BAYSTATE MEDICAL CENTER INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
BAYSTATE MEDICAL CENTER INC (EIN 04-2790311)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-08
IRS object ID
201422209349300877
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-08-08T13:55:08-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN861065772EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Deloitte Tax LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1Two Jericho PlazaAddressLine1
CityJerichoCity
StateNYState
ZIP Code11753ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN042790311EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Baystate Medical Center IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBAYSNameControl
Phone4137940000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1759 Chestnut StreetAddressLine1
CitySpringfieldCity
StateMAState
ZIP Code01199ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDennis W ChalkeName
TitleCFO & Treasurer, Baystate HealthTitle
Phone4137940000Phone
Date Signed2014-08-08DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameChristine KaweckiName
PTINP00743140PTIN
Phone5169187000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDennis W ChalkeNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1759 Chestnut StreetAddressLine1
CitySpringfieldCity
StateMAState
ZIP Code01199ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1009782003GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.baystatehealth.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1983YearFormation
State Legal DomicileMAStateLegalDomicile
Activity Or Mission DescriptionThe mission of the organization is to improve the health of the people in our communities every day, with quality and compassion.ActivityOrMissionDescription
Nbr Voting Members Governing Body22NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees7406TotalNbrEmployees
Total Nbr Volunteers578TotalNbrVolunteers
Total Gross UBI6799384TotalGrossUBI
Net Unrelated Business Txbl Income-3203799NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year6512494ContributionsGrantsPriorYear
Contributions Grants Current Year6114899ContributionsGrantsCurrentYear
Program Service Revenue Prior Year909917621ProgramServiceRevenuePriorYear
Program Service Revenue CY936557350ProgramServiceRevenueCY
Investment Income Prior Year17085746InvestmentIncomePriorYear
Investment Income Current Year17159944InvestmentIncomeCurrentYear
Other Revenue Prior Year19733008OtherRevenuePriorYear
Other Revenue Current Year49553318OtherRevenueCurrentYear
Total Revenue Prior Year953248869TotalRevenuePriorYear
Total Revenue Current Year1009385511TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year6172149GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY6194372GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year419860372SalariesEtcPriorYear
Salaries Etc Current Year435740766SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year456399027OtherExpensePriorYear
Other Expenses Current Year478944887OtherExpensesCurrentYear
Total Expenses Prior Year882431548TotalExpensesPriorYear
Total Expenses Current Year920880025TotalExpensesCurrentYear
Revenues Less Expenses Prior Year70817321RevenuesLessExpensesPriorYear
Revenues Less Expenses CY88505486RevenuesLessExpensesCY
Total Assets BOY1139431156TotalAssetsBOY
Total Assets EOY1188880088TotalAssetsEOY
Total Liabilities BOY633235019TotalLiabilitiesBOY
Total Liabilities EOY542791433TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY506196137NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY646088655NetAssetsOrFundBalancesEOY
Mission DescriptionThe mission of the organization is to improve the health of the people in our communities every day, with quality and compassion.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense417064923Expense
Grants6194372Grants
Revenue494479675Revenue
DescriptionInpatient healthcare services - Providing inpatient community-based medicine and tertiary care to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY13, Baystate Medical Center, Inc. provided 188,351 patient days of inpatient services, with 38,900 discharges.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense290147182Expense
Revenue315314842Revenue
DescriptionOutpatient healthcare services - Providing outpatient clinical services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY13, Baystate Medical Center, Inc. had 423,676 outpatient visits.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense29571502Expense
Revenue35439491Revenue
DescriptionEmergency department services - Providing emergency department services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY13, Baystate Medical Center, Inc. had 100,299 emergency department visits.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense126279814Expense
Revenue128248708Revenue
FieldValueIRS element (for citing)
Total Of Other Program Service Exp126279814TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev128248708TotalOfOtherProgramServiceRev
Total Program Service Expense863063421TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities1ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10961062NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees7406NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members22NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledMAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonPeter Lyons Baystate Health IncNamePerson
Telephone Number4137940000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1759 Chestnut StreetAddressLine1
CitySpringfieldCity
StateMAState
ZIP Code01199ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (38 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Mark R Tolosky
President, CEO & Trustee1.0049.00XX0155504459300
Victor Woolridge
Chair1.002.00XX000
James P Sadowsky
Vice Chair1.002.00XX000
Gregory L Braden MD
Trustee 1/1 - 9/30/131.001.00X000
Ruth H Constantine
Trustee 1/1 - 9/30/131.001.00X000
Charles L D'Amour
Trustee 10/1 - 12/31/121.001.00X000
John H Davis
Trustee1.001.00X000
John A Egelhofer MD
Trustee1.001.00X000
John E Kole
Trustee1.001.00X000
Grace P Makari-Judson MD
Trustee/ Hematologist M. D1.0049.00X329977045148
John F Maybury
Trustee1.001.00X000
Steven M Mitus
Trustee1.001.00X000
Kevin Moriarty MD
Trustee; Pediatric Surgeon1.000.00X448971071041
Jeffery G Mulhern MD
Trustee1.000.00X0150000
John M O'Brien III
Trustee1.001.00X000
Anne M Paradis
Trustee1.001.00X000
Robert L Pura PhD
Trustee 1/1 - 9/30/131.001.00X000
Katherine E Putnam
Trustee1.001.00X000
Timothy S Rice
Trustee1.001.00X000
David C Southworth
Trustee1.001.00X000
Barbara W Stechenberg MD
Trustee/ Infectious Disease1.0049.00X144720032595
Katherine McG Sullivan
Trustee1.001.00X000
Howard G Trietsch MD
Trustee1.001.00X000
Richard B Steele Jr
Trustee1.001.00X000
Dennis W Chalke
Treasurer1.0049.00X072368552277
Kristin R Delaney
Clerk1.0049.00X09811919540
Patricia A Sheldon
Assistant Clerk1.0049.00X06479015809
Gregory A Harb
Executive VP, COO50.000.000799614161885X
Mark R Keroack MD
Executive VP, COO50.000.000814375135233X
Michael F Moran
VP Facilities & Guest Serv50.000.00281296047559X
Deborah Morsi
VP, Patient Care Services50.000.00269039021419X
Deborah A Provost
VP Surg, Anes, Emrg Serv50.000.00264715076033X
Peter Lindenauer MD
Med Dir & Quality & Safety50.000.00294571052779X
Betty K Larue
VP, Heart & Vascular/ Neuro50.000.00268410081343X
David Y Chin PhD
Rad Oncology Med Physics C50.000.00241870046337X
Jason M Newmark
VP Diagnostic Services50.000.00239835030975X
Michael R Favreau
Director Radiology Service50.000.00223813081611X
Keith C McLean-Shinaman
Former Treasurer0.00029898610208X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3007217TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs4369613TotalReportableCompFrmRltdOrgs
Total Other Compensation1041092TotalOtherCompensation
Number Individuals GT100 K289NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources1CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Baystate Administrative Services Inc
759 Chestnut StreetSpringfieldMA01199Management Svcs.74708637
Baystate Medical Practices Inc
759 Chestnut StreetSpringfieldMA01199Medical, Educ, Clin50659102
Baystate Health Inc
759 Chestnut StreetSpringfieldMA01199Strategic Initiatives6000000
Springfield Anesthesia Service Inc
908 Allen StreetSpringfieldMA01118Anesthesia Services5916646
Angelica Textile Service
125 Bath StreetBallston SPANY12020Linen Services3609163
FieldValueIRS element (for citing)
Number Of Contractors GT100 K89NumberOfContractorsGT100K
Government Grants6114899GovernmentGrants
Total Contributions6114899TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
Inpatient Revenue900099519600090519600090
Outpatient Revenue6214004021488473954138616734986
Sponsored Programs90009990881269088126
CMS Elec Med Rec Fdg90009929227802922780
Intercompany Rent90009927975072797507
FieldValueIRS element (for citing)
Total Program Service Revenue936557350TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column12853628TotalRevenueColumn
Exclusion$12,853,628ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real680896Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real349791Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real331105Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column331105TotalRevenueColumn
Exclusion$331,105ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities4253414Securities
Other99603Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities
Other46701Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities4253414Securities
Other52902Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column4306316TotalRevenueColumn
Exclusion$4,306,316ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
Pharmacy Service9000992157920821579208
Intercompany Charges90009999634069963406
Cafeteria Income9000994421123$4,421,123

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column13258476TotalRevenueColumn
Related Or Exempt Function Income12117738RelatedOrExemptFunctionIncome
Unrelated Business Revenue64398UnrelatedBusinessRevenue
Exclusion$1,076,340ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue49222213TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1009385511TotalRevenueColumn
Related Or Exempt Function Income973482716RelatedOrExemptFunctionIncome
Unrelated Business Revenue6799384UnrelatedBusinessRevenue
Exclusion$22,988,512ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total6124646Total
Program Services6124646ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total69726Total
Program Services69726ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total815050Total
Program Services246553ProgramServices
Management And General568497ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total188731Total
Program Services55902ProgramServices
Management And General132829ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total353688696Total
Program Services329524317ProgramServices
Management And General24164379ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total22004652Total
Program Services20577469ProgramServices
Management And General1427183ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total32561323Total
Program Services30336907ProgramServices
Management And General2224416ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total26482314Total
Program Services24637015ProgramServices
Management And General1845299ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total37271564Total
Program Services34312396ProgramServices
Management And General2959168ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1395534Total
Management And General1395534ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total244985Total
Management And General244985ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total83191Total
Management And General83191ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total101047580Total
Program Services94401951ProgramServices
Management And General6645629ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total274022Total
Program Services203156ProgramServices
Management And General70866ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total194283580Total
Program Services190450437ProgramServices
Management And General3833143ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total46897533Total
Program Services46434879ProgramServices
Management And General462654ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total34676792Total
Program Services29551434ProgramServices
Management And General5125358ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total1032661Total
Program Services824666ProgramServices
Management And General207995ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1248992Total
Program Services787667ProgramServices
Management And General461325ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total8935344Total
Program Services8935344ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total41205686Total
Program Services36317519ProgramServices
Management And General4888167ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total10296248Total
Program Services9220262ProgramServices
Management And General1075986ManagementAndGeneral

Other Expenses OtherExpenses

FieldValueIRS element (for citing)
DescriptionNon-Patient Bad Debt ExDescription
Total51175Total
Program Services51175ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total920880025Total
Program Services863063421ProgramServices
Management And General57816604ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY58925828BOY
EOY72620494EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY101595330BOY
EOY90337347EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY200070262BOY
EOY198398223EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY17262322BOY
EOY18838884EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY6342105BOY
EOY7164381EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis934066469LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec630293135LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY291625216BOY
EOY303773334EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY301760637BOY
EOY329431119EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY71682557BOY
EOY75877891EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY90166899BOY
EOY92438415EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1139431156BOY
EOY1188880088EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY102895837BOY
EOY91506008EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY333635193BOY
EOY327856584EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY15818342BOY
EOY12830155EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY180885647BOY
EOY110598686EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY633235019BOY
EOY542791433EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY484327757BOY
EOY626015247EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY17742467BOY
EOY15892834EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY4125913BOY
EOY4180574EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY506196137BOY
EOY646088655EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1139431156BOY
EOY1188880088EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses88505486ReconcilationRevenueExpenses
Reconciliation Unrealized Invest24219467ReconciliationUnrealizedInvest
Reconcilation Other Changes27167565ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$83,191OtherActivitiesAmount
Total Lobbying Expenditures IIB83191TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart IV, Supplemental Information:Identifier
ExplanationBaystate Medical Center, Inc. pays membership dues to the Massachusetts Hospital Association (MHA) and the American Hospital Association (AHA). These organizations have advised us that portions of these dues are used for lobbying purposes for various healthcare matters at the state level. The portion of dues listed as lobbying expenses for the year ending September 30, 2013 is $83,191.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis12334547OtherCostOrOtherBasis
Book Value12334547BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis381272070OtherCostOrOtherBasis
Depreciation204263581Depreciation
Book Value177008489BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis4249352OtherCostOrOtherBasis
Depreciation962148Depreciation
Book Value3287204BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis496722981OtherCostOrOtherBasis
Depreciation407294774Depreciation
Book Value89428207BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis39487519OtherCostOrOtherBasis
Depreciation17772632Depreciation
Book Value21714887BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings303773334TotalOfBookValueLandBuildings

Closely Held Equity Interests CloselyHeldEquityInterests

FieldValueIRS element (for citing)
Book Value1703926BookValue
Method Of ValuationCMethodOfValuation

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionInvestments-securities other less than 5%Description
Book Value74173965BookValue
Method Of ValuationCMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities75877891TotalOfBookValueSecurities

