2025-08-13T07:38:42-05:00 2024-09-30 990 2023-10-01 061161422 Hartford HealthCare Independence at Home Inc HART 8604937144 1290 Silas Deane Hwy Suite 4B Wethersfield CT 06109 Mark Keise Authorized Signer 8602494862 2025-08-13 0 2023 2025-03-06 01:10:19Z Eric Smullen 1290 Silas Deane Hwy Suite 4B Wethersfield CT 06109 15434701 0 X www.hartfordhealthcareathome.org X 1986 CT Hartford HealthCare Independence at Home Inc., is dedicated to improving the health and well being of individuals by providing a full range of home care and community-based health and wellness services. 4 0 577 0 0 0 0 0 14987798 15434701 0 0 0 0 14987798 15434701 0 0 0 0 13241496 13598285 0 0 0 2224859 1908919 15466355 15507204 -478557 -72503 5941703 6003261 773347 907408 5168356 5095853 X Hartford HealthCare Independence at Home Inc., is dedicated to improving the health and well being of individuals by providing a full range of home care and community-based health and wellness services. 0 0 13699665 15434701 Hartford HealthCare Independence is a not-for-profit community-based home health and hospice organization serving Connecticut residents in several locations including Hartford, Fairfiled, Litchfield, Middlesex, New London, New Haven, Tolland and Windham counties. Founded in 1901, Hartford HealthCare at Home is part of an integrated health care system known as Hartford HealthCare. Hartford HealthCare at Home fulfills its mission by enabling individuals to achieve maximum independence, to participate in their own plan of care, and to live with dignity while receiving quality care in their own homes.The Hospice and Palliative Care Programs (H.O.P.E.) work with patients and families in this most difficult of times offering a holistic approach to care of the entire family unit. In addition to supplementing services with patients' comfort items not often covered by insurance, nurses, counselors, social workers, physicians, pastoral care, bereavement workers and volunteers devise an integrated approach toward providing basic care to those without insurance. There are many more ways that Hartford HealthCare at Home, Inc., services benefit our community. Health education presentations at community sites, regular health screenings at senior centers, free flu shot clinics to the homeless and those lacking insurance and fall risk prevention programs are a few of the ways the agency provides assistance. Through the use of charitable funds, the needs of patients and their caregivers are being met. They receive medical care that they might not otherwise seek, for fear of not being able to pay. The care they receive improves or stabilizes their health, allowing them to remain independent and return to normal activities as soon as possible. Patients are able to retain their independence and often family members are able to continue working with the peace of mind that their loved one's needs are being met. 13699665 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 1 0 0 1 4 0 1 577 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 VP Finance 8606966282 9 Farm Springs Road Farmington CT 06032 Chibueze Agba Director/President 2.00 58.00 X X 0 1699330 235578 Tracy Church Director/Chair (Thru 4/24) 2.00 58.00 X X 0 1389309 70458 Rocco Orlando MD Director/Secretary 2.00 58.00 X X 0 1037392 85981 MaryEllen Kosturko Director/Chair 2.00 58.00 X X 0 724131 112406 Eric Smullen Director 1.00 59.00 X 0 655388 72288 David Baranik VP, Finance 7.00 53.00 X 0 427149 28244 Laurie St John Former Key Employee 0.00 60.00 X 0 409528 23010 Lisa Connolly VP, Community Network Svcs 10.00 50.00 X 0 363876 57910 Heather DePaolo VP, Human Resources 10.00 50.00 X 0 313932 38818 Kathryn Mauriello Sr Dir Independence at Home 60.00 0.00 X 206199 0 45706 Eva Baranowski Dir Ops Independence at Home 60.00 0.00 X 138909 0 7226 Johanna Rodriguez Scheduler 60.00 0.00 X 120958 0 15943 Benedicta Achaab Live in Caregiver 60.00 0.00 X 117650 0 12742 