2016-08-12T11:13:35-05:00 2015-09-30 135381590 BDO USA LLP 200 PORTLAND STREET BOSTON MA 021141709 990 2014-10-01 042156082 FRANCISCAN HOSPITAL FOR CHILDREN INC FRAN 6172543800 30 WARREN STREET BRIGHTON MA 02135 CPA CEO 6172543800 2016-08-08 1 JEFFREY T ROGERS P01074284 6177427788 2014 2016-09-27 15:27:22Z JOHN NASH 30 WARREN STREET BRIGHTON MA 02135 58290585 0 X HTTP://WWW.FRANCISCANHOSPITAL.ORG X 1945 MA FRANCISCAN HOSPITAL FOR CHILDREN, INC. IS A CHARITABLE ORGANIZATION DELIVERING MEDICAL AND EDUCATIONAL SERVICES TO CHILDREN AND ADOLESCENTS WITH SPECIAL NEEDS. ADDITIONALLY, THE ORGANIZATION OFFERS PEDIATRIC SERVICES TO THE POPULATION IN GENERAL. 16 15 842 100 0 0 2434300 2072740 54704337 55319293 24115 34641 2354912 342189 59517664 57768863 0 0 0 0 34115008 34834801 56100 61814 631394 21555141 21843763 55726249 56740378 3791415 1028485 42696925 43113481 21169278 22565151 21527647 20548330 X TO PROVIDE COMPASSIONATE CARE AND EDUCATION TO CHILDREN WITH SPECIAL HEALTH CARE NEEDS TO HELP THEM REACH THEIR FULL POTENTIAL. TO CREATE A PEDIATRIC CENTER FOR CHILDREN WITH SPECIAL NEEDS, THAT IS A NATIONALLY AND INTERNATIONALLY RECOGNIZED MODEL, LEADER AND ADVOCATE OF CARE, THAT OFFERS THE BEST POSSIBLE OUTCOME FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS. 0 0 29742319 32457784 INPATIENT SERVICES - DELIVERY OF MEDICAL, EDUCATIONAL AND OTHER SERVICES TO A SPECIAL NEEDS PEDIATRIC POPULATION IN EASTERN MASSACHUSETTS. FRANCISCAN HOSPITAL FOR CHILDREN HAD 832 ADMISSIONS AND 21,778 PATIENT DAYS DURING FY15. 18505143 23376795 OUTPATIENT SERVICES - DELIVERY OF MEDICAL, EDUCATIONAL AND OTHER SERVICES TO A SPECIAL NEEDS PEDIATRIC POPULATION IN EASTERN MASSACHUSETTS. FRANCISCAN HOSPITAL FOR CHILDREN HAD 287,923 OUTPATIENT PROCEDURES DURING FY15. 48247462 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 1 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1 0 0 0 1 101 0 1 842 1 0 0 0 0 0 1 1 0 0 0 0 X 16 15 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 MA X ALEX DENUCCI 6177791225 30 WARREN STREET BRIGHTON MA 021353680 DOUGLAS C CHAMBERLAIN CLERK 1.30 X X 0 0 0 JOAN E SIFF ESQ DIRECTOR 1.30 X 0 0 0 TIMOTHY J FALLON DIRECTOR 1.30 X 0 0 0 JANE L LUNDQUIST DIRECTOR 1.30 X 0 0 0 SR ELIZABETH ANN CONYERS DIRECTOR 1.30 X 0 0 0 SHEILA FARRAGHER-GEMMA DIRECTOR 1.30 X 0 0 0 SR ALINE GIROUX FMM DIRECTOR 1.30 X 0 0 0 PAUL KANE DIRECTOR 1.30 X 0 0 0 DR JAMES MANDELL VICE CHAIR OF BOARD 1.30 X 0 0 0 ROBERT B NEEDHAM CFA CHAIRMAN OF BOARD 1.30 X 0 0 0 JOHN NASH PRESIDENT/CEO 