BAYSTATE NOBLE HOSPITAL CORPORATION: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- BAYSTATE NOBLE HOSPITAL CORPORATION (EIN 22-2537423)
- Tax period
- 2015-10-01 to 2016-09-30
- Filed
- 2017-08-07
- IRS object ID
- 201702199349300735
- Schema version
- 2015v3.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-08-07T13:17:41-05:00 | ReturnTs |
| Tax Period End | 2016-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | Two Jericho Plaza | AddressLine1Txt |
| City | Jericho | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11753 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 222537423 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Baystate Noble Hospital Corporation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BAYS | BusinessNameControlTxt |
| Phone | 4135682811 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 115 West Silver Street | AddressLine1Txt |
| City | Westfield | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 010861634 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DENNIS W CHALKE | PersonNm |
| Person Title | SVP FINANCE, CFO & TREASURER | PersonTitleTxt |
| Phone | 4135682811 | PhoneNum |
| Signature | 2017-08-04 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Christine Kawecki | PreparerPersonNm |
| PTIN | P00743140 | PTIN |
| Phone | 5169187000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DENNIS W CHALKE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 115 West Silver Street | AddressLine1Txt |
| City | Westfield | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 010861634 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $61,494,477 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BAYSTATENOBLEHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1984 | FormationYr |
| Legal Domicile State | MA | LegalDomicileStateCd |
| Activity Or Mission | THE 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 Body | 22 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 655 | TotalEmployeeCnt |
| Total Volunteers | 156 | TotalVolunteersCnt |
| Total Gross UBI | $1,022 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $22 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,005,681 | PYContributionsGrantsAmt |
| CY Contributions Grants | $663,083 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $57,658,428 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $60,613,218 | CYProgramServiceRevenueAmt |
| PY Investment Income | $38,499 | PYInvestmentIncomeAmt |
| CY Investment Income | $39,834 | CYInvestmentIncomeAmt |
| PY Other Revenue | $234,636 | PYOtherRevenueAmt |
| CY Other Revenue | $28,003 | CYOtherRevenueAmt |
| PY Total Revenue | $58,937,244 | PYTotalRevenueAmt |
| CY Total Revenue | $61,344,138 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $30,428,473 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $32,015,378 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $27,725,502 | PYOtherExpensesAmt |
| CY Other Expenses | $25,885,542 | CYOtherExpensesAmt |
| PY Total Expenses | $58,153,975 | PYTotalExpensesAmt |
| CY Total Expenses | $57,900,920 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $783,269 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,443,218 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $29,648,669 | TotalAssetsBOYAmt |
| Total Assets EOY | $31,504,681 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $27,774,157 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $29,150,080 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,874,512 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,354,601 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The 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 Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $25,527,255 | ExpenseAmt |
| Revenue | $24,285,615 | RevenueAmt |
| Desc | Inpatient healthcare services - Providing inpatient community-based medicine and tertiary care to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY2016, Baystate Noble Hospital provided 17,206 patient days of inpatient services. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $21,275,149 | ExpenseAmt |
| Revenue | $24,110,363 | RevenueAmt |
| Desc | Outpatient healthcare services - Providing outpatient clinical services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY2016, Baystate Noble Hospital had 75,045 outpatient visits. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $9,236,216 | ExpenseAmt |
| Revenue | $9,512,530 | RevenueAmt |
| Desc | Emergency department services - Providing emergency department services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY2016, Baystate Noble Hospital had 28,078 emergency department visits. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $502,627 | ExpenseAmt |
| Revenue | $2,844,005 | RevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $502,627 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $2,844,005 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $56,541,247 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (1) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 364 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 655 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 22 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | John Shaver - Baystate Noble Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4135682811 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 115 West Silver Street | AddressLine1Txt |
| City | Westfield | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01085 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (38 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Adrian J Levsky | |||||||||
| Trustee (as of 1/1/16) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Aleksandr Pugach MD | |||||||||
| Trustee (As of 1/1/16) | 48.00 | 1.00 | Yes (X) | $0 | $227,078 | $2,051 | |||
| Anne M Paradis | |||||||||
| Vice Chair | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| Craig Schacher MD | |||||||||
| Trustee (Through 12/31/15) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| David C Southworth | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Edward J Noonan | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Grace Makari-Judson MD | |||||||||
| Trustee/ Hematologist | 1.00 | 40.00 | Yes (X) | $395,012 | $0 | $91,314 | |||
| Gregory L Braden MD | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Harriet A DeVerry | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Hector Toledo | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| James P Sadowsky | |||||||||
