portal.ct.gov · YALE-NEW HAVEN HOSPITAL ANNUAL REPORTING FISCAL YEAR 2013 REPORT 17B - HOSPITAL BED FUNDS HELD OR ADMINISTERED BY THE HOSPITAL Actual Dollar Amount of Earnings available

OFFICE OF HEALTH CARE ACCESS ANNUAL REPORTING YALE-NEW HAVEN HOSPITAL

REPORT 20 1 OF 37 7/28/2014,2:13 PM

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LINE DESCRIPTION AFFILIATE INFORMATION

A. AFFILIATE NAME YNH NETWORK CORPORATION

1 Affiliate Description

YNH NETWORK CORP. IS THE PARENT CORPORATION TO YALE-NEW HAVEN HOSP., YALE-NEW HAVEN AMBULATORY SERVICES CORP., YORK ENTERPRISES, INC., COMMUNITY HEALTH CARE PHYSICIANS (CHCP), AND QUINNIPIAC MEDICAL PC.

2 Affiliate type of service Parent Corporation3 Tax Status Not for Profit4 Street Address 789 Howard Avenue, New Haven, Connecticut5 Town New Haven6 State Connecticut7 Zip Code 06519 - 8 CEO Name Marvin K. Lender9 CEO Title Director10 CT Agent Name William J. Aseltyne11 CT Agent Company Yale-New Haven Health Services Corporation12 CT Agent Company Street Address 789 Howard Ave, CB 230, Legal and Risk Services Dept13 CT Agent Town New Haven14 CT Agent State Connecticut15 CT Agent Zip Code 06519 -

B. AFFILIATE NAME CARITAS INSURANCE COMPANY LTD.

1 Affiliate Description Caritas provides excess professional and general liability insurance.2 Affiliate type of service Insurance3 Tax Status Not for Profit4 Street Address 30 Main Street, Suite 3305 Town Burlington 6 State Vermont7 Zip Code 05401 - 8 CEO Name Christopher M. O'Connor9 CEO Title President10 CT Agent Name Robert Gagliardi, CPA11 CT Agent Company Chartis Insurance12 CT Agent Company Street Address 30 Main Street, Suite 33013 CT Agent Town Burlington14 CT Agent State Vermont15 CT Agent Zip Code 05401 -

C. AFFILIATE NAME CENTURY FINANCIAL SERVICES, INC. AND SUBSIDIARY (CENTURY)

1 Affiliate DescriptionCENTURY OPERATES AN AGENCY SPECIALIZING IN HEALTHCARE PATIENT RECEIVABLE COLLECTIONS IN WHICH YORK ENTERPRISES OWNS A 47.6% INTEREST.

2 Affiliate type of service Collection Agency3 Tax Status For Profit4 Street Address 23 Maiden Lane5 Town North Haven6 State Connecticut7 Zip Code 06473 - 8 CEO Name Eugene Colucci9 CEO Title CFO10 CT Agent Name Steven Markesich11 CT Agent Company Century Financial Services

YALE-NEW HAVEN HOSPITALANNUAL REPORTING FISCAL YEAR 2013

REPORT 20 - REPORT OF EACH JOINT VENTURE, PARTNERSHIPAND CORPORATION RELATED TO THE HOSPITAL


REPORT 20 2 OF 37 7/28/2014,2:13 PM

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12 CT Agent Company Street Address 23 Maiden Lane13 CT Agent Town North Haven14 CT Agent State Connecticut15 CT Agent Zip Code 06473 -

D. AFFILIATE NAME LUKAN INDEMNITY COMPANY LTD.

1 Affiliate Description Lukan provides malpractice liability insuranance.2 Affiliate type of service Insurance3 Tax Status Not for Profit4 Street Address c/o Quest Mgmt Services, 40 Church St, PO Box HM20625 Town Hamilton HMHX6 State Bermuda7 Zip Code - 8 CEO Name Christopher M. O'Connor9 CEO Title President10 CT Agent Name Nick Frost11 CT Agent Company Quest Management Services, Ltd12 CT Agent Company Street Address 10 Church Street13 CT Agent Town Hamilton HMHX14 CT Agent State Bermuda15 CT Agent Zip Code -

E. AFFILIATE NAME MEDICAL CENTER PHARMACY AND HOME CARE CENTER, INC.


MEDICAL CENTER PHARMACY IS A WHOLLY OWNED SUBSIDIARY OF YORK ENTERPRISES, INC. IT OPERATES A RETAIL PHARMACY WITH MULTIPLE LOCATIONS. CURRENTLY INACTIVE IN PROVIDING HOME IV INFUSION SERVICES.

2 Affiliate type of service Pharmacy3 Tax Status For Profit4 Street Address 50 York Street5 Town New Haven6 State Connecticut7 Zip Code 06511 - 8 CEO Name Vincent Tammaro9 CEO Title President10 CT Agent Name William J Aseltyne11 CT Agent Company Yale New Haven Hospital12 CT Agent Company Street Address 20 York Street, CB-23013 CT Agent Town New Haven14 CT Agent State Connecticut15 CT Agent Zip Code 06505 -

F. AFFILIATE NAME MEDICAL CENTER REALTY, INC.

1 Affiliate Description MEDICAL CENTER REALTY, INC. IS A WHOLLY OWNED SUBSIDIARY OF YORK ENTERPRISES, INC. 2 Affiliate type of service Real Estate3 Tax Status For Profit4 Street Address 50 York Street5 Town New Haven6 State Connecticut


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7 Zip Code 06511 - 8 CEO Name Vincent Tammaro9 CEO Title President10 CT Agent Name William J Aseltyne11 CT Agent Company Yale-New Haven Health Services Corporation12 CT Agent Company Street Address 789 Howard Ave, CB230, Legal & Risk Services Dept13 CT Agent Town New Haven14 CT Agent State Connecticut15 CT Agent Zip Code 06519 -

G. AFFILIATE NAME NORTHEAST MEDICAL GROUP, INC.

1 Affiliate DescriptionPhysician related services, such as patient care, medical education, and research and administration to YNHH, BH, GH and the community.

2 Affiliate type of service Physicians Services3 Tax Status Not for Profit4 Street Address 226 Mill Hill Avenue5 Town Bridgeport6 State Connecticut7 Zip Code 06610 - 8 CEO Name Peter Herbert9 CEO Title Chairman of the Board10 CT Agent Name WILLIAM ASELTYNE11 CT Agent Company YALE-NEW HAVEN HEALTH SERVICES CORPORATION12 CT Agent Company Street Address C/O LEGAL & RISK SERVICES , 789 HOWARD AVENUE, CB23013 CT Agent Town NEW HAVEN14 CT Agent State Connecticut15 CT Agent Zip Code 06611 -

H. AFFILIATE NAME NORTHEAST PEDIATRIC SPECIALISTS, INC.

1 Affiliate Description Affiliation between Y-NHH and Connecticut Childrens Hospital for Pediatric Specialty services.2 Affiliate type of service Affilate Support Services3 Tax Status Not for Profit4 Street Address c/o Ct Children's Medical Cent, 282 Washington Street5 Town Hartford6 State Connecticut7 Zip Code 06106 - 8 CEO Name Cynthia Sparer9 CEO Title President10 CT Agent Name R&C Service Company11 CT Agent Company R & C Service Company12 CT Agent Company Street Address 280 Trumbull Street13 CT Agent Town Hartford14 CT Agent State Connecticut15 CT Agent Zip Code 06103 - 3597

I. AFFILIATE NAME SHORELINE SURGERY CENTER, LLC


SHORELINE SURGERY CENTER LLC IS A LIMITED LIABLITY COMPANY AND IS A PARTNERSHIP BETWEEN CGC ENDOSCOPY, LLC, UNRELATED THIRD PARTY AND YALE-NEW HAVEN AMBULATORY SERVICES CORP WHICH HAS A 51% INTEREST.


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2 Affiliate type of service Ambulatory/OP Surgery Center3 Tax Status Not for Profit4 Street Address 789 Howard Avenue5 Town New Haven6 State Connecticut7 Zip Code 06504 - 8 CEO Name Gayle L. Capozzalo9 CEO Title Member10 CT Agent Name Merton G. Gollaher, Jr11 CT Agent Company Wiggin & Dana LLP12 CT Agent Company Street Address 1 Century Tower, 195 Church St13 CT Agent Town New Haven14 CT Agent State Connecticut15 CT Agent Zip Code 06508 -

J. AFFILIATE NAME SSC II, LLC

1 Affiliate DescriptionSSC II, LLC IS A LIMITED LIABILITY COMPANY AND IS A SUBSIDIARY OF SHORELINE SURGERY CENTER, LLC. SSC II, LLC IS AN ENDOSCOPY SURGERY CENTER

2 Affiliate type of service Ambulatory/OP Surgery Center3 Tax Status Not for Profit4 Street Address 111 GOOSE LANE 5 Town GUILFORD6 State Connecticut7 Zip Code 06437 - 8 CEO Name SHORELINE PHYSICIANS HOLDING CO., LLC9 CEO Title MEMBER10 CT Agent Name MERTONG. GOLLAHER, JR11 CT Agent Company WIGGIN & DANA LLP12 CT Agent Company Street Address 1 CENTURY TOWER, 195 CHURCH STREET13 CT Agent Town NEW HAVEN14 CT Agent State Connecticut15 CT Agent Zip Code 06510 -

K. AFFILIATE NAME THE NEW CLINICAL DEVELOPMENT PROGRAM CORPORATION (NCPD)


NCPD is a CT non-profit, non-stock corporation created to provide support for the development of clinical programs and services that will enhance the rendering of patient care at Yale University and Yale-New Haven Hospital.

