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TIN:
SCHEDULE O
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
(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.
Attach to Form 990 or 990-EZ.OMB No. 1545-0047
2010
Open to Public
Inspection
Inspection
Name of the organization
COMMUNITY HEALTH NETWORK OF CONNECTICUT INC
Employer identification number
06-1429341
06-1429341
| Identifier | Return Reference | Explanation |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS 7 MEMBERS (SPONSORS); 7 FQHC SPONSORS HAVE VOTING RIGHTS. | |
| FORM 990, PART VI, SECTION A, LINE 7A | SINGLE CLASS OF MEMBERSHIP - EACH SPONSOR IS A MEMBER AND HAS ONE VOTING RIGHT. | |
| FORM 990, PART VI, SECTION A, LINE 7B | ANY MEMBER MAY BE REMOVED AS A MEMBER, WITH OR WITHOUT CAUSE, BY THE AFFIRMATIVE VOTE OF AT LEAST EIGHTY PERCENT OF THE MEMBERS, EXCLUSIVE OF THE MEMBER PROPOSED FOR REMOVAL. THE FOLLOWING ACTIONS MUST BE APPROVED BY THE AFFIRMATIVE VOTE OF TWO-THIRDS OF THE MEMBERS: A) DISPOSE OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS; B) ENGAGE IN NEW LINES OF BUSINESS; C) APPROVE THE TERMS OF ENGAGEMENT OF ANY MANAGEMENT COMPANY FOR MANAGEMENT OF THE ENTIRE CORPORATION AND THE AMENDMENT, RENEWAL OR TERMINATION OF SUCH ENGAGEMENT; D) AMEND THE CORPORATION'S BYLAWS OR CERTIFICATE OF INCORPORATION | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE DIRECTOR OF FINANCE AND THE CFO REVIEWED THE FORM 990 BEFORE IT WAS FILED. | |
| FORM 990, PART VI, SECTION B, LINE 12C | OFFICERS AND DIRECTORS ARE REQUIRED TO DISCLOSE ANNUAL INTERESTS THAT COULD GIVE RISE TO CONFLICTS TO THE COMPLIANCE COMMITTEE. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE VICE PRESIDENT OF HUMAN RESOURCES COMPILES SURVEYS AND COMPARABLE DATA TO DETERMINE COMPENSATION. THE BOARD APPROVES THE CEO'S SALARY AND BONUSES. | |
| FORM 990, PART VI, SECTION C, LINE 19 | UPON REQUEST, THESE DOCUMENTS WOULD BE MADE AVAILABLE ON THE PREMISES OF THE COMPANY'S CORPORATE LOCATION FOR REVIEW BY THE PUBLIC. | |
| REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS | FORM 990, PART VII, SECTION A, LINE 1A, COLUMN E | THE ORGANIZATION ATTEMPTED TO SECURE THE REPORTABLE COMPENSATION OF THE BOARD MEMBERS FROM THE RELATED ORGANIZATIONS LISTED ON SCHEDULE R. THEY WERE UNABLE TO GET THIS COMPENSATION INFORMATION TO REPORT ON THE FORM 990. |
| ALL OTHER FUNCTIONAL EXPENSES | FORM 990, PART X, LINE 24F | PHYS SERV - NON CAP PCPS: PROGRAM SERVICE EXPENSES 34,037,785. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 34,037,785. OTHER MEDICAL: PROGRAM SERVICE EXPENSES 17,628,607. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,628,607. TRANSPORTATION: PROGRAM SERVICE EXPENSES 14,736,442. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,736,442. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 10,248,872. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,248,872. VISION : PROGRAM SERVICE EXPENSES 10,071,251. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,071,251. HOME INFUSION: PROGRAM SERVICE EXPENSES 3,653,258. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,653,258. CAPITATION: PROGRAM SERVICE EXPENSES 2,472,223. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,472,223. CLAIMS SETTLEMENT EXPENSE: PROGRAM SERVICE EXPENSES 1,959,372. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,959,372. REINSURANCE EXPENSE: PROGRAM SERVICE EXPENSES 819,830. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 819,830. POSTAGE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 750,835. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 750,835. PHARMACY: PROGRAM SERVICE EXPENSES 722,141. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 722,141. SUBCONTRACTOR EXPENSE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 674,193. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 674,193. FACILITY ADMINISTRATION: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 513,013. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 513,013. PRINTING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 232,239. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 232,239. MEMBERSHIP/LICENSE FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 211,884. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 211,884. EQUIPMENT EXPENSE & RENTALS/LEASES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 160,328. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 160,328. OTHER TAXES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 140,133. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 140,133. INPATIENT ADMIN: PROGRAM SERVICE EXPENSES 92,580. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 92,580. INJECTIBLES: PROGRAM SERVICE EXPENSES 87,895. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 87,895. TRAINING, SEMINARS & CONFERENCES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 76,150. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 76,150. PUBLIC RELATIONS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 47,022. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 47,022. SUBS/PUBS/BOOKS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 16,376. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,376. LOSS ON DISPOSAL: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 609. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 609. |
| CHANGES IN NET ASSETS OR FUND BALANCES: | FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -20,141. |
| AN AMENDED RETURN IS BEING FILED TO REPORT THE FOLLOWING CHANGES: PART VII, SECTION B, INDEPENDENT CONTRACTORS WAS UPDATED TO REMOVE CORPORATIONS AND REPORT INDEPENDENT CONTRACTORS PAID MORE THAN $100,000 THAT FIT THE IRS INDEPENDENT CONTRACTOR DEFINITION. ON PART X, BALANCE SHEET $4,997,500 OF INVESTMENTS WERE RECLASSIFIED FROM LINE 2 TO LINE 11 - INVESTMENTS - PUBLICLY TRADED SECURITIES. SCHEDULE I WAS INCLUDED TO REPORT $700,000 OF GRANTS TO ORGANIZATIONS IN THE UNITED STATES. ON FORM 990, PART IX - STATEMENT OF FUNCTIONAL EXPENSES, THE GRANTS OF $700,000 WERE RECLASSFIED FROM LINE 24 - OTHER EXPENSES - QUALITY INCENTIVE - ADMIN TO LINE 1 - GRANTS AND OTHER ASSISTANCE TO GOVERNMENTS AND ORGANIZATIONS IN THE U.S. ON FORM 990, PART IV, LINE 21 WAS CHECKED YES TO REPORT GRANTS OF MORE THAN $5,000. FORM 990, PART III, LINE 4A INCREASED EXPENSES TO INCLUDE GRANTS OF $700,000. ON SCHEDULE R, PART II UNDER COMMUNITY HEALTH NETWORK OF CONNECTICUT FOUNDATION, INC., THE FOLLOWING CHANGES WERE MADE: COLUMN (E) - CHANGED TO LINE 7 COLUMN (F) - INCLUDED COMMUNITY HEALTH NETWORK OF CONNECTICUT, INC. AS THE DIRECT CONTROLLING ENTITY COLUMN (G) - CHECKED YES TO SECTION 512(B)(13) CONTROLLED ORGANIZATION FORM 990, PART IV, LINES 35 AND 35A WERE CHECKED YES TO REPORT THE RELATIONSHIP WITH COMMUNITY HEALTH NETWORK OF CONNECTICUT FOUNDATION, INC. ON SCHEDULE R, PART V, LINE 2, THE TRANSACTIONS WITH THE SEVEN MEMBER CENTERS REPORTED ON PART II AS RELATED TAX-EXEMPT ORGANIZATIONS WERE REMOVED BECAUSE THEY ARE NOT REQUIRED TO BE REPORTED. THESE ORGANIZATIONS ARE NOT CONTROLLED ENTITIES. ON SCHEDULE R, PART V, LINE 2, THE TRANSACTIONS CODED M AND I WITH COMMUNITY HEALTH NETWORK OF CONNECTICUT FOUNDATION, INC. WERE REMOVED BECAUSE THEY WERE UNDER $50,000 AND ARE NOT REQUIRED TO BE REPORTED. |
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
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