BAYSTATE FRANKLIN MEDICAL CENTER: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
BAYSTATE FRANKLIN MEDICAL CENTER (EIN 04-2103575)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-08-13
IRS object ID
201312259349301501
Schema version
2011v1.5
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-08-13T09:28:37-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN346565596EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Ernst & Young LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1200 Claredon StreetAddressLine1
CityBostonCity
StateMAState
ZIP Code02116ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN042103575EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Baystate Franklin Medical CenterBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBAYSNameControl
Phone4137947872Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1164 High StreetAddressLine1
CityGreenfieldCity
StateMAState
ZIP Code01301ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDennis W ChalkeName
TitleSVP Finance & TreasurerTitle
Phone4137940000Phone
Date Signed2013-08-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJeanne M SchusterName
PTINP00743154PTIN
Phone6172662000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

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

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1759 Chestnut StreetAddressLine1
CitySpringfieldCity
StateMAState
ZIP Code01199ZIPCode
FieldValueIRS element (for citing)
Gross Receipts81285889GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.baystatehealth.org/fmc/WebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1895YearFormation
State Legal DomicileMAStateLegalDomicile
Activity Or Mission DescriptionThe mission of the organization is to improve the health of the people in our communities every day, with quality and compassion.ActivityOrMissionDescription
Nbr Voting Members Governing Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees783TotalNbrEmployees
Total Nbr Volunteers366TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year41276ContributionsGrantsPriorYear
Contributions Grants Current Year89950ContributionsGrantsCurrentYear
Program Service Revenue Prior Year74143198ProgramServiceRevenuePriorYear
Program Service Revenue CY79504590ProgramServiceRevenueCY
Investment Income Prior Year326232InvestmentIncomePriorYear
Investment Income Current Year227409InvestmentIncomeCurrentYear
Other Revenue Prior Year1501066OtherRevenuePriorYear
Other Revenue Current Year1249841OtherRevenueCurrentYear
Total Revenue Prior Year76011772TotalRevenuePriorYear
Total Revenue Current Year81071790TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year42689169SalariesEtcPriorYear
Salaries Etc Current Year42255014SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year37027183OtherExpensePriorYear
Other Expenses Current Year38499650OtherExpensesCurrentYear
Total Expenses Prior Year79716352TotalExpensesPriorYear
Total Expenses Current Year80754664TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-3704580RevenuesLessExpensesPriorYear
Revenues Less Expenses CY317126RevenuesLessExpensesCY
Total Assets BOY62064706TotalAssetsBOY
Total Assets EOY69519808TotalAssetsEOY
Total Liabilities BOY29462557TotalLiabilitiesBOY
Total Liabilities EOY33077315TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY32602149NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY36442493NetAssetsOrFundBalancesEOY
Mission DescriptionThe mission of Baystate Franklin Medical Center is to improve the health of the people in our communities every day, with quality and compassion.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense32892960Expense
Revenue30522074Revenue
DescriptionInpatient healthcare services - Providing inpatient community-based medicine and tertiary care to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY12, Baystate Franklin Medical Center provided 19,601 patient days of inpatient services, with 4,370 dischargesDescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense29780034Expense
Revenue33838718Revenue
DescriptionOutpatient healthcare services - Providing outpatient clinical services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY12, Baystate Franklin Medical Center had 87,089 outpatient visits.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense10719944Expense
Revenue11918849Revenue
DescriptionEmergency department services - Providing emergency department services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY12, Baystate Franklin Medical Center had 26,534 emergency department visits.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense1747824Expense
Revenue4073598Revenue
FieldValueIRS element (for citing)
Total Of Other Program Service Exp1747824TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev4073598TotalOfOtherProgramServiceRev
Total Program Service Expense75140762TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109672NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees783NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members20NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Peter Lyons Baystate Health IncBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4137940000TelephoneNumber

Address US AddressUS

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

Form990 Part VII Section A Form990PartVIISectionA (36 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Richard B Steele Jr
Chair1.00XX000
Victor Woolridge
Vice Chair1.00XX000
Allan W Blair
Trustee 10/1 - 12/31/111.00X000
Charles L D'Amour
Trustee1.00X000
John H Davis
Trustee 1/1 - 9/30/121.00X000
John A Egelhofer MD
Trustee1.00X000
John E Kole
Trustee 1/1 - 9/30/121.00X000
Grace P Makari-Judson MD
Trustee1.00X320107075990
John F Maybury
Trustee1.00X000
Alan D McClelland MD
Trustee1.00X341414040980
Steven M Mitus
Trustee1.00X000
John M O'Brien III
Trustee1.00X000
Anne M Paradis
Trustee1.00X000
Katherine E Putnam
Trustee1.00X000
Timothy S Rice
Trustee1.00X000
James P Sadowsky
Trustee1.00X000
David C Southworth
Trustee1.00X000
Barbara W Stechenberg MD
Trustee1.00X145851036735
Frances K Stotz CFP
Trustee 10/1 - 12/31/111.00X000
Katherine McG Sullivan
Trustee1.00X000
Mark R Tolosky
Trustee1.00X0153664099365
Howard G Trietsch MD
Trustee1.00X000
Steven M Wenner MD
Trustee 10/1 - 12/31/111.00X000
Charles Gijanto
President, BFMC1.00X0329648112585
Dennis W Chalke
Treasurer1.00X067263192548
Kristin R Delaney
Clerk1.00X09451147834
Frances C Grabowski
Assistant Clerk 10/1 - 12/31/111.00X05552217868
Patricia A Sheldon
Assistant Clerk 1/1 - 9/30/121.00X06518316061
Gerda Maissel MD
CMO - Northern Region50.003321560145433X
David M Farrick
COO BFMC50.00151758036721X
Deborah A Palmeri
CNO/Dir Patient Care Servi50.00147627057130X
Edward G Tessier
Pharmacist50.00127130018546X
Brian P Joyce
Manager FMC Pharmacy50.00119314037642X
Regina O Campbell
Dir Quality & Risk Managem50.00117496041767X
Donald McCool
Pharmacist50.00114503034032X
Keith C McLean-Shinaman
Former Treasurer0.00080276836779X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1917356TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs3556903TotalReportableCompFrmRltdOrgs
Total Other Compensation948016TotalOtherCompensation
Number Individuals GT100 K13NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources1CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Baystate Administrative Services Inc
759 Chestnut StreetSpringfieldMA01199Management/I.S, Services7182362
Baystate Medical Practices Inc
759 Chestnut StreetSpringfieldMA01199Physician Services/ Lab Services5017527
Baystate Medical Center Inc
759 Chestnut StreetSpringfieldMA01199Lab Services996376
Angelica Textile SVC
125 Bath StreetBallston SpaNY120201300Linen Services319520
Locumtenenscom
PO Box 405547AtlantaGA303840001Physician Services292168
FieldValueIRS element (for citing)
Number Of Contractors GT100 K7NumberOfContractorsGT100K
Government Grants48718GovernmentGrants
All Other Contributions41232AllOtherContributions
Total Contributions89950TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Net Patient Revenue9000997758403777584037
CMS Elec Med Rec Fdg90009913830361383036
Rental Income From Rel532000537517537517
FieldValueIRS element (for citing)
Total Program Service Revenue79504590TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column261211TotalRevenueColumn
Exclusion$261,211ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real134427Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real179447Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-45020Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-45020TotalRevenueColumn
Exclusion-$45,020ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other850Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other34652Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-33802Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-33802TotalRevenueColumn
Related Or Exempt Function Income-33802RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
Net As Rsd from Fnd900099427675427675
Cafeteria Income900099412070$412,070
Printing In House900099182330182330

