2014-08-08T13:55:08-05:00 2013-09-30 861065772 Deloitte Tax LLP Two Jericho Plaza Jericho NY 11753 990 2012-10-01 042790311 Baystate Medical Center Inc BAYS 4137940000 759 Chestnut Street Springfield MA 01199 Dennis W Chalke 4137940000 2014-08-08 1 Christine Kawecki P00743140 5169187000 2012 2015-11-30 17:44:51Z Dennis W Chalke 759 Chestnut Street Springfield MA 01199 1009782003 0 X www.baystatehealth.org X 1983 MA The mission of the organization is to improve the health of the people in our communities every day, with quality and compassion. 22 8 7406 578 6799384 -3203799 6512494 6114899 909917621 936557350 17085746 17159944 19733008 49553318 953248869 1009385511 6172149 6194372 0 0 419860372 435740766 0 0 0 456399027 478944887 882431548 920880025 70817321 88505486 1139431156 1188880088 633235019 542791433 506196137 646088655 The mission of the organization is to improve the health of the people in our communities every day, with quality and compassion. 0 0 417064923 6194372 494479675 Inpatient healthcare services - Providing inpatient community-based medicine and tertiary care to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY13, Baystate Medical Center, Inc. provided 188,351 patient days of inpatient services, with 38,900 discharges. 290147182 315314842 Outpatient 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. 29571502 35439491 Emergency 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. 126279814 128248708 126279814 128248708 863063421 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 1 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 1 0 0 1 1062 0 1 7406 1 1 1 0 0 0 0 0 0 0 0 0 X 22 8 1 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 MA X Peter Lyons Baystate Health Inc 4137940000 759 Chestnut Street Springfield MA 01199 X Mark R Tolosky 1.00 49.00 X X 0 1555044 59300 Victor Woolridge 1.00 2.00 X X 0 0 0 James P Sadowsky 1.00 2.00 X X 0 0 0 Gregory L Braden MD 1.00 1.00 X 0 0 0 Ruth H Constantine 1.00 1.00 X 0 0 0 Charles L D'Amour 1.00 1.00 X 0 0 0 John H Davis 1.00 1.00 X 0 0 0 John A Egelhofer MD 1.00 1.00 X 0 0 0 John E Kole 1.00 1.00 X 0 0 0 Grace P Makari-Judson MD 1.00 49.00 X 329977 0 45148 John F Maybury 1.00 1.00 X 0 0 0 Steven M Mitus 1.00 1.00 X 0 0 0 Kevin Moriarty MD 1.00 0.00 X 448971 0 71041 Jeffery G Mulhern MD 1.00 0.00 X 0 15000 0 John M O'Brien III 1.00 1.00 X 0 0 0 Anne M Paradis 1.00 1.00 X 0 0 0 Robert L Pura PhD 1.00 1.00 X 0 0 0 Katherine E Putnam 1.00 1.00 X 0 0 0 Timothy S Rice 1.00 1.00 X 0 0 0 David C Southworth 1.00 1.00 X 0 0 0 Barbara W Stechenberg MD 1.00 49.00 X 144720 0 32595 Katherine McG Sullivan 1.00 1.00 X 0 0 0 Howard G Trietsch MD 1.00 1.00 X 0 0 0 Richard B Steele Jr 1.00 1.00 X 0 0 0 Dennis W Chalke 1.00 49.00 X 0 723685 52277 Kristin R Delaney 1.00 49.00 X 0 98119 19540 Patricia A Sheldon 1.00 49.00 X 0 64790 15809 Gregory A Harb 50.00 0.00 X 0 799614 161885 Mark R Keroack MD 50.00 0.00 X 0 814375 135233 Michael F Moran 50.00 0.00 X 281296 0 47559 Deborah Morsi 50.00 0.00 X 269039 0 21419 Deborah A Provost 50.00 0.00 X 264715 0 76033 Peter Lindenauer MD 50.00 0.00 X 294571 0 52779 Betty K Larue 50.00 0.00 X 268410 0 81343 David Y Chin PhD 50.00 0.00 X 241870 0 46337 Jason M Newmark 50.00 0.00 X 239835 0 30975 Michael R Favreau 50.00 0.00 X 223813 0 81611 Keith C McLean-Shinaman 0.00 X 0 298986 10208 3007217 4369613 1041092 289 1 1 1 Baystate Administrative Services Inc 759 Chestnut Street Springfield MA 01199 Management Svcs. 74708637 Baystate Medical Practices Inc 759 Chestnut Street Springfield MA 01199 Medical, Educ, Clin 50659102 Baystate Health Inc 759 Chestnut Street Springfield MA 01199 Strategic Initiatives 6000000 Springfield