| Chair | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| James R Phaneuf | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| John A Egelhofer MD | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| John F Maybury | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| John H Davis | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| John M O'Brien III | |||||||||
| Trustee (Through 12/31/15) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Katherine McG Sullivan | |||||||||
| Trustee (Through 12/31/15) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Kathleen B Scoble | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Kevin P Moriarty MD | |||||||||
| Trustee/Chief Ped Surgery | 1.00 | 40.00 | Yes (X) | $634,583 | $0 | $46,896 | |||
| Mark A Keroack MD | |||||||||
| Trustee | 1.00 | 40.00 | Yes (X) | $0 | $1,258,998 | $213,008 | |||
| Paul R Murphy | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Richard B Steele Jr | |||||||||
| Trustee (Through 12/31/15) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Robert J Bacon | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Robert L Pura PhD | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Steven M Mitus | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Victor Woolridge | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Dennis Chalke | |||||||||
| Treasurer | 1.00 | 50.00 | $0 | $1,085,400 | $89,529 | Yes (X) | |||
| Kristin R Delaney | |||||||||
| Clerk | 1.00 | 39.00 | $0 | $109,755 | $31,677 | Yes (X) | |||
| Madeline Torres | |||||||||
| Assistant Clerk | 1.00 | 40.00 | $0 | $53,103 | $16,597 | Yes (X) | |||
| Ronald Bryant | |||||||||
| President, BNH | 40.00 | 10.00 | $216,356 | $204,152 | $26,124 | Yes (X) | |||
| John Shaver | |||||||||
| Chief Financial Officer | 50.00 | 0.00 | $245,128 | $0 | $10,998 | Yes (X) | |||
| Beverly Fein | |||||||||
| VP Human Resources | 50.00 | 0.00 | $189,693 | $0 | $6,286 | Yes (X) | |||
| Stanley Strzempko | |||||||||
| Chief Medical Officer | 50.00 | 0.00 | $292,850 | $0 | $6,208 | Yes (X) | |||
| Allison Gearing-Kalill | |||||||||
| Director of Community Dev't | 50.00 | 0.00 | $125,789 | $0 | $14,653 | Yes (X) | |||
| Deborah Bostic | |||||||||
| Director Patient Care Services | 50.00 | 0.00 | $144,497 | $0 | $14,665 | Yes (X) | |||
| Edward Ballis | |||||||||
| Medical Director Fowler Unit | 50.00 | 0.00 | $118,659 | $0 | $24,882 | Yes (X) | |||
| Hui-Wen Chia | |||||||||
| Pharmacist | 50.00 | 0.00 | $138,422 | $0 | $3,362 | Yes (X) | |||
| John Burke | |||||||||
| Director Patient Fin Services | 50.00 | 0.00 | $165,006 | $0 | $9,106 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,665,995 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,938,486 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $607,356 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 31 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Rehabcare Group East Inc | |||||
| PO Box 502096 | St Louis | MO | 631502096 | Physical Rehabilitation | $2,236,223 |
| Morrison Healthcare Inc | |||||
| PO Box 102289 | Atlanta | GA | 303682289 | Dietary Services | $1,719,652 |
| Harry Grodsky & Co Inc | |||||
| 33 Shaws Lane | Springfield | MA | 01101 | Construction Services | $1,683,335 |
| Crothall Healthcare Inc | |||||
| 13028 Collection Center Drive | Chicago | IL | 60693 | Housekeeping Services | $1,233,298 |
| Springfield Anesthesia Service Inc | |||||
| 908 Allen Street | Springfield | MA | 01101 | Anesthesia Services | $576,242 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $366,732 | FundraisingAmt |
| Government Grants | $265,963 | GovernmentGrantsAmt |
| All Other Contributions | $30,388 | AllOtherContributionsAmt |
| Total Contributions | $663,083 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Hospital Revenue | 622000 | $60,480,969 | $60,480,969 |
| Rental Income From Affiliate | 531390 | $132,249 | $132,249 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $60,613,218 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $39,834 | TotalRevenueColumnAmt |
| Exclusion | $39,834 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $38,025 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $366,732 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $150,339 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$112,314 | TotalRevenueColumnAmt |
| Exclusion | -$112,314 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Vendor Rebates | 900099 | $139,295 | $139,295 | |
| Yankee Alliance K-1 | $1,022 | $1,022 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $140,317 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $61,344,138 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $60,752,513 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,022 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$72,480 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $944,027 | TotalAmt |
| Program Services | $944,027 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,191,937 | TotalAmt |
| Program Services | $25,513,506 | ProgramServicesAmt |
| Management And General | $678,431 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $644,002 | TotalAmt |
| Program Services | $635,952 | ProgramServicesAmt |
| Management And General | $8,050 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,176,426 | TotalAmt |
| Program Services | $2,122,013 | ProgramServicesAmt |
| Management And General | $54,413 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,058,986 | TotalAmt |
| Program Services | $2,033,247 | ProgramServicesAmt |
| Management And General | $25,739 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $170,884 | TotalAmt |
| Program Services | $70,326 | ProgramServicesAmt |
| Management And General | $100,558 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $180,000 | TotalAmt |
| Management And General | $180,000 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,574 | TotalAmt |
| Management And General | $40,574 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,721,347 | TotalAmt |
| Program Services | $1,721,347 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,141 | TotalAmt |
| Program Services | $44,141 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $211,088 | TotalAmt |
| Program Services | $197,885 | ProgramServicesAmt |
| Management And General | $13,203 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $772,542 | TotalAmt |
| Program Services | $772,542 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,928,773 | TotalAmt |
