2013-08-09T12:08:00-07:00 2012-09-30 990 2011-10-01 042103602 MILFORD REGIONAL MEDICAL CENTER INC MILF 5084731190 14 PROSPECT STREET MILFORD MA 017573090 JEANNE P LYNSKEY 5084731190 2013-08-09 2011 2016-03-07 17:11:31Z Jeanne P Lynskey 14 Prospect Street Milford MA 017573090 216599835 0 X WWW.MILFORDREGIONAL.ORG X 1903 MA Milford Regional Medical Center Inc mission statement is to provide quality healthcare services to our community with dignity, compassion, and respect. 23 14 1947 450 526890 0 883873 4465681 184662502 193589549 324847 592954 10172216 13943014 196043438 212591198 0 0 0 0 102450233 107339021 25000 220246 1242123 82030645 82727312 184505878 190286579 11537560 22304619 185316781 210090678 107587749 113400497 77729032 96690181 X Milford Regional Medical Center Inc provides medical and hospital services for the sick and disabled of any race, creed, color, or nationality regardless of an individuals ability to pay. It also carries on such educational, philanthropic and scientific activities and functions as are designed to promote the general health of the communities served. 0 1 58384441 0 56618298 Milford Regional Medical Center (MRMC) serves the healthcare needs of the residents of 19 communities in Central Massachusetts, a population now approaching 250,000. Guided by its mission "to provide quality healthcare services to our community with dignity, compassion and respect," MRMC strives to be responsive to diverse constituencies-individuals and families of all ages, employees and employers of large and small businesses, physicians and other healthcare providers, our school systems, our local and area officials and safety personnel, churches, community organizations, our insurers and payors and our own employees and volunteers. As a charitable hospital, we acknowledge our special concern for the needs of the underserved , especially low-income and minority populations. A full-service community and regional teaching hospital, MRMC is a 121-bed, nonprofit acute-care facility. There are approximately 200 physicians on the active medical staff and an additional 100 courtesy or consulting physicians. MRMC is affiliated with UMass Memorial Health Care as a major teaching hospital. In addition to providing basic acute care services (medical, surgical, emergency medicine, family-centered obstetrics and pediatrics), MRMC has eight state-of-the-art operating suites, consolidated surgical services (including admitting and pre-admission testing) and a medical/surgical floor with private rooms, many with advanced patient monitoring capabilities. MRMC serves approximately 8,800 medical and surgical inpatients annually. In FY2012, MRMC added new services including a Center for Weight Loss Surgery, an interdisciplinary approach to bariatric surgery and support for patients facing chronic weight-related illnesses. Another significant achievement was the introduction of Palliative Care Services under the direction of a physician who is board certified in Hospice and Palliative Medicine. MRMC was recognized for the second consecutive year in US News & World Report's list of Best Hospitals, received a Top 10 Safety Rating from Consumer Reports and an "A" Hospital Safety Score from The Leapfrog Group. Perhaps most important, MRMC completed a feasibility study for a $54-million building expansion, the construction of a new emergency department, ICU and 24 new medical/surgical rooms to eliminate multi-patient rooms. It is estimated that the project will break ground in 2014. 99559126 0 127879225 The Hyman and Shirley Hill Health Center at Milford Regional Medical Center, completed in 1994, is a complete outpatient facility dedicated to the care, education, and wellness of thousands of patients who visit regularly for care, but rarely stay overnight. The Center provides a variety of services including laboratory, cardiac rehabilitation, endoscopic surgery, and other minor surgical services. The Women's Pavilion, opened in 1998, provides a full range of services to meet women's health needs, including digital mammography, ultrasound, bone densitrometry and advanced breast biopsy. Other diagnostic services offered