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HENRY HEYWOOD MEMORIAL HOSPITAL: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
HENRY HEYWOOD MEMORIAL HOSPITAL (EIN 04-2103581)
Tax period
2013-10-01 to 2014-09-30
Filed
2015-05-05
IRS object ID
201501349349305895
Schema version
2013v4.0
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2015-05-05T12:08:26-07:00ReturnTs
Tax Period End2014-09-30TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2013-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN042103581EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HENRY HEYWOOD MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlHENRBusinessNameControlTxt
Phone9786323420PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1242 Green StreetAddressLine1
CityGardnerCity
StateMAState
ZIP Code01440ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRobert CrosbyPersonNm
Person TitleSr VP of Finance, Treasurer, CFOPersonTitleTxt
Phone9786306157PhoneNum
Signature2015-04-17SignatureDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerRobert CrosbyPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1242 Green StreetAddressLine1
CityGardnerCity
StateMAState
ZIP Code01440ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$114,734,426GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.heywood.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1907FormationYr
Legal Domicile StateMALegalDomicileStateCd
Activity Or MissionTo be our communities' trusted choice for exceptional patient-centered care.ActivityOrMissionDesc
Voting Members Governing Body21VotingMembersGoverningBodyCnt
Voting Members Independent20VotingMembersIndependentCnt
Total Employee1097TotalEmployeeCnt
Total Volunteers166TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$908,638PYContributionsGrantsAmt
CY Contributions Grants$2,425,672CYContributionsGrantsAmt
PY Program Service Revenue$107,379,169PYProgramServiceRevenueAmt
CY Program Service Revenue$104,118,171CYProgramServiceRevenueAmt
PY Investment Income$495,533PYInvestmentIncomeAmt
CY Investment Income$761,780CYInvestmentIncomeAmt
PY Other Revenue$1,341,743PYOtherRevenueAmt
CY Other Revenue$1,252,666CYOtherRevenueAmt
PY Total Revenue$110,125,083PYTotalRevenueAmt
CY Total Revenue$108,558,289CYTotalRevenueAmt
PY Grants And Similar Paid$120,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$125,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$55,829,163PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$54,557,727CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$6,744PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$248,020CYTotalFundraisingExpenseAmt
PY Other Expenses$51,288,346PYOtherExpensesAmt
CY Other Expenses$50,617,334CYOtherExpensesAmt
PY Total Expenses$107,244,253PYTotalExpensesAmt
CY Total Expenses$105,300,061CYTotalExpensesAmt
PY Revenues Less Expenses$2,880,830PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,258,228CYRevenuesLessExpensesAmt
Total Assets BOY$95,467,985TotalAssetsBOYAmt
Total Assets EOY$97,123,339TotalAssetsEOYAmt
Total Liabilities BOY$45,613,375TotalLiabilitiesBOYAmt
Total Liabilities EOY$44,445,106TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$49,854,610NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$52,678,233NetAssetsOrFundBalancesEOYAmt
MissionTo be the community's trusted choice for patient-centered care.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$99,156,370ExpenseAmt
Grant$125,000GrantAmt
Revenue$104,118,171RevenueAmt
DescHeywood Hospital is dedicated to the community benefit goals of improving the health status of our community, addressing the specific health care needs of the under-served and collaborating with others to enhance quality and contain the growth of community health care costs. Details to this are published in "The Community Benefit Report of Heywood Hospital - Fiscal Year 2014" filed with the MA Attorney Generals Office.Desc
Total Other Prog Srvc Expense$0TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$0TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$0TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$99,156,370TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document148IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1097EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members21GoverningBodyVotingMembersCnt
Independent Voting Member20IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonRobert CrosbyPersonNm
Phone9786306157PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1242 Green StreetAddressLine1
CityGardnerCity
StateMAState
ZIP Code01440ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Daniel M Asquino
Trustee00Yes (X)$0$0$0
Michael Azzoni
Trustee00Yes (X)$0$0$0
James Garrison
Trustee00Yes (X)$0$0$0
John Kerney
Trustee00Yes (X)$0$0$0
Roy Lake
Trustee00Yes (X)$0$0$0
Michele Parker
Trustee00Yes (X)$0$0$0
JoAnne Parks
Trustee00Yes (X)$0$0$0
Kenneth J Pierce
Chairman-Trustee00Yes (X)$0$0$0
Glenn A Hunt
Vice Chairman -Trustee00Yes (X)$0$0$0
Rebecca Bialecki
2nd Vice Chairman - Trustee00Yes (X)$0$0$0
Cheney Castine
Treasurer - Trustee00Yes (X)$0$0$0
Tina Sbrega
Trustee00Yes (X)$0$0$0
Winfield Brown
President /CEO400Yes (X)$762,263$0$68,064Yes (X)
Robert Chauvin
Trustee00Yes (X)$0$0$0
Joyce Fletcher
Trustee00Yes (X)$0$0$0
John Flick
Trustee00Yes (X)$0$0$0
James Meehan
Trustee00Yes (X)$0$1,400$110
Donald Mruk
Trustee00Yes (X)$0$0$0
Moshen Noreldin
Trustee00Yes (X)$0$32,390$0
John Skrzypczak
Trustee00Yes (X)$0$0$0
Douglas Starrett
Trustee00Yes (X)$0$0$0
Robert Crosby
Sr VP of Finance / CFO400$240,032$0$49,292Yes (X)
Michael Grimmer
VP of Support Services400$244,898$0$47,239Yes (X)
Tina Santos
VP of Patient Care Srvcs/CNO400$237,097$0$33,773Yes (X)
Rose Kavalchuck
VP of Quality Services400$217,554$0$43,701Yes (X)
Carol Roosa
VP of Information Services/CIO400$141,086$0$42,326Yes (X)
Dawn Casavant
VP of Philanthropy400$156,441$0$42,638Yes (X)
Karen McArdle-Coggins
HMG President/VP of Physician Recruiting328$17,001$8,462$2,096Yes (X)
Bruce Bertrand
Chief Medical Officer320$45,255$0$3,965Yes (X)
Steven Yerid
Chief of Emergency Medicine400$462,954$0$40,167Yes (X)
Ellen Ray
Emergency Physician400$337,138$0$30,715Yes (X)
Faith Pinkerton
Emergency Physician400$294,751$0$26,575Yes (X)
David Gill
Staff Phychologist400$250,600$0$28,102Yes (X)
Robert Shepard
Emergency Physician400$216,803$0$26,365Yes (X)
Thomas Cady
VP of Human Resources400$186,165$0$46,665Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,810,038TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$42,252TotReportableCompRltdOrgAmt
Total Other Compensation$531,793TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K73IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
Quartulli and Associates Inc
PO Box 423GardnerMA01440Physical Therapy$2,988,109
Alliance Healthcare Services
100 Bay View CircleNewport BeachCA92660MRI$1,302,455
Diversified Clinical Services
PO Box 636981CincinattiOH45201Wound Care Services$854,088
Quest Diagnostics Inc
5763 Collection Center DriveChicagoIL60693Lab Contracted Services$849,345
New England Inpatient Specialists
120 Waters StreetNorth AndoverMA01845Inpatient Support$667,500
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K34CntrctRcvdGreaterThan100KCnt
Federated Campaigns$0FederatedCampaignsAmt
Membership Dues$0MembershipDuesAmt
Fundraising$103,125FundraisingAmt
Related Organizations$0RelatedOrganizationsAmt
Government Grants$1,929,734GovernmentGrantsAmt
All Other Contributions$392,813AllOtherContributionsAmt
Noncash Contributions$0NoncashContributionsAmt
Total Contributions$2,425,672TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
Ancillary O/P Services622110$61,036,334$61,036,334$0$0
Ancillary I/P & Routine622110$39,603,810$39,603,810$0$0
Contracted Service Revenue900099$2,340,909$2,340,909$0$0
HMG Patient Revenue (Net)621111$1,019,651$1,019,651$0$0
Lifeline624120$47,363$47,363$0$0

