2015-08-11T07:47:15-05:00 2014-09-30 042684828 FEELEY & DRISCOLL PC 200 PORTLAND STREET BOSTON MA 02114 990 2013-10-01 222472997 BROCKTON HOSPITAL INC BROC 5089417000 680 CENTRE STREET BROCKTON MA 02302 KIM HOLLON PRESIDENT/CEO 5089417000 2015-08-11 1 JEFFREY T ROGERS P01074284 6177427788 2013 2016-02-25 16:41:14Z SIGNATURE HEALTHCARE BROCKTON HOSPITAL KIM HOLLON 680 CENTRE STREET BROCKTON MA 02302 244438493 0 X WWW.SIGNATURE-HEALTHCARE.ORG X 1890 MA THE HOSPITAL OPERATES A 245 BED ACUTE CARE FACILITY THAT PROVIDES HEALTH CARE SERVICES TO 20 COMMUNITIES IN SOUTHEASTERN MASSACHUSETTS. IN FISCAL YEAR 2014 THE HOSPITAL PROVIDED $15,483,835 OF UNREIMBURSED CHARITY CARE. THIS EQUATES TO THOUSANDS OF VISITS TO PRIMARY CARE AND SPECIALTY CLINICS. THE HOSPITAL'S CHILDREN AND YOUTH PROGRAM, A HOSPITAL-BASED PRIMARY CARE PRACTICE THAT TREATS UNDER-PRIVILEGED CHILDREN, ACCOMMODATED APPROXIMATELY 10,000 PATIENT VISITS. THOUSANDS OF UNDERINSURED PEOPLE TOOK ADVANTAGE OF ONGOING COMMUNITY HEALTH LECTURES, SCREENINGS, CLASSES AND SUPPORT GROUPS BOTH AT THE HOSPITAL AND IN THE COMMUNITY. 18 13 2001 102 595652 -103323 53320 540461 214142831 226354651 2288782 8432157 8268630 9111224 224753563 244438493 0 0 0 0 117168847 128057630 0 0 0 88440305 90725164 205609152 218782794 19144411 25655699 175530671 184968651 106838500 131630543 68692171 53338108 BROCKTON HOSPITAL'S MISSION IS TO BE A PRIVATE NOT-FOR-PROFIT COMMUNITY BASED HOSPITAL THAT IS RECOGNIZED AS THE "HOSPITAL OF CHOICE" BY STAFF, PATIENTS, AND THE COMMUNITY IT SERVES. 0 0 197479961 231991911 THE HOSPITAL OPERATES A 245 BED ACUTE CARE FACILITY THAT PROVIDES HEALTH CARE SERVICES TO 20 COMMUNITIES IN SOUTHEASTERN MASSACHUSETTS. IN FISCAL YEAR 2014 THE HOSPITAL PROVIDED $15,483,835 OF UNREIMBURSED CHARITY CARE. THIS EQUATES TO THOUSANDS OF VISITS TO PRIMARY CARE AND SPECIALTY CLINICS. THE HOSPITAL'S CHILDREN AND YOUTH PROGRAM, A HOSPITAL-BASED PRIMARY CARE PRACTICE THAT TREATS UNDER-PRIVILEGED CHILDREN, ACCOMMODATED APPROXIMATELY 10,000 PATIENT VISITS. THOUSANDS OF UNDERINSURED PEOPLE TOOK ADVANTAGE OF ONGOING COMMUNITY HEALTH LECTURES, SCREENINGS, CLASSES AND SUPPORT GROUPS BOTH AT THE HOSPITAL AND IN THE COMMUNITY. 197479961 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 235 0 1 2001 1 1 1 0 0 0 0 0 0 0 0 0 X 18 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 MA X X KIM HOLLON 5089417000 680 CENTRE STREET BROCKTON MA 023023395 TIMOTHY J CRUZ TRUSTEE 1.00 X 0 0 0 JOSEPH P DRIER III TRUSTEE 1.00 X 0 0 0 DAVID P FRENETTE TRUSTEE 1.00 X 0 0 0 WALLACE H PECKHAM III TRUSTEE 1.00 X 0 0 0 PATTI ROLAND TRUSTEE 1.00 X 0 0 0 MICHAEL J SULLIVAN TRUSTEE 1.00 X 0 0 0 ROBERT D SULLIVAN TRUSTEE 1.00 X 0 0 0 MARY V WALDRON TRUSTEE 1.00 X 0 0 0 DAVID R WOLOHOJIAN TRUSTEE 1.00 X 0 0 0 KIM HOLLON CHIEF EXECUTIVE OFFICER 40.00 X X 657424 0 34399 DAVID DRINKWATER MD TRUSTEE 1.00 40.00 X 0 502163 22549 PATRICIA TORTORELLA TRUSTEE 1.00 X 0 0 0 MICHAEL L DERN MD TRUSTEE 1.00 40.00 X 0 589524 19815 ROBERT S GREENBERG MD TRUSTEE 1.00 40.00 X 0 271061 20781 JAMES E LEARY TRUSTEE 1.00 X 0 0 0 REV CHERYL HARRIS TRUSTEE 1.00 X 0 0 0 EUGENE MARROW TRUSTEE 1.00 X 0 0 0 KEITH MERLIN TRUSTEE 1.00 40.00 X 0 472530 54904 JAMES PAPADAKOS CHIEF FINANCIAL OFFICER 40.00 X 325452 0 33715 STEPHEN BORGES VICE PRESIDENT 40.00 X 189952 0 31033 DAVID J FISHER VICE PRESIDENT 40.00 X 189381 0 28706 KIMBERLY WALSH VICE PRESIDENT 40.00 X 227492 0 18829 KAREN MURPHY VICE PRESIDENT & GEN'L COUNSEL 40.00 X 289466 0 17843 MARIE F GROSS VICE PRESIDENT 40.00 X 264173 0 9974 JEFFREY MILLER VICE PRESIDENT 40.00 X 187287 0 28035 DENNIS RENAUD DIRECTOR 40.00 X 177544 0 9042 MITCHELL SELINGER VICE PRESIDENT 40.00 X 365917 112407 23838 TIMOTHY R LYNCH MD FORMER TRUSTEE 0.00 40.00 X 0 20629 1735 ROBERT COVETT MD FORMER TRUSTEE 0.00 40.00 X 0 361952 7787 DALE J ELLENBERG MD FORMER TRUSTEE 0.00 40.00 X 0 251185 25049 KEN LAWSON FORMER TRUSTEE 0.00 40.00 X 0 423983 27446 GEORGE C BROWN FORMER TRUSTEE 0.00 40.00 X 0 596012 18134 JEAN-PIERRE GEAGEA FORMER TRUSTEE 0.00 40.00 X 0 633081 3757 MARC GREENWALD FORMER TRUSTEE 0.00 40.00 X 0 341552 11830 DANIEL MUSE FORMER TRUSTEE 0.00 40.00 X 0 446174 18190 ABDEL-HAI HAMMO FORMER TRUSTEE 0.00 40.00 X 0 197789 8669 2874088 5220042 476060 138 1 1 0 MATRIX ANESTHESIA PD 1342 BELMONT STREET STE 205 BROCKTON MA 02302 PHYSICIAN SERVICES 3070816 SECURAMERICA LLC 3399 PEACHTREE RD SUITE 1000 ATLANTA GA 30326 SECURITY SERVICES 856360 PRATT PEDIATRIC ASSOCIATES 750 WASHINGTON STREET BOSTON MA 02111 PHYSICIAN SERVICES 808090 ROPES & GRAY ONE INTERNATIONAL PLACE BOSTON MA 02110 LEGAL SERVICES 539238 FISHER COLLEGE 118 BEACON STREET BOSTON MA 02116 EDUCATIONAL SERVICES 419242 16 405151 135310 540461 PATIENT SERVICE REVENU 900099 225666864 225666864 OUTREACH LAB SERVICES 541380 395885 395885 MEANINGFUL USE EHR REV 900099 291902 291902 226354651 1155428 1155428 6957722 319007 0 0 6957722 319007 7276729 193906 7082823 SCHOOL OF NURSING 900099 5142875 5142875 MISCELLANEOUS 900099 3203305 131087 3072218 VANTAGE JOINT VENTURE 900099 604799 604799 160245 154384 5861 9111224 244438493 231991911 595652 11310469 1589701 1430731 158970 98660302 90786306 7873996 5146809 3860107 1286702 15383995 13505249 1878746 7276823 5457617 1819206 4676426 4676426 415247 311435 103812 208000 156000 52000 156671 117503 39168 744742 558656 186086 3555381 3044835 510546 1555184 1166388 388796 2963080 2222521 740559 186079 149279 36800 1010646 753937 256709 5508242 4131178 1377064 1861212 1405559 455653 OTHER PROFESSIONAL SERV 18483458 17776997 706461 PURCHASED SERVICES 10841053 9107486 1733567 MEDICAL & SURGICAL SUPP 10587979 10558875 29104 OTHER EXPENESE 10279509 8649944 1629565 17692255 17652932 39323 218782794 197479961 21302833 0 5645427 19058323 23655712 22965763 42015519 1570524 1595304 5371818 2723530 206748053 137530430 33557999 69217623 3018896 3340081 60694776 66068027 175530671 184968651 33205876 34005387 1453418 1379554 34324287 47750000 5843137 13012508 32011782 35483094 106838500 131630543 X 63496118 47862379 1947289 2108421 3248764 3367308 68692171 53338108 175530671 184968651 X 25655699 -3597790 -37411972 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 156670 156670 0 PART II-B, LINE 1: THE HOSPITAL PAID THE FOLLOWING COMPANIES FOR LOBBYING ON BEHALF OF THE HOSPITAL REGARDING VARIOUS STATE AND FEDERAL LEGISLATION IMPACTING BOTH THE HOSPITAL AND THE HEALTHCARE INDUSTRY AS A WHOLE. THESE ACTIVITIES REPRESENT AN INSUBSTANTIAL PART OF THE HOSPITAL'S ACTIVITIES. $120,063 WENT TO ELLEN MURPHY & ASSOCIATES. THE ALLOCATED PORTION OF DUES TO THE FOLLOWING ORGANIZATIONS:$27,355 MASSACHUSETTS HOSPITAL ASSOCIATION; $9,252 AMERICAN HOSPITAL ASSOCIATION. 