2019-08-09T10:38:08-05:00 2018-09-30 861065772 Deloitte Tax LLP Two Jericho Plaza Jericho NY 11753 990 2017-10-01 042790311 Baystate Medical Center Inc BAYS 4137940000 759 Chestnut Street Springfield MA 01199 Dennis W Chalke SVP Finance, CFO & Treasurer 4137940000 2019-08-09 1 Jeanne Fahrenbach P01365953 5169187000 208.99.255.205 2019-08-09 08:45:17 ED P D33FA7F254BC09848346BBAA17B51EB9116DA51E D6D028B83EC7BAE48696A0FE418AC7215527A94E 2017 2019-02-21 02:37:17Z Dennis W Chalke 759 Chestnut Street Springfield MA 01199 1331949100 0 X www.baystatehealth.org X 1983 MA The mission of the organization is to improve the health of the people in our communities every day, with quality and compassion. 22 17 8440 424 7136969 -2102303 5891390 9603517 1143646536 1199523762 28302911 34890459 65068460 73946813 1242909297 1317964551 11389487 15807203 0 0 508446278 526939128 0 0 0 627810676 654659686 1147646441 1197406017 95262856 120558534 1339784677 1362808541 575061607 535124648 764723070 827683893 X The mission of the organization is to improve the health of the people in our communities every day, with quality and compassion. 0 0 549702202 15807203 621020153 Inpatient healthcare services - Providing inpatient community-based medicine and tertiary care to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY18, Baystate Medical Center, Inc. provided 210,747 patient days of inpatient services, with 42,416 discharges. 423441750 403610182 Outpatient healthcare services - Providing outpatient clinical services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY18, Baystate Medical Center, Inc. had 465,067 outpatient visits. 38575305 41152130 Emergency department services - Providing emergency department services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY18, Baystate Medical Center, Inc. had 117,299 emergency department visits. 104876712 194475875 Other program services - Providing ambulatory pharmacy and infusion and respiratory services to the surronding region. Services are available to individuals regardless of their ability to pay. 104876712 194475875 1116595969 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 1 0 1 443 0 1 8440 1 1 1 0 0 0 0 0 0 0 0 0 X 22 17 1 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 1 1 MA X Dennis W Chalke Baystate Health 4137940000 759 Chestnut Street Springfield MA 01199 X Anne M Paradis Chair 1.00 2.00 X X 0 0 0 John F Maybury Vice Chair 1.00 1.00 X X 0 0 0 Adrian J Levsky Trustee 1.00 1.00 X 0 0 0 Claudia R Coplein DO Trustee 1.00 1.00 X 0 0 0 Colleen W Holmes Trustee 1.00 1.00 X 0 0 0 Edward J Noonan Trustee 1.00 1.00 X 0 0 0 Grace Makari-Judson MD Trustee/Hematologist (thru 12/31/17) 1.00 40.00 X 340368 0 77945 Gregory L Braden MD Trustee 1.00 1.00 X 0 0 0 Harriet A DeVerry Trustee 1.00 1.00 X 0 0 0 Hector Toledo Trustee 1.00 1.00 X 0 0 0 Irene Rodriguez Martin Trustee (as of 1/1/18) 1.00 1.00 X 0 0 0 James P Sadowsky Trustee (through 12/31/17) 1.00 2.00 X 0 0 0 James R Phaneuf Trustee 1.00 1.00 X 0 0 0 John A Egelhofer MD Trustee 1.00 1.00 X 0 0 0 John H Davis Trustee (through 12/31/17) 1.00 1.00 X 0 0 0 Kathleen B Scoble Trustee 1.00 1.00 X 0 0 0 Kevin P Moriarty MD Trustee/Chief Ped Surg 1.00 40.00 X 686449 0 38262 Maria P Goncalves Trustee (as of 1/1/18) 1.00 1.00 X 0 0 0 Mark A Keroack MD Trustee 1.00 49.00 X 0 1888794 32862 Michael P Albert MD Trustee 49.00 1.00 X 331391 0 59976 Paul R Murphy Trustee 1.00 1.00 X 0 0 0 Robert J Bacon Trustee 1.00 1.00 X 0 0 0 Robert L Pura PhD Trustee 1.00 1.00 X 0 0 0 Timothy F Farrell Trustee 1.00 1.00 X 0 0 0 Victor Woolridge Trustee (through 12/31/17) 1.00 1.00 X 0 0 0 William R Webber Trustee 1.00 1.00 X 0 0 0 Nancy Shendell-Falik President 27.00 23.00 X 0 840145 211038 Dennis Chalke Treasurer 26.00 24.00 X 0 994659 87008 Kristin R Delaney Clerk 1.00 39.00 X 0 143978 37512 Madeline Torres Assistant Clerk 1.00 40.00 X 0 57772 15600 Christine Klucznik VP/ CNO 50.00 0.00 X 0 361915 26959 Tejas Gandhi VP/ COO 50.00 1.00 X 0 514558 40018 Peter Friedmann MD Assoc Dean Chief Res Officer 50.00 0.00 X 405233 0 48388 Douglas Salvador MD SVP/ Chief Quality Officer 50.00 0.00 X 148716 247381 36199 Peter Lindenauer MD Asst Dean Population Health 50.00 0.00 X 370790 0 49671 Vishal Tiwari MD Assoc Med Dir Hosp Care Mgmt 50.00 0.00 X 331951 0 34482 Amy Gottleib MD Assoc Dean Chief Fac Devel 50.00 0.00 X 328938 0 20404 Deborah A Provost Former Chief Regulatory Officer 25.00 25.00 X 283939 0 74164 3227775 5049202 890488 598 1 1 1 Baystate Administrative Services Inc 759 Chestnut Street Springfield MA 01199 Management Svcs. 93046965 Baystate Medical Practices Inc 759 Chestnut Street Springfield MA 01199 Medical, Educ, Clin 67830729 Shields Specialty Pharmacy of Springfiel 1200 Hancock St 300 Quincy MA 02169 Management Svcs. 7226477 Shiftwise 1800 SW 1st Ave Suite 510 Portland MA 97201 Contract Svcs. 5285839 Mayo Clinic Laboratories PO Box 9146 Minneapolis MN 55480 Contract Svcs. 4840443 176 4711574 3437364 1454579 9603517 Inpatient Revenue 900099 646498766 646498766 Outpatient Revenue 621400 530817847 523700923 7116924 Sponsored Programs 900099 9432681 9432681 MCD Waiver Safety Net 900099 6802125 6802125 Next Gen ACO 900099 3353633 3353633 2618710 2618710 1199523762 4599553 4599553 489470 508509 -19039 -19039 -19039 33100448 10666498 5977234 7498806 27123214 3167692 30290906 30290906 Pharmacy Service 900099 38300851 38300851 Intercompany Charges 900099 22417399 22417399 Cafeteria Income 900099 6093256 6093256 7154346 7133252 20045 1049 73965852 1317964551 1260258340 7136969 40965725 X 15776845 15776845 30358 30358 391367 391367 117712 117712 435661212 400396229 35264983 14808202 13607412 1200790 43350491 39843188 3507303 32610144 29973180 2636964 45357694 42327118 3030576 904139 904139 514342 514342 290777 290777 152479705 142099396 10380309 345607 345607 285980942 283514114 2466828 65399474 64775854 623620 23173649 12502515 10671134 1330927 1135522 195405 1299716 1145297 154419 10388286 10388286 58772756 50948794 7823962 8421672 7277175 1144497 1197406017 1116595969 80810048 0 65429707 79823279 206066491 207602809 26575257 26610122 21399490 23322726 1492365251 926759410 579243424 565605841 295536405 340292738 126593862 99699981 1551527 1551527 17388514 18299518 1339784677 1362808541 99424407 100050588 654309 2878331 375586248 370978538 19300107 16833400 80096536 44383791 575061607 535124648 X 749012780 810654158 11451542 11327344 4258748 5702391 764723070 827683893 1339784677 1362808541 X 120558534 -16230361 -41367350 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 290777 290777 0 Part II-B, Line 1-i Baystate Medical Center, Inc. pays membership dues to the Massachusetts Hospital Association (MHA), the American Hospital Association (AHA) and the National Association of Urban Hospitals. These organizations have advised us that portions of these dues are used for lobbying purposes for various healthcare matters at the state level. The portion of dues listed as lobbying expenses for the year ending September 30, 2018 is $290,777. 12535382 12535382 757077149 319539597 437537552 5849806 2457101 3392705 662151675 567677229 94474446 54751239 37085483 17665756 565605841 1683664 C Securities other 96536519 C Securities real estate 1479798 C 99699981 Contractual Adjustments Payable 28671236 Due to Affiliated Companies 540549 Insurance Liability Loss Reserves 7519450 Minimum Pension Liability 6252741 Market Value Swap 1399815 44383791 Schedule D, Part V Certain endowments are held at Baystate Health Foundation, Inc. (BHF), an affiliate, and are reported as temporarily restricted and permanently restricted but Part V has not been completed as it is already addressed on BHF's Form 990 (EIN 04-3549011). 1 1 X 1 X 1 X 1 1 0 1 1 13687136 4010450 9676686 0.00810 236497050 207702155 28794895 0.02400 2878882 2568616 310266 0.00030 253063068 214281221 38781847 0.03240 2300323 0 2300323 0.00190 59522591 18686207 40836384 0.03410 19130085 13067610 6062475 0.00510 18848513 12970955 5877558 0.00490 492314 0 492314 0.00040 100293826 44724772 55569054 0.04640 353356894 259005993 94350901 0.07880 1 6248752 798637 311706578 289016353 22690225 X 1 1 1 1 Baystate Medical Center Inc 759 Chestnut Street Springfield MA 01199 2339 X X X X X X Baystate Medical Center Inc 1 0 0 1 X X X X X X X X X 15 1 1 1 1 X See Part V narratives X See Part V narratives X X 1 16 1 See Part V narratives 0 1 X 150.000000000000 300.000000000000 X X X 1 1 X X X X X 1 X https://www.baystatehealth.org/patients/billing-and-financial-assistance X https://www.baystatehealth.org/patients/billing-and-financial-assistance X https://www.baystatehealth.org/patients/billing-and-financial-assistance X X X X X X X 1 X 0 X X X X 1 X 0 0 Baystate Medical Center, Inc. Part V, Section B, Line 5: A wide range of stakeholders took part in the 2016 Coalition CHNA process, including local and regional public health and health departments, other local municipal agencies, diverse community-based organizations, advocacy organizations, healthcare providers, and community residents. These stakeholders provided input through focus groups, key informant interviews and participation in the CHNA Steering Committee. Additionally, community listening sessions were conducted to vet findings with community members.The following organizations/community stakeholders were interviewed: Public Health Experts: Caulton-Harris, Helen, Commissioner of Public Health, City of Springfield; Dennis, Soloe, Western Region Director, Massachusetts Department of Public Health (MDPH); Garcia, Luz Eneida, Care Coordinator, MDPH Division for Perinatal, Early Childhood and Special Needs, Care Coordination Unit; Hyry-Dermith, Dalila, Supervisor, MDPH Division for Perinatal, Early Childhood and Special Needs, Care Coordination Unit; Merriam, Carolyn, Public Health Nurse, Town of Ware; Metcalf, Judy, Director, Quabbin Health District; O'Leary, Meredith, Director, Northampton Health Department; Steinbock, Lisa, Public Health Nurse, City of Chicopee; Walker, Phoebe, Director of Community Services, Franklin Regional Council of Governments (FRCOG); and White, Lisa, Public Health Nurse, Franklin Regional Council of Governments (FRCOG). Community Leaders or Health or Other Agencies Interviewed: Adzigirey, Liliya, Translator/ Interpreter, Baystate Noble Hospital; Azeez, Robert, Medicaid Behavioral Health Manager, Health New England; Balder, Dr. Andrew, Director, Mason Square Neighborhood Health Center and Health Care for the Homeless; Beck-Brewer, Joni, Vice President, Patient Services, Square One; Benjamin, Dr. Evan, Chief Quality Officer and Sr. VP of Quality and Population Health, Baystate Health; Blanchet, M.D., Jacques, Director of the Emergency Department, Baystate Noble Hospital; Boos, Dr. Stephen, Medical Director, Baystate Family Advocacy; Bouthillette, Marianne, Director of Child and Family Services, Parent Child Development Center, Community Action of the Franklin, Hampshire and North Quabbin Regions; Bradley, Leah, Director of Behavioral Health, Baystate Wing Hospital Griswold Center; Cardaropoli, Antonia, School Adjustment Counselor, Ware Junior/Senior High School; Cox, Jennifer, Director of Behavioral Health, Baystate Franklin Medical Center; Crowley, Kelley, Administrative Director of Behavioral Health, Baystate Noble Hospital; Cummings, Sara, Director of Community Services and Asset Development, Community Action of the Franklin, Hampshire and North Quabbin Regions; Davis, Kim, Nurse Manager, Baystate Mary Lane Hospital; Di Leo, Marlene, Superintendent, Ware Public Schools; Durkin, Dr. Louis, Director of Emergency Medicine, Mercy Medical Center; Gerard, Mary Beth, WIC Director, Community Action of the Franklin, Hampshire and North Quabbin Regions; Hettler, Dr. Joeli, Chief, Pediatric Emergency Medicine, Baystate Health; Higgins, Clare, Executive Director, Community Action of the Franklin, Hampshire and North Quabbin Regions; Jean-Guillaume, M.D., Rock, Chair of Emergency Medicine, Baystate Wing Hospital; Jock, Jacqueline, School Adjustment Counselor, Ware Middle School; Johnson, Yolanda, Executive Officer for Student Services, Springfield Public Schools; LaBounty, Kerry, Medicaid Program Manager, Health