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$70,104TotalRevenueColumnAmt
Related Or Exempt Func Income$70,104RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$104,118,171TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$297,513TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$297,513ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

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

Royalties Revenue RoyaltiesRevenueGrp

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

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$257,469RealAmt
Personal$0PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$257,469RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$257,469TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$257,469ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$6,460,421SecuritiesAmt
Other$84,860OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$6,072,880SecuritiesAmt
Other$8,134OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$387,541SecuritiesAmt
Other$76,726OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$464,267TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$464,267ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$30,280FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$30,280ContriRptFundraisingEventAmt
Fundraising Direct Expenses$95,123FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$64,843TotalRevenueColumnAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$64,843ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

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

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
Meal Revenue722310$671,992$0$0$671,992
Purchase Discounts900099$151,527$0$0$151,527
Pharmacy Misc Revenue900099$142,704$0$0$142,704

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$93,817TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$93,817ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,060,040OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$108,558,289TotalRevenueColumnAmt
Related Or Exempt Func Income$104,118,171RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$2,014,446ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$125,000TotalAmt
Program Services$125,000ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,301,238TotalAmt
Program Services$775,397ProgramServicesAmt
Management And General$1,387,825ManagementAndGeneralAmt
Fundraising$138,016FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

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

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$42,885,566TotalAmt
Program Services$41,596,049ProgramServicesAmt
Management And General$1,260,263ManagementAndGeneralAmt
Fundraising$29,254FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$835,094TotalAmt
Program Services$731,701ProgramServicesAmt
Management And General$86,637ManagementAndGeneralAmt
Fundraising$16,756FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,923,357TotalAmt
Program Services$4,614,947ProgramServicesAmt
Management And General$283,037ManagementAndGeneralAmt
Fundraising$25,373FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,612,472TotalAmt
Program Services$3,463,827ProgramServicesAmt
Management And General$137,512ManagementAndGeneralAmt
Fundraising$11,133FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

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

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$369,325TotalAmt
Program Services$14,705ProgramServicesAmt
Management And General$354,620ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$105,292TotalAmt
Program Services$0ProgramServicesAmt
Management And General$105,292ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt
Fundraising$0FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

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

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$11,623,227TotalAmt
Program Services$11,623,227ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$147,462TotalAmt
Program Services$141,976ProgramServicesAmt
Management And General$5,324ManagementAndGeneralAmt
Fundraising$162FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$14,451,357TotalAmt
Program Services$14,290,757ProgramServicesAmt
Management And General$155,326ManagementAndGeneralAmt
Fundraising$5,274FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,601,685TotalAmt
Program Services$1,601,685ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Royalties RoyaltiesGrp

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

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,148,500TotalAmt
Program Services$2,121,746ProgramServicesAmt
Management And General$26,754ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$100,967TotalAmt
Program Services$72,183ProgramServicesAmt
Management And General$27,537ManagementAndGeneralAmt
Fundraising$1,247FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

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

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$137,803TotalAmt
Program Services$91,824ProgramServicesAmt
Management And General$45,979ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$728,416TotalAmt
Program Services$728,416ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