3742703 274466 4017169 3507330 235373 3742703 3166498 340832 3507330 3335390 -168892 3166498 3187674 147716 3335390 0.84000 0.16000 0 0 2100011 2100011 94184631 45694386 48490245 109194463 91836044 17358419 1268948 1268948 69217623 ASSETS WHOSE USE IS LIMITED 54468893 UNAMORTIZED BOND ISSUANCE COSTS 1048206 INVESTMENT IN JOINT VENTURE 880800 LOAN RECEIVABLE - SPLIT DOLLAR LIFE INSURANCE 995000 SECURITY DEPOSIT 104795 MALPRACTICE INSURANCE RESERVE 7272000 OTHER INTANGIBLES 1298333 66068027 AMOUNTS DUE TO 3RD PARTY PAYORS 7165334 PENSION LIABILITY 28317760 35483094 244438493 0 244438493 0 244438493 218782794 0 218782794 0 218782794 PART V, LINE 4: THE HOSPITAL'S ENDOWMENT CONSISTS OF INDIVIDUAL DONOR RESTRICTED ENDOWMENT FUNDS FOR A VARIETY OF PURPOSES AS WELL AS SPLIT INTEREST AGREEMENTS, WHICH HAVE BEEN DESIGNATED FOR ENDOWMENT. 1 1 1 X 1 X 1 0 1 1 5080978 3741737 1339241 0.00610 56970083 55615803 1354280 0.00620 8030421 6205094 1825327 0.00830 70081482 65562634 4518848 0.02060 162916 162916 0.00070 8112926 6207527 1905399 0.00870 20296888 14675060 5621828 0.02570 47267 47267 0.00020 28619997 20882587 7737410 0.03530 98701479 86445221 12256258 0.05590 44002 44002 0.00020 44002 44002 0.00020 1 3149292 1420350 58054409 54369252 3685157 X 1 1 1 1 SIGNATURE HEALTHCARE BROCKTON HOSPITAL 680 CENTRE STREET BROCKTON MA 02302 WWW.SIGNATURE-HEALTHCARE.ORG 2118 X X X X TCU/PSYCH BROCKTON HOSPITAL 1 1 X X X X X X 13 1 1 1 X X X X X X 0 0 1 1 200.000000000000 1 200.000000000000 1 X X X X X 1 1 X X X X 1 0 1 X 0 0 BROCKTON HOSPITAL PART V, SECTION B, LINE 3: SIGNATURE HEALTHCARE WORKS COLLABORATIVELY WITH THE BROCKTON DEPARTMENT OF PUBLIC HEALTH, THE BROCKTON AREA NEIGHBORHOOD HEALTH CENTER AND NUMEROUS COMMUNITY SOCIAL SERVICE AGENCIES TO COORDINATE PUBLIC HEALTH INITIATIVES TO ADDRESS THE NEEDS OF THE AT-RISK POPULATION. FROM FEBRUARY TO DECEMBER 2013, THE STOUGHTON YOUTH COMMISSION CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT FOR THE GREATER BROCKTON COMMUNITY HEALTH NETWORK AREA (CHNA 22) WITH THE GOAL OF IDENTIFYING UNMET COMMUNITY HEALTH NEEDS, VULNERABLE POPULATIONS AND GAPS IN EXISTING COMMUNITY HEALTH SERVICES. IN THIS VERSION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, THE GREATER BROCKTON CHNA FOCUSED ON THE FOLLOWING FOUR PRIORITY AREAS:- ASTHMA- NUTRITION AND FITNESS- ORAL HEALTH, AND- SUBSTANCE ABUSETHIS UPDATE OF THE COMMUNITY HEALTH NEEDS ASSESSMENT UTILIZED A FOUR PRONGED APPROACH TO UNCOVER THE STATE OF THE HEALTH OF THE CITY OF BROCKTON AND ITS SURROUNDING TOWNS: 1. CONDUCTING KEY INFORMANT INTERVIEWS WITH PEOPLE WHO WORK WITHIN THE CHNA 22 CITIES AND TOWNS INCLUDING BROCKTON TO DETERMINE HOW THE NEEDS OF THE RESIDENTS ARE MET BOTH INSIDE AND OUTSIDE THE CITY;2. REVIEWING EXISTING PROGRAMS/STRATEGIES AND SERVICES IN THE AREA TO DISCOVER GAPS;3. ANALYZING EXISTING DATA TO DETERMINE HOW HEALTH OUTCOMES IN THE CITY OF BROCKTON AND SURROUNDING TOWNS DIFFER FROM EACH OTHER AND THE STATE OF MASSACHUSETTS OVERALL;4. CONDUCTING FOCUS GROUPS WITHIN AND OUTSIDE OF BROCKTON TO EXAMINE THEIR PERCEPTIONS REGARDING THE FOUR AFOREMENTIONED HEALTH TOPICS AND THEIR IMPACT IN THE SERVICE AREA.AT LEAST ONE KEY INFORMANT WAS INTERVIEWED IN EVERY CHNA 22 TOWN AND A TOTAL OF 23 KEY INFORMANT INTERVIEWS WERE CONDUCTED OVERALL. ORGANIZATIONS INCLUDED LOCAL SUBSTANCE ABUSE AND VIOLENCE COALITIONS, VNAS, SCHOOL PERSONNEL, BOARD OF HEALTH, YMCA, COA'S AND MORE. THERE WERE A TOTAL OF FOUR (4) FOCUS GROUPS, ONE ON EACH OF THE CHNA 22 FOCUS AREAS. THESE FOCUS GROUPS TOOK PLACE AT THE MENS SOBER HOUSE IN BROCKTON, THE EAST BRIDGEWATER YMCA, SELF HELP, INC. AND TRINITY BAPTIST CHURCH. BROCKTON HOSPITAL PART V, SECTION B, LINE 4: STEWARD GOOD SAMARITAN HOSPITAL BROCKTON HOSPITAL PART V, SECTION B, LINE 5D: CHNA 22 ORGANIZATION WEBSITE: WWW.CHNA22.ORG. BROCKTON HOSPITAL PART V, SECTION B, LINE 6I: THE SUMMARY OF FINDINGS FOR OUR COMMUNITY HEALTH NEEDS ASSESSMENT CONTINUED TO SHOW CONCERN FOR DIABETES AND NUTRITION THUS THIS IS WHERE SIGNATURE HEALTHCARE PRIMARILY FOCUSED ITS RESOURCES. ACCORDING TO THE DATA COLLECTED, AS WELL AS INFORMATION OBTAINED FROM KEY INFORMANTS AND COMMUNITY MEMBERS, CONTINUED EDUCATION AND SUPPORT RELATED TO THESE AREAS WAS NECESSARY. THROUGHOUT THE YEAR SIGNATURE HEALTHCARE'S NUTRITION AND ENDOCRINOLOGY STAFF AS WELL AS OUR DIABETES EDUCATORS WORKED AT CREATING AND PROVIDING EDUCATIONAL TOOLS AND SEMINARS. ON MANY OCCASIONS THROUGHOUT FISCAL 2014, SIGNATURE HEALTHCARE STAFF MEMBERS OFFERED INFORMATION AND HANDS ON ACTIVITIES TO THE COMMUNITY. ONE MAJOR EVENT EMPLOYEES TOOK PART IN ALONG WITH COMMUNITY PARTNERS WAS SIGNATURE HEALTHCARE'S THIRD ANNUAL "DIABETES DAY." THIS EVENT HAD MANY COMPONENTS INCLUDING: FREE SCREENINGS FOR VASCULAR AND METABOLIC DISEASE; A HEALTHY COOKING DEMONSTRATION IN COLLABORATION WITH VINCENTE'S MARKET, A LOCAL ETHNIC GROCER; HEALTHY RECIPES; AND A VENDOR AREA WHERE COMMUNITY PARTNERS ALONG WITH DEPARTMENTS OF SIGNATURE HEALTHCARE HIGHLIGHTED SERVICES THAT ARE PROVIDED SPECIFIC TO NUTRITION & DIABETES. AN EXERCISE AREA WITH ZUMBA FOR ADULTS AND AN OBSTACLE COURSE FOR CHILDREN WAS PROVIDED BY THE OLD COLONY YMCA. LASTLY, AN "ASK THE EXPERT" AREA MADE SIGNATURE HEALTHCARE PROVIDERS AVAILABLE FOR ATTENDEES TO ASK A VARIETY OF QUESTIONS ON A ONE ON ONE BASIS. THIS EVENT WAS A GREAT SUCCESS WITH OVER 