BAYSTATE NOBLE HOSPITAL CORPORATION: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- BAYSTATE NOBLE HOSPITAL CORPORATION (EIN 22-2537423)
- Tax period
- 2018-10-01 to 2019-09-30
- Filed
- 2020-08-13
- IRS object ID
- 202042269349300529
- Schema version
- 2018v3.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-08-13T13:20:58-05:00 | ReturnTs |
| Tax Period End | 2019-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | Two Jericho Plaza | AddressLine1Txt |
| City | Jericho | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11753 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 222537423 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Baystate Noble Hospital Corporation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BAYS | BusinessNameControlTxt |
| Phone | 4135682811 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 115 West Silver Street | AddressLine1Txt |
| City | Westfield | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 010861634 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Raymond McCarthy | PersonNm |
| Person Title | Interim SVP, CFO and Treasurer | PersonTitleTxt |
| Phone | 4135682811 | PhoneNum |
| Signature | 2020-08-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Jeanne Fahrenbach | PreparerPersonNm |
| PTIN | P01365953 | PTIN |
| Phone | 5169187000 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 208.99.255.62 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-08-13 | IPDt |
| IP Tm | 13:05:14 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | BD88743F010F9F35FF8FC0562FA147AF9CEA6F78 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-23 17:36:50Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Raymond McCarthy | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 759 Chestnut Street | AddressLine1Txt |
| City | Springfield | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01199 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $55,434,483 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BAYSTATENOBLEHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1984 | FormationYr |
| Legal Domicile State | MA | LegalDomicileStateCd |
| Activity Or Mission | The mission of the organization is to improve the health of the people in our communities everyday, with quality and compassion. | ActivityOrMissionDesc |
| Voting Members Governing Body | 24 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 19 | VotingMembersIndependentCnt |
| Total Employee | 669 | TotalEmployeeCnt |
| Total Volunteers | 45 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $326,814 | PYContributionsGrantsAmt |
| CY Contributions Grants | $600,901 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $55,193,256 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $52,848,608 | CYProgramServiceRevenueAmt |
| PY Investment Income | $40,416 | PYInvestmentIncomeAmt |
| CY Investment Income | $50,638 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,453,779 | PYOtherRevenueAmt |
| CY Other Revenue | $1,787,139 | CYOtherRevenueAmt |
| PY Total Revenue | $57,014,265 | PYTotalRevenueAmt |
| CY Total Revenue | $55,287,286 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $32,770,476 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $33,834,351 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $23,954,771 | PYOtherExpensesAmt |
| CY Other Expenses | $26,275,191 | CYOtherExpensesAmt |
| PY Total Expenses | $56,725,247 | PYTotalExpensesAmt |
| CY Total Expenses | $60,109,542 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $289,018 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$4,822,256 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $40,984,125 | TotalAssetsBOYAmt |
| Total Assets EOY | $48,479,638 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $24,213,082 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $33,820,665 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $16,771,043 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $14,658,973 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The mission of the organization is to improve the health of the people in our communities every day, with quality and compassion. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $31,373,737 | ExpenseAmt |
| Revenue | $24,184,129 | RevenueAmt |
| Desc | Inpatient healthcare services - Providing inpatient community-based medicine and tertiary care to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY2019, Baystate Noble Hospital provided 15,718 patient days of inpatient services. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $16,479,802 | ExpenseAmt |
| Revenue | $15,625,371 | RevenueAmt |
| Desc | Outpatient healthcare services - Providing outpatient clinical services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY2019, Baystate Noble Hospital had 69,664 outpatient visits. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $10,794,125 | ExpenseAmt |
| Revenue | $11,503,011 | RevenueAmt |
| Desc | Emergency department services - Providing emergency department services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY2019, Baystate Noble Hospital had 27,620 emergency department visits. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $38,607 | ExpenseAmt |
| Revenue | $3,974,775 | RevenueAmt |
| Desc | Other program services - Providing laboratory andrespiratory services to the surrounding region. Services are availableto individuals regardless of their ability to pay. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $38,607 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $3,974,775 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $58,686,271 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (1) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 62 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 669 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 24 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 19 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | John Shaver - Baystate Noble Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4135682811 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 115 West Silver Street | AddressLine1Txt |
| City | Westfield | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01085 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| John F Maybury | |||||||||
| Chair (as of 1/1/19) | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Robert J Bacon | |||||||||
| Vice Chair (as of 1/1/19) | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Adrian J Levsky | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Aleksandr Pugach MD | |||||||||
| Trustee (thru 12/31/18)/Internist | 45.00 | 5.00 | Yes (X) | $224,520 | $0 | $11,269 | |||
| Anne M Paradis | |||||||||
| Trustee/Chair (Through 12/31/18) | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Claudia R Coplein DO | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Colleen W Holmes | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Edward J Noonan | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Gregory L Braden MD | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Harriet A DeVerry | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Hector Toledo | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Irene Rodriguez Martin | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| James R Phaneuf | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| John A Egelhofer MD | |||||||||
| Trustee (thru 12/31/18) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Kathleen B Scoble | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Kevin P Moriarty MD | |||||||||
| Trustee/Chief Ped Surgery | 1.00 | 49.00 | Yes (X) | $702,493 | $0 | $31,882 | |||
| Maria P Goncalves | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Mark A Keroack MD | |||||||||
| Trustee/ President & CEO, BH | 1.00 | 49.00 | Yes (X) | $0 | $2,027,506 | $40,042 | |||
| Melissa D Cragg | |||||||||
| Trustee (as of 1/1/19) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Paul R Murphy | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Robert L Pura PhD | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Stanley Strzempko MD | |||||||||
| Trustee (as of 1/1/19) | 1.00 | 1.00 | Yes (X) | $7,500 | $0 | $0 | |||
| Timothy F Farrell | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| William R Webber | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Ronald P Bryant | |||||||||
| President | 20.00 | 30.00 | Yes (X) | $0 | $591,144 | $48,176 | |||
| Dennis Chalke | |||||||||
| Treasurer | 1.00 | 49.00 | Yes (X) | $0 | $947,658 | $90,444 | |||
| Kristin R Delaney | |||||||||
| Clerk | 1.00 | 49.00 | Yes (X) | $0 | $145,051 | $37,639 | |||
| Nancy Remillard | |||||||||
| Assistant Clerk (as of 11/13/18) | 1.00 | 39.00 | Yes (X) | $0 | $51,003 | $8,248 | |||
| John Shaver | |||||||||
| Chief Financial Officer | 25.00 | 25.00 | $257,804 | $0 | $15,001 | Yes (X) | |||
| Michele Urban | |||||||||
| VP Patient Care Services/C | 50.00 | 0.00 | $237,943 | $0 | $13,924 | Yes (X) | |||
| Deborah A Kudla | |||||||||
| Director, Surgery | 50.00 | 0.00 | $178,617 | $0 | $5,977 | Yes (X) | |||
| Angela M Coti | |||||||||
| Registered Nurse | 50.00 | 0.00 | $154,789 | $0 | $9,371 | Yes (X) | |||
| Susan A Zak | |||||||||
| Registered Nurse | 50.00 | 0.00 | $145,118 | $0 | $24,716 | Yes (X) | |||
| Khalilah Fullard | |||||||||
| Manager, Pharmacy | 50.00 | 0.00 | $140,158 | $0 | $11,105 | Yes (X) | |||
| Jeffrey Cebula | |||||||||
| Manager, Accounting | 30.00 | 20.00 | $136,020 | $0 | $16,715 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,184,962 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,762,362 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $364,509 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 39 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| NTT Data Services LLC | |||||
| 7950 Legacy Drive Suite 900 | Plano | TX | 75024 | IT Sevices | $3,491,973 |
| Rehabcare Group EastInc | |||||
| PO Box 502096 | St Louis | MO | 631502096 | Physical Rehabilitation | $2,109,048 |
| Morrison HealthcareInc | |||||
| PO Box 102289 | Atlanta | GA | 303682289 | Dietary Services | $1,440,226 |
| Crothall HealthcareInc | |||||
| 13028 Collection Center Drive | Chicago | IL | 60693 | Housekeeping Services | $1,134,889 |
| Springfield Anesthesia Service Inc | |||||
| 908 Allen Street | Springfield | MA | 01101 | Anesthesia Services | $864,023 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 20 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $23,803 | RelatedOrganizationsAmt |
| Government Grants | $547,334 | GovernmentGrantsAmt |
| All Other Contributions | $29,764 | AllOtherContributionsAmt |
| Total Contributions | $600,901 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Hospital Revenue | 622000 | $52,740,288 | $52,740,288 |
| Rental Income from Affiliate | 531390 | $94,247 | $94,247 |
| Medical Record Income | 622000 | $14,073 | $14,073 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $52,848,608 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $50,638 | TotalRevenueColumnAmt |
| Exclusion | $50,638 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $61,982 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $147,197 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$85,215 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$85,215 | TotalRevenueColumnAmt |
| Exclusion | -$85,215 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| Intercompany Charges | 621400 | $1,863,438 | $1,863,438 | |
| Respiratory Therapy | 621400 | $4,976 | $4,976 | |
| Gift Shop Revenue | 561499 | $303 | $303 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,637 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,637 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,872,354 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $55,287,286 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $54,715,683 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$29,298 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $524,672 | TotalAmt |
| Program Services | $251,867 | ProgramServicesAmt |
| Management And General | $272,805 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,067,492 | TotalAmt |
| Program Services | $27,722,840 | ProgramServicesAmt |
| Management And General | $344,652 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $689,839 | TotalAmt |
| Program Services | $679,965 | ProgramServicesAmt |
| Management And General | $9,874 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,452,032 | TotalAmt |
| Program Services | $2,240,447 | ProgramServicesAmt |