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

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,345,728TotalAmt
Program Services$4,319,963ProgramServicesAmt
Management And General$25,718ManagementAndGeneralAmt
Fundraising$47FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$762,021TotalAmt
Program Services$678,550ProgramServicesAmt
Management And General$83,471ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
Professional Fees$5,718,308$4,376,077$1,326,147$16,084
Bad Debt$4,876,447$4,876,447$0$0
Free Care$1,409,381$1,409,381$0$0
Subscriptions & Dues$729,875$251,274$476,737$1,864

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,361,540TotalAmt
Program Services$1,251,238ProgramServicesAmt
Management And General$107,492ManagementAndGeneralAmt
Fundraising$2,810FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$105,300,061TotalAmt
Program Services$99,156,370ProgramServicesAmt
Management And General$5,895,671ManagementAndGeneralAmt
Fundraising$248,020FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,168,080BOYAmt
EOY$4,790,919EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,264,477BOYAmt
EOY$2,183,922EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$12,802,618BOYAmt
EOY$12,412,717EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$171,515BOYAmt
EOY$141,938EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,413,035BOYAmt
EOY$1,293,977EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,057,751BOYAmt
EOY$1,136,493EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$107,149,255LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$55,313,590LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$52,689,420BOYAmt
EOY$51,835,665EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$18,185,573BOYAmt
EOY$20,325,016EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$437,650BOYAmt
EOY$502,992EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$134,526BOYAmt
EOY$139,610EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,143,340BOYAmt
EOY$2,360,090EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$95,467,985BOYAmt
EOY$97,123,339EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$14,314,680BOYAmt
EOY$14,129,444EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$258,468BOYAmt
EOY$601,026EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$24,679,160BOYAmt
EOY$23,948,559EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$294,782BOYAmt
EOY$109,342EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,066,285BOYAmt
EOY$5,656,735EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$45,613,375BOYAmt
EOY$44,445,106EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$44,503,392BOYAmt
EOY$47,224,241EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,345,057BOYAmt
EOY$4,447,768EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,006,161BOYAmt
EOY$1,006,224EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$49,854,610BOYAmt
EOY$52,678,233EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$95,467,985BOYAmt
EOY$97,123,339EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$3,258,228ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,298,967NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts$0DonatedServicesAndUseFcltsAmt
Investment Expense$0InvestmentExpenseAmt
Prior Period Adjustments$0PriorPeriodAdjustmentsAmt
Other Changes In Net Assets-$1,733,572OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

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

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$17,367,013BeginningYearBalanceAmt
Contributions$5,000ContributionsAmt
Investment Earnings Or Losses-$128,702InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$5,345,880OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$11,897,431EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$16,786,738BeginningYearBalanceAmt
Contributions$4,875ContributionsAmt
Investment Earnings Or Losses$958,017InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$382,617OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$17,367,013EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.86BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.05PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.09TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$125,271OtherCostOrOtherBasisAmt
Book Value$125,271BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$66,804,460OtherCostOrOtherBasisAmt
Depreciation$24,483,585DepreciationAmt
Book Value$42,320,875BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