250 PEOPLE IN ATTENDANCE AND OVER 100 OF THOSE SCREENED. THIS INFORMATION WAS SHARED WITH ALL SIGNATURE HEALTHCARE PRIMARY AND SECONDARY SERVICE AREAS. SIGNATURE HEALTHCARE CONTINUES TO BE PART OF A LARGER COMMUNITY WIDE "BROCKTON KNOCKS DOWN DIABETES" (BKDD) INITIATIVE. SIGNATURE HEALTHCARE KICKS OFF THE WEEK WITH DIABETES DAY AND HAS DONE SO FOR THE PAST THREE YEARS. SIGNATURE HEALTHCARE PROVIDES CLINICIANS, ASSISTS WITH COORDINATION AND STAFFING FOR VARIOUS EVENTS, AND OFFERS CLASSES THROUGHOUT THE WEEK. BKDD IS A WEEKLONG INITIATIVE TO PROVIDE EDUCATION AND AWARENESS AROUND DIABETES. NUMEROUS LOCAL PARTNERS PARTICIPATE IN THIS EVENT INCLUDING THE OLD COLONY YMCA, HARBOR ONE, BROCKTON VNA AND THE AMERICAN DIABETES ASSOCIATION. THIS GROUP HAS WORKED DILIGENTLY ON CREATING PROGRAMMING THE COMMUNITY WILL FIND BENEFICIAL. THE ACTIVITIES PLANNED INCLUDE EDUCATIONAL PRESENTATIONS AS WELL AS FITNESS CLASSES. ONE GOAL FOR THE COMING YEAR IS TO BRING THE LATEST IN DIABETES CARE TO THE SOUTH SHORE AREA THROUGH A DIABETES SYMPOSIUM FOR LOCAL PHYSICIANS, SOCIAL WORKERS, NURSES AND NUTRITIONISTS. THROUGH COMMUNITY OUTREACH WITH LOCAL BUSINESS, COMMUNITY GROUPS, AND EVENTS, HOSPITAL STAFF MEMBERS WERE ABLE TO EDUCATE THE COMMUNITY ON OBESITY AND DIABETES IN A VARIETY OF WAYS. SIGNATURE PROVIDED EDUCATIONAL TOOLS, HEALTHY RECIPES, FREE EXERCISE CLASSES AND OPPORTUNITIES FOR QUESTIONS AND ANSWERS WITH CLINICAL STAFF. DURING FY14, HOSPITAL STAFF PARTICIPATED IN MORE THAN TWENTY-FIVE COMMUNITY EVENTS TO PROMOTE EDUCATION ON THE TOPIC OF DIABETES, NUTRITION AND OBESITY. THE EVENTS INCLUDED: -LINCOLN TECHNICAL INSTITUTE, COMMUNITY RESOURCE FAIR-BAMSI'S ANNUAL CONFERENCE -COMMUNITY CARE SERVICES, HEALTH & SAFETY FAIR-MASSASOIT COMMUNITY COLLEGE - CANTON CAMPUS-MASSASOIT COMMUNITY COLLEGE - BROCKTON CAMPUS-FULL GOSPEL TABERNACLE - MEN'S & WOMEN'S MINISTRIES -TABERNACLE OF PRAISE -HAITIAN COMMUNITY PARTNERS - HEALTH & SAFETY FAIR-GE OIL AND ELECTRIC - NUMEROUS HEALTH & WELLNESS PRESENTATIONS -METRO SOUTH CHAMBER OF COMMERCE, TASTE OF METRO SOUTH EVENT-BROCKTON HIGH SCHOOL ANNUAL WELLNESS FAIR-GREATER BROCKTON HEALTH FAIR SPONSORED BY CHNA 22 AND WALGREENS-MARY CRUISE KENNEDY SENIOR CENTER - HEALTHY COOKING AND MEAL PLANNING -BEACON COMMUNITIES - THE PINES AND CHATHAM WEST-SPRING OF WATER CHRISTIAN ASSEMBLY HEALTH FAIR -BRIDGEWATER SENIOR CENTER - HEALTH & PUBLIC SAFETY EXPO-NEIGHBORHOOD HEALTH CENTER " NATIONAL HEALTH CENTER WEEK" HEALTH FAIR -NEW LIFE COMMUNITY EMPOWERMENT CENTER-OLD COLONY YMCA YOUTH DIVISION BROCKTON BRANCH, "HEALTHY KIDS DAY"-OLD COLONY YMCA CENTRAL BRANCH - DIABETES WELLNESS DAY-OLD COLONY YMCA (NUMEROUS KICKOFF AND MIDPOINT EVENTS AS PART OF THE "SMALLEST WINNER" PROGRAM.-BROCKTON PUBLIC SCHOOLS, SUMMER FUN IN THE CITY RESOURCE FAIR-CITY OF BROCKTON "NIGHT OUT AGAINST CRIME"-SUMMERFEST-TAUNTON WIC "CELEBRATION OF THE YOUNG PARENT"-ANNUAL RAYNHAM COMMUNITY PRIDE DAY-WHITMAN HANSON KIDS FITNESS FESTIVALSIGNATURE HEALTHCARE IS A DISPROPORTIONATE SHARE HOSPITAL. SIGNATURE HEALTHCARE OFFERS SPECIALTY CARE CLINICS IN TB, ENDOCRINOLOGY AND GYNECOLOGY TO WHICH THE BROCKTON NEIGHBORHOOD HEALTH CENTER REFERS PATIENTS. SIGNATURE HEALTHCARE DEVELOPED THE CENTER FOR HEALTHY BEGINNINGS, A COMMUNITY OUTREACH PROGRAM FOR PREGNANT WOMEN WHO REQUIRE MEDICAL CARE, SOCIAL SUPPORT, FINANCIAL COUNSELING AND TRANSLATOR SERVICES. GIVEN THE DIVERSE NATURE OF THE PATIENT POPULATION, SIGNATURE HEALTHCARE SUPPLIES 24/7 TRANSLATOR SERVICES WITH FIFTEEN EMPLOYED TRANSLATORS SPEAKING THIRTY SIX LANGUAGES. BROCKTON HOSPITAL PART V, SECTION B, LINE 7: SIGNATURE HEALTHCARE, IN COLLABORATION WITH THE CHNA22, DEVELOPED A COMPREHENSIVE COMMUNITY NEEDS ASSESSMENT FOR THE GREATER BROCKTON AREA IN DECEMBER, 2010. THE ASSESSMENT REVEALED FOUR KEY AREAS OF NEED: ASTHMA, NUTRITION AND FITNESS, ORAL HEALTH, AND SUBSTANCE ABUSE. IN DECEMBER, 2013 THE CHNA 22 AGAIN CONDUCTED A NEEDS ASSESSMENT WHICH FOCUSED SOLELY ON THESE FOUR AREAS OF NEED. IN 2014 SIGNATURE HEALTHCARE ADDRESSED ALL BUT THE ORAL HEALTH NEEDS AS THE ORGANIZATION DOES NOT PROVIDE ORAL HEALTH SERVICES. SIGNATURE HEALTHCARE PRIORITIZED OUR EFFORTS TO ADDRESS THE NUTRITION AND DIABETES NEEDS AND ADDRESSED THE OTHER COMMUNITY NEEDS AS FOLLOWS: 1. SUBSTANCE ABUSE- PARTICIPATED IN BROCKTON MAYOR'S OPIOID OVERDOSE PREVENTION COALITION - PARTICIPATED IN BROCKTON CABLE ACCESS "OPIOIDS IN THE CITY"- PROVIDED EDUCATION TO PARENTS AND STAFF OF AREA HIGH SCHOOLS ON THE USE OF PERFORMANCE ENHANCING SUPPLEMENTS IN ATHLETES AND PROVIDED FISCAL SUPPORT OF BROCKTON AREA MULTI SERVICES, INC. (BAMSI) AND HELPLINE.2. ASTHMA - SIGNATURE HEALTHCARE PEDIATRICS STAFF HOLDS AN ANNUAL "ASTHMA CAMP" TO PROVIDE EDUCATION AND TOOLS NEEDED FOR CHILDREN AND FAMILIES TO MANAGE THEIR ASTHMA.3. ORAL HEALTH - SIGNATURE HEALTHCARE DOES NOT EMPLOY OR PROVIDE GENERAL DENTISTRY CARE. WE WORK COLLABORATIVELY WITH THE BROCKTON NEIGHBORHOOD HEALTH CENTER TO ATTEND TO THE ORAL HEALTH NEEDS OF OUR COMMUNITY. PART I, LINE 7: COSTS FOR FIGURES USED IN THE LINE 7 TABLE ARE DERIVED USING WORKSHEET 2 FOR 7 A-D, DIRECT COSTS FOR 7E AND 7I, AND THE HOSPITAL'S COST ACCOUNTING SYSTEM FOR 7F-G. SCHEDULE H, PART II SIGNATURE HEALTHCARE COLLABORATES WITH AND SUPPORTS AREA ORGANIZATIONS BOTH FINANCIALLY AND WITH OUR CLINICAL EXPERTISE. WE BELIEVE COLLABORATION WITH OUR COMMUNITY PARTNERS ALLOWS US TO MAKE A LARGER IMPACT ON THE OVERALL HEALTH OF OUR COMMUNITY. PART III, LINE 4: THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS EQUAL TO ESTIMATED BAD DEBT LOSSES. THE ESTIMATED LOSSES ARE BASED ON HISTORICAL COLLECTION EXPERIENCE TOGETHER WITH A REVIEW OF THE CURRENT STATUS OF EXISTING RECEIVABLES. THE FOOTNOTE IS FOUND ON PAGE 32 OF THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE HOSPITAL USED THE MEDICARE COST REPORT AS THE COST ACCOUNTING SYSTEM TO CALCULATE ITS MEDICARE ALLOWABLE COSTS. SCHEDULE H, PART III, LINE 2 THE HOSPITAL USED THE RATIO OF ITS TOTAL COSTS TO CHARGES FROM WORKSHEET 2 TO CALCULATE THE AMOUNT