2016-08-05T11:04:44-05:00 2015-09-30 135381590 BDO USA LLP 200 PORTLAND STREET BOSTON MA 02114 990 2014-10-01 912155626 UMASS MEMORIAL HEALTH CARE INC & AFFILIATES UMAS 5083340496 306 BELMONT STREET WORCESTER MA 01604 SERGIO MELGAR EVP/CFO/TREASURER 5083340496 2016-08-01 1 JEFFREY T ROGERS P01074284 6177427788 2014 2016-12-15 16:53:06Z SERGIO MELGAR 306 BELMONT STREET WORCESTER MA 01604 2870065467 1 1 3642 X WWW.UMASSMEMORIAL.ORG X UMASS MEMORIAL HEALTH CARE IS COMMITTED TO IMPROVING THE HEALTH OF THE PEOPLE OF CENTRAL NEW ENGLAND THROUGH EXCELLENCE IN CLINICAL CARE, SERVICE, TEACHING AND RESEARCH. 192 104 15036 1182 1976329 0 11687383 14499867 2539202708 2510679190 47398719 41297302 11933184 11103132 2610221994 2577579491 4940267 4483733 0 0 1292502919 1277516317 301241 323352 835153 1246056328 1201618437 2543800755 2483941839 66421239 93637652 2142414587 2290835371 1235963484 1382662313 906451103 908173058 X UMASS MEMORIAL HEALTH CARE IS COMMITTED TO IMPROVING THE HEALTH OF THE PEOPLE OF CENTRAL NEW ENGLAND THROUGH EXCELLENCE IN CLINICAL CARE, SERVICE, TEACHING AND RESEARCH. 0 0 1187083343 2336260 1498951691 UMASS MEMORIAL MEDICAL CENTERUMASS MEMORIAL MEDICAL CENTER IS COMMITTED TO IMPROVING THE HEALTH OF THE PEOPLE OF CENTRAL NEW ENGLAND THROUGH EXCELLENCE IN CLINICAL CARE, SERVICE, TEACHING AND RESEARCH. UMASS MEMORIAL MEDICAL CENTER DOES THIS BY PROVIDING INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO THE RESIDENTS OF CENTRAL NEW ENGLAND WITHOUT REGARD TO THEIR ABILITY TO PAY.FY 2015 KEY STATISTICS - TOTAL DISCHARGES: 38,396TOTAL SURGICAL CASES: 28,966 TOTAL ER VISITS: 131,052 210667104 69298 269554234 UMASS MEMORIAL COMMUNITY HOSPITALSTHE UMASS MEMORIAL COMMUNITY HOSPITALS (CLINTON HOSPITAL, HEALTH ALLIANCE HOSPITALS, INC., MARLBOROUGH HOSPITAL) ARE COMMITTED TO IMPROVING THE HEALTH OF THE PEOPLE OF THE COMMUNITIES THAT THEY SERVE THROUGH EXCELLENCE IN CLINICAL CARE AND SERVICE. EACH OF THESE HOSPITALS ACCOMPLISHES THIS GOAL BY PROVIDING INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO THE RESIDENTS OF THEIR COMMUNITIES WITHOUT REGARD TO THEIR ABILITY TO PAY.FY 2015 KEY STATISTICS -TOTAL DISCHARGES: 11,534TOTAL SURGICAL CASES: 8,501TOTAL ER VISITS: 84,427 438100920 465476475 UMASS MEMORIAL MEDICAL GROUPTHE UMASS MEMORIAL MEDICAL GROUP IS A MULTISPECIALTY GROUP PRACTICE OF PHYSICIANS WHOSE MISSION AND PURPOSE IS TO SUPPORT THE CLINICAL, EDUCATIONAL, RESEARCH AND COMMUNITY SERVICE MISSIONS OF UMASS MEMORIAL HEALTH CARE AND UMASS MEMORIAL MEDICAL CENTER. UMASS MEMORIAL MEDICAL GROUP ACCOMPLISHES THIS MISSION BY PROVIDING MEDICAL CARE TO RESIDENTS OF CENTRAL NEW ENGLAND WITHOUT REGARD TO THEIR ABILITY TO PAY. 73699339 2078175 277064881 OTHER PROGRAM SERVICESOTHER UMASS MEMORIAL ENTITIES - UMASS MEMORIAL HAS A NUMBER OF SUBSIDIARY ENTITIES THAT FUNCTION PRIMARILY TO DELIVER HEALTH CARE TO PATIENTS OR TO SUPPORT THE DELIVERY OF HEALTH CARE TO PATIENTS OF UMASS MEMORIAL. THEY ACCOMPLISH THIS THROUGH THE DELIVERY OF HEALTH CARE SERVICES WITHOUT REGARD TO THE PATIENT'S ABILITY TO PAY. THEY ALSO ACCOMPLISH THIS BY PROVIDING SUPPORT, OVERSIGHT, ADMINISTRATIVE SERVICES OR PATIENT ADVOCACY SERVICES TO THE PATIENTS OF UMASS MEMORIAL, CENTRAL NEW ENGLAND, AND OTHER GEOGRAPHIES. 73699339 2078175 277064881 1909550706 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 0 0 0 0 0 1 0 1 1 1 0 0 1 0 0 1 1 1 1 0 1 1565 0 1 15036 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 192 104 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 MA X ROBERT FELDMANN 5083340496 306 BELMONT STREET WORCESTER MA 01604 ALFRED HOWARD MD DIRECTOR, UMM ACO, INC. 37.00 X 248148 0 30650 BAGLEY PETER MD DIRECTOR, UMM ACO, INC. 27.00 X 354743 0 121106 BROWN ALAN P MD SECRETARY, UMMHC, INC., DIRECTOR VARIOUS 31.00 X X 193418 0 34737 CARLUCCI DANIEL MD DIRECTOR, MARLBOROUGH HOSPITAL 32.00 X 309832 0 41594 COFONE MICHAEL J TREASURER/DIRECTOR, COORDINATED PRIMARY CARE, INC 40.00 X X 367804 0 37725 CORBETT WILLIAM MD DIRECTOR, MARLBOROUGH HOSPITAL 40.00 X 453989 0 164280 DALY SHEILA PRESIDENT, CLINTON HOSPITAL ASSOC., DIRECTOR HOSP 40.00 X X 283264 0 44867 DICKSON ERIC W MD PRESIDENT & CEO/DIRECTOR, UMM HEALTH CARE, INC. 40.00 X X 1333724 0 270644 DUNCAN DAVID DIRECTOR UNTIL 8/3/15, COORDINATED PRIMARY CARE, 40.00 X 196369 0 30664 EISENSTOCK JORDAN MD DIRECTOR, UMM ACO, INC. 40.00 X 185876 0 32895 FAIRCHILD DAVID MD PRESIDENT/DIRECTOR, UMM ACO, INC. 40.00 X X 512543 0 103616 FERGUSON R KEVIN MD DIRECTOR, UMM MED GROUP, INC. 40.00 X 277690 0 37521 FINBERG ROBERT W MD DIRECTOR, UMM HEALTH CARE, INC. 20.00 X 315755 0 132665 GOTTLIEB PHILIP D MD DIRECTOR UNTIL 12/13, CLINTON HOSPITAL ASSOC. 40.00 X 372910 0 37761 HARLAN DAVID MD DIRECTOR, UMM ACO, INC. 20.00 X 181056 0 34745 IITSUKA CARLOS DIRECTOR, UMASS MEMORIAL HEALTH VENTURES, INC. 40.00 X 93476 0 16575 KENNEDY KATHRYN MD DIRECTOR, UMM MED GROUP, INC. 36.00 X 289156 0 41588 LAPRIORE CHERYL M PRESIDENT/DIRECTOR, UMM HEALTH VENTURES, INC. 40.00 X X 369560 0 123508 LASSER DANIEL H MD DIRECTOR, UMM MED GROUP, INC. 20.00 X 260581 0 83128 MESSINA LOUIS MD DIRECTOR UNTIL 3/14, UMM MED GROUP, INC. 33.00 X 597486 0 41891 METZMAKER JEFFREY N MD DIRECTOR, UMM MED GROUP, INC. 29.00 X 425311 0 39061 MULDOON PATRICK PRESIDENT, UMM MED CTR, INC., 40.00 X X 869566 0 295711 NOMPLEGGI DOMINIC MD DIRECTOR, UMM MED GROUP, INC. 29.00 X 342706 0 43154 OKIKE O NSIDINANYA MD DIRECTOR, UMM HEALTH CARE, INC. 40.00 X 534847 0 40943 O'LEARY DANIEL MD DIRECTOR, COORDINATED PRIMARY CARE, INC. 25.00 X 188960 0 7673 PHILBIN CHRIS DIRECTOR, UMASS MEMORIAL COMMUNITY HOSPITALS, INC 40.00 X 229880 0 49690 ROACH STEVEN PRESIDENT/DIRECTOR, MARLBOROUGH HOSPITAL 40.00 X X 457614 0 65400 ROSEN MAX P MD DIRECTOR, CMMIC, INC. 24.00 X 407337 0 16840 ROSSI CATHERINE DIRECTOR, CLINTON HOSPITAL ASSOCIATION 40.00 X 208552 0 47729 SIOUFI HABIB A MD DIRECTOR, CLINTON HOSPITAL ASSOCIATION 40.00 X 207566 0 34623 SWENSON DANA E PRESIDENT/DIRECTOR, UMM REALTY, INC. 40.00 X X 296299 0 146610 TOSI STEPHEN E MD PRESIDENT, UMM MED GROUP, INC., DIRECTOR VARIOUS 40.00 X X 1249264 0 288367 YOUNG LYNDA M MD DIRECTOR, UMM HEALTH CARE, INC. 1.00 X 40974 0 107 ZIEDONIS DOUGLAS MD PRESIDENT/DIRECTOR, UMBHS, INC. 20.00 X X 227696 0 40499 ALLEN GAIL DIRECTOR, HEALTHALLIANCE HOSPITALS, INC. 1.00 X 0 0 0 ARNOW JONATHAN MD DIRECTOR UNTIL 6/15, CLINTON HOSPITAL ASSOCIATION 1.00 X 0 0 0 BABINEAU ROBERT JR MD DIRECTOR, HEALTHALLIANCE HOSPITALS, INC. 1.00 X 0 0 0 BENNETT DAVID L CHAIRPERSON, UMASS MEMORIAL HEALTH CARE, INC. 1.00 X 0 0 0 BENNETT RICHARD K DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC. 1.00 X 0 0 0 BERGERON ARTHUR DIRECTOR UNTIL 12/14, MARLBOROUGH HOSPITAL 1.00 X 0 0 0 BERKEY DENNIS D EMERITUS TRUSTEE, UMASS MEMORIAL HEALTH CARE, INC. 1.00 X 0 0 0 BERRY SARAH G EMERITA TRUSTEE, UMASS MEMORIAL HEALTH CARE, INC. 1.00 X 0 0 0 BOUDREAU NORMAN DIRECTOR, HEALTHALLIANCE HOSPITALS, INC. 1.00 X 0 0 0 BOVENZI LESLIE DIRECTOR, HEALTHALLIANCE HOSPITALS, INC. 1.00 X 0 0 0 BUDD JOHN H EMERITUS TRUSTEE, UMASS MEMORIAL HEALTH CARE, INC. 1.00 X 0 0 0 CARLSON MARY DIRECTOR UNTIL 7/14, MARLBOROUGH HOSPITAL 1.00 X 0 0 0 CATALINA FERNANDO MD VICE CHAIRPERSON, HEALTHALLIANCE HOSPITALS, INC. 1.00 X 0 0 0 CHERUBINI J PAUL DIRECTOR, CLINTON HOSPITAL ASSOCIATION 1.00 X 0 0 0 CLEMENTI JOHN DIRECTOR, HEALTHALLIANCE HOSPITALS, INC. 1.00 X 0 0 0 COLLINS MICHAEL MD DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC. 1.00 X 0 0 0 COLONERO BENJAMIN H JR DIRECTOR, MARLBOROUGH HOSPITAL 1.00 X 0 0 0 CONNOR EDWARD J DIRECTOR, CLINTON HOSPITAL ASSOCIATION 1.00 X 0 0 0 CONNORS MARTIN JR DIRECTOR UNTIL 4/14, CENTRAL NEW ENGLAND HEALTHALL 1.00 X 0 0 0 CORNELL LOIS D DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC. 1.00 X 0 0 0 CROCKER FREDERICK G DIRECTOR, UMASS MEMORIAL HEALTH VENTURES, INC. 1.00 X 0 0 0 CUTLER J CHRISTOPHER FACHE DIRECTOR, UMASS MEMORIAL MEDICAL GROUP, INC. 1.00 X 0 0 0 D'ALELIO EDWARD DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC. 1.00 X 0 0 0 DAVIS DIX F EMERITUS TRUSTEE, UMASS MEMORIAL HEALTH CARE, INC. 1.00 X 0 0 0 DENNEHY RAYMOND III CHAIRPERSON UNTIL 3/15, HEALTH ALLIANCE HOME HEALT 1.00 X 0 0 0 DIGERONIMO ARTHUR P JR DIRECTOR, HEALTHALLIANCE HOSPITALS, INC. 1.00 X 0 0 0 D'ONFRO PAUL CHAIRPERSON, HEALTHALLIANCE HOSPITALS, INC. 1.00 X 0 0 0 FARRELL LYNNE DIRECTOR, HEALTH ALLIANCE HOME HEALTH AND HOSPICE, 1.00 X 0 0 0 FITCH ROGER DIRECTOR, UMASS MEMORIAL BEHAVIORAL HEALTH SYSTEM, 1.00 X 0 0 0 FLOTTE TERENCE MD DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC. 1.00 X 0 0 0 GRASSETTE AMY DIRECTOR, UMASS MEMORIAL BEHAVIORAL HEALTH SYSTEM, 1.00 X 0 0 0 GRAY JENNIFER DIRECTOR UNTIL 6/15, CLINTON HOSPITAL ASSOCIATION 1.00 X 0 0 0 GUARDIOLA ELVIRA DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC. 1.00 X 0 0 0 HENEBRY CLARK DIRECTOR, CLINTON HOSPITAL ASSOCIATION 1.00 X 0 0 0 HURLEY FRANCIS DIRECTOR, MARLBOROUGH HOSPITAL 1.00 X 0 0 0 JACOBSON M HOWARD EMERITUS TRUSTEE, UMASS MEMORIAL HEALTH CARE, INC. 1.00 X 0 0 0 JOHNSON JOANNE DIRECTOR, UMASS MEMORIAL BEHAVIORAL HEALTH SYSTEM, 1.00 X 0 0 0 KANGAS PAUL DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC. 1.00 X 0 0 0 KAPLAN DANIEL DIRECTOR UNTIL 12/14, UMASS MEMORIAL MEDICAL GROUP 1.00 X 0 0 0 KNOX PETER DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC. 1.00 X 0 0 0 KUPFER BARBARA DIRECTOR, UMASS MEMORIAL ACCOUNTABLE CARE ORGANIZA 1.00 X 0 0 0 LATIMER JOHN MD DIRECTOR, HEALTHALLIANCE HOSPITALS, INC. 1.00 X 0 0 0 LENHARDT STEPHEN W SR EMERITUS TRUSTEE, UMASS MEMORIAL HEALTH CARE, INC. 1.00 X 0 0 0 MACNEILL HARRIS L DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC. 1.00 X 0 0 0 MANZI EDWARD DIRECTOR, UMASS MEMORIAL BEHAVIORAL HEALTH SYSTEM, 1.00 X 0 0 0 MARTIN DONATA DIRECTOR, HEALTHALLIANCE HOSPITALS, INC. 1.00 X 0 0 0 MASEDA LUIS J DIRECTOR, CLINTON HOSPITAL ASSOCIATION 1.00 X 0 0 0 MATTA LALITA MD DIRECTOR, UMASS MEMORIAL ACCOUNTABLE CARE ORGANIZA 1.00 X 0 0 0 MCGRAIL WILLIAM ESQUIRE CHAIRPERSON, CLINTON HOSPITAL ASSOCIATION 1.00 X 0 0 0 MCGUIRE TONI DIRECTOR, UMASS MEMORIAL ACCOUNTABLE CARE ORGANIZA 1.00 X 0 0 0 MCMULLEN CYNTHIA M EDD EMERITA TRUSTEE, UMASS MEMORIAL HEALTH CARE, INC. 1.00 X 0 0 0 MCNAMARA MARY ELLEN DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC. 1.00 X 0 0 0 MENDOZA STEVEN DIRECTOR UNTIL 6/15, CLINTON HOSPITAL ASSOCIATION 1.00 X 0 0 0 MERCADANTE ANTHONY J DIRECTOR, HEALTH ALLIANCE HOME HEALTH AND HOSPICE, 1.00 X 0 0 0 MOLLOY ANN K DIRECTOR, MARLBOROUGH HOSPITAL 1.00 X 0 0 0 MURPHY MICHAEL D VICE CHAIRPERSON, MARLBOROUGH HOSPITAL 1.00 X 0 0 0 PARRY EDWARD J III VICE CHAIRPERSON, UMASS MEMORIAL HEALTH CARE, INC. 1.00 X 0 0 0 PAULHUS ROBERT J JR DIRECTOR, CLINTON HOSPITAL ASSOCIATION 1.00 X 0 0 0 PAULINO JEANNE DIRECTOR, CLINTON HOSPITAL ASSOCIATION 1.00 X 0 0 0 PEDERSON THORU EMERITUS TRUSTEE, UMASS MEMORIAL HEALTH CARE, INC. 1.00 X 0 0 0 PICI MICHAEL MD DIRECTOR, UMASS MEMORIAL ACCOUNTABLE CARE ORGANIZA 1.00 X 0 0 0 PONGOR PAUL J MD DIRECTOR UNTIL 12/14, MARLBOROUGH HOSPITAL 1.00 X 0 0 0 PURCELL PHILIP E DIRECTOR, MARLBOROUGH HOSPITAL 1.00 X 0 0 0 RICHER GERARD P DIRECTOR, MARLBOROUGH HOSPITAL 1.00 X 0 0 0 RIVARD MICHAEL DIRECTOR, HEALTHALLIANCE HOSPITALS, INC. 1.00 X 0 0 0 SANCHEZ CAROL DIRECTOR, MARLBOROUGH HOSPITAL 1.00 X 0 0 0 SEYMOUR-ROUTE PAULETTE PHD DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC. 1.00 X 0 0 0 SHARMA VIBHA MD DIRECTOR, MARLBOROUGH HOSPITAL 1.00 X 0 0 0 SHEA JOHN ESQUIRE DIRECTOR, UMASS MEMORIAL BEHAVIORAL HEALTH SYSTEM, 1.00 X 0 0 0 SHELTON ROBERT LESLIE MD DIRECTOR, HEALTHALLIANCE HOSPITALS, INC. 1.00 X 0 0 0 SIEGRIST RICHARD DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC. 1.00 X 0 0 0 STECYK MARKIAN MD DIRECTOR, MARLBOROUGH HOSPITAL 1.00 X 0 0 0 TAYLOR HARVEY MD DIRECTOR UNTIL 1/15, MARLBOROUGH HOSPITAL 1.00 X 0 0 0 WALTON DAVID DIRECTOR, MARLBOROUGH HOSPITAL 1.00 X 0 0 0 WEISBERG OREN MD DIRECTOR UNTIL 3/15, HEALTHALLIANCE HOSPITALS, INC 1.00 X 0 0 0 WHITNEY MARY DIRECTOR, HEALTHALLIANCE HOSPITALS, INC. 1.00 X 0 0 0 WILSON JACK DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC. 1.00 X 0 0 0 BOLLAND ESHGHI KATHARINE ASSISTANT SECRETARY, UMMHC, INC. 40.00 X 393499 0 95011 BRONHARD JOHN TREASURER, CNEHA, INC. 40.00 X 218445 0 11391 BROWN DOUGLAS S SECRETARY, UMM HEALTH CARE, INC. 40.00 X 885272 0 248130 COCCHIARELLA ANDREW MD DIRECTOR, MARLBOROUGH HOSPITAL 40.00 X 314972 0 38305 CROTEAU MAUREEN SECRETARY, CLINTON HOSPITAL ASSOC. 40.00 X 54459 0 23525 D'AMBRA ANN-MARIA SECRETARY, MARLBOROUGH HOSPITAL 40.00 X 49820 0 25876 EKSTROM DEBORAH PRESIDENT, COMMUNITY HEALTHLINK, INC. 40.00 X 260038 0 119137 GREENWOOD JOHN TREASURER, UMM ACO, INC. 40.00 X 273567 0 104283 KEATING TODD A TREASURER UNTIL 2/14, UMM HEALTH CARE, INC. 40.00 X 1190005 0 149070 MCCUE STEVEN TREASURER, MARLBOROUGH HOSPITAL 40.00 X 195208 0 44640 MELGAR SERGIO TREASURER, UMASS MEMORIAL HEALTH CARE, INC. 40.00 X 857255 0 89174 MORIN LYNN A SECRETARY, CNEHA, INC. 40.00 X 87389 0 7355 O'BRIEN WILLIAM SECRETARY, UMBHS, INC. 40.00 X 124759 0 58649 OLSON JEFFREY TREASURER, CLINTON HOSPITAL ASSOC. 