| Management And General | $211,585 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,100,316 | TotalAmt |
| Program Services | $1,932,291 | ProgramServicesAmt |
| Management And General | $168,025 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,537 | TotalAmt |
| Program Services | $28,121 | ProgramServicesAmt |
| Management And General | $28,416 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,000 | TotalAmt |
| Management And General | $75,000 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,978 | TotalAmt |
| Management And General | $93,978 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,435,854 | TotalAmt |
| Program Services | $4,435,854 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,930 | TotalAmt |
| Program Services | $3,930 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,145,429 | TotalAmt |
| Program Services | $1,042,084 | ProgramServicesAmt |
| Management And General | $103,345 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,813,813 | TotalAmt |
| Program Services | $1,813,813 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,324,771 | TotalAmt |
| Program Services | $1,324,771 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,046 | TotalAmt |
| Program Services | $14,815 | ProgramServicesAmt |
| Management And General | $4,231 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,876 | TotalAmt |
| Program Services | $15,451 | ProgramServicesAmt |
| Management And General | $425 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $324,279 | TotalAmt |
| Program Services | $324,279 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $758,179 | TotalAmt |
| Program Services | $758,179 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,465,827 | TotalAmt |
| Program Services | $3,389,579 | ProgramServicesAmt |
| Management And General | $76,248 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $274,378 | TotalAmt |
| Program Services | $274,378 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Purchased Services | $7,748,551 | $7,748,551 | |
| Medical Supplies | $4,643,544 | $4,643,544 | |
| Dues | $45,210 | $10,523 | $34,687 |
| Equipment Rentals | $18,853 | $18,853 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,136 | TotalAmt |
| Program Services | $12,136 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,109,542 | TotalAmt |
| Program Services | $58,686,271 | ProgramServicesAmt |
| Management And General | $1,423,271 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $575,160 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,648,546 | BOYAmt |
| EOY | $7,287,002 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $852,466 | BOYAmt |
| EOY | $947,687 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $226,381 | BOYAmt |
| EOY | $183,660 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $90,441,213 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $56,584,568 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,565,956 | BOYAmt |
| EOY | $33,856,645 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,348,945 | BOYAmt |
| EOY | $4,283,356 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,341,831 | BOYAmt |
| EOY | $1,346,128 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,984,125 | BOYAmt |
| EOY | $48,479,638 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,105,964 | BOYAmt |
| EOY | $9,384,375 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $559,518 | BOYAmt |
| EOY | $408,450 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,071,666 | BOYAmt |
| EOY | $958,155 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,791,101 | BOYAmt |
| EOY | $6,791,101 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,684,833 | BOYAmt |
| EOY | $16,278,584 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,213,082 | BOYAmt |
| EOY | $33,820,665 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,682,127 | BOYAmt |
| EOY | $9,676,669 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,208,368 | BOYAmt |
| EOY | $4,101,756 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $880,548 | BOYAmt |
| EOY | $880,548 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,771,043 | BOYAmt |
| EOY | $14,658,973 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,984,125 | BOYAmt |
| EOY | $48,479,638 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$4,822,256 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$4,733 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $2,714,919 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $93,978 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $93,978 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | Baystate Noble Hospital Corportation (BNH) pays membership dues to the Massachusetts Hospital Association (MHA), and the American Hospital Association (AHA). These organizations have advised us that portions of these dues are used for lobbying purposes for various healthcare matters at the state level. The portion of dues listed as lobbying expenses for the year ending September 30, 2019 is $93,978. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,276,484 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $96,757 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $162,470 | OtherExpendituresAmt |
| End Year Balance | $4,210,771 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,180,476 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $250,630 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $154,622 | OtherExpendituresAmt |
| End Year Balance | $4,276,484 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,846,559 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $539,708 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $205,791 | OtherExpendituresAmt |
| End Year Balance | $4,180,476 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,668,589 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $634,142 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $456,172 | OtherExpendituresAmt |
| End Year Balance | $3,846,559 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,696,725 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $358,112 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $386,248 | OtherExpendituresAmt |
| End Year Balance | $3,668,589 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.20910 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.79090 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $962,597 | OtherCostOrOtherBasisAmt |
| Book Value | $962,597 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $42,525,545 | OtherCostOrOtherBasisAmt |
| Depreciation | $25,614,143 | DepreciationAmt |
| Book Value | $16,911,402 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $46,953,071 | OtherCostOrOtherBasisAmt |
| Depreciation | $30,970,425 | DepreciationAmt |
| Book Value | $15,982,646 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $33,856,645 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| Accrued Pension Liability | $2,578,365 |
| Medical Malpractice Claims | $275,035 |
| Asset Retirement Obligation | $565,305 |
| Due to Affiliates | $12,859,879 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $16,278,584 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part V, Line 4 | FormAndLineReferenceDesc |
| Explanation | To provide ongoing support for the hospital and its mission to improve the health of the people in our community. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,088,096 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $294,796 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $793,300 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01320 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,597,942 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,789,771 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,808,171 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03010 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $149,366 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $46,247 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $103,119 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,835,404 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,130,814 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,704,590 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04500 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $167,211 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $167,211 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00280 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $177,211 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $177,211 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00300 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,012,615 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,130,814 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,881,801 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04800 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense | $1,276,757 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $68,383 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $20,143,991 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $21,169,701 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,025,710 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Baystate Noble Hospital Corporation | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 115 West Silver Street | AddressLine1Txt |
| City | Westfield | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01085 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | State License #2076 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | Psychiatric and Physical Rehabilitation | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Baystate Noble Hospital Corporation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Part V narratives | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | See Part V narratives | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Part V narratives | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://www.baystatehealth.org/patients/billing-and-financial-assistance | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://www.baystatehealth.org/patients/billing-and-financial-assistance | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://www.baystatehealth.org/patients/billing-and-financial-assistance | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Baystate Noble Hospital Corporation | Part V, Section B, Line 5: The input of the community and other important regional stakeholders was an important part of the CHNA process. A wide range of stakeholders took part in the 2019 CHNA process, including local and regional public health and health departments, other local municipal agencies, diverse community-based organizations, advocacy organizations, healthcare providers, and community residents. These stakeholders provided input through a CHNA Regional Advisory Council (RAC), focus groups, key informant interviews, community conversations, and community chats. Additionally, community forums were conducted towards the end of the CHNA process to vet preliminary findings with community members. Please refer to the hospitals' CHNA Appendix I for a complete listing of public health, community representatives, and other stakeholders included in the process. The CHNA RAC included representatives from each Coalition member hospital/insurer as well as public health and community stakeholders from each hospital service area. Stakeholders on the RAC included local and regional public health and health department representatives; representatives from local and regional organizations serving or representing medically underserved, low-income or populations of color; and individuals from organizations that represent the broad interests of the community. The Coalition conducted a stakeholder analysis to ensure geographic, sector (e.g. schools, community service organizations, healthcare providers, public health, and housing), and racial/ethnic diversity of RAC. The RAC met in workgroups (Data and Reports, Engagement and Dissemination, and Health Equity) to guide the consultants in the process of conducting the CHNA, and prioritizing community health needs, CHNA findings, and dissemination of information. Assessment methods and findings were modified based on the RAC's feedback. The RAC consisted of 31 participants, including Coalition members and consultants. The RAC met monthly from September 2018 through June 2019. Key informant interviews and focus groups were conducted to gather information used to identify priority health needs and engage the community. Key informant interviews were conducted with health care providers, health care administrators, local and regional public health officials, and local leaders that represent the interests of the community or that serve medically underserved, low-income, or populations of color in the service area. Interviews with local and regional public health officials identified priority health areas and community factors that contribute to health needs. Focus group participants included community organization representatives, community members (low-income, people of color, and others), and other community stakeholders. Topics and populations included: substance use, transgender health, older adults, youth, mental health, cancer care, gun violence, and rural food access. Key informant interviews and focus groups were conducted from February 2019 through March 2019. Focus groups and key informant interviews engaged residents primarily in Hampden County, but also across the region. The CHNA also used qualitative data from other hospital service areas as appropriate. Baystate Health held five Community Conversations and over 70 Community Chats. Community Conversations were larger bidirectional information-sharing meetings conducted for each Baystate Hospital service area and one done in Spanish in Springfield. For Community Chats, RAC members brought information about the CHNA and gathered priorities in regular meetings of service providers, community-based organizations, and hospital clinical staff and administrators. While these outreach efforts were spearheaded by Baystate Health, the engagement and findings benefitted all Coalition member hospitals/insurer. Conversations and Chats were held from January 2019 through April 2019 and engaged approximately 900 residents. Five Community Forums were held upon completion of this report to share and validate the findings. Two were offered in Spanish with approximately 100 individuals representing the broad interests of the community; participants in the focus groups, interviews, Conversations, and Chats; and community stakeholders representing medically underserved, low-income, and populations of color. |
| Baystate Noble Hospital Corporation | Part V, Section B, Line 6a: The Coalition of Western MA Hospitals/Insurer (Coalition) is a partnership between eight non-profit hospitals/insurer in western Massachusetts: Baystate Medical Center, Baystate Franklin Medical Center, Baystate Noble Hospital, Baystate Wing Hospital, Cooley Dickinson Hospital, Mercy Medical Center (a member of Trinity Health-New England), Shriners Hospitals for Children-Springfield, and Health New England, a local health insurer whose service area covers the four counties of western Massachusetts. The Coalition formed in 2012 to bring hospitals within western Massachusetts together to share resources and work in partnership to conduct their triennial CHNAs and address regional needs. |
| Baystate Noble Hospital Corporation | Part V, Section B, Line 6b: The Coalition of Western MA Hospitals/ Insurer engaged the Public Health Institute of Western MA (PHIWM), based in Springfield, MA, as the lead consultant to conduct the CHNAs. PHIWM was supported by three other consultant teams; Community Health Solutions (CES), based in Northampton, MA; Franklin Regional Council of Governments (FRCOG), based in Greenfield, MA; and Pioneer Valley Planning Commission (PVPC), based in Springfield, MA. The Coalition includes Health New England, a local health insurer whose service area covers the four counties of western Massachusetts. |
| Baystate Noble Hospital Corporation | Part V, Section B, Line 7d: The hospital facility made its CHNA report widely available to the public via an email distribution, with links to the hospital's website, to community partners and organizations. In addition, the CHNA reports have informed the implementation of county wide community health improvement plans in Franklin and Hampden counties. Hospital and CHNA consultant staff have been invited to various venues and audiences to present on the CHNA process and key findings. The Coalition created a Facebook page, "Western MA CHNA", as a means to communicate with and engage the community throughout the CHNA process. All Coalition CHNAs were posted and shared via this Facebook page. |
| Baystate Noble Hospital Corporation | Part V, Section B, Line 11: The hospital facility anticipates health needs and available resources may change, therefore, a flexible approach was adopted in the development of its implementation strategy. For example, certain community health needs may become more pronounced and require changes to the initiatives identified by the hospital in the Strategy. Other community organizations may address certain needs, indicating that the hospital's strategies should be refocused on alternative community health needs or assume a different focus on the needs identified in the 2019 CHNA.The hospital facility views a community benefits implementation strategy as a "LIVING" document. Baystate hospitals have adopted the term Strategic Implementation Plan (SIP), in lieu of Implementation Strategy. The significant health needs to be addressed by the hospital are referred to as priority focus areas in the SIP. Due to the evolving climate in health care, the hospital's financial health year to year remains unknown; therefore hospital resources and inputs may increase, decrease, or need to be modified. The hospital's SIP work plan provides an opportunity for the hospital to be strategic and focused, yet flexible in its community health planning and improvement efforts. The hospital facility, in partnership with its Community Benefits Advisory Council reviews the work plans quarterly and the hospital updates the work plans on the hospital website annually. No health care system or hospital facility can address all the significant health need present in its community. The hospital facility is committed to adhering to its mission and remaining financially healthy so that it can continue to enhance its clinical excellence and patient experience, as well as address significant health needs identified in the CHNA. The hospital facility's implementation strategy does not explicitly address all significant community health needs identified in the 2019 CHNA due to; 1. limited resources (time, talent, and treasure), 2. the hospital is a stakeholder and/or partner in addressing the directly or indirectly through other hospital clinical and service lines and community partnerships, 3. other hospitals or community organizations within the service area are addressing the need; 4. The need falls outside of the hospitals' mission or limited resource capacity. Significant health needs, referred to by the hospital as priority focus areas, being addressed by the hospital include, mental health and substance use, built environment, and institutional and interpersonal discrimination. Significant health needs not to be addressed include, housing, social environment, basic needs, care coordination, culturally sensitive care, health literacy and language barriers, insurance and healthcare care related challenges, limited providers, Alzheimer's disease, chronic diseases, infant and perinatal health, and sexual health. |
| Baystate Noble Hospital Corporation | Part V, Section B, Line 13b: All patients with account balances (other than balances resulting from co-payments or deductibles on insured services) are eligible to receive a prompt pay discount of 20% of the balance for claims paid in full at time of service or within 60 days of the date of the initial bill. Patients must request the discount. The discount cannot be combined with the Hospital Supplemental Financial Assistance Program. Baystate Noble Hospital offers a co-payment discount program for the patients receiving services in the emergency department of the hospital. This discount program is available to all hospital emergency department patients with co-payment obligations under private or government health insurance (unless prohibited by law or a Baystate Noble Hospital's contract with a private insurer or government authority). These patients may reduce the otherwise applicable emergency department service co-payment by 10% if the patient elects to pay the co-payment at the conclusion of the patient's emergency department visit. |
| Baystate Noble Hospital Corporation | Part V, Section B, Line 15e: Baystate Noble Hospital (BNH) provides patients with information about the availability of State Programs, Health Safety Net, or the Hospital Supplemental Financial Assistance Program which may cover all or some of their unpaid BNH bills as well as about BNH discount programs. For those patients who request such assistance, the hospital assists patients by screening them for eligibility in available State Programs and assisting them in applying for such programs. When applicable, BNH may also assist patients in applying for coverage of services as a Medical Hardship based on the patient's documented income and allowable medical expenses. BNH has contracted with the Executive Office of Health and Human Services and the Commonwealth Health Insurance Connector Authority to serve as a Certified Application Counselor Organization. As a Certified Application Counselor (CAC), appropriate staff will inform a patient of the functions and responsibility of a CAC, seek that the patient sign a Certified Application Counselor Designation Form, and assist the patient in finding applicable financial assistance. |
| Baystate Noble Hospital Corporation | Part V, Section B, Line 16j: Paper copies of our financial assistance policy (FAP) and the FAP application, and a FAP plain language summary as well as the Billing and Collections Policy are available upon request, in English, Spanish, and Russian, and free of charge in the hospital and by mail, as well as the hospital facilities website https://www.baystatehealth.org/patients/billing-and-financial-assistance. A plain language summary of the FAP is offered to all patients at all registration sites including our full service health centers in the community - Baystate Brightwood Health Center and Baystate Mason Square Neighborhood Health Center. In addition, copies of the full FAP, FAP application and Billing and Collections Policy are also available at all Registration sites. Copies of our community health needs assessment are available for viewing and download on our website at https://www.baystatehealth.org/about-us/community-programs/community-benefits/community-health-needs-assessment. Hard copies of our CHNA are available upon request free of charge. We have also shared our CHNA with all the community members who were involved with CHNA as well as each hospitals Community Benefits Advisory Council (CBAC). The hospital is committed to ongoing efforts to widely publicize our FAP and CHNA to the community, specifically, to low-income populations. Additional efforts will include promotion via our hospitals various social media platforms and providing printed materials to key social service agencies and educating their staff that work with low income populations in the hospitals service area. |
| Baystate Noble Hospital Corporation | Part V, Section B, Line 20e: We rely on Medicaid for presumptive eligibility determinations. We would perform these actions if needed but did not have any patient during the tax year where an ECA was initiated. |
| Form 990, Schedule H, Part V, Line 7 | Part V, Section B, Line 7a:https://www.baystatehealth.org/-/media/files/about-us/community-programs/community-benefits/2019-community-health-needs-assessments/baystate-noble-2019-chna-report-final-web.pdfPart V, Section B, Line 7b:www.publichealthwm.org |
| Form 990, Schedule H, Part V, Line 10a | https://www.baystatehealth.org/about-us/community-programs/community-benefits/community-health-needs-assessment |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - Baystate Noble Hospital Sports & Rehab | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 74 Main Street | AddressLine1Txt |
| City | Westfield | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01086 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | Physical Rehabilitation Outpatient Clinic | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 6a: | The hospital facility files an annual community benefits report electronically with the Massachusetts Office of the Attorney General's via their website at https://www.mass.gov/nonprofit-hospital-and-hmo-community-benefits. The hospital facility's annual community benefits report is also published on the Baystate Health website at https://www.baystatehealth.org/about-us/community-programs/ community-benefits/community-health-needs-assessment. The hospital's community benefits report provides the Office of the Attorney General and the general public important information about how the hospital partners with the community to identify and address health needs, as well as details the specific programs and activities the hospital implements or supports to address significant health needs. |
| Part I, Line 7: | Line 7a (Charity Care) - community benefit expense was calculated by applying the ratio of patient care cost to charges, calculated on Worksheet 2, against total charity care gross patient charges from the audited financial statements.Line 7b (Unreimbursed Medicaid) - community benefit expense was derived by applying the ratio of patient care cost to charges, calculated on Worksheet 2, against inpatient and outpatient gross charges for Medicaid and Medicaid managed care plans.Line 7c (Other Means-Tested Programs) - community benefit expense was derived by applying the ratio of patient care cost to charges, calculated on Worksheet 2, against inpatient and outpatient gross charges for other means-tested government programs.Line 7e (Community Health Improvement Services & Benefit Operations) - Community Health Improvement Services calculations are derived from direct and indirect costs associated with community benefit activities that are aligned with the hopital's 2019 community health needs assessment. These activities are carried out to improve community health and wellness and extend beyond patient care, beyond the walls of the hospital. Community Benefit Operations calculations are derived from costs associated with assigned staff and community health needs and/or assets assessment, as well as other costs associated with community benefit strategy and operations.Line 7f (Health Professional Education) - no expense to report for this category in 2019.Line 7g (Subsidized Programs) - There were no subsidized services to report in 2019. |
| Part I, Ln 7 Col(f): | In fiscal year 2019, the organization adopted the provisions of Accounting Standards Update 2014-09, Revenue from Contracts with Customers (Topic 606) ("ASU 2014-09". The update resulted in changes in the presentation and disclosure of revenue primarily related to uninsured and underinsured patients. Under ASU 2014-09 the estimated uncollectible amounts due from these patients are generally considered implicit price concessions that are a direct reduction to net operating revenues. In 2019, these implicit price concessions, formerly known as provision for bad debts, totalled $3,265,392 and is not included in total expenses reported in Part IX, LIne 25, column (A) for the purpose of calculating the percentages in Part 1, LIne 7, column (f). |
| Part II, Community Building Activities: | The following description is not quantified specifically in Part II of Schedule H. The hospital facility is committed to creating healthier communities and understands that many state and federally mandated community benefit programs and services are not sufficient to address ethnic, racial, and economic health disparities and inequities. The hospital embraces the traditional definition of "health" to include economic opportunity, affordable housing, quality education, safe neighborhoods, food security, social and racial justice, and the arts/culture all elements that are needed for individuals, families, and communities to thrive. The hospital provides many valuable services, resources, programs, and financial support - beyond the walls of the hospital and into the communities and homes of the people it serves; including grants and sponsorship of local community-based organizations and the involvement of Baystate Health leadership with various community boards that align with its mission. The hospital facility paid dues to the Greater Westfield Chamber of Commerce totaling $2,000.The hospital participates in the Chamber as it is one of the largest local employers in the service area. The Chamber and its members coordinate activities toward a common purpose of sustainability and economic growth for the region. |
| Part III, Line 4: | The cost of bad debts reported in Part III, line 2 was calculated by applying a ratio of cost to charges (based on the organization's cost accounting system including all hospital inpatients and outpatients) against total implicit price concessions as reflected in the audited financial statements. The portion of bad debt that reasonably could be attributable to patients who may qualify for financial assistance under the hospital's charity care program (reported in Part III line 3) was calculated by applying the percentage of bad debts by zip code (for which the average household income for each zip code is less than 150% of the federal poverty level) to the total cost of bad debt reported in Part III line 2. Since this portion of bad debt is attributable to patients residing in an area where the average income is less than 150% of the Federal poverty level, it is highly likely these patients would have qualified for the organization's charity care program had they applied. For this reason, we believe the amount, totalling $68,365, should be treated as community benefit expense in Part I. As noted above, the organization adopted Accounting Standards Update 2014-09 effective October 1, 2018, which changed the way entities report and disclose certain financial information including implicit price concession (formerly the provision for bad debts). See audited financial statements, footnote #2 (Significant Accounting Policies) on page 15 under the caption "Net Patient Service Revenue and page 17 under the caption "Recently Adopted Accounting Pronouncements" for a description of the organization's reporting of its implicit price concessions (formerly provision for bad debts).If a patient is determined eligible for financial assistance, the appropriate adjustment is made to the patient account based on their income level. Once the necessary approvals are obtained,it then flows to thegeneral ledger. Patients applying for a prompt payment discount will have this allowance entered after agreed upon payment is received. |
| Part III, Line 8: | Line 6 - included all Medicare allowable costs as calculated in Worksheets D-1 Part II (inpatient and inpatient psych), D Part V (outpatient) and E Part A of the hospital's 2019 Medicare cost report, net of Medicare costs reported in Part 1, line 7.g, and based on Medicare costing principles. We believe the shortfall reported of $1,025,710 should be treated as a community benefit expense for tax reporting purposes because providing care for the elderly is a key component of our commitment to the community. The unreimbursed expenses shold be treated similarly to unreimbursed Medicaid since the majority of the local elderly population is not affluent. |
| Part III, Line 9b: | For patients who are known to qualify for Charity Care or Financial Assistance: The patient may have requested assistance up front at time of service with a Financial Counselor or the Patient could have asked for assistance after receiving their bill by contacting our Patient Billing Services Representatives. The Financial Counselor will assist the patient in applying for the appropriate type of assistance based on their income and circumstances. Once approved for a State Medicaid or other program, all billing and collection activity will stop (except for required co-payments or deductibles).For all other patients, our statements contain information regarding how to apply for financial assistance. Notices concerning availability for assistance are also posted at patient care sites. |
| Part VI, Line 2: | The Baystate Board Governance Committee convenes semi-annually and is charged with advocating for community benefits at the board level and throughout the health system and broader community; aligning the system's four (4) hospital-specific community benefits implementation strategies with the health system's strategic plan; review of CHNA data; approval of a community benefits mission statement and health priorities; review impacts of community benefits activities and investments; and ensure Baystate Health's community benefits are in compliance with guidelines established by the MA Attorney General and IRS. Annually, the Office of Government and Community Relations provides updates to the Baystate Board of Trustees, Baystate President's Cabinet, and other Baystate leadership teams, as requested. The hospital Community Benefits Advisory Council (CBAC) continues to bring a community lens and filter for the hospital's health priorities. The CBAC provides a community perspective on how to increase wellness and resilience opportunities for optimal health for an entire population; guidance in matching hospital resources to community resources, thus making the most of what is possible with the goal to improve health status and quality of life; and policy advocacy to assure and restore health equity by targeting resources for residents. Participants on the hospital CBAC represent constituencies and communities served by the hospital. CBAC members are responsible for reviewing community needs assessment data and use this analysis as a foundation for providing the hospital with input on its community benefits planning process.Baystate Health Patient & Family Advisory Council (PFAC) members provided valuable input in enhancing care at Baystate Health based on the knowledge of the unique needs of patients and families. Information from PFAC provides hospital leadership with an enhanced understanding of how to improve quality, program development, service excellence, communications, patient safety, facility design, patient and family education, patient and family satisfaction, and loyalty. PFAC is made up of a diverse group of patients, family members, and community members who represent the collective voice of the patients and families at Baystate Medical Center, Baystate Children's Hospital, Baystate Franklin Medical Center, Baystate Noble Hospital, Baystate Mary Lane Outpatient Center, Baystate Wing Hospital, the D'Amour Center for Cancer Care, and the BeHealthy ACO in Baystate managed health centers. |
| Part VI, Line 3: | The hospital is committed to ensuring that patients in its community have access to quality health care services with fairness and respect without regard to the patients' ability to pay. The hospital recognizes the cost of necessary health care services can impose a significant financial burden on patients who are uninsured or underinsured, and acts affirmatively to lessen that burden by offering eligible patients the opportunity to apply for free or reduced cost services. The hospital not only offers free and reduced cost care as required by law, but has also voluntarily established discount and financial assistance programs that provide additional free and reduced cost care to more patients residing within the communities served by the hospital.The hospital recognizes the billing and collection process can be bewildering and burdensome for patients and has implemented procedures to make the process understandable for patients; to inform patients about discount and financial assistance options; and to ensure that patients are not subject to aggressive collection activities. Consistent with its patient commitment, the hospital is required to maintain a financial assistance policy and a billing and collection policy that reflects its financial assistance options and patient billing and collection procedures and complies with applicable federal and state laws and regulations.The hospital has financial counselors available to help patients apply for financial assistance programs that may cover unpaid hospital bills, including a variety of federal and state programs as well as financial assistance through the hospital. Hospital financial counselors have all been trained and certified by the state as Certified Account Counselors to assist patients in applying for available federal and state programs. The hospital is committed to ensuring that patients or prospective patients in the community are aware of financial assistance programs. For uninsured or underinsured patients, the hospital will assist in applying for available financial assistance programs. The hospital notifies patients of the availability of assistance in both the initial bill sent to patients, as well as in general notices posted throughout the hospital.When applicable, the hospital also assists patients in applying for coverage of services as a Medical Hardship based on the patient's documented income and allowable medical expenses. The hospital provides, upon request, specific information about the eligibility process to be a Low Income Patient under either the Massachusetts Health Safety Net Program or additional assistance for patients who are low income through Baystate's own internal financial assistance program. The hospital also notifies patients about available payment plans based on their family size and income. Baystate Health's Financial Assistance Policy and Billing and Collection Policy are posted on the baystatehealth.org website at https://www.baystatehealth.org/patients/billing-and-financial-assistance. The goal of posting the Financial Assistance Policy and the Billing and Collection Policy is to ensure that patients or prospective patients in the community are aware of the financial assistance programs. Signs about the availability of financial assistance programs at the hospital are translated into Spanish and Russian as these languages are primarily spoken by more than 1,000 or 1% of the residents in the hospital's service area. Signs are large and clearly visible. Hospital signs are 8.5 x 11 inches and the header print font is 24 points. Notice of availability of Financial Assistance Programs are posted in the following locations: inpatient, clinic, emergency department admissions and/or registration areas, central admission/registration area, patient financial counselor areas, and business office areas that are open to patients. |
| Part VI, Line 4: | The following "community information" description is extracted from the hospital's 2019 CHNA. Baystate Noble Hospital (Baystate Noble) is a 97-bed acute care community hospital helping people in the greater Westfield community, offering direct access to world-class technology, diagnostics, and specialists. The hospital works to ensure that patients have access to exceptional healthcare, close to home. Skilled and compassionate nurses and medical support staff offer an ideal combination of "high tech and "high touch", complementing an outstanding team of doctors. Services include obstetrics and gynecology, emergency, laboratory, gastroenterology, surgery, cardiopulmonary services and rehabilitation, cancer care, behavioral health, urology, neurology, inpatient rehabilitation, and diagnostic imaging, including 3D mammography.The service area for Baystate Noble includes ten communities, nine of which are located in the western portion of Hampden County, over 100,000 people, and a majority of this population lives in the cities of West Springfield and Westfield. There is a mix of rural and urban populations. The U.S. Census defines urban areas as consisting of census tracts and/or blocks which meet the minimum population density requirement (2,500-49,999 for urban clusters and over 50,000 for urbanized areas) or are adjacent and meet additional criteria. The population is densest surrounding Westfield, West Springfield, and Agawam (US Census Bureau, Decennial Census 2010). The median age of residents in these cities is approximately 42 years. The Pioneer Valley Transit Authority connects three of the communities to the Springfield metropolitan area to the east, and to the hospital itself. Paratransit service is also available for people with disabilities within three-quarter mile of a fixed route to facilitate access to medical care.The service area has more racial and ethnic diversity than many other parts of western Massachusetts. County-wide, 24% of the population is Latino, 8% is black and 2% is Asian (ACS, 2013-2017), though this diversity is not equally spread throughout the region and tends to be concentrated in the urban core. In the Baystate Noble service area, 86% of the population is white, 7% is Latino, 2% is black and 3% is Asian (ACS, 2013-2017). A substantial proportion of the County's population is from other countries. In 2017, 22% of the state's immigrants came to western Massachusetts. West Springfield has welcomed the highest proportion in Hampden County, and 15% of the city's populations are immigrants. The current political climate has exacerbated threats to immigrant health related to threats to the behavioral, cultural, and structural systems that determine individual health decision on a daily basis. According to the MDPH, in the past 5 calendar years (2014-2018), there were 2,314 refugees with health assessments in western Massachusetts. This assessment is the first medical screening provided to refugees; it is their gateway into the medical system. Economically, the Baystate Noble service area is near many of the largest employers in the region as well as numerous colleges and universities. The largest industries and employers include health care, service and wholesale trade, and manufacturing. Compared to the state, the Baystate Noble service area has slightly lower unemployment and poverty rates, and higher levels of educational attainment. The median household income in the service area is about $61,000 (almost $17,000 less than the state). The poverty rate is 9% (slightly lower than the state rate of 11%). The child poverty rate is 13% (compared to 14.6% at the state level) (ACS, 2013-2017). Despite being near the Knowledge Corridor region, only 31% of the population aged 25 and over has a bachelor's degree, compared to 43% statewide. Unemployment is slightly lower than the state average. The median age for the service area is 41.6 years of age which is older than that of Hampden County and of the state. The population over 45 years old is growing as a percentage of the total population. To give a sense of the change in service needs, between 2010 and 2035, the proportion of people over age 60 in Hampden County is projected to grow from 20% of the population to 28%, with the number of older adults increasing from approximately 92,000 in 2010 to an estimated 140,000 in 2035. Aging projection data specific to the service area was unavailable. In Hampden County 14% of the population has a disability compared to the state rate of 12%. In West Springfield and Westfield, disability rates are comparable to the county at 14% and 15% respectively. |
| Part VI, Line 5: | The hospital facility has a responsibility to respond to health care needs unsupported by government programs. In exchange for this responsibility, the hospital qualifies for tax-exempt status under 501(c)(3). However, providing hospital care alone is not enough to qualify for tax-exempt status. Hospitals also must operate in the public interest and provide programs that benefit the community.The charitable mission of the hospital facility, a member hospital of Baystate Health, is to improve the health of the people in our communities every day, with quality and compassion. The hospital's Community Benefits Mission is to reduce health disparities, promote community wellness, and improve access to care for vulnerable populations. The hospital is committed to meeting the identified health and wellness needs of constituencies and communities served through the combined efforts of Baystate Health's member organizations, affiliated providers, and community partners.The hospital facility meets all of the factors required of medical facilities in order to maintain tax exemption, as first described in Revenue Ruling 69-545. In support of patient care and the medical needs of the communities served by the hospital, medical staff membership and privileges are extended to all qualified physicians and practitioners in western Massachusetts who meet the requirements for credentialing and clinical privileges, whether employed by a related Baystate Health or community-based entity. The hospital's emergency department is open to all in need of care and services; no one requiring emergency care is denied treatment. In addition, surplus funds from operations are generally applied, as permitted, to the following; improvements in patient care, expansion and renovation of existing facilities, purchase and replacement of equipment, debt service, expenses associated with training of physicians and other health care professionals, professional development of medical and other clinical staff, and the support of scientific, translational, and clinical research.Baystate Health's volunteer Board of Trustees, the governing body of the organization and its affiliates, is comprised of the President and Chief Executive Officer of Baystate Health and up to twenty-two (22) other elected trustees who are representative of the broad range of interests which exist in the communities served by Baystate Health and its affiliates. The Governance Committee oversees the nomination of trustees and submits recommendations to the Board of Trustees for membership on the various board committees. In considering nominations or recommendations for trustees, directors, committee members, or officers, the Governance Committee selects nominees who are representative of the various and diverse constituencies served by Baystate Health and its affiliates. In particular the Committee nominates persons who are representative of the community consumer interests of the various neighborhoods and localities which are served by Baystate Health and its affiliates in the carrying out of and pursuant to the charitable mission of the Baystate Health and its affiliates.Please refer to the section above in line 2 for additional examples of the hospital's responsiveness to the community and opportunities for community involvement; including the Board of Trustees' Governance Committee, Community Benefits Advisory Council, and Community Health Needs Assessment. For additional information, please see Line 6 below. |
| Part VI, Line 6: | Baystate Health is a not-for-profit integrated healthcare system serving over 800,000 people throughout western Massachusetts. Nationally recognized as a leader in healthcare quality and safety, Baystate Health has more than 12,000 employees and serves a diverse population of patients at its teaching hospital, Baystate Medical Center in Springfield, as well as at Baystate Children's Hospital, its three community hospitals, several urban health centers, home care and hospice services, and a network of over 80 medical practices. The four hospitals include Baystate Medical Center, Baystate Franklin Medical Center, Baystate Noble Hospital, and Baystate Wing Hospital (which includes Baystate Mary Lane Outpatient Center); the other 501(c)(3) organizations include Baystate Medical Practices, Visiting Nurse Association and Hospice of Western New England, Baystate Administrative Services, and Baystate Health Foundation. Baystate Medical Center (Baystate Medical) is a 724-bed academic medical center based in Springfield, Massachusetts. Baystate Medical is home to western New England's only tertiary care referral medical center, Level I Trauma Center and Level II Pediatric Trauma Center, and neonatal and pediatric intensive care units. The medical center also includes Baystate Children's Hospital and the Wesson Women and Infants' Unit, and is the regional campus of the University of Massachusetts Medical School - Baystate. Baystate Medical is also the community's major referral hospital, providing the highest level of care for conditions such as cancer, acute, and chronic cardiovascular illness, nervous system illness, digestive illness, and other diseases that affect the major organs of the body.Baystate Children's Hospital, part of Baystate Medical, is the only accredited full-service children's hospital and pediatric-specific emergency department in western Massachusetts. It provides primary and advanced medical care to babies, children, adolescents, and their families.Baystate Franklin Medical Center (Baystate Franklin) is an 89-bed facility located in Greenfield, Massachusetts, that provides high-quality inpatient and outpatient services to residents of rural Franklin County and North Quabbin. Inpatient services include behavioral health, intensive care, medical-surgical care, and obstetrics/ midwifery. Outpatient services include cardiology, cardiac rehabilitation and wellness, emergency medicine, gastroenterology, general surgery, neurology, oncology, 3D mammography, radiology, cancer care and infusion, ophthalmology, orthopedics, pediatrics, physical medicine and rehabilitation, pain management, endoscopy, pulmonology and sleep medicine, sports medicine, vascular surgery, and wound care and hyperbaric medicine. In addition, through a partnership with the CHCFC, a dental clinic is located in the Baystate Franklin emergency department.Baystate Noble Hospital (Baystate Noble) is a 97-bed acute care community hospital helping people in the greater Westfield community, offering direct access to world-class technology, diagnostics, and specialists. The hospital works to ensure that patients have access to exceptional healthcare, close to home. Skilled and compassionate nurses and medical support staff offer an ideal combination of "high tech and "high touch", complementing an outstanding team of doctors. Services include obstetrics and gynecology, emergency, laboratory, gastroenterology, surgery, cardiopulmonary services and rehabilitation, cancer care, behavioral health, urology, neurology, inpatient rehabilitation, and diagnostic imaging, including 3D mammography.Baystate Wing Hospital (Baystate Wing) is a 74-bed facility located in Palmer, Massachusetts helping people in a service area that includes three counties Hampden, Hampshire, and Worcester. The hospital services approximately 120,000 residents in seventeen towns, with over half of this population living in Belchertown, Ludlow, Palmer, Wilbraham, and Ware. We offer a broad range of medical, surgical, and psychiatric services. Our expanded Emergency Department (ED) provides comprehensive emergency services for adults and children around the clock. The emergency department includes a six bed critical care unit and is a primary stroke center designated by the Massachusetts Department of Public Health (MDPH). Our hospital offers comprehensive, personalized, and high-quality inpatient and outpatient behavioral health and addiction treatment services through the Griswold Behavioral Health Center and the Center for Geriatric Psychiatry.Baystate Medical Practices (BMP) is a multi-specialty group of over 950 physicians and advanced practice clinicians in primary care, specialty, and surgical disciplines with more than 100 practices across 85 locations. BMP offers patient-centered care, including: family practice, internal medicine and pediatric providers, community health centers, urgent care clinics, suburban and rural practices. Many sites are designated Patient Centered Medical Homes, signifying our emphasis on communication with patients, collaboration among providers, and continuity of care. BMP's policy is to provide care to any patient in need of medical care, regardless of the patient's ability to pay for such care. Dependent upon the patient's financial capability to pay and consistent with Baystate Health and BMP policies, BMP may provide such care free of charge or at amounts below its normal charges. In tax year 2018 BMP provided $1,501,091 in charity care. In addition to the charity care provided to patients, BMP's physicians participate in many and varied ongoing community outreach initiatives in the areas of education, employment, safety, and health. BMP has also taken a leadership role in strengthening the health of disadvantaged citizens in surrounding communities including specific focus on HIV/AIDS and by providing physician staffing for three community-based health centers through Baystate Medical. BMP faculty published 172 peer-reviewed articles in tax year 2018, acquiring and disseminating new knowledge to a broad audience. These original research findings will improve the care we deliver to patients.Visiting Nurse Association and Hospice of Western New England provides the highest quality care and supplies to patients and families, primarily in their homes. It is a comprehensive in-home health care, hospice, and palliative care agency with a staff of over 450 managing more than 90,000 visits annually. The home health team works together to ensure a safe and swift recovery from illness, accident, or surgery in the comfort of patients' home. Visiting Nurse Association and Hospice of Western New England offers medical expertise through its extensive network of caregivers to support patients facing a serious or life limiting illness. Each patient and family is cared for by certified and experienced nurses, therapists, social workers, hospice aides, spiritual and bereavement counselors, and volunteers. This care team works together, with both the patient and family, to bring understanding, comfort, dignity, and a sense of peace, as each patient journey towards the final stage of life.Baystate Reference Laboratories is the region's largest reference laboratory and is staffed by 24 board-certified pathologists and over 500 technologists and support personnel.Health New England is a nonprofit organization offering a range of health care plans including commercial, Medicaid, and Medicare supplemental coverage. It is one of the largest managed care organizations in western Massachusetts.In addition to the brief descriptions of the affiliated entities above, this further information speaks to activities of Baystate Health and its affiliates regarding promotion of community health.In addition to its 12,000 employees, Baystate Health has medical staff, nurses, residents and fellows, medical students, nursing students, and allied health students who gain comprehensive medical education during the year. A recognized leader in educational innovation, Baystate Health has been training doctors since 1914. In tax year 2018, over 350 residents and fellows in 10 residency and 26 fellowship programs trained at Baystate Health. In addition, Baystate Health provided training to over 450 medical students completing clerkships and electives in various specialties. There were over 1,000 nursing students and over 400 allied health students from local colleges and universities, completed clinical training as part of their associate, baccalaureate, master's and post-doctoral work. Baystate Health is a nationally accredited provider of continuing education for the entire team of health care professionals. Continuing education is provided through regional conferences, grand rounds, and internet courses. In tax year 2018, a record 161 nurses graduated from the Baystate Health Nurse Residency Program. The program is a one-year program for register |
| Form 990, Schedule H, Part VI Line 6 continued | In tax year 2018, a record 161 nurses graduated from the Baystate Health Nurse Residency Program. The program is a one-year program for registered nurses with less than 12 months experience, offering practice-based experience, in-depth learning, and ongoing professional development. Baystate Health's Nurse Residency Program was Accredited with Distinction, the highest recognition awarded, as a Practice Transition Program by the American Nurses Credentialing Center's (ANCC) Commission on Accreditation. The program is one of only four in the state of Massachusetts to receive ANCC accreditation. In tax year 2018, Baystate Health provided 31 nurses with forgivable nursing loans towards earning their ADN, BSN, masters, DNP, or PhD in nursing. The program was established in 2002 and to date has supported more than 580 RNs and student nurses providing more than $2,250,000 in forgivable loans.In tax year 2018, Baystate Medical Center's Midwifery Education Program celebrated its 25th anniversary. There have been 116 graduates since the program's inception and the program has maintained a 100 percent certification rate by the American Midwifery Certification Board. This year, the Midwifery Program completed reaccreditation by the Accreditation Commission for Midwifery Education and received the maximum allowed length of accreditation through 2028. Baystate Health is one of 39 midwifery education programs in the country and the only program in Massachusetts. The program also conducts innovative interprofessional education with Baystate Health's OB/GYN residency program.In partnership with the University of Massachusetts Medical School, Baystate Health is now the regional campus for an innovative curriculum track called PURCH (Population-based Urban and Rural Community Health). The PURCH track focuses on addressing social determinants of health for our patients. The PURCH track is designed to prepare students to care for Baystate Health's diverse patient populations by providing classroom and clinical experiences in a variety of clinical settings, led by faculty who have expertise in population health and clinical effectiveness research. The goals of the program are to increase access to students in Massachusetts seeking an affordable medical education; to respond to the health care needs of the Commonwealth by increasing the number of Massachusetts physicians trained in urban and rural primary care; and to apply proven academic research methods to improve population health, reduce health disparities, and make health care better integrated, more efficient, and more effective.In tax year 2018, Baystate Springfield Educational Partnership (BSEP) ran courses for 275 students, primarily residents of Springfield. During the summer, BSEP provided theme-based workshops for 47 students, coordinated 32 summer internships at Baystate Medical, and placed 11 students in work experiences. Overall, more than115 students have been hired as employees at Baystate Health. BSEP awarded a total of $25,000 in scholarships for undergraduate and graduate education to 16 alumni students. The ten-year total of scholarships awarded now exceeds $700,000. Volunteers enhance the work of our employees and interactions with our patients and families every day. In tax year 2018, more than 900 volunteers donated over 100,000 hours providing significant support of the care we provide to our community.In tax year 2018, over 212,000 language interpreter sessions helped patients and families better understand their care. The Interpreter and Translation Services department interpreted 72 languages in person, over the phone, and via video, and translated 3,642 pages of patient-related information. New languages included Oromo from Ethiopia, Foochow from a small region in China, Q'anjob'al (Kanjobal) from Guatemala, and Nepali Sign Language. In tax year 2018, covered lives in Baystate Health's Medicare Accountable Care Organization (ACO) rose from 43,000 to over 50,000. Baystate Health's Medicaid ACO is in its second year and teams have embarked on several novel clinical initiatives that have already demonstrated care transformation to improve quality and lower cost. Community Health Workers have completed a standard assessment of Social Determinants of Health, for example housing insecurity, food insecurity, transportation challenges, and others, that related to poverty and its effect on health. Over 35% of the population has been assessed, the highest rate of any MassHealth ACO, leading to early interventions to prevent illness. Utilization rates for skilled nursing facilities declined 27% over two years and emergency department use has fallen 39%. A newly formed Transition of Care Team at Baystate Medical meets with inpatients facing compliance challenges and continues to follow up with home visits within their first 30 days after discharge.Baystate Health and its affiliates are committed to providing the communities they serve throughout western Massachusetts with the resources necessary to stay informed and healthy by providing both basic and extensive educational opportunities such as parent education classes, including "Baystate's New Beginnings". Also offered are breastfeeding classes, prenatal/postnatal classes, and infant/toddler safety classes. Some classes are free while others are offered at a reasonable fee. No one is turned away due to inability to pay. Baystate Health offers many free parenting support groups including breastfeeding gatherings, new parents groups, toddler groups, parents of multiples groups, and a MotherWoman support group. Most of these groups meet weekly. In addition, Baystate Health has a health science library staffed by professionals who help patients, families, and the general public access reliable health information.The EMPOWER program at Baystate Franklin, designed to help pregnant women with opioid use disorder (OUD) have healthy babies and pursue healthier futures, received a two-year, $1 million federal grant to expand the program. Baystate Franklin partnered with the Center for Human Development (CHD) to pursue the grant. The partnership will allow the agencies to form a medical/behavioral health home. The home will provide expanded support to pregnant, postpartum and parenting women, ages 18 or older (who may also have a child/children 36 months or younger) with OUD and/or a history of opioid overdose. The EMPOWER program currently serves approximately 30 women and families in Franklin County each year.Baystate Medical implemented an enhanced way to care for newborns physiologically dependent on opioids and their mothers called the Rooming-in Program. Previously, babies impacted by maternal OUD were admitted to the Neonatal Intensive Care Unit if they required pharmacological treatment for Neonatal Abstinence Syndrome. Parents understood little about the process and length of stay averaged several weeks. With the Rooming-in Program, eligible babies remain with their mothers in a private room throughout treatment, encouraging breastfeeding and bonding. Mothers receive prenatal and postnatal education to better understand the process and how to care for their babies, leaving them empowered while significantly decreasing length of stay for these babies.The Institute for Healthcare Improvement recognized Baystate Medical Center and Baystate Health's three community health centers as the first age-friendly health care institutions in the nation. The national age-friendly health system movement focuses on improving care by attending to what matters most to patients; medications, mental activity, and mobility. The honor recognized the efforts of the Acute Care for Elders program team and the interprofessional "Geri-Pal" team who recognize the unique problems of older adults, focus on what is most important to patients, and emphasize keeping those in their care as independent and active as possible. They assist with care plans, choosing treatment options, recognizing drug side effects, and making difficult decisions.Baystate Health has provided a safe way to dispose of unwanted medications and sharps through the installation of collection receptacles in the lobbies at each of its four hospitals. Community members now have a resource for safely and confidentially throwing away household sharps (needles and other sharp or glass medical tools) and unused prescription medications. These secure kiosks are available to the community 24 hours a day, seven days a week. |
| Form 990, Schedule H, Part VI Line 6 continued | The Mini-Medical School program is an eight-part health education series offered at Baystate Medical featuring a different aspect of medicine each week. Designed for an adult audience, each course is taught by an energetic faculty member who will explain the science of medicine without resorting to complex terms. Mini-Medical School gives Baystate Health the opportunity to open its doors to the public and share its knowledge of medicine in a comfortable and friendly environment. Many of the students participate due to a general interest and later find that many of the things they learned over the semester are relevant to their own lives. The goal of this program is to help members of the public make more informed decisions about all aspects of their health care while receiving insight on what it's like to be a medical student. Tuition is $95 per person, $80 for Senior Class and Every Woman members. Mini Medical School Alumni is over 2,000 members. Baystate Health offers 50+ free programs to seniors and women. Baystate Health Senior Class is a free loyalty program dedicated to health and wellness offered exclusively for men and women ages 55 and over. The 21,000+ Senior Class members receive a quarterly newsletter with valuable health information, benefits, and invitations to special events designed with their interests in mind. The free Baystate Every Woman Loyalty Program offers its 15,000+ members the latest women's health information through seminars with physicians, nurses, and other medical professionals, in a comfortable and lively setting. The program is designed to increase knowledge of women's health issues, and in turn, provide women with the information they need to make the best decisions regarding their health.In tax year 2018, 22 employees were awarded forgivable loans to purchase their first home through the Mark R. Tolosky Baystate Neighbors Program. This Baystate Health benefit provides forgivable loans to employees purchasing their first home in the communities surrounding Baystate Health hospitals. To date, the program has provided more than $2 million in forgivable home loans. Since its inception in 1994, Rays of Hope has been helping women and men in the fight against breast cancer by walking alongside them on their cancer journey. Through the Baystate Health Breast Network, Rays of Hope cares for the whole person from diagnosis and beyond by supporting research at the Rays of Hope Center for Breast Cancer Research, providing funding for state-of-the-art equipment, breast health programs, and outreach and education throughout Baystate Health as well as providing grants for complementary therapies and cancer programs to our community partners throughout western Massachusetts. Rays of Hope has raised over $15.3 million to date. All funds raised remain local in western Massachusetts.The United Way develops and supports programs that directly improve the lives of people in our communities, a mission proudly shared by Baystate Health. Baystate Health is a strong supporter of the United Way, and a major contributor to the organization with workforce campaigns and thousands of employee donors and volunteers. Baystate Health's contributions help the United Way serve our families, friends, colleagues and others who seek help in different ways and at different times in their lives. Three community campaigns are held annually: Springfield, Westfield, and Palmer workplace to support the United Way of Pioneer Valley, Greenfield workplace to support the United Way of Franklin County, and Ware workplace to support the United Way of Hampshire County. Employees can direct their donations to one or all of the United Way's action areas: Education, Income, and Health, or designate to a qualified agency with a minimum contribution. At the start of the tax year 2018 school year, Baystate Health employees throughout the region donated school supplies to their communities. At Baystate Medical, over 175 storage totes (the most yet) were filled with supplies to assist Springfield elementary school teachers with their "wish list" of classroom essentials. Baystate Wing Hospital and Baystate Mary Lane Outpatient Center employees donated over 1,500 items to teachers in Palmer and Ware Public Schools and Baystate Franklin Medical Center employees collected backpacks and school supplies to support the United Way of Franklin County's Annual Blooming Backpacks which, collected over 330 backpacks for children in Franklin County. Baystate Noble Hospital launched its successful first school supply drive to benefit Abner Gibbs Elementary School in Westfield.Baystate Medical held its annual "Spirit of Giving" Holiday Donation Drive for new and unwrapped toys, books, games, and other greatly needed items for children and families in the community. Baystate Health employees donated more than 2,500 new toys and $1,000 in gift cards for children in the communities served by Baystate Community Health Centers at Mason Square, Brightwood, and High Street, as well as Martin Luther King Jr. Family Services, New North Citizens' Council, and the Ronald McDonald House in Springfield.See also additional information regarding Baystate Health, Inc. and its affiliate's promotion of community health above in Line 5. |
| Form 990, Schedule H, Part VI, Line 7 | List of States Receiving Community Benefit Report: MAAdditional disclosures related to 501(r) complianceIn accordance with the guidance described in Revenue Procedure 2015-21, the hospital hereby discloses the following minor, inadvertent error, that was discovered by the Baystate internal tax department in October 2019, with respect to hospital's Community Health Needs Assessment (CHNA) that was completed in September 2019.Under 1.501(r)-2(b) of the Treasury Regulations, a hospital facility's error with respect to the implementation or operational requirements described in Treas. Reg 1.501(r)-3, will not be considered a failure to meet a requirement of Section 501(r) if: (1) such omission or error was minor and either inadvertent or due to reasonable cause; and (2) the hospital facility corrects such omission or error as promptly after discovery as is reasonable given the nature of the omission or error.In Tax Year 2018 the hospital conducted its CHNA, which was adopted by the Board of Trustees prior to the September 30, 2019 year end. The hospital inadvertently neglected to timely post the CHNA to the hospital website before the end of the tax year. When it was determined that hospital had not uploaded the current CHNA to the hospital website, the Baystate tax department coordinated the posting of the CHNA with community benefits and the website department. The posting was completed by the website department on November 13, 2019. Baystate has reviewed the current policies and procedures and is adopting a formal Community Benefits Policy to ensure compliance with the requirements of Section 501(r), and related regulations. The system intends to regularly monitor the effectiveness of the adopted policies to ensure the hospital maintains compliance with Section 501(r) on an on-going basis. As part of process improvements, during future CHNA implementation years, Baystate will post interim reports on the system website in mid-summer, allowing for community and public review and comments, prior to publishing the final CHNA reports approved by the Board of Trustees at the end of September. To the best of our knowledge, the delay did not affect any individuals, therefore the error will not be considered a failure to meet a requirement of Section 501(r). The hospital has corrected and is self-disclosing the inadvertent omission, and as of the filing of this form 990, the hospital is in compliance with Treas. Reg 1.501(r)-3 requirements for completing its community health needs assessment. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Written Policy Ref T And E Expnss | 0 | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Aleksandr Pugach MD | ||||||||||||||
| Trustee (thru 12/31/18)/Internist | $209,668 | $0 | $2,664 | $0 | $12,188 | $0 | $10,762 | $0 | $507 | $0 | $235,789 | $0 | $0 | $0 |
| Kevin P Moriarty MD | ||||||||||||||
| Trustee/Chief Ped Surgery | $565,382 | $0 | $106,924 | $0 | $30,187 | $0 | $23,375 | $0 | $8,507 | $0 | $734,375 | $0 | $0 | $0 |
| Mark A Keroack MD | ||||||||||||||
| Trustee/ President & CEO, BH | $0 | $1,092,918 | $0 | $555,500 | $0 | $379,088 | $0 | $17,875 | $0 | $22,167 | $0 | $2,067,548 | $0 | $4,050 |
| Ronald P Bryant | ||||||||||||||
| President | $0 | $450,110 | $0 | $113,625 | $0 | $27,409 | $0 | $17,875 | $0 | $30,301 | $0 | $639,320 | $0 | $0 |
| Dennis Chalke | ||||||||||||||
| Treasurer | $0 | $546,049 | $0 | $196,086 | $0 | $205,523 | $0 | $59,898 | $0 | $30,546 | $0 | $1,038,102 | $0 | $4,050 |
| Kristin R Delaney | ||||||||||||||
| Clerk | $0 | $129,310 | $0 | $15,113 | $0 | $628 | $0 | $14,190 | $0 | $23,449 | $0 | $182,690 | $0 | $0 |
| John Shaver | ||||||||||||||
| Chief Financial Officer | $229,273 | $0 | $25,252 | $0 | $3,279 | $0 | $4,100 | $0 | $10,901 | $0 | $272,805 | $0 | $0 | $0 |
| Michele Urban | ||||||||||||||
| VP Patient Care Services/C | $195,864 | $0 | $40,400 | $0 | $1,679 | $0 | $4,785 | $0 | $9,139 | $0 | $251,867 | $0 | $0 | $0 |
| Deborah A Kudla | ||||||||||||||
| Director, Surgery | $158,974 | $0 | $17,489 | $0 | $2,154 | $0 | $3,560 | $0 | $2,417 | $0 | $184,594 | $0 | $0 | $0 |
| Angela M Coti | ||||||||||||||
| Registered Nurse | $154,255 | $0 | $300 | $0 | $234 | $0 | $6,288 | $0 | $3,083 | $0 | $164,160 | $0 | $0 | $0 |
| Susan A Zak | ||||||||||||||
| Registered Nurse | $144,077 | $0 | $790 | $0 | $251 | $0 | $6,033 | $0 | $18,683 | $0 | $169,834 | $0 | $0 | $0 |
| Khalilah Fullard | ||||||||||||||
| Manager, Pharmacy | $138,606 | $0 | $800 | $0 | $752 | $0 | $2,846 | $0 | $8,259 | $0 | $151,263 | $0 | $0 | $0 |
| Jeffrey Cebula | ||||||||||||||
| Manager, Accounting | $130,324 | $0 | $5,230 | $0 | $466 | $0 | $2,836 | $0 | $13,879 | $0 | $152,735 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 1a | #3 & #5 Housing provided for a key employee of the filing organization which requires a tax gross-up. The above item was treated as taxable compensation as appropriate in accordance with Baystate Noble written policies which require compliance with the IRS accountable plan rules. |
| Part I, Line 3 | The compensation of the President is reviewed and determined annually by the compensation committee of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs). This committee consists entirely of individuals serving on the board of the filing organization. The individuals responsible for deliberating the compensation arrangement for the President would be those individuals who do not have a conflict of interest with respect to the compensation arrangement and would be considered independent for compensation deliberation purposes. The compensation of the President is established based on information provided by independent third party consultants for reasonableness and appropriate comparability data. The compensation is then established, reviewed and approved by the duly authorized compensation committee of Baystate Health, Inc. and all such deliberations and decisions are documented contemporaneously. |
| Part I, Line 4b | Ronald P Bryant- Supplemental Retirement of $11,081 is included in column B. This amount was earned and paid in 2018. Dennis W. Chalke - Supplemental Retirement of $151,701 is included in column B. This amount was earned and paid in 2018. Mark A. Keroack, MD Supplemental Retirement of $351,037 is included in column B. This amount was earned in 2018. Kevin P. Moriarty, MD - Supplemental Retirement of $22,859 is included in column B. This amount was earned and paid in 2018. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 1 | The filing organization has a standing executive committee, which is entitled to act between meetings of the Board, on all matters as to which the Board is entitled to act and permitted by law to delegate to a committee. The members of the executive committee are the same individuals serving on the executive committee of Baystate Health, Inc. |
| Form 990, Part VI, Section A, line 2 | Two or more of the persons listed in this Form 990 Part VII have a business relationship with each other by virtue of sitting on one or more Boards of Directors or by serving in an employment relationship with one or more entities in the Baystate Group of affiliated entities and in the community. The following trustees, officers, or key employees have a business relationship: (1) Anne M. Paradis, Paul R. Murphy and Robert L. Pura, PhD, (2) John F. Maybury and Mark A. Keroack, MD, (3) Hector F. Toledo and Timothy F. Farrell. |
| Form 990, Part VI, Section A, line 3 | Baystate Noble Hospital Corporation is affiliated with Baystate Administrative Services, Inc. (BAS) which is a 501(c) (3) organization. Information Technology, Human Resources, Finance, Treasury, Accounting and other management and support functions are delegated to BAS. |
| Form 990, Part VI, Section A, line 6 | The filing organization has one member, Baystate Health, Inc. (BH). |
| Form 990, Part VI, Section A, line 7a | The board of Trustees of the filing organization consists of the same individuals serving as members of the Board of Trustees of Baystate Health, Inc. (BH), with the addition of the president of the medical staff of the filing organization. The Board of Trustees of BH are elected annually by the Board of Trustees of BH at their annual meeting. Form 990, Part VI, Section A, line 8b: The Trustees of Baystate Noble Hospital Corporation (BNH) meet during certain scheduled Baystate Health, Inc. (BH) board meetings. The BH Board of Trustees and its committees, including the Audit and Compliance Committee, contemporaneously document meetings and actions relative to BNH as well as the annual acceptance of the audited financial statements. |
| Form 990, Part VI, Section B, line 11b | Prior to filing the Form 990, appropriate sections were reviewed by the Tax, Finance, and Human Resources areas of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs) and by outside legal counsel. The Form 990 was also reviewed by tax experts from an independent accounting firm and signed-off as a paid preparer. The process, key areas and any new changes were reviewed prior to filing with the Baystate Health Audit and Compliance Committee (ACC), which is composed of trustees of the filing organization. The ACC members had an opportunity to ask questions regarding the tax compliance process and the tax filings in general. The Form 990 was provided to all members of the Board of Trustees prior to filing. |
| Form 990, Part VI, Section B, line 12c | Baystate Noble Hospital Corporation (BNH) is an affiliate of Baystate Health, Inc. (BH). BH and its affiliated entities have a comprehensive conflict of interest policy applicable to all of the affiliated entities. All directors, trustees, officers, key employees, and highest compensated employees of BH and its affiliates are asked to complete an annual "conflict of interest" form. We utilize an electronic database to receive and manage all conflict of interest submissions. This information is reviewed by the Chief Compliance Officer, Chief Executive Officer, Chair of the Board of Trustees, Chief General Counsel and the Chair of the Audit & Compliance Committee. A summary of the conflict of interest disclosures is provided to the Baystate Health Board of Trustees and the Tax Department. Potential conflict of interest transactions are reviewed as appropriate under the policy, which provides for recusal from discussion and deliberation by any party with a potential conflict of interest. |
| Form 990, Part VI, Section B, line 15b | The compensation of the President is reviewed and determined annually by the compensation committee of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs). This committee consists entirely of individuals serving on the board of the filing organization. The individuals responsible for deliberating the compensation arrangement for the President would be those individuals who do not have a conflict of interest with respect to the compensation arrangement and would be considered independent for compensation deliberation purposes. The compensation of the President is established based on information provided by independent third party consultants for reasonableness and appropriate comparability data. The compensation is then established, reviewed and approved by the duly authorized compensation committee of Baystate Health, Inc. The compensation of the Senior Vice President, Finance, CFO and Treasurer is reviewed and determined annually by the compensation committee of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs). This committee consists entirely of individuals serving on the board of Baystate Health, Inc. The individuals responsible for deliberating the compensation arrangement for the Senior Vice President, Finance, CFO and Treasurer and of other officers would be those individuals who do not have a conflict of interest with respect to the compensation arrangement and would be considered independent for compensation deliberation purposes. The compensation of the Senior Vice President, Finance, CFO and Treasurer is established based on information provided by independent third party consultants for reasonableness and appropriate comparability data. The compensation is then established, reviewed and approved by the duly authorized compensation committee of Baystate Health, Inc. The compensation of other officers and key employees of the filing organization is determined by the President of the filing organization in accordance with the Executive Compensation Philosophy Statement, in consultation with Human Resources, based on information provided by independent third party consultants for reasonableness including appropriate comparability data or the Baystate Health Board approved budget and wage program for each fiscal year. Line 15a has been answered No because the President is paid by Baystate Administrative Services, Inc., an affiliate and related organization of the filing organization. |
| Form 990, Part VI, Section C, line 19 | The organization makes its conflict of interest policy and financial statements available to the public at www.baystatehealth.org. Articles of organization and bylaws are generally available at the Commonwealth of Massachusetts website. Form 990, Part VII, Section A, Line 5 Certain officers or trustees of the filing organization are paid by an entity, Baystate Medical Practices, Inc. (BMP) EIN 04-2888373, which is part of the health care system to which the filing organization belongs but does not meet the technical requirements as a "Related Organization" per Schedule R. Compensation from BMP to the officers and trustees of the filing organization therefore, is reported as paid from an unrelated organization in Line 5 and according to the instructions reported as though paid by the filing organization. |
| Form 990, Part XI, line 9: | Net Transfers From Affiliated Companies -5,156,052. Transfers for the cost of land, buildings, and equipment 7,500,363. Net Assets Released From Restrictions 231,563. Beneficial Interest in Related Company 12,837. Restrictions Released for PPE 126,208. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (12 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Baystate Health Inc | ||||||||||
| 759 Chestnut Street | Springfield | MA | 01199 | 042105941 | Healthcare System Parent | MA | 501 (c ) (3) | 7 | Baystate Health Inc | 0 |
| Baystate Medical Center Inc | ||||||||||
| 759 Chestnut Street | Springfield | MA | 01199 | 042790311 | Acute Care Teaching Hospital | MA | 501 (c ) (3) | 3 | Baystate Health Inc | 0 |
| Baystate Franklin Medical Center | ||||||||||
| 164 High Street | Greenfield | MA | 01301 | 042103575 | Hospital | MA | 501 (c ) (3) | 3 | Baystate Health Inc | 0 |
| Baystate Wing Hospital Corporation | ||||||||||
| 40 Wright Street | Palmer | MA | 01069 | 222519813 | Hospital | MA | 501 (c ) (3) | 3 | Baystate Health Inc | 0 |
| Visiting Nurse Assn and Hospice of Western New England Inc | ||||||||||
| 30 Capital Drive Suite A | West Springfield | MA | 01089 | 042105803 | Homehealth and Hospice care | MA | 501 (c ) (3) | 10 | Baystate Health Inc | 0 |
| Baystate Total Home Care Inc | ||||||||||
| 50 Maple Street | Springfield | MA | 01199 | 203260764 | Real Estate and Other | MA | 501 (c ) (3) | 12b, II | Baystate Medical Center | 0 |
| Baystate Administrative Services Inc | ||||||||||
| 759 Chestnut Street | Springfield | MA | 01199 | 222747685 | Administrative services | MA | 501 (c ) (3) | 12c, III | Baystate Health Inc | 0 |
| Baystate Health Foundation Inc | ||||||||||
| 759 Chestnut Street | Springfield | MA | 01069 | 043549011 | Fundraising | MA | 501 (c ) (3) | 7 | Baystate Health Inc | 0 |
| Westfield Medical Corporation | ||||||||||
| 115 West Silver Street | Westfield | MA | 010861634 | 043127730 | Healthcare | MA | 501 (c ) (3) | 12a, I | Baystate Noble Hospital Corporation | 0 |
| Health New England Inc | ||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 042864973 | HMO/Insurance | MA | 501 (c ) (4) | Baystate Health Inc | 0 | |
| HNE of Connecticut Inc | ||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 465190134 | HMO/Insurance | CT | 501 (c ) (4) | Health New England | 0 | |
| Baystate Health Systems Inc Health & Welfare Benefits Plan | ||||||||||
| 759 Chestnut Street | Springfield | MA | 01199 | 222531644 | Voluntary Employees' Benefit Association | MA | 501 (c ) (9) | Baystate Health Inc | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HNE Advisory Services | |||||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 043012347 | Administrative Services | MA | HNE Holding Corporation | C | 0 | ||||
| HNE Insurance Services Inc | |||||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 043183019 | Ancilliary Insurance | MA | HNE Holding Corporation | C | 0 | ||||
| Ingraham Corporation | |||||||||||||
| 759 Chestnut Street | Springfield | MA | 01199 | 043016257 | Health care and other business activities | MA | Baystate Health Inc | C | 0 | ||||
| HNE Holding Corporation | |||||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 464620480 | Holding shares in subsidiary corporations | MA | Health New England Inc | C | 0 | ||||
| HNE Insurance Company Inc | |||||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 454462433 | Health Ins svcs for Mass Medicare supplement members | MA | HNE Holding Corporation | C | 0 | ||||
| Baystate Health Insurance Company LTD | |||||||||||||
| 980421413 | Offshore captive insurance | Baystate Health Inc | C | 0 | North Church St | Georgetown | CJ | CJ | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Westfield Medical Corporation | ||
| A | $94,247 | Actual Amount |
| Westfield Medical Corporation | ||
| B | $13,287,920 | Actual Amount |
| Health New England Inc | ||
| Q | $3,904,158 | Actual Amount |