIC ALSO HAS A HEPATITIS C CLINIC, RUN BY AN ADVANCED PRACTITIONER NURSE. FROM OCTOBER 2004 TO PRESENT, AT LEAST 150 HEPATITIS C MONO AND CO-INFECTED (HEPATITIS C AND HIV) HAVE BEEN EVALUATED AT THE ID CLINIC. THE HEPATITIS C CLINIC PROVIDES A CONSULTATION WITH A NUTRITIONIST TO ADVISE ON HEALTHY EATING; COORDINATION WITH MENTAL HEALTH SERVICES; AND EDUCATIONAL SESSIONS ON SIDE EFFECT MANAGEMENT, THE IMPORTANCE OF HYDRATION AND ADHERENCE, AND POSITIVE COPING STRATEGIES.FORGING COMMUNITY PARTNERSHIPS: SINCE 2009, THE WHIC HAS SERVED AS THE LEAD AGENCY FOR RYAN WHITE PART A FEDERAL FUNDING REGION 2 OF THE NEW HAVEN/FAIRFIELD ELIGIBLE METROPOLITAN AREA. THE WHIC WAS CHOSEN AS LEAD AGENCY BY THE CONSENSUS OF OTHER LOCAL RYAN WHITE PART A AGENCIES DUE TO ITS EXPERTISE IN PATIENT CARE AND FISCAL MANAGEMENT. AS THE LEAD AGENCY, THE WHIC HAS FORMED LONGSTANDING PARTNERSHIPS WITH STAYWELL HEALTH CENTER, INC., HISPANOS UNIDOS, INC., NEW OPPORTUNITIES, INC., RECOVERY NETWORK OF PROGRAMS, INC., CONNECTICUT COUNSELING CENTERS, INC., AND THE WATERBURY HEALTH DEPARTMENT, ALL OF WHOM WORK ALONGSIDE THE WHIC TO PROVIDE PATIENTS IN THE REGION WITH: - PRIMARY CARE; - MEDICAL CASE MANAGEMENT; - ORAL HEALTH CARE; - INPATIENT AND OUTPATIENT SUBSTANCE ABUSE TREATMENT; - HEALTH INSURANCE ASSISTANCE; - MENTAL HEALTH; - EARLY INTERVENTION SERVICES; - HOUSING ASSISTANCE; - EMERGENCY FINANCIAL ASSISTANCE; - MEDICAL TRANSPORTATION; AND - FOOD PANTRY.FOR THE PAST 10 YEARS, THE WHIC HAS PARTNERED WITH YALE UNIVERSITY'S PROJECT TRANSITIONS, A PROGRAM THAT INTEGRATES SUBSTANCE ABUSE TREATMENT AND CONTINGENCY MANAGEMENT INTO A COMPREHENSIVE JAIL RELEASE PROGRAM FOR PLWH. THROUGH THIS PARTNERSHIP, YALE FUNDS A SUBSTANCE ABUSE COUNSELOR AND MEDICAL CASE MANAGER, BOTH OF WHOM ARE SPANISH SPEAKING AND LOCATED ON-SITE AT THE WHIC.RESHAPING HIV TESTING STATEWIDE: SINCE 2008, PATIENTS VISITING WATERBURY HOSPITAL'S EMERGENCY DEPARTMENT ARE OFFERED FREE HIV TESTING WHILE WAITING TO BE EVALUATED OR TREATED FOR OTHER SYMPTOMS. PATIENTS IN THE EMERGENCY DEPARTMENT NOW HAVE TO OPT OUT OF TESTING. THE PROGRAM HAS SUCCESSFULLY SERVED AS A MODEL FOR OTHER HEALTHCARE INSTITUTIONS ACROSS THE STATE. THANKS, IN PART, TO WHIC'S LEADERSHIP, THE STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH NO LONGER REQUIRES PROVIDERS TO HAVE A SEPARATE CONSENT FORM FOR HIV TESTING. [SEE BELOW FOR CONTINUATION]
    PART VI, LINE 7: N/APART VI, LINE 5 (CONTINUED):ENGAGING PATIENTS: IN 2009, THE WHIC ESTABLISHED ITS PEER ADVOCATE PROGRAM. THREE PATIENTS FROM THE CLINIC SERVE AS THE PEER ADVOCATES, WHO WORK WITH CLIENTS AT THE CLINIC AND USE A SOCIAL NETWORKS STRATEGY TO BRING DIFFICULT-TO-REACH CLIENTS IN FOR TESTING AND/OR CARE; THEY HAVE TRAVELED TO HIGH-RISK NEIGHBORHOODS ON THE WATERBURY HEALTH DEPARTMENT'S COMMUNITY HEALTH VAN TO OFFER COUNSELING AND TESTING AND HAVE PARTICIPATED IN AIDS AWARENESS DAYS TO FACILITATE THE LINKAGE OF NEWLY DIAGNOSED PATIENTS TO PRIMARY CARE. PEER ADVOCATES PARTICIPATE IN THE WHIC'S CARE TEAM AND CONTINUUM MEETINGS TO KEEP PROVIDERS AND LOCAL PARTNERS AWARE OF THE PATIENTS' ACTIVITIES AND NEEDS.THE WHIC OFFERS ITS PATIENTS NATIONALLY-RECOGNIZED PEER AND SUPPORT PROGRAMS, INCLUDING ITS PROJECT PHOTOGRAPHY, WHICH WAS ESTABLISHED IN 2007 TO ENCOURAGE NON-COMPLIANT HIV/AIDS PATIENTS IN THE GREATER WATERBURY AREA TO BECOME MORE PROACTIVE IN THE SELF-MANAGEMENT OF THEIR DISEASE. PROJECT PHOTOGRAPHY HAS POSITIVELY TRANSFORMED ITS PARTICIPANT'S SELF-ESTEEM AND CONFIDENCE. PATIENT PROJECTS HAVE INCLUDED: (1) ENROLLING IN PHOTOGRAPHY CLASSES AT NAUGATUCK VALLEY COMMUNITY COLLEGE, (2) TAKING FIELD TRIPS TO BOSTON, (3) DONATING FRAMED PHOTOGRAPHS TO THE HOSPITAL'S ANNUAL FUNDRAISING GALA, (4) PRODUCING HOLIDAY GREETING CARDS FOR THE HOSPITAL, (5) CREATING TEAM PORTRAITS AT THE HOSPITAL'S FUNDRAISING GOLF TOURNAMENT, AND (6) CONSTRUCTING PHOTOGRAPHY EXHIBITS AT THE HOSPITAL, BARNES & NOBLE BOOKSTORE, AND SILAS BRONSON LIBRARY IN WATERBURY.
REPORTS FILED WITH STATES PART VI, LINE 7 CT
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
THE WATERBURY HOSPITAL
 
