HENRY HEYWOOD MEMORIAL HOSPITAL: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: HENRY HEYWOOD MEMORIAL HOSPITAL (EIN 04-2103581)
Tax period: 2012-10-01 to 2013-09-30
Filed: 2014-05-06
IRS object ID: 201401339349303870
Schema version: 2012v2.0
Source: Download XML · Original 990 at ProPublica

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

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule G
Schedule H
Schedule I
Schedule J
Schedule K
Schedule O
Schedule R
Reasonable Cause Explanation

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-05-06T07:46:27-07:00	Timestamp
Tax Period End Date	2013-09-30	TaxPeriodEndDate
Return Type	990	ReturnType
Tax Period Begin Date	2012-10-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	042103581	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	HENRY HEYWOOD MEMORIAL HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	HENR	NameControl
Phone	9786323420	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	242 Green Street	AddressLine1
City	Gardner	City
State	MA	State
ZIP Code	01440	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Robert Crosby	Name
Title	Sr VP of Finance, Treasurer, CFO	Title
Phone	9786306157	Phone
Date Signed	2014-04-25	DateSigned

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	Robert Crosby	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	242 Green Street	AddressLine1
City	Gardner	City
State	MA	State
ZIP Code	01440	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	120212006	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	www.heywood.org	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1907	YearFormation
State Legal Domicile	MA	StateLegalDomicile
Activity Or Mission Description	To be our communities' trusted choice for exceptional patient-centered care.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	21	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	19	NbrIndependentVotingMembers
Total Nbr Employees	1037	TotalNbrEmployees
Total Nbr Volunteers	281	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	3474560	ContributionsGrantsPriorYear
Contributions Grants Current Year	908638	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	100862323	ProgramServiceRevenuePriorYear
Program Service Revenue CY	107379169	ProgramServiceRevenueCY
Investment Income Prior Year	1034227	InvestmentIncomePriorYear
Investment Income Current Year	495533	InvestmentIncomeCurrentYear
Other Revenue Prior Year	967815	OtherRevenuePriorYear
Other Revenue Current Year	1341743	OtherRevenueCurrentYear
Total Revenue Prior Year	106338925	TotalRevenuePriorYear
Total Revenue Current Year	110125083	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	118567	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	120000	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	52430754	SalariesEtcPriorYear
Salaries Etc Current Year	55829163	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	12925	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	6744	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	220956	TotalFundrsngExpCurrentYear
Other Expense Prior Year	49513662	OtherExpensePriorYear
Other Expenses Current Year	51288346	OtherExpensesCurrentYear
Total Expenses Prior Year	102075908	TotalExpensesPriorYear
Total Expenses Current Year	107244253	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	4263017	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	2880830	RevenuesLessExpensesCY
Total Assets BOY	91777100	TotalAssetsBOY
Total Assets EOY	95467985	TotalAssetsEOY
Total Liabilities BOY	46158901	TotalLiabilitiesBOY
Total Liabilities EOY	45613375	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	45618199	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	49854610	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	Heywood Hospital is dedicated to the community benefit goals of improving the health status of our community, addressing the specific health care needs of the under-served and collaborating with others to enhance quality and contain the growth of community health care costs. Details to this are published in "The Community Benefit Report of Heywood Hospital-Fiscal Year 2013" filed with the MA Attorney General's Office.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	1	SignificantChange
Expense	101233786	Expense
Grants	120000	Grants
Revenue	107379169	Revenue
Description	Heywood Hospital is dedicated to the community benefit goals of improving the health status of our community, addressing the specific health care needs of the under-served and collaborating with others to enhance quality and contain the growth of community health care costs. Details to this are published in "The Community Benefit Report of Heywood Hospital - Fiscal Year 2012" filed with the MA Attorney Generals Office.	Description
Total Of Other Program Service Exp	0	TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt	0	TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev	0	TotalOfOtherProgramServiceRev
Total Program Service Expense	101233786	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	0	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	1	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	148	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	1037	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	0	UnrelatedBusinessIncome
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	21	NbrVotingGoverningBodyMembers
Number Independent Voting Members	19	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	0	MembersOrStockholders
Election Of Board Members	0	ElectionOfBoardMembers
Decisions Subject To Approval	0	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
States Where Copy Of Return Is Filed	MA	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	Robert Crosby	NamePerson
Telephone Number	9786306157	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	242 Green Street	AddressLine1
City	Gardner	City
State	MA	State
ZIP Code	01440	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (34 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Highest Compensated EmployeeHighestCompensatedEmployee	FormerFormer
Daniel M Asquino
Trustee	0	0	X	0	0	0
Michael Azzoni
Trustee	0	0	X	0	0	0
James Garrison
Trustee	0	0	X	0	0	0
John Kerney
Trustee	0	0	X	0	0	0
Roy Lake
Trustee	0	0	X	0	0	0
Michele Parker
Trustee	0	0	X	0	0	0
JoAnne Parks
Trustee	0	0	X	0	0	0
Kenneth J Pierce
Chairman-Trustee	0	0	X	0	0	0
Glenn A Hunt
Vice Chairman -Trustee	0	0	X	0	0	0
Rebecca Bialecki
2nd Vice Chairman - Trustee	0	0	X	0	0	0
Cheney Castine
Treasurer - Trustee	0	0	X	0	0	0
Tina Sbrega
Trustee	0	0	X	0	0	0
Winfield Brown
President /CEO	40	0	X	526138	0	50699	X
Robert Chauvin
Trustee	0	0	X	0	0	0
Joyce Fletcher
Trustee	0	0	X	0	0	0
John Flick
Trustee	0	0	X	0	0	0
James Meehan
Trustee	0	40	X	0	33400	3247
Donald Mruk
Trustee	0	0	X	0	0	0
Moshen Noreldin
Trustee	0	0	X	0	0	0
John Skrzypczak
Trustee	0	0	X	0	0	0
Douglas Starrett
Trustee	0	0	X	0	0	0
Robert Crosby
Sr VP of Finance / CFO	40	0		268605	0	48958	X
Michael Grimmer
VP of Support Services	40	0		228187	0	43961	X
Tina Santos
VP of Patient Care Srvcs/CNO	40	0		221225	0	29541	X
Thomas Cady
VP of Human Resources	40	0		175347	0	45927	X
Rose Kavalchuck
VP of Quality Services	40	0		201940	0	42668	X
Carol Roosa
VP of Information Services/CIO	40	0		7558	0	1800	X
Dawn Casavant
VP of Philanthropy	40	0		15603	0	2457	X
David Gill
Staff Phychologist	40	0		255824	0	28343		X
Faith Pinkerton
Emergency Physician	40	0		192560	0	18332		X
Sheila Ebert
Oncology Physician	24	0		196069	0	14653		X
Ellen Ray
Emergency Physician	40	0		182261	0	18130		X
Alice Vaine
OR Nurse Practitioner	40	0		174778	0	13937		X
James Mullen
Sr VP of Patient Care / CNO (termed 5/27/11)	40	0		101328	0	7819			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	2747423	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	33400	TotalReportableCompFrmRltdOrgs
Total Other Compensation	370472	TotalOtherCompensation
Number Individuals GT100 K	45	NumberIndividualsGT100K
Formers Listed	1	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
Quartulli and Associates Inc
PO Box 423	Gardner	MA	01440	Physical Therapy	3099625
Bay State Emergency Medical Inc
44 Crosby Road	Ashburnham	MA	01430	Emergency Room Physicians	1455524
Alliance Healthcare Services
100 Bay View Circle	Newport Beach	CA	92660	MRI	1308445
UMass Memorial Medical Group
3654 Plantation St	Worcester	MA	01605	Physician Services	1104301
Quest Diagnostics Inc
5763 Collection Center Drive	Chicago	IL	60693	Lab Contracted Services	796422

