2012-08-10T10:33:07-05:00 2011-09-30 Ernst & Young LLP 200 Clarendon Street Boston MA 02116 990 2010-10-01 042790311 Baystate Medical Center Inc BAYS 4137940000 759 Chestnut Street Springfield MA 01199 Dennis W Chalke 4137940000 2012-08-10 1 Jeanne M Schuster 6172662000 2010 2016-02-24 21:20:13Z Dennis W Chalke 759 Chestnut Street Springfield MA 01199 891284566 0 X www.baystatehealth.org X 1983 MA The mission of the organization is to improve the health of the people in our communities every day, with quality and compassion. 21 12 7587 540 7422304 -2370649 5892058 6142307 854223345 850547991 10174762 16678873 14653860 17395326 884944025 890764497 18122 1887118 0 0 408656851 416385715 0 0 0 411570975 428346161 820245948 846618994 64698077 44145503 1004860958 1033902625 546392613 578393405 458468345 455509220 X The mission of Baystate is to improve the health of the people in our communities every day, with quality and compassion. 0 0 367363723 1871078 411499327 Inpatient healthcare services - Providing inpatient community-based medicine and tertiary care to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY11, Baystate Medical Center, Inc. provided 177,548 patient days of inpatient services, with 36,668 discharges. 272637121 295341833 Outpatient healthcare services - Providing outpatient clinical services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY11, Baystate Medical Center, Inc. had 418,828 outpatient visits. 30957088 39006498 Emergency department services - Providing emergency department services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY11, Baystate Medical Center, Inc. had 105,962 emergency department visits. 122569976 109340633 Other services primarily consist of medical research and educational programs. 122569976 109340633 793527908 1 1 0 1 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 1 0 1 0 1 473 0 1 7587 1 1 1 0 0 0 0 0 0 0 0 0 X 21 12 1 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 MA X Peter Lyons Baystate Health Inc 4137940000 759 Chestnut Street Springfield MA 01199 X Charles L DAmour 1.00 X X 0 0 0 Richard B Steele Jr 1.00 X X 0 0 0 Mark R Tolosky 1.00 X X 0 1638402 112208 Allan W Blair 1.00 X 0 0 0 John A Egelhofer MD 1.00 X 0 0 0 Loring S Flint MD 1.00 X 0 1511683 77581 Frederic W Fuller III 1.00 X 0 0 0 M Dale Janes 1.00 X 0 0 0 Grace P Makari-Judson MD 1.00 X 311711 0 66075 John F Maybury 1.00 X 0 0 0 Steven M Mitus 1.00 X 0 0 0 Jeffrey G Mulhern MD 1.00 X 0 27650 0 John M OBrien III 1.00 X 0 0 0 Anne M Paradis 1.00 X 0 0 0 Katherine E Putnam 1.00 X 0 0 0 Timothy S Rice 1.00 X 0 0 0 James P Sadowsky 1.00 X 0 0 0 Heather Z Sankey MD 1.00 X 260371 0 41764 David C Southworth 1.00 X 0 0 0 Barbara W Stechenberg MD 1.00 X 222735 0 120085 Frances K Stotz CFP 1.00 X 0 0 0 Katherine McG Sullivan 1.00 X 0 0 0 David W Townsend 1.00 X 0 0 0 Howard G Trietsch MD 1.00 X 0 0 0 Steven M Wenner MD 1.00 X 0 0 0 Victor Woolridge 1.00 X X 0 0 0 Dennis W Chalke 1.00 X 0 564783 51532 Kristin R Delaney 1.00 X 0 92401 29700 Frances C Grabowski 1.00 X 0 56860 22712 Deborah Morsi 50.00 X 249349 0 88624 Deborah A Provost 50.00 X 226530 0 87941 Jonathan Pine 50.00 X 216838 0 31839 Michael F Moran 50.00 X 214018 0 41396 Peter Lindenauer MD 50.00 X 273841 0 52132 David Y Chin PhD 50.00 X 230619 0 44113 Michael R Favreau 50.00 X 201233 0 58553 Randolph Peto MD 50.00 X 198417 0 28222 Betty K Larue 50.00 X 185306 0 45568 Keith C McLean-Shinaman 0.00 X 0 597331 91897 2790968 4489110 1091942 216 1 1 1 Baystate Administrative Services Inc 759 Chestnut Street Springfield MA 01199 Management Svcs. 71782541 Baystate Medical Practices Inc 759 Chestnut Street Springfield MA 01199 Medical, Educ, Clin 48810159 Springfield Anesthesia Service Inc 908 Allen Street Springfield MA 01118 Anesthesia Services 3950003 Angelica Textile Service 125 Bath Street Ballston SPA NY 12020 Linen Services 3551415 New England Orthopedic Surgeons Inc 300 Birnie Avenue Ste 201 Springfield MA 011071121 Management Services 1863001 64 6142307 6142307 Inpatient Revenue 900099 448912354 448912354 Outpatient Revenue 621400 381124176 373723131 7401045 Sponsored Programs 900099 10719510 10719510 CMS Elec Med Rec Fdg 900099 6928571 6928571 Intercompany Rent 900099 2863380 2863380 850547991 10787852 10787852 843922 496032 347890 347890 347890 5856458 58600 24037 5856458 34563 5891021 5891021 Cafeteria Income 900099 4880196 4880196 Intercompany Charges 900099 3265952 3265952 Miscellaneous-Deposits 900099 2818081 2818081 6083207 5957312 21259 104636 17047436 890764497 855188291 7422304 22011595 1871078 1871078 16040 16040 1183537 1183537 336423310 310315397 26107913 18957003 17476427 1480576 36332226 33514661 2817565 23489639 21671786 1817853 32530955 31035296 1495659 1207395 1207395 278275 278275 86800 86800 80481511 75250337 5231174 186149 159115 27034 178397101 174904910 3492191 42944089 42516891 427198 25489930 22103812 3386118 929076 759502 169574 868924 689981 178943 5831349 5831349 40260311 35373493 4886818 5320696 5320696 Patient Bad Debt Expens 13487623 13487623 Other Bad Debt Expense 45977 45977 846618994 793527908 53091086 0 51923423 51592640 86801237 88501693 64755434 65504065 14282955 15977983 5721977 6810841 812713096 551098641 260390652 261614455 275691361 267113273 56927948 64413638 188365971 212374037 1004860958 1033902625 95561830 96190768 316641297 311679229 3111542 2840986 131077944 167682422 546392613 578393405 X 437192629 430622681 17312072 20909439 3963644 3977100 458468345 455509220 1004860958 1033902625 X 44145503 -47104628 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 86800 0 0 86800 0 Part IV, Supplemental Information: Baystate Medical Center, Inc. pays membership dues to the Massachusetts Hospital Association (MHA) and the American Hospital Association (AHA). These organizations have advised us that portions of these dues are used for lobbying purposes for various healthcare matters at the state level. The portion of dues listed as lobbying expenses for the year ending September 30, 2011 is $86,800. 11919647 11919647 310287078 176245778 134041300 2358233 414773 1943460 428198448 356403868 71794580 59949690 18034222 41915468 261614455 1187202 C Investments-securities other less than 5% 63226436 C 64413638 Contractual Adjustment Receivable 20944915 Due From Affiliated Companies 129555937 Beneficial Interest in Net Assets of BHF 24886538 Funds Held - Bond Indenture 36065438 Board Designated - Due From Unrestricted Funds 921209 212374037 Contractual Adjustments Payable 62037617 Refundable Advances 326609 Due to Affiliated Companies 2014309 Line of Credit - Affiliate 3068600 Insurance Liability Loss Reserves 5718000 Deferred Revenue 1088779 Minimum Pension Liability 83003894 Market Value Swap 10424614 167682422 Part X, Line 2 - Baystate Medical Center, Inc. did not have a FIN 48 footnote included in the audited financial statements. 1 1 1 X 1 X 500.000000000000 1 1 1 0 1 1 20928853 10788805 10140048 0.01220 162862415 159819607 3042808 0.00370 15417521 13914897 1502624 0.00180 199208789 184523309 14685480 0.01770 2510998 0 2510998 0.00300 53055233 14283457 38771776 0.04650 17204305 11738734 5465571 0.00660 20623711 0 20623711 0.02480 2605303 0 2605303 0.00310 95999550 26022191 69977359 0.08400 295208339 210545500 84662839 0.10170 100000 100000 0.00010 78109 78109 0.00010 124401 124401 0.00010 302510 302510 0.00030 1 4969501 1642401 205951088 183415104 22535984 X 1 1 1 1 Baystate Medical Center Inc

