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BAYSTATE WING HOSPITAL CORPORATION: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
BAYSTATE WING HOSPITAL CORPORATION (EIN 22-2519813)
Tax period
2020-10-01 to 2021-09-30
Filed
2022-08-05
IRS object ID
202222179349300602
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)
Return2022-08-05T05:02:14-05:00ReturnTs
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)
EIN222519813EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Baystate Wing Hospital CorporationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlBAYSBusinessNameControlTxt
Phone4137943290PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line140 Wright StreetAddressLine1Txt
CityPalmerCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01069ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRaymond McCarthyPersonNm
Person TitleSVP Finance, CFO & TreasurerPersonTitleTxt
Phone4132845210PhoneNum
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 Line1759 CHESTNUT STREETAddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01199ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$96,732,792GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.BAYSTATEWINGHOSPITAL.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 Body12VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee859TotalEmployeeCnt
Total Volunteers10TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,964,171PYContributionsGrantsAmt
CY Contributions Grants$5,231,436CYContributionsGrantsAmt
PY Program Service Revenue$79,479,223PYProgramServiceRevenueAmt
CY Program Service Revenue$88,918,654CYProgramServiceRevenueAmt
PY Investment Income$702,199PYInvestmentIncomeAmt
CY Investment Income$947,208CYInvestmentIncomeAmt
PY Other Revenue$1,196,864PYOtherRevenueAmt
CY Other Revenue$2,109,294CYOtherRevenueAmt
PY Total Revenue$85,342,457PYTotalRevenueAmt
CY Total Revenue$97,206,592CYTotalRevenueAmt
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$45,282,640PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$44,284,319CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$221,045CYTotalFundraisingExpenseAmt
PY Other Expenses$46,979,318PYOtherExpensesAmt
CY Other Expenses$53,864,464CYOtherExpensesAmt
PY Total Expenses$92,261,958PYTotalExpensesAmt
CY Total Expenses$98,148,783CYTotalExpensesAmt
PY Revenues Less Expenses-$6,919,501PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$942,191CYRevenuesLessExpensesAmt
Total Assets BOY$105,263,660TotalAssetsBOYAmt
Total Assets EOY$104,408,982TotalAssetsEOYAmt
Total Liabilities BOY$66,654,595TotalLiabilitiesBOYAmt
Total Liabilities EOY$60,657,488TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$38,609,065NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$43,751,494NetAssetsOrFundBalancesEOYAmt
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$33,487,568ExpenseAmt
Revenue$40,321,650RevenueAmt
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 Wing Hospital Corporation provided 20,279 patient days of inpatient services, with 3,636 discharges.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$30,850,797ExpenseAmt
Revenue$30,476,349RevenueAmt
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 Wing Hospital Corporation had 78,920 outpatient visits.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$15,141,615ExpenseAmt
Revenue$17,271,028RevenueAmt
DescEmergency department services - Providing emergency department services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY21, Baystate Wing Hospital Corporation had 30,904 emergency service visits.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$9,997,846ExpenseAmt
Revenue$2,814,472RevenueAmt
DescProviding 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$9,997,846TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$2,814,472TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$89,477,826TotalProgramServiceExpensesAmt
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 AssetsYes (1)ReportOtherAssetsInd
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 BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
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 EntYes (1)BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgYes (1)TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document47IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee859EmployeeCnt
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 Members12GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
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
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Laurie Martin Baystate Health IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4137940000PhoneNum

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 (27 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
Nancy Shendell-Falik
Director/Pres BMC SVP Hosp (Thru 5/21)4.0046.00Yes (X)$0$1,311,383$46,342
Jo-Ann Davis Esq
Director/SVP/Chief Admin (Thru 10/30/20)5.0045.00Yes (X)$0$854,414$54,919
Brian Laliberte MD
Director/Med Dir Cardio (Thru 12/31)1.0049.00Yes (X)$489,286$0$49,254
Mary Louise Gray
President/Dir BWH40.0010.00Yes (X)$0$417,161$69,448Yes (X)
Kristin Morales-Lemieux
Director (As of 11/1/21)/SVP/CHRO0.0050.00Yes (X)$0$416,288$36,727
Scott Siege MD
Director (As of 1/1/21)/Med Dir Ped2.0048.00Yes (X)$260,721$0$47,428
Edison Bond
Director (As of 07/26/21) Dir Pat Rel45.005.00Yes (X)$0$166,394$25,439
Sheila Cuddy
Vice Chair/Director1.000.00Yes (X)$0$0$0Yes (X)
Steven Lowell
Chair/Director1.000.00Yes (X)$0$0$0Yes (X)
Darryl Goodreau
Director (Thru 2/15/21)1.000.00Yes (X)$0$0$0
Derek Gariepy
Director1.000.00Yes (X)$0$0$0
Elaine J Dustin Boone
Director1.000.00Yes (X)$0$0$0
Julie Quink
Director1.000.00Yes (X)$0$0$0
Kara Noonan Pear
Vice Chair/ Director1.000.00Yes (X)$0$0$0
Mark A O'Connell
Director1.000.00Yes (X)$0$0$0
Paul Scully
Director (Thru 12/31/20)1.000.00Yes (X)$0$0$0
Robert Logan
Director1.000.00Yes (X)$0$0$0