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

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$38,261,543OtherCostOrOtherBasisAmt
Depreciation$30,830,005DepreciationAmt
Book Value$7,431,538BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$1,957,981OtherCostOrOtherBasisAmt
Depreciation$0DepreciationAmt
Book Value$1,957,981BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$51,835,665TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
Est. Settlement w/3rd Party$3,355,109
Est. Insurance Claims$1,751,001
Deferred Comp$550,625
FieldValueIRS element (for citing)
Total Liability$5,656,735TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule D, Part V, Line 4Permanent Endowment funds are established by donor restricted gifts and maintained to provide a permanent source of income. The principal of which is kept in perpetuity. Board Designated Endowment funds are established by the governing body to fund capital projects and/or improvements of the organization. Temporary Restricted funds are established by donor restricted gifts that maintain a source of income for a specific period of time.
Schedule D, Part X, Line 2Heywood Healthcare, Heywood Hospital, Athol and HMGI Have been determined to be not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code (the "Code"), and the Realty Corp. has been determined to be a not-for-profit corporation as described in Section 501(c)(2) of the Code. All of the entities are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Any income not substantially related to these Organizations' exempt purposes may be considered unrelated business income under Internal Revenue Code Section 511 and, as such, be subject to tax at normal corporate rates. In accordance with generally accepted accounting principles ("GAAP"), the Organization annually evaluates its tax status and tax positions taken with respect to its operations and financial position. Tax years from 2010 through the current year remain open for examination by federal and state taxing authorities.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Name Of Event1Golf ClassicNameOfEvent1Amt
Gross Receipts Event1$89,110GrossReceiptsEvent1Amt
Charitable Contri Event1$58,830CharitableContriEvent1Amt
Gross Revenue Event1$30,280GrossRevenueEvent1Amt
Cash Prizes Event1$0CashPrizesEvent1Amt
Non Cash Prizes Event1$11,097NonCashPrizesEvent1Amt
Rent Facility Costs Event1$13,944RentFacilityCostsEvent1Amt
Food And Beverage Event1$18,974FoodAndBeverageEvent1Amt
Entertainment Event1$400EntertainmentEvent1Amt
Other Direct Expenses Event1$6,350OtherDirectExpensesEvent1Amt
Name Of Event2Winter AffairNameOfEvent2Amt
Gross Receipts Event2$25,245GrossReceiptsEvent2Amt
Charitable Contri Event2$25,245CharitableContriEvent2Amt
Gross Revenue Event2$0GrossRevenueEvent2Amt
Cash Prizes Event2$0CashPrizesEvent2Amt
Non Cash Prizes Event2$1,154NonCashPrizesEvent2Amt
Rent Facility Costs Event2$4,552RentFacilityCostsEvent2Amt
Food And Beverage Event2$14,426FoodAndBeverageEvent2Amt
Entertainment Event2$1,800EntertainmentEvent2Amt
Other Direct Expenses Event2$7,000OtherDirectExpensesEvent2Amt
Other Events Total2OtherEventsTotalCnt
Gross Receipts Other Events$19,050GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$19,050CharitableContriOtherEventsAmt
Gross Revenue Other Events$0GrossRevenueOtherEventsAmt
Cash Prizes Other Events$0CashPrizesOtherEventsAmt
Non Cash Prizes Other Events$2,326NonCashPrizesOtherEventsAmt
Rent Fclty Costs Other Events$865RentFcltyCostsOtherEventsAmt
Food And Beverage Other Events$541FoodAndBeverageOtherEventsAmt
Entertainment Other Events$0EntertainmentOtherEventsAmt
Oth Direct Expnss Other Events$11,694OthDirectExpnssOtherEventsAmt
Gross Receipts Total$133,405GrossReceiptsTotalAmt
Charitable Contributions Tot$103,125CharitableContributionsTotAmt
Gross Revenue Total Events$30,280GrossRevenueTotalEventsAmt
Cash Prizes Total Events$0CashPrizesTotalEventsAmt
Non Cash Prizes Total Events$14,577NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$19,361RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$33,941FoodAndBeverageTotalEventsAmt
Entertainment Total Events$2,200EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$25,044OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$95,123DirectExpenseSummaryEventsAmt
Net Income Summary-$64,843NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$1,442,301TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,446,797DirectOffsettingRevenueAmt
Net Community Benefit Expns-$4,496NetCommunityBenefitExpnsAmt
Total Expense0.00TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$19,254,293TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$17,398,110DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,856,183NetCommunityBenefitExpnsAmt
Total Expense0.0176TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$20,696,594TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$18,844,907DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,851,687NetCommunityBenefitExpnsAmt
Total Expense0.0176TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$1,347,073TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$32,894DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,314,179NetCommunityBenefitExpnsAmt
Total Expense0.0125TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$398,748TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$113DirectOffsettingRevenueAmt
Net Community Benefit Expns$398,635NetCommunityBenefitExpnsAmt
Total Expense0.0038TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$53,616TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$53,616NetCommunityBenefitExpnsAmt
Total Expense0.0005TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$1,799,437TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$33,007DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,766,430NetCommunityBenefitExpnsAmt