| Program Services | $1,886,340 | ProgramServicesAmt |
| Management And General | $42,433 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,127 | TotalAmt |
| Program Services | $14,441 | ProgramServicesAmt |
| Management And General | $6,686 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,043 | TotalAmt |
| Program Services | $22,509 | ProgramServicesAmt |
| Management And General | $21,534 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $323,301 | TotalAmt |
| Program Services | $323,301 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,233,120 | TotalAmt |
| Program Services | $2,185,049 | ProgramServicesAmt |
| Management And General | $48,071 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $274,081 | TotalAmt |
| Program Services | $274,081 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Purchased Services | $9,636,476 | $9,636,476 | |
| Medical Supplies | $7,870,304 | $7,870,304 | |
| RIF Expenses | $266,688 | $266,688 | |
| Dues | $147,053 | $7,072 | $139,981 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,900,920 | TotalAmt |
| Program Services | $56,541,247 | ProgramServicesAmt |
| Management And General | $1,359,673 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $782,694 | BOYAmt |
| EOY | $1,907,282 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $572,481 | BOYAmt |
| EOY | $701,873 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,939,214 | BOYAmt |
| EOY | $4,197,745 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $912,464 | BOYAmt |
| EOY | $971,706 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,424 | BOYAmt |
| EOY | $157,191 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $67,173,397 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $48,202,216 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,019,001 | BOYAmt |
| EOY | $18,971,181 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,030,094 | BOYAmt |
| EOY | $3,918,388 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $275,297 | BOYAmt |
| EOY | $679,315 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,648,669 | BOYAmt |
| EOY | $31,504,681 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,757,105 | BOYAmt |
| EOY | $16,947,670 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,448,453 | BOYAmt |
| EOY | $1,879,902 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $6,791,101 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,568,599 | BOYAmt |
| EOY | $3,531,407 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,774,157 | BOYAmt |
| EOY | $29,150,080 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$2,796,650 | BOYAmt |
| EOY | -$2,494,531 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,790,614 | BOYAmt |
| EOY | $3,968,584 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $880,548 | BOYAmt |
| EOY | $880,548 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,874,512 | BOYAmt |
| EOY | $2,354,601 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,648,669 | BOYAmt |
| EOY | $31,504,681 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,443,218 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$2,963,129 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $30,574 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | Yes (1) | RalliesDemonstrationsInd |
| Rallies Demonstrations | $10,000 | RalliesDemonstrationsAmt |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $40,574 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | The organization contracted directly with a consultant to assist in pursuing its government affairs objectives. This consultant was paid to perform lobbying and other public affairs work. Lobbying was conducted on various initiatives related to the delivery and financing of health care. In addition, the organization paid membership dues to the Massachusetts Hospital Association who have advised that portions of those dues were used for lobbying purposes. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,671,162 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $634,142 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $456,172 | OtherExpendituresAmt |
| End Year Balance | $4,849,132 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,699,298 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $358,112 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $386,248 | OtherExpendituresAmt |
| End Year Balance | $4,671,162 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,169,914 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $805,052 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $275,668 | OtherExpendituresAmt |
| End Year Balance | $4,699,298 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,740,947 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $794,284 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $365,317 | OtherExpendituresAmt |
| End Year Balance | $4,169,914 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,300,943 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $598,094 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $158,090 | OtherExpendituresAmt |
| End Year Balance | $3,740,947 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.18160 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.81840 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $962,598 | OtherCostOrOtherBasisAmt |
| Book Value | $962,598 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $35,966,416 | OtherCostOrOtherBasisAmt |
| Depreciation | $22,229,193 | DepreciationAmt |
| Book Value | $13,737,223 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $30,244,383 | OtherCostOrOtherBasisAmt |
| Depreciation | $25,973,023 | DepreciationAmt |
| Book Value | $4,271,360 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $18,971,181 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Accrued Pension Liability | $2,738,213 |
| Medical Malpractice Claims | $227,889 |
| Asset Retirement Obligation | $565,305 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,531,407 | TotalLiabilityAmt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Noble Ball | Event1Nm |
| Gross Receipts Event1 | $383,778 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $345,753 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $38,025 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $142,205 | OtherDirectExpensesEvent1Amt |
| Event2 | 5K | Event2Nm |
| Gross Receipts Event2 | $20,979 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $20,979 | CharitableContriEvent2Amt |
