2022-08-02T10:34:34-05:00 2021-09-30 366055558 GRANT THORNTON LLP 75 STATE ST 13TH FLOOR BOSTON MA 02109 990 2020-10-01 042768252 STURDY MEMORIAL HOSPITAL INC STUR 5082225200 211 PARK STREET PO BOX 2963 ATTLEBORO MA 027030963 AMY PFEFFER CFO 5082368150 2022-08-02 1 AMY PFEFFER XXX-XX-XXXX ERIN COUTURE P01390592 6177237900 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z AIMEE B BREWER 211 PARK STREET PO BOX 2963 ATTLEBORO MA 027030963 385930730 0 X WWW.STURDYMEMORIAL.ORG X 1913 MA PROVIDING SAFE, HIGH QUALITY, COST EFFICIENT HEALTH CARE, AND A BROAD (CONTINUED ON SCH O).RANGE OF DIAGNOSTICS, INPATIENT, OUTPATIENT AND EMERGENCY SERVICES FOR OUR COMMUNITY. 15 14 1886 812 54925 22440 12589692 6863835 203764770 229937634 17306083 27578796 8820225 9883848 242480770 274264113 13096666 10019862 0 0 127096424 134261238 0 0 0 88321987 107443914 228515077 251725014 13965693 22539099 472355538 572094227 62373502 57154523 409982036 514939704 X THE HOSPITAL'S MISSION IS TO PROVIDE HIGH QUALITY CARE TO THE SICK AND INJURED, ON BOTH AN INPATIENT AND OUTPATIENT BASIS, WITHOUT REGARD TO RACE, CREED, NATIONAL ORIGIN, AGE, GENDER, DISABILITY, OR ABILITY TO PAY. (CONTINUED ON SCHEDULE O).ORGANIZATION'S MISSION (CONTINUED)THE HOSPITAL WORKS TO ENSURE THAT AMPLE, HIGH QUALITY PRIMARY AND SPECIALTY PHYSICIAN SERVICES ARE ACCESSIBLE TO AREA RESIDENTS. ADDITIONALLY, WE TRY TO AVOID COSTLY DUPLICATION OF HEALTH CARE SERVICES BY COORDINATING WITH OTHER AREA HEALTH CARE PROVIDERS TO THE EXTENT PRACTICABLE. THE HOSPITAL PROVIDES LEADERSHIP WHILE WORKING IN COOPERATION WITH PUBLIC AND PRIVATE HEALTH ORGANIZATIONS, AS WELL AS CIVIC AND BUSINESS ORGANIZATIONS, TO MEET THE HEALTH CARE NEEDS OF OUR COMMUNITIES. 0 0 219268982 10019862 229937634 STURDY MEMORIAL HOSPITAL, INC. IS A NOT-FOR-PROFIT ACUTE CARE COMMUNITY HOSPITAL WHICH IS DEDICATED TO PROVIDING A BROAD RANGE OF HEALTH CARE SERVICES TO THE RESIDENTS OF ATTLEBORO, MASSACHUSETTS AND SURROUNDING COMMUNITIES. THE HOSPITAL GENERATES VIRTUALLY ALL OF ITS REVENUES IN PURSUIT OF ITS EXEMPT PURPOSES, WHICH IS TO PROVIDE COMPREHENSIVE DIAGNOSTIC, THERAPEUTIC, AND EDUCATIONAL HEALTH CARE SERVICES TO RESIDENTS OF ITS COMMUNITIES. THE HOSPITAL PROVIDES HIGH QUALITY CARE TO THE SICK AND INJURED, ON BOTH AN INPATIENT AND OUTPATIENT BASIS, WITHOUT REGARD TO RACE, CREED, NATIONAL ORIGIN AGE, GENDER, DISABILITY, OR ABILITY TO PAY. THE HOSPITAL TREATED 10,985 INPATIENTS AND OBSERVATION PATIENTS, INCLUDING BIRTHS, OF WHICH THERE WERE 598. (CONTINUED ON SCHEDULE O).THE HOSPITAL TREATED 44,893 PATIENTS IN THE EMERGENCY ROOM AND PERFORMED SURGERY ON 1,571 INPATIENTS AND 8,851 OUTPATIENTS. THE HOSPITAL PROVIDES MANY OTHER SERVICES OF WHICH THE FOLLOWING IS A PARTIAL LIST: ONCOLOGY 8,172 VISITS; MANSFIELD HEALTH CENTER- 23,779 VISITS; CARDIAC REHABILITATION- 8,599 VISITS; AND WOUND CARE- 2,523 VISITS. IN ADDITION, THE HOSPITAL PROVIDES A VARIETY OF ANCILLARY SERVICES - A PARTIAL LIST INCLUDES: LABORATORY, RADIOLOGY, MAMMOGRAPHY, COMPUTERIZED TOMOGRAPHY, MRI, NUCLEAR MEDICINE, VASCULAR, ULTRASOUND, SLEEP STUDY AND PHYSICAL THERAPY. STURDY CONTINUES TO PARTNER WITH COLUMN HEALTH TO BRING SUBSTANCE USE DISORDER TREATMENT TO OUR COMMUNITY.THE HOSPITAL PROVIDED APPROXIMATELY $4,166,936 IN SERVICES FOR THOSE WHO COULD NOT PAY (FREE CARE) OR WOULD NOT PAY (BAD DEBT) IN FISCAL YEAR 2021. IN ADDITION, THE HOSPITAL PROVIDED APPROXIMATELY $10,355,898 IN UN-REIMBURSED MASSHEALTH (MEDICAID) SERVICES DURING THE YEAR. FURTHER, THE HOSPITAL PROVIDES A NUMBER OF PROGRAMS TO BENEFIT OUR COMMUNITY EITHER AT NO CHARGE OR AT REDUCED RATES. THE HOSPITAL ALSO PROVIDES LEADERSHIP IN THE INTEGRATION OF HEALTH SERVICES FOR THE COMMUNITIES IT SERVES. STURDY MEMORIAL HOSPITAL CONTINUES TO PARTNER WITH COLUMN HEALTH TO BRING SUBSTANCE USE DISORDER TREATMENT TO OUR COMMUNITY. 219268982 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 157 0 1 1886 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 14 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 MA X AMY PFEFFER 5082368150 211 PARK STREET PO BOX 2963 ATTLEBORO MA 027030963 JOSEPH CASEY PRESIDENT & CEO 37.00 11.00 X 1032517 0 90522 BRIAN KELLY MD VP & CMO 40.00 6.00 X 574428 0 123900 AMY PFEFFER CFO & TREASURER 35.00 10.00 X 516305 0 160258 BRIAN PATEL MD CHIEF, AMBULATORY 40.00 0.00 X 505500 0 70738 MARK MCGUIRE MD PHYSICIAN 40.00 0.00 X 405158 0 78622 RONALD VAN NESS-OTUNNU MD PHYSICIAN ASSOCIATE DIRECTOR 42.00 1.00 X 403216 0 77030 LAURINE THORNTON-POTTER MD PHYSICIAN 40.00 0.00 X 321754 0 90352 ROBIN MORRIS SVP OF CLINICAL OPS & INTEGRITY 45.00 0.00 X 295487 0 107152 MICHAEL DEMELIS MD PHYSICIAN 40.00 0.00 X 312236 0 88156 DAVID SPOOR SVP OF PATIENT SRVS/CHF. OF NURSING 45.00 0.00 X 258139 0 74563 CAROLYN ROSS CHIEF HUMAN RESOURCES OFFICER 32.00 8.00 X 243392 0 62309 JEAN SIDALL-BENSSON MD PHYSICIAN DIRECTOR 2.00 41.00 X 0 229236 63735 BLAIR BISHER COO 8.00 37.00 X 231436 0 16865 COLLEEN MCGAHAN CLERK 2.00 1.00 X X 0 0 0 RICHARD SMITH MD DIRECTOR (THRU 01/2021) 2.00 3.00 X 0 0 0 RICHARD DIGIACOMO DIRECTOR 2.00 1.00 X 0 0 0 MARCO ARISMENDI DIRECTOR (THRU 01/2021) 2.00 1.00 X 0 0 0 PATRICIA COCHRANE DIRECTOR 2.00 1.00 X 0 0 0 MARK COOPER DIRECTOR 2.00 1.00 X 0 0 0 DWAYNE DEMOND DIRECTOR 2.00 1.00 X 0 0 0 EDWARD DION JR DIRECTOR 2.00 1.00 X 0 0 0 ROGER FORMAN DIRECTOR 2.00 1.00 X 0 0 0 LAURA GIGNAC DIRECTOR 2.00 1.00 X 0 0 0 PAUL HEROUX DIRECTOR 2.00 1.00 X 0 0 0 DENNIS KELLY DIRECTOR 2.00 1.00 X 0 0 0 JOHN KORONA CHAIR 2.00 