Anesthesia Service Inc 908 Allen Street Springfield MA 01118 Anesthesia Services 5916646 Angelica Textile Service 125 Bath Street Ballston SPA NY 12020 Linen Services 3609163 89 6114899 6114899 Inpatient Revenue 900099 519600090 519600090 Outpatient Revenue 621400 402148847 395413861 6734986 Sponsored Programs 900099 9088126 9088126 CMS Elec Med Rec Fdg 900099 2922780 2922780 Intercompany Rent 900099 2797507 2797507 936557350 12853628 12853628 680896 349791 331105 331105 331105 4253414 99603 0 46701 4253414 52902 4306316 4306316 Pharmacy Service 900099 21579208 21579208 Intercompany Charges 900099 9963406 9963406 Cafeteria Income 900099 4421123 4421123 13258476 12117738 64398 1076340 49222213 1009385511 973482716 6799384 22988512 X 6124646 6124646 69726 69726 815050 246553 568497 188731 55902 132829 353688696 329524317 24164379 22004652 20577469 1427183 32561323 30336907 2224416 26482314 24637015 1845299 37271564 34312396 2959168 1395534 1395534 244985 244985 83191 83191 101047580 94401951 6645629 274022 203156 70866 194283580 190450437 3833143 46897533 46434879 462654 34676792 29551434 5125358 1032661 824666 207995 1248992 787667 461325 8935344 8935344 41205686 36317519 4888167 10296248 9220262 1075986 Non-Patient Bad Debt Ex 51175 51175 920880025 863063421 57816604 0 58925828 72620494 101595330 90337347 200070262 198398223 17262322 18838884 6342105 7164381 934066469 630293135 291625216 303773334 301760637 329431119 71682557 75877891 90166899 92438415 1139431156 1188880088 102895837 91506008 333635193 327856584 15818342 12830155 180885647 110598686 633235019 542791433 X 484327757 626015247 17742467 15892834 4125913 4180574 506196137 646088655 1139431156 1188880088 X 88505486 24219467 27167565 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 83191 83191 0 Part IV, Supplemental Information: Baystate Medical Center, Inc. pays membership dues to the Massachusetts Hospital Association (MHA) and the American Hospital Association (AHA). These organizations have advised us that portions of these dues are used for lobbying purposes for various healthcare matters at the state level. The portion of dues listed as lobbying expenses for the year ending September 30, 2013 is $83,191. 12334547 12334547 381272070 204263581 177008489 4249352 962148 3287204 496722981 407294774 89428207 39487519 17772632 21714887 303773334 1703926 C Investments-securities other less than 5% 74173965 C 75877891 Contractual Adjustment Receivable 25923626 Due From Affiliated Companies 44524033 Beneficial Interest in Net Assets of BHF 20073408 Funds Held - Bond Indenture 888862 Board Designated - Due From Unrestricted Funds 1028486 92438415 Contractual Adjustments Payable 54834629 Refundable Advances 615430 Due to Affiliated Companies 137180 Insurance Liability Loss Reserves 6806000 Deferred Revenue 551259 Minimum Pension Liability 40738232 Market Value Swap 6915956 110598686 Part 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). Carribean 0 0 Insurance Premium Transfers 8399000 0 0 0 0 0 0 8399000 0 8399000 1 0 0 0 0 0 Itemization Part 1, Line 3 Total expenditures of $8,399,000 in the Carribean are comprised of insurance premium transfers. 1 1 1 X 1 X 1 1 1 0 1 1 21697439 11372049 10325390 0.01120 179421835 169793645 9628190 0.01050 17628003 15971085 1656918 0.00180 218747277 197136779 21610498 0.02350 2866824 0 2866824 0.00310 52424169 15749844 36674325 0.03980 18931863 12778478 6153385 0.00670 18187556 0 18187556 0.01980 2160172 0 2160172 0.00230 94570584 28528322 66042262 0.07170 313317861 225665101 87652760 0.09520 100000 100000 0.00010 100000 100000 0.00010 1 5078340 1952008 263110825 208088423 55022402 X 1 1 26 1 Baystate Medical Center Inc