| Other Direct Expenses Event2 | $8,134 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $404,757 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $366,732 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $38,025 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $150,339 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $150,339 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$112,314 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,088,566 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $332,249 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $756,317 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01310 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,046,318 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,382,983 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $663,335 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01150 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $615,682 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $485,948 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $129,734 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,750,566 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,201,180 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,549,386 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02680 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $80,990 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $80,990 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $80,990 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $80,990 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,831,556 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,201,180 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,630,376 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02820 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,250 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,250 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,250 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,250 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $950,925 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $69,558 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $20,672,275 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $20,693,832 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$21,557 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Baystate Noble Hospital Corporation | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 115 West Silver Street | AddressLine1Txt |
| City | Westfield | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01086 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | State License #2076 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | Psychiatric and Physical Rehabilitation | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Baystate Noble Hospital Corporation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | Yes (1) | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Part V, Section C | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | See Part V, Section C | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 12 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Part V, Section C | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | 0 | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://www.baystatehealth.org/patients/billing-and-financial-assistance | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://www.baystatehealth.org/patients/billing-and-financial-assistance | FAPAppAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Baystate Noble Hospital Corporation | Part V, Section B, Line 3j: The impact of actions taken to address the significant health needs identified in the hospital facility's prior 2013 CHNA. |
| Baystate Noble Hospital Corporation | Part V, Section B, Line 5: A wide range of stakeholders took part in the 2015 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)- 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, Franklin County Home Care Corp.- 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 CenterThe 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 Corporation | Part V, Section B, Line 6a: In 2016, in partnership with the Coalition of Western MA Hospitals/Insurer, the hospital facility conducted a community health needs assessments ("CHNA") of the geographic area served by the hospital facility. The Coalition of Western Massachusetts Hospitals/Insurer ("Coalition"), a partnership between nine (9) not-for-profit hospitals and an insurer in western Massachusetts that includes: Baystate Medical Center, Baystate Franklin Medical Center, Baystate Noble Hospital, Baystate Wing Hospital, the former Baystate Mary Lane Hospital (now part of BWH and known as the 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 Corporation | Part V, Section B, Line 6b: The Coalition of Western MA Hospitals and Insurer engaged Partners for a Healthier Community ("PHC)", based in Springfield, MA, as the lead consultant to conduct the CHNA's. PHC was supported by two other consultant teams; Community Health Solutions, based in Northampton, MA and Pioneer Valley Planning Commission (PVPC), based in Springfield, MA. he Coalition includes Health New England, a local health insurer whose service area covers the four counties of western Massachusetts. |
| Baystate Noble Hospital Corporation | Part 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 10a:https://www.baystatehealth.org/about-us/community-programs/community-benefits/community-health-needs-assessment The hospital facility made its CHNA report widely available to the public via an email distribution, with links to the hospital's website, to community partners and organizations. The regional findings from the CHNA reports were shared publicly at the Western MA Health Equity Summit in November 2016 (over 300 attendees). In addition, the CHNA reports have informed the development and implementation of county wide community health improvement plans. Hospital and CHNA consultant staff have been invited to various venues and audiences to present on the CHNA process and key findings. |
| Baystate Noble Hospital Corporation | Part V, Section B, Line 2: Baystate Noble Hospital (formally Noble Hospital) was acquired by Baystate Health, Inc. July 1, 2015 |
| Baystate Noble Hospital Corporation | Part 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, Community Education & Training, 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:- Cultural humility- Health equity- Insurance challenges- Mental health and substance use disordersNeeds not being addressed: - Basic needs, including housing - 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- Transportation |
