2024-08-13T10:12:27-05:00 2023-09-30 990 2022-10-01 800458769 St Vincent's Multispecialty Group Inc STVI 8606963563 2800 Main Street Bridgeport CT 06606 Mark Keise Authorized Signer 8606966282 2024-08-13 0 P00670158 2022 2024-08-08 14:25:15Z Neighborhood Health Daniel Gottshall MD 2800 Main Street Bridgeport CT 06606 750736 0 X See Schedule O X 2010 CT Neighborhood Health initiative is designed to bring more health prevention services and support directly to the people and communities we serve. 8 1 0 1 0 0 0 0 0 750736 0 0 0 0 0 750736 0 0 0 0 0 0 0 0 0 0 750736 0 750736 0 0 0 39641 0 39641 0 0 X None 1 0 89649 750736 Neighborhood Health mobile "CareVans" visit and operate daytime health clinics at specifically chosen locations every week. They offer a variety of health services including screenings, mental health counseling, medical referrals, education and support. The Pfizer 2023-2024 COVID-19 vaccine (for those 12 and older) and several other non COVID immunizations are also available.Neighborhood Health was developed in collaboration with trusted community partners throughout the state. These groups and individuals helped determine the health needs and priorities for their residents and communities. These innovative health clinics are adaptable, flexible, and open to feedback to ensure access to needed services and programs.We are currently offering clinics statewide to serve people of all ages (12 and older for Pfizer COVID-19 vaccine), welcome walk-ins, and provide onsite financial assistance (insurance is accepted but not required).Statewide clinics are also currently addressing various urgent needs of the community, which include, but are not limited to:- Common cold/flu- Stomach aches- Earaches/infections and foreign body removal- Family planning- Abscess incision and drainage- Minor burns, lacerations, sprains and fractures- Rashes and insect bites- Corneal abrasionsMedical screenings are provided for blood pressure, blood sugar, urinalysis, and urine pregnancy. Provided lab tests include A1C, Cholesterol, Hepatitis C, Hemoglobin, HIV, Flu, and symptomatic COVID-19. Complete Metabolic Panel tests (Electrolytes, Liver and Kidney function) are also available.Referrals can be made for follow up care in the areas of social services, behavioral health and primary or specialty care.The clinics are also able to provide the following immunizations:- Tetanus (Tdap)- Pneumonia- Shingles- Hepatitis B- Meningitis- Gardasil- Polio- Flu (seasonal)- MMR (Measles, Mumps and Rubella)- COVID-19 (Pfizer 2023-2024, ages 12+) 89649 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 8 1 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X David Baranik 8606962546 c/o 9 Farm Springs Road Farmington CT 06032 Jeffrey Cohen MD Director 2.00 58.00 X 0 1347089 56905 Vincent DiBattista Former President (Thru 9/21) 0.00 0.00 X 0 882083 59090 Christopher Iannuzzi MD Director, Vice Chair 2.00 58.00 X X 0 701346 59752 Daniel Gottshall MD Director/Chair, Pres. & Sec 2.00 58.00 X X 0 585155 61396 Edward Tristine MD Director 2.00 58.00 X 0 404916 54346 Christopher Given Director & Treasurer 2.00 58.00 X X 0 415641 26052 Corina Marcu MD Director (Thru 12/22) 2.00 58.00 X 0 413517 22391 David Baranik VP, Finance 7.00 53.00 X 0 388787 38517 Anna Pankratov MD Director 2.00 58.00 X 0 329727 56698 Robert Fitton MD Director 2.00 58.00 X 0 64650 0 Robert Jumper MD Director 2.00 X 0 0 0 0 5532911 435147 0 1 1 0 0 Program Revenue 621990 750736 750736 750736 750736 750736 0 0 70 70 Allocated Salary 750666 89649 661017 750736 89649 661087 0 0 39641 0 39641 0 39641 0 39641 X 0 0 0 0 0 39641 0 0 X X 0 1 X 1 0 X X X 4 SVMC Holdings Inc dba St Vincent's Medical Center 832550272 3 1 0 0 Hartford Hospital 060646668 3 0 198891 0 The William W Backus Hospital 060250773 3 0 0 0 The Charlotte Hungerford Hospital 060646678 3 0 0 0 4 198891 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 Schedule A, Part IV, Section A, Line 1 St. Vincent's Multispecialty Group, Inc. made changes to it's business model during the fiscal year ended September 30, 2023. Not all governing documents regarding these changes were finalized at the end of the fiscal year. As a result, not all supported organizations are listed in it's governing documents. Schedule A, Part IV, Section B, Line 1 Hartford HealthCare Corporation, the