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 private foundations)
MediumBullet Do not enter Social Security numbers on this form as it may be made public. By law, the IRS
generally cannot redact the information on the form.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
A For the 2013 calendar year, or tax year beginning 10-01-2013 , 2013, and ending 09-30-2014
BCheck if applicable:
CName of organization
THE MILFORD HOSPITAL INC
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
300 SEASIDE AVENUE
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MILFORD, CT06460
D Employer identification number

06-0646741
E Telephone number

G Gross receipts $ 204,319,446
F Name and address of principal officer:
LAURA SMITH
300 SEASIDE AVENUE
MILFORD,CT06460
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.MILFORDHOSPITAL.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1942
M State of legal domicile: CT
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: HOSPITAL SERVICES
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 19
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 18
5 Total number of individuals employed in calendar year 2013 (Part V, line 2a) ...... 5 793
6 Total number of volunteers (estimate if necessary) ............. 6 298
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 4,647,212
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b -2,786
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 306,145 5,720
9 Program service revenue (Part VIII, line 2g) ......... 196,473,067 198,736,085
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 919,106 680,930
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 1,631,323 1,496,468
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 199,329,641 200,919,203
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 85,946 76,200
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) 53,760,794 46,643,509
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 153,563,831 161,045,211
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 207,410,571 207,764,920
19 Revenue less expenses. Subtract line 18 from line 12....... -8,080,930 -6,845,717
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 48,484,725 47,049,222
21 Total liabilities (Part X, line 26)............. 39,769,991 47,964,274
22 Net assets or fund balances. Subtract line 21 from line 20..... 8,714,734 -915,052
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 Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2013)
Form 990 (2013)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: THE MISSION OF MILFORD HOSPITAL IS TO EFFECTIVELY AND EFFICIENTLY PROVIDE HIGH QUALITY HEALTHCARE SERVICES IN A MODERN AND SAFE ENVIRONMENT, BY ANTICIPATING AND EXCEEDING THE NEEDS OF PATIENTS, PHYSICIANS AND ALL OF OUR CUSTOMERS WITH EXCELLENCE, CONVENIENCE AND
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 organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations 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 $ 198,699,239 including grants of $ 76,200 ) (Revenue $ 199,589,080 )
MILFORD HOSPITAL PROVIDES HIGH-QUALITY HEALTHCARE SERVICES TO THE RESIDENTS OF MILFORD, WEST HAVEN, ORANGE AND STRATFORD, CONNECTICUT AND ITS SURROUNDING COMMUNITIES WITHOUT REGARD TO RACE, GENDER, CREED OR ABILITY TO PAY.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 expensesMediumBullet198,699,239
Form 990 (2013)
Form 990 (2013)
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 (see instructions)? ...
2
 
No
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, or have a section 501(h) election in effect during the tax year? 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 IIIClick to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which 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 for escrow or custodial account liability; 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 temporarily restricted endowments, permanent endowments, 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, line 10?
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 VIIClick to see attachment.......
11b
 
No
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 VIIIClick 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 IXClick 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 XClick 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 XClick to see attachment.........................
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
Yes
 
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 and XII 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, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
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 (see instructions).... Click to see attachment
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............ Click to see attachment
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................... Click to see attachment
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II... Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 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 lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
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
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I........
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so, complete Schedule L, Part II....................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV ..........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV.....................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule 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
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, 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...
35b
 
 
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 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
39
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
793
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” to line 3b, 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, securities account, or other financial 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 as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the 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 amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2013)
Form 990 (2013)
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 or note to any line 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
19
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
18
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
Yes
 
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
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete 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 this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did 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 15a or 15b, 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
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
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 made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletJOSEPH PELACCIA300 SEASIDE AVENUEMILFORDCT06460 (203) 876-4230
Form 990 (2013)
Form 990 (2013)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line 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. 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 organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) SAMUEL BERGAMI JR........................................................................
CHAIRMAN
 1.00
........................30 		X   X       0 0 0
(2) LOUIS D'AMATO........................................................................
VICE CHAIRMAN
 1.00
........................30 		X   X       0 0 0
(3) MICHAEL SAFFER ESQ........................................................................
SECRETARY
 1.00
........................30 		X   X       0 0 0
(4) STEPHEN E RONAI ESQ........................................................................
SECRETARY
 1.00
........................30 		X   X       0 0 0
(5) RICHARD MEISENHEIMER........................................................................
TREASURER
 1.00
........................30 		X   X       0 0 0
(6) JOSEPH PELACCIA........................................................................
PRESIDENT & CEO
 41.60
.......................5.20 		X   X       511,837 59,999 122,344
(7) JAMES BEARD........................................................................
DIRECTOR
 1.00
........................30 		X           0 0 0
(8) NANCY BENNETT........................................................................
DIRECTOR
 1.00
........................30 		X           0 0 0
(9) ARMAND CANTAFIO........................................................................
DIRECTOR
 1.00
........................30 		X           0 0 0
(10) LEO CARROLL ESQ........................................................................
DIRECTOR
 1.00
........................30 		X           0 0 0
(11) BRADFORD GESLER........................................................................
DIRECTOR
 1.00
........................30 		X           0 0 0
(12) ANN LOESCH........................................................................
DIRECTOR
 .20
........................10 		X           0 0 0
(13) CAROL MCINNIS........................................................................
DIRECTOR
 .20
........................10 		X           0 0 0
(14) LEN NAPOLI JR........................................................................
DIRECTOR
 1.00
........................30 		X           0 0 0
(15) RAYMOND S OLIVER........................................................................
DIRECTOR
 .20
........................10 		X           0 0 0
(16) GARY OPIN DMD........................................................................
DIRECTOR
 .20
........................10 		X           0 0 0
(17) RONALD SILVERBERG........................................................................
DIRECTOR
 .20
........................10 		X           0 0 0
Form 990 (2013)
Form 990 (2013)
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 (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) CHARLES GUGLIN MD........................................................................
DIRECTOR / MEDICAL STAFF PRESIDENT
 1.00
........................30 		X           0 0 0
(19) RITA CANAS........................................................................
DIRECTOR / AUXILIARY CO-PRESIDENT
 .20
........................10 		X           0 0 0
(20) PATRICIA CUCUZZA........................................................................
DIRECTOR / AUXILIARY CO-PRESIDENT
 .20
........................10 		X           0 0 0
(21) CONNIE MILLER........................................................................
DIRECTOR / AUXILIARY CO-PRESIDENT
 .20
........................10 		X           0 0 0
(22) SANDRA VIGILIO........................................................................
DIRECTOR / AUXILIARY CO-PRESIDENT
 .20
........................10 		X           0 0 0
(23) LLOYD FRIEDMAN MD........................................................................
VP MEDICAL AFFAIRS & COO
 33.30
.......................4.20 		    X       463,836 54,360 125,887
(24) LAURA SMITH........................................................................
VP FINANCE & CFO
 36.30
.......................5.30 		    X       148,687 21,534 59,267
(25) MICHAEL BLOCH........................................................................
E.R. PHYSICIAN
 45.20
.......................   		        X   340,753 0 25,419
(26) ANDREW CHOW........................................................................
HOSPITALIST
 58.20
.......................   		        X   323,436 0 27,890
(27) WILLIAM SACKS........................................................................
E.R. PHYSICIAN
 41.90
.......................   		        X   318,888 0 6,300
(28) ANITHA KAMATH........................................................................
CHIEF PATHOLOGIST
 40.00
.......................   		        X   311,528 0 27,890
(29) JOHN SCARFO........................................................................
E.R. PHYSICIAN
 42.10
.......................   		        X   310,226 0 25,419


