FURP.ORG / PUBLIC DATA EXPLORER

BAYSTATE NOBLE HOSPITAL CORPORATION: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
BAYSTATE NOBLE HOSPITAL CORPORATION (EIN 22-2537423)
Tax period
2016-10-01 to 2017-09-30
Filed
2018-08-09
IRS object ID
201832219349301158
Schema version
2016v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-08-09T13:11:27-05:00ReturnTs
Tax Period End2017-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN861065772PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Deloitte Tax LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1Two Jericho PlazaAddressLine1Txt
CityJerichoCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11753ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN222537423EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Baystate Noble Hospital CorporationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlBAYSBusinessNameControlTxt
Phone4135682811PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1115 West Silver StreetAddressLine1Txt
CityWestfieldCityNm
State AbbreviationMAStateAbbreviationCd
ZIP010861634ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDENNIS W CHALKEPersonNm
Person TitleSVP FINANCE, CFO & TREASURERPersonTitleTxt
Phone4135682811PhoneNum
Signature2018-08-09SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonChristine KaweckiPreparerPersonNm
PTINP00743140PTIN
Phone5169187000PhoneNum
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDENNIS W CHALKEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1115 West Silver StreetAddressLine1Txt
CityWestfieldCityNm
State AbbreviationMAStateAbbreviationCd
ZIP010861634ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$56,536,144GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.BAYSTATENOBLEHOSPITAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1984FormationYr
Legal Domicile StateMALegalDomicileStateCd
Activity Or MissionTHE MISSION OF THE ORGANIZATION IS TO IMPROVE THE HEALTH OF THE PEOPLE IN OUR COMMUNITIES EVERY DAY, WITH QUALITY AND COMPASSION.ActivityOrMissionDesc
Voting Members Governing Body24VotingMembersGoverningBodyCnt
Voting Members Independent17VotingMembersIndependentCnt
Total Employee693TotalEmployeeCnt
Total Volunteers80TotalVolunteersCnt
Total Gross UBI$48TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$663,083PYContributionsGrantsAmt
CY Contributions Grants$304,438CYContributionsGrantsAmt
PY Program Service Revenue$60,613,218PYProgramServiceRevenueAmt
CY Program Service Revenue$56,061,394CYProgramServiceRevenueAmt
PY Investment Income$39,834PYInvestmentIncomeAmt
CY Investment Income$170,264CYInvestmentIncomeAmt
PY Other Revenue$28,003PYOtherRevenueAmt
CY Other Revenue$48CYOtherRevenueAmt
PY Total Revenue$61,344,138PYTotalRevenueAmt
CY Total Revenue$56,536,144CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$32,015,378PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$32,471,956CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$25,885,542PYOtherExpensesAmt
CY Other Expenses$24,519,649CYOtherExpensesAmt
PY Total Expenses$57,900,920PYTotalExpensesAmt
CY Total Expenses$56,991,605CYTotalExpensesAmt
PY Revenues Less Expenses$3,443,218PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$455,461CYRevenuesLessExpensesAmt
Total Assets BOY$31,504,681TotalAssetsBOYAmt
Total Assets EOY$58,197,429TotalAssetsEOYAmt
Total Liabilities BOY$29,150,080TotalLiabilitiesBOYAmt
Total Liabilities EOY$51,306,622TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,354,601NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$6,890,807NetAssetsOrFundBalancesEOYAmt
MissionThe mission of the organization is to improve the health of the people in our communities every day, with quality and compassion.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$27,420,529ExpenseAmt
Revenue$27,416,147RevenueAmt
DescInpatient 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 FY2017, Baystate Noble Hospital provided 15,530 patient days of inpatient services.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$16,907,865ExpenseAmt
Revenue$15,754,952RevenueAmt
DescOutpatient healthcare services - Providing outpatient clinical services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY2017, Baystate Noble Hospital had 43,330 outpatient visits.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$10,677,468ExpenseAmt
Revenue$11,037,449RevenueAmt
DescEmergency department services - Providing emergency department services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY2017, Baystate Noble Hospital had 27,592 emergency department visits.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Revenue$1,852,846RevenueAmt
FieldValueIRS element (for citing)
Total Other Prog Srvc Revenue$1,852,846TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$55,005,862TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgYes (1)TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document123IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee693EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members24GoverningBodyVotingMembersCnt
Independent Voting Member17IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1John Shaver - Baystate Noble HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4135682811PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1115 West Silver StreetAddressLine1Txt
CityWestfieldCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01085ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (38 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Anne M Paradis
Chair (as of 1/1/17)1.002.00Yes (X)Yes (X)$0$0$0
John F Maybury