2 Affiliate type of service Other HealthCare Svcs(Specify)3 Tax Status Not for Profit4 Street Address 789 Howard Avenue5 Town New Haven6 State Connecticut7 Zip Code 06519 - 8 CEO Name Gayle Capozzalo9 CEO Title President10 CT Agent Name D. Terence Jones11 CT Agent Company Wiggin and Dana12 CT Agent Company Street Address One Century Tower13 CT Agent Town New Haven14 CT Agent State Connecticut15 CT Agent Zip Code 06508 - 1832


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L. AFFILIATE NAME YALE-NEW HAVEN AMBULATORY SERVICES CORP.


YALE-NEW HAVEN AMBULATORY SERVICES CORP. IS A WHOLLY OWNED SUBSIDIARY OF YNH NETWORK CORP. IT OPERATES A RECOVERY CARE CENTER. IN FY04, IT ACQUIRED A 51% INTEREST IN YALE-NEW HAVEN SHORELINE SURGERY CENTER LLC.

2 Affiliate type of service Ambulatory/OP Surgery Center3 Tax Status Not for Profit4 Street Address 60 Temple Street5 Town New Haven6 State Connecticut7 Zip Code 06510 - 8 CEO Name Richard D`Aquila9 CEO Title President10 CT Agent Name William J Aseltyne11 CT Agent Company Yale New Haven Hospital12 CT Agent Company Street Address 20 York Street, CB-23013 CT Agent Town New Haven14 CT Agent State Connecticut15 CT Agent Zip Code 06510 -

M. AFFILIATE NAME YALE-NEW HAVEN CARE CONTINUUM

1 Affiliate DescriptionYNHCCC provides long-term care for those unable to live independently and short-term rehabilitation for patients who have experienced elective surgery, an injury or a traumatic major illness.

2 Affiliate type of service Care for the Aged3 Tax Status Not for Profit4 Street Address 789 HOWARD AVENUE5 Town New Haven6 State Connecticut7 Zip Code 06519 - 8 CEO Name GAYLE CAPOZZALO9 CEO Title PRESIDENT10 CT Agent Name William J. Aseltyne11 CT Agent Company Yale-New Haven Health Services Corporation12 CT Agent Company Street Address 789 Howard Avenue, CB230, Legal & Risk Serv D13 CT Agent Town New Haven 14 CT Agent State Connecticut15 CT Agent Zip Code 06519 -

N. AFFILIATE NAME YALE-NEW HAVEN HEALTH SERVICES CORP. (YNHHSC)


YNHHSC IS THE PARENT CORPORATION OF YNH NETWORK CORP., YNHHS MSO INC. WHICH ARE AFFILIATED WITH YALE-NEW HAVEN HOSP., BRIDGEPORT VERTICAL NETWORK, AND GREENWICH VERTICAL NETWORK.

2 Affiliate type of service Parent Corporation3 Tax Status Not for Profit4 Street Address 789 Howard Avenue5 Town New Haven6 State Connecticut7 Zip Code 06519 - 8 CEO Name Marna P. Borgstrom9 CEO Title President10 CT Agent Name William J Aseltyne11 CT Agent Company Yale New Haven Hospital12 CT Agent Company Street Address 20 York Street, CB230, Legal & Risk Services Dept


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13 CT Agent Town New Haven14 CT Agent State Connecticut15 CT Agent Zip Code 06510 -

O. AFFILIATE NAME YALE-NEW HAVEN MEDICAL CENTER, INC. (MEDICAL CENTER)


A TAX-EXEMPT NONPROFIT ORGANIZATION WITH THE PRIMARY PURPOSE TO COORDINATE ACTIVITIES OF YALE-NEW HAVEN HOSPITAL, INC. AND YALE UNIVERSITY-SCHOOLS OF MEDICINE AND NURSING IN AREAS OF MUTUAL CONCERN AND TO CONDUCT LONG-RANGE PLANNING FOR

2 Affiliate type of service Affilate Support Services3 Tax Status Not for Profit4 Street Address 20 York Street, Suite T-1025 Town New Haven6 State Connecticut7 Zip Code 06504 - 8 CEO Name Steve Merz9 CEO Title President10 CT Agent Name William J Aseltyne11 CT Agent Company Yale-New Haven Health Services Corporation12 CT Agent Company Street Address 789 Howard Avenue, CB230, Legal & Risk Services Dept13 CT Agent Town New Haven14 CT Agent State Connecticut15 CT Agent Zip Code 06519 -

P. AFFILIATE NAME YNHH-PHYSICIANS CORPORATION


PHYSICIAN HOSPITAL ORGANIZATION IS A MANAGED CARE CONTRACTING ORGANIZATION. YNHH DOES NOT CONSIDER THE PHO AN AFFILIATE BECAUSE IT IS NOT CONTROLLED BY OR UNDER COMMON CONTROL OR OWNERSHIP WITH YNHH OR YNHH AFFILIATES.

2 Affiliate type of service Physicians Hospital Org. (PHO)3 Tax Status For Profit4 Street Address 789 Howard Avenue5 Town New Haven6 State Connecticut7 Zip Code 06519 - 8 CEO Name Dr. Michael Berman9 CEO Title President and Chairman of the Board10 CT Agent Name Irving S. Schloss Esq.11 CT Agent Company Tyler Cooper & Alcorn LLP12 CT Agent Company Street Address 205 Church St.13 CT Agent Town New Haven14 CT Agent State Connecticut15 CT Agent Zip Code 06509 -

Q. AFFILIATE NAME YNHHS-MSO, INC.

1 Affiliate DescriptionYNNH-MSO, INC. WAS ORIGINALLY FORMED TO MANAGE PHYSICIAN PRACTICES AND PROVIDE THIRD PARTY ADMINISTRATIVE SERVICES ON CERTAIN MANAGED CARE CONTRACTS.

2 Affiliate type of service Managed Services Org. (MSO)3 Tax Status For Profit4 Street Address 789 Howard Avenue5 Town New Haven6 State Connecticut7 Zip Code 06519 -


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8 CEO Name Gayle Capozzalo9 CEO Title President10 CT Agent Name Merton G. Gollaher, JR.11 CT Agent Company Wiggin & Dana LLP12 CT Agent Company Street Address 1 Century Tower, 195 Church St13 CT Agent Town New Haven14 CT Agent State Connecticut15 CT Agent Zip Code 06508 - 1832

R. AFFILIATE NAME YORK ENTERPRISES, INC.


YORK ENTERPRISES, INC. IS A WHOLLY OWNED SUBSIDIARY OF YNH NETWORK CORP. YORK ENTERPRISES INC IS THE PARENT CORPORATION OF MEDICAL CENTER REALTY INC AND MEDICAL CENTER PHARMACY AND HOME CARE CENTER INC.

2 Affiliate type of service Affilate Support Services3 Tax Status For Profit4 Street Address 50 York Street5 Town New Haven6 State Connecticut7 Zip Code 06511 - 8 CEO Name Vincent Tammaro9 CEO Title President10 CT Agent Name William J Aseltyne11 CT Agent Company Yale New Haven Hospital12 CT Agent Company Street Address 20 York Street, CB-23013 CT Agent Town New Haven14 CT Agent State Connecticut15 CT Agent Zip Code 06510 -

* P.O. BOX IS UNACCEPTABLE WITHOUT A STREET ADDRESS FOR EACH AGENT COMPANY


REPORT 5 8 OF 36 7/28/2014, 2:13 PM

(1) (2) (3) (4)FUND DESCRIPTION / BALANCE AS OF

LINE AFFILIATE NAME FUND PURPOSE 9/30/2013

A . YALE-NEW HAVEN HOSPITAL1 Unrestricted $930,988,000 2 Temporarily Restricted by Donor $59,982,000 3 Temporarily Restricted by Board $0 4 Permanently Restricted by Donor $27,155,000 5 Intercompany Eliminations $0

Total: $1,018,125,000

B . YNH NETWORK CORPORATION1 Unrestricted $9,212,000 2 Temporarily Restricted by Donor $0 3 Temporarily Restricted by Board $0 4 Permanently Restricted by Donor $0 5 Intercompany Eliminations ($8,602,000)

Total: $610,000

C . CARITAS INSURANCE COMPANY LTD.1 Unrestricted $3,767,000 2 Temporarily Restricted by Donor $0 3 Temporarily Restricted by Board $0 4 Permanently Restricted by Donor $0 5 Intercompany Eliminations ($3,767,000)

Total: $0

D .CENTURY FINANCIAL SERVICES, INC. AND SUBSIDIARY (CENTURY)

1 Unrestricted $1,900,140 2 Temporarily Restricted by Donor $0 3 Temporarily Restricted by Board $0 4 Permanently Restricted by Donor $0 5 Intercompany Eliminations ($1,900,140)

Total: $0

E . LUKAN INDEMNITY COMPANY LTD.1 Unrestricted $4,793,000 2 Temporarily Restricted by Donor $0 3 Temporarily Restricted by Board $0 4 Permanently Restricted by Donor $0 5 Intercompany Eliminations ($4,793,000)