Ileana Padron ILS Service Rep 60.00 0.00 X 105907 0 21853 689623 7020035 828163 7 1 1 0 Perpetual Care LLC 8 Bruce Lane Avon CT 06001 Medical Services 355815 1 Net Patient Revenue 621610 15434701 15434701 15434701 15434701 15434701 0 0 11562611 10984226 578385 324049 309141 14908 827086 783265 43821 884539 840293 44246 12531 12531 235429 12505 222924 432039 432039 93539 93497 42 99877 96740 3137 1031 998 33 948957 66427 882530 Purchased Services 40965 24334 16631 Medical Supplies 37502 37502 Repairs & Maintenance 5962 5391 571 Dues, Subs & Licenses 772 772 315 4 311 15507204 13699665 1807539 0 3194 1226031 1464521 40691 40691 0 0 4715672 4535546 5941703 6003261 424150 598604 349197 308804 773347 907408 X 5168356 5095853 5168356 5095853 5941703 6003261 -72503 0 X 0 1 X 1 0 X 15677751 15467672 16873460 14987798 15434701 78441382 15677751 15467672 16873460 14987798 15434701 78441382 0 401615 288024 640575 1330214 401615 288024 640575 1330214 77111168 15677751 15467672 16873460 14987798 15434701 78441382 0.98300 0.99080 0.00000 X 40691 40691 0 0 Due From Affiliates 4535546 4535546 Security Deposits 308804 308804 1 1 0 0 0 0 0 1 0 Chibueze Agba Director/President 0 1078863 0 603043 0 17424 0 183155 0 52423 0 1934908 0 0 Tracy Church Director/Chair (Thru 4/24) 0 790665 0 460026 0 138618 0 23100 0 47358 0 1459767 0 0 Rocco Orlando MD Director/Secretary 0 633301 0 272024 0 132067 0 23100 0 62881 0 1123373 0 0 MaryEllen Kosturko Director/Chair 0 460710 0 257344 0 6077 0 81509 0 30897 0 836537 0 0 Eric Smullen Director 0 335210 0 174814 0 145364 0 23100 0 49188 0 727676 0 91900 David Baranik VP, Finance 0 305745 0 114513 0 6891 0 23100 0 5144 0 455393 0 0 Laurie St John Former Key Employee 0 137040 0 0 0 272488 0 9838 0 13172 0 432538 0 0 Lisa Connolly VP, Community Network Svcs 0 270064 0 90058 0 3754 0 23100 0 34810 0 421786 0 0 Heather DePaolo VP, Human Resources 0 234959 0 78216 0 757 0 21829 0 16989 0 352750 0 0 Kathryn Mauriello Sr Dir Independence at Home 165580 0 40383 0 236 0 7727 0 37979 0 251905 0 0 0 Part I, Line 3 The Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare on behalf of Hartford HealthCare Independence at Home 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, Lines 4a-b: In 2023 Laurie St. John (Former Key Employee) received a lump sum severance payment in the amount of $267,880. Part I, Lines 4a-b 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 _Hartford HealthCare Independence At Home, 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. 2023 SERP Accrual was made on behalf of the following individual: Chibueze Agba $160,055 MaryEllen Kostkuro $58,409 2023 SERP Payouts were made on behalf of the following individuals: Eric Smullen $91,900 Eric Smullen $43,933* Tracy Church $49,629* Rocco Orlando $27,820* *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 governed by a Management Board comprised of four employed individuals. These individuals are compensated for their services by Hartford HealthCare Corporation (HHC). HHC is the parent of an integrated healthcare delivery system which includes multiple tax-exempt hospitals that have community boards. Form 990, Part VI, Section A, line 6 Hartford HealthCare Independence at Home Inc., 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 Board. 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 Services (IRS). Once the entire review process was completed, the Form was signed by the Authorized Signatory and then filed with the IRS. Form 990, Part VI, Section B, line 12c The hospital'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 Hartford HealthCare Independence at Home, 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 Hartford HealthCare Independence at Home, 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, 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. 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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