Vice Chair (as of 1/1/17)1.001.00Yes (X)Yes (X)$0$0$0
Adrian J Levsky
Trustee1.001.00Yes (X)$0$0$0
Aleksandr Pugach MD
Trustee48.001.00Yes (X)$98,525$124,703$6,814
Claudia R Coplein DO
Trustee (as of 1/1/17)1.001.00Yes (X)$0$0$0
Colleen W Holmes
Trustee (as of 1/1/17)1.001.00Yes (X)$0$0$0
David C Southworth
Trustee (through 12/31/16)1.001.00Yes (X)$0$0$0
Edward J Noonan
Trustee1.001.00Yes (X)$0$0$0
Grace Makari-Judson MD
Trustee/ Hematologist1.0040.00Yes (X)$347,988$0$78,646
Gregory L Braden MD
Trustee1.001.00Yes (X)$0$0$0
Harriet A DeVerry
Trustee1.001.00Yes (X)$0$0$0
Hector Toledo
Trustee1.001.00Yes (X)$0$0$0
James P Sadowsky
Trustee1.002.00Yes (X)$0$0$0
James R Phaneuf
Trustee1.001.00Yes (X)$0$0$0
John A Egelhofer MD
Trustee1.001.00Yes (X)$0$0$0
John H Davis
Trustee1.001.00Yes (X)$0$0$0
Kathleen B Scoble
Trustee1.001.00Yes (X)$0$0$0
Kevin P Moriarty MD
Trustee/Chief Ped Surgery1.0040.00Yes (X)$0$699,348$45,950
Mark A Keroack MD
Trustee1.0040.00Yes (X)$0$2,182,220$38,487
Paul R Murphy
Trustee1.001.00Yes (X)$0$0$0
Robert J Bacon
Trustee1.001.00Yes (X)$0$0$0
Robert L Pura PhD
Trustee1.001.00Yes (X)$0$0$0
Steven M Mitus
Trustee (through 12/31/16)1.001.00Yes (X)$0$0$0
Timothy F Farrell
Trustee (as of 1/1/17)1.001.00Yes (X)$0$0$0
Victor Woolridge
Trustee1.001.00Yes (X)$0$0$0
William R Webber
Trustee (as of 1/1/17)1.001.00Yes (X)$0$0$0
Dennis Chalke
Treasurer1.0050.00Yes (X)$0$935,201$89,071
Kristin R Delaney
Clerk1.0039.00Yes (X)$0$137,437$37,010
Madeline Torres
Assistant Clerk1.0040.00Yes (X)$0$56,586$13,801
Ronald Bryant
President, BNH40.0010.00Yes (X)$0$545,819$44,592
John Shaver
Chief Financial Officer50.000.00$260,196$0$10,814Yes (X)
Beverly Fein
VP Human Resources50.000.00$191,050$0$4,848Yes (X)
Michele Urban
VP Patient Care Services/CNO50.000.00$176,048$0$4,778Yes (X)
Deborah Kudla
Director of Surgical and Outpatient Services50.000.00$175,609$0$4,780Yes (X)
John Burke
Director Patient Fin Servi50.000.00$169,746$0$7,737Yes (X)
Khalila Fullard
Clinical Pharmacy Manager50.000.00$131,454$0$4,625Yes (X)
David Rosinski
Director of Facilities50.000.00$130,988$0$8,233Yes (X)
Hui-Wen Chia
Pharmacist50.000.00$128,693$0$3,268Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,810,297TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$4,681,314TotReportableCompRltdOrgAmt
Total Other Compensation$403,454TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K34IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other SrcsYes (1)CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Rehabcare Group East Inc
PO Box 502096St LouisMO631502096Physical Rehabilitation$2,077,825
Raymond R Houle Construction Inc
5 Miller StreetLudlowMA01056Construction Services$1,510,200
Morrison Healthcare Inc
PO Box 102289AtlantaGA303682289Dietary Services$1,368,211
Crothall Healthcare Inc
13028 Collection Center DriveChicagoIL60693Housekeeping Services$889,672
Springfield Anesthesia Service Inc
908 Allen StreetSpringfieldMA01101Anesthesia Services$733,161
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K15CntrctRcvdGreaterThan100KCnt
Government Grants$250,320GovernmentGrantsAmt
All Other Contributions$54,118AllOtherContributionsAmt
Total Contributions$304,438TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Hospital Revenue622000$55,896,418$55,896,418
Rental Income From Affiliate531390$132,249$132,249
Medical Record Income622000$32,727$32,727
FieldValueIRS element (for citing)
Total Program Service Revenue$56,061,394TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$170,264TotalRevenueColumnAmt
Exclusion$170,264ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescYankee Alliance K-1Desc
Business523000BusinessCd
Total Revenue Column$48TotalRevenueColumnAmt
Unrelated Business Revenue$48UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Other Revenue Total$48OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$56,536,144TotalRevenueColumnAmt
Related Or Exempt Func Income$56,061,394RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$48UnrelatedBusinessRevenueAmt
Exclusion$170,264ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$647,734TotalAmt
Program Services$181,366ProgramServicesAmt
Management And General$466,368ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$26,627,356TotalAmt
Program Services$25,890,055ProgramServicesAmt
Management And General$737,301ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$626,355TotalAmt
Program Services$612,534ProgramServicesAmt
Management And General$13,821ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,602,521TotalAmt
Program Services$2,487,670ProgramServicesAmt
Management And General$114,851ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,967,990TotalAmt
Program Services$1,924,566ProgramServicesAmt
Management And General$43,424ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$314,421TotalAmt
Program Services$134,602ProgramServicesAmt
Management And General$179,819ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$75,660TotalAmt
Management And General$75,660ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$15,879TotalAmt
Management And General$15,879ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,757,996TotalAmt
Program Services$2,689,026ProgramServicesAmt
Management And General$68,970ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$59,774TotalAmt
Program Services$59,774ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$224,599TotalAmt
Program Services$218,348ProgramServicesAmt
Management And General$6,251ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,911,435TotalAmt
Program Services$1,911,435ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,098,149TotalAmt
