2018-05-15T12:04:48-05:00 2017-06-30 990 2016-07-01 043398280 THE MERCY HOSPITAL INC MERC 4135392689 1221 MAIN STREET NO 213 HOLYOKE MA 010405396 DEAN VITARISI VP FINANCE 4135392689 2018-05-15 2016 2022-09-23 18:48:47Z SEE SCHEDULE O MARK FULCO 271 CAREW SPRINGFIELD MA 01104 321701120 0 0928 X WWW.MERCYCARES.COM X 1898 MA TO PROVIDE HEALTH CARE AND HOSPITAL SERVICES 12 10 2543 161 2177196 -553970 5453463 3833917 264376895 302584733 -96410 142101 4359560 14958135 274093508 321518886 83294 263429 0 0 126685868 140445351 0 0 0 148354570 161198784 275123732 301907564 -1030224 19611322 269258285 365185233 114227998 182776035 155030287 182409198 X WE, SISTERS OF PROVIDENCE HEALTH SYSTEM AND TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES. WE ARE SUSTAINED BY AN UNWAVERING TRUST IN GOD'S PROVIDENCE. THE MERCY HOSPITAL IS A MEMBER OF TRINITY HEALTH OF NEW ENGLAND AND TRINITY HEALTH. 0 0 255726834 263429 313384640 THE MERCY HOSPITAL IS A FULL-SERVICE ACUTE CARE HOSPITAL IN SPRINGFIELD, MASSACHUSETTS. THE ACUTE PROGRAMS AND SERVICES INCLUDE CARDIAC CARE, MATERNITY SERVICES, CANCER TREATMENT, EMERGENCY CARE, DIAGNOSTIC IMAGING, INTENSIVE CARE, CRITICAL CARE AND SURGICAL PROCEDURES, BOTH INPATIENT AND OUTPATIENT. THE MERCY HOSPITAL'S BEHAVORIAL HEALTH PROGRAMS AND SERVICES INCLUDE INPATIENT AND OUTPATIENT PSYCHIATRIC CARE FOR PEOPLE OF ALL AGES, SHORT-TERM RESIDENTIAL TREATMENT FOR PEOPLE WITH ACUTE PSYCHIATRIC AND/OR SUBSTANCE ABUSE PROBLEMS, AND INTENSIVE OUTPATIENT CHEMICAL DEPENDENCY PROGRAMS.PLEASE SEE SCHEDULE H AND THE WEBSITE AT WWW.MERCYCARES.COM FOR ADDITIONAL INFORMATION. 255726834 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 1 0 0 1 310 0 1 2543 1 1 1 0 0 0 0 0 0 0 0 0 X 12 10 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 1 1 MA X PATRICIA HAYES 4135392640 1221 MAIN ST SUITE 213 HOLYOKE MA 01040 BETH O'BRIEN DIRECTOR & INT PRESIDENT AS OF 4/17 47.00 8.00 X X 0 0 0 SCOTT WOLF DIRECTOR, PRESIDENT & CEO THR 3/17 47.00 8.00 X X 0 521489 39297 JOHN SJOBERG DIRECTOR; CHAIR 1.00 5.00 X X 0 0 0 DEAN WHALEN ESQUIRE DIRECTOR; VICE CHAIR 1.00 4.00 X X 0 0 0 PAUL MANCINONE DIRECTOR; SECRETARY 1.00 4.00 X X 0 0 0 MARY GEARY CARITAS SP DIRECTOR 1.00 5.00 X 0 0 0 CHRISTOPHER COMEY MD DIRECTOR & PRES MED STAFF THR 11/16 1.00 49.00 X 0 709937 35112 JOHN JOYCE DIRECTOR 1.00 4.00 X 0 0 0 KATHLEEN KANE DIRECTOR 1.00 4.00 X 0 0 0 ANAND KANJOLIA MD DIRECTOR 1.00 4.00 X 0 0 0 RUTH MCGOLDRICK SP DIRECTOR 1.00 4.00 X 0 0 0 PAUL MARCHESE DIRECTOR 1.00 4.00 X 0 0 0 VANESSA OTERO DIRECTOR 1.00 4.00 X 0 0 0 WILLIAM SILVANIC DIRECTOR 1.00 4.00 X 0 0 0 DANIEL KEENAN ASST. SEC; SVP GOV'T RELATIONS 43.00 7.00 X 0 246029 36536 THOMAS ROBERT TREASURER, SVP & CFO THR 1/17 42.00 8.00 X 0 437500 46521 RALPH BECKER TREASURER & INT VP FINANCE AT 2/17 42.00 8.00 X 0 456654 23648 JAMES HARRIS ASSISTANT TREASURER AS OF 4/17 1.00 49.00 X 0 202553 13539 MARIA RUSSO-APPEL MD VP MERCY BEHAVIORAL HEALTH THR 2/17 50.00 0.00 X 341027 0 29216 SIMON AHTARIDIS MD INTERIM CMO THR 5/17 50.00 0.00 X 0 377156 33287 CHARLES FLINN INTERIM COO AS OF 2/17 43.00 7.00 X 0 468037 15970 VIKRAM SONDHI INTERIM CMO AS OF 5/17 50.00 0.00 X 0 289059 35867 ROBERT ROOSE MD VP MERCY BEHAVIORAL HEALTH AT 2/17 50.00 0.00 X 313436 0 20155 ALLANA LEE DO PHYSICIAN 50.00 0.00 X 312806 0 28577 MARY TARAIL MD PSYCHIATRIST 50.00 0.00 X 276511 0 12571 GAURAV CHAWLA MD CMO BEHAVIORAL HEALTH 50.00 0.00 X 264384 0 37897 CHHEWANG NORSANG MD PSYCHIATRIST 50.00 0.00 X 250300 0 27161 NANCY DUFAULT RN NURSE 50.00 0.00 X 237714 0 31675 DANIEL MOEN FORMER OFFICER; TRINITY EXECUTIVE 0.00 50.00 X 0 922675 45022 LEONARD PANSA FORMER KEY EMP; SVP HR & ADMIN SVCS 43.00 7.00 X 0 449443 20906 1996178 5080532 532957 177 1 1 0 SHERIDAN HEALTHCARE OF MA PC 1613 N HARRISON PKWY STE 200 SUNRISE FL 33323 ANESTHESIOLOGY SERVICES 2290982 RAYMOND HOULE CONSTRUCTION 5 MILLER ST LUDLOW MA 01056 CONSTRUCTION SERVICES 1462004 WESTERN MASS CRITICAL CARE PC 300 STAFFORD ST 300 SPRINGFIELD MA 01104 PHYSICIAN SERVICES 1454099 ANGELICA TEXTILE SERVICES PO BOX 532268 ATLANTA GA 303532268 LAUNDRY SERVICES 1146862 INPATIENT PEDIATRIC SERVICES INC 153 MUNGER HILL ROAD WESTFIELD MA 01085 PHYSICIAN SERVICES 1121662 31 43500 450868 1118313 2221236 120000 3833917 NET PATIENT SERVICE REVENUE 622110 295552474 295552474 SUBSIDIARY FEES 551114 5009301 5009301 PHARMACY REVENUE 446110 2022958 2022958 302584733 204334 204334 484082 0 484082 484082 484082 62233 -62233 -62233 -62233 152439 120001 32438 32438 GOV'T SUBSIDY - DSTI PROGRAM 622110 7400002 7400002 CAFETERIA REVENUE 722514 1464512 1464512 GOV'T SUBSIDY - EHR 622110 111980 111980 5465121 5310883 154238 14441615 321518886 313384640 2177196 2123133 X 263429 263429 1439203 1439203 124543 124543 113051424 106012718 7038706 5205290 4866146 339144 12185541 11362440 823101 8439350 7823040 616310 219337 219337 41924 41924 10190 10190 36845418 30531603 6313815 834586 773638 60948 5312500 4924538 387962 52882 49020 3862 6951986 6444295 507691 229376 212625 16751 66470 61616 4854 3186449 3186449 12066117 11184951 881166 2002774 1856515 146259 MEDICAL SUPPLIES 46527556 46527556 SYSTEM ASSESSMENT FEES 26768305 26768305 INTERCO LAB FEES 8945079 8945079 BAD DEBT EXPENSE 5686892 5686892 5450943 4889741 561202 301907564 255726834 46180730 0 17123047 3611134 3820451 2713028 35764424 54417177 7042 2596094 4929463 5084906 834830 883883 294895870 198716646 92455831 96179224 57458026 78520109 55198116 68122562 1667055 53057116 269258285 365185233 33325697 56384716 1453690 133184 147614 204522 79300997 126053613 114227998 182776035 X 150168245 178251303 4530125 3726758 331917 431137 155030287 182409198 269258285 365185233 X 19611322 1905561 5862028 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 0 0 0 0 1 35314 1 41924 0 0 77238 0 PART II-B, LINE 1: MERCY HOSPITAL HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO REGIONAL AND NATIONAL HEALTH CARE ORGANIZATIONS, WHERE THE ORGANIZATIONS HAVE PROVIDED MERCY HOSPITAL WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. THE MERCY HOSPITAL ALSO PAID A THIRD PARTY LOBBYING FIRM DURING THE YEAR TO LOBBY FOR OR AGAINST LEGISLATION DETERMINED TO BE OF INTEREST TO THE MERCY HOSPITAL. 