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FAIRVIEW HOSPITAL: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
FAIRVIEW HOSPITAL (EIN 04-2133860)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-15
IRS object ID
201402279349302230
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-08-15T10:45:33-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN042133860EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1FAIRVIEW HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlFAIRNameControl
Phone4134472508Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1725 NORTH STREETAddressLine1
CityPITTSFIELDCity
StateMAState
ZIP Code012014109ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDARLENE RODOWICZName
TitleCFOTitle
Phone4134472809Phone
Date Signed2014-08-15DateSigned
Authorize Third Party0AuthorizeThirdParty
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDARLENE RODOWICZNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1725 NORTH STAddressLine1
CityPITTSFIELDCity
StateMAState
ZIP Code012014109ZIPCode
FieldValueIRS element (for citing)
Gross Receipts50662181GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.BHS1.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1912YearFormation
State Legal DomicileMAStateLegalDomicile
Activity Or Mission DescriptionTHE MISSION OF FAIRVIEW HOSPITAL IS TO IMPROVE THE HEALTH OF ALL PEOPLE IN THE BERKSHIRES AND... (CONTINUED FROM FORM 990)...SURROUNDING COMMUNITIES, REGARDLESS OF THEIR ABILITY TO PAY.ActivityOrMissionDescription
Nbr Voting Members Governing Body24NbrVotingMembersGoverningBody
Nbr Independent Voting Members20NbrIndependentVotingMembers
Total Nbr Employees335TotalNbrEmployees
Total Nbr Volunteers50TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year618864ContributionsGrantsPriorYear
Contributions Grants Current Year2549704ContributionsGrantsCurrentYear
Program Service Revenue Prior Year44224749ProgramServiceRevenuePriorYear
Program Service Revenue CY45741030ProgramServiceRevenueCY
Investment Income Prior Year469864InvestmentIncomePriorYear
Investment Income Current Year563728InvestmentIncomeCurrentYear
Other Revenue Prior Year1204552OtherRevenuePriorYear
Other Revenue Current Year732770OtherRevenueCurrentYear
Total Revenue Prior Year46518029TotalRevenuePriorYear
Total Revenue Current Year49587232TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1250GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year25267767SalariesEtcPriorYear
Salaries Etc Current Year25956565SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year128233TotalFundrsngExpCurrentYear
Other Expense Prior Year19396247OtherExpensePriorYear
Other Expenses Current Year19697148OtherExpensesCurrentYear
Total Expenses Prior Year44665264TotalExpensesPriorYear
Total Expenses Current Year45653713TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1852765RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3933519RevenuesLessExpensesCY
Total Assets BOY31956366TotalAssetsBOY
Total Assets EOY37289446TotalAssetsEOY
Total Liabilities BOY18152754TotalLiabilitiesBOY
Total Liabilities EOY17988391TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY13803612NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY19301055NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE MISSION OF FAIRVIEW HOSPITAL IS TO IMPROVE THE HEALTH OF ALL PEOPLE IN THE BERKSHIRES AND SURROUNDING COMMUNITIES, REGARDLESS OF THEIR ABILITY TO PAY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense40176117Expense
Revenue46203948Revenue
DescriptionFAIRVIEW HOSPITAL, A 24 BED CRITICAL ACCESS COMMUNITY HOSPITAL, IS THE PRIMARY PROVIDER OF HEALTH CARE & ACCESS TO HEALTH CARE SERVICES IN SOUTHERN BERKSHIRE COUNTY, MA. THE HOSPITAL SERVES A RURAL AREA WHICH INCLUDES TOWNS IN MA, NORTHWEST CT, & COLUMBIA COUNTY, NY WITH A FULL RANGE OF PRIMARY CARE SERVICES, INCLUDING PREVENTATIVE, DIAGNOSTIC & THERAPEUTIC CARE, ON BOTH AN IN- & OUT-PATIENT BASIS. THE PRIMARY SERVICE AREA HAS A RESIDENT POPULATION OF APPROXIMATELY 30,000. THE HOSPITAL PLAYS AN ACTIVE ROLE IN MEETING THE HEALTH NEEDS OF THE COMMUNITY OUTSIDE THE HOSPITAL WALLS IN ITS PROACTIVE COMMUNITY OUTREACH, EDUCATION, & SCREENING INITIATIVES, WHICH ARE DESIGNED TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY. THROUGH COLLABORATION WITH NUMEROUS HEALTH & SOCIAL SERVICE AGENCIES, (CONTINUED ON SCHEDULE O) (CONTINUED FROM FORM 990)...FAIRVIEW HOSPITAL PROMOTES ACCESS TO INFORMATION & SERVICES, & DRAWS EXTENSIVE MEDICAL, TECHNOLOGICAL, & FINANCIAL RESOURCES TO THE AREA THROUGH ITS AFFILIATION WITH BERKSHIRE MEDICAL CENTER & BERKSHIRE HEALTH SYSTEMS. AS A RESULT, THE SOUTHERN BERKSHIRE COMMUNITY ENJOYS A COMPLETE CONTINUUM OF CARE SERVICES INCLUDING EDUCATION, PREVENTION, SCREENING, DIAGNOSTIC, THERAPEUTIC, REHABILITATIVE, & LONG-TERM CARE SERVICES, AN UNUSUALLY HIGH LEVEL OF HEALTH SERVICES WHEN COMPARED WITH SIMILAR RURAL COMMUNITIES. PLEASE SEE THE FY2013 "COMMUNITY BENEFITS REPORT" AT WWW.CBSYS.AGO.STATE.MA.US/CBPUBLIC/PUBLIC/ANNUAL_REPORTS_START.ASPX FOR MORE DETAILS.Description
Total Program Service Expense40176117TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109694NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees335NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members24NbrVotingGoverningBodyMembers
Number Independent Voting Members20NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMAStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1DARLENE RODOWICZ CFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4134472809TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1725 NORTH STREETAddressLine1
CityPITTSFIELDCity
StateMAState
ZIP Code012014109ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (38 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
LORINDA ACKLEY MAZUR
TRUSTEE0.101.90X000
JEROME J ANDERSON
TRUSTEE0.101.90X000
THOMAS O ANDREWS
TRUSTEE0.101.90X000
ALFRED A BARBALUNGA
TRUSTEE0.101.90X000
BRONLY S BOYD
TRUSTEE/CHAIRMAN0.101.90X000X
BRIAN T BURKE MD
TRUSTEE/PHYSICIAN48.002.00X213235043369
KIT DOBELLE
TRUSTEE0.101.90X000
TIMOTHY C DOHERTY
TRUSTEE0.101.90X000
RICHARD M DOHONEY
TRUSTEE0.101.90X000
A KING FRANCIS
TRUSTEE0.101.90X000
DENNIS J HOGAN
TRUSTEE0.101.90X000
EDMUND H HORNSTEIN DO
TRUSTEE/CONTRACT PHYSICIAN0.101.90X0656560
JOHN R KEARNS MD
TRUSTEE0.101.90X000
ELLEN L KENNEDY
TRUSTEE0.101.90X000
SUSAN M KORMANIK
TRUSTEE0.101.90X000
JOAN M MCFALLS
TRUSTEE0.101.90X000
MICHAEL R MCINERNEY MD
TRUSTEE0.101.90X000
LAURIE NORTON MOFFATT
TRUSTEE0.101.90X000
DAVID PHELPS SEE SCH J PT III
PRESIDENT/TRUSTEE3.5046.50X053062049029X
D PHELPS-RETIREMNT DSTRB1 TIME
PRESIDENT/TRUSTEE0.100.90X018783280X
BARTON D RASER
TRUSTEE0.101.90X000
CAROLE G SIEGEL
TRUSTEE0.101.90X000
GEORGE T SMITH
TRUSTEE0.101.90X000
MARILYN L SPERLING
TRUSTEE0.101.90X000
ANN H TRABULSI
TRUSTEE0.101.90X000
ROBERT P WESPISER MD
TRUSTEE/CONTRACT PHYSICIAN0.101.90X01331540
CHERYL M BOUDREAU
CLERK2.0038.0009723114802X
EUGENE A DELLEA
PRESIDENT, FAIRVIEW HOSPITAL50.000.00025519326111X
DARLENE M RODOWICZ
TREASURER3.0047.00049430339459X
DOREEN HUTCHINSON
VICE PRESIDENT, OPERATIONS50.000.00175261036795X
RAYMOND SABATELLI MD
DIRECTOR, EMERGENCY DEPT.50.000.00241230039733X
RICHARD F SALLUZZO MD
DIRECTOR, EMERGENCY DEPT.50.000.001844892182919488X
WILLIAM F DUKE MD
PHYSICIAN50.000.00251059034177X
ADRIAN ELLIOT MD
PHYSICIAN50.000.002732271073027625X
CORINNE D KALSER MD
PHYSICIAN50.000.00262607035588X
GLEN R LOVEJOY MD
PHYSICIAN50.000.00290629037431X
ROBERT RATTNER MD
PHYSICIAN50.000.00250939040021X
ALEC R BELMAN MD
PHYSICIAN/FORMER KEY EE50.000.00133265019895X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2275941TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs3487044TotalReportableCompFrmRltdOrgs
Total Other Compensation463523TotalOtherCompensation
Number Individuals GT100 K35NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
CONSIGLI CONSTRUCTION COMPANY INC
72 SUMNER STMILFORDMA017571663CONSTRUCTION SVCS1701250
BERKSHIRE SURGICAL ASSOC PC
777 NORTH ST STE 407PITTSFIELDMA012014141HEALTHCARE SERVICES281680
DIVERSIFIED CLINICAL SVCS
5220 BELFORT RD STE 200JACKSONVILLEFL322566019HEALTHCARE SERVICES212186
ENERGY MANAGEMENT CONSULTANTS
120 THADEUS ST STE 1SOUTH PORTLANDME041066253CONSTRUCTION SVCS116939
OPENSKY CORP
PO BOX 251VERNON ROCKVILLECT060660251CONSTRUCTION SVCS104580
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Fundraising Events185197FundraisingEvents
Government Grants60321GovernmentGrants
All Other Contributions2304186AllOtherContributions
Noncash Contributions2717NoncashContributions
Total Contributions2549704TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SVC REVENUEDescription
Business Code622110BusinessCode
Total Revenue Column45741030TotalRevenueColumn
Related Or Exempt Function Income45741030RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue45741030TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column316930TotalRevenueColumn
Exclusion$316,930ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column12510TotalRevenueColumn
Exclusion$12,510ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real46538Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real2281Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real44257Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column44257TotalRevenueColumn
Exclusion$44,257ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1207844Securities
Other6500Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities960610Securities
Other19446Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities247234Securities
Other-12946Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column234288TotalRevenueColumn
Exclusion$234,288ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events92612GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events185197CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses92612FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
PHARMACY SALES446110383585383585
CAFETERIA SALES722514169917$169,917
OPERATING ROOM MISC90009955678$55,678