Total Expense0.0168TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$22,496,031TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$18,877,914DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,618,117NetCommunityBenefitExpnsAmt
Total Expense0.0344TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$219TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$219NetCommunityBenefitExpnsAmt
Total Expense0TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$1,006TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,006NetCommunityBenefitExpnsAmt
Total Expense0TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$148,871TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$148,871NetCommunityBenefitExpnsAmt
Total Expense0.0014TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$198,241TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$198,241NetCommunityBenefitExpnsAmt
Total Expense0.0019TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$348,337TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$348,337NetCommunityBenefitExpnsAmt
Total Expense0.0033TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$1,884,554BadDebtExpenseAmt
Bad Debt Expense Attributable$62,567BadDebtExpenseAttributableAmt
Reimbursed By Medicare$25,739,033ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$23,502,373CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$2,236,660MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Henry Heywood Memorial HospitalBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1242 Green StreetAddressLine1
CityGardnerCity
StateMAState
ZIP Code01440ZIPCode
FieldValueIRS element (for citing)
Website Addresswww.heywood.orgWebsiteAddressTxt
Licensed HospitalYes (X)LicensedHospitalInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Henry Heywood Memorial HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Facility1FacilityNum
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted11CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLwww.heywood.orgOwnWebsiteURLTxt
Rpt Available Upon RequestYes (X)RptAvailableUponRequestInd
Adopt Implementation StrategyYes (X)AdoptImplementationStrategyInd
Exec Implementation StrategyYes (X)ExecImplementationStrategyInd
Develop Community Wide PlanYes (X)DevelopCommunityWidePlanInd
Exec Community Wide PlanYes (X)ExecCommunityWidePlanInd
Include Operational PlanYes (X)IncludeOperationalPlanInd
Adopt BudgetYes (X)AdoptBudgetInd
Prioritize Health NeedsYes (X)PrioritizeHealthNeedsInd
Prioritize ServicesYes (X)PrioritizeServicesInd
All Needs AddressedYes (1)AllNeedsAddressedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Used Deter Elig Free CareYes (1)FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care100FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt CareYes (1)FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care400FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (1)ExplainedBasisInd
Income LevelYes (X)IncomeLevelInd
Insurance StatusYes (X)InsuranceStatusInd
State RegulationYes (X)StateRegulationInd
Other FactorsYes (X)OtherFactorsInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
Posted On WebsiteYes (X)PostedOnWebsiteInd
Attached To InvoiceYes (X)AttachedToInvoiceInd
Posted In Emergency RoomYes (X)PostedInEmergencyRoomInd
Posted In Admission OfficeYes (X)PostedInAdmissionOfficeInd
Provided On AdmissionYes (X)ProvidedOnAdmissionInd
Available On RequestYes (X)AvailableOnRequestInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit Report To Credit AgencyYes (X)PermitReportToCreditAgencyInd
Collection ActivitiesYes (1)CollectionActivitiesInd
Reporting To Credit AgencyYes (X)ReportingToCreditAgencyInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Lowest Negotiated RatesYes (X)LowestNegotiatedRatesInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part V, Section B, Line 3-Henry Heywood Memorial HospitalThe 2011 Community Health Needs Assessment of North Central Massachusetts was a joint effort between MA Department of Public Health's Community Health Network Area of North Central Massachusetts (CHNA 9) and the Joint Coalition on Health. The assessment is designed to provide information and analyses relative to the health status, issues, concerns and assets of the North Central Region of Massachusetts. The assessment includes 27 cities and towns covered by CHNA 9 of which Gardner, Ashburnham, Westminster, Winchendon, Templeton, and Hubbardston are primary service areas of Heywood Hospital, and are included within the reporting region of Gardner. Comparisons are made to Massachusetts as a whole and to Healthy People 2010 goals. All data was gathered systematically utilizing standards which guided the methodologies. The quantitative data collected came from the Massachusetts Community Health Information Profile, the Massachusetts Department of Public Health, the US Census Bureau, the MA Department of Workforce Development, the MA Department of Elementary and Secondary Education and the Massachusetts Behavioral Health Partnership. Qualitative data was gathered using focus groups and interviews that were conducted in cooperation with the Minority Coalition of North Central Beautiful Gate Church, Twin Cities CDC, Gardner CDC, Memorial Congregational Church, New Hope Community Church, Montachusett Opportunity Council, in addition to other area agencies.
Schedule H, Part V, Section B, Line 4-Henry Heywood Memorial HospitalHospitals included in the development of the 2012 Community Health Needs Assessment are Heywood Hospital, Gardner, MA; HealthAlliance Hospital, Leominster, MA; and Clinton Hospital, Clinton, MA.
Schedule H, Part V, Section B, Line 12-Henry Heywood Memorial HospitalMedical Hardship, wherein the patient's medical expenses exceed the patient's income.
Schedule H, Part V, Section B, Line 18-Henry Heywood Memorial HospitalThe Hospital posts general notices throughout the hospital about the financial assistance policy.