40.00 X X 419915 0 91736 RICHARD J SULLIVAN ESQ DIRECTOR 1.30 X 0 0 0 SR ANNE TURBINI FMM DIRECTOR 1.30 X 0 0 0 JEFFREY BLACK DIRECTOR 1.30 X 0 0 0 IKE PAPADOPOULOS DIRECTOR 1.30 X 0 0 0 DAVID LESLIE DIRECTOR/PHYSICIAN 40.00 X 256631 0 18201 JOHN E LARSEN DIRECTOR 1.30 X 0 0 0 LAURA PONTIN DIRECTOR 1.30 X 0 0 0 DONNA POLSELLI COO 40.00 X 241427 0 8056 ALEXANDER DENUCCI CFO/TREASURER OF BOARD 40.00 X 210886 0 17669 JANE O'BRIEN MEDICAL DIRECTOR 40.00 X 216906 0 18225 JEFFREY L FORMAN PHYSICIAN 40.00 X 240893 0 17163 CATHERINE E MILLER ANESTHESIOLOGIST 40.00 X 225846 0 17673 CHARLES KENDRICK ANESTHESIOLOGIST 40.00 X 206027 0 12785 MARK CUMMINGS CHIEF ADVANCEMENT OFFICER 40.00 X 205101 0 13590 MARY LOU KELLEHER VP OF NURSING 40.00 X 223300 0 2248 2446932 0 217346 31 0 1 0 PEDIATRIA HEALTHCARE LLC 5185 PEACHTREE PARKWAY SUITE 350 NORCROSS GA 30082 MANAGEMENT OF HOMECARE 3559030 MCLEAN HOSPITAL CORP 115 MILL STREET BELMONT MA 02478 PSYCHIATRIC CLINICAL MANAGEMENT 1514256 JLU HEALTH RECORD SYSTEMS 2 COLUMBIA ROAD PEMBROKE MA 02359 ON-SITE MEDICAL RECORDS MANAGEMENT 142761 UNIDINE CORPORATION 1000 WASHINGTON STREET SUITE 510 BOSTON MA 02118 FOOD SERVICE MANAGEMENT 137644 PST SERVICES INC PO BOX 742526 ATLANTA GA 30374 BILLING 121488 6 659138 546394 867208 2072740 NET PATIENT SERVICE RE 900099 50104840 50104840 DAY SCHOOL PROGRAM 900099 4884956 4884956 DAY CARE PROGRAM 900099 329497 329497 55319293 34641 34641 348625 659138 521722 -173097 -173097 MISCELLANEOUS 900099 270763 270763 CAFETERIA 900099 244523 244523 515286 57768863 55834579 0 -138456 X 1672994 1672994 28008842 24657011 2872431 479400 379771 239870 135237 4664 2665287 2270914 352072 42301 2107907 1767630 307164 33113 2585834 2585834 192299 15635 176664 105773 105773 83859 83859 61814 61814 7843955 7118544 725411 56723 7659 49064 750995 470210 280785 597643 597643 1418288 1418288 23460 19109 4351 20473 407 20066 594008 535624 58384 2451370 2197083 254287 231180 231180 DRUGS, MEDICAL, LAB & O 3058207 3057289 904 14 EQUIPMENT REPAIR & MAIN 981682 967545 4147 9990 FOOD EXPENSE 490821 452101 38622 98 357193 235529 121664 56740378 48247462 7861522 631394 5882308 4637892 250313 7438658 9180146 832909 944598 194028 228204 612347 309454 58906905 34977594 23009318 23929311 3381522 2854945 1095522 1028931 42696925 43113481 6640682 7131271 325050 36269 10575447 10723131 223066 111533 3405033 4562947 21169278 22565151 X 19349807 18418851 2093156 2049022 84684 80457 21527647 20548330 42696925 43113481 X 1028485 3907 -2011709 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 86250 0 0 86250 0 PART II-B, LINE 1: CONTACT WITH AND REPRESENTATION BEFORE STATE AGENCIES RESPONSIBLE FOR THE HOSPITAL'S PAYMENT RATES AND REGULATORY REQUIREMENTS. 