2025-08-08T10:20:34-05:00 2024-09-30 BDO USA ONE INTERNATIONAL PLACE BOSTON MA 02110 990 2023-10-01 222472997 Brockton Hospital Inc % ROBERT J HAFFEY BROC 5089417000 680 Centre Street Brockton MA 02302 ROBERT J HAFFEY PRESIDENT/CEO 5089417000 2025-08-07 true true Brian Vigneault P00540650 6174220700 2023 2025-03-06 01:10:19Z ROBERT J HAFFEY 680 Centre Street Brockton MA 02302 400977080 false X www.signature-healthcare.org X 1983 MA SIGNATURE HEALTHCARE BROCKTON HOSPITAL IS A COMMUNITY-BASED NOT-FOR-PROFIT (CONTINUED ON SCHEDULE O) 20 16 2271 18 800328 0 10257034 2824918 193859478 163580411 5936123 3780027 157242506 211576523 367295141 381761879 0 0 0 0 159242398 136975435 0 0 0 157955784 160692670 317198182 297668105 50096959 84093774 322843764 450586871 181784196 221596123 141059568 228990748 X SEE SCHEDULE O false false 270567063 0 373791908 BROCKTON HOSPITAL IS AN ACUTE CARE HOSPITAL LICENSED BY THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH TO OPERATE 216 ACUTE CARE BEDS (COMPOSED OF 131 MEDICAL/SURGICAL, 16 INTENSIVE CARE, 8 PEDIATRIC, 20 OBSTETRIC, 22 PSYCHIATRIC), AND 19 BASSINETS (COMPOSED OF 13 WELLINFANT AND 6 SPECIAL CARE). THE HOSPITAL OFFERS A COMPREHENSIVE RANGE OF HEALTH CARE SERVICES TO MEET DIVERSE COMMUNITY NEEDS INCLUDING EMERGENCY CARE, ACUTE CARE (INCLUDING MEDICAL/SURGICAL, OBSTETRICS, PEDIATRIC, PSYCHIATRIC, CARDIAC, AND CANCER CARE. THE HOSPITAL PROVIDES FREE CARE TO THOSE WHO ARE UNABLE TO PAY, SPONSORS FREE HEALTH SCREENINGS, VARIOUS SUPPORT GROUPS AND EDUCATIONAL PROGRAMS, INCLUDING PUBLIC HEALTH EDUCATION, WELLNESS PROGRAMS AND THE TRAINING OF HEALTH PROFESSIONALS SUCH AS FIRST RESPONDER EDUCATION AND TRAINING. DURING THE YEAR ENDED SEPTEMBER 30, 2024 THE HOSPITAL HAD 1,124 TOTAL DISCHARGES AND OBSERVATIONS, 3,533 TOTAL PATIENT DAYS, AND 207,669 OUTPATIENT CLINIC VISITS. THE HOSPITAL'S EMERGENCY DEPARTMENT HAD 7,559 VISITS DURING THE FISCAL YEAR AND IS OPEN 24 HOURS A DAY, EVERY DAY OF THE YEAR AND PROVIDES CARE REGARDLESS OF ONE'S ABILITY TO PAY. DURING FISCAL YEAR 2023, BROCKTON HOSPITAL HAD A FIRE ON FEBRUARY 7, 2023 CAUSING THE CLOSURE OF THE HOSPITAL. AFTER THE FIRE, BROCKTON HOSPITAL OPENED 3 URGENT CARE CENTERS TO SERVICE THE COMMUNITY AND HAD 52,129 VISITS FROM OCTOBER 2023 THROUGH AUGUST 2024. THE HOSPITAL REOPENED ON AUGUST 13, 2024. 270567063 true true false true false false false false false false true false false true true true false true false false false false false false false false true true false false true true false false false false false false false false false true false false false false false true false false false true 217 0 true 2271 true true true false false false false false false false false false false false X 20 16 false false false false true false false true true false false true true true true true true true true true true MA X X ROBERT J HAFFEY 5089417000 680 CENTRE STREET BROCKTON MA 02302 X ROBERT HAFFEY PRESIDENT & CLERK/ CEO 50.0 3.0 X X 709945 0 66406 DAVID DRINKWATER MD PHYSICIAN, TRUSTEE 1.0 52.0 X 0 654729 42531 JASON RADZEVICH CFO & Treasurer 50.0 3.0 X 496097 0 38262 KAREN E MURPHY SENIOR VP GENERAL COUNSEL 50.0 1.0 X 480032 0 26097 JUSSI J MAIJALA CHIEF HUMAN RESOURCES OFFICER 40.0 10.0 X 443250 0 36208 KIMBERLY WALSH SR. VP/CHIEF OPERATING OFFICER 50.0 1.0 X 400366 0 44261 NICHOLAS SZYMANSKI VP/CHIEF INFORMATION OFFICER 40.0 10.0 X 355696 0 27616 STEPHEN BORGES VP FINANCIAL OPER. UNTIL 08/24 1.0 50.0 X 292721 0 50349 JEFFREY MILLER VP DEVELOPMENT 50.0 1.0 X 271175 0 50212 KIM N HOLLON FORMER PRESIDENT/CEO 0.0 0.0 X 283844 0 0 DEEPTI SESHADRI MD PRESIDENT, MEDICAL STAFF 1.0 51.0 X 0 176951 3413 MICHAEL L DERN MD DIRECTOR 1.0 51.0 X 0 54714 1094 ROBERT S GREENBERG MD DIRECTOR 0.0 0.0 X 0 41357 7646 JOSEPH P DRIER III IMMEDIATE PAST CHAIRMAN 0.5 0.5 X 0 0 0 FRED NICCOLI CHAIRMAN, DEVELOPMENT OFFICE 0.5 0.5 X 0 0 0 DAVID R WOLOHOJIAN CHAIR,BOARD OF TRS UNTIL 09/24 0.5 0.5 X X 0 0 0 DAVID M OFFUTT VICE CHAIRMAN 0.5 0.5 X X 0 0 0 DALE ELLENBERG MD DIRECTOR 0.5 0.5 X 0 0 0 DAVID F ENGELKEMEYER DIRECTOR 0.5 0.5 X 0 0 0 MARIA S HARRIS TRUSTEE-AT-LARGE 0.5 0.5 X 0 0 0 JAMES F LEARY DIRECTOR 0.5 0.5 X 0 0 0 SYDNE MARROW DIRECTOR 0.5 0.5 X 0 0 0 VINCENT MARTURANO DIRECTOR 0.5 0.5 X 0 0 0 LUKE MCCABE DIRECTOR 0.5 0.5 X 0 0 0 CHERYL MCCALLION MD DIRECTOR (UNTIL 12/12/23) 0.5 0.5 X 0 0 0 CLARA MIRANDA DIRECTOR 0.5 0.5 X 0 0 0 PATTI ROLAND DIRECTOR 0.5 0.5 X 0 0 0 EDWARD SMITH DIRECTOR 0.5 0.5 X 0 0 0 MICHAEL J SULLIVAN DIRECTOR 0.5 0.5 X 0 0 0 JOSEPH L TANSEY CHAIR,BOARD OF TRS(FROM 09/24) 0.5 0.5 X X 0 0 0 JOHN TWOHIG DIRECTOR (FROM 12/12/23) 0.5 0.5 X 0 0 0 3733126 927751 394095 211 true true false CLEARWAY HEALTH BOSTON MEDICAL CENT PO BOX 845018 BOSTON MA 022845018 PHARMACY SERVICES 4876819 MATRIX ANESTHESIA PD 1342 BELMONT STREET SUITE 205 BROCKTON MA 02302 PHYSICIAN SERVICES 3351586 REMETRONIX MEDICAL LLC 9715 KINCAID DRIVE SUITE 1000 FISHERS IN 46037 MEDICAL EQUIP. SRVCS 3163309 ALLIED UNIVERSAL SECURITY SERVICES PO BOX 828854 PHILADELPHIA PA 191828854 SECURITY SERVICES 1662747 ROPES GRAY LLP PO BOX 70280 PHILADELPHIA PA 191760280 LEGAL SERVICES 1038511 43 2791724 33194 2824918 PATIENT SERVICE REVENUE 622110 147807572 147807572 INTERCOMPANY REVENUE 622110 10744414 10744414 SCHOOL OF NURSING 622110 3245572 3245572 INTERCOMPANY RENT 622110 1326960 1326960 NONPATIENT LAB REVENUE 541380 102 102 455791 455791 163580411 3421992 3421992 0 0 564698 0 564698 0 