Supplemental Information Detail SupplementalInformationDetail (18 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part I, Line 7The costing methodology used to calculate the amounts reported in the table in Part I, for lines 7a through 7c was based on the cost to charge ratio derived from the supplied Worksheet 2, in the IRS schedule H instructions.
Schedule H, Part IIThe Heywood Hospital's Community Benefits Mission Statement is "Heywood Hospital is dedicated to the community benefit goals of improving the health status of our community, addressing the specific health needs of the under-served and collaborating with others to enhance quality and contain the growth of community healthcare costs."
Schedule H, Part II, Line 1Heywood donated plants and beverages toward community wellness paths and gardens to promote a healthier community.
Schedule H, Part II, Line 5Heywood staff provided training to members of the community for early suicide prevention, education and training certification at no cost to the community members.
Schedule H, Part II, Line 6Heywood's approach to Community Benefits has been to collaborate with others through the Joint Coalition on Health and other coalitions to develop our plan, goals and strategies. Partners include the Joint Coalition on Health, Gardner Interagency Team, the CHNA, The Minority Coalition, Montachusett Opportunity Council, Mount Wachusett Community College, the Community Health Connections Health Centers, North Central Human Services, Luc, Inc., Community Health Link, Gardner, VNA, the Gardner Public Schools, the Winchendon Public Schools, the Health Foundation of Central MA, Kresge Foundation, the Department of Public Health, AHEC, and others. At this time we continue to focus our efforts on mental health and substance abuse, insuring those without jobs and/or insurance, addressing the needs of under-served populations, focusing on the needs of youth and children, and targeting adults and children with overweight and obesity issues which lead to chronic diseases and diabetes.
Schedule H, Part II, Line 8Heywood Hospital serves a medically underserved population area, because of this, the Hospital is constantly working to recruit and search for physicians to serve our community.
Schedule H, Part III, Section A, Line 2The costing methodology used for line 2 was based on the cost charge ratio derived from the supplied worksheet 2 in the IRS Schedule H instructions.
Schedule H, Part III, Section A, Line 3The methodology used for line 3 was to take the percentage of financial assistance applications that were due to inadequate documentation divided by the total applications received for FY 2014. This amounted to approximately 3.32% which was applied against the number on line 2. It is our belief that the $62,567 amount of bad debt should be included as a community benefit. As a tax exempt hospital, we must provide necessary services regardless of the patient's ability to pay for the service provided. As a not for profit, patient care is provided to all, regardless of ability to pay for that care, making quality patient care available to all in our community, regardless of their economic means, qualifies bad debts as community benefit.
Schedule H, Part III, Section A, Line 4The footnote can be found on Page 8 of the financial statements - footnote #2 under "Allowance of Doubtful Accounts".
Schedule H, Part III, Section B, Line 6The allowable costs on line 6 were obtained from our FY 2014 Medicare Cost Report, Worksheet D schedules.
Schedule H, Part III, Section B, Line 8There is no shortfall.
Schedule H, Part III, Section C, Line 9bHeywood Hospital provides patients with information about financial assistance programs that are available through the Commonwealth of MA or through Heywood Hospital's own financial assistance program, which may cover all or some of their unpaid hospital bills. For those patients that request such assistance, Heywood Hospital assists patients by screening them for eligibility in an available public program and assisting them in applying for the program. These programs include but are not limited to MassHealth, Commonwealth Care, Children's Medical Security Plan, Healthy Start, Health Safety Net and others. It is the patient's obligation to provide Heywood Hospital with accurate and timely information to determine of the patient is eligible to apply for certain health insurance programs. If the patient of guarantor is unable to provide the necessary information Heywood Hospital may make reasonable efforts to obtain any additional information from other sources. Information the Heywood obtains will be maintained in accordance with applicable federal and state privacy and security laws. The screening and application process for public health insurance program is done through Virtual Gateway, which is an internet portal designed by the MA Executive Office of Health and Human Services. The Virtual Gateway manages the application process from the programs listed above, which is available for children, adults, seniors, veterans, homeless and disabled individuals. Heywood specifically assists the patient in completing the application and secure the necessary documentation required by the applicable financial assistance program. Heywood Hospital will then submit this document to the Commonwealth Office of Medicaid and assist the patient in any additional documentation if such is required by the Commonwealth after completing the application. All Virtual Gateway applications are reviewed and processed by the Commonwealth of MA, Office of Medicaid. Special circumstance applications are reviewed and approved by the MA Division of Health Care Finance and Policy. Hospitals have no role in determination of program eligibility made by the Commonwealth, but at the patient's request may take a direct role in appealing decisions made by the Commonwealth to ensure accurate and timely adjudication of all hospital bills. If the patient does not comply with the request for documentation, then our standard collection procedures apply.
Schedule H, Part VI, Line 2Heywood Hospital collaborates with many local and state agencies and organizations to assess community health needs in the North Central region of MA. We work with representatives from more than 100 local and state organizations and state legislators on our Suicide Prevention Taskforces. We work with the Massachusetts Department of Public Health, GVNA Healthcare, Gardner Area Interagency Team, Gardner, Winchendon, Ashburnham, and Westminster Public Schools, Gardner Police Dept, area Boards of Health, local legislators, Patient Family Advisory Council and direct outreach to community and schools.