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column79333TotalRevenueColumn
Related Or Exempt Function Income79333RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue688513TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column49587232TotalRevenueColumn
Related Or Exempt Function Income46203948RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$833,580ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1014330Total
Program Services1010265ProgramServices
Management And General3490ManagementAndGeneral
Fundraising575Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total19847079Total
Program Services19465536ProgramServices
Management And General327619ManagementAndGeneral
Fundraising53924Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total768980Total
Program Services754249ProgramServices
Management And General12649ManagementAndGeneral
Fundraising2082Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3014132Total
Program Services2962348ProgramServices
Management And General44507ManagementAndGeneral
Fundraising7277Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1312044Total
Program Services1287677ProgramServices
Management And General20923ManagementAndGeneral
Fundraising3444Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total4585299Total
Management And General4585299ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total88564Total
Management And General88564ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total13218Total
Program Services13218ProgramServices

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total19396Total
Management And General19396ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total3426846Total
Program Services3397947ProgramServices
Management And General7466ManagementAndGeneral
Fundraising21433Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total64850Total
Program Services44552ProgramServices
Management And General843ManagementAndGeneral
Fundraising19455Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3293316Total
Program Services3249076ProgramServices
Management And General34039ManagementAndGeneral
Fundraising10201Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total336300Total
Program Services336300ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total744823Total
Program Services731714ProgramServices
Management And General11676ManagementAndGeneral
Fundraising1433Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total154956Total
Program Services150663ProgramServices
Management And General2828ManagementAndGeneral
Fundraising1465Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total221105Total
Program Services221105ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1786883Total
Program Services1753698ProgramServices
Management And General33185ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total352318Total
Program Services345775ProgramServices
Management And General5619ManagementAndGeneral
Fundraising924Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
RECIPROCAL/TEACHNG FEES14321621432162
BAD DEBT13158701315870
MAINTENANCE & REPAIRS59082557985210973
MINOR EQUIPMENT3565253525623811152

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total913892Total
Program Services771548ProgramServices
Management And General136476ManagementAndGeneral
Fundraising5868Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total45653713Total
Program Services40176117ProgramServices
Management And General5349363ManagementAndGeneral
Fundraising128233Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY6000BOY
EOY7078EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY815762BOY
EOY709004EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY3600BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY5162660BOY
EOY5514632EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY19511BOY
EOY20538EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY354928BOY
EOY416063EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY110339BOY
EOY76220EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis27446654LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec16496595LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY9918067BOY
EOY10950059EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY13583585BOY
EOY15352313EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY1565677BOY
EOY1919706EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY10292BOY
EOY8773EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY405945BOY
EOY2315060EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY31956366BOY
EOY37289446EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2994018BOY
EOY2926532EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY26829BOY
EOY47876EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY6205719BOY
EOY5866627EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY8926188BOY
EOY9147356EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY18152754BOY
EOY17988391EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY11447565BOY
EOY16796766EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2097805BOY
EOY2246047EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY258242BOY
EOY258242EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY13803612BOY
EOY19301055EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY31956366BOY
EOY37289446EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses3933519ReconcilationRevenueExpenses
Reconciliation Unrealized Invest1563924ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$13,218OtherActivitiesAmount
Total Lobbying Expenditures IIB13218TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationLOBBYING ACTIVITIES EXPENDITURES FAIRVIEW HOSPITAL PAYS ANNUAL MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE MASSACHUSETTS HOSPITAL ASSOCIATION (MHA). A PORTION OF THESE DUES ARE USED BY THE AHA AND THE MHA TO CONDUCT LOBBYING ACTIVITIES. FOR THE FYE 09/30/2013, THE PORTION OF THE DUES PAID TO THE AHA FOR LOBBYING ACTIVITIES WAS $2,955, AND THE PORTION OF THE DUES PAID TO THE MHA FOR LOBBYING ACTIVITIES WAS $10,263, FOR A TOTAL OF $13,218.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1195038BeginningOfYearBalance
Investment Earnings Or Losses88384InvestmentEarningsOrLosses
End Of Year Balance1283422EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1058317BeginningOfYearBalance
Investment Earnings Or Losses136721InvestmentEarningsOrLosses
End Of Year Balance1195038EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1046753BeginningOfYearBalance
Investment Earnings Or Losses11564InvestmentEarningsOrLosses
End Of Year Balance1058317EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance989912BeginningOfYearBalance
Investment Earnings Or Losses56841InvestmentEarningsOrLosses
End Of Year Balance1046753EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1028277BeginningOfYearBalance
Investment Earnings Or Losses-22233InvestmentEarningsOrLosses
Other Expenditures16132OtherExpenditures
End Of Year Balance989912EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.20120PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.79880TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis16887OtherCostOrOtherBasis
Book Value16887BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2137042OtherCostOrOtherBasis
Depreciation2031348Depreciation
Book Value105694BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis13796480OtherCostOrOtherBasis
Depreciation9664781Depreciation
Book Value4131699BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis11496245OtherCostOrOtherBasis
Depreciation4800466Depreciation
Book Value6695779BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings10950059TotalOfBookValueLandBuildings

Closely Held Equity Interests CloselyHeldEquityInterests

FieldValueIRS element (for citing)
Book Value74319BookValue
Method Of ValuationFMethodOfValuation

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionBLACKROCK EQUITY INDEX FUND BDescription
Book Value1845387BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities1919706TotalOfBookValueSecurities

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM AFFILIATES2181230
DEFERRED COMPENSATION123908
LIFE INSURANCE-CASH VALUE9922
FieldValueIRS element (for citing)
Total Book Value Other Assets2315060TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
DUE TO AFFILIATES$3,300,000
DUE TO THIRD PARTY PAYORS$5,070,713
ACCRUED FIN 47 ACCRETION$648,614
DEFERRED COMPENSATION$123,908
REBATE FUND LIABILITY$4,025
DEFERRED PENSION FORFEITURE$96
FieldValueIRS element (for citing)
Total Of Amounts9147356TotalOfAmounts

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS FAIRVIEW HOSPITAL HAS FIVE PERMANENT ENDOWMENT FUNDS, AS DESCRIBED BELOW: (1) THE BALDWIN FUND'S INCOME IS TO BE USED FOR THE CARE OF PEOPLE WITHOUT OR OF LIMITED MEANS. (2) THE BEECHER FUND'S INCOME IS TO BE USED TO OFFSET THE HEALTHCARE COSTS OF AGING WOMEN OR UNWED MOTHERS. (3) THE BRANDI FUND'S INCOME HAS THREE PURPOSES: (A) TO PROVIDE SCHOLARSHIPS FOR THE CONTINUING EDUCATION OF NURSES OR PROSPECTIVE NURSES ASSOCIATED WITH THE HOSPITAL; (B) TO SERVE AS A SOURCE OF EMERGENCY LOANS TO RETIRED NURSES OR CERTAIN NURSES WHO ARE CURRENTLY WORKING FOR THE HOSPITAL; AND (C) FOR THE PURCHASE OF EQUIPMENT, FURNISHINGS, OR OTHER ITEMS FOR THE BENEFIT OF THE NURSES OR THE MATERNITY SECTION OF THE HOSPITAL. (4) THE MOSKOWITZ FUND'S INCOME IS TO BE USED TO PROVIDE FOR SCHOLARSHIPS TO EMPLOYEES AND CHILDREN OF EMPLOYEES OF THE HOSPITAL WHO ARE ADVANCING THEIR EDUCATION OR TECHNICAL SKILLS AT A RECOGNIZED LEARNING INSTITUTION. (5) THE STANLEY FUND'S INCOME IS TO BE USED FOR THE REPAIR, UPKEEP, AND ADDITIONS TO THE HOSPITAL'S X-RAY EQUIPMENT.
PART X, LINE 2: THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND SUPPLEMENTARY FINANCIAL INFORMATION OF BERKSHIRE HEALTH SYSTEMS, INC. AND AFFILIATES (INCLUDING FAIRVIEW HOSPITAL) FOR THE YEARS ENDED SEPTEMBER 30, 2013 AND 2012 DOES NOT CONTAIN A FOOTNOTE ADDRESSING ANY LIABILITY FOR UNCERTAIN TAX PROVISIONS UNDER FIN 48.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GALANameOfEvent1
Gross Receipts Event1227749GrossReceiptsEvent1
Charitable Contributions Event1151158CharitableContributionsEvent1
Gross Revenue Event176591GrossRevenueEvent1
Non Cash Prizes Event12717NonCashPrizesEvent1
Rent Facility Costs Event113451RentFacilityCostsEvent1
Food And Beverage Event117829FoodAndBeverageEvent1
Entertainment Event127655EntertainmentEvent1
Other Direct Expenses Event114939OtherDirectExpensesEvent1
Name Of Event2GOLF TOURNAMENTNameOfEvent2
Gross Receipts Event250060GrossReceiptsEvent2
Charitable Contributions Event234039CharitableContributionsEvent2
Gross Revenue Event216021GrossRevenueEvent2
Rent Facility Costs Event210790RentFacilityCostsEvent2
Food And Beverage Event26422FoodAndBeverageEvent2
Other Direct Expenses Event2-1191OtherDirectExpensesEvent2
Gross Receipts Total277809GrossReceiptsTotal
Charitable Contributions Total185197CharitableContributionsTotal
Gross Revenue Total Events92612GrossRevenueTotalEvents
Non Cash Prizes Total Events2717NonCashPrizesTotalEvents
Rent Facility Costs Total Events24241RentFacilityCostsTotalEvents
Food And Beverage Total Events24251FoodAndBeverageTotalEvents
Entertainment Total Events27655EntertainmentTotalEvents
Other Direct Expenses Total Events13748OtherDirectExpensesTotalEvents
Direct Expense Summary Events92612DirectExpenseSummaryEvents
Net Income Summary0NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense773717TotalCommunityBenefitExpense
Net Community Benefit Expense773717NetCommunityBenefitExpense
Percent Of Total Expense0.01750PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense5187430TotalCommunityBenefitExpense
Direct Offsetting Revenue4625983DirectOffsettingRevenue
Net Community Benefit Expense561447NetCommunityBenefitExpense
Percent Of Total Expense0.01270PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense3117206TotalCommunityBenefitExpense
Direct Offsetting Revenue2917995DirectOffsettingRevenue
Net Community Benefit Expense199211NetCommunityBenefitExpense
Percent Of Total Expense0.00450PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense9078353TotalCommunityBenefitExpense
Direct Offsetting Revenue7543978DirectOffsettingRevenue
Net Community Benefit Expense1534375NetCommunityBenefitExpense
Percent Of Total Expense0.03470PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense231627TotalCommunityBenefitExpense
Net Community Benefit Expense231627NetCommunityBenefitExpense
Percent Of Total Expense0.00520PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense248523TotalCommunityBenefitExpense
Net Community Benefit Expense248523NetCommunityBenefitExpense
Percent Of Total Expense0.00560PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense6850TotalCommunityBenefitExpense
Net Community Benefit Expense6850NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense487000TotalCommunityBenefitExpense
Net Community Benefit Expense487000NetCommunityBenefitExpense
Percent Of Total Expense0.01100PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense9565353TotalCommunityBenefitExpense
Direct Offsetting Revenue7543978DirectOffsettingRevenue
Net Community Benefit Expense2021375NetCommunityBenefitExpense
Percent Of Total Expense0.04570PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense144112TotalCommunityBuildingExpense
Net Community Building Expense144112NetCommunityBuildingExpense
Percent Of Total Expense0.00330PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense289460TotalCommunityBuildingExpense
Net Community Building Expense289460NetCommunityBuildingExpense
Percent Of Total Expense0.00650PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense433572TotalCommunityBuildingExpense
Net Community Building Expense433572NetCommunityBuildingExpense
Percent Of Total Expense0.00980PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$785,443BadDebtExpenseAmount
Amount Reimbursed By Medicare19118439AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare18946404CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall172035MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1FAIRVIEW HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line129 LEWIS AVEAddressLine1
CityGREAT BARRINGTONCity
StateMAState
ZIP Code012301796ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1FAIRVIEW HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Needs Assessment Conducted11NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities1OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs Addressed0AllNeedsAddressed
Organization Incur Excise Tax0OrganizationIncurExciseTax
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent400.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities3NumberOfOtherFacilities