564698 564698 19552224 21012 18673323 541878 878901 -520866 358035 358035 0 0 0 0 0 0 0 0 0 FIRE RELATED RECOVERIES 622110 156231184 156231184 PHARMACY 622110 4057201 3256975 800226 ALL OTHER REVENUE 622110 50723440 50723440 211011825 381761879 373791908 800328 4344725 0 0 0 0 3733126 3733126 0 105127930 97283889 7844041 4230999 3648651 582348 16286745 14603161 1683584 7596635 6886388 710247 4705364 4705364 810725 810725 419446 25896 393550 125059 125059 0 0 0 917193 19736 897457 4392883 3748144 644739 2104237 1869165 235072 0 7351483 6758100 593383 96268 65702 30566 0 0 3650156 3248639 401517 0 12629248 11240031 1389217 2585979 2443793 142186 DRUGS AND MEDICATIONS 40591422 40591422 PURCHASED SERVICES 36216619 32354668 3861951 MD CONTRACTED 18754421 18754421 MEDICAL & SURGICAL SUPPLIES 7631600 7630975 625 17710567 14688918 3021649 297668105 270567063 27101042 0 1225 3165 54527758 52724479 0 0 9402388 20499494 0 0 0 0 1084186 1344708 5467260 6933300 11579278 11307863 362999931 166389603 136089350 196610328 0 0 5563550 6883858 0 0 990000 990000 98138769 153289676 322843764 450586871 61158265 80589570 0 0 9907311 6623264 68804169 65413610 0 0 0 0 9050000 8700000 0 0 32864451 60269679 181784196 221596123 X 127547964 214718673 13511604 14272075 141059568 228990748 322843764 450586871 X 84093774 12780615 -8943209 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 70000 false true 55059 125059 false SCHEDULE C, PART II-B, LINE I, LOBBYING ACTIVITIES: BROCKTON HOSPITAL PAID A LOBBYING FIRM $70,000 DURING FISCAL YEAR 2024 TO LOBBY ON ITS BEHALF ON VARIOUS FEDERAL AND STATE LEGISLATIVE ISSUES IMPACTING THE ORGANIZATION AND THE HEALTHCARE INDUSTRY AS A WHOLE. AS PART OF THE ORGANIZATION'S MEMBERSHIP IN THE MASSACHUSETTS AND AMERICAN HOSPITALS ASSOCIATION AND AMERICA'S ESSENTIAL HOSPITALS ASSOCIATION OF AMERICA $55,059 OF THE TOTAL AMOUNT OF DUES PAID TO THESE NOT-FOR-PROFIT ASSOCIATIONS WAS USED FOR LOBBYING ACTIVITIES. LOBBYING ACTIVITIES REPRESENT AN INSUBSTANTIAL PART OF THE ORGANIZATION'S ACTIVITIES. 3519569 3519569 225349951 74992411 150357540 12502665 7385254 5117411 109158236 80579833 28578403 12469510 3432105 9037405 196610328 BOARD-DESIGNATED INVESTMENTS 82897526 RIGHT-OF-USE ASSETS 24472282 INSURANCE PROCEEDS RECEIVABLE 15542365 NET PENSION ASSET 10789700 AMOUNTS DUE FROM THIRD-PARTY 9361767 OTHER ASSETS 5793316 ASSET HELD UNDER SPLIT-INT 2233419 ASSETS HELD AS COLLATERAL 2199301 153289676 0 AMOUNTS DUE TO THIRD-PARTY PAYORS 25271873 OTHER LONG-TERM LIABILITIES 23811543 CURRENT PORTION OF LONG-TERM DEBT 7927802 OTHER LIABILITIES 3258461 60269679 X SCHEDULE D, PART X, LINE 2: THE INTERNAL REVENUE SERVICE HAS DETERMINED THAT THE HOSPITAL QUALIFIES AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. UNDER ASC 740, INCOME TAXES, AN ORGANIZATION MUST RECOGNIZE THE FINANCIAL STATEMENT EFFECTS OF A TAX POSITION TAKEN FOR TAX RETURN PURPOSES WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL NOT BE SUSTAINED UPON EXAMINATION BY A TAXING AUTHORITY. THE CORPORATION DOES NOT BELIEVE IT HAS TAKEN ANY MATERIAL UNCERTAIN TAX POSITIONS; IT HAS NOT RECORDED ANY LIABILITY FOR UNRECOGNIZED TAX BENEFITS. true true true X 400. true X 400. true false true true 2552606 156251 2396355 0.00810 64262153 27182516 37079637 0.12460 14573080 11492825 3080255 0.01030 81387839 38831592 42556247 0.14300 147732 147732 0.00050 10611627 5567915 5043712 0.01690 3519886 2232963 1286923 0.00430 65000 65000 0.00020 14344245 7800878 6543367 0.02190 95732084 46632470 49099614 0.16490 1030 1030 0.00000 8000 8000 0.00000 3000 3000 0.00000 2500 2500 0.00000 14530 14530 0.00000 true 2442142 275658 22801804 46315507 -23513703 X true true 1 1 SIGNATURE HEALTHCARE BROCKTON HOSPITA 680 CENTRE STREET BROCKTON MA 02302 HTTPS://WWW.SIGNATURE-HEALTHCARE.ORG/ X X X X PSYCH SIGNATURE HEALTHCARE BROCKTON HOSPITA 1 false false true X X X X X X X X X 22 true false false true X SEE PART V, SECTION C X true 18 true SEE PART V, SECTION C false true X 100 400. X X X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5: THE 2022 SIGNATURE HEALTHCARE COMMUNITY HEALTH NEEDS ASSESSMENT SOLICITED THE INPUT OF A VARIETY OF COMMUNITIES WITHIN ITS SERVICE AREA, WITH A PARTICULAR FOCUS ON INDIVIDUALS AND GROUPS FACING SOCIAL, ENVIRONMENTAL AND FINANCIAL INEQUITIES. SUCH QUALITATIVE INPUT PROVIDED IMPORTANT CONTEXT FOR THE QUANTITATIVE DATA THAT WAS COLLECTED AND ANALYZED. SEVEN FOCUS GROUPS WERE CONDUCTED WITH SIX OF THOSE DONE VIRTUALLY. PARTICIPANTS RANGED SIGNIFICANTLY IN AGE, SOCIO-ECONOMIC STATUS, RESIDENCY, PRIMARY LANGUAGE, RACE AND ETHNICITY. ONE OF THE FOCUS GROUPS WAS CONDUCTED IN COLLABORATION WITH BETH ISRAEL DEACONESS HOSPITAL-MILTON FOR THE COMMUNITY OF RANDOLPH. FEEDBACK FROM FOCUS GROUPS AND KEY INFORMANTS WERE CODED AND PRIORITIZED BASED ON FREQUENCY. EIGHT KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH A VARIETY OF COMMUNITY STAKEHOLDERS. SCHEDULE H, PART V, SECTION B, LINE 7A: HTTPS://WWW.SIGNATURE-HEALTHCARE.ORG/ABOUT/COMMUNITY-BENEFITS SCHEDULE H, PART V, SECTION B, LINE 10A: HTTPS://WWW.SIGNATURE-HEALTHCARE.ORG/ABOUT/COMMUNITY-BENEFITS SCHEDULE H, PART V, SECTION B, LINE 11: HOUSING AND HOMELESSNESS: WE TREAT A LARGE POPULATION OF HOMELESS PATIENTS. THEY RECEIVE TREATMENT REGARDLESS OF THEIR RESIDENCY. WE ARE EXPLORING OPPORTUNITIES TO FURTHER SUPPORT THIS POPULATION WITH THEIR HOUSING NEEDS. SIGNATURE HEALTHCARE & FR. BILLS AND MAINSPRING CONTINUE TO PARTNER TO