3.00 X X 0 0 0 THOMAS NOEL DIRECTOR 2.00 1.00 X 0 0 0 RALPH SCHLENKER DIRECTOR 2.00 3.00 X 0 0 0 STEPHEN BURLONE DIRECTOR (AS OF 01/2021) 2.00 1.00 X 0 0 0 5099568 229236 1104202 203 0 1 0 REMEDI HEALTH SOLUTIONS 90 LAKE STERLINE GATE DRIVE SPRING TX 77379 CONSULTING 2632201 ACCOUNTABLE HEALTHCARE STAFFING PO BOX 732800 DALLAS TX 753732800 CONTRACT LABOR 2069137 ARUP LABORATORIES INC PO BOX 27964 SALT LAKE CITY UT 84217 REFERENCE LAB 1103391 ATLANTIC ANESTHESIA PC 191 PECUNIT STREET CANTON MA 02021 PHYSICIAN SERVICES 1000694 MCLEAN HOSPITAL CORPORATION 115 MILL STREET BELMONT MA 024789106 PHYSICIAN SERVICES 623786 32 6833835 30000 6863835 NET PATIENT SERVICE REVENUE 621400 224309628 224309628 INCENTIVE PAYMENTS 900099 1341387 1341387 REBATES, REFUNDS AND DISCOUNTS 621990 808892 808892 CAFETERIA SALES 722514 782120 782120 PATIENT RELATED REVENUE, OTHER 621990 248357 248357 2447250 2398608 48642 229937634 8165020 6283 8158737 61148 0 61148 61148 61148 131080393 111666617 19413776 19413776 19413776 PENSION/POST RETIREMENT ADJSTMENT 900099 9822700 9822700 9822700 274264113 229106872 54925 38238481 10019862 10019862 2645697 2645697 96844718 83627285 13217433 14007229 11774477 2232752 14725695 12378419 2347276 6037899 5075458 962441 157256 157256 256560 256560 18098 18098 729396 729396 18547852 15576191 2971661 181924 17477 164447 2845479 2460712 384767 9033429 7479121 1554308 3854410 2982418 871992 156384 133541 22843 85776 70227 15549 8713554 7406521 1307033 1102592 718561 384031 MEDICAL SUPPLIES 41196902 41185529 11373 PROVSN FOR DOUBTFL DEBT 13090437 13090437 MAINTENANCE & REPAIRS 3059744 2910500 149244 LICENSES & TAXES 2162490 2101818 60672 2251631 260428 1991203 251725014 219268982 32456032 0 1316 1316 24929789 12786121 18239134 27238758 0 0 0 5405436 6167895 3356408 5463560 195937362 129807492 63426150 66129870 312353553 332517717 21697380 26753344 3177072 3198688 19769300 91836958 472355538 572094227 55060466 51994396 2000000 0 5313036 5160127 62373502 57154523 X 409959445 514917113 22591 22591 409982036 514939704 472355538 572094227 X 22539099 28864925 53553644 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 0 0 1 18098 18098 0 SCHEDULE C, PART II-B, LINE 1B PAID STAFF OR MANAGEMENT HOSPITAL EMPLOYEES MAY MEET WITH LOCAL AND STATE REPRESENTATIVES TO DISCUSS CURRENT ISSUES AFFECTING THE DELIVERY OF HEALTHCARE IN OUR SERVICE AREA. THE HOSPITAL WORKS TO ADVANCE INITIATIVES TO ENHANCE AND IMPROVE ACCESS TO HEALTH CARE SERVICES. SCHEDULE C, PART II-B, LINE 1I DIRECT CONTACT THE AMOUNT REPRESENTS A PERCENTAGE OF THE HOSPITAL'S ANNUAL APPORTIONMENT OF MHA/AHA AND ASSOCIATED INDUSTRIES OF MASSACHUSETTS DUES ATTRIBUTED TO LOBBYING EXPENSES. FOR FISCAL 2021 IT WAS ESTIMATED THAT 13.66% ($18,098) WAS USED FOR LOBBYING PURPOSES. 8325598 14097 1539830 303419 9576106 7799091 8039 630094 111626 8325598 7742025 199655 -688 141901 7799091 7443544 19840 615380 336739 7742025 6891557 5000 903230 356243 7443544 0.40740 0.59260 0 1 1 2014731 2014731 116427093 77259858 39167235 75814039 50995614 24818425 1681499 1552020 129479 66129870 INSURANCE RECOVERIES 1140000 DUE FROM AFFILIATES 2857058 PREPAID PENSION 87839900 91836958 DUE TO AFFILIATE 1871670 ASSET RETIREMENT OBLIGATION 1033465 WORKERS COMP. SELF-INSURANCE RESV. 981992 INSURANCE CLAIMS, LONG TERM 705000 ACCRD. POSTRETIREMENT HEALTH BENF. 568000 5160127 X 289438726 28864925 -12960916 15904009 273534717 729396 729396 274264113 237905181 0 237905181 729396 13090437 13819833 251725014 PART V, LINE 4: ENDOWMENT FUNDS STURDY MEMORIAL FOUNDATION, INC. MAINTAINS ENDOWMENT FUNDS (RESTRICTED TO PRINCIPAL) FOR THE BENEFIT OF STURDY MEMORIAL FOUNDATION AND STURDY MEMORIAL HOSPITAL, INC. AND AFFILIATES. THE ENDOWMENTS CONSIST OF BOTH DONOR RESTRICTED EARNED INCOME AND UNRESTRICTED EARNED INCOME. THE FOUNDATION'S ENDOWMENT INVESTMENT POLICY IS TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO SUPPORT BOTH THE DONOR RESTRICTED REQUIREMENTS AND THE FOUNDATION SPENDING POLICY FOR UNRESTRICTED FUNDS. ANNUALLY, INCOME EARNED ON THE RESTRICTED ENDOWMENT FUNDS IN SUPPORT OF THE DONOR SPECIFIC REQUIREMENTS IS TRANSFERRED TO STURDY MEMORIAL HOSPITAL. A SMALL PORTION OF THE ENDOWMENT IS HELD IN A FUND WITH THE INCOME RESTRICTED FOR "FREE CARE" FOR PATIENTS. THE INCOME ON THIS FUND IS TRANSFERRED ANNUALLY TO STURDY MEMORIAL HOSPITAL, INC. PER THE FOUNDATION RESTRICTED INVESTMENT POLICY, 5% OF THE GENERAL ENDOWMENT IS AVAILABLE FOR SPENDING ANNUALLY AND IS PAID TO THE FOUNDATION. ANNUAL THE INVESTMENT POLICY IS UPDATED AND REVIEWED BY THE INVESTMENT COMMITTEE. THERE WAS AN UPDATE MADE TO THE ENDOWMENT BEGINNING BALANCE REPORTED FOUR YEARS AGO, HENCE, THE BEGINNING BALANCE OF THE FOUR YEARS AGO ENDOWMENT DOES NOT MATCH TO THE PREVIOUS YEAR ENDING BALANCE. PART X, LINE 2: ASC 740 THE HOSPITAL IS A NOT-FOR-PROFIT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AS AMENDED (THE CODE), AND IS GENERALLY EXEMPT FROM INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL IS REQUIRED TO ASSESS UNCERTAIN TAX POSITIONS AND HAS DETERMINED THAT THERE WERE NO SUCH POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: RECLASS FOR BAD DEBT PROVISION -13,090,437. NET ASSETS RELEASED FROM RESTRICTIONS 129,521. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECLASS FOR BAD DEBT PROVISION 13,090,437. 