New England; Manser, Katherine, WIC Senior Nutritionist, Community Action of the Franklin, Hampshire, and North Quabbin Regions; Martoccia, Roseann, Executive Director, LifePath; Ostiguy, Karen, Nurse Manager, Baystate Wing Hospital; Paulson, Tina, Nurse Manager, Baystate Mary Lane Hospital; Plourde, Annette, RN, Nurse, Monson Medical Center; Rathlev, Dr. Niels, Chair, Emergency Medicine, Baystate Health; Reilly, Elizabeth, Hardwick Youth Center and Food Pantry; Roose, Dr. Robert, Chief Medical Officer, Addiction Services for the Sisters of Providence Health System; Member of the Governor's Task Force on Opioid Abuse; Russo-Appel, Dr. Maria, Chief Medical Officer, Providence Behavioral Health Hospital (PBHH); Shaver, John, Chief Financial Officer, Baystate Noble Hospital; Shendell-Falik, Nancy, President, Baystate Medical Center and Sr. VP, Hospital Operations, Baystate Health; Silva, David, Medicaid Community Leader, Health New England; Spain, M.D., Jackie, Medicaid Program Medical Director, Health New England; Talati, M.D., Rakesh, Chair of Emergency Medicine, Baystate Franklin Medical; Taylor, Charles, Reverend, United Church of Ware; Velazquez, M.D., Louis, Baystate Wing Griswold Center. The following individuals served on the CHNA Steering Committee, which met monthly over the course of a year with the Coalition and CHNA Consultant Team: Allard, Andrea, President/CEO, YMCA of Westfield; Amador, Ruth, President, National Association of Hispanic Nurses -Western MA Chapter; Ayres, Jim, President and CEO, United Way of Hampshire County; Barber, Tania, President/CEO, Caring Health Center; Blanchette, Mary Ellen, Nurse Leader, Palmer Public Schools; Caisse, Ed, C3/Safe Neighborhood Initiative - South Holyoke, Hampden County Sheriff's Department; Christopolis, Dave, Executive Director, Hilltown CDC; Garozzo, Salvatore, Executive Director, United Cerebral Palsy Assoc. of Berkshire County, Inc.; Graves, Marie, Program Director, Springfield Dept. Health & Human Services; Rudder, Shannon Executive Director, MotherWoman; Lee, Jennifer, Systems Advocate for Change, Stavros Center for Independent Living; Lewandowski, Sue, Representative for Worcester County, Assumption College; Lopez, Luz, Director, MetroCare of Springfield; McCafferty, Gerry, Director of Housing, City of Springfield, Office of Housing; Prullage, Beth, Clinical Social Worker, Providence Behavioral Health; Reeves, Halley, Community Health Planning And Engagement Specialist, MA Dept. of Public Health; Silverman, Risa, Coordinator, Office for Public Health Practice & Outreach, UMASS Amherst School of Public Health and Health Sciences; Simmons, Tony, Community Liaison, Hampden County District Attorney's Office; Simonds, Jane, Sr. Program Manager, Behavioral Health Network - Outpatient Services; Walker, Phoebe, BFMC CBAC Co-chair, Franklin Regional Council of Governments (FRCOG); Wilson, Gloria, Member Western MA Black Nurses Association; Wood, Ben, Healthy Community Design Coordinator, MA Dept. of Public Health. Baystate Medical Center, Inc. Part V, Section B, Line 6a: In 2016, in partnership with the Coalition of Western MA Hospitals/Insurer, the hospital facility conducted a community health needs assessments ("CHNA") of the geographic area served by the hospital facility. The Coalition of Western Massachusetts Hospitals/Insurer ("Coalition"), a partnership between nine (9) not-for-profit hospitals and an insurer in Western Massachusetts that includes: Baystate Medical Center, Baystate Franklin Medical Center, Baystate Noble Hospital, Baystate Wing Hospital (including Baystate Mary Lane Outpatient Center), Holyoke Medical Center, Cooley Dickinson Hospital, Mercy Medical Center (a member of Trinity Health-New England), Shriners Hospitals for Children-Springfield , and Health New England, a local health insurer whose service area covers the four counties of Western Massachusetts. Baystate Medical Center, Inc. Part V, Section B, Line 6b: The Coalition of Western MA Hospitals and Insurer engaged the Public Health Institute of Western MA (PHIWM), based in Springfield, MA, as the lead consultant to conduct the CHNA's. PHIWM was supported by two other consultant teams; Community Health Solutions, based in Northampton, MA and Pioneer Valley Planning Commision (PVPC), based in Springfield, MA. The Coalition includes Health New England, a local health insurer whose service area covers the four counties of Western Massachusetts. Baystate Medical Center, Inc. Part V, Section B, Line 7d: The hospital facility made its CHNA report widely available to the public via an email distribution, with links to the hospital's website, to community partners and organizations. The regional findings from the CHNA reports were shared publicly at the Western MA Health Equity Summit in November 2016 (over 300 attendees). In addition, the CHNA reports have informed the development and implementation of county wide community health improvement plans. Hospital and CHNA consultant staff have been invited to various venues and audiences to present on the CHNA process and key findings. Baystate Medical Center, Inc. Part V, Section B, Line 11: The hospital facility anticipates health needs and available resources may change, therefore, a flexible approach was adopted in the development of its implementation strategy. For example, certain community health needs may become more pronounced and require changes to the initiatives identified by the hospital in the Strategy. Other community organizations may address certain needs, indicating that the hospital's strategies should be refocused on alternative community health needs or assume a different focus on the needs identified in the 2016 CHNA.Hospital resource inputs that will help address priority health needs include, Community Benefits Investments, Community Relations Investments, Better Together Grant Program, hospital-based community benefits activities, external grants received by hospital, and other hospital-based program/services.The hospital facility views a community benefits implementation strategy as a "LIVING" document. Due to the evolving climate in health care, the hospital's financial health year to year remains unknown; therefore hospital resources and inputs may increase, decrease, or need to be modified. The hospital's implementation strategy work plan provides an opportunity for the hospital to be strategic and focused, yet flexible in its community health planning and improvement efforts. The hospital facility, in partnership with its Community Benefits Advisory Council updates the work plan with annual outputs and outcomes for each input and activity.No health care system or hospital facility can address all the health needs present in its community. The hospital facility is committed to adhering to its mission and remaining financially healthy so that it can continue to enhance its clinical excellence and patient experience, as well as continue community health planning and improvement efforts. The hospital facility's implementation strategy does not explicitly address all the priority community health needs identified in the 2016 CHNA due to; 1. the hospital's limited resources (time, talent and financial), 2. other hospitals or community organizations within service area are addressing the need; 3. the need falls outside of the hospitals' mission or limited resource capacity. However, many, if not all of the CHNA priority health needs will be addressed INDIRECTLY by the hospital and/or community partners through existing community health planning and improvement efforts.Needs being addressed by the hospital include, basic needs (such as housing), care coordination, community safety, cultural humility, health equity, institutional racism, insurance challenges, limited availability of providers, maternal/infant/child health, mental health and substance use disorders, physical activity and healthy diet, and transportation. Needs not directly being addressed by the hospital include, chronic health conditions, environmental concerns, food deserts/insecurity, health literacy, and sexual health. Baystate Medical Center, Inc. Part V, Section B, Line 13b: All patients with account balances (other than balances resulting from co-payments or deductibles on insured services) are eligible to receive a prompt pay discount of 20% of the balance for claims paid in full at time of service or within 60 days of the date of the initial bill. Patients must request the discount. The discount cannot be combined with the Hospital Supplemental Financial Assistance Program. Baystate Medical Center offers a co-payment discount program for the patients receiving services in the emergency department of the hospital. This discount program is available to all hospital emergency department patients with co-payment obligations under private or government health insurance (unless prohibited by law or a Baystate Medical Center's contract with a private insurer or government authority). These patients may reduce the otherwise applicable emergency department service co-payment by 10% if the patient elects to pay the co-payment at the conclusion of the patient's emergency department visit. Baystate Medical Center, Inc. Part V, Section B, Line 15e: Baystate Medical Center (BMC) provides patients with information about the availability of State Programs, Health Safety Net, or the Hospital Supplemental Financial Assistance Program which may cover all or some of their unpaid BMC bills as well as about BMC discount programs. For those patients who request such assistance, the hospital assists patients by screening them for eligibility in available State Programs and assisting them in applying for such programs. When applicable, BMC may also assist patients in applying for coverage of services as a Medical Hardship based on the patient's documented income and allowable medical expenses. BMC has contracted with the Executive Office of Health and Human Services and the Commonwealth Health Insurance Connector Authority to serve as a Certified Application Couselor Organization. As a Certified Application Counselor (CAC), appropriate staff will inform a patient of the functions and responsibility of a CAC, seek that the patient sign a Certified Application Counselor Designation Form, and assist the patient in finding applicable financial assistance. Baystate Medical Center, Inc. Part V, Section B, Line 16j: Paper copies of our financial assistance policy (FAP) and the FAP application, and a FAP plain language summary as well as the Billing and Collections Policy are available upon request, in English, Spanish, and Russian, and free of charge in the hospital and by mail, as well as the hospital facilities website https://www.baystatehealth.org/patients/billing-and-financial-assistance. A plain language summary of the FAP is offered to all patientes at all registration sites including our full service health centers in the community - Baystate Brightwood Health Center and Baystate Mason Square Neighborhood Health Center. In addition, copies of the full FAP, FAP application and Billing and Collections Policy are also available at all Registrations sites.Copies of our community health needs assessment are available for viewing and download on our website at https://www.baystatehealth.org/about-us/community-programs/community-benefits/community-health-needs-assessment. Hard copies of our CHNA are available upon request free of charge. We have also shared our CHNA with all the community members who were involved with CHNA as well as each hospitals Community Benefits Advisory Council (CBAC). The hospital is committed to ongoing efforts to widely publicize our FAP and CHNA to the community, specifically, to low-income populations. Additional efforts will include promotion via our hospitals various social media platforms and providing printed materials to key social service agencies and educating their staff that work with low income populations in the hospitals service area. Baystate Medical Center, Inc. Part V, Section B, Line 20e: We rely on Medicaid for presumptive eligibility determinations. We would perform these actions if