FURP.ORG / PUBLIC DATA EXPLORER

BAYSTATE FRANKLIN MEDICAL CENTER: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
BAYSTATE FRANKLIN MEDICAL CENTER (EIN 04-2103575)
Tax period
2015-10-01 to 2016-09-30
Filed
2017-08-07
IRS object ID
201732199349300888
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 ReturnHeader

FieldValueIRS element (for citing)
Return2017-08-07T13:17:41-05:00ReturnTs
Tax Period End2016-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN861065772PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Deloitte Tax LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1Two Jericho PlazaAddressLine1Txt
CityJerichoCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11753ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN042103575EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Baystate Franklin Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlBAYSBusinessNameControlTxt
Phone4137940000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1164 High StreetAddressLine1Txt
CityGreenfieldCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01301ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDennis W ChalkePersonNm
Person TitleSVP Finance, CFO & TreasurerPersonTitleTxt
Phone4137940000PhoneNum
Signature2017-08-04SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonChristine KaweckiPreparerPersonNm
PTINP00743140PTIN
Phone5169187000PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDennis W ChalkePrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1759 Chestnut StreetAddressLine1Txt
CitySpringfieldCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01199ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$109,383,971GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.baystatehealth.org/fmcWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1895FormationYr
Legal Domicile StateMALegalDomicileStateCd
Activity Or MissionThe mission of the organization is to improve the health of the people in our communities every day, with quality and compassion.ActivityOrMissionDesc
Voting Members Governing Body22VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee830TotalEmployeeCnt
Total Volunteers346TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$163,583PYContributionsGrantsAmt
CY Contributions Grants$329,271CYContributionsGrantsAmt
PY Program Service Revenue$90,744,224PYProgramServiceRevenueAmt
CY Program Service Revenue$94,220,718CYProgramServiceRevenueAmt
PY Investment Income$365,268PYInvestmentIncomeAmt
CY Investment Income$315,178CYInvestmentIncomeAmt
PY Other Revenue$7,227,014PYOtherRevenueAmt
CY Other Revenue$2,352,729CYOtherRevenueAmt
PY Total Revenue$98,500,089PYTotalRevenueAmt
CY Total Revenue$97,217,896CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$45,187,721PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$46,816,490CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$42,681,976PYOtherExpensesAmt
CY Other Expenses$48,824,942CYOtherExpensesAmt
PY Total Expenses$87,869,697PYTotalExpensesAmt
CY Total Expenses$95,641,432CYTotalExpensesAmt
PY Revenues Less Expenses$10,630,392PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,576,464CYRevenuesLessExpensesAmt
Total Assets BOY$106,384,335TotalAssetsBOYAmt
Total Assets EOY$106,088,916TotalAssetsEOYAmt
Total Liabilities BOY$56,871,997TotalLiabilitiesBOYAmt
Total Liabilities EOY$56,162,452TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$49,512,338NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$49,926,464NetAssetsOrFundBalancesEOYAmt
MissionThe mission of the organization is to improve the health of the people in our communities every day, with quality and compassion.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$42,560,928ExpenseAmt
Revenue$42,748,014RevenueAmt
DescInpatient healthcare services - Providing inpatient community-based medicine and tertiary care to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY16, Baystate Franklin Medical Center provided 19,655 patient days of inpatient services, with 5,089 dischargesDesc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$32,806,289ExpenseAmt
Revenue$37,071,222RevenueAmt
DescOutpatient healthcare services - Providing outpatient clinical services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY16, Baystate Franklin Medical Center had 87,876 outpatient visits.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$11,398,379ExpenseAmt
Revenue$12,191,124RevenueAmt
DescEmergency department services - Providing emergency department services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY16, Baystate Franklin Medical Center had 25,957 emergency department visits.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$1,674,322ExpenseAmt
Revenue$4,046,406RevenueAmt
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$1,674,322TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$4,046,406TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$88,439,918TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document70IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee830EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members22GoverningBodyVotingMembersCnt
Independent Voting Member15IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldMAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Peter Lyons Baystate Health IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4137940000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1759 Chestnut StreetAddressLine1Txt
CitySpringfieldCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01199ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (38 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Adrian J Levsky
Trustee (as of 1/1/16)1.001.00Yes (X)$0$0$0
Anne M Paradis
Vice Chair1.002.00Yes (X)$0$0$0
David C Southworth
Trustee1.001.00Yes (X)$0$0$0
Edward J Noonan
Trustee1.001.00Yes (X)$0$0$0
Grace Makari-Judson MD
Trustee/ Hematologist1.0040.00Yes (X)$395,012$0$91,314
Gregory L Braden MD
Trustee1.001.00Yes (X)$0$0$0
Harriet A DeVerry
Trustee1.001.00Yes (X)$0$0$0
Hector Toledo
Trustee1.001.00Yes (X)$0$0$0
James P Sadowsky
Chair1.002.00Yes (X)$0$0$0
James R Phaneuf
Trustee1.001.00Yes (X)$0$0$0
John A Egelhofer MD
Trustee1.001.00Yes (X)$0$0$0
John F Maybury
Trustee1.001.00Yes (X)$0$0$0
John H Davis
Trustee1.001.00Yes (X)$0$0$0
John M O'Brien III
Trustee (Through 12/31/15)1.001.00Yes (X)$0$0$0
Katherine McG Sullivan
Trustee (Through 12/31/15)1.001.00Yes (X)$0$0$0
Kathleen B Scoble
Trustee1.001.00Yes (X)$0$0$0
Kevin P Moriarty MD
Trustee/ Chief Ped Surgery1.0040.00Yes (X)$634,583$0$46,896
Mark A Keroack MD
Trustee1.0040.00Yes (X)$0$1,258,998$213,008
Paul R Murphy
Trustee1.001.00Yes (X)$0$0$0
Richard B Steele Jr
Trustee (Through 12/31/15)1.001.00Yes (X)$0$0$0
Robert J Bacon
Trustee1.001.00Yes (X)$0$0$0
Robert L Pura PhD
Trustee1.001.00Yes (X)$0$0$0
Sara A Rourke MD
Trustee10.0040.00Yes (X)$337,163$0$30,143
Steven M Mitus
Trustee1.001.00Yes (X)$0$0$0
Victor Woolridge
Trustee1.001.00Yes (X)$0$0$0
Cindy L Russo
President (As of 5/30/16)50.000.00$0$0$0Yes (X)
Dennis Chalke
Treasurer1.0050.00$0$1,085,400$89,529Yes (X)
Kristin R Delaney
Clerk1.0039.00$0$109,755$31,677Yes (X)
Madeline Torres
Assistant Clerk1.0040.00$0$53,103$16,597Yes (X)
Thomas L Higgins MD
President (Through 5/30/16)40.0010.00$489,225$0$75,092Yes (X)
Leesa Lee Keith
Chief Nursing Officer50.000.00$194,669$0$14,026Yes (X)
Regina O Campbell
COO (Through 7/2016)50.000.00$199,900$0$68,692Yes (X)
Donald McCool
