﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2010v3.4">
  <ReturnHeader binaryAttachmentCount="0">
    <Timestamp>2012-08-15T16:40:58-05:00</Timestamp>
    <TaxPeriodEndDate>2011-09-30</TaxPeriodEndDate>
    <ReturnType>990</ReturnType>
    <TaxPeriodBeginDate>2010-10-01</TaxPeriodBeginDate>
    <Filer>
      <EIN>042791396</EIN>
      <Name>
        <BusinessNameLine1>BERKSHIRE MEDICAL CENTER INC</BusinessNameLine1>
      </Name>
      <NameControl>BERK</NameControl>
      <Phone>4134472081</Phone>
      <USAddress>
        <AddressLine1>725 NORTH STREET</AddressLine1>
        <City>PITTSFIELD</City>
        <State>MA</State>
        <ZIPCode>012014109</ZIPCode>
      </USAddress>
    </Filer>
    <Officer>
      <Name>DARLENE RODOWICZ</Name>
      <Title>CFO</Title>
      <Phone>4134472508</Phone>
      <DateSigned>2012-08-15</DateSigned>
    </Officer>
    <TaxYear>2010</TaxYear>
    <BuildTS>2016-02-24 21:20:13Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCount="12">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <NameOfPrincipalOfficerPerson>DARLENE RODOWICZ</NameOfPrincipalOfficerPerson>
      <AddressPrincipalOfficerUS>
        <AddressLine1>725 NORTH ST</AddressLine1>
        <City>PITTSFIELD</City>
        <State>MA</State>
        <ZIPCode>01201</ZIPCode>
      </AddressPrincipalOfficerUS>
      <GrossReceipts>371996244</GrossReceipts>
      <GroupReturnForAffiliates>0</GroupReturnForAffiliates>
      <Organization501c3>X</Organization501c3>
      <WebSite>WWW.BHS1.ORG</WebSite>
      <TypeOfOrganizationCorporation>X</TypeOfOrganizationCorporation>
      <YearFormation>1983</YearFormation>
      <StateLegalDomicile>MA</StateLegalDomicile>
      <ActivityOrMissionDescription>THE MISSION OF BERKSHIRE MEDICAL CENTER IS TO IMPROVE THE HEALTH OF ALL PEOPLE IN THE BERKSHIRES AND SURROUNDING COMMUNITIES, REGARDLESS OF THEIR ABILITY TO PAY.</ActivityOrMissionDescription>
      <NbrVotingMembersGoverningBody>24</NbrVotingMembersGoverningBody>
      <NbrIndependentVotingMembers>20</NbrIndependentVotingMembers>
      <TotalNbrEmployees>2868</TotalNbrEmployees>
      <TotalNbrVolunteers>210</TotalNbrVolunteers>
      <TotalGrossUBI>348492</TotalGrossUBI>
      <NetUnrelatedBusinessTxblIncome>347492</NetUnrelatedBusinessTxblIncome>
      <ContributionsGrantsPriorYear>2042733</ContributionsGrantsPriorYear>
      <ContributionsGrantsCurrentYear>1737226</ContributionsGrantsCurrentYear>
      <ProgramServiceRevenuePriorYear>305592033</ProgramServiceRevenuePriorYear>
      <ProgramServiceRevenueCY>327281286</ProgramServiceRevenueCY>
      <InvestmentIncomePriorYear>6684637</InvestmentIncomePriorYear>
      <InvestmentIncomeCurrentYear>8365126</InvestmentIncomeCurrentYear>
      <OtherRevenuePriorYear>799786</OtherRevenuePriorYear>
      <OtherRevenueCurrentYear>1006508</OtherRevenueCurrentYear>
      <TotalRevenuePriorYear>315119189</TotalRevenuePriorYear>
      <TotalRevenueCurrentYear>338390146</TotalRevenueCurrentYear>
      <GrantsAndSimilarAmntsPriorYear>0</GrantsAndSimilarAmntsPriorYear>
      <GrantsAndSimilarAmntsCY>0</GrantsAndSimilarAmntsCY>
      <BenefitsPaidToMembersPriorYear>0</BenefitsPaidToMembersPriorYear>
      <BenefitsPaidToMembersCY>0</BenefitsPaidToMembersCY>
      <SalariesEtcPriorYear>182633194</SalariesEtcPriorYear>
      <SalariesEtcCurrentYear>187339579</SalariesEtcCurrentYear>
      <TotalProfFundrsngExpPriorYear>0</TotalProfFundrsngExpPriorYear>
      <TotalProfFundrsngExpCY>0</TotalProfFundrsngExpCY>
      <TotalFundrsngExpCurrentYear>163871</TotalFundrsngExpCurrentYear>
      <OtherExpensePriorYear>134859008</OtherExpensePriorYear>
      <OtherExpensesCurrentYear>137183743</OtherExpensesCurrentYear>
      <TotalExpensesPriorYear>317492202</TotalExpensesPriorYear>
      <TotalExpensesCurrentYear>324523322</TotalExpensesCurrentYear>
      <RevenuesLessExpensesPriorYear>-2373013</RevenuesLessExpensesPriorYear>
      <RevenuesLessExpensesCY>13866824</RevenuesLessExpensesCY>
      <TotalAssetsBOY>370412006</TotalAssetsBOY>
      <TotalAssetsEOY>377426794</TotalAssetsEOY>
      <TotalLiabilitiesBOY>193250439</TotalLiabilitiesBOY>
      <TotalLiabilitiesEOY>195581835</TotalLiabilitiesEOY>
      <NetAssetsOrFundBalancesBOY>177161567</NetAssetsOrFundBalancesBOY>
      <NetAssetsOrFundBalancesEOY>181844959</NetAssetsOrFundBalancesEOY>
      <InfoInScheduleOPartIII>X</InfoInScheduleOPartIII>
      <MissionDescription>THE MISSION OF BERKSHIRE MEDICAL CENTER IS TO IMPROVE THE HEALTH OF ALL PEOPLE IN THE BERKSHIRES AND SURROUNDING COMMUNITIES, REGARDLESS OF THEIR ABILITY TO PAY.</MissionDescription>
      <SignificantNewProgramServices>0</SignificantNewProgramServices>
      <SignificantChange>0</SignificantChange>
      <Expense>268753348</Expense>
      <Revenue>287891075</Revenue>
      <Description>OPERATE AN ACUTE CARE GENERAL HOSPITAL AND MEDICAL EDUCATIONAL FACILITY, AND TO DELIVER THE HIGHEST QUALITY PATIENT CENTERED CARE IN A LEARINING ENVIRONMENT. TOTAL PATIENT DAYS FOR THE YEAR ARE 58,865, TOTAL LAB PROCEDURES 1,434,482, TOTAL RADIOLOGY PROCEDURES 172,732, TOTAL REHAB VISITS 56,968. HOURS OF OPERATION 24/HRS 365/DAYS PER YEAR.</Description>
      <Activity2>
        <Expense>14953945</Expense>
        <Revenue>30778488</Revenue>
        <Description>OPERATION OF AN EMERGENCY DEPARTMENT AND TRAUMA CARE CENTER AVAILABLE TO ALL REGARDLESS OF ABILITY TO PAY. TOTAL VISITS FOR THE YEAR 55,966. ED IS IN OPERTION 24 HRS/DAY 365 DAYS/YEAR.</Description>
      </Activity2>
      <Activity3>
        <Expense>7143603</Expense>
        <Revenue>7029974</Revenue>
        <Description>VISITING NURSE PROGRAM ALLOWING FOR THE CARE AND REHABILATION OF PATIENTS IN THEIR OWN HOME ENVIRONMENT. TOTAL VISITS FOR THE YEAR 52,153 DETAILED AS FOLLOWS SKILLED NURSING 27,507, HOME HEALTH AIDE 10,019, REHAB 14,220, AND SOCIAL SERVICE 407. HOURS OF OPERATION 7 DAYS/WEEK 8AM-9PM WITH A NURSE ON CALL 24 HOURS.</Description>
      </Activity3>
      <ActivityOther>
        <Expense>2067737</Expense>
        <Revenue>1581749</Revenue>
        <Description>OPERATE A SUBSTANCE ABUSE CENTER WITH PROVIDING THE HIGHEST QUALITY OF PATIENT CARE. TOTAL PATIENT DAYS FOR THE YEAR 6527. PROGRAM OPERATES 24 HRS/DAY 365 DAYS/YEAR.</Description>
      </ActivityOther>
      <TotalOfOtherProgramServiceExp>2067737</TotalOfOtherProgramServiceExp>
      <TotalOfOtherProgramServiceRev>1581749</TotalOfOtherProgramServiceRev>
      <TotalProgramServiceExpense>292918633</TotalProgramServiceExpense>
