2017-05-11T09:45:48-05:00 2016-06-30 990 2015-07-01 043398280 MERCY HOSPITAL INC MERC 4135392689 C/O SPHS 1221 MAIN STREET NO 213 HOLYOKE MA 010405396 RALPH BECKER INTERIM VP FINANCE AND CFO 4135392689 2017-05-11 2015 2021-01-29 14:40:06Z SEE SCHEDULE O SCOTT WOLF 271 CAREW SPRINGFIELD MA 01104 274579112 0 0928 X WWW.MERCYCARES.COM X 1898 MA TO PROVIDE HEALTHCARE AND HOSPITAL SERVICES 13 10 2437 164 1576957 -353177 6184284 5453463 262039192 264406448 387692 -96410 9577924 4330007 278189092 274093508 0 83294 0 0 120437804 126685868 0 0 0 136726465 148354570 257164269 275123732 21024823 -1030224 251011056 269258285 94080022 114227998 156931034 155030287 X WE, SISTERS OF PROVIDENCE HEALTH SYSTEM AND TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES. WE ARE SUSTAINED BY AN UNWAVERING TRUST IN GOD'S PROVIDENCE. MERCY HOSPITAL IS A MEMBER OF SISTERS OF PROVIDENCE HEALTH SYSTEM AND TRINITY HEALTH. 0 0 227251117 83294 265225602 MERCY HOSPITAL IS A FULL-SERVICE ACUTE-CARE HOSPITAL IN SPRINGFIELD, MASSACHUSETTS. THE ACUTE PROGRAMS AND SERVICES INCLUDE CARDIAC CARE, MATERNITY SERVICES, CANCER TREATMENT, EMERGENCY CARE, DIAGNOSTIC IMAGING, INTENSIVE CARE, CRITICAL CARE AND SURGICAL PROCEDURES BOTH INPATIENT AND OUTPATIENT. MERCY HOSPITAL'S BEHAVORIAL HEALTH PROGRAMS AND SERVICES INCLUDE INPATIENT AND OUTPATIENT PSYCHIATRIC CARE FOR PEOPLE OF ALL AGES, SHORT-TERM RESIDENTIAL TREATMENT FOR PEOPLE WITH ACUTE PSYCHIATRIC AND/OR SUBSTANCE ABUSE PROBLEMS, AND INTENSIVE OUTPATIENT CHEMICAL DEPENDENCY PROGRAMS.PLEASE SEE SCHEDULE H AND THE WEBSITE AT WWW.MERCYCARES.COM FOR ADDITIONAL INFORMATION. 227251117 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 282 0 1 2437 1 1 1 0 0 0 0 0 0 0 0 0 X 13 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 1 0 MA X WILLIAM KRASIN 4135392689 C/O SPHS 1221 MAIN ST SUITE 213 HOLYOKE MA 01040 DANIEL P MOEN DIRECTOR; PRESIDENT & CEO THR 12/15 24.00 31.00 X X 0 907010 40995 SCOTT WOLF DIRECTOR; PRESIDENT & CEO AS OF 1/16 24.00 31.00 X X 0 492228 43666 KATHLEEN M KANE DIRECTOR; CHAIR THROUGH 12/15 1.00 4.00 X X 0 0 0 JOHN E SJOBERG DIREC;V CHR THR 12/15;CHR AS OF 1/16 1.00 4.00 X X 0 0 0 DEAN M WHALEN ESQUIRE DIREC;SECR THR 12/15;V CH AS OF 1/16 1.00 4.00 X X 0 0 0 PAUL MANCINONE DIRECTOR; SECRETARY AS OF 1/16 1.00 4.00 X X 0 0 0 SR MARY GEARY CARITAS SP DIRECTOR 1.00 4.00 X 0 0 0 REV MSGR CHRISTOPHER CONNELLY DIRECTOR THROUGH 12/15 1.00 4.00 X 0 0 0 CHRISTOPHER H COMEY MD DIRECTOR; PRES, MED STAFF 1.00 49.00 X 0 741827 40547 CLAYTON FITZHUGH DIRECTOR THR 6/16; TH EVP, CHRO 1.00 54.00 X 0 1423114 42210 JOHN JOYCE DIRECTOR 1.00 4.00 X 0 0 0 ANAND KANJOLIA MD DIRECTOR AS OF 1/16 1.00 4.00 X 0 0 0 SR RUTH F MCGOLDRICK SP DIRECTOR 1.00 4.00 X 0 0 0 LEDA M MCKENRY PHD DIRECTOR THROUGH 12/15 1.00 4.00 X 0 0 0 PAUL MARCHESE DIRECTOR 1.00 4.00 X 0 0 0 MARK J MULLAN MD DIRECTOR THROUGH 12/15 1.00 4.00 X 0 0 0 SHIRIN NASH MD DIRECTOR THROUGH 12/15 1.00 4.00 X 0 0 0 VANESSA OTERO DIRECTOR 1.00 4.00 X 0 0 0 WILLIAM SILVANIC DIRECTOR AS OF 1/16 1.00 4.00 X 0 0 0 DANIEL KEENAN ASST. SEC/SVP GOV'T RELATIONS 20.00 30.00 X 0 245823 41656 THOMAS ROBERT TREASURER/SVP & CFO 20.00 30.00 X 0 430359 49862 MARIA RUSSO-APPEL MD VP MERCY BEHAVIORAL HC AS OF 1/16 50.00 0.00 X 313395 0 31898 SIMON AHTARIDIS MD INTERIM CMO AS OF 1/16 50.00 0.00 X 0 376233 40925 SHARON ADAMS SVP PATIENT CARE-THROUGH 9/15 50.00 0.00 X 324895 0 36977 ROBERT ROOSE MD CMO, ADDICTION SERVICES 50.00 0.00 X 267021 0 23737 JOHN DIGGINS PSYCHIATRIST 50.00 0.00 X 253763 0 17984 GAURAV CHAWLA CHIEF OF PSYCHIATRY 50.00 0.00 X 250737 0 43882 CHHEWANG NORSANG MEDICAL DIRECTOR 50.00 0.00 X 234787 0 26588 LEONARD F PANSA FORMER KEY EMP; SVP HR & ADMIN SVCS 8.00 42.00 X 0 364214 24174 1644598 4980808 505101 162 1 1 0 DANIEL OCONNELLS SONS INC 480 HAMPDEN STREET HOLYOKE MA 01041 CONSTRUCTION SERVICES 7735364 SHERIDAN HEALTHCARE OF MA PC 1613 N HARRISON PKWY STE 200 SUNRISE FL 33323 ANESTHESIOLOGY SERVICES 3444122 BARR AND BARR INC 24 PRIME PARKWAY SUITE 301 NATICK MA 01760 CONSTRUCTION SERVICES 2609179 GE HEALTHCARE PO BOX 640944 PITTSBURGH PA 15264 MAINTENANCE SERVICES 2465349 RAYMOND HOULE CONSTRUCTION 5 MILLER ST LUDLOW MA 01056 CONSTRUCTION SERVICES 1819481 36 223401 1043649 4186413 5453463 NET PATIENT SVC REV 622110 262993743 262993743 PHARMACY REVENUE 446110 1412705 1412705 264406448 255901 255901 516871 0 516871 516871 516871 352311 -352311 -352311 -352311 150664 133293 17371 17371 CAFETERIA REVENUE 722514 1399654 1399654 GOV'T SUBSIDY - EHR 622110 878603 878603 1517508 1353256 164252 3795765 274093508 265225602 1576957 1837486 83294 83294 762451 762451 133800 133800 102584474 96422712 6161762 5094279 4780403 313876 10363729 9719171 644558 7747135 7233694 513441 162732 162732 3191 3191 26040004 24578289 1461715 35131 32803 2328 4850780 4529294 321486 852 796 56 6014442 5615836 398606 185320 173038 12282 64864 60565 4299 2030964 2030964 10259595 9579642 679953 1952786 1823365 129421 MEDICAL SUPPLIES 43800797 43800797 SYSTEM ASSESSMENT FEES 36082862 36082862 INTERCO LAB FEES 9189946 9189946 BAD DEBT EXPENSE 3312594 3312594 4367710 4150114 217596 275123732 227251117 47872615 0 6383297 17123047 3170855 3820451 33458656 35764424 7607 7042 4859679 4929463 677726 834830 251803722 159347891 86633446 92455831 56848252 57458026 56841326 55198116 2130212 1667055 251011056 269258285 31195444 33325697 1453690 147614 62884578 79300997 94080022 114227998 X 152510066 150168245 4075712 4530125 345256 331917 156931034 155030287 251011056 269258285 X -1030224 -1060242 189719 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 51229 0 0 0 51229 0 PART II-B, LINE 1: MERCY HOSPITAL HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO REGIONAL AND NATIONAL HEALTH CARE ORGANIZATIONS, WHERE THE ORGANIZATIONS HAVE PROVIDED MERCY HOSPITAL WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. 