Raymond McCarthy
Treasurer5.0045.00$0$668,402$25,713Yes (X)
Kristin R Delaney
Secretary1.0049.00$0$168,346$40,493Yes (X)
Janice Mayforth
Chief Financial Officer - Ereg30.0020.00$0$219,052$54,719Yes (X)
Donald W Blair MD
Neurologist50.000.00$235,595$0$33,124Yes (X)
Karli Barrett
Dir Patient Care Svs50.000.00$170,955$0$35,601Yes (X)
George D Nolan
Director, Support Services50.000.00$173,995$0$31,190Yes (X)
Edyta I Guberow
Respiratory Therapist Reg50.000.00$162,868$0$10,432Yes (X)
Pamela White
Registered Nurse II50.000.00$152,015$0$21,022Yes (X)
Dennis W Chalke
Former Treasurer0.000.00$0$898,889$76,373Yes (X)
Paul Shafer
Former CFO0.000.00$130,012$0$7,508Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,775,447TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$5,120,329TotReportableCompRltdOrgAmt
Total Other Compensation$665,732TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K40IndivRcvdGreaterThan100KCnt
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
759 Chestnut StSpringfieldMA01199Physician Services$10,359,723
Baystate Administrative Serv Inc
759 Chestnut StSpringfieldMA01199Management Services$5,981,016
ShiftWise
1800 SW 1st Ave Suite 510PortlandOR97201Temporary Help$1,782,963
New England Geriatric
101 Myron St Suite AWest SpringfieldMA01089Management Services$851,000
Morrison Management
POBox 102289AtlantaGA303682289Contract Services$485,508
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K16CntrctRcvdGreaterThan100KCnt
Related Organizations$160,162RelatedOrganizationsAmt
Government Grants$5,071,274GovernmentGrantsAmt
Total Contributions$5,231,436TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Outpatient Revenue622110$47,913,096$47,913,096
Inpatient Revenue622110$40,515,546$40,515,546
Intercompany Rent622110$490,012$490,012
FieldValueIRS element (for citing)
Total Program Service Revenue$88,918,654TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$138,998TotalRevenueColumnAmt
Exclusion$138,998ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$292,393RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$331,769RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$39,376RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$39,376TotalRevenueColumnAmt
Exclusion-$39,376ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$2,641SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities-$78,499SecuritiesAmt
Other-$727,070OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$81,140SecuritiesAmt
Other$727,070OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$808,210TotalRevenueColumnAmt
Exclusion$808,210ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
Intercompany Charges622110$513,753$513,753
Cafeteria Income722514$184,825$184,825

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,450,092TotalRevenueColumnAmt
Related Or Exempt Func Income$1,450,092RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,148,670OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$97,206,592TotalRevenueColumnAmt
Related Or Exempt Func Income$90,882,499RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,092,657ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$35,706,645TotalAmt
Program Services$32,820,030ProgramServicesAmt
Management And General$2,886,615ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,202,560TotalAmt
Program Services$1,105,342ProgramServicesAmt
Management And General$97,218ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,727,741TotalAmt
Program Services$4,345,539ProgramServicesAmt
Management And General$382,202ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,647,373TotalAmt
Program Services$2,433,353ProgramServicesAmt
Management And General$214,020ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$3,849,443TotalAmt
Program Services$679,814ProgramServicesAmt
Management And General$2,948,882ManagementAndGeneralAmt
Fundraising$220,747FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$85,824TotalAmt
Program Services$1,753ProgramServicesAmt
Management And General$84,071ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$8,738TotalAmt
Management And General$8,738ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$16,733TotalAmt
Management And General$16,733ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$26,544,369TotalAmt
Program Services$25,495,982ProgramServicesAmt
Management And General$1,048,387ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$11,596,083TotalAmt
Program Services$11,003,639ProgramServicesAmt
Management And General$592,146ManagementAndGeneralAmt
Fundraising$298FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$3,379,833TotalAmt
Program Services$3,375,978ProgramServicesAmt
Management And General$3,855ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,414,576TotalAmt
Program Services$1,387,613ProgramServicesAmt
Management And General$26,963ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$11,106TotalAmt
Program Services$9,088ProgramServicesAmt
Management And General$2,018ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$53,835TotalAmt
Program Services$38,526ProgramServicesAmt
Management And General$15,309ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$790,440TotalAmt
Program Services$790,440ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$5,720,166TotalAmt
Program Services$5,720,166ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$393,318TotalAmt
Program Services$270,563ProgramServicesAmt
Management And General$122,755ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$98,148,783TotalAmt
Program Services$89,477,826ProgramServicesAmt
Management And General$8,449,912ManagementAndGeneralAmt
Fundraising$221,045FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$15,174,711BOYAmt
EOY$13,442,232EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$12,913,217BOYAmt
EOY$14,580,038EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$61,305BOYAmt