Total: $0

F . MEDICAL CENTER PHARMACY AND HOME CARE CENTER, INC.1 Unrestricted $1,115,591 2 Temporarily Restricted by Donor $0 3 Temporarily Restricted by Board $0 4 Permanently Restricted by Donor $0 5 Intercompany Eliminations $0

Total: $1,115,591

G . MEDICAL CENTER REALTY, INC.1 Unrestricted ($1,496,917)2 Temporarily Restricted by Donor $0 3 Temporarily Restricted by Board $0

YALE-NEW HAVEN HOSPITALANNUAL REPORTING

FISCAL YEAR 2013REPORT 5 - HOSPITAL, AFFILIATE AND RELATED CORPORATION NET ASSETS


REPORT 5 9 OF 36 7/28/2014, 2:13 PM





4 Permanently Restricted by Donor $0 5 Intercompany Eliminations $0

Total: ($1,496,917)

H . NORTHEAST MEDICAL GROUP, INC.1 Unrestricted $2,568,915 2 Temporarily Restricted by Donor $0 3 Temporarily Restricted by Board $0 4 Permanently Restricted by Donor $0 5 Intercompany Eliminations $0

Total: $2,568,915

I . NORTHEAST PEDIATRIC SPECIALISTS, INC.1 Unrestricted $0 2 Temporarily Restricted by Donor $0 3 Temporarily Restricted by Board $0 4 Permanently Restricted by Donor $0 5 Intercompany Eliminations $0

Total: $0

J . SHORELINE SURGERY CENTER, LLC1 Unrestricted $2,242,657 2 Temporarily Restricted by Donor $0 3 Temporarily Restricted by Board $0 4 Permanently Restricted by Donor $0 5 Intercompany Eliminations $0

Total: $2,242,657

K . SSC II, LLC1 Unrestricted $2,541,290 2 Temporarily Restricted by Donor $0 3 Temporarily Restricted by Board $0 4 Permanently Restricted by Donor $0 5 Intercompany Eliminations $0

Total: $2,541,290

L .THE NEW CLINICAL DEVELOPMENT PROGRAM CORPORATION (NCPD)

1 Unrestricted $2,102,842 2 Temporarily Restricted by Donor $0 3 Temporarily Restricted by Board ($2,292)4 Permanently Restricted by Donor $0 5 Intercompany Eliminations ($2,100,550)

Total: $0

M . YALE-NEW HAVEN AMBULATORY SERVICES CORP.1 Unrestricted $5,440,725 2 Temporarily Restricted by Donor $0 3 Temporarily Restricted by Board $0 4 Permanently Restricted by Donor $0 5 Intercompany Eliminations $0

Total: $5,440,725

N . YALE-NEW HAVEN CARE CONTINUUM1 Unrestricted ($1,357,139)


REPORT 5 10 OF 36 7/28/2014, 2:13 PM





2 Temporarily Restricted by Donor $0 3 Temporarily Restricted by Board $0 4 Permanently Restricted by Donor $0 5 Intercompany Eliminations $0

Total: ($1,357,139)

O . YALE-NEW HAVEN HEALTH SERVICES CORP. (YNHHSC)1 Unrestricted $94,753,000 2 Temporarily Restricted by Donor $0 3 Temporarily Restricted by Board $0 4 Permanently Restricted by Donor $0 5 Intercompany Eliminations $0

Total: $94,753,000

P . YALE-NEW HAVEN MEDICAL CENTER, INC. (MEDICAL CENTER)1 Unrestricted $2,614,920 2 Temporarily Restricted by Donor $0 3 Temporarily Restricted by Board $0 4 Permanently Restricted by Donor $0 5 Intercompany Eliminations $0

Total: $2,614,920

Q . YNHH-PHYSICIANS CORPORATION1 Unrestricted $75,996 2 Temporarily Restricted by Donor $0 3 Temporarily Restricted by Board $0 4 Permanently Restricted by Donor $0 5 Intercompany Eliminations ($75,996)

Total: $0

R . YNHHS-MSO, INC.1 Unrestricted $292,000 2 Temporarily Restricted by Donor $0 3 Temporarily Restricted by Board $0 4 Permanently Restricted by Donor $0 5 Intercompany Eliminations $0

Total: $292,000

S . YORK ENTERPRISES, INC.1 Unrestricted $2,959,202 2 Temporarily Restricted by Donor $0 3 Temporarily Restricted by Board $0 4 Permanently Restricted by Donor $0 5 Intercompany Eliminations ($582,619)

Total: $2,376,583

Total of all Affiliates (before Intercompany Eliminations) Fund Balance: $1,151,647,930 Intercompany Eliminations ($21,821,305)Total of all Affiliates Fund Balance: $1,129,826,625


REPORT 6 11 OF 36 7/28/2014, 2:13 PM

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TRANSFER TO / FROMLINE AFFILIATE NAME DESCRIPTION OF TRANSFER DATE HOSPITAL

A. YNH NETWORK CORPORATION

Beginning Unconsolidated Intercompany Balance: 9/30/2012 $613,000 1 Sales/Purchases of Services 09/30/2013 ($191,639)

Ending Unconsolidated Intercompany Balance: 9/30/2013 $421,361

B. CARITAS INSURANCE COMPANY LTD.

Beginning Unconsolidated Intercompany Balance: 9/30/2012 $0 1 Sales/Purchases of Services 09/30/2013 $2,781


C. CENTURY FINANCIAL SERVICES, INC. AND SUBSIDIARY (CENTURY)

Beginning Unconsolidated Intercompany Balance: 9/30/2012 $0 1 Collection Agency Fees Charged 09/30/2013 $1,916,233 2 Net Payments 09/30/2013 ($1,916,233)

Ending Unconsolidated Intercompany Balance: 9/30/2013 $0

D. LUKAN INDEMNITY COMPANY LTD.

Beginning Unconsolidated Intercompany Balance: 9/30/2012 ($383,595)1 Malpractice Insurance Premiums 09/30/2013 $4,832,530 2 Payments to YNHH 09/30/2013 ($4,375,906)


E. MEDICAL CENTER PHARMACY AND HOME CARE CENTER, INC.

Beginning Unconsolidated Intercompany Balance: 9/30/2012 $0 Nothing to Report $0 Ending Unconsolidated Intercompany Balance: 9/30/2013 $0

F. MEDICAL CENTER REALTY, INC.

Beginning Unconsolidated Intercompany Balance: 9/30/2012 $132,082 1 Sales/Purchases of Services 09/30/2013 $29,674


G. NORTHEAST MEDICAL GROUP, INC.


FISCAL YEAR 2013REPORT 6 - TRANSACTIONS BETWEEN THE HOSPITAL AND AFFILIATES OR RELATED CORPORATIONS


REPORT 6 12 OF 36 7/28/2014, 2:13 PM

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Beginning Unconsolidated Intercompany Balance: 9/30/2012 ($2,912,320)1 Sales/Purchases of Services 09/30/2013 $3,460,949


H. NORTHEAST PEDIATRIC SPECIALISTS, INC.

Beginning Unconsolidated Intercompany Balance: 9/30/2012 $0 1 Sales/Purchases of Services 09/30/2013 $756,806


I. SHORELINE SURGERY CENTER, LLC


J. SSC II, LLC


K. THE NEW CLINICAL DEVELOPMENT PROGRAM CORPORATION (NCPD)


L. YALE-NEW HAVEN AMBULATORY SERVICES CORP.

Beginning Unconsolidated Intercompany Balance: 9/30/2012 $13,433,844 1 Sales/Purchases of Services 09/30/2013 ($3,866,689)

Ending Unconsolidated Intercompany Balance: 9/30/2013 $9,567,155

M. YALE-NEW HAVEN CARE CONTINUUM

Beginning Unconsolidated Intercompany Balance: 9/30/2012 $3,592,710 1 Sales/Purchases of Services 09/30/2013 $3,183,094


REPORT 6 13 OF 36 7/28/2014, 2:13 PM

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N. YALE-NEW HAVEN HEALTH SERVICES CORP. (YNHHSC)

Beginning Unconsolidated Intercompany Balance: 9/30/2012 ($26,219,641)1 System Support Fee 09/30/2013 ($24,416,549)2 Information System Contract Fee 09/30/2013 ($44,895,614)3 System Business Office Contract Fee 09/30/2013 ($23,518,210)4 Professional General Liability Insurance 09/30/2013 ($26,928,426)5 Materials Management, Reimbursement & HRIS 09/30/2013 ($84,662,560)6 Facilities Rental 09/30/2013 $3,028,000 7 Transfer of Cash 09/30/2013 $6,000,000 8 Transfer of Net Assets 09/30/2013 ($6,000,000)9 Malpractice Payments 09/30/2013 $26,928,426 10 Intercompany transfer of payments 09/30/2013 $171,059,210

Ending Unconsolidated Intercompany Balance: 9/30/2013 ($29,625,364)

O. YALE-NEW HAVEN MEDICAL CENTER, INC. (MEDICAL CENTER)

Beginning Unconsolidated Intercompany Balance: 9/30/2012 $402,517 1 Sales/Purchases of Services 09/30/2013 $3,160,692


P. YNHH-PHYSICIANS CORPORATION


Q. YNHHS-MSO, INC.


R. YORK ENTERPRISES, INC.

Beginning Unconsolidated Intercompany Balance: 9/30/2012 ($15,912)Nothing to Report $0 Ending Unconsolidated Intercompany Balance: 9/30/2013 ($15,912)