      <DescribedIn501C3 referenceDocumentId="RetDoc1039100001">1</DescribedIn501C3>
      <ScheduleBRequired referenceDocumentId="RetDoc1234500001">1</ScheduleBRequired>
      <PoliticalActivities referenceDocumentId="RetDoc1039700001">0</PoliticalActivities>
      <LobbyingActivities referenceDocumentId="RetDoc1039700001">1</LobbyingActivities>
      <DonorAdvisedFunds referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFunds>
      <ConservationEasements referenceDocumentId="RetDoc1040000001">0</ConservationEasements>
      <CollectionsOfArt referenceDocumentId="RetDoc1040000001">0</CollectionsOfArt>
      <CreditCounseling referenceDocumentId="RetDoc1040000001">0</CreditCounseling>
      <TermOrPermanentEndowments referenceDocumentId="RetDoc1040000001">1</TermOrPermanentEndowments>
      <ReportLandBldgEquip referenceDocumentId="RetDoc1040000001">1</ReportLandBldgEquip>
      <ReportInvestOthSecurities referenceDocumentId="RetDoc1040000001">0</ReportInvestOthSecurities>
      <ReportProgRelInvest referenceDocumentId="RetDoc1040000001">0</ReportProgRelInvest>
      <ReportOtherAssets referenceDocumentId="RetDoc1040000001">0</ReportOtherAssets>
      <ReportOtherLiabilities referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilities>
      <ReportFin48Footnote referenceDocumentId="RetDoc1040000001">0</ReportFin48Footnote>
      <IndependentAuditFinancialStmt referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinancialStmt>
      <ConsolidatedAuditFinancialStmt referenceDocumentId="RetDoc1040000001">1</ConsolidatedAuditFinancialStmt>
      <School>0</School>
      <ForeignOffice>0</ForeignOffice>
      <ForeignActivities>0</ForeignActivities>
      <MoreThan5000KToOrganizations>0</MoreThan5000KToOrganizations>
      <MoreThan5000KToIndividuals>0</MoreThan5000KToIndividuals>
      <ProfessionalFundraising>0</ProfessionalFundraising>
      <FundraisingActivities>1</FundraisingActivities>
      <Gaming>0</Gaming>
      <Hospital referenceDocumentId="RetDoc1041500001">1</Hospital>
      <FinancialStmtAttached referenceDocumentId="RetDoc2436500002">1</FinancialStmtAttached>
      <GrantsToOrganizations>0</GrantsToOrganizations>
      <GrantsToIndividuals>0</GrantsToIndividuals>
      <ScheduleJRequired referenceDocumentId="RetDoc1042400001">1</ScheduleJRequired>
      <TaxExemptBonds referenceDocumentId="RetDoc1053100001">1</TaxExemptBonds>
      <InvestTaxExemptBonds>0</InvestTaxExemptBonds>
      <EscrowAccount>0</EscrowAccount>
      <OnBehalfOfIssuer>0</OnBehalfOfIssuer>
      <ExcessBenefitTransaction>0</ExcessBenefitTransaction>
      <PriorExcessBenefitTransaction>0</PriorExcessBenefitTransaction>
      <LoanToOfficerOrDQP>0</LoanToOfficerOrDQP>
      <GrantToRelatedPerson>0</GrantToRelatedPerson>
      <BsnssRltnshpWithOrganization>0</BsnssRltnshpWithOrganization>
      <BsnssRltnshpThruFamilyMember>0</BsnssRltnshpThruFamilyMember>
      <OfficerEntityWithBsnssRltnshp>0</OfficerEntityWithBsnssRltnshp>
      <DeductibleNonCashContributions referenceDocumentId="RetDoc1042900001">1</DeductibleNonCashContributions>
      <DeductibleContributionsOfArt referenceDocumentId="RetDoc1042900001">0</DeductibleContributionsOfArt>
      <Terminated>0</Terminated>
      <PartialLiquidation>0</PartialLiquidation>
      <DisregardedEntity referenceDocumentId="RetDoc1043400001">0</DisregardedEntity>
      <RelatedEntity referenceDocumentId="RetDoc1043400001">1</RelatedEntity>
      <RelatedOrgControlledEntity>0</RelatedOrgControlledEntity>
      <TransactionRelatedEntity referenceDocumentId="RetDoc1043400001">0</TransactionRelatedEntity>
      <TransfersToExemptNonChrtblOrg referenceDocumentId="RetDoc1043400001">0</TransfersToExemptNonChrtblOrg>
      <ActivitiesConductedPartnership referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPartnership>
      <ScheduleORequired>1</ScheduleORequired>
      <NumberFormsTransmittedWith1096>212</NumberFormsTransmittedWith1096>
      <NumberW2GIncluded>0</NumberW2GIncluded>
      <ComplianceWithBackupWitholding>1</ComplianceWithBackupWitholding>
      <NumberOfEmployees>2868</NumberOfEmployees>
      <EmploymentTaxReturnsFiled>1</EmploymentTaxReturnsFiled>
      <UnrelatedBusinessIncome>1</UnrelatedBusinessIncome>
      <Form990-TFiled>1</Form990-TFiled>
      <ForeignFinancialAccount>0</ForeignFinancialAccount>
      <ProhibitedTaxShelterTrans>0</ProhibitedTaxShelterTrans>
      <TaxablePartyNotification>0</TaxablePartyNotification>
      <NonDeductibleContributions>0</NonDeductibleContributions>
      <QuidProQuoContributions>1</QuidProQuoContributions>
      <QuidProQuoDisclosure>1</QuidProQuoDisclosure>
      <Form8282PropertyDisposedOf>0</Form8282PropertyDisposedOf>
      <FundsToPayPremiums>0</FundsToPayPremiums>
      <PremiumsPaid>0</PremiumsPaid>
      <Form1098CFiled>1</Form1098CFiled>
      <IndoorTanningServices>0</IndoorTanningServices>
      <InfoInScheduleOPartVI>X</InfoInScheduleOPartVI>
      <NbrVotingGoverningBodyMembers>24</NbrVotingGoverningBodyMembers>
      <NumberIndependentVotingMembers>20</NumberIndependentVotingMembers>
      <FamilyOrBusinessRelationship>0</FamilyOrBusinessRelationship>
      <DelegationOfManagementDuties>1</DelegationOfManagementDuties>
      <ChangesToOrganizingDocs>0</ChangesToOrganizingDocs>
      <MaterialDiversionOrMisuse>0</MaterialDiversionOrMisuse>
      <MembersOrStockholders>1</MembersOrStockholders>
      <ElectionOfBoardMembers>1</ElectionOfBoardMembers>
      <DecisionsSubjectToApproval>0</DecisionsSubjectToApproval>
      <MinutesOfGoverningBody>1</MinutesOfGoverningBody>
      <MinutesOfCommittees>1</MinutesOfCommittees>
      <OfficerMailingAddress>0</OfficerMailingAddress>
      <LocalChapters>0</LocalChapters>
      <Form990ProvidedToGoverningBody>1</Form990ProvidedToGoverningBody>
      <ConflictOfInterestPolicy>1</ConflictOfInterestPolicy>
      <AnnualDisclosureCoveredPersons>1</AnnualDisclosureCoveredPersons>
      <RegularMonitoringEnforcement>1</RegularMonitoringEnforcement>
      <WhistleblowerPolicy>1</WhistleblowerPolicy>
      <DocumentRetentionPolicy>1</DocumentRetentionPolicy>
      <CompensationProcessCEO>1</CompensationProcessCEO>
      <CompensationProcessOther>1</CompensationProcessOther>
      <InvestmentInJointVenture>0</InvestmentInJointVenture>
      <StatesWhereCopyOfReturnIsFiled>MA</StatesWhereCopyOfReturnIsFiled>
      <StatesWhereCopyOfReturnIsFiled>NY</StatesWhereCopyOfReturnIsFiled>