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column272786TotalRevenueColumn
Related Or Exempt Function Income272446RelatedOrExemptFunctionIncome
Exclusion$340ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue1294861TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column81071790TotalRevenueColumn
Related Or Exempt Function Income80353239RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$628,601ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total354556Total
Program Services354556ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total32983874Total
Program Services31736709ProgramServices
Management And General1247165ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2194194Total
Program Services2106426ProgramServices
Management And General87768ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4303801Total
Program Services4131649ProgramServices
Management And General172152ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2418589Total
Program Services2321845ProgramServices
Management And General96744ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total5427551Total
Program Services2103966ProgramServices
Management And General3323585ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total116895Total
Program Services116895ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total38866Total
Management And General38866ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total18824Total
Management And General18824ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total16804Total
Program Services14897ProgramServices
Management And General1907ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total21038182Total
Program Services20455500ProgramServices
Management And General582682ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total3456712Total
Program Services3456712ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1533636Total
Program Services1533636ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total88651Total
Program Services61482ProgramServices
Management And General27169ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total34956Total
Program Services22159ProgramServices
Management And General12797ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total121230Total
Program Services121230ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4229837Total
Program Services4225594ProgramServices
Management And General4243ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total180435Total
Program Services180435ProgramServices

Other Expenses OtherExpenses

FieldValueIRS element (for citing)
DescriptionProvision for UncollectDescription
Total2197071Total
Program Services2197071ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total80754664Total
Program Services75140762ProgramServices
Management And General5613902ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2474672BOY
EOY10060311EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY7337412BOY
EOY7652131EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1124060BOY
EOY1108680EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY101031BOY
EOY83592EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis102454343LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec69359467LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY34112886BOY
EOY33094876EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY327351BOY
EOY566577EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY16587294BOY
EOY16953641EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY62064706BOY
EOY69519808EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY5892430BOY
EOY5925550EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY7141116BOY
EOY6762950EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY16429011BOY
EOY20388815EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY29462557BOY
EOY33077315EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY18933027BOY
EOY21656184EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY5914519BOY
EOY6463576EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY7754603BOY
EOY8322733EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY32602149BOY
EOY36442493EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY62064706BOY
EOY69519808EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses317126ReconcilationRevenueExpenses
Reconcilation Other Changes3523218ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations1RalliesDemonstrations
Rallies Demonstrations$18,824RalliesDemonstrationsAmount
Other Activities0OtherActivities
Total Lobbying Expenditures IIB18824TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart IV, Supplemental Information:Identifier
ExplanationBaystate Franklin Medical Center 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 the dues listed as lobbying expenses for the year ending September 30, 2012 is $ 18,824.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis261921OtherCostOrOtherBasis
Book Value261921BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis61277786OtherCostOrOtherBasis
Depreciation35888362Depreciation
Book Value25389424BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis36753662OtherCostOrOtherBasis
Depreciation30058836Depreciation
Book Value6694826BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis4160974OtherCostOrOtherBasis
Depreciation3412269Depreciation
Book Value748705BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings33094876TotalOfBookValueLandBuildings

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
Funds Held By Bond Trustee101872
Benefical Interest in Perpetual Trust BHF4815662
Due from Affiliated Companies25478
Estimated Final Settlement Receivable2039982
Interest- Net assets of BHF9970647
FieldValueIRS element (for citing)
Total Book Value Other Assets16953641TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
Due to Affiliates$1,307,323
Estimated Final Settlement Payable$4,820,295
Insurance Liability Loss Reserve$132,000
Minimum Pension Liability$14,129,197
FieldValueIRS element (for citing)
Total Of Amounts20388815TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

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

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense2571610TotalCommunityBenefitExpense
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Net Community Benefit Expense1178626NetCommunityBenefitExpense
Percent Of Total Expense0.01500PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

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Direct Offsetting Revenue10786856DirectOffsettingRevenue
Net Community Benefit Expense3251270NetCommunityBenefitExpense
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Unreimbursed Costs UnreimbursedCosts

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Total Community Benefit Expense2443444TotalCommunityBenefitExpense
Direct Offsetting Revenue2304286DirectOffsettingRevenue
Net Community Benefit Expense139158NetCommunityBenefitExpense
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Total Charity Care TotalCharityCare

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Net Community Benefit Expense4569054NetCommunityBenefitExpense
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Community Health Services CommunityHealthServices

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Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
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Net Community Benefit Expense1974931NetCommunityBenefitExpense
Percent Of Total Expense0.02510PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

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Net Community Benefit Expense6859838NetCommunityBenefitExpense
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Economic Development EconomicDevelopment

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Total Community Building Expense1944TotalCommunityBuildingExpense
Net Community Building Expense1944NetCommunityBuildingExpense
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Total Community Building Expense1944TotalCommunityBuildingExpense
Net Community Building Expense1944NetCommunityBuildingExpense
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Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$751,044BadDebtExpenseAmount
Amount Attributable To84978AmountAttributableTo
Amount Reimbursed By Medicare21549474AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare22030820CostOfCareReimbursedByMedicare
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Costing Methodology Used CostingMethodologyUsed