Other Facilities OtherFacilities (3 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
FAIRVIEW HSP OUTPATNT PHYSICAL THERAPY
10 MAPLE AVEGREAT BARRINGTONMA01230OUTPATIENT SERVICES
FAIRVIEW PHYSICAL & SPORTS THERAPY CTR
710 STOCKBRIDGE RD STE 1LEEMA01238OUTPATIENT SERVICES
FAIRVIEW HOSPITAL AQUATIC THERAPY PROG
15 CHRISSEY RDGREAT BARRINGTONMA01230OUTPATIENT SERVICES

Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 7: THE TOTAL COMMUNITY BENEFIT EXPENSE REPORTED ON PART I, LINES 7A, 7B, & 7C HAS BEEN CALCULATED USING THE RATIO OF PATIENT CARE COST TO CHARGES AS COMPUTED USING WORKSHEET 2 IN THE SCHEDULE H INSTRUCTIONS. THE TOTAL COMMUNITY BENEFIT EXPENSE REPORTED ON PART I, LINE 7G HAS BEEN CALCULATED USING A COST ACCOUNTING METHOD. BAD DEBT EXPENSE HAS BEEN EXCLUDED FROM THE COMPUTATION OF ALL COMMUNITY BENEFIT EXPENSE SHOWN IN PART I, LINE 7.
PART I, L7 COL(F): BAD DEBT EXPENSE OF $1,315,870 ATTRIBUTABLE TO PATIENT ACCOUNTS AND INCLUDED IN FORM 990, PART IX, LINE 25 COLUMN (A) HAS BEEN EXCLUDED FROM THE COMPUTATION OF ALL COMMUNITY BENEFIT EXPENSE, INCLUDING THE CALCULATION OF THE PERCENTAGES SHOWN IN SCHEDULE H PART I, LINE 7 COLUMN (F).
PART I, LINE 6A: FAIRVIEW HOSPITAL AND BERKSHIRE MEDICAL CENTER EACH FILE A SEPARATE COMMUNITY BENEFITS REPORT WITH THE STATE OF MASSACHUSETTS. FAIRVIEW'S FISCAL YEAR 2013 COMMUNITY BENEFITS REPORT CAN BE ACCESSED AT WWW.CBSYS.AGO.STATE.MA.US/CBPUBLIC/PUBLIC/ANNUAL_REPORTS_START.ASPX.
PART II: COMMUNITY BUILDING ACTIVITIES - AS SUMMARIZED IN PART II, EXPENDITURES BY FAIRVIEW HOSPITAL TO PROTECT OR IMPROVE THE COMMUNITY'S HEALTH OR SAFETY INCLUDE THE FOLLOWING:LINE 3 COMMUNITY SUPPORT: EMERGENCY PREPAREDNESS - COMMUNITY BENEFIT EXPENSE $19,619. THE HOSPITAL PARTICIPATED IN EMERGENCY PREPAREDNESS ACTIVITIES SUCH AS CONTINUING EDUCATION, PARTNERSHIP BUILDING, AND SUSTAINABILITY PURCHASES TO STRENGTHEN THE HOSPITAL'S ALL-HAZARD RESPONSE TO LOCAL, REGIONAL AND NATIONAL EVENTS. LINE 3 COMMUNITY SUPPORT: BIOTERRORISM PREPAREDNESS - COMMUNITY BENEFIT EXPENSE $22,093. THE HOSPITAL PARTICIPATED IN BIOTERRORISM PREPAREDNESS EFFORTS SUCH AS MAINTAINING A PHARMACEUTICAL CACHE, TRAINING WITH COMMUNITY PARTNERS, AND CONTINUING EDUCATION.LINE 3 COMMUNITY SUPPORT: MEDICAL RESERVE CORPS - COMMUNITY BENEFIT EXPENSE $28,438. THE HOSPITAL SUPPORTS THE BERKSHIRE MEDICAL RESERVE CORPS WHO ARE A GROUP OF LICENSED MEDICAL PROFESSIONALS AND NON-LICENSED INDIVIDUALS WHO ARE TRAINED TO RESPOND TO A PUBLIC HEALTH EMERGENCY SUCH AS A PANDEMIC OR SHELTERING SITUATION.LINE 3 COMMUNITY SUPPORT: COMMUNITY INFECTION CONTROL - COMMUNITY BENEFIT EXPENSE $16,445. FAIRVIEW HOSPITAL SPONSORED FREE COMMUNITY FLU CLINICS. FUNDS WERE USED TO PAY FOR THE CLINIC PLANNER, NURSES, SUPPLIES AND ADVERTISING.LINE 3 COMMUNITY SUPPORT: EMS COORDINATOR - COMMUNITY BENEFIT EXPENSE $43,180. FAIRVIEW FUNDS AN EMERGENCY MEDICAL SERVICERS COORDINATOR WHO WORKS WITH ALL LOCAL VOLUNTEER AND PAID AMBULANCE SQUADS TO PROVIDE CONTINUING EDUCATION, REGULATORY UPDATES, AND BEST PRACTICE UPDATES.LINE 3 COMMUNITY SUPPORT: HAZARDOUS MATERIALS RESPONSE DRILLS - COMMUNITY BENEFIT EXPENSE $11,063. FAIRVIEW CONDUCTED A COMMUNITY-WIDE HAZARDOUS MATERIAL FULL-SCALE EXERCISE WHICH INCLUDED PARTICIPATION FROM LOCAL POLICE, FIRE, AND EMS AGENCIES.LINE 3 COMMUNITY SUPPORT: HOMELAND SECURITY EXERCISE - COMMUNITY BENEFIT EXPENSE $3,274. FAIRVIEW PROVIDED STAFF TO WORK ON A HOMELAND SECURITY FUNDED EXERCISE SERIES WHICH DEVELOPED AND TRAINED LOCAL BOARD OF HEALTH STAKEHOLDERS ON FOOD AND WATER SAFETY STANDARD OPERATING GUIDELINES AND PUBLIC INFORMATION OFFICER STANDARD OPERATING GUIDELINES.LINE 8 WORKFORCE DEVELOPMENT: PHYSICIAN RECRUITMENT - COMMUNITY BENEFIT EXPENSE $230,466. THIS IS IN RESPONSE TO CRITICAL PHYSICIAN SHORTAGES IN THE HOSPITAL'S SERVICE AREA AND THE EXPENDITURES REPORTED ARE AN INVESTMENT IN INCREASING ACCESS TO PRIMARY CARE AND SPECIALTY PHYSICIANS AVAILABLE TO THE COMMUNITY BY ASSISTING IN ESTABLISHING NEW PHYSICIANS IN THE SERVICE AREA.LINE 8 WORKFORCE DEVELOPMENT: HEALTHCARE CAREER DEVELOPMENT PROGRAMS - COMMUNITY BENEFIT EXPENSE $58,994. FAIRVIEW OFFERED 26 LOCAL MIDDLE AND HIGH SCHOOL STUDENTS SHADOW AND INTERNSHIP EXPERIENCES EXPOSING THEM TO DIVERSE CAREERS IN HEALTHCARE. FVH OFFERED NINE STUDENTS PURSUING SPECIALIZED MEDICAL EDUCATION, INCLUDING PHYSICIAN'S ASSISTANTS AND PHYSICAL THERAPISTS, THE OPPORTUNITY TO GAIN CLINICAL EXPERIENCE AT THE HOSPITAL. FAIRVIEW ALSO OFFERED 54 NURSING STUDENTS INTERNSHIPS.
PART III, LINE 4: FOOTNOTE 4 ("CHARITY CARE") TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND SUPPLEMENTARY FINANCIAL INFORMATION OF BERKSHIRE HEALTH SYSTEMS, INC. AND AFFILIATES (INCLUDING FAIRVIEW HOSPITAL) FOR THE YEARS ENDED SEPTEMBER 30, 2013 AND 2012 CONTAINS THE FOLLOWING REGARDING BAD DEBT EXPENSE: "THE HEALTH SYSTEM PROVIDES CARE TO PATIENTS WHO MEET CHARITY CARE POLICY CRITERIA WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES." "IF A PATIENT IS INELIGIBLE FOR CHARITY CARE OR CARE AT REDUCED RATES BECAUSE THE PATIENT'S INCOME EXCEEDS THE ELIGIBILITY GUIDELINES, SERVICES RENDERED ARE RECORDED AT ESTABLISHED RATES AND ANY UNPAID ACCOUNT RECEIVABLE BALANCE IS WRITTEN OFF TO BAD DEBTS AFTER A REASONABLE COLLECTION EFFORT HAS BEEN MADE."THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS REPORTED ON LINE 2, PART III WAS CALCULATED USING THE RATIO OF PATIENT CARE COST TO CHARGES AS COMPUTED USING WORKSHEET 2 IN THE SCHEDULE H INSTRUCTIONS. NO BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER FAIRVIEW HOSPITAL'S CHARITY CARE POLICY HAS BEEN REPORTED ON LINE 3, PART III BECAUSE ALL GROSS PATIENT CHARGES ATTRIBUTABLE TO THESE PATIENTS THAT WERE NOT PAID FROM UNCOMPENSATED CARE POOLS OR PROGRAMS WERE WRITTEN OFF AS "FREE CARE" EXPENSE.
PART III, LINE 8: THE AMOUNT REPORTED ON LINE 6, PART III WAS DETERMINED USING THE COST ALLOCATION METHODOLOGY USED FOR THE MEDICARE COST REPORTS.
PART III, LINE 9B: THE FOLLOWING INDIVIDUALS AND PATIENT POPULATIONS ARE EXEMPT FROM ANY COLLECTION OR BILLING PROCEDURES PURSUANT TO STATE REGULATIONS: PATIENTS ENROLLED IN A STATE HEALTH INSURANCE PROGRAM, INCLUDING BUT NOT LIMITED TO, MASSHEALTH, EMERGENCY AID TO THE ELDERLY, DISABLED AND CHILDREN, HEALTHY START, CHILDREN'S MEDICAL SECURITY PLAN, AND "LOW INCOME PATIENTS" AS DETERMINED BY THE OFFICE OF MEDICAID. PLEASE NOTE THAT FAIRVIEW HOSPITAL (FVH) MAY SEEK COLLECTION ACTION AGAINST ANY PATIENT ENROLLED IN THE ABOVE MENTIONED PROGRAMS FOR THEIR REQUIRED CO-PAYMENTS AND DEDUCTIBLES THAT ARE SET FORTH BY EACH SPECIFIC PROGRAM. FVH MAY ALSO INITIATE BILLING OR COLLECTION FOR A PATIENT WHO ALLEGES THAT HE OR SHE IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM THAT COVERS THE COSTS OF THE HOSPITAL SERVICES, BUT FAILS TO PROVIDE PROOF OF SUCH PARTICIPATION. UPON RECEIPT OF SATISFACTORY PROOF THAT A PATIENT IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM (INCLUDING RECEIPT OR VERIFICATION OF SIGNED APPLICATION), FVH SHALL CEASE ITS BILLING OR COLLECTION ACTIVITIES. FVH MAY CONTINUE COLLECTION ACTION ON ANY LOW INCOME PATIENT FOR SERVICES RENDERED PRIOR TO THE LOW INCOME PATIENT DETERMINATION, PROVIDED THAT THE CURRENT LOW INCOME PATIENT STATUS HAS