TY 2014 Form 990

(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)
(1) Diane Wishnafski........................................................................ Director	2.00 .......................	X	0
(2) Carmen Cid PhD........................................................................ Director	2.00 .......................	X	0
(3) Mary Barry MD........................................................................ Director, Medical Director	2.00 .......................	X	33,945
(4) Catina Caban-Owen........................................................................ Director	2.00 .......................	X	0
(5) Carolyn Drescher........................................................................ Director	2.00 .......................	X	0
(6) Elizabeth Conway Esq........................................................................ Director	2.00 .......................	X	0
(7) Deborah Monahan........................................................................ Director	2.00 .......................	X	0
(8) Lynne Quintal-Hill........................................................................ Director	2.00 .......................	X	0
(9) Mark Tramontozzi MD........................................................................ Director	2.00 .......................	X	0
(10) James Watson MD........................................................................ Director	2.00 .......................	X	0
(11) Linda Klein PhD........................................................................ Director (Thru 6/15)	2.00 .......................	X	0
(12) Kenneth Porter........................................................................ Director (Thru 6/15)	2.00 .......................	X	0
(13) Patrice Crosbie........................................................................ Director (Thru 6/15)	2.00 .......................	X	0
(14) Ethan Foxman MD........................................................................ Director (Thru 6/15)	2.00 .......................	X	0
(15) Theodore Armata Jr........................................................................ Director (Thru 6/15)	2.00 .......................	X	0
(16) Nadia Nashid MD........................................................................ Director (Thru 6/15)	2.00 .......................	X	0
(17) Stephen Bacon........................................................................ Director (Thru 6/15)	2.00 .......................	X	0

(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)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) Edward Sawicki MD........................................................................ Director (Thru 6/15)	2.00 .......................	X					0	0	0
(19) Frank Siracusa MD........................................................................ Director (Thru 6/15)	2.00 .......................	X					0	45,000	0
(20) Karla Fox........................................................................ Chair	3.00 .......................	X	X				0	0	0
(21) Anthony Joyce........................................................................ Vice Chair	3.00 .......................	X	X				0	0	0
(22) David Whitehead........................................................................ President & CEO (Thru 12/15)	40.00 .......................20.00	X	X				0	806,006	50,532
(23) Margaret Marchak........................................................................ Secretarty	3.00 .......................		X				0	541,910	108,761
(24) Daniel Lohr........................................................................ VP Finance	30.00 .......................30.00		X				0	593,901	44,016
(25) Carolyn Trantalis........................................................................ VP Operations	30.00 .......................30.00			X			0	267,884	39,198
(26) Mary Bylone........................................................................ VP Patient Care	30.00 .......................30.00			X			0	279,774	32,407
(27) Kismatkumar Detroja MD........................................................................ Physician	60.00 .......................				X		311,288	0	44,998
(28) Melisha Cumberland MD........................................................................ Physician	60.00 .......................				X		232,466	0	27,376
(29) Julian Munoz MD........................................................................ Physician	60.00 .......................				X		230,057	0	31,088
(30) Syera Mathews MD........................................................................ Physician	60.00 .......................				X		225,646	0	11,339
(31) Katherine Flanagan MD........................................................................ Physician	60.00 .......................				X		218,589	0	37,896
(32) Stephen Larcen........................................................................ Former Interim President & CEO	0.00 .......................					X	0	708,126	69,579

(A) Name and business address	(B) Description of services	(C) Compensation
Northeast Emergency Medical Specialist PO Box 742528 Dallas,TX75374	Medical Services	1,689,021
Connecticut Children's Specialty Group 282 Washington Street Hartford,CT06106	Medical Services	308,490
Transcend Services Inc PO Box 740209 Atlanta,GA30374	Transportation	254,407
Physicians for Women's Health 22 Waterville Road Avon,CT06001	Medical Services	251,492
Storrs Associates LLC 1244 Storrs Road Storrs,CT06268	Consulting	244,602
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 19

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 domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ....
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............
4	Benefits paid to or for members ....
5	Compensation of current officers, directors, trustees, and key employees ....
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages ....	35,927,945	35,164,890	683,389	79,666
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,508,921	1,475,397	30,178	3,346
9	Other employee benefits .......	7,223,364	7,062,880	144,467	16,017
10	Payroll taxes ...........	2,548,006	2,491,204	50,960	5,842
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	177,740		177,740
c	Accounting ...........	73,200		73,200
d	Lobbying ...........	18,894		18,894
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	7,861		7,861
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ....	1,520,772	1,520,772
12	Advertising and promotion ....	13,989		13,989
13	Office expenses .......	2,088,135	1,661,661	426,474
14	Information technology ......	3,497,559	3,204,111	293,448
15	Royalties ..
16	Occupancy ...........	1,924,565	1,194,076	730,489
17	Travel ............	42,443	5,452	36,991
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	86,918	1,549	85,369
20	Interest ...........	1,698,978	849,489	849,489
21	Payments to affiliates .......	3,694,034	2,914,687	779,347
22	Depreciation, depletion, and amortization .....	4,243,315	4,243,315
23	Insurance ..............	555,418	555,418
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	Purchased Services	7,799,948	7,540,567	259,381
b	Medical Supplies	7,759,757	7,759,757
c	Repairs & Maintenance	3,327,897	2,153,839	1,174,058
d	Miscellaneous Expenses	323,429		323,429
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	86,063,088	79,799,064	6,159,153	104,871
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 if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	6,502,319	1	4,122,237
2	Savings and temporary cash investments .........		2	560,688
3	Pledges and grants receivable, net ...........	175,678	3	24,847
4	Accounts receivable, net .............	9,207,001	4	9,938,365
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 ..............	1,188,268	8	990,707
9	Prepaid expenses and deferred charges ..........	362,421	9	962,074
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	121,969,212
b	Less: accumulated depreciation .....	10b	82,446,253	42,365,465	10c	39,522,959
11	Investments—publicly traded securities ..........	2,459,958	11	2,291,564
12	Investments—other securities. See Part IV, line 11 .....	381,789	12	318,056
13	Investments—program-related. See Part IV, line 11 .....	38,115	13	38,115
14	Intangible assets ...............		14
15	Other assets. See Part IV, line 11 ...........	6,967,460	15	5,327,385
16	Total assets. Add lines 1 through 15 (must equal line 34)......	69,648,474	16	64,096,997
	17	Accounts payable and accrued expenses .........	3,278,354	17	6,294,158
18	Grants payable .................		18
19	Deferred revenue ................	11,362,327	19	7,723,496
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
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....................	90,279,066	25	101,484,616
26	Total liabilities. Add lines 17 through 25.........	104,919,747	26	115,502,270
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	-40,278,384	27	-56,418,362
28	Temporarily restricted net assets ...........	1,362,936	28	1,368,915
29	Permanently restricted net assets ...........	3,644,175	29	3,644,174
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........	-35,271,273	33	-51,405,273
34	Total liabilities and net assets/fund balances ........	69,648,474	34	64,096,997

- TIN:

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.
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Attach to Form 990 or Form 990-EZ.
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Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization

Windham Community Memorial Hospital

Employer identification number

06-0646966

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations .............................

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2014

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)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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 VI.)..
11	Total support Add lines 7 through 10.

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2013 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2014. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2013. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2013. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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) 2014

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)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2013 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2014 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2013 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2014. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2013. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2014

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Schedule A (Form 990 or 990-EZ) 2014

Page 5

Part IV

Supporting Organizations (continued)

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2014

Page 6

Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1. Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6
7	Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2014

Page 7

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2014 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2014	(iii) Distributable Amount for 2014
1 Distributable amount for 2014 from Section C, line 6
2 Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2014 distributable amount
i Carryover from 2009 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2014 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2014 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2015. Add lines 3j and 4c.
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......
e From 2014.......

