2025-08-12T20:50:20-05:00 2024-09-30 010494526 Baker Newman & Noyes PO Box 507 Portland ME 04112 990 2023-10-01 222520073 Holyoke Medical Center Inc HOLY 4135342667 575 Beech Street Holyoke MA 010402223 Dean Vitarisi Treasurer & CFO 4135342667 2025-08-08 1 0 Connor Smart P02285543 2078792100 2025-08-08 2023 2025-03-06 01:10:19Z Spiridon E Hatiras 575 Beech Street Holyoke MA 010402223 266280916 0 X www.holyokehealth.com X 1984 MA Acute care hospital, providing medical and other healthcare services to residents of Holyoke, MA and the surrounding areas. 13 9 2078 64 2054961 40922 13891859 8261234 228914084 257178852 523642 605202 2212899 100269 245542484 266145557 84130 56399 0 0 145557801 159757435 0 0 0 102970153 104853790 248612084 264667624 -3069600 1477933 123522026 129344658 82757901 89883786 40764125 39460872 X Our Mission at Holyoke Medical Center is to improve the health of all people in our community. We do that with honesty, respect and dignity for our patients, visitors and staff. We do that through expert and compassionate care, education and knowledge sharing, community partnerships, fostering innovation and growth and by inspiring hope in all we touch. We do that by being good stewards of our resources and providing efficient and cost effective care to all. 0 0 223110100 56399 255170360 Holyoke Medical Center, Inc. (HMC) strives to serve the health needs of their medical service community in a high quality and efficient manner. To this end, HMC shall: (1) provide compassionate care to all of whom it serves with a commitment to developing cultural diversity and competencies in our programs and workforce so that we may better serve our patients; (2) identify and serve those needs which are prevalent and substantial in the community as a whole, or within major population groups, and which can be adequately met by the provision of basic primary and secondary health care services; (3) provide information, education, and expertise to our community in order to promote the general health of its citizens; (4) provide an environment of excellence and growth in which health care professionals can use their skills and abilities to the fullest extent possible; (5) provide competitive wages and benefits, as well as safe and dignified working conditions, for all employees; (6) ensure financial responsibility in the operation of the medical center in order to guarantee the future viability of our mission; (7) provide a formal, public, and ongoing program of community benefits, in cooperation with community individuals and organizations, to improve the health status of the public including especially the medically and economically vulnerable. Holyoke Medical Center, Inc. provided inpatient, outpatient, OB/GYN, and emergency healthcare services and certain physician services to the residents of Holyoke, Massachusetts and the surrounding communities. Inpatient healthcare services included medical, surgical, critical care, cardiac, obstetrical, psychiatric, and oncology services. During FY 2024, HMC provided 42,745 patient days of inpatient services with 7,093 discharges. Outpatient healthcare services included a full array of diagnostic, therapeutic, and behavioral health services. During FY 2024, HMC had 366,946 outpatient visits. Emergency services were provided by a 24-hour emergency department. During FY 2024, HMC had 44,387 emergency department visits. 223110100 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 119 0 1 2078 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 9 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 0 MA X Dean Vitarisi 4135342667 575 Beech Street Holyoke MA 010402223 X Simon Ahtaridis MD Director/Medical Director 50.00 0.00 X 373911 0 41531 John Mazzucco MD Director/General Surgeon 50.00 0.00 X 360713 0 19898 Spiridon E Hatiras President & CEO, Clerk 40.00 9.50 X X 0 920224 76706 Dean Vitarisi Treasurer & CFO 40.00 8.00 X X 0 351730 48263 Julie A Beck MD Director (start 2/2024) 0.50 0.00 X 0 0 0 Tom Buck MD Director 0.50 0.00 X 0 0 0 Shannon Gurek Director 0.50 0.00 X 0 0 0 John Hazen Director (end 2/2024) 0.50 0.00 X 0 0 0 Sara Lawrence Director (end 2/2024) 0.50 0.00 X 0 0 0 Mary Jo Maydew Director 0.50 0.50 X 0 0 0 Daniel McIntire Director (end 2/2024) 0.50 0.00 X 0 0 0 Gary Rome Director (start 2/2024) 0.50 0.00 X 0 0 0 Idelia Smith Director 0.50 0.50 X 0 0 0 George Timmons PhD Director (start 2/2024) 0.50 0.00 X 0 0 0 Tricia Koss Chair 1.00 0.00 X X 0 0 0 Michael Marcotte Vice Chair (end 2/2024) 1.00 0.00 X X 0 0 0 Michael Sugrue Director/Vice Chair (start 2/2024) 1.00 0.00 X X 0 0 0 Andrey Pavlov MD Pulmonologist 50.00 0.00 X 962720 0 3062 Noah J Epstein MD Orthopedic Surgeon 50.00 0.00 X 950463 0 25241 Marc J Zerbe MD Obstetrician/Gynecologist 50.00 0.00 X 847071 0 25241 Alexander Berry MD Urologist 50.00 0.00 X 922932 0 25241 Nirav R Sheth MD Cardiologist 50.00 0.00 X 798976 0 25241 5216786 1271954 290424 244 0 1 0 Valley Health Systems Inc 20 Hospital Drive Holyoke MA 01040 Management services 3060785 Unidine Corporation 1000 Washington Street 510 Boston MA 02118 Cafeteria staffing 2334013 Med-Metrix LLC 9 Entin Road Parsippany NJ 07054 Billing services 2254900 Aya Healthcare Inc 5930 Cornerstone Court West 300 San Diego CA 92121 Staffing services 1978035 TriMedx PO Box 636129 Cincinnati OH 45263 Biomedical services 1214412 53 48027 8027559 185648 167 8261234 Patient services 621110 224269688 224269688 Hospital relief payments 621110 25145757 25145757 Pharmacies 456110 3543591 3543591 Auxiliary and lab services 621500 2833450 824958 2008492 Program related rentals 531110 630139 630139 756227 756227 257178852 572896 572896 235628 135359 100269 100269 46469 53800 32306 0 32306 32306 32306 266145557 255170360 2054961 659002 X 38358 38358 18041 18041 796053 715921 80132 130723621 117785427 12938194 3184667 2857520 327147 15059069 12982472 2076597 9994025 9004880 989145 3350386 3350386 414582 186177 228405 101450 101450 78855 78855 24842263 14664512 10177751 418011 8740 409271 4185434 1952454 2232980 2513809 197242 2316567 3825762 3261447 564315 60560 39011 21549 190605 129646 60959 843804 707760 136044 6272743 5261406 1011337 2404149 35369 2368780 Medical supplies 42132869 42124857 8012 Provision for bad debts 5044561 5044561 HSN assessment 3866801 3866801 Laboratory tests 1980546 1973967 6579 2326600 253531 2073069 264667624 223110100 41557524 0 91328 363780 13956451 15481212 29550270 32964138 3684331 3394668 1915780 1354079 187840992 128695081 59735556 59145911 4641524 5568889 3765498 4384160 3439183 2733812 2742105 3954009 123522026 129344658 37523994 42471438 2110294 661936 13340162 13053174 7375516 8373273 22407935 25323965 82757901 89883786 X 36024255 34109615 4739870 5351257 40764125 39460872 123522026 129344658 X 1477933 616690 -3397876 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 18855 1 60000 0 0 78855 0 Part II-B, Line 1: From time to time the Hospital may hire outside consultants to perform services in furtherance of the Hospital's and the other Valley Health System organizations' mission. A portion of the fees paid for such services may be designated for lobbying purposes or for assistance with legistlation of interest, on behalf of the Valley Health System and its related organizations. During the period covered by this Form 990, the Hospital engaged Dempsey, Lucey & Associates, compensating them $60,000 for services related to lobbying activities on behalf of the Hospital and the Valley Health System. The lobbying services were related to causes and issues of relevance to the organizations' charitable missions. The Hospital was also a member of the Massachusetts Health and Hospital Association (MHHA) during the period covered by this Form 990. A portion of the dues paid to the Association was available for lobbying-related expenditures on behalf of the Hospital and other Valley Health System organizations. Lobbying activities conducted by the Association were related to causes and issues of relevance to the organizations' charitable missions and in furtherance of their exempt purposes. The portion of dues paid to MHHA during this tax year that was available for lobbying was $18,855. 