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	27	NumberOfContractorsGT100K
Federated Campaigns	0	FederatedCampaigns
Membership Dues	0	MembershipDues
Fundraising Events	55350	FundraisingEvents
Related Organizations	0	RelatedOrganizations
Government Grants	566103	GovernmentGrants
All Other Contributions	287185	AllOtherContributions
Noncash Contributions	0	NoncashContributions
Total Contributions	908638	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	ExclusionExclusionAmount
Ancillary O/P Service	621110	60367903	60367903	$0
Ancillary I/P & Routine	621110	45117072	45117072	$0
Contracted Services	900099	1357235	1357235	$0
HMG Patient Revenue (Net)	621111	400582	400582	$0
Lifeline	624120	54033	54033	$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	82344	TotalRevenueColumn
Related Or Exempt Function Income	82344	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Field	Value	IRS element (for citing)
Total Program Service Revenue	107379169	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	301252	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$301,252	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	178929	Real
Personal	0	Personal

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	0	Real
Personal	0	Personal

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	178929	Real
Personal	0	Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	178929	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$178,929	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	10236398	Securities
Other	1966	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	10042117	Securities
Other	1966	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	194281	Securities
Other	0	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	194281	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$194,281	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	28025	GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events	55350	CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses	42840	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	-14815	TotalRevenueColumn
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	-$14,815	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount
Meal Revenue	722310	685913	$685,913
Purchase Discounts	900099	175857	$175,857
Pharmacy Misc Revenue	900099	197516	$197,516

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	118343	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$118,343	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	1177629	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	110125083	TotalRevenueColumn
Related Or Exempt Function Income	107379169	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$1,837,276	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	120000	Total
Program Services	120000	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	1964485	Total
Program Services	443411	ProgramServices
Management And General	1399898	ManagementAndGeneral
Fundraising	121176	Fundraising

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	44372423	Total
Program Services	43741246	ProgramServices
Management And General	604852	ManagementAndGeneral
Fundraising	26325	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	822765	Total
Program Services	713429	ProgramServices
Management And General	95684	ManagementAndGeneral
Fundraising	13652	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	5163413	Total
Program Services	4845622	ProgramServices
Management And General	291590	ManagementAndGeneral
Fundraising	26201	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	3506077	Total
Program Services	3329057	ProgramServices
Management And General	166695	ManagementAndGeneral
Fundraising	10325	Fundraising

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	698750	Total
Program Services	11301	ProgramServices
Management And General	687449	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	106640	Total
Program Services	0	ProgramServices
Management And General	106640	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	6744	Total
Fundraising	6744	Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	10576756	Total
Program Services	10545400	ProgramServices
Management And General	31356	ManagementAndGeneral
Fundraising	0	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	99582	Total
Program Services	89919	ProgramServices
Management And General	9663	ManagementAndGeneral
Fundraising	0	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	14983097	Total
Program Services	14739854	ProgramServices
Management And General	239450	ManagementAndGeneral
Fundraising	3793	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	1360901	Total
Program Services	1298747	ProgramServices
Management And General	62154	ManagementAndGeneral
Fundraising	0	Fundraising