Schedule A (Form 990 or 990-EZ) (2014)

Schedule A (Form 990 or 990-EZ) 2014

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

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

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

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) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Windham Community Memorial Hospital

Employer identification number

06-0646966

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

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) 2014

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 Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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? ......................................	Yes No

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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2011	(b) 2012	(c) 2013	(d) 2014	(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) 2014

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)

Yes

(b)

Amount

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:

Volunteers? .........................................

Yes

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Yes

18,894

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? ..........................

Total. Add lines 1c through 1i ...............................

18,894

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

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

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

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."

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ............................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

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, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Part II-B, Line 1:	Windham Community Memorial Hospital paid annual dues to Connecticut Hospital Association (CHA). CHA conducts lobbying activities on behalf of its members. CHA allocates a portion of their dues as lobbying expenses. The portion of dues allocated as lobbying expenses is calculated under current Medicare rules. CHA conducts lobbying activities under current Medicare rules. The total amount of dues allocated for lobbying expenses for FY15 was $18,894.

Return Reference

Explanation

Part II-B, Line 1:

Windham Community Memorial Hospital paid annual dues to Connecticut Hospital Association (CHA). CHA conducts lobbying activities on behalf of its members. CHA allocates a portion of their dues as lobbying expenses. The portion of dues allocated as lobbying expenses is calculated under current Medicare rules. CHA conducts lobbying activities under current Medicare rules. The total amount of dues allocated for lobbying expenses for FY15 was $18,894.

Schedule C (Form 990 or 990EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Windham Community Memorial Hospital

Employer identification number

06-0646966

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 value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

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)? .......................................

Yes No

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.

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.

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)

Revenue included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

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:

Revenue included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2014

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?........

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIII and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

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 ....	2,134,823	1,964,242	1,747,544	1,752,043	2,056,455
b	Contributions ........					350
c	Net investment earnings, gains, and losses	-37,021	183,301	234,012	272,346	-8,245
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........	9,655	12,720	17,314	276,546	296,517
f	Administrative expenses ....
g	End of year balance ......	2,088,147	2,134,823	1,964,242	1,747,544	1,752,043

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

56.000 %

Temporarily restricted endowment SchDMd Bullet

44.000 %

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

Yes

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

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 .................	107,910	1,223,461		1,331,371
b	Buildings ................	833,124	58,032,665	28,445,215	30,420,574
c	Leasehold improvements ............	539,223	5,274,604	4,294,995	1,518,832
d	Equipment ................	78,822	55,729,009	49,706,043	6,101,788
e	Other .................		150,394		150,394
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......					39,522,959

Schedule D (Form 990) 2014

Page 3

Part VII

InvestmentsOther 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.)

Part VIII

InvestmentsProgram 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.)

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) Interest in Investment Endowment				2,016,540
(2) LT Malpractice Claims				1,425,919
(3) Due From Affiliates				19,288
(4) Inter-Company Allocation Bond				1,865,638





Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				5,327,385

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
Accr. Pension & Other LT Liabilities		33,723,223
Interest Rate Swap Obligation		3,914,517
Other Liabilities		7,097,915
IBNR Malpractice Reserve		350,981
Accrued Post Ret - Non Pension		16,205,995
Long Term Debt HHC - Intercompany Bonds		31,132,147
Due to Affiliates		6,147,387
Salaries, Wages & PR Tax		2,369,031
Hospital Provider Tax		543,420
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		101,484,616
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) 2014

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
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1.....................		3
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
c	Add lines 4a and 4b.......................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

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
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
e	Add lines 2a through 2d......................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

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 V, Line 4:	The Hospital has adopted investment and spending policies for endowment assets that attempt to provide a predictable stream of funding to mission related programs such as those described in Part III, lines 4a-d while seeking to maintain purchasing power of the endowment assets. Endowment assets include those assets of donor-restricted funds that the Hospital must hold in perpetuity or for a donor-specific period(s). Under this policy, as approved by the Board of Directors, the endowment assets are invested in a manner that is intended to produce a real return, net of inflation and investment management costs, of a least 4% over the long term. Actual returns in any given year may vary from this amount. The Hospital's endowment consists of hundreds of individual funds established for a variety of purposes. Net assets associated with endowment funds are classified and reported based on the existence or absence of donor-imposed restrictions. The income generated by the funds are used mainly for capital expenses.

Return Reference

Explanation

Part V, Line 4:

The Hospital has adopted investment and spending policies for endowment assets that attempt to provide a predictable stream of funding to mission related programs such as those described in Part III, lines 4a-d while seeking to maintain purchasing power of the endowment assets. Endowment assets include those assets of donor-restricted funds that the Hospital must hold in perpetuity or for a donor-specific period(s). Under this policy, as approved by the Board of Directors, the endowment assets are invested in a manner that is intended to produce a real return, net of inflation and investment management costs, of a least 4% over the long term. Actual returns in any given year may vary from this amount. The Hospital's endowment consists of hundreds of individual funds established for a variety of purposes. Net assets associated with endowment funds are classified and reported based on the existence or absence of donor-imposed restrictions. The income generated by the funds are used mainly for capital expenses.

Schedule D (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the TreasuryInternal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Windham Community Memorial Hospital

Employer identification number

06-0646966

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...

Yes

If "Yes," was it a written policy? .......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other 25000.0000000000 %

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: .........

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used 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.

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"? ..............

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......

Yes

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? ..............

Did the organization prepare a community benefit report during the tax year? ..........

Yes

If "Yes," did the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) ..	4,161,299		4,161,299	4.840 %
b	Medicaid (from Worksheet 3, column a) ....	22,869,407	11,687,539	11,181,868	12.990 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .
d	Total Financial Assistance and Means-Tested Government Programs .	27,030,706	11,687,539	15,343,167	17.830 %
Other Benefits		179,720	6,365	173,355	0.200 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	179,720	6,365	173,355	0.200 %
f	Health professions education (from Worksheet 5) ..	108,008		108,008	0.130 %
g	Subsidized health services (from Worksheet 6) ..	584,802	364,003	220,799	0.260 %
h	Research (from Worksheet 7)
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	223,972	210,889	13,083	0.020 %
j	Total. Other Benefits ..	1,096,502	581,257	515,245	0.610 %
k	Total. Add lines 7d and 7j .	28,127,208	12,268,796	15,858,412	18.440 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014

Schedule H (Form 990) 2014

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)	(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	1	2,035	2,035	0 %
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	1	2,035	2,035

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

4,675,102

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. ......

495,997

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

Enter total revenue received from Medicare (including DSH and IME).....

26,711,261

Enter Medicare allowable costs of care relating to payments on line 5.....

29,494,745

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-2,783,484

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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.......................

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) 2014

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 (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	Windham Community Memorial Hospital 112 Mansfield Avenue Willimantic,CT06226 www.wcmh.org 0061	X	X	X

Schedule H (Form 990) 2014

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)

	Windham Community Memorial Hospital
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?.......................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C..........

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 12....................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 14

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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public? ..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): See Part V

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 14

Is the hospital facility's most recently adopted implementation strategy posted on a website? ........

If "Yes" (list url):

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Yes

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

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)? ...........................

12a

If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ......

12b

If "Yes" to line 12b, 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) 2014

Page

Part VFacility Information (continued)

	Windham Community Memorial Hospital
Name of hospital facility or letter of facility reporting group

Yes

Financial Assistance Policy (FAP)

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 included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 250.000000000000%
and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application.

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application.

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process.

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications.

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?.......

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url): windhamhospital.org/patients-visitors/for-patients/financial-assistance

The FAP application form was widely available on a website (list url): windhamhospital.org/patients-visitors/for-patients/financial-assistance

A plain language summary of the FAP was widely available on a website (list url):
windhamhospital.org/patients-visitors/for-patients/financial-assistance

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

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 all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

	Windham Community Memorial Hospital
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other 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?.........

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Section C)

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? ................................