544171 -4134 300397 239640 573814 1012 30655 544171 431009 134863 7942 573814 628488 1636 199115 431009 555615 77435 -4562 628488 0.65000 0.34000 0.01000 1 0 517554 517554 12068206 6275844 5792362 25301894 12792915 12508979 19579633 15908835 3670798 1439618 1439618 23929311 CASH AND EQUIVALENTS 2395255 F MONEY MARKET FUNDS 411098 F MUTUAL FUNDS 48592 F 2854945 LONG-TERM PENSION LIABILITY 2070932 DUE TO THIRD PARTY PAYERS 2120208 LONG-TERM ASSET RETIREMENT OBLIGATION 371807 4562947 X PART V, LINE 4: USE OF THE ENDOWMENT FUNDS HAVE BEEN RESTRICTED BY DONOR TO A SPECIFIC PERIOD OR PURPOSE. PART X, LINE 2: IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, THE HOSPITAL ANNUALLY EVALUATES ITS TAX STATUS AND TAX POSITIONS TAKEN WITH RESPECT TO ITS OPERATIONS AND FINANCIAL POSITION. X X X X X 1 LIZ NOVACK EVENTS 61 ALBAN ROAD NEWTON MA 02468 COMMUNITY LEADERSHIP AWARD DINNER 0 536929 14018 522911 BLUE SKY 38 RIDGE STREET ARLINGTON MA 02474 WIFFLE BALL 0 77264 30796 46468 COVENTURES MANAGEMENT CO 1 DESIGN CENTER PLACE SUITE 718 BOSTON MA 02210 5K WALK/RUN 0 69565 17000 52565 683758 61814 621944 MA COMMUNITY LEADERSHIP AWARD DINNER 536929 382579 154350 85000 151608 815 4750 107894 CONROY GOLF TOURNAMENT 285860 271140 14720 29851 22188 750 55801 3 184974 5419 179555 227 4250 243 1733 56612 1007763 659138 348625 85227 185709 23246 7233 220307 521722 -173097 1 1 1 X 1 X 1 0 0 26330754 27253543 -922789 0.00000 26330754 27253543 -922789 133282 138744 -5462 0.00000 679746 15680 664066 0.01170 813028 154424 658604 0.01170 27143782 27407967 -264185 0.01170 9 400 232290 152692 79598 0.00140 9 400 232290 152692 79598 0.00140 1 118215 96513 117051 -20538 X 1 1 1 1 FRANCISCAN HOSPITAL FOR CHILDREN INC 30 WARREN STREET BRIGHTON MA 02135 X X X ADOLESCENT PSYCH UNIT FRANCISCAN HOSPITAL FOR CHILDREN INC 1 0 0 1 X X X X X X X X X 14 1 0 0 1 X WWW.FRANCISCANCHILDRENS.ORG X 1 14 0 1 0 1 X 200.000000000000 400.000000000000 X 1 1 X X X 1 X 1 X 1 X X X X X 0 X X 0 0 FRANCISCAN HOSPITAL FOR CHILDREN, INC. PART V, SECTION B, LINE 5: THE FACILITY HIRED A THIRD PARTY THAT CONDUCTED QUALITATIVE RESEARCH WITH COMMUNITY STAKEHOLDERS AND RESIDENTS TO GATHER IN-DEPTH INFORMATION ON THEIR PERCEPTIONS OF COMMUNITY STRENGTHS AND ASSETS, THEIR PRIORITY HEALTH CONCERNS, AND THEIR SUGGESTIONS