2025-08-13T08:14:40-05:00 2024-09-30 990 2023-10-01 066063082 Midstate Medical Center Auxiliary MIDS 2036948275 435 Lewis Avenue Meriden CT 06451 MaryAnne Combelic President 2036948275 2025-08-13 0 2023 2025-03-06 01:10:19Z MaryAnne Combelic 435 Lewis Avenue Meriden CT 06451 465693 0 X See Schedule O X 1951 CT To support Midstate Medical Center's mission to improve the health and healing of the people and communities we serve through various fund-raising activities. 16 16 0 26 0 0 369017 195570 179409 182836 391 387 -69391 -5042 479426 373751 111946 8235 0 0 0 0 0 0 0 201063 191544 313009 199779 166417 173972 227322 211466 0 0 227322 211466 X To advance the welfare of Midstate Medical Center. 0 0 199779 8235 182836 The Midstate Auxiliary supports Midstate Medical Center through a wide variety of fundraising activities both within the Hospital and major events in the community including the Annual Golf Tournament. In addition, merchandise is available for purchase from our Auxiliary Gift Gallery. 199779 1 1 0 0 0 0 0 0 0 0 0 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 0 0 0 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X Sue Bartlett 2036400841 435 Lewis Avenue Meriden CT 06451 X Mary Anne Combelic Director/President 1.00 0.00 X X 0 0 0 Carol Thrope Director/Past President 1.00 0.00 X 0 0 0 Charlene Krock Director/Vice President 1.00 0.00 X X 0 0 0 Elizabeth Tyrrell Director/Secretary 1.00 0.00 X 0 0 0 Sue Bartlett Director/Treasurer 1.00 0.00 X X 0 0 0 Jane Conley Director / Assistant Treasurer 1.00 0.00 X 0 0 0 Lorraine Gamble Director 1.00 0.00 X 0 0 0 Susanne Service Director 1.00 0.00 X 0 0 0 Cheryl Raey Director 1.00 0.00 X 0 0 0 Patricia Colandrea Director 1.00 0.00 X 0 0 0 Linda Braddock Director 1.00 0.00 X 0 0 0 MaryAnn Booth Director 1.00 0.00 X 0 0 0 Barbara Bourland Director 1.00 0.00 X 0 0 0 Diane Shackett Director 1.00 0.00 X 0 0 0 Shirley Warner Director 1.00 0.00 X 0 0 0 Jan Cowles Director 1.00 0.00 X 0 0 0 0 0 0 0 0 0 0 0 1100 79204 115266 195570 Gift Shop Sales 459420 182836 182836 182836 387 387 86900 79204 91942 -5042 -5042 373751 182836 0 -4655 8235 8235 3937 3937 2050 2050 Purchased Merchandise 104138 104138 Allocated Salary 71240 71240 Miscellaneous 10179 10179 199779 199779 0 0 217322 211466 10000 227322 211466 0 0 X 227322 211466 227322 211466 227322 211466 X 173972 -189828 X 0 0 0 X X 1 Midstate Medical Center 060646715 3 1 6100 0 1 6100 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED Golf Event 157750 70850 86900 0 2129 34602 35446 0 17810 Baskets Raffle 8354 8354 0 0 0 0 0 1955 1 0 0 0 0 0 0 0 0 166104 79204 86900 2129 34602 35446 19765 91942 -5042 0 Midstate Medical Center 435 Lewis Avenue Meriden CT 06451 060646715 501(c)3 0 6100 FMV To support the mission of Midstate Medical Center. 1 0 Part I, Line 2: Upon issuing the grant, the hospital attaches a letter that restricts the use of the funds for a specific purpose. All of the grants are made to public charities to assist in funding their exempt programs. Therefore, extensive monitoring of the use of these funds by these entities is not warranted. Form 990, Item J - Website Address The website address for Midstate Medical Center Auxiliary is: https://midstatemedical.org/health-professionals/for-job-seekers/volunte er/auxiliary Form 990, Part III Line 4d: No other program services. Form 990, Part VI, Section B, line 11b The Form 990 was prepared by Hartford HealthCare's Tax Department. It was then forwarded to the Organization's President 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 by the Board President 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 C, line 18 Midstate Medical Center Auxiliary's Form 990 and its attachments are available upon request. Form 990, Part VI, Section C, line 19 Midstate Medical Center Auxiliary'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: Other Adjustments -189,828. 