331917 1968680 43603 29500 2314700 345256 -13339 331917 357806 -12550 345256 357806 357806 357806 25344 25344 357806 0.00000 0.18630 0.81370 0 0 2382702 2382702 146473468 78990629 67482839 2347164 1026488 1320676 132305258 114100650 18204608 11387278 4598879 6788399 96179224 COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 30437740 F HEDGE FUNDS 14494163 F EQUITY METHOD INVESTMENTS 23190659 C 68122562 MISCELLANEOUS RECEIVABLES 29459399 OTHER LONG-TERM ASSETS 1135698 INVESTMENT IN UNCONSOL. AFFILIATES 175892 INTERCOMPANY ACCOUNTS RECEIVABLES 1970951 OTHER ASSETS 5965263 OTHER LONG TERM ASSETS 14349913 53057116 INTERCOMPANY ACCOUNTS PAYABLE 3917851 INTERCOMPANY NOTES PAYABLE 110118416 OTHER CURRENT LIABILITIES 9431964 ANNUITIES PAYABLE 5812 OTHER LONG-TERM LIABILITIES 1007574 DEFERRED COMPENSATION LIABILITY 1571996 126053613 PART V, LINE 4: INCOME FROM ENDOWMENT FUNDS ARE USED TO PROVIDE PATIENT CARE. 1 1 X 1 X 1 X 1 1 1 0 1 1 4 5721 1870104 1258937 611167 0.00210 34 66189 83015247 64164098 18851149 0.06360 6 1661 2866881 1871567 995314 0.00340 44 73571 87752232 67294602 20457630 0.06910 20 1223 1224779 6140 1218639 0.00410 1 119992 119992 0.00040 1 1750062 1133559 616503 0.00210 2 312 6358 6358 0.00000 24 1535 3101191 1139699 1961492 0.00660 68 75106 90853423 68434301 22419122 0.07570 1 1035 1035 0.00000 1 1035 1035 0.00000 0 5686892 0 97743067 84796704 12946363 X 1 1 1 LIFEPATH PARTNERS LLC LABORATORY SERVICES 0.50000 0.00000 0.50000 1 1 MERCY HOSPITAL INC 271 CAREW ST SPRINGFIELD MA 01104 WWW.MERCYCARES.COM STATE LICENSE # VHFO X X X MERCY HOSPITAL INC 1 0 0 1 X X X X X X X X X 15 1 1 1 1 X HTTP://WWW.MERCYCARES.COM/CHNA X SEE SCHEDULE H, PART V, SECTION C X 1 15 1 HTTP://WWW.MERCYCARES.COM/CHNA 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X WWW.MERCYCARES.COM/BILLING X WWW.MERCYCARES.COM/BILLING X WWW.MERCYCARES.COM/BILLING X X X X X X 1 X 0 X X X X 1 X 0 0 MERCY HOSPITAL, INC. PART V, SECTION B, LINE 5: THE INPUT OF THE COMMUNITY AND OTHER IMPORTANT REGIONAL STAKEHOLDERS WAS AN IMPORTANT PART OF THE CHNA PROCESS. BELOW ARE THE PRIMARY MECHANISMS FOR COMMUNITY AND STAKEHOLDER ENGAGEMENT. A CHNA STEERING COMMITTEE WAS FORMED THAT INCLUDED REPRESENTATIVES FROM MERCY HOSPITAL BUT ALSO THE OTHER MEMBERS OF THE WESTERN MASSACHUSETTS HOSPITAL/INSURER COALITION, AS WELL AS PUBLIC HEALTH AND COMMUNITY STAKEHOLDERS FROM EACH HOSPITAL SERVICE AREA. STAKEHOLDERS ON THE STEERING COMMITTEE INCLUDED LOCAL AND REGIONAL PUBLIC HEALTH AND HEALTH DEPARTMENT REPRESENTATIVES; REPRESENTATIVES FROM LOCAL AND REGIONAL ORGANIZATIONS SERVING OR REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME OR MINORITY POPULATIONS; AND INDIVIDUALS FROM ORGANIZATIONS THAT REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY. WHEN IDENTIFYING COMMUNITY AND PUBLIC HEALTH REPRESENTATIVES TO PARTICIPATE, A STAKEHOLDER ANALYSIS WAS CONDUCTED BY THE COALITION AND CONSULTANTS TO ENSURE GEOGRAPHIC, SECTOR (E.G. SCHOOLS, COMMUNITY SERVICE ORGANIZATIONS, HEALTH CARE PROVIDERS, PUBLIC HEALTH, AND HOUSING) AND RACIAL/ETHNIC DIVERSITY OF COMMUNITY REPRESENTATIVES. BY INCLUDING THESE STAKEHOLDERS ON THE STEERING COMMITTEE, THE COMMUNITY AND PUBLIC HEALTH REPRESENTATIVES HAD INPUT ON THE 2016 CHNA PROCESS USED TO IDENTIFY AND PRIORITIZE COMMUNITY HEALTH NEEDS, CHNA FINDINGS, AND DISSEMINATION OF INFORMATION. ASSESSMENT METHODS AND FINDINGS WERE MODIFIED BASED ON THE STEERING COMMITTEE FEEDBACK. THE STEERING COMMITTEE MET MONTHLY FROM OCTOBER 2015 TO JUNE 2016. KEY INFORMANT INTERVIEWS AND FOCUS GROUPS WERE CONDUCTED TO BOTH GATHER INFORMATION THAT WAS UTILIZED TO IDENTIFY PRIORITY HEALTH NEEDS AND ENGAGE THE COMMUNITY. KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH HEALTH CARE PROVIDERS, HEALTH CARE ADMINISTRATORS, LOCAL AND REGIONAL PUBLIC HEALTH OFFICIALS, AND LOCAL ORGANIZATIONAL LEADERS THAT REPRESENT THE BROAD INTERESTS OF THE COMMUNITY OR THAT SERVE MEDICALLY UNDERSERVED, LOW-INCOME OR MINORITY POPULATIONS IN THE SERVICE AREA. INTERVIEWS WITH THE LOCAL AND REGIONAL PUBLIC HEALTH OFFICIALS WERE USED TO IDENTIFY CURRENT AND EMERGING HIGH PRIORITY HEALTH AREAS, AND HEALTH CARE AND COMMUNITY FACTORS THAT CONTRIBUTE TO HEALTH NEEDS. FOCUS GROUP PARTICIPANTS INCLUDED INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING COMMUNITY ORGANIZATIONAL REPRESENTATIVES, VULNERABLE POPULATION COMMUNITY MEMBERS (LOW-INCOME, RACIAL AND ETHNIC MINORITY POPULATIONS, ETC.), AND OTHER COMMUNITY STAKEHOLDERS. TOPICS INCLUDED: MATERNAL AND CHILD HEALTH, MENTAL HEALTH AND SUBSTANCE USE, BEHAVIORAL HEALTH AND EMERGENCY DEPARTMENT CARE, AND FAITH-BASED LEADERS AND COMMUNITY ENGAGEMENT. KEY INFORMANT INTERVIEWS AND FOCUS GROUPS WERE CONDUCTED FROM FEBRUARY 2016 TO APRIL 2016. A COMMUNITY LISTENING SESSION WAS HELD IN JUNE 2016 UPON COMPLETION OF THE CHNA REPORT. THE COMMUNITY LISTENING SESSION INCLUDED INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY AND COMMUNITY STAKEHOLDERS REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. THESE