2017-08-15T09:46:23-04:00 2016-09-30 BDO USA LLP TWO INTERNATIONAL PLACE BOSTON MA 02110 990 2015-10-01 042103577 HARRINGTON MEMORIAL HOSPITAL Inc % TOM SULLIVAN HARR 5087658130 100 South Street Southbridge MA 015508002 EDWARD MOORE CEO 5087658130 2017-08-15 true Brian Vigneault P00540650 6174220700 2015 2021-01-29 14:40:06Z EDWARD MOORE 100 South Street Southbridge MA 015508002 138630707 false X WWW.HARRINGTONHOSPITAL.ORG X 1928 MA CHARITABLE - TO PROVIDE HIGH QUALITY MEDICAL SERVICES IN A COST EFFICIENT AND COST EFFECTIVE MANNER TO THE RESIDENTS OF SOUTH CENTRAL MASSACHUSETTS. 13 11 1492 491 956335 106886 1626816 402947 119960677 130952074 2208069 2733451 3874777 4149962 127670339 138238434 0 0 0 0 68697874 73968051 0 0 448401 48178353 51653702 116876227 125621753 10794112 12616681 124620585 125511568 60380929 59656284 64239656 65855284 THE PRIMARY MISSION OF THE HOSPITAL IS TO PROVIDE HIGH QUALITY MEDICAL SERVICES IN A COST EFFICIENT MANNER TO THE RESIDENTS OF SOUTH CENTRAL MASSACHUSETTS. false false 51034128 77525147 THE OPERATION OF AN ACUTE CARE HOSPITAL, WHICH HAD OVER 255,000 OUTPATIENT VISITS DURING THE YEAR ENDED SEPTEMBER 30, 2016. 33682469 25504129 THE OPERATION OF AN ACUTE CARE HOSPITAL, WHICH PROVIDED 19,029 DAYS OF INPATIENT CARE DURING THE YEAR ENDED SEPTEMBER 30, 2016. IN FY 2016 THE HOSPITAL HAD 113 BEDS AND 12 NURSERIES. 17118207 30459867 THE OPERATION OF AN ACUTE CARE HOSPITAL, WHICH PROVIDED TREATMENT FOR 43,229 EMERGENCY ROOM VISITS DURING THE YEAR ENDED SEPTEMBER 30, 2016. 101834804 true true false true false false false false false true true true false false true true false true false false false false false false false false true true false false true true false false false false false false false false true true false false false false false true false false false true 75 0 true 1492 true true true false false false false false false false false false X 13 11 true false false false true true true true true false false true true true true true true true true true true MA X X TOM SULLIVAN 5087658130 100 SOUTH STREET SOUTHBRIDGE MA 01550 JOSE DINGUI DIRECTOR 1.0 0.0 X 0 0 0 KAREN SPIEWAK DIRECTOR 1.0 0.0 X 0 0 0 ANTHONY M DETARANDO DIRECTOR 1.0 0.0 X 0 0 0 ANTHONY JAY DETARANDO VICE CHAIRPERSON 1.0 0.0 X 0 0 0 PIOTR GRABIAS MD DIRECTOR 1.0 0.0 X 0 0 0 JOHN MICHAEL MCGLONE DIRECTOR 1.0 0.0 X 0 0 0 JOHN G STAGIAS MD DIRECTOR 1.0 0.0 X 0 0 0 FRANCIS POWERS MD DIRECTOR 1.0 0.0 X 0 0 0 JAMES WADDICK CHAIRMAN 1.0 0.0 X 0 0 0 LAURANCE MORRISON DIRECTOR 1.0 0.0 X 0 0 0 ROBERT MUENZBERG JR DIRECTOR 1.0 X 0 0 0 MARK PALMERINO SECRETARY 1.0 0.0 X 0 0 0 RONALD J VAIRO DIRECTOR 1.0 0.0 X 0 0 0 EDWARD H MOORE PRESIDENT/CEO 40.0 0.0 X 627408 0 210681 THOMAS SULLIVAN VICE PRESIDENT/TREASURER 40.0 0.0 X 380245 0 15287 Arthur Russo MD VP of Medical Affair 32.0 0.0 X 341555 0 13675 Thomas Hijeck VP of Nursing 40.0 0.0 X 224917 0 9928 Harold R Lemieux VP and CIO 40.0 0.0 X 206197 0 14717 Christopher Canniff VP of HR 