2017-08-15T13:44:22-05:00 2016-09-30 010494526 Baker Newman & Noyes PO Box 507 Portland ME 04112 990 2015-10-01 222520073 Holyoke Medical Center Inc HOLY 4135342567 575 Beech Street Holyoke MA 010402223 Michael J Koziol Interim CFO 4135342567 2017-08-15 1 Nicholas E Porto P01310283 2078792100 2017-08-15 2015 2021-01-29 14:40:06Z Spiridon E Hatiras 575 Beech Street Holyoke MA 010402223 147228579 0 X www.holyokehealth.com X 1984 MA Acute care hospital, providing medical and other healthcare services to residents of Holyoke, MA and the surrounding areas. 12 8 1438 32 2686162 88868 772717 2280058 126744771 141584553 214733 318869 2444947 2843941 130177168 147027421 23000 23500 0 0 80977228 90353000 0 0 0 45136533 51077410 126136761 141453910 4040407 5573511 67874221 82908525 81680053 98824599 -13805832 -15916074 X Our Mission at Holyoke Medical Center is to improve the health of all people in our community. We do that with honesty, respect and dignity for our patients, visitors and staff. We do that through expert and compassionate care, education and knowledge sharing, community partnerships, fostering innovation and growth and by inspiring hope in all we touch. We do that by being good stewards of our resources and providing efficient and cost effective care to all. 0 0 115298816 23500 141576568 Holyoke Medical Center, Inc. (HMC) strives to serve the health needs of their medical service community in a high quality and efficient manner. See Schedule O for additional information.To this end, HMC shall: (1) provide compassionate care to all of whom it serves with a commitment to developing cultural diversity and competencies in our programs and workforce so that we may better serve our patients; (2) identify and serve those needs which are prevalent and substantial in the community as a whole, or within major population groups, and which can be adequately met by the provision of basic primary and secondary health care services; (3) provide information, education, and expertise to our community in order to promote the general health of its citizens; (4) provide an environment of excellence and growth in which health care professionals can use their skills and abilities to the fullest extent possible; (5) provide competitive wages and benefits, as well as safe and dignified working conditions, for all employees; (6) ensure financial responsibility in the operation of the medical center in order to guarantee the future viability of our mission; (7) provide a formal, public, and ongoing program of community benefits, in cooperation with community individuals and organizations, to improve the health status of the public including especially the medically and economically vulnerable. Holyoke Medical Center, Inc. provided inpatient, outpatient, and emergency healthcare services and certain physician services to the residents of Holyoke, Massachusetts and the surrounding communities. Inpatient healthcare services included medical, surgical, critical care, cardiac, obstetrical, psychiatric, and oncology services. During FY 2016, HMC provided 24,578 patient days of inpatient services with 5,920 discharges. Outpatient healthcare services included a full array of diagnostic, therapeutic, and behavioral health services. During FY 2016, HMC had 275,963 outpatient visits. Emergency services were provided by a 24-hour emergency department. During FY 2016, HMC had 43,233 emergency department visits. 115298816 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 208 0 1438 1 1 1 0 0 0 0 0 0 0 0 0 X 12 8 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X Michael J Koziol 4135342667 575 Beech Street Holyoke MA 010402223 X Kathleen Hankel Director 0.50 0.50 X 0 0 0 Mary Jo Maydew Director 0.50 0.00 X 0 0 0 Doris Ransford Director 0.50 0.50 X 0 0 0 Tricia Koss Director 0.50 0.00 X 0 0 0 Jon Lumbra Director 0.50 0.00 X 0 0 0 Marc Joyce Director 0.50 1.00 X 0 0 0 Vjay V Gandevia MD Director/Pres. Medical Sta 50.00 0.00 X 431311 0 16106 Karen Ferroni MD Director/Medical Director 50.00 0.00 X 276679 0 15189 Marc Zerbe MD Director/VP Medical Staff 0.50 50.00 X 0 458523 17114 Idelia Smith Chair 1.00 0.50 X X 0 0 0 Shannon Gurek Vice Chair 1.00 0.00 X X 0 0 0 Spiridon E Hatiras President & CEO, Clerk 40.00 6.50 X X 0 618158 16283 Paul M Silva Treasurer & CFO 40.00 6.50 X 269370 0 15941 Noah J Epstein MD Orthopedic Surgeon 50.00 0.00 X 707711 0 18905 Nirav Sheth MD Cardiologist 50.00 0.00 X 510694 0 7214 Khaled A Instrum MD Orthopedic Surgeon 50.00 0.00 X 499163 0 16407 Mary E Norris MD Gastroenterologist 50.00 0.00 X 446652 0 12313 Wandana Joshi DO Anesthesiologist 50.00 0.00 X 400622 0 5976 Antonio Correia Former Treasurer 22.00 8.00 X 0 157189 14905 James M Keefe Former Key Employee 50.00 0.00 X 226324 0 15546 Clark A Fenn Former Key Employee 50.00 0.00 X 137779 0 9140 3906305 1233870 181039 81 1 1 0 Hospital Medicine Associates Inc 5870 N Hiatus Road Suite 200 Tamarac FL 33321 Physician Services 3031904 Valley Health Systems Inc 20 Hospital Drive Holyoke MA 01040 Management Services 2528519 Huron Consulting Group Inc 550 W Van Buren Street Chicago IL 60607 Consulting Services 1219232 Quest Diagnostics Nichols Institute 14225 Newbrook Drive Chantilly VA 201512228 Laboratory Services 843759 SMRT Inc PO Box 618 Portland ME 04104 Architecture Services 828505 45 293522 1808891 177645 400 2280058 Patient Service Revenue 621110 130718261 130718261 Miscellaneous Revenue 621110 9677929 9677929 Affiliate Rent 531110 658275 658275 Affiliate Management Fees 561000 375622 375622 Food Services/Coffee Shop 561000 127026 127026 27440 27440 141584553 317369 317369 380084 201158 178926 178926 21147 157779 1500 0 1500 1500 1500 Non-Patient Lab Revenue 621500 2665015 2665015 2665015 147027421 141584553 2686162 476648 X 23500 23500 1024596 893582 131014 71138736 62061845 9076891 3266021 2829867 436154 9845680 8530860 1314820 5077967 4399841 678126 2613646 2613646 60816 17841 42975 100882 100882 122072 122072 12907615 8329806 4577809 285773 9587 276186 4703541 2852012 1851529 2227145 1005692 1221453 2020435 1750923 269512 59413 34980 24433 254313 254313 3802020 2005678 1796342 1725310 947247 778063 Medical Supplies 14381030 14361684 19346 Bad Debt Expense 3796282 3796282 Laboratory Tests 1293033 1293033 Billing & Collection Fe 221145 221145 502939 154556 348383 141453910 115298816 26155094 0 409376 72091 6057161 11649495 21421346 15615083 814183 876357 812451 1345234 141941260 111195325 29773102 30745935 2859164 3159284 3814362 3786382 51563 143118 1861513 15515546 67874221 82908525 22405203 17139241 15000000 5705016 6081547 53569834 60603811 81680053 98824599 X -18496443 -20860776 2445848 2634735 2244763 2309967 -13805832 -15916074 67874221 82908525 X 5573511 140366 -7824119 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 122072 0 0 0 122072 0 Part II-B, Line 1: The Hospital hires outside consultants from time to time to perform services to further the Hospital's and the other System organizations' mission. A portion of those consulting fees paid to each firm was designated for lobbying endeavors. Ellen Murphy & Associates was paid a total of $56,172 by the Hospital related to lobbying activities for the System. Murphy Donoghue Partners was paid a total of $45,500 by the Hospital related to lobbying activities for the System. The Hospital was also a member of the American Hospital Association and the Massachusetts Hospital Association during the fiscal year. A portion of the dues paid to the Massachusetts Hospital Association was available for lobbying expenditures on behalf of the Hospital and the other System organizations in furtherance of their exempt purposes. The portion of dues used for lobbying were $20,400. The Hospital did not pay any dues to the American Hospital Association in FY 2016. 