Form990
Click to see attachment
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Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
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OMB No. 1545-0047
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 10-01-2021 , and ending 09-30-2022
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 $ 488,186,961
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 12
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 10
5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) ...... 5 2,733
6 Total number of volunteers (estimate if necessary) ............. 6 144
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 54,740
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 31,907,808 13,465,525
9 Program service revenue (Part VIII, line 2g) ......... 400,513,833 434,144,168
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 4,193,336 9,679,116
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 4,234,945 4,505,984
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 440,849,922 461,794,793
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 632,147 219,432
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) 186,575,338 204,140,551
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet469,996    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 232,676,648 238,378,221
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 419,884,133 442,738,204
19 Revenue less expenses. Subtract line 18 from line 12....... 20,965,789 19,056,589
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 500,211,474 456,988,884
21 Total liabilities (Part X, line 26)............. 236,608,639 187,363,056
22 Net assets or fund balances. Subtract line 21 from line 20..... 263,602,835 269,625,828
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
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Signature of officer Date
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Type or print name and title
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 (2021)
Form 990 (2021)
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 $ 404,973,048 including grants of $ 219,432 ) (Revenue $ 434,144,169 )
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 expensesMediumBullet404,973,048
Form 990 (2021)
Form 990 (2021)
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 Rev. Proc. 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
 
No
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 (2021)
Form 990 (2021)
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
Yes
 
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...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
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
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
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 the 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 line 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..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................Click to see attachment
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 on 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
195
b
Enter the number of Forms W-2G included on 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 (2021)
Form 990 (2021)
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
2,733
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 the 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
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
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
12
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
10
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe on 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 on 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 on 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 (1024 or 1024-A, if applicable), 990, and 990-T (section 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 (2021)
Form 990 (2021)
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 the 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, Form 1099-MISC, and/or box 1 of Form 1099-NEC) 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 the 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/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(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) STEPHEN ALLEGRETTO......................................................................
FORMER OFFICER (CY2021 COMP)
0.00
.................
0.00
          X 496,565 0 81,398
(2) STEPHEN ALLEGRETTO......................................................................
FORMER OFFICER (VESTED DEFERRED)
0.00
.................
0.00
          X 2,480,400 0 0
(3) WILLIAM J ASELTYNE......................................................................
TRUSTEE (CURRENT YR COMP)
1.00
.................
39.00
X           0 1,202,950 193,088
(4) WILLIAM J ASELTYNE......................................................................
TRUSTEE (VESTED DEFERRED)
1.00
.................
39.00
X           0 579,064 0
(5) PATRICK L GREEN......................................................................
PRESIDENT/TRUSTEE
20.00
.................
20.00
X   X       477,486 477,486 408,284
(6) DENISE FIORE......................................................................
SVP, COO
28.00
.................
12.00
    X       513,446 220,048 130,351
(7) PRATHIBHA VARKEY......................................................................
FORMER TRUSTEE
0.00
.................
0.00
          X 0 806,022 13,113
(8) OLIVER MAYORGA......................................................................
VP, CMO
28.00
.................
12.00
    X       452,595 193,969 97,832
(9) BENJAMIN ARMSTRONG......................................................................
ED PHYSICIAN
40.00
.................
0.00
        X   495,530 0 33,583
(10) CRAIG MITTLEMAN......................................................................
ED MEDICAL DIRECTOR
40.00
.................
0.00
        X   467,841 0 33,414
(11) DONNA EPPS......................................................................
VP, CHRO
32.00
.................
8.00
    X       331,385 82,846 86,992
(12) MICHAEL JOSEPH......................................................................
ED PHYSICIAN
40.00
.................
0.00
        X   455,017 0 33,583
(13) PETER WILLIS......................................................................
ED PHYSICIAN
40.00
.................
0.00
        X   415,383 0 34,136
(14) CYNTHIA TUCKER......................................................................
ED PHYSICIAN
40.00
.................
0.00
        X   413,378 0 33,583
(15) KERIN DACRUZ......................................................................
VP, CNO
40.00
.................
0.00
    X       398,243 0 32,130
(16) MAUREEN ANDERSON......................................................................
ASSISTANT SECRETARY
7.00
.................
33.00
    X       69,398 316,145 44,032
(17) DAVID F REISFELD......................................................................
TRUSTEE
1.00
.................
39.00
X           0 296,031 34,459
Form 990 (2021)
Form 990 (2021)
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/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(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) JOSHUA MORRIS........................................................................
VP
1.00
.......................39.00
    X       0 54,429 2,873
(19) JAMES MITCHELL........................................................................
CHAIRMAN/TRUSTEE
1.00
.......................4.00
X   X       0 0 0
(20) KATHLEEN HOLT........................................................................
VICE CHAIR/TRUSTEE
1.00
.......................2.00
X   X       0 0 0
(21) ROBERT NARDONE........................................................................
SECR/TREASURER/TRUSTEE
1.00
.......................4.00
X   X       0 0 0
(22) TODD BLUE........................................................................
TRUSTEE
1.00
.......................1.00
X           0 0 0
(23) STEPHEN GREENE........................................................................
TRUSTEE
1.00
.......................2.00
X           0 0 0
(24) ROSS J SANFILIPPO........................................................................
TRUSTEE
1.00
.......................1.00
X           0 0 0
(25) REV CATHERINE ZALL........................................................................
TRUSTEE
1.00
.......................1.00
X           0 0 0
(26) JOHN HOLSTEIN........................................................................
TRUSTEE
1.00
.......................3.00
X           0 0 0
(27) MARIE PEAKMAN........................................................................
TRUSTEE
1.00
.......................2.00
X           0 0 0
(28) NIALL DUHIG........................................................................
TRUSTEE
1.00
.......................0.00
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 7,466,667 4,228,990 1,292,851
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 MediumBullet502
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
IPC HOSPITALISTS

