Form990
Click to see attachment
Department of the TreasuryInternal 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)
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OMB No. 1545-0047
2018
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 10-01-2018 , and ending 09-30-2019
BCheck if applicable:
CName of organization
CONNECTICUT CHILDREN'S MEDICAL CENTER
 
% THOMAS M HONAN
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
282 WASHINGTON STREET
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
HARTFORD, CT061063322
D Employer identification number

06-0646755
E Telephone number

G Gross receipts $ 393,917,104
F Name and address of principal officer:
JAMES E SHMERLING DHA FACHE
282 WASHINGTON STREET
HARTFORD,CT061063322
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.CONNECTICUTCHILDRENS.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: 1921
M State of legal domicile: CT
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: CONNECTICUT CHILDREN'S MEDICAL CENTER IS DEDICATED TO IMPROVING THE PHYSICAL AND EMOTIONAL HEALTH OF CHILDREN THROUGH FAMILY-CENTERED CARE, RESEARCH, EDUCATION AND ADVOCACY.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 18
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 16
5 Total number of individuals employed in calendar year 2018 (Part V, line 2a) ...... 5 2,261
6 Total number of volunteers (estimate if necessary) ............. 6 326
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 23,044,053 26,740,770
9 Program service revenue (Part VIII, line 2g) ......... 341,889,316 365,325,590
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... -131,835 66,409
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 2,186,170 1,779,231
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 366,987,704 393,912,000
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 185,281 200,630
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) 167,892,476 182,565,533
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).... 165,277,411 173,233,201
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 333,355,168 355,999,364
19 Revenue less expenses. Subtract line 18 from line 12....... 33,632,536 37,912,636
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 447,316,131 452,452,793
21 Total liabilities (Part X, line 26)............. 132,927,688 136,022,086
22 Net assets or fund balances. Subtract line 21 from line 20..... 314,388,443 316,430,707
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
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Signature of officer Date
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Type or print name and title
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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 (2018)
Form 990 (2018)
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: CONNECTICUT CHILDREN'S MEDICAL CENTER IS DEDICATED TO IMPROVING THE PHYSICAL AND EMOTIONAL HEALTH OF CHILDREN THROUGH FAMILY-CENTERED CARE, RESEARCH, EDUCATION AND ADVOCACY. WE EMBRACE DISCOVERY, TEAMWORK, INTEGRITY AND EXCELLENCE IN ALL THAT WE DO. THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL CHILDREN IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.
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 $ 274,080,332 including grants of $ 200,630 ) (Revenue $ 365,325,590 )
EXPENSES INCURRED TO PROVIDE ACUTE CARE INPATIENT AND OUTPATIENT SERVICES TO CHILDREN FROM CONNECTICUT AND THE SURROUNDING AREA. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet274,080,332
Form 990 (2018)
Form 990 (2018)
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 IIIClick to see attachment.................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment..................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part IIIClick to see attachment.............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
Yes
 
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
Yes
 
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
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........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 IV.....Click 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 attachment
20b
Yes
 
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.....Click to see attachment
21
Yes
 
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........Click to see attachment
22
Yes
 
Form 990 (2018)
Form 990 (2018)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
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............
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L,
Part IV........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV.....................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I.
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II...........
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........Click to see attachment
33
Yes
 
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
 
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
328
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
 
Form 990 (2018)
Form 990 (2018)
Page 5
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
2,261
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for 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
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? If "Yes," see instructions and file Form 4720, Schedule N .....
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income?
If "Yes," complete Form 4720, Schedule O ................
16
 
No
Form 990 (2018)
Form 990 (2018)
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
18
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
16
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
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A 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:
MediumBulletTHOMAS M HONAN282 WASHINGTON STREET   HARTFORD,CT06106 (860) 545-8544
Form 990 (2018)
Form 990 (2018)
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) DAVID M ROTH ESQ......................................................................
CHAIRMAN - DIRECTOR
 1.0
.................
0.0 		X   X       0 0 0
(2) JAMES W FANELLI CFP......................................................................
VICE CHAIRMAN - DIRECTOR
 1.0
.................
0.0 		X   X       0 0 0
(3) TINA BROWN-STEVENSON......................................................................
SECRETARY - DIRECTOR
 1.0
.................
0.0 		X   X       0 0 0
(4) ANDREA BALOGH......................................................................
DIRECTOR
 1.0
.................
0.0 		X           0 0 0
(5) E CLAYTON GENGRAS III......................................................................
DIRECTOR
 1.0
.................
0.0 		X           0 0 0
(6) PRESTON KODAK III......................................................................
DIRECTOR
 1.0
.................
0.0 		X           0 0 0
(7) CATO LAURENCIN MD PHD......................................................................
DIRECTOR
 1.0
.................
0.0 		X           0 0 0
(8) DOROTHY LEVINE MD......................................................................
DIRECTOR
 1.0
.................
0.0 		X           0 0 0
(9) MEGAN MACKEY EDD......................................................................
DIRECTOR
 1.0
.................
0.0 		X           0 0 0
(10) BURKE MAGNUS......................................................................
DIRECTOR
 1.0
.................
0.0 		X           0 0 0
(11) CARLOS MOUTA......................................................................
DIRECTOR
 1.0
.................
0.0 		X           0 0 0
(12) MICHELLE MURPHY......................................................................
DIRECTOR
 1.0
.................
0.0 		X           0 0 0
(13) KOLAWOLE A OLOFINBOBA MD......................................................................
DIRECTOR
 1.0
.................
0.0 		X           0 0 0
(14) TINA ST PIERRE......................................................................
DIRECTOR
 1.0
.................
0.0 		X           0 0 0
(15) JONATHAN RUBIN......................................................................
DIRECTOR
 1.0
.................
0.0 		X           0 0 0
(16) JAMES E SHMERLING DHA FACHE......................................................................
DIRECTOR - PRESIDENT/CEO
 55.0
.................
0.0 		X   X       1,445,193 0 524,532
(17) JEFFREY THOMSON MD......................................................................
DIRECTOR - PRES MED STAFF
 55.0
.................
0.0 		X           0 769,631 63,948
Form 990 (2018)
Form 990 (2018)
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) ANDREW ZEITLIN........................................................................
DIRECTOR
 1.0
.......................0.0 		X           0 0 0
(19) KEVIN COUNIHAN........................................................................
DIRECTOR (TERM ENDED 11/2018)
 1.0
.......................0.0 		X           0 0 0
(20) SUSAN V HERBST PHD........................................................................
DIRECTOR (TERM ENDED 08/2019)
 1.0
.......................0.0 		X           0 0 0
(21) JEFFREY HYAMS MD........................................................................
DIRECTOR (TERM ENDED 12/2018)
 55.0
.......................0.0 		X           0 526,958 109,460
(22) KATHERINE O NIXON........................................................................
DIRECTOR (TERM ENDED 12/2018)
 1.0
.......................0.0 		X           0 0 0
(23) WILLIAM C POPIK MD........................................................................
DIRECTOR (TERM ENDED 12/2018)
 1.0
.......................0.0 		X           0 0 0
(24) SETH VAN ESSENDELFT........................................................................
TREASURER - SVP/CFO
 55.0
.......................0.0 		    X       389,599 0 184,133
(25) GIL PERI MBA MPH........................................................................
PRESIDENT & COO
 55.0
.......................0.0 		    X       553,530 0 310,954
(26) CHRISTINE FINCK MD FACS........................................................................
EVP, SURGEON IN CHIEF
 55.0
.......................0.0 		    X       0 890,682 286,662
(27) JUAN SALAZAR MD MPH........................................................................
EVP, ACADEMIC AFFAIRS
 55.0
.......................0.0 		    X       601,799 0 217,372
(28) PAUL H DWORKIN MD........................................................................
EVP, COMMUNITY CHILD HEALTH
 55.0
.......................0.0 		    X       548,972 0 158,976
(29) ANN G TAYLOR JD........................................................................
EVP, CHIEF ADM OFF(TERM 02/19)
 55.0
.......................0.0 		    X       429,453 0 113,160
(30) LAWRENCE E MILAN MA........................................................................
SVP, HUMAN RESOURCES
 55.0
.......................0.0 		    X       355,594 0 116,722
(31) AIMEE MONROY SMITH........................................................................
SVP GOVT RELATIONS(EFF 05/19)
 55.0
.......................0.0 		    X       0 0 9,335
(32) BOBBY M VARGAS ESQ........................................................................
VP, GENERAL COUNSEL
 55.0
.......................0.0 		    X       370,557 0 143,073
(33) KELLY STYLES MBA........................................................................
SVP, CHIEF INFORMATION OFFICER
 55.0
.......................0.0 		      X     396,209 0 122,863
(34) CHERYL HOEY RN BSN MBA........................................................................
SVP, CLINICAL SERVICES & CNO
 55.0
.......................0.0 		      X     378,184 0 120,834
(35) JAMES MOORE MD PHD........................................................................
VP CLINICAL NTK DEV(EFF 07/19)
 55.0
.......................0.0 		      X     0 526,553 212,593
(36) WILLIAM AGOSTINUCCI MS RPH........................................................................
VP, CLINICAL & SUPPORT SVCS
 55.0
.......................0.0 		      X     297,590 0 95,713
(37) DEB PAPPAS MBA........................................................................
VP MKTG/COMMUNICATIONS OFFICER
 55.0
.......................0.0 		      X     280,577 0 117,514
(38) TRISHA FARMER MSN RN CPHRM........................................................................
VP, REG PARTNERSHIPS & OPS
 55.0
.......................0.0 		      X     244,115 0 106,310
(39) LORI R PELLETIER PHD MBA........................................................................
CHIEF QUALITY OFF (EFF 08/19)
 55.0
.......................0.0 		      X     0 0 0
(40) HEATHER TORY MD MPH CPPS........................................................................
INTERIM PAT SFTY(10/18-07/19)
 55.0
.......................0.0 		      X     178,093 0 18,515
(41) RICHELLE DEMAYO MD........................................................................
CHIEF MED INFORMATION OFFICER
 55.0
.......................0.0 		      X     338,922 0 69,881
(42) GLENN FLORES........................................................................
CHIEF RESEARCH OFFICER
 55.0
.......................0.0 		      X     344,095 0 142,324
(43) JUNG PARK........................................................................
SR DIR, INFORMATION SERVICES
 55.0
.......................0.0 		        X   252,260 0 45,423
(44) MARLENE E FERRIS........................................................................
SR DIR, ORGANIZATIONAL EFFECT.
 55.0
.......................0.0 		        X   228,867 0 19,011
(45) LOUISE M VIOLETTE........................................................................
SR DIR, FINANCE APPLICATION
 55.0
.......................0.0 		        X   204,695 0 63,493
(46) SHANNON M GRAD........................................................................
SR DIR, FAMILY EXP & PROF PRAC
 55.0
.......................0.0 		        X   199,876 0 40,410
(47) PHILIP B HOPKINS........................................................................
DIRECTOR TECHNICAL SERVICES
 55.0
.......................0.0 		        X   198,308 0 28,430
(48) ANDREA L BENIN MD........................................................................
FORMER OFFICER
 0.0
.......................0.0 		          X 450,724 0 48,130
(49) PATRICK J GARVEY CPA CHFP........................................................................
FORMER OFFICER
 0.0
.......................0.0 		          X 407,712 0 47,077
(50) AUDREY WISE MBA........................................................................
FORMER OFFICER
 0.0
.......................0.0 		          X 173,032 0 22,535
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 9,267,956 2,713,824 3,559,383
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet228
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
UNIVERSITY OF CONNECTICUT HEALTH CE,
263 FARMINGTON AVENUE
FARMINGTON,CT06032 		MEDICAL 39,068,110
HARTFORD HOSPITAL,
80 SEYMOUR STREET PO BOX 5037
HARTFORD,CT061025037 		MEDICAL 7,974,088
ARAMARK FACILITY SERVICES,
PO BOX 651009
CHARLOTTE,NC282651009 		CAFETERIA/DIETARY 2,891,385
EPIC SYSTEMS CORPORATION,
PO BOX 88314
MILWAUKEE,WI53288 		IT 2,145,849
AMN HEALTHCARE INC,
12400 HIGH BLUFF DRIVE
SAN DIEGO,CA92130 		STAFFING 1,966,186
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet76
Form 990 (2018)
Form 990 (2018)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 11,112,099
e Government grants (contributions)1e 7,008,118
f All other contributions, gifts, grants, and similar amounts not included above1f 8,620,553
g Noncash contributions included in lines 1a - 1f:$  
h Total. Add lines 1a-1f.......MediumBullet 26,740,770
Program Service RevenueAmt Business Code
2a NET PATIENT SERVICE REVENUE 541900 350,321,309 350,321,309    
b OTHER HEALTHCARE RELATED REVENUE 541900 15,004,281 15,004,281    
c
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f ....MediumBullet 365,325,590
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 71,513     71,513
4 Income from investment of tax-exempt bond proceedsMediumBullet 0      
5 Royalties...........MediumBullet 0      
(ii) Personal (i) Real
6a Gross rents   128,426
b Less: rental expenses    
c Rental income or (loss) 0 128,426
d Net rental income or (loss)......MediumBullet 128,426     128,426
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 0  
b Less: cost or other basis and sales expenses 5,104  
c Gain or (loss) -5,104  
d Net gain or (loss).....MediumBullet -5,104     -5,104
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
a 0
b Less: direct expenses ...b 0
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a 0
b Less: direct expenses ...b 0
c Net income or (loss) from gaming activities..MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances ..
a 0
b Less: cost of goods sold ..b 0
c Net income or (loss) from sales of inventory..MediumBullet 0      
Business Code Miscellaneous Revenue
11a FOOD SERVICES 453000 1,281,614     1,281,614
b CONSULTING 541900 344,691     344,691
c OTHER INCOME 541900 24,500     24,500
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 1,650,805
12 Total revenue. See Instructions......MediumBullet 393,912,000 365,325,590   1,845,640
Form 990 (2018)
Form 990 (2018)
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 21 147,130 147,130
2 Grants and other assistance to domestic individuals. See Part IV, line 22 53,500 53,500
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16. 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 9,724,713   9,724,713  
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 145,575,973 117,600,910 27,975,063  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 7,464,345 7,464,345 0  
9 Other employee benefits ....... 10,289,918 8,147,877 2,142,041  
10 Payroll taxes ........... 9,510,584 7,323,150 2,187,434  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 417,813 321,716 96,097  
c Accounting ........... 406,323 312,869 93,454  
d Lobbying ........... 422,983   422,983  
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 0      
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 47,050,556 36,228,928 10,821,628 0
12 Advertising and promotion .... 2,114,406 1,628,093 486,313  
13 Office expenses ....... 5,867,473 4,517,954 1,349,519  
14 Information technology ...... 5,294,076 4,076,439 1,217,637  
15 Royalties .. 0      
16 Occupancy ........... 12,868,007 9,908,365 2,959,642  
17 Travel ............ 843,251 649,303 193,948  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 933,688 718,940 214,748  
20 Interest ........... 2,230,881 1,717,778 513,103  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization .. 17,729,825 8,705,884 9,023,941  
23 Insurance ... 3,814,635 2,937,269 877,366  
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 41,345,067 31,835,702 9,509,365  
b SPECIALITY GROUP SUPPORT 14,960,153 14,960,153 0  
c GRANT EXPENDITURES 7,759,993 7,759,993 0  
d REPAIRS & MAINTENANCE 5,730,999 4,412,869 1,318,130  
e All other expenses 3,443,072 2,651,165 791,907  
25 Total functional expenses. Add lines 1 through 24e 355,999,364 274,080,332 81,919,032 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 (2018)
Form 990 (2018)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 3,092,574 1 4,229,102
2 Savings and temporary cash investments ......... 0 2 0
3 Pledges and grants receivable, net ...... 0 3 0
4 Accounts receivable, net ............. 44,677,260 4 50,345,261
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 .... 0 7 0
8 Inventories for sale or use ........ 3,107,959 8 4,471,038
9 Prepaid expenses and deferred charges ...... 982,807 9 2,143,092
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 343,868,888
b Less: accumulated depreciation 10b 208,045,750 137,100,971 10c 135,823,138
11 Investments—publicly traded securities . 0 11 0
12 Investments—other securities. See Part IV, line 11 ..... 0 12 0
13 Investments—program-related. See Part IV, line 11 .. 224,181,831 13 227,725,955
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 34,172,729 15 27,715,207
16 Total assets. Add lines 1 through 15 (must equal line 34)... 447,316,131 16 452,452,793
Liabilities 17 Accounts payable and accrued expenses ..... 43,852,537 17 45,017,927
18 Grants payable ... 0 18 0
19 Deferred revenue ......... 0 19 0
20 Tax-exempt bond liabilities ......... 36,736,470 20 31,359,264
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 .. 23,515,792 23 23,515,793
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 28,822,889 25 36,129,102
26 Total liabilities. Add lines 17 through 25.. 132,927,688 26 136,022,086
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 168,221,729 27 166,404,380
28 Temporarily restricted net assets ........... 146,166,714 28 150,026,327
29 Permanently restricted net assets 0 29 0
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 ........... 314,388,443 33 316,430,707
34 Total liabilities and net assets/fund balances ........ 447,316,131 34 452,452,793
Form 990 (2018)
Form 990 (2018)
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
393,912,000
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
355,999,364
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
37,912,636
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
314,388,443
5
Net unrealized gains (losses) on investments ...............
5
 
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
-35,870,372
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
316,430,707
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 (2018)
Form 990 (2018)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
CONNECTICUT CHILDREN'S MEDICAL CENTER
 
Employer identification number

06-0646755
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 12, check only one box.)
1
2
3
4
5
6
7
8
9

10
11
12
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- 10 above (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 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 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) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
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) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (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) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (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) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (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) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d 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 12a or 12b 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 (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) 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 section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
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 I of Schedule L (Form 990 or 990-EZ).
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 9a) 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 9a) 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 section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b 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
 
 
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
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
 
 
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, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) 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) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)
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 2018 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-2018 		(iii)
Distributable
Amount for 2018
1 Distributable amount for 2018 from Section C, line
6 		 
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2018:
a From 2013.......  
b From 2014.......  
c From 2015.......  
d From 2016.......  
e From 2017.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2018 distributable amount  
i Carryover from 2013 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2018 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2018 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2018, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions.		  
6 Remaining underdistributions for 2018. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions.		  
7 Excess distributions carryover to 2019. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a Excess from 2014......  
b Excess from 2015.....  
c Excess from 2016.....  
d Excess from 2017.....  
e Excess from 2018.....  
Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018
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) 2018


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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Name of the organization
CONNECTICUT CHILDREN'S MEDICAL CENTER
 
Employer identification number

06-0646755
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 isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2
Name of organization
CONNECTICUT CHILDREN'S MEDICAL CENTER
  		Employer identification number
06-0646755
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) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Page 3
Name of organization
CONNECTICUT CHILDREN'S MEDICAL CENTER
  		Employer identification number

06-0646755
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) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Page 4
Name of organization
CONNECTICUT CHILDREN'S MEDICAL CENTER
  		Employer identification number

06-0646755
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) (2018)

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 BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
If the organization answered "Yes" on 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" on 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" on 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
CONNECTICUT CHILDREN'S MEDICAL CENTER
 
Employer identification number

06-0646755
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 (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
 

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-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2018

Schedule C (Form 990 or 990-EZ) 2018
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) 2015 (b) 2016 (c) 2017 (d) 2018 (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) 2018


Schedule C (Form 990 or 990-EZ) 2018
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 on 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? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
Yes
 
353,879
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
69,104
j
Total. Add lines 1c through 1i ....................................................................................................
422,983
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, LINES 1G & 1I CONNECTICUT CHILDREN'S MEDICAL CENTER ADVOCATES FOR CHILD-FRIENDLY POLICIES AT THE CONNECTICUT GENERAL ASSEMBLY AND THE UNITED STATES CONGRESS. ADVOCACY CAN INCLUDE MESSAGING SENT TO LEGISLATORS VIA EMAIL, LETTERS AND SOCIAL MEDIA AND SOMETIMES THE PROVISION OF OPPORTUNITIES FOR MEDICAL CENTER EMPLOYEES, MEDICAL STAFF AND SUPPORTERS IN THE COMMUNITY TO REACH OUT TO THEIR SENATORS AND REPRESENTATIVES BY SHARING ACTION ALERTS THROUGH EMAIL. THE ORGANIZATION IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION, CONNECTICUT HOSPITAL ASSOCIATION AND NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS WHICH ALL ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS HAS BEEN ALLOCATED TOWARDS LOBBYING ACTIVITIES PERFORMED ON BEHALF OF THIS ORGANIZATION. THIS ALLOCATION AMOUNTED TO $69,104 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019. DURING THE FISCAL YEAR ENDING SEPTEMBER 30, 2019, THE ORGANIZATION PAID OUTSIDE INDEPENDENT CONSULTING FIRMS A TOTAL OF $221,890 TO LOBBY ON BEHALF OF THE MEDICAL CENTER FOR LEGISLATION AFFECTING CHILDREN'S HEALTH AND OTHER HEALTHCARE LEGISLATIVE MATTERS. THE ORGANIZATION HAS ALLOCATED TOWARD LOBBYING ACTIVITIES A PERCENTAGE OF COMPENSATION PAID TO CERTAIN CONNECTICUT CHILDREN'S MEDICAL CENTER EMPLOYEES TO REPRESENT TIME SPENT LOBBYING ON BEHALF OF THE ORGANIZATION. THIS ALLOCATION AMOUNTED TO $131,989 DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019. VOLUNTEER PARTICIPATION IN LOBBYING ACTIVITIES INCLUDING PHONE CALLS, EMAILS AND LETTERS TO LEGISLATORS AND FEDERAL AND STATE POLICY MAKERS REGARDING VARIOUS CHILD-RELATED ISSUES. THERE WAS NO MONEY INVOLVED IN THESE VOLUNTEER TRANSACTIONS.
Schedule C (Form 990 or 990EZ) 2018