1389593 59854 600 1448847 1500861 -110968 300 1389593 1392894 108387 420 1500861 1315055 165085 86886 360 1392894 1105474 209881 300 1315055 0.00000 0.31730 0.68270 0 1 1 2819096 2819096 61971827 43948853 18022974 73997879 65874506 8123373 3152458 1371966 1780492 30745935 Other Assets 440501 Due from Affiliates 1406924 New Market Tax Credit Receivable 12239000 Estimated Third-Party Payor Settlements 1429121 15515546 Accrued Pension Cost 56815180 Asset Retirement Obligation 163741 Estimated Third Party Payor Settlements 3624890 60603811 X 143305372 140366 3813 201158 345337 142960035 4067386 4067386 147027421 141658881 3813 201158 204971 141453910 0 141453910 Part V, Line 4: The endowment funds are held and administered by Valley Health Systems, Inc. The intended use of the funds is to provide a predictable, stable, and consistent stream of earnings for Holyoke Medical Center, Inc. to be used for free care and general operations. Part X, Line 2: The Medical Center is exempt from income taxes under Section 501(c)(3) of the Internal Revenue Code. Tax-exempt organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by the Financial Accounting Standards Board, assets and liabilities are established for uncertain tax positions taken or positions expected to be taken in income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold, based upon the technical merits of the position. Estimated interest and penalties, if applicable, related to uncertain tax positions are included as a component of income tax expense. The Medical Center has evaluated the position taken on its filed tax returns. The Medical Center has concluded no uncertain income tax positions exist at September 30, 2016. The Medical Center's tax years from 2014 through 2016 are open and subject to examination. Part XI, Line 2d - Other Adjustments: Rental Expenses 201,158. Part XI, Line 4b - Other Adjustments: Pension Related Charges 4,039,406. Change in Beneficial Interest - VHS 27,980. Part XII, Line 2d - Other Adjustments: Rental Expenses 201,158. 1 1 1 X 1 X 1 1 0 1 1 5011 1909213 1233321 675892 0.00490 80511 38490862 34011383 4479479 0.03250 85522 40400075 35244704 5155371 0.03740 31 15799 885668 0 885668 0.00640 3 214 23996 0 23996 0.00020 5 725 10744498 8867927 1876571 0.01360 1 2350000 0 2350000 0.01710 40 16738 14004162 8867927 5136235 0.03730 40 102260 54404237 44112631 10291606 0.07470 8 12707 74445 0 74445 0.00050 3 114 15362 0 15362 0.00010 1 250 6793 0 6793 0.00000 1 41 30223 0 30223 0.00020 13 13112 126823 126823 0.00090 26 26224 253646 253646 0.00170 1 1740975 0 39881291 36487987 3393304 X 1 1 1 1 Holyoke Medical Center Inc 575 Beech Street Holyoke MA 01040 www.holyokehealth.com 2145 X X X Holyoke Medical Center Inc 1 0 0 1 X X X X X X X X X 15 1 1 0 1 X See Part V, Section C X 1 15 1 see Part V, Section C 1 0 1 X 150.000000000000 300.000000000000 X X X X 1 1 X X X 1 X See Part V, Section C X See Part V, Section C X See Part V, Section C X X X X X X 1 X 0 X X X X 1 X 0 0 Holyoke Medical Center, Inc. Part V, Section B, Line 5: Holyoke Medical Center is a member of the Coalition of Western MA Hospitals ("the Coalition") a partnership between ten non-profit hospitals and insurers in the region. The Coalition formed in 2012 to bring hospitals in Western Massachusetts together to share resources and work in partnership to conduct their community health needs assessments (CHNA) and address regional needs. Holyoke Medical Center worked in collaboration with the Coalition to conduct its current assessment. The assessment was conducted so that Holyoke Medical Center can better understand the health needs of the communities it serves and to meet its fiduciary requirement as a tax-exempt hospital.The assessment focused on the nine communities in Holyoke Medical Center's service area, which are found in Hampden and Hampshire Counties and generally center around the Medical Center's location in northern Hampden County. Holyoke comprises the bulk of the Holyoke Medical Center service area. When identifying the areas that can be addressed to improve the health of the population, the assessment used the determinants of health framework since it is recognized that these factors contribute substantially to population health. The prioritized health needs identified in its current CHNA include community level social and economic determinants that impact health, barriers to quality health care, and health conditions and behaviors.The assessment included analysis and synthesis of 1) a variety of social, economic and health data; 2) findings from recent community assessment reports; and 3) information from five focus groups and 21 key informant interviews, some of which were conducted specifically for Holyoke MedicalCenter, and others which were conducted by other Coalition members and were relevant to this CHNA. Vulnerable populations were identified using a health equity framework with available data. Information from this CHNA will be used to inform the updating of Holyoke Medical Center's community health improvement strategies and to inform the Coalition's regional efforts to improve health. Holyoke Medical Center, Inc. Part V, Section B, Line 6a: Holyoke Medical Center is a member of the Coalition of Western Massachusetts Hospitals ("the Coalition") which also includes Baystate Medical Center and its affiliates, Mercy Medical Center, Cooley Dickinson Hospital, Shriners and Health New England. The Coalition hospitals collaborated in preparing their CHNAs. Holyoke Medical Center, Inc. Part V, Section B, Line 11: Please see the attached Implementation Plan for details on how the Hospital is addressing the significant needs identified in its most recently conducted CHNA as well as the needs that are not being addressed. The attached Implementation Plan also describes the reasons any needs are not being addressed and why. Holyoke Medical Center, Inc. Part V, Section B, Line 16i: The Hospital