Program Services$2,051,990ProgramServicesAmt
Management And General$46,159ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$21,740TotalAmt
Program Services$15,506ProgramServicesAmt
Management And General$6,234ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$77,207TotalAmt
Program Services$76,411ProgramServicesAmt
Management And General$796ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$254,970TotalAmt
Program Services$254,970ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,397,225TotalAmt
Program Services$2,344,486ProgramServicesAmt
Management And General$52,739ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$441,943TotalAmt
Program Services$441,943ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Purchased Services$7,391,123$7,391,123
Medical Supplies$5,777,501$5,777,501
Equipment Rentals$287,292$287,292
Dues$170,037$12,566$157,471

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$242,698TotalAmt
Program Services$242,698ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$56,991,605TotalAmt
Program Services$55,005,862ProgramServicesAmt
Management And General$1,985,743ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,907,282BOYAmt
EOY$1,430,128EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$701,873BOYAmt
EOY$701,873EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,197,745BOYAmt
EOY$5,562,906EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$971,706BOYAmt
EOY$924,271EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$157,191BOYAmt
EOY$219,038EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$71,950,790LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$50,600,140LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$18,971,181BOYAmt
EOY$21,350,650EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$3,918,388BOYAmt
EOY$3,836,416EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$679,315BOYAmt
EOY$24,172,147EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$31,504,681BOYAmt
EOY$58,197,429EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$16,947,670BOYAmt
EOY$10,250,965EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$288,019EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,879,902BOYAmt
EOY$1,286,645EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$6,791,101BOYAmt
EOY$6,791,101EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,531,407BOYAmt
EOY$32,689,892EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$29,150,080BOYAmt
EOY$51,306,622EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$2,494,531BOYAmt
EOY$1,443,944EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,968,584BOYAmt
EOY$4,566,315EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$880,548BOYAmt
EOY$880,548EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,354,601BOYAmt
EOY$6,890,807EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$31,504,681BOYAmt
EOY$58,197,429EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$455,461ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$4,991,667OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (1)DirectContactLegislatorsInd
Direct Contact Legislators$15,879DirectContactLegislatorsAmt
Rallies Demonstrations0RalliesDemonstrationsInd
Other Activities0OtherActivitiesInd
Total Lobbying Expenditures$15,879TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationThe organization paid membership dues to the Massachusetts Hospital Association and the American Hospital Association, both of whom have advised that portions of those dues were used for lobbying purposes.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,846,559BeginningYearBalanceAmt
Investment Earnings Or Losses$539,708InvestmentEarningsOrLossesAmt
Other Expenditures$205,791OtherExpendituresAmt
End Year Balance$4,180,476EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,668,589BeginningYearBalanceAmt
Investment Earnings Or Losses$634,142InvestmentEarningsOrLossesAmt
Other Expenditures$456,172OtherExpendituresAmt
End Year Balance$3,846,559EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,696,725BeginningYearBalanceAmt
Investment Earnings Or Losses$358,112InvestmentEarningsOrLossesAmt
Other Expenditures$386,248OtherExpendituresAmt
End Year Balance$3,668,589EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$314,169,914BeginningYearBalanceAmt
Investment Earnings Or Losses$805,052InvestmentEarningsOrLossesAmt
Other Expenditures$275,668OtherExpendituresAmt
End Year Balance$3,696,725EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,738,374BeginningYearBalanceAmt
Investment Earnings Or Losses$794,284InvestmentEarningsOrLossesAmt
Other Expenditures$365,317OtherExpendituresAmt
End Year Balance$3,167,341EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.21060PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.78940TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$962,597OtherCostOrOtherBasisAmt
Book Value$962,597BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$38,420,718OtherCostOrOtherBasisAmt
Depreciation$23,227,209DepreciationAmt
Book Value$15,193,509BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$32,567,475OtherCostOrOtherBasisAmt
Depreciation$27,372,931DepreciationAmt
Book Value$5,194,544BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$21,350,650TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
Medical Malpractice Insurance Recoverable$110,000
Third Party Settlements Receivable$345,647
Due from Affiliates$23,423,680
Beneficial Interest in Net Asset of Baystate Health Foundation$292,820
FieldValueIRS element (for citing)
