HENRY HEYWOOD MEMORIAL HOSPITAL: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: HENRY HEYWOOD MEMORIAL HOSPITAL (EIN 04-2103581)
Tax period: 2015-10-01 to 2016-09-30
Filed: 2017-05-09
IRS object ID: 201721319349305107
Schema version: 2015v3.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule G
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-05-09T14:23:13-07:00	ReturnTs
Tax Period End	2016-09-30	TaxPeriodEndDt
Return Type	990	ReturnTypeCd
Tax Period Begin	2015-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	042103581	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	HENRY HEYWOOD MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	HENR	BusinessNameControlTxt
Phone	9786323420	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	242 Green Street	AddressLine1Txt
City	Gardner	CityNm
State Abbreviation	MA	StateAbbreviationCd
ZIP	01440	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Robert Crosby	PersonNm
Person Title	Sr VP of Finance, Treasurer, CFO	PersonTitleTxt
Phone	9786323420	PhoneNum
Signature	2017-05-08	SignatureDt

Field	Value	IRS element (for citing)
Tax	2015	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	Heywood Hospital	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	Robert Crosby	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	242 Green Street	AddressLine1Txt
City	Gardner	CityNm
State Abbreviation	MA	StateAbbreviationCd
ZIP	01440	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$121,622,766	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.heywood.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1907	FormationYr
Legal Domicile State	MA	LegalDomicileStateCd
Activity Or Mission	To be our community's trusted choice for exceptional patient centered care.	ActivityOrMissionDesc
Voting Members Governing Body	20	VotingMembersGoverningBodyCnt
Voting Members Independent	17	VotingMembersIndependentCnt
Total Employee	1143	TotalEmployeeCnt
Total Volunteers	194	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$2,266,318	PYContributionsGrantsAmt
CY Contributions Grants	$2,617,675	CYContributionsGrantsAmt
PY Program Service Revenue	$107,888,356	PYProgramServiceRevenueAmt
CY Program Service Revenue	$112,270,215	CYProgramServiceRevenueAmt
PY Investment Income	$1,116,944	PYInvestmentIncomeAmt
CY Investment Income	$849,075	CYInvestmentIncomeAmt
PY Other Revenue	$1,346,159	PYOtherRevenueAmt
CY Other Revenue	$1,663,344	CYOtherRevenueAmt
PY Total Revenue	$112,617,777	PYTotalRevenueAmt
CY Total Revenue	$117,400,309	CYTotalRevenueAmt
PY Grants And Similar Paid	$131,414	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$170,445	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$56,128,843	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$59,566,652	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$84,000	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$552,316	CYTotalFundraisingExpenseAmt
PY Other Expenses	$50,119,456	PYOtherExpensesAmt
CY Other Expenses	$52,789,952	CYOtherExpensesAmt
PY Total Expenses	$106,379,713	PYTotalExpensesAmt
CY Total Expenses	$112,611,049	CYTotalExpensesAmt
PY Revenues Less Expenses	$6,238,064	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$4,789,260	CYRevenuesLessExpensesAmt
Total Assets BOY	$96,147,072	TotalAssetsBOYAmt
Total Assets EOY	$95,194,844	TotalAssetsEOYAmt
Total Liabilities BOY	$42,620,658	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$41,566,485	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$53,526,414	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$53,628,359	NetAssetsOrFundBalancesEOYAmt
Mission	To be the community's trusted choice for patient-centered care.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$105,007,291	ExpenseAmt
Grant	$170,445	GrantAmt
Revenue	$114,782,634	RevenueAmt
Desc	Heywood Hospital is dedicated to the community benefit goals of improving the health status of our community, addressing the specific health care needs of the under-served and collaborating with others to enhance quality and contain the growth of the community health care costs. Details to this are published in "The Community Benefit Report of Heywood Hospital - Fiscal year 2015" filed with the MA Attorney General's Office.	Desc
Total Other Prog Srvc Expense	$0	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant	$0	TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue	$0	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$105,007,291	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	Yes (1)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	Yes (1)	ProfessionalFundraisingInd
Fundraising Activities	Yes (1)	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	Yes (1)	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	Yes (1)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	Yes (1)	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	147	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	1143	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	Yes (1)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (1)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	20	GoverningBodyVotingMembersCnt
Independent Voting Member	17	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	MA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	Robert Crosby	PersonNm
Phone	9786306157	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	242 Green Street	AddressLine1Txt
City	Gardner	CityNm
State Abbreviation	MA	StateAbbreviationCd
ZIP	01440	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd
No Listed Persons Compensated	Yes (X)	NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Highest Compensated EmployeeHighestCompensatedEmployeeInd
Daniel Asquino
Trustee	0.2	Yes (X)	$0	$0	$0
Winfield Brown
President/CEO	40	Yes (X)	$782,320	$0	$73,748	Yes (X)
Cheney Castine
Treasurer	0.2	Yes (X)	$0	$0	$0
Robert Chauvin
Trustee	0.2	Yes (X)	$0	$0	$0
Joyce Fletcher
Trustee	0.2	Yes (X)	$0	$0	$0
John Fick
Trustee	0.2	Yes (X)	$0	$0	$0
James Garrison
Trustee	0.2	Yes (X)	$0	$0	$0
Glenn Hunt
Vice Chairman	0.2	Yes (X)	$0	$0	$0
Roy Lake
2nd Vice Chairman	0.2	Yes (X)	$0	$0	$0
James Meehan
Trustee	0.2	Yes (X)	$0	$0	$0
Don Mruk
Trustee	0.2	Yes (X)	$0	$0	$0
Elizabeth Nottleson
Trustee	0.2	Yes (X)	$3,100	$324,310	$20,721		28
Michele Parker
Trustee	0.2	Yes (X)	$0	$0	$0
JoAnne Parks
Clerk	0.2	Yes (X)	$0	$0	$0
Kami Phillips
Trustee	0.2	Yes (X)	$11,000	$17,430	$1,422		24
Kenneth Pierce
Chairman	0.2	Yes (X)	$0	$0	$0
Tina Sbrega
Trustee	0.2	Yes (X)	$0	$0	$0
Joel Shaughnessy
Trustee	0.2	Yes (X)	$0	$0	$0
John Skrzypczak
Trustee	0.2	Yes (X)	$0	$0	$0
Craig Twohey
Trustee	0.2	Yes (X)	$0	$0	$0
Robert Crosby
Sr VP of Finance/CFO	40		$312,908	$0	$56,616	Yes (X)
Michael Grimmer
VP of Support Srvcs	40		$256,070	$0	$52,195	Yes (X)
Bruce Bertrand
Chief Medical Officer	40		$263,226	$0	$36,548	Yes (X)
Rose Kavalchuck
VP of Prof Services	40		$199,198	$0	$45,925	Yes (X)
Karen McArdle-Coggins
HMG President	40		$221,150	$0	$30,331	Yes (X)
Rebecca Bialecki
VP of Comm Hlth Rel	40		$132,623	$0	$26,430	Yes (X)
Tina Santos
VP of Patient Care	40		$250,889	$0	$37,640	Yes (X)
Carol Roosa
CIO/VP of Info Srvcs	40		$178,925	$0	$49,077	Yes (X)
Dawn Casavant
VP of External Affairs	40		$167,495	$0	$48,415	Yes (X)
Tina Griffin
Athol VP & CNO	40		$198,861	$0	$30,503	Yes (X)
Steven Yerid
Chief of ER Medicine	40		$461,336	$0	$39,678			Yes (X)
Ellen Ray MD
ER Physician	40		$360,467	$0	$43,880			Yes (X)
Sarah Gilbert MD
ER Physician	30		$286,594	$0	$41,906			Yes (X)
Marc DeBell MD
ER Physician	30		$254,165	$0	$23,947			Yes (X)
Joshua Lerner MD
ER Physician	30		$250,489	$0	$37,346			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$4,590,816	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$341,740	TotReportableCompRltdOrgAmt
Total Other Compensation	$696,328	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	102	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
Quartulli & Associates
PO Box 423	Gardner	MA	01440	Physical Therapy	$2,612,526
Alliance Healthcare Services
100 Bay View Circle	Newport Beach	CA	92657	MRI	$1,420,708
Quest Diagnostics
5763 Collection Center Dr	Chicago	IL	60693	Lab contracted services	$885,754
Spine & Pain Center
242 Green St	Gardner	MA	01440	Pain Mngmt Physician	$782,843
New England Inpatient Specialists
120 Waters St	North Andover	MA	01845	Hospitalists	$696,667

