2021-07-29T14:52:29-05:00 2020-09-30 366055558 GRANT THORNTON LLP 75 STATE STREET BOSTON MA 02109 990 2019-10-01 042768252 STURDY MEMORIAL HOSPITAL INC STUR 5082225200 211 PARK STREET PO BOX 2963 ATTLEBORO MA 027030963 AMY PFEFFER CFO 5082368150 2021-02-03 1 ERIN COUTURE P01390592 6177237900 2019 2022-09-23 18:48:47Z JOSEPH FX CASEY 211 PARK STREET PO BOX 2963 ATTLEBORO MA 027030963 384188026 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 15 1868 479 76537 20513 854060 12589692 209040488 203764770 13930754 17306083 8913711 8820225 232739013 242480770 7837018 13096666 0 0 122056815 127096424 0 0 0 84294807 88321987 214188640 228515077 18550373 13965693 440585898 472355538 38559549 62373502 402026349 409982036 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). 0 0 200193965 13096666 203764770 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. (CONTINUED ON SCHEDULE O).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. IN FISCAL YEAR 2020, THE HOSPITAL PROVIDED 2,959 FREE CARE VISITS AND 425 PARTIAL FREE CARE VISITS. THE HOSPITAL TREATED 10,199 INPATIENTS AND OBSERVATION PATIENTS, INCLUDING BIRTHS, OF WHICH THERE WERE 606. THE HOSPITAL TREATED 42,002 PATIENTS IN THE EMERGENCY ROOM AND PERFORMED SURGERY ON 1,534 INPATIENTS AND 7,786 OUTPATIENTS. THE HOSPITAL PROVIDES MANY OTHER SERVICES OF WHICH THE FOLLOWING IS A PARTIAL LIST: ONCOLOGY - 8,192 VISITS; MANSFIELD HEALTH CENTER - 19,484 VISITS; CARDIAC REHABILITATION - 9,623 VISITS; AND WOUND CARE - 3,345 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. THE HOSPITAL PROVIDED APPROXIMATELY $7,415,000 IN SERVICES FOR THOSE WHO COULD NOT PAY (FREE CARE) OR WOULD NOT PAY (BAD DEBT) IN FISCAL YEAR 2020. IN ADDITION, THE HOSPITAL PROVIDED APPROXIMATELY $9,148,000 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 CONTINUES TO PARTNER WITH COLUMN HEALTH TO BRING SUBSTANCE USE DISORDER TREATMENT TO OUR COMMUNITY. 200193965 1 1 0 1 0 0 0 0 0 1 1 0 0 0 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 208 0 1 1868 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 X 15 15 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 1403588 0 313185 BRIAN KELLY MD VP & CMO 40.00 5.00 X 559661 0 280249 AMY PFEFFER CFO & TREASURER 35.00 10.00 X 488083 0 299200 BRIAN PATEL MD CHIEF OF EMERGENCY SERVICES 40.00 0.00 X 494645 0 177417 MARK MCGUIRE MD PHYSICIAN 40.00 0.00 X 408237 0 192432 ALLAN RASKIN MD PHYSICIAN 40.00 0.00 X 290333 0 264691 RONALD VAN NESS-OTUNNU MD PHYSICIAN 40.00 0.00 X 390614 0 125188 MICHAEL DEMELIS MD PHYSICIAN 40.00 0.00 X 303641 0 175517 ROBIN MORRIS VP OF CLINICAL OPS & INTEGRITY 45.00 0.00 X 283904 0 180038 BRUCE AUERBACH MD FORMER EXEC. DIRECTOR 0.00 0.00 X 391386 0 40258 DAVID SPOOR VP OF PATIENT SRVS/CHF. OF NURSING 45.00 0.00 X 241345 0 104957 JEAN SIDDALL-BENSSON MD DIRECTOR & PHYSICIAN (THRU 12/2019) 2.00 41.00 X 0 210542 149862 CAROLYN ROSS CHIEF HUMAN RESOURCES OFFICER 32.00 8.00 X 238033 0 21627 ROBERT THRESHER CHAIR (THRU 01/20) 2.00 3.00 X X 0 0 0 COLLEEN MCGAHAN CLERK/DIRECTOR 2.00 1.00 X X 0 0 0 RICHARD SMITH MD DIRECTOR 2.00 3.00 X 0 0 0 RICHARD DIGIACOMO DIRECTOR 2.00 1.00 X 0 0 0 