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Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
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Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

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Facility Number1FacilityNumber

Name Name

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Business Name Line1Baystate Franklin Medical CenterBusinessNameLine1

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Address Line1164 High StreetAddressLine1
CityGreenfieldCity
StateMAState
ZIP Code01301ZIPCode
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Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

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Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent400.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
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Explains Application Method1ExplainsApplicationMethod
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Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Medicare RateXMedicareRate
Amounts Generally Billed0AmountsGenerallyBilled
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Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

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Number Of Other Facilities2NumberOfOtherFacilities

Other Facilities OtherFacilities (2 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Baystate Rehabilitation Care at BFMC
48 Sanderson St Lev 1 Ste 3GreenfieldMA01301Rehabilitation Clinic
Outpatient Behavioral Health Srvcs
48 Sanderson St 2nd FlrGreenfieldMA01301Partial Hospitalization Services

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
Part I, Line 7: Line 7a (Financial Assistance at Cost) - Column (e) Net 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) - Column (e) Net 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) - Column (e) Net 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 7g (Subsidized Programs) - Column (e) Net community benefit expense was derived using the organization's cost accounting system. The expense relates to the inpatient behavioral health program.
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): Bad debt expense of $2,197,071 was 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).
Part II: Specific to Part II Baystate Franklin Medical Center paid dues to the Franklin County Chamber of Commerce in the amount of $1574, to Shelburne Falls Business Association in the amount of $250 and to the Greenfield Business Association in the amount of $120 for FY12. Baystate Franklin Medical Center is a dues paying member of the local Franklin County Chamber of Commerce, and the Shelburne Falls and Greenfield Business Associations. BFMC participates in the Chamber and the local business associations as we are one of the largest local employers in our service area. The Chamber and its membership coordinate activities toward a common purpose of sustainability and economic growth for the region. The following description is not quantified specifically in Part II of Schedule H. Baystate Franklin 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. BFMC extends the traditional definition of "health" to include economic opportunity, affordable housing, education, safe neighborhoods, the arts, and supporting and valuing diversity - all elements that enable families and communities to thrive. In keeping with our commitment to improve health, Baystate Franklin Medical Center provides many valuable services, resources and programs beyond the walls of the hospital and into the communities and homes of the people we serve.
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 expense 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 bad debt expense 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 Baystate Franklin Medical Center's charity care program had they applied. For this reason, we believe the amount should be treated as community benefit expense in Part I. The financial statements do not contain a footnote describing bad debt expense.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 D Part V (outpatient) of the hospital's 2012 Medicare cost report, based on Medicare costing principles. We believe the shortfall reported on line 20 should be treated as community benefit expense for tax reporting purposes because providing care for the elderly is a key component of our commitment to the community. The unreimbursed expenses should be treated similarly to unreimbursed Medicaid since the majority of the local elderly population is not affluent.
Part III, Line 9b: For patients who are known to qualify for Charity Care or Financial Assistance: The patient may have requested assistance up front at time of service with a Financial Counselor or the Patient could have asked for assistance after receiving their bill by contacting our Patient Billing Services Representatives. The Financial Counselor will assist the patient in applying for the appropriate type of assistance based on their income and circumstances. Once approved for a State Medicaid or other program, all billing and collection activity will stop (except for required co-payments or deductibles).For all other patients, our statements contain information regarding how to apply for financial assistance. Notices concerning availability for assistance are also posted at patient care sites.
Part VI, Line 2: Baystate Health completed a community health needs assessment in July 2010. During this assessment process information was gathered and reviewed from various community sources across several counties and Baystate Health's three hospitals and their respective service areas including the following: 1. Baystate Medical Center (BMC) and Hampden County; 2. Baystate Franklin Center (BFMC) and Franklin County; 3. Baystate Mary Lane Hospital (BMLH) and Hampshire County and 13 Quaboag Hills communities.Baystate Health used the Association for Community Health Improvement's (ACHI) Community Health Assessment Toolkit to complete a thorough community health planning and needs assessment process. The toolkit included six core process steps and had a particular emphasis on community engagement. The six-step process included: 1. establishing the assessment infrastructure; 2. defining the purpose and scope; 3. collecting and analyzing data; 4. selecting priorities (included community engagement); 5. documenting and communicating results and 6. planning for action and monitoring progress.The FY2010 community needs assessment process gathered information and reviewed data from a number of sources, including the following: 1. Healthy People 2020 (formerly Healthy People 2010) indicators collected by the Massachusetts Department of Public Health and the Centers for Disease Control and Prevention were major sources of data for community health needs assessment and planning information; 2. Massachusetts Department of Public Health, several of its websites, MassCHIP, and key MDPH staff provided county-level and locality-based data for municipal and neighborhood geographic areas; 3. morbidity and mortality data was drawn from Baystate Health's internal hospital discharge data and statewide data sources. This data, which generally includes reasons for hospitalization and length of stay, can contribute to measuring the burden and cost of illness and disability in the community; 4. both by internal and external respondents in the health care, human service and public health field and unaffiliated stakeholders (community residents) participated in focus groups; 5. hospital Community Benefits Advisory Council, hospital advisory board members, and local community coalitions and task forces played a key role in helping the hospital identify community health needs; 6. existing community needs assessment data (United Way, Pioneer Valley Planning Commission, and Community Action Programs) was included in this assessment; 7. surveys of community stakeholders - expert testimony and resident (lay) opinions - were used to identify and prioritize community health needs.Baystate Franklin Medical Center's needs assessment community partners included the Community Development Corporation, DIAL/SELF, Early Childhood Collaborative, Food Bank of Western MA, Franklin County Community Action Program, Franklin County Community Health Center, Franklin County Home Care, Franklin Regional Council of Governments (COG), Greenfield Community College, Interfaith Council, Montague Catholic Ministries, MotherWoman, School Nurses Association, Service Net, Superintendent of Schools, TRIAD - Jail program, United Way, and YMCA of Greenfield.The ranking and prioritization process and development of target populations was based on input from several sources including surveys of community stakeholders, focus groups of key constituents and key internal and external community member interviews. The needs assessment was a balanced and comprehensive community perspective reflecting the values and experiences of both health care providers and experts and resident opinions in ranking and prioritizing community needs.Four broad health priorities were subjected to ranking and prioritization. Polling of key participant organizations and a variety of other discussions resulted in the following health priorities and target populations. Baystate Franklin Medical Center's health priorities include: 1. promoting wellness of vulnerable populations; 2. reducing racial and ethnic health disparities; 3. chronic disease management in disadvantaged populations; and 4. supporting health care reform.Baystate Franklin Medical Center's target populations include: public school students throughout Franklin County; teachers seeking to enhance their science curriculum via hands-on learning in health care applications; homebound seniors at greater risk for medication management challenges and for falls or other injuries; low-income and obese community members at high-risk of developing diabetes; persons dealing with chronic diseases and other health challenges, for whom sharing the experience with peers has been proven beneficial to long-term health outcomes; and access to care issues with a targeted focus on uninsured or underinsured residents of our communities.Baystate Franklin Medical Center joined the Coalition of Western MA Hospitals, a partnership between seven (7) non-profit hospitals in western Massachusetts; 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). The Coalition, formed in early 2012, developed a successful partnership to identify and address the health needs of their communities while sharing limited resources and enhancing the quality of data collection to benefit the Pioneer Valley community as a whole. The Coalition engaged Verit-Healthcare Consulting to begin community health needs assessments that consider multiple data sources, including secondary data (regarding demographics, health status indicators, and measures of health care access), assessments prepared by other organizations in recent years, and primary data derived from a community survey and from interviews with persons who represent the broad interests of the community, including those with expertise in public health. The needs assessment process will culminating with hospital-specific CHNA reports in April 2013 followed by the Coalition hospital's development of their own respective implementation strategies describing how the hospital plans to address or not address priority needs identified in CHNA report.
