2015-08-13T14:16:55-05:00 2014-09-30 346565596 ERNST & YOUNG LLP 425 HOUSTON ST SUITE 600 FORTH WORTH TX 76102 990 2013-10-01 042791396 BERKSHIRE MEDICAL CENTER INC BERK 4134472081 725 NORTH STREET PITTSFIELD MA 012014109 DARLENE RODOWICZ CFO 4134472508 2015-08-13 0 MELVA SCOTT P01207335 8173486156 2013 2016-02-25 16:41:14Z DARLENE RODOWICZ 725 NORTH ST PITTSFIELD MA 01201 421856750 0 X WWW.BHS1.ORG X 1983 MA THE MISSION OF BERKSHIRE MEDICAL CENTER IS TO IMPROVE THE HEALTH OF ALL PEOPLE IN THE BERKSHIRES AND SURROUNDING COMMUNITIES, REGARDLESS OF THEIR ABILITY TO PAY. 22 18 2951 220 428155 427155 3228887 3866368 355486744 391487761 5915577 15161402 756438 1006689 365387646 411522220 0 0 0 0 198334886 216096784 0 0 172482 142657460 166913544 340992346 383010328 24395300 28511892 470435532 510707767 193886074 197487828 276549458 313219939 X THE MISSION OF BERKSHIRE MEDICAL CENTER IS TO IMPROVE THE HEALTH OF ALL PEOPLE IN THE BERKSHIRES AND SURROUNDING COMMUNITIES, REGARDLESS OF THEIR ABILITY TO PAY. 0 0 293521929 346218835 OPERATE AN ACUTE CARE GENERAL HOSPITAL AND MEDICAL EDUCATIONAL FACILITY, AND TO DELIVER THE HIGHEST QUALITY PATIENT CENTERED CARE IN A LEARNING ENVIRONMENT. TOTAL PATIENT DAYS FOR THE YEAR ARE 61,660, TOTAL LAB PROCEDURES 1,524,249, TOTAL RADIOLOGY PROCEDURES 168,378, TOTAL REHAB VISITS 60,867. HOURS OF OPERATION 24/HRS 365/DAYS PER YEAR. 27483016 35174576 OPERATION OF AN EMERGENCY DEPARTMENT AND TRAUMA CARE CENTER AVAILABLE TO ALL REGARDLESS OF ABILITY TO PAY. TOTAL VISITS FOR THE YEAR 63,998. ED IS IN OPERATION 24 HRS/DAY 365 DAYS/YEAR. 13970484 8192995 VISITING NURSE PROGRAM ALLOWING FOR THE CARE AND REHABILATION OF PATIENTS IN THEIR OWN HOME ENVIRONMENT. TOTAL VISITS FOR THE YEAR 56,388 DETAILED AS FOLLOWS SKILLED NURSING 30,471, HOME HEALTH AIDE 10,125, REHAB 15,258, AND SOCIAL SERVICE 534. HOURS OF OPERATION 7 DAYS/WEEK 8AM-9PM WITH A NURSE ON CALL 24 HOURS. 2126414 1901355 OPERATE A SUBSTANCE ABUSE CENTER WITH PROVIDING THE HIGHEST QUALITY OF PATIENT CARE. TOTAL PATIENT DAYS FOR THE YEAR 5,723. PROGRAM OPERATES 24 HRS/DAY 365 DAYS/YEAR. 2126414 1901355 337101843 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 246 0 1 2951 1 1 1 0 0 0 0 1 1 0 0 0 0 X 22 18 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA NY WI NC CT IL X DARLENE RODOWICZ 4134472809 725 NORTH STREET PITTSFIELD MA 012014109 JEROME J ANDERSON TRUSTEE 1.00 2.00 X 0 0 0 THOMAS O ANDREWS TRUSTEE 1.00 2.00 X 0 0 0 ALFRED A BARBALUNGA TRUSTEE 1.00 2.00 X 0 0 0 BRONLY S BOYD TRUSTEE TERM ENDED 1/29/14 1.00 2.00 X 0 0 0 BRIAN T BURKE MD TRUSTEE/PHYSICIAN 1.00 48.00 X 0 218733 39541 KIT DOBELLE TRUSTEE 1.00 2.00 X 0 0 0 TIMOTHY C DOHERTY TRUSTEE/CHAIRMAN 1.00 2.00 X 0 0 0 RICHARD M DOHONEY TRUSTEE 1.00 2.00 X 0 0 0 ELLEN L KENNEDY TRUSTEE 1.00 2.00 X 0 0 0 A KING FRANCIS TRUSTEE 1.00 2.00 X 0 0 0 DENNIS J HOGAN TRUSTEE 1.00 2.00 X 0 0 0 EDMUND H HORNSTEIN DO TRUSTEE/PHYSICIAN 1.00 2.00 X 64920 0 0 MICHAEL R MCINERNEY MD TRUSTEE/PHYSICIAN 1.00 2.00 X 0 0 0 SUSAN M KORMANIK TRUSTEE 1.00 2.00 X 0 0 0 LORINDA ACKLEY MAZUR TRUSTEE 1.00 2.00 X 0 0 0 JOAN M MCFALLS TRUSTEE 1.00 2.00 X 0 0 0 LAURIE NORTON MOFFATT TRUSTEE 1.00 2.00 X 0 0 0 DAVID E PHELPS PRESIDENT 25.00 23.00 X X 0 679177 39228 DAVID E PHELPS ANNUAL LIFE PRESIDENT INSURANCE 1.00 1.00 X X 0 107692 0 CAROL G SIEGEL TRUSTEE TERM ENDED 1/29/14 1.00 2.00 X 0 0 0 GEORGE T SMITH TRUSTEE 1.00 2.00 X 0 0 0 MARILYN L SPERLING TRUSTEE 1.00 2.00 X 0 0 0 ANN H TRABULSI TRUSTEE 1.00 2.00 X 0 0 0 BARTON D RASOR TRUSTEE 1.00 2.00 X 0 0 0 JOHN R KEARNS MD TRUSTEE/PHYSICIAN 1.00 2.00 X 28368 0 0 DARLENE RODOWICZ TREASURER 37.00 13.00 X 0 463636 36555 CHERYL BOUDREAU CLERK 19.00 21.00 X 0 101178 14944 RONALD HAYDEN CHAIRMAN - EMERGENCY MEDIC 50.00 X 511947 0 41016 DIANE KELLY C.O.O. 50.00 X 398174 0 38297 RAYMOND GARY SOHL ANESTHESIOLOGIST 50.00 X 478913 0 38299 ANTHONY G ELLRODT CHAIRMAN - DEPT OF MEDICIN 50.00 X 490376 0 38484 DAVID I POMERANTZ ANESTHESIOLOGIST 50.00 X 436758 0 43606 CARLOS MARAMAG ANESTHESIOLOGIST 50.00 X 437523 0 46082 TALAL A MAKKAOUI ANESTHESIOLOGIST 50.00 X 428667 0 45901 3275646 1570416 421953 310 0 1 0 BILL DUNBAR AND ASSOCIATES LLC 2601 FORTUNE CIRCLE EAST STE 301A INDIANAPOLIS IN 46241 CONTRACTED LABOR 741480 EXECUTIVE HEALTH RESOURCES PO BOX 822688 PHILADELPHIA PA 191822688 CONTRACTED LABOR 702320 STAFF CARE INC PO BOX 281923 ATLANTA GA 303841923 CONTRACTED LABOR 630561 BAYSTATE REFERENCE LABORATORY PO BOX 3352 BOSTON MA 022413352 MEDICAL LAB SERVICES 527666 DIVERSIFIED CLINICAL SERVICES PO BOX 85001 ORLANDO FL 32885 MANAGEMENT SERVICES 501860 172 104918 2379807 1381643 3866368 PATIENT SERVICES REVENUE 622110 378107683 378107683 OTHER ANCILLARY 622110 6572512 6572512 HEALTH PROMO EDUCATION 611710 3067253 3067253 LAB REVENUE 621511 2064486 2064486 PSYCH PROF SERVICES 621112 1675827 1675827 391487761 3267465 428155 2839310 240527 240527 1516017 1791742 -275725 -275725 -275725 16687349 3454061 8488000 0 8199349 3454061 11653410 11653410 54788 104918 54788 0 CAFETERIA INCOME 722514 1282414 1282414 1282414 411522220 391487761 428155 15739936 910120 910120 171335497 163553824 7688519 93154 6530159 6130053 400106 24579414 23350443 1228971 12741594 12104514 637080 28972407 28972407 286566 286566 46080 46080 6812635 5215182 1597453 372722 353611 18611 500 5246123 4983817 262306 765518 727242 38276 4110555 3905027 205528 808784 808784 23556313 22387546 1168767 2549607 2422127 127480 SUPPLIES 61725738 59988873 1668617 68248 RECIPROCAL/TEACH FEE 12058176 12058176 BAD DEBT 10698388 10698388 EQUIPMENT RENTAL/PURCHA 6859081 6451336 407745 2044851 1630254 404017 10580 383010328 337101843 45736003 172482 10870 10871 31743857 26470652 44871133 47865472 14608124 16158852 7119480 8110150 2164784 2726230 462618398 265953998 178791321 196664400 165789843 181415985 20229940 23780910 5106180 7504245 470435532 510707767 35244930 41120097 409802 1074780 115059786 108592303 43171556 46700648 193886074 197487828 X 254349129 288956394 15452412 17515628 6747917 6747917 276549458 313219939 470435532 510707767 28511892 8158589 0 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 46080 46080 0 PART II-B, LINE 1: LOBBYING ACTIVITIES EXPENDITURES BERKSHIRE MEDICAL CENTER PAYS ANNUAL MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE MASSACHUSETTS HOSPITAL ASSOCIATION (MHA). A PORTION OF THESE DUES ARE USED BY THE AHA AND THE MHA TO CONDUCT LOBBYING ACTIVITIES TO INCREASE THE BUDGET FOR MEDICARE AND MEDICAID FOR THE FYE 9/30/2014. CALCULATION OF THE LOBBYING FEE PORTION OF THE ANNUAL DUES ARE AS FOLLOWS: MHA LOBBYING FEES OF $34,287 ARE 19.44% OF THE $176,375 ANNUAL DUES. AHA LOBBYING FEES OF $11,793 ARE 22.80% OF THE $51,722 ANNUAL DUES. 19636167 1854177 -12550 -11203 21466591 17567495 -20836 2111310 -13100 -8702 19636167 15196985 2399757 -15600 -13646 17567495 15641155 -418714 -19500 -5956 15196985 14530168 128139 1002929 18000 2081 15641155 0.00000 0.31430 0.68570 0 0 7283845 7283845 192785555 86253538 106532017 228263864 173261711 55002153 34285134 6438749 27846385 196664400 DUE TO THIRD PARTIES 28317724 DEFERRED COMPENSATION 4316611 GIFT ANNUITY LIABILTIY -377 INTEREST RATE SWAP LIABILITY 784000 AMOUNT DUE TO AFFILIATE 10617215 ASSET RETIREMENT ACCRETION 2568854 REBATE FUND PAYABLE 96621 46700648 PART V, LINE 4: THE ORGANIZATION HOLDS, INVESTS AND/OR UTILIZES ENDOWMENT FUNDS IN ACCORDANCE WITH ANY EXPRESSED WISH OF THE DONOR OF THOSE FUNDS. TO THE EXTENT THAT THE DONOR INSTRUCTIONS ALLOW THE EXPENDITURE