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2014

Page

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Windham Community Memorial Hospital	Part V, Section B, Line 3j: Windham Community Memorial Hospital completed its last Community Health Needs Assesment in FY 2015. The study area for the survey effort is defined by 16 residential ZIP codes in Connecticut. The population of the hospital's service area is estimated at 270,183 people. It is predominantly non-Hispanic White (81.8%), and has an Hispanic population of (10.4%). The poverty descriptions and segmentation used in the needs assessment report were based on administrative poverty thresholds determined by the US Department of Health & Human Services.This assessment incorporated data from both quantitative and qualitative sources. Quantitative data input include primary research and secondary research. The survey instrument used for this study was based largely on the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS), as well as various other public health surveys and customized questions addressing gaps in indicator data relative to health promotion and disease prevention objectives and other recognized health issues.To ensure the best representation of the population surveyed, a telephone interview methodology - one that incorporates both landline and cell phone interviews - was employed. The sample design used for this effort consisted of a random sample of 579 individuals age 18 and older in the Windham Community Memorial Hospital service area. Because the study was part of a larger effort involving multiple regions and hospital service areas, the surveys were distributed among various strata. Once the interviews were completed, these were weighted in proportion to the actual population distribution so as to appropriately represent the Hartford Region as a whole. A variety of existing (secondary) data sources was consulted to complement the research quality of the Community Health Needs Assessment.Part V, Section B, Line 7a:http://www.windhamhospital.org/about-us/community-health-needs-assessment
Windham Community Memorial Hospital	Part V, Section B, Line 5: To solicit input from key informants and individuals who have a broad interest in the health of the community, an Online Key Informant Survey was also implemented as part of this process. These individuals included physicians, public health representatives, health professionals, social service providers and a variety of other community leaders including:American Ambulance Service, Inc. American Red Cross Blood Services Backus Hospital Catholic Charities Generations Family Health Center, Inc. Mohegan Tribe Norwich Adult Education Reliance House, Inc. Rose City Senior Center Southeastern Regional Action Council St. Vincent de Paul Place Norwich Three Rivers Community College Nursing Program Town of Windham TVCCA Uncas Health District United Community and Family Services Windham Community Memorial Hospital Windham Region No Freeze Project Participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall. Key informants were contacted by email, introducing the purpose of the survey and providing a link to take a survey online. Key informants were asked to rate the degrees to which various health issues were a problem in the Hartford Region. Follow-up questions asked them to describe why they identified areas as such, and how these might be better addressed. Windham Community Memorial Hospital recognizes that it cannot measure all possible aspects of health in the community, nor can it adequately represent all possible populations of interest. In terms of content, the assessment was designed to provide a comprehensive and broad picture of the health of the overall community. The CHNA analysis and report yielded a wealth of information about the health status, behaviors and needs for our population. A distinct advantage of the primary quantitative (survey) research is the ability to segment findings by geographic, demographic and health characteristics to identify the primary and chronic disease needs and other health issues of vulnerable populations, such as uninsured persons, low-income persons, and racial/ethnic minority groups. For additional statistics about uninsured, low-income, and minority health needs please refer to the complete Community Health Needs Assessment report, which can be viewed online at: windhamhospital.org/health-community /community-health-care-needs-assessmentAfter reviewing the Community Health Needs Assessment findings, the community representatives met on June 11, 2015 to determine the health needs to be prioritized for action. During a detailed presentation of the CHNA findings, we used audience response system (ARS) technologies to lead steering committee members through a process of understanding key local data findings (Areas of Opportunity) and ranking identified health issues against the following established, uniform criteria: Magnitude, Impact/Seriousness/Feasibility, Consequences of Inaction. From this exercise, the areas of opportunity were prioritized as follows by the committee: Mental Health, Nutrition, Physical Activity & Weight Status, Diabetes, Substance Abuse, Cancer, Heart Disease and Stroke.
Windham Community Memorial Hospital	Part V, Section B, Line 11: As individual organizations begin to parse out the information from the 2015 Community Health Needs Assessment, it is Windham Community Memorial Hospital's goal that this will foster greater desire to embark on a community-wide community health improvement planning process. Windham Hospital has expressed this intention to partnering organizations and is committed to being a productive member in this process as it evolves. In addition, formal collaboratives have been formed, and system-wide initiatives have been launched that address nutrition education such as our partnership with a statewide super market retailer. In acknowledging the wide range of priority health issues that emerged from the CHNA process, Windham Community Memorial Hospital determined that it could only effectively focus on those which it deemed most pressing, most under-addressed, and most within its ability to influence: * Nutrition, physical activity & weight (obesity), cancer, diabetes, heart disease & stroke, and respiratory diseases* Access to Care, including oral health, dementias, and Alzheimer's Disease* Mental Health & Substance Use, including tobacco useHealth Priorities Not Chosen for Action Reason - None.Together with the community partners, Windham Hospital plans to address all of the issues identified in the CHNA using a community-wide collaborative approach.Sch H Part V, Line 9:Although the approved implementation strategy date reflects the 2014 tax year, the implementation strategy was approved in December 2015. The organization reports its data on a fiscal year basis. As a result, the current software prevents the disclosure of the 2015 date on the current Form. The correct date (2015) will be reflected on FY16 Form.
Windham Community Memorial Hospital	Part V, Section B, Line 13h: Family eligibility criteria for Financial Assistance also include family size, employment status, financial obligations, and amount and frequency of the health care expenses.
Windham Community Memorial Hospital	Part V, Section B, Line 15e: In addition, patient may ask nurse, physician, chaplain, or staff member from Patient Registration, Patient Financial Services, Office of Professional Services, Case Coordination, or Social Services about initiating the Financial Assistance Application process.
Windham Community Memorial Hospital	Part V, Section B, Line 16i: Patients are informed directly by staff of the availability of the Financial Assistance Policy.
Windham Community Memorial Hospital	Part V, Section B, Line 22d: For FY15, the hospital did a computation to determine on average insurance companies reimbursement for the types of services rendered. The average (discount) was offered to all self-pay patients without regards to financial ability. Patients who were unable to pay their bills were able to apply for financial assistance. Based upon factors including family size & income, patients were eligible to receive write-offs ranging between 25 - 100%.The Hospital Financial Assistance Policy (effective January 1, 2016) is compliant with IRS Code Sec. 501R. Per the Hospital's policy, no individual who is determined to be eligible for financial assistance will be charged more for emergency or other medically necessary care than the amount generally billed to individuals who have insurance covering such care. The basis to which any discount is applied is equivalent to the billed charges posted to a patient account minus any prior insurance payments and adjustments from the patient's insurance (if applicable). Starting January 1, 2016, the Hospital used the IRS 501R prescribed methodology to compute self-pay discount (AGB discount). The Hospital calculates AGB based on a retrospective or look back review of amounts allowed by governmental (Medicare, Medicaid, etc.) and commercial insurances.
Part V, Section B, Line 16	Financial Assistance Policy Website Availability
Windham Community Memorial Hospital Part V, Section B, line 16a website:	windhamhospital.org/patients-visitors/for-patients/financial-assistance
Windham Community Memorial Hospital Part V, Section B, line 16b website:	windhamhospital.org/patients-visitors/for-patients/financial-assistance
Windham Community Memorial Hospital Part V, Section B, line 16c website:	windhamhospital.org/patients-visitors/for-patients/financial-assistance

Schedule H (Form 990) 2014

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?3
Name and address		Type of Facility (describe)
1	Windham Middle School Health Center 123 Quarry Street Willimantic,CT06226	In-depth health and mental health assessment
2	Windham High School Wellness Center 355 High Street Willimantic,CT06226	In-depth health and mental health assessment
3	Charles H Barrows STEM Academy 141 Tuckie Road North Windham,CT06256	School based health center
4
5
6
7
8
9
10