PO BOX 844929
LOS ANGELES,CA900844929
HOSPITALISTS 5,807,955
ANESTHESIA ASSOCIATES OF NEW LONDON

PO BOX 744883
ATLANTA,GA30374
MEDICAL SERVICES 3,026,926
VIZIENT INC

290 E JOHN CARPENTER FREEWAY
IRVING,TX75062
HEALTHCARE IMPROVEMENT 1,399,651
UNITEX TEXTILE RENTAL SERVICE

420 LEDYARD STREET
HARTFORD,CT06114
LINENS/LAUNDERING 1,348,103
QUEST DIAGNOSTIC

ONE MALCOM AVENUE
TETERBORO,NJ07608
LAB SERVICES 1,000,362
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet41
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c 145,100
d Related organizations1d 40,000
e Government grants (contributions)1e 10,217,324
f All other contributions, gifts, grants, and similar amounts not included above1f 3,063,101
g Noncash contributions included in lines 1a - 1f:$ 1g 271,968
h Total. Add lines 1a-1f.......MediumBullet 13,465,525
 Program Service RevenueAmt Business Code
2a NET PATIENT SERVICES 621400 422,686,271 422,686,271    
b APOTHECARY INCOME 446110 9,911,348 9,911,348    
c OCCUPATIONAL HEALTH 621400 1,172,457 1,172,457    
d LAB PATHOLOGY 621500 316,114 316,114    
e LAB TESTING 621500 57,978   57,978  
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 434,144,168
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 1,550,853     1,550,853
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   2,505,506 6a
b Less: rental expenses   2,453,300 6b
c Rental income or (loss)   52,206 6c
d Net rental income or (loss).......MediumBullet 52,206     52,206
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 603,167 31,389,090 7a
b Less: cost or other basis and sales expenses 550,285 23,313,709 7b
c Gain or (loss) 52,882 8,075,381 7c
d Net gain or (loss).........MediumBullet 8,128,263     8,128,263
8a Gross income from fundraising events (not including $ 145,100of contributions reported on line 1c). See Part IV, line 18 ....
8a 64,800
b Less: direct expenses ... 8b 74,874
c Net income or (loss) from fundraising events..MediumBullet -10,074   -10,074
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 INVESTNT REV 900099 3,420,051     3,420,051
b DISCNTS,REBATES,OTHER 900099 545,601     545,601
c DINING REVENUE 722514 501,438     501,438
d All other revenue .... -3,238   -3,238  
e Total. Add lines 11a–11d ...... MediumBullet 4,463,852
12 Total revenue. See instructions.....MediumBullet 461,794,793 434,086,190 54,740 14,188,338
Form 990 (2021)
Form 990 (2021)
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 .... 112,185 112,185
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 107,247 107,247
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 ........... 2,960,360   2,960,360  
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........ 168,702,642 155,344,552 13,146,486 211,604
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 5,427,466 4,997,712 422,946 6,808
9 Other employee benefits ....... 15,279,553 14,069,699 1,190,689 19,165
10 Payroll taxes ........... 11,770,530 10,838,524 917,242 14,764
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 431,339 397,185 34,154  
c Accounting ........... 37,562 34,588 2,974  
d Lobbying ........... 102,609 94,484 8,125  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 96,584 88,936 7,648  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 92,193,732 84,893,715 7,082,362 217,655
12 Advertising and promotion .... 2,705 2,491 214  
13 Office expenses ....... 4,084,181 3,760,791 323,390  
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 10,952,767 10,085,513 867,254  
17 Travel ............        
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 171,239 157,680 13,559  
20 Interest ........... 2,555,919 2,353,538 202,381  
21 Payments to affiliates ....... 20,802,161 19,155,019 1,647,142  
22 Depreciation, depletion, and amortization .. 17,592,709 16,199,696 1,393,013  
23 Insurance ... 4,798,433 4,418,487 379,946  
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 34,724,545 31,975,011 2,749,534 0
b MEDICAL & SURGICAL SUPP 32,489,621 29,917,051 2,572,570 0
c SYSTEM SUPPORT 15,370,955 14,153,863 1,217,092 0
d DUES, SUBSCRIPTIONS & E 1,307,479 1,203,951 103,528 0
e All other expenses 663,681 611,130 52,551  
25 Total functional expenses. Add lines 1 through 24e 442,738,204 404,973,048 37,295,160 469,996
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 (2021)
Form 990 (2021)
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 ......... 53,612,720 2 22,068,142
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 61,191,554 4 64,085,477
5 Loans and other receivables from 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 ...........   7  
8 Inventories for sale or use ............ 6,881,712 8 6,292,950
9 Prepaid expenses and deferred charges ...... 899,680 9 694,570
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 290,859,244
b Less: accumulated depreciation 10b 104,944,595 172,527,508 10c 185,914,649
11 Investments—publicly traded securities . 37,240,851 11 6,432,618
12 Investments—other securities. See Part IV, line 11 ..... 53,262,954 12 49,111,076
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ............... 3,250,000 14 2,600,000
15 Other assets. See Part IV, line 11 ........... 111,344,495 15 119,789,402
16 Total assets. Add lines 1 through 15 (must equal line 33)... 500,211,474 16 456,988,884
Liabilities 17 Accounts payable and accrued expenses ..... 55,691,644 17 53,767,002
18 Grants payable ...   18  
19 Deferred revenue .........   19  
20 Tax-exempt bond liabilities .........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to 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 .. 76,980,051 23 72,186,858
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 103,936,944 25 61,409,196
26 Total liabilities. Add lines 17 through 25.. 236,608,639 26 187,363,056
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 .......... 228,660,644 27 238,071,387
28 Net assets with donor restrictions ........... 34,942,191 28 31,554,441
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 ........... 263,602,835 32 269,625,828
33 Total liabilities and net assets/fund balances ........ 500,211,474 33 456,988,884
Form 990 (2021)
Form 990 (2021)
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
461,794,793
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
442,738,204
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
19,056,589
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
263,602,835
5
Net unrealized gains (losses) on investments ...............
5
-15,531,140
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
2,497,544
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
269,625,828
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 on
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 (2021)
Form 990 (2021)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990)

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
2021
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) 2021

Schedule A (Form 990) 2021
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) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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 5 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) 2021

Schedule A (Form 990) 2021
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) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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 on 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) 2021

Schedule A (Form 990) 2021
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined on 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 on 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) 2021

Schedule A (Form 990) 2021
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 on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, 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 line 2 above, 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 lines 2a and 2b 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 on line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2021

Schedule A (Form 990) 2021
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 0.015 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 0.035 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) 2021

Schedule A (Form 990) 2021
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 1  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
2  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations 3  
4 Amounts paid to acquire exempt-use assets 4  
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) 5  
6 Other distributions (describe in Part VI). See instructions 6  
7Total annual distributions. Add lines 1 through 6. 7  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI
). See instructions
8  
9 Distributable amount for 2021 from Section C, line 6 9  
10 Line 8 amount divided by Line 9 amount 10  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2021
(iii)
Distributable
Amount for 2021
1 Distributable amount for 2021 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2021:
a From 2016.......  
b From 2017.......  
c From 2018.......  
d From 2019.......  
e From 2020.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2021 distributable amount  
i Carryover from 2016 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2021 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2021 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2021, 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 2021. 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 2022. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2017.....  
b Excess from 2018.....  
c Excess from 2019.....  
d Excess from 2020.....  
e Excess from 2021.....  
Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021
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) 2021


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990)
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
2021
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) (2021)
Schedule B (Form 990) (2021) 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) (2021)
Schedule B (Form 990) (2021)
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) (2021)
Schedule B (Form 990) (2021)
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) (2021)
Additional Data


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

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
2021
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.
Cat. No. 50084S
Schedule C (Form 990) 2021

Schedule C (Form 990) 2021
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) 2018 (b) 2019 (c) 2020 (d) 2021 (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) 2021


Schedule C (Form 990) 2021
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
 
29,696
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
72,414
j
Total. Add lines 1c through 1i ....................................................................................................
102,610
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 2022. 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 $ 748,930 BRIDGEPORT HOSPITAL EIN 06-0646554 $ 144,723 GREENWICH HOSPITAL EIN 06-0646659 $ 112,579 NORTHEAST MEDICAL GROUP, INC. EIN 06-1330992 $ 38,059 LMW HEALTHCARE, INC. EIN 46-0543230 $ 32,823
Schedule C (Form 990) 2021


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
2021
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) 2021

Schedule D (Form 990) 2021
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 .... 32,171,441 26,457,643 25,568,084 26,196,094 21,547,048
b Contributions ...       20,000  
c Net investment earnings, gains, and losses -2,645,732 6,382,299 2,030,778 490,136 5,672,003
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
2,215,975 604,984 1,141,219 1,100,782 1,022,957
f Administrative expenses .... 56,709 63,517   37,364  
g End of year balance ...... 27,253,025 32,171,441 26,457,643 25,568,084 26,196,094
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 Bullet22.950 %
c
Term endowment SchDMd Bullet77.050 %
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 .....   7,590,001 7,590,001
b Buildings ....   117,746,788 28,148,374 89,598,414
c Leasehold improvements   21,508,269 7,200,803 14,307,466
d Equipment ....   92,499,559 69,595,418 22,904,141
e Other .....   51,514,627   51,514,627
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 185,914,649
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
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
21,873,658 C

(B) LT ENDOWMENT INVESTMENTS
19,427,899 C

(C) INVESTMENTS HELD BY TRUSTEE
7,809,519 C
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 49,111,076
Part VIII
Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
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 10,788,815
(2)DUE FROM AFFILIATES 59,819,644
(3)DUE FROM MCIC 12,445,475
(4)RIGHT OF USE ASSETS 6,171,913
(5)OTHER ASSETS 30,563,555
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 119,789,402
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  
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 61,409,196
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) 2021

Schedule D (Form 990) 2021
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, WHERE APPLICABLE, 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, 2022 AND 2021.
Schedule D (Form 990) 2021


Additional Data


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SCHEDULE G (Form 990)
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
2021
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) 2021
Schedule G (Form 990) 2021
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

FISHERS ISLAND GOLF TOURNAMENT
(event type)
(b) Event #2

 
(event type)
(c) Other events

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

1

Gross receipts . . . . .