Employer identification number

06-0665979
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
Yes
 
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
Yes
 
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
Yes
 
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) JOHN H TOBIN (i)
(ii)		 507,465
0 		0
0 		2,000
0 		264,700
0 		21,173
0 		795,338
0 		0
0
(2) STEVEN L EISEN MD (i)
(ii)		 81,448
54,988 		0
0 		84,847
0 		0
0 		0
217 		166,295
55,205 		0
0
(3) COLLEEN SCOTT (i)
(ii)		 289,220
0 		0
0 		0
0 		13,993
0 		18,757
0 		321,970
0 		0
0
(4) MARY B PRYBYLO (i)
(ii)		 297,897
0 		0
0 		0
0 		6,999
0 		19,093
0 		323,989
0 		0
0
(5) STEVEN SCHNEIDER (i)
(ii)		 345,545
0 		0
0 		0
0 		14,700
0 		20,573
0 		380,818
0 		0
0
(6) MARY K MULSTON (i)
(ii)		 189,324
0 		0
0 		0
0 		5,508
0 		3,315
0 		198,147
0 		0
0
(7) MARYANNE VOLKRINGER (i)
(ii)		 157,764
0 		0
0 		0
0 		4,708
0 		12,168
0 		174,640
0 		0
0
(8) DIANE WOOLLEY (i)
(ii)		 142,826
0 		0
0 		0
0 		4,345
0 		15,558
0 		162,729
0 		0
0
(9) SANDRA IADAROLA (i)
(ii)		 150,958
0 		0
0 		0
0 		4,472
0 		11,953
0 		167,383
0 		0
0
(10) THOMAS REINHARDT (i)
(ii)		 209,077
0 		0
0 		0
0 		6,409
0 		14,191
0 		229,677
0 		0
0
(11) DONALD EDWARDSON (i)
(ii)		 205,098
0 		0
0 		0
0 		6,232
0 		6,670
0 		218,000
0 		0
0
(12) KINSON LEE (i)
(ii)		 197,920
0 		0
0 		0
0 		12,190
0 		11,874
0 		221,984
0 		0
0
(13) PETER PORRELLO (i)
(ii)		 199,700
0 		0
0 		0
0 		6,057
0 		15,618
0 		221,375
0 		0
0
(14) SREEDEVI NAMPOOTHIRI (i)
(ii)		 195,946
0 		0
0 		0
0 		11,899
0 		12,270
0 		220,115
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
  PART I, LINES 4A-B JOHN TOBIN SERP CONTRIBUTION: $250,000 COLLEEN SCOTT SEVERANCE PAY: $109,394 MARY PRYBYLO SEVERANCE PAY: $127,731 MARY MULSTON SEVERANCE PAY: $27,128
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
THE WATERBURY HOSPITAL
 
Employer identification number
06-0665979
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 CONNECTICUT HEALTH & EDUCATIONAL FACILITIES AUTHORITY
  		06-0806186 NONEAVAIL 12-22-2010 25,918,000 REFINANCE/RETIRE EXISTING BONDS & FINANCE NEW MONEY FOR CAPITAL IMPROVEMENTS   X X     X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . . 19,435,000      
2 Amount of bonds defeased . . . . 19,435,000      
3 Total proceeds of issue . . . . 25,918,000      
4 Gross proceeds in reserve funds . .        
5 Capitalized interest from proceeds.        
6 Proceeds in refunding escrow. . . . .        
7 Issuance costs from proceeds . . . 369,888      
8 Credit enhancement from proceeds.        
9 Working capital expenditures from proceeds . .        
10 Capital expenditures from proceeds . . 3,952,298      
11 Other spent proceeds . . 17,638,304      
12 Other unspent proceeds. . . 3,957,510      
13 Year of substantial completion . . . 2013
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? .                
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 . RBS CITIZEN'S NA
  		 
  		 
  		 
 
c Term of hedge . . 10.000000000000      
d Was the hedge superintegrated? .   X            
e Was a hedge terminated? .   X            
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 L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
THE WATERBURY HOSPITAL
 
Employer identification number

06-0665979
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) DAVID PIZZUTO TRUSTEE 22,750 WATERBURY HOSPITAL PAID MR. PIZZUTO A TOTAL OF $22,750 FOR A CHIEF OF STAFF STIPEND.   No
(2) STEVEN EISEN TRUSTEE 16,667 WATERBURY HOSPITAL PAID DR. EISEN A TOTAL OF $16,667 FOR EEG READINGS.   No
(3) CARL SHERTER TRUSTEE 63,150 WATERBURY HOSPITAL PAID DR. SHERTER A TOTAL OF $63,150 FOR A CHIEF OF STAFF STIPEND.   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 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
THE WATERBURY HOSPITAL
 