345256 -13339 331917 357806 -12550 345256 357806 357806 357806 25344 25344 357806 357806 41439 41439 357806 1.00000 0 0 2382702 2382702 146512109 78906773 67605336 97021163 80441118 16580045 5887748 5887748 92455831 COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 22529843 F HEDGE FUNDS 13517906 F EQUITY METHOD INVESTMENTS 19150367 C 55198116 INTERCOMPANY ACCOUNTS PAYABLE 2134338 INTERCOMPANY NOTES PAYABLE 75189958 OTHER CURRENT LIABILITIES 972524 ANNUITIES PAYABLE 6926 OTHER LONG-TERM LIABILITIES 997251 79300997 PART V, LINE 4: INCOME FROM ENDOWMENT FUNDS ARE USED TO PROVIDE PATIENT CARE. 1 1 X 1 X 1 X 1 1 0 1 1 1922397 1686626 235771 0.00090 74933682 58684487 16249195 0.05980 2350523 1523134 827389 0.00300 79206602 61894247 17312355 0.06370 22 2400 1031022 2192 1028830 0.00380 1 0 131783 0 131783 0.00050 1 0 2065355 1061067 1004288 0.00370 6 1214 15550 0 15550 0.00010 30 3614 3243710 1063259 2180451 0.00810 30 3614 82450312 62957506 19492806 0.07180 1 0 618 0 618 0.00000 1 75 13572 0 13572 0.00000 2 75 14190 0 14190 0 3312594 0 97382897 79250390 18132507 X 1 1 1 LIFEPATH PARTNERS LLC LABORATORY SERVICES 0.50000 0.00000 0.50000 1 1 MERCY HOSPITAL INC 271 CAREW ST SPRINGFIELD MA 01104 WWW.MERCYCARES.COM STATE LICENSE # VHFO X X X MERCY HOSPITAL INC 1 0 0 1 X X X X X X X X X 15 1 1 1 1 X HTTP://WWW.MERCYCARES.COM/CHNA X 1 15 1 HTTP://WWW.MERCYCARES.COM/CHIP 0 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X WWW.MERCYCARES.COM/BILLING X WWW.MERCYCARES.COM/BILLING X WWW.MERCYCARES.COM/BILLING X X X X X 1 X 0 X X X X 1 X 0 0 MERCY HOSPITAL, INC. PART V, SECTION B, LINE 5: THE INPUT OF THE COMMUNITY AND OTHER IMPORTANT REGIONAL STAKEHOLDERS WAS AN IMPORTANT PART OF THE CHNA PROCESS. BELOW ARE THE PRIMARY MECHANISMS FOR COMMUNITY AND STAKEHOLDER ENGAGEMENT. A CHNA STEERING COMMITTEE WAS FORMED THAT INCLUDED REPRESENTATIVES FROM MERCY HOSPITAL BUT ALSO THE OTHER MEMBERS OF THE WESTERN MASSACHUSETTS HOSPITAL/INSURER COALITION, AS WELL AS PUBLIC HEALTH AND COMMUNITY STAKEHOLDERS FROM EACH HOSPITAL SERVICE AREA. STAKEHOLDERS ON THE STEERING COMMITTEE INCLUDED LOCAL AND REGIONAL PUBLIC HEALTH AND HEALTH DEPARTMENT REPRESENTATIVES; REPRESENTATIVES FROM LOCAL AND REGIONAL ORGANIZATIONS SERVING OR REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME OR MINORITY POPULATIONS; AND INDIVIDUALS FROM ORGANIZATIONS THAT REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY. WHEN IDENTIFYING COMMUNITY AND PUBLIC HEALTH REPRESENTATIVES TO PARTICIPATE, A STAKEHOLDER ANALYSIS WAS CONDUCTED BY THE COALITION AND CONSULTANTS TO ENSURE GEOGRAPHIC, SECTOR (E.G. SCHOOLS, COMMUNITY SERVICE ORGANIZATIONS, HEALTHCARE PROVIDERS, PUBLIC HEALTH, AND HOUSING) AND RACIAL/ETHNIC DIVERSITY OF COMMUNITY REPRESENTATIVES. BY INCLUDING THESE STAKEHOLDERS ON THE STEERING COMMITTEE, THE COMMUNITY AND PUBLIC HEALTH REPRESENTATIVES HAD INPUT ON THE 2016 CHNA PROCESS USED TO IDENTIFY AND PRIORITIZE COMMUNITY HEALTH NEEDS, CHNA FINDINGS, AND DISSEMINATION OF INFORMATION. ASSESSMENT METHODS AND FINDINGS WERE MODIFIED BASED ON THE STEERING COMMITTEE FEEDBACK. THE STEERING COMMITTEE MET MONTHLY FROM OCTOBER 2015 - JUNE 2016. KEY INFORMANT INTERVIEWS AND FOCUS GROUPS WERE CONDUCTED TO BOTH GATHER INFORMATION THAT WAS UTILIZED TO IDENTIFY PRIORITY HEALTH NEEDS AND ENGAGE THE COMMUNITY. KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH HEALTH CARE PROVIDERS, HEALTH CARE ADMINISTRATORS, LOCAL AND REGIONAL PUBLIC HEALTH OFFICIALS, AND LOCAL ORGANIZATIONAL LEADERS THAT REPRESENT THE BROAD INTERESTS OF THE COMMUNITY OR THAT SERVE MEDICALLY UNDERSERVED, LOW-INCOME OR MINORITY POPULATIONS IN THE SERVICE AREA. INTERVIEWS WITH THE LOCAL AND REGIONAL PUBLIC HEALTH OFFICIALS WERE USED TO IDENTIFY CURRENT AND EMERGING HIGH PRIORITY HEALTH AREAS AND HEALTHCARE AND COMMUNITY FACTORS THAT CONTRIBUTE TO HEALTH NEEDS. FOCUS GROUP PARTICIPANTS INCLUDED INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING COMMUNITY ORGANIZATIONAL REPRESENTATIVES, VULNERABLE POPULATION COMMUNITY MEMBERS (LOW-INCOME, RACIAL AND ETHNIC MINORITY POPULATIONS, ETC.), AND OTHER COMMUNITY STAKEHOLDERS. TOPICS INCLUDED: MATERNAL AND CHILD HEALTH, MENTAL HEALTH AND SUBSTANCE USE, BEHAVIORAL HEALTH AND EMERGENCY DEPARTMENT CARE, AND FAITH-BASED LEADERS AND COMMUNITY ENGAGEMENT. KEY INFORMANT INTERVIEWS AND FOCUS GROUPS WERE CONDUCTED FROM FEBRUARY 2016 - APRIL 2016. A COMMUNITY LISTENING SESSION WAS HELD IN JUNE 2016 UPON COMPLETION OF THE CHNA REPORT. THE COMMUNITY LISTENING SESSION INCLUDED INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY AND COMMUNITY STAKEHOLDERS REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. THESE SESSIONS HELPED TO OBTAIN INPUT ON THE PRIORITIZED HEALTH NEEDS THAT WERE IDENTIFIED IN THE CHNA AND TO GAIN FEEDBACK ON THE NEEDS THAT ARE THE FOCUS OF THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) PROCESS. BELOW IS A LIST OF PUBLIC HEALTH, COMMUNITY REPRESENTATIVES AND OTHER STAKEHOLDERS INVOLVED IN THE PROCESS, WHICH INCLUDED REPRESENTATION OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. THESE VULNERABLE POPULATIONS, WHICH INCLUDE CHILDREN, OLDER ADULTS, LATINOS, AFRICAN AMERICANS, AND REFUGEES, WERE REPRESENTED BY: YMCA OF WESTFIELD, NATIONAL ASSOCIATION OF HISPANIC NURSES - WESTERN MA CHAPTER, UNITED WAY OF HAMPSHIRE COUNTY, CARING HEALTH CENTER, PALMER PUBLIC SCHOOLS, HAMPDEN COUNTY SHERIFF'S DEPT., HILLTOWN