1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 2,729,191 135,893 420,416
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet83
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. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
SODEXO OPERATIONS LLCPO BOX 360170PITTSBURGHPA15251 FOOD SERVICE 702,803
AFTERCARE PHYSICAL THERAPY SERVICES4154 MADISON AVETRUMBULLCT06611 THERAPY SERVICES 702,699
ACCELECARE WOUND CENTER INCPO BOX 671242DALLASTX75267 WOUND SERVICES 363,856
AMERICAN RED CROSSPO BOX 33093NEWARKNJ07188 PROCESS BLOOD 362,475
CORNERSTONE ADVISOR'S GROUP LLCPO BOX 569GEORGETOWNCT06829 MEDICATION RECONCILIATION SVCS 251,139
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet14
Form 990 (2013)
Form 990 (2013)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		5,720
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet 5,720
Program Service RevenueAmt Business Code
2a SPECIAL SERVICES 621500 145,989,509 143,549,597 2,439,912  
b ROUTINE SERVICES 624100 50,594,580 50,594,580    
c OTHER SERVICES 541610 2,151,996   2,151,996  
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 198,736,085
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 333,801     333,801
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents 9,350  
b Less: rental expenses 5,694  
c Rental income or (loss) 3,656  
d Net rental income or (loss).......MediumBullet 3,656     3,656
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 3,642,375 21,157
b Less: cost or other basis and sales expenses 3,295,119 21,284
c Gain or (loss) 347,256 -127
d Net gain or (loss)..........MediumBullet 347,129     347,129
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a 48,409
b Less: direct expenses ...b 10,133
c Net income or (loss) from fundraising events..MediumBullet 38,276   38,276
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 109,984
b Less: cost of goods sold ..b 68,013
c Net income or (loss) from sales of inventory..MediumBullet 41,971     41,971
Miscellaneous Revenue Business Code
11a MEANINGFUL USE INCOME 900099 852,995 852,995    
b CAFETERIA REVENUE 722210 183,813     183,813
c PHARMACY SALES 446110 183,449     183,449
d All other revenue .... 192,308   55,304 137,004
e Total. Add lines 11a–11d ...... MediumBullet 1,412,565
12 Total revenue. See Instructions......MediumBullet 200,919,203 194,997,172 4,647,212 1,269,099
Form 990 (2013)
Form 990 (2013)
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).Check if Schedule O contains a response or note to any line in this Part IX ...............
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 United States. See Part IV, line 21 71,200 71,200
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 5,000 5,000
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 1,879,381 810,967 1,068,414  
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 34,857,249 31,660,992 3,196,257  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 860,623 860,623    
9 Other employee benefits ....... 6,491,806 5,861,504 630,302  
10 Payroll taxes ........... 2,554,450 2,237,286 317,164  
11 Fees for services (non-employees):        
a Management ...... 5,281   5,281  
b Legal ......... 274,252   274,252  
c Accounting ........... 238,154   238,154  
d Lobbying ........... 25,362   25,362  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 1,447   1,447  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 6,392,599 5,215,657 1,176,942  
12 Advertising and promotion .... 99,014 278 98,736  
13 Office expenses ....... 1,109,619 922,126 187,493  
14 Information technology ...... 373,156 69,388 303,768  
15 Royalties ..        
16 Occupancy ........... 1,901,722 1,780,072 121,650  
17 Travel ............ 28,015 10,166 17,849  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 17,520 16,785 735  
20 Interest ........... 26,961   26,961  
21 Payments to affiliates ....... 104,531 90,726 13,805  
22 Depreciation, depletion, and amortization ..... 2,687,423 1,708,169 979,254  
23 Insurance .............. 30,047   30,047  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a ALLOWANCE FOR UNPAID CA 127,615,381 127,615,381    
b MEDICAL EXPENSES 10,680,217 10,680,217    
c BAD DEBTS 5,608,309 5,608,309    
d PHARMACEUTICAL DRUGS 2,133,639 2,133,639    
e All other expenses 1,692,562 1,340,754 351,808  
25 Total functional expenses. Add lines 1 through 24e 207,764,920 198,699,239 9,065,681 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2013)
Form 990 (2013)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 1,331,986 1 927,082
2 Savings and temporary cash investments ......... 2,549,156 2 8,698,413
3 Pledges and grants receivable, net ...........   3  
4 Accounts receivable, net ............. 9,618,035 4 8,850,797
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 918,069 8 799,067
9 Prepaid expenses and deferred charges .......... 1,216,823 9 337,599
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 51,713,669
b Less: accumulated depreciation ..... 10b 30,714,786 22,160,470 10c 20,998,883
11 Investments—publicly traded securities .......... 4,035,828 11 933,032
12 Investments—other securities. See Part IV, line 11 ..... 894,273 12 960,239
13 Investments—program-related. See Part IV, line 11 .....   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 5,760,085 15 4,544,110
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 48,484,725 16 47,049,222
Liabilities 17 Accounts payable and accrued expenses ......... 14,061,882 17 15,605,433
18 Grants payable .................   18  
19 Deferred revenue ................   19  
20 Tax-exempt bond liabilities .............   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Loans and other 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 6,000,000
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 25,708,109 25 26,358,841
26 Total liabilities. Add lines 17 through 25......... 39,769,991 26 47,964,274
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 7,266,461 27 -2,429,291
28 Temporarily restricted net assets ........... 774,510 28 840,476
29 Permanently restricted net assets ........... 673,763 29 673,763
Organizations that do not follow SFAS 117 (ASC 958), 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 ........... 8,714,734 33 -915,052
34 Total liabilities and net assets/fund balances ........ 48,484,725 34 47,049,222
Form 990 (2013)
Form 990 (2013)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
200,919,203
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
207,764,920
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-6,845,717
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
8,714,734
5
Net unrealized gains (losses) on investments ...............
5
-341,223
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-2,442,846
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
-915,052
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line 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
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 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?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
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
 
No
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
 
 
Form 990 (2013)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
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.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
THE MILFORD HOSPITAL INC
 
Employer identification number

06-0646741
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 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
Provide the following information about the supported organization(s).
(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 monetary support
Yes No Yes No Yes No
Total  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..            
11 Total support (Add lines 7 through 10).  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here.................................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2013