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	1701811	Total
Program Services	1678956	ProgramServices
Management And General	22855	ManagementAndGeneral
Fundraising	0	Fundraising

Travel Travel

Field	Value	IRS element (for citing)
Total	95509	Total
Program Services	78890	ProgramServices
Management And General	16619	ManagementAndGeneral
Fundraising	0	Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	84335	Total
Program Services	63505	ProgramServices
Management And General	19681	ManagementAndGeneral
Fundraising	1149	Fundraising

Interest Interest

Field	Value	IRS element (for citing)
Total	708193	Total
Program Services	708193	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	4587648	Total
Program Services	4572888	ProgramServices
Management And General	14760	ManagementAndGeneral
Fundraising	0	Fundraising

Insurance Insurance

Field	Value	IRS element (for citing)
Total	578508	Total
Program Services	509673	ProgramServices
Management And General	68835	ManagementAndGeneral
Fundraising	0	Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral	FundraisingFundraising
Bad Debt	5502302	5502302	0	0
Free Care	2847338	2847338	0	0
Professional Fees	5056562	3681459	1365486	9617
Subscriptions & Dues	714935	225100	487861	1974

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	1585479	Total
Program Services	1487496	ProgramServices
Management And General	97983	ManagementAndGeneral
Fundraising	0	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	107244253	Total
Program Services	101233786	ProgramServices
Management And General	5789511	ManagementAndGeneral
Fundraising	220956	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	2438924	BOY
EOY	4168080	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	2398884	BOY
EOY	2264477	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	10258616	BOY
EOY	12802618	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	72338	BOY
EOY	171515	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	1371294	BOY
EOY	1413035	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	1080396	BOY
EOY	1057751	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	104097688	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	51408268	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	54706913	BOY
EOY	52689420	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	17190937	BOY
EOY	18185573	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	489451	BOY
EOY	437650	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	129347	BOY
EOY	134526	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	1640000	BOY
EOY	2143340	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	91777100	BOY
EOY	95467985	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	13297762	BOY
EOY	14314680	EOY

Grants Payable GrantsPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	258468	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	26312766	BOY
EOY	24679160	EOY

Escrow Account Liability EscrowAccountLiability

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Loans From Officers Directors LoansFromOfficersDirectors

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	729023	BOY
EOY	294782	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	5819350	BOY
EOY	6066285	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	46158901	BOY
EOY	45613375	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	40274861	BOY
EOY	44503392	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	4337245	BOY
EOY	4345057	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1006093	BOY
EOY	1006161	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	45618199	BOY
EOY	49854610	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	91777100	BOY
EOY	95467985	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	2880830	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	2705947	ReconciliationUnrealizedInvest
Reconcilation Donated Services	0	ReconcilationDonatedServices
Reconcilation Invest Expenses	0	ReconcilationInvestExpenses
Reconcilation Prior Adjustment	0	ReconcilationPriorAdjustment
Reconcilation Other Changes	-1350366	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Consolidated	X	FinancialStatementConsolidated

Field	Value	IRS element (for citing)
Audit Committee	1	AuditCommittee
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

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

Contributor Address US ContributorAddressUS

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

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	17128384	BeginningOfYearBalance
Contributions	2200	Contributions
Investment Earnings Or Losses	2044839	InvestmentEarningsOrLosses
Grants Or Scholarships	0	GrantsOrScholarships
Other Expenditures	1096659	OtherExpenditures
Administrative Expenses	0	AdministrativeExpenses
End Of Year Balance	18078764	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	11897431	BeginningOfYearBalance
Contributions	5683	Contributions
Investment Earnings Or Losses	1966503	InvestmentEarningsOrLosses
Grants Or Scholarships	0	GrantsOrScholarships
Other Expenditures	-3258767	OtherExpenditures
Administrative Expenses	0	AdministrativeExpenses
End Of Year Balance	17128384	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	17367013	BeginningOfYearBalance
Contributions	5000	Contributions
Investment Earnings Or Losses	-128702	InvestmentEarningsOrLosses
Grants Or Scholarships	0	GrantsOrScholarships
Other Expenditures	5345880	OtherExpenditures
Administrative Expenses	0	AdministrativeExpenses
End Of Year Balance	11897431	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	16786738	BeginningOfYearBalance
Contributions	4875	Contributions
Investment Earnings Or Losses	958017	InvestmentEarningsOrLosses
Grants Or Scholarships	0	GrantsOrScholarships
Other Expenditures	382617	OtherExpenditures
Administrative Expenses	0	AdministrativeExpenses
End Of Year Balance	17367013	EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	18164728	BeginningOfYearBalance
Contributions	5250	Contributions
Investment Earnings Or Losses	-686973	InvestmentEarningsOrLosses
Grants Or Scholarships	0	GrantsOrScholarships
Other Expenditures	696267	OtherExpenditures
Administrative Expenses	0	AdministrativeExpenses
End Of Year Balance	16786738	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.85	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	0.06	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	0.09	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	0	EndowmentsHeldByRelatedOrgs

Land Land

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	0	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	125271	OtherCostOrOtherBasis
Book Value	125271	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	0	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	65922189	OtherCostOrOtherBasis
Depreciation	22700335	Depreciation
Book Value	43221854	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	0	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	0	OtherCostOrOtherBasis
Depreciation	0	Depreciation
Book Value	0	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	0	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	37252134	OtherCostOrOtherBasis
Depreciation	28707933	Depreciation
Book Value	8544201	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	0	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	798094	OtherCostOrOtherBasis
Depreciation	0	Depreciation
Book Value	798094	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	52689420	TotalOfBookValueLandBuildings
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescription	AmountAmount
Est Settlement with 3rd Party	$4,205,784
Est Insurance Claims	$1,860,501