has had a section on their website related to financial assistance for several years. The Hospital has a financial assistance policy, plain language summary, and financial assistance application that was available to our patients along with financial assistance signs in certain locations in the Hospital (such as patient registration, and the Emergency department). Schedule H, Part V, Section B, line 7a & 10a: The CHNA is available at the Hospital facility's website: http://www.holyokehealth.com/Holyoke/media/Emerge_Holyoke/News/2016_HMC_CHNA.pdf Implementation Strategy:http://holyokestage.stage.bluespiremarketing.net/Holyoke/media/Emerge_Holyoke/About-Us/HMC-Community-Health-Needs-Strategy-16-19.pdf Schedule H, Part V, Section B, Line 16a & 16b: The Hospital's Financial Assistance Policy, Plain Language Summary, and Financial Assistance Applications can be found at: Financial Assistance Policy:https://www.holyokehealth.com/Holyoke/media/Emerge_Holyoke/News/Holyoke-Medical-Center-English-Financial-Assistance-Policy-FY-2016.pdfFinancial Assistance Plain Language Summary:https://www.holyokehealth.com/Holyoke/media/Emerge_Holyoke/News/Holyoke-Medical-Center-Financial-Assistance-Plain-Language-Summary-(ENG).pdf Financial Assistance Application:https://www.holyokehealth.com/Holyoke/media/Emerge_Holyoke/News/Holyoke-Medical-Center-Financial-Assistance-Application-(ENG).pdf Part I, Line 3c: Not Applicable. Part I, Line 6a: Not Applicable. Part I, Line 7: Holyoke Medical Center, Inc. used the cost-to-charge ratio method in determining the cost of health services provided. Holyoke Medical Center, Inc. derived this cost-to-charge ratio based on the total patient care expense, after step-down adjustment, divided by gross patient charges per the Medicare 2552 cost report. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 3,796,282. Part II, Community Building Activities: Holyoke Medical Center, Inc. provides a variety of community sponsorships and ongoing relationships with local community organizations. Our goals for those sponsorships and/or team building are to help support cultural and healthy lifestyle events, whether it be to support youth sports teams, celebrate youth academic leaders and their families and teachers, or support of a community celebration. Our intended outcome is to make this a healthier and livelier community.The majority of our community support is a result of requests from civic, social, and athletic groups within our community. As an example, working with three community partners, Holyoke Medical Center, Inc. staff help coordinate a children's grant to specifically assist speech and language screening and education for children and parents in the community for children with speech and hearing difficulties. Working with our partners, this program helps assist families with obtaining public school services for their children. Our ongoing involvement helps oversee budgets and assure flow to appropriate allocation of funds to those community services which will support those children and their families for speech, occupational and physical therapy, behavioral counseling, therapeutic play, hearing screenings, family literacy, and nutrition. In addition, HMC also partners with a variety of local community agencies to help oversee specific grants that have been awarded for the broader community for children with childhood developmental delays in their cognitive speech and hearing. Family support and teaching pre-school and grammar school educational programs for teachers are held to assist in minimizing the delays that these children would otherwise undergo without this service. Part III, Line 2: Holyoke Medical Center, Inc. utilizes a costing methodology in which the ratio of patient care cost to charges is applied to the bad debt expense attributable to patient accounts to calculate the estimated cost of bad debt attributable to patient accounts that is reported on Line 2. Discounts and payments on patient accounts are recorded as adjustments to revenue, not bad debt expense. Part III, Line 3: See narrative for Part III, Line 2. Part III, Line 4: See Footnote 2 on Page 9 of the attached audited financial statements. Part III, Line 8: Holyoke Medical Center, Inc. utilizes generally accepted accounting principles in the preparation of its financial statements.Holyoke Medical Center, Inc. used the cost-to-charge ratio method in determining the cost of health services provided. Holyoke Medical Center, Inc. derived this cost-to-charge ratio based on the total patient care expense, after step-down adjustment, divided by gross patient charges per the Medicare 2552 Cost Report. Part III, Line 9b: Populations Exempt from Collection Action - The following individuals and patient populations are exempt from any collection actions pursuant to the Massachusetts Health Safety Net Program (HSN) regulations:a. Patients enrolled in, receiving benefits from, or participating in a public health insurance program, including but not limited to MassHealth, Emergency Aid to the Elderly, Disabled and Children (EAEDC), Healthy Start, Children's Medical Security Plan (CMSP (provided the patient's family income is equal to or less than 300% of the FPL)), and low income patients subject to the following:(1) Holyoke Medical Center, Inc. may initiate Collection Action against any patient enrolled in, receiving benefits from, or participating in MassHealth, EAEDC or Healthy Start, and any low income patient, for their required co-payments and deductibles as set forth by each specific program.(2) Holyoke Medical Center, Inc. may also initiate collection action for a patient who alleges that he or she is a participant in MassHealth, EAEDC, Health Start or CMSP but fails to provide proof of such participation. Upon receipt of satisfactory proof that a patient is a participant in such a program (including, in the case of MassHealth, EAEDC or Healthy Start, receipt or verification of a signed application), Holyoke Medical Center, Inc. shall cease billing or collection activities.(3) Low income patients are exempt from Collection Action for Eligible Services (as defined by HSN regulations from time-to-time) they receive during the period for which they have low income patient status.(4) Low income patients with family income between 150% and 300% of FPL are exempt from collection action for the portion of their Holyoke Medical Center, Inc. bill that exceeds the patient's deductible. However, Holyoke Medical Center, Inc. may initiate collection action against patients for their required co-payments and deductibles.(5) Holyoke Medical Center, Inc. may continue collection action on any low income patient for services rendered prior to the low income patient determination, provided that the patient's low income patient status has been terminated or expired. However, once a patient is determined to be eligible and enrolled in the Health Safety Net, MassHealth or certain Commonwealth Care programs, Holyoke Medical Center, Inc. will cease collection action for services rendered prior to the beginning of their eligibility.