ON WHAT PROGRAMMING OR SERVICES ARE MOST NEEDED TO ADDRESS THESE CONCERNS. TO THIS END, DURING FEBRUARY-MARCH 2015, TWO FOCUS GROUPS AND SEVEN KEY INFORMANT INTERVIEWS WERE CONDUCTED TO GATHER FEEDBACK ON RESIDENTS' HEALTH CONCERNS, COMMUNITY CHALLENGES TO ADDRESSING THESE CONCERNS, CURRENT RESOURCES AND STRENGTHS OF THE AREA, AND OPPORTUNITIES FOR THE FUTURE. FRANCISCAN BRAINSTORMED TO IDENTIFY FOCUS GROUP SEGMENTS AND KEY INFORMANTS WORKING ACROSS A RANGE OF SECTORS. PARTICIPANTS REPRESENTED A BROAD CROSS-SECTION FROM THE COMMUNITY, INCLUDING THOSE WHO REPRESENT MEDICALLY UNDERSERVED POPULATIONS, REPRESENTATIVES FROM THE LOCAL GOVERNMENT PUBLIC HEALTH DEPARTMENT WITH EXPERTISE IN PUBLIC HEALTH, COMMUNITY-BASED ORGANIZATIONS, AND HEALTH CARE PROVIDERS. FRANCISCAN HOSPITAL FOR CHILDREN, INC. PART V, SECTION B, LINE 11: AS NOTED IN THE CHNA IMPLEMENTATION STRATEGY ATTACHED TO THIS RETURN, THE HOSPITAL IS DEVELOPING A STRATEGIC PLAN TO IDENTIFY PROGRAMS AND FUTURE PROJECTS THAT WILL ENABLE THE HOSPITAL TO ADDRESS THE SIGNIFICANT NEEDS IN ITS CHNA. FRANCISCAN HOSPITAL FOR CHILDREN, INC. PART V, SECTION B, LINE 18D: USE OF A COLLECTION AGENCY. FRANCISCAN HOSPITAL FOR CHILDREN, INC. PART V, SECTION B, LINE 19D: COLLECTION AGENCIES ATTEMPTED TO COLLECT OUTSTANDING BALANCES. PART I, LINE 7: A COSTING METHODOLOGY WAS NOT USED TO CALCULATE AMOUNTS ON PART I, LINE 7. THE COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2. PART I, LINE 7G: N/A PART I, LN 7 COL(F): N/A PART II, COMMUNITY BUILDING ACTIVITIES: THE ADAPTIVE SKATING PROGRAM INTRODUCES CHILDREN WITH SPECIAL NEEDS TO BASIC ICE SKATING SKILLS. ADAPTIVE BIKE CAMP PROGRAM GOAL VARY BY PARTICIPANT THAT INCLUDES LEARNING HOW TO STEER AND USE THE BRAKES, GETTING ON AND OFF THE BIKE, AND RIDING WITHOUT STOPPING. CHILDREN'S WELLNESS PROVIDES EASILY ACCESSED SCHOOL BASED BEHAVIORIAL HEALTH SERVICES THAT PROMOTE EMOTIONAL AND SOCIAL WELLNESS. FAMILY SUPPORT GROUP DINNERS AND SOCIAL EVENTS ARE ORGANIZED TO HELP FOSTER COMMUNITY AND EXPAND ACCESS TO FAMILY-TO-FAMILY LEARNING. PART III, LINE 4: BAD DEBT EXPENSE IS RECORDED TO REPORT ACCOUNTS RECEIVABLE AT THEIR NET REALIZABLE VALUE. SHOWING THE BAD DEBT AS A DEDUCTION FROM REVENUE MORE CLEARLY REPRESENTS THE AMOUNT OF REVENUE THAT THE FRANCISCAN HOSPITAL ACTUALLY EXPECTS TO COLLECT, THEREBY IMPROVING THE QUALITY AND COMPARABILITY OF THE FINANCIAL STATEMENTS.FRANCISCAN HOSPITAL RECORDS INCLUDES THE AMOUNT OF CHARGES FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY, THE