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," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
SchDMd Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
CONNECTICUT CHILDREN'S MEDICAL CENTER
 
Employer identification number

06-0646755
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on 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" on 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 7/25/06, 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, 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" on 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 on 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 on 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) 2018

Schedule D (Form 990) 2018
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" on 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" on Form 990, Part IV, line 10.
(a)Current year (b)Prior year (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 24,246,534 22,333,915 22,429,597 22,267,000 21,942,979
b Contributions ... 1,705,658 1,611,103 100,411 883,341 498,716
c Net investment earnings, gains, and losses 677,067 1,154,088 163,306 263,705 1,211,645
d Grants or scholarships ... 0 0 0 0 0
e Other expenditures for facilities
and programs ... 		671,437 852,572 359,399 984,449 1,386,340
f Administrative expenses .... 0 0 0 0 0
g End of year balance ...... 25,957,822 24,246,534 22,333,915 22,429,597 22,267,000
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet0 %
c
Temporarily restricted endowment SchDMd Bullet100.000 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations .................
3a(i)
 
No
(ii) related organizations .................
3a(ii)
Yes
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on 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 .....      
b Buildings ....   123,680,021 68,630,343 55,049,678
c Leasehold improvements   40,241,060 14,970,047 25,271,013
d Equipment ....   149,732,643 121,813,391 27,919,252
e Other .....   30,215,164 2,631,969 27,583,195
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 135,823,138
Schedule D (Form 990) 2018

Schedule D (Form 990) 2018
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered "Yes" on 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)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on 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
(1)501(C)(3) TAX-EXEMPT ORG. 135,551,653 F
(2)FUNDS HELD IN TRUST BY OTHERS 92,074,302 F
(3)SPECIALISTS, INC. INVESTMENT 100,000 F
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet 227,725,955
Part IX
Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) DUE FROM AFFILIATED ENTITIES 11,196,577
(2) INSURANCE RECEIVABLE 2,099,339
(3) GROUND LEASE 2,211,638
(4) OTHER RECEIVABLES 10,225,661
(5) OTHER ASSETS 1,981,992
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 27,715,207
Part X
Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes 0
DUE TO THIRD PARTIES 1,556,719
DUE TO AFFILIATED ENTITIES 712,531
ACCRUED PENSION LIABILITY 18,430,733
LEASE INCENTIVE OBLIGATION 6,417,892
OTHER LONG-TERM LIABILITIES 9,011,227
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 36,129,102
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) 2018

Schedule D (Form 990) 2018
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on 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' on 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, PART V, QUESTION 4 THE ENDOWMENT FUNDS REPORTED IN SCHEDULE D, PART V, ARE HELD BY CONNECTICUT CHILDREN'S MEDICAL CENTER FOUNDATION, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION FOR THE BENEFIT OF CONNECTICUT CHILDREN'S MEDICAL CENTER. INCOME FROM ENDOWMENT FUNDS IS CONSIDERED TEMPORARILY RESTRICTED UNTIL IT MEETS THE ORIGINAL DONOR'S TIME OR PURPOSE RESTRICTION OF THE DONATION. THESE FUNDS ARE COMMINGLED WITH OTHER TEMPORARILY RESTRICTED CONTRIBUTIONS FOR THE SAME PURPOSES AND INVESTED UNTIL SUCH TIME THAT THE FUNDS ARE UTILIZED. CONNECTICUT CHILDREN'S MEDICAL CENTER'S SPENDING POLICY IS THAT ANY EXPENDITURE ASSOCIATED WITH THE ENDOWMENT IS APPROPRIATED BASED ON THE DONOR'S INTENTION. RESTRICTED FUNDS ARE USED TO SUPPORT AND FURTHER THE MISSION OF CONNECTICUT CHILDREN'S MEDICAL CENTER BY PROVIDING FUNDS IN SUPPORT OF OPERATIONS AND CAPITAL PURCHASES OF CONNECTICUT CHILDREN'S MEDICAL CENTER.
SCHEDULE D, PART X, QUESTION 2 AN INDEPENDENT FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF CONNECTICUT CHILDREN'S MEDICAL CENTER AND SUBSIDIARIES FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2019 AND SEPTEMBER 30, 2018; RESPECTIVELY. THE FOLLOWING FOOTNOTE IS INCLUDED IN THE ORGANIZATION'S AUDITED CONSOLIDATED FINANCIAL STATEMENTS THAT REPORTS THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740): "THE MEDICAL CENTER ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. MANAGEMENT HAS DETERMINED THAT THERE WERE NO MATERIAL TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2019 AND 2018." IN ADDITION, THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM ISSUES AUDITED CONSOLIDATED FINANCIAL STATEMENTS WHICH INCLUDE ALL RELATED ENTITIES; INCLUDING THIS ORGANIZATION. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS ALSO CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE FOLLOWING FOOTNOTE IS INCLUDED IN THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2019 AND SEPTEMBER 30, 2018 THAT REPORTS THE SYSTEMS LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740): "THE CORPORATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT HAS DETERMINED THAT THERE WERE NO MATERIAL TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2019 AND 2018."
Schedule D (Form 990) 2018


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 Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
CONNECTICUT CHILDREN'S MEDICAL CENTER
 
Employer identification number

06-0646755
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 0 0 Program Services FINANCIAL VEHICLE 4,013,600
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total ..... 0 0 4,013,600
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b) 0 0 4,013,600
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2018
Schedule F (Form 990) 2018
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)		 (c) Region (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) 2018
Schedule F (Form 990) 2018Page 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) 2018
Schedule F (Form 990) 2018
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 separately 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; don't 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 separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) 2018
Schedule F (Form 990) 2018
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 THIS ORGANIZATION PAID NEW ENGLAND PEDIATRICS INDEMNITY, LTD. ("NEPI"), A FINANCIAL VEHICLE, $4,013,600 ON BEHALF OF AND FOR THE BENEFIT OF THIS ORGANIZATION.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2018
Additional Data


Software ID:  
Software Version:  



SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
CONNECTICUT CHILDREN'S MEDICAL CENTER
 
Employer identification number

06-0646755
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

 

No
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) . . . 		    1,386,682   1,386,682 0.390 %
b Medicaid (from Worksheet 3, column a) . . . . .     178,786,186 113,880,215 64,905,971 18.230 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     180,172,868 113,880,215 66,292,653 18.620 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     6,204,898 4,238,454 1,966,444 0.550 %
f Health professions education (from Worksheet 5) . . .     20,575,246 100,377 20,474,869 5.750 %
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .     7,673,257 1,169,946 6,503,311 1.830 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     147,130   147,130 0.040 %
j Total. Other Benefits . .     34,600,531 5,508,777 29,091,754 8.170 %
k Total. Add lines 7d and 7j .     214,773,399 119,388,992 95,384,407 26.790 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
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            
3 Community support     3,560,670 1,637,558 1,923,112 0.540 %
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building     242,250   242,250 0.070 %
7 Community health improvement advocacy     51,505 92,272    
8 Workforce development            
9 Other            
10 Total     3,854,425 1,729,830 2,165,362 0.610 %
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
3,817,147
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
1,491,835
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
96,730
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
245,268
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-148,538
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) 2018
Schedule H (Form 990) 2018
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?4Name, 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 CONNECTICUT CHILDREN'S MEDICAL CENTER
282 WASHINGTON STREET
HARTFORD,CT06106
WWW.CONNECTICUTCHILDRENS.ORG
1-CH 		X X X X   X X     1
2 CCMC - NICU JOHN DEMPSEY HOSPITAL
263 FARMINGTON AVENUE
FARMINGTON,CT06030
WWW.CONNECTICUTCHILDRENS.ORG
2-CH 		X X X X   X       1
3 CCMC - NICU HARTFORD HOSPITAL
80 SEYMOUR STREET
HARTFORD,CT06102
WWW.CONNECTICUTCHILDRENS.ORG
2-CH 		X X X X   X       1
4 CCMC - PEDIATRIC IP UNIT ST MARY'S
56 FRANKLIN STREET
WATERBURY,CT06706
WWW.CONNECTICUTCHILDRENS.ORG
2-CH 		X X X X           1
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 4
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)
CONNECTICUT CHILDREN'S MEDICAL CENTER
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 18
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  
6 a 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   No
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   No
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 18
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): WWWW.CONNECTICUTCHILDRENS.ORG
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
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" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2018
Schedule H (Form 990) 2018
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
CONNECTICUT CHILDREN'S MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
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 Was widely publicized 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
WWWW.CONNECTICUTCHILDRENS.ORG
b
WWWW.CONNECTICUTCHILDRENS.ORG
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 6
Part VFacility Information (continued)