(6) Holyoke Medical Center, Inc. may pursue collection action against low income patients for services other than eligible services for which the patient has agreed to be responsible, provided Holyoke Medical Center, Inc. obtained the patient's prior written consent to be billed for the services. Holyoke Medical Center, Inc. will not bill low income patients for claims denied by the patient's primary insurer resulting from an administrative or billing error unless the error was initiated by patient/ guarantor.(7) Holyoke Medical Center, Inc. will not undertake collection action against an individual who has been approved for ER Bad Debt Medical Hardship or medical hardship under the Massachusetts Health Safety Net Program with respect to the amount of the bill that exceeds the medical hardship contribution.b. With respect to low income patients injured in motor vehicle accidents, Holyoke Medical Center, Inc. will: (1) investigate whether the patient, driver and/or vehicle owner had a motor vehicle liability policy; (2) make every effort to obtain the third party payor information from the patient; (3) if the hospital has prior knowledge and is legally able, attempt to secure assignment on a patient's right to third party coverage on services provided due to an accident; (4) advise patient of duty to notify HSN/MassHealth within 10 days of filing TPL claim/lawsuit, (5) retain documentation of those efforts; (6) where applicable, submit a claim for payment to the motor vehicle liability insurer; and (7) if any portion of the claim was previously billed to the HSN, report any recovery to the HSN.c. Holyoke Medical Center, Inc. will not garnish a low income patient's or their guarantor's wages or execute a lien on the low income patient's or their guarantor's personal residence or motor vehicle unless: (1) Holyoke Medical Center, Inc. can show that the patient or their guarantor has the ability to pay; (2) the patient/guarantor did not respond to HMC requests for information or the patient/guarantor refused to cooperate with HMC to seek an alternative financial assistance program; or (3) for purposes of a lien, it was approved by Holyoke Medical Center, Inc.'s Board of Trustees on an individual case-by-case basis.d. Holyoke Medical Center, Inc. may cease any collection or billing actions against a patient who is unable to pay Holyoke Medical Center, Inc.'s bill at any time during the billing process, if the patient is eligible for assistance under financial assistance programs that HMC may, in its discretion, make available from time-to-time. Holyoke Medical Center, Inc. will keep any and all documentation that shows a patient met the criteria for such programs.e. Holyoke Medical Center, Inc. and its agents shall not continue collection or billing on a patient who is party to bankruptcy proceedings except to secure its rights as a creditor in the appropriate order.f. Holyoke Medical Center, Inc. and its agents will not charge interest on an overdue balance for a low income patient or for patients who are eligible for financial assistance programs that HMC may in its discretion make available from time-to-time. Part VI, Line 2: Holyoke Medical Center, Inc. (HMC) conducts a needs assessment of the communities it serves in conjunction with numerous community agencies. These include Holyoke Health Center, Inc., our sister organizations River Valley Counseling Center, Inc. and Holyoke Visiting Nurse Association, Inc., as well as Holyoke Community College and a wide variety of education institutions in the Holyoke/Springfield area, including the University of Massachusetts Medical School in Worcester. Partnering with these organizations has allowed HMC to utilize our expertise and assessment of the population we serve to better formulate our community benefit initiatives. Based on the needs assessment, HMC determines which initiatives to continue and which programs to implement within our financial means. This includes a focus on community education and community outreach. It is important not to overlook the substantial contribution that the hospital makes to the community through our many educational programs, free flu shots, and our support of community events. HMC will continue to monitor these programs for their need and effectiveness in the community, and, working with our community partners, assess for gaps in the needs of the community that are not being filled. The formal needs assessment done in 2016 by Partners For A Healthier Community, Pioneer Valley Planning Commision, and Collaborative Educational Services combined with our own data and information of our patient population including what is publicly reported by the Department of Public Health - Massachusetts Community Health Information Profiles and other public sources has enabled us to focus our limited resources to better serve our community.The 2016 (tax year 2015) 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 the healthcare we receive.Among these "modifiable" factors that impact health, social and economic factors are estimated to have the greatest impact. The County Health Rankings model, developed by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, estimates the extent to which these modifiable factors contribute to health based on reviews of the scientific literature and a synthesis of data from a number of national sources. It is estimated that social and economic factors account for 40% of our health, followed by health behaviors (30%), clinical care (20%), and the physical environment (10%). Many health disparities occur as a result of inequities in these determinants of health.Among the fourteen Massachusetts counties, County Health Rankings ranked Hampden County last in the state for both health factors and health outcomes in 2016. Hampshire County ranked fifth in health outcomes and third in health factors.Assessment Methods:The primary goals of the 2016 CHNA were to update the list of prioritized community health needs identified in the 2013 CHNA conducted by Verite Healthcare Consulting, and to the extent possible, identify potential areas of action. The prioritized health needs identified in this CHNA include community-level social and economic determinants that impact health, barriers to accessing quality health care, and specific health conditions and behaviors within the population. Assessment methods included:- Analysis of social, economic, and health quantitative data from Massachusetts Department of Public Health, the U.S. Census Bureau, the Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, the County Health