Field	Value	IRS element (for citing)
Total Of Amounts	6066285	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
SchD_P05_S00_L04	Schedule D, Part V, Line 4	Perm Endow 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 Endow funds are established by the governing body to fund capital projects and/or improvements of the organization. Temp Restricted funds are established by donor restricted gifts that maintain a source of income for a specific period of time.
SchD_P10_S00_L02	Schedule D, Part X, Line 2	The Hospital and HMGI (as of April 2006) have been determined to be not-for-profit corporations as described in Section 501(c)(3), and the Realty Corp has been determined to be a not-for-profit corporation as described in Section 501(c)(2) of the Internal Revenue Code (the "Code") and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. The IRS has also previously determined that the Hospital is not a private foundation because it is an organization described under the IRC section 170(i)(A)(iii). Any income not substantially related to these Organizations' exempt purposes may be considered unrelated business income under IRC Section 511 and, as such, subject to tax at normal corporate rates. In accordance with generally accepted accounting principles, the Organization annually evaluates its tax status and tax positions taken with respect to its operations and financial position. Tax years from 2008 through the current year remain open for examination by federal and state taxing authorities.

Schedule G IRS990ScheduleG

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	Golf Classic	NameOfEvent1
Gross Receipts Event1	83375	GrossReceiptsEvent1
Charitable Contributions Event1	55350	CharitableContributionsEvent1
Gross Revenue Event1	28025	GrossRevenueEvent1
Cash Prizes Event1	0	CashPrizesEvent1
Non Cash Prizes Event1	5277	NonCashPrizesEvent1
Rent Facility Costs Event1	14017	RentFacilityCostsEvent1
Food And Beverage Event1	17158	FoodAndBeverageEvent1
Entertainment Event1	400	EntertainmentEvent1
Other Direct Expenses Event1	5988	OtherDirectExpensesEvent1
Food And Beverage Other Events	0	FoodAndBeverageOtherEvents
Entertainment Other Events	0	EntertainmentOtherEvents
Gross Receipts Total	83375	GrossReceiptsTotal
Charitable Contributions Total	55350	CharitableContributionsTotal
Gross Revenue Total Events	28025	GrossRevenueTotalEvents
Cash Prizes Total Events	0	CashPrizesTotalEvents
Non Cash Prizes Total Events	5277	NonCashPrizesTotalEvents
Rent Facility Costs Total Events	14017	RentFacilityCostsTotalEvents
Food And Beverage Total Events	17158	FoodAndBeverageTotalEvents
Entertainment Total Events	400	EntertainmentTotalEvents
Other Direct Expenses Total Events	5988	OtherDirectExpensesTotalEvents
Direct Expense Summary Events	42840	DirectExpenseSummaryEvents
Net Income Summary	-14815	NetIncomeSummary

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent100	X	Pcent100
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent400	X	Pcent400
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	1	ExpensesExceededBudget
Unable To Provide Care	0	UnableToProvideCare
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1882213	TotalCommunityBenefitExpense
Direct Offsetting Revenue	506134	DirectOffsettingRevenue
Net Community Benefit Expense	1376079	NetCommunityBenefitExpense
Percent Of Total Expense	0.0135	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	17041326	TotalCommunityBenefitExpense
Direct Offsetting Revenue	14859011	DirectOffsettingRevenue
Net Community Benefit Expense	2182315	NetCommunityBenefitExpense
Percent Of Total Expense	0.0214	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	0	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	0	NetCommunityBenefitExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Benefit Expense	18923539	TotalCommunityBenefitExpense
Direct Offsetting Revenue	15365145	DirectOffsettingRevenue
Net Community Benefit Expense	3558394	NetCommunityBenefitExpense
Percent Of Total Expense	0.0349	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	982953	TotalCommunityBenefitExpense
Direct Offsetting Revenue	113321	DirectOffsettingRevenue
Net Community Benefit Expense	869632	NetCommunityBenefitExpense
Percent Of Total Expense	0.0085	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	239160	TotalCommunityBenefitExpense
Direct Offsetting Revenue	616	DirectOffsettingRevenue
Net Community Benefit Expense	238544	NetCommunityBenefitExpense
Percent Of Total Expense	0.0023	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	0	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	0	NetCommunityBenefitExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Total Community Benefit Expense	0	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	0	NetCommunityBenefitExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	44743	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	44743	NetCommunityBenefitExpense
Percent Of Total Expense	0.0004	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Benefit Expense	1266856	TotalCommunityBenefitExpense
Direct Offsetting Revenue	113937	DirectOffsettingRevenue
Net Community Benefit Expense	1152919	NetCommunityBenefitExpense
Percent Of Total Expense	0.0112	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Benefit Expense	20190395	TotalCommunityBenefitExpense
Direct Offsetting Revenue	15479082	DirectOffsettingRevenue
Net Community Benefit Expense	4711313	NetCommunityBenefitExpense
Percent Of Total Expense	0.0461	PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

Field	Value	IRS element (for citing)
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

