2019-08-14T08:52:24-05:00 2018-09-30 990 2017-10-01 042133860 FAIRVIEW HOSPITAL FAIR 4134472508 725 NORTH STREET PITTSFIELD MA 012014109 DARLENE RODOWICZ CHIEF FINANCIAL OFFICER/TREASURER 4134472809 2019-08-14 0 199.190.159.246 2019-08-14 09:43:05 ED P 9CD404F795D043EAB58F53AAB690363768679006 AC99457DC19EEDBD5C1E4F4F7FF1D5F3D2EC6E85 2017 2019-02-21 02:37:17Z DARLENE RODOWICZ 725 NORTH ST PITTSFIELD MA 012014109 60280710 0 X WWW.BERKSHIREHEALTHSYSTEMS.ORG X 1912 MA TO IMPROVE THE HEALTH OF ALL PEOPLE IN OUR COMMUNITY, REGARDLESS OF THEIR ABILITY TO PAY. 24 21 355 50 0 0 672238 905921 50741130 55571840 953396 2115038 502948 218160 52869712 58810959 0 0 0 0 30104275 32031633 0 0 212418 18898990 22330111 49003265 54361744 3866447 4449215 43395899 49666793 9462542 12972323 33933357 36694470 X THE MISSION OF FAIRVIEW HOSPITAL IS TO IMPROVE THE HEALTH OF ALL PEOPLE IN THE BERKSHIRES & SURROUNDING COMMUNITIES, REGARDLESS OF THEIR ABILITY TO PAY. 0 0 48105742 55747511 FAIRVIEW HOSPITAL, A 24 BED CRITICAL ACCESS COMMUNITY HOSPITAL, IS THE PRIMARY PROVIDER OF HEALTH CARE & ACCESS TO HEALTH CARE SERVICES IN SOUTHERN BERKSHIRE COUNTY, MA. THE HOSPITAL SERVES A RURAL AREA WHICH INCLUDES TOWNS IN MA, NORTHWEST CT, & COLUMBIA COUNTY, NY WITH A FULL RANGE OF PRIMARY CARE SERVICES, INCLUDING PREVENTATIVE, DIAGNOSTIC & THERAPEUTIC CARE, ON BOTH AN IN- & OUT-PATIENT BASIS. THE PRIMARY SERVICE AREA HAS A RESIDENT POPULATION OF APPROXIMATELY 30,000. THE HOSPITAL PLAYS AN ACTIVE ROLE IN MEETING THE HEALTH NEEDS OF THE COMMUNITY OUTSIDE THE HOSPITAL WALLS IN ITS PROACTIVE COMMUNITY OUTREACH, EDUCATION, & SCREENING INITIATIVES, WHICH ARE DESIGNED TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY. THROUGH COLLABORATION WITH NUMEROUS HEALTH & SOCIAL SERVICE AGENCIES, (CONTINUED ON SCHEDULE O) (CONTINUED FROM FORM 990)...FAIRVIEW HOSPITAL PROMOTES ACCESS TO INFORMATION & SERVICES, & DRAWS EXTENSIVE MEDICAL, TECHNOLOGICAL, & FINANCIAL RESOURCES TO THE AREA THROUGH ITS AFFILIATION WITH BERKSHIRE MEDICAL CENTER & BERKSHIRE HEALTH SYSTEMS. AS A RESULT, THE SOUTHERN BERKSHIRE COMMUNITY ENJOYS A COMPLETE CONTINUUM OF CARE SERVICES INCLUDING EDUCATION, PREVENTION, SCREENING, DIAGNOSTIC, THERAPEUTIC, REHABILITATIVE, & LONG-TERM CARE SERVICES, AN UNUSUALLY HIGH LEVEL OF HEALTH SERVICES WHEN COMPARED WITH SIMILAR RURAL COMMUNITIES. PLEASE SEE THE FY2018 "COMMUNITY BENEFITS REPORT" AT HTTPS://MASSAGO.ONBASEONLINE.COM/MASSAGO/1801CBS/ANNUALREPORT.ASPX FOR MORE DETAILS. 48105742 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 106 0 1 355 1 0 0 0 0 0 1 1 0 0 0 0 X 24 21 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA NY X X DARLENE RODOWICZ CHIEF FINANCIAL OFFICERTREASURER 4134472809 725 NORTH STREET PITTSFIELD MA 012014109 X JEROME J ANDERSON TRUSTEE 1.00 2.00 X 0 0 0 THOMAS O ANDREWS TRUSTEE 1.00 2.00 X 0 0 0 ALFRED A BARBALUNGA TRUSTEE 1.00 2.00 X 0 0 0 JOHN L BISSELL TRUSTEE 1.00 2.00 X 0 0 0 BRONLY S BOYD TRUSTEE/CHAIRMAN 1.00 2.00 X X 0 0 0 MARCELLA W BRADWAY MD TRUSTEE 1.00 2.00 X 0 0 0 BRIAN T BURKE MD TRUSTEE/PHYSICIAN 49.00 1.00 X 230264 0 45152 ROBERT CELLA JR MD TRUSTEE 1.00 2.00 X 0 0 0 KIT DOBELLE TRUSTEE 1.00 2.00 X 0 0 0 TIMOTHY C DOHERTY TRUSTEE 1.00 2.00 X 0 0 0 DANIEL M DOYLE MD TRUSTEE/PHYSICIAN 1.00 49.00 X 0 305410 42130 A KING FRANCIS TRUSTEE 1.00 2.00 X 0 0 0 JONATHAN B GRENOBLE MD TRUSTEE 1.00 2.00 X 0 0 0 DENNIS J HOGAN TRUSTEE 1.00 2.00 X 0 0 0 ELLEN L KENNEDY TRUSTEE 1.00 2.00 X 0 0 0 JAMES G KOLESAR TRUSTEE 1.00 2.00 X 0 0 0 SUSAN M KORMANIK TRUSTEE 1.00 2.00 X 0 0 0 LAURIE NORTON MOFFATT TRUSTEE 1.00 2.00 X 0 0 0 DAVID E PHELPS PRESIDENT/TRUSTEE 3.50 46.50 X X 0 780294 47416 DAVID E PHELPS VESTED RETIREMENT PROGRAM 3.50 46.50 X X 0 1391596 0 BARTON D RASER TRUSTEE 1.00 2.00 X 0 0 0 CAROLE G SIEGEL TRUSTEE 1.00 2.00 X 0 0 0 GEORGE T SMITH TRUSTEE 1.00 2.00 X 0 0 0 ERWIN A STUEBNER JR MD TRUSTEE 1.00 2.00 X 0 0 0 JOSEPH C THOMPSON TRUSTEE 1.00 2.00 X 0 0 0 CHERYL M BOUDREAU CLERK 2.00 38.00 X 0 111134 17696 EUGENE A DELLEA PRESIDENT, FAIRVIEW HOSPIT 50.00 X 0 96959 17061 DARLENE M RODOWICZ TREASURER 3.00 47.00 X 0 514141 45113 ADRIAN ELLIOT MD DIRECTOR, EMERGENCY DEPT. 50.00 X 409248 0 41359 DOREEN HUTCHINSON VICE PRESIDENT, OPERATIONS 50.00 X 212750 0 43232 ROBERT W MALINOWSKI MD ANESTHESIOLOGIST 29.00 21.00 X 0 449945 30936 MICHAEL FASANO MD ANESTHESIOLOGIST 40.00 10.00 X 0 401894 44996 RICHARD SAUPE MD ANESTHESIOLOGIST 32.00 18.00 X 0 383066 41456 JOSHUA M PACHECO MD PHYSICIAN 50.00 X 369903 0 34622 ARTHUR E CHIN MD PHYSICIAN 50.00 X 306662 0 46129 ALEC R BELMAN MD PHYSICIAN/FORMER KEY EE 50.00 X 333365 0 46230 1862192 4434439 543528 57 1 1 0 CLINICAL PROVIDERS STAFFING PO BOX 51279 BOSTON MA 022051279 HEALTHCARE SERVICES 486763 AMN HEALTHCARE INC PO BOX 281939 ATLANTA GA 303841939 HEALTHCARE SERVICES 219013 MEDICUS HOSPITALISTS LLC 22 ROULSTON RD WINDHAM NH 030871209 HEALTHCARE SERVICES 155178 SCRIBE AMERICA LLC PO BOX 417756 BOSTON MA 022417756 HEALTHCARE SERVICES 151056 PITTSFIELD PIPERS INC 73 4TH ST PITTSFIELD MA 012015288 CONSTRUCTION SERVICES 113110 6 126067 191527 588327 12326 905921 NET PATIENT SVC REVENUE 622000 54638924 54638924 ANCILLARY SVCS & SALES 622000 932916 932916 55571840 525287 525287 -1094 -1094 44675 2186 42489 42489 42489 2835937 56500 1301592 0 1534345 56500 1590845 1590845 165973 126067 165973 0 CAFETERIA SALES 722514 175671 175671 175671 58810959 55571840 0 2333198 1016260 1011577 3902 781 24647646 24233174 345386 69086 928789 913184 13004 2601 3828866 3771756 47706 9404 1610072 1583683 21991 4398 5124601 5124601 51479 51479 19851 19851 3307534 3290200 7334 10000 160390 110806 1846 47738 5458576 5409035 38460 11081 839662 827021 11149 1492 159147 154616 2546 1985 141162 141162 2176512 2140839 35673 -22738 -22365 -308 -65 BAD DEBT 1740716 1740716 MINOR EQUIPMENT 764864 757321 7452 91 MAINTENANCE & REPAIRS 752395 740063 12332 HEALTH SAFETY NET ASSES 488958 488958 1167002 762517 350659 53826 54361744 48105742 6043584 212418 38881 9916 438138 420429 5042694 6605924 748892 795485 52374 206450 37405810 24972680 11441385 12433130 21614533 23343944 2766152 3067400 1252850 2784115 43395899 49666793 3132176 3556826 98589 21560 4235228 3913975 1996549 5479962 9462542 12972323 X 29777605 33014860 3897510 3421368 258242 258242 33933357 36694470 43395899 49666793 X 4449215 -4513 -1683589 X 0 1 X 1 1 1 X 0 0 0 0 0 0 0 0 1 51479 51479 0 PART II-B, LINE 1: LOBBYING ACTIVITIES EXPENDITURES FAIRVIEW HOSPITAL PAYS ANNUAL MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE MASSACHUSETTS HEALTH & HOSPITAL ASSOCIATION (MHA). A PORTION OF THESE DUES ARE USED BY THE AHA AND THE MHA TO CONDUCT LOBBYING ACTIVITIES. FOR THE FYE 09/30/2018, THE PORTION OF THE DUES PAID TO THE AHA FOR LOBBYING ACTIVITIES WAS $3,078, AND THE PORTION OF THE DUES PAID TO THE MHA FOR LOBBYING ACTIVITIES WAS $48,401, FOR A TOTAL OF $51,479. THE MHA DUES WERE MUCH HIGHER THAN USUAL IN FY18 BECAUSE OF THE MHA'S ACTIVITIES SURROUNDING THE NOVEMBER 2018 MASSACHUSETTS BALLOT QUESTION ON A PROPOSED LAW WHICH WOULD HAVE LIMITED HOW MANY PATIENTS COULD BE ASSIGNED TO EACH REGISTERED NURSE IN MASSACHUSETTS HOSPITALS AND CERTAIN OTHER HEALTHCARE FACILITIES. 