needed but did not have any patient during the tax year where an ECA was initiated. Form 990, Schedule H, Part V, Line 7 7a: https://www.baystatehealth.org/about-us/community-programs/community-benefits/community-health-needs-assessment7b: http://www.cbsys.ago.state.ma.us/cbpublic/public/annual_reports_start.aspx Form 990, Schedule H, Part V, Line 10 10a: https://www.baystatehealth.org/about-us/community-programs/community-benefits/community-health-needs-assessment 20 1 - Baystate Ambulatory Care Ctr 3300 Main Street Springfield MA 01107 Outpatient Physician Offices 2 - Baystate Ambulatory Care Ctr 140 High Street Springfield MA 01105 Outpatient Facility 3 - Baystate Breast and Wellness Center 100 Wason Avenue Suite 300 Springfield MA 01107 Outpatient Facility 4 - Baystate Brightwood Health Center 380 Plainfield Street Springfield MA 01107 Outpatient Clinic 5 - Baystate Child Hospitalziation Prog 150 Lower Westfield Road Suite 3 Holyoke MA 01040 Outpatient Facility 6 - Baystate Children's Specialty Center 50 Wason Avenue 1st Floor Springfield MA 01107 Outpatient Facility 7 - Baystate Heart & Vascular ProgImaging 10 Main Street Basement Level Florence MA 01060 Outpatient Facility 8 - Baystate Imaging & Transplant Services 100 Wason Avenue Ground Floor Suite 21 Springfield MA 01107 Outpatient Facility 9 - Baystate Mason Sq Neighborhood Hlth Ctr 11 Wilbraham Road Springfield MA 01199 Outpatient Clinic 10 - Baystate Orthopedic Surgery Cntr 50 Wason Avenue 2nd Floor Springfield MA 01107 Outpatient Surgery Center 11 - Baystate Reference Laboratories 361 Whitney Avenue Holyoke MA 01040 Outpatient Laboratory Services 12 - Baystate Regional Cancer Program Davis Blding 85 South St 4th Fl Ware MA 01082 Outpatient Cancer Center 13 - Baystate Rehabilitation Care 294 North Main Street East Longmeadow MA 01028 Rehabilitation Clinic 14 - Baystate Rehabilitation Care 200 Silver St Ste 101 Agawam MA 01001 Rehabilitation Clinic 15 - Baystate Rehab Care Adult OP Svs 360 Birnie Avenue Springfield MA 01107 Rehabilitation Clinic 16 - Baystate Rehabilitation Care Rymd Ctr 470 Granby Rd Ste 4 South Hadley MA 01075 Rehabilitation Clinic 17 - Baystate Specialty Pharmacy 3300 Main Street Springfield MA 01107 Outpatient Facility 18 - Baystate Vascular Services 3500 Main Street 2nd Floor Springfield MA 01107 Outpatient Facility 19 - BMC Pain Management Center 3400 Main Street 2nd Flr Springfield MA 01107 Outpatient Facility 20 - D'Amour Center for Cancer Care 3350 Main Street Springfield MA 01199 Outpatient Cancer Center Part I, Line 6a: The hospital facility files an annual community benefit report electronically with the Massachusetts Office of the Attorney General's via their website at http://www.mass.gov/nonprofit-hospital-and-hmo-community-benefits. The hospital facility's annual community benefit report is also published on the Baystate Health website at https://www.baystatehealth.org/about-us/community-programs/community-benefits/community-health-needs-assessment. The hospital's community benefits report provides the Office of the Attorney General and the general public important information about how the hospital partners with the community to identify and address health needs. Part I, Line 7: Line 7a (Charity Care) - community benefit expense was calculated by applying the ratio of patient care cost to charges, calculated on Worksheet 2, against total charity care gross patient charges from the audited financial statements.Line 7b (Unreimbursed Medicaid) - community benefit expense was derived using the organization's cost accounting system, which takes into account all hospital inpatients, outpatients and emergency room patients for whom services were provided and covered under Medicaid and Medicaid managed care plans.Line 7c (Other Means-Tested Programs) - community benefit expense was derived using the organization's cost accounting system, which takes into account all hospital inpatients, outpatients and emergency room patients for whom services were provided and covered under other means-tested government programs.Line 7e (Community Health Improvement Services & Benefit Operations) - Community Health Improvement Services calculations are derived from direct and indirect costs associated with community benefit activities that are aligned with the hopital's 2013 community health needs assessment. These activities are carried out to improve community health and wellness and extend beyond patient care, beyond the walls of the hospital.Community Benefit Operations calculations are derived from costs associated with assigned staff and community health needs and/or assets assessment, as well as other costs associated with community benefit strategy and operations. Line 7f (Health Professional Education) - community benefit expense was derived using the organization's cost accounting system.Line 7g (Subsidized Programs) - community benefit expense was derived using the organization's cost accounting system. The expense relates to specific outpatient programs. There are no costs attributable to physician clinics reported as subsidized health services in Part I, line 7g.Line 7h (Research) - community benefit expense was derived using the organization's cost accounting system. In addition to the research costs reported on line 7h, there was $790,700 of expenses related to Industry-sponsored grants that we believe should be treated as community benefit expense because they were incurred to promote the health and well-being of the local population and are a key component of our commitment to the community. Part I, Ln 7 Col(f): In fiscal year 2013, the organization adopted the provisions of Accounting Standards Update 2011-07, Health Care Entities (Topic 954), Presentation and disclosure of Patient Service Revenue, Provision for Bad Debts, and the Allowance for Doubtful Accounts for Certain Health Care Entities on October 1, 2012. The update changed how the provision for bad debts is reported on the audited financial statements. In prior years it was included with total operating expenses, and subtracted from total expenses reported in Part IX, Line 25, column (A) for the purpose of calculating the percentages in Part I, Line 7, column (f). Beginning in 2013, the provision for bad debts was reported as a deduction to net patient service revenue. The 2018 provision for bad debts totaled $18,625,048 and is not included in total expenses reported in Part IX, Line 25, column (A) of Form 990 for the purposes of calculating the percentages in Part 1, Line 7, column (f) of this Schedule H. Part II, Community Building Activities: The following description is not quantified specifically in Part II of Schedule H. The hospital facility is committed to creating healthier communities and understands that many state and federal mandated community benefit programs and services are not sufficent to address ethnic, racial and economic health disparities and inequities. The hospital embraces the traditional definition of "health" to include economic opportunity, affordable housing, quality education, safe neighborhoods, food security, social and racial justice, and the arts/culture - all elements that are needed for individuals, families and communities to thrive. The hospital provides many valuable services, resources, programs and financial support - beyond the walls of the hospital and into the communities and homes of the people we serve; including grants and sponsorship of local community-based organizations and the involvement of Baystate leadership with various community boards that align with our mission. Baystate Medical Center provided $215,023 as Payment in Lieu of Taxes (PILOT) to the City of Springfield for our facilities at 3400 Main Street & 11 Wilbraham Road. Baystate Medical Center provided $39,465 as a Payment in Lieu of Taxes (PILOT) to the City of Chicopee for our employee parking lot located at Center Street, Chicopee. The hospital facility is a dues paying member of the Economic Development Council of Western Massachusetts (EDC) and the Springfield Regional Chamber of Commerce. The hospital participates in the EDC and local Chamber as we are the largest employer in our region. The Chamber and its membership coordinate activities toward a common purpose of sustainability and economic growth for the region. Part III, Line 4: The cost of bad debts reported in Part III, line 2 was calculated by applying a ratio of cost to charges (based on the organization's cost accounting system including all hospital inpatients and outpatients) against total patient bad debt net of recoveries as reported in the audited financial statements. The portion of bad debt that reasonably could be attributable to patients who may qualify for financial assistance under the hospital's charity care program (reported in Part III line 3) was calculated by applying the percentage of bad debts by zip code (for which the average household income for each zip code is less than 200% of the federal poverty level) to the total cost of bad debt reported in Part III line 2. Since this portion of bad debt is attributable to patients residing in an area where the average income is less than 200% of the Federal poverty level, it is highly likely these patients would have qualified for the organization's charity care program had they applied. For this reason, we believe the amount, totalling $798,637, should be treated as community benefit expense in Part I. As noted above, the organization adopted Accounting Standards Update 2011-07 effective October 1, 2012, which changed the way entities report and disclose certain financial information including the provision for bad debts. See footnote #2 (Significant Accounting Policies) on page 12 and 13 of the audited financial statements under the caption "Allowance for Uncollectible Accounts" for a description of the organization's reporting of its provision for bad debts.If a patient is determined eligible for financial assistance, the appropriate adjustment is made to the patient account based on their income level. Once the necessary approvals are obtained, it then flows to the general ledger. Patients applying for a prompt payment discount will have this allowance entered after agreed upon payment is received. Part III, Line 8: Line 6 - included all Medicare allowable costs as calculated in Worksheets D-1 Part II (inpatient and inpatient psych), D Part V (outpatient) and E Part A (organ acquisition) of the hospital's 2018 Medicare cost report, net of Medicare costs reported in Part 1, line 7g, and based on Medicare costing principles. There is no shortfall reported on line 7. Part III, Line 9b: For patients who are known to qualify for Charity Care or Financial Assistance: The patient may have requested assistance up front at time of service with a Financial Counselor or the Patient could have asked for assistance after receiving their bill by contacting our Patient Billing Services Representatives. The Financial Counselor will assist the patient in applying for the appropriate type of assistance based on their income and circumstances. Once approved for a State Medicaid or other program, all billing and collection activity will stop (except for required co-payments or deductibles).For all other patients, our statements contain information regarding how to apply for financial assistance. Notices concerning availability for assistance are also posted at patient care sites. Part VI, Line 2: The Baystate Board Governance Committee convenes semi-annually and is charged with advocating for community benefits at the Board level and throughout the health system and broader community; aligning the system's four (4) hospital-specific community benefits implementation strategies into the health system's strategic plan; review of CHNA data; approval of a community benefits mission statement and health priorities; review impacts of community benefits activities and investments; and ensure Baystate's community benefits are in compliance with guidelines established by the MA Attorney General and IRS. Annually, the Office of Government and Community Relations provides updates to the Baystate Board of