40.0 0.0 X 158788 0 11708 James Sullivan Jr Physician 40.0 0.0 X 442284 0 38011 Jarrett M Burns Physician 40.0 0.0 X 334645 0 19788 Andrew Marino Physician 40.0 0.0 X 331528 0 37070 Michael Gray Physician 40.0 0.0 X 321074 0 16468 Giza High Physician 40.0 0.0 X 309571 0 25372 3678212 0 412705 81 false true false Aramark 118 Beacon St Boston MA 02116 Bio-Med/Dietary 1151808 LABSOURCE LLC 168 South St Unit 4 PLAINVILLE MA 02762 Lab/Safety products 739230 SENTRY DATA SYSTEMS INC 800 Fairway Drive Suite 400 DEERFIELD BEACH FL 33441 Data Analytics 527547 HARVARD MEDICAL FACULTY PHYS INC 1101 Beacon St 3W BROOKLINE MA 02446 Diag Imaging Service 424361 THE ROI COMPANIES 85 Prescott Street Suite 402 WORCESTER MA 01605 Critical RCM Svcs 405725 37 402947 402947 Net Patient Service Revenue 900099 126412906 125456571 956335 Contract Revenue 900099 3529123 3529123 Other Clinical Revenue 900099 1010045 1010045 130952074 2312852 2312852 0 0 412383 392273 20110 0 20110 20110 417314 3285 417314 3285 420599 420599 0 0 0 PHARMACY 900099 2480830 2480830 INCENTIVE PAYMENTS 900099 743709 743709 CAFETERIA 900099 636448 636448 268865 268865 4129852 138238434 133489143 956335 3390009 0 0 0 0 2030329 0 2030329 0 0 57671458 50134181 7446414 90863 2689112 2258164 426855 4093 7528468 6321981 1195029 11458 4048684 3399856 642666 6162 0 79222 79222 154370 2370 152000 0 0 0 9402573 5299615 4077556 25402 215388 8840 6453 200095 945756 314378 624987 6391 1815838 120883 1688942 6013 0 6319543 4632885 1666671 19987 174643 128990 45400 253 0 70709 48837 21872 577559 5869 571690 0 5834632 4703732 1108238 22662 943073 660160 282913 medical/Surgical Supplies 9809129 9746536 62593 Pharmaceuticals 6382569 6382569 Physician Fees 4340741 4328173 12568 OTHER EXPENSES 4587957 3336785 1196150 55022 125621753 101834804 23338548 448401 2254643 2325500 0 0 0 0 15023894 13491919 0 0 0 0 512309 639106 2193272 1880261 1603218 1551489 139230056 92739751 46382440 46490305 55613206 56748513 0 0 0 0 0 0 1037603 2384475 124620585 125511568 24055826 23677806 0 0 0 0 17860000 17409082 0 0 0 0 43255 0 1155000 350000 17266848 18219396 60380929 59656284 X 57606780 59113256 535562 566984 6097314 6175044 64239656 65855284 124620585 125511568 X 12616681 2543689 -13544742 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 175151 175151 false false Political Activities The Hospital pays dues to the American Hospital Association. The portion of the Hospital's annual dues allocated to lobbying by the Association was $31,351 for the year ended September 30, 2016. The Hospital also utilizes the services of a consultant, Government Relations Group, for general lobbying on its behalf as an acute care community hospital. Total fees paid to the group were $45,700 for the year ended September 30, 2016. The Hospital pays dues to the Massachusetts Health Association. The portion of the Hospital's annual dues allocated to lobbying by the Association was $98,100 for the year ended September 30, 2016. 