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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-08-15T10:45:33-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 042133860 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAIRVIEW HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | FAIR | NameControl |
| Phone | 4134472508 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 725 NORTH STREET | AddressLine1 |
| City | PITTSFIELD | City |
| State | MA | State |
| ZIP Code | 012014109 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DARLENE RODOWICZ | Name |
| Title | CFO | Title |
| Phone | 4134472809 | Phone |
| Date Signed | 2014-08-15 | DateSigned |
| Authorize Third Party | 0 | AuthorizeThirdParty |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DARLENE RODOWICZ | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 725 NORTH ST | AddressLine1 |
| City | PITTSFIELD | City |
| State | MA | State |
| ZIP Code | 012014109 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 50662181 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.BHS1.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1912 | YearFormation |
| State Legal Domicile | MA | StateLegalDomicile |
| Activity Or Mission Description | THE 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 Body | 24 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 20 | NbrIndependentVotingMembers |
| Total Nbr Employees | 335 | TotalNbrEmployees |
| Total Nbr Volunteers | 50 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 618864 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 2549704 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 44224749 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 45741030 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 469864 | InvestmentIncomePriorYear |
| Investment Income Current Year | 563728 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1204552 | OtherRevenuePriorYear |
| Other Revenue Current Year | 732770 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 46518029 | TotalRevenuePriorYear |
| Total Revenue Current Year | 49587232 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 1250 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 25267767 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 25956565 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 128233 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 19396247 | OtherExpensePriorYear |
| Other Expenses Current Year | 19697148 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 44665264 | TotalExpensesPriorYear |
| Total Expenses Current Year | 45653713 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1852765 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 3933519 | RevenuesLessExpensesCY |
| Total Assets BOY | 31956366 | TotalAssetsBOY |
| Total Assets EOY | 37289446 | TotalAssetsEOY |
| Total Liabilities BOY | 18152754 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 17988391 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 13803612 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 19301055 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE 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 Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 40176117 | Expense |
| Revenue | 46203948 | Revenue |
| Description | FAIRVIEW 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 Expense | 40176117 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 94 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 335 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 24 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 20 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MA | StatesWhereCopyOfReturnIsFiled |
| States Where Copy Of Return Is Filed | NY | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DARLENE RODOWICZ CFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4134472809 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 725 NORTH STREET | AddressLine1 |
| City | PITTSFIELD | City |
| State | MA | State |
| ZIP Code | 012014109 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (38 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|---|
| LORINDA ACKLEY MAZUR | ||||||||||
| TRUSTEE | 0.10 | 1.90 | X | 0 | 0 | 0 | ||||
| JEROME J ANDERSON | ||||||||||
| TRUSTEE | 0.10 | 1.90 | X | 0 | 0 | 0 | ||||