OF THE ENDOWMENT FUNDS, THEY ARE EXPENDED FOR HEALTHCARE SERVICES PURPOSES SUCH AS FREE CARE AND SCHOLARSHIPS, CONSISTENT WITH THE TAX EXEMPTION OF THE ORGANIZATION. PART X LINE 2 THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND OTHER FINANCIAL INFORMATION OF BERKSHIRE HEALTH SYSTEMS, INC. AND AFFILIATES (INCLUDING BERKSHIRE MEDICAL CENTER) FOR THE YEARS ENDED SEPTEMBER 30, 2014, AND 2013 DOES NOT CONTAIN A FOOTNOTE ADDRESSING ANY LIABILITY FOR UNCERTAIN TAX PROVISIONS UNDER FIN 48. GOLF TOURNAMENT 43530 22931 20599 4741 3888 3593 8377 GOLF TOURNAMENT 116176 81987 34189 2685 11160 11460 8884 159706 104918 54788 7426 15048 15053 17261 54788 0 1 1 X 1 X 1 X 1 1 1 0 1 1 708442 708442 0.00190 58350798 49996349 8354449 0.02240 12746205 12113177 633028 0.00170 71805445 62109526 9695919 0.02600 5602728 2644544 2958184 0.00790 14475410 5189649 9285761 0.02490 23773592 14445863 9327729 0.02510 64501 64501 0.00020 43916231 22280056 21636175 0.05810 115721676 84389582 31332094 0.08410 152309 2364 149945 0.00040 73831 73831 0.00020 214278 23000 191278 0.00050 15747 15747 0.00000 456165 25364 430801 0.00110 1 10698388 4775760 132249846 164650708 -32400862 X 1 1 1 1 BERKSHIRE MEDICAL CENTER 725 NORTH STREET PITTSFIELD MA 01201 WWW.BERKSHIREHEALTHSYSTEM.ORG VQKK X X X X BERKSHIRE MEDICAL CENTER 1 1 X X X X X X X X X 12 1 1 1 X WWW.BERKSHIREHEALTSYSTEMS.ORG X X X X X X X X X 1 0 1 1 200.000000000000 1 400.000000000000 1 X X X X 1 1 X X X X 1 0 1 X 0 0 BERKSHIRE MEDICAL CENTER PART V, SECTION B, LINE 3: BMC HAS UTILIZED AN ACTIVE COMMUNITY NEEDS ASSESSMENT AS PART OF ITS COMMUNITY BENEFIT PROCESS SINCE 1996. THE COMMUNITY NEEDS ASSESSMENT IS UPDATED ANNUALLY, AND THE UPDATE IN 2012 DIRECTED OUR EFFORTS IN 2013 . BMC UTILIZED ALL AVAILABLE CLINICAL, HEALTH STATUS, DEMOGRAPHIC, AND SOCIO-ECONOMIC DATA AVAILABLE TO FORM THE FOUNDATION OF OUR NEEDS ASSESSMENT. IN ADDITION WE GATHERED AVAILABLE QUALITATIVE DATA FROM OUR MANY ADVISORY GROUPS, COMMUNITY FORUMS, SURVEYS, AND FOCUS GROUPS. THE WELLNESS AND OUTREACH PROGRAMS ALSO SUPPLEMENT OUR UNDERSTANDING OF THE HEALTH STATUS OF OUR COMMUNITY, HEALTH RISK FACTORS, AND BARRIERS TO HEALTH AND HEALTH CARE. IN NOVEMBER 2011, IN COLLABORATION WITH OUR PUBLIC HEALTH COLLEAGUES FROM ACROSS BERKSHIRE COUNTY, WE ALSO HOSTED A COMMUNITY WIDE MEETING TO REVIEW THE HEALTH NEEDS OF OUR COMMUNITY AND SOLICIT ADDITIONAL FEEDBACK FROM OVER 70 COMMUNITY BASED ORGANIZATIONS. THE FEEDBACK GATHERED INPUT ON SPECIFIC ACTIONS THAT COULD BE TAKEN AT AN INDIVIDUAL, FAMILY AND ORGANIZATIONAL LEVEL AS WELL AS IDENTIFYING GAPS IN SERVICE IN ADDITION TO PRIORITIZING THE MOST IMPORTANT NEEDS FOR THE COMMUNITY AS A WHOLE. WE HAVE CONVENED THIS COMMUNITY GROUP AT LEAST ANNUALLY TO REVIEW DATA, CONFIRM PRIORITIES, DISCUSS NEEDS AND WORK TOGETHER TO ADDRESS THE IDENTIFIED PRIORITIES AND NEEDS. IN 2012 WE FORMALIZED THE COUNTY HEALTH INITIATIVE(CHI) WITH THE GOAL OF WORKING TOGETHER TO IMPROVE COMMUNITY HEALTH. THE LEADERSHIP TEAM OF THE CHI INCLUDED BERKSHIRE MEDICAL CENTER, FAIRVIEW HOSPITAL, NORTH ADAMS REGIONAL HOSPITAL, BERKSHIRE COUNTY BOARDS OF HEALTH, THE BERKSHIRE ALLIANCE FOR PUBLIC HEALTH, TRI-TOWN HEALTH DEPARTMENT, PITTSFIELD BOARD OF HEALTH, BERKSHIRE UNITED WAY AND NORTHERN BERKSHIRE COMMUNITY COALITION. THE NEEDS DATA, ALONG WITH STATE PRIORITIES ARE USED TO DETERMINE OUR ANNUAL COMMUNITY BENEFIT PRIORITIES, WHICH ARE ESTABLISHED BY THE COMMUNITY BENEFIT AND ACCESS COMMITTEE OF THE BOARD OF TRUSTEES. IN ITS PLANNING, BMC LOOKS FOR OPPORTUNITIES TO MAKE BETTER AND MORE EFFECTIVE USE OF EXISTING RESOURCES AND PROVIDERS, AS WELL AS TO IDENTIFY GAPS IN SERVICE. BMC WORKS WITH INTERNAL RESOURCES AND COMMUNITY AND REGIONAL PARTNERS, WITH THE HELP OF EVIDENCED BASED OR BEST PRACTICE PROGRAMS, TO DEVELOP AND IMPLEMENT PROGRAMS AND INITIATIVES TO MEET COMMUNITY NEED. BERKSHIRE MEDICAL CENTER PART V, SECTION B, LINE 4: FAIRVIEW HOSPITAL BERKSHIRE MEDICAL CENTER PART V, SECTION B, LINE 20D: THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO A FAP ELIGIBLE PATIENT IS 95% OF THE FACILITY'S STANDARD CHARGE. THE MAXIMUM AMOUNT THAT WILL BE CHARGED TO A FAP ELIGIBLE PATIENT WILL BE IN COMPLIANCE WITH THE NEW FINALIZED SECTION 501(R) REGULATIONS THAT ARE EFFECTIVE 10/01/2016. PART I, LINE 7: THE TOTAL COMMUNITY BENEFIT EXPENSE REPORTED ON PART I, LINES 7A, 7B, & 7C HAS BEEN CALCULATED USING THE RATIO OF PATIENT CARE COST TO CHARGES AS COMPUTED USING WORKSHEET 2 IN THE SCHEDULE H INSTRUCTIONS. THE TOTAL COMMUNITY BENEFIT EXPENSE REPORTED ON PART I, LINE 7G HAS BEEN CALCULATED USING A COST ACCOUNTING METHOD. PART I, LINE 7G: SUBSTANCE ABUSE UNIT, DENTAL CLINIC, INPATIENT PYSCHIATRIC UNIT PART I, LN 7 COL(F): BAD DEBT EXPENSE OF $10,698,388 ATTRIBUTABLE TO PATIENT ACCOUNTS HAS BEEN EXCLUDED FROM THE COMPUTATION OF ALL COMMUNITY BENEFIT EXPENSE SHOWN IN PART I, LINE 7, COLUMN F. PART II, COMMUNITY BUILDING ACTIVITIES: COALITION BUILDING $73,831:BHS RECOGNIZES THAT ACTIVE INVOLVEMENT IN THE COMMUNITY IS CRUCIAL TO PROMOTING AND PROTECTING THE HEALTH OF AREA RESIDENTS. THE DELIVERY OF HEALTHCARE SERVICES ALONE CANNOT ACHIEVE SIGNIFICANT IMPROVEMENT IN THE HEALTH STATUS OF OUR COMMUNITY. BHS HAS ENGAGED IN COMMUNITY BUILDING ACTIVITIES WITH THE GOAL OF DEVELOPING A SOCIETAL INFRASTRUCTURE THAT ENGAGES ALL SEGMENTS OF THE COMMUNITY WITH THE ULTIMATE PURPOSE OF BETTERING THE LIVES OF PEOPLE IN THE COMMUNITY. THESE ACTIVITIES HAVE REVOLVED AROUND THREE SPECIFIC EFFORTS:COMMUNITY HEALTH IMPROVEMENT ADVOCACY $191,278:1. PARTICIPATION IN GRASSROOTS COMMUNITY WIDE INITIATIVES FOCUSING ON LOCALLY IDENTIFIED CONCERNS:TEEN PREGNANCY PREVENTION INITIATIVEPITTSFIELD YOUTH PREVENTION PARTNERSHIPPITTSFIELD PROMISE (3RD GRADE READING LEVELS)COMMUNITY HEALTH NETWORK OF THE BERKSHIRESYOUTH SUICIDE PREVENTION PROGRAM/BERKSHIRE COALITION FOR SUICIDE PREVENTION.H1N1 FLU VACCINATION CLINICSBERKSHIRE PAIN MANAGEMENT PROGRAM, MULTI-STAKEHOLDER INITIATIVE TO CURTAIL PRESCRIPTION DRUG MISUSE AND DIVERSIONCOMMUNITY WIDE SUPPORT $149,945:EMERGENCY RESPONSE PLANNINGSCHOOL PARTNERSHIPS WITH REID MIDDLE SCHOOL AND CONTE ELEMENTARY SCHOOL 2. SERVING IN A LEADERSHIP CAPACITY WITH COMMUNITY ORGANIZATIONSBERKSHIRE UNITEDBERKSHIRE PRIORITIESAREA HEALTH EDUCATION CENTERPITTSFIELD FAMILY YMCAELDER SERVICES OF BERKSHIRE COUNTYBERKSHIRE COMMUNITY COLLEGEBERKSHIRE COMMUNITY COLLEGE FOUNDATIONLOCAL SCHOOL COMMITTEES (PITTSFIELD, ADAMS CHESHIRE REGIONAL, AND CENTRAL BERKSHIRE)LOCAL BOARDS OF HEALTHBERKSHIRE REGIONAL PLANNING COMMISSION SUSTAINABLE BERKSHIRES INITIATIVELOCAL SCHOOL WELLNESS COMMITTEESAREAS OF ECONOMIC DEVELOPMENT:BERKSHIRE REGIONAL EMPLOYMENT BOARDCHAMBER OF COMMERCEBERKSHIRE ECONOMIC DEVELOPMENT CORPORATION WORKFORCE DEVELOPMENT $15,747:3. WORKING WITH AREA AND REGIONAL INSTITUTIONS OF HIGHER LEARNING TO MAKE EDUCATIONAL OPPORTUNITIES AVAILABLE TO AREA RESIDENTS.ELMS COLLEGE RN TO BSN PROGRAMCAREER LADDER/ CLINICAL TECHNICAL TRAINING PROGRAMS IN NURSING AND ALLIED HEALTH AREASCLINICAL TRAINING SITE FOR AREA STUDENTS IN NURSING AND ALLIED HEALTH DISCIPLINESEMT-TRAINING AND RE-CERTIFICATION PROGRAMSBHS/BCC NURSING ASSISTANT PROGRAM FOR MEMBERS OF THE COMMUNITY AT LARGEYOUTH LEADERSHIP GROUP PART III, LINE 4: PART III SECTION ALINE 2THE HOSPITAL REPORTS ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS, AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON ACTUAL WRITE-OFF'S, A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION, AND EXISTING