      <UponRequest>X</UponRequest>
      <TheBooksAreInCareOf>
        <NameBusiness>
          <BusinessNameLine1>DARLENE RODOWICZ</BusinessNameLine1>
        </NameBusiness>
        <TelephoneNumber>4134472809</TelephoneNumber>
        <AddressUS>
          <AddressLine1>725 NORTH STREET</AddressLine1>
          <City>PITTSFIELD</City>
          <State>MA</State>
          <ZIPCode>012014109</ZIPCode>
        </AddressUS>
      </TheBooksAreInCareOf>
      <InfoInScheduleOPartVII>X</InfoInScheduleOPartVII>
      <Form990PartVIISectionA>
        <NamePerson>JEROME J ANDERSON</NamePerson>
        <Title>TRUSTEE</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>THOMAS O ANDREWS</NamePerson>
        <Title>TRUSTEE</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>ALFRED A BARBALUNGA</NamePerson>
        <Title>TRUSTEE</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>BRONLY S BOYD</NamePerson>
        <Title>TRUSTEE/VICE CHAIRMAN</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>BRIAN T BURKE</NamePerson>
        <Title>TRUSTEE/PHYSICIAN</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>200212</ReportableCompFromRelatedOrgs>
        <OtherCompensation>37926</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>KIT DOBELLE</NamePerson>
        <Title>TRUSTEE</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>TIMOTHY C DOHERTY</NamePerson>
        <Title>TRUSTEE/CHAIRMAN</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>RICHARD M DOHONEY</NamePerson>
        <Title>TRUSTEE</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>BRIAN H FAIRBANKS</NamePerson>
        <Title>TRUSTEE</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>A KING FRANCIS</NamePerson>
        <Title>TRUSTEE</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>DENNIS J HOGAN</NamePerson>
        <Title>TRUSTEE</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>EDMUND H HORNSTEIN DO</NamePerson>
        <Title>TRUSTEE/PHYSICIAN</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>87569</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>JOHN R KEARNS</NamePerson>
        <Title>TRUSTEE/PHYSICIAN</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>SUSAN M KORMANIK</NamePerson>
        <Title>TRUSTEE</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>LORINDA ACKLEY MAZUR</NamePerson>
        <Title>TRUSTEE</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>JOAN M MCFALLS</NamePerson>
        <Title>TRUSTEE</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>LAURIE NORTON MOFFATT</NamePerson>
        <Title>TRUSTEE</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>DAVID E PHELPS</NamePerson>
        <Title>PRESIDENT</Title>
        <AverageHoursPerWeek>58.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <Officer>X</Officer>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>522520</ReportableCompFromRelatedOrgs>
        <OtherCompensation>39741</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>PAUL E RAVERTA</NamePerson>
        <Title>TRUSTEE</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>CAROL G SIEGEL</NamePerson>
        <Title>TRUSTEE</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>GEORGE T SMITH</NamePerson>
        <Title>TRUSTEE</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>MARILYN L SPERLING</NamePerson>
        <Title>TRUSTEE</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>ANN H TRABULSI</NamePerson>
        <Title>TRUSTEE</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>ROBERT P WESPISER</NamePerson>
        <Title>TRUSTEE/PHYSICIAN</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>132035</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>THADDEUS TUCKER S WELCH</NamePerson>
        <Title>TRUSTEE/TERM ENDED 2/8/2011</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>DARLENE RODOWICZ</NamePerson>
        <Title>TREASURER</Title>
        <AverageHoursPerWeek>50.00</AverageHoursPerWeek>
        <Officer>X</Officer>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>329477</ReportableCompFromRelatedOrgs>
        <OtherCompensation>35958</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>PHELPS D 1-TIME RETIREMENT BENE ADJ</NamePerson>
        <Title>PRESIDENT</Title>
        <AverageHoursPerWeek>1.00</AverageHoursPerWeek>
        <Officer>X</Officer>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>1085553</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>CHERYL BOUDREAU</NamePerson>
        <Title>CLERK</Title>
        <AverageHoursPerWeek>41.00</AverageHoursPerWeek>
        <Officer>X</Officer>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>79974</ReportableCompFromRelatedOrgs>
        <OtherCompensation>13078</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>RONALD HAYDEN</NamePerson>
        <Title>CHAIRMAN - EMERGENCY MEDIC</Title>
        <AverageHoursPerWeek>50.00</AverageHoursPerWeek>
        <KeyEmployee>X</KeyEmployee>
        <ReportableCompFromOrganization>440832</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>37086</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>DIANE KELLY</NamePerson>
        <Title>C.O.O.</Title>
        <AverageHoursPerWeek>50.00</AverageHoursPerWeek>
        <KeyEmployee>X</KeyEmployee>
        <ReportableCompFromOrganization>248303</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>36166</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>MARK VANDEN BOSCH</NamePerson>
        <Title>ANESTHESIOLOGIST</Title>
        <AverageHoursPerWeek>50.00</AverageHoursPerWeek>
        <HighestCompensatedEmployee>X</HighestCompensatedEmployee>
        <ReportableCompFromOrganization>455352</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>12473</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>ANTHONY G ELLRODT</NamePerson>
        <Title>CHAIRMAN - DEPT OF MEDICIN</Title>
        <AverageHoursPerWeek>50.00</AverageHoursPerWeek>
        <HighestCompensatedEmployee>X</HighestCompensatedEmployee>
        <ReportableCompFromOrganization>451684</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>35662</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>THOMAS LAPLACA</NamePerson>
        <Title>ANESTHESIOLOGIST</Title>
        <AverageHoursPerWeek>50.00</AverageHoursPerWeek>
        <HighestCompensatedEmployee>X</HighestCompensatedEmployee>
        <ReportableCompFromOrganization>416863</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>47900</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>ALISON MACDONALD</NamePerson>