Total Book Value Other Assets$24,172,147TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
Accrued Pension Liability$2,686,937
Medical Malpractice Claims$408,406
Asset Retirement Obligation$572,788
Due to Affiliates$29,021,761
FieldValueIRS element (for citing)
Total Liability$32,689,892TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart V, Line 4:FormAndLineReferenceDesc
ExplanationTo provide ongoing support for the hospital and its mission to improve the health of the people in our communities.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,021,443TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$140,279DirectOffsettingRevenueAmt
Net Community Benefit Expns$881,164NetCommunityBenefitExpnsAmt
Total Expense0.01550TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,461,686TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,657,325DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,804,361NetCommunityBenefitExpnsAmt
Total Expense0.03170TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$857,257TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$676,140DirectOffsettingRevenueAmt
Net Community Benefit Expns$181,117NetCommunityBenefitExpnsAmt
Total Expense0.00320TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,340,386TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,473,744DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,866,642NetCommunityBenefitExpnsAmt
Total Expense0.05040TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$78,172TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$78,172NetCommunityBenefitExpnsAmt
Total Expense0.00140TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,300TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$15,300NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$93,472TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$93,472NetCommunityBenefitExpnsAmt
Total Expense0.00170TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,433,858TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,473,744DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,960,114NetCommunityBenefitExpnsAmt
Total Expense0.05210TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,000NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,000NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$945,026BadDebtExpenseAmt
Bad Debt Expense Attributable$65,571BadDebtExpenseAttributableAmt
Reimbursed By Medicare$20,344,744ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$21,873,074CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$1,528,330MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Baystate Noble Hospital CorporationBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1115 West Silver StreetAddressLine1Txt
CityWestfieldCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01086ZIPCd
FieldValueIRS element (for citing)
State LicenseState License #2076StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherPsychiatric and Physical RehabilitationOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Baystate Noble Hospital CorporationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Part V, Section COwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLSee Part V, Section COtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSee Part V, Section CStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Other MethodYes (X)OtherMethodInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttps://www.baystatehealth.org/patients/billing-and-financial-assistanceFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttps://www.baystatehealth.org/patients/billing-and-financial-assistanceFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttps://www.baystatehealth.org/patients/billing-and-financial-assistanceFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Baystate Noble Hospital CorporationPart 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 Noble Hospital CorporationPart 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 (part of Sisters of Providence Health System, 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 Noble Hospital CorporationPart 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 Commission (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 Noble Hospital CorporationPart V, Section B, Line 7d: Part V, Line 7a:https://www.baystatehealth.org/about-us/community-programs/community-benefits/community-health-needs-assessmentPart V, Line 7b:http://www.cbsys.ago.state.ma.us/cbpublic/public/hccbindex.aspxPart V, 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.Part V, Line 10a:https://www.baystatehealth.org/about-us/community-programs/community-benefits/community-health-needs-assessment
Baystate Noble Hospital CorporationPart V, Section B, Line 11: The 2016 CHNA was conducted using a determinant of health framework as it is recognized that social and economic determinants of health contribute substantially to population health. It has been estimated that less than a third of our health is influenced by our genetics or biology. Our health is largely determined by the social, economic, cultural, and physical environments that we live in and healthcare we receive.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 cultural humility, health equity, insurance challenges, and mental health and substance use disorders. Needs not directly being addressed the hospital include, basic needs, care coordination, chronic health conditions, food deserts/insecurity, health literacy, limited availability of providers, maternal/infant/child health, physical activity and healthy diet, sexual health, and transportation.