Schedule H (Form 990) 2014

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
Part I, Line 3c:	Windham Community Memoria Hospital uses Federal Poverty Guidelines (FPG) to determine eligibility. In addition to the FPG, the hospital also utilizes other eligibility criteria, such as asset level, medical indigence and insurance status.
Part I, Line 7:	The organization utilized the Ratio of Cost to Charge (RCC), derived from the Medicare Cost Report which already incorporates or is net of non-patient care costs (i.e. bad debt, non-patient care, etc.). The ratio was further reduced to incorporate the directly identified community expenses. This cost to charge ratio was used to calculate costs for Part I lines 7a, b, & g. The costs associated with the activities reported on Part I, Line 7e were captured using actual time multiplied by an average salary rate. These costs were removed from the calculations above to avoid duplication. Costs reported in Part III, Section B6, were calculated from the Medicare cost report and reduced for Medicare costs previously reported on Part I Lines 7f and g.
Part I, Line 7g:	No physician clinic costs were included in the subsidized Health Services cost calculations.
Part II, Community Building Activities:	Our participation in Community Building activities plays an important role in promoting the health and well-being of our community. We work closely with key community partners, such as fire, police, health districts and town governments to ensure the safety of the community and to prepare for potential disasters. The hospital collaborates with the school based health clinics to promote the health and well-being of our youth population. Windham Hospital also partners the Violence and Injury Prevention Program at St. Francis Hospital. Many of the community initiatives would not be successful or effective without the involvement, support and expertise of hospital administrative and clinical staff on an in-kind basis.
Part III, Line 2:	The Hospital has established estimates based on information presently available of amounts due to or from Medicare, Medicaid, and third-party payors for adjustments to current and prior year payment rates, based on industry-wide and Hospital-specific data. Such amounts are included in the accompanying combined balance sheets.
Part III, Line 3:	A pre-bad debt financial assistance screening was put in place to identify patients that may be eligible for financial assistance. Pre-bad debt accounts that are identified as meeting the requirements are adjusted prior to being sent to bad debt. Therefore, any bad debt expense that could have been attributable to charity care at the end of FY 2015 would be immaterial.
Part III, Line 4:	Please see the text of the footnote that describes bad debt expense on pages 16-19 of the Audited Financial Statement.
Part III, Line 8:	The organization Medicare Cost Report was used to accumulate actual costs related to Part III, Section B, Line 6.
Part III, Line 9b:	The Financial Assistance Policy states: In the event a patient fails to qualify for Financial Assistance or fails to timely pay his or her portion of discounted charges pursuant to this Policy, Hartford Hospital reserves the right to institute and pursue Extraordinary Collection Actions (ECA) and remedies such as imposing wage garnishments or filing liens on primary or secondary residences, bank or investment accounts, or other assets, instituting and prosecuting legal actions and reporting the matter to one or more credit rating agencies. For those patients who qualify for Financial Assistance and who, in Hartford Hospital's sole determination, are cooperating in good faith to resolve the outstanding accounts, Hartford Hospital may offer extended payment plans. For patients who meet the terms of the payment plan Hartford Hospital will not impose wage garnishments or liens on primary residences, and will not send unpaid bills that are part of the payment plan to outside collection agencies.No ECA will be initiated during the first 120 days following the first post-discharge billing statement to a valid address or during the time that patient's Financial Assistance Application is processing. Before initiating any ECA, a notice will be provided to the patient 30 days prior to initiating such event.If the patient applies for assistance within 240 days from the first notification of the self-pay balance, and is granted assistance, any ECA's such as negative reporting to a credit bureau or liens that have been filed will be removed.
Part VI, Line 2:	A variety of methods are used to assess needs for programs that we offer to the community. Needs assessment data is collected when applying for grants at the local, state, and federal level utilizing census data, public health district data, state agency data, as well as federal data from the CDC and other sources. More informal methods to assess needs include feedback from Advisory Councils, support groups, and individuals who may need assistance in accessing healthcare services. We coordinate closely with the federally qualified health center in Willimantic, which serves the healthcare needs of low income residents, as well as numerous other organizations including the public schools, other non profit organizations, senior centers, and government agencies in our region. The statewide Connecticut Hospital Association, of which we are a member, provides data collection. Secondary data from other organizations is also utilized to take advantage of other resources such as the United Way, Eastern Highlands Health District, Visiting Nurses, and partner organizations.
Part VI, Line 3:	Windham Community Memorial Hospital will provide information about its Financial Assistance Policy as follows: (i) provide signs regarding this Policy and written plain language summary information describing the Policy along with Financial Assistance contact information in the Emergency Department, Labor and Delivery areas and other patient registration areas; (ii) provide to each patient written plain language summary information describing the Policy along with Financial Assistance contact information in admission, patient registration, discharge, billing and collection written communications; (iii) make paper copies of the Policy, financial assistance application, and plain language summary of the Policy available upon request and without charge, both by mail and in public locations in the hospital facility, including the emergency room (if any) and admissions areas; (iv) post the Policy, plain language summary and financial assistance application on the website with clear linkage to such documents on the HH's home page; (v) educate all admission and registration personnel regarding the Policy so that they can serve as an informational resource to patients regarding the Policy; and (vi) include the tag line "Please ask about our Financial Assistance Policy" in the hospitals written publications.
Part VI, Line 4:	Windham Hospital services 19 towns in Eastern Connecticut which include a portion of Windham County and several towns in New London and Tolland counties. Census data for 2010 reports a population of 118,145 in Windham County. People of Hispanic origin make up 10.9 percent of Connecticut population and 14.4 percent of the total U.S. population; however in four Connecticut counties, including Windham County, the Hispanic population more than doubled between 1990 and 2005. In the Town of Windham, where the Hospital is located, 29.9% (2010 Census) of the population is of Hispanic origin.The poverty rate in Windham County is 10.3% as compared to 10.8% statewide. The unemployment rate is 7.5% in Windham County with a rate of 6.6% for the State of Connecticut. Average income per median household in Windham County is $59,218, as compared to $69,899 statewide.County Health Rankings, a program of the Robert Wood Johnson Foundation and the University of Wisconsin Population Institute reported in 2015 that Windham County ranked seventh of eight counties with respect to health outcomes (mortality and morbidity), and last (8th) in health behaviors including tobacco use, diet & exercise, alcohol use and unsafe sex. Social and economic factors including education, employment, income, family & social support and community safety were also ranked 7th.
Part VI, Line 5:	Windham Community Memorial Hospital was formed to serve its community in 1933 and has been an important resource for nearly 83 years. A regional board governs Windham, Backus, and Natchaug Hospitals. The board is responsible for maintaining outstanding quality services and credentials its medical staff. All of the Directors reside in our service area and are neither employees, family members, nor contractors of the Hospital. The Windham Hospital Foundation, a related organization, raises funds to assure that the latest advancements in technology are available to our patients, as well as a range of community benefit programs that are not funded by other sources. We are a true community resource as we offer space for other community groups to meet at no charge, bring together other health providers for health fairs and educational sessions for the community, and encourage the involvement of our staff on various boards and councils that promote the overall health of the community.
Part VI, Line 6:	Hartford Healthcare Corporation (HHC) is organized as a support organization to govern, manage and provide support services to its affiliates. HHC, through its affiliates including Hartford Hospital, strives to improve health using the "Triple Aim" model: improving quality and experience of care; improving health of the population (population health) and reducing costs. The Strategic Planning and Community Benefit Committee of the HHC Board of Directors ensures the oversight for these services by each hospital community. HHC and its affiliates including all supporting organizations, develop and implement programs to improve the future of health care in our Southern New England region. This includes initiatives to improve the quality and accessibility of health care; create efficiency on both our internal operations and the utilization of health care; and provide patients with the most technically advanced and compassionate coordinated care. In addition, HHC continues to take important steps toward achieving its vision of being "nationally respected for excellence in patient care and most trusted for personalized, coordinated care."The affiliation with HHC creates a strong, integrated health care delivery system with a full continuum of care across a broader geographic area. This allows small communities easy and expedient access to the more extensive and specialized services the larger hospitals are able to offer. This includes continuing education of health care professionals at all the affiliated institutions through the Center of Education, Simulation and Innovation located at Hartford Hospital, the largest of the system hospitals. The affiliation further enhances the affiliates' abilities to support their missions, identity, and respective community roles. This is achieved through integrated planning and communication to meet the changing needs of the region. This includes responsible decision making and appropriate sharing of services, resources and technologies, as well as, cost containment strategies. Additionally, the hospital is affiliated with several other non hospital charitable organizations. These organizations provide significant benefits to the community. These benefits are not reported in the Community Benefit data provided by the hospital.
Part VI, Line 7, Reports Filed With States	CT

Schedule H (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

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

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Windham Community Memorial Hospital

Employer identification number

06-0646966

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

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....