40.00 X 155872 0 58847 SHAKMAN ALICE PRESIDENT, CMMIC, INC. 40.00 X 342099 0 156617 SMITH FRANCIS W CLERK, UMM HEALTH VENTURES, INC. 40.00 X 202881 0 76410 STREETER MICHELE TREASURER, UMM MED GROUP, INC. 40.00 X 593494 0 248789 SZYMANSKI CANDRA D INTERIM PRESIDENT UNTIL 12/13, MARLBOROUGH HOSPIT 40.00 X 190684 0 13521 WEYMOUTH DEBORAH PRESIDENT, CENTRAL NEW ENGLAND HEALTHALLIANCE, IN 40.00 X 223633 0 6415 ANDERSON MILTON SR. VP, CHIEF HR OFFICER UNTIL 9/14 40.00 X 771463 0 388099 BRENCKLE GEORGE PHD SR. VP, CIO UNTIL 4/14 40.00 X 519540 0 349803 CYR JAMES P SR VP, HEART AND VASCULAR DISEASES 40.00 X 321924 0 185405 DAY THERESE VP, FINANCE / CFO OF MED CENTER 40.00 X 371674 0 179287 DIAMOND VICTORIA SR. VP, OPERATIONS, UNTIL 1/14 40.00 X 422990 0 142327 FELDMANN ROBERT VP, CORPORATE CONTROLLER 40.00 X 322778 0 154309 FISHER BARBARA SR VP, OPERATIONS 40.00 X 379613 0 152588 GEORGE PATRICIA VP & DEPUTY CIO 40.00 X 18466 0 340096 HUDLIN MARGARET MD CHIEF MED OFFICER/VP PERIOPERATIVE SVCS 40.00 X 435170 0 68882 HYLKA SHARON SR. VP, HOSPITAL ADMIN UNTIL 1/14 40.00 X 971604 0 270706 JEWELL CATHY SR VP, CHIEF NURSING OFFICER 40.00 X 230486 0 47579 RANDOLPH JOHN CHIEF COMPLIANCE OFFICER 40.00 X 250818 0 118330 TARNOWSKI TIMOTHY SR VP, CHIEF INFO OFFICER 40.00 X 82456 0 1461 THOMPSON DIANE SR VP CHIEF NURSING OFF UNTIL 4/9/15 40.00 X 421608 0 382512 LITWIN DEMETRIUS MD PHYSICIAN, CHAIR OF SURGERY DEPT 27.00 X 717655 0 41775 BOZORGZADEH ADEL MD PHYSICIAN, CHIEF OF ORGAN TRANSPLANTATION 32.00 X 712759 0 41594 AROUS ELIAS J MD PHYSICIAN, ASSOC. CHIEF MEDICAL OFFICER, CHIEF OF 32.00 X 645700 0 39061 AYERS DAVID C MD PHYSICIAN, CHAIR OF ORTHOPEDICS AND PHYSICAL REHA 33.00 X 641344 0 40769 BUSCONI BRIAN D MD PHYSICIAN, CHIEF OF ORTHOPEDICS 33.00 X 617122 0 39061 CHANDLER WILLIS FMR DIR CLINTON UNTIL 12/31/11 0.00 X 43852 0 107 FERRUCCI JOSEPH MD FMR DIR CMMIC UNTIL 3/31/13 0.00 X 276314 0 24085 PAPPAS ARTHUR M MD FMR DIR UNTIL 3/27/13 0.00 X 13536 0 208 MOORE KAREN FMR PRESIDENT/DIR UNTIL 3/25/13 0.00 X 156975 0 40023 BLUTE MICHAEL MD FMR KEY EE UNTIL 3/31/2012, CANCER CENTER OF E 0.00 X 122006 0 107 DALEY JENNIFER MD FMR EXEC VP, COO, UNTIL 3/18/13 0.00 X 529399 0 126216 ETTINGER WALTER H MD FMR KEY EE/PRES MEDCTR UNTIL 1/20/12 0.00 X 716815 0 107 30211370 0 7328209 2662 1 1 1 XEROX BUSINESS SVCS LLC PO BOX 201322 DALLAS TX 75320 I/S MANAGEMENT SERVICES 27975170 UMASS MEMORIAL SHIELDS PHARMACY 25 ROCKWOOD ROAD MARSHFIELD MA 02050 PHARMACY MANAGEMENT SERVICES 14525219 PRICE WATERHOUSE COOPERS LLP PO BOX 7247 8001 PHILADELPHIA PA 19170 CONSULTING SERVICES 5009858 SODEXO INC & AFFILIATES PO BOX 360170 PITTSBURGH PA 152515170 FOOD & HOUSEKEEPING SERVICES 4595689 LEIDOS HEALTH LLC PO BOX 223866 PITTSBURGH PA 15251 PROFESSIONAL BILLING SERVICES 4518377 180 X 70000 731239 446198 8578916 4673514 10853 14499867 NET PATIENT SERVICE RE 900099 1960116077 1960116077 SYSTEM ALLOCATION REVE 900099 171072958 171072958 SPECIAL MEDICAID PAYME 900099 168649504 168649504 AFFILIATE RELATED PROG 900099 148657627 148657627 OTHER PSR & JV 900099 36449481 36449481 25733543 25733543 2510679190 10473582 36162 2186 10435234 78143 78143 2628666 1371048 1257618 1257618 1257618 321450973 183376 290148455 662174 31302518 -478798 30823720 -368600 31192320 283518 731239 304299 -20781 -20781 OTHER REVENUE 900099 7527369 700529 -157778 6984618 LAB OUTREACH PROGRAM 621500 2131921 2131921 SUBLEASE INCOME 900099 128862 128862 9788152 2577579491 2511047281 1976329 50056014 X 4385885 4385885 97848 97848 31388756 14462233 16926523 970434089 789180382 180904401 349306 70119199 57068484 13047416 3299 139261372 107394752 31845944 20676 66312901 53230350 13071540 11011 61196488 46543893 14652595 1723857 91050 1632807 1099208 85 1099123 177020 177020 323352 323352 1020780 1020780 284868879 211958691 72877307 32881 1593284 91822 1483113 18349 23952176 14345605 9599848 6723 51641153 3280896 48360257 73776589 46762931 27009664 3994 2616353 1916464 699317 572 1603035 1029559 571716 1760 15305620 14818411 487209 103110509 79507614 23602895 11293792 6530040 4763752 MEDICAL SUPPLIES 244327125 200099889 44227236 MEDICAL EDUCATION SERVI 131284106 131057825 226281 SYSTEM OVERHEAD ACTIVIT 120694736 69929275 50765461 PURCHASED SERVICES 36073800 25923643 10105523 44634 34259927 29666059 4575272 18596 2483941839 1909550706 573555980 835153 91339673 119788165 51569765 65070897 1221500 562552 262415754 250995615 4432374 4703689 41989817 33456546 24740080 29117718 23751081 22899661 1669626558 1086098052 616971066 583528506 459751041 72182619 164159185 519994237 35417054 63800082 364656197 524735084 2142414587 2290835371 277838208 286431598 584353 338032 9420067 6297369 340791673 327411105 45087007 43756483 32590236 50000000 529651940 668427726 1235963484 1382662313 X 741359678 747417618 86449119 76999973 78642306 83755467 906451103 908173058 2142414587 2290835371 X 93637652 -36655809 -55259888 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 175957 0 1 1063 0 177020 0 115101660 5757118 -2182362 -1200560 119876976 112462194 9419969 -4425190 -2355313 115101660 109418023 8142465 -5098294 112462194 98294963 2557800 12021986 3456726 109418023 104017758 316330 -2402463 3636662 98294963 0.00000 0.71000 0.29000 1 0 8807895 8807895 839373502 514258026 325115476 23930326 13284285 10646041 749469454 554643101 194826353 48045381 3912640 44132741 583528506 BENEFICIAL INTEREST IN TRUSTS 66580170 F COMMONWEALTH PROFESSIONAL ASSURANCE COMPANY LTD 120000 F BIO VENTURES 123323 F INVESTMENT IN UMASS MEMORIAL INVESTMENT PARTNERSHIP, LLP 453170744 F 519994237 DUE FROM RELATED PARTIES 136245479 CSV LIFE INSURANCE 31951 MALPRACTICE TAIL COVERAGE 33862723 LONG TERM SECURITY DEPOSITS 159722 OTHER NON-CURRENT ASSETS 621455 RECEIVABLE FROM MEDICAID 325437201 DUE FROM THIRD PARTIES 28376553 524735084 DUE TO UMASS MEDICAL SCHOOL 165944420 THIRD PARTY LIABILITIES 61203632 DUE TO RELATED PARTIES 120975290 ACCRUED PENSION POST RETIREMENT BENEFITS 205127263 O/S LOSS RESERVES 31526604 ESTIMATED MALPRACTICE COSTS 33862723 OTHER 1425988 ANNUITY PAYABLE 2835602 LT LIABILITY ARO 9763160 ACCRUED LT LIABILITIES 4142820 CLAIMS RESERVES 89125 MEDICARE RESERVES 30000 NOTE PAYABLE TO AFFILIATES (MC AND UMBHS) 31501099 668427726 X PART X, LINE 2: (ASC 740): INCOME TAXES: THE SYSTEM FOLLOWS A TWO-STEP APPROACH FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN. THE SUBSTANTIAL MAJORITY OF UMASS MEMORIAL AND ITS AFFILIATE ENTITIES ARE RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT UNDER SECTION 501 (C) (3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THESE ENTITIES WILL NOT INCUR ANY LIABILITY FOR FEDERAL INCOME TAXES EXCEPT FOR TAX ON UNRELATED BUSINESS INCOME. CERTAIN AFFILIATES ARE TAXABLE ENTITIES. THE MEASUREMENT OF THE AMOUNTS RECORDED AS A PROVISION FOR INCOME TAXES BASED UPON THE AFOREMENTIONED APPROACH IS NOT MATERIAL AND IS RECORDED AS PART OF SUPPLIES AND OTHER EXPENSE IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS. THE SYSTEM DOES NOT BELIEVE IT HAS ANY SIGNIFICANT UNCERTAIN TAX POSITIONS. FORM 990, SCHEDULE D, PART V ENDOWMENT FUNDS QUESTION 3A(I) & 4: ARE THERE ENDOWMENT FUNDS NOT IN THE POSSESSION OF THE ORGANIZATION THAT ARE HELD AND ADMINISTERED FOR THE ORGANIZATION BY: (I) UNRELATED ORGANIZATIONS: YES OR NO HEALTHALLIANCE HOSPITAL - YES BANK OF AMERICA MERRILL LYNCH HOLDS THE BERNARD W DOYLE TRUST FOR HEALTHALLIANCE HOSPITAL. DISTRIBUTIONS ARE PAID TO HEALTHALLIANCE HOSPITAL. BANK OF AMERICA MERRILL LYNCH IS AN UNRELATED ORGANIZATION. BNY MELLON WEALTH MANAGEMENT HOLDS THE FOLLOWING TRUSTS FOR HEALTHALLIANCE HOSPITAL: TRUST U/WILL ART 11 WILLIAM H CROPPER TRUST U/WILL PAR 15 WILLIAM H CROPPER TRUST U/WILL ART 18 WILLIAM H CROPPER TRUST UNDER 2ND CODICIL OF WILL OF WILLIAM H CROPPER TRUST U/WILL 4TH COD WILLIAM H CROPPER DISTRIBUTIONS ARE PAID TO HEALTHALLIANCE HOSPITAL. BNY MELLON WEALTH MANAGEMENT IS AN UNRELATED ORGANIZATION. PART V ENDOWMENT FUNDS QUESTION 4: PARENT - THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS ARE DIRECTED IN ACCORDANCE WITH THE DONOR'S INTENT INCLUDING THE PRESERVATION OF THE ORIGINAL GIFT AND VARIOUS PURPOSES INCLUDING CHARITY CARE, MEDICAL EDUCATION, RESEARCH, HEALTH CARE SERVICES, BUILDINGS AND EQUIPMENT. HEALTHALLIANCE HOSPITAL - THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS ARE DIRECTED IN ACCORDANCE WITH THE DONOR'S INTENT INCLUDING THE PRESERVATION OF THE ORIGINAL GIFT AND VARIOUS PURPOSES INCLUDING CHARITY CARE, MEDICAL EDUCATION, RESEARCH, HEALTH CARE SERVICES, BUILDINGS AND EQUIPMENT. CLINTON HOSPITAL - THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS ARE DIRECTED IN ACCORDANCE WITH THE DONOR'S INTENT INCLUDING THE PRESERVATION OF THE ORIGINAL GIFT AND VARIOUS PURPOSES INCLUDING CHARITY CARE, MEDICAL EDUCATION, RESEARCH, HEALTH CARE SERVICES, BUILDINGS AND EQUIPMENT. MARLBOROUGH HOSPITAL - THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS ARE DIRECTED IN ACCORDANCE WITH THE DONOR'S INTENT INCLUDING THE PRESERVATION OF THE ORIGINAL GIFT AND VARIOUS PURPOSES INCLUDING CHARITY CARE, MEDICAL EDUCATION, RESEARCH, HEALTH CARE SERVICES, BUILDINGS AND EQUIPMENT X X X X X 1 UMASS MEMORIAL FOUNDATION INC 333 SOUTH STREET SHREWSBURY MA 01545 FUNDRAISING 0 541913 227352 314561 JNB ASSOCIATES 21 WATER STREET AMESBURY MA 01913 FUNDRAISING 0 0 96000 -96000 541913 323352 218561 MA NH PARENT-WINTER BALL 375693 313504 62189 21608 19067 8747 12767 CNEHA GOLF TOURNAMENT 305899 162940 142959 26101 80403 36455 8 333165 254795 78370 11567 3134 18100 66350 1014757 731239 283518 37668 105145 19067 26847 115572 304299 -20781 PART I, LINE 2B - FUNDRAISER ADDITIONAL INFORMATION (CONTINUED) UMASS MEMORIAL HEALTH CARE, INC. PAYS UMASS MEMORIAL FOUNDATION, INC. ITS PRORATA SHARE OF OPERATING EXPENSES BASED ON THE SPLIT OF UMASS MEMORIAL CONTRIBUTION RECEIPTS VERSUS THE OVERALL TOTAL CONTRIBUTION RECEIPTS AS COLLECTED BY THE FOUNDATION. SCHEDULE G - ADDITIONAL INFORMATION PART II, COLUMN (A) EVENT #1 THE WINTER BALL WAS HELD BY THE PARENT PART II, COLUMN (B) EVENT #2 THE HOSPITAL GOLF TOURNEY WAS HELD BY CENTRAL NEW ENGLAND HEALTHALLIANCE, INC. PART II, COLUMN (C) OTHER EVENTS (10 EVENTS REPORTED) ARE: 1. SPEAKEASY HELD BY HEALTHALLIANCE HOSPITALS 2. DENNEHY GOLF TOURNAMENT HELD BY HEALTHALLIANCE HOME HEALTH AND HOSPICE, INC. 3. LOVELIGHT HELD BY HEALTHALLIANCE HOME HEALTH AND HOSPICE, INC. 4. NICU GOLF-A-THON WAS HELD BY THE PARENT 5. LINKS TO THE FUTURE EVENT WAS HELD BY THE PARENT, 6. GALA BALL WAS HELD BY CENTRAL NEW ENGLAND HEALTHALLIANCE, INC. 7. GOLF TOURNAMENT WAS HELD BY MARLBOROUGH HOSPITAL, INC. 8. 125TH ANNIVERSARY EVENT WAS HELD BY CLINTON HOSPITAL ASSOCIATION 1 1 X 1 X 1 X 600.000000000000 1 1 1 0 1 1 35049684 22118773 12930911 0.00750 349547956 307533990 42013966 0.02430 13139319 12979868 159451 0.00010 397736959 342632631 55104328 0.03190 3842170 2007471 1834699 0.00110 206454967 109759749 96695218 0.05600 103394362 84456325 18938037 0.01100 104967 27700 77267 0.00000 2740983 2740983 316537449 198992228 117545221 0.06810 714274408 541624859 172649549 0.10000 0 0 0.00000 0 0 0.00000 5953 0 5953 0.00000 0 0 0.00000 0 0 0.00000 2094 0 2094 0.00000 0 0 0.00000 61732 0 61732 0.00000 0 0 0.00000 69779 69779 1 6783144 2756653 371254776 374468928 -3214152 X 1 1 1 COMMONWEALTH PROFESSIONAL ASSURANCE COMPANY LTD PROVIDES INSURANCE 1.00000 0.00000 0.00000 2 UMASS MEMORIAL INVESTMENT PARTNERSHIP LLP MANAGES POOLED INVESTMENTS 1.00000 0.00000 0.00000 3 UMASS MEMORIAL HEALTH ALLIANCE MRI CENTER LLC MAGNETIC RESONANCE IMAGING CENTER 0.60000 0.00000 0.00000 4 UMASS MEMORIAL MRI OF MARLBOROUGH LLC MAGNETIC RESONANCE IMAGING CENTER 0.56000 0.00000 0.00000 5 MEMORIAL OFFICE CONDOMINIUM TRUST CONDO ASSOCIATION THAT OWNS MEDICAL OFFICE BUILDING 0.53690 0.00000 0.00000 6 UMASS MEMORIAL MRI & IMAGING CENTER LLC MAGNETIC RESONANCE IMAGING CENTER 0.50000 0.00000 0.00000 7 NEW ENGLAND REHAB SERVICES OF CENTRAL MA INC (DBA FAIRLAWN REHAB) ACUTE CARE REHABILITATION CENTER 0.20000 0.00000 0.00000 8 BIO LAB INC CLINICAL LABORATORY 1.00000 0.00000 0.00000 9 SHIELDS IMAGING OF MASSACHUSETTS LLC MANAGEMENT COMPANY FOR PET IMAGING 0.25000 0.00000 0.00000 10 UMASS MEMORIAL SHIELDS PHARMACY LLC PHARMACY SERVICES 0.50000 0.00000 0.00000 11 116 BELMONT STREET INC CONDO ASSOCIATION 0.63040 0.00000 0.00000 12 SHIELDS SPECIALTY PHARMACY OF SPRINGFIELD LLC PHARMACY SERVICES 0.50000 0.00000 0.00000 13 SPECIALTY PHARMACY OF NEWARK PHARMACY SERVICES 0.50000 0.00000 0.00000 14 QUEST DIAGNOSTICS MASSACHUSETTS LLC LABORATORY SERVICES 0.18900 0.00000 0.00000 15 CENTRAL MA COMPREHENSIVE CANCER CENTER LLC (DBA NE RADIATION THERAPY) ONCOLOGY SERVICES 0.05000 0.00000 0.00000 16 BIOVENTURES INVESTORS LIMITED PARTNERSHIP MANAGES INVESTMENTS 0.06000 0.00000 0.00000 4 1 UMASS MEMORIAL MEDICAL CENTER INC 55 LAKE AVE 119 BELMONT STREET WORCESTER MA 01605 X X X X X X 2 HEALTHALLIANCE HOSPITAL INC 60 HOSPITAL ROAD LEOMINSTER MA 01453 X X X X 3 MARLBOROUGH HOSPITAL 157 UNION STREET MARLBOROUGH MA 01752 X X X X 4 CLINTON HOSPITAL ASSOCIATION 201 HIGHLAND STREET CLINTON MA 01510 X X X X UMASS MEMORIAL MEDICAL CENTER INC 1 0 0 1 X X X X X X X X X 14 1 0 1 1 X WWW.UMASSMEMORIALHEALTHCARE.ORG/ X WWW.WORCESTERMA.GOV/ X X 1 14 1 WWW.UMASSMEMORIALHEALTHCARE.ORG/ 0 0 1 X 200.000000000000 600.000000000000 X X 1 1 X X X 1 X X X X X 1 X 1 X X X X X 1 X 0 1 HEALTHALLIANCE HOSPITAL INC 2 0 0 1 X X X X X X X X X 14 1 1 1 1 X HTTP://WWW.HEALTHALLIANCE.COM/ X X 1 14 1 HTTP://WWW.HEALTHALLIANCE.COM 0 0 1 X 200.000000000000 600.000000000000 X X X X 1 1 X X X X 1 X X 1 X 1 X X X X 1 X 0 1 MARLBOROUGH HOSPITAL 3 0 0 1 X X X X X X X X X 13 1 1 1 1 X HTTP://WWW.UMASSMEMORIALHEALTHCARE.ORG/MARLBOROUGH-HOSPITAL X HTTP://WWW.MWHEALTH.ORG X 1 13 1 HTTP://WWW.UMASSMEMORIALHEALTHCARE.ORG/ABOUT-US/COMMUNITY-BENEFITS-PROGRAM/ 0 0 1 X 200.000000000000 600.000000000000 X X 1 1 X X X 1 X X X X X 1 X 1 X X X X X 1 X 0 1 CLINTON HOSPITAL ASSOCIATION 4 0 0 1 X X X X X X X X X 14 1 1 1 1 X HTTP://WWW.CLINTONHOSPITAL.ORG X HTTP://CHNA9.COM/INDEX.HTML X X 1 14 1 HTTP://WWW.CLINTONHOSPITAL.ORG 0 0 1 X 200.000000000000 600.000000000000 X X 1 1 X X X 1 X X X X X 1 X 1 X X X X X 1 X 0 1 HEALTHALLIANCE HOSPITAL, INC. PART V, SECTION B, LINE 3J: THE COMMUNITY HEALTH ASSESSMENT PROCESS CONSISTED OF A COMPREHENSIVE GATHERING OF QUANTITATIVE (I.E., HEALTH STATUS INDICATORS) AND QUALITATIVE