759 Chestnut Street Springfield MA 01199

X X X X X X Not required 1 19 Baystate Mason Sq Neighborhood Hlth Cntr

11 Wilbraham Road Springfield MA 01199

Outpatient Clinic Baystate Brightwood Health Center

380 Plainfield Street Springfield MA 01107

Outpatient Clinic BMC Transplant Services

100 Watson Avenue Suite 210 Springfield MA 01107

Outpatient Facility BMC Pain Management Center

3400 Main Street 2nd Flr Springfield MA 01107

Outpatient Facility BMC Comprehensive Breast Center

3400 Main Street 1st Flr Springfield MA 01107

Outpatient Facility Baystate High Street Hlth Cntr

140 High Street Springfield MA 01105

Outpatient Facility Central High School Hlth Cntr

1840 Roosevelt Ave 1st Flr Springfield MA 01109

School based medical services Roger L Putnam Vocational Tech HS

1300 State St 3rd Flr Springfield MA 01109

School based medical services High School of Commerce Hlth Cntr

415 State St 1st Flr Rm 135 Springfield MA 01105

School based medical services Baystate Ambulatory Care Center

3300 Main Street Springfield MA 01107

Outpatient Physician Offices D'Amour Center for Cancer Care

3350 Main Street Springfield MA 01107

Outpatient Cancer Center Baystate Orthopedic Surgery Cntr

298 Carew Street Springfield MA 01104

Outpatient Surgery Center Baystate Rehabilitation Care

294 North Main Street East Longmeadow MA 01028

Rehabilitation Clinic Baystate Rehabilitation Care

360 Birnie Avenue Springfield MA 01107

Rehabilitation Clinic Baystate Rehabilitation Care Rymd Cntr

470 Granby Rd Ste 4 South Hadley MA 01075

Rehabilitation Clinic Baystate Rehabilitation Care

200 Silver St Ste 101 Agawam MA 01001

Rehabilitation Clinic BMC Urgent Care Unit

2 Medical Center Drive Springfield MA 01199

Outpatient Clinic Baystate Reference Laboratories

361 Whitney Avenue Holyoke MA 01040

Outpaitent Laboratory services Baystate Home Infusion & Resp Svs

211 Carando Drive Springfield MA 01004

Home infusion and respiratiory services and durable medical goods Part I, Line 7: Line 7a (Charity Care) - community benefit expense was calculated by applying the ratio of patient care cost to charges, calculated on Worksheet 2, against total charity care gross patient charges from the audited financial statements.Line 7b (Unreimbursed Medicaid) - community benefit expense was derived using the organization's cost accounting system, which takes into account all hospital inpatients, outpatients and emergency room patients for whom services were provided and covered under Medicaid and Medicaid managed care plans.Line 7c (Other Means-Tested Programs) - community benefit expense was derived using the organization's cost accounting system, which takes into account all hospital inpatients, outpatients and emergency room patients for whom services were provided and covered under other means-tested government programs.Line 7f (Health Professional Education) - community benefit expense was derived using the organization's cost accounting system.Line 7g (Subsidized Programs) - community benefit expense was derived using the organization's cost accounting system. The expense relates to specific outpatient programs.Line 7h (Research) - community benefit expense was derived using the organization's cost accounting system. In addition to the research costs reported on line 7h, there was $1,881,972 of expenses related to Industry-sponsored grants that we believe should be treated as community benefit expense because they were incurred to promote the health and well-being of the local population and are a key component of our commitment to the community. Part I, Line 7g: There are no costs attributable to physician clinics reported as subsidized health services in Part I, line 7g. Part I, L7 Col(f): Bad debt expense of $13,533,600 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 Medical Center provided $100,000 to the North End Housing Initiative (NEHI) with the goal of increasing the quantity, quality and healthfulness of affordable single and duplex family housing for low income families with young children in the North End neighborhoods of Springfield, Massachusetts. A portion of the funding is also used to leverage additional funding to write grants for projects what will assist the NEHI to achieve its mission. In addition to providing additional housing in the North End, NEHI also provides homebuyer and financial literacy courses to North End households and maximizes economic opportunities for minority-owned businesses within NEHI construction projects. The NEHI improves the public health of the community by providing greater access to healthy homes, reducing the prevalence of asthma in young children, increasing housing stability and creating safer and more beautiful neighborhoods through affordable homeownership.Baystate Medical Center provided $103,388 as a Payment in Lieu of Taxes (PILOT) to the City of Springfield for our outpatient facility at 3300 Main Street, Springfield. Baystate Medical Center provided $21,013 as a Payment in Lieu of Taxes (PILOT) to the City of Chicopee for our employee parking lot located at Center Street, Chicopee.Baystate Medical Center is a dues paying member of the Economic Development Council of Western Massachusetts and the Affiliated Chambers of Commerce of Greater Springfield. BMC participates in the EDC and Chamber as we are the largest local employer in our region. The Chamber and its membership coordinate activities toward a common purpose of sustainability and economic growth for the region. The amount paid for FY2011 was $78,109.The following description is not quantified specifically in Part II of Schedule H. Baystate Medical Center is committed to creating healthier communities and understands that many state and federally mandated community benefit programs and services are not sufficient to address ethnic, racial and economic health disparities. BMC extends the traditional definition of "health" to include economic opportunity, affordable housing, 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 Medical Center provides many valuable services, resources, programs and financial support - beyond the walls of the hospital and into the communities and homes of the people we serve; including sponsorships for more than 200 non-profit community organizations and events and involvement of Baystate leadership with over 70 community boards that align with our mission. Part III, Line 4: The cost of bad debts reported in Part III, line 2 was calculated by applying a ratio of cost to charges (based on the organization's cost accounting system including all hospital inpatients and outpatients) against total patient bad debt net of recoveries as reported in the audited financial statements. The portion of bad debt 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 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 inpatient psych), D Part V (outpatient) and E Part A (organ acquisition) of the hospital's CY Medicare cost report, based on Medicare costing principles. There is no shortfall reported on line 7. Part III, Line 9b: For patients who are known to qualify for Charity Care or Financial Assistance: The patient may have requested assistance up front at time of service with a Financial Counselor or the Patient could have asked for assistance after receiving their bill by contacting our Patient Billing Services Representatives. The Financial Counselor will assist the patient in applying for the appropriate type of assistance based on their income and circumstances. Once approved for a State Medicaid or other program, all billing and collection activity will stop (except for required co-payments or deductibles).For all other patients, our statements contain information regarding how to apply for financial assistance. Notices concerning availability for assistance are also posted at patient care sites. Part 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 Medical Center's needs assessment community partners included the AIDS Foundation of Western Massachusetts, Alzheimer's Association, American Cancer Society, American Diabetes Association, American Heart Association, Association for Community Living, Behavioral Health Network, Caring Health Center, Center for Human Development, CHNA #4 - Community Health Connections, Dunbar Community Center, Gandara Mental Health Center, Greater Springfield Senior Services, Healthy Start Planning Group, Holyoke Health Center, Holyoke/Chicopee Head Start, Jewish Education Resource Center, Jewish Family Services, Jewish Geriatric Services, Lutheran Social Services, Martin Luther King Jr Family Services, Mason Square Health Task Force, Mass in Motion, Men's Resource Center, Men's Resource International, New North Citizens' Council, North End Campus Coalition, North End Housing Initiative, Partners for a Healthier Community - BEST Oral Health, Pioneer Valley Asthma Coalition, Planned Parenthood, Puerto Rican Cultural Center, Regional/State Public Health Departments, Russian Community Association of Massachusetts, Public School Departments, Springfield Adolescent Health Project, Springfield Dept of Health & Human Services, Springfield Partners for Community Action, Springfield Police Department, Springfield Vietnamese American Civic Association, Square One, Tapestry Health, Valley Opportunity Council, Western MA Hispanic Foundation, YEAH! Network, YMCA of Greater Springfield, YWCA.