BEEN TERMINATED OR EXPIRED. HOWEVER, ONCE A PATIENT IS DETERMINED ELIGIBLE AND ENROLLED IN THE HEALTH SAFETY NET, MASSHEALTH, OR CERTAIN COMMONWEALTH CARE PROGRAMS, FVH WILL CEASE COLLECTION ACTIVITY FOR SERVICES, PREVIOUSLY BILLED, THAT NOW FALL INTO THE ELIGIBILITY PERIOD. FVH MAY SEEK COLLECTION ACTION AGAINST ANY OF THE PATIENTS PARTICIPATING IN THE PROGRAMS LISTED ABOVE FOR NON-COVERED SERVICES THAT THE PATIENT HAS AGREED TO BE RESPONSIBLE FOR, PROVIDED THAT THE HOSPITAL OBTAINED THE PATIENT'S PRIOR WRITTEN CONSENT TO BE BILLED FOR THE SERVICE. FVH WILL NOT UNDERTAKE COLLECTION ACTION AGAINST AN INDIVIDUAL THAT HAS BEEN APPROVED FOR MEDICAL HARDSHIP UNDER THE MASSACHUSETTS HEALTH SAFETY NET PROGRAM WITH RESPECT TO THE AMOUNT OF THE BILL THAT EXCEEDS THE MEDICAL HARDSHIP CONTRIBUTION.FVH DOES NOT GARNISH A PATIENT'S OR THE PATIENT'S GUARANTOR'S WAGES OR EXECUTE A LIEN ON THE PATIENT'S OR THE PATIENT'S GUARANTOR'S PERSONAL RESIDENCE OR MOTOR VEHICLE.FVH AND ITS AGENTS SHALL NOT CONTINUE COLLECTION OR BILLING ON A PATIENT WHO IS A MEMBER OF A BANKRUPTCY PROCEEDING EXCEPT TO SECURE ITS RIGHTS AS A CREDITOR IN THE APPROPRIATE ORDER.
PART V, SECTION B, LINE 3: COMMUNITY HEALTH NEEDS ASSESSMENT - FAIRVIEW HOSPITAL HAS UTILIZED AN ACTIVE COMMUNITY HEALTH NEEDS ASSESSMENT AS PART OF ITS COMMUNITY BENEFIT PROCESS FOR A NUMBER OF YEARS. THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS UPDATED ANNUALLY, AND THE UPDATE IN 2012 DIRECTED OUR EFFORTS IN 2013. FAIRVIEW'S CHNA UTILIZED ALL AVAILABLE CLINICAL, HEALTH STATUS, DEMOGRAPHIC, AND SOCIO-ECONOMIC DATA AVAILABLE TO FORM THE FOUNDATION OF OUR NEEDS ASSESSMENT. IN ADDITION WE GATHERED AVAILABLE QUALITATIVE DATA FROM OUR MANY ADVISORY GROUPS, COMMUNITY FORUMS, SURVEYS, AND FOCUS GROUPS. THE WELLNESS AND OUTREACH PROGRAMS ALSO SUPPLEMENT OUR UNDERSTANDING OF THE HEALTH STATUS OF OUR COMMUNITY, HEALTH RISK FACTORS, AND BARRIERS TO HEALTH AND HEALTHCARE. IN NOVEMBER 2011, IN COLLABORATION WITH OUR PUBLIC HEALTH COLLEAGUES FROM ACROSS BERKSHIRE COUNTY, FAIRVIEW PARTICIPATED IN A COMMUNITY WIDE MEETING SPONSORED BY BERKSHIRE MEDICAL CENTER TO REVIEW THE HEALTH NEEDS OF OUR COMMUNITY AND SOLICIT ADDITIONAL FEEDBACK FROM OVER 70 COMMUNITY BASED ORGANIZATIONS. THE FEEDBACK GATHERED INPUT ON SPECIFIC ACTIONS THAT COULD BE TAKEN AT INDIVIDUAL, FAMILY, AND ORGANIZATIONAL LEVELS AS WELL AS IDENTIFYING GAPS IN SERVICE IN ADDITION TO PRIORITIZING THE MOST IMPORTANT NEEDS FOR THE COMMUNITY AS A WHOLE. WE HAVE PARTICIPATED IN THIS COMMUNITY GROUP AT LEAST ANNUALLY TO REVIEW DATA, CONFIRM PRIORITIES, DISCUSS NEEDS, AND WORK TOGETHER TO ADDRESS THE IDENTIFIED PRIORIES AND NEEDS. IN 2012 WE FORMALIZED THE COUNTY HEALTH INITIATIVE (CHI) WITH THE GOAL OF WORKING TOGETHER TO IMPROVE COMMUNITY HEALTH. THE LEADERSHIP TEAM OF THE CHI INCLUDED BERKSHIRE MEDICAL CENTER, FAIRVIEW HOSPITAL, NORTH ADAMS REGIONAL HOSPITAL, BERKSHIRE COUNTY BOARDS OF HEALTH, THE BERKSHIRE ALLIANCE FOR PUBLIC HEALTH, TRI-TOWN HEALTH DEPARTMENT, PITTSFIELD BOARD OF HEALTH, BERKSHIRE UNITED WAY, AND NORTHERN BERKSHIRE COMMUNITY COALITION. THE NEEDS DATA, ALONG WITH STATE PRIORITIES, ARE USED TO DETERMINE OUR ANNUAL COMMUNITY BENEFIT PRIORITIES, WHICH ARE ESTABLISHED BY THE COMMUNITY BENEFIT AND ACCESS COMMITTEE OF THE BOARD OF TRUSTEES. IN ITS PLANNING, FVH LOOKS FOR OPPORTUNITIES TO MAKE BETTER AND MORE EFFECTIVE USE OF EXISTING RESOURCES AND PROVIDERS, AS WELL AS TO IDENTIFY GAPS IN SERVICE. FVH WORKS WITH INTERNAL RESOURCES AND COMMUNITY AND REGIONAL PARTNERS, WITH THE HELP OF EVIDENCED BASED OR BEST PRACTICE PROGRAMS, TO DEVELOP AND IMPLEMENT PROGRAMS AND INITIATIVES TO MEET COMMUNITY NEED.FAIRVIEW HOSPITAL
PART V, SECTION B, LINE 4: CHNA CONDUCTED WITH OTHER HOSPITAL FACILITIES - FAIRVIEW HOSPITAL IS AN AFFILIATE HOSPITAL OF BERKSHIRE MEDICAL CENTER AND BERKSHIRE HEALTH SYSTEMS, THE REGIONAL PROVIDER OF HEALTHCARE IN THE BERKSHIRES. FAIRVIEW HOSPITAL PARTICIPATES IN THE BERKSHIRE HEALTH SYSTEMS COMMUNITY HEALTH NEEDS ASSESSMENT AND CONSIDERS IT THE PRIMARY RESOURCE FOR COMMUNITY FEEDBACK FOR OVERALL HEALTH NEEDS AND STATUS OF OUR REGION. THE HEALTHCARE PRIORITIES IDENTIFIED BY THE BERKSHIRE HEALTH SYSTEMS REPORT ARE THE GUIDING FRAMEWORK THAT FAIRVIEW USES TO EFFECTIVELY COLLABORATE WITH OTHER PROVIDERS TO IDENTIFY PRIORITY NEEDS AND DEVELOP PLANS TO MEET THEM. IN ADDITION TO THE BERKSHIRE HEALTH SYSTEMS CHNA, FAIRVIEW HOSPITAL CONDUCTS AN ADDITIONAL COMMUNITY HEALTH QUESTIONNAIRE FOR THE TWELVE TOWNS IN THE SOUTHERN BERKSHIRES THAT IT SERVES. THE GOAL OF THIS TARGETED SURVEY IS TO GAIN ADDITIONAL FEEDBACK OF THE PERCEPTIONS OF THE RESIDENTS OF THE SOUTHWESTERN CORNER OF BERKSHIRE COUNTY AS TO THE CHALLENGES, OBSTACLES AND PRIORITY NEEDS THEY FEEL NEED TO BE ADDRESSED.FAIRVIEW HOSPITAL
PART V, SECTION B, LINE 7: WERE ALL NEEDS IDENTIFIED IN CHNA ADDRESSED? - FAIRVIEW HOSPITAL FOLLOWS THE PRIORITIES OF THE BERKSHIRE HEALTH SYSTEMS COMMUNITY HEALTH NEEDS ASSESSMENT. FAIRVIEW HOSPITAL, A CRITICAL ACCESS HOSPITAL, SERVES A RURAL COMMUNITY IN THE SOUTHWESTERN CORNER OF MASSACHUSETTS. FAIRVIEW HAS PUT IN PLACE MANY PROGRAMS AND SERVICES THAT ADDRESS THE NEEDS OF VULNERABLE POPULATIONS, EQUITY OF ACCESS, CHRONIC DISEASE AND WELLNESS IN ADDITION TO ITS ROLE AS SERVING AS THE PRIMARY ACUTE CARE FACILITY FOR OUR NEIGHBORS. FAIRVIEW HAS MADE SIGNIFICANT PROGRESS IN RESPONDING TO NEEDS INCLUDING NEW HEALTH SERVICES, SUPPORT GROUPS, EDUCATION AND OUTREACH, INCLUDING MANY IN COLLABORATION WITH BERKSHIRE MEDICAL CENTER. THE RECENT ESTABLISHMENT OF OPERATION BETTER START, A PROGRAM THAT TARGETS YOUTH OBESITY, AND DIABETES EDUCATION ARE EXAMPLES OF HOW REGIONAL RESOURCES CAN BE MADE AVAILABLE AS A SATELLITE IN A RURAL COMMUNITY. IN CASES THAT REQUIRE MORE SPECIALTY, OR IT CANNOT FINANCIALLY SUPPORT, FAIRVIEW HOSPITAL MAY NOT BE ABLE TO FILL THE NEED LOCALLY AND RELIES ON A REGIONAL NETWORK OF HEALTH RESOURCES OF BERKSHIRE HEALTH SYSTEMS.FAIRVIEW HOSPITAL
PART V, SECTION B, LINE 20D: THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO A PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE IS 95% OF THE FACILITY'S STANDARD CHARGES.FAIRVIEW HOSPITAL
