2011-08-11T16:15:10-05:00 2010-09-30 FEELEY & DRISCOLL PC 200 PORTLAND STREET BOSTON MA 02114 990 2009-10-01 042103577 HARRINGTON MEMORIAL HOSPITAL Inc HARR 5087653010 100 South Street Southbridge MA 015508002 Edward Moore 5087653010 2011-08-09 1 Alan Garofalo 6177427788 2009 2016-02-24 21:20:13Z Edward Moore 100 South Street Southbridge MA 015508002 106192475 0 X WWW.HARRINGTONHOSPITAL.ORG X 1928 MA Charitable - To provide high quality medical services in a cost efficient and cost effective manner to the residents of South Central Massachusetts. 11 11 1353 666 1282616 251427 41969 11566 86414924 103953097 -397160 1327204 633817 356052 86693550 105647919 0 0 48848717 56154459 0 546039 35190483 45791672 84039200 101946131 2654350 3701788 124919012 125277354 47778998 42649065 77140014 82628289 The primary mission of the Hospital is to provide high quality medical services in a cost efficient manner to the residents of South Central Massachusetts 0 0 39025137 56777122 The operation of an acute care hospital, which had 200,000 outpatient visits during the year ended September 30, 2010. 26741066 19890082 The operation of an acute care hospital, which provided 15,645 days of inpatient care during the year ended September 30, 2010. In FY 2010, the Hospital had 113 beds and 12 nurseries. 17805259 26003277 The operation of an acute care hospital, which provided treatment for 35,390 emergency room visits during the year ended September 30, 2010. 83571462 1 0 0 1 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 118 0 1 1353 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 11 11 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 MA X X Tom Sullivan 5087658130 100 South Street Southbridge MA 015508002 Alan Peppel 1.00 X 0 0 0 Ronald Carlson 1.00 X 0 0 0 theresa Colognesi 1.00 X 0 0 0 David Turner 1.00 X 0 0 0 Anthony M Detarando 1.00 X 0 0 0 Vladas Litani MD 1.00 X 0 0 0 Anthony Jay detarando 1.00 X 0 0 0 john g stagias md 1.00 X 0 0 0 tammy vargas md 1.00 X 0 0 0 james waddick 1.00 X 0 0 0 hamer clarke 1.00 X 0 0 0 Ronald Vairo 1.00 X 0 0 0 Mark Palmerino 1.00 X 0 0 0 edward moore 40.00 X 412402 0 45979 thomas sullivan 40.00 X 244718 0 10826 Douglas Crapser 40.00 X 166223 0 22383 Arthur Russo MD 40.00 X 171704 0 5237 James Stephens MD 40.00 X 296309 0 13251 Keith Hilliker MD 40.00 X 275718 0 17653 William Petrone MD 40.00 X 250602 0 29883 Resul Ozbayrak MD 40.00 X 234317 0 17815 michael gaudet md 40.00 X 342750 0 27750 richard mangion X 257960 0 0 2652703 0 190777 31 1 1 0 By Design Construction 55 North Street Suite 220 Bedford MA 01730 Construction 1697557 harvard medical faculty physicians inc 330 brookline avenue boston MA 02215 radiology consultation 1046200 Navin & Haffy Associates 200 Cordwainer Dr Suite 100 Norwell MA 02061 IT Consulting 974699 Quest Diagnostics PO Box 740709 Atlanta GA 30374 Medical Services 703651 suffolk construction 65 allerton street boston MA 02119 construction 593447 5 11566 11566 Net Patient Service Re 900099 100698443 99415827 1282616 Contract Revenue 900099 2060142 2060142 Other Clinical Revenue 900099 1194512 1194512 103953097 1473684 1473684 197617 394755 -197138 -197138 -197138 3321 149801 -149801 3321 -146480 -146480 Cafeteria Revenue 900099 465775 465775 Purchase