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 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 Medical Center's target populations include: families with children/adolescents at risk due to poverty, isolation, language or cultural barriers residing in "limited opportunity" neighborhoods in center city Springfield and the broader Hampden County; families with children/adolescents at risk and/or victims of violence and/or sexual abuse; vulnerable populations, specifically children and their families, which reside and attend schools in the Brightwood and Memorial neighborhoods of Springfield's North End; children and adolescents at risk for preventative injury and death; high risk and vulnerable population that reside in zip code 01109, also referred to as the Greater Mason Square neighborhoods; transgender individuals, their allies and all persons from the broader community that identify as LGBT; Springfield Public School students (elementary, middle, high school and college) who benefit from supplemental instruction and workforce-related experiences to enhance their academic achievements and increase high school graduation and college readiness; vulnerable, low-income populations across the lifespan with particular attention to ethnic minorities experiencing health disparities; Children and adolescents (age two years to twenty-one years) with a diagnosis of obesity (BMI > 95% for age); the broader community with a target of non-English speaking immigrants who are at high risk for exposure and diagnosis of Tuberculosis; and access to care issues with a targeted focus on uninsured or underinsured residents of our communities. Part VI, Line 3: Baystate Medical Center (BMC) is committed to ensuring that patients in its community have access to quality health care services with fairness and respect without regard to the patients' ability to pay. BMC recognizes that the cost of necessary health care services can impose a significant financial burden on patients who are uninsured or underinsured and acts affirmatively to lessen that burden by offering patients in need the opportunity to apply for free or reduced cost services. BMC not only offers free and reduced cost care to the financially needy as required by law, but has also voluntarily established discount and financial assistance programs that provide additional free and reduced cost care to more patients residing within the communities served by BMC.Baystate Medical Center recognizes that the billing and collection process can be bewildering and burdensome for patients and has implemented procedures to make the process understandable for patients; to inform patients about discount and financial assistance options; and to ensure that patients are not subject to aggressive collection activities. Consistent with its patient commitment BMC is required to maintain a credit and collection policy that reflects its patient billing and collection procedures and complies with applicable state and federal laws and regulations. Baystate Medical Center has Financial Counselors available to help patients apply for financial assistance programs that may cover unpaid hospital bills, including a variety of federal and state programs as well as financial assistance through Baystate Medical Center. BMC is committed to ensuring that patients or prospective patients in the community are aware of financial assistance programs. For uninsured or underinsured patients, BMC will assist in applying for available financial assistance programs. BMC notifies patients of the availability of assistance in both the initial bill sent to patients as well as in general notices posted throughout the hospital.When applicable, BMC also assists patients in applying for coverage of services as a Medical Hardship based on the patient's documented income and allowable medical expenses. BMC provides, upon request, specific information about the eligibility process to be a Low Income Patient under either the Massachusetts Health Safety Net Program or additional assistance for patients who are low income through BMC's own internal financial assistance program. BMC also notifies patients about available payment plans based on their family size and income.Signs about the availability of financial assistance programs at Baystate Medical Center are translated into Spanish, because Spanish is primarily spoken by 10% or more of the residents in the hospital's service area. Signs are large enough to be clearly visible. Baystate Medical Center's sign is 8-1/2 x 11 inches and the header print font is 24 pts. Notice of availability of Financial Assistance Programs are posted in the following locations; inpatient, clinic, emergency department admissions and/or registration areas, central admission/registration area, patient financial counselor areas and business office areas that are open to patients. Our Credit and Collection Policy is posted on the baystatehealth.org website. The goal of posting the Credit and Collection Policy is to ensure that patients or prospective patients in our community are aware of our financial assistance programs.Baystate Medical Center's Credit and Collection Policy was developed in partnership with Health Care For All, a Massachusetts non-profit organization dedicated to making adequate and affordable health care accessible to everyone, regardless of income, social or economic status. Part VI, Line 4: Baystate Medical Center (BMC) is a major teaching, clinical and research facility of the Tufts University School of Medicine (TUSM) and a general medical and surgical hospital based in Springfield, Massachusetts. BMC is the only tertiary care referral medical center and Level 1 Trauma Center in western New England. It is also home to the region's only Children's Hospital with Neonatal and Pediatric Intensive Care Units. Springfield is the central city and county seat for Hampden County (pop. 463,490). BMC serves as the community hospital for Hampden County, which is ethnically and racially diverse with 41,644 (9.0%) African American residents and 96,776 (20.9%) Latino residents. The Latino community of Hampden County is concentrated in the cities of Holyoke and Springfield, while the African-American community is concentrated in Springfield. In all, 81% of all Latino residents of Hampden County live in either Springfield (which has 59,451 Latino residents) or Holyoke (which as 19,313 Latino residents). The following 23 cities/town (population) comprise Hampden County include; Agawam (28,438), Blandford (1,233), Brimfield (3,609), Chester (1,337), Chicopee (55,298), East Longmeadow (15,720), Granville (1,566), Hampden (5,139), Holland (2,481), Holyoke (39,880), Longmeadow (15,784), Ludlow (21,103), Monson (8,560), Montgomery (838), Palmer (12,140), Russell (1,775), Southwick (9,502), Springfield (153,060), Tolland (485), Wales (1,838), West Springfield (28,391), Westfield (41,094) and Wilbraham (14,219). Hampden County has a total population of 463,490. Located in Hampden County along the Connecticut River, Springfield is 27 miles north of Hartford CT, while Boston and New York City are 80 and 134 miles away, respectively. The Springfield Metropolitan Statistical Area (MSA) is the fourth-largest metropolitan area in New England and the county's contiguous urban nuclei is comprised of the central city of Springfield, with a population of 156,060, and the cities of Chicopee (55,298), and Holyoke (39,880). Much of BMC's service area has Medically Underserved Area or Population (MUA/P) designation from the Health Resources and Services