DATA, THROUGH FOCUS GROUPS WITH COMMUNITY MEMBERS AND THROUGH INTERVIEWS WITH COMMUNITY MEMBERS AND COMMUNITY LEADERS. PARTICIPANTS WERE DRAWN FROM AMONG COMMUNITY-BASED, EDUCATIONAL, CIVIC, GOVERNMENTAL, AND FAITH-BASED PROFESSIONALS, HEALTH CARE PROVIDERS, AND OTHERS, AND EVERY EFFORT WAS MADE TO ENSURE RACIAL/ETHNIC, SOCIOECONOMIC, AND GEOGRAPHIC DIVERSITY IN THE COMPOSITION OF FOCUS GROUPS AND INTERVIEW PARTICIPANTS. HEALTHALLIANCE HOSPITAL COLLABORATED WITH THE JOINT COALITION ON HEALTH (JCOH) AND HEYWOOD HOSPITAL TO CONDUCT A COMPREHENSIVE COMMUNITY HEALTH ASSESSMENT THAT GATHERED, ANALYZED AND DOCUMENTED QUALITATIVE AND QUANTITATIVE DATA. UMASS MEMORIAL MEDICAL CENTER, INC. PART V, SECTION B, LINE 5: YES, INPUT FROM DIVERSE PERSONS WHO REPRESENT THE COMMUNITY WAS TAKEN INTO ACCOUNT. UMASS MEMORIAL MEDICAL CENTER JOINED EFFORTS WITH THE WORCESTER DIVISION OF PUBLIC HEALTH (WDPH), FALLON HEALTH AND COMMON PATHWAYS, A HEALTHY COMMUNITIES COALITION THAT IS COMPRISED OF 30+ HEALTH AND HUMAN SERVICE ORGANIZATIONS, IN THE DEVELOPMENT OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE DIRECTOR OF THE WDPH AND THE UMASS MEMORIAL VICE PRESIDENT OF COMMUNITY RELATIONS, AND FALLON HEALTH CO-CHAIRED THE LEADERSHIP PROCESS TO DEVELOP A CHNA AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR THE GREATER WORCESTER REGION. DURING THE ASSESSMENT PROCESS, COMMUNITY MEMBERS WERE ENGAGED IN KEY INFORMANT INTERVIEWS, FOCUS GROUPS, AND COMMUNITY DIALOGUES, WHICH ALLOWED FOR COMMUNITY MEMBERS TO REVIEW AND DISCUSS A PRELIMINARY PROFILE OF THE REGION AND PROVIDE THEIR FEEDBACK ON COMMUNITY HEALTH-RELATED STRENGTHS, NEEDS, AND A VISION FOR THE FUTURE. ELEVEN COMMUNITY DIALOGUE SESSIONS WERE HELD: FIVE SESSIONS IN WORCESTER, AND SIX IN THE OUTLYING COMMUNITIES (ONE EACH IN SHREWSBURY, GRAFTON, MILLBURY, WEST BOYLSTON, LEICESTER, AND HOLDEN). MORE THAN A TOTAL OF 1,777 INDIVIDUALS (INCLUDING PARTICIPANTS IN AN ONLINE COMMUNITY SURVEY) REPRESENTING DIVERSE INSTITUTIONS AND COMMUNITY ORGANIZATIONS FROM ACROSS THE REGION WORKED TOGETHER TO ESTABLISH A ROADMAP FOR THE FUTURE HEALTH OF THE REGION. THE PROCESS INCLUDED A STEERING COMMITTEE COMPRISED OF A DIVERSE NUMBER OF STAKEHOLDERS THAT ADVISED AND INFORMED THE CHNA. HEALTHALLIANCE HOSPITAL, INC. PART V, SECTION B, LINE 5: PARTICIPANTS INVOLVED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT WERE DRAWN FROM AMONG COMMUNITY-BASED, EDUCATIONAL, CIVIC, GOVERNMENTAL, AND FAITH-BASED PROFESSIONALS, HEALTH CARE PROVIDERS, AND OTHERS, AND EVERY EFFORT WAS MADE TO ENSURE RACIAL/ETHNIC, SOCIOECONOMIC, AND GEOGRAPHIC DIVERSITY IN THE COMPOSITION OF FOCUS GROUPS AND INTERVIEW PARTICIPANTS. MARLBOROUGH HOSPITAL PART V, SECTION B, LINE 5: THE PROCESS INCLUDED GATHERING COMMUNITY INPUT, AS WELL AS ANALYSIS OF GENERAL DATA COLLECTED FROM THE HOSPITAL AND PUBLICLY AVAILABLE DATA SOURCES. THE PROCESS ALSO INCORPORATED A SURVEY COMPONENT THAT WAS AVAILABLE IN ENGLISH, SPANISH AND PORTUGUESE, AS WELL AS KEY INFORMANT INTERVIEWS AND FOCUS GROUPS. CLINTON HOSPITAL ASSOCIATION PART V, SECTION B, LINE 5: TARGET POPULATIONS FOR CLINTON HOSPITAL'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COMMUNITY INPUT AND PLANNING PROCESS, COLLABORATIVE EFFORTS, AND A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WHICH IS CONDUCTED EVERY THREE YEARS. CLINTON HOSPITAL COLLABORATES WITH THE COMMUNITY HEALTH NETWORK AREA 9 (CHNA 9); A LOCAL COALITION OF PUBLIC, NON-PROFIT, AND PRIVATE SECTORS WORKING TOGETHER TO BUILD HEALTHIER COMMUNITIES IN MASSACHUSETTS THROUGH COMMUNITY-BASED PREVENTION PLANNING AND HEALTH PROMOTION. OTHER PARTNERS INCLUDED; KEY STAKEHOLDERS IN HEALTH IMPROVEMENT: RESIDENTS, CONSUMERS, COALITIONS, COMMUNITIES OF FAITH, BUSINESSES, AND PROVIDERS OF COMMUNITY-BASED HEALTH, EDUCATION, HUMAN SERVICES AND LOCAL AND STATE GOVERNMENTS. HEALTHALLIANCE HOSPITAL, INC. PART V, SECTION B, LINE 6A: HEALTHALLIANCE HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT WITH HEYWOOD HELATHCARE (HEYWOOD HOSPITAL AND ATHOL HOSPITAL) MARLBOROUGH HOSPITAL PART V, SECTION B, LINE 6A: THE ASSESSMENT WAS DONE IN CONJUNCTION WITH THE METRO WEST MEDICAL CENTER. CLINTON HOSPITAL ASSOCIATION PART V, SECTION B, LINE 6A: CLINTON HOSPITAL COLLABORATED WITH TWO OTHER HOSPITALS IN CONDUCTING THE 2011 COMMUNITY HEALTH ASSESSMENT OF NORTH CENTRAL MASSACHUSETTS IN A JOINT EFFORT BETWEEN THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH'S COMMUNITY HEALTH NETWORK AREA OF NORTH CENTRAL MASSACHUSETTS (CHNA 9) AND THE JOINT COALITION ON HEALTH (JCOH) ASSESSMENT. THEY INCLUDE HEALTHALLIANCE, AN AFFILIATE OF UMASS MEMORIAL HEALTH CARE AND HEYWOOD HOSPITAL. TOGETHER, THESE ENTITIES HAVE CAPITALIZED ON THEIR COMPLENTARY EXPERTISE AND HAVE PRODUCED A DOCUMENT THAT CAN BE USED BY STAKEHOLDERS FROM EVERY SECTOR OF THE COMMUNITY TO BETTER THE HEALTH AND WELFARE OF RESIDENTS OF NORTH CENTRAL MASSACHUSETTS. UMASS MEMORIAL MEDICAL CENTER, INC. PART V, SECTION B, LINE 6B: UMASS MEMORIAL CONDUCTED THE CHNA IN COLLABORATION WITH THE WORCESTER DIVISION OF PUBLIC HEALTH AND FALLON HEALTHADDITIONAL PARTNERS INCLUDED:YWCA OF CENTRAL MASOUTH EAST ASIAN COALITIONMARCH OF DIMESWORCESTER PUBLIC SCHOOLSFAMILY HEALTH CENTER OF WORCESTEREDWARD M. KENNEDY HEALTH CENTERUMASS MEDICAL SCHOOLWORCESTER POLICE DEPARTMENTWORCESTER SENIOR CENTERWORCESTER FOOD & ACTIVE LIVING POLICY COUNCILWALKBIKE WORCESTERREGIONAL ENVIRONMENTAL COUNCIL OF WORCESTERMA DEPARTMENT OF PUBLIC HEALTHUNITED WAY OF CENTRAL MACLARK UNIVERSITY MOSAKOWSKI INSTITUTE FOR PUBLIC ENTERPRISEWORCESTER REGIONAL RESEARCH BUREAU HEALTHALLIANCE HOSPITAL, INC. PART V, SECTION B, LINE 6B: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED WITH INPUT FROM OUR COMMNUNITY PARTNERS; COMMUNITY HEALTH CONNECTIONS, HEYWOOD HEALTHCARE, ATHOL HOSPITAL, HEYWOOD HOSPITAL, THE JOINT COALITION ON HEALTH AND THE MONTACHUSETT PUBLIC HEALTH NETWORK. MARLBOROUGH HOSPITAL PART V, SECTION B, LINE 6B: THE ASSESSMENT WAS DONE IN CONJUNCTION WITH METROWEST HEALTH FOUNDATION, EDWARD M. KENNEDY COMMUNITY HEALTH CENTER, AND SOUTHBOROUGH MEDICAL GROUP. CLINTON HOSPITAL ASSOCIATION PART V, SECTION B, LINE 6B: CLINTON HOSPITAL CONDUCTED THE CHNA WITH THE FOLLOWING LISTED ORGANIZATIONS:PARTNERS INCLUDED:- THE COMMUNITY HEALTH NETWORK AREA OF NORTH CENTRAL MASS. (CHNA 9)- THE JOINT COALITION ON HEALTH OF NORTH CENTRAL MASSACHUSETTS- THE MINORITY COALITION OF NORTH CENTRAL MASSACHUSETTS- THE QUALITATIVE WORK WAS COMPLETED WITH THE COMBINED EFFORTS OF THE MINORITY COALITION OF NORTH CENTRAL MASSACHUSETTS, THE SPANISH AMERICAN CENTER, CLEGHORN NEIGHBORHOOD CENTER, HEYWOOD HOSPITAL, HEALTHALLIANCE HOSPITAL, WHEAT, THREE PYRAMIDS, BEAUTIFUL GATE CHURCH, NEW HOPE COMMUNITY CHURCH, TWIN CITIES CDC, GARDNER CDC, MEMORIAL CONGREGATIONAL CHURCH, MONTACHUSETT OPPORTUNITY COUNCIL AND MANY OTHER AGENCIES AND INDIVIDUALS. UMASS MEMORIAL MEDICAL CENTER, INC. PART V, SECTION B, LINE 7D: THE CHNA WAS PUBLICLY ANNOUNCED TO THE COMMUNITY AT A PUBLIC EVENT ATTENDED BY MORE THAN 100 COMMUNITY STAKEHOLDERS AND HOSTED BY THE WORCESTER CITY MANAGER, WORCESTER DIRECTOR OF PUBLIC HEALTH, SENIOR VICE PRESIDENT OF UMASS MEMORIAL HEALTH CARE, PRESIDENT OF THE UMASS MEMORIAL HEALTH CARE HOSPITALS AND THE UMASS MEMORIAL VICE PRESIDENT OF COMMUNITY RELATIONS. THE HOSPITAL AND WDPH ALSO ENGAGED IN VARIOUS MEDIA VENUES INCLUDING; PRINT AND ONLINE ARTICLES IN LOCAL NEWS AND COMMUNITY NEWSPAPERS, CHNA-8, A HEALTHY COMMUNITIES COALITION AND INTERVIEWS TELEVISED ON WCCATV13. HEALTHALLIANCE HOSPITAL, INC. PART V, SECTION B, LINE 7D: THE LAST COMMUNITY HEALTH ASSESSMENT WAS MADE AVAILABLE THROUGH OUR WEBSITE AND PRESENTATIONS TO VARIOUS ORGANIZATIONS AND COMMUNITY FORUMS THROUGHOUT OUR SERVICE AREAS. THE COMMUNITY HEALTH ASSESSMENT IS ALSO AVAILABLE UPON REQUEST. YOU CAN FIND THE LINK TO OUR COMMUNITY HEALTH NEEDS ASSESSMENT HERE:HTTP://WWWW.UMASSMEMORIALHEALTHCARE.ORG/SITES/UMASS-MEMORIAL-HOSPITAL/FILES/DOCUMENTS/MEMBERS/5-21-15%20FINAL%20COMMUNITY_HEALTH_ASSESSMENT_OF_NORTH_CENTRAL_MA.PDF CLINTON HOSPITAL ASSOCIATION PART V, SECTION B, LINE 7D: CLINTON HOSPITAL ALSO UNVEILS THE COMMUNITY HEALTH ASSESSMENT TO COMMUNITY GROUPS, COMMUNITY ADVISORY COMMITTEE, AND TO THE HOSPITAL'S BOARD OF TRUSTEES. UMASS MEMORIAL MEDICAL CENTER, INC. PART V, SECTION B, LINE 11: THE CHNA PROCESS WAS LEAD BY THE WORCESTER DIVISION OF PUBLIC HEALTH, FALLON HEALTH AND THE HOSPITAL VICE PRESIDENT OF COMMUNITY BENEFITS, AND INCLUDED INPUT FROM APPROXIMATELY 100 COMMUNITY STAKEHOLDERS. FURTHERMORE, THE CHNA PROCESS HAS RESULTING IN THE DEVELOPMENT OF THE 2016 GREATER WORCESTER COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). THE HOSPITAL'S COMMUNITY BENEFIT IMPLEMENTATION STRATEGY HAS ALIGNMENT WITH THE CHNA/CHIP. THE OTHER NEEDS THAT ARE NOT INCLUDED IN THE CHNA/CHIP ARE NOT BEING ADDRESSED BECAUSE THEY ARE NOT A PART OF THE IDENTIFIED PRIORITY AREAS AND DUE TO LIMITED FUNDING. HEALTHALLIANCE HOSPITAL, INC. PART V, SECTION B, LINE 11: THE HOSPITAL RESPONDS TO PRIORITY HEALTH NEEDS IN MANY WAYS, AND IN TIMES THAT ARE CRITICAL FOR PATIENTS IN CRISIS. IN ADDITION TO CHARITY CARE, INDIGENT CARE, A SIGNIFICANT NUMBER OF PROGRAMS AND SERVICES OFFERED ADDRESS SOME OF THE PRIORITY NEEDS IDENTIFIED IN THE CHNA. OUR HOSPITAL DOES NOT HAVE THE AVAILABLE RESOURCES TO DEVELOP INITIATIVES TO MEET ALL IDENTIFIED HEALTH NEEDS, WHICH MAKES COLLABORATION WITH COMMUNITY RESOURCES CRITICAL. MARLBOROUGH HOSPITAL PART V, SECTION B, LINE 11: THE HOSPITAL RESPONDS TO PRIORITY HEALTH NEEDS IN MANY WAYS, AND IN TIMES THAT ARE CRITICAL FOR PATIENTS IN CRISIS. IN ADDITION TO CHARITY CARE, INDIGENT CARE, A SIGNIFICANT NUMBER OF PROGRAMS AND SERVICES OFFERED ADDRESS THE PRIORITY NEEDS IDENTIFIED IN THE 2013 CHNA. OUR HOSPITAL DOES NOT HAVE THE AVAILABLE RESOURCES TO DEVELOP INITIATIVES TO MEET EVERY PRIORITY HEALTH NEED IDENTIFIED, WHICH MAKES COLLABORATION WITH COMMUNITY ASSETS CRITICAL. THE HOSPITAL IS NOT CURRENTLY ADDRESSING ALL CHRONIC CONDITIONS DUE TO LIMITED RESOURCES. CLINTON HOSPITAL ASSOCIATION PART V, SECTION B, LINE 11: THE HOSPITAL RESPONDS TO PRIORITY HEALTH NEEDS IN MANY WAYS, AND IN TIMES THAT ARE CRITICAL FOR NORTH CENTRAL MA COMMUNITY, AND PATIENTS IN CRISIS. IN ADDITION TO CHARITY CARE, INDIGENT CARE, A NUMBER OF PROGRAMS AND SERVICES OFFERED ADDRESS SOME OF THE PRIORITY NEEDS IDENTIFIED IN THE CHNA. OUR HOSPITAL DOES NOT HAVE THE AVAILABLE RESOURCES TO DEVELOP INITIATIVES TO MEET EVERY PRIORITY HEALTH NEED IDENTIFIED, WHICH MAKES COLLABORATION WITH COMMUNITY ASSETS CRITICAL. HEALTHALLIANCE HOSPITAL, INC. PART V, SECTION B, LINE 13H: FINANCIAL ASSISTANCE - HAH EMPLOYS A STAFF OF FINANCIAL COUNSELORS, CERTIFIED APPLICATION COUNSELORS, CUSTOMER SERVICE REPRESENTATIVES AND GUARANTOR COLLECTORS WHO ARE AVAILABLE BY PHONE OR BY APPOINTMENT TO SUPPORT PATIENTS IN APPLYING FOR FINANCIAL ASSISTANCE AND RESOLVING THEIR MEDICAL BILLS. FINANCIAL COUNSELORS, CERTIFIED APPLICATION COUNSELORS, CUSTOMER SERVICE REPRESENTATIVES AND GUARANTOR COLLECTORS PROVIDE POTENTIALLY ELIGIBLE PATIENTS WITH THE APPROPRIATE METHODS OF APPLYING FOR HEALTH CARE COVERAGE AS LISTED ON THE MASSACHUSETTS CONNECTORCARE WEBSITE. UMASS MEMORIAL MEDICAL CENTER, INC. PART V, SECTION B, LINE 16I: FINANCIAL ASSISTANCE - UMASSMEMORIAL MEDICAL CENTER EMPLOYS A STAFF OF FINANCIAL COUNSELORS, CERTIFIED APPLICATION COUNSELORS, CUSTOMER SERVICE REPRESENTATIVES AND GUARANTOR COLLECTORS WHO ARE AVAILABLE BY PHONE OR BY APPOINTMENT TO SUPPORT PATIENTS IN APPLYING FOR FINANCIAL ASSISTANCE AND RESOLVING THEIR MEDICAL BILLS. FINANCIAL COUNSELORS, CERTIFIED APPLICATION COUNSELORS, CUSTOMER SERVICE REPRESENTATIVES AND GUARANTOR COLLECTORS PROVIDE POTENTIALLY ELIGIBLE PATIENTS WITH THE APPROPRIATE METHODS OF APPLYING FOR HEALTH CARE COVERAGE AS LISTED ON THE MASSACHUSETTS CONNECTORCARE WEBSITE. HEALTHALLIANCE HOSPITAL, INC. PART V, SECTION B, LINE 16I: PATIENTS WHO ARE SCHEDULED TO BE ADMITTED AND HAVE BEEN IDENTIFIED AS NON INSURED AND/OR IN NEED OF FINANCIAL ASSISTANCE WILL HAVE AN APPOINTMENT SCHEDULED PRIOR TO ADMISSION TO MEET WITH A FINANCIAL COUNSELOR. PATIENTS, WHO ARE ADMITTED TO THE HOSPITAL THROUGH THE EMERGENCY DEPARTMENT, WILL BE VISITED BY THE FINANCIAL COUNSELOR ONCE THE PATIENT IS ON THE INPATIENT FLOOR. THE MEETING WILL BE HELD WITH THE PATIENT AND/OR FAMILY AS THE PATIENT'S MEDICAL CONDITION PERMITS. MARLBOROUGH HOSPITAL PART V, SECTION B, LINE 16I: FINANCIAL ASSISTANCE - MARLBOROUGH HOSPITAL EMPLOYS FINANCIAL COUNSELORS WHO ARE AVAILABLE BY PHONE OR BY APPOINTMENT TO SUPPORT PATIENTS IN APPLYING FOR FINANCIAL ASSISTANCE AND FOR HELP RESOLVING THEIR MEDICAL BILLS. FINANCIAL COUNSELORS PROVIDE POTENTIALLY ELIGIBLE PATIENTS WITH THE APPROPRIATE METHODS OF APPLYING FOR HEALTH CARE COVERAGE AS LISTED ON THE MASSACHUSETTS CONNECTORCARE WEBSITE. CLINTON HOSPITAL ASSOCIATION PART V, SECTION B, LINE 16I: FINANCIAL ASSISTANCE - CLINTON HOSPITAL EMPLOYS A STAFF OF FINANCIAL COUNSELORS, CERTIFIED APPLICATION COUNSELORS, CUSTOMER SERVICE REPRESENTATIVES AND GUARANTOR COLLECTORS WHO ARE AVAILABLE BY PHONE OR BY APPOINTMENT TO SUPPORT PATIENTS IN APPLYING FOR FINANCIAL ASSISTANCE AND RESOLVING THEIR MEDICAL BILLS. FINANCIAL COUNSELORS, CERTIFIED APPLICATION COUNSELORS, CUSTOMER SERVICE REPRESENTATIVES AND GUARANTOR COLLECTORS PROVIDE POTENTIALLY ELIGIBLE PATIENTS WITH THE APPROPRIATE METHODS OF APPLYING FOR HEALTH CARE COVERAGE AS LISTED ON THE MASSACHUSETTS CONNECTORCARE WEBSITE. UMASS MEMORIAL MEDICAL CENTER, INC. PART V, SECTION B, LINE 18D: POLICY ON LIENS-NO LIENS WILL BE INITIATED AGAINST A PATIENT'S PRIMARY RESIDENCE OR MOTOR VEHICLE WITHOUT WRITTEN APPROVAL FROM UMMMC'S BOARD OF TRUSTEES. ALL APPROVALS BY THE BOARD OF