1558385 82813 1641198 1453671 104714 1558385 1368237 85434 1453671 1377268 -9031 1368237 1283422 93846 1377268 0.00000 0.15730 0.84270 0 0 16887 16887 2144669 2108642 36027 2286042 1107690 1178352 23089358 15765257 7324101 9868854 5991091 3877763 12433130 BLACKROCK EQUITY INDEX FUND B 3067400 F 3067400 DUE FROM AFFILIATES 2425976 DEFERRED COMPENSATION 345221 LIFE INSURANCE-CASH VALUE 12918 2784115 DUE TO THIRD PARTY PAYORS 4266057 ACCRUED FIN 47 ACCRETION 868684 DEFERRED COMPENSATION 345221 5479962 X PART V, LINE 4: INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS FAIRVIEW HOSPITAL HAS FIVE PERMANENT ENDOWMENT FUNDS, AS DESCRIBED BELOW: (1) THE BALDWIN FUND'S INCOME IS TO BE USED FOR THE CARE OF PEOPLE WITHOUT OR OF LIMITED MEANS. (2) THE BEECHER FUND'S INCOME IS TO BE USED TO OFFSET THE HEALTHCARE COSTS OF AGING WOMEN OR UNWED MOTHERS. (3) THE BRANDI FUND'S INCOME HAS THREE PURPOSES: (A) TO PROVIDE SCHOLARSHIPS FOR THE CONTINUING EDUCATION OF NURSES OR PROSPECTIVE NURSES ASSOCIATED WITH THE HOSPITAL; (B) TO SERVE AS A SOURCE OF EMERGENCY LOANS TO RETIRED NURSES OR CERTAIN NURSES WHO ARE CURRENTLY WORKING FOR THE HOSPITAL; AND (C) FOR THE PURCHASE OF EQUIPMENT, FURNISHINGS, OR OTHER ITEMS FOR THE BENEFIT OF THE NURSES OR THE MATERNITY SECTION OF THE HOSPITAL. (4) THE MOSKOWITZ FUND'S INCOME IS TO BE USED TO PROVIDE FOR SCHOLARSHIPS TO EMPLOYEES AND CHILDREN OF EMPLOYEES OF THE HOSPITAL WHO ARE ADVANCING THEIR EDUCATION OR TECHNICAL SKILLS AT A RECOGNIZED LEARNING INSTITUTION. (5) THE STANLEY FUND'S INCOME IS TO BE USED FOR THE REPAIR, UPKEEP, AND ADDITIONS TO THE HOSPITAL'S X-RAY EQUIPMENT. PART X, LINE 2: FIN 48 (ASC 740) FOOTNOTE THE FINANCIAL ACTIVITIES OF FAIRVIEW HOSPITAL ARE INCLUDED WITHIN THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND SUPPLEMENTARY INFORMATION OF BERKSHIRE HEALTH SYSTEMS, INC. AND AFFILIATES FOR THE YEARS ENDED SEPTEMBER 30, 2018 AND 2017. THOSE FINANCIALS INCLUDE THE FOLLOWING FOOTNOTE ADDRESSING ANY LIABILITY FOR UNCERTAIN TAX PROVISIONS UNDER FIN 48, STATING "THE HEALTH SYSTEM FOLLOWS THE ACCOUNTING GUIDANCE FOR UNCERTAINTIES IN INCOME TAX POSITIONS, WHICH REQUIRES THAT A TAX POSITION BE RECOGNIZED OR DERECOGNIZED BASED ON A 'MORE LIKELY THAN NOT' THRESHOLD. THE HEALTH SYSTEM HAS DETERMINED THAT THERE ARE NO SUCH POSITIONS, INDIVIDUALLY OR IN THE AGGREGATE, THAT ARE MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS." GALA 247920 92656 155264 28089 30948 57882 38345 GOLF TOURNAMENT 44120 33411 10709 5634 2907 2168 292040 126067 165973 5634 28089 33855 57882 40513 165973 0 1 1 1 X 1 X 1 1 1 0 1 1 429358 429358 0.00820 6831294 6458032 373262 0.00710 288997 261123 27874 0.00050 7549649 6719155 830494 0.01580 486621 486621 0.00920 450951 450951 0.00860 309946 309946 0.00590 1247518 1247518 0.02370 8797167 6719155 2078012 0.03950 7500 7500 0.00010 900 900 0.00000 133457 133457 0.00250 101514 101514 0.00190 243371 243371 0.00450 1 1740716 23631071 23413703 217368 X 1 1 1 1 FAIRVIEW HOSPITAL 29 LEWIS AVENUE GREAT BARRINGTON MA 012301796 BERKSHIREHEALTHSYSTEMS.ORG/FAIRVIEW 2052 X X X X FAIRVIEW HOSPITAL 1 0 0 1 X X X X X X X X 15 1 1 0 1 X SEE PART V SECTION C X 1 15 1 SEE PART V SECTION C 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X X 1 X SEE PART V SECTION C X SEE PART V SECTION C X SEE PART V SECTION C X X X X X 1 X 0 X X X 1 X 0 0 FAIRVIEW HOSPITAL PART V, SECTION B, LINE 5: COMMUNITY HEALTH NEEDS ASSESSMENT - FAIRVIEW HOSPITAL HAS UTILIZED A MULTI-FACETED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) STRATEGY AS PART OF ITS ONGOING COMMUNITY BENEFITS PLANNING PROCESS. FAIRVIEW'S CHNA IS PART OF BERKSHIRE HEALTH SYSTEMS' REGIONALLY FOCUSED CHNA. BERKSHIRE MEDICAL CENTER, FAIRVIEW'S AFFILIATE HOSPITAL IN PITTSFIELD, IS CLOSELY ALIGNED AND INTEGRATED WITH FAIRVIEW HOSPITAL SERVICES AND THE COMMUNITY BENEFITS PLANNING PROCESS REFLECTS THE REGIONAL INTEGRATION OF BERKSHIRE HEALTH SYSTEMS SERVICES. FAIRVIEW PARTICIPATES AS A PARTNER IN BMC'S COMMUNITY BENEFITS COMMITTEE MEETINGS AND REPORTS IN CONJUNCTION WITH MANY BMC COMMUNITY BENEFITS PROGRAMS AND SERVICES. FAIRVIEW ALSO ENHANCES THE BMC ASSESSMENT AND PLANNING PROCESS WITH ITS OWN EFFORTS THAT FOCUS ON THE THIRTEEN RURAL TOWNS OF THE SOUTHERN BERKSHIRE SERVICE AREA THAT ARE IDENTIFIED AS FAIRVIEW'S PRIMARY SERVICE AREA. FOCUS GROUPS, INDIVIDUAL INTERVIEWS, SURVEYS, PATIENT FEEDBACK, PARTICIPATION IN NUMEROUS LOCAL GROUPS AND ORGANIZATIONS, AS WELL AS CLINICAL, HEALTH STATUS, DEMOGRAPHIC AND SOCIO-ECONOMIC DATA ALL ARE USED TO PROVIDE A MORE IN-DEPTH SOURCE OF INFORMATION ABOUT THE NEEDS OF THE RESIDENTS.FAIRVIEW'S WELLNESS AND OUTREACH PROGRAMS ARE WIDE RANGING. IN-HOSPITAL EDUCATION PROGRAMS, BOTH FREE AND LOW-COST, ARE DESIGNED TO RAISE HEALTH LITERACY AND AWARENESS THROUGH PROGRAMMING FOCUSING ON SPECIFIC HEALTH ISSUES INCLUDING HEART DISEASE, PULMONARY DISEASE, NUTRITION, AND DIABETES, AMONG THE TOPICS REGULARLY OFFERED. THE PROGRAMS ARE PRESENTED BY MEMBERS OF FAIRVIEW HOSPITAL'S MEDICAL STAFF. FAIRVIEW IS ACTIVE IN THE COMMUNITY AS WELL, LEADING ITS OWN SPECIAL PROGRAMS SUCH AS HEART NIGHT AND BEING AN ACTIVE PARTICIPANT IN THE EVENTS AND INITIATIVES TO REACH THE TARGETED AUDIENCES OF OTHER ORGANIZATIONS INCLUDING SENIOR CENTERS, SCHOOLS AND SOCIAL AGENCIES. AS PART OF THE LARGER SYSTEMS INTEGRATION, FAIRVIEW HAS BENEFITED FROM RESOURCES THAT RESULTED IN OFFERING CHRONIC DISEASE MANAGEMENT PROGRAMS, MOST NOTABLY THE PREVENTION WELLNESS TRUST FUND, AS WELL AS THE LAUNCH OF BHS' CANYON RANCH INSTITUTE LIFE ENHANCEMENT PROGRAM, A FREE 12-WEEK PROGRAM HELPING COMMUNITY MEMBERS TAKE CHARGE OF THEIR HEALTH. ADDITIONALLY, FAIRVIEW WORKS CLOSELY WITH BMC'S EMERGENCY MANAGEMENT PROGRAM WITH EXTENSIVE NETWORKING, TRAINING, EDUCATION, SUPPORT AND RESOURCES FOR REMOTE AREA EMERGENCY RESPONSE TEAMS TO BUILD COMMUNITY CAPACITY BEYOND FAIRVIEW'S WALLS. THESE RURAL COMMUNITIES, MANY OF WHICH ARE SUPPORTED BY VOLUNTEERS, RELY ON FAIRVIEW HOSPITAL AND OTHERWISE WOULD NOT HAVE ACCESS TO THESE RESOURCES.THROUGH ITS LOCALIZED PLANNING PROCESS, FAIRVIEW IS AWARE OF COMMUNITY VULNERABILITIES AND NEEDS. IN RESPONSE, FAIRVIEW OFFERS TARGETED PROGRAMS, SUPPORT AND SERVICES BASED ON IDENTIFIED HEALTH ISSUES. FOR EXAMPLE, THE RISING FOOD VULNERABILITY OF YOUNG FAMILIES, AS EVIDENCED IN ESCALATING NUMBER OF CHILDREN RECEIVING FREE AND LOW COST MEALS DURING THE SCHOOL YEAR, LED FAIRVIEW TO PARTNER WITH THE LOCAL ELEMENTARY SCHOOL DURING THE SUMMER MONTHS IN THE SUMMER BACKPACK PROGRAM WHICH PROVIDES A BACKPACK OF FOOD FOR FAMILIES WHOSE CHILDREN ARE ENROLLED IN THE SUMMER EDUCATION PROGRAM. ANOTHER EXAMPLE THAT RESPONDS TO LOCAL NEED ADDRESSES THE ALARMING RATE OF ROAD FATALITIES IN THE SOUTHERN BERKSHIRES THAT FAR SURPASSES STATE AND NATIONAL STATISTICS. IN RESPONSE, FAIRVIEW HOSPITAL SPONSORS DRIVING SAFETY PROGRAMS FOR SENIORS AS WELL AS TEENS, AS WELL AS PROVIDING BRIGHTLY COLORED WALKING VESTS TO MAKE PEDESTRIANS MORE VISIBLE ON THE ROADS. FAIRVIEW HOSPITAL PART V, SECTION B, LINE 6A: CHNA CONDUCTED WITH OTHER HOSPITAL FACILITIES - FAIRVIEW HOSPITAL IS AN AFFILIATE HOSPITAL OF BERKSHIRE MEDICAL CENTER AND BERKSHIRE HEALTH SYSTEMS, THE REGIONAL PROVIDER OF HEALTHCARE IN THE BERKSHIRES. FAIRVIEW HOSPITAL PARTICIPATES IN THE BERKSHIRE HEALTH SYSTEMS COMMUNITY HEALTH NEEDS ASSESSMENT AND CONSIDERS IT THE PRIMARY RESOURCE FOR COMMUNITY FEEDBACK FOR OVERALL HEALTH NEEDS AND STATUS OF OUR REGION. THE HEALTHCARE PRIORITIES IDENTIFIED BY THE BERKSHIRE HEALTH SYSTEMS REPORT ARE THE GUIDING FRAMEWORK THAT FAIRVIEW USES TO EFFECTIVELY COLLABORATE WITH OTHER PROVIDERS TO IDENTIFY PRIORITY NEEDS AND DEVELOP PLANS TO MEET THEM. THROUGH EXTENSIVE COMMUNITY ENGAGEMENT, FAIRVIEW CONTINUALLY IDENTIFIES PERCEPTIONS OF HEALTHCARE, NEEDS AND OPPORTUNITIES WHERE THE HOSPITAL CAN PLAY A ROLE. FAIRVIEW HOSPITAL PART V, SECTION B, LINE 11: WERE ALL NEEDS IDENTIFIED IN CHNA ADDRESSED? EDUCATION AND OUTREACH, CHRONIC DISEASE MANAGEMENT AND CARDIAC CARE REFLECT FAIRVIEW'S RESPONSIVENESS TO AREAS IDENTIFIED IN THE CHNA. IN ITS ROLE AS A CRITICAL ACCESS HOSPITAL SERVING THE RURAL COMMUNITIES IN THE SOUTHWESTERN CORNER OF THE BERKSHIRES, FAIRVIEW COLLABORATES WITH BERKSHIRE MEDICAL CENTER (BMC) TO STRENGTHEN PROGRAMS AT FAIRVIEW HOSPITAL AND IMPACT COMMUNITY HEALTH BEYOND HOSPITAL WALLS. THE LAUNCHING OF OPERATION BETTER START, A SATELLITE PROGRAM OF BMC THAT TARGETS YOUTH OBESITY AND DIABETES EDUCATION, HAS BEEN EXTENDED TO A COMMUNITY COLLABORATION WITH LOCAL SCHOOLS AND CHURCHES TO MAKE A BACKPACK OF FOOD AVAILABLE DURING A SUMMER EDUCATION PROGRAM FOR ELEMENTARY STUDENTS AND FAMILIES AT RISK, ADDRESSING FOOD VULNERABILITY