        <Title>ANESTHESIOLOGIST</Title>
        <AverageHoursPerWeek>50.00</AverageHoursPerWeek>
        <HighestCompensatedEmployee>X</HighestCompensatedEmployee>
        <ReportableCompFromOrganization>450289</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>14290</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>RAYMOND GARY SOHL</NamePerson>
        <Title>ANESTHESIOLOGIST</Title>
        <AverageHoursPerWeek>50.00</AverageHoursPerWeek>
        <HighestCompensatedEmployee>X</HighestCompensatedEmployee>
        <ReportableCompFromOrganization>435602</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>33152</OtherCompensation>
      </Form990PartVIISectionA>
      <TotalReportableCompFromOrg>3118529</TotalReportableCompFromOrg>
      <TotalReportableCompFrmRltdOrgs>2217736</TotalReportableCompFrmRltdOrgs>
      <TotalOtherCompensation>343432</TotalOtherCompensation>
      <NumberIndividualsGT100K>221</NumberIndividualsGT100K>
      <FormersListed>0</FormersListed>
      <TotalCompGT150K>1</TotalCompGT150K>
      <CompensationFromOtherSources>0</CompensationFromOtherSources>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>MMODAL</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>9009 CAROTHERS PARKWAY SUITE C-2</AddressLine1>
            <City>FRANKLIN</City>
            <State>TN</State>
            <ZIPCode>37067</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>MEDICAL TRANSCRIPTION</DescriptionOfServices>
        <Compensation>950688</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>QUEST DIAGNOSTIC INC</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>415 MASSACHUSETTS AVE</AddressLine1>
            <City>CAMBRIDGE</City>
            <State>MA</State>
            <ZIPCode>02139</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>MEDICAL LAB SERVICES</DescriptionOfServices>
        <Compensation>898739</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>ROBINSON &amp; SMITH</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>335 NORTH MAIN ST</AddressLine1>
            <City>GLOVERSVILLE</City>
            <State>NY</State>
            <ZIPCode>12078</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>LAUNDRY/LINEN SERVICE</DescriptionOfServices>
        <Compensation>868987</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>DIVERSIFIED CLINICAL SERVICES</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>PO BOX 85001</AddressLine1>
            <City>ORLANDO</City>
            <State>FL</State>
            <ZIPCode>32885</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>MANAGEMENT FEES</DescriptionOfServices>
        <Compensation>508245</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>COMPHEALTH MEDICAL STAFF</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>PO BOX 972670</AddressLine1>
            <City>DALLAS</City>
            <State>TX</State>
            <ZIPCode>753972670</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>CONTRACTED LABOR</DescriptionOfServices>
        <Compensation>483524</Compensation>
      </ContractorCompensation>
      <NumberOfContractorsGT100K>22</NumberOfContractorsGT100K>
      <FundraisingEvents>52690</FundraisingEvents>
      <GovernmentGrants>1101617</GovernmentGrants>
      <AllOtherContributions>582919</AllOtherContributions>
      <NoncashContributions>104187</NoncashContributions>
      <TotalContributions>1737226</TotalContributions>
      <ProgramServiceRevenue>
        <Description>PATIENT SERVICES REVEN</Description>
        <BusinessCode>621399</BusinessCode>
        <TotalRevenueColumn>315676608</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>315676608</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>OTHER ANCILLARY</Description>
        <BusinessCode>621399</BusinessCode>
        <TotalRevenueColumn>5998704</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>5998704</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>LAB REVENUE</Description>
        <BusinessCode>621511</BusinessCode>
        <TotalRevenueColumn>2265381</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>2265381</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>HEALTH PROMO EDUCATION</Description>
        <BusinessCode>611710</BusinessCode>
        <TotalRevenueColumn>1713308</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>1713308</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>PSYCH PROF SERVICES</Description>
        <BusinessCode>621112</BusinessCode>
        <TotalRevenueColumn>1627285</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>1627285</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <TotalProgramServiceRevenue>327281286</TotalProgramServiceRevenue>
      <InvestmentIncome>
        <TotalRevenueColumn>3406308</TotalRevenueColumn>
        <UnrelatedBusinessRevenue>348492</UnrelatedBusinessRevenue>
        <ExclusionAmount>3057816</ExclusionAmount>
      </InvestmentIncome>
      <IncomeFromInvestBondProceeds>
        <TotalRevenueColumn>609695</TotalRevenueColumn>
        <ExclusionAmount>609695</ExclusionAmount>
      </IncomeFromInvestBondProceeds>
      <GrossRents>
        <Real>1451284</Real>
      </GrossRents>
      <LessRentalExpenses>
        <Real>1572611</Real>
      </LessRentalExpenses>
      <RentalIncomeOrLoss>
        <Real>-121327</Real>
      </RentalIncomeOrLoss>
      <NetRentalIncomeOrLoss>
        <TotalRevenueColumn>-121327</TotalRevenueColumn>
        <ExclusionAmount>-121327</ExclusionAmount>
      </NetRentalIncomeOrLoss>
      <GrossAmountSalesAssets>
        <Securities>36325070</Securities>
        <Other>6043</Other>
      </GrossAmountSalesAssets>
      <LessCostOthBasisSalesExpenses>
        <Securities>31566899</Securities>
        <Other>415091</Other>
      </LessCostOthBasisSalesExpenses>
      <GainOrLoss>
        <Securities>4758171</Securities>
        <Other>-409048</Other>
      </GainOrLoss>
      <NetGainOrLossInvestments>
        <TotalRevenueColumn>4349123</TotalRevenueColumn>
        <ExclusionAmount>4349123</ExclusionAmount>
      </NetGainOrLossInvestments>
      <GrossIncomeFundraisingEvents>51497</GrossIncomeFundraisingEvents>
      <CntrbtnsRprtdFundraisingEvents>52690</CntrbtnsRprtdFundraisingEvents>
      <FundraisingDirectExpenses>51497</FundraisingDirectExpenses>
      <NetIncomeFromFundraisingEvents>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetIncomeFromFundraisingEvents>
      <OtherRevenueMisc>