Discounts 900099 87415 87415 553190 105647919 103223671 1282616 1130066 1125006 202476 922530 44325558 37891918 6433640 1494977 1253015 241962 5709461 4774638 934823 3499457 2933070 566387 163922 163922 154898 154898 50497 50497 4613800 3203886 1409914 250468 250468 626930 626930 3731416 2966611 727456 37349 153297 153297 97300 97300 206805 206805 6938004 5620635 1272224 45145 902722 740656 162066 Provision for uncollect 6627945 6627945 Medical/Surgical Suppli 4889134 4889134 0 0 Pharmaceuticals 2488347 2488347 Physician Fees 2260126 2260126 TAXES RELATED TO UBI 107700 107700 11528361 7719005 3596279 213077 101946131 83571462 17828630 546039 3908103 699907 10893654 12301626 388293 326199 1732905 1882889 1034567 692643 100859284 49762213 45573416 51097071 58685477 56842088 2702597 1434931 124919012 125277354 10976518 11899332 20000000 20000000 1362479 1377177 15440001 9372556 47778998 42649065 X 69770289 75074576 2030531 2124413 5339194 5429300 77140014 82628289 124919012 125277354 X 0 1 1 X 1 1 X 0 0 0 0 0 0 0 0 1 45500 45500 0 Part II-B, Line 1i: Explanation of Other Lobbying Activities: During the year, the Hospital utilized the services of Government Relations Group in support of its mission and the impact on its mission of current governmental and regulatory activities. 48284148 -270911 48013237 48772738 -488590 48284148 0.88000 0.01000 0.11000 0 0 853836 853836 45653100 19513631 26139469 3958310 251488 3706822 45625299 28451349 17173950 4768739 1545745 3222994 51097071 Investments 56842088 F 56842088 Estimated Settlements with Third-Party Payors 1764886 Pension liability 3824674 Interest Rate Swaps 1579085 capital lease obligation 2203911 9372556 105647919 101946131 3701788 3338580 -1552093 1786487 5488275 105647919 0 105647919 0 105647919 101946131 0 101946131 0 101946131 Part V, Line 4: Description of Intended Use of Endowment Funds: To support the operations and functions of the organization. Part X: Description of Uncertain Tax Positions Under FIN 48: The Hospital is a not-for-profit corporation and has been recognized as tax-exempt pursuant to Section 501(c)(3) of the Internal Revenue Code (the "Code"), and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Accordingly, no provision for federal income taxes has been recorded in the accompanying financial statements. In accordance with generally accepted accounting principles, the Organization annually evaluates its tax status and tax positions taken with respect to its operations and financial position. Part XI, Line 8 - Other Adjustments: adjustment to minimum pension liability: 7087148. equity transfers: -8288882. unrealized loss on interest rate swap agreement: -632509. Capital Grant: 282150. 1 1 1 X 1 X 1 1 1 0 1 1 2958603 2040458 918145 0.00960 19105343 12596954 6508389 0.06830 3512241 3143490 368751 0.00390 25576187 17780902 7795285 0.08180 1882801 860832 1021969 0.01070 834357 643526 190831 0.00200 2717158 1504358 1212800 0.01270 28293345 19285260 9008085 0.09450 1 3346885 30948 17163183 20348752 -3185569 X 1 1 10 N Main Street Medical Office Space 0.50000 0.00000 0.00000 Central Mass Comprehensive Cancer Center Medical Facility 0.22000 0.00000 0.00000 Charlton MRI MRI Facility 0.50000 0.00000 0.00000 Harrington Memorial Hospital