Pharmacist50.000.00$126,362$0$39,464Yes (X)
Edward G Tessier
Clinical Pharmacy Coordinator50.000.00$136,022$0$20,693Yes (X)
Jason M Kulp
Pharmacist50.000.00$132,231$0$25,031Yes (X)
Linda A West
Manager, Nursing50.000.00$131,586$0$35,654Yes (X)
Lynda J Zukowski
Director Clinical Svcs50.000.00$132,906$0$54,087Yes (X)
Steven F Bradley
Former President, BFMC0.000.00$0$648,442$269,439Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,909,659TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,155,698TotReportableCompRltdOrgAmt
Total Other Compensation$1,121,342TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K30IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other SrcsYes (1)CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Baystate Medical Practices Inc
759 Chestnut StreetSpringfieldMA01199Physician Services/ Lab Services$10,174,395
Baystate Administrative Services Inc
759 Chestnut StreetSpringfieldMA01199Management/I.S, Services$7,806,923
Baystate Medical Center Inc
759 Chestnut StreetSpringfieldMA01199Lab Services$6,032,894
Accelecare Wound Centers Inc
10900 NE 4th Street Suite 1900BellevueWA98004Clinical Support Services$639,629
Compass Clinical Consulting Co
PO Box 19786CincinnatiOH45219Consultant Services$406,028
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K13CntrctRcvdGreaterThan100KCnt
Government Grants$329,271GovernmentGrantsAmt
Total Contributions$329,271TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Revenue900099$93,437,360$93,437,360
Rental Income From Related Organi532000$783,358$783,358
FieldValueIRS element (for citing)
Total Program Service Revenue$94,220,718TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$359,232TotalRevenueColumnAmt
Exclusion$359,232ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$216,148RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$258,506RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$42,358RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$42,358TotalRevenueColumnAmt
Exclusion-$42,358ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$11,863,515SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$11,907,569SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$44,054SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$44,054TotalRevenueColumnAmt
Exclusion-$44,054ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
Pharmacy Services900099$699,883$699,883
Cafeteria Income900099$558,862$558,862
Intercompany Charges900099$506,819$506,819

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$629,523TotalRevenueColumnAmt
Related Or Exempt Func Income$629,346RelatedOrExemptFuncIncomeAmt
Exclusion$177ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,395,087OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$97,217,896TotalRevenueColumnAmt
Related Or Exempt Func Income$96,056,766RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$831,859ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$477,287TotalAmt
Program Services$477,287ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$37,600,427TotalAmt
Program Services$36,576,519ProgramServicesAmt
Management And General$1,023,908ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,614,439TotalAmt
Program Services$1,547,244ProgramServicesAmt
Management And General$67,195ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,175,182TotalAmt
Program Services$4,007,483ProgramServicesAmt
Management And General$167,699ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,949,155TotalAmt
Program Services$2,831,189ProgramServicesAmt
Management And General$117,966ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$5,982,418TotalAmt
Program Services$2,786,319ProgramServicesAmt
Management And General$3,196,099ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$105,061TotalAmt
Program Services$105,061ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$44,967TotalAmt
Management And General$44,967ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$31,650TotalAmt
Management And General$31,650ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$9,155TotalAmt
Program Services$8,068ProgramServicesAmt
Management And General$1,087ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$31,955,399TotalAmt
Program Services$29,422,476ProgramServicesAmt
Management And General$2,532,923ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$3,738,811TotalAmt
Program Services$3,738,811ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,797,312TotalAmt
Program Services$1,797,312ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$89,286TotalAmt
Program Services$75,025ProgramServicesAmt
Management And General$14,261ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$56,408TotalAmt
Program Services$56,105ProgramServicesAmt
Management And General$303ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$287,213TotalAmt
Program Services$287,213ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,568,951TotalAmt
Program Services$4,565,495ProgramServicesAmt
Management And General$3,456ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$158,311TotalAmt
Program Services$158,311ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$95,641,432TotalAmt
Program Services$88,439,918ProgramServicesAmt
Management And General$7,201,514ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$14,994,674BOYAmt
EOY$17,941,665EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$10,008,422BOYAmt
EOY$10,563,949EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,734,754BOYAmt
EOY$1,583,379EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$577,674BOYAmt
EOY$762,598EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$141,497,830LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$85,823,777LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$47,566,055BOYAmt
EOY$55,674,053EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$547,683BOYAmt
EOY$536,028EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$30,955,073BOYAmt
EOY$19,027,244EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$106,384,335BOYAmt
EOY$106,088,916EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$12,517,069BOYAmt
EOY$10,059,998EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$228,509BOYAmt
EOY$462,200EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$27,486,985BOYAmt
EOY$26,878,082EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$16,639,434BOYAmt
EOY$18,762,172EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$56,871,997BOYAmt
EOY$56,162,452EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$31,468,657BOYAmt
EOY$31,639,179EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$9,899,375BOYAmt
EOY$9,965,150EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$8,144,306BOYAmt
EOY$8,322,135EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$49,512,338BOYAmt
EOY$49,926,464EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$106,384,335BOYAmt
EOY$106,088,916EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$1,576,464ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$41,566NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$1,203,904OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$31,650OtherActivitiesAmt
Total Lobbying Expenditures$31,650TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationBaystate Franklin Medical Center pays membership dues to the Massachusetts Hospital Association (MHA) and the American Hospital Association (AHA). These organizations have advised us that portions of these dues are used for lobbying purposes for various healthcare matters at the state level. The portion of the dues listed as lobbying expenses for the year ending September 30, 2016 is $ 31,650.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,275,130OtherCostOrOtherBasisAmt