        <Description>CAFETERIA INCOME</Description>
        <BusinessCode>722212</BusinessCode>
        <TotalRevenueColumn>1127835</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>0</RelatedOrExemptFunctionIncome>
        <ExclusionAmount>1127835</ExclusionAmount>
      </OtherRevenueMisc>
      <TotalOtherRevenue>1127835</TotalOtherRevenue>
      <TotalRevenue>
        <TotalRevenueColumn>338390146</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>327281286</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>348492</UnrelatedBusinessRevenue>
        <ExclusionAmount>9023142</ExclusionAmount>
      </TotalRevenue>
      <CompCurrentOfficersDirectors>
        <Total>299762</Total>
        <ProgramServices>291368</ProgramServices>
        <ManagementAndGeneral>8394</ManagementAndGeneral>
      </CompCurrentOfficersDirectors>
      <OtherSalariesAndWages>
        <Total>149052574</Total>
        <ProgramServices>144685310</ProgramServices>
        <ManagementAndGeneral>4281905</ManagementAndGeneral>
        <Fundraising>85359</Fundraising>
      </OtherSalariesAndWages>
      <PensionPlanContributions>
        <Total>5619636</Total>
        <ProgramServices>5456667</ProgramServices>
        <ManagementAndGeneral>162969</ManagementAndGeneral>
      </PensionPlanContributions>
      <OtherEmployeeBenefits>
        <Total>20897911</Total>
        <ProgramServices>20291871</ProgramServices>
        <ManagementAndGeneral>606040</ManagementAndGeneral>
      </OtherEmployeeBenefits>
      <PayrollTaxes>
        <Total>11469696</Total>
        <ProgramServices>11137075</ProgramServices>
        <ManagementAndGeneral>332621</ManagementAndGeneral>
      </PayrollTaxes>
      <FeesForServicesManagement>
        <Total>22331107</Total>
        <ManagementAndGeneral>22331107</ManagementAndGeneral>
      </FeesForServicesManagement>
      <FeesForServicesLegal>
        <Total>1750</Total>
        <ManagementAndGeneral>1750</ManagementAndGeneral>
      </FeesForServicesLegal>
      <FeesForServicesLobbying>
        <Total>44762</Total>
        <ProgramServices>44762</ProgramServices>
      </FeesForServicesLobbying>
      <FeesForServicesOther>
        <Total>3179566</Total>
        <ProgramServices>3179566</ProgramServices>
      </FeesForServicesOther>
      <OfficeExpenses>
        <Total>165298</Total>
        <ProgramServices>160019</ProgramServices>
        <ManagementAndGeneral>4779</ManagementAndGeneral>
        <Fundraising>500</Fundraising>
      </OfficeExpenses>
      <Occupancy>
        <Total>5048718</Total>
        <ProgramServices>4902306</ProgramServices>
        <ManagementAndGeneral>146412</ManagementAndGeneral>
      </Occupancy>
      <Travel>
        <Total>737480</Total>
        <ProgramServices>716093</ProgramServices>
        <ManagementAndGeneral>21387</ManagementAndGeneral>
      </Travel>
      <Interest>
        <Total>5705849</Total>
        <ProgramServices>5540380</ProgramServices>
        <ManagementAndGeneral>165469</ManagementAndGeneral>
      </Interest>
      <PaymentsToAffiliates>
        <Total>665427</Total>
        <ProgramServices>665427</ProgramServices>
      </PaymentsToAffiliates>
      <DepreciationDepletion>
        <Total>22747280</Total>
        <ProgramServices>22078687</ProgramServices>
        <ManagementAndGeneral>668593</ManagementAndGeneral>
      </DepreciationDepletion>
      <Insurance>
        <Total>3580814</Total>
        <ProgramServices>3476970</ProgramServices>
        <ManagementAndGeneral>103844</ManagementAndGeneral>
      </Insurance>
      <OtherExpenses>
        <Description>PATIENT RELATED SUPPLIE</Description>
        <Total>47332081</Total>
        <ProgramServices>45245411</ProgramServices>
        <ManagementAndGeneral>2019238</ManagementAndGeneral>
        <Fundraising>67432</Fundraising>
      </OtherExpenses>
      <OtherExpenses>
        <Description>BAD DEBT</Description>
        <Total>10552776</Total>
        <ProgramServices>10552776</ProgramServices>
        <ManagementAndGeneral>0</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </OtherExpenses>
      <OtherExpenses>
        <Description>RECIPROCAL SUPPORT TEAC</Description>
        <Total>8324426</Total>
        <ProgramServices>8324426</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>EQUIP RENTAL REPAIR</Description>
        <Total>4738087</Total>
        <ProgramServices>4528917</ProgramServices>
        <ManagementAndGeneral>209170</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </OtherExpenses>
      <OtherExpenses>
        <Description>UNCOMPENSATED CARE POOL</Description>
        <Total>1590667</Total>
        <ProgramServices>1590667</ProgramServices>
        <ManagementAndGeneral>0</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </OtherExpenses>
      <AllOtherExpenses>
        <Total>437655</Total>
        <ProgramServices>49935</ProgramServices>
        <ManagementAndGeneral>377140</ManagementAndGeneral>
        <Fundraising>10580</Fundraising>
      </AllOtherExpenses>
      <TotalFunctionalExpenses>
        <Total>324523322</Total>
        <ProgramServices>292918633</ProgramServices>
        <ManagementAndGeneral>31440818</ManagementAndGeneral>
        <Fundraising>163871</Fundraising>
      </TotalFunctionalExpenses>
      <CashNonInterestBearing>
        <BOY>10969</BOY>
        <EOY>10970</EOY>
      </CashNonInterestBearing>
      <SavingsAndTempCashInvestments>
        <BOY>9924217</BOY>
        <EOY>22831848</EOY>
      </SavingsAndTempCashInvestments>
      <PledgesAndGrantsReceivable>
        <BOY>131348</BOY>
      </PledgesAndGrantsReceivable>
      <AccountsReceivable>
        <BOY>34310834</BOY>
        <EOY>38873348</EOY>
      </AccountsReceivable>
      <OtherNotesLoansReceivableNet>
        <BOY>15811387</BOY>
        <EOY>14704815</EOY>
      </OtherNotesLoansReceivableNet>
      <InventoriesForSaleOrUse>
        <BOY>6388915</BOY>
        <EOY>6297971</EOY>
      </InventoriesForSaleOrUse>
      <PrepaidExpensesDeferredCharges>
        <BOY>3159240</BOY>
        <EOY>3340776</EOY>
      </PrepaidExpensesDeferredCharges>
      <LandBuildingsEquipmentBasis>381596555</LandBuildingsEquipmentBasis>
      <LandBldgEquipmentAccumDeprec>236517834</LandBldgEquipmentAccumDeprec>
      <LandBuildingsEquipmentBasisNet>
        <BOY>149422581</BOY>
        <EOY>145078721</EOY>
      </LandBuildingsEquipmentBasisNet>
      <InvestmentsPubTradedSecurities>
        <BOY>114315449</BOY>