Baystate Noble Hospital CorporationPart 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 Noble Hospital 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 Noble Hospital'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 Noble Hospital CorporationPart V, Section B, Line 15e: Baystate Noble Hospital (BNH) 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 BNH bills as well as about BNH 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, BNH 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. BNH has contracted with the Executive Office of Health and Human Services and the Commonwealth Health Insurance Connector Authority to serve as a Certified Application Counselor 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 Noble Hospital CorporationPart 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 patients 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 Registration 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 Noble Hospital CorporationPart 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.
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line11 - Baystate Noble Hospital Sports & RehabBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line174 Main StreetAddressLine1Txt
CityWestfieldCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01086ZIPCd
FieldValueIRS element (for citing)
FacilityPhysical Rehabilitation Outpatient ClinicFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 6a:The hospital facility files an annual community benefits report electronically with the Massachusetts Office of the Attorney General's via their website at https://www.mass.gov/nonprofit-hospital-and-hmo-community-benefits. The hospital facility's annual community benefits 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 by applying the ratio of patient care cost to charges, calculated on Worksheet 2, against inpatient and outpatient gross charges for Medicaid and Medicaid managed care plans.Line 7c (Other Means-Tested Programs) - community benefit expense was derived by applying the ratio of patient care cost to charges, calculated on Worksheet 2, against inpatient and outpatient gross charges for other means-tested government programs.Line 7f (Health Professional Education) - no expense to report for this category in 2017.
Part I, Line 7g:There are no subsidized health services for 2017 to report in Part I, line 7g.
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 federally mandated community benefit programs and services are not sufficient 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 board that align with our mission. The hospital facility paid dues to the Greater Westfield Chamber of Commerce totaling $2,000. The hospital participates in the Chamber as we are one of the largest local employers in our service area. The Chamber and its membership coordinate activities toward a common purpose of sustainability and economic growth for the region.
Part III, Line 2: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). In 2017, the provision for bad debts was reported as a deduction to net patient service revenue. The 2017 provision for bad debts totalled $2,620,335 and is not included in total expenses reported in Part IX, LIne 25, column (A) for the purpose of calculating the percentages in Part 1, LIne 7, column (f).
Part III, Line 4:The cost of bad debts reported in Part III, line 2 was calculated by applying the ratio of patient care cost to charges, calculated on Worksheet 2, 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 150% 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 150% 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 $65,571, 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 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.
Part III, Line 8:Line 6 - included all Medicare allowable costs as calculated in Worksheets D-1 Part II (inpatient) and D Part V (outpatient) of the hospital's 2017 Medicare cost report, based on Medicare costing principles. We believe the shortfall reported of $1,528,330 should be treated as community benefit expense for tax reporting purposes because providing care for the elderly is a key component of our commitment to the community. The unreimbursed expenses should be treated similarly to unreimbursed Medicaid since the majority of the local elderly population is not affluent.
Part III, Line 9b:All patient bills and statements contain language referencing available free care programs.
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:The hospital 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 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 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 with 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 Baystate'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. https://www.baystatehealth.org/patients/billing-and-financial-assistanceThe 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. Baystate's Billing and Collection Policy was developed to ensure Baystate provides adequate and affordable health care accessible to everyone, regardless of income, social or economic status.Signs about the availability of financial assistance programs at the hospital are translated into Spanish and Russian because Spanish and Russian are primarily spoken by more than 1000 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 Noble is a 97-bed acute care community hospital providing a broad range of services to the Greater Westfield community. Baystate Noble is able to offer direct access to world-class technology, diagnostics, and specialists as a proud member of the Baystate Health system. Baystate Health and Baystate Noble work to ensure that our patients have access to exceptional health care, close to home. An ideal combination of "high tech and "high touch," a staff of highly trained and compassionate nurses and medical support personnel complements an outstanding medical staff. Services include intensive care, diagnostic imaging, emergency services, cardiopulmonary services and rehab, cancer services, lab and behavioral health. The service area for Baystate Noble includes nine communities, eight of which are located in the western portion of Hampden County. The total population of the service area is almost 100,000 people, and a majority of this population lives in the cities of West Springfield and Westfield. There is a mix of rural and urban populations as defined by the U.S. Census Bureau. Urban areas consist of census tracts and/or blocks that meets the minimum population