Administration (HRSA) while the major towns have Health Professional Shortage Area (HPSA) designation.Within Hampden County, Springfield and the surrounding community, especially Holyoke, have many community risk factors that contribute to poor health, including substance abuse, child abuse and neglect, poverty and unemployment, crime and domestic violence, decreased informal social support networks, and overburdened public schools. In 2009, among Massachusetts counties Hampden County had the most teen births in the state with 747. Although the county accounts for only 7.1% of the state's overall population, the county has nearly 16.7% of all teen births in the state in 2009. As a percentage of total births in the county, teen births account for 12.2% of total births in Hampden County. This sharply contrasts with the state, in which teen births accounted for only 5.9% of total births. Hampden County is clearly the most at risk county in the state with regard to teen pregnancy.HIV/AIDS is a major problem, especially within our minority communities. Latinos and African-Americans in the Springfield area have also been disproportionately by the HIV/AIDS epidemic. Local epidemiological data provide by the Massachusetts Department of Public Health on HIV/AIDS for Springfield indicate that Latinos are most impacted by HIV/AIDS. More specifically in Springfield, Latinos account for 27% of the population yet accounted for 57% of the 1,093 people living with HIV/AIDS. It should also be noted that while only 2.3% of the population in Massachusetts live in Springfield, 15% of the Latinos living with HIV/AIDS in the state reside in Springfield.For the last two years, Hampden County has ranked last among Massachusetts counties on health outcomes and health factors (Wisconsin Population Health Institute, County Health Rankings 2010 and 2011). The geographic "driver" of these poor health outcomes is the county's major city of Springfield which is the poorest city in Massachusetts with a median family income of $41,476. The child poverty rate for Springfield is the 6th highest in the country with 44.6% of children under 18 living below the poverty line as compared to 12.4% for Massachusetts (2010 American Community Survey, Census Bureau). The city of Springfield has an overall poverty rate of 27.4% (U.S. Census, 2005-2009 American Community Survey) and has eight census tracts designated by the USDA as food deserts. In the 2010 Census, the Springfield MSA ranked first in the nation for Hispanic-White segregation and 22nd in the nation for Black-White segregation (Center for Population Studies, University of Michigan). The premature mortality rate (PMR), defined as deaths occurring before age 75 (# deaths/100,000 persons), is considered an excellent single measure of population health status. Springfield's PMR for heart disease is 419.5/100,000, compared to the state rate of 284.5/100,000, and the PMR for respiratory diseases is 196.6/100,000 compared to 137.8/100,000 for the state (MA Department of Public Health, 2006-2008 Mortality (Vital Records). As a result, poor people in Springfield have life expectancies 25% lower than people with higher incomes who live in more prosperous communities.BMC is committed to reducing health disparities in Springfield. Our commitment is demonstrated by our investment of significant resources in our three community health centers and pediatric clinic located in Springfield's low-income neighborhoods that have both HPSA and MUA/MUP designation. BMC health centers are primary care first-contact sites for thousands of underserved, low-income people. These community training sites for our Residency Program provide continuity of care for over 130,000 patients annually, most of who reside in an MUA/MUP. BMC provides primary care to a medically-underserved population in Springfield comprised of primarily Latinos and African-Americans. Springfield's black and Latino families fare poorly in comparison to their peers across the state on a myriad of sensitive indicators (e.g., infant deaths per 1,000 live births, low birth weight of less than 2,500 grams, births to adolescent mothers, adequacy of prenatal care). Springfield has one of the highest concentrations of MassHealth eligible populations. This low income population has a special health risk and a specific location in the Mason Square and North End neighborhoods with child poverty rates well above 30% and as high as 70% in some small areas. It is well-known that health disparities related to type 2 diabetes mellitus, obesity and cardiovascular disease are concentrated in black and Latino populations and among the 50,000 residents (30% of the city's population) in Mason Square and North End neighborhoods. Part VI, Line 6: Baystate Medical Center has a responsibility to respond to health care needs unsupported by government programs. In exchange for this responsibility, BMC qualifies for tax-exempt status under 501(c)(3). However, providing hospital care alone is not enough to qualify for tax-exempt status. Hospitals also must operate in the public interest and provide programs that benefit the community. Baystate Medical Center is fully committed to its role in the community and serves with pride and compassion for people in need.The charitable mission of Baystate Medical Center, a member hospital of Baystate Health (BH), is to improve the health of the people in our communities every day, with quality and compassion. Baystate Medical Center's Community Benefits Mission is to reduce health disparities, promote community wellness and improve access to care for vulnerable populations. BMC is committed to meeting the identified health and wellness needs of constituencies and communities served through the combined efforts of Baystate Health's member organizations, affiliated providers, and community partners.Baystate Medical Center meets all of the factors required of medical facilities in order to maintain tax exemption, as first described in Revenue Ruling 69-545. In support of patient care and the medical needs of the communities served by Baystate Medical Center, medical staff membership and privileges are extended to all qualified physicians and practitioners in western Massachusetts who meet the requirements for credentialing and clinical privileges, whether employed by a related Baystate entity or community-based. Baystate Medical Center's emergency department is open to all in need of care and services; no one requiring emergency care is denied treatment. 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 select nominees who are representative of the various and diverse constituencies served by Baystate Health and its affiliates. In particular the Committee nominates persons who are representative of the community consumer interests of the various neighborhoods and localities which are served by Baystate Health and its affiliates in the carrying out of and pursuant to the charitable mission of the Baystate Health and its affiliates. Baystate Medical Center's Patient and Family Advisory Council facilitate patients and families to share information and advise the hospital regarding policies and programs. Information from the Council provides hospital leadership with an enhanced understanding of how to improve quality, program development, service excellence, communications, patient safety, facility design, patient and family education, patient and family satisfaction, and loyalty.Please refer to the section above in line 2 for additional examples of Baystate Medical Center's responsiveness to the community and opportunities for community involvement; including the Board of Trustees' Governance Committee, Community Benefits Advisory Council, and Community Health Needs Assessment. Baystate Medical Center is recognized as a leading academic medical center. As the Western Campus of Tufts University School of Medicine since 1974, BMC offers clinical training and undergraduate and graduate medical student education across all specialties. Baystate Medical Center serves as a safety-net hospital due to the high level of Medicaid and charity care provided. In addition, BMC offers unique, specialized services including Level 1 Trauma, Children's Hospital, Invasive heart and vascular services, Cardiac surgery, Kidney transplantation, Level III Neonatal ICU, Specialized ICU's for children, adults and heart and vascular patients and the D'Amour Center for Cancer Care.Baystate Health encourages all of