1502575 278643 76325 1704893 1423090 141046 61561 1502575 1527403 -42939 61374 1423090 1346962 215145 34704 1527403 1453404 23708 130150 1346962 0.00000 0.26968 0.73032 0 1 1 1942994 1942994 101777883 62018940 39758943 20669265 12902006 7767259 59929913 51799980 8129933 3520937 1974155 1546782 59145911 Accrued pension costs 9759327 Asset retirement obligations 221740 Net estimated third-party payor settlements 9434746 Insurance claims payables 3113937 Operating lease liabilities 2794215 25323965 X 262439402 616690 135359 752049 261687353 4458204 4458204 266145557 259758422 135359 135359 259623063 5044561 5044561 264667624 Part V, Line 4: The endowment funds are held and administered by Valley Health Systems, Inc. The intended use of the funds is to provide a predictable, stable, and consistent stream of earnings for Holyoke Medical Center, Inc. to be used for free care and general operations. Part X, Line 2: The Medical Center is exempt from income taxes under Section 501(c)(3) of the Internal Revenue Code. Tax-exempt organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by the Financial Accounting Standards Board (FASB), assets and liabilities are established for uncertain tax positions taken or positions expected to be taken in income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold, based upon the technical merits of the position. Estimated interest and penalties, if applicable, related to uncertain tax positions are included as a component of income tax expense. The Medical Center has evaluated the position taken on its filed tax returns. The Medical Center has concluded no uncertain income tax positions exist at September 30, 2024. The Medical Center's tax years from 2022 through 2024 are open and subject to examination. Part XI, Line 2d - Other Adjustments: Rental expenses 135,359. Part XI, Line 4b - Other Adjustments: Change in beneficial interest - VHS -586,357. Provision for bad debts 5,044,561. Part XII, Line 2d - Other Adjustments: Rental expenses 135,359. Part XII, Line 4b - Other Adjustments: Provision for bad debts 5,044,561. 1 1 1 X 1 X 1 1 0 1 1 1664914 780232 884682 0.00340 74093168 73328241 764927 0.00290 75758082 74108473 1649609 0.00630 2407507 2407507 0.00930 5616605 5616605 0.02160 6438836 6438836 0.02480 2295553 2295553 0.00880 16758501 16758501 0.06450 92516583 74108473 18408110 0.07080 647796 647796 0.00250 14870 14870 0.00010 68357 68357 0.00030 186450 186450 0.00070 917473 917473 0.00360 1 8666240 0 47284714 46489390 795324 X 1 1 1 1 Holyoke Medical Center Inc 575 Beech Street Holyoke MA 01040 www.holyokehealth.com 2145 X X X Holyoke Medical Center Inc 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X See Part V, Section C X 1 21 1 see Part V, Section C 1 0 1 X 150.000000000000 300.000000000000 X X X X X 1 1 X X X X 1 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 1 X 0 X X X X 1 X 0 0 Holyoke Medical Center, Inc. Part V, Section B, Line 5: Holyoke Medical Center has conducted formal and informal surveys each year to look at the health needs of the people we serve. In the first half of 2021, Holyoke Medical Center conducted a year long study that entailed key stakeholder interviews, community resident interviews, workshops, a lengthy survey given in English and Spanish, and data collection, which has been brought together to create the 2022 Holyoke Medical Center Community Health Needs Assessment (CHNA). The CHNA also determines how Holyoke Medical Center will provide support, resources and education to the communities we serve. A CHNA is a federal requirement for private, nonprofit hospitals and must be done every 3 years with input from the broader community including public health experts and collection of important health data. The 2022 CHNA was published by September 30, 2022, and therefore occurred within the tax year covered by the Hospital's 2021 Form 990. The complete CHNA, as well as the supplemental narratives included on this Form 990, Schedule H, Part VI, provide additional details regarding the Hospital's processes and procedures for gathering community input for its needs assessments. Holyoke Medical Center, Inc. Part V, Section B, Line 11: Please see the attached Implementation Plan for details on how the Hospital is addressing the significant needs identified in its most recently conducted CHNA as well as the needs that are not being addressed. The attached Implementation Plan also describes the needs that are not being addressed. Holyoke Medical Center, Inc. Part V, Section B, Line 16j: The Hospital has had a section on its website related to financial assistance for several years. The Hospital has a financial assistance policy, plain language summary, and financial assistance application that was available to our patients along with financial assistance signs in certain locations in the Hospital (such as patient registration, and the Emergency department). Schedule H, Part V, Section B, line 7a & 10a: The Hospital's 2022 CHNA, covering Tax Years 2021-2023, is available at: https://dashboards.mysidewalk.com/community-health-needs-assessment-5367ef8d9744The Hospital's 2020-2023 CHNA Implementation Strategy is available on the Hospital's website at: https://www.holyokehealth.com/wp-content/uploads/2024/10/HMC-2020-CB-Implementation-Strategy_FINAL-1.pdfThe Hospital's 2023-2026 CHNA Implementation Strategy is availabone on the Hospital's website at:https://www.holyokehealth.com/wp-content/uploads/2024/10/HMC-2023-CB-Strategic-Implementation-Plan-1.pdfOther past year CHNA and Implementation Strategy reports can be found on the Hospital's website at:https://www.holyokehealth.com/About-Us/Community-Benefits/ Schedule H, Part V, Section B, Line 16a & 16b: The Hospital's Financial Assistance Policy is available on the Hospital's website at: https://www.holyokehealth.com/wp-content/uploads/2024/10/Holyoke-Medical-Center-English-Financial-Assistance-Policy-FY-2016.pdfThe Plain Language Summary can be found on the Hospital's website at: https://www.holyokehealth.com/wp-content/uploads/2025/07/Holyoke-Medical-Center-Financial-Assistance-Plain-Language-Summary-ENG_07.2025.pdfThe Financial Assistance Application can be found on the Hospital's website at: https://www.holyokehealth.com/wp-content/uploads/2025/07/Holyoke-Medical-Center-Financial-Assistance-Application-2025-ENG.pdfA list of providers covered by the Hospital's Financial Assistance Program is found online