Book Value$1,275,130BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$88,212,785OtherCostOrOtherBasisAmt
Depreciation$46,399,840DepreciationAmt
Book Value$41,812,945BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$45,900,277OtherCostOrOtherBasisAmt
Depreciation$35,646,575DepreciationAmt
Book Value$10,253,702BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,109,638OtherCostOrOtherBasisAmt
Depreciation$3,777,362DepreciationAmt
Book Value$2,332,276BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$55,674,053TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
Funds Held By Bond Trustee$66,325
Benefical Interest in Perpetual Trust BHF$4,815,064
Due from Affiliated Companies$421,660
Estimated Final Settlement Receivable$251,974
Interest- Net assets of BHF$13,472,221
FieldValueIRS element (for citing)
Total Book Value Other Assets$19,027,244TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
Due to Affiliates$3,748,040
Estimated Final Settlement Payable$2,691,922
Insurance Liability Loss Reserve$144,000
Minimum Pension Liability$11,685,768
Other Liabilities$492,442
FieldValueIRS element (for citing)
Total Liability$18,762,172TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart V, Line 4:FormAndLineReferenceDesc
ExplanationCertain endowments are held at Baystate Health Foundation (BHF), an affiliate, and are reported as temporarily restricted and permanently restricted but Part V has not been completed as it is already addressed on BHF's Form 990 (EIN 04-3549011).ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,605,023TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$594,791DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,010,232NetCommunityBenefitExpnsAmt
Total Expense0.01060TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,390,259TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$15,317,612DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,072,647NetCommunityBenefitExpnsAmt
Total Expense0.04260TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$173,263TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$133,256DirectOffsettingRevenueAmt
Net Community Benefit Expns$40,007NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$21,168,545TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,045,659DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,122,886NetCommunityBenefitExpnsAmt
Total Expense0.05360TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$209,639TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$209,639NetCommunityBenefitExpnsAmt
Total Expense0.00220TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,181,580TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,135,871DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,045,709NetCommunityBenefitExpnsAmt
Total Expense0.02140TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$188,693TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$188,693NetCommunityBenefitExpnsAmt
Total Expense0.00200TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,579,912TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,135,871DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,444,041NetCommunityBenefitExpnsAmt
Total Expense0.02560TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$25,748,457TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$18,181,530DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,566,927NetCommunityBenefitExpnsAmt
Total Expense0.07920TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,035TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,035NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,035TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,035NetCommunityBenefitExpnsAmt
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$781,857BadDebtExpenseAmt
Bad Debt Expense Attributable$149,841BadDebtExpenseAttributableAmt
Reimbursed By Medicare$29,237,153ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$30,315,466CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$1,078,313MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Baystate Franklin Medical CenterBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1164 High StreetAddressLine1Txt
CityGreenfieldCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01301ZIPCd
FieldValueIRS element (for citing)
State License2120StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Baystate Franklin Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
OtherYes (X)OtherInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Part VOwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLSee Part VOtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt12ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSee Part VStrategyWebsiteURLTxt
Strategy Attached0StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Other MethodYes (X)OtherMethodInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttps://www.baystatehealth.org/patients/billing-and-financial-assistanceFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttps://www.baystatehealth.org/patients/billing-and financial-assistanceFAPAppAvailableOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Medicare RatesYes (X)MedicareRatesInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Baystate Franklin Medical CenterPart 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 Franklin Medical CenterPart V, Section B, Line 5: A wide range of stakeholders took part in the 2016 Coalition CHNA process, including local and regional public health and health departments, other local municipal agencies, diverse community-based organizations, advocacy organizations, healthcare providers, and community residents. These stakeholders provided input through focus groups, key informant interviews and participation in the CHNA Steering Committee. Additionally, community listening sessions were conducted to vet findings with community members.The following organizations/community stakeholders were interviewed: Public Health Experts -Caulton-Harris, Helen, Commissioner of Public Health, City of Springfield -Dennis, Soloe, Western Region Director, Massachusetts Department of Public Health (MDPH) -Garcia, Luz Eneida, Care Coordinator, MDPH Division for Perinatal, Early Childhood and Special Needs, Care Coordination Unit -Hyry-Dermith, Dalila, Supervisor, MDPH Division for Perinatal, Early Childhood and Special Needs, Care Coordination Unit -Merriam, Carolyn, Public Health Nurse, Town of Ware -Metcalf, Judy, Director, Quabbin Health District -O'Leary, Meredith, Director, Northampton Health Department -Steinbock, Lisa, Public Health Nurse, City of Chicopee -Walker, Phoebe, Director of Community Services, Franklin Regional Council of Governments (FRCOG) -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 CNBAC 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 Franklin Medical CenterPart 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 Outpaitent 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 Franklin Medical CenterPart 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. The Coalition includes Health New England, a local health insurer whose service area covers the four counties of western Massachusetts.