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.SchCMd Bullet Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
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 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
THE MILFORD HOSPITAL INC
 
Employer identification number

06-0646741
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 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 function 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 Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2013

Schedule C (Form 990 or 990-EZ) 2013
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 SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))		  
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2013


Schedule C (Form 990 or 990-EZ) 2013
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)).
For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(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)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
25,362
j
Total. Add lines 1c through 1i ...............................
25,362
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 carry over 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) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible 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
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
PART II-B, LINE 1: THE HOSPITAL PAID DUES TO THE CT HOSPITAL ASSOCIATION (CHA), WHICH INCLUDED LOBBYING COSTS OF $19,500. CHA REPRESENTS CT HOSPITALS AND WORKS WITH OTHER ORGANIZATIONS LIKE AHA TO ADDRESS STATE AND FEDERAL LEGISLATIVE ISSUES AFFECTING HOSPITALS. THE HOSPITAL ALSO PAID DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA), WHICH INCLUDED LOBBYING COSTS OF $5,862. AHA REPRESENTS ALL HOSPITALS, NATIONWIDE, AND WORKS ALONG WITH STATE HOSPITAL ASSOCIATIONS, LIKE CHA TO ADDRESS FEDERAL LEGISLATIVE ISSUES AFFECTING HOSPITALS.
Schedule C (Form 990 or 990EZ) 2013

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, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions. SchDMd Bullet Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
THE MILFORD HOSPITAL INC
 
Employer identification number

06-0646741
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 can 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 through 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, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax 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 section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, 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 (ASC 958), 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 XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), 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 (ASC 958) 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, 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 XIII.
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 XIII 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 XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 724,626 741,399 685,311 663,319 657,181
b Contributions ........       5,000 5,000
c Net investment earnings, gains, and losses 17,634 -16,773 56,088 16,992 1,138
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		112,750        
f Administrative expenses ....          
g End of year balance ...... 629,510 724,626 741,399 685,311 663,319
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet88.000 %
c
Temporarily restricted endowment SchDMd Bullet12.000 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   825,066 825,066
b Buildings ................ 103,155 15,477,641 1,243,318 14,337,478
c Leasehold improvements ............        
d Equipment ................   34,694,933 28,879,778 5,815,155
e Other .................   612,874 591,690 21,184
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 20,998,883
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. 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    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) DUE FROM AFFILIATES 541,820
(2) OTHER RECEIVABLES 534,579
(3) INSURED CLAIMS RECEIVABLE 3,467,711






Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 4,544,110
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
ACCRUED PENSION 18,262,691
DUE TO THIRD PARTY 2,226,150
DEFERRED COMPENSATION 296,764
DUE TO AFFILIATES 122,749
OTHER ACCRUED BENEFITS 991,713
INSURED CLAIMS LIABILITIES 3,467,711
DEFERRED GRANT INCOME 301,148
MALPRACTICE LIABILITY 689,915

Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 26,358,841
2. Liability for uncertain tax positions In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII ..................................................
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 70,498,808
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a -341,223
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d -349,394
e Add lines 2a through 2d ..................... 2e -690,617
3 Subtract line 2e from line 1..................... 3 71,189,425
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 XIII.) ........... 4b 129,729,778
c Add lines 4a and 4b....................... 4c 129,729,778
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 200,919,203
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 77,684,910
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 XIII.) ............ 2d 127
e Add lines 2a through 2d...................... 2e 127
3 Subtract line 2e from line 1..................... 3 77,684,783
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 1,447
b Other (Describe in Part XIII.) ............ 4b 130,078,690
c Add lines 4a and 4b....................... 4c 130,080,137
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 207,764,920
Part XIII
Supplemental Information
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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
PART XI, LINE 2D - OTHER ADJUSTMENTS: OTHER ALLOWANCES -342,666. INVESTMENT EXPENSES -1,447. MANAGEMENT FEE -5,281.
PART XI, LINE 4B - OTHER ADJUSTMENTS: ALLOWANCE 127,615,381. AUXILIARY REVENUE 72,416. CHARITY CARE 579,794. PASSTHROUGH INCOME 641. OTHER EXPENSES NETTED FROM REVENUE 1,431,807. REVENUE/EXPENSE RECLASS 8,618. LOSS ON SALE OF ASSETS -127. MEDICAL STAFF ACCOUNT REVENUE 21,248.
PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON SALE OF ASSETS 127.
PART XII, LINE 4B - OTHER ADJUSTMENTS: ALLOWANCE 127,615,381. AUXILIARY EXPENSE 76,935. CHARITY CARE 579,794. OTHER EXPENSES NETTED FROM REVENUE 1,431,807. OTHER ALLOWANCES 342,666. REVENUE/EXPENSE RECLASS 8,618. MEDICAL STAFF ACCOUNT EXPENSE 18,208. MANAGEMENT FEE 5,281.
Schedule D (Form 990) 2013

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 arrowAttach to Form 990 or Form 990-EZ. right arrowSee separate instructions.
right arrowInformation about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
THE MILFORD HOSPITAL INC
 
Employer identification number

06-0646741
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
Form 990-EZ filers are not required to complete this part.
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.
(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 contributions or has been notified it is exempt from registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2013
Schedule G (Form 990 or 990-EZ) 2013
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 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.
(a) Event #1

CELEBRATION OF TREES
(event type) 		(b) Event #2

MOTHER'S DAY ROAD RACE
(event type) 		(c) Other events

 
(total number) 		(d) Total events
(add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 17,991 16,398   34,389
2 Less: Contributions . .        
3 Gross income (line 1
minus line 2) . . . 		17,991 16,398   34,389
VerticalDirectExpenses 4 Cash prizes . . .        
5 Noncash prizes . .   308   308
6 Rent/facility costs . .        
7 Food and beverages .        
8 Entertainment . . .        
9 Other direct expenses . 942 5,572   6,514
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 6,822
11 Net income summary. Subtract line 10 from line 3, column (d)........... right arrow 27,567
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. Subtract line 7 from line 1, 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:
 
Schedule G (Form 990 or 990-EZ) 2013
Schedule G (Form 990 or 990-EZ) 2013
Page 3
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? ..........................
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
%
b
An outside facility ........................
13b
%
14
Enter 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 of the third party:
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
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).
Return Reference Explanation
Schedule G (Form 990 or 990-EZ) 2013
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.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
THE MILFORD HOSPITAL INC
 
