Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
A For the 2014 calendar year, or tax year beginning 10-01-2014 , and ending 09-30-2015
BCheck if applicable:
CName of organization
Danbury Hospital
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
24 Hospital Avenue
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Danbury, CT068106099
D Employer identification number

06-0646597
E Telephone number

G Gross receipts $ 695,533,868
F Name and address of principal officer:
Daniel DeBarba Jr
24 Hospital Avenue
Danbury,CT06810
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.danburyhospital.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1885
M State of legal domicile: CT
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: To enhance through medical care,education and research the health and well being of individuals in Danbury, CT and surrounding communities in partnership with those we serve.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 9
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 8
5 Total number of individuals employed in calendar year 2014 (Part V, line 2a) ...... 5 3,666
6 Total number of volunteers (estimate if necessary) ............. 6 378
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 5,663,696
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b -371,649
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 23,605,157 14,913,270
9 Program service revenue (Part VIII, line 2g) ......... 507,620,940 598,482,181
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 4,087,630 4,838,153
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 3,515,639 1,601,785
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 538,829,366 619,835,389
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 239,374,097 280,914,729
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 261,253,127 343,750,186
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 500,627,224 624,664,915
19 Revenue less expenses. Subtract line 18 from line 12....... 38,202,142 -4,829,526
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 838,062,311 836,823,101
21 Total liabilities (Part X, line 26)............. 348,768,773 360,086,728
22 Net assets or fund balances. Subtract line 21 from line 20..... 489,293,538 476,736,373
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2014)
Form 990 (2014)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: To improve the health of every person we serve through the efficient delivery of excellent, innovative and compassionate care.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 196,329,911 including grants of $   ) (Revenue $ 158,301,807 )
SEE SCHEDULE O
4b (Code:   ) (Expenses $ 154,180,970 including grants of $   ) (Revenue $ 171,576,114 )
SEE SCHEDULE O
4c (Code:   ) (Expenses $ 82,328,536 including grants of $   ) (Revenue $ 77,426,210 )
SEE SCHEDULE O
4d Other program services (Describe in Schedule O.)
(Expenses $ 98,288,751 including grants of $   ) (Revenue $ 191,491,715 )
4e Total program service expensesMediumBullet531,128,168
Form 990 (2014)
Form 990 (2014)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part III
Click to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment
...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
Yes
 
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IVClick to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV... Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see list of attachments
20b
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..
21
 
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I.... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................ Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV
..................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
639
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
3,666
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletCJ
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?
.........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2014)
Form 990 (2014)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
9
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
8
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
 
No
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
 
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
 
 
13
Did the organization have a written whistleblower policy? ...............
13
 
No
14
Did the organization have a written document retention and destruction policy? .........
14
 
No
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletMARY JO PAWLAK
24 HOSPITAL AVENUE
Danbury,CT068106099 (203) 739-7000
Form 990 (2014)
Form 990 (2014)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) John M MurphyMD........................................................................
Pres/CEO, WCHN
40.0
.......................9.0
X   X       1,402,828 0 51,844
(2) Neil Culligan MD........................................................................
Director
1.0
.......................1.0
X           0 0 0
(3) David Kramer MD........................................................................
Director (To 1/1)
1.0
.......................1.0
X           0 0 0
(4) D Cyganowski........................................................................
Director
1.0
.......................1.0
X           0 0 0
(5) Richard G Jabara........................................................................
Director
1.0
.......................4.0
X           0 0 0
(6) Anthea Disney........................................................................
Director
1.0
.......................1.0
X           0 0 0
(7) Joseph D Skrzypczak........................................................................
Secretary
1.0
.......................3.0
X   X       0 0 0
(8) Spencer Houldin........................................................................
Director
1.0
.......................3.0
X           0 0 0
(9) Brian C White........................................................................
Director
1.0
.......................3.0
X           0 0 0
(10) James Kennedy........................................................................
Chairman
3.0
.......................5.0
X   X       0 0 0
(11) Steven H Rosenberg........................................................................
SVP/CFO, WCHN
40.0
.......................17.0
    X       779,114 0 42,729
(12) Daniel DeBarba Jr........................................................................
Exec VP/Pres-DH
35.0
.......................12.0
    X       966,102 93,142 57,347
(13) Donna Kaplanis........................................................................
Ass't Secretary
40.0
.......................8.0
    X       252,835 0 51,331
(14) Matthew A Miller MD........................................................................
SVP & Chief Medical Officer
40.0
.......................4.0
      X     308,356 361,965 45,992
(15) Moreen O Donahue........................................................................
Sr VP/Chief Nurse Officer,WCHN
40.0
.......................1.0
      X     446,933 0 50,720
(16) Michael Daglio........................................................................
Chief Oper Officer (To 11/2)
5.0
.......................43.0
      X     550,572 0 44,866
(17) Morris Gross........................................................................
VP of Facilities/Real Estate
40.0
.......................2.0
      X     360,940 6,180 51,603
Form 990 (2014)
Form 990 (2014)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Kathleen A Dematteo........................................................................
Chief Infor.Officer, WCHN
40.0
.......................0.0
      X     475,193 0 32,274
(19) Patrick C Minicus........................................................................
VP of Finance
20.0
.......................22.0
      X     476,177 73,323 50,314
(20) James Varrone........................................................................
VP Supply Chain
36.0
.......................4.0
      X     0 185,641 30,014
(21) Lisa Schmittgall........................................................................
SRVP Strategy-WCHN (To 12/31)
40.0
.......................1.0
        X   724,800 38,261 31,469
(22) Debra Carragher........................................................................
VP of Operations
40.0
.......................0.0
        X   325,179 0 16,137
(23) Carolyn McKenna........................................................................
Sr VP/Gen'l Coun
40.0
.......................0.0
        X   471,111 0 37,202
(24) Ramin Ahmadi MD........................................................................
Dir. of Educ./Res.
40.0
.......................0.0
        X   330,757 0 42,127
(25) Dawn Myles........................................................................
SRV,Qual/Pat. Sfty
40.0
.......................0.0
        X   334,356 0 22,081
(26) Ruth Gregory........................................................................
Director of Materials Dist
40.0
.......................0.0
          X 162,028 0 26,328
(27) Joseph Campbell........................................................................
Chief Audit Compl. Officer
40.0
.......................0.0
          X 291,737 0 50,466
(28) Phyllis F Zappala........................................................................
Sr. VP of Human Resource
40.0
.......................0.0
          X 269,485 0 35,718




1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 8,928,503 758,512 770,562
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet594
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
TOWERS WATSON PENNSYLVANIA,
PO BOX 8500
PHILADELPHIA,PA191787482
CONSULTANTS 1,359,311
ROBINSON COLE LLP,
280 TRUMBULL STREET
HARTFORD,CT06103
ATTORNEYS 1,548,372
DANBURY RADIOLOGICAL ASSOCIATES,
PO BOX 417407
BOSTON,MA02241
RADIOLOGY SERVICES 927,782
E4 SERVICES LLC,
60 NORTH CAROLINA AVE
SINKING SPRING,PA19608
ITG CONSULTANTS 1,029,292
PRICE WATERHOUSE COOPERS LLC,
PO BOX 7247
PHILADELPHIA,PA19170
CONSULTANTS 1,899,925
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet52
Form 990 (2014)
Form 990 (2014)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 11,877,473
e Government grants (contributions)1e 2,730,032
f All other contributions, gifts, grants, and
similar amounts not included above
1f
305,765
g Noncash contributions included in lines
1a-1f:$
 
h Total. Add lines 1a-1f.......MediumBullet 14,913,270
 Program Service RevenueAmt Business Code
2a ANCILLARY SERVICE 621400 297,090,886 297,090,886    
b MEDICARE/MEDICAID PAY'TS 621990 253,818,157 253,818,157    
c ROUTINE PATIENT 621990 37,037,912 37,037,912    
d CONTRACT LAB 621500 4,928,198   4,928,198  
e RENTAL INC.-AFFL. EXEMPT 532000 2,512,565 2,512,565    
f All other program service revenue . 3,094,463 3,094,463    
g Total. Add lines 2a–2f........MediumBullet 598,482,181
 OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 3,637,036     3,637,036
4 Income from investment of tax-exempt bond proceeds..MediumBullet 73,109     73,109
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 910,968  
b Less: rental expenses 178,610  
c Rental income or (loss) 732,358 0
d Net rental income or (loss).......MediumBullet 732,358 11,229 721,129  
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 76,030,605 150,500
b Less: cost or other basis and sales expenses 74,992,138 60,959
c Gain or (loss) 1,038,467 89,541
d Net gain or (loss)..........MediumBullet 1,128,008     1,128,008
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a 465,750
b Less: cost of goods sold ..b 466,772
c Net income or (loss) from sales of inventory..MediumBullet -1,022     -1,022
Miscellaneous Revenue Business Code
11a NUTRITION AND DIETARY 561000 372,148     372,148
b OTHER PATIENT SERVICES 900099 302,436 302,436    
c ADMINISTRATIVE SERVICES 561000 181,496     181,496
d All other revenue .... 14,369   14,369  
e Total. Add lines 11a–11d ...... MediumBullet 870,449
12 Total revenue. See Instructions......MediumBullet 619,835,389 593,867,648 5,663,696 5,390,775
Form 990 (2014)
Form 990 (2014)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 0  
2 Grants and other assistance to domestic individuals. See Part IV, line 22 .... 0  
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............ 0  
4 Benefits paid to or for members .... 0  
5 Compensation of current officers, directors, trustees, and key employees .... 6,573,840 1,740,254 4,833,586  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages .... 218,210,682 179,674,676 38,536,006  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 9,306,626 7,663,076 1,643,550  
9 Other employee benefits ....... 29,978,262 24,684,101 5,294,161  
10 Payroll taxes ........... 16,845,319 13,870,436 2,974,883  
11 Fees for services (non-employees):        
a Management ...... 195,167   195,167  
b Legal ......... 2,643,881   2,643,881  
c Accounting ........... 501,452   501,452  
d Lobbying ........... 172,312 141,882 30,430  
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 269,287   269,287  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) .... 104,940,344 86,407,879 18,532,465  
12 Advertising and promotion .... 1,262,780 1,039,773 223,007  
13 Office expenses ....... 7,793,028 6,416,779 1,376,249  
14 Information technology ...... 17,279,133 14,227,638 3,051,495  
15 Royalties .. 0      
16 Occupancy ........... 14,072,076 11,586,947 2,485,129  
17 Travel ............ 637,526 524,939 112,587  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 291,082 239,677 51,405  
20 Interest ........... 7,515,245 7,515,245    
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 45,346,522 37,338,326 8,008,196  
23 Insurance .............. 10,671,352 10,110,640 560,712  
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 MEDICAL SUPPLIES 91,868,331 91,868,331    
b STATE OF CT HOSPITAL TAX 24,402,044 24,402,044    
c EQUIPMENT RENT AND MAINT. 9,683,926 7,973,745 1,710,181  
d PROFESSIONAL MEMBERSHIP 2,847,778 2,344,860 502,918  
e All other expenses 1,356,920 1,356,920    
25 Total functional expenses. Add lines 1 through 24e 624,664,915 531,128,168 93,536,747 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2014)
Form 990 (2014)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 39,492 1 87,296
2 Savings and temporary cash investments ......... 46,694,493 2 21,119,887
3 Pledges and grants receivable, net ........... 0 3 0
4 Accounts receivable, net ............. 63,595,267 4 76,938,200
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 5 0
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
0 6 0
7 Notes and loans receivable, net ............. 2,476,284 7 0
8 Inventories for sale or use .............. 10,027,585 8 10,950,142
9 Prepaid expenses and deferred charges .......... 3,728,278 9 4,185,867
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 846,418,674
b Less: accumulated depreciation ..... 10b 452,257,825 351,669,715 10c 394,160,849
11 Investments—publicly traded securities .......... 204,327,199 11 64,573,120
12 Investments—other securities. See Part IV, line 11 ..... 0 12 102,260,022
13 Investments—program-related. See Part IV, line 11 ..... 0 13 0
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 155,503,998 15 162,547,718
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 838,062,311 16 836,823,101
Liabilities 17 Accounts payable and accrued expenses ......... 67,327,475 17 75,819,734
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 3,183,583 19 2,565,628
20 Tax-exempt bond liabilities ............. 246,700,000 20 244,850,000
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
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.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
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.................... 31,557,715 25 36,851,366
26 Total liabilities. Add lines 17 through 25......... 348,768,773 26 360,086,728
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 412,096,873 27 406,109,696
28 Temporarily restricted net assets ........... 47,726,160 28 36,051,363
29 Permanently restricted net assets ........... 29,470,505 29 34,575,314
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 489,293,538 33 476,736,373
34 Total liabilities and net assets/fund balances ........ 838,062,311 34 836,823,101
Form 990 (2014)
Form 990 (2014)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
619,835,389
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
624,664,915
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-4,829,526
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
489,293,538
5
Net unrealized gains (losses) on investments ...............
5
-6,685,508
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-1,042,131
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
476,736,373
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? .................
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 13
Form 990, Special Condition Description:
Special Condition Description
Form 990 (2014)
Form 990 (2014)
Page 14
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow 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
Danbury Hospital
 