54967463 -2350120 4438201 623245 56432299 56747795 1740261 -1790459 1730134 54967463 58646800 4960824 6859829 56747795 52651885 6355235 360320 58646800 44179103 8561095 88313 52651885 0.88000 0.11000 0.01000 true false 1032436 1032436 52025629 30529653 21495976 14349190 3434515 10914675 65339545 55994444 9345101 6483256 2781139 3702117 46490305 0 Estimated Settlements with Third-Par 4336996 Pension liability 12127828 Interest Rate Swaps 1360878 capital lease obligation 393694 18219396 X PART V, LINE 4: TO SUPPORT THE OPERATIONS AND FUNCTIONS OF THE ORGANIZATION. PART X, LINE 2: Under ASC 740, an organization must recognize the financial statement effects of a tax position taken for tax return purposes when it is more likely than not that the position will not be sustained upon examination by a taxing authority. The Organization does not believe it has taken any material uncertain tax positions, and, accordingly, it has not recorded any liability for unrecognized tax benefits. true true X true X true X true true true false true true 1906466 1495596 410870 0.00330 29381480 30247951 -866471 0.00690 3530740 4580741 -1050001 0.00840 34818686 36324288 -1505602 0.01200 2393995 1633008 760987 0.00610 1127268 905090 222178 0.00180 3521263 2538098 983165 0.00790 38339949 38862386 -522437 0.00410 4138 4138 0.00000 153269 153269 0.00120 157407 157407 0.00120 true 1865613 25481113 28488554 -3007441 X true true 10 N Main Street Medical Office Space 0.5 0.0 0.0 Central Mass Compreh Medical Facility 0.22 0.0 0.0 1 1 Harrington Memorial Hospital 100 South Street Southbridge MA 015508002 X X X See Sched. O Note HARRINGTON MEMORIAL HOSPITAL 1 false false true X X X X X X X X 13 true false false true X WWW.HARRINGTONHOSPITAL.ORG X true 14 true HTTP://HARRINGTONHOSPITAL.ORG/FOR-PATIENTS/PA false false true X 200. 400. X X X true true X X X true X WWW.HARRINGTONHOSPITAL.ORG X X X X true X X true X X X X X X true X false true PART V, SECTION B, LINE 5: A TOTAL OF THREE FOCUS GROUPS WERE CONDUCTED WITH INDIVIDUALS REPRESENTING THESE POPULATIONS OF INTEREST IN THE HARRINGTON CATCHMENT AREA: (1) SENIOR CITIZENS (OLDER ADULTS), (2) LATINOS, AND (3) SUBSTANCE USERS IN RECOVERY. HARRINGTON LEADERSHIP CHOSE THESE POPULATIONS BASED ON THEIR IDENTIFICATION AS PARTICULARLY VULNERABLE POPULATIONS IN THE HOSPITAL CATCHMENT AREA. THE SENIOR AND RECOVERY GROUPS WERE COMPRISED OF LAY COMMUNITY MEMBERS, WHILE THE LATINO GROUP CONSISTED OF KEY STAKEHOLDERS REPRESENTING COMMUNITY ORGANIZATIONS SERVING THE LATINO POPULATION. REFER TO THE CHNA FOR FURTHER INFORMATION. PART V, SECTION B, LINE 11: AS NOTED ON ITS WEBSITE, THE HOSPITAL DEVELOPED A STRATEGIC PLAN TO IDENTIFY PROGRAMS AND FUTURE PROJECTS THAT WILL ENABLE THE HOSPITAL TO ADDRESS THE SIGNIFICANT NEEDS IN ITS CHNA. PART V, SECTION B, LINE 18D: REFERRAL TO COLLECTION AGENCY. PART V, SECTION B, LINE 19D: COLLECTION AGENCY ACTIVITIES. PART V, SECTION B, LINE 22D: PATIENT RESPONSIBLE AMOUNTS ARE BASED