209,900

 

 

209,900

2

Less: Contributions . . . .

145,100

 

 

145,100
3 Gross income (line 1 minus
line 2) . . . . . .

64,800

 

 

64,800



VerticalDirectExpenses
4 Cash prizes . . . . .        
5 Noncash prizes . . . .        
6 Rent/facility costs . . . . 65,819     65,819
7 Food and beverages . . . 713     713
8 Entertainment . . . .        
9 Other direct expenses . . . 8,342     8,342
10 Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . . right arrow 74,874
11 Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . . right arrow -10,074
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) 2021
Schedule G (Form 990) 2021
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) 2021
Additional Data


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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
2021
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 11,843 30,394,202 11,700,000 18,694,202 4.220 %
b Medicaid (from Worksheet 3, column a) . . . . . 0 74,684 80,576,450 54,921,987 25,654,463 5.790 %
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 . . . . .   86,527 110,970,652 66,621,987 44,348,665 10.010 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 8 2,157 777,305 0 777,305 0.180 %
f Health professions education (from Worksheet 5) . . . 3 1,933 1,802,175 3,200 1,798,975 0.410 %
g Subsidized health services (from Worksheet 6) . . . . 1 0 2,812,093 415,709 2,396,384 0.540 %
h Research (from Worksheet 7) . 0 0 0 0    
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . . 4 45 20,938,629 14,820 20,923,809 4.730 %
j Total. Other Benefits . . 16 4,135 26,330,202 433,729 25,896,473 5.860 %
k Total. Add lines 7d and 7j . 16 90,662 137,300,854 67,055,716 70,245,138 15.870 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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 0 0 0 0    
2 Economic development 1 0 18,000 2,400 15,600 0 %
3 Community support 1 0 3,680 990 2,690 0 %
4 Environmental improvements 0 0 0 0    
5 Leadership development and
training for community members
0 0 0 0    
6 Coalition building 0 0 0 0    
7 Community health improvement advocacy 0 0 0 0    
8 Workforce development 0 0 0 0    
9 Other 0 0 0 0    
10 Total 2   21,680 3,390 18,290 0 %
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
10,818,183
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
170,704,506
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
219,486,331
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-48,781,825
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 %
11 NONE
 