OF BAD DEBT EXPENSE. PART III, LINE 3 THE HOSPITAL USED THE RATIO OF ITS TOTAL COSTS TO CHARGES FROM WORKSHEET 2 TO CALCULATE THE AMOUNT OF BAD DEBT EXPENSE FOR THOSE PATIENTS ELIGIBLE FOR CHARITY CARE. SCHEDULE H, PART VI, LINE 3 - SUPPLEMENTAL INFORMATION 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:INFORMATION REGARDING HOW TO APPLY FOR FINANCIAL ASSISTANCE AND RELATED SIGNAGE IS AVAILABLE FOR PATIENTS IN BROCKTON HOSPITAL EMERGENCY SERVICE AND PATIENT REGISTRATION AREAS. SIMILARLY THIS INFORMATION IS ALSO AVAILABLE ON LINE AT WWW.SIGNATURE-HEALTHCARE.ORG. SCHEDULE H, PART VI, LINE 4 - SUPPLEMENTAL INFORMATION 4 COMMUNITY INFORMATION:THE PAYER MIX OF SIGNATURE HEALTHCARE'S PATIENT PANEL IS AS EXPECTED GIVEN THE DEMOGRAPHICS OF THE COMMUNITY WITH 2% RESIDUALLY UNINSURED, 27% MEDICAID AND MEDICAID MANAGED CARE, AND 70% PUBLIC PAY IN TOTAL. ADDITIONALLY THE COMMERCIAL PAYER RATES VARY CONSIDERABLY IN MASSACHUSETTS PER THE ATTORNEY GENERAL'S 2008 REPORT WHICH REVEALED A GREATER THAN 300 PERCENT VARIATION IN RATES PAID TO THE HOSPITALS BY A COMMERCIAL PAYER. SIGNATURE HEALTHCARE BROCKTON HOSPITAL FELL IN THE LOWEST QUARTILE AND HAD THE 14TH LOWEST RATES OF ALL SIXTY-EIGHT (68) HOSPITALS. SIGNATURE HEALTH HAS BEEN RECOGNIZED AS A LOW COST, HIGH QUALITY PROVIDER OF CARE:- DESIGNED TO RATE HOW WELL HOSPITALS PROTECT PATIENTS FROM ACCIDENTS, ERRORS, INJURIES AND INFECTIONS, THE LATEST (FALL 2014) HOSPITAL SAFETY SCORE HONORED SIGNATURE HEALTHCARE WITH AN "A" - ITS TOP GRADE IN PATIENT SAFETY. THE HOSPITAL SAFETY SCORE IS COMPILED UNDER THE GUIDANCE OF THE NATION'S LEADING EXPERTS ON PATIENT SAFETY AND IS ADMINISTERED BY THE LEAPFROG GROUP, AN INDEPENDENT INDUSTRY WATCHDOG. THE FIRST AND ONLY HOSPITAL SAFETY RATING TO BE PEER-REVIEWED IN THE JOURNAL OF PATIENT SAFETY, THE SCORE IS FREE TO THE PUBLIC AND DESIGNED TO GIVE CONSUMERS INFORMATION THEY CAN USE TO PROTECT THEMSELVES AND THEIR FAMILIES WHEN FACING A HOSPITAL STAY. - SIGNATURE HEALTHCARE BROCKTON HOSPITAL AND SIGNATURE MEDICAL GROUP WERE BOTH RECOGNIZED IN HARVARD PILGRIM HEALTH CARE'S 2014 HOSPITAL AND PHYSICIAN GROUP HONOR ROLLS. THIS PRESTIGIOUS AWARD HONORS HOSPITALS WITH PERFORMANCE AMONG THE TOP 25% MEASURED NATIONALLY ON A SET OF CLINICAL QUALITY AND PATIENT EXPERIENCE MEASURES. THE PHYSICIAN HONOR ROLL RECOGNIZES A COMMITMENT TO HIGH QUALITY CARE, BASED ON PERFORMANCE AGAINST NATIONAL QUALITY BENCHMARKS, AS REPORTED BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE.- SIGNATURE HEALTHCARE EARNED "TOP PERFORMER ON KEY QUALITY MEASURES" RECOGNITION FROM THE JOINT COMMISSION, THE LEADING ACCREDITING AGENCY OF HEALTH CARE ORGANIZATIONS IN AMERICA. SIGNATURE HEALTHCARE WAS RECOGNIZED FOR EXEMPLARY PERFORMANCE IN EVIDENCE BASED CLINICAL PROCESSES SHOWN TO IMPROVE CARE FOR CERTAIN CONDITIONS. SIGNATURE HEALTHCARE IS ONE OF 1,099 HOSPITALS IN THE U.S. EARNING THE TOP PERFORMER DISTINCTION FOR ATTAINING AND SUSTAINING EXCELLENCE IN ACCOUNTABILITY MEASURE PERFORMANCE, AND ONE OF ONLY 17 HOSPITALS IN MA. IN ADDITION, SIGNATURE HEALTHCARE BROCKTON HOSPITAL WAS ONE OF ONLY 8 IN THE STATE TO BE RECOGNIZED IN ALL FOUR OF THE FOLLOWING MEASURE SETS: HEART ATTACK, HEART FAILURE, SURGERY AND PNEUMONIA AND THE ONLY HOSPITAL IN SOUTHEASTERN MA. - SIGNATURE HEALTHCARE WAS RECENTLY RANKED A TOP HOSPITAL BY US NEWS & WORLD REPORT, RANKING NUMBER 11 IN THE BOSTON METRO AREA AND NUMBER 15 IN MASSACHUSETTS. THE HOSPITAL RECEIVED A HIGH PERFORMING RANKING IN THE AREAS OF DIABETES, ENDOCRINOLOGY AND PULMONOLOGY.- SIGNATURE HEALTHCARE WAS AWARDED THE TUFTS HEALTH PLAN 2014 QUALITY INNOVATION AWARD FOR THE MEDICATION RECONCILIATION PROJECT. IN 2008 SIGNATURE HEALTHCARE ACQUIRED A GEOGRAPHICALLY DISPERSED MULTI-SPECIALTY GROUP OF EMPLOYED PHYSICIANS COMPRISED OF SEVENTEEN (17) SPECIALTIES, NOW CALLED SIGNATURE MEDICAL GROUP. SIGNATURE MEDICAL GROUP HAS LONG EMBRACED PROVIDING CARE FOR THE MEDICALLY COMPLEX, UNDERINSURED PATIENTS WHO ARE UNDERSERVED BY BOTH PRIMARY CARE AND SPECIALISTS IN THE AREA: MANY PHYSICIAN PRACTICES, OUTSIDE OF SIGNATURE HEALTHCARE AND THE BROCKTON AREA NEIGHBORHOOD HEALTH CENTER, LIMIT THEIR PRACTICES' ACCEPTANCE OF MEDICAID AND HEALTH SAFETY NET PATIENTS. SIGNATURE MEDICAL GROUP, WHICH SERVES A TOTAL OF 78,000 PATIENTS, IS COMMITTED TO THECARE OF THIS NEEDY POPULATION WHICH HAS RESULTED IN SIGNIFICANT FINANCIAL LOSSES. SCHEDULE H, PART VI, LINE 5 - SUPPLEMENTAL INFORMATION 5 PROMOTION OF COMMUNITY HEALTH:THE FOLLOWING PROGRAMS HAVE BEEN DEVELOPED BY SIGNATURE HEALTHCARE TO HELP FACILITATE THE QUALITY, SAFETY AND CONTINUUM OF CARE FOR OUR PATIENTS IN THE COMMUNITY. THE FUNDING ASSOCIATED WITH THESE PROGRAMS HAS NOT BEEN INCORPORATED INTO THE COMMUNITY BENEFITS CALCULATION. CHRONIC DISEASE MANAGEMENT: COPD AND ASTHMABUILDING ON THE LEARNING AND SUCCESSES OF OUR CONGESTIVE HEART FAILURE PROGRAM, SIGNATURE HEALTHCARE IS EXPANDING OUR CHRONIC DISEASE MANAGEMENT PROGRAM TO MANAGE COPD AND ASTHMA PATIENTS WITH A GOAL OF DECREASING ADMISSIONS FOR THIS POPULATION. COPD AND ASTHMA ARE SERIOUS AND WIDELY PREVALENT DISEASES, WHICH ARE PROGRESSIVE AND TREATABLE IN THEIR EARLY STAGES WITH A WELL ACCEPTED SET OF OUTPATIENT AND HOSPITAL BASED PATHWAYS. ATTENTION TO LOWERING RISKS, ACCURATE DIAGNOSIS, AGGRESSIVE THERAPY AND OVERSIGHT CAN YIELD A HIGHER QUALITY OF LIFE FOR PATIENTS AS WELL AS REDUCE HOSPITALIZATIONS, READMISSIONS, AND COST OF CARE. COMMUNITY LINKSTHE COMMUNITY LINKS PROGRAM IS DESIGNED TO SERVE PATIENTS WHO ARE FOLLOWED BY PRIMARY CARE PHYSICIANS IN THE OUTPATIENT DEPARTMENT. WE UNDERSTAND MANY PATIENTS WHO VISIT THEIR PCPS HAVE UNMET PSYCHOSOCIAL NEEDS. THIS PROGRAM PROVIDES THESE PATIENTS WITH THE OPPORTUNITY TO WORK WITH A COMMUNITY LINKS REPRESENTATIVE FOR ASSISTANCE WITH REFERRALS TO AREA AGENCIES TO ADDRESS NEEDS INCLUDING HOUSING, FOOD, INCOME SUPPORTS, EMPLOYMENT/ADULT EDUCATION, COUNSELING, PHARMACY PROGRAMS, CLOTHING, FUEL/UTILITIES ASSISTANCE, ADULT DAY PROGRAMS AND CHILDCARE. THIS PROGRAM IS ALSO AN INTERNSHIP