100 South Street Southbridge MA 015508002

X X X See Sched. O Note Harrington Healthcare at hubbard

340 Thompson Road Webster MA 01570

X X Harrington Specialty Services

336 Thompson Road Webster MA 01570

Outpatient Services Harrington Occupational Health Service

32 Oakes Avenue 1st Floor Southbridge MA 015508002

Outpatient Services George B Wells Human Service Center

367 East Main Street East Brookfield MA 01515

Outpatient Services South Central WIC on Wheels

410 North Main Street North Uxbridge MA 01538

Outpatient Services George B Wells Human Service Center

228 Main Street Suite A Webster MA 01570

Outpatient Services Harrington Healthcare at hubbard

72 Cudworth Road Webster MA 01570

Outpatient Services Harrington Healthcare at Charlton

10 North Main Street Suite 100 Charlton MA 01507

Outpatient Services The Cancer Center at Harrington

55 Sayles Street 2nd Floor Southbridge MA 015508002

Outpatient Services Part III, Line 4: The Organization provides an allowance for doubtful accounts equal to estimated bad debt losses. The estimated losses are based on historical collection experience together with a review of the current status of existing receivables.The Organization used a ratio of its total costs to charges to calculate the amount of bad debt expense at cost. Part III, Line 8: The shortfall experienced by the Organization from providing care to Medicare beneficiaries should be treated as a community benefit as it represents the Organization's contribution to providing care to the frail and elder citizens of the community it serves beyond the amount it receives from the Medicare program. This contribution level is consistent with the Organization's overall charitable mission to provide care to all individuals, regardless of the level of payment received for providing that care.The Organization used a ratio of its total costs to charges to calculate the allowable costs related to Medicare revenue received. X X 1 1 0 0 0 0 0 0 0 edward moore 403372 0 0 0 9030 0 10329 0 35650 0 458381 0 0 0 thomas sullivan 244718 0 0 0 0 0 6367 0 4459 0 255544 0 0 0 Douglas Crapser 166223 0 0 0 0 0 4073 0 18310 0 188606 0 0 0 Arthur Russo MD 171704 0 0 0 0 0 4087 0 1150 0 176941 0 0 0 James Stephens MD 296309 0 0 0 0 0 7073 0 6178 0 309560 0 0 0 Keith Hilliker MD 275718 0 0 0 0 0 7121 0 10532 0 293371 0 0 0 William Petrone MD 250602 0 0 0 0 0 6625 0 23258 0 280485 0 0 0 Resul Ozbayrak MD 234317 0 0 0 0 0 5661 0 12154 0 252132 0 0 0 michael gaudet md 342750 0 0 0 0 0 8261 0 19489 0 370500 0 0 0 richard mangion 257960 0 0 0 0 0 0 0 0 0 257960 0 0 0 Part I, Lines 4a-b: The Hospital maintains a severance agreement with its Former President/CEO. The agreement provides for compensation upon termination/retirement based on a formula that includes the individual's length of service and average earnings during his service period. $257,960 was paid out during the calendar year ended December 31, 2009. Massachusetts Health and Educational Facilities Authority 042456011 57586C7U3 2008-06-26 20000000 Construction and Renovations 0 0 Massachusetts Health and Educational Facilities Authority 042456011 123456789 2006-02-14 3906000 Equipment Master Lease and Purchase 0 0 20735780 6990589 306250 13309806 0 0 0 1 3906000 3906000 2006 0 0 1 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 0 0 0 0 0 0 0 0 0 0 Form 990, Part VI, Section A, line 2 Board members Anthony M. Detarando and Anthony Jay Detarando are related as father and son. Form 990, Part VI, Section A, line 4 In October 2009, Harrington HealthCare System, Inc. became the sole member of Harrington Hospital, Inc. Harrington Healthcare System, Inc. was organized to operate exclusively for the benefit of Harrington Memorial Hospital, Inc. and its other affiliated charitable organizations. Form 990, Part VI, Section A, line 6 The Hospital's sole corporate member is Harrington HealthCare System, Inc. Form 990, Part VI, Section A, line 7a The Hospital's sole corporate member is Harrington HealthCare System, Inc. Form 990, Part VI, Section A, line 7b The Hospital's sole corporate member is Harrington HealthCare System, Inc. Form 990, Part VI, Section B, line 11 The Form 990 is prepared by the Hospital's outside independent accountant with information given to them by the hospital staff. After completion, it is reviewed by the Hospital's Controller and VP of Finance before being presented to the board of directors. Form 990, Part VI, Section B, line 12c The Corporation requires that all employees, and members and officers of the Board of Directors of the Corporation and any member of any committee disclose in writing (and update annually) all business and other relationships which might potentially create a conflict of interest and all conflicts of interest as defined by the policy. Form 990, Part VI, Section B, line 15 The Board of Directors review and approve the compensation of the CEO and top management. The CEO reviews and approves top management salaries. Top management will then review and approve key employee salaries. Form 990, Part VI, Section C, line 18 The Hospital makes its Form 990 and 990-T available to the public upon request. Additionally, the Hospital's Form 990 and 990-T are available on the Public Charities website maintained by the Commonwealth of Massachusetts Attorney General. Form 990, Part VI, Section C, line 19 The Hospital makes its governing documents, conflict of interest policy and financial statements available to the public upon request. Additionally, the Hospital's financial statements are available on the Public Charities website maintained by the Commonwealth of Massachusetts Attorney General. The Organization's audit oversight process has not changed since the prior year. Harrington Physician Services Inc 100 south street southbridge MA 015508002 134366504 Healthcare Services MA 501(c)(3) 9 Harrington Memorial Hospital Harrington HealthCare System Inc 100 south street Southbridge MA 015508002 001014624 Healthcare Support MA 501(c)(3) 9 Charlton MRI Services LLC 10 North Main Street Charlton MA 01507 000993849 Healthcare Services MA BIH Radiologic Foundation Inc investment 133559 3450000 0 0 Central Massachusetts Comprehensive Cancer Center LLC 55 sayles street southbridge MA 01550 261795998 Healthcare Services MA New England Radiation Therapy Management Services Inc investment 9672 866521 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 Harrington Physician Services Q 8288882