2011-08-11T08:42:00-05:00 2010-09-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2009-10-01 222563466 NORTHERN BERKSHIRE HEALTHCARE NORT 4136645000 71 HOSPITAL AVENUE NORTH ADAMS MA 01247 CHRISTOPHER HICKEY 4136645000 2011-08-08 true Brian D Todd 4178658701 2009 2016-02-24 21:20:13Z RICHARD PALMISANO 71 HOSPITAL AVENUE NORTH ADAMS MA 01247 6650686 false X WWW.NBHEALTH.ORG X 1984 MA THE ORGANIZATION SUPPORTS THE ADVANCEMENT AND PRACTICE OF HEALTHCARE TO MEET THE NEEDS OF THE COMMUNITY AND OPERATE EXCLUSIVELY FOR THE BENEFIT OF NORTH ADAMS REGIONAL HOSPITAL AND ITS AFFILIATES. 17 15 35 32 178694 2299 625306 204069 4196640 4731818 -490722 114611 -5619 -29716 4325605 5020782 0 0 0 0 3277191 3487803 0 0 170249 1063040 2130740 4340231 5618543 -14626 -597761 3532945 15732521 2553197 16374334 979748 -641813 THE ORGANIZATION'S MISSION IS TO PROVIDE EXCEPTIONAL HEALTHCARE FROM THE HEART. false false 3957757 4553124 NORTHERN BERKSHIRE HEALTHCARE SUPPORTS THE ADVANCEMENT AND PRACTICE OF HEALTHCARE TO MEET THE NEEDS OF THE COMMUNITY AND OPERATES EXCLUSIVELY FOR THE BENEFIT OF NORTH ADAMS REGIONAL HOSPITAL AND ITS AFFILIATES. 3957757 true true false false false false false false false true false false false false false false false false true false false false false true false false false false false false false false false false false false false true true false false true 47 0 true 35 true true true false false false false true true false false false 17 15 false false false false true true true true true false true true true true true true true true true true false X CHRISTOPHER HICKEY 4136645000 71 HOSPITAL AVENUE NORTH ADAMS MA 01247 RICHARD PALMISANO 5.0 X X 0 398431 40368 PAUL DONOVAN 1.0 X X 0 326070 36682 BYRON SHERMAN 1.0 X X 0 0 0 JANE ALLEN 1.0 X 0 0 0 ELLEN BERNSTEIN 1.0 X 0 0 0 JULIA BOLTON 1.0 X 0 0 0 JONATHAN CLUETT 1.0 X 0 0 0 STEPHEN FIX 1.0 X 0 0 0 BILL GREENWALD 1.0 X 0 0 0 BRUCE GRINNELL 1.0 X 0 0 0 RICHARD JETTE 1.0 X 0 0 0 STEPHEN KLASS 1.0 X 0 0 0 MARTHA STOREY 1.0 X 0 0 0 ERWIN STUEBNER 1.0 X 0 0 0 ARTHUR TURTON 1.0 X 0 0 0 STEPHEN PAGNOTTA 1.0 X 0 0 0 CHRISTOPHER HICKEY 5.0 X 0 212147 1235 ROBERT CALWAY 1.0 X 0 189273 17487 BILLIE ALLARD 40.0 X 133248 0 7880 PAUL DABRODY 40.0 X 137985 0 8844 ARTHUR SCOTT 40.0 X 139993 0 19339 KATHLEEN ARABIA 40.0 X 130847 0 6754 DAVID DELANO 40.0 X 127313 0 20542 669386 1125921 159131 7 false true false AM HEALTHCARE INDUSTRY CONSULTING SERVICES 219150 BKD LLP ACCOUNTING SERVICES 214500 2 59893 144176 204069 MANAGEMENT FEE 561000 4550407 4550407 IT INCOME 900099 52499 52499 CONSIGNMENT INCOME 541519 126195 126195 OTHER REVENUE 900099 2717 2717 4731818 32152 32152 0 0 1645762 1558272 5031 87490 -5031 82459 82459 36885 59893 66601 -29716 -29716 0 0 0 5020782 4553124 178694 84895 0 0 0 0 0 0 2906479 2371204 433274 102001 200902 163902 29949 7051 195320 159348 29117 6855 185102 151013 27593 6496 0 749425 749425 12600 12600 0 0 5339 5339 1036308 845455 154484 36369 113845 92879 16971 3995 27113 22119 4042 952 0 0 9125 7445 1360 320 33680 27477 5021 1182 0 22849 18641 3406 802 0 0 3967 3237 591 139 2376 1939 354 83 LICENSES, DUES & SUBSCRIPTIONS 31891 26018 4754 1119 RECRUITING 76885 62726 11461 2698 MISCELLANEOUS 5337 4354 796 187 5618543 3957757 1490537 170249 1494 17855 