OPPORTUNITY FOR UNDERGRADUATE STUDENTS FROM LOCAL COLLEGES AND UNIVERSITIES. THE PROGRAM IS MANAGED BY A MASTER'S LEVEL SOCIAL WORKER WHO SUPERVISES 3-4 STUDENTS EACH SEMESTER. SINCE THE INTRODUCTION OF THIS NEW SERVICE FOR PATIENTS IN THE SIGNATURE HEALTHCARE OUTPATIENT DEPARTMENT, 337 PATIENTS WERE SUPPORTED, 95 OF WHOM CONTINUE TO BE FOLLOWED. DURING 2014, THE PARTNERSHIP WITH LOCAL SCHOOLS WAS EXPANDED TO INCLUDE STONEHILL COLLEGE. A PROVIDER SATISFACTION SURVEY HAS BEEN CONDUCTED TWICE SINCE THE START OF THE PROGRAM IN OCTOBER WITH 100% SATISFACTION. SOME OF THE COMMENTS RECEIVED FROM THE PROVIDERS INCLUDE, "A VERY GOOD SERVICE TO OPD AND WE NEED IT," "I CANNOT IMAGINE WORKING WITHOUT ASSISTANCE FROM THIS PROGRAM. FOR THE PATIENT POPULATION WE HAVE HERE IN THE OPD, IT IS A MUST," "THIS SERVICE HAS RESULTED IN INCREASING THE THERAPEUTIC RELATIONSHIP BETWEEN THE PATIENT AND PROVIDER. IT MAKES THE WRAP UP PROCESS OF MANY VISITS SMOOTHER, AND PROVIDES GREATER SATISFACTION FOR MY WORK AND FOR MY PATIENTS." WE HAVE PREPARED A PATIENT SATISFACTION SURVEY TO BE MAILED IN THE FALL; DATA RECEIVED FROM THAT SURVEY WILL BE SUMMARIZED IN A REPORT. THE FOLLOWING INFORMATION PROVIDES SPECIFIC DATA REGARDING THE PATIENTS WHO HAVE BENEFITED FROM THIS PROGRAM. INITIAL CONCERN IDENTIFIED:ISSUE INDICATED PATIENTS AVERAGE AGEADULT EDUCATION 1 63.0CHILDCARE 1 39.0CLOTHING 1 31.0COUNSELING 127 49.0DAY PROGRAM 4 33.5EMPLOYMENT 8 34.9FOOD 34 49.3HOUSING 25 50.1INCOME 8 54.0INSURANCE 23 62.0MEDICATION 37 57.2OTHER 60 62.4UTILITIES 8 48.6GRAND TOTAL 337 52.8SOME OF THE ISSUES IN THE "OTHER" CATEGORY INCLUDE TRANSPORTATION; REFERRALS FOR COMMUNITY AGENCIES FOR SERVICES INCLUDING HOSPICE, VNA, ELDER SERVICES; CARE COORDINATION AND ASSISTANCE WITH COMPLETION OF HEALTH CARE PROXIES.COMPLEX CARE COORDINATIONSIGNATURE HEALTHCARE'S COMPLEX CARE INITIATIVE IDENTIFIES AND CREATES A PROCESS TO MANAGE THE HIGH RISK COMPLEX CARE ELDERLY PATIENTS. SIGNATURE HEALTHCARE ACCOMPLISHES THIS BY CREATING INFRASTRUCTURE TO IDENTIFY HIGH RISK ELDERS, AND DEVELOP SYSTEMS AND PROCESSES TO ENGAGE THESE PATIENTS IN A TEAM BASED, PATIENT CENTERED APPROACH TO CARE. THE AIM IS TO INCORPORATE A TEAM OF PROVIDERS DEDICATED AND PREPARED TO MEET THE CHALLENGING NEEDS OF THE HIGH RISK ELDER POPULATION; TO INTERVENE IN A WAY THAT FOSTERS FUNCTIONAL INDEPENDENCE, WITH THE HIGHEST REGARD TO MAINTAINING A QUALITY OF LIFE. THE STRATEGY AND TACTICS TO ACHIEVE THIS ARE BASED ON THE PATIENT'S FUNCTIONAL GOALS AND ARE DEVELOPED IN A WAY THAT IDENTIFIES THE UNIQUE NEEDS OF THE POPULATION. WITHIN THIS STRATEGY IS AN EMPHASIS ON FALL RISK AND DEPRESSION SCREENING TOOLS. DIABETIC ROSTERSIGNATURE MEDICAL GROUP ENGAGED THE PROVIDERS AND STAFF IN POPULATION HEALTH REVIEWS. OUR FOCUS IS THE DIABETIC PATIENTS WITHIN EACH PRACTICE. THE CARE TEAM MEETS QUARTERLY TO REVIEW ALL DIABETIC PATIENTS AND MONITOR HOW WELL THEIR DIABETES IS IN CONTROL. THE CARE TEAM CONSISTS OF THE PRIMARY CARE PHYSICIAN, NURSE PRACTITIONER, CLINICAL AND CLERICAL STAFF, PHARMACIST AND ENDOCRINOLOGISTS. OUR GOAL IS TO ENSURE EACH PATIENT IS UP TO DATE WITH ANNUAL LABS, EYE EXAM, KIDNEY FUNCTION AND BLOOD PRESSURE CONTROL. THE TEAM VERIFIES THE PATIENT'S LAB WORK IS WITHIN NORMAL RANGE TO PREVENT COMPLICATIONS OF DIABETES. MEDICATIONS ARE ADJUSTED AND FREQUENT FOLLOW UP APPOINTMENTS ARE SCHEDULED. EACH PATIENT'S UNIQUE COPING MECHANISMS ARE DISCUSSED AND IF BARRIERS TO CARE ARE IDENTIFIED, THE TEAM ENGAGES OUR CASE MANAGEMENT AND/OR SOCIAL WORK DEPARTMENTS TO SUPPORT PATIENTS WITH MEDICATIONS, NUTRITIONAL OR TRANSPORTATION NEEDS. ADDITIONALLY, SIGNATURE MEDICAL GROUP HAS BEEN HOLDING GROUP CLASSES FOR PATIENTS TO HELP PATIENTS MANAGE THEIR CHRONIC DISEASE.EXPANSION OF SERVICESIN ALL OF OUR AMBULATORY SITES, WE ARE REMODELING AND EXPANDING TO ACCOMMODATE ADDITIONAL PHYSICIANS TO PROVIDE HEALTHCARE TO THE GROWING POPULATION. HEALTHCARE GAPS: VERISK SIGNATURE HEALTHCARE RECENTLY PURCHASED A LICENSE FOR THE VERISK HEALTH PRODUCT. THIS DATABASE PROVIDES DETAILED INFORMATION RELATING TO THE QUALITY AND COST OF SIGNATURE MEDICAL GROUP PATIENTS UNDER CONTRACTUAL RISK. THIS INFORMATION ADDS TO THE ABILITY OF SMG PROVIDERS TO IMPROVE QUALITY PROCESSES AND OUTCOMES FOR THEIR PATIENTS. FOR EXAMPLE, SMG PCPS, WITH THE ASSISTANCE OF VERISK HEALTH DATA, CAN NOW IDENTIFY DIABETICS WITH LESS THAN 80% COMPLIANCE TO FILLING CHOLESTEROL REDUCING DRUG PRESCRIPTIONS. THIS DATA IS CRITICAL IN PCP FOLLOW-UP TO THEIR PATIENTS.USING PROVIDER INTELLIGENCE FOR COMMUNITY-BASED POPULATION HEALTH, VERISK HEALTH SOFTWARE WAS SUCCESSFULLY INTEGRATED WITH SIGNATURE HEALTHCARE'S DATA WAREHOUSE, CARETRACKER. DATA FROM 75,500 PATIENTS IN SIGNATURE MEDICAL GROUP'S PRIMARY CARE PRACTICES FROM 2012 TO 2013 IN CLAIMS FOR FIVE HEALTH INSURANCE PLANS WERE UPLOADED. THE EXPERIENCE WITH VERISK HAS IMPROVED SIGNATURE HEALTHCARE'S ABILITY TO DOWNLOAD CLAIMS, INTEGRATE TABLES WITH THE EMR ALLSCRIPTS PROGRAM, AND INTERNALLY QUERY CARETRACKER. IN ADDITION TO GENERATING DATA ON UTILIZATION AND COST, THE DIAGNOSTIC COST GROUPS (DXCG) STATISTICAL ALGORITHM AND PREDICTIVE MODELING, WHICH ARE PART OF VERISK, PROVIDE STATISTICAL PREDICTIONS OF THE "LIKELIHOOD OF HOSPITALIZATION" AND FUTURE COSTS. THIS ABILITY TO STRATIFY POPULATIONS BY DISEASE BURDEN, UTILIZATION, AND COST THROUGH PREDICTIVE MODELING PROVIDES A DATA-DRIVEN SYSTEM FOR EFFECTIVE POPULATION MANAGEMENT.SMG UTILIZES MULTIPLE DATABASES AND TOOLS TO GUIDE THE PCPS IN FOCUSING ON QUALITY DEFECTS. IN COMPARING DIABETIC QUALITY PROCESS MEASURES, SMG DEFECTS HAVE DECLINED IN FAMILY PRACTICE FROM 19% TO 16% AND INTERNAL MEDICINE 38% TO 23%. SCHEDULE H, PART VI, LINE 5 - SUPPLEMENTAL INFORMATION CARETRACKERCARETRACKER IS A CUSTOMIZED SOFTWARE MANAGEMENT TOOL USED TO HELP PROVIDE SUSTAINED IMPROVEMENTS IN COMPLIANCE WITH RECOMMENDED PREVENTATIVE SCREENINGS DEEP AND WIDE THROUGHOUT THE ORGANIZATION. TO DATE, EVERY PCP HAS DEMONSTRATED >5% REDUCTION IN MISSING TESTS ON AT LEAST 1 OF THE 6 MEASURES; 80% OF