Field	Value	IRS element (for citing)
Total Community Building Expense	240	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	240	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Leadership Development LeadershipDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Total Community Building Expense	126353	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	126353	NetCommunityBuildingExpense
Percent Of Total Expense	0.0012	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	110701	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	110701	NetCommunityBuildingExpense
Percent Of Total Expense	0.0011	PercentOfTotalExpense

Other Other

Field	Value	IRS element (for citing)
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Building Expense	237294	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	237294	NetCommunityBuildingExpense
Percent Of Total Expense	0.0023	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$2,255,163	BadDebtExpenseAmount
Amount Attributable To	92236	AmountAttributableTo
Amount Reimbursed By Medicare	32944291	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	28809621	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	4134670	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Other	X	Other

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Henry Heywood Memorial Hospital	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	242 Green Street	AddressLine1
City	Gardner	City
State	MA	State
ZIP Code	01440	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Henry Heywood Memorial Hospital	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	1	CHNAConducted
Community Definition	X	CommunityDefinition
Community Demographics	X	CommunityDemographics
Existing Resources	X	ExistingResources
How Data Obtained	X	HowDataObtained
Community Health Needs	X	CommunityHealthNeeds
Other Health Issues	X	OtherHealthIssues
Identifying Process	X	IdentifyingProcess
Consulting Process	X	ConsultingProcess
Information Gaps	X	InformationGaps
Needs Assessment Conducted	11	NeedsAssessmentConducted
Take Into Account	1	TakeIntoAccount
Other Facilities	1	OtherFacilities
CHNA Widely Available	1	CHNAWidelyAvailable
Own Website	X	OwnWebsite
On Request	X	OnRequest
Adopt Implement Strategy	X	AdoptImplementStrategy
Execute Implement Strategy	X	ExecuteImplementStrategy
Develop Community Plan	X	DevelopCommunityPlan
Participate Community Plan	X	ParticipateCommunityPlan
Include Operational Plans	X	IncludeOperationalPlans
Adopt Budget	X	AdoptBudget
Prioritize Health Needs	X	PrioritizeHealthNeeds
Prioritize Services	X	PrioritizeServices
All Needs Addressed	1	AllNeedsAddressed
Organization Incur Excise Tax	0	OrganizationIncurExciseTax
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	100	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	400	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Insurance Status	X	InsuranceStatus
State Regulation	X	StateRegulation
Other Factors	X	OtherFactors
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Attached To Invoices	X	AttachedToInvoices
Posted In Emergency Room	X	PostedInEmergencyRoom
Posted In Admission Office	X	PostedInAdmissionOffice
Provided On Admission	X	ProvidedOnAdmission
Available On Request	X	AvailableOnRequest
Actions On Nonpayment	1	ActionsOnNonpayment
Permit Report To Credit Agency	X	PermitReportToCreditAgency
Collection Activities	1	CollectionActivities
Report To Credit Agency	X	ReportToCreditAgency
Notify Upon Admission	X	NotifyUponAdmission
Notify Before Discharge	X	NotifyBeforeDischarge
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Other Actions Taken	X	OtherActionsTaken
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Lowest Negotiated Rates	X	LowestNegotiatedRates
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (21 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
SchH_P01_S00_L06a	Schedule H, Part I, Line 6a	The Organization makes it's annual Community Benefit Report available to the public by transmitting the report electronically to the Attorney General's Community Benefit office which then makes it public on their website.
SchH_P01_S00_L07	Schedule H, Part I, Line 7	The costing methodology used to calculate the amounts reported in the table in Part I, for lines 7a through 7c was based on the cost to charge ratio derived from the supplied Worksheet 2, in the IRS schedule H instructions. The costs for lines 7e through 7i were actual costs incurred.
SchH_P02_S00_L00	Schedule H, Part II	The Heywood Hospital's community Benefits Mission Statement is "Heywood Hospital is dedicated to the community benefit goals of improving the health status of our community, addressing the specific health needs of the under-served and collaborating with others to enhance quality and contain the growth of community healthcare costs".
SchH_P02_S00_L04	Schedule H, Part II, Line 4	This year's expenses were related to Heywood Hospital's Green Team and their sponsorship of Earth Day events which included a recycling day and plant sales.
SchH_P02_S00_L06	Schedule H, Part II, Line 6	Heywood's approach to Community Benefits has been to collaborate with others through the Joint Coalition on Health and other coalitions to develop our plan, goals and strategies. Partners include the Joint Coalition on Health, Gardner Interagency Team, the CHNA, The Minority Coalition, Montachusetts 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 Dpt of Public Health, AHEC and others. At his 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.
SchH_P02_S00_L08	Schedule H, Part II, Line 8	Heywood Hospital serves a medically underserved population area, because of this, the Hospital is constantly working to recruit and search for physicians to serve our community.
SchH_P03_S0A_L02	Schedule H, Part III, Section A, Line 2	The costing methodology used for line 2 was based on the cost charge ratio derived from the supplied worksheet 2 in the IRS sch H instructions.
SchH_P03_S0A_L03	Schedule H, Part III, Section A, Line 3	The methodology used for line 3 was to take the percentage of financial assistance applications that were due to inadequate documentation divided by the total applications received for FY 2013. This amounted to approximately 4.09% which was applied against the number on line2.. It is our belief that the $92,236 amount of bad debt should be included as a community benefit. As a ax 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 devts as a community benefit.
SchH_P03_S0A_L04	Schedule H, Part III, Section A, Line 4	The footnote can be found on Page 8 of the financial statements - footnote #2 under "Allowance of Doubtful Accounts".
SchH_P03_S0B_L06	Schedule H, Part III, Section B, Line 6	The allowable costs on line 6 were obtained from our FY 2013 Medicare Cost Report, Worksheet D schedules.
SchH_P03_S0B_L08	Schedule H, Part III, Section B, Line 8	There is no shortfall.
SchH_P03_S0C_L09b	Schedule H, Part III, Section C, Line 9b	Heywood Hospital provides patients with information about financial assistance programs that are available through the Commonwealth of MA or through Heywood Hospital's own financial assistance program, which may cover all or some of their unpaid hospital bills. For those patients that request such assistance, Heywood Hospital assists patients by screening them for eligibility in an available public program and assisting them in applying for the program. These programs, include but are not limited to MassHealth, Commoneealth 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 if the patient is eligible to apply for certain health insurance programs. If the patient or guarantor is unable to provide the necessary information Heywood Hospital may make reasonable efforts to obtain any additional information from other sources. Information that Heywood obtains will be maintained in accordance with applicable federal and state privacy and security laws. The screening and application process for a 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. Heywod 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 Commonweatlh 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 the determination of program eligibility made by the Commonwealth, but at the patient's request may take a direct role in appealing or 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.