Baystate Franklin Medical CenterPart V, Section B, Line 7d: The hospital facility made its CHNA report widely available to the public via an email distribution, with links to the hospital's website, to community partners and organizations. The regional findings from the CHNA reports were shared publicly at the Western MA Health Equity Summit in November 2016 (over 300 attendees). In addition, the CHNA reports have informed the development and implementation of county wide community health improvement plans. Hospital and CHNA consultant staff have been invited to various venues and audiences to present on the CHNA process and key findings.
Baystate Franklin Medical CenterPart 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 will update 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: -Care coordination -Chronic health conditions -Cultural humility -Health equity -Insurance challenges -Limited availability of providers -Maternal/infant/ child health -Mental health and substance use disorders -Sexual health/teen pregnancyNeeds not being addressed: -Basic needs, including housing -Transportation -Food deserts/ insecurity -Health literacy -Physical activity and healthy diet
Baystate Franklin Medical CenterPart V, Section B, Line 13b: All patients with account balances (other than balances resulting from co-payments or deductibles on insured services) are eligible to receive a prompt pay discount of 20% of the balance for claims paid in full at time of service or within 60 days of the date of the initial bill. Patients must request the discount. The discount cannot be combined with the Hospital Supplemental Financial Assistance Program. The hospital offers a co-payment discount program for patients receiving services in the emergency departments of the hospitals. This discount program is available to all hospital emergency department patients with co-payment obligations under private or government health insurance (unless prohibited by law or a BH Hospital's contract with a private insurer or government authority). These patients may reduce the otherwise applicable emergency department service co-payment by 10% if the patient elects to pay the co-payment at the conclusion of the patient's emergency department visit.
Baystate Franklin Medical CenterPart V, Section B, Line 15e: The hospital provides patients with information about the availability of State Programs, Health Safety Net, or the Hospital Supplemental Financial Assistance Program which may cover all or some of their unpaid hospital bill as well as about the hospital discount programs. For those patients who request such assistance, the hospital assists patients by screening them for eligibility in available State Programs and assisting them in applying for such programs. When applicable, the hospital may also assist patients in applying for coverage of services as a Medical Hardship based on the patient's documented income and allowable medical expenses. The hospital has contracted with the Executive Office of Health and Human Services and the Commonwealth Health Insurance Connector Authority to serve as a Certified Application Counselor Organization. As a Certified Application Counselor (CAC), appropriate staff will inform a patient of the functions and responsibility of a CAC, seek that the patient sign a Certified Application Counselor Designation Form, and assist the patient in finding applicable financial assistance.
Form 990, Schedule H, Part V, Line 77a: https://www.baystatehealth.org/about-us/community-programs/community-benefits/community-health needs-assessment7b: http://www.cbsys.ago.state.ma.us/cbpublic/public/annual_reports_start.aspx
Form 990, Schedule H, Part V, Line 1010a: https://www.baystatehealth.org/about-us/community-programs/ community-benefits/community-health-needs-assessmentThe 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.
FieldValueIRS element (for citing)
Facility2FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - Baystate Rehabilitation Care at BFMC
48 Sanderson Street Lev 1 Ste 3GreenfieldMA01301Rehabilitation Clinic
2 - Outpatient Behavioral Health Srvcs
48 Sanderson Street 2nd FlrGreenfieldMA01301Partial Hospitalization Services

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 6a:The hospital facility files an annual community benefits report electronically with the Massachusetts Office of the Attorney General's via their website at ttp://www.cbsys.ago.state.ma.us/cbpublic/public/annual_reports_start.aspxThe hospital facility's annual community benefits report is also published on the Baystate Health website at https://www.baystatehealth.org/about-us/community-programs/community-benefits/community-health-needs-assessment. The hospital's community benefits report provides the Office of the Attorney General and the general public important information about how the hospital partners with the community to identify and address health needs.
