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BAYSTATE NOBLE HOSPITAL CORPORATION: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
BAYSTATE NOBLE HOSPITAL CORPORATION (EIN 22-2537423)
Tax period
2020-10-01 to 2021-09-30
Filed
2022-08-05
IRS object ID
202222179349300402
Schema version
2020v4.2
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-08-05T04:59:30-05:00ReturnTs
Tax Period End2021-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN861065772PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Deloitte Tax LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1Two Jericho PlazaAddressLine1Txt
CityJerichoCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11753ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN222537423EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Baystate Noble Hospital CorporationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlBAYSBusinessNameControlTxt
Phone4135682811PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1115 West Silver StreetAddressLine1Txt
CityWestfieldCityNm
State AbbreviationMAStateAbbreviationCd
ZIP010861634ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRaymond McCarthyPersonNm
Person TitleSVP Finance, CFO & TreasurerPersonTitleTxt
Phone4135682811PhoneNum
Signature2022-08-01SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstRaymondPersonFirstNm
Person LastMcCarthyPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonChristine KaweckiPreparerPersonNm
PTINP00743140PTIN
Phone5169187000PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerRaymond McCarthyPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1115 West Silver StreetAddressLine1Txt
CityWestfieldCityNm
State AbbreviationMAStateAbbreviationCd
ZIP010861634ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$68,814,311GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.baystatenoblehospital.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1984FormationYr
Legal Domicile StateMALegalDomicileStateCd
Activity Or MissionThe mission of the organization is to improve the health of the people in our communities every day, with quality and compassion.ActivityOrMissionDesc
Voting Members Governing Body19VotingMembersGoverningBodyCnt
Voting Members Independent14VotingMembersIndependentCnt
Total Employee671TotalEmployeeCnt
Total Volunteers18TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$4,610,183PYContributionsGrantsAmt
CY Contributions Grants$3,674,140CYContributionsGrantsAmt
PY Program Service Revenue$47,322,608PYProgramServiceRevenueAmt
CY Program Service Revenue$62,937,220CYProgramServiceRevenueAmt
PY Investment Income$45,709PYInvestmentIncomeAmt
CY Investment Income$38,176CYInvestmentIncomeAmt
PY Other Revenue$2,408,243PYOtherRevenueAmt
CY Other Revenue$2,086,943CYOtherRevenueAmt
PY Total Revenue$54,386,743PYTotalRevenueAmt
CY Total Revenue$68,736,479CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$30,964,986PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$34,039,135CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$33,259,690PYOtherExpensesAmt
CY Other Expenses$34,664,623CYOtherExpensesAmt
PY Total Expenses$64,224,676PYTotalExpensesAmt
CY Total Expenses$68,703,758CYTotalExpensesAmt
PY Revenues Less Expenses-$9,837,933PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$32,721CYRevenuesLessExpensesAmt
Total Assets BOY$53,343,507TotalAssetsBOYAmt
Total Assets EOY$55,567,412TotalAssetsEOYAmt
Total Liabilities BOY$28,165,050TotalLiabilitiesBOYAmt
Total Liabilities EOY$24,795,331TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$25,178,457NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$30,772,081NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionThe mission of the organization is to improve the health of the people in our communities every day, with quality and compassion.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$29,800,066ExpenseAmt
Revenue$30,889,840RevenueAmt
DescInpatient 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 FY21, Baystate Noble Hospital provided 17,304 patient days of inpatient services.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$23,917,623ExpenseAmt
Revenue$21,603,815RevenueAmt
DescOutpatient healthcare services - Providing outpatient clinical services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY21, Baystate Noble Hospital had 93,739 outpatient visits.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$11,594,880ExpenseAmt
Revenue$11,615,393RevenueAmt
DescEmergency departments services - Providing emergency department services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY21, Baystate Noble Hospital had 24,722 emergency department visits.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$2,277,832ExpenseAmt
Revenue$923,858RevenueAmt
DescProviding lab, pharmacy and support services to the surrounding region. Services available to individuals regardless of their ability to pay.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$2,277,832TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$923,858TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$67,590,401TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document36IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee671EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members19GoverningBodyVotingMembersCnt
Independent Voting Member14IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Laurie MartinBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4135682811PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1759 Chestnut StreetAddressLine1Txt
CitySpringfieldCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01199ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Mark A Keroack MD
Trustee/President & CEO, BH1.0049.00Yes (X)$0$2,511,656$39,342
Kevin P Moriarty MD
Trustee/Chief Ped Surgery1.0049.00Yes (X)$713,152$0$39,464
Denzil M Reid MD
Trustee (As Of 01/01)/Med Dir Pulm49.001.00Yes (X)$382,424$0$48,457
Stanley Strzempko MD
Trustee (Thru 12/31)1.0049.00Yes (X)$82,133$0$1,533
Akinyele K Lovelace DO
Trustee/ Per Diem Internist1.0049.00Yes (X)$56,330$0$845
Robert J Bacon
Chair1.006.00Yes (X)$0$0$0Yes (X)
Adrian J Levsky
Trustee (Thru 3/31/21)1.004.00Yes (X)$0$0$0
Anne M Paradis
Trustee (Thru 12/31/20)1.005.00Yes (X)$0$0$0
Claudia R Coplein DO
Trustee1.004.00Yes (X)$0$0$0
Colleen W Holmes
Trustee1.004.00Yes (X)$0$0$0
Denise R Jordan
Trustee1.004.00Yes (X)$0$0$0
Edward J Noonan
Trustee1.004.00Yes (X)$0$0$0
Gregory L Braden MD
Trustee1.004.00Yes (X)$0$0$0
Harriet A Deverry
Vice Chair/ Trustee1.005.00Yes (X)$0$0$0
Hector F Toledo
Trustee (Thru 12/31/20)1.005.00Yes (X)$0$0$0
Irene Rodriguez Martin
Trustee1.004.00Yes (X)$0$0$0
James R Phaneuf
Trustee1.004.00Yes (X)$0$0$0
John F Maybury
Trustee1.006.00Yes (X)$0$0$0
Kathleen B Scoble
Trustee1.005.00Yes (X)$0$0$0
Maria P Goncalves
Trustee1.005.00Yes (X)$0$0$0
Paul C Picknelly
Trustee1.004.00Yes (X)$0$0$0
Paul R Murphy
Trustee1.004.00Yes (X)$0$0$0
William R Webber
Trustee1.004.00Yes (X)$0$0$0
Raymond McCarthy
Treasurer5.0045.00$0$668,402$25,713Yes (X)
Ronald P Bryant
President24.0026.00$0$597,706$47,607Yes (X)
Kristin R Delaney
Clerk1.0049.00$0$168,346$40,493Yes (X)
Nancy Remillard
Assistant Clerk1.0049.00$0$60,003$11,278Yes (X)
T Britton Percy MD
VP/CMO50.000.00$338,786$0$48,816Yes (X)
John Shaver
Chief Financial Officer25.0025.00$263,513$0$24,131Yes (X)
Jeffrey Cebula
Dir Finance BFMC & BNH25.0025.00$169,249$0$23,515Yes (X)
Pamela Fournier
Registered Nurse50.000.00$153,927$0$15,493Yes (X)
Michele Urban
Former Vp Patient Care Srvs50.000.00$166,027$0$3,000Yes (X)
Angela M Cotti
Registered Nurse50.000.00$159,507$0$9,065Yes (X)
Khalilah Burgin
Mgr. Pharmacy (Thru 3/21)50.000.00$150,347$0$11,393Yes (X)
Dennis W Chalke
Former Treasurer0.000.00$0$898,889$76,373Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,635,395TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$4,905,002TotReportableCompRltdOrgAmt
Total Other Compensation$466,518TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K43IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other SrcsYes (1)CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Baystate Medical Practices Inc
759 Chestnut StSpringfieldMA01199Medical, Educational & Clinical Services$8,177,493
Baystate Administrative Serv Inc
759 Chestnut StSpringfieldMA01199Management Services$2,865,348
Morrison Management
PO Box 102289AtlantaGA30368Contract Services$1,771,053
Shiftwise
1800 SW 1st Ave Suite 510PortlandOR97201Contract Services$1,638,940
Baystate Medical Center Inc
759 Chestnut StSpringfieldMA01199Management Services$1,623,497
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K16CntrctRcvdGreaterThan100KCnt
Related Organizations$119,690RelatedOrganizationsAmt
Government Grants$3,466,885GovernmentGrantsAmt
All Other Contributions$87,565AllOtherContributionsAmt
Total Contributions$3,674,140TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Outpatient revenue622110$32,520,483$32,520,483
Inpatient revenue622110$30,416,737$30,416,737
FieldValueIRS element (for citing)
Total Program Service Revenue$62,937,220TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$37,176TotalRevenueColumnAmt
Exclusion$37,176ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$50,527RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$77,832RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$27,305RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$27,305TotalRevenueColumnAmt
Exclusion-$27,305ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$1,000OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$1,000OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,000TotalRevenueColumnAmt
Exclusion$1,000ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
Intercompany Charges622110$2,000,816$2,000,816
Cafeteria622110$18,562$18,562

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$94,870TotalRevenueColumnAmt
Related Or Exempt Func Income$94,870RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,114,248OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$68,736,479TotalRevenueColumnAmt
Related Or Exempt Func Income$65,032,906RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$29,433ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$287,644TotalAmt
Management And General$287,644ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$28,353,068TotalAmt
Program Services$28,153,584ProgramServicesAmt
Management And General$199,484ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$566,211TotalAmt
Program Services$558,293ProgramServicesAmt