Employer identification number

06-0665979
Identifier Return Reference Explanation
PROGRAM SERVICE STATEMENT FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED): TOTAL COMMUNITY BENEFITS FOR FY 2011 BY CATEGORY: A. COMMUNITY HEALTH IMPROVEMENT SERVICES & COMMUNITY BENEFIT OPERATIONS BENEFIT: $12,823,398 PERSONS SERVED: 30,230 - COMMUNITY HEALTH EDUCATION - COMMUNITY-BASED CLINICAL SERVICES - HEALTH CARE SUPPORT SERVICES B. HEALTH PROFESSIONS EDUCATION BENEFIT: $14,506,339 PERSONS SERVED: 8,096 - PHYSICIANS/MEDICAL STUDENTS - NURSES/NURSING STUDENTS - OTHER HEALTH PROFESSIONS EDUCATION - SCHOLARSHIPS/FUNDING FOR PROFESSIONAL EDUCATION - OTHER D. RESEARCH BENEFIT: $116,911 PERSONS SERVED: 283 - CLINICAL RESEARCH - COMMUNITY HEALTH RESEARCH E. FINANCIAL AND IN-KIND CONTRIBUTIONS BENEFIT: $412,704 PERSONS SERVED: 61,972 - CASH DONATIONS - IN-KIND DONATIONS F. COMMUNITY BUILDING ACTIVITIES BENEFIT: $529,607 PERSONS SERVED: 1,703 - COMMUNITY SUPPORT - ENVIRONMENTAL IMPROVEMENTS - LEADERSHIP DEVELOPMENT/TRAINING COMMUNITY MEMBERS/ YOUTH PIPELINE - COALITION BUILDING - OTHER G. COMMUNITY BENEFIT OPERATIONS BENEFIT: $64,373 PERSONS SERVED: N/A SUBTOTAL FOR COMMUNITY BENEFITS: $28,453,332 SUBTOTAL FOR PERSONS SERVED: 102,284 TRADITIONAL CHARITY CARE COSTS - FREE CARE: $936,076 - BAD DEBT: $3,038,674 - UNPAID MEDICAID COSTS: $15,540,048 - UNPAID MEDICARE COSTS: $8,335,190 SUBTOTAL FOR CHARITY CARE COSTS BENEFIT: $27,849,988 TOTAL BENEFIT - FY 2011: $56,303,320 CATEGORY A: COMMUNITY HEALTH IMPROVEMENT SERVICES TOTAL BENEFIT: $12,823,398 TOTAL PERSONS SERVED: 30,230 REALIZING THE DIVERSE NEEDS OF RESIDENTS IN OUR COMMUNITY, WATERBURY HOSPITAL REMAINS DEDICATED TO PROVIDING COMPREHENSIVE HEALTH SERVICES TO ENSURE EVERY INDIVIDUAL HAS ACCESS TO APPROPRIATE, QUALITY HEALTHCARE. DURING 2011, WATERBURY HOSPITAL'S SPECTRUM OF SERVICES CONTINUED TO HAVE A POSITIVE IMPACT ON THE WELFARE OF WATERBURY'S CITIZENS. TO REMAIN CONSISTENT WITH WATERBURY HOSPITAL'S MISSION, MANY OF OUR SERVICES ARE TARGETED FOR VULNERABLE MEMBERS OF OUR COMMUNITY, INCLUDING THOSE WHO ARE UNINSURED OR UNDERINSURED. KEY PROGRAMS: WATERBURY HEALTH ACCESS PROGRAM WATERBURY HOSPITAL IS AWARE OF THE ECONOMIC NEEDS MANY PATIENTS IN OUR COMMUNITY, AND, AS A RESULT, WE REMAIN COMMITTED TO THE WATERBURY HEALTH ACCESS PROGRAM. FOUNDED IN 2003 AS A PARTNERSHIP BETWEEN WATERBURY HOSPITAL, ST. MARY'S HOSPITAL, STAYWELL HEALTH CENTER (FQHC), AND THE WATERBURY HEALTH DEPARTMENT, THE WATERBURY HEALTH ACCESS PROGRAM IMPROVES ACCESS TO HIGH-QUALITY MEDICAL CARE BY PROVIDING COMPREHENSIVE CASE MANAGEMENT, PHARMACY ASSISTANCE, AND ACCESS TO PRIMARY AND SUB-SPECIALTY MEDICAL CARE FOR THE UNINSURED AND UNDERINSURED RESIDENTS OF THE GREATER WATERBURY REGION. DURING 2011, THE WATERBURY HEALTH ACCESS PROGRAM HAD OVER 3,600 ACTIVE CLIENTS. ADDITIONALLY, DURING WATERBURY HOSPITAL'S FY 2011, WATERBURY HOSPITAL PROVIDED $397,785 WORTH OF DONATED SERVICES TO WHAP PATIENTS. BEHAVIORAL HEALTH - WATERBURY HOSPITAL'S CENTER FOR BEHAVIORAL HEALTH IS ONE OF THE REGION'S LARGEST, PROVIDING COMPREHENSIVE INPATIENT AND OUTPATIENT SERVICES AND A VARIETY OF SUPPORT GROUPS. OUR BEHAVIORAL HEALTH DEPARTMENT BOASTS A CRISIS CENTER, WHICH PROVIDED SERVICES TO OVER 2,400 INDIVIDUALS DURING 2011. OTHER PROGRAMS INCLUDE HOMELESS OUTREACH, A RESPITE PROGRAM, A PARENT SUPPORT GROUP, A SIBLINGS SUPPORT GROUP, AND A MEDICAL TRANSPORTATION PROGRAM THAT BRINGS CHILDREN AND ADOLSCENTS TO THEIR OUTPATIENT THERAPY APPOINTMENTS AT WATERBURY HOSPITAL. BE WELL BUS - IN ORDER TO ENSURE THAT PATIENTS HAVE ACCESS TO MEDICAL APPOINTMENTS, AT THE HOSPITAL AND AT LOCAL PHYSICIANS' OFFICES, WATERBURY HOSPITAL'S BE WELL BUS PROVIDES TRANSPORTATION SERVICES TO PATIENTS FROM WATERBURY AND ELEVEN OF ITS SURROUNDING TOWNS. DURING 2011, THE BE WELL BUS COMPLETED OVER 4,400 TRANSPORTS TO AND FROM MEDICAL APPOINTMENTS. WATERBURY HOSPITAL HAS CONTRACTED WITH A TRANSPORATION PROVIDER TO OFFER THE BUS SERVICE, AND AREA PROVIDERS PAY A SMALL FEE TO PARTICIPATE. HEART CENTER OF GREATER WATERBURY - FORMED IN COLLABORATION WITH SAINT MARY'S HOSPITAL, THE HEART CENTER OF GREATER WATERBURY PROVIDES DIVERSE MEDICAL SUPPORT INITIATIVES TO HELP EDUCATE RESIDENTS IN THE GREATER WATERBURY COMMUNITY ABOUT PERTINENT HEALTH AND WELLNESS ISSUES. THIS PAST YEAR, THE HEART CENTER CONDUCTED A SERIES OF HEALTH FAIRS AND VARIOUS HEALTH AND WELLNESS EDUCATION SESSIONS, INCLUDING "ASK THE NURSE," WHICH PROVIDES PATIENTS WITH COMPLIMENTARY BLOOD PRESSURE SCREENINGS AND HEALTH AWARENESS EDUCATION AND A "FREEDOM FROM SMOKING" SERIES TO HELP OUR RESIDENTS KICK THE HABIT. DURING 2011, THE HEART CENTER'S PROGRAMS SERVED OVER 3,800 RESIDENTS FROM THE GREATER WATERBURY AREA. FAMILY BIRTHING CENTER - PROVIDING A CHILD-CENTERED FOCUS, WATERBURY HOSPITAL'S FAMILY BIRTHING CENTER OFFERS EXPECTANT PARENTS A VARIETY OF CLASSES TO PREPARE THEM FOR THEIR BABY'S ARRIVAL. BETWEEN BREAST FEEDING, CHILDBIRTH, AND INFANT CARE CLASSES, OUR FAMILY BIRTHING CENTER PROVIDED VITAL INSTRUCTION TO OVER 170 PARENTS LAST YEAR. THANK GOD I'M FEMALE - FOR THE PAST 20 YEARS, WATERBURY HOSPITAL'S "THANK GOD I'M FEMALE" HAS SERVED AS AN ANNUAL WOMEN'S WELLNESS FORUM THAT FEATURES 40 EDUCATIONAL BOOTHS AND HEALTH-RELATED GIVEAWAYS. THE ULTIMATE GOAL OF THE FORUM IS TO EDUCATE ATTENDEES ABOUT STRESS, MENTAL WELL-BEING, HEART HEALTH, DIET, OSTEOPOROSIS AND BONE HEALTH, CHANGE OF LIFE, AND MORE. IN 2011, OVER 400 AREA RESIDENTS ATTENDED THE EVENT. EVERGREEN 50 CLUB - WATERBURY HOSPITAL'S EVERGREEN 50 CLUB IS AN ORGANIZATION COMPRISED OF OVER 15,000 MEMBERS OVER THE AGE OF 50. THE CLUB OFFERS WELLNESS PROGRAMMING, MEDICARE COUNSELING, AND HEALTH EDUCATION PRESENTATIONS ON A VARIETY OF TOPICS ARE PRESENTED BY HEALTH CARE PROFESSIONALS. PRESENTATION TOPICS INCLUDE: HOLISTIC HEALTH, VARICOSE VEIN TREATMENT, HEART DISEASE, SUMMER SKIN CARE, WEIGHT LOSS, BLOOD PRESSURE, BLADDER SCREENINGS, JOINT CARE AND REPLACEMENT, AND RESOLVING ADVERSE OUTCOMES WITH PATIENTS AND