2014-08-08T10:43:36-05:00 2013-09-30 042684828 FEELEY & DRISCOLL PC 200 PORTLAND STREET BOSTON MA 02114 990 2012-10-01 912155626 UMASS MEMORIAL HEALTH CARE INC & AFFILIATES - GROUP RETURN UMAS 5083340496 306 BELMONT STREET WORCESTER MA 01604 SERGIO MELGAR 5083340496 2014-07-16 1 ALAN GAROFALO P00744592 6177427788 2012 2015-11-30 17:44:51Z SERGIO MELGAR 306 BELMONT STREET WORCESTER MA 01604 2759187032 1 1 3642 X WWW.UMASSMEMORIAL.ORG UMASS MEMORIAL HEALTH CARE IS COMMITTED TO IMPROVING THE HEALTH OF THE PEOPLE OF CENTRAL NEW ENGLAND THROUGH EXCELLENCE IN CLINICAL CARE, SERVICE, TEACHING AND RESEARCH. 201 115 16343 1346 8841226 0 18486920 9831011 2551874632 2475711754 -1602742 112241056 44638442 15990297 2613397252 2613774118 2056000 3477289 0 0 1225466308 1241420589 1213795 0 970011 1382216501 1317174393 2610952604 2562072271 2444648 51701847 2000206154 2152708574 1364049191 1262465868 636156963 890242706 X UMASS MEMORIAL HEATLH CARE IS COMMITTED TO IMPROVING THE HEALTH OF THE PEOPLE OF CENTRAL NEW ENGLAND THROUGH EXCELLENCE IN CLINICAL CARE, SERVICE, TEACHING AND RESEARCH. 0 0 1161573921 2400000 1388722679 UMASS MEMORIAL MEDICAL CENTERUMASS MEMORIAL MEDICAL CENTER IS COMMITTED TO IMPROVING THE HEALTH OF THE PEOPLE OF CENTRAL NEW ENGLAND THROUGH EXCELLENCE IN CLINICAL CARE, SERVICE, TEACHING AND RESEARCH. UMASS MEMORIAL MEDICAL CENTER DOES THIS BY PROVIDING INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO THE RESIDENTS OF CENTRAL NEW ENGLAND WITHOUT REGARD TO THEIR ABILITY TO PAY.FY 2013 KEY STATISTICS - TOTAL DISCHARGES: 38,403 TOTAL SURGICAL CASES: 29,648 TOTAL ER VISITS: 134,891 417243458 447632422 UMASS MEMORIAL MEDICAL GROUPTHE UMASS MEMORIAL MEDICAL GROUP IS A MULTISPECIALTY GROUP PRACTICE OF PHYSICIANS WHOSE MISSION AND PURPOSE IS TO SUPPORT THE CLINICAL, EDUCATIONAL, RESEARCH AND COMMUNITY SERVICE MISSIONS OF UMASS MEMORIAL HEALTH CARE AND UMASS MEMORIAL MEDICAL CENTER. UMASS MEMORIAL MEDICAL GROUP ACCOMPLISHES THIS MISSION BY PROVIDING MEDICAL CARE TO RESIDENTS OF CENTRAL NEW ENGLAND WITHOUT REGARD TO THEIR ABILITY TO PAY. 291818318 77289 346096417 OTHER PROGRAM SERVICESOTHER UMASS MEMORIAL ENTITIES - UMASS MEMORIAL HAS A NUMBER OF SUBSIDIARY ENTITIES THAT FUNCTION PRIMARILY TO DELIVER HEALTH CARE TO PATIENTS OR TO SUPPORT THE DELIVERY OF HEALTH CARE TO PATIENTS OF UMASS MEMORIAL. THEY ACCOMPLISH THIS THROUGH THE DELIVERY OF HEALTH CARE SERVICES WITHOUT REGARD TO THE PATIENT'S ABILITY TO PAY. THEY ALSO ACCOMPLISH THIS BY PROVIDING SUPPORT, OVERSIGHT, ADMINISTRATIVE SERVICES OR PATIENT ADVOCACY SERVICES TO THE PATIENTS OF UMASS MEMORIAL, CENTRAL NEW ENGLAND, AND OTHER GEOGRAPHIES. 74766438 1000000 293910134 UMASS MEMORIAL COMMUNITY HOSPITALSTHE UMASS MEMORIAL COMMUNITY HOSPITALS (CLINTON HOSPITAL, HEALTH ALLIANCE HOSPITALS, INC., MARLBOROUGH HOSPITAL, WING MEMORIAL HOSPITAL AND MEDICAL CENTERS) ARE COMMITTED TO IMPROVING THE HEALTH OF THE PEOPLE OF THE COMMUNITIES THAT THEY SERVE THROUGH EXCELLENCE IN CLINICAL CARE AND SERVICE.O EACH OF THESE HOSPITALS ACCOMPLISHES THIS GOAL BY PROVIDING INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO THE RESIDENTS OF THEIR COMMUNITIES WITHOUT REGARD TO THEIR ABILITY TO PAY.FY 2013 KEY STATISTICS -TOTAL DISCHARGES: 14,710TOTAL SURGICAL CASES: 9,641TOTAL ER VISITS: 125,825 74766438 1000000 293910134 1945402135 1 1 0 1 0 0 0 0 0 1 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 1 0 1 1 1 1 0 1 0 0 1 1 1 1 0 1 2088 0 16343 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 201 115 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 MA X ROBERT FELDMANN 5083340496 306 BELMONT STREET WORCESTER MA 01604 X ANDRIENI JULIA MD 31.00 X 304253 0 25142 BROWN ALAN P MD 31.00 X 189608 0 33379 BROWN DOUGLAS S 40.00 X X 531712 0 218497 CARLUCCI DANIEL MD 32.00 X 312927 0 27123 CAVAGNARO III CHARLES MD 40.00 X X 388591 0 218011 COFONE MICHAEL J 40.00 X X 291379 0 23427 CORBETT WILLIAM MD 40.00 X 392975 0 100060 DALY SHEILA 40.00 X X 286008 0 135083 DICKSON ERIC W MD 40.00 X X 545340 0 168423 FAIRCHILD DAVID MD 40.00 X 450045 0 87215 FERGUSON R KEVIN MD 40.00 X 219260 0 34758 FERRUCCI JOSEPH MD 32.00 X 383230 0 39112 FINBERG ROBERT W MD 20.00 X 299143 0 159525 GOTTLIEB PHILIP D MD 40.00 X 373805 0 44328 KEATING TODD A 40.00 X X 606611 0 292549 KENNEDY KATHRYN MD 36.00 X 286961 0 40429 LAPIDAS GARY N 40.00 X X 478212 0 214570 LAPRIORE CHERYL M 40.00 X X 298443 0 93310 LASSER DANIEL H MD 20.00 X 269881 0 172588 MAGUIRE DAVID L MD 40.00 X 250203 0 11174 MATTA LALITA MD 24.00 X 129859 0 25242 MESSINA LOUIS MD 36.00 X 632105 0 40438 METZMAKER JEFFREY N MD 29.00 X 407081 0 37438 MOORE KAREN 40.00 X X 328862 0 309053 MULDOON PATRICK L 40.00 X X 528963 0 238516 O'BRIEN JOHN G 40.00 X X 4053252 0 720966 OKIKE O NSIDINANYA MD 40.00 X 522904 0 42755 O'LEARY DANIEL MD 25.00 X 156913 0 1142 PAPPAS ARTHUR MD 16.00 X 13874 0 2015 ROSEN MAX P MD 24.00 X 156569 0 6706 SCHOONOVER LINDA MD 24.00 X 146008 0 24850 SEYMOUR-ROUTE PAULETTE PHD 40.00 X 4198 0 28614 SOAR BART MD 40.00 X 163534 0 17386 SWENSON DANA 40.00 X X 295467 0 113855 SZYMANSKI CANDRA 40.00 X X 185204 0 15113 TOSI STEPHEN E MD 40.00 X 658479 0 265896 WESOLOWSKI PAUL 40.00 X 56780 0 1577 ZIEDONIS DOUGLAS MD 20.00 X X 224040 0 38658 ALLEN GAIL 1.00 X 0 0 0 ANDERSON ELAINE 1.00 X 0 0 0 ANTONIONI ROBERT 1.00 X 0 0 0 BABINEAU ROBERT JR MD 1.00 X 0 0 0 BENNETT DAVID L 1.00 X 0 0 0 BENNETT RICHARD K 1.00 X 0 0 0 BERGERON ARTHUR 1.00 X 0 0 0 BERKEY DENNIS D 1.00 X 0 0 0 BERRY SARAH G 1.00 X 0 0 0 BOUDREAU NORMAN 1.00 X 0 0 0 BOVENZI LESLIE 1.00 X 0 0 0 BUDD JOHN H 1.00 X 0 0 0 CARLSON MARY 1.00 X 0 0 0 CATALINA FERNANDO MD 1.00 X 0 0 0 CHERUBINI J PAUL 1.00 X 0 0 0 CHRISTENSEN RONALD 1.00 X 0 0 0 CLEMENTI JOHN 1.00 X 0 0 0 COLLINS MICHAEL MD 1.00 X 0 0 0 CONNORS MARTIN JR 1.00 X 0 0 0 COOLIDGE KATHERINE 1.00 X 0 0 0 CORNELL LOIS D 1.00 X 0 0 0 CROCKER FREDERICK G 1.00 X 0 0 0 D'ALELIO EDWARD 1.00 X 0 0 0 DAVIS DIX F 1.00 X 0 0 0 DENNEHY RAYMOND III 1.00 X 0 0 0 DIGERONIMO ARTHUR P JR 1.00 X 0 0 0 DITULLIO DANIEL 1.00 X 0 0 0 DOBECK PAM 1.00 X 0 0 0 D'ONFRO PAUL 1.00 X 0 0 0 FITCH ROGER 1.00 X 0 0 0 FLOTTE TERENCE MD 1.00 X 0 0 0 GIBLIN DAVID R 1.00 X 0 0 0 GRAY JENNIFER 1.00 X 0 0 0 HAVELES ROBERT 1.00 X 0 0 0 HENEBRY CLARK 1.00 X X 0 0 0 HEWITT FRANK 1.00 X 0 0 0 HOLLISTER MATT 1.00 X 0 0 0 JACOBSON M HOWARD 1.00 X 0 0 0 JOHNSON JOANNE 1.00 X 0 0 0 KANGAS PAUL 1.00 X 0 0 0 KAPLAN DANIEL 1.00 X 0 0 0 KATSOUNAKIS THEA 1.00 X 0 0 0 KNOX PETER 1.00 X 0 0 0 LENHARDT STEPHEN W SR 1.00 X 0 0 0 LOWELL STEVEN 1.00 X 0 0 0 LYONS CYNTHIA 1.00 X 0 0 0 LYONS MICHAEL MD 1.00 X 0 0 0 MACNEILL HARRIS L 1.00 X 0 0 0 MANZI EDWARD 1.00 X 0 0 0 MARTIN DONATA 1.00 X 0 0 0 MCGRAIL WILLIAM ESQUIRE 1.00 X 0 0 0 MCMAHON RICHARD MD 1.00 X 0 0 0 MCMULLEN CYNTHIA M EDD 1.00 X 0 0 0 MCNAMARA MARY ELLEN 1.00 X 0 0 0 MENDOZA STEVEN 1.00 X 0 0 0 MERCADANTE ANTHONY J 1.00 X 0 0 0 MITCHELL LINDA 1.00 X 0 0 0 MOLLOY ANN K 1.00 X 0 0 0 MORRILLY DARLENE 1.00 X 0 0 0 MURPHY MICHAEL D 1.00 X 0 0 0 NOONAN EDWARD J 1.00 X 0 0 0 PAEN GENARO 1.00 X 0 0 0 PARRY EDWARD J III 1.00 X 0 0 0 PAULINO JEANNE 1.00 X X 0 0 0 PEDERSON THORU 1.00 X 0 0 0 PEREZ JUDGE LUIS 1.00 X 0 0 0 PHANEUF JAMES 1.00 X 0 0 0 PONGOR PAUL J MD 1.00 X 0 0 0 PURCELL PHILIP E 1.00 X 0 0 0 RICHER GERALD P 1.00 X 0 0 0 RIVARD MICHAEL 1.00 X 0 0 0 SANCHEZ CAROL 1.00 X 0 0 0 SCULLY PAUL 1.00 X 0 0 0 SHEA JOHN ESQUIRE 1.00 X 0 0 0 SHELTON ROBERT LESLIE MD 1.00 X 0 0 0 SIEGRIST RICHARD 1.00 X 0 0 0 SIMMONS IRINA 1.00 X 0 0 0 ST AMAND JAMES 1.00 X 0 0 0 STARR STANLEY B JR 1.00 X 0 0 0 STECYK MARKIAN MD 1.00 X 0 0 0 SULLIVAN WILLIAM F SR 1.00 X 0 0 0 TAYLOR HARVEY MD 1.00 X 0 0 0 TURLEY PATRICK 1.00 X 0 0 0 WEISBERG OREN MD 1.00 X 0 0 0 WHITNEY MARY 1.00 X 0 0 0 WILSON JACK 1.00 X 0 0 0 YOUNG LYNDA M 1.00 X 0 0 0 ALLICON KEARY T 40.00 X 165712 0 61925 BRONHARD JOHN 40.00 X 150285 0 6668 CROTEAU MAUREEN 40.00 X 32783 0 12172 D'AMBRA ANN-MARIA 40.00 X 49373 0 25711 EKSTROM DEBORAH 40.00 X 252864 0 151882 FELDMANN ROBERT 40.00 X 314111 0 194540 FRAKER MURIEL E ESQUIRE 40.00 X 184867 0 110230 MCCUE STEVEN 40.00 X 197255 0 41035 MILLER LAUREN B 40.00 X 79277 0 11957 MORABITO NANCY E 32.00 X 46083 0 8689 MORIN LYNN A 40.00 X 84543 0 5897 O'BRIEN WILLIAM H 40.00 X 121253 0 73887 OLSON JEFFREY 40.00 X 139290 0 21830 SHAKMAN ALICE 40.00 X 291254 0 31149 SMITH FRANCIS W 40.00 X 190672 0 76009 STREETER MICHELE M 40.00 X 373330 0 193075 ANDERSON MILTON C 40.00 X 529912 0 88069 BLUTE MICHAEL MD 40.00 X 141719 0 133970 BOLLAND ESHGHI KATHARINE 40.00 X 338695 0 67056 BRENCKLE GEORGE PHD 40.00 X 385261 0 164172 CYR JAMES P 40.00 X 266309 0 41819 DALEY JENNIFER MD 40.00 X 593638 0 919806 DIAMOND VICTORIA 40.00 X 379990 0 174782 ETTINGER WALTER H MD 40.00 X 128625 0 249000 FISHER BARBARA 40.00 X 336028 0 140830 HUDLIN MARGARET MD 40.00 X 333780 0 36178 HYLKA SHARON 40.00 X 420176 0 284804 KLUGMAN ROBERT MD 40.00 X 501084 0 284146 KRUGER NANCY 40.00 X 319806 0 68870 PHILLIPS ROBERT A MD 40.00 X 844144 0 302160 RANDOLPH JOHN T 40.00 X 248138 0 171007 LITWIN DEMETRIUS MD 27.00 X 708522 0 39783 TAM STANLEY MD 30.00 X 707593 0 39112 AROUS ELIAS J MD 32.00 X 595081 0 37438 AYERS DAVID C MD 33.00 X 594456 0 39112 BOZORGZADEH ADEL MD 32.00 X 588599 0 39873 CHANDLER WILLIS 0.00 X 36251 0 61315 27493438 0 8478881 2593 1 1 1 XEROX BUSINESS SVCS LLC PO BOX 201322 DALLAS TX 75320 I/S MANAGEMENT SERVICES 28938466 MCKINSEY & CO INC PO BOX 7247-7255 PHILADELPHIA PA 181707255 CONSULTING SERVICES 12775000 TURNER CONSTRUCTION 2 SEAPORT 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PRIVATE EQUITY FUND (497,714 SHARES) 382370 F BENEFICIAL INTEREST IN TRUSTS 77537199 F AETOS CAPITAL LONG/SHORT STRATEGIES (70,908 SHARES) 7441167 F AETOS CAPITAL DISTRESSED INV STRATEGIES (23,360 SHARES) 3271891 F AETOS CAPITAL MULTI-STRATEGY ARBITRAGE (39,011 SHARES) 4607795 F MPPLTD/PORTFOLIO CLASS A (2,333 SHARES) 176323 F TIFF ABSOLUTE RETURN POOL CLASS C (3,876 SHARES) 7503010 F 129979998 DUE FROM RELATED PARTIES 106050402 CSV LIFE INSURANCE 635012 MALPRACTICE TAIL COVERAGE 30135892 DUE FROM CLINTON HOSPITAL FOUNDATION 1217696 LONG TERM SECURITY DEPOSITS 207722 OTHER NON-CURRENT ASSETS 54961 RECEIVABLE FROM MEDICAID 160000000 298301685 DUE TO UMASS MEDICAL SCHOOL 61445602 THIRD PARTY LIABILITIES 58494347 DUE TO RELATED PARTIES 104500453 ACCRUED PENSION POST RETIREMENT BENEFITS 182917886 O/S LOSS RESERVES 32603135 ESTIMATED MALPRACTICE COSTS 30186145 OTHER 4369210 ANNUITY PAYABLE 3235444 LT LIABILITY ARO 10656876 ACCRUED LT LIABILITIES 3468820 CLAIMS RESERVES 89125 MEDICARE RESERVES 30000 491997043 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: FIN 48 FOOTNOTE: INCOME TAXES: THE SYSTEM FOLLOWS A TWO-STEP APPROACH FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN. THE SUBSTANTIAL MAJORITY OF UMASS MEMORIAL AND ITS AFFILIATE ENTITIES ARE RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT UNDER SECTION 501 (C) (3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THESE ENTITIES WILL NOT INCUR ANY LIABILITY FOR FEDERAL INCOME TAXES EXCEPT FOR TAX ON UNRELATED BUSINESS INCOME. CERTAIN AFFILIATES ARE TAXABLE ENTITIES. THE MEASUREMENT OF THE AMOUNTS RECORDED AS A PROVISION FOR INCOME TAXES BASED UPON THE AFOREMENTIONED APPROACH IS NOT MATERIAL AND IS RECORDED AS PART OF SUPPLIES AND OTHER EXPENSE IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS. THE SYSTEM DOES NOT BELIEVE IT HAS ANY SIGNIFICANT UNCERTAIN TAX POSITIONS. PART V ENDOWMENT FUNDS QUESTION 3 A (I): ARE THERE ENDOWMENT FUNDS NOT IN THE POSSESSION OF THE ORGANIZATION THAT ARE HELD AND ADMINISTERED FOR THE ORGANIZATION BY: (I) UNRELATED ORGANIZATIONS: YES OR NO WING - YES BANK OF AMERICA HOLDS 3 TRUST FUNDS FOR WING MEMORIAL HOSPITAL: DORNOE PARKER TRUST, RATHBONE 1950 TRUST, RATHBONE 1951 TRUST BANK OF AMERICA HOLDS 3 TRUST FUNDS FOR WING MEMORIAL HOSPITAL THAT THEY HAVE PARTIAL INTEREST IN: OTTOLIE BROWN AND THEODORE NORMAN TRUST FUNDS INTEREST IS PAID TO WING. BANK OF AMERICA IS AN UNRELATED ORGANIZATION. HEALTHALLIANCE HOSPITAL - YES BANK OF AMERICA MERRILL LYNCH HOLDS THE BERNARD W DOYLE TRUST FOR HEALTHALLIANCE HOSPITAL. DISTRIBUTIONS ARE PAID TO HEALTHALLIANCE HOSPITAL. BANK OF AMERICA MERRILL LYNCH IS AN UNRELATED ORGANIZATION. BYN MELLON WEALTH MANAGEMENT HOLDS THE FOLLOWING TRUSTS FOR HEALTHALLIANCE HOSPITAL: TRUST U/WILL ART 11 WILLIAM H CROPPER TRUST U/WILL PAR 15 WILLIAM H CROPPER TRUST U/WILL ART 18 WILLIAM H CROPPER TRUST UNDER 2ND CODICIL OF WILL OF WILLIAM H CROPPER TRUST U/WILL 4TH COD WILLIAM H CROPPER DISTRIBUTIONS ARE PAID TO HEALTHALLIANCE HOSPITAL. BYN MELLON WEALTH MANAGEMENT IS AN UNRELATED ORGANIZATION. PART V ENDOWMENT FUNDS QUESTION 4: PARENT - THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS ARE DIRECTED IN ACCORDANCE WITH THE DONOR'S INTENT INCLUDING THE PRESERVATION OF THE ORIGINAL GIFT AND VARIOUS PURPOSES INCLUDING CHARITY CARE, MEDICAL EDUCATION, RESEARCH, HEALTH CARE SERVICES, BUILDINGS AND EQUIPMENT. HEALTHALLIANCE HOSPITAL - THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS ARE DIRECTED IN ACCORDANCE WITH THE DONOR'S INTENT INCLUDING THE PRESERVATION OF THE ORIGINAL GIFT AND VARIOUS PURPOSES INCLUDING CHARITY CARE, MEDICAL EDUCATION, RESEARCH, HEALTH CARE SERVICES, BUILDINGS AND EQUIPMENT. X X X X X 0 UMASS MEMORIAL FOUNDATION INC 333 SOUTH STREET SHREWSBURY MA 01545 FUNDRAISING 1 1129201 52694 1076507 1129201 52694 1076507 MA NH PARENT-WINTER BALL 678157 678157 369422 CNEHA GOLF TOURNAMENT 293517 119673 173844 43610 104868 14447 10 554378 249108 305270 19622 30440 150104 1526052 368781 1157271 63232 135308 533973 732513 424758 PART I, LINE 2B; COLUMN (III) PART I, LINE 2B - FUNDRAISER ADDITIONAL INFORMATION UMASS MEMORIAL FOUNDATION, INC. IS IDENTIFIED AS THE ADMINISTRATOR OF THE PHILANTHROPIC ACTIVITIES OF THE REPORTING ENTITIES OF UMASS MEMORIAL HEALTH CARE, INC. THIS INCLUDES THE COORDINATION OF ALL CHARITABLE WORK AND THE MANAGEMENT OF OFFICE OPERATIONS TO SUPPORT FUNDRAISING INCLUDING THE FOLLOWING PROCEDURES: 1) ACTIVE DEVELOPMENT WORK 2) DONOR RELATIONS AND COMMUNICATIONS 3) SERVICES TO UMASS MEMORIAL STAFF 4) CONTRIBUTION REPORTS, DONOR RECORD FILES 5) TRANSFER OF CONTRIBUTIONS RECEIVED (CONTRIBUTIONS RECEIVED BY THE FOUNDATION THAT ARE DESIGNATED TO A UMASS MEMORIAL REPORTING ENTITY ARE DEPOSITED INTO A DESIGNATED ACCOUNT OF THE RESPECTIVE REPORTING ENTITY UPON RECEIPT.) 6) EXPENDITURES OF CONTRIBUTIONS PART I, LINE 2B; COLUMN (V) PART I, LINE 2B - FUNDRAISER ADDITIONAL INFORMATION (CONTINUED) UMASS MEMORIAL HEALTH CARE, INC. PAYS UMASS MEMORIAL FOUNDATION, INC. ITS PRORATA SHARE OF OPERATING EXPENSES BASED ON THE SPLIT OF UMASS MEMORIAL CONTRIBUTION RECEIPTS VERSUS THE OVERALL TOTAL CONTRIBUTION RECEIPTS AS COLLECTED BY THE FOUNDATION. PART II SCHEDULE G - ADDITIONAL INFORMATION PART II, COLUMN (A) EVENT #1 THE WINTER BALL WAS HELD BY THE PARENT PART II, COLUMN (B) EVENT #2 THE HOSPITAL GOLF TOURNEY WAS HELD BY CENTRAL NEW ENGLAND HEALTHALLIANCE, INC. PART II, COLUMN (C) OTHER EVENTS (10 EVENTS REPORTED) ARE: GOLF TOURNAMENT HELD BY WING MEMORIAL HOSPITAL CORPORATION SPEAKEASY HELD BY HEALTHALLIANCE HOSPITALS DENNEHY GOLF TOURNAMENT HELD BY HEALTH ALLIANCE HOME HEALTH AND HOSPICE, INC. LOVELIGHT HELD BY HEALTHALLIANCE HOME HEALTH AND HOSPICE, INC. TEE UP FOR TOTS GOLF TOURNAMENT WAS HELD BY THE PARENT OTHER EVENTS WERE HELD BY THE PARENT, GOLF TOURNAMENT WAS HELD BY MARLBOROUGH HOSPITAL, INC. SPANISH FOR KIDS HELD BY COMMUNITY HEALTHLINK. MARANDA HOUSE MOTHER'S DAY FUNDRAISER WAS HELD BY COMMUNITY HEALTHLINK, AND DOG WALK PAWS FOR CAUSE WAS HELD BY COMMUNITY HEALTHLINK 1 1 X 1 X 1 X 600.000000000000 1 1 1 0 1 1 61037114 27391424 33645690 0.01890 286384445 259916272 26468173 0.01490 47513401 42848786 4664615 0.00260 394934960 330156482 64778478 0.03640 3872046 2320968 1551078 0.00090 200757227 126236106 74521121 0.04190 87451088 77417999 10033089 0.00560 0 0 4555380 2000000 2555380 0.00140 296635741 207975073 88660668 0.04980 691570701 538131555 153439146 0.08620 9215 9215 0.00000 1931 1931 0.00000 30545 30545 0.00000 518315 518315 0.00030 560006 560006 0.00030 1 4625317 2264397 370183110 375079009 -4895899 X 1 1 1 COMMONWEALTH PROFESSIONAL ASSURANCE COMPANY LTD PROVIDES INSURANCE 1.00000 0.00000 0.00000 2 UMASS MEMORIAL INVESTMENT PARTNERSHIP LLP MANAGES POOLED INVESTMENTS 1.00000 0.00000 0.00000 3 UMASS MEMORIAL HEALTH ALLIANCE MRI CENTER LLC MAGNETIC RESONANCE IMAGING CENTER 0.60000 0.00000 0.00000 4 UMASS MEMORIAL MRI OF MARLBOROUGH LLC MAGNETIC RESONANCE IMAGING CENTER 0.56000 0.00000 0.00000 5 MEMORIAL OFFICE CONDOMINIUM TRUST CONDO ASSOCIATION THAT OWNS MEDICAL OFFICE BUILDING 0.53690 0.00000 0.00000 6 UMASS MEMORIAL MRI & IMAGING CENTER LLC MAGNETIC RESONANCE IMAGING CENTER 0.50000 0.00000 0.00000 7 NEW ENGLAND REHABILITATION SERVICES OF CENTRAL MASSACHUSETTS INC ACUTE CARE REHABILITATION FACILITY 0.50000 0.00000 0.00000 8 BIO LABS INC CLINICAL LABORATORY 1.00000 0.00000 0.00000 9 HEALTHALLIANCE WITH PHYSICIANS INC PHYSICIAN ALLIANCE 0.50000 0.00000 0.00000 10 SHIELDS IMAGING OF MASSACHUSETTS LLC MANAGEMENT COMPANY FOR PET IMAGING 0.25000 0.00000 0.00000 11 UMASS MEMORIAL SHIELDS PHARMACY LLC PHARMACY SERVICES 0.50000 0.00000 0.00000 12 116 BELMONT STREET INC CONDO ASSOCIATION 0.63040 0.00000 0.00000 5 1 UMASS MEMORIAL MEDICAL CENTER INC