ECONOMIC CONDITIONS AND TRENDS.LINE 3THE ESTIMATED COST OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENT ACCOUNTS REPORTED ON LINE 3, PART III WAS CALCULATED USING THE RATIO OF PATIENT CARE COST TO CHARGES AS COMPUTED USING WORKSHEET 2 IN THE SCHEDULE H INSTRUCTIONS. NO BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER BERKSHIRE MEDICAL CENTER'S CHARITY CARE POLICY HAS BEEN REPORTED ON LINE 3, PART III BECAUSE ALL GROSS PATIENT CHARGES ATTRIBUTABLE TO THESE PATIENTS THAT WERE NOT PAID FROM UNCOMPENSATED CARE POOLS OR PROGRAMS WERE WRITTEN OFF AS "FREE CARE" EXPENSE. THIS PORTION OF OUR BAD DEBT IS A BENEFIT TO THE COMMUNITY BECAUSE REIMBURSEMENT WILL NOT BE RECEIVED FOR SERVICES RENDER. LINE 4"THE HEALTH SYSTEM PROVIDES CARE TO PATIENTS WHO MEET CHARITY CARE POLICY CRITERIA WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES." "BECAUSE HEALTH SYSTEM ENTITIES DO NOT PURSUE COLLECTION OF AMOUNTS QUALIFYING AS CHARITY CARE, SUCH AMOUNTS ARE NOT REPORTED AS REVENUE." "THE HEALTH SYSTEM'S CHARITY CARE POLICY IS BASED ON THE POVERTY INCOME GUIDELINES ESTABLISHED BY THE MASSACHUSETTS DIVISION OF HEALTHCARE FINANCE AND POLICY." "IF A PATIENT IS INELIGIBLE FOR CHARITY CARE OR CARE AT REDUCED RATES BECAUSE THE PATIENT'S INCOME EXCEEDS THE ELIGIBILITY GUIDELINES, SERVICES RENDERED ARE RECORDED AT ESTABLISHED RATES AND ANY UNPAID ACCOUNT RECEIVABLE BALANCE IS WRITTEN OFF TO BAD DEBTS AFTER A REASONABLE COLLECTION EFFORT HAS BEEN MADE." PART III, LINE 8: THE AMOUNT REPORTED ON LINE 6, PART III WAS DETERMINED USING THE COST ALLOCATION METHODOLOGY USED FOR THE MEDICARE COST REPORTS. THE LOSS ON MEDICARE ACTIVITY AS REPORTED IN SECTION II, LINE 7 IS A COMMUNITY BENEFIT BECAUSE IT IS THE MISSION OF BERKSHIRE MEDICAL CENTER TO PROVIDE HIGH QUALITY HEALTH CARE TO RESIDENTS OF BERKSHIRE COUNTY REGARDLESS OF THEIR ABILITY TO PAY. THE COST TO PROVIDE SERVICES TO MEDICARE BENEFICIARIES OFTEN EXCEEDS THE REIMBURSEMENT FOR SUCH SERVICES BUT ELDERLY PATIENTS ARE AMONG THE MOST NEEDY IN OUR COMMUNITY AND PROVIDING SERVICES TO THEM CLOSE TO HOME IMPROVES THE QUALITY OF THEIR CARE, INCREASES ACCESS AND ENHANCES HEALTH AND WELLNESS FOR THIS POPULATION. SERVICES SUCH AS EMERGENCY CARE, CARDIAC SERVICES, PSYCHIATRIC CARE, RENAL DIALYSIS AND WOUND CARE SERVICES ARE AMONG THOSE THAT PROVIDE A SIGNIFICANT BENEFIT TO THE FRAIL ELDERLY. THE BREADTH OF ACUTE AND AMBULATORY SERVICES PROVIDED BY BMC MEANS THAT THE MEDICARE BENEFICIARIES IN OUR COUNTY DO NOT HAVE TO LEAVE THE COUNTY FOR MOST SERVICES. PART III, LINE 9B: POPULATIONS EXEMPT FROM COLLECTION ACTIVITIESTHE FOLLOWING INDIVIDUALS AND PATIENT POPULATIONS ARE EXEMPT FROM ANY COLLECTION OR BILLING PROCEDURES PURSUANT TO STATE REGULATIONS:A. PATIENTS ENROLLED IN A STATE HEALTH INSURANCE PROGRAM, INCLUDING BUT NOT LIMITED TO, MASSHEALTH, EMERGENCY AID TO THE ELDERLY, DISABLED AND CHILDREN, HEALTHY START, CHILDREN'S MEDICAL SECURITY PLAN, "LOW INCOME PATIENTS" AS DETERMINED BY THE OFFICE OF MEDICAID.1. PLEASE NOTE THAT BMC MAY SEEK COLLECTION ACTION AGAINST ANY PATIENT ENROLLED IN THE ABOVE MENTIONED PROGRAMS FOR THEIR REQUIRED CO-PAYMENTS AND DEDUCTIBLES THAT ARE SET FORTH BY EACH SPECIFIC PROGRAM.2. BMC MAY ALSO INITIATE BILLING OR COLLECTION FOR A PATIENT WHO ALLEGES THAT HE OR SHE IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM THAT COVERS THE COSTS OF THE HOSPITAL SERVICES, BUT FAILS TO PROVIDE PROOF OF SUCH PARTICIPATION. UPON RECEIPT OF SATISFACTORY PROOF THAT A PATIENT IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM, (INCLUDING RECEIPT OR VERIFICATION OF SIGNED APPLICATION) BMC SHALL CEASE ITS BILLING OR COLLECTION ACTIVITIES. 3. BMC MAY CONTINUE COLLECTION ACTION ON ANY LOW INCOME PATIENT FOR SERVICES RENDERED PRIOR TO THE LOW INCOME PATIENT DETERMINATION, PROVIDED THAT THE CURRENT LOW INCOME PATIENT STATUS HAS BEEN TERMINATED OR EXPIRED. HOWEVER, ONCE A PATIENT IS DETERMINED ELIGIBLE AND ENROLLED IN THE HEALTH SAFETY NET, MASSHEALTH, OR CERTAIN COMMONWEALTH CARE PROGRAMS, BMC WILL CEASE COLLECTION ACTIVITY FOR SERVICES, PREVIOUSLY BILLED, THAT NOW FALL INTO THE ELIGIBILITY PERIOD. 4. BMC MAY SEEK COLLECTION ACTION AGAINST ANY OF THE PATIENTS PARTICIPATING IN THE PROGRAMS LISTED ABOVE FOR NON-COVERED SERVICES THAT THE PATIENT HAS AGREED TO BE RESPONSIBLE FOR, PROVIDED THAT THE HOSPITAL OBTAINED THE PATIENT'S PRIOR WRITTEN CONSENT TO BE BILLED FOR THE SERVICE.5. BMC WILL NOT UNDERTAKE COLLECTION ACTION AGAINST AN INDIVIDUAL THAT HAS BEEN APPROVED FOR MEDICAL HARDSHIP UNDER THE MASSACHUSETTS HEALTH SAFETY NET PROGRAM WITH RESPECT TO THE AMOUNT OF THE BILL THAT EXCEEDS THE MEDICAL HARDSHIP CONTRIBUTION.B. BMC DOES NOT GARNISH A PATIENT'S OR THE PATIENT'S GUARANTOR'S WAGES OR EXECUTE A LIEN ON THE PATIENT'S OR THE PATIENT'S GUARANTOR'S PERSONAL RESIDENCE OR MOTOR VEHICLE. C. BMC AND ITS AGENTS SHALL NOT CONTINUE COLLECTION OR BILLING ON A PATIENT WHO IS A MEMBER OF A BANKRUPTCY PROCEEDING EXCEPT TO SECURE ITS RIGHTS AS A CREDITOR IN THE APPROPRIATE ORDER. PART VI, LINE 2: COMMUNITY BENEFITS MISSION STATEMENTFURTHERING OUR CHARITABLE PURPOSE, THE BERKSHIRE MEDICAL CENTER'S COMMUNITY BENEFIT MISSION IS TO IDENTIFY, PRIORITIZE AND INVEST IN OUR COMMUNITY'S HEALTH NEEDS BY PURSUING NEEDED INITIATIVES AND PROGRAMS. THE COMMUNITY BENEFIT GOALS INCLUDE SATISFYING UNMET NEEDS IN THE BERKSHIRES AND IMPROVING THE HEALTH STATUS OF OUR COMMUNITY WITH A PARTICULAR FOCUS ON ACCESS TO HEALTHCARE AND "AT RISK" POPULATIONS. RECOGNIZING THE VALUE OF BMC'S PARTNERSHIP WITH OUR COMMUNITY, BMC WILL SEEK INPUT AND MEANINGFUL COLLABORATION IN OUR EFFORT TO MEET COMMUNITY NEED. BMC WILL OUTLINE IN AN ANNUAL COMMUNITY BENEFIT PLAN, THE PRIORITIES TO BE ADDRESSED AND THE INITIATIVES TO BE FUNDED.BMC AND FAIRVIEW HOSPITAL ARE BOTH PART OF BERKSHIRE HEALTH SYSTEMS AND THEREFORE WORK TOGETHER TO MEET COMMUNITY NEED. COMMUNITY BENEFIT AND ACCESS COMMITTEEAS A STANDING COMMITTEE OF THE BOARD OF TRUSTEES - ITSELF MADE UP OF COMMUNITY VOLUNTEERS, THIS COMMITTEE IS RESPONSIBLE FOR UNDERSTANDING THE HEALTH NEEDS AND BARRIERS TO CARE IN OUR SERVICE AREA. THE COMMITTEE OVERSEES THE COMMUNITY BENEFIT PROCESS OF THE ORGANIZATION, INCLUDING HEALTH NEEDS ASSESSMENTS, DETERMINING TARGET POPULATIONS AND PRIORITIES, DEVELOPMENT OF THE COMMUNITY BENEFITS PLAN AND EVALUATING PERFORMANCE AGAINST GOALS AND OBJECTIVES. THE COMMITTEE IS COMPRISED OF PEOPLE FROM THE BOARD OF TRUSTEES AND THE COMMUNITY AT LARGE, AND MEETS MONTHLY THOUGH OUT THE YEAR. COMMUNITY BENEFITS LEADERSHIP/TEAMRUTH BLODGETT, BHS SENIOR VICE PRESIDENT, PLANNING AND DEVELOPMENT; MICHAEL LEARY, BHS DIRECTOR OF MEDIA RELATIONS; CATHIE MCHUGH, PLANNING ANALYST; KAREN BENZIE, RN VP INTEGRATED CARE; ED PERLAK, VICE PRESIDENT, COMMUNITY SERVICES; LEE SANTOS, BHS FISCAL ADMINISTRATION; PROGRAM DIRECTORS OF COMMUNITY BENEFIT PROGRAMS.COMMUNITY BENEFITS MEETINGSTHE BHS COMMUNITY BENEFITS AND ACCESS COMMITTEE MEETS MONTHLY TO DISCUSS COMMUNITY BENEFIT PROGRAMS, POTENTIAL NEW INITIATIVES, COMMUNITY NEEDS AND OUTCOMES. THROUGHOUT THE YEAR, INTERNAL COMMUNITY BENEFIT AND PROGRAM LEADERS MEET TO COORDINATE THE COMMUNITY BENEFIT PLAN AND PROGRAMS. HEALTH NEEDS ASSESSMENTBMC HAS UTILIZED AN ACTIVE COMMUNITY NEEDS ASSESSMENT AS PART OF ITS COMMUNITY BENEFIT PROCESS SINCE 1996. THE COMMUNITY NEEDS ASSESSMENT IS UPDATED ANNUALLY, WITH A COMPLETE ASSESSMENT DONE EVERY THREE YEARS. BMC UTILIZED ALL AVAILABLE CLINICAL, HEALTH STATUS, DEMOGRAPHIC, AND SOCIO-ECONOMIC DATA AVAILABLE TO