its affiliates, hospital and non-hospital to align their charity care and collections standards with Baystate Health's Credit and Collection Policy. While some of the rules and regulations are hospital specific, the guidelines stated in the Baystate Health Credit and Collection Policy concern all affiliates. Baystate Medical Center built a visionary new facility which opened in March 2012 that will meet our community's needs today, while laying the foundation for future growth. Hundreds of people, from patients to care providers to the community at large, have shared ideas and experiences to design the 641,000 sq. foot facility that includes a dedicated heart and vascular center, new patient care units with spacious private rooms, new emergency department and shell space for future growth. A major part of the public health commitment of Baystate Medical Center's Hospital of the Future project is the delivery of $9.6 million in new aid to community benefit initiatives in Springfield. Baystate Medical Center made an additional investment of $2 million in new community benefit funding tied to the new Emergency Department. The $11.6 million, to be distributed over a period of seven years, addresses public health priorities such as nutrition, teen pregnancy, violence prevention, oral health and asthma, as well broader issues such as education, homelessness and employment. Baystate Medical Center participates in advocacy activities on behalf of health care coverage for all persons and for improved public health. Baystate Health leaders serve on the community boards for Health Care For All, a Massachusetts non-profit organization dedicated to making adequate and affordable health care accessible to everyone, regardless of income, social or economic status and the Massachusetts Public Health Association, a non-profit organization that promotes laws, policies, and programs that protect the health of our families, communities, and workplaces. In addition, Baystate Medical Center provides annual funding to Partners for a Healthier Community, a local leader in public health policy advocacy, building collaborations and leadership capacity to address various public health issues.For additional information, please see Line 6 below. Part VI, Line 7: 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, Baystate Visiting Nurse Association and Hospice, and Baystate Health Foundation. In addition to its 10,000 employees, Baystate Health has 1,500 medical staff, 2,000 nurses, 2,000 students including residents, fellow, and medical, nursing and allied health students, and over 900 volunteers. Baystate Medical Center (BMC), the flagship 783-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 FY2011 Baystate Medical Center provided $14.7 million in charity care, $38.8 million in health professions education, $5.5 in subsidized health services, $20.6 million in research and $2.5 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 93-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 FY2011 Baystate Franklin Medical Center provided $5.1 million in charity care, $1.9 in subsidized health services and $204,378 in community health improvement services. BFMC's community benefit efforts included the ongoing support group through the Franklin County Postpartum Partnership - a partnership initiated by BFMC nurses; expanded senior outreach program to focus on persons most at-risk for hospital readmission due to issues with medication management; and continued the regionally recognized Blood & Guts program for youth, including an annual hospital-based event for high school students and three school-based events for elementary school students and their families.In addition, BFMC HealthBeat TV, a monthly 30-minute cable access talk show produced, directed and hosted by Baystate Franklin employees, engages the hospital's physicians, employees, patients and community leaders in discussions of interest to residents of Franklin County. Topics range from new surgical services to heart health, emergency response and 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 FY2011 Baystate Mary Lane Hospital provided $1.3 million in charity care and $156,499 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 2011) have taken the EMT Basic Course. In December 2010 Baystate Mary Lane Hospital sponsored the first Paramedic Training program. A total of 15 EMT Basic candidates enrolled in this new class held at the hospital two nights a week through 2011. 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 as they addressed health topics including H1N1, Lyme Disease, Nutrition, Osteoporosis, Diabetes, Stroke Prevention, Exercise, Women's health issues including HPV and Cervical Cancer, Men's Health and much more. 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 concussion and children, fitness, stroke, lyme disease, nutrition, and much more. The program runs more than 60 times a month.Baystate Medical Practices (BMP) is a tax-exempt, not-for-profit corporation organized to support and assist Baystate Health and its affiliate hospitals, including BMC, BFMC and BMLH, each of which is a Massachusetts not-for-profit corporation, in achieving the fulfillment of their clinical, teaching, research, and other missions related to health care. Baystate Medical Practices, Inc. provides physician services, medical education and research programs to people in the community within its geographic location. BMP's policy is to provide care to any patient in need of medical care, regardless of the patient's ability to pay for such care. Dependent upon the patient's financial capability to pay, BMP may provide such care free of charge or at amounts below its normal charges. Because BMP does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue. In FY2011 BMP provided $4,580,612 in charity care. In addition to the charity care provided to patients, BMP's physicians participate in many and varied ongoing community outreach initiatives in the areas of education, employment, safety and health. BMP has also taken a leadership role in strengthening the health of disadvantaged citizens in surrounding communities including specific focus on AIDS and HIV and by providing physician staffing for three community-based health centers through Baystate Medical Center.Visiting Nurse Association and Hospice of Western New England, Inc. (VNAH) based in Springfield, Massachusetts is a tax-exempt, not-for-profit corporation organized to support and assist Baystate Health and its affiliate hospitals, including BMC and BMLH, each of which is a Massachusetts not-for-profit corporation, in achieving the fulfillment of their clinical, teaching, research, and other missions related to health care. VNAH is a comprehensive home health care agency committed to providing the highest quality care to patients and families, primarily in the home setting. Form 990, Schedule H, Part VI, Line 6 continued VNAH has the expertise to meet individual needs by bringing experienced nurses, rehabilitation therapists, social workers and home care aides to patients' homes. The Home Care Program of Baystate's Visiting Nurse Association and Hospice serves over 6,000 patients annually. The services, aimed at allowing patients to recuperate while remaining in the comfort of their homes, includes skilled nursing, rehabilitation therapy, medical social work and homecare aides. The Hospice and Palliative Care Program of Baystate's Visiting Nurse Association and Hospice provides end of life care for patients in the community, assisted living facilities and skilled nursing facilities. The program coordinates care for an average daily census of about 140 to 180 patients of all ages. 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 $13.9 million in 2011; $8.9 million for the Hospital of the Future and an additional $5 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 Medical Center, Inc. and its affiliates other activities regarding promotion of community health.Baystate Health interpreters provided over 113,422 sessions in 49 languages in 2011 to help deliver a positive patient care experience. 