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? ..

Yes

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

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 ............

Yes

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 .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2014

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 in column(B) reported as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Mary Barry MDDirector, Medical Director	(i) (ii)	0 ............................... 33,945	0 ............................... 0	0 ............................... 0	0 ............................... 0	0 ............................... 0	0 ............................... 33,945	0 ............................... 0
2David WhiteheadPresident & CEO (Thru 12/15)	(i) (ii)	0 ............................... 539,164	0 ............................... 140,531	0 ............................... 126,311	0 ............................... 14,040	0 ............................... 36,492	0 ............................... 856,538	0 ............................... 0
3Margaret MarchakSecretarty	(i) (ii)	0 ............................... 432,566	0 ............................... 101,007	0 ............................... 8,337	0 ............................... 72,165	0 ............................... 36,596	0 ............................... 650,671	0 ............................... 0
4Daniel LohrVP Finance	(i) (ii)	0 ............................... 375,616	0 ............................... 85,582	0 ............................... 132,703	0 ............................... 14,040	0 ............................... 29,976	0 ............................... 637,917	0 ............................... 0
5Carolyn TrantalisVP Operations	(i) (ii)	0 ............................... 215,367	0 ............................... 50,771	0 ............................... 1,746	0 ............................... 15,600	0 ............................... 23,598	0 ............................... 307,082	0 ............................... 0
6Mary ByloneVP Patient Care	(i) (ii)	0 ............................... 219,944	0 ............................... 47,630	0 ............................... 12,200	0 ............................... 14,040	0 ............................... 18,367	0 ............................... 312,181	0 ............................... 0
7Kismatkumar Detroja MDPhysician	(i) (ii)	310,808 ............................... 0	300 ............................... 0	180 ............................... 0	15,600 ............................... 0	29,398 ............................... 0	356,286 ............................... 0	0 ............................... 0
8Melisha Cumberland MDPhysician	(i) (ii)	231,995 ............................... 0	300 ............................... 0	171 ............................... 0	14,053 ............................... 0	13,323 ............................... 0	259,842 ............................... 0	0 ............................... 0
9Julian Munoz MDPhysician	(i) (ii)	229,624 ............................... 0	300 ............................... 0	133 ............................... 0	13,907 ............................... 0	17,181 ............................... 0	261,145 ............................... 0	0 ............................... 0
10Syera Mathews MDPhysician	(i) (ii)	225,138 ............................... 0	300 ............................... 0	208 ............................... 0	0 ............................... 0	11,339 ............................... 0	236,985 ............................... 0	0 ............................... 0
11Katherine Flanagan MDPhysician	(i) (ii)	218,211 ............................... 0	200 ............................... 0	178 ............................... 0	13,384 ............................... 0	24,512 ............................... 0	256,485 ............................... 0	0 ............................... 0
12Stephen LarcenFormer Interim President & CEO	(i) (ii)	0 ............................... 477,856	0 ............................... 105,563	0 ............................... 124,707	0 ............................... 37,700	0 ............................... 31,879	0 ............................... 777,705	0 ............................... 0

Schedule J (Form 990) 2014

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 1b	Tax indemnification and gross-up payments to certain individuals for benefits were included as taxable income on their 2014 Form W-2.
Part I, Line 3	The Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare on behalf of Windham Community Memorial Hospital, hires an outside consultant, Integrated Healthcare Strategies, a division of Gallagher Benefit Services, Inc., to determine best practices in governing executive compensation. Please refer to compensation narrative reported on Schedule O.
Part I, Line 4b	Hartford Healthcare Corporation, a related organization, maintains a 457(f) plan. Participants include certain officers and key employees at the President, Executive Vice President, Senior Vice President and Vice President levels that are reported by Windham Hospital on Form 990, Part VII. Contributions are made by Hartford Healthcare Corporation to the plan based on a percentage of the participant's compensation. Participants vest in the plan at the earlier of reaching age 55 and having 5 years of service, death, disability, involuntary separation without reasonable cause or upon reaching age 65. Each participant ceases to be eligible for further contributions by Hartford Healthcare Corporation on the date of the participant's separation from service. Participants receive a one-time lump sum payment of the accumulated amount during the 30-day period following the participant's separation from service. 2014 SERP Accruals was made on behalf of the following individual: Mrs. Margaret Marchak $53,965 2014 SERP payouts were made on behalf of the following individuals: Mr. David Whitehead $108,000 Mr. Daniel Lohr $ 74,000
Part I, Line 7	Hartford HealthCare Corporation, a related organization, has an At Risk Plan that encourages and rewards achievements of significant functional goals for management that contribute to organization(s) strategic and financial direction. The Plan utilizes market practice alignment to ensure competitive recruitment and retention. Awards are based on CEO and/or Hartford HealthCare Corporation's Compensation Committee discretionary assessment of overall organization performance and individual contribution to results.

Schedule J (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

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 990-EZ 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

2014

Open to Public
Inspection

Name of the organization

Windham Community Memorial Hospital

Employer identification number

06-0646966

Return Reference	Explanation
Form 990, Part VI, Section A, line 4	The Amended and Restated Certificate of Incorporation of the Corporation includes the following substantive amendments: 1. The Corporation's purposes have been revised but are consistent with its charitable purposes. 2. The board's role was revised to focus on quality in health care. 3. Section 12 relating to the indemnification of directors, officers, and committee members of the Corporation has been revised consistent with Connecticut Law. The Organizations' governing documents are available upon request.
Form 990, Part VI, Section A, line 6	Windham Community MemorialHospital is organized as a non-stock not for profit entity. Hartford HealthCare Corporation is the sole member.
Form 990, Part VI, Section A, line 7a	The sole member of the organization has the authority to approve/remove members of the governing body.
Form 990, Part VI, Section A, line 7b	The sole member of the organization has the right to review, approve, disapprove and deny significant transactions such as mergers, acquisitions, dissolutions etc.
Form 990, Part VI, Section B, line 11	The Form 990 was prepared by Hartford HealthCare's Tax Department. It was then reviewed by an independent accounting firm. It was then forwarded to the organization's top management including the Sr. Vice President for review. The final Form was provided to the entire Board prior to submission to the Internal Revenue Services (IRS). Once the entire review process was completed, the Form was signed by the Sr.VP and then filed with the IRS.
Form 990, Part VI, Section B, line 12c	The Hospital's board has adopted the policy of the member, Hartford HealthCare Corporation (HHC). HHC's Conflict of Interest Policy (Policy) requires all covered individuals, including board members and officers, to provide a disclosure of relationships that create or have the appearance of creating a conflict of interest or commitment. The Policy requires updates if changes in circumstances arise during the year that either (a) create a new potential conflict of interest or commitment or (b) change or eliminate a conflict of interest or commitment previously disclosed. Conflict of Interest disclosure statements are maintained by the HHC Office of Compliance, Audit & Privacy (OCAP). Employee disclosures are reviewed by OCAP in collaboration with the Covered Individual's supervisor when deemed appropriate, to determine if there is a potential conflict. Oversight review of employee disclosures is provided by the HHC Conflict of Interest Committee (the Committee) which includes representation from the Medical Staff, the Legal Department, Human Resources, Supply Chain Management and Compliance. The Committee assesses and may recommend the conflicting interest either be (a) eliminated for a continued relationship with HHC, or (b) managed through a management plan. Board member disclosures are reported to the HHC Nominating and Governance Committee for determinations of conflicts and the management of them, where applicable.
Form 990, Part VI, Section B, line 15	The Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare on behalf of Windham Community Memorial Hospital, hires an outside consultant, Integrated Healthcare Strategies, a division of Gallagher Benefit Services, Inc., to determine best practices in governing executive compensation. The following steps were taken: - Use of an Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare, on behalf of Windham Hospital, established and regularly reviews Executive Compensation Philosophy - The Committee regularly reviews scope and depth of positions taking into account complexity and the financial impact and accountability of all "disqualified persons" - National peer group selected for comparative purposes based on organizational size, operating revenue, geography and other relevant factors - Analysis of current total compensation versus market performed by independent third party compensation consulting firm, reviewed by the committee - Recommendations are made based on data analysis to ensure appropriate competitive positioning within parameters of compensation philosophy - The CEO compensation was reviewed by The Committee based on comparative market information and organizational performance - All changes are reviewed and approved by Executive Compensation Committee The CEO compensation determination process is reviewed on an annual basis. All other executive compensation is regularly reviewed for scope and depth of positions taking into account complexity and the financial impact and accountability.
Form 990, Part VI, Section C, line 18	The Hospital's Form 990, 990T and form 1023 and its attachments are available upon request.
Form 990, Part VI, Section C, line 19	The Hospital's Financial Statements, Governing Documents and the Conflict of Interest Policy are available for inspection upon request at the Organization's address.
Form 990, Part XI, line 9:	Change In Funding Status of Pension -4,674,170. Transfer To Affiliates -5,660,427. Rounding 5,425. Income From Endowment Investments -54,724. Endowment Adjustment to Tie to K-1 (Interest & Dividends) -34,917. Endowment Adjustment to Tie to K-1 (Realized Gains) -120,386. Endowment Adjustment to Tie to K-1 (Other Income) -908. Endowment Adjustment to Tie to K-1 (Management Expense) 7,861. Endowment Adjustment to Tie to K-1 (Miscellaneous Expense) 1,794. MedEast K-1 Income 33,890.
Form 990 Part XII, Lines 3a & 3b	Although the organization was not required to undergo A-133 Federal Audit, the results were included in a consolidated A-133 audit performed at the parent level - Hartford HealthCare Corporation.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Windham Community Memorial Hospital