Employer identification number

06-0646741
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance 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 discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance 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 Financial Assistance at cost
(from Worksheet 1) .. 		  271 264,381 20,299 244,082 0.120 %
b Medicaid (from Worksheet 3,
column a) .... 		  10,579 11,724,814 7,346,713 4,378,101 2.170 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		  10,850 11,989,195 7,367,012 4,622,183 2.290 %
Other Benefits
 41 101,131 78,204 2,885 75,319 0.040 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		7 154 484,644   484,644 0.240 %
g Subsidized health services
(from Worksheet 6) .. 		           
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		11 68,002 108,038   108,038 0.050 %
j Total. Other Benefits .. 59 169,287 670,886 2,885 668,001 0.330 %
k Total. Add lines 7d and 7j . 59 180,137 12,660,081 7,369,897 5,290,184 2.620 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development 1   5,298   5,298 0 %
3 Community support 2 54,523 55,595   55,595 0.030 %
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building 1   18,691   18,691 0.010 %
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total 4 54,523 79,584   79,584 0.040 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did 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. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
5,608,309
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
579,795
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
19,296,474
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
24,102,580
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-4,806,106
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
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(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) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?1
Name, address, primary website address, and state license number 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 THE MILFORD HOSPITAL INC
300 SEASIDE AVENUE
MILFORD,CT06460 		X X         X      
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
THE MILFORD HOSPITAL INC
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		1
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? 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 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4   No
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7 Yes  
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 250.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If "Yes," indicate the FPG family income limit for eligibility for discounted care: 400.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.......... 17   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 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?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference Explanation
THE MILFORD HOSPITAL, INC. PART V, SECTION B, LINE 3: IN PREPARING THE CHNA, MILFORD HOSPTIAL CONSULTED WITH HOLLERAN ASSOCIATES. THE CHNA WAS COMPRISED OF BOTH QUALITATIVE AND QUANTITATIVE RESEARCH COMPONENTS INCLUDING IN DEPTH REVIEW OF THE MILFORD COMMUNITY NEEDS ASSESSMENT CONDUCTED BY THE UNITED WAY OF CONNECTICUT'S COMMUNITY RESULTS CENTER. THIS STUDY WAS COMPRISED OF FOCUS GROUPS, KEY INFORMANT INTERVIEWS, A WEB BASED SURVEY AND SECONDARY DATA. IN ADDITION, A COLLECTION AND ANALYSIS OF ADDITIONAL DATA INCLUDING HEALTH INDICATORS AND STATISTICS AS REPORTED BY THE CDC AND THE STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH WAS CONDUCTED.IN DEVELOPING AN IMPLEMENTATION STRATEGY AND COMMUNITY PLAN, THE HOSPITAL HELD A STRATEGIC PLANNING SESSION WITH THE FOLLOWING COMMUNITY LEADERS AND PROVIDERS:JOSEPH PELACCIA, MILFORD HOSPITAL, PRESIDENT AND CEOLAURA SMITH, MILFORD HOSPITAL, VICE PRESIDENT FINANCE AND CFODR. LLOYD FRIEDMAN, VICE PRESIDENT MEDICAL AFFAIRS AND COOKAREN KIPFER, MILFORD HOSPITAL, DIRECTOR OF COMMUNITY RELATIONSSENATOR GAYLE SLOSSBERG, STATE SENATORSTEVE FOURNIER, ASSISTANCE MAYOR, CITY OF MILFORDDR. ELIZABETH FESER, SUPERINTENDENT OF SCHOOLS, CITY OF MILFORDDR. DENNIS MCBRIDE, DIRECTOR, CITY OF MILFORD HEALTH DEPARTMENTJOHN A. HARKINS, MAYOR, CITY OF STRATFORD, CTGARY JOHNSON, UNITED WAY OF MILFORD, PRESIDENTBARRY KASDAN, PRESIDENT AND CEO, BRIDGES, A COMMUNITY SUPPORT SYSTEMROBERT LEWIS, MD, CARDIOVASCULAR PHYSICIANS AND CONSULTANTS, LLCJOYCE LINDSAY, DIRECTOR, HOME CARE PLUSANN MARIE RICKS, MD, SEASIDE OB/GYN OF MILFORDCALVIN E. ROBINSON, JR., PASTOR, FIRST BAPTIST CHURCH
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?1
Name and address Type of Facility (describe)
1 THE MILFORD HOSPITAL WALK-IN CENTER
831 BOSTON POST ROAD
MILFORD,CT06460 		WALK IN CENTER
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.
Form and Line Reference Explanation
THE MILFORD HOSPITAL, INC. PART V, SECTION B, LINE 3: IN PREPARING THE CHNA, MILFORD HOSPTIAL CONSULTED WITH HOLLERAN ASSOCIATES. THE CHNA WAS COMPRISED OF BOTH QUALITATIVE AND QUANTITATIVE RESEARCH COMPONENTS INCLUDING IN DEPTH REVIEW OF THE MILFORD COMMUNITY NEEDS ASSESSMENT CONDUCTED BY THE UNITED WAY OF CONNECTICUT'S COMMUNITY RESULTS CENTER. THIS STUDY WAS COMPRISED OF FOCUS GROUPS, KEY INFORMANT INTERVIEWS, A WEB BASED SURVEY AND SECONDARY DATA. IN ADDITION, A COLLECTION AND ANALYSIS OF ADDITIONAL DATA INCLUDING HEALTH INDICATORS AND STATISTICS AS REPORTED BY THE CDC AND THE STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH WAS CONDUCTED.IN DEVELOPING AN IMPLEMENTATION STRATEGY AND COMMUNITY PLAN, THE HOSPITAL HELD A STRATEGIC PLANNING SESSION WITH THE FOLLOWING COMMUNITY LEADERS AND PROVIDERS:JOSEPH PELACCIA, MILFORD HOSPITAL, PRESIDENT AND CEOLAURA SMITH, MILFORD HOSPITAL, VICE PRESIDENT FINANCE AND CFODR. LLOYD FRIEDMAN, VICE PRESIDENT MEDICAL AFFAIRS AND COOKAREN KIPFER, MILFORD HOSPITAL, DIRECTOR OF COMMUNITY RELATIONSSENATOR GAYLE SLOSSBERG, STATE SENATORSTEVE FOURNIER, ASSISTANCE MAYOR, CITY OF MILFORDDR. ELIZABETH FESER, SUPERINTENDENT OF SCHOOLS, CITY OF MILFORDDR. DENNIS MCBRIDE, DIRECTOR, CITY OF MILFORD HEALTH DEPARTMENTJOHN A. HARKINS, MAYOR, CITY OF STRATFORD, CTGARY JOHNSON, UNITED WAY OF MILFORD, PRESIDENTBARRY KASDAN, PRESIDENT AND CEO, BRIDGES, A COMMUNITY SUPPORT SYSTEMROBERT LEWIS, MD, CARDIOVASCULAR PHYSICIANS AND CONSULTANTS, LLCJOYCE LINDSAY, DIRECTOR, HOME CARE PLUSANN MARIE RICKS, MD, SEASIDE OB/GYN OF MILFORDCALVIN E. ROBINSON, JR., PASTOR, FIRST BAPTIST CHURCH
Schedule H (Form 990) 2013
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
THE MILFORD HOSPITAL INC
 