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 2011, we ran 60 courses for a total of 493.34 hours. A total of 3,742 people attended, for a total of 27151.57 credits assigned. We also ran 34 series, 441 sessions, for a total of 454.2 hours. A total of 11,814 people attended these sessions, for a total of 12076.2 credits assigned. All courses and sessions were attended by both employees and non employees. Our educational activities are a service to the community. Baystate Medical Center'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 1-year Pharmacy residency. Baystate'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 practicum's for baccalaureate, masters, or doctoral-level nursing students in affiliation the University of Massachusetts, University of Connecticut, Yale University, and other schools of nursing. Baystate Medical Center's high quality nursing care earned the re-designation Magnet Hospital for Nursing Excellence by the American Nurses Credentialing Center (ANCC) - one of 170 in the nation and only five in Massachusetts.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 Nurses Credentialing Center's (ANCC) Commission on Accreditation), American Psychological Association, American Heart Association, Global Health Education Consortium, Medical Library Association.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.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); Children's 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).Baystate Medical Center is also a research partner with University of Massachusetts through the Pioneer Valley Life Sciences Institute. Formed in 2003, PVLSI is a research institution which applies its translational research efforts in the areas of cancer, diabetes, obesity, and wound healing. Its scientists and technicians are committed to improving human health and reducing suffering from disease through creative strategies for early detection and preventive interventions.Other Baystate Health affiliations include Council of Teaching Hospitals and Health Systems (COTH) of the Association of American Medical Colleges (AAMC), Alliance of Independent Academic Medical Centers (AIAMC), and Group on Regional Medical Campuses (GRMC) of the Association of American Medical Colleges (AAMC), Joint Commission and Medical Library Association (MLA).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. Form 990, Schedule H, Part VI, Line 6 continued 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. 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 helped 101 employees become homeowners in communities served by Baystate Health hospitals, helping to stabilize housing in those communities. Since 1994, Rays of Hope - A Walk & Run Toward the Cure of Breast Cancer has been committed to improving the breast health of people in our communities with quality and compassion. Through the Baystate Health Foundation, the Walk has grown from 500 participants to over 21,000 and has raised over $10.25 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, a collaboration between clinicians at Baystate Health and scientists at UMass-Amherst, to continue locally based breast cancer research on a broader scale. The United Way develops and supports programs that directly improve the lives of people in our communities, a mission proudly shared by Baystate Health. Baystate Health is a strong supporter of the United Way, and a major contributor to the organization with three workforce campaigns and thousands of employee donors and volunteers. Baystate Health's contributions help the United Way serve our families, friends, colleagues and others who seek help in different ways and at different times in their lives. Three community campaigns are held annually: Springfield workplace to support the United Way of Pioneer Valley, Greenfield workplace to support the United Way of Franklin County and Ware workplace to support the United Way of Hampshire County. Employees can direct their donations to one or all of the United Way's action areas: Education, Income and Health or designate to a qualified agency with a minimum contribution. Baystate employees also support the United Way by volunteering on work time to participate in a variety of community-based projects for the United Way Day of Caring. Form 990, Schedule H, Part VI, Line 7 List of States Receiving Community Benefit Report: MA 1 Baystate Health Foundation Inc 759 Chestnut Street Springfield MA 01199 043549011 501(C)(3) 171078 To provide support for radiology education & research, pediatric programs, and breast cancer education, research & patient care programs. Baystate Health Inc 759 Chestnut Street Springfield MA 01199 042105941 501(C)(3) 1700000 Strategic initiatives 2 Nurse Midwifery Program-Federal Traineeship Awards .99I3 . \M\*4,9,S,1 2 16040 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: The vast majority of the funds awarded are applied directly to tuition. Specific guidance is given as to appropriate use of the funds. Funds may be used for tuition, living expenses and up to $500 in required textbooks. They may not be utilized for travel or to defray costs of attending professional meetings. X X X X X 0 1 1 0 0 0 0 0 0 Mark R Tolosky 0 680614 0 380604 0 577184 0 73034 0 39174 0 1750610 0 0 Loring S Flint MD 0 917432 0 360152 0 234099 0 48361 0 29220 0 1589264 0 0 Grace P Makari-Judson MD 254073 0 34903 0 22735 0 40633 0 25442 0 377786 0 0 0 Heather Z Sankey MD 246550 0 10537 0 3284 0 24767 0 16997 0 302135 0 0 0 Barbara W Stechenberg MD 194771 0 24923 0 3041 0 103668 0 16417 0 342820 0 0 0 Dennis W Chalke 0 315800 0 113223 0 135760 0 23333 0 28199 0 616315 0 0 Deborah Morsi 193057 0 43301 0 12991 0 64847 0 23777 0 337973 0 0 0 Deborah A Provost 176707 0 41349 0 8474 0 79107 0 8834 0 314471 0 0 0 Jonathan Pine 155281 0 45509 0 16048 0 8293 0 23546 0 248677 0 0 0 Michael F Moran 173463 0 40186 0 369 0 22219 0 19177 0 255414 0 0 0 Peter Lindenauer MD 229932 0 38520 0 5389 0 27569 0 24563 0 325973 0 0 0 David Y Chin PhD 202116 0 17406 0 11097 0 19200 0 24913 0 274732 0 0 0 Michael R Favreau 165965 0 19287 0 15981 0 41013 0 17540 0 259786 0 0 0 Randolph Peto MD 185562 0 10241 0 2614 0 16228 0 11994 0 226639 0 0 0 Betty K Larue 153703 0 18199 0 13404 0 23012 0 22556 0 230874 0 0 0 Keith C McLean-Shinaman 0 373623 0 146922 0 76786 0 51333 0 40564 0 689228 0 0 Part I, Lines 4b-c Dennis W. Chalke - Supplemental Retirement of $109,384 is included in column E. This amount was earned in 2010. Loring S. Flint, MD - Supplemental Retirement of $142,221 is included in column E. This amount was earned in 2010. Peter Lindenauer, MD - Supplemental Retirement of $4,615 is included in column E. This amount was earned in 2010. Grace Makari-Judson, MD- Supplemental Retirement of $10,461 is included in column E. This amount was earned in 2010. Keith C. McLean Shinaman - Supplemental Retirement of $60,038 is included in column E. This amount was earned in 2010. Deborah Morsi - Supplemental Retirement of $2,442 is included in column E. This amount was earned in 2010. Heather Sankey, MD - Supplemental Retirement of $2,237 is included in column E. This amount was earned in 2010. Mark R. Tolosky - Supplemental Retirement of $418,714 is included in column E. This amount was earned in 2010. 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 2010 compensation of $102,413 was based on the difference between the fair market value at the date of exercise and the exercise price. Supplemental Information Part III Part 1, Line 3 The board of the filing organization has appointed the compensation committee of Baystate Health, Inc., a related organization and the parent organization of the 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 II Dr. Flint terminated employment effective 12/30/2010. The compensation numbers include various one time termination payments. MA Health & Education Facil Authority 042456011 57586CNHA 2005-10-27 71740000 MA HEFA Series G - See Part V 0 0 0 MA Health & Education Facil Authority 042456011 2007-01-18 10000000 MA HEFA Series H - See Part V 0 0 0 MA Health & Education Facil Authority 042456011 2008-06-30 10157671 MA HEFA Series M2 - See Part V 0 0 0 MA Health & Education Facil Authority 042456011 57586EKC4 2009-06-25 198611250 MA HEFA Series IJK - See Part V 0 0 0 15830000 71740000 735004 6990000 64014996 2005 0 1 1 1 3111111 10000000 72250 9927750 2006 0 0 1 1 1375436 10157671 87687 10069984 2008 1 0 1 1 199113377 2530232 93479 98647754 65000000 32339785 1 0 0 1 0 0 1 1 1 0.00770 0.00000 0.00770 1 0 0 1 1 1 0.00040 0.00030 0.00070 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 1 1 Citibank 20.700000000000 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 1 0 1 0 0 0 0 Schedule K Supplemental Information on Tax-Exempt Bonds Part I, Column (f) Description of Purpose: A - MHEFA Series Series G Part