ON FAMILY SIZE AND RELATIONSHIP OF THE FAMILY'S INCOME TO THE FEDERAL POVERTY GUIDELINES, PER THE HOSPITAL'S UNINSURED RELIEF POLICY. RELIEF IS AVAILABLE FOR INDIVIDUALS WHOSE FAMILY INCOME IS 400% OR LESS OF THE FEDERAL POVERTY GUIDELINES. RELIEF PROVIDED TO THE PATIENT RANGES FROM 100% RELIEF TO 20% RELIEF OF OUTSTANDING AMOUNTS DEPENDING ON FAMILY SIZE AND INCOME LEVEL. PART V, SECTION B, LINE 24: ALL HOSPITAL PATIENTS ARE CHARGED ACCORDING TO THE HOSPITAL'S ESTABLISHED CHARGES FOR SERVICES. IT IS INCUMBENT UPON THE PATIENT TO AVAIL HIMSELF/HERSELF OF RELIEF THROUGH THE HOSPITAL'S UNINSURED RELIEF PROGRAM. PART II, COMMUNITY BUILDING ACTIVITIES: AFTER-CARE NURSES & HOME VISITING PROGRAMS FREE-CARE VAN INTERPRETER SERVICES MENTAL HEALTH CLINIC PREVENTIVE HEALTH DEPARTMENT (HEALTH EDUCATION, MAMMOGRAMS, ETC.) PROVISION OF MEETING SPACES FOR RECOVERY COMMUNITY MEETINGS SENIOR CITIZEN LUNCHES VETERANS MEALS VOLUNTEER PROGRAM PART III, LINE 2: THE ORGANIZATION USED A RATIO OF ITS TOTAL COSTS TO CHARGES APPLIED TO ITS TOTAL BAD DEBT EXPENSE. PART III, LINE 4: THE ORGANIZATION PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS EQUAL TO ESTIMATED BAD DEBT LOSSES. THE ESTIMATED LOSSES ARE BASED ON HISTORICAL COLLECTION EXPERIENCE TOGETHER WITH A REVIEW OF THE CURRENT STATUS OF EXISTING RECEIVABLES. THE ORGANIZATION USED A RATIO OF ITS TOTAL COSTS TO CHARGES TO CALCULATE THE AMOUNT OF BAD DEBT EXPENSE AT COST. PART III, LINE 8: THE SHORTFALL EXPERIENCED BY THE ORGANIZATION FROM PROVIDED CARE TO MEDICARE BENEFICIARIES SHOULD BE TREATED AS A COMMUNITY BENEFIT AS IT REPRESENTS THE ORGANIZATION'S CONTRIBUTION TO PROVIDING CARE TO THE FRAIL AND ELDER CITIZENS OF THE COMMUNITY IT SERVES BEYOND THE AMOUNT IT RECEIVES FROM THE MEDICARE PROGRAM. THIS CONTRIBUTION LEVEL IS CONSISTENT WITH THE ORGANIZATION'S OVERALL CHARITABLE MISSION TO PROVIDE CARE TO ALL INDIVIDUALS, REGARDLESS OF THE LEVEL OF PAYMENT RECEIVED FOR PROVIDING THAT CARE. THE ORGANIZATION USED A RATIO OF ITS TOTAL COSTS TO CHARGES TO CALCULATE THE ALLOWANCE COSTS RELATED TO MEDICARE REVENUE RECEIVED. PART III, LINE 9B: CO-PAYMENT AND/OR DEDUCTIBLE AMOUNTS FOR NON-EMERGENT OR NON-URGENT SERVICES IN ACCORDANCE WITH EMTALA SHALL BE COLLECTED AT TIME OF SERVICES OR REQUESTED BY SENDING A DAY AFTER LETTER. THE FIRST STATEMENT WILL INCLUDE INFORMATION ABOUT THE AVAILABILITY OF A FINANCIAL ASSISTANCE, MEDICAL HARDSHIP, BUDGETS, AND THE HOSPITAL'S UNINSURED RELIEF PROGRAM THAT MIGHT BE ABLE TO COVER THE COST OF THE HOSPITAL'S BILL, ALONG WITH NOTICE OF A PROMPT PAYMENT DISCOUNT FOR UNINSURED PATIENTS OF 20% IF PAID IN FULL WITHIN 10 BUSINESS DAYS OF RECEIVING THE FIRST STATEMENT. A TOTAL OF 3 STATEMENTS AND A FINAL NOTICE LETTER, TELEPHONE CALL ON ALL ACCOUNTS OVER $500.00, COLLECTION LETTERS, PERSONAL CONTACT NOTICES, DAY AFTER LETTER TO COLLECT COPAY AND/OR DEDUCTIBLE AT TIME OF SERVICE, COMPUTER NOTIFICATIONS, OR ANY OTHER NOTIFICATION METHOD THAT CONSTITUTES A GENUINE