Trustees, Baystate President's Cabinet, and other Baystate leadership teams, as requested. The hospital Community Benefits Advisory Council (CBAC) continues to bring a community lens and filter for the hospital's health priorities. The CBAC provides a community perspective on how to increase wellness and resilience opportunities for optimal health for an entire population; guidance in matching hospital resources to community resources, thus making the most of what is possible with the goal to improve health status and quality of life; and policy advocacy to assure and restore health equity by targeting resources for residents. Participants on the hospital CBAC represent constituencies and communities served by the hospital. CBAC members are responsible for reviewing community needs assessment data and use this analysis as a foundation for providing the hospital with input on its community benefits planning process. Part VI, Line 3: Baystate Medical Center (BMC) is committed to ensuring that patients in its community have access to quality health care services with fairness and respect without regard to the patients' ability to pay. The hospital recognizes that the cost of necessary health care services can impose a significant financial burden on patients who are uninsured or underinsured and acts affirmatively to lessen that burden by offering patients in need the opportunity to apply for free or reduced cost services. The hospital not only offers free and reduced cost care to the financially needy as required by law, but has also voluntarily established discount and financial assistance programs that provide additional free and reduced cost care to more patients residing within the communities served by the hospital.The hospital recognizes that the billing and collection process can be bewildering and burdensome for patients and has implemented procedures to make the process understandable for patients; to inform patients about discount and financial assistance options; and to ensure that patients are not subject to aggressive collection activities. Consistent with its patient commitment the hospital is required to maintain a financial assistance policy and a billing and collection policy that reflects its financial assistance options and patient billing and collection procedures and complies with applicable state and federal laws and regulations.The hospital has financial counselors available to help patients apply for financial assistance programs that may cover unpaid hospital bills, including a variety of federal and state programs as well as financial assistance through the hospital. Hospital financial counselors have all been trained and certified by the state as Certified Account Counselors to assist patients in applying for available state and federal programs. The hospital is committed to ensuring that patients or prospective patients in the community are aware of financial assistance programs. For uninsured or underinsured patients, the hospital will assist in applying for available financial assistance programs. The hospital notifies patients of the availability of assistance in both the initial bill sent to patients as well as in general notices posted throughout the hospital.When applicable, the hospital also assists patients in applying for coverage of services as a Medical Hardship based on the patient's documented income and allowable medical expenses. The hospital provides, upon request, specific information about the eligibility process to be a Low Income Patient under either the Massachusetts Health Safety Net Program or additional assistance for patients who are low income through BMC's own internal financial assistance program. The hospital also notifies patients about available payment plans based on their family size and income. Our Financial Assistance Policy and Billing and Collection Policy are posted on the baystatehealth.org website at https://www.baystatehealth.org/-/media/files/patients-and-visitors/billing-and-financial-assistance/baystate-health-hospitals-billing-collections-policy-91516.pdf?la=en. The goal of posting the Financial Assistance Policy and the Billing and Collection Policy is to ensure that patients or prospective patients in our community are aware of our financial assistance programs. Signs about the availability of financial assistance programs at the hospital are translated into Spanish, and Russian as Spanish and Russian are primarily spoken by more than 1000 residents or 1% of the residents in the hospital's service area. Signs are large enough to be clearly visible. Hospital signs are 8.5 x 11 inches and the header print font is 24 pts. Notice of availability of Financial Assistance Programs are posted in the following locations; inpatient, clinic, emergency department admissions and/or registration areas, central admission/registration area, patient financial counselor areas and business office areas that are open to patients. Part VI, Line 4: Baystate Medical Center is a 724-bed academic medical center (including Baystate Children's Hospital) based in Springfield, Massachusetts and is Western New England's only tertiary care referral medical center, Level 1 trauma center, and neonatal and pediatric intensive care units. Baystate Medical Center serves as a regional resource for specialty medical care and research, while providing comprehensive primary medical services to the community. The service area for Baystate Medical Center includes all 23 communities within Hampden County, including the third largest city in Massachusetts -- Springfield (population over 150,000). Three adjacent cities (Holyoke, Chicopee and West Springfield) create a densely-populated urban core that includes over half of the population of the service area (around 270,000 people). Smaller, suburban communities exist to the east and west of this central core area. Many of these communities have populations under 20,000 people. Urban areas, as defined by the U.S. Census Bureau consist of census tracts and/or blocks meeting the minimum population density requirement (2,500-49,999 for urban clusters and over 50,000 for urbanized areas) or are adjacent and meet additional criteria. The service area has more racial and ethnic diversity than many other parts of Western Massachusetts. County-wide, 22% of the population identifies as Hispanic or Latino, 9% Black or African American, and 2% as Asian (ACS, 2010-2014). However, this diversity is not equally spread throughout the region and tends to be concentrated in the urban core. The Pioneer Valley Transit Authority, the second largest public transit system in the state, serves 11 communities in the service area and connects suburban areas to the core cities and services. Paratransit service is also available for people with disabilities within 3/4 mile of a fixed route to facilitate access to medical care. Economically, the Baystate Medical Center service area is home to many of the largest employers in the region as well as numerous colleges and universities, and provides a strong economic engine for the broader region. The largest industries and employers include health care, service and wholesale trade and manufacturing. At the same time, the county struggles with higher rates of unemployment and poverty, lower household incomes and lower rates of educational attainment as compared to the state. The median household income in the service area is about $50,000 ($17,000 less than the state) (ACS 2010-2014). The poverty rate is more than 5% higher than that statewide, and the child poverty rate is an alarming 27%, more than 10% higher than the state rate (ACS, 2010-2014). Despite being at the core of the Knowledge Corridor region, only 26% of the population age 25 and over has a bachelor's degree. Hampden County's unemployment rate of 6.8% is higher than the state average of 4.9%. The unemployment rate is based on the number of people who are either working or actively seeking work. The median age for the service area is similar to that of Massachusetts, though the population over 45 years old is growing as a percentage of the total population. Part VI, Line 5: The hospital facility has a responsibility to respond to health care needs unsupported by government programs. In exchange for this responsibility, the hospital qualifies for tax-exempt status under 501(c)(3). However, providing hospital care alone is not enough to qualify for tax-exempt status. Hospitals also must operate in the public interest and provide programs that benefit the community. The hospital is fully committed to its role in the community and serves with pride and compassion for people in need.The charitable mission of the hospital facility, a member hospital of Baystate Health (BH), is to improve the health of the people in our communities every day, with quality and compassion. The hospital's Community Benefits Mission is to reduce health disparities, promote community wellness and improve access to care for vulnerable populations. The hospital is committed to meeting the identified health and wellness needs of constituencies and communities served through the combined efforts of Baystate Health's member organizations, affiliated providers, and community partners.The hospital facility meets all of the factors required of medical facilities in order to maintain tax exemption, as first described in Revenue Ruling 69-545. In support of patient care and the medical needs of the communities served by the hospital, medical staff membership and privileges are extended to all qualified physicians and practitioners in western Massachusetts who meet the requirements for credentialing and clinical privileges, whether employed by a related Baystate entity or community-based. The hospital's emergency department is open to all in need of care and services; no one requiring emergency care is denied treatment. In addition, surplus funds from operations are generally applied, as permitted, to the following; improvements in patient care, expansion and renovation of existing facilities, purchase and replacement of equipment, debt service, expenses associated with training of physicians and other health care professionals, professional development of medical and other clinical staff, and the support of scientific, translational, and clinical research.Baystate Health's volunteer Board of Trustees, the governing body of the organization, is comprised of the President and Chief Executive Officer of Baystate Health and up to twenty-two (22) other elected Trustees who are representative of the broad range of interests which exist in the communities served by Baystate Health and its affiliates. The Governance Committee oversees the nomination of Trustees and submits recommendations to the Board of Trustees for membership on the various Board committees. In considering nominations or recommendations for trustees, directors, committee members or officers the Governance Committee select nominees who are representative of the various and diverse constituencies served by Baystate Health and its affiliates. In particular the Committee nominates persons who are representative of the community consumer interests of the various neighborhoods and localities which are served by Baystate Health in the carrying out of and pursuant to the charitable mission of the Baystate Health and its affiliates.The hospital's Patient and Family Advisory Council facilitate patients and families to share information and advise the hospital regarding policies and programs. Information from the Council provides hospital leadership with an enhanced understanding of how to improve quality, program development, service excellence, communications, patient safety, facility design, patient and family education, patient and family satisfaction, and loyalty.Please refer to the section above in line 2 for additional examples of the hospital's responsiveness to the community and opportunities for community involvement; including the Board of Trustees' Governance Committee, Community Benefits Advisory Council, and Community Health Needs Assessment. For additional information, please see Line 6 below. Part VI, Line 6: Baystate Health, Inc. is the parent entity of a multi-institutional integrated delivery system composed of four hospitals and other 501(c)(3) organizations. The four hospitals are Baystate Medical Center, Inc., Baystate Franklin Medical Center, Baystate Noble Hospital Corporation, and Baystate Wing Hospital Corporation (and Baystate Mary Lane Outpatient Center); the other 501(c)(3) organizations include Baystate Medical Practices, Inc., Visiting Nurse Association and Hospice of Western New England, Inc., Noble Visiting Nurse Services, Inc., Baystate Administrative Services, Inc., Baystate Total Home Care, Inc., Westfield Medical Corporation and Baystate Health Foundation, Inc. In addition to its 12,000 employees, Baystate Health has medical staff, nurses, residents and fellows, medical students, nursing students, and allied health students who gain comprehensive medical education during the year. A recognized leader in educational innovation, Baystate Medical Center has been training doctors since 1914. Now the regional campus of the University of Massachusetts Medical School, we offer: 10 ACGME-accredited residencies; 20+ fellowships; 50 4th-year electives for medical students; and Population-based Urban and Rural Community Health (PURCH)-a curriculum track of the University of Massachusetts Medical School. We are a nationally accredited provider of continuing education for the entire team of health care professionals. Continuing education is provided through regional conferences, grand rounds, and internet courses. We offer clinical practicums for baccalaureate, masters, or doctoral-level nursing students at affiliated schools of nursing. We offer four pharmacy residencies-two PGY1 programs and two PGY2 programs-through our affiliations with the Massachusetts College of Pharmacy and Health Science, and Western New England University College of Pharmacy and Health Science. We also offer Advanced Practitioners education including: Midwifery Education Program, Physician Assistant Residency in Emergency Medicine, and Clinical rotations for Advanced Practice students. Volunteers enhance the work of our employees and interactions with our patients and families. In 2018, more than 900 volunteers donated over 100,000 hours showing their belief in the care we provide to our community.Baystate Medical Center (BMC) is a 724-bed, 57-bassinet, academic medical center in Springfield, Massachusetts. As a major referral care center and the only Level 1 trauma center and pediatric trauma center for western Massachusetts, BMC has one of New England's busiest emergency rooms. In addition, the medical center offers the Baystate Children's Hospital, Baystate Heart & Vascular Program and the Baystate Regional Cancer Program, among other advanced specialty medical, behavioral health, diagnostic, and surgical services.Baystate Children's Hospital, part of Baystate Medical Center, is the only accredited full-service children's hospital and pediatric-specific emergency department in western Massachusetts. It provides primary and advanced medical care to babies, children, adolescents, and their families.Baystate Franklin Medical Center, located in Greenfield, Massachusetts, is an 89-bed acute care hospital that boasts a state-of-the-art surgical center. The hospital provides comprehensive inpatient and outpatient services including 24-hour emergency, heart & vascular, cancer care, behavioral medicine, and family-centered obstetrical care.Baystate Noble Hospital, a 97-bed community hospital located in Westfield, Massachusetts, offers a variety of inpatient and outpatient services for over 80,000 residents in the Westfield, Massachusetts area including surgery, pulmonary rehabilitation and acute inpatient rehabilitation, cardiac, behavioral health, and emergency care. Baystate Noble Hospital's network also includes Noble Medical Group Primary Care physicians and specialists, Visiting Nurse Association and Hospice of Western New England, Noble Visiting Nurse Services, Inc., and Noble Sports & Rehabilitation Center.Baystate Wing Hospital, a 74-bed community hospital located in Palmer, Massachusetts, offers 24-hour emergency care and a broad range of inpatient and outpatient medical and surgical services, including comprehensive outpatient behavioral health and addiction recovery services. Satellite facility Baystate Mary Lane Outpatient Center offers 24-hour emergency services, and outpatient medical, surgical, ancillary, and cancer care.Baystate Medical Practices (BMP) is a multi-specialty group of over 950 physicians and advanced practice clinicians in primary care, specialty, and surgical disciplines with more than 100 practices across 85 locations. BMP offers patient-centered care, including: family practice, internal medicine and pediatric providers, community health centers, urgent care clinics, suburban and rural practices. Many sites are designated Patient Centered Medical Homes, signifying our emphasis on communication with patients, collaboration among providers, and continuity of care. BMP's policy is to provide care to any patient in need of medical care, regardless of the patient's ability to pay for such care. Dependent upon the patient's financial capability to pay and consistent with BH and BMP policy, BMP may provide such care free of charge or at amounts below its normal charges. In 2018 BMP provided $1,475,687 in charity care. In addition to the charity care provided to patients, BMP's physicians participate in many and varied ongoing community outreach initiatives in the areas of education, employment, safety and health. BMP has also taken a leadership role in strengthening the health of disadvantaged citizens in surrounding communities including specific focus on AIDS and HIV and by providing physician staffing for three community-based health centers through Baystate Medical Center.Visiting Nurse Association and Hospice of Western New England and Noble Visiting Nurse Services, Inc. provide the highest quality care and supplies to patients and families, primarily in their homes. They are a comprehensive in-home health care, hospice, and palliative care agency with a staff of over 450 managing more than 90,000 visits annually. Our home health team works together to ensure a safe and swift recovery from illness, accident, or surgery in the comfort of home. Visiting Nurse Association and Hospice of Western New England, and Noble Visiting Nurse Services, Inc. offers medical expertise through our extensive network of caregivers to support patients facing a serious or life limiting illness. Each patient and family is cared for by our certified and experienced nurses, therapists, social workers, hospice aides, spiritual and bereavement counselors, and volunteers. This care team works together, with both the patient and family, to bring understanding, comfort, dignity and a sense of peace, as each patient journey towards the final stage of life.Baystate Reference Laboratories, part of Baystate Health, is the region's largest reference laboratory and is staffed by 24 board-certified pathologists and over 500 technologists and support personnel.In addition to the brief descriptions of some of the affiliated entities above, this further information speaks to activities of Baystate Health and its affiliates regarding promotion of community health.In 2018, over 170,700 language interpreter sessions helped patients and families better understand their care. Staff interpreted about 59 languages in person, over the phone, and via video, and translated 3,264 pages of patient-related information. In partnership with the University of Massachusetts Medical School, Baystate Health is now the regional campus for an innovative new curriculum track called PURCH (Population-based Urban and Rural Community Health). The PURCH track focuses on addressing the social determinants of health for our patients. Forty-eight students are currently enrolled in PURCH; twenty-nine are Massachusetts residents. The PURCH track is designed to prepare students to care for Baystate's diverse patient populations by providing classroom and clinical experiences in a variety of clinical settings, led by faculty who have expertise in population health and clinical effectiveness research. The goals of the program are to increase access to students in Massachusetts seeking an affordable medical education; to respond to the health care needs of the Commonwealth by increasing the number of Massachusetts physicians trained in urban and rural primary care; and to apply proven academic research methods to improve population health, reduce health disparities, and make health care better integrated, more efficient, and more effective. Form 990, Schedule H, Part VI, Line 6 continued The Nurse Residency Program expanded to all Baystate Health hospitals. Baystate's Nurse Residency Program is a one-year program for newly graduated registered nurses, offering hands-on clinical experience, in-depth learning through monthly seminars, participation in evidence-based projects, and ongoing professional development. Baystate Health is committed to continuing education programs in 30 different professional areas through partnerships with Elms College, Springfield College, Western New England University, STCC, Greenfield Community College, Holyoke Community College, Westfield State University, and many others. Our post graduate programs expanded to 10 medical residencies and 20 fellowships, including new fellowship training programs in hospital medicine and gastroenterology. Baystate Springfield Educational Partnership (BSEP) ran courses for 307 students, primarily residents of Springfield. During the summer, BSEP provided theme-based workshops for 66 students, coordinated 13 summer internships at Baystate Medical Center and placed 16 students in work experiences as part of the Workforce Innovation and Opportunity Act program and the YouthWorks program, both sponsored by the Regional Employment Board of Hampden County and awarded 18 BSEP alumni with a total of $25,000 in scholarships for undergraduate and graduate education. Baystate Health and its affiliates are committed to providing the communities they serve throughout western Massachusetts with the resources necessary to stay informed and healthy by providing both basic and extensive educational opportunities such as parent education classes, including "Baystate's New Beginnings". Also offered are breastfeeding classes, prenatal/postnatal classes, and infant/toddler safety classes. Some classes are free while others are offered at a reasonable fee. No one is turned away due to inability to pay. Baystate Health offers many free parenting support groups including breastfeeding gatherings, new parents groups, toddler groups, parents of multiples groups, and a MotherWoman support group. Most of these groups meet weekly. In addition, Baystate Health has a health science library staffed by professionals who help patients, families and the general public access reliable health information.Baystate Medical Center provided a safe way to dispose of unwanted medications and sharps. Community members now have a resource for safely and confidentially throwing away household sharps (needles and other sharp or glass medical tools), thanks to collection receptacles now installed in the Daly lobby at Baystate Medical Center. These secure kiosks are available to the community 24 hours a day, seven days a week. With the help of Baystate Franklin Medical Center's EMPOWER (Engaging Mothers for Positive Outcomes With Early Referrals) program, a team of nurses and doctors at Baystate Medical Center implemented an innovative program called "rooming-in" where babies at risk for neonatal abstinence syndrome (a condition where babies need treatment for symptoms of withdrawal after birth) stay in a private hospital room with their mothers after birth. The program allows mothers to care for their babies while receiving specialized nursing support. Results of the program show that babies are requiring less to no medication to treat withdrawal symptoms and their hospital lengths of stay are shorter. This was a wonderful example of collaboration between the two hospitals, utilizing Baystate Franklin's expertise and working together to address the Opioid crisis in our communities. Baystate Health certified Specialty Pharmacy liaisons continue to help patients save dollars in out-of-pocket medication expenses. Liaisons are located in multiple outpatient practices including the Children's Specialty Center, the D'Amour Center for Cancer Care, and Baystate Franklin Medical Center to help ensure patients have access to critically needed and often expensive medications. The Mini-Medical School program is an eight-part health education series offered at Baystate Medical Center featuring a different aspect of medicine each week. Designed for an adult audience, each course is taught by an energetic faculty member who will explain the science of medicine without resorting to complex terms. Mini-Medical School gives Baystate Health the opportunity to open our doors to the public and share our knowledge of medicine in a comfortable and friendly environment. Many of the students participate due to a general interest and later find that many of the things they learned over the semester are relevant to their own lives. The goal of this program is to help members of the public make more informed decisions about all aspects of their health care while receiving insight on what it's like to be a medical student. Tuition is $95 per person, $80 for Senior Class and Every Woman members. Mini Medical School Alumni is now over 2,000 members. Baystate Health offers 50+ free programs to seniors and women. Baystate Health Senior Class is a loyalty program dedicated to health and wellness for men and women ages 55 and over. The 21,300 Senior Class members receive a quarterly newsletter with valuable health information, benefits and invitations to special events designed with their interests in mind. Baystate Every Woman Loyalty Program offers its 15,730 members 50+ monthly seminars with direct access to physicians, nurses and other medical professionals and the latest women's health information. The program is designed to increase knowledge of women's health issues so they are well prepared to make the best decisions regarding their health.Baystate Home Buying Program helped employees purchase their first homes. In 2018, 20 employees were awarded forgivable loans to purchase their first home through the Mark R. Tolosky Baystate Neighbors Program. This Baystate Health benefit provides forgivable loans to employees purchasing their first homes in the communities surrounding Baystate Health hospitals. To-date, the program has provided more than $1.8 million in forgivable home loans.Since its inception in 1994, Rays of Hope has been helping women and men in the fight against breast cancer by walking alongside them on their cancer journey. Through the Baystate Health Breast Network, Rays of Hope cares for the whole person from diagnosis and beyond by supporting research at the Rays of Hope Center for Breast Cancer Research, providing funding for state-of-the-art equipment, breast health programs and outreach and education throughout Baystate Health as well as providing grants for complementary therapies and cancer programs to our community partners throughout western Massachusetts. Now in its 25th year, Rays of Hope has raised over $14.8 million to date. All funds raised remain local in western Massachusetts. The United Way develops and supports programs that directly improve the lives of people in our communities, a mission proudly shared by Baystate Health. Baystate Health is a strong supporter of the United Way, and a major contributor to the organization with workforce campaigns and thousands of employee donors and volunteers. Baystate Health's contributions help the United Way serve our families, friends, colleagues and others who seek help in different ways and at different times in their lives. Three community campaigns are held annually: Springfield, Westfield, and Palmer workplace to support the United Way of Pioneer Valley, Greenfield workplace to support the United Way of Franklin County and Ware workplace to support the United Way of Hampshire County. Employees can direct their donations to one or all of the United Way's action areas: Education, Income and Health or designate to a qualified agency with a minimum contribution.See also additional information regarding Baystate Health, Inc. and its affiliate's promotion of community health above in Line 5. Form 990, Schedule H, Part VI, Line 7 List of States Receiving Community Benefit Report: MA 1 Cancer Connection Inc 41 Locust Street Northampton MA 01060 043493483 501(c)(3) 36392 Support groups, complementary therapies, workshops and classes for women living with breast cancer and their families and caregivers. Baystate Health Inc 759 Chestnut Street Springfield MA 01199 042105941 501(C)(3) 15663000 Strategic initiatives Pioneer Valley Riverfront Club 121 West Street Springfield MA 01104 260251831 501(c)(3) 20729 Breast cancer survivors dragon boat team. YMCA of Greater Springfield 275 Chestnut Street Springfield MA 01104 041859893 501(c)(3) 34545 Breast cancer survivors excercise program. CHD Cancer House of Hope Inc 1999 Westfield Street West Springfield MA 01089 042503926 501(C)(3) 17859 Funding expenses of the most well-attended CHH programming utilized by women with breast cancer. Breast cancer survivors dragon boat team 6 0 Art therapy workshops for breast cancer survivors 1 11800 Yoga and water dance for breast cancer survivors 1 8130 Water fitness classes for women with breast cancer 1 10428 Part I, Line 2: Explanation: The Rays of Hope grants that are awarded are reviewed and approved by the Rays of Hope Community Advisory Board. Recipients are required to submit a Community Program Grant Application. As part of the application process the recipient is required to provide their SSN or EIN. Once the grant is awarded by the Advisory Board quarterly reports are submitted by the recipient to monitor the grant. A final report of the grant program and budget summary is due upon completion of the program. Part III For items in Part III the number of recipients are not easily quantified. Items are purchased in bulk and distributed as needed. X X X X 0 1 0 0 0 0 0 0 0 Grace Makari-Judson MD Trustee/Hematologist (thru 12/31/17) 291317 0 44081 0 4970 0 56259 0 21686 0 418313 0 0 0 Kevin P Moriarty MD Trustee/Chief Ped Surg 543203 0 100207 0 43039 0 22950 0 15312 0 724711 0 0 0 Mark A Keroack MD Trustee 0 1001554 0 525000 0 362240 0 17550 0 15312 0 1921656 0 0 Michael P Albert MD Trustee 288237 0 39432 0 3722 0 37250 0 22726 0 391367 0 0 0 Nancy Shendell-Falik President 0 554723 0 262899 0 22523 0 185570 0 25468 0 1051183 0 0 Dennis Chalke Treasurer 0 518753 0 189630 0 286276 0 58410 0 28598 0 1081667 0 0 Kristin R Delaney Clerk 0 128397 0 14975 0 606 0 13738 0 23774 0 181490 0 0 Christine Klucznik VP/ CNO 0 295998 0 61656 0 4261 0 22167 0 4792 0 388874 0 0 Tejas Gandhi VP/ COO 0 406015 0 107625 0 918 0 17550 0 22468 0 554576 0 0 Peter Friedmann MD Assoc Dean Chief Res Officer 332576 0 70686 0 1971 0 25238 0 23150 0 453621 0 0 0 Douglas Salvador MD SVP/ Chief Quality Officer 148216 162047 0 81839 500 3495 0 17550 9279 9370 157995 274301 0 0 Peter Lindenauer MD Asst Dean Population Health 294510 0 45183 0 31097 0 29448 0 20223 0 420461 0 0 0 Vishal Tiwari MD Assoc Med Dir Hosp Care Mgmt 302294 0 19393 0 10264 0 13500 0 20982 0 366433 0 0 0 Amy Gottleib MD Assoc Dean Chief Fac Devel 270890 0 56700 0 1348 0 17550 0 2854 0 349342 0 0 0 Deborah A Provost Former Chief Regulatory Officer 227879 0 33719 0 22341 0 60873 0 13291 0 358103 0 0 0 Part I, Line 3 The compensation committee of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs) has been appointed through board resolution as the compensation committee of the filing organization. This committee consists entirely of individuals serving on the board of Baystate Health, Inc. The individuals responsible for deliberating the compensation arrangement for the President and CEO would be those individuals who do not have a conflict of interest with respect to the compensation arrangement and would be considered independent for compensation deliberation purposes. The compensation of the President and CEO is established based on information provided by independent third party consultants for reasonableness and appropriate comparability data. The compensation is then established, reviewed and approved by the duly authorized compensation committee of Baystate Health, Inc. and all such deliberations and decisions are documented contemporaneously. Part I, Line 4b Michael Albert, MD - Supplemental Retirement of $5,761 is included in column B. This amount was earned and paid in 2017. Dennis W. Chalke - Supplemental Retirement of $186,459 is included in column B. This amount was earned and paid in 2017. Peter Friedmann, MD - Supplemental Retirement of $7,688 is included in column B. This amount was earned and paid in 2017. Mark A. Keroack, MD - Total Supplemental Retirement of $334,356 is included in column B. This amount was earned in 2017. Christine E. Klucznik, MD - Total Supplemental Retirement of $4,617 is included in column B. This amount was earned in 2017. Peter Lindenauer, MD - Supplemental Retirement of $6,845 is included in column E. This amount was earned and paid in 2017. Grace Makari-Judson, MD- Supplemental Retirement of $9,031 is included in column B. This amount was earned in 2017. Kevin P. Moriarty, MD - Supplemental Retirement of $39,037 is included in column B. This amount was earned and paid in 2017. Douglas Salvador, MD - Supplemental Retirement of $6,312 is included in column B. This amount was earned and paid in 2017. Nancy Shendell-Falik- Supplemental Retirement of $168,020 is included in column C. This amount was earned in 2017. A MA Health & Educ Facil Authority - Ser G 042456011 57586CNHA 2005-10-27 71740000 MA HEFA Series G - See Part VI 0 0 0 B MA Health & Educ Facil Authority - Ser H 042456011 2007-01-18 10000000 MA HEFA Series H - See Part VI 0 0 0 C MA Health & Educ Facil Authority - Ser M2 042456011 2008-06-30 10157671 MA HEFA Series M2 - See Part VI 0 0 1 D MA Health & Educ Facil Authority - Ser IJK 042456011 57586EKC4 2009-06-25 198611250 MA HEFA Series IJK - See Part VI 0 0 0 A 38840000 71740000 735004 6990000 64014996 2005 0 1 1 1 B 7777778 10000000 72250 9927750 2006 0 0 1 1 C 5727122 10157671 43671 10114000 1999 1 0 1 1 D 199122425 1845403 93479 132183543 65000000 2012 1 0 1 1 A 0 0 1 1 1 1 0.00020 0.00010 0.00030 0 0 1 B 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 D 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 1 1 Citibank 20.700000000000 0 0 0 0 1 B 0 0 1 0 1 0 0 0 1 C 0 0 0 1 1 0 0 0 1 D 0 0 0 1 1 0 0 0 1 A 1 B 1 C 1 D 1 Date Rebate Computation Performed Issuer Name: MA Health & Educ. Facil. Authority - Ser. G Date the Rebate Computation was Performed: 09/27/2006 Issuer Name: MA Health & Educ. Facil. Authority - Ser. M2 Date the Rebate Computation was Performed: 06/18/2013 Issuer Name: MA Health & Educ. Facil. Authority - Ser. IJK Date the Rebate Computation was Performed: 08/24/2012 Bond Issues Supplemental Information A - MHEFA Series G Bonds Part I - Per the Official Statement, the purpose of the bond proceeds is: (i) to advance refund $61,930,000 principal amount of the Authority's Revenue Bonds, Baystate Medical Center (the Institution) Issue, Series E (the "Series E Bonds"), which were issued July 11, 1996 to finance or refinance the following property owned by the Institution: (a) construction of a new 104,500 gross square foot Ambulatory Care Center at 3300 Main Street, Springfield, Massachusetts; (b) construction of a new 100,000 gross square foot building to house the Ambulatory Surgery Center, Medical Library and education/conference space on the Institution's North campus located at 759 Chestnut Street, Springfield, Massachusetts; (c) renovation of various existing spaces within the Institution's North campus; and (d) acquisition of equipment for the new facilities; (ii) to finance routine capital construction, renovations, and equipping of various facilities of the Institution; and (iii) to pay certain costs of issuance of the Series G Bonds. B- MHEFA Series H Bonds Part I - Per the Official Statement, the purpose of the bond proceeds is: (i) the construction, improvement, equipping, and other related capital expenditures of a parking garage walkway, and other related work at an existing building at 280 Chestnut Street owned and used by the Institution, and (ii) the acquisition and installation of capital equipment and renovations to existing facilities of the Institution and other routine capital expenditures in connection with the Institution's hospital operations. C- MHEFA Series M-2, Pool 2 Part I - Per the Loan Document the purpose of the bond is to refinance Baystate Medical Center's MHEFA Pool J-2 Loan, which was issued February 2, 1999 to finance the acquisition and equipping of the property located at 280 Chestnut Street, Springfield, Massachusetts (the "Property"), and the renovation of the Property and existing facilities of the Institution and the acquisition of capital equipment for the Institution's existing facilities. The MHEFA indebtedness listed is a pool loan; therefore the issue price, Parts I, II, III, and IV (Lines 5-7) are being answered with respect to the Baystate Medical Center loan alone rather than with respect to proceeds loaned to other conduit borrowers. The actual date of issue of the MHEFA Series M2 Bonds was 5/30/2002, and the CUSIP number shown on Form 8038 was 57585KA57. While that issue was not a refunding issue, the purpose of the loan taken by BMC was to refund prior debt, as reflected in our response to Part II, Line 14. Accordingly, Part III has not been completed, as the original project was financed with bonds issued prior to 2003. D- MHEFA Series I, J-1, J-2, K-1, K-2 Part I - Per the Official Statement, the purpose of the bond proceeds is: (i) to pay a portion of the costs associated with the acquisition of land, site development, construction or alteration of buildings or the acquisition or installation of furnishings and equipment, refinancing of, or any combination of the foregoing, in connection with the construction, improvement, equipping, and other related capital expenditures of a seven-story, approximately 599,100 gross square foot primarily inpatient building located at 759 Chestnut Street, Springfield, Massachusetts, including demolition and site work, which building will be constructed by Baystate Total Home Care (BTHC) and leased to Baystate Medical Center by BTHC; (ii) for the acquisition and installation of capital equipment and renovations to existing facilities of the Medical Center and other routine capital expenditures included or to be included in the Medical Center's capital budget over the next three years for use in connection with the Medical Center's hospital operations; (iii) for the refinancing of a portion of an outstanding commercial loan in the amount of $65,000,000 made by Bank of America, N.A. on October 20, 2008 to the Medical Center in connection with the defeasance of the Authority's Revenue Bonds, Baystate Medical Center Issue, Series D, issued September 16, 1993; (iv) for the financing of costs associated with the issuance of bonds and; (v) financing of routine capital construction, renovations, and equipping of various facilities of Baystate Medical Center. E - MDFA Revenue Bonds, Series L Part I - Per the Official Statement, the purpose of the bond proceeds is for the construction, improvement, and other capital expenditures relating to the build-out of an equipping of certain interior space within a seven-story approximately 599,100 gross square foot primarily inpatient building owned by Baystate Total Home Care, Inc. and leased to the Institution located at 759 Chestnut Street, Springfield, Massachusetts, such build-out to consist of space to be used for the Emergency Department of the Institution and ancillary support areas and the financing costs associated with the issuance of the bonds. F - MDFA Tax Exempt Capital Lease Part I - Per the Master Lease and Sublease Agreement, the purpose of the Tax Exempt Capital Lease is for the Acquisition of Equipment. "Equipment" means the fixed and moveable personal property to be used in connection with the Sub-Lessee's health care operations identified in a Schedule executed by or pursuant to the Agency of the Lessee and the Sub-Lessee, accepted by the Lessor and acknowledged by the Escrow Agent in writing and identified as part of this Master Lease (including certain items originally financed through internal advances of the Sub-Lessee in anticipation of obtaining permanent financing through the Lessee), together with all replacement parts, additions, repairs, accessions, and accessories incorporated therein and/or affixed to such personal property and replacements and substitutions therefor and proceeds and products thereof. G - MDFA Revenue Bonds Series M - Part I - The purpose of the bond proceeds is: (i) to advance refund $39,907,339 principal amount of Massachusetts Health and Education Facilities Authority's Revenue Bonds, Baystate Medical Center (the Institution) Issue, Series F (the "Series F Bonds"), issued June 12, 2002 the proceeds of which financed the Construction of a new Cancer Center with a partial third floor medical record and support area; acquisition of a surgery center facility, certain renovations and equipment acquisitions; and (ii) finance costs of issuance relating to the Bond. H - MDFA Revenue Bonds Series N - Part I - The purpose of the bond proceeds is: (i) capital expenditures, including capitalized interest, in connection with the following projects (the "Project"); a) the build-out of and equipping of certain interior space within a seven-story, approximately 599,100 gross square foot primarily inpatient building owned by BTHC and leased to Baystate Medical Center located at 759 Chestnut Street, Springfield, Massachusetts, such build-out to include inpatient rooms, operating rooms, and inpatient pharmacy, and b) the acquisition of medical equipment, information technology equipment, and other equipment and assets to be owned or leased and used by the Medical Center at the Medical Center's health care facilities located at 759 Chestnut Street, Springfield, Massachusetts, 3300,3350,3400 and 3601 Main Street, Springfield, Massachusetts and 50, 80, and 100 Wason Avenue, Springfield, Massachusetts, and (ii) costs of issuance relating to the Bonds. I - MDFA Revenue Bonds Series O Part I - The purpose of the bond proceeds is to indirectly finance the following: (a) the construction, improvement, equipping, and other related capital expenditures of a seven-story, approximately 599,100 gross square foot primarily inpatient building located at 759 Chestnut Street, Springfield, Massachusetts, including demolition and site work, which building was constructed by BTHC and leased to the Medical Center by BTHC; and (b) the acquisition and installation of capital equipment and renovations to existing facilities of the Medical Center and other routine capital expenditures included or to be included in the Medical Center's capital budget over a three-year period for use in connection with the Medical Center's hospital operations at the following facilities of the Medical Center: Springfield Building (including all wings and attached buildings), located at 759 Chestnut Street, Springfield, Massachusetts (the principal uses of which include Cardiac Services, Medical Services, Lab, and Inpatient Beds); Wesson Women and Infants Building, 759 Chestnut Street, Springfield, Massachusetts (the principal uses of which include Birthing Services, Neonatal Services, and Inpatient Beds); Daly Building (formerly the Centennial Building), 759 Chestnut Street, Springfield, Massachusetts (the principal uses of which include Emergency Room, Radiology, MRI, Ultrasound, Ambulatory and Inpatient Pharmacies, Lab, Operating Rooms, Inpatient Beds, ElectroPhysio Labs, ICU, and PICU); Daly Parking Garage, 759 Chestnut Street, Springfield, Massachusetts (a patient and visitor parking garage); D'Amour's Center for Cancer Care, 3350 Main Street, Springfield, Massachusetts (primarily used for Clinical Cancer Services); Chestnut Building, 759 Chestnut Street, Springfield, Massachusetts (primarily used for Ambulatory Surgery, Library, and Simulation Center); and Whitney Avenue Building (specifically capital expenditures related to information technology), 361 Whitney Avenue, Holyoke, Massachusetts (used for general health system purposes). J - MDFA CoGen Lease A Part I - The purpose of the lease is to finance the construction of an approximately 5,000 square foot co-generational, combined heat and power plant providing electricity, chilled water and steam to the facilities of the Institution. K - MDFA LA #1 Lease B Part I - The purpose of the lease is to finance the acquisition and installation of a linear accelerator. L - MDFA LA #2 Lease Part I The purpose of the lease is to finance the acquisition and installation of a linear accelerator. M - MDFA Series P-1 Part I - The Bond is being issued for the purpose of providing funds to refund on an advance basis a portion of the $63,380,000 aggregate stated principal amount outstanding as of the date hereof of the Revenue Bonds, Baystate Medical Center Issue, Series I (the "Refunded Bonds"), the proceeds of which were used to pay a portion of the construction costs of a new hospital building located at 759 Chestnut Street, Springfield, Massachusetts. Part I and Part II, Differences between the issue price (Part I) and total proceeds (Part II, Line 3) are due to investment earnings. Part III, Lines 4 and 5, Column D (Series IJK): As the refunded bonds were issued prior to January 1, 2003, this question is being answered solely with respect to the new money portion of the bonds. Part III, Column G (Series M): As these bonds refunded debt issued prior to January 1, 2003, the organization is availing itself of the Part III reporting exemption available for such bonds. Part IV, Line 2c, Column C (Series M-2): The Issuing Authority engages an outside consultant to prepare rebate computations. As of the most recent computation period, May 29, 2017 no rebate was owed. The cumulative rebate amount is zero as of the outside consultant's most recent report. Part IV, Line 6, Column A (Series G): This question is being answered without regard to yield-restricted advance funding escrow financed with proceeds of the bonds. A MA Development Finance Agency - Ser L 043431814 2011-11-02 25000000 MA DFA Series L - See Part VI 0 0 0 B MA Development Finance Agency - Cap Lease 043431814 2011-11-02 20000000 MA DFA Cap Lease - See Part VI 0 0 0 C MA Development Finance Agency - Ser M 043431814 2012-08-09 40137000 MA DFA Series M - See Part VI 0 0 0 D MA Development Finance Agency - Ser N 043431814 57583UN79 2014-11-06 60742119 MA DFA Series N - See Part VI 0 0 0 A 3887363 25022063 168438 24853625 2012 0 0 1 1 B 19487305 20013326 20013326 2012 0 0 1 1 C 7220000 40137000 229661 39907339 2004 1 0 1 1 D 60786027 753513 60032514 2016 0 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 0 1 0 1 0 0 0 1 C 0 0 1 0 1 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 A MA Development Finance Agency - Ser O 043431814 000000000 2016-05-12 20000000 MDFA Series O-see Part VI 0 0 0 B MA Development Finance Agency - Cap Lease 043431814 000000000 2016-09-22 14062890 MDFA CoGen Lease - See Part VI 0 0 0 C MA Development Finance Agency - Cap Lease 043431814 000000000 2016-12-29 3000000 MDFA LA #1 Lease - See Part VI 0 0 0 D MA Development Finance Agency - Cap Lease 043431814 000000000 2017-11-15 2937110 MDFA LA #2 Lease - See Part VI 0 0 0 A 1941706 20000000 20000000 2016 0 0 1 1 B 2636389 14076660 14076660 2017 0 0 0 1 C 715816 3000772 3000772 2017 0 0 0 1 D 329090 2939696 2939696 2017 0 0 0 1 A 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 A MA Development Finance Agency - Ser P-1 043431814 000000000 2017-12-21 40595000 MA DFA Series P-1 - See Part VI 0 0 0 A 1279609 40595000 39871232 2193327 2017 0 1 1 1 A 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 0 A 1 Hector Toledo Family member of Hector Toledo 18251 See Part V - Family member of Hector Toledo employed by the filing organization. 