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
Contractual Adjustment Receivable25923626
Due From Affiliated Companies44524033
Beneficial Interest in Net Assets of BHF20073408
Funds Held - Bond Indenture888862
Board Designated - Due From Unrestricted Funds1028486
FieldValueIRS element (for citing)
Total Book Value Other Assets92438415TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (7 entries)

DescriptionDescriptionAmountAmount
Contractual Adjustments Payable$54,834,629
Refundable Advances$615,430
Due to Affiliated Companies$137,180
Insurance Liability Loss Reserves$6,806,000
Deferred Revenue$551,259
Minimum Pension Liability$40,738,232
Market Value Swap$6,915,956
FieldValueIRS element (for citing)
Total Of Amounts110598686TotalOfAmounts

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
ExplanationPart X, Line 2 - Baystate Medical Center, Inc. did not have a FIN 48 footnote included in the audited financial statements. Additional Information: Part V: Certain endowments are held at Baystate Health Foundation (BHF), an affiliate, and are reported as temporarily restricted and permanently restricted but Part V has not been completed as it is already addressed on BHF's Form 990 (EIN 04-3549011).Explanation

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable

FieldValueIRS element (for citing)
RegionCarribeanRegion
Number Of Offices0NumberOfOffices
Number Of Employees0NumberOfEmployees
Type Of Activities ConductedInsurance Premium TransfersTypeOfActivitiesConducted
Total Expenditures8399000TotalExpenditures
FieldValueIRS element (for citing)
Subtotal Number Of Offices0SubtotalNumberOfOffices
Subtotal Number Of Employees0SubtotalNumberOfEmployees
Cont Number Of Offices0ContNumberOfOffices
Cont Number Of Employees0ContNumberOfEmployees
Total Number Of Offices0TotalNumberOfOffices
Total Number Of Employees0TotalNumberOfEmployees
Subtotal Amount Spent8399000SubtotalAmountSpent
Cont Amount Spent0ContAmountSpent
Total Amount Spent8399000TotalAmountSpent
Transfer To Foreign Corp1TransferToForeignCorp
Interest In Foreign Trust0InterestInForeignTrust
Own Foreign Corp0OwnForeignCorp
Passive Foreign Invest Co0PassiveForeignInvestCo
Foreign Partnership0ForeignPartnership
Boycott Countries0BoycottCountries

Form990 Schedule F Part V Form990ScheduleFPartV

FieldValueIRS element (for citing)
IdentifierItemizationIdentifier
Return ReferencePart 1, Line 3ReturnReference
ExplanationTotal expenditures of $8,399,000 in the Carribean are comprised of insurance premium transfers.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense21697439TotalCommunityBenefitExpense
Direct Offsetting Revenue11372049DirectOffsettingRevenue
Net Community Benefit Expense10325390NetCommunityBenefitExpense
Percent Of Total Expense0.01120PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense179421835TotalCommunityBenefitExpense
Direct Offsetting Revenue169793645DirectOffsettingRevenue
Net Community Benefit Expense9628190NetCommunityBenefitExpense
Percent Of Total Expense0.01050PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense17628003TotalCommunityBenefitExpense
Direct Offsetting Revenue15971085DirectOffsettingRevenue
Net Community Benefit Expense1656918NetCommunityBenefitExpense
Percent Of Total Expense0.00180PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense218747277TotalCommunityBenefitExpense
Direct Offsetting Revenue197136779DirectOffsettingRevenue
Net Community Benefit Expense21610498NetCommunityBenefitExpense
Percent Of Total Expense0.02350PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense2866824TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense2866824NetCommunityBenefitExpense
Percent Of Total Expense0.00310PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense52424169TotalCommunityBenefitExpense
Direct Offsetting Revenue15749844DirectOffsettingRevenue
Net Community Benefit Expense36674325NetCommunityBenefitExpense
Percent Of Total Expense0.03980PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense18931863TotalCommunityBenefitExpense
Direct Offsetting Revenue12778478DirectOffsettingRevenue
Net Community Benefit Expense6153385NetCommunityBenefitExpense
Percent Of Total Expense0.00670PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense18187556TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense18187556NetCommunityBenefitExpense
Percent Of Total Expense0.01980PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense2160172TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense2160172NetCommunityBenefitExpense
Percent Of Total Expense0.00230PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense94570584TotalCommunityBenefitExpense
Direct Offsetting Revenue28528322DirectOffsettingRevenue
Net Community Benefit Expense66042262NetCommunityBenefitExpense
Percent Of Total Expense0.07170PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense313317861TotalCommunityBenefitExpense
Direct Offsetting Revenue225665101DirectOffsettingRevenue
Net Community Benefit Expense87652760NetCommunityBenefitExpense
Percent Of Total Expense0.09520PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Total Community Building Expense100000TotalCommunityBuildingExpense
Net Community Building Expense100000NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense100000TotalCommunityBuildingExpense
Net Community Building Expense100000NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$5,078,340BadDebtExpenseAmount
Amount Attributable To1952008AmountAttributableTo
Amount Reimbursed By Medicare263110825AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare208088423CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall55022402MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities26NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (26 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalChildrens HospitalChildrensHospitalTeaching HospitalTeachingHospitalResearch FacilityResearchFacilityEr24 HoursEr24HoursOtherOther
Baystate Medical Center Inc
1759 Chestnut StreetSpringfieldMA01199XXXXXX
Baystate Reference Laboratories
2361 Whitney AvenueHolyokeMA01040Outpatient Laboratory services
Baystate High Street Hlth Cntr
3140 High StreetSpringfieldMA01105Outpatient Facility
Baystate Ambulatory Care Center
43300 Main StreetSpringfieldMA01107Outpatient Physician Offices
Baystate Mason Sq Neighborhood Hlth Cntr
511 Wilbraham RoadSpringfieldMA01199Outpatient Clinic
Baystate Brightwood Health Center
6380 Plainfield StreetSpringfieldMA01107Outpatient Clinic
D'Amour Center for Cancer Care
73350 Main StreetSpringfieldMA01199Outpatient Cancer Center
BMC Comprehensive Breast Center
83400 Main Street 1st FlrSpringfieldMA01107Outpatient Facility
Baystate Rehabilitation Care at Spfld
9360 Birnie AvenueSpringfieldMA01107Rehabilitation Clinic
BMC Pain Management Center
103400 Main Street 2nd FlrSpringfieldMA01107Outpatient Facility
Baystate Orthopedic Surgery Cntr
1150 Wason Avenue 2nd FloorSpringfieldMA01107Outpatient Surgery Center
Baystate Vascular Services
123500 Main Street 2nd FloorSpringfieldMA01107Outpatient Facility
Baystate Rehabilitation Care
13294 North Main StreetEast LongmeadowMA01028Rehabilitation Clinic
Baystate Rehabilitation Care Rymd Cntr
14470 Granby Rd Ste 4South HadleyMA01075Rehabilitation Clinic
Baystate Rehabilitation Care
15200 Silver St Ste 101AgawamMA01001Rehabilitation Clinic
Baystate Heart & Vascular Prog Imaging
1610 Main Street Basement LevelFlorenceMA01060Outpatient Facility
BMC Transplant Services
17100 Wason Avenue Suite 210SpringfieldMA01107Outpatient Facility
Baystate Regional Cancer Program
18Davis Blding 85 South St 4th FlWareMA01082Outpatient Cancer Center
Baystate Home Infusion & Resp Svs
19211 Carando DriveSpringfieldMA01004Home infusion & resp srvcs & durable medical goods
Baystate Home Infusion & Resp Svs
20489 Bernardston Road Suite CGreenfieldMA01301Home infusion & resp srvcs & durable medical goods
Baystate Home Infusion & Resp Svs
2185 South Street D101WareMA01082Home infusion & resp srvcs & durable medical goods
Baystate Breast and Wellness Center
22100 Wason Avenue Suite 300SpringfieldMA01107Outpatient Facility
Central High School Hlth Cntr
231840 Roosevelt Ave 1st FlrSpringfieldMA01109School based medical services
Roger L Putnam Vocational Tech HS
241300 State St 3rd FlrSpringfieldMA01109School based medical services
High School of Commerce Hlth Cntr
25415 State St 1st Flr Rm 135SpringfieldMA01105School based medical services
Baystate Orthopedic Surgery Cntr
26298 Carew StreetSpringfieldMA01104Outpatient Surgery Center