Billing and Collections
CONNECTICUT CHILDREN'S MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
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 nonpayment?.................................. 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
f
19 Did the hospital facility or other authorized 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
e
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 19. (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
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
CONNECTICUT CHILDREN'S MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
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) 2018
Schedule H (Form 990) 2018
Page 8
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, 16j, 18e, 19e, 20e, 21c, 21d, 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
SCHEDULE H, PART V, SECTION B, QUESTIONS 5 & 6 WHILE CONDUCTING ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") THE ORGANIZATION TOOK 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. THE ORGANIZATION DEVELOPED THE CHNA WITH STRONG GUIDANCE FROM THE CONNECTICUT CHILDRENS OFFICE FOR COMMUNITY CHILD HEALTH ("THE OFFICE"). ADDITIONALLY, THE ORGANIZATION PARTNERED WITH VARIOUS OUTSIDE ORGANIZATIONS AS WELL AS A VARIETY OF KEY COMMUNITY STAKEHOLDERS. THIS COLLABORATION ALLOWED THE ORGANIZATION TO PRESENT COMMUNITY HEALTH NEEDS ACROSS THE AGE SPAN AND SECTORS OF SERVICE AND WITHIN THE CONTEXT OF KEY COMMUNITY CONTRIBUTORS TO HEALTH. PRIMARY DATA COLLECTION EFFORTS =============================== AS DESCRIBED IN THE ORGANIZATIONS CHNA, IN AN EFFORT TO TAKE INTO ACCOUNT INPUT FORM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED, THE ORGANIZATION USED A VARIETY OF METHODS TO COMPILE DATA. THESE METHODS ARE OUTLINED BELOW: KEY INFORMANT MEETING: ---------------------- THE HARTFORD FOUNDATION FOR PUBLIC GIVING HOSTED A KEY INFORMANT MEETING TO INFORM THE COMMUNITY HEALTH NEEDS ASSESSMENTS OF CONNECTICUT CHILDRENS AND ANOTHER INSTITUTION. THE MEETING INCLUDED A PRESENTATION OF HARTFORD WELL-BEING SURVEY DATA FROM DATA-HAVEN. IT ALSO INCLUDED A SURVEY AND SEVEN STATIONS WHERE PARTICIPANTS SHARED THOUGHTS ON DEMOGRAPHICS & INCOME, HOUSEKEEPING, EDUCATION, COMMUNITY HEALTH, HEALTH & CHIME DATA, COMMUNITY VITALITY & INFRASTRUCTURE, AND ECONOMIC OPPORTUNITY & JOB ACCESS. THE MEETING INCLUDED 56 PARTICIPANTS FROM THE FOLLOWING INSTITUTIONS/ORGANIZATIONS: - ASYLUM HILL NEIGHBORHOOD ASSN. (AHNA) - BICICO - CAPITOL REGION COUNCIL OF GOVERNMENTS (CRCOG) - CATHOLIC CHARITIES - CHFA - CHRYSALIS CENTER - CITY COUNCIL/CHARTER OAK HEALTH CENTER - CITY OF HARTFORD - CITY OF HARTFORD DEPARTMENT OF HEALTH AND HUMAN SERVICES - COMMUNITY HEALTH SERVICES, INC. - COMMUNITY RENEWAL TEAM, INC. - CONNECTICUT CHILDRENS - CONNECTICUT CHILDRENS HEALTHY HOMES PROGRAM - CONNECTICUT CHILDRENS INJURY PREVENTION CENTER - CONNECTICUT HEALTH FOUNDATION - CT RIDES - DATAHAVEN - ECHN, INC./MANCHESTER MEMORIAL HOSPITAL - FARMINGTON VALLEY HEALTH DISTRICT - FOODSHARE - GREATER HARTFORD HARM REDUCTION - HARTFORD BEHAVIORAL HEALTH - HARTFORD COMMUNITIES THAT CARE - HARTFORD FOOD SYSTEM - HARTFORD FOUNDATION FOR PUBLIC GIVING - HARTFORD HEALTHCARE - HISPANIC HEALTH COUNCIL - HOSPITAL FOR SPECIAL CARE - INTERVAL HOUSE - LISC - NHPZ REP FOR HEALTH AND HUMAN SERVICES WORKGROUP - NORTH CENTRAL DISTRICT HEALTH DEPARTMENT (ENFIELD, ELLINGTON ETC) - NORTH HARTFORD TRIPLE AIM COLLABORATIVE - OPEN COMMUNITIES ALLIANCE - PLANNED PARENTHOOD OF SOUTHERN NEW ENGLAND - PPSNE - PRUDENCE CRANDALL CENTER - SINA - TOWN OF EAST HARTFORD HEALTH DEPARTMENT - TRINITY COLLEGE CENTER FOR URBAN AND GLOBAL STUDIES - TRINITY HEATH - SAINT FRANCIS - UNITED WAY CNCT - UNITED WAY OF CENTRAL AND NORTHEASTERN CONNECTICUT - UPPER ALBANY REVITALIZATION ZONE ORGANIZATION (UARZO) - WELLVILLE - WEST HARTFORD BLOOMFIELD HEALTH DISTRICT - WHEELER CLINIC, INC. FOCUS GROUPS: ------------- CONNECTICUT CHILDRENS SPONSORED TWO FOCUS GROUPS TO INFORM THIS CHNA. ELEVEN PARTICIPANTS TOOK PART IN THE FOCUS GROUP HELD AT CATHOLIC CHARITIES IN HARTFORDS SOUTH END, INCLUDING FOUR STAFF MEMBERS AND SEVEN COMMUNITY MEMBERS. CONNECTICUT CHILDRENS ALSO HOSTED A FOCUS GROUP AT THE FAMILY CENTER AT PARKER MEMORIAL COMMUNITY CENTER IN HARTFORDS NORTH END, IN WHICH MORE THAN A DOZEN COMMUNITY MEMBERS AND ONE STAFF MEMBER PARTICIPATED. SCHOOL NURSE SURVEY: -------------------- CONNECTICUT CHILDRENS COMMISSIONED A SURVEY OF SCHOOL NURSES WHO WORK AT HARTFORD PUBLIC SCHOOLS AND RECEIVED 31 RESPONSES. ADDITIONAL SOURCES: ------------------- CONNECTICUT CHILDRENS REVIEWED MANY ADDITIONAL SOURCES OF INFORMATION TO INFORM THIS CHNA, WHICH ARE LISTED IN THE REFERENCES PAGE OF THE CHNA.
SCHEDULE H, PART V, SECTION B, QUESTIONS 7A & 7B THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 7A, IS THE HOME PAGE FOR THE SYSTEM. THE ORGANIZATION'S FULL CHNA CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: WWW.CONNECTICUTCHILDRENS.ORG/ABOUT-US/COMMUNITY-BENEFITS
SCHEDULE H, PART V, SECTION B, QUESTION 10 THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 10, IS THE HOME PAGE FOR THE SYSTEM. THE ORGANIZATION'S IMPLEMENTATION STRATEGY CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: WWW.CONNECTICUTCHILDRENS.ORG/ABOUT-US/COMMUNITY-BENEFITS
SCHEDULE H, PART V, SECTION B, QUESTION 11 THROUGHOUT THE CHNA THE ORGANIZATION IDENTIFIED THE FOLLOWING UNMET COMMUNITY HEALTH NEEDS: - MENTAL HEALTH, BEHAVIORAL HEALTH, AND TRAUMA - SCHOOL READINESS - CHILDHOOD OBESITY PREVENTION - HOUSING, ENVIRONMENT AND COMMUNITY FACTORS THE ORGANIZATIONS CHNA OFFERS A NUMBER OF LONG-RANGE RECOMMENDATIONS THAT INFORM THE THREE-YEAR IMPLEMENTATION STRATEGY ("IS"). THE IS SERVES AS A FLUID DOCUMENT AND MAY FLUCTUATE AS THE CAPACITY OF CONNECTICUT CHILDRENS TO BUILD PARTNERSHIPS TO ADDRESS THE STATED OBJECTIVES, ALONG WITH OTHER OBJECTIVES YET TO BE IDENTIFIED, BECOMES CLEARER. THE PROCESS FOR SETTING GOALS AND OBJECTIVES IN THE IS INVOLVED REVIEWING THE CHNA RECOMMENDATIONS AND ENGAGING WITH HOSPITAL LEADERSHIP, COMMUNITY PROGRAM STAFF, AND COMMUNITY BASED PROGRAMS TO DETERMINE THE FOLLOWING COURSE OF ACTION. CONNECTICUT CHILDRENS OFFICE FOR COMMUNITY CHILD HEALTH ("THE OFFICE") HOUSES THE MANY PROGRAMS AND RESOURCES THAT CONNECT THE LARGER ORGANIZATION TO COMMUNITY OPPORTUNITIES THAT CONTRIBUTE TO THE HEALTH AND WELL-BEING OF CONNECTICUTS CHILDREN. THE OFFICES 15 PROGRAMS ENGAGE IN RIGOROUS DATA COLLECTION AND MEASUREMENT TO ENSURE THAT THEIR EFFORTS ARE EFFECTIVE. THESE PROGRAMS CURRENTLY USE, OR HAVE DEVELOPED IN RESPONSE TO THE 2019 CHNA, THE FOLLOWING OBJECTIVES AND ASSOCIATED MEASURES TO TRACK CONNECTICUT CHILDRENS PROGRESS IN ADDRESSING THE NEEDS IDENTIFIED IN THE MOST RECENT CHNA. BEHAVIORAL HEALTH, MENTAL HEALTH AND TRAUMA ------------------------------------------- GOAL: PROMOTE WELL-BEING AMONG CHILDREN AND YOUTH BY ENSURING EQUITABLE ACCESS TO AFFORDABLE BEHAVIORAL AND MENTAL HEALTH SERVICES. OBJECTIVES: 1) TRACK NUMBER OF MATERNAL DEPRESSION SCREENS BILLED TO MEDICAID BY PEDIATRIC PRIMARY CARE PROVIDERS. 2) INCREASE COLLABORATION WITH HARTFORD COMMUNITIES THAT CARE AND COMPASS YOUTH COLLABORATIVE IN IMPLEMENTATION OF VIOLENCE PREVENTION MODEL ADVOCATED BY THE HEALTH ALLIANCE FOR VIOLENCE INTERVENTION. 3) PROVIDE CARE COORDINATION TRAININGS AT SCHOOLS WORKING WITH COMPASS YOUTH COLLABORATIVE TO INCREASE REFERRALS TO CONNECTICUT CHILDRENS AND ENHANCE COMMUNITY PARTNERSHIPS. 4) INCREASE CLIENTS SERVED THROUGH CONNECTICUT CHILDRENS BEHAVIORAL HEALTH TRANSITIONS CLINIC. 5) INCREASE REFERRALS FROM CONNECTICUT CHILDRENS CLINICIANS AND/OR CARE NETWORK CLINICIANS TO CONNECTICUT CHILDRENS CENTER FOR CARE COORDINATION FOR THOSE WHO SEEK CARE FOR MENTAL HEALTH CONCERNS IN AN EFFORT TO DECREASE ED VISITS. 6) INCREASE REFERRALS FROM CONNECTICUT CHILDRENS CLINICIANS AND/OR CARE NETWORK CLINICIANS TO COMMUNITY SUPPORTS FOR CHILDREN AND YOUTH EXPOSED TO DOMESTIC VIOLENCE, ABUSE, NEGLECT, AND OTHER TRAUMA. SCHOOL READINESS ---------------- GOAL: PREPARE HARTFORD STUDENTS FOR KINDERGARTEN BY PROMOTING EARLY LITERACY AMONG INFANTS, TODDLERS AND PRE-SCHOOL AGE CHILDREN. OBJECTIVES: 1) TRACK NUMBER OF DEVELOPMENTAL SCREENS BILLED TO MEDICAID BY PEDIATRIC PRIMARY CARE PROVIDERS. 2) STRENGTHEN HELP ME GROW CTS ADOPTION OF HELP ME GROW NATIONAL CENTER RESOURCES TO INCREASE HELP ME GROW CTS CAPACITY TO CONNECT CHILDREN AND FAMILIES TO SERVICES. 3) WORK WITH COMMUNITY PARTNERS TO BRING THE IMAGINATION LIBRARY EARLY LITERACY PROGRAM TO ALL CHILDREN OF HARTFORD RESIDENTS. 4)INCREASE COLLABORATION WITH EARLY CARE AND EDUCATION PROVIDERS, HOME VISITORS, FAMILY CENTERS, AND PUBLIC SCHOOLS TO CHAMPION SCHOOL READINESS INITIATIVES, WHICH INCLUDE EARLY LITERACY PROMOTION, BACK TO SCHOOL EVENTS, SCHOOL SUPPLY DRIVES, ETC. CHILDHOOD OBESITY PREVENTION ---------------------------- GOAL: INCREASE EDUCATION AND AWARENESS ABOUT HEALTHY LIFESTYLES TO REDUCE CHILDHOOD OBESITY. OBJECTIVES: 1) DEVELOP AND DEPLOY AN ELECTRONIC MEDICAL RECORD TOOL TO HELP PRIMARY CARE CHILD HEALTH PROVIDERS PREVENT CHILDHOOD OBESITY AND TRACK DOWNLOADS UPON EXPECTED DEPLOYMENT IN 2021. 2) INCREASE NUMBER OF FAMILIES SERVED THROUGH COMMUNITY OUTREACH PROGRAMS THAT PROMOTE NUTRITION AND PHYSICAL ACTIVITY AS MEASURED BY ATTENDANCE AT START CHILDHOOD OFF RIGHT MONTHLY WELLNESS EVENTS. HOUSING AND COMMUNITY FACTORS ----------------------------- GOAL: INCREASE HEALTH AND WELL-BEING OF HARTFORD RESIDENTS BY RAISING AWARENESS ABOUT THE CRITICAL LINK BETWEEN HOUSING, ENVIRONMENTAL FACTORS, AND HEALTH. OBJECTIVES: 1) INCREASE THE USE OF THE EASY BREATHING ASTHMA MANAGEMENT PROGRAM AMONG PRIMARY CARE CHILD HEALTH PROVIDERS. 2) INCREASE THE NUMBER OF TRAININGS COMPLETED FOR CARE NETWORK PRACTICES THAT ADDRESS SOCIAL AND ENVIRONMENTAL NEEDS OF CHILDREN. 3) EXPAND THE BUILDING FOR HEALTH CROSS-SECTOR REFERRAL INITIATIVE FROM ITS CURRENT SERVICE AREAS OF FROG HOLLOW AND NORTH HARTFORD TO SERVE RESIDENTS CITYWIDE. 4) INCREASE REFERRALS FROM CONNECTICUT CHILDRENS CLINICIANS TO CONNECTICUT CHILDRENS CENTER FOR CARE COORDINATION FOR THOSE WHO SEEK SUPPORT FOR CHRONIC HEALTH CONDITIONS. 5) CONTINUE TO PARTNER WITH NORTH HARTFORD TRIPLE AIM COLLABORATIVE WITH GOAL OF LAUNCHING A HEALTH HUB IN NORTH HARTFORD, FEATURING A HEALTH CLINIC, SUPERMARKET, AFFORDABLE CHILD CARE, EXERCISE FACILITIES, JOB TRAINING, ETC. STATEWIDE AND LOCAL POLICY ADVOCACY ----------------------------------- GOAL: TO ENHANCE SYSTEMS OF SUPPORT FOR CHILDREN AND FAMILIES THROUGH ADMINISTRATIVE AND LEGISLATIVE POLICY CHANGES. OBJECTIVES: 1) ADVOCATE FOR INCREASED INSURANCE COVERAGE FOR, AND ACCESS TO, MENTAL HEALTH COUNSELING. 2) ADVOCATE FOR A CENTRALIZED SYSTEM OF CARE COORDINATION IN HARTFORD. 3) ADVOCATE FOR HOUSING AND DEVELOPMENTAL SERVICES FOR CHILDREN WITH BLOOD LEAD LEVELS AS LOW AS 5 MICROGRAMS PER DECILITER. 4) INCREASE THE ADOPTION OF STRENGTHENING FAMILIES PROTECTIVE FACTORS FRAMEWORK AMONG PEDIATRICIANS, COMMUNITY HEALTH WORKERS, AND OTHERS WHO WORK WITH CHILDREN.
SCHEDULE H, PART V, SECTION B, QUESTION 16 THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 16, IS THE HOME PAGE FOR THE SYSTEM. THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND PLAIN LANGUAGE SUMMARY ARE MADE WIDELY AVAILABLE ON THE ORGANIZATION'S WEBSITE. THESE DOCUMENTS CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: WWW.CONNECTICUTCHILDRENS.ORG/BILLING-AND-FINANCES
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 9
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?15
Name and address Type of Facility (describe)
1 CCMC SPECIALTY CENTER
505 FARMINGTON AVENUE
FARMINGTON,CT06030 		SPEECH THERAPY, AUDIOLOGY, SLEEP LAB, EEG, EMG, AMBULATORY SURGERY CENTER
2 CCMC SPECIALTY CENTER
399 FARMINGTON AVENUE
FARMINGTON,CT06032 		OCCUPATIONAL & PHYSICAL THERAPY, RADIOLOGY, MOTION ANALYSIS
3 CCMC SPECIALTY CENTER
310 WESTERN BOULEVARD
GLASTONBURY,CT06033 		OCCUPATIONAL, PHYSICAL & SPEECH THERAPY, AUDIOLOGY, RADIOLOGY, ECHO
4 CCMC HARTFORD HOSP BONE & JOINT INST
31 SEYMOUR STREET
HARTFORD,CT06106 		RADIOLOGY
5 CCMC SPECIALTY CENTER
676 HEBRON AVENUE
GLASTONBURY,CT06033 		SLEEP LAB
6 CCMC 100 RETREAT
100 RETREAT AVENUE 4TH FLOOR
HARTFORD,CT06016 		SPEECH THERAPY
7 CCMC 111 FOUNDERS
111 FOUNDERS PLAZA
EAST HARTFORD,CT06108 		CLINICAL NUTRITION
8 CCMC HARTFORD HOSP MED OFFICE BLDG
85 SEYMOUR STREET
HARTFORD,CT06106 		PULMONARY FUNCTION LAB
9 CCMC AVON FAMILY WELLNESS CENTER
100 SIMSBURY ROAD
AVON,CT06001 		PHYSICAL THERAPY, OCCUPATIONAL THERAPY
10 CCMC SOLTERA ACADEMY
300 JOHN DOWNEY DRIVE
NEW BRITAIN,CT06051 		OCCUPATIONAL THERAPY
11 CONNECTICUT CHILDREN'S ORTHO&SPORTS MED
2 IVY BROOK ROAD SUITE 213
SHELTON,CT06484 		ORTHOPEDICS & SPORTS MEDICINE
12 CCMC SPECIALTY CENTER
10 BIRDSEYE ROAD
FARMINGTON,CT06032 		ENDOCRINOLOGY, INFECTIOUS DISEASE & IMMUNOLOGY, GASTROENTEROLOGY, RHEUMATOLOGY
13 CCMC SPECIALTY CENTER
84 WILLIMANSETT STREET SUITE 3
SOUTH HADLEY,MA01075 		GASTROENTEROLOGY, NEPHROLOGY, RHEUMATOLOGY
14 CCMC SPECIALTY CENTER
11 SOUTH ROAD
FARMINGTON,CT06032 		CARDIOLOGY, DEVELOPMENTAL PEDIATRICS, GENETICS, NEWBORN SCREENING
15 CCMC SPECIALTY CENTER
105 - A NEWTOWN ROAD
DANBURY,CT06810 		VARIOUS OUTPATIENT SPECIALTY SERVICES
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 10
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 NOT APPLICABLE.
SCHEDULE H, PART I; LINE 6A THE ORGANIZATION PREPARED A COMMUNITY BENEFIT REPORT WHICH REPORTS THE RESULTS OF ITS EFFORTS TO SERVICE THE COMMUNITY AND HAVE A MEASURABLE IMPACT ON CHILDREN AND FAMILIES ACROSS THE STATE OF CONNECTICUT AND BEYOND. THE ORGANIZATIONS COMMUNITY BENEFIT REPORT IS MADE WIDELY AVAILABLE ON THE ORGANIZATION'S WEBSITE. ADDITIONALLY, HARD COPIES WERE DISTRIBUTED TO KEY COMMUNITY LEADERS AND WERE MADE AVAILABLE ON REQUEST THROUGH THE OFFICE OF COMMUNITY CHILD HEALTH.
SCHEDULE H, PART I; LINE 7 LINES 7A AND 7B WERE DETERMINED USING A RATIO OF COST TO CHARGES. LINES 7E THROUGH 7I WERE ALL REPORTED AT TRUE COST, NOT USING A COST TO CHARGE RATIO.
SCHEDULE H, PART II CONNECTICUT CHILDRENS MEDICAL CENTERS ("CONNECTICUT CHILDRENS") CORE MISSION IS TO IMPROVE THE PHYSICAL AND EMOTIONAL HEALTH OF CHILDREN ACROSS THE STATE OF CONNECTICUT. WE RECOGNIZE THAT CHILDREN DO NOT LIVE IN ISOLATION. THEY ARE PART OF FAMILIES AND COMMUNITIES. IN ORDER TO FULFILL OUR MISSION, WE PROVIDE LEADERSHIP, PARTICIPATE IN COMMUNITY BASED PROGRAMS THAT HELP BUILD HEALTHIER COMMUNITIES, AND STRENGTHEN SYSTEMS THAT SUPPORT FAMILIES. OUR OFFICE OF COMMUNITY CHILD HEALTH ("OCCH") WAS CREATED TO SERVE AS A COORDINATING ENTITY FOR OUR COMMUNITY-ORIENTED PROGRAMS AND PROVIDE US WITH A STRONGER ADVOCACY VOICE IN SUPPORTING IMPROVED SYSTEMS FOR SUPPORTING FAMILIES. THE FOLLOWING WERE COMMUNITY BASED PROGRAMS UNDER OCCHS UMBRELLA: - ADVANCING KIDS INNOVATION PROGRAM (AKIP) - CARE COORDINATION COLLABORATIVE MODEL - CENTER FOR CARE COORDINATION - CHILDRENS CENTER ON FAMILY VIOLENCE - CHILDRENS HOSPITAL LEARNING COLLABORATIVE - CO-MANAGEMENT - EASY BREATHING - EDUCATING PRACTICES IN THE COMMUNITY - HARTFORD YOUTH HIV IDENTIFICATION AND LINKAGE CONSORTIUM - HEALTH HOMES PROGRAM - HELP ME GROW NATIONAL CENTER - INJURY PREVENTION CENTER - MID-LEVEL DEVELOPMENTAL ASSESSMENT - PERSON-CENTERED MEDICAL HOME - PRACTICE QUALITY IMPROVEMENT - RESIDENT EDUCATION IN ADVOCACY AND COMMUNITY HEALTH ALL PROGRAMS HAVE ELEMENTS OF COMMUNITY BUILDING IN THEIR PURPOSE. SOME INVOLVE WORKING WITH LOCAL COMMUNITIES, SOME WITH STATE-WIDE COMMUNITIES, SOME WORK ON NATIONAL LEVELS, AND SOME PROVIDE OUR EXPERTISE TO CLINICIANS TO HELP THEM BETTER SERVE FAMILIES IN THEIR COMMUNITIES. OCCH FOCUSES ON PROMOTING OPTIMAL HEALTHY DEVELOPMENT ACROSS ALL SECTORS IMPACTING CHILDREN. WE PAY PARTICULAR ATTENTION TO ADDRESSING SOCIAL DETERMINANTS OF HEALTH THAT SERVE AS MAJOR RISK FACTORS FOR POORER OUTCOMES. NO ONE ENTITY ALONE CAN HAVE THE KIND OF IMPACT THAT WE DESIRE. TO THAT END, THE PROGRAMS LISTED ABOVE, WORK WITH MORE THAN 150 COMMUNITY PARTNERS. ADDITIONAL COMMUNITY BUILDING INCLUDES OUR WORK WITH THE NEIGHBORHOOD PARTNERSHIP KNOWN AS SOUTHSIDE INSTITUTIONS NEIGHBORHOOD ALLIANCE ("SINA"). SINA IS A NEIGHBORHOOD PARTNERSHIP BETWEEN CONNECTICUT CHILDRENS, HARTFORD HOSPITAL, AND TRINITY COLLEGE. WE PAY DUES TO SUPPORT SINAS ANNUAL OPERATIONS BUDGET. THREE EMPLOYEES FROM CONNECTICUT CHILDRENS ARE ON SINAS BOARD OF DIRECTORS, AND IN 2017, THERE WERE ABOUT 20 EMPLOYEES WHO PARTICIPATED IN SINA COORDINATED COMMUNITY ACTIVITIES THAT PROMOTED EDUCATION, IMPROVED HOUSING, AND PUBLIC SAFETY IN OUR NEIGHBORHOOD. TWO WAYS THAT WE SUPPORTED EDUCATION DURING THE YEAR INCLUDE THE SPONSORSHIP OF A LOCAL ELEMENTARY SCHOOLS SCIENCE FAIR. SINA PAID FOR THE MANY OF THE SCHOOL SUPPLIES, FOOD FOR THE DAY, AND RECRUITING AND COORDINATED THE JUDGES FOR THE DAY. MOST OF THE JUDGES WERE CONNECTICUT CHILDRENS EMPLOYEES. OUR ORGANIZATION ALSO COORDINATED A BOOK DRIVE TO SUPPORT THE SCHOOLS AFTER-SCHOOL PROGRAM AND GET BOOKS INTO THE HOMES OF MANY OF THE STUDENTS. SINA RECEIVED A MAJOR GRANT FROM THE STATE OF CONNECTICUT TO BUILD NEW OWNER OCCUPIED HOUSING, IN PLACE OF SOME OF THE NEIGHBORHOODS BLIGHTED PROPERTIES. TWELVE NEW HOMES WILL BE A PART OF THE PROJECT, COMPLETED IN 2019. TO DATE, SINA HAS BUILT MORE THAN 60 HOMES IN THE AREA, ADDING CLOSE TO $500,000 PER YEAR TO THE CITYS TAX BASE. IN 2017, HARTFORD WAS HAVING DISCUSSIONS WITH THE STATE REGARDING ITS LARGE OPERATING DEFICIT. CONTRIBUTING TO THE DEFICIT IS THE LOW RATE OF HOMEOWNERSHIP. ADDITIONALLY, OUR HEALTH HOMES PROGRAM BEGAN WORKING WITH SINA TO IDENTIFY WAYS THAT THE TWO COULD COMPLEMENT ONE ANOTHER. SINAS OUTREACH STAFF BEGAN TO LOOK AT OPPORTUNITIES TO IDENTIFY PROPERTY OWNERS IN THE NEIGHBORHOOD WHO COULD BENEFIT FROM THE HEALTHY HOMES INTERVENTIONS. FOR PUBLIC SAFETY, SINA DEVELOPED A NEIGHBORHOOD SAFETY TEAM IN 2017. MADE UP OF REPRESENTATIVES FROM RESIDENTS, THE POLICE, LOCAL BUSINESSES, AND THE SINA PARTNERS, THE GOALS OF THE TEAM ARE TO GET TO KNOW EACH OTHER, OPEN UP THE LINES OF COMMUNICATION, IDENTIFY PROBLEMS IN THE NEIGHBORHOOD, AND GET A QUICK RESPONSE TO THOSE PROBLEMS. ADDITIONALLY, STAFF AT CONNECTICUT CHILDRENS ATTEND AND PARTICIPATE WITH THE NEIGHBORHOOD REVITALIZATION ZONE MEETINGS HELD MONTHLY, WHERE THE FOCUS IS ON PUBLIC SAFETY AND OTHER QUALITY OF LIFE ISSUES. A COMPONENT OF OUR COMMUNITY HEALTH NEEDS ASSESSMENT WAS SINAS ECONOMIC DEVELOPMENT STUDY, IDENTIFYING THE POVERTY IN THE NEIGHBORHOOD AS A MAJOR SOCIAL DETERMINANT. A PORTION OF THE STUDY RECOMMENDED THAT SINA AND ITS INSTITUTIONAL PARTNERS DEVELOP AN EMPLOYMENT PROGRAM. IN 2017, SINA WAS AWARDED A GRANT FROM THE HARTFORD FOUNDATION FOR PUBLIC GIVING TO HIRE A CAREER NAVIGATOR, WHO COULD WORK WITH NEIGHBORHOOD RESIDENTS IN GETTING EMPLOYMENT. ONE OF CONNECTICUT CHILDRENS HUMAN RESOURCES STAFF HAS BEEN IDENTIFIED TO SUPPORT THESE EFFORTS BEGINNING IN 2018.
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