Employer identification number

06-0646966

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?
(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	Yes	No
(1) Hartford Hospital 80 Seymour Street Hartford,CT06102 06-0646668	Healthcare Services	CT	501(C)(3)	3	Hartford HealthCare Corporation	Yes
(2) Windham Hospital Foundation Inc 112 Mansfield Avenue Willimantic,CT06226 56-2546632	Supporting Organization	CT	501(C)(3)	11(A)	Windham Community Memorial Hospital	Yes
(3) Midstate Medical Center 435 Lewis Avenue Meriden,CT06451 06-0646715	Healthcare Services	CT	501(C)(3)	3	Hartford HealthCare Corporation	Yes
(4) Hartford HealthCare Corporation One State Street Suite 19 Hartford,CT06103 22-2672834	Support & Management Svcs.to HH and Affiliates	CT	501(C)(3)	11(C)	N/A		No
(5) Natchaug Hospital Inc 189 Storrs Road Mansfield Ctr,CT06226 06-0966963	Behavioral Health	CT	501(C)(3)	3	Hartford HealthCare Corporation	Yes
(6) Hartford HealthCare At Home Inc 1290 Silas Deane Hwy Suite 4B Wethersfield,CT06109 06-0646938	Home Healthcare	CT	501(C)(3)	7	Hartford HealthCare Corporation	Yes
(7) Rushford Center Inc 883 Paddock Avenue Meriden,CT06450 06-0932875	Substance Abuse Healthcare Services	CT	501(C)(3)	7	Hartford HealthCare Corporation	Yes
(8) Hartford Hospital Auxiliary co Hartford Hospital 80 Seymour Street Hartford,CT06115 06-6040747	Fundraising	CT	501(C)(3)	11(C)	Hartford Hospital	Yes
(9) Connecticut Health Systems Inc 80 Seymour Street Hartford,CT06102 22-2779421	Coordination of Health Care Delivery	CT	501(C)(3)	11(C)	N/A	Yes
(10) VNA Health Resources Inc 1290 Silas Deane Hwy Suite 4B Wethersfield,CT06109 06-1161422	Home Healthcare	CT	501(C)(3)	9	Hartford HealthCare At Home Inc	Yes
(11) WCMH Women's Auxiliary Inc 112 Mansfield Avenue Willimantic,CT06226 06-0677728	Fundraising	CT	501(C)(3)	11(A)	Windham Community Memorial Hospital	Yes
(12) The Hatch Hospital Corporation 112 Mansfield Avenue Willimantic,CT06226 06-6076412	Healthcare Services	CT	501(C)(3)	3	Windham Community Memorial Hospital	Yes
(13) The Hospital of Central CT and Bradley Memorial 100 Grand Street New Britain,CT06050 06-0646768	Healthcare Services	CT	501(C)(3)	3	Hartford HealthCare Corporation	Yes
(14) Central CT Senior Healh Svc dba Southington Care Center 45 Meriden Avenue Southington,CT06489 22-2635676	Sub-Acute & Long Term Healthcare	CT	501(C)(3)	9	Hartford HealthCare Corporation	Yes
(15) Bradley Health Services 100 Grand Street New Britain,CT06050 06-1367014	Healthcare Services	CT	501(C)(3)	9	Hartford HealthCare Corporation	Yes
(16) Central CT Health Alliance 100 Grand Street New Britain,CT06050 22-2785033	Support & Management Svcs. To THOCC and Affiliates - Shell	CT	501(C)(3)	11(B)	Hartford HealthCare Corporation	Yes
(17) Rushford Foundation Inc 883 Paddock Avenue Meriden,CT06450 06-1432692	Supporting Organization	CT	501(C)(3)	11(A)	Rushford Center Inc	Yes
(18) The Orchards of Southington 34 Hobart Street Southington,CT06489 06-1490803	Residential Services for Senior Care	CT	501(C)(3)	9	Central CT Senior Health Services Inc	Yes
(19) Mulberry Gardens of Southington LLC 58 Mulberry Street Plantsville,CT06479 82-0586577	Assisted Living & Adult Day Care Facility	CT	501(C)(3)	9	Central CT Senior Health Services Inc	Yes
(20) Midstate Medical Center Auxiliary 435 Lewis Avenue Meriden,CT06451 06-6063082	Fundraising	CT	501(C)(3)	11(A)	Midstate Medical Center	Yes
(21) HHC PhysiciansCare Inc 80 Seymour Street Hartford,CT06102 45-4456939	Practice Medicine and Provide Health Care Services to the Public	CT	501(C)(3)	9	Hartford HealthCare Corporation	Yes
(22) Hartford HealthCare Accountable Care Org Inc 1290 Silas Deane Hwy 2nd Floor Wethersfield,CT06109 46-0886367	To Manage and Coordinate Care for Medicare Beneficiares	CT	501(C)(3)	7	HHC PhysiciansCare Inc	Yes
(23) Hartford HealthCare Corp Group (VEBA) 777 Main Street Hartford,CT06102 26-6671355	To provide Medical Benefits to Employees	CT	501(C)(9)	N/A	Hartford HealthCare Corporation	Yes
(24) Backus Corporation 326 Washington Street Norwich,CT06360 22-2757608	Support Organization	CT	501(C)(3)	11(B)	Hartford HealthCare Corporation	Yes
(25) The William W Backus Hospital 326 Washington Street Norwich,CT06360 06-0250773	Support Organization	CT	501(C)(3)	3	Hartford HealthCare Corporation	Yes
(26) Backus HealthCare Inc 326 Washington Street Norwich,CT06360 22-2481794	Support Organization	CT	501(C)(3)	11(A)	Hartford HealthCare Corporation	Yes
(27) Eva Sterns Faulkner Foundation 435 Lewis Avenue Meriden,CT06451 06-6065398	Support Organization	CT	501(C)(3)	3	Midstate Medical Center	Yes
(28) Caring for Colleagues Employee Crisis Fund 100 Grand Street New Britain,CT06052 22-4469178	Employee Fund	CT	501(C)(3)	7	Hartford HealthCare Corporation	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2014