Ranking Reports, Community Commons, and a variety of other data sources;- Analysis of findings from one focus group and four key informant interviews conducted specifically for Holyoke Medical Center;- Analysis of findings from an additional four focus groups and 17 key informant interviews that were conducted for other Coalition members and considered relevant for this CHNA;- Review of 12 existing assessment reports published since 2013 that were completed by community and regional agencies serving Holyoke Medical Center's service area.The assessment focused on community-level data as available. In some instances, data constraints related to accessibility and availability limited analyses to select communities in the Holyoke Medical Center service area. In these instances, analyses focused on Chicopee, Holyoke, West Springfield, and Easthampton. To the extent possible given data and resource constraints, vulnerable populations were identified using information from focus groups and interviews as well as quantitative data stratified (or broken down) by race/ethnicity and age with a focus on children/youth and older adults.Prioritization ProcessA systematic process was conducted to develop a list of prioritized community health needs. Community level social and economic determinant of health factor related needs and access to care needs were assessed using quantitative and qualitative data gathered for the 2016 CHNA. Health conditions were identified based on consideration of the following: magnitude of impact (low, moderate, high), severity of impact (low, moderate, high), populations impacted (including vulnerable populations), and rates compared to a referent (generally the state rate). Prioritized health needs were those that had the greatest combined magnitude and severity or that disproportionately impacted vulnerable populations in the community. Part VI, Line 3: 1) General Principles:Holyoke Medical Center, Inc. or its agents will assist uninsured and underinsured patients with the process of applying for available financial assistance programs that may pay for some or all of their hospital bills. In order to help uninsured and underinsured patients find and apply for available financial assistance, HMC will provide all patients with a general notice of the availability of programs by way of posted notices throughout HMC and by way of individual notices to patients. The goal of these notices is to inform patients regarding the availability of financial assistance, as well as assistance with the application process. Holyoke Medical Center, Inc. will assist patients with the application process for the following Massachusetts programs: MassHealth, Commonwealth Care, CMSP, Healthy Start, Health Safety Net, and Medical Hardship through the Health Safety Net. Holyoke Medical Center, Inc. will provide, upon request, specific information about: (a) the eligibility criteria to be a low income patient under the Massachusetts Health Safety Net program or (b) additional financial assistance programs that HMC may in its discretion make available to low income patients from time-to-time. Holyoke Medical Center, Inc. will also notify the patient about available payment plans that may be available to them pursuant to HSN regulations.2) Role of Hospital Patient Financial Counselors and Other Finance Staff:Holyoke Medical Center, Inc. will attempt to identify available coverage options for patients who may be uninsured or underinsured when the patient is scheduling services, while the patient is at HMC, upon discharge and for a reasonable time following discharge. Holyoke Medical Center, Inc. will direct all patients seeking available coverage options to HMC's Patient Financial Counseling office for eligibility screening and assistance with the application process, including the application process for financial assistance programs that HMC may in its discretion make available to low income patients from time-to-time.Holyoke Medical Center, Inc. will also provide information on how to contact the appropriate staff within the hospital's Finance Department to verify the accuracy of the hospital bill or to dispute certain charges.3) Notification Practices:Holyoke Medical Center, Inc. will post a notice (signs) of availability of financial assistance in the following locations:a. Service delivery areas (e.g., inpatient, clinic, emergency department admission and/or registration areas);b. Patient financial counselor areas;c. Central admission/registration areas; and/ord. Business office areas that are open to patients.Posted signs will be clearly visible and legible to patients visiting these areas. The hospital will also include a notice about the availability of financial assistance in all initial bills.When a patient contacts the hospital, the hospital finance staff will attempt to identify if a patient qualifies for a public financial assistance program or a payment plan. A patient who is enrolled in a public financial assistance program (e.g., MassHealth or the Health Safety Net) may qualify for certain plans. Patients may also qualify for additional assistance based on the hospital's own internal criteria for financial assistance or qualify for coverage of services as a medical hardship based on the patient's documented income and allowable medical expenses.For cases in which the hospital is using the Virtual Gateway application, the hospital will assist the patient in completing the application for MassHealth, Commonwealth Care, Children's Medical Security Plan, Health Start, Health Safety Net, or other forms of financial assistance programs as they become part of the Virtual Gateway program.All signs and notices shall be translated into languages other than English if such language is primarily spoken by 10% or more of the residents in the hospital service area, which is based on the hospital admissions and/or discharge information. Part VI, Line 4: The service area for Holyoke Medical Center includes nine communities, three of which are located in Hampden County (Chicopee, Holyoke, and West Springfield) and six of which are located in Hampshire County (Belchertown, Easthampton, Granby, South Hadley, Southampton, and Westhampton). The total population of the service area is over 180,000 people. The three largest communities in the service area - Holyoke, Chicopee and West Springfield - are located in Hampden County and contain two-thirds of the service area's population. Approximately 89% of the population in the Holyoke Medical Center service area lives in urban areas. Urban areas consist of census tracts and/or blocks meeting the minimum population density requirement (2,500-49,999 for urban clusters and over 50,000 for urbanized areas) or are adjacent and meet additional criteria. The median ages in these cities hover near the Hampden County median age