to outpatients throughout the Milford Regional system include radiology, ultrasound, MRI, CT scans, PET services, nuclear medicine, cardiovascular and laboratory/pathology. Testing and rehabilitation services are offered in several locations throughout the hospital's service are to improve access for our patients. In FY2012, MRMC made significant investment in improving diagnostic services, adding two SPECT/CT gamma cameras in nuclear medicine, and improving laboratory automation to provide faster test results. Another important outpatient program, The Center for Adolescent Health, provides comprehensive and multi-disciplinary care to more than 3,000 adolescent clients and their families on an annual basis. It is the only facility in Central Massachusetts offering a continuum of care with a multi-disciplinary team approach to health and lifestyle challenges faced by adolescents. MRMC is also the home of The Center for Multiple Sclerosis, offering comprehensive care for patients with MS, with an emphasis on education and compassion. Recognizing a need for comprehensive cancer treatment in the region, MRMC entered into a collaboration with Dana-Farber Cancer Institute and Brigham and Women's Physicians Organization to develop a comprehensive Cancer Center which includes medical oncology and radiation oncology. This 54,000 square foot structure opened in 2008 and has made a tremendous difference to the quality of life for residents seeking cancer treatment. In FY12, MRMC provided laboratory tests, CT scans, MRI's and PET Scans in the care and treatment of Cancer Center patients. Tri-County Medical Associates (TCMA) is a not-for-profit corporation that was established in 1992 as a medical group practice. It operates for the benefit of the Hospital by assisting the Hospital in carrying out its charitable purpose of promoting healthcare in its service area. TCMA employs over 70 physicians and over 300 employees. The group is principally comprised of primary care physicians including internal medicine, pediatrics, family medicine, and adolescent medicine. Specialists in the group include: obstetrics and gynecology, pulmonary and critical care, urology, sleep specialists, rheumatology, and endocrinology. In FY2012, thirteen TCMA physicians made the U.S. News & World Report top Doctor's list. 7484623 0 8565136 The VNA and Hospice of Greater Milford (VNA) has been a part of the community since 1918, and a department of MRMC in 1997. After careful consideration, MRMC made the decision to sell the VNA to Salmon Health and Retirement (Salmon). Salmon acquired the VNA on August 1, 2012 and this acquisition completes their post-acute continuum and enhances their opportunities to support and partner with doctors and hospitals in the Greater Milford Area. The transition was seemless for the VNA patients and allows for Salmon patients to be able to be served by the VNA. The transition continues the VNA's mission of providing patient-centered care in patient's homes. 0 0 0 165428190 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 1 0 0 1 1 1 1 1 0 0 1 1 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 1 0 0 0 0 1 173 0 1 1947 1 1 1 0 0 0 1 1 1 1 0 0 0 0 0 0 X 23 14 1 0 1 0 1 0 0 1 1 0 1 1 0 1 1 1 1 1 1 1 0 MA X X Jeanne P Lynskey 5084731190 14 PROSPECT STREET MILFORD MA 017573090 X Kevin P Meehan 1 X 0 0 0 Christine H Burke 1 X 0 0 0 Bartholomew R Lawless 1 X 0 0 0 M Catherine Burke MD 1 X 0 0 0 Francis J Larkin 1 X 0 0 0 John A Rauth 1 X 0 0 0 John J Burns 1 X 0 0 0 Stephen G Ellis 1 X 0 0 0 Patrick R McSweeney MD 1 X 0 352447 28105 William G Burrill 1 X 0 0 0 Albert A Crimaldi MD 1 X 9100 0 0 Warren S Heller 10 X 0 0 0 Harold D Gould Jr 1 X 0 0 0 John N Pandiscio 1 X 13000 0 0 Louis P Bertonazzi 1 X 0 0 0 Lawrence J Hill 1 X 0 0 0 Tina Afonso 1 X 0 0 0 Richard G Buma 1 X 0 0 0 Roger V Calarese 1 X 0 0 0 Marjorie E Kenney 1 X 0 0 0 Linda L Varney 1 X 0 0 0 Nancy F Gannett 1 X 0 0 0 William B Gannett 1 X 0 0 0 Francis M Saba 50 X 481247 0 211212 Edward J Kelly 50 X 515518 0 57870 Jeanne P Lynskey 50 X 221872 0 17480 Salvatore Perla 50 X 198925 0 22626 Cheryl L Bonasoro 50 X 201605 0 7181 Linda Yates 50 X 