TRUSTEES WILL BE MADE ON AN INDIVIDUAL CASE BASES. WE ALSO SEND STATEMENTS AND MAKE PHONE CALLS. HEALTHALLIANCE HOSPITAL, INC. PART V, SECTION B, LINE 18D: POLICY ON LIENS-NO LIENS WILL BE INITIATED AGAINST A PATIENT'S PRIMARY RESIDENCE OR MOTOR VEHICLE WITHOUT WRITTEN APPROVAL FROM HEALTHALLIANCE'S BOARD OF TRUSTEES. ALL APPROVALS BY THE BOARD OF TRUSTEES WILL BE MADE ON AN INDIVIDUAL CASE BASES. WE ALSO SEND STATEMENTS AND MAKE PHONE CALLS. MARLBOROUGH HOSPITAL PART V, SECTION B, LINE 18D: POLICY ON LIENS-NO LIENS WILL BE INITIATED AGAINST A PATIENT'S PRIMARY RESIDENCE OR MOTOR VEHICLE WITHOUT WRITTEN APPROVAL FROM MARLBOROUGH'S BOARD OF TRUSTEES. ALL APPROVALS BY THE BOARD OF TRUSTEES WILL BE MADE ON AN INDIVIDUAL CASE BASES. WE ALSO SEND STATEMENTS AND MAKE PHONE CALLS. CLINTON HOSPITAL ASSOCIATION PART V, SECTION B, LINE 18D: POLICY ON LIENS-NO LIENS WILL BE INITIATED AGAINST A PATIENT'S PRIMARY RESIDENCE OR MOTOR VEHICLE WITHOUT WRITTEN APPROVAL FROM CLINTON'S BOARD OF TRUSTEES. ALL APPROVALS BY THE BOARD OF TRUSTEES WILL BE MADE ON AN INDIVIDUAL CASE BASES. WE ALSO SEND STATEMENTS AND MAKE PHONE CALLS. UMASS MEMORIAL MEDICAL CENTER, INC. PART V, SECTION B, LINE 19D: UMMMC REFERS ACCOUNTS TO A CREDIT AGENCY WHEN WRITTEN OFF AS BAD DEBT FOR FURTHER COLLECTIONS. THESE AGENCIES CONTINUE COLLECTIONS WITHOUT IMPACT TO THE CREDIT RATING. HEALTHALLIANCE HOSPITAL, INC. PART V, SECTION B, LINE 19D: HEALTHALLIANCE HOSPITAL REFERS ACCOUNTS TO A CREDIT AGENCY WHEN WRITTEN OFF AS BAD DEBT FOR FURTHER COLLECTIONS. THESE AGENCIES CONTINUE COLLECTIONS WITHOUT IMPACT TO THE CREDIT RATING. MARLBOROUGH HOSPITAL PART V, SECTION B, LINE 19D: MARLBOROUGH ENGAGES A THIRD PARTY AGENCY TO ASSIST ON ALL SELF PAY ACCOUNTS AT ORIGINATION. THEY REFER ACCOUNTS TO A CREDIT AGENCY WHEN WRITTEN OFF AS BAD DEBT FOR FURTHER COLLECTIONS. THESE AGENCIES CONTINUE COLLECTIONS WITHOUT IMPACT TO THE CREDIT RATING. CLINTON HOSPITAL ASSOCIATION PART V, SECTION B, LINE 19D: CLINTON REFERS ACCOUNTS TO A CREDIT AGENCY WHEN WRITTEN OFF AS BAD DEBT FOR FURTHER COLLECTIONS. THESE AGENCIES CONTINUE COLLECTIONS WITHOUT IMPACT TO THE CREDIT RATING. HEALTHALLIANCE HOSPITAL, INC. PART V, SECTION B, LINE 20E: 1. PATIENTS WITH SELF-PAY RESPONSIBILITIES, INCLUDING EMERGENCY, ELECTIVE, SCHEDULED AND URGENT SERVICES WILL RECEIVE AN INITIAL BILL DELINEATING THE SERVICES AND AMOUNTS DUE FOR WHICH THEY ARE RESPONSIBLE.2. FOR ANY SELF-PAY RESPONSIBILITIES THAT REMAIN UNPAID AFTER THE INITIAL BILL, THE PATIENT WILL RECEIVE A SERIES OF MONTHLY STATEMENTS FOR 4 MONTHS OR UNTIL THE BALANCE IS RESOLVED, THE 4TH STATEMENT INDICATED AS A FINAL NOTICE. 3. PROVIDER ACCOUNTING STAFF WILL MAKE A TELEPHONE CALL TO ANY PATIENT WITH AN OUTSTANDING SELF-PAY BALANCE OF $1,000 OR MORE DURING THE NORMAL SELF-PAY BILLING AND COLLECTION PROCESS. 4. HAH WILL SEND A FINAL NOTICE BY CERTIFIED MAIL FOR BALANCES OVER $1,000 WHERE NOTICES HAVE NOT BEEN RETURNED AS "INCORRECT ADDRESS OR "UNDELIVERABLE" FOR EMERGENCY CARE PATIENTS.5. ADDITIONAL NOTICES AND/OR LETTERS MAY BE SENT TO DEBTOR PATIENTS DURING THE BILLING AND COLLECTION PROCESS IN AN EFFORT TO RESOLVE OUTSTANDING BALANCES.6. RETURNED MAIL AND/OR UNDELIVERABLE MAIL WILL BE RESEARCHED BY THE PROVIDER ACCOUNTING STAFF TO OBTAINED VALID ADDRESSES. DATABASES AND PRIOR VISIT INFORMATION WILL BE UTILIZED.7. ALL SUCH EFFORTS TO COLLECT BALANCES, AS WELL AS ANY PATIENT INITIATED INQUIRIES, WILL BE DOCUMENTED ON THE GUARANTOR'S ACCOUNT AND AVAILABLE FOR REVIEW. UMASS MEMORIAL MEDICAL CENTER, INC. PART V, SECTION B, LINE 22D: THE HOSPITAL FACILITY BILLS GROSS CHARGES WITH A 20% PROMPT PAY DISCOUNT. ONCE A PATIENT IS DETERMINED ELIGIBLE FOR A DISCOUNT, THIS DISCOUNT IS APPLIED TO TOTAL CHARGES AND THE PATIENT RESPONSIBILITY IS REDUCED. HEALTHALLIANCE HOSPITAL, INC. PART V, SECTION B, LINE 22D: HEALTHALLIANCE CHARGES ALL PATIENTS THE PUBLISHED CHARGE. WHEN THE PATIENT HAS BEEN DETERMINED FOR A DISCOUNT, THE DISCOUNT IS THEN APPLIED TO THE TOTAL CHARGE, AND THE AMOUNT OWED BY THE GUARANTOR IS NOW REDUCED. MARLBOROUGH HOSPITAL PART V, SECTION B, LINE 22D: THE HOSPITAL FACILITY BILLS GROSS CHARGES WITH A 20% PROMPT PAY DISCOUNT. CLINTON HOSPITAL ASSOCIATION PART V, SECTION B, LINE 22D: THE HOSPITAL FACILITY BILLS GROSS CHARGES WITH A 20% PROMPT PAY DISCOUNT. ONCE A PATIENT IS DETERMINED ELIGIBLE FOR A DISCOUNT, THE DISCOUNT IS APPLIED TO TOTAL CHARGES AND THE PATIENT RESPONSIBILITY IS REDUCED. UMASS MEMORIAL MEDICAL CENTER, INC. PART V, SECTION B, LINE 24: UMMMC CHARGES ALL PATIENTS THE PUBLISHED CHARGE. WHEN THE PATIENT HAS BEEN DETERMINED FOR A DISCOUNT, THE DISCOUNT IS THEN APPLIED TO THE TOTAL CHARGE, AND THE AMOUNT OWED BY THE GUARANTOR IS NOW REDUCED. HEALTHALLIANCE HOSPITAL, INC. PART V, SECTION B, LINE 24: HEALTHALLIANCE CHARGES ALL PATIENTS THE PUBLISHED CHARGE. WHEN THE PATIENT HAS BEEN DETERMINED FOR A DISCOUNT, THE DISCOUNT IS THEN APPLIED TO THE TOTAL CHARGE, AND THE AMOUNT OWED BY THE GUARANTOR IS NOW REDUCED. MARLBOROUGH HOSPITAL PART V, SECTION B, LINE 24: MARLBOROUGH CHARGES ALL PATIENTS THE PUBLISHED CHARGE. WHEN THE PATIENT HAS BEEN DETERMINED FOR A DISCOUNT, THE DISCOUNT IS THEN APPLIED TO THE TOTAL CHARGE, AND THE AMOUNT OWED BY THE GUARANTOR IS NOW REDUCED. CLINTON HOSPITAL ASSOCIATION PART V, SECTION B, LINE 24: CLINTON CHARGES ALL PATIENTS THE PUBLISHED CHARGE. WHEN THE PATIENT HAS BEEN DETERMINED FOR A DISCOUNT, THE DISCOUNT IS THEN APPLIED TO THE TOTAL CHARGE, AND THE AMOUNT OWED BY THE GUARANTOR IS NOW REDUCED. PART V LINE 7A & 7B UMASS MEMORIAL MEDICAL CENTER:YES, THE CHNA WAS POSTED ON THE HOSPITAL WEBSITE AND THE WORCESTER DIVISION OF PUBLIC HEALTH WEBSITE: (NOTE: THE FULL URLS INDICATED BELOW DID NOT FIT IN THEIR ENTIRETY ON THE UMASS MEMORIAL MEDICAL CENTER SCHEDULE H FORM).HOSPITAL WEBSITE: HTTP://WWW.UMASSMEMORIALHEALTHCARE.ORG/SITES/UMASS-MEMORIAL-HOSPITAL/FILES/DOCUMENTS/ABOUT/UMASS_MEMORIAL_CBI_MEASURES-CHAFINAL.PDFWORCESTER DIVISION OF PUBLIC HEALTH WEBSITE: HTTP://WWW.WORCESTERMA.GOV/UPLOADS/E3/8B/E38B32C7D4A96243C9C48BBD3250B00E/CHA-REPORT.PDFCLINTON HOSPITAL:YES, CLINTON HOSPITAL MAKES THE CHNA REPORT WIDELY AVAILABLE TO THE PUBLIC AND IT IS POSTED ON THE HOSPITAL'S WEBSITE:HTTP://WWW.UMASSMEMORIALHEALTHCARE.ORG/CLINTON-HOSPITAL/ABOUT-USTHE COMMUNITY BENEFITS REPORT IS ALSO POSTED ON THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH'S COMMUNITY NETWORK AREA OF NORTH CENTRAL, LINK:HTTP://WWW.CI.FITCHBURG.MA.US/GOVERNMENT/DEPARTMENTS/HEALTH/MPHN-PAGE/AND THE JOINT COALITION ON HEALTH (JCOH) WEBSITES WITH AVAILABILITY UPON REQUEST BY ANY OF THE ORGANIZATIONS MENTIONED. 4 UMASS MEMORIAL MED CENTER (LAB SVCS) BIOTECH ONE 365 PLANTATION STREET WORCESTER MA 01605 SATELLITE - LAB SERVICES UMASS MEMORIAL MED CENTER (PATHOLOGY) BIOTECH THREE ONE INNOVATION DRIVE WORCESTER MA 01605 SATELLITE - PATHOLOGY UMASS MEMORIAL MED CENTER AMBULANCE 23 WELLS STREET WORCESTER MA 01604 SATELLITE - AMBULATORY SERVICES UMASS MEMORIAL MED CENTER 100 PROVIDENCE STREET WORCESTER MA 01604 SATELLITE - AMBULATORY SERVICES PART I OTHER - RESEARCH EXPENSES THE AMOUNT OF RESEARCH EXPENSES FOR FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS BEING REPORTED BY UMASS MEMORIAL HEALTH CARE IS LOW SINCE THESE COSTS ARE SUPPORTED BY THE UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL. THE MEDICAL SCHOOL IS CLOSELY ASSOCIATED WITH UMASS MEMORIAL HEALTH CARE AND PROVIDES A SIGNIFICANT NUMBER OF COMMUNITY BASED PROGRAMS. PART II, COMMUNITY BUILDING ACTIVITIES: UMASS MEMORIAL MEDICAL CENTER: UMMC RECOGNIZES THE COMMUNITY BUILDING ACTIVITIES AS BEING A PART OF THE "SOCIAL DETERMINANTS OF HEALTH" THAT IMPACT THE HEALTH OF THE COMMUNITY. WE INVEST IN YOUTH WORKFORCE DEVELOPMENT FOR AT-RISK YOUTH. PROGRAMS ARE BASED ON OUR COMMUNITY BENEFITS MISSION WHICH WAS RECOMMENDED BY A COMMUNITY BENEFITS ADVISORY COMMITTEE AND DRAWS INSPIRATION FROM THE WORLD HEALTH ORGANIZATION'S BROAD DEFINITION OF HEALTH, AS "A STATE OF COMPLETE, PHYSICAL, MENTAL AND SOCIAL WELL BEING AND NOT MERELY THE ABSENCE OF DISEASE." BY ADOPTING THIS DEFINITION, UMASS MEMORIAL MEDICAL CENTER HAS EXPANDED ITS STRATEGY TO INCLUDE THE SOCIAL AND ECONOMIC OBSTACLES THAT PREVENT PEOPLE FROM ACHIEVING OPTIMAL HEALTH. ALL OF OUR COMMUNITY BUILDING ACTIVITIES ARE THE RESULT OF AN IDENTIFIED NEED AND ENGAGE THE COMMUNITY. THEY INCLUDE COLLABORATIVE EFFORTS, ADVOCACY ACTIVITIES AND PARTNERSHIPS THAT ENGAGE A BROAD ARRAY OF COMMUNITY STAKEHOLDERS IN ADDRESSING THESE UNMET SOCIAL DETERMINANTS OF HEALTH.COMMUNITY BUILDING ACTIVITY EXAMPLES INCLUDE: FUNDING AND PROMOTING WORKFORCE AND HEALTH CAREER DEVELOPMENT OPPORTUNITIES FOR INNER-CITY YOUTH.HEALTHALLIANCE HOSPITAL: FOR WORKFORCE DEVELOPMENT HEALTHALLIANCE HAS PROVIDED FINANCIAL ASSISTANCE TO STUDENTS WHO WISH TO PURSUE A CAREER IN THE HEALTH CARE FIELD VIA AN INTERNSHIP PROGRAM PROVIDING FINANCIAL ASSISTANCE AND EXPERIENCE THROUGH HANDS ON PRACTICE AND OBSERVATION. FOR COMMUNITY SUPPORT, COMMUNITY EMERGENCY PREPAREDNESS AND DRILLS ARE CONDUCTED IN COLLABORATION WITH THE LEOMINSTER AND FITCHBURG FIRE DEPARTMENTS AND MEDSTAR EMS.MARLBOROUGH HOSPITAL: MARLBOROUGH HOSPITAL PROVIDES ASSISTANCE TO COGNITIVELY CHALLENGED POST GRAD STUDENTS AGED 18 TO 22 BY HELPING THEM GAIN WORK/LIFE SKILLS TO ASSIST THEM IN THEIR TRANSITION FROM A SCHOOL ENVIRONMENT TO A WORK AND COMMUNITY SETTING. ADDITIONALLY, DISADVANTAGED STUDENTS, INCLUDING BOTH ECONOMICALLY OR DISENGAGED YOUTH AT RISK, LEARN THE TOOOLS TO OVERCOME BARRIERS AND MOVE INTO SELF SUSTAINING EMPLOYMENT IN SECTORS OF THE ECONOMY WHERE THERE IS A NEED.CLINTON HOSPITAL: CLINTON HOSPITAL IS WORKING TO ADDRESS BASIC, SOCIAL AND PERSONAL NEEDS AS A WAY TO IMPROVE THEIR COMMUNITIES' HEALTH. CLINTON HOSPITAL PROVIDES HIGH SCHOOL STUDENTS WITH THE OPPORTUNITY OF A HEALTH CAREER PREPARATION PROGRAM. THE PROGRAM EXPOSES STUDENTS TO HEALTH CAREER POSSIBILITIES, ROLE MODELS AND HOW HEALTH ORGANIZATIONS OPERATE; IT IS ALSO AN OPPORTUNITY FOR PRACTICAL EXPERIENCE TO LEARN BY DOING AND APPLYING THE KNOWLEDGE. THE STUDENTS LEARN NEW SKILLS AND DEVELOP THEIR OWN PERSONAL AND PROFESSIONAL INTERESTS. THEY ALSO EXPAND THEIR EDUCATIONAL OPPORTUNITIES, PERSONAL NETWORK AND MAKE CONNECTIONS. THIS PROGRAM WAS DEVELOPED AND IMPLEMENTED IN RESPONSE TO AN IDENTIFIED NEED IN THE COMMUNITY. WORKFORCE DEVELOPMENT IS IDENTIFIED AS A NEED NATIONALLY AND IN ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. CLINTON HOSPITAL PARTNERED WITH THE CLINTON PUBLIC HIGH SCHOOL AND THE WORKFORCE INVESTMENT BOARD TO IMPLEMENT THE PROGRAM. PART III, LINE 8: THE MEDICARE COSTS ARE OBTAINED FROM THE COST REPORT FOR INPATIENT, PSYCHIATRIC, CAPITAL, AND OUTPATIENT SERVICES. IN ADDITION, FEE BASED SERVICES SUCH AS LABS, PT, OT, ETC., ARE DETERMINED THROUGH PS&R CHARGES TIMES OUTPATIENT COST TO CHARGE RATIO. PART III, LINE 9B: EXEMPTION FROM SELF-PAY BILLING AND COLLECTION ACTION - THE ORGANIZATION WILL NOT INITIATE SELF-PAY BILLING AND COLLECTION ACTIVITY:A. UPON SUFFICIENT PROOF THAT A PATIENT IS A RECIPIENT OF EMERGENCY AID TO THE ELDERLY, DISABLED AND CHILDREN (EAEDC), OR ENROLLED IN THE HEALTH SAFETY NET (HSNO) OR MASSHEALTH, HEALTHY START, OR THE CHILDREN'S MEDICAL SECURITY PLAN WHOSE FAMILY INCOME IS EQUAL OR LESS THAN 400% OF THE FPL, WITH THE EXCEPTION OF CO-PAYS AND DEDUCTIBLES REQUIRED UNDER THE PROGRAM OF ASSISTANCE.B. IF THE HOSPITAL HAS PLACED THE ACCOUNT IN LEGAL OR ADMINISTRATIVE HOLD STATUS AND/OR SPECIFIC PAYMENT ARRANGEMENTS HAVE BEEN MADE WITH THE PATIENT OR GUARANTOR.C. FOR MEDICAL HARDSHIP BILLS THAT EXCEED THE MEDICAL HARDSHIP CONTRIBUTION.D. UNLESS UMMMC HAS CHECKED THE EVS SYSTEM TO DETERMINE IF THE PATIENT HAS FILED AN APPLICATION FOR MASSHEALTH.E. FOR PARTIAL HEALTH SAFETY NET ELIGIBLE PATIENTS, WITH THE EXCEPTION OF ANY DEDUCTIBLES REQUIRED.NOTE: THE ORGANIZATION MAY BILL FOR HEALTH SAFETY NET ELIGIBLE AND MEDICAL HARDSHIP PATIENTS FOR NON-MEDICALLY NECESSARY SERVICES PROVIDED AT THE REQUEST OF THE PATIENT AND FOR WHICH THE PATIENT HAS AGREED BY WRITTEN CONSENT. PART V, SECTION B, LINE 9: UMASS MEMORIAL MEDICAL CENTER, INC.UMMCI MOST RECENTLY ADOPTED AN IMPLEMENTATION STRATEGY IN APRIL 2016, EFFECTIVELY DURING THE 2015 FISCAL TAX YEAR. HOWEVER, THIS IS NOT AN ALLOWED RESPONSE FOR E-FILING PURPOSES, AS SUCH 2014 HAS BEEN ENTERED AS A RESPONSE ON THIS LINE. PART VI, LINE 2: UMASS MEMORIAL MEDICAL CENTER COMPLETED ITS COMMUNITY HEALTH NEEDS ASSESSMENT BY ASSEMBLING A DIVERSE GROUP OF COMMUNITY STAKEHOLDERS THAT INCLUDE, BUT ARE NOT LIMITED TO, MEMBERS OF HEALTH AND HUMAN SERVICE ORGANIZATIONS, PHILANTHROPY, COMMUNITIES OF COLOR, NEIGHBORHOOD RESIDENTS AND THE WORCESTER DIVISION OF PUBLIC HEALTH AS PART OF THE GROUP THAT ASSISTED AND GUIDED THE ASSESSMENT PROCESS. THE HOSPITALS COMMUNITY BENEFIT IMPLEMENTATION STRATEGY IS ALIGNED WITH THE CHIP. THE OTHER NEEDS THAT ARE NOT INCLUDED IN THE CHNA/CHIP ARE NOT BEING ADDRESSED BECAUSE THEY ARE NOT A PART OF THE FIVE IDENTIFIED PRIORITY CHIP DOMAIN AREAS AND DUE TO LIMITED FUNDING. THE FOLLOWING STRATEGIES ARE CONDUCTED TO COMPLETE THE ASSESSMENT:- CONDUCTED KEY INFORMANT INTERVIEWS AND FOCUS GROUPS WITH COMMUNITY-BASED ORGANIZATIONS AND RESIDENTS- CONDUCTED OUTREACH EFFORTS TO MEDICALLY-UNDERSERVED POPULATIONS AND CONVENE MEETINGS WITH NEIGHBORHOOD/COMMUNITY GROUPS- REVIEWED PRIMARY AND SECONDARY DATA- CONDUCTED ONLINE COMMUNITY SURVEY- ORGANIZED COMMUNITY FORUMS TO SHARE FINDINGS AND RELEASE OF FINAL REPORT - ORGANIZED TASK FORCES FOR FURTHER ACTION TO IDENTIFY PRIORITY AREASTHE FOLLOWING SOURCES INFORM AND ENHANCE OUR EFFORTS TO IDENTIFY PRIORITIES AND UNMET NEEDS:- U.S. CENSUS 2010- HEALTHY PEOPLE 2020- NATIONAL PREVENTION STRATEGY- MASSACHUSETTS DEPARTMENT OF EDUCATION REPORTS INCLUDING LOCAL ENROLLMENT AND LANGUAGE DATA - MASSACHUSETTS DEPARTMENT OF EMPLOYMENT AND TRAINING- HOSPITAL UTILIZATION DATA - MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH/ MASSCHIP- DATA FROM VARIOUS CITY OF WORCESTER DEPARTMENTS INCLUDING, BUT NOT LIMITED TO, THE LOCAL DIVISION OF PUBLIC HEALTH, NEIGHBORHOOD SERVICES AND POLICE.