Employer identification number
06-0646741
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) MILFORD HOSPITAL FOUNDATION VIA MH WAYS & MEANS
300 SEASIDE AVENUE
MILFORD,CT06460 		22-2627350 501(C)(3) 26,500   BOOK N/A EQUIPMENT PURCHASE
(2) MILFORD HOSPITAL FOUNDATION VIA MH HOSPITALITY SHOP
300 SEASIDE AVENUE
MILFORD,CT06460 		22-2627350 501(C)(3) 44,000   BOOK N/A EQUIPMENT PURCHASE




















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
2
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2013

Schedule I (Form 990) 2013
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance
(1) SCHOLARSHIPS AWARDED TO JUNIOR VOLUNTEERS FOR HIGHER EDUCATION 5 3,000   BOOK N/A
(2) SCHOLARSHIPS 2 2,000   BOOK N/A










Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
PART I, LINE 2: HOSPITAL ADMINISTRATION MONITORS THE USE OF GRANT FUNDS BY REQUIRING A CAPITAL EQUIPMENT REQUEST (CER) AND A REQUEST FOR PAYMENT BE COMPLETED BEFORE FUNDS ARE RELEASED. ALL CERS MUST BE APPROVED BY THE CEO AND CFO OF THE HOSPITAL. THE REQUEST FOR PAYMENT IS APPROVED BY THE DIRECTOR OF THE FOUNDATION AND THE CFO OF THE HOSPITAL.
Schedule I (Form 990) 2013


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, line 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
THE MILFORD HOSPITAL INC
 
Employer identification number

06-0646741
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 or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (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 as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)JOSEPH PELACCIAPRESIDENT & CEO (i)
(ii)		 478,837
59,999 		0
0 		33,000
0 		100,423
12,583 		8,298
1,040 		620,558
73,622 		0
0
(2)LLOYD FRIEDMAN MDVP MEDICAL AFFAIRS & COO (i)
(ii)		 433,836
54,360 		0
0 		30,000
0 		91,765
11,498 		20,105
2,519 		575,706
68,377 		0
0
(3)LAURA SMITHVP FINANCE & CFO (i)
(ii)		 148,687
21,534 		0
0 		0
0 		34,208
4,954 		17,562
2,543 		200,457
29,031 		0
0
(4)MICHAEL BLOCHE.R. PHYSICIAN (i)
(ii)		 340,753
0 		0
0 		0
0 		6,300
0 		19,119
0 		366,172
0 		0
0
(5)ANDREW CHOWHOSPITALIST (i)
(ii)		 323,436
0 		0
0 		0
0 		6,300
0 		21,590
0 		351,326
0 		0
0
(6)WILLIAM SACKSE.R. PHYSICIAN (i)
(ii)		 318,888
0 		0
0 		0
0 		6,300
0 		0
0 		325,188
0 		0
0
(7)ANITHA KAMATHCHIEF PATHOLOGIST (i)
(ii)		 311,528
0 		0
0 		0
0 		6,300
0 		21,590
0 		339,418
0 		0
0
(8)JOHN SCARFOE.R. PHYSICIAN (i)
(ii)		 310,226
0 		0
0 		0
0 		6,300
0 		19,119
0 		335,645
0 		0
0
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
PART I, LINE 4B JOSEPH PELACCIA, LAURA SMITH AND LLOYD FRIEDMAN PARTICIPATED IN A SUPPLEMENTAL RETIREMENT PLAN.
Schedule J (Form 990) 2013

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.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
THE MILFORD HOSPITAL INC
 