SESSIONS HELPED TO OBTAIN INPUT ON THE PRIORITIZED HEALTH NEEDS THAT WERE IDENTIFIED IN THE CHNA AND TO GAIN FEEDBACK ON THE NEEDS THAT ARE THE FOCUS OF THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) PROCESS. BELOW IS A LIST OF PUBLIC HEALTH AND COMMUNITY REPRESENTATIVES, AND OTHER STAKEHOLDERS INVOLVED IN THE PROCESS, WHICH INCLUDED REPRESENTATION OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. THESE VULNERABLE POPULATIONS, WHICH INCLUDE CHILDREN, OLDER ADULTS, LATINOS, AFRICAN AMERICANS, AND REFUGEES, WERE REPRESENTED BY: YMCA OF WESTFIELD, NATIONAL ASSOCIATION OF HISPANIC NURSES - WESTERN MA CHAPTER, UNITED WAY OF HAMPSHIRE COUNTY, CARING HEALTH CENTER, PALMER PUBLIC SCHOOLS, HAMPDEN COUNTY SHERIFF'S DEPT., HILLTOWN CDC, UNITED CEREBRAL PALSY ASSOC. OF BERKSHIRE COUNTY, SPRINGFIELD DEPT. HEALTH & HUMAN SERVICES, MOTHERWOMAN, BMC QUALITY & POPULATION HEALTH, STAVROS CENTER FOR INDEPENDENT LIVING, ASSUMPTION COLLEGE, STAND FOR CHILDREN, CITY OF SPRINGFIELD - OFFICE OF HOUSING, PROVIDENCE BEHAVIORAL HEALTH, MA DEPT. OF PUBLIC HEALTH, UMASS AMHERST SCHOOL OF PUBLIC HEALTH & HEALTH SCIENCES, HAMPDEN COUNTY DISTRICT ATTORNEY'S OFFICE, BEHAVIORAL HEALTH NETWORK - OUTPATIENT SERVICES, FRANKLIN REGIONAL COUNCIL OF GOVERNMENTS, WESTERN MA BLACK NURSES ASSOCIATION, HMC BEHAVIORAL HEALTH, MASON SQUARE NEIGHBORHOOD HEALTH CENTER, HMC DISCHARGE TRANSITIONS, HEALTH CARE FOR THE HOMELESS, GOVERNOR'S TASK FORCE ON OPIOID ABUSE, MDPH DIVISION FOR PERINATAL, EARLY CHILDHOOD AND SPECIAL NEEDS - CARE COORDINATION, QUABBIN HEALTH DISTRICT, NORTHAMPTON HEALTH DEPARTMENT, CITY OF CHICOPEE PUBLIC HEALTH, FAMILY ADVOCACY CENTER, SQUARE ONE, CITY OF SPRINGFIELD PUBLIC SCHOOLS, BMC EMERGENCY MEDICINE, HOLYOKE LEARN TO COPE, BMC CHNA STEERING COMMITTEE, SPRINGFIELD FAITH-BASED ASSOC., HOLYOKE COMMUNITY COLLEGE, HOMEWORK HOUSE, BEHAVIORAL HEALTH NETWORK, HOLYOKE HEALTH CENTER, BE FIT, FAMILY ADVOCACY CENTER, AND BMC PEDIATRIC MEDICINE. MERCY HOSPITAL, INC. PART V, SECTION B, LINE 6A: MERCY HOSPITAL IS A MEMBER OF THE COALITION OF WESTERN MASSACHUSETTS HOSPITALS AND COLLABORATED WITH THE FOLLOWING HOSPITALS IN CONDUCTING THE CHNA: BAYSTATE MEDICAL CENTER, BAYSTATE FRANKLIN MEDICAL CENTER, BAYSTATE NOBLE HOSPITAL, BAYSTATE WING HOSPITAL, COOLEY DICKINSON HOSPITAL, HOLYOKE MEDICAL CENTER, AND SHRINERS HOSPITAL FOR CHILDREN. MERCY HOSPITAL, INC. PART V, SECTION B, LINE 6B: MERCY HOSPITAL COLLABORATED WITH HEALTH NEW ENGLAND, A HEALTH INSURANCE PROVIDER, IN CONDUCTING THE CHNA. MERCY HOSPITAL, INC. PART V, SECTION B, LINE 11: SIGNIFICANT HEALTH NEEDS BEING ADDRESSED: MERCY HOSPITAL IS FOCUSING ON AND SUPPORTING INITIATIVES TO IMPROVE THE FOLLOWING HEALTH NEEDS: -ACCESS AND BARRIERS TO QUALITY HEALTH CARE -HEALTH CONDITIONS AND BEHAVIORS MERCY HOSPITAL HAS DEVELOPED THREE STRATEGIC INITIATIVES TO ADDRESS THESE TWO SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA. ACCESS AND BARRIERS TO QUALITY HEALTH CARE - A SIGNIFICANT HEALTH NEED WAS FOUND IN REGARD TO HAMPDEN COUNTY RESIDENTS EXPERIENCING CHALLENGES IN ACCESSING CARE DUE TO THE SHORTAGE OF PROVIDERS. FIFTY-FOUR PERCENT OF HAMPDEN COUNTY RESIDENTS LIVE IN A HEALTH CARE PROFESSIONAL SHORTAGE AREA. THE FIRST INITIATIVE IS IMPROVING HEALTH CARE SERVICES AND OUTCOMES TO INDIVIDUALS WHO ARE FREQUENT UTILIZERS OF THE EMERGENCY DEPARTMENT. THE IMPLEMENTATION STRATEGY'S GOAL IS TO EXPAND THE SERVICES TO HIGH-END UTILIZERS (HEU) OF THE EMERGENCY DEPARTMENT. TO ACCOMPLISH THIS GOAL AND TO ENCOURAGE HEALTHY OUTCOMES, WE EMPLOYED COMMUNITY OUTREACH WORKERS TO PROVIDE INTENSIVE CASE MANAGEMENT SERVICES FOR THE HEU PARTICIPANTS TO ASSESS THEIR INDIVIDUAL HEALTH ISSUES AND BEHAVIORS. THE COMMUNITY HEALTH OUTREACH WORKERS ALSO PROVIDED ASSISTANCE WITH ENROLLMENT IN HEALTH INSURANCE, SOLIDIFIED CONNECTIONS TO PRIMARY CARE, AND PROVIDED RESOURCES AND GUIDANCE TO ACCESS TRANSPORTATION, MENTAL HEALTH SERVICES AND HEALTH CARE EDUCATION. THE SECOND INITIATIVE IS DEVISED TO IMPROVE HEALTH LITERACY, ALONG WITH ACCESS TO CERVICAL CANCER SCREENINGS AND MAMMOGRAMS FOR HOMELESS WOMEN. THE IMPLEMENTATION STRATEGY'S GOAL IS TO INCREASE THE NUMBER OF HOMELESS WOMEN WHO PARTICIPATE IN WOMEN'S HEALTH SCREENINGS. TO ACCOMPLISH THIS GOAL, WE PERFORMED CERVICAL CANCER SCREENINGS, WHILE ALSO VERIFYING THE CERVICAL SCREENING RECORDS AND MAMMOGRAMS PERFORMED INSIDE AND OUTSIDE OF THE MERCY HOSPITAL SYSTEM. ADDITIONALLY, WE PROVIDED EDUCATION ON THE HEALTH RISKS PERTAINING TO WOMEN'S HEALTH.HEALTH CONDITIONS AND BEHAVIORS - THE SECOND SIGNIFICANT HEALTH NEED WAS FOUND TO BE MENTAL HEALTH. MENTAL HEALTH WAS IDENTIFIED AS ONE OF THE TOP THREE URGENT HEALTH NEEDS/PROBLEMS IMPACTING THE AREA. AN ESTIMATED 15.9% OF HAMPDEN COUNTY RESIDENTS HAVE POOR MENTAL HEALTH 15 DAYS OR MORE IN A MONTH. ER VISIT RATES FOR MENTAL HEALTH DISORDERS IN HAMPDEN COUNTY ARE 24% HIGHER THAN THAT OF THE STATE, WITH PARTICULARLY HIGH RATES IN HOLYOKE AND SPRINGFIELD. IN RESPONSE TO THIS SECOND HEALTH NEED, A THIRD STRATEGIC INITIATIVE WAS IDENTIFIED TO IMPROVE MENTAL HEALTH SERVICES AND PROVIDE EDUCATION AND AWARENESS TO DIFFERENT POPULATION GROUPS WITHIN THE COMMUNITY. THE IMPLEMENTATION STRATEGY'S GOAL IS TO INCREASE THE MENTAL HEALTH AWARENESS OF HAMPDEN COUNTY RESIDENTS AND TO REDUCE THE STIGMA OF SEEKING HELP. TO ACCOMPLISH THIS GOAL, WE OFFERED, IN PARTNERSHIP WITH THE WESTERN MASSACHUSETTS COALITION OF HOSPITALS, MENTAL HEALTH FIRST AID TRAINING (MHFA) BY CERTIFIED INSTRUCTORS TO DIVERSE RESIDENTS WITHIN THE HOSPITAL SERVICE AREA. THE MHFA PROGRAM HELPS TO RAISE AWARENESS