- INFORMATION COLLECTED FROM HEALTH CARE PROVIDERS, COMMUNITY GROUPS/UNDERSERVED POPULATIONS AND INDIVIDUALS WHO HAVE EXPERTISE ON COMMUNITY HEALTH ISSUES.HEALTHALLIANCE HOSPITAL:THE COMMUNITY HEALTH NEEDS ASSESSMENT COMPREHENSIVE PROCESS CONSISTED OF COLLECTING QUANTITATIVE AND QUALITATIVE DATA THROUGH FOCUS GROUPS WITH COMMUNITY MEMBERS AND INTERVIEWS WITH COMMUNITY MEMBERS AND COMMUNITY LEADERS. PARTICIPANTS WERE FROM COMMUNITY-BASED ORGANIZATIONS, EDUCATIONAL, CIVIC, GOVERNMENTAL, FAITH-BASED PROFESSIONALS, HEALTH CARE PROVIDERS, AND OTHERS. WE MAKE A STRONG EFFORT TO ENSURE RACIAL/ETHNIC, SOCIOECONOMIC, AND GEOGRAPHIC DIVERSITY IN THE COMPOSITION OF ALL FOCUS GROUPS AND INTERVIEWS. THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED WITH HEALTHALLIANCE HOSPITAL AND HEYWOOD HEALTHCARE (HEYWOOD HOSPITAL AND ATHOL HOSPITAL).MARLBOROUGH HOSPITAL:THE COMMUNITY BENEFITS ADVISORY COUNCIL, COMPRISED OF MEMBERS OF DIFFERENT AGENCIES AND BUSINESSES IN THE AREA, HELPS TO IDENTIFY PROGRAMS IN SUPPORT OF THE COMMUNITY PRIORITIES. THE ASSESSMENT WAS COMPLETED IN CONJUNCTION WITH THE METROWEST HEALTH FOUNDATION, EDWARD M. KENNEDY COMMUNITY HEALTH CENTER, BOARDS OF HEALTH FROM MARLBOROUGH AND HUDSON AND THE SOUTHBOROUGH MEDICAL GROUP.CLINTON HOSPITAL:CLINTON HOSPITAL CONDUCTED A COMMUNITY HEALTH ASSESSMENT (CHNA) IN COLLABORATION WITH THE MONTACHUSETT PUBLIC HEALTH NETWORK (MPHN), THE JOINT COALITION ON HEALTH OF NORTH CENTRAL MASSACHUSETTS (JCOH) AND COMMUNITY HEALTH NETWORK AREA 9 (CHNA9) IN 2014. THE JCOH IS A GROUP OF COMMITTED INDIVIDUALS AND ORGANIZATIONS WORKING COLLABORATIVELY AS CATALYSTS FOR CHANGE AND AS ADVOCATES FOR THE UNDERSERVED TO IMPROVE THE HEALTH AND WELL-BEING OF EVERYONE IN NORTH CENTRAL MASSACHUSETTS. THE MONTACHUSETTS PUBLIC HEALTH NETWORK (MPHN) IS A COLLABORATIVE COMMITTEE OF ALL THE BOARD OF HEALTH'S COVERING THE MONTACHUSETT REGION (ATHOL, GARDNER, FITCHBURG, LEOMINSTER, WESTMINSTER, PRINCETON, STERLING, ROYALSTON, PHILLIPSTON, TEMPLETON AND CLINTON) THE STATE GOAL OF THE MPHN IS "RAISING THE HEALTH STATUS OF THE RESIDENTS OF OUR COMMUNITIES TO THE HIGHEST LEVELS ANYWHERE IN THE COUNTRY". THE COMMUNITY HEALTH NETWORK OF NORTH CENTRAL MASSACHUSETTS (CHNA9) IS ONE OF 17 CHNAS ACCROSS MASSACHUSETTS, CREATED BY THE DEPARTMENT OF PUBLIC HEALTH IN 1992. CHNA-9 MISSION BRINGS TOGETHER AND SUPPORTS DIVERSE VOICES TO PROMOTE HEALTH EQUITY IN OUR COMMUNITIES. CLINTON HOSPITAL TOOK INTO ACCOUNT INPUT FROM REPRESENTATIVES OF THE COMMUNITY, INCLUDING DIVERSE MEMBERS WHO WERE INTERVIEWED IN THE COMMUNITY HEALTH ASSESSMENT FOCUS GROUPS. CLINTON HOSPITAL UTILIZED THE INFORMATION IN THE CHNA TO COLLABORATE WITH OTHER COMMUNITY BASED ORGANIZATIONS TO ADOPT IMPLEMENTATION STRATEGIES THAT ADDRESS THE UNMET HEALTH NEEDS OF CLINTON HOSPITAL'S CATCHMENT AREA. PART VI, LINE 4: GEOGRAPHICAL REACH: THE 2015 COMMUNITY HEALTH ASSESSMENT (CHA) AND SUBSEQUENT GREATER WORCESTER COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOCUSES ON THE CITY OF WORCESTER AND THE OUTLYING COMMUNITIES OF SHREWSBURY, MILLBURY, WEST BOYLSTON, LEICESTER, GRAFTON AND HOLDEN, A SUB-SECTION OF ITS PRIMARY SERVICE AREA. THIS SPECIFIC GEOGRAPHIC AREA IS THE FOCUS FOR THE CITY OF WORCESTER DIVISION OF PUBLIC HEALTH REGIONALIZATION INTITIATIVE, AND OVERLAPS WITH THE SERVICE AREA OF MANY OTHER LOCAL ORGANIZATIONS. FOCUSING UMASS MEMORIAL'S CHNA ON THIS GEOGRAPHIC AREA FACILITATES THE ALIGNMENT OF THE HOSPITAL'S EFFORTS WITH COMMUNITY AND GOVERNMENTAL PARTNERS, SPECIFICALLY THE CITY HEALTH DEPARTMENT, THE AREA FEDERALLY QUALIFIED HEALTH CENTERS, AND COMMUNITY-BASED ORGANIZATIONS. THIS FOCUS ALSO FACILITATES COLLABORATION WITH THE CHIP ADVISORY COMMITTEE THAT IMPLEMENTS KEY STRATEGIES OF THE CHIP SO THAT FUTURE INITIATIVES CAN BE DEVELOPED IN A MORE COORDINATED APPROACH.REGIONAL DESCRIPTION: THE CITY OF WORCESTER IS VERY ETHNICALLY-DIVERSE, CONSIDERABLY MORE SO THAN THE NATION AND STATE OVERALL. THE NUMBER OF HISPANICS LIVING IN THE CITY HAS GROWN BY 35% OVER THE PAST 10 YEARS. REFUGEES FROM IRAQ CURRENTLY ACCOUNT FOR THE GREATEST PERCENTAGE OF NEW IMMIGRANTS (51%) FOLLOWED BY REFUGEES FROM BHUTAN, BURMA, LIBERIA AND OTHER AFRICAN NATIONS. HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) HAS DESIGNATED THE CITY OF WORCESTER A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) IN PRIMARY CARE, MENTAL HEALTH AND DENTAL SERVICES DUE TO ITS LOW INCOME POPULATION. THE CITY OF WORCESTER HAS SEVERAL NEIGHBORHOODS WITH A SHORTAGE OF HEALTH PROVIDERS AND HRSA HAS DETERMINED THAT MANY CENSUS TRACTS IN THE CITY ARE MEDICALLY-UNDERSERVED AREAS (MUAS).ECONOMIC CHARACTERISTICS: THE U.S. CENSUS DATA FOR 2010 INDICATED THAT THE MEDIAN HOUSEHOLD INCOME FOR WORCESTER COUNTY WAS $29,316. FOR THE CITY OF WORCESTER, THE REGION'S LARGEST URBAN AREA, IT WAS CONSIDERABLY LOWER AT $23,135. ACCORDING TO THE CENSUS DATA, OF THE CITY'S TOTAL 181,045 RESIDENTS, 19.4% ARE LIVING BELOW THE POVERTY LEVEL. THE NUMBER OF CHILDREN UNDER THE AGE OF 18 LIVING BELOW THE POVERTY LEVEL ROSE TO 29.6% IN 2010 FROM 25% IN 2005-2009 (SOURCE: U.S. CENSUS 2010 AND 2010 AMERICAN COMMUNITY SURVEY 1-YEAR ESTIMATES, U.S. CENSUS). THE UNEMPLOYMENT RATE IN WORCESTER COUNTY RANGED BETWEEN 9.3 IN JANUARY 2011 AND 7.2 IN DECEMBER 2011 (SOURCE: MASSACHUSETTS EXECUTIVE OFFICE OF LABOR WORKFORCE AND DEVELOPMENT). THESE FACTORS HAVE RESULTED IN A STRONG NEED FOR FOOD ASSISTANCE SERVICES. FOR EXAMPLE, ACCORDING TO THE MASSACHUSETTS DEPARTMENT OF EDUCATION, 64% OF STUDENTS IN THE WORCESTER PUBLIC SCHOOL SYSTEM RECEIVE FREE SCHOOL LUNCH (SOURCE: MASSACHUSETTS DEPARTMENT OF EDUCATION).DEMOGRAPHICS: WORCESTER IS THE LARGEST SITE FOR REFUGEE RESETTLEMENT IN MASSACHUSETTS, WITH MORE THAN 1,600 REFUGEES RESETTLED IN THE CITY IN THE PAST FIVE YEARS. AS A RESULT, THE CITY OF WORCESTERS FOREIGN BORN POPULATION IS SIGNIFICANTLY HIGHER THAN WORCESTER COUNTY AS A WHOLE, ACCOUNTING FOR THE MAJORITY OF THIS POPULATION IN THE REGION. ACCORDING TO U.S. CENSUS 2010 FIGURES, THE HISPANIC POPULATION AND OTHER NON-HISPANIC, NON-WHITE ETHNIC GROUPS IN THE CITY HAVE NOTABLY INCREASED WHILE THE WHITE, NON-HISPANIC POPULATION HAS DECREASED. REFLECTING THIS DIVERSITY, NINETY PERCENT OF ALL MEDICAL INTERPRETATIONS PROVIDED BY UMMHC ARE CONDUCTED IN: SPANISH, PORTUGUESE, VIETNAMESE, ARABIC, ALBANIAN AND AMERICAN SIGN LANGUAGE. THE REMAINING TEN PERCENT ARE CONDUCTED IN OTHER NON-PRIMARY LANGUAGES, THE POOL OF WHICH CONSISTS OF 81 DIFFERENT LANGUAGES. THE SENIOR POPULATION IN THE REGION ALSO CONTINUES TO GROW AS BABY BOOMERS REACH THE AGE OF 65. ACCORDING TO THE U.S. CENSUS, RESIDENTS BETWEEN THE AGES OF 20-64 ACCOUNT FOR THE MAJORITY OF THE POPULATION IN WORCESTER COUNTY AT 61%.HEALTHALLIANCE HOSPITAL: OUR TARGET POPULATIONS FOCUS ON MEDICALLY-UNDERSERVED AND VULNERABLE GROUPS OF ALL AGES IN NORTH CENTRAL MASSACHUSETTS. OUR MOST VULNERABLE POPULATIONS INCLUDE CHILDREN, ETHNIC AND LINGUISTIC MINORITIES AND THOSE LIVING IN POVERTY. THESE POPULATIONS OFTEN BECOME ISOLATED AND DISENFRANCHISED DUE TO NEGLIGENCE, MISPERCEPTIONS, AND EVEN FEAR. THE STUDY AREA CONFIGURATION FOR THE CURRENT ASSESSMENT INCLUDES THE 30 SURROUNDING MUNICIPALITIES INCLUDING NINE (9) CITIES AND TOWNS INCLUDED FOR THE FIRST TIME IN THIS REPORT AND EXCLUDING SIX (6) CITIES AND TOWNS REPRESENTED IN PRIOR REPORTS: BARRE, BERLIN, HARDWICK, NEW BRAINTREE, OAKHAM, AND RUTLAND.WITHIN THE HEALTH STATUS AND OUTCOMES SECTION OF THE REPORT, SOME DATA SETS REFLECT A FURTHER DISTILLATION OF DATA FROM THE COMMUNITIES OF: PRINCETON/EAST PRINCETON; LANCASTER/SOUTH LANCASTER; GROTON/WEST GROTON; TOWNSEND/WEST TOWNSEND; AND WINCHENDON/WINCHENDON SPRINGS, RESULTING IN A PRESENTATION OF DATA FROM 35 COMMUNITIES.THE HOSPITAL IS ACTIVELY INVOLVED IN COALITION BUILDING THAT FOCUSES ON IMPROVING THE HEALTH OF THE COMMUNITY, INCLUDING THE JOINT COALITION ON HEALTH. THE COALITION HAS BROUGHT POSITIVE CHANGE TO THE SERVICE AREA. HEALTHALLIANCE HOSPITAL IS ALSO ACTIVELY ENGAGED WITH THE CHNA 9, WHOSE GOAL IS CONTINUOUS IMPROVEMENT OF HEALTH STATUS, WITH A FOCUS ON HEALTH EQUALITY AND ADDRESSING AND ELIMINATING HEALTH DISPARITIES.MARLBOROUGH HOSPITAL: BETWEEN 2000 AND 2011, MARLBOROUGH EXPERIENCED THE GREATEST POPULATION INCREASED FROM 36,255 TO 38,087 (5.1%), NEARLY TWICE AS LARGE OF A PERCENT CHANGE AT THE STATE LEVEL (2.6%). HUDSON'S POPULATION ALSO EXCEEDED THE STATE'S AT 4.0%. IN TERMS OF AGE DISTRIBUTION, MOST OF MARLBOROUGH'S POPULATION WAS BETWEEN THE AGES OF 25 TO 44 YEARS OLD (32.4%) WHILE HUDSON'S POPULATION HAD THE GREATEST PERCENT BETWEEN 45 TO 64 YEARS OLD (29.7%). QUANTITATIVE DATA ALSO ILLUSTRATE THAT JUST OVER THREE-FOURTHS OF THE MASSACHUSETTS POPULATION IS WHITE (76.9%) WHICH WAS LARGELY CONSISTENT WITH MARLBOROUGH (79.2%). BOTH AT THE STATE LEVEL AND IN MARLBOROUGH, THE HISPANIC POPULATION WAS THE NEXT LARGEST RACIAL/ETHNIC GROUP (9.3% AND 9.2%, RESPECTIVELY). HUDSON'S POPULATION FOLLOWED A SIMILAR PATTERN, THE PROPORTION OF ITS POPULATION THAT IDENTIFIED AS WHITE WAS EVEN LARGER (90.5%). ENGLISH, PORTUGUESE AND SPANISH ARE THE PREDOMINANT LANGUAGE FOR THE COMMUNITIES THE HOSPITAL SERVES.CLINTON HOSPITAL: CLINTON HOSPITAL PRIMARILY SERVES THE COMMUNITIES OF CLINTON, BERLIN, BOLTON, LANCASTER AND STERLING WITH POPULATIONS OF 13,606, 2,866, 4,897, 7,582 AND 9,564 RESPECTIVELY. THE POPULATION OF THE TOTAL SERVICE AREA IS 36,759. CLINTON HAS A POPULATION OF 13,606. THE MAJORITY OF CLINTON RESIDENTS ARE WHITE NON-HISPANIC (84%), FOLLOWED BY HISPANIC (11.6%) AND BLACK NON-HISPANIC (1.80%). THE CLINTON HOSPITAL SERVICE AREA IS ALSO PRIMARILY WHITE NON-HISPANIC (88%), FOLLOWED BY HISPANIC (6.4%), AND BLACK NON-HISPANIC (2.8%). CLINTON HOSPITAL'S COMMUNITY BENEFITS PLAN FOCUSES ON THE NEEDS OF CLINTON DUE TO ITS LARGE CONCENTRATION OF DIVERSE, VULNERABLE POPULATIONS. PART VI, LINE 5: UMASS MEMORIAL HAS A DESIGNATED COMMUNITY BENEFIT DEPARTMENT HOUSED WITHIN COMMUNITY RELATIONS THAT IS WHOLLY DEDICATED TO PROMOTING THE COMMUNITY BENEFIT AGENDA WITH A SPECIAL FOCUS ON COMMUNITY HEALTH IMPROVEMENT. OUR COMMUNITY BENEFITS STAFF WORKS VERY CLOSELY WITH MULTIPLE COMMUNITY ORGANIZATIONS FORGING PARTNERSHIPS. THE HOSPITAL HAS A STRONG AND LONGSTANDING PARTNERSHIP WITH THE WORCESTER DIVISION OF PUBLIC HEALTH WHICH HAS RESULTED IN SIGNIFICANT OPPORTUNITIES THAT HAVE LEVERAGED FUNDING AND IMPLEMENTATION OF PREVENTIVE COMMUNITY-CLINICAL LINKAGES. IN ADDITION, WE WORK CLOSELY WITH THE TWO FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS AND LEVERAGE INTERNAL RESOURCES WITHIN THE SYSTEM TO INCREASE PROGRAM CAPACITY WHENEVER POSSIBLE. THE COMMUNITY RELATIONS/COMMUNITY BENEFITS DEPARTMENT WORKS CLOSELY WITH PEDI-PRIMARY CARE, FAMILY AND COMMUNITY MEDICINE, PEDI-PULMONOLOGY AND PLUMLEY VILLAGE HEALTH SERVICES. WE ALSO PROVIDE MEDICAL AND DENTAL SERVICES TO THE UNDERSERVED AT 11 NEIGHBORHOOD SITES AND 20 SCHOOLS THROUGH THE UMASS MEMORIAL CARE MOBILE.HEALTHALLIANCE HOSPITAL: HEALTHALLIANCE HOSPITAL HAS A COMMUNITY BENEFIT PROGRAM THAT IS RESPONSIBLE FOR PROMOTING THE COMMUNITY BENEFIT AGENDA FOCUSING ON COMMUNITY HEALTH IMPROVEMENT. OUR STAFF WORKS VERY CLOSELY WITH MULTIPLE COMMUNITY ORGANIZATIONS FORGING PARTNERSHIPS. IN ADDITION, WE LEVERAGE INTERNAL RESOURCES WITHIN THE SYSTEM TO INCREASE PROGRAM CAPACITY WHENEVER POSSIBLE. WE CONTINUE TO SUPPORT HEALTH EDUCATION AND SCREENINGS RELATED TO CHRONIC DISEASES AND PREVALENT HEALTH CONDITIONS IN THE COMMUNITY INCLUDING BREAST AND LUNG CANCER, CHRONIC OCCLUSIVE PULMONARY DISEASE (COPD), HEART HEALTH, DEPRESSION, DIABETES AND MENTAL/BEHAVIORAL HEALTH. THE PRIMARY DRIVING FORCE BEHIND THE HEALTHALLIANCE HOSPITAL COMMUNITY BENEFITS IMPLEMENTATION PLAN (THROUGH 2015) IS THE PRIORITY NEEDS IDENTIFIED IN THE COMMUNITY HEALTH ASSESSMENT OF NORTH CENTRAL MA (CHA-NCMA) AND THE MONTACHUSETT PUBLIC HEALTH NETWORK (MPHN). ONE UNIQUE ASPECT OF THE CURRENT ASSESSMENT IS THE LEVEL OF ATTENTION PAID TO MINORITY HEALTH ISSUES. IN ADDITION, THOSE RESPONSIBLE FOR GATHERING QUALITATIVE DATA MADE EVERY EFFORT TO ENSURE RACIAL/ETHNIC, SOCIOECONOMIC, AND GEOGRAPHIC DIVERSITY IN THE COMPOSITION OF FOCUS GROPUS AND WITH INTERVIEW PARTICIPANTS. THE RESULT IS A MUCH MORE COMPREHENSIVE PICTURE OF THE HEALTH STATUS, ISSUES, CONCERNS, AND ASSETS OF NORTH CENTRAL MASSACHUSETTS. ANOTHER KEY FEATURE OF THIS COMMUNITY HEALTH ASSESSMENT IS THE AMOUNT OF COLLABORATION THAT HAS GONE INTO GATHERING AND ANALYZING THE DATA PRESENTED HEREIN.MARLBOROUGH HOSPITAL: MARLBOROUGH HOSPITAL PARTICIPATES IN AREA EVENTS AND PROVIDES FACILITIES FOR SUPPORT GROUPS. IN ADDITION, WHENEVER POSSIBLE WE LEVERAGE INTERNAL RESOURCES TO BUILD CAPACITY IN OUR PROGRAMMING AND WE HAVE STAFF THAT SUPPORTS COMMUNITY BENEFITS ACTIVITIES.CLINTON HOSPITAL: CLINTON HOSPITAL'S COMMUNITY BENEFITS PROGRAMS MIRROR THE FIVE CORE PRINCIPLES OUTLINES BY THE PUBLIC HEALTH INSTITUTE IN TERMS OF THE "EMPHASIS ON COMMUNITIES WITH DISPROPORTIONATE UNMET HEALTH-RELATED NEEDS; EMPHASIS ON PRIMARY PREVENTION; BUILDING A SEAMLESS CONTINUUM OF CARE; BUILDING COMMUNITY CAPACITY; AND COLLABORATIVE GOVERNANCE." TARGET POPULATIONS FOR CLINTON HOSPITAL'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COMMUNITY INPUT AND PLANNING PROCESS, COLLABORATIVE EFFORTS, AND A CHNA WHICH IS CONDUCTED EVERY THREE YEARS. PART VI, LINE 6: UMASS MEMORIAL MEDICAL CENTER IS PART OF THE UMASS MEMORIAL HEALTH CARE SYSTEM (FOUR HOSPITALS TOTAL IN CENTRAL MASSACHUSETTS). EACH HOSPITAL HAS DESIGNATED COMMUNITY BENEFITS STAFF TO WORK WITH THEIR RESPECTIVE LOCAL COMMUNITIES. EACH HOSPITAL IS RESPONSIBLE FOR DEVELOPING THEIR OWN COMMUNITY HEALTH NEEDS ASSESSMENT IN COLLABORATION WITH LOCAL COMMUNITY STAKEHOLDERS AND DEVELOPS A COMMUNITY BENEFIT IMPLEMENTATION STRATEGY FOR THEIR RESPECTIVE COMMUNITY. PART VI, LINE 7, REPORTS FILED WITH STATES MA PART VI LINE 7 YES, ALL FOUR HOSPITALS FILE INDIVIDUAL COMMUNITY BENEFIT REPORTS WITH THE MASSACHUSETTS ATTORNEY GENERAL'S OFFICE. 