Management And General$7,918ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,833,164TotalAmt
Program Services$2,627,567ProgramServicesAmt
Management And General$205,597ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,999,048TotalAmt
Program Services$1,848,433ProgramServicesAmt
Management And General$150,615ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$237,227TotalAmt
Program Services$237,227ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$25,804TotalAmt
Management And General$25,804ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$12,495TotalAmt
Management And General$12,495ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$12,811,900TotalAmt
Program Services$12,691,164ProgramServicesAmt
Management And General$120,736ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$117,532TotalAmt
Program Services$117,532ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$853,871TotalAmt
Program Services$851,530ProgramServicesAmt
Management And General$2,341ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$38,923TotalAmt
Program Services$38,923ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,008,376TotalAmt
Program Services$1,008,376ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,023TotalAmt
Program Services$912ProgramServicesAmt
Management And General$111ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,565TotalAmt
Program Services$1,565ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$108,329TotalAmt
Program Services$108,329ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$1,051,688TotalAmt
Program Services$1,051,688ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,566,472TotalAmt
Program Services$4,468,300ProgramServicesAmt
Management And General$98,172ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$173,354TotalAmt
Program Services$173,354ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
Purchased services$8,376,334$8,376,334
Medical supplies$5,015,131$5,015,131
Equipment rentals$217,802$217,802
Recruitment expense$44,357$44,357

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,440TotalAmt
Management And General$2,440ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$68,703,758TotalAmt
Program Services$67,590,401ProgramServicesAmt
Management And General$1,113,357ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$10,816,218BOYAmt
EOY$12,452,455EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,908,987BOYAmt
EOY$7,030,969EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$940,994BOYAmt
EOY$914,914EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$219,241BOYAmt
EOY$120,170EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$94,184,925LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$65,608,997LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$30,928,764BOYAmt
EOY$28,575,928EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$4,278,153BOYAmt
EOY$5,057,787EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,251,150BOYAmt
EOY$1,415,189EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$53,343,507BOYAmt
EOY$55,567,412EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$10,213,701BOYAmt
EOY$10,849,865EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$12,252,451BOYAmt
EOY$7,341,098EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$703,438BOYAmt
EOY$466,731EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,995,460BOYAmt
EOY$6,137,637EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$28,165,050BOYAmt
EOY$24,795,331EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$20,367,546BOYAmt
EOY$25,132,711EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,810,911BOYAmt
EOY$5,639,370EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$25,178,457BOYAmt
EOY$30,772,081EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$53,343,507BOYAmt
EOY$55,567,412EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$32,721ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$903,447NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$4,657,456OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (1)DirectContactLegislatorsInd
Direct Contact Legislators$12,495DirectContactLegislatorsAmt
Rallies Demonstrations0RalliesDemonstrationsInd
Other Activities0OtherActivitiesInd
Total Lobbying Expenditures$12,495TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationBaystate Noble Hospital Corporation (BNH) pays membership dues to the Massachusetts Hospital Association (MHA) $8,011, the American Hospital Association (AHA) $4,379 and the National Association of Urban Hospitals (NASH) $105. 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, 2021 is $12,495.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,905,361BeginningYearBalanceAmt
Investment Earnings Or Losses$973,278InvestmentEarningsOrLossesAmt
Other Expenditures$144,734OtherExpendituresAmt
End Year Balance$4,733,905EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,210,771BeginningYearBalanceAmt
Investment Earnings Or Losses-$158,244InvestmentEarningsOrLossesAmt
Other Expenditures$147,166OtherExpendituresAmt
End Year Balance$3,905,361EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,276,484BeginningYearBalanceAmt
Investment Earnings Or Losses$96,757InvestmentEarningsOrLossesAmt
Other Expenditures$162,470OtherExpendituresAmt
End Year Balance$4,210,771EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,180,476BeginningYearBalanceAmt
Investment Earnings Or Losses$250,630InvestmentEarningsOrLossesAmt
Other Expenditures$154,622OtherExpendituresAmt
End Year Balance$4,276,484EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,846,559BeginningYearBalanceAmt
Investment Earnings Or Losses$539,708InvestmentEarningsOrLossesAmt
Other Expenditures$205,791OtherExpendituresAmt
End Year Balance$4,180,476EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY1.00000BoardDesignatedBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$962,597OtherCostOrOtherBasisAmt
Book Value$962,597BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$41,996,102OtherCostOrOtherBasisAmt
Depreciation$27,783,654DepreciationAmt
Book Value$14,212,448BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$474,533OtherCostOrOtherBasisAmt
Depreciation$439,337DepreciationAmt
Book Value$35,196BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$50,751,693OtherCostOrOtherBasisAmt
Depreciation$37,386,006DepreciationAmt
Book Value$13,365,687BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$28,575,928TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
Accrued Pension Liability$2,406,643
Medical Malpractice Claims$177,277
Asset Retirement Obligation$565,305
Due to Affiliates$2,285,496
Operating Lease Liability$140,711
Employer Tax Deferral$562,205
FieldValueIRS element (for citing)
Total Liability$6,137,637TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart V, Line 4:FormAndLineReferenceDesc
ExplanationTo provide ongoing support for the hospital and its mission to improve the health of the people in our community.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$365,047TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$144,245DirectOffsettingRevenueAmt
Net Community Benefit Expns$220,802NetCommunityBenefitExpnsAmt
Total Expense0.00320TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,219,309TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,816,380DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,402,929NetCommunityBenefitExpnsAmt
Total Expense0.04950TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,007,287TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$779,602DirectOffsettingRevenueAmt
Net Community Benefit Expns$227,685NetCommunityBenefitExpnsAmt
Total Expense0.00330TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,591,643TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,740,227DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,851,416NetCommunityBenefitExpnsAmt
Total Expense0.05600TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$186,673TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$186,673NetCommunityBenefitExpnsAmt
Total Expense0.00270TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,016,692TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,683,467DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,333,225NetCommunityBenefitExpnsAmt
Total Expense0.01940TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$72,250TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$72,250NetCommunityBenefitExpnsAmt
Total Expense0.00110TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,275,615TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,683,467DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,592,148NetCommunityBenefitExpnsAmt
Total Expense0.02320TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$18,867,258TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$13,423,694DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,443,564NetCommunityBenefitExpnsAmt
Total Expense0.07920TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,000NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,000NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$714,624BadDebtExpenseAmt
Bad Debt Expense Attributable$37,692BadDebtExpenseAttributableAmt
Reimbursed By Medicare$20,849,000ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$20,118,012CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$730,988MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Baystate Noble Hospital CorporationBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1115 West Silver StreetAddressLine1Txt
CityWestfieldCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01085ZIPCd
FieldValueIRS element (for citing)