System Parent of the organization and it's supported organizations, has the authority to approve/remove members of the governing body. 0 Due to Affiliates 39641 39641 0 1 0 0 0 0 0 1 0 Jeffrey Cohen MD Director 0 780568 0 424285 0 142236 0 21350 0 35555 0 1403994 0 0 Vincent DiBattista Former President (Thru 9/21) 0 469269 0 380999 0 31815 0 21350 0 37740 0 941173 0 10631 Christopher Iannuzzi MD Director, Vice Chair 0 700195 0 600 0 551 0 21350 0 38402 0 761098 0 0 Daniel Gottshall MD Director/Chair, Pres. & Sec 0 450103 0 130888 0 4164 0 21350 0 40046 0 646551 0 0 Edward Tristine MD Director 0 348387 0 55977 0 552 0 21350 0 32996 0 459262 0 0 Christopher Given Director & Treasurer 0 317165 0 97424 0 1052 0 21350 0 4702 0 441693 0 0 Corina Marcu MD Director (Thru 12/22) 0 357737 0 55228 0 552 0 21350 0 1041 0 435908 0 0 David Baranik VP, Finance 0 281803 0 103159 0 3825 0 21350 0 17167 0 427304 0 0 Anna Pankratov MD Director 0 277425 0 51750 0 552 0 21350 0 35348 0 386425 0 0 Part I, Line 3 The Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare on behalf of St. Vincent's Multispecialty Group, Inc. hires an outside consultant, Human Resources and Compensation Consulting Practice of Gallagher, to determine best practices in governing executive compensation. Please refer to compensation narrative reported on Schedule O. Part I, Line 4b Hartford Healthcare Corporation, a related organization, maintains a 457(f) Supplemental Executive Retirement Plan (SERP). Participants include certain officers and key employees at the President & CEO, Executive Vice President and Senior Vice President levels that are reported by St. Vincent's Multispecialty Group, Inc. on its Form 990, Part VII. Contributions are made by Hartford HealthCare Corporation to the plan based on a percentage of the participant's compensation. Participants vest in the plan at the earlier of reaching age 55 and having 5 years of service, death, disability, involuntary separation without reasonable cause, upon reaching age 65 or the occurrence of a change in control. Each participant ceases to be eligible for further contributions by Hartford Healthcare Corporation on the date of the participant's separation from service. Participants receive a one-time lump sum payment of the accumulated amount during the 30-day period following the participant's separation from service. 2022 SERP Payouts were made on behalf of the following individuals: Vincent DiBattista $10,631 Jeffrey Cohen $75,131* *For this individual, vesting occurred, causing taxable income. This portion of the vested amount was used to pay the associated tax liability. The remaining balance was deposited into the employee SERP account. Part I, Line 7 Hartford HealthCare Corporation, a related organization, has a Compensation At Risk Plan that encourages and rewards achievements of significant functional goals. These goals contribute to the organization's strategic and financial direction. The plan utilizes market practice alignment to ensure competitive recruitment and retention. Awards are based on CEO and/or Hartford HealthCare Corporation's Compensation Committee discretionary assessment of overall organization performance and individual contribution to results. Page 1, Item J - Company Website The website address for St. Vincent's Multispecialty Group, Inc d/b/a Neighborhood Health is https://hartfordhealthcare.org/health-wellness/neighborhood-health Form 990, Part III, line 2 Effective FY2023, St. Vincent's Multispecialty Group, Inc. d/b/a Neighborhood Health was re-purposed from professional medical services to mobile CareVan clinics. See Part III, Line 4a for more details. Form 990, Part VI, Section A, line 6 St. Vincent's Multispecialty Group, Inc. is organized as a non-stock not-for-profit entity. SVMC Holdings, Inc. dba St. Vincent's Medical Center is the sole member. Form 990, Part VI, Section A, line 7a Hartford HealthCare Corporation, the System Parent of the organization, has the authority to approve/remove members of the governing body. The bylaws and articles of incorporation of St. Vincent's Multispecialty Group, Inc. cannot be amended without the approval of Hartford HealthCare Corporation. Form 990, Part VI, Section A, line 7b Hartford HealthCare Corporation, the System Parent of the organization, has the right to