SCHEDULE H, PART III, SECTION B; QUESTION 8 MEDICARE COSTS WERE DERIVED FROM THE MEDICARE COST REPORT. THE ORGANIZATION FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. AS OUTLINED MORE FULLY BELOW THE ORGANIZATION BELIEVES THAT THESE SERVICES AND RELATED COSTS PROMOTE THE HEALTH OF THE COMMUNITY AS A WHOLE AND ARE RENDERED IN CONJUNCTION WITH THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES AND MISSION IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUAL'S IN A NON-DISCRIMINATORY MANNER WITHOUT REGARD TO RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY AND CONSISTENT WITH THE COMMUNITY BENEFIT STANDARD PROMULGATED BY THE IRS. THE COMMUNITY BENEFIT STANDARD IS THE CURRENT STANDARD FOR A HOSPITAL FOR RECOGNITION AS A TAX-EXEMPT AND CHARITABLE ORGANIZATION UNDER INTERNAL REVENUE CODE ("IRC") 501(C)(3). THE ORGANIZATION IS RECOGNIZED AS A TAX-EXEMPT ENTITY AND CHARITABLE ORGANIZATION UNDER 501(C)(3) OF THE IRC. ALTHOUGH THERE IS NO DEFINITION IN THE TAX CODE FOR THE TERM "CHARITABLE" A REGULATION PROMULGATED BY THE DEPARTMENT OF THE TREASURY PROVIDES SOME GUIDANCE AND STATES THAT "[T]HE TERM CHARITABLE IS USED IN 501(C)(3) IN ITS GENERALLY ACCEPTED LEGAL SENSE,PROVIDES EXAMPLES OF CHARITABLE PURPOSES, INCLUDING THE RELIEF OF THE POOR OR UNPRIVILEGED; THE PROMOTION OF SOCIAL WELFARE; AND THE ADVANCEMENT OF EDUCATION, RELIGION, AND SCIENCE. NOTE IT DOES NOT EXPLICITLY ADDRESS THE ACTIVITIES OF HOSPITALS. IN THE ABSENCE OF EXPLICIT STATUTORY OR REGULATORY REQUIREMENTS APPLYING THE TERM "CHARITABLE" TO HOSPITALS, IT HAS BEEN LEFT TO THE IRS TO DETERMINE THE CRITERIA HOSPITALS MUST MEET TO QUALIFY AS IRC 501(C)(3) CHARITABLE ORGANIZATIONS. THE ORIGINAL STANDARD WAS KNOWN AS THE CHARITY CARE STANDARD. THIS STANDARD WAS REPLACED BY THE IRS WITH THE COMMUNITY BENEFIT STANDARD WHICH IS THE CURRENT STANDARD. CHARITY CARE STANDARD IN 1956, THE IRS ISSUED REVENUE RULING 56-185, WHICH ADDRESSED THE REQUIREMENTS HOSPITALS NEEDED TO MEET IN ORDER TO QUALIFY FOR IRC 501(C)(3) STATUS. ONE OF THESE REQUIREMENTS IS KNOWN AS THE "CHARITY CARE STANDARD." UNDER THE STANDARD, A HOSPITAL HAD TO PROVIDE, TO THE EXTENT OF ITS FINANCIAL ABILITY, FREE OR REDUCED-COST CARE TO PATIENTS UNABLE TO PAY FOR IT. A HOSPITAL THAT EXPECTED FULL PAYMENT DID NOT, ACCORDING TO THE RULING, PROVIDE CHARITY CARE BASED ON THE FACT THAT SOME PATIENTS ULTIMATELY FAILED TO PAY. THE RULING EMPHASIZED THAT A LOW LEVEL OF CHARITY CARE DID NOT NECESSARILY MEAN THAT A HOSPITAL HAD FAILED TO MEET THE REQUIREMENT SINCE THAT LEVEL COULD REFLECT ITS FINANCIAL ABILITY TO PROVIDE SUCH CARE. THE RULING ALSO NOTED THAT PUBLICLY SUPPORTED COMMUNITY HOSPITALS WOULD NORMALLY QUALIFY AS CHARITABLE ORGANIZATIONS BECAUSE THEY SERVE THE ENTIRE COMMUNITY, AND A LOW LEVEL OF CHARITY CARE WOULD NOT AFFECT A HOSPITAL'S EXEMPT STATUS IF IT WAS DUE TO THE SURROUNDING COMMUNITY'S LACK OF CHARITABLE DEMANDS. COMMUNITY BENEFIT STANDARD IN 1969, THE IRS ISSUED REVENUE RULING 69-545, WHICH "REMOVE[D]" FROM REVENUE RULING 56-185 "THE REQUIREMENTS RELATING TO CARING FOR PATIENTS WITHOUT CHARGE OR AT RATES BELOW COST." UNDER THE STANDARD DEVELOPED IN REVENUE RULING 69-545, WHICH IS KNOWN AS THE "COMMUNITY BENEFIT STANDARD," HOSPITALS ARE JUDGED ON WHETHER THEY PROMOTE THE HEALTH OF A BROAD CLASS OF INDIVIDUALS IN THE COMMUNITY. THE RULING INVOLVED A HOSPITAL THAT ONLY ADMITTED INDIVIDUALS WHO COULD PAY FOR THE SERVICES (BY THEMSELVES, PRIVATE INSURANCE, OR PUBLIC PROGRAMS SUCH AS MEDICARE), BUT OPERATED A FULL-TIME EMERGENCY ROOM THAT WAS OPEN TO EVERYONE. THE IRS RULED THAT THE HOSPITAL QUALIFIED AS A CHARITABLE ORGANIZATION BECAUSE IT PROMOTED THE HEALTH OF PEOPLE IN ITS COMMUNITY. THE IRS REASONED THAT BECAUSE THE PROMOTION OF HEALTH WAS A CHARITABLE PURPOSE ACCORDING TO THE GENERAL LAW OF CHARITY, IT FELL WITHIN THE "GENERALLY ACCEPTED LEGAL SENSE" OF THE TERM "CHARITABLE," AS REQUIRED BY TREAS. REG. 1.501(C)(3)-1(D)(2). THE IRS RULING STATED THAT THE PROMOTION OF HEALTH, LIKE THE RELIEF OF POVERTY AND THE ADVANCEMENT OF EDUCATION AND RELIGION, IS ONE OF THE PURPOSES IN THE GENERAL LAW OF CHARITY THAT IS DEEMED BENEFICIAL TO THE COMMUNITY AS A WHOLE EVEN THOUGH THE CLASS OF BENEFICIARIES ELIGIBLE TO RECEIVE A DIRECT BENEFIT FROM ITS ACTIVITIES DOES NOT INCLUDE ALL MEMBERS OF THE COMMUNITY, SUCH AS INDIGENT MEMBERS OF THE COMMUNITY, PROVIDED THAT THE CLASS IS NOT SO SMALL THAT ITS RELIEF IS NOT OF BENEFIT TO THE COMMUNITY. THE IRS CONCLUDED THAT THE HOSPITAL WAS "PROMOTING THE HEALTH OF A CLASS OF PERSONS THAT IS BROAD ENOUGH TO BENEFIT THE COMMUNITY" BECAUSE ITS EMERGENCY ROOM WAS OPEN TO ALL AND IT PROVIDED CARE TO EVERYONE WHO COULD PAY, WHETHER DIRECTLY OR THROUGH THIRD-PARTY REIMBURSEMENT. OTHER CHARACTERISTICS OF THE HOSPITAL THAT THE IRS HIGHLIGHTED INCLUDED THE FOLLOWING: ITS SURPLUS FUNDS WERE USED TO IMPROVE PATIENT CARE, EXPAND HOSPITAL FACILITIES, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH; IT WAS CONTROLLED BY A BOARD OF TRUSTEES THAT CONSISTED OF INDEPENDENT CIVIC LEADERS; AND HOSPITAL MEDICAL STAFF PRIVILEGES WERE AVAILABLE TO ALL QUALIFIED PHYSICIANS. MEDICARE UNDERPAYMENTS AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS SHOULD BE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE AMERICAN HOSPITAL ASSOCIATION ("AHA") FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THIS ORGANIZATION AGREES WITH THE AHA POSITION. AS OUTLINED IN THE AHA LETTER TO THE IRS DATED AUGUST 21, 2007 WITH RESPECT TO THE FIRST PUBLISHED DRAFT OF THE NEW FORM 990 AND SCHEDULE H, THE AHA FELT THAT THE IRS SHOULD INCORPORATE THE FULL VALUE OF THE COMMUNITY BENEFIT THAT HOSPITALS PROVIDE BY COUNTING MEDICARE UNDERPAYMENTS (SHORTFALL) AS QUANTIFIABLE COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. - MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. RECENTLY, MEDICARE REIMBURSES HOSPITALS ONLY 92 CENTS FOR EVERY DOLLAR THEY SPEND TO TAKE CARE OF MEDICARE PATIENTS. THE MEDICARE PAYMENT ADVISORY COMMISSION ("MEDPAC") IN ITS MARCH 2007 REPORT TO CONGRESS CAUTIONED THAT UNDERPAYMENT WILL GET EVEN WORSE, WITH MARGINS REACHING A 10-YEAR LOW AT NEGATIVE 5.4 PERCENT. - MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR. MORE THAN 46 PERCENT OF MEDICARE SPENDING IS FOR BENEFICIARIES WHOSE INCOME IS BELOW 200 PERCENT OF THE FEDERAL POVERTY LEVEL. MANY OF THOSE MEDICARE BENEFICIARIES ARE ALSO ELIGIBLE FOR MEDICAID -- SO CALLED ELIGIBLES." THERE IS EVERY COMPELLING PUBLIC POLICY REASON TO TREAT MEDICARE AND MEDICAID UNDERPAYMENTS SIMILARLY FOR PURPOSES OF A HOSPITAL'S COMMUNITY BENEFIT AND INCLUDE THESE COSTS ON FORM 990, SCHEDULE H, PART I. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY AND SHOULD COUNT AS A QUANTIFIABLE COMMUNITY BENEFIT. BOTH THE AHA AND THIS ORGANIZATION ALSO FEEL THAT PATIENT BAD DEBT IS A COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. LIKE MEDICARE UNDERPAYMENT (SHORTFALLS), THERE ALSO ARE COMPELLING REASONS THAT PATIENT BAD DEBT SHOULD BE COUNTED AS QUANTIFIABLE COMMUNITY BENEFIT AS FOLLOWS: - A SIGNIFICANT MAJORITY OF BAD DEBT IS ATTRIBUTABLE TO LOW-INCOME PATIENTS, WHO, FOR MANY REASONS, DECLINE TO COMPLETE THE FORMS REQUIRED TO ESTABLISH ELIGIBILITY FOR HOSPITALS' CHARITY CARE OR FINANCIAL ASSISTANCE PROGRAMS. A 2006 CONGRESSIONAL BUDGET OFFICE ("CBO") REPORT, NONPROFIT HOSPITALS AND THE PROVISION OF COMMUNITY BENEFITS, CITED TWO STUDIES INDICATING THAT "THE GREAT MAJORITY OF BAD DEBT WAS ATTRIBUTABLE TO PATIENTS WITH INCOMES BELOW 200% OF THE FEDERAL POVERTY LINE." - THE REPORT ALSO NOTED THAT A SUBSTANTIAL PORTION OF BAD DEBT IS PENDING CHARITY CARE. UNLIKE BAD DEBT IN OTHER INDUSTRIES, HOSPITAL BAD DEBT IS COMPLICATED BY THE FACT THAT HOSPITALS FOLLOW THEIR MISSION TO THE COMMUNITY AND TREAT EVERY PATIENT THAT COMES THROUGH THEIR EMERGENCY DEPARTMENT, REGARDLESS OF ABILITY TO PAY. PATIENTS WHO HAVE OUTSTANDING BILLS ARE NOT TURNED AWAY, UNLIKE OTHER INDUSTRIES. BAD DEBT IS FURTHER COMPLICATED BY THE AUDITING INDUSTRY'S STANDARDS ON REPORTING CHARITY CARE. MANY PATIENTS CANNOT OR DO NOT PROVIDE THE NECESSARY, EXTENSIVE DOCUMENTATION REQUIRED TO BE DEEMED CHARITY CARE BY AUDITORS. AS A RESULT, ROUGHLY 40% OF BAD DEBT IS PENDING CHARITY CARE. - THE CBO CONCLUDED THAT ITS FINDINGS "SUPPORT THE VALIDITY OF THE USE OF UNCOMPENSATED CARE [BAD DEBT AND CHARITY CARE] AS A MEASURE OF COMMUNITY BENEFITS" ASSUMING THE FINDINGS ARE GENERALIZABLE NATIONWIDE; THE EXPERIENCE OF HOSPITALS AROUND THE NATION REINFORCES THAT THEY ARE GENERALIZABLE. AS OUTLINED BY THE AHA, DESPITE THE HOSPITALS' BEST EFFORTS AN
SCHEDULE H, PART III, SECTION B; QUESTION 9B CONNECTICUT CHILDREN'S MEDICAL CENTER ("CONNECTICUT CHILDREN'S") HAS A BILLING AND COLLECTION POLICY. THE PURPOSE OF THIS POLICY IS TO ENSURE THAT THE ORGANIZATIONS BILLING, CREDIT AND COLLECTION PRACTICES COMPLY WITH ALL FEDERAL AND STATE LAWS, REGULATIONS GUIDELINES AND POLICIES. CONNECTICUT CHILDREN'S IS COMMITTED TO PROVIDING THE AVAILABLE HEALTHCARE, ALONG WITH CONVENIENT BILLING SERVICES, PAYMENT OPTIONS AND FINANCIAL ASSISTANCE. CONNECTICUT CHILDREN'S WILL MAKE EVERY EFFORT TO COMMUNICATE THE PATIENT FINANCIAL ASSISTANCE, BILLING, CREDIT AND COLLECTION PROCESSES TO THE PATIENT AND/OR THEIR FAMILY. PATIENTS AND THEIR FAMILIES ARE RESPONSIBLE TO PROVIDE TIMELY AND ACCURATE INFORMATION SUCH AS, BUT NOT LIMITED TO, DEMOGRAPHIC, INSURANCE, AND INCOME TO CONNECTICUT CHILDREN'S TO FACILITATE THE PATIENT FINANCIAL ASSISTANCE, BILLING, CREDIT AND COLLECTION PROCESSES. IT IS THE RESPONSIBILITY OF THE PATIENTS AND THEIR FAMILIES TO KNOW, UNDERSTAND, AND COMPLY WITH THEIR INSURANCE COVERAGE, COINSURANCE, COPAYS, DEDUCTIBLES, AND BENEFIT/COVERAGE LIMITATIONS. WE ASK OUR PATIENTS FAMILIES TO REMEMBER THAT AN INSURANCE POLICY IS A CONTRACT BETWEEN THEM AND THE INSURANCE COMPANY, AND THAT THEY HAVE THE FINAL RESPONSIBILITY FOR PAYMENT OF THEIR HOSPITAL BILL. CONNECTICUT CHILDREN'S PROVIDES PATIENT FINANCIAL SERVICES TO HELP FAMILIES NAVIGATE THE PROCESS OF BILLING AND MEDICAL INSURANCE. IN ADDITION, CUSTOMER SERVICE REPRESENTATIVES ARE AVAILABLE TO PROVIDE COPIES OF ITEMIZED PATIENT BILLS, EXPLAIN PARTICULAR BILLS, SET UP PAYMENT ARRANGEMENTS OR REVIEW WHAT COSTS INSURANCE HAS PAID AND WHAT PAYMENTS ARE DUE. AS A COURTESY TO ITS PATIENTS, CONNECTICUT CHILDREN'S SUBMITS BILLS TO THEIR INSURANCE COMPANIES AND MAKES EVERY EFFORT TO ADVANCE THEIR CLAIM. HOWEVER, IT MAY BECOME NECESSARY FOR A POLICY HOLDER TO CONTACT THEIR INSURANCE PROVIDER OR SUPPLY ADDITIONAL INFORMATION REQUIRED FOR CLAIMS PROCESSING PURPOSES OR TO EXPEDITE PAYMENT. THE ORGANIZATION REQUESTS BILLS BE PAID IN FULL WITHIN THIRTY (30) DAYS. THE GUARANTOR IS RESPONSIBLE TO OBTAIN THE NECESSARY FUNDS FROM ANY SOURCE, SUCH AS OBTAINING A LOAN THROUGH THEIR BANK AND/OR CREDIT UNION. IF THE GUARANTOR IS UNABLE TO PAY BY OBTAINING A LOAN OR USE OF A CREDIT CARD, PAYMENT ARRANGEMENTS MAY BE MADE WITH COUNSELORS. MONTHLY PAYMENTS ARE REQUIRED. REQUESTS FOR ESTABLISHING PAYMENT PLANS THAT EXTEND PAST THE ABOVE RECOMMENDED TERMS GREATER THAN 12 MONTHS MUST BE REVIEWED AND APPROVED BY MANAGEMENT. IN ADDITION, ANY REQUESTS FOR ESTABLISHING PAYMENT PLANS THAT EXTEND PAST A 60 MONTH TERM MUST BE REVIEWED AND APPROVED BY MANAGEMENT. CONNECTICUT CHILDREN'S WILL ONLY REFER THOSE ACCOUNTS TO COLLECTION AGENCIES WHEN IT HAS BEEN DETERMINED THAT THE PATIENT/GUARANTOR HAS THE MEANS TO PAY THE BALANCE AND HAS CHOSEN NOT TO APPLY FOR PATIENT FINANCIAL ASSISTANCE.
SCHEDULE H, PART VI; QUESTION 2 IN ADDITION TO THE CHNA REPORTED IN SCHEDULE H, PART V, SECTION B, THE ORGANIZATION CONTINUALLY WORKS TO ASSESS THE HEALTH OF THE COMMUNITY IN A NUMBER OF WAYS. WE COLLECT DATA REGARDING HOSPITAL USAGE AND REPORT THAT INFORMATION TO THE CONNECTICUT HOSPITAL ASSOCIATION. THAT DATA IS ANALYZED TO LOOK AT TRENDS AND OFTEN SUPPORTS OUR RESEARCH OR APPLICATIONS FOR GRANTS. EACH OF THE GRANTS THAT WE APPLY FOR INCORPORATES THE USE OF DATA AND RESEARCH TO EITHER RESPOND TO A NEED IDENTIFIED BY AN OUTSIDE FUNDING SOURCE, OR RESPOND TO A NEED THAT OUR ORGANIZATION HAS IDENTIFIED. CONNECTICUT HOSPITAL ASSOCIATION HAS A NUMBER OF MEETING GROUPS THAT GATHER PEOPLE FROM HOSPITALS ACROSS THE STATE TO SHARE TRENDS THAT THEY ARE SEEING AND SHARE BEST PRACTICES. THERE IS A POPULATION HEALTH GROUP AND A COMMUNITY HEALTH GROUP. A RECENTLY FORMED SOCIAL DETERMINANTS OF HEALTH GROUP HAS REPLACED THE HEALTH EQUITY GROUP. CONNECTICUT CHILDRENS IS REPRESENTED ON ALL OF THESE. WE ARE ALSO REPRESENTED ON BOARDS OF DIRECTORS/ADVISORY BOARDS OF A NUMBER OF ENTITIES THAT HELP US UNDERSTAND THE NEEDS OF THE COMMUNITY. A FEW EXAMPLES INCLUDE: - THE CHILDRENS FUND/CHILD HEALTH AND DEVELOPMENT INSTITUTE - CONNECTICUT AREA HEALTH EDUCATION CENTER - SOUTHSIDE INSTITUTE NEIGHBORHOOD ALLIANCE - URBAN LEAGUE OF GREATER HARTFORD - UNITED WAY OF CENTRAL AND NORTHEASTERN CONNECTICUT - STATE DEPARTMENT OF PUBLIC HEALTHS HEALTH IMPROVEMENT TASK FORCE - CITY OF HARTFORDS HEALTH DEPARTMENTS PUBLIC HEALTH ADVISORY COMMITTEE - NORTH HARTFORDS TRIPLE AIM CONNECTICUT CHILDRENS FORMED A COMMUNITY CHILD HEALTH LEARNING COLLABORATIVE, WITH THE FIRST COHORT CONSISTING OF NINE OTHER CHILDRENS HOSPITALS FROM AROUND THE COUNTRY. THE COLLABORATIVE EMPHASIZES PEER TO PEER LEARNING THROUGH SITE VISITS AND WEBINARS. THIS HELPS ALL PARTICIPANTS COMPARE TRENDS AND SHARE BEST PRACTICES.
SCHEDULE H, PART VI; QUESTION 3 IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 501(R)(4) THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE BY WIDELY PUBLICIZING VARIOUS DOCUMENTS. THESE DOCUMENTS ARE WIDELY PUBLICIZED IN THE FOLLOWING WAYS: 1) THE ORGANIZATIONS FINANCIAL ASSISTANCE POLICY ("FAP"), FINANCIAL ASSISTANCE APPLICATION AND PLAIN LANGUAGE SUMMARY ("PLS") ARE ALL AVAILABLE ON THE ORGANIZATION'S WEBSITE. 2) PAPER COPIES OF THE FAP, APPLICATION AND THE PLS ARE AVAILABLE UPON REQUEST WITHOUT CHARGE BY MAIL AND ARE AVAILABLE WITHIN VARIOUS AREAS THROUGHOUT CT CHILDRENS FACILITIES. THIS INCLUDES, BUT IS NOT LIMITED TO, EMERGENCY ROOMS, PATIENT REGISTRATION CHECK-IN AREAS AND THE PATIENT ACCESS DEPARTMENT. 3) THE ORGANIZATIONS FAP, APPLICATION AND PLS ARE AVAILABLE IN ENGLISH AND IN THE PRIMARY LANGUAGE OF POPULATIONS WITH LIMITED PROFICIENCY IN ENGLISH ("LEP") THAT CONSTITUTES THE LESSER OF 1,000 INDIVIDUALS OR 5% OF THE COMMUNITY SERVED WITHIN CT CHILDRENS PRIMARY SERVICE AREA. 4) ALL PATIENTS OF THE MEDICAL CENTER WILL BE OFFERED A COPY OF THE PLS AS PART OF THE INTAKE/DISCHARGE PROCESS. COPIES OF THE PLS WILL BE MADE AVAILABLE AT ALL CONNECTICUT CHILDRENS SPECIALTY GROUP OFFICE LOCATIONS. 5) SIGNS OR DISPLAYS INFORMING PATIENT ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE WILL BE CONSPICUOUSLY POSTED IN PUBLIC LOCATIONS INCLUDING THE EMERGENCY DEPARTMENT, PATIENT REGISTRATION CHECK-IN AREAS AND THE PATIENT ACCESS DEPARTMENT. 6) CT CHILDRENS WILL ALSO MAKE REASONABLE EFFORTS TO INFORM MEMBERS OF THE COMMUNITY ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE.
SCHEDULE H, PART VI; QUESTION 4 CONNECTICUT CHILDRENS SERVES PATIENTS ACROSS THE STATE OF CONNECTICUT AND BEYOND AND IS COMMITTED TO BUILDING STRONGER COMMUNITIES TO BETTER SUPPORT CHILDRENS HEALTH, DEVELOPMENT AND WELL-BEING. WITH ITS MAIN CAMPUS LOCATED IN THE CAPITAL CITY, HARTFORD SERVES AS THE HUB OF CONNECTICUT CHILDRENS COMMUNITY BUILDING EFFORTS, WHERE INTERVENTIONS ARE TESTED, REFINED, AND SCALED FOR IMPLEMENTATION IN ADDITIONAL COMMUNITIES AROUND THE STATE AND COUNTRY. FOUNDED IN 1637, HARTFORD IS AMONG THE OLDEST CITIES IN THE UNITED STATES. IT IS HOME TO THE COUNTRYS OLDEST ART MUSEUM, THE WADSWORTH ATHENEUM MUSEUM OF ART; THE OLDEST PUBLIC PARK, BUSHNELL PARK; AND THE OLDEST CONTINUOUSLY PUBLISHED NEWSPAPER, THE HARTFORD COURANT. AUTHORS MARK TWAIN AND HARRIET BEECHER STOWE ARE AMONG THE CITYS MOST NOTABLE FORMER RESIDENTS. DESPITE ITS RICH HISTORY, RESIDENTS WHO LIVE IN HARTFORD EXPERIENCE EXTENSIVE DISPARITIES WITH REGARD TO HEALTH CARE ACCESS, HEALTH OUTCOMES, HOME OWNERSHIP, EDUCATIONAL ACHIEVEMENT, AND ECONOMIC SUCCESS COMPARED TO THE REST OF THE STATE. IN 2018, THE LATEST YEAR DATA ARE AVAILABLE, THE CITY HAD A POPULATION OF MORE THAN 122,000 RESIDENTS, OF WHICH 44% ARE HISPANIC OR LATINO, 38% ARE BLACK OR AFRICAN-AMERICAN, AND 15% ARE WHITE. HARTFORD CONSISTENTLY RANKS AMONG THE POOREST CITIES OF ITS SIZE IN THE COUNTRY. TABLE 1 OF THE ORGANIZATIONS CHNA DEPICTS THE MANY AREAS WHERE HARTFORD RESIDENTS LAG BEHIND THE STATE AS A WHOLE. U.S. CENSUS DATA HIGHLIGHT THAT HARTFORD RESIDENTS ARE POORER, EXPERIENCE LESS HOUSING STABILITY, ACHIEVE LOWER LEVELS OF EDUCATION, ARE LESS LIKELY TO HAVE HEALTH INSURANCE, AND ARE MORE LIKELY TO HAVE A DISABILITY THAN RESIDENTS ACROSS CONNECTICUT, WHICH IS AMONG THE WEALTHIEST STATES IN THE NATION BASED ON PER CAPITA INCOME. THE CITYS MAJOR EMPLOYERS INCLUDE THE STATE OF CONNECTICUT, UNITED TECHNOLOGIES CORPORATION, HARTFORD HEALTHCARE, THE HARTFORD FINANCIAL SERVICES GROUP, AETNA, THE TRAVELERS, UNITEDHEALTHCARE, TRINITY COLLEGE AND CONNECTICUT CHILDRENS. AS OF MAY 2019, THE UNEMPLOYMENT RATE FOR RESIDENTS OF HARTFORD STOOD AT 6.3%, WHICH IS THE HIGHEST OF ANY MUNICIPALITY IN THE STATE, ACCORDING TO THE CONNECTICUT DEPARTMENT OF LABOR. IN CONTRAST, THE UNEMPLOYMENT RATE FOR RESIDENTS STATEWIDE WAS 3.6%. HARTFORD DISPARITIES TABLE: HARTFORD RESIDENTS CT RESIDENTS ------------------- ------------ MEDIAN HOUSEHOLD INCOME $33,841 $73,781 RESIDENTS LIVING IN POVERTY 30.5% 9.6% OWNER OCCUPIED HOUSING RATES 23.8% 66.6% HS GRADUATE OR HIGHER EDUCATION 72.7% 90.2% BACHELORS DEGREE OR HIGHER EDUCATION 16.6% 38.4% PERSONS W/O HEALTH INSURANCE UNDER 65 12.2% 6.4% PERSONS WITH DISABILITIES UNDER 65 11.4% 7.3%
SCHEDULE H, PART VI; QUESTION 5 CONNECTICUT CHILDREN'S MEDICAL CENTER HAS A VISION TO MAKE CONNECTICUTS CHILDREN THE HEALTHIEST IN THE NATION. WHILE THE ORGANIZATION PROVIDES LEADING MEDICAL CARE, TREATMENT, AND FOLLOW-UP SUPPORT WITHIN ITS FACILITIES, SOME OF THEIR BEST WORK IS PROMOTING CHILDREN'S HEALTH HAPPENS WITHIN CONNECTICUTS COMMUNITIES. THE OFFICE OF COMMUNITY CHILD HEALTH (OCCH) SERVES AS OUR ORGANIZATIONS KEY VEHICLE FOR PROMOTING CHILDRENS OPTIMAL HEALTHY DEVELOPMENT. WE PROMOTE COMMUNITY HEALTH ON A LOCAL, STATE-WIDE AND NATIONAL LEVEL. OCCH ADMINISTRATORS, PROGRAM LEADERS, AND STAFF ALL INTERFACE WITH DIFFERENT COMMUNITY LEADERS AND PARTNERS. OUR WORK IS SHARED, AND OUR EXPERTISE IS OFTEN WELCOMED IN THE NUMEROUS SETTINGS TO WHICH WE ARE INVOLVED. WE ARE CONTINUALLY DEVELOPING PARTNERSHIPS ON ALL LEVELS AS WE RECOGNIZE THAT AN "ALL SECTORS IN" APPROACH IS WHAT WILL LEAD TO POSITIVE CHANGE. WE BRING A LEVEL OF HEALTH PROMOTION EVIDENT WITH OUR MISSION STATEMENT TO ALL PARTNERSHIPS, WITH CONCEPT THAT WE ALL NEED EACH OTHERS HELP. SOME OF THE PROGRAMS UNDER OCCH (EASY BREATHING, EPIC, MAINTENANCE OF CERTIFICATION, CO-MANAGEMENT) WORK WITH HEALTH PROVIDERS ACROSS THE STATE TO IDENTIFY BETTER APPROACHES TO MANAGING CHILDRENS HEALTH ISSUES. WEEKLY GRAND ROUNDS ARE ALSO HELD FOR BOTH INTERNAL AND EXTERNAL PROVIDERS WITH TOPICS THAT OFTEN INCLUDE THE PROMOTION OF COMMUNITY HEALTH. PROGRAMS LIKE THOSE OF OUT INJURY PREVENTION CENTER FOCUS MUCH OF THEIR EFFORTS IN THE SHARING OF THEIR RESEARCH AND PROMOTING PREVENTION THROUGH THEIR ACTIVITIES. HEALTHY HOMES, EASY BREATHING, HYHIL, AND REACH ALL HAVE HEALTH PROMOTION OR PREVENTION AS COMMON THEMES WITH THEIR ACTIVITY. THE OFFICE OF GOVERNMENT RELATIONS USES INFORMATION GATHERED FROM THE PROGRAMS UNDER OCCH TO ALSO PROMOTE HEALTH TO KEY LEADERS OF OUR STATE LEGISLATORS AS WELL AS OUR REPRESENTATIVES AT THE FEDERAL LEVEL. AN EXAMPLE OF THEIR WORK CAN BE SEEN THROUGH THEIR EFFORTS IN HELPING STATE OFFICIALS INTERPRET CAR ACCIDENT STATISTICS GATHERED BY OUR INJURY PREVENTION CENTER, LEADING TO OUR STATE EXAMINING LAWS SURROUNDING NEW TEEN DRIVERS. CONNECTICUT IMPLEMENTED NEW DRIVER RESTRICTIONS FOR THAT AGE GROUP AS A RESULT. WE HAVE A REFERRING PROVIDER BOARD OF PEDIATRICIANS, REPRESENTING DIFFERENT GEOGRAPHIC PORTIONS OF CONNECTICUT, THAT HELP US UNDERSTAND WHAT THEY SEE AS KEY ISSUES IN THEIR COMMUNITIES, AND SUPPORT OUR MESSAGES ABOUT HEALTH PROMOTION. OUR TUESDAY MORNING GRAND ROUNDS IS OPEN TO COMMUNITY CLINICIANS AND WILL OFTEN DISCUSS NEW RESEARCH, NEW APPROACHES TO TREATMENT, AND HEALTH PROMOTION.
SCHEDULE H, PART VI; QUESTION 6 OUTLINED BELOW IS A SUMMARY OF THE ENTITIES WHICH COMPRISE CCMC CORPORATION AND SUBSIDIARIES: NOT FOR-PROFIT ENTITIES: ======================== CCMC CORPORATION ---------------- CCMC CORPORATION IS THE TAX-EXEMPT PARENT OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM WHICH CONSISTS OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. CCMC CORPORATION IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). AS THE PARENT ORGANIZATION, CCMC CORPORATION STRIVES TO CONTINUALLY DEVELOP AND OPERATE A HEALTHCARE SYSTEM WHICH PROVIDES SUBSTANTIAL COMMUNITY BENEFIT THROUGH THE PROVISION OF A COMPREHENSIVE SPECTRUM OF HEALTHCARE SERVICES TO THE CHILDREN OF CONNECTICUT AND SURROUNDING COMMUNITIES. CCMC CORPORATION IS THE SOLE MEMBER OF CONNECTICUT CHILDREN'S MEDICAL CENTER. CONNECTICUT CHILDREN'S MEDICAL CENTER ------------------------------------- CONNECTICUT CHILDREN'S MEDICAL CENTER IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL CHILDREN REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. NO CHILDREN ARE DENIED NECESSARY MEDICAL CARE, TREATMENT OR SERVICES. MOREOVER, CCMC OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL CHILDREN REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2. OPERATES AN ACTIVE EMERGENCY DEPARTMENT FOR ALL CHILDREN; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF THE HOSPITAL RESTS WITH ITS BOARD OF DIRECTORS AND THE BOARD OF DIRECTORS OF CCMC CORPORATION. BOTH BOARDS ARE COMPRISED OF A MAJORITY OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; AND 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE; PROGRAMS AND ACTIVITIES. CONNECTICUT CHILDREN'S MEDICAL CENTER FOUNDATION, INC. ------------------------------------------------------ CONNECTICUT CHILDREN'S MEDICAL CENTER FOUNDATION, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). THE ORGANIZATION SUPPORTS CONNECTICUT CHILDREN'S MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, AND ITS AFFILIATES IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO THE COMMUNITY IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. CCMC AFFILIATES, INC. --------------------- CCMC AFFILIATES, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). PRIOR TO CEASING OPERATIONS EFFECTIVE JUNE 2, 2018, THIS ORGANIZATION PROVIDED SPECIALIZED EDUCATION AND CHILD DEVELOPMENT PROGRAMS TO CHILDREN OF CONNECTICUT AND THE SURROUNDING AREAS. CONNECTICUT CHILDREN'S SPECIALTY GROUP, INC. -------------------------------------------- CONNECTICUT CHILDREN'S SPECIALTY GROUP, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL CHILDREN REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. CHILDREN'S FUND OF CONNECTICUT, INC. ------------------------------------ CHILDREN'S FUND OF CONNECTICUT, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THE ORGANIZATION SUPPORTS CONNECTICUT CHILDREN'S MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, AND ITS AFFILIATES IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL CHILDREN REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. CHILDREN'S HEALTH AND DEVELOPMENT INSTITUTE, INC. ------------------------------------------------- CHILDREN'S HEALTH AND DEVELOPMENT INSTITUTE, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. CAPITAL AREA HEALTH CONSORTIUM, INC. ------------------------------------ CAPITAL AREA HEALTH CONSORTIUM, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THE ORGANIZATION SUPPORTS CONNECTICUT CHILDREN'S MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, AND ITS AFFILIATES IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL CHILDREN REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. CONNECTICUT CHILDREN'S CARE NETWORK, LLC ---------------------------------------- CONNECTICUT CHILDREN'S CARE NETWORK, LLC IS A LIMITED LIABILITY COMPANY FORMED IN THE STATE OF CONNECTICUT WHOSE SOLE MEMBER IS CONNECTICUT CHILDREN'S MEDICAL CENTER. THE ORGANIZATION WAS FORMED AS A CLINICALLY INTEGRATED NETWORK, DESIGNED TO EVALUATE AND MODIFY PRACTICES OF PARTICIPATING PHYSICIANS AND CREATE A HIGH DEGREE OF INTERDEPENDENCE AND COOPERATION AMONG PARTICIPATING PHYSICIANS. FOR-PROFIT ENTITIES: =================== CCMC VENTURES, INC. ------------------- A FOR-PROFIT ENTITY, WHOSE SOLE SHAREHOLDER IS CCMC CORPORATION. THE ORGANIZATION IS LOCATED IN HARTFORD, CONNECTICUT. THIS ENTITY IS CURRENTLY INACTIVE. NEW ENGLAND PEDIATRICS INDEMNITY, LTD. -------------------------------------- A FOR-PROFIT ENTITY, WHOSE SOLE SHAREHOLDER IS CCMC CORPORATION. THE ORGANIZATION IS A MEDICAL MALPRACTICE INSURANCE FOREIGN CAPTIVE ORGANIZATION LOCATED IN BERMUDA.
SCHEDULE H, PART VI; QUESTION 7 THE STATE OF CONNECTICUT HAS AN OFFICE OF THE HEALTHCARE ADVOCATE. THEY SURVEY EACH HOSPITALS SCHEDULE H OF THE 990 FILING TO ENSURE THAT COMMUNITY BENEFITS HAVE BEEN REPORTED IN LIEU OF SEPARATE REPORTS FROM HOSPITALS.
Schedule H (Form 990) 2018
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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
CONNECTICUT CHILDREN'S MEDICAL CENTER
 