       
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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) 2021
Schedule H (Form 990) 2021
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 21
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 21
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) 2021
Schedule H (Form 990) 2021
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) 2021
Schedule H (Form 990) 2021
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) 2021
Schedule H (Form 990) 2021
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) 2021
Schedule H (Form 990) 2021
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 5: COMMUNITY ENGAGEMENT AND FEEDBACK WERE AN INTEGRAL PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. LAWRENCE+MEMORIAL HOSPITAL AND ITS COMMUNITY PARTNERS SOUGHT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL. 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/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
LAWRENCE + MEMORIAL HOSPITAL PART V, SECTION B, LINE 6B: YES, THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED WITH COMMUNITY PARTNERS THAT PROVIDED GUIDANCE, EXPERTISE, AND ONGOING COLLABORATION TO FOSTER COLLECTIVE IMPACT IN IMPROVING THE HEALTH AND WELLBEING OF THE GREATER NEW LONDON COMMUNITY. THIS INCLUDED THE HEALTH IMPROVEMENT COLLABORATIVE OF SOUTHEASTERN CONNECTICUT, WHOSE MEMBER ORGANIZATIONS ARE REPRESENTATIVE OF THOSE IN THE COMMUNITY WHO SERVE UNDERSERVED, LOW-INCOME, AND HARD TO REACH POPULATIONS. THIS APPROACH TO ASSESSMENT AND PLANNING AIMS TO ENGAGE AGENCIES, ORGANIZATIONS, AND RESIDENTS IN THE AREA THROUGH PARTICIPATORY AND COLLABORATIVE APPROACHES.
LAWRENCE + MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: LAWRENCE+MEMORIAL HOSPITAL DEVELOPED A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) TO GUIDE OUR EFFORTS IN RESPONDING TO OUR COMMUNITY'S NEEDS. USING RECOMMENDATIONS FROM THE PEOPLE WHO DELIVER AND USE THESE SERVICES, WE WILL FOSTER COLLABORATION TO BETTER COORDINATE OUR COMMUNITY RESOURCES. WE WILL SEEK TO BETTER CONNECT PEOPLE TO THE SERVICES THEY NEED AND REDUCE DISPARITIES IN HEALTH AND SOCIOECONOMIC MEASURES THAT STEM FROM UNDERLYING INEQUITIES IN OUR SOCIETY. WE USED THE TOP NEEDS IDENTIFIED THROUGH COMMUNITY ENGAGEMENT AS A FOUNDATION FOR OUR CHIP DEVELOPMENT TO ADDRESS THE NEEDS OF GREATEST CONCERN TO COMMUNITY MEMBERS. THESE INDIVIDUALS PROVIDED DIVERSE PERSPECTIVES ON HEALTH TRENDS, SHARED LIVED EXPERIENCES AMONG HISTORICALLY DISENFRANCHISED AND UNDERSERVED POPULATIONS, AND PROVIDED INSIGHTS INTO SERVICE DELIVERY GAPS THAT CONTRIBUTE TO HEALTH DISPARITIES AND INEQUITIES. THE COMMUNITY NEEDS ARE AFFORDABLE HEALTHCARE, BEHAVIORAL HEALTH, DRUG/ALCOHOL MISUSE, EDUCATION, FINANCIAL SECURITY, FOOD SECURITY AND HOUSING. THE CHIP PROVIDES DIRECTION FOR ADDRESSING THE HEALTH AND WELLBEING NEEDS OF THE COMMUNITY.THE CHIP WAS DEVELOPED BY A HOSPITAL TASK FORCE COMPRISED OF LEADERS FROM MULTIPLE DEPARTMENTS TO CAPTURE ALL HOSPITAL AND HEALTH SYSTEM EFFORTS THAT IMPACT THE HEALTH OF THE LOCAL COMMUNITY. CHIP GOALS REFLECT IDENTIFIED NEEDS AND WERE CONFIRMED THROUGH DISCUSSIONS WITH COMMUNITY LEADERS AND STAKEHOLDERS. OUR PRIORITY AREAS COME FROM THE TOP NEEDS IDENTIFIED BY THE CHNA AND ARE ALIGNED WITH THOSE OF OUR COLLECTIVE IMPACT PARTNERSHIP, THE HEALTH IMPROVEMENT COLLABORATIVE (HIC) OF SOUTHEASTERN CONNECTICUT: ACCESS TO CARE, BEHAVIORAL HEALTH, COMMUNITY HEALTH AND WELLBEING, AND HEALTHY LIVING. THESE PRIORITY AREAS REFLECT THE GREATEST NEEDS IN THE COMMUNITY WITH HEALTH SYSTEM AND HOSPITAL GENERATED STRATEGIES FOR ACTION AND ALIGNMENT WITH STATEWIDE EFFORTS IN THE STATE OF CONNECTICUT HEALTH IMPROVEMENT PLAN.
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) 2021
Schedule H (Form 990) 2021
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?6
Name and address Type of Facility (describe)
1 1 - LAWRENCE MEMORIAL HOSPITAL
224 GOLD STAR HIGHWAY
GROTON,CT06340
SLEEP MEDICINE
2 2 - LAWRENCE MEMORIAL HOSPITAL
194 HOWARD STREET
NEW LONDON,CT06320
MEDICAL FACILITY
3 3 - LAWRENCE MEMORIAL HOSPITAL
79 WAWECUS STREET
NORWICH,CT06360
CARDIOLOGY, BLOOD DRAW
4 4 - LAWRENCE MEMORIAL HOSPITAL
91 VOLUNTOWN ROAD
STONINGTON,CT06379
MEDICAL FACILITY
5 5 - LAWRENCE MEMORIAL HOSPITAL
412 OCEAN AVENUE
NEW LONDON,CT06320
COVID TESTING SITE
6 6 - LAWRENCE MEMORIAL HOSPITAL
345 MONTAUK AVENUE
NEW LONDON,CT06320
MEDICAL FACILITY
7
8
9
10
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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 HOSPITAL USES A COST ACCOUNTING SYSTEM, STRATA, TO CALCULATE THE AMOUNTS PRESENTED IN PART I, LINE 7 IN CONJUNCTION WITH ESTIMATING THE COST OF FREE CARE AND CHARITY CARE, THE RATIO OF COST TO CHARGE PERCENTAGE UTILITIZING THE COMPONENTS FROM THE HOSPITAL'S FINANCIAL STATEMENTS.
PART II, COMMUNITY BUILDING ACTIVITIES: LAWRENCE+MEMORIAL 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) TO CATALOG THESE BENEFITS. THESE TWO ORGANIZATIONS HAVE WORKED TOGETHER FOR OVER 30 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 ACTIVITIES THE ORGANIZATION ENGAGES IN TO PROTECT OR IMPROVE THE HEALTH AND SAFETY OF ITS RESIDENTS. THESE ACTIVITIES ARE CATEGORIZED INTO EIGHT DISTINCT AREAS INCLUDING PHYSICAL IMPROVEMENT AND HOUSING, ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT, ENVIRONMENTAL IMPROVEMENTS, LEADERSHIP DEVELOPMENT AND TRAINING, COALITION BUILDING, COMMUNITY HEALTH IMPROVEMENT ADVOCACY, 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 2022, L+M HOSPITAL PROVIDED $18,300 IN FINANCIAL AND IN-KIND DONATIONS IN THE AREA OF COMMUNITY BUILDING ACTIVITIES. THE HOSPITAL CONSIDERS THESE INVESTMENTS PART OF ITS OVERALL COMMITMENT OF BUILDING STRONGER NEIGHBORHOODS. LAWRENCE+MEMORIAL PROVIDES SUPPORT TO OTHER ORGANIZATIONS ADDRESSING THE ISSUE OF FOOD INSECURITY, SOCIAL COHESION, AND ECONOMIC VITALITY.
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 $78.4 MILLION AND $87.7 MILLION FOR THE YEARS ENDED SEPTEMBER 30, 2022 AND 2021, RESPECTIVELY. THE ESTIMATED COST OF UNCOMPENSATED CARE IS BASED ON THE RATIO OF COST TO CHARGES, AS DETERMINED BY HOSPITAL SPECIFIC DATA.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 PATIENT SERVICE REVENUE. THE SYSTEM MADE PAYMENTS INTO THE CDSHP OF $317.2 MILLION AND $326.6 MILLION FOR THE YEARS ENDED SEPTEMBER 30, 2022 AND 2021, RESPECTIVELY, FOR THE ASSESSMENT.DURING THE YEARS ENDED SEPTEMBER 30, 2022 AND 2021, THE SYSTEM RECEIVED $197.3 MILLION AND $187.8 MILLION, RESPECTIVELY, IN CDSHP DISTRIBUTIONS. THESE ARE RECORDED IN 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: COMMUNITY NEEDS ARE ROUTINELY REVIEWED AND ADDRESSED AS PART OF THE OPERATIONS AND SERVICE LINE TEAMS AT LAWRENCE+MEMORIAL HOSPITAL. THESE MULTI-DISCIPLINARY GROUPS PROVIDE ANALYSIS AND INSIGHT INTO PATIENT UTILIZATION TRENDS ACROSS OUR DELIVERY OF CARE AND ARE REVIEWED IN TANDEM WITH CARE MANAGEMENT AND PATIENT SATISFACTION RESULTS AND OTHER COMMUNITY FEEDBACK. COUPLED WITH THE RECENTLY COMPLETED COMMUNITY NEEDS ASSESSMENT, THIS INFORMATION ASSISTS WITH THE DEVELOPMENT OF NEW INITIATIVES, PARTNERSHIPS, PROGRAMS, AND SERVICES TO BENEFIT OUR COMMUNITY.
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: TO DEFINE COMMUNITY FOR COMMUNITY HEALTH NEEDS ASSESSMENT PURPOSES, L+M HOSPITAL USES A GEOGRAPHIC APPROACH FOCUSING ON THE 10 TOWNS ALONG THE CONNECTICUT SHORELINE BETWEEN RHODE ISLAND AND THE CONNECTICUT RIVER: EAST LYME, GROTON, LEDYARD, LYME, MONTVILLE, NEW LONDON, NORTH STONINGTON, OLD LYME, STONINGTON, AND WATERFORD. THESE COMMUNITIES ARE SERVED BY L+M HOSPITAL REPRESENTING APPROXIMATELY 50% OF TOTAL DISCHARGES AND DO NOT OVERLAP WITH CHNA AREAS IDENTIFIED BY OTHER ACUTE CARE HOSPITALS AND/OR COLLABORATIONS. UPON DEFINING THE GEOGRAPHIC AREA AND POPULATION SERVED IN GREATER NEW LONDON, L+M HOSPITAL WAS DILIGENT TO ENSURE THAT NO GROUPS, ESPECIALLY MINORITY, LOW-INCOME OR MEDICALLY UNDER-SERVED, WERE EXCLUDED.NUMEROUS FACTORS ARE ASSOCIATED WITH THE HEALTH OF A COMMUNITY INCLUDING WHAT RESOURCES AND SERVICES ARE AVAILABLE AS WELL AS WHO LIVES IN THE COMMUNITY. WHILE INDIVIDUAL CHARACTERISTICS SUCH AS AGE, GENDER, RACE, AND ETHNICITY HAVE AN IMPACT ON PEOPLE'S HEALTH, THE DISTRIBUTION OF THESE CHARACTERISTICS ACROSS A COMMUNITY IS ALSO CRITICALLY IMPORTANT AND CAN AFFECT THE NUMBER AND TYPE OF SERVICES AND RESOURCES AVAILABLE. THE GREATER NEW LONDON REGION HAS A POPULATION OF 151,774. THE LIFE EXPECTANCY IN YEARS ACROSS THE REGION VARIES BETWEEN 83.9 YEARS IN ONE SHORELINE TOWN TO 77.2 YEARS IN NEW LONDON. IN GREATER NEW LONDON 74% OF THE TOTAL POPULATION IDENTIFIED AS WHITE, 12% AS HISPANIC, AND 5% AS BLACK. IN THE CITY OF NEW LONDON, 45% IDENTIFIED AS WHITE, 33% HISPANIC AND 13% BLACK. THE TOWNS IN THE REGION VARY DRAMATICALLY IN TERMS OF THEIR RACIAL AND ETHNIC COMPOSITION BUT ARE ALL GROWING MORE DIVERSE THAN THE STATE OF CONNECTICUT WITH 67% OF THE POPULATION IDENTIFYING AS WHITE, 16% HISPANIC, AND 10% BLACK. EACH AREA INCLUDED 7 TO 9% OF THE POPULATION THAT IDENTIFIED AS OTHER.INCOME AND POVERTY ARE CLOSELY CONNECTED TO HEALTH OUTCOMES. A HIGHER INCOME MAKES IT EASIER TO LIVE IN A SAFE NEIGHBORHOOD WITH GOOD SCHOOLS AND MANY RECREATIONAL OPPORTUNITIES. HIGHER WAGE EARNERS ARE BETTER ABLE TO BUY MEDICAL INSURANCE AND MEDICAL CARE, PURCHASE NUTRITIOUS FOODS, AND OBTAIN QUALITY CHILDCARE THAN THOSE EARNING LOWER WAGES. COMMUNITIES WHERE RESIDENTS HAVE LOWER INCOME LEVELS HAVE BEEN SHOWN TO HAVE HIGHER RATES OF ASTHMA, DIABETES, AND HEART DISEASE, AND LOWER LIFE EXPECTANCIES. THERE WERE WIDE GAPS IN MEDIAN HOUSEHOLD INCOME, RANGING FROM $46,298 IN NEW LONDON TO $100,435 IN LYME. THE PROPORTION OF RESIDENTS IN THE GREATER NEW LONDON REGION WITH A COLLEGE DEGREE OR HIGHER (37%) WAS ROUGHLY THE SAME AS THE STATE OVERALL (39%). ONLY 25% OF CITY OF NEW LONDON ADULTS HAD A COLLEGE DEGREE OR HIGHER. THIS DATA DEMONSTRATES THAT THERE ARE SIGNIFICANT INEQUITIES RELATED TO HIGHER EDUCATION WITH BETWEEN 63 AND 75% OF THE POPULATION WITH NO HIGH SCHOOL DIPLOMA OR A HIGH SCHOOL DIPLOMA OR EQUIVALENT AND SOME COLLEGE.
PART VI, LINE 5: 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 2022, L+M INVESTED $70.2 MILLION IN FINANCIAL AND IN-KIND CONTRIBUTIONS THROUGH FIVE WIDE-RANGING PROGRAMS: GUARANTEEING ACCESS TO CARE; ADVANCING CAREERS IN HEALTH CARE; PROMOTING HEALTH & WELLNESS; BUILDING STRONGER NEIGHBORHOODS; 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 A MAJORITY 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. IN FISCAL YEAR 2022 THERE WERE A TOTAL OF 760 MEMBERS ON THE L+M HOSPITAL MEDICAL STAFF. L+M HOSPITAL, FOUNDED IN 1912, IS A 308-BED HOSPITAL SERVING 16,970 INPATIENTS AND 371,079 OUTPATIENT ENCOUNTERS IN 2022. LAWRENCE + MEMORIAL INCLUDES SOUTHEASTERN CONNECTICUT'S ONLY NEWBORN INTENSIVE CARE UNIT, A WOUND AND HYPERBARIC CENTER, AND AN ACUTE REHABILITATION UNIT. THE SMILOW CANCER HOSPITAL CARE CENTER IN WATERFORD, CONNECTICUT, PROVIDES MEDICAL ONCOLOGY SERVICES, GYNECOLOGIC ONCOLOGY, AND RADIATION ONCOLOGY L+M HOSPITAL IS ONE OF THE LARGEST PRIVATE EMPLOYERS IN SOUTHEASTERN CT WITH 2,553 EMPLOYEES IN 2022.
PART VI, LINE 6: THE ENTITIES OF LAWRENCE+MEMORIAL HEALTHCARE INCLUDING L+M HOSPITAL, THE VISITING NURSE ASSOCIATION OF SOUTHEASTERN CT (VNASC), AND WESTERLY HOSPITAL ARE PART OF YALE NEW HAVEN HEALTH. THE YALE NEW HAVEN HEALTH SYSTEM'S FUNDAMENTAL MISSION IS TO ENSURE THAT THE DELIVERY NETWORKS SUCH AS L+M 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 AND IMPLEMENTATION STRATEGIES FOR WHICH THEY ARE HELD ACCOUNTABLE. IN ADDITION, REGULAR REPORTING ON COMMUNITY BENEFITS IS REQUIRED ON A ROUTINE BASIS.
PART VI, LINE 7, REPORTS FILED WITH STATES CT
Schedule H (Form 990) 2021
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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
2021
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) CITY OF NEW LONDON
111 UNION STREET
NEW LONDON,CT06320
06-6001880 GOVERNMENT 75,000 0     SUPPORT ORGANIZATION
(2) EASTERN CT SYMPHONY ORCHESTRA INC
289 STATE STREET
NEW LONDON,CT06320
06-6068892 501(C)(3) 6,500 0     SUPPORT ORGANIZATION
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
2
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2021