Employer identification number

06-0646597
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
a
b
c
d
e
f
Enter the number of supported organizations .............................  
g
Provide the following information about the supported organization(s).
(i)Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total    

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2014
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) right arrow (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) right arrow (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.  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2014
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) right arrow (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) right arrow (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2014
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
No
1
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.
1
 
 
2
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).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
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.
3b
 
 
c
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.
3c
 
 
4a
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.
4a
 
 
b
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....
4b
 
 
c
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.
4c
 
 
5a
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).
5a
 
 
b
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?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
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.
6
 
 
7
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) .
7
 
 
8
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).
8
 
 
9a
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.
9a
 
 
b
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.
9b
 
 
c
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.
9c
 
 
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
 
 
b
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
 
 
11
Has the organization accepted a gift or contribution from any of the following persons?
a
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
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
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
Schedule A (Form 990 or 990-EZ) 2014
Page 5
Part IV
Supporting Organizations (continued)

Section B. Type I Supporting Organizations
Yes
No
1
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.
1
 
 
2
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.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
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).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
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?
1
 
 
2
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).
2
 
 
3
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.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
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.
2a
 
 
b
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.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
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.
3a
 
 
b
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.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2014
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
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:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Name of the organization
Danbury Hospital
 
Employer identification number

06-0646597
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 2
Name of organization
Danbury Hospital
 
Employer identification number

06-0646597
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
 
 

   
 
 
  ,    

$RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 3
Name of organization
Danbury Hospital
 
Employer identification number

06-0646597
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 4
Name of organization
Danbury Hospital
 
Employer identification number

06-0646597
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Additional Data


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

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

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet 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
Danbury Hospital
 
Employer identification number

06-0646597
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

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

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

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










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2014

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 Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the 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


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)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
Yes
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
Yes
 
42
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
Yes
 
76,895
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
94,902
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
473
j
Total. Add lines 1c through 1i ...............................
172,312
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Schedule C, Part II-B - Description of Lobbying Activity Dues were paid to CHA in the amount of $390,877, of which 15.43% of this amount or $60,312 were expended on lobbying. AHA dues of $72,733 had 22.80% or $16,583 expended on lobbying activities. Both amounts are reflected on 1f. Only state and local officials were lobbied during 2015. As part of this miscellaneous office expense such as phone, computer supplies, refreshment etc. were incurred and were reflected on line #1i accordingly. Direct contact with legislators and state leaders were lobbied in support of maintaining patient access to essential services for both the uninsured and under insured.
Schedule C (Form 990 or 990EZ) 2014

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
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
Danbury Hospital
 
Employer identification number

06-0646597
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 ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenue included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII .......
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ........          
c Net investment earnings, gains, and losses          
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........
         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   4,992,068 4,992,068
b Buildings ................   508,885,933 234,589,427 274,296,506
c Leasehold improvements ............   9,549,698 3,938,712 5,610,986
d Equipment ................   306,225,446 213,729,686 92,495,760
e Other .................   16,765,529   16,765,529
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 394,160,849
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
(3)Other
(A) COMMON COLLECTIVE FUNDS
77,271,753 F

(B) HARD TO VALUE FUNDS
24,988,269 F







Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 102,260,022
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) 457B ASSET 898,100
(2) BOND ESCROW FUND 1,868,178
(3) BOND ISSUANCE COST 3,192,086
(4) BULK ACCOUNTS NET OF RESERVE 684,627
(5) CSV ON OFFICER'S LIFE POLICY 1,806,700
(6) DUE FROM RELATED PARTIES 6,402,385
(7) INTEREST IN WCHN FOUNDATION 92,379,063
(8) INVESTMENT IN WCHIC, LTD. 53,694,168
(9) MORRISON DEPOSIT 96,418
(10) OTHER RECEIVABLES 1,525,993
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 162,547,718
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 0
457B LIABILITY 898,100
ASSET RETIREMENT OBLIGATION 411,783
DUE TO 3RD PARTIES 18,231,699
MALPRACTICE TRUST FUND RESERVE 10,246,000
RESERVE FOR WORKERS COMPENSATION 7,063,784




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 36,851,366
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

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
Schedule D (Form 990) 2014

Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990.Right pointing arrow large image Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
Danbury Hospital
 
Employer identification number

06-0646597
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants
and other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria
used to award the grants or assistance? ...........................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region
(f) Total expenditures
for and investments
in region
Central America and the Caribbean 1 1 Program Services Malpractice Ins.  
Central America and the Caribbean 1 1 Investments Malpractice Ins. 53,694,168
Central America and the Caribbean 1 1 Program Services Malpractice Ins. 10,080,158
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total ..... 3 3 63,774,326
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b) 3 3 63,774,326
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2014
Schedule F (Form 990) 2014
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)
(a)(c) Region (b)(d) Purpose of
grant
(e) Amount of
cash grant
(f) Manner of
cash
disbursement
(g) Amount
of non-cash
assistance
(h) Description
of non-cash
assistance
(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter ....MediumBullet
 
3
Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2014
Schedule F (Form 990) 2014Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant
(e) Manner of cash
disbursement
(f) Amount of
non-cash
assistance
(g) Description
of non-cash
assistance
(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2014
Schedule F (Form 990) 2014
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; do not file with Form 990)............................
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)...............................................
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713; do not file with Form 990).....................................
Schedule F (Form 990) 2014
Schedule F (Form 990) 2014
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
ReturnReference Explanation
Schedule F, Part I, Line 3f - Method of Accounting All information for Part I, Line 3, column (f) is accounted for on the audited financial statements on the accrual basis.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2014
Additional Data


Software ID:  
Software Version:  



SCHEDULE H (Form 990)
Department of the TreasuryInternal Revenue Service
Hospitals
MediumBullet 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
Danbury Hospital
 
Employer identification number

06-0646597
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the 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.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) ..
    12,551,226 1,547,976 11,003,250 1.760 %
b Medicaid (from Worksheet 3,
column a) ....
  82,775 98,753,200 46,712,575 52,040,625 8.330 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) .
           
d Total Financial Assistance
and Means-Tested
Government Programs .
  82,775 111,304,426 48,260,551 63,043,875 10.090 %
Other Benefits
310 239,099 297,710 80,578 217,132 0.030 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) ..
40 239 21,006,755 7,249,420 13,757,335 2.200 %
g Subsidized health services
(from Worksheet 6) ..
21 9,645 2,854,080 1,813,934 1,040,146 0.170 %
h Research (from Worksheet 7) 1 126 2,329,841 583,095 1,746,746 0.280 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8)
           
j Total. Other Benefits .. 372 249,109 26,488,386 9,727,027 16,761,359 2.680 %
k Total. Add lines 7d and 7j . 372 331,884 137,792,812 57,987,578 79,805,234 12.770 %
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) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development 2   355   355  
3 Community support 1   152   152  
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building 47   9,169   9,169  
7 Community health improvement advocacy 3   4,697   4,697  
8 Workforce development            
9 Other            
10 Total 53   14,373   14,373  
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
7,709,381
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
1,431,402
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
209,181,129
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
264,752,197
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-55,571,068
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2014
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?2
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)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 Danbury Hospital
24 Hospital Avenue
Danbury,CT06810
www.danburyhospital.org
0039
X X   X   X X      
2 New Milford Hospital Campus
21 Elm Street
New Milford,CT06776
www.newmilfordhospital.org
0039
X X         X      
Schedule H (Form 990) 2014
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)
Danbury 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):
1
Yes No
Community Health Needs Assessment
1 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?....................... 1   No
2 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.......... 2   No
3 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.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b 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. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. .............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE PART V, SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 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   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c 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
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Danbury Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Danbury Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
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)
New Milford Hospital Campus
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):
2
Yes No
Community Health Needs Assessment
1 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?....................... 1   No
2 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.......... 2 Yes  
3 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.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b 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. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. .............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE PART V, SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 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   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c 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
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

New Milford Hospital Campus
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