SchH_P05_S0B_L03	Schedule H, Part V, Section B, Line 3	The 2011 Community Health Needs Assessment of North Cental Massachusetts was a joint effort between MA Dept 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 areals 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 Dept of Public Health, the US Census Bureau, the MA Dept of Workforce Development, the MA Dept of Elementary and Secondary Education and the Massachusetts Behavorial 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, Montachusestt Opportunity Council, in addition to other area agencies.
SchH_P05_S0B_L04	Schedule H, Part V, Section B, Line 4	Hospitals 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.
SchH_P05_S0B_L12	Schedule H, Part V, Section B, Line 12	12h:Medical Hardship, wherein the patient's medical expenses exceed the patient's income
SchH_P05_S0B_L18	Schedule H, Part V, Section B, Line 18	18e: The Hospital posts general notices throughout the hospital about the financial assistance policy.
SchH_P06_S00_L02	Schedule H, Part VI, Line 2	Heywood Hospital assesses the health needs of the communities it serves in a variety of ways in addition to the CHNA. The Patient and Family Advisory Council which meets every other month includes 14 patients and two hospital representatives. This council, comprised of former patients and their families, provides general input on community needs, as well as input on hospital-specific services and opportunities for improvement. In addition, the hospital works closely throughout the year with area social service agencies obtaining input on community health needs including, Gardner Board of Health, the Joint Coalition on Healthcare, the Minority Coalition of North Central MA, Gardner CDC, the Massachusetts Department of Public Health, more than 100 agencies belonging to the Suicide Prevention Taskforce, Gardner Public Schools, Ashburnham Public Schools, Winchendon Public Schools, Gardner Area Interagency Team, Mount Wachusett Community College, Alzheimer Association, Montachusett Veterans Outreach, Gardner Area Seniors, Gardner VNA and the Greater Gardner Religious Council. The hospital solicits feedback from social service and nursing staff, as well as physicians regarding patient feedback. The hospital also provides space for/and facilitates support groups which provide feedback on community interests and needs.
SchH_P06_S00_L03	Schedule H, Part VI, Line 3	General Principles: For those patients who are uninsured or under-insured, Heywood Hospital will work with them to assist with applying for available financial assistance programs that may cover some or all of their unpaid hospital bills. In order to help uninsured and under-insured patients find available and appropriate financial assistance programs, Heywood Hospital will provide all patients with a general notice of the availability of programs in both the bills that are sent to patients as well as in general notices that are posted throughout the hospital. 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, Heywood Hospital may also assist patients in applying for coverage of services as a Medical Hardship based on the patients who are low income through Heywood Hospital's own internal financial assistance program. Heywood Hospital will also notify the patient about available payment plans that may available to them based on their family size and income. Role of Hospital Patient Financial Counselors and other Finance staff: Heywood Hospital will try to identify available coverage options for patients who may be uninsured or under-insured with their current insurance program when the patient is scheduling their services, while the patient is in Heywood Hospital, upon discharge, and for a reasonable time following discharge from the hospital. The hospital registration and admission staff will direct all patients seeking available coverage options or financial assistance to the hospital's patient financial counseling office to determine if they are eligible and then o screen for eligibility in an appropriate coverage option. Heywood Hospital will then assist the patient in applying for the appropriate coverage options that are available or notify them of the availability of financial assistance through the hospital's own internal financial assistance program. Heywood Hospital will also provide information on how to contact the appropriate staff within the hospital's finance office to verify the accuracy of the hospital bill or to dispute certain charges. Notification Practices: Heywood Hospital will post a notice of availability of financial assistance in the following locations; 1) Service Delivery Areas such as Inpatient, Clinic and Emergency Department admissions and registration areas. 2) Patient Financial Counselor areas. 3) Central Admission and Registration areas. and 4) Business office areas that are open to patients. Posted signs will be clearly visible and legible to patients visiting these areas. Heywood Hospital will also include a notice about the availability of financial assistance in all initial bills. When the patient contacts Heywood Hospital, the hospital finance staff will attempt to identify if a patient qualifies for a public financial assistance program or a payment plan... A patient who is enrolled in a public financial assistance program may qualify for certain plans. Patients may also qualify for additional assistance based on Heywood 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. For cases where Heywood Hospital is using the Virtual Gateway application, the hospital will assist the patient in completing the application for MassHealth, Commonwealth Care, Children's Medical Security Plan, Healthy Start, Health Safety Net or other forms of financial assistance programs, as they become part of the Virtual Gateway program.
SchH_P06_S00_L04	Schedule H, Part VI, Line 4	The 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 over 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.
SchH_P06_S00_L05	Schedule H, Part VI, Line 5	The 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 over 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.
SchH_P06_S00_L06	Schedule H, Part VI, Line 6	Heywood Hospital works closely with the community to promote health in areas identified by the 2011 Community Health Needs Assessment (CHNA) through a variety of means. The hospital works with area school systems to address childhood obesity and onset of adult diabetes through nutrition/fitness programs targeting young students K-2, in order to help develop healthy habits which may result in a reduction of chronic illness and obesity as indicated in the 2011 CHNA. Financial counselors help uninsured populations, ncluding 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 at the school, providing nearly 1000 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 health equity.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Amount Of Non Cash AssistanceAmountOfNonCashAssistance	Method Of ValuationMethodOfValuation	Description Of Non Cash AssistanceDescriptionOfNonCashAssistance	Purpose Of GrantPurposeOfGrant
Montachusett Home Care Corp
680 Mechanic St	Leominster	MA	01453	042551175	501(c)(3)	76800	0	N/A	N/A	The funds will be used by the Community Health Network of North Central MA as support and collaborative community health assessment work.
Montachusett Opportunity Council
133 Pritchard St	Fitchburg	MA	01420	042401111	501(c)(3)	43200	0	N/A	N/A	The 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.