| THOMAS O ANDREWS | ||||||||||
| TRUSTEE | 0.10 | 1.90 | X | 0 | 0 | 0 | ||||
| ALFRED A BARBALUNGA | ||||||||||
| TRUSTEE | 0.10 | 1.90 | X | 0 | 0 | 0 | ||||
| BRONLY S BOYD | ||||||||||
| TRUSTEE/CHAIRMAN | 0.10 | 1.90 | X | 0 | 0 | 0 | X | |||
| BRIAN T BURKE MD | ||||||||||
| TRUSTEE/PHYSICIAN | 48.00 | 2.00 | X | 213235 | 0 | 43369 | ||||
| KIT DOBELLE | ||||||||||
| TRUSTEE | 0.10 | 1.90 | X | 0 | 0 | 0 | ||||
| TIMOTHY C DOHERTY | ||||||||||
| TRUSTEE | 0.10 | 1.90 | X | 0 | 0 | 0 | ||||
| RICHARD M DOHONEY | ||||||||||
| TRUSTEE | 0.10 | 1.90 | X | 0 | 0 | 0 | ||||
| A KING FRANCIS | ||||||||||
| TRUSTEE | 0.10 | 1.90 | X | 0 | 0 | 0 | ||||
| DENNIS J HOGAN | ||||||||||
| TRUSTEE | 0.10 | 1.90 | X | 0 | 0 | 0 | ||||
| EDMUND H HORNSTEIN DO | ||||||||||
| TRUSTEE/CONTRACT PHYSICIAN | 0.10 | 1.90 | X | 0 | 65656 | 0 | ||||
| JOHN R KEARNS MD | ||||||||||
| TRUSTEE | 0.10 | 1.90 | X | 0 | 0 | 0 | ||||
| ELLEN L KENNEDY | ||||||||||
| TRUSTEE | 0.10 | 1.90 | X | 0 | 0 | 0 | ||||
| SUSAN M KORMANIK | ||||||||||
| TRUSTEE | 0.10 | 1.90 | X | 0 | 0 | 0 | ||||
| JOAN M MCFALLS | ||||||||||
| TRUSTEE | 0.10 | 1.90 | X | 0 | 0 | 0 | ||||
| MICHAEL R MCINERNEY MD | ||||||||||
| TRUSTEE | 0.10 | 1.90 | X | 0 | 0 | 0 | ||||
| LAURIE NORTON MOFFATT | ||||||||||
| TRUSTEE | 0.10 | 1.90 | X | 0 | 0 | 0 | ||||
| DAVID PHELPS SEE SCH J PT III | ||||||||||
| PRESIDENT/TRUSTEE | 3.50 | 46.50 | X | 0 | 530620 | 49029 | X | |||
| D PHELPS-RETIREMNT DSTRB1 TIME | ||||||||||
| PRESIDENT/TRUSTEE | 0.10 | 0.90 | X | 0 | 1878328 | 0 | X | |||
| BARTON D RASER | ||||||||||
| TRUSTEE | 0.10 | 1.90 | X | 0 | 0 | 0 | ||||
| CAROLE G SIEGEL | ||||||||||
| TRUSTEE | 0.10 | 1.90 | X | 0 | 0 | 0 | ||||
| GEORGE T SMITH | ||||||||||
| TRUSTEE | 0.10 | 1.90 | X | 0 | 0 | 0 | ||||
| MARILYN L SPERLING | ||||||||||
| TRUSTEE | 0.10 | 1.90 | X | 0 | 0 | 0 | ||||
| ANN H TRABULSI | ||||||||||
| TRUSTEE | 0.10 | 1.90 | X | 0 | 0 | 0 | ||||
| ROBERT P WESPISER MD | ||||||||||
| TRUSTEE/CONTRACT PHYSICIAN | 0.10 | 1.90 | X | 0 | 133154 | 0 | ||||
| CHERYL M BOUDREAU | ||||||||||
| CLERK | 2.00 | 38.00 | 0 | 97231 | 14802 | X | ||||
| EUGENE A DELLEA | ||||||||||
| PRESIDENT, FAIRVIEW HOSPITAL | 50.00 | 0.00 | 0 | 255193 | 26111 | X | ||||
| DARLENE M RODOWICZ | ||||||||||
| TREASURER | 3.00 | 47.00 | 0 | 494303 | 39459 | X | ||||
| DOREEN HUTCHINSON | ||||||||||
| VICE PRESIDENT, OPERATIONS | 50.00 | 0.00 | 175261 | 0 | 36795 | X | ||||
| RAYMOND SABATELLI MD | ||||||||||
| DIRECTOR, EMERGENCY DEPT. | 50.00 | 0.00 | 241230 | 0 | 39733 | X | ||||
| RICHARD F SALLUZZO MD | ||||||||||
| DIRECTOR, EMERGENCY DEPT. | 50.00 | 0.00 | 184489 | 21829 | 19488 | X | ||||
| WILLIAM F DUKE MD | ||||||||||
| PHYSICIAN | 50.00 | 0.00 | 251059 | 0 | 34177 | X | ||||
| ADRIAN ELLIOT MD | ||||||||||
| PHYSICIAN | 50.00 | 0.00 | 273227 | 10730 | 27625 | X | ||||
| CORINNE D KALSER MD | ||||||||||
| PHYSICIAN | 50.00 | 0.00 | 262607 | 0 | 35588 | X | ||||
| GLEN R LOVEJOY MD | ||||||||||
| PHYSICIAN | 50.00 | 0.00 | 290629 | 0 | 37431 | X | ||||
| ROBERT RATTNER MD | ||||||||||
| PHYSICIAN | 50.00 | 0.00 | 250939 | 0 | 40021 | X | ||||
| ALEC R BELMAN MD | ||||||||||
| PHYSICIAN/FORMER KEY EE | 50.00 | 0.00 | 133265 | 0 | 19895 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2275941 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 3487044 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 463523 | TotalOtherCompensation |
| Number Individuals GT100 K | 35 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| CONSIGLI CONSTRUCTION COMPANY INC | |||||
| 72 SUMNER ST | MILFORD | MA | 017571663 | CONSTRUCTION SVCS | 1701250 |
| BERKSHIRE SURGICAL ASSOC PC | |||||
| 777 NORTH ST STE 407 | PITTSFIELD | MA | 012014141 | HEALTHCARE SERVICES | 281680 |
| DIVERSIFIED CLINICAL SVCS | |||||
| 5220 BELFORT RD STE 200 | JACKSONVILLE | FL | 322566019 | HEALTHCARE SERVICES | 212186 |
| ENERGY MANAGEMENT CONSULTANTS | |||||
| 120 THADEUS ST STE 1 | SOUTH PORTLAND | ME | 041066253 | CONSTRUCTION SVCS | 116939 |
| OPENSKY CORP | |||||
| PO BOX 251 | VERNON ROCKVILLE | CT | 060660251 | CONSTRUCTION SVCS | 104580 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Fundraising Events | 185197 | FundraisingEvents |
| Government Grants | 60321 | GovernmentGrants |
| All Other Contributions | 2304186 | AllOtherContributions |