AND INCREASING THE SUCCESS OF THE VITAL EDUCATION PROGRAM THAT KEEPS CHILDREN FROM FALLING BEHIND ACADEMICALLY. FAIRVIEW HOSPITAL HAS ESTABLISHED ITS OWN CANYON RANCH LIFE ENHANCEMENT INSTITUTE PROGRAM, A FREE 12-WEEK PROGRAM HELPING COMMUNITY MEMBERS TAKE CHARGE OF THEIR HEALTH, FOLLOWING THE SUCCESS OF THE PROGRAM AT BMC. IN RURAL EMERGENCY MANAGEMENT EFFORTS, FAIRVIEW WORKS CLOSELY WITH BMC'S EMERGENCY MANAGEMENT PROGRAM WITH EXTENSIVE NETWORKING, EDUCATION AND COMMUNITY CAPACITY BUILDING THAT BRINGS RESOURCES TO THE SMALL TOWNS IN THE AREA THAT WOULD NOT HAVE ACCESS TO THIS SUPPORT OTHERWISE. FAIRVIEW HOSPITAL FOLLOWS THE PRIORITIES OF THE BERKSHIRE HEALTH SYSTEMS COMMUNITY HEALTH NEEDS ASSESSMENT. IN CASES THAT REQUIRE MORE SPECIALTY, OR IT CANNOT FINANCIALLY SUPPORT, FAIRVIEW HOSPITAL MAY NOT BE ABLE TO FILL THE NEED LOCALLY AND RELIES ON A REGIONAL NETWORK OF HEALTH RESOURCES OF BERKSHIRE HEALTH SYSTEMS.BERKSHIRE HEALTH SYSTEMS (BHS) REGULARLY ASSESSES THE HEALTH NEEDS OF BERKSHIRE COUNTY RESIDENTS AS PART OF THE STRATEGIC PLANNING PROCESS AND COMMUNITY BENEFITS PROGRAMMING. BHS COMPILED THE BERKSHIRE COUNTY HEALTH ASSESSMENT REPORT IN COLLABORATION WITH THE COUNTY HEALTH INITIATIVE STEERING COMMITTEE COMPRISED OF BERKSHIRE MEDICAL CENTER, FAIRVIEW HOSPITAL, BERKSHIRE COUNTY BOARDS OF HEALTH ASSOCIATION, TRI-TOWN HEALTH DEPARTMENT, BERKSHIRE PUBLIC HEALTH ALLIANCE, PITTSFIELD HEALTH DEPARTMENT, BERKSHIRE UNITED WAY, BERKSHIRE REGIONAL PLANNING COMMISSION, AND NORTHERN BERKSHIRE COMMUNITY COALITION. THE INTENT IS TO BROADLY IDENTIFY THE MAJOR TRENDS IN HEALTH STATUS AND OUR COMMUNITY'S HEALTH NEEDS WITH AN UNDERSTANDING OF THE FACTORS THAT ARE LIKELY TO AFFECT THE POPULATION OF BERKSHIRE COUNTY. THE FRAMEWORK OF THIS PLAN SPANS FISCAL YEARS 2015-2018. THE OBJECTIVES OF THE CHNA WERE: TO GATHER STATISTICALLY VALID INFORMATION ON THE HEALTH STATUS OF THE RESIDENTS OF BERKSHIRE COUNTY, TO DEVELOP ACCURATE COMPARISONS TO STATE AND NATIONAL BENCHMARKS OF HEALTH AND QUALITY OF LIFE MEASURES TO PROVIDE TRENDING INFORMATION FOR THE FUTURE, TO IDENTIFY KEY AREAS OF SIGNIFICANT COMMUNITY NEEDS AND VULNERABLE POPULATIONS, TO UTILIZE FINDINGS FOR COMMUNITY BENEFIT AND HOSPITAL PLANNING ACTIVITIES, AND TO MEET THE MASSACHUSETTS ATTORNEY GENERAL'S AND IRS REQUIREMENTS RELATED TO THE NEEDS ASSESSMENT. WHILE DEMOGRAPHIC, SOCIOECONOMIC AND HEALTH STATUS INDICATORS PROVIDE AN EFFECTIVE MEANS OF IDENTIFYING POTENTIAL NEEDS AND/OR PROBLEMS, SUCH A BROAD-BASED VIEW CANNOT IDENTIFY ALL OF THE HEALTH AND HUMAN SERVICE PROBLEMS FACING A COMMUNITY. THIS IS RATHER ONE STEP OF MANY IN AN ON-GOING PROCESS OF COLLECTING AND DISSEMINATING HEALTH STATUS INFORMATION SO THAT, WORKING TOGETHER, WE CAN ADDRESS THE HEALTH NEEDS OF OUR COMMUNITY AND HELP TO ENSURE BETTER OUTCOMES FOR ALL THE PEOPLE LIVING IN BERKSHIRE COUNTY. WE INCORPORATE FEEDBACK FROM MANY COMMUNITY FORUMS, INCLUDING NORTHERN BERKSHIRE COMMUNITY COALITION MONTHLY COMMUNITY MEETINGS, BI-ANNUAL COMMUNITY MEETINGS, RURAL HEALTH PLANNING TEAM, AND MANY COMMUNITY OUTREACH INTERACTIONS.COMMUNITY BENEFIT AND ACCESS COMMITTEEAS A STANDING COMMITTEE OF THE BOARD OF TRUSTEES - ITSELF MADE UP OF COMMUNITY VOLUNTEERS - THIS COMMITTEE IS RESPONSIBLE FOR UNDERSTANDING THE HEALTH NEEDS AND BARRIERS TO CARE IN OUR SERVICE AREA. THE COMMITTEE OVERSEES THE COMMUNITY BENEFIT PROCESS OF THE ORGANIZATION, INCLUDING HEALTH NEEDS ASSESSMENTS, DETERMINING TARGET POPULATIONS AND PRIORITIES, DEVELOPMENT OF THE COMMUNITY BENEFITS PLAN AND EVALUATING PERFORMANCE AGAINST GOALS AND OBJECTIVES. THE COMMITTEE IS COMPRISED OF PEOPLE FROM THE BOARD OF TRUSTEES AND THE COMMUNITY AT LARGE, AND MEETS MONTHLY THOUGHOUT THE YEAR. THE BHS COMMUNITY BENEFITS AND ACCESS COMMITTEE REVIEWS AND DISCUSSES COMMUNITY BENEFIT PROGRAMS, POTENTIAL NEW INITIATIVES, COMMUNITY NEEDS, AND OUTCOMES. THE COMMITTEE FORMALLY REVIEWS ANY UPDATES TO COMMUNITY NEEDS AND REAFFIRMS PRIORITIES ANNUALLY AND COMPLETES A COMPREHENSIVE NEEDS ASSESSMENT EVERY THREE YEARS. THROUGHOUT THE YEAR, INTERNAL COMMUNITY BENEFITS AND PROGRAM LEADERS MEET TO COORDINATE THE COMMUNITY BENEFIT PLAN AND PROGRAMS. IN 2012 WE FORMALIZED THE COUNTY HEALTH INITIATIVE (CHI) WITH THE GOAL OF WORKING TOGETHER TO IMPROVE COMMUNITY HEALTH. THE LEADERSHIP TEAM OF THE CHI INCLUDES BERKSHIRE MEDICAL CENTER, FAIRVIEW HOSPITAL, BERKSHIRE COUNTY BOARDS OF HEALTH ASSOCIATION, BERKSHIRE PUBLIC HEALTH ALLIANCE, TRI-TOWN HEALTH DEPARTMENT, PITTSFIELD HEALTH DEPARTMENT, BERKSHIRE REGIONAL PLANNING COMMISSION, BERKSHIRE UNITED WAY, AND NORTHERN BERKSHIRE COMMUNITY COALITION. BHS IS THE ONLY HEALTH SYSTEM IN BERKSHIRE COUNTY AND THEREFORE WE ASSUME A SIGNIFICANT LEADERSHIP ROLE IN ADDRESSING THE PRIORITIES IDENTIFIED IN THE CHNA. WE ARE FORTUNATE TO WORK COLLABORATIVELY WITH MANY COMMUNITY ORGANIZATIONS. BERKSHIRE HEALTH SYSTEMS HAS A STRONG REPUTATION AS A LEADER AND COLLABORATOR IN MEETING COMMUNITY HEALTH NEEDS THROUGH ITS ONGOING COMMUNITY BENEFIT PROGRAMS AND SERVICES. BHS PLANS TO PROVIDE COMMUNITY BENEFIT PROGRAMS IN RESPONSE TO THE HEALTH NEEDS IDENTIFIED IN THE 2015-2017 COMMUNITY HEALTH NEEDS ASSESSMENT. THESE INCLUDE, BUT ARE NOT LIMITED TO, NORTH COUNTY NEIGHBORHOOD FOR HEALTH, CANYON RANCH LIFE ENHANCEMENT PROGRAM, PRESCRIPTION PAIN MEDICATION INITIATIVE, PREVENTION WELLNESS TRUST FUND INITIATIVES, HEALTH EDUCATION PROGRAMS, SCREENINGS, SUPPORT GROUPS, MENTAL HEALTH SERVICES, AND OTHER COMMUNITY HEALTH IMPROVEMENT SERVICES AND ACCESS TO CARE THROUGH A NUMBER OF LEVERAGED SOURCES (GRANTS). DUE TO EVER CHANGING HEALTHCARE NEEDS, THE STRATEGIES MAY CHANGE, AND NEW PROGRAMS MAY BE ADDED OR PROGRAMS MAY BE ELIMINATED DURING THE 2015-2018 PERIOD.LISTED BELOW ARE THE IDENTIFIED PRIORITY HEALTH NEEDS, INCLUDING THE HOSPITAL'S STRATEGIC PRIORITY HEALTH NEEDS.CLINICAL CARE: ACCESS TO MEDICAL PROFESSIONALS, ACCESS FOR UNDERINSURED AND UNINSURED, AND HEALTHCARE DISPARITIES.HEALTH BEHAVIORS: ADOLESCENT AND YOUTH - TEEN PREGNANCY, INFECTIOUS DISEASE, OBESITY, SMOKING, AND SUBSTANCE ABUSE.MORBIDITY AND MORTALITY: CANCER, CARDIOVASCULAR HEALTH, DIABETES, INFECTIOUS DISEASE, MATERNAL/CHILD HEALTH, MENTAL HEALTH - DEPRESSION, AND STROKE/BLOOD PRESSURE.PHYSICAL ENVIRONMENT: EMERGENCY PREPAREDNESS.SOCIAL/ECONOMIC: COMMUNITY DEVELOPMENT AND SAFETY.THE CHNA INCLUDES A NEW FOCUS ON THE POPULATION OF NORTH COUNTY GIVEN THE SUDDEN CLOSING OF NORTH ADAMS REGIONAL HOSPITAL IN MARCH 2014. BHS AND BERKSHIRE MEDICAL CENTER WORKED WITH INPUT AND SUPPORT FROM MANY GOVERNMENT AND COMMUNITY ORGANIZATIONS TO RESTORE CLINICAL SERVICES AND THIS PROCESS IS STILL GOING ON. IN THE RECENT CHNA WE ALSO NOTED AN INCREASE IN VIOLENCE IN OUR COMMUNITY AND A DRAMATIC INCREASE IN OVERDOSES AND DEATHS DUE TO SUBSTANCE ABUSE. BHS IS COLLABORATING WITH THE BRIEN CENTER, PUBLIC HEALTH AUTHORITIES, THE LOCAL FQHC, AND LAW ENFORCEMENT OFFICIALS TO ENHANCE EXISTING EFFORTS TO EXPAND OUR WORK FOR PREVENTION, TREATMENT AND DIVERSION. SCHEDULE H (FORM 990) PART V, SECTION B, LINE 7A THE HOSPITAL'S LATEST CHNA REPORT IS AVAILABLE ON THE HEALTH SYSTEMS' WEBSITE, WWW.BERKSHIREHEALTHSYSTEMS.ORG. USING THE QUICK LINKS DROP-DOWN LIST AT THE TOP OF THE PAGE, SELECT "COUNTY HEALTH NEEDS ASSESSMENT". SCHEDULE H (FORM 990) PART V, SECTION B, LINE 10A THE HOSPITAL'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY IS AVAILABLE ON THE HEALTH SYSTEMS' WEBSITE, WWW.BERKSHIREHEALTHSYSTEMS.ORG. USING THE QUICK LINKS DROP-DOWN LIST AT THE TOP OF THE PAGE, SELECT "BHS COMMUNITY BENEFITS IMPLEMENTATION PLAN". SCHEDULE H (FORM 990) PART V, SECTION B, LINE 16A THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY (FAP) IS AVAILABLE ON THE HEALTH SYSTEMS' WEBSITE, WWW.BERKSHIREHEALTHSYSTEMS.ORG/FINANCIAL-COUNSELING. SELECT THE ENGLISH DOCUMENT "FINANCIAL ASSISTANCE POLICY - FAIRVIEW HOSPITAL OR THE SPANISH DOCUMENT "LA POLITICA DE AYUDA FINANCIERA DE FAIRVIEW HOSPITAL". SCHEDULE H (FORM 990) PART V, SECTION B, LINE 16B THE HOSPITAL'S FAP APPLICATION IS AVAILABLE ON THE HEALTH SYSTEMS' WEBSITE, WWW.BERKSHIREHEALTHSYSTEMS.ORG/FINANCIAL-COUNSELING. SELECT THE ENGLISH DOCUMENT "FINANCIAL ASSISTANCE APPLICATION OR THE SPANISH DOCUMENT "SOLICITUD PARA AYUDA FINANCIERA". SCHEDULE H (FORM 990) PART V, SECTION B, LINE 16C THE HOSPITAL'S PLAIN LANGUAGE SUMMARY OF THE FAP IS AVAILABLE ON THE HEALTH SYSTEMS' WEBSITE, WWW.BERKSHIREHEALTHSYSTEMS.ORG/FINANCIAL-COUNSELING. SELECT THE ENGLISH DOCUMENT "PLAIN LANGUAGE SUMMARY OF FINANCIAL ASSISTANCE POLICIES OR THE SPANISH DOCUMENT "RESUMEN EN LANGUAGE SENCILLO". 