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)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 10-01-2019 , and ending 09-30-2020
BCheck if applicable:
CName of organization
LAWRENCE MEMORIAL HOSPITAL INC
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
365 MONTAUK AVENUE
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
NEW LONDON, CT06320
D Employer identification number

06-0646704
E Telephone number

G Gross receipts $ 403,069,303
F Name and address of principal officer:
PATRICK L GREEN
365 MONTAUK AVENUE
NEW LONDON,CT06320
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.LMHOSPITAL.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: 1912
M State of legal domicile: CT
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: TO IMPROVE THE HEALTH OF THE REGION AND TO PROVIDE HEALTHCARE SERVICES.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 11
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 7
5 Total number of individuals employed in calendar year 2019 (Part V, line 2a) ...... 5 2,406
6 Total number of volunteers (estimate if necessary) ............. 6 240
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 148,970
b Net unrelated business taxable income from Form 990-T, line 39 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 2,257,052 35,454,446
9 Program service revenue (Part VIII, line 2g) ......... 371,642,512 337,768,265
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 3,386,583 3,785,629
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 2,115,656 6,571,955
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 379,401,803 383,580,295
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 381,151 297,574
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) 168,946,456 177,948,162
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet556,422    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 187,778,402 216,689,995
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 357,106,009 394,935,731
19 Revenue less expenses. Subtract line 18 from line 12....... 22,295,794 -11,355,436
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 411,338,982 460,648,797
21 Total liabilities (Part X, line 26)............. 190,866,616 243,996,813
22 Net assets or fund balances. Subtract line 21 from line 20..... 220,472,366 216,651,984
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
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Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2019)
Form 990 (2019)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: TO IMPROVE THE HEALTH OF THE REGION AND TO PROVIDE HEALTHCARE SERVICES.
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 $ 347,762,345 including grants of $ 297,574 ) (Revenue $ 337,768,265 )
SEE SCHEDULE O
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 expensesMediumBullet347,762,345
Form 990 (2019)
Form 990 (2019)
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 V......
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
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
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.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....Click to see attachment
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............ Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................Click to see attachment
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? 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
 
Form 990 (2019)
Form 990 (2019)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I .... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part IIClick to see attachment...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part IIIClick to see attachment.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................Click to see attachment
28a
Yes
 
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
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
237
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
 
 
Form 990 (2019)
Form 990 (2019)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
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
2,406
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
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
Yes
 
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
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
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 (2019)
Form 990 (2019)
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
11
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
7
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
Yes
 
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:
MediumBulletVERNETTE D GRAY789 HOWARD AVE   NEW HAVEN,CT06519 (203) 688-9585
Form 990 (2019)
Form 990 (2019)
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.

See instructions for the order in which to list the persons above.
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) PRATHIBHA VARKEY......................................................................
TRUSTEE
1.00
.................
39.00
X           0 1,131,054 368,603
(2) PATRICK L GREEN......................................................................
PRESIDENT/CEO/TRUSTEE
32.00
.................
8.00
X   X       712,243 178,060 346,308
(3) DENISE FIORE......................................................................
SVP, COO (CURRENT YEAR COMP)
36.00
.................
4.00
    X       734,445 0 123,165
(4) DENISE FIORE......................................................................
SVP, COO (VESTED DEFERRED)
36.00
.................
4.00
    X       347,860 0 0
(5) STEPHEN ALLEGRETTO......................................................................
SVP, CFO
36.00
.................
4.00
    X       548,697 60,967 241,984
(6) OLIVER MAYORGA......................................................................
VP, CMO
4.00
.................
36.00
    X       70,823 519,365 96,347
(7) MAUREEN ANDERSON......................................................................
ASSISTANT SECRETARY
7.00
.................
33.00
    X       70,853 322,775 41,526
(8) CAREN LEWIS......................................................................
VP PATIENT CARE
40.00
.................
0.00
    X       392,452 0 34,107
(9) BENJAMIN ARMSTRONG......................................................................
PHYSICIAN
40.00
.................
0.00
        X   395,611 0 28,092
(10) DONNA EPPS......................................................................
VP, CHRO
38.00
.................
2.00
    X       410,940 0 31,122
(11) CRAIG MITTLEMAN......................................................................
EMERGENCY DEPT MEDICAL DIRECTOR
40.00
.................
0.00
        X   380,680 0 23,452
(12) DAVID F REISFELD......................................................................
TRUSTEE
1.00
.................
39.00
X           0 366,238 32,548
(13) EMILY MILLER......................................................................
PHYSICIAN
40.00
.................
0.00
        X   329,042 0 16,591
(14) CYNTHIA TUCKER......................................................................
TRUSTEE
40.00
.................
0.00
X           315,858 0 27,517
(15) DAVID BOUSLOUGH......................................................................
PHYSICIAN
40.00
.................
0.00
        X   294,653 0 25,611
(16) WILLIAM STANLEY......................................................................
VP DEVELOPMENT
40.00
.................
0.00
        X   268,397 0 33,123
(17) KERIN DACRUZ......................................................................
VP, CNO
40.00
.................
0.00
    X       247,713 0 30,678
Form 990 (2019)
Form 990 (2019)
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) TODD BLUE........................................................................
TRUSTEE
1.00
.......................1.00
X           0 0 0
(19) KATHLEEN HOLT........................................................................
TRUSTEE
1.00
.......................1.00
X           0 0 0
(20) JAMES MITCHELL........................................................................
SECR/TREASURER AND TRUSTEE
1.00
.......................3.00
X   X       0 0 0
(21) ROBERT NARDONE........................................................................
VICE CHAIR/TRUSTEE
1.00
.......................5.00
X   X       0 0 0
(22) ROSS J SANFILIPPO........................................................................
TRUSTEE
1.00
.......................1.00
X           0 0 0
(23) B MICHAEL RAUH........................................................................
CHAIRMAN/TRUSTEE
1.00
.......................6.00
X   X       0 0 0
(24) REV CATHERINE ZALL........................................................................
TRUSTEE
1.00
.......................1.00
X           0 0 0












1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 5,520,267 2,578,459 1,500,774
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 MediumBullet383
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
IPC HOSPITALISTS

PO BOX 844929
LOS ANGELES,CA900844929
HOSPITALISTS 3,374,844
PAYETTE ASSOCIATES

290 CONGRESS STREET
BOSTON,MA02210
CONSULTING ENGINEER 3,173,929
VIZIENT INC

290 E JOHN CARPENTER FREEWAY
IRVING,TX75062
HEALTHCARE IMPROVEMENT 2,136,748
UNITEX TEXTILE RENTAL SERVICE

420 LEDYARD STREET
HARTFORD,CT06114
LINENS/LAUNDERING 1,413,430
ANESTHESIA ASSOCIATES OF NEW LONDON

365 MONTAUK AVENUE
NEW LONDON,CT06320
MEDICAL SERVICES 1,089,097
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet40
Form 990 (2019)
Form 990 (2019)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c 48,375
d Related organizations1d 15,230
e Government grants (contributions)1e 34,148,983
f All other contributions, gifts, grants, and similar amounts not included above1f 1,241,858
g Noncash contributions included in lines 1a - 1f:$ 1g 4,160
h Total. Add lines 1a-1f.......MediumBullet 35,454,446
 Program Service RevenueAmt Business Code
2a NET PATIENT SERVICES 900099 329,599,139 329,599,139    
b APOTHECARY INCOME 446110 6,921,682 6,921,682    
c OCCUPATIONAL HEALTH 621400 819,992 819,992    
d LAB PATHOLOGY 621500 276,639 276,639    
e LAB TESTING 621500 150,813   150,813  
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 337,768,265
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 1,962,075   -1,843 1,963,918
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   2,381,670 6a
b Less: rental expenses   1,228,222 6b
c Rental income or (loss)   1,153,448 6c
d Net rental income or (loss).......MediumBullet 1,153,448     1,153,448
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 92,500 19,977,840 7a
b Less: cost or other basis and sales expenses 0 18,246,786 7b
c Gain or (loss) 92,500 1,731,054 7c
d Net gain or (loss).........MediumBullet 1,823,554     1,823,554
8a Gross income from fundraising events (not including $ 48,375of contributions reported on line 1c). See Part IV, line 18 ....
8a 14,000
b Less: direct expenses ... 8b 14,000
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a CLINICAL INVESTMENT REVENUE 900099 4,641,291     4,641,291
b DINING REVENUE 722514 367,140     367,140
c DISCOUNTS, REBATES AND OTHER SERV 900099 331,011     331,011
d All other revenue .... 79,065     79,065
e Total. Add lines 11a–11d ...... MediumBullet 5,418,507
12 Total revenue. See instructions.....MediumBullet 383,580,295 337,617,452 148,970 10,359,427
Form 990 (2019)
Form 990 (2019)
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 .... 297,574 297,574
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ...........    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 3,907,066 390,707 3,516,359  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........        
7 Other salaries and wages........ 151,222,871 134,326,491 16,500,729 395,651
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 2,508,588 2,228,300 273,725 6,563
9 Other employee benefits ....... 9,338,322 8,294,936 1,018,954 24,432
10 Payroll taxes ........... 10,971,315 9,745,472 1,197,138 28,705
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 498,719 442,996 55,723  
c Accounting ........... 18,879 16,770 2,109  
d Lobbying ........... 65,560 58,235 7,325  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 152,320 135,301 17,019  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 83,485,008 74,157,090 9,226,847 101,071
12 Advertising and promotion .... 982,956 873,129 109,827  
13 Office expenses ....... 7,348,537 6,527,473 821,064  
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 11,959,231 10,623,006 1,336,225  
17 Travel ............        
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 416,424 369,896 46,528  
20 Interest ........... 3,037,096 2,697,756 339,340  
21 Payments to affiliates ....... 19,752,470 17,545,494 2,206,976  
22 Depreciation, depletion, and amortization .. 21,097,488 18,740,231 2,357,257  
23 Insurance ... 6,482,574 5,758,265 724,309  
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 PHARMACEUTICALS 29,402,675 26,117,466 3,285,209 0
b MEDICAL & SURGICAL SUPP 24,880,339 22,100,418 2,779,921 0
c SYSTEM SUPPORT FEE 5,394,437 4,791,708 602,729 0
d DUES, SUBSCRIPTIONS & E 962,363 854,837 107,526 0
e All other expenses 752,919 668,794 84,125  
25 Total functional expenses. Add lines 1 through 24e 394,935,731 347,762,345 46,616,964 556,422
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 (2019)
Form 990 (2019)
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 ........   1  
2 Savings and temporary cash investments ......... 20,124,882 2 26,004,514
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 47,402,818 4 49,593,812
5 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6  
7 Notes and loans receivable, net ........... 101,755 7 101,755
8 Inventories for sale or use ............ 8,671,717 8 8,573,509
9 Prepaid expenses and deferred charges ...... 907,540 9 1,665,118
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 242,115,181
b Less: accumulated depreciation 10b 75,573,918 170,727,694 10c 166,541,263
11 Investments—publicly traded securities . 54,527,795 11 28,954,529
12 Investments—other securities. See Part IV, line 11 ..... 28,272,429 12 46,245,268
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ............... 4,550,000 14 3,900,000
15 Other assets. See Part IV, line 11 ........... 76,052,352 15 129,069,029
16 Total assets. Add lines 1 through 15 (must equal line 33)... 411,338,982 16 460,648,797
Liabilities 17 Accounts payable and accrued expenses ..... 41,126,300 17 40,619,983
18 Grants payable ...   18  
19 Deferred revenue .........   19  
20 Tax-exempt bond liabilities ......... 88,191,306 20 81,604,221
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
  22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ..   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 61,549,010 25 121,772,609
26 Total liabilities. Add lines 17 through 25.. 190,866,616 26 243,996,813
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 192,324,982 27 187,562,512
28 Net assets with donor restrictions ........... 28,147,384 28 29,089,472
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 220,472,366 32 216,651,984
33 Total liabilities and net assets/fund balances ........ 411,338,982 33 460,648,797
Form 990 (2019)
Form 990 (2019)
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
383,580,295
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
394,935,731
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-11,355,436
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
220,472,366
5
Net unrealized gains (losses) on investments ...............
5
380,404
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
7,154,650
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
216,651,984
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 (2019)
Form 990 (2019)
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 instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
LAWRENCE MEMORIAL HOSPITAL INC
 
Employer identification number

06-0646704
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed 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) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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) 2019

Schedule A (Form 990 or 990-EZ) 2019
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) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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) 2019

Schedule A (Form 990 or 990-EZ) 2019
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
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 2019 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-2019
(iii)
Distributable
Amount for 2019
1 Distributable amount for 2019 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2019:
a From 2014.......  
b From 2015.......  
c From 2016.......  
d From 2017.......  
e From 2018.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2019 distributable amount  
i Carryover from 2014 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2019 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2019 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2019, 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 2019. 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 2020. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2015.....  
b Excess from 2016.....  
c Excess from 2017.....  
d Excess from 2018.....  
e Excess from 2019.....  
Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019
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) 2019


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
2019
Name of the organization
LAWRENCE MEMORIAL HOSPITAL INC
 
Employer identification number

06-0646704
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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2
Name of organization
LAWRENCE MEMORIAL HOSPITAL INC
 
Employer identification number
06-0646704
Part I
Contributors
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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 3
Name of organization
LAWRENCE MEMORIAL HOSPITAL INC
 
Employer identification number

06-0646704
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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 4
Name of organization
LAWRENCE MEMORIAL HOSPITAL INC
 
Employer identification number

06-0646704
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) (2019)

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
2019
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
LAWRENCE MEMORIAL HOSPITAL INC
 
Employer identification number

06-0646704
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) 2019

Schedule C (Form 990 or 990-EZ) 2019
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) 2016 (b) 2017 (c) 2018 (d) 2019 (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) 2019


Schedule C (Form 990 or 990-EZ) 2019
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)
Yes|No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
Yes
 
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
Yes
 
500
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
 
25,725
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
39,335
j
Total. Add lines 1c through 1i ....................................................................................................
65,560
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
PART II-B, LINE 1: THE AMOUNT REPORTED IN "OTHER ACTIVITIES" REPRESENTS A PORTION OF PROFESSIONAL DUES ATTRIBUTABLE TO LOBBYING DURING FY 2020. ALSO, THE HEALTH SYSTEM OFFICIALS HAD MEETINGS AND CONTACTS WITH STATE GOVERNMENT OFFICIALS, INCLUDING STATE LEGISLATORS AND THEIR STAFF TO DISCUSS VARIOUS HEALTH CARE REFORM PROPOSALS. LAWRENCE + MEMORIAL HOSPITAL IS PART OF A CONTROLLED GROUP WITH THE FOLLOWING LOBBYING EXPENSES: YALE NEW HAVEN HOSPITAL EIN 06-0646652 $ 453,814 BRIDGEPORT HOSPITAL EIN 06-0646554 $ 98,002 GREENWICH HOSPITAL EIN 06-0646659 $ 68,805 NORTHEAST MEDICAL GROUP EIN 06-1330992 $ 32,337 LMW HEALTHCARE, INC. EIN 46-0543230 $ 24,657
Schedule C (Form 990 or 990EZ) 2019


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 instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
LAWRENCE MEMORIAL HOSPITAL INC
 
Employer identification number

06-0646704
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 FASB 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 FASB 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 FASB 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) 2019

Schedule D (Form 990) 2019
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 .... 25,568,084 26,196,094 21,547,048 19,258,522 17,802,690
b Contributions ... 0 20,000      
c Net investment earnings, gains, and losses 2,030,778 490,136 5,672,003 2,559,901 1,586,788
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
1,141,219 1,100,782 1,022,957 234,505 77,634
f Administrative expenses ....   37,364   36,870 53,322
g End of year balance ...... 26,457,643 25,568,084 26,196,094 21,547,048 19,258,522
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 Bullet25.080 %
c
Term endowment SchDMd Bullet74.920 %
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)
 