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	31	CntrctRcvdGreaterThan100KCnt
Federated Campaigns	$0	FederatedCampaignsAmt
Membership Dues	$0	MembershipDuesAmt
Fundraising	$54,255	FundraisingAmt
Related Organizations	$0	RelatedOrganizationsAmt
Government Grants	$1,744,315	GovernmentGrantsAmt
All Other Contributions	$819,105	AllOtherContributionsAmt
Noncash Contributions	$0	NoncashContributionsAmt
Total Contributions	$2,617,675	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
Ancillary O/P Services	622110	$72,005,100	$72,005,100	$0	$0
Ancillary I/P & Routine Services	622110	$34,256,074	$34,256,074	$0	$0
HMG Patient Revenue (net)	621111	$3,103,393	$3,103,393	$0	$0
Contracted Service Revenue	900099	$2,834,906	$2,834,906	$0	$0
Lifeline Service Revenue	624120	$41,451	$41,451	$0	$0

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$29,291	TotalRevenueColumnAmt
Related Or Exempt Func Income	$29,291	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$112,270,215	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$353,834	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$353,834	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$565,699	RealAmt
Personal	$0	PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$565,699	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$565,699	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$565,699	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$4,494,115	SecuritiesAmt
Other	$131,573	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$4,034,802	SecuritiesAmt
Other	$95,645	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$459,313	SecuritiesAmt
Other	$35,928	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$495,241	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$495,241	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$112,777	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$54,255	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$92,010	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$20,767	TotalRevenueColumnAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$20,767	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
Meal Revenue	722310	$767,629	$0	$0	$767,629
Purchase Discounts	900099	$169,121	$0	$0	$169,121
ACLS Training	611710	$27,300	$0	$0	$27,300

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$112,828	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$112,828	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,076,878	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$117,400,309	TotalRevenueColumnAmt
Related Or Exempt Func Income	$112,270,215	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$2,512,419	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$164,400	TotalAmt
Program Services	$164,400	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$6,045	TotalAmt
Program Services	$6,045	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$3,222,467	TotalAmt
Program Services	$1,233,590	ProgramServicesAmt
Management And General	$1,807,586	ManagementAndGeneralAmt
Fundraising	$181,291	FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$46,223,622	TotalAmt
Program Services	$43,954,888	ProgramServicesAmt
Management And General	$2,136,605	ManagementAndGeneralAmt
Fundraising	$132,129	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$984,232	TotalAmt
Program Services	$815,876	ProgramServicesAmt
Management And General	$145,961	ManagementAndGeneralAmt
Fundraising	$22,395	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$5,357,254	TotalAmt
Program Services	$4,913,680	ProgramServicesAmt
Management And General	$406,819	ManagementAndGeneralAmt
Fundraising	$36,755	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$3,779,077	TotalAmt
Program Services	$3,544,149	ProgramServicesAmt
Management And General	$215,123	ManagementAndGeneralAmt
Fundraising	$19,805	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$395,555	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$395,555	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$118,691	TotalAmt
Program Services	$27,755	ProgramServicesAmt
Management And General	$90,936	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$167,284	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$167,284	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$84,000	TotalAmt
Fundraising	$84,000	FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$13,807,282	TotalAmt
Program Services	$13,807,282	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$296,456	TotalAmt
Program Services	$291,794	ProgramServicesAmt
Management And General	$3,895	ManagementAndGeneralAmt
Fundraising	$767	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$14,985,102	TotalAmt
Program Services	$14,782,439	ProgramServicesAmt
Management And General	$180,015	ManagementAndGeneralAmt
Fundraising	$22,648	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$1,619,551	TotalAmt
Program Services	$1,542,990	ProgramServicesAmt
Management And General	$67,472	ManagementAndGeneralAmt
Fundraising	$9,089	FundraisingAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$2,077,926	TotalAmt
Program Services	$1,915,624	ProgramServicesAmt
Management And General	$162,302	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$63,871	TotalAmt
Program Services	$40,854	ProgramServicesAmt
Management And General	$23,009	ManagementAndGeneralAmt
Fundraising	$8	FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$94,101	TotalAmt
Program Services	$83,082	ProgramServicesAmt
Management And General	$9,795	ManagementAndGeneralAmt
Fundraising	$1,224	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$747,126	TotalAmt
Program Services	$747,126	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$4,149,277	TotalAmt
Program Services	$4,134,471	ProgramServicesAmt
Management And General	$14,617	ManagementAndGeneralAmt
Fundraising	$189	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$639,916	TotalAmt
Program Services	$547,757	ProgramServicesAmt
Management And General	$92,159	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
Professional Fees	$5,386,475	$4,729,552	$618,405	$38,518
Bad Debt	$4,419,880	$4,419,880	$0	$0
Free Care	$1,432,200	$1,432,200	$0	$0
Subscription and Dues	$753,316	$306,648	$442,124	$4,544