| Noncash Contributions | 2717 | NoncashContributions |
| Total Contributions | 2549704 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SVC REVENUE | Description |
| Business Code | 622110 | BusinessCode |
| Total Revenue Column | 45741030 | TotalRevenueColumn |
| Related Or Exempt Function Income | 45741030 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 45741030 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 316930 | TotalRevenueColumn |
| Exclusion | $316,930 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12510 | TotalRevenueColumn |
| Exclusion | $12,510 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 46538 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 2281 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 44257 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 44257 | TotalRevenueColumn |
| Exclusion | $44,257 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1207844 | Securities |
| Other | 6500 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 960610 | Securities |
| Other | 19446 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 247234 | Securities |
| Other | -12946 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 234288 | TotalRevenueColumn |
| Exclusion | $234,288 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 92612 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 185197 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 92612 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| PHARMACY SALES | 446110 | 383585 | 383585 | |
| CAFETERIA SALES | 722514 | 169917 | $169,917 | |
| OPERATING ROOM MISC | 900099 | 55678 | $55,678 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 79333 | TotalRevenueColumn |
| Related Or Exempt Function Income | 79333 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 688513 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 49587232 | TotalRevenueColumn |
| Related Or Exempt Function Income | 46203948 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $833,580 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1014330 | Total |
| Program Services | 1010265 | ProgramServices |
| Management And General | 3490 | ManagementAndGeneral |
| Fundraising | 575 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19847079 | Total |
| Program Services | 19465536 | ProgramServices |
| Management And General | 327619 | ManagementAndGeneral |
| Fundraising | 53924 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 768980 | Total |
| Program Services | 754249 | ProgramServices |
| Management And General | 12649 | ManagementAndGeneral |
| Fundraising | 2082 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3014132 | Total |
| Program Services | 2962348 | ProgramServices |
| Management And General | 44507 | ManagementAndGeneral |
| Fundraising | 7277 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1312044 | Total |
| Program Services | 1287677 | ProgramServices |
| Management And General | 20923 | ManagementAndGeneral |
| Fundraising | 3444 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4585299 | Total |
| Management And General | 4585299 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 88564 | Total |
| Management And General | 88564 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13218 | Total |
| Program Services | 13218 | ProgramServices |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19396 | Total |
| Management And General | 19396 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3426846 | Total |
| Program Services | 3397947 | ProgramServices |
| Management And General | 7466 | ManagementAndGeneral |
| Fundraising | 21433 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 64850 | Total |
| Program Services | 44552 | ProgramServices |
| Management And General | 843 | ManagementAndGeneral |
| Fundraising | 19455 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3293316 | Total |
| Program Services | 3249076 | ProgramServices |
| Management And General | 34039 | ManagementAndGeneral |
| Fundraising | 10201 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 336300 | Total |
| Program Services | 336300 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 744823 | Total |
| Program Services | 731714 | ProgramServices |
| Management And General | 11676 | ManagementAndGeneral |
| Fundraising | 1433 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 154956 | Total |