Employer identification number

06-0646741
Return Reference Explanation
FORM 990, PART III, LINE 1 COMPASSION. AS A COMMUNITY HEALTHCARE PROVIDER, MILFORD HOSPITAL IS COMMITTED TO REMAINING IN THE FOREFRONT OF THE CLINICAL, TECHNOLOGICAL, AND ELECTRONIC INFORMATION ADVANCES THAT MAKE THE CONTINUOUS DELIVERY OF HIGH-QUALITY, COST-EFFECTIVE HEALTHCARE SERVICES POSSIBLE. MILFORD HOSPITAL RECOGNIZES THAT THE QUALITY OF HUMAN RESOURCES - STAFF, PHYSICIANS AND VOLUNTEERS - IS THE KEY TO CONTINUED SUCCESS AND THEREFORE STRIVES TO CREATE AN ENVIRONMENT OF TEAMWORK AND PARTICIPATION WHERE, THROUGH CONTINUOUS QUALITY IMPROVEMENT AND A FOCUS ON PATIENT SAFETY, PEOPLE PURSUE EXCELLENCE AND TAKE PRIDE IN THE QUALITY OF THEIR WORK IN THE ORGANIZATION. MILFORD HOSPITAL ENGAGES IN A WIDE RANGE OF HEALTH EDUCATIONAL ACTIVITIES DESIGNED TO MEET THE EDUCATIONAL NEEDS OF PATIENTS, STAFF, PHYSICIANS AND THE COMMUNITY.
FORM 990, PART III, LINE 4A AS A COMMUNITY HEALTHCARE PROVIDER, MILFORD HOSPITAL IS COMMITTED TO THOSE WE SERVE, BOTH PATIENTS AND NON-PATIENTS. OUR GOAL IS NOT ONLY TO PROVIDE QUALITY COMPASSIONATE CARE WHEN AN INDIVIDUAL ENTERS OUR HEALTHCARE INSTITUTION, BUT ALSO TO PROMOTE AND COMMUNICATE WELLNESS INFORMATION AND EDUCATION SO THAT FAMILIES IN OUR AREA CAN KEEP FROM BECOMING ILL AND LEAD HEALTHIER LIVES. IN FY 2014, MILFORD HOSPITAL PROVIDED HEALTHCARE SERVICES TO: 3,119 PATIENTS ON AN INPATIENT BASIS 31,198 PATIENTS THROUGH THE EMERGENCY DEPARTMENT/WALK-IN CENTER 1,458 PATIENTS IN OUR AMBULATORY SURGERY SUITE IN ADDITION TO DIRECT PATIENT CARE, THE HOSPITAL PROVIDED EDUCATION, HEALTH SCREENINGS AND SUPPORT SERVICES TO OVER 5,000 INDIVIDUALS THROUGH A VARIETY OF MODALITIES INVOLVING PERSONAL INTERACTION. INDIRECTLY, DURING FY 2014, VIA OUR WEBSITE ALONE, THE HOSPITAL PROVIDED INFORMATION TO MORE THAN 93,000 UNIQUE USERS FROM OUR SERVICE AREA AND BEYOND. IN SEPTEMBER 2013, IN ACCORDANCE WITH THE REQUIREMENTS SET FORTH IN THE AFFORDABLE CARE ACT, MILFORD HOSPITAL LED A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE PURPOSE OF THE CHNA WAS TO GATHER INFORMATION ABOUT LOCAL HEALTH NEEDS AND BEHAVIORS IN AN EFFORT TO ENSURE THAT MILFORD HOSPITAL PROGRAMS, SERVICES AND OFFERINGS ARE IN ALIGNMENT WITH COMMUNITY NEEDS. THE FINDINGS OF THE CHNA WERE EVALUATED AND PRIORITIZED BY A TEAM OF COMMUNITY PARTNERS AND LEADERS. DURING THE EARLY MONTHS OF FY 2014, AN IMPLEMENTATION STRATEGY WAS DEVELOPED AND ADOPTED TO GUIDE THE COMMUNITY BENEFIT INITIATIVES OF THE INSTITUTION. WHILE THE CHNA PROVIDES AN OVERVIEW AND PERSPECTIVE OF OUR LOCAL COMMUNITY, A NUMBER OF OVERLAPPING HEALTH ISSUES WERE MADE CLEAR INCLUDING: A BROAD RANGE OF CHRONIC HEALTH CONDITIONS, THE RAPIDLY AGING POPULATION, MATERNAL AND CHILD HEALTH AND ACCESS TO CARE. AMONG OUR GOALS RELATIVE TO COMMUNITY BENEFITS IN FY 2014 WAS TO ADDRESS THE COMMON RISK FACTORS ASSOCIATED WITH AGING AS WELL AS CHRONIC AND INFECTIOUS DISEASES. IN DOING SO, THE HOSPITAL ESTABLISHED AN OBJECTIVE OF CONTINUING AND EXPANDING IT'S OFFERING OF COMMUNITY HEALTH AND WELLNESS PROGRAMS BOTH AT MILFORD HOSPITAL AND IN THE COMMUNITY. THESE PROGRAMS ARE OFFERED AT NO-CHARGE AND ARE DELIVERED BY HEALTH CARE PROFESSIONALS AND EDUCATORS AND INCLUDED THE FOLLOWING: - FIBROMYALGIA AND CHRONIC FATIGUE SYNDROME - UNDERSTANDING DIABETES AND DIABETES MANAGEMENT - THYROID CONDITIONS - BECOMING HEART SMART - END THE WEIGHT - NON-SURGICAL AND SURGICAL TECHNIQUES IN WEIGHT-LOSS. - UNDERSTANDING AND TREATING GASTROINTESTINAL DISTURBANCES - ARTHRITIS AND CHRONIC KNEE PAIN - THE SMART WEIGH - NUTRITION AND WEIGHT MANAGEMENT (6 SESSION SERIES) - WHAT EVERY GIRL WANTS TO KNOW - WOMEN LIVING WELL - FEMALE PHYSICAL AND MENTAL WELLNESS - WOMEN'S HEALTH AWARENESS SERIES - FROM PUBERTY TO MENOPAUSE AND BEYOND (4 SESSION SERIES) - WOUND CARE BASICS - UNDERSTANDING AND TREATING CHRONIC / NON-HEALING WOUNDS - MINDFUL MEDITATION (4 SESSION SERIES) - WHAT EVERY GIRL WANTS TO KNOW - THE PHYSICAL AND EMOTIONAL CHANGES OF PUBERTY AND ADOLESCENCE (2 SESSION SERIES) - SPRING INTO DRUMS ALSO AS PART OF ITS' OBJECTIVE TO INCREASE AWARENESS AND UNDERSTANDING OF HEALTHY LIFESTYLES, RISK FACTORS AND DISEASE PREVENTION, THE HOSPITAL CONTINUED TO CONDUCT FREE AND LOW COST HEALTH SCREENINGS. OFFERED ON A QUARTERLY BASIS, SCREENINGS ARE HELD BOTH IN THE HOSPITAL AND IN THE COMMUNITY. IN FY 2014, HEALTH SCREENINGS AND DISEASE PREVENTION INITIATIVES INCLUDED: - BLOOD PRESSURE SCREENING - BLOOD SUGAR (DIABETES) SCREENING - CHOLESTEROL (TOTAL AND HDL) TESTING - PROSTATE CANCER SCREENING - INFLUENZA IMMUNIZATIONS - ARTHRITIC CONDITIONS OF THE KNEE SCREENING IN ADDITION, MILFORD HOSPITAL WORKS WITH LOCAL BUSINESSES AND ORGANIZATIONS AS A WELLNESS PARTNER FOR THEIR EMPLOYEES. HEALTH SCREENINGS AND COUNSELING ARE PROVIDED OFF-SITE, IN THE WORK PLACE, AND INCLUDE, CHOLESTEROL, BLOOD PRESSURE, BLOOD SUGAR SCREENING AND NUTRITIONAL COUNSELING. THE FOLLOWING IS A LIST OUR CORPORATE / ORGANIZATIONAL PARTNERS: - MILFORD SENIOR CENTER - CITY OF MILFORD - MILFORD POLICE DEPARTMENT - ALINABAL, INC. - BIC CORPORATION, MAIN BUILDING - BIC CORPORATION, BUILDING 5 - THE EDGE - FITNESS CENTER - REGIONAL WATER AUTHORITY - DRILL MASTERS FOR COMMUNITY MEMBERS DIAGNOSED WITH, OR CARING FOR SOMEONE WITH, AN ILLNESS OR CHRONIC HEALTH CONDITION, A COMMUNITY NETWORK OF SUPPORT IS AVAILABLE AT MILFORD HOSPITAL. TO FOSTER UNDERSTANDING AND THE ABILITY TO COPE WITH ILLNESS AND CHRONIC HEALTH CONDITIONS THE HOSPITAL OFFERS THE FOLLOWING SUPPORT GROUPS ON A REGULARLY SCHEDULED BASIS: - ALZHEIMER'S SUPPORT GROUP - MULTIPLE SCLEROSIS SUPPORT GROUP - LUPUS - BREAST CANCER - EPILEPSY THE FAMILY CHILDBIRTH CENTER AT MILFORD HOSPITAL AND THEIR STAFF OF WOMEN'S HEALTH EDUCATORS OFFERED ONGOING CHILDBIRTH AND PARENTING EDUCATION CLASSES TO WOMEN OF CHILDBEARING AGE WHICH INCLUDED: - PREPARED CHILDBIRTH EDUCATION - BREASTFEEDING BASICS AND SUPPORT - BIG BROTHERS & SISTERS ALSO RELATIVE TO MATERNAL CHILD HEALTH, MILFORD HOSPITAL HAS A LONG-STANDING PARTNERSHIP WITH THE YOUNG PARENT PROGRAM (YPP) OF MILFORD. THE YPP PROVIDES PARENTING AND PREGNANCY SERVICES TO TEENS AND YOUNG ADULTS WHICH PROMOTE POSITIVE BIRTH OUTCOMES, HEALTHY CHOICES, PREGNANCY PREVENTION AND RESPONSIBLE DECISION. THE HOSPITAL PROVIDES THE ORGANIZATION WITH OFFICE SPACE AND ALL ASSOCIATED OVERHEAD EXPENSES, CLERICAL SUPPORT AND MORE. THE FOLLOWING LIST IS INCLUSIVE OF SPECIAL EVENTS AND SERVICES THAT THE HOSPITAL OFFERS TO PATIENTS AND THE COMMUNITY. WHILE NOT ALL OF THE OFFERINGS ARE UNIQUE TO MILFORD HOSPITAL, THEY ARE, NONETHELESS, AVAILABLE AND OFFERED AS A RESOURCE, A SERVICE OR AN OPPORTUNITY TO SUPPORT OUR PATIENTS AND OUR COMMUNITY: - THE HOSPITAL PROVIDES LITERACY PROGRAMS: BOOKS FOR BABIES AND BIRTHDAY BOOKS FOR BABIES PROGRAM IN COORDINATION WITH THE LITERACY CENTER OF MILFORD; PROVIDES PREGNANCY EDUCATION