| Part V Section B | The Hospital is currently in compliance with the final 501(r) regulations effective for the tax year beginning 10/1/2016. This schedule will be answered accordingly with the 2016 return. This return has been filed according to the proposed regulations which were in place at the time of the 2015 tax year. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - Baystate Noble Hospital Sports & Rehab | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 74 Main Street | AddressLine1Txt |
| City | Westfield | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01086 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | Physical Rehabilitation Outpatient Clinic | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 http://www.cbsys.ago.state.ma.us/cbpublic/public/hccbindex.aspx. The hospital facility's annual community benefits report is also published on the Baystate Health website athttps://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 2016.Line 7g (Subsidized Programs) - There were no subsidized services to report in 2016. |
| Part I, Line 7g: | There are no subsidized health services for 2016 to report in Part I, line 7g. |
| Part II, Community Building Activities: | Part II. 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 $3,250 in 2016.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 2016, the provision for bad debts was reported as a deduction to net patient service revenue. The 2016 provision for bad debts totalled $3,066,403 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 200% of the federal poverty level) to the total cost of bad debt reported in Part III line 2. Since this portion of bad debt is attributable to patients residing in an area where the average income is less than 200% of the Federal poverty level, it is highly likely these patients would have qualified for the organization's charity care program had they applied. For this reason, we believe the amount, totalling $69,558, 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 2016 Medicare cost report, based on Medicare costing principles. We believe the shortfall reported of $21,557 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 meets twice a year and is charged with advocating for community benefits at the Board level and throughout the health system and community; aligning the system's four (4) hospital-specific community benefits implementation strategies into the health system's strategic plan; periodic 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 Public Health and Community Relations provides updates to the Baystate Health Board of Trustees, Baystate President's Cabinet, and other Baystate leadership teams, as requested. In 2016, through the community benefits grant investments and the community health needs assessment, the hospital engaged more internal and community stakeholders in its community benefits planning efforts. The 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 in meeting its 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 credit and collection policy that reflects its 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 Credit and Collection Policy is posted on the baystatehealth.org website. The goal of posting the Credit and Collection Policy is to ensure that patients or prospective patients in our community are aware of our financial assistance programs. Baystate's Credit and Collection Policy was developed in partnership with Health Care For All, a Massachusetts non-profit organization dedicated to making adequate and affordable health care accessible to everyone, regardless of income, social or economic status.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 andcompassionate 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 populationwith a bachelor's degree or higher is slightly higher than the county rate of 26%. The area's 2015 unemployment rate of 5% is comparable to the county unemployment rate (Massachusetts EOLWD). 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, Baystate Wing Hospital and the former Baystate Mary Lane Hospital (now part of BWH and known as the Baystate Mary Lane Outpatient Center) and the other 501(c)(3) organizations include Baystate Medical Practices, Visiting Nurse Association and Hospice of Western New England, Inc., and Baystate Health Foundation. In September 2016, the Massachusetts Public Health Council approved Baystate Wing Hospital's application to merge Baystate Mary Lane Hospital and Baystate Wing Hospital and their respective satellite facilities under one hospital license. Baystate Mary Lane Hospital, now referred to Baystate Mary Lane Outpatient Center, is a satellite of Baystate Wing. Inpatient care at Baystate Mary Lane transitioned to Baystate Wing, while all outpatient services continue at Baystate Mary Lane Outpatient Center. The Emergency Department at Baystate Mary Lane Outpatient Center operates as a satellite emergency facility of Baystate Wing Hospital. In July 2015, Baystate Noble Hospital became part of the Baystate Health System. In addition to its nearly 12,000 employees, Baystate Health has medical staff, nurses and residents and fellows, medical students, nursing students, and allied health students who gain comprehensive medical education during the year. Volunteers enhance the work of our employees and interactions with our patients and families. In 2016, more than 1,200 volunteers donated over 104,000 hours showing their belief in the care we provide to our community.Baystate Medical Center (BMC), the flagship 716-bed hospital (including Baystate Children's Hospital) based in Springfield, Massachusetts is Western New England's only tertiary care referral medical center, Level 1 trauma center and neonatal and pediatric intensive care units. BMC serves as a regional resource for specialty medical care and research, while providing comprehensive primary medical services to the community. Baystate Franklin Medical Center (BFMC), a 90-bed facility located in Greenfield, Massachusetts (40 miles north of Springfield near the Vermont border) provides high quality inpatient and outpatient services to residents of rural Franklin county and the North Quabbin region. Inpatient services include behavioral health, intensive care, medical-surgical care, and obstetrics/midwifery. Outpatient services include cardiology, emergency medicine, gastroenterology, general surgery, neurology, oncology, ophthalmology, orthopedics, pediatrics, physical