| Program Services | 150663 | ProgramServices |
| Management And General | 2828 | ManagementAndGeneral |
| Fundraising | 1465 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 221105 | Total |
| Program Services | 221105 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1786883 | Total |
| Program Services | 1753698 | ProgramServices |
| Management And General | 33185 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 352318 | Total |
| Program Services | 345775 | ProgramServices |
| Management And General | 5619 | ManagementAndGeneral |
| Fundraising | 924 | Fundraising |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| RECIPROCAL/TEACHNG FEES | 1432162 | 1432162 | ||
| BAD DEBT | 1315870 | 1315870 | ||
| MAINTENANCE & REPAIRS | 590825 | 579852 | 10973 | |
| MINOR EQUIPMENT | 356525 | 352562 | 3811 | 152 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 913892 | Total |
| Program Services | 771548 | ProgramServices |
| Management And General | 136476 | ManagementAndGeneral |
| Fundraising | 5868 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 45653713 | Total |
| Program Services | 40176117 | ProgramServices |
| Management And General | 5349363 | ManagementAndGeneral |
| Fundraising | 128233 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6000 | BOY |
| EOY | 7078 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 815762 | BOY |
| EOY | 709004 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3600 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5162660 | BOY |
| EOY | 5514632 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19511 | BOY |
| EOY | 20538 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 354928 | BOY |
| EOY | 416063 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 110339 | BOY |
| EOY | 76220 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 27446654 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 16496595 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9918067 | BOY |
| EOY | 10950059 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13583585 | BOY |
| EOY | 15352313 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1565677 | BOY |
| EOY | 1919706 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10292 | BOY |
| EOY | 8773 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 405945 | BOY |
| EOY | 2315060 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31956366 | BOY |
| EOY | 37289446 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2994018 | BOY |
| EOY | 2926532 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26829 | BOY |
| EOY | 47876 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6205719 | BOY |
| EOY | 5866627 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8926188 | BOY |
| EOY | 9147356 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18152754 | BOY |
| EOY | 17988391 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11447565 | BOY |
| EOY | 16796766 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2097805 | BOY |
| EOY | 2246047 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 258242 | BOY |
| EOY | 258242 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13803612 | BOY |
| EOY | 19301055 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31956366 | BOY |
| EOY | 37289446 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 3933519 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 1563924 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $13,218 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 13218 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | LOBBYING 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1195038 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 88384 | InvestmentEarningsOrLosses |
| End Of Year Balance | 1283422 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1058317 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 136721 | InvestmentEarningsOrLosses |
| End Of Year Balance | 1195038 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1046753 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 11564 | InvestmentEarningsOrLosses |
| End Of Year Balance | 1058317 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 989912 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 56841 | InvestmentEarningsOrLosses |