PART VI, LINE 2: NEEDS ASSESSMENT - FAIRVIEW ASSESSES THE NEEDS AND CHANGES IN OUR COMMUNITY THROUGH A BROAD RANGE OF ASSESSMENT INITIATIVES AND CONSTANT INTERACTION AND ENGAGEMENT WITH THE LOCAL COMMUNITY. STATISTICAL EVIDENCE FROM HOSPITAL DATABASES, INCLUDING IN-PATIENT, EMERGENCY AND MAJOR DIAGNOSTIC CATEGORIES, AUGMENT FEDERAL, STATE AND LOCAL ASSESSMENTS WHICH HELP IDENTIFY AREAS CONSISTENT WITH, AND THOSE ABOVE, STANDARD NORMS. FAIRVIEW RELIES ON THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH DEMOGRAPHIC DATA AND HEALTH REGIONALIZATION STATUS REPORTS TO OBTAIN THIS INFORMATION.FAIRVIEW ALSO PARTICIPATES WITH THE WORK OF REGIONAL PARTNER ORGANIZATIONS AND UTILIZES ASSESSMENTS MADE AVAILABLE ON BEHALF OF SPECIFIC COMMUNITY INTERESTS. AMONG THE ORGANIZATIONS THAT PROVIDE RELEVANT DATA ARE BERKSHIRE HEALTH SYSTEMS COMMUNITY HEALTH ASSESSMENT SURVEY, SOUTHERN BERKSHIRE YOUTH COALITION YOUTH SURVEY, UNITED WAY COMMUNITY IMPACT BASELINE REPORT, MASSACHUSETTS PREVENTION NEEDS ASSESSMENT SURVEY, CROSS-CULTURAL ACTION NETWORK, MASSACHUSETTS COUNTY HEALTH RANKINGS, BERKSHIRE HILLS REGIONAL SCHOOL DISTRICT BMI REPORTS, AND THE BERKSHIRE BOARDS OF HEALTH ASSOCIATION BERKSHIRE COMMUNITY HEALTH ASSESSMENT. FAIRVIEW ALSO CONDUCTS ITS OWN SURVEY, SPECIFICALLY TARGETING THE SOUTHERN BERKSHIRE REGION, TO UNDERSTAND RESIDENTS' PERCEPTIONS OF HEALTHCARE SERVICE ACCESS, OBSTACLES TO CARE, PREFERRED METHODS OF COMMUNICATIONS, PERCEIVED HEALTH THREATS AND SIGNIFICANT ISSUES THAT AFFECT THEIR HEALTH STATUS.FAIRVIEW HOSPITAL PLACES A HIGH PRIORITY ON BUILDING CLOSE ALLIANCES WITH EDUCATIONAL, BUSINESS, HEALTH AND WELFARE, SAFETY, AND LAW ENFORCEMENT AGENCIES AND SOCIAL SERVICES IN THE SOUTHERN BERKSHIRES. THROUGH CONTINUAL ENGAGEMENT AND PARTNERING, FAIRVIEW STAYS ABREAST OF THE BROAD RANGE OF ISSUES AFFECTING OUR COMMUNITY ALLOWING IT TO RESPOND TO ISSUES. THROUGH A CONSTITUENCY FOCUSED OUTREACH AND EDUCATION PROGRAM, WHICH IS BASED ON HEALTH NEEDS ASSESSMENTS AND TARGETS SPECIFIC HEALTH INFORMATION TO MEET THE NEEDS OF SPECIAL POPULATIONS, FAIRVIEW STRIVES TO INCREASE AWARENESS OF AND ACCESS TO PROGRAMS AND SERVICES, EDUCATION, SUPPORT AND INFORMATION, AND TO RAISE THE OVERALL HEALTH LITERACY AMONG OUR NEIGHBORS. IN ADDITION, COMMUNITY HOSPITAL COMMITTEES, INCLUDING THE PATIENT FAMILY ADVISORY COUNCIL, ETHICS COUNCIL AND SPECIAL EVENTS COMMITTEES ALLOW FAIRVIEW TO MAINTAIN A DIRECT LINE TO OUR COMMUNITY, IN OUR EFFORT TO SERVE OUR COMMUNITY EFFECTIVELY.
PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - FAIRVIEW HOSPITAL IS EXTREMELY PROACTIVE IN HELPING PATIENTS ACCESS COVERAGE. THROUGH CONTINUOUS OUTREACH ACTIVITIES AND MEDIA COVERAGE, FAIRVIEW'S ADVOCACY FOR ACCESS TEAM PROMOTES INFORMATION ABOUT ELIGIBILITY TO INDIVIDUALS WHO CAN RECEIVE ASSISTANCE FROM FEDERAL, STATE, AND LOCAL GOVERNMENTS. PATIENTS ARE CONNECTED TO THESE PROGRAMS BOTH FROM WITHIN THE HOSPITAL AS WELL AS ON A COMMUNITY LEVEL. THE ADVOCACY FOR ACCESS OFFICE, LOCATED IN THE FRONT LOBBY OF THE HOSPITAL, MAINTAINS FLEXIBLE HOURS TO ACCOMMODATE THOSE SEEKING COVERAGE. THROUGHOUT THE HOSPITAL, THE ADVOCACY TEAM HAS TRAINED STAFF TO INITIATE CONTACT TO FACILITATE ENROLLMENT AND ANSWER QUESTIONS PATIENTS MAY HAVE. IN ADDITION, A FINANCIAL ADVISOR IS AVAILABLE DURING BUSINESS HOURS TO ASSIST PATIENTS IN CREATING FLEXIBLE BILLING ARRANGEMENTS AS WELL AS ADDRESSING BILLING ISSUES AND QUESTIONS.THE SERVICE ECONOMY IN THE SOUTHERN BERKSHIRES HAS MANY UNINSURED AND UNDERINSURED WORKERS. MANY OF THESE INDIVIDUALS HOLD MORE THAN ONE JOB. THE ADVOCACY FOR ACCESS TEAM HAS PLACED SPECIAL EMPHASIS ON REACHING OUT TO THE SELF-EMPLOYED AS WELL AS IMMIGRANT COMMUNITIES TO PROVIDE THEM WITH INFORMATION AND ENROLL THEM IN HEALTH COVERAGE DURING THE PAST YEAR.
PART VI, LINE 4: COMMUNITY INFORMATION - FAIRVIEW HOSPITAL SERVES A RURAL AREA IN THE SOUTHWESTERN CORNER OF MASSACHUSETTS IN ADDITION TO NEARBY COMMUNITIES ACROSS THE BORDERS OF NEW YORK AND CONNECTICUT. THERE IS A WIDE SOCIO-ECONOMIC RANGE IN THE COMMUNITY, NECESSITATING A DIVERSE COMMUNICATIONS PLAN, INCLUDING BOTH TRADITIONAL AND SOCIAL MEDIA. HOWEVER, FAIRVIEW RECOGNIZES THE IMPACT THAT WORD-OF-MOUTH CONTINUES TO HOLD AND ENGAGES WITH A NETWORK OF COMMUNITY LEADERS WHO REPRESENT VARIOUS CONSTITUENCIES TO TAP INTO THESE NETWORKS DIRECTLY AND THROUGH COMMUNITY AFFILIATIONS SUCH AS THE SOUTHERN BERKSHIRE REGIONAL EMERGENCY PLANNING COMMITTEE, AN ALLIANCE OF THE TOWNS, EMERGENCY SERVICES, BOARDS OF HEALTH, SELECTMEN OF INDIVIDUAL TOWNS, AND THE HOSPITAL. WHILE THE SOUTHERN BERKSHIRE COMMUNITY IS PREDOMINATELY CAUCASIAN, THERE IS A GROWING MULTI-CULTURAL COMMUNITY. FAIRVIEW HOSPITAL HAS EXPANDED ITS NETWORK OF CONTACTS AND RESOURCES TO SERVE THIS COMMUNITY. WHEN ANY HEALTH ISSUE IS ADDRESSED OR PROGRAM PROMOTED, THERE ARE MANY POINTS OF CONTACT REPRESENTING THIS COMMUNITY TO INITIATE A SIMILAR DISTRIBUTION OF INFORMATION TAILORED TO THE NEEDS OF SPECIFIC GROUPS. ADDITIONALLY, THERE IS A SIGNIFICANT SECTOR OF SECOND-HOMEOWNERS, WHICH PROVIDES AN ECONOMIC BOOST TO THE CONSTRUCTION AND SERVICE INDUSTRY, BUT RAISES THE PRICE OF HOUSING, PLACING IT OUT OF REACH OF MANY LOCAL FAMILIES. THERE ARE A SIGNIFICANT PERCENTAGE OF FAMILIES LIVING IN POVERTY. IN FACT, TWENTY-FIVE PERCENT OF FAMILIES ARE LIVING BELOW 200% OF THE POVERTY LEVEL (MORE THAN 3% OVER THE STATE AVERAGE) AND THE AVERAGE PER CAPITA INCOME IS $3,297 LOWER THAN THE STATE AVERAGE. OVER 35% OF THE STUDENTS IN THE LOCAL ELEMENTARY SCHOOL ARE ON FREE OR REDUCED PRICE LUNCHES. RURAL HOMELESSNESS IS A HIDDEN, BUT PERVASIVE SOCIAL AND ECONOMIC ISSUE. FAIRVIEW HOSPITAL COLLABORATES WITH BOTH THE LOCAL HOMELESS SHELTER AND VOLUNTEERS IN MEDICINE TO PROVIDE NEEDED MEDICAL CARE AND MEALS. THE PERCENTAGE OF ELDERS IN THE SOUTHERN BERKSHIRES IS SIGNIFICANTLY ABOVE THE STATE AVERAGE, SURPASSING 20% IN SOME RURAL COMMUNITIES. ADDITIONALLY, MANY ELDERS ARE LIVING ALONE. SENIOR CENTERS AND SERVICES ARE AN IMPORTANT COMMUNITY RESOURCE AND FAIRVIEW REGULARLY OFFERS PROGRAMS THROUGH THESE ORGANIZATIONS.PUBLIC TRANSPORTATION IS LIMITED AND NOT EASILY ACCESSIBLE. AS A RESULT, TRANSPORTATION IS AN OBSTACLE TO CARE FOR MANY, PARTICULARLY AMONG THE ELDERLY. A PUBLIC TRANSPORTATION AGENCY RUNS A LIMITED BUS ROUTE WITH LIMITED HOURS. ADDITIONAL ELDERLY TRANSPORTATION IS AVAILABLE BUT LIMITED. PEOPLE WHO NEED TO ACCESS HEALTHCARE MUST RELY ON FAMILY OR FRIENDS TO GET TO MEDICAL CARE. SPECIALTY CARE IS A PARTICULAR CHALLENGE TO OBTAIN. FAIRVIEW HOSPITAL COLLABORATES WITH AREA ORGANIZATIONS TO HELP MAKE TRANSPORTATION OPTIONS AVAILABLE. HEALTHCARE AND EDUCATION ARE THE PRIMARY EMPLOYMENT SECTORS. THE SOUTHERN BERKSHIRE ECONOMY'S PRIMARY ECONOMIC ENGINE IS TOURISM, WITH A HIGH NUMBER OF HOTELS, BED AND BREAKFASTS, RESTAURANTS, AND RETAIL SHOPS AND SERVICES CATERING TO THE TOURIST COMMUNITY. THE LOCAL CONSTRUCTION INDUSTRY WAS SEVERELY IMPACTED BY THE ECONOMIC DOWNTURN. ALTHOUGH THESE ARE OFTEN SEASONAL AND SERVICE BASED JOBS, THEY ARE A SIGNIFICANT PART OF THE ECONOMY.
PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH - FURTHERING OUR CHARITABLE PURPOSE AS PART OF BERKSHIRE HEALTH SYSTEMS, FAIRVIEW HOSPITAL'S COMMUNITY BENEFIT MISSION IS COMMITTED TO IDENTIFY, PRIORITIZE, AND MAKE INVESTMENTS THAT ADDRESS OUR COMMUNITIES' HEALTH NEEDS AND RAISE THE HEALTH STATUS OF OUR NEIGHBORS. FAIRVIEW SERVES AS THE RURAL REGION'S PRIMARY HEALTHCARE ORGANIZATION, AND ADDRESSES THE NEEDS OF "AT RISK" AND VULNERABLE POPULATIONS AS PART OF OVERALL PUBLIC HEALTH. FAIRVIEW SEEKS INPUT AND FEEDBACK TO IMPROVE EFFICIENT USE OF RESOURCES TO MEET IDENTIFIED COMMUNITY NEEDS AND ACTS AS A CATALYST TO PROMOTE HEALTH INITIATIVES SUCH AS FLU CLINICS, EMERGENCY PLANNING, AND OTHER PUBLIC HEALTH MANDATES. FAIRVIEW PARTICIPATES IN THE BERKSHIRE MEDICAL CENTER MONTHLY COMMUNITY BENEFITS MEETINGS AS WELL AS MAINTAINING A SEPARATE FAIRVIEW HOSPITAL COMMUNITY BENEFITS COMMITTEE WHICH MEETS TWICE A YEAR AND PROVIDES A PLATFORM THAT FOCUSES ON THE TWELVE SOUTHERN BERKSHIRE TOWNS IN ITS SERVICE AREA, ENGAGING COMMUNITY PROFESSIONALS ON THE SPECIFIC NEEDS OF OUR GEOGRAPHIC DISTRICT. THE FHCBC INCLUDES THE PRESIDENT, TWO VICE PRESIDENTS, AND LEADERS OF THE HOSPITAL DEPARTMENTS AND STAFF WHO