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	2	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	0	TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	SchI_P01_S00_L02	Identifier
Return Reference	Schedule I, Part I, Line 2	ReturnReference
Explanation	Montachusett 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.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Housing Allowance Or Residence	X	HousingAllowanceOrResidence
Written Policy Re T And E Expenses	0	WrittenPolicyReTAndEExpenses
Substantiation Required	0	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	1	SeverancePayment
Supplemental Nonqual Retire Plan	0	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	1	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Winfield Brown
President /CEO	383569	0	133569	0	9000	0	19261	0	31438	0	576837	0	0	0
Robert Crosby
Sr VP of Finance / CFO	225978	0	41469	0	1158	0	21255	0	27703	0	317563	0	0	0
Michael Grimmer
VP of Support Services	190066	0	25621	0	12500	0	17000	0	26961	0	272148	0	0	0
Tina Santos
VP of Patient Care Srvcs/CNO	195816	0	25233	0	176	0	17780	0	11761	0	250766	0	0	0
Thomas Cady
VP of Human Resources	153094	0	21352	0	901	0	20283	0	25643	0	221273	0	0	0
Rose Kavalchuck
VP of Quality Services	177031	0	23938	0	971	0	20675	0	21993	0	244608	0	0	0
David Gill
Staff Phychologist	253233	0	0	0	2591	0	5326	0	23017	0	284167	0	0	0
Faith Pinkerton
Emergency Physician	182352	0	10000	0	208	0	0	0	18332	0	210892	0	0	0
Sheila Ebert
Oncology Physician	195570	0	0	0	499	0	3901	0	10752	0	210722	0	0	0
Ellen Ray
Emergency Physician	171937	0	10000	0	324	0	0	0	18130	0	200391	0	0	0
Alice Vaine
OR Nurse Practitioner	174279	0	0	0	499	0	3601	0	10335	0	188714	0	0	0
James Mullen
Sr VP of Patient Care / CNO (termed 5/27/11)	0	0	0	0	101328	0	0	0	7819	0	109147	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
SchJ_P01_S00_L01a	Schedule J, Part I, Line 1a	Housing allowance provided to Michael Grimmer, VP of Support Services, per contract. Paid through his weekly salary.
SchJ_P01_S00_L01b	Schedule J, Part I, Line 1b	Housing allowance was part of his employment contract.
SchJ_P01_S00_L04	Schedule J, Part I, Line 4	James Mullen, former CNO received severance payments in CY 2012. Total severance paid in 2012 was $101,328.
SchJ_P01_S00_L06	Schedule J, Part I, Line 6	Heywood Hospital accrues 15% of the executive team's salary for a bonus payment that is based on the financial condition of the hospital and other quality based criteria.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Bond ReferenceBondReferenceCd	Issuer EINIssuerEIN	CUSIP NumberCUSIPNumber	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer	Pool FinancingPoolFinancing
MA Health and Educational Facilitiy Authority
A	042456011	57586EGT2	2009-03-31	17785000	Funds used for new Watkins Bldg project	0	0	0
MA Health and Educational Facility Authority
B	042456011	57586C7E9	2008-06-19	6715000	Refunding and new Watkins Bldg project	0	0	0

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Bond ReferenceBondReferenceCd	Amount RetiredAmountRetired	Amount Bond DefeasedAmountBondDefeased	Total ProceedsTotalProceeds	Amount In Reserve FundAmountInReserveFund	Capitalized InterestCapitalizedInterest	Refunding EscrowRefundingEscrow	Issuance Costs From ProceedsIssuanceCostsFromProceeds	Credit EnhancementCreditEnhancement	Working Capital ExpendituresWorkingCapitalExpenditures	Capital ExpendituresCapitalExpenditures	Other Spent ProceedsOtherSpentProceeds	Amount UnspentAmountUnspent	Year Of Subst CompletionYearOfSubstCompletion	Current RefundingCurrentRefunding	Advance RefundingAdvanceRefunding	Final Allocation MadeFinalAllocationMade	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
A	0	0	66235	0	0	0	281690	0	0	17569545	0	0	2010	0	0	1	1
B	0	0	19154	0	0	0	329467	0	3597891	2806796	0	0	2008	1	0	1	1