of 40 years old. Racial and ethnic diversity is more common in the three largest communities in the service area, where over 15% of the population identifies as Black or African American, American Indian, Asian, or some other race. There is also a sizeable Hispanic or Latino population in this service area, where 47% of the population of Holyoke and almost 17% of the population in Chicopee identifies as such. In Holyoke, 44% of the population speaks a language other than English at home. In Chicopee and West Springfield over 20% of the population speaks a language other than English at home. Public transit access is facilitated by the Pioneer Valley Transit Authority, which provides bus service to all but one of the nine communities (Westhampton). Paratransit services are offered throughout the service area for people with disabilities within 3/4 mile of a fixed route in order to facilitate access to medical care.Economically, there is significant variation between communities in the Holyoke Medical Center service area. Annual per capita income in the service area is $27,165, which is considerably less than the state average of $36,440. On a community-level, there is wide variation, with the per capita income ranging from $19,997 in Holyoke to $32,459 in Belchertown (ACS, 2010-2014). In this service area, the overall percentage of those who pay more than 30% of their income for housing costs is 35. Again, these figures vary within the service area, where 42% of renters and owners in Holyoke are cost-burdened, versus 30% and 31% in Easthampton and Westhampton, respectively. Approximately 15% of Holyoke Medical Center service area residents live below the federal poverty level, as compared to 17% of Hampden County residents and the state rate of 12%. The child poverty rate for the Holyoke Medical Center service area is 22%, which is lower than that of Hampden County (27%), but higher than that of state (15%). At the community level, these rates vary widely. In Holyoke, the overall poverty rate is 30%, and the child poverty rate is nearly 50% - over three times the state rate.As a whole, 85% of the population has a high school diploma, with rates varying from 77% in Holyoke to over 92% in Easthampton and Belchertown. The service area's unemployment rate is 6%. The unemployment rate is based on the number of people who are either working or actively seeking work. Some communities struggle with unemployment rates more so than others - Holyoke and Chicopee have rates at 8% and 7% respectively, while Belchertown and Easthampton have unemployment rates below 5%. The service industry is the largest employment sector in the area, but the manufacturing and wholesale and retail trade industries are also strong economic drivers in this service area. Part VI, Line 5: The impact of Holyoke Medical Center, Inc.'s (HMC) outreach efforts are evidenced by the fact that countless service agencies rely on HMC to ensure their own success. Among the key accomplishments this year were:Kate's KitchenKate's Kitchen, a program of Providence Ministries, serves a noontime meal 365 days a year to anyone with no questions asked. Kate's also offers a brown bag supper to people from 5-6pm. It served its first lunchtime meal in 1980, and since that day, the program has run continuously, providing a total of over one million meals. The kitchen depends heavily on volunteers to assure the smooth running of the kitchen.Homework HouseThe mission of Homework House is to rekindle a love of learning, one page and one child at a time. Homework house is an arena to assist children with homework after the school hours. It is open from 3 to 5pm Monday -Friday at the Immaculate Conception Church or Sacred Heart Church.5-2-1-05-2-1-0 Let's Go! is a nationally recognized childhood obesity prevention program implemented throughout Holyoke and in communities as far as Maine. It partners with schools, child care and out-of-school programs, health care practices and community organizations to change environments where children and families live, learn, work, and play.Lung Cancer ScreeningHMC provides CT Lung Cancer Screening Services. Studies have shown that Low Dose Lung Cancer Screening Cat Scans can lower the risk of death from lung cancer by 20% in people who are at high risk. HMC has committed the following staffing resources for this service: Radiologist, Technologist for scan, PCP and Nurse Navigator.Nutrition for the Cancer PatientHMC ensures access to care for all oncology patients with lack of food access or financial hardship. Upon admission, patients are evaluated to assess needs and follow-up services are provided.Survivorship with all cancer patientsA survivorship care plan is started for all cancer patients. Patients are considered survivors from the beginning of their journey to the end.Transportation ServicesIf you live in Holyoke and need help getting to and from the medical center campus, Holyoke Medical Center offers a van service with no appointment necessary available Monday through Friday between the hours of 7:30 a.m. and 5 p.m.Other Community Health Involvement:- Oversaw emergency ambulance services for the City of Holyoke in conjunction with American Medical Response;- Operated the only Emergency Department in the City of Holyoke, providing emergency medical and behavioral health services to the community 24 hours a day, 7 days a week, 365 days per year;- Provided a variety of behavioral health services, including community liaison work with agencies in the mental health community in order to improve the provision of behavioral health/psychiatric services for community members, education lectures and provided transportation to members of the community who do not have their own transportation and are in need of partial hospitalization or intensive outpatient levels of care for mental health treatment;- Provided numerous outreach classes and services, through the Medical Center's Speech and Hearing department, to members of the community with hearing and speech difficulties. The department has also worked with a variety of long-term care facilities and elder communities to educate elders on hearing loss, hearing aids, medical conditions, speech, and swallowing issues.