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) New Britain MRI Limited Partnership 100 Grand Street New Britain,CT06050 06-1271349	Magnetic Resonance Imaging	CT	N/A
(2) Hartford HealthCare Endowment LLC 80 Seymour Street Hartford,CT06102 45-4181103	Endowment Management	CT	N/A
(3) Ambulance Service of Manchester LLC PO Box 300 Manchester,CT06450 06-1557358	Ambulatory Services	CT	N/A
(4) Connecticut Imaging Partners LLC 111 Founders Plaza East Hartford,CT06108 13-4298940	Imaging Services	CT	N/A
(5) Glastonbury Endoscopy Center LLC 300 Western Blvd Suite B Glastonbury,CT06033 26-1721234	Endoscopy Services	CT	N/A
(6) Glastonbury Surgery Center LLC 195 Eastern Boulevard Glastonbury,CT06033 26-2600828	Surgery Services	CT	N/A
(7) Hartford-Middlesex Clinical System LLC 80 Seymour Street Hartford,CT06110 06-1543605	Affiliate Support Services	CT	N/A
(8) Med-East Assoc LLC 1703 West Main Street Willimantic,CT06226 06-1469575	Outpatient Care Clinic	CT	N/A	Related	-33,890	213,644		No			No	50.000 %
(9) Omni Home Health Services E CTLLC dba Backus Home HealthCare 12 Case Street 317 Norwich,CT06360 06-1458837	Home Health Care	CT	N/A
(10) HHC Southington Surgery Center LLC 81 Meriden Avenue Southington,CT06489 46-5500829	Surgery Services	CT	N/A

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?
(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		Yes	No
(1) Windham Health Services Inc 112 Mansfield Avenue Willimantic,CT06226 06-1461101	Home Healthcare	CT	Windham Community Memorial Hospital	C	82,459,394	-51,405,273	100.000 %	Yes
(2) HHMOB Corporation & Subsidiary 80 Seymour Street Hartford,CT06102 06-1140244	Real Estate Parking	CT	N/A	C				Yes
(3) Hartford HealthCare Indemnity Services Ltd FB Perry Blvd 40 Church Street Hamilton BD	Captive Insurance	BD	N/A	C				Yes
(4) Windham Physician Hospital Organization 112 Mansfield Avenue Willimantic,CT06226 06-1441614	Medical Services	CT	Windham Community Memorial Hospital	C		66,578	50.000 %	Yes
(5) Windham Family Medical Services 112 Mansfield Avenue Willimantic,CT06226 06-1491649	Medical Services	CT	N/A	C				Yes
(6) CenConn Services Inc 100 Grand Street New Britain,CT06050 22-2836001	Holding Company	CT	N/A	C				Yes
(7) Hartford Physician Services PC 80 Seymour Street Hartford,CT06102 06-1254082	Medical Services	CT	N/A	C				Yes
(8) Meriden Imaging Center 101 North Plains Industrial Road Meriden,CT06429 06-1541468	Imaging	CT	N/A	S				Yes
(9) Hartford Physician Hospital Organization Inc 80 Seymour Street Hartford,CT06102 22-2785918	Physician & Hospital Support	CT	N/A	C				Yes
(10) Aetna Ambulance Service Inc PO BOX 1150 Manchester,CT06045 06-0795431	Ambulance Services	CT	N/A	C				Yes
(11) Metro Wheelchair Service Inc PO BOX 300 Manchester,CT06045 06-0878432	Wheelchair Services	CT	N/A	C				Yes
(12) WWB Corporation 326 Washington Street Norwich,CT06360 06-1094836	Holding Company	CT	N/A	C				Yes
(13) ConnCare Inc 326 Washington Street Norwich,CT06360 06-1387598	Health Care Services	CT	N/A	C				Yes
(14) Backus Medical Center Condo Assoc Inc 330 Washington Street Norwich,CT06360 06-1542647	Condo Association	CT	N/A	C				Yes
(15) Windham Professional Office Condominium 1120 Mansfield Avenue Willimantic,CT06226 06-1090041	Condo Association	CT	Windham Community Memorial Hospital	C	21,600	141,784	60.000 %	Yes
(16) Midstate Medical Group PC 435 Lewis Avenue Meriden,CT06450 20-4327968	Medical Services	CT	N/A	C				Yes

Schedule R (Form 990) 2014

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

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 . . . . . . . . . . . . . . . . . . . . . . .

Yes

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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
(1) Hartford Hospital	M	632,998	FMV
(2) Hartford Hospital	O	234,497	FMV
(3) Hartford Hospital	P	107,092	FMV
(4) Hartford Hospital	R	165,665	FMV
(5) Natchaug Hospital	O	121,604	FMV
(6) Natchaug Hospital	P	153,450	FMV
(7) HHC PhysiciansCare Inc	A	572,840	FMV
(8) HHC PhysiciansCare Inc	P	320,719	FMV
(9) HHC PhysiciansCare Inc	Q	53,751	FMV
(10) Hartford HealthCare Rehabilitation Network	P	58,998	FMV

Schedule R (Form 990) 2014

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)	(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2014

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) 2014

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: The mission of Windham Community Memorial Hospital is to offer comprehensive services in an environment where innovation and teaching are integral to care; where we are proud to serve patients and one another; where meeting the challenge of complex medical needs is viewed as a defining competency; and where quality and safety of care are a constant.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	13
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	11
5	Total number of individuals employed in calendar year 2014 (Part V, line 2a) ......	5	749
6	Total number of volunteers (estimate if necessary) .............	6	261
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	1,369,726
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	-120,390

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	958,656	374,390
9	Program service revenue (Part VIII, line 2g) .........	79,429,746	80,551,098
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	213,524	223,604
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,174,045	998,214
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	82,775,971	82,147,306
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	47,790,897	47,208,236
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 104,871
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	38,583,559	38,854,852
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	86,374,456	86,063,088
19	Revenue less expenses. Subtract line 18 from line 12.......	-3,598,485	-3,915,782
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	69,648,474	64,096,997
21	Total liabilities (Part X, line 26).............	104,919,747	115,502,270
22	Net assets or fund balances. Subtract line 21 from line 20.....	-35,271,273	-51,405,273