759 Chestnut Street Springfield MA 01199

X X X X X X 2 Baystate Reference Laboratories

361 Whitney Avenue Holyoke MA 01040

Outpatient Laboratory services 3 Baystate High Street Hlth Cntr

140 High Street Springfield MA 01105

Outpatient Facility 4 Baystate Ambulatory Care Center

3300 Main Street Springfield MA 01107

Outpatient Physician Offices 5 Baystate Mason Sq Neighborhood Hlth Cntr

11 Wilbraham Road Springfield MA 01199

Outpatient Clinic 6 Baystate Brightwood Health Center

380 Plainfield Street Springfield MA 01107

Outpatient Clinic 7 D'Amour Center for Cancer Care

3350 Main Street Springfield MA 01199

Outpatient Cancer Center 8 BMC Comprehensive Breast Center

3400 Main Street 1st Flr Springfield MA 01107

Outpatient Facility 9 Baystate Rehabilitation Care at Spfld

360 Birnie Avenue Springfield MA 01107

Rehabilitation Clinic 10 BMC Pain Management Center

3400 Main Street 2nd Flr Springfield MA 01107

Outpatient Facility 11 Baystate Orthopedic Surgery Cntr

50 Wason Avenue 2nd Floor Springfield MA 01107

Outpatient Surgery Center 12 Baystate Vascular Services

3500 Main Street 2nd Floor Springfield MA 01107

Outpatient Facility 13 Baystate Rehabilitation Care

294 North Main Street East Longmeadow MA 01028

Rehabilitation Clinic 14 Baystate Rehabilitation Care Rymd Cntr

470 Granby Rd Ste 4 South Hadley MA 01075

Rehabilitation Clinic 15 Baystate Rehabilitation Care

200 Silver St Ste 101 Agawam MA 01001

Rehabilitation Clinic 16 Baystate Heart & Vascular Prog Imaging

10 Main Street Basement Level Florence MA 01060

Outpatient Facility 17 BMC Transplant Services

100 Wason Avenue Suite 210 Springfield MA 01107

Outpatient Facility 18 Baystate Regional Cancer Program

Davis Blding 85 South St 4th Fl Ware MA 01082

Outpatient Cancer Center 19 Baystate Home Infusion & Resp Svs

211 Carando Drive Springfield MA 01004

Home infusion & resp srvcs & durable medical goods 20 Baystate Home Infusion & Resp Svs

489 Bernardston Road Suite C Greenfield MA 01301

Home infusion & resp srvcs & durable medical goods 21 Baystate Home Infusion & Resp Svs

85 South Street D101 Ware MA 01082

Home infusion & resp srvcs & durable medical goods 22 Baystate Breast and Wellness Center