| End Of Year Balance | 1046753 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1028277 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -22233 | InvestmentEarningsOrLosses |
| Other Expenditures | 16132 | OtherExpenditures |
| End Of Year Balance | 989912 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.20120 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.79880 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 16887 | OtherCostOrOtherBasis |
| Book Value | 16887 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2137042 | OtherCostOrOtherBasis |
| Depreciation | 2031348 | Depreciation |
| Book Value | 105694 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 13796480 | OtherCostOrOtherBasis |
| Depreciation | 9664781 | Depreciation |
| Book Value | 4131699 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 11496245 | OtherCostOrOtherBasis |
| Depreciation | 4800466 | Depreciation |
| Book Value | 6695779 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 10950059 | TotalOfBookValueLandBuildings |
Closely Held Equity Interests CloselyHeldEquityInterests
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | 74319 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | BLACKROCK EQUITY INDEX FUND B | Description |
| Book Value | 1845387 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 1919706 | TotalOfBookValueSecurities |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DUE FROM AFFILIATES | 2181230 |
| DEFERRED COMPENSATION | 123908 |
| LIFE INSURANCE-CASH VALUE | 9922 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 2315060 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (6 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 9147356 | TotalOfAmounts |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GALA | NameOfEvent1 |
| Gross Receipts Event1 | 227749 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 151158 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 76591 | GrossRevenueEvent1 |
| Non Cash Prizes Event1 | 2717 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 13451 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 17829 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 27655 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 14939 | OtherDirectExpensesEvent1 |
| Name Of Event2 | GOLF TOURNAMENT | NameOfEvent2 |
| Gross Receipts Event2 | 50060 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 34039 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 16021 | GrossRevenueEvent2 |
| Rent Facility Costs Event2 | 10790 | RentFacilityCostsEvent2 |
| Food And Beverage Event2 | 6422 | FoodAndBeverageEvent2 |
| Other Direct Expenses Event2 | -1191 | OtherDirectExpensesEvent2 |
| Gross Receipts Total | 277809 | GrossReceiptsTotal |
| Charitable Contributions Total | 185197 | CharitableContributionsTotal |
| Gross Revenue Total Events | 92612 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 2717 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 24241 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 24251 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 27655 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 13748 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 92612 | DirectExpenseSummaryEvents |
| Net Income Summary | 0 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 773717 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 773717 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01750 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5187430 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4625983 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 561447 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01270 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3117206 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2917995 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 199211 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00450 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9078353 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7543978 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1534375 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03470 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 231627 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 231627 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00520 