Schedule H, Part VI, Line 3Role of Hospital Certified Financial Counselors and other Finance Staff: The hospital will try to identify available coverage options for patients who may be uninsured or underinsured with their current insurance program when the patient is scheduling their services, while the patient is in the hospital, upon discharge, and for a reasonable time following discharge from the hospital. The hospital will direct all patients seeking available coverage options, or those that the hospital determines may be eligible, to the hospital's patient financial counseling to screen for eligibility in an appropriate coverage option. The hospital will then assist the patient in applying for the appropriate coverage options that are available or notify them of availability of financial assistance through the hospital's own internal financial assistance program, if available. Notification Practices: Individual printed notices are available by contacting a Financial Counselor or through the Patient Accounts Office. Notices indicate the criteria used to determine eligibility for MassHealth and the Health Safety Net Trust Fund and where or how patients may apply. The goal of these notices is to assist patients in applying for coverage within a financial assistance program such as MassHealth, Commonwealth Care, Children's Medical Security Plan, Healthy Start, and Health Safety Net. When applicable, the hospital may also assist patients in applying for coverage of services as a Medical Hardship based on the patient's documented income and allowable medical expenses. When a patient contacts the hospital, Patient Accounting, Financial Counseling or Social Service Staff will attempt to identify if a patient qualifies for a public financial assistance program or payment plan. Patients who are already enrolled in a public financial assistance program, such as MassHealth or Health Safety Net, may qualify for certain federal, state and private assistance agencies. Patients may also qualify for additional assistance based on the hospital's own internal criteria for financial assistance, or qualify for coverage of services as a Medical Hardship based on the patient's documented income and allowable medical expenses. The following items outline more specifically the notification process, criteria, and availability of information beyond the signs that are posted in the hospital. 1. The hospital will provide an individual notice of the availability of financial assistance programs and other programs of public assistance to a patient expected to incur charges for which he/she will be personally responsible, exclusive of personal convenience items or services that may not be paid in full by third party coverage. 2. The hospital or its agents will include a notice or statement about Eligible Services to Low Income Patients and other programs of public assistance in its initial bill and subsequent correspondence with the patient. All correspondence will direct the patient where and how they can receive more information or additional assistance and will inform the patient that they may apply or reapply for financial and public assistance before, during or after care, or after collection agency assignment if their situation changes. 3. The hospital will include a notice regarding the availability of financial assistance and other programs of public assistance to Low Income Patients in all written collection actions. The hospital will notify the patient that it offers a payment plan if the patient is determined to be eligible for MassHealth or free care/uncompensated care through the Health Safety Net Trust Fund as a low income patient or due to Medical Hardship. These payment plans are consistent with 1016 CMR 6613.08 (1)(f)(4). The hospital will also offer payment plan options for those individuals who do not qualify for Low Income Patient status. 4. Heywood Hospital will include language on its written notices that reads: "You may be eligible for assistance through our Financial Assistance Program. For eligibility information, please contact our Customer Services Department at 1-800-305-6757." Verbiage may change to accommodate changes of department information. 5. There is no primary language other than English that is spoken by 5% or more of the hospital's service area. Signage and other documentation will be provided in English. The hospital provides translator services for several other languages and this service may be accessed for those individuals whose primary language is not English or Spanish. 6. For cases where the hospital continues to determine eligibility for free care/uncompensated care through the Health Safety Net Trust Fund application, then MassHealth will provide written notice of determination that the patient is or is not eligible within 30 days of receiving a completed application and the required supporting documentation. The vast majority of patients will however be screened via the common intake process and processed through the Virtual Gateway and MA-21 system. 7. Whether the hospital is using the MassHealth application process through the Virtual Gateway or submitting a MassHealth application directly, the hospital will assist the patient in completing the application or intake process for enrollment and eligibility screening.
Schedule H, Part VI, Line 4The Assessment includes 27 cities and towns covered by CHNA9, of which Gardner, Ashburnham, Westminster, Winchendon, Templeton and Hubbardston are primary service areas for Heywood Hospital. 33% of Gardner population made up of age 65+ living alone, 10% single females with children, 9.6% of population living below 100% of poverty level, with Suicide Mortality rates at 12.3%-state average is 7%.
Schedule H, Part VI, Line 5The Greater Gardner area, comprised of the City of Gardner, and five surrounding towns, has a population of 60,000 people, a median income below the state average and an unemployment rate above the state average. The community has been affected by the loss of the furniture industry of the past few decades, and by the current economic downturn. Mental health and substance abuse are significant challenges for many residents of the area. The Hospital is the largest employer in the area, with around 1,000 employees. The community is largely white, non-Hispanic, but has a growing Hispanic population. Gardner is one of three cities in the region; the others are Fitchburg and Leominster, which frequently collaborates for the betterment of the region. Heywood Hospital collaborates with the competing hospital in the Fitchburg/Leominster area, HealthAlliance, on the community health improvement activities.
Schedule H, Part VI, Line 6Heywood Hospital works closely with the community to promote health in areas identified by the 2011 Community Health Needs Assessment (CHNA) through a variety of means. The hospital works with area school systems to address childhood obesity and onset of adult diabetes through nutrition/fitness programs targeting young students K-2, in order to help develop healthy habits which may result in a reduction of chronic illness and obesity as indicated in the 2011 CNHA. Financial counselors help uninsured populations, including those recently unemployed and those experiencing financial hardship to enroll in appropriate programs to ensure healthcare coverage, an identified barrier to obtaining health care, as indicated in the 2011 CHNA. Community programs targeting nutrition and fitness are offered free and at reduced rates focusing on nutrition, healthy cooking and consistent exercise, focusing on the reduction of chronic disease including diabetes and cardiovascular disease in adults as indicated in the 2011 CHNA. Operation of a school-based health center which enrolls an average of 79% of all students in the school, providing nearly 1,000 behavioral health visits annually, addressing higher than normal suicide and substance abuse rate, as indicated in the 2011 CHNA. The Suicide Prevention Taskforce, which partners with approximately 100 area social service agencies, provides educational tools, and raises community and legislative awareness of significant area mental health and substance abuse issues, resulting in a Gardner suicide rate approximately twice the state average. Continue to work with the Minority Coalition, Joint Coalition of Health and other community agencies to raise awareness and skills among health providers to reduce disparities and strive for equal health.
Schedule H, Part VI, Line 7Community Benefit Report is filed with Attorney General's Office, State of Massachusetts.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtValuation Method UsedValuationMethodUsedDescNon Cash AssistanceNonCashAssistanceDescPurpose Of GrantPurposeOfGrantTxt
Montachusett Home Care Corp