THROUGH ANNUAL "BABY FAIR" AND PARTICIPATES IN FUNDRAISERS, COMMUNITY EDUCATION PROGRAMS, AND ANNUAL FAIR FOR KIDS COUNT 12345. - THE HOSPITAL HOSTS VARIETY OF HEALTH AND WELLNESS SUPPORT GROUPS AND PROGRAMS. OF THESE, SIX MEET MONTHLY. OTHERS MAY MEET LESS FREQUENTLY. EACH IS PROVIDED WITH MEETING SPACE, REFRESHMENTS AND ASSOCIATED COSTS AT NO CHARGE. - MILFORD HOSPITAL OFFERS A "WOMEN LIVING WELL" PROGRAM. THIS IS A FREE INFORMATIVE DAY LONG SEMINAR FOR WOMEN ON HEALTH AND WELLNESS ISSUES AND CONCERNS. - STAFF AND PHYSICIANS PARTICIPATE IN A LOCAL CABLE TALK SHOW "HEALTH FROM THE HILL" AS A GUEST EXPERTS ON HEALTH AND WELLNESS TOPICS. - THE HOSPITAL MAINTAINS A SPEAKERS BUREAU, WHICH PROVIDES PHYSICIANS AND MEMBERS OF THE HOSPITAL STAFF TO SPEAK TO LOCAL COMMUNITY ORGANIZATIONS ON A WIDE VARIETY OF TOPICS AT NO CHARGE. - MILFORD HOSPITAL HOSTS AN ANNUAL 5K "LIVE WELL" COMMUNITY EVENT. THIS EVENT OFFSETS THE COST ASSOCIATED WITH COMMUNITY PROGRAMMING AND HEALTH SCREENINGS OFFERED BY MILFORD HOSPITAL. - THE HOSPITAL SPONSORS RED CROSS BLOOD DRIVES THREE TIMES A YEAR IN PROVIDING, AUDITORIUM SPACE, VOLUNTEERS, REFRESHMENTS AND ASSISTANCE PROMOTING EACH DRIVE. - IN COMPLIANCE WITH THE CONSENT DECREE REGARDING THE HEARING IMPAIRED, MILFORD HOSPITAL PROVIDES VARIOUS ASSISTED LISTENING DEVICES FOR THE HARD OF HEARING, INTERPRETERS, AND TTY MACHINES FOR THE DEAF, FREE OF CHARGE FOR ANY PATIENT/COMPANION. - MILFORD HOSPITAL ALSO PROVIDES A LINGUISTIC SERVICE FOR NON-ENGLISH-SPEAKING PATIENTS. IF A LANGUAGE INTERPRETER MUST BE CALLED VIA A SPECIAL PHONE, THE COST OF THE CALL IS ASSUMED BY THE HOSPITAL.
FORM 990, PART III, LINE 4A - MILFORD HOSPITAL OFFERS A "PHYSICIAN FINDER" TELEPHONE SERVICE FOR COMMUNITY RESIDENTS NEEDING A DOCTOR, AND PROVIDES A "DIRECTORY OF STAFF PHYSICIANS" WHICH LISTS THEIR SPECIALTY, PHONE NUMBER, AND ADDRESS. - THE PHARMACY DEPARTMENT COMMUNICATES WITH AND MAKES AVAILABLE TIME TO MEET WITH RESIDENTS TO REVIEW THEIR PRESCRIPTIONS AND MEDICATIONS. THIS IS TYPICALLY DONE IN COORDINATION WITH NATIONAL PHARMACY WEEK. - HOSPITAL MEETING SPACE IS MADE AVAILABLE TO HEALTH RELATED AND OTHER NOT - FOR- PROFIT COMMUNITY GROUPS IN NEED OF A MEETING ROOM AT NO -CHARGE. - THE HOSPITAL PROVIDES FREE MEDICARE / MEDICAID COUNSELING AND ASSISTANCE BY TRAINED HOSPITAL VOLUNTEERS. IN ADDITION, THE HOSPITAL HOSTED HEALTH CARE EXCHANGE ENROLLMENT AND INFORMATION SESSIONS IN COORDINATION WITH THE STATE OF CONNECTICUT. - CLINICAL STAFF INITIATED A FOLLOW-UP PROGRAM FOR CONGESTIVE HEART FAILURE PATIENTS TO PROVIDE EDUCATION AND CLINICAL SUPPORT. - THE HOSPITAL OFFERS COLLEGE AND POST GRADUATE STUDENTS TRAINING OPPORTUNITIES IN REGISTERED NURSING, LICENSED PRACTICAL NURSING, DIAGNOSTIC IMAGING, MEDICAL CODING SCIENCES, PHARMACY, LABORATORY SCIENCES, DIETETIC SERVICES, PUBLIC AND COMMUNITY HEALTH, ENVIRONMENT OF CARE -EMERGENCY PREPAREDNESS AND NURSING ASSISTANT. - THE SOCIAL SERVICES DEPARTMENT OFFERS ASSISTANCE TO PATIENTS AND THEIR FAMILIES WITH COMPLETION OF TITLE-19 APPLICATIONS, CONSERVATOR APPLICATIONS, COMPLETION OF ADVANCED DIRECTIVES AND REFERRALS TO OTHER SOCIAL SERVICE AGENCIES. - CAB VOUCHERS ARE PROVIDED TO PATIENTS AND FAMILIES THROUGH THE SOCIAL SERVICE DEPARTMENT WHEN OTHER FORMS OF TRANSPORTATION ARE NOT AVAILABLE. THE HOSPITAL HAS ALSO COVERED THE COST OF AMBULANCE TRANSPORTATION FOR UNINSURED TITLE-19 PATIENTS GOING TO DMHAS FACILITIES. - THE SOCIAL SERVICES DEPARTMENT ALSO MAINTAINS A FUND TO PROVIDE ASSISTANCE TO PATIENTS AS NEEDED; I.E., COVER COST OF PRESCRIPTIONS, TRANSPORTATION ETC. - ADMINISTRATION AND DEPARTMENT LEADERSHIP RESPOND TO REQUESTS FOR SPEAKERS AT VARIOUS COMMUNITY FORUMS AND ORGANIZATIONS (INCLUDING SCHOOL GROUPS, CIVIC ORGANIZATIONS, SENIOR PROGRAMS ETC.) - MILFORD HOSPITAL ADMINISTRATION AND DEPARTMENT LEADERSHIP MAINTAINS PROFESSIONAL AFFILIATIONS WITH AND STRONGLY SUPPORT LOCAL ORGANIZATIONS THROUGH PARTICIPATION ON BOARDS, ADVISORY COMMITTEE, AND COUNCILS OF THE FOLLOWING: - ALZHEIMERS ASSOCIATION OF CONNECTICUT - AMERICAN CANCER SOCIETY - AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES - AMERICAN HEART ASSOCIATION - AMERICAN LUNG ASSOCIATION - AMERICAN RED CROSS - BRIDGES - A COMMUNITY SUPPORT AGENCY - CITY OF MILFORD HEALTH AND WELLNESS COUNCIL - CONNECTICUT ASSOCIATION OF RESPIRATORY CARE - CONNECTICUT COLLEGE OF HEALTH CARE EXECUTIVES - CONNECTICUT HOSPITAL ASSOCIATION - CONNECTICUT LEAGUE FOR NURSING - CONNECTICUT ORGANIZATION FOR NURSE EXECUTIVES - CONNECTICUT TUBERCULOSIS ADVISORY COMMITTEE - CONNECTICUT YANKEE COUNCIL - BOY SCOUTS OF AMERICA - HEALTHCARE HUMAN RESOURCES ASSOCIATION - KIDS COUNT 12345 - MILFORD CHAMBER OF COMMERCE - MILFORD MAYORS YOUTH FORUM - MILFORD - ORANGE YMCA - MILFORD PREVENTION COUNCIL - NEW HAVEN TUBERCULOSIS COALITION - PARTNERSHIP FOR GREATER NEW HAVEN - RAPE CRISIS CENTER - SOCIAL SERVICES NETWORK OF MILFORD - STATE REGIONAL PSYCHIATRIC COMMITTEE - UNITED WAY OF MILFORD - YOUNG PARENT PROGRAM THE ACTIVITIES AS OUTLINED ABOVE ARE REFLECTIVE OF THE STRONG COMMITMENT BY MILFORD HOSPITAL AND ITS STAFF TO THE WELL-BEING OF THE COMMUNITIES WE SERVE. THE FUTURE OF HOSPITAL HEALTH CARE DEPENDS AS MUCH ON THE SUCCESSFUL PREVENTION OF ILLNESS AS DOES THE TREATMENT. OUR INVESTMENT IN COMMUNITY EDUCATION, SPECIAL OUTREACH PROGRAMS, HEALTHCARE SEMINARS, AND MEMBERSHIPS IN INDEPENDENT HEALTH ORGANIZATIONS, ALL CONTRIBUTE TOWARD THE OVERALL WELFARE OF OUR CITIZENRY.
FORM 990, PART VI, SECTION A, LINE 2 BOARD MEMBERS JOSEPH PELACCIA, SAMUEL BERGAMI, JR., LOUIS D'AMATO, JAMES BEARD, LEO CARROLL, AND CAROL MCINNIS ARE ALSO BOARD MEMBERS OF THE MILFORD BANK.
FORM 990, PART VI, SECTION B, LINE 11 IN ADDITION TO A REVIEW OF FORM 990 BY MANAGEMENT OF THE MILFORD HOSPITAL, THE RETURN IS REVIEWED BY THE CFO / VICE PRESIDENT OF FINANCE ON BEHALF OF THE BOARD OF DIRECTORS. THE RETURN IS THEN MADE AVAILABLE VIA OFFICE OUTLOOK WEB ACCESS TO EACH BOARD MEMBER BEFORE IT'S FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE SENT TO OFFICERS, DIRECTORS, AND KEY EMPLOYEES ANNUALLY. THE COMPLETED STATEMENTS ARE REVIEWED BY THE PRESIDENT.
FORM 990, PART VI, SECTION B, LINE 15 BOARD OF DIRECTORS APPROVES COMPENSATION OF OFFICERS.
FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE KEPT IN THE PRESIDENT'S OFFICE AND ARE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9: PASSTHROUGH INCOME FROM CT HOSPITAL LAB NETWORK, LLC -641. TRANSFER TO AFFILIATES -926,625. TRANSFER FROM AFFILIATES 74,440. CHANGE IN EQUITY INTEREST IN MILFORD HOSPITAL FOUNDATION 65,966. CHANGE IN PENSION FUND OBLIGATION -1,655,986.
FORM 990, PART XII, LINE 2C: THE BOARD OF DIRECTORS HAS DELEGATED ITS OVERSIGHT RESPONSIBILITY OF THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS TO THE FINANCE, INSURANCE AND PENSION COMMITTEE.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2013