1 EDWARD M KENNEDY COMMUNITY HEALTH CENTER INC 650 LINCOLN STREET WORCESTER MA 01605 042513817 501(C)(3) 1000000 SUPPORT FOR HEALTH CENTER'S MISSION FAMILY HEALTH CENTER OF WORCESTER INC 26 QUEEN STREET WORCESTER MA 01610 042485308 501(C)(3) 1000000 SUPPORT FOR HEALTH CENTER'S MISSION UNIVERSITY OF MA MEDICAL SCHOOL 55 LAKE AVE N WORCESTER MA 01655 043167352 501(C)(3) 200000 MUSCULOSKELETAL CENTER OF EXCELLENCE GRANT UNIVERSITY OF MA MEDICAL SCHOOL 55 LAKE AVE N WORCESTER MA 01655 043167352 501(C)(3) 50000 INTERVENTIONAL NEURORADIOLOGY RESEARCH UNIVERSITY OF MA MEDICAL SCHOOL 55 LAKE AVE N WORCESTER MA 01655 043167352 501(C)(3) 22580 COMPLEX AORTIC ANEURYSM REPAIR STUDY UNIVERSITY OF MA MEDICAL SCHOOL 55 LAKE AVE N WORCESTER MA 01655 043167352 501(C)(3) 2000000 ACADEMIC CHAIR FUNDING QCC FOUNDATION INC 670 WEST BOYLSTON STREET WORCESTER MA 01606 042897624 501(C)(3) 5000 ANNIVERSARY SPONSORSHIP UNIVERSITY OF MA MEDICAL SCHOOL 55 LAKE AVE N WORCESTER MA 01655 043167352 501(C)(3) 5000 SPONSORSHIP OF SEED SYMPOSIUM COMMUNITY HEALTHLINK 72 JACQUES AVE WORCESTER MA 01610 042626179 501(C)(3) 6500 SPONSORSHIP FAMILY FUN FEST & "LISTEN IN" EVENT CLINTON HOSPITAL 201 HIGHLAND STREET CLINTON MA 01510 041185520 501(C)(3) 33125 125TH MATCH 6 INTERNSHIPS 34 69298 SPONSORSHIPS 16 28550 FORM 990, SCHEDULE I, PART I LINE 2: PART I LINE 2: MEDICAL CENTER: AT REASONABLE INTERVALS, RE-EVALUATION OF THE GRANTS WILL OCCUR TO ENSURE THAT THE ARRANGEMENTS ARE EXPECTED TO CONTINUE TO SATISFY THE STANDARD SET FORTH. THE HEALTH CENTERS WILL DOCUMENT THE RE-EVALUATION CONTEMPORANEOUSLY. PART I LINE 2: MEDICAL CENTER: AS PART OF THE FUNDING AGREEMENT, BI-ANNUAL UPDATES WILL BE PROVIDED TO THE SENIOR VICE PRESIDENT FOR OPERATIONS OF THE MEDICAL CENTER RESPONSIBLE FOR THE MUSCULOSKELETAL CENTER OF EXCELLENCE. PART I LINE 2: MEDICAL CENTER: RESEARCH GRANTS WILL BE FUNDED ANNUALLY, FOLLOWING ANNUAL UPDATES PROVIDED BY THE DIVISION DIRECTOR AND/OR DEPARTMENT CHAIR TO THE SENIOR VICE PRESIDENT OF OPERATIONS RESPONSIBLE FOR THE RADIOLOGY DEPARTMENT AND THE INTERVENTIONAL NEURORADIOLOGY DIVISION. PART I LINE 2: MEDICAL CENTER: GRANT FUNDED ON A PER YEAR BASIS FOR THE DURATION OF THE STUDY; WITH ANNUAL COST RECONCILIATIONS PERFORMED AND PROVIDED TO THE MEDICAL CENTER. PART II LINE 1(H): MEDICAL CENTER: THE STANDARD SET FORTH IS A REASONABLE EXPECTATION THAT THE GRANTS WILL CONTRIBUTE MEANINGFULLY TO EACH OF THE HEALTH CENTER'S ABILITY TO MAINTAIN OR INCREASE THE AVAILABILITY, OR ENHANCE THE QUALITY, OF SERVICES PROVIDED TO A MEDICALLY UNDERSERVED POPULATION SERVICED BY THE HEALTH CENTERS. EACH HEALTH CENTER HAS DOCUMENTED THE BASIS FOR SAID REASONABLE EXPECTATION. PART II LINE 1(H): MEDICAL CENTER: THESE GRANTS REPRESENT HIGHLY COLLABORATIVE PROJECTS AMONG THREE DEPARTMENTS (ORTHOPEDICS, MEDICINE (PHEUMATOLOGY) AND CELL BIOLOGY) THAT FOCUS ON THE ROLE OF MICRORNAS IN THE PATHOGENESIS OF RHEUMATOID ARTHRITIS AND OSTEOARTHRITIS, AND ADDRESS THE POTENTIAL ROLE OF MICRORNAS AS BIOMARKERS OF DISEASE. PART II LINE 1(H): MEDICAL CENTER: THIS GRANT ALLOWS THE MEDICAL SCHOOL TO RECEIVE A THREE YEAR RESEARCH GRANT FOR START UP FUNDING RESEARCH UNDER THE DIRECTOR OF THE MEDICAL SCHOOL'S DIVISION DIRECTOR FOR INTERVENTIONAL NEURORADIOLOGY. PART II LINE 1(H): MEDICAL CENTER: THE PRIMARY OBJECTIVE OF THE PRESENT STUDY IS TO EVALUATE THE SAFETY AND EFFICACY OF PHYSICIAN-MODIFICATION OF FDA-APPROVED OFF-THE-SHELF ENDOVASCULAR GRAFTS IN THE TREATMENT OF PATIENTS WITH COMPLEX ABDOMINAL OR THOROCOABDOMINAL ANEURYSMS OR ULCERS. PART I LINE 2: HEALTHALLIANCE HOSPITALS, INC.: PRIOR TO THE DISTRIBUTION OF ANY AND ALL SCHOLARSHIP/INTERNSHIP FUNDS, HEALTHALLIANCE REQUIRES VERIFICATION OF PROGRAM ENROLLMENT FROM ALL RECIPIENTS. X X X X X X 1 1 0 0 0 0 0 0 0 ALFRED HOWARD MD DIRECTOR, UMM ACO, INC. 237821 0 10327 0 0 0 18536 0 12114 0 278798 0 0 0 BAGLEY PETER MD DIRECTOR, UMM ACO, INC. 237823 0 116920 0 0 0 92512 0 28594 0 475849 0 0 0 BROWN ALAN P MD SECRETARY, UMMHC, INC., DIRECTOR VAR 170318 0 23100 0 0 0 10064 0 24673 0 228155 0 0 0 CARLUCCI DANIEL MD DIRECTOR, MARLBOROUGH HOSPITAL 287163 0 22669 0 0 0 13000 0 28594 0 351426 0 0 0 COFONE MICHAEL J TREASURER/DIRECTOR, COORDINATED PRIM 294265 0 70675 0 2864 0 7800 0 29925 0 405529 0 0 0 CORBETT WILLIAM MD DIRECTOR, MARLBOROUGH HOSPITAL 318625 0 104564 0 30800 0 142507 0 21773 0 618269 0 30800 0 DALY SHEILA PRESIDENT, CLINTON HOSPITAL ASSOC., 205300 0 77964 0 0 0 33757 0 11110 0 328131 0 0 0 DICKSON ERIC W MD PRESIDENT & CEO/DIRECTOR, UMM HEALTH 773029 0 520000 0 40695 0 230517 0 40127 0 1604368 0 38913 0 DUNCAN DAVID DIRECTOR UNTIL 8/3/15, COORDINATED P 167076 0 28474 0 819 0 6940 0 23724 0 227033 0 0 0 EISENSTOCK JORDAN MD DIRECTOR, UMM ACO, INC. 164454 0 16357 0 5065 0 9586 0 23309 0 218771 0 5065 0 FAIRCHILD DAVID MD PRESIDENT/DIRECTOR, UMM ACO, INC. 378547 0 97060 0 36936 0 94041 0 9575 0 616159 0 36936 0 FERGUSON R KEVIN MD DIRECTOR, UMM MED GROUP, INC. 217960 0 53694 0 6036 0 13000 0 24521 0 315211 0 6036 0 FINBERG ROBERT W MD DIRECTOR, UMM HEALTH CARE, INC. 251386 0 49354 0 15015 0 101571 0 31094 0 448420 0 15015 0 GOTTLIEB PHILIP D MD DIRECTOR UNTIL 12/13, CLINTON HOSPIT 230340 0 134444 0 8126 0 13000 0 24761 0 410671 0 8126 0 HARLAN DAVID MD DIRECTOR, UMM ACO, INC. 148056 0 33000 0 0 0 9415 0 25330 0 215801 0 0 0 KENNEDY KATHRYN MD DIRECTOR, UMM MED GROUP, INC. 227786 0 61370 0 0 0 13000 0 28588 0 330744 0 0 0 LAPRIORE CHERYL M PRESIDENT/DIRECTOR, UMM HEALTH VENT 244120 0 94804 0 30636 0 100910 0 22598 0 493068 0 30636 0 LASSER DANIEL H MD DIRECTOR, UMM MED GROUP, INC. 207486 0 29457 0 23638 0 56027 0 27101 0 343709 0 23638 0 MESSINA LOUIS MD DIRECTOR UNTIL 3/14, UMM MED GROUP, 520117 0 77369 0 0 0 13789 0 28102 0 639377 0 0 0 METZMAKER JEFFREY N MD DIRECTOR, UMM MED GROUP, INC. 305811 0 119500 0 0 0 13000 0 26061 0 464372 0 0 0 MULDOON PATRICK PRESIDENT, UMM MED CTR, INC., 579577 0 258750 0 31239 0 267751 0 27960 0 1165277 0 31239 0 NOMPLEGGI DOMINIC MD DIRECTOR, UMM MED GROUP, INC. 222270 0 120436 0 0 0 13000 0 30154 0 385860 0 0 0 OKIKE O NSIDINANYA MD DIRECTOR, UMM HEALTH CARE, INC. 425028 0 90569 0 19250 0 13000 0 27943 0 575790 0 19250 0 O'LEARY DANIEL MD DIRECTOR, COORDINATED PRIMARY CARE, 166973 0 20466 0 1521 0 3340 0 4333 0 196633 0 0 0 PHILBIN CHRIS DIRECTOR, UMASS MEMORIAL COMMUNITY H 189880 0 40000 0 0 0 24558 0 25132 0 279570 0 0 0 ROACH STEVEN PRESIDENT/DIRECTOR, MARLBOROUGH HOSP 328968 0 128646 0 0 0 41706 0 23694 0 523014 0 0 0 ROSEN MAX P MD DIRECTOR, CMMIC, INC. 377877 0 29460 0 0 0 13000 0 3840 0 424177 0 0 0 ROSSI CATHERINE DIRECTOR, CLINTON HOSPITAL ASSOCIATI 172552 0 36000 0 0 0 25467 0 22262 0 256281 0 0 0 SIOUFI HABIB A MD DIRECTOR, CLINTON HOSPITAL ASSOCIATI 199247 0 0 0 8319 0 10719 0 23904 0 242189 0 8319 0 SWENSON DANA E PRESIDENT/DIRECTOR, UMM REALTY, INC. 235564 0 60735 0 0 0 124837 0 21773 0 442909 0 0 0 TOSI STEPHEN E MD PRESIDENT, UMM MED GROUP, INC., DIRE 614181 0 281303 0 353780 0 259762 0 28605 0 1537631 0 353780 0 ZIEDONIS DOUGLAS MD PRESIDENT/DIRECTOR, UMBHS, INC. 199796 0 27900 0 0 0 11905 0 28594 0 268195 0 0 0 BOLLAND ESHGHI KATHARINE ASSISTANT SECRETARY, UMMHC, INC. 295192 0 73588 0 24719 0 71413 0 23598 0 488510 0 24719 0 BRONHARD JOHN TREASURER, CNEHA, INC. 181856 0 25943 0 10646 0 4601 0 6790 0 229836 0 0 0 BROWN DOUGLAS S SECRETARY, UMM HEALTH CARE, INC. 443477 0 396974 0 44821 0 225532 0 22598 0 1133402 0 44821 0 COCCHIARELLA ANDREW MD DIRECTOR, MARLBOROUGH HOSPITAL 197022 0 117950 0 0 0 13000 0 25305 0 353277 0 0 0 EKSTROM DEBORAH PRESIDENT, COMMUNITY HEALTHLINK, INC 193355 0 50131 0 16552 0 93352 0 25785 0 379175 0 15608 0 GREENWOOD JOHN TREASURER, UMM ACO, INC. 213448 0 44000 0 16119 0 82830 0 21453 0 377850 0 16119 0 KEATING TODD A TREASURER UNTIL 2/14, UMM HEALTH CAR 91987 0 0 0 1098018 0 147144 0 1926 0 1339075 0 1098018 0 MCCUE STEVEN TREASURER, MARLBOROUGH HOSPITAL 175880 0 19328 0 0 0 23654 0 20986 0 239848 0 0 0 MELGAR SERGIO TREASURER, UMASS MEMORIAL HEALTH CAR 560318 0 285000 0 11937 0 59208 0 29966 0 946429 0 0 0 O'BRIEN WILLIAM SECRETARY, UMBHS, INC. 117117 0 7642 0 0 0 33517 0 25132 0 183408 0 0 0 OLSON JEFFREY TREASURER, CLINTON HOSPITAL ASSOC. 139702 0 16170 0 0 0 35085 0 23762 0 214719 0 0 0 SHAKMAN ALICE PRESIDENT, CMMIC, INC. 253236 0 64081 0 24782 0 147863 0 8754 0 498716 0 24782 0 SMITH FRANCIS W CLERK, UMM HEALTH VENTURES, INC. 187014 0 15867 0 0 0 50459 0 25951 0 279291 0 0 0 STREETER MICHELE TREASURER, UMM MED GROUP, INC. 389263 0 178200 0 26031 0 224630 0 24159 0 842283 0 26031 0 SZYMANSKI CANDRA D INTERIM PRESIDENT UNTIL 12/13, MARLB 90876 0 0 0 99808 0 12383 0 1138 0 204205 0 88494 0 WEYMOUTH DEBORAH PRESIDENT, CENTRAL NEW ENGLAND HEALT 193633 0 30000 0 0 0 297 0 6118 0 230048 0 0 0 ANDERSON MILTON SR. VP, CHIEF HR OFFICER UNTIL 9/14 278569 0 188883 0 304011 0 369884 0 18215 0 1159562 0 304011 0 BRENCKLE GEORGE PHD SR. VP, CIO UNTIL 4/14 110652 0 0 0 408888 0 340242 0 9561 0 869343 0 408888 0 CYR JAMES P SR VP, HEART AND VASCULAR DISEASES 241332 0 62636 0 17956 0 162807 0 22598 0 507329 0 17956 0 DAY THERESE VP, FINANCE / CFO OF MED CENTER 273845 0 70628 0 27201 0 156689 0 22598 0 550961 0 27201 0 DIAMOND VICTORIA SR. VP, OPERATIONS, UNTIL 1/14 36051 0 0 0 386939 0 138442 0 3885 0 565317 0 386939 0 FELDMANN ROBERT VP, CORPORATE CONTROLLER 258169 0 64609 0 0 0 152358 0 1951 0 477087 0 0 0 FISHER BARBARA SR VP, OPERATIONS 251672 0 64915 0 63026 0 130815 0 21773 0 532201 0 63026 0 GEORGE PATRICIA VP & DEPUTY CIO 18466 0 0 0 0 0 339530 0 566 0 358562 0 0 0 HUDLIN MARGARET MD CHIEF MED OFFICER/VP PERIOPERATIVE S 338331 0 87500 0 9339 0 43750 0 25132 0 504052 0 9339 0 HYLKA SHARON SR. VP, HOSPITAL ADMIN UNTIL 1/14 94281 0 0 0 877323 0 263324 0 7382 0 1242310 0 877323 0 JEWELL CATHY SR VP, CHIEF NURSING OFFICER 217068 0 13418 0 0 0 24981 0 22598 0 278065 0 0 0 RANDOLPH JOHN CHIEF COMPLIANCE OFFICER 199185 0 51633 0 0 0 93732 0 24598 0 369148 0 0 0 TARNOWSKI TIMOTHY SR VP, CHIEF INFO OFFICER 37456 0 45000 0 0 0 0 0 1461 0 83917 0 0 0 THOMPSON DIANE SR VP CHIEF NURSING OFF UNTIL 4/9/15 325897 0 89792 0 5919 0 360115 0 22397 0 804120 0 0 0 LITWIN DEMETRIUS MD PHYSICIAN, CHAIR OF SURGERY DEPT 555716 0 161939 0 0 0 13000 0 28775 0 759430 0 0 0 BOZORGZADEH ADEL MD PHYSICIAN, CHIEF OF ORGAN TRANSPLANT 469603 0 243156 0 0 0 13000 0 28594 0 754353 0 0 0 AROUS ELIAS J MD PHYSICIAN, ASSOC. CHIEF MEDICAL OFFI 596100 0 49600 0 0 0 13000 0 26061 0 684761 0 0 0 AYERS DAVID C MD PHYSICIAN, CHAIR OF ORTHOPEDICS AND 606387 0 34957 0 0 0 13000 0 27769 0 682113 0 0 0 BUSCONI BRIAN D MD PHYSICIAN, CHIEF OF ORTHOPEDICS 501137 0 115985 0 0 0 13000 0 26061 0 656183 0 0 0 CHANDLER WILLIS FMR DIR CLINTON UNTIL 12/31/11 0 0 0 0 43852 0 0 0 107 0 43959 0 43852 0 FERRUCCI JOSEPH MD FMR DIR CMMIC UNTIL 3/31/13 259317 0 15612 0 1385 0 8300 0 15785 0 300399 0 0 0 PAPPAS ARTHUR M MD FMR DIR UNTIL 3/27/13 12736 0 800 0 0 0 101 0 107 0 13744 0 0 0 MOORE KAREN FMR PRESIDENT/DIR UNTIL 3/25/13 0 0 0 0 156975 0 26309 0 13714 0 196998 0 156975 0 BLUTE MICHAEL MD FMR KEY EE UNTIL 3/31/2012, CANCER C 0 0 0 0 122006 0 0 0 107 0 122113 0 122006 0 DALEY JENNIFER MD FMR EXEC VP, COO, UNTIL 3/18/13 0 0 0 0 529399 0 100961 0 25255 0 655615 0 529399 0 ETTINGER WALTER H MD FMR KEY EE/PRES MEDCTR UNTIL 1/20/12 0 0 0 0 716815 0 0 0 107 0 716922 0 716815 0 PART I, LINES 4A-B PART I, LINE 4A: RECEIVE A SEVERANCE PAYMENT OR CHANGE-OF-CONTROL PAYMENT. THE FOLLOWING INDIVIDUALS RECEIVED OR HAD DEFERRED SEVERANCE IN THE REPORTING PERIOD: INCLUDED IN SCH. J COL. BIII: ANDERSON, MILTON $127,422 BRENCKLE, GEORGE, PH.D. $198,020 DALEY, JENNIFER, MD $479,079 DIAMOND, VICTORIA $235,532 FERRUCCI, JOSEPH, MD $ 1,385 HYLKA, SHARON $217,849 KEATING, TODD $389,532 MOORE, KAREN $142,257 SZYMANSKI, CANDRA D. $ 88,494 INCLUDED IN SCH. J COL. C: ANDERSON, MILTON $293,123 BRENCKLE, GEORGE, PH.D. $225,567 DIAMOND, VICTORIA $ 12,296 GEORGE, PATRICIA $339,530 HYLKA, SHARON $190,143 THOMPSON, DIANE $313,225 THE DEFERRED SEVERANCE REPORTED ON SCH. J COL. C IS THE MAXIMUM POTENTIAL OBLIGATION FOR UMMHC AND AFFILIATES. THESE SEVERANCE COSTS ARE OFFSET IN PART BY THE RECIPIENTS GAINING EMPLOYMENT. THEREFORE, THEIR OVERALL SEVERANCE BENEFIT COULD BE SUBSTANTIALLY LOWER. PART I, LINE 4B: NAME OF PARTICIPANTS IN OR RECEIVING PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN EXECUTIVES BOLLAND ESHGHI, KATHARINE $24,719 BROWN, DOUGLAS S. $44,821 CORBETT, WILLIAM, MD $30,800 DALY, SHEILA $0 DICKSON, ERIC, M.D. $38,913 EKSTROM, DEBORAH $15,608 FAIRCHILD, DAVID, M.D. $35,436 FINBERG, ROBERT W., MD $0 GREENWOOD, JOHN $16,119 IITSUKA, CARLOS $0 KEATING, TODD A. $76,900 LAPRIORE, CHERYL M. $30,636 MELGAR, SERGIO $0 MULDOON, PATRICK L. $31,239 PHILBIN, CHRIS $0 ROACH, STEVEN $0 ROSSI, CATHERINE $0 SHAKMAN, ALICE $24,782 STREETER, MICHELE M. $26,031 SWENSON, DANA $0 TOSI, STEPHEN E., M.D. $257,069 WEYMOUTH, DEBORAH $0 SUBTOTAL EXECUTIVES $653,071 KEY EMPLOYEES ANDERSON, MILTON $12,086 BRENCKLE, GEORGE, PH.D. $55,236 CYR, JAMES P. $17,956 DAY, THERESE $27,201 DIAMOND, VICTORIA $43,540 FELDMANN, ROBERT $0 FISHER, BARBARA $63,026 GEORGE, PATRICIA $0 HUDLIN, MARGARET, M.D. $9,339 HYLKA, SHARON $66,871 RANDOLPH, JOHN $0 TARNOWSKI, TIMOTHY $0 THOMPSON, DIANE $0 SUBTOTAL KEY EMPLOYEES $295,257 FORMER O/D OR KEY EMPLOYEES BLUTE, MICHAEL, MD $122,006 CHANDLER, WILLIS $ 30,786 DALEY, JENNIFER, MD $ 50,320 ETTINGER, WALTER H., MD $ 77,458 MOORE, KAREN $ 14,718 SUBTOTAL FORMER $295,287 TOTAL - ALL $1,243,615 PART II - DISCLOSURES: 1) THE ABOVE DIRECTORS RECEIVE NO COMPENSATION FOR THEIR ROLE AS DIRECTORS. ALL COMPENSATION RECEIVED RELATES TO THEIR POSITION AS A PHYSICIAN/ADMINISTRATOR. PART II - UNRELATED ORGANIZATION: THE OFFICERS, DIRECTORS AND HIGHEST COMPENSATED EMPLOYEES LISTED IN PART II THAT RECEIVED COMPENSATION FROM AN UNRELATED ORGANIZATION WERE PAID FOR THEIR SERVICES RELATED TO MEDICAL RESEARCH, EDUCATION OF MEDICAL STUDENTS AND RESIDENT TRAINING. AMOUNTS INCLUDE THEIR BASE COMPENSATION AND DEFERRED COMPENSATION FOR CALENDAR YEAR 2014. THE NAME OF THE UNRELATED ORGANIZATION IS UMASS MEDICAL SCHOOL. PART III - UNRELATED ORGANIZATION COMPENSATION OFFICERS, DIRECTORS, TRUSTEES ALFRED, HOWARD, MD $ 24,667 BAGLEY, PETER, MD $134,387 BROWN, ALAN P., MD $ 64,030 CARLUCCI, DANIEL, MD $ 92,600 COCCHIARELLA, ANDREW, MD $129,095 FINBERG, ROBERT W., MD $305,351 HARLAN, DAVID, MD $166,150 KENNEDY, KATHRYN, MD $ 38,782 LASSER, DANIEL H., MD $260,363 MESSINA, LOUIS, MD $129,000 METZMAKER, JEFFREY N., MD $144,351 NOMPLEGGI, DOMINIC, MD $170,252 ROSEN, MAX P., MD $254,953 ZIEDONIS, DOUGLAS, MD $254,377 SUBTOTAL OFF., DIR., TRUSTEES $2,168,358 FORMER FERRUCCI, JOSEPH, MD $ 39,877 SUBTOTAL FORMER $ 39,877 TOP 5 HIGHEST PAID LITWIN, DEMETRIUS, MD $276,118 BOZORGZADEH, ADEL, MD $139,000 AROUS, ELIAS J., MD $160,068 AYERS, DAVID C., MD $192,088 BUSCONI, BRIAN, MD $136,500 SUBTOTAL TOP 5 HIGHEST PAID $903,774 TOTAL COMP. FROM UNREL. ORG. $3,112,009 A MHEFA-UMASS MEMORIAL SERIES D 042456011 57586CLQ6 2005-08-18 107450000 SEE PART VI 0 0 0 B MHEFA-UMASS MEMORIAL VARIABLE RATE SERIES E 042456011 57586EHZ7 2009-05-22 30000000 SEE PART VI 0 0 0 C MHEFA-UMASS MEMORIAL VARIABLE RATE SERIES F 042456011 57586EJA0 2009-05-22 30000000 SEE PART VI 0 0 0 D MDFA-MARLBOROUGH HOSPITAL VARIABLE RATE SERIES A 043431814 2009-11-24 9420000 SEE PART VI 0 0 0 A 110521543 10709415 5411300 1384731 3427397 95000000 2006 0 0 1 1 B 30000000 30062453 170731 205455 29856998 2012 0 0 1 1 C 30000000 30062772 238917 118700 29944072 2012 0 0 1 1 D 1203000 9420000 191609 93458 9326542 2009 1 0 1 1 A 0 0 1 1 0 0.00580 0.00580 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 D 0 0 0 0 0 0 1 A 1 0 0 0 0 1 B 1 1 0 0 0 1 C 1 1 0 0 0 1 D 1 1 0 0 0 1 A 1 B 1 C 1 D 1 PART I - BOND ISSUES (A) ISSUER NAME: MHEFA - UMASS MEMORIAL, SERIES D MHEFA - UMASS MEMORIAL VARIABLE RATE, SERIES E MHEFA - UMASS MEMORIAL VARIABLE RATE, SERIES F MDFA - MARLBOROUGH HOSPITAL VARIABLE RATE, SERIES A MHEFA - UMASS MEMORIAL MASTER LEASE MHEFA - UMASS MEMORIAL MASTER LEASE MHEFA - UMASS MEMORIAL MASTER LEASE MHEFA - UMASS MEMORIAL MASTER LEASE MHEFA - UMASS MEMORIAL, SERIES G MDFA - UMASS MEMORIAL MASTER LEASE MDFA - UMASS MEMORIAL, SERIES H MDFA - UMASS MEMORIAL, MASTER LEASE MDFA - UMASS MEMORIAL, MASTER LEASE MDFA - UMASS MEMORIAL VARIABLE RATE, SERIES E MDFA - UMASS MEMORIAL VARIABLE RATE, SERIES F PART I - BOND ISSUE MHEFA-UMASS MEMORIAL, SERIES D PART I COLUMN (C ) CUSIP #: 57586CLP8 - 57586CLQ6 PART I COLUMN (F) DESCRIPTION OF PURPOSE: COMPLETION OF THE EXPANSION OF THE EMERGENCY DEPT AND ROUTINE CAPITAL EQUIPMENT AND/OR RENOVATION PROJECTS PART I - BOND ISSUE MHEFA-UMASS MEMORIAL VARIABLE RATE, SERIES E PART I COLUMN (C ) CUSIP #: 57586EHZ7 PART I COLUMN (F) DESCRIPTION OF PURPOSE: RENOVATION, EQUIPPING AND CONSTRUCTION FOR CLINICAL, SUPPORT SERVICE AND INFRASTRUCTURE PROJECTS PART I - BOND ISSUE MDFA-UMASS MEMORIAL VARIABLE RATE, SERIES E PART I COLUMN (F) DESCRIPTION OF PURPOSE: PROCEEDS OF THE BONDS USED TO REISSUE THE OUTSTANDING SERIES E BONDS PART I - BOND ISSUE MHEFA-UMASS MEMORIAL VARIABLE RATE, SERIES F PART I COLUMN (C ) CUSIP #: 57586EJA0 PART I COLUMN (F) DESCRIPTION OF PURPOSE: RENOVATION, EQUIPPING AND CONSTRUCTION FOR CLINICAL, SUPPORT SERVICE AND INFRASTRUCTURE PROJECTS PART I - BOND ISSUE MDFA-UMASS MEMORIAL VARIABLE RATE, SERIES F PART I COLUMN (F) DESCRIPTION OF PURPOSE: PROCEEDS OF THE BONDS USED TO REISSUE THE OUTSTANDING SERIES F BONDS PART I - BOND ISSUE MDFA-MARLBOROUGH HOSPITAL VARIABLE RATE, SERIES A PART I COLUMN (F) DESCRIPTION OF PURPOSE: PAY OFF HEFA POOL O LOAN, ER RENOVATIONS, EICU EQUIPMENT, CT SCAN LEASE, MAMMOGRAPHY UNIT PART I - BOND ISSUE MHEFA-UMASS MEMORIAL, SERIES G PART I COLUMN (C ) CUSIP #: 57586EUS8 - 57586EUT6 - 57586EUU3 - 57586EUV1 - 57586EUW9 - 57586EUX7 - 57586EUY5 - 57586EUZ2 - 57586EVA6 - 57586EVB4 - 57586EVC2 - 57586EVD0 - 57586EVE8 - 57586EVF5 - 57586EVG3 - 57586EVH1 - 57586EVJ7 PART I COLUMN (F) DESCRIPTION OF PURPOSE: REFUNDING OF CENTRAL NEW ENGLAND HEALTH ALLIANCE SERIES A BOND (1993) AND MEDICAL CENTER OF CENTRAL MASSACHUSETTS, SERIES B (1992) PART I - BOND ISSUE MDFA-UMASS MEMORIAL, SERIES H PART I COLUMN (C ) CUSIP #: 57583UGP7 - 57583UGQ5 - 57583UGR3 - 57583UGS1 - 57583UGT9 - 57583UGU6 - 57583UGV4 - 57583UGW2 - 57583UGX0 - 57583UGY8 - 57583UGZ5 - 57583UHA9 - 57583UHB7 - 57583UHC5 PART I COLUMN (F) DESCRIPTION OF PURPOSE: PARTIAL REFUNDING OF MEDICAL CENTER VARIABLE RATE SERIES A BONDS (1998), REFUNDING IN FULL OF CENTRAL NEW ENGLAND HEALTH ALLIANCE SERIES B BONDS (1998) AND UMASS MEMORIAL SERIES C (2001). PART II - PROCEEDS MHEFA - UMASS MEMORIAL, SERIES D COLUMN (E) ISSUE PRICE OF $107,450,000; ADD ISSUE PREMIUM OF $604,814, ADD INTEREST EARNED ON PROCEEDS OF $3,427,397, LESS ISSUE DISCOUNT OF ($960,668), EQUALS LINE 3 OF $110,521,543. MHEFA - UMASS MEMORIAL VARIABLE RATE, SERIES E COLUMN (E) ISSUE PRICE OF $30,000,000; ADD INTEREST EARNED ON PROCEEDS OF $62,453, EQUALS LINE 3 OF $30,062,453. MHEFA - UMASS MEMORIAL VARIABLE RATE, SERIES F COLUMN (E) ISSUE PRICE OF $30,000,000; ADD INTEREST EARNED ON PROCEEDS OF $62,772, EQUALS LINE 3 OF $30,062,772. MHEFA - UMASS MEMORIAL MASTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $717,238, EQUALS LINE 3 OF $20,717,238. MHEFA - UMASS MEMORIAL MASTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $152,952, EQUALS LINE 3 OF $20,152,952. MHEFA - UMASS MEMORIAL MASTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $24,254, EQUALS LINE 3 OF $20,024,254. MHEFA - UMASS MEMORIAL, SERIES G COLUMN (E) ISSUE PRICE OF $60,445,000; ADD ISSUE PREMIUM OF $1,388,656 ADD INTEREST EARNED ON PROCEEDS OF $180, EQUALS LINE 3 OF $61,833,836 MDFA - UMASS MEMORIAL MASTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $5,301, EQUALS LINE 3 OF $20,005,301. MDFA - UMASS MEMORIAL, SERIES H COLUMN (E) ISSUE PRICE OF $90,990,000; ADD ISSUE PREMIUM OF $1,303,778, EQUALS LINE 3 OF $92,293,778. MDFA - UMASS MEMORIAL MASTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $13,504, EQUALS LINE 3 OF $20,013,504. MDFA - UMASS MEMORIAL MASTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $723, EQUALS LINE 3 OF $20,000,723. A MHEFA-UMASS MEMORIAL MASTER LEASE 042456011 2005-12-07 10000000 CAPITAL EQUIPMENT 0 0 0 B MHEFA-UMASS MEMORIAL MASTER LEASE 042456011 2006-12-27 20000000 CAPITAL EQUIPMENT 0 0 0 C MHEFA-UMASS MEMORIAL MASTER LEASE 042456011 2008-04-24 20000000 CAPITAL EQUIPMENT 0 0 0 D MHEFA-UMASS MEMORIAL MASTER LEASE 042456011 2009-07-24 20000000 CAPITAL EQUIPMENT 0 0 0 A 10000000 10000000 10000000 2006 0 0 1 1 B 20000000 20717238 26965 717238 19973035 2007 0 0 1 1 C 20000000 20152952 29072 152952 19970928 2009 0 0 1 1 D 20000000 20024254 46165 28500 24254 19971500 2010 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 D 0 0 0 0 0 0 1 A 1 0 0 0 0 1 B 1 0 0 0 0 1 C 1 0 0 0 0 1 D 1 0 0 0 0 1 A 1 B 1 C 1 D 1 A MHEFA-UMASS MEMORIAL SERIES G 042456011 57586EUS8 2010-05-27 60445000 SEE PART VI 0 0 0 B MDFA-UMASS MEMORIAL MASTER LEASE 043431814 2010-12-09 20000000 CAPITAL EQUIPMENT 0 0 0 C MDFA-UMASS MEMORIAL SERIES H 043431814 57583UGP7 2011-08-10 90990000 SEE PART VI 0 0 0 D MDFA-UMASS MEMORIAL MASTER LEASE 043431814 2011-12-28 20000000 CAPITAL EQUIPMENT 0 0 0 A 22850000 61833836 2048188 60734797 1099039 2010 0 0 1 1 B 15670619 20005301 100675 33031 5301 19966969 2011 0 0 1 1 C 16845000 92293778 4117468 91058463 1235315 2011 1 0 1 1 D 12276004 20013504 156122 29000 13504 19971000 2013 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 D 0 0 0 0 0 0 1 A 1 0 0 0 0 1 B 1 0 0 0 0 1 C 1 0 0 0 0 1 D 1 0 0 0 0 1 A 1 B 1 C 1 D 1 A MDFA-UMASS MEMORIAL MASTER LEASE 043431814 2013-08-14 20000000 CAPITAL EQUIPMENT 0 0 0 B MDFA-UMASS MEMORIAL VARIABLE RATE SERIES E 043431814 2015-04-01 27290000 SEE PART VI 0 0 0 C MDFA-UMASS MEMORIAL VARIABLE RATE SERIES F 043431814 2015-05-21 27290000 SEE PART VI 0 0 0 A 6788688 20000723 172391 36810 723 19963190 2013 0 0 1 1 B 765000 27290000 181155 27290000 2015 1 0 1 1 C 765000 27290000 106839 27290000 2015 1 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 A 1 0 0 0 0 1 B 1 1 0 0 0 1 C 1 1 0 0 0 1 A 1 B 1 C 1 FLOYD CONNELLY FORMER EXECUTIVE DIRECTOR OF CMMIC, INC. CSV OF LIFE INSURANCE X 455570 301054 0 1 1 THOMAS CUMMINGS FORMER CEO OF MARLBOROUGH HOSPITAL CSV OF LIFE INSURANCE X 377630 230850 0 1 1 WILLIAM J WILLIAMS FORMER OFFICER OF HEALTHALLIANCE HOSPITALS, INC. CSV OF LIFE INSURANCE X 1981627 4171785 0 1 1 4703689 FERNANDO CATALINA MD BOD 346180 RENTAL OF PROPERTY - INCOME 0 ANTHONY J MERCADANTE BOD 448004 PHYSICIAN SERVICES WERE PROVIDED TO HA HOSPITALS, INC. BY CARDIOLOGY INTERNISTS OF LEOMINSTER, INC., OF WHICH ANTHONY J. MERCADANTE'S BROTHER, NICHOLAS MERCADANTE, IS A PRINCIPAL. 0 EDWARD MANZI BOD 212570 RENTAL OF PROPERTY - EXPENSE 0 ERIC W DICKSON MD OFFICER/BOD 493770 ED SERVICES WERE PROVIDED TO HA HOSPITALS, INC. BY WACHUSETT EMERGENCY PHYSICIANS PC, A COMPANY WHICH CONTRACTS ED SERVICES FROM PRINCETON BIO-MEDICAL, A COMPANY WHICH IS CO-OWNED BY ERIC W. DICKSON, M.D. & HIS SPOUSE CATHERINE JONES, M.D. 0 JOHN H BUDD (OF COUNSEL) BOD 1035462 LEGAL SERVICES WERE PROVIDED TO UMM HEALTH CARE, INC. AND UMM MEDICAL CENTER, INC. BY MIRICK, O'CONNELL, DEMALLIE, & LOUGEE, LLP. JOHN H. BUDD IS OF COUNSEL TO THIS LAW FIRM BUT PERFORMED NO WORK FOR UMM AND/OR AFFILIATED ENTITIES. 0 KATHLEEN HYLKA FAMILY MEMBER OF SHARON HYLKA, KEY EMPLOYEE (JANUARY 2014 RETIREMENT) 102657 EMPLOYMENT ARRANGEMENT W/ UMM MEDICAL CENTER, INC. 0 JOANNE D'ONFRO FAMILY MEMBER OF PAUL D'ONFRO, BOD 51529 EMPLOYMENT ARRANGEMENT W/ HA HOSPITALS, INC. 0 ELLEN CARLUCCI FAMILY MEMBER OF DANIEL CARLUCCI, M.D., BOD 128426 EMPLOYMENT ARRANGEMENT W/ MARLBOROUGH HOSPITAL 0 KATHRYN C MAY FAMILY MEMBER OF DEBORAH EKSTROM, OFFICER 44084 EMPLOYMENT ARRANGEMENT W/ UMM MEDICAL CENTER, INC. 0 EILEEN HENRICKSON RN FAMILY MEMBER OF DEBORAH EKSTROM, OFFICER 127940 EMPLOYMENT ARRANGEMENT W/ UMM MEDICAL CENTER, INC. 0 KAREN BUCKLEY RN FAMILY MEMBER OF MARY CARLSON, BOD 51302 EMPLOYMENT ARRANGEMENT W/ MARLBOROUGH HOSPITAL 0 ELAINE GRANVILLE RN FAMILY MEMBER OF CHERYL LAPRIORE, OFFICER/BOD 93949 EMPLOYMENT ARRANGEMENT W/ UMM MEDICAL CENTER, INC. 0 JOSHUA P SZYMANSKI FAMILY MEMBER OF CANDRA SZYMANSKI, INTERIM OFFICER/BOD (UNTIL 12/13) 29352 EMPLOYMENT ARRANGEMENT W/ MARLBOROUGH HOSPITAL 0 LALITA MATTA MD BOD 31132 AMOUNTS WERE PAID TO LALITA MATTA, M.D. BY UMM MEDICAL GROUP, INC., ACTING AS MEDIATOR, FOR MEETING CERTAIN TARGETS AND/OR OTHER CRITERION AS ESTABLISHED IN 3RD PARTY PAYER CONTRACTS. DEPENDENT ON THE AGREEMENT AND THE MEASURES MET, PAYMENTS CAN BE IN THE FORM OF ADDITIONAL COMPENSATION AND/OR AS A RETURN OF WITHHELD FUNDS. 0 WILLIAM MCGRAIL ESQUIRE BOD 775527 CLINTON HOSPITAL ASSOCIATION HAS A CERTIFICATE OF DEPOSIT WITH CLINTON SAVINGS BANK, OF WHICH WILLIAM MCGRAIL, ESQUIRE IS A BOARD MEMBER. THE INTEREST RATE WAS ASSESSED AND COMPARED WITH THOSE OF OTHER LOCAL BANKS AND DETERMINED TO BE FAIR MARKET VALUE. 0 ROBERT J PAULHUS JR BOD 775527 CLINTON HOSPITAL ASSOCIATION HAS A CERTIFICATE OF DEPOSIT WITH CLINTON SAVINGS BANK, OF WHICH ROBERT J. PAULHUS, JR. IS THE PRESIDENT AND CEO. THE INTEREST RATE WAS ASSESSED AND COMPARED WITH THOSE OF OTHER LOCAL BANKS AND DETERMINED TO BE FAIR MARKET VALUE. 0 GERARD P RICHER BOD 433501 MARLBOROUGH HOSPITAL HAS A CERTIFICATE OF DEPOSIT WITH ST. MARY'S CREDIT UNION, OF WHICH GERARD P. RICHER IS THE CHAIRPERSON OF THE BOARD OF DIRECTORS. THE INTEREST RATE WAS ASSESSED AND COMPARED WITH THOSE OF OTHER LOCAL BANKS AND DETERMINED TO BE FAIR MARKET VALUE. 