1 1 1 X 1 X 1 1 1 0 1 1 1748193 99360 1648833 0.00690 31338503 22825786 8512717 0.03570 33086696 22925146 10161550 0.04260 584899 0 584899 0.00250 12118805 4725800 7393005 0.03100 59636 0 59636 0.00020 12763340 4725800 8037540 0.03370 45850036 27650946 18199090 0.07630 0.00000 0.00000 3 56038 56038 0.00020 0.00000 0.00000 1 1805 1805 0.00000 0.00000 4 90335 90335 0.00040 2 42601 42601 0.00020 10 190779 190779 0.00080 0 6058254 1401880 69108392 80746767 -11638375 X 1 1 1 1 STURDY MEMORIAL HOSPITAL INC PO BOX 2963 211 PARK STREET ATTLEBORO MA 02703 WWW.STURDYMEMORIAL.ORG 2100 X X X STURDY MEMORIAL HOSPITAL INC 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X SEE SECTION C X 1 19 1 SEE SECTION C 0 1 X 150.000000000000 300.000000000000 X X X X 1 1 X X X 1 X SEE SECTION C X SEE SECTION C X SEE SECTION C X X X X X X X 1 X 0 X X X X X 1 X 0 0 STURDY MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 5: INPUT FROM PERSONS WHO REPRESENT THE COMMUNITYCOMMUNITY ENGAGEMENT AND FEEDBACK WAS AN INTEGRAL PART OF STURDY'S CHNA PROCESS. HOLLERAN CONSULTING, AN INDEPENDENT RESEARCH AND CONSULTING FIRM, COLLECTED AND INTERPRETED INFORMATION FROM SECONDARY SOURCES AND KEY INFORMANTS. KEY INFORMANTS WERE DEFINED AS COMMUNITY STAKEHOLDERS WITH EXPERT KNOWLEDGE, INCLUDING PUBLIC HEALTH AND HEALTH CARE PROFESSIONALS, SOCIAL SERVICE PROVIDERS, NON-PROFIT LEADERS, BUSINESS LEADERS, FAITH-BASED ORGANIZATIONS, AND OTHER COMMUNITY LEADERS. THE HOSPITAL IDENTIFIED THESE INDIVIDUALS WITH ASSISTANCE FROM HOLLERAN CONSULTING. FROM APRIL 5 THROUGH MAY 6, 2019, AN ONLINE KEY INFORMANT SURVEY WAS CONDUCTED. THE SURVEY WAS DESIGNED TO UNDERSTAND HEALTH ISSUES IN THE COMMUNITY, MISSING RESOURCES/SERVICES, ACCESS TO HEALTH CARE, IDENTIFICATION OF UNDERSERVED, LOW INCOME AND MINORITY POPULATIONS, AND COMMUNITY ASSETS. THE PURPOSE OF THE SURVEY WAS TO OBTAIN A COMBINATION OF QUANTITATIVE RATINGS AND QUALITATIVE FEEDBACK THROUGH CLOSED AND OPEN-ENDED QUESTIONS AROUND HEALTH ISSUES AND BARRIERS TO HEALTH CARE ACCESS IN THE COMMUNITY. SIXTY-SEVEN KEY INFORMANTS COMPLETED THE SURVEY. A COPY OF THE SURVEY TOOL AND LIST OF SURVEY PARTICIPANTS AND THEIR CONNECTION TO THE COMMUNITY IS INCORPORATED IN THE CHNA.STURDY MEMORIAL HOSPITAL, INC:PART V, SECTION B, LINE 7A:HOSPITAL FACILITY'S WEBSITE - CHNA REPORTSTURDY MEMORIAL HOSPITAL'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE FOUND AT:HTTPS://WWW.STURDYMEMORIAL.ORG/APP/FILES/PUBLIC/074AF432-28E8-4C81-8CB1-E6D6CBF29DEF/2019-CHNA.PDFSTURDY MEMORIAL HOSPITAL, INC: PART V, SECTION B, LINE 9: HOSPITAL FACILITY'S WEBSITE - IMPLEMENTATION STRATEGYSTURDY MEMORIAL'S COMMUNITY HEALTH NEEDS ASSESSMENT WAS APPROVED BY THE BOARD OF MANAGERS ON SEPTEMBER 23, 2019. THE BOARD OF MANAGERS APPROVED THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION PLAN ON JANUARY 27, 2020, WITHIN THE STATUTORY ADOPTION PERIOD. STURDY MEMORIAL HOSPITAL, INC: PART V, SECTION B, LINE 10A:THE HOSPITAL'S MOST RECENTLY ADOPTED CHNA IMPLEMENTATION STRATEGY CAN BEFOUND AT:HTTPS://WWW.STURDYMEMORIAL.ORG/APP/FILES/PUBLIC/760C1C79-D67E-41B7-B8B8-6B6DE7391458/2020-2020-IMPLEMENTATION-PLAN.PDF STURDY MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 11: SIGNIFICANT NEEDSTHE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IDENTIFIED FIVE KEY COMMUNITY HEALTH ISSUES: ACCESS TO CARE, BEHAVIORAL HEALTH AND SUBSTANCE ABUSE, CANCER, CHRONIC DISEASE MANAGEMENT, AND OBESITY. THE HOSPITAL'S IMPLEMENTATION PLAN FURTHER PRIORITIZED ITS COMMUNITY HEALTH NEEDS AS: ACCESS TO CARE, BEHAVIORAL HEALTH AND SUBSTANCE ABUSE, CHRONIC DISEASE MANAGEMENT AND PREVENTION, AND CANCER PREVENTION EDUCATION AND SCREENING. IT WAS DETERMINED THAT OBESITY WOULD BE ADDRESSED AS PART OF CHRONIC DISEASE MANAGEMENT AND PREVENTION. ACCESS TO CARE: STURDY WILL ADDRESS BARRIERS TO ACCESSING CARE BY INCREASING PROVIDERS IN ITS SERVICE AREA. THE CHNA DETERMINED THAT THE PROVIDER DENSITY IN STURDY'S PRIMARY SERVICE AREA IS LOWER THAN OTHER MASSACHUSETTS COMMUNITIES. STURDY PLANS TO RECRUIT AND RETAIN MORE PROVIDERS AT BOTH THE HOSPITAL AND STURDY MEMORIAL ASSOCIATES (SMA), AN AFFILIATE. STURDY ALSO PLANS TO REDUCE BARRIERS TO CARE BY INVESTIGATING/IDENTIFYING TELEMEDICINE OPPORTUNITIES AND OFF-HOURS CLINICS THAT CAN ACCOMMODATE INDIVIDUALS WHO HAVE LIMITED DAYTIME FLEXIBILITY. OTHER INITIATIVES WILL ASSIST INDIVIDUALS WITH LIMITED TRANSPORTATION OPTIONS, HELP CONNECT EMERGENCY DEPARTMENT PATIENTS WITH PRIMARY CARE PHYSICIANS, HELP CONNECT THE UNINSURED/UNDERINSURED TO FINANCIAL COUNSELORS AND PARTNER WITH LOCAL DENTIST OFFICES FOR SCREENING.BEHAVIORAL HEALTH AND SUBSTANCE ABUSE: MANY RESPONDENTS TO THE KEY INFORMANT SURVEY CONDUCTED THROUGH THE CHNA PROCESS LISTED ACCESS TO BEHAVIORAL HEALTH AND TREATMENT OF SUBSTANCE ABUSE DISORDERS AS THE MOST SIGNIFICANT PROBLEMS FACING STURDY'S PRIMARY AND SECONDARY SERVICE AREAS. ACCESS AND INTEGRATION/COORDINATION OF SERVICES WAS SEEN AS INADEQUATE COMPARED TO THE NEEDS OF THE COMMUNITY. STURDY PLANS TO ADDRESS THIS NEED BY CONTINUING TO PROVIDE TREATMENT AND SERVICES, AS WELL AS PARTNER WITH COLUMN HEALTH, A PROVIDER OF INTEGRATED MENTAL HEALTH/SUBSTANCE ABUSE PROGRAMS. OTHER INITIATIVES WILL CONTINUE SCREENING AND EDUCATION, INCREASE PRIMARY AND SPECIALTY PROVIDERS WITHIN SMA WITH INTEGRATED BEHAVIORAL HEALTH SERVICES, COLLABORATE WITH LOCAL ORGANIZATIONS TO ADDRESS THE HIGH PERCENTAGE OF AT-RISK YOUTH IN THE SERVICE AREA, WORK WITH COMMUNITY ORGANIZATIONS TO CREATE A COMPREHENSIVE LIST OF MENTAL HEALTH PROVIDERS IN STURDY'S SERVICE AREA, AND EXPLORE TELEHEALTH OPTIONS FOR BEHAVIORAL HEALTH PATIENTS.CHRONIC DISEASE PREVENTION