FAMILIES. ANNUALLY, THE EVERGREEN 50 CLUB HOSTS A HEALTH FAIR FOR ITS MEMBERS, WHICH PROVIDES FREE FLU SHOTS AND HEALTHCARE SCREENINGS. MEMBERS ALSO ENJOY COMPLIMENTARY PARKING AT WATERBURY HOSPITAL AND RECEIVE A NEWSLETTER THREE TIMES A YEAR WITH INFORMATION ABOUT STAYING HEALTH AND THE COMMUNITY. YALE PRIMARY CARE RESEARCH DAY - THROUGH COLLABORATION WITH ST. MARY'S HOSPITAL IN WATERBURY, CT, WATERBURY HOSPITAL HOSTED ITS ANNUAL YALE PRIMARY CARE RESEARCH DAY. DURING THE DAY, PHYSICIANS AND MEDICAL STUDENTS PRESENT RESEARCH PROJECTS TO THE PHYSICIAN COMMUNITY. HIGH SCHOOL STUDENTS ARE ALSO ENCOURAGED TO PARTICIPATE IN THE ACTIVITIES. WATERBURY HOSPITAL ID CLINIC - CURRENT SERVICES: THE WHIC OFFERS A COMPREHENSIVE "ONE-STOP SHOPPING" MODEL THAT PROVIDES PATIENTS WITH ON-SITE PRIMARY AND SPECIALTY SERVICES, MEDICAL CASE MANAGEMENT, INDIVIDUALIZED MEDICATION ADHERENCE SERVICES, MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES, NUTRITION COUNSELING, INDIVIDUALIZED HIV EDUCATION, LABORATORY TESTING, AND RADIOLOGY SERVICES. IN 2011, WHIC SERVED OVER 470 PEOPLE LIVING WITH HIV/AIDS. WHIC'S STAFF MEMBERS ACTIVELY PARTICIPATE IN STATEWIDE AND AREA COLLABORATIVES, SUCH AS THE CONNECTICUT HIV PLANNING CONSORTIUM (CHPC) AND THE RYAN WHITE PART A PLANNING COUNCIL, AND WHIC FACILITATES THE GREATER WATERBURY HIV CONSORTIUM. WHIC HAS A VERY ACTIVE CONSUMER ADVISORY GROUP (CAG), WHICH ORGANIZES SOCIAL AND TESTING EVENTS FOR THE COMMUNITY AND FACILITATES THE WATERBURY HOSPITAL PHOTOGRAPHY GROUP. THE WHIC ALSO HAS A HEPATITIS C CLINIC, RUN BY AN ADVANCED PRACTITIONER NURSE. FROM OCTOBER 2004 TO PRESENT, AT LEAST 150 HEPATITIS C MONO AND CO-INFECTED (HEPATITIS C AND HIV) HAVE BEEN EVALUATED AT THE ID CLINIC. THE HEPATITIS C CLINIC PROVIDES A CONSULTATION WITH A NUTRITIONIST TO ADVISE ON HEALTHY EATING; COORDINATION WITH MENTAL HEALTH SERVICES; AND EDUCATIONAL SESSIONS ON SIDE EFFECT MANAGEMENT, THE IMPORTANCE OF HYDRATION AND ADHERENCE, AND POSITIVE COPING STRATEGIES. FORGING COMMUNITY PARTNERSHIPS: SINCE 2009, THE WHIC HAS SERVED AS THE LEAD AGENCY FOR RYAN WHITE PART A FEDERAL FUNDING REGION 2 OF THE NEW HAVEN/FAIRFIELD ELIGIBLE METROPOLITAN AREA. THE WHIC WAS CHOSEN AS LEAD AGENCY BY THE CONSENSUS OF OTHER LOCAL RYAN WHITE PART A AGENCIES DUE TO ITS EXPERTISE IN PATIENT CARE AND FISCAL MANAGEMENT. AS THE LEAD AGENCY, THE WHIC HAS FORMED LONGSTANDING PARTNERSHIPS WITH STAYWELL HEALTH CENTER, INC., HISPANOS UNIDOS, INC., NEW OPPORTUNITIES, INC., RECOVERY NETWORK OF PROGRAMS, INC., CONNECTICUT COUNSELING CENTERS, INC., AND THE WATERBURY HEALTH DEPARTMENT, ALL OF WHOM WORK ALONGSIDE THE WHIC TO PROVIDE PATIENTS IN THE REGION WITH: - PRIMARY CARE; - MEDICAL CASE MANAGEMENT; - ORAL HEALTH CARE; - INPATIENT AND OUTPATIENT SUBSTANCE ABUSE TREATMENT; - HEALTH INSURANCE ASSISTANCE; - MENTAL HEALTH; - EARLY INTERVENTION SERVICES; - HOUSING ASSISTANCE; - EMERGENCY FINANCIAL ASSISTANCE; - MEDICAL TRANSPORTATION; AND - FOOD PANTRY.
    FOR THE PAST 10 YEARS, THE WHIC HAS PARTNERED WITH YALE UNIVERSITY'S PROJECT TRANSITIONS, A PROGRAM THAT INTEGRATES SUBSTANCE ABUSE TREATMENT AND CONTINGENCY MANAGEMENT INTO A COMPREHENSIVE JAIL RELEASE PROGRAM FOR PLWH. THROUGH THIS PARTNERSHIP, YALE FUNDS A SUBSTANCE ABUSE COUNSELOR AND MEDICAL CASE MANAGER, BOTH OF WHOM ARE SPANISH SPEAKING AND LOCATED ON-SITE AT THE WHIC. RESHAPING HIV TESTING STATEWIDE: SINCE 2008, PATIENTS VISITING WATERBURY HOSPITAL'S EMERGENCY DEPARTMENT ARE OFFERED FREE HIV TESTING WHILE WAITING TO BE EVALUATED OR TREATED FOR OTHER SYMPTOMS. PATIENTS IN THE EMERGENCY DEPARTMENT NOW HAVE TO OPT OUT OF TESTING. THE PROGRAM HAS SUCCESSFULLY SERVED AS A MODEL FOR OTHER HEALTHCARE INSTITUTIONS ACROSS THE STATE. THANKS, IN PART, TO WHIC'S LEADERSHIP, THE STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH NO LONGER REQUIRES PROVIDERS TO HAVE A SEPARATE CONSENT FORM FOR HIV TESTING. ENGAGING PATIENTS: IN 2009, THE WHIC ESTABLISHED ITS PEER ADVOCATE PROGRAM. THREE PATIENTS FROM THE CLINIC SERVE AS THE PEER ADVOCATES, WHO WORK WITH CLIENTS AT THE CLINIC AND USE A SOCIAL NETWORKS STRATEGY TO BRING DIFFICULT-TO-REACH CLIENTS IN FOR TESTING AND/OR CARE; THEY HAVE TRAVELED TO HIGH-RISK NEIGHBORHOODS ON THE WATERBURY HEALTH DEPARTMENT'S COMMUNITY HEALTH VAN TO OFFER COUNSELING AND TESTING AND HAVE PARTICIPATED IN AIDS AWARENESS DAYS TO FACILITATE THE LINKAGE OF NEWLY DIAGNOSED PATIENTS TO PRIMARY CARE. PEER ADVOCATES PARTICIPATE IN THE WHIC'S CARE TEAM AND CONTINUUM MEETINGS TO KEEP PROVIDERS AND LOCAL PARTNERS AWARE OF THE PATIENTS' ACTIVITIES AND NEEDS. THE WHIC OFFERS ITS PATIENTS NATIONALLY-RECOGNIZED PEER AND SUPPORT PROGRAMS, INCLUDING ITS PROJECT PHOTOGRAPHY, WHICH WAS ESTABLISHED IN 2007 TO ENCOURAGE NON-COMPLIANT HIV/AIDS PATIENTS IN THE GREATER WATERBURY AREA TO BECOME MORE PROACTIVE IN THE SELF-MANAGEMENT OF THEIR DISEASE. PROJECT PHOTOGRAPHY HAS POSITIVELY TRANSFORMED ITS PARTICIPANT'S SELF-ESTEEM AND CONFIDENCE. PATIENT PROJECTS HAVE INCLUDED: (1) ENROLLING IN PHOTOGRAPHY CLASSES AT NAUGATUCK VALLEY COMMUNITY COLLEGE, (2) TAKING FIELD TRIPS TO BOSTON, (3) DONATING FRAMED PHOTOGRAPHS TO THE HOSPITAL'S ANNUAL FUNDRAISING GALA, (4) PRODUCING HOLIDAY GREETING CARDS FOR THE HOSPITAL, (5) CREATING TEAM PORTRAITS AT THE HOSPITAL'S FUNDRAISING GOLF TOURNAMENT, AND (6) CONSTRUCTING PHOTOGRAPHY EXHIBITS AT THE HOSPITAL, BARNES & NOBLE BOOKSTORE, AND SILAS BRONSON LIBRARY IN WATERBURY. CATEGORY B: HEALTH PROFESSIONS EDUCATION TOTAL BENEFIT: $14,506,339 TOTAL PERSONS SERVED: 8,096 SINCE IT FIRST AFFILIATED WITH THE YALE UNIVERSITY SCHOOL OF MEDICINE IN 1973, WATERBURY HOSPITAL HAS SERVED AS THE CLINICAL TRAINING SITE FOR THOUSANDS OF MEDICAL PROFESSIONALS IN TRAINING. DURING 2011, STUDENTS COMPLETED CLINICAL ROTATIONS, INTERNSHIPS, AND SHADOWING EXPERIENCES AT WATERBURY HOSPITAL. KEY PROGRAMS: YALE PRIMARY CARE INTERNAL MEDICINE RESIDENCY PROGRAM - DURING 2011, OUR YALE PRIMARY CARE INTERNAL MEDICINE RESIDENCY COMPLEMENT CONSISTED OF THE FOLLOWING BREAKDOWN: 21 