2025-08-13T07:43:57-05:00 2024-09-30 990 2023-10-01 222635676 HARTFORD HEALTHCARE SENIOR SERVICES INC HART 8606219559 45 MERIDEN AVENUE SOUTHINGTON CT 06489 Mark Keise Authorized Signer 8606966282 2025-08-13 0 2023 2025-03-06 01:10:19Z Eric Smullen 45 MERIDEN AVENUE SOUTHINGTON CT 06489 21938335 0 X www.hhcseniorservices.org X 1990 CT To provide sub-acute and long-term care services to a senior population. 4 0 316 15 0 0 72982 42226 20647107 21632866 182510 237415 14159 13755 20916758 21926262 0 1000 0 0 14075853 15447507 0 0 0 6206844 6440832 20282697 21889339 634061 36923 13699196 13197830 8571800 8381500 5127396 4816330 To provide and promote wellness and independence to ensure optimal quality of life for the people we serve. 0 0 17829097 1000 21632866 Hartford HealthCare Senior Services, Inc. is a licensed, 130-bed skilled nursing home facility, which provides room and board, nursing and physical therapy services to its residents in the community served. 17829097 1 0 0 0 0 0 0 0 0 0 1 1 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 32 0 1 316 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 c/o 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 04/2024) 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 (eff 04/10/24) 2.00 58.00 X X 0 724131 112406 Eric Smullen Director 1.00 59.00 X 0 655388 72288 David Baranik VP, Finance 6.00 54.00 X 0 427149 28244 Laurie St John Former Key Empl (VP, Clin Svcs) 0.00 0.00 X 0 409528 23010 Lisa Connolly VP, Community Living 10.00 50.00 X 0 363876 57910 Heather DePaolo VP, Human Resources 10.00 50.00 X 0 313932 38818 Julie Norko Reg Dir Community Living 60.00 0.00 X 196662 0 45809 Sharon Robinson Reg Dir SNF Operations 60.00 0.00 X 215903 0 18586 Stephen Barrett Exec Dir SNF 60.00 0.00 X 190546 0 7765 Lori Toombs Reg Dir Assisted Living Ops 60.00 0.00 X 180152 0 17527 Cirie Dorosh Dir Nursing Services 60.00 0.00 X 112889 0 33289 896152 7020035 847669 14 1 1 0 The Nurse Network LLC 653 Main Street Plantsville CT 06479 Medical Service 674804 Morrison Mgmt Spec Inc Senior Svcs 400 Northbridge Road Sandy Springs GA 30350 Food Service 636037 Berstein-Magoon-Gay LLC PO Box 61323 King of Prussia PA 19406 Laundry Service 265618 Saucier Mechanical Svcs Inc 148 Norton Street Plantsville CT 06479 Maintenance 137136 Crothall Hlthcare Inc (EVS Portion) 13028 Collections Center Dr Chicago IL 60693 Transportation Service 112021 5 42226 42226 Net Patient Services 623000 21632866 21632866 21632866 221041 221041 25828 12073 13755 13755 13755 15774 600 0 0 15774 600 16374 16374 21926262 21632866 0 251170 1000 1000 12822100 10601076 2221024 327090 270432 56658 1419792 1173858 245934 878525 726348 152177 5803 5803 1088577 1088577 9183 9183 221669 10339 211330 495211 495211 551046 338015 213031 16615 16615 7999 2275 5724 99289 34751 64538 554302 33258 521044 367655 242619 125036 58155 58155 Purchased Services 1194560 1043288 151272 Medical Supplies 838951 838951 Nursing Home User Fee 706253 706253 Repairs & Maintenance 192515 164691 27824 33049 33049 21889339 17829097 4060242 0 7760 8616 1579788 1739444 58290 50836 8568422 4822306 3794670 3746116 5384330 5991931 2874358 1660887 13699196 13197830 1666270 1671539 200605 204809 6704925 6505152 8571800 8381500 X 5037257 4723372 90139 92958 5127396 4816330 13699196 13197830 X 36923 376588 -724577 X X 0 1 X 1 1 1 X 98644 154272 98349 72982 42226 466473 18856360 18361328 19863680 20647107 21632866 99361341 18955004 18515600 19962029 20720089 21675092 99827814 0 71195 255807 108101 24125 2505 461733 71195 255807 108101 24125 2505 461733 99366081 112803 38178 85913 115934 234796 587624 112803 38178 85913 115934 234796 587624 19067807 18553778 20047942 20836023 21909888 100415438 0.98950 0.88340 0.00590 0.00470 X 5403619 553217 -7662 5949173 5175265 238089 -9735 5403619 5389259 -204474 -9520 5175265 4158063 1237987 6791 5389259 3880225 283339 5501 4158063 0.98070 0.00110 0.01820 0 1 1 810000 810000 6757329 4039304 2718026 119019 119019 0 882074 663983 218090 3746116 Assets Held in Trust 5194 F Investment in Endowment LLC 5986737 F 5991931 Due from Affiliates 1653380 Long Term Workers Compensation 7507 1660887 Payable to HHC - Interco Bonds 6180152 Other Liabilities Program Related 309257 Program Related Liability 15743 6505152 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 04/2024) 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 (eff 04/10/24) 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 Empl (VP, Clin Svcs) 0 137040 0 0 0 272488 0 9838 0 13172 0 432538 0 0 Lisa Connolly VP, Community Living 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 Julie Norko Reg Dir Community Living 162561 0 33441 0 660 0 7399 0 38410 0 242471 0 0 0 Sharon Robinson Reg Dir SNF Operations 187951 0 26973 0 979 0 7620 0 10966 0 234489 0 0 0 Stephen Barrett Exec Dir SNF 165227 0 24720 0 599 0 6662 0 1103 0 198311 0 0 0 Lori Toombs Reg Dir Assisted Living Ops 157847 0 22000 0 305 0 6396 0 11131 0 197679 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 Senior Services, 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. 