REPORT 6 14 OF 36 7/28/2014, 2:13 PM

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Grand Total: ($7,770,746)


REPORT 6A 15 OF 36 7/28/2014,2:13 PM

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LINE AFFILIATE TRANSFERRING FUNDS AFFILIATE RECEIVING FUNDS DESCRIPTION OF TRANSFER DATE AMOUNTBeginning Unconsolidated

Intercompany Balance 10/01/2012 $154,214A. YNH NETWORK CORPORATION1 YNH NETWORK CORPORATION System Support Fee 09/30/2013 $143,6302 YNH NETWORK CORPORATION Management Services 09/30/2013 $4,1213 YNH NETWORK CORPORATION Payments/Adjustments 09/30/2013 $60,132

Total: 9/30/2013 $207,883

B. CARITAS INSURANCE COMPANY LTD.Nothing to Report $0

Total: 9/30/2013 $0

C. CENTURY FINANCIAL SERVICES, INC. AND SUBSIDIARY (CENTURY)1 YNH NETWORK CORPORATION Management Services 09/30/2013 $94,6692 YNH NETWORK CORPORATION Payments/Adjustments 09/30/2013 ($72,000)

Total: 9/30/2013 $22,669

D. LUKAN INDEMNITY COMPANY LTD.Nothing to Report $0

Total: 9/30/2013 $0

E. MEDICAL CENTER PHARMACY AND HOME CARE CENTER, INC.1 YNH NETWORK CORPORATION System Support Fee 09/30/2013 $20,9022 YNH NETWORK CORPORATION Payments/Adjustments 09/30/2013 $2,334

Total: 9/30/2013 $23,236

F. MEDICAL CENTER REALTY, INC.1 YNH NETWORK CORPORATION System Support Fee 09/30/2013 $8,1962 YNH NETWORK CORPORATION Management Services 09/30/2013 $24,4493 YNH NETWORK CORPORATION Payments/Adjustments 09/30/2013 $106,182

Total: 9/30/2013 $138,827

G. NORTHEAST MEDICAL GROUP, INC.1 YNH NETWORK CORPORATION System Support Fee 09/30/2013 $1,052,3782 YNH NETWORK CORPORATION Management Services 09/30/2013 $4,318,1283 YNH NETWORK CORPORATION Payments/Adjustments 09/30/2013 ($761,610)

Total: 9/30/2013 $4,608,896

H. NORTHEAST PEDIATRIC SPECIALISTS, INC.Nothing to Report $0

Total: 9/30/2013 $0

I. SHORELINE SURGERY CENTER, LLC1 YNH NETWORK CORPORATION Management Services 09/30/2013 $36,2842 YNH NETWORK CORPORATION Payments/Adjustments 09/30/2013 ($38,859)


FISCAL YEAR 2013REPORT 6A - TRANSACTIONS BETWEEN HOSPITAL AFFILIATES OR RELATED CORPORATIONS


REPORT 6A 16 OF 36 7/28/2014,2:13 PM

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LINE AFFILIATE TRANSFERRING FUNDS AFFILIATE RECEIVING FUNDS DESCRIPTION OF TRANSFER DATE AMOUNT



Total: 9/30/2013 ($2,575)

J. SSC II, LLC1 YNH NETWORK CORPORATION Management Services 09/30/2013 $35,4782 YNH NETWORK CORPORATION Payments/Adjustments 09/30/2013 ($36,614)

Total: 9/30/2013 ($1,136)

K. THE NEW CLINICAL DEVELOPMENT PROGRAM CORPORATION (NCPD)Nothing to Report $0

Total: 9/30/2013 $0

L. YALE-NEW HAVEN AMBULATORY SERVICES CORP.1 YNH NETWORK CORPORATION System Support Fee 09/30/2013 $43,0362 YNH NETWORK CORPORATION Management Services 09/30/2013 $135,9263 YNH NETWORK CORPORATION Payments/Adjustments 09/30/2013 $18,609

Total: 9/30/2013 $197,571

M. YALE-NEW HAVEN CARE CONTINUUM1 YNH NETWORK CORPORATION System Support Fee 09/30/2013 $157,4562 YNH NETWORK CORPORATION Payments/Adjustments 09/30/2013 ($138,145)

Total: 9/30/2013 $19,311

N. YALE-NEW HAVEN HEALTH SERVICES CORP. (YNHHSC)Nothing to Report $0

Total: 9/30/2013 $0

O. YALE-NEW HAVEN MEDICAL CENTER, INC. (MEDICAL CENTER)1 YNH NETWORK CORPORATION Management Services 09/30/2013 $15,6452 YNH NETWORK CORPORATION Payments/Adjustments 09/30/2013 $164,516

Total: 9/30/2013 $180,161

P. YNHH-PHYSICIANS CORPORATION1 YNH NETWORK CORPORATION System Support Fee 09/30/2013 $2,4632 YNH NETWORK CORPORATION Payments/Adjustments 09/30/2013 $250

Total: 9/30/2013 $2,713

Q. YNHHS-MSO, INC.Nothing to Report $0

Total: 9/30/2013 $0

R. YORK ENTERPRISES, INC.1 YNH NETWORK CORPORATION System Support Fee 09/30/2013 $171,1232 YNH NETWORK CORPORATION Management Services 09/30/2013 $5683 YNH NETWORK CORPORATION Payments/Adjustments 09/30/2013 $74,598


REPORT 6A 17 OF 36 7/28/2014,2:13 PM

(1) (2) (3) (4) (5) (6)