COST OF SERVICES AND SUPPLIES, AND EQUIVALENT SERVICES STATISTICS. PART III, LINE 8: THE COSTING METHODOLOGY USED TO DETERMINE MEDICARE ALLOWABLE COST WAS THE COST TO OUTPATIENT ANCILLARY CHARGE RATIOS AND INPATIENT DAY PER DIEM COST AS REPORTED ON THE MEDICARE 2552 COST REPORT FOR FYE 09/30/2015. PART III, LINE 9B: THE COLLECTION PROCESS ENCOMPASSES BILLING THE PATIENT'S HEALTH INSURANCE(S), FILING APPEALS FOR NON-PAYMENT AND BILLING THE PATIENT. THE STATEMENT/DATA MAILERS ARE PROCESSED BY THE HOSPITAL AND AN EXTERNAL COMPANY. THEY ARE SENT ONCE A MONTH, ONE BUSINESS DAY AFTER THE MONTH-END CLOSE. STATEMENTS/DATA MAILERS ARE SENT TO THE PATIENT'S RESPONSIBLE PARTY EACH MONTH FOR SERVICES NOT COVERED BY THE PATIENT'S INSURANCE COMPANY. THERE WILL BE FOUR STATEMENTS FOR SELF AND SELF-PAY AFTER INSURANCE AND FIVE FOR SELF-PAYMENT. THERE IS A DIFFERENT MESSAGE ON EACH STATEMENT INDICATING STATUS OF ACCOUNT CONTACT.LOW INCOME FAMILIES WHO MEET THE FOLLOWING CRITERIA ARE ELIGIBLE FOR PARTIAL FREE CARE:1. MASSACHUSETTS RESIDENTS WHOSE FAMILY INCOME IS FROM 201% TO 400% OF THE FEDERAL POVERTY INCOME GUIDELINES WILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE FOR THAT PORTION OF THE BILL WHICH EXCEEDS THEIR FAMILY'S ANNUAL DEDUCTIBLE. THIS WILL BE DETERMINED BY A SLIDING FEE SCALE.2. ANY PARTICIPANT IN THE CHILDREN'S MEDICAL SECURITY PLAN WHOSE FAMILY INCOME IS FROM 201% AND 400% OF THE FEDERAL POVERTY INCOME GUIDELINES WILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE FOR THAT PORTION OF THE BILL WHICH EXCEEDS THEIR FAMILY'S ANNUAL DEDUCTIBLE.3. ANY PARTICIPANT IN HEALTH START WHOSE FAMILY INCOME IS FROM 201% AND 400% OF THE FEDERAL POVERTY INCOME GUIDELINES WILL BE ELIGIBLE FOR THAT PORTION OF THE BILL WHICH EXCEEDS THEIR FAMILY'S ANNUAL DEDUCTIBLE.NOTE: THE ANNUAL DEDUCTIBLE FOR PARTIAL FREE CARE EQUALS 40% OF THE DIFFERENCE BETWEEN THE APPLICANT'S FAMILY INCOME AND 200% OF THE FEDERAL POVERTY INCOME GUIDELINES. THE PATIENT IS RESPONSIBLE FOR PAYMENT FOR ALL SERVICES PROVIDED UP TO THIS DEDUCTIBLE AMOUNT. THERE IS ONLY ONE DEDUCTIBLE PER APPROVED PERIOD, THEREFORE, IT IS THE RESPONSIBILITY OF THE PATIENT TO PROVIDE DOCUMENTATION THAT THEIR OBLIGATION HAS BEEN MET. PART VI, LINE 2: ASSESS HEALTH CARE NEEDS OF THE COMMUNITY BY THE FOLLOWING PARTICIPATION IN A TASK FORCE. THE ALLSTON BRIGHTON HEALTH COLLABORATIVE CONDUCTS THE FOLLOWING.DEMOGRAPHICS: IDENTIFY DATA SOURCES, REVIEW EXISTING DATAHELD COMMUNITY FORUM TO SOLICIT INPUT FROM THE COMMUNITY