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Baystate Medical CenterBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
OtherXOther
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities1OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Other MethodXOtherMethod
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
Other Needs AddressedXOtherNeedsAddressed
All Needs Addressed0AllNeedsAddressed
Organization Incur Excise Tax0OrganizationIncurExciseTax
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent400.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Medicare RateXMedicareRate
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (23 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
Part I, Line 6a: Baystate Medical Center files an annual community benefit report electronically with the Massachusetts Attorney General's office via their website at http://www.cbsys.ago.state.ma.us/cbpublic/public/hccbindex.aspx. Baystate Medical Center's annual community benefit report is available to the public via the Massachusetts Attorney General's website (see above) and via Baystate Health's website http://www.baystatehealth.org/Baystate/Main+Nav/About+Us/Community+Programs/Community+Health+Planning/Community+Benefits+Program. Our community benefit report provides the Attorney General's Office and the general public important information about how Baystate Medical Center partners with our communities to identify and address unmet health needs of disadvantaged and vulnerable populations in support of our charitable mission.
Part I, Line 7: Line 7a (Charity Care) - community benefit expense was calculated by applying the ratio of patient care cost to charges, calculated on Worksheet 2, against total charity care gross patient charges from the audited financial statements.Line 7b (Unreimbursed Medicaid) - community benefit expense was derived using the organization's cost accounting system, which takes into account all hospital inpatients, outpatients and emergency room patients for whom services were provided and covered under Medicaid and Medicaid managed care plans.Line 7c (Other Means-Tested Programs) - community benefit expense was derived using the organization's cost accounting system, which takes into account all hospital inpatients, outpatients and emergency room patients for whom services were provided and covered under other means-tested government programs.Line 7f (Health Professional Education) - community benefit expense was derived using the organization's cost accounting system.Line 7g (Subsidized Programs) - community benefit expense was derived using the organization's cost accounting system. The expense relates to specific outpatient programs.Line 7h (Research) - community benefit expense was derived using the organization's cost accounting system. In addition to the research costs reported on line 7h, there was $1,359,939 of expenses related to Industry-sponsored grants that we believe should be treated as community benefit expense because they were incurred to promote the health and well-being of the local population and are a key component of our commitment to the community.
Part I, Line 7g: There are no costs attributable to physician clinics reported as subsidized health services in Part I, line 7g.
Part I, L7 Col(f): 'In fiscal year 2013, the organization adopted the provisions of Accounting Standards Update 2011-07, Health Care Entities (Topic 954), Presentation and disclosure of Patient Service Revenue, Provision for Bad Debts, and the Allowance for Doubtful Accounts for Certain Health Care Entities on October 1, 2012. The update changed how the provision for bad debts is reported on the audited financial statements. In prior years it was included with total operating expenses, and subtracted from total expenses reported in Part IX, Line 25, column (A) for the purpose of calculating the percentages in Part I, Line 7, column (f). In 2013, the provision for bad debts was reported as a deduction to net patient service revenue. The 2013 provision for bad debts totalled $13,487,538 and is not included in total expenses reported in Part IX, LIne 25, column (A) for the purpose of calculating the percentages in Part 1, LIne 7, column (f).
Part II: Specific to Part II Baystate Medical Center provided $100,000 to the North End Housing Initiative (NEHI) with the goal of increasing the quantity, quality and healthfulness of affordable single and duplex family housing for low income families with young children in the North End neighborhoods of Springfield, Massachusetts. A portion of the funding is also used to leverage additional funding to write grants for projects what will assist the NEHI to achieve its mission. In addition to providing additional housing in the North End, NEHI also provides homebuyer and financial literacy courses to North End households and maximizes economic opportunities for minority-owned businesses within NEHI construction projects. The NEHI improves the public health of the community by providing greater access to healthy homes, reducing the prevalence of asthma in young children, increasing housing stability and creating safer and more beautiful neighborhoods through affordable homeownership. The following description is not quantified specifically in Part II of Schedule H. Baystate Medical Center provided $150,000 as a Voluntary Contribution to the City of Springfield, specifically to fund public health initiatives under the Department of Health and Human Services. Baystate Medical Center provided $108,622.36 as a Payment in Lieu of Taxes (PILOT) to the City of Springfield for our outpatient facility at 3300 Main Street, Springfield. Baystate Medical Center provided $34,881.58 as a Payment in Lieu of Taxes (PILOT) to the City of Chicopee for our employee parking lot located at Center Street, Chicopee. Baystate Medical Center is a dues paying member of the Economic Development Council of Western Massachusetts (EDC) and the Affiliated Chambers of Commerce of Greater Springfield (ACCGS). BMC participates in the EDC and ACCGS as we are the largest local employer in our region. The Chamber and its membership coordinate activities toward a common purpose of sustainability and economic growth for the region. The amount paid for FY 2013 was $75,050.Baystate Medical Center is committed to creating healthier communities and understands that many state and federally mandated community benefit programs and services are not sufficient to address ethnic, racial and economic health disparities. BMC extends the traditional definition of "health" to include economic opportunity, affordable housing, quality education, safe neighborhoods, food security, arts/culture, and racism and homophobia free communities all elements that are needed for individuals, families and communities to thrive. Baystate Medical Center provides many valuable services, resources, programs and financial support - beyond the walls of the hospital and into the communities and homes of the people we serve; including sponsorships for more than 200 non-profit community organizations and events and involvement of Baystate leadership with over 70 community boards that align with our mission.
Part III, Line 4: The cost of bad debts reported in Part III, line 2 was calculated by applying a ratio of cost to charges (based on the organization's cost accounting system including all hospital inpatients and outpatients) against total patient bad debt net of recoveries as reported in the audited financial statements. The portion of bad debt that reasonably could be attributable to patients who may qualify for financial assistance under the hospital's charity care program (reported in Part III line 3) was calculated by applying the percentage of bad debts by zip code (for which the average household income for each zip code is less than 200% of the federal poverty level) to the total cost of bad debt reported in Part III line 2. Since this portion of bad debt is attributable to patients residing in an area where the average income is less than 200% of the Federal poverty level, it is highly likely these patients would have qualified for the organization's charity care program had they applied. For this reason, we believe the amount, totalling $1,952,008, should be treated as community benefit expense in Part I. As noted above, the organization adopted Accounting Standards Update 2011-07 effective October 1, 2012, which changed the way entities report and disclose certain financial information including the provision for bad debts. See footnote #2 (Significant Accounting Policies) on page 12 of the audited financial statements under the caption "Allowance for Uncollectible Accounts" for a description of the organization's reporting of its provision for bad debts.If a patient is determined eligible for financial assistance, the appropriate adjustment is made to the patient account based on their income level. Once the necessary approvals are obtained, it then flows to the general ledger. Patients applying for a prompt payment discount will have this allowance entered after agreed upon payment is received.
Part III, Line 8: Line 6 - included all Medicare allowable costs as calculated in Worksheets D-1 Part II (inpatient and inpatient psych), D Part V (outpatient) and E Part A (organ acquisition) of the hospital's 2013 Medicare cost report, net of Medicare costs reported in Part 1, line 7g, and based on Medicare costing principles. There is no shortfall reported on line 7.
Part III, Line 9b: For patients who are known to qualify for Charity Care or Financial Assistance: The patient may have requested assistance up front at time of service with a Financial Counselor or the Patient could have asked for assistance after receiving their bill by contacting our Patient Billing Services Representatives. The Financial Counselor will assist the patient in applying for the appropriate type of assistance based on their income and circumstances. Once approved for a State Medicaid or other program, all billing and collection activity will stop (except for required co-payments or deductibles).For all other patients, our statements contain information regarding how to apply for financial assistance. Notices concerning availability for assistance are also posted at patient care sites.
Part V, Section B, Line 1j: The CHNA report also described collaborating organizations. BMC collaborated with each of the hospital facilities that are members of the Coalition of Western Massachusetts Hospitals for its CHNA. BMC also collaborated with organizations that participated in a "Design Team" established by the Coalition. Representatives from the Collaborative for Community Health, Inc., the Franklin Regional Council of Governments, the Massachusetts Department of Public Health, and the Springfield Department of Health and Human Services participated on this Team. Many individuals provided input for this assessment. Lists of interviewees are included in the report.Baystate Medical Center
Part V, Section B, Line 3: Community input was gathered through interviews, a community survey, and community listening sessions. Interviews were conducted with public health experts, representatives of health, social services, or other departments or agencies, community leaders, health care providers, and persons representing the broad interests of the community. The interviews were structured to help identify the most pressing health status and access issues in the community. BMC also sought input from the public regarding the health of the community through an online and paper-based survey. A website link to the survey (in both English and Spanish) was made available from January through February 2013. Paper copies of the survey were distributed at various local organizations and clinics in multiple languages. Efforts were made to reach those without internet access as well as vulnerable populations such as racial and ethnic minorities, low-income groups, individuals with low literacy levels, and non-English speakers. The survey was publicized via flyers, social media, human services organizations, boards of health, newspapers, email listservs, and other methods. A listening session was held during which community members reviewed and discussed preliminary findings from this assessment. Discussion at the listening session was helpful in that it validated assessment findings and contributed to the prioritization process. The survey consisted of 48 questions about a range of health status and access issues and respondent demographic characteristics. 1,321 residents from the Baystate community completed the survey. Seventy-four percent of respondents were female and 49 percent were between the ages of 45 and 64. Seventy-two percent were White and 98 percent did not identify as Hispanic (or Latino). The majority of respondents reported being in good or very good overall health (70 percent), married (50 percent), employed full time (61 percent), privately insured (67 percent), and having an undergraduate degree or higher (53 percent). The majority (83 percent) of respondents speak English in the home. Spanish was the top non-English language reported. Seven percent of respondents reported that they spoke multiple languages at home. Survey responses were received from residents of 43 of the Baystate community's 51 ZIP codes. Although the survey garnered many respondents, the sample is not representative of the community and the results are not generalizable to the community as a whole. 1,321 residents in Baystate's community responded to the community survey. Key informant interviews were conducted face-to-face and by telephone by Mark Rukavina, Principal at Community Health Advisors, LLC. The interviews were designed to gain perspective into health needs in the community served by Baystate. A total of 39 local key informants, including external and internal stakeholders (those affiliated or employed by Baystate Medical Center) were interviewed during December 2012 through February 2013. In addition, 10 staff members from the Massachusetts Department of Public Health regional office in Northampton also were interviewed as a part of this assessment. These interviews were conducted using a structured questionnaire. Informants were asked to discuss community health issues and encouraged to look broadly at the social determinants of health. Interviewees were asked about issues related to health care access, changes in community population, prevalence of chronic health conditions, and health disparities. The frequency with which community health issues was mentioned and the interviewees' perceptions of the significance of each concern were assessed.The 49 stakeholders were comprised of public health experts; individuals from health or other departments and agencies; leaders or representatives of medically underserved, low-income, and minority populations; and other community members. In addition, 18 community members participated in the CHNA listening sessions. The following organizations/community stakeholders were interviewed: Public Health Experts- Tracy Osbahr, Director, Massachusetts Department of Public Health, Early Intervention Program- Ben Wood, Healthy Community Design Coordinator, Massachusetts Department of Public Health, Division of Prevention and Wellness- Donna Salloom, Community Liaison, MA Department of Public Health, Division of Prevention and Wellness- Ruth Jacobson-Hardy, Regional Manager, Massachusetts Department of Public Health, Substance Abuse Services- Molly Butler, Program Coordinator, Massachusetts Department of Public Health, Rural Health- Barbara Coughlin, Advisor, Massachusetts Department of Public Health, STD Program- Charles Kaniecki, District Health Officer, Massachusetts Department of Public Health, Western Mass Region- Ronnie Rom, Coordinator, Massachusetts Department of Public Health, Rural Hospital Program - Amy Waldman, Project Director, Massachusetts Department of Public Health, Rural Domestic and Sexual Violence Project- Cathy O'Connor, Director, Massachusetts Department of Public Health, Office of Healthy Communities- Helen Caulton-Harris, Director, City of Springfield, Dept. of Health and Human Services- Ben Cluff, Assistance Regional Manager, Bureau of Substance Abuse ServicesHealth or Other Departments or Agencies- Michael Ashe, Hampden County Sheriff, Hampden County Corrections- Andrew Morehouse, Executive Director, Food Bank of Western Massachusetts- Ann Awad, President/CEO, Caring Health Center (FQHC)- Bill Miller, Executive Director, Friends of the Homeless- Deleney McGoffin, Executive Assistant, Community Affairs at YMCA of Greater Springfield, YMCA of Greater Springfield- Dora Robinson, President/CEO, United Way of Pioneer Valley- Elaine Massery, Executive Director, Greater Springfield Senior Services- Janet Denney, Director, City of Springfield, Elder Affairs- Jeanne Clancy, Nursing Supervisor, Springfield Public Schools- John Roberson, Vice-President of Children and Family Services, Center for Human Development- Juan Campbell, Vice-President of Sales, Health New England- Kathy Wilson, President/CEO, Behavioral Health Network- Kristina Chapell, Development Officer, Alzheimer's Association- Mary Walachy, Project Director, Davis Foundation- Nanyamka Hales, Director for Health Initiatives, American Cancer Association - Nikki Burnett, Regional Vice President for Health Equity , American Heart Association- Pamella Wells, Resident Services Manager, Springfield Housing Authority- Robert Marmor, President/CEO, Jewish Family Services - Sally Fuller, Executive Director, Davis Foundation- Soloe Dennis, Emergency Preparedness Planner , Pioneer Valley Planning Commission- Sr. Mary Caritas, Vice President, Sisters of Providence Health System- Vickie Nelson, Associate Director of Development, YMCA of Greater Springfield- William Abrashkin, Judge, Springfield Housing AuthorityCommunity Leaders or Representatives Interviewed- Jay Minkarah, President/CEO, Develop Springfield- Sarah Perez-McAdoo, Director, Youth Empowerment Adolescent Health (YEAH)- Bill Ward, Executive Director, Regional Employment Board- Carlos Gonzalez, President/CEO, MA Latino Chamber of Commerce- Cindy Miller, Hampden County Health Services Manager, Tapestry Health, CHNA #4, Community Health Connections- Giang Phan, Professor, University of Massachusetts Amherst, Vietnamese American Civic Association- Henry Thomas, President, Urban League of Springfield- Maly Son, Executive Director, Springfield Vietnamese American Civic Association- Mike Suzor, Assistant to the President, Springfield Technical Community College- Mila Dubinchik, Regional Director, Russian Community Association of MA- Sr. Maxyne Schneider President, Sisters of St. Joseph- Rev. Talbert Swan, Pastor, Spring of Hope Church- Theresa Glenn, CHNA #4, Community Health Connections- Timothy Paul Baymon, Ph.D., Archbishop, Council of Churches of Greater Springfield- Vanessa Otero, Director, North End Campus Coalition- Wanda Givens, Director, Mason Square Health Task ForceOther Interviewees Representing the Broad Interests of the Community- Patrick McCarthy, Clinical Director, Hampden County Sheriff's Dept.- Shannon Giordano, Legislative Aide , Office of Rep. Coakley-Rivera- Domenic Sarno, Mayor , City of Springfield- Jeff Ciuffreda, President, Affiliated Chambers of Commerce of Greater Springfield- John Barberi, Sergeant, City of Springfield Police Department- Kate Kane, Managing Director , Northwestern Mutual Financial Services- Nicholas Fyntrilakis, Vice-President of Community Responsibility, MassMutual- Shawn Sullivan, Communications and Infectious Control Officer, City of Springfield Police Department- William Messner, President, Holyoke Community CollegeBaystate Medical Center
Part V, Section B, Line 4: Baystate Medical Center is a member of the Coalition of Western Massachusetts Hospitals, a partnership between seven (7) not-for-profit hospitals in western Massachusetts that includes: Baystate Medical Center, Baystate Franklin Medical Center, Baystate Mary Lane Hospital, Holyoke Medical Center, Cooley Dickinson Hospital, Mercy Medical Center (a member of Sisters of Providence Health System) and Wing Memorial Hospital and Medical Centers (a member of UMass Memorial Health Care), and Health New England, a local health insurer whose service areas covers the four counties of western Massachusetts. The Coalition, formed in 2012, put competition aside to conduct a regional community health needs assessment while sharing limited resources and enhancing the quality of data collection to benefit the community as a whole.Baystate Medical Center
Part V, Section B, Line 5c: Baystate Medical Center made its CHNA report widely available to the public via an email distribution, with links to the hospital's website, to all key informant interviewees, listening session participants and an internal communication to hospital employees.Baystate Medical Center
Part V, Section B, Line 6i: For more information about Baystate Medical Center's Community Benefit Implementation Strategy, as related to the hospitals 2013 CHNA, and adopted by the hospital's Board of Trustees, please visit:http://www.baystatehealth.org/StaticFiles/Baystate/About%20Us/Community%20Programs/Community%20Health%20Planning/Community%20Benefits%20Program/BMC-Implementation-Strategy.pdf.Baystate Medical Center
Part V, Section B, Line 7: No community hospital facility can address all of the health needs present in its community. BMC is committed to adhering to its mission and remaining financially healthy so that it can continue to enhance its clinical excellence and to provide a wide range of community benefits. The Strategy does not address the following community health needs identified in the 2013 CHNA due to no new funding or resources, other hospitals or community organizations within service area are already addressing the need or the need falls outside of the hospitals' mission or capacity.Racial and Ethnic Disparities in Disease Morbidity and Mortality: the hospital understands the connection between institutional racism and ethnic and racial health disparities and has committed DoN resources (see Section C and Appendix A of BMC Implementation Strategy) to fund local undoing racism education and training. Lack of Access to Dental Care: pediatric dental access is being addressed through Partners for aHealthier Community's BEST Oral Health Initiative (see Section 4b of BMC Implementation Strategy). High Rates of Alcohol, Tobacco, and Drug Use: a variety of existing community-based non-profits and agencies are addressing these needs, including, but not limited to: Behavioral Health Net, Center for Human Development, City of Springfield Tobacco Program, Gandara, and the Mason Square Drug Free Task Force. High Rates of Unsafe Sex, Teen Pregnancy, and Chlamydia: Teen pregnancy is being addressed through the efforts of the YEAH! Network and the Springfield Pregnant and Parenting Teens Collaborative (see Section 4b of BMC Implementation Strategy) as well as the City of Springfield's Springfield Adolescent Sexual Health Advisory Committee and the Community Health Network Area #4's Springfield Adolescent Health Project. Pediatric Disability: hospital clinicians and staff co-lead and participate in the Medical Home Workgroup for Children with Special Needs. As part of its regular service line, the hospital has a new Developmental and Behavioral Pediatrics Department (see section 6 of BMC Implementation Strategy). High Rates of Asthma: being addressed through Partners for a Healthier Community and the Pioneer Valley Asthma Coalition (see Section 4b of BMC Implementation Strategy). Poor Built Environment and Environmental Quality: being addressed through Partners for a Healthier Community's Live Well Springfield and Healthy Environment, Healthy Springfield Initiatives (see Section 4b of BMC Implementation Strategy).Baystate Medical Center
None of the actions listed in Line 17 are permitted under the Hospital facility's policies and none of the actions were taken during the current tax year ended September 30, 2013.Schedule H, Part V, Section B, Line 18
Part VI, Line 2: In partnership with the Coalition of Western MA Hospitals, Baystate Medical Center conducted its most recent community health needs assessment (CHNA) in 2013 of the geographic areas served by the hospital pursuant to the requirements of the MA Attorney General's Community Benefit Guidelines and Section 501(r) of the Internal Revenue Code ("Section 501(r)"). The CHNA findings were made available on the hospital's website in September 2013. Per the Internal Revenue Service (IRS) and the Massachusetts Office of the Attorney General, each non-profit hospital must conduct a formal community health needs assessment (CHNA) every three-years in partnership with community organizations and individuals across the hospital's service area. The aim is to identify community assets as well as the critical gaps/needs in public health resources and the weak connections between medical care and community care. This "gaps analysis" assists Baystate Health's Board of Trustees and senior managers in developing community benefit policy, which targets our charitable resources in focused areas. These areas frame existing community benefit programs, assist in transforming community service activities to comply with the IRS and MA Attorney General's criteria, and set priorities in the design of new programs. The CHNA is the basis for developing accountable community benefit programs. In an ideal situation, an effective and large scale community benefit program will demonstrate measurable community impacts on the health status and quality of life for residents - effectively closing gaps when current data is compared to initial CHNA baseline indicators. At a more practical program level, the CHNA guides a "theory of change" linking health needs to community benefit efforts to desired program and community outcomes. BMC's CHNA began by identifying the communities served by the hospital. Findings are based on various quantitative analyses regarding health-related needs in those areas, a review of health assessments conducted by other organizations in recent years, information obtained from interviews, and findings from a community survey. Preliminary assessment findings were discussed with community stakeholders during a series of "listening sessions" and feedback from participants helped validate findings. Finally, Verite applied a ranking methodology to help prioritize the community health needs identified by the assessment. Including multiple data sources and stakeholder views is important when assessing the level of consensus that exists regarding priority community health needs. If alternative data sources including interviews support similar conclusions, then confidence is increased regarding the most problematic health needs in a community. Further information about the analytic methods and prioritization process and criteria can be found in the hospitals 2013 CHNA report. The list that follows describes the health needs identified throughout the assessment as priorities in the community served by Baystate Medical Center. These needs are presented in alphabetical order, by category. The prioritized list identifies the 15 most problematic community health needs found by this assessment. Needs were determined by synthesizing findings from multiple data sources.Access to Care: Lack of Affordable and Accessible Medical CareNeed for Care Coordination and Culturally Sensitive Care Dental Health:Lack of Access to Dental Care Health Behaviors:High Rates of Alcohol, Tobacco, and Drug Use High Rates of Unsafe Sex, Teen Pregnancy, and Chlamydia Maternal and Child Health:Prevalent Infant Health Risk Factors (e.g., smoking during pregnancy, lack of prenatal care) Pediatric DisabilityMental Health:Lack of Access to Mental Health Services and Poor Mental Health Status Use Morbidity and Mortality:High Rates of Diet and Exercise-Related Diseases and Mortality High Rates of Asthma Racial and Ethnic Disparities in Disease Morbidity and Mortality Physical Environment:Poor Community Safety (e.g., homicide and other violent crimes) Poor Built Environment and Environmental Quality (e.g., air quality, presence of food deserts) Social and Economic Factors:Basic Needs Insecurity: Financial Hardship, Housing, and Food Access Low Educational Achievement Baystate Health's Board of Trustees is actively involved in overseeing community benefit programs and expenditures. In July 2010, the Baystate Health Board of Trustees assigned oversight of community benefits to the Board's Governance Committee. Through its regular board meetings, internal hospital meetings and leadership activities, Baystate Health is actively involved in shaping community benefits provided by the system. For FY 2013 the systems Vice President for Government and Community Relations and Public Affairs, under the direction of the Sr. Vice President for Strategy & External Relations, supervised the Director of Community Health Planning and Manager of Community Relations and Community Benefit. In addition, the Director and Manager work collaboratively with the Regional Director of Public Affairs & Communications for Baystate Health Northern and Eastern Regions and the Public Relations & Community Relations Specialist at Baystate Mary Lane Hospital to oversee the hospitals' community benefit planning, community health needs assessments, annual program data collection, and state and federal reporting of community benefit. The Baystate Health Board Governance Committee meets minimally two times per year and is charged with advocating for community benefits at the Board level and throughout the health system; integrating the three (3) hospital-specific community benefit plans into the health system's strategic plan; periodic review of community health needs assessment data; approval of a community benefit mission statement and health priorities; review impact of community benefit programs in promoting health of the community; and ensure community benefits programs are in compliance with guidelines established by the MA Attorney General and IRS. Bi-annually, Baystate Health's Vice President for Government and Community Relations and Public Affairs and the Director of Community Health Planning or Community Benefit Manager present a system-wide community benefit update to the full Board of Trustees. Baystate Medical Center is in the planning phase of kicking-off a formal Community Benefit Advisory Council (CBAC). A CBAC brings a community lens and filter for interpreting findings of a community health needs assessment and priority setting process. The CBAC provides a community perspective on how to increase wellness and resilience opportunities for optimal health for an entire population; guidance in matching Baystate Medical Center resources to community resources, thus making the most of what is possible with the goal to improve health status and quality of life; and policy advocacy to assure and restore health equity by targeting resources for residents. Participants on a CBAC for Baystate Medical Center will represent employees, community benefit program managers and Hampden county constituencies and communities that the hospital serves. CBAC members will be responsible for reviewing community needs assessment data and use this analysis as a foundation for providing the hospital with input on its community benefit planning process.
Part VI, Line 3: Baystate Medical Center (BMC) is committed to ensuring that patients in its community have access to quality health care services with fairness and respect without regard to the patients' ability to pay. BMC recognizes that the cost of necessary health care services can impose a significant financial burden on patients who are uninsured or underinsured and acts affirmatively to lessen that burden by offering patients in need the opportunity to apply for free or reduced cost services. BMC not only offers free and reduced cost care to the financially needy as required by law, but has also voluntarily established discount and financial assistance programs that provide additional free and reduced cost care to more patients residing within the communities served by BMC.Baystate Medical Center recognizes that the billing and collection process can be bewildering and burdensome for patients and has implemented procedures to make the process understandable for patients; to inform patients about discount and financial assistance options; and to ensure that patients are not subject to aggressive collection activities. Consistent with its patient commitment BMC is required to maintain a credit and collection policy that reflects its patient billing and collection procedures and complies with applicable state and federal laws and regulations.Baystate Medical Center has Financial Counselors available to help patients apply for financial assistance programs that may cover unpaid hospital bills, including a variety of federal and state programs as well as financial assistance through Baystate Medical Center. BMC Financial Counselors have all been trained and certified by the state as Certified Account Counselors to assist patients in applying for available state and federal programs. BMC is committed to ensuring that patients or prospective patients in the community are aware of financial assistance programs. For uninsured or underinsured patients, BMC will assist in applying for available financial assistance programs. BMC notifies patients of the availability of assistance in both the initial bill sent to patients as well as in general notices posted throughout the hospital.When applicable, BMC also assists patients in applying for coverage of services as a Medical Hardship based on the patient's documented income and allowable medical expenses. BMC provides, upon request, specific information about the eligibility process to be a Low Income Patient under either the Massachusetts Health Safety Net Program or additional assistance for patients who are low income through BMC's own internal financial assistance program. BMC also notifies patients about available payment plans based on their family size and income. Signs about the availability of financial assistance programs at Baystate Medical Center are translated into Spanish, because Spanish is primarily spoken by 10% or more of the residents in the hospital's service area. Signs are large enough to be clearly visible. Baystate Medical Center's sign is 8-1/2 x 11 inches and the header print font is 24 pts. Notice of availability of Financial Assistance Programs are posted in the following locations; inpatient, clinic, emergency department admissions and/or registration areas, central admission/registration area, patient financial counselor areas and business office areas that are open to patients.Our Credit and Collection Policy is posted on the baystatehealth.org website. The goal of posting the Credit and Collection Policy is to ensure that patients or prospective patients in our community are aware of our financial assistance programs. Baystate Medical Center's Credit and Collection Policy was developed in partnership with Health Care For All, a Massachusetts non-profit organization dedicated to making adequate and affordable health care accessible to everyone, regardless of income, social or economic status.