I - Per the Official Statement, the purpose of the bond proceeds is: (i) to advance refund $61,930,000 principal amount of the Authority's Revenue Bonds, Baystate Medical Center (the Institution) Issue, Series E (the "Series E Bonds"), which were issued July 11, 1996 to finance or refinance the following property owned by the Institution: (a)construction of a new 104,500 gross square foot Ambulatory Care Center at 3300 Main Street, Springfield, Massachusetts; (b) construction of a new 100,000 gross square foot building to house the Ambulatory Surgery Center, Medical Library and education/conference space on the Institution's North campus located at 759 Chestnut Street, Springfield, Massachusetts; (c) renovation of various existing spaces within the Institution's North campus; (d) acquisition of equipment for the new facilities; (ii) to finance routine capital construction, renovations, and equipping of various facilities of the Institution; and (iii) to pay certain costs of issuance of the Series G Bonds. B- MHEFA Series H Part I - Per the Official Statement, the purpose of the bond proceeds is: (i) the construction, improvement, equipping, and other related capital expenditures of a parking garage walkway, and other related work at an existing building at 280 Chestnut Street owned and used by the Institution (the "Garage"), and (ii) the acquisition and installation of capital equipment and renovations to existing facilities of the Institution and other routine capital expenditures in connection with the Institution's hospital operations. MA Hefa Series H were private placement bonds and therefore, there is no CUSIP number associated with these bonds. C- MHEFA Series M-2, Pool 2 Part I - Per the Official Statement, the purpose of the bond is to refinance Baystate Medical Center's Mass HEFA Pool J-2 Loan, which were issued February 2, 1999 to finance the acquisition and equipping of the property located at 280 Chestnut Street, Springfield, Massachusetts (the "Property"), and the renovation of the Property and existing facilities of the Institution and the acquisition of capital equipment for the Institution's existing facilities. The MA HEFA indebtedness listed is a pool loan therefore the questions are being answered with respect to the Baystate Medical Center loan alone rather than with respect to proceeds loaned to other conduit borrowers. There is no CUSIP associated with this loan. D- MHEFA Series I, J-1, J-2, K-1, K-2 Part I - Per the Official Statement, the purpose of the bond proceeds are: (i) to pay a portion of the costs associated with the acquisition of land, site development, construction or alteration of buildings or the acquisition or installation of furnishings and equipment, refinancing of, or any combination of the foregoing, in connection with the construction, improvement, equipping, and other related capital expenditures of a seven-story, approximately 599,100 gross square foot primarily inpatient building located at 759 Chestnut Street, Springfield, Massachusetts, including demolition and site work, which building will be constructed by Baystate Total Home Care (BTHC) and leased to Baystate Medical Center by BTHC; (ii)for the acquisition and installation of capital equipment and renovations to existing facilities of the Medical Center and other routine capital expenditures included or to be included in the Medical Center's capital budget over the next three years for use in connection with the Medical Center's hospital operations; (iii) for the refinancing of a portion of an outstanding commercial loan in the amount of $65,000,000 made by Bank of America, N.A. on October 20, 2008 to the Medical Center in connection with the defeasance of the Authority's Revenue Bonds, Baystate Medical Center Issue, Series D, issued September 16, 1993; and (iv) for the financing of costs associated with the issuance of bonds. (iii) financing of routine capital construction, renovations, and equipping of various facilities of Baystate Medical Center. Part II Proceeds, Line 7, Issuance Costs Bond D - Issuance costs per Form 8038 were $2,530,232, however the total amount of actual issuance costs expended was $1,845,403 due to $684,829 of expected issuance costs being unused and transferred to the project fund. The organization follows management practice 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 and procedures. Part III, Lines 4 and 5, Column B: For all projects financed with proceeds of tax-exempt bonds, Baystate Medical Center also contributed equity. Baystate timely elected to first allocate private business use to its equity contributions, therefore, has reported 0% private business use of proceeds for its Series H bond issue on Schedule K. Part III, Lines 4 and 5, Column C: For all projects financed with proceeds of tax-exempt bonds, Baystate Medical Center also contributed equity. Baystate timely elected to first allocate private business use to its equity contributions, therefore, has reported 0% private business use of proceeds for its Series J-2 bond issue on Schedule K. Part III, Lines 4 and 5, Column D: The private business use percentage is listed as 0% because the refunded bond financed assets were place in service prior to 12/31/2002. The new project portion of the bond financing has not been completed and placed in service as of 9/30/2011. Part IV, Line 1, Column A & D: A rebate calculation was performed and no amounts were owed, therefore, no Form 8038-T was required to be filed. Part IV, Line 1, Column B & C: An exception to the rebate applied to these bond issues, therefore, no Form 8038-T was required to be filed. American Excess Insurance Exchange Board Overlap 1346126 See 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 Balise Motor Sales Co Balise Board Overlap 42060 See Part V - Steven Mitus, Board Member of the filing organization is also the Executive Vice President & CFO of Balise. The filing organization made payments to Balise relating to the purchase and rental of vehicles. 0 Baycare Health Partners Inc (BHP) Common Board Members or Officers 763369 See Part V - The filing organization received payments from BHP for patient care services for which BHP is the intermediary between the filing organization and third party payers. BHP is an affiliate corporation of the filing organization. 0 Baycare Health Partners Inc (BHP) Common Board Members or Officers 1417284 See Part V - The filing organization made payments to BHP for annual support fees. BHP is an affiliate corporation of the filing organization. 0 Baystate Health System Ambulance Inc (BHSA) Common Board Members or Officers 5604 See Part V - The filing organization received payments from BHSA for an employee benefit program. BHSA is an affiliate corporation of the filing organization. 0 Baystate Health System Ambulance Inc (BHSA) Common Board Members or Officers 360395 See Part V - The filing organization made payments to BHSA of $198,339 for patient transport services and $162056 for patient care services. BHSA is an affiliate corporation of the filing organization. 0 Baystate Radiology & Imaging (BRI) Common Board Members or Officers 787061 See Part V - The filing organization received payments from BRI of $625,000 for partnership distributions, $161,335 for Outside Technologists and $726 for Rent. BRI is an affiliate corporation of the filing organization. 0 Health New England Inc (HNE) Common Board Members or Officers 86821184 See Part V - The filing organization received payments from HNE of $111,293 for certain employee benefit programs, $30,709 for reimbursement of expenses and $86,679,182 related to medical claims. HNE is an affiliate corporation of the filing organization. 0 Ingraham Corporation (IC) Common Board Members or Officers 91817 See Part V - The filing organization received payments from IC for rent. IC is an affiliate corporation of the filing organization. 0 Ingraham Corporation (IC) Common Board Members or Officers 54057 See Part V - The filing organization made payments to IC of $1,420 for phone services and $52,637 as lease payment. IC is an affiliate corporation of the filing organization. 0 New England Dermatology Laser Cen NEDLC owned more than 5% by family member of Dr. Wenner, Board Mbr of BMC 19723 See Part V - The filing organization made payments to NEDLC for medical services. 0 New England Orthopedic Surgeons In Corporation owned more than 5% by Dr. Steven Wenner, Board Member of BMC 27500 See Part V - The filing organization received payments from NEOS for rental of parking spaces. 