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 248523 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 248523 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00560 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6850 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 6850 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 487000 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 487000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01100 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9565353 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7543978 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2021375 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04570 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 144112 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 144112 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00330 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 289460 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 289460 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00650 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 433572 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 433572 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00980 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $785,443 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 19118439 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 18946404 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 172035 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAIRVIEW HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 29 LEWIS AVE | AddressLine1 |
| City | GREAT BARRINGTON | City |
| State | MA | State |
| ZIP Code | 012301796 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAIRVIEW HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Needs Assessment Conducted | 11 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 1 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 0 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 400.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 3 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (3 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| FAIRVIEW HSP OUTPATNT PHYSICAL THERAPY | ||||
| 10 MAPLE AVE | GREAT BARRINGTON | MA | 01230 | OUTPATIENT SERVICES |
| FAIRVIEW PHYSICAL & SPORTS THERAPY CTR | ||||
| 710 STOCKBRIDGE RD STE 1 | LEE | MA | 01238 | OUTPATIENT SERVICES |
| FAIRVIEW HOSPITAL AQUATIC THERAPY PROG | ||||
| 15 CHRISSEY RD | GREAT BARRINGTON | MA | 01230 | OUTPATIENT SERVICES |
Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)
| ExplanationExplanation | IdentifierIdentifier | Return 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. | ||
| MA | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRIAN T BURKE MD | ||||||||||||||
| TRUSTEE/PHYSICIAN | 194286 | 0 | 0 | 0 | 18949 | 0 | 9982 | 0 | 33387 | 0 | 256604 | 0 | 0 | 0 |
| DAVID PHELPS SEE SCH J PT III | ||||||||||||||
| PRESIDENT/TRUSTEE | 0 | 475914 | 0 | 0 | 0 | 54706 | 0 | 11250 | 0 | 37779 | 0 | 579649 | 0 | 0 |
| D PHELPS-RETIREMNT DSTRB1 TIME | ||||||||||||||
| PRESIDENT/TRUSTEE | 0 | 0 | 0 | 0 | 0 | 1878328 | 0 | 0 | 0 | 0 | 0 | 1878328 | 0 | 0 |
| EUGENE A DELLEA | ||||||||||||||
| PRESIDENT, FAIRVIEW HOSPITAL | 0 | 172408 | 0 | 0 | 0 | 82785 | 0 | 10969 | 0 | 15142 | 0 | 281304 | 0 | 0 |
| DARLENE M RODOWICZ | ||||||||||||||
| TREASURER | 0 | 367007 | 0 | 0 | 0 | 127296 | 0 | 11250 | 0 | 28209 | 0 | 533762 | 0 | 0 |
| DOREEN HUTCHINSON | ||||||||||||||
| VICE PRESIDENT, OPERATIONS | 154312 | 0 | 0 | 0 | 20949 | 0 | 8266 | 0 | 31588 | 0 | 215115 | 0 | 0 | 0 |
| RAYMOND SABATELLI MD | ||||||||||||||
| DIRECTOR, EMERGENCY DEPT. | 195029 | 0 | 10530 | 0 | 35671 | 0 | 11203 | 0 | 28903 | 0 | 281336 | 0 | 0 | 0 |
| RICHARD F SALLUZZO MD | ||||||||||||||
| DIRECTOR, EMERGENCY DEPT. | 143879 | 21829 | 0 | 0 | 40610 | 0 | 0 | 0 | 21107 | 0 | 205596 | 21829 | 0 | 0 |
| WILLIAM F DUKE MD | ||||||||||||||
| PHYSICIAN | 199570 | 0 | 11087 | 0 | 40402 | 0 | 9839 | 0 | 33161 | 0 | 294059 | 0 | 0 | 0 |
| ADRIAN ELLIOT MD | ||||||||||||||
| PHYSICIAN | 252607 | 10602 | 11087 | 0 | 9533 | 128 | 3287 | 0 | 28293 | 0 | 304807 | 10730 | 0 | 0 |
| CORINNE D KALSER MD | ||||||||||||||
| PHYSICIAN | 228745 | 0 | 15649 | 0 | 18213 | 0 | 11250 | 0 | 29060 | 0 | 302917 | 0 | 0 | 0 |