Part VI, Line 4: Baystate Medical Center, located in Springfield, Massachusetts, is an academic, research, and teaching hospital that serves as the western campus of Tufts University School of Medicine. The Hospital is a 716-bed facility with 57 bassinets and is the only Level 1 trauma center in western Massachusetts, treating the most critical and urgent cases in the region. The hospital is also home to the second-busiest emergency department in Massachusetts. The primary community served by the hospital is defined based on the geographic origins of the hospital's discharges. The hospital's primary community is comprised of 51 ZIP codes in 21 cities and towns: Agawam, Blandford, Brimfield, Chester, Chicopee, East Longmeadow, Granville, Hampden, Holland, Holyoke, Longmeadow, Ludlow, Monson, Palmer, Russell, Southwick, Springfield, Wales, West Springfield, Westfield, and Wilbraham. The 51 ZIP codes collectively and essentially are equivalent to Hampden County. Hampden County has a total population of 464,416.In 2012, the community served by the hospital was comprised of 76% White residents, 9.1% African American residents, 21.8 % Latino residents and 2.1% Asian residents. The Latino community of Hampden County is concentrated in the cities of Holyoke and Springfield, while the African-American community is concentrated in Springfield. In all, 81% of all Latino residents of Hampden County live in either Springfield or Holyoke. Non-White populations are expected to grow faster than White populations in the community. The Asian, American Indian, Black, and Other are expected to have the fastest growth. The growing diversity of the community is important to recognize, given the presence of health disparities. Located in Hampden County along the Connecticut River, Springfield is 27 miles north of Hartford CT, while Boston and New York City are 80 and 134 miles away, respectively. The Springfield Metropolitan Statistical Area (MSA) is the fourth-largest metropolitan area in New England and the county's contiguous urban nuclei is comprised of the central city of Springfield, with a population of 152,998, and the cities of Chicopee (55,453), and Holyoke (40,073). Much of BMC's service area has Medically Underserved Area or Population (MUA/P) designation from the Health Resources and Services Administration (HRSA) while the major towns have Health Professional Shortage Area (HPSA) designation. Within Hampden County, Springfield and the surrounding community, especially Holyoke, have many community risk factors that contribute to poor health, including substance abuse, child abuse and neglect, poverty and unemployment, crime and domestic violence, decreased informal social support networks, and overburdened public schools.For FY 2013 BMC's ethnic mix of inpatient & outpatient patients included 48.5% White; 35.8% Hispanic; 11.9% Black; 1.4% Asian, 0.1% Native American, 2.3% Other. BMC's payer mix of patients included 40.77% Medicare; 26.59% Medicaid; 27.79% Managed Care; 1.92% Non-Managed Care; 2.93% Other. In FY 2013 BMC had 79,306 Emergency Department visits. Payer mix for ED visits included 20.37% Medicaid; 3.41% Free Care; 22.78% Healthnet; 2.36% Commonwealth Care; 51.08% Other.BMC is committed to reducing health disparities in Springfield. Our commitment is demonstrated by our investment of significant resources in our three community health centers and pediatric clinic located in Springfield's low-income neighborhoods that have both HPSA and MUA/MUP designation. BMC health centers are primary care first-contact sites for thousands of underserved, low-income people. These community training sites for our Residency Program provide continuity of care for over 130,000 patients annually, most of who reside in an MUA/MUP. BMC provides primary care to a medically-underserved population in Springfield comprised of primarily Latinos and African-Americans. Springfield's black and Latino families fare poorly in comparison to their peers across the state on a myriad of sensitive indicators (e.g., infant deaths per 1,000 live births, low birth weight, births to adolescent mothers, adequacy of prenatal care). Springfield has one of the highest concentrations of MassHealth eligible populations. This low income population has a special health risk and a specific location in the Mason Square and North End neighborhoods with child poverty rates well above 30% and as high as 70% in some small areas.
Part VI, Line 5: Baystate Medical Center has a responsibility to respond to health care needs unsupported by government programs. In exchange for this responsibility, BMC qualifies for tax-exempt status under 501(c)(3). However, providing hospital care alone is not enough to qualify for tax-exempt status. Hospitals also must operate in the public interest and provide programs that benefit the community. Baystate Medical Center is fully committed to its role in the community and serves with pride and compassion for people in need.The charitable mission of Baystate Medical Center, a member hospital of Baystate Health (BH), is to improve the health of the people in our communities every day, with quality and compassion. Baystate Medical Center's Community Benefits Mission is to reduce health disparities, promote community wellness and improve access to care for vulnerable populations. BMC is committed to meeting the identified health and wellness needs of constituencies and communities served through the combined efforts of Baystate Health's member organizations, affiliated providers, and community partners.Baystate Medical Center meets all of the factors required of medical facilities in order to maintain tax exemption, as first described in Revenue Ruling 69-545. In support of patient care and the medical needs of the communities served by Baystate Medical Center, medical staff membership and privileges are extended to all qualified physicians and practitioners in western Massachusetts who meet the requirements for credentialing and clinical privileges, whether employed by a related Baystate entity or community-based. Baystate Medical Center's emergency department is open to all in need of care and services; no one requiring emergency care is denied treatment. In addition, surplus funds from operations are generally applied, as permitted, to the following; improvements in patient care, expansion and renovation of existing facilities, purchase and replacement of equipment, debt service, expenses associated with training of physicians and other health care professionals, professional development of medical and other clinical staff, and the support of scientific, translational, and clinical research.Baystate Health's volunteer Board of Trustees, the governing body of the organization and its affiliates, is comprised of the President and Chief Executive Officer of Baystate Health and up to twenty-two (22) other elected Trustees who are representative of the broad range of interests which exist in the communities served by Baystate Health and its affiliates. The Governance Committee oversees the nomination of Trustees and submits recommendations to the Board of Trustees for membership on the various Board committees. In considering nominations or recommendations for trustees, directors, committee members or officers the Governance Committee select nominees who are representative of the various and diverse constituencies served by Baystate Health and its affiliates. In particular the Committee nominates persons who are representative of the community consumer interests of the various neighborhoods and localities which are served by Baystate Health and its affiliates in the carrying out of and pursuant to the charitable mission of the Baystate Health and its affiliates.Baystate Medical Center's Patient and Family Advisory Council facilitate patients and families to share information and advise the hospital regarding policies and programs. Information from the Council provides hospital leadership with an enhanced understanding of how to improve quality, program development, service excellence, communications, patient safety, facility design, patient and family education, patient and family satisfaction, and loyalty.Please refer to the section above in line 2 for additional examples of Baystate Medical Center's responsiveness to the community and opportunities for community involvement; including the Board of Trustees' Governance Committee, Community Benefits Advisory Council, and Community Health Needs Assessment. Baystate Medical Center is recognized as a leading academic medical center. As the Western Campus of Tufts University School of Medicine since 1974, BMC offers clinical training and undergraduate and graduate medical student education across all specialties. Baystate Medical Center serves as a safety-net hospital due to the high level of Medicaid and charity care provided. In addition, BMC offers unique, specialized services including Level 1 Trauma, Children's Hospital, Invasive heart and vascular services, Cardiac surgery, Kidney transplantation, Level III Neonatal ICU, Specialized ICU's for children, adults and heart and vascular patients and the D'Amour Center for Cancer Care. Baystate Health encourages all of its affiliates, hospital and non-hospital to align their charity care and collections standards with Baystate Health's Credit and Collection Policy. While some of the rules and regulations are hospital specific, the guidelines stated in the Baystate Health Credit and Collection Policy concern all affiliates.Baystate Medical Center built a visionary new facility which opened in March 2012 that will meet our community's needs today, while laying the foundation for future growth. Hundreds of people, from patients to care providers to the community at large, have shared ideas and experiences to design the 641,000 sq. foot facility that includes a dedicated heart and vascular center, new patient care units with spacious private rooms, new emergency department and shell space for future growth. A major part of the public health commitment of Baystate Medical Center's Hospital of the Future project is the delivery of $9.6 million in new aid to community benefit initiatives in Springfield. Baystate Medical Center made an additional investment of $2 million in new community benefit funding tied to the new Emergency Department. The $11.6 million, to be distributed over a period of seven years, addresses public health priorities such as nutrition, teen pregnancy, violence prevention, oral health and asthma, as well broader issues such as education, homelessness and employment. Baystate Medical Center participates in advocacy activities on behalf of health care coverage for all persons and for improved public health. Baystate Health leaders serve on the community boards for Health Care For All, a Massachusetts non-profit organization dedicated to making adequate and affordable health care accessible to everyone, regardless of income, social or economic status and the Massachusetts Public Health Association, a non-profit organization that promotes laws, policies, and programs that protect the health of our families, communities, and workplaces. In addition, Baystate Medical Center provides annual funding to Partners for a Healthier Community, a local leader in public health policy advocacy, building collaborations and leadership capacity to address various public health issues.For additional information, please see Line 6 below.
Part VI, Line 6: Baystate Health, Inc. is the parent entity of a multi-institutional integrated delivery system composed of three hospitals and other 501(c)(3) organizations. The three hospitals include Baystate Medical Center, Baystate Franklin Medical Center, and Baystate Mary Lane Hospital and the other 501(c)(3) organizations include Baystate Medical Practices, Visiting Nurse Association and Hospice of Western New England, Inc., and Baystate Health Foundation. In addition to its nearly 10,000 employees, Baystate Health has 1,729 medical staff, 2,388 nurses and 2,251 new residents and fellows, medical students, nursing students, and allied health students who gained comprehensive medical education during the year. In addition, 1,044 volunteers and auxiliary members donated 101,162 hours to Baystate Medical Center, Baystate Franklin Medical Center, Baystate Mary Lane Hospital and Baystate Visiting Nurse Association & Hospice.Baystate Medical Center (BMC), the flagship 773-bed hospital (including Baystate Children's Hospital) based in Springfield, Massachusetts is Western New England's only tertiary care referral medical center, Level 1 trauma center and neonatal and pediatric intensive care units. BMC serves as a regional resource for specialty medical care and research, while providing comprehensive primary medical services to the community. BMC's community benefit efforts included providing assessment, treatment and crisis support to child abuse victims and their non-offending caretakers affected by child abuse and domestic violence in western Massachusetts, offering enrichment and career development programs for disadvantaged Springfield students, ensuring cohesive health care for school-aged children and the broader community, prevention of accidental childhood injuries and death through public awareness, safety education and distribution of safety devices, coordination of health education focus groups, community health forums and fairs, supporting transgender individuals, their allies and anyone from the broader community who identifies as LGBT through a peer lead and psychosocial support group, providing TB diagnosis and treatment to patients throughout western Massachusetts, and providing financial counseling services to inpatient and outpatient individuals who have concerns about how to pay for care. Baystate Franklin Medical Center (BFMC), a 90-bed facility located in Greenfield, Massachusetts (40 miles north of Springfield near the Vermont border) provides high quality inpatient and outpatient services to residents of rural Franklin county and the North Quabbin region. Inpatient services include behavioral health, intensive care, medical-surgical care, and obstetrics/midwifery. Outpatient services include cardiology, emergency medicine, gastroenterology, general surgery, neurology, oncology, ophthalmology, orthopedics, pediatrics, physical medicine & rehabilitation, pulmonology & sleep medicine, sports medicine, vascular surgery, wound care & hyperbaric medicine. BFMC's community benefit efforts included the ongoing support group through the Franklin County Postpartum Partnership - a partnership initiated by BFMC nurses; expanded senior outreach program to focus on persons most at-risk for hospital readmission due to issues with medication management; and continued the regionally recognized Blood & Guts program for youth, including an annual hospital-based event for high school students and three school-based events for elementary school students and their families. In addition, BFMC HealthBeat TV, a monthly 30-minute cable access talk show produced, directed and hosted by Baystate Franklin employees, engages the hospital's physicians, employees, patients and community leaders in discussions of interest to residents of Franklin County. Topics range from heart health, emergency response to senior outreach. The program runs more than 60 times a month on stations throughout the county.Baystate Mary Lane Hospital (BMLH), a 25-bed facility located in rural Ware, Massachusetts (20 miles east of Springfield) provides quality patient care services to communities in Hampshire, Hampden and Worcester counties. Inpatient services include critical care and medical-surgical care. Outpatient services include cancer care, cardiology, children's medicine, emergency medicine, endocrinology and diabetes, gastroenterology, infectious disease, obstetrics and gynecology, orthopedics, physical medicine and rehabilitation, pulmonary medicine, senior care, surgery, urology, and women's health. BMLH's community benefit efforts included a continued partnership with Quality EMT Educators of Worcester to offer Basic EMT Training to community members. To date over 100 community have taken the EMT Basic Course. BMLH physicians shared their expertise beyond the walls of the hospital by offering high quality training and continuing education programs at no cost to EMS providers in our communities. The close working relationship between Emergency Physicians and EMS providers is essential to ensuring that patients receive the highest quality care in the field. BMLH provided critical support and resources to the community at large through our Support Groups including; Alcoholic Anonymous, Caregivers Support Group, Quilting Support Group for those touched by Cancer, Diabetes Support Group, Grieving Support Group, Hepatitis C Support Group & WIC Sponsored Breast Feeding Support Group. In addition, BMLH and its staff offered over 100 outreach programs providing a variety of education and wellness seminars to the community at large at no cost. These programs were presented by physicians, nurses and staff that work at the hospital and addressed ways to live healthier by offering a variety of educational opportunities and health screening. Lectures and screenings were offered at the hospital and in community settings including area schools and senior centers, and promoted disease prevention, behavior change, and healthier lifestyles for community members of all ages. In addition, BMLH HealthBeat TV, a monthly 30-minute cable access talk show produced, directed and hosted by Baystate Mary Lane Hospital employees, engages the hospital's physicians, employees, patients and community leaders in discussions of interest to residents of the 15-town Quaboag Hills region. Topics range from winter health safety, cancer, Lyme disease to stroke awareness. The program runs more than 60 times a month.Baystate Medical Practices (BMP) is a tax-exempt, not-for-profit corporation organized to support and assist Baystate Health and its affiliate hospitals, including BMC, BFMC and BMLH, each of which is a Massachusetts not-for-profit corporation, in achieving the fulfillment of their clinical, teaching, research, and other missions related to health care. Baystate Medical Practices, Inc. provides physician services, medical education and research programs to people in the community within its geographic location. BMP's policy is to provide care to any patient in need of medical care, regardless of the patient's ability to pay for such care. Dependent upon the patient's financial capability to pay and consistent with BH and BMP policy, BMP may provide such care free of charge or at amounts below its normal charges. In FY 2013 BMP provided $4,120,580 in charity care. In addition to the charity care provided to patients, BMP's physicians participate in many and varied ongoing community outreach initiatives in the areas of education, employment, safety and health. BMP has also taken a leadership role in strengthening the health of disadvantaged citizens in surrounding communities including specific focus on AIDS and HIV and by providing physician staffing for three community-based health centers through Baystate Medical Center.
Visiting Nurse Association and Hospice of Western New England, Inc. (VNAH) based in Springfield, Massachusetts is a tax-exempt, not-for-profit corporation organized to support and assist Baystate Health and its affiliate hospitals, including BMC and BMLH, each of which is a Massachusetts not-for-profit corporation, in achieving the fulfillment of their clinical, teaching, research, and other missions related to health care. VNAH is a comprehensive home health care agency committed to providing the highest quality care to patients and families, primarily in the home setting. VNAH has the expertise to meet individual needs by bringing experienced nurses, rehabilitation therapists, social workers and home care aides to patients' homes. The Home Care Program of Baystate's Visiting Nurse Association and Hospice serves over 6,000 home health and hospice patients annually of which approximately 1,000 are on service daily. The services, aimed at allowing patients to recuperate while remaining in the comfort of their homes, includes skilled nursing, rehabilitation therapy, medical social work and homecare aides. The Hospice and Palliative Care Program of Baystate's Visiting Nurse Association and Hospice provides end of life care for patients in the community, assisted living facilities and skilled nursing facilities. The Hospice and Palliative Care program coordinates care for an average daily census of about 175 patients of all ages. In FY 2013 there were approximately 120,000 home health, hospice and palliative visits rendered by Baystate Visiting Nurse Association & Hospice nurses. Hospice has an interdisciplinary approach using nursing, social work, chaplains, hospice aides and volunteers to allow patients to meet goals related to comfort and symptom management. Baystate Health Foundation raised $1 million in 2013 for the Baystate Children's Specialty Clinic and an additional $3.1 through system wide annual fundraising efforts. Along with the Campaign for Baystate Children's Specialty Center, the Foundation actively engaged in annual fund, major gift, and event fundraising to ensure ongoing annual support for education, research, programs and capital needs throughout the health system that impact patient care throughout western Massachusetts.In addition to the brief descriptions of the affiliated entities above, this further information speaks to activities of Baystate Health and its affiliates regarding promotion of community health.In FY 2013 Baystate Health's Interpreter and Translation Services provided over 156,000 sessions in 49 languages to help deliver a positive patient care experience. In addition, nearly 4,000 pages of documents, signs and clinical research were translated for providers. Interpreter sessions included in person, telephonic and video interpreting for American Sign Language. Languages interpreted include Spanish, Russian, Vietnamese, Ukrainian, Mandarin (Chinese), American Sign Language, Arabic and Portuguese. Interpreters also translated the newest language to come into the area, Tigrinya, a language spoken in Ethiopia and Eritrea.Baystate Health contracts with local agencies to provide in-person interpreter services as needed for patients who come to the hospital for pre-scheduled appointments or for emergencies. The hospital has in place a telephonic interpreting system by which any staff member can pick up any house phone, dial an internal extension and be nearly immediately connected to a national telephonic interpreting agency that provides trained and competent interpreters for over 200 languages. BH also subscribes to software called Care Notes by Micromedex that provides information on illnesses for patients or their family members in 15 languages and the documents are written at a 5th grade reading level. Similarly, BH purchased software called Exit Writer from Krames that was integrated into the patient's electronic medical record. Information in 15 languages about illnesses and aftercare instructions can be provided to patients and their family members and be documented in the patient's electronic medical record as patient education automatically. Baystate Health Interpreter Services also assisted the City of Springfield Fire Department with the translation of fire safety documents and to provide fire safety education in Spanish, Russian, Vietnamese and Nepali. Immigrants and refugees were carrying over cooking practices from their home countries and kitchens were catching on fire, so it proved critical to provide fire safety information in native languages.Baystate Medical Center is recognized as a leading academic medical center. As the Western Campus of Tufts University School of Medicine since 1974, BMC offers clinical training and undergraduate and graduate medical student education across all specialties. In addition to BMC, Medical Residents and Fellows rotate through Baystate Franklin Medical Center and Baystate Mary Lane Hospital.Baystate Health is a nationally accredited provider of continuing education for health care professionals, including physicians, nurses, pharmacists, mental health counselors and psychologists. We also arrange credit for other health care professionals. Baystate provides both live and web based courses. Our educational activities are designed for Baystate staff and non Baystate health care professionals throughout Western New England. Our mission is to provide high-quality, evidence based continuing education to maintain and enhance the knowledge, expertise, and performance of health care professionals, to improve the health of the people in our communities every day, with quality and compassion. In 2013, Baystate Health provided 214 courses and series for a total of 1,239 hours of continuing education instruction. A total of 17,181 health care professionals attended these credit bearing activities. Our educational activities are a service to the community. Baystate Health's Midwifery Education Program is offered in collaboration with the Midwifery Institute of Philadelphia University. Through our affiliation with the Massachusetts College of Pharmacy and Health Science, we offer a one-year pharmacy residency. Baystate Health's educational partnerships allow us to offer allied health programs such as emergency medical technician (EMT), pharmacy technician and surgical technologist. For nursing we offer clinical practicums for baccalaureate, masters, or doctoral-level nursing students in affiliation with the University of Massachusetts, University of Connecticut, Yale University, and other schools of nursing. Baystate Medical Center's high quality nursing care earned re-designation as a Magnet Hospital for Nursing Excellence by the American Nurses Credentialing Center (ANCC) - one of 170 in the nation and only five in Massachusetts. As an academic teaching hospital and the Western Campus of Tufts University School of Medicine, Baystate Medical Center is a center for research. Strong partnerships with other research organizations allow BMC to further its institutional commitment to improve the health of the community through research and education. Collaborations enable Baystate Health to better support the innovative research of our investigators and to improve the lives of the people in the communities we serve. Baystate Medical Center is an active participant in the research communities of Massachusetts and a member institution of the state and regional organizations that also promote the goals of biomedical research. Its faculty and research staff are engaged in basic, clinical and biomedical research across a broad spectrum of medical and surgical specialties, with nationally-recognized research programs in quality of care. Baystate Medical Center serves as a regional resource for specialty medical care while providing comprehensive primary medical services to its community.Baystate Medical Center is also a research partner with University of Massachusetts through the Pioneer Valley Life Sciences Institute. Formed in 2003, PVLSI is a research institution which applies its translational research efforts in the areas of cancer, diabetes, obesity, and wound healing. Its scientists and technicians are committed to improving human health and reducing suffering from disease through creative strategies for early detection and preventive interventions. Other Baystate Health affiliations include Council of Teaching Hospitals and Health Systems (COTH) of the Association of American Medical Colleges (AAMC), Alliance of Independent Academic Medical Centers (AIAMC), and Group on Regional Medical Campuses (GRMC) of the Association of American Medical Colleges (AAMC), Joint Commission and Medical Library Association (MLA).Form 990, Schedule H, Part VI, Line 6 continued
Baystate Health and its affiliates are committed to creating healthier communities and continue to partner with members of the community to ensure we are meeting the diverse needs of the community. Baystate Health extends the traditional definition of "health" to include economic opportunity, affordable housing, quality education, safe neighborhoods, food security, arts/culture and racism and homophobia free communities -- all elements that enable families and communities to thrive. In keeping with this commitment to improve health Baystate Health and its affiliates provide a range of community benefits including support groups, financial counseling and assistance and other health and wellness programs. As an integrated delivery system BH provides further benefits to the hospital' community by coordinating within and among its various entities.Baystate Health and its affiliates are committed to providing the communities they serve throughout western Massachusetts with the resources necessary to stay informed and healthy by providing both basic and extensive educational opportunities such as parent education classes, including our new program "Baystate's New Beginnings". Also offered are teen programs, including Teen CPR and Babysitter's Academy. Some classes are free while others are offered at a reasonable fee. No one is turned away due to inability to pay. Baystate Health offers many free parenting support groups (breastfeeding, new parents, and toddler groups) each month. In addition, Baystate Health has libraries and resource centers at Baystate Medical Center and Baystate Franklin Medical Center staffed by professionals who help patients, families and the general public access reliable health information.The Mini-Medical School program is an eight-part health education series offered at Baystate Medical Center featuring a different aspect of medicine each week. Designed for an adult audience, each course is taught by an energetic faculty member who will explain the science of medicine without resorting to complex terms. Mini-Medical School gives Baystate Health the opportunity to open our doors to the public and share our knowledge of medicine in a comfortable and friendly environment. Many of the students participate due to a general interest and later find that many of the things they learned over the semester are relevant to their own lives. The goal of this program is to help members of the public make more informed decisions about all aspects of their health care while receiving insight on what it's like to be a medical student. Tuition is $95 per person, $80 for Senior Class and Spirit of Women members. Baystate Health offers 50+ free programs to seniors and women. Baystate Health Senior Class is a loyalty program dedicated to health and wellness for men and women ages 55 and over. The 23,000 Senior Class members receive a quarterly newsletter with valuable health information, benefits and invitations to special events designed with their interests in mind. Baystate Spirit of Women Loyalty Program offers its 15,000 members 50+ monthly seminars with direct access to physicians, nurses and other medical professionals and the latest women's health information. The program is designed to increase knowledge of women's health issues so they are well prepared to make the best decisions regarding their health.The Baystate Neighbors Program, which began in 1999, was established to help employee first-time homebuyers purchase a home and to promote homeownership in neighborhoods around Baystate Medical Center, Baystate Franklin Medical Center, and Baystate Mary Lane Hospital. Employees were granted forgivable loans, which increased from $5,000 to $7,500 in 2006, that may be used towards a down payment or closing costs. In the past 13 years, the Baystate Neighbors Program has awarded 131 loans, a total of $898,473.08, to help employees become homeowners in communities served by Baystate Health hospitals, helping to stabilize housing in those communities. Specific to FY 2013, 15 neighbor loans were awarded, for a total of $112,500.Since 1994, Rays of Hope - A Walk & Run Toward the Cure of Breast Cancer has been committed to improving the breast health of people in our communities with quality and compassion. Through the Baystate Health Foundation, the Walk has grown from 500 participants to over 24,000. Now in its 21st year, Rays of Hope has raised nearly $12 million - all of which has been awarded locally throughout western Massachusetts. 2009 marked the first year the event expanded into Franklin County. Funding benefits programs through the Baystate Health Breast Network including Baystate Medical Center in Springfield, Baystate Franklin Medical Center in Greenfield, Baystate Mary Lane Hospital in Ware, outreach and education, and various community support projects and organizations. Funding also supports the Rays of Hope Center for Breast Cancer Research at the Pioneer Valley Life Sciences Institute, a collaboration between clinicians at Baystate Health and scientists at UMass-Amherst, to continue locally based breast cancer research on a broader scale.The United Way develops and supports programs that directly improve the lives of people in our communities, a mission proudly shared by Baystate Health. Baystate Health is a strong supporter of the United Way, and a major contributor to the organization with three workforce campaigns and thousands of employee donors and volunteers. Baystate Health's contributions help the United Way serve our families, friends, colleagues and others who seek help in different ways and at different times in their lives. Three community campaigns are held annually: Springfield workplace to support the United Way of Pioneer Valley, Greenfield workplace to support the United Way of Franklin County and Ware workplace to support the United Way of Hampshire County. Employees can direct their donations to one or all of the United Way's action areas: Education, Income and Health or designate to a qualified agency with a minimum contribution. Baystate employees also support the United Way by volunteering on work time to participate in a variety of community-based projects for the United Way Day of Caring. Baystate Health employees once again donated generously to the United Way of the Pioneer Valley in 2013, raising a total of $410,000. Baystate Franklin Medical Center employees raised $32,000 for the United Way of Franklin County. Baystate Mary Lane Hospital employees raised $15,769 for the United Way of Hampshire Country.See also additional information regarding Baystate Health, Inc. and its affiliates promotion of community health above in Line 5.Form 990, Schedule H, Part VI, Line 6 continued
List of States Receiving Community Benefit Report: MAForm 990, Schedule H, Part VI, Line 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
Cancer Connection Inc
PO Box 60452FlorenceMA010620452043493483501(c)(3)42000Support groups, complementary therapies, workshops and classes for women living with breast cancer and their families and caregivers.
La Experanza The Hope of the Pioneer Valley Inc
237 South StreetNorthamptonMA01060272760538501(c)(3)31792Support group for Latina women living with breast cancer.
Cancer House of Hope Inc
86 Court StreetWestfieldMA010853511043298631501(c)(3)17765Partial funding (36%) of the expenses of the most well-attended CHH programming utilized by women with breast cancer.
Baystate Health Inc
759 Chestnut StreetSpringfieldMA01199042105941501(C)(3)6000000Strategic initiatives
Pioneer Valley Riverfront Club
PO Box 60762LongmeadowMA01106260251831501(c)(3)16000Breast cancer survivors excercise and recreation program.
YMCA of Greater Springfield
275 Chestnut Street Suite 1SpringfieldMA01104041859893501(c)(3)12589Breast cancer survivors excercise program.
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants6TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations5TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII (5 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrant
Art therapy workshops for breast cancer survivors113735
The healing art of Yoga for ongoing cancer recovery, and water dance112090
Massage therapies to patients receiving chemotherapy123775
Reiki for breast cancer patients and survivors in Franklin County18175
Swedish Massage for breast cancer patients andsurvivors18850

