2017-08-07T13:17:41-05:00 2016-09-30 861065772 Deloitte Tax LLP Two Jericho Plaza Jericho NY 11753 990 2015-10-01 042790311 Baystate Medical Center Inc BAYS 4137940000 759 Chestnut Street Springfield MA 01199 Dennis W Chalke SVP Finance, CFO & Treasurer 4137940000 2017-08-04 1 Christine Kawecki P00743140 5169187000 2015 2021-01-29 14:40:06Z Dennis W Chalke 759 Chestnut Street Springfield MA 01199 1892730832 0 X www.baystatehealth.org X 1983 MA The mission of the organization is to improve the health of the people in our communities every day, with quality and compassion. 22 15 8252 446 4935059 -1443131 6983165 7376278 1058280813 1105390145 19795343 44858751 100029192 62528058 1185088513 1220153232 11263000 11422627 0 0 495512954 518014655 0 0 0 563141629 584840103 1069917583 1114277385 115170930 105875847 1261866305 1329927264 599937016 647980519 661929289 681946745 The mission of the organization is to improve the health of the people in our communities every day, with quality and compassion. 0 0 510445658 11422627 572442421 Inpatient healthcare services - Providing inpatient community-based medicine and tertiary care to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY16, Baystate Medical Center, Inc. provided 197,609 patient days of inpatient services, with 41,142 discharges. 376260197 365944847 Outpatient healthcare services - Providing outpatient clinical services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY16, Baystate Medical Center, Inc. had 421,059 outpatient visits. 41220616 38581269 Emergency department services - Providing emergency department services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY16, Baystate Medical Center, Inc. had 114,774 emergency department visits. 109023415 177459950 109023415 177459950 1036949886 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 1 0 1 567 0 1 8252 1 1 1 0 0 0 0 0 0 0 0 0 X 22 15 1 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 1 1 MA X Peter Lyons Baystate Health Inc 4137940000 759 Chestnut Street Springfield MA 01199 X Adrian J Levsky Trustee (as of 1/1/16) 1.00 1.00 X 0 0 0 Anne M Paradis Vice Chair 1.00 2.00 X 0 0 0 David C Southworth Trustee 1.00 1.00 X 0 0 0 Edward J Noonan Trustee 1.00 1.00 X 0 0 0 Grace Makari-Judson MD Trustee / Hematologist 1.00 40.00 X 395012 0 91314 Gregory L Braden MD Trustee 1.00 1.00 X 0 0 0 Harriet A DeVerry Trustee 1.00 1.00 X 0 0 0 Hector Toledo Trustee 1.00 1.00 X 0 0 0 James P Sadowsky Chair 1.00 2.00 X 0 0 0 James R Phaneuf Trustee 1.00 1.00 X 0 0 0 John A Egelhofer MD Trustee 1.00 1.00 X 0 0 0 John F Maybury Trustee 1.00 1.00 X 0 0 0 John H Davis Trustee 1.00 1.00 X 0 0 0 John M O'Brien III Trustee (Through 12/31/15) 1.00 1.00 X 0 0 0 Katherine McG Sullivan Trustee (Through 12/31/15) 1.00 1.00 X 0 0 0 Kathleen B Scoble Trustee 1.00 1.00 X 0 0 0 Kevin P Moriarty MD Trustee/Chief Ped Surg 1.00 40.00 X 634583 0 46896 Mark A Keroack MD Trustee 1.00 40.00 X 0 1258998 213008 Paul R Murphy Trustee 1.00 1.00 X 0 0 0 Richard B Steele Jr Trustee (Through 12/31/15) 1.00 1.00 X 0 0 0 Robert J Bacon Trustee 1.00 1.00 X 0 0 0 Robert L Pura PhD Trustee 1.00 1.00 X 0 0 0 Steven M Mitus Trustee 1.00 1.00 X 0 0 0 Victor Woolridge Trustee 1.00 1.00 X 0 0 0 William McGee MD Trustee 50.00 0.00 X 366050 0 60325 Dennis Chalke Treasurer 10.00 40.00 X 0 1085400 89529 Kristin R Delaney Clerk 1.00 39.00 X 0 109755 31677 Madeline Torres Assistant Clerk 1.00 40.00 X 0 53103 16597 Nancy Shendell-Falik President 40.00 10.00 X 0 582157 151908 Betty K Larue VP Heart& Vascular (thru 11/15) 40.00 10.00 X 202991 63257 50216 Christine Klucznik VP/ CNO (As of 11/2015) 50.00 1.00 X 178339 51349 27294 Michael F Moran VP Facilities (Thru 1/29/16) 10.00 40.00 X 260746 0 48415 David Y Chin Rad Oncology Med Physics 50.00 0.00 X 269309 0 42537 Deborah A Provost VP Surg,Anesth/ Neuro 50.00 0.00 X 259249 0 83219 Douglas Salvador MD VP Medical Affairs 50.00 0.00 X 337959 0 32663 Michael Albert MD Mdir OR & Surgical Units 50.00 0.00 X 290419 0 75959 Peter Lindenauer MD Med Dir & Qual & Safety 50.00 0.00 X 313309 0 60498 Mark R Tolosky President Emeritus, BH 0.00 0.00 X 0 745184 80519 3507966 3949203 1202574 470 1 1 1 Baystate Administrative Services Inc 759 Chestnut Street Springfield MA 01199 Management Svcs. 84649907 Baystate Medical Practices Inc 759 Chestnut Street Springfield MA 01199 Medical, Educ, Clin 59891391 Baystate Health Inc 759 Chestnut Street Springfield MA 01199 Strategic Initiatives 11263000 Shields Specialty Pharmacy of Springfiel 1200 Hancock St 300 Quincy MA 02169 Management Svcs. 3888811 Sound Physicians 1123 Pacific Avenue Tacoma WA 98402 Management Svcs. 2350781 5 5224724 2151554 7376278 Inpatient Revenue 900099 604991541 604991541 Outpatient Revenue 621400 490711854 485878507 4833347 Sponsored Programs 900099 7777519 7777519 Intercompany Rent 900099 1909231 1909231 1105390145 9412957 9412957 1012224 473479 538745 538745 538745 707467754 82161 672045996 58125 35421758 24036 35445794 35445794 Intercompany Charges 900099 23418046 23418046 Pharmacy Service 900099 18731548 18731548 Cafeteria Income 900099 6619160 6619160 13220559 11722095 101712 1396752 61989313 1220153232 1154428487 4935059 53413408 X 11388273 11388273 34354 34354 766162 766162 310536 310536 418232506 382238673 35993833 17653107 16303813 1349294 49002711 44788362 4214349 32049633 29258368 2791265 43854414 40504703 3349711 1363395 1363395 586109 586109 85947 85947 111887658 104620821 7266837 310845 304442 6403 273301443 264066373 9235070 58948522 58381463 567059 31265669 29225285 2040384 1410774 1212196 198578 1891183 1699882 191301 8074891 8074891 49450987 43189252 6261735 2401029 1340962 1060067 Bad Debt Expense 7237 7237 1114277385 1036949886 77327499 0 82882571 83626766 108012112 115397066 194580561 192566171 23416617 25078010 13113792 18494260 1121575622 767971491 349443493 353604131 279421681 297344100 94285592 126663114 1550827 1551527 115159059 115602119 1261866305 1329927264 101607373 116311186 987606 774412 372914819 385906539 10381610 21170869 114045608 123817513 599937016 647980519 X 646414982 666777448 11287449 10889020 4226858 4280277 661929289 681946745 1261866305 1329927264 X 105875847 -576949 -85281442 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 85947 85947 0 Part II-B, Line 1-i Baystate Medical Center, Inc. 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 dues listed as lobbying expenses for the year ending September 30, 2016 is $85,947. 12369482 12369482 461925185 246053132 215872053 6540781 2138313 4402468 606242482 496736716 109505766 34497692 23043330 11454362 353604131 2061323 C Securities other 121052423 C Securities real estate 3549368 C 126663114 Contractual Adjustment Receivable 16374328 Due From Affiliated Companies 67930965 Beneficial Interest in Net Assets of BHF 15169297 Funds Held - Bond Indenture 15108960 Board Designated - Due From Unrestricted Funds 1018569 115602119 Contractual Adjustments Payable 29874401 Due to Affiliated Companies 8383621 Insurance Liability Loss Reserves 8489450 Minimum Pension Liability 71756536 Market Value Swap 5156431 Refundable Advances 157074 123817513 Schedule D, Part V Certain 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). 