at:https://www.holyokehealth.com/wp-content/uploads/2024/10/Providers-Covered-Under-Financial-Assistance-Rev-05-08-17.pdfAll of the above-linked documents and materials can be accessed from the Hospital's financial assistance home page. These documents are also available in Spanish. The Financial Assistance Home Page web-link is as follows:https://www.holyokehealth.com/Patients-Visitors/Financial-Assistance/ 17 1 - CMC - Radiology 1962 Memorial Drive Chicopee MA 01020 Radiology & Ultrasound Services 2 - HMC - Laboratory 1964 Memorial Drive Chicopee MA 01020 Laboratory Draws 3 - HMC - Physical Therapy 1970 Memorial Drive Chicopee MA 01020 Physical Therapy Services 4 - HMC - OBGYN & Midwifery 140 Southampton Road Westfield MA 01085 Women's Services 5 - HMC - Physical Therapy 140 Southampton Road Westfield MA 01085 Physical Therapy Services 6 - HMC - Gastroenterology 140 Southampton Road Westfield MA 01085 Gastroenterology 7 - HMC - Laboratory 140 Southampton Road Westfield MA 01085 Laboratory Draws 8 - HMC - Vascular Center 2 Hospital Drive Holyoke MA 01040 Heart and Lung 9 - HMC - Women's Center 2 Hospital Drive Holyoke MA 01040 Women's Services 10 - HMC - Pulmonary Services 5 Hospital Drive Holyoke MA 01040 Pulmonary Services 11 - Endocrinology & Diabetes Center 10 Hospital Drive Holyoke MA 01040 Endocrinology Services 12 - HMC - Urology 10 Hospital Drive Holyoke MA 01040 Urology Services 13 - Holyoke Orthopedics 10 Hospital Drive Holyoke MA 01040 Orthopedic Services 14 - HMC - Pain Management 10 Hospital Drive Holyoke MA 01040 Pain Management Services 15 - HMC - Wound Care Center 18 Hospital Drive Holyoke MA 01040 Wound Care 16 - HMC - Spine Center 10 Hospital Drive Suite 101 Holyoke MA 01040 Spinal Surgery 17 - HMC - Kidney Associates 10 Hospital Drive Suite 302 Holyoke MA 01040 Nephrology Practice Part I, Line 7: Holyoke Medical Center, Inc. used the cost-to-charge ratio method in determining the cost of health services provided. Holyoke Medical Center, Inc. derived this cost-to-charge ratio based on total patient care expenses, divided by gross patient service charges per the state CHIA cost report. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 5,044,561. Part II, Community Building Activities: Holyoke Medical Center, Inc. provides a variety of community sponsorships and ongoing relationships with local community organizations. Our goals for those sponsorships and/or team building are to help support organizations where their programming aligns with Holyoke Medical Center's Community Health Needs Assessment. Our intended outcome is to make this a healthier community. Part III, Line 2: Holyoke Medical Center, Inc. utilizes a costing methodology in which the ratio of patient care cost to charges is applied to the bad debt expense attributable to patient accounts to calculate the estimated cost of bad debt attributable to patient accounts that is reported on Line 2. Discounts and payments on patient accounts are recorded as adjustments to revenue, not bad debt expense. Part III, Line 3: See narrative for Part III, Line 2. Part III, Line 4: See Footnote 2 on Page 11 of the attached audited financial statements. Part III, Line 8: Holyoke Medical Center, Inc. utilizes generally accepted accounting principles in the preparation of its financial statements.Holyoke Medical Center, Inc. used the cost-to-charge ratio method in determining the cost of health services provided. Holyoke Medical Center, Inc. derived this cost-to-charge ratio based on the total patient care expenses, divided by gross patient service charges per the state CHIA cost report. Part III, Line 9b: Populations Exempt from Collection Action - The following individuals and patient populations are exempt from any collection actions pursuant to the Massachusetts Health Safety Net Program (HSN) regulations:a. Patients enrolled in, receiving benefits from, or participating in a public health insurance program, including but not limited to MassHealth, Emergency Aid to the Elderly, Disabled and Children (EAEDC), Healthy Start, Children's Medical Security Plan (CMSP (provided the patient's family income is equal to or less than 300% of the FPL)), and low income patients subject to the following:(1) Holyoke Medical Center, Inc. may initiate Collection Action against any patient enrolled in, receiving benefits from, or participating in MassHealth, EAEDC or Healthy Start, and any low income patient, for their required co-payments and deductibles as set forth by each specific program.(2) Holyoke Medical Center, Inc. may also initiate collection action for a patient who alleges that he or she is a participant in MassHealth, EAEDC, Health Start or CMSP but fails to provide proof of such participation. Upon receipt of satisfactory proof that a patient is a participant in such a program (including, in the case of MassHealth, EAEDC or Healthy Start, receipt or verification of a signed application), Holyoke Medical Center, Inc. shall cease billing or collection activities.(3) Low income patients are exempt from Collection Action for Eligible Services (as defined by HSN regulations from time-to-time) they receive during the period for which they have low income patient status.(4) Low income patients with family income between 150% and 300% of FPL are exempt from collection action for the portion of their Holyoke Medical Center, Inc. bill that exceeds the patient's deductible. However, Holyoke Medical Center, Inc. may initiate collection action against patients for their required co-payments and deductibles.(5) Holyoke Medical Center, Inc. may continue collection action on any low income patient for services rendered prior to the low income patient determination, provided that the patient's low income patient status has been terminated or expired. However, once a patient is determined to be eligible and enrolled in the Health Safety Net, MassHealth or certain Commonwealth Care programs, Holyoke Medical Center, Inc. will cease collection action for services rendered prior to the beginning of their eligibility.(6) Holyoke Medical Center, Inc. may pursue collection action against low income patients for services other than eligible services for which the patient has agreed to be responsible, provided Holyoke Medical Center, Inc. obtained the patient's prior written consent to be billed for the services. Holyoke Medical Center, Inc. will not bill low income patients for claims denied by the patient's primary insurer resulting from an administrative or billing error unless the error was initiated by patient/ guarantor.