        <EOY>129261201</EOY>
      </InvestmentsPubTradedSecurities>
      <InvestmentsOtherSecurities>
        <BOY>33796258</BOY>
        <EOY>14053043</EOY>
      </InvestmentsOtherSecurities>
      <OtherAssetsTotal>
        <BOY>3140808</BOY>
        <EOY>2974101</EOY>
      </OtherAssetsTotal>
      <TotalAssets>
        <BOY>370412006</BOY>
        <EOY>377426794</EOY>
      </TotalAssets>
      <AccountsPayableAccruedExpenses>
        <BOY>34031981</BOY>
        <EOY>33226219</EOY>
      </AccountsPayableAccruedExpenses>
      <DeferredRevenue>
        <BOY>419651</BOY>
        <EOY>170090</EOY>
      </DeferredRevenue>
      <TaxExemptBondLiabilities>
        <BOY>134807657</BOY>
        <EOY>130052213</EOY>
      </TaxExemptBondLiabilities>
      <UnsecuredNotesLoansPayable>
        <BOY>14325</BOY>
      </UnsecuredNotesLoansPayable>
      <OtherLiabilities>
        <BOY>23976825</BOY>
        <EOY>32133313</EOY>
      </OtherLiabilities>
      <TotalLiabilities>
        <BOY>193250439</BOY>
        <EOY>195581835</EOY>
      </TotalLiabilities>
      <FollowSFAS117>X</FollowSFAS117>
      <UnrestrictedNetAssets>
        <BOY>159373932</BOY>
        <EOY>164886504</EOY>
      </UnrestrictedNetAssets>
      <TemporarilyRestrictedNetAssets>
        <BOY>11018883</BOY>
        <EOY>10189702</EOY>
      </TemporarilyRestrictedNetAssets>
      <PermanentlyRestrictedNetAssets>
        <BOY>6768752</BOY>
        <EOY>6768753</EOY>
      </PermanentlyRestrictedNetAssets>
      <TotalNetAssetsFundBalances>
        <BOY>177161567</BOY>
        <EOY>181844959</EOY>
      </TotalNetAssetsFundBalances>
      <TotalLiabNetAssetsFundBalances>
        <BOY>370412006</BOY>
        <EOY>377426794</EOY>
      </TotalLiabNetAssetsFundBalances>
      <InfoInScheduleOPartXI>X</InfoInScheduleOPartXI>
      <ReconcilationRevenueExpenses>13866824</ReconcilationRevenueExpenses>
      <ReconcilationOtherChanges>-9183432</ReconcilationOtherChanges>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>0</AccountantCompileOrReview>
      <FSAudited>1</FSAudited>
      <AuditCommittee>1</AuditCommittee>
      <FinancialStatementConsolidated>X</FinancialStatementConsolidated>
      <FederalGrantAuditRequired>1</FederalGrantAuditRequired>
      <FederalGrantAuditPerformed>1</FederalGrantAuditPerformed>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <Hospital170b1Aiii>X</Hospital170b1Aiii>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInfo>
        <ContributorNumber>RESTRICTED</ContributorNumber>
        <ContributorNameBusiness>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorNameBusiness>
        <ContributorAddressUS>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorAddressUS>
        <AggregateContributions>RESTRICTED</AggregateContributions>
      </ContributorInfo>
    </IRS990ScheduleB>
    <IRS990ScheduleC documentId="RetDoc1039700001">
      <Volunteers>0</Volunteers>
      <PaidStaffOrManagement>0</PaidStaffOrManagement>
      <MediaAdvertisements>0</MediaAdvertisements>
      <MailingsMembers>0</MailingsMembers>
      <PublicationsOrBroadcast>0</PublicationsOrBroadcast>
      <GrantsOtherOrganizations>0</GrantsOtherOrganizations>
      <DirectContactLegislators>0</DirectContactLegislators>
      <RalliesDemonstrations>0</RalliesDemonstrations>
      <OtherActivities>1</OtherActivities>
      <OtherActivitiesAmount>44762</OtherActivitiesAmount>
      <TotalLobbyingExpendituresIIB>44762</TotalLobbyingExpendituresIIB>
      <NotDescribedIn501c3>0</NotDescribedIn501c3>
      <Form990ScheduleCPartIV>
        <Identifier>EXPLANATION OF OTHER LOBBYING ACTIVITIES:</Identifier>
        <ReturnReference>PART II-B, LINE 1I:</ReturnReference>
        <Explanation>LOBBYING ACTIVITIES EXPENDITURES BERKSHIRE MEDICAL CENTER 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 9/30/2011.</Explanation>
      </Form990ScheduleCPartIV>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <CurrentYear>
        <BeginningOfYearBalance>15641155</BeginningOfYearBalance>
        <Contributions>0</Contributions>
        <InvestmentEarningsOrLosses>-418714</InvestmentEarningsOrLosses>
        <GrantsOrScholarships>-19500</GrantsOrScholarships>
        <OtherExpenditures>-5956</OtherExpenditures>
        <EndOfYearBalance>15196985</EndOfYearBalance>
      </CurrentYear>
      <CurrentYearMinus1Year>
        <BeginningOfYearBalance>14530168</BeginningOfYearBalance>
        <Contributions>128139</Contributions>
        <InvestmentEarningsOrLosses>1002929</InvestmentEarningsOrLosses>
        <GrantsOrScholarships>18000</GrantsOrScholarships>
        <OtherExpenditures>2081</OtherExpenditures>
        <EndOfYearBalance>15641155</EndOfYearBalance>
      </CurrentYearMinus1Year>
      <CurrentYearMinus2Years>
        <BeginningOfYearBalance>14373083</BeginningOfYearBalance>
        <Contributions>40498</Contributions>
        <InvestmentEarningsOrLosses>128713</InvestmentEarningsOrLosses>
        <GrantsOrScholarships>7400</GrantsOrScholarships>
        <OtherExpenditures>4726</OtherExpenditures>
        <EndOfYearBalance>14530168</EndOfYearBalance>
      </CurrentYearMinus2Years>
      <BoardDesignatedEOYBalance>0.55520</BoardDesignatedEOYBalance>
      <PermanentEndowmentEOYBalance>0.44470</PermanentEndowmentEOYBalance>
      <EndowmentsHeldByUnrelatedOrgs>1</EndowmentsHeldByUnrelatedOrgs>
      <EndowmentsHeldByRelatedOrgs>0</EndowmentsHeldByRelatedOrgs>
      <Land>
        <OtherCostOrOtherBasis>6735560</OtherCostOrOtherBasis>
        <BookValue>6735560</BookValue>
      </Land>
      <Buildings>
        <OtherCostOrOtherBasis>157469825</OtherCostOrOtherBasis>
        <Depreciation>85199693</Depreciation>
        <BookValue>72270132</BookValue>
      </Buildings>
      <Equipment>
        <OtherCostOrOtherBasis>190535434</OtherCostOrOtherBasis>
        <Depreciation>142239024</Depreciation>
        <BookValue>48296410</BookValue>
      </Equipment>
      <OtherLandBuildings>
        <OtherCostOrOtherBasis>26855736</OtherCostOrOtherBasis>
        <Depreciation>9079117</Depreciation>
        <BookValue>17776619</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>145078721</TotalOfBookValueLandBuildings>
      <OtherLiabilities>
        <Description>DUE TO THIRD PARTIES</Description>
        <Amount>16839145</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>DEFERRED COMPENSATION</Description>
        <Amount>2227418</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>PENSION FORFEITURE ESCROW</Description>