medicine & rehabilitation, pulmonology & sleep medicine, sports medicine, vascular surgery, wound care & hyperbaric medicine. Baystate Wing Hospital (BWH), a 74-bed facility located in Palmer, Massachusetts (18 miles east of Springfield) provides a broad range of emergency, medical, surgical and psychiatric services. Our five medical centers in Belchertown, Ludlow, Monson, Palmer and Wilbraham offer extensive outpatient services to meet the needs of our communities. BWH also includes the Griswold Behavioral Health Center, providing comprehensive behavioral health and addiction recovery services and the Wing VNA and Hospice. We are fully accredited by the Joint Commission and are a designated Primary Stroke Service by the Massachusetts Department of Public Health. Baystate Mary Lane serves the residents of Ware and surrounding communities offering a variety of primary and specialty health care including cancer, cardiology, surgery, and imaging services. The Satellite Emergency Facility at Baystate Mary Lane provides care for emergency injuries or illness, with highly skilled emergency medicine physicians, nurses and staff. Baystate Noble Hospital (BNH) is a 97-bed acute care community hospital providing a broad range of services to the Greater Westfield community. BNH is able to offer direct access to world-class technology, diagnostics, and specialists as a proud member of Baystate Health. Together, we passionately 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. Baystate Medical Practices (BMP) is a tax-exempt, not-for-profit corporation organized to support and assist Baystate Health and its affiliate hospitals, including BMC, BFMC and BMLH, each of which is a Massachusetts not-for-profit corporation, in achieving the fulfillment of their clinical, teaching, research, and other missions related to health care. Baystate Medical Practices, Inc. provides physician services, medical education and research programs to people in the community within its geographic location. 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 FY 2016 BMP provided $2,782,513 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 provides high quality care, expressly tailored to meet each patients' needs. Our home health team works together to ensure a safe and swift recovery from illness, accident, or surgery in the comfort of home. Baystate Hospice 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.The Baystate Health Foundation Inc's Keeping Care Local campaign raised $5 million for Baystate Franklin Medical Center's new $26 million, 55,000 square-foot surgical facility which proudly opened its doors in the Spring of 2016, helping to enhance surgical services to the people in Franklin County. In addition, the Baystate Health Foundation actively engaged in annual fund, major gift, and event fundraising to ensure ongoing annual support for education, research, programs and capital needs throughout the health system that impact patient care throughout western Massachusetts.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.Over 195,000 language interpreter sessions helped patients and families better understand their care in person, over the phone or via video. Staff interpreted in about 70 languages such as Spanish, American Sign Language, Arabic, Mandarin Chinese, Nepali, Portuguese, Russian, Somali, Ukrainian, and Vietnamese. New languages interpreted this year were Gujarati (India), Fukienese (China), and Mon - an ancient language spoken in Burma and Thailand. UMass Medical School (UMMS) established a regional medical school campus in Springfield, UMMS-Baystate. The new medical school will enroll 25 students in its first class beginning in 2017 in a unique tract called PURCH (Population-based Urban and Rural Community Health). 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.(Continued) |
| 6 Affiliated Health Care System (continued) | The Nurse Residency Program expanded to all Baystate Health hospitals. In partnership with Vizient and American Association of Colleges of Nursing, Baystate welcomed 57 nurse residents this year, 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 curriculum for newly graduated registered nurses, offering hands-on clinical experience, in-depth learning through monthly seminars, participation in evidence-based projects, and ongoing professional development.Baystate Health is committed to continuing education programs in 30 different professional areas through partnerships with Elms College, Springfield College, Western New England University, STCC, Greenfield Community College, Holyoke Community College, Westfield State University, and many others. Our post graduate programs expanded to 10 medical residencies and 20 fellowships, including new fellowship training programs in hospital medicine and gastroenterology. In addition, Baystate Medical Center welcomed 1,770 new residents, fellows, medical students, nursing students, and allied health students.Research at Baystate Health continued to grow. Baystate Medical Practice faculty members received $7.41M in external funding. Baystate Health researchers received 41 new research awards valued at over $4.4M. Noteworthy new grant activity occurred in the following areas:- Assessing the impact of early pulmonary rehabilitation for chronic obstructive pulmonary disease- Improving antibiotic prescribing for patients with community-acquired pneumonia- Studying the environmental determinants of breast cancer- Advancing the care of neonates born with opioid dependency- Training primary care providers in principles of geriatric medicine- Using evidence-based psychotherapy in the care of pediatric victims of psychological trauma- Coordinating the care of complex illness in pediatricsBaystate 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, a "Just for Dads" class, Prenatal/Postnatal Yoga and infant/toddler safety classes. We also offer Babysitter's Academy, which provides a full day class for teens. 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.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 Spirit of Women 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 23,000 Senior Class members receive a quarterly newsletter with valuable health information, benefits and invitations to special events designed with their interests in mind. Baystate Spirit of Women Loyalty Program offers its 15,000 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.The Mark R. Tolosky Baystate Neighbors Program, named in honor of our past President and CEO, provides forgivable loans to Baystate Health employees purchasing their first homes in the communities surrounding our hospitals. Qualified employees are granted a forgivable loan up to $7,500 that may be used towards a down payment or closing costs. In 2016, Baystate Health granted 50 loans to employees. Since 1999, Baystate Health has invested over $1.6 million in the futures of more than 220 employees and their families.