3 1 - FAIRVIEW HSP OUTPATNT PHYSICAL THERAPY 10 MAPLE AVE GREAT BARRINGTON MA 01230 OUTPATIENT SERVICES 2 - FAIRVIEW PHYSICAL & SPORTS THERAPY CTR 710 STOCKBRIDGE RD STE 1 LEE MA 01238 OUTPATIENT SERVICES 3 - FAIRVIEW HOSPITAL AQUATIC THERAPY PROG 15 CHRISSEY RD GREAT BARRINGTON MA 01230 OUTPATIENT SERVICES PART I, LINE 7: COMPUTATION OF COMMUNITY BENEFIT EXPENSE - THE TOTAL COMMUNITY BENEFIT EXPENSE REPORTED ON PART I, LINES 7A, 7B, & 7C HAS BEEN CALCULATED USING THE RATIO OF PATIENT CARE COST TO CHARGES AS COMPUTED USING WORKSHEET 2 IN THE SCHEDULE H INSTRUCTIONS. BECAUSE FAIRVIEW HOSPITAL IS A FEDERALLY-DESIGNATED CRITICAL ACCESS HOSPITAL, THE REVENUE RECEIVED FROM MASSACHUSETTS FOR PATIENTS ELIGIBLE FOR MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS (LINES 7B & 7C, COLUMN (D)) IS BASED ON A COST-BASIS MODEL AND IS HIGHER THAN IT WOULD BE FOR NON-CRITICAL ACCESS HOSPITALS. BAD DEBT EXPENSE HAS BEEN EXCLUDED FROM THE COMPUTATION OF ALL COMMUNITY BENEFIT EXPENSE SHOWN IN PART I, LINE 7. PART I, LN 7 COL(F): COMPUTATION OF COMMUNITY BENEFIT EXPENSE PERCENTAGES - BAD DEBT EXPENSE OF $1,740,716 ATTRIBUTABLE TO PATIENT ACCOUNTS AND INCLUDED IN FORM 990, PART IX, LINE 25 COLUMN (A) HAS BEEN EXCLUDED FROM THE COMPUTATION OF ALL COMMUNITY BENEFIT EXPENSE, INCLUDING THE CALCULATION OF THE PERCENTAGES SHOWN IN SCHEDULE H PART I, LINE 7 COLUMN (F). SCHEDULE H (FORM 990) PART I, LINE 6B PUBLIC ACCESS TO COMMUNITY BENEFITS REPORT - FAIRVIEW HOSPITAL AND BERKSHIRE MEDICAL CENTER EACH FILE A SEPARATE COMMUNITY BENEFITS REPORT WITH THE STATE OF MASSACHUSETTS. FAIRVIEW'S FISCAL YEAR 2018 COMMUNITY BENEFITS REPORT CAN BE ACCESSED AT HTTPS://MASSAGO.ONBASEONLINE.COM/MASSAGO/1801CBS/ANNUALREPORT.ASPX. PART II, COMMUNITY BUILDING ACTIVITIES: AS SUMMARIZED IN PART II, EXPENDITURES BY FAIRVIEW HOSPITAL TO PROTECT OR IMPROVE THE COMMUNITY'S HEALTH OR SAFETY INCLUDE THE FOLLOWING:LINE 1 PHYSICAL IMPROVEMENTS & HOUSING: LOW INCOME HOUSING ASSISTANCE - COMMUNITY BENEFIT EXPENSE $7,500. THE HOSPITAL DONATED MONEY TO A LOCAL NON-PROFIT WHICH HELPS PROVIDE HOUSING ASSISTANCE TO LOW INCOME INDIVIDUALS.LINE 2 ECONOMIC DEVELOPMENT: FACILITY USAGE - COMMUNITY BENEFIT EXPENSE $900. THE HOSPITAL DONATED USE OF MEETING SPACE TO LOCAL GROUPS WHICH ASSIST IN CREATING NEW EMPLOYMENT OPPORTUNITIES IN THE HOSPITAL'S SERVICE AREA.LINE 3 COMMUNITY SUPPORT: EMERGENCY PREPAREDNESS - COMMUNITY BENEFIT EXPENSE $24,368. THE HOSPITAL PARTICIPATED IN EMERGENCY PREPAREDNESS ACTIVITIES SUCH AS CONTINUING EDUCATION, PARTNERSHIP BUILDING, AND SUSTAINABILITY PURCHASES TO STRENGTHEN THE HOSPITAL'S ALL-HAZARD RESPONSE TO LOCAL, REGIONAL AND NATIONAL EVENTS. LINE 3 COMMUNITY SUPPORT: MEDICAL RESERVE CORPS - COMMUNITY BENEFIT EXPENSE $26,238. THE HOSPITAL SUPPORTS THE BERKSHIRE MEDICAL RESERVE CORPS WHO ARE A GROUP OF LICENSED MEDICAL PROFESSIONALS AND NON-LICENSED INDIVIDUALS WHO ARE TRAINED TO RESPOND TO A PUBLIC HEALTH EMERGENCY SUCH AS A PANDEMIC OR SHELTERING SITUATION.LINE 3 COMMUNITY SUPPORT: COMMUNITY INFECTION CONTROL - COMMUNITY BENEFIT EXPENSE $9,719. FAIRVIEW HOSPITAL SPONSORED FREE COMMUNITY FLU CLINICS. FUNDS WERE USED TO PAY FOR THE CLINIC PLANNER, NURSES, SUPPLIES AND ADVERTISING.LINE 3 COMMUNITY SUPPORT: EMS COORDINATOR - COMMUNITY BENEFIT EXPENSE $68,620. FAIRVIEW FUNDS AN EMERGENCY MEDICAL SERVICERS COORDINATOR WHO WORKS WITH ALL LOCAL VOLUNTEER AND PAID AMBULANCE SQUADS TO PROVIDE CONTINUING EDUCATION, REGULATORY UPDATES, AND BEST PRACTICE UPDATES.LINE 3 COMMUNITY SUPPORT: HAZARDOUS MATERIALS RESPONSE DRILLS - COMMUNITY BENEFIT EXPENSE $4,512. FAIRVIEW CONDUCTS COMMUNITY-WIDE HAZARDOUS MATERIAL FULL-SCALE EXERCISES WHICH INCLUDE PARTICIPATION FROM LOCAL POLICE, FIRE, AND EMS AGENCIES.LINE 8 WORKFORCE DEVELOPMENT: PHYSICIAN RECRUITMENT - COMMUNITY BENEFIT EXPENSE $81,514. THIS IS IN RESPONSE TO CRITICAL PHYSICIAN SHORTAGES IN THE HOSPITAL'S SERVICE AREA AND THE EXPENDITURES REPORTED ARE AN INVESTMENT IN INCREASING ACCESS TO PRIMARY CARE AND SPECIALTY PHYSICIANS AVAILABLE TO THE COMMUNITY BY ASSISTING IN ESTABLISHING NEW PHYSICIANS IN THE SERVICE AREA.LINE 8 WORKFORCE DEVELOPMENT: COMMUNITY EDUCATION - COMMUNITY BENEFIT EXPENSE $20,000. FAIRVIEW OFFERED LOCAL MIDDLE AND HIGH SCHOOL STUDENTS SHADOW AND INTERNSHIP EXPERIENCES EXPOSING THEM TO DIVERSE CAREERS IN HEALTHCARE. FVH OFFERED STUDENTS PURSUING SPECIALIZED MEDICAL EDUCATION, INCLUDING PHYSICIAN'S ASSISTANTS AND PHYSICAL THERAPISTS, THE OPPORTUNITY TO GAIN CLINICAL EXPERIENCE AT THE HOSPITAL. FAIRVIEW ALSO OFFERED INTERNSHIPS TO NURSING STUDENTS. PART III, LINE 2: COMPUTATION OF BAD DEBT EXPENSE - IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, FAIRVIEW HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PART III, LINE 3: BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER FINANCIAL ASSISTANCE POLICY - NO BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER FAIRVIEW HOSPITAL'S FINANCIAL ASSISTANCE POLICY HAS BEEN REPORTED ON PART III, LINE 3 BECAUSE ALL GROSS PATIENT CHARGES ATTRIBUTABLE TO THESE PATIENTS THAT WERE NOT PAID FROM UNCOMPENSATED CARE POOLS OR PROGRAMS WERE WRITTEN OFF AS "FREE CARE" EXPENSE. A PORTION OF FREE CARE EXPENSE, CALCULATED USING THE RATIO OF PATIENT CARE COST TO CHARGES AS COMPUTED USING WORKSHEET 2 IN THE SCHEDULE H INSTRUCTIONS, IS INCLUDED IN THE "FINANCIAL ASSISTANCE AT COST" AMOUNT IN SCHEDULE H PART I, LINE 7(A), COLUMN (C). PART III, LINE 4: FOOTNOTE 4 ("CHARITY CARE") TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND SUPPLEMENTARY INFORMATION OF BERKSHIRE HEALTH SYSTEMS, INC. AND AFFILIATES (INCLUDING FAIRVIEW HOSPITAL) FOR THE YEARS ENDED SEPTEMBER 30, 2018 AND 2017 CONTAINS THE FOLLOWING REGARDING BAD DEBT EXPENSE: "THE HEALTH SYSTEM PROVIDES CARE TO PATIENTS WHO MEET CHARITY CARE POLICY CRITERIA WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES." "IF A PATIENT IS INELIGIBLE FOR CHARITY CARE OR CARE AT REDUCED RATES BECAUSE THE PATIENT'S INCOME EXCEEDS THE ELIGIBILITY GUIDELINES, SERVICES RENDERED ARE RECORDED AT ESTABLISHED RATES AND ANY UNPAID ACCOUNT RECEIVABLE BALANCE IS WRITTEN OFF TO BAD DEBTS AFTER A REASONABLE COLLECTION EFFORT HAS BEEN MADE." PART III, LINE 8: THE AMOUNT REPORTED ON PART III SECTION B LINE 6 ("MEDICARE ALLOWABLE COSTS OF CARE RELATING TO PAYMENTS ON LINE 5") WAS DETERMINED USING THE COST ALLOCATION METHODOLOGY USED FOR THE MEDICARE COST REPORTS. PART III, LINE 9B: THE FOLLOWING INDIVIDUALS AND PATIENT POPULATIONS ARE EXEMPT FROM ANY COLLECTION OR BILLING PROCEDURES PURSUANT TO STATE REGULATIONS: PATIENTS ENROLLED IN A STATE HEALTH INSURANCE PROGRAM, INCLUDING BUT NOT LIMITED TO, MASSHEALTH, EMERGENCY AID TO THE ELDERLY, DISABLED AND CHILDREN, HEALTHY START, CHILDREN'S MEDICAL SECURITY PLAN, AND "LOW INCOME PATIENTS" AS DETERMINED BY THE OFFICE OF MEDICAID. PLEASE NOTE THAT FAIRVIEW HOSPITAL (FVH) MAY SEEK COLLECTION ACTION AGAINST ANY PATIENT ENROLLED IN THE ABOVE MENTIONED PROGRAMS FOR THEIR REQUIRED CO-PAYMENTS AND DEDUCTIBLES THAT ARE SET FORTH BY EACH SPECIFIC PROGRAM. FVH MAY ALSO INITIATE BILLING OR COLLECTION FOR A PATIENT WHO ALLEGES THAT HE OR SHE IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM THAT COVERS THE COSTS OF THE HOSPITAL SERVICES, BUT FAILS TO PROVIDE PROOF OF SUCH PARTICIPATION. UPON RECEIPT OF