2014-08-15T10:45:33-05:00 2013-09-30 990 2012-10-01 042133860 FAIRVIEW HOSPITAL FAIR 4134472508 725 NORTH STREET PITTSFIELD MA 012014109 DARLENE RODOWICZ 4134472809 2014-08-15 0 2012 2015-11-30 17:44:51Z DARLENE RODOWICZ 725 NORTH ST PITTSFIELD MA 012014109 50662181 0 X WWW.BHS1.ORG X 1912 MA 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. 24 20 335 50 0 0 618864 2549704 44224749 45741030 469864 563728 1204552 732770 46518029 49587232 1250 0 0 0 25267767 25956565 0 0 128233 19396247 19697148 44665264 45653713 1852765 3933519 31956366 37289446 18152754 17988391 13803612 19301055 X 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. 0 0 40176117 46203948 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. 40176117 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 94 0 1 335 1 0 0 0 0 0 1 1 0 0 0 0 X 24 20 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA NY X DARLENE RODOWICZ CFO 4134472809 725 NORTH STREET PITTSFIELD MA 012014109 X LORINDA ACKLEY MAZUR 0.10 1.90 X 0 0 0 JEROME J ANDERSON 0.10 1.90 X 0 0 0 THOMAS O ANDREWS 0.10 1.90 X 0 0 0 ALFRED A BARBALUNGA 0.10 1.90 X 0 0 0 BRONLY S BOYD 0.10 1.90 X X 0 0 0 BRIAN T BURKE MD 48.00 2.00 X 213235 0 43369 KIT DOBELLE 0.10 1.90 X 0 0 0 TIMOTHY C DOHERTY 0.10 1.90 X 0 0 0 RICHARD M DOHONEY 0.10 1.90 X 0 0 0 A KING FRANCIS 0.10 1.90 X 0 0 0 DENNIS J HOGAN 0.10 1.90 X 0 0 0 EDMUND H HORNSTEIN DO 0.10 1.90 X 0 65656 0 JOHN R KEARNS MD 0.10 1.90 X 0 0 0 ELLEN L KENNEDY 0.10 1.90 X 0 0 0 SUSAN M KORMANIK 0.10 1.90 X 0 0 0 JOAN M MCFALLS 0.10 1.90 X 0 0 0 MICHAEL R MCINERNEY MD 0.10 1.90 X 0 0 0 LAURIE NORTON MOFFATT 0.10 1.90 X 0 0 0 DAVID PHELPS SEE SCH J PT III 3.50 46.50 X X 0 530620 49029 D PHELPS-RETIREMNT DSTRB1 TIME 0.10 0.90 X X 0 1878328 0 BARTON D RASER 0.10 1.90 X 0 0 0 CAROLE G SIEGEL 0.10 1.90 X 0 0 0 GEORGE T SMITH 0.10 1.90 X 0 0 0 MARILYN L SPERLING 0.10 1.90 X 0 0 0 ANN H TRABULSI 0.10 1.90 X 0 0 0 ROBERT P WESPISER MD 0.10 1.90 X 0 133154 0 CHERYL M BOUDREAU 2.00 38.00 X 0 97231 14802 EUGENE A DELLEA 50.00 0.00 X 0 255193 26111 DARLENE M RODOWICZ 3.00 47.00 X 0 494303 39459 DOREEN HUTCHINSON 50.00 0.00 X 175261 0 36795 RAYMOND SABATELLI MD 50.00 0.00 X 241230 0 39733 RICHARD F SALLUZZO MD 50.00 0.00 X 184489 21829 19488 WILLIAM F DUKE MD 50.00 0.00 X 251059 0 34177 ADRIAN ELLIOT MD 50.00 0.00 X 273227 10730 27625 CORINNE D KALSER MD 50.00 0.00 X 262607 0 35588 GLEN R LOVEJOY MD 50.00 0.00 X 290629 0 37431 ROBERT RATTNER MD 50.00 0.00 X 250939 0 40021 ALEC R BELMAN MD 50.00 0.00 X 133265 0 19895 2275941 3487044 463523 35 1 1 0 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 5 185197 60321 2304186 2717 2549704 NET PATIENT SVC REVENUE 622110 45741030 45741030 45741030 316930 316930 12510 12510 46538 2281 44257 44257 44257 1207844 6500 960610 19446 247234 -12946 234288 234288 92612 185197 92612 0 PHARMACY SALES 446110 383585 383585 CAFETERIA SALES 722514 169917 169917 OPERATING ROOM MISC 900099 55678 55678 79333 79333 688513 49587232 46203948 0 833580 1014330 1010265 3490 575 19847079 19465536 327619 53924 768980 754249 12649 2082 3014132 2962348 44507 7277 1312044 1287677 20923 3444 4585299 4585299 88564 88564 13218 13218 19396 19396 3426846 3397947 7466 21433 64850 44552 843 19455 3293316 3249076 34039 10201 336300 336300 744823 731714 11676 1433 154956 150663 2828 1465 221105 221105 1786883 1753698 33185 352318 345775 5619 924 RECIPROCAL/TEACHNG FEES 1432162 1432162 BAD DEBT 1315870 1315870 MAINTENANCE & REPAIRS 590825 579852 10973 MINOR EQUIPMENT 356525 352562 3811 152 913892 771548 136476 5868 45653713 40176117 5349363 128233 6000 7078 815762 709004 3600 0 5162660 5514632 19511 20538 354928 416063 110339 76220 27446654 16496595 9918067 10950059 13583585 15352313 1565677 1919706 10292 8773 405945 2315060 31956366 37289446 2994018 2926532 26829 47876 6205719 5866627 8926188 9147356 18152754 17988391 X 11447565 16796766 2097805 2246047 258242 258242 13803612 19301055 31956366 37289446 3933519 1563924 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 13218 13218 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: 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. 