New Milford Hospital Campus
Name of hospital facility or letter of facility reporting group  
Yes No
19 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
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
Part V, Line 5 - Account input from persons who represent the community Facility: Danbury Hospital Danbury Hospital in conducting its most recent CHNA in 2012 (completed and approved in 2013), developed effective strategies to improve community health involve active collaboration and commitment among health providers, public and community health agencies, educators, work sites, community and faith-based organizations and groups, and the public they serve. The hospital collaborates with community partners for assessment of community health needs and action planning. Danbury Hospital, and its New Milford Hospital Campus, participated in the development of a Community Report Card for the Housatonic Valley Region, a 10-district municipality that includes Danbury and New Milford, CT. The other eight towns are Bridgewater, Bethel, Brookfield, New Fairfield, Newtown, Redding, Ridgefield and Sherman, CT, all towns within the primary service area of both hospitals. Developing a plan for health improvement in our region involves collective action by and sharing of expertise and resources across agencies and organizations in both the public and private sectors.
Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted needs Assessment Facility: Danbury Hospital Danbury Hospital, and its New Milford Hospital Campus, participated in the development of a Community Report Card for the Housatonic Valley Region, a 10-district municipality that includes Danbury and New Milford, CT.
Part V, Line 6b - CHNA Conducted by Orgnizations Other Than Hospital Facility: Danbury Hospital As noted in Part VI, Line #2, Needs Assessment narrative, the CHNA was conducted with various community organizations participating in the Community Forum at Danbury Hospital and its New Milford Hospital Campus.
Part V, Line 2 - Acquistion Of Facility Placed In Service Facility: New Milford Hospital Campus On October 1, 2014 (the merger date), Danbury Hospital (the Hospital) received a single provider license to include The New Milford Hospital Incorporated (New Milford Hospital). As a result, New Milford Hospital merged with the Hospital and the operations of New Milford Hospital became a campus of Danbury Hospital effective October 1, 2014. The Hospital will operate as one licensed facility with two campuses.
Part V, Line 5 - Account Input from Person Who Represent the Community Facility: New Milford Hospital Campus New Milford Hospital Campus in conducting its most recent CHNA in 2012 (completed and approved in 2013), developed effective strategies to improve community health involve active collaboration and commitment among health providers, public and community health agencies, educators, work sites, community and faith-based organizations and groups, and the public they serve. The hospital collaborates with community partners for assessment of community health needs and action planning. New Milford Hospital and Danbury Hospital Campuses participated in the development of a Community Report Card for the Housatonic Valley Region, a 10-district municipality that includes Danbury and New Milford, CT. The other eight towns are Bridgewater, Bethel, Brookfield, New Fairfield, Newtown, Redding, Ridgefield and Sherman, CT, all towns within the primary service area of both hospitals. Developing a plan for health improvement in our region involves collective action by and sharing of expertise and resources across agencies and organizations in both the public and private sectors.
Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted needs assessment Facility: New Milford Hospital Campus New Milford Hospital and Danbury Hospital Campuses participated in the development of a Community Report Card for the Housatonic Valley Region, a 10-district municipality that includes Danbury and New Milford, CT. that includes Danbury and New Milford, CT.
Part V, Line 6b - CHNA Conducted by Orgnizations Other Than Hospital Facility: New Milford Hospital Campus As noted in Part VI, Line #2, Needs Assessment narrative, the CHNA was conducted with various community organizations participating in the Community Forum at Danbury Hospital and its New Milford Hospital Campus. Hospital and its New Milford Hospital Campus. Part V, Line 7A - URL Facility: DANBURY HOSPITAL http://www.danburyhospital.org/about-us/about-danbury-hospital/community-b enefit Part V, Line 7A - URL Facility: NEW MILFORD HOSPITAL http://www.newmilfordhospital.org/about-us/about-us/community-benefit Part V, Line 7B - URL Facility: DANBURY HOSPITAL http://www.chime.org/advocacy/community-health/ Part V, Line 7B - URL Facility: NEW MILFORD HOSPITAL http://www.chime.org/advocacy/community-health/ Part V, Line 10A - URL Facility: DANBURY HOSPITAL http://www.danburyhospital.org/about-us/about-danbury-hospital/community-b enefit Part V, Line 10A - URL Facility: NEW MILFORD HOSPITAL http://www.newmilfordhospital.org/about-us/about-us/community-benefit Part V, Line 16A - URL Facility: DANBURY HOSPITAL http://www.danburyhospital.org/patient-and-visitors-info/billing Part V, Line 16A - URL Facility: NEW MILFORD HOSPITAL http://www.newmilfordhospital.org/patient-and-visitors-info/billing Part V, Line 16B - URL Facility: DANBURY HOSPITAL http://www.danburyhospital.org/patient-and-visitors-info/billing Part V, Line 16B - URL Facility: NEW MILFORD HOSPITAL http://www.newmilfordhospital.org/patient-and-visitors-info/billing Part V, Line 16C - URL Facility: DANBURY HOSPITAL http://www.danburyhospital.org/patient-and-visitors-info/billing Part V, Line 16C - URL Facility: NEW MILFORD HOSPITAL http://www.newmilfordhospital.org/patient-and-visitors-info/billing
Part V, Line 16i - Other Means Hospital Facility Publicized the Policy Facility: Danbury Hospital Danbury Hospital has messages on all statements providing information regarding how the patient can get assistance with their hospital bill. Counselors are also available to provide further assistance. available to provide further assistance.
Part V, Line 16i - Other Means Hospital Facility Publicized the Policy Facility: New Milford Hospital Campus New Milford Hospital Campus has messages on all statements providing information regarding how the patient can get assistance with their hospital bill. Counselors are also available to provide further assistance.
Part V, Line 22d - Other Billing Determination of Individuals Without Insurance Facility: Danbury Hospital Danbury Hospital intends to be in compliance with the regulations regarding the maximum amounts that can be charged to FAP-eligible individuals for emergency and other medical necessary care by the effective date (10/1/2016). Part V, Line 22d - Other Billing Determination of Individuals Without Insurance Facility: New Milford Hospital Campus New Milford Hospital intends to be in compliance with the regulations regarding the maximum amounts that can be charged to FAP-eligible individuals for emergency and other medical necessary care by the effective date (10/1/2016).
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2014
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?23
Name and address Type of Facility (describe)
1 Danbury Hospital Ridgefield Surg Ctr
901 Ethan Allen Highway
Ridgefield,CT06877
Outpatient Surgical Center
2 Breast Imaging Center
20 Germantown Road
Danbury,CT06810
Diagnostic
3 Main Street Rehabilitation Center
235 Main Street
Danbury,CT06810
Rehabilitation
4 Siefert & Ford Community Health Ctr
70 Main Street
Danbury,CT06810
Outpatient-Physician Clinic
5 Danbury Hospital Sleep Lab II
25 Lake Avenue-Extension
Danbury,CT06810
Diagnostic
6 Comm Ctr for Behaviorial Health
152 West Street
Danbury,CT06810
Outpatient-Physician Clinic
7 Southbury Cardiovascular Diagnostics
22 Old Waterbury Road
Southbury,CT06488
Diagnostic
8 Pulmonary Services
33 Germantown Road
Danbury,CT06810
Diagnostic
9 The Anticoagulation Center
41 Germantown Road
Danbury,CT06810
Diagnostic
10 Physical Medicine Center of Southbury
22 Old Waterbury Road Suite 101
Southbury,CT06488
Outpatient-Physician Clinic
11 New Milford Hospital Behavorial Healt
23 Poplar Street
New Milford,CT06776
Outpatient-Physician Clinic
12 Danbury Hospital Laboratory
79 Sandpit Road
Danbury,CT06810
Diagnostic
13 Center for Child & Adol Treat
152 West Street
Danbury,CT06810
Outpatient-Physician Clinic
14 Danbury Hospital Laboratory Center NM
120 Park Lane Suite A201
New Milford,CT06776
Diagnostic
15 Danbury Hospital Southbury Laboratory
22 Old Waterbury Road Suite 101
Southbury,CT06488
Diagnostic
16 Danbury Hospital Lab Ctr in Brookfield
60 Old New Milford Road Unit 1C
Brookfield,CT06804
Diagnostic
17 Danbury Hospital Diabetes Education Ct
41 Germantown Road
Danbury,CT06810
Education Center
18 Ridgefield Specimen Collection Facili
10 South Street
Ridgefield,CT06877
Diagnostic
19 Bethel Laboratory
68 Stony Hill Road
Bethel,CT06801
Diagnostic
20 Newtown Laboratory
14-18 Church Hill Road
Newtown,CT06470
Diagnostic
21 Kenosia Lab
51-53 Kenosia Avenue
Danbury,CT06810
Diagnostic
22 Danbury Hospital Research Institute
131 West Street
Danbury,CT06813
Diagnostic
23 New Milford Integrated Medicine Prgm
30 Elm Street
New Milford,CT06776
Outpatient-Physician Clinic
Schedule H (Form 990) 2014
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
SCHEDULE H, PART I, LINE 3C Annual income and liquid assets are combined to determine eligibility. If family income limit for eligibility is between 400% and 500% then 50% will be taken off based on a sliding scale. If the income limit for eligibility is between 500% and 600% then 100% will be taken off based on a sliding scale.
SCHEDULE H, PART I, LINE 6A Part I, Line 6a & 6b: The Community Benefit report is reported on a Network basis. It contains the organization's community benefit programs and services' descriptions and financial data. The form is made available to the public on the Office of Health Care Access' website: http://www.ct.gov/dph/lib/dph/ohca/hospitalfillings/2012/irs990/danby990_h ospital_2012.pdf
SCHEDULE H, PART 1, LINE #7 Charity Care At Cost Percentage: Total Gross Patient charges written off to charity (Income Statement) * Patient Cost to Charge % (see below) = Total Community Benefit Expense Total Community Benefit Expenses - Revenue from Uncompensated Care Pools and programs (DHS * % of cost of uncompensated care shown on the OCHA Schedule 500) = Net community benefits expenses Net community benefits expenses / total expenses = % of total expenses Ratio Cost To Charge Calculation Total Operating Expenses - non-patient care activities, medicaid provider tax, total community benefit expense and total community building expense = Adjusted Patient Care Cost. Adjusted Patient Care Cost divided by Gross Patient Charges= Ratio of patient care costs to charges.
SCHEDULE H, PART I, LINE 7G Part I, Line 7g - Costs Associated With Physicans Clinics There are no physician clinics included in this amount.
SCHEDULE H, PART III, LINE #2 The ratio of cost to charges is applied to the bad debt expense on the audited financial statements.
SCHEDULE H, PART III, LINE #3 It is the policy of the Hospital to provide necessary care to all persons seeking treatment without discrimination on the grounds of age, race, creed, national origin or any other grounds unrelated to an individual's need for the service or the availability of the needed service at the Hospital. A patient is classified as a charity care patient by reference to established policies of the Hospital. Essentially, these policies define charity services as those services for which no payment is anticipated. In assessing a patient's inability to pay, the Hospital utilizes the generally recognized federal poverty income guidelines, but also includes certain cases where incurred charges are significant when compared to a responsible party's income and their countable assets. Those charges are not included in net patient service revenue for financial reporting purposes. Because the hospital is not paid for these services, they are considered to be community benefit. When private pay patients are sent to the collection agency their account is considered to be a bad debt. Subsequently, Medicaid may be granted for some of those patients. At that time those accounts would become charity care or a community benefit.
SCHEDULE H, PART III, LINE #4 The Hospital's estimation of the allowance for uncollectible accounts is based primarily upon the type and age of the patient accounts receivable and the effectiveness of the Hospital's collection efforts. The Hospital's policy is to reserve a portion of all self-pay receivables, including amounts due from the uninsured and amounts related to co-payments and deductibles, as these charges are recorded. On a monthly basis, the Hospital reviews its accounts receivable balances and various analytics to support the basis for its estimates. These efforts primarily consist of reviewing the following: Historical write-off and collection experience using a hindsight or look-back approach; Revenue and volume trends by payor, particularly the self-pay components; Changes in the aging and payor mix of accounts receivable, including increased focus on accounts due from the uninsured and accounts that represent co-payments and deductibles due from patients; Cash collections as a percentage of net patient revenue less the provision for uncollectible accounts; and Trending of days revenue in accounts receivable The amount of the allowance for uncollectible accounts is based upon management's assessment of historical and expected net collections, business and economic conditions, trends in Medicare and Medicaid health care coverage, and other collection indicators. The Hospital regularly performs hindsight procedures to evaluate historical write-off and collection experience throughout the year to assist in determining the reasonableness of its process for estimating the allowance for uncollectible accounts. The Hospital's primary concentration of credit risk is patient accounts receivable, which consists of amounts owed by various governmental agencies, insurance companies and private patients. The Hospital manages the receivables by regularly reviewing its patient accounts and contracts, and by providing appropriate allowances for uncollectible amounts. Significant concentrations of gross patient accounts receivable include 30%, 13% and 57% and 37%, 13% and 50% for Medicare, Medicaid and non-government payors, respectively, at September 30, 2015 and 2014, respectively.
SCHEDULE H, PART III, LINE #8 Danbury Hospital's Medicare shortfall should be treated as a community benefit as the organization strives to provide 24/7 coverage, improved patient access, highest clinical quality as well as addressing the needs of the community by offering critical services to our geographic area. As a result, the organization must balance the cost of these programs against the continued decreasing government reimbursement levels, uninsured population and community needs. A cost accounting system is used to calculate the shortfall, which is Medicare Net Patient Revenue less applicable costs.