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedProperty	Any Lease ArrangementsAnyLeaseArrangements	Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Any Research AgreementsAnyResearchAgreements	Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers	Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI	Total Private Business UseTotalPrivateBusinessUse	Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest	Change In Use Bond Financed PropChangeInUseBondFinancedProp	Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A	0	0	0	0	0	0	0	1	0	1
B	0	0	0	0	0	0	0	1	0	1

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiled	Rebate Not Due YetRebateNotDueYet	Exception To RebateExceptionToRebate	No Rebate DueNoRebateDue	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Term Of HedgeTermOfHedge	Superintegrated HedgeSuperintegratedHedge	Hedge TerminatedHedgeTerminated	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC	Gross Proceeds InvestedGrossProceedsInvested	Written Proc To Monitor ReqsWrittenProcToMonitorReqs
TD Bank
A	0	0	0	1	1	1	18.7	0	0	0	0	1
Piper Jaffrey
B	0	0	0	1	1	1	18.7	0	0	0	0	1

Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)

Bond ReferenceBondReferenceCd	Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A	0
B	0

Form990 Schedule K Part VI Form990ScheduleKPartVI

Field	Value	IRS element (for citing)
Identifier	SchK_P04_S00_L02c	Identifier
Return Reference	Schedule K, Part IV, Line 2c	ReturnReference
Explanation	Rebate computation was performed October 8, 2013.	Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
F990_P03_S00_L03	Form 990, Part III, Line 3	In August 2013, Heywood Hospital closed its Transitional Care Unit and reduced the number of beds in its Pediatric unit.
F990_P06_S0B_L11b	Form 990, Part VI, Section B, Line 11b	The Senior Accountant at Heywood Hospital prepares the form 900 and provides to the controller for review. The form is then sent to the CFO for final review. Once review, 990 is placed on Hospital Cyber Board for Board of Trustee review. The 990 is then approved by the board and submitted by the accounting department.
F990_P06_S0B_L12c	Form 990, Part VI, Section B, Line 12c	Annually, a Conflict of Interest form is sent out to the managers, trustees and employees with broad discretionary authority. These forms are required to be signed and are monitored by the Corporate Compliance office for completion.
F990_P06_S0B_L15	Form 990, Part VI, Section B, Line 15	The CEO and Officer's salary is determined by the market data provided to the search committee by a search firm, an independent third party. This data supplemented the first hand knowledge of other comparable facilities in New England and that search firm had based on prior searches. Sources such as the Massachusetts Hospital Salary Survey and intimate knowledge of the going salaries for senior executives in healthcare also played a major role in determining salaries
F990_P06_S0C_L19	Form 990, Part VI, Section C, Line 19	The organization makes the governing documents, conflict of interest policy and financial statements available to the public by providing completed copies to the Administrative Assistant, who provides copies upon request.
F990_P11_S00_L09	Form 990, Part XI, Line 9	The amount that makes up the other changes in net assets or fund balance is from discounts on pledge receivables and inter-corporate and inter-corporate transfers to related organizations, to support their operations.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg	Direct Controlling Entity NADirectControllingEntityNA
Heywood Affiliated Medical Group
242 Green Street	Gardner	MA	01440	043163589	employ physicians	MA	501(c)(3)	9	Heywood Healthcare	0
Heywood Hospital Realty Corporation
242 Green Street	Gardner	MA	01440	043327447	property holding company	MA	501(c)(2)		Heywood Healthcare	0
Athol Memorial Hospital
2033 Main Street	Athol	MA	01331	042126583	Hospital	MA	501(c)(3)	3	Heywood Healthcare	0
Heywood Healthcare Inc
242 Green Street	Gardner	MA	01440	222720658	Parent Corp	MA	501(c)(3)	7		0	N/A
Heywood Healthcare Charitable Foundation
242 Green Street	Gardner	MA	01440	222720562	Charitable Foundation	MA	501(c)(3)	7	Heywood Healthcare	0
HHMH Aid Association
242 Green Street	Gardner	MA	01440	042198019	raise funds for the Hospital	MA	501(c)(3)	9		0	N/A
Winchendon Health Foundation
87 Central Street	Winchendon	MA	01475	042113276	supporting organization	MA	501(c)(3)	PF		0	N/A
Heywood Physician Hospital Organization
242 Green Street	Gardner	MA	01440	043153119	Managed care contracted physicians	MA	501(c)(3)	9		0	N/A

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	0	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	0	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	0	DividendsRelatedOrganization
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	1	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	1	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	1	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	0	PerformOfServicesByOtherOrgs
Sharing Of Facilities	0	SharingOfFacilities
Sharing Of Paid Employees	0	SharingOfPaidEmployees
Reimbursement Paid To Other Org	1	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	1	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	1	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

Field	Value	IRS element (for citing)
Business Name Line1	Heywood Hospital Realty Corporation	BusinessNameLine1

Field	Value	IRS element (for citing)
Transaction Type	q	TransactionType
Amount Involved	229571	AmountInvolved
Method Of Amt Determination	Actual Cost.	MethodOfAmtDetermination

Reasonable Cause Explanation ReasonableCauseExplanation

Field	Value	IRS element (for citing)
Explanation	Extension was granted.	Explanation