PCPS IMPROVED ON 4 OF 6 MEASURES; AND 50% OF PCPS IMPROVED ON 5 OF 6 MEASURES. IN SOME CASES, PCPS WERE ABLE TO REDUCE THE PERCENTAGE IN MISSING TESTS IN THEIR PATIENT PANEL BY >40%. SIGNATURE HEALTHCARE PLANS TO ADVANCE THIS APPROACH TO POPULATION MANAGEMENT AS WE ADDRESS THE HIGH PREVALENCE OF MULTIPLE CHRONIC CONDITIONS. HEART FAILURE DISEASE MANAGEMENT PROGRAMTHE FOCUS OF THIS PROGRAM IS TO ENROLL HIGH RISK PATIENTS WITH A PRIMARY ADMISSION OF ACUTE DECOMPENSATED HEART FAILURE. ACHIEVEMENTS WHICH IMPROVE THE CARE OF THIS PATIENT POPULATION ARE THE USE OF TEACH BACK IN EDUCATION OF OUR PATIENTS, THE IMPLEMENTATION OF A HOSPITAL WIDE CASE MANAGEMENT RISK ASSESSMENT TOOL, AND FURTHER EXPANSION OF OUR MULTIDISCIPLINARY ROUNDS TO INCLUDE REPRESENTATION FROM THE PHARMACY. POLYPHARMACY ISSUES ARE COMMON IN THE CHALLENGES IDENTIFIED FOR CARE OF THE CHF PATIENT POPULATION.HOMEWARD BOUNDHOMEWARD BOUND IS AN INNOVATIVE PARTNERSHIP BETWEEN BROCKTON HOSPITAL AND BROCKTON HOSPITAL SCHOOL OF NURSING TO COORDINATE THE CARE FOR PATIENTS WHO HAVE BEEN HOSPITALIZED WITH CONGESTIVE HEART FAILURE (CHF). APPROXIMATELY 28% OF BROCKTON HOSPITAL PATIENTS WITH CHF ARE READMITTED TO THE HOSPITAL WITHIN 30 DAYS COMPARED TO THE NATIONAL AVERAGE OF 24.7%. HOMEWARD BOUND WAS SPECIFICALLY DESIGNED TO LOWER THE 30-DAY READMISSION RATE FOR THESE PATIENTS. ACCORDING TO THE CENTERS FOR MEDICARE AND MEDICAID SERVICES, 90% OF ALL READMISSIONS FOR HEART FAILURE ARE UNPLANNED OR PREVENTABLE.(STAMP,ET.AL.,2013) MOST READMISSIONS ARE DUE TO PATIENTS' POOR UNDERSTANDING OF THEIR DIAGNOSIS, NON-COMPLIANCE WITH THEIR MEDICATION REGIME, AND LACK OF MOTIVATION TO CHANGE THEIR DIET AND/OR EXERCISE. THE NURSING STUDENTS, HOSPITAL STAFF AND FACULTY WORK TOGETHER TO MONITOR PATIENT'S CONDITIONS ON A DAILY BASIS THROUGH HOME VISITS AND TELEMEDICINE. THE GOAL OF THESE VISITS IS TO REDUCE THE 30-DAY READMISSION RATES FOR CHF PATIENTS. IN THE FIRST YEAR, HOMEWARD BOUND WORKED WITH 22 PATIENTS, NONE OF WHOM WERE RE-HOSPITALIZED. HPIIN 2014 SIGNATURE HEALTHCARE INITIATED A PARTNERSHIP WITH HEALTHCARE PERFORMANCE IMPROVEMENT (HPI) TO CONDUCT A SAFETY ASSESSMENT AND DEVELOP AN INTERVENTION PLAN DESIGNED TO REDUCE SERIOUS ADVERSE EVENTS IN THE HOSPITAL BY 50-80% IN TWO YEARS. THE INITIAL ASSESSMENT IDENTIFIED OPPORTUNITIES IN SIGNATURE HEALTHCARE'S CURRENT SAFETY CULTURE. WE ENGAGED THE SERVICES OF HPI TO LEAD SIGNATURE HEALTHCARE IN A JOURNEY TOWARDS ZERO-HARM. HPI IS CURRENTLY EDUCATING MANAGEMENT STAFF AND PHYSICIAN LEADERSHIP ON IMPLEMENTING A CULTURE OF SAFETY, LEADING TO PRACTICE, PROCESS AND BEHAVIORAL CHANGES AIMED AT REDUCING EVENTS WHICH CAUSE HARM TO PATIENTS. PERAHEALTHPERATREND SOFTWARE FROM PERAHEALTH WAS INTEGRATED INTO THE MEDITECH ELECTRONIC MEDICAL RECORD (EMR) FOR USE ON MEDICAL/SURGICAL WARD A5 IN SIGNATURE HEALTHCARE BROCKTON HOSPITAL. PERATREND SOFTWARE IS AN EMR-COMPLIMENT THAT UTILIZES THE ROTHMAN INDEX (RI), A GENERAL MEASURE OF INDIVIDUAL PATIENT CONDITION. IN IMPLEMENTING THIS TOOL, NURSING DOCUMENTATION HAD TO BE RESTRUCTURED WHICH LED TO IMPROVED CLINICAL DOCUMENTATION. CLINICAL PROVIDERS, NURSING STAFF AND HOSPITALISTS ROUTINELY REVIEW THE RI ON EACH PATIENT IN ORDER TO PROMPT REASSESSMENTS, FACILITATE COMMUNICATION BETWEEN CLINICIANS, AND MAKE DECISIONS ABOUT CARE TRANSITIONS. STAFF EXPERIENCE WITH PERATREND ON WARD A5 HAS BEEN POSITIVE WITH 88% OF STAFF REPORTING THAT THE RI IS A VALUABLE TOOL AND WOULD RECOMMEND EXTENDING THE TOOL HOSPITAL-WIDE. INDEED, SIGNATURE HEALTHCARE PLANS TO EXPAND THE USE OF THE PERATREND TOOL AND THE IMPROVED NURSING DOCUMENTATION ACROSS THE HOSPITAL IN 2015.PRE-DIABETES PILOTAT THE BEGINNING OF FY 14, THE SIGNATURE HEALTHCARE BRIDGEWATER OFFICE CREATED A PROGRAM AIMED AT REDUCING THE PERCENTAGE OF PATIENTS WITH RISK FACTORS FOR PRE-DIABETES. THIS PROGRAM HAD MANY COMPONENTS, THE FIRST OF WHICH WAS HOW TO IDENTIFY THE TARGET POPULATION. A PRE-VISIT PREPARATION WORKSHEET FOR MEDICAL ASSISTANTS TO COMPLETE PRIOR TO PATIENT APPOINTMENTS WAS DEVELOPED. THEY RECORDED THE PATIENT'S LAST HEMOGLOBIN A1C RESULT AND SCREENING NEED BASED ON AGE (45 OR OLDER) OR BMI (25 OR GREATER). THE PATIENTS WERE THEN FLAGGED WHEN THEY WERE IN NEED OF SCREENING AT POINT OF SERVICE. THE OFFICE DEVELOPED STANDARD REPORTS FOR USE WITHIN THE PRACTICE TO MONITOR THE 'AT RISK' POPULATION'S SCREENING DEFECT RATE OVER TIME. A FOUR COMPONENT SCREENING PROCESS WAS DEVELOPED. FIRST, THE POINT OF CARE HBA1C TESTING WAS IMPLEMENTED ALLOWING RESULTS TO BE DETERMINED WITHIN 3 MINUTES AFTER SPECIMEN COLLECTION. SECOND, THE CLINICAL STAFF PERFORMED TESTING BASED ON STANDING ORDERS WITH RESULTS AVAILABLE BEFORE THE PROVIDERS ENTERED THE EXAM ROOM. THIS STANDARD PROCESS ALLOWED THE PRIMARY CARE PHYSICIAN TO PROVIDE REAL TIME INTERVENTION AT THE TIME OF THE APPOINTMENT. THIRD, THE OFFICE STAFF TOOK STEPS TO ASSIST THE PATIENT IN MANAGING LIFESTYLE CHANGES. PATIENT EDUCATION MATERIALS WERE DEVELOPED WITH INFORMATION ABOUT HEALTHY EATING AND PHYSICAL ACTIVITY. SIGNATURE HEALTHCARE PARTNERED WITH THE OLD COLONY YMCA DIABETES PREVENTION PROGRAM TO PROVIDE LIFESTYLE COACHING AFTER HOURS. FOURTH, RESOURCES WERE LEVERAGED WITHIN THE PRACTICE, SUCH AS NUTRITION COUNSELING AND ENDOCRINOLOGY CONSULTS TO MEET A PATIENT'S NEEDS. IN THE FIRST YEAR OF THIS PROJECT, 2,755 PATIENTS OF THE 6,100 PATIENT PRIMARY CARE PRACTICE WERE SCREENED, REDUCING THE SCREENING DEFECT RATE FROM 85% TO 29%. OF THIS, 988 PATIENTS (36%) WERE DIAGNOSED WITH PRE-DIABETES AND 49 PATIENTS DIAGNOSED WITH TYPE 2 DIABETES. OF THE PATIENTS DIAGNOSED WITH PRE-DIABETES, MORE THAN 64% LOST WEIGHT OVER THE COURSE OF THE YEAR, WITH 31% LOSING AT LEAST 5% OF THEIR BODY WEIGHT. AS ANTICIPATED, THE PRE-DIABETIC PATIENT'S WEIGHT LOSS GENERATED A CORRESPONDING IMPROVEMENT IN HEMOGLOBIN A1C LEVELS WITH 72% OF PRE-DIABETIC PATIENTS HBA1C DECREASING OVER BASELINE, AND 25% OF PRE-DIABETIC PATIENTS ACHIEVING NORMAL HBA1C VALUES. SUBSTANCE ABUSE INITIATIVESIGNATURE HEALTHCARE EMERGENCY DEPARTMENT