        <Amount>37061</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>GIFT ANNUITY LIABILTIY</Description>
        <Amount>8363</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>INTEREST RATE SWAP LIABILITY</Description>
        <Amount>2270941</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>AMOUNT DUE TO AFFILIATE</Description>
        <Amount>8999990</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>ASSET RETIREMENT ACCRETION</Description>
        <Amount>1706895</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>REBATE FUND PAYABLE</Description>
        <Amount>43500</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>32133313</TotalOfAmounts>
      <Form990ScheduleDPartXIV>
        <Identifier>DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:</Identifier>
        <ReturnReference>PART V, LINE 4:</ReturnReference>
        <Explanation>THE ORGANIZATION HOLDS, INVESTS AND/OR UTILIZES ENDOWMENT FUNDS IN ACCORDANCE WITH ANY EXPRESSED WISH OF THE DONOR OF THOSE FUNDS. TO THE EXTENT THAT THE DONOR INSTRUCTIONS ALLOW THE EXPENDITURE OF THE ENDOWMENT FUNDS, THEY ARE EXPENDED FOR HEALTHCARE SERVICES PURPOSES SUCH AS FREE CARE AND SCHOLARSHIPS, CONSISTENT WITH THE TAX EXEMPTION OF THE ORGANIZATION.</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:</Identifier>
        <ReturnReference>PART X:</ReturnReference>
        <Explanation>THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND OTHER FINANCIAL INFORMATION OF BERKSHIRE HEALTH SYSTEMS, INC. AND AFFILIATES (INCLUDING BERKSHIRE MEDICAL CENTER) FOR THE YEARS ENDED SEPTEMBER 30, 2011 AND 2010 DOES NOT CONTAIN A FOOTNOTE ADDRESSING ANY LIABILITY FOR UNCERTAIN TAX PROVISIONS UNDER FIN 48.</Explanation>
      </Form990ScheduleDPartXIV>
    </IRS990ScheduleD>
    <IRS990ScheduleG documentId="RetDoc1041300001">
      <EventsInformation>
        <NameOfEvent1>GOLF TOURNAMENT</NameOfEvent1>
        <GrossReceiptsEvent1>26101</GrossReceiptsEvent1>
        <CharitableContributionsEvent1>7106</CharitableContributionsEvent1>
        <GrossRevenueEvent1>18995</GrossRevenueEvent1>
        <NonCashPrizesEvent1>792</NonCashPrizesEvent1>
        <RentFacilityCostsEvent1>11113</RentFacilityCostsEvent1>
        <OtherDirectExpensesEvent1>7090</OtherDirectExpensesEvent1>
        <NameOfEvent2>GOLF TOURNAMENT</NameOfEvent2>
        <GrossReceiptsEvent2>78086</GrossReceiptsEvent2>
        <CharitableContributionsEvent2>45584</CharitableContributionsEvent2>
        <GrossRevenueEvent2>32502</GrossRevenueEvent2>
        <NonCashPrizesEvent2>2560</NonCashPrizesEvent2>
        <RentFacilityCostsEvent2>21183</RentFacilityCostsEvent2>
        <OtherDirectExpensesEvent2>8759</OtherDirectExpensesEvent2>
        <GrossReceiptsTotal>104187</GrossReceiptsTotal>
        <CharitableContributionsTotal>52690</CharitableContributionsTotal>
        <GrossRevenueTotalEvents>51497</GrossRevenueTotalEvents>
        <NonCashPrizesTotalEvents>3352</NonCashPrizesTotalEvents>
        <RentFacilityCostsTotalEvents>32296</RentFacilityCostsTotalEvents>
        <OtherDirectExpensesTotalEvents>15849</OtherDirectExpensesTotalEvents>
        <DirectExpenseSummaryEvents>51497</DirectExpenseSummaryEvents>
        <NetIncomeSummary>0</NetIncomeSummary>
      </EventsInformation>
    </IRS990ScheduleG>
    <IRS990ScheduleH documentId="RetDoc1041500001">
      <CharityCarePolicy>1</CharityCarePolicy>
      <WrittenPolicy>1</WrittenPolicy>
      <PolicyAppliedToAllHospitals>X</PolicyAppliedToAllHospitals>
      <FPGReferenceFreeCare>1</FPGReferenceFreeCare>
      <Pcent200>X</Pcent200>
      <FPGReferenceDiscountedCare>1</FPGReferenceDiscountedCare>
      <Pcent400>X</Pcent400>
      <FreeDiscCareMedicallyIndigent>1</FreeDiscCareMedicallyIndigent>
      <AmountsBudgetedForCharityCare>1</AmountsBudgetedForCharityCare>
      <ExpensesExceededBudget>1</ExpensesExceededBudget>
      <UnableToProvideCare>0</UnableToProvideCare>
      <AnnualCommunityBenefitReport>1</AnnualCommunityBenefitReport>
      <ReportPublicallyAvailable>1</ReportPublicallyAvailable>
      <CharityCareAtCost>
        <TotalCommunityBenefitExpense>2649676</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>2649676</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00820</PercentOfTotalExpense>
      </CharityCareAtCost>
      <UnreimbursedMedicaid>
        <TotalCommunityBenefitExpense>40424144</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>37203742</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>3220402</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00990</PercentOfTotalExpense>
      </UnreimbursedMedicaid>
      <UnreimbursedCosts>
        <TotalCommunityBenefitExpense>15944625</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>13279207</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>2676418</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00820</PercentOfTotalExpense>
      </UnreimbursedCosts>
      <TotalCharityCare>
        <TotalCommunityBenefitExpense>59018445</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>50482949</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>8546496</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.02630</PercentOfTotalExpense>
      </TotalCharityCare>
      <CommunityHealthServices>
        <TotalCommunityBenefitExpense>2917563</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>1238046</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>1679517</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00520</PercentOfTotalExpense>
      </CommunityHealthServices>
      <HealthProfessionsEducation>
        <TotalCommunityBenefitExpense>12741090</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>4964964</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>7776126</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.02400</PercentOfTotalExpense>
      </HealthProfessionsEducation>
      <SubsidizedHealthServices>
        <TotalCommunityBenefitExpense>12262111</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>9648741</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>2613370</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00810</PercentOfTotalExpense>
      </SubsidizedHealthServices>
      <Research>
        <TotalCommunityBenefitExpense>56589</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>56589</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00020</PercentOfTotalExpense>