AND MANAGEMENT: KEY INFORMANTS RECOGNIZED THAT HEALTH BEHAVIORS ARE OFTEN CORRELATED WITH CERTAIN CHRONIC HEALTH CONDITIONS. CHRONIC ILLNESSES SUCH AS CANCER AND HEART DISEASE, ARE THE LEADING CAUSES OF DEATH IN STURDY'S PRIMARY AND SECONDARY SERVICE AREAS. INDIVIDUALS OFTEN LACK THE TIME, KNOWLEDGE AND RESOURCES TO MANAGE CHRONIC ILLNESS. STURDY PLANS TO CONTINUE TO HOLD HEALTH FAIRS FOR SCREENING AND COMMUNITY EDUCATION. ALSO, THE HOSPITAL WILL SUPPORT CURRENT PROGRAMS THAT INCREASE PHYSICAL ACTIVITY OPPORTUNITIES FOR AT-RISK INDIVIDUALS. STURDY PLANS TO IMPROVE CARE COORDINATION FOR DIABETIC/PRE-DIABETIC PATIENTS AND INCREASE SCREENING FOR PRE-DIABETIC PATIENTS. STURDY WILL EXPLORE OPPORTUNITIES/PROGRAMS THAT INCREASE ACCESS TO HEALTHY FOODS, SUPPORT NUTRITION EDUCATION AND DETERMINE IF A NEW SMOKING CESSATION PROGRAM SHOULD BE IMPLEMENTED. THE HOSPITAL WILL CONTINUE TO COLLABORATE WITH THE HEALTHY LIVING CONSORTIUM TO INCREASE EDUCATION AND AWARENESS IN THE COMMUNITY.CANCER PREVENTION EDUCATION AND SCREENING: CANCER IS A LEADING CAUSE OF DEATH IN BOTH THE HOSPITAL'S PRIMARY AND SECONDARY SERVICE AREAS. STURDY'S OBJECTIVE IS TO PROVIDE SERVICES TO DECREASE CANCER MORTALITY WITHIN ITS SERVICE AREA. TO DO THIS, THE HOSPITAL WILL CONTINUE TO OFFER EARLY DETECTION AND PREVENTION THROUGH VARIOUS SCREENINGS, EDUCATION AND SUPPORT PROGRAMS. THIS INCLUDES PROVIDING EARLY INTERVENTION AND SCREENING AND EARLY NAVIGATION FOR PATIENTS WITH ABNORMAL FINDINGS ON BREAST IMAGING. STURDY WILL ENHANCE ITS CURRENT ONCOLOGY PROGRAM AND DEVELOP ADDITIONAL SERVICES, ADDING PROVIDERS AND FACILITATING RELATIONSHIPS BETWEEN PRIMARY CARE PROVIDERS AND ONCOLOGISTS. NURSE NAVIGATIONS WILL REDUCE BARRIERS TO CARE BY IDENTIFYING UNINSURED/UNDERINSURED PATIENTS AND HELPING PATIENTS WITH TRANSPORTATION.LACK OF AFFORDABLE HOUSING IN OUR PRIMARY AND SECONDARY SERVICE AREAS WAS NOTED BY MANY RESPONDENTS AS A BARRIER TO CARE. STURDY MEMORIAL HOSPITAL ACKNOWLEDGES THAT THE INABILITY TO SECURE AFFORDABLE HOUSING IS A DIFFICULTY FACED BY MANY RESIDENTS IN OUR AREA BUT IS UNABLE TO FULLY ADDRESS THIS ISSUE AS IT IS BEYOND OUR SCOPE AS A HEALTHCARE PROVIDER.STURDY MEMORIAL HOSPITAL, INC: PART V, SECTION B, LINE 16A:OTHER FINANCIAL ASSISTANCE POLICY PUBLICITY METHODSSTURDY MEMORIAL HOSPITAL'S FINANCIAL ASSISTANCE POLICY CAN BE FOUND AT:HTTPS://WWW.STURDYMEMORIAL.ORG/APP/FILES/PUBLIC/467DC58C-0840-4574-AC85-D82F49D994F4/SMH-FAP-POLICY---UPDATED-FOR-FY19.PDFSTURDY MEMORIAL HOSPITAL, INC: PART V, SECTION B, LINE 16B:THE HOSPITAL'S FAP APPLICATION FORMS CAN BE FOUND AT: HTTPS://WWW.STURDYMEMORIAL.ORG/APP/FILES/PUBLIC/721/ACA-ENGLISH-FY20.PDFSTURDY MEMORIAL HOSPITAL, INC: PART V, SECTION B, LINE 16C:SCHEDULE H, PART V, SECTION B, LINE 16CTHE HOSPITAL'S FAP PLAIN LANGUAGE SUMMARY CAN BE FOUND AT:HTTPS://WWW.STURDYMEMORIAL.ORG/APP/FILES/PUBLIC/71188A53-E09D-4E9C-B3FD-6177B8902E91/FAP-PLAIN-LANGUAGE-FY20-ENGLISH.PDF STURDY MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 16J: THE HOSPITAL'S POLICY IS ATTACHED TO BILLING INVOICES. ADDITIONALLY, STURDY MEMORIAL MAKES THIS INFORMATION AVAILABLE AT LOCATIONS THROUGHOUT ITS FACILITY-IN THE MAIN LOBBY, EMERGENCY DEPARTMENT, PATIENT REGISTRATION, AND FINANCIAL COUNSELORS' OFFICE. INDIVIDUALS IN OUR COMMUNITY WITHOUT INSURANCE ARE DIRECTED TO A FINANCIAL COUNSELOR WHO WILL PROVIDE THEM WITH STURDY'S FINANCIAL ASSISTANCE POLICY AS WELL AS RESOURCES AVAILABLE TO THEM THROUGH MASSHEALTH OR THE COMMONWEALTH'S HEALTH SAFETY NET. FINANCIAL COUNSELORS WILL ASSIST ANYONE IN COMPLETING AN APPLICATION FOR FREE OR SUBSIDIZED CARE, AS WELL AS MASSHEALTH. THIS SERVICE IS AVAILABLE TO ANYONE IN THE COMMUNITY. SCHEDULE H, PART V, SECTION B, LINE 20: NOTIFICATION OF FINANCIAL ASSISTANCEFOR PLANNED ADMISSIONS, PATIENTS ARE NOTIFIED OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY PRIOR TO ADMISSION. EMERGENT PATIENTS ARE NOTIFIED PRIOR TO DISCHARGE OR THE FOLLOWING BUSINESS DAY. PATIENTS ARRIVING AT THE HOSPITAL FOR OUTPATIENT VISITS ARE NOTIFIED OF THE FINANCIAL ASSISTANCE POLICY AT THE TIME OF REGISTRATION (IF REGISTERED AT THE MAIN REGISTRATION AREA). NOTIFICATION IS ALSO INCLUDED WITH PATIENT BILLS. 1 1 - MANSFIELD HEALTH CENTER 200 COPELAND DRIVE MANSFIELD MA 02488 LICENSED OUTPUT CLINIC PHYSICIAN PRACTICE PART I, LINE 7: FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFITS CALCULATIONSTURDY MEMORIAL HOSPITAL USES THE COST TO CHARGE RATIO FOR CALCULATING AMOUNTS IN THE TABLE FOR LINE 7. THE COST TO CHARGE RATIO IS TOTAL PATIENT CARE COSTS DIVIDED BY TOTAL PATIENT CARE CHARGES PER WORKSHEET S-10, LINE 1 OF THE MEDICARE COST REPORT. BAD DEBT IS NOT INCLUDED IN ANY AMOUNTS REPORTED IN THE TABLE. PART I, LN 7 COL(F): BAD DEBT EXPENSE OF $13,090,437 ATTRIBUTABLE TO PATIENT ACCOUNTS HAS BEEN EXCLUDED FROM THE COMPUTATION OF ALL COMMUNITY BENEFIT EXPENSE SHOWN IN PART I, LINE 7, COLUMN F. PART II, COMMUNITY BUILDING ACTIVITIES: STURDY MEMORIAL HOSPITAL UNDERTAKES COMMUNITY BUILDING ACTIVITIES DESIGNED TO PROMOTE THE WELLBEING OF RESIDENTS IN ITS PRIMARY AND SECONDARY SERVICE AREAS. THE HOSPITAL IS INVOLVED IN EMERGENCY MANAGEMENT AND PREPAREDNESS AND WORKS WITH OTHERS IN ITS REGION TO COORDINATE ITS PREPARATION AND RESPONSE TO CATASTROPHIC HEALTH EVENTS. THE ORGANINIZATION WORKS WITH LOCAL, STATE AND FEDERAL LAW ENFORCEMENT AND OTHER FIRST RESPONDERS ON MATTERS OF PUBLIC SAFETY. THE HOSPITAL PROVIDES TRAINING OPPORTUNITIES FOR LOCAL STUDENTS COMPLETING MEDICAL LABORATORY