PHYSICIANS WORK WITH LOCAL POLICE AND FIRE DEPARTMENTS - PROVIDING TRAINING AND MEDICAL GUIDANCE. POLICE DEPARTMENTS FROM NORFOLK, PLYMOUTH AND BRISTOL COUNTIES WERE TRAINED ON PROPER USE OF NASAL NARCAN. THE ED PHYSICIANS ARE ALSO WORKING ON PROJECTS WITH THE NORFOLK AND PLYMOUTH COUNTY DISTRICT ATTORNEY'S OFFICES TO PROVIDE LECTURES TO STUDENTS, PARENTS, TEACHERS AND OTHER HEALTHCARE PROFESSIONALS ON CONCUSSIONS, SPORTS INJURIES AND SUBSTANCE ABUSE. A SECOND INITIATIVE WITHIN THE SIGNATURE HEALTHCARE EMERGENCY DEPARTMENT HAS BEEN CREATED TO ADDRESS THE NEEDS OF OVERDOSE PATIENTS. AT TIME OF DISCHARGE, THESE PATIENTS WILL RECEIVE NASAL NARCAN, A LIST OF DETOXIFICATION FACILITIES AND COUNSELING. THE ED PHYSICIANS ARE ALSO LIMITING THE NUMBER OF NARCOTICS THEY ARE PRESCRIBING TO PATIENTS. THEY WILL NOT FILL LOST PRESCRIPTIONS AND THEY ARE ADVANCING USE OF THE STATE'S "PRESCRIPTION MONITORING PROGRAM." SIGNATURE HEALTHCARE/WALGREENS PHARMACY PROGRAMSIGNATURE HEALTHCARE PHARMACY AND WALGREENS PARTNERED IN 2012 TO PROVIDE DISCHARGE MEDICATIONS TO PATIENTS AT THE BEDSIDE. A WALGREENS EMPLOYEE VISITS THE PATIENT, FILLS THE MEDICATIONS AND RETURNS THEM TO THE PATIENT BEFORE DISCHARGE. APPROXIMATELY 100 PATIENTS PER MONTH PARTICIPATE IN THIS PROGRAM. MOST IMPORTANTLY FOR OUR PATIENTS, THIS PROGRAM MEANS MORE PERSONAL ATTENTION AND HELP UNDERSTANDING HOW AND WHEN TO TAKE NEW DRUGS, AS WELL AS WHICH MIGHT CONFLICT WITH WHAT THEY'RE ALREADY TAKING AT HOME. PATIENT COMPLIANCE WITH MEDICATION REGIMENS IS KEY TO IMPROVING AND MAINTAINING GOOD HEALTH - AVOIDING HOSPITAL READMISSIONS. SCHEDULE H, PART VI, LINE 5 - SUPPLEMENTAL INFORMATION WEIGHT & WELLNESS CENTERTHROUGH HARD WORK AND DEDICATION, SIGNATURE HEALTHCARE'S WEIGHT AND WELLNESS CENTER BECAME AN MBASQIP ACCREDITED CENTER. A BARIATRIC SURGICAL CENTER ACHIEVES ACCREDITATION FOLLOWING A RIGOROUS REVIEW PROCESS DURING WHICH IT DEMONSTRATES AN ABILITY TO MEET CERTAIN PHYSICAL RESOURCES, HUMAN RESOURCES AND STANDARDS OF PRACTICE. ALL ACCREDITED CENTERS REPORT THEIR OUTCOMES TO THE MBASQIP DATABASE. ALSO, IN FY 14 OUR WEIGHT AND WELLNESS CENTER ADDED A DOCTOR-SUPERVISED MEDICAL WEIGHT LOSS PROGRAM TO QUALIFIED PATIENTS. THIS IS A 12 WEEK PROGRAM LED BY DR. DEB ABELES, DIRECTOR OF THE WEIGHT & WELLNESS CENTER AND BARIATRIC SURGEON. THE FIRST GROUP ENROLLED IN THIS PROGRAM GRADUATED IN SEPTEMBER 2014 WITH GREAT OUTCOMES. THE AVERAGE WEIGHT LOSS WAS 11.2% AND THE AVERAGE DECREASE IN HVA1C WAS 0.7%. OUR WEIGHT & WELLNESS CENTER PROVIDES CONVENIENT ACCESS TO A WIDE RANGE OF ADVANCED SURGICAL AND NONSURGICAL WEIGHT LOSS OPTIONS, UTILIZING AN INDIVIDUAL APPROACH, INCLUDING A SURGEON, PHYSICIAN, DIETICIAN AND BEHAVIORAL THERAPIST. WHETHER ON A SURGICAL OR NON-SURGICAL PATH, OUR CENTER STRIVES TO TEACH PATIENTS NUTRITIONAL AND LIFESTYLE CHANGES NEEDED FOR LONG-TERM SUCCESS. WELLNESS TOGETHER EMPLOYEE PROGRAMSIGNATURE HEALTHCARE ESTABLISHED THE WELLNESS TOGETHER PROGRAM IN 2013 TO SUPPORT, IMPROVE AND INSPIRE THE HEALTH AND WELL BEING OF SIGNATURE EMPLOYEES. TO ASSIST IN ACHIEVING THIS GOAL, SIGNATURE PARTNERED WITH THE VITALITY GROUP, A PROPRIETARY WELLNESS PROGRAM WITH AN ONLINE PORTAL THAT DELIVERS EVIDENCE BASED RESULTS. THE PROGRAM IS DESIGNED SPECIFICALLY TO MITIGATE HEALTH RISKS AND LOWER HEALTHCARE COSTS BY REDUCING LIFESTYLE RISK FACTORS ASSOCIATED WITH CHRONIC DISEASES. REPLICATING THE SAME WELLNESS PLATFORM, SIGNATURE HEALTHCARE IS REACHING OUT TO COMMUNITY EMPLOYERS TO ASSIST THEM IN IMPROVING THE HEALTH AND WELLBEING OF THEIR EMPLOYED POPULATION AND ULTIMATELY REDUCING THEIR HEALTHCARE COST. 360 CONCIERGE PROGRAMSIGNATURE HEALTHCARE'S HOSPITAL-BASED 360 CONCIERGE PROGRAM DEMONSTRATES SIGNIFICANT RESULTS IN REDUCING TOTAL MEDICAL EXPENSE OF THE MANAGED MEDICARE POPULATION. THIS PROGRAM WAS THE BASIS FOR DEVELOPING A MIRROR PROGRAM WITH A COMPLEX CARE CLINIC IN THE AMBULATORY SETTING. COMPLEX ELDERLY PATIENTS ARE OUR MOST VULNERABLE PATIENTS WITH MULTIPLE CHRONIC ILLNESS, FUNCTIONAL LIMITATIONS, AND UNIQUE SOCIAL NEEDS. SCHEDULE H, PART VI, LINE 6 - SUPPLEMENTAL INFORMATION 6 AFFILIATED HEALTH CARE SYSTEM: SIGNATURE HEALTHCARE AFFILIATED WITH BETH ISRAEL DEACONESS MEDICAL CENTER IN JUNE OF 2013 FOR THE PROVISION OF ADULT MEDICAL AND SURGICAL SERVICES. THIS AFFILIATION IS AIMED AT PROVIDING THE PATIENTS OF GREATER BROCKTON WITH ENHANCED ACCESS TO TERTIARY LEVEL SERVICES CLOSE TO HOME AND COORDINATED CARE MANAGEMENT FOR PATIENTS WHO MUST SEEK CARE AT THE TERTIARY LEVEL HOSPITAL IN BOSTON, MA.SIMILARLY, SIGNATURE HEALTHCARE EXPANDED UPON ITS AFFILIATION WITH TUFTS FLOATING HOSPITAL FOR CHILDREN IN JUNE OF 2013. WITH THIS EXPANDED AFFILIATION, SIGNATURE HEALTHCARE BUILDS ON THE HOSPITALS' EXISTING COLLABORATION TO CARE FOR NEWBORNS; FLOATING HOSPITAL NEONATOLOGISTS HAVE CARED FOR BABIES IN SIGNATURE HEALTHCARE BROCKTON HOSPITAL'S LEVEL II NURSERY SINCE 2010. SIGNATURE HEALTHCARE HAS ENABLED THOUSANDS OF CHILDREN TO RECEIVE THEIR CARE CLOSER TO HOME. WHEN CHILDREN NEED TERTIARY CARE AT FLOATING HOSPITAL, OUR HOSPITALISTS HELP MAKE THAT TRANSITION SEAMLESS. SIGNATURE HEALTHCARE PEDIATRICIANS ARE ABLE TO COMMUNICATE DIRECTLY WITH THE HOSPITALISTS DURING AND FOLLOWING THEIR PATIENT'S HOSPITALIZATION TO ENABLE EASY TRANSITION OF CARE.TUFTS FLOATING HOSPITAL PROVIDES PEDIATRIC SPECIALTY CARE AT SIGNATURE HEALTHCARE IN THE FOLLOWING AREAS:-CARDIOLOGY-ENDOCRINOLOGY-GASTROENTEROLOGY-GENETICS-NEPHROLOGY-NEUROLOGY-PULMONOLOGY -RHEUMATOLOGY SCHEDULE H, PART VI, LINE 7 - SUPPLEMENTAL INFORMATION 7 STATE FILING OF COMMUNITY BENEFIT REPORT:SIGNATURE HEALTHCARE FILES AN ANNUAL COMMUNITY BENEFIT REPORT WITH THE COMMONWEALTH OF MASSACHUSETTS. X 0 1 X X X X X X 0 1 0 0 0 0 0 0 0 KIM HOLLON CHIEF EXECUTIVE OFFICER 657424 0 0 0 0 0 11475 0 22924 0 691823 0 0 0 DAVID DRINKWATER MD TRUSTEE 0 502163 0 0 0 0 0 0 0 22549 0 524712 0 0 MICHAEL L DERN MD TRUSTEE 0 589524 0 0 0 0 0 5100 0 14715 0 609339 0 0 ROBERT S GREENBERG MD TRUSTEE 0 271061 0 0 0 0 0 5100 0 15681 0 291842 0 0 KEITH