55 LAKE AVE 119 BELMONT STREET WORCESTER MA 01605

X 2 HEALTHALLIANCE HOSPITAL INC

60 HOSPITAL ROAD LEOMINSTER MA 01453

X 3 MARLBOROUGH HOSPITAL

157 UNION STREET MARLBOROUGH MA 01752

X 4 WING MEMORIAL HOSPITAL CORPORATION

40 WRIGHT STREET PALMER MA 01069

X 5 CLINTON HOSPITAL ASSOCIATION

201 HIGHLAND STREET CLINTON MA 01510

X UMASS MEMORIAL MEDICAL CENTER INC 1 1 X X X X X X X X X 12 1 0 1 X X X X X X X X X X X 0 0 1 1 200.000000000000 1 600.000000000000 1 X X X X 1 1 X X X X X X 1 X 1 X X X X X 1 X 0 1 HEALTHALLIANCE HOSPITAL INC 2 1 X X X X X X X X X 11 1 1 1 X X X X X X X X X X X 0 0 1 1 200.000000000000 1 600.000000000000 1 X X X 1 1 X X X X X 1 X 1 X X X X X X 1 X 0 1 MARLBOROUGH HOSPITAL 3 1 X X X X X X X X 12 1 1 1 X X X X X X X X X X 0 0 1 1 200.000000000000 1 600.000000000000 1 X X X X 1 1 X X X X X 1 X 1 X X X X X 1 X 0 1 WING MEMORIAL HOSPITAL CORPORATION 4 1 X X X X X X X X 12 1 1 1 X X X X X X X X X X 0 0 1 1 200.000000000000 1 600.000000000000 1 X X X X 1 1 X X X X X X 1 X 1 X X X X X 1 X 0 1 CLINTON HOSPITAL ASSOCIATION 5 1 X X X X X X X X X 11 1 1 1 X X X X X X X X X X 0 0 1 1 200.000000000000 1 600.000000000000 1 X X X X 1 1 X X X X X X 1 X 1 X X X X X 1 X 0 1 4 UMASS MEMORIAL LABORATORIES

BIOTECH ONE 365 PLANTATION STREET WORCESTER MA 01605

SATELLITE - LAB SERVICES UMASS MEMORIAL MEDICAL CENTER(PATHOLOGY)