MEMBERSCOMMITTEE BRAINSTORMING PART VI, LINE 3: INPATIENTWE REVIEW ALL POTENTIAL PATIENTS' INSURANCE POLICIES BEFORE ADMISSION FOR LENGTH OF STAY AND COVERAGE GUIDELINES AND LIMITATIONS. MOST PATIENTS WHO HAVE PRIVATE INSURANCE EXHAUST THEIR REHAB BENEFITS WHILE HERE. WE MEET WITH PARENTS/GUARDIANS TO EDUCATE THEM ON THEIR OPTIONS AND IF NECESSARY ASSIST THEM WITH APPLYING FOR GOVERNMENT ASSISTANCE. FOR THOSE WHO DO NOT APPLY OR DO NOT QUALIFY FOR GOVERNMENT ASSISTANCE, THE HOSPITAL PROVIDES MEDICAL AND FINANCIAL HARDSHIP ASSISTANCE BASED ON THE FEDERAL AND STATE POVERTY GUIDELINES.OUTPATIENTWE REVIEW ELIGIBILITY FOR EACH VISIT. WE CONTACT PARENT/GUARDIAN IF THERE IS AN ISSUE. WE ALSO ASSIST PATIENTS WITH THE MASSHEALTH APPLICATION. FOR THOSE WHO DO NOT APPLY OR DO NOT QUALIFY FOR GOVERNMENT ASSISTANCE, THE HOSPITAL PROVIDES MEDICAL AND FINANCIAL HARDSHIP ASSISTANCE BASED ON THE FEDERAL AND STATE POVERTY GUIDELINES. PART VI, LINE 4: TARGET POPULATION - ALLSTON/BRIGHTON NEIGHBORHOOD BUT ALSO FROM METRO BOSTON AND BEYOND.50% OF RESIDENTS ARE BETWEEN THE AGES OF 20-29.NEARLY 90% OF HOUSEHOLDS ARE CHILDLESS (DO NOT HAVE CHILDREN UNDER 18)NEARLY 80% OF RESIDENTS REPORT RENTING RATHER THAN OWNING THEIR PRIMARY RESIDENCY.ALLSTON-BRIGHTON HAS A PREDOMINANTLY CAUCASIAN (WHITE) POPULATION; IT IS ALSO HOME TO A LARGE NUMBER OF DIVERSE GROUPS INCLUDING MANY RECENT IMMIGRANTS FROM SPANISH-SPEAKING COUNTRIES, BRAZIL, CHINA AND RUSSIA.THE MEDIAN INCOME OF ALLSTON-BRIGHTON RESIDENTS IS $47,814THE UNEMPLOYMENT RATE IN ALLSTON-BRIGHTON (4%) WAS HALF THAT OF BOSTON, MA. PART VI, LINE 5: FAMILY SUPPORT GROUPS - FAMILY DINNERS AND SOCIAL EVENTS ARE ORGANIZED TO HELP FOSTER COMMUNITY AND EXPAND ACCESS TO FAMILY-TO-FAMILY LEARNING. PROVIDE SKILLED, RELIABLE INTERPRETER SERVICES TO INCREASE ACCESS TO CARE FOR FAMILIES WHOSE PRIMARY LANGUAGE IS NOT ENGLISH. CHILDHOOD SAFETY ADVOCACY - HOST PRESS CONFERENCES TO INFORM CAREGIVERS ABOUT POOL SAFETY AND HAZARDS TO AVOID. EDUCATION SUPPORT OF HIGHER EDUCATION - WE SERVE AS A SITE WHERE NURSING, PSYCHOLOGY AND MEDICAL RESIDENTS DO THEIR CLINICAL ROTATION. PARTICIPATE IN THE ALLSTON BRIGHTON SUBSTANCE ABUSE TASK FORCE THAT RECEIVED FUNDING TO CONDUCT A COMMUNITY ASSESSMENT. COMMUNITY BENEFITS HAPPENS VIA SEVERAL COMMITTEES THAT ARE MULTI-DISCIPLINARY - MEDICAL PARENT ADVISORY COUNCIL, BEHAVIORIAL PARENT ADVISORY COUNCIL, AND KENNEDY DAY SCHOOL ADVISORY GROUP. PART VI, LINE 6: THE HOSPITAL HAS MAINTAINED A RELATIONSHIP WITH BOSTON UNIVERSITY SCHOOL OF