FORM THE FOUNDATION OF OUR NEEDS ASSESSMENT. IN ADDITION WE GATHERED AVAILABLE QUALITATIVE DATA FROM OUR MANY ADVISORY GROUPS, COMMUNITY FORUMS, SURVEYS, AND FOCUS GROUPS. THE WELLNESS AND OUTREACH PROGRAMS ALSO SUPPLEMENT OUR UNDERSTANDING OF THE HEALTH STATUS OF OUR COMMUNITY, HEALTH RISK FACTORS, AND BARRIERS TO HEALTH AND HEALTH CARE. IN NOVEMBER 2011, IN COLLABORATION WITH OUR PUBLIC HEALTH COLLEAGUES FROM ACROSS BERKSHIRE COUNTY, WE ALSO HOSTED A COMMUNITY WIDE MEETING TO REVIEW THE HEALTH NEEDS OF OUR COMMUNITY AND SOLICIT ADDITIONAL FEEDBACK FROM OVER 70 COMMUNITY BASED ORGANIZATIONS (SEE ATTACHMENT) . THE FEEDBACK GATHERED INPUT ON SPECIFIC ACTIONS THAT COULD BE TAKEN AT AN INDIVIDUAL, FAMILY AND ORGANIZATIONAL LEVEL AS WELL AS IDENTIFYING GAPS IN SERVICE IN ADDITION TO PRIORITIZING THE MOST IMPORTANT NEEDS FOR THE COMMUNITY AS A WHOLE. WE HAVE CONVENED THIS COMMUNITY GROUP AT LEAST ANNUALLY TO REVIEW DATA, CONFIRM PRIORITIES, DISCUSS NEEDS AND WORK TOGETHER TO ADDRESS THE IDENTIFIED PRIORITIES AND NEEDS. IN 2012 WE FORMALIZED THE COUNTY HEALTH INITIATIVE(CHI) WITH THE GOAL OF WORKING TOGETHER TO IMPROVE COMMUNITY HEALTH. THE LEADERSHIP TEAM OF THE CHI INCLUDED BERKSHIRE MEDICAL CENTER, FAIRIVEW HOSPITAL, NORTH ADAMS REGIONAL HOSPITAL, BERKSHIRE COUNTY BOARDS OF HEALTH, THE BERKSHIRE ALLIANCE FOR PUBLIC HEALTH, TRI-TOWN HEALTH DEPARTMENT, PITTSFIELD BOARD OF HEALTH, BERKSHIRE UNITED WAY AND NORTHERN BERKSHIRE COMMUNITY COALITION. THE NEEDS DATA, ALONG WITH STATE PRIORITIES ARE USED TO DETERMINE OUR ANNUAL COMMUNITY BENEFIT PRIORITIES, WHICH ARE ESTABLISHED BY THE COMMUNITY BENEFIT AND ACCESS COMMITTEE OF THE BOARD OF TRUSTEES. IN ITS PLANNING, BMC LOOKS FOR OPPORTUNITIES TO MAKE BETTER AND MORE EFFECTIVE USE OF EXISTING RESOURCES AND PROVIDERS, AS WELL AS TO IDENTIFY GAPS IN SERVICE AND ALSO SEEKS OUT AVAILABLE GRANTS TO FACILITATE MEETING COMMUNITY NEED. BMC WORKS WITH INTERNAL RESOURCES AND COMMUNITY AND REGIONAL PARTNERS, WITH THE HELP OF EVIDENCED BASED OR BEST PRACTICE PROGRAMS, TO DEVELOP AND IMPLEMENT PROGRAMS AND INITIATIVES TO MEET COMMUNITY NEED. DATA SOURCESCOMMUNITY FOCUS GROUPS, HOSPITAL DATA, CONSUMER AND ADVISORY GROUPS, INTERVIEWS, MASSCHIP, PUBLIC HEALTH PERSONNEL, SURVEYS, OTHER - HEALTHY PEOPLE 2020; DEPARTMENT OF PUBLIC HEALTH BUREAU OF FAMILY AND COMMUNITY HEALTH INJURY REPORT; DEPARTMENT OF PUBLIC HEALTH PRESCRIPTION MONITORING PROGRAM DATA; PHYSICIAN MANPOWER DATA; WORKFORCE NEEDS DATA; WELLNESS DATA; EMERGENCY DEPARTMENT/TRAUMA REGISTRY; BERKSHIRE UNITED WAY; BERKSHIRE REGIONAL PLANNING COMMISSION; CHAMBER OF COMMERCE BLUEPRINT STUDY, AND THE STROUDWATER HEALTHCARE MARKET ASSESSMENT FOR NORTH COUNTY, COMPLETED IN AUGUST 2014 AS A RESULT OF THE CLOSURE OF NORTHERN BERKSHIRE HEALTH SYSTEM. GOALS: STATEWIDE PRIORITIES: AS PART OF OUR PLANNING PROCESS, BMC ALSO INCORPORATES THE MA STATEWIDE PRIORITIES AS PART OF OUR LOCAL ASSESSMENT, PRIORITIES AND INITIATIVES. THE COMMONWEALTH'S PRIORITIES ARE: ADDRESS UNMET HEALTH NEEDS OF THE UNINSURED CHRONIC DISEASE MANAGEMENT IN DISADVANTAGED POPULATIONS PROMOTING WELLNESS OF VULNERABLE POPULATIONS REDUCING HEALTH DISPARITY, SUPPORTING HEALTHCARE REFORMTARGET POPULATIONSMEDICALLY UNDERSERVED - BERKSHIRE COUNTY HAS ONE OF THE HIGHEST NUMBER OF MEDICALLY UNDERSERVED RESIDENT POPULATIONS IN MASSACHUSETTS. UNINSURED - DUE TO ITS ECONOMIC AND EMPLOYMENT STATUS, BERKSHIRE COUNTY HAS A SIGNIFICANT NUMBER OF INDIVIDUALS AND FAMILIES WHO ARE UNINSURED OR UNDERINSURED.SENIOR POPULATION - BERKSHIRE COUNTY HAS ONE OF THE LARGEST ELDERLY POPULATIONS IN THE STATE. RACIAL AND ETHNIC POPULATIONS - THE BERKSHIRES IS EXPERIENCING A STEADY RISE IN IMMIGRANT POPULATION, PARTICULARLY LATIN AMERICAN AND RUSSIAN IMMIGRANTS. ENTIRE GEOGRAPHIC POPULATION OF BERKSHIRE COUNTY - BERKSHIRE COUNTY IS THE MOST RURAL COUNTY IN THE STATE AND IS GEOGRAPHICALLY ISOLATED FROM LARGER COMMUNITIES. AS A RESULT, BMC IS THE PRIMARY PROVIDER OF HEALTHCARE SERVICES TO THE REGION. ECONOMICALLY VULNERABLE - BERKSHIRE COUNTY HAS ONE OF THE HIGHEST UNEMPLOYMENT AND UNDEREMPLOYMENT RATES IN THE STATE AND LOW MEDIAN INCOME. YOUTH - LOCAL HEALTHCARE STATISTICS ON YOUTH AT RISK. PREGNANCY AND CHILDBIRTH - LOCAL HEALTHCARE STATISTICS ON MATERNAL CHILD HEALTH. POPULATIONS WITH HEALTH DISPARITIES - LOCAL HEALTH DATA. COMMUNITY BENEFIT PRIORITIES* CANCER* CARDIOVASCULAR HEALTH* DIABETES* MENTAL HEALTH* OBESITY* STROKE/BLOOD PRESSURE* SUBSTANCE ABUSE* ACCESS TO HEALTHCARE MEDICAL PROFESSIONALS UNDER & UNINSURED* ADOLESCENT & YOUTH HEALTH* TEEN PREGNANCY* DEPRESSION* EMERGENCY PREPAREDNESS * HEALTHCARE DISPARITIES* INFECTIOUS DISEASE* INJURY PREVENTION* MATERNAL/CHILD HEALTH * SMOKINGWE REVISITED THE PRIORITIES MID-YEAR AFTER THE CLOSURE OF NORTHERN BERKSHIRE HEALTH SYSTEM. THE NEEDS ASSESSMENT FOR BMC HAS ALWAYS ENCOMPASSED THE WHOLE COUNTY, BUT THE CLOSURE OF THE NBH PRESENTED NEW CHALLENGES WITH ACCESS AND TRANSPORTATION, AND BMC BECAME THE PRIMARY PROVIDER OF HEALTH SERVICES FOR THIS POPULATION. GIVEN THE URGENCY OF THE SITUATION, WE FOCUSED ON REESTABLISHING ESSENTIAL AND CRITICAL SERVICES FIRST, WITH EXTRA RESOURCES TO HELP WITH NAVIGATION, COMMUNICATION AND TRANSPORTATION ISSUES. AS WE MOVE INTO 2015, WE WILL UTILIZE THE INPUT OF THE NEWLY CREATED STROUDWATER REPORT, THE NORTHERN BERKSHIRE COMMUNITY COALITION INPUT ON NEEDS AS WELL AS OTHER RESOURCES TO REFINE THE NEEDS ASSESSMENT AND COMMUNITY BENEFIT PLANS FOR THE NORTHERN PART OF OUR COMMUNITY.CONTINUED ON SCHEDULE O. PART VI, LINE 3: BMC PROMINENTLY ADVERTISES THROUGHOUT THE COMMUNITY, AT ALL OF ITS FACILITIES AND ON ITS WEBSITE ITS PROGRAM KNOWN AS "ADVOCACY FOR ACCESS." THE GOAL OF THIS PROGRAM IS TO ASSIST THE UNINSURED AND UNDERINSURED IN BERKSHIRE COUNTY IN ACCESSING VARIOUS PROGRAMS THAT CAN PAY FOR HEALTHCARE SERVICES (AS WELL AS AVENUES TO RECEIVE HEALTHCARE SERVICES AT NO COST). THE ADVOCACY FOR ACCESS PROGRAM HELPS REDUCE THE PERCEPTION BY THOSE WITH AN INABILITY TO PAY FOR HEALTHCARE THAT THEIR INABILITY IS, IN FACT, A BARRIER TO NECESSARY CARE. THE STAFF FACILITATES THE APPLICATION PROCESS FOR INDIVIDUALS AND FAMILIES IN ORDER TO BENEFIT ONE OF THE SEVERAL LOW-COST HEALTH INSURANCE PROGRAMS FOR ADULTS AND CHILDREN WHO LIVE IN MASSACHUSETTS. THE STAFF RECOGNIZE THAT MANY OF THESE STATE AND FEDERAL PROGRAMS CAN BE COMPLEX AND CONFUSING AND MAINTAINS AS ITS GOAL MAKING ACCESS TO HEALTH INSURANCE AS SIMPLE AS POSSIBLE. WHEN AN INDIVIDUAL OR FAMILY'S CIRCUMSTANCES CHANGE, THE ADVOCACY STAFF CAN ASSIST IN UPDATING THE APPROPRIATE AGENCY TO FACILITATE THE PROCESS.THE ADVOCACY FOR ACCESS PROGRAMS HELP THOUSANDS OF PEOPLE EACH YEAR ACCESS INSURANCE OR OTHER COVERAGE PROGRAMS TO AID THEM IN ADDRESSING THEIR HEALTHCARE NEEDS.INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE IS OFFERED TO OUR PATIENTS IN THE FOLLOWING MANNER:NOTICES OF THE AVAILABILITY OF FINANCIAL ASSISTANCE ARE POSTED THROUGHOUT THE HOSPITAL, SPECIFICALLY IN ALL SERVICE DELIVERY AREAS, FINANCIAL COUNSELING OFFICES THROUGHOUT THE CLINICAL CAMPUSES AND ALL BERKSHIRE FACULTY SERVICES PHYSICIAN PRACTICES. ADVOCACY FOR ACCESS PROGRAM STAFF ARE AVAILABLE DAILY TO MEET WITH PATIENTS WHO ARE PRESENT AT THE EMERGENCY DEPARTMENT FOR SERVICES AS REQUESTED.APPOINTMENTS CAN BE MADE WITH THE ADVOCACY FOR ACCESS PROGRAM OFFICE TO ASSIST PATIENTS IN FILING AN ELECTRONIC APPLICATION VIA WWW.MAHEALTHCONNECTOR.ORG FOR STATE FINANCIAL ASSISTANCE PROGRAMS. AT PRE-REGISTRATION, SELF-PAY PATIENTS ARE OFFERED AN