Part I, Line 7:Line 7a (Charity Care) - community benefit expense was calculated by applying the ratio of patient care cost to charges, calculated on Worksheet 2, against total charity care gross patient charges from the audited financial statements.Line 7b (Unreimbursed Medicaid) - community benefit expense was derived using the organization's cost accounting system, which takes into account all hospital inpatients, outpatients and emergency room patients for whom services were provided and covered under Medicaid and Medicaid managed care plans.Line 7c (Other Means-Tested Programs) - community benefit expense was derived using the organization's cost accounting system, which takes into account all hospital inpatients, outpatients and emergency room patients for whom services were provided and covered under other means-tested government programs.Line 7e Community Health Improvement Services calculations are derived from direct and indirect costs associated with community benefit activities that are aligned with the hospital's 2013 community health needs assessment. These activities are carried out to improve community health and wellness and extend beyond patient care beyond the walls of the hospital. Community Benefit Operations calculations are derived from costs associated with assigned staff and community health needs and/or assets assessment, as well as other costs associated with community benefit strategy and operations. Line 7g (Subsidized Programs) - community benefit expense was derived using the organization's cost accounting system. The expense relates to the inpatient behavioral health program.
Part I, Line 7g:There are no costs attributable to physician clinics reported as subsidized health services in Part I, line 7g.
Part I, Ln 7 Col(f):In fiscal year 2013, the organization adopted the provisions of Accounting Standards Update 2011-07, Health Care Entities (Topic 954), Presentation and disclosure of Patient Service Revenue, Provision for Bad Debts, and the Allowance for Doubtful Accounts for Certain Health Care Entities on October 1, 2012. The update changed how the provision for bad debts is reported on the audited financial statements. In prior years it was included with total operating expenses, and subtracted from total expenses reported in Part IX, Line 25, column (A) for the purpose of calculating the percentages in Part I, Line 7, column (f). In 2016, the provision for bad debts was reported as a deduction to net patient service revenue. The 2016 provision for bad debts totaled $2,166,000 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 II, Community Building Activities:The following description is not quantified specifically in Part II of Schedule H. The hospital facility is committed to creating healthier communities and understands that many state and federally mandated community benefit programs and services are not sufficient to address ethnic, racial and economic health disparities and inequities. The hospital embraces the traditional definition of "health" to include economic opportunity, affordable housing, quality education, safe neighborhoods, food security, social and racial justice, and the arts/culture - all elements that are needed for individuals, families and communities to thrive. The hospital provides many valuable services, resources, programs and financial support - beyond the walls of the hospital and into the communities and homes of the people we serve; including grants and sponsorship of local community-based organizations and the involvement of Baystate leadership with various community board that align with our mission. The hospital facility provided $50,000 as a Payment in Lieu of Taxes (PILOT) to the City of Greenfield. The hospital facility paid dues to the Franklin County Chamber of Commerce, the Greenfield Business Association, and the Shelburne Falls Business Association, totaling $2,035 in 2016. The hospital participates in the Chamber and local business associations 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 4:The cost of bad debts reported in Part III, line 2 was calculated by applying a ratio of cost to charges (based on the organization's cost accounting system including all hospital inpatients and outpatients) against total patient bad debt net of recoveries as reported in the audited financial statements. The portion of bad debt that reasonably could be attributable to patients who may qualify for financial assistance under the hospital's charity care program (reported in Part III line 3) was calculated by applying the percentage of bad debts by zip code (for which the average household income for each zip code is less than 200% of the federal poverty level) to the total cost of bad debt reported in Part III line 2. Since this portion of bad debt is attributable to patients residing in an area where the average income is less than 200% of the Federal poverty level, it is highly likely these patients would have qualified for the organization's charity care program had they applied. For this reason, we believe the amount, totaling $149,841, 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 13 of the audited financial statements under the caption "Allowance for Uncollectible Accounts" for a description of the organization's reporting of its provision for bad debts.If a patient is determined eligible for financial assistance, the appropriate adjustment is made to the patient account based on their income level. Once the necessary approvals are obtained, it then flows to the general ledger. Patients applying for a prompt payment discount will have this allowance entered after agreed upon payment is received.
Part III, Line 8:Line 6 - included all Medicare allowable costs as calculated in Worksheets D-1 Part II (inpatient) and D Part V (outpatient) of the hospital's 2016 Medicare cost report, net of Medicare costs reported in Part I, line 7.g, based on Medicare costing principles. We believe the shortfall of $1,078,313 reported on line 20 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 elder population is not affluent.
Part III, Line 9b:For patients who are known to qualify for Charity Care or Financial Assistance: The patient may have requested assistance up front at time of service with a Financial Counselor or the Patient could have asked for assistance after receiving their bill by contacting our Patient Billing Services Representatives. The Financial Counselor will assist the patient in applying for the appropriate type of assistance based on their income and circumstances. Once approved for State Medicaid or other program, all billing and collection activity will stop (except for required co-payments or deductibles).For all other patients, our statements contain information regarding how to apply for financial assistance. Notices concerning availability for assistance are also posted at patient care sites.