LINE AFFILIATE TRANSFERRING FUNDS AFFILIATE RECEIVING FUNDS DESCRIPTION OF TRANSFER DATE AMOUNT



Total: 9/30/2013 $246,289

Ending Unconsolidated Intercompany Balance 9/30/2013 $5,798,059


REPORT 7 18 OF 36 7/28/2014, 2:13 PM

(1) (2) (3) (4)AFFILIATE NAME &

LINE DESCRIPTION OF EXPENDITURE AMOUNT DATE

A. YNH NETWORK CORPORATION0 Nothing to Report $0

Total: $0 9/30/2013

B. CARITAS INSURANCE COMPANY LTD.0 Nothing to Report $0

Total: $0 9/30/2013

C. CENTURY FINANCIAL SERVICES, INC. AND SUBSIDIARY (CENTURY)0 Nothing to Report $0

Total: $0 9/30/2013

D. LUKAN INDEMNITY COMPANY LTD.0 Nothing to Report $0

Total: $0 9/30/2013

E. MEDICAL CENTER PHARMACY AND HOME CARE CENTER, INC.0 Nothing to Report $0

Total: $0 9/30/2013

F. MEDICAL CENTER REALTY, INC.0 Nothing to Report $0

Total: $0 9/30/2013

G. NORTHEAST MEDICAL GROUP, INC.0 Nothing to Report $0

Total: $0 9/30/2013

H. NORTHEAST PEDIATRIC SPECIALISTS, INC.0 Nothing to Report $0

Total: $0 9/30/2013

I. SHORELINE SURGERY CENTER, LLC0 Nothing to Report $0

Total: $0 9/30/2013

J. SSC II, LLC0 Nothing to Report $0

Total: $0 9/30/2013

K. THE NEW CLINICAL DEVELOPMENT PROGRAM CORPORATION (NCPD)0 Nothing to Report $0

Total: $0 9/30/2013

L. YALE-NEW HAVEN AMBULATORY SERVICES CORP.0 Nothing to Report $0

Total: $0 9/30/2013

M. YALE-NEW HAVEN CARE CONTINUUM0 Nothing to Report $0

Total: $0 9/30/2013

N. YALE-NEW HAVEN HEALTH SERVICES CORP. (YNHHSC)0 Nothing to Report $0

Total: $0 9/30/2013

O. YALE-NEW HAVEN MEDICAL CENTER, INC. (MEDICAL CENTER)


FISCAL YEAR 2013REPORT 7- EXPENDITURES BY AFFILIATES / RELATED CORPORATIONS FOR THE BENEFIT OF THE HOSPITAL


REPORT 7 19 OF 36 7/28/2014, 2:13 PM


LINE DESCRIPTION OF EXPENDITURE AMOUNT DATE


FISCAL YEAR 2013REPORT 7- EXPENDITURES BY AFFILIATES / RELATED CORPORATIONS FOR THE BENEFIT OF THE HOSPITAL

0 Nothing to Report $0Total: $0 9/30/2013

P. YNHH-PHYSICIANS CORPORATION0 Nothing to Report $0

Total: $0 9/30/2013

Q. YNHHS-MSO, INC.0 Nothing to Report $0

Total: $0 9/30/2013

R. YORK ENTERPRISES, INC.0 Nothing to Report $0

Total: $0 9/30/2013

Grand Total: $0 9/30/2013


REPORT 8 20 OF 36 7/28/2014,2:13 PM


LINE DESCRIPTION OF THE COMMITMENT AND/OR ENDORSEMENT AMOUNT TERM IN YEARS

A. YNH NETWORK CORPORATION0 Nothing to Report $0 0

Total: $0

B. CARITAS INSURANCE COMPANY LTD.0 Nothing to Report $0 0

Total: $0

C. CENTURY FINANCIAL SERVICES, INC. AND SUBSIDIARY (CENTURY)0 Nothing to Report $0 0

Total: $0

D. LUKAN INDEMNITY COMPANY LTD.0 Nothing to Report $0 0

Total: $0

E. MEDICAL CENTER PHARMACY AND HOME CARE CENTER, INC.0 Nothing to Report $0 0

Total: $0

F. MEDICAL CENTER REALTY, INC.0 Nothing to Report $0 0

Total: $0

G. NORTHEAST MEDICAL GROUP, INC.1 Funding for the Hospitalist Program $36,606,992 1

Total: $36,606,992

H. NORTHEAST PEDIATRIC SPECIALISTS, INC.0 Nothing to Report $0 0

Total: $0

I. SHORELINE SURGERY CENTER, LLC0 Nothing to Report $0 0

Total: $0

J. SSC II, LLC0 Nothing to Report $0 0

Total: $0

K. THE NEW CLINICAL DEVELOPMENT PROGRAM CORPORATION (NCPD)0 Nothing to Report $0 0


FISCAL YEAR 2013REPORT 8 - HOSPITAL COMMITMENTS / ENDORSEMENTS FOR THE BENEFIT OF AFFILIATES / RELATED CORPORATIONS


REPORT 8 21 OF 36 7/28/2014,2:13 PM


LINE DESCRIPTION OF THE COMMITMENT AND/OR ENDORSEMENT AMOUNT TERM IN YEARS


FISCAL YEAR 2013REPORT 8 - HOSPITAL COMMITMENTS / ENDORSEMENTS FOR THE BENEFIT OF AFFILIATES / RELATED CORPORATIONS

Total: $0

L. YALE-NEW HAVEN AMBULATORY SERVICES CORP.0 Nothing to Report $0 0

Total: $0

M. YALE-NEW HAVEN CARE CONTINUUM0 Nothing to Report $0 0

Total: $0

N. YALE-NEW HAVEN HEALTH SERVICES CORP. (YNHHSC)0 Nothing to Report $0 0

Total: $0

O. YALE-NEW HAVEN MEDICAL CENTER, INC. (MEDICAL CENTER)0 Nothing to Report $0 0

Total: $0

P. YNHH-PHYSICIANS CORPORATION0 Nothing to Report $0 0

Total: $0

Q. YNHHS-MSO, INC.0 Nothing to Report $0 0

Total: $0

R. YORK ENTERPRISES, INC.0 Nothing to Report $0 0

Total: $0

Grand Total: $36,606,992


REPORT 16 22 OF 36 7/28/2014, 2:13 PM

(1) (2) (3) (4) (5) (6)

LINE DESCRIPTIONFY 2012 ACTUAL

FY 2013 ACTUAL AMOUNT DIFFERENCE % DIFFERENCE

A . Indigent CareBeginning Balance $0.00 $0.00 $0.00 0%

1 Donations $0.00 $0.00 $0.00 0%2 Income $0.00 $0.00 $0.00 0%3 Expenditures $0.00 $0.00 $0.00 0%4 Unrealized Gains and Losses $0.00 $0.00 $0.00 0%

Ending Balance $0.00 $0.00 $0.00 0%5 Projected Interest Income $0.00 $0.00 $0.00 0%

B . Free BedsBeginning Balance $9,414,855.00 $9,543,192.00 $128,337.00 1%

1 Donations $0.00 $0.00 $0.00 0%2 Income $106,218.00 $172,124.00 $65,906.00 62%3 Expenditures $888,528.00 $641,000.00 ($247,528.00) -28%4 Unrealized Gains and Losses $910,647.00 $876,099.00 ($34,548.00) -4%

Ending Balance $9,543,192.00 $9,950,415.00 $407,223.00 4%5 Projected Interest Income $75,000.00 $100,000.00 $25,000.00 33%

C . OtherBeginning Balance $0.00 $0.00 $0.00 0%

1 Donations $0.00 $0.00 $0.00 0%2 Income $0.00 $0.00 $0.00 0%3 Expenditures $0.00 $0.00 $0.00 0%4 Unrealized Gains and Losses $0.00 $0.00 $0.00 0%

Ending Balance $0.00 $0.00 $0.00 0%5 Projected Interest Income $0.00 $0.00 $0.00 0%


FISCAL YEAR 2013 REPORT 16 - DONATIONS AND FUNDS RESTRICTED FOR

INDIGENT CARE AND FREE BEDS


REPORT 17A PATIENT ACTIVITY 23 OF 36 7/28/2014, 2:13 PM

(1) (2) (3)Patient Name of Hospital Bed Fund (FULL NAME) Amount

6262

$641,000.14

1 Strouse Adler $271.801 Loring W. Andrews $460.681 The Anna Fund $656.031 Anna F. Ardenghi $460.681 Harriet Atwater $120.252 Harriet Atwater $340.432 Mary E. Baldwin $1,032.972 George Benedict $460.652 Bennett $552.812 Edwin B. Bowditch $460.682 Henry Bronson $339.303 Henry Bronson $121.383 Susan Ellen Brown $78.834 Susan Ellen Brown $468.005 Susan Ellen Brown $39.895 Samuel Clifford Carlisle $132.626 Samuel Clifford Carlisle $328.066 William & Laura Carmalt $92.027 William & Laura Carmalt $1,059.677 Joseph Cimerol, Jr. $184.277 Charles Henry Collins $48.558 Charles Henry Collins $412.138 Idalina Darrow $336.648 Deane $426.508 George B. Dines, Jr. $4.618 Cora C.T. Dwight $230.348 Dr. Jonathan Edwards $460.688 Henry Eld $230.348 Henry F. English $460.688 James E. English $1,421.408 Henry Farnum $230.348 William Fitch $230.348 Edwin Foote $2,649.729 Edwin Foote $10,624.0610 Edwin Foote $2,422.0411 Edwin Foote $1,357.4912 Edwin Foote $11,102.4912 Grace Salisbury Foote $459.4112 Levi Goodell Fox $460.6812 Elizabeth Hamlin Fox $460.6812 Simeon & Arthur Ward Fox $1,509.5112 Charles D. Hall $673.1012 Sylvia C. Hall $791.2613 Sylvia C. Hall $471.0013 Jessie A. Harmon $460.6813 Henry Baldwin Harrison $447.4113 Mrs. Henry Baldwin Harrison $447.4113 Home for the Friendliness ($0.01)13 John H. Hopson $230.3413 Henry Hotchkiss ($0.01)13 Timothy A. Hunt $421.4113 Abigail Bradley Hunt $87.2514 Abigail Bradley Hunt $334.1614 Hoadley B. Ives $230.3414 Mary E. Ives $230.3414 Robert E. Ives $460.6814 Walter Judson $46.0714 Charles Kohn $4.6114 Lenhardt $230.3414 George W. Mallory $230.3414 Mary B. Mallory $184.2714 John W. Mansfield $230.3414 Philip Marett $7,162.61

1. Number of Applications for Hospital Bed Funds2. A. Number of Patients receiving Hospital Bed Fund Grants 2. B. The Actual Total Dollar Amount provided to all patients from Hospital Bed Funds:


REPORT 17A - HOSPITAL BED FUNDS HELD OR ADMINISTERED BY THE HOSPITAL

A. Patient Activity




6262

$641,000.14




A. Patient Activity

14 Levy Morris $549.9814 Organized Charities $0.0114 Paul $230.3414 Maud Trowbridge Reynolds $2,142.5214 Leonard J.Sanford & Anna Cutter $447.7814 Julia Sanford $460.6814 Sargent $230.3414 Mark M. Selleck $460.6814 George Thomas Smith $230.3414 Chris Tanuis $1.3814 Margarette Elford Dean Trowbridge $691.0114 Morton Warner $552.8114 Hermanus M. Welch $230.3414 Cynthia Ann Tracy Wetmore $0.0114 Whitney $479.1014 Albert Aaron Williams $1,245.3914 Ann Phillips Wurtenberg $328.9514 Alfred Blakeslee $460.6815 Julia Alling $4,224.7615 Charles Amos Baldwin $5,391.1416 Charles Amos Baldwin $687.1917 Charles Amos Baldwin $4,755.3217 Deane $10,027.4217 Ellen M. Gifford $5,341.2417 Wyllys Atwater $10,699.1617 Dwight Place Church $2,674.7917 William Townsend Hayes $554.9218 William Townsend Hayes $10,144.2418 Dr. Thomas Wells $5,349.5818 Armstrong $7,233.7118 Frank Walter Benedict $10,682.5418 Henry Walter Benedict $10,682.5418 Helen & John T. Mason $15,308.2718 Frank L. Hunt $11,277.5519 Frank L. Hunt $9,860.2420 Frank L. Hunt $8,683.5121 Frank L. Hunt $7,982.8022 Frank L. Hunt $2,314.5023 Frank L. Hunt $4,163.3224 Frank L. Hunt $150.0025 Frank L. Hunt $25,157.6425 Evelina J. Jones $1,505.0526 Evelina J. Jones $4,058.7626 Elizabeth Hotchkiss $5,563.8126 Mary Lamb $272.9426 Bassett Bed #2 $10,904.6527 Bassett Bed #3 $233.4627 Fannie Keyes $11,209.4927 Leete $16,835.3827 George T. Newhall & Julia Leete $19,090.3327 Stiles $12,767.1628 Stiles $3,664.3329 Stiles $2,037.1630 Stiles $229.9131 Stiles $8,151.4032 Stiles $500.0033 Stiles $12,979.8034 Stiles $7,026.0235 Stiles $861.6036 Stiles $3,986.8737 Stiles $12,348.6138 Stiles $9,039.9339 Stiles $170.93