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" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
THE MILFORD HOSPITAL INC
 
Employer identification number

06-0646741
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity










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


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1) MILFORD HEALTH & MEDICAL INC

300 SEASIDE AVE

MILFORD,CT06460
22-2627346 		SUPPORTING ORGANIZATION CT 501(C)(3) LINE 11B, II N/A
 
No
(2) MILFORD HEALTH CARE SERVICES INC

300 SEASIDE AVE

MILFORD,CT06460
22-2627353 		HEALTH CARE SERVICES CT 501(C)(3) PF MILFORD HEALTH & MEDICAL
 
 
No
(3) MILFORD HOSPITAL FOUNDATION INC

300 SEASIDE AVE

MILFORD,CT06460
22-2627350 		FUNDRAISING CT 501(C)(3) PF MILFORD HEALTH & MEDICAL
 
 
No
(4) HOME CARE PLUS INC

P O BOX 161

MILFORD,CT06460
06-1044331 		HOME HEALTH SERVICES CT 501(C)(3) LINE 9 MILFORD HEALTH & MEDICAL
 
 
No






For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
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












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
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) SEABRIDGE CORPORATION

300 SEASIDE AVE
MILFORD,CT06460
22-2626962 		OTHER MEDICAL SERVICES CT N/A
 C         No
(2) MILFORD MEDICAL LABORATORY INC

300 SEASIDE AVE
MILFORD,CT06460
06-6368893 		LABORATORY SERVICES CT N/A
 C         No
(3) TORRY CORPORATION

300 SEASIDE AVE
MILFORD,CT06460
01-0724230 		RENTAL REAL ESTATE CT N/A
 C         No
(4) SEASIDE INDEMNITY ALLIANCE LTD

300 SEASIDE AVE
MILFORD,CT06460
 LIABILITY INSURANCE CJ N/A
 C         No






Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
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 or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved





Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
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)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(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 Yes No






























Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2013
Additional Data


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