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: The Rays of Hope grants that are awarded are reviewed and approved by the Rays of Hope Community Advisory Board. Recipients are required to submit a Community Program Grant Application. As part of the application process the recipient is required to provide their SS# or T.I.N. Once the grant is awarded by the Advisory Board quarterly reports are submitted by the recipient to monitor the grant. A final report of the grant program and budget summary is due upon completion of the program. The vast majority of the funds awarded for the Nurse Midwifery Program are applied directly to tuition. Specific guidance is given as to appropriate use of the funds. Funds may be used for tuition, living expenses and up to $500 in required textbooks. They may not be utilized for travel or to defray costs of attending professional meetings.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (16 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Mark R Tolosky
President, CEO & Trustee0697835044153604156730280890312110161434400
Grace P Makari-Judson MD
Trustee/ Hematologist M. D2765050302320232400277500173980375125000
Kevin Moriarty MD
Trustee; Pediatric Surgeon417870029751013500440620269790520012000
Barbara W Stechenberg MD
Trustee/ Infectious Disease132412012299090221320104630177315000
Dennis W Chalke
Treasurer036578501555500202350028000024277077596200
Gregory A Harb
Executive VP, COO0444085023643001190990139147022738096149900
Mark R Keroack MD
Executive VP, COO0446725017095501966950119597015636094960800
Michael F Moran
VP Facilities & Guest Serv220502051912088820271150204440328855000
Deborah Morsi
VP, Patient Care Services167153047884054002000214190290458000
Deborah A Provost
VP Surg, Anes, Emrg Serv20732004866408731066546094870340748000
Peter Lindenauer MD
Med Dir & Quality & Safety2360040398520187150324180203610347350000
Betty K Larue
VP, Heart & Vascular/ Neuro168554091912079440568040245390349753000
David Y Chin PhD
Rad Oncology Med Physics C2112370184900121430196910266460288207000
Jason M Newmark
VP Diagnostic Services17710406242203090119100190650270810000
Michael R Favreau
Director Radiology Service1643390414900179840623650192460305424000
Keith C McLean-Shinaman
Former Treasurer0000029898600010208030919400