density requirement (2,500-49,999 for urban clusters and over 50,000 for urbanized areas) or is adjacent and meet additional criteria. The population is densest surrounding Westfield, West Springfield, and Agawam (CC, US Census Bureau, Decennial Census 2010). The median age of these cities hovers near the county median age of 39. Racial and ethnic diversity is more common in the urban communities, where over 12% of the population identifies as Black or African American, American Indian, Asian, or some other race. Approximately 9% of the service area's population is Hispanic or Latino, and there has been a recent surge in immigrants from Asia and the Middle East to both West Springfield and Westfield. The Pioneer Valley Transit Authority connects three of the communities to the Springfield metropolitan area to the east, and to the hospital itself. Paratransit service is also available for people with disabilities within mile of a fixed route to facilitate access to medical care. Annual per capita income in the service area exceeds the county average by about $3,000, and the percentage of those who pay more than 30% of their income for housing costs is below the county rate by more than 4%. The overall poverty rate for this service area is less than 10% -- almost half of the county rate. Child poverty, however, is slightly higher than the county rate of 27%. The population has high rates of education, with over 90% having a high school diploma. The percent of the population with a bachelor's degree or higher is slightly higher than the county rate of 26%. The hospital's service area's unemployment rate of 5.2% is comparable to the county unemployment rate of 4.6%. The unemployment rate is based on the number of people who are either working or actively seeking work. Major employers in the area include the service, wholesale and retail trade, and health care industries.
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 and its affiliates, 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 and its affiliates 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 include Baystate Medical Center, Baystate Franklin Medical Center, Baystate Noble Hospital, and Baystate Wing Hospital (and Baystate Mary Lane Outpatient Center); the other 501(c)(3) organizations include Baystate Medical Practices, Visiting Nurse Association and Hospice of Western New England, Noble Visiting Nurse Services, Inc., Baystate Administrative Services, and Baystate Health Foundation. In addition to its nearly 12,000 employees, Baystate Health has 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 2017, more than 1,053 volunteers donated over 86,000 hours showing their belief in the care we provide to our community.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 Medical Center (BMC) is a 713-bed, 57-bassinet, academic medical center in Springfield, Massachusetts which has Medical staff of over 1,300 physicians. Baystate Medical Center was awarded magnet hospital designation for nursing excellence from the American Nurses Credentialing Center and is ranked third among hospitals in MA by U.S. News & World Report, with the highest rating in nine procedures or conditions. BMC was named a top 50 cardiovascular hospital by Watson Health. Baystate Medical Center Emergency & Trauma Center is the busiest single-site emergency department in Massachusetts and the region's only Level 1 Trauma Center serving over 120,000 adult and pediatric patients. Baystate Reference Laboratories, part of Baystate Medical Center, Inc., is the region's largest reference laboratory and is staffed by 24 board-certified pathologists and over 500 technologists and support personnel.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 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 2017 BMP provided $ $1,521,968 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. It is 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.In addition to the brief descriptions of the affiliated entities above, this further information speaks to activities of Baystate Health and its affiliates regarding promotion of community health.In 2017, over 199,000 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 3,293 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. Twenty-one students enrolled in the first year (2017), fifteen of whom 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 6The Nurse Residency Program expanded to all Baystate Health hospitals. In 2017 Baystate welcomed 140 Nurse Residents providing both advanced curricular activities and fellowship activities to ease the transition from school to practice. 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 has hired 366 new graduate nurse residents from the program to-date.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. In addition, Baystate Medical Center welcomed 1,770 new residents, fellows, medical students, nursing students, and allied health students.Baystate Springfield Educational Partnership (BSEP) ran courses for 251 students, primarily residents of Springfield. During the summer, BSEP provided theme-based workshops for 78 students, coordinated 21 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. To 29 alumni of its program, BSEP awarded a total of $54,500 in scholarships for undergraduate and graduate education. The seven-year total of scholarships awarded now exceeds $650,000.Baystate Awarded Research Grants. In 2017, Baystate received research grants from the National Institute of Health including: $2.55 million to study the use of pulmonary rehabilitation by patients with chronic obstructive pulmonary disease following hospital discharge, $1.2 million to study the epidemiology and service accessibility for people who use opioids in rural northern New England. Total grant funding has increased by more than 50% over the past five years.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 provides 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. In the first six months of the program, 300 pounds of medications and 330 pounds of sharps were deposited and sent for safe disposal.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. In 2017, Baystate Health certified Specialty Pharmacy liaisons saved patients an estimated $5 million 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 1,934 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 2017, 25 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 $1.7 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 $14.2 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.