Part VI, Line 2:The Baystate Board Governance Committee 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 priorites. 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 retore 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 will assist in applying for available financial assistance programs. The hospital notifies patients of the availability of assistance in both the initial bill sent to patients as well as in general notices posted throughout the hospital.When applicable, the hospital also assists patients in applying for coverage of services as a Medical Hardship based on the patient's documented income and allowable medical expenses. The hospital provides, upon request, specific information about the eligibility process to be a Low Income Patient under either the Massachusetts Health Safety Net Program or additional assistance for patients who are low income through 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 posted around the hospital to notify patients of the availability of financial assistance programs. Signs are clearly visible in the hospital's service area: they are 8.5 x 11 inches and the Header print font is 32 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 Franklin is a 90-bed acute-care community hospital. Our top priority is giving Franklin County and the North Quabbin Region the clinical excellence, advanced technology, neighborly warmth and convenience of a community hospital. Hospital specialties provided include inpatient behavioral health, cancer care, cardiology, children's medicine, critical care, emergency medicine, endocrinology and diabetes, gastroenterology, infectious disease, maternal fetal medicine, midwifery, neurology, neurosurgery, orthopedics, physical medicine and rehabilitation, plastic surgery, pulmonary medicine, senior care, surgery, thoracic surgeryurology and women's health.The service area for Baystate Franklin includes the 26 communities in Franklin County, as well as the Town of Athol, which is located in Worcester County. The region is fairly rural, and borders the state of Vermont to the north. The total population of the service area is just over 80,000. 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 main population centers in the service area include Greenfield (a city of about 17,000 people), and the North Quabbin region(population of about 18,000) located approximately 20 miles to the east of Greenfield. Many communities in the area are nestled among hilly, forested terrain, and have populations under 2,000. The median age in this service area is higher than the state's at 45 years old (ACS, 2010-2014). Less than six percent of the population identifies as either Black or African American, Asian, American Indian or some other race. Those who identify as Hispanic and Latino population comprise 4% of the total population. Economic indicators vary somewhat between the two population centers in the Baystate Franklin service area. The median household income in Franklin County is just over $54,000 ($13,000 less than the state). The overall poverty rate in Franklin County is similar to that of the state at 12%, and the child poverty rate of 16% is slightly higher than that of the state (ACS, 2010-2014). Athol is more economically depressed, with an overall poverty rate of 17% and a child poverty rate of 28%, almost double the state rate of 15%. Approximately 92% of adults over the age of 25 hold a high school diploma and over 34% hold a bachelor's degree or higher. In Athol, these numbers are lower at 85% and 15% respectively.The unemployment rate in February 2016 was comparable to the state's rate of 4% (CC, U.S. Department of Labor, Bureau of Labor Statistics). The unemployment rate is based on the number of people who are either working or actively seeking work. Major employers in the region include the health care and social assistance industry, as well as the education, retail and manufacturing industries.The area is served by a regional transit (bus) system that connects population and employment centers within the region. Paratransit service is also available for people with disabilities within 3/4 mile of a fixed route to facilitate access to medical care. Daily train service provides access to larger cities to the south, such as Springfield and Hartford.
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, BFMC 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. Baystate Franklin Medical Center 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 are Baystate Medical Center, Baystate Franklin Medical Center, Baystate Noble Hospital and Baystate Wing Hospital (and 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, Inc. 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, BWH and BNH, 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, Inc. 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'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.
Form 990, Schedule H, Part VI, Line 6The 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, the Mark R. Tolosky Baystate Neighbors Program 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.
Form 990, Schedule H, Part VI, Line 7List of States Receiving Community Benefits Report: MA

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
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
Sara A Rourke MD
Trustee$272,788$0$62,129$0$2,246$0$13,250$0$16,893$0$367,306$0$0$0
Dennis Chalke
Treasurer$0$466,083$0$357,889$0$261,428$0$64,000$0$25,529$0$1,174,929$0$0
Thomas L Higgins MD
President (Through 5/30/16)$372,295$0$76,150$0$40,780$0$62,728$0$12,364$0$564,317$0$0$0
Leesa Lee Keith
Chief Nursing Officer$161,524$0$31,733$0$1,412$0$12,674$0$1,352$0$208,695$0$0$0
Regina O Campbell
COO (Through 7/2016)$167,506$0$25,286$0$7,108$0$52,763$0$15,929$0$268,592$0$0$0
Donald McCool
Pharmacist$122,985$0$0$0$3,377$0$33,037$0$6,427$0$165,826$0$0$0
Edward G Tessier
Clinical Pharmacy Coordinator$133,599$0$0$0$2,423$0$14,098$0$6,595$0$156,715$0$0$0
Jason M Kulp
Pharmacist$132,100$0$0$0$131$0$10,644$0$14,387$0$157,262$0$0$0
Linda A West
Manager, Nursing$129,696$0$0$0$1,890$0$30,322$0$5,332$0$167,240$0$0$0
Lynda J Zukowski
Director Clinical Svcs$119,500$0$11,871$0$1,535$0$46,312$0$7,775$0$186,993$0$0$0
Steven F Bradley
Former President, BFMC$0$157,831$0$78,208$0$412,403$0$252,324$0$17,115$0$917,881$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3The compensation committee of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs) has been appointed through board resolution as the compensation committee of the filing organization. The compensation committee reviews and approves the compensation philosophy that is used to administer the specific pay decisions for the President of the filing organization. The compensation committee consists entirely of individuals serving on the board of the filing organization. The compensation of the President of the filing organization is determined by the member of the President's Cabinet (the Health System's senior leadership) responsible for that filing organization, in consultation with Human Resources, based on information provided by independent third party consultants for reasonableness including appropriate comparability data and based on the Executive Compensation Philosophy Statement established by the compensation committee.