EFFORT TO CONTACT THE PARTY RESPONSIBLE FOR THE OBLIGATION. DOCUMENTATION OF ALL COLLECTION EFFORTS TO LOCATE THE PARTY RESPONSIBLE FOR THE OBLIGATION OR THE CORRECT ADDRESS ON BILLINGS. SENDING A FINAL NOTICE BY CERTIFIED MAIL FOR UNINSURED PATIENTS (THOSE WHO ARE NOT ENROLLED IN A PUBLIC PROGRAM SUCH AS THE HEALTH SAFETY NET OF MASSHEALTH). THE HOSPITAL SHALL NOT ASSIGN A PATIENT'S ACCOUNTS FOR COLLECTION TO AN OUTSIDE AGENCY PRIOR TO 120 DAYS AFTER THE INITIAL BILL. CHECKING THE ELIGIILITY VERIFICATION SYSTEM (EVS) TO ENSURE THAT THE PATIENT IS NOT A LOW INCOME PATIENT AS DETERMINED BY THE OFFICE OF MEDICAID AND HAS NOT SUBMITTED AN APPLICATION TO THE VIRTUAL GATEWAY SYSTEM FOR COVERAGE OF THE SERVICES UNDER A PUBLIC PROGRAM, PRIOR TO SUBMITTING CLAIMS TO THE HEALTH SAFETY NET OFFICE FOR EMERGENCY BAD DEBT COVERAGE OF AN EMERGENCY LEVEL OR URGENT CARE SERVICE. THE FOLLOWING INDIVIDUALS AND PATIENT POPULATIONS ARE EXEMPT FROM ANY COLLECTION OR BILLING PROCEDURES BEYOND THE INITIAL BILL PURSUANT TO STATE REGULATIONS: PATIENTS ENROLLED IN A PUBLIC HEALTH INSURANCE PROGRAM, INCLUDING BUT NOT LIMITED TO: MASSHEALTH, EMERGENCY AID TO THE ELDERLY, DISABLED AND CHILDREN, HEALTHY START, CHILDREN'S MEDICAL SECURITY PLAN, "LOW INCOME PATIENTS" AS DETERMINED BY THE OFFICE OF MEDICAID SUBJECT TO CERTAIN EXCEPTIONS AS DESCRIBED IN ITS CREDIT AND COLLECTION POLICY. PART VI, LINE 2: IN NEEDING TO CREATE A NEW HEALTH ASSESSMENT FOR 2011-2013, AN EXTERIOR COMMITTEE WAS FORMED IN 2009 - CONSISTING OF SEVEN MEMBERS, RANGING FROM THOSE IN THE MEDICAL FIELD TO COMMUNITY LIAISONS AND TOWN/LEAGUE REPRESENTATIVES, INCLUDING A CURRENT HARRINGTON HOSPITAL BOARD MEMBER. MEETINGS WERE HELD APPROXIMATELY ONCE PER MONTH FROM JANUARY-DECEMBER 2010, NOT INCLUDING ADDITIONAL EMAIL COMMUNICATION. SURVEY DESIGNED AND IMPLEMENTED IN 2010. COMMITTEE UTILIZED THIRD-PARTY RESOURCES TO ORIGINATE INITIAL DATA ON REGION. 20 QUESTION SURVEY DESIGNED AND DISTRIBUTED TO SEVEN OF THE MAJOR TOWNS HARRINGTON SERVICES. THE SURVEY INCLUDED DEMOGRAPHIC INDICATORS (AGE, INCOME, HOUSEHOLD MEMBERS, ETHNICITY, ZIP CODE OF RESIDENCE, GENDER, EDUCATION LEVEL) AND COMMUNITY HEALTH INDICATORS. MOST QUESTIONS RANKED HEALTH CONDITIONS ON A 1-5 SCALE AND INCLUDED RATING CONDITIONS/ISSUES IN ORDER OF PRIORITY FOR FUNDING, AND A SEPARATE HEALTH CONDITION ANALYSIS FOR YOUTH AND SENIORS. IN 2013, HARRINGTON RECOGNIZED THE NEED TO UPDATE ITS ASSESSMENT DATA AND COMMUNITY INFORMATION FROM THE PREVIOUS STUDY. A FIVE MEMBER COMMITTEE WAS ORGANIZED IN EARLY 2013. THE GROUPS' LEADERSHIP CAME FROM THE HARRINGTON MARKETING DEPARTMENT. MEMBERS REPRESENTED COMMUNITY LIAISONS, HEALTH PROFESSIONALS AND TOWN/LEAGUE REPRESENTATIVES, INCLUDING CURRENT HARRINGTON HOSPITAL BOARD MEMBER. MEETINGS WERE HELD FROM JANUARY TO DECEMBER. THE COMMITTEE ENLISTED THE ASSITANCE OF THE INSTITUE FOR COMMUNITY HEALTH OUT OF BOSTON TO COLLECT, ANALYZE AND PRODUCE A WRITTEN REPORT ON THE HEALTH DEFICITS IN HARRINGTON'S