BIOTECH THREE ONE INNOVATION DRIVE WORCESTER MA 01605

SATELLITE - PATHOLOGY SERVICES UMASS MEMORIAL MEDICAL CENTER AMBULANCE

23 WELL STREET WORCESTER MA 01604

SATELLITE - AMBULATORY SERVICES UMASS MEMORIAL MEDICAL CENTER AMBULANCE

100 PROVIDENCE STREET WORCESTER MA 01604

SATELLITE - AMBULATORY SERVICES PART II: UMASS MEMORIAL HEALTH CARE RECOGNIZES COMMUNITY BUILDING ACTIVITIES AS BEING A PART OF THOSE 'SOCIAL DETERMINANTS OF HEALTH' THAT IMPACT THE HEALTH OF THE COMMUNITY. WE INVEST IN EDUCATIONAL COLLABORATIVES, COALITION BUILDING, ADVOCACY EFFORTS, COMMUNITY GARDENS, WORKFORCE DEVELOPMENT AND LEADERSHIP TRAINING PROGRAMS THAT SUPPORT YOUTH WHO ARE AT RISK OF DEVELOPING POOR AND RISKY HEALTH BEHAVIORS AND ARE EXPERIENCING VIOLENCE DUE TO POVERTY. WE ALSO INVEST IN ENVIRONMENTAL AND PHYSICAL IMPROVEMENT PROGRAMS SUCH AS BEAUTIFICATION OF LOW INCOME NEIGHBORHOOD PARKS TO ENABLE ACCESS TO SAFE PLAYGROUNDS THAT PROMOTE PHYSICAL ACTIVITY AS A WAY TO REDUCE OBESITY. THESE PROGRAMS ARE BASED ON OUR COMMUNITY BENEFITS MISSION WHICH WAS RECOMMENDED BY A COMMUNITY BENEFITS ADVISORY COMMITTEE AND DRAWS INSPIRATION FROM THE WORLD HEALTH ORGANIZATION'S BROAD DEFINITION OF HEALTH, AS 'A STATE OF COMPLETE, PHYSICAL, MENTAL, AND SOCIAL WELL BEING AND NOT MERELY THE ABSENCE OF DISEASE.' BY ADOPTING THIS DEFINITION, UMASS MEMORIAL HEALTH CARE HAS EXPANDED ITS STRATEGY TO INCLUDE THE SOCIAL AND ECONOMIC OBSTACLES THAT PREVENT PEOPLE FROM ACHIEVING OPTIMAL HEALTH. ALL OF OUR COMMUNITY BUILDING ACTIVITIES ARE THE RESULT OF AN IDENTIFIED NEED AND ENGAGE THE COMMUNITY. THEY INCLUDE COLLABORATIVE EFFORTS, ADVOCACY ACTIVITIES AND PARTNERSHIPS THAT ENGAGE A BROAD ARRAY OF COMMUNITY STAKEHOLDERS IN ADDRESSING THESE UNMET SOCIAL DETERMINANTS OF HEALTH (COMMUNITY BUILDING ACTIVITIES).EXAMPLES INCLUDE:- FUNDING AND PROMOTING WORKFORCE OPPORTUNITIES FOR INNER-CITY YOUTH.- FUNDING A TEEN PARENT LITERACY PROGRAM.HEALTHALLIANCE HOSPITAL: FOR WORKFORCE DEVELOPMENT HEALTHALLIANCE HAS PROVIDED FINANCIAL ASSISTANCE THROUGH PROCEEDS FROM THE ANNUAL GOLF TOURNAMENT TO STUDENTS WHO WISH TO PURSUE A CAREER IN THE HEALTH CARE FIELD VIA A INTERNSHIP PROGRAM PROVIDING FINANCIAL ASSISTANCE AND EXPERIENCE THROUGH HAND ON PRACTICE AND OBSERVATION. FOR COMMUNITY SUPPORT, COMMUNITY EMERGENCY PREPAREDNESS AND DRILLS ARE CONDUCTED IN COLLABORATION WITH THE LEOMINSTER AND FITCHBURG FIRE DEPARTMENTS AND MEDSTAR EMS. MARLBOROUGH HOSPITAL: MARLBOROUGH HOSPITAL OFFERS OPPORTUNITIES FOR CHALLENGED STUDENTS TO DEVELOP LIFE SKILLS. AS PART OF THE HUMAN SERVICES COALITION, ASSISTANCE IS ALSO PROVIDED TO THOSE UNDERSERVED IN OUR COMMUNITY.WING MEMORIAL HOSPITAL: WING MEMORIAL HOSPITAL PARTICIPATED IN SEVERAL PROGRAMS AND CAREER FAIRS WITH AREA HIGH SCHOOL STUDENTS TO PROVIDE EDUCATION, SHADOWING, TRAINING AND AWARENESS OF THE HEALTHCARE INDUSTRY TO INCREASE STUDENTS' UNDERSTANDING THE BENEFITS OF PURSUING FUTURE EDUCATION IN THE HEALTH CARE FIELD. PART III, LINE 8: THE MEDICARE COSTS ARE OBTAINED FROM THE COST REPORT FOR INPATIENT, PSYCHIATRIC, CAPITAL, AND OUTPATIENT SERVICES. IN ADDITION, FEE BASED SERVICES SUCH AS LABS, PT, OT, ETC., ARE DETERMINED THROUGH PS&R CHARGES TIMES OUTPATIENT COST TO CHARGE RATIO. PART III, LINE 9B: EXEMPTION FROM SELF-PAY BILLING AND COLLECTION ACTION - THE ORGANIZATION WILL NOT INITIATE SELF-PAY BILLING AND COLLECTION ACTIVITY:A. UPON SUFFICIENT PROOF THAT A PATIENT IS A RECIPIENT OF EMERGENCY AID TO THE ELDERLY, DISABLED AND CHILDREN (EAEDC), OR ENROLLED IN THE HEALTH SAFETY NET (HSNO) OR MASSHEALTH, HEALTHY START, OR THE CHILDREN'S MEDICAL SECURITY PLAN WHOSE FAMILY INCOME IS EQUAL OR LESS THAN 400% OF THE FPL, WITH THE EXCEPTION OF CO-PAYS AND DEDUCTIBLES REQUIRED UNDER THE PROGRAM OF ASSISTANCE.B. IF THE HOSPITAL HAS PLACED THE ACCOUNT IN LEGAL OR ADMINISTRATIVE HOLD STATUS AND/OR SPECIFIC PAYMENT ARRANGEMENTS HAVE BEEN MADE WITH THE PATIENT OR GUARANTOR.C. FOR MEDICAL HARDSHIP BILLS THAT EXCEED THE MEDICAL HARDSHIP CONTRIBUTION.D. UNLESS UMMMC HAS CHECKED THE EVS SYSTEM TO DETERMINE IF THE PATIENT HAS FILED AN APPLICATION FOR MASSHEALTH.E. FOR PARTIAL HEALTH SAFETY NET ELIGIBLE PATIENTS, WITH THE EXCEPTION OF ANY DEDUCTIBLES REQUIRED.NOTE: THE ORGANIZATION MAY BILL FOR HEALTH SAFETY NET ELIGIBLE AND MEDICAL HARDSHIP PATIENTS FOR NON-MEDICALLY NECESSARY SERVICES PROVIDED AT THE REQUEST OF THE PATIENT AND FOR WHICH THE PATIENT HAS AGREED BY WRITTEN CONSENT. UMASS MEMORIAL MEDICAL CENTER, INC. PART V, SECTION B, LINE 3: YES, INPUT FROM DIVERSE PERSONS WHO REPRESENT THE COMMUNITY WAS TAKEN INTO ACCOUNT. UMASS MEMORIAL MEDICAL CENTER JOINED EFFORTS WITH THE WORCESTER DIVISION OF PUBLIC HEALTH (WDPH) AND COMMON PATHWAYS, A HEALTHY COMMUNITIES COALITION THAT IS COMPRISED OF 30+ HEALTH AND HUMAN SERVICE ORGANIZATIONS, IN THE DEVELOPMENT OF ITS NEEDS ASSESSMENT REPORT. THE DIRECTOR OF THE WDPH AND THE UMASS MEMORIAL VICE PRESIDENT OF COMMUNITY RELATIONS CO-CHAIRED THE LEADERSHIP PROCESS TO DEVELOP A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR THE GREATER WORCESTER REGION. DURING THE ASSESSMENT PROCESS, COMMUNITY MEMBERS WERE ENGAGED IN KEY INFORMANT INTERVIEWS, FOCUS GROUPS, AND COMMUNITY DIALOGUES, WHICH ALLOWED FOR COMMUNITY MEMBERS TO REVIEW AND DISCUSS A PRELIMINARY PROFILE OF THE REGION AND PROVIDE THEIR FEEDBACK ON COMMUNITY HEALTH-RELATED STRENGTHS, NEEDS, AND A VISION FOR THE FUTURE. TEN COMMUNITY DIALOGUE SESSIONS WERE HELD: FIVE SESSIONS IN WORCESTER, AND FIVE IN THE OUTLYING COMMUNITIES (ONE EACH IN SHREWSBURY, MILLBURY, WEST BOYLSTON, LEICESTER, AND HOLDEN). MORE THAN A TOTAL OF 3,000 INDIVIDUALS (INCLUDING PARTICIPANTS IN AN ONLINE COMMUNITY SURVEY) REPRESENTING DIVERSE INSTITUTIONS AND COMMUNITY ORGANIZATIONS FROM ACROSS THE REGION. OUR COMMUNITY BENEFITS PLAN ALIGNS WITH THE CHIP. HEALTHALLIANCE HOSPITAL, INC. PART V, SECTION B, LINE 3: THE COMMUNITY HEALTH ASSESSMENT PROCESS CONSISTED OF A COMPREHENSIVE GATHERING OF QUANTITATIVE (I.E., HEALTH STATUS INDICATORS) AND QUALITATIVE DATA, THROUGH FOCUS GROUPS WITH COMMUNITY MEMBERS AND THROUGH INTERVIEWS WITH COMMUNITY MEMBERS AND COMMUNITY MEMBERS AND COMMUNITY LEADERS. PARTICIPANTS WERE DRAWN FROM AMONG COMMUNITY-BASED, EDUCATIONAL, CIVIC, GOVERNMENTAL, AND FAITH-BASED PROFESSIONALS, HEALTH CARE PROVIDERS, AND OTHERS, AND EVERY EFFORT WAS MADE TO ENSURE RACIAL/ETHNIC, SOCIOECONOMIC, AND GEOGRAPHIC DIVERSITY IN THE COMPOSITION OF FOCUS GROUPS AND INTERVIEW PARTICIPANTS. THIS ASSESSMENT WAS A JOINT EFFORT OF THE JOINT COALITION ON HEALTH (JCOH) AND THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH'S COMMUNITY HEALTH NETWORK AREA (CHNA 9), WHICH ALSO INCLUDES HEYWOOD HOSPITAL AND CLINTON HOSPITAL. A COMMUNITY HEALTH ASSESSMENT WAS CONDUCTED IN FY11 SO A COORDINATED PLAN HAS PRIORITIZED THE NEEDS OF THE COMMUNITY. MARLBOROUGH HOSPITAL PART V, SECTION B, LINE 3: THE PROCESS INCLUDED GATHERING COMMUNITY INPUT, AS WELL AS ANALYSIS OF GENERAL DATA COLLECTED FROM THE HOSPITAL AND PUBLICLY AVAILABLE DATA SOURCES. THE PROCESS ALSO INCORPORATED A SURVEY COMPONENT THAT WAS AVAILABLE IN ENGLISH, SPANISH AND PORTUGUESE, AS WELL AS KEY INFORMANT INTERVIEWS AND FOCUS GROUPS. WING MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 3: INTERVIEWS WERE CONDUCTED WITH PUBLIC HEALTH EXPERTS, REPRESENTATIVES OF HEALTH OR OTHER DEPARTMENTS OR AGENCIES, COMMUNITY LEADERS, AND PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY. THE INTERVIEWS WERE STRUCTURED TO HELP IDENTIFY THE MOST PRESSING HEALTH STATUS AND ACCESS ISSUES IN THE COMMUNITY.WING MEMORIAL HOSPITAL ALSO SOUGHT INPUT FROM THE PUBLIC REGARDING THE HEATLH OF THE COMMUNITY THROUGH AN ONLINE AND PAPER-BASED SURVEY. A WEBSITE LINK TO THE SURVEY (IN ENGLISH AND SPANISH) WAS MADE AVAILABLE FROM JANUARY THROUGH FEBRUARY 2013. PAPER COPIES OF THE SURVEY WERE DISTRIBUTED AT VARIOUS LOCAL ORGANIZATIONS AND CLINICS IN MULTIPLE LANGUAGES. EFFORTS WERE MADE TO REACH THOSE WITHOUT INTERNET ACCESS AS WELL AS VULNERABLE POPULATIONS SUCH AS RACIAL AND ETHIC MINORITIES, LOW-INCOME GROUPS, INDIVIDUALS WITH LOW LITERACY LEVELS, AND NON-ENGLISH SPEAKERS. THE SURVEY WAS PUBLICIZED VIA FLYERS, SOCIAL MEDIA, NEWSPAPERS, EMAIL LIST-SERVES, AND OTHER METHODS. IN ADDITION, A LISTENING SESSION WAS HELD DURING WHICH COMMUNITY MEMBERS REVIEWED AND DISCUSSED PRELIMINARY FINDINGS FROM THIS ASSESSMENT. CLINTON HOSPITAL ASSOCIATION PART V, SECTION B, LINE 3: CLINTON HOSPITAL HAS BEEN INVOLVED IN THE DEVELOPMENT OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHA) AND UTILIZES THE INFORMATION IN THE CHA TO COLLABORATE WITH OTHER COMMUNITY BASED ORGANIZATIONS, SCHOOLS, DIVERSE STAKEHOLDERS, AND MEMBERS OF THE COMMUNITY TO ADOPT IMPLEMENTATION STRATEGIES THAT ADDRESS THE UNMET HEALTH NEEDS OF THE HOSPITAL'S CATCHMENT AREA. HEALTHALLIANCE HOSPITAL, INC. PART V, SECTION B, LINE 4: HEALTHALLIANCE HOSPITAL DID A COMMUNITY NEEDS ASSESSMENT WITH CLINTON HOSPITAL AND HEYWOOD HOSPITAL. LINK:HTTP:WWW.UMASSMEMORIALHEALTHCARE.ORG/SITES/UMASS-MEMORIAL-HOSPITAL/FILES/DOCUMENTS/PATIENTS VISITORS/HEALTHALLIANCE%20HOSPITAL%20BENEFITS%20PIAN%20FY13-FY14%20FINAL.PDF MARLBOROUGH HOSPITAL PART V, SECTION B, LINE 4: THE ASSESSMENT WAS DONE IN CONJUNCTION WITH THE METRO WEST MEDICAL CENTER. WING MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 4: WING MEMORIAL HOSPITAL'S CHNA WAS CONDUCTED WITH ON OR MORE OTHER HOSPITAL FACILITIES. WING IS A MEMBER OF THE COALITION OF WESTERN MASSACHUSETTS HOSPITALS WHICH ALSO INCLUDES BAYSTATE MEDICAL CENTER, MERCY MEDICAL CENTER, BAYSTATE FRANKLIN MEDICAL CENTER, BAYSTATE MARY LANE HOSPITAL, COOLEY DICKINSON HOSPITAL, AND HOLYOKE MEDICAL CENTER. THE COALITION HOSPITALS COLLABORATED IN PREPARING THEIR CHNAS. CLINTON HOSPITAL ASSOCIATION PART V, SECTION B, LINE 4: THE CHA WORK WAS COMPLETED WITH THE COMBINED EFFORTS OF THE MINORITY COALITION OF NORTH CENTRAL MASSACHUSETTS, THE SPANISH AMERICAN CENTER, CLEGHORN NEIGHBORHOOD CENTER, WHEAT, THREE PYRAMIDS, BEAUTIFUL GATE CHURCH, NEW HOPE COMMUNITY CHURCH, TWIN CITIES CDC, GARDNER CDC, MEMORIAL CONGREGATIONAL CHURCH, CMAHEC, MONTACHUSETT OPPORTUNITY COUNCIL AND MANY OTHER AGENCIES, INDIVIDUALS, AND THE FOLLOWING HOSPITALS; HEYWOOD HOSPITAL, HEALTHALLIANCE HOSPITAL, CLINTON HOSPITAL. TOGETHER, THESE ENTITIES HAVE CAPITALIZED ON THEIR COMPLEMENTARY EXPERTISE AND HAVE PRODUCED A DOCUMENT THAT CAN BE USED BY STAKEHOLDERS FROM EVERY SECTOR OF THE COMMUNITY TO BETTER THE HEALTH AND WELFARE OF RESIDENTS OF NORTH CENTRAL MASSACHUSETTS. UMASS MEMORIAL MEDICAL CENTER, INC. PART V, SECTION B, LINE 5C: CHNA WAS PUBLICALLY ANNOUNCED TO THE COMMUNITY AT A PUBLIC EVENT ATTENDED BY MORE THAN 100 COMMUNITY STAKEHOLDERS AND HOSTED BY THE WORCESTER CITY MANAGER, WORCESTER DIRECTOR OF PUBLIC HEALTH, CEO OF MASS MEMORIAL HEALTH CARE AND THE UMASS MEMORIAL VICE PRESIDENT OF COMMUNITY RELATIONS. IN ADDITION, PRESENTATIONS HAVE BEEN MADE TO DIFFERENT GROUPS INCLUDING TWO MAJOR PHILANTHROPIC ORGANIZATIONS, PHYSICIANS AND MEDICAL STUDENTS AT UMASS MEDICAL SCHOOL AND THROUGH ONGONG COMMUNITY ENGAGEMENT ACTIVITIES. HEALTHALLIANCE HOSPITAL, INC. PART V, SECTION B, LINE 5C: THE LAST COMMUNITY HEALTH ASSESSMENT WAS MADE AVAILABLE THROUGH OUR WEBSITE AND PRESENTATIONS TO VARIOUS ORGANIZATIONS AND COMMUNITY FORUMS THROUGHOUT OUR SERVICE AREAS. THE COMMUNITY HEALTH ASSESSMENT IS ALSO AVAILABLE UPON REQUEST. MARLBOROUGH HOSPITAL PART V, SECTION B, LINE 5C: INTERNAL COMMUNICATION WAS THROUGH MARLBOROUGH HOSPITAL'S EMPLOYEE NEWSLETTER AND PRESENTATIONS TO GROUPS INCLUDING MANAGEMENT MEETINGS AND BOARD OF TRUSTEES. EXTERNAL COMMUNICATION WAS DONE BY PRESS RELEASE, POSTING ON MARLBOROUGH HOSPITAL'S WEB SITE AND FACEBOOK PAGE, AND A SUMMARY BOOKLET WAS DEVELOPED. HIGHLIGHTS OF THE INFORMATION WILL BE ALSO BE PUBLISHED IN THE ANNUAL UMASS MEMORIAL HEALTH CARE, INC. COMMUNITY BENEFIT REPORT. LINK TO COMMUNITY NEEDS ASSESSMENT:HTTP://WWW.UMASSMEMORIALHEALTHCARE.ORG/SITES/UMASS-MEMORIAL-HOSPITAL/FILES/DOCUMENTS/PATIENTS VISITORS/MARLBOROUGH-HOSPITAL-COMMUNITY-HEALTH-NEEDS-ASSESSMENT-FOR-MARLBOROUGH-AND-HUDSON---SEPTEMBER-2013.PDF CLINTON HOSPITAL ASSOCIATION PART V, SECTION B, LINE 5C: THE COMMUNITY HEALTH ASSESSMENT (CHA) IS AVAILABLE ON CLINTON HOSPITAL, THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH'S COMMUNITY HEALTH NETWORK AREA OF NORTH CENTRAL, AND THE JOINT COALITION ON HEALTH (JCOH) WEBSITES WITH THE AVAILABILITY UPON REQUEST FROM ANY OF THE ORGANIZATIONS MENTIONED. CLINTON HOSPITAL ALSO UNVEILS THE COMMUNITY HEALTH ASSESSMENT TO COMMUNITY GROUPS, COMMUNITY ADVISORY COMMITTEE, AND TO THE BOARD OF TRUSTEES. UMASS MEMORIAL MEDICAL CENTER, INC. PART V, SECTION B, LINE 7: UMASS MEMORIAL MEDICAL CENTER'S COMMUNITY BENEFITS PLAN FUNDS AND SUPPORTS PROGRAMS AND EFFORTS THAT ADDRESS ALL PRIORITY AREAS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. THESE PRIORITY AREAS ALIGN WITH THE GREATER WORCESTER COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) COMPLETED IN COLLABORATION WITH THE WORCESTER DIVISION OF PUBLIC HEALTH AND WIDE COMMUNITY