TECHNICIAN AND PHLEBOTOMY PROGRAMS. HIGH SCHOOL STUDENTS INTERESTED IN HEALTH CARE CAREERS MAY SHADOW STAFF MEMBERS OR PARTICIPATE IN INTERNSHIPS. SOME COMMUNITY BUILDING ACTIVITIES WERE TEMPORARILY SUSPENDED IN FY21 DUE TO THE COVID CRISIS. PART III, LINE 2: BAD DEBT EXPENSE - EXPLANATION FOR PART III, LINES 2, 3 AND 4EFFECTIVE OCTOBER 1, 2020, THE HOSPITAL ADOPTED FINANCIAL ACCOUNTING STANDARDS BOARD ("FASB") ACCOUNTING STANDARDS UPDATE ("ASU") 2014-09, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606) ("ASC 606"), USING THE RETROSPECTIVE METHOD OF APPLICATION TO ALL CONTRACTS EXISTING ON OCTOBER 1, 2020. THE CORE PRINCIPLE OF THE STANDARD IS THAT AN ENTITY SHOULD RECOGNIZE REVENUE TO DEPICT THE TRANSFER OF PROMISED GOODS OR SERVICES TO CUSTOMERS IN AN AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE ENTITY EXPECTS TO BE ENTITLED IN EXCHANGE FOR THOSE GOODS OR SERVICES. THE ADOPTION OF THE STANDARD HAD NO IMPACT ON THE HOSPITAL'S CURRENT OR HISTORICAL FINANCIAL POSITION, RESULTS OF OPERATIONS OR CASH FLOWS. THE HOSPITAL NOW RECOGNIZES ITS PREVIOUSLY REPORTED PROVISION FOR BAD DEBTS, PRIMARILY RELATED TO ITS SELF-PAY PATIENT POPULATION, AS A DIRECT REDUCTION TO REVENUES AND RECEIVABLES AS AN IMPLICIT PRICING CONCESSION, INSTEAD OF SEPARATELY AS A DISCRETE DEDUCTION TO ARRIVE AT NET PATIENT SERVICE REVENUE IN THE STATEMENT OF OPERATIONS OR AS A PARENTHETICAL NOTE ON ACCOUNTS RECEIVABLE FOR SERVICES TO PATIENTS IN THE BALANCE SHEET. PART III, LINE 8: SHORTFALL TREATED AS COMMUNITY BENEFITSTURDY MEMORIAL HOSPITAL, IN KEEPING WITH ITS CHARITABLE MISSION, PROVIDES CARE TO MEDICARE ELIGIBLE PATIENTS OF THE COMMUNITY IT SERVES BEYOND THE AMOUNT IT RECEIVES FROM THE MEDICARE PROGRAM. THESE INDIVIDUALS WOULD HAVE TO TRAVEL OUT OF OUR AREA OR POSSIBLY FORGO MEDICAL TREATMENT WITHOUT THE SERVICES THE HOSPITAL PROVIDES. THE MEDICARE SHORTFALL INCURRED BY THE HOSPITAL IS VIEWED AS LESSENING THE BURDEN OF GOVERNMENT, THEREFORE PROVIDING A VALUABLE COMMUNITY BENEFIT. PART III, LINE 9B: DEBT COLLECTION POLICYTHE HOSPITAL'S COLLECTION POLICY CONTAINS PROCEDURES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. ONCE IT IS DETERMINED THAT A PATIENT QUALIFIES FOR FREE CARE, ALL COLLECTION PROCEDURES CEASE AND THE FULL BALANCE IS WRITTEN OFF. IF THE PATIENT QUALIFIES FOR PARTIAL FREE CARE, THE AMOUNT THAT QUALIFIES UNDER PARTIAL FREE CARE IS WRITTEN OFF AND THE REMAINING BALANCE IS SUBJECT TO NORMAL COLLECTION PROCEDURES. MASSACHUSETTS HOSPITALS ARE REQUIRED TO ADOPT CREDIT AND COLLECTION POLICIES. STATE REGULATIONS (101 CMR 613.00) OUTLINE THE SPECIFIC PROCESS FOR DETERMINING ELIGIBILITY FOR PUBLIC ASSISTANCE PROGRAMS AND HOSPITAL COLLECTION PRACTICES. THE HOSPITAL PROVIDES PATIENTS WITH INFORMATION ABOUT FREE CARE AVAILABLE THROUGH THE HOSPITAL (A SIGNIFICANT PORTION OF WHICH IS COORDINATED THROUGH THE STATE'S HEALTH SAFETY NET PROGRAM, AS WELL AS FINANCIAL ASSISTANCE PROGRAMS, SUCH AS MASSHEALTH AND COMMONWEALTH CARE, THAT ARE AVAILABLE THROUGH THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES). THE HOSPITAL EMPLOYS TWO FULL-TIME FINANCIAL COUNSELORS THAT ASSIST PATIENTS, AND ANYONE ELSE PRESENTING WHO REQUIRES ASSISTANCE, IN APPLYING FOR FREE CARE AND STATE FINANCIAL ASSISTANCE PROGRAMS THROUGH THE STATE'S UNIFORM APPLICATION. THE HOSPITAL FINANCIAL ASSISTANCE POLICY AND BILLING & COLLECTION POLICY, THAT OUTLINES ITS CHARITY CARE PRACTICES, IS FILED WITH THE MASSACHUSETTS CENTER FOR HEALTH INFORMATION AND ANALYSIS AND ALSO AVAILABLE TO PATIENTS UPON REQUEST. PART VI, LINE 2: WITH GUIDANCE AND OVERSIGHT FROM THE HOSPITAL'S PLANNING COMMITTEE, STURDY'S COMMUNITY BENEFITS REPORT IS DEVELOPED TO REFLECT ON ACTIVITIES FROM THE PRIOR YEAR AND PROVIDE RECOMMENDATIONS FOR THE HOSPITAL'S FOCUS ON COMMUNITY INVOLVEMENT FOR THE FOLLOWING YEAR. COMMUNITY BENEFITS PLANNING IS INTEGRATED INTO STURDY'S ANNUAL PLANNING AND BUDGETING PROCESS TO ENSURE WE EFFECTIVELY SUPPORT COMMUNITY BENEFITS PROGRAMMING. STURDY MEMORIAL HOSPITAL IS INVOLVED IN ONGOING ASSESSMENTS OF THE HEALTH NEEDS IN OUR COMMUNITIES AND PARTICIPATES IN A NUMBER OF COMMUNITY BASED PROGRAMS. CONTINUALLY BEING ENGAGED IN AND FAMILIAR WITH OUR COMMUNITIES PROVIDES US WITH OPPORTUNITIES TO IDENTIFY HEALTH ISSUES OF GREATEST CONCERN TO OUR CARE PROVIDERS AND COMMUNITY PARTNERS AND CONSIDER COMMITTING BUDGETED RESOURCES TO THOSE AREAS, WHENEVER APPROPRIATE, TO GUIDE EFFORTS TO IMPROVE COMMUNITY HEALTH AND WELLNESS. THE HOSPITAL CONSTANTLY MONITORS THE RESULTS OF PATIENT SATISFACTION SURVEYS, SERVICE STATISTICS, PROVIDER AND COMMUNITY FEEDBACK, INSURER DATA, AND OTHER LOCAL AND REGIONAL DATA. IN ADDITION, THE HOSPITAL CONTINUALLY WORKS CLOSELY WITH COMMUNITY LEADERS, SCHOOL AND SOCIAL SERVICES PERSONNEL, AND OTHER HEALTH CARE PROVIDERS TO IDENTIFY HEALTH CARE TRENDS AND NEEDS. PART VI, LINE 3: PATIENTS ARE INFORMED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE BY WAY OF POSTED NOTICES THROUGHOUT THE HOSPITAL AS WELL AS PRINTED FINANCIAL ASSISTANCE BROCHURES AVAILABLE IN COMMON AREAS OF THE HOSPITAL. FINANCIAL ASSISTANCE INFORMATION IS PRINTED ON ALL ITEMIZED BILLS AND PATIENT STATEMENTS. SCHEDULED SELF PAY SURGICAL DAY CARE (SDC) & INPATIENTS ARE REVIEWED PRIOR TO ADMISSION TO DETERMINE PAYMENT ARRANGEMENT OR TO COORDINATE A MEETING WITH A FINANCIAL COUNSELOR. SDC & INPATIENTS WHO ARE UNABLE TO LEAVE A DEPOSIT OR MAKE A PAYMENT ARRANGEMENT TOWARDS A LARGE OUT OF POCKET EXPENSE ARE ALSO ENCOURAGED TO