Part I, Lines 4a-b4a Steven F. Bradley received $363,880 in 2015 and $252,324 in 2016. 4b Dennis W. Chalke - Supplemental Retirement of $171,159 is included in column E. This amount was earned and paid in 2015. Thomas L. Higgins, MD - Supplemental Retirement of $19,765 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. Mark R. Tolosky - Supplemental Retirement of $101,139 is included in column E. This amount was earned and paid in 2015

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
MA Health and Educ Facil Auth - Ser M4
A0425460112005-02-11$9,100,000MHEFA Series M-4; See Part VI00Yes (1)
MA Development Finance Agency-Series A
B0434318142014-12-04$22,000,000MA MDFA Series A; See Part VI000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$4,090,441$9,766,531$49,594$45,500$9,630,031$41,406200700Yes (1)Yes (1)
B$131,477$22,013,298$131,800$21,881,4982016000Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndEngage Bond Counsel ContractsEngageBondCounselContractsIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A00Yes (1)Yes (1)00.007200.000000.0072000Yes (1)
B00Yes (1)Yes (1)00.000000.000000.0000000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A000Yes (1)Yes (1)000Yes (1)
B0Yes (1)000000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Date Rebate Computation PerformedIssuer Name: MA Health and Educ. Facil. Auth. - Ser. M4 Date the Rebate Computation was Performed: 12/17/2013
Form 990 Schedule K, Part IA - MHEFA Capital Asset Program Series M-4 Per the Official Statement, the purpose of the bond is three projects ("The Project") all to be owned and operated by Baystate Franklin Medical Center, to be located at 164 High Street, Greenfield, Massachusetts, consisting of: (a) the renovation and expansion of the radiology department (including a CAT scan suite, three mammography rooms and one ultrasound room) and the emergency department; (b) acquisition of equipment for the radiology department (including one CAT scan and one mammography unit) and for the emergency department; and (c) the renovation of approximately 28,400 square feet of inpatient units. The HEFA indebtedness listed is a pool loan therefore Parts I, II, III, and IV (Lines 5-7) are being answered with respect to Baystate Franklin Medical Center's pool loan alone rather than with respect to proceeds loaned to other conduit borrowers. The actual date of issue of the MHEFA Series M4 bonds that funded BFMC's loan was 11/4/2004, and the CUSIP number shown on Form 8038 was 57586CDX0. B - MDFA Revenue Bond, Series A Per the Official Statement, the purpose of the bond is to finance (i) capital expenditures, including capitalized interest, in connection with the following projects (the "Project"); construction, improvement, equipping and other capital expenditures relating to the (i) construction of an approximately 55,000 gross square foot addition on the Borrower's campus for use as a surgical unit, including operating rooms, preoperative patient care, patient recovery and central sterile processing, as well as approximately 10,000 gross square feet of shell space, and (i) renovation of approximately 13,000 gross square feet of existing hospital space to be used for endoscopy and bronchoscopy, as well as staff and patient support space including a lobby and waiting room, which in each case are to be owned by the borrower and located at 164 High Street in Greenfield, Massachusetts; and (ii) costs of issuance relating to the Bond. Part IV, Line 2c, Column B (Series M-4): The Issuing Authority engages an outside consultant to prepare rebate computations. As of the second computation date, 11/3/2014, no rebate was owed.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 1a. 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 2Robert J. Bacon, Gregory L. Braden, MD, Regina, Campbell, Dennis W. Chalke, John H. Davis, Kristin R. Delaney, Harriet A. Deverry, John A. Egelhofer, MD, Thomas Higgins, MD, Leesa Lee Keith, Mark A. Keroack, MD, Adrian J. Levsky, Grace P. Makari-Judson, MD, John F. Maybury, Steven M. Mitus, Kevin P. Moriarty MD, Edward Noonan, John M. O'Brien, III, Anne M. Paradis, James Phaneuf, CIC, Robert L. Pura, PhD, Sara Rourke, MD, Cindy L. Russo, James P. Sadowsky, Kathleen B. Scoble, David C. Southworth, Richard B. Steele, Jr., Katherine McG. Sullivan, Hector Toledo, Mark R. Tolosky, Madeline Torres, 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) Robert L Pura, PhD, Richard B Steele, Jr.; (3)John F Maybury, Mark A Keroack MD; (4) John M. O'Brien, III, Victor, Woolridge; (5) John M. O'Brien, III Victor Woolridge; (6) John F, Mayberry, Anne M. Paradis
Form 990, Part VI, Section A, line 3Baystate Franklin Medical Center is affiliated with Baystate Administrative Services, Inc. (BAS) which is a 501(c)(3) organization. Information Technology, Human Resources, Finance, Treasury, Accounting and other management and support functions are delegated to BAS.
Form 990, Part VI, Section A, line 6The filing organization has one member, Baystate Health, Inc. (BH).
Form 990, Part VI, Section A, line 7aThe Board of Trustees of the filing organization are the same individuals serving as members of the Board of Trustees of BH with the addition of the president of the medical staff of the filing organization. The Board of Trustees of BH are elected annually by the Board of Trustees of BH at their annual meeting.
Form 990, Part VI, Section B, line 11Prior to the filing of this return appropriate parts of this Form 990 were reviewed by representatives from the Tax, Finance, and Human Resources Departments of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs), 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 and trustees 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 12cBaystate 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 15The compensation committee of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs) has been appointed through board resolution as the compensation committee of the filing organization. The compensation committee 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 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. 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 B, Line 16b: Baystate Health, Inc. has a joint venture policy that covers affiliated tax exempt entities including Baystate Franklin Medical Center
Form 990, Part VI, Section C, line 19The organization makes its conflict of interest policy and financial statements available to the public at www.baystatehealth.org. Articles of organization and bylaws are generally available at the Commonwealth of Massachusetts website.