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,635,943	TotalAmt
Program Services	$1,565,209	ProgramServicesAmt
Management And General	$71,780	ManagementAndGeneralAmt
Fundraising	-$1,046	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$112,611,049	TotalAmt
Program Services	$105,007,291	ProgramServicesAmt
Management And General	$7,051,442	ManagementAndGeneralAmt
Fundraising	$552,316	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$3,931,381	BOYAmt
EOY	$4,760,131	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,139,222	BOYAmt
EOY	$528,176	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$13,485,224	BOYAmt
EOY	$13,114,002	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$122,696	BOYAmt
EOY	$33,251	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,599,887	BOYAmt
EOY	$1,636,151	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$1,152,865	BOYAmt
EOY	$1,114,913	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$108,364,719	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$60,029,671	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$50,954,258	BOYAmt
EOY	$48,335,048	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$20,554,685	BOYAmt
EOY	$22,690,343	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$417,530	BOYAmt
EOY	$527,550	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$145,902	BOYAmt
EOY	$152,684	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$2,643,422	BOYAmt
EOY	$2,302,595	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$96,147,072	BOYAmt
EOY	$95,194,844	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$13,259,267	BOYAmt
EOY	$12,113,071	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$245,096	BOYAmt
EOY	$252,045	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$23,581,586	BOYAmt
EOY	$22,853,204	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$249,040	BOYAmt
EOY	$366,311	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$5,285,669	BOYAmt
EOY	$5,981,854	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$42,620,658	BOYAmt
EOY	$41,566,485	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$49,424,721	BOYAmt
EOY	$49,949,292	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,095,407	BOYAmt
EOY	$2,672,715	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,006,286	BOYAmt
EOY	$1,006,352	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$53,526,414	BOYAmt
EOY	$53,628,359	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$96,147,072	BOYAmt
EOY	$95,194,844	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$4,789,260	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$1,278,731	NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts	$0	DonatedServicesAndUseFcltsAmt
Investment Expense	$0	InvestmentExpenseAmt
Prior Period Adjustments	$0	PriorPeriodAdjustmentsAmt
Other Changes In Net Assets	-$5,966,046	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$20,377,782	BeginningYearBalanceAmt
Contributions	$0	ContributionsAmt
Investment Earnings Or Losses	$1,888,246	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	-$194,761	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$22,460,789	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$20,170,666	BeginningYearBalanceAmt
Contributions	$18,245	ContributionsAmt
Investment Earnings Or Losses	-$665,620	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	-$854,491	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$20,377,782	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$18,078,764	BeginningYearBalanceAmt
Contributions	$100	ContributionsAmt
Investment Earnings Or Losses	$1,729,112	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	-$362,690	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$20,170,666	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$17,128,384	BeginningYearBalanceAmt
Contributions	$2,200	ContributionsAmt
Investment Earnings Or Losses	$2,044,839	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$1,096,659	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$18,078,764	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$11,897,431	BeginningYearBalanceAmt
Contributions	$5,683	ContributionsAmt
Investment Earnings Or Losses	$1,966,503	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	-$3,258,767	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$17,128,384	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.88	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.05	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.07	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$210,871	OtherCostOrOtherBasisAmt
Book Value	$210,871	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$66,863,313	OtherCostOrOtherBasisAmt
Depreciation	$26,741,598	DepreciationAmt
Book Value	$40,121,715	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$0	OtherCostOrOtherBasisAmt
Depreciation	$0	DepreciationAmt
Book Value	$0	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$39,304,156	OtherCostOrOtherBasisAmt
Depreciation	$32,033,628	DepreciationAmt
Book Value	$7,270,528	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$1,986,379	OtherCostOrOtherBasisAmt
Depreciation	$1,254,445	DepreciationAmt
Book Value	$731,934	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$48,335,048	TotalBookValueLandBuildingsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
Est. settlements with third party payors	$3,724,173
Est. Insurance Claims	$2,257,681

Field	Value	IRS element (for citing)
Total Liability	$5,981,854	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule D, Part V, Line 4

Permanent Endowment funds are established by donor restricted gifts and maintained to provide a permanent source of income. The principal of which is kept in perpetuity. Board Designated Endowment funds are established by the governing body to fund capital projects and/or improvements of the organization. Temporary Restricted funds are established by donor restricted gifts that maintain a source of income for a specific period of time.

Schedule D, Part X, Line 2

Income Taxes - Heywood Healthcare, Heywood Hospital, Athol, HMGI, Charitable Foundation, and Quabbin Healthcare have been determined to be not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code (the "Code"), and the Realty Corp. has been determined to be a not-for-profit corporation as described in Section 501(c)(2) of the Code. All of the entities that are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. The Organization annually evaluates its tax status and tax positions taken with respect to its operations and financial position. Tax years from 2012 through the current year remain open for examination by federal and state taxing authorities. Additionally, the Organization has filed all applicable returns, as required, in jurisdictions where so required. For the years ended September 30, 2016 and 2015, there were no interest or penalties recorded or included in the statement of operations.

Schedule G IRS990ScheduleG

Field	Value	IRS element (for citing)
Mail Solicitations	Yes (X)	MailSolicitationsInd
Email Solicitations	Yes (X)	EmailSolicitationsInd
Phone Solicitations	Yes (X)	PhoneSolicitationsInd
In Person Solicitations	Yes (X)	InPersonSolicitationsInd
Solicitation Of Non Govt Grants	Yes (X)	SolicitationOfNonGovtGrantsInd
Solicitation Of Govt Grants	Yes (X)	SolicitationOfGovtGrantsInd
Special Fundraising Events	Yes (X)	SpecialFundraisingEventsInd
Agrmt Prof Fundraising Acty	Yes (1)	AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	ActivityActivityTxt	Fundraiser Control Of FundsFundraiserControlOfFundsInd	Gross ReceiptsGrossReceiptsAmt	Retained By ContractorRetainedByContractorAmt	Net To OrganizationNetToOrganizationAmt
JNB & Associates
21 Water St	Amesbury	MA	01913	consultant	0	$0	$168,000	-$168,000
Kimberly Gagnon
12 Kodiak Rd	Brookline	NH	03033	consultant	0	$0	$7,066	-$7,066

Field	Value	IRS element (for citing)
Total Gross Receipts	$0	TotalGrossReceiptsAmt
Total Retained By Contractors	$175,066	TotalRetainedByContractorsAmt
Total Net To Organization	-$175,066	TotalNetToOrganizationAmt
Licensed States	MA	LicensedStatesCd