MEET WITH A FINANCIAL COUNSELOR. UPON DISCHARGE FROM THE EMERGENCY CARE CENTER (ECC), UNINSURED PATIENTS ARE ENCOURAGED TO MEET WITH A FINANCIAL COUNSELOR. IF UNABLE TO SEE A FINANCIAL COUNSELOR FOLLOWING DISCHARGE, THE PATIENT IS GIVEN A FINANCIAL ASSISTANCE LETTER OUTLINING THE APPLICATION PROCESS, THE DOCUMENTS REQUIRED, TELEPHONE NUMBERS AND DIRECTIONS TO THE FINANCIAL COUNSELOR'S OFFICE. FOLLOWING AN ECC VISIT, UNINSURED PATIENTS RECEIVE A PHONE CALL FROM A PATIENT FINANCIAL SERVICES REPRESENTATIVE ENCOURAGING THE PATIENT TO MEET WITH A FINANCIAL COUNSELOR FOR FINANCIAL ASSISTANCE. PART VI, LINE 4: COMMUNITY INFORMATIONTHE HOSPITAL SERVES A TOTAL POPULATION BASE OF 228,800 (BASED ON 2010 U.S. CENSUS DATA) IN 12 SUBURBAN COMMUNITIES LOCATED BETWEEN BOSTON, MA AND PROVIDENCE, RI THAT IS LARGELY EDUCATED (COMPLETED HIGH SCHOOL), EMPLOYED, AND ENGLISH SPEAKING. AS A COMMUNITY RESOURCE, THE HOSPITAL HAS A PRIMARY COMMITMENT TO SERVE THE RESIDENTS OF ATTLEBORO, FOXBORO, MANSFIELD, NORTH ATTLEBORO, NORTON, PLAINVILLE, SEEKONK, REHOBOTH, AND WRENTHAM. NORFOLK, SHARON, AND WALPOLE ARE CONSIDERED PART OF OUR SECONDARY SERVICE AREA. WE ALSO SERVE BORDERING TOWNS IN NEARBY RHODE ISLAND. HOWEVER, ANYONE WHO REQUIRES CARE WILL RECEIVE IT, REGARDLESS OF PLACE OF RESIDENCE. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHSTURDY MEMORIAL HOSPITAL FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH AND WELLBEING OF MEMBERS OF THE COMMUNITIES IT SERVES, IN ADDITION TO PROVIDING HEALTH CARE TO ALL, REGARDLESS OF ABILITY TO PAY. ALTHOUGH CURTAILED IN FISCAL 2021 DUE TO COVID-19, THE HOSPITAL USUALLY OFFERS NEARLY ONE HUNDRED COMMUNITY BENEFIT PROGRAMS AND EVENTS EACH YEAR. SOME PROGRAMS ARE NOW MEETING VIRTUALLY, WITH ADDITIONAL OFFERINGS IN FISCAL 2022. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN OUR SERVICE AREA. A MAJORITY OF THE HOSPITAL'S BOARD OF MANAGERS ARE COMPRISED OF INDIVIDUALS LIVING IN THE COMMUNITY WHO ARE INDEPENDENT CIVIC, HEALTH CARE AND BUSINESS LEADERS. SURPLUS FUNDS ARE USED TO IMPROVE OUR FACILITIES, PURCHASE STATE-OF-THE ART MEDICAL EQUIPMENT AND EXPAND OUR COMMUNITY OFFERINGS. PART VI, LINE 6: STURDY MEMORIAL HOSPITAL IS PART OF AN AFFILIATED HEALTH CARE SYSTEM. UNDER THE CONTROL OF ITS PARENT ORGANIZATION, STURDY MEMORIAL FOUNDATION, AFFILIATES STURDY MEMORIAL HOSPITAL AND STURDY MEMORIAL ASSOCIATES COORDINATE THE PROVISION OF HEALTH CARE SERVICES TO RESIDENTS IN ITS SERVICE AREA OF BRISTOL AND NORFOLK COUNTIES IN MASSACHUSETTS. PART VI, LINE 7, REPORTS FILED WITH STATES MA 1 CITY OF ATTLEBORO 77 PARK STREET ATTLEBORO MA 02703 046001378 GOVT 18000 COMMUNITY SUPPORT STURDY MEMORIAL ASSOCIATES 211 PARK STREET PO BOX 2963 ATTLEBORO MA 02703 042706501 501(C)(3) 9961731 GENERAL SUPPORT ATTLEBORO AREA INTERFAITH COLLABORATIVE PO BOX 368 ATTLEBORO MA 02703 042301039 501(C)(3) 6000 COMMUNITY SUPPORT SIGNATURE HEALTHCARE - BROCKTON HOSPITAL 680 CENTRE STREET BROCKTON MA 02302 042103554 501(C)(3) 32431 FMV COVID TEST KITS COMMUNITY SUPPORT 4 0 PART I, LINE 2: PROCEDURES FOR MONITORING USE OF GRANT FUNDS THE HOSPITAL PROVIDES GRANTS IN FURTHERANCE OF ITS CHARITABLE MISSION AND TO PROMOTE GENERAL WELL-BEING IN THE COMMUNITIES IT SERVES. WHEN GRANTS ARE MADE, THEY ARE REVIEWED AND APPROVED BY THE BOARD OF MANAGERS. THE HOSPITAL MONITORS GRANTS TO ENSURE THEY ARE USED FOR THEIR INTENDED PURPOSE. X 0 1 X X X X 0 1 0 0 0 0 0 1 0 JOSEPH CASEY PRESIDENT & CEO 643219 0 1769 0 387529 0 64029 0 26493 0 1123039 0 0 0 BRIAN KELLY MD VP & CMO 451949 0 54607 0 67872 0 99796 0 24104 0 698328 0 0 0 AMY PFEFFER CFO & TREASURER 386458 0 50207 0 79640 0 136853 0 23405 0 676563 0 0 0 BRIAN PATEL MD CHIEF, AMBULATORY 432911 0 50207 0 22382 0 46558 0 24180 0 576238 0 0 0 MARK MCGUIRE MD PHYSICIAN 371782 0 15798 0 17578 0 53436 0 25186 0 483780 0 0 0 RONALD VAN NESS-OTUNNU MD PHYSICIAN ASSOCIATE DIRECTOR 379882 0 11490 0 11844 0 51986 0 25044 0 480246 0 0 0 LAURINE THORNTON-POTTER MD PHYSICIAN 297175 0 7473 0 17106 0 65431 0 24921 0 412106 0 0 0 ROBIN MORRIS SVP OF CLINICAL OPS & INTEGRITY 236805 0 48232 0 10450 0 96868 0 10284 0 402639 0 0 0 MICHAEL DEMELIS MD PHYSICIAN 287078 0 9822 0 15336 0 63468 0 24688 0 400392 0 0 0 DAVID SPOOR SVP OF PATIENT SRVS/CHF. OF NURSING 219056 0 30226 0 8857 0 64404 0 10159 0 332702 0 0 0 CAROLYN ROSS CHIEF HUMAN RESOURCES OFFICER 224228 0 18230 0 934 0 39434 0 22875 0 305701 0 0 0 JEAN SIDALL-BENSSON MD PHYSICIAN DIRECTOR 0 222712 0 5189 0 1335 0 52336 0 11399 0 292971 0 0 BLAIR BISHER COO 192596 0 38727 0 113 0 0 0 16865 0 248301 0 0 0 PART I, LINE 1A TAX INDEMNIFICATION AND GROSS-UP PAYMENTS HOSPITAL PAYMENTS TO RETIREMENT PLANS THAT ARE TAXABLE UPFRONT, ARE PARTIALLY GROSSED UP FOR TAXES. DURING CALENDER YEAR 2020, THE PRESIDENT AND CEO RECEIVED A PAYMENT (SEE SCHEDULE J, PART I, LINE 4 EXPLANATION FOR MORE DETAIL). ALSO, THE HOSPITAL PAID A BONUS TO ALL HOSPITAL EMPLOYEES. EMPLOYEES RECEIVED THE SAME NET AMOUNT (PRORATED FOR HOURS WORKED), WITH THE HOSPITAL EFFECTIVELY PAYING TAXES. THE HOSPITAL ALSO PROVIDES ITS SENIOR MANAGERS WITH LONG-TERM DISABILITY INSURANCE. THE COST OF THIS INSURANCE IS GROSSED UP TO EFFECTIVELY PAY FOR THE RELATED TAXES AND IS ADDED TO THE MANAGERS' GROSS EARNINGS. THIS BENEFIT WAS PROVIDED TO JOSEPH CASEY, AMY PFEFFER, DAVID SPOOR, ROBIN MORRIS, CAROLYN ROSS, BRIAN PATEL, MD, AND BRIAN KELLY, MD DURING CALENDAR YEAR 2020. PART I, LINE 1B APPROVAL FOR GROSS-UP PAYMENTS THE EXECUTIVE COMMITTEE APPROVES THE