SCHEDULE H, PART III, LINE 9B It is the policy of Danbury Hospital to provide "Financial Assistance" (either free care or reduced patient obligations) to persons or families where: (i) there is limited or no health insurance available; (ii) the patient fails to qualify for governmental assistance (for example Medicare or Medicaid); (iii) the patient cooperates with the Hospital in providing the requested information; (iv) the patient demonstrates financial need; and (v) Danbury Hospital makes an administrative determination that Financial Assistance is appropriate. After the Hospital determines that a patient is eligible for Financial Assistance, the Hospital will determine the amount of Financial Assistance available to the patient by utilizing the Charitable Assistance Guidelines, which are based upon the most recent federal poverty guidelines. Danbury Hospital shall regularly review this Financial Assistance Policy to ensure that at all times it: (i) reflects the philosophy and mission of the Hospital; (ii) explains the decision processes of who may be eligible for Financial Assistance and in what amounts; and (iii) complies with all applicable state and federal laws, rules, and regulations concerning the provision of financial assistance to indigent patients. Consistent with this mission, Danbury Hospital recognizes its obligation to the community it serves to provide financial assistance to indigent persons within the community. In furtherance of its charitable mission, Danbury Hospital will provide both (i) emergency treatment to any person requiring such care; and (ii) essential, non-emergent care to patients who are permanent residents of its primary service area who meet the conditions and criteria set forth in this Policy, without regard to the patients' ability to pay for such care. Elective procedures generally will not be considered essential, non-emergent care and usually will not be eligible for Financial Assistance. Danbury Hospital will collect from individuals on financial assistance if they received a partial charitable discount. All patients can apply for charitable care on balances they feel that they cannot afford.
SCHEDULE H, PART V 14 Diagnostic Centers 6 Outpatient Physician Clinics 1 Outpatient Surgical Center 1 Rehabilitation Center 1 Education Center
SCHEDULE H, PART VI, LINE 2 Needs Assessment: The Community Forum held in 2014 was attended by 37 community stakeholders from the Housatonic Valley Region (HVR). This included representatives from 5 Health Departments/Districts (Danbury, New Milford, Bethel, Newtown, and Pomperaug), Western CT Health Network, Danbury EMS, the Bethel Visiting Nurse Association, the United Way of Western CT, the Regional YMCA, the Housatonic Valley Coalition Against Substance Abuse, the Mid-Western CT Council on Alcoholism, the AmerCares Free Clinic, the CIFC Community Health Center, Doctor's Express Urgent Care Center, the Regional Educational Service Center, the Danbury Fire Department, the New Milford Senior Center, and the Peter and Carmen Lucia Buck Foundation. Two community health conversations were held with key community stakeholders in October 2012 - (Danbury and New Milford, CT) to ensure accessibility by key stakeholders throughout the region. Attendees included a total of 52 representatives from hospitals; community health centers; school-based health centers; Visiting Nurse Associations/Services; municipal health, education, social service, senior centers and fire departments; non-profit organizations; and a legislator's office. Geographically, all 10 HVR municipalities were represented either directly or through regional agencies and organizations. The participation and insights of community leaders and agencies/organizations who provide direct programs and services for the low income/minority members of the community was important to the data collection and assessment process. The Western CT Health Network (of which Danbury Hospital is a part) conducted a Physician Resource Assessment to evaluate the supply of health care providers within its combined service area towns. This is done to document community need for health care providers, and to develop a plan to meet the health care needs of the community served. Through Western CT Health Network's annual Planning Process, an environmental assessment is conducted to identify health care gaps and needs of the service area community brought about by local and national trends in economic, legislative, demographic, health care industry and other environmental factors. These forces are considered and incorporated in meeting the health care needs of the community by helping to frame the priorities, goals and initiatives of Western CT Health Network's long range and annual strategic plans.
SCHEDULE H, PART VI, LINE 3 part vi- PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE The Hospital has messages on all statements providing information regarding how the patient can get assistance with their hospital bill. Also signs are posted throughout the hospital and counselors are available to provide further assistance. All uninsured inpatients are interviewed by financial counselors and assessed for eligibility for assistance programs. The hospital provides informational handouts to all uninsured patients at the time of registration which refers them to financial counseling if they would like assistance with their bills. Further, the hospital mails notices to all self-pay accounts referring them to financial counseling if they need assistance. The collection department will also refer patients to financial counseling when a patient indicates that they cannot afford their balances; and finally, schedulers refer uninsured patients to financial counseling prior to their test or procedure. The policy and applications for assistance are also available on line.
SCHEDULE H, PART VI, LINE 4 PART VI - COMMUNITY INFORMATION Community Information: Danbury Hospital and the New Milford Hospital Campus serves an area with a population of about 280,000 people. The Primary Service Area includes Bethel, Bridgewater, Brookfield, Danbury, New Fairfield, New Milford, Newtown, Ridgefield, and Southbury (in CT), and the Secondary Service Area includes Kent, Redding, Roxbury, Sherman, Washington, Wingdale, and Woodbury (in CT) and Brewster, North Salem, Patterson, and Pawling (in NY). This service area is comprised of a densely populated core of the urban/suburban City of Danbury surrounded by moderately affluent residential and rural towns. Danbury is also listed as a Medically Underserved Area, or MUA. Danbury has a median household income of $65,981 and a poverty rate of 11.1%,while New Milford has a household income of $49,575 and a poverty rate of 15.6%. The overall uninsured population rate for the state is estimated to be 3.8%. Although the population of the primary and secondary service areas is expected to remain virtually level from 2010 to 2020, the cohort aged 65 and over is expected to increase by 2.78% in Danbury and 4.05% in New Milford, while the age 20-44 age cohort is forecast to slightly increase at 0.68% in Danbury and decrease by 1.13% in New Milford over the same time period.
SCHEDULE H, PART II: Community Building Activities Relates to Line #6, Coalition Building, totaling $9,169: Western Connecticut Health Network (WCHN) participates as a member of a regional collaborative representing the Housatonic Valley Region and ten municipalities. A Steering Committee comprised of health care providers, community-based providers, and local government agencies meets no less than twice a year to oversee a community health improvement plan (CHIP) that was developed utilizing data from a report card and previous community conversations. Four priority health indicators (PHI) are being addressed through a work group structure that includes a designated leader who convenes the group to further develop and refine their action plans. Community stakeholders participated in an April 2014 community forum facilitated by the Center for Health Schools & Communities @ Education Connection. Overall, data obtained from the conversations provided high quality information to frame the beginning of a community health improvement change process in the region. 1. Prevention and Education of Most Prevalent Chronic Diseases/Health Conditions: Obesity, Type 2 diabetes, and hypertension were identified as the most prevalent health conditions in the community. The PHI team goals are to increase healthy eating options, enhance access to physical activities, and promote a universal healthy lifestyle. In July 2014, the PHI team received the YMCA Diabetes Prevention Program Grant which was used to fund their diabetes prevention program. The program began in October 2014, and through December 2015 10 classes had been conducted (average class size of 5.4 participants, average age of 59 years, and 75% of the referrals were from physician offices). Participants exceeded the targeted weight loss goal of 7% (achieved 10.4%) which was supported by consistent program participation, physical activity and food tracker completion. The team also participated in National Walk Day, which garnered over 150 people from the Housatonic Valley Region and formation of 3 community walking groups. The Coalition for Healthy Kids is piloting a "Walking School Bus" program with a local school to encourage physical activity. A wellness campaign building on the "5, 2, 1, 0 Let's Go" messaging was implemented and the "Know Your Numbers" campaign tracked 338 individuals with blood pressure monitoring. 2. Improving Access/Utilization to Substance Abuse and Mental Health Services: Mental health issues and substance abuse continue to be prevalent issues in the community. This PHI team is collaborating with 12 Local Prevention Councils, the CT Prevention Framework, and other entities to increase outreach efforts. Their goals are to identify gaps in services and access, provide education, and increase awareness regarding services and programs. There is awareness to vulnerable target groups in need of enhanced services and supports, such as the homeless population and youth. The team worked to improve education and information dissemination, and supported integration of a "question-persuade-refer" model for suicide prevention. Areas of focus targeted prescription drug use, support for community "drop boxes" , opiate use, underage drinking, and behavioral health initiates in primary care practices. 3. Improve Assessment and Service Planning to Senior Health: Senior citizens, particularly homebound elderly and immigrants, are in need of assessment and service planning to address their health, housing, and social support needs. The main goal is to increase awareness, services, and education for senior health. This team is supporting and collaborating with the Aging in Place initiatives funded by the Peter and Carmen Lucia Buck Foundation, which includes the "Safe at Home" program that delivers home safety items to seniors. Efforts continue to move the Danbury community as a "livable" community and to share learnings with adjacent communities. 4. Improve Awareness and Utilization of Existing Health and Social Programs/Services: This team focused on enhancing awareness and utilization of existing programs and services in the community, including support of Infoline 2-1-1 and 5 Health Access CT Assistor sites by target populations. It also established a partnership with FamilyWize to provide promotional materials for distribution to health providers and key community sites. The individual CHIP Steering Committee members, including WCHN, support the importance of shared commitment and responsibility in development and execution of its recommended action plans for health improvement. To the best of the organization's knowledge, all prevalent issues in the community are being addressed. Relates to Line #2, Economic Development, Line #3, Community Support and Line #7, Community Health Improvement Advocacy totaling $5,204: Part II: Community Health Improvement Advocacy: Largely state and local elected officials and agency heads were lobbied in support of maintaining patient access to essential services for the uninsured and under insured. As part of this effort, miscellaneous expenses are noted in Schedule C, Part II-B 1i.
SCHEDULE H, PART VI, LINE 5 Promotion of community health. Danbury Hospital served approximately 239,099 persons through over 310 health events. One of the highest impact outreach activities includes approximately 187,000 individuals served through Health Talk. Health Talk which airs twice a week focuses on disease prevention, new treatments in pulmonary, embolism atrial fibrillation, pediatric asthma, heart health, colon cancer, exercise and wellness talks, to name a few examples. Over 50% of the Board Members are independent and do not get paid by Danbury Hospital. Danbury Hospital also has an open medical staff. Surplus funds are used to provide innovative technology to clinical care in addition to expanding our service area. PART VI-AFFILIATED HEALTH CARE SYSTEM ROLES AND PROMOTION Western Connecticut Health Network (WCHN) is an integrated health care delivery system comprised of three community hospitals and their affiliated entities. In addition to Norwalk Hospital, Danbury Hospital and its New Milford Hospital Campus, the continuum of care includes a large medical group, home health care services, a nationally renowned biomedical research institute, the WCHN and Norwalk Hospital Foundations, and other related affiliates (the Network). WCHN's mission is to improve the health of every person we serve through the efficient delivery of excellent, innovative and compassionate care. For 2015, WCHN provided approximately $19,826,631 in total charity care. Danbury Hospital, its New Milford Hospital Campus and Norwalk Hospital provide medical services to the community regardless of the individual's ability to pay. Services include routine inpatient ancillary and outpatient care in support of the Network's mission statement, as noted above, For 2015, charity care was provided in the following amounts: Norwalk Hospital, $7,649,926, Danbury Hospital and its New Milford Hospital Campus, approximately $11,003,250. Western Connecticut Medical Group/Norwalk Hospital Physicians & Surgeons: The mission of Western Connecticut Medical Group is to provide safe, innovative, convenient and coordinated primary and specialty health care in the communities they serve and strive to be aware of and respond to their patients'needs. They support a commitment to advance the health and well-being of individuals in their community by delivering quality care, participating in medical research and medical residency programs and the provision of medical services to patients. For 2015, WCMG/NHP&S provided approximately $1,023,000 in charity care. Western Connecticut Health Network Foundation Inc.'s mission is to raise funds, reinvest and administer these funds and make distributions to Danbury Hospital and its New Milford Hospital Campus and other Danbury not-for-profit health care affiliates. Norwalk Hospital Foundation's mission is to raise funds, reinvest and administer these funds and make distributions to Norwalk Hospital and other not-for-profit Norwalk Hospital affiliates. Western Connecticut Health Network Affiliates principal purpose is to provide outpatient health care services in various locations and also provide ambulance services to Danbury and surrounding towns, while serving those that cannot afford the care. Western Connecticut Home Care, Inc. (WCHC) provides state of the art clinical services ranging from pediatric patients to the elderly utilizing best practice in home care to meet the needs of their patients. For 2015, WCHC provided approximately $91,000 in charity care. Eastern New York Medical Services (ENYMS): The mission at ENYMS is to provide safe, innovative, convenient and coordinated primary and gastroenterology health care in the communities we serve and strive to be aware of and respond to our patients' needs.
SCHEDULE H, PART VI, Line 7 CT.
Schedule H (Form 990) 2014
Additional Data