TWENTY ZIP CODE CATCHMENT AREA. THIS ASSESSMENT INVOLVED A MIXED-METHODS APPROACH INCLUDING EXTENSIVE REVIEW OF SECONDARY COMMUNITY DATA SOURCES ACROSS A VARIETY OF SOCIO-DEMOGRAPHIC AND HEALTH INDICATORS FOR THE CATCHMENT AREA COMPARED TO THE STATE OF MASSACHUSETTS, AS WELL AS THREE FOCUS GROUPS WITH A TOTAL OF 24 COMMUNITY RESIDENTS AND KEY STAKEHOLDERS BELONGING TO KEY POPULATIONS OF INTEREST: SENIOR CITIZENS, LATINOS, AND SUBSTANCE USERS IN RECOVERY. FOR SECONDARY DATA GATHERING, TOP HEALTH CONCERNS FOR THE CATCHMENT AREA WERE PRIORITIZED BASED ON THE AVERAGE PERCENT DIFFERENCE COMPARED TO MASSACHUSETTS ACROSS SECONDARY DATA INDICATORS. KEY THEMES IDENTIFIED THROUGH THE THREE FOCUS GROUPS WERE ALSO CONSIDERED. TOP HEALTH CONCERNS THAT EMERGED INCLUDED CARDIOVASCULAR DISEASE/RESPIRATORY HEALTH, DIABETES, OBESITY, CANCER MORTALITY, MENTAL HEALTH, AND TEEN PREGNANCY. ADDITIONAL COMMUNITY-WIDE CONCERNS WERE ALSO IDENTIFIED THROUGH THE THREE FOCUS GROUPS CONDUCTED: CRIME AND SAFETY, ESPECIALLY AMONGST YOUTH; SOCIAL CONCERNS AFFECTING YOUTH, ESPECIALLY LACK OF POSITIVE COMMUNITY ACTIVITIES FOR YOUTH; AND SUBSTANCE ABUSE, INCLUDING PRESCRIPTION DRUG ABUSE AND NEWER DRUG USE AMONGST YOUTH. PART VI, LINE 3: FOR THOSE PATIENTS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL AND ITS FINANCIAL COUNSELORS WILL WORK WITH THEM TO ASSIST WITH APPLYING FOR AVAILABLE FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED PATIENTS FIND AVAILABLE AND APPROPRIATE FINANCIAL ASSISTANCE PROGRAMS, THE HOSPITAL WILL PROVIDE ALL PATIENTS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PROGRAMS IN BOTH THE INITIAL BILL THAT IS SENT TO PATIENTS AS WELL AS IN GENERAL NOTICES THAT ARE POSTED THROUGHOUT THE HOSPITAL. THE GOAL OF THESE NOTICES IS TO ASSIST PATIENTS IN APPLYING FOR COVERAGE WITHIN A FINANCIAL ASSISTANCE PROGRAM, SUCH AS MASSHEALTH, COMMONWEALTH CARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTHY START, HEALTH SAFETY NET, OR MEDICAL HARDSHIP THROUGH THE HEALTH SAFETY NET. THE HOSPITAL WILL PROVIDE, 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 THE UNINSURED RELIEF PROGRAM. THE HOSPITAL WILL ALSO NOTIFY THE PATIENT ABOUT AVAILABLE PAYMENT PLANS THAT MAY BE AVAILABLE TO THEM BASED ON THEIR FAMILY SIZE AND INCOME. THE HOSPITAL SHALL POST A NOTICE (SIGNS) OF AVAILABILITY OF FINANCIAL ASSISTANCE IN THE FOLLOWING LOCATIONS: I. INPATIENT, CLINIC, AND EMERGENCY DEPARTMENT ADMISSION AND/OR REGISTRATION AREAS; II. PATIENT FINANCIAL COUNSELOR AREAS; III. CENTRAL ADMISSION/REGISTRATION AREAS; AND IV. BUSINESS OFFICE AREAS THAT IS OPEN TO PATIENTS. PART VI, LINE 4: THE HARRINGTON HEALTHCARE SYSTEM CATCHMENT AREA FOCUSED ON FOR THE ASSESSMENT IS LOCATED PRIMARILY IN THE SOUTHERN REGION OF CENTRAL MASSACHUSETTS, AND INCLUDES 17 MASSACHUSETTS COMMUNITIES (BRIMFIELD, BROOKFIELD, CHARLTON, DOUGLAS, DUDLEY, EAST BROOKFIELD, HOLLAND, NORTH BROOKFIELD, OXFORD, PALMER, SOUTHBRIDGE, SPENCER, STURBRIDGE, WALES, WARREN, WEBSTER, WEST