IMPUT. HEALTHALLIANCE HOSPITAL, INC. PART V, SECTION B, LINE 7: THE HOSPITAL RESPONDS TO PRIORITY HEALTH NEEDS IN MANY WAYS, AND IN TIMES THAT ARE CRITICAL FOR PATIENTS IN CRISIS. IN ADDITION TO CHARITY CARE, INDIGENT CARE, A SIGNIFICANT NUMBER OF PROGRAMS AND SERVICES OFFERED ADDRESS THE PRIORITY NEED IDENTIFIED IN THE CHNA. OUR HOSPITAL DOES NOT HAVE THE AVAILABLE RESOURCES TO DEVELOP INITIATIVES TO MEET EVERY PRIORITY HEALTH NEED IDENTIFIED, WHICH MAKES COLLABORATION WITH COMMUNITY ASSETS CRITICAL. THE HOSPITAL IS NOT CURRENTLY ADDRESSING ALL CHRONIC CONDITIONS. MARLBOROUGH HOSPITAL PART V, SECTION B, LINE 7: THE HOSPITAL RESPONDS TO PRIORITY HEALTH NEEDS IN MANY WAYS, AND IN TIMES THAT ARE CRITICAL FOR PATIENTS IN CRISIS. IN ADDITION TO CHARITY CARE, INDIGENT CARE, A SIGNIFICANT NUMBER OF PROGRAMS AND SERVICES OFFERED ADDRESS THE PRIORITY NEEDS IDENTIFIED IN THE 2013 CHNA. OUR HOSPITAL DOES NOT HAVE THE AVAILABLE RESOURCES TO DEVELOP INITIATIVES TO MEET EVERY PRIORITY HEALTH NEED IDENTIFIED, WHICH MAKES COLLABORATION WITH COMMUNITY ASSETS CRITICAL. THE HOSPITAL IS NOT CURRENTLY ADDRESSING ALL CHRONIC CONDITIONS. WING MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 7: THE HOSPITAL RESPONDS TO PRIORITY HEALTH NEEDS IN MANY WAYS, AND IN TIMES THAT ARE CRITICAL FOR PATIENTS IN CRISIS. IN ADDITION TO CHARITY CARE, INDIGENT CARE, A SIGNIFICANT NUMBER OF PROGRAMS AND SERVICES OFFERED ADDRESS THE PRIORITY NEEDS IDENTIFIED IN THE 2013 CHNA. OUR HOSPITAL DOES NOT HAVE THE AVAILABLE RESOURCES TO DEVELOP INITIATIVES TO MEET EVERY PRIORITY HEALTH NEED IDENTIFIED, WHICH MAKES COLLABORATION WITH COMMUNITY ASSETS CRITICAL. THE HOSPITAL IS NOT CURRENTLY ADDRESSING ALL CHRONIC CONDITIONS. CLINTON HOSPITAL ASSOCIATION PART V, SECTION B, LINE 7: THE HOSPITAL RESPONDS TO PRIORITY HEALTH NEEDS IN MANY WAYS, AND IN TIMES THAT ARE CRITICAL FOR PATIENTS IN CRISIS. IN ADDITION TO CHARITY CARE, INDIGENT CARE, A SIGNIFICANT NUMBER OF PROGRAMS AND SERVICES OFFERED ADDRESS THE PRIORITY NEEDS IDENTIFIED IN THE CHNA. OUR HOSPITAL DOES NOT HAVE THE AVAILABLE RESOURCES TO DEVELOP INITIATIVES TO MEET EVERY PRIORITY HEALTH NEED IDENTIFIED, WHICH MAKES COLLABORATION WITH COMMUNITY ASSETS CRITICAL. THE HOSPITAL IS NOT CURRENTLY ADDRESSING ALL CHRONIC CONDITIONS. HEALTHALLIANCE HOSPITAL, INC. PART V, SECTION B, LINE 14G: PATIENTS WHO ARE SCHEDULED TO BE ADMITTED AND HAVE BEEN IDENTIFIED AS NON INSURED AND/OR IN NEED OF FINANCIAL ASSISTANCE WILL HAVE AN APPOINTMENT SCHEDULED PRIOR TO ADMISSION TO MEET WITH A FINANCIAL COUNSELOR. PATIENTS, WHO ARE ADMITTED TO THE HOSPITAL THROUGH THE EMERGENCY DEPARTMENT, WILL BE VISITED BY THE FINANCIAL COUNSELOR ONCE THE PATIENT IS ON THE INPATIENT FLOOR. THE MEETING WILL BE HELD WITH THE PATIENT AND/OR FAMILY AS THE PATIENT'S MEDICAL CONDITION PERMITS. UMASS MEMORIAL MEDICAL CENTER, INC. PART V, SECTION B, LINE 16E: POLICY ON LIENS-NO LIENS WILL BE INITIATED AGAINST A PATIENT'S PRIMARY RESIDENCE OR MOTOR VEHICLE WITHOUT WRITTEN APPROVAL FROM UMMMC'S BOARD OF TRUSTEES. ALL APPROVALS BY THE BOARD OF TRUSTEES WILL BE MADE ON AN INDIVIDUAL CASE BASES. WE ALSO SEND STATEMENTS AND MAKE PHONE CALLS. HEALTHALLIANCE HOSPITAL, INC. PART V, SECTION B, LINE 16E: POLICY ON LIENS-NO LIENS WILL BE INITIATED AGAINST A PATIENT'S PRIMARY RESIDENCE OR MOTOR VEHICLE WITHOUT WRITTEN APPROVAL FROM HEALTHALLIANCE'S BOARD OF TRUSTEES. ALL APPROVALS BY THE BOARD OF TRUSTEES WILL BE MADE ON AN INDIVIDUAL CASE BASES. WE ALSO SEND STATEMENTS AND MAKE PHONE CALLS. MARLBOROUGH HOSPITAL PART V, SECTION B, LINE 16E: POLICY ON LIENS-NO LIENS WILL BE INITIATED AGAINST A PATIENT'S PRIMARY RESIDENCE OR MOTOR VEHICLE WITHOUT WRITTEN APPROVAL FROM MARLBOROUGH'S BOARD OF TRUSTEES. ALL APPROVALS BY THE BOARD OF TRUSTEES WILL BE MADE ON AN INDIVIDUAL CASE BASES. WE ALSO SEND STATEMENTS AND MAKE PHONE CALLS. WING MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 16E: POLICY ON LIENS-NO LIENS WILL BE INITIATED AGAINST A PATIENT'S PRIMARY RESIDENCE OR MOTOR VEHICLE WITHOUT WRITTEN APPROVAL FROM WING'S BOARD OF TRUSTEES. ALL APPROVALS BY THE BOARD OF TRUSTEES WILL BE MADE ON AN INDIVIDUAL CASE BASES. WE ALSO SEND STATEMENTS AND MAKE PHONE CALLS. CLINTON HOSPITAL ASSOCIATION PART V, SECTION B, LINE 16E: POLICY ON LIENS-NO LIENS WILL BE INITIATED AGAINST A PATIENT'S PRIMARY RESIDENCE OR MOTOR VEHICLE WITHOUT WRITTEN APPROVAL FROM CLINTON'S BOARD OF TRUSTEES. ALL APPROVALS BY THE BOARD OF TRUSTEES WILL BE MADE ON AN INDIVIDUAL CASE BASES. WE ALSO SEND STATEMENTS AND MAKE PHONE CALLS. UMASS MEMORIAL MEDICAL CENTER, INC. PART V, SECTION B, LINE 17E: UMMMC REFERS ACCOUNTS TO A CREDIT AGENCY WHEN WRITTEN OFF AS BAD DEBT FOR FURTHER COLLECTIONS. THESE AGENCIES CONTINUE COLLECTIONS WITHOUT IMPACT TO THE CREDIT RATING. HEALTHALLIANCE HOSPITAL, INC. PART V, SECTION B, LINE 17E: HEALTHALLIANCE HOSPITAL REFERS ACCOUNTS TO A CREDIT AGENCY WHEN WRITTEN OFF AS BAD DEBT FOR FURTHER COLLECTIONS. THESE AGENCIES CONTINUE COLLECTIONS WITHOUT IMPACT TO THE CREDIT RATING. MARLBOROUGH HOSPITAL PART V, SECTION B, LINE 17E: MARLBOROUGH ENGAGES A THIRD PARTY AGENCY TO ASSIST ON ALL SELF PAY ACCOUNTS AT ORIGINATION. THEY REFER ACCOUNTS TO A CREDIT AGENCY WHEN WRITTEN OFF AS BAD DEBT FOR FURTHER COLLECTIONS. THESE AGENCIES CONTINUE COLLECTIONS WITHOUT IMPACT TO THE CREDIT RATING. WING MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 17E: WING REFERS ACCOUNTS TO A CREDIT AGENCY WHEN WRITTEN OFF AS BAD DEBT FOR FURTHER COLLECTIONS. THESE AGENCIES CONTINUE COLLECTIONS WITHOUT IMPACT TO THE CREDIT RATING. CLINTON HOSPITAL ASSOCIATION PART V, SECTION B, LINE 17E: CLINTON REFERS ACCOUNTS TO A CREDIT AGENCY WHEN WRITTEN OFF AS BAD DEBT FOR FURTHER COLLECTIONS. THESE AGENCIES CONTINUE COLLECTIONS WITHOUT IMPACT TO THE CREDIT RATING. HEALTHALLIANCE HOSPITAL, INC. PART V, SECTION B, LINE 18E: 1. PATIENTS WITH SELF-PAY RESPONSIBILITIES, INCLUDING EMERGENCY, ELECTIVE, SCHEDULED AND URGENT SERVICES WILL RECEIVE AN INITIAL BILL DELINEATING THE SERVICES AND AMOUNTS DUE FOR WHICH THEY ARE RESPONSIBLE.2. FOR ANY SELF-PAY RESPONSIBILITIES THAT REMAIN UNPAID AFTER THE INITIAL BILL, THE PATIENT WILL RECEIVE A SERIES OF MONTHLY STATEMENTS FOR 4 MONTHS OR UNTIL THE BALANCE IS RESOLVED, THE 4TH STATEMENT INDICATED AS A FINAL NOTICE. 3. PROVIDER ACCOUNTING STAFF WILL MAKE A TELEPHONE CALL TO ANY PATIENT WITH AN OUTSTANDING SELF-PAY BALANCE OF $1,000 OR MORE DURING THE NORMAL SELF-PAY BILLING AND COLLECTION PROCESS. 4. HAH WILL SEND A FINAL NOTICE BY CERTIFIED MAIL FOR BALANCES OVER $1,000 WHERE NOTICES HAVE NOT BEEN RETURNED AS "INCORRECT ADDRESS" OR "UNDELIVERABLE" FOR EMERGENCY CARE PATIENTS.5. ADDITIONAL NOTICES AND/OR LETTERS MAY BE SENT TO DEBTOR PATIENTS DURING THE BILLING AND COLLECTION PROCESS IN AN EFFORT TO RESOLVE OUTSTANDING BALANCES.6. RETURNED MAIL AND/OR UNDELIVERABLE MAIL WILL BE RESEARCHED BY THE PROVIDER ACCOUNTING STAFF TO OBTAINED VALID ADDRESSES. DATABASES AND PRIOR VISIT INFORMATION WILL BE UTILIZED.7. ALL SUCH EFFORTS TO COLLECT BALANCES, AS WELL AS ANY PATIENT INITIATED INQUIRIES, WILL BE DOCUMENTED ON THE GUARANTOR'S ACCOUNT AND AVAILABLE FOR REVIEW. UMASS MEMORIAL MEDICAL CENTER, INC. PART V, SECTION B, LINE 20D: THE HOSPITAL FACILITY BILLS GROSS CHARGES WITH A 20% PROMPT PAY DISCOUNT. HEALTHALLIANCE HOSPITAL, INC. PART V, SECTION B, LINE 20D: HEALTHALLIANCE CHARGES ALL PATIENTS THE PUBLISHED CHARGE. WHEN THE PATIENT HAS BEEN DETERMINED FOR A DISCOUNT, THE DISCOUNT IS THEN APPLIED TO THE TOTAL CHARGE, AND THE AMOUNT OWED BY THE GUARANTOR IS NOW REDUCED. MARLBOROUGH HOSPITAL PART V, SECTION B, LINE 20D: THE HOSPITAL FACILITY BILLS GROSS CHARGES WITH A 20% PROMPT PAY DISCOUNT. WING MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 20D: THE HOSPITAL FACILITY BILLS GROSS CHARGES WITH A 20% PROMPT PAY DISCOUNT. CLINTON HOSPITAL ASSOCIATION PART V, SECTION B, LINE 20D: THE HOSPITAL FACILITY BILLS GROSS CHARGES WITH A 20% PROMPT PAY DISCOUNT. UMASS MEMORIAL MEDICAL CENTER, INC. PART V, SECTION B, LINE 22: UMMMC CHARGES ALL PATIENTS THE PUBLISHED CHARGE. WHEN THE PATIENT HAS BEEN DETERMINED FOR A DISCOUNT, THE DISCOUNT IS THEN APPLIED TO THE TOTAL CHARGE, AND THE AMOUNT OWED BY THE GUARANTOR IS NOW REDUCED. HEALTHALLIANCE HOSPITAL, INC. PART V, SECTION B, LINE 22: HEALTHALLIANCE CHARGES ALL PATIENTS THE PUBLISHED CHARGE. WHEN THE PATIENT HAS BEEN DETERMINED FOR A DISCOUNT, THE DISCOUNT IS THEN APPLIED TO THE TOTAL CHARGE, AND THE AMOUNT OWED BY THE GUARANTOR IS NOW REDUCED. MARLBOROUGH HOSPITAL PART V, SECTION B, LINE 22: MARLBOROUGH CHARGES ALL PATIENTS THE PUBLISHED CHARGE. WHEN THE PATIENT HAS BEEN DETERMINED FOR A DISCOUNT, THE DISCOUNT IS THEN APPLIED TO THE TOTAL CHARGE, AND THE AMOUNT OWED BY THE GUARANTOR IS NOW REDUCED. WING MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 22: WING CHARGES ALL PATIENTS THE PUBLISHED CHARGE. WHEN THE PATIENT HAS BEEN DETERMINED FOR A DISCOUNT, THE DISCOUNT IS THEN APPLIED TO THE TOTAL CHARGE, AND THE AMOUNT OWED BY THE GUARANTOR IS NOW REDUCED. CLINTON HOSPITAL ASSOCIATION PART V, SECTION B, LINE 22: CLINTON CHARGES ALL PATIENTS THE PUBLISHED CHARGE. WHEN THE PATIENT HAS BEEN DETERMINED FOR A DISCOUNT, THE DISCOUNT IS THEN APPLIED TO THE TOTAL CHARGE, AND THE AMOUNT OWED BY THE GUARANTOR IS NOW REDUCED. PART VI, LINE 2: UMASS MEMORIAL MEDICAL CENTER COMPLETED ITS COMMUNITY HEALTH NEEDS ASSESSMENT BY ASSEMBLING A DIVERSE GROUP OF COMMUNITY STAKEHOLDERS THAT INCLUDE, BUT ARE NOT LIMITED TO, MEMBERS OF HEALTH AND HUMAN SERVICE ORGANIZATIONS, PHILANTHROPY, COMMUNITIES OF COLOR, FAITH-BASED ORGANIZATIONS, AND THE WORCESTER DIVISION OF PUBLIC HEALTH AS PART OF THE GROUP THAT ASSISTED AND GUIDED THE ASSESSMENT PROCESS.THE FOLLOWING STRATEGIES ARE CONDUCTED TO COMPLETE THE ASSESSMENT:- CONDUCT KEY INFORMANT INTERVIEWS AND FOCUS GROUPS WITH COMMUNITY-BASED ORGANIZATIONS AND RESIDENTS- CONDUCT OUTREACH EFFORTS TO MEDICALLY-UNDERSERVED POPULATIONS AND CONVENE MEETINGS WITH NEIGHBORHOOD/COMMUNITY GROUPS- REVIEW PRIMARY AND SECONDARY DATA- CONDUCT ONLINE COMMUNITY SURVEY- ORGANIZE COMMUNITY FORUMS TO SHARE FINDINGS AND RELEASE OF FINAL REPORT - ORGANIZE TASK FORCES FOR FURTHER ACTION TO IDENTIFY PRIORITY AREASTHE FOLLOWING SOURCES INFORM AND ENHANCE OUR EFFORTS TO IDENTIFY PRIORITIES AND UNMET NEEDS:- U.S. CENSUS 2010- HEALTHY PEOPLE 2020- NATIONAL PREVENTION STRATEGY- MASSACHUSETTS DEPARTMENT OF EDUCATION REPORTS INCLUDING LOCAL ENROLLMENT AND LANGUAGE DATA - MASSACHUSETTS DEPARTMENT OF EMPLOYMENT AND TRAINING- HOSPITAL UTILIZATION DATA - MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH/ MASSCHIP- DATA FROM VARIOUS CITY OF WORCESTER DEPARTMENTS INCLUDING, BUT NOT LIMITED TO, THE LOCAL DIVISION OF PUBLIC HEALTH, NEIGHBORHOOD SERVICES AND POLICE.- INFORMATION COLLECTED FROM HEALTH CARE PROVIDERS, COMMUNITY GROUPS/UNDERSERVED POPULATIONS AND INDIVIDUALS WHO HAVE EXPERTISE ON COMMUNITY HEALTH ISSUES.HEALTHALLIANCE HOSPITAL:THE COMMUNITY HEALTH ASSESSMENT PROCESS CONSISTED OF COMPREHENSIVE GATHERING OF QUANTITATIVE AND QUALITATIVE DATA, THROUGH FOCUS GROUPS WITH COMMUNITY MEMBERS AND INTERVIEWS WITH COMMUNITY MEMBERS AND COMMUNITY LEADERS. PARTICIPANTS WERE FROM COMMUNITY BASED, EDUCATIONAL, CIVIC, GOVERNMENTAL, FAITH BASED PROFESSIONALS, HEALTH CARE PROVIDERS, AND OTHERS. WE MAKE A STRONG EFFORT TO ENSURE RACIAL/ETHIC, SOCIOECONOMIC AND GEOGRAPHIC DIVERSITY IN THE COMPOSITION OF ALL FOCUS GROUPS AND INTERVIEWS.MARLBOROUGH HOSPITAL:THE COMMUNITY BENEFITS ADVISORY COUNCIL, COMPRISED OF MEMBERS OF DIFFERENT AGENCIES AND BUSINESSES IN THE AREA, HELPS TO IDENTIFY PROGRAMS IN SUPPORT OF THE COMMUNITY PRIORITIES. THE ASSESSMENT WAS COMPLETED IN CONJUNCTION WITH THE COMMUNITY COALITION OF METROWEST, EDWARD M. KENNEDY COMMUNITY HEALTH CENTER, BOARDS OF HEALTH FROM MARLBORO AND HUDSON AND THE SOUTHBOROUGH MEDICAL GROUP.WING MEMORIAL HOSPITAL:WING MEMORIAL HOSPITAL AND MEDICAL CENTERS ASSESSES THE HEALTH CARE NEEDS OF OUR COMMUNITIES BY COMPLETING A COMMUNITY HEALTH NEEDS ASSESSMENT. THE CHNA CONSIDERS MULTIPLE DATA SOURCES, INCLUDING SECONDARY DATA (REGARDING DEMOGRAPHICS, HEALTH STATUS INDICATORS, AND MEASURES OF HEALTH CARE ACCESS), ASSESSMENTS PREPARED BY OTHER ORGANIZATIONS IN RECENT YEARS, AND PRIMARY DATA DERIVED FROM A COMMUNITY SURVEY AND FROM INTERVIEWS WITH PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING THOSE WITH EXPERTISE IN PUBLIC HEALTH.DURING THE ASSESSMENT PROCESS, COMMUNITY MEMBERS WERE ENGAGED IN KEY INFORMANT INTERVIEWS AND FOCUS GROUPS, WHICH ALLOWED FOR COMMUNITY MEMBERS TO REVIEW AND DISCUSS A PRELIMINARY PROFILE OF THE REGION AND PROVIDE THEIR FEEDBACK ON COMMUNITY HEALTH-RELATED STRENGTHS, NEEDS, AND A VISION FOR THE FUTURE. OVER 1,200 COMMUNITY MEMBERS ALSO RESPONDED TO A COMMUNITY-WIDE SURVEY.WING FORMED A COMMUNITY HEALTH ADVISORY COMMITTEE TO GUIDE AND OFFER FEEDBACK ON THE COMMUNITY BENEFITS AND CHNA PROCESSES. THE COMMITTEE REVIEWED THE CHNA IN DRAFT FORM AND PROVIDED FEEDBACK. THE WING MEMORIAL HOSPITAL COMMUNITY BENEFITS PLAN WAS