Iefile GRAPHIC print - DO NOT PROCESS IAs Filed Data - Form990 Department of the Treasury Internal Revenue Seniice foundations) Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private Ir Do not enter security numbers on this form as it may be made public II- Information about Form 990 and Its instructions is at OMB No 1545-0047 2014 Open to Public Inspection A For the Check if applicable Address change Name change Initial retu Final return/terminated Amended Application pending 2014 calendar year, or tax year beginning 10-01-2014 and ending 09-30-2015 Name of organization GREENWICH HOSPITAL Domg busmess as 06-0646659 Employer identification number Number and street (or 0 box if mail is not delivered to street address) 5 PERRYRIDGE ROAD Room/swte Telephone number (203)863-3000 return City or town, state or provmce, country, and ZIP or foreign postal code GREENWICH, CT 06830 Name and address of prinCIpal officer NORMAN ROTH 5 PERRYRIDGE ROAD 06830 I Tax?exem pt status l7 501(c)(3) l? 501(c)( )1 (insert no) 4947(a)(1) or 527 Website: II- GREENWICHHOSPITAL ORG Gross receipts 370,743,242 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 Ir Form of organization '7 Corporation Trust Other Summary I Year of formation 1903 State of legal domICIIe CT 1 Briefly describe the organization's missmn or most Significant actIVIties TO PROVIDE HEALTHCARE SERVICES a 2 Check this box ifthe organization discontinued its operations or disposed of more than 25% ofits net assets 3,5 3 Number ofvoting members ofthe governing body (Part VI, line 1a) 3 24 4 Number ofindependent voting members of the governing body (Part VI, line 1b) 4 18 5 Total numberofindiwduals employedincalendaryear2014 (PartV, ine 2a) 5 2,094 6 Total number ofvolunteers (estimate if necessary) 6 625 7aTota unrelated busmess revenue from 12 7a 7,982,037 Net unrelated busmess taxable income from Form 990-T, line 34 7b 0 Prior Year Current Year 8 Contributions and grants 1h) 10,299,278 8,402,281 9 Program serVIce revenue 29) 332,206,599 340,737,212 10 Investmentincome (Part 3,4,and 7d 1,835,603 5,155,848 11 5,6d,8c,9c,10c,and11e) 15,135,410 11,612,471 12 Total revenue?add lines 8 through 11 (must equal Part column (A), line 12) 359,476,890 365,907,812 13 Grants and Similar amounts paid (PartIX,co umn 1?3) 445,476 397,291 14 Benefits paid to orfor members (Part IX, column (A), line 4) 0 0 15 benefits (PartIX,co umn 155,513,957 164,159,732 16a Professmnalfundraismg fees (PartIX,co umn lie) 0 0 Total fundraismg expenses (Part column (D), line 25) F3r703r026 17 167,819,110 167,474,118 18 Totalexpenses Add lines 323,778,543 332,031,141 19 Revenue less expenses Subtract line 18 from line 12 35,698,347 33,876,671 3 Beginning of Current End of Year ?g Year 33 20 489,110,692 494,263,689 5E 21 147,264,308 143,652,158 ?3 22 Net assets orfund balances Subtract line 21 from line 20 341,846,384 350,611,531 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 I 2016?08?04 Sign Sig nature of officer Date Here EUGENE COLUCCI SR VP Type or print name and title Print/Type preparer's name Preparers Signature Date Check ,f PTIN self_employed P00431862 al Firm's name KPMG LLP Firm's EIN 13?5565207 Pre pare Firrn's address FONE FINANCIAL PLAZA 755 MAIN STREET Phone no (860) 297?6085 Use Only HARTFORD, CT 06103 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 I_Yes Form 990 (2014) Form 990(2014) Page2 Statement of Program Service Accomplishments . . . . . . . . . . . . . .I7 1 Briefly describe the organization?s missmn TO PROVIDE HEALTHCARE SERVICES 2 Did the organization undertake any Significant program serVIces during the year which were not listed on thepriorForm990 or990-EZI_Yes If"Yes," describe these new serVIces on Schedule 0 3 Did the organization cease conducting, or make Significant changes in how it conducts, any program If "Yes," describe these changes on Schedule 0 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 ofgrants and allocations to others, the total expenses, and revenue, ifany, for each program serVIce reported 4a (Code (Expenses 289,934,937 including grants of 397,291 (Revenue 352,196,521 SEE SCHEDULE 0 4b (Code (Expenses including grants of (Revenue 44; (Code (Expenses including grants of (Revenue 4d Other program serVIces (Describe in Schedule 0 (Expenses including grants of$ (Revenue 4e Total program service expenseslr 289,9 34,9 37 Form 990(2014) Form 990 (201420a Page 3 Part IV Checklist of Required Schedules Yes No Is the organization described In section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," Yes complete Schedule A 1 Is the organization reqUIred to complete Schedule 3, Schedule of Contributors (see instructions)? 2 Yes Did the organization engage in direct or indirect political campaign actIVIties on behalf ofor in opp05ition to No candidates for public office? If "Yes," complete Schedule C, Part I 3 Section 501(c)(3) organizations. Did the organization engage in lobbying actIVIties, or have a section 501(h) Yes election in effect during the tax year? If "Yes,? complete Schedule C, Part II 4 Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or Similar amounts as defined in Revenue Procedure 98-19? If "Yes,?complete Schedule C, as 5 N0 Part . Did the organization maintain any donor adVIsed funds or any Similarfunds or accounts for which donors have the right to prowde adVIce on the distribution or investment ofamounts in such funds or accounts? If "Yes,? complete Schedule D, Part IE 6 0 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 II 7 0 Did the organization maintain collections ofworks ofart, historical treasures, or other Similar assets? If "Yes," complete Schedule D, Part 8 0 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 prowde credit counseling, debt management, credit repair, or debt negotiation serVIces? If "Yes,? complete Schedule D, PartI 9 0 Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, 10 Yes permanent endowments, or quaSI-endowments? If "Yes," complete Schedule D, Part Ifthe organization?s answerto any ofthe followmg questions is "Yes," then complete Schedule D, Parts VI, VII, IX, or as applicable Did the organization report an amount for land, bUIldings, and eqUIpment in Part X, line 10? If "Yes," complete Schedule D, Part VI . 11a es 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 11b es 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 11C 0 Did the organization report an amount for other assets in Part X, line 15 that is 5% or more ofits total assets reported in Part X, line 16? If "Yes," complete Schedule D, PartI . . . . . . . 11-" es Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, PartXE 11e Yes Did the organization's separate or consolidated finanCIal statements for the tax year include a footnote that 11f Yes addresses the organization's liability for uncertain tax p05itions under FIN 48 (ASC 740)? If "Yes,? complete Schedule D, Part Did the organization obtain separate, independent audited finanCIal statements for the tax year? If "Yes," complete Schedule D, Parts XI and XII 123 N0 Was the organization included in consolidated, independent audited finanCIal statements for the tax year? If 12b Yes "Yes," and If the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII lS optional Is the organization a school described in section If "Yes,?complete ScheduleE 13 No Did the organization maintain an office, employees, or agents outSIde ofthe United States? 14a No Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraismg, busmess, 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 N0 Did the organization report on Part IX, column (A), line 3, more than $5,000 ofgrants or other a55istance to or for any foreign organization? If ?Yes,? complete Schedule F, Parts II and IV 15 0 Did the organization report on Part IX, column (A), line 3, more than $5,000 ofaggregate grants or other a55istance to orforforeign indIVIduals? If ?Yes,?complete ScheduleF, Parts and IV . 16 0 Did the organization report a total of more than $15,000 ofexpenses for professmnal fundraismg serVIces on Part 17 No IX, column (A), lines 6 and 11e? If "Yes,? complete Schedule G, Part I (see instructions) Did the organization report more than $15,000 total offundraismg event gross income and contributions on Part lines 1c and 8a? If "Yes,"complete Schedule G, Part II 1-3 es Did the organization report more than $15,000 ofgross income from gaming actIVIties on Part line 9a? If 19 No "Yes, complete Schedule G, Part Did the organization operate one or more hospital faCIlities? If "Yes,"complete ScheduleH . . . . 20a Yes If"Yes" to line 20a, did the organization attach a copy ofits audited finanCIal statements to this return? 20b Yes Form 990(2014) Form 990 (2014Part I Page 4 Part IV Checklist of Required Schedules (continued) Did the organization report more than $5,000 ofgrants or other a55istance to any domestic organization or 21 Yes domestic government on Part IX, column (A), line 1? If ?Yes,?complete Schedule I, Parts I and II Did the organization report more than $5,000 ofgrants or other a55istance to or for domestic indIVIduals on Part 22 IX, column (A), line 2? If ?Yes,? complete Schedule I, Parts I and 0 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,? 23 es complete Schedule] . Did the organization have a tax-exempt bond issue With an outstanding prinCIpaI amount of more than $100,000 as ofthe last day ofthe 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 es Did the organization invest any proceeds oftax-exempt bonds beyond a temporary period exception? 24b 0 Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds? 244: 0 Did the organization act as an "on behalfof" issuerfor bonds outstanding at any time during the year? 24d No 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, PartI 25a N0 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 ofthe organization?s prior Forms 990 or If 25b No "Yes, complete Schedule L, Part I Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? 26 No If "Yes," complete Schedule L, Part II Did the organization prowde a grant or other a55istance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family 27 N0 member of any ofthese persons? If "Yes," complete Schedule L, Part Was the organization a party to a busmess transaction With one of the fo 0Wing parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions) A current or former officer, director, trustee, or key employee? If "Yes,? complete Schedule L, Part IVE 28a NO A family member ofa current or former officer, director, trustee, or key employee? If "Yes,? completeScheduleL,PartIV . . . . . . . . . . . . . . . . . . . . . 28'? 0 An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV . 23C es Did the organization receive more than $25,000 in non-cash contributions? If "Yes,"complete ScheduleM . IE 29 Yes Did the organization receive contributions of art, historical treasures, or other Similar assets, or qualified conservation contributions? If "Yes," complete ScheduleM 3? 0 Did the organization liqUIdate, terminate, or dissolve and cease operations? If "Yes,? complete Schedule N, No 31 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 Did the organization own 100% ofan entity disregarded as separate from the organization under Regulations sections 301 7701-2 and 301 7701-3? If "Yes,"complete Schedule R, PartI 33 es Was the organization related to any tax-exempt or taxable entity? If "Yes,"complete Schedule R, Part II, orIV, Yes and Part V, line 1 34 Did the organization have a controlled entity Within the meaning ofsection 512(b)(13)? 35a Yes If?Yes?to line 35a, did the organization receive any payment from or engage in any transaction With a controlled 35b entity Within the meaning of section 5 12(b)(13)? If "Yes," complete Schedule R, Part V, line2 0 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 35 0 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 VI 37 0 Did the organization complete Schedule 0 and prowde explanations in Schedule 0 for Part VI, lines 11b and 19? Note. All Form 990 filers are reqUIred to complete Schedule 0 33 es Form 990(2014) Form 990(2014) Page5 Statements Regarding Other IRS Filings and Tax Compliance Check IfSchedule contaIns a response or note to any Me In thIs Part Yes No 1a Enter the number reported In Box 3 of Form 1096 Enter-0- If not appIIcable . . 1a 334 Enter the number of Forms W-ZG Included In Me 1a Enter-0- If not appIIcable 1b 0 the organIzatIon comply WIth backup WIthholdIng rules for reportable payments to vendors and reportable gamIng (gambIIng) WInnIngs to prIze WInners? 1C 2a Enter the number ofemployees reported on Form W-3, TransmIttal ofWage and Tax Statements, ?led for the calendar year endIng WIth or WIthIn the year covered 23 2.094 Ifat least one IS reported on Me 2a, dId the organIzatIon ?le all reqUIred federal employment tax returns? 2b Note. Ifthe sum ofIInes 1a and 2a Is greater than 250, you may be reqUIred to e-fIIe (see InstructIons) es 3a the organIzatIon have unrelated busmess gross Income of$1,000 or more durIng the year? 3a Yes If?Yes,? has It ?led a Form 990-T for thIs year? If ?No? to [me 3b, prowde an explanation In Schedule 0 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 otherfInanCIal account)? 4a No If"Yes," enter the name ofthe foreIgn country Ir See InstructIons reqUIrements for Form 114, Report of ForeIgn Bank and FInanCIal Accounts (FBAR) 5a Was the organIzatIon a party to a prothIted tax shelter transactIon at any tIme durIng the tax year? 5a No any taxable party notIfy the organIzatIon that It was or Is a party to a prothIted tax shelter transactIon? 5b No If"Yes," to Me 5a or 5b, dId the organIzatIon ?le Form 5c 6a Does the organIzatIon have annual gross receIpts that are normally greater than $100,000, and dId the Ga No organIzatIon so ICIt any contrIbutIons that were not tax deducthle as charItable contrIbutIons? If"Yes," dId the organIzatIon Include WIth every so ICItatIon an express statement that such contrIbutIons or were not tax deducthle? 6b 7 Organizations that may receive deductible contributions under section 170(c). a the organIzatIon recere a payment In excess of$75 made partly as a contrIbutIon and partly for goods and 7a Yes serVIces prOVIded to the payor'? If"Yes," dId the organlzatIon notIfy the donor ofthe value of the goods or serVIces prOVIded? 7b Yes the organIzatIon sell, exchange, or otherWIse dIspose oftangIble personal property for It was requIred to fIleForm8282? 7C N0 If"Yes," IndIcate the number of Forms 8282 ?led durIng the year . . . . I 7d I the organIzatIon recere any funds, dIrectly or IndIrectly, to pay prequms on a personal bene?t contract? 7e No the organIzatIon, durIng the year, pay prequms, dIrectly or IndIrectly, on a personal bene?t contract? 7f No 9 Ifthe organIzatIon recered a contrIbutIon Intellectual property, dId the organIzatIon ?le Form 8899 as requIred? 7g Ifthe organIzatIon recered a contrIbutIon ofcars, boats, aIrplanes, or other vehIcles, dId the organIzatIon ?le a Form 7h 8 Sponsoring organizations maintaining donor advised funds. a donor adVIsed fund maIntaIned by the sponsorIng organIzatIon have excess busmess holdIngs at any tIme durIng the year? 8 9a the sponsorIng organIzatIon make any taxable dIstrIbutIons under sectIon 4966? 9a the sponsorIng organIzatIon make a dIstrIbutIon to a donor, donor adVIsor, or related person? 9b 10 Section 501(c)(7) organizations. Enter InItIatIon fees and capItal contrIbutIons Included on Part Me 12 . . . 10a Gross receIpts, Included on Form 990, Part Me 12, for pubIIc use ofclub 10b 11 Section 501(c)(12) organizations. Enter a Gross Income from members or shareholders . . . . . . . . . 11a Gross Income from other sources (Do not net amounts due or paId to other sources agaInst amounts due or recered from them11b 12a Section 4947(a)(1) non-exempt charitable trusts. Is the organIzatIon fIlIng Form 990 In lIeu of Form 1041? 12a If "Yes," enter the amount of tax-exempt Interest recered or accrued durIng the 12" 13 Section 501(c)(29) qualified nonprofit health insurance issuers. a Is the organIzatIon lIcensed to Issue health plans In more than one state? 13a Note. See the InstructIons for addItIonal InformatIon the organIzatIon must report on Schedule 0 Enter the amount of reserves the organIzatIon Is reqUIred to maIntaIn by the states In the organIzatIon IS lIcensed to Issue health plans . . . . 13?" Enterthe amount of reserves on hand . . . . . . . . . . . . 13c 14a the organIzatIon recere any payments for IndoortannIng serVIces durIng the tax year? 14a No If "Yes," has It ?led a Form 720 to report these payments? If "No,?prowde an explanation In Schedule 0 14b Form 990(2014) Form 990 (2014) Page 6 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 0. See instructions. Check IfSchedule contaIns a response or note to any Me In thIs Part VI .I7 Section A. Governing Body and Management Yes No 1a Enter the number ofvotIng members ofthe governIng body at the end ofthe tax 1a 24 year Ifthere are materIal dIfferences In votIng rIghts among members ofthe governIng body, or Ifthe governIng body delegated broad authorIty to an executIve commIttee or commIttee, explaIn In Schedule 0 Enter the number ofvotIng members Included In Me 1a, above, who are 18 2 any of?cer, dIrector, trustee, or key employee have a famIIy relatIonshIp or a busIness relatIonshIp WIth any other of?cer, dIrector, trustee, or key employee? 2 Yes 3 the organIzatIon delegate control over management dutIes customarIIy performed by or under the dIrect 3 No superVISIon of of?cers, dIrectors or trustees, or key employees to a management company or other person? 4 the organIzatIon make any SIgnIfIcant changes to Its governIng documents smce the prIor Form 990 was ?led? No 5 the organIzatIon become aware durIng the year ofa SIgnIfIcant dIversIon of the organIzatIon's assets? 5 No the organIzatIon have members or stockholders? Yes 7a the organIzatIon have members, stockholders, or other persons who had the power to elect or appomt one or more members ofthe governIng body? 7a Yes Are any governance deCISIons ofthe organIzatIon reserved to (or subject to approval by) members, stockholders, 7b Yes or persons other than the governIng body? 8 the organIzatIon contemporaneously document the meetIngs held or ertten actIons undertaken durIng the year by the followmg a The governIng body? 8a Yes Each commIttee WIth authorIty to act on behalfof the governIng body? 8b Yes 9 Is there any of?cer, dIrector, trustee, or key employee Isted In Part VII, SectIon A, who cannot be reached at the organIzatIon? address? If "Yes,? ?prowde the names and addresses In Schedule 0 . . 9 N0 Section B. Policies (This Section requests information about policies not required by the Internal Revenue Code.) Yes No 10a the organIzatIon have local chapters, branches, or 10a Yes If"Yes," dId the organIzatIon have ertten polICIes and procedures governIng the actIVItIes ofsuch chapters, and branches to ensure theIr operatIons are conSIstent WIth the organIzatIon's exempt purposes? 10" Yes 11a Has the organIzatIon prOVIded a complete copy ofthIs Form 990 to all members ofIts governIng body before fIlIng the form? 11a Yes DescrIbe In Schedule 0 the process, Ifany, used by the organIzatIon to reVIew thIs Form 990 12a the organIzatIon have a ertten coanIct of Interest pollcy? If "No,"go to ?ne 13 12a Yes Were offIcers, dIrectors, or trustees, and key employees reqUIred to dIsclose annually Interests that could gIve rIse to coanIcts? 12b Yes the organIzatIon regularly and conSIstently monItor and enforce compIIance WIth the pollcy? If "Yes,"descrIbe In Schedule 0 how M5 was done 12C Yes 13 the organIzatIon have a ertten po Icy? 13 Yes 14 the organIzatIon have a ertten document retentIon and destructIon pollcy? 14 Yes 15 the process for determInIng compensatIon ofthe followmg persons Include a reVIew and approval by Independent persons, data, and contemporaneous substantIatIon of the deIIberatIon and deCISIon?? a The organIzatIon?s CEO, ExecutIve DIrector, or top management offICIal 15a Yes Other of?cers or key employees of the organIzatIon 15b Yes If"Yes" to Me 15a or 15b, descrIbe the process In Schedule 0 (see InstructIons) 16a the organIzatIon Invest In, contrIbute assets to, or partICIpate In a Jomt venture or arrangement WIth a taxable entIty durIng the year? 16a Yes If "Yes," dId the organIzatIon follow a ertten pollcy or procedure reqUIrIng the organIzatIon to evaluate Its partICIpatIon In venture arrangements under appIIcable federal tax law, and take steps to safeguard the organIzatIon?s exempt status WIth respect to such arrangements? 