BROOKFIELD) AS WELL AS TWO COMMUNITIES (THOMPSON AND WOODSTOCK) IN NORTHERN CONNECTICUT. PART VI, LINE 5: REFER TO THE CHNA AND HOSPITAL WEBSITE FOR FURTHER DETAILS. PART VI, LINE 6: NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. PART VI, LINE 7, LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT: MA X X false true false false false false false false false EDWARD H MOORE PRESIDENT/CEO 439520 165426 22462 190600 20081 838089 THOMAS SULLIVAN VICE PRESIDENT/TREASURER 301256 78989 0 10600 4687 395532 Arthur Russo MD VP of Medical Affair 270931 70624 0 10076 3599 355230 Thomas Hijeck VP of Nursing 180394 42761 1762 7234 2694 234845 Harold R Lemieux VP and CIO 166416 39781 0 6797 7920 220914 Christopher Canniff VP of HR 127797 30991 0 3912 7796 170496 James Sullivan Jr Physician 409284 33000 0 10600 27411 480295 Jarrett M Burns Physician 307749 26896 0 10600 9188 354433 Andrew Marino Physician 301560 29968 0 10499 26571 368598 Michael Gray Physician 288193 32881 0 10491 5977 337542 Giza High Physician 273691 35880 0 10519 14853 334943 PART I, LINE 4B: EDWARD MOORE PARTICIPATES IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, WHICH WAS CREDITED WITH $180,000 IN DEFERRED COMPENSATION FOR CALENDAR YEAR 2015. THOMAS SULLIVAN PARTICIPATES IN A 457F PLAN, WHICH WAS CREDITED WITH $18,000 IN DEFERRED COMPENSATION FOR CALENDAR YEAR 2015. ARTHUR RUSSO PARTICIPATES IN A 457F PLAN, WHICH WAS CREDITED WITH $18,000 IN DEFERRED COMPENSATION FOR CALENDAR YEAR 2015. A MASSACHUSETTS HEALTH AND EDUCATIONAL FACILITIES 042456011 57586C703 2008-06-26 20000000 CONSTRUCTION AND RENOVATIONS false false false A 0 0 20950278 0 2037221 0 306250 0 0 20497287 94106 358885 false false false true A false false false false 0 false false false true A false false false false true true PIPER JAFFRAY FINAN 15. false false false 0 true false A false SCHEDULE K, PART I, BOND ISSUES: (A) Issuer Name: Massachusetts HEALTH AND EDUCATIONAL FACILITIES AUTHORITY JRD REALTY TRUST TRUSTEES OF THE TRUST 252722 THE HOSPITAL false SCH. L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF PERSON: JRD REALTY TRUST (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: TRUSTEES OF THE TRUST ARE INDIVIDUAL BOARD MEMBERS OF THE HOSPITAL. (D) DESCRIPTION OF TRANSACTION: THE HOSPITAL LEASED SPACE OWNED BY THE JRD REALTY TRUST, THE TRUSTEES OF WHICH ARE ANTHONY M. DETARANDO AND ANTHONY J. DETARANDO, BOTH OF WHOM ARE INDIVIDUAL BOARD MEMBERS OF THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 2: BOARD MEMBERS ANTHONY M. DETARANDO AND ANTHONY JAY DETARANDO ARE RELATED AS FATHER AND SON. FORM 990, PART VI, SECTION A, LINE 6: THE HOSPITAL'S SOLE CORPORATE MEMBER IS HARRINGTON HEALTHCARE SYSTEM, INC. FORM 990, PART VI, SECTION A, LINE 7A: THE HOSPITAL'S SOLE CORPORATE MEMBER IS HARRINGTON HEALTHCARE SYSTEM, INC. FORM 990, PART VI, SECTION A, LINE 7B: THE HOSPITAL'S SOLE CORPORATE MEMBER IS HARRINGTON HEALTHCARE SYSTEM, INC. FORM 990, PART VI, SECTION