SATISFACTORY PROOF THAT A PATIENT IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM (INCLUDING RECEIPT OR VERIFICATION OF A SIGNED APPLICATION), FVH SHALL CEASE ITS BILLING OR COLLECTION ACTIVITIES. FVH MAY CONTINUE COLLECTION ACTION ON ANY LOW INCOME PATIENT FOR SERVICES RENDERED PRIOR TO THE LOW INCOME PATIENT DETERMINATION, PROVIDED THAT THE CURRENT LOW INCOME PATIENT STATUS HAS BEEN TERMINATED OR EXPIRED. HOWEVER, ONCE A PATIENT IS DETERMINED ELIGIBLE AND ENROLLED IN THE HEALTH SAFETY NET, MASSHEALTH, OR CERTAIN COMMONWEALTH CARE PROGRAMS, FVH WILL CEASE COLLECTION ACTIVITY FOR SERVICES, PREVIOUSLY BILLED, THAT NOW FALL INTO THE ELIGIBILITY PERIOD. FVH MAY SEEK COLLECTION ACTION AGAINST ANY OF THE PATIENTS PARTICIPATING IN THE PROGRAMS LISTED ABOVE FOR NON-COVERED SERVICES THAT THE PATIENT HAS AGREED TO BE RESPONSIBLE FOR, PROVIDED THAT THE HOSPITAL OBTAINED THE PATIENT'S PRIOR WRITTEN CONSENT TO BE BILLED FOR THE SERVICE. FVH WILL NOT UNDERTAKE COLLECTION ACTION AGAINST AN INDIVIDUAL THAT HAS BEEN APPROVED FOR MEDICAL HARDSHIP UNDER THE MASSACHUSETTS HEALTH SAFETY NET PROGRAM WITH RESPECT TO THE AMOUNT OF THE BILL THAT EXCEEDS THE MEDICAL HARDSHIP CONTRIBUTION.FVH DOES NOT GARNISH A PATIENT'S OR THE PATIENT'S GUARANTOR'S WAGES OR EXECUTE A LIEN ON THE PATIENT'S OR THE PATIENT'S GUARANTOR'S PERSONAL RESIDENCE OR MOTOR VEHICLE.FVH AND ITS AGENTS SHALL NOT CONTINUE COLLECTION OR BILLING ON A PATIENT WHO IS A MEMBER OF A BANKRUPTCY PROCEEDING EXCEPT TO SECURE ITS RIGHTS AS A CREDITOR IN THE APPROPRIATE ORDER. PART VI, LINE 2: NEEDS ASSESSMENT - FAIRVIEW ASSESSES THE NEEDS AND CHANGES IN OUR COMMUNITY THROUGH A BROAD RANGE OF ASSESSMENT INITIATIVES AND CONSTANT INTERACTION AND ENGAGEMENT WITH THE LOCAL COMMUNITY. STATISTICAL EVIDENCE FROM HOSPITAL DATABASES, INCLUDING IN-PATIENT, EMERGENCY AND MAJOR DIAGNOSTIC CATEGORIES, AUGMENT FEDERAL, STATE AND LOCAL ASSESSMENTS WHICH HELP IDENTIFY AREAS CONSISTENT WITH, AND THOSE ABOVE, STANDARD NORMS. FAIRVIEW RELIES ON THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH DEMOGRAPHIC DATA AND HEALTH REGIONALIZATION STATUS REPORTS TO OBTAIN THIS INFORMATION.FAIRVIEW ALSO PARTICIPATES WITH THE WORK OF REGIONAL PARTNER ORGANIZATIONS AND UTILIZES ASSESSMENTS MADE AVAILABLE ON BEHALF OF SPECIFIC COMMUNITY INTERESTS. AMONG THE ORGANIZATIONS THAT PROVIDE RELEVANT DATA ARE BERKSHIRE HEALTH SYSTEMS COMMUNITY HEALTH ASSESSMENT SURVEY, SOUTHERN BERKSHIRE YOUTH COALITION YOUTH SURVEY, UNITED WAY COMMUNITY IMPACT BASELINE REPORT, MASSACHUSETTS PREVENTION NEEDS ASSESSMENT SURVEY, CROSS-CULTURAL ACTION NETWORK, MASSACHUSETTS COUNTY HEALTH RANKINGS, BERKSHIRE HILLS REGIONAL SCHOOL DISTRICT BMI REPORTS, AND THE BERKSHIRE BOARDS OF HEALTH ASSOCIATION BERKSHIRE COMMUNITY HEALTH ASSESSMENT. FAIRVIEW ALSO CONDUCTS ITS OWN SURVEY, SPECIFICALLY TARGETING THE SOUTHERN BERKSHIRE REGION, TO UNDERSTAND RESIDENTS' PERCEPTIONS OF HEALTHCARE SERVICE ACCESS, OBSTACLES TO CARE, PREFERRED METHODS OF COMMUNICATIONS, PERCEIVED HEALTH THREATS AND SIGNIFICANT ISSUES THAT AFFECT THEIR HEALTH STATUS.FAIRVIEW HOSPITAL PLACES A HIGH PRIORITY ON BUILDING CLOSE ALLIANCES WITH EDUCATIONAL, BUSINESS, HEALTH AND WELFARE, SAFETY, AND LAW ENFORCEMENT AGENCIES AND SOCIAL SERVICES IN THE SOUTHERN BERKSHIRES. THROUGH CONTINUAL ENGAGEMENT AND PARTNERING, FAIRVIEW STAYS ABREAST OF THE BROAD RANGE OF ISSUES AFFECTING OUR COMMUNITY ALLOWING IT TO RESPOND TO ISSUES. THROUGH A CONSTITUENCY FOCUSED OUTREACH AND EDUCATION PROGRAM, WHICH IS BASED ON HEALTH NEEDS ASSESSMENTS AND TARGETS SPECIFIC HEALTH INFORMATION TO MEET THE NEEDS OF SPECIAL POPULATIONS, FAIRVIEW STRIVES TO INCREASE AWARENESS OF AND ACCESS TO PROGRAMS AND SERVICES, EDUCATION, SUPPORT AND INFORMATION, AND TO RAISE THE OVERALL HEALTH LITERACY AMONG OUR NEIGHBORS. IN ADDITION, COMMUNITY HOSPITAL COMMITTEES, INCLUDING THE PATIENT FAMILY ADVISORY COUNCIL, ETHICS COUNCIL AND SPECIAL EVENTS COMMITTEES ALLOW FAIRVIEW TO MAINTAIN A DIRECT LINE TO OUR COMMUNITY, IN OUR EFFORT TO SERVE OUR COMMUNITY EFFECTIVELY. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - FAIRVIEW HOSPITAL IS EXTREMELY PROACTIVE IN HELPING PATIENTS ACCESS COVERAGE. THROUGH CONTINUOUS OUTREACH ACTIVITIES AND MEDIA COVERAGE, FAIRVIEW'S ADVOCACY FOR ACCESS TEAM PROMOTES INFORMATION ABOUT ELIGIBILITY TO INDIVIDUALS WHO CAN RECEIVE ASSISTANCE FROM FEDERAL, STATE, AND LOCAL GOVERNMENTS. PATIENTS ARE CONNECTED TO THESE PROGRAMS BOTH FROM WITHIN THE HOSPITAL AS WELL AS ON A COMMUNITY LEVEL. FAIRVIEW HOSPITAL IS COMMITTED TO REMOVE THE OBSTACLES TO HEALTH CARE DUE TO COVERAGE, AND HAS INVESTED IN ADDITIONAL SPACE FOR THE ADVOCAY FOR ACCESS TEAM. THE NEW OFFICE IS LOCATED OFF OF THE MAIN HALLWAY AND OFFERS A LESS PUBLIC AREA TO HANDLE THE INCREASED UTILIZATION AND PRIVACY REQUIREMENTS NEEDED TO OFFER A SAFE AND RESPECTFUL ENVIRONMENT. FLEXIBLE HOURS, INDIVIDUAL APPOINTMENTS, AND TRANSLATION SERVICES ARE OFFERED TO LOWER BARRIERS TO CARE.TRAINED STAFF INITIATE, SUPPORT AND FACILITATE ENROLLMENT TO ASSIST INDIVIDUALS AND FAMILIES NAVIGATE EXTENSIVE ADMINISTRATIVE PROCESSES. A FINANCIAL ADVISOR IS AVAILABLE DURING BUSINESS HOURS TO ASSIST PATIENTS IN CREATING FLEXIBLE BILLING ARRANGEMENTS, ADDRESS BILLING ISSUES AND QUESTIONS, AND REFER PATIENTS TO THE ADVOCACY FOR ACCESS OFFICE WHEN APPROPRIATE. AS A TESTAMENT TO IMPACT, FAIRVIEW HOSPITAL'S ADVOCACY FOR ACCESS COORDINATOR HAS BEEN SELECTED BY BERKSHIRE MAGAZINE'S "BERKSHIRE 25" IN 2016, HONORING INDIVIDUALS IN THE BERKSHIRE REGION WHO MAKE A DIFFERENCE AND CONTRIBUTE TO MAKE LIFE IN THE BERKSHIRES SO SPECIAL.THE SERVICE ECONOMY IN THE SOUTHERN BERKSHIRES HAS MANY UNINSURED AND UNDERINSURED WORKERS. MANY OF THESE INDIVIDUALS HOLD MORE THAN ONE JOB. THE ADVOCACY FOR ACCESS TEAM HAS PLACED SPECIAL EMPHASIS ON REACHING OUT TO THE SELF-EMPLOYED AS WELL AS IMMIGRANT COMMUNITIES TO PROVIDE THEM WITH INFORMATION AND ENROLL THEM IN HEALTH COVERAGE DURING THE PAST YEAR. PART VI, LINE 4: COMMUNITY INFORMATION - FAIRVIEW HOSPITAL SERVES A RURAL AREA IN THE SOUTHWESTERN CORNER OF MASSACHUSETTS IN ADDITION TO NEARBY COMMUNITIES ACROSS THE BORDERS OF NEW YORK AND CONNECTICUT. THERE IS A WIDE SOCIO-ECONOMIC RANGE IN THE COMMUNITY, NECESSITATING A DIVERSE COMMUNICATIONS PLAN, INCLUDING BOTH TRADITIONAL AND SOCIAL MEDIA. HOWEVER, FAIRVIEW RECOGNIZES THE IMPACT THAT WORD-OF-MOUTH CONTINUES TO HOLD AND ENGAGES WITH A NETWORK OF COMMUNITY LEADERS WHO REPRESENT VARIOUS CONSTITUENCIES TO TAP INTO THESE NETWORKS DIRECTLY AND THROUGH COMMUNITY AFFILIATIONS SUCH AS THE SOUTHERN BERKSHIRE REGIONAL EMERGENCY PLANNING COMMITTEE, AN ALLIANCE OF THE TOWNS, EMERGENCY SERVICES, BOARDS OF HEALTH, SELECTMEN OF INDIVIDUAL TOWNS, AND THE HOSPITAL.FAIRVIEW HOSPITAL ENGAGES WITH THE COMMUNITY USING MULTIPLE TRADITIONAL AND NON-TRADITIONAL MEDIA AVENUES TO SHARE INFORMATION ACROSS THE MULTIPLE GEOGRAPHIC, SOCIO-ECONOMIC AND DEMOGRAPHIC AUDIENCES WE SERVE. THROUGH COLLABORATION AND ONGOING DISCUSSION, FAIRVIEW DISPERSES IMPORTANT HEALTH INFORMATION TO SEGMENTS OF THE COMMUNITY THROUGH THEIR FORMAL AND INFORMAL NETWORKS, WHICH ARE PARTICULARLY STRONG IN RURAL COMMUNITIES. FOR EXAMPLE, TO REACH THE NON-ENGLISH SPEAKING POPULATION, FAIRVIEW SHARES IMPORTANT HEALTH INFORMATION THROUGH SOCIAL SERVICE, RELIGIOUS, EDUCATIONAL, CULTURAL AND BUSINESS CHANNELS WHERE OTHER NEEDS ARE MET. WHILE THE SOUTHERN BERKSHIRE COMMUNITY IS PREDOMINATELY CAUCASIAN, THERE IS A GROWING MULTI-CULTURAL COMMUNITY. FAIRVIEW HOSPITAL HAS EXPANDED ITS NETWORK OF CONTACTS AND RESOURCES TO SERVE THIS COMMUNITY. WHEN ANY HEALTH ISSUE IS ADDRESSED OR PROGRAM PROMOTED, THERE ARE MANY POINTS OF CONTACT REPRESENTING THIS COMMUNITY TO INITIATE A SIMILAR DISTRIBUTION OF INFORMATION TAILORED TO THE NEEDS OF SPECIFIC GROUPS.DUE TO THE SIGNIFICANCE OF THE REGION AS A VACATION AND RETIREMENT DESTINATION, HOUSING COSTS HAVE ESCALATED AND EXCEED THE SCOPE OF LOCAL WAGES, FORCING MANY