100 Wason Avenue Suite 300 Springfield MA 01107

Outpatient Facility 23 Central High School Hlth Cntr

1840 Roosevelt Ave 1st Flr Springfield MA 01109

School based medical services 24 Roger L Putnam Vocational Tech HS

1300 State St 3rd Flr Springfield MA 01109

School based medical services 25 High School of Commerce Hlth Cntr

415 State St 1st Flr Rm 135 Springfield MA 01105

School based medical services 26 Baystate Orthopedic Surgery Cntr

298 Carew Street Springfield MA 01104

Outpatient Surgery Center Baystate Medical Center 1 1 X X X X X X X X X X 12 1 1 1 X X X X X X X X X 0 0 1 1 200.000000000000 1 400.000000000000 1 X X X X X 1 1 X X X X X 1 0 1 X 0 0 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. Baystate Medical Center 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 College Baystate 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). Schedule H, Part V, Section B, Line 18 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. 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. Form 990, Schedule H, Part VI, Line 6 continued 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 7 List of States Receiving Community Benefit Report: MA 1 Cancer Connection Inc PO Box 60452 Florence MA 010620452 043493483 501(c)(3) 42000 Support groups, complementary therapies, workshops and classes for women living with breast cancer and their families and caregivers. La Experanza The Hope of the Pioneer Valley Inc 237 South Street Northampton MA 01060 272760538 501(c)(3) 31792 Support group for Latina women living with breast cancer. Cancer House of Hope Inc 86 Court Street Westfield MA 010853511 043298631 501(c)(3) 17765 Partial funding (36%) of the expenses of the most well-attended CHH programming utilized by women with breast cancer. Baystate Health Inc 759 Chestnut Street Springfield MA 01199 042105941 501(C)(3) 6000000 Strategic initiatives Pioneer Valley Riverfront Club PO Box 60762 Longmeadow MA 01106 260251831 501(c)(3) 16000 Breast cancer survivors excercise and recreation program. YMCA of Greater Springfield 275 Chestnut Street Suite 1 Springfield MA 01104 041859893 501(c)(3) 12589 Breast cancer survivors excercise program. 6 5 Art therapy workshops for breast cancer survivors 1 13735 The healing art of Yoga for ongoing cancer recovery, and water dance 1 12090 Massage therapies to patients receiving chemotherapy 1 23775 Reiki for breast cancer patients and survivors in Franklin County 1 8175 Swedish Massage for breast cancer patients andsurvivors 1 8850 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule 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. X X X X 1 1 0 0 0 0 0 0 0 Mark R Tolosky 0 697835 0 441536 0 415673 0 28089 0 31211 0 1614344 0 0 Grace P Makari-Judson MD 276505 0 30232 0 23240 0 27750 0 17398 0 375125 0 0 0 Kevin Moriarty MD 417870 0 29751 0 1350 0 44062 0 26979 0 520012 0 0 0 Barbara W Stechenberg MD 132412 0 12299 0 9 0 22132 0 10463 0 177315 0 0 0 Dennis W Chalke 0 365785 0 155550 0 202350 0 28000 0 24277 0 775962 0 0 Gregory A Harb 0 444085 0 236430 0 119099 0 139147 0 22738 0 961499 0 0 Mark R Keroack MD 0 446725 0 170955 0 196695 0 119597 0 15636 0 949608 0 0 Michael F Moran 220502 0 51912 0 8882 0 27115 0 20444 0 328855 0 0 0 Deborah Morsi 167153 0 47884 0 54002 0 0 0 21419 0 290458 0 0 0 Deborah A Provost 207320 0 48664 0 8731 0 66546 0 9487 0 340748 0 0 0 Peter Lindenauer MD 236004 0 39852 0 18715 0 32418 0 20361 0 347350 0 0 0 Betty K Larue 168554 0 91912 0 7944 0 56804 0 24539 0 349753 0 0 0 David Y Chin PhD 211237 0 18490 0 12143 0 19691 0 26646 0 288207 0 0 0 Jason M Newmark 177104 0 62422 0 309 0 11910 0 19065 0 270810 0 0 0 Michael R Favreau 164339 0 41490 0 17984 0 62365 0 19246 0 305424 0 0 0 Keith C McLean-Shinaman 0 0 0 0 0 298986 0 0 0 10208 0 309194 0 0 Part I, Line 3 The 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-b Part 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. A MA Health & Educ Facil Authority - Ser G 042456011 57586CNHA 2005-10-27 71740000 MA HEFA Series G - See Part VI 0 0 0 B MA Health & Educ Facil Authority - Ser H 042456011 