No
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" 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 .....   8,110,001 8,110,001
b Buildings ....   117,273,120 14,984,044 102,289,076
c Leasehold improvements   26,589,304 3,896,828 22,692,476
d Equipment ....   86,183,377 56,693,046 29,490,331
e Other .....   3,959,379   3,959,379
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 166,541,263
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
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) ST ENDOWMENT INVESTMENTS
19,110,450 C

(B) LT ENDOWMENT INVESTMENTS
18,477,422 C

(C) INVESTMENTS HELD BY TRUSTEE
8,657,396 C
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 46,245,268
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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)OTHER RECEIVABLES 7,203,563
(2)DUE FROM AFFILIATES 62,948,957
(3)DUE FROM MCIC 23,751,469
(4)RIGHT OF USE ASSETS 5,724,178
(5)OTHER ASSETS 29,440,862
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 129,069,029
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  
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 121,772,609
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) 2019

Schedule D (Form 990) 2019
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
PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUNCTIONS TO SUPPORT AND PROVIDE INCOME FOR THE FURTHERANCE OF THE HEALTHCARE MISSION OF LAWRENCE + MEMORIAL HOSPITAL.
PART X, LINE 2: LAWRENCE + MEMORIAL HOSPITAL IS INCLUDED IN THE CONSOLIDATED YALE NEW HAVEN HEALTH SYSTEM AND SUBSIDIARIES AUDITED FINANCIAL STATEMENTS. FOLLOWING IS THE FOOTNOTE FROM THE CONSOLIDATED FINANCIAL STATEMENTS: MOST ENTITIES WITHIN THE SYSTEM ARE NOT FOR PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE CODE, AND ARE GENERALLY EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. PROVISIONS FOR INCOME TAXES AND DEFERRED TAXES, WHICH ARE NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS, HAVE BEEN MADE FOR THE TAXABLE ENTITIES LISTED ABOVE UNDER THE DESCRIPTION OF THE SYSTEM. U.S. GAAP REQUIRES THE SYSTEM TO EVALUATE TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN THE COURSE OF PREPARING THE SYSTEM'S TAX RETURNS TO DETERMINE WHETHER THE TAX POSITIONS ARE "MORE LIKELY THAN NOT" OF BEING SUSTAINED BY THE APPLICABLE TAX AUTHORITY BASED UPON THE TECHNICAL MERITS OF THE POSITION. THE SYSTEM RECOGNIZES THE EFFECT OF TAX POSITIONS ONLY IF THEY ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. THIS EVALUATION HAD NO IMPACT ON THE OPERATIONS OF THE SYSTEM AS OF AND FOR THE YEARS ENDED SEPTEMBER 30, 2020 AND 2019.
Schedule D (Form 990) 2019


Additional Data


Software ID:  
Software Version:  




SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrowAttach to Form 990 or Form 990-EZ.
right arrowGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
LAWRENCE MEMORIAL HOSPITAL INC
 
Employer identification number

06-0646704
Part I
Fundraising Activities.Complete if the organization answered "Yes" on Form 990, Part IV, line 17.
Form 990-EZ filers are not required to complete this part.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.


(i) Name and address of individual
or entity (fundraiser)
(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity
(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i)
(vi) Amount paid to
(or retained by)
organization
Yes No
             
             
             
             
             
             
             
             
             
             
Total . . . . . . . . . . . . . . . . . . . . right arrow      
3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2019
Schedule G (Form 990 or 990-EZ) 2019
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.









VerticalRevenue
(a) Event #1

GALA
(event type)
(b) Event #2

GOLF CLASSIC
(event type)
(c) Other events

 
(total number)
(d) Total events
(add col. (a) through col. (c))

1

Gross receipts . . . . .

21,875

40,500

 

62,375

2

Less: Contributions . . . .

21,875

26,500

 

48,375
3 Gross income (line 1 minus
line 2) . . . . . .

 

14,000

 

14,000



VerticalDirectExpenses
4 Cash prizes . . . . .        
5 Noncash prizes . . . .        
6 Rent/facility costs . . . .   14,000   14,000
7 Food and beverages . . .        
8 Entertainment . . . .        
9 Other direct expenses . . .        
10 Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . . right arrow 14,000
11 Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . . right arrow 0
Part III
Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue
(a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo
(c) Other gaming (d) Total gaming (add col.(a) through col.(c))

1

Gross revenue . . . . .

 

 

 

 
VerticalDirectExpenses

2

Cash prizes . . . . .

 

 

 

 

3

Noncash prizes . . . .

 

 

 

 

4

Rent/facility costs . . . .

 

 

 

 

5

Other direct expenses . . .

 

 

 

 


6


Volunteer labor . . . .
%
%
%


7

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

 

8

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

 

9
Enter the state(s) in which the organization conducts gaming activities:
a
Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2019
Schedule G (Form 990 or 990-EZ) 2019
Page 3
11
Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? . . . . . . . . . . . . . . . . .
13
Indicate the percentage of gaming activity conducted in:
a
The organization's facility . . . . . . . . . . . . . . . . . .
13a
%
b
An outside facility . . . . . . . . . . . . . . . . . . . .
13b
%
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? . . . . . . . . . . . . . . . . . . . . . . . .
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? . . . . . . . . . . . . . . . . . . .
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.
Return Reference Explanation
Schedule G (Form 990 or 990-EZ) 2019
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
2019
Open to Public Inspection
Name of the organization
LAWRENCE MEMORIAL HOSPITAL INC
 
Employer identification number

06-0646704
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
0 6,623 33,284,287 12,274,976 21,009,311 5.320 %
b Medicaid (from Worksheet 3, column a) . . . . . 0 53,028 67,632,312 44,106,266 23,526,046 5.960 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . . 0 0 0 0    
d Total Financial Assistance and Means-Tested Government Programs . . . . .   59,651 100,916,599 56,381,242 44,535,357 11.280 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 28 12,252 1,640,897 260,300 1,380,597 0.350 %
f Health professions education (from Worksheet 5) . . . 4 12,566 1,827,817 3,000 1,824,817 0.460 %
g Subsidized health services (from Worksheet 6) . . . . 4 1,247 1,979,115 166,134 1,812,981 0.460 %
h Research (from Worksheet 7) . 0 0 0 0    
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . . 7 67 3,565,080 325 3,564,755 0.900 %
j Total. Other Benefits . . 43 26,132 9,012,909 429,759 8,583,150 2.170 %
k Total. Add lines 7d and 7j . 43 85,783 109,929,508 56,811,001 53,118,507 13.450 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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 1 0 1,209 0 1,209 0 %
2 Economic development 1 0 19,141 0 19,141 0 %
3 Community support 2 125 33,206 0 33,206 0.010 %
4 Environmental improvements 0 0 0 0    
5 Leadership development and
training for community members
0 0 0 0    
6 Coalition building 1 0 2,108 0 2,108 0 %
7 Community health improvement advocacy 0 0 0 0    
8 Workforce development 1 0 3,000 0 3,000 0 %
9 Other 0 0 0 0    
10 Total 6 125 58,664   58,664 0.010 %
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 Healthcare 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
9,787,201
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
 
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
135,341,071
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
183,382,705
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-48,041,634
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) 2019
Schedule H (Form 990) 2019
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?1Name, 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 LAWRENCE MEMORIAL HOSPITAL
365 MONTAUK AVE
NEW LONDON,CT06320
WWW.LMHOSPITAL.ORG
0047
X X         X X    
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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)
LAWRENCE MEMORIAL HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
 