review, approve, disapprove and deny significant transactions such as mergers, acquisitions, dissolutions, etc. Form 990, Part VI, Section B, line 11b The Form 990 was prepared by Hartford Healthcare's Tax Department and reviewed by the Tax Director. It was then forwarded to the VP of Finance for review. The final Form was provided to the entire Board prior to submission to the Internal Revenue Service (IRS). Once the entire review process was completed, the Form was signed by the Tax Director who is the Authorized Signer and then filed with the IRS. Form 990, Part VI, Section B, line 12c The Organization's board has adopted the policy of the member, Hartford HealthCare Corporation (HHC). HHC's Conflict of Interest Policy (Policy) requires all covered individuals, including board members and officers, to provide a disclosure of relationships that create or have the appearance of creating a conflict of interest or commitment. The Policy requires updates if changes in circumstances arise during the year that either (a) create a new potential conflict of interest or commitment or (b) change or eliminate a conflict of interest or commitment previously disclosed. Conflict of interest disclosure statements are maintained by the HHC Office of Compliance and Integrity (OCI). Employee and physician disclosures are reviewed by OCI in collaboration with the Covered Individuals' supervisor, when deemed appropriate, to determine if there is a potential conflict. Conflict mitigation plans are developed by OCI. Other individuals who may review potential conflicts of interest and approve conflict management plans include: the SVP/EVP of the department/area in which the individual works, the Institute Physician-In-Chief, the Medical Group Physician-In-Chief, the Regional Vice President of Medical Affairs, and/or the HHC Legal Department. Board member disclosures are reported to the HHC Nominating and Governance Committee for determinations of conflicts and the management of them, where applicable. Form 990, Part VI, Section B, line 15 The Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare on behalf of St. Vincent's Multispecialty Group, Inc., hires an outside consultant, Human Resources and Compensation Consulting Practice of Gallagher, to determine best practices in governing executive compensation. The following steps were taken: - The use of an Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare, on behalf of St. Vincent's Multispecialty Group, Inc., established and regularly reviews Executive Compensation Philosophy; - The Committee regularly reviews scope and depth of positions taking into account complexity and the financial impact and accountability of all "disqualified persons; - National peer groups are selected for comparative purposes based on organizational size, operating revenue, geography and other relevant factors; - Analysis of current total compensation versus market is performed by independent third party compensation consulting firm and is then reviewed by the committee; - Recommendations are made based on market data analysis to ensure appropriate competitive positioning within parameters of compensation philosophy; -The President & CEO compensation is reviewed by the Committee and is based on comparative market information and organizational performance; - All changes are reviewed and approved by the Executive Compensation Committee; The compensation determination process for the President & CEO is reviewed on an annual basis. All other executive compensation is regularly reviewed for scope and depth of positions taking into account complexity and the financial impact and accountability. Form 990, Part VI, Section C, line 18 The St. Vincent's Multispecialty Group, Inc. Form 990 and its attachments are available upon request. Form 990, Part VI, Section C, line 19 The St. Vincent's Multispecialty Group, Inc. Financial Statements, Governing Documents and Conflict of Interest Policy are available for inspection upon request at the Organization's address. Form 990, Part XII, Line 2c The activity of St. Vincent's Multispecialty Group, Inc. is included in the consolidated financial statements of Hartford HealthCare Corporation and Subsidiaries. The finance and audit committee of Hartford HealthCare Corporation's board assumes responsibility for the consolidated organization