(7) Holyoke Medical Center, Inc. will not undertake collection action against an individual who has been approved for ER Bad Debt Medical Hardship or medical hardship under the Massachusetts Health Safety Net Program with respect to the amount of the bill that exceeds the medical hardship contribution.b. With respect to low income patients injured in motor vehicle accidents, Holyoke Medical Center, Inc. will: (1) investigate whether the patient, driver and/or vehicle owner had a motor vehicle liability policy; (2) make every effort to obtain the third party payor information from the patient; (3) if the hospital has prior knowledge and is legally able, attempt to secure assignment on a patient's right to third party coverage on services provided due to an accident; (4) advise patient of duty to notify HSN/MassHealth within 10 days of filing TPL claim/lawsuit, (5) retain documentation of those efforts; (6) where applicable, submit a claim for payment to the motor vehicle liability insurer; and (7) if any portion of the claim was previously billed to the HSN, report any recovery to the HSN.c. Holyoke Medical Center, Inc. will not garnish a low income patient's or their guarantor's wages or execute a lien on the low income patient's or their guarantor's personal residence or motor vehicle unless: (1) Holyoke Medical Center, Inc. can show that the patient or their guarantor has the ability to pay; (2) the patient/guarantor did not respond to HMC requests for information or the patient/guarantor refused to cooperate with HMC to seek an alternative financial assistance program; or (3) for purposes of a lien, it was approved by Holyoke Medical Center, Inc.'s Board of Trustees on an individual case-by-case basis.d. Holyoke Medical Center, Inc. may cease any collection or billing actions against a patient who is unable to pay Holyoke Medical Center, Inc.'s bill at any time during the billing process, if the patient is eligible for assistance under financial assistance programs that HMC may, in its discretion, make available from time-to-time. Holyoke Medical Center, Inc. will keep any and all documentation that shows a patient met the criteria for such programs.e. Holyoke Medical Center, Inc. and its agents shall not continue collection or billing on a patient who is party to bankruptcy proceedings except to secure its rights as a creditor in the appropriate order.f. Holyoke Medical Center, Inc. and its agents will not charge interest on an overdue balance for a low income patient or for patients who are eligible for financial assistance programs that HMC may in its discretion make available from time-to-time. Part VI, Line 2: Holyoke Medical Center conducts a Community Health Needs Assessment (CHNA) of the community it serves every three years in conjunction with numerous agencies. As part of the CHNA, community meetings were held with numerous local agencies including Holyoke Housing Authority residents, Holyoke City Officials, Holyoke High and Dean Vocational High School students, Holyoke Medical Center (Valley Health Systems' staff members, including representatives from Holyoke Medical Center, River Valley Counseling Center and Holyoke Visiting Nurse Association), The Salvation Army Holyoke representatives, Lorraine's Soup Kitchen community members, and board members from the Chicopee Chamber of Commerce, House of Color LGBTQ+ Support Group staff and members of their group, Holyoke residents at Key Foods Grocery Store on three occasions and public school therapists. HMC Community Benefits maintains partnerships with many of these agencies throughout the year to continue to assess community needs. HMC conducted over 30 stakeholder interviews for its 2022 CHNA, which included meeting with two Council on Aging directors from Holyoke, Chicopee and South Hadley; Board of Health Directors from Holyoke, South Hadley, Chicopee and West Springfield; Holyoke's Mayor, Director of Planning and Economic Development, a City Councilor, and Chief of Police; the Holyoke Boys & Girls Club' Executive Director, Holyoke and South Hadley's Housing Authority, Holyoke Health Center's Chief Medical Officer, MA State Representative, Pat Duffy, MA State Senator, John Velis, Valley Opportunity Council, Lorraine's Soup Kitchen Executive Director, WestMass ElderCare, Action Ambulance, River Valley Counseling, OneHolyoke CDC, Holyoke Public Schools Superintendent, two of HMC's Nurse Navigation members, and the Community Benefits Advisory Committee which includes representatives from HMC, The Salvation Army, OneHolyoke CDC, Hampden County Sheriff's Department, HMC Behavioral Health, Holyoke Boys & Girls Club, Holyoke Health Center and River Valley Counseling Center, among others. In addition, as part of the CHNA process, HMC implemented a survey with over 60 questions in English and Spanish, among over 400 community members. These questions were developed with the Western Massachusetts Hospital Coalition so that all involved asked the same questions in the various communities they serve. This collaboration and consistency allows data to be shared and analyzed between the other Western Massachusetts hospitals so that solutions can be worked on regionally through the Community Health Improvement Plan (CHIP). The results help to inform the Holyoke Medical Center's Strategic Implementation Plan and the type of programming to offer in the community to help address the needs identified. In addition to the CHNA, HMC uses the Thrive survey, a tool used to screen for social determinants of health. Based on the responses, providers are able to make referrals for those showing need in areas of housing, food, paying for medication, caring for a dependent, paying for utilities, domestic violence, and transportation. In 2022, HMC provided 13,000 THRIVE screenings and referred those in need to resources.HMC Community Benefits Director also participates in a variety of boards and committees to continually assess the needs of the community and create relationships with non-profit organizations for their feedback. These include the Greater Holyoke Chamber, Girls Inc. of the Valley, The Salvation Army, Hampden County Community Health Improvement Plan committee through Pioneer Valley Planning Authority - Community Team 4 Healthy and Active Living, Holyoke Food & Resources with State Representative, Pat Duffy, Holyoke High Dean Campus Program Advisory Committee, Let's Move Hampden County, 5210 committee, McKinney-Vento Homeless Coalition for Holyoke Public Schools, McKinney-Vento Homeless Coalition for Chicopee Public Schools, Safe Routes to School - Walking School Bus, School Community Health Advisory Council for Holyoke Public Schools, Westover Job Corps Community Relations Council and Western Mass Hospital Coalition. These meetings not only serve the respective organization's specific community, they also connect the hospital to many other community based organizations who are participants. In addition, other HMC staff participate in other committees and boards including the Greater Chicopee Chamber of Commerce, Holyoke Rotary, Holyoke HUB, and the Greater Holyoke YMCA to name a few. Key Objectives:The objective of Holyoke Medical Center's 2022 Community Health Needs Assessment was to: 1. Look at the 2019 findings and identify which key health issues and concerns remain the same for the residents in Holyoke Medical Center's primary service area. 2. Identify the vulnerable populations that are experiencing health disparities. 3. Look at other contributing factors that create barriers to living healthier lives.CHNA Conclusions: Holyoke Medical Center gathered comments put forward from the community and narrowed the list down to the top common priority areas from the community input. HMC also developed a set of principles to help determine our highest priorities and guide our decision-making process regarding community benefits. Holyoke Medical Center's goals are to: 1. Increase access to care centered on the Social Determinants of Health. 2. Serve vulnerable and underserved populations especially with chronic conditions. 3. Concentrate on the greatest level of community concern and most consistent with the organization's strengths.Significant Health Needs Identified in Order of Priority Include: Social and Economic Issues that Impact Health:- Transportation- Cultural awareness- Employment training for youth- Housing Security and HomelessnessAccess to Healthcare in the following areas:- Primary Care- Mental health services- Affordable medications- Assistance with finances and insurance- Educational resources- Food security- Affordable housingCommunication Assistance Needed to Improve Health Outcomes:- Understanding of Doctor's Instructions- Simplified terminology by providers for patients understanding- Instructions provided in preferred language (written and spoken)- Promotion of educational resources and support groups- Social Interactions for Seniors- Medication managementHealth:- Pain management- Substance use of drugs and alcohol- Mental health- Upper respiratory disease- Asthma- Obesity- Dementia and Alzheimer's- DiabetesVulnerable Populations:- Low income residents who lack access to healthcare- Residents that lack transportation- People who struggle with drug addiction/overdose challenges- Older adults especially with language barriers- Residents with chronic mental illness- Children in our target area- Homeless- Veterans- Spanish speaking families- People who are overweight or obese- Youth at RiskIt is important not to overlook the substantial contribution that the hospital makes to the community through our many educational programs, and our support of community events. HMC will continue to monitor these programs for their need and effectiveness in the community, and, working with our community partners, assess for gaps in the needs of the community that are not being filled.The 2022 CHNA was conducted using a social determinant of health framework as it is recognized that social and economic determinants of health contribute substantially to population health. It has been estimated that less than a third of our health is influenced by our genetics or biology. Our health is largely determined by the social, economic, cultural, and physical environments that we live in and the healthcare we receive.Among these "modifiable" factors that impact health, social and economic factors are estimated to have the greatest impact. The County Health Rankings model, developed by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, estimates the extent to which these modifiable factors contribute to health based on reviews of the scientific literature and a synthesis of data from a number of national sources. It is estimated that social and economic factors account for (40%) of our health, followed by health behaviors (30%), clinical care (20%), and the physical environment (10%). Many health disparities occur as a result of inequities in these determinants of health.In addition to the community meetings, stakeholder meetings, and survey, HMC outsourced MySidewalk to help collect data from a large number of sources that include, USDA, US Census, local data and hospital data and helped HMC develop an online version of our CHNA that will be updated annually and not have to wait for three years for the next CHNA.(This narrative is continued later in the supplemental statements.) Part VI, Line 3: 1) General Principles:Holyoke Medical Center, Inc. or its agents will assist uninsured and underinsured patients with the process of applying for available financial assistance programs that may pay for some or all of their hospital bills. In order to help uninsured and underinsured patients find and apply for available financial assistance, HMC will provide all patients with a general notice of the availability of programs by way of posted notices throughout HMC and by way of individual notices to patients. The goal of these notices is to inform patients regarding the availability of financial assistance, as well as assistance with the application process. Holyoke Medical Center, Inc. will assist patients with the application process for the following Massachusetts programs: MassHealth, Commonwealth Care, CMSP, Healthy Start, Health Safety Net, and Medical Hardship through the Health Safety Net. Holyoke Medical Center, Inc. will provide, upon request, specific information about: (a) the eligibility criteria to be a low income patient under the Massachusetts Health Safety Net program or (b) additional financial assistance programs that HMC may in its discretion make available to low income patients from time-to-time. Holyoke Medical Center, Inc. will also notify the patient about available payment plans that may be available to them pursuant to HSN regulations.2) Role of Hospital Patient Financial Counselors and Other Finance Staff:Holyoke Medical Center, Inc. will attempt to identify available coverage options for patients who may be uninsured or underinsured when the patient is scheduling services, while the patient is at HMC, upon discharge and for a reasonable time following discharge. Holyoke Medical Center, Inc. will direct all patients seeking available coverage options to HMC's Patient Financial Counseling office for eligibility screening and assistance with the application process, including the application process for financial assistance programs that HMC may in its discretion make available to low income patients from time-to-time.Holyoke Medical Center, Inc. will also provide information on how to contact the appropriate staff within the hospital's Finance Department to verify the accuracy of the hospital bill or to dispute certain charges.3) Notification Practices:Holyoke Medical Center, Inc. will post a notice (signs) of availability of financial assistance in the following locations: a. Service delivery areas (e.g., inpatient, clinic, emergency department admission and/or registration areas); b. Patient financial counselor areas; c. Central admission/registration areas; and/or d. Business office areas that are open to patients.Posted signs will be clearly visible and legible to patients visiting these areas. The hospital will also include a notice about the availability of financial assistance in all initial bills.When a patient contacts the hospital, the hospital finance staff will attempt to identify if a patient qualifies for a public financial assistance program or a payment plan. A patient who is enrolled in a public financial assistance program (e.g., MassHealth or the Health Safety Net) may qualify for certain plans. Patients may also qualify for additional assistance based on the hospital's own internal criteria for financial assistance or qualify for coverage of services as a medical hardship based on the patient's documented income and allowable medical expenses.For cases in which the hospital is using the Virtual Gateway application, the hospital will assist the patient in completing the application for MassHealth, Commonwealth Care, Children's Medical Security Plan, Health Start, Health Safety Net, or other forms of financial assistance programs as they become part of the Virtual Gateway program.All signs and notices shall be translated into languages other than English if such language is primarily spoken by 10% or more of the residents in the hospital service area, which is based on the hospital admissions and/or discharge information. Part VI, Line 4: The primary service area for Holyoke Medical Center includes the five communities of Holyoke, Chicopee, South Hadley, Westfield, and West Springfield, all of which are located in Hampden County and Hampshire Counties. The secondary service area of HMC includes Belchertown, Easthampton, Granby, and Southampton. The total population of the service area is over 180,000 people. The communities served are a mix of urban, suburban and rural. The median age in Hampden County is 39.4, while the median age in Hampshire County is 36.4. In Hampden County, there is a diverse population with 18.4% identifying as Black or African American, American Indian, Asian or a race besides White and 27% identifies as Hispanic or Latino. In Hampshire County, 12.4% of the population identifies as Black or African American, American Indian, Asian, or race besides White and 12.4% identifies as Hispanic or Latino. In Holyoke, more than half of the residents identify as Hispanic or Latino at 53.3% of the population. In Holyoke, 21% of homes do not have a vehicle vs. 11% of homes within HMC's primary service area and 12% of homes in Massachusetts. Public transit access is facilitated by the Pioneer Valley Transit Authority, which provides bus service to all of HMC's service area communities. Paratransit services are offered throughout the service area for people with disabilities within 3/4 mile of a fixed route. In addition, HMC provides free transportation through two shuttles within the city of Holyoke as well as door-to-door van service from areas not serviced by the shuttle. Economically, there is significant variation between communities in the HMC service area. The median income for the service area is $66,200, which is considerably less than the state's median income of $89,026. Within HMC's primary service area, 14% of the population live in poverty vs. 10% of the population in all of Massachusetts. On a community-level, there is wide variation, with Holyoke's median household income at $45,045 and nearby South Hadley's median household income at $82,987. In the service area, the overall percentage of those who pay more than 30% of their income for housing costs is 46% of rented homes and 23% of owned homes. Again, these figures vary within the service area, where 49% of renters and 25% owners in Holyoke are cost-burdened. Part VI, Line 5: The impact of Holyoke Medical Center, Inc.'s (HMC) outreach efforts are evidenced by the fact that countless service agencies rely on HMC to ensure their own success. HMC conducts a triennial Community Health Needs Assessment which not only helps to guide the Strategic Implementation Plan and Community Benefits programming, but it is also used by internal departments and community partners as a resource for grant writing. Key accomplishments from the 2023 tax year include: 1. CHNA Completion and Continuation: In a past tax year, Holyoke Medical Center completed the triennial Community Health Needs Assessment, which provided key data and information about the challenges and opportunities heard through community engagement with residents and community leaders. This information continues to help guide the hospital's Strategic Implementation Plans, as well as to help us to serve those most in need. The Hospital continuously works to address the health needs identified in the CHNA and has outlined its strategies to do so in its 2020-2023 and 2023-2026 CHNA Implementation Plan reports. 2. Continued to strengthen overdose prevention strategies and provide treatment for substance use disorder: Holyoke Medical Center's Comprehensive Care Center provided outpatient treatment for individuals looking to reduce or stop substance use. Recovery coaches help to support individuals coming through the Emergency Department (ED) for substance misuse. 3. Utilization of Thrive Screening: Using this social determinants of health screening tool, Holyoke Medical Group providers are able to make referrals for those showing need in areas of housing, food, paying for medication, caring for a dependent, paying for utilities, domestic violence, and transportation. 4. Education: Both on site and in the community, education continued to be a priority for HMC. Health education continued in the community both remote and in-person during the year. HMC staff provided educational health workshops to area residents at senior centers, the public library, schools and non-profit organizations. In addition, HMC continued distribution of its newsletter, which included topics such as chronic disease management and prevention. Holyoke Medical Center also continued to support agencies that focus on educational needs for disadvantaged youth. Key education service statistics during the 2024 fiscal year included the following: - Over 200,000 educational magazines were distributed. - 2,160 visits from youth to school-based health clinics. - 699 individuals provided with financial counseling and financial literacy assistance. - 46,000 hours spent on educating and training nursing students and interns; 8,700 hours with nurse practitioners and physician assistant students; and another 1,100 hours with students aspiring to become physicians. 5. Holyoke Medical Center continued to address food insecurity and to help provide access to proper nutrition and food resources. During the 2024 fiscal year, the Hospital provided 2,950 meals, and the Hospital estimates that over 5,000 people attended the farmers markets held at the Medical Center. 6. Improving transportation and access to care remains a priority for the communities that Holyoke Medical Center serves. 11% of homes in HMC's primary service area and 21% of homes in Holyoke do not have a vehicle. To address this community challenge, the Hospital continued to provide transportation assistance and transit services, including the following in the 2024 fiscal year: - The operation of two community shuttles, which served over 16,000 patients. - The coordination of over 2,200 rideshares. - Valet parking assistance for 15,871 vehicles. - Door-to-door transportation services for more than 4,400 patients. 7. For patients whose preferred language is not English, there are many resources available. Over 90% of such patients use Spanish as their preferred language. American Sign Language and Polish are the second and third most frequently used language after Spanish at our campus. HMC's Interpreter Services in-house Spanish speaking Medical Interpreters are available seven days a week. Additionally, we have Language Mediators who are staff members with interpretive capabilities, serving primarily in their home department in several languages. HMC also has service contracts with two local interpretive companies. If an interpreter for a particular language is not available in person, we rely on an appropriate interpreter through several nationally recognized remote telephonic and video interpreting language company services. Further, the Community Outreach staff are readily available to offer bilingual information about our health services. Support groups and information sessions are usually bilingual in Spanish and English. We have the ability to support other languages. When someone is discharged from the hospital, there is also a Community Navigation team in the Call Center that follows up with the patient to make sure they understand the doctor's instructions and see if they need any additional help or resources. They routinely use telephonic interpreting services when they do not have the ability to communicate in the preferred language of the patient. During the 2024 fiscal year, HMC provided interpretive services in 39 languages across 40,000 unique patient encounters. 8. Family Services: Holyoke Medical Center is proud to offer support and services to families, including young children and mothers. For example, during the 2024 fiscal year, the Hospital: - Assisted 100 mothers going back to school to earn their HiSET while their babies received care through the HMC Family Care Center. - Participated in an Adopt-a-Family Initiative, where 434 employees of the Hospital helped to provide 141 children with over 500 gifts, donate over 60 grocery store gift cards, and support 51 families in the area. 9. Community Health Responses: Access to care, support resources, and drug and substance prevention and rehabilitation remain important public health issues in the Hospital's community. In response to these critical health concerns, during this 2024 fiscal year, the Hospital: - Provided 399 patients with in-home blood testing, who due to mobility issues would otherwise not be able to obtain such care. This amounted to 6,441 offsite blood draws, primarily assisting veterans. - Referred 47 accountable care organization patients to secure housing solutions. - Treated over 1,300 patients through HMC's addiction counseling services. 58% of these patients came through the ED, 19% of which were being seen in response to an overdose. Through these engagements HMC dispensed 788 doses of take-home naloxone to prevent lethal overdoses. - Provided 284 patients with uncompensated legal assistance.Through these efforts and more, Holyoke Medical Center remains committed to advancing the general health and wellbeing of its community. Part VI, Line 6: Holyoke Medical Center (HMC) is a 219-bed independent community hospital with over 1,600 employees serving individuals and families throughout the cities and towns of the Pioneer Valley. The medical staff includes more than 375 physicians and consulting staff. Holyoke Medical Center is a nationally-accredited hospital and is the first and only hospital in Western Massachusetts to obtain the prestigious accomplishment of becoming certified in the ISO 9001:2015 Quality Management System. Among some of the top-rated services at Holyoke Medical Center is the award winning Holyoke Medical Center Stroke Service which has been consistently rated as one of the best in the state. HMC received the Top Hospital Award in 2020, 2016, and 2014 from the Leapfrog Group for excellence in quality of care and patient safety. Areas of clinical emphasis also include behavioral health, critical care, emergency care, orthopedics, oncology, rehabilitation, women's health services, speech and hearing, bariatric, and wound care services.Holyoke Medical Center is a member of Valley Health Systems in Holyoke, which also includes the affiliates Holyoke Medical Group, Holyoke Visiting Nurse Association & Hospice Life Care, and River Valley Counseling Center. Our Mission at Holyoke Medical Center is to improve the health of all people in our community. We do that with honesty, respect and dignity for our patients, visitors and staff. We do that through expert and compassionate care, education and knowledge sharing, community partnerships, fostering innovation and growth and by inspiring hope in all we touch. We do that by being good stewards of our resources and providing efficient and cost effective care to all.The Community Benefit Mission Statement is to collaborate with community partners to assess and improve the health needs of our residents. We will do this by providing resources, education, and services to address the needs of our most vulnerable community members Part VI, Line 7, Reports Filed With States MA Part VI, Line 5, Continued: Part VI, Line 2, Continued: The Implementation Plan was completed in January of 2023 with our Community Benefits Advisory Committee meeting over several months to help develop. Members of the Community Benefits Advisory Committee include:- The Salvation Army of Greater Holyoke- Greater Holyoke YMCA- One Holyoke CDC- Holyoke Housing Authority- Holyoke Boys and Girls Club- River Valley Counseling Center- Holyoke Medical Center Nurse Navigation/Community Health Worker- Providence Ministries for the Needy- Holyoke Medical Center Behavioral Health- Holyoke Medical Center ACO Operations - Holyoke Board of Health - HMC Addiction Consult Services 1 Nueva Esperanza Inc 401 Main Street Holyoke MA 01040 042774010 501(c)(3) 20000 0 Charitable Mission and Event Sponsor St Patrick's Parade Committee of Holyoke PO Box 871 Holyoke MA 01040 042633859 501(c)(3) 9350 0 Charitable Mission and Event Sponsor City of Chicopee 17 Springfield Street Chicopee MA 01013 GOV 7000 0 Charitable Mission and Event Sponsor 3 0 Employee Emergency Financial Relief 25 18041 Part I, Line 2: The Hospital awarded sponsorship and grants to various tax-exempt organizations, public charities, or municipalities, and so additional monitoring is not deemed necessary. The Hospital also maintains a restricted fund to provide emergency financial relief to qualifying employees. Awards for financial relief paid to employees range from $500-$1,000 per payment. 0 1 0 0 0 0 0 0 0 Spiridon E Hatiras President & CEO, Clerk 0 920224 0 0 0 0 0 55147 0 21559 0 996930 0 0 Noah J Epstein MD Orthopedic Surgeon 950463 0 0 0 0 0 3300 0 21941 0 975704 0 0 0 Andrey Pavlov MD Pulmonologist 962720 0 0 0 0 0 0 0 3062 0 965782 0 0 0 Alexander Berry MD Urologist 922932 0 0 0 0 0 3300 0 21941 0 948173 0 0 0 Marc J Zerbe MD Obstetrician/Gynecologist 847071 0 0 0 0 0 3300 0 21941 0 872312 0 0 0 Nirav R Sheth MD Cardiologist 798976 0 0 0 0 0 3300 0 21941 0 824217 0 0 0 Simon Ahtaridis MD Director/Medical Director 373911 0 0 0 0 0 26479 0 15052 0 415442 0 0 0 Dean Vitarisi Treasurer & CFO 0 351730 0 0 0 0 0 26322 0 21941 0 399993 0 0 John Mazzucco MD Director/General Surgeon 360713 0 0 0 0 0 3300 0 16598 0 380611 0 0 0 Part I, Line 3 The compensation for the Organization's CEO was established by a related organization, Valley Health Systems, Inc. That organization established the CEO's compensation by using a compensation committee and a compensation study. The compensation was also approved by the System's compensation committee. Part I, Line 4b Holyoke Medical Center adopted a 457(f) non-qualified deferred compensation plan that became effective as of July 1, 2017. The Plan allows for eligible individuals and employees of the Medical Center to receive benefits under the Plan until the attainment of age 65. Non-elective contributions made for a Plan participant are tracked and will vest separately based on anniversaries of participants' employment. Each contribution will be 0% vested until the participant reaches the end of their second year of employment after each contribution. Each contribution will become 100% vested as of the last day of the 2nd year of a participant's employment, if the participant is still employed on that date. Only eligible employees are participants in the plan, and the plan does not allow for employee elective deferrals or employer matches. For the 2023 calendar tax year, the following listed individuals received 457(f) contributions under the plan are: - Spiros Hatiras, $51,847. - Dean Vitarisi, $23,022. - Simon Ahtaridis, $23,179. A Massachusetts Development Finance Agency 043431814 2015-12-18 15000000 Construction of Addition to Hospital Facility & Parking Lot 0 0 0 A 1947509 15000000 509511 622161 16940433 2017 0 0 0 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 0 A 0 1 0 0 1 0 0 0 0 A 0 Schedule K, Part III; Part IV; and Part V Although formal written policies are not in place to ensure that violations are timely identified and corrected, the bonds issuer, monitors regulation Sections 1.141-12, 1.145-2, and 148 requirements for the Organization. Furthermore, the Organization works closely with bond counsel to monitor any lease agreements or management service contracts that have the potential to result in private business use and to ensure that safeguards are in place to take appropriate and timely remedial action should any violations of federal tax requirements occur. Form 990, Part VI, Section A, line 2 Certain officers and directors of Holyoke Medical Center, Inc. are employed by a related tax-exempt organization with common officers and/or directors with the Medical Center. By virtue of this arrangement, certain individuals listed on this Form 990, Part VII have a business relationship with one another. Form 990, Part VI, Section A, line 6 The sole member of Holyoke Medical Center is Valley Health Systems, Inc. Form 990, Part VI, Section A, line 7a Valley Health Systems, Inc. elects the members of the governing body of Holyoke Medical Center, Inc. Valley Health Systems, Inc. also has the power to remove any member of the governing body, with or without cause, at any time by giving written notice to such governing body member. Form 990, Part VI, Section A, line 7b Significant decisions of the governing body of Holyoke Medical Center, Inc. are subject to the approval of Valley Health Systems, Inc. as specified in the Organization's bylaws. Form 990, Part VI, Section B, line 11b A copy of the Hospital's Form 990 was provided to each voting member of the governing body prior to its filing with the Internal Revenue Service. The Form 990 was prepared with the assistance of an independent public accounting firm and thoroughly reviewed by the Senior Vice President of Finance and CFO and key financial staff of the Hospital prior to distributing it to the governing body for review. Form 990, Part VI, Section B, line 12c The conflict of interest policy of Holyoke Medical Center, Inc. (HMC) is monitored and enforced as part of the Valley Health Systems, Inc. System and is reviewed annually by the System's conflict of interest committee. HMC board members, officers, and key employees complete and sign a conflict of interest questionnaire annually. All signed questionnaires are then submitted to HMC and to Valley Health Systems, Inc. (parent) for review and monitoring. Form 990, Part VI, Section B, line 15 The compensation committee of the Valley Health System, Inc. utilizes a market compensation survey to recommend to the Board the approval of its determination of the appropriate compensation of the Chief Executive Officer. During that process, the Committee also reviews the compensation levels of other senior management and key employees of the System. These individuals are not members of the compensation committee and do not participate in this process. The CEO, as a member of the Board of VHS, does not participate in the approval process of that officer's compensation. Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest policy, and financial statements of Valley Health Systems and Affiliates, which includes supplemental information of the filing entity, are available to the public upon request at the Organization's administrative office at 575 Beech Street, Holyoke, MA. Form 990, Part VI, Section B, Line 16b: Holyoke Medical Center does not have a separate, formal joint venture policy. However, all joint venture arrangements and similar business agreements are subject to the review, approval, and oversight of the Organization's top management and operational officials, including the CEO and COO. The Organization's legal counsel also reviews all joint venture agreements or similar contracts to ensure the arrangements are in compliance with applicable law. Additionally, the Organization's CFO and Director of Financial Planning review any joint venture or similar activities closely and regularly. Accordingly, while there is no separate joint venture policy, any business arrangements that are similar in nature to a joint venture are thoroughly monitored and regularly reviewed to ensure that such activities are compliant with requisite laws and regulations, and that any such activities also contribute meaningfully to the Organization's ability to fulfill its charitable purpose. Form 990, Part VII: Simon Ahtaridis, MD, and John Mazzucco, MD are listed on Form 990, Part VII as voting members of the Hospital's board of directors. In accordance with IRS instructions, each has reportable compensation and benefit information disclosed on Part VII. However, each person is a licensed, full-time physician-employee of the Hospital or one of its affiliates, and their compensation and benefits represents remuneration in their capacity as such. No part of their reportable compensation or benefits is paid in their capacity as board members of the Hospital. Form 990, Part IX, Column D: All philanthropic and solicitation activity is carried out by Holyoke Medical Center affiliates. Therefore, no expenses have been allocated as fundraising expenses on Form 990, Part IX. Form 990, Part XI, line 9: Net transfers (to)/from affiliates -1,210,000. Change in beneficial interest - VHS 586,357. Pension-related changes other than net periodic costs -2,774,233. Form 990, Part XII, Line 2c: The audit process has not changed from the prior year. Community Health Foundation of Western Mass Inc 575 Beech Street Holyoke MA 01040 222568962 Raise & Invest Funds for Affiliates MA 501(c)(3) Line 7 Valley Health Systems Inc 0 H-C Management Services Inc 20 Hospital Drive Holyoke MA 01040 222515981 Supporting Organization MA 501(c)(3) Line 12b, II Valley Health Systems Inc 0 Holyoke Visiting Nurse Association Inc 575 Beech Street Holyoke MA 01040 042104310 Home Health Care MA 501(c)(3) Line 10 Valley Health Systems Inc 0 MassWest Services Inc 575 Beech Street Holyoke MA 01040 222515964 Health Care MA 501(c)(3) Line 12b, II Valley Health Systems Inc 0 River Valley Counseling Center Inc 187 High Street Holyoke MA 01040 042174657 Outpatient Mental Health MA 501(c)(3) Line 10 Valley Health Systems Inc 0 Valley Health Systems Inc 20 Hospital Drive Holyoke MA 01040 042103583 Health Care MA 501(c)(3) Line 7 N/A 0 Western Mass Physician Associates Inc 15 Hospital Drive Holyoke MA 01040 043202198 Medical Care Services MA 501(c)(3) Line 3 MassWest Services Inc 0 William Skinner TUA-Holyoke Hospital Trust PO Box 1802 Providence RI 029011802 046035855 Grantmaking MA 4797(a)(1) PF Valley Health Systems Inc 0 0 0 1 1 0 0 0 0 0 1 1 1 1 1 1 0 0 1 1