Yes 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 Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
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) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
LAWRENCE MEMORIAL HOSPITAL
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
SEE PART V, SECTION C
b
SEE PART V, SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
LAWRENCE MEMORIAL HOSPITAL
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) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
LAWRENCE MEMORIAL HOSPITAL
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) 2019
Schedule H (Form 990) 2019
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, 20a, 20b, 20c, 20d, 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
LAWRENCE + MEMORIAL HOSPITAL PART V, SECTION B, LINE 3J: SINCE 2016 THE HEALTH IMPROVEMENT COLLABORATIVE OF SOUTHEASTERN CT HAS REGULARLY CONVENED WITH PARTICIPATION FROM INDIVIDUALS/ORGANIZATIONS WITH PUBLIC HEALTH KNOWLEDGE, INFORMATION, AND/OR EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY OR MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. THE HEALTH IMPROVEMENT COLLABORATIVE REVIEWS THE PRIMARY AND SECONDARY CHNA DATA AND DETERMINES, BY STRUCTURED PRIORITIZATION PROCESSES AND GROUP CONSENSUS, THE PRIORITY AREAS FOR HEALTH IMPROVEMENT PLANNING. THE SELECTED PRIORITY AREAS ARE FOCUSED ON IDENTIFIED NEED AND DISPARITIES CONSIDERING FACTORS INCLUDING BUT NOT LIMITED TO INCOME, RACE, ETHNICITY, AND EDUCATIONAL ATTAINMENT. ALL PRIMARY AND SECONDARY DATA THAT HAS BEEN COLLECTED, ANALYZED AND REVIEWED SUPPORTS THE ESTABLISHMENT OF THE PRIORITY AREAS.
LAWRENCE + MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: COMMUNITY ENGAGEMENT AND FEEDBACK WERE AN INTEGRAL PART OF THE CHNA PROCESS WHICH WAS LED BY THE COORDINATING TEAM OF THE HEALTH IMPROVEMENT COLLABORATIVE WITH REPRESENTATIVES FROM: LAWRENCE + MEMORIAL HOSPITAL, LEDGE LIGHT HEALTH DISTRICT (THE REGIONAL LOCAL PUBLIC HEALTH ENTITY), CONNECTICUT COLLEGE, THAMES VALLEY COUNCIL FOR COMMUNITY ACTION (ANTI-POVERTY AGENCY), THE COMMUNITY FOUNDATION OF SE CT, THE NEW LONDON NAACP, AND FRESH NEW LONDON (FOOD JUSTICE ORGANIZATION). EACH OF THESE ORGANIZATIONAL REPRESENTATIVES HAS ENDEAVORED TO BRING THE VOICE OF THE COMMUNITIES THEY SERVE. THROUGHOUT, PARTNERS SOUGHT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY THROUGH COMMUNITY MEETINGS AND INCLUSION OF RESIDENTS AND COMMUNITY PARTNERS IN THE PRIORITIZATION AND IMPLEMENTATION PLANNING PROCESS. PUBLIC HEALTH AND HEALTH CARE PROFESSIONALS SHARED KNOWLEDGE AND EXPERTISE ABOUT HEALTH ISSUES, WHILE LEADERS AND REPRESENTATIVES OF NON-PROFIT AND COMMUNITY-BASED ORGANIZATIONS PROVIDED INSIGHT ON THE COMMUNITY SERVED BY THE HOSPITAL, INCLUDING MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITY POPULATIONS. SCHEDULE H, PART V, SEC B, LINE 7A AND 10A:HTTPS://WWW.LMHOSPITAL.ORG/ABOUT/COMMUNITY-INVOLVEMENT/COMMUNITY-PARTNERSHIPS.ASPX AND HTTPS://WWW.LLHD.ORG/ABOUT-US/ASSESSMENT
LAWRENCE + MEMORIAL HOSPITAL PART V, SECTION B, LINE 6B: THE CHNA WAS GUIDED BY THE HEALTH IMPROVEMENT COLLABORATIVE OF SOUTHEASTERN CT, A COALITION OF HEALTH CARE PROVIDERS, LOCAL PUBLIC HEALTH, FEDERALLY QUALIFIED HEALTH CENTERS, PHILANTHROPY, HIGHER EDUCATION, RESIDENTS, AND NUMEROUS NON-PROFIT ORGANIZATIONS SERVING THE REGION. PARTNERS INCLUDE:SOUTHEASTERN MENTAL HEALTH AUTHORITYTHAMES VALLEY COUNCIL FOR COMMUNITY ACTIONSE REGIONAL ACTION COUNCILTOWN OF GROTON, PARKS AND RECREATIONTHE HEALTH EDUCATION CENTERNEW LONDON RECREATION DEPARTMENTUNITED COMMUNITY AND FAMILY SERVICESNEW LONDON POLICE DEPARTMENTTHAMES VALLEY COUNCIL FOR COMMUNITY ACTIONCHILD AND FAMILY AGENCYMINISTERIAL ALLIANCE OF SECTL+M HOSPITALCONNECTICUT COLLEGECT LEGAL SERVICESVISITING NURSE ASSOCIATION OF SE CTCOMMUNITY HEALTH CENTER, INC.SE CT ENTERPRISE REGIONALLIANCE FOR LIVINGSOUND COMMUNITY SERVICESSE CT COUNCIL OF GOVERNMENTSFRESH NLLEDGE LIGHT HEALTH DISTRICTUNCAS HEALTH DISTRICTHISPANIC ALLIANCENEW LONDON HUMAN SERVICESNEW LONDON NAACPCOMMUNITY FOUNDATION OF E CTGROTON TOWN MANAGERMAYOR, CITY OF NEW LONDONTOWN OF WATERFORD DEPARTMENT OF PLANNINGTOWN OF GROTON DEPARTMENT OF PLANNINGCONNECTICUT COLLEGEMASHANTUCKET PEQUOT TRIBAL NATIONUNITED WAY OF SOUTHEASTERN CTMOHEGAN TRIBAL HEALTH DEPARTMENTHIGHER EDGE
LAWRENCE + MEMORIAL HOSPITAL PART V, SECTION B, LINE 7D: IN THE GREATER NEW LONDON AREA, THE COORDINATING TEAM OF THE HEALTH IMPROVEMENT COLLABORATIVE HAS LED THE EFFORTS TO SHARE CHNA FINDINGS AS WELL AS IN MAKING PROGRESS IN ADDRESSING THOSE FINDINGS. TRANSPARENCY AND FREQUENCY OF COMMUNICATIONS HAS BEEN IDENTIFIED AS A CORE VALUE OF THE COLLABORATIVE. CHNA FINDINGS WERE PRESENTED AT A MEETING OF THE HEALTH IMPROVEMENT COLLABORATIVE ON MAY 29, 2019 AND AT A MEETING OF COMMUNITY AND LOCAL AGENCY LEADERSHIP ON SEPTEMBER 11, 2019. IN ATTENDANCE WERE COMMUNITY PARTNERS REPRESENTING OTHER NON-PROFIT ORGANIZATIONS, BUSINESS LEADERS, INDIVIDUALS REPRESENTING THE EDUCATION SECTOR, HOSPITAL STAFF, MEMBERS OF THE MEDIA, AND COMMUNITY MEMBERS. PRINTED COPIES OF THE REPORT HAVE BEEN AVAILABLE FOR THOSE INTERESTED AND THE REPORT IS POSTED ON THE HOSPITAL AND PARTNER AGENCIES WEBSITES.A PUBLIC COMMENT PERIOD WAS ALSO MADE AVAILABLE FOR THE 2016 CHNA AS PART OF THE 2019 CHNA PROCESS. PUBLIC NOTICES WERE PLACED IN EACH OF THE MAJOR NEWSPAPERS IN THE LOCAL DELIVERY NETWORKS GEOGRAPHY REQUESTING COMMENT. THE PUBLIC COMMENT PERIOD WILL BE REPEATED ANNUALLY (E.G. 2019, 2020, AND 2021) AS PART OF THE 2022 CHNA PROCESS.
LAWRENCE + MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: IN MARCH 2020, EFFORTS SHIFTED TO ADDRESS THE COVID-19 PANDEMIC IN OUR COMMUNITY. LAWRENCE + MEMORIAL HOSPITAL, AS PART OF YALE NEW HAVEN HEALTH SWIFTLY CONVERTED HOSPITAL SPACE TO COVID-19 UNITS, ASSEMBLED DRIVE-THROUGH SPECIMEN COLLECTION SITES AND MOBILE TESTING UNITS, CREATED ONSITE SPECIMEN TESTING CAPABILITIES, INSTITUTED NEW TREATMENT AND MEDICATION THERAPIES, LAUNCHED EMPLOYEE WELLNESS INITIATIVES AND PROCURED NEARLY IMPOSSIBLE-TO-FIND RESOURCES FROM PPE TO VENTILATORS TO MEDICATIONS. VERY SIGNIFICANT WORK WAS UNDERTAKEN TO ADDRESS THE FOOD INSECURITY IN OUR COMMUNITIES LAID BARE BY THE PANDEMIC.FOLLOWING THE COMPLETION OF THE 2019 CHNA, THE HEALTH IMPROVEMENT COLLABORATIVE OF SE CT ENGAGED IN A PROCESS TO PRIORITIZE ISSUES AND DEVELOP STRATEGIES TO IMPROVE HEALTH AND WELL-BEING IN THE REGION. IN ORDER TO CONSIDER ALL OF THE DATA COLLECTED, THE COLLABORATIVE FACILITATED PRIORITIZATION MEETINGS IN MAY AND JUNE OF 2019 AND DEVELOPED THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). PRIORITIES WERE SELECTED WITH PRIMARY ATTENTION TO THE RACIAL DISPARITIES HIGHLIGHTED IN MULTIPLE HEALTH DRIVERS AND OUTCOMES AS REVEALED IN THE ASSESSMENT PROCESS. THE RESULTANT ACTION TEAMS ARE FOCUSED ON SPECIFIC OUTCOMES OR POPULATIONS INCLUDING: ACCESS TO CARE (PARTICULARLY FOR LOW INCOME POPULATIONS), THE BLACK HEALTH COLLECTIVE (SPECIFICALLY ADDRESSING DISPARITIES AMONG BLACK/AFRICAN AMERICAN AREA RESIDENTS), THE OVERDOSE ACTION TEAM (SPECIFICALLY THE OVERDOSE CRISIS) AND THE HISPANIC ALLIANCE MENTAL HEALTH NETWORK (ADDRESSING DISPARITIES REVEALED AMONG LATINX AREA RESIDENTS). HOWEVER, THE WORK TO ADDRESS HEALTH DISPARITIES CANNOT BE LIMITED TO THESE TEAMS. SIGNIFICANT ACTION IS REQUIRED OF THE MULTIPLE SECTORS AND PARTNERS ON THE HEALTH IMPROVEMENT COLLABORATIVE (HIC). AS SUCH, THE HIC HAS PRIORITIZED ADDRESSING RACISM AS A PUBLIC HEALTH ISSUE IN ADDITION TO THE ACTION TEAM EFFORTS DESCRIBED ABOVE.BASED ON THE FINDINGS OF THE CHNA, TWO COMMUNITY HEALTH IMPROVEMENT PLANS (CHIPS) WERE DEVELOPED. THE FIRST WAS CREATED WITH COMMUNITY PARTNERS/EXTERNAL ORGANIZATIONS AND PROVIDES A ROADMAP FOR THE ACTION TEAMS. THE SECOND CHIP REVOLVES AROUND COLLABORATION WITH INTERNAL HOSPITAL STAKEHOLDERS TO CREATE OPPORTUNITIES FOR THE HOSPITAL-BASED IMPLEMENTATION STRATEGIES.IN PARTNERSHIP WITH OTHER ORGANIZATIONS, ALL OF THE AREAS PRIORITIZED AREA ARE BEING ADDRESSED. A DRIVING PHILOSOPHY OF L+M'S COMMUNITY BENEFIT EFFORTS IS TO BUILD ON COMMUNITY RESOURCES, PROGRAMS AND SERVICES AND TO NOT DUPLICATE THEM. AS SUCH, IN EXAMINING EACH OF THE PRIORITIZED COMMUNITY HEALTH NEEDS, EXISTING COMMUNITY ASSETS WERE IDENTIFIED BEFORE CONSIDERING ANY NEW STRATEGIES THAT L+M MIGHT INITIATE AND/OR THOSE TO BE CONTINUED. WHERE THERE IS AN EXISTING COMMUNITY-BASED PROGRAM ADDRESSING ANY OF THE PRIORITIZED NEEDS, OR DUE TO RESOURCE LIMITATIONS, L+M WILL WORK TO SUPPORT AND BUILD CAPACITY OF THOSE PROGRAMS RATHER THAN TO CREATE SOMETHING NEW.L+M HOSPITAL AND ITS COMMUNITY PARTNERS ARE ACTIVELY ENGAGED TO MEET IDENTIFIED COMMUNITY NEEDS. IN ADDITION, L+M HOSPITAL HAS CONTINUED EXISTING PROGRAMS, SERVICES AND INITIATIVES IN THE AREAS OF ASTHMA, DIABETES, MATERNAL AND CHILD HEALTH, AND BREAST AND CERVICAL CANCER AND CARDIOVASCULAR DISEASE PREVENTION AND EARLY DETECTION.THE HIC PARTICIPATED IN 3 PHASES OF HEALTH ENHANCEMENT COMMUNITY GRANT OPPORTUNITIES FROM THE CONNECTICUT DEPARTMENT OF PUBLIC HEALTH. THE HEALTH ENHANCEMENT COMMUNITY INITIATIVE IS A PARTNERSHIP BETWEEN THE STATE OF CONNECTICUT AND PARTICIPANT COMMUNITIES THAT FOCUSES ON IMPROVING COMMUNITY HEALTH BY WORKING ALONGSIDE COMMUNITY MEMBERS TO ADDRESS ISSUES AIMED TO ALLEVIATE ROOT CAUSES AND PREVENT PEOPLE FROM GETTING SICK IN THE FIRST PLACE.
LAWRENCE + MEMORIAL HOSPITAL PART V, SECTION B, LINE 13H: THESE PROGRAMS COVER EMERGENCY AND OTHER MEDICALLY NECESSARY CARE ONLY.
LAWRENCE + MEMORIAL HOSPITAL PART V, SECTION B, LINE 16J: WEBSITE PROVIDES DIRECT EMAIL LINK TO FINANCIAL COUNSELORS.
SCHEDULE H, PART V, SECTION B, LINE 16A, 16B AND 16C: WWW.LMHOSPITAL.ORG/PATIENTS-VISITORS/PATIENTS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE.ASPX
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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?8
Name and address Type of Facility (describe)
1 1 - LAWRENCE MEMORIAL HOSPITAL
339 FLANDERS ROAD
EAST LYME,CT06333
BLOOD DRAW, OUTPATIENT REHAB
2 2 - LAWRENCE MEMORIAL HOSPITAL
224 GOLD STAR HIGHWAY
GROTON,CT06340
SLEEP MEDICINE
3 3 - LAWRENCE MEMORIAL HOSPITAL
52 HAZELNUT HILL ROAD
GROTON,CT06340
ER, ASC, RADIOLOGY, REHAB, BLOOD DRAW
4 4 - LAWRENCE MEMORIAL HOSPITAL
194 HOWARD STREET
NEW LONDON,CT06320
BLOOD DRAW
5 5 - LAWRENCE MEMORIAL HOSPITAL
59 FAIRE HARBOUR
NEW LONDON,CT06320
OUTPATIENT REHAB
6 6 - LAWRENCE MEMORIAL HOSPITAL
230 WATERFORD PARKWAY SOUTH
WATERFORD,CT06375
ONCOLOGY
7 7 - LAWRENCE MEMORIAL HOSPITAL
40 BOSTON POST ROAD
WATERFORD,CT06375
WOUND CARE, OUTPATIENT REHAB
8 8 - LAWRENCE MEMORIAL HOSPITAL
196 PARKWAY SOUTH
WATERFORD,CT06375
DIAGNOSTIC RADIOLOGY
9
10
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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
PART I, LINE 3C: THE FINANCIAL ASSISTANCE POLICY PROVIDES THAT THE PATIENT MUST SUBMIT A FINANCIAL ASSISTANCE APPLICATION.
PART I, LINE 7: THE AMOUNTS REPORTED ON PART I, LINE 7 WERE CALCULATED AS DIRECT, SEPARATELY IDENTIFIABLE COSTS INCURRED BY THE HOSPITAL PLUS AN ALLOCATION OF OVERHEAD.
PART II, COMMUNITY BUILDING ACTIVITIES: L+M HOSPITAL, ALONG WITH MANY OTHER HOSPITALS ACROSS THE COUNTRY, UTILIZES THE COMMUNITY BENEFITS INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA) DATABASE DEVELOPED BY LYON SOFTWARE TO CATALOG ITS COMMUNITY BENEFIT AND COMMUNITY BUILDING ACTIVITIES AND THE GUIDELINES DEVELOPED BY THE CATHOLIC HOSPITAL ASSOCIATION (CHA) IN ORDER TO CATALOG THESE BENEFITS. THESE TWO ORGANIZATIONS HAVE WORKED TOGETHER FOR OVER 20 YEARS TO PROVIDE SUPPORT TO NOT-FOR-PROFIT HOSPITALS TO DEVELOP AND SUSTAIN EFFECTIVE COMMUNITY BENEFIT PROGRAMS.THE MOST RECENT VERSION OF THE CHA GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFIT DEFINES COMMUNITY BUILDING ACTIVITIES AS PROGRAMS THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS AND ENVIRONMENTAL PROBLEMS. THESE ACTIVITIES ARE CATEGORIZED INTO EIGHT DISTINCT AREAS INCLUDING PHYSICAL IMPROVEMENT AND HOUSING, ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT, ENVIRONMENTAL IMPROVEMENTS, LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS, COALITION BUILDING, ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENTS, AND WORKFORCE DEVELOPMENT. L+M HOSPITAL ENHANCES THE LIVES OF THOSE WE SERVE BY PROVIDING ACCESS TO INTEGRATED, HIGH-VALUE, PATIENT-CENTERED CARE IN COLLABORATION WITH OTHERS WHO SHARE OUR VALUES. AS SUCH, L+M HOSPITAL IS INCREASINGLY AWARE OF HOW SOCIAL DETERMINANTS IMPACT THE HEALTH OF INDIVIDUALS AND COMMUNITIES. A PERSON'S HEALTH AND CHANCES OF BECOMING SICK AND DYING EARLY ARE GREATLY INFLUENCED BY POWERFUL SOCIAL FACTORS SUCH AS EDUCATION, INCOME, NUTRITION, HOUSING AND NEIGHBORHOODS. DURING FISCAL YEAR 2020, L+M HOSPITAL INVESTED IN COMMUNITY BUILDING EFFORTS THAT PROMOTE THRIVING AND HEALTHY COMMUNITIES IN OUR REGION INCLUDING SUPPORT FOR HOUSING INITIATIVES, ECONOMIC DEVELOPMENT, AND AN ARRAY OF ORGANIZATIONS THAT POSITIVELY IMPACT SOCIAL DETERMINANTS OF HEALTH IN THE BROADER COMMUNITY.
PART III, LINE 2: LAWRENCE + MEMORIAL HOSPITAL ("L+M OR "L+M HOSPITAL") USES A COST REPORTING SYSTEM TO DETERMINE THE BAD DEBT EXPENSE. THE AMOUNT OF BAD DEBT EXPENSE (AT COST) REPORTED ON PART III, LINE 2 IS TAKEN DIRECTLY FROM THE AUDITED FINANCIAL STATEMENTS.DUE TO THE ADOPTION OF ASU NO. 2014-09 REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606) BAD DEBT EXPENSE IS NO LONGER REPORTED ON THE AUDITED FINANCIAL STATEMENTS. RATHER IT IS TREATED AS A PRICE CONCESSION. BAD DEBT IS DETERMINED IF THERE WAS AN ADVERSE EVENT THAT PREVENTED A PATIENT FROM BEING ABLE TO PAY THE EXPECTED AMOUNT. FOR THE PATIENTS WHO WERE DETERMINED BY THE HOSPITAL TO HAVE THE ABILITY TO PAY UNCOLLECTED AMOUNTS BUT DID NOT, THESE UNCOLLECTED AMOUNTS ARE TREATED AS IMPLICIT PRICE CONCESSIONS. THE HOSPITAL IS REPORTING BOTH BAD DEBT AND IMPLICIT PRICE CONCESSIONS ON SCHEDULE H, PART III, LINE 2.
PART III, LINE 3: THE ORGANIZATION DOES NOT CURRENTLY HAVE A METHODOLOGY TO ACCURATELY QUANTIFY OR ESTIMATE THE AMOUNT OF BAD DEBT EXPENSE THAT WOULD BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.
PART III, LINE 4: LAWRENCE + MEMORIAL HOSPITAL IS INCLUDED IN THE CONSOLIDATED YALE NEW HAVEN HEALTH SERVICES CORPORATION AUDITED FINANCIAL STATEMENTS. FOLLOWING IS THE FOOTNOTE FROM THE CONSOLIDATED FINANCIAL STATEMENTS:THE SYSTEM'S COMMITMENT TO COMMUNITY SERVICE IS EVIDENCED BY SERVICES PROVIDED TO THE POOR AND BENEFITS PROVIDED TO THE BROADER COMMUNITY. SERVICES PROVIDED TO THE POOR INCLUDE SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTHCARE BECAUSE OF INADEQUATE RESOURCES, AND/OR WHO ARE UNINSURED OR UNDERINSURED.THE SYSTEM PROVIDES FREE CARE PROGRAMS FOR QUALIFYING PATIENTS. IN ACCORDANCE WITH THE ESTABLISHED POLICIES OF THE SYSTEM, DURING THE REGISTRATION, BILLING, AND COLLECTION PROCESS, A PATIENT'S ELIGIBILITY FOR FREE CARE FUNDS IS DETERMINED. FOR PATIENTS WHO WERE DETERMINED BY THE SYSTEM TO HAVE THE ABILITY TO PAY BUT DID NOT, THE UNCOLLECTED AMOUNTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS. FOR PATIENTS WHO DO NOT AVAIL THEMSELVES OF ANY FREE CARE PROGRAM, AND WHOSE ABILITY TO PAY CANNOT BE DETERMINED BY THE SYSTEM, CARE GIVEN BUT NOT PAID FOR IS CLASSIFIED AS CHARITY CARE.TOGETHER, CHARITY CARE AND FREE CARE REPRESENT UNCOMPENSATED CARE. THE ESTIMATED COST OF TOTAL UNCOMPENSATED CARE IS APPROXIMATELY $102.0 MILLION AND $88.9 MILLION FOR THE YEARS ENDED SEPTEMBER 30, 2020 AND 2019, RESPECTIVELY. THE ESTIMATED COST OF UNCOMPENSATED CARE IS BASED ON THE RATIO OF COST TO CHARGES, AS DETERMINED BY CLAIMS ACTIVITY.THE ALLOCATION BETWEEN IMPLICIT PRICE CONCESSION AND CHARITY CARE IS DETERMINED BASED ON MANAGEMENT'S ANALYSIS ON THE PREVIOUS 12 MONTHS OF HOSPITAL DATA. THIS ANALYSIS CALCULATES THE ACTUAL PERCENTAGE OF ACCOUNTS WRITTEN OFF OR DESIGNATED AS IMPLICIT PRICE CONCESSIONS VERSUS CHARITY CARE WHILE TAKING INTO ACCOUNT THE TOTAL COSTS INCURRED BY THE SYSTEM FOR EACH ACCOUNT ANALYZED.THE CONNECTICUT DISPROPORTIONATE SHARE HOSPITAL PROGRAM (CDSHP) WAS ESTABLISHED TO PROVIDE FUNDS TO HOSPITALS FOR THE PROVISION OF UNCOMPENSATED CARE AND IS FUNDED, IN PART, BY AN ASSESSMENT ON HOSPITAL NET PATIENT SERVICE REVENUE. THE SYSTEM MADE PAYMENTS INTO THE CDSHP OF $330.7 MILLION AND $333.1 MILLION FOR THE YEARS ENDED SEPTEMBER 30, 2020 AND 2019, RESPECTIVELY, FOR THE ASSESSMENT.DURING THE YEARS ENDED SEPTEMBER 30, 2020 AND 2019, THE SYSTEM RECEIVED $184.4 MILLION AND $155.1 MILLION, RESPECTIVELY, IN CDSHP DISTRIBUTIONS, OF WHICH APPROXIMATELY $108.0 MILLION AND 92.0 MILLION WAS RELATED TO CHARITY CARE. THESE ARE RECORDED IN NET PATIENT SERVICE REVENUE.ADDITIONALLY, THE SYSTEM PROVIDES BENEFITS FOR THE BROADER COMMUNITY, WHICH INCLUDES SERVICES PROVIDED TO OTHER NEEDY POPULATIONS THAT MAY NOT QUALIFY AS POOR BUT NEED SPECIAL SERVICES AND SUPPORT. BENEFITS INCLUDE THE COST OF HEALTH PROMOTION AND EDUCATION OF THE GENERAL COMMUNITY, INTERNS AND RESIDENTS, HEALTH SCREENINGS, AND MEDICAL RESEARCH. THE BENEFITS ARE PROVIDED THROUGH THE COMMUNITY HEALTH CENTERS, SOME OF WHICH SERVICE NON ENGLISH SPEAKING RESIDENTS, DISABLED CHILDREN, AND VARIOUS COMMUNITY SUPPORT GROUPS. THE SYSTEM VOLUNTARILY ASSISTS WITH THE DIRECT FUNDING OF SEVERAL CITY OF NEW HAVEN PROGRAMS, INCLUDING AN ECONOMIC DEVELOPMENT PROGRAM AND A YOUTH INITIATIVE PROGRAM.IN ADDITION TO THE QUANTIFIABLE SERVICES DEFINED ABOVE, THE SYSTEM PROVIDES BENEFITS TO THE COMMUNITY THROUGH ITS ADVOCACY OF COMMUNITY SERVICE BY EMPLOYEES. THE SYSTEM'S EMPLOYEES SERVE NUMEROUS ORGANIZATIONS THROUGH BOARD REPRESENTATION, MEMBERSHIP IN ASSOCIATIONS AND OTHER RELATED ACTIVITIES. THE SYSTEM ALSO SOLICITS THE ASSISTANCE OF OTHER HEALTHCARE PROFESSIONALS TO PROVIDE THEIR SERVICES AT NO CHARGE THROUGH PARTICIPATION IN VARIOUS COMMUNITY SEMINARS AND TRAINING PROGRAMS.