680 Mechanic StreetLeominsterMA01453042551175501(c)(3)$80,000$0n/an/aThe funds will be used by the Community Health Network of North Central MA as support and collaborative community health assessment work.
MOC Inc
133 Pritchard StreetFitchburgMA01420042401111501(c)(3)$45,000$0n/an/aThe funds will be used by Joint Coalition on Health as support of operations to provide Community Health grants in conjunction with identified priorities of the JCOH service area, and to support the Gardner Area InterAgency Team.
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule I, Part I, Line 2FormAndLineReferenceDesc
ExplanationMontachusett Home Care Corp and the Community Health Network of MA file an annual report with the Office of Healthy Communities that contains a summary of how the funds are allocated.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Housing Allowance Or ResidenceYes (X)HousingAllowanceOrResidenceInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E Expnss0WrittenPolicyRefTAndEExpnssInd
Substantiation Required0SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Winfield Brown
President /CEO$399,129$0$111,540$0$251,595$0$22,600$0$45,463$0$830,327$0$0$0
Robert Crosby
Sr VP of Finance / CFO$238,806$0$0$0$1,226$0$22,455$0$26,837$0$289,324$0$0$0
Michael Grimmer
VP of Support Services$197,484$0$32,432$0$14,983$0$20,589$0$26,649$0$292,137$0$0$0
Tina Santos
VP of Patient Care Srvcs/CNO$204,903$0$31,941$0$253$0$21,229$0$12,544$0$270,870$0$0$0
Rose Kavalchuck
VP of Quality Services$186,024$0$30,011$0$1,519$0$21,368$0$22,333$0$261,255$0$0$0
Carol Roosa
VP of Information Services/CIO$135,697$0$5,000$0$389$0$17,500$0$24,826$0$183,412$0$0$0
Dawn Casavant
VP of Philanthropy$134,236$0$22,051$0$154$0$17,500$0$25,138$0$199,079$0$0$0
Steven Yerid
Chief of Emergency Medicine$378,552$0$77,000$0$7,402$0$18,789$0$21,378$0$503,121$0$0$0
Ellen Ray
Emergency Physician$336,490$0$0$0$649$0$2,412$0$28,302$0$367,853$0$0$0
Faith Pinkerton
Emergency Physician$294,751$0$0$0$0$0$0$0$26,575$0$321,326$0$0$0
David Gill
Staff Phychologist$248,009$0$0$0$2,591$0$5,100$0$23,002$0$278,702$0$0$0
Robert Shepard
Emergency Physician$215,632$0$0$0$1,171$0$0$0$26,365$0$243,168$0$0$0
Thomas Cady
VP of Human Resources$158,222$0$26,768$0$1,175$0$20,923$0$25,742$0$232,830$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 1aHousing allowance provided to Michael Grimmer, VP of Support Services, per contract. This is paid through his weekly salary. Social Club Membership dues provided to Mr. Brown, CEO, per contract.
Schedule J, Part I, Line 1bThere was no written policy for the housing allowance provided to Michael Grimmer; it was part of his employment contract. There was no written policy for the Social Club Membership dues; it was part of his employment contract.
Schedule J, Part I, Line 6Heywood Hospital accrues 15% of the executive team's salary as part of an incentive compensation program, and service goals are set by the Hospital's trustees annually.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
MA Health and Educational Facilitiy Authority
A04245601157586EGT22009-03-31$17,785,000Funds used for new Watkins Bldg project000
MA Health and Educational Facility Authority
B04245601157586C7E92008-06-19$6,715,000Refunding and new Watkins Bldg project000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtBond DefeasedBondDefeasedAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtCapitalized InterestCapitalizedInterestAmtRefunding EscrowRefundingEscrowAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCredit EnhancementCreditEnhancementAmtWorking Capital ExpendituresWorkingCapitalExpendituresAmtCapital ExpendituresCapitalExpendituresAmtOther Spent ProceedsOtherSpentProceedsAmtUnspentUnspentAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$0$0$66,235$0$0$0$281,690$0$0$17,569,545$0$0201000Yes (1)Yes (1)
B$0$0$19,154$0$0$0$329,467$0$3,597,891$2,806,796$0$02008Yes (1)0Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0000000Yes (1)0Yes (1)
B0000000Yes (1)0Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndTerm Of HedgeTermOfHedgePctSuperintegrated HedgeSuperintegratedHedgeIndHedge TerminatedHedgeTerminatedIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
TD Bank
A000Yes (1)Yes (1)Yes (1)18.70000Yes (1)
Piper Jaffrey
B000Yes (1)Yes (1)Yes (1)18.70000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
A0
B0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule K, Part IV, Line 2c-03/31/2009 17,785,000 MA Health and Educational Facilitiy AuthorityRebate computation was performed on October 8, 2013.
Schedule K, Part IV, Line 2c-06/19/2008 6,715,000 MA Health and Educational Facility AuthorityRebate computation was performed on October 8, 2013.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section B, Line 11bThe accountant at Heywood Hospital prepares the Form 990 and provides to the controller for review. The form is then sent to the CFO for final review. Once reviewed, the 990 is received by the Board of Trustees. The 990 is then approved by the board, and submitted by the accounting department.
Form 990, Part VI, Section B, Line 12cAnnually, a Conflict of Interest Form is sent out to the manager, trustees, and employees with broad discretionary authority. These forms are required to be signed and are monitored by the Corporate Compliance office for completion.
Form 990, Part VI, Section B, Line 15The CEO and Executive Staff's compensation is determined by market data and analysis provided to the Hospital's Compensation Committee and Board of Trustees by an independent compensation consultant engaged by the Board of Trustees annually. Mr. Brown, CEO, also receives an annual contribution as payment for deferred compensation which is subject to a multi-year vesting schedule that is incumbent upon his ongoing employment.
Form 990, Part VI, Section C, Line 19The organization makes the governing documents, conflict of interest policy, and financial statements available to the public by providing completed copies to the Administrative Assistant, who provides copies upon request.
Form 990, Part IX, Line 11gIncluded in Fees for services (non-employees) other expenses are: Physician Fees: $6,367,621 Outside Clinical Fees: $4,980,534 Temporary Employees: $259,038 Medical Staff: $16,034
Form 990, Part XI, Line 9The amount that makes up the other changes in net assets or fund balance is from discounts on pledge receivables and transfers to inter-corporate related organizations to support their operations.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
Heywood Affiliated Medical Group
242 Green StreetGardnerMA01440043163589employ physiciansMA501(c)(3)9Heywood Healthcare0
Heywood Hospital Realty Corporation
242 Green StreetGardnerMA01440043327447property holding companyMA501(c)(2)Heywood Healthcare0
Athol Memorial Hospital
2033 Main StreetAtholMA01331042126583HospitalMA501(c)(3)3Heywood Healthcare0
Heywood Healthcare Inc
242 Green StreetGardnerMA01440222720658Parent CorpMA501(c)(3)70N/A
Heywood Healthcare Charitable Foundation
242 Green StreetGardnerMA01440222720562Charitable FoundationMA501(c)(3)7Heywood Healthcare0
HHMH Aid Association
242 Green StreetGardnerMA01440042198019raise funds for the HospitalMA501(c)(3)90N/A
Winchendon Health Foundation
87 Central StreetWinchendonMA01475042113276supporting organizationMA501(c)(3)PF0N/A
Heywood Physician Hospital Organization
242 Green StreetGardnerMA01440043153119Managed care contracted physiciansMA501(c)(3)90N/A
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Heywood Hospital Realty Corporation
j$85,815Actual Cost
Heywood Hospital Realty Corporation
q$218,321Actual Cost

Reasonable Cause Explanation ReasonableCauseExplanation

FieldValueIRS element (for citing)
ExplanationExtension granted.ExplanationTxt