CDC, UNITED CEREBRAL PALSY ASSOC. OF BERKSHIRE COUNTY, SPRINGFIELD DEPT. HEALTH & HUMAN SERVICES, MOTHERWOMAN, BMC QUALITY & POPULATION HEALTH, STAVROS CENTER FOR INDEPENDENT LIVING, ASSUMPTION COLLEGE, STAND FOR CHILDREN, CITY OF SPRINGFIELD - OFFICE OF HOUSING, PROVIDENCE BEHAVIORAL HEALTH, MA DEPT. OF PUBLIC HEALTH, UMASS AMHERST SCHOOL OF PUBLIC HEALTH & HEALTH SCIENCES, HAMPDEN COUNTY DISTRICT ATTORNEY'S OFFICE, BEHAVIORAL HEALTH NETWORK - OUTPATIENT SERVICES, FRANKLIN REGIONAL COUNCIL OF GOVERNMENTS, WESTERN MA BLACK NURSES ASSOCIATION, HMC BEHAVIORAL HEALTH, MASON SQUARE NEIGHBORHOOD HEALTH CENTER, HMC DISCHARGE TRANSITIONS, HEALTH CARE FOR THE HOMELESS, GOVERNOR'S TASK FORCE ON OPIOID ABUSE, MDPH DIVISION FOR PERINATAL, EARLY CHILDHOOD AND SPECIAL NEEDS- CARE COORDINATION, QUABBIN HEALTH DISTRICT, NORTHAMPTON HEALTH DEPARTMENT, CITY OF CHICOPEE PUBLIC HEALTH, FAMILY ADVOCACY CENTER, SQUARE ONE, CITY OF SPRINGFIELD PUBLIC SCHOOLS, BMC EMERGENCY MEDICINE, HOLYOKE LEARN TO COPE, BMC CHNA STEERING COMMITTEE, SPRINGFIELD FAITH-BASED ASSOC. HOLYOKE COMMUNITY COLLEGE; HOMEWORK HOUSE; BEHAVIORAL HEALTH NETWORK; HOLYOKE HEALTH CENTER, BE FIT, FAMILY ADVOCACY CENTER, AND BMC PEDIATRIC MEDICINE. MERCY HOSPITAL, INC. PART V, SECTION B, LINE 6A: MERCY HOSPITAL IS A MEMBER OF THE COALITION OF WESTERN MASSACHUSETTS HOSPITALS AND COLLABORATED WITH THE FOLLOWING HOSPITALS IN CONDUCTING THE CHNA: BAYSTATE MEDICAL CENTER, BAYSTATE FRANKLIN MEDICAL CENTER, BAYSTATE NOBLE HOSPITAL, BAYSTATE WING HOSPITAL, COOLEY DICKINSON HOSPITAL, HOLYOKE MEDICAL CENTER, AND SHRINERS HOSPITAL FOR CHILDREN. MERCY HOSPITAL, INC. PART V, SECTION B, LINE 6B: MERCY HOSPITAL COLLABORATED WITH HEALTH NEW ENGLAND, A HEALTH INSURANCE PROVIDER IN CONDUCTING THE CHNA. MERCY HOSPITAL, INC. PART V, SECTION B, LINE 11: SIGNIFICANT HEALTH NEEDS TO BE ADDRESSED: MERCY HOSPITAL WILL FOCUS ON DEVELOPING AND/OR SUPPORTING INITIATIVES AND MEASURE THEIR EFFECTIVENESS TO IMPROVE THE FOLLOWING HEALTH NEEDS: -ACCESS AND BARRIERS TO QUALITY HEALTH CARE -HEALTH CONDITIONS AND BEHAVIORS MERCY HOSPITAL HAS DEVELOPED FOUR STRATEGIC INITIATIVES TO ADDRESS THESE TWO SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA. ACCESS AND BARRIERS TO QUALITY HEALTH CARE - A SIGNIFICANT HEALTH NEED WAS FOUND IN REGARD TO HAMPDEN COUNTY RESIDENTS EXPERIENCING CHALLENGES IN ACCESSING CARE DUE TO THE SHORTAGE OF PROVIDERS. FIFTY-FOUR PERCENT OF HAMPDEN COUNTY RESIDENTS LIVE IN A HEALTHCARE PROFESSIONAL SHORTAGE AREA. THE FIRST INITIATIVE IS TO IMPROVE HEALTH CARE SERVICES AND OUTCOMES TO INDIVIDUALS WHO ARE FREQUENT UTILIZERS OF THE EMERGENCY DEPARTMENT. THE IMPLEMENTATION STRATEGY IS TO EXPAND SERVICES TO HIGH END UTILIZERS (HEU) OF THE EMERGENCY DEPARTMENT TO INCLUDE ENROLLMENT IN HEALTH INSURANCE, SOLID CONNECTIONS TO PRIMARY CARE, TRANSPORTATION RESOURCES, CASE MANAGEMENT, MENTAL HEALTH RESOURCES AND HEALTHCARE EDUCATION. ADDITIONALLY THE STRATEGY ENLISTS SERVICES OF A COMMUNITY OUTREACH WORKER AND SOCIAL WORKER TO PROVIDE INTENSIVE CASE MANAGEMENT SERVICES TO INCLUDE CONTACT WITH THE HEU PARTICIPANT TO ASSESS HEALTH ISSUES AND BEHAVIORS TO ENCOURAGE HEALTHY OUTCOMES.THE SECOND INITIATIVE IS TO ENSURE HEALTH INFORMATION IS UNDERSTANDABLE AND ACCESSIBLE TO THE RESIDENTS OF HAMPDEN COUNTY. DATA FROM FOCUS GROUPS IDENTIFIED IN THE CHNA INDICATE THE NEED FOR INCREASED HEALTH LITERACY, INCLUDING UNDERSTANDING HEALTH INFORMATION, TYPES OF SERVICES AND HOW TO ACCESS THEM, AND HOW TO ADVOCATE FOR ONESELF IN THE HEALTHCARE SYSTEM. THE THIRD INITIATIVE IS DEVISED TO IMPROVE HEALTH LITERACY ALONG WITH ACCESS TO CERVICAL CANCER SCREENINGS AND MAMMOGRAMS FOR HOMELESS WOMEN. THE IMPLEMENTATION STRATEGY IS TO INCREASE THE NUMBER OF HOMELESS WOMEN WHO PARTICIPATE IN WOMEN'S HEALTH SCREENINGS BY PERFORMING CERVICAL CANCER SCREENINGS, VERIFICATION OF CERVICAL SCREENING RECORDS AND MAMMOGRAMS OUTSIDE OF THE MERCY HOSPITAL SYSTEM. ADDITIONALLY THE STRATEGY IS TO INCREASE EDUCATIONAL PROGRAMS ON HEALTH RISKS PERTAINING TO WOMEN'S HEALTH.HEALTH CONDITIONS AND BEHAVIORS - THE SECOND SIGNIFICANT HEALTH NEED WAS FOUND TO BE MENTAL HEALTH. MENTAL HEALTH WAS IDENTIFIED AS ONE OF THE TOP THREE URGENT HEALTH NEEDS/PROBLEMS IMPACTING THE AREA. AN ESTIMATED 15.9% OF HAMPDEN COUNTY RESIDENTS HAVE POOR MENTAL HEALTH 15 DAYS OR MORE IN A MONTH. ER VISIT RATES FOR MENTAL HEALTH DISORDERS IN HAMPDEN COUNTY ARE 24% HIGHER THAN THAT OF THE STATE, WITH PARTICULARLY HIGH RATES IN HOLYOKE AND SPRINGFIELD. IN RESPONSE TO THIS SECOND HEALTH NEED, A FOURTH STRATEGIC INITIATIVE WAS IDENTIFIED TO IMPROVE MENTAL HEALTH SERVICES AND PROVIDE EDUCATION AND AWARENESS TO DIFFERENT POPULATION GROUPS WITHIN THE COMMUNITY. THE IMPLEMENTATION STRATEGY IS TO INCREASE THE MENTAL HEALTH AWARENESS OF HAMPDEN COUNTY RESIDENTS AND TO REDUCE THE STIGMA OF SEEKING HELP BY OFFERING MENTAL HEALTH FIRST AID TRAINING (MHFA) BY CERTIFIED INSTRUCTORS TO DIVERSE RESIDENTS WITHIN THE HOSPITAL SERVICE AREA. THE MHFA PROGRAM WILL HELP TO RAISE AWARENESS ABOUT MENTAL HEALTH AND ITS ISSUES ALONG WITH TEACHING PARTICIPANTS ABOUT VARIOUS MENTAL HEALTH SUPPORT SERVICES. MERCY HOSPITAL IS COMMITTED TO ADHERING TO ITS MISSION AND REMAINING GOOD STEWARDS OF ITS RESOURCES SO IT CAN CONTINUE TO ENHANCE ITS CLINICAL ACTIVITIES AND TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THE FOLLOWING AREAS HAVE BEEN IDENTIFIED IN THE CHNA AS NEEDS THAT ARE NOT ADDRESSED IN THE IMPLEMENTATION STRATEGY FOR THE FOLLOWING REASONS: COMMUNITY LEVEL SOCIAL AND ECONOMIC DETERMINANTS THAT IMPACT HEALTH - MERCY HOSPITAL, ALTHOUGH PLAYING ITS ROLE IN THIS COLLECTIVE EFFORT, IS NOT