FIRST-YEAR RESIDENTS, 14 SECOND-YEAR RESIDENTS, 14 THIRD-YEAR RESIDENTS, AND 5 CHIEF RESIDENTS, FOR A TOTAL OF 54 RESIDENTS. RESIDENT ACTIVITIES INCLUDED: - PARTICIPATION IN RESEARCH DAYS AT YALE AND WATERBURY/ST. MARY'S HOSPITALS; - ACP REGIONAL AND NATIONAL MEETINGS; - THE ANNUAL HEALTH FAIR HELD ON THE WATERBURY GREEN; - HOME/OFFICE VISITS FOR CLINIC PATIENTS; AND - EDUCATIONAL SEMINARS HELD AT WATERBURY HOSPITAL AND YALE UNIVERSITY. AT WATERBURY HOSPITAL, WE SEEK TO TRAIN PHYSICIANS WHO DESIRE A GENERALIST BACKGROUND TO THEIR CAREERS IN MEDICINE. THIS PROGRAM IS UNIQUE IN THAT IT PROVIDES THE MEDICAL RESIDENTS THE OPPORTUNITY TO WORK EACH YEAR IN A TERTIARY MEDICAL CENTER AT YALE-NEW HAVEN HOSPITAL, A COMMUNITY HOSPITAL AT WATERBURY HOSPITAL, AND OUTPATIENT PRACTICE SITES THAT INCLUDE PRIVATE PRACTICE OFFICES AND COMMUNITY HEALTH CENTERS IS UNIQUE IN RESIDENCY TRAINING. OUR GRADUATES ARE HIGHLY SOUGHT AFTER BY PRIVATE PRACTICE OFFICES, HOSPITALIST PROGRAMS, AND FELLOWSHIP PROGRAMS THROUGHOUT THE COUNTRY. NURSING AND CERTIFIED NURSE'S AID STUDENTS - DURING 2011, NURSING AND CERTIFIED NURSE'S AID (CNA) STUDENTS FROM NAUGATUCK VALLEY COMMUNITY COLLEGE, WESTERN CONNECTICUT STATE UNIVERSITY, UCONN, QUINNIPIAC UNIVERSITY, BRIDGEPORT HOSPITAL SCHOOL OF NURSING, KAYNOR HIGH SCHOOL, WILBY HIGH SCHOOL, PORTER & CHESTER INSTITUTE, WATERTOWN HIGH SCHOOL, AND YALE UNIVERSITY COMPLETED CLINICAL ROTATIONS AT WATERBURY HOSPITAL. DURING THEIR TIME AT THE HOSPITAL, THESE STUDENTS WORKED IN OVER EIGHTEEN DEPARTMENTS, RANGING FROM THE EMERGENCY DEPARTMENT TO THE CHILD CARE CENTER. STUDENT NURSE INTERN PROGRAM (SNI) - THE SNI PROGRAM IS AVAILABLE FOR NURSING STUDENTS ENTERING THEIR SENIOR YEAR. THE PROGRAM PROVIDES THESE STUDENT NURSES WITH SHADOWING OPPORTUNITIES SO THEY CAN APPLY THEIR CONTENT KNOWLEDGE TO AUTHENTIC PATIENT CARE SITUATIONS. STAFF RNS SERVE AS THE STUDENTS' MENTORS AS THE STUDENTS ACCOMPANY THEM ON THEIR MEDICAL ROUNDS. THE GOALS OF THE PROGRAM ARE: (1) TO PROVIDE THE STUDENT NURSES WITH THE KNOWLEDGE AND SKILLS NECESSARY TO PASS THE NCLEX EXAM AND (2) TO SOCIALIZE THE STUDENT NURSE IN AN ATTEMPT TO DECREASE THE STRESS OF ASSIMILATING INTO THE HOSPITAL'S WORK ENVIRONMENT, SHOULD THEY BE HIRED AS GRADUATE NURSES AT WATERBURY HOSPITAL. PHYSICIAN'S ASSISTANT (PA) STUDENTS - OVER 20 P.A. STUDENTS FROM QUINNIPIAC UNIVERSITY AND UCONN COMPLETED CLINICAL ROUNDS IN SEVERAL DEPARTMENTS AROUND THE HOSPITAL, INCLUDING THE OPERATING ROOM, EMERGENCY DEPARTMENT, BEHAVIORAL HEALTH, AND RADIOLOGY. THE EXPERIENCE IS DESIGNED FOR THE STUDENT TO LEARN TO APPLY THE KNOWLEDGE GAINED FROM DIDACTIC COURSE WORK IN MEDICINE, SURGERY, AND THE BASIC AND BEHAVIORAL SCIENCES INTO THE CLINICAL ARENA RESULTING IN THE ABILITY TO SUCCESSFULLY MANAGE PATIENTS IN A THOROUGH AND COMPREHENSIVE MANNER. THE PRIMARY GOAL OF CLINICAL ROTATIONS IS TO EXPOSE THE STUDENT TO PATIENTS OF ALL AGES, PATIENTS IN A VARIETY OF DIFFERENT SETTINGS, AND PATIENTS WITH A BROAD RANGE OF MEDICAL, SURGICAL, AND PSYCHOSOCIAL PROBLEMS. THE P.A. STUDENTS PARTICIPATE IN: - HISTORY TAKING; - EXAMINING THE PATIENT; - ASSISTING IN AND/OR PERFORMING DIAGNOSTIC TESTING; - ASSISTING IN AND/OR PERFORMING THERAPEUTIC TASKS; - ORAL PRESENTATIONS; - MEDICAL DOCUMENTATION OF THE PATIENT ENCOUNTER; - FORMULATING A DIFFERENTIAL DIAGNOSIS AND PROBLEM LIST; - FORMULATING A TREATMENT PLAN; AND - COUNSELING OF PATIENTS REGARDING MEDICATION, DIET, AND LIFESTYLE CHANGES SUCH AS SMOKING CESSATION, EXERCISE, AND WELL-BEING. PHARMD STUDENTS FROM UCONN - WATERBURY HOSPITAL PHARMACY DEPARTMENT PROVIDES ROTATIONS IN CRITICAL CARE, INFECTIOUS DISEASE, AND INSTITUTIONAL PHARMACY FOR PHARMD STUDENTS COMPLETING THEIR FINAL YEAR. THE CRITICAL CARE AND INFECTIOUS DISEASE ROTATIONS REQUIRE THE STUDENTS TO PERFORM CASE PRESENTATIONS, JOURNAL CLUB PRESENTATIONS, SOAP PRESENTATIONS AND PARTICIPATE IN ROUNDS WITH THE MEDICAL TEAM. A PHARMACIST OVERSEES THE STUDENTS AS THEY ACTIVELY PARTICIPATE IN ROUNDS AND ALSO PROVIDES INSTRUCTION FOR FORMAT AND CONTENT OF THEIR PRESENTATIONS. THE INSTITUTIONAL PHARMACY EXPERIENCE CONSISTS OF, BUT IS NOT LIMITED TO, LEARNING HOW TO CALCULATE, MIX AND DETERMINE STABILITIES AND STERILITIES OF IV MEDICATIONS. PHARMACISTS AND PHARMACY TECHNICIANS FACILITATE THE EDUCATION AND TRAINING FOR THE INSTITUTIONAL ROTATION. THROUGHOUT ALL THREE ROTATIONS THE STUDENTS LEARN TO PROVIDE DRUG INFORMATION. THE STUDENTS ARE AN ASSET TO THE PHARMACIST AS DRUG INFORMATION QUESTIONS ARISE. THIS IS THE PERFECT OPPORTUNITY FOR THE STUDENT TO UTILIZE WHAT THEY HAVE LEARNED WHILE PROVIDING SUPPORT FOR THE CLINICIANS AT WATERBURY HOSPITAL. WATERBURY HOSPITAL PHARMACY IS ENRICHED WHILE PROVIDING THESE ROTATIONS TO DOCTOR OF PHARMACY CANDIDATES. TRAINING NEW PHARMACISTS ALLOWS FOR CONSTANT REVIEW OF OUR POLICIES AND PROCEDURES TO REMAIN CURRENT WITH NEW TECHNOLOGY AND DRUG INFORMATION. DURING 2011, TWENTY PHARMACY STUDENTS COMPLETED ROTATIONS AT WATERBURY HOSPITAL.
    RADIOLOGY STUDENTS FROM NVCC - THE NAUGATUCK VALLEY COMMUNITY COLLEGE (NVCC) RADIOLOGY STUDENTS ARE INVOLVED WITH MANY ACTIVITIES WHILE ASSIGNED TO WATERBURY HOSPITAL. UNDER THE SUPERVISION OF A NVCC CLINICAL INSTRUCTOR AND HOSPITAL RADIOLOGIC TECHNOLOGISTS, THE STUDENTS ARE ASSIGNED TO THE VARIOUS RADIOGRAPHIC SUITES AND MODALITIES. DURING THEIR ASSIGNMENT, STUDENTS ARE PERFORMING OR ASSISTING WITH RADIOGRAPHIC PROCEDURES, INCLUDING CHEST X-RAYS, SKELETAL EXAMS, FLUOROSCOPIC PROCEDURES, MOBILE X-RAYS IN THE VARIOUS PATIENT UNITS, AND SURGICAL CASES. THE STUDENTS ALSO INCREASE THE NUMBER OF INDIVIDUALS AVAILABLE IN THE DEPARTMENT TO ASSIST IN MOVING AND TRANSPORTING PATIENTS AS WELL AS CHAPERONING SENSITIVE EXAMS. IN ADDITION TO THE DIAGNOSTIC RADIOLOGY THE STUDENTS ARE ASSIGNED TO EXPERIENCES IN INTERVENTIONAL RADIOLOGY, CT, MRI, NUCLEAR MEDICINE, AND ULTRASOUND. STUDENTS WORK IN THESE MODALITIES UNDER THE DIRECT SUPERVISION OF THE HOSPITAL STAFF. WATERBURY HOSPITAL'S AFFILIATION WITH NVCC AS A CLINICAL SITE FOR