PART III, LINE 8: THE MEDICARE SHORTFALL REPORTED IN PART III, LINE 7 WAS CALCULATED BASED ON COST REPORTING. THE COSTING METHOD WAS FROM THE MEDICARE COST REPORT'S OWN METHODOLOGY OF ALLOCATING COST BY DEPARTMENT AND DERIVING A RATIO OF COST TO CHARGES. THIS AMOUNT SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE THE RATES PAID BY MEDICARE DO NOT ACCURATELY REFLECT THE COST OF CARE PROVIDED BY LAWRENCE & MEMORIAL HOSPITAL. ACCORDINGLY, LAWRENCE + MEMORIAL HOSPITAL MUST SUBSIDIZE THE COST OF CARE PROVIDED TO MEDICARE BENEFICIARIES WITH OTHER REVENUES.
PART III, LINE 9B: IT IS THE HOSPITAL'S POLICY TO TREAT ALL PATIENTS EQUITABLY WITH RESPECT AND COMPASSION, FROM THE BEDSIDE TO THE BILLING OFFICE. THE HOSPITAL WILL PURSUE PATIENT ACCOUNTS, DIRECTLY AND THROUGH ITS COLLECTION AGENTS, FAIRLY AND CONSISTENTLY TAKING INTO CONSIDERATION DEMONSTRATED FINANCIAL NEED. AS PART OF ITS COLLECTION PROCESS, THE HOSPITAL WILL MAKE REASONABLE EFFORTS TO DETERMINE IF AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER ITS FINANCIAL ASSISTANCE POLICY. IN THE EVENT A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL WILL NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTION AS DEFINED BY LAW AND HOSPITAL POLICY.
PART VI, LINE 2: L+M HOSPITAL EMPLOYS A VARIETY OF STRATEGIES IN GAUGING THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES. THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), COVERING THE LAWRENCE + MEMORIAL PRIMARY SERVICE AREA, WAS CARRIED OUT IN PART (HOUSEHOLD SURVEY) THROUGH A PARTNERSHIP WITH DATAHAVEN. ADDITIONAL METHODS INCLUDED USING SCIENTIFICALLY VALID DATA, COMPARATIVE INFORMATION, AND INPUT FROM LOCAL RESIDENTS, PROVIDERS AND LEADERS. INDICATORS WERE COMPUTED FROM AN EXTENSIVE SET OF SECONDARY HEALTH-RELATED DATA. WORK TO GAIN A DEEPER UNDERSTANDING OF ISSUES IDENTIFIED IN THE CHNA WAS CONDUCTED BASED ON THE FINDINGS.L+M HOSPITAL REVIEWS DISEASE INCIDENCE AND PREVALENCE RATES FOR THE LOCAL COMMUNITY, STATE, AND NATION. RATES ARE COLLECTED FROM MEDICAL JOURNALS, THE CT DEPARTMENT OF HEALTH, OR NATIONAL HEALTH RESOURCES SUCH AS THE KAISER FAMILY FOUNDATION OR CDC. THIS ANALYSIS INFORMS L+M ON THE HEALTH STATUS OF THE COMMUNITY AND IS USED TO FOCUS PROGRAM AND SERVICE DEVELOPMENT ON AREAS OF GREATEST CONCERN. INFORMATION ON COMMUNITY NEEDS IS ALSO GATHERED THROUGH PARTNERSHIPS WITH OTHER COMMUNITY ORGANIZATIONS SUCH AS THE LEDGE LIGHT HEALTH DISTRICT, AND OTHER LOCAL NON-PROFITS. PERIODIC REVIEW OF DATA AND UPDATING AS APPROPRIATE IS CONDUCTED. ALL COMMUNITY BENEFIT ACTIVITIES ARE REGULARLY EVALUATED FOR IMPACT AND EFFECTIVENESS AND AUDITED FOR COMPLIANCE WITH THE ORGANIZATION'S COMMUNITY BENEFIT POLICY.
PART VI, LINE 3: LAWRENCE + MEMORIAL HOSPITAL INFORMS INDIVIDUALS ABOUT ITS FINANCIAL ASSISTANCE PROGRAMS ON ITS WEBSITE, THROUGH VISIBLE POSTINGS AND COMMUNICATIONS AT POINTS OF REGISTRATION AND FRONT LINE ACCESS. THE FINANCIAL ASSISTANCE POLICY, APPLICATION AND SUMMARY ARE AVAILABLE ONREQUEST WITHOUT CHARGE BY MAIL, INCLUDING AT THE ADMITTING DEPARTMENT. FURTHER, PATIENTS RECEIVE A SUMMARY OF FINANCIAL ASSISTANCE PROGRAMS, INCLUDING ELIGIBILITY REQUIREMENTS THROUGH A FIRST STATEMENT MAILER AS PART OF THE BILLING PROCESS. THESE COMMUNICATIONS INCLUDE TELEPHONE NUMBERS AND THE POINT OF CONTACT FOR INDIVIDUALS TO VISIT OR CALL. THEHOSPITAL HAS RESOURCES TO ASSIST PATIENTS WITH STATE OF CONNECTICUT MEDICAID APPLICATIONS.
PART VI, LINE 4: GENERAL DEMOGRAPHICSTHE COMMUNITIES THAT COMPRISE THE SERVICE AREA OF LAWRENCE+MEMORIAL HOSPITAL, REFERRED TO AS THE GREATER NEW LONDON AREA, INCLUDES TEN TOWNS ALONG THE CONNECTICUT SHORELINE BETWEEN RHODE ISLAND AND THE CONNECTICUT RIVER AND INLAND: STONINGTON, NORTH STONINGTON, GROTON, LEDYARD, NEW LONDON, WATERFORD, MONTVILLE, EAST LYME, OLD LYME, AND LYME. OUR COMMUNITIES REPRESENT A BROAD MIX OF COMMUNITY TYPES. IN 2018, 38.6% OF THE POPULATION IN GREATER NEW LONDON LIVE IN URBAN COMMUNITIES, WHICH IS LESS THAN THE PERCENTAGE IN 2017 (41.7%). ON THE OTHER HAND, POPULATION IN RURAL TOWNS HAS MARKEDLY INCREASED FROM 52.9% IN 2017 TO 55.7% OUT OF THE GREATER NEW LONDON REGION, WITH SUBURBAN COMMUNITIES SHOWED SLIGHT INCREASE IN POPULATION FROM 5.4% IN 2017 TO 5.8% IN 2018. THIS SHOWS TENDENCY OF RESIDENTS MOVE-IN TO THE REGION'S RURAL COMMUNITIES. THIS OBSERVATION IS OPPOSING THE NATIONAL TREND OF URBANIZATION. ACCORDING TO THE 2018 AMERICAN COMMUNITY SURVEY, THE POPULATION OF GREATER NEW LONDON IS 171,477, A DECLINE OF 2% SINCE 2010. SIMILAR TO CONNECTICUT, GREATER NEW LONDON SHOWS A TRENDY DECLINE THROUGH THE YEARS IN OVERALL POPULATION COUNTS (175,012 IN 2010, 173,437 IN 2015, 172,687 IN 2017, AND 171,477 IN 2018). MOST OF THIS CHANGE WAS IN COMMUNITIES LIKE MONTVILLE (-2.6%), FOLLOWED BY GROTON AND WATERFORD (-2.5% EACH), THEN OLD LYME (-2.3%). ALMOST ALL COMMUNITIES IN THE REGION EXPERIENCED REDUCTION IN THEIR POPULATION SIZE IN 2018 COMPARED TO 2010, EXCEPT FOR LYME THAT HAS INCREASE IN ITS POPULATION BY 2.5% FROM 2010. THE POPULATION IS NEARLY EVENLY DIVIDED BY SEX, WITH 50.3% BEING MALE, THOUGH THE POPULATION 65 YEARS AND OLDER IS MADE UP OF MORE FEMALES (54.6%). IN TOTAL, 17.9% OF THE POPULATION IN 2018 IS 65 OR OLDER, WITH INCREASE IN THIS AGE GROUP COMPARED TO THE 2015 PERCENTAGE WHICH WAS 17% OF THE POPULATION. AS THE ELDERLY COMMUNITY CONTINUES TO GROW, THIS WILL PLACE INCREASING HEALTH, SOCIAL AND ECONOMIC PRESSURES ON FAMILIES, SOCIAL SERVICE AND GOVERNMENTAL AGENCIES. BOTH IN ABSOLUTE TERMS AND AS A PERCENTAGE OF THE POPULATION (25.6%), THE POPULATION OF NON-WHITE MINORITIES HAS GROWN IN GREATER NEW LONDON OVER THE PAST TEN YEARS; 20% IN 2009, 24% IN 2015, 25% IN 2017, AND 25.6% IN 2018. AS SEEN IN PREVIOUS YEARS, THIS GROWTH HAS BEEN DRIVEN PRIMARILY BY THOSE IDENTIFYING AS HISPANIC OR LATINO, WHOSE POPULATION HAS GROWN FROM 7.7% OF THE POPULATION IN 2009, TO 10.4% IN 2015, 11.7% IN 2017 AND FINALLY TO 12.7% IN 2018.MAJOR EMPLOYERSTHE REGION HAS TRANSITIONED FROM A LARGELY DEFENSE INDUSTRY-BASED ECONOMY TO ONE THAT RELIES HEAVILY UPON EMPLOYMENT IN THE SERVICE AND TRADE SECTORS AND IN GENERAL HAS A HIGHER PERCENTAGE OF PERSONS EMPLOYED IN THOSE SECTORS WITH CORRESPONDING LOWER RATES OF PAY WHICH IS CORRELATED WITH THE LOWER PER CAPITA INCOME AND GREATER ECONOMIC VULNERABILITY. MAJOR EMPLOYERS INCLUDE THE MASHANTUCKET PEQUOT AND MOHEGAN TRIBES (FOXWOODS RESORT AND CASINO AND MOHEGAN SUN CASINO RESPECTIVELY), PFIZER GLOBAL RESEARCH AND DEVELOPMENT, EDUCATIONAL INSTITUTIONS (CONNECTICUT COLLEGE, MITCHELL COLLEGE AND THE U.S. COAST GUARD ACADEMY), GENERAL DYNAMICS/ELECTRIC BOAT, DOMINION, AND LAWRENCE + MEMORIAL HOSPITAL. PRIMARY SOCIAL AND HEALTH CARE FACTORSIN THE URBAN CENTERS OF THE REGION, THERE ARE RACIAL AND ETHNIC HEALTH DISPARITIES, HIGHER POVERTY AND UNEMPLOYMENT RATES, LOWER LEVELS OF EDUCATIONAL ATTAINMENT, LIMITED ACCESS TO AFFORDABLE HOUSING AND TRANSPORTATION, HIGHER RATES OF DEATH FROM CHRONIC ILLNESS, AND A GREATER LIKELIHOOD OF RESIDENTS NOT HAVING HEALTH INSURANCE, ALL OF WHICH PRESENT PARTICULAR CHALLENGES. THE BURDEN OF PREMATURE LIFE LOSS IS HIGH DUE TO PARTICULAR CONDITIONS LIKE CANCER, ACCIDENTS AND HEART DISEASES. THE LIKELIHOOD OF PREMATURE DEATH DUE TO ALCOHOL OR COPD IN NEW LONDON IS THREE TIMES THE STATE RATE, FOLLOWED BY DIABETES AND STROKE WITH DOUBLE THE RISK OF PREMATURE DEATH COMPARED TO CONNECTICUT. MEDIAN HOUSEHOLD INCOME IN THE LAWRENCE+MEMORIAL HOSPITAL SERVICE AREA IS FAR BELOW THAT OF THE STATE, WITH AFRICAN AMERICAN AND HISPANIC FAMILIES' INCOMES SIGNIFICANTLY LOWER THAN WHITE FAMILIES' INCOMES. THE REGION INCLUDES ONE PRIORITY SCHOOL DISTRICT. POVERTY RATE HAS INCREASED IN THE GREATER NEW LONDON REGION OVER THE PREVIOUS FOUR YEARS, BUT THIS INCREASE IS GREATER AMONG BLACK OR AFRICAN AMERICANS (FROM 19.1% IN 2015 TO 21.9% IN 2018, THE MOST RECENT YEAR FOR WHICH DATA ARE AVAILABLE). OVER THE YEARS, HISPANICS OR LATINOS HAD HIGHER POVERTY RATES THAN OTHER SUBGROUPS AMONG GNL RESIDENTS, BUT IN THE RECENT YEARS POVERTY RATES HAVE STARTED TO FLUCTUATE FOR THIS SUB-GROUP (FROM 30.6% IN 2015, AND 29.1% IN 2017, TO 30.4% IN 2018). IN 2018 THE PERCENTAGE OF FAMILIES WITH CHILDREN WHO LIVE BELOW POVERTY LEVEL IN GREATER NEW LONDON HAVE STARTED TO DECREASE FROM 13.1% IN 2017 TO 10% IN 2018 (THE MOST RECENT YEAR FOR WHICH DATA ARE AVAILABLE). HOWEVER, THIS INDICATOR DEMONSTRATE MARKED DISPARITIES AMONG COMMUNITIES WITHIN THE REGION. NEW LONDON HAS 38% OF ITS FAMILIES WITH CHILDREN LIVING BELOW POVERTY LEVEL, WHICH IS HIGHER THAN 2017 RATE OF 37.7%. THE NEXT HIGHEST COMMUNITY WITH IS STONINGTON WITH 14.2%, FOLLOWED BY GROTON WITH 12.7%. OVERALL THE PERCENTAGE OF FAMILIES LIVING IN POVERTY IN NEW LONDON IS 25.1%, WHICH IS HIGHER THAN THE PERCENTAGE IN 2017 (23.8%) AND DOUBLE AND A HALF THE REGION'S AVERAGE OF 10%.
PART VI, LINE 5: L+M HOSPITAL'S COMMUNITY BENEFIT PROGRAMS AND SERVICES FORWARD THE ORGANIZATIONAL MISSION AND ALIGN WITH THE PRINCIPLES AS SET FORTH IN THE ORGANIZATION'S COMMUNITY BENEFIT POLICY. THOSE PRINCIPLES INCLUDE:1. EMPHASIS ON PROGRAMS TO MEET A SIGNIFICANT UNMET HEALTH NEED INCLUDING EFFORTS TO IDENTIFY AND INCLUDE VULNERABLE POPULATIONS OR THOSE MOST AT-RISK AS DETERMINED BY RISK FACTORS WHICH PREDISPOSE THOSE POPULATIONS TOWARD A HIGHER INCIDENCE OF DISEASE AND/OR BARRIERS TO OBTAINING APPROPRIATE HEALTHCARE.2. EMPHASIS ON PRIMARY PREVENTION AND INCLUDING AT LEAST ONE OF THREE PRIMARY PREVENTION STRATEGIES: HEALTH PROMOTION, DISEASE PREVENTION, AND HEALTH PROTECTION. HEALTH PROMOTION ENTAILS ENCOURAGING HEALTHY LIFESTYLES; DISEASE PREVENTION FOCUSES ON INDIVIDUALS IDENTIFIED AS AT-RISK FOR HEALTH PROBLEMS; HEALTH PROTECTION ACTIVITIES INFLUENCE THE ENVIRONMENT TO SUPPORT HEALTHY BEHAVIORS.3. PROGRAMS SHOULD DEVELOP EVIDENCE-BASED LINKS BETWEEN CLINICAL SERVICES AND HEALTH IMPROVEMENT ACTIVITIES DELIVERED BOTH INSIDE AND OUTSIDE THE HOSPITAL. 4. PROGRAMS SHOULD FOCUS ON TARGETING CHARITABLE RESOURCES THAT MOBILIZE AND BUILD CAPACITY WITHIN EXISTING COMMUNITY ASSETS WHILE MINIMIZING DUPLICATION OF EFFORT.5. PROGRAMS SHOULD EMPHASIS COLLABORATION WITH COMMUNITY STAKEHOLDERS.AS EVIDENCED BY THE WIDE RANGE OF COMMUNITY BENEFIT PROGRAMS AND SERVICES OFFERED, L+M IS ENGAGED IN MEETING THE IDENTIFIED HEALTH NEEDS OF THE COMMUNITIES WE SERVE. THERE IS AN ORGANIZATIONAL HISTORY OF COLLECTING DATA TO DETERMINE HOW BEST TO DIRECT OUR RESOURCES AND HOW TO MAKE THE GREATEST IMPACT IN PROMOTING COMMUNITY HEALTH. OUR ANNUAL COMMUNITY BENEFIT REPORT PUBLICATION DESCRIBES A SAMPLING OF PROGRAMS AND THE AMOUNT OF INVESTMENT THAT L+M MAKES IN CARRYING OUT THESE PROGRAMS.COMMUNITY INVOLVEMENT IN GOVERNANCE AND ADVISORY GROUPS:COMMUNITY ENGAGEMENT IN THE PLANNING, IMPLEMENTATION AND EVALUATION OF L+M HOSPITAL INITIATIVES IS OF UTMOST IMPORTANCE. CONSUMERS AND STAKEHOLDER ORGANIZATIONS PARTICIPATE IN A RANGE OF ACTIVITIES SO AS TO ENSURE THAT MANY PERSPECTIVES ARE CONSIDERED, INCLUDING THE PATIENT AND FAMILY ADVISORY COUNCIL. THE COUNCIL WORKS TO IMPROVE THE QUALITY OF CARE AND PATIENT EXPERIENCE WITH A PATIENT AND FAMILY CENTERED APPROACH. IT ALSO IDENTIFIES AND PROMOTES OPPORTUNITIES FOR COMMUNICATION AND COLLABORATION AMONG PATIENTS AND FAMILIES, HEALTH CARE PROFESSIONALS AND THE COMMUNITY. THROUGH THE PRESS GANEY SURVEYS, WE RECEIVE WRITTEN COMMENTS FROM PATIENTS AND FAMILIES THAT WE VIEW AS VALUABLE FEEDBACK ON HOW WE CAN IMPROVE OUR SERVICES AND THE PATIENT EXPERIENCE. THE PATIENT EXPERIENCE TEAM AT L+M RECEIVES ONGOING FEEDBACK FROM CONSUMERS AND COMMUNITY MEMBERS ABOUT THEIR EXPERIENCES. THEY OFTEN IDENTIFY OPPORTUNITIES FOR IMPROVEMENT, WHICH IS SHARED WITH LEADERS THROUGHOUT THE ORGANIZATION.AS A COMMUNITY HEALTH CARE SERVICES PROVIDER, L+M HOSPITAL REMAINS ATTENTIVE TO HEALTH AND WELL-BEING THROUGH EDUCATION, OUTREACH AND OTHER INNOVATIVE SERVICES. DURING FISCAL YEAR 2020, L+M HOSPITAL PROVIDED OVER $51 MILLION IN COMMUNITY BENEFITS THROUGH FINANCIAL AND IN-KIND CONTRIBUTIONS IN FIVE WIDE-RANGING PROGRAMS GUARANTEEING ACCESS TO CARE; PROMOTING HEALTH AND WELLNESS; ADVANCING CAREERS IN HEALTH CARE; RESEARCH; AND CREATING HEALTHIER COMMUNITIES. L+M HOSPITAL ALSO CONTRIBUTES TO THE COMMUNITY IN WAYS THAT ARE NOT QUANTIFIED AS PART OF COMMUNITY BENEFITS AND SERVES AS AN IMPORTANT COMMUNITY RESOURCE. THIS INCLUDES HAVING A COMMUNITY-BASED BOARD OF TRUSTEES WITH MANY MEMBERS RESIDING OR WORKING IN THE AREA SERVED BY THE HOSPITAL. THE HOSPITAL ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY. L+M HOSPITAL, FOUNDED IN 1912, IS A 308-BED HOSPITAL SERVING 12,609 INPATIENTS AND 284,718 OUTPATIENT ENCOUNTERS IN 2020. L+M HOSPITAL IS ONE OF THE LARGEST PRIVATE EMPLOYERS IN SOUTHEASTERN CT WITH 2,307 EMPLOYEES IN 2020. IN FISCAL YEAR 2020 THERE WERE A TOTAL OF 709 MEMBERS OF THE L+M HOSPITAL MEDICAL STAFF.
PART VI, LINE 6: L+M HEALTHCARE IS AFFILIATED WITH THE YALE NEW HAVEN HEALTH SYSTEM. THE ENTITIES OF L+M HEALTHCARE INCLUDE LAWRENCE+MEMORIAL HOSPITAL, THE VISITING NURSE ASSOCIATION OF SOUTHEASTERN CT (VNASC), AND WESTERLY HOSPITAL (RHODE ISLAND,) EACH OF WHICH HAVE A ROLE IN PROMOTING THE HEALTH OF OUR COMMUNITIES. THE LAWRENCE+MEMORIAL HOSPITAL ROLE IS DESCRIBED IN QUESTION 5 ABOVE AND WESTERLY HOSPITAL OPERATES IN SIMILAR FASHION: IMPLEMENTING COMMUNITY HEALTH IMPROVEMENT ACTIVITIES, PROVIDING OPPORTUNITIES FOR HEALTH PROFESSIONS STUDENTS, ENSURING ACCESS TO CARE, PROMOTING PRIMARY PREVENTIVE CARE, PROVIDING SUBSIDIZED HEALTH SERVICES AND SERVING AS A SAFETY NET PROVIDER. VNASC CARES FOR EVERYONE FROM THE ELDERLY WHO WISH TO REMAIN IN THEIR HOMES FOR AS LONG AS THEY CAN AND PATIENTS RECOVERING FROM SURGERY OR ILLNESS, TO NEW MOTHERS, SCHOOLCHILDREN, AND THE HOMELESS USING THE MOST CURRENT MEDICAL ADVANCES AND TECHNOLOGIES IN HOME HEALTHCARE, AND STRENGTHEN COMMUNITY RESOURCES FOR EVERYONE. THE YALE NEW HAVEN HEALTH SYSTEM'S FUNDAMENTAL MISSION IS TO ENSURE THAT THE DELIVERY NETWORKS SUCH AS LAWRENCE+MEMORIAL HOSPITAL ASSOCIATED WITH THE SYSTEM PROMOTE THE HEALTH OF THE COMMUNITIES THEY SERVE AND ENSURE THAT ALL PATIENTS HAVE ACCESS TO APPROPRIATE HEALTHCARE SERVICES. THE YALE NEW HAVEN HEALTH SYSTEM REQUIRES ITS HOSPITALS TO INCORPORATE PLANS TO PROMOTE HEALTHY COMMUNITIES WITHIN THE HOSPITAL'S EXISTING BUSINESS PLANS FOR WHICH THEY ARE HELD ACCOUNTABLE. IN ADDITION, REGULAR REPORTING ON COMMUNITY BENEFITS IS REQUIRED ON A QUARTERLY BASIS.
PART VI, LINE 7, REPORTS FILED WITH STATES CT
Schedule H (Form 990) 2019
Additional Data