Form 990, Schedule H, Part VI, Line 6See also additional information regarding Baystate Health, Inc. and its affiliate's promotion of community health above in Line 5.
Part VI, Line 7, List of States Receiving Community Benefit ReportMA

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Housing Allowance Or ResidenceYes (X)HousingAllowanceOrResidenceInd
Written Policy Ref T And E Expnss0WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Aleksandr Pugach MD
Trustee$95,961$104,472$0$0$2,564$20,231$5,936$715$131$32$104,592$125,450$0$0
Grace Makari-Judson MD
Trustee/ Hematologist$275,652$0$50,668$0$21,668$0$60,173$0$18,473$0$426,634$0$0$0
Kevin P Moriarty MD
Trustee/Chief Ped Surgery$0$537,664$0$124,279$0$37,405$0$26,500$0$19,450$0$745,298$0$0
Mark A Keroack MD
Trustee$0$876,848$0$401,474$0$903,898$0$19,875$0$18,612$0$2,220,707$0$562,123
Dennis Chalke
Treasurer$0$489,983$0$162,064$0$283,154$0$63,576$0$25,495$0$1,024,272$0$0
Kristin R Delaney
Clerk$0$122,188$0$14,668$0$581$0$18,742$0$18,268$0$174,447$0$0
Ronald Bryant
President, BNH$0$422,431$0$97,708$0$25,680$0$19,875$0$24,717$0$590,411$0$0
John Shaver
Chief Financial Officer$228,216$0$29,844$0$2,136$0$4,825$0$5,989$0$271,010$0$0$0
Beverly Fein
VP Human Resources$167,576$0$22,671$0$803$0$0$0$4,848$0$195,898$0$0$0
Michele Urban
VP Patient Care Services/CNO$153,968$0$20,682$0$1,398$0$0$0$4,778$0$180,826$0$0$0
Deborah Kudla
Director of Surgical and Outpatient$160,250$0$13,213$0$2,146$0$0$0$4,780$0$180,389$0$0$0
John Burke
Director Patient Fin Servi$156,866$0$5,519$0$7,361$0$3,116$0$4,621$0$177,483$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 1a#3 & #5 Housing provided for an employee of the filing organization which requires a tax gross-up. The above item was treated as taxable compensation as appropriate in accordance with Baystate Noble written policies which require compliance with the IRS accountable plan rules.
Part I, Line 3The compensation committee of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs) reviews and approves the compensation philosophy that is used to administer the specific pay decisions for the President of the filing organization. The compensation committee consists entirely of individuals serving on the board of the filing organization. The compensation of the President of the filing organization is determined by the member of the President's Cabinet (the Health System's senior leadership) responsible for that filing organization, in consultation with Human Resources, based on information provided by independent third party consultants for reasonableness including appropriate comparability data and based on the Executive Compensation Philosophy Statement established by the compensation committee.
Part I, Line 4bRonald Bryant - Supplemental Retirement of $12,000 is included in column E. This amount was earned and paid in 2016. Dennis W. Chalke - Supplemental Retirement of $257,706 is included in column E. This amount was earned and paid in 2016. Mark A. Keroack, MD - Total Supplemental Retirement of $881,458 is included in column E. This amount consists of $264,321 earned and paid in 2016 and $562,123 that was previously reported as deferred compensation in prior years Forms 990, and that is currently reported as taxable income. This also includes $55,014 of investment earnings on prior year contributions. The amount is listed in Column F in accordance with reporting requirements. Grace Makari-Judson, MD- Supplemental Retirement of $16,599 is included in column E. This amount was earned in 2016. Kevin P. Moriarty, MD - Supplemental Retirement of $33,542 is included in column E. This amount was earned and paid in 2016.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 1The 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 2Two 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) Claudia R. Coplein, DO and Victor Woolridge (5) John F. Maybury and Anne M. Paradis.
Form 990, Part VI, Section A, line 3Baystate Noble Hospital Corporation 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 6The filing organization has one member, Baystate Health, Inc. (BH).
Form 990, Part VI, Section A, line 7aThe board of Trustees of the filing organization consists of 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 Noble Hospital Corporation 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 the Trust Baystate Noble Hospital Corporation as well as the annual acceptance of the audited financial statements.