as a whole. Cardiology Physicians of Fairfield County LLC 2800 Main Street Bridgeport CT 06606 300734694 Physicians Services CT 0 0 St Vincent Multispecialty Group Primary Care Physicians of Stratford LLC 2800 Main Street Bridgeport CT 06606 475613906 Physicians Services CT 0 0 St Vincent Multispecialty Group St Vincent's Urgent Care LLC 2800 Main Street Bridgeport CT 06606 472516729 Physicians Services CT 0 0 St Vincent Multispecialty Group Backus HealthCare Inc 326 Washington Street Norwich CT 06360 222481794 Supporting Organization CT 501(c)(3) 12 (a) Hartford HealthCare Corporation 1 Connecticut Health System Inc 80 Seymour Street Hartford CT 06102 222779421 Coordination of Health Care Delivery CT 501(c)(3) 12 (c) Hartford HealthCare Corporation 1 Hartford HealthCare ACO Inc 1290 Silas Deane Hwy 2nd Floor Wethersfield CT 06109 460886367 Government Contracts CT 501(c)(3) 7 Hartford HealthCare Medical Group Inc 1 Hartford HealthCare at Home Inc 1290 Silas Deane Hwy Suite 4B Wethersfield CT 06109 060646938 Home Healthcare CT 501(c)(3) 10 Hartford HealthCare Corporation 1 Hartford HealthCare Corporation 100 Pearl Street Hartford CT 06103 222672834 Support & Management Svcs. 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061432692 Supporting Organization CT 501(c)(3) 12 (a) Rushford Center Inc 1 St Vincent's Development Inc 95 Merritt Boulevard Trumbull CT 06611 222554128 Holding Company CT 501(c)(25) St Vincent's Health Services Corp 1 St Vincent's Health Services Corp 2800 Main Street Bridgeport CT 06606 222558134 Supporting Organization CT 501(c)(3) 12 (a) SVMC Holdings Inc dba St Vincent's Medical Center 1 St Vincent's Medical Center Foundation Inc 2800 Main Street Bridgeport CT 06606 222558132 Fundraising CT 501(c)(3) 7 SVMC Holdings Inc dba St Vincent's Medical Center 1 St Vincent's Special Needs Center Inc 95 Merritt Boulevard Trumbull CT 06611 060702617 Residential Services for Handicapped CT 501(c)(3) 10 St Vincent's Health Services Corp 1 SVMC Holdings Inc dba St Vincent's Medical Center 2800 Main Street Bridgeport CT 06606 832550272 Hospital CT 501(c)(3) 3 Hartford HealthCare Corporation 1 The Charlotte Hungerford Hospital 540 Litchfield Street PO Box 988 Torrington CT 06790 060646678 Healthcare Services CT 501(c)(3) 3 Hartford HealthCare Corporation 1 The Hospital of Central CT and Bradley Memorial 100 Grand Street New Britian CT 06052 060646768 Healthcare Services CT 501(c)(3) 3 Hartford HealthCare Corporation 1 The Orchards of Southington 34 Hobart Street Southington CT 06489 061490803 Residential Services for Senior Citizens CT 501(c)(3) 10 Hartford HealthCare Senior Services Inc 1 The William W Backus Hospital 326 Washington Street Norwich CT 06360 060250773 Hospital CT 501(c)(3) 3 Hartford HealthCare Corporation 1 WCMH Women's Auxiliary Inc 112 Mansfield Avenue Willimantic CT 06226 060677728 Fundraising CT 501(c)(3) 12 (a) Windham Community Memorial Hospital 1 Windham Community Memorial Hospital 112 Mansfield Avenue Willimantic CT 06226 060646966 Healthcare Services CT 501(c)(3) 3 Hartford HealthCare Corporation 1 Windham Hospital Foundation Inc 112 Mansfield Avenue Willimantic CT 06226 562546632 Supporting Organization CT 501(c)(3) 12 (a) Windham Community 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Indemnity Services Ltd FB Perry Bld 40 Church Street Hamilton BD Captive Insurance BD N/A C 1 Hartford Physician Services PC 80 Seymour Street Hartford CT 06102 061254082 Medical Services CT N/A C 1 Hunter's Ambulance Service Inc 450 West Main Street Meriden CT 06451 060789464 Ambulance Services CT N/A S 1 Meriden Imaging Center Inc 101 North Plains Industrial Road Meriden CT 06429 061541468 Imaging CT N/A S 1 Metro Wheelchair Service Inc PO Box 300 Manchester CT 06045 060878432 Wheelchair Services CT N/A C 1 The Cancer Care Fund Of The Litchfield Hills Inc 200 Kennedy Drive Torrington CT 06790 510474072 Cancer Care Fund CT N/A C 1 Windham Professional Office Condo Assoc 112 Mansfield Avenue Willimantic CT 06226 061090041 Condo Association CT N/A C 1 WWB Corporation 326 Washington Street Norwich CT 06360 061094838 Holding Company CT N/A C 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 Hartford Hospital R 198891 FMV Hartford Hospital S 458268 FMV The Charlotte Hungerford Hospital S 109234 FMV The William W Backus Hospital S 77970 FMV