MARCO ARISMENDI DIRECTOR 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 3.00 X 0 0 0 EDWARD DION JR DIRECTOR 2.00 1.00 X 0 0 0 ROGER FORMAN DIRECTOR (AS OF 01/2020) 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 DIRECTOR (THRU 01/2020)/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 BLAIR BISHER COO (AS OF 03/2020) 8.00 37.00 X 0 0 0 5493470 210542 2324621 181 1 1 0 CROSSCOUNTRY CONSULTING LLC 1600 TYSONS BLVD SUITE 1100 MCLEAN VA 22209 CONSULTING 1770171 MEDASSETS SUPPLY CHAIN SYSTEMS LLC PO BOX 742081 ATLANTA GA 303742081 CONTRACT LABOR 1133070 ARUP LABORATORIES INC PO BOX 27964 SALT LAKE CITY UT 84127 REFERENCE LAB 942541 ACCOUNTABLE HEALTHCARE STAFFING PO BOX 732800 DALLAS TX 753732800 CONTRACT LABOR 799357 ATLANTIC ANESTHESIA 191 PECUNIT STREET CANTON MA 02021 PHYSICIAN SERVICES 758000 33 12589692 12589692 NET PATIENT SERVICE REVENUE 621400 198068175 198068175 PATIENT RELATED REVENUE, OTHER 621990 1318612 1318612 CAFETERIA SALES 722514 923661 923661 INCENTIVE PAYMENTS 900099 646489 646489 OTHER PROGRAM 4 900099 482324 429280 53044 2325509 2325509 203764770 7731220 23493 7707727 32825 0 32825 32825 32825 151281219 900 141707256 0 9573963 900 9574863 9574863 PENSION/POST RETIREMENT ADJSTMNTS 900099 8787400 8787400 8787400 242480770 202788065 76537 27026476 13096666 13096666 2826585 2826585 91710341 79603441 12106900 14078132 11853787 2224345 12717578 10708201 2009377 5763788 4853110 910678 238138 238138 207125 207125 13264 13264 840287 840287 10870248 8592131 2278117 282674 282674 2859493 2220620 638873 7725176 6856990 868186 3656950 3414361 242589 97795 48370 49425 104099 87571 16528 8204617 6973924 1230693 1095729 707360 388369 MEDICAL SUPPLIES 38713018 38696032 16986 PROVSN FOR DOUBTFL DEBT 7175877 7175877 MAINTENANCE & REPAIRS 3111054 2894178 216876 LICENSES AND TAXES 2177224 2158260 18964 949219 253086 696133 228515077 200193965 28321112 0 1598 1316 4687678 24929789 0 0 18645467 18239134 0 0 0 0 0 0 4227155 5405436 4867822 3356408 184544207 121118057 52477220 63426150 314696903 312353553 22788460 21697380 543804 3177072 17649791 19769300 440585898 472355538 32406807 55060466 0 0 73792 2000000 0 0 0 0 0 0 0 0 0 0 6078950 5313036 38559549 62373502 X 402003758 409959445 22591 22591 402026349 409982036 440585898 472355538 X 13965693 -107951 -5902055 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 0 0 1 13264 13264 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 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 2020 IT WAS ESTIMATED THAT 11.08% ($18,264) WAS USED FOR LOBBYING PURPOSES. THIS AMOUNT IS NETTED AGAINST A ($5,000) PRIOR YEAR OVER ACCRUAL FOR LOBBYING EXPENSES RELATED TO DIRECT CONTACT WITH A REGISTERED LOBBYIST. 