FAMILIES AND INDIVIDUALS TO STRUGGLE WITH BASIC LIVING EXPENSES. FAMILIES LIVING BELOW 200% OF THE POVERTY LEVEL AND THE AVERAGE PER CAPITA INCOME ARE BOTH SIGNIFICANTLY LOWER THAN THE STATE AVERAGE. THE NUMBER OF ELDERS (SURPASSING 20% IN SOME RURAL LOCATIONS) EXCEEDS STATE AVERAGES. STUDENTS ON REDUCED OR FREE LUNCH SERVICES HAVE BEEN RISING STEADILY AND NOW APPROACH 40% IN THE ELEMENTARY AND MIDDLE SCHOOLS. FOR THIS REASON, WORKING WITH THE SCHOOLS AND SENIOR ORGANIZATIONS ARE CENTRAL TO FAIRVIEW'S COMMUNICATIONS AND OUTREACH STRATEGY. RURAL HOMELESSNESS IS A HIDDEN, BUT PERVASIVE SOCIAL AND ECONOMIC ISSUE. FAIRVIEW HOSPITAL COLLABORATES CLOSELY WITH BOTH THE LOCAL HOMELESS SHELTER AND VOLUNTEERS IN MEDICINE TO ARRANGE FOR APPROPRIATE CLINICAL CARE FOR THIS VULNERABLE POPULATION. FAIRVIEW ALSO DONATES UNSOLD FRESHLY COOKED MEALS FROM ITS LUNCH AND DINNER SERVICES TO CONSTRUCT, A GREAT BARRINGTON NON-PROFIT "COMMITTED TO AFFORABLE HOUSING FOR EVERYONE...IN THE SOUTHERN BERKSHIRE REGION." THESE MEALS ARE DONATED THREE DAYS A WEEK, SUPPORTING THE SHELTER AND AVOIDING UNNECESSARY WASTE OF HIGH QUALITY FOODS. THE PERCENTAGE OF ELDERS IN THE SOUTHERN BERKSHIRES IS SIGNIFICANTLY ABOVE THE STATE AVERAGE, SURPASSING 20% IN SOME RURAL COMMUNITIES. ADDITIONALLY, MANY ELDERS ARE LIVING ALONE. SENIOR CENTERS AND SERVICES ARE AN IMPORTANT COMMUNITY RESOURCE AND FAIRVIEW REGULARLY OFFERS PROGRAMS THROUGH THESE ORGANIZATIONS.PUBLIC TRANSPORTATION IS LIMITED AND NOT EASILY ACCESSIBLE. AS A RESULT, TRANSPORTATION IS AN OBSTACLE TO CARE FOR MANY, PARTICULARLY AMONG THE ELDERLY. A PUBLIC TRANSPORTATION AGENCY RUNS A LIMITED BUS ROUTE WITH LIMITED HOURS. ADDITIONAL ELDERLY TRANSPORTATION IS AVAILABLE BUT LIMITED. PEOPLE WHO NEED TO ACCESS HEALTHCARE MUST RELY ON FAMILY OR FRIENDS TO GET TO MEDICAL CARE. SPECIALTY CARE IS A PARTICULAR CHALLENGE TO OBTAIN. FAIRVIEW HOSPITAL COLLABORATES WITH AREA ORGANIZATIONS TO HELP MAKE TRANSPORTATION OPTIONS AVAILABLE. HEALTHCARE AND EDUCATION ARE THE PRIMARY EMPLOYMENT SECTORS. THE SOUTHERN BERKSHIRE ECONOMY'S PRIMARY ECONOMIC ENGINE IS TOURISM, WITH A HIGH NUMBER OF HOTELS, BED AND BREAKFASTS, RESTAURANTS, AND RETAIL SHOPS AND SERVICES CATERING TO THE TOURIST COMMUNITY. THE LOCAL CONSTRUCTION INDUSTRY WAS SEVERELY IMPACTED BY THE ECONOMIC DOWNTURN. ALTHOUGH THESE ARE OFTEN SEASONAL AND SERVICE BASED JOBS, THEY ARE A SIGNIFICANT PART OF THE ECONOMY. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH - FURTHERING OUR CHARITABLE PURPOSE AS PART OF BERKSHIRE HEALTH SYSTEMS, FAIRVIEW HOSPITAL'S COMMUNITY BENEFIT MISSION IS COMMITTED TO IDENTIFY, PRIORITIZE, AND MAKE INVESTMENTS THAT ADDRESS OUR COMMUNITIES' HEALTH NEEDS AND RAISE THE HEALTH STATUS OF OUR NEIGHBORS. FAIRVIEW HOSPITAL IS COMMITTED TO BUILD A HEALTHIER COMMUNITY AND APPROACHES THIS CHALLENGE AS A KEY LEADER IN A REGIONAL NETWORK THAT IS FOCUSED ON ADDRESSING PRIORITY HEALTH ISSUES AMONG VULNERABLE POPULATIONS THROUGH OFFERING HIGH QUALITY EDUCATION, PROGRAMS AND SERVICES THAT WILL IMPROVE HEALTH STATUS. FAIRVIEW SERVES AS THE RURAL REGION'S PRIMARY HEALTHCARE ORGANIZATION, AND ADDRESSES THE NEEDS OF "AT RISK AND VULNERABLE POPULATIONS AS PART OF OVERALL PUBLIC HEALTH. FAIRVIEW SEEKS INPUT AND FEEDBACK TO IMPROVE EFFICIENT USE OF RESOURCES TO MEET IDENTIFIED COMMUNITY NEEDS AND ACTS AS A CATALYST TO PROMOTE HEALTH INITIATIVES SUCH AS FLU CLINICS, EMERGENCY PLANNING, AND OTHER PUBLIC HEALTH MANDATES. FAIRVIEW PARTICIPATES IN THE BERKSHIRE MEDICAL CENTER MONTHLY COMMUNITY BENEFITS MEETINGS AS WELL AS MAINTAINING A SEPARATE FAIRVIEW HOSPITAL COMMUNITY BENEFITS COMMITTEE WHICH MEETS ONCE A YEAR AND PROVIDES A PLATFORM THAT FOCUSES ON THE TWELVE SOUTHERN BERKSHIRE TOWNS IN ITS SERVICE AREA, ENGAGING COMMUNITY PROFESSIONALS ON THE SPECIFIC NEEDS OF OUR GEOGRAPHIC DISTRICT. THE FHCBC INCLUDES THE PRESIDENT, TWO VICE PRESIDENTS, AND LEADERS OF THE HOSPITAL DEPARTMENTS AND STAFF WHO ARE DIRECTLY INVOLVED WITH PATIENTS, ALLOWING A GREATER FOCUS ON THE SPECIFIC NEEDS OF THIS GEOGRAPHIC DISTRICT THROUGH A MULTIDISCIPLINARY APPROACH TO IDENTIFY EMERGING HEALTH ISSUES IN THE COMMUNITY.THROUGH THE COMMUNITY BENEFITS REPORTING PROCESS, FAIRVIEW HAS ARTICULATED AND QUANTIFIED THE ISSUES AND RESPONSES THAT ADDRESS PRIORITY NEEDS FROM THE STATEWIDE FRAMEWORK DEVELOPED BY THE MASSACHUSETTS ATTORNEY GENERAL'S OFFICE. AS THE CENTER OF HEALTHCARE IN THE SOUTHERN BERKSHIRES, FAIRVIEW PROVIDES THE SAFETY NET AND PRIMARY SERVICES THAT ARE VITAL TO THE COMMUNITY'S HEALTH NEEDS AND OFFERS PROGRAMS THAT ARE DESIGNED TO SUPPORT THE MOST VULNERABLE INDIVIDUALS AS WELL AS BUILD A HEALTHIER FUTURE FOR THE REGION.FAIRVIEW HOSPITAL VALUES THE COMMUNITY'S VITAL ROLE AS PARTNERS IN THE VITALITY OF THEIR COMMUNITY HOSPITAL. MEMBERS OF THE COMMUNITY, REPRESENTING VARIOUS DEMOGRAPHIC AND CONSTITUENCY GROUPS, SERVE ON OUR GOVERNING BOARDS AS WELL AS VARIOUS COMMITTEES, INCLUDING THE PATIENT FAMILY ADVISORY COUNCIL, THE ETHICS COMMITTEE AND OTHER GROUPS THAT CREATE OPPORTUNITY FOR DIALOGUE WHICH ASSURE THE INPUT AND INTERESTS OF THE COMMUNITY ARE REPRESENTED AT THE HIGHEST LEVELS. HOSPITAL STAFF ALSO PLAY AN ACTIVE ROLE IN MANY LOCAL AND REGIONAL ORGANIZATIONS, SUPPORTING THEIR EFFORTS AND, BY ENGAGING WITH THEIR MISSION AND INTERESTS, CREATING NEW AVENUES OF COLLABORATION AND OPPORTUNITY TO BETTER MEET OUR COMMUNITY'S HEALTH NEEDS.AT THE END OF FISCAL YEAR 2018, THE CURRENT GOVERNING BODY OF FAIRVIEW HOSPITAL CONSISTED OF 17 COMMUNITY VOLUNTEERS, SIX PHYSICIAN REPRESENTATIVES, AND AS AN EX-OFFICIO MEMBER, THE CHIEF EXECUTIVE OFFICER. THE COMMUNITY VOLUNTEERS ARE ELECTED FOR TERMS OF UP TO THREE YEARS, ARE SUBJECT TO TERM LIMITS, AND REPRESENT A WIDE SPECTRUM OF COMMUNITY INTERESTS - INCLUDING SOCIAL SERVICE PROVIDERS, LOCAL BUSINESS LEADERS, FINANCIAL PROFESSIONALS, CONSUMER ADVOCATES, AND EDUCATIONAL LEADERS. MOST COMMITTEES OF THE BOARD OF TRUSTEES INCLUDE ADDITIONAL COMMUNITY REPRESENTATIVES. FAIRVIEW ALSO MAINTAINS A PATIENT AND FAMILY COUNCIL TO PROVIDE INPUT AND ADVICE ON A WIDE RANGE OF SERVICE TOPICS.THE MEDICAL STAFF OF FAIRVIEW HOSPITAL IS OPEN TO ALL PHYSICIANS WHO MEET CLINICAL AND PATIENT SERVICE CRITERIA, ALTHOUGH CERTAIN HOSPITAL BASED SERVICES - RADIOLOGY, ANESTHESIA, EMERGENCY DEPARTMENT AND PATHOLOGY - ARE FUNCTIONALLY CLOSED BECAUSE OF THE MANNER IN WHICH THOSE DEPARTMENTS ARE STRUCTURED.FAIRVIEW REGULARLY EXPENDS PERSONNEL AND FINANCIAL RESOURCES IN SUPPORT OF COMMUNITY INITIATIVES THAT PROMOTE IMPROVEMENTS IN COMMUNITY HEALTH AND WELL-BEING FOR WHICH IT DOES NOT EXPECT REIMBURSEMENT. THE HOSPITAL UTILIZES SURPLUS FUNDS FOR CAPITAL IMPROVEMENTS, TO MAINTAIN ACCESS TO HOSPITAL SERVICES AND PRIMARY CARE, TO EXPAND ACCESS POINTS OF CARE, AND TO SUPPORT SERVICES THAT SUPPORT COMMUNITY BENEFIT PRIORITIES INCLUDING CHRONIC DISEASE, EDUCATION, AND ACCESS TO CARE. FAIRVIEW'S EXTENSIVE COMMUNITY OUTREACH AND SUPPORT PROGRAMS INCLUDE TOBACCO TREATMENT, PARKINSON'S EXERCISE, AND CPR AND LIFE SAFETY TRAINING. IN ADDITION, FAIRVIEW PROVIDES FINANCIAL SUPPORT FOR LOCAL INITIATIVES, INCLUDING YOUTH SPORTS AND RECREATION, PROGRAMS SUPPORTING AWARENESS AND ACCESS TO LOCAL HEALTH ISSUES SUCH AS SUBSTANCE ABUSE, AND ROAD SAFETY INITIATIVES DESIGNED TO IMPROVE DRIVER SKILLS IN RESPONSE TO HIGH RATES OF ACCIDENTS AND FATALITIES ON UNLIT RURAL COUNTRY ROADS.FAIRVIEW HOSPITAL'S SERVICE AREA IS DESIGNATED A MEDICALLY UNDERSERVED REGION. A HIGH PRIORITY HAS BEEN PLACED ON STABILIZING THE CURRENT MEDICAL COMMUNITY, AS WELL AS ATTRACTING NEW PHYSICIANS AND SPECIALISTS TO THE REGION. FAIRVIEW COLLABORATES WITH AREA MEDICAL PRACTICES AND SERVICES TO BUILD A STRONG FOUNDATION OF SERVICES AND INFORMATION TO ASSURE HIGH QUALITY CARE IS AVAILABLE. MOREOVER, BMC AND FAIRVIEW HAVE, IN APPROPRIATE WAYS, PROVIDED SUBSTANTIAL ASSISTANCE TO COMMUNITY MEDICAL PRACTICES TO RECRUIT AND SUPPORT THE PRACTICE START-UP OF NEW PHYSICIANS IN NEEDED