1195038 88384 1283422 1058317 136721 1195038 1046753 11564 1058317 989912 56841 1046753 1028277 -22233 16132 989912 0.00000 0.20120 0.79880 0 0 16887 16887 2137042 2031348 105694 13796480 9664781 4131699 11496245 4800466 6695779 10950059 74319 F BLACKROCK EQUITY INDEX FUND B 1845387 F 1919706 DUE FROM AFFILIATES 2181230 DEFERRED COMPENSATION 123908 LIFE INSURANCE-CASH VALUE 9922 2315060 DUE TO AFFILIATES 3300000 DUE TO THIRD PARTY PAYORS 5070713 ACCRUED FIN 47 ACCRETION 648614 DEFERRED COMPENSATION 123908 REBATE FUND LIABILITY 4025 DEFERRED PENSION FORFEITURE 96 9147356 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. GALA 227749 151158 76591 2717 13451 17829 27655 14939 GOLF TOURNAMENT 50060 34039 16021 10790 6422 -1191 277809 185197 92612 2717 24241 24251 27655 13748 92612 0 1 1 1 X 1 X 1 1 1 0 1 1 773717 773717 0.01750 5187430 4625983 561447 0.01270 3117206 2917995 199211 0.00450 9078353 7543978 1534375 0.03470 231627 231627 0.00520 248523 248523 0.00560 6850 6850 0.00020 487000 487000 0.01100 9565353 7543978 2021375 0.04570 144112 144112 0.00330 289460 289460 0.00650 433572 433572 0.00980 1 785443 19118439 18946404 172035 X 1 1 1 1 FAIRVIEW HOSPITAL

29 LEWIS AVE GREAT BARRINGTON MA 012301796

X X X X FAIRVIEW HOSPITAL 1 1 X X X X X X X X 11 1 1 1 X X X X X X X X X X 0 0 1 1 200.000000000000 1 400.000000000000 1 X X X X 1 1 X X X X 1 0 1 X 0 0 3 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 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. FAIRVIEW HOSPITAL 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. 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. REPORTS FILED WITH STATES PART VI, LINE 7 MA X X X X X 0 1 0 0 0 0 0 0 0 BRIAN T BURKE MD 194286 0 0 0 18949 0 9982 0 33387 0 256604 0 0 0 DAVID PHELPS SEE SCH J PT III 0 475914 0 0 0 54706 0 11250 0 37779 0 579649 0 0 D PHELPS-RETIREMNT DSTRB1 TIME 0 0 0 0 0 1878328 0 0 0 0 0 1878328 0 0 EUGENE A DELLEA 0 172408 0 0 0 82785 0 10969 0 15142 0 281304 0 0 DARLENE M RODOWICZ 0 367007 0 0 0 127296 0 11250 0 28209 0 533762 0 0 DOREEN HUTCHINSON 154312 0 0 0 20949 0 8266 0 31588 0 215115 0 0 0 RAYMOND SABATELLI MD 195029 0 10530 0 35671 0 11203 0 28903 0 281336 0 0 0 RICHARD F SALLUZZO MD 143879 21829 0 0 40610 0 0 0 21107 0 205596 21829 0 0 WILLIAM F DUKE MD 199570 0 11087 0 40402 0 9839 0 33161 0 294059 0 0 0 ADRIAN ELLIOT MD 252607 10602 11087 0 9533 128 3287 0 28293 0 304807 10730 0 0 CORINNE D KALSER MD 228745 0 15649 0 18213 0 11250 0 29060 0 302917 0 0 0 GLEN R LOVEJOY MD 255076 0 11087 0 24466 0 10036 0 31816 0 332481 0 0 0 ROBERT RATTNER MD 226820 0 11087 0 13032 0 7991 0 39002 0 297932 0 0 0 ALEC R BELMAN MD 119203 0 5616 0 8446 0 6179 0 14766 0 154210 0 0 0 SUPPLEMENTAL INFORMATION PART III 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 A MASS HEALTH & EDUCATION FACIL AUTHORITY SER F 042456011 57586CLN3 2005-07-26 53089428 REFUND SER C & D BONDS;CAPITAL EXP 0 0 0 B MASS DEVELOPMENT FINANCE AGENCY BHS ISSUESER G 043431814 57583UQP6 2012-05-23 93491421 REFUND SER A, B, & E; CAPITAL EXP 0 0 0 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 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 A 1 0 0 0 1 0 B 0 1 0 0 0 0 0 0 0 A 1 B 1 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. AVERAGE HOURS PER WEEK 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. TRUSTEE NOT SERVING AT YEAR-END 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. OVERSIGHT OF AUDIT & SELECTION OF INDEPENDENT ACCOUNTANT 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. 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