- Promoted health care career education throughout the community, such as hosting site visits to high school students to expand their knowledge of community hospitals and encourage youth to enter healthcare professions;- Provided numerous educational programs to promote healthy behaviors, encourage routine medical screenings to prevent a variety of common diseases in our community. For example, conducted diabetes education classes, conducted programs that provided information regarding the recognition, treatment, and prevention of stroke, and conducted CPR classes for the community;- Provided education on infectious disease and flu vaccine clinics which administered free flu vaccines to the general public;- Educated and implemented programs to promote access to primary and preventative care, utilizing medical and professional staff to educate the community to encourage routine medical screenings, education on speech and hearing issues, preventing pulmonary disease, and behavioral health issues;- Provided birthing, lactation and parenting skill education classes. Part VI, Line 6: Holyoke Medical Center is a 198-bed facility with over 1,200 employees serving individuals and families throughout the Pioneer Valley. The medical staff includes more than 300 physicians and consulting staff. Among some of the top-rated services at Holyoke Medical Center is the award winning Holyoke Medical Center Stroke Service which has been consistently rated as one of the best in the state. Areas of clinical emphasis also include behavioral health, critical care, emergency care, orthopedics, oncology, rehabilitation, women's health services, and speech and hearing services.Holyoke Medical Center is a member of Valley Health Systems, which also includes the affiliates Holyoke Visiting Nurse Association & Hospice Life Care, Western Mass Physician Associates, and River Valley Counseling Center. For more information, please visit www.HolyokeHealth.com.The mission of Holyoke Medical Center and the affiliated healthcare system is to serve the health needs of the community in a high quality and efficient manner. To this end, Holyoke Medical Center shall:- Provide compassionate care to all whom it serves with a commitment to cultural diversity in our programs and workforce, and the development of cultural competencies in our workforce so that we may better serve our patients;- Identify and serve those needs which are prevalent and substantial in the community as a whole or within major population groups, and which can be adequately met by the provision of basic primary and secondary health care services;- Provide information, education, and expertise to our community in order to promote the general health of its citizens;- Provide an environment of excellence and growth in which health care professionals can use their skills and abilities to the fullest extent possible; - Provide competitive wages and benefits, as well as safe and dignified working conditions, for all employees;- Ensure financial responsibility in the operation of the Medical Center in order to guarantee the future viability of our mission;- Provide a formal, public, and ongoing program of community benefits, in cooperation with community individuals and organizations, to improve the health status of the public including especially the medically and economically vulnerable. Part VI, Line 7, Reports Filed With States MA 1 City of Holyoke 536 Dwight Street Holyoke MA 01040 Municipality 8500 St. Patrick's Committee of Holyoke Sponsorship 1 Part I, Line 2: The Hospital awarded sponsorship and grants to various 501(c)(3) public charities or municipalities, additional monitoring is not deemed necessary. 1 0 0 0 0 0 0 1 0 Vjay V Gandevia MD Director/Pres. Medical Sta 431311 0 0 0 0 0 0 0 16106 0 447417 0 0 0 Karen Ferroni MD Director/Medical Director 276679 0 0 0 0 0 0 0 15189 0 291868 0 0 0 Marc Zerbe MD Director/VP Medical Staff 0 458523 0 0 0 0 0 0 0 17114 0 475637 0 0 Spiridon E Hatiras President & CEO, Clerk 0 618158 0 0 0 0 0 0 0 16283 0 634441 0 0 Paul M Silva Treasurer & CFO 269370 0 0 0 0 0 0 0 15941 0 285311 0 0 0 Noah J Epstein MD Orthopedic Surgeon 707711 0 0 0 0 0 0 0 18905 0 726616 0 0 0 Nirav Sheth MD Cardiologist 510694 0 0 0 0 0 0 0 7214 0 517908 0 0 0 Khaled A Instrum MD Orthopedic Surgeon 499163 0 0 0 0 0 0 0 16407 0 515570 0 0 0 Mary E Norris MD Gastroenterologist 446652 0 0 0 0 0 0 0 12313 0 458965 0 0 0 Wandana Joshi DO Anesthesiologist 399670 0 952 0 0 0 0 0 5976 0 406598 0 0 0 Antonio Correia Former Treasurer 0 157189 0 0 0 0 0 0 0 14905 0 172094 0 0 James M Keefe Former Key Employee 226324 0 0 0 0 0 0 0 15546 0 241870 0 0 0 Clark A Fenn Former Key Employee 23202 0 0 0 114577 0 0 0 9140 0 146919 0 0 0 Part I, Line 3 The compensation for the Organization's CEO was established by a related organization, Valley Health Systems, Inc. That organization established the CEO's compensation by using a compensation committee and a compensation study. The compensation was also approved by the System's compensation committee. Part I, Line 4a Clark A. Fenn, a former key employee of the Hospital who left the organization in July of 2015, received severance payments during the calendar year ending 12/31/15 of $114,577. This amount is reflected in Box 5 of his W-2 and is further disclosed in Form 990, Part VII and Schedule J, Part II, Column B(iii). Part I, Line 7 At-risk compensation, which is subject to review and paid annually. It is based on several predefined metrics, including patient satisfaction, quality, and financial targets. Schedule J, Part I, Line 4a: Clark A. Fenn and James M. Keefe are individuals listed as former key employees of the Hospital. James M. Keefe is still a current employee of the Hospital in the same or similar capacity as in prior years. Additionally, Clark A. Fenn continued to serve in a similar capacity as in prior years until his departure from the Hospital in July, 2015. However, due to IRS reporting requirements, they no longer qualify as current key employees. In accordance with IRS instructions, they have been listed as former key employees. Schedule J, Part II: Antonio Correia, though no longer an officer of the filing organization, remained employed by Valley Health Systems, Inc. and H-C Management Services, Inc. as Chief Strategy Officer until March, 2016. Compensation and hours reflected on Form 990, Part VII and Schedule J, Part II is for his services as Chief Strategy Officer and does not reflect compensation in his capacity as a former officer of the organization. A Massachusetts Development Finance Agency 043431814 2015-12-18 15000000 Construction of Addition to Hospital Facility & Parking Lot 0 0 0 A 15000000 2258670 509955 622161 5429877 9447723 2017 0 0 0 1 A 0 0 1 1 0 1 0 0 A 0 1 0 0 1 0 0 0 0 A 0 Schedule K, Part III; Part IV; and Part V Although formal written policies are not in place to ensure that violations are timely identified and corrected, the bonds issuer, monitors regulation Sections 1.141-12, 1.145-2, and 148 requirements for the Organization. Furthermore, the Organization works closely with bond counsel to monitor any lease agreements or management service contracts that have the potential to result in private business use and to ensure that safeguards are in place to take appropriate and timely remedial action should any violations of federal tax requirements occur. James M Keefe Family Member Salary 66396 The son of Holyoke Medical Center, Inc. key employee, James M. Keefe, received compensation as an employee (registered nurse) of Holyoke Medical Center, Inc. Dr. Keefe's son was paid a salary of $61,747 with employee benefits of $4,649. Salary and benefits paid to Dr. Keefe's son are in line with the salary structure for similarly employed persons at the Hospital and do not represent higher than market rate compensation due to his familial relationship with Dr. Keefe. 