STUDENTS HAS MANY BENEFITS. PERHAPS THE SINGLE MOST IMPORTANT BENEFIT IS THE HOSPITAL HAS A CONTINUOUS STREAM OF POTENTIAL RADIOLOGY EMPLOYEES. STUDENTS ARE IN THE PROGRAM FOR 22 MONTHS AND IN THAT TIME BECOME VERY FAMILIAR WITH THE HOSPITAL EQUIPMENT, ROUTINES, PERSONAL, AND MISSION. THIS PROVIDES WATERBURY HOSPITAL WITH NEW EMPLOYEES WHO HAVE A STRONG SKILL SET AND PROVEN DEDICATION TO THE HOSPITAL COMMUNITY. OTHER CLINICAL STUDENTS - WATERBURY HOSPITAL ALSO HOSTED THE FOLLOWING STUDENTS FROM DIVERSE CLINICAL BACKGROUNDS: - DRUG & ALCOHOL STUDENTS FROM GATEWAY COMMUNITY COLLEGE AND NAUGATUCK VALLEY COMMUNITY COLLEGE - MARRIAGE & FAMILY THERAPY STUDENTS FROM SOUTHERN CONNECTICUT STATE UNIVERSITY - OCCUPATIONAL THERAPY STUDENTS FROM QUINNIPIAC UNIVERSITY - ART THERAPY STUDENTS FROM ALBERTUS MAGNUS COLLEGE - MEDICAL STUDENTS FROM YALE UNIVERSITY CATEGORY D: RESEARCH TOTAL BENEFIT: $116,911 TOTAL PERSON SERVED: 283 DURING 2011, WATERBURY HOSPITAL PARTICIPATED IN SEVERAL CLINICAL TRIALS THAT BENEFITED RESIDENTS IN GREATER WATERBURY. THESE TRIALS INCLUDED THE SAPPHIRE STUDY, WHICH EXAMINED STENTING AND ANGIOPLASTY WITH PROTECTION IN PATIENTS AT HIGH-RISK FOR ENDARTECTOMY, AND THE KONICA-MINOLTA XPRESS DIGITAL MAMMOGRAPHY SYSTEM STUDY FOR COMPUTER AIDED DETECTION ON MAMMOGRAM AND BREAST BIOPSY. CATEGORY E: FINANCIAL & IN-KIND CONTRIBUTIONS TOTAL BENEFIT: $412,704 TOTAL PERSONS SERVED: 61,972 WATERBURY HOSPITAL CONTINUES TO PROVIDE FINANCIAL AND IN-KIND CONTRIBUTIONS TO MEMBERS OF OUR COMMUNITY. FROM UNITED WAY DONATIONS FROM HOSPITAL EMPLOYEES TO PARKING VOUCHERS FOR PATIENTS, WATERBURY HOSPITAL PROVIDED $412,704 WORTH OF FINANCIAL AND IN-KIND SUPPORT DURING 2011. LOCAL AGENCIES RECEIVING DONATIONS INCLUDED: - AMERICAN LIVER FOUNDATION - EASTER SEALS - HOMELESS CONNECT - MATTATUCK MUSEUM - NATIONAL KIDNEY FOUNDATION - PALACE THEATER - UNITED WAY OF GREATER WATERBURY - VNA HEALTH AT HOME - WATERBURY SYMPHONY ORCHESTRA - WATERBURY REGIONAL CHAMBER CATEGORY F: COMMUNITY BUILDING ACTIVITIES TOTAL BENEFIT: $529,607 TOTAL PERSONS SERVED: 1,703 AS THE LARGEST PRIVATE EMPLOYER IN THE CITY OF WATERBURY, WATERBURY HOSPITAL UNDERSTANDS ITS ROLE AS A LEADER IN THE COMMUNITY. MANY OF OUR PROGRAMS ARE SPECIFICALLY TARGETED AT STRENGTHENING THE WELFARE AND AWARENESS OF THE CITIZENS WITHIN OUR COMMUNITY. FROM EDUCATING WATERBURY'S YOUTH ABOUT HEALTHCARE CAREERS TO OFFERING SUPPORT GROUPS TO FAMILIES WHO HAVE LOST A LOVED ONE, WATERBURY HOSPITAL REMAINS COMMITTED TO MAKING THE GREATER WATERBURY AREA A HEALTHIER, STRONGER, MORE PRODUCTIVE COMMUNITY. KEY PROGRAMS: YOUTH PIPELINE INITIATIVES: SINCE THE YOUTH PIPELINE INITIATIVES WERE ESTABLISHED IN 2001 AS A PARTNERSHIP BETWEEN WATERBURY HOSPITAL AND WATERBURY PUBLIC SCHOOLS, ITS MISSION HAS REMAINED THE SAME: TO CLOSE THE ACHIEVEMENT GAP FOR MINORITY AND ECONOMICALLY DISADVANTAGED STUDENTS IN WATERBURY SO THEY CAN MATRICULATE AND COMPETE NATIONALLY FOR PLACEMENT IN POST-SECONDARY EDUCATION PROGRAMS IN PREPARATION FOR HEALTH CAREERS. WATERBURY HOSPITAL HAS REMAINED DEDICATED TO ENHANCING AND ENRICHING THE LIVES OF WATERBURY'S YOUTH. WE TAKE PRIDE IN HELPING STUDENTS REALIZE THEIR POTENTIAL AS THEY EMBARK ON THEIR ACADEMIC AND PERSONAL JOURNEYS. TO THIS END, DURING 2011, WATERBURY HOSPITAL CONTINUED TO PROVIDE OVER 600 STUDENTS AND PARENTS IN GREATER WATERBURY WITH UNIQUE EDUCATIONAL PROGRAMS THAT WILL ENHANCE THE OVERALL WELFARE OF OUR COMMUNITY. THE YOUTH PIPELINE INITIATIVES ARE A MULTIFACETED SERIES WITH FIVE FOCUS AREAS DURING 2011, INCLUDING: - PROVIDING EARLY ACQUAINTANCE WITH CAREERS IN HEALTHCARE (PEACH) - SINCE ITS INCEPTION IN 2004, WATERBURY HOSPITAL'S PROVIDING EARLY ACQUAINTANCE WITH CAREERS IN HEALTHCARE (PEACH) PROGRAM HAS WORKED WITH ADMINISTRATORS, TEACHERS, AND STUDENTS AT WATERBURY'S NORTH END MIDDLE SCHOOL AND WEST SIDE MIDDLE SCHOOL TO ADDRESS PROJECTED SHORTAGES OF HEALTHCARE WORKERS AND TO CLOSE THE ACHIEVEMENT GAP FOR STUDENTS IN WATERBURY PUBLIC SCHOOLS. THROUGH THE PEACH PROGRAM, STUDENTS ENGAGE WITH HEALTHCARE WORKERS IN A NON-EMERGENCY SETTING AND ARE INFORMED OF THE VARIETY OF HEALTHCARE CAREER OPPORTUNITIES AVAILABLE IN OUR COMMUNITY. EACH SPRING, OVER 100 SEVENTH GRADERS FROM WATERBURY TAKE PART IN A DAY-LONG PEACH TOUR AT WATERBURY HOSPITAL, DURING WHICH THEY VISIT AT LEAST SIX HOSPITAL DEPARTMENTS AND COMPLETE HANDS-ON LEARNING ACTIVITIES WITH HOSPITAL STAFF. ANNUALLY, WATERBURY HOSPITAL ALSO OFFERS IT PEACH SPRING BREAK EXPLORATION CAMP, IN WHICH 20 MIDDLE SCHOOL STUDENTS FROM WATERBURY TAX PART IN SHADOWING AND HANDS-ON LEARNING ACTIVITIES AT THE HOSPITAL AND ARE CPR CERTIFIED. - 9TH GRADE MENTORING - FOR THE PAST SIX YEARS, DOZENS OF WATERBURY HOSPITAL EMPLOYEES HAVE SERVED AS MENTORS AT WATERBURY'S WILBY HIGH SCHOOL. WATERBURY HOSPITAL'S MENTORS VOLUNTEER FOR ONE HOUR PER WEEK FOR 25 TO 30 WEEKS PER SCHOOL YEAR TO GUIDE STUDENTS AS THEY SET ACADEMIC AND PERSONAL GOALS FOR HIGH SCHOOL AND BEYOND. IN 2011, FIFTEEN WATERBURY HOSPITAL STAFF MEMBERS WORKED WITH A TOTAL OF 200 STUDENTS FOR OVER 500 HOURS. - PARENT LEADERSHIP TRAINING INSTITUTE (PLTI) - IN 2011, SIXTEEN PARENTS IN THE GREATER WATERBURY SUCCESSFULLY COMPLETED WATERBURY'S PLTI, A 20-WEEK CURRICULUM TEACHING LEADERSHIP AND ADVOCACY SKILLS. WATERBURY HOSPITAL HAS HOSTED THE WATERBURY PLTI SINCE 2000, AND THE PROGRAM HAS TRAINED AND GRADUATED OVER 150 AREA PARENTS. PLTI'S CORE MISSION IS TO IMPART LEADERSHIP AND ADVOCACY SKILLS TO PARENTS WHILE SIMULTANEOUSLY EDUCATING THEM ABOUT VOLUNTEERISM, CIVIC LIFE, AND THE PROCESS BY WHICH STATE AND LOCAL GOVERNMENTS ENACT AND CHANGE LAWS. EACH PARTICIPANT COMPLETES AND IMPLEMENTS A COMMUNITY PROJECT; EXAMPLE PROJECTS FROM 2011 INCLUDE "BRIDGE THE GAP" (TO CLOSE THE ACHIEVEMENT GAP FOR STUDENTS) AND "ALL DAY WEE CARE (A 24-HOUR LEARNING CENTER TO BETTER CHILDREN AND THE COMMUNITY). - WH SUMMER BRIDGE PROGRAM - DURING THE SUMMER OF 2011, TWENTY-SIX LOCAL STUDENTS FROM WATERBURY, GRADES 6-11, PARTICIPATED IN THE WH SUMMER BRIDGE PROGRAM, WHICH