171179 0 23034 Martin Richman 50 X 155879 0 19483 Laurence Fraize 50 X 154630 0 20681 Jennifer Childs-Roshak 50 X 197939 0 20869 Nancy Tomaso 50 X 154362 0 5595 Kamala Murali 50 X 139063 0 20065 Donna M Saul 50 X 133141 0 23496 2747460 352447 477697 86 0 1 0 Alliance Healthcare Inc PO Box 96485 Chicago IL 60693 MRI Services/PET Services 3644616 Aramark 12483 Collections Center Drive Chicago IL 60693 BioMedical Engineering Services 1279243 Milford Anesthesia Associates Inc 113 Water Street 213 Milford MA 01757 Anesthesia Services 1415938 University of Massachusetts Medical 55 Lake Ave North Worcester MA 01655 Fee for Residency Program 1106598 Quest Diagnostics Nichols Institute 12436 Collections Center Drive Chicago IL 60693 Outside lab fees 797839 9 0 0 755690 0 0 3709991 109675 4465681 Outpatient Revenue 621500 128406115 127879225 526890 0 Inpatient Revenue 621500 56618298 56618298 0 0 VNA & Hospice Revenue 621500 8565136 8565136 0 0 0 0 0 0 193589549 380272 0 0 380272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3926079 11000 3694195 30202 231884 -19202 212682 0 0 212682 281802 755690 278742 3060 0 3060 47116 5498 41618 0 0 41618 0 0 0 0 0 0 Sale of VNA 900099 3506410 0 0 3506410 Cancer Center 900099 3394354 0 0 3394354 Rents 900099 2242442 0 0 2242442 4755130 0 0 4755130 13898336 212591198 193062659 526890 14535968 1395735 1395735 84712396 75429012 8882673 400711 1501467 1321291 165161 15015 13393721 11786475 1473309 133937 6335702 5575418 696927 63357 1927034 1873831 53203 67811 67811 48800 48800 220246 220246 385397 385397 34482285 33001426 1302061 178798 825877 702837 87855 35185 7518465 5907680 1566262 44523 374261 325321 46250 2690 4254621 4254621 9231368 8123604 1015450 92314 1072360 943677 117959 10724 Contract services 8285486 6184071 2056792 44623 Physician fees & collection fees 3442016 3442016 0 0 Health Safety Net & Community health service initiative 1692180 1692180 0 0 Provision for bad debt 9119351 9119351 0 0 190286579 165428190 23616266 1242123 3940 3640 51505316 69993935 236410 2848636 23541315 25358673 0 0 0 3367070 3319645 1778778 3971880 172560521 87485765 87768175 85074756 0 4922247 6039881 0 0 12193530 13479632 185316781 210090678 17531574 22107319 0 0 82072308 80020640 0 0 4177679 7247803 0 3806188 4024735 107587749 113400497 X 75304261 91030391 1796830 5031849 627941 627941 77729032 96690181 185316781 210090678 X 22304619 -3343470 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 1 0 0 0 1 0 1 28460 0 28460 0 SchC_P2B_S00_L01 Schedule C, Part II-B, Line 1 Letter D and G - From time to time, the Hospital reaches out to our state and federal legislators on matters relating to Hospital Operations. Letter H - The $28,460 shown on letter H represents a portion of Massachusetts Hospital and American Hospital Association dues used for lobbying purposes as defined by Medicare. 1667003 0 373387 0 35472 0 2004918 1660561 0 25807 0 19365 0 1667003 1561182 0 118549 0 19170 0 1660561 1597614 0 -12267 0 24165 0 1561182 0 0.31 0.69 0 0 3920828 0 3920828 87270164 0 27565360 59704804 568616 0 369954 198662 75816248 0 56690159 19126089 4984665 0 2860292 2124373 85074756 Funds Held by Trustees 13470499 Accrued Interest and Dividends 9133 13479632 Amounts due to third party payors 4024735 4024735 SchD_P05_S00_L04 Schedule D, Part V, Line 4 The organization has a Spending Policy which provides a policy with regard to the use of Investment Income and gains on amounts held in the Endowment Funds. Further to provide a consistent, predictable level of support to operations and permit the organization to maintain the purchasing power of the amounts held in the Endowment Fund. The amount to be made available to the operating fund will be calculated at the end of the third quarter of each fiscal year. SchD_P10_S00_L02 Schedule D, Part X, Line 2 A review has been performed of each of the Organization's Revenue Streams in relation to FIN 48. The result of the review is that the following has been identified as Unrelated Business Income: Non patient laboratory testing provided to nursing homes and non-affililated (non Tri-County Medical Associates) physician offices. Central America and the Caribbean 0 0 Investments 113341 East Asia and the Pacific 0 0 Investments 119010 Europe (including Iceland and Greenland) 0 0 Investments 741050 North America (including Canada and Mexico, but not the United States) 0 0 Investments 10621 0 0 984022 0 0 0 0 0 0 X X X X X X 1 Ghiorsi & Sorrenti 255 Madison Avenue Wyckoff NJ 07481 Capital Campaign Management 0 211650 230246 -18596 211650 230246 -18596 MA Golf 250555 232920 17635 0 10311 21942 3560 0 14121 Melange 693340 520695 172645 0 0 0 54708 7140 107831 11 93597 2075 91522 0 0 0 150 1975 57004 1037492 755690 281802 0 10311 21942 58418 9115 178956 278742 3060 0 0 0 0 0 0 0 0 0 0 47116 5358 0 0 140 0 47116 5358 0 0 140 5498 41618 MA 1 0 1 0 0 1 Martin Richman 14 Prospect Street Milford MA 01757 0 Martin Richman 0 Vice President of Philanthropy X 0 0 SchG_P01_S00_L01 Schedule G, Part I, Line 1 A total of $10,746 was paid to Ghiorsi & Sorrenti Inc for travel and lodging during FY 12. The agreement distinguishes between professional fund raising and expense payments. 1 1 1 X 1 X 1 1 0 1 1 9855043 4774097 5080946 0.028 14737846 12953815 1784031 0.0098 3910567 2730818 1179749 0.0065 0 0 28503456 20458730 8044726 0.0443 381813 84406 297407 0.0016 1459390 712167 747223 0.0041 2998739 356080 2642659 0.0146 0 0 0 0 20913 0 20913 0.0001 0 0 4860855 1152653 3708202 0.0204 0 0 33364311 21611383 11752928 0.0647 2500 2500 0 358718 358718 0.002 0 0 361218 0 361218 0.002 0 2898641 596962 44839751 48887872 -4048121 X 1 1 1 1 Milford Regional Medical Center Inc

14 Prospect Street Milford MA 01757

X X X Milford Regional Medical Center Inc 1 1 X X X X X X X X X 12 1 0 1 X X X X X X X X X X 0 1 1 200 1 400 1 X X X X X X 1 1 X 0 0 1 X 0 1 SchH_P01_S00_L06a Schedule H, Part I, Line 6a Milford Regional Medical Center prepares and distributes a printed community benefits report, made available on the hospital website. In addition, the annual report filed with the Massachusetts Attorney General is published online and available to the public. SchH_P01_S00_L07 Schedule H, Part I, Line 7 Lines 7 a/b/c were calculated using Worksheets 1, 2, 3 provided in the instructions. Line 7f was determined by the cost & reimbursement information on the Medicare Cost Report. It was calculated by dividing Column E, Net Community Benefit Expense by total of Part IX line 25 of Form 990 Core Form of $190,286,579 less line 24D, Provision for Bad Debt of $9,119,351 or $181,167,228. SchH_P02_S00_L00 Schedule H, Part II Milford Regional plays an active role in the economic development of our service area, supporting organizations such as the 495/MetroWest Partnership for Economic Development and the Blackstone Valley, Hopkinton and Milford Area Chambers of Commerce. For the second year, CEO Francis Saba led the Greater Milford Health Access Coalition, made possible by a Synergy Initiative pilot grant from the Health Foundation of Central Massachusetts. This coalition of health leaders and community members shared the common goal of improving access to care for uninsured and underinsured residents of our service area by facilitating the development of a satellite site of Edward M. Kennedy Community Health Center, the first of its kind in the town of Milford. SchH_P03_S0A_L04 Schedule H, Part III, Section A, Line 4 In Line 2, Worksheet A in the instructions was used by taking bad debt as reported in Milford Regional Medical Center, Inc.'s (the Hospital) auditied financial statements multiplied by the cost-to-charge ratio calculated in Worksheet 2 in the instructions. SchH_P03_S0B_L08 Schedule H, Part III, Section B, Line 8 The Hospital's Medicare Cost Report was used to determine the amount reported on Line 6. SchH_P03_S0C_L09b Schedule H, Part III, Section C, Line 9b Once it is determined that a patient qualifies for full or partial free care, all collection procedures cease and the full balance, or the amount that qualifies under partial free care, is written off. Massachusetts hospitals are required to adopt a credit and collection policy under the Health Safety Net (HSN) regulations (114.6 CMR 13.08(1)(c)) that outlines the specific process for determining eligibility for public assistance programs and hospital collection practices. Hospitals make reasonable and diligent efforts to collect the patient's insurance and other information to verify other coverage for the health care services provided by the hospital prior to deeming the services to be charity care. The Hospital provides patients with information about financial assistance programs that are available through the Massachusetts Executive Office of Health and Human Services, including charity care services that are provided through HSN, and also assist patients in applying for these services through the State's uniform application. The Hospital credit and collection policy, that outlines its charity care practices, is filed with the Massachusetts Division of Health Care Finance and Policy and also available to patients upon request. SchH_P05_S0B_L03 Schedule H, Part V, Section B, Line 3 Milford Regional Medical Center Inc completed a community health needs assessment in 2012 working with Health Resources in action. Community input was included through a series of key informant interviews and two public Community Health Dialogues conducted by the consultants. Key informants were selected across a broad range of sectors, and included public safety officials, educators, mental health agencies, councils on aging, and the department of transitional assistance. SchH_P05_S0B_L05 Schedule H, Part V, Section B, Line 5 The Needs Assessment report was also made available to the public through a meeting of the Community Health Network in our area that was open to the public, led by Health Resources in Action. SchH_P05_S0B_L07 Schedule H, Part V, Section B, Line 7 The hospital will make every attemp to address the needs identified within the Needs Assessment, through policies such as its own non-smoking campus and employee wellness and through leadership of community partnerships to address specific issues related to youth mental health, chronic disease prevention and obesity prevention. Given the scope of issues identified in the assessment, this work will be ongoing. SchH_P05_S0B_L11 Schedule H, Part V, Section B, Line 11 Asset level is used for Medicare patients only. This follows Medicare guidelines. SchH_P05_S0B_L21 Schedule H, Part V, Section B, Line 21 At the Hospital, all patients are charged the gross charges for any services. Upon contact from an uninsured patient, a discussion occurs which may result in the discounting of gross charges. SchH_P06_S00_L02 Schedule H, Part VI, Line 2 Milford Regional Medical Center Inc stays current with studies by other agencies, particularly the Adolescent Health Survey conducted by the MetroWest Health Foundation. Active participation in the Community Health Network and other community coalitions provide another important source of information on emerging health needs. SchH_P06_S00_L03 Schedule H, Part VI, Line 3 Patients are informed of the availability of financial assistance by way of patient statements printed with financial assistance information. At the time of discharge from the Emergency Department, uninsured patients are encouraged to meet with an on-site Financial Counselor. If unable to see a Financial Counselor at the time of discharge, the patient is given a screening letter that gives contact information for our financial assistance department. The day following an emergency room visit a form is generated on each uninsured patient and sent to the Financial Counselors. At that time, the Financial Counselors contacts the patient to coordinate a meeting to apply for assistance. Scheduled self-pay Surgical Day Care (SDC) & Inpatients are reviewed prior to admission to determine payment arrangements or to coordinate a meeting with a Financial Counselor. Insured SDC & Inpatients who are unable to leave a deposit or make payment arrangements towards a large out of pocket expense are also encouraged to meet with a Financial Counselor. SchH_P06_S00_L04 Schedule H, Part VI, Line 4 Milford Regional Medical Center serves the healthcare needs of the residents of 19 communities in Central Massachusetts, spanning 3 separate counties: Worcester, Norfolk and Middlesex. The Hospital's primary service area consists of Milford, Franklin, Bellingham, Northbridge, Whitinsville, Uxbridge, Blackstone, Hopedale, Medway and Mendon, a population of 145,362 according to 2010 US Census data. The Hospital's secondary service area consists of Doulgas, Grafton, Hopkinton, Holliston, Millis, Wrentham, Upton, Medfield and Millville, a population of 96,310. The population of the MRMC service area has grown almost 9% over the past decade, as opposed to the statewide average of 3%. The residents of this region are primarily Caucasian, accounting for 93.6% of the population. Hispanics comprise 2.7% of the population, with Asians also at 2.7% and Blacks at 1.0%. The population is nearly even in terms of gender, with 51% females. The bulk of the adult population (71.6%) is between the ages of 18-54, slightly higher than the state percentage, which is 68%. There has been an influx of Egyptian, Central American and Brazilian immigrants into the area, most likely not represented in these totals, but estimated at several thousand additional residents. SchH_P06_S00_L05 Schedule H, Part VI, Line 5 Milford Regional Medical Center Inc furthers its exempt purpose by striving to fulfill its mission "to provide quality healthcare services to our community with dignity, compassion and respect." We do this by providing inpatient and outpatient health care services to the residents of our service area without regard to their ability to pay, and through a range of community benefits programs and partnerships. Our corporate board represents the communities we serve, and the majority is comprised of members who reside in our service area and are not employed by Milford Regional. Surplus funds are consistently invested in strategic initiatives designed to improve efficiency and patient care. Our ongoing collaboration with Dana-Farber Cancer Institute and Brigham and Women's Hospital to operate a comprehensive Cancer Center including medical oncology and radiation oncology has made a tremendous difference to the quality of life for residents seeking cancer treatment. We worked with a broad range of community partners to address unmet health needs identified by our community health needs assessment. We received a second Synergy Initiative grant from the Health Foundation of Central Massachusetts to support the pilot phase of an effort to improve access to care for uninsured and underinsured residents of our service area. Grant funds continued to support the work of the Greater Milford Health Access Coalition to facilitate the planned opening of a satellite location of the Edward M. Kennedy Community Health Center in Milford in 2013. SchH_P06_S00_L06 Schedule H, Part VI, Line 6 The Organization consists of Milford Regional Medical Center, Inc. (the "Hospital" or "Parent"), Tri-County Medical Associates ("Tri-County"), and Milford Regional Healthcare Foundation, Inc (the "Foundation"), collectively referred to as the "Organization". The Hospital provides medical and hospital services for the sick and disabled of any race, creed, color, or nationality regardless of an individual's ability to pay. Tri-County, a large multi-specialty group practice, operates for the benefit of the Hospital by assisting the Hospital in carrying out its charitable mission purpose of promoting healthcare in its service area. Tri-County's vision is to consistently meet the changing healthcare needs and expectations of the communitites its serves. The Foundation supports the mission of both the Hospital and Tri-County through fund raising activities. SchH_P06_S00_L07 Schedule H, Part VI, Line 7 Massachusetts X X X X X 0 1 0 0 0 0 0 0 0 M Catherine Burke MD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Patrick R McSweeney MD 0 352447 0 0 0 0 0 0 0 28105 0 380552 0 0 Albert A Crimaldi MD 0 0 0 0 9100 0 0 0 0 0 9100 0 0 0 John N Pandiscio 0 0 0 0 13000 0 0 0 0 0 13000 0 0 0 Francis M Saba 431247 0 50000 0 0 0 188925 0 22287 0 692459 0 90406 0 Edward J Kelly 358866 0 40000 0 116652 0 32717 0 25153 0 573388 0 37468 0 Jeanne P Lynskey 221872 0 0 0 0 0 0 0 17480 0 239352 0 0 0 Salvatore Perla 198925 0 0 0 0 0 0 0 22626 0 221551 0 0 0 Cheryl L Bonasoro 201605 0 0 0 0 0 0 0 7181 0 208786 0 0 0 Linda Yates 171179 0 0 0 0 0 0 0 23034 0 194213 0 0 0 Martin Richman 155879 0 0 0 0 0 0 0 19483 0 175362 0 0 0 Laurence Fraize 154630 0 0 0 0 0 0 0 20681 0 175311 0 0 0 Nancy Tomaso 154362 0 0 0 0 0 0 0 5595 0 159957 0 0 0 Kamala Murali 139063 0 0 0 0 0 0 0 20065 0 159128 0 0 0 Donna M Saul 133141 0 0 0 0 0 0 0 23496 0 156637 0 0 0 Jennifer Childs-Roshak 197939 0 0 0 0 0 0 0 20869 0 218808 0 0 0 SchJ_P01_S00_L04 Schedule J, Part I, Line 4 Francis M Saba and Edward J Kelly had deposits to their SERPs of $188,925 and $32,717, respectively. The compensation of Edward J. Kelly, President, includes the payout of fully vested SERP amounts of $116,652. Massachusetts Health & Education Facilities Authority 042456011 57586CXJ9 2007-02-21 70279953 See Supplemental Information 0 0 0 2540000 0 70279953 2662312 1509967 30555914 833657 0 0 34718103 0 0 2008 0 1 1 1 0 1 1 1 0 0.018 0 0.018 1 0 0 0 0 0 0 SchK_P01_S00_L00f Schedule K, Part I, Column f The proceeds of the Series E Bonds were applied to the following: (1) Constructing, furnishing and equipping an approximately 54,013 gross square feet, two story building on the Milford campus across the street from the Hospital building. The Cancer Center will be owned and partially occupied by the Hospital for diagnostic imaging services (including MRI, CT scan and diagnostic radiology), laboratory services and other administrative space. In addition, the Hospital has executed leases with two tenants for the Cancer Center. Dana-Farber Cancer Institute to provide medical/oncology services and Brigham and Women's Physicians Organization to provide radiation/oncology services. (2) Purchasing of four properties and demolishing three existing structures located thereon for the purpose of constructing the Cancer Center. (3) Renovating, constructing, furnishing and equipping for the approximately 2,438 gross square feet of existing space for a Cardiac Catheterization Lab on the Milford Campus. (4) Renovating approximately 8,800 square feet of existing space which previously served as the Hospital's operating room area (prior to the issuance of the Series D Bonds in 2002), to relocate outpatient and other administrative spaces. (5) Renovating the Gannett Inpatient Unit consisting of approximately 9,569 gross square feet. (6) Renovating and expanding the Cardiovascular Department consisting of approximately 1,982 gross square feet. (7) Various renovations, improvements, equipment and furnishings at the Milford Campus and the Whitinsville Division. (8) Refinancing the Series D Bonds, the proceeds of which were applied primarily for the purpose of modernizing and expanding surgical services and expanding the maternity unit. Lawrence Hill Trustee 183061 Payments were made to M Hill Companies with which the Hospital has entered into lease agreements. 0 M Catherine Burke MD Trustee 301676 Payments were made to Orion Emergency Services Inc for services provided to the Hospital. Dr Burke is President of Orion Emergency Services, Inc. 0 Albert Crimaldi MD Trustee 384283 Payments were made to Milford Gastroenterology Associates Inc which provides services to the Hospital. Dr. Crimaldi is part owner of Milford Gastroenterolgy Associates Inc. Payments were also made to Milford Gastroenterolgy Realty with which the Hospital has entered into a lease agreement. Dr Crimaldi is part owner of Milford Gastroenterology Realty. 0 X 0 FMV X 2 109675 FMV X 4 0 FMV X Food and supplies for charitable fund raising event 5 0 FMV X Tickets to sporting events or entertainment for fund raising event 16 0 FMV X Travel package for fund raising event 5 0 FMV X Gift certificates and gift baskets for fund raising event 11 0 FMV X Dinner packages and beverages for fund raising events 8 0 FMV X Miscellaneous toys 8 0 FMV X Freezer for fund raising event 1 0 FMV X Computers for fund raising event 3 0 FMV X Seiko mens watch 1 0 FMV X Nike golf club putter 1 0 FMV 0 0 1 0 SchM_P01_S00_L33 Schedule M, Part I, Line 33 MRMC, Inc. does not currently account for certain non-cash contributions or in-kind donations as revenue. F990_P03_S00_L03 Form 990, Part III, Line 3 The VNA and Hospice of Greater Milford (VNA) has been a part of the community since 1918, and a department of MRMC in 1997. After careful consideration, MRMC made the decision to sell the VNA to Salmon Health and Retirement (Salmon). Salmon acquired the VNA on August 1, 2012 and this acquisition completes their post-acute continuum and enhances their opportunities to support and partner with doctors and hospitals in the Greater Milford area. The transition was seemless for the VNA patients and allows for Salmon patients to be able to be served by the VNA. The transition continues the VNA's mission of providing patient-centered care in patients homes. F990_P06_S0A_L02 Form 990, Part VI, Section A, Line 2 Three board of trustee members have disclosed via the organization's conflict of interest disclosure process that they have business relationships with other board members. F990_P06_S0A_L04 Form 990, Part VI, Section A, Line 4 The bylaws were amended for term limits for board members. F990_P06_S0A_L06 Form 990, Part VI, Section A, Line 6 The organization is governed by a Board of Trustees. In addition, the organization has incorporators who serve in an advisory capacity to the Board of Trustees. F990_P06_S0B_L11b Form 990, Part VI, Section B, Line 11b The FORM 990 was reviewed with the Chairman of the Board. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c The organization has a written Code of Business Conduct which states its conflict of interest policy. A conflict of interest disclosure statement is mailed annually to members of the Board of Trustees and senior management. They are required to complete the form and submit it to the Corporate Compliance Officer. The forms are reviewed and monitored. The organization also has established a hotline for any staff member who may wish to discuss a potential violation of the Code,our policy or law on an annonymous basis. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 The Compensation Committee approves all compensation plans and guidelines, as well as all compensation for the orgaznization's senior management employees in accordance with such plans and guidelines. The committee may consult with a nationally-recognized consultant to assist it in determining that the organization's compensation structure and ranges are reasonable. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 The organization makes it governing documents available to the public, such as it's bylaws which include the organization's conflict of interest policy, through the annual filing of the Massachusetts Division of Public Charities Form PC. The Form PC is available for viewing by the public on the Massachusetts Attorney General's website and is also attached to the annual filing of the Massachusetts Form 3ABC which is submitted to town offices where the organization owns or leases property. The organization's financial statements are included in the Form PC filing and are also included in a quarterly filing to the organization's bond holders. F990_P07_S0A_L01a Form 990, Part VII, Section A, Line 1a Two executives, as disclosed in Schedule J, receive supplemental retirement benefits. F990_P11_S00_L05 Form 990, Part XI, Line 5 The Change in Net Assets results from transferring to affiliates ($4,743,475), Auxiliary activity ($17,997), change in market value $271,345, Unrealized gains $1,146,659 and rounding ($2). Tri-County Medical Associates Inc 9 Industrial Road Suite 5 Milford MA 01757 043159969 Physician Group MA 501(C)(3) 11A N/A MWRH Management Services Inc 14 Prospect Street Milford MA 01757 311631252 Provides office space, support to satellite clinics MA 501(C)(3) 11A N/A Milford Regional Healthcare Foundation Inc 14 Prospect Street Milford MA 01757 200773697 Fundraising MA 501(C)(3) 11A N/A Milford Whitinsville Healthcare Consortium Inc 14 Prospect Street Milford MA 01757 043248004 Physician Hospital Organization MA N/A C 0 366 0.5 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 1 0 Tri-County Medical Associates Inc i 283149 Market value Tri-County Medical Associates Inc j -75203 Market value Tri-County Medical Associates Inc q 7850000 Cost Tri-County Medical Associates Inc o -3330470 Cost