SUPPLEMENTAL RETIREMENT PLAN. THE ANNUAL BONUS AND DECISION TO GROSS UP THE AMOUNT IS DISCRETIONARY AND ISSUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN APPROVED BY THE BOARD OF MANAGERS. PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN STURDY MEMORIAL HOSPITAL PROVIDES A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN TO CERTAIN EXECUTIVES. SUPPLEMENTAL RETIREMENT CONTRIBUTIONS WERE MADE THROUGH NON-QUALIFIED RETIREMENT PLANS FOR QUALIFIED EMPLOYEES IN CALENDAR YEAR 2020. THE TOTAL OF NON-QUALIFIED RETIREMENT CONTRIBUTIONS IN 2020 ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). JOSEPH CASEY ($19,500) PARTICIPATED IN THE PLAN IN 2020. PART I, LINE 7: NON-FIXED PAYMENTS COMPENSATION PACKAGES FOR THE CEO, SENIOR MANAGERS, AND LISTED PHYSICIANS INCLUDE OPPORTUNITIES TO EARN INCENTIVE COMPENSATION BASED ON A COMBINATION OF MEETING OR EXCEEDING PRE-DETERMINED GOALS. ALL INCENTIVE COMPENSATION IS SUBJECT TO REVIEW AND APPROVAL BY THE COMPENSATION COMMITTEE AND HAS BEEN REPORTED ON SCHEDULE J, PART II, COLUMN B (II). PART II, COLUMN (C): DEFERRED COMPENSATION THIS COLUMN INCLUDES AN ACCRUAL OF BENEFITS RELATED TO THE HOSPITAL'S DEFINED BENEFIT PLAN. THIS ACCRUAL CALCULATION IS COMPLETED BY A THIRD PARTY AND THE ACCRUAL AMOUNT MAY SHIFT DEPENDING ON THE REQUIRED DISCOUNT RATE APPLIED. FORM 990, PART V, LINE 2A: EMPLOYEES REPORTED ON FORM W-3 STURDY MEMORIAL HOSPITAL, INC. IS THE COMMON PAYMASTER FOR STURDY MEMORIAL ASSOCIATES, INC. AND STURDY MEMORIAL FOUNDATION, INC. THE TOTAL NUMBER OF EMPLOYEES LISTED ON PART V, LINE 2A REPRESENTS HOSPITAL EMPLOYEES INCLUDED UNDER THE COMMON PAYMASTER FILING. FORM 990, PART VI, SECTION A, LINE 1 VOTING RIGHTS OF GOVERNING BODY THE BYLAWS OF STURDY MEMORIAL HOSPITAL, INC. STATE THAT "THE EXECUTIVE COMMITTEE SHALL HAVE THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL DURING THE INTERIM BETWEEN THE MEETINGS OF THE BOARD OF MANAGERS EXCEPT FOR SUCH MATTERS AS ARE SPECIFIED IN SECTION 55 OF THE [MASSACHUSETTS] GENERAL LAWS, CHAPTER 156B." THE EXECUTIVE COMMITTEE CONSISTS ONLY OF MEMBERS OF THE BOARD OF MANAGERS OF STURDY MEMORIAL HOSPITAL. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIPS WITH GOVERNING BODY JOSEPH CASEY, DENNIS KELLY, PATRICIA COCHRANE AND EDWARD DION-BUSINESS RELATIONSHIP. PAUL HEROUX AND LAURA GIGNAC-BUSINESS RELATIONSHIP. IN ADDITION, OTHER PERSONS LISTED IN PART VII HAVE A "BUSINESS RELATIONSHIP" WITH ONE ANOTHER DUE TO THE OVERLAPPING BOARD STRUCTURE OF STURDY MEMORIAL FOUNDATION AND ITS AFFILIATES. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS STURDY MEMORIAL FOUNDATION, INC., A MASSACHUSETTS CHARITABLE CORPORATION, ACTING THROUGH ITS BOARD OF DIRECTORS, IS THE SOLE MEMBER OF STURDY MEMORIAL HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OR STOCKHOLDERS WHO MAY ELECT MEMBERS OF GOVERNING BODY THE BOARD OF MANAGERS OF STURDY MEMORIAL HOSPITAL, INC. CONSISTS OF THOSE PERSONS WHO SERVE AS THE DIRECTORS OF STURDY MEMORIAL FOUNDATION, INC. FOUNDATION MEMBERS ARE ELIGIBLE TO ATTEND ALL MEETINGS OF THE CORPORATION AND TO HOLD OFFICE. NEW MEMBERS ARE ELECTED TO MEMBERSHIP BY THE EXISTING MEMBERS FOR THREE YEAR TERMS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS FORM 990 IS PREPARED BY STURDY MEMORIAL'S TAX PROVIDERS, GRANT THORNTON LLP, USING INFORMATION PROVIDED BY MANAGEMENT UPON COMPLETION OF THE ANNUAL INDEPENDENT AUDIT. THE INFORMATION PROVIDED IS THE RESPONSIBILITY OF THE CFO AND STURDY'S FISCAL SERVICES DEPARTMENT. THE RETURN IS REVIEWED BY GRANT THORNTON LLP, THE CONTROLLER AND CFO, AND COMPENSATION AND BENEFIT SECTIONS ARE SPECIFICALLY REVIEWED BY THE CHIEF HUMAN RESOURCES OFFICER FOR STURDY MEMORIAL HOSPITAL, INC. FORM 990 IS THEN PRESENTED TO THE AUDIT COMMITTEE FOR REVIEW AND RECOMMENDATION OF APPROVAL. EVERY BOARD MEMBER RECEIVES FORM 990 AND ALL SCHEDULES PRIOR TO FILING THE RETURN WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY MONITORING & ENFORCEMENT ALL HOSPITAL LEADERSHIP AND BOARD MEMBERS COMPLETE AND SIGN AN ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE STATEMENT REQUIRES DISCLOSURE OF ANY OUTSIDE INTERESTS IN ANY BUSINESS, OUTSIDE ACTIVITY, GIFTS, OR ENTERTAINMENT THAT MAY HAVE INFLUENCED THE RESPONDENT. IN ADDITION, THESE SIGNED STATEMENTS ARE REVIEWED BY THE INTEGRITY OFFICER AND ANY POTENTIAL CONFLICTS ARE ADDRESSED AND RESOLVED. THE INTEGRITY OFFICER DISCUSSES DISCLOSED POTENTIAL CONFLICTS WITH EMPLOYEES, OFFICERS AND DIRECTORS OF THE HOSPITAL, SO THAT THEY UNDERSTAND WHAT CONSTITUTES AN INAPPROPRIATE BUSINESS ACTIVITY. ANY GIFTS RECEIVED THAT CREATE A CONFLICT OR ARE IN VIOLATION OF THE CONFLICT OF INTEREST POLICY MUST BE RETURNED. INDIVIDUALS WITH DOCUMENTED CONFLICTS MUST ABSTAIN FROM ANY DECISION MAKING SPECIFIC TO THE IDENTIFIED AREA. AN ANNUAL REPORT IS PREPARED AND PROVIDED TO THE HOSPITAL'S PRESIDENT AND CEO AS WELL AS BOARD OF MANAGERS; THIS COMPREHENSIVE REPORT INCLUDES ALL INTEGRITY COMPLIANCE ISSUES AS WELL AS ANY NEWLY IDENTIFIED CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 PROCESS FOR DETERMINING COMPENSATION COMPENSATION DECISIONS FOR THE ORGANIZATION'S CEO, CFO AND SENIOR MANAGEMENT (KEY EMPLOYEES) ARE MADE THROUGH ITS EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE CONSISTS SOLELY OF MEMBERS WHO DO NOT HAVE A CONFLICT OF INTEREST WITH REGARDS TO COMPENSATION MATTERS. THE BOARD UTILIZES AN INDEPENDENT OUTSIDE CONSULTANT TO DETERMINE EXECUTIVE COMPENSATION. THE CONSULTANT PRESENTS NATIONAL