7799091 8039 630094 111626 8325598 7742025 199655 -688 141901 7799091 7443544 19840 615380 336739 7742025 6891557 5000 903230 356243 7443544 6886412 430702 234568 7082546 0.49400 0.50600 0 1 1 1841160 1841160 111948898 74000255 37948643 0 69072650 45598645 23474005 1681499 1519157 162342 63426150 INSURANCE CLAIMS, LONG TERM 1400000 WORKERS COMP. SELF-INSURANCE RESV. 1318485 ASSET RETIREMENT OBLIGATION 1018277 DUE TO AFFILIATE 921074 ACCRD. POSTRETIREMENT HEALTH BENF. 655200 5313036 X 234619000 -107951 -6913532 -7021483 241640483 840287 840287 242480770 220498913 0 220498913 840287 7175877 8016164 228515077 PART V, LINE 4: ENDOWMENT FUNDS STURDY MEMORIAL FOUNDATION, INC. MAINTAINS ENDOWMENT FUNDS (RESTRICTED TO PRINCIPAL) FOR THE BENEFIT OF STURDY MEMORIAL FOUNDATION, 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 THREE YEARS AGO, HENCE, THE BEGINNING BALANCE OF THE THREE 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 -7,175,877. NET ASSETS RELEASED FROM RESTRICTIONS 262,345. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECLASS FOR BAD DEBT PROVISION 7,175,877. 1 1 1 X 1 X 1 1 1 0 1 1 1791567 590012 1201555 0.00530 27963470 21042054 6921416 0.03030 29755037 21632066 8122971 0.03560 850620 0 850620 0.00370 10444278 3599038 6845240 0.03000 30569 0 30569 0.00010 11325467 3599038 7726429 0.03380 41080504 25231104 15849400 0.06940 4 2420 2420 0.00000 1 1765 1765 0.00000 7 79240 79240 0.00030 6 47506 47506 0.00020 18 130931 130931 0.00050 0 3408542 788737 64269584 76438914 -12169330 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 REPORT STURDY MEMORIAL HOSPITAL'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTCAN 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 METHODS STURDY 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: THE 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.SCHEDULE H, PART I, LINE 7, COLUMN (F)BAD DEBT EXPENSE OF $7,175,877 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 FY20 DUE TO THE COVID CRISIS. PART III, LINE 2: BAD DEBT EXPENSE - EXPLANATION FOR PART III, LINES 2, 3 AND 4ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLES AND COPAYMENT BALANCES DUE), THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. 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 2020 DUE TO COVID-19, THE HOSPITAL USUALLY OFFERS NEARLY ONE HUNDRED COMMUNITY BENEFIT PROGRAMS AND EVENTS EACH YEAR. 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: STATE FILING OF COMMUNITY BENEFITS REPORTSTURDY MEMORIAL HOSPITAL FILES ITS COMMUNITY BENEFITS REPORT IN MASSACHUSETTS. 1 CITY OF ATTLEBORO 77 PARK STREET ATTLEBORO MA 02703 046001378 GOVT 18000 COMMUNITY SUPPORT STURDY MEMORIAL ASSOICATES 211 PARK STREET 2963 ATTLEBORO MA 02703 042706501 501(C)(3) 13075416 GENERAL SUPPORT 2 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 1 1 0 0 0 0 0 1 0 JOSEPH CASEY PRESIDENT & CEO 620493 0 162680 0 620415 0 291430 0 21755 0 1716773 0 0 0 BRIAN KELLY MD VP & CMO 459529 0 42680 0 57452 0 256494 0 23755 0 839910 0 0 0 AMY PFEFFER CFO & TREASURER 373774 0 37680 0 76629 0 277941 0 21259 0 787283 0 0 0 BRIAN PATEL MD CHIEF OF EMERGENCY SERVICES 444378 0 28680 0 21587 0 155662 0 21755 0 672062 0 0 0 MARK MCGUIRE MD PHYSICIAN 377595 0 12577 0 18065 0 170677 0 21755 0 600669 0 0 0 ALLAN RASKIN MD PHYSICIAN 273130 0 1943 0 15260 0 242936 0 21755 0 555024 0 0 0 RONALD VAN NESS-OTUNNU MD PHYSICIAN 369711 0 4812 0 16091 0 103433 0 21755 0 515802 0 0 0 MICHAEL DEMELIS MD PHYSICIAN 286559 0 2144 0 14938 0 153762 0 21755 0 479158 0 0 0 ROBIN MORRIS VP OF CLINICAL OPS & INTEGRITY 232866 0 44680 0 6358 0 169967 0 10071 0 463942 0 0 0 BRUCE AUERBACH MD FORMER EXEC. DIRECTOR 0 0 0 0 391386 0 27540 0 12718 0 431644 0 0 0 DAVID SPOOR VP OF PATIENT SRVS/CHF. OF NURSING 210564 0 22680 0 8101 0 94086 0 10871 0 346302 0 0 0 JEAN SIDDALL-BENSSON MD DIRECTOR & PHYSICIAN (THRU 12/2019) 0 206643 0 2680 0 1219 0 140991 0 8871 0 360404 0 0 CAROLYN ROSS CHIEF HUMAN RESOURCES OFFICER 225029 0 12500 0 504 0 267 0 21360 0 259660 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 2019, THE EXECUTIVE DIRECTOR 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 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, BRUCE AUERBACH, MD, AMY PFEFFER, DAVID SPOOR, ROBIN MORRIS, BRIAN PATEL, MD, CAROLYN ROSS AND BRIAN KELLY, MD DURING CALENDAR YEAR 2019. 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 IS SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN APPROVED BY THE BOARD OF MANAGERS. PART I, LINES 4A-B PART I, LINE 4A: SEVERANCE PAYMENTS BRUCE AUERBACH, MD, EXECUTIVE DIRECTOR THROUGH 8/2018, RECEIVED $383,806 IN SEVERANCE PAY IN 2019 FROM STURDY MEMORIAL HOSPITAL. THE AMOUNT WAS TREATED AS TAXABLE INCOME AND IS INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). 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 2019. THE TOTAL OF NON-QUALIFIED RETIREMENT CONTRIBUTIONS IN 2019 ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). JOSEPH CASEY ($14,455) PARTICIPATED IN THE PLAN IN 2019. 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. ORGANIZATION'S MISSION (CONTINUED) FORM 990, PART III, LINE 1 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. 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 DECEMBER OF 2018. 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, THE HOSPITAL HAS BEGUN TO SEE INCREASES IN ITS PATIENT VISITS, ADMISSIONS, AND MEDICAL PROCEDURES, ALTHOUGH IN DECEMBER 2020, THE COMMONWEALTH AGAIN IMPOSED RESTRICTIONS ON INPATIENT ELECTIVE PROCEDURES. 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, 2021. FORM 990, PART XI, LINE 9: TRANSFER TO AFFILIATE -6,000,000. PENSION ADJUSTMENT -164,400. NET ASSETS RELEASED FROM RESTRICTIONS 262,345. 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 SHV INC 127 PEARL STREET ATTLEBORO MA 02703 042855097 SALES AND RENTAL MA SMF C 0 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: RECRUIT PHYSICIANS TO EXPAND AND IMPROVE THE AVAILABILITY OF QUALITY MEDICAL CARE IN THE STURDY MEMORIAL HOSPITAL SERVICE AREA. STURDY MEMORIAL FOUNDATION, INC.'S PRIMARY ACTIVITIES: ENGAGING IN PHILANTHROPHIC ACTIVITIES TO SUPPORT THE MISSION AND PURPOSE OF STURDY MEMORIAL HOSPITAL, INC. RELATED ORGANIZATION TAXABLE AS A CORPORATION SCHEDULE R, PART IV SHV, INC., WHICH DOES BUSINESS UNDER THE TRADE OF NAME ATTLEBORO AREA MEDICAL EQUIPMENT CO, IS A FOR-PROFIT CORPORATION ACTIVELY ENGAGED IN THE SALE AND RENTAL OF MEDICAL EQUIPMENT AND ACCESSORIES IN THE GREATER ATTLEBORO AREA. THE COMPANY EXTENDS CREDIT TO ITS CUSTOMERS AND IS PAID DIRECTLY OR BY PRIVATE INSURANCE. SHV INC. FILED ITS ARTICLES OF DISSOLUTION ON OCTOBER 9, 2019 AND THEREFORE WILL NOT BE LISTED ON THE RETURN IN FUTURE YEARS.