0 New England Orthopedic Surgeons In Corporation owned more than 5% by Dr. Steven Wenner, Board Member of BMC 1863001 See Part V - The filing organization made payments to NEOS of $400,905 for patient care services, $1,032,096 for management services and $430,000 for contracted services. 0 Form 990, Part VI, Section A, line 2 Allan W. Blair, Dennis W. Chalke, Charles L. D'Amour, Kristin R. Delaney, John A. Egelhofer, MD, Loring S. Flint, MD, Frederic W. Fuller, III, Frances C. Grabowski, M. Dale Janes, 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, 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 Baystate Health, Inc. & 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) Mark R. Tolosky and David Southworth; (3) Steven M. Mitus, Timothy S. Rice and Richard B. Steele, Jr.; (4) Allan W. Blair, Charles L. D'Amour, Steven M. Mitus and Mark R. Tolosky; (5) M. Dale Janes and James P. Sadowsky; (6) M. Dale Janes, Allan W. Blair and Victor Woolridge; (7) Mark R. Tolosky and Victor Woolridge; (8) Steven M. Mitus and Victor Woolridge; (9) David W. Townsend and Mark R. Tolosky. Form 990, Part VI, Section A, line 3 Baystate Medical Center, Inc. is affiliated with Baystate Administrative Services, Inc. (BAS) which is a 501 (c)(3) organization. Various management and support functions are delegated to BAS. Form 990, Part VI, Section A, line 6 The filing organization has one member, Baystate Health, Inc. ("BH"). Form 990, Part VI, Section A, line 7a The Board of Trustees of the filing organization are the same individuals serving as members of the Board of Trustees of BH with the addition of the president of the medical staff of the filing organization. The Board of Trustees of BH are elected annually by the Board of Trustees of BH at their annual meeting. Form 990, Part VI, Section B, line 11 Prior to the filing of this return appropriate parts of this Form 990 were reviewed by representatives from the Tax, Finance, and Human Resources Departments of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs), some of whom are officers or trustees of the filing organization and by outside legal counsel. The entire return was reviewed by a tax expert from an outside accounting firm. The entire return was also reviewed prior to filing by the Audit and Compliance Committee of Baystate Health, Inc., which also includes some of the officers and trustees of the filing organization. Form 990, Part VI, Section B, line 12c Baystate Health, Inc. (BH) has a comprehensive conflict of interest policy which has been adopted by the filing organization. All directors, trustees, officers, key employees, and highest compensated employees of BH and its affiliates are asked to complete an annual conflict of interest form. We utilize an electronic database to receive and manage all conflict of interest submissions. This information is reviewed by the BH Chief Compliance Officer, the BH Chief Executive Officer, the Chair of the BH Board of Trustees, and the Chair of the Audit & Compliance Committee of BH. A summary of the conflict of interest disclosures is provided to the Baystate Health Board of Trustees and the Tax Department and reviewed by outside counsel. Potential conflict of interest transactions are reviewed as appropriate under the policy, which provides for recusal from discussion and deliberation by any party with a potential conflict of interest. Form 990, Part VI, Section B, line 15 The compensation of the President, and all key officers and employees is reviewed and determined annually by the compensation committee of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs), which has been appointed as the compensation committee of the filing organization and consists entirely of individuals serving on the board of the filing organization. Form 990, Part VI, Section B, Line 16b Baystate Health, Inc. has a joint venture policy that covers affiliated tax exempt entities including Baystate Medical Center, Inc. Form 990, Part VI, Section C, line 19 The organization makes its conflict of interest policy and financial statements available to the public at www.baystatehealth.org. Articles or organization and bylaws are generally available at the Commonwealth of Massachusetts website. Average hours per week: 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. Form 990, Part VII, Section A, Line 5 Certain officers or trustees of the filing organization are paid by an entity, Baystate Medical Practices, Inc. (BMP) EIN 04-2888373, 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. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized losses on investments: -16,068,920. Transfer of funds for strategic initiative to affiliated companies -12,246,185. Transfer of funds for land, bldg. & equip. to affiliated companies 4,868,049. Minimum pension liability adjustment -27,755,216. Equity gain to unconsolidated affiliates 486,821. Change in value of interest in BHF-Temporarily Restricted 3,610,823. Total to Form 990, Part XI, Line 5: -47,104,628. Baystate Administrative Services Inc 759 Chestnut Street Springfield MA 01199 222747685 Administrative services MA 501 (c ) (3) 11c, IIIc Baystate Health Inc 0 Baystate Franklin Medical Center 164 High Street Greenfield MA 01301 042103575 Hospital MA 501 (c ) (3) 3 Baystate Health Inc 0 Baystate Health Foundation Inc 759 Chestnut Street Springfield MA 01199 043549011 Fundraising MA 501 (c ) (3) 7 Baystate Health Inc 0 Baystate Health Systems Inc Health & Welfare Benefits Plan 759 Chestnut Street Springfield MA 01199 222531644 Voluntary Employees' Benefit Association MA 501 (c ) (9) Baystate Health Inc 0 Baystate Health Inc 759 Chestnut Street Springfield MA 01199 042105941 Healthcare System Parent MA 501 (c ) (3) 7 Baystate Health Inc 0 Baystate Mary Lane Hospital Corporation 85 South Street Ware MA 01082 042103584 Hospital MA 501 (c ) (3) 3 Baystate Health Inc 0 Baystate Medical Center Auxiliary Inc 759 Chestnut Street Springfield MA 01199 046065279 Supporting organization for Hospital MA 501 (c ) (3) 7 Baystate Health Inc 0 Baystate Total Home Care Inc 50 Maple Street Springfield MA 01199 203260764 Real Estate and Other MA 501 (c ) (3) 11b, II Baystate Health Inc 0 BH Insurance Company Ltd North Church Street Georgetown CJ 980421413 Offshore captive Insurance CJ Baystate Health Inc 0 Visiting Nurse Assn and Hospice of Western New England Inc 50 Maple Street Springfield MA 01199 042105803 Homehealth and Hospice care MA 501 (c ) (3) 9 Baystate Health Inc 0 Health New England Inc Monarch Place Suite 1500 Springfield MA 011441500 042864973 HMO/Insurance MA Baystate Health Inc C HNE Advisory Services Monarch Place Suite 1500 Springfield MA 011441500 043012347 Administrative Svs MA Health New England Inc C Health New England Insurance Monarch Place Suite 1500 Springfield MA 011441500 043183019 Ancilliary Insurance MA Health New England Inc C Health New England of Connecticut Monarch Place Suite 1500 Springfield MA 011441500 061398662 Dormant MA Health New England Inc C Ingraham Corporation 759 Chestnut Street Springfield MA 01199 043016257 Health care and other business activities MA Baystate Health Inc C Baystate Health System Ambulance Inc 759 Chestnut Street Springfield MA 01199 043018550 Ambulance Svs MA Ingraham Corporation C 0 1 0 0 1 0 0 0 1 1 1 1 0 0 0 1 1 1 Baystate Health Foundation Inc B 171078 Baystate Health Inc B 1700000 Baystate Health Inc E 532648 Visiting Nurse Association and Hospice of Western New England Inc J 118020 Baystate Administrative Services Inc I 1096990 Baystate Health Inc J 268340 Baystate Total Home Care Inc J 5312795 Baystate Total Home Care Inc I 100010 Baystate Administrative Services Inc L 71782541 Baystate Franklin Medical Center K 1077454 Baystate Mary Lane Hospital K 502663 Baystate Administrative Services Inc K 68945 Baystate Health Inc Q 13941983 Ingraham Corporation I 91817 Ingraham Corporation J 52637 Baystate Health System Ambulance Inc L 360395 Health New England Inc P 86790475 Baystate Medical Center Auxiliary P 259128 Baystate Medical Center Auxiliary G 172499 Baystate Medical Center Auxiliary G 114619 Baystate Health Inc R 1744898 Baystate Health Inc R 135326 Baystate Health Foundation Inc R 1772095 baystate Health Foundation Inc R 4732722 Form 990, Schedule R, Part II Baystate Health (EIN 04-2105941) is filing Form 5471 Information Return of US Person with respect to Certain Foreign Corporation on behalf of the filing organization.