16b Yes Section C. Disclosure 17 18 19 20 LIst the States WIth a copy ofthIs Form 990 Is reqUIred to be fIledIr SectIon 6104 reqUIres an organIzatIon to make Its Form 1023 (or 1024 IfappIIcable), 990, and 990-T (501(c) (3)s only) avaIIable for pubIIc InspectIon IndIcate how you made these avaIIable Check all that apply Own webSIte Another's webSIte I7 Upon request Other (explaIn In Schedule 0) DescrIbe In Schedule 0 whether (and Ifso, how) the organIzatIon made Its governIng documents, coanIct of Interest po Icy, and fInanCIal statements avaIIable to the pubIIc durIng the tax year State the name, address, and telephone number of the person who possesses the organIzatIon's books and records II-KEITH TANDLER 789 HOWARD AVENUE 06519 (203)688-9642 Form 990(2014) Form 990(2014) Page7 Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors Check ifSchedule 0 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 I List all ofthe organization?s current officers, directors, trustees (whether indIVIduals or organizations), regardless ofamount ofcompensation Enter-O- in columns (D), (E), and (F) if no compensation was paid I List all ofthe organization?s current key employees, ifany See instructions for definition of "key employee I List the organization?s five current highest compensated employees (other than an officer, director, trustee or key employee) who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the organization and any related organizations I List all ofthe 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 I List all ofthe organization?s former directors or trustees that received, in the capaCIty as a former director or trustee ofthe organization, more than $10,000 of reportable compensation from the organization and any related organizations List persons in the followmg order indIVIduaI trustees or directors, institutional trustees, officers, key employees, highest compensated employees, and former such persons Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee (A) (B) (C) (D) (E) (F) Name and Title Average POSItion (do not check Reportable Reportable Estimated hours per more than one box, unless compensation compensation amount of other week (list person is both an officer from the from related compensation any hours and a director/trustee) organization (W- organizations (W- from the forrelated C, 3 3 I _n organization and organizations a; E. 9 related below 5 .1: EE 3 organizations I1 3 us- II-I dotted lineForm 990(2014) Form 990 (2014) Page 8 Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued) (A) (B) (C) Name and Title Average P05ition (do not check hours per more than one box, unless week (list person IS both an officer any hours and a director/trustee) for related I3 I '13 I ?n organizations a :u 3 3.13 Q- CI 5.: DEIOW E. i1: in i1 3 II-I dotted line) i: :i Pr E- 2 11(D) Reportable compensation from the organization (W- (E) Reportable compensation from related organizations (W- (F) Estimated amount of other compensation from the organization and related organizations 1b Sub-Total Total from continuation sheets to Part VII, Section A Total (add lines 1b and 1c) 10,927,536 3,706,200 1,852,340 2 Total number of indIVIduals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationlr308 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 Schedulleor such indiwdual . . . . . . 3 Yes 4 For any IndIVIduaI 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 Schedulleorsuch Individual 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 Schedulleorsuch person . . . . 5 No Section B. Independent Contractors 1 Complete this table for yourfive 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 busmess address (3) Description of serwces (C) Compensation GREENWICH ULTRASOUND ASSOC 67 HOLLY HILL RD GREENWICH, CT 06830 ULTRASOUN SE RVIC 3,074,109 NURSEFINDERS INC 524 EAST LAMAR BLVD STE 300 76011 TRAVELING NURSES 1,662,563 UNITEX TEXTILE RENTAL 161 SOUTH MACQESTEN PARKWAY MOUNT VERNON, NY 10550 UNIFORM LAUNDERING 1,402,707 QUEST DIAGNOSTIC 15 CAMPUS BOULEVARD NEWTOWN SQUARE, PA 19073 MEDICAL COMPLIANCE 576,086 LAWN MAINTENANCE 22 ARTHUR STREET GREENWICH, CT 06831 MAINTENANCE 496,158 2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 ofcompensation from the organization #62 Form 990(2014) Form 990 (2014) Statement of Revenue Page 9 CheckifScheduleO contains a response ornote to any lineinthis . . . . . (A) (B) (C) (D) Total revenue Related or Unrelated Revenue exempt busmess excluded from function revenue tax under revenue sections 512-514 3 1a Federated campaigns . . 1a Membership dues . . . . 1b til Fundraismg events . . . . 1c 1,323,948 Related organizations . . . 1d I'll; Government grants (contributions) 1e 173,735 '17: .E All other contributions, gifts, grants, and 1f 6,904,598 Similar amounts not included above 3 i i oncas contri ions in ines 648 113 1a?1f$ '5 '3 Total. Add lines la-lf 8,402,281 Ir Busmess Code 2a OUTPATIENT PROGRAM SERVICES 621400 190,323,237 190,323,237 INPATIENT PROGRAM SERVICES 612990 142,431,880 142,431,880 3 OUTREACH LAB 621500 7,982,095 7,982,095 p? 6 a All other program serVIce revenue Total. Add lines 2a?2f Ir 340,737,212 3 Investment income (including diVidends, interest, 875 413 58 875 471 and otherSImilar amounts) Income from investment of tax?exempt bond proceeds F- 5 Royalties Real (ii) Personal 6a Gross rents 1.000.855 Less rental 75,760 expenses Rental income 925,095 or(loss) Net rental income or (loss) p. 925,095 925,095 Securities (ii) Other 7a Gross amount from sales of 8,065,742 23,530 assets other than inventory Less cost or other ba5is and 3,808,837 0 sales expenses Gain or (loss) 4,256,905 23,530 Net gain or (loss) .p 4.280.435 4,280,435 8a Gross income from fundraismg events (not including 1,323,948 3, ofcontributions reported on line 1c) See PartIV,line 18 a 178,900 :5 Less direct expenses . . . 950,833 Net income or (loss) from fundraismg events . . ?771.933 -771,933 9a Gross income from gaming actiwties See Part IV, line 19 a Less direct expenses . . . Net income or (loss) from gaming actIVIties . . 10a Gross sales of inventory, less returns and allowances a Less cost ofgoods sold . . Net income or (loss) from sales ofinventory . . Miscellaneous Revenue Busmess Code [3 CLINIC SERVICES 900099 1,437,258 1,437,258 IVF SERVICE INCOME 900099 1,367,403 1,367,403 All other revenue 5.919.153 5,919,153 Total.Addlines 11a?11d Ir 11,459,309 12 Total revenue. See Instructions 365,907,812 344,214,426 7,982,037 5,309,068 Form 990 (2014) Form 990(2014) Page 10 Statement of Functional Expenses Section 501(c)(3)and 501(c)(4) organizations must complete all columns All other organizations must complete column (A) CheckIfScheduleO containsa response or note to In this PartIX . . . . . .l7 Do not include amounts reported on lines 6bPart Total expenses expenses general expenses expenses 1 Grants and other aSSIstance to domestic organizations and domestic governments See Part IV, line 21 397,291 397,291 2 Grants and other aSSIstance to domestic IndIVIdualS See Part IV, line 22 3 Grants and other aSSIstance to foreign organizations, foreign governments, and foreign IndIVIdualS See Part IV, lines 15 and 16 Benefits paid to or for members 5 Compensation of current officers, directors, trustees, and key employees 10,544,110 10,544,110 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 116,865,962 112,371,915 2,907,051 1,586,996 8 PenSIon plan accruals and contributions (Include section 401(k) and 403 employer contributions) 10,543,973 10,273,367 125,518 145,088 9 Other employee benefits 17,916,810 17,385,955 285,318 245,537 10 Payroll taxes 8,288,877 7,970,130 206,187 112,560 11 Fees for serVIces (non-employees) a Management 4,883,994 3,809,515 1,074,479 Legal 127,016 3,965 1,118 121,933 Accounting 231,250 180,375 50,875 Lobbying 116,429 116,429 Professmnal fundraismg serVIces See Part IV, line 17 Investment management fees 9 Other (Ifllne 11g amount exceeds 10% ofllne 25, column (A) amount, list We 1 lg expenses on Schedule 0) 53,503,489 42,446,153 10,849,001 208,335 12 and promotion 13 Office expenses 6,098,141 3,940,258 1,111,355 1,046,528 14 Information technology 9,355,018 7,296,914 2,058,104 15 Royalties 16 upa nc 16,140,380 12,405,378 3,498,953 236,049 17 Travel 18 Payments of travel or entertainment expenses for any federal, state, or local public offICIals 19 Conferences, conventions, and meetings 666,108 519,564 146,544 20 Interest 334,145 260,633 73,512 21 Payments to affiliates 22 DepreCIatIon, depletion, and amortization 18,765,214 14,636,867 4,128,347 23 Insurance 1,812,189 1,413,507 398,682 24 Other expenses Itemize expenses not covered above (LIst miscellaneous expenses In line 24e IfIIne 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule 0) a PHARMECEUTICAL SUPPLIES 25,982,689 25,982,689 0 0 MEDICAL SUPPLY EXPENSE 25,212,496 25,212,496 0 0 EDUCATIO 81 OTHER EM PL 3,440,766 2,683,797 756,969 0 MEMBERSHIP DUES FEES 804,794 627,739 177,055 0 All other expenses 25 Total functional expenses. Add lines 1 through 24e 332,031,141 289,934,937 38,393,178 3,703,026 26 Joint costs. Complete thIs line only Ifthe organization reported in column (B)Jomt costs from a combined educational campaign and fundraismg soIICItatlon Check here It Iffollowmg SOP 98-2 (ASC 958-720) Form 990 (2014) Form 990 (2014) Page 11 Balance Sheet Check ifSchedule 0 contains a response or note to any line In this Part . . (A) (B) Beginning ofyear End ofyear 1 Cash?non-interest-bearing 40,011,451 1 24,997,890 2 Savmgs and temporary cash investments 36,350,555 2 74,483,889 3 Pledges and grants receivable, net 3 4 Accounts receivable, net 37,984,141 4 38,149,419 5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees Complete Part II of Schedule 5 6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described In section 4958(c)(3)(B), and contributing employers and sponsoring organizations ofsection 501(c)(9) voluntary employees' benefICIary organizations (see instructions) Complete Part II ofSchedule 6 7 Notes and loans receivable, net 7 8 Inventories for sale or use 2,126,798 8 1,636,165 Prepaid expenses and deferred charges 7.645.355 9 6.244.397 10a Land, bUIldings, and eqUIpment cost or other basis Complete Part VI ofSchedule 103 447-790-954 Less accumulated depreCIation 10b 231,814,752 223,222,919 10c 215,976,202 11 Investments?publicly traded securities 15241.45?) 11 9.085.610 12 Investments?other securities See Part IV, line 11 76,034,299 12 88,158,568 13 Investments?program-related See Part IV, line 11 13 14 Intangible assets 14 15 Other assets See Part IV, line 11 49,493,718 15 35,531,549 16 Total assets. Add lines 1 through 15 (must equal line 34) 489,110,692 16 494,263,689 17 Accounts payable and accrued expenses 32,649,839 17 31,776,164 18 Grants payable 18 19 Deferred revenue 19 20 Tax-exempt bond liabilities 37,710,000 20 35,105,000 r, 21 Escrow or custodial account liability Complete Part IV ofSchedule 21 :2 22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified 7% persons Complete Part II ofSchedule 22 23 Secured mortgages and notes payable to unrelated third parties 23 24 Unsecured notes and loans payable to unrelated third parties 24 25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24) Complete Part ofSchedule 76,904,469 25 76,770,994 26 Total liabilities. Add lines 17 through 25 147264.308 26 143552.158 Organizations that follow SFAS 117 (ASC 958), check here It 7 and complete 3 lines 27 through 29, and lines 33 and 34. 27 Unrestricted net assets 287,992,251 27 298,677,899 28 Temporarily restricted net assets 44.115.410 28 41.782.451 29 Permanently restricted net assets 9,738,723 29 10,151,181 If Organizations that do not follow SFAS 117 (ASC 958), check here II- and complete lines 30 through 34. 3 30 Capital stock or trust prinCIpal, or current funds 30 Iii-1,, 31 Paid-in or capital surplus,or and, bUIIdlng or eqUIpment fund 31 32 Retained earnings, endowment, accumulated income, or other funds 32 ii; 33 Total net assets or fund balances 341,846,384 33 350,611,531 2 34 Total liabilities and net assets/fund balances 489,110,692 34 494,263,689 Form 990 (2014) Form 990(2014) Page 12 Reconcilliation of Net Assets Check IfSchedule contaIns a response or note to any Me In thIs Part XI . I7 1 Total revenue (must equal Part column (A), Me 12) 1 365,907,812 2 Total expenses (must equal Part IX, column (A), Me 25) 2 332,031,141 3 Revenue less expenses Subtract Me 2 from Me 1 3 33,876,671 4 Net assets orfund balances at begInnIng ofyear (must equal Part X, Me 33, column 4 341,846,384 5 Net unrealized gaIns (losses) on Investments 5 -7,035,416 6 Donated serVIces and use of 6 7 Investment expenses 7 8 WIN perIod adjustments 8 9 Other changes In net assets orfund balances (explaIn In Schedule 0) 9 -18,076,108 10 Net assets orfund balances at end ofyear CombIne lInes 3 through 9 (must equal Part X, Me 33, column 10 350,611,531 Financial Statements and Reporting Check IfSchedule contaIns a response or note to any Me In thIs Part XII . Yes No 1 AccountIng method used to prepare the Form 990 Cash I7 Accrual ther Ifthe organIzatIon changed Its method ofaccountIng from a prIor year or checked "Other," explaIn In Schedule 0 2a Were the organIzatIon?s fInanCIal statements compIIed or reVIewed by an Independent accountant? 2a No If?Yes,?check a box below to IndIcate whether the fInanCIal statements for the year were compIIed or reVIewed on a separate consolldated or both Separate Consolldated Both consolldated and separate Were the organlzatIon?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, consolldated baSIs, or both Separate I7 Consolldated Both consolldated and separate If "Yes," to Me 2a or 2b, does the organIzatIon have a commIttee that assumes for overSIght ofthe audIt, reVIew, or compIIatIon ofIts fInanCIal statements and selectIon ofan Independent accountant? 2C Yes Ifthe organIzatIon changed eIther Its overSIght process or selectIon process durIng the tax year, explaIn In Schedule 0 3a As a result ofa federal award, was the organIzatIon requIred to undergo an audIt or audIts as set forth In the SIngle AudItAct and OMB CIrcularA-133? 3a Yes If "Yes," dId the organIzatIon undergo the reqUIred audIt or audIts'? Ifthe organIzatIon dId not undergo the 3b Yes reqUIred audIt or audIts, explaIn why In Schedule 0 and descrIbe any steps taken to undergo such audIts Form 990(2014) Additional Data Software ID: Software Version: EIN: Name: 06-0646659 GREENWIC HOSPITAL Form 990, Part VII - Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Inde Jendent Contractors (A) (B) (C) (D) (E) (F) Name and Average (do not check Reportable Reportable Estlmated amount hours per more than one box, unless compensation compensation of other week (Ilst person IS both an of?cer from the from related compensation any hours and a director/trustee) organization (W- organizations (W- from the for related 3 I I ?n organization and organlzatlons a; =l .59. 3.1: 9 related below a a :12: organlzatlons dotted line(1) APOSTOLIDES 1 00 0 0 0 DIRECTOR 1 00 (1) WILLIAM BERKLEY 1 00 0 0 0 DIRECTOR 1 00 (2) RICHARD BRAUER MD 1 00 0 0 0 DIRECTOR (END 12/ 14) 1 00 (3) ALAN BREED 1 00 0 0 0 DIRECTOR 2 00 (4) NANCY BROWN 1 00 0 0 0 DIRECTOR 1 00 (5) GAYLE CAPOZZALO 4 00 132,393 1,191,535 37,933 DIRECTOR (END 10/14) 36 00 (6) KEVIN CONBOY MD 1 00 0 0 0 DIRECTOR (END 12/ 14) 1 00 (7) FRANK CORVINO 32 00 1,151,328 287,832 61,252 PRES CEO (END 12/14) 8 00 (8) PETER DAPUZZO 1 00 0 0 0 DIRECTOR 2 00 (9) DAVID EVANS MD 1 00 0 0 0 DIRECTOR (END 12/ 14) 1 00 (10) ELIZABETH GALT 1 00 0 0 0 SECRETARY 1 00 (11) ANNE JUGE 1 00 0 0 0 TREASURER (START 12/14) 2 00 (12) ROBIN KANAREK 1 00 0 0 0 DIRECTOR 1 00 (13) DONALD KIRK 1 00 0 0 0 DIRECTOR 1 00 (14) SALLY LOCHNER 1 00 0 0 0 DIRECTOR (START 10/14) 1 00 (15) ARTHUR MARTINEZ 1 00 0 0 0 CO CHAIR 2 00 (16) BARBARA MILLER 1 00 0 0 0 VICE CHAIR 2 00 (17) AMY MINELLA 1 00 0 0 0 DIRECTOR 2 00 (18) JACK M1TCHELL 1 00 0 0 0 DIRECTOR 1 00 (19) DANIEL MOSLEY 1 00 0 0 0 CHAIRMAN (END 10/14) 4 00 (20) CHRISTOPHER 1 00 35,936 1,161,907 379,455 DIRECTOR (START 10/14) 39 00 (21) VENITA OSTERER 1 00 0 0 0 DIRECTOR 1 00 (22) THOMAS PELLECHI 1 00 0 0 0 DIRECTOR (START 1/15) 1 00 (23) NORMAN ROTH 32 00 2,913,189 728,297 94,724 PRESIDENT (START 1/15) 8 00 (24) JIM SABETTA 39 00 380,023 0 82,974 DIRECTOR (START 1/15) 1 00 Form 990, Part VII - Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Inde Jendent Contractors (A) (B) (C) (D) (E) (F) Name and Average (do not check Reportable Reportable Estlmated amount hours per more than one box, unless compensatlon compensatlon of other week (IIst person IS both an of?cer from the from related compensatlon any hours and a dIrector/trustee) organlzatlon (W- organlzatlons (W- from the for related 3 I ?n organlzatlon and organlzatlons a; E. 3.1: 9 related below .1: 3 organlzatlons '1 3 II-I dotted Me) I: m, H- '1 a 15'? I: I: c.(26) JOHN SCHMELTZER 1 00 0 0 0 DIRECTOR 1 00 (1) JOHN TOWNSEND 1 00 0 0 0 CHAIR 3 00 (2) BRUCE WARWICK 1 00 0 0 0 DIRECTOR 1 00 (3) FELICE ZWAS 1 00 0 0 0 DIRECTOR (START 1/15) 1 00 (4) CHRISTINE BEECHNER 39 00 201,556 0 38,728 VP 1 00 (5) SUSAN BROWN 39 00 367,481 0 58,369 SENIOR VP 1 00 (6) EUGENE COLUCCI 32 00 520,442 130,110 208,413 SENIOR VP 8 00 (7) DEBORAH HODYS 39 00 445,709 0 38,692 VP 1 00 (8) MARC KOSAK 39 00 299,491 0 42,772 VP 1 00 (9) NANCY LEVII 1 00 425,164 0 150,143 SENIOR VP 39 00 (10) SPIKE LIPSCHUTZ MD 39 00 497,130 0 34,925 VP 1 00 (11) MELISSA TURNER 20 00 206,519 206,519 140,548 SENIOR VP 20 00 (12) BRIAN DORAN 40 00 596,437 0 223,383 SENIOR VP (END 5/2015) 0 00 (13) VICKI ALTM EYER 40 00 601,116 0 55,484 DIRECTOR OF PATHOLOGY 0 00 (14) RICHARD EISEN 40 00 552,489 0 55,702 DIRECTOR OF PATHOLOGY 0 00 (15) ERIC DIAMOND 40 00 461,807 0 57,272 PATHOLOGIST 0 00 (16) DOROTHY BLACKMUN 40 00 469,981 0 29,966 PATHOLOGIST 0 00 (17) STEPHEN JONES 40 00 390,661 0 61,605 CHIEF SAFETY 0 00 (18) QUINTON FRIESEN 00 278,684 0 0 FORMER OFFICER (9/2012) 0 00 Iefile GRAPHIC print - DO NOT PROCESS As Filed Data - DLN: 93493224007096I 0 MB No 1545-0047 SCHEDULE A Public Charity Status and Public Support (Form 990 990EZ) Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) 20 1 4 nonexempt charitable trust. Department of the It Attach to Form 990 or Form 990-EZ. Open to Public Treasury Information about Schedule A (Form 990 or 990-EZ) and its instructions is at I . Internal Revenue Sewice Name of the organization Employer identification number GREENWICH HOSPITAL 06-0646659 Reason for Public Charity Status (All organizations must complete this part.) See instructions. The organization is not a private foundation because it is (For lines 1 through 11, check only one box) 1 A church, convention ofchurches, or assomation ofchurches described in section 2 A school described in section (Attach Schedule 3 I7 A hospital or a cooperative hospital serVIce organization described in section 4 A medical research organization operated in conjunction With a hospital described in section Enter the hospital's name, City, and state 5 An organization operated for the benefit ofa college or univerSIty owned or operated by a governmental unit described in section (Complete Part II 6 A federal, state, or local government or governmental unit described in section 7 An organization that normally receives a substantial part ofits support from a governmental unit orfrom the general public described in section (Complete Part II 8 A community trust described in section 170(b)(1)(A)(vi) (Complete Part II 9 An organization that normally receives (1) more than 331/30/0 of its support from contributions, membership fees, and gross receipts from actIVIties related to its exempt functions?subject to certain exceptions, and (2) no more than 331/30/0 of its support from gross investment income and unrelated busmess taxable income (less section 511 tax) from busmesses achIred by the organization afterJune 30, 1975 See section 509(a)(2). (Complete Part 10 An organization organized and operated excluswely to test for public safety See section 509(a)(4). 