1503120 3297003 419101 374979 28809 38021 78483 588746 64854 60530 13322 4324 915739 265112 16283 16283 556594 11130198 3532945 15732521 1643431 2004828 13585000 909766 784506 2553197 16374334 X 74793 -1492531 904955 850718 979748 -641813 3532945 15732521 X false false false X 1259828 1148171 1297532 560131 204069 4469731 1259828 1148171 1297532 560131 204069 4469731 1511007 2958724 43604 86104 69673 39596 32152 271129 4740860 18470749 0.62409 0.79241 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 64854 60530 4324 4324 CSV LIFE INSURANCE 160245 INTEREST IN FLYNT TRUST 440450 DUE FROM AFFILIATES 10529503 11130198 0 DERIVATIVE LIABILITY 784506 784506 GOLF TOURNAMENT 57385 52850 4535 1960 10755 8386 CIRCUS SMIRKUS 39393 7043 32350 1252 32350 11898 0 96778 59893 36885 1960 12007 32350 20284 66601 -29716 X X X X X X false true false false false false false true false RICHARD PALMISANO 0 240827 0 51053 0 106551 0 17228 0 23140 0 438799 PAUL DONOVAN 0 321561 0 0 0 4509 0 18542 0 18140 0 362752 CHRISTOPHER HICKEY 0 190526 0 10000 0 11621 0 0 0 1235 0 213382 ROBERT CALWAY 0 162094 0 25503 0 1676 0 0 0 17487 0 206760 ARTHUR SCOTT 138783 0 0 0 1210 0 7175 0 12164 0 159332 0 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B RICHARD PALMISANO, CEO/PRESIDENT, PARTICIPATES IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. IN THE CURRENT YEAR, CONTRIBUTIONS WERE $93,494. BONUSES SCHEDULE J, PART I, LINE 7 RICHARD PALMISANO, CHRISTOPHER HICKEY, AND ROBERT CALWAY RECEIVE AN ANNUAL BONUS OF UP TO A CERTAIN PERCENT OF BASE SALARY UPON ACCOMPLISHMENT OF GOALS AND OBJECTIVES ESTABLISHED ANNUALLY BY THE BOARD. THEY ARE PAID BY NORTHERN BERKSHIRE HEALTHCARE, WITH ALL COMPENSATION, INCLUDING BONUS, ALLOCATED TO RELATED ORGANIZATIONS. IN ADDITION, ROBERT CALWAY RECEIVED A RETENTION BONUS. MEMBERS FORM 990, PART VI, SECTION A, LINES 6, 7A, & 7B THE MEMBERS OF THE CORPORATION ARE THE CORPORATORS. THE TRUSTEES ARE ELECTED BY THE CORPORATORS AT THE ANNUAL MEETING. THE BYLAWS MAY BE AMENDED OR REPEALED IN WHOLE OR IN PART BY VOTE OF A TWO-THIRDS MAJORITY OF MEMBERS PRESENT AT THE ANNUAL MEETING OF THE CORPORATION. FORM 990 REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11A THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE FORM 990 WILL BE INITIALLY INTERNALLY REVIEWED BY THE CFO. AFTER THIS REVIEW, THE FORM 990 WILL BE GIVEN TO THE BOARD OF DIRECTORS AT THEIR JULY MEETING. THIS WILL ALLOW FOR BOARD MEMBERS TO ASK QUESTIONS, PROVIDE COMMENTS, OR MAKE CHANGES BEFORE THE FINAL FORM 990 IS FILED. CONFLICT OF INTEREST POLICY COMPLIANCE FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY BOARD MEMBERS AND THE SENIOR EXECUTIVE TEAM ARE REQUIRED TO FILL OUT A QUESTIONNAIRE REGARDING CONFLICTS OF INTEREST. THIS YEAR THESE INDIVIDUALS ALSO RESPONDED TO A QUESTIONNAIRE DESIGNED SPECIFICALLY FOR THE FORM 990. IF THERE IS A CONFLICT OF INTEREST, THE BOARD MEMBERS OR EXECUTIVE TEAM MEMBER WOULD RECUSE THEMSELVES FROM THE VOTE. COMPENSATION DETERMINATION FORM 990, PART VI, SECTION B, LINES 15A & 15B THE BOARD COMPENSATION COMMITTEE IS COMPOSED OF INDEPENDENT TRUSTEES. THIS COMMITTEE CONDUCTS AN ANNUAL PERFORMANCE EVALUATION. THE EVALUATION IS BASED ON DIRECT OBSERVATION, THE CEO'S COMPLETION OF PRE-DETERMINED GOALS, A CEO SELF-EVALUATION, AND THE RESULTS OF WRITTEN SURVEYS DISTRIBUTED BY THE COMMITTEE TO ALL TRUSTEES, HOSPITAL AND HEALTH SYSTEM EXECUTIVES, AND EMPLOYED PHYSICIANS. THE COMMITTEE ALSO REVIEWS INDEPENDENTLY COLLECTED AND PUBLISHED MARKET DATA FOR CEO COMPENSATION AT SIMILAR FACILITIES, SUCH AS THE ANNUAL MASSACHUSETTS HOSPITAL ASSOCIATION EXECUTIVE COMPENSATION AND/OR SIMILAR DOCUMENTS. CONSIDERING THE PERFORMANCE EVALUATION AND THE MARKET DATA, THE COMPENSATION COMMITTEE THEN MAKES A RECOMMENDATION FOR ANY CHANGES TO THE CEO'S COMPENSATION, WHICH THEN REQUIRES APPROVAL BY A VOTE OF THE FULL BOARD. DURING THE ANNUAL REVIEW PROCESS, THE COMPENSATION COMMITTEE ALSO DEVELOPS THE CEO'S PERFORMANCE GOALS FOR THE UPCOMING YEAR. THE CEO CONDUCTS ANNUAL PERFORMANCE EVALUATIONS FOR EACH EXECUTIVE OR OFFICER, CONSIDERING PERFORMANCE AGAINST PRE-DETERMINED ANNUAL PERFORMANCE GOALS, PERFORMANCE AGAINST THE JOB DESCRIPTION, AND FEEDBACK SURVEYS DISTRIBUTED BY THE HUMAN RESOURCES STAFF TO A GROUP OF PEERS AND SUBORDINATES. AT THIS TIME, THE CEO ALSO REVIEWS INDEPENDENTLY COLLECTED AND PUBLISHED MARKET DATA FOR SIMILAR POSITIONS IN SIMILAR ORGANIZATIONS. BASED ON THE MERITS OF THE PERFORMANCE EVALUATION AND THE COMPARISON TO MARKET DATA, THE CEO DETERMINES ANY CHANGE TO THE OFFICERS' COMPENSATION. COMPENSATION FOR ALL EXECUTIVES AND OFFICERS IS PRESENTED TO THE BOARD OF TRUSTEES ANNUALLY FOR THEIR REVIEW AND COMMENT, BUT CHANGES TO EXECUTIVE COMPENSATION, WITH THE EXCEPTION OF THE CEO, DO NOT REQUIRE BOARD APPROVAL. ALL EXECUTIVE COMPENSATION DECISIONS ARE GUIDED BY THE ORGANIZATION'S STATEMENT OF COMPENSATION PHILOSOPHY AS WELL AS BY GUIDELINES AND REGULATIONS REGARDING EXECUTIVE COMPENSATION IN NON-PROFIT ORGANIZATIONS PUT FORWARD BY THE IRS, THE ATTORNEY GENERAL, AND OTHER RELEVANT GOVERNING BODIES. GOVERNING DOCUMENT AVAILABILITY FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. THE ORGANIZATION'S 990 IS AVAILABLE FOR VIEWING ON-SITE UPON WRITTEN REQUEST TO THE CFO. NORTH ADAMS REGIONAL HOSPITAL 71 HOSPITAL AVENUE NORTH ADAMS MA 01247 041676720 HOSPITAL MA 501(C)(3) 3 NA NORTHERN BERKSHIRE REALTY CO 71 HOSPITAL AVENUE NORTH ADAMS MA 01247 222563465 PROPERTY MGMT MA 501(C)(3) 11A I NA NORTHERN BERKSHIRE HEALTHCARE PHYSICIANS 71 HOSPITAL AVENUE NORTH ADAMS MA 01247 743253218 PHYS SERVICES MA 501(C)(3) 9 NA NORTHERN BERKSHIRE COMMUNITY SERVICES 71 HOSPITAL AVENUE NORTH ADAMS MA 01247 222563464 RESIDENT CARE MA 501(C)(3) 9 NA REACH COMMUNITY HEALTH FOUNDATION 71 HOSPITAL AVENUE NORTH ADAMS MA 01247 043470287 COMM. ACTIV. MA 501(C)(3) 7 NA VISITING NURSE ASSOCIATION & HOSPICE 71 HOSPITAL AVENUE NORTH ADAMS MA 01247 042910547 HOME HEALTH MA 501(C)(3) 9 NA false false false true true false false false false false true false true true true true true true NORTH ADAMS REGIONAL HOSPITAL K 3480090 NORTHERN BERKSHIRE COMMUNITY SERVICES K 522214 VISITING NURSE ASSOCIATION & HOSPICE K 142933 NORTHERN BERKSHIRE HEALTHCARE PHYSICIANS K 405170 NORTH ADAMS REGIONAL HOSPITAL O 4773682 VISITING NURSE ASSOCIATION & HOSPICE O 54903 NORTHERN BERKSHIRE COMMUNITY SERVICES P 1403045 NORTHERN BERKSHIRE REALTY CO P 70785 NORTHERN BERKSHIRE HEALTHCARE PHYSICIANS P 1859510 NORTH ADAMS REGIONAL HOSPITAL Q 974885 NORTHERN BERKSHIRE COMMUNITY SERVICES R 12934514