Software ID:  
Software Version:  
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet 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
Danbury Hospital
 
Employer identification number

06-0646597
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
Yes
 
b
Any related organization? .........................
6b
Yes
 
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2014

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
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1John M MurphyMDPres/CEO, WCHN (i)
(ii)
949,990
...............................
0
450,000
...............................
0
2,838
...............................
0
12,750
...............................
0
39,094
...............................
0
1,454,672
...............................
0
0
...............................
0
2Steven H RosenbergSVP/CFO, WCHN (i)
(ii)
557,258
...............................
0
200,000
...............................
0
21,856
...............................
0
12,750
...............................
0
29,979
...............................
0
821,843
...............................
0
0
...............................
0
3Daniel DeBarba JrExec VP/Pres-DH (i)
(ii)
637,084
...............................
19,466
310,000
...............................
0
19,018
...............................
73,676
12,750
...............................
4,197
40,400
...............................
0
1,019,252
...............................
97,339
0
...............................
0
4Donna KaplanisAss't Secretary (i)
(ii)
193,923
...............................
0
40,000
...............................
0
18,912
...............................
0
24,188
...............................
0
27,143
...............................
0
304,166
...............................
0
0
...............................
0
5Matthew A Miller MDSVP & Chief Medical Officer (i)
(ii)
126,404
...............................
168,034
175,000
...............................
175,000
6,952
...............................
18,931
12,750
...............................
12,750
9,343
...............................
11,149
330,449
...............................
385,864
0
...............................
0
6Moreen O DonahueSr VP/Chief Nurse Officer,WCHN (i)
(ii)
339,737
...............................
0
100,000
...............................
0
7,196
...............................
0
20,400
...............................
0
30,320
...............................
0
497,653
...............................
0
0
...............................
0
7Michael DaglioChief Oper Officer (To 11/2) (i)
(ii)
404,582
...............................
0
145,000
...............................
0
990
...............................
0
15,300
...............................
0
29,566
...............................
0
595,438
...............................
0
0
...............................
0
8Morris GrossVP of Facilities/Real Estate (i)
(ii)
255,758
...............................
0
100,000
...............................
0
5,182
...............................
6,180
25,500
...............................
0
26,103
...............................
0
412,543
...............................
6,180
0
...............................
0
9Kathleen A DematteoChief Infor.Officer, WCHN (i)
(ii)
343,359
...............................
0
110,461
...............................
0
21,373
...............................
0
22,950
...............................
0
9,324
...............................
0
507,467
...............................
0
0
...............................
0
10Patrick C MinicusVP of Finance (i)
(ii)
375,651
...............................
45,622
100,000
...............................
0
526
...............................
27,701
0
...............................
2,376
45,461
...............................
2,477
521,638
...............................
78,176
0
...............................
0
11James VarroneVP Supply Chain (i)
(ii)
0
...............................
159,641
0
...............................
26,000
0
...............................
0
0
...............................
9,019
0
...............................
20,995
0
...............................
215,655
0
...............................
0
12Lisa SchmittgallSRVP Strategy-WCHN (To 12/31) (i)
(ii)
384,629
...............................
38,097
339,262
...............................
0
909
...............................
164
0
...............................
1,722
27,824
...............................
1,923
752,624
...............................
41,906
0
...............................
0
13Debra CarragherVP of Operations (i)
(ii)
249,594
...............................
0
75,000
...............................
0
585
...............................
0
12,750
...............................
0
3,387
...............................
0
341,316
...............................
0
0
...............................
0
14Carolyn McKennaSr VP/Gen'l Coun (i)
(ii)
344,800
...............................
0
125,000
...............................
0
1,311
...............................
0
12,750
...............................
0
24,452
...............................
0
508,313
...............................
0
0
...............................
0
15Ramin Ahmadi MDDir. of Educ./Res. (i)
(ii)
259,797
...............................
0
70,000
...............................
0
960
...............................
0
12,750
...............................
0
29,377
...............................
0
372,884
...............................
0
0
...............................
0
16Dawn MylesSRV,Qual/Pat. Sfty (i)
(ii)
253,756
...............................
0
80,000
...............................
0
600
...............................
0
17,850
...............................
0
4,231
...............................
0
356,437
...............................
0
0
...............................
0
17Ruth GregoryDirector of Materials Dist (i)
(ii)
143,679
...............................
0
17,050
...............................
0
1,299
...............................
0
15,978
...............................
0
10,350
...............................
0
188,356
...............................
0
0
...............................
0
18Joseph CampbellChief Audit Compl. Officer (i)
(ii)
229,337
...............................
0
60,000
...............................
0
2,400
...............................
0
22,950
...............................
0
27,516
...............................
0
342,203
...............................
0
0
...............................
0
19Phyllis F ZappalaSr. VP of Human Resource (i)
(ii)
264,230
...............................
0
0
...............................
0
5,255
...............................
0
22,950
...............................
0
12,768
...............................
0
305,203
...............................
0
0
...............................
0
Schedule J (Form 990) 2014