MERLIN TRUSTEE 0 472530 0 0 0 0 0 32355 0 22549 0 527434 0 0 JAMES PAPADAKOS CHIEF FINANCIAL OFFICER 325452 0 0 0 0 0 8751 0 24964 0 359167 0 0 0 STEPHEN BORGES VICE PRESIDENT 189952 0 0 0 0 0 11016 0 20017 0 220985 0 0 0 DAVID J FISHER VICE PRESIDENT 189381 0 0 0 0 0 12872 0 15834 0 218087 0 0 0 KIMBERLY WALSH VICE PRESIDENT 227492 0 0 0 0 0 9232 0 9597 0 246321 0 0 0 KAREN MURPHY VICE PRESIDENT & GEN'L COUNSEL 289466 0 0 0 0 0 14847 0 2996 0 307309 0 0 0 MARIE F GROSS VICE PRESIDENT 264173 0 0 0 0 0 6633 0 3341 0 274147 0 0 0 JEFFREY MILLER VICE PRESIDENT 187287 0 0 0 0 0 6425 0 21610 0 215322 0 0 0 DENNIS RENAUD DIRECTOR 177544 0 0 0 0 0 7990 0 1052 0 186586 0 0 0 MITCHELL SELINGER VICE PRESIDENT 365917 112407 0 0 0 0 7650 0 16188 0 389755 112407 0 0 TIMOTHY R LYNCH MD FORMER TRUSTEE 0 20629 0 0 0 0 0 0 0 1735 0 22364 0 0 ROBERT COVETT MD FORMER TRUSTEE 0 361952 0 0 0 0 0 0 0 7787 0 369739 0 0 DALE J ELLENBERG MD FORMER TRUSTEE 0 251185 0 0 0 0 0 2500 0 22549 0 276234 0 0 KEN LAWSON FORMER TRUSTEE 0 423983 0 0 0 0 0 4898 0 22548 0 451429 0 0 GEORGE C BROWN FORMER TRUSTEE 0 596012 0 0 0 0 0 2454 0 15680 0 614146 0 0 JEAN-PIERRE GEAGEA FORMER TRUSTEE 0 633081 0 0 0 0 0 3676 0 81 0 636838 0 0 MARC GREENWALD FORMER TRUSTEE 0 341552 0 0 0 0 0 3446 0 8384 0 353382 0 0 DANIEL MUSE FORMER TRUSTEE 0 446174 0 0 0 0 0 17885 0 305 0 464364 0 0 ABDEL-HAI HAMMO FORMER TRUSTEE 0 197789 0 0 0 0 0 0 0 8669 0 206458 0 0 PART I, LINE 1B THE COMPENSATION ELEMENTS INDICATED ON SCHEDULE J, PART I (TAX INDEMNIFICATION/GROSS-UP PAYMENTS) WERE PROVIDED PURSUANT TO THE EMPLOYMENT CONTRACT MAINTAINED BETWEEN THE HOSPITAL AND THE INDIVIDUAL. PART I, LINE 4B DURING THE YEAR ENDED 9/30/2014 THE HOSPITAL MADE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN CONTRIBUTIONS FOR FOUR EMPLOYEES. CONSISTENT WITH REPORTING REQUIREMENTS FOR IRS FORM 990, THE HOSPITAL REPORTS COMPENSATION AND OTHER PAYMENTS TO EMPLOYEES AND FORMER EMPLOYEES ON A CALENDAR YEAR (FORM W-2) BASIS. CONSEQUENTLY, THE FOLLOWING AMOUNTS ARE REPORTED FOR THE FISCAL YEAR ENDING 9/30/2014: JAMES PAPADAKOS - $1,326 KAREN MURPHY - $3,372 DAVID FISHER - $1,126 MARIE F GROSS - $427 A MASSACHUSETTS DEVELOPMENT FINANCING AGENCY 043431814 2014-09-30 47750000 REFINANCING OF EXISTING LONG-TERM DEBT AND RETIREMENT OF PRIOR MDFA BONDS 0 0 0 A 47750000 385000 46865000 2014 1 0 0 1 A 0 1 1 1 0 0.00730 0.00730 0 0 0 A 0 1 0 0 1 0 0 0 0 MICHAEL L CONNORS FMR CFO LOAN RECEIVABLE - SPLIT DOLLAR LIFE INSURANCE POLICY X 995000 995000 0 1 1 995000 FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S FORM 990 IS PREPARED BY AN OUTSIDE INDEPENDENT CERTIFIED PUBLIC ACCOUNTANT IN CONJUCTION WITH INPUT PROVIDED BY ORGANIZATION MANAGEMENT. THE COMPLETED FORM 990 WAS PROVIDED TO EACH BOARD MEMBER ELECTRONICALLY. IN ADDITION, A BOARD MEETING WAS CONVENED TO REVIEW THE FORM 990 IN ADVANCE OF THE FILING DATE. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR THE ORGANIZATION CIRCULATES A CONFLICT OF INTEREST QUESTIONNAIRE. RESPONSES TO THE STATEMENT ARE REVIEWED AND PRESENTED TO THE BOARD FOR REVIEW AND ACTION. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR OFFICERS AND KEY EMPLOYEES IS REVIEWED ANNUALLY BY THE BOARD OF DIRECTORS AND ADJUSTMENTS TO COMPENSATION ARE BASED ON PERFORMANCE STANDARDS AND COMPARISON OF COMPENSATION LEVELS TO SIMILAR PROVIDER ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION MAKES ITS 990 AND 990-T AVAILABLE UPON REQUEST. ADDITIONALLY, THE ORGANIZATION'S FORM 990 IS AVAILABLE ON THE WEBSITE OF THE MASSACHUSETTS ATTORNEY GENERAL. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST, FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. ADDITIONALLY, THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AVAILABLE ON THE WEBSITE OF THE MASSACHUSETTS ATTORNEY GENERAL AS WELL AS WITH THE MUNICIPAL SECURITIES RULEMAKING BOARD. FORM 990, PART XI, LINE 9: PENSION RELATED CHANGES OTHER THAN NET PERIODIC BENEFIT COST -4,952,111. CHANGE IN INTEREST IN INVESTMENTS OF SIGNATURE HEALTHCARE, INC. 71,480. TRANSFERS (TO) FROM AFFILIATES -32,505,210. NET ASSETS RELEASED FROM RESTRICTION FOR PURCHACE OF P,P&E 30,979. LOSS ON EARLY EXTINGUISHMENT OF DEBT -181,011. CHANGE IN FAIR VALUE OF SPLIT INTEREST AGREEMENTS 41,901. GIFT AND BEQUESTS 82,000. SIGNATURE HEALTHCARE CORPORATION 680 CENTRE STREET BROCKTON MA 02302 042103554 MANAGEMENT MA 501(C)(3) PUBLIC CHARITY N/A 0 SIGNATURE HEALTHCARE MEDICAL GROUP 680 CENTRE STREET BROCKTON MA 02302 043306782 MEDICAL CARE MA 501(C)(3) PUBLIC CHARITY SIGNATURE HEALTHCARE CORPORATION 0 BROCKTON RADIATION ONCOLOGY LLC 680 CENTRE STREET BROCKTON MA 02302 222472997 RADIATION ONCOLOGY SERVICES MA N/A RELATED 1085720 880800 0 0 0.40000 BRIDGEWATER GODDARD PARK MEDICAL ASSOCIATES 680 CENTRE STREET BROCKTON MA 02302 042530255 PHYSICIAN GROUP MA N/A C 0 BROCKTON PHYSICIAN HOSPITAL ORGANIZATION 680 CENTRE STREET BROCKTON MA 02302 043189274 MEDICAL MANAGEMENT MA N/A C 840 135810 0.50000 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 110 LIBERTY STREET LLC H 30362603 FMV SIGNATURE HEALTHCARE CORPORATION I 14751784 FMV BRIDGEWATER GODDARD PARK MEDICAL ASSOCIATES I 1956736 FMV 110 LIBERTY STREET LLC I 30362103 FMV SIGNATURE HEALTHCARE MEDICAL GROUP J 70041 FMV SIGNATURE HEALTHCARE CORPORATION K 645000 FMV SIGNATURE HEALTHCARE MEDICAL GROUP K 177776 FMV SIGNATURE HEALTHCARE CORPORATION O 354973 FMV SIGNATURE HEALTHCARE MEDICAL GROUP O 16195549 FMV SIGNATURE HEALTHCARE CORPORATION P 44722 FMV SIGNATURE HEALTHCARE MEDICAL GROUP P 445130 FMV SIGNATURE HEALTHCARE CORPORATION Q 198086 FMV BRIDGEWATER GODDARD PARK MEDICAL ASSOCIATES Q 670554 FMV 110 LIBERTY STREET LLC Q 500 FMV SIGNATURE HEALTHCARE MEDICAL GROUP Q 9396023 FMV SIGNATURE HEALTHCARE CORPORATION R 5481875 FMV BRIDGEWATER GODDARD PARK MEDICAL ASSOCIATES R 600932 FMV SIGNATURE HEALTHCARE MEDICAL GROUP R 14237068 FMV SIGNATURE HEALTHCARE CORPORATION S 150050 FMV BRIDGEWATER GODDARD PARK MEDICAL ASSOCIATES S 3108578 FMV SIGNATURE HEALTHCARE MEDICAL GROUP S 6958008 FMV