Part VI, Line 3: Baystate Franklin Medical Center (BFMC) 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. BFMC 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. BFMC 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 BFMC.Baystate Franklin 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 BFMC 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 Franklin Medical Center has Financial Counselors available to help patients apply for available financial assistance programs that may cover unpaid hospital bills, including a variety of federal and state programs as well as financial assistance through Baystate Franklin Medical Center. BFMC is committed to ensuring that patients or prospective patients in the community are aware of financial assistance programs. For uninsured or underinsured patients, BFMC will assist in applying for available financial assistance programs. To assist patients the hospital provides all patients with a general notice of the availability of programs in both the initial bill sent to patients as well as in general notices posted throughout the hospital.The goal of these notices is to assist patients in applying for coverage within a financial assistance program. When applicable, BFMC also assists patients in applying for coverage of services as a Medical Hardship based on the patient's documented income and allowable medical expenses. BFMC 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 BFMC's own internal financial assistance program. BFMC also notifies patients about available payment plans based on their family size and income. Signs are posted around the hospital to notify patients of the availability of financial assistance programs. Signs are clearly visible in the hospital's service area: they are 8-1/2 x 11 inches and the Header print font is 32 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 Franklin 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 Franklin Medical Center (BFMC) is located in Greenfield, Massachusetts, the county seat of rural Franklin County. Its service area also includes parts of rural northwestern Worcester County, referred to as the North Quabbin Region.The BFMC service area encompasses a large rural area of over 880 square miles inhabited by 86,871 people (US Census, America Communities Survey, 2009). The community consists of the Massachusetts Department of Public Health's Community Health Network Area (CHNA 2 Upper Valley Health) and is comprised of the following 30 towns: Ashfield, Athol, Bernardston, Buckland, Charlemont, Colrain, Conway, Deerfield, Erving, Gill, Greenfield, Hawley, Heath, Leverett, Leyden, Monroe, Montague, New Salem, Northfield, Orange, Petersham, Phillipston, Rowe, Royalston, Shelburne, Shutesbury, Sunderland, Warwick, Wendell and Whately. The average family income is very low and the BFMC service area is one of the poorest regions in the state. According to the 2010 Census, the population of Franklin County is 94% white. From 1990 to 2009, the proportion of Latinos in the population of Franklin County grew from 1.2% to 2.8%, a 133% increase. The proportion of Franklin County residents who are Asian doubled between 1990 and 2000, and then stabilized. The Latino members of our community are primarily of Mexican and Puerto Rican origin. The median age for Franklin County is 40, which is slightly higher than the median age for the Commonwealth: approximately 37. Eighty-eight percent of County residents over 25 have a high school degree or higher compared with almost 85% for the Commonwealth. Approximately 29% of the County have a bachelor's degree or higher compared with 33% for the Commonwealth. The poverty rates in the County range from 3% in Whately to almost 22% in Monroe. The American Community Survey from 2006-2008 estimates median household income for Franklin County as $51,102 compared with $64,684 in Massachusetts. In Franklin County, 15.5% of the population aged 0 - 17 were living in poverty compared with 12.6% for Massachusetts and 18.2% for the United States. Almost 40% of the housing in the County was built before 1939, a far higher percentage than the statewide rate of 13%. Of the 30 towns in the BFMC service region, seven have a population of under 1,000, 13 have a population of between 1,000 and 2,000, and two have a population of between 2,000 and 3,000. To summarize, the region has more Caucasian residents, is slightly older, slightly less well-educated, and has older housing than the state as a whole. Because it is a very large, rural region, BFMC has pockets of great poverty and a growing immigrant population that are not apparent from these statistics. The 26-towns of Franklin County cover 727 square miles and have a population of 71,826 people (U.S. Census, American Communities Survey 2009). With a population density of 98.7 people per square mile it is the most rural county in Massachusetts. The towns of Greenfield, Orange and Montague (pop. 13,761, pop. 7,518 and pop. 8,489 respectively) make up nearly 40% of the Franklin County's population. The four Worcester County towns in the North Quabbin area are anchored by the town of Athol (pop. 11,827). In the past, these population centers were the "mill towns" of the region, supported by textiles and light manufacturing and surrounded by small farming communities. In the last thirty years the manufacturing base of the region has dissipated. Over the last three decades, Massachusetts has experienced a technology-based economic boom that completely bypassed the western part of the state. Unfortunately, the residents of the BFMC 30-town communities now suffer an economic downturn that has not bypassed them. Nationwide and in Massachusetts, poverty rates are higher in rural areas than in metropolitan areas. Rural-based adults have less formal schooling, and a greater share derive their livelihood from low-skill, low-wage jobs. The lower population density in our rural community makes it much more difficult to have all support services -- public transportation, education and job training, child care, emergency services, and health and mental health care -- available and easily accessible. Much of BFMC 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. Perinatal and child indicators in the BFMC service area are similar to state-wide indicators. Infectious disease indicators in the BFMC service area indicate that pertussis is a public health issue that needs to be addressed. Chronic disease indicators in the BFMC service area indicate that persons die of cancer and cardiovascular disease prematurely in the community at a higher rate than rest of the state. In the BFMC service area there is a higher rate of discharges for bacterial pneumonia in comparison to the rest of the state, while the community fares better than the state in the area of asthma and angina. The BFMC service area is similar to the rest of the state in meeting Healthy People 2010 Chronic Disease Objectives and fares considerably better in meeting objectives related to reducing asthma hospitalizations. The BFMC service area is similar to the rest of the state in meeting Healthy People 2010 Maternal Child Health Objectives.
Part VI, Line 5: Baystate Franklin Medical Center has a responsibility to respond to health care needs unsupported by government programs. In exchange for this responsibility, BFMC 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 Franklin 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 Franklin 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 Franklin Medical Center's Community Benefits Mission is to reduce health disparities, promote community wellness and improve access to care for vulnerable populations. BFMC 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 Franklin Medical Center provides high quality inpatient and outpatient services to residents of rural Franklin and Hampshire counties and Southern Vermont. The Birthplace, Cardiopulmonary Services, a Dialysis Unit, outpatient surgical services, rehabilitation and sports medicine services, and orthopedics are some of the specialized programs available at this acute care facility. In addition, Baystate Franklin 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 Franklin 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 Franklin Medical Center's emergency department is open to all in need of care and services; no one requiring emergency care is denied treatment. Additionally, 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 selects 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 Franklin Medical Center's Patient and Family Advisory Council facilitates 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 Franklin 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.In addition to Tufts University School of Medicine Baystate Health's other education affiliations & accreditations include Accreditation Council for Graduate Medical Education (ACGME), American College of Nurse-Midwives, Accreditation Commission for Midwifery Education, Midwifery Institute of Philadelphia University, American International College, Elms College, Fitchburg State College, Greenfield Community College, Holyoke Community College, Springfield Technical Community College, University of Massachusetts Amherst, American Society of Health System Pharmacists, Massachusetts College of Pharmacy and Health Sciences-Worcester, Accreditation Council for Continuing Medical Education, Massachusetts Association of Registered Nurses, Inc. (an accredited approver by the American Nursing Credentialing Center's (ANCC) Commission on Accreditation), American Psychological Association, American Heart Association, Global Health Education Consortium, Medical Library Association.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. Many of Baystate Health's physicians, researchers, and leaders also serve in leadership roles with our affiliates, which include the following organizations; Tufts Clinical and Translational Science Institute; University of Massachusetts Amherst; Eastern Cooperative Oncology Group (ECOG); Childrens Oncology Group (COG); Gynecologic Oncology Group (GOG); Radiation Therapy Oncology Group (RTOG); Massachusetts Society for Medical Research; American Association for Laboratory Animal Science; Massachusetts Technology Collaborative (MTC); Regional Technology Corporation (RTC); Western Massachusetts Economic Development Council; The Association of University Technology Managers; Massachusetts Association of Technology Transfer Offices (MATTO).