DEVELOPED BY THE COMMUNITY HEALTH ADVISORY COMMITTEE, WHICH IS COMPRISED OF INTERNAL AND COMMUNITY REPRESENTATIVES. THE GROUP REVIEWED THE CURRENT COMMUNITY BENEFITS PROGRAMS, ALONG WITH THE CHNA, TO HELP ENVISION AND DEFINE PRIORITY AREAS FOR THE FUTURE. BASED ON THIS FOUNDATION, PRIORITY AREAS WERE IDENTIFIED AND GOALS WERE DEFINED. THE COMMITTEE CREATED STRATEGIES FOR EACH GOAL AND OUTCOME INDICATORS WERE ESTABLISHED FOR EACH PRIORITY AREA.CLINTON HOSPITAL:BOTH QUANTITATIVE AND QUALITATIVE DATA WERE COLLECTED FOR THE COMMUNITY HEALTH ASSESSMENT. ALL DATA WERE GATHERED SYSTEMATICALLY UTILIZING THE FOLLOWING STANDARDS OR PRINCIPLES WHICH GUIDED THE METHODOLOGIES AND SOURCE SELECTIONS:1. AVAILABILITY OF MULTIPLE YEARS OF DATA ON STUDY ELEMENTS;2. SPECIFICITY OF DATA TO THE STUDY AREA COMMUNITIES;3. APPROPRIATENESS OF DATA COLLECTION METHODOLOGIES TO THE DATA SOURCE;4. BROAD PARTICIPATION AMOUNG THE STAKEHOLDER POPULATIONS;5. BROAD RANGE OF INPUT FROM QUALITATIVE AND QUANTITATIVE SOURCES.THE MAJORITY OF THE QUANTITATIVE DATA COLLECTED FOR THE CHA CAME FROM THE MASSACHUSETTS COMMUNITY HEALTH INFORMATION PROFILE (MASS CHIP). OTHER SOURCES INCLUDE: THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH; THE UNITED STATES CENSUS BUREAU; THE MASSACHUSETTS DEPARTMENT OF WORKFORCE DEVELOPMENT; THE MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION; AND THE MASSACHUSETTS BEHAVIORAL HEALTH PARTNERSHIP. WHENEVER POSSIBLE, THREE YEARS OF DATA WERE USED FOR EACH MEASURE AND, WHEN FEASIBLE, DATA IS PROVIDED FOR INDIVIDUAL TOWNS.QUALITATIVE DATA WAS ELICITED TO ENHANCE, CLARIFY, AND ADD "COMMUNITY VOICES" AND REAL LIFE EXPERIENCES TO THE QUANTITATIVE DATA INCLUDED IN THE REPORT. QUALITATIVE DATA ALSO PROVIDES A LENS INTO CURRENT CONDITIONS - ECONOMIC AND CULTURAL - WHICH QUANTITATIVE DATA CANNOT DUE TO THE LAGS BETWEEN DATA COLLECTION, REPORTING, AND RETRIEVAL. FOR EXAMPLE, THE QUALITATIVE DATA PRESENTED HERE STRONGLY REFLECTS THE ECONOMIC CRISIS WHICH OCCURRED DURING THE QUALITATIVE DATA COLLECTION PROCESS BUT AFTER MUCH OF THE QUANTITATIVE DATA HAD ALREADY BEEN COLLECTED AND REPORTED.QUALITATIVE DATA FOR THIS ASSESSMENT WAS GATHERED VIS FOCUS GROUPS WITH COMMUNITY MEMBERS AND THROUGH INTERVIEWS WITH COMMUNITY MEMBERS AND COMMUNITY LEADERS. FOCUS GROUPS AND INTERVIEWS WERE CONDUCTED. EVERY EFFORT WAS MADE TO ENSURE RACIAL/ETHIC, SOCIOECONOMIC, AND GEOGRAPHIC DIVERSITY IN THE COMPOSITION OF FOCUS GROUPS AND INTERVIEW PARTICIPANTS. PART VI, LINE 4: GEOGRAPHICAL REACH - THE 2012 COMMUNITY HEALTH ASSESSMENT (CHA) AND SUBSEQUENT COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOCUSES ON THE CITY OF WORCESTER AND THE OUTLYING COMMUNITIES OF SHREWSBURY, MILBURY, WEST BOYLSTON, LEICESTER, AND HOLDEN, A SUB-SECTION OF ITS PRIMARY SERVICE AREA. THIS SPECIFIC GEOGRAPHIC AREA IS THE FOCUS FOR THE CITY OF WORCESTER DIVISION OF PUBLIC HEALTH IN ITS REGIONALIZATION INITIATIVE, AND OVERLAPS WITH THE SERVICE AREA OF MANY OTHER LOCAL ORGANIZATIONS. FOCUSING UMASS MEMORIAL'S CHNA ON THIS GEOGRAPHIC AREA FACILITATES THE ALIGNMENT OF THE HOSPITAL'S EFFORTS WITH COMMUNITY AND GOVERNMENTAL PARTNERS, SPECIFICALLY THE CITY HEALTH DEPARTMENT, THE AREA FEDERALLY QUALIFIED HEALTH CENTERS, AND SEVERAL COMMUNITY-BASED ORGANIZATIONS. THIS FOCUS ALSO FACILITATES COLLABORATION WITH THE (CHIP) ADVISORY COMMITTEE THAT WILL BE IMPLEMENTING KEY STRATEGIES OF THE CHIP SO THAT FUTURE INITIATIVES CAN BE DEVELOPED IN A MORE COORDINATED APPROACH.REGIONAL DESCRIPTION - THE CITY OF WORCESTER IS VERY ETHNICALLY-DIVERSE, CONSIDERABLY MORE SO THAN THE NATION AND STATE OVERALL, AND THAT DIVERSITY CONTINUES TO EXPAND. THE NUMBER OF HISPANICS LIVING IN THE CITY HAS GROWN BY 35% OVER THE PAST 10 YEARS. REFUGEES FROM IRAQ CURRENTLY ACCOUNT FOR THE GREATEST PERCENTAGE OF NEW IMMIGRANTS FOLLOWED BY REFUGEES FROM BHUTAN, LIBERIA AND OTHER AFRICAN NATIONS. HEALTH RESOURCES AND SERVICES ADMINISTRATION (HSRA) HAS DESIGNATED THE CITY OF WORCESTER A HEALTH PROFESSIONAL AREA (HPSA) IN PRIMARY CARE, MENTAL HEALTH AND DENTAL SERVICES DUE TO ITS LOW INCOME POPULATION. THE CITY OF WORCESTER HAS SEVERAL NEIGHBORHOODS WITH A SHORTAGE OF HEALTH PROVIDERS AND HRSA HAS DETERMINED THAT MANY CENSUS TRACTS IN THE CITY ARE MEDICALLY-UNDERSERVED AREAS (MUAS).ECONOMIC CHARACTERISTICS - THE U.S. CENSUS DATA FOR 2010 INDICATED THAT THE MEDIAN HOUSEHOLD INCOME FOR WORCESTER COUNTY WAS $29,316. FOR THE CITY OF WORCESTER, THE REGION'S LARGEST URBAN AREA, IT WAS CONSIDERABLY LOWER AT $23,135. ACCORDING TO THE CENSUS DATA, OF THE CITY'S TOTAL 181,045 RESIDENTS, 19.4% ARE LIVING BELOW THE POVERTY LEVEL. THE NUMBER OF CHILDREN UNDER THE AGE OF 18 LIVING BELOW THE POVERTY LEVEL ROSE TO 29.6% IN 2010 FROM 25% IN 2005-2009. (SOURCE: U.S. CENSUS 2010 AND 2010 AMERICAN COMMUNITY SURVEY 1-YEAR ESTIMATES, U.S. CENSUS.) THE UNEMPLOYMENT RATE IN WORCESTER COUNTY RANGED BETWEEN 9.3 IN JANUARY 2011 AND 7.2 IN DECEMBER 2011. (SOURCE: MASSACHUSETTS EXECUTIVE OFFICE OF LABOR WORKFORCE AND DEVELOPMENT.) THESE FACTORS HAVE RESULTED IN A STRONG NEED FOR FOOD ASSISTANCE SERVICES. FOR EXAMPLE, ACCORDING TO THE MASSACHUSETTS DEPARTMENT OF EDUCATION, 64% OF STUDENTS IN THE WORCESTER PUBLIC SCHOOL SYSTEM RECEIVE FREE SCHOOL LUNCH. (SOURCE: MASSACHUSETTS DEPARTMENT OF EDUCATION.) DEMOGRAPHIC AND HEALTH FACTORS - THE DEMOGRAPHICS OF THE REGION VARY WIDELY ACROSS THE REGION. WORCESTER COUNTY HAS A TOTAL POPULATION OF 798,552 AND IS 86% WHITE. THE CITY OF WORCESTER IS A LEADING RESETTLEMENT SITE FOR IMMIGRANTS DUE TO ITS LOWER COST OF LIVING AND AVAILABLE SERVICES AND ACCOUNTS FOR THE GREATEST INCREASE OF DIVERSITY IN THE REGION. ACCORDING TO U.S. CENSUS 2010 FIGURES, THE HISPANIC POPULATION AND OTHER NON-HISPANIC, NON-WHITE ETHNIC GROUPS HAVE NOTABLY INCREASED WHILE THE WHITE, NON-HISPANIC POPULATION HAS DECREASED. THE NUMBER OF HISPANICS LIVING IN THE CITY OF WORCESTER HAS GROWN BY 35% AND BY MORE THAN 46% STATEWIDE OVER THE PAST 10 YEARS. THE CITY'S FOREIGN BORN POPULATION IS SIGNIFICANTLY HIGHER THAN WORCESTER COUNTY AS A WHOLE, ACCOUNTING FOR THE MAJORITY OF THIS POPULATION IN THE REGION. THE CITY'S FOREIGN BORN POPULATION IS ALSO SIGNIFICANTLY HIGHER COMPARED TO THE NATION AND STATE OVERALL. ADDING TO THIS DIVERSITY IS AN INFLUX OF IMMIGRANTS AND NEW ARRIVAL REFUGEES. REFUGEES FROM IRAQ CURRENTLY ACCOUNT FOR THE GREATEST PERCENTAGE OF NEW IMMIGRANTS FOLLOWED BY REFUGEES FROM BHUTAN, BURMA AND LIBERIA. THIS GROWING DIVERSITY HAS BROADENED THE NEED FOR INTERPRETER SERVICES FOR MEDICAL CARE. FOR EXAMPLE, IN ITS FISCAL YEAR 2012, UMASS MEMORIAL HEALTH CARE DELIVERED 144,320 DOCUMENTED INTERPRETATIONS FOR MEDICAL SERVICES IN OVER 133 LANGUAGES. NINETY PERCENT OF ALL INTERPRETATIONS PROVIDED BY UMMHC WERE CONDUCTED IN: SPANISH, PORTUGUESE, VIETNAMESE, ARABIC, ALBANIAN AND AMERICAN SIGN LANGUAGE. THE REMAINING TEN PERCENT WERE CONDUCTED IN OTHER "NON-PRIMARY" LANGUAGES, THE POOL OF WHICH CONSISTS OF 81 DIFFERENT LANGUAGES. THE SENIOR POPULATION IN THE REGION ALSO CONTINUES TO GROW AS BABY BOOMERS REACH THE AGE OF 65. ACCORDING TO THE U.S. CENSUS, RESIDENTS BETWEEN THE AGES OF 20-64 ACCOUNT FOR THE MAJORITY OF THE POPULATION IN WORCESTER COUNTY AT 61%.ACCESS TO CARE - APPROXIMATELY 90% OF PEOPLE HAVE HEALTH INSURANCE. DESPITE THIS, THERE REMAINS A CHURNING OF ENROLLMENTS WITH MANY DROPPING OFF. HEALTH INSURANCE ENROLLMENT REMAINS AN ISSUE AS EVIDENCED BY UMMHC'S RATES OF ENROLLMENT ASSISTANCE IN HEALTH SAFETY NETWORK, COMMONWEALTH CARE AND MEDICAID APPLICATIONS.CHRONIC DISEASE OVERVIEW:- OVERWEIGHT & OBESITY: HIGH RATES OF OVERWEIGHT AND OBESITY ARE A LEADING PUBLIC HEALTH CONCERN IN THE REGION AND PARTICULARLY IN THE CITY OF WORCESTER. LOWER-INCOME RESIDENTS ARE SIGNIFICANTLY MORE LIKELY TO SUFFER FROM OBESITY AND OTHER DIET-RELATED HEALTH PROBLEMS. NEARLY 70% OF HISPANIC ADULTS IN THE REGION WERE OVERWEIGHT OR OBESE, BUT WITHIN ETHNIC GROUPS, BLACKS WERE MORE LIKELY TO BE OBESE. CHILDREN LIVING IN THE CITY OF WORCESTER ARE OVERWEIGHT AT HIGHER RATES THAN THE STATE AS A WHOLE. OVERALL, THE AVERAGE FOR OBESE YOUTH ENTERING FIRST GRADE IN THE CITY OF WORCESTER IS 20.25% COMPARED TO THE NATIONWIDE AVERAGE OF 10%. PARTICULARLY ALARMING IS A DRAMATIC INCREASE IN THE PAST DECADE OF OBESITY AMONG 1ST GRADERS IN THE ASIAN COMMUNITY. IN WORCESTER COUNTY, OBESITY IS MORE PREVALENT AMONG MINORITY ETHNIC GROUPS. AMONG ADULTS, NEARLY 70% OF HISPANICS WERE OVERWEIGHT OR OBESE, BUT WITHIN ETHNIC GROUPS, BLACKS WERE MORE LIKELY TO BE OBESE. (SOURCE: MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH/MASSCHIP; DALE MAGEE, COMMISSIONER, WORCESTER DEPARTMENT OF PUBLIC HEALTH, HEALTH OF WORCESTER 2011 REPORT, WORCESTER PUBLIC SCHOOLS.)- DIABETES: THE PREVALENCE OF DIABETES AMONG WORCESTER COUNTY RESIDENTS IS SLIGHTLY LOWER THAN THE STATE AS A WHOLE. DIABETES IS MORE PREVALENT AMONG BLACK AND HISPANIC POPULATIONS AND THOSE 65 YEARS OLD AND OVER. THE PREVALENCE OF HEART DISEASE IN THE REGION IS SIGNIFICANTLY HIGHER AMONG LOWER INCOME RESIDENTS.- ASTHMA: ASTHMA AFFECTS PEOPLE OF ALL AGES, RACES, GENDERS AND SOCIO-ECONOMIC STATUS, HOWEVER, IT OCCURS AT DISPROPORTIONATELY HIGHER RATES AMONG SOME ETHNIC AND RACIAL POPULATIONS. THE PREVALENCE OF ASTHMA IS HIGHER AMONG FEMALES AND HISPANIC ADULTS IN WORCESTER COUNTY COMPARED TO THE STATE AND INCREASING AMONG CHILDREN AGES 0-19 YEARS OLD. (SOURCE: MDPH, MASSCHIP CUSTOMER REPORTS.)- CANCER: CANCER WAS THE SECOND LEADING CAUSE OF DEATH IN WORCESTER COUNTY IN 2008. (SOURCE: MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH/MASSCHIP; DALE MAGEE, COMMISSIONER, WORCESTER DEPARTMENT OF PUBLIC HEALTH, HEALTH OF WORCESTER, 2011 REPORT.) OF THOSE DEATHS, LUNG CANCER ACCOUNTED FOR THE GREATEST PERCENTAGE OF CANCER-RELATED DEATHS WITH HIGH ASSOCIATION WITH SMOKING.- SMOKING: APPROXIMATELY 23% OF ADULTS IN THE CITY OF WORCESTER SMOKE COMPARED TO 17% IN THE STATE AND 15% IN THE NATION.HEALTHALLIANCE HOSPITAL: OUR TARGET POPULATIONS FOCUS ON MEDICALLY-UNDERSERVED AND VULNERABLE GROUPS OF ALL AGES IN NORTH CENTRAL MASSACHUSETTS. OUR MOST VULNERABLE POPULATIONS INCLUDE CHILDREN, ETHNIC AND LINGUISTIC MINORITIES AND THOSE LIVING IN POVERTY. THESE POPULATIONS OFTEN BECOME ISOLATED AND DISENFRANCHISED DUE TO NEGLIGENCE, MISPERCEPTIONS, AND EVEN FEAR. THE COMMUNITY HEALTH AND ASSESSMENT OF NORTH CENTRAL MA INCLUDES THE 27 CITIES AND TOWNS COVERED BY COMMUNITY HEALTH NETWORK AREA 9 (CHNA9), INCLUDING THE CITIES OF FITCHBURG, LEOMINSTER, GARDNER, AND THE TOWNS OF ASHBURNHAM, ASHBY, AYER, BARRE, BERLIN, BOLTON, CLINTON, GROTON, HARDWICK, HARVARD, HUBBARDSTON, LANCASTER, LUNENBERG, NEW BRAINTREE, OAKHAM, PEPPERELL, PRINCETON, RUTLAND, SHIRLEY, STERLING, TEMPLETON, TOWNSEND, WESTMINSTER, AND WINCHENDON. ELEVEN OF THESE CITIES AND TOWNS (FITCHBURG, LEOMINSTER, GARDNER, ASHBURNHAM, ASHBY, HUBBARDSTON, LUNENBURG, TEMPLETON, TOWNSEND, WESTMINSTER, AND WINCHENDON) ARE ALSO WITHIN THE SERVICE AREA.CONTINUED ON SCHEDULE O PART VI, LINE 5: UMASS MEMORIAL MEDICAL CENTER HAS A DESIGNATED COMMUNITY BENEFIT DEPARTMENT HOUSED WITHIN THE COMMUNITY RELATIONS DEPARTMENT THAT IS WHOLLY DEDICATED TO PROMOTING THE COMMUNITY BENEFIT AGENDA WITH A SPECIAL FOCUS ON COMMUNITY HEALTH IMPROVEMENT. OUR COMMUNITY BENEFITS STAFF WORKS VERY CLOSELY WITH MULTIPLE COMMUNITY ORGANIZATIONS FORGING PARTNERSHIPS. IN ADDITION, WE LEVERAGE INTERNAL RESOURCES WITHIN THE SYSTEM TO INCREASE PROGRAM CAPACITY WHENEVER POSSIBLE. THIS DEPARTMENT WORKS CLOSELY WITH PEDI-PRIMARY CARE, FAMILY AND COMMUNITY MEDICINE, PEDI-PULMONOLOGY AND PLUMLEY VILLAGE HEALTH SERVICES.HEALTHALLIANCE HOSPITAL: HEALTHALLIANCE HOSPITAL HAS A COMMUNITY BENEFIT PROGRAM WITHIN THE MARKETING/COMMUNICATIONS DEPARTMENT THAT IS RESPONSIBLE FOR PROMOTING THE COMMUNITY BENEFIT AGENDA FOCUSING ON COMMUNITY HEALTH IMPROVEMENT. OUR COMMUNITY BENEFITS STAFF WORKS VERY CLOSELY WITH MULTIPLE COMMUNITY ORGANIZATIONS FORGING PARTNERSHIPS. IN ADDITION, WE LEVERAGE INTERNAL RESOURCES WITHIN THE SYSTEM TO INCREASE PROGRAM CAPACITY WHENEVER POSSIBLE. WE CONTINUE TO SUPPORT HEALTH EDUCATION AND SCREENINGS RELATED TO CHRONIC OCCLUSIVE PULMONARY DISEASE (COPD), HEART HEALTH, DEPRESSION, AND DIABETES.MARLBOROUGH HOSPITAL: MARLBOROUGH HOSPITAL PARTICIPATES IN AREA EVENTS AND PROVIDES FACILITIES FOR SUPPORT GROUPS. IN ADDITION, WHENEVER POSSIBLE WE LEVERAGE INTERNAL RESOURCES TO BUILD CAPACITY IN OUR PROGRAMMING AND WE HAVE STAFF THAT SUPPORTS COMMUNITY BENEFITS ACTIVITIES.WING MEMORIAL HOSPITAL: WING MEMORIAL HOSPITAL HAS A PART TIME DESIGNATED COMMUNITY BENEFIT STAFF PERSON TO PROMOTE THE COMMUNITY BENEFIT AGENDA WITH A SPECIAL FOCUS ON COMMUNITY HEALTH IMPROVEMENT. THIS STAFF MEMBER WORKS CLOSELY WITH MULTIPLE COMMUNITY ORGANIZATIONS FORGING PARTNERSHIPS. IN ADDITION, THE HOSPITAL LEVERAGES INTERNAL RESOURCES TO INCREASE PROGRAM CAPACITY WHENEVER POSSIBLE.CLINTON HOSPITAL ASSOCIATION: CLINTON HOSPITAL'S COMMUNITY BENEFITS PROGRAM STRIVES TO MEET AND EXCEED THE SCHEDULE H/FORM 990 IRS MANDATE TO "PROMOTE HEALTH FOR A CLASS OF PERSONS SUFFICIENTLY LARGE SO THE COMMUNITY AS A WHOLE BENEFITS." OUR PROGRAMS MIRROR THE FIVE CORE PRINCIPLES OUTLINED BY THE PUBLIC HEALTH INSTITUTE IN TERMS OF THE "EMPHASIS ON COMMUNITIES WITH DISPROPORTIONATE UNMET HEALTHRELATED NEEDS; EMPHASIS ON PRIMARY PREVENTION; BUILDING A SEAMLESS CONTINUUM OF CARE; BUILDING COMMUNITY CAPACITY; AND COLLABORATIVE GOVERNANCE." TARGET POPULATIONS FOR CLINTON HOSPITAL'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COMMUNITY INPUT AND PLANNING PROCESS, COLLABORATIVE EFFORTS, AND A CHA WHICH IS CONDUCTED EVERY THREE YEARS. PART VI, LINE 6: UMASS MEMORIAL MEDICAL CENTER, HEALTHALLIANCE HOSPITAL, MARLBOROUGH HOSPITAL, WING MEMORIAL HOSPITAL, AND THE CLINTON HOSPITAL ASSOCIATION ARE PART OF THE UMASS MEMORIAL HEALTH CARE SYSTEM (FIVE HOSPITALS TOTAL IN CENTRAL MASSACHUSETTS). EACH HOSPITAL HAS DESIGNATED COMMUNITY BENEFITS STAFF TO WORK WITH THEIR RESPECTIVE LOCAL COMMUNITIES. EACH HOSPITAL IS RESPONSIBLE FOR DEVELOPING THEIR OWN COMMUNITY HEALTH NEEDS ASSESSMENT IN COLLABORATION WITH LOCAL COMMUNITY STAKEHOLDERS AND A COMMUNITY BENEFIT IMPLEMENTATION PLAN. REPORTS FILED WITH STATES PART VI, LINE 7 MA PART VI LINE 7 YES, ALL FIVE HOSPITALS FILE INDIVIDUAL COMMUNITY BENEFIT REPORTS WITH THE MASSACHUSETTS ATTORNEY GENERAL'S OFFICE. 