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 15,742,458 including grants of $ ) (Revenue $ 14,156,439 )
	Emergency Services:The Emergency Team consists of nurses, physicians' assistants, advanced practice registered nurses (APRN), physicians, patient care technicians, and paramedics who are trained to handle any type of emergency that might arise. The Windham Hospital Emergency Department provides treatment for approximately 34,000 patients annually.Wait times in the ED are posted on the hospital's website, and are available by downloading a free iPhone app (from the Apple store). The physicians in the Emergency Department strive to see each patient within 30 minutes of their arrival at the hospital.At Windham Hospital, the Emergency Department physicians are from Northeast Emergency Medicine Specialists, a private practice group. They are dedicated to providing prompt access to healthcare, understanding the concerns of their patients, ensuring safety, and using a respectful and friendly approach.The Emergency Department is located on the first floor. Signs are conveniently posted outside the hospital for visitors. In 2006, a major expansion of the Emergency Department was funded by contributions from the community, and named for its major benefactor, Jeffrey P. Ossen. The department doubled in size, and includes 20 treatment rooms, 2 critical care suites, isolation and decontamination rooms, and state of the art equipment and systems throughout the department.A new computer-based Emergency Department Informatics System (EDIS) provides staff with a centralized data system that makes accurate tracking and treatment information available to all caregivers on the Hospital's secure network. The Picture Archival and Communications System (PACS) allows images obtained at the Hospital to be read onsite by physicians from Jefferson Radiology, or sent to their specialists through special high-speed computer connections. The new, efficient space allows optimal privacy, security, and comfort for our patients. Many of the rooms feature personal TVs. In-room, bedside registration improves confidentiality and reduces the amount of time patients wait before their treatment.Windham Community Memorial Hospital is proud to offer the Emergency Department services as a community resource 24 hours a day, 365 days a year. We are grateful to the many individuals and organizations that played vital roles in design, fundraising and operational implementation of this facility.Patients arriving at the Emergency Department can expect the following process:1. A trained nurse with experience in emergency medicine will give the patient a rapid assessment of the patient's condition, called "triage, and will determine the patient's acuity.2. The patient will be placed in a treatment room according to availability.3. Patients are then treated by appropriate staff members.4. While the patient is in the treatment room, registration personnel will complete the registration process. Registration ensures that the hospital has the patient's correct contact information as well as information required of all patients.All Emergency Department patients (whether insured or not) will be given the opportunity to pay either their insurance co-pay or a deposit on charges at the time of the discharge. Insurance or payment (or lack of) will not affect the quality of care. Patients receive top-quality care, regardless of ability to pay.At Windham Community Memorial Hospital's Emergency Department, there is an assortment of physicians with differing specialties. This ensures that patients will have the best care during their visit to the Center.

4b	(Code: ) (Expenses $ 8,433,683 including grants of $ ) (Revenue $ 11,218,520 )
	Surgical Operations:Scope of Service - The Operating Room (OR)is a five-room suite on the second floor of the Windham Hospital, with operational hours Monday - Friday and a call system in place to provide care for after-hours surgical procedures. The average utilization is 75%. Service is provided to patients of all ages from infants to geriatrics. * Care is provided for patients undergoing: 1. One Day Surgical Procedures 2. Same Day Admission Procedures 3. Inpatients * Procedures include the following specialties: 1. Orthopedic 2. General Gastrointestinal 3. Ear, Nose & Throat (ENT)4. Gynecology (GYN)5. Genitourinary (GU) 6. Laser Laparoscopic Procedures 7. Peripheral Vascular 8. Pediatric 9. Ophthalmic Staffing Plan - A modified primary nursing care model is used as the method to deliver care on this unit. There is a Surgical Services Manager assigned five days a week. There is a Clinical Coordinator who facilitates the day-to-day operative schedule. A Registered Nurse (RN) is assigned to all patients undergoing invasive procedures. The RNs, and Surgical Technologists are required to take call for emergent and urgent procedures. The OR Associates and OR Technicians are required to take call for housekeeping duties related to weekend and holiday emergent and urgent procedures. Direct hours exclude the Manager.* The unit is comprised of the following individuals who work 8 or 10-hour shifts: 1. RNs 2. Surgical Technologists 3. OR Technicians 4. OR Associates 5. Surgical Schedulers

4c	(Code: ) (Expenses $ 4,315,821 including grants of $ ) (Revenue $ 4,296,252 )
	Pulmonary Rehabilitation:Shortness of breath associated with lung disease can certainly compromise your lifestyle, but there are always ways to better manage your breathing problems. Windham Hospital's Outpatient Pulmonary Rehabilitation Program can help those coping with lung disease breathe easier and more efficiently.The Outpatient Pulmonary Rehabilitation Program is individually tailored to meet each patient's needs and includes classes, which take place on Tuesdays and Thursdays at Windham Hospital, and are held for eight consecutive weeks. The program emphasizes physical conditioning and education about breathing and energy conservation. It also highlights education about their specific lung disease and respiratory medications associated with them. Aerobic and strengthening exercises have been shown to be beneficial in reducing the effects of lung disease on daily activities and reducing physician office visits and hospitalization. Those interested in joining the program need a referral from their physician.Some preadmission testing is necessary, including:* Pulmonary function test * Exercise oximetry * Arterial blood gas samplingAfter a physician's referral is obtained, and preadmission testing is completed, an interview will be scheduled with both the respiratory therapist and physical therapist.Payment for the Outpatient Pulmonary Rehabilitation at Windham Hospital is usually covered by Medicare, Anthem Blue Cross, PHS and other insurance providers.For those who are uninsured or underinsured, we now have additional resources from the Senior Resources Area Agency on Aging to help seniors continue their Pulmonary Maintenance Program even after insurance benefits expire.

	(Code: ) (Expenses $ 51,307,102 including grants of $ ) (Revenue $ 51,081,516 )
	Windham Hospital Operations serve health care needs with numerous inpatient and outpatient services to the communities of Andover, Ashford, Brooklyn Canterbury, Chaplin, Colchester, Columbia, Coventry, Eastford, Franklin, Hampton, Hebron, Lebanon, Mansfield, Scotland, Sprague, Willington and Windham Connecticut. The hospital also offers programs designed to address specific needs within those communities. These programs include student health services, diabetes and nutritional education, pre-natal services, senior wellness services and paramedic intercept program. Windham hospital operates its mobile Healthlink van throughtout its service area, providing regular health screenings for blood sugar and cholesterol, as well as other screenings.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 51,307,102 including grants of $ ) (Revenue $ 51,081,516 )
4e	Total program service expenses79,799,064

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	1,218,046	3,276,546	497,190

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
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		374,390

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			374,390
			Business Code
2a	Inpatient & Outpatient Services		621400	79,181,372	79,181,372
b	Lab Ref. Testing & Fees		621500	1,369,726		1,369,726
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			80,551,098
3	Investment income (including dividends, interest, and other similar amounts).......			102,477			102,477
4	Income from investment of tax-exempt bond proceeds..
5	Royalties...........
		(i) Real	(ii) Personal
6a	Gross rents	1,125,112
b	Less: rental expenses	482,970
c	Rental income or (loss)	642,142
d	Net rental income or (loss).......			642,142			642,142
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	124,956
b	Less: cost or other basis and sales expenses	0	3,829
c	Gain or (loss)	124,956	-3,829
d	Net gain or (loss)..........			121,127			121,127
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
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...
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Miscellaneous Revenue			Business Code
11a	Cafeteria Income		722210	154,383			154,383
b	Classes/Tuition		900099	151,328	151,328
c	Other Operating Income		900099	50,361	50,361
d	All other revenue ....
e	Total. Add lines 11a–11d ......			356,072
12	Total revenue. See Instructions......			82,147,306	79,383,061	1,369,726	1,020,129


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			6,502,319	1	4,122,237
2	Savings and temporary cash investments .........				2	560,688
3	Pledges and grants receivable, net ...........			175,678	3	24,847
4	Accounts receivable, net .............			9,207,001	4	9,938,365
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 ..............			1,188,268	8	990,707
9	Prepaid expenses and deferred charges ..........			362,421	9	962,074
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	121,969,212
b	Less: accumulated depreciation .....	10b	82,446,253	42,365,465	10c	39,522,959
11	Investments—publicly traded securities ..........			2,459,958	11	2,291,564
12	Investments—other securities. See Part IV, line 11 .....			381,789	12	318,056
13	Investments—program-related. See Part IV, line 11 .....			38,115	13	38,115
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			6,967,460	15	5,327,385
16	Total assets. Add lines 1 through 15 (must equal line 34)......			69,648,474	16	64,096,997
17	Accounts payable and accrued expenses .........			3,278,354	17	6,294,158
18	Grants payable .................				18
19	Deferred revenue ................			11,362,327	19	7,723,496
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
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....................			90,279,066	25	101,484,616
26	Total liabilities. Add lines 17 through 25.........			104,919,747	26	115,502,270
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			-40,278,384	27	-56,418,362
28	Temporarily restricted net assets ...........			1,362,936	28	1,368,915
29	Permanently restricted net assets ...........			3,644,175	29	3,644,174
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........			-35,271,273	33	-51,405,273
34	Total liabilities and net assets/fund balances ........			69,648,474	34	64,096,997