Form 990, Part VI, Section B, line 11bPrior 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 12cBaystate Noble Hospital Corporation is an affiliate of Baystate Health, Inc. Baystate Health, Inc. 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 15The compensation committee of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs) reviews and approves the compensation philosophy that is used to administer the specific pay decisions for the President and employees of the filing organization. The compensation committee consists entirely of individuals serving on the board of Baystate Health. The compensation of the President of the filing organization is determined by the member of the President's Cabinet (the Health System's senior leadership) responsible for that filing organization, in consultation with Human Resources, based on information provided by independent third party consultants for reasonableness including appropriate comparability data and based on the Executive Compensation Philosophy Statement established by the compensation committee. The compensation of other officers+D823 and key employees of the filing organization is determined by the President of the filing organization in accordance with 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.
Form 990, Part VI, Section C, line 19The 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 XI, line 9:Net Transfers From Affiliated Companies 5,789,470. Forgiveness Of Inter-Company -1,518,222. Yankee Alliance K-1 Revenue -48. Beneficial Interst in Related Company 292,820. Net Assets Released From Restrictions 427,647.
Form 990, Part VII, Section A, Line 5Certain 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.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (13 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Baystate Administrative Services Inc
759 Chestnut StreetSpringfieldMA01199222747685Administrative servicesMA501 (c ) (3)12c, IIIBaystate Health Inc0
Baystate Health Foundation Inc
759 Chestnut StreetSpringfieldMA01199043549011FundraisingMA501 (c ) (3)7Baystate Health Inc0
Baystate Health Systems Inc Health & Welfare Benefits Plan
759 Chestnut StreetSpringfieldMA01199222531644Voluntary Employees' Benefit AssociationMA501 (c ) (9)Baystate Health Inc0
Baystate Health Inc
759 Chestnut StreetSpringfieldMA01199042105941Healthcare System ParentMA501 (c ) (3)7Baystate Health Inc0
Baystate Medical Center Inc
759 Chestnut StreetSpringfieldMA01199042790311Acute Care Teaching HospitalMA501 (c ) (3)3Baystate Health Inc0
Baystate Total Home Care Inc
280 Chestnut StreetSpringfieldMA01199203260764Real Estate and OtherMA501 (c ) (3)12b, IIIBaystate Medical Center0
Visiting Nurse Assn and Hospice of Western New England Inc
50 Maple StreetSpringfieldMA01199042105803Home health and Hospice careMA501 (c ) (3)10Baystate Health Inc0
Baystate Wing Hospital Corporation
40 Wright StreetPalmerMA01069222519813HospitalMA501 (c ) (3)3Baystate Health Inc0
Health New England Inc
Monarch Place Suite 1500SpringfieldMA011441500042864973HMO/InsuranceMA501 (c ) (4)Baystate Health Inc0
HNE of Connecticut Inc
Monarch Place Suite 1500SpringfieldMA011441500455190134HMO/InsuranceCT501 (c ) (4)Health New England Inc0
Baystate Franklin Medical Center
164 High StreetGreenfieldMA01301042103575HospitalMA501 (c ) (3)3Baystate Health Inc0
Westfield Medical Corporation
115 West Silver St PO Box 1634WestfieldMA010861634043127730Physician ServicesMA501 (c ) (3)12a,1Baystate Noble Hospital CorporationYes (1)
Noble Visiting Nurse Services Inc
77 Mill StreetWestfieldMA01085222757446Home Health Care & HospiceMA501 (c ) (3)10Visiting Nurse Assn and Hospice of Western New England IncYes (1)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
HNE Advisory Services
Monarch Place Suite 1500SpringfieldMA011441500043012347Administrative ServicesMAHealth New England IncC0
HNE Insurance Services Corporation
Monarch Place Suite 1500SpringfieldMA011441500043183019Ancilliary InsuranceMAHealth New England IncC0
Ingraham Corporation
759 Chestnut StreetSpringfieldMA01199043016257Health care and other business activitiesMABaystate Health IncC0
Baystate Health Insurance Company Ltd
980421413Offshore captive InsuranceBaystate Health Inc0North Church StreetGeorgetownCJCJ
HNE Holding Corporation
Monarch Place Suite 1500SpringfieldMA011441500464620480Holding shares in subsidiary corporationMAHealth New England IncC0
HNE Insurance Company Inc
Monarch Place Suite 1500SpringfieldMA011441500454462433Health services For Mass Medicare SupplementMAHealth New England IncC0
Noble Health Services - Vanguard
115 W Silver Street PO Box 870WestfieldMA01085912156429Financial support for hospitalMABaystate Noble Hospital CorporationT0
Noble Health Services - Fidelity
115 W Silver Street PO Box 870WestfieldMA01085222909354Financial support for hospitalMABaystate Noble Hospital CorporationT0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmt
Westfield Medical Corporation
A$147,171
Westfield Medical Corporation
B$1,518,222