11 An organization organized and operated exc u5ive y for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2) See section 509(a)(3). Check the box in lines 11a through 11d that describes the type ofsupporting organization and complete lines 11e, 11f, and 119 a Type I. A supporting organization operated, superVIsed, or controlled by its supported organization(s), typically by giVing the supported organization(s) the powerto regularly appomt or elect a majority ofthe directors or trustees ofthe supporting organization You must complete Part IV, Sections A and B. Type II. A supporting organization superVIsed or controlled in connection With its supported organization(s), by haying control or management of the supporting organization vested in the same persons that control or manage the supported organization(s) You must complete Part IV, Sections A and C. Type functionally integrated. A supporting organization operated in connection With, and functionally integrated With, its supported organization(s) (see instructions) You must complete Part IV, Sections A, D, and E. Type non-functionally integrated. A supporting organization operated in connection With its supported organization(s) that is not functionally integrated The organization generally must satisfy a distribution reqUIrement and an attentiveness reqUIrement (see instructions) You must complete Part IV, SectionsA and D, and Part V. Check this box ifthe organization received a written determination from the IRS that it is a Type I, Type II, Type functionally integrated, orType non-functionally integrated supporting organization Enter the number ofsupported organizations . . . . . . . . Prowde the followmg information about the supported organization(s) (i)Name ofsupported (ii) EIN Type of (iv) Is the organization Amount of (vi) Amount of organization organization listed in your governing monetary support other support (see (described on lines document? (see instructions) instructions) 1- 9 above section (see instructions)) Yes No Total For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ. Cat N0 11285F ScheduleA(Form 990 or 990-EZ) 2014 ScheduleA (Form 990 or990-EZ)2014 Page2 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 If the organization fails to qualify under the tests listed below, please complete Part Section A. Public Support Calendar year (or fiscal year beginning 1 6 in)I'* (a)2010 (b)2011 2012 (d)2013 (e)2014 (f)Tota Gifts, grants, contributions, and membership fees received (Do not include any "unusual grants Tax revenues evred forthe organization's benefit and either paid to or expended on its behalf The value ofserVIceS or faCIlitieS furnished by a governmental unit to the organization Without charge Total.Add lines 1 through 3 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 1 1, column Public support. Subtract line 5 from line 4 Section B. Total Support Calendar year (or fiscal year beginning 7 8 10 11 12 13 (a)2010 (b)2011 2012 (d)2013 (e)2014 (f)Tota Amounts from line 4 Gross income from interest, leldendS, payments received on securities loans, rents, royalties and income from Similar sources Net income from unrelated busmess actIVItieS, whether or not the busmess IS regularly carried on Other income Do not include gain or loss from the sale ofcapital assets (Explain in Part VI) Total support Add lines 7 through 14 15 16a 10 Gross receipts from related actIVItieS, etc (see instructions) 12 First five years. Ifthe Form 990 IS for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, checkthiS box and stop here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Section C. Computation of Public Support Percentage Public support percentage for 2014 (line 6, column lelded by line 11, column 14 Public support percentage for 2013 Schedule A, Part II, line 14 15 33 1/3?/o support test?2014.Ifthe organization did not check the box on line 13, and line 14 IS 33 1/3% or more, check this box and stop here. The organization qualifies as a publicly supported organization 33 1/3?/o support test?2013.Ifthe organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this box and stop here.The organization qualifies as a publicly supported organization 17a 18 organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and ifthe organization meets the "facts-and-CIrcumstanceS" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-Circumstances" test The organization qualifies as a publicly supported organization organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 IS 10% or more, and ifthe organization meets the "facts-and-CIrcumstanceS" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-CIrcumstanceS" test The organization qualifies as a publicly supported organization Private foundation. Ifthe organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see instructions Schedule A (Form 990 or 990-EZ) 2014 ScheduleA (Form 990 or990-EZ)2014 Page3 Support Schedule for Organizations Described in Section 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.) Section A. Public Support Calendar year (or fiscal year beginning 1 7a 8 in)F 2010 2011 (c)2012 2013 2014 Total Gifts, grants, contributions, and membership fees received (Do not include any "unusual grants Gross receipts from merchandise sold or serVIces performed, orfaCIlities furnished in any actIVIty that is related to the organization's tax-exempt purpose Gross receipts from actIVIties that are not an unrelated trade or busmess under section 513 Tax revenues leVIed forthe organization's benefit and either paid to or expended on its behalf The value ofserVIces or faCIlities furnished by a governmental unit to the organization Without charge Total.Add lines 1 through 5 Amounts included on lines 1, 2, and 3 received from disqualified persons Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of$5,000 or 1% ofthe amount on line 13 for the year Add lines 7a and 7b Public support (Subtract line 7c from line 6 Section B. Total Support Calendar year (or fiscal year beginning 9 10a 11 12 13 14 2010 2011 (c)2012 2013 2014 (f)Tota Amounts from line 6 Gross income from interest, diVidends, payments received on securities loans, rents, royalties and income from Similar sources Unrelated busmess taxable income (less section 511 taxes) from busmesses achIred after June 30, 1975 Add lines 10a and 10b Net income from unrelated busmess actIVIties not included in line 10b, whether or not the busmess is regularly carried on Other income Do not include gain or loss from the sale of capital assets (Explain in Part VI) Total support. (Add lines 9, 10c, 11, and 12) First five years. Ifthe 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 Section C. Computation of Public Support Percentage 15 Public support percentage for 2014 (line 8, column lelded by line 13, column 15 16 Public support percentage from 2013 Schedule 15 15 Section D. Computation of Investment Income Percentage 17 Investment income percentage for 2014 (line 10c, column lelded by line 13, column 17 18 Investment income percentage from 2013 Schedule A, Part line 17 13 19a 33 1/3?/o support tests?2014.Ifthe organization did not check the box on line 14, and line 15 is more than 33 and line 17 is not more than 33 check this box and stop here. The organization qualifies as a publicly supported organization 33 1/3?/o support tests?2013.Ifthe organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 check this box and stop here. The organization qualifies as a publicly supported organization Fl? 20 Private foundation. Ifthe organization did not check a box on line 14, 19a, or 19b, check this box and see instructions Schedule A (Form 990 or 990-EZ) 2014 Schedule A (Form 990 or 990-EZ) 2014 Part IV Supporting Organizations (Complete only ifyou checked a box on line 11 ofPartI Ifyou checked 11a ofPart I, complete Sections A and Ifyou checked 11b ofPart I, complete Sections A and Ifyou checked 11c ofPart I, complete Sections A, D, and Ifyou checked 11d ofPart I, complete Sections A and D, and complete Part V) Section A. All Supporting Organizations Page 4 1 3a 5a Are all ofthe 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 de5ignated by class or purpose, describe the deSignation. If historic and continumg relationship, explain. Did the organization have any supported organization that does not have an IRS determination ofstatus under section 509 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). Did the organization have a supported organization described in section 501(c)(4), (5), or If "Yes," answer and below. 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,"describein Part VI when and how the organization made the determination. Did the organization ensure that all support to such organizations was used excluswely for section 170(c)(2)(B) purposes? If "Yes,"explain in Part VI what controls the organization put in place to ensure such use. Was any supported organization not organized in the United States ("foreign supported organization")? If ?Yes? and if you checked lie or 11b in Part I, answer and below. 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. 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 If ?Yes,?explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used excluswely for section 170(c)(2)(B) purposes. Did the organization add, substitute, or remove any supported organizations during the tax year? If ?Yes,?answer and below (if applicable). Also, prowde detail in Part VI, including the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, the authority under the organization?s organizmg document authorizmg such action, and (iv) how the action was accomplished (such as by amendment to the organizmg document). Type I or Type II only. Was any added or substituted supported organization part ofa class already deSIgnated in 9a 10a 11 the organization's organi2ing document? Substitutions only. Was the substitution the result ofan event beyond the organization's control? Did the organization prowde support (whether in the form ofgrants or the prOVI5ion ofserVIces or faCIlities) to anyone otherthan its supported organizations, IndIVIdualS that are part of the charitable class benefited by one or more of its supported organizations, or other supporting organizations that also support or benefit one or more ofthe filing organization's supported organizations? If ?Yes,?prowde detail in Part VI. Did the organization prowde a grant, loan, compensation, or other Similar payment to a substantial contributor (defined in IRC a family member ofa substantial contributor, ora 35-percent controlled entity With regard to a substantial contributor? If ?Yes,?complete PartI of ScheduleL (Form 990). Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If ?Yes, complete Part II of Schedule (Form 990). 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 or If ?Yes,?provrde detail in Part VI. Did one or more disqualified persons (as defined in line hold a controlling interest in any entity in which the supporting organization had an interest? If ?Yes,?prOVide detail in Part VI. Did a disqualified person (as defined in line have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If ?Yes,?provrde detail in Part VI. Was the organization subJect to the excess busmess holdings rules 4943 because 4943(f) (regarding certain Type II supporting organizations, and all Type non-functionally integrated supporting organizations)? If ?Yes,?answerb below. Did the organization have any excess busmess holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess busmess holdings). Has the organization accepted a gift or contribution from any ofthe followmg persons? A person who directly or indirectly controls, either alone ortogether With persons described in and below, the governing body ofa supported organization? A family member ofa person described in above? A 35% controlled entity ofa person described in or above? If ?Yes to a, b, or c, prowde detail in Part VI10a 10b 11a 11b 11c Schedule A (Form 990 or 990-EZ) 2014 ScheduleA (Form 990 or990-EZ)2014 Page5 Part IV Supporting Organizations (continued) Section B. Type I Supporting Organizations Yes No 1 Did the directors, trustees, or membership ofone or more supported organizations have the power to regularly appomt 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, superwsed, 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 ofany supported organization other than the supported organization(s) that operated, superVIsed, or controlled the supporting organization? If ?Yes,?explain in Part VI how prowding such benefit carried out the purposes of the supported organization(s) that operated, superVised or controlled the supporting organization. Section C. Type II Supporting Organizations Yes No 1 Were a majority ofthe organization?s directors or trustees during the tax year also a majority of the directors or trustees ofeach ofthe 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 Supporting Organizations Yes No 1 Did the organization prowde to each of its supported organizations, by the last day ofthe fifth month ofthe organization?s tax year, (1) a written notice describing the type and amount ofsupport prowded during the prior tax year, (2) a copy ofthe Form 990 that was most recently filed as ofthe date of notification, and (3) copies of the organization?s governing documents in effect on the date of notification, to the extent not preVIously prowded? 1 2 Were any of the organization's officers, directors, or trustees either appomted or elected by the supported organization(s) or (ii) serVIng on the governing body ofa 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 ofthe relationship described in (2), did the organization?s supported organizations have a Significant mice in the organization?s investment and in directing the use ofthe 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 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 The organization satisfied the ActIVIties Test Complete line 2 below The organization is the parent ofeach of its supported organizations Complete line 3 below The organization supported a governmental entity Describe in Part VI how you supported a government entity (see instructions) 2 ActIVItIes Test Answer and below. Yes No a Did substantially all of the organization's actiVities during the tax year directly further the exempt purposes ofthe supported organization(s) to which the organization was responswe? 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 Did the actiVities described in 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 posrtion that its supported organization(s) would have engaged in these actiVities but for the organization?s involvement. 2b 3 Parent of Supported rganlzatlons Answer and below. a Did the organization have the power to regularly appomt or elect a majority ofthe officers, directors, or trustees of each ofthe supported organizations? PrOVide details in Part VI. 3a Did the organization exerCIse a substantial degree ofdirection overthe programs and actiVities ofeach of its supported organizations? If "Yes,? describe in Part VI the role played by the organization in this regard. 3b Schedule A (Form 990 or 990-EZ) 2014 Schedule A (Form 990 or 990-EZ) 2014 Page 6 Part Type Non-Functionally Integrated 509(a)(3) Supporting Organizations 1 Check here ifthe organization satisfied the Integral Part Test as a qualifying trust on Nov 20, 1970 See instructions. All other Type non-functionally integrated supporting organizations must complete Sections A through m-hWNl-l- Section A - Adjusted Net Income (A) Prior ear (B) Current Year (optional) Net short-term capital gain Recoveries of prior-year distributions Other gross income (see instructions) Add lines 1 through 3 m-hWNl-l- DepreCIation and depletion Portion ofoperating expenses paid or incurred for production or collection of gross income orfor management, conservation, or maintenance of property held for production ofincome (see instructions) 01 Other expenses (see instructions) 7 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8 A @NmU'l Q?u??i Section - Minimum Asset Amount (A) Prior Year (B) Current Year (optional) Aggregate fair market value ofall non-exempt-use assets (see instructions for short tax year or assets held for part ofyear) 1 Average value ofsecurities 1a Average cash balances 1b Fair market value of other non-exempt-use assets 1c Total (add lines 1a, 1b, and 1c) 1d Discount claimed for blockage or other factors (explain in detail in Part VI) AchISItion indebtedness applicable to non-exempt use assets Subtract line 2 from line 1d Cash deemed held for exempt use Enter 1-1/2% of line 3 (for greater amount, see instructions) Net value of non-exempt-use assets (subtract line 4 from line 3) Multiply line 5 by 035 Recoveries of prior-year distributions GNOIM-B Minimum Asset Amount (add line 7 to line 6) Section - Distributable Amount Adjusted net income for prior year (from Section A, line 8, Column A) Enter 85% ofline 1 Minimum asset amount for prior year (from Section B, line 8, Column A) Enter greater ofline 2 orline 3 Income tax imposed in prior year Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) Check here if the current year is the organization's first as a non-functionally-integrated Type supporting organization (see instructions) Current Year m-hWNI-l- Schedule A (Form 990 or 990-EZ) 2014 Schedule A (Form 990 or 990-EZ) 2014 Page 7 Section - Distributions Current Year 1 Amounts paid to supported organizations to accomplish exempt purposes 2 Amounts paid to perform actIVIty that directly furthers exempt purposes ofsupported organizations, in excess of income from actIVIty 3 Administrative expenses paid to accomplish exempt purposes ofsupported organizations 4 Amounts paid to achIre exempt-use assets 5 Qualified set-aSIde amounts (prior IRS approval reqUIred) 6 Other distributions (describe in Part VI) See instructions \l Total annual distributions. Add lines 1 through 6 8 Distributions to attentive supported organizations to which the organization is responswe (prowde details in Part VI) See instructions 9 Distributable amount for 2014 from Section C, line 6 10 Line 8 amount lelded by Line 9 amount Section - Distribution Allocations (see (ii) instructions) Excess Distributions Undegtls-tzr?T?i?t ions Distributable Amount for 2014 1 Distributable amount for 2014 from Section C, line 6 2 Underdistributions, ifany, for years prior to 2014 (reasonable cause reqUIred--see instructions) 3 Excess distributions carryover, ifany, to 2014 From 2009. From 2010. From 2011. From 2012. From 2013. . Total oflines 3a through 9 Applied to underdistributions of prior years Applied to 2014 distributable amount i Carryoverfrom 2009 not applied (see instructions) Remainder Subtract lines 39, 3h, and 3i from 3f 4 Distributions for 2014 from Section D, line 7 a Applied to underdistributions of prior years Applied to 2014 distributable amount Remainder Subtract lines 4a and 4b from 4 5 Remaining underdistributions for years prior to 2014, ifany Subtract lines 39 and 4a from line 2 (ifamount greater than zero, see instructions) 6 Remaining underdistributions for 2014 Subtract lines 3h and 4b from line 1 (ifamount greaterthan zero, see instructions) 7 Excess distributions carryover to 2015. A dd lines 3] and 4c 8 Breakdown ofline 7 From 2010. From 2011. From 2012. From 2013. From 2014. Schedule A (Form 990 or 990-EZ) (20 14) ScheduleA (Form 990 or990-EZ)2014 Page8 Supplemental Information. Prowde the explanations reqUIred by Part II, line 10; Part II, line 17a or 17b; Part line 12; Part IV, Section A, lines 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 Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions). Facts And Circumstances Test Return Reference Explanation Schedule A (Form 990 or 990-EZ) 2014 Iefile GRAPHIC print - DO NOT PROCESS IAs Filed Data - DLN: 93493224007096I SCHEDULE Political Campaign and Lobbying Activities 0MB N0 1545-0047 (Form 990 or 990452) For Organizations Exempt From Income Tax Under section 501 and section 527 201 4 Department ofthe Treasury Ir Complete if the organization is described below. II- Attach to Form 990 or Form 990-EZ. Ir Information about Schedule (Form 990 or 990-EZ) and its instruct ions is at Open to Public Internal Revenue Seniice . . Ins I ection If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 99042, Part V, line 46 (Political Cam paign Activities), then I- Section 501(c)(3) organizations Complete Parts I-A and Do not complete Part I-C in Section 501(c) (other than section 501(c)(3)) organizations Complete Parts I-A and below Do not complete Part I-B a Section 527 organizations Complete Part I-A only If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 99042, Part VI, line 47 (Lobbying Activities), then in Section 501(c)(3) organizations that have filed Form 5768 (election under section Complete Part II-A Do not complete Part a Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)) Complete Part Do not complete Part II-A If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 99042, Part V, line 35c (Proxy Tax) (see separate instructions), then a Section 501(c)(4), (5), or (6) organizations Complete Part Name ofthe organization Employer identification number GREENWICH 06-0646659 Complete if the organization is exempt under section 501(c) or is a section 527 organization. 1 Prowde a description of the organization's direct and indirect political campaign actIVIties in Part IV 2 Political expenditures b- 3 Volunteer hours Part I-B Complete if the organization is exempt under section 501(c)(3). 