ARE DIRECTLY INVOLVED WITH PATIENTS, ALLOWING A GREATER FOCUS ON THE SPECIFIC NEEDS OF THIS GEOGRAPHIC DISTRICT THROUGH A MULTIDISCIPLINARY APPROACH TO IDENTIFY EMERGING HEALTH ISSUES IN THE COMMUNITY.FAIRVIEW HOSPITAL VALUES THE COMMUNITY'S VITAL ROLE AS STEWARDS OF THEIR COMMUNITY HOSPITAL. MEMBERS OF THE COMMUNITY, REPRESENTING VARIOUS DEMOGRAPHIC AND CONSTITUENCY GROUPS, SERVE ON OUR GOVERNING BOARDS AS WELL AS VARIOUS COMMITTEES WHICH ASSURE THE INPUT AND INTERESTS OF THE COMMUNITY ARE REPRESENTED AT THE HIGHEST LEVELS. HOSPITAL STAFF ALSO PLAY AN ACTIVE ROLE IN MANY LOCAL AND REGIONAL ORGANIZATIONS, SUPPORTING THEIR EFFORTS AND, BY ENGAGING WITH THEIR MISSION AND INTERESTS, CREATING NEW AVENUES OF COLLABORATION AND OPPORTUNITY TO BETTER MEET OUR COMMUNITY'S HEALTH NEEDS.THE CURRENT GOVERNING BODY OF FAIRVIEW HOSPITAL CONSISTS OF 19 COMMUNITY VOLUNTEERS, FOUR PHYSICIAN REPRESENTATIVES, AND AS AN EX-OFFICIO MEMBER, THE CHIEF EXECUTIVE OFFICER. THE COMMUNITY VOLUNTEERS ARE ELECTED FOR TERMS OF UP TO THREE YEARS, ARE SUBJECT TO TERM LIMITS, AND REPRESENT A WIDE SPECTRUM OF COMMUNITY INTERESTS - INCLUDING SOCIAL SERVICE PROVIDERS, LOCAL BUSINESS LEADERS, FINANCIAL PROFESSIONALS, CONSUMER ADVOCATES, AND EDUCATIONAL LEADERS. MOST COMMITTEES OF THE BOARD OF TRUSTEES INCLUDE ADDITIONAL COMMUNITY REPRESENTATIVES. FAIRVIEW ALSO MAINTAINS A PATIENT AND FAMILY COUNCIL TO PROVIDE INPUT AND ADVICE ON A WIDE RANGE OF SERVICE TOPICS.THE MEDICAL STAFF OF FAIRVIEW HOSPITAL IS OPEN TO ALL PHYSICIANS WHO MEET CLINICAL AND PATIENT SERVICE CRITERIA, ALTHOUGH CERTAIN HOSPITAL BASED SERVICES - RADIOLOGY, ANESTHESIA, EMERGENCY DEPARTMENT AND PATHOLOGY - ARE FUNCTIONALLY CLOSED BECAUSE OF THE MANNER IN WHICH THOSE DEPARTMENTS ARE STRUCTURED.FAIRVIEW REGULARLY EXPENDS PERSONNEL AND FINANCIAL RESOURCES IN SUPPORT OF COMMUNITY INITIATIVES THAT PROMOTE IMPROVEMENTS IN COMMUNITY HEALTH AND WELL-BEING FOR WHICH IT DOES NOT EXPECT REIMBURSEMENT. THE HOSPITAL UTILIZES SURPLUS FUNDS FOR CAPITAL IMPROVEMENTS, TO MAINTAIN ACCESS TO HOSPITAL SERVICES AND PRIMARY CARE, TO EXPAND ACCESS POINTS OF CARE, AND TO SUPPORT SERVICES THAT SUPPORT COMMUNITY BENEFIT PRIORITIES INCLUDING CHRONIC DISEASE, EDUCATION, AND ACCESS TO CARE. FAIRVIEW'S EXTENSIVE COMMUNITY OUTREACH AND SUPPORT PROGRAMS INCLUDE TOBACCO TREATMENT, PARKINSON'S EXERCISE, AND CPR AND LIFE SAFETY TRAINING. IN ADDITION, FAIRVIEW PROVIDES FINANCIAL SUPPORT FOR LOCAL INITIATIVES, INCLUDING YOUTH SPORTS AND RECREATIONAL ACTIVITIES, TIED TO MESSAGING THAT ADDRESSES THE COMMUNITY'S CONCERN FOR ALCOHOL AND SUBSTANCE ABUSE, AN ISSUE IDENTIFIED AS A COMMUNITY CONCERN IN A RECENT ASSESSMENT.FAIRVIEW HOSPITAL'S SERVICE AREA IS A DESIGNATED MEDICALLY UNDERSERVED COMMUNITY AND IT HAS PLACED A HIGH PRIORITY ON RECRUITING PHYSICIANS AND MEDICAL PERSONNEL TO THE AREA TO SUPPORT ACCESS TO PRIMARY HEALTH NEEDS. FURTHER EFFORT AND RESOURCES HAVE BEEN SPENT INCREASING ACCESS TO SPECIALTY SERVICES. MANY OF THESE PROVIDERS ARE NOW EMPLOYEES DIRECTLY AFFILIATED WITH FAIRVIEW HOSPITAL, BERKSHIRE MEDICAL CENTER, OR BERKSHIRE HEALTH SYSTEMS. MOREOVER, BMC AND FAIRVIEW HAVE, IN APPROPRIATE WAYS, PROVIDED SUBSTANTIAL ASSISTANCE TO COMMUNITY MEDICAL PRACTICES TO RECRUIT AND SUPPORT THE PRACTICE START-UP OF NEW PHYSICIANS IN NEEDED SPECIALTIES.FACING AN INCREASINGLY CHALLENGING ENVIRONMENT IN WHICH TO ATTRACT SKILLED HEALTHCARE PROVIDERS, FAIRVIEW HOSPITAL IS ACTIVELY ENGAGED IN CAREER DEVELOPMENT AT MANY LEVELS OF PROFESSIONAL TRAINING TO ALLOW STUDENTS LIVING IN OUR RURAL COMMUNITY ACCESS TO HIGH QUALITY TRAINING PROGRAMS IN THE HOPE THAT THEY WILL BE THE FOUNDATION OF OUR FUTURE HEALTHCARE WORKFORCE.AS STEWARD OF THE COMMUNITY'S PRIMARY HEALTH ORGANIZATION, AND A NOT-FOR-PROFIT ORGANIZATION, FAIRVIEW HOSPITAL UTILIZES ANY SURPLUS FUNDS TO MEET THE HIGHEST PRIORITY NEEDS INCLUDING PATIENT CARE, SERVICE AND PROGRAM DEVELOPMENT, MEDICAL EDUCATION OF ALL STAFF, COMMUNITY SUPPORT, AND EDUCATION AND RESEARCH.AS THE CENTER OF THE HEALTHCARE COMMUNITY IN THE SOUTHERN BERKSHIRES, FAIRVIEW HOSPITAL IS AN ACTIVE LEADER IN THE PROMOTION OF BETTER HEALTH IN OUR COMMUNITY. FAIRVIEW OFFERS:PRIMARY SERVICES TO ALL WHO SEEK CARE, REGARDLESS OF ABILITY TO PAY;FREE OR LOW-COST EDUCATIONAL PROGRAMS, SUPPORT GROUPS, AND SCREENINGS TO PROVIDE VALUABLE INFORMATION TO OUR COMMUNITY, WITH PARTICULAR FOCUS ON VULNERABLE POPULATIONS;ONGOING MEDIA COMMUNICATION FOR IMPORTANT HEALTH ACCESS INFORMATION INCLUDING FLU PREVENTION, VACCINATIONS, AND COMMONWEALTH CARE DEADLINES;HEALTHY MENUS, MORE SUSTAINABLE OR ENVIRONMENTALLY FRIENDLY POLICIES, AND DISCONTINUATION OF SUGAR DRINKS IN THE HOSPITAL TO SERVE AS A ROLE MODEL FOR A HEALTHIER COMMUNITY; ANDLEADERSHIP AND COLLABORATION IN PUBLIC HEALTH INITIATIVES INCLUDING EMERGENCY PLANNING, BOARDS OF HEALTH, AND OTHER COMMUNITY-WIDE INITIATIVES.A SPECIFIC AREA OF FOCUS THAT REFLECTS THE IMPORTANCE AND IMPACT OF COLLABORATION IS YOUTH OBESITY. FAIRVIEW HOSPITAL HAS LAUNCHED OPERATION BETTER START, A SATELLITE PROGRAM OF BERKSHIRE MEDICAL CENTER, TO BRING AN AWARD WINNING PROGRAM TO THE SOUTHERN BERKSHIRES. THIS PROGRAM TARGETS OBESITY IN YOUTH WITH A MULTI-DISCIPLINARY TEAM THAT ADDRESSES THE MANY ISSUES INVOLVED IN OBESITY AND TREATS NOT ONLY THE CHILD, BUT THE FAMILY, TO ACHIEVE IMPROVED HEALTH FOR THE ENTIRE FAMILY UNIT. IN OTHER AREAS, FAIRVIEW HAS TAKEN A PROACTIVE APPROACH TO BETTER HEALTH THROUGH BETTER NUTRITION AS WELL. IN ADDITION TO NUTRITION COUNSELING, FAIRVIEW OFFERS A SIX-WEEK MINDFULNESS EATING PROGRAM, AND ITS FOOD SERVICES IS A LEADER IN THE NATION AS A HOSPITAL THAT SETS A HIGHER STANDARD IN HEALTHY EATING WITHIN THE HOSPITAL. FAIRVIEW WAS THE FIRST HOSPITAL IN THE COUNTRY TO DISCONTINUE THE SALE OF SUGAR-SWEETENED BEVERAGES AT THE HOSPITAL AND THE FIRST HOSPITAL IN MASSACHUSETTS TO SIGN THE HEALTHCARE WITHOUT HARM PLEDGE.
PART VI, LINE 6: AFFILIATED HEALTHCARE SYSTEM - FAIRVIEW HOSPITAL IS A PART OF AN INTEGRATED, NON-PROFIT HEALTHCARE SYSTEM THAT INCLUDES (A) A TEACHING HOSPITAL, (B) A CRITICAL ACCESS COMMUNITY HOSPITAL [FAIRVIEW], (C) A LARGE, MULTISPECIALTY FACULTY PRACTICE ORGANIZATION, (D) A HOME HEALTH AGENCY, AND (E) BY CONTRACT AND CLOSE COORDINATION, A NON-PROFIT SENIOR CARE ORGANIZATION THAT INCLUDES SUB-ACUTE SERVICES IN REHABILITATION AND LONG-TERM CARE FACILITIES, ASSISTED LIVING FACILITIES, HOSPICE CARE SERVICES, SENIOR DAY CARE, AND OTHER ELDERCARE SERVICES. FAIRVIEW ENGAGES IN HEALTHCARE NEEDS ASSESSMENT AND PLANNING ON A SYSTEM-WIDE BASIS, WITH A GOAL OF A SEAMLESS TRANSITION OF PATIENT-CENTERED CARE ACROSS THE SPECTRUM OF SERVICES OFFERED BY EACH OF THE SYSTEM'S COMPONENT ENTITIES. FAIRVIEW, ALONG WITH ITS AFFILIATES, CONTINUES TO DEVELOP INTEGRATED CLINICAL AND INFORMATION SYSTEMS ACROSS THE ENTIRE ORGANIZATION SO AS TO RENDER CARE EFFICIENTLY, EFFECTIVELY, AND CONSISTENTLY AT EVERY CARE SITE. THE VARIOUS AFFILIATES, SUCH AS THE FACULTY PRACTICE ORGANIZATION, ARE FULLY INTEGRATED INTO THE COMMUNITY BENEFIT PROCESS AND SUPPORT THE HOSPITAL'S PRIORITIES BY HONORING OUR FREE CARE GUIDELINES AND ENGAGING IN SPECIFIC PROGRAMS AND INITIATIVES DESIGNED TO MEET COMMUNITY NEEDS.
MAREPORTS FILED WITH STATESPART VI, LINE 7