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	Golf Classic	Event1Nm
Gross Receipts Event1	$96,500	GrossReceiptsEvent1Amt
Charitable Contri Event1	$38,580	CharitableContriEvent1Amt
Gross Revenue Event1	$57,920	GrossRevenueEvent1Amt
Cash Prizes Event1	$0	CashPrizesEvent1Amt
Non Cash Prizes Event1	$3,356	NonCashPrizesEvent1Amt
Rent Facility Costs Event1	$20,487	RentFacilityCostsEvent1Amt
Food And Beverage Event1	$21,228	FoodAndBeverageEvent1Amt
Entertainment Event1	$352	EntertainmentEvent1Amt
Other Direct Expenses Event1	$5,216	OtherDirectExpensesEvent1Amt
Event2	ROYL	Event2Nm
Gross Receipts Event2	$36,544	GrossReceiptsEvent2Amt
Charitable Contri Event2	$0	CharitableContriEvent2Amt
Gross Revenue Event2	$36,544	GrossRevenueEvent2Amt
Cash Prizes Event2	$0	CashPrizesEvent2Amt
Non Cash Prizes Event2	$278	NonCashPrizesEvent2Amt
Rent Facility Costs Event2	$1,324	RentFacilityCostsEvent2Amt
Food And Beverage Event2	$0	FoodAndBeverageEvent2Amt
Entertainment Event2	$0	EntertainmentEvent2Amt
Other Direct Expenses Event2	$13,586	OtherDirectExpensesEvent2Amt
Other Events Total	2	OtherEventsTotalCnt
Gross Receipts Other Events	$33,988	GrossReceiptsOtherEventsAmt
Charitable Contri Other Events	$15,675	CharitableContriOtherEventsAmt
Gross Revenue Other Events	$18,313	GrossRevenueOtherEventsAmt
Cash Prizes Other Events	$0	CashPrizesOtherEventsAmt
Non Cash Prizes Other Events	$732	NonCashPrizesOtherEventsAmt
Rent Fclty Costs Other Events	$3,388	RentFcltyCostsOtherEventsAmt
Food And Beverage Other Events	$10,738	FoodAndBeverageOtherEventsAmt
Entertainment Other Events	$3,000	EntertainmentOtherEventsAmt
Oth Direct Expnss Other Events	$8,325	OthDirectExpnssOtherEventsAmt
Gross Receipts Total	$167,032	GrossReceiptsTotalAmt
Charitable Contributions Tot	$54,255	CharitableContributionsTotAmt
Gross Revenue Total Events	$112,777	GrossRevenueTotalEventsAmt
Cash Prizes Total Events	$0	CashPrizesTotalEventsAmt
Non Cash Prizes Total Events	$4,366	NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$25,199	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$31,966	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$3,352	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$27,127	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$92,010	DirectExpenseSummaryEventsAmt
Net Income Summary	$20,767	NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent100	Yes (X)	Percent100Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,355,006	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,122,857	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$232,149	NetCommunityBenefitExpnsAmt
Total Expense	0.0021	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$21,983,084	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$19,527,104	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,455,980	NetCommunityBenefitExpnsAmt
Total Expense	0.0218	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$23,338,090	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$20,649,961	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,688,129	NetCommunityBenefitExpnsAmt
Total Expense	0.0239	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,142,367	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$27,541	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,114,826	NetCommunityBenefitExpnsAmt
Total Expense	0.0099	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$187,092	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$286	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$186,806	NetCommunityBenefitExpnsAmt
Total Expense	0.0017	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$240,489	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$240,489	NetCommunityBenefitExpnsAmt
Total Expense	0.0021	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$1,569,948	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$27,827	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,542,121	NetCommunityBenefitExpnsAmt
Total Expense	0.0137	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$24,908,038	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$20,677,788	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,230,250	NetCommunityBenefitExpnsAmt
Total Expense	0.0376	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,255	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,255	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$30	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$30	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,276	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,276	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$36,023	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$36,023	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$360,144	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$360,144	NetCommunityBenefitExpnsAmt
Total Expense	0.032	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$399,728	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$399,728	NetCommunityBenefitExpnsAmt
Total Expense	0.032	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$1,910,038	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$25,282,617	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$23,497,688	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$1,784,929	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Henry Heywood Memorial Hospital	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	242 Green Street	AddressLine1Txt
City	Gardner	CityNm
State Abbreviation	MA	StateAbbreviationCd
ZIP	01440	ZIPCd