6262

$641,000.14




A. Patient Activity

40 Stiles $2,705.3441 Stiles $7,503.8142 Stiles $1,639.9143 Stiles $2,480.0044 Stiles $13,366.1645 Stiles $62.6146 Stiles ($18,887.63)47 Stiles $52,128.2148 Stiles $17,937.0049 Stiles $4,076.8150 Stiles $13,243.3151 Stiles $1,393.5052 Stiles $2,060.2553 Stiles $52,963.7754 Stiles $3,294.4955 Stiles $4,677.0156 Stiles $17,487.6457 Stiles $500.0058 Stiles $9,451.1958 Rose Porter $7,233.7158 Lucy Hall Boardman $7,989.3358 Ellen M. Gifford Executors $4,991.1559 Ellen M. Gifford Executors $599.5059 Nathan Howell Sanford $517.1660 Nathan Howell Sanford $896.0261 Nathan Howell Sanford $9,770.3061 Arthur Herbert Trowbridge $5,929.9461 Edwin Harrison Beebe $7,853.7961 Julia A. Leete Newhall $24,864.7062 Patients of German Extraction $171.26

Grand Total $641,000.14


REPORT 17B FUND ACTIVITY 26 OF 36 7/28/2014, 2:13 PM

(1) (2) (3) (4) (5) (6)

Line Name of Hospital Bed Fund FMV of Principal Actual Earnings Earnings Reinvested Earnings Available

(3)

(4)

(5)

(6)

New Haven Grays Hospital Bed Fund $10,000.00 $4,282.00 $0.00 $4,282.00Thanksgiving Hospital Bed Fund $5,000.00 $444.00 $0.00 $444.00Trinity Church Hospital Bed Fund $5,000.00 $2,164.00 $0.00 $2,164.00Mary Wade Hospita Bed Fund $5,000.00 $2,557.00 $0.00 $2,557.00Erika Banhan Hospital Bed Fund $40,097.00 $927.00 $0.00 $927.00Womens Seamans Friend Society of Conn. Hospital Bed Fund $10,000.00 $5,201.00 $0.00 $5,201.00Adelaide Bushnell Curtis Hospital Bed Fund $5,000.00 $90.00 $0.00 $90.00

Robert Dickerman Hospital Bed Fund $6,000.00 $107.00 $0.00 $107.00German Society Hospital Bed Fund $21,269.00 $383.00 $0.00 $383.00Walter Charles Goodrich Hospital Bed Fund $25,223.00 $453.00 $0.00 $453.00Sarah Barney Harrison Hospital Bed Fund $9,712.00 $174.00 $0.00 $174.00Elret Stone Hospital Bed Fund $500.00 $9.00 $0.00 $9.00Alma DeBeust Streitein Hospital Bed Fund $35,984.00 $644.00 $0.00 $644.00Mary Southgate Trowbridge Hospital Bed Fund $5,000.00 $90.00 $0.00 $90.00Ellen Treadway Yeckley Hospital Bed Fund $5,000.00 $90.00 $0.00 $90.00

Marcellus B Wilcox Hospital Bed Fund $10,000.00 $180.00 $0.00 $180.00Henry Baldwin Harrison Hospital Bed Fund $9,712.00 $177.00 $0.00 $177.00Mrs. Henry Baldwin Harrison Hospital Bed Fund $9,712.00 $177.00 $0.00 $177.00Home for the Friendliness Hospital Bed Fund $2,500.00 $45.00 $0.00 $45.00John H. Hopson Hospital Bed Fund $5,000.00 $91.00 $0.00 $91.00Henry Hotchkiss Hospital Bed Fund $5,000.00 $90.00 $0.00 $90.00Timothy A. Hunt Hospital Bed Fund $9,148.00 $166.00 $0.00 $166.00

Abigail Bradley Hunt Hospital Bed Fund $9,148.00 $166.00 $0.00 $166.00Hoadley B. Ives Hospital Bed Fund $5,000.00 $91.00 $0.00 $91.00Mary E. Ives Hospital Bed Fund $5,000.00 $91.00 $0.00 $91.00Robert E. Ives Hospital Bed Fund $10,000.00 $182.00 $0.00 $182.00Walter Judson Hospital Bed Fund $1,000.00 $18.00 $0.00 $18.00Charles Kohn Hospital Bed Fund $100.00 $2.00 $0.00 $2.00Lenhardt Hospital Bed Fund $5,000.00 $91.00 $0.00 $91.00


FISCAL YEAR 2013REPORT 17B - HOSPITAL BED FUNDS HELD OR ADMINISTERED BY THE HOSPITAL

Actual Dollar Amount of Earnings available for Patient Care.

B. BED FUND ACTIVITY

Fair Market Value of the Principal of each individual Hospital Bed Fund, or the Principal attributable to each Hospital Bed

Total Actual Earnings for each Hospital Bed Fund or the Earnings attributable to each Hospital Bed Fund.

Actual Dollar Amount of Earnings reinvested as Principal, if any.



(1) (2) (3) (4) (5) (6)





George W. Mallory Hospital Bed Fund $5,000.00 $91.00 $0.00 $91.00Mary B. Mallory Hospital Bed Fund $4,000.00 $73.00 $0.00 $73.00

John W. Mansfield Hospital Bed Fund $5,000.00 $91.00 $0.00 $91.00Philip Marett Hospital Bed Fund $155,480.00 $2,827.00 $0.00 $2,827.00Levy Morris Hospital Bed Fund $11,938.00 $217.00 $0.00 $217.00

Organized Charities Hospital Bed Fund $10,000.00 $179.00 $0.00 $179.00Paul Hospital Bed Fund $5,000.00 $91.00 $0.00 $91.00Maud Trowbridge Reynolds Hospital Bed Fund $46,508.00 $846.00 $0.00 $846.00Leonard J.Sanford & Anna Cutter Hospital Bed Fund $9,720.00 $177.00 $0.00 $177.00Julia Sanford Hospital Bed Fund $10,000.00 $182.00 $0.00 $182.00Sargent Hospital Bed Fund $5,000.00 $91.00 $0.00 $91.00Mark M. Selleck Hospital Bed Fund $10,000.00 $182.00 $0.00 $182.00George Thomas Smith Hospital Bed Fund $5,000.00 $91.00 $0.00 $91.00Chris Tanuis Hospital Bed Fund $30.00 $1.00 $0.00 $1.00Margarette Elford Dean Trowbridge Hospital Bed Fund $15,000.00 $273.00 $0.00 $273.00Morton Warner Hospital Bed Fund $12,000.00 $218.00 $0.00 $218.00

Hermanus M. Welch Hospital Bed Fund $5,000.00 $91.00 $0.00 $91.00Cynthia Ann Tracy Wetmore Hospital Bed Fund $60,000.00 $1,074.00 $0.00 $1,074.00Whitney Hospital Bed Fund $10,400.00 $189.00 $0.00 $189.00

Albert Aaron Williams Hospital Bed Fund $27,034.00 $492.00 $0.00 $492.00Ann Phillips Wurtenberg Hospital Bed Fund $7,141.00 $130.00 $0.00 $130.00Alfred Blakeslee Hospital Bed Fund $10,000.00 $182.00 $0.00 $182.00Julia Alling Hospital Bed Fund $5,000.00 $816.00 $0.00 $816.00Charles Amos Baldwin Hospital Bed Fund $10,000.00 $2,094.00 $0.00 $2,094.00Deane Hospital Bed Fund $10,000.00 $1,938.00 $0.00 $1,938.00Ellen M. Gifford Hospital Bed Fund $5,000.00 $1,032.00 $0.00 $1,032.00Wyllys Atwater Hospital Bed Fund $10,000.00 $2,068.00 $0.00 $2,068.00

Dwight Place Church Hospital Bed Fund $5,000.00 $517.00 $0.00 $517.00William Townsend Hayes Hospital Bed Fund $10,000.00 $2,068.00 $0.00 $2,068.00Dr. Thomas Wells Hospital Bed Fund $5,000.00 $1,034.00 $0.00 $1,034.00Armstrong Hospital Bed Fund $5,000.00 $1,398.00 $0.00 $1,398.00Frank Walter Benedict Hospital Bed Fund $10,000.00 $2,064.00 $0.00 $2,064.00Henry Walter Benedict Hospital Bed Fund $10,000.00 $2,064.00 $0.00 $2,064.00Helen & John T. Mason Hospital Bed Fund $14,318.00 $2,958.00 $0.00 $2,958.00Frank L. Hunt Hospital Bed Fund $80,976.00 $13,448.00 $0.00 $13,448.00Evelina J. Jones Hospital Bed Fund $5,000.00 $1,075.00 $0.00 $1,075.00



(1) (2) (3) (4) (5) (6)





Elizabeth Hotchkiss Hospital Bed Fund $5,000.00 $1,075.00 $0.00 $1,075.00Mary Lamb Hospital Bed Fund $275.00 $53.00 $0.00 $53.00Bassett Bed #2 Hospital Bed Fund $10,000.00 $2,152.00 $0.00 $2,152.00Fannie Keyes Hospital Bed Fund $10,000.00 $2,166.00 $0.00 $2,166.00Leete Hospital Bed Fund $15,000.00 $3,253.00 $0.00 $3,253.00George T. Newhall & Julia Leete Hospital Bed Fund $17,412.00 $3,689.00 $0.00 $3,689.00Stiles Hospital Bed Fund $113,304.00 $50,602.00 $0.00 $50,602.00Rose Porter Hospital Bed Fund $5,000.00 $1,398.00 $0.00 $1,398.00