1 EDWARD M KENNEDY COMMUNITY HEALTH CENTER INC 19 TACOMA STREET WORCESTER MA 01605 042513817 1000000 0 SUPPORT FOR HEALTH CENTER'S MISSION FAMILY HEALTH CENTER OF WORCESTER INC 26 QUEEN STREET WORCESTER MA 01610 042485308 1000000 0 SUPPORT FOR HEALTH CENTER'S MISSION UNIVERSITY OF MA MEDICAL SCHOOL 55 LAKE AVE WORCESTER MA 01605 043167352 1000000 0 ACADEMIC CHAIR FUNDING UNIVERSITY OF MA MEDICAL SCHOOL 55 LAKE AVE WORCESTER MA 01605 043167352 400000 0 MUSCULOSKELETAL CENTER EXCELLENCE GRANT 4 0 SCHOLARSHIPS 2 4000 INTERNSHIPS 33 73289 PART I LINE 2: MEDICAL CENTER: AT REASONABLE INTERVALS, RE-EVALUATION OF THE GRANTS OCCURS TO ENSURE THAT THE ARRANGEMENTS ARE EXPECTED TO CONTINUE TO SATISFY THE STANDARD SET FORTH. THE HEALTH CENTERS WILL DOCUMENT THE RE-EVALUATION CONTEMPORANEOUSLY. PART I LINE 2: MEDICAL CENTER: AS PART OF THE FUNDING AGREEMENT, BI-ANNUAL UPDATES WILL BE PROVIDED TO THE SENIOR VICE RPESIDENT FOR OPERATIONS OF THE MEDICAL CENTER RESPONSIBLE FOR THE MUSCULOSKELETAL CENTER OF EXCELLENCE. PART II LINE 1(H): MEDICAL CENTER: THE STANDARD SET FORTH IS A REASONABLE EXPECTATION THAT THE GRANTS WILL CONTRIBUTE MEANINGFULLY TO EACH OF THE HEALTH CENTER'S ABILITY TO MAINTAIN OR INCREASE THE AVAILABILITY, OR ENHANCE THE QUALITY, OF SERVICES PROVIDED TO A MEDICALLY UNDERSERVED POPULATION SERVICED BY THE HEALTH CENTERS. EACH HEALTH CENTER HAS DOCUMENTED THE BASIS FOR SAID REASONABLE EXPECTATION. PART II LINE 1(H): MEDICAL CENTER: THESE GRANTS REPRESENT HIGHLY COLLABORATIVE PROJECTS AMONG THREE DEPARTMENTS (ORTHOPEDICS, MEDICINE (PHEUMATOLOGY) AND CELL BIOLOGY) THAT FOCUS ON THE ROLE OF MICRORNAS IN THE PATHOGENESIS OF RHEUMATOID ARTHRITIS AND OSTEOARTHRITIS, AND ADDRESS THE POTENTIAL ROLE OF MICRORNAS AS BIOMARKERS OF DISEASE. PART I LINE 2: HEALTHALLIANCE HOSPITALS, INC.: PRIOR TO THE DISTRIBUTION OF ANY AND ALL SCHOLARSHIP/INTERNSHIP FUNDS, HEALTHALLIANCE REQUIRES VERIFICATION OF PROGRAM ENROLLMENT FROM ALL RECIPIENTS. X 1 1 X X X X X X 0 1 0 0 0 0 0 0 0 ANDRIENI JULIA MD 273199 0 31054 0 0 0 12750 0 12392 0 329395 0 0 0 BROWN ALAN P MD 166308 0 23300 0 0 0 9787 0 23592 0 222987 0 0 0 BROWN DOUGLAS S 396070 0 100266 0 35376 0 195153 0 23344 0 750209 0 35376 0 CARLUCCI DANIEL MD 264109 0 32203 0 16615 0 0 0 27123 0 340050 0 0 0 CAVAGNARO III CHARLES MD 302028 0 86563 0 0 0 157132 0 60879 0 606602 0 0 0 COFONE MICHAEL J 251709 0 38371 0 1299 0 799 0 22628 0 314806 0 0 0 CORBETT WILLIAM MD 291621 0 76427 0 24927 0 79775 0 20285 0 493035 0 24927 0 DALY SHEILA 202742 0 51928 0 31338 0 108374 0 26709 0 421091 0 31338 0 DICKSON ERIC W MD 419373 0 103620 0 22347 0 111023 0 57400 0 713763 0 20844 0 FAIRCHILD DAVID MD 375936 0 74109 0 0 0 60922 0 26293 0 537260 0 0 0 FERGUSON R KEVIN MD 202116 0 17144 0 0 0 10900 0 23858 0 254018 0 0 0 FERRUCCI JOSEPH MD 356540 0 26690 0 0 0 12750 0 26362 0 422342 0 0 0 FINBERG ROBERT W MD 246772 0 52371 0 0 0 129892 0 29633 0 458668 0 0 0 GOTTLIEB PHILIP D MD 231666 0 142139 0 0 0 12750 0 31578 0 418133 0 0 0 KEATING TODD A 472105 0 89313 0 45193 0 269603 0 22946 0 899160 0 45193 0 KENNEDY KATHRYN MD 229483 0 57478 0 0 0 12729 0 27700 0 327390 0 0 0 LAPIDAS GARY N 367356 0 68995 0 41861 0 202237 0 12333 0 692782 0 41861 0 LAPRIORE CHERYL M 225404 0 53821 0 19218 0 72353 0 20957 0 391753 0 19218 0 LASSER DANIEL H MD 207049 0 62832 0 0 0 146524 0 26064 0 442469 0 0 0 MAGUIRE DAVID L MD 215385 0 34056 0 762 0 9673 0 1501 0 261377 0 0 0 MATTA LALITA MD 124877 0 4450 0 532 0 2584 0 22658 0 155101 0 0 0 MESSINA LOUIS MD 397761 0 234344 0 0 0 12750 0 27688 0 672543 0 0 0 METZMAKER JEFFREY N MD 287640 0 119441 0 0 0 12750 0 24688 0 444519 0 0 0 MOORE KAREN 281170 0 47692 0 0 0 284971 0 24082 0 637915 0 0 0 MULDOON PATRICK L 389759 0 105271 0 33933 0 199175 0 39341 0 767479 0 33933 0 O'BRIEN JOHN G 941448 0 232336 0 2879468 0 702230 0 18736 0 4774218 0 2416000 0 OKIKE O NSIDINANYA MD 451572 0 71332 0 0 0 12750 0 30005 0 565659 0 0 0 O'LEARY DANIEL MD 140156 0 16131 0 626 0 0 0 1142 0 158055 0 0 0 ROSEN MAX P MD 146569 0 10000 0 0 0 5638 0 1068 0 163275 0 0 0 SCHOONOVER LINDA MD 98050 0 47700 0 258 0 1527 0 23323 0 170858 0 0 0 SOAR BART MD 142661 0 20813 0 60 0 6426 0 10960 0 180920 0 0 0 SWENSON DANA 233386 0 62081 0 0 0 93570 0 20285 0 409322 0 0 0 SZYMANSKI CANDRA 175001 0 5287 0 4916 0 12469 0 2644 0 200317 0 0 0 TOSI STEPHEN E MD 387109 0 185251 0 86119 0 239786 0 26110 0 924375 0 86119 0 ZIEDONIS DOUGLAS MD 191470 0 32570 0 0 0 11625 0 27033 0 262698 0 0 0 ALLICON KEARY T 142409 0 17647 0 5656 0 41287 0 20638 0 227637 0 0 0 BRONHARD JOHN 137271 0 12788 0 226 0 1417 0 5251 0 156953 0 0 0 EKSTROM DEBORAH 191803 0 45686 0 15375 0 124399 0 27483 0 404746 0 14554 0 FELDMANN ROBERT 248070 0 66041 0 0 0 172970 0 21570 0 508651 0 0 0 FRAKER MURIEL E ESQUIRE 171057 0 13810 0 0 0 81468 0 28762 0 295097 0 0 0 MCCUE STEVEN 184592 0 5355 0 7308 0 21302 0 19733 0 238290 0 0 0 O'BRIEN WILLIAM H 114091 0 7162 0 0 0 50585 0 23302 0 195140 0 0 0 OLSON JEFFREY 129169 0 7534 0 2587 0 -1308 0 23138 0 161120 0 0 0 SHAKMAN ALICE 226982 0 43619 0 20653 0 16790 0 14359 0 322403 0 20653 0 SMITH FRANCIS W 177149 0 13523 0 0 0 50724 0 25285 0 266681 0 0 0 STREETER MICHELE M 290933 0 65156 0 17241 0 171672 0 21403 0 566405 0 17241 0 ANDERSON MILTON C 397857 0 102510 0 29545 0 53932 0 34137 0 617981 0 0 0 BLUTE MICHAEL MD 141719 0 0 0 0 0 121712 0 12258 0 275689 0 0 0 BOLLAND ESHGHI KATHARINE 263476 0 75219 0 0 0 46099 0 20957 0 405751 0 0 0 BRENCKLE GEORGE PHD 299172 0 53799 0 32290 0 138732 0 25440 0 549433 0 32290 0 CYR JAMES P 216941 0 49368 0 0 0 20862 0 20957 0 308128 0 0 0 DALEY JENNIFER MD 471116 0 85618 0 36904 0 887505 0 32301 0 1513444 0 36904 0 DIAMOND VICTORIA 258887 0 73741 0 47362 0 146196 0 28586 0 554772 0 47362 0 ETTINGER WALTER H MD 53421 0 0 0 75204 0 247254 0 1746 0 377625 0 70554 0 FISHER BARBARA 247551 0 62356 0 26121 0 118545 0 22285 0 476858 0 26121 0 HUDLIN MARGARET MD 244303 0 89477 0 0 0 12913 0 23265 0 369958 0 0 0 HYLKA SHARON 303806 0 80412 0 35958 0 263847 0 20957 0 704980 0 35958 0 KLUGMAN ROBERT MD 388171 0 76580 0 36333 0 260637 0 23509 0 785230 0 36333 0 KRUGER NANCY 223233 0 51084 0 45489 0 52773 0 16097 0 388676 0 27847 0 PHILLIPS ROBERT A MD 601362 0 172241 0 70541 0 292112 0 10048 0 1146304 0 70541 0 RANDOLPH JOHN T 195361 0 52777 0 0 0 148090 0 22917 0 419145 0 0 0 LITWIN DEMETRIUS MD 569695 0 138827 0 0 0 12750 0 27033 0 748305 0 0 0 TAM STANLEY MD 540380 0 167213 0 0 0 12750 0 26362 0 746705 0 0 0 AROUS ELIAS J MD 361584 0 233497 0 0 0 12750 0 24688 0 632519 0 0 0 AYERS DAVID C MD 563206 0 31250 0 0 0 12750 0 26362 0 633568 0 0 0 BOZORGZADEH ADEL MD 436911 0 151688 0 0 0 12750 0 27123 0 628472 0 0 0 CHANDLER WILLIS 10273 0 0 0 25978 0 60403 0 912 0 97566 0 25978 0 PART I, LINE 1A SPLIT DOLLAR GROSS UP CALCULATIONS TO WALTER ETTINGER WHICH ARE TREATED AS TAXABLE COMPENSATION. PART I, LINE 4B NAME OF PARTICIPANTS IN OR RECEIVING PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN EXECUTIVES BROWN, DOUGLAS S. $35,376 CAVAGNARO, CHARLES III, M.D. $0 COFONE, MICHAEL J. $0 CORBETT, WILLIAM M.D. $24,927 DALY, SHEILA $31,338 DICKSON, ERIC, M.D. $20,844 EKSTROM, DEBORAH $14,554 FAIRCHILD, DAVID, M.D. $0 FELDMANN, ROBERT $0 FINBERG, ROBERT W., M.D. $0 KEATING, TODD A. $45,193 LAPIDAS, GARY N. $41,861 LAPRIORE, CHERYL M. $19,218 MOORE, KAREN $0 MULDOON, PATRICK L. $33,933 O'BRIEN, JOHN G. $0 SHAKMAN, ALICE $20,653 STREETER, MICHELE M. $17,241 SWENSON, DANA $0 TOSI, STEPHEN E., M.D. $86,119 SUBTOTAL EXECUTIVES $391,257 KEY EMPLOYEES ANDERSON, MILTON C. $0 BLUTE, MICHAEL, M.D. $0 BRENCKLE, GEORGE, PH.D. $32,290 BOLLAND ESHGHI, KATHERINE $0 CYR, JAMES P. $0 DALEY, JENNIFER M.D. $36,904 DIAMOND, VICTORIA $47,362 ETTINGER, WALTER H., M.D. $70,554 FISHER, BARBARA $26,121 HUDLIN, MARGARET, M.D. $0 HYLKA, SHARON $35,958 KLUGMAN, ROBERT, M.D. $36,333 KRUGER, NANCY $27,847 PHILLIPS, ROBERT A., M.D. $70,541 RANDOLPH, JOHN $0 SUBTOTAL KEY EMPLOYEES $383,910 FORMER O/D OR KEY EMPLOYEES CHANDLER, WILLIS $25,978 SUBTOTAL FORMER $25,978 TOTAL - ALL $801,145 SUPPLEMENTAL INFORMATION PART III PART II - DISCLOSURES: 1) DURING CY12 THE MAJORITY OF THE AMOUNT REPORTED IN JOHN O'BRIEN'S COLUMN C - COMPENSATION ($2,733,454) WAS DUE TO A PAYOUT OF RETIREMENT FUNDS REPRESENTING THE CULMINATION OF MANY YEARS OF RETIREMENT CONTRIBUTIONS, WHICH WERE PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN THOSE PRIOR YEARS. 2) JOHN O'BRIEN'S RETIREMENT AND OTHER DEFERRED COMPENSATION AMOUNT INCLUDES A CONTINGENT DEFERRED COMPENSATION ACCRUAL OF $626,633 WHICH REMAINS THE PROPERTY OF UMASS MEMORIAL UNTIL THE TERMS OF THE DEFERRED AGREEMENT IS FULFILLED. 3) THE ABOVE DIRECTORS RECEIVE NO COMPENSATION FOR THEIR ROLE AS DIRECTORS. ALL COMPENSATION RECEIVED RELATES TO THEIR POSITION AS A PHYSICIAN/ADMINISTRATOR. PART II - UNRELATED ORGANIZATION: THE OFFICERS, DIRECTORS AND HIGHEST COMPENSATED EMPLOYEES LISTED IN PART II THAT RECEIVED COMPENSATION FROM AN UNRELATED ORGANIZATION WERE PAID FOR THEIR SERVICES RELATED TO MEDICAL RESEARCH, EDUCATION OF MEDICAL STUDENTS AND RESIDENT TRAINING. AMOUNTS INCLUDE THEIR BASE COMPENSATION AND DEFERRED COMPENSATION FOR CALENDAR YEAR 2012. THE NAME OF THE UNRELATED ORGANIZATION IS UMASS MEDICAL SCHOOL. PART III - UNRELATED ORGANIZATION COMPENSATION ANDRIENI, JULIA, M.D. $96,164 BROWN, ALAN P., M.D. $63,278 CARLUCCI, DANIEL, M.D. $90,300 FERRUCCI, JOSEPH, M.D. $211,620 FINBERG, ROBERT W., M.D. $297,641 KENNEDY, KATHRYN, M.D. $35,698 LASSER, DANIEL H., M.D. $256,262 MESSINA, LOUIS, M.D. $70,870 METZMAKER, JEFFREY N., M.D. $130,596 ROSEN, MAX P., M.D. $75,888 ZIEDONIS, DOUGLAS, M.D. $212,405 LITWIN, DEMETRIUS, M.D. $277,880 TAM, STANLEY, M.D. $202,106 AROUS, ELIAS J., M.D. $145,918 AYERS, DAVID C., M.D. $166,965 BOZORGZADEH, ADEL, M.D. $131,616 TOTAL COMPENSATION $2,465,207 A MHEFA-UMASS MEMORIAL SERIES D 042456011 57586CLQ6 2005-08-18 107450000 SEE PART VI 0 0 0 B MHEFA-UMASS MEMORIAL VARIABLE RATE SERIES E 042456011 57586EH27 2009-05-22 30000000 SEE PART VI 0 0 0 C MHEFA-UMASS MEMORIAL VARIABLE RATE SERIES F 042456011 57586EH27 2009-05-22 30000000 SEE PART VI 0 0 0 D MHEFA-MARLBOROUGH HOSPITAL VARIABLE RATE SERIES A 042456011 2009-11-24 9420000 SEE PART VI 0 0 0 A 110212484 10709415 5411300 1384731 3118338 95000000 2006 0 0 1 1 B 1985000 30062453 335209 205455 29856998 2012 0 0 1 1 C 1985000 30062772 613645 118700 29944072 2012 0 0 1 1 D 757000 9420000 215838 93458 9326542 2009 1 0 1 1 A 0 0 1 1 0 0.00580 0.00580 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 D 0 0 0 0 0 0 1 A 1 0 0 0 0 0 B 1 1 0 0 0 1 C 1 1 0 0 0 1 D 1 1 0 0 0 1 A 1 B 1 C 1 D 1 PART I - BOND ISSUES (A) ISSUER NAME MHEFA - UMASS MEMORIAL, SERIES D MHEFA - UMASS MEMORIAL VARIABLE RATE, SERIES E MHEFA - UMASS MEMORIAL VARIABLE RATE, SERIES F MHEFA - MARLBOROUGH HOSPITAL VARIABLE RATE, SERIES A MHEFA - UMASS MEMORIAL MASTER LEASE MHEFA - UMASS MEMORIAL MASTER LEASE MHEFA - UMASS MEMORIAL MASTER LEASE MHEFA - UMASS MEMORIAL MASTER LEASE MHEFA - UMASS MEMORIAL, SERIES G MDFA - UMASS MEMORIAL MASTER LEASE MDFA - UMASS MEMORIAL, SERIES H MDFA - UMASS MEMORIAL, MASTER LEASE MDFA - UMASS MEMORIAL, MASTER LEASE PART I - BOND ISSUE MHEFA - UMASS MEMORIAL, SERIES D PART I COLUMN (C ) CUSIP #: 57586CLQ6 PART I COLUMN (F) DESCRIPTION OF PURPOSE: COMPLETION OF THE EXPANSION OF THE EMERGENCY DEPT AND ROUTINE CAPITAL EQUIPMENT AND/OR RENOVATION PROJECTS PART I - BOND ISSUE MHEFA - UMASS MEMORIAL VARIABLE RATE, SERIES E PART I COLUMN (C ) CUSIP #: 57586EH27 PART I COLUMN (F) DESCRIPTION OF PURPOSE: RENOVATION, EQUIPPING AND CONSTRUCTION FOR CLINICAL, SUPPORT SERVICE AND INFRASTRUCTURE PROJECTS PART I - BOND ISSUE MHEFA - UMASS MEMORIAL VARIABLE RATE, SERIES F PART I COLUMN (C ) CUSIP #: 57586EH27 PART I