ABOUT MENTAL HEALTH AND RELATED ISSUES, ALONG WITH TEACHING PARTICIPANTS ABOUT VARIOUS MENTAL HEALTH SUPPORT SERVICES. MERCY HOSPITAL IS COMMITTED TO ADHERING TO ITS MISSION AND REMAINING GOOD STEWARDS OF ITS RESOURCES SO IT CAN CONTINUE TO ENHANCE ITS CLINICAL ACTIVITIES AND TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THE FOLLOWING AREAS HAVE BEEN IDENTIFIED IN THE CHNA AS NEEDS THAT ARE NOT ADDRESSED IN THE IMPLEMENTATION STRATEGY FOR THE FOLLOWING REASONS: COMMUNITY LEVEL SOCIAL AND ECONOMIC DETERMINANTS THAT IMPACT HEALTH - MERCY HOSPITAL, ALTHOUGH PLAYING ITS ROLE IN THIS COLLECTIVE EFFORT, IS NOT QUALIFIED TO FULLY ADDRESS THE POVERTY QUESTION IN THE COMMUNITY. FURTHERMORE, AS A HEALTH CARE CENTER, THE ABILITY OF MERCY HOSPITAL TO SOLVE THE SOCIAL DETERMINANTS OF HEALTH AT THE COMMUNITY LEVEL WILL BE LIMITED. FOR REFERENCE, THE SOCIAL AND ECONOMIC DETERMINANTS OF HEALTH AT THE COMMUNITY LEVEL INCLUDE: SAFETY, FOOD AVAILABILITY, AIR POLLUTION, HEALTH DISPARITIES, AND RACIAL INEQUALITIES. MERCY HOSPITAL, INC. PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTH CARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. MERCY HOSPITAL, INC. - PART V, SECTION B, LINE 9 AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC. THE MERCY HOSPITAL - PART V, SECTION B, LINE 7B HTTP://WWW.TRINITYHEALTHOFNE.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS PART I, LINE 3C: IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS. PART I, LINE 6A: MERCY HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT, WHICH IT SUBMITS TO THE STATE OF MASSACHUSETTS. IN ADDITION, MERCY HOSPITAL REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH (EIN 35-1443425) IN ITS AUDITED FINANCIAL STATEMENTS, AVAILABLE AT WWW.TRINITY-HEALTH.ORG. IN ADDITION, MERCY HOSPITAL INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM. PART I, LN 7 COL(F): THE FOLLOWING NUMBER, $5,686,892, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F). PART II, COMMUNITY BUILDING ACTIVITIES: MERCY HOSPITAL PARTNERED AGAIN WITH THE SPRINGFIELD NON-PROFIT REVITALIZE CDC. REVITALIZE CDC PERFORMS CRITICAL REPAIRS, MODIFICATIONS AND REHABILITATION ON THE HOMES AND NON-PROFIT FACILITIES OF LOW-INCOME FAMILIES WITH CHILDREN, THE ELDERLY, MILITARY VETERANS, AND PEOPLE WITH SPECIAL NEEDS IN HOLYOKE AND SPRINGFIELD, MASSACHUSETTS. REVITALIZE CDC IMPROVES HOMES, NEIGHBORHOODS AND LIVES THROUGH PRESERVATION, EDUCATION AND COMMUNITY INVOLVEMENT. THEY LEVERAGE THE INVESTMENTS OF DONORS, GRANTORS AND VOLUNTEERS TO MAKE SIGNIFICANT HOME REPAIRS THAT STABILIZE NEIGHBORHOODS, STRENGTHEN THE TAX BASE, AND ALLOW ELDERLY HOMEOWNERS TO "AGE IN PLACE." MERCY HOSPITAL HELPED REVITALIZE CDC AS A SPONSOR, ALONG WITH OUR STAFF AMONG THE 1,000 VOLUNTEERS, TO RESTORE 62 HOMES FOR THE GREEN 'N FIT NEIGHBORHOOD BLOCK REBUILD ON LEBANON AND GREENE STREETS, AND MONSON AND NELSON AVENUE IN SPRINGFIELD. PART III, LINE 2: METHODOLOGY USED FOR LINE 2 - ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS. PART III, LINE 3: MERCY HOSPITAL USES A PREDICTIVE MODEL THAT INCORPORATES THREE DISTINCT VARIABLES IN COMBINATION TO PREDICT WHETHER A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE: (1) SOCIO-ECONOMIC SCORE, (2) ESTIMATED FEDERAL POVERTY LEVEL (FPL), AND (3) HOMEOWNERSHIP. BASED ON THE MODEL, CHARITY CARE CAN STILL BE EXTENDED TO PATIENTS EVEN IF THEY HAVE NOT RESPONDED TO FINANCIAL COUNSELING EFFORTS AND ALL OTHER FUNDING SOURCES HAVE BEEN EXHAUSTED. FOR FINANCIAL STATEMENT PURPOSES, MERCY HOSPITAL IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, MERCY HOSPITAL IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL. PART III, LINE 4: MERCY HOSPITAL IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE FROM PAGE 14 OF THOSE STATEMENTS: "THE CORPORATION RECOGNIZES A SIGNIFICANT AMOUNT OF PATIENT SERVICE REVENUE AT THE TIME THE SERVICES ARE RENDERED EVEN THOUGH THE CORPORATION DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY AT THAT TIME. AS A RESULT, THE PROVISION FOR BAD DEBTS IS PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS). FOR UNINSURED AND UNDERINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE CORPORATION ESTABLISHES AN ALLOWANCE TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THIS ALLOWANCE IS ESTABLISHED BASED ON THE AGING OF ACCOUNTS RECEIVABLE AND THE HISTORICAL COLLECTION EXPERIENCE BY THE HEALTH MINISTRIES AND FOR EACH TYPE OF PAYOR. A SIGNIFICANT PORTION OF THE CORPORATION'S PROVISION FOR DOUBTFUL ACCOUNTS RELATES TO SELF-PAY PATIENTS, AS WELL AS CO-PAYMENTS AND DEDUCTIBLES OWED TO THE CORPORATION BY PATIENTS WITH INSURANCE."PART III, LINE 5:TOTAL MEDICARE REVENUE REPORTED IN PART III, LINE 5 HAS BEEN REDUCED BY THE TWO PERCENT SEQUESTRATION REDUCTION. PART III, LINE 8: MERCY HOSPITAL DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CATHOLIC HEALTH ASSOCIATION RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT. PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. COLLECTION PRACTICES FOR THE REMAINING BALANCES ARE CLEARLY OUTLINED IN THE ORGANIZATION'S COLLECTION POLICY. THE HOSPITAL HAS IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS. PART VI, LINE 2: NEEDS ASSESSMENT - MERCY MEDICAL CENTER ASSESSES THE HEALTH STATUS OF ITS COMMUNITY, IN PARTNERSHIP WITH COMMUNITY COALITIONS, AS PART OF THE NORMAL COURSE OF OPERATIONS AND IN THE CONTINUOUS EFFORTS TO IMPROVE PATIENT CARE AND THE HEALTH OF THE OVERALL COMMUNITY. TO ASSESS THE HEALTH OF THE COMMUNITY, THE HOSPITAL MAY USE PATIENT DATA, PUBLIC HEALTH DATA, ANNUAL COUNTY HEALTH RANKINGS, MARKET STUDIES, AND GEOGRAPHICAL MAPS SHOWING AREAS OF HIGH UTILIZATION FOR EMERGENCY SERVICES AND INPATIENT CARE, WHICH MAY INDICATE POPULATIONS OF INDIVIDUALS WHO DO NOT HAVE ACCESS TO PREVENTATIVE SERVICES OR ARE UNINSURED. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - MERCY HOSPITAL IS COMMITTED TO:- PROVIDING ACCESS TO QUALITY HEALTH CARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE, PARTICULARLY THE POOR AND THE UNDERSERVED IN OUR COMMUNITIES- CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES- ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE - BALANCING NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO SUSTAIN VIABILITY AND PROVIDE THE QUALITY AND QUANTITY OF SERVICES FOR ALL WHO MAY NEED CARE IN A COMMUNITYIN ACCORDANCE WITH AMERICAN HOSPITAL ASSOCIATION RECOMMENDATIONS, MERCY HOSPITAL HAS ADOPTED THE FOLLOWING GUIDING PRINCIPLES WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS:- PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS- MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS- OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS- IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER- IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONSMERCY HOSPITAL COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES AND EXTERNAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE.FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTH CARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. FINANCIAL ASSISTANCE APPLICATIONS WILL BE ACCEPTED UNTIL ONE YEAR AFTER THE FIRST BILLING STATEMENT TO THE PATIENT.MERCY HOSPITAL OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH PATIENT BROCHURES, MESSAGES ON PATIENT BILLS, POSTED NOTICES IN PUBLIC REGISTRATION AREAS INCLUDING EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS ALSO AVAILABLE ON HOSPITAL WEBSITES. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN OTHER LANGUAGES AS REQUIRED BY INTERNAL REVENUE CODE SECTION 501(R), REFLECTING OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITAL. MERCY HOSPITAL HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. MERCY HOSPITAL MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. PART VI, LINE 4: COMMUNITY INFORMATION - THE SERVICE AREA FOR MERCY MEDICAL CENTER INCLUDES ALL 23 COMMUNITIES WITHIN HAMPDEN COUNTY, INCLUDING SPRINGFIELD, THE THIRD LARGEST CITY IN MASSACHUSETTS (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 (270,000 PEOPLE). SMALLER 'BEDROOM' COMMUNITIES EXIST TO THE EAST AND WEST OF THIS CENTRAL CORE AREA. MANY OF THESE COMMUNITIES HAVE POPULATIONS UNDER 20,000 PEOPLE. THE SERVICE AREA HAS MORE RACIAL AND ETHNIC DIVERSITY THAN MANY OTHER PARTS OF WESTERN MASSACHUSETTS. COUNTY-WIDE, 22.1% OF THE POPULATION IS LATINO, 8.7% IS BLACK AND 2.1% IS ASIAN (ACS, 2010-2014), THOUGH THIS DIVERSITY IS NOT EQUALLY SPREAD THROUGHOUT THE REGION AND TENDS TO BE CONCENTRATED IN THE URBAN CORE. THE MERCY HOSPITAL 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. SIMULTANEOUSLY, THE COUNTY STRUGGLES WITH HIGHER RATES OF UNEMPLOYMENT AND POVERTY, LOWER HOUSEHOLD INCOMES AND LOWER RATES OF EDUCATIONAL ATTAINMENT. THE MEDIAN HOUSEHOLD INCOME IN THE SERVICE AREA IS ABOUT $50,000 ($17,000 LESS THAN THE STATE). AT THE SAME TIME, THE COST OF HOUSING IS ALMOST $400/MONTH LOWER THAN THE STATEWIDE AVERAGE. STILL, THE POVERTY RATE IS MORE THAN 5% HIGHER THAN WHAT IS REPORTED 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 25.6% OF THE POPULATION AGE 25 AND OVER HAS A BACHELOR'S DEGREE. UNEMPLOYMENT IS SOMEWHAT HIGHER THAN THE STATE AVERAGE. 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.HAMPDEN COUNTY CONTAINS SIX ACUTE CARE HOSPITAL FACILITIES. SEVERAL AREAS AND POPULATIONS IN HAMPDEN COUNTY ARE DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA). FIFTY-FOUR PERCENT OF HAMPDEN COUNTY RESIDENTS LIVE IN A HPSA, COMPARED TO 14.6% FOR MASSACHUSETTS RESIDENTS OVERALL. THE U.S. HEALTH RESOURCES AND SERVICES ADMINISTRATION DESIGNATED MEDICALLY UNDERSERVED AREAS AND POPULATIONS (MUA/MUP) IN HAMPDEN COUNTY THAT ARE PRIMARILY FOUND IN HOLYOKE, SPRINGFIELD, WEST SPRINGFIELD, WESTFIELD, BLANDFORD, AND CHESTER. MUA'S AND MUP'S ARE IDENTIFIED BASED ON AVAILABILITY OF PRIMARY CARE PROVIDERS, INFANT MORTALITY RATE, POVERTY RATE, AND PROPORTION OF OLDER ADULTS. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH -MERCY HOSPITAL'S GOVERNING BODY IS ITS BOARD OF DIRECTORS. THE MAJORITY OF THIS BOARD RESIDES IN THE ORGANIZATION'S SERVICE AREA AND IS COMPRISED OF INDIVIDUALS WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS. THE ORGANIZATION EXTENDS MEDICAL PRIVILEGES TO QUALIFIED PHYSICIANS IN THE COMMUNITY FOR ITS DEPARTMENTS AND SPECIALTIES, PROVIDED THESE PHYSICIANS MEET THE QUALIFICATIONS OUTLINED AND CERTIFIED BY THE MEDICAL CREDENTIALING OFFICE. AS MERCY HOSPITAL IS A NON-PROFIT ENTITY, ANY AND ALL EXCESS FUNDS ARE USED TO FUND IMPROVEMENTS IN PATIENT CARE AND MEDICAL EDUCATION. TOBACCO 21 ADVOCACY: MERCY HOSPITAL IS A MEMBER OF TOBACCO FREE SPRINGFIELD (TFS) AND THE STATEWIDE TOBACCO FREE MASS COALITION TO HELP PASS LOCAL AND STATEWIDE LEGISLATION TO INCREASE THE MINIMUM SMOKING AGE TO 21. MERCY HAS PARTNERED WITH THE CITY OF SPRINGFIELD DEPARTMENT OF HEALTH, THE TOBACCO CESSATION AND PREVENTION PROGRAM FOR LOCAL ADVOCACY AND TECHNICAL ASSISTANCE, HOSTED TFS MEETINGS, AND LOBBIED AT THE MASSACHUSETTS STATE HOUSE ON YOUTH TOBACCO PREVENTION DAY TO PERSUADE LEGISLATORS TO PASS A COMPREHENSIVE STATE-WIDE TOBACCO 21 BILL.MERCY HOSPITAL FURTHER PROMOTES THE HEALTH OF THE COMMUNITY BY OFFERING THE FOLLOWING:HEALTH CARE FOR THE HOMELESS: MERCY HOSPITAL'S DEPARTMENT OF COMMUNITY HEALTH PROVIDES CARE TO THE COMMUNITY'S HOMELESS POPULATION IN FRANKLIN, HAMPSHIRE, AND HAMPDEN COUNTIES THROUGH PRIMARY CARE SERVICES, HEALTH EDUCATION, CASE MANAGEMENT, MENTAL HEALTH SERVICES, AND FREE CLINICS TO MORE THAN 2,250 PERSONS EACH YEAR. THE VIETNAMESE HEALTH PROJECT: THIS PROGRAM PROVIDES CASE MANAGEMENT AND INTERPRETATION SERVICES TO THE REFUGEE AND IMMIGRANT VIETNAMESE POPULATION IN THE GREATER SPRINGFIELD AREA. ANNUALLY, THIS COMMUNITY HEALTH OUTREACH PROGRAM REACHES NEARLY 700 VIETNAMESE PATIENTS. ADULTS AND CHILDREN IN PSYCHIATRIC AND/OR SUBSTANCE ABUSE DISTRESS: PROVIDENCE BEHAVIORAL HEALTH HOSPITAL, OPERATING UNDER THE SAME HOSPITAL LICENSE AS MERCY HOSPITAL, IS A 126-BED HOSPITAL LOCATED IN HOLYOKE, MASSACHUSETTS, THAT PROVIDES BOTH INPATIENT AND OUTPATIENT MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES FOR PEOPLE OF ALL AGES EXPERIENCING ACUTE PSYCHIATRIC DISTRESS AND/OR SEVERE SUBSTANCE ABUSE PROBLEMS.LACK OF AFFORDABLE AND ACCESSIBLE CARE: THE HOSPITAL OFFERS FINANCIAL COUNSELING TO THOSE WHO NEED ASSISTANCE. ADDITIONAL SUPPORT IS PROVIDED THROUGH COUNSELORS AND CASE MANAGERS WHO ASSIST PATIENTS WITH ACCESSING HEALTH INSURANCE THROUGH THE STATE. LACK OF AFFORDABLE AND ACCESSIBLE PRESCRIPTION MEDICATIONS: THE HOSPITAL PROVIDES PATIENT COUNSELING AND EDUCATION REGARDING PRESCRIPTION ASSISTANCE, AND ALSO PROVIDES DIRECT CO-PAY ASSISTANCE THROUGH THE HEALTH CARE FOR THE HOMELESS PROGRAM. THE HOSPITAL IS ALSO REGISTERED IN THE FEDERAL 340B PHARMACEUTICAL DRUG ACCESS PROGRAM, WHICH PROVIDES DISCOUNTS TO QUALIFYING HOSPITALS ON COVERED OUTPATIENT MEDICATIONS, WHICH ARE THEN PROVIDED TO THE PATIENTS AT A REDUCED COST.SUPPORT GROUPS: FOR THOSE EXPERIENCING LIFE-ALTERING CONDITIONS, MERCY HOSPITAL PROVIDES A WIDE RANGE OF ONGOING FREE SUPPORT GROUPS FOR PATIENTS (AND THEIR FAMILIES OR CAREGIVERS) CHALLENGED BY DIAGNOSES SUCH AS CANCER, STROKE, AMPUTATIONS, APHASIA, TRAUMATIC BRAIN INJURY, MULTIPLE SCLEROSIS, AND SPINAL CORD INJURIES.THE TRANSFORMING COMMUNITIES INITIATIVE IS A PARTNERSHIP BETWEEN MERCY MEDICAL CENTER & LIVE WELL SPRINGFIELD TO ADDRESS HEALTH DISPARITIES THROUGH TARGETED POLICY, SYSTEMS, AND ENVIRONMENT CHANGE IN SPRINGFIELD, MA. WE KNOW THAT HEALTHIER LIFESTYLES START WITH ACCESS TO HEALTHY PLACES TO LIVE, LEARN, PLAY, AND WORK. LIVE WELL SPRINGFIELD IS A COMMUNITY MOVEMENT TO SUPPORT HEALTHY EATING AND ACTIVE LIVING. LIVE WELL SPRINGFIELD WORKS TO INFLUENCE POLICY, SYSTEMS, AND THE ENVIRONMENT THAT WILL INCREASE ACCESS TO AND UTILIZATION OF HEALTHY FOOD AND PHYSICAL ACTIVITY OPTIONS FOR RESIDENTS IN SPRINGFIELD, MA. POLICY FOCUSES INCLUDE: COMPLETE STREETS TO MAKE IT SAFER IN THE CITY FOR ALL MODES OF TRANSPORTATION; IMPROVING PHYSICAL ACTIVITY AND NUTRITION IN PRE-K AND K-12 ENVIRONMENTS TO PREVENT AND REDUCE CHRONIC DISEASE AND OBESITY; AND SMOKING PREVENTION AMONG YOUTH. OTHER PROJECTS INCLUDE A MOBILE FARMERS' MARKET AND PARTNERSHIPS TO IMPROVE THE BUILT ENVIRONMENT IN PLACES WHERE PEOPLE LIVE, GROW, WORK, AND PLAY.THE FOLLOWING TRANSFORMING COMMUNITY INITIATIVES ARE BEING ADDRESSED WITH THE FOLLOWING PARTNERS:SCHOOL WELLNESS - SPRINGFIELD PUBLIC SCHOOLS, SQUARE ONE, AND WAY FINDERS - CONSISTENT FITNESS OPPORTUNITIES FOR YOUTH- EFFECTIVE PHYSICAL EDUCATION CURRICULUMTOBACCO PREVENTION - MLK, JR. FAMILY SERVICES AND WAY FINDERS - INCREASING THE SMOKING AGE TO 21 - PROMOTING SMOKE-FREE HOUSINGNUTRITION & GARDENING - SPRINGFIELD FOOD POLICY COUNCIL AND SQUARE ONE - HEALTHIER MEALS WITH LOCAL FRUITS & VEGETABLES- SCHOOL GARDENS AS A FOOD SOURCE AND TEACHING TOOLCOMPLETE STREETS - PIONEER VALLEY PLANNING COMMISSION AND WAY FINDERS - IMPROVING SIDEWALKS, CROSSWALKS, AND STREETS FOR PEDESTRIAN SAFETY- TRAINING YOUTH TO WALK AND BICYCLE SAFELY PART VI, LINE 6: MERCY HOSPITAL IS A MEMBER OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE DELIVERY SYSTEMS IN THE COUNTRY. TRINITY HEALTH ANNUALLY REQUIRES THAT ALL MEMBER ORGANIZATIONS DEFINE - AND ACHIEVE - SPECIFIC COMMUNITY HEALTH AND WELL-BEING GOALS. IN FISCAL YEAR 2017, GOALS INCLUDED 1) PARTICIPATING IN LOCAL COALITION AND ADVOCACY EFFORTS AIMED AT CURBING TOBACCO USE AND PREVENTING OBESITY, 2) ASSESSING CAPACITY TO IDENTIFY AND SUPPORT INDIVIDUALS THAT ARE HOUSING INSECURE AND ACKNOWLEDGING OTHER BARRIERS INDIVIDUALS HAVE ACCESSING HEALTH CARE AND 3) EXPANDING ACCESS AND DELIVERY OF DIABETES PREVENTION PROGRAMS. TRINITY HEALTH ACKNOWLEDGES THE IMPACT SOCIAL DETERMINANTS SUCH AS ADEQUATE HOUSING, SAFETY, ACCESS TO FOOD, EDUCATION, INCOME, AND HEALTH COVERAGE HAVE ON THE HEALTH OF THE COMMUNITY. IN FISCAL YEAR 2016, TRINITY HEALTH LAUNCHED THE TRANSFORMING COMMUNITIES INITIATIVE (TCI), AWARDING EIGHT COMMUNITIES FUNDING TO IMPROVE THE HEALTH AND WELL-BEING OF THEIR COMMUNITIES IN PARTNERSHIP WITH THE LOCAL TRINITY HEALTH MEMBER HOSPITAL. THE AWARDED COMMUNITIES FOCUS ON POLICY, SYSTEM, AND ENVIRONMENTAL CHANGES THAT SPECIFICALLY IMPACT COMMUNITY IDENTIFIED NEEDS AND THAT WILL REDUCE CHILDHOOD OBESITY AND YOUTH TOBACCO USE. IN FISCAL YEAR 2017, TRINITY HEALTH INVESTED $2.7 MILLION IN TCI.AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO OUR COMMUNITIES THROUGH PROGRAMS SERVING THOSE WHO ARE POOR AND VULNERABLE, HELPING MANAGE CHRONIC CONDITIONS LIKE DIABETES, PROVIDING HEALTH EDUCATION, PROMOTING WELLNESS AND DEVELOPING PROGRAMS AND POLICIES TO SPECIFICALLY SUPPORT VULNERABLE POPULATIONS. ANNUALLY, THE ORGANIZATION INVESTS OVER $1.1 BILLION IN SUCH COMMUNITY BENEFITS AND WORKS TO ENSURE THAT ITS MEMBER HOSPITALS