QUALIFIED TO FULLY ADDRESS THE POVERTY QUESTION IN THE COMMUNITY. FURTHERMORE, AS A HEALTHCARE CENTER, THE ABILITY OF MERCY HOSPITAL TO SOLVE THE SOCIAL DETERMINANTS OF HEALTH AT THE COMMUNITY LEVEL WILL BE LIMITED. FOR REFERENCE THE SOCIAL AND ECONOMIC DETERMINANTS OF HEALTH AT THE COMMUNITY LEVEL INCLUDE: HOUSING, SAFETY, FOOD AVAILABILITY, AIR POLLUTION, HEALTH DISPARITIES, AND RACIAL INEQUALITIES. MERCY HOSPITAL, INC. PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. MERCY HOSPITAL, INC. PART V, SECTION B, LINE 22D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. ACUTE CARE PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE ACUTE CARE CONTRACTUAL ADJUSTMENT FOR MEDICARE. AMBULATORY PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE PHYSICIAN CONTRACTUAL ADJUSTMENT FOR MEDICARE. THE ACUTE AND PHYSICIAN AVERAGE CONTRACTUAL ADJUSTMENT AMOUNTS FOR MEDICARE ARE CALCULATED UTILIZING THE LOOK BACK METHODOLOGY OF CALCULATING THE SUM OF PAID CLAIMS DIVIDED BY THE TOTAL GROSS CHARGES FOR THOSE CLAIMS ANNUALLY USING TWELVE MONTHS OF PAID CLAIMS WITH A 30 DAY LAG FROM REPORT DATE TO THE MOST RECENT DISCHARGE DATE. MERCY HOSPITAL - PART V, SECTION B, LINE 9 AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC. PART I, LINE 3C: IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS. PART I, LINE 6A: MERCY HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT, WHICH IT SUBMITS TO THE STATE OF MASSACHUSETTS. IN ADDITION, MERCY HOSPITAL REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH (EIN 35-1443425) IN ITS AUDITED FINANCIAL STATEMENTS, AVAILABLE AT WWW.TRINITY-HEALTH.ORG. IN ADDITION, MERCY HOSPITAL INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM. PART I, LN 7 COL(F): THE FOLLOWING NUMBER, $3,312,594, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F). PART II, COMMUNITY BUILDING ACTIVITIES: COALITION BUILDING - COLLABORATIVE PARTNERSHIPS - MERCY HOSPITAL IS AN ACTIVE MEMBER OF THE PARTNERS FOR A HEALTHIER COMMUNITY (PHC). THIS NON-PROFIT ORGANIZATION IS COMMITTED TO IMPROVING THE PUBLIC'S HEALTH BY FOSTERING INNOVATION, LEVERAGING RESOURCES, AND BUILDING PARTNERSHIPS ACROSS SECTORS, INCLUDING GOVERNMENT AGENCIES, COMMUNITIES, THE HEALTH CARE DELIVERY SYSTEM, MEDIA, AND ACADEMIA. PHC USES A COLLABORATIVE PROGRAMMING APPROACH TO SOLVE PRESSING COMMUNITY HEALTH ISSUES. PHC FACILITATES AND PROMOTES COMMUNITY COLLABORATIONS, SUCH AS: CONVENING AND PARTNERING - SUPPORTING COMMUNITY, PUBLIC, AND PRIVATE SECTOR STAKEHOLDERS TO ADDRESS HEALTH CHALLENGES FACING THE COMMUNITY; HEALTH POLICY DEVELOPMENT - USING DATA ANALYSIS, COMMUNITY PARTICIPATION, AND ADVOCACY TO FORGE POLICY CHANGES THAT WILL EMBED PROGRAMMING AND LEAD TO BETTER HEALTH OUTCOMES; AND RESEARCH AND EVALUATION - IMPLEMENTING COMMUNITY-BASED RESEARCH TO UNDERSTAND GAPS, NEEDS, AND BEST PRACTICES, AS WELL AS MONITORING AND EVALUATING OUTCOMES OF PROGRAMS AND COALITIONS AIMED AT IMPROVING HEALTH AND WELL-BEING.WORKFORCE DEVELOPMENT - MERCY HOSPITAL IS ACTIVELY INVOLVED WITH THE FOLLOWING GROUPS THAT ARE FOCUSED ON THE IMPROVEMENT OF THE LABOR FORCE WITHIN THE HOSPITAL'S SERVICE AREA:DRESS FOR SUCCESS - THEIR PURPOSE IS TO OFFER LONG-LASTING SOLUTIONS THAT ENABLE WOMEN TO BREAK THE CYCLE OF POVERTY. THIS NON-PROFIT ORGANIZATION PROVIDES PROFESSIONAL ATTIRE FOR LOW-INCOME WOMEN TO HELP SUPPORT THEIR JOB-SEARCH AND INTERVIEW PROCESS. THE ORGANIZATION'S APPROACH IS BASED ON SOCIAL RESEARCH SUGGESTING THAT SUITABLE ATTIRE IS IMPORTANT TO "IMPRESSION FORMATION", WHICH IN TURN POSITIVELY IMPACTS JOB PROSPECTS.REGIONAL EMPLOYMENT BOARD OF HAMDEN COUNTY - THE BOARD PLANS, COORDINATES AND OVERSEES THE GROWTH AND EFFECTIVE USE OF PUBLIC AND PRIVATE INVESTMENT IN WORKFORCE DEVELOPMENT INITIATIVES FOR QUALITY JOBS. THEY PROVIDE LEADERSHIP IN CREATING STRATEGIC ALLIANCES WITH BUSINESS, GOVERNMENT, EDUCATION AND COMMUNITY ORGANIZATIONS TO PROVIDE ACCESS TO EDUCATION, TRAINING AND EMPLOYMENT OPPORTUNITIES FOR ALL WORKERS, ESPECIALLY FOR LOW INCOME ADULTS AND YOUTH, DISADVANTAGED MINORITIES AND NEWCOMERS, DISLOCATED WORKERS, INCUMBENT WORKERS, AND THEIR FAMILIES.MASSACHUSETTS DEPARTMENT OF COMMUNITY HEALTH WORKERS BOARD - THE STATE OF MASSACHUSETTS RECOGNIZED THE IMPORTANCE OF COMMUNITY HEALTH WORKERS (CHW) IN HELPING TO EXPAND ACCESS TO MEDICAL INSURANCE COVERAGE AND ELIMINATE HEALTH DISPARITIES WITHIN ITS BORDERS. THE BOARD DEVELOPS RECOMMENDATIONS FOR A SUSTAINABLE CHW PROGRAM TO PROMOTE: 1) PUBLIC AND PRIVATE PARTNERSHIPS TO IMPROVE ACCESS TO CARE, ELIMINATE DISPARITIES, INCREASE THE USE OF PRIMARY CARE, AND REDUCE INAPPROPRIATE HOSPITAL EMERGENCY ROOM USE; AND 2) STRONGER WORKFORCE DEVELOPMENT, INCLUDING A TRAINING CURRICULUM AND CERTIFICATION PROGRAM TO INSURE HIGH STANDARDS, CULTURAL COMPETENCY AND QUALITY OF SERVICES. PART III, LINE 2: METHODOLOGY USED FOR LINE 2 - ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS. PART III, LINE 3: MERCY HOSPITAL USES A PREDICTIVE MODEL THAT INCORPORATES THREE DISTINCT VARIABLES IN COMBINATION TO PREDICT WHETHER A PATIENT QUALIFIES FOR CHARITY: (1) SOCIO-ECONOMIC SCORE, (2) ESTIMATED FEDERAL POVERTY LEVEL (FPL), AND (3) HOMEOWNERSHIP. BASED ON THE MODEL, CHARITY CARE CAN STILL BE EXTENDED TO PATIENTS EVEN IF THEY HAVE NOT RESPONDED TO FINANCIAL COUNSELING EFFORTS AND ALL OTHER FUNDING SOURCES HAVE BEEN EXHAUSTED. FOR FINANCIAL STATEMENT PURPOSES, MERCY HOSPITAL IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, MERCY HOSPITAL IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL. PART III, LINE 4: MERCY HOSPITAL IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE FROM PAGE 15 OF THOSE STATEMENTS: "THE CORPORATION RECOGNIZES A SIGNIFICANT AMOUNT OF PATIENT SERVICE REVENUE AT THE TIME THE SERVICES ARE RENDERED EVEN THOUGH THE CORPORATION DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY AT THAT TIME. AS A RESULT, THE PROVISION FOR BAD DEBTS IS PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS). FOR UNINSURED AND UNDERINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE CORPORATION ESTABLISHES AN ALLOWANCE TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THIS ALLOWANCE IS ESTABLISHED BASED ON THE AGING OF ACCOUNTS RECEIVABLE AND THE HISTORICAL COLLECTION EXPERIENCE BY THE HEALTH MINISTRIES AND FOR EACH TYPE OF PAYOR. A SIGNIFICANT PORTION OF THE CORPORATION'S PROVISION FOR DOUBTFUL ACCOUNTS RELATES TO SELF-PAY PATIENTS, AS WELL AS CO-PAYMENTS AND DEDUCTIBLES OWED TO THE CORPORATION BY PATIENTS WITH INSURANCE."PART III, LINE 5:TOTAL MEDICARE REVENUE REPORTED IN PART III, LINE 5 HAS BEEN REDUCED BY THE TWO PERCENT SEQUESTRATION REDUCTION. PART III, LINE 8: MERCY HOSPITAL DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CATHOLIC HEALTH ASSOCIATION RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTHCARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT. PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. COLLECTION PRACTICES FOR THE REMAINING BALANCES ARE CLEARLY OUTLINED IN THE ORGANIZATION'S COLLECTION POLICY. THE HOSPITAL HAS IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS. PART VI, LINE 2: NEEDS ASSESSMENT - MERCY MEDICAL CENTER ASSESSES THE HEALTH STATUS OF ITS COMMUNITY, IN PARTNERSHIP WITH COMMUNITY COALITIONS, AS PART OF THE NORMAL COURSE OF OPERATIONS AND IN THE CONTINUOUS EFFORTS TO IMPROVE PATIENT CARE AND THE HEALTH OF THE OVERALL COMMUNITY. TO ASSESS THE HEALTH OF THE COMMUNITY, THE HOSPITAL MAY USE PATIENT DATA, PUBLIC HEALTH DATA, ANNUAL COUNTY HEALTH RANKINGS, MARKET STUDIES, AND GEOGRAPHICAL MAPS SHOWING AREAS OF HIGH UTILIZATION FOR EMERGENCY SERVICES AND INPATIENT CARE, WHICH MAY INDICATE POPULATIONS OF INDIVIDUALS WHO DO NOT HAVE ACCESS TO PREVENTATIVE SERVICES OR ARE UNINSURED. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - MERCY HOSPITAL IS COMMITTED TO:- PROVIDING ACCESS TO QUALITY HEALTHCARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE, PARTICULARLY THE POOR AND THE UNDERSERVED IN OUR COMMUNITIES- CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES- ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE - BALANCING NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO SUSTAIN VIABILITY AND PROVIDE THE QUALITY AND QUANTITY OF SERVICES FOR ALL WHO MAY NEED CARE IN A COMMUNITYIN ACCORDANCE WITH AMERICAN HOSPITAL ASSOCIATION RECOMMENDATIONS, MERCY HOSPITAL HAS ADOPTED THE FOLLOWING GUIDING PRINCIPLES WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS:- PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS- MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS- OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS- IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER- IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONSMERCY HOSPITAL COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES AND EXTERNAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE.FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTHCARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. FINANCIAL ASSISTANCE APPLICATIONS WILL BE ACCEPTED UNTIL ONE YEAR AFTER THE FIRST BILLING STATEMENT TO THE PATIENT.MERCY HOSPITAL OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH PATIENT BROCHURES, MESSAGES ON PATIENT BILLS, POSTED NOTICES IN PUBLIC REGISTRATION AREAS INCLUDING EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS ALSO AVAILABLE ON HOSPITAL WEBSITES. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN SPANISH, REFLECTING OTHER LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITAL. MERCY HOSPITAL HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. MERCY HOSPITAL MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. PART VI, LINE 4: COMMUNITY INFORMATION - THE SERVICE AREA FOR MERCY MEDICAL CENTER INCLUDES ALL 23 COMMUNITIES WITHIN HAMPDEN COUNTY INCLUDING THE THIRD LARGEST CITY IN MASSACHUSETTS -- SPRINGFIELD (POPULATION OVER 150,000). THREE ADJACENT CITIES (HOLYOKE, CHICOPEE AND WEST SPRINGFIELD) CREATE A DENSELY-POPULATED URBAN CORE THAT INCLUDES OVER HALF OF THE POPULATION OF THE SERVICE AREA (270,000 PEOPLE). SMALLER 'BEDROOM' COMMUNITIES EXIST TO THE EAST AND WEST OF THIS CENTRAL CORE AREA. MANY OF THESE COMMUNITIES HAVE POPULATIONS UNDER 20,000 PEOPLE. THE SERVICE AREA HAS MORE RACIAL AND ETHNIC DIVERSITY THAN MANY OTHER PARTS OF WESTERN MASSACHUSETTS. COUNTY-WIDE, 22.1% OF THE POPULATION IS LATINO, 8.7% IS BLACK AND 2.1% IS ASIAN (ACS, 2010-2014), THOUGH THIS DIVERSITY IS NOT EQUALLY SPREAD THROUGHOUT THE REGION AND TENDS TO BE CONCENTRATED IN THE URBAN CORE. THE MERCY HOSPITAL SERVICE AREA IS HOME TO MANY OF THE LARGEST EMPLOYERS IN THE REGION, AS WELL AS NUMEROUS COLLEGES AND UNIVERSITIES, AND PROVIDES A STRONG ECONOMIC ENGINE FOR THE BROADER REGION. THE LARGEST INDUSTRIES AND EMPLOYERS INCLUDE HEALTH CARE, SERVICE AND WHOLESALE TRADE AND MANUFACTURING. SIMULTANEOUSLY, THE COUNTY STRUGGLES WITH HIGHER RATES OF UNEMPLOYMENT AND POVERTY, LOWER HOUSEHOLD INCOMES AND LOWER RATES OF EDUCATIONAL ATTAINMENT. THE MEDIAN HOUSEHOLD INCOME IN THE SERVICE AREA IS ABOUT $50,000 ($17,000 LESS THAN THE STATE). AT THE SAME TIME, THE COST OF HOUSING IS ALMOST $400/MONTH LOWER THAN THE STATEWIDE AVERAGE. STILL, THE POVERTY RATE IS MORE THAN 5% HIGHER THAN WHAT IS REPORTED STATEWIDE, AND THE CHILD POVERTY RATE IS AN ALARMING 