APPOINTMENT WITH ADVOCACY FOR ACCESS PROGRAM OFFICE ALONG WITH AN EXPLANATION OF THE SERVICE.BROCHURES ARE DISTRIBUTED AT ALL ACCESS POINTS INFORMING PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE WITH PHONE NUMBERS TO CONTACT THE ADVOCACY FOR ACCESS PROGRAM OFFICE TO SET UP APPOINTMENTS. STATEMENTS MAILED TO PATIENTS WHO HAVE A SELF-PAY BALANCE WILL HAVE A MESSAGE INDICATING THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE AND THE PHONE NUMBERS TO CONTACT THE ADVOCACY FOR ACCESS OFFICE FOR ADDITIONAL INFORMATION. ALL PATIENT STATEMENTS HAVE A MESSAGE ON THE BACK OF THE STATEMENT INDICATING THE AVAILABILITY OF FINANCIAL ASSISTANCE. PART VI, LINE 4: BERKSHIRE COUNTY IS A LARGELY RURAL AREA LOCATED AT THE FAR WESTERN END OF MASSACHUSETTS, ADJACENT TO NEW YORK STATE TO THE WEST, VERMONT TO THE NORTH AND CONNECTICUT TO THE SOUTH. COMPRISING ROUGHLY 15% OF THE LAND MASS OF MASSACHUSETTS, ITS APPROXIMATELY 131,000 RESIDENTS ACCOUNT FOR 2% OF THE POPULATION OF THE COMMONWEALTH.THE POPULATION IS RELATIVELY HOMOGENEOUS ETHNICALLY:WHITE NON-HISPANIC PERSONS: 92.5%BLACK NON-HISPANIC PERSONS: 2.7%HISPANIC PERSONS: 3.5%ASIAN PERSONS: 1.2%THE COUNTY IS COMPRISED OF THREE DISTINCT SUB-REGIONS: NORTH, SOUTH AND CENTRAL WHICH FORM THE OVERALL COUNTY PROFILE OF A LARGELY RURAL AREA WITH SMALL URBAN, AGRARIAN, AND POST-INDUSTRIAL TOWNS AND CITIES. WHILE TIED TOGETHER ECONOMICALLY, SOCIALLY AND POLITICALLY, EACH SUB-REGION REFLECTS A DEGREE OF SOCIAL AND ECONOMIC DIFFERENCES, PRIMARILY DUE TO THE 50-MILE LENGTH OF THE COUNTY FROM NORTH TO SOUTH. IN MARCH 2014, THE NORTHERN BERKSHIRE HEALTH SYSTEM AND NORTH ADAMS REGIONAL HOSPITAL CLOSED ABRUPTLY LEAVING THE NORTHERN BERKSHIRE COMMUNITY WITHOUT A LOCAL PROVIDER. BERKSHIRE MEDICAL CENTER AND BERKSHIRE HEALTH SYSTEMS STEPPED IN TO PRESERVE ESSENTIAL SERVICES, AND IS UTILIZING A NEEDS ASSESSMENT COMPLETED IN AUGUST OF 2014 TO HELP UNDERSTAND COMMUNITY NEED AND THE RESTORE THE MOST CRITICAL SERVICES FOR THE COMMUNITY. THIS NEEDS ASSESSMENT HIGHLIGHTS THE SOCIO-ECONOMIC AND HEALTH NEEDS OF THE NORTHERN REGION, AND WILL FORM THE BLUEPRINT OF OUR COMMUNITY BENEFIT AND SERVICE DELIVERY WORK AS WE HEAD INTO 2015.BERKSHIRE COUNTY IS A COMMUNITY IN TRANSITION FROM AN ECONOMY RELYING ON MANUFACTURING TO A SERVICE SECTOR DEPENDENT ECONOMY. THE GENERAL ELECTRIC COMPANY, WHICH AT ONE POINT IN THE 1970S EMPLOYED UPWARDS OF 15,000 PEOPLE, SOLD THE LAST SEGMENT OF ITS BUSINESS IN THE BERKSHIRES (GE PLASTICS, WHICH EMPLOYED ABOUT 500 PEOPLE) TO A SAUDI ARABIAN OWNED COMPANY, SABIC. OTHER MAJOR EMPLOYERS, FOR EXAMPLE, SPRAGUE ELECTRIC (ELECTRICAL COMPONENTS) AND BELOIT-JONES (PAPER MAKING MACHINERY) ALSO CLOSED.THE LAST FOUR YEARS HAVE SEEN THE CLOSING OF FIVE PAPER MILLS, WHICH HAD ACCOUNTED FOR A LARGE PART OF THE REMAINING INDUSTRIAL BASE IN THE AREA.SUBSEQUENTLY, THE COUNTY HAS TAKEN ADVANTAGE OF ITS RURAL ENVIRONMENT, CULTURAL ATTRACTIONS, AND ITS SMALL TOWN ATMOSPHERE TO DEVELOP A THREE SEASON TOURIST/VACATION "DESTINATION" PROXIMAL TO THE NEW YORK AND BOSTON METROPOLITAN AREAS (WITHIN A THREE HOUR DRIVE).ALTHOUGH THIS EFFORT HAS BEEN MET WITH A REASONABLE LEVEL OF SUCCESS (UPWARDS OF 2 MILLION TOURISTS VISIT EACH YEAR), THE JOBS CREATED IN THIS EMPLOYMENT SECTOR CANNOT ADEQUATELY REPLACE WHAT HAS BEEN LOST DUE TO THE MAJOR DEINDUSTRIALIZATION OF THE COUNTY OVER THE LAST TWO DECADES. THIS IS REFLECTED IN THE ECONOMIC DEMOGRAPHIC OF THE COUNTY COMPARED TO THE COMMONWEALTH OF MASSACHUSETTS:PER CAPITA INCOME IS 16% BELOW THE STATE AVERAGEMEDIAN HOUSEHOLD INCOME IS 28% BELOW THE STATE AVERAGE% OF POPULATION BELOW 200% OF THE POVERTY LEVEL IS 18% HIGHER THAN THE STATE% OF CHILDREN LESS THAN 18 YEARS OF AGE LIVING BELOW 100% OF THE POVERTY LINE IS 10% HIGHER THAN THE STATE54.4% OF PREGNANT WOMEN RECEIVE PUBLICLY FINANCED PRENATAL CARE COMPARED TO 36.1% STATEWIDE.THE POPULATION DEMOGRAPHIC HAS BEEN SIMILARLY AFFECTED:2.8 % OF A POPULATION DECLINE IN THE COUNTY FROM 2000 TO 2010 FOLLOWING A 3.25 % DROP IN POPULATION FROM 1990-2000. % OF PERSONS UNDER THE AGE OF 20 YEARS IN THE COUNTY IS 10% LOWER THAN THE STATEWIDE AVERAGE.% OF PERSONS AGE 65 AND OLDER IS APPROXIMATELY 1/3 HIGHER THAN THE STATE (18.5% VS. 13.7%)THE EDUCATION PROFILE OF COUNTY RESIDENTS REFLECTS THE ECONOMIC AND POPULATION DEMOGRAPHIC:THE PERCENTAGE OF RESIDENTS AGE 25+ WHO HAVE GRADUATED HIGH SCHOOL (90.7%) IS ABOUT THE SAME AS THE STATE EXPERIENCE (88.9%).THE PERCENTAGE OF RESIDENTS AGE 25+ WITH A BACHELORS DEGREE OR HIGHER IS APPROX. 23.6% LOWER THAN THE COMMONWEALTH AS A WHOLE (29.8% VS. 39.0%).THE CUMULATIVE IMPACT OF THIS TRANSITION HAS HAD A SIGNIFICANT IMPACT ON THE FABRIC OF THE COMMUNITY. TRADITIONAL SUPPORT SYSTEMS OF FAMILY, SCHOOLS AND RELIGION, HAVE BEEN CHALLENGED BY THESE DEVELOPMENTS:ALCOHOL AND DRUG ABUSE ARE SIGNIFICANT ISSUES. COUNTY RESIDENTS ARE ADMITTED INTO SUBSTANCE ABUSE TREATMENT AT A FAR GREATER RATE THAN THE STATE AVERAGE.THE SUICIDE RATE IN BERKSHIRE COUNTY IS HIGHER THAN THE STATE AVERAGE. (11.05 VS. 8.78 STATEWIDE)IN 2010, THE COMMUNITIES OF NORTH ADAMS AND PITTSFIELD (THE TWO LARGEST COMMUNITIES IN BERKSHIRE COUNTY) WERE RANKED 1ST AND 3RD RESPECTIVELY STATEWIDE IN REPORTING RATE FOR CHILD MALTREATMENT. (NORTH ADAMS AT 195.2 REPORTED PER 1000 RESIDENT CHILDREN AND PITTSFIELD AT 156.0 REPORTED PER 1000 RESIDENT CHILDREN COMPARED TO A STATEWIDE RATE OF 56.3 PER 1000.) IN TERMS OF VICTIMIZATION RATES (SUPPORTED ALLEGATIONS) NORTH ADAMS AT 48.8 AND PITTSFIELD AT 46.5 WERE 2ND AND 3RD STATEWIDE RESPECTIVELY COMPARED TO A STATEWIDE AVERAGE OF 15.8. (MASS. DEPARTMENT OF CHILDREN AND FAMILIES NOV. 2012)THE CITY OF PITTSFIELD IS ONE OF SIX CITIES IN MASSACHUSETTS WITH THE HIGHEST LEVEL OF DIVISION OF YOUTH SERVICES INVOLVEMENT IN THE COMMONWEALTH. (MASS. JUVENILE JUSTICE ADVISORY CTE. REPORT TO THE GOVERNOR MAY 2007)IN 8TH GRADE IN 2013, 31.9% OF BERKSHIRE COUNTY STUDENTS SELF-REPORTED ALCOHOL USE. IN 12TH GRADE THE PERCENTAGE WAS 74.7% IN 2013. (2013 PREVENTION NEEDS ASSESSMENT SURVEY RESULTS: BERKSHIRE COUNTY. BERKSHIRE YOUTH DEVELOPMENT PROJECT)THE SCHOOL POPULATION OF THE COUNTY HAS BECOME INCREASINGLY MOBILE AND UNSTABLE IN RESPONSE TO AN UNPRECEDENTED INCREASE IN HOUSING COSTS IN SOUTHERN BERKSHIRE COUNTY DUE PRIMARILY TO THE INFLUX OF SECOND HOME BUYERS. FAMILIES ARE RELOCATING TO LOWER COST HOUSING IN THE CENTRAL AND NORTHERN PARTS OF THE COUNTIES DISRUPTING ESTABLISHED SCHOOL SUPPORT SYSTEMS FOR THEIR CHILDREN (SCHOOL MOBILITY RATES BERKSHIRE HILLS REGIONAL SCHOOL DISTRICT).THE BERKSHIRE COUNTY JUVENILE RESOURCE CENTER TRUANCY, INTERVENTION, AND SUSPENSION/EXPULSION ALTERNATIVE PROGRAM SERVES OVER 460 YOUTHS/YEAR. (MASS. JUVENILE JUSTICE ADVISORY CTE. REPORT)1852 JUVENILE CASES WERE OPENED IN BERKSHIRE JUVENILE COURT (70% MALE, 30% FEMALE) (OFFICE OF BERKSHIRE DISTRICT ATTORNEY DAVID CAPELESS MAY 2010)14 CHURCHES CLOSED WITHIN THE LAST FIVE YEARS.THE IMPACT OF THE LOCAL "ENVIRONMENT" ON YOUTH AND ITS IMPLICATIONS FOR THE FUTURE OF THE COUNTY IS FURTHER MAGNIFIED BY TWO SIGNIFICANT FINDINGS: THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH HAS IDENTIFIED BERKSHIRE COUNTY AS BEING AT HIGH RISK FOR YOUTH SUICIDE (ONE OF EIGHT AREAS OUT OF 27 DEFINED AREAS).A COUNTY-WIDE EFFORT TO ADDRESS THIS ISSUE HAS BEEN INITIATED. UNDER THE AUSPICES OF THE COMMUNITY HEALTH NETWORK OF THE BERKSHIRES (COMPRISED OF MEMBERS OF THE HEALTHCARE AND JUVENILE SERVICES PROVIDERS IN THE COUNTY), GRANT FUNDING FROM THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH HAS BEEN OBTAINED (ONE OF ONLY THREE PROPOSALS FUNDED) TO INITIATE A THREE YEAR YOUTH SUICIDE PREVENTION PROGRAM. THE FOCUS OF THIS EFFORT IS TO HELP COMMUNITY ORGANIZATIONS WORKING WITH ADOLESCENTS TO ESTABLISH SUSTAINABLE ACTIVITIES TO PROVIDE SUPPORTIVE ENVIRONMENTS FOR YOUTH, IDENTIFY YOUTH AT RISK, AND MAKE APPROPRIATE REFERRALS TO THE INTERVENTION SAFETY NET. THE NUMBER OF BIRTHS IN BERKSHIRE COUNTY IS DECLINING. FROM 2009 TO 2012 THE TEEN PREGNANCY RATE IN BERKSHIRE COUNTY, DECREASED OVER 50% AND THE 2012 BERKSHIRE COUNTY RATE WAS 10.32 COMPARED TO A STATEWIDE RATE OF 13.57. THE BERKSHIRE UNITED WAY HAS LEAD A COMMUNITY WIDE EFFORT TO REDUCE TEEN PREGNANCY. HEALTH STATUSTHE ROBERT WOOD JOHNSON FOUNDATION AND THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE PRESENTED THE 2015 COUNTY HEALTH RANKINGS, A COLLECTION OF 50 REPORTS THAT REFLECT THE OVERALL HEALTH OF COUNTIES IN EVERY STATE ACROSS THE COUNTRY.SUMMARY HEALTH OUTCOMES & HEALTH FACTORS RANKINGSCOUNTIES RECEIVE TWO SUMMARY RANKS: HEALTH OUTCOMES HEALTH FACTORS EACH OF THESE RANKS REPRESENTS A WEIGHTED SUMMARY OF A NUMBER OF MEASURES. HEALTH OUTCOMES REPRESENT HOW HEALTHY A COUNTY IS WHILE HEALTH FACTORS ARE WHAT INFLUENCES THE HEALTH OF THE COUNTY. THE INFORMATION BELOW REFLECTS THE SOCIAL AND ECONOMIC STATUS OF OUR COMMUNITY AND INFLUENCES OUR HEALTH STATUS.OUT OF THE FOURTEEN COUNTIES OF MASSACHUSETTS, BERKSHIRE COUNTY RANKED 11TH FOR MORTALITY, MORBIDITY, 8TH FOR HEALTH BEHAVIORS, 10TH FOR SOCIAL & ECONOMIC FACTORS, 6TH FOR PHYSICAL ENVIRONMENT AND 3RD FOR CLINCIAL CARE. CONTINUED ON SCHEDULE O. PART VI, LINE 5: THE GOVERNING BODY OF BMC CONSISTS OF 25 COMMUNITY VOLUNTEERS, THREE PHYSICIAN REPRESENTATIVES OF THE HOSPITALS' MEDICAL STAFFS AND, AS AN EX OFFICIO MEMBER, THE CHIEF EXECUTIVE OFFICER. THE COMMUNITY VOLUNTEERS ARE ELECTED FOR TERMS OF UP TO THREE YEARS, ARE SUBJECT TO TERM LIMITS AND REPRESENT A WIDE SPECTRUM OF COMMUNITY INTERESTS-INCLUDING SOCIAL SERVICE PROVIDERS, LOCAL BUSINESS LEADERS, FINANCIAL PROFESSIONALS, CONSUMER ADVOCATES AND EDUCATIONAL LEADERS. MOST COMMITTEES OF THE BOARD OF TRUSTEES INCLUDE ADDITIONAL COMMUNITY REPRESENTATIVES. BMC MAINTAINS A PATIENT AND FAMILY COUNCIL TO PROVIDE INPUT AND ADVICE ON A WIDE RANGE OF SERVICE TOPICS.THE MEDICAL STAFF OF BMC IS OPEN TO ALL PHYSICIANS WHO MEET CLINICAL AND PATIENT SERVICE CRITERIA, ALTHOUGH CERTAIN HOSPITAL BASED SERVICES-RADIOLOGY, ANESTHESIA, EMERGENCY DEPARTMENT AND PATHOLOGY-ARE FUNCTIONALLY CLOSED BECAUSE OF THE MANNER IN WHICH THOSE DEPARTMENTS ARE STRUCTURED.BMC REGULARLY EXPENDS PERSONNEL AND FINANCIAL RESOURCES IN SUPPORT OF COMMUNITY INITIATIVES THAT PROMOTE IMPROVEMENTS IN COMMUNITY HEALTH AND WELL-BEING AND FOR WHICH IT DOES NOT EXPECT REIMBURSEMENT. THE HOSPITAL UTILIZES SURPLUS FUNDS FOR CAPITAL IMPROVEMENTS AND TO MAINTAIN ACCESS TO PATIENT SERVICES AND EXPAND ACCESS POINTS OF CARE AND SERVICES THAT SUPPORT COMMUNITY BENEFIT PRIORITIES TO PATIENTS THROUGHOUT THE COMMUNITY. THE BERKSHIRE COUNTY COMMUNITY HAS LONG LABORED UNDER A CRITICAL PHYSICIAN SHORTAGE IN VARIOUS SPECIALTIES AND BMC HAS IN RECENT YEARS EXPENDED SIGNIFICANT PERSONNEL TIME AND FINANCIAL RESOURCES IN RECRUITING PHYSICIANS TO THE AREA AS DIRECT EMPLOYEES OF BMC OR ITS AFFILIATES. MOREOVER, BMC HAS, IN APPROPRIATE WAYS, PROVIDED SUBSTANTIAL ASSISTANCE TO COMMUNITY MEDICAL PRACTICES TO RECRUIT AND SUPPORT THE PRACTICE START-UP OF NEW PHYSICIANS IN NEEDED SPECIALTIES. AS IS DISCUSSED AT GREATER LENGTH ELSEWHERE IN THIS SUPPLEMENTAL INFORMATION, BMC HAS EXTENSIVE COMMUNITY OUTREACH PROGRAMS AND SUPPORT, COMPREHENSIVE, COMMUNITY-BASED INITIATIVES TO ADDRESS SUCH DIVERSE HEALTHCARE CHALLENGES AS DIABETES, HEART FAILURE AND CHRONIC PAIN MANAGEMENT/NARCOTICS MISUSE AND DIVERSION. PART VI, LINE 6: BMC IS A PART OF AN INTEGRATED, NON-PROFIT HEALTHCARE SYSTEM THAT INCLUDES (A) A TEACHING HOSPITAL, (B) A CRITICAL ACCESS COMMUNITY HOSPITAL, (C) A LARGE, MULTISPECIALTY FACULTY PRACTICE ORGANIZATION, (D) A HOME HEALTH AGENCY AND (E), BY CONTRACT AND CLOSE COORDINATION, A NON-PROFIT SENIOR CARE ORGANIZATION THAT INCLUDES SUB-ACUTE SERVICES IN REHABILITATION AND LONG TERM CARE FACILITIES, ASSISTED LIVING FACILITIES, HOSPICE CARE SERVICES, SENIOR DAY CARE AND OTHER ELDERCARE SERVICES. BMC ENGAGES IN HEALTHCARE NEEDS ASSESSMENT AND PLANNING ON A SYSTEM-WIDE BASIS, WITH A GOAL OF A SEAMLESS TRANSITION OF PATIENT-CENTERED CARE ACROSS THE SPECTRUM OF SERVICES OFFERED BY EACH OF THE SYSTEM'S COMPONENT ENTITIES. BMC, ALONG WITH ITS AFFILIATES, CONTINUES TO DEVELOP INTEGRATED CLINICAL AND INFORMATION SYSTEMS ACROSS THE ENTIRE ORGANIZATION SO AS TO RENDER CARE EFFICIENTLY, EFFECTIVELY AND CONSISTENTLY AT EVERY CARE SITE. THE BMC AFFILIATES SUCH, AS THE PHYSICIAN FACULTY PRACTICE, ARE FULLY INTEGRATED INTO OUR COMMUNITY BENEFIT PROCESS AND SUPPORT THE ORGANIZATION'S PRIORITIES BY HONORING OUR FREE CARE GUIDELINES AND IN ENGAGING IN SPECIFIC PROGRAMS AND INITIATIVES DESIGNED TO MEET COMMUNITY NEED. PART VI, LINE 7, REPORTS FILED WITH STATES MA 0 1 0 0 0 0 0 0 0 BRIAN T BURKE MD TRUSTEE/PHYSICIAN 0 214225 0 0 0 4508 0 10031 0 29510 0 258274 0 0 DAVID E PHELPS PRESIDENT 0 639677 0 0 0 39500 0 11475 0 27753 0 718405 0 0 DAVID E PHELPS ANNUAL LIFE PRESIDENT INSURANCE 0 0 0 0 0 107692 0 0 0 0 0 107692 0 0 DARLENE RODOWICZ TREASURER 0 419918 0 0 0 43718 0 11475 0 25080 0 500191 0 0 RONALD HAYDEN CHAIRMAN - EMERGENCY MEDIC 425889 0 45717 0 40341 0 11475 0 29541 0 552963 0 0 0 DIANE KELLY C.O.O. 330737 0 25695 0 41742 0 11021 0 27276 0 436471 0 0 0 RAYMOND GARY SOHL ANESTHESIOLOGIST 460168 0 16123 0 2622 0 6375 0 31924 0 517212 0 0 0 ANTHONY G ELLRODT CHAIRMAN - DEPT OF MEDICIN 410050 0 34553 0 45773 0 11366 0 27118 0 528860 0 0 0 DAVID I POMERANTZ ANESTHESIOLOGIST 402324 0 16123 0 18311 0 11363 0 32243 0 480364 0 0 0 CARLOS MARAMAG ANESTHESIOLOGIST 403386 0 16123 0 18014 0 11371 0 34711 0 483605 0 0 0 TALAL A MAKKAOUI ANESTHESIOLOGIST 368480 0 16123 0 44064 0 11373 0 34528 0 474568 0 0 0 PART I, LINE 3 IN REFERENCE TO FORM 990, PART VII AND SCHEDULE J PART II, NO COMPENSATION IS PAID BY THE FILING ENTITY TO ANY DIRECTOR (TRUSTEE) FOR HIS OR HER ROLE AS DIRECTOR (TRUSTEE). THE OFFICERS OF THE FILING ENTITY ARE COMPENSATED FOR THEIR ROLES AS OFFICERS. A PORTION OF THE COMPENSATION AMOUNT PAID TO OFFICERS OF THE FILING ENTITY IS ALLOCATED INTERNALLY AMONG THE FILING ENTITY AND ITS 26 ASSOCIATED NON-PROFIT, TAX-EXEMPT ENTITIES IN ORDER TO PROPERLY REFLECT THE DIVISION OF THE OFFICERS' TIME AND EFFORT AMONG THOSE VARIOUS ENTITIES AND EACH ENTITY'S RELATIVE CONTRIBUTION TO THE OFFICERS' TOTAL COMPENSATION (SEE BELOW). COMPENSATION OF THE CHIEF EXECUTIVE OFFICER, DAVID PHELPS, IS REVIEWED AND ESTABLISHED AT LEAST BIANNUALLY BY THE INDEPENDENT VOLUNTEER GOVERNING BODY OF BERKSHIRE HEALTH SYSTEMS, INC. (PARENT ORGANIZATION OF THE FILING ENTITY), BASED ON PERFORMANCE REVIEWS AND COMPARISON TO INDEPENDENTLY ESTABLISHED, REGIONALLY APPROPRIATE BENCHMARKS FOR SIMILAR POSITIONS IN SIMILARLY SIZED HEALTHCARE ORGANIZATIONS, AS VERIFIED BY INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANTS. COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS SET IN ACCORDANCE WITH GOVERNING-BODY ESTABLISHED PRINCIPLES BASED ON COMPARABLE BENCHMARK IDENTIFIED BY SUCH INDEPENDENT CONSULTANTS. IN THE REPORTING YEAR, THE GOVERNING BODY TARGETED TOTAL COMPENSATION FOR MANAGEMENT EMPLOYEES AT THE 60TH PERCENTILE OF APPROPRIATE