AND REGIONAL COMPARABILITY DATA FOR SIMILAR ORGANIZATIONS. THE DATA INCLUDES COMPREHENSIVE SALARY AND BENEFITS INFORMATION FOR THE CEO, CFO AND KEY EMPLOYEES INCLUDING COMPARISON OF BASE PAY, INCENTIVE PAY, BENEFITS AND TOTAL COMPENSATION. IN ADDITION, THE COMMITTEE IS PROVIDED WITH PERFORMACE INFORMATION FOR MASSACHUSETTS HOSPITALS OBTAINED THROUGH THE CENTER FOR HEALTH INFORMATION AND ANALYSIS. THE EXECUTIVE COMMITTEE REVIEWS THE COMPARATIVE DATA FOR THE CEO AND CFO AND VOTES TO APPROVE THEIR COMPENSATION. THE CEO USES COMPARATIVE MARKET DATA TO DETERMINE PROPOSED BASE PAY COMPENSATION INCREASES AND POTENTIAL INCENTIVE PAY FOR ALL OTHER SENIOR MANAGERS AND PRESENTS THIS TO THE EXECUTIVE COMMITTEE FOR THEIR CONSIDERATION. THE EXECUTIVE COMMITTEE REVIEWS ALL RELEVANT INFORMATION AND VOTES TO ACCEPT THE RECOMMENDATIONS OF THE CEO FOR SENIOR MANAGER PAY. ALL DATA PRESENTED, AS WELL AS COMPENSATION DELIBERATION AND VOTES, ARE DOCUMENTED IN THE EXECUTIVE COMMITTEE MINUTES. THE MOST RECENT COMPENSATION STUDY WAS PERFORMED IN OCTOBER OF 2020. FORM 990, PART VI, SECTION B, LINE 16B: PARTICIPATION IN JOINT VENTURE ARRANGEMENTS STURDY MEMORIAL HOSPITAL HAS A POLICY REQUIRING EVALUATION OF ITS PARTICIPATION IN JOINT VENTURE ARRANGEMENTS UNDER APPLICABLE FEDERAL AND STATE LAW. THE HOSPITAL REQUIRES THAT ANY VENTURE OR ARRANGEMENT WITH THIRD PARTIES NOT ENGAGE IN ANY ACTIVITIES THAT WOULD JEOPARDIZE THE HOSPITAL'S EXEMPTION, SUCH AS POLITICAL ACTIVITIES, SUBSTANTIAL LOBBYING, PRIVATE INUREMENT OR SUBSTANTIAL NONEXEMPT ACTIVITIES. THE HOSPITAL SHALL MAINTAIN CONTROL, PRIORITIZE ITS EXEMPT PURPOSES, ENTER CONTRACTS AT ARMS-LENGTH, REQUIRE TRANSPARENT REPORTING, AND ENSURE ANY VENTURE COMPLY WITH INTERNAL REVENUE CODE SECTION 501(R). THE HOSPITAL'S MANAGEMENT SHALL NEGOTIATE ANY VENTURES OR ARRANGEMENTS WITH THE ASSISTANCE OF LEGAL COUNSEL, IF NECESSARY, AND THE HOSPITAL'S BOARD OF MANAGERS APPROVES ANY VENTURE OR ARRANGEMENT. THE HOSPITAL CURRENTLY PARTICIPATES IN SEVERAL VENTURES, ALL RELATED TO HEALTH CARE OPERATIONS. FORM 990, PART VI, SECTION C, LINE 19 HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC THE HOSPITAL MAKES AVAILABLE COPIES OF ITS BY-LAWS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS TO THE GENERAL PUBLIC UPON REQUEST. IMPACT OF THE COVID-19 PANDEMIC: IN MARCH 2020, THE WORLD HEALTH ORGANIZATION DECLARED COVID-19, THE DISEASE CAUSED BY THE NOVEL CORONAVIRUS, A PANDEMIC, WHICH STARTED TO AND CONTINUES TO SPREAD THROUGHOUT THE UNITED STATES OF AMERICA. AS A RESULT OF THE COVID-19 PANDEMIC, THE HOSPITAL EXPERIENCED A DECLINE IN PATIENT VISITS, ADMISSIONS, AND MEDICAL PROCEDURES PERFORMED. ELECTIVE MEDICAL PROCEDURES WERE SUSPENDED BY STATE GOVERNMENT BEGINNING IN MID-MARCH THROUGH MAY 2020, CONTRIBUTING TO A SIGNIFICANT DECLINE IN PATIENT SERVICE REVENUE DUE TO COVID-19 WHEN COMPARED TO HISTORIC AND FORECASTED RESULTS FOR THAT PERIOD. ADDITIONALLY, IN RESPONSE TO THE PANDEMIC, THE HOSPITAL INCURRED ADDITIONAL COSTS FOR TESTING, PERSONAL PROTECTIVE EQUIPMENT, THIRD-PARTY CONTRACT SERVICES AND OTHER OPERATING COSTS ASSOCIATED WITH ENSURING EMPLOYEE AND PATIENT SAFETY WHILE OPERATING DURING A PANDEMIC. SINCE MAY 2020, THE HOSPITAL HAS EXPERIENCED SLOW INCREASES IN OUTPATIENT AND EMERGENCY DEPARTMENT VISITS AND ANCILLARY PROCEDURES. ON OCCASION, COVID CASES IN THE COMMONWEALTH WILL INCREASE TO A LEVEL THAT RESULTS IN TEMPORARY MANDATED REDUCTIONS ON INPATIENT ELECTIVE PROCEDURES. THIS OCCURRED FROM DECEMBER 2020 INTO JANUARY 2021 AND HAS RECENTLY OCCURRED AGAIN. MANAGEMENT IS ACTIVELY MONITORING OPERATING REVENUE AND EXPENSES AND BASED ON THE CONTINUED UNCERTAINTIES OF COVID-19, IT IS UNABLE TO DETERMINE IF IT WILL HAVE A MATERIAL IMPACT ON ITS OPERATIONS FOR THE YEAR ENDING SEPTEMBER 30, 2022. THE HOSPITAL RECEIVED GRANT PAYMENTS, WHICH ARE CONSIDERED NONEXCHANGE TRANSACTIONS, FROM THE FEDERAL GOVERNMENT DISTRIBUTED UNDER THE CORONAVIRUS AID, RECOVERY AND ECONOMIC SECURITY ("CARES") ACT. FOR THE YEARS ENDED SEPTEMBER 30, 2021 AND 2020, THE HOSPITAL RECEIVED TOTAL PAYMENTS OF $4,833,835 AND $14,549,482, RESPECTIVELY. A TOTAL OF $6,833,835 AND $12,549,482 OF THESE PAYMENTS ARE INCLUDED IN OTHER OPERATING REVENUE IN THE STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS FOR THE YEARS ENDED SEPTEMBER 30, 2021 AND 2020 RESPECTIVELY. WHILE FEDERAL REVIEW HAS NOT YET BEEN SATISFIED, THE HOSPITAL BELIEVES IT HAS MET THE CONDITIONS AND WILL NOT BE REQUIRED TO REPAY THESE FUNDS. FORM 990, PART XI, LINE 9: TRANSFER TO AFFILIATE -4,000,000. PENSION ADJUSTMENT 57,416,100. NET ASSETS RELEASED FROM RESTRICTIONS 137,544. STURDY MEMORIAL ASSOCIATES INC 211 PARK STREET PO BOX 2963 ATTLEBORO MA 02703 042709501 PHYSICIANS MA 501(C)(3) LINE 12B, II SMF 0 STURDY MEMORIAL FOUNDATION INC 211 PARK STREET PO BOX 2963 ATTLEBORO MA 02703 042103631 DEVELOPMENT MA 501(C)(3) LINE 12B, II N/A 0 EMORY STREET RADIOLOGY ASSOCIATES INC 211 PARK STREET PO BOX 2963 ATTLEBORO MA 02703 043137282 RADIOLOGY MA 501(C)(3) LINE 12B, II SMH 1 0 1 1 0 0 0 0 0 0 1 1 1 1 1 1 1 1 0 0 RELATED TAX-EXEMPT ORGANIZATIONS SCHEDULE R, PART II STURDY MEMORIAL ASSOCIATES, INC.'S PRIMARY ACTIVITIES: PROVIDE PRIMARY AND SPECIALTY MEDICAL CARE IN THE STURDY MEMORIAL HOSPITAL SERIVCE AREA AND RECRUIT PHYSICIANS TO EXPAND AND PROVIDE QUALITY MEDICAL CARE. STURDY MEMORIAL FOUNDATION, INC.'S PRIMARY ACTIVITIES: ENGAGE IN PHILANTHROPIC ACTIVITIES THAT SUPPORT THE MISSION AND PURPOSE OF STURDY MEMORIAL HOSPITAL, INC.