2024-08-13T10:03:33-05:00 2023-09-30 990 2022-10-01 820586577 MULBERRY GARDENS OF SOUTHINGTON LLC MULB 8602761020 58 MULBERRY STREET PLANTSVILLE CT 06479 Mark Keise Authorized Signer 8606966296 2024-08-13 0 2022 2024-08-08 14:25:15Z Eric Smullen 58 MULBERRY STREET PLANTSVILLE CT 06479 6677846 0 X WWW.MULBERRYGARDENS.ORG X 2003 CT Assisted living facility and adult day care services. 4 0 124 5 0 0 7573 12570 6105707 6665276 21 0 0 0 6113301 6677846 0 0 0 0 3716372 4167772 0 0 0 2512846 2466306 6229218 6634078 -115917 43768 8669905 8331132 5684430 5301889 2985475 3029243 Our mission is to provide the highest quality community-based program in a safe and positive environment. We provide care to individuals with a variety of socialization and cognitive needs. 0 0 5452877 6665276 Mulberry Gardens is a 95 apartment senior living community. The assisted living program is designed to promote the independence and dignity of seniors by providing assistance with activities of daily living. These actives includes: bathing, dressing, ambulating and medication reminders in a residential setting. Other services include weekly housekeeping, meals, health promotion, exercise programs, cultural, educational and social activities. Mulberry Gardens also offers Adult Day Care services. 5452877 1 0 0 0 0 0 0 0 0 0 1 0 0 1 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 0 1 1 0 0 0 1 24 0 1 124 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X David Baranik 8606962546 181 Patricia M Genova Dr Newington CT 06111 Tracy Church Director/Chair 2.00 58.00 X X 0 1315366 45721 Rocco Orlando MD Director/Secretary 2.00 58.00 X X 0 972488 69623 Eric Smullen Director 1.00 59.00 X 0 482672 104904 Chibueze Agba Director/President 2.00 58.00 X X 0 1533173 190199 David Baranik VP, Finance 6.00 54.00 X 0 388787 38517 Lisa Connolly VP, Community Network Serv 10.00 50.00 X 0 326646 47384 Laurie St John VP, Clinical Services (Thru 7/2023) 10.00 50.00 X 0 315342 43330 Heather DePaolo VP, Human Resources 10.00 50.00 X 0 285490 20775 Jacquelyn Gaulin Exec Dir Assisted Living 60.00 0.00 X 136014 0 35431 136014 5619964 595884 2 0 1 0 Morrison Management Specialists Inc 400 Northbridge Road Sandy Springs GA 30350 Food Services 361941 Champion Maintenance & Construction LLC PO Box 320204 Fairfield CT 06825 Construction Service 173664 Exterior Trim Specialties LLC 300 Riverside Ave Bristol CT 06010 Construction Service 137636 Elder Crew LLC 123 Farmington Ave Bristol CT 06010 Staffing Service 122401 Origin Incorporated 1800 SW 1st Street Suite 510 Portland OR 97201 Staffing Service 121120 5 12570 12570 Patient Services 623000 6665276 6665276 6665276 6677846 6665276 0 0 3350024 2898819 451205 80297 69482 10815 517745 448011 69734 219706 185189 34517 151847 151847 7209 7209 143087 69160 73927 132639 132639 400861 221011 179850 1671 212 1459 375 375 74328 45340 28988 183292 183292 314732 234504 80228 51903 51903 Purchased Services 545984 511280 34704 Repairs & Maintentance 360746 352891 7855 Medical Supplies 75094 75094 Dues Subs and Licenses 22538 5495 17043 6634078 5452877 1181201 0 2 58924 67422 40186 34856 8453115 3126162 5465048 5326953 3105747 2901899 8669905 8331132 845981 735519 103933 30880 4734516 4535490 5684430 5301889 X 2985475 3029243 2985475 3029243 8669905 8331132 43768 0 X X 0 1 X 1 1 1 X 12701 8531 7776 7573 12570 49151 7085710 6316658 5441784 6105707 6665276 31615135 7098411 6325189 5449560 6113280 6677846 31664286 0 2105104 600838 683793 695570 4085305 2105104 600838 683793 695570 4085305 27578981 6775 2478 77 21 0 9351 6775 2478 77 21 9351 7105186 6327667 5449637 6113301 6677846 31673637 0.87070 0.86010 0.00030 0.00040 X 1973947 1973947 5685191 2508684 3176507 789346 617478 171868 4631 4631 5326953 Due from Affiliates 2874843 Other Assets 27056 2901899 Payable to HHC - Interco Bonds 4023615 Program Related Liability 511875 4535490 0 1 0 0 0 0 0 1 0 Chibueze Agba Director/President 0 