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 3The board of the filing organization has appointed the compensation committee of Baystate Health, Inc., a related organization and the parent organization of the heatlh care system to which the filing organization belongs, as the compensation committee of the filing organization. The compensation committee consists entirely of individuals serving on the board of the filing organization. The compensation committee uses an independent compensation consultant and appropriate comparability date to establish the compensation of the organization's key officers, directors and employees, which includes the filing organization's top management officials, and approves compensation of those individuals.
Part I, Lines 4a-bPart I, Lines 4a-b: Line 4a: Keith McLean-Shinaman terminated employment effective 9/30/2011. The compensation numbers include various one time termination payments. Line 4b: Dennis W. Chalke - Supplemental Retirement of $127,250 is included in column E. This amount was earned in 2012. Gregory A. Harb Supplemental Retirement of $16,819 is included in column E. This amount was earned in 2012. Mark A. Keroack, MD, MPH Supplemental Retirement of $3,994 is included in column E. This amount was earned in 2012. Peter Lindenauer, MD - Supplemental Retirement of $5,620 is included in column E. This amount was earned in 2012. Grace Makari-Judson, MD- Supplemental Retirement of $8,900 is included in column E. This amount was earned in 2012. Kevin Moriarty, MD- Supplemental Retirement of $7,750 is included in column E. This amount was earned in 2012. Michael Moran Supplemental Retirement of $8,281 is included in column E. This amount was earned in 2012. Deborah Morsi - Supplemental Retirement of $3,252 is included in column E. This amount was earned in 2012. Mark R. Tolosky - Supplemental Retirement of $351,666 is included in column E. This amount was earned in 2012.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
MA Health & Educ Facil Authority - Ser G
A04245601157586CNHA2005-10-2771740000MA HEFA Series G - See Part VI000
MA Health & Educ Facil Authority - Ser H
B0424560112007-01-1810000000MA HEFA Series H - See Part VI000
MA Health & Educ Facil Authority - Ser M2
C0424560112008-06-3010157671MA HEFA Series M2 - See Part VI001
MA Health & Educ Facil Authority - Ser IJK
D04245601157586EKC42009-06-25198611250MA HEFA Series IJK - See Part VI000