Schedule I (Form 990) 2021
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) SPECIAL PATIENT PURCHASES 60 7,285   FMV  
(2) PATIENT TRANSPORTATION 1494 99,962   FMV  
(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. ASSISTANCE PROVIDED TO PATIENTS IS ON AN AS NEEDED BASIS IN SUPPORT OF THE INDIVIDUAL'S HEALTH AND WELLNESS. LMH MAINTAINS FULL AND COMPLETE RECORDS OF ALL MONETARY ASSISTANCE PROVIDED BUT LMH DOES NOT MONITOR SPECIFIC FUNDS.
Schedule I (Form 990) 2021



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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
2021
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) 2021

Schedule J (Form 990) 2021
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, 1099-MISC compensation, and/or 1099-NEC (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
1STEPHEN ALLEGRETTO
FORMER OFFICER (CY2021 COMP)
(i)

(ii)
376,721
-------------
0
91,600
-------------
0
28,244
-------------
0
69,122
-------------
0
12,276
-------------
0
577,963
-------------
0
0
-------------
0
2STEPHEN ALLEGRETTO
FORMER OFFICER (VESTED DEFERRED)
(i)

(ii)
0
-------------
0
0
-------------
0
2,480,400
-------------
0
0
-------------
0
0
-------------
0
2,480,400
-------------
0
1,539,016
-------------
0
3WILLIAM J ASELTYNE
TRUSTEE (CURRENT YR COMP)
(i)

(ii)
0
-------------
887,761
0
-------------
201,500
0
-------------
113,689
0
-------------
171,950
0
-------------
21,138
0
-------------
1,396,038
0
-------------
0
4WILLIAM J ASELTYNE
TRUSTEE (VESTED DEFERRED)
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
579,064
0
-------------
0
0
-------------
0
0
-------------
579,064
0
-------------
0
5PATRICK L GREEN
PRESIDENT/TRUSTEE
(i)

(ii)
353,186
-------------
353,186
90,000
-------------
90,000
34,300
-------------
34,300
193,573
-------------
193,573
10,569
-------------
10,569
681,628
-------------
681,628
0
-------------
0
6DENISE FIORE
SVP, COO
(i)

(ii)
358,498
-------------
153,642
84,560
-------------
36,240
70,388
-------------
30,166
85,750
-------------
36,750
5,496
-------------
2,355
604,692
-------------
259,153
0
-------------
0
7PRATHIBHA VARKEY
FORMER TRUSTEE
(i)

(ii)
0
-------------
421,716
0
-------------
210,000
0
-------------
174,306
0
-------------
8,485
0
-------------
4,628
0
-------------
819,135
0
-------------
106,500
8OLIVER MAYORGA
VP, CMO
(i)

(ii)
352,640
-------------
151,131
77,000
-------------
33,000
22,955
-------------
9,838
53,841
-------------
23,075
14,641
-------------
6,275
521,077
-------------
223,319
0
-------------
0
9BENJAMIN ARMSTRONG
ED PHYSICIAN
(i)

(ii)
495,230
-------------
0
0
-------------
0
300
-------------
0
11,400
-------------
0
22,183
-------------
0
529,113
-------------
0
0
-------------
0
10CRAIG MITTLEMAN
ED MEDICAL DIRECTOR
(i)

(ii)
466,551
-------------
0
0
-------------
0
1,290
-------------
0
11,400
-------------
0
22,014
-------------
0
501,255
-------------
0
0
-------------
0
11DONNA EPPS
VP, CHRO
(i)