Lucy Hall Boardman Hospital Bed Fund $11,329.00 $1,544.00 $0.00 $1,544.00Ellen M. Gifford Executors Hospital Bed Fund $5,000.00 $1,080.00 $0.00 $1,080.00Nathan Howell Sanford Hospital Bed Fund $10,000.00 $2,161.00 $0.00 $2,161.00Arthur Herbert Trowbridge Hospital Bed Fund $5,000.00 $1,146.00 $0.00 $1,146.00Edwin Harrison Beebe Hospital Bed Fund $25,000.00 $1,518.00 $0.00 $1,518.00

Julia A. Leete Newhall Hospital Bed Fund $17,412.00 $4,805.00 $0.00 $4,805.00Bassett Bed #1 Hospital Bed Fund $10,000.00 $5,113.00 $0.00 $5,113.00

Richard S Fellowes Hospital Bed Fund $5,165.00 $591.00 $0.00 $591.00

Isaphene Hillhouse Hospital Bed Fund $5,000.00 $2,557.00 $0.00 $2,557.00Joseph T Mary L Hotchkiss Hospital Bed Fund $15,000.00 $7,681.00 $0.00 $7,681.00"Anna" Hospital Bed Fund $14,241.00 $259.00 $0.00 $259.00Anna F. Ardenghi Hospital Bed Fund $10,000.00 $182.00 $0.00 $182.00Strouse Adler Hospital Bed Fund $5,900.00 $107.00 $0.00 $107.00

Loring W. Andrews Hospital bed Fund $10,000.00 $182.00 $0.00 $182.00Harriet Atwater $10,000.00 $182.00 $0.00 $182.00Mary E. Baldwin Hospital Bed Fund $22,423.00 $408.00 $0.00 $408.00George Benedict Hospital Bed Fund $10,000.00 $182.00 $0.00 $182.00Bennett Hospital Bed Fund $12,000.00 $218.00 $0.00 $218.00

Edwin B. Bowditch Hospital Bed Fund $10,000.00 $182.00 $0.00 $182.00Henry Bronson Hospital Bed Fund $10,000.00 $182.00 $0.00 $182.00

Susan Ellen Brown Hospital Bed Fund $12,736.00 $232.00 $0.00 $232.00Samuel Clifford Carlisle Hospital Bed Fund $10,000.00 $182.00 $0.00 $182.00William & Laura Carmalt Hospital Bed Fund $25,000.00 $455.00 $0.00 $455.00

Joseph Cimerol, Jr. Hospital Bed Fund $4,000.00 $73.00 $0.00 $73.00

Charles Henry Collins Hospital Bed Fund $10,000.00 $182.00 $0.00 $182.00Idalina Darrow Hospital Bed Fund $7,308.00 $133.00 $0.00 $133.00Deane Hospital Bed Fund $9,258.00 $168.00 $0.00 $168.00



(1) (2) (3) (4) (5) (6)





George B. Dines, Jr. Hospital Bed Fund $100.00 $2.00 $0.00 $2.00Cora C.T. Dwight Hospital Bed Fund $5,000.00 $91.00 $0.00 $91.00Dr. Jonathan Edwards Hospital Bed Fund $10,000.00 $182.00 $0.00 $182.00Henry Eld Hospital Bed Fund $5,000.00 $91.00 $0.00 $91.00Henry F. English Hospital Bed Fund $10,000.00 $182.00 $0.00 $182.00James E. English Hospital Bed Fund $30,855.00 $561.00 $0.00 $561.00Henry Farnum Hospital Bed Fund $5,000.00 $91.00 $0.00 $91.00William Fitch Hospital Bed Fund $5,000.00 $91.00 $0.00 $91.00Edwin Foote Hospital Bed Fund $611,185.00 $11,112.00 $0.00 $11,112.00Grace Salisbury Foote Hospital Bed Fund $10,000.00 $182.00 $0.00 $182.00Levi Goodell Fox Hospital Bed Fund $10,000.00 $182.00 $0.00 $182.00

Elizabeth Hamlin Fox Hospital Bed Fund $10,000.00 $182.00 $0.00 $182.00Simeon & Arthur Ward Fox Hospital Bed Fund $32,767.00 $596.00 $0.00 $596.00Charles D. Hall Hospital Bed Fund $14,611.00 $266.00 $0.00 $266.00Sylvia C. Hall Hospital Bed Fund $27,400.00 $498.00 $0.00 $498.00Jessie A. Harmon Hospital Bed Fund $10,000.00 $182.00 $0.00 $182.00Total Bed Funds : $2,164,331.00 $172,128.00 $0.00 $172,128.00


REPORT 18 30 OF 35 7/28/2014,2:13 PM

(1) (2) (3)LINE DESCRIPTION COLLECTION INFORMATION

I. GENERAL COLLECTION PROCESSES AND PROCEDURESA. Hospital's processes and policies for assigning a debt to a

Collection Agent

See Policies and Procedures associated with Credit and Collections files as part of Annual Reporting Section 19(a)-167g-91(b)(22)

B. Hospital's processes and policies for compensating a Collection Agent for services rendered

Each collection agent is reimbursed for services and rendered based on separately negotiated performance related contracts.

C. Total Recovery Rate on accounts assigned (excluding Medicare accounts) to Collection Agents 9.30%

II. SPECIFIC COLLECTION AGENT INFORMATIONA Collection Agent 1 Collection Agent Name Nair & Levin, P.C.2 Collection Agent Type Attorney3 Related / Not Related Entity Not Related4 If the Hospital follows the same processes and policies described

in Section I, for assigning debt with this Collection Agent? indicate "Same as General Processes and Policies" Otherwise Provide Details. See Policies and Procedures associated with Credit and Collections files as part of

Annual Reporting Section 19(a)-167g-91(b)(22)5 If the Hospital follows the same processes and policies described

in Section I, for compensating this Collection Agent? indicate "Same as General Processes and Policies" Otherwise Provide Details. Each collection agent is reimbursed for services and rendered based on

separately negotiated performance related contracts.6 Recovery Rate on Accounts Assigned (excluding Medicare

accounts) to Collection Agent. 20.10%

B Collection Agent 1 Collection Agent Name Tobin, Cerberry, OMallery, Riley, Sellinger PC2 Collection Agent Type Attorney


FISCAL YEAR 2013REPORT 18 - HOSPITAL COLLECTION PLACEMENT POLICIES AND COLLECTION AGENT INFORMATION


REPORT 18 31 OF 35 7/28/2014,2:13 PM

(1) (2) (3)LINE DESCRIPTION COLLECTION INFORMATION


FISCAL YEAR 2013REPORT 18 - HOSPITAL COLLECTION PLACEMENT POLICIES AND COLLECTION AGENT INFORMATION

3 Related / Not Related Entity Not Related4 If the Hospital follows the same processes and policies described






C Collection Agent 1 Collection Agent Name Century Financial Services2 Collection Agent Type Collection Agency3 Related / Not Related Entity Related4 If the Hospital follows the same processes and policies described







REPORT 19 32 OF 36 7/28/2014, 2:13 PM

LINE POSITION TITLE SALARY FRINGE BENEFITS TOTAL


FISCAL YEAR 2013REPORT 19 - SALARIES AND FRINGE BENEFITS OF THE TEN HIGHEST PAID HOSPITAL POSITIONS

1. President & CEO(repr YNHH & YNHHS) $2,511,717 $752,041 $3,263,758

2. Exec VP, COO(repr YNHH & YNHHS) $1,502,352 $440,336 $1,942,688

3. SR VP Finance, CFO(repr YNHH & YNHHS) $1,214,946 $382,265 $1,597,211

4. SR VP, Chief of Staff(repr YNHH & YNHHS) $1,402,687 $79,436 $1,482,123

5. Senior VP, CIO(repr YNHH & YNHHS) $719,193 $284,399 $1,003,592

6. Senior VP HR(repr YNHH & YNHHS) $768,977 $233,367 $1,002,344

7. VP of Legal Services $757,853 $241,024 $998,877

8. VP & Exec Dir of Childrens Hospital $635,529 $217,588 $853,117

9. SVP OPS/SMILOW $599,523 $200,580 $800,103

10. Senior VP Patient Services $657,852 $45,622 $703,474

Grand Total: $10,770,629 $2,876,658 $13,647,287


REPORT 21 33 OF 36 7/28/2014,2:13 PM

(1) (2) (3) (4) (5)

LINE DESCRIPTION

SALARIES (Directly or Indirectly)C

FRINGE BENEFITSA(Directl

y or Indirectly)C TOTAL

A . YNH NETWORK CORPORATION1 Paid by the Entity Listed Above to Hospital Employees(B) $0 $0 $0 2 Paid by the Hospital to Employees of the Entity Listed Above $0 $0 $0

B . CARITAS INSURANCE COMPANY LTD.1 Paid by the Entity Listed Above to Hospital Employees(B) $0 $0 $0 2 Paid by the Hospital to Employees of the Entity Listed Above $0 $0 $0

C .CENTURY FINANCIAL SERVICES, INC. AND SUBSIDIARY (CENTURY)

1 Paid by the Entity Listed Above to Hospital Employees(B) $0 $0 $0 2 Paid by the Hospital to Employees of the Entity Listed Above $0 $0 $0