| GLEN R LOVEJOY MD | ||||||||||||||
| PHYSICIAN | 255076 | 0 | 11087 | 0 | 24466 | 0 | 10036 | 0 | 31816 | 0 | 332481 | 0 | 0 | 0 |
| ROBERT RATTNER MD | ||||||||||||||
| PHYSICIAN | 226820 | 0 | 11087 | 0 | 13032 | 0 | 7991 | 0 | 39002 | 0 | 297932 | 0 | 0 | 0 |
| ALEC R BELMAN MD | ||||||||||||||
| PHYSICIAN/FORMER KEY EE | 119203 | 0 | 5616 | 0 | 8446 | 0 | 6179 | 0 | 14766 | 0 | 154210 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SUPPLEMENTAL INFORMATION | Identifier |
| Return Reference | PART III | ReturnReference |
| Explanation | SUPPLEMENTAL 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 $533,762 | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Bond ReferenceBondReferenceCd | Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|---|
| MASS HEALTH & EDUCATION FACIL AUTHORITY SER F | ||||||||
| A | 042456011 | 57586CLN3 | 2005-07-26 | 53089428 | REFUND SER C & D BONDS;CAPITAL EXP | 0 | 0 | 0 |
| MASS DEVELOPMENT FINANCE AGENCY BHS ISSUESER G | ||||||||
| B | 043431814 | 57583UQP6 | 2012-05-23 | 93491421 | REFUND SER A, B, & E; CAPITAL EXP | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Bond ReferenceBondReferenceCd | Amount RetiredAmountRetired | Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Credit EnhancementCreditEnhancement | Working Capital ExpendituresWorkingCapitalExpenditures | Capital ExpendituresCapitalExpenditures | Other Spent ProceedsOtherSpentProceeds | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | 19790000 | 54978523 | 5019000 | 1003800 | 898795 | 73681 | 9003428 | 38979819 | 2008 | 1 | 0 | 1 | 1 |
| B | 2670000 | 93491421 | 1245681 | 8171944 | 84073796 | 2011 | 1 | 0 | 1 | 1 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest | Change In Use Bond Financed PropChangeInUseBondFinancedProp | Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | 0 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Written Proc To Monitor ReqsWrittenProcToMonitorReqs | Rebate Not Due YetRebateNotDueYet | Exception To RebateExceptionToRebate | No Rebate DueNoRebateDue |
|---|---|---|---|---|---|---|---|---|---|
| A | 1 | 0 | 0 | 0 | 1 | 0 | |||
| B | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 |
Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)
| Bond ReferenceBondReferenceCd | Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction |
|---|---|
| A | 1 |
| B | 1 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | FAIRVIEW 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 6 | BERKSHIRE HEALTH SYSTEMS, INC. IS THE SOLE CORPORATE MEMBER. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE 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 11 | BERKSHIRE 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 12C | THE 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 15 | FAIRVIEW 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 19 | THE 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 2C | A 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/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| BERKSHIRE HEALTH SYSTEMS INC | ||||||||||
| 725 NORTH ST | PITTSFIELD | MA | 01201 | 042442944 | PARENT CORPORATION | MA | 501(C)(3) | 11B | N/A | 0 |
| BERKSHIRE MEDICAL CENTER INC | ||||||||||
| 725 NORTH ST | PITTSFIELD | MA | 01201 | 042791396 | ACUTE CARE HOSPITAL | MA | 501(C)(3) | 3 | N/A | 0 |
| BERKSHIRE FACULTY SERVICES INC | ||||||||||
| 725 NORTH ST | PITTSFIELD | MA | 01201 | 042995053 | PHYSICIAN SERVICES | MA | 501(C)(3) | 11B | N/A | 0 |
| BHS MANAGEMENT SERVICES INC | ||||||||||
| 725 NORTH ST | PITTSFIELD | MA | 01201 | 222755258 | MANAGEMENT SERVICES | MA | 501(C)(3) | 11B | N/A | 0 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TRI-STATE MEDICAL MANAGEMENT CORP | |||||||||||||
| 725 NORTH STREET | PITTSFIELD | MA | 01201 | 042913352 | REAL ESTATE MGMT | MA | FAIRVIEW HOSPITAL | C | 4616 | 232676 | 1.00000 | 0 | |
| WILLIAMSTOWN MEDICAL ASSOCIATES PC | |||||||||||||
| 197 ADAMS ROAD | WILLIAMSTOWN | MA | 01267 | 042680535 | HEALTHCARE SERVICES | MA | C | 0 | N/A | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRI-STATE MEDICAL MANAGEMENT CORP | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | D | TransactionType |
| Amount Involved | 225730 | AmountInvolved |
| Method Of Amt Determination | FAIR MARKET VALUE | MethodOfAmtDetermination |