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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
2019
Open to Public
Inspection
Name of the organization
LAWRENCE MEMORIAL HOSPITAL INC
 
Employer identification number
06-0646704
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) CHAMBER OF COMMERCE OF EASTERN CONNECTICUT
914 HARTFORD TURNPIKE
WATERFORD,CT06385
06-0475490 501C6 16,000       SUPPORT ORGANIZATION
(2) CT CANCER FOUNDATION
15 NORTH MAIN STREET
OLD SAYBROOK,CT06475
06-1240574 501C3 26,000       SUPPORT ORGANIZATION
(3) CHILDRENS MUSEUM OF SOUTHEASTERN CONNECTICUT
409 MAIN STREET
NIANTIC,CT06357
11-2113076 501C3 6,000       SUPPORT ORGANIZATION
(4) MYSTIC CHAMBER OF COMMERCE
14 HOLMES STREET
MYSTIC,CT06355
06-0861879 501C6 25,000       SUPPORT ORGANIZATION
(5) AMERICAN HEART ASSOCIATION
7272 GREENVILLE AVE
DALLAS,TX75231
13-5613797 501C3 30,000       SUPPORT ORGANIZATION
(6) SOFIA SEES HOPE
PO BOX 705
LEDYARD,CT06339
46-4552134 501C3 6,500       SUPPORT ORGANIZATION
(7) GARDE ARTS CENTER INC
325 STATE STREET
NEW LONDON,CT06320
06-1143582 501C3 6,000       SUPPORT ORGANIZATION
(8) CITY OF NEW LONDON
111 UNION STREET
NEW LONDON,CT06320
06-6001880 GOVERNMENT 75,000       SUPPORT ORGANIZATION
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
6
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) 2019

Schedule I (Form 990) 2019
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)
(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
FORM 990, SCHEDULE I, PART IV NONE OF THE AMOUNTS REPORTED ON SCHEDULE I, PART II ARE GRANTS. THESE AMOUNTS ARE DONATIONS AND SPONSORSHIPS GIVEN TO ORGANIZATIONS TO ASSIST IN THE FURTHERANCE OF ITS CHARITABLE MISSION. LAWRENCE + MEMORIAL HOSPITAL ("LMH") CARRIES OUT DUE DILIGENCE IN PROVIDING MONETARY ASSISTANCE ONLY TO QUALIFYING 501(C)(3) OR ORGANIZATIONS THAT COMPLEMENT ITS MISSION OR SUPPORT SERVED. LMH VERIFIES EACH ORGANIZATION'S EIN AS LISTED ON IRS FORM W-9 THAT HAS BEEN SUBMITTED TO LMH. ASSISTANCE DONATED BY LMH TO THESE QUALIFYING ORGANIZATIONS IS NOT OUTCOMES-BASED AND IS GIVEN IN SUPPORT OF AN INDIVIDUAL ORGANIZATION'S FUNDRAISING EVENTS OR IN SUPPORT OF DIRECT SERVICES. LMH MAINTAINS FULL AND COMPLETE RECORDS OF ALL MONETARY ASSISTANCE PROVIDED BUT LMH DOES NOT MONITOR SPECIFIC FUNDS.
Schedule I (Form 990) 2019



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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
2019
Open to Public Inspection
Name of the organization
LAWRENCE MEMORIAL HOSPITAL INC
 
Employer identification number

06-0646704
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 on 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 on 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
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 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
 
No
b
Any related organization? ......................
6b
 
No
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) 2019

Schedule J (Form 990) 2019
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
1PRATHIBHA VARKEY
TRUSTEE
(i)

(ii)
0
-------------
760,140
0
-------------
281,904
0
-------------
89,010
0
-------------
360,589
0
-------------
8,014
0
-------------
1,499,657
0
-------------
0
2PATRICK L GREEN
PRESIDENT/CEO/TRUSTEE
(i)

(ii)
501,632
-------------
125,408
167,285
-------------
41,821
43,326
-------------
10,831
261,002
-------------
65,251
16,044
-------------
4,011
989,289
-------------
247,322
0
-------------
0
3DENISE FIORE
SVP, COO (CURRENT YEAR COMP)
(i)

(ii)
492,682
-------------
0
157,504
-------------
0
84,259
-------------
0
115,400
-------------
0
7,765
-------------
0
857,610
-------------
0
0
-------------
0
4DENISE FIORE
SVP, COO (VESTED DEFERRED)
(i)

(ii)
0
-------------
0
0
-------------
0
347,860
-------------
0
0
-------------
0
0
-------------
0
347,860
-------------
0
0
-------------
0
5STEPHEN ALLEGRETTO
SVP, CFO
(i)

(ii)
419,388
-------------
46,599
104,860
-------------
11,651
24,449
-------------
2,717
205,382
-------------
22,820
12,404
-------------
1,378
766,483
-------------
85,165
0
-------------
0
6OLIVER MAYORGA
VP, CMO
(i)

(ii)
53,715
-------------
393,907
13,908
-------------
101,988
3,200
-------------
23,470
9,198
-------------
67,452
2,364
-------------
17,333
82,385
-------------
604,150
0
-------------
0
7MAUREEN ANDERSON
ASSISTANT SECRETARY
(i)

(ii)
57,497
-------------
261,930
9,275
-------------
42,255
4,081
-------------
18,590
3,987
-------------
18,163
3,488
-------------
15,888
78,328
-------------
356,826
0
-------------
0
8CAREN LEWIS
VP PATIENT CARE
(i)

(ii)
307,443
-------------
0
81,445
-------------
0
3,564
-------------
0
17,287
-------------
0
16,820
-------------
0
426,559
-------------
0
0
-------------
0
9BENJAMIN ARMSTRONG
PHYSICIAN
(i)

(ii)
363,142
-------------
0
32,250
-------------
0
219
-------------
0
11,200
-------------
0
16,892
-------------
0
423,703
-------------
0
0
-------------
0
10DONNA EPPS
VP, CHRO
(i)

(ii)
302,308
-------------
0
76,741
-------------
0
31,891
-------------
0
30,400
-------------
0
722
-------------
0
442,062
-------------
0
0
-------------
0
11CRAIG MITTLEMAN
EMERGENCY DEPT MEDICAL DIRECTOR
(i)

(ii)
329,737
-------------
0
50,000
-------------
0
943
-------------
0
6,098
-------------
0
17,354
-------------
0
404,132
-------------
0
0
-------------
0
12DAVID F REISFELD
TRUSTEE
(i)