PROVIDE RESPITE FOR HOMELESS PATIENTS BEING DISCHARGED FROM THE HOSPITAL OR RELEASED FROM THE ED. BECAUSE PATIENTS REQUIRE CONTINUED REST TO PROMOTE HEALING, TWO BEDS ARE UTILIZED IN THE SHELTER FOR PATIENTS TO BE ABLE TO "STAY IN" FOR RECUPERATION AND AVOID BEING OUT ON THE STREETS THROUGHOUT THE DAY, POTENTIALLY EXACERBATING THE CONDITION IN WHICH THEY WERE TREATED. IN ADDITION, THIS COLLABORATION EXTENDS TO BROCKTON VNA TO PROVIDE ADDITIONAL HOME CARE SERVICES TO THE PARTICIPANTS INCLUDING NURSING AND PHYSICAL THERAPY. ENSURING THAT HOMELESS PATIENTS WITH A MEDICAL NEED FOR RESPITE CARE BE PLACED IN A COMMUNITY PROGRAM THAT PROVIDES HOUSING REFERRALS AND RESOURCES REMAINS THE PRIMARY GOAL. DUE TO THE HOSPITAL CLOSURE, THIS PROGRAM WAS NOT IN PLACE IN FY24, BUT THE AGREEMENT HAS BEEN REINSTATED AND WILL UTILIZE REPSITS BEDS IN FY25. SIGNATURE HEALTHCARE BROCKTON HOSPITAL PARTNERS WITH FATHER BILLS AND MAINSPRING HOUSE JOB DEVELOPERS ALONG WITH OTHER SUPPORTERS OF LOCAL BUSINESSES INCLUDING BRIDGEWATER STATE UNIVERSITY, DEPARTMENT OF TRANSITIONAL ASSISTANCE, ARBELLA INSURANCE FOUNDATION, STATE STREET, UNITED WAY OF GREATER PLYMOUTH COUNTY AND CITIZENS BANK. WE RECRUIT GRADUATES FROM THE WORK EXPRESS AND WORK READY PROGRAM INTO PAYING JOBS WHERE THEY CAN WORK TO BROADEN THEIR SKILLS AND EXPERIENCE VARIOUS HEALTHCARE EMPLOYMENT OPPORTUNITIES. IN MANY CASES PARTICIPATION IN THIS PROGRAM HELPS REBUILD THEIR LIVES AND PROVIDE FOR THEIR FAMILIES SIGNATURE HEALTHCARE HAS BEEN SUCCESSFUL IN HIRING GRADUATES FROM BOTH PROGRAMS INTO VARIOUS PART TIME, PER DIEM AND FULL TIME POSITIONS WITHIN THE HOSPITAL SETTING. HEALTH CARE ACCESS: SIGNATURE HEALTHCARE AIMS TO LINK THOSE WHO FACE BARRIERS TO HEALTHCARE ACCESS OR DISPARITIES IN HEALTH OUTCOMES DUE TO THE SOCIAL DETERMINANTS OF HEALTH TO APPROPRIATE COMMUNITY BASED SERVICES, SCHEDULE APPOINTMENTS WITH PRIMARY AND SPECIALTY CARE PROVIDERS AND OFFER FREE SCREENINGS. SIGNATURE HEALTHCARE ALSO PROVIDES PHYSICIAN OUTREACH DIRECTLY IN THE COMMUNITIES WHERE SIGNATURE HEALTHCARE CORPORATION PATIENTS RESIDE FOR "ONE ON ONE" INTERACTION. THROUGHOUT FY24, SIGNATURE HEALTHCARE WORKED WITH THE CITY OF BROCKTON AND LOCAL COMMUNITY PARTNERS, SUCH AS BROCKTON NEIGHBORHOOD HEALTH CENTER, ON THE "BROCKTON COMMUNITY CONNECTIONS" EVENTS. THESE EVENTS WERE SCHEDULED THROUGHOUT THE CITY TO ACCOMMODATE THE NEEDS OF OUR MIGRANT POPULATION. THESE EVENTS ASSISTED THOSE INDIVIDUALS WHO WERE NEW TO THE BROCKTON AREA CONNECT WITH LOCAL RESOURCES, INCLUDING HEALTH CARE, INSURANCE COVERAGE, HOUSING, FOOD, JOBS, AND EDUCATION. IN ADDITION, DUE TO THE ABRUPT CLOSURE OF A LOCAL MEDICAL GROUP, 65K PATIENTS WERE LEFT WITHOUT PRIMARY CARE AND OTHER SIGNIFICANT HEALTHCARE SERVICES. SIGNATURE HEALTHCARE EXPANDED SERVICES BY LEASING A 75,000 SQUARE FOOT MEDICAL OFFICE BUILDING TO ENHANCE SERVICES FOR EAST BRIDGEWATER AND THE SURROUNDING COMMUNITIES. THIS FACILITY OFFICERS PRIMARY CARE, MAMMOGRAPHY, CARDIOLOGY, NEPHROLOGY, AND ANCILLARY SUPPORT SERVICES, IMPROVING ACCESS FOR OUR PATIENTS. IN NOVEMBER 2024, A GRAND OPENING OF THIS NEW SPACE WAS HELD WHERE THE COMMUNITY WAS INVITED TO ATTEND. MANY OFFERINGS WERE PROVIDED THAT DAY INCLUDING THE OPPORTUNITY TO ASK QUESTIONS OF OUR PROVIDERS, SCHEDULE APPOINTMENTS, SCREENINGS, VACCINES AND MORE. SAFETY: DOMESTIC VIOLENCE WAS SEEN AS AN ISSUE IN THE BROCKTON AREA. OUR CLINICIANS HAVE PROVIDED EDUCATION ON HEALTHY RELATIONSHIPS TO AREA COMMUNITY GROUPS. SIGNATURE HEALTHCARE CONTINUES TO WORK CLOSELY WITH AND SUPPORT FAMILY & COMMUNITY RESOURCES, INC., HEALTH IMPERATIVES AND CAPE VERDEAN WOMEN UNITED, ALL OF WHICH PROVIDE DOMESTIC VIOLENCE SUPPORT TO THOSE LIVING IN OUR COMMUNITY. MATERNAL AND CHILD HEALTH: SIGNATURE HEALTHCARE HAS 10 OB/GYN PHYSICIANS WITHIN ALL SIGNATURE MEDICAL GROUP LOCATIONS ALONG WITH 8 PEDIATRICIANS IN BROCKTON, EASTON, AND RANDOLPH. SIGNATURE HEALTHCARE BROCKTON HOSPITAL HAS AN INPATIENT PEDIATRICS DEPT. WHICH IS STAFFED 24/7 BY TUFTS FLOATING HOSPITALISTS. SIGNATURE HEALTHCARE IS A "BABY FRIENDLY DESIGNATED HOSPITALSTRIVES TO SUPPORT MOTHERS TO BREASTFEED BABIES FOR THE BEST START IN LIFE. SIGNATURE HEALTHCARE WROTE A BREASTFEEDING POLICY THAT IS ROUTINELY COMMUNICATED TO ALL HEALTHCARE STAFF AND PROVIDES EDUCATION AND INFORMATION TO ALL EXPECTING MOTHERS ON THE BENEFITS OF BREASTFEEDING. MATERNITY STAFF HELP MOTHERS INITIATE BREASTFEEDING WITHIN ONE HOUR OF BIRTH AND CONTINUE TO SHOW MOTHERS HOW TO BREASTFEED AND MAINTAIN LACTATION EVEN IF THEY ARE SEPARATED FROM THEIR INFANTS. SIGNATURE HEALTHCARE OFFERS BABE-E-NEWS A FREE; OPT-IN, ELECTRONIC NEWSLETTER PROVIDING EDUCATION, TOOLS AND RESOURCES FOR PREGNANCY INTO EARLY CHILDHOOD. THE INFORMATION IS TAILORED TO A MOTHER' S DUE DATE OR CHILD 'S BIRTH DATE, MAKING THE WEEKLY INFORMATION RELEVANT AND USEFUL. THIS NEWSLETTER CAN ALSO BE SHARED WITH ANY NUMBER OF FAMILY MEMBERS WHO CAN SELECT TO READ THE NEWSLETTER IN MULTIPLE LANGUAGES. COMMUNICATING TO PATIENTS IN THEIR NATIVE LANGUAGE HELPS TO PROMOTE COMPLIANCE AND UNDERSTANDING OF THEIR PERSONAL HEALTHCARE. SIGNATURE HEALTHCARE CONTINUES TO BE PARTNER WITH YOMINGO, AN ONLINE CHILDBIRTH EDUCATION PROGRAM. BY WORKING WITH YOMINGO, SIGNATURE HEALTHCARE WAS ABLE TO HELP OUR PATIENTS ELIMINATE THE HURDLE OF FITTING IN-PERSON CHILDBIRTH CLASSES INTO THEIR SCHEDULE AND PRACTICE SOCIAL DISTANCING AND INSTEAD BRINGS CLASSES TO THEM. THIS IS A FREE PROGRAM FOR OUR PATIENTS