SPECIALTIES.IN ADDITION, FAIRVIEW HOSPITAL OFFERS MANY OPPORTUNITIES FOR ACCESS FOR STUDENTS TO EXPLORE AND FURTHER THEIR SKILLS IN MEDICINE. DEVELOPING OUR FUTURE WORKFORCE THROUGH ACCESSIBLE TRAINING AND CAREER PROGRAMMING IS STRATEGICALLY IMPORTANT TO DEVELOP A FUTURE WORKFORCE IN AN INCREASING CHALLENGING HEALTHCARE ENVIRONMENT. AS STEWARD OF THE COMMUNITY'S PRIMARY HEALTH ORGANIZATION, AND A NOT-FOR-PROFIT ORGANIZATION, FAIRVIEW HOSPITAL UTILIZES ANY SURPLUS FUNDS TO MEET THE HIGHEST PRIORITY NEEDS INCLUDING PATIENT CARE, SERVICE AND PROGRAM DEVELOPMENT, MEDICAL EDUCATION OF ALL STAFF, COMMUNITY SUPPORT, AND EDUCATION AND RESEARCH.AS THE CENTER OF THE HEALTHCARE COMMUNITY IN THE SOUTHERN BERKSHIRES, FAIRVIEW HOSPITAL IS AN ACTIVE LEADER IN THE PROMOTION OF BETTER HEALTH IN OUR COMMUNITY. FAIRVIEW OFFERS:PRIMARY SERVICES TO ALL WHO SEEK CARE, REGARDLESS OF ABILITY TO PAY;FREE OR LOW-COST EDUCATIONAL PROGRAMS, SUPPORT GROUPS, AND SCREENINGS TO PROVIDE VALUABLE INFORMATION TO OUR COMMUNITY, WITH PARTICULAR FOCUS ON VULNERABLE POPULATIONS;ONGOING MEDIA COMMUNICATION FOR IMPORTANT HEALTH ACCESS INFORMATION INCLUDING FLU PREVENTION, VACCINATIONS, AND COMMONWEALTH CARE DEADLINES;HEALTHY MENUS, MORE SUSTAINABLE OR ENVIRONMENTALLY FRIENDLY POLICIES, AND DISCONTINUATION OF SUGAR DRINKS IN THE HOSPITAL TO SERVE AS A ROLE MODEL FOR A HEALTHIER COMMUNITY; ANDLEADERSHIP AND COLLABORATION IN PUBLIC HEALTH INITIATIVES INCLUDING EMERGENCY PLANNING, BOARDS OF HEALTH, AND OTHER COMMUNITY-WIDE INITIATIVES.A SPECIFIC AREA OF FOCUS THAT REFLECTS THE IMPORTANCE AND IMPACT OF COLLABORATION IS THE PRIORITY OF ADDRESSING YOUTH OBESITY. STATISTICS PROVIDED BY THE SCHOOL DISTRICTS REFLECT HIGH RATES OF OBESITY AMONG YOUTH IN THE AREA, A SIGNIFICANT THREAT TO THE IMMEDIATE AND LONG-TERM HEALTH STATUS OF OUR COMMUNITY. FAIRVIEW HOSPITAL SUCESSFULLY EXPANDED BERKSHIRE MEDICAL CENTER'S OPERATION BETTER START PROGRAM TO SOUTHERN BERKSHIRE COUNTY, PROVIDING A TEAM OF NUTRITION SPECIALISTS WHO PROVIDE EDUCATION AND SUPPORT. EARLY EFFORTS TO REACH THE ADOLESCENT POPULATION WERE LIMITED DUE TO LIMITED ACCESS TO HOSPITAL-BASED PROGRAMS DUE TO GEOGRAPHIC AND TRANSPORTATION OBSTACLES TO ATTENDANCE. IN RESPONSE, OPERATION BETTER START INSTITUTED THE "TAKE SIX" PROGRAM IN COLLABORATION WITH THE REGIONAL HIGH SCHOOL. OFFERED AT THE SCHOOL DURING THE SCHOOL DAY, YOUTH ARE ABLE TO ACCESS THE SUPPORT AND INFORMATION AVAILABLE. NOW THE SERVICES ARE AVAILABLE BOTH AT THE HOSPITAL AND IN THE COMMUNITY.IN ADDITION TO OPERATION BETTER START AND NUTRITION COUNSELING SERVICES, FAIRVIEW HOSPITAL OFFERS A SIX-WEEK MINDFULNESS BASED EATING PROGRAM, AN INNOVATIVE WELLNESS PROGRAM DESIGNED TO HELP INDIVIDUALS IMPROVE THEIR HEALTH THROUGH IMPROVED EATING HABITS. INCREASED AWARENESS OF EATING HABITS AND THE IMPACT OF THESE HABITS HAVE RECEIVED POSITIVE REVIEWS FROM ATTENDEES.AS THE HUB OF HEALTHCARE IN THE SOUTHERN BERKSHIRES, FAIRVIEW IS COMMITTED TO PROVIDING ROLE MODELING FOR THE COMMUNITY BY SETTING A HIGH STANDARD IN HEALTHY EATING WITHIN THE HOSPITAL. FAIRVIEW WAS THE FIRST HOSPITAL IN THE COUNTRY TO DISCONTINUE THE SALE OF SUGAR-SWEETENED BEVERAGES AT THE HOSPITAL AND THE FIRST HOSPITAL IN MASSACHUSETTS TO SIGN THE HEALTHCARE WITHOUT HARM PLEDGE. SODA IS NO LONGER AVAILABLE AT FAIRVIEW HOSPITAL. PART VI, LINE 6: AFFILIATED HEALTHCARE SYSTEM - FAIRVIEW HOSPITAL IS A PART OF AN INTEGRATED, NON-PROFIT HEALTHCARE SYSTEM THAT INCLUDES (A) A TEACHING HOSPITAL, (B) A CRITICAL ACCESS COMMUNITY HOSPITAL [FAIRVIEW], (C) A LARGE, MULTISPECIALTY FACULTY PRACTICE ORGANIZATION, (D) A HOME HEALTH AGENCY, AND (E) BY CONTRACT AND CLOSE COORDINATION, A NON-PROFIT SENIOR CARE ORGANIZATION THAT INCLUDES SUB-ACUTE SERVICES IN REHABILITATION AND LONG-TERM CARE FACILITIES, ASSISTED LIVING FACILITIES, HOSPICE CARE SERVICES, SENIOR DAY CARE, AND OTHER ELDERCARE SERVICES. FAIRVIEW ENGAGES IN HEALTHCARE NEEDS ASSESSMENT AND PLANNING ON A SYSTEM-WIDE BASIS, WITH A GOAL OF A SEAMLESS TRANSITION OF PATIENT-CENTERED CARE ACROSS THE SPECTRUM OF SERVICES OFFERED BY EACH OF THE SYSTEM'S COMPONENT ENTITIES. FAIRVIEW, ALONG WITH ITS AFFILIATES, CONTINUES TO DEVELOP INTEGRATED CLINICAL AND INFORMATION SYSTEMS ACROSS THE ENTIRE ORGANIZATION SO AS TO RENDER CARE EFFICIENTLY, EFFECTIVELY, AND CONSISTENTLY AT EVERY CARE SITE. THE VARIOUS AFFILIATES, SUCH AS THE FACULTY PRACTICE ORGANIZATION, ARE FULLY INTEGRATED INTO THE COMMUNITY BENEFIT PROCESS AND SUPPORT THE HOSPITAL'S PRIORITIES BY HONORING OUR FREE CARE GUIDELINES AND ENGAGING IN SPECIFIC PROGRAMS AND INITIATIVES DESIGNED TO MEET COMMUNITY NEEDS. PART VI, LINE 7, REPORTS FILED WITH STATES MA 0 0 0 0 0 0 0 0 0 BRIAN T BURKE MD TRUSTEE/PHYSICIAN 223350 0 0 0 6914 0 10499 0 34653 0 275416 0 0 0 DANIEL M DOYLE MD TRUSTEE/PHYSICIAN 0 294851 0 0 0 10559 0 12150 0 29980 0 347540 0 0 DAVID E PHELPS PRESIDENT/TRUSTEE 0 747260 0 0 0 33034 0 12050 0 35366 0 827710 0 0 DAVID E PHELPS VESTED RETIREMENT PROGRAM 0 0 0 0 0 1391596 0 0 0 0 0 1391596 0 0 DARLENE M RODOWICZ TREASURER 0 467524 0 0 0 46617 0 11643 0 33470 0 559254 0 0 ADRIAN ELLIOT MD DIRECTOR, EMERGENCY DEPT. 377128 0 29845 0 2275 0 12150 0 30002 0 451400 0 0 0 DOREEN HUTCHINSON VICE PRESIDENT, OPERATIONS 180340 0 0 0 32410 0 9151 0 34632 0 256533 0 0 0 ROBERT W MALINOWSKI MD ANESTHESIOLOGIST 0 428235 0 16000 0 5710 0 6750 0 25101 0 481796 0 0 MICHAEL FASANO MD ANESTHESIOLOGIST 0 380250 0 16000 0 5644 0 11736 0 34203 0 447833 0 0 RICHARD SAUPE MD ANESTHESIOLOGIST 0 364055 0 16000 0 3011 0 10746 0 32374 0 426186 0 0 JOSHUA M PACHECO MD PHYSICIAN 340649 0 27090 0 2164 0 1480 0 38816 0 410199 0 0 0 ARTHUR E CHIN MD PHYSICIAN 275078 0 27453 0 4131 0 12049 0 34883 0 353594 0 0 0 ALEC R BELMAN MD PHYSICIAN/FORMER KEY EE 307665 0 23395 0 2305 0 12150 0 34631 0 380146 0 0 0 FORM 990, PART VII AND SCHEDULE J (FORM 990), PART II SUPPLEMENTAL COMPENSATION INFORMATION IN REFERENCE TO FORM 990, PART VII AND SCHEDULE J PART II, NO COMPENSATION IS PAID BY THE FILING ENTITY TO ANY DIRECTOR (TRUSTEE) FOR HIS OR HER ROLE AS DIRECTOR (TRUSTEE). BRIAN T. BURKE, MD'S REPORTED COMPENSATION RELATES SOLELY TO SERVICES RENDERED FOR TAX-EXEMPT PURPOSES AND NOT TO HIS ROLE AS DIRECTOR (TRUSTEE). DANIEL M. DOYLE, MD'S REPORTED COMPENSATION RELATES SOLELY TO SERVICES RENDERED FOR TAX-EXEMPT PURPOSES AND NOT TO HIS ROLE AS DIRECTOR (TRUSTEE). THE PRINCIPAL OFFICERS OF FAIRVIEW HOSPITAL ARE ALL COMPENSATED BY BHS MANAGEMENT SERVICES, INC. (BMS), A SUPPORTING ORGANIZATION OF THE FILING ENTITY. A PORTION OF THE COMPENSATION AMOUNT PAID TO THE PRINCIPAL OFFICERS OF THE FILING ENTITY IS ALLOCATED INTERNALLY AMONG THE FILING ENTITY AND ITS 23 ASSOCIATED NON-PROFIT, TAX-EXEMPT ENTITIES IN ORDER TO PROPERLY REFLECT THE DIVISION OF THE OFFICERS' TIME AND EFFORT AMONG THOSE VARIOUS ENTITIES AND EACH ENTITY'S RELATIVE CONTRIBUTION TO THE OFFICERS' TOTAL COMPENSATION (SEE BELOW). COMPENSATION OF THE CHIEF EXECUTIVE OFFICER, DAVID PHELPS, IS REVIEWED AND ESTABLISHED AT LEAST BIANNUALLY BY THE INDEPENDENT VOLUNTEER GOVERNING BODY OF BERKSHIRE HEALTH SYSTEMS, INC. (PARENT ORGANIZATION OF FAIRVIEW HOSPITAL), BASED ON PERFORMANCE REVIEWS AND COMPARISON TO INDEPENDENTLY ESTABLISHED, REGIONALLY APPROPRIATE BENCHMARKS FOR SIMILAR POSITIONS IN SIMILARLY SIZED HEALTHCARE ORGANIZATIONS, AS VERIFIED BY INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANTS. COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS SET IN ACCORDANCE WITH GOVERNING BODY-ESTABLISHED PRINCIPLES BASED ON COMPARABLE BENCHMARKS IDENTIFIED BY SUCH INDEPENDENT CONSULTANTS. IN THE REPORTING YEAR, THE GOVERNING BODY TARGETED TOTAL COMPENSATION FOR MANAGEMENT EMPLOYEES AT THE 60TH PERCENTILE OF APPROPRIATE BENCHMARKS (OTHER THAN THE CHIEF EXECUTIVE OFFICER WHOSE TOTAL COMPENSATION REMAINS TARGETED AT THE 50TH PERCENTILE). MR. PHELPS' TOTAL COMPENSATION AS REPORTED ON THIS TAX RETURN INCLUDES PAYOUTS FROM A VESTED