(ii)
0
-------------
334,123
0
-------------
8,529
0
-------------
23,586
0
-------------
17,587
0
-------------
14,961
0
-------------
398,786
0
-------------
0
13EMILY MILLER
PHYSICIAN
(i)

(ii)
311,892
-------------
0
16,858
-------------
0
292
-------------
0
3,319
-------------
0
13,272
-------------
0
345,633
-------------
0
0
-------------
0
14CYNTHIA TUCKER
TRUSTEE
(i)

(ii)
300,639
-------------
0
15,000
-------------
0
219
-------------
0
10,625
-------------
0
16,892
-------------
0
343,375
-------------
0
0
-------------
0
15DAVID BOUSLOUGH
PHYSICIAN
(i)

(ii)
279,324
-------------
0
15,000
-------------
0
329
-------------
0
8,609
-------------
0
17,002
-------------
0
320,264
-------------
0
0
-------------
0
16WILLIAM STANLEY
VP DEVELOPMENT
(i)

(ii)
211,153
-------------
0
53,815
-------------
0
3,429
-------------
0
23,933
-------------
0
9,190
-------------
0
301,520
-------------
0
0
-------------
0
17KERIN DACRUZ
VP, CNO
(i)

(ii)
198,118
-------------
0
48,414
-------------
0
1,181
-------------
0
8,584
-------------
0
22,094
-------------
0
278,391
-------------
0
0
-------------
0
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
PART I, LINE 3 THE FILING ORGANIZATION DOES NOT HAVE AND/OR COMPENSATE ITS OWN CEO/EXECUTIVE DIRECTOR. THESE POSITIONS ARE FILLED BY EMPLOYEES OF A RELATED ORGANIZATION(S) AND COMPENSATED THROUGH THE RESPECTIVE RELATED ORGANIZATION(S). THE METHOD(S) USED BY THE RELATED ORGANIZATION(S) FOR DETERMINING COMPENSATION FOR THESE INDIVIDUALS ARE: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINE 4B THE INDIVIDUALS LISTED BELOW PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN OF A RELATED ORGANIZATION. THESE ACCRUALS ARE INCLUDED IN THE AMOUNTS REPORTED IN PART II, COLUMN C (DEFERRED COMPENSATION) AND REPRESENTS BOTH THE REPORTING ENTITY'S AND RELATED ENTITY'S COMBINED AMOUNTS THAT HAVE NOT YET BEEN VESTED CONSISTENT WITH THE COMPENSATION REPORTING PER IRS. SEVERANCE NONQUALIFIED EQUITY-BASED PRATHIBHA VARKEY $0 $249,939 $0 PATRICK GREEN $0 $206,307 $0 STEPHEN ALLEGRETTO $0 $143,260 $0 THE INDIVIDUAL LISTED BELOW BECAME VESTED IN BENEFITS VALUED AT THE AMOUNT RESPECTIVELY REPORTED BELOW DURING THE REPORTING YEAR. INCLUDED IN SECTION II, COLUMN B (III) IS THE AMOUNT VESTED DURING THE 2019 CALENDAR YEAR THAT IS RECOGNIZED AS A TAXBLE EVENT AND REPORTED IN THE INDIVIDUAL'S 2019 CALENDAR YEAR FORM W-2. DENISE FIORE $347,860 THE SUPPLEMENTAL RETIREMENT INCOME PLAN (SRIP) / EXECUTIVE DEFERRED COMPENSATION ACCOUNT PLAN (EDCAP) ARE DESIGNED TO ENSURE THE PAYMENT OF A COMPETITIVE LEVEL OF RETIREMENT INCOME WHEN ADDED TO OTHER SOURCES OF RETIREMENT INCOME IN ORDER TO ATTRACT AND RETAIN KEY MANAGEMENT EMPLOYEES SERVING AS CORPORATE OFFICERS. THE PLAN PROVIDES SUPPLEMENTAL RETIREMENT INCOME THROUGH AN UNFUNDED, NONQUALIFIED DEFERRED COMPENSATION ARRANGEMENT UNDER SECTION 457(F) AND THROUGH A DEFERRED COMPENSATION PLAN UNDER SECTION 409A OF THE INTERNAL REVENUE CODE AND A MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES' PLAN UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (ERISA).
PART I, LINE 7 THE SHORT TERM INCENTIVE PLAN (STIP) IS A VARIABLE COMPENSATION PLAN WHICH PROVIDES ONE-TIME PAYMENTS TO ELIGIBLE MEMBERS OF MANAGEMENT IN RECOGNITION OF THE ACCOMPLISHMENT OF KEY ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE OBJECTIVES. PERFORMANCE LEVELS ARE ESTABLISHED AND REVIEWED ANNUALLY AT THRESHOLD, TARGET AND MAXIMUM LEVELS, ACCORDING TO PLANNED "STRETCH" GOALS AND OBJECTIVES. INCENTIVE AWARD OPPORTUNITIES ARE ESTABLISHED ACCORDING TO MARKET PRACTICES BASED ON EACH ELIGIBLE POSITION'S RESPONSIBILITIES, PERFORMANCE AND LEVEL OF AUTHORITY. PERFORMANCE RELATIVE TO STIP AWARD OPPORTUNITIES INCORPORATES A BROAD SPECTRUM OF PRE-DEFINED FINANCIAL AND NON-FINANCIAL METRICS THAT ARE ALIGNED WITH ORGANIZATIONAL MISSION AND VALUES.
Schedule J (Form 990) 2019

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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 , line 24a. Provide descriptions,
explanations, and any additional information in Part .
SchKMediumBullet Attach to Form 990.

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
LAWRENCE MEMORIAL HOSPITAL INC
 
Employer identification number
06-0646704
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A CHEFA - SERIES G
 
06-0806186 000000000 10-10-2013 30,000,000 CONSTRUCTION   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 6,215,000      
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 30,000,152      
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 299,001      
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 29,701,151      
11 Other spent proceeds .............        
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2014
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2018, a current refunding issue)? ........
  X            
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2018, an advance refunding issue)? ........
  X            
16 Has the final allocation of proceeds been made? .......... X              
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X              
Part
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            
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X              
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2019

Schedule K (Form 990) 2019
Page 2
Part
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              
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? X              
c Are there any research agreements that may result in private business use of bond-financed property? .............   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?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0 %      
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet        
6 Total of lines 4 and 5 ............. 0 %      
7 Does the bond issue meet the private security or payment test? ...   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            
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? .............                
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            
Part
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            
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? ....... X              
b Exception to rebate? ........ X              
c No rebate due? ......... X              
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? .....   X            
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X            
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
Schedule K (Form 990) 2019

Schedule K (Form 990) 2019
Page 3
Part
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            
b Name of provider ..........  
 
 
 
 
 
 
 
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            
7 Has the organization established written procedures to monitor the requirements of section 148? ... X              
Part
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              
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CHEFA - SERIES G DATE THE REBATE COMPUTATION WAS PERFORMED: 10/10/2018
PART II, LINE 3: SERIES G THE DIFFERENCE BETWEEN THE ISSUE PRICE REPORTED ON PART I, COLUMN (E) AND TOTAL PROCEEDS REPORTED ON PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS.
PART III, LINE 3B THE ORGANIZATION IS A MEMBER OF THE YALE NEW HAVEN HEALTH OBLIGATED GROUP ("YNHHS"). YNHHS HAS IN-HOUSE LEGAL COUNSEL STAFF WHO REVIEW MANAGEMENT, OR SERVICE CONTRACTS AND RESEARCH AGREEMENTS RELATING TO THE FINANCED PROPERTY TO ENSURE THAT SUCH AGREEMENTS ARE COMPLIANT WITH APPLICABLE SAFE HARBORS. IN-HOUSE COUNSEL CONSULTS WITH THE HOSPITAL'S OUTSIDE BOND COUNSEL AS NEEDED, INCLUDING ON NON-ROUTINE ISSUES.
PART III, LINE 9 & PART V THE ORGANIZATION HAS POLICIES AND PROCEDURES IN PLACE TO ENSURE COMPLIANCE WITH FEDERAL TAX LAW, AND TO TIMELY IDENTIFY NONCOMPLIANCE. IN THE EVENT OF NON-COMPLIANCE THE ORGANIZATION WOULD INVOLVE ITS LEGAL COUNSEL TO ADVISE REGARDING APPROPRIATE REMEDIATION.
Schedule K (Form 990) 2019

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Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
LAWRENCE MEMORIAL HOSPITAL INC
 
Employer identification number

06-0646704
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) In default? (h) Approved by board or committee? (i) Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2019
Schedule L (Form 990 or 990-EZ) 2019
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) SUBST CONTR #1
 
VENDOR 7,140,157 CONSTR   No
(2) SUBST CONTR #30
 
VENDOR 727,367 CONSTR   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2019


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
2019
Open to Public
Inspection
Name of the organization
LAWRENCE MEMORIAL HOSPITAL INC
 