0 Form 990, Part VI, Section A, line 2 Certain officers and directors of Holyoke Medical Center, Inc. are employed by a related tax-exempt organization which has common officers and/or directors. By virtue of this arrangement, certain individuals listed in Form 990, Part VII have a business relationship with one another. Form 990, Part VI, Section A, line 6 The sole member of Holyoke Medical Center is Valley Health Systems, Inc. Form 990, Part VI, Section A, line 7a Valley Health Systems, Inc. elects the members of the governing body of Holyoke Medical Center, Inc. Valley Health Systems, Inc. also has the power to remove any member of the governing body, with or without cause, at any time by giving written notice to such governing body member. Form 990, Part VI, Section A, line 7b Significant decisions of the governing body of Holyoke Medical Center, Inc. are subject to the approval of Valley Health Systems, Inc. as specified in the Organization's bylaws. Form 990, Part VI, Section B, line 11 A copy of the Hospital's Form 990 was provided to each voting member of the governing body prior to its filing with the Internal Revenue Service. The Form 990 was prepared with the assistance of an independent public accounting firm and thoroughly reviewed by the Senior Vice President of Finance and CFO and key financial staff of the Hospital prior to distibuting it to the governing body for review. Form 990, Part VI, Section B, line 12c The conflict of interest policy of Holyoke Medical Center, Inc. (HMC) is monitored and enforced as part of the Valley Health Systems, Inc. System and is reviewed annually by the System's conflict of interest committee. HMC board members, officers, and key employees complete and sign a conflict of interest questionnaire annually. All signed questionnaires are then submitted to HMC and to Valley Health Systems, Inc. (parent) for review and monitoring. Form 990, Part VI, Section B, line 15 The compensation committee of the Valley Health System, Inc. utilizes a market compensation survey to recommend to the Board the approval of its determination of the appropriate compensation of the Chief Executive Officer. During that process, the Committee also reviews the compensation levels of other senior management and key employees of the System. These individuals are not members of the compensation committee and do not participate in this process. The CEO, as a member of the Board of VHS, does not participate in the approval process of that officer's compensation. Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest policy, and financial statements of Valley Health Systems and Affiliates, which includes supplemental information of the filing entity, are available to the public upon request at the Organization's administrative office at 575 Beech Street, Holyoke, MA. Form 990, Part VII: Antonio Correia, though no longer an officer of the filing organization, remained employed by Valley Health Systems, Inc. and H-C Management Services, Inc. as Chief Strategy Officer until March, 2016. Compensation and hours reflected on Form 990, Part VII and Schedule J, Part II is for his services as Chief Strategy Officer and does not reflect compensation in his capacity as a former officer of the organization. Vjay V. Gandevia, MD, Karen M. Ferroni, MD, and Marc Zerbe, MD are listed on Form 990, Part VII as voting members of the Hospital's board of directors. In accordance with IRS instructions, each has reportable compensation and benefit information disclosed on Part VII. However, each are licensed, full-time physician employees of the Hospital or one of its affiliates and their compensation and benefits represents remuneration in their capacity as such. No part of their reportable compensation or benefits is paid in their capacity as board members of the Hospital. Clark A. Fenn and James M. Keefe are individuals listed as former key employees of the Hospital. James M. Keefe is still a current employee of the Hospital in the same or similar capacity as in prior years. Additionally, Clark A. Fenn continued to serve in a similar capacity as in prior years until his departure from the Hospital in July, 2015. Due to IRS reporting requirements, they no longer qualify as current key employees. In accordance with IRS instructions, they have been listed as former key employees. During the fiscal year following the period covered by this return, the Organization's CFO and Treasurer, Paul M. Silva, resigned his position within the affiliated hospital system. Michael J. Koziol became interim-CFO in April of 2017. Accordingly, Mr. Silva is listed in Part VII while Mr. Koziol is listed on Page 1 as the authorized signing officer. Mr. Koziol will be listed in Part VII of the Organization's 9/30/17 Form 990. Form 990, Part IX, Column D: All philanthropic and solicitation activity is carried out by Holyoke Medical Center affiliates. Therefore, no expenses have been allocated as fundraising expenses on Form 990, Part IX. Form 990, Part XI, line 9: Equity Transfer to Affiliates -3,756,733. Change in Beneficial Interest - VHS -27,980. Pension Related Charges -4,039,406. Form 990, Part XII, Line 2c: The audit process has not changed from the prior year. Community Health Foundation of Western Mass Inc 113 Hampden Street Holyoke MA 01040 222568962 Raise & Invest Funds for Affiliates MA 501(c)(3) Line 7 Valley Health Systems Inc 0 H-C Management Services Inc 20 Hospital Drive Holyoke MA 01040 222515981 Management Services MA 501(c)(3) Line 11b, II Valley Health Systems Inc 0 Holyoke Visiting Nurse Association Inc 113 Hampden Street Holyoke MA 01040 042104310 Home Health Care MA 501(c)(3) Line 9 Valley Health Systems Inc 0 MassWest Services Inc 575 Beech Street Holyoke MA 01040 222515964 Health Care MA 501(c)(3) Line 11b, II Valley Health Systems Inc 0 River Valley Counseling Center Inc 319 Beech Street Holyoke MA 01040 042174657 Outpatient Mental Health MA 501(c)(3) Line 9 Valley Health Systems Inc 0 Valley Health Systems Inc 20 Hospital Drive Holyoke MA 01040 042103583 Healthcare MA 501(c)(3) Line 7 N/A 0 Western Mass Physician Associates Inc 15 Hospital Drive Holyoke MA 01040 043202198 Medical Care Services MA 501(c)(3) Line 3 MassWest Services Inc 0 William Skinner TUA-Holyoke Hospital Trust PO Box 1802 Providence RI 029011802 046035855 Grantmaking MA 4797(a)(1) PF Valley Health Systems Inc 0 1 1 0 1 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0