DENTAL MEDICINE'S OUTPATIENT PEDIATRIC DENTAL PROGRAM. RESIDENTS OF THAT PROGRAM COMPLETE A ROTATION IN THE DENTAL CLINIC AT THE HOSPITAL. PART VI, LINE 7, REPORTS FILED WITH STATES MA X 0 0 X X X X 0 0 0 0 0 0 0 0 0 JOHN NASH PRESIDENT/CEO 356915 0 63000 0 0 0 73183 0 18553 0 511651 0 0 0 DAVID LESLIE DIRECTOR/PHYSICIAN 256631 0 0 0 0 0 0 0 18201 0 274832 0 0 0 DONNA POLSELLI COO 231427 0 10000 0 0 0 0 0 8056 0 249483 0 0 0 ALEXANDER DENUCCI CFO/TREASURER OF BOARD 205886 0 5000 0 0 0 0 0 17669 0 228555 0 0 0 JANE O'BRIEN MEDICAL DIRECTOR 206906 0 10000 0 0 0 0 0 18225 0 235131 0 0 0 JEFFREY L FORMAN PHYSICIAN 240893 0 0 0 0 0 0 0 17163 0 258056 0 0 0 CATHERINE E MILLER ANESTHESIOLOGIST 225846 0 0 0 0 0 0 0 17673 0 243519 0 0 0 CHARLES KENDRICK ANESTHESIOLOGIST 206027 0 0 0 0 0 0 0 12785 0 218812 0 0 0 MARK CUMMINGS CHIEF ADVANCEMENT OFFICER 205101 0 0 0 0 0 0 0 13590 0 218691 0 0 0 MARY LOU KELLEHER VP OF NURSING 223300 0 0 0 0 0 0 0 2248 0 225548 0 0 0 A MASSACHUSETTS HEALTH AND EDUCATIONAL FACILITIES AUTHORITY SERIES A 042456011 2010-02-04 11000000 CONSTRUCTION OF NEW SCHOOL 1 0 0 B MASSACHUSETTS DEVELOPMENT FINANCE AGENCY SERIES B 042456011 2015-09-01 10500000 REFINANCING SERIES A BOND 0 0 0 A 975244 10024756 11000000 201162 3077530 6974444 746864 2012 0 0 1 1 B 10500000 568934 122805 9808261 2016 1 0 0 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 0 0 0 1 0 0 0 0 B 0 0 0 0 1 0 0 0 0 A 0 B 0 CAMBRIDGE APPLETON TRUST NA 49% OWNED BY APPLETON PARTNERS, INC. (DOUGLAS CHAMBERLAIN OWNS 35% OF API) 43907 FRANCISCAN HOSPITAL FOR CHILDREN USES CAMBRIDGE APPLETON TRUST N.A. AS ITS INVESTMENT COMPANY. 0 CAROL NASH RELATIVE OF CEO 45415 CONTRACTOR SERVICES FOR RESEARCH/GRANT FUNDING 0 FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION PREPARES THE FORM 990 AND THE RELATED DISCLOSURES WITH ASSISTANCE AND GUIDANCE FROM ITS INDIVIDUAL TAX ADVISORS (CPA FIRM). THE FORM 990 IS REVIEWED BY THE MANAGEMENT TEAM AND THEN COPIES ARE MADE AVAILABLE TO THE BOARD OF DIRECTORS FOR THEIR REVIEW. THE FORM 990 IS SIGNED BY THE PRESIDENT/CEO PRIOR TO SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES THAT ALL MEMBERS AND OFFICERS OF THE BOARD OF DIRECTORS AND ANY MEMBER OF ANY COMMITTEE DISCLOSE IN WRITING (AND UPDATE ANNUALLY) ALL BUSINESS AND OTHER RELATIONSHIPS WHICH MIGHT POTENTIALLY CREATE A CONFLICT OF INTEREST AS DEFINED BY THE POLICY. THE WRITTEN DISCLOSURE SHALL INCLUDE AN ITEMIZATION OF ANY SUBSTANTIVE CONFLICT OF INTEREST FOR SUCH INDIVIDUAL BY VIRTUE OF HIS OR