0 SCH L, PART II, LOANS FROM INTERESTED PERSONS: NAME OF INTERESTED PERSON, TITLE, ORIGINAL PRINCIPAL AMOUNT, BALANCE DUETHOMAS CUMMINGS, FORMER CEO OF MARLBOROUGH HOSPITAL, $377,630, $230,850WILLIAM J. WILLIAMS, FORMER OFFICER OF HEALTHALLIANCE HOSPITALS, INC., $1,981,627, $4,171,785FLOYD CONNELLY, FORMER DIRECTOR OF CMMIC, INC., $455,570, $301,054TOTAL ORIGINAL PRINCIPAL AMOUNT $2,814,827TOTAL BALANCE DUE $4,703,689AMOUNTS DUE FROM FORMER OFFICERS PERTAIN TO SPLIT DOLLAR LIFE INSURANCE POLICIES OF THE RESPECTED INDIVIDUALS. THESE POLICIES WERE ORIGINATED AT VARIOUS TIMES DURING THE INSURED'S EMPLOYMENT WITH UMASS MEMORIAL HEALTH CARE, INC. THE CORRESPONDING POLICY PREMIUMS WERE FUNDED BY THE EMPLOYER AS AN EMPLOYEE BENEFIT. IN ACCORDANCE WITH IRS NOTICE 2002-8, TREASURY REGULATION 1.61-22 AND TREASURY REGULATION 1.7872-15, THESE PAYMENTS REQUIRE CLASSIFICATION AS LOANS DUE FROM THE INSURED. THESE LOAN BALANCES ARE REFLECTED AT THE LOWER OF THE DISCOUNTED CASH SURRENDER VALUE OR DISCOUNTED CUMULATIVE PREMIUMS PAID. SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: SEVERAL OF OUR COMMUNITY HOSPITALS MAINTAIN LOCAL BANK ACCOUNTS IN THEIR RESPECTIVE COMMUNITIES. EACH ALSO HAS TRUSTEES FROM THESE BANKS ON THEIR BOARDS. THESE BANKING RELATIONSHIPS HAVE BEEN ASSESSED, MEET FAIR MARKET VALUE REQUIREMENTS, AND MOST ARE VALUED WELL BELOW THE DISCLOSURE THRESHOLDS. BALANCES PERTAINING TO CERTIFICATES OF DEPOSIT THAT EXCEED THE DISCLOSURE THRESHOLDS HAVE BEEN SEPARATELY REPORTED. CENTRAL MASSACHUSETTS MAGNETIC IMAGING CENTER, INC. - CASH 2015-09-30 506905 BOOK VALUE 222605679 UMASS MEMORIAL HEALTH VENTURES INC 306 BELMONT STREET WORCESTER MA 01604 501(C)(3) CENTRAL MASSACHUSETTS MAGNETIC IMAGINING CENTER, INC. - CURRENT ASSETS 2015-09-30 14767673 BOOK VALUE 222605679 UMASS MEMORIAL HEALTH VENTURES INC 306 BELMONT STREET WORCESTER MA 01604 501(C)(3) CENTRAL MASSACHUSETTS MAGNETIC IMAGING CENTER, INC. - NOTES RECEIVABLE 2015-09-30 1739565 BOOK VALUE 222605679 UMASS MEMORIAL HEALTH VENTURES INC 306 BELMONT STREET WORCESTER MA 01604 501(C)(3) CENTRAL MASSACHUSETTS MAGNETIC IMAGING CENTER, INC. - INVESTMENTS 2015-09-30 9999523 BOOK VALUE 222605679 UMASS MEMORIAL HEALTH VENTURES INC 306 BELMONT STREET WORCESTER MA 01604 501(C)(3) CENTRAL MASSACHUSETTS MAGNETIC IMAGING CENTER, INC. - OTHER ASSETS 2015-09-30 4125282 BOOK VALUE 222605679 UMASS MEMORIAL HEALTH VENTURES INC 306 BELMONT STREET WORCESTER MA 01604 501(C)(3) 1 0 0 0 1 1 1 1 0 PART I, LINE 2E: EXPLANATION OF INVOLVEMENT: SEVERAL OF THE DIRECTORS OF CENTRAL MASSACHUSETTS MAGNETIC IMAGING CENTER, INC. ARE ALREADY OFFICERS AND/OR DIRECTORS OF THE TRANSFEREE ORGANIZATION. BOTH ORGANIZATIONS ARE INCLUDED IN THIS GROUP RETURN - GROUP EXEMPTION #3642SERGIO MELGARFRANCIS W. SMITHTODD A. KEATINGPAUL KANGASJOHN H. BUDDFREDERICK G. CROCKERGERARD P. RICHERERIC W. DICKSON, MDCHERYL LAPRIOREEDWARD J. PARRY, IIICENTRAL MASSACHUSETTS MAGNETIC IMAGING CENTER, INC. WAS MERGED INTO ANOTHER ORGANIZATION WITHIN THE UMASS MEMORIAL SYSTEM.SEE ATTACHED MERGER DOCUMENTS FORM 990, PART VI, SECTION A, LINE 2 DISCLOSURE YEAR, DISCLOSING INDIVIDUAL, TITLE/ROLE, RELATIONSHIP WITH, RELATIONSHIP UMMHC 2014 - BENNETT, RICHARD, BOARD MEMBER, MARLBOROUGH SAVINGS BANK (BUSINESS) VENTURES 2014 - BUDD, JOHN, BOARD MEMBER, PAUL D'ONFRO (BUSINESS) MEMBER ENTITIES HEALTHALLIANCE 2014 - CLEMENTI, JOHN, BOARD MEMBER, 80 ERDMAN WAY LLC (BUSINESS) 2014 - CATALINA, FERNANDO, BOARD MEMBER, BOYS & GIRLS CLUB (BUSINESS) CHL 2014 - EKSTROM, DEBORAH, CEO, CHL, FIDELITY COOPERATIVE BANK (EDWARD MANZI) (BUSINESS), FIDELITY MUTUAL HOLDING COMPANY (BUSINESS) MARLBOROUGH 2014 - BENNETT, RICHARD, BOARD MEMBER, MARLBOROUGH SAVINGS BANK (BUSINESS) 2014 - CARLUCCI, DANIEL, BOARD MEMBER, ELLEN CARLUCCI (FAMILY) CLINTON 2014 - PAULHUS, JR., ROBERT, BOARD MEMBER, PAUL CHERUBINI (BUSINESS) 2014 - CHERUBINI, PAUL, BOARD MEMBER, PAULHUS, JR., ROBERT (BUSINESS) UMM ACO 2014 - NONE UMM MED GROUP 2014 - NONE FORM 990, PART VI, SECTION A, LINE 6 THERE ARE NO CLASSES OF DIRECTORS. THE VOTING RIGHTS OF EACH MEMBER'S BOARD ARE ABSOLUTE. FORM 990, PART VI, SECTION A, LINE 7A THE MAJORITY OF ENTITIES IN THE CONSOLIDATED GROUP HAVE A SOLE MEMBER (WHICH IS ALSO WITHIN THE CONSOLIDATED GROUP) THAT ELECTS THE BOARD OF TRUSTEES. THERE ARE NO CLASSES OF TRUSTEES. THE MAJORITY OF THE ENTITIES RESERVE TO THE MEMBER THE POWER TO REMOVE TRUSTEES, TO FILL VACANCIES, AND TO INCREASE OR DECREASE THE SIZE OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 7B THE MAJORITY OF THE ENTITIES IN THE CONSOLIDATED GROUP HAVE A SOLE MEMBER (WHICH IS ALSO WITHIN THE CONSOLIDATED GROUP) WITH THE RIGHT TO APPROVE OR RATIFY DECISIONS OF THE ENTITY, WHICH IS EXERCISED BY THAT MEMBER'S BOARD OF TRUSTEES. THERE ARE NO CLASSES OF TRUSTEES OR MEMBERS. THUS, THE VOTING RIGHTS OF A MEMBER BOARD ARE ABSOLUTE. GENERALLY, THE SOLE MEMBER OF EACH ENTITY RESERVES THE POWER TO APPROVE MAJOR TRANSACTIONS; TO MERGE, CONSOLIDATE OR LIQUIDATE THE CORPORATION'S ASSETS; TO ADOPT ANNUAL OPERATING AND CAPITAL BUDGETS AND AMENDMENTS; TO ENTER INTO LOAN AGREEMENTS AND/OR GUARANTEES; TO APPOINT AND/OR ELECT THE PRESIDENT AND/OR CEO; TO ELECT AND/OR APPOINT AND REMOVE TRUSTEES, FILL VACANCIES, TO INCREASE OR DECREASE THE SIZE OF THE BOARD; AND TO APPROVE UNBUDGETED EXPENDITURES. FORM 990, PART VI, SECTION B, LINE 11 SECTIONS OF THE CORE FORM 990 RELATED TO EXECUTIVE COMPENSATION AND SCHEDULE J ARE REVIEWED IN DETAIL WITH THE ORGANIZATION'S COMPENSATION COMMITTEE OF THE BOARD. THE COMPLIANCE COMMITTEE OF THE BOARD REVIEWS ALL CONTENT ASSOCIATED WITH SCHEDULE L. THE AUDIT COMMITTEE OF THE BOARD REVIEWS THE FORM 990, INCLUDING THE ABOVE SCHEDULES AND RECOMMENDS THE FORM 990 TO THE FULL BOARD FOR APPROVAL. THE FULL BOARD IS GIVEN ACCESS TO THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C PAGE 6 SECTION B. POLICIES LINE 12C: THE CONFLICT OF INTEREST POLICY REQUIRES BOARD MEMBERS AND MANAGEMENT TO COMPLETE ANNUAL DISCLOSURE STATEMENTS AND, TO UPDATE THESE DISCLOSURE STATEMENTS FOR SIGNIFICANT CHANGES IN THEIR OUTSIDE GOVERNANCE AND PROFESSIONAL ACTIVITIES OR, FINANCIAL RELATIONSHIPS AS APPROPRIATE. ADDITIONALLY, ALL TRANSACTIONS INVOLVING BOARD MEMBERS OR MANAGEMENT AND THE ORGANIZATION ARE REQUIRED TO BE APPROVED BY THE COMPLIANCE COMMITTEE OF THE BOARD AND, THERE IS ACTIVE MONITORING AND COMMUNICATION TO ENSURE INDIVIDUALS WITH OUTSIDE RELATIONSHIPS DO NOT INAPPROPRIATELY PARTICIPATE IN BUSINESS DECISIONS OF THE ORGANIZATION, PURCHASING OR RESEARCH DECISIONS. FORM 990, PART VI, SECTION B, LINE 15 PAGE 6 SECTION B. POLICIES LINE 15B: AT UMASS MEMORIAL, ALL COMPENSATION MATTERS FOR THE CEO AND SENIOR EXECUTIVES THROUGHOUT THE SYSTEM (INCLUDING ALL "DISQUALIFIED PERSONS") ARE GOVERNED AND OVERSEEN BY THE BOARD OF TRUSTEES OF THE PARENT. THE BOARD APPROVED A COMPENSATION PHILOSOPHY THAT GOVERNS ALL SUCH DECISIONS. THE PHILOSOPHY INCLUDES THE OBJECTIVES OF THE PROGRAM, COMPONENTS OF EXECUTIVE COMPENSATION, THE RELEVANT MARKET, POSITIONING IN THE MARKET, FACTORS CONSIDERED IN SETTING EXECUTIVE COMPENSATION AND THE IMPORTANCE OF TYING SUCH COMPENSATION TO PERFORMANCE. THE BOARD ESTABLISHED A COMPENSATION COMMITTEE, MADE UP OF DISINTERESTED TRUSTEES, WHO ARE GIVEN THE AUTHORITY TO ESTABLISH COMPENSATION FOR ALL SENIOR EXECUTIVES, WITHIN THE PARAMETERS OF THE PHILOSOPHY, AND WITH FULL AND COMPLETE REPORTING TO THE FULL BOARD. THE COMPENSATION COMMITTEE PERFORMS ITS WORK PURSUANT TO ITS CHARTER AND A COMPENSATION POLICY THAT ESTABLISHES THE PROCESS THE COMMITTEE WILL FOLLOW IN REVIEWING AND APPROVING EXECUTIVE COMPENSATION EACH YEAR. THE COMMITTEE ENSURES THAT ITS PROCESS MEETS THE REBUTABLE PRESUMPTION OF REASONABLENESS ESTABLISHED BY THE IRS. IN ORDER TO ASSIST THE COMMITTEE IN ITS RESPONSIBILITIES, THE COMPENSATION COMMITTEE HIRES INDEPENDENT, OUTSIDE COMPENSATION CONSULTANTS TO ADVISE THE COMMITTEE AND THE BOARD ON THE REASONABLENESS OF OVERALL EXECUTIVE COMPENSATION PROGRAM, INCLUDING COMPENSATION OF THE SPECIFIC EXECUTIVES. THESE CONSULTANTS REPORT DIRECTLY TO THE COMMITTEE AND NOT TO MANAGEMENT. THE COMMITTEE WORKS WITH THESE CONSULTANTS, AND WITH LEGAL COUNSEL, TO ENSURE THAT ALL COMPENSATION PAID, AS WELL AS THE PROCESS FOLLOWED TO DETERMINE SUCH COMPENSATION, IS REASONABLE, MEETS ALL REGULATORY REQUIREMENTS AND IS COMPETITIVE WITH THE RELEVANT MARKET. FORM 990, PART VI, SECTION C, LINE 19 PAGE 6: LINE 19 UMASS MEMORIAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AS REQUIRED BY APPLICABLE STATE AND FEDERAL LAWS, AND BY REQUEST ON A CASE-BY-CASE BASIS. FORM 990, PART VIII, LINE 11 - MISC. REVENUE, COLUMN C - UNREL. BUS. REVENU JOINT VENTURE UNRELATED BUSINESS INCOME (LOSS) FROM K-1'S TAX YEAR EIN NAME 2014 04-2708828 BIO-LAB, INC. 2013 46-4276493 SHIELDS SPECIALTY PHARMACY OF SPRINGFIELD, LLC 2014 46-4276493 SHIELDS SPECIALTY PHARMACY OF SPRINGFIELD, LLC 2014 47-1510851 SHIELDS PHARMACY OF NEWARK, LLC FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 211,958,691. MANAGEMENT AND GENERAL EXPENSES 72,877,307. FUNDRAISING EXPENSES 32,881. TOTAL EXPENSES 284,868,879. FORM 990, PART IX, LINE 11G - DETAIL LINE 25 - TOTAL FUNCTIONAL EXPENSES - COLUMN (A) $2,483,941,839 LINE 11G - OTHER FEES - COLUMN (A) $ 284,868,879 PERCENTAGE OF EXPENSES ON LINE 11G TO TOTAL EXPENSES 11% DETAIL OF OTHER FEES ON LINE 11G AFFILIATE PURCHASED SERVICES $ 98,528,699 MEDICAL SCHOOL INTERNS AND RESIDENTS SERVICES $ 39,526,447 OUTSIDE LAB SERVICES $ 12,873,728 CLINICAL ENGINEERING SERVICES $ 11,686,014 PURCHASED TEMPORARY HELP $ 9,038,274 ICD-10 CHARGES $ 4,212,717 TRANSCRIPTION SERVICES $ 3,964,440 PROFESSIONAL MEDICAL SERVICES $ 3,287,213 DISCOUNT PURCHASING SERVICES $ 2,006,491 PRIVACY ADVISORY SERVICES $ 1,256,055 RECRUITMENT FEES $ 831,317 MEDICAL SCHOOL PARTICIPATION PAYMENT $ 631,844 COLLECTION AGENCY SERVICES $ 478,039 SHIELDS CARE PURCHASED SERVICES $ 245,462 LINEN SERVICES $ 70,913 ANSWERING SERVICES $ 20,917 OTHER $ 96,210,309 TOTAL $ 284,868,879 FORM 990, PART XI, LINE 9: NET ASSETS RELEASED FROM RESTRICTIONS FOR OPERATIONS 1,757,904. PENSION RELATED CHANGES OTHER THAN NET PERIODIC BENEFIT COST -57,317,934. CHANGE IN BENEFICIAL INTERESTS IN PERPETUAL TRUSTS -1,846,398. MISCELLANEOUS 184. NET ASSETS RELEASED FROM RESTRICTION FOR PPE 594,093. TEMPORARY RESTRICTED FUND EXPENDITURES -2,352,948. ALLOWANCE FOR UNCOLLECTIBLE PLEDGES 84,976. PLEDGE RECEIVABLES, WRITE-OFFS AND ADJUSTMENTS -224,049. TRANSFERS TO FR FUNDS -75,438. BOOK TO TAX DIFFERENCE FROM S-CORP K-1 4,119,722. PAGE 1, LINE H(B) LIST OF AFFILIATED ORGANIZATIONS THE CLINTON HOSPITAL ASSOCIATION; 201 HIGHLAND STREET, CLINTON, MA 01510 EIN: 04-1185520 FISCAL YEAR END: 9/30/2015 MARLBOROUGH HOSPITAL; 157 UNION STREET, MARLBOROUGH, MA 01752 EIN: 04-2104693 FISCAL YEAR END: 9/30/2015 UMASS MEMORIAL BEHAVIORAL HEALTH SYSTEM, INC.; 306 BELMONT STREET, WORCESTER, MA 01604 EIN: 04-3374724 FISCAL YEAR END: 9/30/2015 UMASS MEMORIAL COMMUNITY HOSPITALS, INC.; 306 BELMONT STREET, WORCESTER, MA 01604 EIN: 04-3296271 FISCAL YEAR END: 9/30/2015 UMASS MEMORIAL HEALTH VENTURES, INC.; 306 BELMONT STREET, WORCESTER, MA 01604 EIN: 22-2605679 FISCAL YEAR END: 9/30/2015 UMASS MEMORIAL MEDICAL CENTER, INC.; 306 BELMONT STREET, WORCESTER, MA 01604 EIN: 04-3358564 FISCAL YEAR END: 9/30/2015 UMASS MEMORIAL MEDICAL GROUP, INC.; 306 BELMONT STREET, WORCESTER, MA 01604 EIN: 04-2911067 FISCAL YEAR END: 9/30/2015 UMASS MEMORIAL REALTY, INC.; 306 BELMONT STREET, WORCESTER, MA 01604 EIN: 04-2805630 FISCAL YEAR END: 9/30/2015 UMASS MEMORIAL HEALTH CARE, INC. (PARENT); 306 BELMONT STREET, WORCESTER, MA 01604 EIN: 04-3358566 FISCAL YEAR END: 9/30/2015 COMMUNITY HEALTHLINK, INC.; 72 JAQUES AVENUE, WORCESTER, MA 01610 EIN: 04-2626179 FISCAL YEAR END: 9/30/2015 CENTRAL MASSACHUSETTS MAGNETIC IMAGING CENTER, INC.; 367 PLANTATION STREET, WORCESTER, MA 01605 EIN: 04-2981362 FISCAL YEAR END: 9/30/2015 CENTRAL NEW ENGLAND HEALTHALLIANCE, INC.; 60 HOSPITAL ROAD, LEOMINSTER, MA 01453 EIN: 04-3172496 FISCAL YEAR END: 9/30/2015 COORDINATED PRIMARY CARE, INC.; 60 HOSPITAL ROAD, LEOMINSTER, MA 01453 EIN: 04-3210002 FISCAL YEAR END: 9/30/2015 HEALTHALLIANCE HOME HEALTH AND HOSPICE, INC.; 25 TUCKER ROAD, LEOMINSTER, MA 01453 EIN: 04-2932308 FISCAL YEAR END: 9/30/2015 HEALTHALLIANCE HOSPITALS, INC.; 60 HOSPITAL ROAD, LEOMINSTER, MA 01453 EIN: 04-2103555 FISCAL YEAR END: 9/30/2015 UMASS MEMORIAL ACCOUNTABLE CARE ORGANIZATION, INC.; 306 BELMONT STREET, WORCESTER, MA 01604 EIN: 46-2871359 FISCAL YEAR END: 9/30/2015 UMASS MEMORIAL FOUNDATION INC 333 SOUTH STREET SHREWSBURY MA 01545 043108190 FUNDRAISING SUPPORT MA 501(C)(3) 11C N/A 0 HEALTH ALLIANCE REALTY CORPORATION 60 HOSPITAL ROAD LEOMINSTER MA 01473 042560754 REAL ESTATE MANAGEMENT MA 501(C)(2) N/A N/A 0 UMASS MEMORIAL INVESTMENT PARTNERSHIP LLP ONE BIOTECH PARK 355 PLANTATION ST WORCESTER MA 01605 043530755 INVESTMENT MANAGEMENT MA N/A EXCLUDED 514 23004489 453170744 0 2186 1 1.00000 UMASS MEMORIAL MRI OF MARLBOROUGH LLC 157 UNION STREET MARLBOROUGH MA 01752 202293995 MAGNETIC RESONANCE IMAGING MA MARLBOROUGH HOSPITAL RELATED 565497 412728 0 0 0.56000 UMASS MEMORIAL HEALTH ALLIANCE MRI CENTER LLC 60 HOSPITAL ROAD LEOMINSTER MA 01453 043561571 MAGNETIC RESONANCE IMAGING MA N/A RELATED 993573 1289638 0 0 0.60000 COMMONWEALTH PROFESSIONAL ASSURANCE CO LTD PO BOX 1051 GT GRAND CAYMAN CJ 980226143 INSURANCE CJ N/A C -14339873 167731722 1.00000 0 MEMORIAL OFFICE CONDOMINIUM TRUST 306 BELMONT STREET WORCESTER MA 01604 046616900 CONDOMINIUM ASSOCIATION MA UMASS MEMORIAL MEDICAL CENTER INC T 271634 0.53690 0 BIO-LAB INC 215 WEST STREET MILFORD MA 01757 042708828 CLINICAL LABORATORY MA UMASS MEMORIAL HEALTH VENTURES INC S -45915 2212007 1.00000 0 116 BELMONT ST INC CO APPLETON CORP 57 SUFFOLK STREET HOLYOKE MA 01040 042717865 CONDOMINIUM ASSOCIATION MA UMASS MEMORIAL REALTY INC C 215 144305 0.63040 0 0 1 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 1 COMMONWEALTH PROFESSIONAL ASSURANCE COMPANY LTD L 25903450 FAIR VALUE UMASS MEMORIAL MEDICAL CENTER INC B 328847 FAIR VALUE UMASS MEMORIAL REALTY INC P 256898 FAIR VALUE MARLBOROUGH HOSPITAL P 4131200 FAIR VALUE THE CLINTON HOSPITAL ASSOCIATION P 2743141 FAIR VALUE CENTRAL NEW ENGLAND HEALTH ALLIANCE INC P 4016667 FAIR VALUE UMASS MEMORIAL MEDICAL CENTER INC P 135617159 FAIR VALUE UMASS MEMORIAL MEDICAL GROUP INC P 34291782 FAIR VALUE COMMUNITY HEALTHLINK INC P 485800 FAIR VALUE UMASS MEMORIAL MEDICAL GROUP INC B 705787 FAIR VALUE UMASS MEMORIAL REALTY INC J 3152642 FAIR VALUE THE CLINTON HOSPITAL ASSOCIATION B 312500 FAIR VALUE COMMONWEALTH PROFESSIONAL ASSURANCE COMPANY LTD P 33585804 FAIR VALUE UMASS MEMORIAL MEDICAL CENTER INC S 483561 FAIR VALUE UMASS MEMORIAL MEDICAL CENTER INC Q 27935 FAIR VALUE UMASS MEMORIAL MEDICAL GROUP INC L 5383644 FAIR VALUE CENTRAL NEW ENGLAND HEALTH ALLIANCE INC Q 8026 FAIR VALUE UMASS MEMORIAL ACCOUNTABLE CARE ORGANIZATION INC L 353923 FAIR VALUE MARLBOROUGH HOSPITAL B 9312 FAIR VALUE CENTRAL NEW ENGLAND HEALTH ALLIANCE INC B 112589 FAIR VALUE COMMUNITY HEALTHLINK INC R 5895 FAIR VALUE