Field	Value	IRS element (for citing)
Website Address	www.heywood.org	WebsiteAddressTxt
State License	04-2103581	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Henry Heywood Memorial Hospital	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Information Gaps	Yes (X)	InformationGapsInd
Other	Yes (X)	OtherInd
CHNA Conducted	15	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	www.heywood.org	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	www.jointcoalitionhealth.org	OtherWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	15	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	www.heywood.org	StrategyWebsiteURLTxt
Strategy Attached	0	StrategyAttachedInd
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	100	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400	FPGFamilyIncmLmtDscntCarePct
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	www.heywood.org	FAPAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	www.heywood.org	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit Report To Credit Agency	Yes (X)	PermitReportToCreditAgencyInd
Permit Legal Judicial Process	Yes (X)	PermitLegalJudicialProcessInd
Collection Activities	0	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Lowest Negotiated Rates	Yes (X)	LowestNegotiatedRatesInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 3-Henry Heywood Memorial Hospital	The 2015 Community Health Needs Assessment of North Central Massachusetts was a joint effort between Heywood Healthcare's Heywood Hospital and Athol Hospital, Health Alliance Hospital, Community Health Connections FQHC, the Montachusett Public Health Network (MPHN), MA Department of Public Health's Community Health Network Area of North Central Massachusetts (CHNA 9) and the Joint Coalition on Health. The assessment is designed to provide information and analyses relative to the health status, issues, concerns and assets of the North Central Region of Massachusetts. The assessment includes 30 cities and towns which are primary service areas of the three hospitals-Heywood Hospital, Athol Hospital and Health Alliance Hospital. The data was presented and analyzed in four ways including, the entire region, Heywood Healthcare Service Areas, Health Alliance Service Areas, and the MPHN Service Areas. Comparisons were made between the different service areas and to Massachusetts as a whole. All data was gathered systematically utilizing standards which guided the methodologies. The quantitative data collected came from the Massachusetts Community Health Information Profile, the Massachusetts Department of Public Health, the US Census Bureau, the MA Department of Workforce Development, the MA Department of Elementary and Secondary Education, the Youth Risk Behavior Survey (YRBS) Data, and the CD Behavioral Risk Factor Surveillance System (BRFSS). Qualitative data was gathered through 16 focus groups and 26 key informant interviews representing diverse communities and populations in the region, such as illness, Black African Americans, Latinos, Brazilian's, Hmong, LGBTQ, elders, young adults, homeless individuals, veterans and adults with major mental illness. They were conducted in cooperation with Westwinds Clubhouse; North Quabbin Community Coalition; Veterans Homestead Inc; 15 West Teen Coffeehouse; Clinton Hospital; Montachusett Opportunity Council; New Hope Baptist Church; Hope Center; Fitchburg Senior Center; Goodrich Academy Alternative High School; and Regional Behavioral Health Collaborative. Priority Health Issues identified from the CHNA are Mental Health and Substance Abuse; Suicide Prevention; Chronic Disease and related risk factors; Nutrition Issues including Obesity and food insecurity. As well as addressing health disparities that exist in our region and improving access to care for populations adversely affected by social determinants of health
Schedule H, Part V, Section B, Line 5-Henry Heywood Memorial Hospital	Heywood Hospital's 2015 Community Health Needs Assessment took into account input from person's who represent the community. This input was gathered through 16 focus groups and 26 key informant interviews representing diverse communities and populations in the region, such as Black African Americans, Latinos, Brazilians, Hmong, LGBTQ, elders, young adults, homeless individuals, veterans, and adults with major mental illness.
Schedule H, Part V, Section B, Line 6a-Henry Heywood Memorial Hospital	Hospitals included in the development of the 2015 Community Health Needs Assessment are Heywood Hospital, Gardner, MA; Athol Hospital, Athol, MA; HealthAlliance Hospital, Leominster, MA.
Schedule H, Part V, Section B, Line 6b-Henry Heywood Memorial Hospital	Other organizations involved in the development of the 2015 Community Health Needs Assessment was Community Health Connections FQHC, the Montachusett Public Health Network (MPHN), MA Department of Public Health's Community Health Network Area of North Central Massachusetts (CHNA 9) and the Joint Coalition on Health. The focus groups were conducted in collaboration with the Westwinds Clubhouse; North Quabbin Community Coalition; Veterans Homestead Inc; 15 West Teen Coffeehouse; Clinton Hospital; Montachusett Opportunity Council; New Hope Baptist Church; Hope Center; Fitchburg Senior Center; Goodrich Academy Alternative High School; and Regional Behavioral Health Collaborative.
Schedule H, Part V, Section B, Line 11-Henry Heywood Memorial Hospital	Heywood Hospital's approach to addressing the critical health needs identified by the CHNA is to actively participate on and collaborate with cross-sector coalitions, healthcare and behavioral health providers, community, and faith-based organizations and businesses to develop and implement our plan, goals, and strategies. Partners include: CHNA9; Montachusett Public Health Network; Gardner Area Interagency Team (GAIT); Suicide Prevention Task Force; Regional Behavioral Health Collaborative; Minority Health Coalition; Health Disparities Collaborative; Community Health Connections FQHC; GVNA Healthcare; Community Health Link; LUK, Inc; AED Foundation; SHINE Initiative; Gardner Community Action Team (GCAT); and Montachusett Opioid Prevention Coalition (MOPC); Gardner Religious Council; Unitarian Church; Gardner CAC; HOPE House; Peoples Place Tobacco Cessation Group; Gardner, Ashburnham, Winchendon and Westminster Public School Districts; Montachuset Vocational Technical High School; The Winchendon School; Mount Wachusett Community College; Fitchburg State University; Framingham State University; University of New Hampshire; Bates College; Gardner Rotary Club; Hannaford. Key Accomplishments of Reporting Year: * Provided nutrition education to 142 individuals through cooking classes and interactive presentations promoting wellness and managing chronic disease with good nutrition. * Robust partnership with the Gardner and Ashburnham-Westminster schools offering nutrition education and physical activities to over 151 elementary students and provided food assistance to 220 low- income and at-risk youth through a weekend backpack food program. * Provided health information about heart disease and diabetes to over 125 individuals by participating in community health fairs and events reaching vulnerable populations. * Offered wellness instruction and self-care techniques to 705 individuals to manage symptoms associated with having cancer, chronic conditions, and mental health and/or substance use. * Lead several multi-sector coalitions and actively participated on community boards and committees to collaboratively address community health needs and gaps in services. * Provided health and financial insurance information and enrollment assistance to 5,026 individuals reducing financial barriers to accessing healthcare. * Offered free psychosocial support to 58 community members looking for information and referrals on issues related to housing, food, transportation, behavioral and substance abuse. * Assisted and paid for legal services for 25 patients who did not have the means to pay. * Assisted 122 patients with transportation and as a result was able to follow up with their healthcare and prevented missed appointments. * Provided 1171 hours of mentorship to 315 students pursuing careers in healthcare. * Distributed $127,000 grants to 25 local organizations that provide programs in line with the hospital's community benefit areas of focus and reach the targeted population.