1 1 1 X 1 X 1 1 1 0 1 1 16153658 5722169 10431489 0.00940 231717282 203581981 28135301 0.02520 1479714 1457011 22703 0.00000 249350654 210761161 38589493 0.03460 2408905 0 2408905 0.00220 57465412 16937745 40527667 0.03640 18599510 10826752 7772758 0.00700 21269774 14061200 7208574 0.00650 458251 0 458251 0.00040 100201852 41825697 58376155 0.05250 349552506 252586858 96965648 0.08710 1 5711304 1942384 260251458 220564528 39686930 X 1 1 1 1 Baystate Medical Center Inc 759 Chestnut Street Springfield MA 01199 2339 X X X X X X Baystate Medical Center Inc 1 0 0 1 X X X X X X X X X X 15 1 1 1 1 X See Part V X See Part V X X 1 12 1 See Part V 0 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X X X 1 X https://www.baystatehealth.org/patients/billing-and-financial-assistance X https://www.baystatehealth.org/patients/billing-and-financial-assistance X X X 1 X 0 X X X X 1 X 0 0 Baystate Medical Center, Inc. Part V, Section B, Line 3j: The impact of actions taken to address the significant health needs identified in the hospital facility's prior 2013 CHNA. Baystate Medical Center, Inc. Part 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 CBAC Co-chair, Franklin Regional Council of Governments (FRCOG)-Wilson, Gloria, Member Western MA Black Nurses Association-Wood, Ben, Healthy Community Design Coordinator, MA Dept. of Public Health Baystate Medical Center, Inc. Part V, Section B, Line 6a: In 2016, in partnership with the Coalition of Western MA Hospitals/Insurer, the hospital facility conducted a community health needs assessments ("CHNA") of the geographic area served by the hospital facility. The Coalition of Western Massachusetts Hospitals/Insurer ("Coalition"), a partnership between nine (9) not-for-profit hospitals and an insurer in Western Massachusetts that includes: Baystate Medical Center, Baystate Franklin Medical Center, Baystate Noble Hospital, Baystate Wing Hospital, the former Baystate Mary Lane Hospital (now part of BWH and known as the Baystate Mary Lane Outpatient Center), Holyoke Medical Center, Cooley Dickinson Hospital, Mercy Medical Center (part of the 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 Medical Center, Inc. Part V, Section B, Line 6b: The Coalition of Western MA Hospitals and Insurer engaged Partners for a Healthier Community ("PHC"), based in Springfield, MA, as the lead consultant to conduct the CHNA's. PHC was supported by two other consultant teams; Community Health Solutions, based in Northampton, MA and Pioneer Valley Planning Commision (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 Medical Center, Inc. Part 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 Medical Center, Inc. Part V, Section B, Line 11: The 2016 CHNA was conducted using a determinant of health framework as it is recognized that social and economic determinants of health contribute substantially to population health. It has been estimated that less than a third of our health is influenced by our genetics or biology. Our health is largely determined by the social, economic, cultural, and physical environments that we live in and healthcare we receive.The hospital facility anticipates health needs and available resources may change, therefore, a flexible approach was adopted in the development of its implementation strategy. For example, certain community health needs may become more pronounced and require changes to the initiatives identified by the hospital in the Strategy. Other community organizations may address certain needs, indicating that the hospital's strategies should be refocused on alternative community health needs or assume a different focus on the needs identified in the 2016 CHNA.Hospital resource inputs that will help address priority health needs include, Community Benefits Investments, Community Relations Investments, Better Together Grant Program, Community Education & Training, hospital-based community benefits activities, external grants received by hospital, and other hospital-based program/services.The hospital facility views a community benefits implementation strategy as a "LIVING" document. Due to the evolving climate in health care, the hospital's financial health year to year remains unknown; therefore hospital resources and inputs may increase, decrease, or need to be modified. The hospital's implementation strategy work plan provides an opportunity for the hospital to be strategic and focused, yet flexible in its community health planning and improvement efforts. The hospital facility, in partnership with its Community Benefits Advisory Council updates the work plan with annual outputs and outcomes for each input and activity.No health care system or hospital facility can address all the health needs present in its community. The hospital facility is committed to adhering to its mission and remaining financially healthy so that it can continue to enhance its clinical excellence and patient experience, as well as continue community health planning and improvement efforts. The hospital facility's implementation strategy does not explicitly address all the priority community health needs identified in the 2016 CHNA due to; 1. the hospital's limited resources (time, talent and financial), 2. other hospitals or community organizations within service area are addressing the need; 3. the need falls outside of the hospitals' mission or limited resource capacity. However, many, if not all of the CHNA priority health needs will be addressed INDIRECTLY by the hospital and/or community partners through existing community health planning and improvement efforts.Needs being addressed:-Basic needs, including housing -Care coordination-Community safety-Cultural humility -Health equity-Institutional racism-Insurance challenges-Limited availability of providers -Maternal/infant/child health -Mental health and substance use disorders-Physical activity and healthy diet -Transportation Needs not being addressed: -Chronic health conditions-Environmental concerns-Food deserts/insecurity-Health literacy-Sexual health Baystate Medical Center, Inc. Part 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. Baystate Medical Center offers a co-payment discount program for the patients receiving services in the emergency department of the hospital. 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 Baystate Medical Center'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 Medical Center, Inc. Part V, Section B, Line 15e: Baystate Medical Center (BMC) 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 BMC bills as well as about BMC 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, BMC 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. BMC has contracted with the Executive Office of Health and Human Services and the Commonwealth Health Insurance Connector Authority to serve as a Certified Application Couselor 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 10a 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. Form 990, Schedule H, Part V, Line 7 Line 7a: Hospital facility's website: https://www.baystatehealth.org/about-us/community-programs/community-benefits/community-health-needs-assessmentLine 7b: Other website:http://www.cbsys.ago.state.ma.us/cbpublic/public/annual_reports_start.aspx 23 1 - Baystate Reference Laboratories 361 Whitney Avenue Holyoke MA 01040 Outpatient Laboratory Services 2 - Baystate High Street Hlth Cntr 140 High Street Springfield MA 01105 Outpatient Facility 3 - Baystate Ambulatory Care Center 3300 Main Street Springfield MA 01107 Outpatient Physician Offices 4 - Baystate Mason Sq Neighborhood Hlth Ctr 11 Wilbraham Road Springfield MA 01199 Outpatient Clinic 5 - Baystate Breast and Wellness Center 100 Wason Avenue Suite 300 Springfield MA 01107 Outpatient Facility 6 - Baystate Brightwood Health Center 380 Plainfield Street Springfield MA 01107 Outpatient Clinic 7 - D'Amour Center for Cancer Care 3350 Main Street Springfield MA 01199 Outpatient Cancer Center 8 - Baystate Rehabilitation Care at Spfld 360 Birnie Avenue Springfield MA 01107 Rehabilitation Clinic 9 - BMC Pain Management Center 3400 Main Street 2nd Flr Springfield MA 01107 Outpatient Facility 10 - Baystate Orthopedic Surgery Cntr 50 Wason Avenue 2nd Floor Springfield MA 01107 Outpatient Surgery Center 11 - Baystate Vascular Services 3500 Main Street 2nd Floor Springfield MA 01107 Outpatient Facility 12 - Baystate Heart & Vascular ProgImaging 10 Main Street Basement Level Florence MA 01060 Outpatient Facility 13 - Baystate Rehabilitation Care 294 North Main Street East Longmeadow MA 01028 Rehabilitation Clinic 14 - Baystate Rehabilitation Care Rymd Ctr 470 Granby Rd Ste 4 South Hadley MA 01075 Rehabilitation Clinic 15 - Baystate Rehabilitation Care 200 Silver St Ste 101 Agawam MA 01001 Rehabilitation Clinic 16 - Baystate Regional Cancer Program Davis Blding 85 South St 4th Fl Ware MA 01082 Outpatient Cancer Center 18 - Baystate Home Infusion & Resp Svcs 211 Carando Drive Springfield MA 01004 Home infusion & resp srvcs & durable medical goods 19 - Baystate Home Infusion & Resp Svcs 489 Bernardston Road Suite C Greenfield MA 01301 Home infusion & resp srvcs & durable medical goods 20 - Baystate Home Infusion & Resp Svcs 85 South Street D101 Ware MA 01082 Home infusion & resp srvcs & durable medical goods 21 - Baystate Children's Specialty Center 50 Wason Avenue 1st Floor Springfield MA 01107 Outpatient Facility 22 - Baystate Specialty Pharmacy 298 Carew Street Springfield MA 01104 Outpatient Facility 23 - Baystate Child Hospitalziation Prog 150 Lower Westfield Road Suite 3 Holyoke MA 01040 Outpatient Facility 24 - Baystate Imaging & Transplant Services 100 Wason Avenue Ground Floor Suite 21 Springfield MA 01107 Outpatient Facility Part I, Line 6a: The hospital facility files an annual community benefit report electronically with the Massachusetts Office of the Attorney General's via their website at http://www.cbsys.ago.state.ma.us/cbpublic/public/annual_reports_start.aspx. The hospital facility's annual community benefit 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 & Benefit Operations) - Community Health Improvement Services calculations are derived from direct and indirect costs associated with community benefit activities that are aligned with the hopital'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 7f (Health Professional Education) - community benefit expense was derived using the organization's cost accounting system.Line 7g (Subsidized Programs) - community benefit expense was derived using the organization's cost accounting system. The expense relates to specific outpatient programs. There are no costs attributable to physician clinics reported as subsidized health services in Part I, line 7g.Line 7h (Research) - community benefit expense was derived using the organization's cost accounting system. In addition to the research costs reported on line 7h, there was $1,061,432 of expenses related to Industry-sponsored grants that we believe should be treated as community benefit expense because they were incurred to promote the health and well-being of the local population and are a key component of our commitment to the community. 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). The 2016 provision for bad debts totaled $15,121,791 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 federal mandated community benefit programs and services are not sufficent to address ethnic, racial and economic health disparities and inequities. The hospital embraces the traditional definition of "health" to include economic opportunity, affordable hoousing, 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 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 boards that align with our mission. The hospital facility provided $116,974 as a Payment in Lieu of Taxes (PILOT) to the City of Springfield for our outpatient facility at 3300 Main Street and $204,662 as a Payment in Lieu of Taxes (PILOT) to the City of Springfield for our facilities at 3400 Main Street & 11 Wilbraham Road. Baystate Medical Center provided $37,564 as a Payment in Lieu of Taxes (PILOT) to the City of Chicopee for our employee parking lot located at Center Street, Chicopee. The hospital facility is a dues paying member of the Economic Development Council of Western Massachusetts (EDC) and the Springfield Regional Chamber of Commerce. The hospital participates in the EDC and local Chamber as we are the largest employer in our region. 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, totalling $1,942,384, 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 inpatient psych), D Part V (outpatient) and E Part A (organ acquisition) of the hospital's 2016 Medicare cost report, net of Medicare costs reported in Part 1, line 7g, and based on Medicare costing principles. There is no shortfall reported on line 7. 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 a 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 priorities. The CBAC provides a community perspective on how to increase wellness and resilience opportunities for optimal health for an entire population; guidance in matching hospital resources to community resources in meeting its goal to improve health status and quality of life; and policy advocacy to assure and restore health equity by targeting resources for residents. Participants on the hospital CBAC represent constituencies and communities served by the hospital. CBAC members are responsible for reviewing community needs assessment data and use this analysis as a foundation for providing the hospital with input on its community benefits planning process. Part VI, Line 3: Baystate Medical Center (BMC) 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. BMC recognizes that 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. BMC 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 BMC.Baystate Medical Center recognizes that 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 BMC 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.Baystate Medical Center 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 Baystate Medical Center. BMC 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. BMC is committed to ensuring that patients or prospective patients in the community are aware of financial assistance programs. For uninsured or underinsured patients, BMC will assist in applying for available financial assistance programs. BMC 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, BMC also assists patients in applying for coverage of services as a Medical Hardship based on the patient's documented income and allowable medical expenses. BMC 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 BMC's own internal financial assistance program. BMC 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 Medical Center'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 about the availability of financial assistance programs at the hospital are translated into Spanish, because Spanish is primarily spoken by 10% or more of the residents in the hospital's service area. Signs are large enough to be clearly visible. Hospital signs are 8.5 x 11 inches and the header print font is 24 pts. Notice of availability of Financial Assistance Programs are posted in the following locations; inpatient, clinic, emergency department admissions and/or registration areas, central admission/registration area, patient financial counselor areas and business office areas that are open to patients. Part VI, Line 4: Baystate Medical is a 716-bed academic medical center (including Baystate Children's Hospital) based in Springfield, Massachusetts and is Western New England's only tertiary care referral medical center, Level 1 trauma center, and neonatal and pediatric intensive care units. Baystate Medical serves as a regional resource for specialty medical care and research, while providing comprehensive primary medical services to the community.The service area for Baystate Medical 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 (around 270,000 people). Smaller, suburban communities exist to the east and west of this central core area. Many of these communities have populations under 20,000 people. Urban areas, as defined by the U.S. Census Bureau consist of census tracts and/or blocks meeting the minimum population density requirement (2,500-49,999 for urban clusters and over 50,000 for urbanized areas) or are adjacent and meet additional criteria. The service area has more racial and ethnic diversity than many other parts of western Massachusetts. County-wide, 22% of the population identifies as Hispanic or Latino, 9% Black or African American, and 2% as Asian (ACS, 2010-2014). However, this diversity is not equally spread throughout the region and tends to be concentrated in the urban core. The Pioneer Valley Transit Authority, the second largest public transit system in the state, serves 11 communities in the service area and connects suburban areas to the core cities and services. Paratransit service is also available for people with disabilities within 3/4 mile of a fixed route to facilitate access to medical care. Economically, the Baystate Medical 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. At the same time, the county struggles with higher rates of unemployment and poverty, lower household incomes and lower rates of educational attainment as compared to the state. The median household income in the service area is about $50,000 ($17,000 less than the state) (ACS 2010-2014). The poverty rate is more than 5% higher than that 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 26% of the population age 25 and over has a bachelor's degree. Unemployment is somewhat higher than the state average. The unemployment rate is based on the number of people who are either working or actively seeking work. 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. Part VI, Line 5: The hospital facility has a responsibility to respond to health care needs unsupported by government programs. In exchange for this responsibility, the hospital qualifies for tax-exempt status under 501(c)(3). However, providing hospital care alone is not enough to qualify for tax-exempt status. Hospitals also must operate in the public interest and provide programs that benefit the community. The hospital is fully committed to its role in the community and serves with pride and compassion for people in need.The charitable mission of the hospital facility, a member hospital of Baystate Health (BH), is to improve the health of the people in our communities every day, with quality and compassion. The hospital's Community Benefits Mission is to reduce health disparities, promote community wellness and improve access to care for vulnerable populations. The hospital is committed to meeting the identified health and wellness needs of constituencies and communities served through the combined efforts of Baystate Health's member organizations, affiliated providers, and community partners.The hospital facility meets all of the factors required of medical facilities in order to maintain tax exemption, as first described in Revenue Ruling 69-545. In support of patient care and the medical needs of the communities served by the hospital, medical staff membership and privileges are extended to all qualified physicians and practitioners in western Massachusetts who meet the requirements for credentialing and clinical privileges, whether employed by a related Baystate entity or community-based. The hospital's emergency department is open to all in need of care and services; no one requiring emergency care is denied treatment. In addition, surplus funds from operations are generally applied, as permitted, to the following; improvements in patient care, expansion and renovation of existing facilities, purchase and replacement of equipment, debt service, expenses associated with training of physicians and other health care professionals, professional development of medical and other clinical staff, and the support of scientific, translational, and clinical research.Baystate Health's volunteer Board of Trustees, the governing body of the organization and its affiliates, is comprised of the President and Chief Executive Officer of Baystate Health and up to twenty-two (22) other elected Trustees who are representative of the broad range of interests which exist in the communities served by Baystate Health and its affiliates. The Governance Committee oversees the nomination of Trustees and submits recommendations to the Board of Trustees for membership on the various Board committees. In considering nominations or recommendations for trustees, directors, committee members or officers the Governance Committee select nominees who are representative of the various and diverse constituencies served by Baystate Health and its affiliates. In particular the Committee nominates persons who are representative of the community consumer interests of the various neighborhoods and localities which are served by Baystate Health and its affiliates in the carrying out of and pursuant to the charitable mission of the Baystate Health and its affiliates.The hospital's Patient and Family Advisory Council facilitate patients and families to share information and advise the hospital regarding policies and programs. Information from the Council provides hospital leadership with an enhanced understanding of how to improve quality, program development, service excellence, communications, patient safety, facility design, patient and family education, patient and family satisfaction, and loyalty.Please refer to the section above in line 2 for additional examples of the hospital's responsiveness to the community and opportunities for community involvement; including the Board of Trustees' Governance Committee, Community Benefits Advisory Council, and Community Health Needs Assessment. For additional information, please see Line 6 below. Part VI, Line 6: Baystate Health, Inc. is the parent entity of a multi-institutional integrated delivery system composed of four hospitals and other 501(c)(3) organizations. The four hospitals include Baystate Medical Center, Baystate Franklin Medical Center, Baystate Noble Hospital, and Baystate Wing Hospital (and Baystate Mary Lane Outpatient Center) and the other 501(c)(3) organizations include Baystate Medical Practices, Visiting Nurse Association and Hospice of Western New England, Inc., and Baystate Health Foundation. In September 2016, the Massachusetts Public Health Council approved Baystate Wing Hospital's application to merge Baystate Mary Lane Hospital and Baystate Wing Hospital and their respective satellite facilities under one hospital license. Baystate Mary Lane Hospital, now referred to as 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 6 continued The Nurse Residency Program expanded to all Baystate Health hospitals. In partnership with Vizient and American Association of Colleges of Nursing, Baystate welcomed 57 nurse residents this year, providing both advanced curricular activities and fellowship activities to ease the transition from school to practice. Baystate's Nurse Residency Program is a one-year curriculum for newly graduated registered nurses, offering hands-on clinical experience, in-depth learning through monthly seminars, participation in evidence-based projects, and ongoing professional development.Baystate Health is committed to continuing education programs in 30 different professional areas through partnerships with Elms College, Springfield College, Western New England University, STCC, Greenfield Community College, Holyoke Community College, Westfield State University, and many others. Our post graduate programs expanded to 10 medical residencies and 20 fellowships, including new fellowship training programs in hospital medicine and gastroenterology. In addition, Baystate Medical Center welcomed 1,770 new residents, fellows, medical students, nursing students, and allied health students.Research at Baystate Health continued to grow. Baystate Medical Practice faculty members received $7.41M in external funding. Baystate Health researchers received 41 new research awards valued at over $4.4M. Noteworthy new grant activity occurred in the following areas:-Assessing the impact of early pulmonary rehabilitation for chronic obstructive pulmonary disease-Improving antibiotic prescribing for patients with community-acquired pneumonia-Studying the environmental determinants of breast cancer-Advancing the care of neonates born with opioid dependency-Training primary care providers in principles of geriatric medicine-Using evidence-based psychotherapy in the care of pediatric victims of psychological trauma-Coordinating the care of complex illness in pediatricsBaystate Health and its affiliates are committed to providing the communities they serve throughout western Massachusetts with the resources necessary to stay informed and healthy by providing both basic and extensive educational opportunities such as parent education classes, including "Baystate's New Beginnings". Also offered are breastfeeding classes, a "Just for Dads" class, Prenatal/Postnatal Yoga and infant/toddler safety classes. We also offer Babysitter's Academy, which provides a full day class for teens. Some classes are free while others are offered at a reasonable fee. No one is turned away due to inability to pay. Baystate Health offers many free parenting support groups including breastfeeding gatherings, new parents groups, toddler groups, parents of multiples groups, and a MotherWoman support group. Most of these groups meet weekly. In addition, Baystate Health has a health science library staffed by professionals who help patients, families and the general public access reliable health information.The Mini-Medical School program is an eight-part health education series offered at Baystate Medical Center featuring a different aspect of medicine each week. Designed for an adult audience, each course is taught by an energetic faculty member who will explain the science of medicine without resorting to complex terms. Mini-Medical School gives Baystate Health the opportunity to open our doors to the public and share our knowledge of medicine in a comfortable and friendly environment. Many of the students participate due to a general interest and later find that many of the things they learned over the semester are relevant to their own lives. The goal of this program is to help members of the public make more informed decisions about all aspects of their health care while receiving insight on what it's like to be a medical student. Tuition is $95 per person, $80 for Senior Class and Spirit of Women members. Baystate Health offers 50+ free programs to seniors and women. Baystate Health Senior Class is a loyalty program dedicated to health and wellness for men and women ages 55 and over. The 23,000 Senior Class members receive a quarterly newsletter with valuable health information, benefits and invitations to special events designed with their interests in mind. Baystate Spirit of Women Loyalty Program offers its 15,000 members 50+ monthly seminars with direct access to physicians, nurses and other medical professionals and the latest women's health information. The program is designed to increase knowledge of women's health issues so they are well prepared to make the best decisions regarding their health.The Mark R. Tolosky Baystate Neighbors Program, named in honor of our past President and CEO, provides forgivable loans to Baystate Health employees purchasing their first homes in the communities surrounding our hospitals. Qualified employees are granted a forgivable loan up to $7,500 that may be used towards a down payment or closing costs. In 2016, Baystate Health granted 50 loans to employees. Since 1999, Baystate Health has invested over $1.6 million in the futures of more than 220 employees and their families.Since its inception in 1994, Rays of Hope has been helping women and men in the fight against breast cancer by walking alongside them on their cancer journey. Through the Baystate Health Breast Network, Rays of Hope cares for the whole person from diagnosis and beyond by supporting research at the Rays of Hope Center for Breast Cancer Research, providing funding for state-of-the-art equipment, breast health programs and outreach and education throughout Baystate Health as well as providing grants for complementary therapies and cancer programs to our community partners throughout western Massachusetts. Now in its 24th year, Rays of Hope has raised over $13.7 million - all of which has been awarded locally throughout western Massachusetts.The United Way develops and supports programs that directly improve the lives of people in our communities, a mission proudly shared by Baystate Health. Baystate Health is a strong supporter of the United Way, and a major contributor to the organization with workforce campaigns and thousands of employee donors and volunteers. Baystate Health's contributions help the United Way serve our families, friends, colleagues and others who seek help in different ways and at different times in their lives. Three community campaigns are held annually: Springfield, Westfield, and Palmer workplace to support the United Way of Pioneer Valley, Greenfield workplace to support the United Way of Franklin County and Ware workplace to support the United Way of Hampshire County. Employees can direct their donations to one or all of the United Way's action areas: Education, Income and Health or designate to a qualified agency with a minimum contribution. See also additional information regarding Baystate Health, Inc. and its affiliates promotion of community health above in Line 5. Form 990, Schedule H, Part VI, Line 7 List of States Receiving Community Benefit Report: MA 1 Cancer Connection Inc 41 Locust Street Northampton MA 01060 043493483 501(c)(3) 41075 Support groups, complementary therapies, workshops and classes for women living with breast cancer and their families and caregivers. La Experanza The Hope of the Pioneer Valley Inc PO Box 6820 Holyoke MA 010416820 272760538 501(c)(3) 31818 Latino breast cancer support program. Baystate Health Inc 759 Chestnut Street Springfield MA 01199 042105941 501(C)(3) 11263000 Strategic initiatives Pioneer Valley Riverfront Club 121 West Street Springfield MA 01104 260251831 501(c)(3) 17000 Breast cancer survivors dragon boat team. YMCA of Greater Springfield 275 Chestnut Street Springfield MA 01104 041859893 501(c)(3) 15635 Breast cancer survivors excercise program. CHD Cancer House of Hope Inc 1999 Westfield Street West Springfield MA 01089 042503926 501(C)(3) 19745 Funding expenses of the most well-attended CHH programming utilized by women with breast cancer. 6 Art therapy workshops for breast cancer survivors 1 11340 Reiki for breast cancer patients and survivors in Franklin County 1 8175 Yoga and water dance for breast cancer survivors 1 8130 Water fitness classes for women with breast cancer 1 5009 Provide comfort pillows to help women after a surgical procedure 1 1700 Part I, Line 2: Explanation: The Rays of Hope grants that are awarded are reviewed and approved by the Rays of Hope Community Advisory Board. Recipients are required to submit a Community Program Grant Application. As part of the application process the recipient is required to provide their SS# or T.I.N. Once the grant is awarded by the Advisory Board quarterly reports are submitted by the recipient to monitor the grant. A final report of the grant program and budget summary is due upon completion of the program. X X X 1 1 0 0 0 0 0 0 0 Grace Makari-Judson MD Trustee / Hematologist 299974 0 64558 0 30480 0 56254 0 35060 0 486326 0 0 0 Kevin P Moriarty MD Trustee/Chief Ped Surg 502996 0 96018 0 35569 0 27825 0 19071 0 681479 0 0 0 Mark A Keroack MD Trustee 0 760075 0 310077 0 188846 0 192620 0 20388 0 1472006 0 90766 William McGee MD Trustee 324787 0 12905 0 28358 0 57919 0 2406 0 426375 0 0 0 Dennis Chalke Treasurer 0 466083 0 357889 0 261428 0 64000 0 25529 0 1174929 0 0 Nancy Shendell-Falik President 0 436797 0 116688 0 28672 0 125008 0 26900 0 734065 0 0 Betty K Larue VP Heart& Vascular (thru 11/15) 193320 24538 0 37398 9671 1321 33399 0 15352 1465 251742 64722 0 0 Christine Klucznik VP/ CNO (As of 11/2015) 176715 21070 0 30079 1624 200 18691 0 8229 374 205259 51723 0 0 Michael F Moran VP Facilities (Thru 1/29/16) 223365 0 32663 0 4718 0 33520 0 14895 0 309161 0 0 0 David Y Chin Rad Oncology Med Physics 243062 0 12577 0 13670 0 27825 0 14712 0 311846 0 0 0 Deborah A Provost VP Surg,Anesth/ Neuro 209256 0 36444 0 13549 0 74718 0 8501 0 342468 0 0 0 Douglas Salvador MD VP Medical Affairs 278609 0 58718 0 632 0 17372 0 15291 0 370622 0 0 0 Michael Albert MD Mdir OR & Surgical Units 265806 0 22188 0 2425 0 57088 0 18871 0 366378 0 0 0 Peter Lindenauer MD Med Dir & Qual & Safety 260205 0 31851 0 21253 0 37368 0 23130 0 373807 0 0 0 Mark R Tolosky President Emeritus, BH 0 263594 0 150000 0 331590 0 66319 0 14200 0 825703 0 138300 Part I, Line 3 The 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. This committee consists entirely of individuals serving on the board of Baystate Health, Inc. The individuals responsible for deliberating the compensation arrangement for the President and CEO would be those individuals who do not have a conflict of interest with respect to the compensation arrangement and would be considered independent for compensation deliberation purposes. The compensation of the President and CEO is established based on information provided by independent third party consultants for reasonableness and appropriate comparability data. The compensation is then established, reviewed and approved by the duly authorized compensation committee of Baystate Health, Inc. and all such deliberations and decisions are documented contemporaneously. Part I, Lines 4a-b 4a Mark R. Tolosky received $138,300. 4b Dennis W. Chalke - Supplemental Retirement of $171,159 is included in column E. This amount was earned and paid in 2015. Mark A. Keroack, MD - Supplemental Retirement of $328,081 is included in column E. This amount consists of $237,315 earned and paid in 2015 and $90,766 that was previously reported as deferred compensation in prior years Forms 990, and that is currently reported as taxable income. The amount is listed in Column F in accordance with reporting requirements. Peter Lindenauer, MD - Supplemental Retirement of $6,383 is included in column E. This amount was earned and paid in 2015. Grace Makari-Judson, MD- Supplemental Retirement of $14,673 is included in column E. This amount was earned in 2015. William T. McGee, MD - Supplemental Retirement of $13,828 is included in column E. This amount was earned and paid in 2015. Michael F. Moran - Supplemental Retirement of $3,989 is included in column E. This amount was earned and paid in 2015 Kevin P. Moriarty, MD - Supplemental Retirement of $32,279 is included in column E. This amount was earned and paid in 2015. Douglas Salvador, MD- Supplemental Retirement of $4,122 is included in column E. This amount was earned in 2015. Nancy Shendell-Falik- Supplemental Retirement of $107,783 is included in column E. This amount was earned in 2015. Mark R. Tolosky - Supplemental Retirement of $101,139 is included in column E. This amount was earned and paid in 2015. A MA Health & Educ Facil Authority - Ser G 042456011 57586CNHA 2005-10-27 71740000 MA HEFA Series G - See Part VI 0 0 0 B MA Health & Educ Facil Authority - Ser H 042456011 2007-01-18 10000000 MA HEFA Series H - See Part VI 0 0 0 C MA Health & Educ Facil Authority - Ser M2 042456011 2008-06-30 10157671 MA HEFA Series M2 - See Part VI 0 0 1 D MA Health & Educ Facil Authority - Ser IJK 042456011 57586EKC4 2009-06-25 198611250 MA HEFA Series IJK - See Part VI 0 0 0 A 31775000 71740000 735004 6990000 64014996 2005 0 1 1 1 B 6444445 10000000 72250 9927750 2006 0 0 1 1 C 4294471 10157671 57800 10099871 1999 1 0 1 1 D 199122425 1845403 93479 132183543 65000000 2012 1 0 1 1 A 0 0 1 1 1 1 0.00010 0.00000 0.00010 0 0 1 B 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 D 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 1 1 Citibank 20.700000000000 0 0 0 0 1 B 0 0 1 0 1 0 0 0 1 C 0 0 0 1 1 0 0 0 1 D 0 0 0 1 1 0 0 0 1 A 1 B 1 C 1 D 1 Date Rebate Computation Performed Issuer Name: MA Health & Educ. Facil. Authority - Ser. G Date the Rebate Computation was Performed: 09/27/2006 Issuer Name: MA Health & Educ. Facil. Authority - Ser. M2 Date the Rebate Computation was Performed: 06/18/2013 Issuer Name: MA Health & Educ. Facil. Authority - Ser. IJK Date the Rebate Computation was Performed: 08/24/2012 Bond Issues Supplemental Information A - MHEFA Series G Bonds Part I - Per the Official Statement, the purpose of the bond proceeds is: (i) to advance refund $61,930,000 principal amount of the Authority's Revenue Bonds, Baystate Medical Center (the Institution) Issue, Series E (the "Series E Bonds"), which were issued July 11, 1996 to finance or refinance the following property owned by the Institution: (a) construction of a new 104,500 gross square foot Ambulatory Care Center at 3300 Main Street, Springfield, Massachusetts; (b) construction of a new 100,000 gross square foot building to house the Ambulatory Surgery Center, Medical Library and education/conference space on the Institution's North campus located at 759 Chestnut Street, Springfield, Massachusetts; (c) renovation of various existing spaces within the Institution's North campus; and (d) acquisition of equipment for the new facilities; (ii) to finance routine capital construction, renovations, and equipping of various facilities of the Institution; and (iii) to pay certain costs of issuance of the Series G Bonds. B- MHEFA Series H Bonds Part I - Per the Official Statement, the purpose of the bond proceeds is: (i) the construction, improvement, equipping, and other related capital expenditures of a parking garage walkway, and other related work at an existing building at 280 Chestnut Street owned and used by the Institution, and (ii) the acquisition and installation of capital equipment and renovations to existing facilities of the Institution and other routine capital expenditures in connection with the Institution's hospital operations. C- MHEFA Series M-2, Pool 2 Part I - Per the Loan Document the purpose of the bond is to refinance Baystate Medical Center's MHEFA Pool J-2 Loan, which was issued February 2, 1999 to finance the acquisition and equipping of the property located at 280 Chestnut Street, Springfield, Massachusetts (the "Property"), and the renovation of the Property and existing facilities of the Institution and the acquisition of capital equipment for the Institution's existing facilities. The MHEFA indebtedness listed is a pool loan; therefore the issue price, Parts I, II, III, and IV (Lines 5-7) are being answered with respect to the Baystate Medical Center loan alone rather than with respect to proceeds loaned to other conduit borrowers. The actual date of issue of the MHEFA Series M2 Bonds was 5/30/2002, and the CUSIP number shown on Form 8038 was 57585KA57. While that issue was not a refunding issue, the purpose of the loan taken by BMC was to refund prior debt, as reflected in our response to Part II, Line 14. Accordingly, Part III has not been completed, as the original project was financed with bonds issued prior to 2003. D- MHEFA Series I, J-1, J-2, K-1, K-2 Part I - Per the Official Statement, the purpose of the bond proceeds is: (i) to pay a portion of the costs associated with the acquisition of land, site development, construction or alteration of buildings or the acquisition or installation of furnishings and equipment, refinancing of, or any combination of the foregoing, in connection with the construction, improvement, equipping, and other related capital expenditures of a seven-story, approximately 599,100 gross square foot primarily inpatient building located at 759 Chestnut Street, Springfield, Massachusetts, including demolition and site work, which building will be constructed by Baystate Total Home Care (BTHC) and leased to Baystate Medical Center by BTHC; (ii) for the acquisition and installation of capital equipment and renovations to existing facilities of the Medical Center and other routine capital expenditures included or to be included in the Medical Center's capital budget over the next three years for use in connection with the Medical Center's hospital operations; (iii) for the refinancing of a portion of an outstanding commercial loan in the amount of $65,000,000 made by Bank of America, N.A. on October 20, 2008 to the Medical Center in connection with the defeasance of the Authority's Revenue Bonds, Baystate Medical Center Issue, Series D, issued September 16, 1993; (iv) for the financing of costs associated with the issuance of bonds and; (v) financing of routine capital construction, renovations, and equipping of various facilities of Baystate Medical Center. E - MDFA Revenue Bonds, Series L Part I - Per the Official Statement, the purpose of the bond proceeds is for the construction, improvement, and other capital expenditures relating to the build-out of an equipping of certain interior space within a seven-story approximately 599,100 gross square foot primarily inpatient building owned by Baystate Total Home Care, Inc. and leased to the Institution located at 759 Chestnut Street, Springfield, Massachusetts, such build-out to consist of space to be used for the Emergency Department of the Institution and ancillary support areas and the financing costs associated with the issuance of the bonds. F - MDFA Tax Exempt Capital Lease Part I - Per the Master Lease and Sublease Agreement, the purpose of the Tax Exempt Capital Lease is for the Acquisition of Equipment. "Equipment" means the fixed and moveable personal property to be used in connection with the Sub-Lessee's health care operations identified in a Schedule executed by or pursuant to the Agency of the Lessee and the Sub-Lessee, accepted by the Lessor and acknowledged by the Escrow Agent in writing and identified as part of this Master Lease (including certain items originally financed through internal advances of the Sub-Lessee in anticipation of obtaining permanent financing through the Lessee), together with all replacement parts, additions, repairs, accessions, and accessories incorporated therein and/or affixed to such personal property and replacements and substitutions therefor and proceeds and products thereof. G - MDFA Revenue Bonds Series M - Part I - The purpose of the bond proceeds is: (i) to advance refund $39,907,339 principal amount of Massachusetts Health and Education Facilities Authority's Revenue Bonds, Baystate Medical Center (the Institution) Issue, Series F (the "Series F Bonds"), issued June 12, 2002 the proceeds of which financed the Construction of a new Cancer Center with a partial third floor medical record and support area; acquisition of a surgery center facility, certain renovations and equipment acquisitions; and (ii) finance costs of issuance relating to the Bond. H - MDFA Revenue Bonds Series N - Part I - The purpose of the bond proceeds is: (i) capital expenditures, including capitalized interest, in connection with the following projects (the "Project"); a) the build-out of and equipping of certain interior space within a seven-story, approximately 599,100 gross square foot primarily inpatient building owned by BTHC and leased to Baystate Medical Center located at 759 Chestnut Street, Springfield, Massachusetts, such build-out to include inpatient rooms, operating rooms, and inpatient pharmacy, and b) the acquisition of medical equipment, information technology equipment, and other equipment and assets to be owned or leased and used by the Medical Center at the Medical Center's health care facilities located at 759 Chestnut Street, Springfield, Massachusetts, 3300,3350,3400 and 3601 Main Street, Springfield, Massachusetts and 50, 80, and 100 Wason Avenue, Springfield, Massachusetts, and (ii) costs of issuance relating to the Bonds. Part I and Part II, Differences between the issue price (Part I) and total proceeds (Part II, Line 3) are due to investment earnings. Part III, Lines 4 and 5, Column D (Series IJK): As the refunded bonds were issued prior to January 1, 2003, this question is being answered solely with respect to the new money portion of the bonds. Part III, Column G (Series M): As these bonds refunded debt issued prior to January 1, 2003, the organization is availing itself of the Part III reporting exemption available for such bonds. Part IV, Line 2c, Column C (Series M-2): The Issuing Authority engages an outside consultant to prepare rebate computations. As of the most recent computation period, May 29, 2012 no rebate was owed. The cumulative rebate amount is zero as of the outside consultant's most recent report. Part IV, Line 6, Column A (Series G): This question is being answered without regard to yield-restricted advance funding escrow financed with proceeds of the bonds. A MA Development Finance Agency - Ser L 043431814 2011-11-02 25000000 MA DFA Series L - See Part VI 0 0 0 B MA Development Finance Agency - Cap Lease 043431814 2011-11-02 20000000 MA DFA Cap Lease - See Part VI 0 0 0 C MA Development Finance Agency - Ser M 043431814 2012-08-09 40137000 MA DFA Series M - See Part VI 0 0 0 D MA Development Finance Agency - Ser N 043431814 57583UN79 2014-11-06 60742119 MA DFA Series N - See Part VI 0 0 0 A 2640900 25022063 168438 24853625 2012 0 0 1 1 B 13478767 20013326 20013326 2012 0 0 1 1 C 4535000 40137000 229661 39907339 2004 1 0 1 1 D 60786025 753513 59953438 18872920 2016 0 0 0 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 0 1 0 1 0 0 0 1 C 0 0 1 0 1 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 A MA Development Finance Agency - Ser O 043431814 000000000 2016-05-12 20000000 MDFA Series O-see Part VI 0 0 0 B MA Development Finance Agency - Cap Lease 043431814 000000000 2016-09-22 14062890 MDFA CoGen Lease - See Part VI 0 0 0 A 280987 20000000 20000000 2016 0 0 1 1 B 14062924 14062924 0 0 0 1 A 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 John M O'Brien III Family member of John M. O'Brien 45014 See Part V - Family member of John M. O'Brien employed by the filing organization. 0 James R Phaneuf CIC Family member of James R. Phaneuf, CIC 53940 See Part V - Family member of James R. Phaneuf CIC is employed by the filing organization. 0 Dennis W Chalke Family member of Dennis W. Chalke 12911 See Part V - Family member of Dennis W. Chalke employed by the filing organization. 0 Hector Toledo Family member of Hector Toledo 106643 See Part V - Family member of Hector Toledo employed by the filing organization. 0 Form 990, Part VI, Section A, line 1 The filing organization has a standing executive committee, which is entitled to act between meetings of the Board, on all matters as to which the Board is entitled to act and permitted by law to delegate to a committee. The members of the executive committee are the same individuals serving on the executive committee of Baystate Health, Inc. Form 990, Part VI, Section A, line 2 Robert J Bacon, Gregory L. Braden, MD, Dennis W. Chalke, John H. Davis, Kristin R. Delaney, Harriet A. Deverry, John A. Egelhofer, MD, Tejas Gandhi, Mark A. Keroack, MD, Christine Klucznik, Adrian Levsky, Grace P. Makari-Judson, MD, John F. Maybury, William Mcgee, MD, Betty K. Larue, Steven M. Mitus, Michael Moran, Kevin P. Moriarty, MD, Paul R. Murphy, Edward Noonan, John M. O'Brien, III, Anne M. Paradis, James Phaneuf, CIC, Donald F. Pion, Robert L. Pura, PhD, Timothy S. Rice, James P. Sadowsky, Kathleen B. Scoble, David C. Southworth, Richard B. Steele, Jr., Katherine McG. Sullivan, Hector Toledo, Mark R. Tolosky, Madeline Torres, Howard G. Trietsch, MD, 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. Maybury, Michael F. Moran, Anne M Paradis Form 990, Part VI, Section A, line 3 Baystate Medical Center, Inc. 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 6 The filing organization has one member, Baystate Health, Inc. (BH). Form 990, Part VI, Section A, line 7a The Board of Trustees of the filing organization 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 11 Prior to the filing of this return appropriate parts of this Form 990 were reviewed by representatives from the Tax, Finance, and Human Resources Departments of Baystate Health, Inc. (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 12c Baystate Health, Inc. (BH) and its affiliated entities have a comprehensive conflict of interest policy applicable to all of the affiliated entities. 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 Chief Compliance Officer, Chief Executive Officer, Chair of the Board of Trustees, and the Chair of the Audit & Compliance Committee. A summary of the conflict of interest disclosures is provided to the Baystate Health Board of Trustees and the Tax Department and reviewed by outside counsel. Potential conflict of interest transactions are reviewed as appropriate under the policy, which provides for recusal from discussion and deliberation by any party with a potential conflict of interest. Form 990, Part VI, Section B, line 15 The compensation of the President and CEO is reviewed and determined annually by the compensation committee of Baystate Health, Inc. (The parent organization of the health care system to which the filing organization belongs), which has been appointed through board resolution as the compensation committee of the filing organization. This committee consists entirely of individuals serving on the board of the filing organization. The individuals responsible for deliberating the compensation arrangement for the President and CEO would be those individuals who do not have a conflict of interest with respect to the compensation arrangement and would be considered independent for compensation deliberation purposes. The compensation of the President and CEO is established based on information provided by independent third party consultants for reasonableness and appropriate comparability data. The compensation is then established, reviewed and approved by the duly authorized compensation committee of Baystate Health, Inc. The compensation of other officers and key employees is administered under the Executive Compensation Philosophy Statement or the Baystate Health Board approved budget and wage program for each fiscal year. Line 15a has been answered No because the President and CEO is paid by Baystate Administrative Services, Inc., an affiliate and related organization of the filing organization. Form 990, Part VI, Section B, Line 16b Baystate Health, Inc. has a joint venture policy that covers affiliated tax exempt entities including Baystate Medical Center, Inc. Form 990, Part VI, Section C, line 19 The organization makes its conflict of interest policy and financial statements available to the public at www.baystatehealth.org. Articles of organization and bylaws are generally available at the Commonwealth of Massachusetts website. Form 990, Part VII, Section A, Line 5 Certain officers or trustees of the filing organization are paid by an entity, Baystate Medical Practices, Inc. (BMP) EIN 04-2888373, which is part of the health care system to which the filing organization belongs but does not meet the technical requirements as a "Related Organization" per Schedule R. Compensation from BMP to the officers and trustees of the filing organization therefore, is reported as paid from an unrelated organization in Line 5 and according to the instructions reported as though paid by the filing organization. Form 990, Part IX, line 11g BMP Support: Program service expenses 54,764,621. Management and general expenses 0. Fundraising expenses 0. Total expenses 54,764,621. Fees, Physicians: Program service expenses 7,743,587. Management and general expenses 0. Fundraising expenses 0. Total expenses 7,743,587. Fees, Laboratory & Clinical: Program service expenses 7,695,865. Management and general expenses 0. Fundraising expenses 0. Total expenses 7,695,865. Other: Program service expenses 34,416,748. Management and general expenses 7,266,837. Fundraising expenses 0. Total expenses 41,683,585. Form 990, Part XI, line 9: Transfer from affiliate for land, buildings and equipment 1,269,896. Transfer of funds for strategic initiative to affiliated companies -53,543,000. Transfer of funds for land, bldg. & equip. to affiliated companies 1,602,652. Minimum pension liability adjustment -34,660,414. Equity gain to unconsolidated affiliates -7,220. Change in value of interest in BHF-Temporarily Restricted -398,429. Change in value of interest in BHF-Permanently Restricted 53,419. Funds utilized for property and equipment 401,654. Pioneer Valley Information Exchange LLC 101 Wason Avenue Suite 200 Springfield MA 01107 042790311 Operation of a health information exchange and related activities MA Baystate Medical Center Inc Baystate Administrative Services Inc 759 Chestnut Street Springfield MA 01199 222747685 Administrative services MA 501 (c ) (3) 11c, IIIc Baystate Health Inc 0 Baystate Franklin Medical Center 164 High Street Greenfield MA 01301 042103575 Hospital MA 501 (c ) (3) 3 Baystate Health Inc 0 Baystate Health Foundation Inc 759 Chestnut Street Springfield MA 01199 043549011 Fundraising MA 501 (c ) (3) 7 Baystate Health Inc 0 Baystate Health Systems Inc Health & Welfare Benefits Plan 759 Chestnut Street Springfield MA 01199 222531644 Voluntary Employees' Benefit Association MA 501 (c ) (9) Baystate Health Inc 0 Baystate Health Inc 759 Chestnut Street Springfield MA 01199 042105941 Healthcare System Parent MA 501 (c ) (3) 7 Baystate Health Inc 0 Baystate Mary Lane Hospital Corporation 85 South Street Ware MA 01082 042103584 Hospital MA 501 (c ) (3) 3 Baystate Health Inc 0 Baystate Total Home Care Inc 280 Chestnut Street Springfield MA 01199 203260764 Real Estate and Other MA 501 (c ) (3) 11b, II Baystate Medical Center Inc 1 Visiting Nurse Assn and Hospice of Western New England Inc 50 Maple Street Springfield MA 01199 042105803 Homehealth and Hospice care MA 501 (c ) (3) 9 Baystate Health Inc 0 Health New England Inc Monarch Place Suite 1500 Springfield MA 011441590 042864973 HMO/Insurance MA 501 (c ) (4) Baystate Health Inc 0 Baystate Wing Hospital Corporation 40 Wright Street Palmer MA 01069 222519813 Hospital MA 501 (c ) (3) 3 Baystate Health Inc 0 HNE of Connecticut Inc Monarch Place Suite 1500 Springfield MA 011441590 455190134 HMO/Insurance CT 501 (c ) (4) Health New England Inc 0 Baystate Noble Hospital Corporation 115 West Silver Street PO Box 1634 Westfield MA 010861634 222537423 Hospital MA 501 (c ) (3) 3 Baystate Health Inc 0 Westfield Medical Corporation 115 West Silver Street PO Box 1634 Westfield MA 010861634 043127730 Physician Services MA 501 (c ) (3) 11a, I Baystate Noble Hospital Corporation 0 Noble Visiting Nurse Services Inc 77 Mill Street Westfield MA 01085 222757446 Home Health Care and Hospice MA 501 (c ) (3) 9 Baystate Noble Hospital Corporation 0 HNE Advisory Services Inc Monarch Place Suite 1500 Springfield MA 011441500 043012347 Administrative Services MA Health New England Inc C 0 HNE Insurance Services Inc Monarch Place Suite 1500 Springfield MA 011441500 043183019 Ancilliary Insurance MA Health New England Inc C 0 Ingraham Corporation 759 Chestnut Street Springfield MA 01199 043016257 Health care and other business activities MA Baystate Health Inc C 0 Baystate Health Insurance Company Ltd North Church Street Georgetown CJ 980421413 Offshore captive Insurance CJ Baystate Health Inc C 0 HNE Insurance Company Inc Monarch Place Suite 1500 Springfield MA 011441500 454462433 Health services for Massachusetts Medicare Supplement Members MA Health New England Inc C 0 HNE Holding Corporation Monarch Place Suite 1500 Springfield MA 011441500 464620480 Holding shares in subsidiary corporation MA Health New England Inc C 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 Baystate Total Home Care Inc J 10595282 Baystate Total Home Care Inc I 100010