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 are Baystate Medical Center, Baystate Franklin Medical Center, and Baystate Mary Lane Hospital and 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 and its affiliates has 1,689 medical staff, 2,536 nurses and 2,185 new residents and fellows, medical students, nursing students, allied health students being educated for the future. Additionally, 1,107 volunteers and auxiliary members donated 112,602 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. In FY 2012 Baystate Medical Center provided $17.0 million in financial assistance and means-tested government programs, $35.6 million in health professions education, $6.1 in subsidized health services, $18.7 million in research and $3.4 million in community health improvement services. 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, assisting low-income patients access free prescription medications 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 and Hampshire counties and Southern Vermont. The Birthplace, Cardiopulmonary Services, a Dialysis Unit, outpatient surgical services, rehabilitation and sports medicine services, and orthopedics are some of the specialized programs available at this acute care facility. In FY2012 Baystate Franklin Medical Center provided $4.6 million in financial assistance and means-tested government programs, $2.0 in subsidized health services and $312,971 in community health improvement services. BFMCs 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 more than twelve Central Massachusetts communities. In addition to offering a wide spectrum of services from women's health, OB/GYN and pediatrics to surgical, intensive care and emergency care. In FY2012 Baystate Mary Lane Hospital provided $1.3 million in financial assistance and means-tested programs and $291,088 in community health improvement services. 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 90 community members (22 community members in FY 2012) have taken the EMT Basic Course. In December 2010 Baystate Mary Lane Hospital sponsored the first Paramedic Training program. A total of 25 EMT Basic candidates enrolled in this new class held at the hospital two nights a week. Through 2012 BMLH physicians shared their expertise beyond the walls of the hospital by offering high quality training and continuing education programs at no cost to EMS providers in our communities. The close working relationship between Emergency Physicians and EMS providers is essential to ensuring that patients receive the highest quality care in the field. BMLH provided critical support and resources to the community at large through our Support Groups including; Alcoholic Anonymous, Caregivers Support Group, Quilting Support Group for those touched by Cancer, Diabetes Support Group, Grieving Support Group, Hepatitis C Support Group & WIC Sponsored Breast Feeding Support Group. In addition, BMLH and its staff offered over 100 outreach programs providing a variety of education and wellness seminars to the community at large at no cost. These programs were presented by physicians, nurses and staff that work at the hospital and addressed ways to live healthier by offering a variety of educational opportunities and health screening. Lectures and screenings were offered at the hospital and in community settings including area schools and senior centers, and promoted disease prevention, behavior change, and healthier lifestyles for community members of all ages. In addition, BMLH HealthBeat TV, a monthly 30-minute cable access talk show produced, directed and hosted by Baystate Mary Lane Hospital employees, engages the hospital's physicians, employees, patients and community leaders in discussions of interest to residents of the 15-town Quaboag Hills region. Topics range from winter health safety, cancer, Lyme's disease to stroke awareness. The program runs more than 60 times a month.Baystate 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. BMP, 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, BMP may provide such care free of charge or at amounts below its normal charges. In FY 2012 BMP provided $4,115,241 in financial assistance. In addition to the charity care provided to patients, BMP's physicians participate in many and varied ongoing community outreach initiatives in the areas of education, employment, safety and health. BMP has also taken a leadership role in strengthening the health of disadvantaged citizens in surrounding communities including specific focus on AIDS and HIV and by providing physician staffing for three community-based health centers through Baystate Medical Center.Visiting Nurse Association and Hospice of Western New England, Inc. (VNAH) based in Springfield, Massachusetts is a tax-exempt, not-for-profit corporation organized to support and assist Baystate Health and its affiliate hospitals, including BMC and BMLH, each of which is a Massachusetts not-for-profit corporation, in achieving the fulfillment of their clinical, teaching, research, and other missions related to health care. VNAH is a comprehensive home health care agency committed to providing the highest quality care to patients and families, primarily in the home setting.
VNAH has the expertise to meet individual needs by bringing experienced nurses, rehabilitation therapists, social workers and home care aides to patients' homes.The Home Care Program of Baystate's VNAH serves over 6,000 patients annually of which approximately 950 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 VNAH 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 140 to 180 patients of all ages. In FY 2012 a total of 128,605 home visits were made by Baystate Visiting Nurse Association & Hospice nurses. Additionally, the VNAH provided $30.2 million in financial assistance for FY 2012. 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 2012 for the Hospital of the Future and an additional $5.7 million through system wide annual fundraising efforts. Along with the Campaign for Baystate Medical Center's Hospital of the Future capital expansion project, 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 other activities regarding promotion of community health.In FY 2012 Baystate Health interpreters provided over 142,471 sessions in 49 languages to help deliver a positive patient care experience and 4,601 pages of documents were translated for providers. Interpreter sessions included in person, telephonic and video interpreting. 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 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 the Baystate Franklin Medical Center and Baystate Mary Lane Hospital.Baystate Health is a nationally accredited provider of continuing education for health care professionals on staff and in the community. 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 2012, Baystate Health ran 65 courses for a total of 1,143 hours of continuing education activities. A total of 14,173 health care professionals attended these live activities. All courses and sessions were attended by both employees and non employees. 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 us BMC to further its institutional commitment to the Advancement of Knowledge. 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 and diabetes and metabolism. 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 preventiveinterventions. Baystate Administrative Services, Inc. the management company of the 3 hospitals 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 the region. The Chamber and its membership coordinate activites toward a common purpose of sustainability and economic growth for the region. The amount paid in dues for FY 2012 was $57,952.Other Baystate Health affiliations include Council of Teaching Hospitals and Health Systems (COTH) of the Association of American Medical Colleges (AAMC), Alliance of Independent Academic Medical Centers (AIAMC), and Group on Regional Medical Campuses (GRMC) of the Association of American Medical Colleges (AAMC), Joint Commission and Medical Library Association (MLA). Baystate Health and its affiliates are committed to creating healthier communities and continue to partner with members of the community to ensure we are meeting the diverse needs of the community. Baystate Health extends the traditional definition of "health" to include economic opportunity, affordable housing, education, safe neighborhoods, the arts, and supporting and valuing diversity - all elements that enable families and communities to thrive. In keeping with this commitment to improve health, Baystate Health and its various entities provide many valuable services, resources, programs and financial support - beyond the walls of the hospitals and into the communities and homes of the people we serve.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; including smoking cessation programs, parent education classes and babysitting academy. Some classes are free while others are offered at a reasonable fee. No one is turned away due to inability to pay. 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.(Continued)Form 990, Schedule H, Part VI, Line 6
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 116 loans, a total of $785,973, to help employees become homeowners in communities served by Baystate Health hospitals, helping to stabilize housing in those communities. Specific to FY 2012, 15 neighbor loans were awarded, for a total of $112,500Since 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 22,000. Now in its 20th year, Rays of Hope has raised over $11.08 million - all of which has been awarded locally throughout western Massachusetts. 2009 marked the first year the event expanded into Franklin County. Funding benefits the Baystate Regional Cancer Program's Comprehensive Breast Center, breast health programs at Baystate Medical Center in Springfield, Baystate Franklin Medical Center in Greenfield, Baystate Mary Lane Hospital in Ware, local breast cancer research, outreach and education, and various community support projects and organizations. In 2011 $1.5 million was awarded over five years to form the Rays of Hope Center for Breast Cancer Research at the Pioneer Valley Life Sciences Institute, 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 workforcecampaigns 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 2012, raising a total of $400,000. Baystate Mary Lane Hospital employees raised $11,754 for the United Way of Hampshire County.See also additional information regarding Baystate Health, Inc. and itsaffiliates promotion of community health above in Line 5.Baystate Franklin Medical Center intends to be in compliance with 501(r) regulations when they become final.(Continued)Form 990, Schedule H, Part VI,Line 6
MAReports Filed With StatesPart VI, Line 7