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
SCHEDULE J, PART I, LINE #4 Severance: During the fiscal year ending September 30, 2015, Lisa Schmittgall received $597,184 in severance payments. A severance benefit of one and a half (1 ) years of compensation was paid in a lump sum within 60 days of the termination date of December 31, 2014. Supplemental Executive Retirement Plans: Western Connecticut Health Network (WCHN) established three separate Supplemental Executive Retirement Plans (SERP). These plans provide supplemental retirement benefits to key members of the executive group. Under the agreements for SERP Plans #1 and #2, amounts promised to eligible executives are based on targeted retirement benefits and the payment of benefits is subject to vesting. The benefits at the vested age are provided in the form of an actuarial equivalent lump sum plus a tax gross-up amount to the participants. WCHN has on its books an accrual for the participants of the SERP, which is maintained solely for accounting purposes and is unfunded. SERP Plan #1 - During the fiscal year ending September 30, 2015, Dr. Matthew Miller, Chief Medical Officer and Phyllis Zappala, former Senior VP of Human Resources were the only participants. Under the terms of SERP Plan #1, a payment of $350,006 was made to Phyllis Zappala during the year. SERP Plan #2 - During the fiscal year ending September 30, 2015, no payments were made to either, Dr. John Murphy, President/CEO of WCHN and Steven H. Rosenberg, CFO of WCHN, participants of SERP Plan #2. SERP Plan #3 - Earnings and losses on the investments selected by participants of SERP Plan #3 are added to the balance of the account. During the fiscal year ending September 30, 2015, no payments were made to either Daniel DeBarba, Jr., Executive VP/President of Danbury Hospital and Michael Daglio, Chief Operating Officer, participants of SERP #3.
SCHEDULE J, PART I, LINE #6 Summary of Executive Incentive Plan The Plan is administered by the Executive Compensation Committee (the Committee) of Western Connecticut Health Network,Inc.(WCHN). Eligibility to participate in the Plan is limited to those exempt executives employed by WCHN and its subsidiaries (the Network) during the Plan year who are in positions in which their decisions, actions and counsel significantly affect the operations of the Network. The Committee, with input provided by senior management of the Network will determine which eligible executive employees of the Network will participate in the Plan. Prior to the beginning of each Plan year, or as soon thereafter as practicable, the Committee will establish target and maximum award opportunity for the participant, in the appropriate tier in the Plan, along with a team scorecard of Plan measures. Soon after the close of the Plan Year, actual organization and individual performance and results will be measured and assessed in comparison to published goals and expectations established for such Plan Year. Recommendations for individual incentive awards will be prepared and submitted to the Committee for evaluation and approval. Notwithstanding any other provision of the Plan, at the discretion of the Committee, awards may not be paid under the Plan for any Plan Year if the level of performance specified in one or more Network level "Circuit Breaker Goals" is not achieved during the Plan Year.
SCHEDULE J, PART III, ADDITIONAL INFORMATION The organization relied on a related organization, Western Connecticut Health Network, Inc. which used the following methods described below to establish top management's compensation: -Compensation committee. -Independent compensation. -Written employment contract. -Compensation survey or study. -Approval by board or compensation committee.
Schedule J (Form 990) 2014

Additional Data


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Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990.

SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
Danbury Hospital
 
Employer identification number
06-0646597
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A CHEFA RevBondsSeries H
 
06-0806186 20774UCL7 03-16-2006 40,924,665 See Part VI for purpose   X   X   X
B CHEFA (WCHN) Series M
 
06-0806186 20774U8A6 07-13-2011 45,523,137 See Part VI for purpose   X   X   X
C CHEFA (WCHN) Series N
 
06-0806186 20774YEJ2 11-22-2011 40,735,995 See Part VI for purpose   X   X   X
D CHEFA (WCHN) Series O
 
06-0806186   05-08-2015 122,120,000 See Part VI for purpose   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 1,945,000 0 2,795,000 0
2 Amount of bonds legally defeased . . . . . . . . . . . 0 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . . 42,742,900 45,576,281 40,735,995 122,120,000
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0 0 0 0
5 Capitalized interest from proceeds . . . . . . . . . . . 2,237,472 7,328,241 0 0
6 Proceeds in refunding escrows . . . . . . . . . . . . 0 0 0 0
7 Issuance costs from proceeds . . . . . . . . . . . . 606,787 908,228 749,768 797,294
8 Credit enhancement from proceeds . . . . . . . . . . . 828,469 0 0 0
9 Working capital expenditures from proceeds . . . . . . . . . 0 0 0 0
10 Capital expenditures from proceeds . . . . . . . . . . . 39,070,172 37,339,812 0 0
11 Other spent proceeds . . . . . . . . . . . . . . 0 0 39,986,227 121,322,706
12 Other unspent proceeds . . . . . . . . . . . . . . 0 0 0 0
13 Year of substantial completion . . . . . . . . . . . . 2007 2014 2011 2015
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . .   X   X X   X  
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X   X   X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X       X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X     X       X
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X     X       X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . X     X       X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?   X            
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0.010 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet        
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0.010 %      
7 Does the bond issue meet the private security or payment test? . . . . .   X   X       X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X       X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X       X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . .
X   X       X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X X   X   X  
b Exception to rebate? . . . . . . . .   X   X   X   X
c No rebate due? . . . . . . . . X     X   X   X
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . .   X X     X X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . . . 0
 
0
 
0
 
 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was the hedge terminated? . . . . . .                
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X   X
b Name of provider . . . . . . . . . 0
 
0
 
0
 
0
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
SCHEDULE K, ADDITIONAL INFORMATION Series H Bonds ($41,560,000): Proceeds from the sales of Series H Bonds were used, together with other monies available to 1) finance a portion of the costs of the Series H project, 2) to fund capitalized interest, if any on the Series H Bonds, and 3) to pay certain costs of issuance and bond insurance premiums incurred in connection with the issuance of Series H Bonds. Series M Bonds ($46,030,000): Series M Bonds were issued concurrently in 2011 with Series L bonds and were used to fund the planning, design, acquisition, construction, equipping and furnishing of Danbury Hospital's new patient tower, expansion of a parking garage, capital improvements and to fund capitalized interest. Series N Bonds ($39,880,000): Series N Bonds mature serially from July 1, 2014 to July 1, 2029. The proceeds were used to refund Danbury Hospital's Series G Bonds which were issued on September 29, 1999. Series O Bonds ($122,120,000): Series O Bonds mature serially from July 1, 2022 to July 1, 2041. The proceeds were used to refund Danbury Hospital's Series K and Series L Bonds which were fully redeemed as of September 30, 2015. Part II, Line #3 includes investment earnings of $1,818,235 for Series H Bonds. Part II, Line #3 includes investment earnings of $53,144 for Series M Bonds. Part IV, Line #2c The date that the rebate computation was performed was March, 2014 for Series H Bonds.
Schedule K (Form 990) 2014

Additional Data


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Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletInformation about Schedule L (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
Danbury Hospital
 
Employer identification number

06-0646597
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





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

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2014
Schedule L (Form 990 or 990-EZ) 2014
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) Kaufman Hall Associates See Part V 397,546 Consulting Firm   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L, Part IV, Col (c) During the year the following transactions are at arm's length, entered into the ordinary course of business and in compliance with the Organization's Conflict of Interest Policy: David M. Cyganowski, a director at Danbury Hospital is a shareholder of Kaufman Hall & Associates, Inc., which provides financial and forecasting services.
Schedule L (Form 990 or 990-EZ) 2014

Additional Data


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Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

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

Complete to provide information for responses to specific questions on
Form 990 or 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
Danbury Hospital
 
Employer identification number

06-0646597
Return Reference Explanation
FORM 990, PART VII (ADDT'L INFORMATION) For those officers and top 5 employees, for which only 40 hours is noted to reflect paid hours, actual hours worked exceeded this amount. Note: All amounts in column F, of Part VII,"Estimated Amount of Other Compensation", represent benefits, and do not reflect any compensation for which the average amount of time worked can be reflected.
FORM 990, PART IX, COLUMN D ALTHOUGH CONTRIBUTIONS ARE REFLECTED ON LINE #1 OF PAGE #1 ON FORM 990, ALL FUNDRAISING EXPENSES WERE INCURRED BY THE WESTERN CONNECTICUT HEALTH NETWORK FOUNDATION, INC.
Form 990, Part VI, Line 7A The sole member shall be responsible for electing, at the annual meeting of the membership, the members of the Board of Directors of the Hospital to serve for three year terms and until their successors are elected and have qualified.
Form 990, Part III On October 1, 2014 (the merger date), Danbury Hospital (the Hospital) received a single provider license to include The New Milford Hospital Incorporated (New Milford Hospital). As a result, New Milford Hospital merged with the Hospital and the operations of New Milford Hospital became a campus of Danbury Hospital effective October 1, 2014. The Hospital will operate as one licensed facility with two campuses.
Form 990, Part VI, Section B, 12A, 13 and 14 The policies exist at the parent level, which are followed by each entity and are approved by the parent board, but not each individual board. This excludes the record retention policy, which is approved only by the parent audit committee. Form 990, Part III - PROGRAM SERVICE, Line 4A MEDICAL SERVICE LINE Danbury Hospital's Medical Service Line consists of the following services: Inpatient Cases: Gastrointestinal 1,925 Infectious Disease 1,199 Internal Medicine 651 Neurology Medicine 509 Renal/Urology Medicine 802 Pulmonary Medicine 1,435 All Other Inpatient 1,917 Outpatient Service Line Cases: O/P Medicine 9,685 O/P Medicine Comm. Clinic 31,667 O/P Medical Oncology 10,448 O/P Pulmonary Medicine 5,125 DIGESTIVE DISEASES: Our Digestive Disease Center is staffed by renowned fellowship-trained gastroenterologists. We use advanced diagnostic and treatment technology in a compassionate and supportive manner. The following services are provided: Ablation therapy for Barrett's esophagus, Colon cancer screening, Colonoscopy, Cryotherapy, Endoscopy, Endoscopic ultrasound and fine-needle aspiration,, Lactose tolerance testing, LINX Reflux Management System for treatment of GERD, Wireless capsule endoscopy and Laparoscopic fundoplication for GERD. INFECTIOUS DISEASE: Danbury Hospital's infectious disease specialists treat the full range of infectious diseases, including conditions caused by living organisms (bacteria, viruses, fungi and parasites), HIV, and related conditions, Lyme disease, chronic and wound-related infection, and travel-related infection. Our doctors have expertise in the proper use of antibiotics and other anti-infective medicines to treat disease and also collaborate with primary care doctors, specialists and surgeons to provide individualized treatment for each patient. INTERNAL MEDICINE: Whatever your medical needs, Danbury Hospital provides expert care in the warm, focused and personal manner you deserve. Specialists in primary care, our family medicine physicians treat infants, children and adults of all ages. Services include preventive medicine (including vaccines and immunizations), diagnosis and treatment of chronic and acute illnesses and injuries, and coordination of specialty care. Our family physicians are trained to provide medical care for patients ranging in age from pediatrics through adult and geriatrics. NEUROLOGY AND STROKE: We offer expertise in treatment of neurological disorders, including stroke, epilepsy, headache, Parkinson's disease, Alzheimer's disease and Vertigo. One of the nation's first hospitals to earn primary stroke center accreditation from the Joint Commission, we have been regularly recognized by the Connecticut Department of Public Health for consistently demonstrating the ability to rapidly diagnose and treat stroke. Committed to remaining on the forefront of rapid and effective stroke care, we continue to incorporate the latest effective treatments. UROLOGY: Our expert urologists treat conditions such as: -Female urologic disorders, including urinary incontinence and voiding dysfunction -Infertility -Kidney, bladder, prostate and testicular cancer -Kidney stones -Male sexual difficulties -Prostate cancer -Urinary tract infections -Vasectomy and vasectomy reversal Procedures we perform include: -Extracorporeal shock wave lithotripsy for kidney stones -Laparoscopic nephrectomy -Minimally invasive photo-vaporization of the prostate -Minimally invasive surgical treatment for female incontinence -Pyeloplasty PULMONOLOGY: We offer outstanding diagnosis, treatment and care for patients with all types of pulmonary conditions. We perform specialized services, such as cardiopulmonary exercise testing to measure degree of fitness and aid in the assessment of shortness of breath; specific diagnostic asthma testing; and testing to determine the need for supplemental oxygen for everyday living and air travel. All programs are administered consistent with Danbury Hospital's financial assistance policy. Form 990, Part III - PROGRAM SERVICE, Line 4B SURGERY SERVICE LINE Inpatient Cases: Major Joint Replacement 1,078 Trauma Surgery 568 Minor GI Surgery 267 General Surgery 325 Urology Surgery 158 Colon/Bowel Surgery 236 Obesity Surgery 164 Spinal Surgery 398 All Other Inpatient Surgery 571 Outpatient Service Line Cases: Abdomen GI Surgery 1,426 Breast Surgery-Non Plastic 260 Endoscopy 12,933 Misc. General Surgery 3,765 Oral Surgery 111 Opthamology 766 Urology 988 Pain Injection Procedures 701 Head/Neck Surgery 1,139 Plastic Surgery 1,071 All Other Outpatient Surgery 1,342 GENERAL SURGERY: Danbury Hospital's surgeons are continually recognized for their experience, excellent outcomes, and expertise in minimally invasive surgical techniques. Here are just some of the awards we've been privileged to receive: -Intersocietal Accreditation Commission's Vein Center Accreditation for the Vascular Surgical Service (2015) -Participant, Institute for Healthcare Improvements International Joint Replacement Learning Community (2014) -Member, Institute for Healthcare Improvement's International Joint Replacement Learning Community (2015) -Joint Commission Top Performer, America's Improving Quality and Safety (2014/13) -Top 100 Community Value Leadership Award for providing high-quality, high-value service at an appropriate cost, from Cleverly and Associates (2014) -Top 100 Great Community Hospitals from Becker's Hospital Review (2012) -Recertification, Joint Commission Disease Specific Certification in Hip Arthroplasty, Knee Arthroplasty and Spine Surgery (2015) -The Center for Weight Loss Surgery has been named the Comprehensive Center with the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) (2015 - 2018) -A Bariatric Center for Excellence under The Clinical Science Institute (CSI) of Optum (2015) -Recipient of The Aetna Institute of Quality Bariatric Designation (2015) At Danbury Hospital our expert surgeons excel at using advanced technology to perform minimally invasive procedures, allowing patients to undergo surgery with less pain, shorter hospital stays, and quicker recovery periods. Surgeons use very small incisions, meaning less trauma to the body, less blood loss, smaller scars and a lower need for pain medication. Our surgeons have been recognized for excellence in laparoscopic techniques performed in many surgical specialties including weight loss, colorectal, and general surgical procedures. For robotic surgery, we use the latest, most advanced robotic technology available, the da Vinci surgical system. We are committed to staying at the forefront of innovation, equipping our surgeons with sophisticated technology so they can offer innovative surgical procedures here in our community. Our da Vinci surgical system gives surgeons better visualization and tools that improve dexterity. With more control they can operate with greater precision. Our doctors use this advanced technology to perform a wide range of procedures, including single-incision robotic surgery. As a Level II Trauma Center, Danbury Hospital's team of board certified surgeons provide immediate, 24/7 care for acute and life-threatening injuries to children and adults. ORTHOPEDIC SURGERY: Our Center for Advanced Orthopedic and Spine Care has earned the "Center of Excellence" designation from the Joint Commission for providing comprehensive, multidisciplinary care, including hip, knee, shoulder, and ankle replacement. Our Danbury Hospital orthopedic surgeons offer a wide array of joint replacement procedures. Our continuum of care includes: -A care coordinator who provides education and guidance every step of the way, pre-op through your rehabilitation. -Pre-admission testing in our dedicated unit, designed to meet the unique needs of joint replacement patients and families. Services include individualized patient education, nursing and anesthesia assessments, and collaboration with you on planning a pain management program for your surgical recovery. -Dedicated orthopedic operating rooms and clinical support staff. -A comfortable orthopedic recovery unit with physician assistants, nursing and rehabilitation staff specially trained to care for total joint replacement patients. -Advanced, digital diagnostic imaging technology. -Acute in-hospital therapy -Outpatient physical and occupational -Access to home care services with Western Connecticut Home Care (formerly DVNA). DIGESTIVE DISEASE: Our expert general and digestive disease surgeons specialize in major and minor surgical procedures of the abdomen, digestive tract, endocrine system, breasts, skin and blood vessels. UROLOGIC SURGERY: Danbury Hospital urologists are known nationally for innovation. Procedures performed include: Extracorporeal shock wave lithotripsy for kidney stones; Laparoscopic nephrectomy, Minimally invasive photo-vaporization of the prostate; Minimally invasive surgical treatment for female incontinence and Pyeloplasty. Danbury
990, Part VI, Line #2 Richard Jabara and James Kennedy, both directors of Danbury Hospital have a business relationship.
990, Part VI, Line #6 Western Connecticut Health Network, Inc. is the sole member of Danbury Hospital.
990, Part VI, Line #7B Certain fundamental decisions to be undertaken by the Hospital require the approval of the Member. a) The actions listed below, taken for the Hospital or in its capacity voting as a shareholder or member of a subsidiary ("Danbury Subsidiary") shall not require approval by the Board and are reserved solely to the Member: -The amendment of the Hospital's bylaws; -The election or removal of a director; -Approval of investment policies; -Approval of the adoption of or amendment to any qualified or any non-qualified benefit plan; -Approval of the adoption of or any amendment to the policies and procedures governing a) indemnification of directors and officers of the Hospital or any Danbury Subsidiary; b) conflicts or dualities of interest; c) accounting and investment standards and practices and d) such other policies the Member may determine; -Approval of system-wide quality, performance and credentialing standards and procedures to which the Hospital or any Danbury Subsidiary is expected to adhere; and -Approval of regulatory compliance and methodology for physician compensation arrangements. The actions listed below, taken for the Hospital or in its capacity voting as a shareholder or member of a Danbury Subsidiary, which require approval of the Board, must also be approved by the Member: -The election and removal of a director of a Danbury Subsidiary; -The election of the officers of the Hospital; -Approval of all operating and capital budgets of the Hospital and Danbury Subsidiary; -Approval of any amendment or restatement of the Hospital's certificate of incorporation, bylaws, or operating agreement of any Danbury Subsidiary; -Approval of any sale, lease, exchange, or other disposition of all or substantially all the property or assets of the Hospital or any Danbury Subsidiary; -Approval of the creation of any corporation of which the Hospital or a Danbury Subsidiary is the sole or controlling member or sole or controlling shareholder; the merger or consolidation of the Hospital or any Danbury Subsidiary with another corporation;and the reorganization, liquidation or dissolution of the Hospital or any Danbury Subsidiary; -Approval of any loans by the Hospital or any Danbury Subsidiary,or the incurring of any indebtedness, secured or unsecured, which exceeds two million dollars ($2.0 million) or which has a term longer than one year; -Approval of unbudgeted expenditures in excess of two million dollars ($2.0 million) or any increase in any approved annual operating or capital budget. -Approval of any agreement or transaction of the Hospital or any Danbury Subsidary involving an amount greater than two million dollars ($2.0 million)with another individual or entity; -Approval of the affiliation of the Hospital or any Danbury Subsidiary with any other entity for the purposes of the joint conduct of business; -Creation of any committee which shall have the authority to act on behalf of the Board or on behalf of any Danbury Subsidiary; -Approval of any conveyance of, or the granting of mortgages or trusts on any real property assets of the Hospital or of any Danbury Subsidiary; -Approval of the strategic plan of the Hospital and of any Danbury Subsidiary; and -Approval of any commencement, cessation, location, relocation or consolidation of significant clinical services provided by the Hospital or any Danbury Subsidiary.
990, Part VI, Line 11B Steven Rosenberg, SVP/CFO of Western Connecticut Health Network, Inc., will review the 990 prior to it being sent to the IRS. A preliminary 990, is presented to the Audit Committee in June, who reviews it on behalf of the Board. E&Y is on hand to review the 990 with the Audit Committee and answer any questions. Prior to the 990 being filed with the IRS, the Board will receive a full and accurate copy on a secured website for their review.
990, Part VI, Line 12C The Organization's Process for Monitoring and Enforcing Conflicts of Interest The Western Connecticut Health Network and its affiliates' (The Network) Conflict of Interest Policy provides that annually, its Representatives shall sign a statement affirming that they disclosed all potential conflicts, as documented in the Conflict of Interest Policy. In addition, General Counsel is part of the routine contracts review process and watches for potential conflicts with any of The Network's Representatives. Who Is Covered By the Policy The Network's Conflict of Interest Policy covers each director, officer and manager of The Network, also referred to as "Representatives". Level At Which Determinations of Whether There Is a Conflict In connection with any actual or possible conflict of interest, an interested person must disclose the facts of the conflict. The Compliance Officer and the Audit Committee review and evaluate each disclosure to determine if there is a conflict of interest. After presentation of a potential transaction or arrangement is made by an interested person, the remaining disinterested Board or Committee members shall decide if a conflict of interest exist. Level That Reviews and Determines What To Do If There Is a Conflict After exercising due diligence the full Board would determine what actions should be taken for all conflicts by Officers and Directors. Any conflicts occurring by a manager are reviewed by the Compliance Committee to determine what further action should be taken. Restrictions on The Conflicted Person No director having a conflict of interest on any matter shall vote on that matter or be counted in determining the quorum for the meeting at which the vote is taken, even when permitted by law. No Representative having a conflict of interest on any matter shall use his or her personal influence on the matter. If the Board of Directors, in its sole discretion, determines that any Representative has conflicts of interest sufficient in number and/or importance that the effectiveness of such individual on behalf of The Network may be significantly impaired, the Board may ask the individual to resign.
Part V, Line 15B Compensation for Other Officers and Key Employees: In order to achieve its mission and its overall performance objectives, Western Connecticut Health Network, Inc. employs a performance-based total compensation program for its senior executives that is market competitive, compliant with regulatory guidelines, and representative of best practices. Eligible executives are generally direct reports of the CEO along with other executives designated by the CEO. To meet Western Connecticut Health Network Inc.'s total compensation objectives for executives, the following survey sources are used for comparison purposes: -Blend of national Confidential Source, IHS, and Hay Group points, health care data (where data available), plus 15% geographic differential. Title match data cuts selected based on revenue size. -For Physician executives, surveys covering physician compensation in accredited medical schools (AAMC) are used in combination with proprietary surveys compiled by nationally known consulting firm, Sullivan Cotter and the Medical Group Management Association (MGMA). Western Connecticut Health Network, Inc. targets cash compensation at market competitive levels. Base salary plus short-term (annual) incentive awards (total cash) approximate market competitive levels for total cash compensation. Executive performance is expected to meet or exceed predetermined operational and financial metrics. Other factors, such as competitive market forces, job performance, unique qualifications, and/or individual job responsibilities are also considered in Western Connecticut Health Network, Inc's executive compensation decisions. Roles of the Compensation Committee and Key Executives in the Executive Compensation Process - The Compensation Committee in consultation with the CEO and the SVP Human Resources (HR) selects the outside compensation consultants. The current consultant is the Hay Group, whose purpose is to provide a valid independent assessment of the relevant market rates and pay practices for health care executives, physician executives and for physicians in general. - The compensation consulting firm compiles appropriate market data, job evaluation and ranking information for all executives and physicians of the organization, excluding the CEO, and will supply this material to the CEO and SVP HR for review and agreement. Once the report is final, it will be supplied to the Compensation Committee for their consideration and acceptance. -The Compensation Committee determines the CEO's salary based on overall performance and market data supplied by the outside compensation consultant. The last executive compensation evaluation by an outside consultant was done in December, 2015.
990, Part VI, Line #19 The information that has been posted on Danbury Hospital's website for 2014 includes: The Code of Business Ethics, information about our Compliance Program, and a copy of our policy regarding Preventing of Fraud, Waste and Abuse. All governing documents required by law and the financial statements are made available upon request. The conflict of interest policy is available upon request.
Form 990, Part VII (Comments Attached) NEIL CULLIGAN, MD A stipend was paid to Neil Culligan, MD, a director, during the year for stroke program directorship and Chief of Neurology. It was not reflected in Part VII as compensation, since it was in box #6 rather than box #7 of the 1099. DAVID KRAMER, MD (TO 1/1) David Kramer was a director to January 1, 2015. MIKE DAGLIO (TO 11/2) Mike Daglio was Chief Operating Officer of Danbury Hospital until November 2, 2014, when he became the President of Norwalk Hospital. LISA SCHMITTGALL (TO 12/31) Lisa Schmittgall's employment was terminated on December 31, 2014.
Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances CAPTIVE UBI . . . . . . . . . . . . . . . . . . . . . . . $ -14,369. CHANGE IN EQUITY INTEREST OF WCHNIC. . . . . . . . . . . . 13,329,262. CHANGE IN INVESTMENT OF WHNF. . . . . . . . . . . . . . . .-16,094,946. EQUITY TRANSFER TO WCHN-W/O OF INTERCOMPANY. . . . . . . . -19,356,313. EQUITY TRANSFER TO WCMG-W/O OF INTERCOMPANY. . . . . . . . -13,034,066. NMH NET ASSETS TRFD TO DH. . . . . . . . . . . . . . . . . .34,128,301. ______________________ Total $ -1,042,131.
FORM 990 PART IX LINE 11G DESCRIPTION:HEALTHCARE PROFESSIONALS TOTAL FEES:74824188
FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:30116156
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