Employer identification number

06-0646704
Return Reference Explanation
FORM 990, PART III, LINE 4A: FOUNDED IN 1912, LAWRENCE + MEMORIAL (L+M) HOSPITAL IS A 308-BED, NOT-FOR-PROFIT, GENERAL ACUTE CARE HOSPITAL THAT PROVIDES MEDICAL, SURGICAL, PEDIATRIC, PSYCHIATRIC AND OBSTETRICAL SERVICES TO THE COMMUNITIES OF SOUTHEASTERN CONNECTICUT, FISHERS ISLAND, NEW YORK, AND WASHINGTON COUNTRY, RHODE ISLAND. L+M OFFERS CARDIAC ACUTE, STEP-DOWN AND REHABILITATION PROGRAMS AND IS THE ONLY EASTERN CONNECTICUT HOSPITAL THAT PERFORMS EMERGENCY AND ELECTIVE ANGIOPLASTY. THE SMILOW CANCER HOSPITAL CARE CENTER IN WATERFORD PROVIDES MEDICAL ONCOLOGY SERVICES, GYNECOLOGICAL ONCOLOGY AND RADIATION ONCOLOGY TO AREA RESIDENTS. INTO ITS FOURTH YEAR OF AFFILIATION WITH YALE NEW HAVEN HEALTH, LAWRENCE + MEMORIAL HOSPITAL HAD JUST COMPLETED ANOTHER YEAR OF DOUBLE-DIGIT GROWTH IN PATIENT VOLUMES, FINANCIAL PERFORMANCE WAS STRONG THE HOSPITAL WAS MAKING INVESTMENTS IN INFRASTRUCTURE AND STAFF WHEN THE CORONAVIRUS PANDEMIC STRUCK. THE HOSPITAL, AS A MEMBER OF YALE NEW HAVEN HEALTH SYSTEM, QUICKLY FOCUSED ON A DUAL TRACK: RESPONDING TO THE IMMEDIATE, EMERGENT NEEDS OF PATIENTS AND STAFF WHILE CONTINUING TO PROVIDE FOR THE ONGOING CARE AND TREATMENT OF PATIENTS IN NEED OF THE HOSPITAL'S SERVICES. AS THE GLOBAL PANDEMIC TOOK HOLD, L+M RESPONDED RAPIDLY, INCLUDING SETTING UP SPECIMEN COLLECTION STATIONS. OVER THE COURSE OF THE YEAR, MORE THAN 25,000 TESTS WERE PERFORMED AT L+M. FROM FACILITIES TO CLINICAL SERVICES, ALMOST EVERY CORNER OF OUR HOSPITALS BENEFITED FROM INVESTMENTS IN NEW TECHNOLOGY, ENHANCED CLINICAL SERVICES AND REFRESHED PATIENT AREAS IN 2020. TO SUPPORT L+M HOSPITAL FOR FUTURE GROWTH AND TECHNOLOGY UPGRADES IN COMING YEARS, A MULTI-PHASE, MULTI-YEAR $81 MILLION PROJECT WAS LAUNCHED IN 2020 THAT INCLUDES A MAJOR POWER UPGRADE TO THE ELECTRICAL LINES SERVING THE HOSPITAL THAT PROVIDE POWER BACK-UP AS WELL AS THE INSTALLATION OF A 40,000 GALLON TANK TO PROVIDE BACK-UP FUEL SOURCES FOR GENERATORS AND BOILERS TO IMPROVE SAFETY. WHEN COMPLETED, THE FULL RENOVATION OF THE EMERGENCY DEPARTMENT WILL PROVIDE MORE COMFORT, PRIVACY AND CLINICAL FLEXIBILITY FOR PATIENTS AND CAREGIVERS. UPON COMPLETION, THE ED WILL INCLUDE ALL PRIVATE EXAM ROOMS, NEW PATIENT WAITING AND TRIAGE AREAS AND ENHANCED CLINICAL STATIONS THAT WILL FACILITATE STAFF WORKFLOW. TELEMEDICINE, BOTH INPATIENT AND OUTPATIENT, EXPLODED WITH EXPONENTIAL GROWTH WITH THE FIRST WAVE OF THE CORONAVIRUS PANDEMIC. TELEHEALTH CARTS ON INPATIENT UNITS ALLOWED PATIENTS TO STAY CONNECTED WITH THEIR FAMILIES DESPITE VISITOR RESTRICTIONS, AND, IN SOME CASES, ALLOWED THEM TO CONNECT AT THE END OF LIFE. TELEHEALTH CARTS ALSO PLAYED A MAJOR ROLE IN LIMITING STAFF EXPOSURE TO THE CORONAVIRUS BY REDUCING THE NUMBER OF TIMES CAREGIVERS MUST ENTER A PATIENT'S ROOM, ALLOWING PHYSICIANS AND CAREGIVERS TO COMMUNICATE WITH PATIENTS IN A SAFE AND SECURE WAY. IN THE OUTPATIENT SETTING, YALE NEW HAVEN HEALTH SYSTEM'S EPIC-BASED TELEHEALTH PLATFORM HAS ENABLED CARE TO CONTINUE FOR PATIENTS FROM THE SAFETY AND COMFORT OF THEIR HOMES. THIS YEAR, L+M RECEIVED $384,000 THROUGH THE CARES ACT GRANT TO CONTINUE TO EXPAND TELEHEALTH OPPORTUNITIES. L+M REMAINED FOCUSED ON IMPROVING AND GROWING SPECIALTY SERVICE LINES INCLUDING CARDIAC SERVICES, ONCOLOGY, SURGICAL SERVICES AND ORTHOPEDICS. A NEW ULTRASOUND SUITE ENHANCED THE EXPERIENCE FOR PATIENTS, FAMILIES AND STAFF. ENHANCEMENTS INCLUDE LARGER EXAM ROOMS AND DIGITAL MONITORS FOR EXPECTANT FAMILIES TO VIEW THEIR ULTRASOUND. THE SCREENS ALSO COME IN HANDY WITH PEDIATRIC PATIENTS WHO CAN WATCH CARTOONS OR SPORTS TO MAKE THEM FEEL MORE RELAXED. THE HOSPITAL ALSO OPENED A PROGRESSIVE CARE UNIT (PCU) AS AN ADJUNCT TO ITS RESPIRATORY UNIT, FILLING A CLINICAL NICHE IN CARE FOR PATIENTS TOO SICK FOR A REGULAR MEDICAL/SURGICAL FLOOR YET NOT QUITE SICK ENOUGH TO JUSTIFY PLACEMENT IN AN INTENSIVE CARE UNIT. SIX NEW DEDICATED BEDS WITH SPECIALLY TRAINED NURSES GIVE L+M HOSPITAL THE ABILITY TO BETTER CARE FOR PATIENTS WHILE ALSO KEEPING ICU BEDS OPEN FOR PATIENTS IN NEED OF THE HIGHEST LEVEL OF CARE AND SUPERVISION. PEQUOT HEALTH CENTER INTRODUCED A NEW PROGRAM THAT GIVES PATIENTS WITH PARKINSON'S DISEASE SIGNIFICANT BENEFITS. WITH THE AVAILABILITY OF LSVT BIG AND LSVT LOUD THERAPIES, PATIENTS NOW HAVE ACCESS TO THE BEST TREATMENTS AT THE EARLIEST STAGES OF THEIR DISEASE. THESE THERAPIES INVOLVE EXAGGERATED MOTIONS AND LOUD VOCALIZATION TO HELP PATIENTS MAINTAIN MOTOR SKILLS AS WELL AS VERBAL SKILLS. FOR THE FIRST TIME, LAWRENCE + MEMORIAL EARNED A PRESS GANEY AWARD FOR ACHIEVING AND SUSTAINING EXCELLENCE IN PATIENT EXPERIENCE. THE GUARDIAN OF EXCELLENCE AWARD RECOGNIZES THE ACHIEVEMENTS OF THE ACUTE INPATIENT REHABILITATION UNIT IN ACHIEVING THE 95TH PERCENTILE OR ABOVE FOR PERFORMANCE IN PATIENT EXPERIENCE. PATIENT SAFETY IS A HALLMARK OF THE CARE WE PROVIDE OUR PATIENTS, AND L+M ACHIEVED SIGNIFICANT MILESTONES IN REDUCING HOSPITAL-ACQUIRED INFECTIONS. THE NEUROLOGY AND ORTHOPEDIC UNITS AT L+M SUCCEEDED IN GOING MORE THAN A FULL YEAR WITHOUT A SINGLE CATHETER-ASSOCIATED URINARY TRACT INFECTION (CAUTI). L+M, WITH WESTERLY HOSPITAL, WAS THE FIRST IN THE HEALTHCARE SYSTEM TO LAUNCH SECURE CHAT TO ENHANCE PATIENT PRIVACY. THIS IPHONE-BASED PLATFORM ALLOWS CLINICIANS TO SEND SECURE INSTANT MESSAGES WITHIN THE EPIC ELECTRONIC MEDICAL RECORD PROVIDING THE ABILITY TO COMMUNICATE PATIENT INFORMATION WITH COLLEAGUES ACROSS THE ORGANIZATION. SECURE CHAT ALSO ALLOWS MESSAGES TO BE ATTACHED TO A PATIENT RECORD. FROM CAR SEAT PROGRAMS, ASTHMA EDUCATION IN SCHOOLS AND CONNECTING FAMILIES WITH THE RESOURCES THEY NEED TO HELP THEIR CHILDREN, COMMUNITY PARTNERSHIPS CONTINUED PROVIDING SERVICES, EVEN IF IT MEANT CONNECTING WITH PEOPLE VIA ZOOM, SKYPE, FACETIME AND OTHER TECHNOLOGIES. L+M CAME TO THE AID OF THE CITY OF NEW LONDON WITH A DONATION TO PROCURE A PARCEL OF LAND TO CREATE A SMALL PARK. THE HOSPITAL DONATION IS PART OF A COORDINATED EFFORT BY THE CITY AND THE FREEDOM TRAIL NEIGHBORHOOD ASSOCIATION TO TRANSFORM THE SITE INTO GREEN SPACE WHICH SUPPORTS L+M'S WORK IN IMPROVING THE HEALTH AND WELLNESS OF THE COMMUNITY IT SERVES. L+M HOSPITAL'S ACUTE INPATIENT REHABILITATION UNIT WAS NAMED THE 2020 GUARDIAN OF EXCELLENCE AWARD WINNER BY PRESS GANEY ASSOCIATES LLC FOR ACHIEVING AND SUSTAINING EXCELLENCE IN PATIENT EXPERIENCE. THE GUARDIAN OF EXCELLENCE AWARD RECOGNIZES TOP-PERFORMING HEALTH CARE ORGANIZATIONS THAT HAVE ACHIEVED THE 95TH PERCENTILE OR ABOVE FOR PERFORMANCE IN PATIENT EXPERIENCE. THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION RECOGNIZED L+M HOSPITAL FOR HIGH QUALITY CARE OF PATIENTS EXPERIENCING STROKES. L+M EARNED THE GET WITH THE GUIDELINES STROKE GOLD PLUS QUALITY ACHIEVEMENT AWARD. PLATINUM LEVEL RECOGNITION, WORKPLACE PARTNERSHIP FOR LIFE HOSPITAL ORGAN DONATION CAMPAIGN L+M HOSPITAL EARNED PLATINUM-LEVEL RECOGNITION FOR PARTICIPATION IN THE WORKPLACE PARTNERSHIP FOR LIFE HOSPITAL ORGAN DONATION CAMPAIGN, WHICH AIMS TO INCREASE ORGAN, EYE AND TISSUE DONOR REGISTRATIONS. THROUGH ITS AFFILIATION WITH YALE NEW HAVEN HEALTH, L+M CONTINUED TO IMPROVE ITS PERFORMANCE IN FISCAL YEAR 2020 WHILE MANAGING PATIENT AND COMMUNITY NEEDS WITH OPERATIONAL RESOURCE CHALLENGES CREATED DURING AN UNPRECEDENTED PANDEMIC.
FORM 990, PART VI, SECTION A, LINE 1 PART I, LINE 4 & PART VI, LINE 1B NUMBER OF INDEPENDENT VOTING MEMBERS OF THE GOVERNING BODY THE ORGANIZATION SOUGHT TO CONFIRM THE INDEPENDENCE OF EACH VOTING MEMBER OF ITS GOVERNING BODY BY REQUESTING THAT EACH SUCH VOTING MEMBER RESPOND TO A QUESTIONNAIRE CONTAINING THE PERTINENT INSTRUCTIONS AND DEFINITIONS AND DESIGNED TO ELICIT THE INFORMATION NECESSARY TO DETERMINE INDEPENDENCE. IN THE EVENT THAT THE ORGANIZATION DOES NOT RECEIVE A RESPONSE FROM ANY SUCH VOTING MEMBER, THE ORGANIZATION REVIEWS OTHER INFORMATION KNOWN TO IT REGARDING THE VOTING MEMBER AND MAKES A REASONABLE ASSESSMENT OF INDEPENDENCE BASED ON THAT INFORMATION.
FORM 990, PART VI, SECTION A, LINE 2 CERTAIN OF THE ORGANIZATION'S CURRENT OFFICERS AND/OR TRUSTEES MAY SERVE AS OFFICERS AND/OR DIRECTORS OF TAX-EXEMPT AND TAXABLE AFFILIATES WITHIN THE ORGANIZATION'S CORPORATE SYSTEM OR JOINT VENTURES IN WHICH THE ORGANIZATION'S CORPORATE SYSTEM HAS AN OWNERSHIP INTEREST. THE INDIVIDUAL OFFICERS AND/OR TRUSTEES DO NOT HAVE PERSONAL FINANCIAL INTERESTS IN SUCH AFFILIATES AND SERVE ONLY AS A FUNCTION OF THEIR ROLES WITH THE ORGANIZATION OR WITHIN THE ORGANIZATION'S CORPORATE SYSTEM.
FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION'S BYLAWS WERE AMENDED EFFECTIVE AS OF OCTOBER 1, 2019. THE AMENDMENTS EXPANDED THE TOTAL PERMITTED NUMBER OF TRUSTEES FROM A MAXIMUM OF 12 TO A MAXIMUM OF 17 TRUSTEES, AND ALSO ELIMINATED ONE EX-OFFICIO TRUSTEE SEAT.
FORM 990, PART VI, SECTION A, LINE 6 LAWRENCE + MEMORIAL CORPORATION IS THE SOLE MEMBER OF LAWRENCE + MEMORIAL HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7A LAWRENCE + MEMORIAL CORPORATION, AS SOLE MEMBER OF LAWRENCE + MEMORIAL HOSPITAL, ELECTS THE BOARD OF TRUSTEES OF LAWRENCE + MEMORIAL HOSPITAL, SUBJECT TO THE ADDITIONAL APPROVAL OF LAWRENCE + MEMORIAL CORPORATION'S SOLE MEMBER, YALE NEW HAVEN HEALTH SERVICES CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7B THE HOSPITAL'S SOLE MEMBER, LAWRENCE + MEMORIAL CORPORATION, HAS THE RIGHT TO ELECT THE BOARD OF TRUSTEES OF THE ORGANIZATION AND APPOINT THE PRESIDENT, AND HAS THE FOLLOWING ADDITIONAL RIGHTS, ALL SUBJECT THE ADDITIONAL APPROVAL OF ITS SOLE MEMBER, YALE NEW HAVEN HEALTH SERVICES CORPORATION: TO APPROVE OPERATING, CASH FLOW AND CAPITAL BUDGETS; TO APPROVE GRADUATE AND UNDERGRADUATE MEDICAL EDUCATION ARRANGEMENTS; TO APPROVE MAJOR NEW CLINICAL PROGRAMS AND SERVICES AND CONTINUATION OF SAME; APPROVAL OF STRATEGIC PLANS; AND ADOPTION OF SAFETY AND QUALITY ASSESSMENT POLICIES; TO APPROVE THE MERGER, CONSOLIDATION, DISSOLUTION OR THE SALE OF ALL OR SUBSTANTIALLY ALL THE ORGANIZATION'S ASSETS; TO AMEND THE CERTIFICATE OF INCORPORATION AND BYLAWS OF THE ORGANIZATION, TO APPROVE THE EXECUTION OF LONG-TERM OR MATERIAL AGREEMENTS, AND TO AUTHORIZE THE EXECUTION OF CONTRACTS WITH AN UNRELATED THIRD PARTY FOR MANAGEMENT OF THE ASSETS OR OPERATIONS OF THE ORGANIZATION. YALE-NEW HAVEN HEALTH SERVICES CORPORATION RETAINS THE FOLLOWING AUTHORITY: ADOPTION OF BUDGETARY TARGETS, INDEBTEDNESS, MANAGEMENT AND CONTROL OF LIQUID ASSETS, AND APPOINTMENT OF THE INDEPENDENT AUDITOR.
FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S PROCESS TO REVIEW FORM 990: THE FORM 990 TAX RETURN AND ATTACHED SCHEDULES WERE PREPARED BY EMPLOYEES OF THE YNHHS TAX DEPARTMENT. THE RETURN IS INITIALLY REVIEWED BY THE EXECUTIVE DIRECTOR OF CORPORATE FINANCE. SUBSEQUENTLY, IT IS SENT TO KPMG LLP FOR THEIR INITIAL REVIEW. AFTER ALL COMMENTS FROM THE ABOVE GROUPS ARE RECEIVED AND REVIEWED, THE RETURN IS THEN REVIEWED BY THE CHIEF FINANCIAL OFFICER OF THE ORGANIZATION AND A FINAL VERSION OF THE RETURN IS SENT BACK TO KPMG LLP FOR FINAL REVIEW. PRIOR TO FILING, THE ORGANIZATION MADE AVAILABLE A COMPLETE COPY OF THE RETURN TO ITS BOARD OF TRUSTEES BY WEB PORTAL.
FORM 990, PART VI, SECTION B, LINE 12C LAWRENCE + MEMORIAL HOSPITAL IS COVERED UNDER THE YNHHS CONFLICT OF INTEREST POLICY APPROVED AND ADOPTED BY THE SYSTEM COMPLIANCE COMMITTEE, WHICH HAS BEEN DELEGATED THE AUTHORITY TO APPROVE AND ADOPT COMPLIANCE POLICIES ON BEHALF OF THE ENTITIES IN THE SYSTEM. THE YALE NEW HAVEN HEALTH SYSTEM CONFLICT OF INTEREST POLICY AND INDIVIDUAL ANNUAL DISCLOSURE FORM APPLIES TO A POOL OF EMPLOYEES, BOARD MEMBERS AND NON-BOARD MEMBERS SERVING ON BOARD COMMITTEES. THESE "COVERED INDIVIDUALS" ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT, UPON BEGINNING EMPLOYMENT OR OTHERWISE BECOMING A COVERED INDIVIDUAL AND ANNUALLY THEREAFTER. COVERED INDIVIDUALS ARE ALSO REQUIRED TO IMMEDIATELY REPORT MATERIAL CHANGES TO THEIR MOST RECENTLY COMPLETED DISCLOSURE STATEMENT. THESE DISCLOSURE STATEMENTS AND REPORTS ARE REVIEWED BY THE OFFICE OF PRIVACY AND CORPORATE COMPLIANCE AND/OR THE LEGAL AND RISK SERVICES DEPARTMENT TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. IF A POTENTIAL CONFLICT ARISES, THE PRESIDENT AND CEO WOULD CONSULT WITH THE BOARD CHAIRPERSON AND THE LEGAL AND RISK SERVICES DEPARTMENT AND TAKE ANY ACTIONS THAT HE DEEMS REQUIRED OR APPROPRIATE TO MANAGE OR RESOLVE A POTENTIAL CONFLICT OF INTEREST. FOR EXAMPLE, A VOTING BOARD OR COMMITTEE MEMBER WOULD BE REQUIRED TO RECUSE HIMSELF OR HERSELF FROM VOTING ON MATTERS RELATED TO THE POTENTIAL CONFLICT AND THE POTENTIAL CONFLICT WOULD BE DISCLOSED TO OTHER VOTING MEMBERS.
FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION PROCESS FOR CEO/TOP OFFICIAL: THE TOP LMH OFFICIAL IS AN EMPLOYEE OF YNHHS. THE YNHHS COMPENSATION AND LEADERSHIP DEVELOPMENT COMMITTEE (THE "YNHHS COMPENSATION COMMITTEE"), WHICH INCLUDES A REPRESENTATIVE OF THE HOSPITAL, IS RESPONSIBLE FOR (1) DETERMINING THE OVERALL TOTAL COMPENSATION STRATEGY FOR YNHHS OFFICER-LEVEL EXECUTIVES, (2) APPROVING ALL COMPENSATION AND BENEFITS DECISIONS FOR YNHHS OFFICER-LEVEL EXECUTIVES, AND (3) REPORTING SUCH ACTIONS TO THE FULL YNHHS BOARD OF TRUSTEES ON AN ANNUAL BASIS. IN ADDITION, THE YNHHS COMPENSATION COMMITTEE EXPRESSLY DETERMINES THE REASONABLENESS OF TOTAL COMPENSATION AND BENEFITS FOR ALL YNHHS OFFICER-LEVEL EXECUTIVES, AND ASSURES THAT ALL OFFICER-LEVEL EXECUTIVE COMPENSATION DECISIONS ARE MADE AFTER THOROUGH CONSIDERATION OF AND COMPARISON TO THE MARKET PRACTICES OF OTHER SIMILARLY SITUATED ORGANIZATIONS. THE YNHHS COMPENSATION COMMITTEE CONSISTS OF TRUSTEES WHO DO NOT HAVE MATERIAL FINANCIAL INTERESTS THAT COULD BE AFFECTED BY THE OFFICER-LEVEL EXECUTIVE COMPENSATION DECISIONS MADE BY THE COMMITTEE. THE COMPARABILITY DATA USED TO ASSIST THE COMMITTEES IN ITS COMPENSATION DELIBERATIONS IS COMPILED BY AN INDEPENDENT, NATIONAL COMPENSATION CONSULTING FIRM THAT IS RETAINED BY AND REPORTS DIRECTLY TO THE YNHHS COMPENSATION COMMITTEE. THE DATA COLLECTED BY THE CONSULTANT CONSISTS OF MARKET INFORMATION FOR EXECUTIVES IN FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THE DELIBERATIONS AND DECISIONS OF THE YNHHS COMPENSATION COMMITTEE IS CONTEMPORANEOUSLY DOCUMENTED, REVIEWED AND APPROVED BY THE COMMITTEE, AND PROVIDED TO THE BOARD OF TRUSTEES OF YNHHS AND LMH. FORM 990, PART VI, SECTION B, LINE 15B: COMPENSATION PROCESS FOR OTHER OFFICERS CERTAIN OFFICER-LEVEL EXECUTIVES ARE EMPLOYEES OF YNHHS, OTHER OFFICER-LEVEL EXECUTIVES ARE EMPLOYED DIRECTLY BY LMH. COMPENSATION DETERMINATIONS OF YNHHS EMPLOYEES ARE MADE BY THE YNHHS COMPENSATION COMMITTEE. COMPENSATION OF OFFICER-LEVEL EXECUTIVES EMPLOYED DIRECTLY BY LMH IS APPROVED BY THE L+M HEALTHCARE COMPENSATION COMMITTEE, THE COMPENSATION COMMITTEE OF THE ORGANIZATION'S SOLE MEMBER. FOR OFFICER-LEVEL EXECUTIVES EMPLOYED L+M HEALTHCARE'S EXECUTIVE COMPENSATION COMMITTEES IS RESPONSIBLE FOR (1) DETERMINING THE OVERALL TOTAL COMPENSATION STRATEGY FOR ITS, AND ITS AFFILIATES, OFFICER-LEVEL EXECUTIVES, (2) APPROVING ALL COMPENSATION AND BENEFITS DECISIONS FOR OFFICER-LEVEL EXECUTIVES, AND (3) REPORTING SUCH ACTIONS TO THE FULL BOARD ON AN ANNUAL BASIS, AS APPLICABLE. IN ADDITION, THE EXECUTIVE COMPENSATION COMMITTEE EXPRESSLY DETERMINES THE REASONABLENESS OF TOTAL COMPENSATION AND BENEFITS FOR ALL OFFICER-LEVEL EXECUTIVES EMPLOYED BY LMH, AND ASSURES THAT ALL OFFICER-LEVEL EXECUTIVE COMPENSATION DECISIONS ARE MADE AFTER THOROUGH CONSIDERATION OF AND COMPARISON TO THE MARKET PRACTICES OF OTHER SIMILARLY SITUATED ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEE CONSISTS OF BOARD MEMBERS WHO DO NOT HAVE MATERIAL FINANCIAL INTERESTS THAT COULD BE AFFECTED BY THE COMPENSATION DECISIONS MADE BY THE COMMITTEE. THE COMPARABILITY DATA USED TO ASSIST THE EXECUTIVE COMPENSATION COMMITTEE IN ITS COMPENSATION DELIBERATIONS ARE COMPILED BY AN INDEPENDENT, NATIONAL COMPENSATION CONSULTING FIRM THAT IS RETAINED BY AND REPORTS DIRECTLY TO THE EXECUTIVE COMPENSATION COMMITTEE. THE DATA COLLECTED BY THE CONSULTANT CONSISTS OF MARKET INFORMATION FOR EXECUTIVES IN FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THE DELIBERATIONS AND DECISIONS OF THE EXECUTIVE COMPENSATION COMMITTEES ARE CONTEMPORANEOUSLY DOCUMENTED, REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE, AND PROVIDED TO THE L+M HEALTHCARE BOARD.
FORM 990, PART VI, SECTION C, LINE 19 COPIES OF ALL AVAILABLE DOCUMENTS ARE ACCESSIBLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11G MEDICAL SPECIALTY PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 5,252,272. MANAGEMENT AND GENERAL EXPENSES 660,662. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,912,934. OTHER OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 68,904,818. MANAGEMENT AND GENERAL EXPENSES 8,566,185. FUNDRAISING EXPENSES 101,071. TOTAL EXPENSES 77,572,074.
FORM 990, PART XI, LINE 9: TRANSFER TO AFFILIATES -60,000. CHANGE IN MINIMUM PENSION LIABILITY 6,989,015. CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST 225,635.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2019