AND IS AVAILABLE IN 14 LANGUAGES. YOMINGO'S EVIDENCE-BASED ONLINE MATERNITY EDUCATION INCLUDES EDUCATION ON LABOR AND BIRTH AND TOPICS SUCH AS BREASTFEEDING, NEWBORN CARE, COMMUNITY HEALTH RESOURCES, SUPPORT GROUPS AMONGST VARIOUS OTHER TOOLS. STD HIV/AIDS - REFER TO FAMILY PLANNING FOR EVALUATION AND TREATMENT AND WITH THE POSSIBILITY OF BEING REFERRED TO OUR INFECTIOUS DISEASE PHYSICIAN FOR FURTHER TREATMENT AND FUTURE HEALTH CARE NEEDS. RISKY BEHAVIORS AND HEALTH SCREENINGS: SIGNATURE HEALTHCARE CONTINUES TO WORK WITH STAFF FROM HIGH POINT, THE BROCKTON AREA PREVENTION COLLABORATIVE AND THE PLYMOUTH COUNTY DRUG ABUSE TASK FORCE. SIGNATURE HEALTHCARE EMERGENCY DEPARTMENT PHYSICIANS WORK WITH LOCAL POLICE AND FIRE DEPARTMENTS PROVIDING TRAINING AND MEDICAL GUIDANCE. POLICE DEPARTMENTS FROM NORFOLK AND PLYMOUTH COUNTIES WERE TRAINED ON THE PROPER USE OF NASAL NARCAN. THE ED PHYSICIANS ALSO TO PROVIDE LECTURES TO STUDENTS, PARENTS, TEACHERS AND OTHER HEALTHCARE PROFESSIONALS ON SUBSTANCE USE AND OTHER HEALTH CONCERNS FACING OUR AREA YOUTH. DR. MUSE SERVES AS THE EMS MEDICAL DIRECTOR FOR 14 LOCAL FIRE DEPARTMENTS AND IS VERY ACTIVE IN OTHER MATTERS RELATED TO SUBSTANCE USE, INCLUDING INDEPENDENCE ACADEMY, AND PLYMOUTH COUNTIES SUBSTANCE ABUSE COALITION. DR. DAN MUSE, SIGNATURE HEALTHCARE ED PHYSICIAN, OF COORDINATES TEACHING ROUNDS WITH LOCAL EMS TEAMS. THESE INCLUDE EDUCATION ON VARIOUS TOPICS INCLUDING, HUMAN TRAFFICKING: LEGAL AND SOCIAL RAMIFICATIONS, DOMESTIC ABUSE, ADVERSE CHILDHOOD EVENTS, PEDIATRIC TRAUMA CARE AND NEWBORN CARE IN-FIELD DELIVERY, TO NAME A FEW. SIGNATURE HEALTHCARE AND DR. DAN MUSE HAVE ESTABLISHED A VERY CLOSE RELATIONSHIP WITH THE CITY OF BROCKTON. DR. MUSE IS THE MEDICAL DIRECTOR FOR BROCKTON POLICE AND FIRE. HE ALSO SERVES AS THE MEDICAL DIRECTOR FOR THE BROCKTON FIRE DEPARTMENT DISPATCH. HE ALSO WORKS CLOSELY WITH LOCAL POLICE AND FIRE ON SPECIAL PROGRAMS IN THEIR DEPARTMENTS AND TOWNS. WITHIN THE SIGNATURE HEALTHCARE EMERGENCY DEPARTMENT OVERDOSE PATIENTS RECEIVE NASAL NARCAN, A LIST OF DETOX FACILITIES AND COUNSELING. THE ED PHYSICIANS ARE ALSO LIMITING THE NUMBER OF NARCOTICS THEY PRESCRIBE TO PATIENTS. THEY WILL NOT FILL LOST PRESCRIPTIONS AND ARE ADVANCING USE OF THE STATE'S "PRESCRIPTION MONITORING PROGRAM." SIGNATURE HEALTHCARE CREATED A PAIN AND OPIOID MANAGEMENT COMMITTEE WHO DEVELOPED A CHARTER TO GUIDE OUR PURPOSE AND ENSURE WE'RE MEETING THE REGULATORY REQUIREMENTS OF THE JOINT COMMISSION AS THEY RELATE TO PAIN AND OPIOID MANAGEMENT. WE STARTED BY ENSURING APPROPRIATE PAIN AND OPIOID MANAGEMENT POLICIES WERE DEVELOPED TO MEET THE NEEDS OF OUR PATIENT POPULATIONS. AT THE SAME TIME, WE HAVE BEEN MONITORING THE EFFECTIVENESS OF PATIENT PAIN ASSESSMENTS AND PAIN MANAGEMENT THROUGHOUT THE ORGANIZATION. PART OF OUR EFFORT INCLUDES RAISING AWARENESS OF AVAILABLE SERVICES FOR CONSULTATION AND REFERRAL FOR PATIENTS WITH COMPLEX PAIN MANAGEMENT NEEDS AMONG STAFF AND OUR LICENSED INDEPENDENT PRACTITIONERS. THE COMMITTEE WORKS TO ENSURE EDUCATIONAL RESOURCES AND PROGRAMS ARE AVAILABLE TO IMPROVE PAIN ASSESSMENT PAIN MANAGEMENT, AND SAFE USE OF OPIOID MEDICATIONS THROUGHOUT THE ORGANIZATION IN AN ONGOING BASIS. CHRONIC DISEASE: BASED ON THE FINDINGS IN THE COMMUNITY HEALTH NEEDS ASSES SCHEDULE H, PART V, LINE 16A, FAP WEBSITE: HTTPS://WWW.SIGNATURE-HEALTHCARE.ORG/PATIENTS-VISITORS/PATIENT FORMS/FINANCIAL-ASSISTANCE SCHEDULE H, PART V, LINE 16B, FAP APPLICATION WEBSITE: HTTPS://WWW.SIGNATURE-HEALTHCARE.ORG/PATIENTS-VISITORS/PATIENT-FORMS/FINAN CIAL-ASSISTANCE SCHEDULE H, PART V, LINE 16C, FAP PLAN LANGUAGE SUMMARY WEBSITE: HTTPS://WWW.SIGNATURE-HEALTHCARE.ORG/PATIENTS-VISITORS/PATIENT-FORMS/FINAN CIAL-ASSISTANCE SCHEDULE H, PART V, SECTION B, LINE 16H: THE HOSPITAL, IN COLLABORATION WITH LOCAL NOT FOR PROFIT ORGANIZATIONS SUCH AS THE UNITED WAY AND MASSASOIT COMMUNITY COLLEGE, MAINTAINS COPIES OF ITS ONE PAGE PLAIN LANGUAGE SUMMARY FINANCIAL ASSISTANCE POLICY ON-SITE AT THESE ORGANIZATIONS IN AN EFFORT TO NOTIFY MEMBERS OF ITS COMMUNITIES WHO ARE MOST LIKELY IN NEED OF FINANCIAL ASSISTANCE ABOUT THE AVAILABILITY OF SUCH ASSISTANCE. SCHEDULE H, PART V, SECTION B, LINE 16J: WHEN REGISTERING FOR SERVICES OR IF RECEIVING A BILL, THE HOSPITAL ENCOURAGES PATIENTS TO CONTACT STAFF TO DETERMINE IF THEY AND/OR A FAMILY MEMBER ARE IN NEED OF AND ELIGIBLE FOR FINANCIAL ASSISTANCE. THE HOSPITAL POSTS GENERAL NOTICES AT SERVICE DELIVERY AREAS WHERE THERE IS REGISTRATION OR A CHECK-IN AREA (INCLUDING, BUT NOT LIMITED TO INPATIENT, OUTPATIENT, EMERGENCY DEPARTMENTS AND AFFILIATED HEALTH CENTER LOCATIONS, CERTIFIED APPLICATION COUNSELORS ("CAC") OFFICES AND IN GENERAL BUSINESS OFFICE AREAS CUSTOMARILY USED BY PATIENTS THAT INFORM PATIENTS ABOUT THE AVAILABILITY OF PUBLIC ASSISTANCE AND HOSPITAL FINANCIAL ASSISTANCE AS WELL AS THE LOCATIONS WITHIN THE HOSPITAL AND/OR THE PHONE NUMBERS TO CALL TO SCHEDULE AN APPOINTMENT WITH A CAC. SCHEDULE H, PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT IS MADE AVAILABLE AT HTTPS://WWW.SIGNATURE-HEALTHCARE.ORG/ABOUT/COMMUNITY-BENEFITS. SCHEDULE H, PART I, LINE 7: COSTS FOR FIGURES USED IN THE LINE 7 TABLE ARE DERIVED USING WORKSHEET 2 FOR 7 A-D. DIRECT COSTS FOR 7E AND 7I, AND THE HOSPITAL'S COST ACCOUNTING SYSTEM FOR 7F-G. SCHEDULE H, PART II, COMMUNITY BUILDING ACTIVITIES: SIGNATURE HEALTHCARE COLLABORATES WITH AND SUPPORTS AREA ORGANIZATIONS BOTH FINANCIALLY AND WITH OUR CLINICAL EXPERTISE. WE BELIEVE THAT BY SUPPORTING AND WORKING WITH COMMUNITY PARTNERS, WE ARE ABLE TO MAKE A LARGER IMPACT ON THE OVERALL HEALTH OF OUR COMMUNITY. SCHEDULE H, PART III, LINE 2: THE HOSPITAL USED THE RATIO OF ITS TOTAL COSTS TO CHARGES FROM WORKSHEET 2 TO CALCULATE THE AMOUNT OF BAD DEBT EXPENSE. SCHEDULE H, PART III, LINE 3: THE HOSPITAL USED THE RATIO OF ITS TOTAL COSTS TO CHARGES FROM WORKSHEET 2 TO CALCULATE THE AMOUNT OF BAD DEBT EXPENSE FOR THOSE PATIENTS ELIGIBLE FOR CHARITY CARE. SCHEDULE H, PART III, LINE 4: THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS EQUAL TO ESTIMATED BAD DEBT LOSSES. THE ESTIMATED LOSSES ARE BASED ON HISTORICAL COLLECTION EXPERIENCE TOGETHER WITH A REVIEW OF THE CURRENT STATUS OF EXISTING RECEIVABLES. THIS FOOTNOTE IS FOUND ON PAGE 36 OF THE AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, LINE 8: THE HOSPITAL CONTINUES TO SERVE ITS VULNERABLE INDIGENT POPULATION AMIDST RISING COSTS WHILE MANY AREAS OF REIMBURSEMENT CONTINUE TO ERODE. THE CHANGE IN DSH PAYMENT METHODOLOGY, AS ONE SIGNIFICANT EXAMPLE, HAS REDUCED THE HOSPITAL'S DSH PAYMENT BY NEARLY HALF OF WHAT IT WAS UNDER THE FORMER METHODOLOGY. THE HOSPITAL USES THE MEDICARE COST REPORT AS THE COST ACCOUNTING SYSTEM TO CALCULATE ITS MEDICARE COSTS. SCHEDULE H, PART III, LINE 9B: THE FOLLOWING PATIENT POPULATIONS ARE EXEMPT FROM ANY COLLECTION OR BILLING PROCEDURES PURSUANT TO STATE REGULATIONS AND POLICIES: PATIENTS ENROLLED IN A PUBLIC HEALTH INSURANCE PROGRAM, INCLUDING BUT NOT LIMITED TO, MASSHEALTH, EMERGENCY AID TO THE ELDERLY, DISABLED AND CHILDREN (EAEDC), CHILDREN'S MEDICAL SECURITY PLAN (CMSP), IF MAGI INCOME IS EQUAL TO OR LESS THAN 300% OF THE FPL; LOW INCOME PATIENTS AS DETERMINED BY MASSHEALTH AND SAFETY NET, INCLUDING THOSE WITH MAGI HOUSEHOLD INCOME OR MEDICAL HARDSHIP FAMILY COUNTABLE INCOME BETWEEN 150.1% TO 300% OF THE FPL; AND MEDICAL HARDSHIP, SUBJECT TO THE FOLLOWING EXCEPTIONS: (A) THE HOSPITAL MAY SEEK COLLECTION ACTION AGAINST ANY PATIENT ENROLLED IN THE ABOVE MENTIONED PROGRAMS FOR THEIR REQUIRED CO-PAYMENTS AND DEDUCTIBLES THAT ARE SET FORTH BY EACH SPECIFIC PROGRAM; (B) THE HOSPITAL MAY ALSO INITIATE BILLING OR COLLECTION FOR A PATIENT WHO ALLEGES THAT HE OR SHE IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM THAT COVERS THE COSTS OF THE HOSPITAL SERVICES, BUT FAILS TO PROVIDE PROOF OF SUCH PARTICIPATION. UPON RECEIPT OF SATISFACTORY PROOF THAT A PATIENT IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM (INCLUDING RECEIPT OR VERIFICATION OF SIGNED APPLICATION) THE HOSPITAL SHALL CEASE ITS BILLING OR COLLECTION ACTIVITIES; (C) THE HOSPITAL MAY CONTINUE COLLECTION ACTION ON ANY LOW INCOME PATIENT FOR SERVICES RENDERED PRIOR TO THE LOW INCOME PATIENT DETERMINATION, PROVIDED THAT THE CURRENT LOW INCOME PATIENT STATUS HAS BEEN TERMINATED EXPIRED OR NOT OTHERWISE IDENTIFIED ON THE STATE ELIGIBILITY VERIFICATION SYSTEM OR MEDICAID MANAGEMENT INFORMATION SYSTEM. HOWEVER, ONCE A PATIENT IS DETERMINED ELIGIBLE AND ENROLLED IN MASSHEALTH THE PREMIUM ASSISTANCE PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PLAN OR MEDICAL HARDSHIP, THE HOSPITAL WILL CEASE COLLECTION ACTIVITY FOR SERVICES (WITH THE EXCEPTION OF ANY COPAYMENTS AND DEDUCTIBLES) PROVIDED PRIOR TO THE BEGINNING OF THEIR ELIGIBILITY. (D) THE HOSPITAL MAY SEEK COLLECTION ACTION AGAINST ANY OF THE PATIENTS PARTICIPATING IN THE PROGRAMS LISTED ABOVE FOR NON-COVERED SERVICES THAT THE PATIENT HAS AGREED TO BE RESPONSIBLE FOR, PROVIDED THAT THE HOSPITAL OBTAINED THE PATIENT'S PRIOR WRITTEN CONSENT TO BE BILLED FOR SUCH SERVICE(S). HOWEVER, EVEN IN THESE CIRCUMSTANCES THE HOSPITAL MAY NOT BILL THE PATIENT FOR CLAIMS RELATED TO MEDICAL ERRORS OR CLAIMS DENIED BY THE PATIENT'S PRIMARY INSURER DUE TO AN ADMINISTRATIVE OR BILLING ERROR. SCHEDULE H, PART VI, LINE 2: SIGNATURE HEALTHCARE WORKS COLLABORATIVELY WITH THE BROCKTON DEPARTMENT OF PUBLIC HEALTH THE BROCKTON AREA NEIGHBORHOOD HEALTH CENTER AND NUMEROUS COMMUNITY SOCIAL SERVICE AGENCIES TO COORDINATE PUBLIC HEALTH INITIATIVES TO ADDRESS THE NEEDS OF THE AT-RISK POPULATION. SIGNATURE HEALTHCARE FOLLOWS THE GUIDELINES BY PARTICIPATING IN A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS. WE USE A MULTI PRONGED APPROACH TO THESE ASSESSMENTS THAT INCLUDES: CONDUCTING KEY INFORMANT INTERVIEWS WITH PEOPLE WHO WORK WITHIN OUR SERVICE AREA TO DETERMINE HOW THE NEEDS OF THE RESIDENTS ARE MET, BY REVIEWING EXISTING PROGRAMS/STRATEGIES AND SERVICES IN THE AREA, BY ANALYZING DATA TO DETERMINE HOW HEALTH OUTCOMES IN THE CITY AND SURROUNDING TOWNS COMPARED TO THE STATE AVERAGE AND LASTLY BY PARTICIPATING IN FOCUS GROUPS TO EXAMINE PERCEPTIONS ON HOW PARTICULAR ISSUES IMPACT THOSE INDIVIDUALS. SCHEDULE H, PART VI, LINE 3: FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE. IN ADDITION, THE HOSPITAL ALSO POSTS GENERAL NOTICES AND MAKES PAPER COPIES OF THE FAP DOCUMENTS AVAILABLE UPON REQUEST AND WITHOUT CHARGE BOTH BY MAIL AND AT SERVICE DELIVERY AREAS WHERE THERE IS A REGISTRATION OR CHECK-IN AREA (INCLUDING, BUT NOT LIMITED TO, INPATIENT, OUTPATIENT EMERGENCY DEPARTMENTS, AND AFFILIATED COMMUNITY HEALTH CENTER LOCATIONS), IN CERTIFIED APPLICATION COUNSELOR ("CAC") OFFICES AND IN GENERAL BUSINESS OFFICE AREAS THAT ARE CUSTOMARILY USED BY PATIENTS (E.G., ADMISSIONS AND REGISTRATION AREAS OR PATIENT FINANCIAL SERVICES OFFICES THAT ARE ACTIVELY OPEN TO THE PUBLIC). IN ADDITION, THE HOSPITAL POSTS NOTICES IN LOCAL COMMUNITY HEALTH CENTERS, SENIOR AND EDUCATION FACILITIES. THE GENERAL NOTICE WILL INFORM THE PATIENT ABOUT THE AVAILABILITY OF PUBLIC ASSISTANCE AND HOSPITAL FINANCIAL ASSISTANCE (INCLUDING MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET AND MEDICAL HARDSHIP) AS WELL AS THE LOCATION (S) WITHIN THE HOSPITAL AND/OR THE PHONE NUMBERS TO CALL TO SCHEDULE AN APPOINTMENT WITH A CAC. INFORMATION ABOUT APPLYING FOR FINANCIAL ASSISTANCE IS ALSO AVAILABLE ONLINE AT WWW.SIGNATURE-HEALTHCARE.ORG. THE GOAL OF THESE NOTICES IS TO ASSIST INDIVIDUALS IN APPLYING FOR COVERAGE WITHIN ONE OR MORE OF THESE PROGRAMS. SCHEDULE H, PART VI, LINE 4: SHBH SERVES OVER 100,000 PATIENTS ON AN ANNUAL BASIS. AS A DISPROPORTIONATE SHARE HOSPITAL AND THE HUB AND SOLE HOSPITAL OF SIGNATURE HEALTHCARE, WE PROVIDE A FULL RANGE OF PRIMARY AND SPECIALTY CARE SERVICES FOR ECONOMICALLY DISADVANTAGED AND AT-RISK INDIVIDUALS. THE POVERTY IN OUR SERVICE AREA IS SO SEVERE (72% OF PATIENTS QUALIFY FOR GOVERNMENT INSURANCE) AND RESIDENTS LACK RESOURCES FOR BASIC LIVING EXPENSES. ADD TO THAT THE FEAR OF NAVIGATING A CANCER DIAGNOSIS. OUR SERVICE AREA ALSO INCLUDES LARGE NUMBERS OF IMMIGRANT AND FIRST-GENERATION FAMILIES FROM HAITI AND CAPE VERDE AMONG OTHERS FOR WHOM ENGLISH IS A STRUGGLE. MASSACHUSETTS HAS THE HIGHEST CAPE VERDEAN POPULATION - 53,174 - IN THE UNITED STATES. THE MAJORITY - 11,709 - RESIDE IN BROCKTON, MASSACHUSETTS. *MASSACHUSETTS IS ALSO A TOP STATE IN THE UNITED STATES FOR HAITIAN POPULATION AT NEARLY 37,000 OF LEGAL RESIDENCE. THE BROCKTON AREA IS IN FACT HOME TO THE LARGEST HAITIAN COMMUNITY IN THE UNITED STATES. (*SOURCE: CENTER FOR IMMIGRATION STUDIES) WITH EXTENSIVE TRANSLATION SERVICES, A HIGH PERCENTAGE OF STAFF WHO SPEAK MORE THAN ONE LANGUAGE AND A FULL UNDERSTANDING OF THE MULTICULTURAL POPULATION IN OUR COMMUNITIES, SHBH IS UNIQUELY ABLE TO ASSIST PATIENTS AND THEIR FAMILIES THROUGHOUT THE COMMUNITIES WE SERVE. THE IMPORTANCE OF CLEAR COMMUNICATION, SUPPORT AND ACCESS TO QUALITY CARE WHEN FACING A MEDICAL CHALLENGE CANNOT BE OVERSTATED. SCHEDULE H, PART VI, LINE 6: BROCKTON HOSPITAL (BH) IS PART OF AN AFFILIATED HEALTH CARE SYSTEM. UNDER THE CONTROL OF ITS PARENT ORGANIZATION, SIGNATURE HEALTHCARE CORPORATION, INC. (SHC) AFFILIATES BH, SIGNATURE HEALTHCARE MEDICAL GROUP, INC. (SMG), AND SIGNATURE HEALTHCARE URGENT CARE (SHUC), COORDINATE THE PROVISION OF HEALTH CARE AND RELATED SERVICES TO THE RESIDENTS OF BROCKTON AND ITS SURROUNDING CITIES AND TOWNS. SCHEDULE H, PART VI, LINE 7, LIST OF STATES REC. COMMUNITY BENEFIT REPORT: MA false false false false false false false false false STEPHEN BORGES VP FINANCIAL OPER. UNTIL 08/24 214224 0 27264 0 51233 0 20448 0 29901 0 343070 0 0 0 ROBERT HAFFEY PRESIDENT & CLERK/ CEO 623318 0 34127 0 52500 0 19800 0 46606 0 776351 0 0 0 DAVID DRINKWATER MD PHYSICIAN, TRUSTEE 0 570449 0 31780 0 52500 0 6600 0 35931 0 697260 0 0 JASON RADZEVICH CFO & Treasurer 420096 0 46001 0 30000 0 3185 0 35077 0 534359 0 0 0 KAREN E MURPHY SENIOR VP GENERAL COUNSEL 383748 0 43784 0 52500 0 19800 0 6297 0 506129 0 0 0 JUSSI J MAIJALA CHIEF HUMAN RESOURCES OFFICER 325750 0 65000 0 52500 0 1212 0 34996 0 479458 0 0 0 KIMBERLY WALSH SR. VP/CHIEF OPERATING OFFICER 311471 0 36385 0 52510 0 24750 0 19511 0 444627 0 0 0 NICHOLAS SZYMANSKI VP/CHIEF INFORMATION OFFICER 300800 0 32396 0 22500 0 13021 0 14595 0 383312 0 0 0 JEFFREY MILLER VP DEVELOPMENT 192850 0 25240 0 53085 0 15144 0 35068 0 321387 0 0 0 KIM N HOLLON FORMER PRESIDENT/CEO 0 0 0 0 283844 0 0 0 0 0 283844 0 0 0 DEEPTI SESHADRI MD PRESIDENT, MEDICAL STAFF 0 161025 0 0 0 15926 0 3347 0 66 0 180364 0 0 ROBERT S GREENBERG MD DIRECTOR 0 37604 0 0 0 3753 0 6600 0 1046 0 49003 0 0 SCHEDULE J, PART I, LINE 3: THE ORGANIZATION'S BOARD OF TRUSTEES STANDING COMPENSATION COMMITTEE IS EMPOWERED BY THE BOARD OF TRUSTEES TO REVIEW AND APPROVE ALL MATTERS PERTAINING TO COMPENSATION AND SHALL REPORT ALL ACTIONS TAKEN BY IT ON THESE MATTERS TO THE BOARD OF TRUSTEES. THE COMPENSATION COMMITTEE SHALL REVIEW AND APPROVE THE OVERALL COMPENSATION PHILOSOPHY FOR THE HOSPITAL PRESIDENT AND CEO, MEMBERS OF THE HOSPITAL SENIOR MANAGEMENT TEAM, PHYSICIAN COMPENSATION FOR SMG AND HOSPITAL CHIEFS OF SERVICE, AND ANY INDIVIDUAL WHO FALLS WITHIN THE INTERNAL REVENUE SERVICE DEFINITION OF A DISQUALIFIED PERSON AND SHALL BE RESPONSIBLE FOR THE GENERAL OVERSIGHT OF ALL COMPENSATION RELATED DECISIONS WITH THE EXCEPTION OF THOSE INDIVIDUALS WHOSE SALARY AND BENEFITS ARE SUBJECT TO COLLECTIVE BARGAINING AGREEMENTS. THE COMMITTEE WILL BE RESPONSIBLE FOR REVIEWING, AT LEAST EVERY 3 YEARS, THE OVERALL COMPENSATION RANGE OF THE HOSPITAL AND ITS AFFILIATES AS COMPARED TO COMPARABLE ORGANIZATIONS AND SHALL ESTABLISH THE GENERAL PERCENTILE FOR AVERAGE COMPENSATION IN MAKING THIS DETERMINATION. THE COMMITTEE SHALL ENGAGE A BENEFIT CONSULTING FIRM TO CONDUCT MARKET ANALYSIS BASED ON THE RECOMMENDATIONS OF THE VICE PRESIDENT OF HUMAN RESOURCES. THE COMMITTEE SHALL HAVE THE POWER TO: APPROVE ALL FINAL DETERMINATIONS WITH RESPECT TO COMPENSATION; RETAIN AND TERMINATE A QUALIFIED COMPENSATION CONSULTANT TO ASSIST IN THE ASSESSMENT OF COMPENSATION; AND RETAIN AND TERMINATE LEGAL, ACCOUNTING OR OTHER EXPERTS NECESSARY TO CARRY OUT ITS DUTIES. THE MINUTES OF THE COMPENSATION COMMITTEE SHALL REFLECT THE DELIBERATIONS AND DECISIONS OF THE COMMITTEE. SCHEDULE J, PART II, COLUMN D - DEFINED BENEFIT PLAN: THE HOSPITAL MAINTAINS TWO DEFINED BENEFIT PENSION PLANS COVERING HOSPITAL EMPLOYEES WITH AT LEAST ONE YEAR OF SERVICE. PRIOR TO JANUARY 2016, ALL PARTICIPANTS WERE COVERED BY ONE PLAN. EFFECTIVE JANUARY 2016, ALL INACTIVE PARTICIPANTS AND ACTIVE PARTICIPANTS WITH FROZEN BENEFITS WERE SPUN OFF TO A NEW PLAN, THE SIGNATURE HEALTHCARE RETIREMENT PLAN. THE REMAINING PLAN IS FOR ACTIVE PARTICIPANTS WHO CONTINUE TO ACCRUE BENEFITS. IN DECEMBER 2008, THE BOARD APPROVED AMENDEMENTS TO FREEZE THE PENSION PLANS FOR CERTAIN EMPLOYEES EFFECTIVE MARCH 2009, AFTER WHICH NO BENEFIT WILL ACCRUE FOR THOSE EMPLOYEES. EFFECTIVE 2012 AND 2014, ANY NEW HIRES COVERED BY THE SERVICE EMPLOYEES INTERNATIONAL UNION AND MASSACHUSETTS NURSES ASSOCIATION AGREEMENTS, RESPECTIVELY, ARE NOT ELIGIBLE TO PARTICIPATE IN THE PENSION PLANS. SCHEDULE J, PART II, COLUMN D - DEFINED CONTRIBUTION PLAN: IN APRIL 2009, THE CORPORATION IMPLEMENTED A DEFINED CONTRIBUTION 403(B) PLAN FOR CERTAIN HOSPITAL EMPLOYEES AND IN OCTOBER 2010, THE PLAN WAS MADE AVAILABLE TO CERTAIN SIGNATURE HEALTHCARE MEDICAL GROUP EMPLOYEES. THE CORPORATION MAINTAINS CONTRIBUTORY, DEFINED CONTRIBUTION PLANS THAT ARE AVAILABLE TO EMPLOYEES WHO MEET CERTAIN MINIMUM REQUIREMENTS. THE PLANS REQUIRE THAT THE CORPORATION MATCH SPECIFIED PERCENTAGES OF PARTICIPANT CONTRIBUTIONS UP TO CERTAIN MAXIMUM LEVELS. THE CORPORATION'S CONTRIBUTIONS WERE FUNDED PERIODICALLY DURING THE YEAR. SCHEDULE J, PART II, COLUMN D - DEFERRED COMPENSATION PLANS: THE CORPORATION MAINTAINS A 457(B) DEFERRED COMPENSATION PLAN WHICH COVERS KEY EMPLOYEES. UNDER THIS PLAN, EMPLOYEES MAY ELECT TO DEFER A PORTION OF THEIR COMPENSATION. THE CORPORATION MAINTAINS A 457(F) NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR ACTIVELY EMPLOYED ELIGIBLE PHYSICIANS. EMPLOYEES WILL BE VESTED IN THE CONTRIBUTION FOR A PLAN YEAR ON JANUARY 1 TEN YEARS FROM THE YEAR IN WHICH EMPLOYEE CONTRIBUTIONS ARE MADE OR ON JANUARY 1 IN THE YEAR IN WHICH THEY REACH THE RETIREMENT AGE OF 65 AND HAVE TWO YEARS OF PLAN SERVICE. SCHEDULE J, PART II, COLUMN D: THE CORPORATION IS SELF-INSURED FOR ITS MEDICAL AND DENTAL INSURANCE PLANS. A MASSACHUSETTS DEVELOPMENT FINANCE AGENCY (MDFA) 043431814 NONEAVAIL 2017-12-21 50047441 SEE PART VI false false false B MASSACHUSETTS DEVELOPMENT FINANCE AGENCY (MDFA) 043431814 NONEAVAIL 2021-08-23 20000000 SEE PART VI false false false C MASSACHUSETTS DEVELOPMENT FINANCE AGENCY (MDFA') 043431814 NONEAVAIL 2022-05-12 19400000 SEE PART VI false false false A 0 0 50047441 0 0 0 483298 0 0 8376978 41670863 0 2019 true false true true B 0 0 20000000 0 0 0 631570 0 0 19368430 0 0 2021 false false true true C 0 0 19400000 0 0 0 378520 0 0 10793445 8606555 0 2022 false false true true A true true true false false 0.00710 0.00710 false false false true B false false false 0 false false false true C false false false 0 false false false true A false true false false true false 0 false 0 false true B false true false false false false 0 false 0 false true C false true false false false false 0 false 0 false true A true B true C true SCHEDULE K, PART I, COLUMN (F) ROW A (A) ISSUER NAME: MASSACHUSETTS DEVELOPMENT FINANCING AGENCY ("MDFA") (F) DESCRIPTION OF PURPOSE: REFINANCE DEBT ISSUED 9/30/2014 AND FINANCE CONSTRUCTION, RENOVATIONS AND ACQUISITIONS OF CAPITAL EQUIPMENT. ROW B (A) ISSUER NAME: MASSACHUSETTS DEVELOPMENT FINANCING AGENCY ("MDFA") (F) DESCRIPTION OF PURPOSE: ACQUIRE PROPERTY ROW C (A) ISSUER NAME: MASSACHUSETTS DEVELOPMENT FINANCING AGENCY ("MDFA") (F) DESCRIPTION OF PURPOSE: CONSOLIDATE EXISTING DEBT AND FINANCE CONSTRUCTION/RENOVATIONS FOR ASC AND ED UNITS NICCOLI BROTHERS OIL SEE PART V 55942 SUPPLIES PURCHASE false SCHEDULE L, PART IV, COLUMN (B): FRED NICCOLI GREATER THAN 35% CONTROLLED ENTITY FORM 990, PART I, LINE I, DESCRIPTION OF ORGANIZATION MISSION: TEACHING HOSPITAL SERVING MORE THAN 460,000 RESIDENTS IN MORE THAN 20 SOUTHEASTERN MASSACHUSETTS COMMUNITIES. THE HOSPITAL HAS 216 LICENSED BEDS AND PROVIDES A FULL RANGE OF CLINICAL SERVICES INCLUDING MEDICAL/SURGICAL, PEDIATRICS, OBSTETRICS, INPATIENT AND OUTPATIENT PSYCHIATRY, RADIATION, AND MEDICAL ONCOLOGY, CARDIAC CATHETERIZATION, LEVEL II NURSERY AND MAGNETIC RESONANCE IMAGING. FORM 990, PART III, LINE I: SIGNATURE HEALTHCARE BROCKTON HOSPITAL IS A PRIVATE, NOT-FOR-PROFIT, COMMUNITY-BASED TEACHING HOSPITAL SERVING MORE THAN 460,000 RESIDENTS IN MORE THAN 20 SOUTHEASTERN MASSACHUSETTS COMMUNITIES. OUR MISSION IS TO BE THE LEADING COMMUNITY BASED HEALTHCARE DELIVERY SYSTEM IN SOUTHEASTERN MASSACHUSETTS, PROVIDING THE FULL RANGE OF INTEGRATED PRIMARY CARE, SPECIALTY CARE, ACUTE HOSPITAL CARE AND RELATED ANCILLARY HEALTHCARE SERVICES. SIGNATURE HEALTHCARE PHYSICIANS AND SIGNATURE HEALTHCARE BROCKTON HOSPITAL STRIVE TO BE RECOGNIZED AS THE "PROVIDERS OF CHOICE" BY STAFF, PATIENTS AND THE COMMUNITY. SIGNATURE HEALTHCARE IS GUIDED BY THESE PRINCIPLES: - TAKE A LEADERSHIP ROLE IN ASSESSING THE HEALTH CARE NEEDS OF THE METRO SOUTH AREA BY COMMITTING TO A HOSPITAL-COMMUNITY PARTNERSHIP AND BY COLLABORATING WITH OTHER PROVIDERS AND COMMUNITY MEMBERS TO OFFER A BROAD RANGE OF EDUCATION, HEALTH SERVICES AND OTHER ACTIVITIES FOR ALL PATIENTS AND, IN PARTICULAR, THE UNDERSERVED AND DISADVANTAGED POPULATIONS. - DEVELOP NEW SERVICES AND PROGRAMS AND PARTICIPATE IN ALTERNATIVE DELIVERY AND REGIONAL HEALTH CARE SYSTEM TO RESPOND TO COMMUNITY NEED AND ENHANCE ACCESS TO CARE. - PARTICIPATE IN THE EDUCATION OF HEALTH CARE PROFESSIONALS TO ENHANCE THE HOSPITAL'S ACCESS TO MEDICAL EXPERTISE AND TO ASSURE THE MOST UP-TO-DATE APPROACHES FOR PROVIDING CARE. - COMMIT TO AN ELECTRONIC MEDICAL RECORD ENVIRONMENT AIMED AT (1) REDUCING MEDICAL ERRORS WITH MORE ACCURATE AND TIMELY INFORMATION FOR PROVIDERS, (II) ENHANCING PHYSICIAN PRODUCTIVITY AND JOB SATISFACTION, (III) RESPONDING TO CONSUMER REQUESTS FOR ELECTRONIC COMMUNICATION. - BE AN EQUITABLE EMPLOYER THAT VALUES AND REWARDS EXCELLENCE IN ITS ASSOCIATES. - MANAGE FINANCES AGGRESSIVELY TO REMAIN COST EFFECTIVE AND FISCALLY SOUND. PART OF SIGNATURE HEALTHCARE BROCKTON HOSPITAL'S COMMUNITY FOCUS, AND INDEED THE VERY CORE OF OUR MISSION, IS TO CARE FOR THOSE IN GREATEST NEED. WE ARE ESPECIALLY PROUD OF OUR DISTINGUISHED, CENTURY-PLUS TRADITION OF REACHING OUT TO ALL PATIENTS IN OUR COMMUNITY. FROM EVERY WALK OF LIFE, REGARDLESS OF THEIR ABILITY TO PAY. FORM 990, PART VI, SECTION A, LINE 6: SIGNATURE HEALTHCARE CORPORATION, A CHARITABLE ORGANIZATION ORGANIZED UNDER THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS, ACTING THROUGH ITS BOARD OF TRUSTEES, IS THE SOLE CORPORATE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B: THE ORGANIZATION'S FORM 990 IS PREPARED BY AN OUTSIDE INDEPENDENT CERTIFIED PUBLIC ACCOUNTING FIRM AND IS PRESENTED TO AND REVIEWED BY THE CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER AND COPIES OF FORM 990 ARE PROVIDING TO EACH MEMBER OF THE BOARD OF TRUSTEES PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C: COMPLETED CONFLICT OF INTEREST QUESTIONNAIRES SHALL BE SUBMITTED TO THE PRESIDENT OR HIS DESIGNEE BY DECEMBER 1ST, PRIOR TO THE BEGINNING OF EACH CALENDAR YEAR, THE PRESIDENT OR HIS DESIGNEE SHALL, IN WRITING, ADVISE MEMBERS (TRUSTEES, SENIOR MANAGEMENT, DEPARTMENT MANAGERS AND PHYSICIANS) AND INDIVIDUALS ON THE MEDICAL EXECUTIVE COMMITTEE WHO ARE NOT MEMBERS OF THE CONFLICT OF INTEREST POLICY AND REQUEST THAT EACH INDIVIDUAL COMPLETE AND SUBMIT TO THE PRESIDENT OR HIS DESIGNEE, A QUESTIONNAIRE OUTLINING ANY POSSIBLE CONFLICTS OF INTEREST OR INDICATING THAT NO SUCH CONFLICT OF INTEREST EXISTS. THE PRESIDENT OR HIS DESIGNEE SHALL REVIEW ALL CONFLICT-OF-INTEREST QUESTIONNAIRES AND AT LEAST ANNUALLY DISCLOSE TO THE EXECUTIVE COMMITTEE THE RESULTS OF THE QUESTIONNAIRES. AT LEAST ANNUALLY THE PRESIDENT OR HIS DESIGNEE SHALL REQUEST A COMMITTEE OF THE BOARD TO REVIEW STANDARD RELATIONSHIPS WITH LOCAL BANKS, INSURANCE FIRMS, VENDORS AND OTHER ENTITIES SERVING THE INSTITUTION TO ASSURE THAT THE RELATIONSHIP IS IN THE BEST INTEREST OF THE INSTITUTION AND IS OTHERWISE CONSISTENT WITH THE TERMS OF THE CONFLICT-OF-INTEREST POLICY. ANY MEMBER HAVING A POSSIBLE CONFLICT OF INTEREST ON ANY MATTER SHOULD NOT VOTE, USE HIS/HER PERSONAL INFLUENCE OR MAKE AN ADMINISTRATIVE DECISION ON THE MATTER, AND IN THE CASE OF A TRUSTEE, SHOULD NOT BE COUNTED IN DETERMINING THE QUORUM FOR THE ACTION OF THE MATTER. THE MINUTES OF THE MEETING SHOULD REFLECT THAT A FULL AND ACCURATE DISCLOSURE WAS MADE, THAT THE MEMBER ABSTAINED FROM VOTING OR DECISION MAKING AND THE QUORUM OTHERWISE PRESENT. THE CONFLICT-OF-INTEREST POLICY SHALL BE REVIEWED ANNUALLY BY THE MEMBERS AND EACH NEW MEMBER SHALL BE ADVISED OF THE POLICY PRIOR TO THE INDIVIDUAL'S SELECTION AS A MEMBER AND SHALL BE REQUIRED TO FILE WITHIN 30 DAYS THEREAFTER A COMPLETED QUESTIONNAIRE. FORM 990, PART VI, SECTION B, LINE 15: THE STANDING COMMITTEE OF THE BOARD OF TRUSTEES OF THE ORGANIZATION'S PARENT, SIGNATURE HEALTHCARE CORPORATION, SERVES AS THE COMPENSATION COMMITTEE OF THE ORGANIZATION AND IS EMPOWERED TO REVIEW AND APPROVE ALL MATTERS PERTAINING TO COMPENSATION AND SHALL REPORT ALL ACTIONS TAKEN BY IT ON THESE MATTERS TO THE BOARD OF TRUSTEES. ANNUALLY, THE COMPENSATION COMMITTEE ENGAGES AN INDEPENDENT COMPENSATION CONSULTING FIRM TO PREPARE AN EXECUTIVE COMPENSATION ANALYSIS WHICH INCLUDES A COMPETITIVE ASSESSMENT OF THE TOTAL COMPENSATION PROGRAM FOR THE ORGANIZATION'S EXECUTIVE POSITIONS (CEO, CFO AND VICE PRESIDENT) FOR REVIEW BY THE COMPENSATION COMMITTEE. THE MINUTES OF THE COMPENSATION COMMITTEE REFLECT THE DELIBERATIONS AND DECISIONS OF THE COMMITTEE. FORM 990, PART VI, SECTION C, LINE 18: FORM 990 IS AVAILABLE FOR PUBLIC INSPECTION ON THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE LOCATED AT WWW.MASS.GOV. FORM 990, PART VI, SECTION C, LINE 19: THE ARTICLES OF ORGANIZATION ARE OPEN TO THE PUBLIC ON THE MASSACHUSETTS SECRETARY OF STATE'S WEBSITE AND THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AVAILABLE ON THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE. FORM 990, PART XI, LINE 9, CHANGE IN NET ASSETS: PENSION-RELATED CHANGES $ 2,964,064 NET ASSETS RELEASED FROM DONOR RESTRICTIONS $ 3,687,888 CHANGE IN INTEREST IN NET ASSETS OF SHC $ 1,026,640 CHANGE IN FAIR VALUE OF SPLIT-INTEREST AGREEMENTS $ 352,888 TRANSFERS FROM (TO) AFFILIATES $(16,974,689) TOTAL TO LINE 9: $( 8,943,209) SIGNATURE HEALTHCARE CORPORATION INC 680 CENTRE STREET BROCKTON MA 02302 042103554 MGMT & FUNDRA MA 501(C)(3) 12B NA false SIGNATURE HEALTHCARE MEDICAL GROUP INC 680 CENTRE STREET BROCKTON MA 02302 043306782 PHYSICIAN PRA MA 501(C)(3) 10 SHC false SIGNATURE HEALTHCARE URGENT CARE INC 680 CENTRE STREET BROCKTON MA 02302 991362817 URGENT CARE MA 501(C)(3) 10 SHC false false false false false false false false true false true true true false false true true true true true