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 24th year, Rays of Hope has raised over $13.7 million - all of which has been awarded locally throughout western Massachusetts.The United Way develops and supports programs that directly improve the lives of people in our communities, a mission proudly shared by Baystate Health. Baystate Health is a strong supporter of the United Way, and a major contributor to the organization with workforce campaigns and thousands of employee donors and volunteers. Baystate Health's contributions help the United Way serve our families, friends, colleagues and others who seek help in different ways and at different times in their lives. Three community campaigns are held annually: Springfield, Westfield, and Palmer workplace to support the United Way of Pioneer Valley, Greenfield workplace to support the United Way of Franklin County and Ware workplace to support the United Way of Hampshire County. Employees can direct their donations to one or all of the United Way's action areas: Education, Income and Health or designate to a qualified agency with a minimum contribution. See also additional information regarding Baystate Health, Inc. and its affiliates promotion of community health above in Line 5. |
| Part VI, Line 7, List of States Receiving Community Benefit Report | MA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Written Policy Ref T And E Expnss | 0 | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Aleksandr Pugach MD | ||||||||||||||
| Trustee (As of 1/1/16) | $0 | $225,002 | $0 | $0 | $0 | $2,076 | $0 | $1,031 | $0 | $1,020 | $0 | $229,129 | $0 | $0 |
| Grace Makari-Judson MD | ||||||||||||||
| Trustee/ Hematologist | $299,974 | $0 | $64,558 | $0 | $30,480 | $0 | $56,254 | $0 | $35,060 | $0 | $486,326 | $0 | $0 | $0 |
| Kevin P Moriarty MD | ||||||||||||||
| Trustee/Chief Ped Surgery | $502,996 | $0 | $96,018 | $0 | $35,569 | $0 | $27,825 | $0 | $19,071 | $0 | $681,479 | $0 | $0 | $0 |
| Mark A Keroack MD | ||||||||||||||
| Trustee | $0 | $760,075 | $0 | $310,077 | $0 | $188,846 | $0 | $192,620 | $0 | $20,388 | $0 | $1,472,006 | $0 | $90,766 |
| Dennis Chalke | ||||||||||||||
| Treasurer | $0 | $466,083 | $0 | $357,889 | $0 | $261,428 | $0 | $64,000 | $0 | $25,529 | $0 | $1,174,929 | $0 | $0 |
| Ronald Bryant | ||||||||||||||
| President, BNH | $215,754 | $197,997 | $0 | $0 | $602 | $6,155 | $0 | $16,224 | $0 | $9,900 | $216,356 | $230,276 | $0 | $0 |
| John Shaver | ||||||||||||||
| Chief Financial Officer | $244,225 | $0 | $0 | $0 | $903 | $0 | $4,894 | $0 | $6,104 | $0 | $256,126 | $0 | $0 | $0 |
| Beverly Fein | ||||||||||||||
| VP Human Resources | $189,362 | $0 | $0 | $0 | $331 | $0 | $0 | $0 | $6,286 | $0 | $195,979 | $0 | $0 | $0 |
| Stanley Strzempko | ||||||||||||||
| Chief Medical Officer | $292,162 | $0 | $0 | $0 | $688 | $0 | $5,300 | $0 | $908 | $0 | $299,058 | $0 | $0 | $0 |
| Deborah Bostic | ||||||||||||||
| Director Patient Care Services | $144,309 | $0 | $0 | $0 | $188 | $0 | $2,308 | $0 | $12,357 | $0 | $159,162 | $0 | $0 | $0 |
| John Burke | ||||||||||||||
| Director Patient Fin Services | $164,320 | $0 | $0 | $0 | $686 | $0 | $3,050 | $0 | $6,056 | $0 | $174,112 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 4b | Dennis W. Chalke - Supplemental Retirement of $171,159 is included in column E. This amount was earned and paid in 2015. Mark A. Keroack, MD - Supplemental Retirement of $328,081 is included in column E. This amount consists of $237,315 earned and paid in 2015 and $90,766 that was previously reported as deferred compensation in prior years Forms 990, and that is currently reported as taxable income. The amount is listed in Column F in accordance with reporting requirements. Grace Makari-Judson, MD- Supplemental Retirement of $14,673 is included in column E. This amount was earned in 2015. Kevin P. Moriarty, MD - Supplemental Retirement of $32,279 is included in column E. This amount was earned and paid in 2015. |
| Form 990 Schedule J line 3 | The 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. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 1 | The filing organization has a standing executive committee, which is entitled to act between meetings of the Board, on all matters as to which the Board is entitled to act and permitted by law to delegate to a committee. The members of the executive committee are the same individuals serving on the executive committee of Baystate Health, Inc. |
| Form 990, Part VI, Section A, line 2 | Ronald Bryant, Robert Bacon, Anne M Paradis, Dennis W Chalke, Kristin R Delaney, Madeline Torres, Gregory Braden, MD, John H Davis, Harriet A DeVerry, John A Egelhofer, MD, Beverly Fein, Mark A Keroack, MD, Adrian J. Levsky, Grace P Makari-Judson MD, John Maybury, Steven M Mitus, Kevin Moriarty MD, Paul R Murphy, Edward J Noonan, John M O'Brien III, James R Phaneuf, Alexandr Pugach, MD, Robert L Pura, PhD, James P Sadowsky, Craig Schacher, MD, John Shaver, Kathleen B Scoble, David C Southworh, Richard B Steel Jr,Stanley Strzempko, MD, Katherine McG Sullivan, Hector Toledo and Victor Woolridge are also officers or trustees of its affiliated entities. The following trustees, officers, or key employees serve on a common board of a non-affiliated entity: (1) Richard B. Steele, Jr., James P Sadowsky, John H Davis (2) John F. Maybury, Mark A Keroack MD (3) John M. O'Brien, III, Victor Woolridge (4) John M. O'Brien, III, Victor Woolridge (5) John F Maybury, Anne M Paradis (6) Robert L. Pura, PhD, Richard B Steele Jr |
| Form 990, Part VI, Section A, line 3 | Baystate 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 BA |
| Form 990, Part VI, Section A, line 6 | The filing organization has one member, Baystate Health, Inc. (BH). |
| Form 990, Part VI, Section A, line 7a | The board of Trustees of the filing organization 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 8 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 Corporation as well as the annual acceptance of the audited financial statements. |