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement1EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Grace P Makari-Judson MD
2773850207250219970494080265820396097000
Alan D McClelland MD
285231053312028710241320168480382394000
Barbara W Stechenberg MD
13119001396806930221320146030182586000
Mark R Tolosky
0696553031585605242310586330407320163600500
Charles Gijanto
0280176037638011834088631023954044223300
Dennis W Chalke
036318001316250177826058000034548076517900
Gerda Maissel MD
27794803409402011401284530169800477589000
David M Farrick
14118901011904500141450225760188479000
Deborah A Palmeri
136363010007012570305120266180204757000
Brian P Joyce
1191100002040195680180740156956000
Regina O Campbell
10946206216018180181700235970159263000
Keith C McLean-Shinaman
02764850137200038908300036779083954700

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 3The board of the filing organization has appointed the compensation committee of Baystate Health, Inc., a related organization and the parent organization of the health 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 data to establish the compensation of its key officers, directors, and employees, which includes the filing organization's top management officials, and approves the compensation of those individuals.
Part I, Lines 4a-cPart I, Lines 4a-c: 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 $145,066 is included in column E. This amount was earned in 2011. Charles Gijanto - Supplemental Retirement of $72,706 is included in column E. This amount was earned in 2011. Gerda Maissel, MD- Supplemental Retirement of $6,949 is included in column E. This amount was earned in 2011. Grace Makari-Judson, MD- Supplemental Retirement of $7,354 is included in column E. This amount was earned in 2011. Allan McClelland, MD- Supplemental Retirement of $4,532 is included in column E. This amount was earned in 2011. Keith C. McLean Shinaman - Supplemental Retirement of $41,190 is included in column E. This amount was earned in 2011. Mark R. Tolosky - Supplemental Retirement of $332,054 is included in column E. This amount was earned in 2011. Line 4c The supplemental retirement plan offered to Mr. Tolosky from 1997-2002 provided the right to purchase mutual fund shares at a specified price, with the rights expiring at the end of the 10 years. The 2011 compensation of $130,991 was based on the difference between the fair market value at the date of exercise and the exercise price.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1MA Health and Education Facilities AuthorityBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN042546011IssuerEIN
Date Issued2005-02-11DateIssued
Issue Price9100000IssuePrice
Description Of PurposeMHEFA Series M-4; See Section VDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired2337050AmountRetired
Total Proceeds9766531TotalProceeds
Amount In Reserve Fund67668AmountInReserveFund
Credit Enhancement45500CreditEnhancement
Capital Expenditures8963500CapitalExpenditures
Other Spent Proceeds23332OtherSpentProceeds
Year Of Subst Completion2007YearOfSubstCompletion
Current Refunding0CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty1MngmentCntrctBondFinancdPrprty
Engage Bond Counsel Contracts1EngageBondCounselContracts
Any Research Agreements0AnyResearchAgreements
Prcntge Prvt Business Use By Others0.00730PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00730TotalPrivateBusinessUse
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue1VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate
FieldValueIRS element (for citing)
Fed Tax Requirements ComplianceXFedTaxRequirementsCompliance