1 Enter the amount ofany eXCIse tax incurred by the organization under section 4955 h- 2 Enter the amount ofany eXCIse tax incurred by organization managers under section 4955 h- 3 Ifthe organization incurred a section 4955 tax, did it file Form 4720 forthis year? Yes No 4a Was a correction made? Yes No If"Yes,"describeinPartIV 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 Ir 2 Enter the amount ofthe filing organization's funds contributed to other organizations for section 527 exempt function actIVIties Ir 3 Total exempt function expenditures Add lines 1 and 2 Enter here and on Form 1120-PO L, line 17b Did the filing organization file Form 1120-POL for this year? Yes No 5 Enter the names, addresses and employer identification number (EIN)ofa 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 and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC) Ifadditional space is needed, prowde information in Part IV Name (b)Address (C) EIN (d)Amount paid from (e)Amount 0f political filing organization's contributions received funds Ifnone, enter -0- and and directly delivered to a separate political organization Ifnone, enter-0- For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ. Cat No 500345 Schedule (Form 990 or 990-52) 2014 Schedule (Form 990 or 990-EZ) 2014 Page 2 Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)). A Check h- ifthe filing organization belongs to an affiliated group (and list In Part IV each affiliated group member's name, address, EIN, expenses, and share ofexcess lobbying expenditures) Check h- ifthe filing organization checked box A and "limited control" apply Limits on Lobbying Expenditures or?aaglgl?rogm 3:33?? (The term "expenditures" means amounts paid or incurred.) totals totals 1a Total lobbying expenditures to influence public opinion (grass roots lobbying) Total lobbying expenditures to influence a legislative body (direct lobbying) Total lobbying expenditures (add lines 1a and 1b) Other exempt purpose expenditures Total exempt purpose expenditures (add lines 1c and 1d) Lobbying nontaxable amount Enter the amount from the followmg table in both columns If the amount on line 1e, column or is: The lobbying nontaxable amount is: Not over $500,000 20% 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 Grassroots nontaxable amount (enter 25% ofline if) Subtract line 1g from line 1a Ifzero or less, enter-0- i Subtract line 1ffrom line 1c Ifzero or less, enter-0- Ifthere is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax forthis year? _Yes No 4-Year Averaging Period Under section 50 1(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) 7-011 ?0 7-012 (c)2013 (d)2014 Total 2a Lobbying nontaxable amount Lobbying ceiling amount (150% ofline 2a, column(e)) Total lobbying expenditures Grassroots nontaxable amount Grassroots ceiling amount (150% ofline 2d, column Grassroots lobbying expenditures Schedule (Form 990 or 990-EZ) 2014 ScheduleC (Form 990 or990-EZ)2014 Page3 Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)). For each "Yes response to lines 1a through 1i below, prowde in Part IV a detailed description of the lobbying actiwty. Yes No 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 Paid staff or management (Include compensation In expenses reported on lines 1c through Yes Media advertisements? No Mailings to members, legislators, orthe public? Yes 500 Publications,or published or broadcast statements? No Grants to other organizations for lobbying purposes? No 9 Direct contact With legislators, their staffs, government offICIals, or a legislative body? Yes 54,624 lectures,or any Similar means? No i Other actIVItIes? Yes 61,305 Total Add lines 1c through 1I 116,429 2a Did the actIVItIes In line 1 cause the organization to be not described In section 501(c)(3)? I No If "Yes," enter the amount ofany tax Incurred under section 4912 If "Yes," enter the amount ofany tax Incurred by organization managers under section 4912 Ifthe fIlIng organization Incurred a section 4912 tax, dId It file Form 4720 for this year? I 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 the organization make only In-house lobbying expenditures of$2,000 or less? 2 3 the organization agree to carry over lobbying and political expenditures from the prior year? 3 Part Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either BOTH Part lines 1 and 2, are answered "No" 0R Part line 3, is answered ?Yes." 5 Dues, assessments and Similar amounts from members Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid). Current year Carryover from last year Total Aggregate amount reported In section 6033(e)(1)(A) notices of nondeductible section 162(e) dues 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? Taxable amount oflobbyIng and political expenditures (see Instructions) 1 2a 2b 2c Part IV Supplemental Information 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 line 1 Also, complete thIs part for any additional Information Return Reference Explanation PART II-B, LINE 1 MEDICAL GROUP EIN 06-1330992 51,985 THE AMOUNT REPORTED IN REPRESENTS A PORTION OF PROFESSIONAL DUES ATTRIBUTABLE TO LOBBYING DURING FY 2015 HEALTH SYSTEM OFFICIALS HAD MEETINGS AND CONTACTS WITH STATE GOVERNMENT STATE LEGISLATORS AND THEIR STAFF TO DISCUSS VARIOUS HEALTH CARE REFORM PROPOSALS GREENWICH HOSPITAL IS PART OF A CONTROLLED GROUP WITH THE FOLLOWING LOBBYING EXPENSES YALE-NEW HAVEN HOSPITAL EIN 06- 0646652 $771,458 BRIDGEPORT HOSPITAL EIN 06-0646554 $149,774 NORTHEAST Schedule (Form 990 or 990EZ) 2014 ScheduleC (Form 990 or990-EZ)2013 Page4 Su lemental Information continued Return Reference Explanation Schedule (Form 990 or 990EZ) 2014 Iefile GRAPHIC print - DO NOT PROCESS IAs Filed Data - DLN: 93493224007096I . . OMB No 1545-0047 SCHEDULE Supplemental FInanCIal Statements (Form 990) hr Complete if the organization answered "Yes," to Form 990, Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b. Department ofthe Treasury Attach to Form 990- Open to Public Inlemal Revenue Servrce Information about Schedule (Form 990) and its instructions is at Inspection Name of the organization Employer identification number GREENWICH HOSPITAL 06-0646659 Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete If the organIzatIon answered "Yes" to Form 990 Part IVDonor adVIsed funds Funds and other accounts Total number at end of year Aggregate value ofcontrIbutIons to (durIng year) Aggregate value ofgrants from (durIng year) Aggregate value at end ofyear the organIzatIon Inform all donors and donor adVIsors In ertIng that the assets held In donor adVIsed funds are the organIzatIon's property, subject to the organIzatIon's excluswe legal control? Yes No the organIzatIon Inform all grantees, donors, and donor adVIsors In ertIng that grant funds can be used only for charItable purposes and not for the bene?t ofthe donor or donor adVIsor, or for any other purpose conferrIng ImpermISSIble prIvate bene?t? Yes NO Conservation Easements. Complete If the organlzatIon answered ?Yes? to Form 990, Part IV, Ine 7. 1 Purpose(s) ofconservatIon easements held by the organIzatIon (check all that apply) PreservatIon ofland for pubIIc use (e recreatIon or educatIon) PreservatIon ofan historically Important land area ProtectIon of natural habItat PreservatIon ofa certIerd hIstorIc structure PreservatIon ofopen space Complete Ines 2a through 2d Ifthe organlzatIon held a conservatIon contrIbutIon In the form ofa conservatIon easement on the last day ofthe tax year Held at the End of the Year Total number ofconservatIon easements 2a Total acreage restrIcted by conservatIon easements 2b Number ofconservatlon easements on a certIerd hIstorIc structure Included In 2c Number ofconservatlon easements Included In achIred after 8/17/06, and not on a hIstorIc structure Isted In the NatIonal RegIster 2d Number ofconservatIon easements modIerd, transferred, released, extIngUIshed, or termInated by the organIzatIon durIng the tax year Ir Number ofstates where property subject to conservatIon easement Is located II- Does the organIzatIon have a ertten pollcy regardIng the perIodIc monItorIng, InspectIon, handIIng ofVIolatIons, and enforcement ofthe conservatIon easements It holds? Yes No Staff and volunteer hours devoted to monItorIng, InspectIng, and enforCIng conservatIon easements durIng the year II- Amount ofexpenses Incurred In monItorIng, InspectIng, and enforcmg conservatIon easements durIng the year Does each conservatIon easement reported on Me 2(d) above satIsfy the reqUIrements ofsectIon and sectIon Yes No In Part descrIbe how the organIzatIon reports conservatIon easements In Its revenue and expense statement, and balance sheet, and Include, IfappIIcable, the text of the footnote to the organIzatIon?s fInanCIal statements that descrIbes the organIzatIon?s accountIng for conservatIon easements Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets. 1a Complete If the organrzatron answered ?Yes" to Form 990, Part IV, Me 8. Ifthe organIzatIon elected, as permItted under SFAS 116 (ASC 958), not to report In Its revenue statement and balance sheet works ofart, hIstorIcal treasures, or other assets held for pubIIc ethbItIon, educatIon, or research In furtherance of pubIIc serVIce, prOVIde, In Part the text ofthe footnote to Its fInanCIal statements that descrIbes these Items Ifthe organIzatIon elected, as permItted under SFAS 116 (ASC 958), to report In Its revenue statement and balance sheet works ofart, hIstorIcal treasures, or other assets held for pubIIc ethbItIon, educatIon, or research In furtherance of pubIIc serVIce, prowde the followmg amounts relatIng to these Items Revenue Included In Form 990, Part Me 1 Ir (ii)Assets IncludedIn Form 990,PartX hr$ Ifthe organIzatIon recered or held works ofart, hIstorIcal treasures, or other assets for fInanCIal gaIn, prowde the followmg amounts reqUIred to be reported under SFAS 116 (ASC 958) relatIng to these Items RevenueIncludedIn Form Ir$ Assets IncludedIn Form 990,PartX For Paperwork Reduction Act Notice, see the Instructions for Form 990Schedule (Form 990) 2014 Schedule (Form 990) 2014 Manizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued) 3 Page 2 Usmg the organIzatIon's achISItIon, acceSSIon, and other records, check any ofthe followmg that are a SIgnIfIcant use of Its collection Items (check all that apply) PubIIc ethbItIon Scholarly research PreservatIon forfuture generations Loan or exchange programs Other 4 a description of the organIzatIon's collections and explaIn how they further the organIzatIon?s exempt purpose In Part 5 DurIng the year, did the organization so ICIt or receive donations ofart, historical treasures or other Similar assets to be sold to raise funds ratherthan to be maintaIned as part ofthe organIzatIon?s collectIon'? Yes No Escrow and Custodial Arrangements. Complete If the organization answered ?Yes" to Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21. 1a Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not Included on Form 990,Part I_Yes _No If "Yes," explaIn the arrangement In Part and complete the followmg table Amount Beginning balance 1c Additions durIng the year 1d Distributions during the year 1e EndIng balance 1f 2a Did the organization Include an amount on Form 990,Part X, Ine 21,forescroworcustodIal I_Yes If"Yes," explaIn the arrangement In Part Check here Ifthe explanation has been prOVIded In Part Part Endowment Funds. Complete If the organization answered ?Yes" to 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 ofyear balance 87,493,000 78,904,000 72,853,000 64,905,000 69,106,000 ContrIbutIons 388,000 925,000 125,000 100,000 45,000 NetInvestment earnIngs,gaIns,and losses ?783,000 10,828,000 8,395,000 10,512,000 ?1,833,000 Grants or scholarships Other EXpendltures for 413 000 and programs I AdmInIstratIve expenses 9 End ofyear balance 83,683,000 87,493,000 78,904,000 72,853,000 64,905,000 2 the estImated percentage ofthe current year end balance (line lg, column held as a Board deSIgnated or quaSI-endowment II- 51 900 0/0 Permanent endowment II- 28 200 0/0 TemporarIIy restrIcted endowment hr 19 900 0/0 The percentages In lines 2a, 2b, and 2c should equal 100% 3a Are there endowment funds not In the posseSSIon ofthe organIzatIon that are held and admInIstered for the organIzatIon by Yes No unrelated organizations 3a(i) No (ii) related organizations . . . . . . . . . . . . . . 3a(ii) Yes If"Yes" to are the related organIzatIons listed as reqUIred on Schedule 3b Yes 4 DescrIbe In Part the Intended uses ofthe organIzatIon's endowment funds Land, Buildings, and Equipment. Complete If the organIzatIon answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10. Description of property Cost or other (b)Cost or other Accumulated Book value (Investment) (other) depreCIatIon 1a Land 6,333,484 6,333,484 230,622,802 80,812,632 149,810,170 Leasehold Improvements 27,436,281 10,111,943 17,324,338 EqUIpment 178,820,075 140,890,177 37,929,898 Other . . . . . . . . . . . . . . . 4,578,312 4,578,312 Total. Add lInes 1a through 1e (Column must equal Form 990, Part X, column (3), ?ne Ir 215,976,202 Schedule (Form 990) 2014 Schedule (Form 990)2014 Page3 Investments?Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12. Description ofsecurity or category (b)Book value Method ofvaluation (including name ofsecurity) Cost or end-of?year market value (1 )FinanCIal derivatives (2)Closely-held eqUIty interests (3)0ther SECURITIES 88,158,568 Total. (Column must equal Form 990, PartX, col (B) line 12) 88,1 58,568 Investments?Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13. Description of investment Book value Method ofvaluation Cost or end-of?year market value Total. (Column must equal Form 990, PartX, col (B) line 13) Other Assets. Complete ifthe organization answered 'Yes' to Form 990, Part IV, line 11d See Form 990, Part X, line 15 Description Book value RECEIVABLES 26,257,118 SHARED PROJECT 9,274,431 Total. (Column must equal Form 990, Part X, col.(B) line 15II- 35,531,549 Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25. 1 Description ofliability Book value Federal income taxes DUE-3RD PARTY PAYORS 11,228,517 EST LIABILITY-SELFINSURANCE 18,647,236 FORWARDINTEREST RATE SWAP 4,108,253 ACCRUED PENSION 42,786,988 Total. (Column must equal Form 990, PartX, col (B) line 25) p. 76,770,994 2. Liability for uncertain tax pOSItions In Part prowde the text ofthe footnote to the organization's finanCIal statements that reports the organization's liability for uncertain tax p05itions under FIN 48 (ASC 740) Check here ifthe text ofthe footnote has been prowded in Part 7 Schedule (Form 990) 2014 Schedule (Form 990) 2014 Page 4 Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete If the organization answered 'Yes' to Form 990, Part IV, lIne 12a. Total revenue, gaIns, and other support per audIted fInanCIal statements 1 355,025,126 2 Amounts Included on Me 1 but not on Form 990, Part Me 12 a Net unreaIIzed gaIns (losses) on Investments 2a -8,465,884 Donated serVIces and use of 2b RecoverIes of prIor year grants 2c Other (DescrIbe In Part 2d 9,279,584 Add lInes 2a through 2d 2e 813,700 3 Subtract lIne 2e from Me 1 3 354,211,426 4 Amounts Included on Form 990, Part Investment expenses not Included on Form 990, Part lIne 7b 4a Other (DescrIbe In Part 4b 11,696,386 AddlInes4aand 4b 4c 11,696 ,386 5 Totalrevenue Add lInes 3and4c (ThIs must equalForm 990 PartI, Me 12 5 365 9,07 8,12 Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete If the organIzatIon answered 'Yes' to Form 990, Part IV, IIne 12a. 1 Total expenses and losses per audIted fInanCIal statements 1 328,168,956 2 Amounts Included on Me 1 but not on Form 990, Part IX, Me 25 a Donated serVIces and use 2a PrIor year adjustments 2b Otherlosses 2c Other (DescrIbe In Part 2d 1,003,050 Add lInes 2a through 2d 2e 1,003,050 3 SubtractIIne 2e fromIIne 1 3 327,165,906 4 Amounts Included on Form 990, Part IXInvestment expenses notIncluded on Form 7b . . 4a Other (DescrIbe In Part 4b 4,865,235 AddlInes4aand 4b 4c 4,865,235 Total expenses Add lInes 3and 4c. (ThIs must equal Form 990, PartI332,031,141 Supplemental Information the descrIptIons requIred for Part II, lInes 3, 5, and 9, Part lInes 1a and 4, Part IV, lInes 1b and 2b, Part V, Me 4, Part X, Me 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 ENDOWED INTENDED USE IS TO GENERATE INCOME TO SUPPORT GREENWICH HOSPITAL PROGRAM SERVICE FUNCTIONS AND OTHER OPERATIONS IN ACCORDANCE WITH THE GREENWICH HOSPITAL POOLED INVESTMENT POLICY PART X, LINE 2 THE CONSOLIDATED FINANCIAL STATEMENTS OF GREENWICH HOSPITAL INCLUDE THE FOLLOWING FIN48 DISCLOSURE THE HOSPITAL IS A NOT FOR PROFIT CORPORATION AS DESCRIBED IN SECTION OF THE INTERNAL REVENUE CODE (THE IS EXEMPT FROM FEDERALINCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501 CODE THE HOSPITAL ALSO IS EXEMPT FROM STATE INCOME TAX THERE ARE CERTAIN TRANSACTIONS THAT COULD BE DEEMED BUSINESS INCOME AND WOULD RESULT IN A TAX LIABILITY MANAGEMENT REVIEWS TRANSACTIONS TO ESTIMATE POTENTIALTAX LIABILITIES USING A THRESHOLD OF MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINABLE BASED ON THE MERITS OFTHE POSITION IT IS ESTIMATION THAT THERE ARE NO MATERIALTAX LIABILITIES THAT NEED TO BE RECORDED PART XI, LINE 2D - OTHER INCOME FROM FOUNDATION RECOGNIZED ON SEPARATE RETURN 4,496,374 NET ASSETS ADJUSTMENTS RELEASED FROM OPERATIONS 4,783,198 MISCELLANEOUS 12 PART XI, LINE 4B - OTHER RECLASS FROM EXPENSE - GAIN ON SALE OFASSETS 23,530 AUXILIARY REVENUE ADJUSTMENTS 1,174,724 CONTRIBUTIONS FROM TEMPO RARILY RESTRICTED 5,358,000 RENTAL EXPENSES - RECLASS FROM EXPENSES TO REVENUE -75,747 GAIN FROM SALE OF SECURITIES 1,956,000 RECLASS TO EXPENSE - NON-OPS 3,259,879 PART XII, LINE 2D - OTHER RECLASS - GAIN ON SALE OF ASSETS SPECIAL EVENTS RECLASS TO INCOME ADJUSTMENTS 950,833 RENTAL EXPENSES - RECLASS FROM EXPENSES TO REVENUE 75,747 PART XII, LINE 4B - OTHER AUXILIARY EXPENSES 654,523 FUNDRAISING EXPENSES FROM NON-OPERATING REVENUE ADJUSTMENTS 4,210,712 Schedule (Form 990) 2014 Schedule (Form 990)2013 Pages Su lemental Information continued Return Reference Explanation Schedule (Form 990) 2014 lefile GRAPHIC print - DO NOT PROCESS IAs Filed Data - DLN: 93493224007096 OMBN 1545-0047 SCHEDULEG Supplemental Information Regarding Form 990 or 990-Fundraismg or Gaming ActIVIties 201 4 Complete ifthe organization answered "Yes" to Form 990, Fan IV, lines 17, 18, or 19, or ifthe organization entered more than $15,000 on Fom1 line 6a. Deparlment Of the Treasury I'Attach to Form 990 or Form 990-EZ. Ope to Pu I Internal Revenue semce FInformation about Schedule (Fom1 990 or 990-EZ) and its instructions is at gov/form990. InspeCtlon a me of the rga izatio Employer identification number GREENWICH HOSPITAL 06-0646659 Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17. Form filers are not requured to complete this part. 1 Indicate whether the organization raised funds through any ofthe followmg actIVIties Check all that apply a Mail SOIICItations SOIICItation of non-government grants Internet and email SOIICItations SOIICItation ofgovernment grants Phone SOIICItations SpeCIal fundraismg events In-person SOIICItations 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 professmnal fundraismg serVIces? Yes No If"Yes," list the ten highest paid indiViduals or entities (fundraisers) pursuant to agreements under which the fundraiser is to be compensated at least $5,000 by the organization Name and address of (ii) ActIVIty Did (iv) Gross receipts Amount paid to (vi) Amount paid to indIVIdual fundraiser have from actIVIty (or retained by) (or retained by) or entity (fundraiser) custody or fundraiser listed in organization control of col contributionsList all states in which the organization is registered or licensed to contributions or has been notified it is exempt from registration or licensmg For Paperwork Reduction Act Notice, see the Instructions for Form 9900r 990-EZ. Cat No 50083H Schedule (Form 990 or 990-EZ) 2014 ScheduleG(Form 990 or990-EZ)2014 Page2 Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 of fundraismg event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events With gross receipts greater than $5,000. Event #1 Event #2 Other events Total events (add col through GALA UNDER THE STARS 1 col (event type) (event type) (total number) 1 Gross receipts 1,131,228 235,427 136,193 1,502,848 5 2 Less Contributions - - 1,032,528 195,227 96,193 1,323,948 a: 3 Gross income (line 1 minus line 2) . . . 98,700 40,200 40,000 178,900 4 Cash prizes 5 Noncash prizes 3 6 Rent/faCIlity costs . . 95,890 24,246 37,364 157,500 EL Ii 7 Food and beverages . 137,601 47,473 5,583 190,657 8 Entertainment . . . 9,000 4,355 3,500 16,855 5? 9 Other direct expenses . 318,980 210,765 56,076 585,821 10 Direct expense summary Add lines4 through 9 in column . . . . . . . . . . . It (950:833) 11 Netincome summary Subtractline 10 from line 3,column . . . . . . . . . . . #711933 Gaming. Complete if the organization answered ?Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form line 6a. Bingo Pull tabs/Instant Other gaming Total gaming (add 2 bingo/progresswe bingo col through col a: 1 Gross revenue 2 Cash prizes 3 Non-cash prizes 4 Rent/faculty costs E: 5 Other direct expenses Yes Yes Yes 6 Volunteer labor . . . No No No 7 Directexpensesummary Addline52through5incolumn(Netgamingincomesummary . . . . . . . . . It 9 Enter the state(s) in which the organization conducts gaming actIVIties Isthe organizationlicensedto conductgaming actIVIties in eachofthese states _Yes If"No," explain 10a Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year"Yes," explain Schedule (Form 990 or 990-EZ) 2014 ScheduleG(Form 990 or990-EZ)2014 Page3 Does the organization conduct gaming actIVIties With nonmembersthe organization a grantor, benefICIary or trustee ofa trust or a member ofa partnership or other entity formed to administer charitable gamingIndicate the percentage ofgaming actIVIties conducted in Theorganization'sfaCIlity . . . . . . . . . . . . . . . . . . . . . . 