State LicenseState License #2076StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherPsychiatric and Physical RehabilitationOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Baystate Noble Hospital CorporationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttps://www.baystatehealth.org/about-us/community-programs/community-benefiOwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLwww.publichealthwm.orgOtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLhttps://www.baystatehealth.org/about-us/community-programs/community-benefiStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Other MethodYes (X)OtherMethodInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttps://www.baystatehealth.org/patients/billing-and-financial-assistanceFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttps://www.baystatehealth.org/patients/billing-and-financial-assistanceFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttps://www.baystatehealth.org/patients/billing-and-financial-assistanceFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Baystate Noble Hospital CorporationPart V, Section B, Line 5: Baystate Medical is a member of the Coalition of Western Massachusetts Hospitals/Insurer (Coalition). The Coalition is a collaboration between eight non-profit hospitals/insurer in western Massachusetts: Baystate Medical Center, Baystate Franklin Medical Center, Baystate Noble Hospital, Baystate Wing Hospital, Cooley Dickinson Hospital, Mercy Medical Center (a member of Trinity Health New England), Shriners Hospitals for Children Springfield, and Health New England, a local health insurer whose service areas covers the four counties of western Massachusetts. The Coalition formed in 2012 to bring hospitals within western Massachusetts together to share resources and work in collaboration to conduct their triennial community health needs assessments (CHNAs) and address regional needs. The input of the community and other important regional stakeholders was an important part of the CHNA process. A wide range of stakeholders took part in the 2018 CHNA process, including local and regional public health and health departments, other local municipal agencies, diverse community-based organizations, advocacy organizations, healthcare providers, and community residents. These stakeholders provided input through a CHNA Regional Advisory Council (RAC), focus groups, key informant interviews, community conversations, and community chats. Additionally, community forums were conducted towards the end of the CHNA process to vet preliminary findings with community members. Please refer to the hospitals' CHNA Appendix I for a complete listing of public health, community representatives, and other stakeholders included in the process. The CHNA RAC included representatives from each Coalition member hospital/insurer as well as public health and community stakeholders from each hospital service area. Stakeholders on the RAC included local and regional public health and health department representatives; representatives from local and regional organizations serving or representing medically underserved, low-income or populations of color; and individuals from organizations that represent the broad interests of the community. The Coalition conducted a stakeholder analysis to ensure geographic, sector (e.g. schools, community service organizations, healthcare providers, public health, and housing), and racial/ethnic diversity of RAC. The RAC met in workgroups (Data and Reports, Engagement and Dissemination, and Health Equity) to guide the consultants in the process of conducting the CHNA, and prioritizing community health needs, CHNA findings, and dissemination of information. Assessment methods and findings were modified based on the RAC's feedback. The RAC consisted of 31 participants, including Coalition members and consultants. The RAC met monthly from September 2018 through June 2019. Key informant interviews and focus groups were conducted to gather information used to identify priority health needs and engage the community. Key informant interviews were conducted with health care providers, health care administrators, local and regional public health officials, and local leaders that represent the interests of the community or that serve medically underserved, low-income, or populations of color in the service area. Interviews with local and regional public health officials identified priority health areas and community factors that contribute to health needs. Focus group participants included community organization representatives, community members (low-income, people of color, and others), and other community stakeholders. Topics and populations included: substance use, transgender health, older adults, youth, mental health, cancer care, gun violence, and rural food access. Key informant interviews and focus groups were conducted from February 2019 through March 2019. Focus groups and key informant interviews engaged residents primarily in Hampden County, but also across the region. The CHNA also used qualitative data from other hospital service areas as appropriate. Baystate Health held five Community Conversations and over 70 Community Chats. Community Conversations were larger bidirectional information-sharing meetings conducted for each Baystate hospital service area and one done in Spanish in Springfield. For Community Chats, RAC members brought information about the CHNA and gathered priorities in regular meetings of service providers, community-based organizations, and hospital clinical staff and administrators. While these outreach efforts were spearheaded by Baystate Health, the engagement and findings benefitted all Coalition member hospitals/insurer. Conversations and Chats were held from January 2019 through April 2019 and engaged approximately 900 residents. Five Community Forums were held upon completion of this report to share and validate the findings. Two were offered in Spanish with approximately 100 individuals representing the broad interests of the community; participants in the focus groups, interviews, Conversations, and Chats; and community stakeholders representing medically underserved, low-income, and populations of color.
Baystate Noble Hospital CorporationPart V, Section B, Line 6a: The Coalition of Western MA Hospitals/Insurer (Coalition) is a collaboration between eight non-profit hospitals/insurer in western Massachusetts: Baystate Medical Center, Baystate Franklin Medical Center, Baystate Noble Hospital, Baystate Wing Hospital, Cooley Dickinson Hospital, Mercy Medical Center (a member of Trinity Health New England), Shriners Hospitals for Children Springfield, and Health New England, a local health insurer whose service area covers the four counties of western Massachusetts. The Coalition formed in 2012 to bring hospitals within western Massachusetts together to share resources and work in collaboration to conduct their triennial CHNAs and address regional needs.
Baystate Noble Hospital CorporationPart V, Section B, Line 6b: The Coalition of Western MA Hospitals/ Insurer engaged the Public Health Institute of Western MA (PHIWM), based in Springfield, MA, as the lead consultant to conduct the CHNAs. PHIWM was supported by three other consultant teams: Community Health Solutions (CES), based in Northampton, MA; Franklin Regional Council of Governments (FRCOG), based in Greenfield, MA; and Pioneer Valley Planning Commission (PVPC), based in Springfield, MA. The Coalition includes Health New England, a local health insurer whose service area covers the four counties of western Massachusetts.
Baystate Noble Hospital CorporationPart V, Section B, Line 7d: The hospital facility made its CHNA report widely available to the public via an email distribution, with links to the hospital's website, to community partners and organizations. In addition, the CHNA reports have informed the implementation of county wide community health improvement plans in Franklin and Hampden counties. Hospital and CHNA consultant staff have been invited to various venues and audiences to present on the CHNA process and key findings. The Coalition created a Facebook page, "Western MA CHNA", as a means to communicate with and engage the community throughout the CHNA process. All Coalition CHNAs were posted and shared via this Facebook page.
Baystate Noble Hospital CorporationPart V, Section B, Line 11: The hospital facility anticipates health needs and available resources may change, therefore, a flexible approach was adopted in the development of its implementation strategy. For example, certain community health needs may become more pronounced and require changes to the initiatives identified by the hospital in the Strategy. Other community organizations may address certain needs, indicating that the hospital's strategies should be refocused on alternative community health needs or assume a different focus on the needs identified in the 2018 CHNA.The hospital facility views a community benefits implementation strategy as a "LIVING" document. Baystate hospitals have adopted the term Strategic Implementation Plan (SIP), in lieu of Implementation Strategy. The significant health needs to be addressed by the hospital are referred to as priority focus areas in the SIP. Due to the evolving climate in health care, the hospital's financial health year to year remains unknown; therefore hospital resources and inputs may increase, decrease, or need to be modified. The hospital's SIP work plan provides an opportunity for the hospital to be strategic and focused, yet flexible in its community health planning and improvement efforts. The hospital facility, in partnership with its Community Benefits Advisory Council reviews the work plans quarterly and the hospital updates the work plans on the hospital website annually.No health care system or hospital facility can address all the significant health need present in its community. The hospital facility is committed to adhering to its mission and remaining financially healthy so that it can continue to enhance its clinical excellence and patient experience, as well as address significant health needs identified in the CHNA. The hospital facility's strategic implementation strategy does not explicitly address all significant community health needs identified in the 2018 CHNA due to: 1. limited resources (time, talent, and treasure), 2. the hospital is a stakeholder and/or partner in addressing the need directly or indirectly through other hospital clinical and service lines and community partnerships, 3. other hospitals or community organizations within the service area are addressing the need; 4. The need falls outside of the hospital's mission or limited resource capacity. Significant health needs, referred to by the hospital as priority focus areas, being addressed by the hospital include, mental health and substance use, built environment, and institutional and interpersonal discrimination. Significant health needs not to be addressed include, housing, social environment, basic needs, care coordination, culturally sensitive care, health literacy and language barriers, insurance and healthcare care related challenges, limited providers, Alzheimer's disease, chronic diseases, infant and perinatal health, and sexual health.
Baystate Noble Hospital CorporationPart V, Section B, Line 13b: All patients with account balances (other than balances resulting from co-payments or deductibles on insured services) are eligible to receive a prompt pay discount of 20% of the balance for claims paid in full at time of service or within 60 days of the date of the initial bill. Patients must request the discount. The discount cannot be combined with the Hospital Supplemental Financial Assistance Program.Baystate Noble Hospital offers a co-payment discount program for the patients receiving services in the emergency department of the hospital. This discount program is available to all hospital emergency department patients with co-payment obligations under private or government health insurance (unless prohibited by law or a Baystate Noble Hospital's contract with a private insurer or government authority). These patients may reduce the otherwise applicable emergency department service co-payment by 10% if the patient elects to pay the co-payment at the conclusion of the patient's emergency department visit.
Baystate Noble Hospital CorporationPart V, Section B, Line 15e: Baystate Noble Hospital (BNH) provides patients with information about the availability of State Programs, Health Safety Net, or the Hospital Supplemental Financial Assistance Program which may cover all or some of their unpaid BNH bills as well as about BNH discount programs. For those patients who request such assistance, the hospital assists patients by screening them for eligibility in available State Programs and assisting them in applying for such programs. When applicable, BNH may also assist patients in applying for coverage of services as a Medical Hardship based on the patient's documented income and allowable medical expenses.BNH has contracted with the Executive Office of Health and Human Services and the Commonwealth Health Insurance Connector Authority to serve as a Certified Application Counselor Organization.As a Certified Application Counselor (CAC), appropriate staff will inform a patient of the functions and responsibility of a CAC, seek that the patient sign a Certified Application Counselor Designation Form, and assist the patient in finding applicable financial assistance.
Baystate Noble Hospital CorporationPart V, Section B, Line 16j: Paper copies of our financial assistance policy (FAP) and the FAP application, and a FAP plain language summary as well as the Billing and Collections Policy are available upon request, in English, Spanish, and Russian, and free of charge in the hospital and by mail, as well as the hospital facilities website https://www.baystatehealth.org/patients/billing-and-financial-assistance.A plain language summary of the FAP is offered to all patients at all registration sites including our full service health centers in the community - Baystate Brightwood Health Center and Baystate Mason Square Neighborhood Health Center. In addition, copies of the full FAP, FAP application and Billing and Collections Policy are also available at all Registration sites.Copies of our community health needs assessment are available for viewing and download on our website at https://www.baystatehealth.org/about-us/community-programs/community-benefits/community-health-needs-assessment. Hard copies of our CHNA are available upon request free of charge. We have also shared our CHNA with all the community members who were involved with CHNA as well as each hospitals Community Benefits Advisory Council (CBAC). The hospital is committed to ongoing efforts to widely publicize our FAP and CHNA to the community, specifically, to low-income populations. Additional efforts will include promotion via our hospitals various social media platforms and providing printed materials to key social service agencies and educating their staff that work with low income populations in the hospitals service area.
Baystate Noble Hospital CorporationPart V, Section B, Line 20e: We rely on Medicaid for presumptive eligibility determinations. We would perform these actions if needed but did not have any patient during the tax year where an ECA was initiated.
Form 990, Schedule H, Part V, Line 7a:https://www.baystatehealth.org/about-us/community-programs/community-benefits/community-health-needs-assessment
Form 990, Schedule H, Part V, Line 7b:www.publichealthwm.org
Form 990, Schedule H, Part V, Line 10a:https://www.baystatehealth.org/about-us/community-programs/community-benefits/community-health-needs-assessment
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Business Name Line11 - Baystate Noble Hospital Sports & RehabBusinessNameLine1Txt

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Supplemental Information Detail SupplementalInformationDetail (15 entries)

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Part I, Line 6a:The hospital facility files an annual community benefits report electronically with the Massachusetts Office of the Attorney General's via their website at https://www.mass.gov/nonprofit-hospital-and-hmo-community-benefits. The hospital facility's annual community benefits report is also published on the Baystate Health website at https://www.baystatehealth.org/about-us/community-programs/community-benefits/community-health-needs-assessment. The hospital's community benefits report provides the Office of the Attorney General and the general public important information about how the hospital partners with the community to identify and address health needs.
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 by applying the ratio of patient care cost to charges, calculated on Worksheet 2, against inpatient and outpatient gross charges for Medicaid and Medicaid managed care plans.Line 7c (Other Means-Tested Programs) - community benefit expense was derived by applying the ratio of patient care cost to charges, calculated on Worksheet 2, against inpatient and outpatient gross charges for other means-tested government programs.Line 7e (Community Health Improvement Services & Benefit Operations) - Community Health Improvement Services calculations are derived from direct and indirect costs associated with community benefit activities that are aligned with the hospital's 2018 community health needs assessment. These activities are carried out to improve community health and wellness and extend beyond patient care, beyond the walls of the hospital. Community Benefit Operations calculations are derived from costs associated with assigned staff and community health needs and/or assets assessment, as well as other costs associated with community benefit strategy and operations.Line 7f (Health Professional Education) - no expense to report for this category in 2021.Line 7g (Subsidized Programs) - community benefit expense was derived using the organization's cost accounting system. The expense relates to inpatient behavioral health and to specific outpatient programs. There are no costs attributable to physician clinics reported as subsidized health services in Part I, line 7g.
Part I, Ln 7 Col(f):Estimated uncollectible amounts due from patients (bad debt expense) is an implicit price concession and a direct reduction to net operating revenue. These implicit price concessions are not included in total expenses reported in Part IX, LIne 25, column (A) for the purpose of calculating the percentages in Part 1, LIne 7, column (f)
Part II, Community Building Activities:The following description is not quantified specifically in Part II of Schedule H. The hospital facility 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 and inequities. The hospital embraces the traditional definition of "health" to include economic opportunity, affordable housing, quality education, safe neighborhoods, food security, social and racial justice, and the arts/culture all elements that are needed for individuals, families, and communities to thrive. The hospital provides many valuable services, resources, programs, and financial support - beyond the walls of the hospital and into the communities and homes of the people it serves; including grants and sponsorship of local community-based organizations and the involvement of Baystate Health leadership with various community boards that align with its mission. The hospital facility paid dues to the Greater Westfield Chamber of Commerce totaling $2,000. The hospital participates in the Chamber as it is one of the largest local employers in the service area. The Chamber and its members coordinate activities toward a common purpose of sustainability and economic growth for the region.
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 implicit price concessions as reflected in the audited financial statements. The portion of bad debt 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 150% of the federal poverty level) to the total cost of bad debt 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 150% of the Federal poverty level, it is highly likely these patients would have qualified for the organization's charity care program had they applied. Uncollectible balances owed on patient accounts (bad debt expense) is an implicit price concession when determining net patient service revenue. The Net Patient Service Revenue disclosure included in footnote 2, Significant Accounting Policies, describes the organization's reporting of its implicit price concessions."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 of the hospital's 2021 Medicare cost report, net of Medicare costs reported in Part 1, line 7.g, and based on Medicare costing principles.
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:The Baystate Board Governance Committee convenes semi-annually and is charged with advocating for community benefits at the board level and throughout the health system and broader community; aligning the system's four (4) hospital-specific community benefits implementation strategies with the health system's strategic plan; review of CHNA data; approval of a community benefits mission statement and health priorities; review impacts of community benefits activities and investments; and ensure Baystate Health's community benefits are in compliance with guidelines established by the MA Attorney General and IRS. Annually, the Office of Government and Community Relations provides updates to the Baystate Board of Trustees, Baystate President's Cabinet, and other Baystate leadership teams, as requested. The hospital Community Benefits Advisory Council (CBAC) continues to bring a community lens and filter for the hospital's health priorities. The CBAC provides a community perspective on how to increase wellness and resilience opportunities for optimal health for an entire population; guidance in matching hospital resources to community resources, thus making the most of what is possible with the goal to improve health status and quality of life; and policy advocacy to assure and restore health equity by targeting resources for residents. Participants on the hospital CBAC represent constituencies and communities served by the hospital. CBAC members are responsible for reviewing community needs assessment data and use this analysis as a foundation for providing the hospital with input on its community benefits planning process.Baystate Health Patient & Family Advisory Council (PFAC) members provided valuable input in enhancing care at Baystate Health based on the knowledge of the unique needs of patients and families. Information from PFAC 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. PFAC is made up of a diverse group of patients, family members, and community members who represent the collective voice of the patients and families at Baystate Medical Center, Baystate Children's Hospital, Baystate Franklin Medical Center, Baystate Noble Hospital, Baystate Mary Lane Outpatient Center, Baystate Wing Hospital, the D'Amour Center for Cancer Care, and the BeHealthy Accountable Care Organization (ACO) in Baystate managed health centers.
Part VI, Line 3:The hospital 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. The hospital recognizes 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 eligible patients the opportunity to apply for free or reduced cost services. The hospital not only offers free and reduced cost care 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 the hospital.The hospital recognizes 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, the hospital is required to maintain a financial assistance policy and a billing and collection policy that reflects its financial assistance options and patient billing and collection procedures and complies with applicable federal and state laws and regulations.The hospital 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 the hospital. Hospital financial counselors have all been trained and certified by the state as Certified Account Counselors to assist patients in applying for available federal and state programs. The hospital is committed to ensuring that patients or prospective patients in the community are aware of financial assistance programs. For uninsured or underinsured patients, the hospital will assist in applying for available financial assistance programs. The hospital 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, the hospital also assists patients in applying for coverage of services as a Medical Hardship based on the patient's documented income and allowable medical expenses. The hospital 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 Baystate's own internal financial assistance program. The hospital also notifies patients about available payment plans based on their family size and income. Baystate Health's Financial Assistance Policy and Billing and Collection Policy are posted on the baystatehealth.org website at https://www.baystatehealth.org/patients/billing-and-financial-assistance. The goal of posting the Financial Assistance Policy and the Billing and Collection Policy is to ensure that patients or prospective patients in the community are aware of the financial assistance programs. Signs about the availability of financial assistance programs at the hospital are translated into Spanish and Russian as these languages are primarily spoken by more than 1,000 or 1% of the residents in the hospital's service area. Signs are large and clearly visible. Hospital signs are 8.5 x 11 inches and the header print font is 24 points. 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.
Part VI, Line 4:The following "community information" description is extracted from the hospital's 2018 CHNA with updated changes where necessary for Tax Year 2020. Baystate Noble Hospital (Baystate Noble) is a 85-bed acute care community hospital helping people in the greater Westfield community, offering direct access to world-class technology, diagnostics, and specialists. The hospital works to ensure that patients have access to exceptional healthcare, close to home. Skilled and compassionate nurses and medical support staff offer an ideal combination of "high tech and "high touch", complementing an outstanding team of doctors. Services include obstetrics and gynecology, emergency, laboratory, gastroenterology, surgery, cardiopulmonary services and rehabilitation, cancer care, behavioral health, urology, neurology, inpatient rehabilitation, and diagnostic imaging, including 3D mammography.The service area for Baystate Noble includes ten communities, nine of which are located in the western portion of Hampden County, over 100,000 people, and a majority of this population lives in the cities of West Springfield and Westfield. There is a mix of rural and urban populations. The U.S. Census defines urban areas as consisting of census tracts and/or blocks which meet the minimum population density requirement (2,500-49,999 for urban clusters and over 50,000 for urbanized areas) or are adjacent and meet additional criteria. The population is densest surrounding Westfield, West Springfield, and Agawam (US Census Bureau, Decennial Census 2010). The median age of residents in these cities is approximately 42 years. The Pioneer Valley Transit Authority connects three of the communities to the Springfield metropolitan area to the east, and to the hospital itself. Paratransit service is also available for people with disabilities within three-quarter mile of a fixed route to facilitate access to medical care.The service area has more racial and ethnic diversity than many other parts of western Massachusetts. County-wide, 24% of the population is Latino, 8% is black and 2% is Asian (ACS, 2013-2017), though this diversity is not equally spread throughout the region and tends to be concentrated in the urban core. In the Baystate Noble service area, 86% of the population is white, 7% is Latino, 2% is black and 3% is Asian (ACS, 2013-2017). A substantial proportion of the County's population is from other countries. In 2017, 22% of the state's immigrants came to western Massachusetts. West Springfield has welcomed the highest proportion in Hampden County, and 15% of the city's populations are immigrants. The current political climate has exacerbated threats to immigrant health related to threats to the behavioral, cultural, and structural systems that determine individual health decision on a daily basis. According to the MDPH, in the past 5 calendar years (2014-2018), there were 2,314 refugees with health assessments in western Massachusetts. This assessment is the first medical screening provided to refugees; it is their gateway into the medical system. Economically, the Baystate Noble service area is near many of the largest employers in the region as well as numerous colleges and universities. The largest industries and employers include health care, service and wholesale trade, and manufacturing. Compared to the state, the Baystate Noble service area has slightly lower unemployment and poverty rates, and higher levels of educational attainment. The median household income in the service area is about $61,000 (almost $17,000 less than the state). The poverty rate is 9% (slightly lower than the state rate of 11%). The child poverty rate is 13% (compared to 14.6% at the state level) (ACS, 2013-2017). Despite being near the Knowledge Corridor region, only 31% of the population aged 25 and over has a bachelor's degree, compared to 43% statewide. Unemployment is slightly lower than the state average. The median age for the service area is 41.6 years of age which is older than that of Hampden County and of the state. The population over 45 years old is growing as a percentage of the total population. To give a sense of the change in service needs, between 2010 and 2035, the proportion of people over age 60 in Hampden County is projected to grow from 20% of the population to 28%, with the number of older adults increasing from approximately 92,000 in 2010 to an estimated 140,000 in 2035. Aging projection data specific to the service area was unavailable. In Hampden County 14% of the population has a disability compared to the state rate of 12%. In West Springfield and Westfield, disability rates are comparable to the county at 14% and 15% respectively.
Part VI, Line 5:The hospital facility has a responsibility to respond to health care needs unsupported by government programs. In exchange for this responsibility, the hospital 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.The charitable mission of the hospital facility, a member hospital of Baystate Health, is to improve the health of the people in our communities every day, with quality and compassion. The hospital's Community Benefits Mission is to reduce health disparities, promote community wellness, and improve access to care for vulnerable populations. The hospital 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.The hospital facility 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 the hospital, 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 Health or community-based entity. The hospital's emergency department is open to all in need of care and services; no one requiring emergency care is denied treatment. In addition, surplus funds from operations are generally applied, as permitted, to the following: improvements in patient care, expansion and renovation of existing facilities, purchase and replacement of equipment, debt service, expenses associated with training of physicians and other health care professionals, professional development of medical and other clinical staff, and the support of scientific, translational, and clinical research.Baystate Health's volunteer Board of Trustees, the governing body of the organization and its affiliates, is comprised of the President and Chief Executive Officer of Baystate Health and up to twenty-two (22) other elected trustees who are representative of the broad range of interests which exist in the communities served by Baystate Health and its affiliates. The Governance Committee oversees the nomination of trustees and submits recommendations to the Board of Trustees for membership on the various board committees. In considering nominations or recommendations for trustees, directors, committee members, or officers, the Governance Committee selects nominees who are representative of the various and diverse constituencies served by Baystate Health and its affiliates. In particular the Committee nominates persons who are representative of the community consumer interests of the various neighborhoods and localities which are served by Baystate Health and its affiliates in the carrying out of and pursuant to the charitable mission of the Baystate Health and its affiliates.Please refer to the section above in line 2 for additional examples of the hospital'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.
Part VI, Line 6:Baystate Health is a not-for-profit integrated healthcare system serving over 800,000 people throughout western Massachusetts. Nationally recognized as a leader in healthcare quality and safety, Baystate Health has more than 12,000 employees and serves a diverse population of patients at its teaching hospital, Baystate Medical Center in Springfield, as well as at Baystate Children's Hospital, its three community hospitals, several urban health centers, home care and hospice services, and a network of over 80 medical practices. The four hospitals include Baystate Medical Center, Baystate Franklin Medical Center, Baystate Noble Hospital, and Baystate Wing Hospital (which includes Baystate Mary Lane Outpatient Center); the other 501(c)(3) organizations include Baystate Medical Practices, Visiting Nurse Association and Hospice of Western New England, Baystate Administrative Services, and Baystate Health Foundation. Baystate Medical Center (Baystate Medical) is a 746-bed academic medical center based in Springfield, Massachusetts. Baystate Medical is home to western New England's only tertiary care referral medical center, Level I Trauma Center and Level II Pediatric Trauma Center, and neonatal and pediatric intensive care units. The medical center also includes Baystate Children's Hospital and the Wesson Women and Infants' Unit, and is the regional campus of the UMass Chan Medical School. Baystate Medical is also the community's major referral hospital, providing the highest level of care for conditions such as cancer, acute, and chronic cardiovascular illness, nervous system illness, digestive illness, and other diseases that affect the major organs of the body.Baystate Children's Hospital, part of Baystate Medical, is the only accredited full-service children's hospital and pediatric-specific emergency department in western Massachusetts. It provides primary and advanced medical care to babies, children, adolescents, and their families.Baystate Franklin Medical Center (Baystate Franklin) is an 89-bed facility located in Greenfield, Massachusetts, that provides high-quality inpatient and outpatient services to residents of rural Franklin County and North Quabbin. Inpatient services include behavioral health, intensive care, medical-surgical care, and obstetrics/ midwifery. Outpatient services include cardiology, cardiac rehabilitation and wellness, emergency medicine, gastroenterology, general surgery, neurology, oncology, 3D mammography, radiology, cancer care and infusion, ophthalmology, orthopedics, pediatrics, physical medicine and rehabilitation, pain management, endoscopy, pulmonology and sleep medicine, sports medicine, vascular surgery, and wound care and hyperbaric medicine. In addition, through a partnership with the CHCFC, a dental clinic is located in the Baystate Franklin emergency department.Baystate Noble Hospital (Baystate Noble) is a 85-bed acute care community hospital helping people in the greater Westfield community, offering direct access to world-class technology, diagnostics, and specialists. The hospital works to ensure that patients have access to exceptional healthcare, close to home. Skilled and compassionate nurses and medical support staff offer an ideal combination of "high tech and "high touch", complementing an outstanding team of doctors. Services include obstetrics and gynecology, emergency, laboratory, gastroenterology, surgery, cardiopulmonary services and rehabilitation, cancer care, behavioral health, urology, neurology, inpatient rehabilitation, and diagnostic imaging, including 3D mammography.Baystate Wing Hospital (Baystate Wing) is a 68-bed facility located in Palmer, Massachusetts helping people in a service area that includes three counties Hampden, Hampshire, and Worcester. The hospital services approximately 120,000 residents in seventeen towns, with over half of this population living in Belchertown, Ludlow, Palmer, Wilbraham, and Ware. We offer a broad range of medical, surgical, and psychiatric services. Our expanded Emergency Department (ED) provides comprehensive emergency services for adults and children around the clock. The emergency department includes a six bed critical care unit and is a primary stroke center designated by the Massachusetts Department of Public Health (MDPH). Our hospital offers comprehensive, personalized, and high-quality inpatient and outpatient behavioral health and addiction treatment services through the Griswold Behavioral Health Center and the Center for Geriatric Psychiatry.
Part VI, Line 7, Reports Filed With StatesMA
Form 990, Schedule H, Part VI, Line 6 continuedBaystate Medical Practices (BMP) is a multi-specialty group of over 1,131 physicians and advanced practice clinicians in primary care, specialty, and surgical disciplines with more than 100 practices across 85 locations. BMP offers patient-centered care, including: family practice, internal medicine and pediatric providers, community health centers, urgent care clinics, suburban and rural practices. Many sites are designated Patient Centered Medical Homes, signifying our emphasis on communication with patients, collaboration among providers, and continuity of care. 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 and consistent with Baystate Health and BMP policies, BMP may provide such care free of charge or at amounts below its normal charges. In tax year 2020 BMP provided $1,438,140 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 HIV/AIDS and by providing physician staffing for three community-based health centers through Baystate Medical. BMP faculty published 278 peer-reviewed articles in tax year 2020, acquiring and disseminating new knowledge to a broad audience. This was a 13% increase over the last fiscal year. These original research findings will improve the care delivered to patients.Visiting Nurse Association and Hospice of Western New England provides the highest quality of care to patients and families, primarily in their homes. It is a comprehensive home health, hospice, and palliative care agency with a staff of over 250 managing more than140,000 visits annually. Each patient and family is cared for by certified and experienced nurses, therapists, social workers, hospice aides, spiritual and bereavement counselors, and volunteers in collaboration with their primary care physicians and/or other providers. The home health team works together to ensure a safe and swift recovery from illness, accident, or surgery in the comfort of patients' home. The Hospice and Palliative Care Team offers medical, spiritual and other support services through its extensive network of caregivers to support patients facing a serious or life limiting illness. This care team works together, with both the patient and family, to bring understanding, comfort, dignity, and a sense of peace, as each patient journey towards the final stage of life. Over the past year, home health services were rendered to over 400 patients discharged from the hospital with covid-19. In addition to skilled nursing visits, telehealth monitoring was provided to these patients on a daily basis until they were rehabilitated and safely discharged from home services. Baystate Reference Laboratories (BRL) is Baystate Health's clinical diagnostic laboratory service, providing state-of-the-art, convenient pathology testing services to physicians, hospitals, and other health care services throughout the region. BRL is the region's largest academic medical center-based reference laboratory and is staffed by more than 20 board-certified pathologists and over 650 technologists and lab support personnel.Based in Springfield, Massachusetts, Health New England is a not-for-profit health plan serving members in Massachusetts and Connecticut. A wholly-owned subsidiary of Baystate Health, Health New England offers a range of health care plans including commercial, Medicaid, and Medicare supplemental coverage. For over 30 years, Health New England has been meeting the health care needs of our members, and continue to be the most trusted and valued health plan in our community. In addition to the brief descriptions of the affiliated entities above, the information below speaks to activities of Baystate Health and its affiliates regarding promotion of community health.In addition to its 12,000 employees, Baystate Health has medical staff, nurses, residents and fellows, medical students, nursing students, and allied health students who gain comprehensive medical education during the year. A recognized leader in educational innovation, Baystate Health has been training doctors since 1914. In tax year 2020, over 315 residents and fellows in 10 residency and 15 fellowship programs trained at Baystate Health. In addition, Baystate Health provided training to over 150 medical students completing clerkships and electives in various specialties. 107 medical students enrolled in the Population-based Urban and Rural Community Health (PURCH) track at UMass Chan Medical School Baystate. There were over 1,000 nursing students and over 320 allied health students from local colleges and universities that completed clinical training as part of their associate, baccalaureate, master's and post-doctoral work. Baystate Health is a nationally accredited provider of continuing education for the entire team of health care professionals. Continuing education is provided through regional conferences, grand rounds, and internet courses. During the Covid pandemic Baystate Health has continued to support the local nursing program clinical placement requirements to ensure outstanding learning opportunities and experiences for new nurses. These trying times have served as an opportunity to build our collaborative partnerships. In tax year 2020, 134 nurses graduated from the Baystate Health Nurse Residency Program. The program is a 10-month long program for registered nurses with less than 12 months experience, offering practice-based experience, in-depth learning, and ongoing professional development. Baystate Health's Nurse Residency Program successfully achieved reaccreditation in July 2021 as a Practice Transition Program by the American Nurses Credentialing Center's (ANCC) Commission on Accreditation. The program also achieved national recognition as an Industry-Recognized Apprenticeship Program (IRAP) through the US Department of Labor as well. In tax year 2020, Baystate Health provided 28 nurses with forgivable nursing loans towards earning their ADN, BSN, masters, DNP, or PhD in nursing. The program was established in 2002 and to date has supported more than 600 RNs and student nurses providing more than $2,451,250 in forgivable loans.The Baystate Medical Center's Midwifery Education Program was able to graduate six students in tax year 2020, though pandemic related disruptions delayed the graduation of two students until December. Two graduates are scheduled to take their board exam in March. This program has a historical pass rate of 100% on the American Midwifery Certification Exam. Three graduates are employed as Certified Nurse-Midwives (CNMs) in Springfield, Connecticut, and Rhode Island while the fourth is interviewing with a practice in New Jersey. This was another challenging year but Baystate was one of the few education programs in the country that was able to provide uninterrupted clinical experience to our students. The Baystate Midwifery Education Program continues to support area workforce, with program alumni comprising 30% of CNMs employed in practices Springfield and surrounding areas.
Form 990, Schedule H, Part VI, Line 6 continuedThe Mini-Medical School program is an eight-part health education series offered at Baystate Medical 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 its doors to the public and share its 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 Baystate Health Every Woman members. Mini-Medical School Alumni is over 2,000 members. Baystate Health is committed to caring for those we serve, due to current concerns about the COVID-19 outbreak and recommendations by the CDC, about social distancing, Baystate Health is instituting restrictions for events and meetings and the Mini Medical School was cancelled. Because the program is comprehensive and consists of in-person meetings, gatherings, and tours within the hospital, in 2021 Baystate Health did not host the program. These are important policy changes that support our priority focused on the health and safety of our community, patients and team members.Baystate Health offers free programs to women and seniors 55+. Baystate Health Senior Class is a free loyalty program dedicated to health and wellness offered exclusively for men and women ages 55 and over. The 21,000+ Senior Class members receive a quarterly newsletter and bi-monthly eNews with valuable health information, benefits, and invitations to special events, including virtual events designed with their interests in mind. The free Baystate Health Every Woman Loyalty Program offers its 15,000+ members the latest women's health information through seminars with physicians, nurses, and other medical professionals in a comfortable and lively setting as well as virtual events. Members receive a quarterly newsletter and monthly eNews. The program is designed to increase knowledge of women's health issues, and in turn, provide women with the information they need to make the best decisions regarding their health.In tax year 2020, 28 employees were awarded forgivable loans to purchase their first home through the Mark R. Tolosky Baystate Neighbors Program. This Baystate Health benefit provides forgivable loans to employees purchasing their first home in the communities surrounding Baystate Health hospitals. To date, the program has provided more than $2 million in forgivable home loans.Since its inception in 1994, Rays of Hope has been helping women and men in the fight against breast cancer by walking alongside them on their cancer journey. Through the Baystate Health Breast Network, Rays of Hope cares for the whole person from diagnosis and beyond by supporting research at the Rays of Hope Center for Breast Cancer Research, providing funding for state-of-the-art equipment, breast health programs, and outreach and education throughout Baystate Health as well as providing grants for complementary therapies and cancer programs to our community partners throughout western Massachusetts. Covid-19 lead to a decrease in funds raised and the shuttering of the many community programs we normally provide grants to. Since 1994, Rays of Hope has raised over $16.1 million to date. All funds raised remain in western Massachusetts.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 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, Westfield, and Palmer 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. As part of an annual tradition, in tax year 2020 Baystate Health team members generously donate school supplies to local elementary schools located in each of our four hospital communities. This year, despite COVID-19, employees were able to participate in school supplies donation drives in person at our facilities. Each hospital uniquely selects which schools and/or non-profit to make the donations through. This year, Baystate Franklin employees chose to donate through the United Way of Franklin County Blooming Backpacks Initiative, serving students from elementary to high school. Baystate Noble's employees allocated all donations to the Abner Gibbs Elementary school. Baystate Wing employees were able to collect and donate 1,058 items to Palmer, Ware and Quaboag Regional Schools. Baystate Medical Center and its community health centers were able to donate to six local elementary schools in Springfield. Beneficiary schools included: Brightwood Elementary School, William N. DeBerry Elementary School, Gerena Community School, Lincoln Elementary School, Margaret C. Ells Elementary School, and Milton Bradley Elementary School. The COVID-19 pandemic and holiday surge may have prohibited our hospitals from hosting their annual in person holiday toy drives, but it did not stop our employees from generously donating new toys/gifts to benefit local children during the holiday season. Each Baystate hospital created a safe plan for employees to mail or deliver their toy donations. Baystate Medical team members donated over 300 toys, shipped directly by the Baystate Health Warehouse team to our three Springfield community health centers for staff and providers to gift to pediatrics patients. Baystate Health's Community Benefits Program provided one-time holiday basic needs grants to New North Citizens' Council and Martin Luther King, Jr. Family Services, both based in Springfield. Baystate Health Eastern Region team members donated toys/gifts to benefit 90 children from Ware, Palmer, Belchertown, the Brookfields, Brimfield, and Warren served by Behavioral Health Network (BHN). Franklin County children served by Community Action of Pioneer Valley's Family Center were the recipients of several dozen toys/gifts donated by Baystate Franklin team members. Baystate Noble team member donations benefited Greater Westfield children served by Behavioral Health Network (BHN). See also additional information regarding Baystate Health, Inc. and its affiliate's promotion of community health above in Line 4.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Written Policy Ref T And E Expnss0WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Mark A Keroack MD
Trustee/President & CEO, BH$0$1,425,333$0$677,350$0$408,973$0$12,825$0$26,517$0$2,550,998$0$0
Dennis W Chalke
Former Treasurer$0$406,832$0$175,603$0$316,454$0$58,691$0$17,682$0$975,262$0$0
Kevin P Moriarty MD
Trustee/Chief Ped Surgery$569,741$0$93,081$0$50,330$0$24,225$0$15,239$0$752,616$0$0$0
Raymond McCarthy
Treasurer$0$487,508$0$154,214$0$26,680$0$21,375$0$4,338$0$694,115$0$0
Ronald P Bryant
President$0$429,758$0$120,375$0$47,573$0$18,525$0$29,082$0$645,313$0$0
Denzil M Reid MD
Trustee (As Of 01/01)/Med Dir Pulm$328,091$0$37,926$0$16,407$0$18,525$0$29,932$0$430,881$0$0$0
T Britton Percy MD
VP/CMO$284,998$0$51,579$0$2,209$0$21,371$0$27,445$0$387,602$0$0$0
John Shaver
Chief Financial Officer$216,193$0$24,415$0$22,905$0$4,921$0$19,210$0$287,644$0$0$0
Kristin R Delaney
Clerk$0$151,161$0$16,435$0$750$0$15,836$0$24,657$0$208,839$0$0
Jeffrey Cebula
Dir Finance BFMC & BNH$135,340$0$22,986$0$10,923$0$3,251$0$20,264$0$192,764$0$0$0
Pamela Fournier
Registered Nurse$151,332$0$2,380$0$215$0$6,897$0$8,596$0$169,420$0$0$0
Michele Urban
Former Vp Patient Care Srvs$144,466$0$0$0$21,561$0$687$0$2,313$0$169,027$0$0$0
Angela M Cotti
Registered Nurse$158,439$0$800$0$268$0$6,117$0$2,948$0$168,572$0$0$0
Khalilah Burgin
Mgr. Pharmacy (Thru 3/21)$149,533$0$500$0$314$0$3,049$0$8,344$0$161,740$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3The compensation of the President 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). This committee consists entirely of individuals serving on the board of the filing organization. The individuals responsible for deliberating the compensation arrangement for the President would be those individuals who do not have a conflict of interest with respect to the compensation arrangement and would be considered independent for compensation deliberation purposes. The compensation of the President is established based on information provided by independent third party consultants for reasonableness and appropriate comparability data. The compensation is then established, reviewed and approved by the duly authorized compensation committee of Baystate Health, Inc. and all such deliberations and decisions are documented contemporaneously.
Part I, Lines 4a-bLine 4a: A severance agreement was in place between BNH and key executives stating that under certain circumstances the executive would receive compensation. Michelle Urban received $107,505 in 2020. Line 4b: Ronald P. Bryant- Supplemental Retirement of $11,163 is included in column B. This amount was earned and paid in 2020. Dennis W. Chalke - Supplemental Retirement of $146,809 is included in column B. This amount was earned and paid in 2020. Mark A. Keroack, MD Supplemental Retirement of $363,205 is included in column B. This amount was earned in 2020. Kevin P. Moriarty, MD - Supplemental Retirement of $24,072 is included in column B. This amount was earned and paid in 2020. Raymond McCarthy - Supplemental Retirement of $187 is included in column B. This amount was earned in 2020. T. Britton Percy, MD - Supplemental Retirement of $485 is included in column B. This amount was earned and paid in 2020. Denzil Reid, MD - Supplemental Retirement of $1,376 is included in column B. This amount was earned and paid in 2020.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 1The filing organization has a standing executive committee, which is entitled to act between meetings of the Board, on all matters as to which the Board is entitled to act and permitted by law to delegate to a committee. The members of the executive committee are the same individuals serving on the executive committee of Baystate Health, Inc.
Form 990, Part VI, Section A, line 2Two or more of the persons listed in this Form 990 Part VII have a business relationship with each other by virtue of sitting on one or more Boards of Directors or by serving in an employment relationship with one or more entities in the Baystate Group of affiliated entities and in the community. The following trustees, officers, or key employees have a business relationship: (1) Anne M. Paradis, Mark A. Keroack, MD and Paul R. Murphy (2) John F. Maybury and Mark A. Keroack, MD.
Form 990, Part VI, Section A, line 3Baystate Noble Hospital is affiliated with Baystate Administrative Services, Inc. (BAS) which is a 501(c)(3) organization. Information Technology, Human Resources, Finance, Treasury, Accounting and other management and support functions are delegated to BAS
Form 990, Part VI, Section A, line 6The filing organization has one member, Baystate Health, Inc. (BH).
Form 990, Part VI, Section A, line 7aThe board of Trustees of the filing organization consists of the same individuals serving as members of the Board of Trustees of Baystate Health, Inc. (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 A, line 7bUnder Massachusetts law, a voluntary dissolution of the organization is required to be approved by Baystate Health, Inc., as the sole member of the filing organization. As the sole member, Baystate Health also has the authority to amend the bylaws of the filing organization.
Form 990, Part VI, Section B, line 11bPrior to filing the Form 990, appropriate sections were reviewed by the Tax, Finance, and Human Resources areas of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs) and by outside legal counsel. The Form 990 was also reviewed by tax experts from an independent accounting firm and signed-off as a paid preparer. The process, key areas and any new changes were reviewed prior to filing with the Baystate Health Audit and Compliance Committee (ACC), which is composed of trustees of the filing organization. The ACC members had an opportunity to ask questions regarding the tax compliance process and the tax filings in general. The Form 990 was provided to all members of the Board of Trustees prior to filing.
Form 990, Part VI, Section B, line 12cBaystate Noble Hospital Corporation is an affiliate of Baystate Health, Inc. (BH). BH and its affiliated entities have a comprehensive conflict of interest policy applicable to all of the affiliated entities. 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 Chief Compliance Officer, Chief Executive Officer, Chair of the Board of Trustees, Chief General Counsel and the Chair of the Audit & Compliance Committee. A summary of the conflict of interest disclosures is provided to the Baystate Health Board of Trustees and the Tax Department. 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 15bThe compensation of the President 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) This committee consists entirely of individuals serving on the board of the filing organization. The individuals responsible for deliberating the compensation arrangement for the President would be those individuals who do not have a conflict of interest with respect to the compensation arrangement and would be considered independent for compensation deliberation purposes. The compensation of the President is established based on information provided by independent third party consultants for reasonableness and appropriate comparability data. The compensation is then established, reviewed and approved by the duly authorized compensation committee of Baystate Health, Inc. The compensation of the Senior Vice President, Finance, CFO and Treasurer 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). This committee consists entirely of individuals serving on the board of Baystate Health, Inc. The individuals responsible for deliberating the compensation arrangement for the Senior Vice President, Finance, CFO and Treasurer and of other officers would be those individuals who do not have a conflict of interest with respect to the compensation arrangement and would be considered independent for compensation deliberation purposes. The compensation of the Senior Vice President, Finance, CFO and Treasurer is established based on information provided by independent third party consultants for reasonableness and appropriate comparability data. The compensation is then established, reviewed and approved by the duly authorized compensation committee of Baystate Health, Inc. The compensation of other officers and key employees of the filing organization is determined by the President of the filing organization in accordance with the Executive Compensation Philosophy Statement, in consultation with Human Resources, based on information provided by independent third party consultants for reasonableness including appropriate comparability data or the Baystate Health Board approved budget and wage program for each fiscal year. Line 15a has been answered No because the President is paid by Baystate Administrative Services, Inc., an affiliate and related organization of the filing organization.
Form 990, Part VI, Section C, line 19The organization makes its conflict of interest policy and financial statements available to the public at www.baystatehealth.org. Articles of organization and bylaws are generally available at the Commonwealth of Massachusetts website.
Form 990, Part VI, Section A, Line 8b:The Trustees of Baystate Noble Hospital meet during certain scheduled Baystate Health, Inc. (BH) board meetings. The BH Board of Trustees and its committees, including the Audit and Compliance Committee, contemporaneously document meetings and actions relative to Baystate Noble Hospital as well as the annual acceptance of the audited financial statements.
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, which is part of the health care system to which the filing organization belongs but does not meet the technical requirements as a "Related Organization" per Schedule R. Compensation from BMP to the officers and trustees of the filing organization therefore, is reported as paid from an unrelated organization in Line 5 and according to the instructions reported as though paid by the filing organization.
Form 990, Part IX, line 11gOther: Program service expenses 12,691,164. Management and general expenses 120,736. Fundraising expenses 0. Total expenses 12,811,900.
Form 990, Part XI, line 9:Net Transfers From Affiliated Companies 4,525,000. Net Assets Released From Restrictions 132,456.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Baystate Administrative Services Inc
759 Chestnut StreetSpringfieldMA01199222747685Administrative servicesMA501(c)(3)12C, III-FIBaystate Health Inc0
Baystate Franklin Medical Center
164 High StreetGreenfieldMA01301042103575HospitalMA501(c)(3)3Baystate Health Inc0
Baystate Health Foundation Inc
759 Chestnut StreetSpringfieldMA01199043549011FundraisingMA501(c)(3)7Baystate Health Inc0
Baystate Health Systems Inc Health & Welfare Benefits Plan
759 Chestnut StreetSpringfieldMA01199222531644Voluntary Employees' Benefit AssociationMA501(c)(9)Baystate Health Inc0
Baystate Health Inc
759 Chestnut StreetSpringfieldMA01199042105941Healthcare System ParentMA501(c)(3)7Baystate Health Inc0
Baystate Medical Center Inc
759 Chestnut StreetSpringfieldMA01199042790311Acute Care Teaching HospitalMA501(c)(3)3Baystate Health Inc0
Baystate Total Home Care Inc
280 Chestnut StreetSpringfieldMA01104203260764Real Estate and OtherMA501(c)(3)12B, IIBaystate Medical Center Inc0
Baystate Wing Hospital Corporation
40 Wright StreetPalmerMA01069222519813HospitalMA501(c)(3)3Baystate Health Inc0
Health New England Inc
Monarch Place Suite 1500SpringfieldMA011441500042864973HMO/InsuranceMA501(c)(4)Baystate Health Inc0
HNE of Connecticut Inc
Monarch Place Suite 1500SpringfieldMA011441500465190134HMO/InsuranceCT501(c)(4)Health New England Inc0
Visiting Nurse Assn and Hospice of Western New England Inc
30 Capital Drive Suite AWest SpringfieldMA01089042105803Homehealth and Hospice CareMA501(c)(3)10Baystate Health Inc0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)

Address Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile Foreign CountryLegalDomicileForeignCountryCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdLegal Domicile StateLegalDomicileStateCd
Baystate Health Insurance Company Ltd
North Church StreetGeorgetownCJ980421413Offshore Captive InsuranceCJBaystate Health IncC0
HNE Advisory Services Inc
043012347Administrative ServicesHNE Holding CorporationC0Monarch Place Suite 1500SpringfieldMA011441500MA
HNE Holding Corporation
464620480Holding shares in subsidiary corporationsHealth New England IncC0Monarch Place Suite 1500SpringfieldMA011441500MA
HNE Insurance Company Inc
454462433Health Insurance Services for MA Medicare Supplement MembersHNE Holding CorporationC0Monarch Place Suite 1500SpringfieldMA011441500MA
HNE Insurance Services Inc
043183019Ancillary InsuranceHNE Holding CorporationC0Monarch Place Suite 1500SpringfieldMA011441500MA
Ingraham Corporation
043016257Health care and other business activitiesBaystate Health IncC0759 Chestnut StreetSpringfieldMA01199MA
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Health New England IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeQTransactionTypeTxt
Involved$7,866,986InvolvedAmt
Method Of Amount DeterminationActual AmountMethodOfAmountDeterminationTxt