COLUMN (F) DESCRIPTION OF PURPOSE: RENOVATION, EQUIPPING AND CONSTRUCTION FOR CLINICAL, SUPPORT SERVICE AND INFRASTRUCTURE PROJECTS PART I - BOND ISSUE MHEFA - MARLBOROUGH HOSPITAL VARIABLE RATE, SERIES A PART I COLUMN (F) DESCRIPTION OF PURPOSE: PAY OFF HEFA POOL O LOAN, ER RENOVATIONS, EICU EQUIPMENT, CT SCAN LEASE, MAMMOGRAPHY UNIT PART I - BOND ISSUE MHEFA - UMASS MEMORIAL, SERIES G PART I COLUMN (C ) CUSIP #: 57586EUS8 - 57586EUT6 - 57586EUU3 - 57586EUV1 - 57586EUW9 - 57586EUX7 - 57586EVE8 - 57586EUY5 - 57586EVF5 - 57586EUZ2 - 57586EVG3 - 57586EVA6 - 57586EVH1 - 57586EVB4 - 57586EVJ7 - 57586EVC2 - 57586EVD0 PART I COLUMN (F) DESCRIPTION OF PURPOSE: REFUNDING OF CENTRAL NEW ENGLAND HEALTH ALLIANCE SERIES A BOND (1993) AND MEDICAL CENTER OF CENTRAL MASSACHUSETTS, SERIES B (1992) PART I - BOND ISSUE MHEFA - UMASS MEMORIAL, SERIES H PART I COLUMN (C ) CUSIP #: 57583UGP7 - 57583UGQ5 - 57583UGR3 - 57583UGS1 - 57583UGT9 - 57583UGU6 - 57583UGV4 - 57583UGW2 - 57583UHC5 - 57583UGX0 - 57583UGY8 - 57583UGZ5 - 57583UHA9 - 57583UHB7 PART I COLUMN (F) DESCRIPTION OF PURPOSE: PARTIAL REFUNDING OF MEDICAL CENTER VARIABLE RATE SERIES A BONDS (1998), REFUNDING IN FULL OF CENTRAL NEW ENGLAND HEALTH ALLIANCE SERIES B BONDS (1998) AND UMASS MEMORIAL SERIES C (2001). PART II - PROCEEDS DIFFERENCE BETWEEN PART I, COLUMN(E) AND PART II, LINE 3 MHEFA - UMASS MEMORIAL, SERIES D COLUMN (E) ISSUE PRICE OF $107,450,000; ADD ISSUE PREMIUM OF $604,814, ADD INTEREST EARNED ON PROCEEDS OF $3,118,338, LESS ISSUE DISCOUNT OF ($960,668), EQUALS LINE 3 OF $110,212,484. MHEFA - UMASS MEMORIAL VARIABLE RATE, SERIES E COLUMN (E) ISSUE PRICE OF $30,000,000; ADD INTEREST EARNED ON PROCEEDS OF $62,453, EQUALS LINE 3 OF $30,062,453. MHEFA - UMASS MEMORIAL VARIABLE RATE, SERIES F COLUMN (E) ISSUE PRICE OF $30,000,000; ADD INTEREST EARNED ON PROCEEDS OF $62,772, EQUALS LINE 3 OF $30,062,772. MHEFA - UMASS MEMORIAL MASTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $717,238, EQUALS LINE 3 OF $20,717,238. MHEFA - UMASS MEMORIAL MASTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $152,952, EQUALS LINE 3 OF $20,152,952. MHEFA - UMASS MEMORIAL MASTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $24,254, EQUALS LINE 3 OF $20,024,254. MHEFA - UMASS MEMORIAL, SERIES G COLUMN (E) ISSUE PRICE OF $60,445,000; ADD ISSUE PREMIUM OF $1,388,656 ADD INTEREST EARNED ON PROCEEDS OF $180, EQUALS LINE 3 OF $61,833,836 MHEFA - UMASS MEMORIAL MASTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $5,301, EQUALS LINE 3 OF $20,005,301. MDFA - UMASS MEMORIAL, SERIES H COLUMN (E) ISSUE PRICE OF $90,990,000; ADD ISSUE PREMIUM OF $1,303,778, EQUALS LINE 3 OF $92,293,778. MDFA - UMASS MEMORIAL MASTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $13,504, EQUALS LINE 3 OF $20,013,504. MDFA - UMASS MEMORIAL MSTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $280, EQUALS LINE 3 OF $20,000,280. A MHEFA-UMASS MEMORIAL MASTER LEASE 042456011 2005-12-07 10000000 CAPITAL EQUIPMENT 0 0 0 B MHEFA-UMASS MEMORIAL MASTER LEASE 042456011 2006-12-27 20000000 CAPITAL EQUIPMENT 0 0 0 C MHEFA-UMASS MEMORIAL MASTER LEASE 042456011 2008-04-24 20000000 CAPITAL EQUIPMENT 0 0 0 D MHEFA-UMASS MEMORIAL MASTER LEASE 042456011 2009-07-24 20000000 CAPITAL EQUIPMENT 0 0 0 A 10000000 10000000 10000000 2006 0 0 1 1 B 20000000 20717238 5102 26965 717238 19973035 2007 0 0 1 1 C 17904403 20152952 112621 29072 152952 19970928 2009 0 0 1 1 D 13461646 20024254 278569 28500 19971500 2010 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 D 0 0 0 0 0 0 1 A 1 0 0 0 0 1 B 1 0 0 0 0 1 C 1 0 0 0 0 1 D 1 0 0 0 0 1 A 1 B 1 C 1 D 1 A MHEFA-UMASS MEMORIAL SERIES G 042456011 57586EUS8 2010-05-27 60445000 SEE PART VI 0 0 0 B MHEFA-UMASS MEMORIAL MASTER LEASE 043431814 2010-12-09 20000000 CAPITAL EQUIPMENT 0 0 0 C MHEFA-UMASS MEMORIAL SERIES H 043431814 57583UGP7 2011-08-10 90990000 SEE PART VI 0 0 0 D MDFA-UMASS MEMORIAL MASTER LEASE 043431814 2011-12-28 20000000 CAPITAL EQUIPMENT 0 0 0 A 13845000 61833836 2463488 60734797 1099039 2010 0 0 1 1 B 8924389 20005301 209682 33031 5301 19966969 2011 0 0 1 1 C 5090000 92293778 4458468 910585463 1235315 2011 1 0 1 1 D 5637961 20013504 260626 29000 13504 19971000 2012 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 D 0 0 0 0 0 0 1 A 1 0 0 0 0 1 B 1 0 0 0 0 1 C 1 0 0 0 0 1 D 1 0 0 0 0 1 A 1 B 1 C 1 D 1 A MDFA-UMASS MEMORIAL MASTER LEASE 043431814 2013-08-14 20000000 CAPITAL EQUIPMENT 0 0 0 A 268438 20000280 19167 36810 280 13939920 6023270 2013 0 0 0 1 A 0 0 0 0 0 0 1 A 0 0 0 0 0 0 0 0 1 A 1 FLOYD CONNELLY FORMER EXECUTIVE DIRECTOR OF CMMIC, INC. CSV OF LIFE INSURANCE X 455570 251480 0 1 1 THOMAS CUMMINGS FORMER CEO OF MARLBOROUGH HOSPITAL CSV OF LIFE INSURANCE X 377630 200437 0 1 1 RICHARD H SCHEFFER FORMER CEO OF WING MEMORIAL CORP. CSV OF LIFE INSURANCE X 26660 29324 0 1 1 WILLIAM J WILLIAMS FORMER OFFICER OF HEALTHALLIANCE HOSPITALS, INC. CSV OF LIFE INSURANCE X 1981627 3714699 0 1 1 4195940 ROBERT KLUGMAN MD KEY EMPLOYEE 209777 RENTAL OF PROPERTY - EXPENSE 0 FERNANDO CATALINA MD CURRENT DIRECTOR 311508 RENTAL OF PROPERTY - INCOME 0 MICHAEL J LYONS MD CURRENT DIRECTOR 311508 RENTAL OF PROPERTY - INCOME 0 JOHN CLEMENTI CURRENT DIRECTOR 35324 RENTAL OF PROPERTY - EXPENSE 0 ANTHONY J MERCADANTE CURRENT DIRECTOR & FAMILY MEMBER OF NICHOLAS MERCADANTE 207108 INDEPENDENT CONTACTOR ARRANGEMENT 0 EDWARD MANZI CURRENT DIRECTOR 206570 RENTAL OF PROPERTY - EXPENSE 0 ERIC W DICKSON MD CURRENT OFFICE & DIRECTOR 130000 INDEPENDENT CONTRACTOR ARRANGEMENT 0 ROBERT HAVELES CURRENT DIRECTOR 29668 INDEPENDENT CONTACTOR ARRANGEMENT 0 WILLIAM F SULLIVAN SR CURRENT DIRECTOR 254656 INDEPENDENT CONTACTOR ARRANGEMENT 0 JOHN BUDD CURRENT DIRECTOR 586332 INDEPENDENT CONTACTOR ARRANGEMENT 0 KATHLEEN HYLKA FAMILY MEMBER OF SHARON HYLKA, KEY EMPLOYEE 98045 EMPLOYMENT ARRANGEMENT 0 JOANNE D'ONFRO FAMILY MEMBER OF PAUL D'ONFRO, DIRECTOR 51279 EMPLOYMENT ARRANGEMENT 0 ELLEN CARLUCCI FAMILY MEMBER OF DANIEL CARLUCCI, MD, DIRECTOR 115593 EMPLOYMENT ARRANGEMENT 0 CHERYL SWENSON RN FAMILY MEMBER OF DANA SWENSON, DIRECTOR 15911 EMPLOYMENT ARRANGEMENT 0 KATHRYN C MAY FAMILY MEMBER OF DEBORAH EKSTROM, OFFICER 41688 EMPLOYMENT ARRANGEMENT 0 EILEEN HENRICKSON RN FAMILY MEMBER OF DEBORAH EKSTROM, OFFICER 114468 EMPLOYMENT ARRANGEMENT 0 KAREN BUCKLEY RN FAMILY MEMBER OF MARY CARLSON, DIRECTOR 62718 EMPLOYMENT ARRANGEMENT 0 ELAINE GRANVILLE RN FAMILY MEMBER OF CHERYL LAPRIORE, KEY EMPLOYEE 64064 EMPLOYMENT ARRANGEMENT 0 JOSHUA P SZYMANSKI FAMILY MEMBER OF CANDRA SZYMANSKI, CURRENT OFFICER & DIRECTOR 27048 EMPLOYMENT ARRANGEMENT 0 PART II - LOANS FROM INTERESTED PERSONS THE CASH VALUE OF LIFE INSURANCE POLICIES: NAME OF INTERESTED PERSON, TITLE, ORIGINAL PRINCIPAL AMOUNT, BALANCE DUETHOMAS CUMMINGS, FORMER CEO OF MARLBOROUGH HOSPITAL, $377,630, $200,437RICHARD H. SCHEFFER, FORMER CEO OF WING MEMORIAL CORP., $26,660, $29,324WILLIAM J. WILLIAMS, FORMER OFFICER OF HEALTHALLIANCE HOSPITALS, INC., $1,981,627, $3,714,699FLOYD CONNELLY, FORMER DIRECTOR OF CMMIC, INC., $455,570, $251,480TOTAL ORIGINAL PRINCIPAL AMOUNT $2,841,487TOTAL BALANCE DUE $4,195,940AMOUNTS DUE FROM CURRENT AND FORMER OFFICERS PERTAIN TO SPLIT DOLLAR LIFE INSURANCE POLICIES OF THE RESPECTED INDIVIDUALS. THESE POLICIES WERE ORIGINATED AT VARIOUS TIMES DURING THE INSURED'S EMPLOYMENT WITH UMASS MEMORIAL HEALTH CARE, INC. THE CORRESPONDING POLICY PREMIUMS WERE FUNDED BY THE EMPLOYER AS AN EMPLOYEE BENEFIT. IN ACCORDANCE WITH IRS NOTICE 2002-8, TREASURY REGULATION 1.61-22 AND TREASURY REGULATION 1.7872-15, THESE PAYMENTS REQUIRE CLASSIFICATION AS LOANS DUE FROM THE INSURED. THESE LOAN BALANCES ARE REFLECTED AT THE LOWER OF THE DISCOUNTED CASH SURRENDER VALUE OR DISCOUNTED CUMULATIVE PREMIUMS PAID. PART IV - BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS SEVERAL OF OUR COMMUNITY HOSPITALS MAINTAIN LOCAL BANKING RELATIONSHIPS IN THEIR RESPECTIVE COMMUNITIES, WHICH HAVE BEEN ASSESSED AND MEET FAIR MARKET VALUE REQUIREMENTS. THE VALUE OF THESE RESPECTIVE RELATIONSHIPS ARE WELL BELOW THE DISCLOSURE THRESHOLDS. X 3831 159892 FMV/SELLING PRICE 0 1 1 THIRD PARTY USE: PART I, LINE 32B: UMASS MEMORIAL HEALTH CARE, INC. UTILIZES THE SERVICES OF UMASS MEMORIAL FOUNDATION, INC. TO SOLICIT DONOR CONTRIBUTIONS, ON OCCASION, THE ORGANIZATION RECEIVES GIFTS OF PUBLICLY TRADED STOCK. ALL GIFTS OF PUBLICLY TRADED STOCK ARE IMMEDIATELY SOLD UPON RECEIPT THROUGH AN INVESTMENT SERVICES FIRM. CASH 2012-10-01 1107898 BOOK VALUE 043358564 UMASS MEMORIAL MEDICAL CENTER INC 306 BELMONT STREET WORCESTER MA 01604 501(C)(3) NOTES RECEIVABLE 2012-10-01 1139661 BOOK VALUE 043358564 UMASS MEMORIAL MEDICAL CENTER INC 306 BELMONT STREET WORCESTER MA 01604 501(C)(3) FIXED ASSETS 2012-10-01 2848278 BOOK VALUE 043358564 UMASS MEMORIAL MEDICAL CENTER INC 306 BELMONT STREET WORCESTER MA 01604 501(C)(3) INVESTMENTS 2012-10-01 6339355 BOOK VALUE 043358564 UMASS MEMORIAL MEDICAL CENTER INC 306 BELMONT STREET WORCESTER MA 01604 501(C)(3) OTHER ASSETS 2012-10-01 1314290 BOOK VALUE 043358564 UMASS MEMORIAL MEDICAL CENTER INC 306 BELMONT STREET WORCESTER MA 01604 501(C)(3) 1 0 0 0 1 1 1 1 0 SEVERAL OF THE DIRECTORS OF THE ORGANIZATION ARE ALREADY OFFICERS AND/OR DIRECTORS OF THE TRANSFEREE ORGANIZATION, BOTH ORGANIZATIONS ARE INCLUDED IN THIS GROUP RETURN - GROUP EXEMPTION #3642THIS INCLUDES:JOHN G. O'BRIENEDWARD J. PARRY, IIIPAUL KANGASJOHN H. BUDDUMASS MEMORIAL LABORATORIES, INC. WAS MERGED INTO ANOTHER ORGANIZATION WITHIN THE UMASS MEMORIAL SYSTEM.SEE ATTACHED MERGER DOCUMENTS FORM 990, PART VI, SECTION A, LINE 2 DISCLOSURE YEAR, DISCLOSING INDIVIDUAL, TITLE/ROLE, RELATIONSHIP WITH, RELATIONSHIP UMMHC 2012 - BUDD, JOHN, BOARD MEMBER, PAUL D'ONFRO (BUSINESS), ARTHUR BERGERON (BUSINESS) 2012 - PHILLIPS, ROBERT, KEY EMPLOYEE, JULIA ANDRIENI (FAMILY) VENTURES 2012, NONE MEDICAL GROUP 2012, NONE MEMBER ENTITIES HEALTH ALLIANCE 2012 - CLEMENTE, JOHN, BOARD MEMBER, 80 ERDMAN WAY LLC (BUSINESS) 2012 - CATALINO, FERNANDO, BOARD MEMBER, GAIL ALLEN (BOARD MEMBER), NORMAN BOUDREAU (BOARD MEMBER), DONATA MARTIN (BOARD MEMBER), BOYS & GIRLS CLUB (BOARD MEMBER) 2012 - MERCANDANTE, ANTHONY, BOARD MEMBER, NICHOLAS MERCANDANTE (FAMILY) 2012 - MERCANDANTE, NICHOLAS, BOARD MEMBER, ANTHONY MERCANDANTE (FAMILY) CHL 2012 - EKSTROM, DEBORAH, BOARD MEMBER, FIDELITY MUTUAL HOLDING COMPANY (BOARD MEMBER) & FIDELITY COOPERATIVE BANK (BUSINESS) MARLBOROUGH 2012 - CARLUCCI, DANIEL, BOARD MEMBER, ELLEN CARLUCCI (FAMILY( 2012 - BERGERON, ARTHUR, BOARD MEMBER, MARLBOROUGH CANCER CENTER (BUSINESS) WING 2012 - COOLIDGE, KATHERINE, BOARD MEMBER, EDWARD NOONAN (BUSINESS), JAMES PHANEUF (BUSINESS), PAUL SCULLY (BUSINESS) 2012 - PHANEUF, JAMES, BOARD MEMBER, CHARLES CAVAGNARO (BUSINESS), EDWARD NOONAN (BUSINESS), ROBERT S. HAVELES (BUSINESS), JAMES ST. AMAND (BUSINESS), PAUL SCULLY (BUSINESS), KATHERINE COOLIDGE (BUSINESS) 2012 - MITCHELL, LINDA, BOARD MEMBER, STEVEN LOWELL (BUSINESS), RON CHRISTIANSEN (BUSINESS), PAUL SCULLY (BUSINESS), PATRICK TURLEY (BUSINESS), ROBERT S. HAVELES (BUSINESS) 2012 - NOONAN, EDWARD, BOARD MEMBER, CHARLES CAVAGNARO (BUSINESS), JAMES ST. AMAND (BUSINESS), JAMES PHANEUF (BUSINESS), KATHERINE COOLIDGE (BUSINESS), ROBERT S. HAVELES (BUSINESS), PATRICK TURLEY (BUSINESS), LAUREN MILLER (BUSINESS), ELAINE ANDERSON (BUSINESS) 2012 - TURLEY, PATRICK, BOARD MEMBER, EDWARD NOONAN (BUSINESS), RON CHRISTIANSEN (BUSINESS), PAUL SCULLY (BUSINESS) 2012 - HAVELES, ROBERT, BOARD MEMBER, EDWARD NOONAN (BUSINESS), JAMES PHANEUF (BUSINESS), PAUL SCULLY (BUSINESS) , JAMES ST. ARMAND (BUSINESS) 2012 - CHRISTIANSEN, RONALD, BOARD MEMBER, LINDA MITCHELL (BUSINESS), PATRICK TURLEY (BUSINESS) 2012 - SCULLY, PAUL, BOARD MEMBER, RON CHRISTIANSEN (BUSINESS), PATRICK TURLEY (BUSINESS), ROBERT HAVELES (BUSINESS), JAMES PHANEUF (BUSINESS), CHARLES CAVAGNARO (BUSINESS), KATHERINE COOLIDGE (BUSINESS), LINDA MITCHELL (BUSINESS), ELAINE ANDERSON (BUSINESS) 2012 - ANDERSON, ELAINE, BOARD MEMBER, EDWARD NOONAN (BUSINESS) CLINTON 2012 - NONE FORM 990, PART VI, SECTION A, LINE 6 THERE ARE NO CLASSES OF DIRECTORS. THE VOTING RIGHTS OF EACH MEMBER'S BOARD IS ABSOLUTE. FORM 990, PART VI, SECTION A, LINE 7A THE MAJORITY OF ENTITIES IN THE CONSOLIDATED GROUP HAVE A SOLE MEMBER (WHICH IS ALSO WITHIN THE CONSOLIDATED GROUP) THAT ELECTS THE BOARD OF TRUSTEES. THERE ARE NO CLASSES OF TRUSTEES. THE MAJORITY OF THE ENTITIES RESERVE TO THE MEMBER THE POWER TO REMOVE TRUSTEES, TO FILL VACANCIES, AND TO INCREASE OR DECREASE THE SIZE OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 7B THE MAJORITY OF THE ENTITIES IN THE CONSOLIDATED GROUP HAVE A SOLE MEMBER (WHICH IS ALSO WITHIN THE CONSOLIDATED GROUP) WITH THE RIGHT TO APPROVE OR RATIFY DECISIONS OF THE ENTITY, WHICH IS EXERCISED BY THAT MEMBER'S BOARD OF TRUSTEES. THERE ARE NO CLASSES OF TRUSTEES OR MEMBERS. THUS, THE VOTING RIGHTS OF A MEMBER BOARD ARE ABSOLUTE. GENERALLY, THE SOLE MEMBER OF EACH ENTITY RESERVES THE POWER TO APPROVE MAJOR TRANSACTIONS; TO MERGE, CONSOLIDATE OR LIQUIDATE THE CORPORATION'S