27%, MORE THAN 10% HIGHER THAN THE STATE RATE (ACS, 2010-2014). DESPITE BEING AT THE CORE OF THE KNOWLEDGE CORRIDOR REGION, ONLY 25.6% OF THE POPULATION AGE 25 AND OVER HAS A BACHELOR'S DEGREE. UNEMPLOYMENT IS SOMEWHAT HIGHER THAN THE STATE AVERAGE. THE MEDIAN AGE FOR THE SERVICE AREA IS SIMILAR TO THAT OF MASSACHUSETTS, THOUGH THE POPULATION OVER 45 YEARS OLD IS GROWING AS A PERCENTAGE OF THE TOTAL POPULATION.HAMPDEN COUNTY CONTAINS SIX ACUTE CARE HOSPITAL FACILITIES. SEVERAL AREAS AND POPULATIONS IN HAMPDEN COUNTY ARE DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA). FIFTY-FOUR PERCENT OF HAMPDEN COUNTY RESIDENTS LIVE IN A HPSA, COMPARED TO 14.6% FOR MASSACHUSETTS RESIDENTS OVERALL. THE U.S. HEALTH RESOURCES AND SERVICES ADMINISTRATION DESIGNATED MEDICALLY UNDERSERVED AREAS AND POPULATIONS (MUA/MUP) IN HAMPDEN COUNTY ARE PRIMARILY FOUND IN HOLYOKE, SPRINGFIELD, WEST SPRINGFIELD, WESTFIELD, BLANDFORD, AND CHESTER. MUA'S AND MUP'S ARE IDENTIFIED BASED ON AVAILABILITY OF PRIMARY CARE PROVIDERS, INFANT MORTALITY RATE, POVERTY RATE AND PROPORTION OF OLDER ADULTS. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH -MERCY HOSPITAL'S GOVERNING BODY IS ITS BOARD OF DIRECTORS. THE MAJORITY OF THIS BOARD RESIDES IN THE ORGANIZATION'S SERVICE AREA AND IS COMPRISED OF INDIVIDUALS WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS. THE ORGANIZATION EXTENDS MEDICAL PRIVILEGES TO QUALIFIED PHYSICIANS IN THE COMMUNITY FOR ITS DEPARTMENTS AND SPECIALTIES, PROVIDED THESE PHYSICIANS MEET THE QUALIFICATIONS OUTLINED AND CERTIFIED BY THE MEDICAL CREDENTIALING OFFICE. AS MERCY HOSPITAL IS A NON-PROFIT ENTITY, ANY AND ALL EXCESS FUNDS ARE USED TO FUND IMPROVEMENTS IN PATIENT CARE AND MEDICAL EDUCATION. TOBACCO 21 ADVOCACY: MERCY HOSPITAL JOINED THE TOBACCO FREE MASS STATE-WIDE COALITION TO HELP PASS LOCAL AND STATE WIDE LEGISLATION TO INCREASE THE MINIMUM SMOKING AGE TO 21. THEY PARTNERED WITH THE CITY OF SPRINGFIELD DEPARTMENT OF HEALTH, TOBACCO CESSATION & PREVENTION PROGRAM FOR LOCAL ADVOCACY AND TECHNICAL ASSISTANCE, HOSTED A MEETING WITH THE STATE COMMISSIONER OF HEALTH TO ADDRESS SMOKING AND ITS RELATED HEALTH ISSUES, AND LOBBIED AT THE MASSACHUSETTS STATE HOUSE ON YOUTH TOBACCO PREVENTION DAY TO PERSUADE LEGISLATORS TO PASS A COMPREHENSIVE STATE-WIDE TOBACCO 21 BILL.MERCY HOSPITAL FURTHER PROMOTES THE HEALTH OF THE COMMUNITY BY OFFERING THE FOLLOWING:HEALTH CARE FOR THE HOMELESS: MERCY HOSPITAL'S DEPARTMENT OF COMMUNITY HEALTH PROVIDES CARE TO THE COMMUNITY'S HOMELESS POPULATION IN FRANKLIN, HAMPSHIRE, AND HAMPDEN COUNTIES THROUGH PRIMARY CARE SERVICES, HEALTH EDUCATION, CASE MANAGEMENT, MENTAL HEALTH SERVICES, AND FREE CLINICS TO MORE THAN 2,250 PERSONS EACH YEAR. THE VIETNAMESE HEALTH PROJECT: THIS PROGRAM PROVIDES CASE MANAGEMENT AND INTERPRETATION SERVICES TO THE REFUGEE AND IMMIGRANT VIETNAMESE POPULATION IN THE GREATER SPRINGFIELD AREA. ANNUALLY, THIS COMMUNITY HEALTH OUTREACH PROGRAM REACHES NEARLY 700 VIETNAMESE PATIENTS. ADULTS AND CHILDREN IN PSYCHIATRIC AND/OR SUBSTANCE ABUSE DISTRESS: PROVIDENCE BEHAVIORAL HEALTH HOSPITAL, OPERATING UNDER THE SAME HOSPITAL LICENSE AS MERCY HOSPITAL, IS A 126-BED HOSPITAL LOCATED IN HOLYOKE, MASSACHUSETTS THAT PROVIDES BOTH INPATIENT AND OUTPATIENT MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES FOR PEOPLE OF ALL AGES EXPERIENCING ACUTE PSYCHIATRIC DISTRESS AND/OR SEVERE SUBSTANCE ABUSE PROBLEMS.LACK OF AFFORDABLE AND ACCESSIBLE CARE: THE HOSPITAL OFFERS FINANCIAL COUNSELING TO THOSE WHO NEED ASSISTANCE. ADDITIONAL SUPPORT IS PROVIDED THROUGH COUNSELORS AND CASE MANAGERS WHO ASSIST PATIENTS WITH ACCESSING HEALTH INSURANCE THROUGH THE STATE. LACK OF AFFORDABLE AND ACCESSIBLE PRESCRIPTION MEDICATIONS: THE HOSPITAL PROVIDES PATIENT COUNSELING AND EDUCATION REGARDING PRESCRIPTION ASSISTANCE AND ALSO PROVIDES DIRECT CO-PAY ASSISTANCE THROUGH THE HEALTH CARE FOR THE HOMELESS PROGRAM. THE HOSPITAL IS ALSO REGISTERED IN THE FEDERAL 340-B PHARMACEUTICAL DRUG ACCESS PROGRAM, WHICH PROVIDES DISCOUNTS TO QUALIFYING HOSPITALS ON COVERED OUTPATIENT MEDICATION WHICH ARE THEN PROVIDED TO THE PATIENTS AT A REDUCED COST.SUPPORT GROUPS: FOR THOSE EXPERIENCING LIFE-ALTERING CONDITIONS, MERCY HOSPITAL PROVIDES A WIDE RANGE OF ONGOING, FREE, SUPPORT GROUPS FOR PATIENTS (AND THEIR FAMILIES OR CAREGIVERS) CHALLENGED BY DIAGNOSES SUCH AS CANCER, STROKE, AMPUTATIONS, APHASIA, TRAUMATIC BRAIN INJURY, MULTIPLE SCLEROSIS, AND SPINAL CORD INJURIES. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM - MERCY HOSPITAL IS A MEMBER OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE DELIVERY SYSTEMS IN THE COUNTRY. TRINITY HEALTH ANNUALLY REQUIRES THAT ALL MEMBER ORGANIZATIONS DEFINE - AND ACHIEVE - SPECIFIC COMMUNITY HEALTH AND WELL-BEING GOALS. IN FISCAL YEAR 2016, GOALS INCLUDED 1) PARTNERING WITH COMMUNITY ORGANIZATIONS IN INSURANCE ENROLLMENT ACTIVITIES TARGETED AT UNINSURED INDIVIDUALS TO IMPROVE ACCESS TO HEALTHCARE, 2) PARTICIPATING IN LOCAL ADVOCACY EFFORTS AIMED AT CURBING TOBACCO USE AND PREVENTING OBESITY, AND 3) DEVELOPING A STRATEGY WITH MULTI-DISCIPLINARY TEAMS TO OPTIMIZE CARE FOR VULNERABLE PERSONS, WITH PARTICULAR FOCUS ON THOSE WHO ARE DUALLY ENROLLED IN MEDICAID AND MEDICARE. TRINITY HEALTH APPRECIATES THE IMPACT SOCIAL DETERMINANTS SUCH AS ADEQUATE HOUSING, SAFETY, ACCESS TO FOOD, EDUCATION, INCOME, AND HEALTH COVERAGE HAVE ON THE HEALTH OF THE COMMUNITY. IN FISCAL YEAR 2016, TRINITY HEALTH LAUNCHED THE TRANSFORMING COMMUNITIES INITIATIVE (TCI), AWARDING EIGHT COMMUNITIES FUNDING TO IMPROVE THE HEALTH AND WELL-BEING OF THEIR COMMUNITIES IN PARTNERSHIP WITH THE LOCAL TRINITY HEALTH MEMBER HOSPITAL. THE AWARDED PROGRAMS FOCUS ON POLICY, SYSTEM, AND ENVIRONMENTAL CHANGES THAT SPECIFICALLY IMPACT COMMUNITY IDENTIFIED AREAS OF NEED AND THAT WILL REDUCE OBESITY AND TOBACCO USE.AS A SYSTEM, TRINITY HEALTH SUPPORTED PROGRAMS AND ORGANIZATIONS WHO ADDRESS THESE SOCIAL DETERMINANTS OF HEALTH. PROGRAMS INCLUDE GRANTING SEVEN DACA "DREAMERS" LOW INTEREST LOANS, ENABLING RECIPIENTS TO ATTEND MEDICAL SCHOOL AT STRITCH SCHOOL OF MEDICINE, AND PROVIDING A GRANT TO THE U.S. SOCCER FOUNDATION TO FUND ITS SOCCER FOR SUCCESS PROGRAM IN NINE COMMUNITIES, OFFERING STUDENTS IN UNDERSERVED AREAS THE OPPORTUNITY TO SAFELY AND COST-EFFECTIVELY ENGAGE IN A HEALTHY AND ACTIVE LIFESTYLE. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO OUR COMMUNITIES THROUGH PROGRAMS SERVING THOSE WHO ARE POOR AND UNINSURED, HELPING MANAGE CHRONIC CONDITIONS LIKE DIABETES, PROVIDING HEALTH EDUCATION, PROMOTING WELLNESS AND REACHING OUT TO UNDERSERVED POPULATIONS. ANNUALLY, THE ORGANIZATION INVESTS NEARLY $1 BILLION IN SUCH COMMUNITY BENEFITS AND WORKS TO ENSURE THAT ITS MEMBER HOSPITALS AND OTHER ENTITIES/AFFILIATES ENHANCE THE OVERALL HEALTH OF THE COMMUNITIES THEY SERVE BY ADDRESSING THE SPECIFIC NEEDS OF EACH COMMUNITY.FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG. PART VI, LINE 7, REPORTS FILED WITH STATES MA 1 PIONEER VALLEY PLANNING COMMISSION 60 CONGRESS STREET FL 1 SPRINGFIELD MA 01104 042376717 GOVERNMENT ORG 5896 COMMUNITY SUPPORT SQUARE ONE 1095 MAIN STREET FLOOR 2 SPRINGFIELD MA 01103 042103855 501(C)(3) 7961 COMMUNITY SUPPORT MARTIN LUTHER KING JR FAMILY SERVICES 3 RUTLAND STREET SPRINGFIELD MA 01139 042647035 501(C)(3) 18630 COMMUNITY SUPPORT HAP INC 322 MAIN STREET SPRINGFIELD MA 01105 042518368 501(C)(3) 6750 COMMUNITY SUPPORT PARTNERS FOR A HEALTHIER COMMUNITY INC 127 STATE STREET SPRINGFIELD MA 01103 043342182 501(C)(3) 36277 COMMUNITY SUPPORT SPRINGFIELD PARTNERS FOR COMMUNITY ACTION 721 STATE STREET SPRINGFIELD MA 01109 042374279 501(C)(3) 7280 COMMUNITY SUPPORT 6 0 PART I, LINE 2: DONATIONS MADE BY MERCY HOSPITAL TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE. DONATIONS ARE INCLUDED IN COMMUNITY BENEFITS IN SCHEDULE H IF THE CONTRIBUTION HAS BEEN FORMALLY RESTRICTED TO A COMMUNITY BENEFIT ACTIVITY THAT MEETS THE CRITERIA TO BE REPORTED ON SCHEDULE H. 0 1 0 0 0 0 0 0 0 DANIEL P MOEN DIRECTOR; PRESIDENT & CEO THR 12/15 0 490868 0 213060 0 203082 0 17125 0 23870 0 948005 0 0 SCOTT WOLF DIRECTOR; PRESIDENT & CEO AS OF 1/16 0 379923 0 111287 0 1018 0 15825 0 27841 0 535894 0 0 CHRISTOPHER H COMEY MD DIRECTOR; PRES, MED STAFF 0 669937 0 71840 0 50 0 15825 0 24722 0 782374 0 0 CLAYTON FITZHUGH DIRECTOR THR 6/16; TH EVP, CHRO 0 737704 0 321392 0 364018 0 26350 0 15860 0 1465324 0 0 DANIEL KEENAN ASST. SEC/SVP GOV'T RELATIONS 0 188690 0 56663 0 470 0 15809 0 25847 0 287479 0 0 THOMAS ROBERT TREASURER/SVP & CFO 0 322723 0 93771 0 13865 0 23775 0 26087 0 480221 0 0 MARIA RUSSO-APPEL MD VP MERCY BEHAVIORAL HC AS OF 1/16 285211 0 27727 0 457 0 10171 0 21727 0 345293 0 0 0 SIMON AHTARIDIS MD INTERIM CMO AS OF 1/16 0 329529 0 41366 0 5338 0 15825 0 25100 0 417158 0 0 SHARON ADAMS SVP PATIENT CARE-THROUGH 9/15 217438 0 78338 0 29119 0 21004 0 15973 0 361872 0 0 0 ROBERT ROOSE MD CMO, ADDICTION SERVICES 256170 0 0 0 10851 0 15336 0 8401 0 290758 0 0 0 JOHN DIGGINS PSYCHIATRIST 238006 0 5800 0 9957 0 11485 0 6499 0 271747 0 0 0 GAURAV CHAWLA CHIEF OF PSYCHIATRY 250309 0 0 0 428 0 18834 0 25048 0 294619 0 0 0 CHHEWANG NORSANG MEDICAL DIRECTOR 229232 0 5000 0 555 0 10281 0 16307 0 261375 0 0 0 LEONARD F PANSA FORMER KEY EMP; SVP HR & ADMIN SVCS 0 272950 0 78191 0 13073 0 19800 0 4374 0 388388 0 0 PART I, LINE 3 MERCY HOSPITAL IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. MERCY HOSPITAL'S CEO IS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF MERCY HOSPITAL'S CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2015. THE PLAN PROVIDES RETIREMENT BENEFITS TO CERTAIN TRINITY HEALTH EXECUTIVES SUBJECT TO MEETING SPECIFIED VESTING AND EMPLOYMENT DATE REQUIREMENTS. BENEFITS FOR PARTICIPANTS VESTED IN A PLAN WERE PAID OUT IN 2015, AND BENEFITS FOR PARTICIPANTS NOT YET VESTED IN A PLAN WERE ACCRUED IN 2015. THE FOLLOWING PAYOUTS FOR 2015 FOR THE PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: CLAYTON FITZHUGH - $276,846 DANIEL MOEN - $148,909 SUSAN WHALEN FAMILY MEMBER OF DEAN M. WHALEN, ESQUIRE, DIRECTOR 133800 EMPLOYEE ARRANGEMENT 0 0 FORM 990, PAGE 1, DOING BUSINESS AS NAMES: MERCY MEDICAL CENTER PROVIDENCE BEHAVORIAL HEALTH HOSPITAL WELDON REHABILITATION HOSPITAL SR. MARY CARITAS CANCER CENTER @ MERCY MEDICAL CENTER HEALTHCARE FOR THE HOMELESS @ MERCY MEDICAL CENTER FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF MERCY HOSPITAL IS SISTERS OF PROVIDENCE HEALTH SYSTEM. SEE LINE 7 FOR ADDITIONAL INFORMATION. FORM 990, PART VI, SECTION A, LINE 7A SISTERS OF PROVIDENCE HEALTH SYSTEM IS THE SOLE MEMBER OF MERCY HOSPITAL. SISTERS OF PROVIDENCE HEALTH SYSTEM HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF MERCY HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER, SISTERS OF PROVIDENCE HEALTH SYSTEM MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. SISTERS OF PROVIDENCE HEALTH SYSTEM MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS AND MODIFICATIONS TO GOVERNING DOCUMENTS. FORM 990, PART VI, SECTION B, LINE 11 PRIOR TO FILING, THE FORM 990 FOR MERCY HOSPITAL IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE FINANCE COMMITTEE AS WELL AS THE BOARD OF DIRECTORS. EACH MEMBER OF THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C MERCY HOSPITAL HAS ADOPTED TRINITY HEALTH'S GOVERNANCE POLICY NO. 1, WHICH SETS FORTH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND PROCESSES. IT APPLIES TO ALL "INTERESTED PERSONS" OF MERCY HOSPITAL, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS, KEY EMPLOYEES, AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS. INTERESTED PERSONS ARE EXPECTED TO DISCHARGE THEIR DUTIES IN A MANNER THE PERSON REASONABLY BELIEVES TO BE IN THE BEST INTERESTS OF MERCY HOSPITAL AND TO AVOID SITUATIONS INVOLVING A CONFLICT OF INTEREST. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE PROVIDED TO INTERNAL LEGAL COUNSEL AND THE INTEGRITY AND COMPLIANCE OFFICER, FROM WHICH LEGAL COUNSEL PREPARES A REPORT FOR THE BOARD CHAIR AND CEO. A SUMMARY OF POTENTIAL CONFLICTS IS REVIEWED WITH THE BOARD OF DIRECTORS OF MERCY HOSPITAL (OR A DELEGATED COMMITTEE OF THE BOARD) ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO MERCY HOSPITAL OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF MERCY HOSPITAL (OR A DELEGATED COMMITTEE OF THE BOARD) IS RESPONSIBLE FOR THE REVIEW OF TRANSACTIONS TO DETERMINE WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS. IN THE EVENT OF AN ACTUAL CONFLICT, THE BOARD (OR A DELEGATED COMMITTEE OF THE BOARD) WILL EITHER AVOID THE CONFLICT OR APPROPRIATELY SCRUTINIZE THE TRANSACTION TO ENSURE IT IS IN THE BEST INTERESTS OF MERCY HOSPITAL. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE POLICY FURTHER ADDRESSES THE PROPER DOCUMENTATION OF THE PROCEEDINGS AND POTENTIAL DISCIPLINARY AND CORRECTIVE ACTION FOR VIOLATIONS OF THE POLICY. THE POLICY IS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 15B QUESTION 15A IS ANSWERED "NO" BECAUSE THE COMPENSATION FOR MERCY HOSPITAL'S CEO IS ESTABLISHED BY TRINITY HEALTH, A RELATED ORGANIZATION. IN ESTABLISHING CEO COMPENSATION, TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF THE CEO OF MERCY HOSPITAL ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS. FOR THE COMPENSATION OF OTHER EMPLOYEES, WHEN THEY WERE HIRED BY MERCY HOSPITAL IT HAD A PROCESS FOR DETERMINING COMPENSATION WHICH INCLUDED THE FOLLOWING: THE BOARD HAD AN INDEPENDENT COMMITTEE REVIEW AND APPROVE ALL ELEMENTS OF REMUNERATION FOR ALL DISQUALIFIED PARTIES, AS WELL AS OTHER KEY MANAGEMENT. THE BOARD/COMMITTEE HAD AN ESTABLISHED COMPENSATION PHILOSOPHY WHICH DETAILED THE OBJECTIVES OF MARKET POSITIONING AND PAY ELEMENTS. THE COMMITTEE ENGAGED WITH EXTERNAL CONSULTANTS TO PROVIDE MARKET DATA COMPARING THE ORGANIZATION'S ROLES TO SIMILARLY SIZED ORGANIZATIONS UTILIZING BOTH TITLE AND JOB CONTENT COMPARISONS. THE COMMITTEE REVIEWED THE MARKET ANALYSIS, APPROVED ANY SALARY ADJUSTMENTS FOR THE EXECUTIVE POPULATION, CONSIDERED BOTH REASONABLENESS AND EFFECTIVENESS OF ALL REMUNERATIVE PROGRAMS AND ESTABLISHED THE DETAILED PERFORMANCE EXPECTATIONS WHICH HAVE BEEN INCORPORATED INTO THE INCENTIVE PLAN. ALL OF THESE DISCUSSIONS AND DECISIONS WERE DOCUMENTED THROUGH THE PROVISION OF MEETING MINUTES. FORM 990, PART VI, SECTION C, LINE 19 MERCY HOSPITAL IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, MERCY HOSPITAL INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. MERCY HOSPITAL'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: EQUITY TRANSFERS TO/FROM AFFILIATES -175,845. EQUITY GAIN IN UNCONSOLIDATED AFFILIATES 365,564. FORM 990, PART XII, LINE 2: MERCY HOSPITAL'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY16 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. ACCOUNTABLE CARE ORGANIZATION OF NEW ENGLAND LLC C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE MA 01040 454565187 ACCOUNTABLE CARE ORGANIZATION MA -78004 -72303 MERCY HOSPITAL INC MERCY CARE ALLIANCE LLC C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE MA 01040 471561725 ACCOUNTABLE CARE ORGANIZATION MA -40346 1264791 MERCY HOSPITAL INC ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP 245 STATE ST SE GRAND RAPIDS MI 49503 272491974 HEALTHCARE SERVICES MI 501(C)(3) LINE 9 TRINITY HEALTH-MICHIGAN 1 ALBANY MEMORIAL HOSPITAL 600 NORTHERN BLVD ALBANY NY 12204 141338457 HEALTHCARE AND HOSPITAL SERVICES NY 501(C)(3) LINE 3 ST PETER'S HEALTH PARTNERS 1 ALLEGANY FRANCISCAN MINISTRIES INC 33920 US HIGHWAY 19 NORTH SUITE 269 PALM HARBOR FL 34684 581492325 HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT FL 501(C)(3) LINE 11A, I TRINITY HEALTH CORPORATION 1 AMICARE HOSPICE SERVICES INC 20555 VICTOR PARKWAY LIVONIA MI 48152 382949053 HOSPICE SERVICES MI 501(C)(3) LINE 9 TRINITY HOME HEALTH SERVICES 1 ASYLUM HILL FAMILY 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1 CATHERINE MCAULEY HEALTH SERVICES CORP PO BOX 995 ANN ARBOR MI 48106 382507173 HEALTHCARE SERVICES (INACTIVE) MI 501(C)(3) LINE 3 TRINITY HEALTH-MICHIGAN 1 CATHOLIC HEALTH MINISTRIES 20555 VICTOR PARKWAY LIVONIA MI 48152 GOVERNANCE AND MANAGEMENT OF TRINITY HEALTH SYSTEM VT 501(C)(3) LINE 1 N/A 0 COLUMBUS ACQUISITION CORP 111 CENTRAL AVENUE NEWARK NJ 07102 262616342 INACTIVE ENTITY NJ 501(C)(3) LINE 9 SAINT MICHAEL'S MEDICAL CENTER 1 COMMUNITY HEALTH PARTNERS OF SOUTH BEND PO BOX 3998 SOUTH BEND IN 46619 263051440 HEALTHCARE SERVICES IN 501(C)(3) LINE 3 SAINT JOSEPH REGIONAL MEDICAL CENTER INC 1 CRANBROOK HOSPICE CARE 1111 W LONG LAKE RD STE 102 TROY MI 48098 383320699 HOSPICE SERVICES MI 501(C)(3) LINE 9 TRINITY HOME HEALTH SERVICES 1 DILEY RIDGE MEDICAL CENTER 6150 EAST BROAD STREET COLUMBUS OH 43213 342032340 HEALTHCARE AND HOSPITAL SERVICES OH 501(C)(3) LINE 3 MOUNT CARMEL HEALTH SYSTEM 1 DUBUQUE MERCY HEALTH FOUNDATION INC 250 MERCY DRIVE DUBUQUE IA 52001 262227941 FOUNDATION IA 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