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredTotal ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindAmount In Reserve FundAmountInReserveFundCredit EnhancementCreditEnhancement
A219250007174000073500469900006401499620050111
B44444451000000072250992775020060011
C243543810157671100814601999101176211
D1991224251845403132183543650000002012101193479

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsEngage Bond Counsel ResearchEngageBondCounselResearchPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersTotal Private Business UseTotalPrivateBusinessUseBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrsPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI
A0011110.000600.00060001
B0011110.000000.000000010.00000
D0011110.000000.000000010.00000

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsTerm Of HedgeTermOfHedgeSuperintegrated HedgeSuperintegratedHedgeHedge TerminatedHedgeTerminatedGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
Citibank
A00011120.70000000000000001
(no name)
B001010001
(no name)
C000110001
(no name)
D000110001

Form990 Schedule K Part V Form990ScheduleKPartV (4 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A1
B1
C1
D1

Form990 Schedule K Part VI Form990ScheduleKPartVI (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Schedule K Part IV, Arbitrage, Line 2cDate Rebate Computation PerformedIssuer Name: MA Health & Educ. Facil. Authority - Ser. G Date the Rebate Computation was Performed: 09/27/2006 Issuer Name: MA Health & Educ. Facil. Authority - Ser. M2 Date the Rebate Computation was Performed: 06/18/2013 Issuer Name: MA Health & Educ. Facil. Authority - Ser. IJK Date the Rebate Computation was Performed: 08/24/2012
A - MHEFA Series G Bonds Part I - Per the Official Statement, the purpose of the bond proceeds is: (i) to advance refund $61,930,000 principal amount of the Authority's Revenue Bonds, Baystate Medical Center (the Institution) Issue, Series E (the "Series E Bonds"), which were issued July 11, 1996 to finance or refinance the following property owned by the Institution: (a)construction of a new 104,500 gross square foot Ambulatory Care Center at 3300 Main Street, Springfield, Massachusetts; (b) construction of a new 100,000 gross square foot building to house the Ambulatory Surgery Center, Medical Library and education/conference space on the Institution's North campus located at 759 Chestnut Street, Springfield, Massachusetts; (c) renovation of various existing spaces within the Institution's North campus; (d) acquisition of equipment for the new facilities; (ii) to finance routine capital construction, renovations, and equipping of various facilities of the Institution; and (iii) to pay certain costs of issuance of the Series G Bonds. B- MHEFA Series H Bonds Part I - Per the Official Statement, the purpose of the bond proceeds is: (i) the construction, improvement, equipping, and other related capital expenditures of a parking garage walkway, and other related work at an existing building at 280 Chestnut Street owned and used by the Institution (the "Garage"), and (ii) the acquisition and installation of capital equipment and renovations to existing facilities of the Institution and other routine capital expenditures in connection with the Institution's hospital operations. MA HEFA Series H bonds are private placement bonds and therefore, there is no CUSIP number associated with these bonds. C- MHEFA Series M-2, Pool 2 Part I Per the Loan Document the purpose of the bond is to refinance Baystate Medical Center's Mass HEFA Pool J-2 Loan, which was issued February 2, 1999 to finance the acquisition and equipping of the property located at 280 Chestnut Street, Springfield, Massachusetts (the "Property"), and the renovation of the Property and existing facilities of the Institution and the acquisition of capital equipment for the Institution's existing facilities. The HEFA indebtedness listed is a pool loan therefore the issue price, Parts I, II, III, IV (Lines 5-7) are being answered with respect to the Baystate Medical Center loan alone rather than with respect to proceeds loaned to other conduit borrowers. The actual date of issue of the MHEFA Series M2 Bonds was 5/30/2002, and the CUSIP number shown on Form 8038 was 57585KA57. While that issue was not a refunding issue, the purpose of the loan taken by BMC was to refund prior debt, as reflected in our response to Part II, Line 14. Accordingly, Part III has not been completed, as the original project was financed with bonds issued prior to 2003. D- MHEFA Series I, J-1, J-2, K-1, K-2 Part I - Per the Official Statement, the purpose of the bond proceeds is: (i) to pay a portion of the costs associated with the acquisition of land, site development, construction or alteration of buildings or the acquisition or installation of furnishings and equipment, refinancing of, or any combination of the foregoing, in connection with the construction, improvement, equipping, and other related capital expenditures of a seven-story, approximately 599,100 gross square foot primarily inpatient building located at 759 Chestnut Street, Springfield, Massachusetts, including demolition and site work, which building will be constructed by Baystate Total Home Care (BTHC) and leased to Baystate Medical Center by BTHC; (ii)for the acquisition and installation of capital equipment and renovations to existing facilities of the Medical Center and other routine capital expenditures included or to be included in the Medical Center's capital budget over the next three years for use in connection with the Medical Center's hospital operations; (iii) for the refinancing of a portion of an outstanding commercial loan in the amount of $65,000,000 made by Bank of America, N.A. on October 20, 2008 to the Medical Center in connection with the defeasance of the Authority's Revenue Bonds, Baystate Medical Center Issue, Series D, issued September 16, 1993; (iv) for the financing of costs associated with the issuance of bonds and; (v) financing of routine capital construction, renovations, and equipping of various facilities of Baystate Medical Center. E - MA DFA Revenue Bonds, Series L Part I - Per the Official Statement, the purpose of the bond proceeds is: for the construction, improvement, and other capital expenditures relating to the build-out of an equipping of certain interior space within a seven-story approximately 599,100 gross square foot primarily inpatient building owned by Baystate Total Home Care, Inc. and leased to the Institution located at 759 Chestnut Street, Springfield, Masssachusetts, such build-out to consist of space to be used for the Emergency Department of the Institution and ancillary support areas and the financing costs associated with the issuance of the bonds. F - MA DFA Tax Exempt Capital Lease Part I - Per the Master Lease and Sublease Agreement, the purpose of the Tax Exempt Capital Lease is for the Acquistition of Equipment. "Equipment" means the fixed and moveable personal property to be used in connection with the Sub-Lessee's health care operations identified in a Schedule executed by or pursuant to the Agency of the Lessee and the Sub-Lessee, accepted by the Lessor and acknowledged by the Escrow Agent in writing and identified as part of the Master Lease (including certain items originally financed through internal advances of the Sub-Lessee in anticipation of obtaining permanent financing through the Lessee), together with all replacement parts, additions, repairs, accessions, and accessories incorporated therein and/or affixed to such personal property and replacements and substitutions therefor and proceeds and products thereof. G - MA DFA Revenue Bonds Series M - Part I - The purpose of the bond proceeds is: (i) to advance refund $39,907,339 principal amount of Massachusetts Health and Education Facilities Authority's Revenue Bonds, Baystate Medical Center (the Institution) Issue, Series F (the "Series F Bonds"), issued June 12, 2002 the proceeds of which financed the Construction of a new Cancer Center with a partial third floor medical record and support area; acquisition of a surgery center facility; certain renovations and equipment acquisitions and (ii) finance costs of issuance relating to the Bond. Part I and Part II, Differences between the issue price (Part I) and total proceeds (Part II, Line 3) are due to investment earnings. Part III, Lines 4 and 5, Column D: As the refunded bonds were issued prior to January 1, 2003, this question is being answered solely with respect to the new money portion of the bonds. Part III, Lines 4 and 5, Column G: As these bonds refunded debt issued prior to January 1, 2003, the organization is availing itself of the Part III reporting exemption available for such bonds.
Part IV, Line 2c, Column C: The Issuing Authority engages an outside consultant to prepare rebate computations. As of the most recent computation period, May 29, 2012 no rebate was owed. The cumulative rebate amount is zero as of the outside consultants most recent report, dated 6/18/2013. Part IV, Line 6, Column A, This question is being answered without regard to yield-restricted advance funding escrow financed with proceeds of the bonds.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
MA Development Finance Agency - Ser L
A0434318142011-11-0225000000MA DFA Series L - See Part VI000
MA Development Finance Agency - Cap Lease
B0434318142011-11-0220000000MA DFA Cap Lease - See Part VI000
MA Development Finance Agency - Ser M
C0434318142012-08-0940137000MA DFA Series M - See Part VI000

