Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
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| FORM 990, PART VI | PART I, LINE 4 & PART VI, LINE 1B NUMBER OF INDEPENDENT VOTING MEMBERS OF THE GOVERNING BODY THE ORGANIZATION SOUGHT TO CONFIRM THE INDEPENDENCE OF EACH VOTING MEMBER OF ITS GOVERNING BODY BY REQUESTING THAT EACH SUCH VOTING MEMBER RESPOND TO A QUESTIONNAIRE CONTAINING THE PERTINENT INSTRUCTIONS AND DEFINITIONS AND DESIGNED TO ELICIT THE INFORMATION NECESSARY TO DETERMINE INDEPENDENCE. BASED ON RESPONSES TO THE QUESTIONNAIRES RECEIVED BY THE ORGANIZATION AND ANNUAL CONFLICTS OF INTEREST DISCLOSURES, THE ORGANIZATION WAS ABLE TO CONFIRM THAT NONE OF THE VOTING MEMBERS ARE INDEPENDENT. THE ORGANIZATION IS A RELATED ORGANIZATION OF BRIDGEPORT HOSPITAL. PURSUANT TO ITS BYLAWS, ALL MEMBERS OF THE ORGANIZATION'S BOARD OF TRUSTEES ARE APPOINTED BY BRIDGEPORT HOSPITAL AS A FUNCTION OF THEIR POSITIONS AS OFFICERS OF BRIDGEPORT HOSPITAL. AS A RESULT, NONE OF THE ORGANIZATION'S VOTING MEMBERS ARE INDEPENDENT BECAUSE ALL ARE COMPENSATED AS OFFICERS OR EMPLOYEES OF THE ORGANIZATION OR A RELATED ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 2 | BUSINESS RELATIONSHIPS BETWEEN OFFICERS, DIRECTORS, TRUSTEES, OR KEY EMPLOYEES CERTAIN OF THE ORGANIZATION'S CURRENT OFFICERS AND/OR TRUSTEES MAY SERVE AS OFFICERS AND/OR DIRECTORS OF TAX-EXEMPT AND TAXABLE AFFILIATES WITHIN THE ORGANIZATION'S CORPORATE SYSTEM OR JOINT VENTURES IN WHICH THE ORGANIZATION'S CORPORATE SYSTEM HAS AN OWNERSHIP INTEREST. THE INDIVIDUAL OFFICERS AND/OR TRUSTEES DO NOT HAVE PERSONAL FINANCIAL INTERESTS IN SUCH AFFILIATES AND SERVE ONLY AS A FUNCTION OF THEIR ROLES WITH THE ORGANIZATION OR WITHIN THE ORGANIZATION'S CORPORATE SYSTEM. |
| FORM 990, PART VI, SECTION A, LINE 6 | BRIDGEPORT HOSPITAL IS THE ORGANIZATION'S SOLE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE ORGANIZATION'S SOLE MEMBER, BRIDGEPORT HOSPITAL, HAS THE RIGHT TO ELECT THE ORGANIZATION'S BOARD OF TRUSTEES IN ACCORDANCE WITH THE BYLAWS. |
| FORM 990, PART VI, SECTION A, LINE 7B | BRIDGEPORT HOSPITAL, AS THE ORGANIZATION'S SOLE MEMBER, AND YALE NEW HAVEN HEALTH SERVICES CORPORATION, AS THE ULTIMATE PARENT OF THE YALE NEW HAVEN HEALTH SYSTEM (YNHHS) HAVE THE RIGHTS, POWERS AND PRIVILEGES SET FORTH IN THE ORGANIZATION'S BYLAWS, INCLUDING, IN PART, THE AUTHORITY TO APPROVE THE NOMINEES TO THE ORGANIZATION'S BOARD OF TRUSTEES, AMENDMENTS TO THE GOVERNING DOCUMENTS, OPERATING AND CAPITAL BUDGETS, INITIATION OF NEW PROGRAMS AND CLINICAL SERVICES OR THE DISCONTINUATION OR CONSOLIDATION OF SUCH PROGRAMS, AND CERTAIN FUNDAMENTAL CORPORATION TRANSACTIONS. IN ADDITION, YNHHS HAS SOLE AUTHORITY TO TAKE CERTAIN ACTIONS, INCLUDING, IN PART, THE ISSUANCE AND INCURRENCE OF INDEBTEDNESS. |
| FORM 990, PART VI, SECTION A, LINE 8B | THIS ORGANIZATION DOES NOT HAVE ANY BOARD COMMITTEES. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 TAX RETURN AND ATTACHED SCHEDULES WERE PREPARED BY EMPLOYEES OF THE YNHHS TAX DEPARTMENT. THE RETURN IS INITIALLY REVIEWED BY THE EXECUTIVE DIRECTOR/DIRECTOR OF FINANCE. SUBSEQUENTLY IT IS SENT TO KPMG LLP FOR THEIR INITIAL REVIEW. AFTER ALL COMMENTS FROM THE ABOVE GROUP ARE CLEARED, THE RETURN IS THEN REVIEWED BY THE CHIEF FINANCIAL OFFICER OF THE ORGANIZATION'S SOLE MEMBER, BRIDGEPORT HOSPITAL. A FINAL VERSION OF THE RETURN IS SENT BACK TO KPMG LLP FOR FINAL REVIEW. PRIOR TO FILING, THE ORGANIZATION MADE AVAILABLE A COMPLETE COPY OF THE RETURN TO THE BOARD OF TRUSTEES. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE SOUTHERN CONNECTICUT HEALTH SYSTEM PROPERTIES INC. IS COVERED UNDER THE YNHHS CONFLICT OF INTEREST POLICY APPROVED AND ADOPTED BY THE SYSTEM COMPLIANCE COMMITTEE, WHICH HAS BEEN DELEGATED THE AUTHORITY TO APPROVE AND ADOPT COMPLIANCE POLICIES ON BEHALF OF THE ENTITIES IN THE SYSTEM. THE YALE NEW HAVEN HEALTH SYSTEM CONFLICT OF INTEREST POLICY AND INDIVIDUAL ANNUAL DISCLOSURE FORM APPLIES TO A POOL OF EMPLOYEES, BOARD MEMBERS AND NON-BOARD MEMBERS SERVING ON BOARD COMMITTEES. THESE "COVERED INDIVIDUALS" ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT, UPON BEGINNING EMPLOYMENT OR OTHERWISE BECOMING A COVERED INDIVIDUAL AND ANNUALLY THEREAFTER. COVERED INDIVIDUALS ARE ALSO REQUIRED TO IMMEDIATELY REPORT MATERIAL CHANGES TO THEIR MOST RECENTLY COMPLETED DISCLOSURE STATEMENT. THESE DISCLOSURE STATEMENTS AND REPORTS ARE REVIEWED BY THE OFFICE OF PRIVACY AND CORPORATE COMPLIANCE AND/OR THE LEGAL AND RISK SERVICES DEPARTMENT TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. IF A POTENTIAL CONFLICT ARISES, THE PRESIDENT OF THE HOSPITAL WOULD CONSULT WITH THE BOARD CHAIRPERSON AND THE LEGAL AND RISK SERVICES DEPARTMENT AND TAKE ANY ACTIONS THAT SHE DEEMS REQUIRED OR APPROPRIATE TO MANAGE OR RESOLVE A POTENTIAL CONFLICT OF INTEREST. FOR EXAMPLE, A VOTING BOARD OR COMMITTEE MEMBER WOULD BE REQUIRED TO RECUSE HIMSELF OR HERSELF FROM VOTING ON MATTERS RELATED TO THE POTENTIAL CONFLICT AND THE POTENTIAL CONFLICT WOULD BE DISCLOSED TO OTHER VOTING MEMBERS. FORM 990, PART VI, SECTION B, LINES 13 & 14: THE SOUTHERN CONNECTICUT HEALTH SYSTEM PROPERTIES INC. IS COVERED UNDER THE YNHHS DOCUMENT RETENTION AND WHISTLEBLOWER POLICIES APPROVED AND ADOPTED BY THE SYSTEM COMPLIANCE COMMITTEE, WHICH HAS BEEN DELEGATED THE AUTHORITY TO APPROVE AND ADOPT COMPLIANCE POLICIES ON BEHALF OF THE ENTITIES IN THE SYSTEM. |
| FORM 990, PART VI, SECTION C, LINE 19 | COPIES OF FORM 990, FORM 1024 (IF AVAILABLE) AND AUDITED FINANCIAL STATEMENTS ARE MAINTAINED IN THE YNHHS TAX DEPARTMENT. OTHER CORPORATE GOVERNING DOCUMENTS ARE MAINTAINED BY THE LEGAL AND RISK SERVICES DEPARTMENT. THE CONFLICT OF INTEREST POLICY, WHISTLEBLOWER POLICY, AND DOCUMENT RETENTION POLICY ARE AVAILABLE TO ALL EMPLOYEES ON THE CORPORATE INTERNAL WEBSITE. COPIES OF ALL DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OUTSIDE CONTRACTUAL SERVICES: PROGRAM SERVICE EXPENSES 40,905. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 40,905. |
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