PROVIDED THE STUDENTS WITH ACADEMIC PREPARATION, SUCH AS SAT MATH AND SAT ENGLISH REVIEW, JOB READINESS ACTIVITIES, AND JOB SHADOWING THROUGHOUT THE HOSPITAL. IN ORDER TO INCREASE THE PROGRAM'S DIVERSITY, A HANDFUL OF PROGRAM SLOTS WERE ALLOCATED FOR STUDENTS OF WATERBURY HOSPITAL EMPLOYEES. BY THE END OF THE PROGRAM, STUDENTS: - LEARNED 360 NEW SAT VOCABULARY WORDS; - COMPLETED 11 HOURS OF ALGEBRA AND GEOMETRY REVIEW; - READ LORD OF THE FLIES AND WORKED ON A JOURNAL; - COMPLETED A PHOTOGRAPHY SELF-PORTRAIT, WHICH THEY CONTRIBUTED TO THE CLASS PHOTO BOOK; - COMPLETED MOCK JOB APPLICATIONS AND JOB INTERVIEWS WITH THE HOSPITAL'S HUMAN RESOURCES CONSULTANTS; - LEARNED MICROSOFT OFFICE AND ADOBE PHOTOSHOP FROM WH'S INFORMATIONS SERVICES TRAINER; AND - SHADOWED WH CLINICIANS IN GASTROENTEROLOGY, TRAUMA, RADIOLOGY, ELECTROENCEPHALOGRAPHY, AND EMERGENCY DEPARTMENTS. SUPPORT GROUPS - DURING 2011, WATERBURY HOSPITAL HOSTED SEVERAL SUPPORT GROUPS FOR ITS PATIENTS AND THEIR FAMILIES, INCLUDING: - SHARE, A SUPPORT GROUP RUN BY THE FAMILY BIRTHING CENTER FOR PARENTS WHO HAVE LOST A BABY; - BEHAVIORAL HEALTH'S PARENT AND SIBLING SUPPORT GROUP, WHICH OFFERS EMOTIONAL ASSISTANCE TO FAMILIES WHO HAVE CHILDREN IN TREATMENT; AND - ALCOHOLICS ANONYMOUS, WHICH MEETS WEEKLY THROUGHOUT THE YEAR AND IS COORDINATED BY OUR BEHAVIORAL HEALTH DEPARTMENT.
FORM 990, PART VI, SECTION A, LINE 6   GREATER WATERBURY HEALTH NETWORK, INC. IS SOLE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7A   GREATER WATERBURY HEALTH NETWORK, INC. ELECTS HOSPITAL BOARD.
FORM 990, PART VI, SECTION A, LINE 7B   GREATER WATERBURY HEALTH NETWORK, INC. HAS RESERVED POWERS FOR HOSPITAL TRANSACTIONS.
FORM 990, PART VI, SECTION B, LINE 11   REVIEWED AND APPROVED BY ORGANIZATION'S AUDIT COMMITTEE. A COPY OF THE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF THE AUDIT COMMITTEE BEFORE IT IS FILED.
  FORM 990, PART VI, SECTION B, LINE 12C THE HOSPITAL COMPLIANCE OFFICER REVIEWS ANNUALLY THE SUBMISSION OF POTENTIAL/ACTUAL CONFLICT DECLARATIONS. THEY ARE ALSO REVIEWED ANNUALLY AT THE BOARD'S COMPLIANCE AND ETHICS COMMITTEE MEETING AND RECOMMENDATIONS FOR ACTION ARE MADE TO THE FULL BOARD AS NECESSARY. ADDITIONALLY, RESPONSES ARE PROFILED, BY MEMBER, FOR EACH COMMITTEE OF THE BOARD/NETWORK, AND DISTRIBUTED AT EACH COMMITTEE MEETING AS A WAY TO PROMOTE TRANSPARENCY. THE COMMITTEE CHAIR AND MEMBERS SHARE RESPONSIBILITY IN IDENTIFYING AND MANAGING THESE DECLARED CONFLICTS OF INTEREST WHEN MAKING BUSINESS DECISIONS ON BEHALF OF THE HOSPITAL.
  FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION IS UNDER THE PURVIEW OF THE BOARD OF TRUSTEES. THERE IS A COMPENSATION COMMITTEE AND THEY ALWAYS USE THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTANT WHO USES NATIONAL, STATE AND REGIONAL COMPENSATION SURVEY DATA FOR SIMILAR TAX EXEMPT COMMUNITY HOSPITALS.
  FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL RESULTS ARE MADE AVAILABLE IN THE ANNUAL REPORT TO THE COMMUNITY. GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.
  FORM 990, PART VII, SECTION A: AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: JOHN H. TOBIN - 5.00 HRS CARL CONTADINI - 0.30 HRS JACK KELLY - 0.30 HRS DARLENE STROMSTAD - 5.00 HRS CARL SHERTER, MD - 0.30 HRS O.J. BIZZOZERO, JR., MD - 0.50 HRS RONALD D'ANDREA, MD - 0.20 HRS STEVEN L. EISEN, MD - 0.30 HRS JAMES H. GATLING, PH.D - 0.40 HRS FREDERICK L. LUEDKE - 0.50 HRS PATRICIA MCKINLEY - 0.40 HRS JOHN A. MICHAELS - 0.50 HRS DAVID J. PIZZUTO, MD - 0.30 HRS WILLIAM J. PIZZUTO, PH.D - 0.90 HRS ANDREW K. SKIPP - 0.20 HRS AJ WASSERSTEIN - 0.40 HRS MICHAEL A. WILSON, CPA, MBA - 0.20 HRS DAVID W. GRIFFIN, ESQ. - 0.60 HRS WILLIAM E. SOLBERG - 0.20 HRS COLLEEN SCOTT - 6.00 HRS MARY B. PRYBYLO - 5.00 HRS STEVEN E. SCHNEIDER - 6.00 HRS MARY K. MULSTON - 5.30 HRS MARYANNE VOLKRINGER - 5.00 HRS DAVID CEMENO - 5.00 HRS DIANE WOOLLEY - 5.00 HRS SANDRA IADAROLA - 5.30 HRS
CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -2,049,953. PRIOR PERIOD ADJUSTMENTS: -2,760,000. INCREASE IN FAIR VALUE OF FUNDS HELD IN TRUST BY OTHERS -2,221,826. ALLIANCE SUBSIDY -9,331,460. PENSION LIABILITY ADJUSTMENT -1,816,446. INTEREST RATE SWAP ADJUSTMENT -2,414,415. INCOME FROM WATERBURY GASTROENTEROLGY -10,356. TOTAL TO FORM 990, PART XI, LINE 5: -20,604,456.
  FORM 990, PART XII, LINE 2C: THE AUDIT COMMITTEE AND THE BOARD OF DIRECTORS HAS THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT. THE AUDIT COMMITTEE MAKES RECOMMENDATIONS TO THE BOARD OF DIRECTORS IN REGARD TO THE SELECTION OF AN INDEPENDENT AUDITOR.
AMENDED RETURN   DURING FISCAL YEAR 2012, IT WAS DETERMINED THAT INVENTORY OF CERTAIN DEPARTMENTS, PREVIOUSLY BELIEVED TO BE IMMATERIAL, SHOULD BE RECORDED. THE HOSPITAL RECORDED A $2,400,000 INCREASE TO INVENTORY ON THE SEPTEMBER 30, 2010 BALANCE SHEET. ALSO DURING FISCAL YEAR 2012, IT WAS DETERMINED THAT THE PATIENT ACCOUNTS RECEIVABLE WAS OVERSTATED BY $5,160,000 AS OF SEPTEMBER 30, 2010 AND BAD DEBT EXPENSE WAS UNDERSTATED BY 2,210,000 FOR THE YEAR ENDED SEPTEMBER 30, 2011, PRIMARILY RESULTING FROM PATIENT ACCOUNTS RECEIVABLE BALANCES FROM WORKERS' COMPENSATION COMPANIES AND SELF-PAY PATIENTS. THE FOLLOWING PARTS AND SCHEDULES OF THE FORM 990 WERE AMENDED AS A RESULT OF THE RESTATED FINANCIAL STATEMENTS: - FORM 990, PART III, LINE 4A, PROGRAM EXPENSE AMOUNT - FORM 990, PART IV, LINE 33,CHANGE TO YES - FORM 990, PART IX, LINE 24, BAD DEBT EXPENSE AMOUNT - FORM 990, PART X, LINE 3, PLEDGES AND GRANTS RECEIVABLE AMOUNT - FORM 990, PART X, LINE 4, ACCOUNTS RECEIVABLE AMOUNT - FORM 990, PART X, LINE 8, INVENTORIES - FORM 990, PART X, LINE 17, ACCOUNTS PAYABLE AND ACCRUED EXPENSES - FORM 990, PART X, LINE 27, UNRESTRICTED NET ASSETS - FORM 990, PART XI, RECONCILIATION OF NET ASSETS - SCHEDULE D, PART XI, RECONCILIATION OF NET ASSETS - SCHEDULE D, PART XII, RECONCILAITION OF REVENUES - SCHEDULE D, PART XIII, RECONCILIATION OF EXPENSES
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
THE WATERBURY HOSPITAL
 