D . LUKAN INDEMNITY COMPANY LTD.1 Paid by the Entity Listed Above to Hospital Employees(B) $0 $0 $0 2 Paid by the Hospital to Employees of the Entity Listed Above $0 $0 $0

E . MEDICAL CENTER PHARMACY AND HOME CARE CENTER, INC.1 Paid by the Entity Listed Above to Hospital Employees(B) $0 $0 $0 2 Paid by the Hospital to Employees of the Entity Listed Above $0 $0 $0

F . MEDICAL CENTER REALTY, INC.1 Paid by the Entity Listed Above to Hospital Employees(B) $0 $0 $0 2 Paid by the Hospital to Employees of the Entity Listed Above $0 $0 $0

G . NORTHEAST MEDICAL GROUP, INC.1 Paid by the Entity Listed Above to Hospital Employees(B) $0 $0 $0 2 Paid by the Hospital to Employees of the Entity Listed Above $0 $0 $0

H . NORTHEAST PEDIATRIC SPECIALISTS, INC.1 Paid by the Entity Listed Above to Hospital Employees(B) $0 $0 $0 2 Paid by the Hospital to Employees of the Entity Listed Above $0 $0 $0

I . SHORELINE SURGERY CENTER, LLC1 Paid by the Entity Listed Above to Hospital Employees(B) $0 $0 $0 2 Paid by the Hospital to Employees of the Entity Listed Above $0 $0 $0

J . SSC II, LLC1 Paid by the Entity Listed Above to Hospital Employees(B) $0 $0 $0 2 Paid by the Hospital to Employees of the Entity Listed Above $0 $0 $0

K .THE NEW CLINICAL DEVELOPMENT PROGRAM CORPORATION (NCPD)

1 Paid by the Entity Listed Above to Hospital Employees(B) $0 $0 $0 2 Paid by the Hospital to Employees of the Entity Listed Above $0 $0 $0

L . YALE-NEW HAVEN AMBULATORY SERVICES CORP.1 Paid by the Entity Listed Above to Hospital Employees(B) $0 $0 $0 2 Paid by the Hospital to Employees of the Entity Listed Above $0 $0 $0

M . YALE-NEW HAVEN CARE CONTINUUM1 Paid by the Entity Listed Above to Hospital Employees(B) $0 $0 $0


FISCAL YEAR 2013REPORT 21- HOSPITAL SALARIES AND FRINGE BENEFITS

PAID BY JOINT VENTURES, AFFILIATES AND RELATED CORPORATIONS


REPORT 21 34 OF 36 7/28/2014,2:13 PM

(1) (2) (3) (4) (5)

LINE DESCRIPTION

SALARIES (Directly or Indirectly)C

FRINGE BENEFITSA(Directl

y or Indirectly)C TOTAL


FISCAL YEAR 2013REPORT 21- HOSPITAL SALARIES AND FRINGE BENEFITS

PAID BY JOINT VENTURES, AFFILIATES AND RELATED CORPORATIONS

2 Paid by the Hospital to Employees of the Entity Listed Above $0 $0 $0

N . YALE-NEW HAVEN HEALTH SERVICES CORP. (YNHHSC)1 Paid by the Entity Listed Above to Hospital Employees(B) $2,114,251 $491,544 $2,605,795 2 Paid by the Hospital to Employees of the Entity Listed Above $91,103,560 $27,082,776 $118,186,336

O . YALE-NEW HAVEN MEDICAL CENTER, INC. (MEDICAL CENTER)1 Paid by the Entity Listed Above to Hospital Employees(B) $0 $0 $0 2 Paid by the Hospital to Employees of the Entity Listed Above $0 $0 $0

P . YNHH-PHYSICIANS CORPORATION1 Paid by the Entity Listed Above to Hospital Employees(B) $0 $0 $0 2 Paid by the Hospital to Employees of the Entity Listed Above $0 $0 $0

Q . YNHHS-MSO, INC.1 Paid by the Entity Listed Above to Hospital Employees(B) $0 $0 $0 2 Paid by the Hospital to Employees of the Entity Listed Above $0 $0 $0

R . YORK ENTERPRISES, INC.1 Paid by the Entity Listed Above to Hospital Employees(B) $0 $0 $0 2 Paid by the Hospital to Employees of the Entity Listed Above $0 $0 $0

For each entity listed on Report 20, complete Report 21.

A - Fringe benefits shall represent the value of all forms of compensation as described in Section 19a-643-206-(b)(21), including the fair market value where appropriate. B - A hospital employee is anyone who provides a service which incurs an expense for the hospital. C - Indirect payments include but are not limited to payments made to related entities.


REPORT 22 35 OF 36 7/28/2014,2:13 PM

(1) (2) (3)

LINE DESCRIPTION ACTUAL FY 2013

A Transfer of Assets or Operations

1.

Name of the Person or Entity Organized or Operated For Profit involved in each Transfer of Assets or Operations or Change of Control involving Hospital Clinical or Nonclinical Services or Functions. N/A

2.Description of each Transfer of Assets or Operations or Change of Control involving Hospital Clinical or Nonclinical Services or Functions. N/A

3.Description of each Hospital Clinical or Nonclinical Service or Function transferred or involved in a change of control. N/A

4.Date that each Transfer of Assets or Operations or Change of Control involving Hospital Clinical or Nonclinical Services or Functions occurred. N/A

5.Amount of each Transfer of Assets or Operations or Change of Control involving Hospital Clinical or Nonclinical Services or Functions. $0


FISCAL YEAR 2013REPORT 22 - TRANSFER OF ASSETS OR OPERATIONS OR

CHANGE OF CONTROL FROM THE HOSPITAL TO A PROFIT ENTITY


REPORT 23 36 of 37 7/28/2014, 2:13 PM

(1) (2) (3) (4) (5) (6)FY 2012 FY 2013 AMOUNT %

LINE DESCRIPTION AMOUNT AMOUNT DIFFERENCE DIFFERENCE

A. Hospital Charity Care (see Hospital Audited Financial Statement Notes)

1. Number of Applicants 29,220 32,876 3,656 13%2. Number of Approved Applicants 27,590 31,600 4,010 15%

3. Total Charges (A) $78,094,472 $86,526,000 $8,431,528 11%Average Charges $2,831 $2,738 ($92) -3%

4. Ratio of Cost to Charges (RCC) 0.322455 0.301756 (0.020699) -6%Total Cost $25,181,953 $26,109,740 $927,787 4%Average Cost $913 $826 ($86) -9%

5. Charity Care - Inpatient Charges $28,944,417 $48,253,478 $19,309,061 67%

6.Charity Care - Outpatient Emergency Department Charges 9,964,992 5,979,444 (3,985,548) -40%

7.Charity Care - Outpatient Charges (Excludes ED Charges) 39,185,063 32,293,078 (6,891,985) -18%Total Charges (A) $78,094,472 $86,526,000 $8,431,528 11%

8. Charity Care - Number of Patient Days 10,004 17,637 7,633 76%9. Charity Care - Number of Discharges 1,354 2,387 1,033 76%

10. Charity Care - Number of Outpatient ED Visits 5,058 5,793 735 15%

11.Charity Care - Number of Outpatient Visits (Excludes ED Visits) 24,265 27,792 3,527 15%

(A) The total amount must agree with the total amount listed in the Hospital Audited Financial Statement Notes.

B. Hospital Bed Funds (see Hospital Reporting System - Report 17)

1. Number of Applicants 83 62 (21) -25%2. Number of Approved Applicants 83 62 (21) -25%

3. Total Charges (B) $888,528 $641,000 ($247,528) -28%Average Charges $10,705 $10,339 ($366) -3%

4. Ratio of Cost to Charges (RCC) 0.322455 0.301756 (0.020699) -6%Total Cost $286,510 $193,426 ($93,085) -32%Average Cost $3,452 $3,120 ($332) -10%

5. Bed Funds - Inpatient Charges $329,318 $357,470 $28,152 9%

6. Bed Funds - Outpatient Emergency Department Charges 113,378 44,297 (69,081) -61%

7. Bed Funds - Outpatient Charges (Excludes ED Charges) 445,832 239,233 (206,599) -46%Total Charges (B) $888,528 $641,000 ($247,528) -28%

8. Bed Funds - Number of Patient Days 632 472 (160) -25%9. Bed Funds - Number of Discharges 173 130 (43) -25%

10. Bed Funds - Number of Outpatient ED Visits 1,732 1,294 (438) -25%

11.Bed Funds - Number of Outpatient Visits(Excludes ED Visits) 223 166 (57) -26%

(B) The total amount must agree with the total amount listed on Hospital Reporting System - Report 17.


FISCAL YEAR 2013REPORT 23 - CHARITY CARE AND REDUCED COST SERVICES PROVIDED BY THE HOSPITAL


REPORT 23 37 of 37 7/28/2014, 2:13 PM

(1) (2) (3) (4) (5) (6)FY 2012 FY 2013 AMOUNT %

LINE DESCRIPTION AMOUNT AMOUNT DIFFERENCE DIFFERENCE


FISCAL YEAR 2013REPORT 23 - CHARITY CARE AND REDUCED COST SERVICES PROVIDED BY THE HOSPITAL

Documents

portal.ct.gov · YALE-NEW HAVEN HOSPITAL ANNUAL REPORTING FISCAL YEAR 2013 REPORT 17B - HOSPITAL BED FUNDS HELD OR ADMINISTERED BY THE HOSPITAL Actual Dollar Amount of Earnings available