(ii)
248,656
-------------
62,164
54,400
-------------
13,600
28,329
-------------
7,082
58,000
-------------
14,500
11,594
-------------
2,898
400,979
-------------
100,244
0
-------------
0
12MICHAEL JOSEPH
ED PHYSICIAN
(i)

(ii)
429,777
-------------
0
25,000
-------------
0
240
-------------
0
11,400
-------------
0
22,183
-------------
0
488,600
-------------
0
0
-------------
0
13PETER WILLIS
ED PHYSICIAN
(i)

(ii)
389,693
-------------
0
25,000
-------------
0
690
-------------
0
12,122
-------------
0
22,014
-------------
0
449,519
-------------
0
0
-------------
0
14CYNTHIA TUCKER
ED PHYSICIAN
(i)

(ii)
372,565
-------------
0
40,513
-------------
0
300
-------------
0
11,400
-------------
0
22,183
-------------
0
446,961
-------------
0
0
-------------
0
15KERIN DACRUZ
VP, CNO
(i)

(ii)
325,501
-------------
0
71,500
-------------
0
1,242
-------------
0
11,954
-------------
0
20,176
-------------
0
430,373
-------------
0
0
-------------
0
16MAUREEN ANDERSON
ASSISTANT SECRETARY
(i)

(ii)
59,828
-------------
272,548
5,850
-------------
26,650
3,720
-------------
16,947
4,131
-------------
18,819
3,795
-------------
17,287
77,324
-------------
352,251
0
-------------
0
17DAVID F REISFELD
TRUSTEE
(i)

(ii)
0
-------------
288,138
0
-------------
5,025
0
-------------
2,868
0
-------------
19,331
0
-------------
15,128
0
-------------
330,490
0
-------------
0
Schedule J (Form 990) 2021

Schedule J (Form 990) 2021
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 INDIVIDUAL(S) 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 PATRICK GREEN $0 $265,897 $0 THE INDIVIDUAL(S) 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 2021 CALENDAR YEAR THAT IS RECOGNIZED AS A TAXABLE EVENT AND REPORTED IN THE INDIVIDUAL'S 2021 CALENDAR YEAR FORM W-2. STEPHEN ALLEGRETTO $2,480,400 WILLIAM ASELTYNE $ 579,064 THE FORMER OFFICER(S) BELOW RECEIVED PAYMENTS THROUGHOUT THE YEAR FROM THE NONQUALIFIED PLAN. THE FOLLOWING PAYMENTS WERE MADE DIRECTLY TO THEM FROM THE RABBI TRUST: STEPHEN ALLEGRETTO $14,641 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) 2021

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990)
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
2021
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) 2021
Schedule L (Form 990) 2021
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 #60
 
VENDOR 21,738,768 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) 2021


Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)


Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
Right pointing arrow large imageGo to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
LAWRENCE MEMORIAL HOSPITAL INC
 
Employer identification number

06-0646704
Part I
Types of Property
(a)
Check if applicable
(b)
Number of contributions or items contributed
(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g
(d)
Method of determining
noncash contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods .......
     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 11 271,968 FAIR MARKET VALUE
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests ....
       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures .....
       
14 Qualified conservation
contribution—Other ...
       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( )
26 Other Right pointing arrow large image ( )
27 Other Right pointing arrow large image ( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?
31
 
No
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2021)
Schedule M (Form 990) (2021)
Page 2
Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Return Reference Explanation
PART I, COLUMN (B): THE ORGANIZATION IS REPORTING IN PART I, COLUMN (B), THE NUMBER OF CONTRIBUTIONS RECEIVED.
SCHEDULE M, PART I, LINE 31: WHILE THE ORGANIZATION DOES NOT CURRENTLY HAVE A BOARD-APPROVED GIFT ACCEPTANCE POLICY, NONSTANDARD CONTRIBUTIONS ARE REVIEWED BY THE SENIOR VICE PRESIDENT OF DEVELOPMENT IN CONSULTATION WITH THE PRESIDENT AND OTHER STAKEHOLDERS AS APPROPRIATE DEPENDING ON THE NATURE OF THE PROPOSED GIFT (E.G., TAX AND REAL ESTATE DEPARTMENTS).
Schedule M (Form 990) (2021)