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
LAWRENCE MEMORIAL HOSPITAL INC
 
Employer identification number

06-0646704
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity











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


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


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

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)BRIDGEPORT HOSPITAL
267 GRANT STREET

BRIDGEPORT,CT06610
06-0646554
HEALTHCARE SERVICES CT 501C3 LINE 3 YALE NEW HAVEN HEALTH SERVICES CORP
 
Yes
 
(2)BRIDGEPORT HOSPITAL AUXILIARY INC
267 GRANT STREET

BRIDGEPORT,CT06610
06-6042500
SYSTEM SUPPORT SERVICES CT 501C3 LINE 12A, I SEE PART VII
 
Yes
 
(3)BRIDGEPORT HOSPITAL FOUNDATION INC
267 GRANT STREET

BRIDGEPORT,CT06610
22-2908698
SYSTEM SUPPORT SERVICES CT 501C3 LINE 7 BRIDGEPORT HOSPITAL
 
Yes
 
(4)BRIDGEPORT HOSPITAL FRIENDS OF PEDIATRICS INC
120 COLUMBINE DRIVE

TRUMBULL,CT06611
06-6048427
SYSTEM SUPPORT SERVICES CT 501C3 LINE 12A, I YALE NEW HAVEN HOSPITAL
 
Yes
 
(5)GREENWICH HOSPITAL
5 PERRYRIDGE ROAD

GREENWICH,CT06830
06-0646659
HEALTHCARE SERVICES CT 501C3 LINE 3 YALE NEW HAVEN HEALTH SERVICES CORP
 
Yes
 
(6)LAWRENCE MEMORIAL CORPORATION
365 MONTAUK AVENUE

NEW LONDON,CT06320
22-2553028
PROMOTE HEALTHCARE CT 501C3 LINE 12A, I YALE NEW HAVEN HEALTH SERVICES CORP
 
 
No
(7)LMW HEALTHCARE INC
365 MONTAUK AVENUE

NEW LONDON,CT06320
46-0543230
HEALTHCARE SERVICES RI 501C3 LINE 3 LAWRENCE MEMORIAL CORPORATION
 
Yes
 
(8)NORTHEAST MEDICAL GROUP INC
99 HAWLEY LANE

STRATFORD,CT06614
06-1330992
HEALTHCARE SERVICES CT 501C3 LINE 10 YALE NEW HAVEN HEALTH SERVICES CORP
 
Yes
 
(9)NORTHEAST MEDICAL GROUP PLLC
99 HAWLEY LANE

STRATFORD,CT06614
35-2380180
HEALTHCARE SERVICES NY 501C3 LINE 12A, I NORTHEAST MEDICAL GROUP INC
 
Yes
 
(10)PERRYRIDGE CORPORATION
5 PERRYRIDGE ROAD

GREENWICH,CT06830
06-1207316
SYSTEM SUPPORT SERVICES CT 501C3 LINE 10 GREENWICH HOSPITAL
 
Yes
 
(11)SOUTHERN CONNECTICUT HEALTH SYSTEM PROPERTIES INC
267 GRANT STREET

BRIDGEPORT,CT06610
06-1297708
TITLE HOLDING CT 501C2   BRIDGEPORT HOSPITAL
 
Yes
 
(12)THE GREENWICH HOSPITAL ENDOWMENT FUND INC
5 PERRYRIDGE ROAD

GREENWICH,CT06830
06-1526642
SYSTEM SUPPORT SERVICES CT 501C3 LINE 12C, III-FI GREENWICH HOSPITAL
 
Yes
 
(13)THE WESTERLY HOSPITAL FOUNDATION INC
25 WELLS STREET

WESTERLY,RI02891
05-0508064
FUNDRAISING SERVICES RI 501C3 LINE 12A, I LMW HEALTHCARE INC
 
Yes
 
(14)VISITING NURSE ASSOCIATION OF SOUTHEASTERN CONNECTICUT INC
403 NORTH FRONTAGE ROAD

WATERFORD,CT06385
06-0646616
HOME HEALTHCARE SERVICES CT 501C3 LINE 10 LAWRENCE MEMORIAL CORPORATION
 
Yes
 
(15)WESTERLY HOSPITAL AUXILIARY INC
25 WELLS STREET

WESTERLY,RI02891
22-2507181
FUNDRAISING ACTIVITIES RI 501C3 LINE 12A, I LMW HEALTHCARE INC
 
Yes
 
(16)YALE NEW HAVEN HEALTH SERVICES CORP
789 HOWARD AVE

NEW HAVEN,CT06519
22-2529464
SYSTEM SUPPORT SERVICES CT 501C3 LINE 12A, I N/A
 
No
(17)YALE NEW HAVEN HOSPITAL
20 YORK STREET

NEW HAVEN,CT06504
06-0646652
HEALTHCARE SERVICES CT 501C3 LINE 3 YALE NEW HAVEN HEALTH SERVICES CORP
 
Yes
 
(18)YALE NEW HAVEN CARE CONTINUUM CORP
789 HOWARD AVE

NEW HAVEN,CT06519
45-5235566
NURSING HOME CT 501C3 LINE 3 YALE NEW HAVEN HOSPITAL
 
Yes
 
(19)L&M HEALTHCARE INC
365 MONTAUK AVENUE

NEW LONDON,CT06320
22-2553031
SYSTEM SUPPORT SERVICES CT 501C3 LINE 12A, I SEE PART VII
 
Yes
 
(20)HOME CARE PLUS INC
789 HOWARD AVE

NEW HAVEN,CT06519
06-1044331
HOME HEALTHCARE SERVICES CT 501C3 LINE 10 YALE NEW HAVEN CARE CONTINUUM CORP
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



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

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




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



(k)
Percentage
ownership


Yes No Yes No
(1) SHORELINE ENDOSCOPY CENTER LLC

111 GOOSE LANE
GUILFORD,CT06437
90-0110459
HEALTHCARE SERVICES CT N/A
                 
(2) TOTAL HEALTH CONNECTICUT LLC

789 HOWARD AVENUE
NEW HAVEN,CT06519
47-4070024
HEALTHCARE SERVICES CT N/A
                 
(3) YALE NEW HAVEN HEALTH SYSTEM INVESTMENT

20 YORK STREET
NEW HAVEN,CT06510
27-1374301
INVESTMENT DE N/A
                 
(4) YNHHSCUSP SURGERY CENTERS LLC

15305 DALLAS PKWY STE 1600
ADDISON,TX75001
38-4021595
HEALTHCARE SERVICES CT N/A
                 






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

789 HOWARD AVE
NEW HAVEN,CT06519
06-1467717
MANAGEMENT SERVICES CT N/A
C       Yes  
(2) YALE NEW HAVEN AMBULATORY SERVICES

40 TEMPLE STREET
NEW HAVEN,CT06510
06-1398526
HEALTHCARE SERVICES CT N/A
C       Yes  
(3) GREENWICH FERTILITY & IVF PC

5 PERRYRIDGE ROAD
GREENWICH,CT06830
30-0145464
HEALTHCARE SERVICES CT N/A
C       Yes  
(4) YNHH-PHYSICIANS CORP

789 HOWARD AVE
NEW HAVEN,CT06519
06-1202305
ADMINISTRATIVE SERVICES CT N/A
C       Yes  
(5) MEDICAL CENTER PHARMACY INC AND HOME CARE CENTER INC

50 YORK STREET
NEW HAVEN,CT06511
06-1087673
PHARMACY CT N/A
C       Yes  
(6) GREENWICH OCCUPATIONAL HEALTH SERVICES OF NY PC

5 PERRYRIDGE ROAD
GREENWICH,CT06830
06-1540101
HEALTHCARE SERVICES NY N/A
C       Yes  
(7) GREENWICH OCCUPATIONAL HEALTH SERVICES OF NEW JERSEY

5 PERRYRIDGE ROAD
GREENWICH,CT06830
45-3833883
HEALTHCARE SERVICES NJ N/A
C       Yes  
(8) CENTURY FINANCIAL SERVICES INC

23 MAIDEN LANE
NORTH HAVEN,CT06473
06-1110797
DEBT COLLECTION SERVICES CT N/A
C       Yes  
(9) L & M SYSTEMS INC

365 MONTAUK AVENUE
NEW LONDON,CT06320
22-2553037
HEALTHCARE RELATED SERVICES CT N/A
C       Yes  
(10) L&M HOME CARE SERVICES INC

365 MONTAUK AVENUE
NEW LONDON,CT06320
06-1389272
HOME THERAPY CT N/A
C       Yes  
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
Yes
 
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
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) MEDICAL CENTER PHARMACY & HOME CARE CENTER INC

M 1,106,106 COMPARABLE MARKET VALUE
(2) MEDICAL CENTER PHARMACY & HOME CARE CENTER INC

R 6,767,426 CASH
(3) VISITING NURSE ASSOCIATION OF SOUTHEASTERN CONNECTICUT INC

O 1,594,176 TRANSACTION REVIEW
(4) VISITING NURSE ASSOCIATION OF SOUTHEASTERN CONNECTICUT INC

P 722,495 TRANSACTION REVIEW
(5) VISITING NURSE ASSOCIATION OF SOUTHEASTERN CONNECTICUT INC

S 1,663,135 CASH
(6) LMW HEALTHCARE INC

M 161,165 COMPARABLE MARKET VALUE
(7) LMW HEALTHCARE INC

O 12,457,093 TRANSACTION REVIEW
(8) LMW HEALTHCARE INC

P 46,715,918 TRANSACTION REVIEW
(9) LMW HEALTHCARE INC

R 1,567,736 CASH
(10) LMW HEALTHCARE INC

S 44,500,000 CASH
(11) L&M CORPORATION

S 253,679 CASH
(12) NORTHEAST MEDICAL GROUP INC

M 13,588,743 COMPARABLE MARKET VALUE
(13) NORTHEAST MEDICAL GROUP INC

P 1,447,008 TRANSACTION REVIEW
(14) NORTHEAST MEDICAL GROUP INC

R 10,265,448 CASH
(15) NORTHEAST MEDICAL GROUP INC

Q 102,864 TRANSACTION REVIEW
(16) YALE NEW HAVEN HEALTH SERVICES CORPORATION

M 42,944,775 COMPARABLE MARKET VALUE
(17) YALE NEW HAVEN HEALTH SERVICES CORPORATION

Q 11,502,483 TRANSACTION REVIEW
(18) YALE NEW HAVEN HEALTH SERVICES CORPORATION

R 52,318,399 CASH
(19) YALE NEW HAVEN HEALTH SERVICES CORPORATION

S 4,732,494 CASH
(20) YALE NEW HAVEN HOSPITAL

M 3,637,964 COMPARABLE MARKET VALUE
(21) YALE NEW HAVEN HOSPITAL

O 311,948 TRANSACTION REVIEW
(22) YALE NEW HAVEN HOSPITAL

P 6,307,463 TRANSACTION REVIEW
(23) YALE NEW HAVEN HOSPITAL

Q 265,532 TRANSACTION REVIEW
(24) YALE NEW HAVEN HOSPITAL

R 17,278,388 CASH
(25) GREENWICH HOSPITAL

P 414,010 TRANSACTION REVIEW
(26) GREENWICH HOSPITAL

O 86,134 TRANSACTION REVIEW
(27) GREENWICH HOSPITAL

R 341,871 CASH
(28) YALE NEW HAVEN HOSPITAL

I 1,367,876 TRANSACTION REVIEW
(29) LMW HEALTHCARE INC

I 231,014 TRANSACTION REVIEW
(30) NORTHEAST MEDICAL GROUP INC

J 2,165,155 COMPARABLE MARKET VALUE
(31) YALE NEW HAVEN HEALTH SERVICES CORPORATION

L 101,120 COMPARABLE MARKET VALUE
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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) 2019
Schedule R (Form 990) 2019
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. (see instructions).
Return Reference Explanation
PART II, IDENTIFICATION OF RELATED TAX-EXEMPT ORGANIZATIONS: NAME OF RELATED ORGANIZATION: BRIDGEPORT HOSPITAL AUXILIARY INC. - ENTITY DISSOLVED 9/29/2020 NAME OF CONTROLLING ENTITY: BRIDGEPORT HOSPITAL UNTIL DISSOLUTION NAME OF RELATED ORGANIZATION: L&M HEALTHCARE INC - ENTITY DISSOLVED 9/25/2020 NAME OF CONTROLLING ENTITY: LAWRENCE + MEMORIAL CORPORATION UNTIL DISSOLUTION
Schedule R (Form 990) 2019

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