0 James R Phaneuf CIC Family member of James R. Phaneuf, CIC 52814 See Part V - Family member of James R. Phaneuf CIC is employed by the filing organization. 0 Form 990, Part VI, Section A, line 1 The filing organization has a standing executive committee, which is entitled to act between meetings of the Board, on all matters as to which the Board is entitled to act and permitted by law to delegate to a committee. The members of the executive committee are the same individuals serving on the executive committee of Baystate Health, Inc. Form 990, Part VI, Section A, line 2 Two or more of the persons listed in this Form 990 Part VII have a business relationship with each other by virtue of sitting on one or more Boards of Directors or by serving in an employment relationship with one or more entities in the Baystate Group of affiliated entities and in the community. The following trustees, officers, or key employees have a business relationship: (1) Grace P. Makari-Judson, MD, James P. Sadowsky and John H. Davis, (2) Paul R. Murphy and Robert L. Pura, PhD, (3) John F. Maybury and Mark A. Keroack, MD, (4) Hector F. Toledo and Timothy F. Farrell, (5) Claudia R. Coplein, DO and Victor Woolridge, (6) Colleen W. Holmes and James P. Sadowsky, (7) John F. Maybury and Anne M. Paradis. Form 990, Part VI, Section A, line 3 Baystate Medical Center, Inc. is affiliated with Baystate Administrative Services, Inc. (BAS) which is a 501(c) (3) organization. Information Technology, Human Resources, Finance, Treasury, Accounting and other management and support functions are delegated to BAS. Form 990, Part VI, Section A, line 6 The filing organization has one member, Baystate Health, Inc. (BH). Form 990, Part VI, Section A, line 7a The Board of Trustees of the filing organization are the same individuals serving as members of the Board of Trustees of BH with the addition of the president of the medical staff of the filing organization. The Board of Trustees of BH are elected annually by the Board of Trustees of BH at their annual meeting. Form 990, Part VI, Section A, line 8b: The Trustees of Baystate Medical Center, Inc. meet during certain scheduled Baystate Health, Inc. (BH) board meetings. The BH Board of Trustees and its committees, including the Audit and Compliance Committee, contemporaneously document meetings and actions relative to Baystate Medical Center, Inc. as well as the annual acceptance of the audited financial statements. Form 990, Part VI, Section B, line 11b Prior to the filing of this return appropriate parts of this Form 990 were reviewed by representatives from the Tax, Finance, and Human Resources Departments of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs) and by outside legal counsel. The entire return was reviewed by a tax expert from an outside accounting firm. The entire return was also reviewed prior to filing by the Audit and Compliance Committee of Baystate Health, Inc., which also includes some of the officers and trustees of the filing organization. This committee also reviews the audited financial statements for the health system. The Form 990 was provided to all members of the Board of Trustees prior to filing. Form 990, Part VI, Section B, line 12c Baystate Medical Center, Inc. is an affiliate of Baystate Health, Inc. (BH). BH and its affiliated entities have a comprehensive conflict of interest policy applicable to all of the affiliated entities. All directors, trustees, officers, key employees, and highest compensated employees of BH and its affiliates are asked to complete an annual "conflict of interest" form. We utilize an electronic database to receive and manage all conflict of interest submissions. This information is reviewed by the Chief Compliance Officer, Chief Executive Officer, Chair of the Board of Trustees, Chief General Counsel and the Chair of the Audit & Compliance Committee. A summary of the conflict of interest disclosures is provided to the Baystate Health Board of Trustees and the Tax Department. Potential conflict of interest transactions are reviewed as appropriate under the policy, which provides for recusal from discussion and deliberation by any party with a potential conflict of interest. Form 990, Part VI, Section B, line 15 The compensation of the President and CEO is reviewed and determined annually by the compensation committee of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs), which has been appointed through board resolution as the compensation committee of the filing organization. This committee consists entirely of individuals serving on the board of the filing organization. The individuals responsible for deliberating the compensation arrangement for the President and CEO would be those individuals who do not have a conflict of interest with respect to the compensation arrangement and would be considered independent for compensation deliberation purposes. The compensation of the President and CEO is established based on information provided by independent third party consultants for reasonableness and appropriate comparability data. The compensation is then established, reviewed and approved by the duly authorized compensation committee of Baystate Health, Inc. The compensation of other officers and key employees is administered under the Executive Compensation Philosophy Statement, in consultation with Human Resources, based on information provided by independent third party consultants for reasonableness including appropriate comparability data or the Baystate Health Board approved budget and wage program for each fiscal year. Line 15a has been answered No because the President and CEO is paid by Baystate Administrative Services, Inc., an affiliate and related organization of the filing organization. Form 990, Part VI, Section B, Line 16b Baystate Health, Inc. has a joint venture policy that covers affiliated tax exempt entities including Baystate Medical Center, Inc. Form 990, Part VI, Section C, line 19 The organization makes its conflict of interest policy and financial statements available to the public at www.baystatehealth.org. Articles of organization and bylaws are generally available at the Commonwealth of Massachusetts website. Form 990, Part VII, Section A, Line 5 Certain officers or trustees of the filing organization are paid by an entity, Baystate Medical Practices, Inc. (BMP) EIN 04-2888373, which is part of the health care system to which the filing organization belongs but does not meet the technical requirements as a "Related Organization" per Schedule R. Compensation from BMP to the officers and trustees of the filing organization therefore, is reported as paid from an unrelated organization in Line 5 and according to the instructions reported as though paid by the filing organization. Form 990, Part IX, line 11g BMP Support: Program service expenses 67,830,729. Management and general expenses 0. Fundraising expenses 0. Total expenses 67,830,729. Fees, Physicians: Program service expenses 8,478,232. Management and general expenses 0. Fundraising expenses 0. Total expenses 8,478,232. Fees, Laboratory & Clinical: Program service expenses 12,319,016. Management and general expenses 0. Fundraising expenses 0. Total expenses 12,319,016. Purchased Service: Program service expenses 12,212,913. Management and general expenses 4,361,283. Fundraising expenses 0. Total expenses 16,574,196. Supplementary Service: Program service expenses 6,987,874. Management and general expenses 1,894,575. Fundraising expenses 0. Total expenses 8,882,449. Temporary Help: Program service expenses 10,236,375. Management and general expenses 243,693. Fundraising expenses 0. Total expenses 10,480,068. Consulting: Program service expenses 4,364,775. Management and general expenses 2,349,115. Fundraising expenses 0. Total expenses 6,713,890. Contracted Service: Program service expenses 9,466,588. Management and general expenses 689,462. Fundraising expenses 0. Total expenses 10,156,050. Outside Services: Program service expenses 6,140,242. Management and general expenses 0. Fundraising expenses 0. Total expenses 6,140,242. Subcontractor: Program service expenses 1,306,361. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,306,361. Billing Service: Program service expenses 1,218,980. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,218,980. Transcription Service: Program service expenses 1,138,669. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,138,669. Garage Administrative: Program service expenses 398,642. Management and general expenses 842,181. Fundraising expenses 0. Total expenses 1,240,823. Form 990, Part XI, line 9: Transfer from affiliate for land, buildings and equipment 2,631,116. Transfer of funds to affiliated companies -62,665,429. Minimum pension liability adjustment 15,347,813. Funds utilized for property and equipment 3,430,205. Net assets released from restrictions from affiliates -111,055. Pioneer Valley Information Exchange LLC 101 Wason Avenue Suite 200 Springfield MA 01107 042790311 Operation of a health information exchange and related activities MA Baystate Medical Center Inc Baystate Administrative Services Inc 759 Chestnut Street Springfield MA 01199 222747685 Administrative services MA 501 (c ) (3) 12c, III Baystate Health Inc 0 Baystate Franklin Medical Center 164 High Street Greenfield MA 01301 042103575 Hospital MA 501 (c ) (3) 3 Baystate Health Inc 0 Baystate Health Foundation Inc 759 Chestnut Street Springfield MA 01199 043549011 Fundraising MA 501 (c ) (3) 7 Baystate Health Inc 0 Baystate Health Systems Inc Health & Welfare Benefits Plan 759 Chestnut Street Springfield MA 01199 222531644 Voluntary Employees' Benefit Association MA 501 (c ) (9) Baystate Health Inc 0 Baystate Health Inc 759 Chestnut Street Springfield MA 01199 042105941 Healthcare System Parent MA 501 (c ) (3) 7 Baystate Health Inc 0 Baystate Total Home Care Inc 280 Chestnut Street Springfield MA 01104 203260764 Real Estate and Other MA 501 (c ) (3) 12b, II Baystate Medical Center Inc 1 Visiting Nurse Assn and Hospice of Western New England Inc 50 Maple Street Springfield MA 01199 042105803 Homehealth and Hospice care MA 501 (c ) (3) 10 Baystate Health Inc 0 Health New England Inc Monarch Place Suite 1500 Springfield MA 011441590 042864973 HMO/Insurance MA 501 (c ) (4) Baystate Health Inc 0 Baystate Wing Hospital Corporation 40 Wright Street Palmer MA 01069 222519813 Hospital MA 501 (c ) (3) 3 Baystate Health Inc 0 HNE of Connecticut Inc Monarch Place Suite 1500 Springfield MA 011441590 465190134 HMO/Insurance CT 501 (c ) (4) Health New England Inc 0 Baystate Noble Hospital Corporation 115 West Silver Street PO Box 1634 Westfield MA 010861634 222537423 Hospital MA 501 (c ) (3) 3 Baystate Health Inc 0 Westfield Medical Corporation 115 West Silver Street PO Box 1634 Westfield MA 010861634 043127730 Healthcare MA 501 (c ) (3) 12a, I Baystate Noble Hospital Corporation 0 Noble Visiting Nurse Services Inc 77 Mill Street Westfield MA 01085 222757446 Homehealth and Hospice care MA 501 (c ) (3) 10 Visiting Nurse Assn and Hospice of Western New England Inc 0 HNE Advisory Services Inc Monarch Place Suite 1500 Springfield MA 011441500 043012347 Administrative Services MA HNE Holding Corporation C 0 HNE Insurance Services Inc Monarch Place Suite 1500 Springfield MA 011441500 043183019 Ancilliary Insurance MA HNE Holding Corporation C 0 Ingraham Corporation 759 Chestnut Street Springfield MA 01199 043016257 Health care and other business activities MA Baystate Health Inc C 0 HNE Holding Corporation Monarch Place Suite 1500 Springfield MA 011441500 464620480 Holding shares in subsidiary corporation MA Health New England Inc C 0 HNE Insurance Company Inc Monarch Place Suite 1500 Springfield MA 011441500 454462433 Health Ins svcs for Mass Medicare supplement members MA HNE Holding Corporation C 0 Baystate Health Insurance Company LTD North Church St Georgetown CJ 980421413 Offshore captive insurance CJ Baystate Health Inc C 0 0 1 1 0 0 0 0 0 0 1 1 1 1 0 0 0 1 1 1 Health New England Inc Q 185076145