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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501(c)(3) 3 Hartford HealthCare Corporation 1 Hartford Hospital Auxiliary co Hartford Hospital 80 Seymour Street Hartford CT 06102 066040747 Fundraising CT 501(c)(3) 10 Hartford Hospital 1 Midstate Medical Center 435 Lewis Avenue Meriden CT 06451 060646715 Healthcare Services CT 501(c)(3) 3 Hartford HealthCare Corporation 1 Mulberry Gardens of Southington LLC 58 Mulberry Street Plantsville CT 06479 820586577 Assisted Living & Adult Day Care Facility CT 501(c)(3) 10 Hartford HealthCare Senior Services Inc 1 Natchaug Hospital Inc 189 Storrs Road Mansfield Center CT 06226 060966963 Behavioral Health CT 501(c)(3) 3 Hartford HealthCare Corporation 1 Rushford Center Inc 883 Paddock Avenue Meriden CT 06450 060932875 Substance Abuse Healthcare Services CT 501(c)(3) 7 Hartford HealthCare Corporation 1 Rushford Foundation Inc 883 Paddock Avenue Meriden CT 06450 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 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 Svcs CT N/A 0 0 Hartford-Middlesex Clinical System LLC 80 Seymour Street Hartford CT 06110 061543605 Affiliate Support Services CT N/A 0 0 HHC Hartford Surgery Center LLC 100 Avon Meadow Lane Avon CT 06001 812637261 Surgery Svcs CT N/A 0 0 HHC Southington Surgery Center LLC 100 Avon Meadow Lane Avon CT 06001 465500829 Surgery Svcs CT N/A 0 0 Hartford HealthCare-GoHealth Urgent Care LLC 5555 Glenridge Connector Suite 700 Atlanta GA 30342 815112698 Urgent Care Services DE N/A 0 0 New Britain MRI Limited Partnership 100 Grand Street New Britain CT 06050 061271349 Magnetic resonance imaging CT N/A 0 0 Rocky Hill Surgery Center LLC 1111 Cromwell Avenue Building 1 Rocky Hill CT 06067 833096156 Surgery Svcs CT N/A 0 0 The Endoscopy Center of Northwest Connecticut LLC 245 Alvord Park Road Torrington CT 06790 061609993 Endoscopy Svcs CT N/A 0 0 Wallingford Endoscopy Center LLC 863 North Main Street Ext Suite 300 Wallingford CT 06492 824601730 Endoscopy Svcs CT N/A 0 0 Aetna Ambulance Service Inc PO Box 1150 Manchester CT 06045 060795431 Ambulance Services CT N/A C 0 American Ambulance Services Inc One American Way Norwich CT CT 06360 061028857 Ambulance Services CT N/A S 0 American Professional Educational Services Inc One American Way Norwich CT CT 06360 061459930 Educational Services CT N/A S 0 Backus Medical Center Condo Assoc Inc 330 Washington Street Norwich CT 06360 061542647 Condo Association CT N/A C 0 CenConn Services Inc 100 Grand Street New Britain CT 06050 222836001 Billing Services CT N/A C 0 ConnCare Inc 326 Washington Street Norwich CT 06360 061387598 Health Care Services CT N/A C 0 HHMOB Corporation 80 Seymour Street PO Box 5037 Hartford CT 06102 061140244 Real Estate & Parking CT N/A C 0 Hartford HealthCare Indemnity Services Ltd FB Perry Bld 40 Church Street Hamilton BD Captive Insurance BD N/A C 0 Hunter's Ambulance Service Inc 450 West Main Street Meriden CT 06451 060789464 Ambulance Services CT N/A S 0 Meriden Imaging Center Inc 101 North Plains Industrial Road Meriden CT 06429 061541468 Imaging CT N/A S 0 Metro Wheelchair Service Inc PO Box 300 Manchester CT 06045 060878432 Wheelchair Services CT N/A C 0 The Cancer Care Fund Of The Litchfield Hills Inc 200 Kennedy Drive Torrington CT 06790 510474072 Cancer Care Fund CT N/A C 0 Windham Professional Office Condo Assoc 112 Mansfield Avenue Willimantic CT 06226 061090041 Condo Association CT N/A C 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Midstate Medical Center B 6100 FMV