Additional Data


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

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
2021
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: AS PART OF YALE NEW HAVEN HEALTH (YNHHS), LAWRENCE + MEMORIAL HOSPITAL (LAWRENCE + MEMORIAL, L+M HOSPITAL, L+M) WAS AT THE FOREFRONT OF DELIVERING PATIENT-CENTERED CARE TO SOUTHEASTERN CONNECTICUT THROUGH INPATIENT AND AMBULATORY PROGRAM SERVICES IN ADDITION TO THE FRONTLINE DELIVERY OF COVID-19 VACCINATIONS, CARE AND TREATMENT. IN 2022, THE EMERGENCY DEPARTMENTS (EDS) CONTINUED TO OPERATE AT HIGH CENSUS AS COVID, INFLUENZA AND RESPIRATORY SYNCYTIAL VIRUS (RSV) CASES INCREASED, ESPECIALLY AS YOUNG CHILDREN AND THE ELDERLY WERE ESPECIALLY VULNERABLE AND MANY SOUGHT EMERGENCY MEDICAL CARE. RECOGNIZING THAT OLDER PEOPLE HAVE UNIQUE SYMPTOMS AND NEEDS, STAFF IN THE EDS AT L+M AND PEQUOT HEALTH CENTER WERE TRAINED TO LOOK FOR POTENTIALLY LIFE-THREATENING SIGNS AND SYMPTOMS IN THE ELDERLY. THE INITIATIVE EARNED EACH ED, AS WELL AS THOSE ACROSS YALE NEW HAVEN HEALTH SYSTEM, THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS (ACEP) ELITE HEALTH SYSTEM GERIATRIC EMERGENCY DEPARTMENT ACCREDITATION AS SENIOR FRIENDLY. YNHHS WAS AMONG ONLY 13 HEALTH SYSTEMS NATIONWIDE TO RECEIVE THE DESIGNATION. CLINICAL INNOVATION A NEW IMAGING AGENT DESIGNED SPECIFICALLY TO DETECT CERTAIN TYPES OF RECURRENT OR METASTATIC BREAST CANCER WAS INTRODUCED AT L+M. PATIENTS AT SMILOW CANCER HOSPITAL CARE CENTER AT WATERFORD HAVE ACCESS TO CUTTING-EDGE PRECISION MEDICINE TO TREAT BREAST CANCER. THE POSITRON EMISSION TOMOGRAPHY (PET) NUCLEAR MEDICINE IMAGING AGENT DETECTS ESTROGEN RECEPTOR POSITIVE LESIONS TO HELP DETERMINE TREATMENT PROTOCOLS FOR PATIENTS WITH RECURRENT OR METASTATIC BREAST CANCER. INTEGRATED, PATIENT-FOCUSED CARE THE EMERGENCY DEPARTMENT AT L+M DECREASED THE TIME IT TAKES FOR A HEART ATTACK PATIENT TO GET A VITAL ELECTROCARDIOGRAPH (EKG). A MULTIDISCIPLINARY TEAM LEARNED THAT EXISTING EKG GUIDELINES DID NOT INCLUDE SOME OF THE MORE SUBTLE SIGNS OF HEART ATTACK, POTENTIALLY DELAYING AN ORDER. SIMILARLY, AS HEART ATTACKS CAN HAPPEN TO YOUNG PEOPLE, A GUIDELINE THAT RECOMMENDED EKGS FOR PATIENTS 40 YEARS OR OLDER WAS ELIMINATED. THE CHANGES RESULTED IN LOWERING THE "DOOR TO EKG" NATIONAL STANDARD OF 10 MINUTES. L+M CELEBRATED MORE THAN A YEAR WITHOUT A SINGLE CATHETER ACQUIRED URINARY TRACT INFECTION AND REDUCED THE NUMBER OF COLON SURGICAL SITE INFECTIONS. A COLLABORATION BETWEEN THE OPERATING ROOM AND STERILE PROCESSING TEAMS AT L+M RESULTED IN A REDUCTION IN THE NUMBER OF SURGICAL INSTRUMENTS WHEELED INTO THE OPERATING ROOM. MANY OF THE PREPARED INSTRUMENTS WERE NOT USED IN SURGERY BUT STILL HAD TO BE STERILIZED AFTER EACH OPERATION. THE INITIATIVE IDENTIFIED AND REMOVED 668 INSTRUMENTS FROM SURGICAL TRAYS. SAFETY WAS ENHANCED BY MORE ORGANIZED SURGICAL TRAYS, AND THE ELIMINATION OF UNNECESSARY INSTRUMENTS HELPS REDUCE SURGICAL ERRORS. CARDIOVASCULAR REHABILITATION PROGRAMS AT L+M HELPED PEOPLE RECOVER AFTER EVENTS THAT CAN INCLUDE HEART ATTACK, CORONARY ARTERY BYPASS GRAFT SURGERY AND OTHER CONDITIONS. THE PROGRAM INCLUDES EXERCISE, EDUCATION, COUNSELING AND SUPPORT FOR PATIENTS AND THEIR FAMILIES. THE TEAM AT L+M RECENTLY EARNED RE-CERTIFICATION FOR THE PROGRAM BY THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION (AACVPR). NEW INPATIENT TECHNOLOGY IS HELPING IDENTIFY SILENT SEIZURES IN CRITICALLY ILL PATIENTS AT L+M. THIS NEW TECHNOLOGY PROVIDES A RAPID WAY TO DIAGNOSE PATIENTS AND REDUCE THE WAITING TIME THAT CAN BE ASSOCIATED WITH OBTAINING A STANDARD EEG. THE CERIBELL EEG RAPID RESPONSE MONITOR CONSISTS OF A SIMPLE HEADBAND, A POCKET-SIZE DATA RECORDER AND AN ONLINE PORTAL FOR STAFF TO REMOTELY VIEW THE PATIENT'S NEUROLOGIC ACTIVITY AND DETERMINE IF THE PATIENT IS HAVING A SEIZURE AND NEEDS IMMEDIATE INTERVENTION. THE UROLOGY TEAM IN SOUTHEASTERN CONNECTICUT AND SOUTHERN RHODE ISLAND PARTNERED WITH YALE SCHOOL OF MEDICINE (YSM) AND SMILOW CANCER HOSPITAL TO ENROLL PATIENTS IN CLINICAL TRIALS OFFERED REGIONALLY AND IN NEW HAVEN, OPENING NEW AVENUES FOR TREATMENT TO PATIENTS IN OUR COMMUNITIES. L+M WAS THE FIRST HOSPITAL WITHIN YALE NEW HAVEN HEALTH TO EQUIP TELEVISIONS IN NEARLY ALL ITS INPATIENT ROOMS WITH TELEHEALTH CAPABILITIES, MAKING IT EASY AND CONVENIENT TO BRING PATIENTS AND PROVIDERS TOGETHER WHEN CIRCUMSTANCES MAKE IN-PERSON VISITS DIFFICULT. HAVING BUILT-IN TECHNOLOGY AT THE FINGERTIPS OF CAREGIVERS IN EACH ROOM ENHANCES PROVIDER COMMUNICATION OVER PATIENT CARE. L+M WAS THE FIRST HOSPITAL IN THE YALE NEW HAVEN HEALTH SYSTEM TO INSTALL AN ALTERNATE ENERGY SOURCE ON CAMPUS. AS A RESULT, L+M ANTICIPATES MORE THAN $9 MILLION IN SAVINGS OVER THE 20-YEAR CONTRACT PERIOD. LAWRENCE + MEMORIAL WAS ONE OF 240 HOSPITALS PARTICIPATING IN THE PREMIER QUEST HIGH PERFORMING HOSPITALS NATIONAL COLLABORATIVE. QUEST HOSPITALS COMPARE THEMSELVES AGAINST EACH OTHER, CAREFULLY MEASURING PROGRESS AND SHARING BEST PRACTICES TO DELIVER TOP QUALITY CARE AND ACHIEVE SUPERIOR MEDICAL OUTCOMES. IMPROVING ACCESS TO CARE YALE NEW HAVEN HEALTH OPENED THE UNCASVILLE MEDICAL CENTER AT MOHEGAN SUN OFFERING WALK-IN CARE FOR NON-LIFE-THREATENING ISSUES AS WELL AS PRIMARY CARE, ENDOCRINOLOGY, OB/GYN, CARDIOVASCULAR PROGRAMS FOR WOMEN AND PHYSIATRY. THE 8,500-SQUARE-FOOT FACILITY IS STAFFED BY NORTHEAST MEDICAL GROUP CLINICIANS, MANY OF THEM ALSO ON STAFF AT L+M. THE FACILITY INCLUDES NINE EXAM ROOMS AND ONE PROCEDURE ROOM. THE HEALTH CENTER IS OPEN TO THE PUBLIC. L+M EXPANDED SERVICES TO INCLUDE CARDIOMEMS IMPLANTS, GIVING PATIENTS WITH CONGESTIVE HEART FAILURE THE OPTION OF AN EARLY WARNING SYSTEM TO PREVENT SEVERE ILLNESS AND POTENTIAL HOSPITALIZATION. CARDIOMEMS IS A HEART FAILURE MONITORING SYSTEM THAT INCLUDES A DEVICE IMPLANTED PERMANENTLY INTO A LARGE VESSEL IN THE LUNG CIRCULATION. THE IMPLANT GIVES REAL-TIME FEEDBACK TO AN EXTERNAL MONITORING SOURCE THAT CAN SENSE, BEFORE OUTWARD SYMPTOMS ARE DETECTABLE, IF A PATIENT IS DETERIORATING. DATA FROM THE DEVICE GOES DIRECTLY TO THE HOSPITAL'S NEW CONGESTIVE HEART FAILURE DISEASE MANAGEMENT TEAM AND CAN HELP PREVENT AN EMERGENCY HOSPITAL VISIT. IN 2022, THROUGH YNHHS' AFFILIATION WITH YALE SCHOOL OF MEDICINE, ADDITIONAL ONCOLOGY SPECIALISTS WERE AVAILABLE LOCALLY TO TREAT PATIENTS, PARTICULARLY THOSE WITH LIVER AND BLADDER CANCERS. SEVEN DISEASE-SPECIFIC MEDICAL ONCOLOGISTS AND FOUR DISEASE-SPECIFIC RADIATION ONCOLOGISTS PROVIDE PERSONALIZED CANCER CARE ALL HIGHLY TRAINED AND SKILLED IN THEIR AREA OF EXPERTISE BRINGING AN EXCEPTIONAL LEVEL OF CARE TO PATIENTS. PATIENTS ALSO HAVE ACCESS TO MORE THAN 40 CLINICAL TRIALS. L+M, WITH ITS YNHHS-MEMBER WESTERLY HOSPITAL, PERFORMED MORE THAN 1,700 UROLOGIC PROCEDURES. THE 37 PERCENT INCREASE IN SURGERIES WAS THE RESULT OF THE OPENING OF A NEW OFFICE IN WARWICK, RI, AND THE ADDITION OF NORTHEAST MEDICAL GROUP AND YALE MEDICINE UROLOGISTS TO TREAT PATIENTS. BUILDING HEALTHY COMMUNITIES ACKNOWLEDGING THE EVER-PRESENT NEED FOR ADDITIONAL MENTAL HEALTH SERVICES, L+M ENLARGED ITS PSYCHIATRIC AND BEHAVIORAL HEALTH STAFF OVER THE PAST YEAR WITH THE HIRING OF A DIRECTOR AND ADDITIONAL YALE MEDICINE PROVIDERS OFFERING SERVICES IN THE NEW LONDON COMMUNITY. THROUGH OUR ADULT INTENSIVE OUTPATIENT PROGRAM (IOP) AND TRADITIONAL OUTPATIENT PSYCHIATRIC SERVICES, MORE THAN 500 PATIENTS MEET WITH LICENSED CLINICAL SOCIAL WORKERS AND A PSYCHIATRIST EVERY MONTH FOR TREATMENT AND COUNSELING AT OUR SIX PRIMARY CARE OFFICES IN THE REGION. NEW LONDON FOOD PARTNERSHIP, WHICH DELIVERS OVER 10,000 POUNDS OF FOOD TO NEW LONDON FAMILIES EACH WEEK, IS RUN BY THE HEALTH IMPROVEMENT COLLABORATIVE OF SOUTHEASTERN CONNECTICUT (HIC). WITH THE HELP OF OTHER L+M EMPLOYEES AND VOLUNTEERS, MORE THAN 200 FAMILIES OR 800 TO 1,000 PEOPLE ARE PROVIDED FRESH PRODUCE AND NUTRITIOUS GROCERIES EACH WEEK. THROUGH THE #GIVEHEALTHY MOVEMENT YALE NEW HAVEN HEALTH AND LAWRENCE + MEMORIAL HOSPITAL COLLECTED 1,464 POUNDS OF FOOD EQUALING 1,220 MEALS AND WAS DONATED TO F.R.E.S.H. NEW LONDON, A COMMUNITY GROUP DEDICATED TO BUILDING AND SUSTAINING A HEALTHY AND JUST FOOD SYSTEM TO ESTABLISH COMMUNITY FOOD SECURITY IN CONNECTICUT.
FORM 990, PART VI, SECTION A, LINE 1A 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 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 905,465. MANAGEMENT AND GENERAL EXPENSES 77,861. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 983,326. OTHER OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 83,988,250. MANAGEMENT AND GENERAL EXPENSES 7,004,501. FUNDRAISING EXPENSES 217,655. TOTAL EXPENSES 91,210,406.
FORM 990, PART XI, LINE 9: TRANSFER TO AFFILIATES -33,289. CHANGE IN MINIMUM PENSION LIABILITY 3,622,989. CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST -1,092,156.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