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 6a	Heywood's approach to Community Benefits has been to collaborate with others through the Joint Coalition on Health and other coalitions to develop our plan, goals and strategies. Partners include the Joint Coalition on Health, Gardner Interagency Team, the CHNA, The Minority Coalition, Montachusett Opportunity Council, Mount Wachusett Community College, the Community Health Connections Health Centers, North Central Human Services, Luc, Inc., Community Health Link, Gardner, VNA, the Gardner Public Schools, the Winchendon Public Schools, the Health Foundation of Central MA, Kresge Foundation, the Department of Public Health, AHEC, and others. At this time we continue to focus our efforts on mental health and substance abuse, insuring those without jobs and/or insurance, addressing the needs of under-served populations, focusing on the needs of youth and children, and targeting adults and children with overweight and obesity issues which lead to chronic diseases and diabetes.
Schedule H, Part I, Line 7	The costing methodology used to calculate the amounts reported in the table in Part I, for lines 7a through 7c was based on the cost to charge ratio derived from the supplied Worksheet 2, in the IRS schedule H instructions.
Schedule H, Part II	The Heywood Hospital's Community Benefits Mission Statement is "Heywood Hospital is dedicated to the community benefit goals of improving the health status of our community, addressing the specific health needs of the under-served and collaborating with others to enhance quality and contain the growth of community healthcare costs."
Schedule H, Part II, Line 8	Heywood Hospital serves a medically underserved population area, because of this, the Hospital is constantly working to recruit and search for physicians to serve our community.
Schedule H, Part III, Section A, Line 2	The costing methodology used for line 2 was based on the cost charge ratio derived from the supplied worksheet 2 in the IRS Schedule H instructions.
Schedule H, Part III, Section A, Line 3	The methodology used for line 3 was to take the percentage of financial assistance applications that were due to inadequate documentation divided by the total applications received for FY 2016. This amounted to approximately 0% which was applied against the number on line 2. As a tax exempt hospital, we must provide necessary services regardless of the patient's ability to pay for the service provided. As a not for profit, patient care is provided to all, regardless of ability to pay for that care, making quality patient care available to all in our community, regardless of their economic means, qualifies bad debts as community benefit.
Schedule H, Part III, Section A, Line 4	The footnote can be found on Page 10 of the financial statements - footnote #2 under "Allowance of Doubtful Accounts".
Schedule H, Part III, Section B, Line 6	The allowable costs on line 6 were obtained from our FY 2016 Medicare Cost Report, Worksheet D schedules.
Schedule H, Part III, Section B, Line 8	There is no shortfall.
Schedule H, Part III, Section C, Line 9b	Heywood Hospital provides patients with information about financial assistance programs that are available through the Commonwealth of MA or through Heywood Hospital's own financial assistance program, which may cover all or some of their unpaid hospital bills. For those patients that request such assistance, Heywood Hospital assists patients by screening them for eligibility in an available public program and assisting them in applying for the program. These programs include but are not limited to MassHealth, Commonwealth Care, Children's Medical Security Plan, Healthy Start, Health Safety Net and others. It is the patient's obligation to provide Heywood Hospital with accurate and timely information to determine of the patient is eligible to apply for certain health insurance programs. If the patient of guarantor is unable to provide the necessary information Heywood Hospital may make reasonable efforts to obtain any additional information from other sources. Information the Heywood obtains will be maintained in accordance with applicable federal and state privacy and security laws. The screening and application process for public health insurance program is done through Virtual Gateway, which is an internet portal designed by the MA Executive Office of Health and Human Services. The Virtual Gateway manages the application process from the programs listed above, which is available for children, adults, seniors, veterans, homeless and disabled individuals. Heywood specifically assists the patient in completing the application and secure the necessary documentation required by the applicable financial assistance program. Heywood Hospital will then submit this document to the Commonwealth Office of Medicaid and assist the patient in any additional documentation if such is required by the Commonwealth after completing the application. All Virtual Gateway applications are reviewed and processed by the Commonwealth of MA, Office of Medicaid. Special circumstance applications are reviewed and approved by the MA Division of Health Care Finance and Policy. Hospitals have no role in determination of program eligibility made by the Commonwealth, but at the patient's request may take a direct role in appealing decisions made by the Commonwealth to ensure accurate and timely adjudication of all hospital bills. If the patient does not comply with the request for documentation, then our standard collection procedures apply.
Schedule H, Part VI, Line 2	Heywood Hospital collaborates with many local and state agencies and organizations to assess community health needs in the North Central region of MA. We continue to assess the health care needs of the community and collaboratively develop strategies to address these issues through our active participation with the following coalitions and organizations: Minority Coalition; Multicultural task force; Health Disparities Collaborative; Greater Gardner Religious Council; House of Peace and Education; Gardner Rotary; Community Health Connections; SHINE
Schedule H, Part VI, Line 3	Role of Hospital Certified Financial Counselors and other Finance Staff: The hospital will try to identify available coverage options for patients who may be uninsured or underinsured with their current insurance program when the patient is scheduling their services, while the patient is in the hospital, upon discharge, and for a reasonable time following discharge from the hospital. The hospital will direct all patients seeking available coverage options, or those that the hospital determines may be eligible, to the hospital's patient financial counseling to screen for eligibility in an appropriate coverage option. The hospital will then assist the patient in applying for the appropriate coverage options that are available or notify them of availability of financial assistance through the hospital's own internal financial assistance program, if available. Notification Practices: Individual printed notices are available by contacting a Financial Counselor or through the Patient Accounts Office. Notices indicate the criteria used to determine eligibility for MassHealth and the Health Safety Net Trust Fund and where or how patients may apply. The goal of these notices is to assist patients in applying for coverage within a financial assistance program such as MassHealth, Commonwealth Care, Children's Medical Security Plan, Healthy Start, and Health Safety Net. When applicable, the hospital 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. When a patient contacts the hospital, Patient Accounting, Financial Counseling or Social Service Staff will attempt to identify if a patient qualifies for a public financial assistance program or payment plan. Patients who are already enrolled in a public financial assistance program, such as MassHealth or Health Safety Net, may qualify for certain federal, state and private assistance agencies. Patients may also qualify for additional assistance based on the hospital's own internal criteria for financial assistance, or qualify for coverage of services as a Medical Hardship based on the patient's documented income and allowable medical expenses. The following items outline more specifically the notification process, criteria, and availability of information beyond the signs that are posted in the hospital. 