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredTotal ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindOther Spent ProceedsOtherSpentProceeds
A903662250220631684382485362520120011
B4945400200133262001332620120011
C1040000401370002296612004101139907339

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUseBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A001100.000000.000000.00000001
B001100.000000.000000.00000001

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
A001010001
B001010001
C001010001

Form990 Schedule K Part V Form990ScheduleKPartV (3 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A1
B1
C1

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (14 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
American Excess Insurance Exchange (AEIX)
Board Overlap846614See Part V - Mark Tolosky, President of the filing organization is also a Member of the Board of Directors of AEIX. The filing organization purchases general & professional liability insurance from AEIX.0
Baycare Health Partners Inc (BHP)
Common Board Members or Officers1039446See Part V - The filing organization received payments of $1,039,446 for patient care services for which BHP is the intermediary between the filing organization and third party payer from BHP. BHP is an affiliate corporation of the filing organization.0
Baycare Health Partners Inc (BHP)
Common Board Members or Officers1533300See Part V - The filing organization made payments to BHP for annual support fees. BHP is an affiliate corporation of the filing organization.0
Baystate Health Insurance Company Ltd (BHIC)
Common Board Members or Officers3423000See Part V - The filing organization made payments of $3,423,000 for Retrospective pass-thru premiums to BHIC. BHIC is an affiliate corporation of the filing organization.0
Baystate Health System Ambulance Inc (BHSA)
Common Board Members or Officers6252See Part V - The filing organization received payments from BHSA for an employee assistance program. BHSA is an affiliate corporation of the filing organization.0
Baystate Health System Ambulance Inc (BHSA)
Common Board Members or Officers443656See Part V - The filing organization made payments to BHSA of $279,071 for patient transport services and $164,585 for patient care services. BHSA is an affiliate corporation of the filing organization.0
Baystate Radiology & Imaging (BRI)
Common Board Members or Officers1548150See Part V - The filing organization received payments from BRI of $562,500 for partnership distributions, $231,595 for Outside Technologists, $753,923 for Contracted Services, and $132 for Rent. BRI is an affiliate corporation of the filing organization.0
Health New England Inc (HNE)
Common Board Members or Officers111721093See Part V - The filing organization received payments of $105,774,685 related to medical claims, $200,306 for support of community and quality programs and $5,746,102 in Surplus Sharing payments from HNE. HNE is an affiliate corporation of the filing organization.0
Ingraham Corporation (IC)
Common Board Members or Officers96569See Part V - The filing organization received payments from IC for rent. IC is an affiliate corporation of the filing organization.0
Ingraham Corporation (IC)
Common Board Members or Officers54173See Part V - The filing organization made payments to IC of $54,173 as lease payments. IC is an affiliate corporation of the filing organization.0
Western New England Renal & Transplant Associates PC(WNERTA)
Board Overlap224355See Part V - Gregory L. Braden, MD,and Jeffrey G. Mulhern, MD are Board Members of the filing organization and Members of the Board of Directors of WNERTA. The filing organization made payments to WNERTA of $25,424 for Contracted Physician Services, $183,305 for Physician Stipends, and $15,626 for lease payments.0
Western New England Renal & Transplant Associates PC(WNERTA)
Board Overlap2987See Part V - Gregory L. Braden, MD, and Jeffrey G. Mulhern, MD are Board Members of the filing organization and Members of the Board of Directors of WNERTA. The filing organization received payments to WNERTA of $1,487 for Pharmacy and $1,500 for Supplemental Services.0
John M O'Brien III
Family member of John M. O'Brien46042See Part V - Family member of John M. O'Brien employed by the filing organization.0
Timothy S Rice
Family member of Timothy S. Rice132837See Part V - Family member of Timothy S. Rice is employed by the filing organization.0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 1a. The filing organization has a standing executive committee, which is entitled to act between meetings of the Board, on all matters as to which the Board is entitled to act and permitted by law to delegate to a committee. The members of the executive committee are the same individuals serving on the executive committee of Baystate Health, Inc. b. Four members of the Board of Trustees of the filing organization are not considered independent as a result of their service on the board of an affiliate of the filing organization.
Form 990, Part VI, Section A, line 2Gregory L. Braden, MD, Dennis W. Chalke, Ruth H. Constantine, Charles L. D'Amour, John H. Davis, Kristin R. Delaney, John A. Egelhofer, MD, John F. Kole, Grace P. Makari-Judson, MD, John E. Maybury, Steven M. Mitus, John M. O'Brien, III, Ann M. Paradis, Robert L. Pura, PhD, Katherine E. Putnam, Timothy S. Rice, James P. Sadowsky, Patricia A. Sheldon, David C. Southworth, Barbara W. Stechenberg, MD, Richard B. Steele, Jr., Katherine M. Sullivan, Mark R. Tolosky, Howard G. Trietsch, MD, and Victor Woolridge are also officers or trustees of its affiliated entities. The following trustees, officers, or key employees serve on a common board of a non-affiliated entity: (1)Katherine E. Putnam and David Southworth; (2)Richard B. Steele, Jr. and Katherine McG. Sullivan; (3)Steven M. Mitus, Robert L. Pura, PhD and Richard B. Steele, Jr. (4) Charles D'Amour, John F. Maybury and Mark R. Tolosky (5) John M. O'Brien, III and Victor Woolridge (6) Gregory L. Braden, MD and Jeffrey G. Mulhern, MD.
Form 990, Part VI, Section A, line 3Baystate Medical Center, Inc. is affiliated with Baystate Administrative Services, Inc. (BAS) which is a 501 (c)(3) organization. Various management and support functions are delegated to BAS.
Form 990, Part VI, Section A, line 6The filing organization has one member, Baystate Health, Inc. (BH).
Form 990, Part VI, Section A, line 7aThe Board of Trustees of the filing organization are the same individuals serving as members of the Board of Trustees of BH with the addition of the president of the medical staff of the filing organization. The Board of Trustees of BH are elected annually by the Board of Trustees of BH at their annual meeting.
Form 990, Part VI, Section B, line 11Prior to the filing of this return appropriate parts of this Form 990 were reviewed by representatives from the Tax, Finance, and Human Resources Departments of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs), some of whom are officers or trustees of the filing organization and by outside legal counsel. The entire return was reviewed by a tax expert from an outside accounting firm. The entire return was also reviewed prior to filing by the Audit and Compliance Committee of Baystate Health, Inc., which also includes some of the officers and trustees of the filing organization. The Form 990 was provided to all members of the Board of Trustees prior to filing.
Form 990, Part VI, Section B, line 12cBaystate Health, Inc. (BH) has a comprehensive conflict of interest policy which has been adopted by the filing organization. All directors, trustees, officers, key employees, and highest compensated employees of BH and its affiliates are asked to complete an annual conflict of interest form. We utilize an electronic database to receive and manage all conflict of interest submissions. This information is reviewed by the BH Chief Compliance Officer, the BH Chief Executive Officer, the Chair of the BH Board of Trustees, and the Chair of the Audit & Compliance Committee of BH. A summary of the conflict of interest disclosures is provided to the Baystate Health Board of Trustees and the Tax Department and reviewed by outside counsel. Potential conflict of interest transactions are reviewed as appropriate under the policy, which provides for recusal from discussion and deliberation by any party with a potential conflict of interest.
Form 990, Part VI, Section B, line 15The compensation of the President, and all key officers and employees is reviewed and determined annually by the compensation committee of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs), which has been appointed as the compensation committee of the filing organization and consists entirely of individuals serving on the board of the filing organization. Form 990, Part VI, Section B, Line 16b Baystate Health, Inc. has a joint venture policy that covers affiliated tax exempt entities including Baystate Medical Center, Inc.
Form 990, Part VI, Section C, line 19The organization makes its conflict of interest policy and financial statements available to the public at www.baystatehealth.org. Articles of organization and bylaws are generally available at the Commonwealth of Massachusetts website.
Form 990, Part VII, Section A, Column (B)Individuals with reported compensation who have 10 or less average hours per week listed in Part VII, worked between 40 - 60 hours among all related entities.Average hours per week:
Form 990, Part VII, Section A, Line 5Certain officers or trustees of the filing organization are paid by an entity, Baystate Medical Practices, Inc. (BMP) EIN 04-2888373, which is part of the health care system to which the filing organization belongs but does not meet the technical requirements as a "Related Organization" per Schedule R. Compensation from BMP to the officers and trustees of the filing organization therefore, is reported as paid from an unrelated organization in Line 5 and according to the instructions reported as though paid by the filing organization.
Form 990, Part IX, line 11gBMP Support: Program service expenses 41,466,335. Management and general expenses 0. Fundraising expenses 0. Total expenses 41,466,335. Other: Program service expenses 52,935,616. Management and general expenses 6,645,629. Fundraising expenses 0. Total expenses 59,581,245.Other Fees
Form 990, Part XI, line 9:Transfer from affiliate for land, buildings and equipment 3,883,812. Transfer of funds for strategic initiative to affiliated companies -35,190,827. Transfer of funds for land, bldg. & equip. to affiliated companies 5,438,755. Minimum pension liability adjustment 54,785,686. Equity gain to unconsolidated affiliates 44,410. Change in value of interest in BHF-Temporarily Restricted -1,848,932. Change in value of interest in BHF-Permanently Restricted 54,661.Changes in Net Assets or Fund Balances:

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Pioneer Valley Information Exchange LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1101 Wason Avenue Suite 200AddressLine1
CitySpringfieldCity
StateMAState
ZIP Code01107ZIPCode
FieldValueIRS element (for citing)
EIN042790311EIN
Primary ActivitiesOperation of a health information exchange and related activitiesPrimaryActivities
Legal Domicile StateMALegalDomicileState
Total Income0TotalIncome
EOY Assets0EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Baystate Medical Center IncBusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Baystate Administrative Services Inc
759 Chestnut StreetSpringfieldMA01199222747685Administrative servicesMA501 (c ) (3)11c, IIIcBaystate Health Inc0
Baystate Franklin Medical Center
164 High StreetGreenfieldMA01301042103575HospitalMA501 (c ) (3)3Baystate Health Inc0
Baystate Health Foundation Inc
759 Chestnut StreetSpringfieldMA01199043549011FundraisingMA501 (c ) (3)7Baystate Health Inc0
Baystate Health Systems Inc Health & Welfare Benefits Plan
759 Chestnut StreetSpringfieldMA01199222531644Voluntary Employees' Benefit AssociationMA501 (c ) (9)Baystate Health Inc0
Baystate Health Inc
759 Chestnut StreetSpringfieldMA01199042105941Healthcare System ParentMA501 (c ) (3)7Baystate Health Inc0
Baystate Mary Lane Hospital Corporation
85 South StreetWareMA01082042103584HospitalMA501 (c ) (3)3Baystate Health Inc0
Baystate Medical Center Auxiliary Inc
759 Chestnut StreetSpringfieldMA01199046065279Supporting organization for HospitalMA501 (c ) (3)7Baystate Health Inc0
Baystate Total Home Care Inc
50 Maple StreetSpringfieldMA01199203260764Real Estate and OtherMA501 (c ) (3)11b, IIBaystate Medical Center Inc1
Visiting Nurse Assn and Hospice of Western New England Inc
50 Maple StreetSpringfieldMA01199042105803Homehealth and Hospice careMA501 (c ) (3)9Baystate Health Inc0

Form990 Schedule R Part IV Form990ScheduleRPartIV (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityControlled OrgControlledOrgAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountry
Health New England Inc
Monarch Place Suite 1500SpringfieldMA011441500042864973HMO/InsuranceMABaystate Health IncC0
HNE Advisory Services
Monarch Place Suite 1500SpringfieldMA011441500043012347Administrative SvsMAHealth New England IncC0
Health New England Insurance
Monarch Place Suite 1500SpringfieldMA011441500043183019Ancilliary InsuranceMAHealth New England IncC0
Health New England of Connecticut
Monarch Place Suite 1500SpringfieldMA011441500061398662DormantMAHealth New England IncC0
Ingraham Corporation
759 Chestnut StreetSpringfieldMA01199043016257Health care and other business activitiesMABaystate Health IncC0
Baystate Health System Ambulance Inc
759 Chestnut StreetSpringfieldMA01199043018550Ambulance SvsMAIngraham CorporationC0
BH Insurance Company Ltd
980421413Offshore captive InsuranceBaystate Health IncC0North Church StreetGeorgetownCJCJ
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets1ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Baystate Total Home Care Inc
J11203025
Baystate Total Home Care Inc
I6741389

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