990224 0 531597 0 11352 0 158999 0 31200 0 1723372 0 0 Tracy Church Director/Chair 0 755951 0 434139 0 125276 0 21350 0 24371 0 1361087 0 0 Rocco Orlando MD Director/Secretary 0 612847 0 254131 0 105510 0 21350 0 48273 0 1042111 0 0 Eric Smullen Director 0 327503 0 152483 0 2686 0 66477 0 38427 0 587576 0 0 David Baranik VP, Finance 0 281803 0 103159 0 3825 0 21350 0 17167 0 427304 0 0 Lisa Connolly VP, Community Network Serv 0 246979 0 77304 0 2363 0 21350 0 26034 0 374030 0 0 Laurie St John VP, Clinical Services (Thru 7/2023) 0 235025 0 74900 0 5417 0 20846 0 22484 0 358672 0 0 Heather DePaolo VP, Human Resources 0 223552 0 61223 0 715 0 18959 0 1816 0 306265 0 0 Jacquelyn Gaulin Exec Dir Assisted Living 122012 0 13914 0 88 0 5092 0 30339 0 171445 0 0 0 Part I, Line 3 The Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare on behalf of Mulberry Gardens of Southington, LLC, 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 The Charlotte Hungerford Hospital 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 Accrual was made on behalf of the following individual: Chibueze Agba $137,649 2022 SERP Payouts were made on behalf of the following individual: Tracy Church $61,746 Rocco Orlando $54,324* *For these individuals, 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. Form 990, Part VI, Section A, line 1a The Organization is member managed by its member Hartford Healthcare Senior Services, Inc. (HHCSS). HHCSS does not have any independent board members as all board members are compensated for their services by the Parent, Hartford Healthcare Corporation (HHC). HHCS is a member of an integrated healthcare delivery system which includes multiple tax-exempt hospitals that have community boards. Form 990, Part VI, Section A, line 6 Mulberry Gardens of Southington, LLC is organized as a non-stock not for profit entity. Hartford HealthCare Corporation is the sole member. Form 990, Part VI, Section A, line 7a The sole member of the Organization has the authority to approve/remove members of the governing body. Form 990, Part VI, Section A, line 7b The sole member 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. 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 and then filed with the IRS. Form 990, Part VI, Section B, line 12c The Mulberry Gardens of Southington, LLC'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 disclosures are reviewed by OCI in collaboration with the Covered Individuals' supervisor when deemed appropriate, to determine if there is a potential conflict. Oversight review of employee disclosures is provided by the HHC Conflict of Interest Committee. The Conflict of Interest Committee assesses and may recommend the conflicting interest either be (a) eliminated for continued relationship with HHC/HHC Affiliate, or, (b) managed through a management plan. Oversight review of physician disclosures is provided by the HHC Physician Conflict Resolution Committee. The Physician Conflict Resolution Committee assesses and may recommend the conflicting interest either be (a) eliminated for continued relationship with HHC/HHC Affiliate, or, (b) managed through a management plan. 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 Mulberry Gardens of Southington, LLC, 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 Hartford Healthcare Senior Services, 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 Organization's Form 990, 990T and Form 1023 and its attachments are available upon request. Form 990, Part VI, Section C, line 19 The Organization's Financial Statements, Governing Documents and the Conflict of Interest Policy are available for inspection upon request at the Organization's address. Form 990, Part XII, Line 3a & b: Although the organization was not required to undergo A-133 Audit, the results were included in a consolidated A-133 audit performed at the parent level. 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