RETIREMENT PROGRAM AND A LIFE INSURANCE POLICY, AS WELL AS CERTAIN OTHER TAXABLE BENEFITS THAT ARE GENERALLY AVAILABLE TO EMPLOYEES OF FAIRVIEW HOSPITAL AND ITS RELATED ORGANIZATIONS. MR. PHELPS' VESTED RETIREMENT PROGRAM PAYMENT IS REPORTED SEPARATELY IN FORM 990 PART VII SECTION A LINE 1A AND SCHEDULE J PART II. THE FOLLOWING LIST SHOWS THE ENTITIES TO WHICH THE IDENTIFIED OFFICER PROVIDED SERVICES, THE AVERAGE WEEKLY HOURS ALLOCATED TO EACH ENTITY, AND THE RESPECTIVE ALLOCABLE SHARE OF HIS OR HER ANNUAL REPORTABLE COMPENSATION FOR CALENDAR 2017: DAVID E. PHELPS, PRESIDENT & CEO (ALLOCATION IS EXCLUSIVE OF $1,391,596 VESTED REIREMENT PROGRAM PAYMENTS WHICH ARE INCLUDED IN FORM 990 PART VII SECTION A LINE 1A ITEM 20 COLUMN E AND SCHEDULE J PART II ITEM 4 COLUMN B(III).) BERKSHIRE MEDICAL CENTER, INC: 26 WEEKLY HOURS/50 WEEKLY HOURS $405,753 FAIRVIEW HOSPITAL: 3.5 HOURS/50 HOURS $54,621 BERKSHIRE FACULTY SERVICES, INC: 8.75 HOURS/50 HOURS $136,551 BERKSHIRE INDEMNITY CO, SPC, LTD: 1.75 HOURS/50 HOURS $27,310 BHS MANAGEMENT SERVICES, INC (10 HOURS/50 HOURS) FOR BENEFIT OF: BOURNE MANAGEMENT SYSTEMS, INC: $10,406 GREENFIELD MANAGEMENT SYSTEMS, INC: $9.604 NEW BEDFORD MANAGEMENT SYSTEMS, INC: $10,974 NORTHAMPTON MANAGEMENT SYSTEMS, INC: $11,657 EAST LONGMEADOW MANAGEMENT SYSTEMS, INC: $5,456 DANVERS MANAGEMENT SYSTEMS, INC: $5,060 PEABODY MANAGEMENT SYSTEMS, INC: $9,168 SOUTH YARMOUTH MANAGEMENT SYSTEMS, INC: $5,846 WILLOWOOD OF GREAT BARRINGTON, INC: $7,966 WILLOWOOD OF NORTH ADAMS, INC: $9,124 WILLOWOOD OF WILLIAMSTOWN, INC: $11,550 HILLCREST EXTENDED CARE SERVICES, INC: $21,248 BERKSHIRE RETIREMENT COMMUNITY, INC: $3,702 BERKSHIRE EXTENDED CARE SERVICES, INC: $1,784 INTEGRINURSE, INC: $1,545 INTEGRISCRIPT, INC: $3,914 HOSPICE OF FRANKLIN COUNTY, INC: $2,164 HOSPICECARE IN THE BERKSHIRES, INC: $6,200 PITTSFIELD MANAGEMENT SYSTEMS, INC: $10,101 HOLYOKE RETIREMENT COMMUNITY, INC: $8,588 TOTAL REPORTABLE COMPENSATION $780,294 DARLENE RODOWICZ, CHIEF FINANCIAL OFFICER AND TREASURER BERKSHIRE MEDICAL CENTER, INC: 37 WEEKLY HOURS/50 WEEKLY HOURS $380,465 FAIRVIEW HOSPITAL: 3 HOURS/50 HOURS $30,848 BERKSHIRE FACULTY SERVICES, INC: 7 HOURS/50 HOURS $71,980 BERKSHIRE INDEMNITY CO, SPC, LTD: 2.5 HOURS/50 HOURS $25,707 BHS MANAGEMENT SERVICES, INC FOR THE BENEFIT OF BERKSHIRE HEALTHCARE SYSTEMS, INC: 0.5 HOUR/50 HOURS $5,141 TOTAL REPORTABLE COMPENSATION $514,141 A MASS DEVELOPMENT FINANCE AGENCY BHS ISSUESER G 043431814 57583UQP6 2012-05-23 93491421 REFUND SER A, B, & E; CAPITAL EXP 0 0 0 B MASS DEVELOPMENT FINANCE AGENCY BHS ISSUESER H 043431814 2016-11-18 10540000 REFUND SERIES F BONDS 0 0 0 A 15285000 93491421 1245681 8171944 84073796 2011 1 0 1 1 B 3200000 10540000 196296 10343704 2008 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: MASS DEVELOPMENT FINANCE AGENCY, BHS ISSUE,SER G DATE THE REBATE COMPUTATION WAS PERFORMED: 09/30/2017 FORM 990, PART VI, SECTION A, LINE 6 BERKSHIRE HEALTH SYSTEMS, INC. IS THE SOLE CORPORATE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF TRUSTEES IS COMPOSED OF THE INCUMBENT MEMBERS OF THE BOARD OF TRUSTEES OF BERKSHIRE HEALTH SYSTEMS, INC. FORM 990, PART VI, SECTION B, LINE 11B BERKSHIRE HEALTH SYSTEMS, INC. MAKES THE FORMS 990 FOR BHS AND ITS AFFILIATES AVAILABLE TO THE MEMBERS OF THE RESPECTIVE GOVERNING BODIES FOR THEIR REVIEW BY (A) SENDING COPIES TO THEM PHYSICALLY OR ELECTRONICALLY, OR (B) NOTIFYING THE MEMBERS THAT THE FORMS 990 CAN BE ACCESSED BY A SECURE WEB-BASED FOLDER BEFORE THEY ARE FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MONITORS AND ENFORCES ITS CONFLICT OF INTEREST POLICY BY REQUIRING ALL MEMBERS OF THE GOVERNING BODY AND ALL OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST (A) ANNUALLY AND (B) AS POTENTIAL CONFLICTS ARISE. THE EXECUTIVE COMMITTEE OF THE GOVERNING BODY IS CHARGED WITH REVIEWING POTENTIAL CONFLICTS OF INTEREST INVOLVING MEMBERS OF THE GOVERNING BODY OR THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION. THE PRESIDENT AND CHIEF EXECUTIVE OFFICER IS CHARGED WITH REVIEWING POTENTIAL CONFLICTS OF INTEREST INVOLVING ANY OTHERS. OFFICERS (INCLUDING THE PRESIDENT AND CHIEF EXECUTIVE OFFICER), KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES ARE NOT PERMITTED TO HAVE MATERIAL CONFLICTS OF INTEREST. THE DISINTERESTED MEMBERS OF THE GOVERNING BODY ARE CHARGED WITH DETERMINING WHETHER A CONFLICT EXISTS IN THE CASE OF MEMBERS OF THE GOVERNING BODY AND HOW THE AFFECTED MEMBER IS TO ABSTAIN FROM ACTIONS THAT MAY BE INFLUENCED BY HIS OR HER CONFLICT OR POTENTIAL CONFLICT, INCLUDING BY (A) NOT VOTING, OR (B) NOT VOTING AND LEAVING THE ROOM, OR (C) LEAVING THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 15 FAIRVIEW HOSPITAL RELIES ON BHS MANAGEMENT SERVICES, INC. TO SUPPLY ITS CHIEF EXECUTIVE OFFICER. THE COMPENSATION OF CEO DAVID PHELPS IS REVIEWED AND ESTABLISHED AT LEAST BIANNUALLY BY THE INDEPENDENT VOLUNTEER GOVERNING BODY OF BERKSHIRE HEALTH SYSTEMS, INC. (PARENT ORGANIZATION OF FAIRVIEW HOSPITAL), BASED ON PERFORMANCE REVIEWS AND COMPARISON TO INDEPENDENTLY ESTABLISHED, REGIONALLY APPROPRIATE BENCHMARKS FOR SIMILAR POSITIONS IN SIMILARLY SIZED HEALTHCARE ORGANIZATIONS, AS VERIFIED BY INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANTS. COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS SET IN ACCORDANCE WITH GOVERNING BODY ESTABLISHED PRINCIPLES BASED ON COMPARABLE BENCHMARKS IDENTIFIED BY SUCH INDEPENDENT CONSULTANTS. IN THE REPORTING YEAR, THE GOVERNING BODY TARGETED TOTAL COMPENSATION FOR MANAGEMENT EMPLOYEES AT THE 60TH PERCENTILE OF APPROPRIATE BENCHMARKS (OTHER THAN THE CHIEF EXECUTIVE OFFICER WHOSE TOTAL COMPENSATION REMAINS TARGETED AT THE 50TH PERCENTILE.) FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC AT THE OFFICES OF (A) THE CHIEF FINANCIAL OFFICER & (B) THE VICE PRESIDENT, GENERAL COUNSEL AT 725 NORTH STREET, PITTSFIELD, MASSACHUSETTS 01201. FORM 990, PART VII, SECTION A, COLUMN (B) AVERAGE HOURS PER WEEK: DANIEL M. DOYLE, MD RECEIVED PAYMENT FROM BERKSHIRE FACULTY SERVICES FOR PHYSICIAN SERVICES, AND MOST OF THE HOURS SHOWN IN PART VII, SECTION A, COLUMN (B) AS HOURS FOR RELATED ORGANIZATIONS ARE RELATED TO THESE SERVICES. DR. DOYLE'S HOURS FOR SERVICES AS A TRUSTEE ARE THE SAME AS FOR OTHER TRUSTEES WHO ARE NOT EMPLOYED BY BERKSHIRE FACULTY SERVICES, FAIRVIEW HOSPITAL, OR ANY RELATED ORGANIZATION, AND HE RECEIVES NO COMPENSATION FOR HIS SERVICES AS A TRUSTEE. BRIAN T. BURKE, MD RECEIVED PAYMENT FROM FAIRVIEW HOSPITAL FOR PHYSICIAN SERVICES, AND MOST OF THE HOURS SHOWN IN PART VII, SECTION A, COLUMN (B) AS AVERAGE HOURS PER WEEK ARE RELATED TO THESE SERVICES. DR. BURKE'S HOURS FOR SERVICES AS A TRUSTEE ARE THE SAME AS FOR OTHER TRUSTEES WHO ARE NOT EMPLOYED BY FAIRVIEW HOSPITAL OR ANY RELATED ORGANIZATION, AND HE RECEIVES NO COMPENSATION FOR HIS SERVICES AS A TRUSTEE. ALL TRUSTEES (BOARD MEMBERS) RECEIVE NO COMPENSATION FOR SERVICES AS TRUSTEES. FORM 990, PART XI, LINE 9: RECIPROCAL/TEACHING FEES -1,683,589. BERKSHIRE HEALTH SYSTEMS INC 725 NORTH ST PITTSFIELD MA 01201 042442944 PARENT CORPORATION MA 501(C)(3) 12B-II N/A 0 BERKSHIRE MEDICAL CENTER INC 725 NORTH ST PITTSFIELD MA 01201 042791396 ACUTE CARE HOSPITAL MA 501(C)(3) 3 N/A 0 BERKSHIRE FACULTY SERVICES INC 725 NORTH ST PITTSFIELD MA 01201 042995053 PHYSICIAN SERVICES MA 501(C)(3) 12B-II N/A 0 BHS MANAGEMENT SERVICES INC 725 NORTH ST PITTSFIELD MA 01201 222755258 MANAGEMENT SERVICES MA 501(C)(3) 12B-II N/A 0 TRI-STATE MEDICAL MANAGEMENT CORPORATION 725 NORTH STREET PITTSFIELD MA 01201 042913352 REAL ESTATE MANAGEMENT MA FAIRVIEW HOSPITAL C 1.00000 0 WILLIAMSTOWN MEDICAL ASSOCIATES PC 197 ADAMS ROAD WILLIAMSTOWN MA 01267 042680535 HEALTHCARE SERVICES MA N/A C 0 BERKSHIRE ORTHOPAEDIC ASSOCIATES INC 24 PARK STREET PITTSFIELD MA 01201 043017240 HEALTHCARE SERVICES MA N/A C 0 1 1 0 1 0 0 0 0 0 1 1 1 1 1 1 1 1 1 1 TRI-STATE MEDICAL MANAGEMENT CORP A 1064 FAIR MARKET VALUE