13a 0/0 0/0 Enter the name and address ofthe person who prepares the organization's gaming/speCIal events books and records Name!Ir Address I Does the organization have a contract With a third party from whom the organization receives gaming If "Yes," enter the amount ofgaming revenue received by the organization and the amount ofgaming revenue retained by the third party If "Yes," enter name and address of the third party Name? Address Gaming manager information Namel'" Gaming manager compensation Description ofserVIces prowded Director/officer Employee Independent contractor Mandatory distributions Is the organization reqUIred under state law to make charitable distributions from the gaming proceeds to retainthestategaminglicense _Yes _No 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!" Part IV Supplemental Information. Prowde the explanations reqUIred by Part I, line 2b, columns and and Part lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also prowde any additional information (see instructions). Return Reference Explanation Schedule (Form 990 or 990-EZ) 2014 lefile GRAPHIC print - DO NOT PROCESS As Filed Data - SCHEDULE (Form 990) Department of the Treasury Internal Revenue Senrlce OMB No 1545-0047 Hospitals II- Complete if the organization answered "Yes" to Form 990, Part IV, question 20. hr Attach to Form 990. Name of the organization GREENWICH HOSPITAL Ir Information about Schedule (Form 990) and its instructions is at Open to Public Inspection Employer identification number 06-0646659 Financial Assistance and Certain Other Community Benefits at Cost Yes No 1a the organIzatIon have a fInanCIal aSSIstance pollcy durIng the tax year? If"No," skIp to questIon 6a 1a Yes If"Yes," was It a ertten po Icy7 1b Yes 2 Ifthe organIzatIon had multIple hospItal IndIcate ofthe followmg best descrIbes appIIcatIon of the fInanCIal aSSIstance pollcy to Its various hospItal durIng the tax year I7 Applied unIformly to all hospItal ApplIed unIformly to most hospItal Generally taI ored to IndIVIdual hospItal 3 Answer the followmg based on the fInanCIal aSSIstance crIterIa that appIIed to the largest number of the organIzatIon's patIents durIng the tax year a the organIzatIon use Federal Poverty GUIdeIInes (FPG) as a factor In determInIng for prOVIdIng freecare? If "Yes," IndIcate ofthe followmg was the FPG famIIy Income for for free care 3a Yes 100% l? 150% l? 200% I7 Other 25000 0000000000 0/0 the organIzatIon use FPG as a factor In determInIng for prOVIdIng dIscounted care? If "Yes," IndIcate ofthe followmg was the famIIy Income for for dIscounted care 3b No l? 200% l? 250% l? 300% l? 350% l? 400% Other 0/0 Ifthe organIzatIon used factors otherthan FPG In determInIng descrIbe In Part VI the crIterIa used for determInIng 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 for free or dIscounted care 4 the organIzatIon's fInanCIal aSSIstance pollcy that appIIed to the largest number of Its patIents durIng the tax year prOVIde forfree or dIscounted care to the "medIcally IndIgent'?? . . . . . . . . . . . . 4 Yes 5a the organIzatIon budget amounts forfree 0r dIscounted care prowded under Its fInanCIal aSSIstance pollcy durIng the tax year? 5a Yes If "Yes," dId the organIzatIon's fInanCIal aSSIstance expenses exceed the budgeted amount? 5b Yes If "Yes" to Me 5b, as a result of budget conSIderatIons, was the organIzatIon unable to prowde free or dIscounted care to a patIent who was for free or dIscounted care? 5c No 6a the organIzatIon prepare a communIty bene?t report durIng the tax year? 6a Yes If"Yes," dId the organIzatIon make It avaIIable to the pubIIc7 6b Yes Complete the followmg table usmg the worksheets prowded In the Schedule Instructlons Do not sumet these worksheets WIth the Schedule 7 FInanCIal ASSIstance and CertaIn Other CommunIty Bene?ts at Cost Financial Assistance and Numberof Persons Total communIty DIrect offsettIng Net communIty benefIt Percent of Means-Tested aCt'V't'eS or served benefIt expense revenue expense total expense programs Government Programs (Uphonal) (Opt'ona') a FInanCIal ASSIstance at cost (from Worksheet 1) . 14,574 21,655,139 409,540 21,245,599 6 400 0/o MedIcaId (from Worksheet 3, column a) . . . . 27,502 25,377,016 12,699,959 12,677,057 3 820 Costs of other mea ns?tested government programs (from Worksheet 3, column b) . 0 0 0 Total FInanCIal ASSIstance and Means?Tested Government Programs 42,076 47,032,155 13,109,499 33,922,656 10 220 0/0 Other Benefits CommunIty health Improvement serVIces and communIty benefIt operatIons (from Worksheet 4) 17 20,525 841,407 25,000 816,407 0 250 Health profes5Ions educatIon (from Worksheet 5) 3 257 5,077,826 1,307,410 3,770,416 1 140 SubSIdIzed health serVIces (from Worksheet 6) . . 2 8,509 5,546,774 2,926,483 2,620,291 0 790 0/o Research (from Worksheet 7) 0 0 0 0 I Cash and In?kInd contrIbutIons for communIty bene?t (from Worksheet 8) 3 1,746 261,885 0 261,885 0 080 Total. Other Bene?ts 25 31,037 11,727,892 4,258,893 7,468,999 2 260 0/0 Total. Add IInes 7d and 7] 25 73,113 58,760,047 17,368,392 41,391,655 12 480 0/o For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat No 50192T Schedule (Form 990) 2014 Schedule (Form 990) 2014 Community Building Activities Complete this table If the organization conducted any community bUIIdlng actIVItIes during the tax year, and describe In Part VI how Its community bUIIdlng actIVItIes promoted the health of the communities It serves. Page 2 Number of Persons Total community Direct offsetting Net community Percent of actIVItIes or served (optional) budding expense revenue budding expense total expense programs (optional) 1 PhySIcal improvements and housmg 1 0 259,963 0 259,963 0 080 2 Economic development 1 0 8,193 0 8,193 0 3 Community support 0 0 0 0 4 EnVIronmental improvements 0 0 0 0 Leadership development and training for community members 0 0 0 0 5 Coalltlon bUIldIng 2 195 56,218 0 56,218 0 020 0/0 Community health improvement advocacy 0 0 0 0 3 Workforce development 1 39 5,703 0 5,703 0 9 Other 0 0 0 0 1? Total 5 234 330,077 330,077 0 100 0/0 Bad Debt, Medicare, 8: Collection Practices Section A. Bad Debt Expense Yes No 1 Did the organization report bad debt expense In accordance With Heathcare FInanCIal Management Assomatlon StatementN015Enter the amount ofthe organIzatIon's bad debt expense Explain In Part VI the methodology used by the organIzatIon to estimate thIs amount 2 12,337,894 3 Enter the estImated amount ofthe organIzatIon's bad debt expense attributable to patIents eIIgIble 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,forIncludIng thIs portion of bad debt as community benefit 3 0 4 In Part VI the text ofthe footnote to the organIzatIon's fInanCIal statements that describes bad debt expense or the page number on thIs footnote Is contained In the attached fInanCIal statements Section B. Medicare 5 Enter total revenue received from MedIcare (Including DSH and IME) 5 92,479,481 6 Enter MedIcare allowable costs ofcare relatIng to payments on Me 5 6 129,091,597 7 Subtract line 6 from line 5 ThIs Is the surplus (or shortfall) . . . 7 -36,612,116 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 I7 Cost accounting system Cost to charge ratIo Other Section C. Collection Practices 9a Did the organIzatIon have a written debt collectIon policy during the tax year? 9a Yes If "Yes," did the organIzatIon?s collectIon policy that appIIed 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 quaIIfy forfInanCIal aSSIstance? DescrIbe In Part VI 9b Yes Part IV Management Companies and Joint Venture5(owned 10% or more by officers, directors, trustees, key employees, and phySICIans?see Instructions) Name of entity Description of primary actIVIty of entity Organization's profit 0/0 or stock ownership Officers, directors, trustees, or key employees' profit 0/0 PhySICIans' profit 0/0 or stock ownership 0/0 or stock ownership 1 1 NONE NONE 1O 11 12 13 Schedule (Form 990) 2014 Schedule (Form 990) 2014 Page 2 Facility 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? 1 Name, address, primary webSIte address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital faCIlity) pesLiam?l 13 [maueg rend-30L: mud-aw BEE-E13313 [caning Llama-33H 133?53 Jaw?Ha Other (describe) FaCIlity reporting group See Additional Data Table Schedule (Form 990) 2014 Schedule (Form 990) 2014 Page 2 Facility Information (continued) Section B. Facility Policies and Practices (Complete a separate SectIon for each of the hospItal reportIng groups lIsted In Part V, SectIon A) GREENWICH 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 fIrst lIcensed, regIstered, or SImIIarly recognIzed by a State as a hospItal In the current tax year or the ImmedIately precedIng tax yearWas the hospItal acquIred or placed Into serVIce as a tax- exempt hospItal In the current tax year or the ImmedIately precedIng tax year? If?Yes,? prOVIde detalls ofthe achISItIon In SectIon . . . . 2 No 3 DurIng the tax year or eIther ofthe two ImmedIately precedIng tax years, dId the hospItal conduct a communIty health needs assessment If"No, skIp "Yes," IndIcate what the CHNA report descrIbes (check all that apply) a I7 A defInItIon ofthe communIty served by the hospItal '7 of the communIty '7 EXIstIng health care and resources WIthIn the communIty that are avaIIable to respond to the health needs of the communIty I7 How data was obtaIned '7 The 5IgnIfIcant health needs ofthe communIty '7 PrImary and chronIc dIsease needs and other health Issues ofunInsured persons, low-Income persons, and mInorIty groups 9 I7 The process for IdentIfyIng and prIorItIZIng communIty health needs and serVIces to meet the communIty health needs I7 The process for consultIng WIth persons the communIty?s Interests i '7 InformatIon gaps that lImIt the hospItal to assess the communIty?s health needs Other (descrIbe In SectIon C) 4 IndIcate the tax yearthe hospItal last conducted a CHNA 20 13 5 In conductIng Its most recent CHNA, dId the hospItal take Into account Input from persons who represent the broad Interests ofthe communIty served by the hospItal IncludIng those WIth speCIal knowledge oforexpertlse In pubIIc health? If "Yes, descrIbe In SectIon how the hospItal took Into account Input from persons who represent the communIty, and IdentIfy the persons the hospItal consultedWas the hospItal CHNA conducted WIth one or more other hospItal If' 'Yes, lIst the other hosp-Ital In SectIon . . . . . . . . 6a No Was the hospItal CHNA conducted WIth one or more organIzatIons other than hospItal If?Yes lIst the other organIzatIons In SectIon . . . . . . . . . . . . . . . . . 5b YES 7 the make Its CHNA report WIdely awvallable to the pubIIc2"Yes," IndIcate how the CHNA report was made WIdely avaIIable (check all that apply) I7 Hospltal webSIte (Ilst url) SEE PART V, SUPPLEMENTAL INFORMATION 7 OtherwebSIte (lIst url) SEE PART v, SUPPLEMENTAL INFORMATION '7 Made a paper copy avaIIable for pubIIc InspectIon WIthout charge at the hospItal Other (descrIbe In SectIon C) 8 the hospItal adopt an Implementatlon strategy to meet the 5IgnIfIcant communIty health needs Yes IdentIerd through Its most recently conducted If"No," skIp IndIcate the tax yearthe hospItal last adopted an Implementatlon strategy 20 13 Is the hospItal most recently adopted Implementatlon strategy posted on a webSIte? . 10 Yes a url) SEE PARTV, SUPPLEMENTALINFORMATION If"No, "Is the hospItal most recently adopted Implementatlon strategy attached to thIs returnDescrIbe In SectIon how the hospItal Is addressmg the SIgnIfIcant needs IdentIerd 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 the organIzatIon Incur an eXCIse tax under sectIon 4959 forthe hospItal faI ure to conduct a CHNA If' 'Yes" to Me 12a, dId the organIzatIon ?le Form 4720 to report the sectIon 4959 eXCIse tax'r?. . . . . . 12b If"Yes" to Me 12b, what Is the total amount ofsectIon 4959 eXCIse tax the organIzatIon reported on Form 4720 for all of Its hospItal Schedule (Form 990) 2014 Schedule (Form 990) 2014 Page 2 Facility Information (continued) GREENWICH HOSPITAL Name of hospital facility or letter of facility reporting group Yes No Financial Assistance Policy (FAP) the hospItal have In place durIng the tax year a ertten fInanCIal aSSIstance pollcy that 13 ExplaIned e IgIbI Ity crIterIa forfInanCIal aSSIstance, and whether such aSSIstance Included free or dIscounted care? 13 Yes If?Yes,? IndIcate the e IgIbI Ity crIterIa explaIned In the FAP a '7 Federal poverty QUIdeIInes (FPG), WIth FPG famIIy Income ?wt for e IgIbI Ity forfree care of 250 0000000000000/0 and FPG famIIy Income ?wt for e IgIbI Ity for dIscounted care of_% Income level other than FPG (descrIbe In SectIon C) Asset level MedIcal IndIgency '7 Insurance status I7 UnderInsurance dIscount '7 ReSIdency '7 Other (descrIbe In SectIon C) 14 ExplaIned the for calculatIng amounts charged to patIentsExplaIned the method for applyIng forfInanCIal aSSIstanceYes If?Yes,? IndIcate how the hospItal FAP or FAP appIIcatIon form (IncludIng InstructIons) explaIned the method for applyIng for fInanCIal aSSIstance (check all that apply) a '7 DescrIbed the InformatIon the hospItal may reqUIre an IndIVIdual to prowde as part oths or her appIIcatIon '7 DescrIbed the supportIng documentatlon the hospItal may reqUIre an IndIVIdual to sumet as part oths or her appIIcatIon '7 PrOVIded the contact InformatIon of hospItal staff who can prOVIde an IndIVIdual WIth InformatIon about the FAP and FAP appIIcatIon process '7 PrOVIded the contact InformatIon of nonpro?t organIzatIons or government agenCIes that may be sources of aSSIstance WIth FAP appIIcatIons Other (descrIbe In SectIon C) 16 Included measures to pubIICIze the pollcy WIthIn the communIty served by the hospItal . . . . . . . 16 Yes If"Yes," IndIcate how the hospItal the pollcy (check all that apply) a I7 The FAP was WIdely avaIIable on a webSIte (lIst url) SEE PART V, SUPPLEMENTAL INFORMATION SEE PART V, SUPPLEMENTAL '7 The FAP appIIcatIon form was WIdely avaIIable on a webSIte (IIst url) INFORMATION I7 A plaIn language summary of the FAP was WIdely avaIIable on a webSIte (IIst url) SEE PART V, SUPPLEMENTAL INFORMATION I7 The FAP was avaIIable upon request and WIthout charge (In pubIIc locatIons In the hospItal and by mall) I7 The FAP appIIcatIon form was avaIIable upon request and WIthout charge (In pubIIc locatIons In the hospItal and by maII) I7 A plaIn language summary of the FAP was avaIIable upon request and WIthout charge (In pubIIc locatIons In the hospItal and by mall) '7 NotIce of the FAP was conspIcuously dIsplayed throughout the hospItal '7 NotIerd members ofthe communIty who are most lIkely to reqUIre fInanCIal aSSIstance about ofthe FAP i Other (descrIbe In SectIon C) Billing and Collections 17 the hospItal have In place durIng the tax year a separate bIllIng and collectIons pollcy, ora ertten fInanCIal aSSIstance pollcy (FAP) that explaIned all of the actIons the hospItal or other authorIzed party may take upon 17Yes 18 Check all of the followmg actIons agaInst an IndIVIdual that were permItted underthe hospItal polICIes durIng the tax year before makIng reasonable efforts to determIne the IndIVIdual?s e IgIbI Ity under the FAP ReportIng to credIt agency(Ies) an IndIVIdual's debt to another party ActIons that reqUIre a legal process Other actIons (descrIbe In SectIon C) mono-n! '7 None ofthese actIons or other actIons were permItted Schedule (Form 990) 2014 Schedule (Form 990) 2014 Page 2 Facility Information (continued) GREENWICH HOSPITAL Name of hospital facility or letter of facility reporting group Yes No 19 the hospItal or other authorIzed thIrd party perform any ofthe followmg actIons durIng the tax year before makIng reasonable efforts to determIne theIndIVIdual's e IgIbI Ity underthe . . . . . . . . . 19 N0 If"Yes," check all actIons In the hospItal or a thIrd party engaged ReportIng to credIt agency(Ies) an IndIVIdual's debt to another party ActIons that reqUIre a legal orJudICIal process Qnu??l Other actIons (descrIbe In SectIon C) 20 IndIcate efforts the hospItal or other authorIzed party made before InItIatIng any ofthe actIons lIsted (whether or not checked) In Me 18 (check all that apply) '7 NotIerd of the fInanCIal aSSIstance pollcy on admISS 0n '7 NotIerd IndIVIduals of the fInanCIal aSSIstance pollcy prIorto dIscharge '7 NotIerd IndIVIduals of the fInanCIal aSSIstance pollcy In communIcatIons WIth the IndIVIduals regardIng the IndIVIduals? bIlls '7 Documented Its determInatIon of whether IndIVIduals were eIIgIble forfInanCIal aSSIstance under the hospItal fInanCIal aSSIstance pollcy Other (descrIbe In SectIon C) None ofthese efforts were made Policy Relating to Emergency Medical Care 21 the hospItal have In place durIng the tax year a ertten pollcy relatIng to emergency medIcal care that reqUIred the hospItal to prOVIde, WIthout dIscrImInatIon, care for emergency medIcal condItIons to IndIVIduals regardless of under the hospItal fInanCIal aSSIstance pollcy7 . . . . . . . . . . . . . . . . 21 Yes If IndIcate why The hospItal dId not prOVIde care for any emergency medIcal condItIons The hospItal pollcy was not In ertIng our!? The hospItal lImIted who was eIIgIble to recere care for emergency medIcal condItIons (descrIbe In SectIon C) Other (descrIbe In SectIon C) Charges to Individuals Eligible for Assistance Under the FAP (FA P-Eligible Individuals) 22 IndIcate how the hospItal determIned, durIng the tax year, the maXImum amounts that can be charged to FA P- eIIgIble IndIVIduals for emergency or other medIcally necessary care a The hospItal used Its lowest negotIated commerCIal Insurance rate when calculatIng the maXImum amounts that can be charged The hospItal used the average of Its three lowest negotIated commerCIal Insurance rates when calculatIng the maXImum amounts that can be charged The hospItal used the MedIcare rates when calculatIng the maXImum amounts that can be charged '7 Other (descrIbe In SectIon C) 23 DurIng the tax year, dId the hospItal charge any FA P-eIIgIble IndIVIdual to whom the hospItal prOVIded emergency or other medIcally necessary serVIces more than the amounts generally bIlled to IndIVIduals who had Insurance 23 N0 If"Yes," explaIn In SectIon 24 DurIng the tax year, dId the hospItal charge any FA P-eIIgIble IndIVIduaI an amount equal to the gross charge for any . . . . . . . . . . . . . . . . . . . . . . . . . . 24 N0 If"Yes," explaIn In SectIon Schedule (Form 990) 2014 ScheduleH (Form 990)2014 Page6 2 Facility Information (continued) Section C. Supplemental Information for Part V, Section B. Prowde descriptions reqUIred for Part V, Section B, lines 2, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, prowde separate descriptions for each hospital faCIlity in a faCIlity reporting group, de5ignated by faCIlity reporting group letter and hospital line number from Part Section A A 1 4 2 3 etc. and name of hos ital faCIli Form and Line Reference Explanation See Additional Data Table Schedule (Form 990) 2014 ScheduleH (Form 990)2014 Page8 2 Facility Information (continued) Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list In order of suze, from largest to smallest) How many non?hospital health care did the organization operate during the tax year? 17 Name and address of describe See Data Table l-I Schedule (Form 990) 2014 ScheduleH (Form 990)2014 Page9 2 Supplemental Information the followmg Information 1 Required descriptions. the descriptions reqUIred for Part I, llnes 3c, 6a, and 7, Part II and Part lines 2, 3, 4, 8 and 9b Needs assessment. Describe how the organization assesses the health care needs ofthe communities It serves, In addition to any CHNAS reported In Part V, Section 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 underfederal, state, or local government programs or under the organization's flnanCial 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. 