EOY$61,305EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$9,405,440BOYAmt
EOY$11,132,250EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,593,265BOYAmt
EOY$1,267,139EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$302,535BOYAmt
EOY$217,040EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$109,038,459LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$61,441,302LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$54,210,979BOYAmt
EOY$47,597,157EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$2,395,153BOYAmt
EOY$2,807,030EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$9,207,055BOYAmt
EOY$13,304,791EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$105,263,660BOYAmt
EOY$104,408,982EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$7,456,836BOYAmt
EOY$13,078,304EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$15,902,553BOYAmt
EOY$10,698,621EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$25,453,151BOYAmt
EOY$24,558,214EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$17,842,055BOYAmt
EOY$12,322,349EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$66,654,595BOYAmt
EOY$60,657,488EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$26,669,446BOYAmt
EOY$29,085,260EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$11,939,619BOYAmt
EOY$14,666,234EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$38,609,065BOYAmt
EOY$43,751,494EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$105,263,660BOYAmt
EOY$104,408,982EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$942,191ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$4,146,789NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$1,937,831OtherChangesInNetAssetsAmt
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 Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$16,733OtherActivitiesAmt
Total Lobbying Expenditures$16,733TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationBaystate Wing Hospital Corporation (BWH) pays membership dues to the Massachusetts Hospital Association (MHA) $11,403, the American Hospital Association (AHA) $5,225, and the National Association of Urban Hospitals $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 $16,733.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$10,172,477BeginningYearBalanceAmt
Investment Earnings Or Losses$1,704,211InvestmentEarningsOrLossesAmt
End Year Balance$11,876,688EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$9,616,469BeginningYearBalanceAmt
Investment Earnings Or Losses$556,008InvestmentEarningsOrLossesAmt
End Year Balance$10,172,477EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$9,915,069BeginningYearBalanceAmt
Investment Earnings Or Losses-$298,600InvestmentEarningsOrLossesAmt
End Year Balance$9,616,469EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$9,657,100BeginningYearBalanceAmt
Investment Earnings Or Losses$257,969InvestmentEarningsOrLossesAmt
End Year Balance$9,915,069EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$9,054,591BeginningYearBalanceAmt
Investment Earnings Or Losses$602,500InvestmentEarningsOrLossesAmt
End Year Balance$9,657,091EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$498,255OtherCostOrOtherBasisAmt
Book Value$498,255BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$69,334,912OtherCostOrOtherBasisAmt
Depreciation$30,981,879DepreciationAmt
Book Value$38,353,033BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$978,182OtherCostOrOtherBasisAmt
Depreciation$978,182DepreciationAmt
Book Value$0BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$36,630,036OtherCostOrOtherBasisAmt
Depreciation$28,714,696DepreciationAmt
Book Value$7,915,340BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,597,074OtherCostOrOtherBasisAmt
Depreciation$766,545DepreciationAmt
Book Value$830,529BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$47,597,157TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescSeries A - Bond Indenture AgreementDesc
Book Value$13,304,791BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$13,304,791TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
Contractual Adjustment Payable$3,111,722
Due to Affiliated Companies$7,611,609
Operating Lease Liability$7,392
Malpratice Reserve$190,049
Employer Tax Deferral$1,401,577
FieldValueIRS element (for citing)
Total Liability$12,322,349TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart V, Line 4:FormAndLineReferenceDesc
ExplanationEndowment assets are to provide funding to support programs that further Baystate Wing Hospital Corporation's mission.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$941,820TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$413,656DirectOffsettingRevenueAmt
Net Community Benefit Expns$528,164NetCommunityBenefitExpnsAmt
Total Expense0.00540TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,631,244TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$12,480,090DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,151,154NetCommunityBenefitExpnsAmt
Total Expense0.03210TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$210,763TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$119,831DirectOffsettingRevenueAmt
Net Community Benefit Expns$90,932NetCommunityBenefitExpnsAmt
Total Expense0.00090TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$16,783,827TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$13,013,577DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,770,250NetCommunityBenefitExpnsAmt
Total Expense0.03840TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$228,560TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$228,560NetCommunityBenefitExpnsAmt
Total Expense0.00230TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$20,540,739TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,839,406DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,701,333NetCommunityBenefitExpnsAmt
Total Expense0.08870TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$146,701TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$146,701NetCommunityBenefitExpnsAmt
Total Expense0.00150TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$20,916,000TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,839,406DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,076,594NetCommunityBenefitExpnsAmt
Total Expense0.09250TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$37,699,827TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$24,852,983DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,846,844NetCommunityBenefitExpnsAmt
Total Expense0.13090TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,600TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,600NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,600TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,600NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$1,188,095BadDebtExpenseAmt
Bad Debt Expense Attributable$12,138BadDebtExpenseAttributableAmt
Reimbursed By Medicare$22,103,681ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$16,919,012CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$5,184,669MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
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 Wing Hospital CorporationBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line140 Wright StreetAddressLine1Txt
CityPalmerCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01069ZIPCd
FieldValueIRS element (for citing)
State LicenseLicense #2181StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Baystate Wing 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 Wing 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 Wing 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 Wing 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 Wing 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 Wing 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, social environment, mental health and substance use, domestic violence, basic needs. Significant health needs not to be addressed include, built environment, housing, care coordination, culturally sensitive care, health literacy, and language barriers, insurance and healthcare care related challenges, limited providers, transportation, Alzheimer's disease, chronic diseases, infant and perinatal health, and sexual health.
Baystate Wing Hospital CorporationPart V, Section B, Line 13b: All patients with account balances (other than balances resulting from co-payments or deductibles on insuredservices) 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 Wing Hospital offers a co-payment discount program for 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 Wing Hospital 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 Wing Hospital CorporationPart V, Section B, Line 15e: Baystate Wing Hospital 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 Baystate Wing Hospital bills as well as about Baystate Wing Hospital 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, Baystate Wing Hospital 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. Baystate Wing Hospital have 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 Wing 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 aswell 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 allRegistration sites.Copies of our community health needs assessment are available for viewing and download on our website athttps://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 thecommunity, 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 Wing Hospital CorporationPart V, Section B, Line 20e: We rely on Medicaid for presumptive eligibility determinations. We would perform these actions if needed butdid 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 10:https://www.baystatehealth.org/about-us/community-programs/community-benefits/community-health-needs-assessment
FieldValueIRS element (for citing)
Facility6FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - Baystate Wing Hospital - MMC
2 Main StreetMonsonMA01057Outpatient Facility
2 - Baystate Wing Hospital - LMC
34 Hubbard StreetLudlowMA01056Outpatient Facility
3 - Baystate Wing Hospital - VNA
40 Wright StreetPalmerMA01069Outpatient Facility
4 - Baystate Wing Hospital - Griswold Center
42 Wright StreetPalmerMA01069Outpatient Facility
5 - Outpatient Radiology Services
95 Sargent StreetBelchertownMA01007Outpatient Facility
6 - Baystate Mary Lane Outpatient Center
85 South StreetWareMA01082Outpatient Facility

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 using the organization's cost accounting system, which takes into account all hospital inpatients, outpatients and emergency room patients for whom services were provided and covered under Medicaid and Medicaid managed care plans.Line 7c (Other Means-Tested Programs) - community benefit expense was derived using the organization's cost accounting system, which takes into account all hospital inpatients, outpatients and emergency room patients for whom services were provided and covered under other means-tested government programs.Line 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. Theseactivities 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 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, Line 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 Quaboag Hills Chamber of Commerce totaling $1,600. The hospital participates in the Chamber as it is one of the largest local employers in our 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 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 8Line 6 included all Medicare allowable costs as calculated in Worksheets D-1 Part II (inpatient and inpatient psych), D Part V (outpatient) and E Part A (organ acquisition) of the hospital's 2021 Medicare cost report, net of Medicare costs reported in Part I, line 7.g, and based on Medicare costing principles. There is no shortfall reported on line 7.
Part III, Line 9b:For patients who are known to qualify for Charity Care or Financial Assistance: The patient may have requested assistance up front at time of service with a Financial Counselor or the Patient could have asked for assistance after receiving their bill by contacting our Patient Billing Services Representatives. The Financial Counselor will assist the patient in applying for the appropriate type of assistance based on their income and circumstances. Once approved for a State Medicaid or other program, all billing and collection activity will stop (except for required co-payments or deductibles).For all other patients, our statements contain information regarding how to apply for financial assistance. Notices concerning availability for assistance are also posted at patient care sites.
Part VI, Line 2: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 pulls from the hospital's 2018 CHNA. 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. Baystate Wing offers a broad range of medical, surgical, and psychiatric services. The expanded Emergency Department (ED) provides comprehensive emergency services for adults and children around the clock. The ED includes a six bed critical care unit and is a primary stroke center designated by the Massachusetts Department of Public Health (MDPH). Baystate Wing 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.The Baystate Wing service area overlaps to a great degree the region that is also known as the Quaboag Hills. The region is 90 miles west of Boston, 30 miles northeast of Springfield and 30 miles west of Worcester, representing 17 communities in a 440-square mile region in west-central Massachusetts with a total population of 122,033. Numerous small, rural towns make up the region (Belchertown, Brimfield, Brookfield, East Brookfield, Hampden, Hardwick, Holland, Ludlow, Monson, New Braintree, North Brookfield, Palmer, Spencer, Wales, Ware, Warren, West Brookfield, and Wilbraham) which crosses three county lines (Hampden, Hampshire, and Worcester Counties).The towns are comprised of densely populated former mill villages surrounded by rural areas and developing commuter neighborhoods.Thirteen of the 17 towns have populations of less than 10,000 people living in them, and all 17 towns meet the state definition of "rural", defined as "a municipality in which there are fewer than 500 people per square mile." Transportation is extremely limited. Demographically, the service area is overwhelmingly white (more than 96%) with 2% Latino and less than 1% black or Asian. However recent trends show growing numbers of new immigrants and Spanish-speaking residents. For example, the town of Ware and the Quaboag Regional Schools each have a student body that is 6% Latino and Palmer students are 8% Latino. The region has been characterized by chronic high unemployment, historically 1 to 2 points above the state average. Education levels in the Quaboag Hills are significantly lower than the average in Massachusetts. In the 2018 Robert Wood Johnson Foundation County Health Rankings, Hampden County ranked last (14th of 14 counties), Worcester County ranks 9th, and Hampshire County ranks 5th. Economically, the region has been hard-hit by lost manufacturing jobs and recession. In four of the six school districts, over 33% of students are eligible for reduced price/free lunch. An average of 8% of families live below the poverty level; in Ware, Warren, and Hardwick, over 20% of families live in poverty. The Worcester Community Action Council, Inc.'s Community Action Plan 2015-2017 ranked the town of Hardwick as one of the five towns in Worcester County with the highest individual, childhood, and family poverty rates. Many families living in poverty are headed by single females. The town of Ware (pop. 9,872) serves as the region's economic and service "hub" with the broadest network of commercial entities, service providers, employers, and health care providers. In Hampden County, 16% of the population has a disability compared to the state prevalence of 12%. In Hampshire County, 10% of the population has a disability. Disability prevalence in Ware and Palmer is higher than the state at 16% and 17%, respectively. People with disabilities tend to have higher rates of poverty and lower levels of education. In Hampden County, poverty rates among those with a disability (27%) were more than double than those among people without a disability (12%). Similarly, 30% of the disabled population did not have a high school diploma compared to 11% among those without a disability (U.S. Census Bureau, ACS, 2013-2017).
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)
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 (17 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
Nancy Shendell-Falik
Director/Pres BMC SVP Hosp (Thru 5/2$0$744,791$0$335,013$0$231,579$0$18,525$0$27,817$0$1,357,725$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
Jo-Ann Davis Esq
Director/SVP/Chief Admin (Thru 10/30$0$474,336$0$203,571$0$176,507$0$40,300$0$14,619$0$909,333$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
Brian Laliberte MD
Director/Med Dir Cardio (Thru 12/31)$404,308$0$49,266$0$35,712$0$21,375$0$27,879$0$538,540$0$0$0
Mary Louise Gray
President/Dir BWH$0$317,579$0$84,843$0$14,739$0$47,012$0$22,436$0$486,609$0$0
Kristin Morales-Lemieux
Director (As of 11/1/21)/SVP/CHRO$0$313,327$0$91,133$0$11,828$0$18,195$0$18,532$0$453,015$0$0
Scott Siege MD
Director (As of 1/1/21)/Med Dir Ped$230,547$0$21,877$0$8,297$0$18,545$0$28,883$0$308,149$0$0$0
Janice Mayforth
Chief Financial Officer - Ereg$0$166,561$0$30,765$0$21,726$0$31,151$0$23,568$0$273,771$0$0
Donald W Blair MD
Neurologist$225,706$0$0$0$9,889$0$14,306$0$18,818$0$268,719$0$0$0
Kristin R Delaney
Secretary$0$151,161$0$16,435$0$750$0$15,836$0$24,657$0$208,839$0$0
Karli Barrett
Dir Patient Care Svs$153,441$0$17,235$0$279$0$12,265$0$23,336$0$206,556$0$0$0
George D Nolan
Director, Support Services$152,480$0$17,659$0$3,856$0$9,908$0$21,282$0$205,185$0$0$0
Edison Bond
Director (As of 07/26/21) Dir Pat Re$0$129,755$0$9,900$0$26,739$0$6,597$0$18,842$0$191,833$0$0
Edyta I Guberow
Respiratory Therapist Reg$162,295$0$500$0$73$0$9,741$0$691$0$173,300$0$0$0
Pamela White
Registered Nurse II$151,271$0$500$0$244$0$9,394$0$11,628$0$173,037$0$0$0
Paul Shafer
Former CFO$52,290$0$76,928$0$794$0$2,723$0$4,785$0$137,520$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 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 Baystate Health, Inc. 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, Line 4a:A severance agreement was in place between BWH and key executives stating that under certain circumstances the executive would receive compensation. Paul Shafer received $76,134 in 2020.
Part I, Line 4b: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. Nancy Shendell-Falik- Total Supplemental Retirement of $187,422 is included in column B. This amount was earned and paid in 2020.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1MA Development Finance AgencyBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN043431814BondIssuerEIN
CUSIP000000000CUSIPNum
Bond Issued2017-04-13BondIssuedDt
Issue Price$14,700,000IssuePriceAmt
PurposeMDFA Series A - See Part VIPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$1,157,425RetiredAmt
Total Proceeds$14,832,594TotalProceedsAmt
Capital Expenditures$14,832,594CapitalExpendituresAmt
Substantial Completion2018SubstantialCompletionYr
Refunding Tax Exempt Bonds0RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Use By Others0.00000PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00000PrivateBusConcerningUBIPct
Total Private Business Use0.00000TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due YetYes (1)RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceForm 990 Schedule K, Part I:FormAndLineReferenceDesc
ExplanationA MDFA Series A Part I, Description of Purpose The purpose of the bond proceeds is for: (i) the construction, renovation, and equipping of the emergency department located at the Borrower's campus at 40 Wright Street in Palmer, Massachusetts (the "Campus"); and (ii) other routine capital expenditures of the Borrower at the Campus and at 20 Daniel Shays Highway, Belchertown, Massachusetts 01007, 42 Wright Street, Palmer, Massachusetts 01069, 34 Hubbard Street, Ludlow, Massachusetts 01056, 2 Main Street, Monson, Massachusetts 01057, 2034-2040 Boston Road, Suite 16, Wilbraham, Massachusetts 01095, 2344 Boston Road, Wilbraham, Massachusetts 01095, 4 Springfield Street, Palmer, Massachusetts 01080 and other routine capital expenditures and equipment included in the Fiscal Year 2017 and Fiscal Year 2018 capital budgets. Part I and Part II: Differences between the issue price (Part I) and total proceeds (Part II, Line 3) are due to investment earnings.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Kara Noonan PearBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionFamily member of DirectorRelationshipDescriptionTxt
Transaction$113,285TransactionAmt
TransactionSee Part V - Kara Noonan Pear has a family member that has a more than 35% ownership interest in Noonan Energy Corporation (NEC). The filing organization paid NEC $113,285 for fuel during FY2021.TransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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.
Form 990, Part VI, Section A, line 3Baystate Wing 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 7aFour of the directors of the filing organization serve ex officio based on positions they hold with BH or the filing organization and the remaining directors are elected by Baystate Health, Inc. (BH) as the organization's sole member. The trustee of a certain trust of which the organization is the beneficiary has the right to designate one individual to serve on the Board of Directors pursuant to the terms of the trust document and the organization's bylaws.
Form 990, Part VI, Section A, line 7bThe bylaws of the filing organization provide that the following matters are subject to the approval of Baystate Health, Inc. (BH) as a member: (1) the appointment or removal of the President and treasurer of the Corporation, (2) the adoption or amendment of annual operating and capital budgets, (3) approval of any unbudgeted expenditure in excess of $250,000, (4) the issuance of indebtedness, loans, guarantees or other encumbrances in excess of $1,000,000, (5) adoption of the organization's Strategic Plan and significant changes thereto, (6) an amendment of the organization's medical staff bylaws, (7) the making of any significant change to clinical services provided by the organization, (8) the filing of a Determination of Need application under Massachusetts law, (9) the creation of a corporate affiliation with a health care provider not affiliated with BH, (10) engaging the services of a certified public accountant or attorney, and (11) any merger, consolidation, change in control, dissolution, liquidation, or transfer of interest in all or substantially all of the organization's assets or operations.
Form 990, Part VI, Section B, line 11bPrior to the filing 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 includes some of the 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 Health, Inc. (BH) has a comprehensive conflict of interest policy which has been adopted by the filing organization. All directors, trustees, officers, key employees, and highest compensated employees of BH and its affiliates are asked to complete an annual conflict of interest form. We utilize an electronic database to receive and manage all conflict of interest submissions. This information is reviewed by the BH Chief Compliance Officer, the BH Chief General Counsel, the BH Chief Executive Officer, the Chair of the BH Board of Trustees, and the Chair of the Audit & Compliance Committee of BH. A summary of the conflict of interest disclosures is provided to the Baystate Health Board of Trustees and the Tax Department. 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. Conflict of Interest Disclosures are also reviewed by the Baystate Wing Hospital Corporation Board of Trustees.
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 VII, Section A, Line 5:Certain officers or directors 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 directors 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 11gSupplementary Svcs- Laundry: Program service expenses 389,623. Management and general expenses 0. Fundraising expenses 0. Total expenses 389,623. Supplementary Svcs-Facilities: Program service expenses 621,325. Management and general expenses 0. Fundraising expenses 0. Total expenses 621,325. Supplementary Svcs-Geri IP: Program service expenses 850,752. Management and general expenses 0. Fundraising expenses 0. Total expenses 850,752. Temporary Help: Program service expenses 2,424,649. Management and general expenses 22,902. Fundraising expenses 0. Total expenses 2,447,551. Physicians Fees: Program service expenses 9,798,406. Management and general expenses 312,147. Fundraising expenses 0. Total expenses 10,110,553. Impairment Expense: Program service expenses 2,196,868. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,196,868. Other Expense-Demolition-Remediaton: Program service expenses 4,415,737. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,415,737. Program Support: Program service expenses 1,531,549. Management and general expenses 223,242. Fundraising expenses 0. Total expenses 1,754,791. All Other: Program service expenses 3,267,073. Management and general expenses 490,096. Fundraising expenses 0. Total expenses 3,757,169.
Form 990, Part XI, line 9:Funds utilized for property and equipment 104,581. Pension adjustment 1,833,250.

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, IIIBaystate 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 Noble Hospital Corporation
115 West Silver StreetWestfieldMA010861634222537423HospitalMA501(c)(3)3Baystate Health Inc0
Baystate Total Home Care Inc
280 Chestnut StreetSpringfieldMA01104203260764Real Estate and OtherMA501(c)(3)12B, IIBaystate Medical Center 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 & 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 SupplementHNE 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 OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

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