B, LINE 11: THE FORM 990 IS PREPARED BY THE HOSPITAL'S OUTSIDE INDEPENDENT ACCOUNTANT WITH INFORMATION GIVEN TO THEM BY THE HOSPITAL STAFF. AFTER COMPLETION, IT IS REVIEWED BY THE HOSPITAL'S CONTROLLER AND VP OF FINANCE BEFORE BEING PRESENTED TO THE BOARD OF DIRECTORS. FORM 990, PART VI SECTION B, LINE 12C: THE CORPORATION REQUIRES THAT ALL EMPLOYEES, AND MEMBERS AND OFFICERS OF THE BOARD OF DIRECTORS OF THE CORPORATION AND ANY MEMBER OF ANY COMMITTEE DISCLOSE IN WRITING (AND UPDATE ANNUALLY) ALL BUSINESS AND OTHER RELATIONSHIPS WHICH MIGHT POTENTIALLY CREATE A CONFLICT OF INTEREST AND ALL CONFLICTS OF INTEREST AS DEFINED BY THE POLICY. FORM 990, PART VI, SECTION B, LINE 15: THE BOARD OF DIRECTORS REVIEW AND APPROVE THE COMPENSATION OF THE CEO AND TOP MANAGEMENT. THE CEO REVIEWS AND APPROVES TOP MANAGEMENT SALARIES. TOP MANAGEMENT WILL THEN REVIEW AND APPROVE KEY EMPLOYEE SALARIES. FORM 990, PART VI, SECTION C, LINE 18: THE HOSPITAL MAKES ITS FORM 990 AND 990-T AVAILABLE TO THE PUBLIC UPON REQUEST. ADDITIONALLY, THE HOSPITAL'S FORM 990 AND 990-T ARE AVAILABLE ON THE PUBLIC CHARITIES WEBSITE MAINTAINED BY THE COMMONWEALTH OF MASSACHUSETTS ATTORNEY GENERAL. FORM 990, PART VI, SECTION C, LINE 19: THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. ADDITIONALLY, THE HOSPITAL'S FINANCIAL STATEMENTS ARE AVAILABLE ON THE PUBLIC CHARITIES WEBSITE MAINTAINED BY THE COMMONWEALTH OF MASSACHUSETTS ATTORNEY GENERAL. FORM 990, PART XI, LINE 9, CHANGE IN NET ASSETS -573,829 ADJUSTMENT TO MINIMUM PENSION LIABILITY -12,985,186 EQUITY TRANSFERS TO AFFILIATE 14,273 UNREALIZED GAIN ON INTEREST RATE SWAP AGREEMENT -13,544,742 Total to FORM 990, PART XI, LINE 9 Harrington Physician Services Inc 100 south street southbridge MA 015508002 134366504 Healthcare Se MA 501(C)(3) 9 HHS INC false Harrington HealthCare System Inc 100 south street Southbridge MA 015508002 800518491 Healthcare Su MA 501(C)(3) 9 N/A false Charlton MRI Services LLC 10 North Main Street Charlton MA 01507 000993849 Healthcare MA BIH Radiolog RELATED 0 0 false 0 false Central Massachusetts Comprehensive Care 55 sayles street southbridge MA 01550 261795998 Healthcare MA NE RADIATION TH RELATED 244421 625900 false 0 false 10 North Main Street LLC 10 North Main Street Charlton MA 01507 000000001 Healthcare MA Compass DeVELOP RELATED 238321 2556000 false 0 false false false false false false false false false false false false false false false false false false true false Harrington Physician Services Inc R 12985186 cost PART III, IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS PARTNERSHIP: NAME OF RELATED ORGANIZATION: CHARLTON MRI SERVICES, LLC EIN: 00-0993849 DIRECT CONTROLLING ENTITY: B.I.H. RADIOLOGIC FOUNDATION, INC. NAME, ADDRESS, AND EIN OF RELATED ORGANIZATION: CENTRAL MASSACHUSETTS COMPREHENSIVE CANCER CENTER, LLC EIN: 26-1795998 55 SAYLES STREET SOUTHBRIDGE, MA 01550 DIRECT CONTROLLING ENTITY: NEW ENGLAND RADIATION THERAPY MANAGEMENT SERVICES, INC.