Employer identification number
06-0646755
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) MANDELL GREATER HARTFORD JEWISH COMM CTR
335 BLOOMFIELD AVE
WEST HARTFORD,CT06117 		06-0662142 501(C)(3) 12,500       PROGRAM SUPPORT
(2) CONNECTICUT DOUBLE PLAY LLC
PO BOX 231417
HARTFORD,CT06103 		45-2704533   35,980       PROGRAM SUPPORT
(3) THE AMERICAN SPORTS PROPERTIES
PO BOX 843038
KANSAS CITY,MO64184 		90-0776492   32,000       PROGRAM SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
1
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
2
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2018

Schedule I (Form 990) 2018
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1) EDUCATIONAL SCHOLARSHIPS 10 53,500      
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
SCHEDULE I, PART I, QUESTION 2 GRANTS ARE MONITORED BY THE ORGANIZATION'S FINANCE PERSONNEL THROUGH THE UTILIZATION OF COST CENTERS AND OTHER INFORMATION; INCLUDING WRITTEN DOCUMENTATION AND RECEIPTS.
SCHEDULE I, PART II PLEASE NOTE, THE ORGANIZATION PROVIDED A NUMBER OF GRANTS AND OTHER ASSISTANCE TO DOMESTIC ORGANIZATIONS THAT DID NOT EXCEED $5,000 AND THEREFORE, ARE NOT REQUIRED TO BE INCLUDED WITHIN SCHEDULE I, PART II. SCHEDULE I,
Schedule I (Form 990) 2018



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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" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
CONNECTICUT CHILDREN'S MEDICAL CENTER
 
Employer identification number

06-0646755
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 on 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 on 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 on 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," on line 5a or 5b, describe in Part III.
6
For persons listed on 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," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported on 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" on 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) 2018

Schedule J (Form 990) 2018
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 on 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 on prior Form 990
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1JAMES E SHMERLING DHA FACHE
DIRECTOR - PRESIDENT/CEO 		(i)

(ii)		 965,388
-------------
0 		457,193
-------------
0 		22,612
-------------
0 		504,358
-------------
0 		20,174
-------------
0 		1,969,725
-------------
0 		301,781
-------------
0
2JEFFREY THOMSON MD
DIRECTOR - PRES MED STAFF 		(i)

(ii)		 0
-------------
747,092 		0
-------------
0 		0
-------------
22,539 		0
-------------
37,718 		0
-------------
26,230 		0
-------------
833,579 		0
-------------
0
3JEFFREY HYAMS MD
DIRECTOR (TERM ENDED 12/2018) 		(i)

(ii)		 0
-------------
443,812 		0
-------------
43,801 		0
-------------
39,345 		0
-------------
80,730 		0
-------------
28,730 		0
-------------
636,418 		0
-------------
43,801
4SETH VAN ESSENDELFT
TREASURER - SVP/CFO 		(i)

(ii)		 389,175
-------------
0 		0
-------------
0 		424
-------------
0 		171,018
-------------
0 		13,115
-------------
0 		573,732
-------------
0 		0
-------------
0
5GIL PERI MBA MPH
PRESIDENT & COO 		(i)

(ii)		 534,112
-------------
0 		0
-------------
0 		19,418
-------------
0 		278,224
-------------
0 		32,730
-------------
0 		864,484
-------------
0 		0
-------------
0
6CHRISTINE FINCK MD FACS
EVP, SURGEON IN CHIEF 		(i)

(ii)		 0
-------------
764,471 		0
-------------
124,803 		0
-------------
1,408 		0
-------------
262,141 		0
-------------
24,521 		0
-------------
1,177,344 		0
-------------
124,803
7JUAN SALAZAR MD MPH
EVP, ACADEMIC AFFAIRS 		(i)

(ii)		 456,788
-------------
0 		137,979
-------------
0 		7,032
-------------
0 		188,492
-------------
0 		28,880
-------------
0 		819,171
-------------
0 		137,979
-------------
0
8PAUL H DWORKIN MD
EVP, COMMUNITY CHILD HEALTH 		(i)

(ii)		 444,170
-------------
0 		95,101
-------------
0 		9,701
-------------
0 		158,976
-------------
0 		0
-------------
0 		707,948
-------------
0 		95,101
-------------
0
9ANN G TAYLOR JD
EVP, CHIEF ADM OFF(TERM 02/19) 		(i)

(ii)		 314,857
-------------
0 		92,057
-------------
0 		22,539
-------------
0 		96,144
-------------
0 		17,016
-------------
0 		542,613
-------------
0 		92,057
-------------
0
10LAWRENCE E MILAN MA
SVP, HUMAN RESOURCES 		(i)

(ii)		 286,431
-------------
0 		64,724
-------------
0 		4,439
-------------
0 		107,993
-------------
0 		8,729
-------------
0 		472,316
-------------
0 		64,724
-------------
0
11BOBBY M VARGAS ESQ
VP, GENERAL COUNSEL 		(i)

(ii)		 305,468
-------------
0 		64,477
-------------
0 		612
-------------
0 		112,396
-------------
0 		30,677
-------------
0 		513,630
-------------
0 		64,477
-------------
0
12KELLY STYLES MBA
SVP, CHIEF INFORMATION OFFICER 		(i)

(ii)		 307,762
-------------
0 		65,908
-------------
0 		22,539
-------------
0 		113,486
-------------
0 		9,377
-------------
0 		519,072
-------------
0 		65,908
-------------
0
13CHERYL HOEY RN BSN MBA
SVP, CLINICAL SERVICES & CNO 		(i)

(ii)		 306,597
-------------
0 		67,548
-------------
0 		4,039
-------------
0 		94,604
-------------
0 		26,230
-------------
0 		499,018
-------------
0 		67,548
-------------
0
14JAMES MOORE MD PHD
VP CLINICAL NTK DEV(EFF 07/19) 		(i)

(ii)		 0
-------------
494,953 		0
-------------
18,442 		0
-------------
13,158 		0
-------------
183,713 		0
-------------
28,880 		0
-------------
739,146 		0
-------------
18,442
15WILLIAM AGOSTINUCCI MS RPH
VP, CLINICAL & SUPPORT SVCS 		(i)

(ii)		 224,768
-------------
0 		65,035
-------------
0 		7,787
-------------
0 		84,484
-------------
0 		11,229
-------------
0 		393,303
-------------
0 		65,035
-------------
0
16DEB PAPPAS MBA
VP MKTG/COMMUNICATIONS OFFICER 		(i)

(ii)		 248,654
-------------
0 		30,000
-------------
0 		1,923
-------------
0 		97,746
-------------
0 		19,768
-------------
0 		398,091
-------------
0 		0
-------------
0
17TRISHA FARMER MSN RN CPHRM
VP, REG PARTNERSHIPS & OPS 		(i)

(ii)		 202,468
-------------
0 		40,609
-------------
0 		1,038
-------------
0 		76,333
-------------
0 		29,977
-------------
0 		350,425
-------------
0 		40,609
-------------
0
18LORI R PELLETIER PHD MBA
CHIEF QUALITY OFF (EFF 08/19) 		(i)

(ii)		 0
-------------
0 		0
-------------
0 		0
-------------
0 		0
-------------
0 		0
-------------
0 		0
-------------
0 		0
-------------
0
19HEATHER TORY MD MPH CPPS
INTERIM PAT SFTY(10/18-07/19) 		(i)

(ii)		 151,494
-------------
0 		26,313
-------------
0 		286
-------------
0 		12,515
-------------
0 		6,000
-------------
0 		196,608
-------------
0 		16,313
-------------
0
20RICHELLE DEMAYO MD
CHIEF MED INFORMATION OFFICER 		(i)

(ii)		 283,260
-------------
0 		54,744
-------------
0 		918
-------------
0 		60,922
-------------
0 		8,959
-------------
0 		408,803
-------------
0 		54,744
-------------
0
21GLENN FLORES
CHIEF RESEARCH OFFICER 		(i)

(ii)		 341,463
-------------
0 		0
-------------
0 		2,632
-------------
0 		113,444
-------------
0 		28,880
-------------
0 		486,419
-------------
0 		0
-------------
0
22JUNG PARK
SR DIR, INFORMATION SERVICES 		(i)

(ii)		 206,317
-------------
0 		45,507
-------------
0 		436
-------------
0 		45,423
-------------
0 		0
-------------
0 		297,683
-------------
0 		35,507
-------------
0
23MARLENE E FERRIS
SR DIR, ORGANIZATIONAL EFFECT. 		(i)

(ii)		 186,474
-------------
0 		40,506
-------------
0 		1,887
-------------
0 		1,887
-------------
0 		17,124
-------------
0 		247,878
-------------
0 		30,506
-------------
0
24LOUISE M VIOLETTE
SR DIR, FINANCE APPLICATION 		(i)

(ii)		 175,076
-------------
0 		27,085
-------------
0 		2,534
-------------
0 		39,705
-------------
0 		23,788
-------------
0 		268,188
-------------
0 		0
-------------
0
25SHANNON M GRAD
SR DIR, FAMILY EXP & PROF PRAC 		(i)

(ii)		 170,914
-------------
0 		28,612
-------------
0 		350
-------------
0 		40,410
-------------
0 		0
-------------
0 		240,286
-------------
0 		28,612
-------------
0
26PHILIP B HOPKINS
DIRECTOR TECHNICAL SERVICES 		(i)

(ii)		 177,923
-------------
0 		18,806
-------------
0 		1,579
-------------
0 		28,430
-------------
0 		0
-------------
0 		226,738
-------------
0 		18,806
-------------
0
27ANDREA L BENIN MD
FORMER OFFICER 		(i)

(ii)		 175,777
-------------
0 		92,909
-------------
0 		182,038
-------------
0 		16,400
-------------
0 		31,730
-------------
0 		498,854
-------------
0 		92,909
-------------
0
28PATRICK J GARVEY CPA CHFP
FORMER OFFICER 		(i)

(ii)		 0
-------------
0 		68,914
-------------
0 		338,798
-------------
0 		16,400
-------------
0 		30,677
-------------
0 		454,789
-------------
0 		78,446
-------------
0
29AUDREY WISE MBA
FORMER OFFICER 		(i)

(ii)		 0
-------------
  		0
-------------
0 		173,032
-------------
0 		8,585
-------------
0 		13,950
-------------
0 		195,567
-------------
0 		0
-------------
0
Schedule J (Form 990) 2018

Schedule J (Form 990) 2018
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
CORE FORM, PART VII AND SCHEDULE J TAXABLE COMPENSATION REPORTED HEREIN IS DERIVED FROM 2018 FORMS W-2.
SCHEDULE J, PART I; QUESTION 3 EACH YEAR, ARTHUR GALLAGHER ASSOCIATES CONDUCTS A MARKET ANALYSIS OF CONNECTICUT CHILDREN'S MEDICAL CENTER'S ("CONNECTICUT CHILDREN'S") PRESIDENT/CHIEF EXECUTIVE OFFICER, OFFICERS AND OTHER KEY EMPLOYEES. TO AUGMENT THEIR PROPRIETARY AND OTHER DATA TO WHICH THEY HAVE ACCESS, CONNECTICUT CHILDREN'S PROVIDES THE DATA RESULTS FROM SALARY SURVEYS IN WHICH CONNECTICUT CHILDREN'S PARTICIPATES. THE ANALYSIS AND PRESENTATION OF THE DATA IS PRESENTED BY THE ARTHUR GALLAGHER ASSOCIATES REPRESENTATIVE TO THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND THE MEMBERS OF THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. ANNUALLY THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND THE BOARD OF DIRECTORS THEN REVIEW AND DISCUSS SALARY RECOMMENDATIONS FOR THE OFFICERS AND OTHER KEY EMPLOYEES AND SIGN OFF ON THE FINAL RECOMMENDATIONS. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS MEETS INDEPENDENTLY WITH THE PRESIDENT/CHIEF EXECUTIVE OFFICER TO DISCUSS HIS INDIVIDUAL PERFORMANCE. FOLLOWING THE PERFORMANCE EVALUATION, A SALARY RECOMMENDATION IS MADE AND COMMUNICATED TO THE SENIOR VICE PRESIDENT OF HUMAN RESOURCES TO AUTHORIZE PROCESSING.
SCHEDULE J, PART I; QUESTION 4A THE FOLLOWING INDIVIDUALS RECEIVED A SEVERANCE PAYMENT DURING CALENDAR YEAR 2018 WHICH WAS INCLUDED IN EACH INDIVIDUAL'S 2018 FORM W-2, BOX 5 AS TAXABLE MEDICARE WAGES: ANDREA L. BENIN, M.D., $181,120; PATRICK J. GARVEY, CPA, CHFP, $337,880 AND AUDREY WISE, MBA, $171,407.
SCHEDULE J, PART I; QUESTION 4B THE DEFERRED COMPENSATION AMOUNT REFLECTED IN SCHEDULE J, PART II, COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDES UNVESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN EACH INDIVIDUAL'S 2018 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: JAMES E. SHMERLING, DHA, FACHE, $171,720; JEFFREY THOMSON, M.D., $20,900; JEFFREY HYAMS, M.D., $11,293; SETH VAN ESSENDELFT, $49,001; GIL PERI, MBA, MPH, $75,654; CHRISTINE FINCK, M.D., FACS, $80,626; JUAN SALAZAR, M.D., MPH, $49,321; PAUL H. DWORKIN, M.D., $43,206; LAWRENCE E. MILAN, MA, $30,149; AIMEE MONROY SMITH, $9,335; BOBBY M. VARGAS, ESQ., $36,540; KELLY STYLES, MBA, $31,336; CHERYL HOEY, RN, BSN, MBA, $29,943; JAMES MOORE, M.D., PH.D., $15,400; WILLIAM AGOSTINUCCI, MS, RPH, $25,672; DEB PAPPAS, MBA, $30,602; TRISHA FARMER, MSN, RN, CPHRM, $22,737; HEATHER TORY, M.D., MPH, CPPS, $3,500 AND GLENN FLORES, $35,700.
SCHEDULE J, PART I; QUESTIONS 6A & 6B THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE ORGANIZATION'S BOARD OF DIRECTORS HAS AN EXECUTIVE COMPENSATION COMMITTEE ("COMMITTEE"). ACCORDINGLY, THE ORGANIZATION'S COMMITTEE MAY ELECT TO MAKE INCENTIVE AWARDS IN ITS SOLE DISCRETION. IF THE COMMITTEE ELECTS TO MAKE SUCH INCENTIVE AWARDS, THE AMOUNT OF AN ELIGIBLE EMPLOYEES INCENTIVE AWARD IS BASED GENERALLY UPON THE FOLLOWING CRITERIA: - CCMC CORPORATION ACHIEVING THRESHOLD FOR THE FINANCIAL GOALS, OTHERWISE NO INCENTIVE WILL BE PAID; - INDIVIDUAL AND CORPORATION PERFORMANCE AND WHETHER THE LEVEL OF PERFORMANCE ACHIEVED IS AT THRESHOLD, TARGET, OR STRETCH; AND - THE PERCENTAGE OF THE AWARD COMPRISED OF CORPORATION VERSUS INDIVIDUAL PERFORMANCE. THE COMPENSATION FOR CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II OF THIS FORM 990 CONSIST OF BOTH A FIXED SALARY AND ADDITIONAL AT-RISK INCENTIVE COMPENSATION.
SCHEDULE J, PART I; QUESTION 7 IF THE COMPENSATION COMMITTEE ELECTS TO MAKE INCENTIVE AWARDS, THESE AWARDS ARE TO BE PAID NO LATER THAN TWO AND ONE-HALF MONTHS AFTER THE END OF THE FISCAL OR CALENDAR YEAR, WHICHEVER IS LATER, AFTER WHICH THE AMOUNT OF SUCH AWARDS ARE DETERMINED. THEREFORE, IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS, RULES AND REGULATIONS, CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED INCENTIVE AWARDS DURING CALENDAR YEAR 2018 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2018 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT. ADDITIONALLY, INCENTIVE AWARDS DETERMINED FOR THE ORGANIZATION'S CURRENT FISCAL YEAR TO BE PAID IN A FUTURE CALENDAR YEAR, ARE CURRENTLY INCLUDED IN SCHEDULE J, PART II, COLUMN C, AS OTHER DEFERRED COMPENSATION.
SCHEDULE J, PART II; COLUMN F THE AMOUNTS REPORTED WITHIN SCHEDULE J, PART II, COLUMN F FOR THE FOLLOWING INDIVIDUALS INCLUDE EMPLOYEE INCENTIVE AWARDS AS THESE AMOUNTS WERE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THESE AMOUNTS WERE PREVIOUSLY REPORTED WITHIN SCHEDULE J, PART II, COLUMN C AS RETIREMENT AND OTHER DEFERRED COMPENSATION ON PRIOR YEARS FORMS 990. THESE AMOUNTS WERE TREATED AS TAXABLE INCOME AND REPORTED IN EACH INDIVIDUALS 2018 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: JAMES E. SHMERLING, DHA, FACHE, $301,781; JEFFREY HYAMS, M.D., $43,801; CHRISTINE FINCK, M.D., FACS, $124,803; JUAN SALAZAR, M.D., MPH, $137,979; PAUL H. DWORKIN, M.D., $95,101; ANN G. TAYLOR, JD, $92,057; LAWRENCE E. MILAN, MA, $64,724; BOBBY M. VARGAS, ESQ., $64,477; KELLY STYLES, MBA, $65,908; CHERYL HOEY, RN, BSN, MBA, $67,548; JAMES MOORE, M.D., PH.D., $18,442; WILLIAM AGOSTINUCCI, MS, RPH, $65,035; TRISHA FARMER, MSN, RN, CPHRM, $40,609; HEATHER TORY, M.D., MPH, CPPS, $16,313; RICHELLE DEMAYO, M.D., $54,744; JUNG PARK, $35,507; MARLENE E. FERRIS, $30,506; SHANNON M. GRAD, $28,612; PHILIP B. HOPKINS, $18,806; ANDREA L. BENIN, M.D., $92,909 AND PATRICK J. GARVEY, CPA, CHFP, $78,446.
Schedule J (Form 990) 2018
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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 Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet Attach to Form 990.
SchKMediumBulletGo to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
CONNECTICUT CHILDREN'S MEDICAL CENTER
 
Employer identification number
06-0646755
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 CT HEALTH & EDUCATIONAL FACILITIES AUTHORITY
  		06-0806186   06-30-2011 41,580,000 REFI SER B&C BOND/LEASE FINANCINGS   X   X   X
B CT HEALTH & EDUCATIONAL FACILITIES AUTHORITY
  		06-0806186   10-12-2007 8,500,000 LEASE FINANCE VARIOUS EQUIPMENT X     X   X
C CT HEALTH & EDUCATIONAL FACILITIES AUTHORITY
  		06-0806186   04-04-2013 13,500,000 CONSTRUCT & EQUIP ASC   X   X   X
Part Ⅱ
Proceeds
A B C D
1 Amount of bonds retired .................. 11,055,375 0 12,343,070  
2 Amount of bonds legally defeased .............. 0 8,500,000 0  
3 Total proceeds of issue .................. 41,580,000 8,500,000 13,500,000  
4 Gross proceeds in reserve funds ............. 0 0 0  
5 Capitalized interest from proceeds ............. 0 0 0  
6 Proceeds in refunding escrows ............... 10,255,050 0 0  
7 Issuance costs from proceeds ............... 779,214 34,581 49,245  
8 Credit enhancement from proceeds ............. 0 0 0  
9 Working capital expenditures from proceeds ............. 0 0 0  
10 Capital expenditures from proceeds ............. 0 8,465,419 13,450,755  
11 Other spent proceeds ............. 30,545,736 0 0  
12 Other unspent proceeds ............. 0 0 0  
13 Year of substantial completion ............. 2011 2010 2015
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? .... X     X   X    
15 Were the bonds issued as part of an advance refunding issue? ..... X     X   X    
16 Has the final allocation of proceeds been made? .......... X   X   X      
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. 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) 2018

Schedule K (Form 990) 2018
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       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 1.540 % 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 ............. 1.540 %      
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    
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......                
b Exception to rebate? ........ X   X   X      
c No rebate due? .........                
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    
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X     X   X    
b Name of provider .......... BANK OF AMERICA
  		0
  		0
  		 
 
c Term of hedge ......... 2080 %      
d Was the hedge superintegrated? ......   X            
e Was the hedge terminated? ........   X            
Schedule K (Form 990) 2018

Schedule K (Form 990) 2018
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    
b Name of provider .......... 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    
7 Has the organization established written procedures to monitor the requirements of section 148? ... 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      
Part Ⅵ
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
Schedule K (Form 990) 2018

Additional Data


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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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
CONNECTICUT CHILDREN'S MEDICAL CENTER
 