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
BRIAN T BURKE MD
TRUSTEE/PHYSICIAN19428600018949099820333870256604000
DAVID PHELPS SEE SCH J PT III
PRESIDENT/TRUSTEE047591400054706011250037779057964900
D PHELPS-RETIREMNT DSTRB1 TIME
PRESIDENT/TRUSTEE00000187832800000187832800
EUGENE A DELLEA
PRESIDENT, FAIRVIEW HOSPITAL017240800082785010969015142028130400
DARLENE M RODOWICZ
TREASURER0367007000127296011250028209053376200
DOREEN HUTCHINSON
VICE PRESIDENT, OPERATIONS15431200020949082660315880215115000
RAYMOND SABATELLI MD
DIRECTOR, EMERGENCY DEPT.1950290105300356710112030289030281336000
RICHARD F SALLUZZO MD
DIRECTOR, EMERGENCY DEPT.1438792182900406100002110702055962182900
WILLIAM F DUKE MD
PHYSICIAN199570011087040402098390331610294059000
ADRIAN ELLIOT MD
PHYSICIAN252607106021108709533128328702829303048071073000
CORINNE D KALSER MD
PHYSICIAN2287450156490182130112500290600302917000
GLEN R LOVEJOY MD
PHYSICIAN2550760110870244660100360318160332481000
ROBERT RATTNER MD
PHYSICIAN226820011087013032079910390020297932000
ALEC R BELMAN MD
PHYSICIAN/FORMER KEY EE1192030561608446061790147660154210000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Return ReferencePART IIIReturnReference
ExplanationSUPPLEMENTAL COMPENSATION INFORMATION IN REFERENCE TO FORM 990, PART VII AND SCHEDULE J PART II, NO COMPENSATION IS PAID BY THE FILING ENTITY TO ANY DIRECTOR (TRUSTEE) FOR HIS OR HER ROLE AS DIRECTOR (TRUSTEE), WITH THE EXCEPTION OF BRIAN T. BURKE, MD, WHOSE COMPENSATION RELATES SOLELY TO SERVICES RENDERED FOR TAX-EXEMPT PURPOSES AND NOT TO HIS ROLE AS DIRECTOR (TRUSTEE). THE PRINCIPAL OFFICERS OF FAIRVIEW HOSPITAL ARE ALL COMPENSATED BY BHS MANAGEMENT SERVICES, INC. (BMS), A SUPPORTING ORGANIZATION OF THE FILING ENTITY. A PORTION OF THE COMPENSATION AMOUNT PAID TO THE PRINCIPAL OFFICERS OF THE FILING ENTITY IS ALLOCATED INTERNALLY AMONG THE FILING ENTITY AND ITS 26 ASSOCIATED NON-PROFIT, TAX-EXEMPT ENTITIES IN ORDER TO PROPERLY REFLECT THE DIVISION OF THE OFFICERS' TIME AND EFFORT AMONG THOSE VARIOUS ENTITIES AND EACH ENTITY'S RELATIVE CONTRIBUTION TO THE OFFICERS' TOTAL COMPENSATION (SEE BELOW). COMPENSATION OF THE CHIEF EXECUTIVE OFFICER, DAVID PHELPS, IS REVIEWED AND ESTABLISHED AT LEAST BIANNUALLY BY THE INDEPENDENT VOLUNTEER GOVERNING BODY OF BERKSHIRE HEALTH SYSTEMS, INC. (PARENT ORGANIZATION OF FAIRVIEW HOSPITAL), BASED ON PERFORMANCE REVIEWS AND COMPARISON TO INDEPENDENTLY ESTABLISHED, REGIONALLY APPROPRIATE BENCHMARKS FOR SIMILAR POSITIONS IN SIMILARLY SIZED HEALTHCARE ORGANIZATIONS, AS VERIFIED BY INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANTS. COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS SET IN ACCORDANCE WITH GOVERNING BODY-ESTABLISHED PRINCIPLES BASED ON COMPARABLE BENCHMARKS IDENTIFIED BY SUCH INDEPENDENT CONSULTANTS. IN THE REPORTING YEAR, THE GOVERNING BODY TARGETED TOTAL COMPENSATION FOR MANAGEMENT EMPLOYEES AT THE 60TH PERCENTILE OF APPROPRIATE BENCHMARKS. FOR MOST OF MR. PHELPS' MORE THAN 20-YEAR TENURE AS CHIEF EXECUTIVE OFFICER, A WRITTEN AGREEMENT BETWEEN BERKSHIRE HEALTH SYSTEMS AND MR. PHELPS HAS CALLED FOR BERKSHIRE HEALTH SYSTEMS (AND ITS AFFILIATES) TO FUND A RETIREMENT PROGRAM THAT, WHEN ADDED TO HIS BASE COMPENSATION AND OTHER ROUTINE BENEFITS, WAS INTENDED TO BRING MR. PHELPS' TOTAL COMPENSATION CLOSE TO THE 50TH PERCENTILE RANGE OF TOTAL COMPENSATION FOR COMPARABLE EXECUTIVES IN COMPARABLE HEALTHCARE ORGANIZATIONS, AS DETERMINED BY INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION REVIEWERS. CONTRIBUTIONS TO MR. PHELPS' RETIREMENT PROGRAM HAVE BEEN FULLY REPORTED IN PRIOR YEARS. MR. PHELPS' INTEREST IN THE RETIREMENT PROGRAM BECAME FULLY VESTED AND THEREFORE FULLY REPORTABLE AND TAXABLE AS INCOME IN THE REPORTING YEAR. THE FULL AMOUNT OF MR. PHELPS' INTEREST IN THE RETIREMENT PROGRAM IS REFLECTED ON FORM 990 PART VII SECTION A LINE 1A ITEM 20 COLUMN E AND SCHEDULE J PART II ITEM 3 COLUMN B(III). A PORTION OF THE RETIREMENT PROGRAM FUNDING IS ALLOCATED AMONG BERKSHIRE HEALTH SYSTEMS AND ITS DIRECT AFFILIATES. THE FOLLOWING LIST SHOWS THE ENTITIES TO WHICH THE IDENTIFIED OFFICER PROVIDED SERVICES, THE AVERAGE WEEKLY HOURS ALLOCATED TO EACH ENTITY, AND THE RESPECTIVE ALLOCABLE SHARE OF HIS OR HER ANNUAL COMPENSATION (REPORTABLE COMPENSATION AND OTHER COMPENSATION) FOR CALENDAR 2012: DAVID E. PHELPS, PRESIDENT (ALLOCATION IS INCLUSIVE OF $107,692 LIFE INSURANCE CASHOUT WHICH IS INCLUDED IN FORM 990 PART VII SECTION A LINE 1A ITEM 20 COLUMN E AND SCHEDULE J PART II ITEM 3 COLUMN B(III).) BERKSHIRE MEDICAL CENTER, INC: 25.9 WEEKLY HOURS/50 WEEKLY HOURS $358,104 FAIRVIEW HOSPITAL: 3.5 HOURS/50 HOURS $47,427 BERKSHIRE FACULTY SERVICES, INC: 8.6 HOURS/50 HOURS $120,285 BERKSHIRE INDEMNITY CO, SPC, LTD: 2 HOURS/50 HOURS $24,057 BHS MANAGEMENT SERVICES, INC (10 HOURS/50 HOURS) FOR BENEFIT OF: BOURNE MANAGEMENT SYSTEMS, INC: $9,210 GREENFIELD MANAGEMENT SYSTEMS, INC: $8,523 NEW BEDFORD MANAGEMENT SYSTEMS, INC: $9,760 NORTHAMPTON MANAGEMENT SYSTEMS, INC: $8,248 EAST LONGMEADOW MANAGEMENT SYSTEMS, INC: $4,674 DANVERS MANAGEMENT SYSTEMS, INC: $4,399 PEABODY MANAGEMENT SYSTEMS, INC: $7,973 SOUTH YARMOUTH MANAGEMENT SYSTEMS, INC: $5,086 BERKSHIRE PENNSYLVANIA, INC: $7,561 XENIA EAST MANAGEMENT SYSTEMS, INC: $2,199 WILLOWOOD OF GREAT BARRINGTON, INC: $7,011 WILLOWOOD OF NORTH ADAMS, INC: $7,973 WILLOWOOD OF WILLIAMSTOWN, INC: $10,035 HILLCREST EXTENDED CARE SERVICES, INC: $18,421 BERKSHIRE RETIREMENT COMMUNITY, INC: $6,186 BERKSHIRE EXTENDED CARE SERVICES, INC: $550 INTEGRINURSE, INC: $1,650 INTEGRISCRIPT, INC: $3,987 HOSPICECARE IN THE BERKSHIRES, INC: $8,798 PITTSFIELD MANAGEMENT SYSTEMS, INC: $5,224 NON-AFFILIATED RABBI TRUST (ONE TIME PAYMENT) $1,770,636 TOTAL REPORTABLE COMPENSATION AND OTHER COMPENSATION $2,457,977 DARLENE RODOWICZ, TREASURER BERKSHIRE MEDICAL CENTER, INC: 37 WEEKLY HOURS/50 WEEKLY HOURS $394,984 FAIRVIEW HOSPITAL: 3 HOURS/50 HOURS $32,026 BERKSHIRE FACULTY SERVICES, INC: 7 HOURS/50 HOURS $74,726 BERKSHIRE INDEMNITY CO, SPC, LTD: 2.5 HOURS/50 HOURS $26,688 BHS MANAGEMENT SERVICES, INC FOR THE BENEFIT OF BERKSHIRE HEALTHCARE SYSTEMS, INC: 0.5 HOUR/50 HOURS $5,338 TOTAL REPORTABLE COMPENSATION AND OTHER COMPENSATION $533,762Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
MASS HEALTH & EDUCATION FACIL AUTHORITY SER F
A04245601157586CLN32005-07-2653089428REFUND SER C & D BONDS;CAPITAL EXP000
MASS DEVELOPMENT FINANCE AGENCY BHS ISSUESER G
B04343181457583UQP62012-05-2393491421REFUND SER A, B, & E; CAPITAL EXP000