BENCHMARKS (OTHER THAN THE CHIEF EXECUTIVE OFFICER WHOSE TOTAL COMPENSATION REMAINS TARGETED AT THE 50TH PERCENTILE). FOR MOST OF MR. PHELPS' 20+-YEAR TENURE AS CHIEF EXECUTIVE OFFICER, A WRITTEN AGREEMENT BETWEEN BERKSHIRE HEALTH SYSTEMS AND MR. PHELPS HAS CALLED FOR BERKSHIRE HEALTH SYSTEMS (AND ITS AFFILIATES) TO FUND A RETIREMENT PROGRAM THAT, WHEN ADDED TO HIS BASE COMPENSATION AND OTHER ROUTINE BENEFITS, WAS INTENDED TO BRING MR. PHELPS' TOTAL COMPENSATION CLOSE TO THE 50TH PERCENTILE RANGE OF TOTAL COMPENSATION FOR COMPARABLE EXECUTIVES IN COMPARABLE HEALTHCARE ORGANIZATIONS, AS DETERMINED BY INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION REVIEWERS. MR. PHELPS' TOTAL COMPENSATION INCLUDES THE COST OF A LIFE INSURANCE POLICY AS WELL AS CERTAIN OTHER TAXABLE BENEFITS THAT ARE GENERALLY AVAILABLE TO EMPLOYEES OF THE REPORTING ENTITY AND ITS RELATED ORGANIZATIONS. MR. PHELPS' BASE COMPENSATION AND LIFE INSURANCE (AND OTHER TAXABLE BENEFITS) ARE REPORTED SEPARATELY ON SCHEDULE J, PART II, COLUMNS (B) (I) AND B (II) RESPECTIVELY AND FORM 990, PART VII COLUMN (E). MR. PHELPS' CASH COMPENSATION AND BENEFITS ARE ALLOCATED AMONG THE 26 RELATED ENTITIES FOR WHICH MR. PHELPS IS RESPONSIBLE. DAVID E. PHELPS, PRESIDENT (ALLOCATION IS INCLUSIVE OF $107,692 LIFE INSURANCE): BERKSHIRE MEDICAL CENTER, INC. 25.9 HOURS/50 TOTAL HOURS $429,571 BERKSHIRE FACULTY SERVICES, INC. 8.6/50 HOURS $144,567 FAIRVIEW HOSPITAL 3.5/50 HOURS $57,827 BERKSHIRE INDEMNITY COMPANY, SPC, LTD. 2/50 HOURS $28,913 BHS MANAGEMENT SERVICES, INC. 10/50 HOURS FOR THE BENEFIT OF: BOURNE MANAGEMENT SYSTEMS, INC. $ 10,904 GREENFIELD MANAGEMENT SYSTEMS, INC. $ 10,078 NEW BEDFORD MANAGEMENT SYSTEMS, INC. $ 11,565 NORTHAMPTON MANAGEMENT SYSTEMS, INC. $ 9,748 EAST LONGMEADOW MANAGEMENT SYSTEMS, INC. $ 5,617 DANVERS MANAGEMENT SYSTEMS, INC. $ 5,287 PEABODY MANAGEMENT SYSTEMS, INC. $ 9,583 SOUTH YARMOUTH MANAGEMENT SYSTEMS, INC. $ 6,113 BERKSHIRE PENNSYLVANIA, INC. $ 9,087 XENIA EAST MANAGEMENT SYSTEMS, INC. $ 2,478 WILLOWOOD OF GREAT BARRINGTON, INC. $ 8,261 WILLOWOOD OF NORTH ADAMS, INC. $ 9,583 WILLOWOOD OF WILLIAMSTOWN, INC. $ 12,226 HILLCREST EXTENDED CARE SERVICES, INC. $ 22,305 BERKSHIRE RETIREMENT COMMUNITY, INC. $ 7,435 BERKSHIRE EXTENDED CARE SERVICES, INC. $ 661 INTEGRINURSE, INC. $ 1,983 INTEGRISCRIPT, INC. $ 5,122 HOSPICECARE IN THE BERKSHIRES, INC. $ 6,774 PITTSFIELD MANAGEMENT SYSTEMS, INC. $ 10,409 DARLENE RODOWICZ: BERKSHIRE MEDICAL CENTER, INC. 37 HOURS/50 TOTAL HOURS $370,141 BERKSHIRE FACULTY SERVICES, INC. 7/50 HOURS $70,027 FAIRVIEW HOSPITAL 3/50 HOURS $30,011 BERKSHIRE INDEMNITY COMPANY, SPC, LTD. 2.5/50 HOURS $25,010 BHS MANAGEMENT SERVICES, INC. 0.5/50 HOURS FOR THE BENEFIT OF: BERKSHIRE HEALTHCARE SYSTEMS, INC. $5,002 PART II RELATED COMPENSATION: MR. PHELPS' BASE COMPENSATION AND LIFE INSURANCE (AND OTHER TAXABLE BENEFITS) ARE REPORTED SEPARATELY ON SCHEDULE J, PART II, COLUMNS (B) (I) AND B (II) RESPECTIVELY AND FORM 990, PART VII COLUMN (E). MR. PHELPS' CASH COMPENSATION AND BENEFITS ARE ALLOCATED AMONG THE 26 RELATED ENTITIES FOR WHICH MR. PHELPS IS RESPONSIBLE. DAVID E. PHELPS, PRESIDENT (ALLOCATION IS INCLUSIVE OF $107,692 LIFE INSURANCE): BERKSHIRE MEDICAL CENTER, INC. 25.9 HOURS/50 TOTAL HOURS $429,571 BERKSHIRE FACULTY SERVICES, INC. 8.6/50 HOURS $144,567 FAIRVIEW HOSPITAL 3.5/50 HOURS $57,827 BERKSHIRE INDEMNITY COMPANY, SPC, LTD. 2/50 HOURS $28,913 BHS MANAGEMENT SERVICES, INC. 10/50 HOURS FOR THE BENEFIT OF: BOURNE MANAGEMENT SYSTEMS, INC. $ 10,904 GREENFIELD MANAGEMENT SYSTEMS, INC. $ 10,078 NEW BEDFORD MANAGEMENT SYSTEMS, INC. $ 11,565 NORTHAMPTON MANAGEMENT SYSTEMS, INC. $ 9,748 EAST LONGMEADOW MANAGEMENT SYSTEMS, INC. $ 5,617 DANVERS MANAGEMENT SYSTEMS, INC. $ 5,287 PEABODY MANAGEMENT SYSTEMS, INC. $ 9,583 SOUTH YARMOUTH MANAGEMENT SYSTEMS, INC. $ 6,113 BERKSHIRE PENNSYLVANIA, INC. $ 9,087 XENIA EAST MANAGEMENT SYSTEMS, INC. $ 2,478 WILLOWOOD OF GREAT BARRINGTON, INC. $ 8,261 WILLOWOOD OF NORTH ADAMS, INC. $ 9,583 WILLOWOOD OF WILLIAMSTOWN, INC. $ 12,226 HILLCREST EXTENDED CARE SERVICES, INC. $ 22,305 BERKSHIRE RETIREMENT COMMUNITY, INC. $ 7,435 BERKSHIRE EXTENDED CARE SERVICES, INC. $ 661 INTEGRINURSE, INC. $ 1,983 INTEGRISCRIPT, INC. $ 5,122 HOSPICECARE IN THE BERKSHIRES, INC. $ 6,774 PITTSFIELD MANAGEMENT SYSTEMS, INC. $ 10,409 DARLENE RODOWICZ: BERKSHIRE MEDICAL CENTER, INC. 37 HOURS/50 TOTAL HOURS $370,141 BERKSHIRE FACULTY SERVICES, INC. 7/50 HOURS $70,027 FAIRVIEW HOSPITAL 3/50 HOURS $30,011 BERKSHIRE INDEMNITY COMPANY, SPC, LTD. 2.5/50 HOURS $25,010 BHS MANAGEMENT SERVICES, INC. 0.5/50 HOURS FOR THE BENEFIT OF: BERKSHIRE HEALTHCARE SYSTEMS, INC. $5,002 A MHEFA BHS SERIES F 042456011 57586CLN3 2005-07-26 53089428 REFUND SERIES C AND D BONDS 0 0 0 B MDFA BHS SERIES G 043431814 57583UQP6 2012-05-23 93491421 REFUND SERIES E, A & B, RENOVATIONS AND EQUIPMENT 0 0 0 A 23360000 55228739 5019000 1003800 898795 73681 9003428 2008 1 0 1 1 B 5025000 93491421 1104925 8171944 2011 1 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 1 0 0 0 1 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 SCHEDULE K PART II LINE 3 A PORTION OF THE SERIES F BOND PROCEEDS ARE HELD IN A REQUIRED DEBT SERVICE RESERVE FUND. THIS FUND IS INVESTED AND THE EARNINGS ARE INCLUDED IN PART II LINE 3. THESE EARNINGS ARE NOT INCLUDED IN PART I LINE A COLUMN (E) ISSUE PRICE. FORM 990, PART I, LINE 9 IN FISCAL YEARS 2012, 2013 AND 2014, BERKSHIRE MEDICAL CENTER AND ALMOST ALL OTHER MASSACHUSETTS HOSPITALS EXPERIENCED AN UNUSUAL AND LIKELY TEMPORARY INCREASE IN REIMBURSEMENT FROM THE MEDICARE PROGRAM DUE TO THE MANNER IN WHICH THE MEDICARE PROGRAM APPLIED ONE ELEMENT OF ITS REIMBURSEMENT CALCULATION. FOR MANY YEARS, THE APPLICATION OF THIS SAME ELEMENT OF THE REIMBURSEMENT CALCULATION WORKED TO THE DETRIMENT OF MASSACHUSETTS HOSPITALS, INCLUDING BERKSHIRE MEDICAL CENTER. THE HOSPITAL IS NOT EXPECTING THAT THIS TEMPORARY, POSITIVE ADJUSTMENT WILL CONTINUE. THE VALUE OF THE RURAL FLOOR PROVISION TO BMC IN FY 2014 WAS $12.6 MILLION. FORM 990, PART VI, SECTION A, LINE 3 BERKSHIRE MEDICAL CENTER, INC. RELIES ON BHS MANAGEMENT SERVICES, INC. TO PROVIDE MANAGEMENT AND SUPPORT SERVICES FOR THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, VP GENERAL COUNSEL, AND VP OF HUMAN RESOURCES . FORM 990, PART VI, SECTION A, LINE 6 BERKSHIRE HEALTH SYSTEMS, INC. IS THE SOLE CORPORATE MEMBER OF BERKSHIRE MEDICAL CENTER, INC. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF TRUSTEES IS COMPOSED OF THE INCUMBENT MEMBERS OF THE BOARD OF TRUSTEES OF BERKSHIRE HEALTH SYSTEMS, INC. FORM 990, PART VI, SECTION B, LINE 11 BHS WILL MAKE THE FORMS 990 FOR BHS AND AFFILIATES AVAILABLE TO THE MEMBERS OF THE RESPECTIVE GOVERNING BODIES FOR THEIR REVIEW BY (A) SENDING COPIES TO THEM PHYSICALLY OR ELECTRONICALLY, OR (B) NOTIFYING THE MEMBERS THAT THE FORMS 990 CAN BE ACCESSED BY A SECURE WEB-BASED FOLDER BEFORE THEY ARE FILED WITH THE IRS. IN ADDITION, BHS MANAGEMENT WILL REVIEW THE FORMS 990 WITH THE BHS FINANCE COMMITTEE AND ADDRESS QUESTIONS AND COMMENTS COVERING KEY ELEMENTS OF THE FORMS 990 THAT ARE OF CONCERN TO ALL OF THE FORMS 990, AND ANY SIGNIFICANT ELEMENTS THAT ARE PECULIAR TO ONE OR MORE OF THE AFFILIATES' FORMS 990. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION ENFORCES AND MONITORS ITS CONFLICT OF INTEREST POLICY BY REQUIRING ALL MEMBERS OF THE GOVERNING BODY AND SENIOR MANAGEMENT TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST (A) ANNUALLY AND (B) AS POTENTIAL CONFLICTS ARISE. SENIOR EMPLOYEES ARE NOT PERMITTED TO HAVE MATERIAL CONFLICTS OF INTEREST AND MEMBERS OF THE GOVERNING BODY ARE TO ABSTAIN FROM ACTION THAT MAY BE INFLUENCED BY THEIR CONFLICT OR POTENTIAL CONFLICT BY (A) NOT VOTING OR (B) NOT VOTING AND LEAVING THE ROOM OR (C) LEAVING THE GOVERNING BODY AS DETERMINED BY THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF THE CHIEF EXECUTIVE OFFICER IS REVIEWED AND ESTABLISHED AT LEAST BIANNUALLY BY THE INDEPENDENT, VOLUNTEER, BHS GOVERNING BODY, BASED ON PERFORMANCE REVIEWS AND COMPARISON TO INDEPENDENTLY ESTABLISHED, REGIONALLY APPROPRIATE BENCHMARKS FOR SIMILAR POSITIONS IN SIMILARLY SIZED HEALTHCARE ORGANIZATIONS, AS VERIFIED BY INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANTS. COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS SET IN ACCORDANCE WITH GOVERNING BODY-ESTABLISHED PRINCIPLES BASED ON COMPARABLE BENCHMARK IDENTIFIED BY SUCH INDEPENDENT CONSULTANTS. IN THE REPORTING YEAR, THE GOVERNING BODY TARGETED TOTAL COMPENSATION FOR MANAGEMENT EMPLOYEES AT THE 60TH PERCENTILE OF APPROPRIATE BENCHMARKS. THE ORGANIZATION FOLLOWED THIS PROCESS FOR YEAR ENDED 9/30/14. FORM 990, PART VI, SECTION C, LINE 19 GOVERNANCE DOCUMENTS, THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC AT THE OFFICE OF (A) THE CHIEF FINANCIAL OFFICER AND (B) THE VICE PRESIDENT AND GENERAL COUNSEL AT 725 NORTH STREET, PITTSFIELD MA 01201. SCHEDULE H PART VI LINE 2 COMMUNITY PARTNERS PITTSFIELD PUBLIC SCHOOLS, PITTSFIELD BOARD OF HEALTH, HEAD START, BERKSHIRE COMMUNITY ACTION COUNCIL, CENTER FOR ECOLOGICAL TECHNOLOGY, TEEN PARENT PROGRAM, BRIEN CENTER FOR MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES, PITTSFIELD POLICE, MASSACHUSETTS COALITION FOR SUICIDE PREVENTION, MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, LOCAL COMMUNITY PHARMACISTS, ELDER SERVICES, PITTSFIELD SENIOR CENTER, GREYLOCK FEDERAL CREDIT UNION, BOXCAR MEDIA, YMCA, TRI-TOWN HEALTH BOARD, SHINE PROGRAM, BERKSHIRE IMMIGRANT CENTER, BERKSHIRE COMMUNITY COLLEGE, BERKSHIRE COUNTY SHERIFF'S DEPARTMENT, LOCAL AMBULANCE COMPANIES, BERKSHIRE BREAST HEALTH TEAM, COMMUNITY HEALTH PROGRAM, BERKSHIRE DISTRICT ATTORNEY, BERKSHIRE UNITED WAY, BERKSHIRE YOUTH DEVELOPMENT PROJECT, NORTHERN BERKSHIRE COMMUNITY COALITION, CHNA(COMMUNITY HEALTH NETWORK ASSOCIATION), LOCAL COMMUNITY-BASED ORGANIZATIONS AND THE BUSINESS COMMUNITY. OTHER RESOURCES AND ORGANIZATIONS INCLUDE: MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH; UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE; BERKSHIRE COUNTY BOARDS OF HEALTH; LOCAL SCHOOL DISTRICTS; BERKSHIRE COUNTY REGIONAL PLANNING COMMISSION; BERKSHIRE UNITED WAY; BERKSHIRE, AMERICAN HEART ASSOCIATION, AMERICAN STROKE ASSOCIATION, AMERICAN DIABETES ASSOCIATION, AMERICAN CANCER SOCIETY, CHAMBER OF COMMERCE; MASSACHUSETTS MEDICAL SOCIETY; REGIONAL PAIN COLLABORATIVE; BERKSHIRE COUNTY REGIONAL EMERGENCY OPERATIONS PLANNING COMMITTEE. PROGRAM PLANNING AND EVALUATION THE COMMUNITY HEALTH NEEDS ASSESSMENT IS USED TO FOCUS OUR COMMUNITY BENEFIT PROGRAM AND INITIATIVE PLANNING AS WELL AS TO MONITOR RESULTS AND REPRIORITIZE FOR FUTURE EFFORTS. SCHEDULE H, PART VI, 4 WE ALSO USED THE HEALTH STATUS DATA PROVIDED BY THE DEPARTMENT OF PUBLIC HEALTH AS PART OF THE PREVENTION AND WELLNESS TRUST FUND PROCESS TO UNDERSTAND CRITICAL HEALTH RISKS IN OUR COMMUNITY AND SELECTED HYPERTENSION, SMOKING CESSATION, FALLS IN ELDERLY AND DIABETES AS OUR INITIATIVES DUE TO THE HIGH PREVALENCE OF CONCERN IN OUR COMMUNITY FOR THESE HEALTH CONDITIONS. CHRONIC DISEASE: HYPERTENSION *IN WORKSITES WITH ACTIVE WELLNESS PROGRAMS (> 220 EMPLOYEES), THE PERCENTAGE OF EMPLOYEES WITH HTN IS APPROXIMATELY 7%. *36% OF EMPLOYEES HAVE PRE-HYPERTENSION NON-WORKING POPULATIONS WITH LIMITED ACCESS TO CARE (HOMELESS, LOW SOCIOECONOMIC, MENTAL HEALTH CONDITIONS AND SUBSTANCE ABUSE) SHARE A DISPROPORTIONATE BURDEN OF RISK AS EVIDENCED BY DATA FROM THE BHS COMMUNITY HEALTH VAN: 21.1% (N= 450) OF POPULATION HAVE BP > 140/90 OF THOSE WITH HBP 244,(54.2%) ARE ON MEDS AND NOT CONTROLLED -UNDERTREATED OF THOSE WITH HBP 206 (45.8%) ARE NOT ON MEDS - NOT TREATED 701 PATIENTS HAVE PREHTN AND MORE THAN 30% WILL GO ON TO DEVELOP HBP AND REQUIRED RX- PREVENTION RISK FACTOR PREVALENCE IN VULNERABLE POPULATION OF 115 PEOPLE: HEALTH SCREENING TYPE (N=115) TOTAL # % TOTAL CHOLESTEROL (>240) HIGH 17 15% TOTAL CHOLESTEROL (200-239) BORDERLINE 31 27.4% BP (PRE) 42 36.5% BP (STAGE I) 20 17.4% BP (STAGE II) 5 4.3% BLOOD GLUCOSE (HIGH) 17 15.2% BMI (>30) OBESE 33 29.7% BMI (25-29) OVERWEIGHT 48 43.2% BMI (<25) 30 27.0% EMPLOYEE WELLNESS 1/1/2014 TO 12/31/2014 POPULATION: EMPLOYEES AND SPOUSES BASED ON BIOMETRIC DATA AND PERSONAL HEALTH ASSESSMENT USERS START WITH A SCORE OF 100 AUTOMATIC HIGH RISK: BMI >30, TOBACCO USE, HIGH RISK ON ANY RECORDED BIOMETRICS (BP, CHOLESTEROL, BLOOD GLUCOSE). THERE IS AN AVERAGE OF ALL THE SECTIONS TO CALCULATE THE SCORE; ALL SECTIONS ARE WEIGHTED EVENLY. IF THERE ARE NO RECORDED BIOMETRICS THEY WILL NOT BE INCLUDED IN PROCESSING THE SCORE. OTHER RISK SCORES INCLUDE: CARDIAC RISK / FRAMINGHAM RISK, DIABETES RISK, ASTHMA RISK, STROKE RISK AND COPD RISK. TOTAL NUMBER 2947 HIGH RISK (0-59) 1297 44% MODERATE RISK (60-79) 417 14% LOW RISK (80-100) 1233 42% HEALTH AND CLINICAL INDICATORS ADDITIONAL HEALTH INFORMATION THAT HELPS DEPICT THE PROFILE OF BERKSHIRE COUNTY INCLUDES: BERKSHIRE COUNTY HAS HIGHER THAN STATE AVERAGES FOR CARDIOVASCULAR MORTALITY RATES. THROUGH THE EFFORTS OF OUR CLINICAL CARE AND OUTREACH, THE RATE HAS DECLINED CONSISTENTLY OVER THE LAST TEN YEARS TO CLOSER WITH THE STATE. OUR AGE ADJUSTED SPECIFIC RATE FOR ALL CANCER DEATHS IS 150.35 WHICH IS LOWER THAN THE STATE RATE OF 162.86 (PER 100,000 PERSONS) FOR SUBSTANCE ABUSE, OUR ADMISSION RATE TO DPH FUNDED TREATMENT PROGRAMS IS 2818.9 VERSUS 1636.5 FOR THE STATE, AND ALCOHOL AND OTHER DRUG RELATED HOSPITAL DISCHARGES IS 995.0 VERSUS 362.0 (PER 100,000 PERSONS) DIABETES MORTALITY EXCEEDS THE STATE RATE 15.22 VERSUS 13.59 WORKFORCE SHORTAGES AND ACCESS TO CARE IN THE LAST DECADE BERKSHIRE COUNTY HAS EXPERIENCED A SHORTAGE OF PHYSICIANS FOR OUR COMMUNITY, AS WELL AS SHORTAGES FOR KEY CLINICAL SPECIALTIES, SUCH AS NURSING, RADIOLOGY AND LABORATORY. THESE SHORTAGES CREATE ACCESS TO CARE ISSUES FOR THE RESIDENTS OF BERKSHIRE COUNTY. IN THE LAST 5-8 YEARS, BMC HAS EDUCATED AND TRAINED HUNDREDS OF STAFF IN ITS CRITICAL SHORTAGE PROGRAMS AS WELL AS HELPED RECRUIT APPROXIMATELY 150 PHYSICIANS TO THE COMMUNITY, REDUCING THE COUNTY'S EXISTING SHORTAGE OF PROVIDERS BY 40 FTES. GIVEN NATIONAL SHORTAGES, INCREASED DEMAND, AND OUR RURAL LOCATION, BMC EXPECTS THAT THIS CHALLENGE OF HAVING AN ADEQUATE NUMBER OF HEALTH CARE PROFESSIONAL TO MEET THE COMMUNITY NEED WILL CONTINUE. BERKSHIRE HEALTH SYSTEMS INC 725 NORTH ST PITTSFIELD MA 01201 042442944 PARENT CORP MA 501 (C)(3) 11B N/A 0 FAIRVIEW HOSPITAL 725 NORTH ST PITTSFIELD MA 01201 042133860 ACUTE CARE MA 501 (C)(3) 3 N/A 0 BERKSHIRE FACULTY SERVICES INC 725 NORTH ST PITTSFIELD MA 01201 042995053 PHYSICIAN SVC MA 501 (C)(3) 11B N/A 0 BHS MANAGEMENT SERVICES INC 725 NORTH ST PITTSFIELD MA 01201 222755258 MANAGEMENT MA 501 (C)(3) 11B N/A 0 TRI-STATE MEDICAL MANAGEMENT CORP 725 NORTH STREET PITTSFIELD MA 01201 042913352 REAL ESTATE MANAGEMENT MA N/A C 0 WILLIAMSTOWN MEDICAL ASSOCIATES PC 197 ADAMS ROAD WILLIAMSTOWN MA 01267 042680535 HEALTH SERVICES MA N/A C 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 1