Employer identification number

06-0646755
Return Reference Explanation
CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS BACKGROUND ========== CONNECTICUT CHILDREN'S MEDICAL CENTER ("CONNECTICUT CHILDREN'S") IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE ("IRS") AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES CONNECTICUT CHILDREN'S PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL CHILDREN IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, CONNECTICUT CHILDREN'S OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. CONNECTICUT CHILDREN'S PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL CHILDREN REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2. CONNECTICUT CHILDREN'S OPERATES AN ACTIVE EMERGENCY ROOM FOR ALL CHILDREN WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. CONNECTICUT CHILDREN'S MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF CONNECTICUT CHILDREN'S RESTS WITH ITS BOARD OF DIRECTORS. ITS BOARD IS COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE, PROGRAMS AND ACTIVITIES. THE OPERATIONS OF CONNECTICUT CHILDREN'S, AS SHOWN THROUGH THE FACTORS OUTLINED ABOVE AND OTHER INFORMATION CONTAINED HEREIN, CLEARLY DEMONSTRATE THE HOSPITAL PROVIDES SUBSTANTIAL COMMUNITY BENEFIT AND THAT THE USE AND CONTROL OF CONNECTICUT CHILDREN'S IS FOR THE BENEFIT OF THE PUBLIC, AND THAT NO PART OF THE INCOME OR NET EARNINGS OF THE ORGANIZATION INURES TO THE BENEFIT OF ANY PRIVATE INDIVIDUAL, NOR IS ANY PRIVATE INTEREST BEING SERVED OTHER THAN INCIDENTALLY. ADDITIONALLY, CONNECTICUT CHILDRENS BOARD CERTIFIED PHYSICIANS AND HIGHLY TRAINED SPECIALISTS PROVIDE ADVANCED CLINICAL AND SURGICAL CARE TO CHILDREN OF ALL AGERS. HOWEVER, THE IMPACT MADE ON HEALTH CARE IN CONNECTICUT REACHES FAR BEYOND THEIR WALLS AND INTO COMMUNITIES ACROSS THE STATE. CONNECTICUT CHILDRENS PIONEERED AN INNOVATIVE COMMUNITY CHILD HEALTH MODEL WHICH LEADS RESEARCH, DEVELOPMENT AND DELIVERY OF ROBUST OUTREACH PROGRAMS THAT ADDRESS CRITICAL ISSUES AFFECTING THE HEALTH, DEVELOPMENT AND WELL-BEING OF CONNECTICUTS CHILDREN. THIS MODEL, WHICH SERVES AS AN EXAMPLE FOR OTHER CHILDRENS HOSPITALS NATIONWIDE, HELPS KEEP CHILDREN SAFER AND HEALTHIER. IT ALSO EMPOWERS COMMUNITY PEDIATRICIANS TO PROVIDE BETTER PRIMARY CARE, SO THAT TOGETHER THEY CAN SUCCEED IN MAKING CHILDREN IN CONNECTICUT THE HEALTHIEST IN THE NATION. PATIENTS AND FAMILIES FROM EVERY CORNER OF CONNECTICUT, AND NOW MASSACHUSETTS, HAVE BENEFITED FROM CONNECTICUT CHILDRENS ONGOING CLINICAL AND COMMUNITY-FOCUSED GROWTH. NEW CONSTRUCTION AND EXTENDED PATIENT SERVICES HAVE EXPANDED CAPABILITIES THROUGHOUT CONNECTICUT AND SOUTHERN NEW ENGLAND. HISTORY ======= CONNECTICUT CHILDREN'S IS A NATIONALLY RECOGNIZED NOT-FOR-PROFIT WITH A MEDICAL STAFF OF MORE THAN 1,000 WHO PROVIDE COMPREHENSIVE, WORLD-CLASS HEALTHCARE IN MORE THAN 30 PEDIATRIC SPECIALTIES AND SUBSPECIALTIES. CONNECTICUT CHILDRENS IS THE PRIMARY PEDIATRIC TEACHING HOSPITAL FOR THE UCONN SCHOOL OF MEDICINE, HAS A TEACHING PARTNERSHIP WITH THE FRANK H. NETTER, M.D. SCHOOL OF MEDICINE AT QUINNIPIAC UNIVERSITY AND IS A RESEARCH PARTNER OF THE JACKSON LABORATORY. THE HISTORY OF CONNECTICUT CHILDREN'S SPANS MORE THAN 100 YEARS. FOUNDED AS A 10-BED HOSPITAL FOR CHILDREN WHO SUFFERED THEN INCURABLE CONDITIONS SUCH AS CEREBRAL PALSY, SPINA BIFIDA AND POLIO, CONNECTICUT CHILDREN'S IS NOW ONE OF ONLY TWO FREESTANDING CHILDREN'S HOSPITALS IN NEW ENGLAND AND IS THE ONLY FREESTANDING CHILDREN'S HOSPITAL IN CONNECTICUT. CONNECTICUT CHILDREN'S PROVIDES AN ARRAY OF PEDIATRIC SERVICES IN LOCATIONS ACROSS CONNECTICUT AND IN MASSACHUSETTS, INCLUDING AT HOSPITALS IN HARTFORD AND WATERBURY, NEONATAL INTENSIVE CARE UNITS IN HARTFORD AND FARMINGTON, AN AMBULATORY SURGERY CENTER IN FARMINGTON PRIMARY CARE CENTERS AND EAST HARTFORD AND WEST HARTFORD, FIVE SPECIALTY CARE CENTERS, AND 11 OTHER LOCATIONS. ITS LEVEL 1 PEDIATRIC TRAUMA CENTER IS THE BUSIEST BETWEEN BOSTON AND NEW YORK. MISSION ======= CONNECTICUT CHILDREN'S IS DEDICATED TO IMPROVING THE PHYSICAL AND EMOTIONAL HEALTH OF CHILDREN THROUGH FAMILY-CENTERED CARE, RESEARCH, EDUCATION AND ADVOCACY. CONNECTICUT CHILDREN'S EMBRACES DISCOVERY, TEAMWORK, INTEGRITY AND EXCELLENCE IN ALL THAT IT DOES. PROGRAMS OF EXCELLENCE ====================== CONNECTICUT CHILDREN'S OFFERS THE HIGHEST LEVEL OF CARE TO CHILDREN AND OUR PHYSICIANS AND PROGRAMS ARE CONSISTENTLY HONORED FOR THEIR EXCELLENCE. RECENT AWARDS INCLUDE THE 2019 WOMENS CHOICE AWARD FOR BEST CHILDRENS HOSPITALS AND THE 2019 U.S. NEWS & WORLD REPORT BEST CHILDRENS HOSPITAL. IN ADDITION, THERE ARE SEVERAL PROGRAMS OF EXCELLENCE AT THE MEDICAL CENTER THAT HAVE TIME AND AGAIN EARNED NATIONAL AND INTERNATIONAL HONORS AND ACCOLADES INCLUDING, BUT NOT LIMITED TO: - DIABETES & ENDOCRINOLOGY; - GASTROENTEROLOGY; - NEONATOLOGY; - ORTHOPAEDICS; - RECONSTRUCTIVE AND SOLID TUMOR SURGERY; - SURGERY; AND - UROLOGY. EACH OF OUR PROGRAMS OF EXCELLENCE OFFERS SUPERIOR PEDIATRIC CLINICAL CARE AND HAS DEMONSTRATED THE ABILITY TO: 1) EXPAND ACCESS TO SERVICES TO MEET THE GROWING NEEDS OF CHILDREN AND FAMILIES; 2) INTEGRATE VARIOUS DISCIPLINES OF CLINICAL PRACTICE TO PROVIDE EXPANDED ADVANCED CARE; 3) DEVELOP OPPORTUNITIES TO EXPAND BASIC AND CLINICAL RESEARCH; AND 4) CREATE OPPORTUNITIES TO BE AN INNOVATIVE LEADER IN EDUCATION AND TRAINING. OUTCOMES -------- NOTHING MATTERS MORE THAN THE OUTCOME. CONNECTICUT CHILDREN'S KEEPS KIDS HEALTHY, PROTECTS THEM FROM SURGICAL COMPLICATIONS AND IMPROVES THE QUALITY OF LIFE OF THOSE WITH CHRONIC CONDITIONS. PROCESS OF CARE --------------- SEVERAL ELEMENTS ARE CONSIDERED, INCLUDING HOSPITAL COMPLIANCE WITH BEST PRACTICES AND A COMMITMENT TO INFECTION CONTROL. RESEARCH ======== CONNECTICUT CHILDREN'S IS COMMITTED TO MAKING CHILDREN AND FAMILIES HEALTHIER. OUR TALENTED MEDICAL PROFESSIONALS ARE AT THE FOREFRONT OF RESEARCH AND CLINICAL TRIALS. SUCH SCIENTIFIC INQUIRIES CHANGE THE FUTURE OF CHILDREN'S HEALTHCARE. FROM FUNDAMENTAL MOLECULAR SCIENCE THAT HELPS US UNDERSTAND DISEASES AT THE MOST BASIC LEVEL, TO MOTION STUDIES DESIGNED TO DISCOVER NEW WAYS FOR YOUNG ATHLETES TO AVOID INJURIES AND CLINICAL TRIALS THAT ESTABLISH THE MOST EFFECTIVE AND EFFICIENT PROTOCOLS FOR TREATING CHILDREN, CONNECTICUT CHILDREN'S IS A RESEARCH LEADER. FOR EXAMPLE, CONNECTICUT CHILDREN'S DIVISION OF HEMATOLOGY & ONCOLOGY IS ENGAGED IN CONDUCTING MORE THAN 100 ACTIVE CLINICAL TRIALS AND RESEARCH STUDIES THROUGH THE CHILDREN'S ONCOLOGY GROUP, THE NEUROBLASTOMA AND MEDULLOBLASTOMA TREATMENT RESEARCH CONSORTIUM, THE PEDIATRIC CANCER FOUNDATION'S SUNSHINE PROJECT, THE SUNCOAST COMMUNITY CLINICAL ONCOLOGY PROGRAM AND PHARMACEUTIC COMPANY SPONSORS. THIS NUMBER OF OPEN PROTOCOLS DISTINGUISHES CONNECTICUT CHILDREN'S HEMATOLOGY & ONCOLOGY DIVISION AMONG THE TOP 20 PERCENT AMONG ITS PEERS. ADDITIONALLY, THE DIVISION IS IN THE TOP THIRD PERCENTILE FOR TOTAL PEDIATRIC CANCER PATIENTS ENROLLED IN TRIALS. THIS IS ESPECIALLY IMPRESSIVE GIVEN THAT CONNECTICUT CHILDREN'S IS CONSIDERED ONE OF THE SMALLER FREE-STANDING CHILDREN'S HOSPITALS IN THE COUNTRY. AWARDS AND RECOGNITION ====================== CONNECTICUT CHILDRENS HAS RECEIVED THE FOLLOWING AWARDS: - 2019, 2018 & 2017 WOMENS CHOICE AWARD FOR BEST CHILDRENS HOSPITALS; - 2019, 2018 & 2017 CHIME HEALTHCARES MOST WIRED AWARD; - 2019, 2018 & 2017 U.S. NEWS & WORLD REPORT BEST CHILDRENS HOSPITAL; - 2019, 2018 & 2017 LANTERN AWARD; - 2018 3M AWARD FOR EXCELLENCE IN SKIN SAFETY; - 2016 CHILDKIND HOSPITAL DESIGNATION; - 2016 PRESS GANEY SUCCESS STORY AWARD; - 2016 HARTFORD BUSINESS JOURNAL HEALTHCARE HERO (CHRISTINE FINCK, M.D.); - 2016 HARTFORD BUSINESS JOURNAL BEST IN BUSINESS, ONCOLOGY (CENTER FOR CANCER AND BLOOD DISORDERS); - 2016 TOP MASTERS IN HEALTHCARE ADMINISTRATION; - 2016 GET WITH THE GUIDELINES - RESUSCITATION SILVER AWARD; AND - 2015 TOP WORKPLACE IN CONNECTICUT, RANKED 10TH IN LARGE ORGANIZATION CATEGORY.
CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS OFFICE OF COMMUNITY CHILD HEALTH ("OCCH") ========================================= CONNECTICUT CHILDRENS OFFICE FOR COMMUNITY CHILD HEALTH ELEVATES THE EFFECTIVENESS AND STATUS OF THE MEDICAL CENTER AS A CRITICAL COMMUNITY RESOURCE BY DEVELOPING, PROMOTING, SUPPORTING, EVALUATING AND DISSEMINATING INNOVATIVE, EFFECTIVE COMMUNITY-ORIENTED PROGRAMS AND SERVICES TO ADDRESS CHILDRENS CRITICAL HEALTH NEEDS. WHAT WE DO ---------- OCCH ADDRESSES CRITICAL CONTEMPORARY ISSUES IN CHILDRENS LIVES THAT HAVE THE POTENTIAL TO ADVERSELY AFFECT THEIR HEALTH AND DEVELOPMENT. THE OFFICE NOT ONLY SERVES AS A CRITICAL COMMUNITY RESOURCE, BUT ALSO CULTIVATES INNOVATIVE AND COST-EFFECTIVE SOLUTIONS TO ADDRESS EXISTING GAPS IN OUR HEALTH CARE AND CHILD SERVICE SYSTEMS. THROUGH THE OFFICE, CONNECTICUT CHILDRENS MEDICAL CENTER ENSURES THAT FAMILIES HAVE ACCESS TO A COMPREHENSIVE SYSTEM OF COMMUNITY PROGRAMS AND SERVICES THAT SUPPORTS THEM IN PROMOTING THEIR CHILDRENS OPTIMAL HEALTHY DEVELOPMENT. OUR MODEL --------- THE OFFICE OVERSEES A VARIETY OF COMMUNITY-ORIENTED PROGRAMS THAT ADDRESS A WIDE RANGE OF FACTORS THAT INFLUENCE CHILDRENS HEALTHY DEVELOPMENT. THOSE PROGRAMS, AND THEIR COMMUNITY-BASED PARTNERS, NOT ONLY FOCUS ON THE TRADITIONAL AREAS OF CHILD HEALTH SERVICES, FAMILY SUPPORT, AND EARLY CARE AND EDUCATION, BUT ALSO TOUCH OTHER SECTORS INCLUDING FOOD AND NUTRITION, HOUSING, ECONOMIC DEVELOPMENT, CHILD WELFARE, AND TRANSPORTATION. THE OFFICE TAKES A THREE-PRONGED APPROACH TO PROMOTING CHILDRENS OPTIMAL HEALTHY DEVELOPMENT: 1. STRENGTHENING EXISTING COMMUNITY-ORIENTED PROGRAMS; 2. FACILITATING SYNERGIES AMONG THOSE PROGRAMS; AND 3. SERVING AS AN INNOVATION INCUBATOR FOR PROMISING APPROACHES THAT IMPROVE SHORT AND LONG-TERM HEALTH OUTCOMES FOR CHILDREN. THE OFFICE SERVES AS A NEW MODEL FOR OTHER CHILDRENS HOSPITALS TO FOLLOW IN TERMS OF DEMONSTRATING THEIR COMMUNITY BENEFIT TO MAINTAIN TAX EXEMPT STATUS. IN THE PAST, HOSPITALS HAVE TRADITIONALLY RELIED ON DOCUMENTING THE DISCOUNTED AND UNREIMBURSED CARE THAT THEY PROVIDE TO PATIENTS. NOW, UNDER THE AFFORDABLE CARE ACT, THERE HAS BEEN A SHARP REDUCTION IN THE NUMBER OF AMERICANS WHO ARE UNINSURED AND, THEREFORE, A REDUCTION IN THE NEED FOR DISCOUNTED OR UNREIMBURSED CARE. BECAUSE OF THAT, HOSPITALS ARE BEING ENCOURAGED TO FIND NEW WAYS TO DEMONSTRATE THE BENEFIT THEY OFFER TO THEIR COMMUNITIES. THE OFFICES MODEL OFFERS A STRATEGIC APPROACH THAT SHOWS HOW ITS PROGRAMS ARE LINKED TO CRITICAL COMMUNITY NEEDS AND HOW THEY ARE ADDRESSING THOSE NEEDS. ALSO, THE OFFICES FOCUS ON PREVENTIVE AND COST-EFFECTIVE MODELS OF CARE FOR CHILDREN IS TIMELY GIVEN THE SHIFT IN HEALTHCARE TOWARDS ACCOUNTABLE CARE THAT EMPHASIZES VALUE IN TERMS OF KEEPING POPULATIONS HEALTHY. THE OFFICE TAKES AN ACTIVE LEADERSHIP ROLE IN INFORMING POPULATION HEALTH EFFORTS AT THE LOCAL, STATE AND NATIONAL LEVELS. OUR IMPACT, AT A GLANCE ----------------------- THE OCCH HAS ESTABLISHED ITSELF AS A CRITICAL RESOURCE IN THE STATE AND ACROSS THE NATION AND IS: - PARTNERING WITH THE CONNECTICUT OFFICE FOR EARLY CHILDHOOD TO LEAD THE DEVELOPMENT OF A COMPREHENSIVE, STATEWIDE EARLY CHILDHOOD SYSTEM; AND - ENGAGED IN ONGOING DIALOGUE ON KEY PUBLIC POLICY CONCEPTS NECESSARY FOR SYSTEM-BUILDING WITH A WIDE ARRAY OF FEDERAL AGENCIES, INCLUDING THE MATERNAL AND CHILD HEALTH BUREAU, THE ADMINISTRATION FOR CHILDREN AND FAMILIES AND THE SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION. OCCH PROGRAMS ------------- CONNECTICUT CHILDREN'S OCCH OPERATES A TOTAL OF 15 PROGRAMS: INNOVATION: - THE HELP ME GROW NATIONAL CENTER; - CONNECTICUT CHILDRENS ADVANCING KIDS INNOVATION PROGRAM; - EASY BREATHING; - KOHLS START CHILDHOOD OFF RIGHT PROGRAM; AND - CARE COORDINATION COLLABORATIVE MODEL. DIRECT SERVICES: - CONNECTICUT CHILDRENS CENTER FOR CARE COORDINATION; - CONNECTICUT CHILDRENS HEALTHY HOMES PROGRAM; - HARTFORD YOUTH HIV IDENTIFICATION AND LINKAGE CONSORTIUM; AND - PERSON-CENTERED MEDICAL HOME. EDUCATION AND RESEARCH: - INJURY PREVENTION CENTER; - CO-MANAGEMENT; - CHILDRENS CENTER ON FAMILY VIOLENCE; - EDUCATING PRACTICES IN THE COMMUNITY; - PRACTICE QUALITY IMPROVEMENT PROGRAM; AND - RESIDENT EDUCATION IN ADVOCACY AND COMMUNITY HEALTH. DESCRIPTIONS OF THOSE PROGRAMS ARE LISTED BELOW: INNOVATION ---------- THE HELP ME GROW NATIONAL CENTER, INNOVATED IN HARTFORD AND BASED AT CONNECTICUT CHILDRENS MEDICAL CENTER, SERVES AS A NATIONAL RESOURCE FOR SUPPORTING THE REPLICATION OF HELP ME GROW SYSTEMS THROUGHOUT THE COUNTRY. TESTED AS A PILOT PROJECT IN HARTFORD IN 1997, THE PROGRAM EXPANDED STATEWIDE IN 2002 AND IS ALSO BEING REPLICATED AROUND THE COUNTRY. HELP ME GROW LINKS CHILDREN WHO ARE AT RISK FOR DEVELOPMENTAL OR BEHAVIORAL PROBLEMS TO HELPFUL COMMUNITY-BASED PROGRAMS AND SERVICES. CONNECTICUT CHILDRENS ADVANCING KIDS INNOVATION PROGRAM CONNECTICUT CHILDRENS ADVANCING KIDS INNOVATION PROGRAM ("AKIP") OFFERS INDIVIDUALS AND ORGANIZATIONS AN EXCITING OPPORTUNITY TO GET CRUCIAL GUIDANCE, ACCESS TO KEY STAKEHOLDERS, AND TECHNICAL ASSISTANCE NEEDED TO MAKE INNOVATIONS PROMOTING THE OPTIMAL HEALTHY DEVELOPMENT OF CHILDREN SUCCESSFUL ON A LOCAL, STATEWIDE, AND EVEN NATIONAL LEVEL. AKIP, WHICH IS PART OF CONNECTICUT CHILDRENS OFFICE FOR COMMUNITY CHILD HEALTH (THE OFFICE), SEEKS TO ESTABLISH A PIPELINE OF INNOVATIONS THAT FOCUS ON THE HEALTH OF CHILDREN, STRENGTHEN FAMILIES, AND SHOW HIGH POTENTIAL FOR BEING BOTH SUSTAINABLE AND REPLICABLE. AKIP SEEKS TO ENGAGE A BROAD RANGE OF POTENTIAL COMMUNITY HEALTH INNOVATORS ADDRESSING CRITICAL COMMUNITY HEALTH NEEDS, INCLUDING INDIVIDUAL ENTREPRENEURS, BUSINESSES, COMMUNITY-BASED ORGANIZATIONS; RESEARCHERS; BEHAVIORAL HEALTH PROVIDERS, OTHER HEALTHCARE PROVIDERS, HEALTHCARE PAYERS AND OTHERS COMMITTED TO IMPROVING CHILDRENS HEALTHY DEVELOPMENT. THE PROGRAM PLANS TO SUPPORT INNOVATIONS AS THEY MOVE TOWARDS MORE EVIDENCE-INFORMED, HIGHER IMPACT SOLUTIONS DESIGNED TO CLOSE EXISTING GAPS IN PROGRAMS AND SERVICES CURRENTLY OFFERED TO CHILDREN ACROSS A VARIETY OF SECTORS. EASY BREATHING IS A COMMUNITY-BASED ASTHMA MANAGEMENT PROGRAM INNOVATED AT CONNECTICUT CHILDRENS AND HOUSED IN OUR ASTHMA CENTER. IT ENSURES CHILDREN, FAMILIES AND PHYSICIANS WORK TOGETHER TO MANAGE ASTHMA SYMPTOMS USING NATIONAL ASTHMA GUIDELINES. THE PROGRAM IS AVAILABLE TO CHILDREN ACROSS CONNECTICUT AND IS ALSO BEING REPLICATED IN OTHER STATES. THE KOHLS START CHILDHOOD OFF RIGHT (SCOR) PROGRAM IS DEDICATED TO DECREASING OBESITY IN HARTFORD CHILDREN FROM BIRTH TO AGE 2 BY FIVE PERCENT. SCOR IS WORKING TO ACCOMPLISH THAT GOAL THROUGH THE FOLLOWING ACTIVITIES: 1) CONVENE A COLLABORATIVE OF COMMUNITY PARTNERS WHO ARE MOBILIZED TO COMBAT CHILDHOOD OBESITY; 2) EDUCATE PEDIATRIC PROVIDERS TO COUNSEL HARTFORD FAMILIES ON HEALTHY NUTRITION AND ACTIVITY AND PROVIDE REFERRALS TO COMMUNITY RESOURCES FOR AT RISK 0-2 YEAR OLDS; 3) TRAIN COMMUNITY OUTREACH WORKERS ON COUNSELING AND SUPPORTING FAMILIES WITH 0-2 YEAR OLDS TO UTILIZE CONSISTENT HEALTHY GROWTH MESSAGING; 4) CONNECT HARTFORD FAMILIES TO HEALTH PROMOTION ORGANIZATIONS DURING WELLNESS EVENTS AND SHARING HEALTHY EATING MESSAGES; AND 5) REFER AT RISK FAMILIES TO CHILD DEVELOPMENT INFOLINE TO CONNECT THEM TO COMMUNITY RESOURCES. THE CARE COORDINATION COLLABORATIVE MODEL IS THE SIGNATURE INNOVATION OF CONNECTICUT CHILDRENS CETNER FOR CARE COORDINATION. THE MODEL IMPROVES COLLABORATION AMONG CARE COORDINATORS FROM DIVERSE SECTORS INCLUDING CHILD HEALTH, EARLY CARE AND EDUCATION, AND FAMILY SUPPORT. IT ALSO PROVIDES CHILDREN AND FAMILIES WITH LINKS TO EFFECTIVE SERVICES. IT WORKS BY BRINGING TOGETHER CARE COORDINATORS FROM SEVERAL CHILD-SERVING SECTORS FOR PERIODIC MEETINGS TO LEARN ABOUT AVAILABLE SERVICES AND HOW TO HELP FAMILIES ACCESS THEM, TO REVIEW CHALLENGING CASES AND DEVELOP SOLUTIONS FOR FAMILIES, AND TO ADVOCATE FOR POLICY LEVEL SOLUTIONS TO HELP FAMILIES ADDRESS CHALLENGES THEY FACE CONNECTING TO SERVICES. INITIALLY LAUNCHED IN THE GREATER HARTFORD AREA, THE PROGRAM HAS EXPANDED ACROSS THE STATE OF CONNECTICUT AND INTO ADDITIONAL STATES.
CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS DIRECT SERVICES --------------- THE CONNECTICUT CHILDRENS CENTER FOR CARE COORDINATION (THE CENTER) EMPOWERS FAMILIES OF ALL CHILDREN, INCLUDING THOSE WITH SPECIAL NEEDS, BY HELPING THEM ADVOCATE FOR ACCESS TO APPROPRIATE MEDICAL, BEHAVIORAL, EDUCATIONAL, LEGAL, AND SOCIAL SERVICES. THE CENTER ALSO PROVIDES TRAINING AND TECHNICAL SUPPORT FOR COMMUNITY-BASED PRIMARY CARE PROVIDERS, SUPPORTING THEM TO BECOME MEDICAL HOMES FOR THE CHILDREN THEY SERVE. THE CONNECTICUT CHILDRENS HEALTHY HOMES PROGRAM IMPROVES THE LIVES OF CHILDREN BY MAKING THEIR HOMES HEALTHIER, SAFER AND MORE ENERGY EFFICIENT. THE PROGRAM PROVIDES QUALIFIED HOMEOWNERS AND TENANTS WITH INSPECTIONS AND PLANS FOR THE REMOVAL OF LEAD, ASTHMA TRIGGERS, AND SAFETY HAZARDS. IT ALSO PROVIDES FINANCIAL ASSISTANCE FOR REMEDIATION, RELOCATION ASSISTANCE DURING CONSTRUCTION, REFERRALS TO LOW-COST OR NO-COST WEATHERIZATION PROGRAMS TO INCREASE ENERGY EFFICIENCY, AND EDUCATION PERTAINING TO HEALTHY AND SAFE HOMES. THE HARTFORD YOUTH HIV IDENTIFICATION AND LINKAGE CONSORTIUM WORKS TO PREVENT THE SPREAD OF HIV AND OTHER SEXUALLY TRANSMITTED DISEASES AMONG YOUTH. THE PROGRAM PROVIDES INTERACTIVE PREVENTION EDUCATION, COMMUNITY ENGAGEMENT AND OUTREACH, AND YOUTH FRIENDLY HIV/STD SCREENINGS. THE CONSORTIUM ALSO LINKS YOUTH TO MEDICAL CARE SERVICES, EMPLOYMENT SERVICES AND OTHER COMMUNITY RESOURCES. THE CONNECTICUT CHILDREN'S PRIMARY CARE CENTER RECENTLY RECEIVED DESIGNATION AS A PERSON CENTERED MEDICAL HOME. IN ACHIEVING THAT RECOGNITION, THE CENTER MET RIGOROUS STANDARDS SET BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE AND WAS RECOGNIZED FOR COORDINATING PATIENT CARE, MAINTAINING A HIGH LEVEL OF QUALITY IN SERVICE DELIVERY, AND ENSURING THAT PATIENTS AND FAMILIES REMAIN AT THE CENTER OF ALL CARE. SEVERAL PROGRAMS OVERSEEN BY THE OFFICE FOR COMMUNITY CHILD HEALTH SUPPORT THE PRIMARY CARE CENTER IN ITS MEDICAL HOME STATUS. EDUCATION AND RESEARCH ---------------------- THE INJURY PREVENTION CENTER ENGAGES IN RESEARCH, COMMUNITY OUTREACH, EDUCATION, TRAINING, AND PUBLIC POLICY WORK TO REDUCE PREVENTABLE INJURIES AND VIOLENCE TO CHILDREN. ITS THREE PRIMARY FOCUS AREAS ARE TEEN DRIVING SAFETY, TEEN SUICIDE PREVENTION AND DOMESTIC VIOLENCE PREVENTION. ITS COMMUNITY PROGRAMS, INCLUDING SAFE KIDS CONNECTICUT AND THE INJURY FREE COALITION FOR KIDS OF HARTFORD, ADDRESS A WIDE RANGE OF CHILD SAFETY CONCERNS RANGING FROM CHILD PASSENGER SAFETY TO POISONING PREVENTION AND OTHER HOME SAFETY ISSUES. CO-MANAGEMENT EMPOWERS PRIMARY CARE PROVIDERS TO IMPROVE THE BREADTH AND QUALITY OF CARE THEY PROVIDE TO CHILDREN. PRIMARY CARE PROVIDERS PARTNER WITH SUBSPECIALISTS TO DESIGN PROTOCOLS FOR THE CARE OF CERTAIN HIGH PREVALENCE CONDITIONS THAT ARE TYPICALLY REFERRED TO SUBSPECIALISTS. BY DOING SO, THIS CARE MODEL ALLOWS CHILDREN TO RECEIVE SOME SUBSPECIALTY CARE WITHIN THEIR MEDICAL HOME AND ENSURES THAT THEY RECEIVE TIMELY ACCESS TO SUBSPECIALTY CARE WHEN NEEDED. THE MODEL FREES UP SUBSPECIALTY APPOINTMENTS FOR CHILDREN WHOSE CONDITIONS CANNOT BE MANAGED IN THE PRIMARY CARE SETTING. THE CHILDRENS CENTER ON FAMLIY VIOLENCE AIMS TO INCREASE UNDERSTANDING ABOUT THE IMPACT FAMILY VIOLENCE HAS ON CHILDREN AND TO INCREASE SUPPORT SERVICES FOR AFFECTED CHILDREN. THE CENTER IS A PARTNERSHIP BETWEEN THE CONNECTICUT CHILDRENS SUSPECTED CHILD ABUSE AND NEGLECT PROGRAM, THE CONNECTICUT CHILDRENS INJURY PREVENTION CENTER, AND THE CONNECTICUT COALITION AGAINST DOMESTIC VIOLENCE. THE CENTERS GOALS INCLUDE IMPROVING SERVICE SYSTEMS FOR AFFECTED FAMILIES, WHICH CURRENTLY OFTEN DO NOT UTILIZE BEST PRACTICES, AND ENHANCING RESEARCH EFFORTS FOR CHILD-FOCUSED INTERVENTIONS, WHERE THE EVIDENCE BASE IS CURRENTLY INADEQUATE. THE CENTER ALSO PLANS TO ESTABLISH A STATEWIDE FAMILY VIOLENCE INFORMATION SYSTEM TO GATHER DATA, IDENTIFY TRENDS, AND TRACK PROGRESS OVER TIME. THE EDUCATING PRACTICES IN THE COMMUNITY PROGRAM IS A SIGNATURE INNOVATION OF THE CHILD HEALTH AND DEVELOPMENT INSTITUTE OF CONNECTICUT AND IS SUPPORTED BY THE CONNECTICUT CHILDRENS OFFICE FOR COMMUNITY CHILD HEALTH. ITS DESIGNED TO BRING THE NEWEST DEVELOPMENTS IN PEDIATRIC PRIMARY CARE TO CONNECTICUTS CHILD HEALTH PROVIDERS THROUGH THE PROCESS OF ACADEMIC DETAILING AND WORKS TO ADVANCE SUSTAINABLE IMPROVEMENTS IN PRIMARY AND PREVENTIVE HEALTH AND MENTAL HEALTH CARE PRACTICES FOR ALL CONNECTICUT CHILDREN. THE PRACTICE QUALITY IMPROVEMENT PROGRAM HELPS PRIMARY CARE PHYSICIANS USE A DATA-DRIVEN, QUALITY IMPROVEMENT APPROACH TO ENHANCE THE SERVICES THEY PROVIDE TO CHILDREN. PROGRAM ACTIVITIES HELP PRACTICES IMPROVE THEIR SURVEILLANCE AND SCREENING FOR DEVELOPMENTAL RISKS, IMPROVE THEIR IDENTIFICATION OF BEHAVIORAL CONCERNS, AND CONNECT CHILDREN AND FAMILIES TO HELPFUL SERVICES. THE RESIDENT EDUCATION IN ADVOCACY AND COMMUNITY HEALTH PROGRAM HELPS TO FOSTER THE GROWTH OF FUTURE GENERATIONS OF PEDIATRICIANS WHO ARE COMMUNITY CHILD HEALTH ADVOCATES. THE PROGRAM NURTURES PEDIATRIC RESIDENTS TO BECOME FUTURE LEADERS BY PROVIDING THEM WITH UNIQUE OPPORTUNITIES TO DEVELOP KNOWLEDGE AND SKILLS IN THE AREAS OF ADVOCACY, COMMUNITY HEALTH AND PUBLIC POLICY. DURING THEIR TIME IN THE PROGRAM, PEDIATRIC RESIDENTS WORK CLOSELY WITH EXPERTS IN THE FIELDS OF POPULATION HEALTH, COMMUNITY RESEARCH, POLICY REFORM, AND SOCIAL INNOVATION ALL WITH THE GOAL OF PROMOTING CHILDRENS HEALTHY DEVELOPMENT.
CORE FORM, PART V, QUESTIONS 3A & 3B AS OF THE DUE DATE OF THE ORGANIZATION'S 2018 FEDERAL FORM 990, THE ORGANIZATION DID NOT HAVE ANY UNRELATED BUSINESS INCOME ("UBI"). PLEASE NOTE, QUESTIONS 3A AND 3B WITHIN CORE FORM, PART V OF THIS FORM 990 ARE MARKED "YES" BECAUSE THE ORGANIZATION ANTICIPATED HAVING UBI IN EXCESS OF $1,000. THEREFORE, THE ORGANIZATION PROPERLY FILED A FORM 8868, APPLICATION FOR EXTENSION OF TIME TO FILE, FOR ITS FORM 990-T. ON DECEMBER 20, 2019 CONGRESS PASSED TWO BILLS WHICH INCLUDED THE RETROACTIVE REPEAL OF INTERNAL REVENUE CODE ("IRC") 512(A)(7). AS A RESULT OF THIS TAX REPEAL, QUALIFIED TRANSPORTATION BENEFITS WOULD NO LONGER BE TREATED AS UBI AND REPORTED WITHIN THE FORM 990-T. SINCE THE ORGANIZATION PREVIOUSLY FILED AN EXTENSION FOR ITS FORM 990-T, BUT DOES NOT ENGAGE IN ANY ADDITIONAL UBI ACTIVITIES, IT HAS FILED A FINAL FORM 990-T WHICH REFLECTS NO UBI FOR THE YEAR ENDED SEPTEMBER 30, 2019.
CORE FORM, PART VI, SECTION A, QUESTION 2 WILLIAM C. POPIK, M.D. & DAVID M. ROTH, ESQ. - BUSINESS RELATIONSHIP.
CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 CCMC CORPORATION IS THE SOLE MEMBER OF THIS ORGANIZATION. CCMC CORPORATION HAS THE RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF DIRECTORS AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS.
CORE FORM, PART VI, SECTION B; QUESTION 11B THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF ITS GOVERNING BODY (ITS BOARD OF DIRECTORS) PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE ("IRS"). THE ORGANIZATION'S FINANCE AND AUDIT COMMITTEE ASSUMES THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990 PREPARATION, REVIEW AND FILING PROCESS. AS PART OF THE ORGANIZATION'S FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED A PROFESSIONAL CPA FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE SYSTEM'S FINANCE PERSONNEL INCLUDING THE SENIOR VICE PRESIDENT/CHIEF FINANCIAL OFFICER, CORPORATE CONTROLLER, ACCOUNTING MANAGER AND VARIOUS OTHER INDIVIDUALS ("INTERNAL WORKING GROUP") TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE SYSTEM'S INTERNAL WORKING GROUP FOR REVIEW. THE SYSTEM'S INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE SYSTEM'S INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL. THE FORM 990 WAS THEN PROVIDED AND PRESENTED TO THE ORGANIZATION'S FINANCE AND AUDIT COMMITTEE AND SUBSEQUENTLY TO EACH VOTING MEMBER OF ITS GOVERNING BODY PRIOR TO FILING WITH THE IRS.
CORE FORM, PART VI, SECTION B; QUESTION 12 THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE ORGANIZATION AND SYSTEM REGULARLY MONITOR AND ENFORCE COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS AND SENIOR MANAGEMENT PERSONNEL ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE. THE ORGANIZATION'S CORPORATE COMPLIANCE/CONFLICT OF INTEREST COMMITTEE ("COMMITTEE") HAS OVERSIGHT OVER THE MANAGEMENT OF IDENTIFIED OR REPORTED CASES OF CONFLICTS OF INTEREST. THE COMMITTEE IS ALSO RESPONSIBLE FOR DEVELOPING, APPROVING, AND IMPLEMENTING, AS APPROPRIATE, POLICIES AND EDUCATION RELATING TO VARIOUS TYPES OF CONFLICTS OF INTEREST. THE COMMITTEE HAS DELEGATED THE DAY TO DAY INVESTIGATION OF DISCLOSURES TO THE SYSTEM'S GENERAL COUNSEL AND DIRECTOR OF COMPLIANCE. COMPLETED QUESTIONNAIRES ARE RETURNED TO THE SYSTEM'S GENERAL COUNSEL, WHO PERFORMS AN INITIAL SCREENING OF THE CONFLICT OF INTEREST DISCLOSURES. IF POTENTIAL CONFLICTS OF INTERESTS ARE REPORTED, GENERAL COUNSEL COMPLETES FURTHER INVESTIGATION AND RECOMMENDS A MANAGEMENT PLAN OR OTHER CORRECTIVE ACTIONS TO THE COMMITTEE.
CORE FORM, PART VI, SECTION B; QUESTION 15 THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE ORGANIZATION'S BOARD OF DIRECTORS HAS AN EXECUTIVE COMPENSATION COMMITTEE ("COMMITTEE"). THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES OF THE COMPENSATION AND BENEFITS OF CONNECTICUT CHILDREN'S SENIOR MANAGEMENT. THE COMMITTEE REVIEWS THE "TOTAL COMPENSATION" OF THESE INDIVIDUALS WHICH IS INTENDED TO INCLUDE BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED. THE COMMITTEE'S REVIEW IS DONE ON AT LEAST AN ANNUAL BASIS AND ENSURES THAT THE "TOTAL COMPENSATION" OF SENIOR MANAGEMENT OF THE ORGANIZATION IS REASONABLE. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THE ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF THE SENIOR MANAGEMENT TEAM. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES EACH OF WHO ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEWING OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING BUT NOT LIMITED TO SIMILAR SIZED HOSPITALS, # OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE, INCLUDING COMPLEXITY OF SERVICES. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS ONLY APPLIES TO CERTAIN SENIOR MANAGEMENT PERSONNEL. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990 ARE REVIEWED ANNUALLY BY THE PRESIDENT/CHIEF EXECUTIVE OFFICER WITH ASSISTANCE FROM THE ORGANIZATION'S SENIOR VICE PRESIDENT OF HUMAN RESOURCES AND THE HUMAN RESOURCES DEPARTMENT, IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR AND IS BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY THE ORGANIZATION. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS AND PERFORMANCE FEEDBACK MEETINGS. PLEASE ALSO REFER TO OUR RESPONSE INCLUDED IN SCHEDULE J, PART III, QUESTION 3 FOR FURTHER INFORMATION ON HOW CONNECTICUT CHILDREN'S MEDICAL CENTER SATISFIES THE CRITERIA TO SATISFY THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO EXECUTIVE COMPENSATION REVIEW AND APPROVAL.
CORE FORM, PART VI, SECTION C; QUESTION 19 THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE CONNECTICUT SECRETARY OF STATE. ADDITIONALLY, THE ORGANIZATION'S GOVERNING POLICIES AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
CORE FORM, PART VII AND SCHEDULE J CORE FORM, PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THIS ORGANIZATION OR A RELATED ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THIS ORGANIZATION OR THE RELATED ORGANIZATION; NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THE ORGANIZATION'S BOARD OF DIRECTORS.
CORE FORM, PART VII AND SCHEDULE J CERTAIN INDIVIDUALS WERE REPORTED AS OFFICERS ON THE 2017 FORM 990, CORE FORM, PART VII AND SCHEDULE J. UPON A REVIEW OF THEIR RESPECTIVE DUTIES, ROLES AND RESPONSIBILITIES IT WAS DETERMINED THAT THESE INDIVIDUALS DO NOT SATISFY THE CRITERIA TO BE AN OFFICER UNDER (1) FORM 990 RULES, REGULATIONS AND INSTRUCTIONS; (2) CONNECTICUT LAW; OR (3) THE ORGANIZATION'S BYLAWS. HOWEVER, IT WAS DETERMINED THAT THESE INDIVIDUALS SATISFY THE CRITERIA TO BE CLASSIFIED AS KEY EMPLOYEES FOR FORM 990 REPORTING PURPOSES. ACCORDINGLY, THESE INDIVIDUALS HAVE BEEN INCLUDED ON THIS 2018 FORM 990 AS KEY EMPLOYEES.
CORE FORM, PART VII AND SCHEDULE J AIMEE MONROY SMITH SERVED AS A VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY UNTIL APRIL 2019. EFFECTIVE MAY 2019, MS. SMITH WAS HIRED AS THE SENIOR VICE PRESIDENT, GOVERNMENT RELATIONS & EXTERNAL AFFAIRS OF THIS ORGANIZATION. IN ADDITION, DURING THE FISCAL YEAR, LORI R. PELLETIER, PH.D, M.D., WAS HIRED AS THE CHIEF QUALITY AND PATIENT SAFETY OFFICER. IN ACCORDANCE WITH INTERNAL REVENUE SERVICE FORM 990 RULES, REGULATIONS AND INSTRUCTIONS, THE COMPENSATION REPORTED WITHIN CORE FORM, PART VII AND SCHEDULE J, PART II OF THIS FORM 990 IS DERIVED FROM 2018 FORMS W-2. ACCORDINGLY, THESE INDIVIDUALS HAVE NO W-2 COMPENSATION REPORTED ON THE CURRENT YEAR FEDERAL FORM 990, CORE FORM VII, SECTION A, COLUMN D. JAMES MOORE, M.D., PH.D. BECAME A KEY EMPLOYEE OF THE ORGANIZATION DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019. HOWEVER, HE WAS PREVIOUSLY EMPLOYED BY A RELATED ORGANIZATION IN A NON-OFFICER CAPACITY. THE COMPENSATION BEING REPORTED FOR DR. MOORE ON THIS FORM 990 REFLECTS COMPENSATION EARNED IN A NON-OFFICER CAPACITY. SARAH MATNEY, PREVIOUSLY REPORTED AS AN OFFICER ON THIS ORGANIZATION'S FORM 990, IS EMPLOYED AS THE VICE PRESIDENT, AMBULATORY OPERATIONS OF CONNECTICUT CHILDREN'S SPECIALTY GROUP ("CCSG"); A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. ACCORDINGLY, HER RESPECTIVE REPORTABLE COMPENSATION, RETIREMENT/OTHER DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED WITHIN CORE FORM, PART VII AND SCHEDULE J OF THE CCSG (EIN: 06-1446900) FEDERAL FORM 990. PLEASE REFER TO THE CCSG FORM 990 FOR THIS INFORMATION.
CORE FORM, PART VII, SECTION A, COLUMN B THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). CERTAIN BOARD OF DIRECTOR MEMBERS AND OFFICERS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENT THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF DIRECTORS OF OTHER RELATED ORGANIZATIONS WITHIN THE SYSTEM, THEIR RESPECTIVE HOURS ARE APPROXIMATELY THE SAME AS REFLECTED ON CORE FORM, PART VII OF THIS FORM 990. THE HOURS REFLECTED CORE FORM, PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF THE SYSTEM; NOT SOLELY THIS ORGANIZATION.
CORE FORM, PART X; LINES 27 29 IN 2019, THE MEDICAL CENTER ADOPTED THE FINANCIAL ACCOUNTING STANDARD BOARDS (FASB) ACCOUNTING STANDARDS UPDATE (ASU) NO. 2016-14, NOT-FOR-PROFIT ENTITIES (TOPIC 958): PRESENTATION OF FINANCIAL STATEMENTS OF NOT-FOR-PROFIT ENTITIES. ASU NO. 2016-14 ADDRESSES THE COMPLEXITY AND UNDERSTANDABILITY OF NET ASSET CLASSIFICATION, DEFICIENCIES IN INFORMATION ABOUT LIQUIDITY AND AVAILABILITY OF RESOURCES, AND THE LACK OF CONSISTENCY IN THE TYPE OF INFORMATION PROVIDED ABOUT EXPENSES AND INVESTMENT RETURN. THE MEDICAL CENTER HAS ADJUSTED THE PRESENTATION OF THESE FINANCIAL STATEMENTS ACCORDINGLY. ASU NO. 2016-14 HAS BEEN APPLIED RETROSPECTIVELY TO ALL PERIODS PRESENTED, EXCEPT FOR THE DISCLOSURES AROUND LIQUIDITY AND AVAILABILITY OF RESOURCES AND ANALYSIS OF EXPENSES BY NATURE AND FUNCTION. THESE DISCLOSURES HAVE BEEN PRESENTED FOR 2019 ONLY, AS ALLOWED BY ASU NO. 2016-14. THE NEW STANDARD CHANGES THE FOLLOWING ASPECTS OF THE FINANCIAL STATEMENTS: - THE UNRESTRICTED NET ASSETS CLASS HAS BEEN RENAMED NET ASSETS WITHOUT DONOR RESTRICTIONS; - THE TEMPORARILY AND PERMANENTLY RESTRICTED NET ASSET CLASSES HAVE BEEN COMBINED INTO A SINGLE NET ASSET CLASS CALLED NET ASSETS WITH DONOR RESTRICTIONS; - THE FINANCIAL STATEMENTS INCLUDE A DISCLOSURE ABOUT LIQUIDITY AND AVAILABILITY OF RESOURCES AT SEPTEMBER 30, 2019; AND - THE FUNCTIONAL EXPENSE DISCLOSURE FOR 2019 INCLUDES EXPENSES REPORTED BOTH BY NATURE AND FUNCTION.
CORE FORM, PART XI; QUESTION 9 OTHER CHANGES IN NET ASSETS INCLUDE: - CHANGE IN EQUITY INTEREST IN THE NET ASSETS OF CONNECTICUT CHILDREN'S MEDICAL CENTER FOUNDATION; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION - $3,692,910; - TRANSFER TO CONNECTICUT CHILDREN'S SPECIALTY GROUP, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION - ($26,282,611); - TRANSFER FROM CCMC AFFILIATES, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION - $236,378; - CHANGE IN FUNDED STATUS OF PENSION AND POST-RETIREMENT PLANS - ($13,368,263); - DONOR RESTRICTED CHANGE IN EQUITY INTEREST IN THE NET ASSETS OF CONNECTICUT CHILDREN'S MEDICAL CENTER FOUNDATION; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION - $914,225; AND - DONOR RESTRICTED CHANGE IN FUNDS HELD IN TRUST BY OTHERS - ($1,063,011).
CORE FORM, PART XII; QUESTION 2 THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF CONNECTICUT CHILDREN'S MEDICAL CENTER AND SUBSIDIARIES, FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2019 AND SEPTEMBER 30, 2018; RESPECTIVELY. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE INDEPENDENT CPA FIRM ISSUED AN UNMODIFIED OPINION WITH RESPECT TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. IN ADDITION, CCMC CORPORATION AND SUBSIDIARIES ALSO RECEIVED AUDITED CONSOLIDATED FINANCIAL STATEMENTS FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2019 AND SEPTEMBER 30, 2018; RESPECTIVELY. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE INDEPENDENT CPA FIRM ISSUED AN UNMODIFIED OPINION WITH RESPECT TO THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. THE ORGANIZATION'S FINANCE AND AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR.
CORE FORM, PART XII; QUESTION 3 THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM ENGAGED AN INDEPENDENT ACCOUNTING FIRM TO PREPARE AND ISSUE A CONSOLIDATED AUDIT UNDER THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133.
FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:25693081
FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:10145264
FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED SERVICES TOTAL FEES:7491596
FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING FEES TOTAL FEES:2118677
FORM 990 PART IX LINE 11G DESCRIPTION:AGENCY FEES TOTAL FEES:468019
FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTION FEES TOTAL FEES:352327
FORM 990 PART IX LINE 11G DESCRIPTION:ADMINISTRATIVE FEES TOTAL FEES:131558
FORM 990 PART IX LINE 11G DESCRIPTION:OTHER FEES TOTAL FEES:650034
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2018