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
A1979000054978523501900010038008987957368190034283897981920081011
B267000093491421124568181719448407379620111011

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUseBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A00000.000000.000000.00000000
B00000.000000.000000.00000000

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqsRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDue
A100010
B000000100

Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A1
B1

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 3FAIRVIEW HOSPITAL RELIES ON BHS MANAGEMENT SERVICES, INC. (BMS) TO PROVIDE MANAGEMENT AND SUPPORT SERVICES. THE FOLLOWING LIST SHOWS POSITIONS THAT ARE HELD BY EMPLOYEES OF BMS AND THE AMOUNT OF COMPENSATION PAID IN CALENDAR YEAR 2012 TO THOSE EMPLOYEES BY BMS: DAVID E. PHELPS, CHIEF EXECUTIVE OFFICER (SEE COMPENSATION REPORTED ON FORM 990, PART VII, SECTION A, AND SCHEDULE J, PART II) DARLENE M. RODOWICZ, CHIEF FINANCIAL OFFICER (SEE COMPENSATION REPORTED ON FORM 990, PART VII, SECTION A, AND SCHEDULE J, PART II) JOHN ROGERS, VP-GENERAL COUNSEL: REPORTABLE COMPENSATION FROM BMS $449,595; OTHER COMPENSATION FROM BMS $44,148 ARTHUR MILANO, VP-HUMAN RESOURCES: REPORTABLE COMPENSATION FROM BMS $263,672; OTHER COMPENSATION FROM BMS $40,642 EUGENE A. DELLEA, PRESIDENT-FAIRVIEW HOSPITAL (SEE COMPENSATION REPORTED ON FORM 990, PART VII, SECTION A, AND SCHEDULE J, PART II) ANTHONY J. RINALDI, VP-FAIRVIEW HOSPITAL: REPORTABLE COMPENSATION FROM BMS $260,312; OTHER COMPENSATION FROM BMS $43,239
FORM 990, PART VI, SECTION A, LINE 6BERKSHIRE HEALTH SYSTEMS, INC. IS THE SOLE CORPORATE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7ATHE BOARD OF TRUSTEES IS COMPOSED OF THE INCUMBENT MEMBERS OF THE BOARD OF TRUSTEES OF BERKSHIRE HEALTH SYSTEMS, INC.
FORM 990, PART VI, SECTION B, LINE 11BERKSHIRE HEALTH SYSTEMS, INC. WILL MAKE THE FORMS 990 FOR BHS AND ITS AFFILIATES AVAILABLE TO THE MEMBERS OF THE RESPECTIVE GOVERNING BODIES FOR THEIR REVIEW BY (A) SENDING COPIES TO THEM PHYSICALLY OR ELECTRONICALLY, OR (B) NOTIFYING THE MEMBERS THAT THE FORMS 990 CAN BE ACCESSED BY A SECURE WEB-BASED FOLDER BEFORE THEY ARE FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION ENFORCES & MONITORS ITS CONFLICT OF INTEREST POLICY BY REQUIRING ALL MEMBERS OF THE GOVERNING BODY & SENIOR MANAGEMENT TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST (A) ANNUALLY & (B) AS POTENTIAL CONFLICTS ARISE. SENIOR EMPLOYEES ARE NOT PERMITTED TO HAVE MATERIAL CONFLICTS OF INTEREST. MEMBERS OF THE GOVERNING BODY ARE TO ABSTAIN FROM ACTIONS THAT MAY BE INFLUENCED BY THEIR CONFLICT OR POTENTIAL CONFLICT BY: (A) NOT VOTING, OR (B) NOT VOTING & LEAVING THE ROOM, OR (C) LEAVING THE GOVERNING BODY, AS DETERMINED BY THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 15FAIRVIEW HOSPITAL RELIES ON BHS MANAGEMENT SERVICES, INC. TO SUPPLY ITS CHIEF EXECUTIVE OFFICER. THE COMPENSATION OF CEO DAVID PHELPS IS REVIEWED AND ESTABLISHED AT LEAST BIANNUALLY BY THE INDEPENDENT VOLUNTEER BHS GOVERNING BODY, BASED ON PERFORMANCE REVIEWS AND COMPARISON TO INDEPENDENTLY ESTABLISHED, REGIONALLY APPROPRIATE BENCHMARKS FOR SIMILAR POSITIONS IN SIMILARLY SIZED HEALTHCARE ORGANIZATIONS, AS VERIFIED BY INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANTS. COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS SET IN ACCORDANCE WITH GOVERNING BODY-ESTABLISHED PRINCIPLES BASED ON COMPARABLE BENCHMARKS IDENTIFIED BY SUCH INDEPENDENT CONSULTANTS. IN THE REPORTING YEAR, THE GOVERNING BODY TARGETED TOTAL COMPENSATION FOR MANAGEMENT EMPLOYEES AT THE 60TH PERCENTILE OF APPROPRIATE BENCHMARKS.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC AT THE OFFICES OF (A) THE CHIEF FINANCIAL OFFICER & (B) THE VICE PRESIDENT, GENERAL COUNSEL AT 725 NORTH STREET, PITTSFIELD, MASSACHUSETTS 01201.
FORM 990, PART VII, SECTION A, COLUMN (B)EDMUND H. HORNSTEIN, DO'S HOURS SHOWN ARE FOR SERVICES AS A TRUSTEE, FOR WHICH HE RECEIVES NO COMPENSATION. DR. HORNSTEIN RECEIVES PAYMENT FROM BERKSHIRE MEDICAL CENTER FOR PHYSICIAN SERVICES. ROBERT P. WESPISER, MD'S HOURS SHOWN ARE FOR SERVICES AS A TRUSTEE, FOR WHICH HE RECEIVES NO COMPENSATION. DR. WESPISER RECEIVES PAYMENT FROM BERKSHIRE MEDICAL CENTER FOR PHYSICIAN SERVICES. ALL TRUSTEES (BOARD MEMBERS) RECEIVE NO COMPENSATION FOR SERVICES AS TRUSTEES.AVERAGE HOURS PER WEEK
FORM 990, PART VII, SECTION A, COLUMN (A)ROBERT P. WESPISER, MD'S TERM AS A TRUSTEE EXPIRED PRIOR TO THE END OF THE FISCAL YEAR REPORTED ON THIS RETURN.TRUSTEE NOT SERVING AT YEAR-END
FORM 990, PART XII, QUESTION 2CA COMMITTEE OF THE BOARD OF TRUSTEES HAS RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR FISCAL YEAR.OVERSIGHT OF AUDIT & SELECTION OF INDEPENDENT ACCOUNTANT

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
BERKSHIRE HEALTH SYSTEMS INC
725 NORTH STPITTSFIELDMA01201042442944PARENT CORPORATIONMA501(C)(3)11BN/A0
BERKSHIRE MEDICAL CENTER INC
725 NORTH STPITTSFIELDMA01201042791396ACUTE CARE HOSPITALMA501(C)(3)3N/A0
BERKSHIRE FACULTY SERVICES INC
725 NORTH STPITTSFIELDMA01201042995053PHYSICIAN SERVICESMA501(C)(3)11BN/A0
BHS MANAGEMENT SERVICES INC
725 NORTH STPITTSFIELDMA01201222755258MANAGEMENT SERVICESMA501(C)(3)11BN/A0

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipControlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
TRI-STATE MEDICAL MANAGEMENT CORP
725 NORTH STREETPITTSFIELDMA01201042913352REAL ESTATE MGMTMAFAIRVIEW HOSPITALC46162326761.000000
WILLIAMSTOWN MEDICAL ASSOCIATES PC
197 ADAMS ROADWILLIAMSTOWNMA01267042680535HEALTHCARE SERVICESMAC0N/A
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1TRI-STATE MEDICAL MANAGEMENT CORPBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeDTransactionType
Amount Involved225730AmountInvolved
Method Of Amt DeterminationFAIR MARKET VALUEMethodOfAmtDetermination