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 open medical staff, community board, use ofsurplus funds, etc) 6 Affiliated health care system. Ifthe organization is part ofan affiliated health care system, describe the respective roles ofthe 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 PARTI LINE 3c THE FINANCIAL ASSISTANCE POLICY PROVIDES THAT THE PATIENT MUST SUBMIT A FINANCIAL ASSISTANCE APPLICATION THE FINANCIALASSISTANCE POLICY PROVIDES FOR ELIGIBILITY OF DISCOUNTED CARE REGARDLESSOFINCOME Form and LIne Reference Explanation PART I, LINE 7 THE HOSPITAL USES A COST ACCOUNTING SYSTEM, CALCULATE THE AMOUNTS PRESENTED IN PART I, LINE 7 THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS Form and LIne Reference Explanation PART I, LINE 7 CONTINUED REGISTRY DESCRIPTION OF INCONSISTENCIES FROM REPORTING IN PRIOR YEARS THE CATHOLIC HOSPITAL WHAT COUNTS TASK FORCE DISCUSSED WHETHERTHE COSTS FOR CANCER REGISTRIES SHOULD BE REPORTED AS COMMUNITY BENEFIT THE TASK FORCE WAS ASKED TO REVIEWITS RECOMMENDATION THAT CANCER REGISTRIES NOT BE REPORTED AS COMMUNITY BENEFIT THE TASK FORCE CONCLUDED THAT SINCE REGISTRIES ARE REQUIRED FOR ACCREDITATION AS A CANCER HOSPITAL, IT SHOULD AFFIRM ITS GUIDANCE THAT THEIR COST NOT BE REPORTED AS COMMUNITY BENEFIT IN 2014, GREENWICH HOSPITALATTRIBUTED $468,440 IN TOTAL COSTS TO ITS CANCER SHEEHVD EHVI) OJ. CINV .LV SI EHJ. NI E2 E0 HEEHVD EHVI) OJ. DNIDHOOHLNI NV CINV HEJSEHD NI HDIH J.NIOE SHEEHVD EHVI) O.L HDIH CINV EDDOOHLNI O.L EHJ. EDVHHODNE OJ. HEDIH ESOHJ. SEIVEA EDVEIEAV NO OHM SEIVEA OS-SZ CIEDV HOE CINV HEJ..LE8 CIEJ.VIDOSSV SI HEHDIH EEHJ. EHJ. CINV HOAIAHHS HEDNVD NECIEIVE) EH.L NI OEJDHONOD EEIV CINV NI DNIES CIEJ.VIDOSSV CINV EHJ. EHJ. O.L E8 OJ. SJ.I NO NECIHVE) HEMOEE OJ. EH.L HDIMNEEHE) CINV SS EDV EDNOIAIV .LNECIIDDV EDHCIEH OJ. CIECINEJ.NI SI CINV EHJ. EH.L EDNICINE.LJ.V CINV HEJSEHDLSEM OSE HOE DNIAIHCI NV EHJ. CINV HDIMNEEHE) DNIAIHCI O.L EHJ. CINV SAVM DNIDVHDODNE OJ. EHJ. CINV OJ. NEHCHIHD .LDENNOI) MEN AHJ. OJ. NEHCHIHI) EDVHDODNE DNIJVE EDVEIDODNE SNECIHVE) EHJ. HSEEIE HELSEHD SVH EH.L CINV OJ. SHEELNFHOA SEZINVDHO SEDIAHES EH.L SHELNED CINV S.HE.LSEHD NI OJ. HSEEIE OJ. CINV HELSEHD EH.L NI SI SIH.L SNECIHVE) SI EESVOHOEEV OJ. SSEDDV HDIMNEEHE) A8 AJINHWWODEVHEAESEO DNIJVEHD CINV SCIOOHEIOSHEDIEN DNIZIEVLIAEH SVEHV EH.L NO MOEES SCIOOHHOSHDIEN HEDNOHLS DNICHIDS SJ.I ESEH.L SHECIISNOI) EHJ. DNICHIDS VEHV EHJ. NI NI HVEAWVDSIE DNIHHCI EDEIOEMEIOM HOE ADVDOACIV HOE DNINIVHJCINV DINONODE CINV SVEEIV OJ.NI CIEZIEIODEJVI) EHV ESEHJ. CINV SV J.OOH EHJ. SSEEICICIV J.VHJ. SV CINV HOE VH3 NOISHEA JNEDEH EHJ. CINV O.L OJ. OJ. SHVEA HEAO HOE HEHJEDOJ. SN OIJVZINVDHO ESEHJ. ESEH.L OJ. HECIEIO NI (VH3) EHJ. A8 EH.L CINV CINV SJ.I O.L EHVMLEOS HOE AHOJNEANI EHJ. AHJNHOD EH.L SSOHDV EIEHJ.O ANVIAI HDIMNEEHE) DNICHIHE pue (1V8 EIAIHEICI CINV EILVWDIAIHDDV OJ. 53211un WEILSAS EIHJ. CIVS EIEIV CIICI i??El EIHJ. EIAVH EIHJ. AEI OHM 80d CIEINIIAIHEILEICI SI EIHVC) CINV DNIWWIEI EIHJ. DNIEIDCI EIHJ. EIDNVCIEIODDV NI uoneueIdxg iHVd DUB swouvzmvaao EIHJ. OJ. amvmamuv as i930 ova iNnowv EIHJ. EILVNILSEI HO Aleianb OJ. EIAVH saoa NOILVZINVDHO ?1 ?Nd aauaJaJaa pue uuod Form and LIne Reference Explanation PART LINE 4 THE 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 WHO ARE UNINSURED OR UNDERINSURED THE HOSPITAL MAKES AVAILABLE FREE CARE PROGRAMS FOR QUALIFYING PATIENTS IN ACCORDANCE WITH THE ESTABLISHED POLICIES OFTHE HOSPITAL, DURING THE REGISTRATION, BILLING AND COLLECTION PROCESS A ELIGIBILITY FOR FREE CARE FUNDS IS DETERMINED FOR PATIENTS WHO WERE DETERMINED BY THE HOSPITAL TO HAVE THE ABILITY TO PAY BUT DID UNCOLLECTED AMOUNTS ARE BAD DEBT EXPENSE FOR PATIENTS WHO DO NOT AVAIL THEMSELVES OFANY FREE CARE PROGRAM AND WHOSE ABILITY TO PAY CANNOT BE DETERMINED BY THE HOSPITAL, CARE GIVEN BUT NOT PAID FOR, IS CLASSIFIED AS CHARITY CARE TOGETHER, CHARITY CARE AND THE PROVISION FOR BAD DEBT REPRESENT UNCOMPENSATED CARE THE ESTIMATED COST OFTOTAL UNCOMPENSATED CARE IS APPROXIMATELY $12 3 MILLION AND $17 0 MILLION FORTHE YEARS ENDED SEPTEMBER 30, 2015 AND 2014, RESPECTIVELY THE ESTIMATED COST OF UNCOMPENSATED CARE IS DETERMINED BY THE COST ACCOUNTING SYSTEM THIS ANALYSIS CALCULATES THE ACTUAL PERCENTAGE OFACCOUNTS WRITTEN OFF OR DESIGNATED AS BAD DEBT VS CHARITY CARE WHILE TAKING INTO ACCOUNT THE TOTAL COSTS INCURRED BY THE HOSPITAL FOR EACH ACCOUNT ANALYZED THE ESTIMATED COST OF CHARITY CARE AND FREE CARE PROVIDED WAS APPROXIMATELY $7 7 MILLION AND $7 5 MILLION FOR THE YEARS ENDED SEPTEMBER 30, 2015 AND 2014, RESPECTIVELY THE ESTIMATED COST OF CHARITY CARE IS DETERMINED BY THE COST ACCOUNTING SYSTEM FORTHE YEARS ENDED SEPTEMBER 30, 2015 AND PROVISION FOR BAD APPROXIMATELY $12 5 MILLION AND $25 1 MILLION, RESPECTIVELY FOR THE YEARS ENDED SEPTEMBER 30, 2015 AND 2014, BAD DEBT APPROXIMATELY $4 6 MILLION AND $9 5 MILLION, RESPECTIVELY THE PROVISION FOR BAD DEBT IS MULTIPLIED BY THE RATIO OF COST TO CHARGES FOR PURPOSES OF INCLUSION IN THE TOTAL UNCOMPENSATED CARE AMOUNT IDENTIFIED ABOVE THE CONNECTICUT DISPROPORTIONATE SHARE HOSPITAL PROGRAM ESTABLISHED TO PROVIDE FUNDS TO HOSPITALS FORTHE PROVISION OF UNCOMPENSATED CARE AND IS FUNDED, IN PART, BY AN ASSESSMENT ON HOSPITAL NET PATIENT SERVICE REVENUE DURING THE YEARS ENDED SEPTEMBER 30, 2015 AND 2014, THE HOSPITAL RECEIVED APPROXIMATELY $0 4 MILLION AND $1 2 MILLION, RESPECTIVELY, IN DISTRIBUTIONS, OFWHICH APPROXIMATELY $0 3 MILLION WAS RELATED TO CHARITY CARE, RESPECTIVELY THE HOSPITAL MADE PAYMENTS INTO THE OF APPROXIMATELY $14 0 MILLION AND $12 1 MILLION FORTHE YEARS ENDED SEPTEMBER 30, 2015 AND 2014, RESPECTIVELY, FOR THE ASSESSMENT THE STATE OF CONNECTICUT IMPLEMENTED CHANGES TO THE HOSPITAL FUNDING LEVELS FORTHE IN THEIR FISCAL 2016 BIENNIUM BUDGET AS A RESULT OFTHESE BUDGET FUNDING FOR THIS PROGRAM WAS REDUCED EFFECTIVE JULY 1, 2015 THE REDUCTION IN FUNDING WAS APPROXIMATELY $0 3 MILLION FORTHE PERIOD JULY 1, 2015 TO SEPTEMBER 30, 2015 AND THE FUNDING HAS BEEN ELIMINATED FORTHE STATE FISCAL YEAR 2016 IN THE AMOUNT OF $1 4 MILLION HOSPITAL PROVIDES BENEFITS FORTHE BROADER COMMUNITY WHICH INCLUDES SERVICES PROVIDED TO OTHER NEEDY PO PULATIO NS THAT MAY NOT QUALIFY AS POOR BUT NEED SPECIAL SERVICES AND SUPPORT BENEFITS INCLUDE THE COST OF HEALTH PROMOTION AND EDUCATION OFTHE GENERAL COMMUNITY, INTERNS AND RESIDENTS, HEALTH MEDICAL RESEARCH THE BENEFITS ARE PROVIDED THROUGH THE COMMUNITY HEALTH OFWHICH SERVICE NON ENGLISH SPEAKING VARIOUS COMMUNITY SUPPORT GROUPSIN ADDITION TO THE QUANTIFIABLE SERVICES DEFINED HOSPITAL PROVIDES ADDITIONAL BENEFITS TO THE COMMUNITY THROUGH ITS ADVOCACY OF COMMUNITY SERVICE BY EMPLOYEES THE EMPLOYEES SERVE NUMEROUS ORGANIZATIONS THROUGH BOARD REPRESENTATION, MEMBERSHIP IN ASSOCIATIONS AND OTHER RELATED ACTIVITIES THE HOSPITALALSO SOLICITS THE ASSISTANCE OF OTHER HEALTH CARE PROFESSIONALS TO PROVIDE THEIR SERVICES AT NO CHARGE THROUGH PARTICIPATION IN VARIOUS COMMUNITY SEMINARS AND TRAINING PROGRAMS Form and LIne Reference Explanation PART LINE 8 THE ENTIRE MEDICARE LOSS PRESENTED SHOULD BE TREATED AS A COMMUNITY BENEFIT FORTHE FOLLOWING REASONS THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO MEDICARE BENEFICIARIES, IRS REVENUE RULING 69-545 INDICATES THAT HOSPITALS OPERATE FORTHE PROMOTION OF HEALTH IN THE COMMUNITY WHEN IT PROVIDES CARE TO PATIENTS WITH GOVERNMENTAL HEALTH ORGANIZATION PROVIDES CARE TO MEDICARE PATIENTS REGARDLESS OF MEDICARE SHORTFALLS (REDUCING THE BURDEN ON THE MANY OF THE MEDICARE PARTICIPANTS WOULD HAVE QUALIFIED FORTHE CHARITY CARE OR OTHER MEANS TESTED PROGRAMS ABSENT BEING ENROLLED IN THE MEDICARE PROGRAM THE MEDICARE SHORTFALL REPORTED IS DETERMINED BY THE COST ACCOUNTING SYSTEM, STRATAJAZZ Form and LIne Reference Explanation PART LINE 9B IT IS THE POLICY TO TREAT ALL PATIENTS EQUITABLY WITH RESPECT AND COMPASSIONI 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 HOSPITAL WILL MAKE REASONABLE EFFORTS TO DETERMINE IF AN INDIVIDUAL IS ELIGIBLE FOR FINANCIALASSISTANCE UNDER ITS FINANCIAL ASSISTANCE POLICY IN THE EVENT A PATIENT IS ELIGIBLE FOR FINANCIAL HOSPITAL WILL NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTION AS DEFINED BY LAWAND HOSPITAL POLICY OJ. SEIDIAHEIS CINV AILNEIDEIEI EIHJ. NDVECIEIEH HEIHLO CINV CINV EIEIVI) NI EIEIV CINV EIHVC) SSOHDV SCINEIELL CINV SISAWVNV 'Ii?l?lAl HDIMNEIEIHE) SIAIVELL EIDIAHEIS CINV iHVd SV CIEISSEIEICICIV CINV AWEINLLDOEI EIEIV uoneueIdxg iHVd DUB OJ. SEIDEIDOSEIH SVH "I?l?v'D HO OJ. 80d CINV EISEIHJ. DNIWWIEI iHVd SV HEHIVIAI AEI NO EWSVWIVAV EIEIV CINV SSEIDDV CINV CINV NO HDIMNEIEIHE) iHVd uoneueIdxg DUB Form and LIne Reference Explanation PART VI, LINE 4 GREENWICH COMMUNITY HEALTH IMPROVEMENT EFFORTS ARE SPECIFICALLY FOCUSED IN THE TOWNS WHERE THE HOSPITAL IS ENGAGED WITH COMMUNITY PARTNERS THIS GEOGRAPHIC AREA INCLUDES THE TOWN OF GREENWICH, CONNECTICUT AND THE FOLLOWING TOWNS LOCATED IN THE STATE OF NEWYORK ARMONK, BEDFORD, LARCHMONT, MAMARONECK, POUND RIDGE, PORT RYE OVER 191,400 PEOPLE LIVE IN THESE TOWNS INCLUDING 47,414 UNDER THE AGE OF 18, 34,361 BETWEEN THE AGES OF 18 AND 34, 78,873 BETWEEN THE AGES OF 35 AND 64, AND 30,766 OVER THE AGE OF 65 APPROXIMATELY 23% OF HOUSEHOLDS HAVE INCOMES LESS THAN $50,000, 36% OF HOUSEHOLDS HAVE INCOMES BETWEEN $50,000 AND $150,000 AND THE REMAINING 41% OF HOUSEHOLDS HAVE INCOMES GREATER THAN $150,000 STOZ NI 028,13 NI EINO HDIMNEIEIHE) CINV EIEDNVH EICIIM SHElzlle HVEIA OOEILBZ CINV SEISEIVHDSICI NVHJ. EIHOIAI SVH DNIHDVEIJ. (138-902 SI NI 9179 EIHEIM STOZ NI NI EIHJ. EIHJ. A8 CINV HDIMNEIEIHE) NMOJ. EIHJ. NI DNINH 80 DNICIISEIH CIEIVOE ANVIAI CIEIVOEI DNIAVH SEICIFHDNI SIHJ. EIDHHOSEIEI NV SV CINV iHVd SV EIHV SAVM NI SELLDEIEILNOC) CINV NI SHEIEIHVC) DNIDNVACIV CINV OJ. SSEIDDV - DNIDNVH-EICIIM NI CININ-NI NI 17 HDIMNEIEIHE) ISTOZ CINV HDVEIELLDO HDHOHHJ. CINV OJ. SEIDIAHEIS EIHVC) SV uoneueIdxg iHVd DUE SISVS NO SI NO NI EWEVLNHODDV EIEIV AEIHJ. HDIHM 80d SSEINISDE OJ. IAIELLSAS NEIAVHMEIN ENVA OJ. SSEIDDV EIAVH CINV AEIHJ. EIHJ. EIHJ. SXHOMIEIN EIHJ. EIEIDSNEI SI NOISSIIAI NEIAVHMEIN ENVA uoneueIdxg 9 iHVd DUB Form and LIne Reference Explanation PART VI, LINE 7, REPORTS FILED WITH STATES Schedule (Form 990) 2014 Additional Data Software ID: Software Version: EIN: 06?0646659 Name: GREENWICH HOSPITAL Form 990 Part Section Supplemental Information for Part V, Section B. Section C. Supplemental Information for Part V, Section B.Provude descriptions requnred for Part V, Section B, lines 3, 4, 5d, 7, 10, 11, 12l, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provude separate descriptions Ifor each In a reporting group, de5 gnated by etc. Form and LIne Reference Explanatlon PART V, SECTION A THIS STATE LICENSE FORTHE HOSPITAL LOCATION LISTED IN SCHEDULE H, PART V, SECTION COVERS VARIOUS SATELLITE LOCATIONS OPERATED UNDER AND EXPRESSLY LISTED ON THE SAME STATE HOSPITAL LICENSE Form 990 Part Section Supplemental Information for Part V, Section B. Section C. Supplemental Information for Part V, Section descriptions reqwred for Part V, Section B, lines 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, prowde separate descriptions Ifor each faCIlity in a faCIlity reporting group, de5ignated by "FaCIlity "FaCIlity etc. Form and Line Reference Explanation GREENWICH HOSPITAL PART V, SECTION B, LINE 5 COMMUNITY ENGAGEMENT AND FEEDBACK WERE AN INTEGRAL PART OFTHE CHNA PROCESS GREENWICH HOSPITAL SOUGHT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OFTHE COMMUNITY SERVED BY THE HOSPITAL THROUGH FOCUS GROUPS WITH COMMUNITY MEMBERS, KEY INFORMANT INTERVIEWS WITH COMMUNITY INCLUSION OF COMMUNITY PARTNERS IN THE PRIORITIZATION AND IMPLEMENTATION PLANNING PROCESS PUBLIC HEALTH AND HEALTH CARE PROFESSIONALS SHARED KNOWLEDGE AND EXPERTISE ABOUT HEALTH LEADERS AND REPRESENTATIVES OF NON-PROFIT AND COMMUNITY-BASED ORGANIZATIONS PROVIDED INSIGHT ON THE COMMUNITY SERVED BY GREENWICH HOSPITAL, INCLUDING MEDICALLY UNDERSERVED, MINORITY POPULATIONS Form 990 Part Section Supplemental Information for Part V, Section B. Section C. Supplemental Information for Part V, Section descriptions reqwred for Part V, Section B, lines 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, prowde separate descriptions Ifor each faCIlity in a faCIlity reporting group, de5ignated by "FaCIlity "FaCIlity etc. Form and Explanation Line Reference GREENWICHPART V, SECTION B, LINE 6B THE GREENWICH HOSPITAL BOARD OFTRUSTEES IS DIRECTLY HOSPITAL INVOLVED IN THE CHNA THROUGH A SUBCOMMITTEE CALLED THE COMMUNITY ADVISORY COMMITTEE THE COMMUNITY ADVISORY COMMITTEE INCLUDES 3O MEMBERS WHO REPRESENT A VARIETY OF COMMUNITY ORGANIZATIONS SUCH AS THE UNITED YWCA, HOUSES OF WORSHIP, LOCAL MUNICIPAL HEALTH DEPARTMENTS, HISPANIC HEALTH COUNCIL, FAMILY CENTERS, YOUTH AND SENIOR SERVICES REPRESENTATIVES, NATIONAL ASSOCIATION FORTHE ADVANCEMENT OF COLORED PEOPLE, HOUSING AUTHORITIES OF GREENWICH AND PORT CHESTER, CHAMBER OF COMMERCE, FEDERALLY QUALIFIED HEALTH EMERGENCY MEDICAL SERVICES AND OTHER PRIVATE AND CORPORATE GROUPS IN COMMUNITY ADVISORY COUNCIL ESTABLISHED THE GREENWICH COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP TO ASSIST WITH MEETING THE HEALTH NEEDS OFTHE GREENWICH COMMUNITY GREENWICH COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP MEMBERS INCLUDE REPRESENTATIVES FROM TOWN OF GREENWICH DEPARTMENT OF HEALTH, DEPARTMENT OF SOCIAL UNITED WAY, BOARD OF AUTHORITY OF GREENWICH, CHILD GUIDANCE CENTERS, GREENWICH POLICE DEPARTMENT, FAMILY CENTERS, INC COMMUNITIES 4 ACTION, LOWER FAIRFIELD REGIONAL ACTION COUNCIL (LFRAC) SOUTHWEST REGIONAL MENTAL HEALTH BOARD, NATIONAL ALLIANCE ON MENTAL ILLNESS EMERGENCY MEDICAL SERVICES (GEMS) SENIOR AND YOUTH REPRESENTATIVES (BOYS GIRLS CLUB, GREENWICH ADULT DAY CARE), GREENWICH ALLIANCE FOR EDUCATION AND NUMEROUS INTERESTED COMMUNITY MEMBERS IN NEWYORK, GREENWICH HOSPITAL COLLABORATES WITH THE COUNCIL OF COMMUNITY SERVICES OF PORT CHESTER, RYE RYE TOWN TO PROVIDE COMMUNITY HEALTH OUTREACH ACTIVITIES THE COUNCIL OF COMMUNITY SERVICES BOARD MEMBERS MEET AND A GREENWICH HOSPITAL REPRESENTATIVE IS A BOARD MEMBER THE COUNCIL OF COMMUNITY SERVICES HAS APPROXIMATELY 10 COMMUNITY COALITIONS THAT MEET AND REPORT UP TO THE COUNCIL OF COMMUNITY SERVICES BOARD AND INCLUDE THE ADOLESCENT HEALTH TASK NETWORK, LATINO INFORMATION PORT CHESTER CARE COMMITTEE PART V, SECTION B, LINE 7A WEBSITE B, LINE 7B B, LINE 10B WEBSITE WEBSITE HTTP PDFPART Form 990 Part Section Supplemental Information for Part V, Section B. Section C. Supplemental Information for Part V, Section descriptions reqwred for Part V, Section B, lines 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, prowde separate descriptions Ifor each faCIlity in a faCIlity reporting group, de5ignated by "FaCIlity "FaCIlity etc. Form and Line Reference Explanation GREENWICH HOSPITAL PART B, LINE 11 BASED ON THE FEEDBACK FROM COMMUNITY PARTNERS INCLUDING HEALTH CARE PROVIDERS, PUBLIC HEALTH EXPERTS, HEALTH AND HUMAN SERVICE OTHER COMMUNITY REPRESENTATIVES, GREENWICH HOSPITAL PLANS TO FOCUS COMMUNITY HEALTH IMPROVEMENT EFFORTS ON THE FOLLOWING HEALTH PRIORITIES OVER THE NEXT THREE-YEAR CYCLE ACCESS TO MENTAL HEALTH AND BEHAVIORAL PROMOTING HEALTHY LIFESTYLES AREAS IDENTIFIED AS PART OFTHE COMMUNITY HEALTH NEEDS ASSESSMENT NOT BEING ADDRESSED AS A RESULT OFA PRIORITIZATION PROCESS INCLUDE DENTAL CARE, DIABETES, HEART DISEASE, RESPIRATORY DISEASE AND STROKE TO LEARN MORE ABOUT HOW GREENWICH HOSPITAL AND ITS COMMUNITY PARTNERS ARE MEETING THESE NEEDS PLEASE REVIEWTHE GREENWICH HOSPITAL COMMUNITY HEALTH IMPROVEMENT PLAN ATTACHED TO THIS FILING GREENWICH HOSPITAL RECOGNIZES THAT PARTNERSHIPS WITH COMMUNITY AGENCIES HAVE THE BROADEST REACH TO IMPROVE COMMUNITY HEALTH ISSUES AS HOSPITAL IS PROVIDING FACILITATION SUPPORT FORTHE IMPLEMENTATION OFTHE COMMUNITY-WIDE HEALTH IMPROVEMENT PLAN THAT WILL FOCUS ON ALL FOUR AREAS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT PART B, LINE 16A WEBSITE ASPXPART B, LINE 16B WEBSITE ASPXPART B, LINE 16C WEBSITE ASPX Form 990 Part Section Supplemental Information for Part V, Section B. Section C. Supplemental Information for Part V, Section descriptions reqwred for Part V, Section B, lines 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, prowde separate descriptions Ifor each faCIlity in a faCIlity reporting group, de5ignated by "FaCIlity "FaCIlity etc. Form and Line Reference Explanation GREENWICH HOSPITAL PART B, LINE 13H THESE PROGRAMS COVER MEDICALLY NECESSARY CARE ONLY Form 990 Part Section Supplemental Information for Part V, Section B. Section C. Supplemental Information for Part V, Section descriptions reqUIred for Part V, Section B, lines 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, prOVIde separate descriptions Ifor each faCility in a faCility reporting group, de5ignated by "FaCIlity "FaCIlity etc. Explanation GREENWICH HOSPITAL PART B, LINE 22D PRIORTO BECOMING ARE CHARGED STANDARD GROSS CHARGES AFTER AN INDIVIDUAL IS DEEMED TO BE FAP- DISCOUNTS OR FREE CARE ASSISTANCE DISCOUNTS ARE APPLIED IN ACCORDANCE WITH THE FAP PROGRAM THE INDIVIDUAL QUALIFIES FOR THE DISCOUNTS ARE ADJUSTED OFF THE ACCOUNT WHICH IS ALSO REFLECTED IN THE BILLING Form and Line Reference Form 990 Part Section Supplemental Information for Part V, Section B. Section C. Supplemental Information for Part V, Section descriptions reqwred for Part V, Section B, lines 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, prOVIde separate descriptions Ifor each faCility in a faCility reporting group, de5ignated by "FaCIlity "FaCIlity etc. Form and Line Reference Explanation SCHEDULE H, PART V, SECTION THE FACILITY LOCATIONS LISTED IN SCHEDULE H, PART v, SECTION D, INCLUDE OFF- CAMPUS OUTPATIENT HEALTH CARE FACILITIES THAT GREENWICH HOSPITAL OPERATED DURING THE TAX YEAR UNDERITS STATE HOSPITAL LICENSE Form 990 Part Section Supplemental Information for Part V, Section B. Section C. Supplemental Information for Part V, Section descriptions reqwred for Part V, Section B, lines 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, prowde separate descriptions Ifor each faCIlity in a faCIlity reporting group, de5ignated by "FaCIlity "FaCIlity etc. Form and Line Reference Explanation PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY Form 990 Part Section Supplemental Information for Part V, Section B. Section C. Supplemental Information for Part V, Section descriptions reqwred for Part V, Section B, lines 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, prowde separate descriptions Ifor each faCIlity in a faCIlity reporting group, de5ignated by "FaCIlity "FaCIlity etc. Form and Line Reference Explanation GREENWICH HOSPITAL PART V, SEE PART SECTION B, LINE 16A WEBSITE Form 990 Part Section Supplemental Information for Part V, Section B. Section C. Supplemental Information for Part V, Section descriptions reqwred for Part V, Section B, lines 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, prowde separate descriptions Ifor each faCIlity in a faCIlity reporting group, de5ignated by "FaCIlity "FaCIlity etc. Form and Line Reference Explanation GREENWICH HOSPITAL PART V, SEE PART SECTION B, LINE 168 WEBSITE Form 990 Part Section Supplemental Information for Part V, Section B. Section C. Supplemental Information for Part V, Section descriptions reqwred for Part V, Section B, lines 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, prowde separate descriptions Ifor each faCIlity in a faCIlity reporting group, de5ignated by "FaCIlity "FaCIlity etc. Form and Line Reference Explanation GREENWICH HOSPITAL PART V, SEE PART SECTION B, LINE 16C WEBSITE Form 990 Schedule H, Part Section D. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility Hospital Facility (list In order of snze, from largest to smallest) Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a How many non?hospital health care dId the organization operate during the tax year? Name and address Type of (describe) PHYSICAL MEDICINE REHAB CENTER 2015 WEST MAIN STREET 06902 AMBULATORY SURGICAL CENTER 55 HOLLY HILL LANE 06830 GREENWICH HOSPITAL HOME CARE 500 WEST PUTNAM AVENUE 06831 GREENWICH HOSPITAL LAB 49 LAKE AVENUE 06830 GREENWICH HOSPITAL LAB 90 MORGAN STREET 06905 HOSPITALOUTPATIENT MEDICALONCOLOGY LA 15 VALLEY DRIVE 06831 GREENWICH HOSPITAL LAB 159 WEST PUTNAM AVENUE 06831 GREENWICH HOSPITAL OCCUP HEALTH 75 HOLLY HILL LANE 06830 GREENWICH HOSPITAL LAB 40 CROSS STREET 06850 GREENWICH HOSPITAL LAB 90 SOUTH RIDGE STREET RYE 10573 GREENWICH HOSPITAL LAB 1275 SUMMER STREET 06902 GREENWICH HOSPITAL LAB 4 DEERFIELD DRIVE 06830 GREENWICH HOSPITAL LAB 31 RIVER ROAD 06830 GREENWICH HOSPITAL LAB 106 NOROTON AVENUE 06820 GREENWICH HOSPITAL LAB 148 EAST AVENUE 06850 DIAGNOSTIC, LAB, REHAB DIAGNOSTIC, LAB, REHAB DIAGNOSTIC, LAB, REHAB DIAGNOSTIC, LAB, REHAB DIAGNOSTIC, LAB, REHAB DIAGNOSTIC, LAB, REHAB DIAGNOSTIC, LAB, REHAB DIAGNOSTIC, LAB, REHAB DIAGNOSTIC, LAB, REHAB DIAGNOSTIC, LAB, REHAB DIAGNOSTIC, LAB, REHAB DIAGNOSTIC, LAB, REHAB DIAGNOSTIC, LAB, REHAB DIAGNOSTIC, LAB, REHAB DIAGNOSTIC, LAB, REHAB Form 990 Schedule H, Part Section D. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list In order of snze, from largest to smallest) How many non?hospital health care dId the organization operate during the tax year? Name and address Type of (describe) GREENWICH HOSPITAL OUTPATIENT DIAGNOSTIC, LAB, REHAB 260 LONG RIDGE ROAD 06902 GREENWICH HOSPITAL MEDICAL CENTER DIAGNOSTIC, LAB, REHAB 35 RIVER ROAD COS 06807 lefile GRAPHIC print - DO NOT PROCESS IAs Filed Data - DLN: 93493224007096 ScheduleI . . . OMB No 1545-0047 (Form 990) Grants and Other AsSIstance to Organizations, Governments and Individuals in the United States 2014 Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22. Department of the Treasury Attach to Form 990. Open to Public Internal Revenue It Information about Schedule I (Form 990) and its instructions is at Inspection Name of the organization Employer identification number GREENWICH HOSPITAL 06-0646659 General Information on Grants and Assistance 1 Does the organization maintain records to substantiate the amount of the grants or a99istance, the grantees' eligibility for the grants or a99istance, and the selectioncriteria usedtoawardthegrants ora99istance7 7Yes 2 Describe in Part IV the organization' 5 procedures for monitoring the use ofgrant funds in the United States Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" to Form 990, Part IV, line 21, for any moment that received more than $5,000. Part II can be duplicated if additional space is needed. Name and address of EIN IRC section Amount ofcash Amount of non- Method of (9) Description of Purpose ofgrant organization ifapplicable grant cash valuation non-cash a55istance ora55istance or government a55istance (book, FMV, appraisal, other) See Additional Data Table For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat No 50055P Schedule I (Form 990) 2014 Schedule I (Form 990) 2014 Page 2 Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" to Form 990, Part IV, line 22. Part can be duplicated if additional space is needed. (a)Type of grant or a55istance (b)Number of moments (c)Amount of cash grant (d)Amount of non-cash aSSIstance (e)Method ofvaluation (book, FMV, appraisal, other) (f)Description of non-cash aSSIstance Part IV Supplemental Information. Prowde the information reqwred in Part I, line 2, Part column and any other additional information. Return Reference Explanation PART I, LINE 2 NONE OFTHE AMOUNTS REPORTED ON SCHEDULE I, PART II ARE GRANTS THESE AMOUNTS ARE DONATIONS AND SPONSORSHIPS GIVEN TO ORGANIZATIONS TO ASSIST IN THE FURTHERANCE OFTHEIR CHARITABLE MISSION GREENWICH HOSPITAL OUT DUE DILIGENCE IN PROVIDING MONETARY ASSISTANCE ONLY TO QUALIFYING ORGANIZATIONS THAT COMPLEMENT ITS MISSION OR SUPPORT THE GREATER GOOD IN THE COMMUNITIES SERVES GH VERIFIES EACH EIN AS LISTED ON IRS FORM W-9 THAT HAS BEEN SUBMITTED TO GH ASSISTANCE DONATED BY GH TO THESE QUALIFYING ORGANIZATIONS IS NOT OUTCOMES-BASED AND IS GIVEN IN SUPPORT OF AN INDIVIDUAL FUNDRAISING EVENTS OR IN SUPPORT OF DIRECT SERVICES GH MAINTAINS FULL AND COMPLETE RECORDS OF ALL MONETARY ASSISTANCE PROVIDED, HOWEVER DOES NOT MONITOR SPECIFIC FUNDS Schedule I (Form 990) 2014 Additional Data Software ID: Software Version: EIN: Name: 06-0646659 GREENWIC HOSPITAL Form 990,Schedule I, Part II, Grants and Other Assistance to Domestic Organizations and Domestic Governments. Name and address of EIN IRC Code sectlon Amount ofcash Amount of non- Method of of Purpose ofgrant organlzatlon grant cash valuatlon non-cash aSSIstance or aSSIstance or government aSSIstance (book, FMV,appraIsal, other) AMERICAN CANCER 13-1788491 10,000 SUPPORT SOCIETY372 DANBURY ORGANIZATION ROAD 06897 AMERICAN HEART 13-5613797 13,500 SUPPORT ASSOCIATION7272 ORGANIZATION GREENVILLE AVENUE 75231 BREAST CANCER 06-1453500 55,000 SUPPORT ALLIANCE48 MAPLE ORGANIZATION AVENUE 06830 Form 990,Schedule I, Part II, Grants and Other Assistance to Domestic Org anizations and Domestic Governments. of Purpose of grant Name and address of EIN IRC Code sectlon Amount ofcash Amount of non- Method of organlzatlon grant cash valuatlon non-cash aSSIstance or aSSIstance or government aSSIstance (book, FMV,appraIsal, other) COLUMBUS CITIZENS 13-6118967 7,500 SUPPORT FOUNDATIONS 69TH ORGANIZATION STREET 10021 GEMS111EPUTNAM AVE 22-2721171 83,417 SUPPORT 06878 ORGANIZATION GREENWICH UNITED WAY 06-0646578 11,834 SUPPORT ORGANIZATION ONE LAFAYETTE COURT 06830 Form 990,Schedule I, Part II, Grants and Other Assistance to Domestic Org anizations and Domestic Governments. Name and address of EIN IRC Code sectlon Amount ofcash Amount of non- Method of of Purpose ofgrant organlzatlon grant cash valuatlon non-cash aSSIstance or aSSIstance or government aSSIstance (book, FMV,appraIsal, other) LYME RESEARCH 06-1559393 13,500 SUPPORT ALLIANCE2001 WEST ORGANIZATION MAIN STREET 06902 ONS FOUNDATION6 26-1394760 55,000 SUPPORT GREENWICH OFFICE PARK ORGANIZATION 06831 TOWN OF GREENWICH101 06-6002006 10,000 SUPPORT ORGANIZATION FIELD POINT ROAD 06830 Form 990,Schedule I, Part II, Grants and Other Assistance to Domestic Organizations and Domestic Governments. Name and address of EIN IRC Code sectlon Amount ofcash Amount of non- Method of of Purpose ofgrant organlzatlon grant cash valuatlon non-cash aSSIstance or aSSIstance or government aSSIstance (book, FMV,appraIsal, other) VISITING NURSE 13-2601443 6,700 SUPPORT ASSOCIATION360 ORGANIZATION MAMARONECK AVE WHITE 10605 YWCA OFGREENWICH259 06-0646992 20,000 SUPPORT PUTNAM AVENUE 06830 ORGANIZATION lefile GRAPHIC print - DO NOT PROCESS IAs Filed Data - Schedule Compensation Information 0MB No 1545-0047 (Form 990) For certain Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees 2014 IF Complete if the organization answered "Yes" to Form 990, Part IV, line 23. Depariment ofthe Treasury I. Attach to Form 990_ Open to Internal Revenue Service II- Information about Schedule (Form 990) and its instructions is at InSPeCtlon Name ofthe organization GREENWICH HOSPITAL 06-0646659 Questions Regarding Compensation 1a 9 Employer identification number Check the approprate box(es) rfthe organization provrded any ofthe followrng to or for a person listed in Form 990, Part VII, Section A, lrne 1a Complete Part to provrde any relevant information regarding these items First-class or charter travel Housrng allowance or resrdence for personal use Travel for companions Payments for busrness use of personal resrdence Tax and gross-up payments Health or socral club dues or fees spending account Personal servrces (e maid, chauffeur, chef) Ifany of the boxes in lrne 1a are checked, did the organization followa written policy regarding payment or reimbursement or provrsron ofall ofthe expenses described above? If"No," complete Part to explain Did the organization requrre substantiation prrorto or allowrng expenses incurred by all directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in lrne 1a? Indicate which, rfany, ofthe followrng the organization used to establish the compensation ofthe organization's CEO/Executive Director Check all that apply Do not check any boxes for methods used by a related organization to establish compensation ofthe CEO/Executive Director, but explain in Part I7 Compensation committee I7 Written employment contract I7 Independent compensation consultant I7 Compensation survey or study Form 990 of other organizations I7 Approval by the board or compensation committee During the year, did any person listed in Form 990, Part VII, Section A, lrne 1a With respect to the organization or a related organization Receive a severance payment or change-of?control payment? in, or receive payment from, a supplemental nonqualrfred retirement plan? in, or receive payment from, an equrty-based compensation arrangement? If"Yes" to any oflrnes 4a-c, the persons and provrde the applicable amounts for each item in Part Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9. For persons listed in Form 990, Part VII, Section A, lrne 1a, did the organization pay or accrue any compensation contingent on the revenues of The organization? Any related organization? If"Yes," to lrne 5a or 5b, describe in Part For persons listed in Form 990, Part VII, Section A, lrne 1a, did the organization pay or accrue any compensation contingent on the net earnings of The organization? Any related organization? If"Yes," to lrne 6a or 6b, describe in Part For persons listed in Form 990, Part VII, Section A, lrne 1a, did the organization provrde any non-fixed payments not described in lines 5 and 6? If"Yes," describe in Part Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was subject to the initial contract exception described in Regulations section 53 If"Yes," describe in Part If"Yes" to lrne 8, did the organization also follow the rebuttable presumption procedure described in Regulations section For Paperwork Reduction Act Notice, see the Instructions for Form 990. at 5 OO 5 3T Schedule (Form 990) 2014 Schedule] (Form 990)2014 Page 2 Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed. For each indIVIduaI whose compensation must be reported In Schedule J, report compensation from the organization on row 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 ofcolumns for each listed indIVIduaI must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that indIVIduaI (A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and (D) Nontaxable (E) Total of (F) Compensation in Base (ii) Bonus Other other deferred benefits columns column(B) reported corn ensation incentive reportable compensation as deferred in prior compensation compensation Form 990 See Additional Data Table Schedule (Form 990) 2014 VIOZ (066 W105) CINV NOISSIIAI CIEINEDIJV EIHV J.VHJ. ON CINV CIHVMV OJ. CINV HDVEI NO CIEISVS OJ. DNICIEIODDV EIHV CIHVMV EIAIJNEIDNI CINV SJVOE) O.L EDNICIHODDV CINV .LV CINV EIHV SJEIAEH CINV AEIX NI EITEIIDIJEI O.L HDIHM EITEIVIEIVA SI WHEIJ EIH.L (VSIHEI) AJIHDDEIS JNEINEIHILEIH AJHDIH HO CINV EICIOI) CIEIHHEHEICI NOIJDEIS CIEIHHEHEICI NV HDHOHHJ EINODNI JNEIWEIHIJEIH EIHJ. SV DNIAHEIS NIVJEIH CINV OJHEICIHO NI JNEINEIHILEIH HEIHLO OJ. CIEICICIV EINODNI JNEIWEIHIJEIH EIH.L O.L CIEINDISEICI JNEINEIHILEIH EIHJ. NEISEIIHJ EIHJ. NIH OJ. AJLDEIHICI EICIVIAI 8 NOIJDEIS NI CIEICIFHDNI SI SIHJ. EINO ENAVE) HJOH NVIAIHON Z-M HVEIA HVCINEHVD EIHJ. NI CINV SV CIEIZINDODEIH EIHEIM HVCINEHVI) EIH.L El NIAHHOD NOIJDEIS NI HVEIA EIHJ. EIHJ. .LV NI M0138 0$ 0$ ADNVN 0$ 0$ IDDFHOD 0$ 0$ NVHOCI NVIHQ 0$ 0$ HONNOD.O CIEISVQ-AJJHOEI SN SHI EIHJ. JNEIJSISNOD CINV EIHJ. CIEIHHEHEICI) I) NIAHHOD NI EIHJ. NI EIHV EISEIHJ. JNEIWEIHIJEIH NI EIHVMOJEIEI EIH.L uo! 12H eldxg 93" 133 AueJo; lJt-Ed sup, aqeldLuoa osw 11 aged Jo; pure '8 pure ?q9 ?29 ?qg ?95 ?qu ?2 ?qt ?eI sauu ?1 aged Jo; paJInbaJ suonduasep J0 ?uoneueldxe sq), uoneuuow: exuewa ddns 362d 17102 (066 uuoa) alnpeuas Additional Data Software ID: Software Version: EIN: 06?0646659 Name: GREENWICH HOSPITAL Form 990, Schedule J, Part II - Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and (D) Nontaxable (E) Total ofcolumns (F) Compensation in column (B) Base (ii) Bonus Other other deferred benefits rep0ited as deferred Compensation incentive reportable compensation prior Form 990 compensation compensation (I) 79,650 26,292 26,451 2,310 1,483 136,186 7,627 (II) 716,846 236,632 238,057 20,790 13,350 1,225,675 68,639 PRES (I) 793,691 265,365 92,272 22,329 26,673 1,200,330 0 (II) 198,423 66,341 23,068 5,582 6,668 300,082 0? (I) 24,868 8,110 2,958 10,735 649 47,320 629 (II) 804,053 262,212 95,642 347,102 20,969 1,529,978 20,337 (I) 414,853 116,769 2,381,567 63,929 11,850 2,988,968 810,445 (II) 103,713 29,192 595,392 15,982 2,963 747,242 202,611 DIRECTOR 327-7345 32,698 24,980 36,285 46,689 462,997 CHRISTINEBEECHNERJ VP (I) 147,744 45,687 8,125 12,455 26,273 240,284 0 (IIVEUSAN SENIOR (I) 317,591 47,815 2,075 36,285 22,084 425,850 0 (II(I) 377,177- 85,825 57,445 151,090 15,641 687,173 4,706 (II) 942-93 21,456 14,361 37,772 3,910 171,792 42,352 DEBORAH VP (I) 367,529 55,372 22,808 15,689 23,003 484,401 0 (II(I) 242,903 38,842 17,746 17,694 25,078 342,263 152 (II(I) 308,676 75,609 40,879 146,623 3,520 575,307 0 (II(I) 405,625 61,633 29,872 15,970 18,955 532,055 16,056 (IISENIOR (I) 144,380 38,305 23,834 59,090 11,184 276,793 0 (II) 144,380 38,305 23,834 59,090 11,184 276,793 0? SENIORVP 421:013 111,825 63,599 201,397 21,986 819,820 287,100 VICKIALTMEYER, . 525,946 DIRECTOR OF PATHOLOGY (fl; 0 48,273 26,893 36,283 19,193 656,608 4,59(13 RICHARD EISEN, . 5 14,963 DIRECTOR OF PATHOLOGY (fl; 0 12,11(13 25,418 30,203 25,493 608,19(13 15,89; Pf??ggl?ggm 437,625 0 24,182 40,285 16,987 519,079 32,045 4517757- 0 18,229 20,222 9,744 499,947 21,242 STEPHEN JONES, CHIEF I 351,326 SAFETY 0 14,423 24,903 36,283 25,328 452,268 18,273 QUINTON FRIESEN, FORMER OFFICER (9/2012) (fl; 0 8 278'683 8 278?683 278'683 Iefile GRAPHIC print - DO NOT PROCESS IAs Filed Data - DLN: 93493224007096 ScheduleK OMB No 1545-0047 (Form 990) Supplemental Information on Tax Exempt Bonds Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions, 20 1 4 explanations, and any additional information in Part VI. h- Attach to Form 990. 0 en to Public Depa'tment 0f the Treasury II-Information about Schedule (Form 990) and its instructions is at . Internal Revenue Serwce Inspect Ion Name of the organization Employer identification number GREENWICH HOSPITAL 06-0646659 Bond Issues Issuer name Issuer EIN CUSIP Date issued Issue price Description of purpose (9) Defeased On behalfof financmg issuer Yes No Yes No Yes No A CHEFA 2008-SERIESC 06-0806186 20774UYC3 05-07-2008 53,630,000 REFINANCE SERIES 20068 Proceeds A 1 Amount ofbonds retired 13,525,000 2 Amount of bonds legally defeased 3 Total proceeds ofissue 55,211,662 4 Gross proceeds in reserve funds 5 Capitalized interest from proceeds 5 Proceeds in refunding escrows 7 Issuance costs from proceeds 477,359 3 Credit enhancement from proceeds 72,256 9 Working capital expenditures from proceeds 10 Capital expenditures from proceeds 11 Other spent proceeds 54,662,047 12 Other unspent proceeds 13 Year ofsubstantial completion 2008 Yes Were the bonds issued as part ofa current refunding issue? 15 Were the bonds issued as part ofan advance refunding issue? 16 Has the final allocation of proceeds been made? 17 Does the organization maintain adequate books and records to support the final allocation of proceeds? Private Business Use Was the organization a partner in a partnership, or a member ofan LLC, which owned property financed by tax-exempt bonds? 2 Are there any lease arrangements that may result in private busmess use of bond- financed property? For Paperwork Reduction Act Notice, see the Instructions for Form 990Schedule (Form 990) 2014 ScheduleK(Form990)2014 Page2 Private Business Use (ContinuedAre there any management or serVIce contracts that may result In private busmess use of bond-financed property? If"Yes" to line 3a, does the organization routinely engage bond counsel or other outSIde counsel to reVIew any management or serVIce contracts relating to the financed property? Are there any research agreements that may result in private busmess use of bond- financed property? If"Yes" to line 3c, does the organization routinely engage bond counsel or other outSIde counsel to reVIew any research agreements relating to the financed property? 4 Enter the percentage offinanced property used in a private busmess use by entities 0 other than a section 501(c)(3)organization or a state or local government II- 1 860 5 Enter the percentage offinanced property used in a private busmess use as a result of unrelated trade or busmess actIVIty carried on by your organization, another section 0 310 0/0 501(c)(3) organization, or a state or local government Ir Totaloflines4and5 2 170 0/0 Does the bond issue meet the private security or payment test? 8a Has there been a sale or disp05ition ofany ofthe bond-financed property to a nongovernmental person other than a 501(c)(3) organization Since the bonds were issued? If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1 141-12 and 1 145-2? 9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance With the reqUIrements under Regulations sections 1 141-12 and 1 145-2? Part IV Arbitrage Has the issuerfiled Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu ofArbitrage Rebate? 2 If"No" to line 1,did the followmgapply? a Rebate not due yet? Exception to rebate? No rebate due? If"Yes" to line 2c, prowde in Part VI the date the rebate computation was performed 3 Is the bond issue a variable rate issue? 4a Has the organization or the governmental issuer entered into a qualified hedge With respect to the bond issue? Name of prowder Term of hedge Was the hedge superintegrated? Was the hedge terminated? Schedule (Form 990) 2014 Schedule (Form 990) 2014 Part IV Arbitrage (Continued) 5a Page 3 Were gross proceeds invested In a guaranteed investment contract Yes Name of prowder Term Was the regulatory safe harborfor establishing the fair market value ofthe GIC satisfied? 6 Were any gross proceeds invested beyond an available temporary penod? 7 Has the organization established written procedures to monitor the reqUIrements ofsection 148? Procedures To Undertake Corrective Action Yes Has the organization established written procedures to ensure that Violations of federal tax reqUIrements are timely identified and corrected through the voluntary closmg agreement program if self-remediation is not available under applicable regulations? SCHEDULE SUPPLENTAL INFORMATION Supplemental Information. Prowde additional information for responses to questions on Schedule (see instructions). Return Reference REFINANCE ISSUANCE DATE 4/6/2006 Explanation Ret urn Reference Expla nation THE DIFFERENCE BETWEEN THE ISSUE PRICE REPORTED ON PART TOTAL PROCEEDS PART II, LINE 3 REPORTED ON PART II, LINE 3 IS DUE TO EITHER INVESTMENT EARNINGS OR PREMIUM RECEIVED FROM PURCHASER Return Reference Explanation THE ORGANIZATION HAS IN-HOUSE LEGAL STAFF WHO PROVIDE ROUTINE REVIEWOF MANAGEMENT OR SERVICE CONTRACTS OR RESEARCH AGREEMENTS RELATING TO THE FINANCED PROPERTY TO ENSURE THAT SUCH AGREEMENTS ARE COMPLIANT WITH APPLICABLE SAFE HARBORS IN-HOUSE COUNSEL CONSULT WITH THE OUTSIDE BOND COUNSEL AS NEEDED, INCLUDING ON NON-ROUTINE ISSUES PART LINE 3C Return Reference Explanation THE ORGANIZATION HAS POLICIES AND PROCEDURES IN PLACE TO ENSURE COMPLIANCE WITH FEDERAL TAX PART LINE 9 PART TO TIMELY IDENTIFY NONCOMPLIANCE IN THE EVENT OF NON-COMPLIANCE THE ORGANIZATION WOULD INVOLVE ITS LEGAL COUNSEL TO ADVISE REGARDING APPROPRIATE REMEDIATION Return Ref erenoe Explanation SCHEDULE K, PART IV, ISSUER NAME CHEFA 2008 - SERIES DATE THE REBATE COMPUTATION WAS PERFORMED 06/30/2009 2C 06/30/2014 Iefile GRAPHIC print - DO NOT PROCESS As Filed Data - DLN: 93493224007096I Schedule Transactions With Interested Persons 0MB 1545 0047 Form 990 or 99042) Ir 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. Department ofthe Treasury Ir Attach to Form 990 or Form 990-EZ. Open to Public lniemal Revenue Servrce FInformation about Schedule (Form 990 or 990-EZ) and its instructions is at Inspection Name ofthe organization Employer identification number GREENWICH HOSPITAL 06-0646659 Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only) Complete ifthe organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b 1 Name ofdisqualified person Relationship between disqualified Description oftransaction Corrected? person and organization Yes No 2 Enter the amount oftax incurred by organization managers or disqualified persons during the year under section 3 Enter the amount oftax, ifany, on line 2, above, reimbursed by the organization . . . . . . . Loans to and/or From Interested Persons. Complete ifthe organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26, or ifthe organization reported an amount on Form 990, Part X, line 5, 6, or 22 Name of Relationship Loan to (e)Original (f)Balance In (i)Written interested With organization Purpose of or from the prinCIpal due default? Approved agreement? person loan organization? amount by board or committeeTotal I I I Grants or Assistance Benefiting Interested Persons. Complete if the organization answered "Yes" on Form 990, Part IV, line 27. Name of interested Relationship between Amount ofa55istance Type ofa55istance Purpose ofa55istance person interested person and the organization For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Cat No 50056A Schedule (Form 990 or 990-52) 2014 Schedule (Form 990 or 990-EZ) 2014 Part IV Business Transactions Involving Interested Persons. Complete if the organization answered ?Yes" on Form 990, Part IV, line 28a, 28b, or 28c. Page 2 Name of interested person Relationship Amount of Description oftransaction Sharing between interested transaction of person and the organization's organization revenues? Yes No 35% OWNED 120,000 CONSULTANT No CONTR #32 VENDOR 120,000 CONSULTANT No CONTR #182 VENDOR 1,337,135 LAUNDRY No Supplemental Information Prowde additional information for responses to questions on Schedule (see instructions) Ret urn Reference Explanation PART IV - BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS NAME OF INTERESTED PERSON CORVINO AND CORVINO FRANKA CORVINO IS A GREATERTHAN 35% OWNER OFCORVINO AND CORVINO CONSULTING CORVINO AND CORVINO CONSULTING PROVIDED CONSULTING SERVICES TO THE HOSPITAL AMOUNT OFTRANSACTION $120,000 Schedule (Form 990 or 990-EZ) 2014 lefile GRAPHIC print - DO NOT PROCESS As Filed Data - SCHEDULE (Form 990) Department of the Treasury Internal Revenue Servroe Noncash Contributions irComplete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30. h- Attach to Form 990. OMB No 1545-0047 2014 irInformation about Schedule (Form 990) and its instructions is at Open to PUbliC Ins - ection Name of the organization GREENWICH HOSPITAL Employer identification number 06-0646659 Types of Property Art?Works ofart Art?Historical treasures Art?Fractional interests Books and publications m-thi-I Clothing and household goods Cars and other vehicles Boats and planes Intellectual property IDGNG Securities?Publicly traded 10 Securities?Closely held stock . 11 Securities?Partnership,LLC, ortrustinterests . . 12 Securities?M iscellaneous 13 ualified conservation contribution?H istoric structures 14 ualified conservation contribution?O ther 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 Otheriv( MISCELLANEOUS) Check if applicable Number of contributions or Items contributed (C) Noncash contribution amounts reported on Form 990, Part line lg Method ofdetermining noncash contribution amounts 40,000 FAIR MARKET VALUE 79,895 FAIR MARKET VALUE 109,675 FAIR MARKET VALUE 3,125 FAIR MARKET VALUE 173,735 FAIR MARKET VALUE 353 115,143 FAIR MARKET VALUE 26 Otheri-( 23 107,540 FAIR MARKET VALUE 27 Otheriv( PHOTOGRAPHY) 19,000 FAIR MARKET VALUE 28 Otheri-( 29 Number of Forms 8283 received by the organization during the tax yearfor contributions for which the organization completed Form 8283, Part IV, Donee Acknowledgement 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 is not reqUIred to be used for exempt purposes forthe entire holding period? If"Yes," describe the arrangement in Part II 31 Does the organization have a gift acceptance policy that reqUIres the reVIew ofany non-standard contributions? 