HER ACTIVITIES. THE CONFLICT OF INTEREST POLICY IS REVIEWED BY THE LEGAL DEPARTMENT TO ENSURE INDIVIDUALS WITH OUTSIDE RELATIONSHIPS DO NOT INAPPROPRIATELY PARTICIPATE IN BUSINESS DECISIONS OF THE ORGANIZATION IN WHICH THEY ARE NOT INDEPENDENT. FORM 990, PART VI, SECTION B, LINE 15 ALL COMPENSATION FOR THE CEO, TOP MANAGEMENT OFFICIALS AND OTHER OFFICERS AND KEY EMPLOYEES ARE DETERMINED AND REVIEWED BY THE BOARD OF DIRECTORS. THE BOARD ESTABLISHED A COMPENSATION COMMITTEE, MADE UP OF DISINTERESTED TRUSTEES, WHO ARE GIVEN THE AUTHORITY TO ESTABLISH COMPENSATION FOR ALL PERSONS LISTED ABOVE. THE COMPENSATION COMMITTEE PERFORMS ANNUAL REVIEWS AND APPROVES EXECUTIVE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. ADDITIONALLY, THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AVAILABLE ON THE PUBLIC CHARITIES WEBSITE MAINTAINED BY THE COMMONWEALTH OF MASSACHUSETTS ATTORNEY GENERAL. FORM 990, PART IX, LINE 11G HOME HEALTHCARE: PROGRAM SERVICE EXPENSES 4,475,393. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,475,393. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 763,579. MANAGEMENT AND GENERAL EXPENSES 9,081. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 772,660. CONSULTING, RECRUITING AND OTHER: PROGRAM SERVICE EXPENSES 1,879,572. MANAGEMENT AND GENERAL EXPENSES 716,330. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,595,902. FORM 990, PART XI, LINE 9: ADJUSTMENT TO MINIMUM PENSION LIABILITY -1,313,545. LOSS ON REFINANCING -698,164. FORM 990, PART XII, LINE 2 THE ORGANIZATIONN'S FINANCIAL STATEMENTS WERE AUDITED BY AN INDEPENDENT ACCOUNTING FIRM ON A CONSOLIDATED BASIS. THE ORGANIZATION HAS AN AUDIT COMMITTEE RESPONSIBLE FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AS WELL AS THE SELECTION OF AN INDEPENDENT ACCOUNTING FIRM. NEW ENGLAND HEALTH SYSTEMS INC 30 WARREN STREET BRIGHTON MA 02135 043421002 MANAGEMENT SERVICES MA FRANCISCAN HOSPITAL FOR CHILDREN INC NEW ENGLAND HEALTH STAFFING INC 30 WARREN STREET BRIGHTON MA 02135 043421001 STAFFING AND PLACING SERVICES MA FRANCISCAN HOSPITAL FOR CHILDREN INC CLINICAL RESOURCES OF NEW ENGLAND INC 30 WARREN STREET BRIGHTON MA 02135 043421000 MEDICAL EQUIPMENT AND SUPPLIES MA FRANCISCAN HOSPITAL FOR CHILDREN INC FRANCISCAN PEDIATRICS INC 30 WARREN ST BRIGHTON MA 02135 043160358 PHYSICIAN SERVICES MA FRANCISCAN HOSPITAL FOR CHILDREN INC C -27112 417635 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 FRANCISCAN PEDIATRICS INC R 719198 COST FRANCISCAN PEDIATRICS INC N 2116351 COST