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierPart I, Column (f) Description of Purpose (continued):Identifier
ExplanationA - MHEFA Capital Asset Program Series M-4 Per the Official Statement, the purpose of the bond are three projects ("The Project") all to be owned and operated by Franklin Medical Center, to be located at 164 High Street, Greenfield, Massachusetts, consisting of: (a) the renovation and expansion of the radiology department(including a CAT scan suite, three mammography rooms and one ultrasound room) and the emergency department; (b) acquisition of equipment for the radiology department (including one CAT scan and one mammography unit) and for the emergency department; and (c) the renovation of approximately 28,400 square feet of inpatient units. The HEFA indebtedness listed is a pool loan therefore the questions are being answered with respect to Baystate Franklin Medical Center's pool loan alone rather than with respect to proceeds loaned to other conduit borrowers. There is no CUSIP associated with this loan. Part II, Line 7, The organization follows management practices and procedures to ensure the post-issuance compliance of its tax exempt bond liabilities and is currently in the process of reviewing and modifying these practices. Part IV, Line 1, Column A: A rebate calculation was performed and no amounts were owed, therefore, no Form 8038-T was required to be filed.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (7 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
American Excess Insurance
Board Overlap29232See Part V - Mark Tolosky, President of the filing organization is also Chairman 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 Officers35000See Part V - The filing organization made payments to BHP for annual support fees. BHP is an affiliate corporation of the filing organization.0
Baycare Health Partners Inc (BHP)
Common Board Members or Officers135962See Part V - The filing organization received payments from BHP for patient care services for which BHP is the intermediary between the filing organization. BHP is an affiliate corporation of the filing organization.0
Health New England Inc (HNE)
Common Board Members or Officers10859895See Part V - The filing organization received payments from HNE related to medical claims. HNE is an affiliate corporation of the filing organization.0
Franklin MRI Center LLC (FMRI)
Common Board Members or Officers128805See Part V - Dennis W. Chalke, Treasurer of the filing organization is also on the board of directors of Franklin MRI Center, LLC. (FMRI). The filing organization paid FMRI for patient care services. FMRI is an affiliate entity of the filing organization.0
Franklin MRI Center LLC (FMRI)
Common Board Members or Officers253900See Part V - Dennis W. Chalke, Treasurer of the filing organization is also on the board of directors of Franklin MRI Center, LLC. (FMRI). The filing organization received $200,000 in investment income, $53900 for rental of medical and office space.0
Baystate Health System Ambulance
Common Board Members or Officers23310See Part V - The filing organization made payments to BHSA for patient transport services. BHSA is an affiliate corporation of the filing organization.0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 1The 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.
Form 990, Part VI, Section A, line 2Allan W. Blair, Dennis W. Chalke, Charles L. D'Amour, John H. Davis, Kristin R. Delaney, John A. Egelhofer, MD, Charles Gijanto, Frances C. Grabowski, John E. Kole, Grace P. Makari-Judson, MD, John E. Maybury, Steven M. Mitus, John M. O'Brien, III, Ann M. Paradis, Katherine E. Putnam, Timothy S. Rice, James P. Sadowsky, Patricia A. Sheldon, David C. Southworth, Barbara W. Stechenberg, MD, Richard B. Steele, Jr., Frances K. Stotz, CFP, Katherine M. Sullivan, Mark R. Tolosky, David W. Townsend, Howard G. Trietsch, MD, Steven M. Wenner, 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) Steven M. Mitus, Timothy S. Rice and Richard B. Steele, Jr.; (3) Allan W. Blair, Charles D'Amour, David C. Southworth, and Mark R. Tolosky; (4) Allan W. Blair and Victor Woolridge; (5) John E. Kole and Steven M. Wenner; (6) John M. O'Brien and Victor Woolridge;(7) Steven M. Mitus and Victor Woolridge.
Form 990, Part VI, Section A, line 3Baystate Franklin Medical Center is affiliated with Baystate Administrative Services, Inc. (BAS) which is a 501(c) (3) organization. Various management and support functions are delegated to BAS.
Form 990, Part VI, Section A, line 6The filing organization has one member, Baystate Health, Inc. (BH).
Form 990, Part VI, Section A, line 7aThe Board of Trustees of the filing organization are the same individuals serving as members of the Board of Trustees of BH with the addition of the president of the medical staff of the filing organization. The Board of Trustees of BH are elected annually by the Board of Trustees of BH at their annual meeting.
Form 990, Part VI, Section B, line 11Prior to the filing of this return appropriate parts of this Form 990 were reviewed by representatives from the Tax, Finance, and Human Resources Departments of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs), some of whom are officers or trustees of the filing organization and by outside legal counsel. The entire return was reviewed by a tax expert from an outside accounting firm. The entire return was also reviewed prior to filing by the Audit and Compliance Committee of Baystate Health, Inc., which also includes some of the officers and trustees of the filing organization.
Form 990, Part VI, Section B, line 12cBaystate Health, Inc. (BH) has a comprehensive conflict of interest policy which has been adopted by the filing organization. All directors, trustees, officers, key employees, and highest compensated employees of BH and its affiliates are asked to complete an annual conflict of interest form. We utilize an electronic database to receive and manage all conflict of interest submissions. This information is reviewed by the BH Chief Compliance Officer, the BH Chief Executive Officer, the Chair of the BH Board of Trustees, and the Chair of the Audit & Compliance Committee of BH. A summary of the conflict of interest disclosures is provided to the Baystate Health Board of Trustees and the Tax Department and reviewed by outside counsel. Potential conflict of interest transactions are reviewed as appropriate under the policy, which provides for recusal from discussion and deliberation by any party with a potential conflict of interest.
Form 990, Part VI, Section B, line 15The compensation of the President, and all key officers and employees is reviewed and determined annually by the compensation committee of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs), which has been appointed as the compensation committee of the filing organization and consists entirely of individuals serving on the board of the filing organization. Form 990, Part VI, Section B, Line 16b: Baystate Health, Inc. has a joint venture policy that covers affiliated tax exempt entities including Baystate Franklin Medical Center.
Form 990, Part VI, Section C, line 19The organization makes its conflict of interest policy and financial statements available to the public at www.baystatehealth.org. Articles of organization and bylaws are generally available at the Commonwealth of Massachusetts website.
Form 990, Part VII, Section A, Line 1a, Column (B)Individuals with reported compensation who have 10 or less average hours per week listed in Part VII, worked between 40 - 60 hours among all related entities.Average hours per week:
Form 990, Part VII, Section A, Line 5Certain officers or trustees of the filing organization are paid by an entity, Baystate Medical Practices, Inc. (BMP) EIN 04-2888373, who is part of the health care system to which the filing organization belongs but one that does not meet the technical requirements as a "Related Organization" per Schedule R. Compensation from BMP to the officers and trustees of the filing organization therefore, is reported as paid from an unrelated organization in Line 5 and according to the instructions reported as though paid by the filing organization.
Form 990, Part XI, line 5:Net unrealized gains on investments: 439,226. Transfer for the cost of Land, Bldg. and Equip from affiliated companies 141,042. Minimum Pension Liability adjustment -2,429,237. Change in value of benefical interest net assets BHF temporarily restricted 549,057. Change in value of benefical interest net assets BHF permanently restricted 568,130. Transfer from Affiliated Companies 4,255,000. Total to Form 990, Part XI, Line 5: 3,523,218.Changes in Net Assets or Fund Balances:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountry
Baystate Administrative Services Inc
759 Chestnut StreetSpringfieldMA01199222747685Administrative servicesMA501 (c ) (3)11c, IIIcBaystate Health Inc0
Baystate Health Foundation Inc
759 Chestnut StreetSpringfieldMA01199043549011FundraisingMA501 (c ) (3)7Baystate Health Inc0
Baystate Health Systems Inc Health & Welfare Benefits Plan
759 Chestnut StreetSpringfieldMA01199222531644Voluntary Employees' Benefit AssociationMA501 (c ) (9)Baystate Health Inc0
Baystate Health Inc
759 Chestnut StreetSpringfieldMA01199042105941Healthcare System ParentMA501 (c ) (3)7Baystate Health Inc0
Baystate Mary Lane Hospital Corporation
85 South StreetWareMA01082042103584HospitalMA501 (c ) (3)3Baystate Health Inc0
Baystate Medical Center Inc
759 Chestnut StreetSpringfieldMA01199042790311Acute Care Teaching HospitalMA501 (c ) (3)3Baystate Health Inc0
Baystate Total Home Care Inc
50 Maple StreetSpringfieldMA01199203260764Real Estate and OtherMA501 (c ) (3)11b, IIBaystate Health Inc0
BH Insurance Company Ltd
980421413Offshore captive InsuranceBaystate Health Inc0North Church StreetGeorgetownCJCJ
Visiting Nurse Assn and Hospice of Western New England Inc
50 Maple StreetSpringfieldMA01199042105803Homehealth and Hospice careMA501 (c ) (3)9Baystate Health Inc0

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Franklin MRI Center LLC Year Ended 123108BusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1164 High StreetAddressLine1
CityGreenfieldCity
StateMAState
ZIP Code01301ZIPCode
FieldValueIRS element (for citing)
EIN161766731EIN
Primary ActivityManagement of Radiology ServicesPrimaryActivity
Legal Domicile StateMALegalDomicileState
Share Of Total Income481696ShareOfTotalIncome
Share Of EOY Assets833957ShareOfEOYAssets
Disproportionate Allocations0DisproportionateAllocations
General Or Managing Partner0GeneralOrManagingPartner

Form990 Schedule R Part IV Form990ScheduleRPartIV (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityPercentage OwnershipPercentageOwnership
Health New England Inc
Monarch Place Suite 1500SpringfieldMA011441500042864973HMO/InsuranceMABaystate Health IncC
HNE Advisory Services
Monarch Place Suite 1500SpringfieldMA011441500043012347Administrative SvsMAHealth New England IncC
Health New England Insurance
Monarch Place Suite 1500SpringfieldMA011441500043183019Ancilliary InsuranceMAHealth New England IncC
Health New England of Connecticut
Monarch Place Suite 1500SpringfieldMA011441500061398662DormantMAHealth New England IncC
Ingraham Corporation
759 Chestnut StreetSpringfieldMA01199043016257Health care and other business activitiesMABaystate Health IncC
Baystate Health System Ambulance Inc
759 Chestnut StreetSpringfieldMA01199043018550Ambulance SvsMAIngraham CorporationC
Tr UW John H Sanderson
100 Federal StreetBostonMA02110046028223TrustMAT1.00000
Ada B Darling UW
100 Federal StreetBostonMA02110046017199TrustMAT1.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Baystate Medical Center
L996376
Baystate Administrative Services
L7182362
Health New England Inc
P10859895
Baystate Health Foundation
R870480
Baystate Health Foundation
L101000
Baystate Health Inc
R4254999

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