2007-01-18 10000000 MA HEFA Series H - See Part VI 0 0 0 C MA Health & Educ Facil Authority - Ser M2 042456011 2008-06-30 10157671 MA HEFA Series M2 - See Part VI 0 0 1 D MA Health & Educ Facil Authority - Ser IJK 042456011 57586EKC4 2009-06-25 198611250 MA HEFA Series IJK - See Part VI 0 0 0 A 21925000 71740000 735004 6990000 64014996 2005 0 1 1 1 B 4444445 10000000 72250 9927750 2006 0 0 1 1 C 2435438 10157671 76211 10081460 1999 1 0 1 1 D 199122425 1845403 93479 132183543 65000000 2012 1 0 1 1 A 0 0 1 1 1 1 0.00060 0.00060 0 0 1 B 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 D 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 1 1 Citibank 20.700000000000 0 0 0 0 1 B 0 0 1 0 1 0 0 0 1 C 0 0 0 1 1 0 0 0 1 D 0 0 0 1 1 0 0 0 1 A 1 B 1 C 1 D 1 Schedule K Part IV, Arbitrage, Line 2c Date Rebate Computation Performed Issuer Name: MA Health & Educ. Facil. Authority - Ser. G Date the Rebate Computation was Performed: 09/27/2006 Issuer Name: MA Health & Educ. Facil. Authority - Ser. M2 Date the Rebate Computation was Performed: 06/18/2013 Issuer Name: MA Health & Educ. Facil. Authority - Ser. IJK Date the Rebate Computation was Performed: 08/24/2012 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. A MA Development Finance Agency - Ser L 043431814 2011-11-02 25000000 MA DFA Series L - See Part VI 0 0 0 B MA Development Finance Agency - Cap Lease 043431814 2011-11-02 20000000 MA DFA Cap Lease - See Part VI 0 0 0 C MA Development Finance Agency - Ser M 043431814 2012-08-09 40137000 MA DFA Series M - See Part VI 0 0 0 A 903662 25022063 168438 24853625 2012 0 0 1 1 B 4945400 20013326 20013326 2012 0 0 1 1 C 1040000 40137000 229661 39907339 2004 1 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 0 1 0 1 0 0 0 1 C 0 0 1 0 1 0 0 0 1 A 1 B 1 C 1 American Excess Insurance Exchange (AEIX) Board Overlap 846614 See 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 Officers 1039446 See 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 Officers 1533300 See 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 Officers 3423000 See 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 Officers 6252 See 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 Officers 443656 See 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 Officers 1548150 See 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 Officers 111721093 See 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 Officers 96569 See 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 Officers 54173 See 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 Overlap 224355 See 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 Overlap 2987 See 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'Brien 46042 See Part V - Family member of John M. O'Brien employed by the filing organization. 0 Timothy S Rice Family member of Timothy S. Rice 132837 See Part V - Family member of Timothy S. Rice is employed by the filing organization. 0 Form 990, Part VI, Section A, line 1 a. 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 2 Gregory 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 3 Baystate 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 6 The filing organization has one member, Baystate Health, Inc. (BH). Form 990, Part VI, Section A, line 7a The Board of Trustees of the filing organization are the same individuals serving as members of the Board of Trustees of BH with the addition of the president of the medical staff of the filing organization. The Board of Trustees of BH are elected annually by the Board of Trustees of BH at their annual meeting. Form 990, Part VI, Section B, line 11 Prior to the filing of this return appropriate parts of this Form 990 were reviewed by representatives from the Tax, Finance, and Human Resources Departments of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs), some of whom are officers or trustees of the filing organization and by outside legal counsel. The entire return was reviewed by a tax expert from an outside accounting firm. The entire return was also reviewed prior to filing by the Audit and Compliance Committee of Baystate Health, Inc., which also includes some of the officers and trustees of the filing organization. The Form 990 was provided to all members of the Board of Trustees prior to filing. Form 990, Part VI, Section B, line 12c Baystate Health, Inc. (BH) 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 15 The 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 19 The organization makes its conflict of interest policy and financial statements available to the public at www.baystatehealth.org. Articles of organization and bylaws are generally available at the Commonwealth of Massachusetts website. Average hours per week: 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. Form 990, Part VII, Section A, Line 5 Certain officers or trustees of the filing organization are paid by an entity, Baystate Medical Practices, Inc. (BMP) EIN 04-2888373, which is part of the health care system to which the filing organization belongs but does not meet the technical requirements as a "Related Organization" per Schedule R. Compensation from BMP to the officers and trustees of the filing organization therefore, is reported as paid from an unrelated organization in Line 5 and according to the instructions reported as though paid by the filing organization. Other Fees Form 990, Part IX, line 11g BMP 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. Changes in Net Assets or Fund Balances: 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. Pioneer Valley Information Exchange LLC 101 Wason Avenue Suite 200 Springfield MA 01107 042790311 Operation of a health information exchange and related activities MA 0 0 Baystate Medical Center Inc Baystate Administrative Services Inc 759 Chestnut Street Springfield MA 01199 222747685 Administrative services MA 501 (c ) (3) 11c, IIIc Baystate Health Inc 0 Baystate Franklin Medical Center 164 High Street Greenfield MA 01301 042103575 Hospital MA 501 (c ) (3) 3 Baystate Health Inc 0 Baystate Health Foundation Inc 759 Chestnut Street Springfield MA 01199 043549011 Fundraising MA 501 (c ) (3) 7 Baystate Health Inc 0 Baystate Health Systems Inc Health & Welfare Benefits Plan 759 Chestnut Street Springfield MA 01199 222531644 Voluntary Employees' Benefit Association MA 501 (c ) (9) Baystate Health Inc 0 Baystate Health Inc 759 Chestnut Street Springfield MA 01199 042105941 Healthcare System Parent MA 501 (c ) (3) 7 Baystate Health Inc 0 Baystate Mary Lane Hospital Corporation 85 South Street Ware MA 01082 042103584 Hospital MA 501 (c ) (3) 3 Baystate Health Inc 0 Baystate Medical Center Auxiliary Inc 759 Chestnut Street Springfield MA 01199 046065279 Supporting organization for Hospital MA 501 (c ) (3) 7 Baystate Health Inc 0 Baystate Total Home Care Inc 50 Maple Street Springfield MA 01199 203260764 Real Estate and Other MA 501 (c ) (3) 11b, II Baystate Medical Center Inc 1 Visiting Nurse Assn and Hospice of Western New England Inc 50 Maple Street Springfield MA 01199 042105803 Homehealth and Hospice care MA 501 (c ) (3) 9 Baystate Health Inc 0 Health New England Inc Monarch Place Suite 1500 Springfield MA 011441500 042864973 HMO/Insurance MA Baystate Health Inc C 0 HNE Advisory Services Monarch Place Suite 1500 Springfield MA 011441500 043012347 Administrative Svs MA Health New England Inc C 0 Health New England Insurance Monarch Place Suite 1500 Springfield MA 011441500 043183019 Ancilliary Insurance MA Health New England Inc C 0 Health New England of Connecticut Monarch Place Suite 1500 Springfield MA 011441500 061398662 Dormant MA Health New England Inc C 0 Ingraham Corporation 759 Chestnut Street Springfield MA 01199 043016257 Health care and other business activities MA Baystate Health Inc C 0 Baystate Health System Ambulance Inc 759 Chestnut Street Springfield MA 01199 043018550 Ambulance Svs MA Ingraham Corporation C 0 BH Insurance Company Ltd North Church Street Georgetown CJ 980421413 Offshore captive Insurance CJ Baystate Health Inc C 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 Baystate Total Home Care Inc J 11203025 Baystate Total Home Care Inc I 6741389