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SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet
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
Danbury Hospital
 
Employer identification number

06-0646597
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity











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


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


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

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1) West CT Health Network Affiliates
95 Locust Avenue

Danbury,CT06810
22-2594968
OP HLTHCR SVC CT 501(C)(3) 9 WCHN
 
Yes
 
(2) Western CT Health Network Inc
24 Hospital Avenue

danbury,CT06810
22-2594977
PROGRAM DEVLP CT 501(C)(3) 11, TYPE 2 NA
 
 
No
(3) West CT Health Network Foundation
24 Hospital Avenue

Danbury,CT06810
23-7425557
ADMIN CONTRIB CT 501(C)(3) 7 WCHN
 
Yes
 
(4) Western CT Home Care Inc
4 Liberty Street

Danbury,CT06810
06-0655138
HOME HLTHCARE CT 501(C)(3) 9 WCHN
 
Yes
 
(5) Western CT Medical Group Inc
14 Research Drive Suite 201A

Bethel,CT06801
06-1137531
PHYSICIAN SVC CT 501(C)(3) 9 WCHN
 
Yes
 
(6) Eastern NY Medical Services PC
14 Research Drive Suite 201A

Bethel,CT06810
45-5431389
PHYSICIAN SVC NY 501(C)(3) 9 WCHN
 
Yes
 
(7) The Norwalk Hospital Association
24 Stevens Street

Norwalk,CT06850
06-6068853
HEALTH SVCS CT 501 (C) (3) 3 NHSC
 
Yes
 
(8) Norwalk Hospital Phys and Surgeons
24 Stevens Street

Norwalk,CT06850
06-1522078
PHYSICIAN SVC CT 501 (C) (3) 11, TYPE 2 NHSC
 
Yes
 
(9) Norwalk Health Care Inc
24 Stevens Street

Norwalk,CT06850
22-2577722
INACTIVE CT 501 (C) (3) 9 NHSC
 
Yes
 
(10) Norwalk Hospital Foundation
34 Maple Street

Norwalk,CT06850
22-2577708
ADMIN CONTRIB CT 501 (C) (3) 7 NHSC
 
Yes
 
(11) Advanced Ctr for Rehab Medicine
24 Stevens Street

Norwalk,CT06850
06-1304799
INACTIVE CT 501 (C) (3) 11, TYPE 2 NHSC
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2014
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


Yes No Yes No
(1) New Milford MRI

21 Elm Street
New Milford,CT06776
27-1877801
INACTIVE CT NMH
 
N/A 0 0   No 0   No  
(2) Norwalk Surgery

40 Cross Street
Norwalk,CT06851
27-2394942
SURGERY CENTER CT NH
 
RELATED 0 0   No 0   No  










Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) West CT Health Network Insur

23 Lime Tree Bay PO Box 105
Grand Cayman    
CJ
98-0438151
MALPRCTICE CJ DH
 
C CORP 23,409,419 132,830,968 100.000 % Yes  
(2) Medical Services of Danbury

24 Hospital Avenue
Danbury,CT06811
06-1635945
INACTIVE CT WCMG
 
C CORP 0 0   Yes  
(3) SWC Corporation

24 Stevens Street
Norwalk,CT06850
22-2577718
PHARMACY CT NHSC
 
C CORP 0 0   Yes  








Schedule R (Form 990) 2014
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
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
Yes
 
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) West CT Health Network Affiliates

j 104,356 COST
(2) West CT Health Network Affiliates

l 357,015 COST
(3) West CT Health Network Affiliates

m 477,289 COST
(4) West CT Health Network Affiliates

o 154,934 COST
(5) West CT Health Network Affiliates

q 5,906,776 COST
(6) West CT Health Network Affiliates

s 6,324,920 COST
(7) West CT Health Network Foundation

c 11,877,473 cost
(8) West CT Health Network Foundation

j 81,493 cost
(9) West CT Health Network Foundation

k 56,258 cost
(10) West CT Health Network Foundation

o 1,966,467 cost
(11) West CT Health Network Foundation

q 1,848,190 cost
(12) West CT Health Network Foundation

s 8,701,234 cost
(13) Western CT Home Care Inc

l 154,967 cost
(14) Western CT Home Care Inc

o 147,394 cost
(15) Western CT Home Care Inc

q 859,175 cost
(16) Western CT Home Care Inc

r 250,000 cost
(17) Western CT Home Care Inc

s 1,194,306 cost
(18) Western CT Medical Group Inc

b 13,034,066 cost
(19) Western CT Medical Group Inc

i 97,726 cost
(20) Western CT Medical Group Inc

j 2,319,887 cost
(21) Western CT Medical Group Inc

l 4,028,047 cost
(22) Western CT Medical Group Inc

m 67,706,087 cost
(23) Western CT Medical Group Inc

o 962,897 cost
(24) Western CT Medical Group Inc

q 75,038,541 cost
(25) Western CT Medical Group Inc

s 1,622,201 cost
(26) Eastern NY Medical Services PC

q 169,718 cost
(27) The Norwalk Hospital Association

i 1,012,175 cost
(28) The Norwalk Hospital Association

j 416,543 cost
(29) The Norwalk Hospital Association

l 5,792,729 cost
(30) The Norwalk Hospital Association

o 9,606,088 cost
(31) The Norwalk Hospital Association

q 11,936,824 cost
(32) The Norwalk Hospital Association

s 24,191,633 cost
(33) Norwalk Hospital Phys and Surgeons

o 127,264 cost
(34) Norwalk Hospital Phys and Surgeons

q 670,239 cost
(35) Norwalk Hospital Phys and Surgeons

s 783,006 cost
(36) West CT Health Network Insur Co LTD

q 10,981,551 cost
(37) West CT Health Network Insur Co LTD

r 13,106,977 cost
(38) West CT Health Network Insur Co LTD

s 10,910,500 cost
(39) SWC Corporation

o 128,029 Cost
(40) SWC Corporation

q 105,949 cost
(41) SWC Corporation

r 214,835 cost
Schedule R (Form 990) 2014
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)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2014
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, Part III - Partnership Full Name, Address, FEIN New Milford MRI JV, LLC 27-1877801 21 Elm Street New Milford, CT 06776 Norwalk Surgery Center, LLC 27-2394942 40 Cross Street, #120 Norwalk, CT 06851
Schedule R (Form 990) 2014
Additional Data


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