ASSETS; TO ADOPT ANNUAL OPERATING AND CAPITAL BUDGETS AND AMENDMENTS; TO ENTER INTO LOAN AGREEMENTS AND/OR GUARANTEES; TO APPOINT AND/OR ELECT THE PRESIDENT AND/OR CEO; TO ELECT AND/OR APPOINT AND REMOVE TRUSTEES, FILL VACANCIES, TO INCREASE OR DECREASE THE SIZE OF THE BOARD; AND TO APPROVE UNBUDGETED EXPENDITURES. FORM 990, PART VI, SECTION B, LINE 11 SECTIONS OF THE CORE FORM 990 RELATED TO EXECUTIVE COMPENSATION AND SCHEDULE J ARE REVIEWED IN DETAIL WITH THE ORGANIZATION'S COMPENSATION COMMITTEE OF THE BOARD. THE COMPLIANCE COMMITTEE OF THE BOARD REVIEWS ALL CONTENT ASSOCIATED WITH SCHEDULE L. THE AUDIT COMMITTEE OF THE BOARD REVIEWS THE FORM 990, INCLUDING THE ABOVE SCHEDULES AND RECOMMENDS THE FORM 990 TO THE FULL BOARD FOR APPROVAL. THE FULL BOARD IS GIVEN ACCESS TO THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C PAGE 6 SECTION B. POLICIES LINE 12C: THE CONFLICT OF INTEREST POLICY REQUIRES BOARD MEMBERS AND MANAGEMENT TO COMPLETE ANNUAL DISCLOSURE STATEMENTS AND, TO UPDATE THESE DISCLOSURE STATEMENTS FOR SIGNIFICANT CHANGES IN THEIR OUTSIDE GOVERNANCE AND PROFESSIONAL ACTIVITIES OR, FINANCIAL RELATIONSHIPS AS APPROPRIATE. ADDITIONALLY, ALL TRANSACTIONS INVOLVING BOARD MEMBERS OR MANAGEMENT AND THE ORGANIZATION ARE REQUIRED TO BE APPROVED BY THE COMPLIANCE COMMITTEE OF THE BOARD AND, THERE IS ACTIVE MONITORING AND COMMUNICATION TO ENSURE INDIVIDUALS WITH OUTSIDE RELATIONSHIPS DO NOT INAPPROPRIATELY PARTICIPATE IN BUSINESS DECISIONS OF THE ORGANIZATION, PURCHASING OR RESEARCH DECISIONS. FORM 990, PART VI, SECTION B, LINE 15 PAGE 6 SECTION B. POLICIES LINE 15B: AT UMASS MEMORIAL, ALL COMPENSATION MATTERS FOR THE CEO AND SENIOR EXECUTIVES THROUGHOUT THE SYSTEM (INCLUDING ALL "DISQUALIFIED PERSONS") ARE GOVERNED AND OVERSEEN BY THE BOARD OF TRUSTEES OF THE PARENT. THE BOARD APPROVED A COMPENSATION PHILOSOPHY THAT GOVERNS ALL SUCH DECISIONS. THE PHILOSOPHY INCLUDES THE OBJECTIVES OF THE PROGRAM, COMPONENTS OF EXECUTIVE COMPENSATION, THE RELEVANT MARKET, POSITIONING IN THE MARKET, FACTORS CONSIDERED IN SETTING EXECUTIVE COMPENSATION AND THE IMPORTANCE OF TYING SUCH COMPENSATION TO PERFORMANCE. THE BOARD ESTABLISHED A COMPENSATION COMMITTEE, MADE UP OF DISINTERESTED TRUSTEES, WHO ARE GIVEN THE AUTHORITY TO ESTABLISH COMPENSATION FOR ALL SENIOR EXECUTIVES, WITHIN THE PARAMETERS OF THE PHILOSOPHY, AND WITH FULL AND COPMLETE REPORTING TO THE FULL BOARD. THE COMPENSATION COMMITTEE PERFORMS ITS WORK PURSUANT TO ITS CHARTER AND A COMPENSATION POLICY THAT ESTABLISHES THE PROCESS THE COMMITTEE WILL FOLLOW IN REVIEWING AND APPROVING EXECUTIVE COMPENSATION EACH YEAR. THE COMMITTEE ENSURES THAT ITS PROCESS MEETS THE REBUTABLE PRESUMPTION OF REASONABLENESS ESTABLISHED BY THE IRS. IN ORDER TO ASSIST THE COMMITTEE IN ITS RESPONSIBILITIES, THE COMPENSATION COMMITTEE HIRES INDEPENDENT, OUTSIDE COMPENSATION CONSULTANTS TO ADVISE THE COMMITTEE AND THE BOARD ON THE REASONABLENESS OF OVERALL EXECUTIVE COMPENSATION PROGRAM, INCLUDING COMPENSATION OF THE SPECIFIC EXECUTIVES. THESE CONSULTANTS REPORT DIRECTLY TO THE COMMITTEE AND NOT TO MANAGEMENT. THE COMMITTEE WORKS WITH THESE CONSULTANTS, AND WITH LEGAL COUNSEL, TO ENSURE THAT ALL COMPENSATION PAID, AS WELL AS THE PROCESS FOLLOWED TO DETERMINE SUCH COMPENSATION, IS REASONABLE, MEETS ALL REGULATORY REQUIREMENTS AND IS COMPETITIVE WITH THE RELEVANT MARKET. FORM 990, PART VI, SECTION C, LINE 19 PAGE 6: LINE 19 UMASS MEMORIAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AS REQUIRED BY APPLICABLE STATE AND FEDERAL LAWS, AND BY REQUEST ON A CASE-BY-CASE BASIS. PAGE 8 PART VII SECTION B. INDEPENDENT CONTRACTORS - DESCRIPTION OF SERVICE DESCRIPTION OF SERVICES FOOTNOTE A - SPECIALTY TRADE CONTRACTORS: SUBCONTRACTS TO A VARIETY OF EXHIBIT AND MARKETING SERVICES INCLUDING BUT NOT LIMITED TO: GENERAL CONSULTATION, COST OF MATERIALS AND SUPPLIES, DESIGN, CONSTRUCTION, LABORERS. THIS VENDOR MAY ALSO SUPPLY THEIR OWN LABORERS AS OPPOSED TO SUBCONTRACT. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: NET ASSETS RELEASED FROM RESTRICTIONS FOR OPERATIONS 4,120,073. PENSION RELATED CHANGES OTHER THAN NET PERIODIC BENEFIT COST 177,914,762. CHANGE IN BENEFICIAL INTERESTS IN PERPETUAL TRUSTS 2,102,136. MISCELLANEOUS -19,152. NET ASSETS RELEASED FROM RESTRICTION FOR PPE 740,737. TEMPORARY RESTRICTED FUND EXPENDITURES -4,837,792. GAIN/(LOSS) ON DISCONTINUED OPERATIONS -1,534,089. ALLOWANCE FOR UNCOLLECTIBLE PLEDGES 2,474. K-1 ACTIVITY FROM PARTNERSHIPS 850,880. TRANSFERS TO RELATED PARTIES 100,935. GROUP RETURN PAGE 1, LINE H(B) LIST OF AFFILIATED ORGANIZATIONS THE CLINTON HOSPITAL ASSOCIATION; 201 HIGHLAND STREET, CLINTON, MA 01510 EIN: 04-1185520 FISCAL YEAR END: 9/30/2012 MARLBOROUGH HOSPITAL; 157 UNION STREET, MARLBOROUGH, MA 01752 EIN: 04-2104693 FISCAL YEAR END: 9/30/2012 UMASS MEMORIAL BEHAVIORAL HEALTH SYSTEM, INC.; 306 BELMONT STREET, WORCESTER, MA 01604 EIN: 04-3374724 FISCAL YEAR END: 9/30/2012 UMASS MEMORIAL HOSPITALS, INC.; 306 BELMONT STREET, WORCESTER, MA 01604 EIN: 04-3296271 FISCAL YEAR END: 9/30/2012 UMASS MEMORIAL HEALTH VENTURES, INC.; 306 BELMONT STREET, WORCESTER, MA 01604 EIN: 22-2605679 FISCAL YEAR END: 9/30/2012 UMASS MEMORIAL LABORATORIES, INC.; 306 BELMONT STREET, WORCESTER, MA 01604 EIN: 04-3321703 FISCAL YEAR END: 9/30/2012 UMASS MEMORIAL MEDICAL CENTER, INC.; 306 BELMONT STREET, WORCESTER, MA 01604 EIN: 04-3358564 FISCAL YEAR END: 9/30/2012 UMASS MEMORIAL MEDICAL GROUP, INC.; 306 BELMONT STREET, WORCESTER, MA 01604 EIN: 04-2911067 FISCAL YEAR END: 9/30/2012 UMASS MEMORIAL REALTY, INC.; 306 BELMONT STREET, WORCESTER, MA 01604 EIN: 04-2805630 FISCAL YEAR END: 9/30/2012 WING MEMORIAL HOSPITAL CORP.; 40 WRIGHT STREET, PALMER, MA 01069 EIN: 22-2519813 FISCAL YEAR END: 9/30/2012 UMASS MEMORIAL HEALTH CARE, INC. (PARENT); 306 BELMONT STREET, WORCESTER, MA 01604 EIN: 04-3358566 FISCAL YEAR END: 9/30/2012 COMMUNITY HEALTHLINK, INC.; 72 JAQUES AVENUE, WORCESTER, MA 01610 EIN: 04-2626179 FISCAL YEAR END: 9/30/2012 CENTRAL MASSACHUSETTS MAGNETIC IMAGING CENTER, INC.; 367 PLANTATION STREET, WORCESTER, MA 01605 EIN: 04-2981362 FISCAL YEAR END: 9/30/2012 CENTRAL NEW ENGLAND HEALTHALLIANCE, INC.; 60 HOSPITAL ROAD, LEOMINSTER, MA 01453 EIN: 04-3172496 FISCAL YEAR END: 9/30/2012 COORDINATED PRIMARY CARE, INC.; 60 HOSPITAL ROAD, LEOMINSTER, MA 01453 EIN: 04-3210002 FISCAL YEAR END: 9/30/2012 HEALTHALLIANCE HOME HEALTH AND HOSPICE, INC.; 25 TUCKER ROAD, LEOMINSTER, MA 01453 EIN: 04-2932308 FISCAL YEAR END: 9/30/2012 HEALTHALLIANCE HOSPITALS, INC.; 60 HOSPITAL ROAD, LEOMINSTER, MA 01453 EIN: 04-2103555 FISCAL YEAR END: 9/30/2012 CAITLIN RAYMOND INTERNATIONAL REGISTRY, INC.; 306 BELMONT STREET, WORCESTER, MA 01604 EIN: 06-1749208 FISCAL YEAR END: 9/30/2012 CLINTON HOSPITAL FOUNDATION, INC.; 306 BELMONT STREET, WORCESTER, MA 01604 EIN: 04-3357881 FISCAL YEAR END: 9/30/2012 COMMUNITY INFORMATION - CONTINUED FROM SCHEDULE H SCHEDULE H, PART VI - SUPPLEMENTAL INFORMATION - CONTINUED MARLBOROUGH HOSPITAL: BETWEEN 2000 AND 2011, MARLBOROUGH EXPERIENCED THE GREATEST POPULATION INCREASED FROM 36,255 TO 38,087 (5.1%), NEARLY TWICE AS LARGE OF A PERCENT CHANGE AT THE STATE LEVEL (2.6%). HUDSON'S POPULATION ALSO EXCEEDED THE STATE'S POPULATION AT 4.0%. IN TERMS OF AGE DISTRIBUTION, MOST OF MARLBOROUGH'S POPULATION WAS BETWEEN THE AGES OF 25 TO 44 YEARS OLD (32.4%) WHILE HUDSON'S POPULATION HAD THE GREATEST PERCENT BETWEEN 45 TO 64 YEARS OLD (29.7%). QUANTITATIVE DATA ALSO ILLUSTRATE THAT JUST OVER THREE-FOURTHS OF THE MASSACHUSETTS POPULATION IS WHITE (76.9%) WHICH WAS LARGELY CONSISTENT WITH MARLBOROUGH (79.2%). BOTH AT THE STATE LEVEL AND IN MARLBOROUGH, THE HISPANIC POPULATION WAS THE NEXT LARGEST RACIAL/ETHNIC GROUP (9.3% AND 9.2%, RESPECTIVELY). HUDSON'S POPULATION FOLLOWED A SIMILAR PATTERN, THE PROPORTION OF ITS POPULATION THAT IDENTIFIED AS WHITE WAS EVEN LARGER (90.5%). ENGLISH, PORTUGUESE AND SPANISH ARE THE PREDOMINANT LANGUAGE FOR THE COMMUNITIES THE HOSPITAL SERVES. WING MEMORIAL HOSPITAL: THE COMMUNITY WING MEMORIAL HOSPITAL AND MEDICAL CENTERS SERVES INCLUDES 17 TOWNS IN HAMPDEN, WORCESTER AND HAMPSHIRE COUNTIES: AGAWAM, BELCHERTOWN, BRIMFIELD, CHICOPEE, EAST LONGMEADOW, HAMPDEN, HOLLAND, LONGMEADOW, LUDLOW, MONSON, PALMER, SPRINGFIELD, WALES, WARE, WARREN, WEST BROOKFIELD AND WILBRAHAM. THE TOWNS THAT MAKE UP THE PRIMARY SERVICE AREA INCLUDE: BELCHERTOWN, LUDLOW, MONSON, PALMER, WARREN AND WILBRAHAM. THE TOWNS THAT MAKE UP THE SECONDARY SERVICE AREA INCLUDE: BRIMFIELD, GRANBY, HAMPDEN, WALES AND WARE. TARGET POPULATIONS FOR WING MEMORIAL'S COMMUNITY BENEFITS INITIATIVES FOCUS ON MEDICALLY-UNDERSERVED AND VULNERABLE GROUPS OF ALL AGES IN WING MEMORIAL'S SERVICE AREA. THE MOST VULNERABLE POPULATIONS INCLUDE CHILDREN, ELDERS, INDIVIDUALS WHO ARE OBESE/OVERWEIGHT, THOSE LIVING IN POVERTY, AND THE UNDERINSURED/UNINSURED. CLINTON HOSPITAL ASSOCIATION: TARGET POPULATIONS FOR CLINTON HOSPITAL'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COMMUNITY INPUT AND PLANNING PROCESS, COLLABORATIVE EFFORTS WITH A BROAD ARRAY OF STAKEHOLDERS, AND THE DEVELOPMENT OF A COMMUNITY HEALTH NEEDS ASSESSMENT (CHA) WHICH IS CONDUCTED EVERY THREE YEARS. CLINTON HOSPITAL COLLABORATES WITH THE COMMUNITY HEALTH NETWORK AREA 9 (CHNA 9); A LOCAL COALITION OF PUBLIC, NON-PROFIT, AND PRIVATE SECTORS WORKING TOGETHER TO BUILD HEALTHIER COMMUNITIES IN MASSACHUSETTS THROUGH COMMUNITY-BASED PREVENTION PLANNING AND HEALTH PROMOTION. OTHER PARTNERS INCLUDE KEY STAKEHOLDERS SUCH AS: RESIDENTS, CONSUMERS, COALITIONS, COMMUNITIES OF FAITH, BUSINESSES, SCHOOLS, HEALTH AND HUMAN SERVICE ORGANIZATIONS AND LOCAL AND STATE GOVERNMENTS. OUR TARGET POPULATIONS FOCUS ON MEDICALLY-UNDERSERVED AND VULNERABLE GROUPS OF ALL AGES, AS FOLLOWS: - ELDERLY - YOUTH/CHILDREN - POPULATIONS LIVING IN POVERTY - UNDERSERVED/UNINSURED - ETHNIC AND LINGUISTIC MINORITIES CLINTON HOSPITAL PRIMARILY SERVES THE COMMUNITIES OF CLINTON, BERLIN, BOLTON, LANCASTER AND STERLING WITH POPULATIONS OF 13,606, 2,866, 4,897, 7,582 AND 9,564 RESPECTIVELY. THE POPULATION OF THE TOTAL SERVICE AREA IS 36,759. CLINTON HAS A POPULATION OF 13,606. THE MAJORITY OF CLINTON RESIDENTS ARE WHITE NON-HISPANIC (84%), FOLLOWED BY HISPANIC (11.6%) AND BLACK NON-HISPANIC (1.80%). THE CLINTON HOSPITAL SERVICE AREA IS ALSO PRIMARILY WHITE NON-HISPANIC (88%), FOLLOWED BY HISPANIC (6.4%), AND BLACK NON-HISPANIC (2.8%). CLINTON HOSPITAL'S COMMUNITY BENEFITS PLAN FOCUSES ON THE NEEDS OF CLINTON DUE TO ITS LARGE CONCENTRATION OF DIVERSE, VULNERABLE POPULATIONS. UMASS MEMORIAL FOUNDATION INC 333 SOUTH STREET SHREWSBURY MA 01545 043108190 FUNDRAISING SUPPORT MA 501(C)(3) 11C N/A 0 HEALTH ALLIANCE REALTY CORPORATION 60 HOSPITAL ROAD LEOMINSTER MA 01473 042560754 REAL ESTATE MANAGEMENT MA 501(C)(3) N/A N/A 0 UMASS MEMORIAL INVESTMENT PARTNERSHIP LLP ONE BIOTECH PARK 355 PLANTATION ST WORCESTER MA 01605 043530755 INVESTMENT MANAGEMENT MA N/A EXCLUDED 514 42700567 424244029 0 -423 1 1.00000 UMASS MEMORIAL MRI OF MARLBOROUGH LLC 157 UNION STREET MARLBOROUGH MA 01752 202293995 MAGNETIC RESONANCE IMAGING MA MARLBOROUGH HOSPITAL RELATED 554282 337933 0 0 0.56000 UMASS MEMORIAL HEALTH ALLIANCE MRI CENTER LLC 60 HOSPITAL ROAD LEOMINSTER MA 01453 043561571 MAGNETIC RESONANCE IMAGING MA N/A RELATED 989029 1245441 0 0 0.60000 COMMONWEALTH PROFESSIONAL ASSURANCE CO LTD PO BOX 1051 GT GRAND CAYMAN CJ 980226143 INSURANCE CJ N/A C 6015243 174115169 1.00000 0 MEMORIAL OFFICE CONDOMINIUM TRUST 306 BELMONT STREET WORCESTER MA 01604 046616900 CONDOMINIUM ASSOCIATION MA UMASS MEMORIAL MEDICAL CENTER INC T 484255 0.53690 0 BIO-LAB INC 215 WEST STREET MILFORD MA 01757 042708828 CLINICAL LABORATORY MA UMASS MEMORIAL HEALTH VENTURES INC S 699142 1059405 1.00000 0 116 BELMONT ST INC CO APPLETON CORP 57 SUFFOLK STREET HOLYOKE MA 01040 042717865 CONDOMINIUM ASSOCIATION MA UMASS MEMORIAL REALTY INC C 465 97010 0.63040 0 0 1 1 0 0 0 0 0 0 1 0 1 0 1 0 1 1 0 0 COMMONWEALTH PROFESSIONAL ASSURANCE COMPANY LTD L 24387201 FAIR VALUE UMASS MEMORIAL MEDICAL CENTER INC B 2091975 FAIR VALUE UMASS MEMORIAL MEDICAL GROUP INC Q 83803 FAIR VALUE UMASS MEMORIAL MEDICAL GROUP INC L 2895540 FAIR VALUE UMASS MEMORIAL MEDICAL GROUP INC N 814423 FAIR VALUE WING MEMORIAL HOSPITAL CORPORATION Q 300000 FAIR VALUE UMASS MEMORIAL REALTY INC J 4411002 FAIR VALUE UMASS MEMORIAL HEALTH VENTURES INC P 367632 FAIR VALUE UMASS MEMORIAL REALTY INC P 369228 FAIR VALUE MARLBOROUGH HOSPITAL P 2039339 FAIR VALUE THE CLINTON HOSPITAL ASSOCIATION P 1388103 FAIR VALUE WING MEMORIAL HOSPITAL CORPORATION P 2192554 FAIR VALUE WING MEMORIAL HOSPITAL CORPORATION N 94515 FAIR VALUE CENTRAL NEW ENGLAND HEALTH ALLIANCE INC P 3526765 FAIR VALUE UMASS MEMORIAL MEDICAL CENTER INC P 145815172 FAIR VALUE UMASS MEMORIAL MEDICAL GROUP INC P 38719918 FAIR VALUE CENTRAL MASSACHUSETTS MAGNETIC IMAGING CENTER INC P 135084 FAIR VALUE COMMUNITY HEALTHLINK INC P 596650 FAIR VALUE COMMONWEALTH PROFESSIONAL ASSURANCE COMPANY LTD P 21365213 FAIR VALUE UMASS MEMORIAL MEDICAL CENTER INC C 58695581 FAIR VALUE