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 Senior Services, 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 Accruals were made on behalf of the following individuals: Chibueze Agba $160,055 MaryEllen Kosturko $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 Senior Services, 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 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. It was then provided to the VP of Finance for review. 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 and then filed with the IRS. Form 990, Part VI, Section B, line 12c Hartford HealthCare Senior Services, Inc.'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 Senior Services, 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 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 company's Form 990, Form 990-T, Form 1023 and its attachments are available upon request. Form 990, Part VI, Section C, line 19 The company'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 XI, line 9: Transfer to Affiliated Entity -722,555. Net Assets Released from Restriction for Operations -2,022. Form 990, Part XII, Line 3a & b: Although the organization was not required to undergo A-133 Federal Audit, the results were included in a consolidated A-133 audit performed at the parent level Hartford HealthCare Corporation. 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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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 Multispecialty Group Inc 2800 Main Street Bridgeport CT 06606 800458769 Healthcare Services 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 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 Memorial Hospital 1 Advanced Medical Imaging of NW CT LLC 57 Commercial Blvd Torrington CT 06790 061594854 Magnetic Resonance Imaging CT N/A 0 0 Ambulance Service of Manchester LLC PO Box 300 Manchester CT 06450 061557358 Ambulatory Service CT N/A 0 0 Central Connecticut Endoscopy Center 440 New Britain Avenue Plainville CT 06062 141855010 Endoscopy Svcs CT N/A 0 0 Connecticut Imaging Partners LLC 1500 Concord Terrace Sunrise FL 33323 134298940 Imaging Services CT N/A 0 0 Connecticut Orthopaedic Surgery Center LLC 100 Avon Meadow Lane Avon CT 06001 832570191 Surgery Svcs CT N/A 0 0 Connecticut Proton Therapy Center LLC 789 Howard Ave Suite CB 230 New Haven CT 06519 871371777 Proton Therapy Services CT N/A 0 0 Constitution Surgery Center East LLC 174 Cross Road Waterford CT 06385 061574704 Surgery Svcs CT N/A 0 0 CT GI Endoscopy Center LLC ( Bloomfield) 4 Northwestern Drive Bloomfield CT 06002 061573358 GI Services CT N/A 0 0 Glastonbury Endoscopy Center LLC 300 Western Blvd Suite B Glastonbury CT 06033 261721234 Endoscopy Svcs CT N/A 0 0 Glastonbury Surgery Center LLC 195 Eastern Boulevard Glastonbury CT 06033 262600828 Surgery 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Inc PO Box 1150 Manchester CT 06045 060795431 Ambulance Services CT N/A C 1 American Ambulance Services Inc One American Way Norwich CT CT 06360 061028857 Ambulance Services CT N/A S 1 American Professional Educational Services Inc One American Way Norwich CT CT 06360 061459930 Educational Services CT N/A S 1 Backus Medical Center Condo Assoc Inc 330 Washington Street Norwich CT 06360 061542647 Condo Association CT N/A C 1 CenConn Services Inc 100 Grand Street New Britain CT 06050 222836001 Billing Services CT N/A C 1 ConnCare Inc 326 Washington Street Norwich CT 06360 061387598 Health Care Services CT N/A C 1 HHMOB Corporation 80 Seymour Street PO Box 5037 Hartford CT 06102 061140244 Real Estate & Parking CT N/A C 1 Hartford HealthCare Indemnity Services Ltd FB Perry Bld 40 Church Street Hamilton BD Captive Insurance BD 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 Hartford Hospital O 220689 FMV Hartford Hospital P 1652013 FMV Hartford Hospital Q 390207 FMV Hartford Hospital R 65652 FMV Hartford Hospital S 674080 FMV The Hospital of Central CT and Bradley Memorial A 25828 FMV St Vincent's Special Needs Center Inc S 252000 FMV Hartford HealthCare Rehabilitation Network Inc R 56712 FMV Midstate Medical Center P 56630 FMV