| Form 990, Part VI, Section B, line 11 | Prior to the filing of this return appropriate parts of this Form 990 were reviewed by representatives from the Tax, Finance, and Human Resources Departments of Baystate Health, Inc., some of whom are officers or trustees of the filing organization 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 of the filing organization. The Form 990 was provided to all members of the Board of Trustees prior to filing. |
| Form 990, Part VI, Section B, line 12c | Baystate Health, Inc. (BH) has a comprehensive conflict of interest policy which has been adopted by the filing organization. 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 BH Chief Compliance Officer, the BH Chief Legal Counsel, the BH Chief Executive Officer, the Chair of the BH Board of Trustees, and the Chair of the Audit & Compliance Committee of BH. A summary of the conflict of interest disclosures is provided to the Baystate Health Board of Trustees and the Tax Department and reviewed by outside counsel. Potential conflict of interest transactions are reviewed as appropriate under the policy, which provides for recusal from discussion and deliberation by any party with a potential conflict of interest. |
| Form 990, Part VI, Section B, line 15 | The compensation 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 salaries of other employees of the filing organization are determined by the President of the filing organization in accordance with the Executive Compensation Philosophy Statement or the Baystate Health Board approved budget and wage program for each fiscal year. |
| Form 990, Part VI, Section C, line 19 | The organization makes its conflict of interest policy and financial statements available to the public at www.baystatehealth.org. Articles of organization and bylaws are generally available at the Commonwealth of Massachusetts website. |
| Part VII - Section A, Line 5 | Certain officers or trustees of the filing organization are paid by an entity, Baystate Medical Practices, Inc. (BMP) EIN 04-2888373, which is part of the health care system to which the filing organization belongs but does not meet the technical requirements as a "Related Organization" per Schedule R. Compensation from BMP to the officers and trustees of the filing organization therefore, is reported as paid from an unrelated organization in Line 5 and according to the instructions reported as though paid by the filing organization. |
| Form 990, Part XI, line 9: | Net Transfers From Affiliated Companies 2,727,032. Forgiveness Of Inter-Company -5,689,139. Yankee Alliance K-1 Revenue -1,022. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (14 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Baystate Administrative Services Inc | ||||||||||
| 759 Chestnut Street | Springfield | MA | 01199 | 222747685 | Administrative services | MA | 501 (c ) (3) | 11c, III | Baystate Health Inc | 0 |
| Baystate Health Foundation Inc | ||||||||||
| 759 Chestnut Street | Springfield | MA | 01199 | 043549011 | Fundraising | MA | 501 (c ) (3) | 7 | Baystate Health Inc | 0 |
| Baystate Health Systems Inc Health & Welfare Benefits Plan | ||||||||||
| 759 Chestnut Street | Springfield | MA | 01199 | 222531644 | Voluntary Employees' Benefit Association | MA | 501 (c ) (9) | Baystate Health Inc | 0 | |
| Baystate Health Inc | ||||||||||
| 759 Chestnut Street | Springfield | MA | 01199 | 042105941 | Healthcare System Parent | MA | 501 (c ) (3) | 7 | Baystate Health Inc | 0 |
| Baystate Mary Lane Hospital Corporation | ||||||||||
| 85 South Street | Ware | MA | 01082 | 042103584 | Hospital | MA | 501 (c ) (3) | 3 | Baystate Health Inc | 0 |
| Baystate Medical Center Inc | ||||||||||
| 759 Chestnut Street | Springfield | MA | 01199 | 042790311 | Acute Care Teaching Hospital | MA | 501 (c ) (3) | 3 | Baystate Health Inc | 0 |
| Baystate Total Home Care Inc | ||||||||||
| 280 Chestnut Street | Springfield | MA | 01199 | 203260764 | Real Estate and Other | MA | 501 (c ) (3) | 11b, II | Baystate Medical Center | 0 |
| Visiting Nurse Assn and Hospice of Western New England Inc | ||||||||||
| 50 Maple Street | Springfield | MA | 01199 | 042105803 | Homehealth and Hospice care | MA | 501 (c ) (3) | 9 | Baystate Health Inc | 0 |
| Baystate Wing Hospital Corporation | ||||||||||
| 40 Wright Street | Palmer | MA | 01069 | 222519813 | Hospital | MA | 501 (c ) (3) | 3 | Baystate Health Inc | 0 |
| Health New England Inc | ||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 042864973 | HMO/Insurance | MA | 501 (c ) (4) | Baystate Health Inc | 0 | |
| HNE of Connecticut Inc | ||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 455190134 | HMO/Insurance | CT | 501 (c ) (4) | Health New England Inc | 0 | |
| Baystate Franklin Medical Center | ||||||||||
| 164 High Street | Greenfield | MA | 01301 | 042103575 | Hospital | MA | 501 (c ) (3) | 3 | Baystate Health Inc | 0 |
| Westfield Medical Corporation | ||||||||||
| 115 West Silver St PO Box 1634 | Westfield | MA | 010861634 | 043127730 | Physician Services | MA | 501 (c ) (3) | 11a,1 | Baystate Noble Hospital Corporation | Yes (1) |
| Noble Visiting Nurse Services Inc | ||||||||||
| 77 Mill Street | Westfield | MA | 01085 | 222757446 | Home Health Care & Hospice | MA | 501 (c ) (3) | 9 | Baystate Noble Hospital Corporation | Yes (1) |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HNE Advisory Services | |||||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 043012347 | Administrative Services | MA | Health New England Inc | C | 0 | ||||
| HNE Insurance Services Corporation | |||||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 043183019 | Ancilliary Insurance | MA | Health New England Inc | C | 0 | ||||
| Ingraham Corporation | |||||||||||||
| 759 Chestnut Street | Springfield | MA | 01199 | 043016257 | Health care and other business activities | MA | Baystate Health Inc | C | 0 | ||||
| Baystate Health Insurance Company Ltd | |||||||||||||
| 980421413 | Offshore captive Insurance | Baystate Health Inc | 0 | North Church Street | Georgetown | CJ | CJ | ||||||
| HNE Holding Corporation | |||||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 464620480 | Holding shares in subsidiary corporation | MA | Health New England Inc | C | 0 | ||||
| HNE Insurance Company Inc | |||||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 454462433 | Health services For Mass Medicare Supplement | MA | Health New England Inc | C | 0 | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt |
|---|---|
| Westfield Medical Corporation | |
| A | $132,249 |
| Westfield Medical Corporation | |
| B | $5,692,139 |
| Noble Visiting Nurse Services Inc | |
| Q | $354,288 |