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SCHEDULE R
(Form 990)

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

OMB No. 1545-0047
2021
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 FOUNDATION INC
267 GRANT STREET

BRIDGEPORT,CT06610
22-2908698
SYSTEM SUPPORT SERVICES CT 501C3 LINE 7 BRIDGEPORT HOSPITAL
 
Yes
 
(3)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
 
(4)GREENWICH HOSPITAL
5 PERRYRIDGE ROAD

GREENWICH,CT06830
06-0646659
HEALTHCARE SERVICES CT 501C3 LINE 3 YALE NEW HAVEN HEALTH SERVICES CORP
 
Yes
 
(5)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
(6)LMW HEALTHCARE INC
365 MONTAUK AVENUE

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

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

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

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

BRIDGEPORT,CT06610
06-1297708
TITLE HOLDING CT 501C2   BRIDGEPORT HOSPITAL
 
Yes
 
(11)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
 
(12)THE WESTERLY HOSPITAL FOUNDATION INC
25 WELLS STREET

WESTERLY,RI02891
05-0508064
FUNDRAISING SERVICES RI 501C3 LINE 12A, I LMW HEALTHCARE INC
 
Yes
 
(13)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
 
(14)WESTERLY HOSPITAL AUXILIARY INC
25 WELLS STREET

WESTERLY,RI02891
22-2507181
FUNDRAISING ACTIVITIES RI 501C3 LINE 12A, I LMW HEALTHCARE INC
 
Yes
 
(15)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
(16)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
 
(17)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
 
(18)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) 2021
Schedule R (Form 990) 2021
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
        No     No  
(2) YALE NEW HAVEN HEALTH SYSTEM INVESTMENT

20 YORK STREET
NEW HAVEN,CT06510
27-1374301
INVESTMENT DE N/A
        No     No  
(3) YNHHSCUSP SURGERY CENTERS LLC

15305 DALLAS PKWY STE 1600
ADDISON,TX75001
38-4021595
HEALTHCARE SERVICES CT N/A
        No     No  








Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) 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 DISSOLVED 9122022

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) 2021
Schedule R (Form 990) 2021
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) BRIDGEPORT HOSPITAL

P 692,403 COST
(2) BRIDGEPORT HOSPITAL

R 657,915 COST
(3) BRIDGEPORT HOSPITAL

I 66,365 COST
(4) YALE NEW HAVEN HEALTH SERVICES CORP

M 51,284,160 COST
(5) YALE NEW HAVEN HEALTH SERVICES CORP

S 7,713,630 COST
(6) YALE NEW HAVEN HEALTH SERVICES CORP

P 292,064 COST
(7) YALE NEW HAVEN HEALTH SERVICES CORP

O 340,495 COST
(8) YALE NEW HAVEN HEALTH SERVICES CORP

I 106,794 COST
(9) YALE NEW HAVEN HEALTH SERVICES CORP

Q 47,848,005 COST
(10) YALE NEW HAVEN HEALTH SERVICES CORP

R 109,671,664 COST
(11) YALE NEW HAVEN HOSPITAL

I 361,261 COST
(12) YALE NEW HAVEN HOSPITAL

M 5,560,387 COST
(13) YALE NEW HAVEN HOSPITAL

O 81,244 COST
(14) YALE NEW HAVEN HOSPITAL

P 2,835,873 COST
(15) YALE NEW HAVEN HOSPITAL

S 1,738,039 COST
(16) YALE NEW HAVEN HOSPITAL

R 17,541,924 COST
(17) GREENWICH HOSPITAL

P 464,759 COST
(18) GREENWICH HOSPITAL

R 399,715 COST
(19) NORTHEAST MEDICAL GROUP

M 10,276,548 COST
(20) NORTHEAST MEDICAL GROUP

J 2,279,281 COST
(21) NORTHEAST MEDICAL GROUP

P 1,358,400 COST
(22) NORTHEAST MEDICAL GROUP

Q 6,722,007 COST
(23) NORTHEAST MEDICAL GROUP

R 12,759,247 COST
(24) MEDICAL CENTER PHARMACY & HOME CARE CENTER INC

L 8,849,050 FAIR MARKET VALUE
(25) MEDICAL CENTER PHARMACY & HOME CARE CENTER INC

M 1,801,826 FAIR MARKET VALUE
(26) MEDICAL CENTER PHARMACY & HOME CARE CENTER INC

S 7,209,719 FAIR MARKET VALUE
(27) LAWRENCE & MEMORIAL CORPORATION

S 2,708,587 COST
(28) LMW HEALTHCARE INC

I 1,038,101 COST
(29) LMW HEALTHCARE INC

P 10,392,344 COST
(30) LMW HEALTHCARE INC

S 38,515,143 COST
(31) LMW HEALTHCARE INC

L 2,788,545 COST
(32) LMW HEALTHCARE INC

O 28,604,356 COST
(33) VISITING NURSE ASSOCIATION OF SOUTHEASTERN CONNECTICUT INC

S 1,827,817 COST
(34) VISITING NURSE ASSOCIATION OF SOUTHEASTERN CONNECTICUT INC

O 1,518,723 COST
(35) VISITING NURSE ASSOCIATION OF SOUTHEASTERN CONNECTICUT INC

P 745,136 COST
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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) 2021
Schedule R (Form 990) 2021
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference Explanation
Schedule R (Form 990) 2021

Additional Data


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Software Version: