2019-08-09T10:38:08-05:00 2018-09-30 861065772 Deloitte Tax LLP Two Jericho Plaza Jericho NY 11753 990 2017-10-01 042103575 Baystate Franklin Medical Center BAYS 4137940000 164 High Street Greenfield MA 01301 Dennis W Chalke SVP Finance, CFO & Treasurer 4137940000 2019-08-09 1 Jeanne Fahrenbach P01365953 5169187000 208.99.255.205 2019-08-09 08:39:07 ED P E6E6B1DEE2C3A01552DA3A94E9AF66566F60AB34 D6D028B83EC7BAE48696A0FE418AC7215527A94E 2017 2019-02-21 02:37:17Z Dennis W Chalke 759 Chestnut Street Springfield MA 01199 103820811 0 X www.baystatehealth.org/fmc X 1895 MA The mission of the organization is to improve the health of the people in our communities every day, with quality and compassion. 22 17 861 327 0 0 604308 2309011 93077499 95211536 909005 711507 2994199 4224778 97585011 102456832 0 0 0 0 45367246 43740762 0 0 0 53039531 57037974 98406777 100778736 -821766 1678096 97598411 92638303 45456818 39425972 52141593 53212331 X The mission of the organization is to improve the health of the people in our communities every day, with quality and compassion. 0 0 39489228 40614403 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 FY18, Baystate Franklin Medical Center provided 18,795 patient days of inpatient services, with 4,920 discharges. 34639920 39333306 Outpatient healthcare services - Providing outpatient clinical services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY18, Baystate Franklin Medical Center had 87,125 outpatient visits. 11585814 14087580 Emergency department services - Providing emergency department services to the surrounding region. Services are available to individuals regardless of their ability to pay. During FY18, Baystate Franklin Medical Center had 25,496 emergency department visits. 7521050 4951813 Other Program services - Providing pharmacy services to the surronding region. Services are available to individuals regardless of their ability to pay. 7521050 4951813 93236012 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 60 0 1 861 1 0 0 0 0 0 0 0 0 0 0 X 22 17 1 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 1 1 MA X Dennis W Chalke Baystate Health Inc 4137940000 759 Chestnut Street Springfield MA 01199 X Anne M Paradis Chair 1.00 2.00 X X 0 0 0 John F Maybury Vice Chair 1.00 1.00 X X 0 0 0 Adrian J Levsky Trustee 1.00 1.00 X 0 0 0 Claudia R Coplein DO Trustee 1.00 1.00 X 0 0 0 Colleen W Holmes Trustee 1.00 1.00 X 0 0 0 Edward J Noonan Trustee 1.00 1.00 X 0 0 0 Grace Makari-Judson MD Trustee/Hematologist (thru 12/31/17) 1.00 40.00 X 340368 0 77945 Gregory L Braden MD Trustee 1.00 1.00 X 0 0 0 Harriet A DeVerry Trustee 1.00 1.00 X 0 0 0 Hector Toledo Trustee 1.00 1.00 X 0 0 0 Irene Rodriguez Martin Trustee (as of 1/1/18) 1.00 1.00 X 0 0 0 James P Sadowsky Trustee (through 12/31/17) 1.00 2.00 X 0 0 0 James R Phaneuf Trustee 1.00 1.00 X 0 0 0 John A Egelhofer MD Trustee 1.00 1.00 X 0 0 0 John H Davis Trustee (through 12/31/17) 1.00 1.00 X 0 0 0 Kathleen B Scoble Trustee 1.00 1.00 X 0 0 0 Kevin P Moriarty MD Trustee/ Chief Ped Surgery 1.00 40.00 X 686449 0 38262 Maria P Goncalves Trustee (as of 1/1/18) 1.00 1.00 X 0 0 0 Mark A Keroack MD Trustee 1.00 49.00 X 0 1888794 32862 Paul R Murphy Trustee 1.00 1.00 X 0 0 0 Rakesh Talati MD Trustee 49.00 1.00 X 429737 0 32326 Robert J Bacon Trustee 1.00 1.00 X 0 0 0 Robert L Pura PhD Trustee 1.00 1.00 X 0 0 0 Timothy F Farrell Trustee 1.00 1.00 X 0 0 0 Victor Woolridge Trustee (through 12/31/17) 1.00 1.00 X 0 0 0 William R Webber Trustee 1.00 1.00 X 0 0 0 Cindy L Russo President (through 1/12/18) 50.00 0.00 X 0 443528 30779 Ronald P Bryant President (as of 1/13/18) 50.00 0.00 X 0 583904 46551 Dennis Chalke Treasurer 1.00 49.00 X 0 994659 87008 Kristin R Delaney Clerk 1.00 39.00 X 0 143978 37512 Madeline Torres Assistant Clerk 1.00 40.00 X 0 57772 15600 Deborah A Provost Chief Nursing & Admin Officer 25.00 25.00 X 0 283939 74164 John Shaver Chief Financial Officer BNH 50.00 0.00 X 0 256150 12029 Leesa Lee Keith Chief Nursing Officer (thru 11/4/17) 50.00 0.00 X 197981 0 55588 Regina O Campbell COO (through 11/18/17) 50.00 0.00 X 193800 0 21462 Gregory Oles Director of Support Services 50.00 0.00 X 150553 0 36317 Jenni L Lanoue Director Med/Surg/Tele/ICU 50.00 0.00 X 150011 0 26651 Lynda J Zukowski Director Clinical Svcs 50.00 0.00 X 149683 0 40783 Charles W Redd Dir Patient Care Svcs 50.00 0.00 X 140125 0 32436 Linda A West Manager, Nursing 50.00 0.00 X 134080 0 29115 Jason M Kulp Pharmacist 50.00 0.00 X 133067 0 11088 Thomas L Higgins MD Former Interim President, BFMC 40.00 10.00 X 602546 0 36432 3308400 4652724 774910 28 1 1 1 Baystate Medical Practices Inc 759 Chestnut Street Springfield MA 01199 Physician Services 11440307 Baystate Administrative Services Inc 759 Chestnut Street Springfield MA 01199 Management/I.S, Services 8207899 Baystate Medical Center Inc 759 Chestnut Street Springfield MA 01199 Lab Services/ Support Services 6073433 Freedom Healthcare Staffing 2851 S Parker Road Ste 1100 Aurora CO 80014 Support Services 2010034 Morrison Management Specialist PO Box 102289 Atlanta GA 303682289 Management Services 482377 14 1182154 1126857 2309011 Net Patient Revenue 622110 93713493 93713493 Rental Income Relate Organization 532000 928168 928168 MCD Waiver Safety Net Care 622110 569875 569875 95211536 379629 379629 217566 230199 -12633 -12633 -12633 1465658 1133780 331878 331878 331878 Pharmacy Services 622110 2080100 2080100 Intercompany Printing 622110 469365 469365 Cateria Income 622110 461845 461845 1226101 1226101 4237411 102456832 98987102 0 1160719 604101 417231 186870 36131824 35768801 363023 226185 199788 26397 4045238 3893379 151859 2733414 2624077 109337 6307890 3085298 3222592 63028 62890 138 43182 43182 90187 90187 37715874 34421033 3294841 3887194 3887194 2079165 2079165 67845 32856 34989 74348 57907 16441 689160 689160 5591664 5588796 2868 428437 428437 100778736 93236012 7542724 0 8022597 4359718 11404484 14129646 1471182 1651038 861668 1052362 149944096 96678459 55747175 53265637 530081 495818 19561224 17684084 97598411 92638303 7863083 10695927 517219 259429 25722050 24675111 11354466 3795505 45456818 39425972 X 34095901 36043139 9832495 8917267 8213197 8251925 52141593 53212331 97598411 92638303 X 1678096 -1049795 442437 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 90187 90187 0 Part II-B, Line 1: Baystate Franklin Medical Center 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 the dues listed as lobbying expenses for the year ending September 30, 2018 is $ 90,187. 1275130 1275130 95161750 52904467 42257283 47986806 39721117 8265689 5520410 4052875 1467535 53265637 Funds Held By Bond Trustee 78620 Benefical Interest in Perpetual Trust BHF 4744854 Benefical Interest in Net Assets of BHF 12860610 17684084 Insurance Liability Loss Reserve 287000 Minimum Pension Liability 3408292 Other Liabilities 100213 3795505 Part V, Line 4: Certain endowments are held at Baystate Health Foundation (BHF), an affiliate, and are reported as temporarily restricted and permanently restricted but Part V has not been completed as it is already addressed on BHF's Form 990 (EIN 04-3549011). 1 1 X 1 X 1 X 1 1 1 0 1 1 1375906 395023 980883 0.00970 19123690 14316342 4807348 0.04770 146492 129668 16824 0.00020 20646088 14841033 5805055 0.05760 220125 220125 0.00220 3449434 2641831 807603 0.00800 160743 160743 0.00160 3830302 2641831 1188471 0.01180 24476390 17482864 6993526 0.06940 1780 1780 0.00000 1780 1780 0.00000 1 784517 728 29585321 31115088 -1529767 X 1 1 1 1 Baystate Franklin Medical Center 164 High Street Greenfield MA 01301 2120 X X X Baystate Franklin Medical Center 1 0 0 1 X X X X X X X X X 15 1 1 1 1 X See Part V X See Part V X X 1 16 1 See Part V 0 1 X 150.000000000000 300.000000000000 X X X 1 1 X X X X X 1 X https://www.baystatehealth.org/patients/billing-and-financial-assistance X https://www.baystatehealth.org/patients/billing-and financial-assistance X https://www.baystatehealth.org/patients/billing-and-financial-assistance X X X X X X X 1 X 0 X X X X 1 X 0 0 Baystate Franklin Medical Center Part V, Section B, Line 5: A wide range of stakeholders took part in the 2016 Coalition 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 focus groups, key informant interviews and participation in the CHNA Steering Committee. Additionally, community listening sessions were conducted to vet findings with community members.The following organizations/community stakeholders were interviewed: Public Health Experts: Caulton-Harris, Helen, Commissioner of Public Health, City of Springfield; Dennis, Soloe, Western Region Director, Massachusetts Department of Public Health (MDPH); Garcia, Luz Eneida, Care Coordinator, MDPH Division for Perinatal, Early Childhood and Special Needs, Care Coordination Unit; Hyry-Dermith, Dalila, Supervisor, MDPH Division for Perinatal, Early Childhood and Special Needs, Care Coordination Unit; Merriam, Carolyn, Public Health Nurse, Town of Ware; Metcalf, Judy, Director, Quabbin Health District; O'Leary, Meredith, Director, Northampton Health Department; Steinbock, Lisa, Public Health Nurse, City of Chicopee; Walker, Phoebe, Director of Community Services, Franklin Regional Council of Governments (FRCOG); and White, Lisa, Public Health Nurse, Franklin Regional Council of Governments (FRCOG). Community Leaders or Health or Other Agencies Interviewed: Adzigirey, Liliya, Translator/ Interpreter, Baystate Noble Hospital; Azeez, Robert, Medicaid Behavioral Health Manager, Health New England; Balder, Dr. Andrew, Director, Mason Square Neighborhood Health Center and Health Care for the Homeless; Beck-Brewer, Joni, Vice President, Patient Services, Square One Benjamin, Dr. Evan, Chief Quality Officer and Sr. VP of Quality and Population Health, Baystate Health; Blanchet, M.D., Jacques, Director of the Emergency Department, Baystate Noble Hospital; Boos, Dr. Stephen, Medical Director, Baystate Family Advocacy; Bouthillette, Marianne, Director of Child and Family Services, Parent Child Development Center, Community Action of the Franklin, Hampshire and North Quabbin Regions; Bradley, Leah, Director of Behavioral Health, Baystate Wing Hospital Griswold Center; Cardaropoli, Antonia, School Adjustment Counselor, Ware Junior/Senior High School; Cox, Jennifer, Director of Behavioral Health, Baystate Franklin Medical Center; Crowley, Kelley, Administrative Director of Behavioral Health, Baystate Noble Hospital; Cummings, Sara, Director of Community Services and Asset Development, Community Action of the Franklin, Hampshire and North Quabbin Regions; Davis, Kim, Nurse Manager, Baystate Mary Lane Hospital; Di Leo, Marlene, Superintendent, Ware Public Schools; Durkin, Dr. Louis, Director of Emergency Medicine, Mercy Medical Center; Gerard, Mary Beth, WIC Director, Community Action of the Franklin, Hampshire and North Quabbin Regions; Hettler, Dr. Joeli, Chief, Pediatric Emergency Medicine, Baystate Health; Higgins, Clare, Executive Director, Community Action of the Franklin, Hampshire and North Quabbin Regions; Jean-Guillaume, M.D., Rock, Chair of Emergency Medicine, Baystate Wing Hospital; Jock, Jacqueline, School Adjustment Counselor, Ware Middle School; Johnson, Yolanda, Executive Officer for Student Services, Springfield Public Schools; LaBounty, Kerry, Medicaid Program Manager, Health New England; Manser, Katherine, WIC Senior Nutritionist, Community Action of the Franklin, Hampshire, and North Quabbin Regions; Martoccia, Roseann, Executive Director, LifePath; Ostiguy, Karen, Nurse Manager, Baystate Wing Hospital; Paulson, Tina, Nurse Manager, Baystate Mary Lane Hospital; Plourde, Annette, RN, Nurse, Monson Medical Center; Rathlev, Dr. Niels, Chair, Emergency Medicine, Baystate Health; Reilly, Elizabeth, Hardwick Youth Center and Food Pantry; Roose, Dr. Robert, Chief Medical Officer, Addiction Services for the Sisters of Providence Health System; Member of the Governor's Task Force on Opioid Abuse; Russo-Appel, Dr. Maria, Chief Medical Officer, Providence Behavioral Health Hospital (PBHH); Shaver, John, Chief Financial Officer, Baystate Noble Hospital; Shendell-Falik, Nancy, President, Baystate Medical Center and Sr. VP, Hospital Operations, Baystate Health; Silva, David, Medicaid Community Leader, Health New England; Spain, M.D., Jackie, Medicaid Program Medical Director, Health New England; Talati, M.D., Rakesh, Chair of Emergency Medicine, Baystate Franklin Medical; Taylor, Charles, Reverend, United Church of Ware; Velazquez, M.D., Louis, Baystate Wing Griswold Center. The following individuals served on the CHNA Steering Committee, which met monthly over the course of a year with the Coalition and CHNA Consultant Team: Allard, Andrea, President/CEO, YMCA of Westfield; Amador, Ruth, President, National Association of Hispanic Nurses -Western MA Chapter; Ayres, Jim, President and CEO, United Way of Hampshire County; Barber, Tania, President/CEO, Caring Health Center; Blanchette, Mary Ellen, Nurse Leader, Palmer Public Schools; Caisse, Ed, C3/Safe Neighborhood Initiative - South Holyoke, Hampden County Sheriff's Department; Christopolis, Dave, Executive Director, Hilltown CDC; Garozzo, Salvatore, Executive Director, United Cerebral Palsy Assoc. of Berkshire County, Inc.; Graves, Marie, Program Director, Springfield Dept. Health & Human Services; Rudder, Shannon Executive Director, MotherWoman; Lee, Jennifer, Systems Advocate for Change, Stavros Center for Independent Living; Lewandowski, Sue, Representative for Worcester County, Assumption College; Lopez, Luz, Director, MetroCare of Springfield; McCafferty, Gerry, Director of Housing, City of Springfield, Office of Housing; Prullage, Beth, Clinical Social Worker, Providence Behavioral Health; Reeves, Halley, Community Health Planning And Engagement Specialist, MA Dept. of Public Health; Silverman, Risa, Coordinator, Office for Public Health Practice & Outreach, UMASS Amherst School of Public Health and Health Sciences; Simmons, Tony, Community Liaison, Hampden County District Attorney's Office; Simonds, Jane, Sr. Program Manager, Behavioral Health Network - Outpatient Services; Walker, Phoebe, BFMC CBAC Co-chair, Franklin Regional Council of Governments (FRCOG); Wilson, Gloria, Member Western MA Black Nurses Association; Wood, Ben, Healthy Community Design Coordinator, MA Dept. of Public Health. Baystate Franklin Medical Center Part V, Section B, Line 6a: In 2016, in partnership with the Coalition of Western MA Hospitals/Insurer, the hospital facility conducted a community health needs assessments ("CHNA") of the geographic area served by the hospital facility. The Coalition of Western Massachusetts Hospitals/Insurer ("Coalition"), a partnership between nine (9) not-for-profit hospitals and an insurer in western Massachusetts that includes: Baystate Medical Center, Baystate Franklin Medical Center, Baystate Noble Hospital, Baystate Wing Hospital,(including Baystate Mary Lane Outpaitent Center), Holyoke Medical Center, 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. Baystate Franklin Medical Center Part V, Section B, Line 6b: The Coalition of Western MA Hospitals and Insurer engaged the Public Health Institue of Western MA (PHIWM), based in Springfield, MA, as the lead consultant to conduct the CHNA's. PHIWM was supported by two other consultant teams; Community Health Solutions, based in Northampton, 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 Franklin Medical Center 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. The regional findings from the CHNA reports were shared publicly at the Western MA Health Equity Summit in November 2016 (over 300 attendees). In addition, the CHNA reports have informed the development and implementation of county wide community health improvement plans. Hospital and CHNA consultant staff have been invited to various venues and audiences to present on the CHNA process and key findings. Baystate Franklin Medical Center 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 2016 CHNA.Hospital resource inputs that will help address priority health needs include, Community Benefits Investments, Community Relations Investments, Better Together Grant Program, hospital-based community benefits activities, external grants received by hospital, and other hospital-based program/services.The hospital facility views a community benefits implementation strategy as a "LIVING" document. 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 implementation strategy 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 patnership with its Community Benefits Advisory Council updates the work plan with annual outputs and outcomes for each input and activity. No health care system or hospital facility can address all the health needs 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 continue community health planning and improvement efforts. The hospital facility's implementation strategy does not explicitly address all the priority community health needs identified in the 2016 CHNA due to; 1. the hospital's limited resources (time, talent and financial), 2. other hospitals or community organizations within service area are addressing the need; 3. the need falls outside of the hospitals' mission or limited resource capacity. However, many, if not all of the CHNA priority health needs will be addressed INDIRECTLY by the hospital and/or community partners through existing community health planning and improvement efforts.Needs being addressed include, care coordination, chronic health conditions, cultural humility, health equity, insurance challenges, limited availability of providers, maternal/infant/ child health, mental health and substance use disorders, and sexual health/teen pregnancy. Needs not directly being addressed the hospital include, basic needs, transportation, food deserts/ insecurity, health literacy, and physical activity and healthy diet. Baystate Franklin Medical Center 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 Franklin Medical Center offers a co-payment discount program for patients receiving services in the emergency department of the hospital. This discount program is available to all hospital emergency department patients with co-payment obligations under private or government health insurance (unless prohibited by law or a Baysate Franklin Medical Center'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 Franklin Medical Center Part V, Section B, Line 15e: Baystate Franklin Medical Center (BFMC) 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 BFMC bills as well as about BFMC 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, BFMC 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. BFMC 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 Franklin Medical Center 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 Franklin Medical Center 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 7a: https://www.baystatehealth.org/about-us/community-programs/community-benefits/community-health-needs-assessment7b: http://www.cbsys.ago.state.ma.us/cbpublic/public/annual_reports_start.aspx Form 990, Schedule H, Part V, Line 10 10a: https://www.baystatehealth.org/about-us/community-programs/ community-benefits/community-health-needs-assessment 2 1 - Baystate Rehabilitation Care at BFMC 48 Sanderson Street Lev 1 Ste 3 Greenfield MA 01301 Rehabilitation Clinic 2 - Outpatient Behavioral Health Srvcs 48 Sanderson Street 2nd Flr Greenfield MA 01301 Partial Hospitalization Services Part I, Line 6a: The hospital facility files an annual community benefits report electronically with the Massachusetts Office of the Attorney General's via their website at https://www.mass.gov/nonprofit-hospital-and-hmo-community-benefits. The hospital facility's annual community benefits report is also published on the Baystate Health website at https://www.baystatehealth.org/about-us/community-programs/ community-benefits/community-health-needs-assessment. The hospital's community benefits report provides the Office of the Attorney General and the general public important information about how the hospital partners with the community to identify and address health needs. Part I, Line 7: Line 7a (Charity Care) - community benefit expense was calculated by applying the ratio of patient care cost to charges, calculated on Worksheet 2, against total charity care gross patient charges from the audited financial statements.Line 7b (Unreimbursed Medicaid) - community benefit expense was derived using the organization's cost accounting system, which takes into account all hospital inpatients, outpatients and emergency room patients for whom services were provided and covered under Medicaid and Medicaid managed care plans.Line 7c (Other Means-Tested Programs) - community benefit expense was derived using the organization's cost accounting system, which takes into account all hospital inpatients, outpatients and emergency room patients for whom services were provided and covered under other means-tested government programs.Line 7e Community Health Improvement Services calculations are derived from direct and indirect costs associated with community benefit activities that are aligned with the hospital's 2013 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 7g (Subsidized Programs) - community benefit expense was derived using the organization's cost accounting system. The expense relates to the inpatient behavioral health program. Part I, Line 7g: There are no costs attributable to physician clinics reported as subsidized health services in Part I, line 7g. Part I, Ln 7 Col(f): In fiscal year 2013, the organization adopted the provisions of Accounting Standards Update 2011-07, Health Care Entities (Topic 954), Presentation and disclosure of Patient Service Revenue, Provision for Bad Debts, and the Allowance for Doubtful Accounts for Certain Health Care Entities on October 1, 2012. The update changed how the provision for bad debts is reported on the audited financial statements. In prior years it was included with total operating expenses, and subtracted from total expenses reported in Part IX, Line 25, column (A) for the purpose of calculating the percentages in Part I, Line 7, column (f). In 2018, the provision for bad debts was reported as a deduction to net patient service revenue. The 2018 provision for bad debts totaled $2,381,553 and is not included in total expenses reported in Part IX, Line 25, column (A) of Form 990 for the purpose of calculating the percentages in Part 1, Line 7, column (f) of this Schedule H. 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 we serve; including grants and sponsorship of local community-based organizations and the involvement of Baystate leadership with various community board that align with our mission. The hospital facility paid dues to the Franklin County Chamber of Commerce and the Greenfield Business Association, and the Shelburne Falls Business Association, totaling $1,780. The hospital participates in the Chamber and local business associations as we are one of the largest local employers in our service area. The Chamber and its membership 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 patient bad debt net of recoveries as reported 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, totaling $728 should be treated as community benefit expense in Part I. As noted above, the organization adopted Accounting Standards Update 2011-07 effective October 1, 2012, which changed the way entities report and disclose certain financial information including the provision for bad debts. See footnote #2 (Significant Accounting Policies) on page 13 of the audited financial statements under the caption "Allowance for Uncollectible Accounts" for a description of the organization's reporting of its 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 the general ledger. Patients applying for a prompt payment discount will have this allowance entered after agreed upon payment is received. Part III, Line 8: Line 6 - included all Medicare allowable costs as calculated in Worksheets D-1 Part II (inpatient) and D Part V (outpatient) of the hospital's 2018 Medicare cost report, net of Medicare costs reported in Part I, line 7.g, based on Medicare costing principles. We believe the shortfall of $1,529,767 reported on line 20 should be treated as 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 should be treated similarly to unreimbursed Medicaid since the majority of the local elder 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 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 into the health system's strategic plan; review of CHNA data; approval of a community benefits mission statement and health priorities; reviewing impacts of community benefits activities and investments; and ensuring Baystate'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 priorites. 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 retore 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. 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 patients in need the opportunity to apply for free or reduced cost services. The hospital not only offers free and reduced cost care to the financially needy 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 state and federal 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 state and federal 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. Our Financial Assistance Policy and Billing and Collection Policy are posted on the baystatehealth.org website athttps://www.baystatehealth.org/-/media/files/patients-and-visitors/billing -and-financial-assistance/baystate-health-hospitals-billing-collections -policy-91516.pdf?la=en. The goal of posting the Financial Assistance Policy and the Billing and Collection Policy is to ensure that patients or prospective patients in our community are aware of our financial assistance programs. Signs about the availability of financial assistance programs at the hospital are translated into Spanish and Russian as Spanish and Russian are primarily spoken by more than 1000 residents or 1% of the residents in the hospital's service area. Signs are large enough to be clearly visible. Hospital signs are 8.5 x 11 inches and the header print font is 24 pts. 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: Baystate Franklin Medical Center (BFMC) is a 89-bed acute-care community hospital. Our top priority is giving Franklin County and the North Quabbin Region the clinical excellence, advanced technology, neighborly warmth and convenience of a community hospital. Hospital specialties provided include inpatient behavioral health, cancer care, cardiology, children's medicine, critical care, emergency medicine, endocrinology and diabetes, gastroenterology, infectious disease, maternal fetal medicine, midwifery, neurology, neurosurgery, orthopedics, physical medicine and rehabilitation, plastic surgery, pulmonary medicine, senior care, surgery, thoracic surgery, urology and women's health.The service area for Baystate Franklin includes the 26 communities in Franklin County, as well as the Town of Athol, which is located in Worcester County. The region is fairly rural, and borders the state of Vermont to the north. The total population of the service area is just over 80,000. There is a mix of rural and urban populations as defined by the U.S. Census Bureau. Urban areas consist of census tracts and/or blocks that meets the minimum population density requirement (2,500-49,999 for urban clusters and over 50,000 for urbanized areas) or is adjacent and meet additional criteria. The main population centers in the service area include Greenfield (a city of about 17,000 people), and the North Quabbin region(population of about 18,000) located approximately 20 miles to the east of Greenfield. Many communities in the area are nestled among hilly, forested terrain, and have populations under 2,000. The median age in this service area is higher than the state's at 45 years old (ACS, 2010-2014). Less than six percent of the population identifies as either Black or African American, Asian, American Indian or some other race. Those who identify as Hispanic and Latino population comprise 4% of the total population. Economic indicators vary somewhat between the two population centers in the Baystate Franklin service area. The median household income in Franklin County is just over $54,000 ($13,000 less than the state). The overall poverty rate in Franklin County is similar to that of the state at 12%, and the child poverty rate of 16% is slightly higher than that of the state (ACS, 2010-2014). Athol is more economically depressed, with an overall poverty rate of 17% and a child poverty rate of 28%, almost double the state rate of 15%. Approximately 92% of adults over the age of 25 hold a high school diploma and over 34% hold a bachelor's degree or higher. In Athol, these numbers are lower at 85% and 15% respectively.The Franklin County unemployment rate of 4.4% was comparable to the state's rate of 4.9% (CC, U.S. Department of Labor, Bureau of Labor Statistics). The unemployment rate is based on the number of people who are either working or actively seeking work. Major employers in the region include the health care and social assistance industry, as well as the education, retail and manufacturing industries.The area is served by a regional transit (bus) system that connects population and employment centers within the region. Paratransit service is also available for people with disabilities within 3/4 mile of a fixed route to facilitate access to medical care. Daily train service provides access to larger cities to the south, such as Springfield and Hartford. 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 hospital is fully committed to its role in the community and serves with pride and compassion for people in need.The charitable mission of the hospital facility, a member hospital of Baystate Health (BH), 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 entity or community-based. 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, 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 select 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.The hospital's Patient and Family Advisory Council facilitate patients and families to share information and advise the hospital regarding policies and programs. Information from the Council 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.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, Inc. is the parent entity of a multi-institutional integrated delivery system composed of four hospitals and other 501(c)(3) organizations. The four hospitals are Baystate Medical Center, Baystate Franklin Medical Center, Baystate Noble Hospital Corporation and Baystate Wing Hospital Corporation (and Baystate Mary Lane Outpatient Center); the other 501(c)(3) organizations include Baystate Medical Practices Inc., Visiting Nurse Association and Hospice of Western New England Inc., Noble Visiting Nurse Services, Inc., Baystate Administrative Services Inc., Baystate Total Home Care, Inc., Westfield Medical Corporation and Baystate Health Foundation Inc. In addition to its nearly 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 Medical Center has been training doctors since 1914. Now the regional campus of the University of Massachusetts Medical School, we offer: 10 ACGME-accredited residencies; 20+ fellowships; 50 4th-year electives for medical students; and Population-based Urban and Rural Community Health (PURCH)-a curriculum track of the University of Massachusetts Medical School. We are 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. We offer clinical practicums for baccalaureate, masters, or doctoral-level nursing students at affiliated schools of nursing. We offer four pharmacy residencies-two PGY1 programs and two PGY2 programs-through our affiliations with the Massachusetts College of Pharmacy and Health Science, and Western New England University College of Pharmacy and Health Science. We also offer Advanced Practitioners education including: Midwifery Education Program, Physician Assistant Residency in Emergency Medicine, and Clinical rotations for Advanced Practice students. Volunteers enhance the work of our employees and interactions with our patients and families. In 2018, more than 900 volunteers donated over 100,000 hours showing their belief in the care we provide to our community.Baystate Medical Center (BMC) is a 724-bed, 57-bassinet, academic medical center in Springfield, Massachusetts. As a major referral care center and the only Level 1 trauma center and pediatric trauma center for western Massachusetts, BMC has one of New England's busiest emergency rooms. In addition, the medical center offers the Baystate Children's Hospital, Baystate Heart & Vascular Program and the Baystate Regional Cancer Program, among other advanced specialty medical, behavioral health, diagnostic, and surgical services. Baystate Children's Hospital, part of Baystate Medical Center, 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, located in Greenfield, Massachusetts, is an 89-bed acute care hospital that boasts a state-of-the-art surgical center. The hospital provides comprehensive inpatient and outpatient services including 24-hour emergency, heart & vascular, cancer care, behavioral medicine, and family-centered obstetrical care.Baystate Noble Hospital, a 97-bed community hospital located in Westfield, Massachusetts,offers a variety of inpatient and outpatient services for over 80,000 residents in the Westfield, Massachusetts area including surgery, pulmonary rehabilitation and acute inpatient rehabilitation, cardiac, behavioral health, and emergency care. Baystate Noble Hospital's network also includes Noble Medical Group Primary Care physicians and specialists, Visiting Nurse Association and Hospice of Western New England, Noble Visiting Nurse Services, Inc., and Noble Sports & Rehabilitation Center.Baystate Wing Hospital, a 74-bed community hospital located in Palmer, Massachusetts, offers 24-hour emergency care and a broad range of inpatient and outpatient medical and surgical services, including comprehensive outpatient behavioral health and addiction recovery services. Satellite facility Baystate Mary Lane Outpatient Center offers 24-hour emergency services, and outpatient medical, surgical, ancillary, and cancer care.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 BH and BMP policy, BMP may provide such care free of charge or at amounts below its normal charges. In 2018 BMP provided $1,475,687 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 AIDS and HIV and by providing physician staffing for three community-based health centers through Baystate Medical Center.Visiting Nurse Association and Hospice of Western New England and Noble Visiting Nurse Services, Inc. provide the highest quality care and supplies to patients and families, primarily in their homes. They are a comprehensive in-home health care, hospice, and palliative care agency with a staff of over 450 managing more than 90,000 visits annually. Our home health team works together to ensure a safe and swift recovery from illness, accident, or surgery in the comfort of home. Visiting Nurse Association and Hospice of Western New England, and Noble Visiting Nurse Services, Inc. offers medical expertise through our extensive network of caregivers to support patients facing a serious or life limiting illness. Each patient and family is cared for by our 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, part of Baystate Health, is the region's largest reference laboratory and is staffed by 24 board-certified pathologists and over 500 technologists and support personnel.In addition to the brief descriptions of some of the affiliated entities above, this further information speaks to activities of Baystate Health and its affiliates regarding promotion of community health.In 2018, over 170,700 language interpreter sessions helped patients and families better understand their care. Staff interpreted about 59 languages in person, over the phone, and via video, and translated 3,264 pages of patient-related information. In partnership with the University of Massachusetts Medical School, Baystate Health is now the regional campus for an innovative new curriculum track called PURCH (Population-based Urban and Rural Community Health). The PURCH track focuses on addressing the social determinats of health for our patients. Forty-eight students are currently enrolled in PURCH;twenty-nine are Massachusetts residents. The PURCH track is designed to prepare students to care for Baystate'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. Form 990, Schedule H, Part VI, Line 6 Continued The Nurse Residency Program expanded to all Baystate Health hospitals. Baystate's Nurse Residency Program is a one-year program for newly graduated registered nurses, offering hands-on clinical experience, in-depth learning through monthly seminars, participation in evidence-based projects, and ongoing professional development. Baystate Health is committed to continuing education programs in 30 different professional areas through partnerships with Elms College, Springfield College, Western New England University, STCC, Greenfield Community College, Holyoke Community College, Westfield State University, and many others. Our post graduate programs expanded to 10 medical residencies and 20 fellowships, including new fellowship training programs in hospital medicine and gastroenterology.Baystate Springfield Educational Partnership (BSEP) ran courses for 307 students, primarily residents of Springfield. During the summer, BSEP provided theme-based workshops for 66 students, coordinated 13 summer internships at Baystate Medical Center and placed 16 students in work experiences as part of the Workforce Innovation and Opportunity Act program and the Youth Works program, both sponsored by the Regional Employment Board of Hampden County and awarded 18 BSEP alumni with a total of $25,000 in scholarships for undergraduate and graduate education.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 Mother Woman 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.Baystate Medical Center provides a safe way to dispose of unwanted medications and sharps. Community members now have a resource for safely and confidentially throwing away household sharps (needles and other sharp or glass medical tools), thanks to collection receptacles now installed in the Daly lobby at Baystate Medical Center. These secure kiosks are available to the community 24 hours a day, seven days a week.With the help of Baystate Franklin Medical Center's EMPOWER (Engaging Mothers for Positive Outcomes With Early Referrals) program, a team of nurses and doctors at Baystate Medical Center implemented an innovative program called "rooming-in" where babies at risk for neonatal abstinence syndrome (a condition where babies need treatment for symptoms of withdrawal after birth) stay in a private hospital room with their mothers after birth. The program allows mothers to care for their babies while receiving specialized nursing support. Results of the program show that babies are requiring less to no medication to treat withdrawal symptoms and their hospital lengths of stay are shorter. This was a wonderful example of collaboration between the two hospitals, utilizing Baystate Franklin's expertise and working together to address the Opioid crisis in our communities. Baystate Health certified Specialty Pharmacy liaisons continue to help patients save dollars in out-of-pocket medication expenses. Liaisons are located in multiple outpatient practices including the Children's Specialty Center, the D'Amour Center for Cancer Care, and Baystate Franklin Medical Center to help ensure patients have access to critically needed and often expensive medications.The Mini-Medical School program is an eight-part health education series offered at Baystate Medical Center 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 our doors to the public and share our 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 now over 2,000 members. Baystate Health offers 50+ free programs to seniors and women. Baystate Health Senior Class is a loyalty program dedicated to health and wellness for men and women ages 55 and over. The 21,300 Senior Class members receive a quarterly newsletter with valuable health information, benefits and invitations to special events designed with their interests in mind. Baystate Every Woman Loyalty Program offers its 15,730 members 50+ monthly seminars with direct access to physicians, nurses and other medical professionals and the latest women's health information. The program is designed to increase knowledge of women's health issues so they are well prepared to make the best decisions regarding their health.Baystate Home Buying Program helped employees purchase their First Homes. In 2018, 20 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 homes in the communities surrounding Baystate Health hospitals. To-date, the program has provided more than $1.8 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. Now in its 25th year, Rays of Hope has raised over $14.8 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. Form 990, Schedule H, Part VI, Line 6 Continued 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 Benefits Report: MA X X 1 1 0 0 0 0 0 0 0 Grace Makari-Judson MD Trustee/Hematologist (thru 12/31/17) 291317 0 44081 0 4970 0 56259 0 21686 0 418313 0 0 0 Kevin P Moriarty MD Trustee/ Chief Ped Surgery 543203 0 100207 0 43039 0 22950 0 15312 0 724711 0 0 0 Mark A Keroack MD Trustee 0 1001554 0 525000 0 362240 0 17550 0 15312 0 1921656 0 0 Rakesh Talati MD Trustee 353196 0 67486 0 9055 0 20250 0 12076 0 462063 0 0 0 Cindy L Russo President (through 1/12/18) 0 329344 0 88358 0 25826 0 13500 0 17279 0 474307 0 0 Ronald P Bryant President (as of 1/13/18) 0 423246 0 111563 0 49095 0 17550 0 29001 0 630455 0 0 Dennis Chalke Treasurer 0 518753 0 189630 0 286276 0 58410 0 28598 0 1081667 0 0 Kristin R Delaney Clerk 0 128397 0 14975 0 606 0 13738 0 23774 0 181490 0 0 Deborah A Provost Chief Nursing & Admin Officer 0 227879 0 33719 0 22341 0 60873 0 13291 0 358103 0 0 John Shaver Chief Financial Officer BNH 0 253639 0 0 0 2511 0 4286 0 7743 0 268179 0 0 Leesa Lee Keith Chief Nursing Officer (thru 11/4/17) 141920 0 35217 0 20844 0 54536 0 1052 0 253569 0 0 0 Regina O Campbell COO (through 11/18/17) 142708 0 17870 0 33222 0 3502 0 17960 0 215262 0 0 0 Gregory Oles Director of Support Services 114807 0 4711 0 31035 0 25160 0 11157 0 186870 0 0 0 Jenni L Lanoue Director Med/Surg/Tele/ICU 126633 0 13124 0 10254 0 10056 0 16595 0 176662 0 0 0 Lynda J Zukowski Director Clinical Svcs 125829 0 13950 0 9904 0 26265 0 14518 0 190466 0 0 0 Charles W Redd Dir Patient Care Svcs 118955 0 9993 0 11177 0 10041 0 22395 0 172561 0 0 0 Linda A West Manager, Nursing 132107 0 0 0 1973 0 22657 0 6458 0 163195 0 0 0 Thomas L Higgins MD Former Interim President, BFMC 480429 0 0 0 122117 0 29700 0 6732 0 638978 0 0 0 Part I, Line 3 The compensation committee of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs) has been appointed through board resolution as the compensation committee of the filing organization. The compensation committee reviews and approves the compensation philosophy that is used to administer the specific pay decisions for the President of the filing organization. The compensation committee consists entirely of individuals serving on the board of the filing organization. The compensation of the President of the filing organization is determined by the member of the President's Cabinet (the Health System's senior leadership) responsible for that filing organization, in consultation with Human Resources, based on information provided by independent third party consultants for reasonableness including appropriate comparability data and based on the Executive Compensation Philosophy Statement established by the compensation committee. Part I, Lines 4a-b Line 4a: Thomas L. Higgins, MD received 9 months of variable compensation according to a severance and release agreement. He received $51,370 in 2017. Leesa Lee Keith received salary continuation of 4 months according to a severance and release agreement. She received $12,900 in 2017. She will receive $51,600 in 2018. Line 4b: Ronald P Bryant- Supplemental Retirement of $18,953 is included in column B. This amount was earned and paid in 2017. Dennis W. Chalke - Supplemental Retirement of $186,459 is included in column B. This amount was earned and paid in 2017. Thomas L. Higgins, MD - Supplemental Retirement of $8,103 is included in column B. This amount was earned and paid in 2017. Mark A. Keroack, MD - Total Supplemental Retirement of $334,356 is included in column B. This amount was earned in 2017. Grace Makari-Judson, MD- Supplemental Retirement of $9,031 is included in column B. This amount was earned in 2017. Kevin P. Moriarty, MD - Supplemental Retirement of $39,037 is included in column B. This amount was earned and paid in 2017. Rajesh Talati, MD - Supplemental Retirement of $8,263 is included in column B. This amount was earned and paid in 2017. A MA Health and Educ Facil Auth - Ser M4 042546011 2005-02-11 9100000 MHEFA Series M-4; See Part VI 0 0 1 B MA Development Finance Agency-Series A 043431814 2014-12-04 22000000 MA MDFA Series A; See Part VI 0 0 0 A 5132878 9766531 39342 45500 9630031 51658 2007 0 0 1 1 B 1159497 22013298 131800 21881498 2016 0 0 1 1 A 0 0 1 1 0 0.00720 0.00000 0.00720 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 1 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 Date Rebate Computation Performed Issuer Name: MA Health and Educ. Facil. Auth. - Ser. M4 Date the Rebate Computation was Performed: 12/17/2013 Form 990 Schedule K, Part I A - MHEFA Capital Asset Program Series M-4 Per the Official Statement, the purpose of the bond is three projects ("The Project") all to be owned and operated by Baystate Franklin Medical Center, to be located at 164 High Street, Greenfield, Massachusetts, consisting of: (a) the renovation and expansion of the radiology department (including a CAT scan suite, three mammography rooms and one ultrasound room) and the emergency department; (b) acquisition of equipment for the radiology department (including one CAT scan and one mammography unit) and for the emergency department; and (c) the renovation of approximately 28,400 square feet of inpatient units. The HEFA indebtedness listed is a pool loan therefore Parts I, II, III, and IV (Lines 5-7) are being answered with respect to Baystate Franklin Medical Center's pool loan alone rather than with respect to proceeds loaned to other conduit borrowers. The actual date of issue of the MHEFA Series M4 bonds that funded BFMC's loan was 11/4/2004, and the CUSIP number shown on Form 8038 was 57586CDX0. B - MDFA Revenue Bond, Series A Per the Official Statement, the purpose of the bond is to finance (i) capital expenditures, including capitalized interest, in connection with the following projects (the "Project"); construction, improvement, equipping and other capital expenditures relating to the (i) construction of an approximately 55,000 gross square foot addition on the Borrower's campus for use as a surgical unit, including operating rooms, preoperative patient care, patient recovery and central sterile processing, as well as approximately 10,000 gross square feet of shell space, and (i) renovation of approximately 13,000 gross square feet of existing hospital space to be used for endoscopy and bronchoscopy, as well as staff and patient support space including a lobby and waiting room, which in each case are to be owned by the borrower and located at 164 High Street in Greenfield, Massachusetts; and (ii) costs of issuance relating to the Bond. Part IV, Line 2c, Column B (Series M-4): The Issuing Authority engages an outside consultant to prepare rebate computations. As of the second computation date, 11/3/2014, no rebate was owed. 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) Grace P. Makari-Judson, MD, James P. Sadowsky and John H. Davis, (2) Paul R. Murphy and Robert L. Pura, PhD, (3) John F. Maybury and Mark A. Keroack, MD, (4) Hector F, Toledo and Timothy F. Farrell, (5) Claudia R. Coplein, DO and Victor Woolridge, (6) Colleen W. Holmes and James P. Sadowsky, (7) John F. Maybury and Anne M. Paradis. Form 990, Part VI, Section A, line 3 Baystate Franklin Medical Center 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 are 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 Franklin Medical Center meet during certain scheduled Baystate Health, Inc. (BH) board meetings. The BH Board of Trustees and its committees, including the Audit and Compliance Committee, contemporaneously document meetings and actions relative to Baystate Franklin Medical Center as well as the annual acceptance of the audited financial statements. Form 990, Part VI, Section B, line 11b Prior to the filing of this return appropriate parts of this Form 990 were reviewed by representatives from the Tax, Finance, and Human Resources Departments of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs) and by outside legal counsel. The entire return was reviewed by a tax expert from an outside accounting firm. The entire return was also reviewed prior to filing by the Audit and Compliance Committee of Baystate Health, Inc., which also includes some of the officers and trustees of the filing organization. This committee also reviews the audited financial statements for the health system. 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 Franklin Medical Center 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 15 The compensation committee of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs) has been appointed through board resolution as the compensation committee of the filing organization. The compensation committee reviews and approves the compensation philosophy that is used to administer the specific pay decisions for the President and employees of the filing organization. The compensation committee consists entirely of individuals serving on the board of the filing organization. The compensation of the President of the filing organization is determined by the member of the President's Cabinet (the Health System's senior leadership) responsible for that filing organization, in consultation with Human Resources, based on information provided by independent third party consultants for reasonableness including appropriate comparability data and based on the Executive Compensation Philosophy Statement established by the compensation committee. 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. Form 990, Part VI, Section B, Line 16b: Baystate Health, Inc. has a joint venture policy that covers affiliated tax exempt entities including Baystate Franklin Medical Center. 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: Minimum pension liability adjustment 1,942,437. Net assets released to /from affiliates -1,500,000. 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 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 50 Maple Street Springfield MA 01199 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) Line 12b, II Baystate Medical Center Inc 0 Baystate Administrative Services Inc 759 Chestnut Street Springfield MA 01199 222747685 Administrative services MA 501 (c ) (3) Line 12c, III Baystate Health Inc 0 Baystate Health Foundation Inc 759 Chestnut Street Springfield MA 01199 043549011 Fundraising MA 501 (c ) (3) Line 7 Baystate Health Inc 0 Baystate Noble Hospital Corporation 115 West Silver Street Westfield MA 010861634 222537423 Hospital MA 501 (c ) (3) Line 3 Baystate Health Inc 0 Westfield Medical Corporation 115 West Silver Street Westfield MA 010861634 043127730 Healthcare MA 501 (c ) (3) Line 12a, I Baystate Noble Hospital Corporation 0 Noble Visiting Nurse Services Inc 77 Mill Street Westfield MA 01085 222757446 Homehealth and Hospice care MA 501 (c ) (3) Line 10 Visiting Nurse Assn and Hospice of Western New England Inc 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 HNE Advisory Services Inc 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 Baystate Health Inc C 0 Baystate Health Insurance Company LTD North Church St Georgetown CJ 980421413 Offshore captive Insurance CJ Health New England Inc C 0 Tr UW John H Sanderson 100 Federal Street Boston MA 02110 046028223 Trust MA N/A T 1.00000 0 Ada B Darling UW 100 Federal Street Boston MA 02110 046017199 Trust MA N/A T 1.00000 0 0 1 0 0 0 0 0 0 0 1 0 1 1 0 0 0 1 0 1 Health New England Inc Q 14660967 Fair Market Value