Form 990, Part VII, Section A, Line 5Certain officers or trustees of the filing organization are paid by an entity, Baystate Medical Practices, Inc. (BMP) EIN 04-2888373, which is part of the health care system to which the filing organization belongs but does not meet the technical requirements as a "Related Organization" per Schedule R. Compensation from BMP to the officers and trustees of the filing organization therefore, is reported as paid from an unrelated organization in Line 5 and according to the instructions reported as though paid by the filing organization.
Form 990, Part XI, line 9:Minimum Pension Liability adjustment -3,669,861. Change in value of benefical interest net assets BHF temporarily restricted 177,829. Change in value of benefical interest net assets BHF permanently restricted 65,774. PP & E Released from Restrictions - transfer from affiliate 1,634,133. Net assets Released from Foundation 588,221.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (14 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Baystate Administrative Services Inc
759 Chestnut StreetSpringfieldMA01199222747685Administrative servicesMA501 (c ) (3)11c, IIIcBaystate Health Inc0
Baystate Health Foundation Inc
759 Chestnut StreetSpringfieldMA01199043549011FundraisingMA501 (c ) (3)7Baystate Health Inc0
Baystate Health Systems Inc Health & Welfare Benefits Plan
759 Chestnut StreetSpringfieldMA01199222531644Voluntary Employees' Benefit AssociationMA501 (c ) (9)Baystate Health Inc0
Baystate Health Inc
759 Chestnut StreetSpringfieldMA01199042105941Healthcare System ParentMA501 (c ) (3)7Baystate Health Inc0
Baystate Mary Lane Hospital Corporation
85 South StreetWareMA01082042103584HospitalMA501 (c ) (3)3Baystate Health Inc0
Baystate Medical Center Inc
759 Chestnut StreetSpringfieldMA01199042790311Acute Care Teaching HospitalMA501 (c ) (3)3Baystate Health Inc0
Baystate Total Home Care Inc
280 Chestnut StreetSpringfieldMA01199203260764Real Estate and OtherMA501 (c ) (3)11b, IIBaystate Medical Center0
Visiting Nurse Assn and Hospice of Western New England Inc
50 Maple StreetSpringfieldMA01199042105803Homehealth and Hospice careMA501 (c ) (3)9Baystate Health Inc0
Baystate Wing Hospital Corporation
40 Wright StreetPalmerMA01069222519813HospitalMA501 (c ) (3)3Baystate Health Inc0
Health New England Inc
Monarch Place Suite 1500SpringfieldMA011441500042864973HMO/InsuranceMA501 (c ) (4)4Baystate Health Inc0
HNE of Connecticut Inc
Monarch Place Suite 1500SpringfieldMA011441500455190134HMO/InsuranceCT501 (c ) (4)4Health New England Inc0
Baystate Noble Hospital Corporation
115 West Silver St PO Box 1634WestfieldMA010861634222537423HospitalMA501 (c ) (3)3Baystate Health Inc0
Westfield Medical Corporation
115 West Silver St PO Box 1634WestfieldMA010861634043127730Physician ServicesMA501 (c ) (3)11a,1Baystate Noble Hospital Corporation0
Noble Visiting Nurse Services Inc
77 Mill StreetWestfieldMA01085222757446Home health Care & HospiceMA501 (c ) (3)9Baystate Noble Hospital Corporation0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Franklin MRI Center LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1164 High StreetAddressLine1Txt
CityGreenfieldCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01301ZIPCd
FieldValueIRS element (for citing)
EIN161766731EIN
Primary ActivitiesManagement of Radiology ServicesPrimaryActivitiesTxt
Legal Domicile StateMALegalDomicileStateCd
Share Of Total Income$759,564ShareOfTotalIncomeAmt
Share Of EOY Assets$1,265,438ShareOfEOYAssetsAmt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing Partner0GeneralOrManagingPartnerInd
Ownership0.50000OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACdOwnershipOwnershipPctAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
HNE Advisory Services Inc
1 Monarch Place Suite 1500SpringfieldMA011441500043012347Administrative ServicesMAHealth New England IncC0
HNE Insurance Services Corporation
1 Monarch Place Suite 1500SpringfieldMA011441500043183019Ancilliary InsuranceMAHealth New England IncC0
Ingraham Corporation
759 Chestnut StreetSpringfieldMA01199043016257Health care and other business activitiesMABaystate Health IncC0
Tr UW John H Sanderson
100 Federal StreetBostonMA02110046028223TrustMAT0N/A1.00000
Ada B Darling UW
100 Federal StreetBostonMA02110046017199TrustMAT0N/A1.00000
Baystate Health Insurance Company Ltd
980421413Offshore captive InsuranceBaystate Health Inc0North Church StreetGeorgetownCJCJ
HNE Holding Corporation
Monarch Place Suite 1500SpringfieldMA011441500464620480Holding shares in subsidiary corporationMAHealth New England IncC0
HNE Insurance Company Inc
Monarch Place Suite 1500SpringfieldMA011441500454462433Health services For Mass Medicare SupplementMAHealth New England IncC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd