BAYSTATE NOBLE HOSPITAL CORPORATION: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- BAYSTATE NOBLE HOSPITAL CORPORATION (EIN 22-2537423)
- Tax period
- 2014-10-01 to 2015-09-30
- Filed
- 2016-08-11
- IRS object ID
- 201612249349300346
- Schema version
- 2014v6.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-08-11T09:41:29-05:00 | ReturnTs |
| Tax Period End | 2015-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | Two Jericho Plaza | AddressLine1Txt |
| City | Jericho | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11753 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 222537423 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Baystate Noble Hospital Corporation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BAYS | BusinessNameControlTxt |
| Phone | 4135682811 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 115 West Silver Street | AddressLine1Txt |
| City | Westfield | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 010861634 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DENNIS W CHALKE | PersonNm |
| Person Title | SVP FINANCE, CFO & TREASURER | PersonTitleTxt |
| Phone | 4135682811 | PhoneNum |
| Signature | 2016-08-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Christine Kawecki | PreparerPersonNm |
| PTIN | P00743140 | PTIN |
| Phone | 5169187000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-12-15 16:53:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DENNIS W CHALKE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 115 West Silver Street | AddressLine1Txt |
| City | Westfield | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 010861634 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $59,087,628 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BAYSTATENOBLEHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1984 | FormationYr |
| Legal Domicile State | MA | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF THE ORGANIZATION IS TO IMPROVE THE HEALTH OF THE PEOPLE IN OUR COMMUNITIES EVERY DAY, WITH QUALITY AND COMPASSION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 24 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 18 | VotingMembersIndependentCnt |
| Total Employee | 641 | TotalEmployeeCnt |
| Total Volunteers | 167 | TotalVolunteersCnt |
| Total Gross UBI | $994 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,952,138 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,005,681 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $54,748,051 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $57,658,428 | CYProgramServiceRevenueAmt |
| PY Investment Income | $59,580 | PYInvestmentIncomeAmt |
| CY Investment Income | $38,499 | CYInvestmentIncomeAmt |
| PY Other Revenue | $280,901 | PYOtherRevenueAmt |
| CY Other Revenue | $234,636 | CYOtherRevenueAmt |
| PY Total Revenue | $57,040,670 | PYTotalRevenueAmt |
| CY Total Revenue | $58,937,244 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $29,778,531 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $30,428,473 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $25,756,726 | PYOtherExpensesAmt |
| CY Other Expenses | $27,725,502 | CYOtherExpensesAmt |
| PY Total Expenses | $55,535,257 | PYTotalExpensesAmt |
| CY Total Expenses | $58,153,975 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,505,413 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $783,269 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $26,052,963 | TotalAssetsBOYAmt |
| Total Assets EOY | $29,648,669 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $29,070,441 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $27,774,157 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$3,017,478 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,874,512 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The mission of the organization is to improve the health of the people in our communities every day, with quality and compassion. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $55,858,044 | ExpenseAmt |
| Revenue | $57,718,523 | RevenueAmt |
| Desc | 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 FY2015, Baystate Noble Hospital provided 17,253 patient days of inpatient services.Outpatient healthcare services - Providing outpatient clinical services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY2015, Baystate Noble Hospital had 71,016 outpatient visits.Emergency department services - Providing emergency department services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY2015, Baystate Noble Hospital had 28,743 emergency department visits. | Desc |
| Total Program Service Expenses | $55,858,044 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 147 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 641 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 24 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 18 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | John Shaver - Baystate Noble Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4135682811 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 115 West Silver Street | AddressLine1Txt |
| City | Westfield | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01085 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (50 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| James P Sadowsky | |||||||||
| Chair 7/1/2015-9/30/15 | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Robert J Bacon | |||||||||
| Chair through 6/30/15; Trustee | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Anne M Paradis | |||||||||
| Vice Chair 7/1/2015-9/30/15 | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Kevin Queenin | |||||||||
| Vice Chair 10/1/14-6/30/15 | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Robert L LaPalme | |||||||||
| Treasurer 10/1/14-6/30/15 | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Mark Morin | |||||||||
| Secretary 10/1/14-6/30/15 | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Donald Bieker | |||||||||
| Trustee 10/1/14-6/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Gregory L Braden MD | |||||||||
| Trustee 7/1/15-9/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Roger Butler | |||||||||
| Trustee 10/1/14-6/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Scott Cooper MD | |||||||||
| Trustee 10/1/14-6/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| John H Davis | |||||||||
| Trustee 7/1/15-9/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Harriet A DeVerry | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| John A Egelhofer MD | |||||||||
| Trustee 7/1/15-9/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Hon John Greaney | |||||||||
| Trustee 10/1/14-6/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| William Harmon | |||||||||
| Trustee 10/1/14-6/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Robin Jensen | |||||||||
| Trustee 10/1/14-6/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Carol Kauffman | |||||||||
| Trustee 10/1/14-6/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Mark A Keroack MD | |||||||||
| Trustee 7/1/15-9/30/15 | 1.00 | 49.00 | Yes (X) | $0 | $980,230 | $203,356 | |||
| Grace P Makari-Judson MD | |||||||||
| Trustee 7/1/15-9/30/15 | 1.00 | 49.00 | Yes (X) | $369,844 | $0 | $85,491 | |||
| John F Maybury | |||||||||
| Trustee 7/1/15-9/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Michael McCabe | |||||||||
| Trustee 10/1/14-6/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Steven M Mitus | |||||||||
| Trustee 7/1/15-9/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Kevin P Moriarty MD | |||||||||
| Trustee 1/1/15-9/30/15 | 1.00 | 49.00 | Yes (X) | $594,308 | $0 | $43,650 | |||
| Paul R Murphy | |||||||||
| Trustee 1/1/15-9/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Edward J Noonan | |||||||||
| Trustee 7/1/15-9/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| John M O'Brien III | |||||||||
| Trustee 7/1/15-9/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| David Peterson MD | |||||||||
| Trustee 10/1/14-6/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| James R Phaneuf | |||||||||
| Trustee 7/1/15-9/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Donald F Pion | |||||||||
| Trustee 10/1/14-6/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Robert L Pura PhD | |||||||||
| Trustee 7/1/15-9/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Craig Schacher MD | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Kathleen B Scoble | |||||||||
| Trustee 7/1/15-9/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| David C Southworth | |||||||||
| Trustee 7/1/15-9/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Richard B Steele Jr | |||||||||
| Trustee 7/1/15-9/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Deborah Strycharz | |||||||||
| Trustee 10/1/14-6/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Stanley Strzempko MD | |||||||||
| Trustee 10/1/14-6/30/15 | 50.00 | 0.00 | Yes (X) | $399,520 | $0 | $6,358 | |||
| Katherine McG Sullivan | |||||||||
| Trustee 7/1/15-9/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Hector Toledo | |||||||||
| Trustee 7/1/15-9/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Victor Woolridge | |||||||||
| Trustee 7/1/15-9/30/15 | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Ronald Bryant | |||||||||
| President | 40.00 | 10.00 | Yes (X) | $421,230 | $0 | $15,728 | |||
| Dennis W Chalke | |||||||||
| Treasurer 7/1/15-9/30/15 | 1.00 | 49.00 | Yes (X) | $0 | $929,051 | $79,645 | |||
| Kristin R Delaney | |||||||||
| Clerk 7/1/15-9/30/15 | 1.00 | 49.00 | Yes (X) | $0 | $107,000 | $29,470 | |||
| Madeline Torres | |||||||||
| Assistant Clerk 7/1/15-9/30/15 | 1.00 | 49.00 | Yes (X) | $0 | $28,799 | $7,703 | |||
| John C Shaver | |||||||||
| Chief Financial Officer | 40.00 | 10.00 | $233,038 | $0 | $9,647 | Yes (X) | |||
| Steven P Cummings | |||||||||
| CIO/VP of Operations | 40.00 | 10.00 | $208,027 | $0 | $12,357 | Yes (X) | |||
| John M Burke | |||||||||
| Director of Patient Financial Services | 50.00 | 0.00 | $171,190 | $0 | $7,001 | Yes (X) | |||
| Diane Brunelle | |||||||||
| VP Patient Care Services/CNO | 50.00 | 0.00 | $165,405 | $0 | $12,234 | Yes (X) | |||
| Hui-Wen Chia | |||||||||
| Pharmacist | 50.00 | 0.00 | $130,463 | $0 | $3,256 | Yes (X) | |||
| Sandra J Lortsher | |||||||||
| RN | 50.00 | 0.00 | $126,207 | $0 | $7,061 | Yes (X) | |||
| David A Rosinski | |||||||||
| Director of Engineering | 50.00 | 0.00 | $118,652 | $0 | $5,277 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,937,884 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,045,080 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $528,234 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 33 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Rehabcare Group East Inc | |||||
| PO Box 502096 | St Louis | MO | 631502096 | Physical Rehabilitation | $1,941,678 |
| Crothall Healthcare Inc | |||||
| 13028 Collection Center Drive | Chicago | IL | 60693 | Housekeeping Services | $746,435 |
| Morrison Healthcare Inc | |||||
| PO Box 102289 | Atlanta | GA | 303682289 | Dietary Services | $733,703 |
| Bay State Surgical Services LLC | |||||
| PO Box 96024 | Las Vegas | NV | 89193 | Surgical Services | $429,123 |
| Raymond R Houle Construction Inc | |||||
| 5 Miller Street | Ludlow | MA | 01056 | Construction Services | $309,377 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 27 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $67,647 | FundraisingAmt |
| Government Grants | $507,205 | GovernmentGrantsAmt |
| All Other Contributions | $430,829 | AllOtherContributionsAmt |
| Total Contributions | $1,005,681 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Hospital Revenue | 622000 | $57,443,102 | $57,443,102 |
| Rental Income From Affiliate | 531390 | $215,326 | $215,326 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $57,658,428 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $30,679 | TotalRevenueColumnAmt |
| Exclusion | $30,679 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $7,820 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $7,820 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,820 | TotalRevenueColumnAmt |
| Exclusion | $7,820 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $323,931 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $67,647 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $150,384 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $173,547 | TotalRevenueColumnAmt |
| Exclusion | $173,547 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Vendor Rebates | 900099 | $60,095 | $60,095 | |
| Yankee Alliance K-1 | $994 | $994 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $61,089 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $58,937,244 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $57,718,523 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $994 | UnrelatedBusinessRevenueAmt |
| Exclusion | $212,046 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,261,815 | TotalAmt |
| Program Services | $399,520 | ProgramServicesAmt |
| Management And General | $862,295 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,341,493 | TotalAmt |
| Program Services | $24,081,594 | ProgramServicesAmt |
| Management And General | $259,899 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $619,731 | TotalAmt |
| Program Services | $606,097 | ProgramServicesAmt |
| Management And General | $13,634 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,193,585 | TotalAmt |
| Program Services | $2,145,326 | ProgramServicesAmt |
| Management And General | $48,259 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,011,849 | TotalAmt |
| Program Services | $1,967,588 | ProgramServicesAmt |
| Management And General | $44,261 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $565,797 | TotalAmt |
| Program Services | $10,295 | ProgramServicesAmt |
| Management And General | $555,502 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $180,000 | TotalAmt |
| Management And General | $180,000 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,229 | TotalAmt |
| Management And General | $65,229 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,355,329 | TotalAmt |
| Program Services | $12,355,329 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $150,532 | TotalAmt |
| Program Services | $150,532 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $178,249 | TotalAmt |
| Program Services | $174,106 | ProgramServicesAmt |
| Management And General | $4,143 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $682,596 | TotalAmt |
| Program Services | $682,596 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,196,173 | TotalAmt |
| Program Services | $2,147,857 | ProgramServicesAmt |
| Management And General | $48,316 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,411 | TotalAmt |
| Program Services | $26,863 | ProgramServicesAmt |
| Management And General | $10,548 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,676 | TotalAmt |
| Program Services | $14,160 | ProgramServicesAmt |
| Management And General | $12,516 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $413,249 | TotalAmt |
| Program Services | $413,249 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,263,768 | TotalAmt |
| Program Services | $2,215,037 | ProgramServicesAmt |
| Management And General | $48,731 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $742,579 | TotalAmt |
| Program Services | $742,579 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $7,714,844 | $7,714,844 | |
| Dues | $153,070 | $10,472 | $142,598 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,153,975 | TotalAmt |
| Program Services | $55,858,044 | ProgramServicesAmt |
| Management And General | $2,295,931 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,750 | BOYAmt |
| EOY | $782,694 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $848,783 | BOYAmt |
| EOY | $572,481 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,647,248 | BOYAmt |
| EOY | $4,900,387 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $872,584 | BOYAmt |
| EOY | $912,464 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $255,199 | BOYAmt |
| EOY | $117,424 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $65,336,281 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $47,317,279 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,775,146 | BOYAmt |
| EOY | $18,019,002 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,418,253 | BOYAmt |
| EOY | $4,030,094 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,185,000 | BOYAmt |
| EOY | $314,123 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,052,963 | BOYAmt |
| EOY | $29,648,669 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,482,184 | BOYAmt |
| EOY | $15,757,105 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,422 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,893,331 | BOYAmt |
| EOY | $8,448,453 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,667,504 | BOYAmt |
| EOY | $3,568,599 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,070,441 | BOYAmt |
| EOY | $27,774,157 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$7,715,124 | BOYAmt |
| EOY | -$2,796,650 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,817,098 | BOYAmt |
| EOY | $3,790,614 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $880,548 | BOYAmt |
| EOY | $880,548 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$3,017,478 | BOYAmt |
| EOY | $1,874,512 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,052,963 | BOYAmt |
| EOY | $29,648,669 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $783,269 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $4,108,721 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $48,000 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | Yes (1) | RalliesDemonstrationsInd |
| Rallies Demonstrations | $17,229 | RalliesDemonstrationsAmt |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $65,229 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | The organization contracted directly with a consultant to assist in pursuing its government affairs objectives. This consultant was paid to perform lobbying and other public affairs work. Lobbying was conducted on various initiatives related to the delivery and financing of health care. In addition, the organization paid membership dues to the Massachusetts Hospital Association and to the American Hospital Association, both of whom have advised that portions of those dues were used for lobbying purposes. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,699,298 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $358,112 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $386,248 | OtherExpendituresAmt |
| End Year Balance | $4,671,162 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,169,914 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $805,052 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $275,668 | OtherExpendituresAmt |
| End Year Balance | $4,699,298 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,740,947 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $794,284 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $365,317 | OtherExpendituresAmt |
| End Year Balance | $4,169,914 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,300,943 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $598,094 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $158,090 | OtherExpendituresAmt |
| End Year Balance | $3,740,947 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributions | $3,300,943 | ContributionsAmt |
| End Year Balance | $3,300,943 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.18850 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.81150 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $962,598 | OtherCostOrOtherBasisAmt |
| Book Value | $962,598 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $34,258,128 | OtherCostOrOtherBasisAmt |
| Depreciation | $21,207,550 | DepreciationAmt |
| Book Value | $13,050,578 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $30,115,555 | OtherCostOrOtherBasisAmt |
| Depreciation | $26,109,729 | DepreciationAmt |
| Book Value | $4,005,826 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $18,019,002 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Accrued Pension Liability | $2,775,405 |
| Medical Malpractice Claims | $227,889 |
| Asset Retirement Obligation | $565,305 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,568,599 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D | FormAndLineReferenceDesc |
| Explanation | Entity was acuired on July 1, 2015 therefore there was a seperate audit performed for activity October 1, 2014 through June 30, 2015 resulting in two sets of audited financial statements for the full fiscal year. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Noble Ball | Event1Nm |
| Gross Receipts Event1 | $362,131 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $38,200 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $323,931 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $143,165 | OtherDirectExpensesEvent1Amt |
| Event2 | 5K | Event2Nm |
| Gross Receipts Event2 | $29,447 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $29,447 | CharitableContriEvent2Amt |
| Other Direct Expenses Event2 | $7,219 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $391,578 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $67,647 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $323,931 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $150,384 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $150,384 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $173,547 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | 0 | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $948,486 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $193,467 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $755,019 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01300 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,624,771 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,498,461 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,126,310 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01940 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $489,298 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $393,425 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $95,873 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,062,555 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,085,353 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,977,202 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03400 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $75,628 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $75,628 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $75,628 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $75,628 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,138,183 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,085,353 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,052,830 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03530 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,250 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,250 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,250 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,250 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,022,346 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $22,488,025 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $20,639,595 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $1,848,430 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Baystate Noble Hospital Corporation | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 115 West Silver Street | AddressLine1Txt |
| City | Westfield | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01086 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | State License #2076 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | Psychiatric and Physical Rehabilitation | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Baystate Noble Hospital Corporation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | Yes (1) | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | Please see narrative for website address | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 12 | ImplementationStrategyAdptYr |
| Strategy Posted Website | 0 | StrategyPostedWebsiteInd |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | 0 | ExplainedBasisInd |
| App Financial Asst Expln | 0 | AppFinancialAsstExplnInd |
| Includes Publicity Measures | 0 | IncludesPublicityMeasuresInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 2 | Baystate Noble Hospital (formally Noble Hospital) was acquired by Baystate Health, Inc. July 1, 2015. |
| Part V, Line 5 | In fall 2011, Noble Hospital and Holyoke Health Center HHC) collaborated on a project to conduct research and do preliminary planning for the development of a community health center serving the city of Westfield, Massachusetts. As part of this research, HHC contracted with Jessica Payne Consulting to complete a healthcare needs assessment using a qualitative research process to 1) identify significant populations, current health needs, available health services, and key providers and community resources; and 2) network, build relationships and identify key stakeholders for future planning and board development. Staff from HHC collaborated closely with principal researcher Jessica Payne in the project design and implementation. This report summarizes findings from the assessment research and should be read in conjunction with demographic data collected by HHC. The research for this report expands upon a preliminary needs assessment completed by Jessica Payne Consulting in spring 2010. Payne reconnected with many individuals contacted in the first study to obtain updated information on health status, needs, and access to and use of services. Additional contacts were made through in-person and phone meetings. Research was targeted to address specific low-income populations, providers, and health issues, including: Populations: New immigrants (Bhutanese, Burmese, Iraqi, Afghani); Latinos; Russians and Ukrainians; families with young children; adolescents; adults, seniors, veterans, homeless individuals. Health issues: Chronic disease; primary care; mental and behavioral health; women's health; insurance eligibility and enrollment.Contact was made with providers and community members in municipal, public, and private programs and organizations, schools, resettlement programs, housing agencies, community based social programs and services, and ethnic organizations. Informants made recommendations for other contacts, leading to a broad network of connections in various organizations throughout the city. Interviews were conducted in person or by phone using open-ended questions which were tailored to the expertise and experience of each informant. These open-ended questions, combined with follow up questions to elicit further elaboration, encouraged informants to speak in unstructured ways about their perspectives regarding the structure of organizations and programs, their subjective observations of populations and healthcare needs, and their experience of collaboration and partnership within the community. The resulting data was collated for common themes and concerns, and taken as a whole, reflects an interconnected network of providers and programs and recurring patterns of need, access, and utilization.The following organizations/community stakeholders were interviewed: Public Health Experts - Deb Mulvenna, Supervising Public Health Nurse, Westfield Board of Health - Jennifer Cochrane, Director, DPH Refugee and Immigrant Health Program - Sergut Wolde-Yohannes, Coordinator of Direct Client Services, DPH Refugee and Immigrant Health ProgramHealth or Other Departments or Agencies - Tina Gorman, Director, Westfield Council on Aging - Karen Noblit, SHINE, Senior Health Advisor, Westfield Council on Aging - Fran Aguda, Companion Program Coordinator, Westfield Council on Aging - Bob Callahan, Veteran's Agent, Westfield Veterans Service Office - Sally Popoli, Lead Nurse, Westfield School District - Barbara Lavoie, Nurse, Westfield High School - Karen Chaoush, Nurse, Westfield High School - Kathy Damon, Director, Carson Center - Dennis Manley, Community Service Agency Coordinator, Carson Center - Daniel Kelly, Executive Director, Westfield Housing Authority - Karen Casey, State Program Administrator, Westfield Housing AuthorityCommunity Leaders or Representatives Interviewe: - Lisa McMahon, Executive Director, Westfield Business Improvement District - Gail LaGasse, Director, Social Service Center, Salvation ArmyOther Interviewees Representing the Broad Interests of the Community - Hilda Colon, Personnel Department, City of Westfield - Jennifer Pappas, Nurse , Noble Hospital - Gail Szatrowski, Unified Life Education Supervisor, Westfield School District - Teresa A. Benedetti, Ph.D. District ELL Coordinator, Highland Elementary School - Connie Kelly, Volunteer Nurse, Westfield Free Clinic - Ann Lentini, Director, Domus, Inc - Donna Suckow, Domestic Violence Officer, Westfield Police Dept. - Dan Green, Nurse and Clinical Coordinator, Westfield Youth Service Center - Lily Pantus, Caseworker, Lutheran Social Services - Bandhu Adhikari, Employment Counselor, Lutheran Social Services - Mohamed Mohamed, New American Program Director, Jewish Family Services - Harith Mohammed, Refugee Medical Case Manager, Jewish Family Services - Luz Rodriquez, Social Service Center, Salvation Army |
| Part V, Line 6b | In fall 2011, Noble Hospital and Holyoke Health Center HHC) collaborated on a project to conduct research and do preliminary planning for the development of a community health center serving the city of Westfield, Massachusetts. As part of this research, HHC contracted with Jessica Payne Consulting to complete a healthcare needs assessment using a qualitativeresearch process to 1) identify significant populations, current health needs, available health services, and key providers and community resources; and 2) network, build relationships and identify key stakeholders for future planning and board development. Staff from HHCcollaborated closely with principal researcher Jessica Payne in the project design and implementation. |
| Part V, Line 11 | Per the Internal Revenue Service (IRS) and the Massachusetts Office of the Attorney General, each non-profit hospital must conduct a formal community health needs assessment (CHNA) every three-years in partnership with community organizations and individuals across the hospital's service area. The aim is to identify community assets as well as the critical gaps/needs in public health resources and the weak connections between medical care and community care. This "gaps analysis" assists Baystate Health's Board of Trustees, senior leaders and Baystate Noble Hospital in developing community benefit policy, which targets our charitable resources in focused areas. These areas frame existing community benefit programs, assist in transforming community service activities to comply with the IRS and MA Attorney General's criteria, and set priorities in the design of new programs. The CHNA is the basis for developing accountable community benefit programs. In an ideal situation, an effective and large scale community benefit program will demonstrate measurable community impacts on the health status and quality of life for residents - effectively closing gaps when current data is compared to initial CHNA baseline indicators. At a more practical program level, the CHNA guides a "theory of change" - linking health needs to community benefit efforts to desired program and community outcomes. BNH's CHNA began by identifying the community served by the hospital. Findings are based on qualitative research and analyses regarding target populations and health-related needs. The research for this report expands upon a preliminary needs assessment completed by Jessica Payne Consulting in spring 2010. Payne reconnected with many individuals contacted in the first study to obtain updated information on health status, needs, and access to and use of services. Additional contacts were made through in-person and phone meetings. Research was targeted to address specific low-income populations, providers, and health issues, including: - Populations: New immigrants (Bhutanese, Burmese, Iraqi, Afghani); Latinos; Russians and Ukrainians; families with young children; adolescents; adults, seniors, veterans, homeless individuals. - Health issues: Chronic disease; primary care; mental and behavioral health; women's health; insurance eligibility and enrollment.The list that follows describes the health needs identified throughout the assessment as priorities in the community served by Baystate Noble Hospital. 1. Primary Pediatric And Adult Care2. Dental Health3. Mental And Behavioral Health4. Addiction5. Coordinated CareNo community hospital facility can address all of the health needs present in its community. BNH is committed to adhering to its mission and remaining financially healthy so that it can continue to enhance its clinical excellence and to provide quality community benefit programs. The hospital has limited resources and is not explicitly addressing the priority health needs identified in the 2012 CHNA due to no new funding or resources, other hospitals or community organizations within service area are already addressing the need or the need falls outside of the hospital's mission or capacity. However, by becoming part of the Baystate Health system, there are system level and centralized resources available to BNH to assist them in further identifying opportunities to more explicitly address priority health needs. |
| Part V, Line 7A | The CHNA report can be found at the following site: http://baystatenoblehospital.org/about/needs-assessment/ |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Baystate Noble Hospital Sports & Rehab | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 74 Main Street | AddressLine1Txt |
| City | Westfield | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01086 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | Physical Rehabilitation Outpatient Clinic | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 6a: | Baystate Noble Hospital files an annual community benefits report electronically with the Massachusetts Attorney General's office via their website at http://www.cbsys.ago.state.ma.us/cbpublic/public/hccbindex.aspx. Baystate Noble Hospital's annual community benefits report is available to the public via the Massachusetts Attorney General's website (see above) and via Baystate Health's website http://www.baystatehealth.org. Our community benefits report provides the Attorney General's Office and the general public important information about how Baystate Noble Hospital partners with our communities to identify and address unmet health needs of disadvantaged and vulnerable populations in support of our charitable mission. |
| 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 by applying the ratio of patient care cost to charges, calculated on Worksheet 2, against inpatient and outpatient gross charges for Medicaid and Medicaid managed care plans.Line 7c (Other Means-Tested Programs) - community benefit expense was derived by applying the ratio of patient care cost to charges, calculated on Worksheet 2, against inpatient and outpatient gross charges for other means-tested government programs.Line 7e (Community Health Improvement Services) - calculations are derived from direct and indirect costs associated with community benefit activities that are aligned with the hospital's 2012 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. |
| Part I, Ln 7 Col(f): | In fiscal year 2013, the organization adopted the provisions of Accounting Standards Update 2011-07, Health Care Entities (Topic 954), Presentation and disclosure of Patient Service Revenue, Provision for Bad Debts, and the Allowance for Doubtful Accounts for Certain Health Care Entities on October 1, 2012. The update changed how the provision for bad debts is reported on the audited financial statements. In prior years it was included with total operating expenses, and subtracted from total expenses reported in Part IX, Line 25, column (A) for the purpose of calculating the percentages in Part I, Line 7, column (f). In 2015, the provision for bad debts was reported as a deduction to net patient service revenue. The 2015 provision for bad debts totaled $3,177,142 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: | Part II: Specific to Part II Baystate Noble Hospital paid $3,250 to the Greater Westfield Chamber of Commerce. BNH participates in the Chamber as we are one of the largest local employers in our service area. The Chamber and its membership coordinate activities toward a common purpose of sustainability and economic growth.The following description is not quantified specifically in Part II of Schedule H. Baystate Noble Hospital is committed to creating healthier communities and understands that many state and federally mandated community benefit programs and services are not sufficient to address ethnic, racial and economic health disparities. BNH extends the traditional definition of "health" to include economic opportunity, affordable housing, quality education, safe neighborhoods, food security, arts/culture, and racism and homophobia free communities - all elements that are needed for individuals, families and communities to thrive. In keeping with our commitment to improve health, Baystate Noble Hospital provides many valuable services, resources and programs beyond the walls of the hospital and into the communities and homes of the people we serve; including community sponsorships and involvement of hospital employees with not-for-profit boards that align with our mission. |
| Part III, Line 4: | The cost of bad debts reported in Part III, line 2 was calculated by applying the ratio of patient care cost to charges, calculated on Worksheet 2, against total patient bad debt net of recoveries as reported in the audited financial statements. The portion of bad debt that reasonably could be attributable to patients who may qualify for financial assistance under the hospital's charity care program (reported in Part III line 3) was calculated by applying the percentage of bad debts by zip code (for which the average household income for each zip code is less than 200% of the federal poverty level) to the total cost of bad debt reported in Part III line 2. Since this portion of bad debt is attributable to patients residing in an area where the average income is less than 200% of the Federal poverty level, it is highly likely these patients would have qualified for the organization's charity care program had they applied. For this reason, we believe the amount, totaling $74,895, 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 12 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. |
| Part III, Line 8: | Line 6 - included all Medicare allowable costs as calculated in Worksheets D-1 Part II (inpatient) and D Part V (outpatient) of the hospital's 2015 Medicare cost report, based on Medicare costing principles. We believe the shortfall reported should be treated as community benefit expense for tax reporting purposes because providing care for the elderly is a key component of our commitment to the community. The unreimbursed expenses should be treated similarly to unreimbursed Medicaid since the majority of the local elderly population is not affluent. |
| Part III, Line 9b: | All patient bills and statements contain language referencing available free care programs. |
| Part VI, Line 2: | Baystate Health's Board of Trustees and Baystate Noble Hospital leadership are actively involved in overseeing community benefits activities and expenditures. In July 2010, the Baystate Health Board of Trustees assigned oversight of community benefits to the Board's Governance Committee. Through its regular board meetings, internal hospital meetings and leadership activities, Baystate Health is actively involved in shaping community benefits provided by the system. For FY 2015 the system's Vice President for Public Health and Community Relations, under the direction of the Sr. Vice President for Strategy & External Relations, supervised the Community Benefits Manager. In addition, the Manager worked collaboratively with the Vice President of Community Development to oversee the hospitals' community benefits planning, community health needs assessments, annual program data collection, and state and federal reporting of community benefits. The Baystate Health Board Governance Committee meets minimally two times per year and is charged with advocating for community benefits at the Board level and throughout the health system; aligning the five (5) hospital-specific community benefits implementation strategies into the health system's strategic plan; periodic review of community health needs assessment data; approval of a community benefits mission statement and health priorities; review impact of community benefits programs in promoting health of the community; and ensure community benefits programs 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. In 2016, Baystate Noble Hospital will begin the planning phase of building a Community Benefits Advisory Council (CBAC). A CBAC brings a community lens and filter for interpreting findings of a community health needs assessment and priority setting process. The CBAC provides a community perspective on how to increase wellness and resilience opportunities for optimal health for an entire population; guidance in matching Baystate Noble Hospital resources to community resources, thus making the most of what is possible with the 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 a CBAC for Baystate Noble Hospital will represent employees, community benefits activity managers and Hampden County constituencies and communities that the hospital serves. CBAC members will be 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 Noble Hospital (BNH) 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. BNH 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. BNH 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 BNH.Baystate Noble Hospital 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 BNH 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 Noble Hospital has Financial Counselors available to help patients apply for financial assistance programs that may cover unpaid hospital bills, including a variety of federal and state programs as well as financial assistance through Baystate Noble Hospital. BNH 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. BNH is committed to ensuring that patients or prospective patients in the community are aware of financial assistance programs. For uninsured or underinsured patients, BNH will assist in applying for available financial assistance programs. BNH 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, BNH also assists patients in applying for coverage of services as a Medical Hardship based on the patient's documented income and allowable medical expenses. BNH 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 BNH's own internal financial assistance program. BNH also notifies patients about available payment plans based on their family size and income. Signs are large enough to be clearly visible. Baystate Noble Hospital's sign is 8-1/2 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.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 Noble Hospital'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. |
| Part VI, Line 4: | Baystate Noble Hospital, located in Westfield, Massachusetts, is a 97-bed facility with a broad range of services to the Greater Westfield community. Services include intensive care, diagnostic imaging, emergency services, cardiopulmonary services and rehab, cancer services, lab and behavioral health.For FY 2015 BNH's ethnic mix of inpatient & outpatient patients included 92.97% White; 5.08% Hispanic; 1.57% Black; 0.37% Asian, 0.01% Native American, 0.01% Native Hawaiian/Pacific Islander. BNH's payer mix of patients included 61.65% Medicare; 17.2% Medicaid; 14.53% Managed Care; 3.36% Non-Managed Care; 3.26% Other. In FY 2015 BNH had 3,305 inpatient discharges and 25,464 emergency service visits. Payer mix for ED visits included 24.19% Medicaid; 3.20% Free Care; 11.60% Healthnet; 2.11% Commonwealth Care; 58.89% Other. |
| Part VI, Line 5: | Baystate Noble Hospital has a responsibility to respond to health care needs unsupported by government programs. In exchange for this responsibility, BNH qualifies for tax-exempt status under 501(c)(3). However, providing hospital care alone is not enough to qualify for tax-exempt status. Hospitals also must operate in the public interest and provide programs that benefit the community. Baystate Noble Hospital is fully committed to its role in the community and serves with pride and compassion for people in need.The charitable mission of Baystate Noble Hospital, a member hospital of Baystate Health (BH), is to improve the health of the people in our communities every day, with quality and compassion. Baystate Noble Hospital's Community Benefits Mission is to reduce health disparities, promote community wellness and improve access to care for vulnerable populations. BNH 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.Baystate Noble Hospital 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 Baystate Noble 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. Baystate Noble 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.Please refer to the section above in line 2 for additional examples of Baystate Noble 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 five hospitals and other 501(c)(3) organizations. The five hospitals include Baystate Medical Center, Baystate Franklin Medical Center, Baystate Mary Lane Hospital, Baystate Noble Hospital, and Baystate Wing Hospital 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 2014 Baystate Wing Hospital became part of the Baystate Health system. Additionally, in July 2015, Baystate Noble Hospital became part of the Baystate Health System. In addition to its nearly 12,500 employees, Baystate Health has 1,504 medical staff, 2,428 nurses and 2,274 new residents and fellows, medical students, nursing students, and allied health students who gained comprehensive medical education during the year. In addition, 541 volunteers donated 48,205 hours to Baystate Medical Center; 320 volunteers and auxiliary members donated over 30,000 hours to Baystate Franklin Medical Center; 32 volunteers donated 3,600 hours to Baystate Mary Lane Hospital; 75 volunteers donated 6,000 hours to Baystate Wing Hospital. Baystate Medical Center (BMC), the flagship 710-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. BMC's community benefit efforts included providing assessment, treatment and crisis support to child abuse victims and their non-offending caretakers affected by child abuse and domestic violence in western Massachusetts, offering enrichment and career development programs for disadvantaged Springfield students, ensuring cohesive health care for school-aged children and the broader community, prevention of accidental childhood injuries and death through public awareness, safety education and distribution of safety devices, coordination of health education focus groups, community health forums and fairs, supporting transgender individuals, their allies and anyone from the broader community who identifies as LGBT through a peer lead and psychosocial support group, providing TB diagnosis and treatment to patients throughout western Massachusetts, and providing financial counseling services to inpatient and outpatient individuals who have concerns about how to pay for care. 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. BFMC's community benefit efforts included the ongoing support group through the Franklin County Postpartum Partnership - a partnership initiated by BFMC nurses; expanded senior outreach program to focus on persons most at-risk for hospital readmission due to issues with medication management; and continued the regionally recognized Blood & Guts program for youth, including an annual hospital-based event for high school students and three school-based events for elementary school students and their families. In addition, BFMC HealthBeat TV, a monthly 30-minute cable access talk show produced, directed and hosted by Baystate Franklin employees, engages the hospital's physicians, employees, patients and community leaders in discussions of interest to residents of Franklin County. Topics range from heart health, emergency response to senior outreach. The program runs more than 60 times a month on stations throughout the county.Baystate Mary Lane Hospital (BMLH), a 25-bed facility located in rural Ware, Massachusetts (20 miles east of Springfield) provides quality patient care services to communities in Hampshire, Hampden and Worcester counties. Inpatient services include critical care and medical-surgical care. Outpatient services include cancer care, cardiology, children's medicine, emergency medicine, endocrinology and diabetes, gastroenterology, infectious disease, obstetrics and gynecology, orthopedics, physical medicine and rehabilitation, pulmonary medicine, senior care, surgery, urology, and women's health. BMLH's community benefit efforts included a continued partnership with Quality EMT Educators of Worcester to offer Basic EMT Training to community members. To date over 100 community members have taken the EMT Basic Course. BMLH physicians shared their expertise beyond the walls of the hospital by offering high quality training and continuing education programs at no cost to EMS providers in our communities. The close working relationship between Emergency Physicians and EMS providers is essential to ensuring that patients receive the highest quality care in the field. BMLH provided critical support and resources to the community at large through our Support Groups including; Alcoholic Anonymous, Caregivers Support Group, Quilting Support Group for those touched by Cancer, Diabetes Support Group, Grieving Support Group, Hepatitis C Support Group & WIC Sponsored Breast Feeding Support Group. In addition, BMLH and its staff offered over 100 outreach programs providing a variety of education and wellness seminars to the community at large at no cost. These programs were presented by physicians, nurses and staff that work at the hospital and addressed ways to live healthier by offering a variety of educational opportunities and health screening. Lectures and screenings were offered at the hospital and in community settings including area schools and senior centers, and promoted disease prevention, behavior change, and healthier lifestyles for community members of all ages. In addition, BMLH HealthBeat TV, a monthly 30-minute cable access talk show produced, directed and hosted by Baystate Mary Lane Hospital employees, engages the hospital's physicians, employees, patients and community leaders in discussions of interest to residents of the 15-town Quaboag Hills region. Topics range from winter health safety, cancer, Lyme's disease to stroke awareness. The program runs more than 60 times a month.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. BWH's community benefit efforts include community outreach and education, support for Belchertown/Palmer Public Health Nurse, financial counseling, and support groups. |
| Part VI, Line 7, Reports Filed With States | MA |
| 6. Affiliated Health Care System (continued) | 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, BMLH, 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 2015 BMP provided $2,373,564 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. (BVNAH) based in Springfield, Massachusetts is a tax-exempt, not-for-profit corporation organized to support and assist Baystate Health and its affiliate hospitals, including BMC and BMLH, 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. BVNAH is a comprehensive home health care agency committed to providing the highest quality care to patients and families, primarily in the home setting. BVNAH has the expertise to meet individual needs by bringing experienced nurses, rehabilitation therapists, social workers and home care aides to patients' homes. The Home Care Program of Baystate's Visiting Nurse Association and Hospice serves over 6,950 home health and hospice patients annually of which approximately 995 are on service daily. Home Care services are aimed at allowing patients to recuperate and achieve independence with their own care in the comfort of their homes. The Hospice and Palliative Care Program of Baystate's Visiting Nurse Association and Hospice provides end of life care for patients in the community, assisted living facilities and skilled nursing facilities. Hospice has an interdisciplinary approach using nursing, social work, chaplains, hospice aides and volunteers to provide patients and their families with comfort and symptom management. The Hospice and Palliative Care program coordinates care for an average daily census of about 170 patients of all ages. In FY 2015 there were approximately 110,000 home health, hospice and palliative visits rendered by Baystate Visiting Nurse Association & Hospice staff.Baystate Health Foundation raised $3.5 million in fiscal year 2015 for the Baystate Franklin Surgery Center Expansion and an additional $4.0 million through system wide annual fundraising efforts. Along with the Campaign for the Baystate Franklin Surgery Center, the 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.In FY 2015 Baystate Health's Interpreter and Translation Services provided over 196,684 sessions in 70 languages to help deliver a positive patient care experience. In addition, nearly 4,693 pages of documents, signs and clinical research were translated for providers. Interpreter sessions included in person, telephonic and video interpreting for American Sign Language. Baystate Health has more than 60 staff interpreters throughout our health system for American Sign Language, Arabic, Mandarin, Nepali, Polish, Portuguese, Romanian, Russian, Somali, Spanish, Ukrainian, and Vietnamese. Baystate Health also contracts with local agencies to provide in-person interpreter services as needed for patients who come to Baystate Medical Center for pre-scheduled appointments or for emergencies for languages not covered by staff interpreters, such as Swahili. The health system contracts with a telephonic interpreting company by which any staff member can pick up any house phone, dial an internal extension and be nearly immediately connected to a national telephonic interpreting agency that provides trained and competent interpreters for over 200 languages. BH also subscribes to software called Care Notes by Micromedex that provides information on illnesses for patients or their family members in 15 languages and the documents are written at a 5th grade reading level. Similarly, BH purchased software called Exit Writer from Krames that was integrated into the patient's electronic medical record. Information in five languages about illnesses and aftercare instructions can be provided to patients and their family members and be documented in the patient's electronic medical record as patient education automatically. Baystate Health also added 20 video interpreting units to better assist our Deaf patients and their family members, and also assist patients that speak any of the other 15 languages that are now available at our five (5) hospitals. |
| 6. Affiliated Health Care System (continued) | Baystate Medical Center is recognized as a leading academic medical center. As the Western Campus of Tufts University School of Medicine since 1974, BMC offers clinical training and undergraduate and graduate medical student education across all specialties. In addition to BMC, medical residents and fellows rotate through Baystate Franklin Medical Center and Baystate Mary Lane Hospital.Baystate Health is a nationally accredited provider of continuing education for health care professionals, including physicians, nurses, pharmacists, mental health counselors and psychologists. We also arrange credit for other health care professionals. Baystate provides both live and web based courses. Our educational activities are designed for Baystate staff and non Baystate health care professionals throughout Western New England. Our mission is to provide high-quality, evidence based continuing education to maintain and enhance the knowledge, expertise, and performance of health care professionals, to improve the health of the people in our communities every day, with quality and compassion. In 2015, Baystate Health provided a total of 440 hours of continuing education instruction. Total attendance for credit bearing activities was 3,292. Our educational activities are a service to the community. Baystate Medical Center's Midwifery Education Program is offered in collaboration with the Midwifery Institute of Philadelphia University. Through our affiliation with the Massachusetts College of Pharmacy and Health Science, we offer a one-year pharmacy residency. Baystate Health's educational partnerships allow us to offer allied health programs such as emergency medical technician (EMT), pharmacy technician and surgical technologist. For nursing we offer clinical practicums for baccalaureate, masters, or doctoral-level nursing students in affiliation with the University of Massachusetts, University of Connecticut, Yale University, and other schools of nursing. Baystate Medical Center's high quality nursing care earned re-designation as a Magnet Hospital for Nursing Excellence by the American Nurses Credentialing Center (ANCC) - one of 170 in the nation and only five in Massachusetts. As an academic teaching hospital and the Western Campus of Tufts University School of Medicine, Baystate Medical Center is a center for research. Strong partnerships with other research organizations allow BMC to further its institutional commitment to improve the health of the community through research and education. Collaborations enable Baystate Health to better support the innovative research of our investigators and to improve the lives of the people in the communities we serve. Baystate Medical Center is an active participant in the research communities of Massachusetts and a member institution of the state and regional organizations that also promote the goals of biomedical research. Its faculty and research staff are engaged in basic, clinical and biomedical research across a broad spectrum of medical and surgical specialties, with nationally-recognized research programs in quality of care. Baystate Medical Center serves as a regional resource for specialty medical care while providing comprehensive primary medical services to its community.Baystate Medical Center is also a research partner with University of Massachusetts through the Pioneer Valley Life Sciences Institute. Formed in 2003, PVLSI is a research institution which applies its translational research efforts in the areas of cancer, diabetes, obesity, and wound healing. Its scientists and technicians are committed to improving human health and reducing suffering from disease through creative strategies for early detection and preventive interventions. Other Baystate Health affiliations include Council of Teaching Hospitals and Health Systems (COTH) of the Association of American Medical Colleges (AAMC), Alliance of Independent Academic Medical Centers (AIAMC), and Group on Regional Medical Campuses (GRMC) of the Association of American Medical Colleges (AAMC), Joint Commission and Medical Library Association (MLA). Baystate Health and its affiliates are committed to creating healthier communities and continue to partner with members of the community to ensure we are meeting the diverse needs of the community. Baystate Health extends the traditional definition of "health" to include economic opportunity, affordable housing, quality education, safe neighborhoods, food security, arts/culture and racism and homophobia free communities -- all elements that enable families and communities to thrive. In keeping with this commitment to improve health Baystate Health and its affiliates provide a range of community benefits including support groups, financial counseling and assistance and other health and wellness programs. As an integrated delivery system BH provides further benefits to the hospital's community by coordinating within and among its various entities. |
| 6. Affiliated Health Care System (continued) | Baystate 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 our new program "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 libraries and resource centers at Baystate Medical Center and Baystate Franklin Medical Center 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.Named in honor of our past President and CEO, the Mark R. Tolosky Baystate Neighbors Program provides forgivable loans to Baystate Health employees purchasing their first homes in the communities surrounding our hospitals. Qualified employees are granted a forgivable loan up to $7,500 that may be used towards a down payment or closing costs. In FY 2015, Baystate Health granted $165,000 to 22 employees and their families.Since 1999, Baystate Health has invested over $1 million in the futures of more than 167 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 23rd year, Rays of Hope has raised over $13 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 three 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 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. Baystate Medical Center and Baystate Wing Hospital employees once again donated generously to the United Way of the Pioneer Valley in 2015, raising a total of $351,542. Baystate Franklin Medical Center employees raised about $35,000 for the United Way of Franklin County. Baystate Mary Lane Hospital employees raised $9,413 for the United Way of Hampshire CountrySee also additional information regarding Baystate Health, Inc. and its affiliate's promotion of community health above in Line 5. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Written Policy Ref T And E Expnss | 0 | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mark A Keroack MD | ||||||||||||||
| Trustee 7/1/15-9/30/15 | $0 | $658,452 | $0 | $301,313 | $0 | $20,465 | $0 | $185,350 | $0 | $18,006 | $0 | $1,183,586 | $0 | $0 |
| Grace P Makari-Judson MD | ||||||||||||||
| Trustee 7/1/15-9/30/15 | $300,766 | $0 | $36,984 | $0 | $32,094 | $0 | $53,652 | $0 | $31,839 | $0 | $455,335 | $0 | $0 | $0 |
| Kevin P Moriarty MD | ||||||||||||||
| Trustee 1/1/15-9/30/15 | $467,406 | $0 | $92,796 | $0 | $34,106 | $0 | $27,300 | $0 | $16,350 | $0 | $637,958 | $0 | $0 | $0 |
| Stanley Strzempko MD | ||||||||||||||
| Trustee 10/1/14-6/30/15 | $357,210 | $0 | $41,278 | $0 | $1,032 | $0 | $5,200 | $0 | $1,158 | $0 | $405,878 | $0 | $0 | $0 |
| Ronald Bryant | ||||||||||||||
| President | $390,318 | $0 | $28,800 | $0 | $2,112 | $0 | $3,119 | $0 | $12,609 | $0 | $436,958 | $0 | $0 | $0 |
| Dennis W Chalke | ||||||||||||||
| Treasurer 7/1/15-9/30/15 | $0 | $432,876 | $0 | $264,360 | $0 | $231,815 | $0 | $55,591 | $0 | $24,054 | $0 | $1,008,696 | $0 | $0 |
| John C Shaver | ||||||||||||||
| Chief Financial Officer | $232,372 | $0 | $0 | $0 | $666 | $0 | $4,673 | $0 | $4,974 | $0 | $242,685 | $0 | $0 | $0 |
| Steven P Cummings | ||||||||||||||
| CIO/VP of Operations | $197,799 | $0 | $0 | $0 | $10,228 | $0 | $0 | $0 | $12,357 | $0 | $220,384 | $0 | $0 | $0 |
| John M Burke | ||||||||||||||
| Director of Patient Financial Servic | $150,573 | $0 | $11,063 | $0 | $9,554 | $0 | $3,157 | $0 | $3,844 | $0 | $178,191 | $0 | $0 | $0 |
| Diane Brunelle | ||||||||||||||
| VP Patient Care Services/CNO | $161,717 | $0 | $0 | $0 | $3,688 | $0 | $2,954 | $0 | $9,280 | $0 | $177,639 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 1a | #3 & #5 Housing provided for certain executives which requires a tax gross-up. The above item was treated as taxable compensation as appropriate in accordance with Baystate Noble written policies which require compliance with the IRS accountable plan rules. |
| Part I, Line 4b | Dennis W. Chalke - Supplemental Retirement of $146,489 is included in column E. This amount was earned and paid in 2014. Mark A. Keroack, MD - Supplemental Retirement of $164,550 is included in column E. This amount was earned in 2014. Grace Makari-Judson, MD- Supplemental Retirement of $15,889 is included in column E. This amount was earned in 2014. Kevin P. Moriarty, MD - Supplemental Retirement of $31,163 is included in column E. This amount was earned in 2014. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 2 | Certain Trustees on the Board of Trustees "Board" of the organization had various business relationships with certain other trustees on the board in their respective business capacities within the greater Westfield community. The following trustees, officers, or key employees serve on a common board of a non-affiliated entity: Bay Path University - Richard B. Steele, Jr., Katherine McG Sullivan, James P Sadowsky, John H Davis Economic Development Council - John F. Maybury, David C. Southworth, Mark A Keroack MD, John H. Davis Springfield Library and Museums - John M. O'Brien, III, Victor Woolridge Westmass Development Corp - John F Maybury, Anne M Paradis Community Foundation of Western Mass - Steven M. Mitus, Robert L. Pura, PhD, John H Davis |
| Form 990, Part VI, Section A, line 4 | The filing organization amended its Articles of Organization to change its name from the Trustees of Noble Hospital, Inc to Baystate Noble Hospital Corporation and to delete language stating that the organization shall not have members. The organization also adopted a new set of bylaws that (1) reflect the name change, (2) provide for a sole member, which is Baystaate Health, Inc ("BH"), (3) change the composition of and method of appointing its board of trustees, (4) provide that BH, as member, shall approve any amendments to the bylaws. |
| 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 consists of 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., 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 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) has a comprehensive conflict of interest policy which has been adopted by the filing organization. All directors, trustees, officers, key employees, and highest compensated employees of BH and its affiliates are asked to complete an annual conflict of interest form. We utilize an electronic database to receive and manage all conflict of interest submissions. This information is reviewed by the BH Chief Compliance Officer, the BH Chief Legal Counsel, the BH Chief Executive Officer, the Chair of the BH Board of Trustees, and the Chair of the Audit & Compliance Committee of BH. A summary of the conflict of interest disclosures is provided to the Baystate Health Board of Trustees and the Tax Department and reviewed by outside counsel. Potential conflict of interest transactions are reviewed as appropriate under the policy, which provides for recusal from discussion and deliberation by any party with a potential conflict of interest. The following was the policy in place prior to the merging with Baystate Health: All Directors, upon appointment to the Board and annually thereafter, are required to disclose any interests that could give rise to conflicts in a signed trustee's declaration. The declaration forms are reviewed and signed by the Board's Chairman and Vice Chairman, then forwarded to the President and CEO of the organization for further review. As matters come before the Board and in the event of any conflict, the Chairman (or Vice Chairman) will require the Director(s) involved be removed from any further discussion and voting on the matter. |
| 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. |
| Disclosure for 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 | Physician fees: Program service expenses 1,646,690. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,646,690. Purchased Services: Program service expenses 10,708,639. Management and general expenses 0. Fundraising expenses 0. Total expenses 10,708,639. |
| Form 990, Part XI, line 9: | Net Purchase Accounting Adjustments 6,701,000. Net Assets Released From restrictions For Equipment 42,842. Net Transfers From Affiliated Companies 2,499,249. Forgiveness Of Inter-Company -5,107,009. Net Temporary Restricted Activity -26,367. Yankee Alliance K-1 Revenue -994. |
| Disclosure for Form 990, Part XII - Line 2B | The entity was acquired on July 1, 2015 and therefore two sets of audited financial statements are attached to this return. One set of audited financial statements are for the period October 1, 2014 through June 30, 2015 (the day prior to being acquired). The second set of audited financials is for the period July 1, 2015 through September 30, 2015. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (14 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Baystate Administrative Services Inc | ||||||||||
| 759 Chestnut Street | Springfield | MA | 01199 | 222747685 | Administrative services | MA | 501 (c ) (3) | 11c, III | 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 Medical Center Inc | ||||||||||
| 759 Chestnut Street | Springfield | MA | 01199 | 042790311 | Acute Care Teaching 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 | 0 |
| 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 |
| Baystate Wing Hospital Corporation | ||||||||||
| 40 Wright Street | Palmer | MA | 01069 | 222519813 | Hospital | MA | 501 (c ) (3) | 3 | Baystate Health Inc | 0 |
| Health New England Inc | ||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 042864973 | HMO/Insurance | MA | 501 (c ) (4) | Baystate Health Inc | 0 | |
| HNE of Connecticut Inc | ||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 455190134 | HMO/Insurance | CT | 501 (c ) (4) | Health New England Inc | 0 | |
| Baystate Franklin Medical Center | ||||||||||
| 164 High Street | Greenfield | MA | 01301 | 042103575 | Hospital | MA | 501 (c ) (3) | 3 | Baystate Health Inc | 0 |
| Westfield Medical Corporation | ||||||||||
| 115 West Silver St PO Box 1634 | Westfield | MA | 010861634 | 043127730 | Physician Services | MA | 501 (c ) (3) | 11a,1 | Baystate Noble Hospital Corporation | Yes (1) |
| Noble Visiting Nurse & Hospices Inc | ||||||||||
| 77 Mill Street | Westfield | MA | 01085 | 222757446 | Home health Care & Hospice | MA | 501 (c ) (3) | 9 | Baystate Noble Hospital Corporation | Yes (1) |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HNE Advisory Services | |||||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 043012347 | Administrative Services | MA | Health New England Inc | C | 0 | ||||
| HNE Insurance Services Corporation | |||||||||||||
| 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 System Ambulance Inc | |||||||||||||
| 759 Chestnut Street | Springfield | MA | 01199 | 043018550 | Ambulance Svs | MA | Ingraham Corporation | C | 0 | ||||
| BH Insurance Company Ltd | |||||||||||||
| 980421413 | Offshore captive Insurance | Baystate Health Inc | 0 | North Church Street | Georgetown | CJ | CJ | ||||||
| HNE Holding Corporation | |||||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 464620480 | Holding shares in subsidiary corporation | MA | Health New England Inc | C | 0 | ||||
| HNE Insurance Company Inc | |||||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 454462433 | Health services For Mass Medicare Supplement | MA | Health New England Inc | C | 0 | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt |
|---|---|
| Westfield Medical Corporation | |
| A | $138,182 |
| Westfield Medical Corporation | |
| B | $5,103,041 |
| Noble Visiting Nurse & Hospices Inc | |
| Q | $77,875 |