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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 Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
CONNECTICUT CHILDREN'S MEDICAL CENTER
 
Employer identification number

06-0646755
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
(1) CONNECTICUT CHILDREN'S CARE NETWORK LLC
282 WASHINGTON STREET
HARTFORD,CT06106
83-4451707 		CLIN INT NTWK CT 0 0 CT CHILDRENS
 










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)CCMC CORPORATION
282 WASHINGTON STREET

HARTFORD,CT06106
22-2619876 		HLTHCARE SVCS CT 501(C)(3) 509(A)(3) NA
 
 
No
(2)CONNECTICUT CHILDREN'S MEDICAL CTR FDN
282 WASHINGTON STREET

HARTFORD,CT06106
22-2619869 		FUNDRAISING CT 501(C)(3) 509(A)(1) CCMC CORP
 
 
No
(3)CCMC AFFILIATES INC
282 WASHINGTON STREET

HARTFORD,CT06106
22-2619870 		INACTIVE CT 501(C)(3) 509(A)(2) CCMC CORP
 
 
No
(4)CONNECTICUT CHILDREN'S SPECIALTY GROUP
282 WASHINGTON STREET

HARTFORD,CT06106
06-1446900 		HLTHCARE SVCS CT 501(C)(3) 509(A)(2) CT CHILDRENS
 
Yes
 
(5)CHILDREN'S FUND OF CONNECTICUT INC
270 FARMINGTON AVENUE

FARMINGTON,CT06032
06-1364513 		HLTHCARE SVCS CT 501(C)(3) 509(A)(3) CT CHILDRENS
 
Yes
 
(6)CHILDREN'S HEALTH & DEVEL INSTITUTE INC
270 FARMINGTON AVENUE

FARMINGTON,CT06032
06-1504725 		HLTHCARE SVCS CT 501(C)(3) 509(A)(1) CFCT
 
 
No
(7)CAPITAL AREA HEALTH CONSORTIUM INC
270 FARMINGTON AVENUE

FARMINGTON,CT06032
51-0173264 		SUPPORT SVCS CT 501(C)(3) 509(A)(3) CT CHILDRENS
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












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

282 WASHINGTON STREET
HARTFORD,CT06106
22-2619873 		INACTIVE CT NA
  		C CORP.         No
(2) NEW ENGLAND PEDIATRICS INDEMNITY LTD

50 CEDAR AVENUE
HAMILTON,BERMUDAHM 11
BD
FINANCIAL VEHICLE BD NA
  		FOREIGN CORP.         No










Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
Yes
 
e Loans or loan guarantees by related organization(s) ............................
1e
Yes
 
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
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
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) CCMC CORPORATION

 O 102,390 COST
(2) CCMC CORPORATION

 R 149,302 COST
(3) CONNECTICUT CHILDREN'S SPECIALTY GROUP

 P 14,960,153 COST
(4) CONNECTICUT CHILDREN'S SPECIALTY GROUP

 R 26,282,611 COST


Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
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) 2018
Schedule R (Form 990) 2018
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
SCHEDULE R, PART V THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). IN THE ORDINARY COURSE OF BUSINESS, THIS ORGANIZATION MAY PAY EXPENSES OR TRANSFER FUNDS AMONGST AND FOR VARIOUS AFFILIATES. THESE RELATED PARTY TRANSACTIONS ARE RECORDED ON THE REVENUE/EXPENSE AND BALANCE SHEET STATEMENTS OF THIS ORGANIZATION AND ITS AFFILIATES. THESE ENTITIES WORK TOGETHER TO DELIVER HIGH QUALITY HEALTHCARE AND WELLNESS SERVICES TO THE COMMUNITIES IN WHICH THEY ARE SITUATED.
Schedule R (Form 990) 2018

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