1. The hospital will provide an individual notice of the availability of financial assistance programs and other programs of public assistance to a patient expected to incur charges for which he/she will be personally responsible, exclusive of personal convenience items or services that may not be paid in full by third party coverage. 2. The hospital or its agents will include a notice or statement about Eligible Services to Low Income Patients and other programs of public assistance in its initial bill and subsequent correspondence with the patient. All correspondence will direct the patient where and how they can receive more information or additional assistance and will inform the patient that they may apply or reapply for financial and public assistance before, during or after care, or after collection agency assignment if their situation changes. 3. The hospital will include a notice regarding the availability of financial assistance and other programs of public assistance to Low Income Patients in all written collection actions. The hospital will notify the patient that it offers a payment plan if the patient is determined to be eligible for MassHealth or free care/uncompensated care through the Health Safety Net Trust Fund as a low income patient or due to Medical Hardship. These payment plans are consistent with 1016 CMR 6613.08 (1)(f)(4). The hospital will also offer payment plan options for those individuals who do not qualify for Low Income Patient status. 4. Heywood Hospital will include language on its written notices that reads: "You may be eligible for assistance through our Financial Assistance Program. For eligibility information, please contact our Customer Services Department at 1-800-305-6757." Verbiage may change to accommodate changes of department information. 5. There is no primary language other than English that is spoken by 5% or more of the hospital's service area. Signage and other documentation will be provided in English. The hospital provides translator services for several other languages and this service may be accessed for those individuals whose primary language is not English or Spanish. 6. For cases where the hospital continues to determine eligibility for free care/uncompensated care through the Health Safety Net Trust Fund application, then MassHealth will provide written notice of determination that the patient is or is not eligible within 30 days of receiving a completed application and the required supporting documentation. The vast majority of patients will however be screened via the common intake process and processed through the Virtual Gateway and MA-21 system. 7. Whether the hospital is using the MassHealth application process through the Virtual Gateway or submitting a MassHealth application directly, the hospital will assist the patient in completing the application or intake process for enrollment and eligibility screening.
Schedule H, Part VI, Line 4	The Heywood Hospital Service Area is comprised of the city of Gardner and five surrounding towns, Ashburnham, Westminster, Winchendon, Templeton and Hubbardston. The area has a population of approx. 57,000, a median income below the state average and an unemployment rate above the state average. The community is largely white, non Hispanic, but has a growing Hispanic population.
Schedule H, Part VI, Line 5	Heywood Hospital is dedicated to the community benefit goals of improving the health status of our community, addressing the special health needs of the underserved and collaboration with others to enhance quality and contain the growth of community healthcare costs. Examples of activities the hospital participates in to promote the health of the community include: Provide nutrition education to through cooking classes, shopping tours and interactive presentations promoting wellness and chronic disease management.; Partner with the Gardner and Ashburnham schools offering nutrition education and physical activities and food assistance to low- income and at-risk youth through a weekend backpack program; Provided health information by participating at community health fairs and events at venues reaching vulnerable populations; offer free workshops promoting self care techniques such as meditation and Reikki; Provide insurance information and enrollment assistance to individuals reducing financial barriers to accessing healthcare; Offered free psychosocial support to community members looking for information on issues related to housing, food, transportation, behavioral and substance abuse.
Schedule H, Part VI, Line 6	Heywood Hospital works closely with the community to promote health in areas identified by the 2011 Community Health Needs Assessment (CHNA) through a variety of means. The hospital works with area school systems to address childhood obesity and onset of adult diabetes through nutrition/fitness programs targeting young students K-2, in order to help develop healthy habits which may result in a reduction of chronic illness and obesity as indicated in the 2011 CNHA. Financial counselors help uninsured populations, including those recently unemployed and those experiencing financial hardship to enroll in appropriate programs to ensure healthcare coverage, an identified barrier to obtaining health care, as indicated in the 2011 CHNA. Community programs targeting nutrition and fitness are offered free and at reduced rates focusing on nutrition, healthy cooking and consistent exercise, focusing on the reduction of chronic disease including diabetes and cardiovascular disease in adults as indicated in the 2011 CHNA. Operation of a school-based health center which enrolls an average of 79% of all students in the school, providing nearly 1,000 behavioral health visits annually, addressing higher than normal suicide and substance abuse rate, as indicated in the 2011 CHNA. The Suicide Prevention Taskforce, which partners with approximately 100 area social service agencies, provides educational tools, and raises community and legislative awareness of significant area mental health and substance abuse issues, resulting in a Gardner suicide rate approximately twice the state average. Continue to work with the Minority Coalition, Joint Coalition of Health and other community agencies to raise awareness and skills among health providers to reduce disparities and strive for equal health.
Schedule H, Part VI, Line 7	Community Benefit Report is filed with Attorney General's Office, State of Massachusetts.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
Montachusett Home Care Corp
680 Mechanics St	Leominster	MA	01453	042551175	501(c)(3)	$36,414	home care-elderly & disabled
Heywood Healthcare Chart Foundation
242 Green St	Gardner	MA	01440	222720562	501(c)(3)	$104,000	support local organizations
United Way of North Central MA
649 John Fitch Hwy	Fitchburg	MA	01420	042233021	501(c)(3)	$7,986	annual appeal