31 32a Does the organization hire or use third parties or related organizations to process, or sell noncash contributions? If"Yes," describe in Part II 33 Ifthe organization did not report an amount in column for a type of property for which column is checked, describe in Part For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat NO 51227] Schedule (Form 990) (2014) Schedule (Form 990) (2014) Page 2 Supplemental Information. the Information reqUIred by Part I, IInes 30b, 32b, and 33, and whether the organization IS reporting In Part I, column the number of COI'ltl?lbUthnS, the number of Items or a combination of both. Also complete part for any additional Information. Return Reference Explanation Schedule (Form 990) (2014) lefile GRAPHIC print - DO NOT PROCESS IAs Filed Data - DLN: 93493224007096 SCHEDULE 0 (Form 990 or 990-EZ) Department of the Treasury Internal Revenue Senrlce OMB No 1545-0047 Supplemental Information to Form 990 or 990-EZ 201 4 Complete to provide information for responses to specific questions on Form 990 or 990-EZ or to provide any additional information. Open to Public Attach to Form 990 or 990-EZ. Inspection h- Information about Schedule 0 (Form 990 or 990-EZ) and its instructions is at Name of the organization GREENWICH HOSPITAL Employer identification number 06-0646659 23:. 3 mx_u_m:m:o: 80. >m :03me 2m<< I>20 2cmm_2? >20 m_n_n_0_m20_mm mmzmAImz mammZQAImsz m_n_nOm._.m m>_n_m m2<=uO _nO_u >20 IC00_ _mm >20 mOC20m _2 No.2 m. LOCEZQ _2 m2 me I>m Im_ _um0 mm0COm w< .3 Umm0m2._. 2.0mm mmoc?j >20 memm mwO_ > Ummt>m>j02m mm0m_<_m0 Oc>m0_>2 O>2m< >20 No.2 m>m2m0 _nOm mx_um_?__m20_m_ O>20mm O>mm >20 0 O>20mm O>mm _nOm m _2 mO<< _2 3.1m _2 m_u_2_m>20 IO m_U_O_m mm0m_<_m0 _nOm _ncm_O 2. 22mm >20 _u_ucm mamOZm mm_O>2 Dmomm._.__n__m0 E09325 mx_u>20_m0 O>m0_>0 _2 O>m0_>0 >20 me>2 >2 BOOZE GEO 2C_<__w_mm m3mm?m20< 2m<< ._.mrm._OC Im0 w< >20 w< >20 O_<_mm IO _2 O>mm >2 >00_m0 mmOOm 0 N35. Z5529 meOZm 0:32 _2 2cmm_2O mmOmO>2_N_m0 _Z__umO<_m O>mm_ >20 _2 m>_n_m >20 wm?>2 LOCEZQ m>m2 >20 >m mI>mm0 _2 >_umO m2I>20m0 >20 wm0> _2 >_umO 2m<< ._.mcm O>20mm O>mm >00m0 mcmOmOz. mcmOmOZ _2 OZOOFOOJA O>20mm >20 >2 <0<>20m0 0> 20_ mOwO._. mx_u>20 cmOrOO<_ Omzmm>r >20 mC mx_u>20_m0 >20 00 mm>OIm0 _20m_ OEOCUM <20 _2 >20 >0<_mOm< 0 I m20 ZCme >20 O>20mm >2 C2_2mcmm0 mm0m_<_m0 _m_n_H O>20mm wm>m 0mm<< >2 OI ._Noo >20 20 mx_u>20_m0 >20 me2m<<_02 OO _20_ C0_m0 O>m20 m20 mm0m_<_m0 0m_<_mm IO Return Explanation Reference FORM 990, ST AWARD FOR A SECOND YEAR IN A ROW FOR HAVING THE MOST PARTICIPANTS IN CONNECTICUT PART PART LINE I, LINE4 PART VI, LINE 1B NUMBER OF INDEPENDENT VOTING MEMBERS OF THE GOVERNING BODY TH 4A ORGANIZATION SOUGHT TO CONFIRM THE INDEPENDENCE OF EACH VOTING MEMBER OF ITS GOVERNING ODY BY REQUESTING THAT EACH SUCH VOTING MEMBER RESPOND TO A QUESTIONNAIRE CONTAINING THE ERTINENT INSTRUCTIONS AND DEFINITIONS AND DESIGNED TO ELICIT THE INFORMATION NECESSARY TO DETERMINE INDEPENDENCE BASED ON RESPONSES TO THE QUESTIONNAIRES RECEIVED BY THE ORGANIZAT ION AND ANNUAL CONFLICTS OF INTEREST DISCLOSURES, THE ORGANIZATION WAS ABLE TO CONFIRM THA EIGI-ITEEN (18) VOTING MEMBERS ARE INDEPENDENT Return Reference Explanation FORM 990, PART VI, SECTION A, LINE 2 TRUSTEE WILLIAM BERKLEY, .JR AND FRANK A CORVINO ARE BOARD MEMBERS OF THE SA ME BUSINESS ENTITY THE ORGANIZATIONS CURRENT OFFICERS TRUSTEES SERVE AS OFFICERS DIRECTORS OF TAXABLE AFFILIATES WITHIN THE CORPORATE SYSTEM OR JOINT VENTURES IN WHICH THE ORGANIZATIONS CORPORATE SYSTEM HAS AN OWNERSHIP INTEREST THE INDIVIDUAL OFFICERS DO NOT HAVE PERSONAL FINANCIAL INTERESTS IN THE TAXABLE AFFILIATE AND SERVE ONLY AS A FUNCTION OF THEIR ROLES WITH THE ORGANIZATION OR WITHIN THE CORPORATE SYSTEM Return Reference Explanation FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS THE HOSPITAL IS A CONNECTICUT CORPORATION ITS SOLE MEMBER IS GREENWICH HEALTH CARE SERVICES, INC ITSELF A CONNECTICUT CORPORATION DESCRIBED IN SECTION 501 OF THE CODE Return Reference Explanation FORM 990, PART VI, SECTION A, LINE 7A ELECTION OF MEMBERS AND THEIR RIGHTS YALE NEW HAVEN HEALTH SERVICES CORPORATION THE SOLE MEMBER OF GHCSI (THE SOLE MEMBER), HAS THE AUTHORITY TO DESIGNATE ONE REPRESENTATIVE OF TO SERVE AS A TRUSTEE OF THE HOSPITAL AND APPROVE NOMINEES TO THE BOARD OF TRUSTEES IN ACCORDANCE WITH THE BY LAWS AND THAT CERTAIN SYSTEM AFFILIATION AGREEMENT (THE BY AND AMONG GHCSI AND THE HOSPITAL 32:3 memzmzo: mm?mqmsom mac. 0m0_m_02m I>m >20 5. 010m; mIOm__ _2 >m mOrm 50$me I>m 02E ._.IOm_m 201.5. >20 mmo._._02 mmDC?mU w< mm 2029.002. ZOZBOEA _2 3w >00020>20m w< >20 I>m 291.5. >20 02m >m 0mm_?2_m_m wm Om Amid wO>m0 Umo<_m_02m 9H w< >20 A AOVAO wO>m0 _2 UmO<_m_02m w< >20 >20 >20 >20 Amid 002mm2._. 3 Om >mm_nl_.QIOQ >20 Om w< Return Reference Explanation FORM 990, PART VI, SECTION B, LINE 1 THE PROCESS TO REVIEW FORM 990 THE FORM 990 TAX RETURN AND ATTACHED SCHEDULES WERE PREPARED BY EMPLOYEES OF THE SYSTEM TAX DEPARTMENT THE RETURN IS INITIALLY REVIEWED BY THE HOSPITAL 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 HOSPITAL AND A FINAL VERSION OF THE RETURN IS SENT BACK TO KPMG US LLP FOR FINAL REVIEW PRIOR TO FILING, THE ORGANIZATION MADE AVAILABLE A COMPLETE COPY OF THE RETURN TO THE BOARD OF TRUSTEES BY WEB PORTAL Return Reference Explanation FORM 990, PART VI, SECTION B, LINE 12C GREENWICH HOSPITAL IS COVERED UNDER THE YALE NEW HAVEN HEALTH SYSTEM CONFLICT OF INTEREST POLICY THE YALE NEW HAVEN HEALTH SYSTEM CONFLICT OF INTEREST POLICY (CC AND INDIVIDUAL ANNUAL DISCLOSURE FORM APPLIES TO A POOL OF EMPLOYEES, BOARD MEMBERS AND MEMBERS SERVING ON BOARD COMMITTEES THESE ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT, UPON BEGINNING EMPLOY MENT OR OTHERWISE BECOMING A COVERED INDIVIDUAL AND ANNUALLY THEREAPTER 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 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 RESOLVEA 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 Return Explanation Reference FORM 990, COMPENSATION PROCESS FOR TOP OFFICIALS THE TOP OFFICIAL IS AN EMPLOYEE OF THE EXECUTIVE PART VI, COMPENSATION COMMITTEES OF GREENWICH HOSPITAL AND STRIVE TO TAKE THE STEPS NECESSARY TO QUALIFY SECTION B, FOR THE PRESUMPTION OF UNDER FEDERAL TAX LAW THE EXECUTIVE COMPENSATION LINE 15 COMMITTEES ARE RESPONSIBLE FOR (1) DETERMINING THE OVERALL TOTAL COMPENSATION STRATEGY FOR THEIR RESPECTIVE CORPORATE OFFICERS, (2) APPROVING ALL COMPENSATION AND BENEFITS DECISIONS FOR RESPECTIVE CORPORATE OFFICERS, AND (3) REPORTING SUCH ACTIONS TO THE FULL GREENVVICH HOSPITAL AND BOARDS ON AN ANNUAL BASIS IN ADDITION, THE EXECUTIVE COMPENSATION COMMITTEES EXPRESSLY DETERMINE THE REASONABLENESS OF TOTAL COMPENSATION AND BENEFITS FOR ALL CORPORATE OFFICERS, AND ASSURES THAT ALL OFFICER COMPENSATION DECISIONS ARE MADE AFTER THOROUGH CONSIDERATION OF AND COMPARISON TO THE MARKET PRACTICES OF OTHER SIMILARLY SITUATED HEALTHCARE EXECUTIVES IN COMPARABLE ORGANIZATIONS THE EXECUTIVE COMPENSATION COMMITTEES CONSIST OF BOARD MEMBERS WHO DO NOT HAVE MATERIAL FINANCIAL INTERESTS THAT COULD BE AFFECTED BY THE OFFICER COMPENSATION DECISIONS MADE BY THE COMMITTEES THE COMPARABILITY DATA USED TO ASSIST THE EXECUTIVE COMPENSATION COMMITTEES IN THEIR COMPENSATION DELIBERATIONS ARE COMPILED BY AN INDEPENDENT, NATIONAL COMPENSATION CONSULTING FIRM THAT IS RETAINED BY AND REPORTS DIRECTLY TO THE EXECUTIVE COMPENSATION COMMITTEES THE DATA COLLECTED BY THE CONSULTANT CONSISTS OF MARKET INFORMATION FOR EXECUTIVES IN FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED FOR-PROFIT HEALTHCARE ORGANIZATIONS THE DELIBERATIONS AND DECISIONS OF THE EXECUTIVE COMPENSATION COMMITTEES ARE CONTEMPORANEOUSLY DOCUMENTED, REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEES, AND PROVIDED TO THE BOARDS OF AND THE HOSPITAL FORM 990, PART VI, SECTION B, LINE 15B COMPENSATION PROCESS FOR OFFICERS CERTAIN OFFICERS ARE EMPLOYEES OF OTHER OFFICERS ARE EMPLOYED DIRECTLY BY THE HOSPITAL COMPENSATION DETERMINATIONS OF EMPLOYEES ARE MADE BOTH BY THE COMPENSATION COMMITTEES AND BOARDS OF AND THE HOSPITAL COMPENSATION DETERMINATION OF THE HOSPITAL EMPLOYEES ARE MADE BY THE COMPENSATION COMMITTEE AND BOARD THE EXECUTIVE COMPENSATION COMMITTEES OF GREENWICH HOSPITAL AMD STRIVE TO TAKE THE STEPS NECESSARY TO QUALIFY FOR THE PRESUMPTION OF UNDER FEDERAL TAX LAW THE EXECUTIVE COMPENSATION COMMITTEES ARE RESPONSIBLE FOR (1) DETERMINING THE OVERALL TOTAL COMPENSATION STRATEGY FOR ALL THEIR RESPECTIVE CORPORATE OFFICERS, (2) APPROVING ALL COMPENSATION AND BENEFITS DECISIONS FOR CORPORATE OFFICERS, AND (3) REPORTING SUCH ACTIONS TO THE FULL GREENVVICH HOSPITAL AND BOARD ON AN ANNUAL BASIS, AS APPLICABLE IN ADDITION, THE EXECUTIVE COMPENSATION COMMITTEES, AS APPLICABLE, EXPRESSLY DETERMINE THE REASONABLENESS OF TOTAL COMPENSATION AND BENEFITS FOR ALL CORPORATE OFFICERS, AND ASSURES THAT ALL OFFICER COMPENSATION DECISIONS ARE MADE AI-TTER THOROUGH CONSIDERATION OF AND COMPARISON TO THE MARKET PRACTICES OF OTHER SIMILARLY SITUATED HEALTHCARE EXECUTIVES IN COMPARABLE ORGANIZATIONS THE EXECUTIVE COMPENSATION COMMITTEES CONSIST OF BOARD MEMBERS WHO DO NOT HAVE MATERIAL FINANCIAL INTERESTS TI-IAT COULD BE AFFECTED BY THE OFFICER COMPENSATION DECISIONS MADE BY THE COMMITTEES THE COMPARABILITY DATA USED TO ASSIST THE EXECUTIVE COMPENSATION COMMITTEES IN THEIR COMPENSATION DELIBERATIONS ARE COMPILED BY AN INDEPENDENT, NATIONAL COMPENSATION CONSULTING FIRM THAT IS RETAINED BY AND REPORTS DIRECTLY TO THE EXECUTIVE COMPENSATION COMMITTEES THE DATA COLLECTED BY THE CONSULTANT CONSISTS OF MARKET INFORMATION FOR EXECUTIVES IN FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED HEALTHCARE ORGANIZATIONS THE DELIBERATIONS AND DECISIONS OF THE EXECUTIVE COMPENSATION COMMITTEES ARE CONTEMPORANEOUSLY DOCUMENTED, REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEES, AND PROVIDED TO THE BOARDS OF THE HOSPITAL, AS APPLICABLE NEE: memsmzo: mm?mqmsom mm? moo. Aowm >20 >mm _2 mm0._._02 O. m< ?Omm Return Explanation Reference FORM 990, LAUNDERING SERVICE PROGRAM SERVICE EXPENSES 875,932 MANAGEMENT AND GENERAL EXPENSES 247,058 PART IX, LINE FUNDRAISING EXPENSES 0 TOTAL EXPENSES 1,122,990 OTHER PURCHASED SERVICES PROGRAM SERVICE EXPENSES 11G 31,787,719 MANAGEMENT AND GENERAL EXPENSES 7,842,776 FUNDRAISING EXPENSES 208,335 TOTAL EXPENSES 39,838,830 OTHER PROFESSIONAL FEES PROGRAM SERVICE EXPENSES 9,782,502 MANAGEMENT AND GENERAL EXPENSES 2,759,167 FUNDRAISING EXPENSES 0 TOTAL EXPENSES 12,541,669 Return Explanation Reference FORM 990, PENSION ADJUSTMENT AMORTIZATION -163,000 TRANSFERS TO AFFILIATES -8,458,000 ASSETS PART XI, LINE 9 RELEASED FOR OPERATIONS -4,783,000 RESTRICTED CONTRIBUTIONS 5,358,000 REALIZED GAIN ON INVESTMENTS 1,956,000 CHANGE IN FOUNDATION NET ASSETS ,567 CHANGE IN AUXILIARY NET ASSETS 321,932 BOOK TO TAX ITEMS 1,235,527 lefile GRAPHIC print - DO NOT PROCESS IAs Filed Data - DLN: 93493224007096 SCHEDULE (Form 990) Department of the Treasury Internal Revenue Seniice h- Attach to Form 990. Related Organizations and Unrelated Partnerships Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37. Information about Schedule (Form 990) and its instructions is at OMB No 1545-0047 Open to Public Inspection Name of the organization GREENWICH HOSPITAL Identification of Disregarded Entities Complete Employer identification number 06-0646659 if the organization answered ?Yes" on Form 990, Part IV, line 33. Name, address, and EIN (if applicable) of disregarded entity Primary actIVIty (C) Legal domICIle (state or foreign country) Total Income End?of?year assets Direct controlling entity (1) 900 KING STREET ASSOCIATES LLC 5 PERRYRIDGE ROAD GREENWICH, CT 06830 26-0805259 BUILDING OP ERATION CT 0 GREENWICH HOSPITAL (2) GREENWICH CLINICAL PATHOLOGY ASSOCIATES LLC 5 PERRYRIDGE ROAD GREENWICH, CT 06830 26-2455578 HEALTHCARE SERVICES CT 1,633,204 263,317 GREENWICH HOSPITAL (3) GREENWICH PATHLOGY ASSOCIATES LLC 5 PERRYRIDGE ROAD GREENWICH, CT 06830 06-6140101 HEALTHCARE SERVICES CT 3,134,300 482,824 GREENWICH HOSPITAL 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. Name, address, and EIN of related organization Prima ry activ ity (C) Legal domICIle (state or foreign country) Exem pt Code section (6) (9) Public charity status Direct controlling Section 512(b) (if section 501(c)(3)) entity (13) controlled ntity 7? Yes See Additional Data Table For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat No 50135Y Schedule (Form 990) 2014 ScheduleR(Form990)2014 Page2 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. (C) (E) (9) Name, address, and EIN of Primary actIVIty Legal Direct Predominant Share of Share of Disproprtionate Code General or Percentage related organization domICIIe controlling income(re ated, total income end?of? allocations? amount in managing ownership (state or entity unrelated, year box 20 of partner? foreign excluded from assets Schedule country) tax under (Form 1065) sections 512? 514) Yes No Yes No (1) SHORELINE SURGERY CENTER LLC HEALTHCARE CT SERVICES 60 TEMPLE STREET NEW HAVEN, CT 06510 90?0110459 (2) SSC II LLC HEALTHCARE CT SERVICES 111 GOOSE LANE GUILFORD, CT 06437 26?1709382 (3) ORTHOPAEDIC NEUROSURGERY HEALTHCARE CT CENTER SERVICES 55 HOLLY HILL LANE GREENWICH, CT 06830 27?3477197 (4) TOTAL HEALTH CONNECTICUT LLC HEALTHCARE CT SERVICES 789 HOWARD AVENUE NEW HAVEN, CT 06519 47?4070024 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. (C) (E) Name, address, and EIN of Primary actIVIty Legal Direct controlling Type of entity Share of total Share of end? Percentage Section 512 related organization domICIIe entity (C corp, income of?year ownership (state or foreign corp, assets controlled country) or trust) entity? Yes No See Additional Data Table Schedule (Form 990) 2014 ScheduleR(Form990)2014 Page3 Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36. Note. Complete line 1 ifany entity is listed In Parts II, or IV of this schedule Yes N0 1 During the tax year, did the orgranization engage In any of the followmg transactions With one or more related organizations listed in Parts a Receipt of interest, (ii) annUIties, royalties, or (iv) rent from a controlled entity 1a NO Gift, grant, or capital contribution to related organization(s) 1b No Gift, grant, or capital contribution from related organization(s) 1C N0 Loans or loan guarantees to or for related organization(s) 1d N0 Loans or loan guarantees by related organization(s) 1e N0 DIVldendS from related organization(s) 1f N0 9 Sale ofassets to related organization(s) 19 NO Purchase ofassets from related organization(s) 1" No i Exchange ofassets With related organization(s) 1i N0 Lease offaCIlities, eqUIpment, or other assets to related organization(s) 1i N0 Lease of faCIlities, eqUIpment, or other assets from related organization(s) 1k Yes I Performance ofserVIces or membership or fundraismg SOIICItations for related organization(s) 1' Yes Performance ofserVIces or membership orfundraismg SOIICItations by related organization(s) 1m Yes Sharing offaCIlities, eqUIpment, mailing lists, or other assets With related organization(s) 1n N0 0 Sharing of paid employees With related organization(s) 10 N0 Reimbursement paid to related organization(s) for expenses 1D Yes Reimbursement paid by related organization(s) for expenses 1q Yes Othertransfer ofcash or property to related organization(s) 1r Yes 5 Other transfer ofcash or property from related organization(s) 15 Yes 2 Ifthe answerto any ofthe above is "Yes," see the instructions for information on Who must complete this line, including covered relationships and transaction thresholds (C) Name of related organization Transaction Amount involved Method of determining amount involved type See Additional Data Table Schedule (Form 990) 2014 Schedule (Form 990) 2014 Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37. Prowde the followmg 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 exc u5ion for certain investment partnerships Page 4 Name, address, and EIN of entity Prima ry activ ity (C) Legal domICIle (state or foreign country) Predominant income (related, unrelated, excluded from tax under sections 512? 514) Are all partners organizations? (6) 501(c)(3) Ya (0 Share of total income (9) Share of nd ?of? yea assets Dispropitio nate allocations? Yes Code amount in box 20 of Schedule (Form 1065) General or managing partner? 00 Percentage ownership Yes No Schedule (Form 990) 2014 Schedule (Form 990) 2014 Page 5 Supplemental Information Prowde additional Information for responses to questions on Schedule (see Instructions) Ret urn Reference Explanation Schedule (Form 990) 2014 Additional Data Software ID: Software Version: Form 990, Schedule R, Part II - Identification of Related Tax-Exempt Organizations EIN: 06-0646659 Name: GREENWICH HOSPITAL (C) Name,address,andEIN ofrelated organlzatlon Prlmary actIVIty LegaldomICIle ExemptCode Publlc charlty DIrect Sectlon 512 (state sectlon status orforelgn (Ifsectlon 501(c) controlled country) Yes No HOSPITAL HEALTHCARE CT 501C3 LINE3 YALE NEWHAVEN Yes SERVICES HEALTH SERVICES 267 GRANT STREET CORP BRIDGEPORT, CT 06610 06-0646554 HOSPITALAUXILIARYINC SYSTEM SUPPORT CT 501C3 LINE BRIDGEPORT Yes SERVICES HOSPITAL 267 GRANT STREET BRIDGEPORT, CT 06610 06-6042500 HOSPITAL FOUNDATIONINC SYSTEM SUPPORT CT 501C3 LINE7 BRIDGEPORT Yes SERVICES HOSPITAL 267 GRANT STREET BRIDGEPORT, CT 06610 22-2908698 12152014 INSURANCE VT 501C3 LINE YALE NEWHAVEN Yes HOSPITAL 40 MAIN STREET 05401 03-0322238 MEDICAL GROUPINC HEALTHCARE CT 501C3 LINE9 YALE NEWHAVEN Yes SERVICES HEALTH SERVICES 99 HAWLEY LANE CORP STRATFORD, CT 06614 06-1330992 MEDICAL GROUP PLLC HEALTHCARE CT 501C3 LINE NORTHEAST Yes SERVICES MEDICAL GROUP INC 99 HAWLEY LANE STRATFORD, CT 06614 35-2380180 CORPORATION SYSTEM SUPPORT CT 501C3 LINE GREENWICH HEALTH Yes SERVICES CARE SERVICESINC 5 PERRYRIDGE ROAD 06830 06-1207316 CONNECTICUT HEALTH SYSTEM TITLE HOLDING CT 501C2 BRIDGEPORT Yes PROPERTIESINC HOSPITAL 267 GRANT STREET BRIDGEPORT, CT 06610 06-1297708 GREENWICH HOSPITAL ENDOWMENT FUNDINC SYSTEM SUPPORT CT 501C3 LINE GREENWICH HEALTH Yes SERVICES CARE SERVICESINC 5 PERRYRIDGE ROAD 06830 06-1526642 NEWHAVEN HEALTH SERVICES CORP SYSTEM SUPPORT CT 501C3 LINE No SERVICES 789 HOWARD AVE NEWHAVEN, CT 06519 22-2529464 CARE CONTINUUM CORP NURSING HOME CT 501C3 LINE3 YALE-NEWHAVEN Yes HOSPITAL 789 HOWARD AVE NEWHAVEN, CT 06519 45-5235566 HOSPITAL HEALTHCARE CT 501C3 LINE3 YALE NEWHAVEN Yes SERVICES HEALTH SERVICES 20 YORK STREET CORP NEWHAVEN, CT 06504 06-0646652 HEALTH CARE SERVICESINC SYSTEM SUPPORT CT 501C3 LINE YALE NEWHAVEN Yes SERVICES HEALTH SERVICES 5 PERRYRIDGE ROAD CORP 06830 22-2593399 HOSPITAL FRIENDS OF PEDIATRICSINC SYSTEM SUPPORT CT 501C3 LINE YALE-NEWHAVEN Yes SERVICES HOSPITAL 120 COLUMBINE DRIVE TRUMBULL, CT 06611 06-6048427 Form 990, Schedule R, Part IV - Identification of Related Organizations Taxable as a Corporation or Trust Name, address, and EIN of related organization Yes GREENWICH FERTILITY IVF PC 5 PERRYRIDGE ROAD GREENWICH, CT 06830 30-0145464 Primary actIVIty No HEALTHCARE SERVICES (C) Legal (State or Foreign Country) CT Direct Controlling Type ofentity ntity (C corp, corp, ortrust) Share of total income (9) Share of end-of?year assets Percentage ownership Section 512(b) (1 3) controlled Yes entity? GREENWICH HEALTH SERVICESINC -TERMINATED 6302015 5 PERRYRIDGE ROAD 06830 06-1233643 HEALTHCARE SERVICES CT Yes GREENWICH OCCUPATIONAL HEALTH SERVICES OF NY PC 5 PERRYRIDGE ROAD GREENWICH, CT 06830 06-1540101 HEALTHCARE SERVICES NY Yes MEDICAL CENTER PHARMACY INC 50 YORK STREET NEW HAVEN, CT 06511 06-1087673 PHARMACY CT Yes MEDICAL CENTER REALTY INC 50 YORK STREET NEW HAVEN, CT 06511 06-1110858 REAL ESTATE CT Yes YALE NEW HAVEN AMBULATORY SERVICES 40 TEMPLE STREET NEW HAVEN, CT 06510 06-1398526 HEALTHCARE SERVICES CT Yes YNHH-PHYSICIANS CORP 789 HOWARD AVE NEW HAVEN, CT 06519 06-1202305 ADMINISTRATIVE SERVICES CT Yes INC 789 HOWARD AVE NEWHAVEN, CT 06519 06-1467717 MANAGEMENT SERVICES CT Yes YORK ENTERPRISES INC 50 YORK STREET NEW HAVEN, CT 06511 06-1110937 TITLE HOLDING CT Yes GREENWICH OCCUPATIONAL HEALTH SERVICES OF NJ PC 5 PERRYRIDGE ROAD GREENWICH, CT 06830 45-3833883 HEALTHCARE SERVICES NJ Yes LUKAN INDEMNITY COMPANY - TERMINATED 3312015 58 PAR-LA-VALLIS RD HAMILTON BD 98-1072793 INSURANCE BD Yes PRIMARYNET OF CONNECTICUT INC 789 HOWARD AVE NEW HAVEN, CT 06519 06-1463534 HEALTHCARE SERVICES CT Yes CENTURY FINANCIAL SERVICESINC 23 MAIDEN LANE NORTH HAVEN, CT 06473 06-1110797 DEBT COLLECTION CT Yes CENTURY MANAGEMENT SERVICES INC 23 MAIDEN LANE NORTH HAVEN, CT 06473 06-1303173 RECEIVABLE MANAGEMENT CT Yes Form 990, Schedule R, Part - Transactions With Related Organizations (C) Name of related organlzatlon Transactlon AmountInvolved Method amount type(a-s) Involved YALE NEWHAVEN HEALTH SERVICES CORP 6,048,814 FAIR MARKET VALUE YALE NEWHAVEN HEALTH SERVICES CORP 44,125,764 FAIR MARKET VALUE GREENWICH HEALTH CARE SERVICESINC 8,910,519 ASSET TRANSFER GREENWICH HOSPITAL ENDOWMENT FUND 2,510,421 FAIR MARKET VALUE PERRYRIDGE CORPORATION 783,384 FAIR MARKET VALUE PERRYRIDGE CORPORATION 277,329 ACTUAL COST PERRYRIDGE CORPORATION 37,440 FAIR MARKET VALUE PERRYRIDGE CORPORATION 470,397 CASH