AND OTHER ENTITIES/AFFILIATES ENHANCE THE OVERALL HEALTH OF THE COMMUNITIES THEY SERVE BY ADDRESSING THE SPECIFIC NEEDS OF EACH COMMUNITY.FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG. PART VI, LINE 7, REPORTS FILED WITH STATES MA 1 PIONEER VALLEY PLANNING COMMISSION 60 CONGRESS STREET FL 1 SPRINGFIELD MA 01104 042376717 GOVERNMENT 27000 TCI GRANT REIMBURSEMENT SQUARE ONE 1095 MAIN ST FL 2 SPRINGFIELD MA 01107 042103855 501(C)(3) 37001 TCI GRANT REIMBURSEMENT MARTIN LUTHER KING JR FAMILY SERVICES 106 WILBRAHAM ROAD SPRINGFIELD MA 01109 042647035 501(C)(3) 35722 TCI GRANT REIMBURSEMENT WAY FINDERS INC 120 MAPLE STREET STE 400 SPRINGFIELD MA 01103 042518368 501(C)(3) 30000 TCI GRANT REIMBURSEMENT PARTNERS FOR A HEALTHIER COMMUNITY INC 127 STATE STREET SPRINGFIELD MA 01101 043342182 501(C)(3) 109450 TCI GRANT REIMBURSEMENT SPRINGFIELD PARTNERS FOR COMMUNITY ACTION 721 STATE STREET SPRINGFIELD MA 01109 042374279 501(C)(3) 24255 TCI GRANT REIMBURSEMENT 6 0 PART I, LINE 2: DONATIONS MADE BY THE MERCY HOSPITAL TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE. DONATIONS ARE INCLUDED IN COMMUNITY BENEFITS IN SCHEDULE H IF THE CONTRIBUTION HAS BEEN FORMALLY RESTRICTED TO A COMMUNITY BENEFIT ACTIVITY THAT MEETS THE CRITERIA TO BE REPORTED ON SCHEDULE H. 0 1 0 0 0 0 0 0 0 SCOTT WOLF DIRECTOR, PRESIDENT & CEO THR 3/17 0 413041 0 101378 0 7070 0 11925 0 27372 0 560786 0 0 CHRISTOPHER COMEY MD DIRECTOR & PRES MED STAFF THR 11/16 0 689821 0 20020 0 96 0 11925 0 23187 0 745049 0 0 DANIEL KEENAN ASST. SEC; SVP GOV'T RELATIONS 0 202351 0 42000 0 1678 0 11692 0 24844 0 282565 0 0 THOMAS ROBERT TREASURER, SVP & CFO THR 1/17 0 342890 0 80000 0 14610 0 19875 0 26646 0 484021 0 0 RALPH BECKER TREASURER & INT VP FINANCE AT 2/17 0 313509 0 137872 0 5273 0 11925 0 11723 0 480302 0 0 JAMES HARRIS ASSISTANT TREASURER AS OF 4/17 0 181747 0 20000 0 806 0 12037 0 1502 0 216092 0 0 MARIA RUSSO-APPEL MD VP MERCY BEHAVIORAL HEALTH THR 2/17 308960 0 31344 0 723 0 8613 0 20603 0 370243 0 0 0 SIMON AHTARIDIS MD INTERIM CMO THR 5/17 0 339384 0 37722 0 50 0 11925 0 21362 0 410443 0 0 CHARLES FLINN INTERIM COO AS OF 2/17 0 324679 0 140931 0 2427 0 11925 0 4045 0 484007 0 0 VIKRAM SONDHI INTERIM CMO AS OF 5/17 0 259442 0 29567 0 50 0 12035 0 23832 0 324926 0 0 ROBERT ROOSE MD VP MERCY BEHAVIORAL HEALTH AT 2/17 285335 0 15200 0 12901 0 12264 0 7891 0 333591 0 0 0 ALLANA LEE DO PHYSICIAN 300347 0 12200 0 259 0 7950 0 20627 0 341383 0 0 0 MARY TARAIL MD PSYCHIATRIST 272198 0 1400 0 2913 0 11926 0 645 0 289082 0 0 0 GAURAV CHAWLA MD CMO BEHAVIORAL HEALTH 263524 0 200 0 660 0 16502 0 21395 0 302281 0 0 0 CHHEWANG NORSANG MD PSYCHIATRIST 246418 0 2800 0 1082 0 7875 0 19286 0 277461 0 0 0 NANCY DUFAULT RN NURSE 224305 0 1500 0 11909 0 11264 0 20411 0 269389 0 0 0 DANIEL MOEN FORMER OFFICER; TRINITY EXECUTIVE 0 611995 0 160861 0 149819 0 11925 0 33097 0 967697 0 0 LEONARD PANSA FORMER KEY EMP; SVP HR & ADMIN SVCS 0 338785 0 89014 0 21644 0 15900 0 5006 0 470349 0 0 PART I, LINE 3 MERCY HOSPITAL'S CEO WAS PAID DIRECTLY BY THE HOSPITAL'S PARENT ENTITY, SISTERS OF PROVIDENCE HEALTH SYSTEM, WHICH MERGED INTO THE MERCY HOSPITAL EFFECTIVE DECEMBER 30, 2016. SISTERS OF PROVIDENCE HEALTH SYSTEM USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF MERCY HOSPITAL'S CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2016. THE PLAN PROVIDES RETIREMENT BENEFITS TO CERTAIN TRINITY HEALTH EXECUTIVES SUBJECT TO MEETING SPECIFIED VESTING AND EMPLOYMENT DATE REQUIREMENTS. BENEFITS FOR PARTICIPANTS VESTED IN A PLAN WERE PAID OUT IN 2016, AND BENEFITS FOR PARTICIPANTS NOT YET VESTED IN A PLAN WERE ACCRUED IN 2016. THE FOLLOWING PAYOUTS FOR 2016 FOR THE PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: DANIEL MOEN - $129,453 SUSAN WHALEN FAMILY MEMBER OF DEAN WHALEN, ESQUIRE, DIRECTOR 124543 EMPLOYMENT ARRANGEMENT 0 0 X 1 120000 DONOR PROVIDED VALUE 0 1 0 FORM 990, PAGE 1, DOING BUSINESS AS NAMES: MERCY MEDICAL CENTER PROVIDENCE BEHAVORIAL HEALTH HOSPITAL WELDON REHABILITATION HOSPITAL SR. MARY CARITAS CANCER CENTER @ MERCY MEDICAL CENTER HEALTHCARE FOR THE HOMELESS @ MERCY MEDICAL CENTER SISTERS OF PROVIDENCE HEALTH SYSTEM FORM 990, PART VI, SECTION A, LINE 2 THE MERCY HOSPITAL BOARD MEMBERS KATHLEEN KANE AND JOHN JOYCE HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 4 THE ARTICLES OF INCORPORATION AND BYLAWS OF THE MERCY HOSPITAL WERE AMENDED AND RESTATED TO CHANGE THE SOLE MEMBER OF THE CORPORATION. EFFECTIVE AUGUST 16, 2016, THE SOLE MEMBER IS TRINITY HEALTH OF NEW ENGLAND. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE MERCY HOSPITAL IS TRINITY HEALTH OF NEW ENGLAND. SEE LINE 7 FOR ADDITIONAL INFORMATION. FORM 990, PART VI, SECTION A, LINE 7A TRINITY HEALTH OF NEW ENGLAND IS THE SOLE MEMBER OF THE MERCY HOSPITAL. TRINITY HEALTH OF NEW ENGLAND HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF THE MERCY HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER, TRINITY HEALTH OF NEW ENGLAND MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. TRINITY HEALTH OF NEW ENGLAND MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS AND MODIFICATIONS TO GOVERNING DOCUMENTS. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, THE FORM 990 FOR THE MERCY HOSPITAL IS REVIEWED BY MANAGEMENT. EACH MEMBER OF THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE, AND THE RETURN IS REVIEWED AT THE NEXT SCHEDULED BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C THE MERCY HOSPITAL HAS ADOPTED TRINITY HEALTH'S GOVERNANCE POLICY NO. 1, WHICH SETS FORTH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND PROCESSES. IT APPLIES TO ALL "INTERESTED PERSONS" OF THE MERCY HOSPITAL, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS, KEY EMPLOYEES, AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS. INTERESTED PERSONS ARE EXPECTED TO DISCHARGE THEIR DUTIES IN A MANNER THE PERSON REASONABLY BELIEVES TO BE IN THE BEST INTERESTS OF THE MERCY HOSPITAL AND TO AVOID SITUATIONS INVOLVING A CONFLICT OF INTEREST. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE PROVIDED TO INTERNAL LEGAL COUNSEL AND THE INTEGRITY AND COMPLIANCE OFFICER, FROM WHICH LEGAL COUNSEL PREPARES A REPORT FOR THE BOARD CHAIR AND CEO. A SUMMARY OF POTENTIAL CONFLICTS IS REVIEWED WITH THE BOARD OF DIRECTORS OF THE MERCY HOSPITAL (OR A DELEGATED COMMITTEE OF THE BOARD) ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO THE MERCY HOSPITAL OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF THE MERCY HOSPITAL (OR A DELEGATED COMMITTEE OF THE BOARD) IS RESPONSIBLE FOR THE REVIEW OF TRANSACTIONS TO DETERMINE WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS. IN THE EVENT OF AN ACTUAL CONFLICT, THE BOARD (OR A DELEGATED COMMITTEE OF THE BOARD) WILL EITHER AVOID THE CONFLICT OR APPROPRIATELY SCRUTINIZE THE TRANSACTION TO ENSURE IT IS IN THE BEST INTERESTS OF THE MERCY HOSPITAL. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE POLICY FURTHER ADDRESSES THE PROPER DOCUMENTATION OF THE PROCEEDINGS AND POTENTIAL DISCIPLINARY AND CORRECTIVE ACTION FOR VIOLATIONS OF THE POLICY. THE POLICY IS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 15B QUESTIONS 15A AND 15B ARE ANSWERED "NO" BECAUSE THE COMPENSATION FOR THE MERCY HOSPITAL'S CEO AND OTHER KEY MANAGEMENT OFFICIALS WAS ESTABLISHED BY SISTERS OF PROVIDENCE HEALTH SYSTEM, A RELATED ORGANIZATION THAT WAS MERGED INTO THE MERCY HOSPITAL EFFECTIVE DECEMBER 30, 2016. THE PROCESS FOR ESTABLISHING THE COMPENSATION FOR THE CEO AND OTHER KEY MANAGEMENT OFFICIALS INCLUDES THE FOLLOWING: THE BOARD HAS AN INDEPENDENT COMMITTEE REVIEW AND APPROVE ALL ELEMENTS OF REMUNERATION FOR ALL DISQUALIFIED PERSONS, AS WELL AS OTHER KEY MANAGEMENT OFFICIALS. THE BOARD/COMMITTEE HAS AN ESTABLISHED COMPENSATION PHILOSOPHY WHICH DETAILS THE OBJECTIVES OF MARKET POSITIONING AND PAY ELEMENTS. THE COMMITTEE ENGAGES WITH EXTERNAL CONSULTANTS TO PROVIDE MARKET DATA COMPARING THE ORGANIZATION'S ROLES TO SIMILARLY SIZED ORGANIZATIONS, UTILIZING BOTH TITLE AND JOB CONTENT COMPARISONS. THE COMMITTEE REVIEWS THE MARKET ANALYSIS, APPROVES ANY SALARY ADJUSTMENTS FOR THE EXECUTIVE POPULATION, CONSIDERS BOTH REASONABLENESS AND EFFECTIVENESS OF ALL REMUNERATIVE PROGRAMS, AND ESTABLISHES THE DETAILED PERFORMANCE EXPECTATIONS WHICH ARE INCORPORATED INTO THE INCENTIVE PLAN. ALL OF THESE DISCUSSIONS AND DECISIONS ARE DOCUMENTED THROUGH THE PROVISION OF MEETING MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE MERCY HOSPITAL IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, THE MERCY HOSPITAL INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. THE MERCY HOSPITAL'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G MISC. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 23,980,681. MANAGEMENT AND GENERAL EXPENSES 6,116,728. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 30,097,409. MEDICAL SPECIALIST FEES: PROGRAM SERVICE EXPENSES 3,378,227. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,378,227. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 2,005,748. MANAGEMENT AND GENERAL EXPENSES 158,016. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,163,764. MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 670,998. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 670,998. RECRUITING SERVICES: PROGRAM SERVICE EXPENSES 223,705. MANAGEMENT AND GENERAL EXPENSES 17,624. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 241,329. BILLING SERVICES: PROGRAM SERVICE EXPENSES 133,401. MANAGEMENT AND GENERAL EXPENSES 10,509. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 143,910. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 138,843. MANAGEMENT AND GENERAL EXPENSES 10,938. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 149,781. FORM 990, PART XI, LINE 9: EQUITY GAIN IN UNCONSOLIDATED AFFILIATES 396,903. EQUITY TRANSFERS TO/FROM AFFILIATES -2,708,390. TRANSFER OF SISTERS OF PROVIDENCE HEALTH SYSTEM NET ASSETS UPON MERGER 8,173,515. FORM 990, PART XII, LINE 2: THE MERCY HOSPITAL'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY17 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. ACCOUNTABLE CARE ORGANIZATION OF NEW ENGLAND LLC 1221 MAIN ST STE 213 HOLYOKE MA 01040 454565187 ACCOUNTABLE CARE ORGANIZATION MA 3556951 3398581 THE MERCY HOSPITAL INC MERCY CARE ALLIANCE LLC 1221 MAIN ST STE 213 HOLYOKE MA 01040 471561725 ACCOUNTABLE CARE ORGANIZATION MA 2084491 352275 THE MERCY HOSPITAL INC MERCY HEALTH ACCOUNTABLE CARE ORGANIZATION 1221 MAIN ST STE 213 HOLYOKE MA 01040 821007572 ACCOUNTABLE CARE ORGANIZATION MA 0 0 THE MERCY HOSPITAL INC ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP 245 STATE ST SE GRAND RAPIDS MI 49503 272491974 HEALTH CARE SERVICES MI 501(C)(3) LINE 10 TRINITY HEALTH-MICHIGAN 1 ALLEGANY FRANCISCAN MINISTRIES INC 33920 US HIGHWAY 19 NORTH SUITE 269 PALM HARBOR FL 34684 581492325 GRANT MAKING FL 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION 1 ASYLUM HILL FAMILY MEDICINE CENTER INC 114 WOODLAND STREET HARTFORD CT 06105 061450170 HEALTH CARE SERVICES CT 501(C)(3) LINE 3 TRINITY HEALTH OF NEW ENGLAND CORP INC 1 BAUM HARMON MERCY HOSPITAL 255 NORTH 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