Field	Value	IRS element (for citing)
Total501c3 Org	3	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

Field	Value	IRS element (for citing)
Grant Type	No grants submitted to individuals over $5,000	GrantTypeTxt
Recipient	0	RecipientCnt
Cash Grant	$0	CashGrantAmt
Non Cash Assistance	$0	NonCashAssistanceAmt
Valuation Method Used	cash	ValuationMethodUsedDesc

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule I, Part I, Line 2	FormAndLineReferenceDesc
Explanation	Montachusett Home Care Corp files an annual report with the Office of Healthy Communities that contains a summary of how the funds are allocated.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Travel For Companions	Yes (X)	TravelForCompanionsInd
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	0	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	0	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Form990 Of Other Organizations	Yes (X)	Form990OfOtherOrganizationsInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	Yes (1)	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Winfield Brown
President/CEO	$459,347	$0	$52,728	$0	$270,244	$0	$23,200	$0	$50,548	$0	$856,067	$0
Elizabeth Nottleson
Trustee	$3,100	$308,618	$0	$15,326	$0	$366	$0	$6,000	$0	$14,721	$3,100	$345,031	$0	$0
Kami Phillips
Trustee	$11,000	$0	$0	$17,430	$0	$0	$0	$0	$0	$1,422	$11,000	$18,852	$0	$0
Robert Crosby
Sr VP of Finance/CFO	$271,280	$0	$39,000	$0	$2,628	$0	$23,300	$0	$33,316	$0	$369,524	$0	$0	$0
Michael Grimmer
VP of Support Srvcs	$217,471	$0	$18,818	$0	$19,781	$0	$21,281	$0	$30,914	$0	$308,265	$0	$0	$0
Bruce Bertrand
Chief Medical Officer	$257,654	$0	$751	$0	$4,822	$0	$22,996	$0	$13,551	$0	$299,774	$0	$0	$0
Rose Kavalchuck
VP of Prof Services	$196,386	$0	$0	$0	$2,812	$0	$21,110	$0	$24,815	$0	$245,123	$0	$0	$0
Karen McArdle-Coggins
HMG President	$203,504	$0	$16,995	$0	$652	$0	$18,000	$0	$12,331	$0	$251,482	$0	$0	$0
Tina Santos
VP of Patient Care	$225,266	$0	$24,898	$0	$725	$0	$22,542	$0	$15,099	$0	$288,530	$0	$0	$0
Carol Roosa
CIO/VP of Info Srvcs	$154,834	$0	$23,515	$0	$575	$0	$21,288	$0	$27,789	$0	$228,001	$0	$0	$0
Dawn Casavant
VP of External Affairs	$147,098	$0	$20,161	$0	$236	$0	$21,107	$0	$27,308	$0	$215,910	$0	$0	$0
Tina Griffin
Athol VP & CNO	$197,106	$0	$0	$0	$1,754	$0	$5,963	$0	$24,540	$0	$229,363	$0	$0	$0
Steven Yerid
Chief of ER Medicine	$399,816	$0	$60,000	$0	$1,520	$0	$22,200	$0	$17,478	$0	$501,014	$0	$0	$0
Ellen Ray MD
ER Physician	$305,352	$0	$30,442	$0	$24,673	$0	$13,351	$0	$30,530	$0	$404,348	$0	$0	$0
Sarah Gilbert MD
ER Physician	$257,961	$0	$27,683	$0	$949	$0	$16,543	$0	$25,364	$0	$328,500	$0	$0	$0
Marc DeBell MD
ER Physician	$253,985	$0	$0	$0	$180	$0	$7,363	$0	$16,584	$0	$278,112	$0	$0	$0
Joshua Lerner MD
ER Physician	$229,313	$0	$21,000	$0	$177	$0	$11,675	$0	$25,671	$0	$287,836	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, Part I, Line 1a	Travel expenses for the CEO's wife were paid through the hospital. Additionally, Social Club Membership dues provided to Winfield Brown, CEO, per his employment contract.
Schedule J, Part I, Line 1b	There was no written policy for the Social Club Membership dues; it was part of his employment contract.
Schedule J, Part I, Line 6	Heywood Hospital accrues 15% of the executive team's salary as part of an incentive compensation program, and service goals are set by the Hospital's Trustees annually.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
MA Health & Ed Facility
A	042456011	57586EGT2	2009-03-31	$17,785,000	funds used for new Watkins Building Project	0	0	0
MA Health & Ed Facility
B	042456011	57586C7E9	2008-06-19	$6,715,000	Refunding and for new Watkins Building Project	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	UnspentUnspentAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$0	$0	$66,235	$0	$0	$0	$281,690	$0	$0	$17,569,545	$0	$0	2010	0	0	Yes (1)	Yes (1)
B	$0	$0	$19,154	$0	$0	$0	$329,467	$0	$3,597,891	$2,806,796	$0	$0	2008	Yes (1)	0	Yes (1)	Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Any Research AgreementsAnyResearchAgreementsInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Private Bus Concerning UBIPrivateBusConcerningUBIPct	Total Private Business UseTotalPrivateBusinessUsePct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	0	0	0	0	0	0	0	Yes (1)	0	Yes (1)
B	0	0	0	0	0	0	0	Yes (1)	0	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Term Of HedgeTermOfHedgePct	Superintegrated HedgeSuperintegratedHedgeInd	Hedge TerminatedHedgeTerminatedInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
TD Bank
A	0	0	0	Yes (1)	Yes (1)	Yes (1)	18.7	0	0	0	0	Yes (1)
Piper Jaffrey
B	0	0	0	Yes (1)	0	Yes (1)	18.7	0	0	0	0	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	0
B	0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule K, Part IV, Line 2c-03/31/2009 17,785,000 MA Health & Ed Facility	The rebate computation was performed on November 21, 2016.
Schedule K, Part IV, Line 2c-06/19/2008 6,715,000 MA Health & Ed Facility	The rebate computation was performed on November 21, 2016.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
Flick Kaw Group PC
Trustee J Flick is Owner	$103,830	Attorney fees	0
Heather Bialecki-Canning
daughter of Officer	$51,268	Salaries as NQCC Director	0
Brigitte Flick
wife of Trustee J. Flick	$24,041	Salaries of Philanthropy Coord	0
Eliot Nottleson
husband of Trustee E.N.	$97,372	Salaries of Phys Assistant	0
Kaitlin Fletcher
family member of Trustee J.F.	$64,956	Salaries of RN	0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI, Section B, Line 11b	The accountant at Heywood Hospital prepares the Form 990 and provides to the controller for review. The form is then sent to the CFO for a final review. Once reviewed, the 990 is received by the Board of Trustees. The 990 is then approved by the board and submitted by the accounting department.
Form 990, Part VI, Section B, Line 12c	Annually, a Conflict of Interest Form is sent out to the manager, trustees and employees with broad discretionary authority. These forms are required to be signed and are monitored by the Corporate Compliance office for completion.
Form 990, Part VI, Section B, Line 15	The CEO and Executive Staff's compensation is determined by market data and analysis provided to the Hospital's Compensation Committee and Board of Trustees by an independent compensation consultant engaged by the Board of Trustees annually. Winfield Brown, CEO, also receives an annual contribution as payment for deferred compensation which is subject to a multi-year vesting schedule that is incumbent upon his ongoing employment.
Form 990, Part VI, Section C, Line 19	The Organization makes the governing documents, conflict of interest policy and financial statements available to the public by providing completed copies to the Administrative Assistant, who provides copies upon request.
Form 990, Part VII, Section A, Line 1a	Elizabeth Nottleson, Trustee to the Organization, received compensation from the organization as Medical Director and not for serving on the Board. Additionally, she received wages from a related organization for her employment as Family Practice Physician. Kami Phillips, Trustee to the Organization, received compensation from the organization as Medical Staff President and not for serving on the Board. Additionally, she received wages from a related organization for her employment as Family Practice Physician, which ended on December 14, 2014. Her wages in 2015 was for her final bonus pay out.
Form 990, Part IX, Line 11g	Other Non-Employee Fees for Services consist of the following: Outside Physician Fees 8,307,950 Outside Clinical Fees 5,306,605 Temporary Employees 169,613 Medical Staff 23,114
Form 990, Part XI, Line 9	The amount that makes up the other changes in net assets or fund balance is from discounts on pledge receivables, $3,452, and transfers to related organizations to support their operations, $5,962,594.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Heywood Healthcare Inc (HHI)
242 Green St	Gardner	MA	01440	222720658	Parent Corp	MA	501(c)(3)	11b	N/A	0
Athol Memorial Hospital
2033 Main St	Athol	MA	01331	042126583	Hospital	MA	501(c)(3)	3		0	HHI
Heywood Medical Group
242 Green St	Gardner	MA	01440	043163589	Employ Physicians	MA	501(c)(3)	9		0	HHI
Quabbin Healthcare Inc
242 Green St	Gardner	MA	01440	812053488	Behavioral Health Services	MA	pending	pending		0	HHI
Heywood Realty Corp
242 Green St	Gardner	MA	01440	043327447	Property Holding Co	MD	501(c)(2)			0	HHI
Heywood Healthcare Charitable Foundation
242 Green St	Gardner	MA	01440	222720562	Charitable Foundation	MA	501(c)(3)	7		0	HHI
HHMH Aid Association
242 Green St	Gardner	MA	01440	042198019	Raising funds for the Hospital	MA	501(c)(3)	9	N/A	0
Winchendon Health Foundation
87 Central St	Winchendon	MA	01475	042113276	supports organization	MA	501(c)(3)	PF	N/A	0

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	0	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	Yes (1)	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (1)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Heywood Realty Corp
k	$81,483	cost per sq ft
Heywood Realty Corp
l	$208,500	contract
Heywood Realty Corp
o	$132,511	actual cost

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule R, Part II	FormAndLineReferenceDesc
Explanation	Quabbin Healthcare Inc. is a newly established corporation this past fiscal year. We are in the process of filing for exemptions which is why the status is "pending". This corp will be for Behavioral Health and Addiction Recovery services.	ExplanationTxt