Employer identification number

06-0665979
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







(1) CARDIOLOGY ASSOCIATES OF GREATER WATERBURY LLC
455 CHASE PARKWAY
WATERBURY,CT06708
27-3828899 		CARDIOLOGY PRACTICE CT -1,991,205 3,321,506 THE WATERBURY HOSPITAL
 










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) GREATER WATERBURY HEALTH NETWORK INC

64 ROBBINS STREET

WATERBURY,CT06721
22-2572044 		HEALTH CARE MANAGEMENT CT 501(C)(3) 11 TYPE 1 N/A
 
No
(2) GREATER WATERBURY HEALTH SERVICES INC

64 ROBBINS STREET

WATERBURY,CT06708
22-2572042 		HEALTH SERVICES CT 501(C)(3) 9 GREATER WATERBURY HEALTH NETWORK INC
 
 
No
(3) ALLIANCE MEDICAL GROUP INC

1625 STRAITS TURNPIKE SUITE 211

MIDDLEBURY,CT06762
26-3520540 		HEALTH SERVICES CT 501(C)(3) 9 THE WATERBURY HOSPITAL
 
Yes
 








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) ACCESS REHAB CENTERS LLC

22 TOMPKINS STREET
WATERBURY,CT06708
06-1527429 		THERAPY SERVICES CT THE WATERBURY HOSPITAL
  		RELATED 556,297 2,240,450   No     No  
(2) GREATER WATERBURY IMAGING CENTER LLP

64 ROBBINS STREET
WATERBURY,CT06721
06-1242903 		IMAGING SERVICES CT THE WATERBURY HOSPITAL
  		RELATED 1,454,539 3,375,862   No     No  
(3) IMAGING PARTNERS LLC

134 GRANDVIEW AVENUE
WATERBURY,CT06708
06-1617047 		IMAGING SERVICES CT THE WATERBURY HOSPITAL
  		RELATED 65,887 148,535   No     No  
(4) WATERBURY GASTROENTEROLOGY CO-MANAGEMENT COMPANY LLC

64 ROBBINS STREET
WATERBURY,CT06721
27-2417014 		MEDICAL SERVICES CT THE WATERBURY HOSPITAL
  		RELATED 10,356 12,301   No     No  






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












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
Yes
 
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
Yes
 
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
 
No
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
Yes
 
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
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) ACCESS REHAB CENTERS LLC

 A 66,438  
(2) ACCESS REHAB CENTERS LLC

 L 1,255,322  
(3) ALLIANCE MEDICAL GROUP

 A 13,823  
(4) GREATER WATERBURY IMAGING CENTER LLP

 A 109,408  
(5) GREATER WATERBURY IMAGING CENTER LLP

 L 1,114,200  
(6) ALLIANCE MEDICAL GROUP

 B 277,380  
(7) ALLIANCE MEDICAL GROUP

 Q 9,331,459  
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


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