      </Research>
      <CashAndInKindContributions>
        <TotalCommunityBenefitExpense>0</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
      </CashAndInKindContributions>
      <TotalOtherBenefits>
        <TotalCommunityBenefitExpense>27977353</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>15851751</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>12125602</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.03750</PercentOfTotalExpense>
      </TotalOtherBenefits>
      <TotalCommunityBenefits>
        <TotalCommunityBenefitExpense>86995798</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>66334700</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>20672098</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.06380</PercentOfTotalExpense>
      </TotalCommunityBenefits>
      <CommunitySupport>
        <TotalCommunityBuildingExpense>10000</TotalCommunityBuildingExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBuildingExpense>10000</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00000</PercentOfTotalExpense>
      </CommunitySupport>
      <CoalitionBuilding>
        <TotalCommunityBuildingExpense>45932</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>45932</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00010</PercentOfTotalExpense>
      </CoalitionBuilding>
      <WorkforceDevelopment>
        <TotalCommunityBuildingExpense>1057533</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>1057533</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00330</PercentOfTotalExpense>
      </WorkforceDevelopment>
      <Total>
        <TotalCommunityBuildingExpense>1113465</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>1113465</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00340</PercentOfTotalExpense>
      </Total>
      <BadDebtExpenseReported>1</BadDebtExpenseReported>
      <BadDebtExpenseAmount>5042923</BadDebtExpenseAmount>
      <AmountAttributableTo>0</AmountAttributableTo>
      <AmountReimbursedByMedicare>104569778</AmountReimbursedByMedicare>
      <CostOfCareReimbursedByMedicare>98494256</CostOfCareReimbursedByMedicare>
      <MedicareSurplusOrShortfall>6075522</MedicareSurplusOrShortfall>
      <CostingMethodologyUsed>
        <CostToChargeRatio>X</CostToChargeRatio>
      </CostingMethodologyUsed>
      <WrittenDebtCollectionPolicy>1</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>1</ProvisionForCharityCare>
      <NumberOfHospitalFacilities>1</NumberOfHospitalFacilities>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>1</FacilityNumber>
        <Name>
          <BusinessNameLine1>BERKSHIRE MEDICAL CENTER</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>725 NORTH ST</AddressLine1>
          <City>PITTSFIELD</City>
          <State>MA</State>
          <ZIPCode>01201</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
        <GeneralMedicalAndSurgical>X</GeneralMedicalAndSurgical>
        <TeachingHospital>X</TeachingHospital>
        <Er24Hours>X</Er24Hours>
        <Other>HOME HEALTH, SUBSTANCE ABUSE, MENTAL HEALTH SERVICES, DENTAL CLINIC, RENAL D</Other>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>BERKSHIRE MEDICAL CENTER INC</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>1</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVI>
        <Explanation>PART I, LINE 7: THE TOTAL COMMUNITY BENEFIT EXPENSE REPORTED ON PART I, LINES 7A, 7B, &amp; 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.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART I, LINE 7G: SUBSTANCE ABUSE UNIT, DENTAL CLINIC, INPATIENT PYSCHIATRIC UNIT</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART I, L7 COL(F): BAD DEBT EXPENSE OF $10,552,776 ATTRIBUTABLE TO PATIENT ACCOUNTS HAS BEEN EXCLUDED FROM THE COMPUTATION OF ALL COMMUNITY BENEFIT EXPENSE SHOWN IN PART I, LINE 7, COLUMN F.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART II: BHS RECOGNIZES THAT ACTIVE INVOLVEMENT IN THE COMMUNITY IS CRUCIAL TO PROMOTING AND PROTECTING THE HEALTH OF AREA RESIDENTS. THE DELIVERY OF HEALTHCARE SERVICES ALONE CANNOT ACHIEVE SIGNIFICANT IMPROVEMENT IN THE HEALTH STATUS OF OUR COMMUNITY. BHS HAS ENGAGED IN COMMUNITY BUILDING ACTIVITIES WITH THE GOAL OF DEVELOPING A SOCIETAL INFRASTRUCTURE THAT ENGAGES ALL SEGMENTS OF THE COMMUNITY WITH THE ULTIMATE PURPOSE OF BETTERING THE LIVES OF PEOPLE IN THE COMMUNITY. THESE ACTIVITIES HAVE REVOLVED AROUND THREE SPECIFIC EFFORTS:1. PARTICIPATION IN GRASSROOTS COMMUNITY WIDE INITIATIVES FOCUSING ON LOCALLY IDENTIFIED CONCERNS:TEEN PREGNANCY PREVENTION INITIATIVEPITTSFIELD YOUTH PREVENTION PARTNERSHIPPITTSFIELD PROMISE (3RD GRADE READING LEVELS)COMMUNITY HEALTH NETWORK OF THE BERKSHIRESBE WELL BERKSHIRESYOUTH SUICIDE PREVENTION PROGRAM/BERKSHIRE COALITION FOR SUICIDE PREVENTION.H1N1 FLU VACCINATION CLINICSBERKSHIRE PAIN MANAGEMENT PROGRAM, MULTI-STAKEHOLDER INITIATIVE TO CURTAIL PRESCRIPTION DRUG MISUSE AND DIVERSIONEMERGENCY RESPONSE PLANNINGSCHOOL PARTNERSHIPS WITH REID MIDDLE SCHOOL AND CONTE ELEMENTARY SCHOOL 2. SERVING IN A LEADERSHIP CAPACITY WITH COMMUNITY ORGANIZATIONSBERKSHIRE UNITEDBERKSHIRE PRIORITIESAREA HEALTH EDUCATION CENTERPITTSFIELD FAMILY YMCAELDER SERVICES OF BERKSHIRE COUNTYBERKSHIRE COMMUNITY COLLEGEBERKSHIRE COMMUNITY COLLEGE FOUNDATIONLOCAL SCHOOL COMMITTEES (PITTSFIELD AND CENTRAL BERKSHIRE)LOCAL BOARDS OF HEALTHBERKSHIRE REGIONAL PLANNING COMMISSION SUSTAINABLE BERKSHIRES INITIATIVELOCAL SCHOOL WELLNESS COMMITTEESAREAS OF ECONOMIC DEVELOPMENT:BERKSHIRE REGIONAL EMPLOYMENT BOARDCHAMBER OF COMMERCEBERKSHIRE ECONOMIC DEVELOPMENT CORPORATION 3. WORKING WITH AREA AND REGIONAL INSTITUTIONS OF HIGHER LEARNING TO MAKE EDUCATIONAL OPPORTUNITIES AVAILABLE TO AREA RESIDENTS.ELMS COLLEGE RN TO BSN PROGRAMCAREER LADDER/ CLINICAL TECHNICAL TRAINING PROGRAMS IN NURSING AND ALLIED HEALTH AREASCLINICAL TRAINING SITE FOR AREA STUDENTS IN NURSING AND ALLIED HEALTH DISCIPLINESEMT-TRAINING AND RE-CERTIFICATION PROGRAMSBHS/BCC NURSING ASSISTANT PROGRAM FOR MEMBERS OF THE COMMUNITY AT LARGEYOUTH LEADERSHIP GROUP</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART III, LINE 4: FOOTNOTE 11 ("CHARITY CARE") TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND OTHER FINANCIAL INFORMATION OF BERKSHIRE HEALTH SYSTEMS, INC. AND AFFILIATES (INCLUDING BERKSHIRE MEDICAL CENTER) FOR THE YEARS ENDED SEPTEMBER 30, 2011 AND 2010 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 ESTALISHED RATES." "IF A PATIENT IS INELIGIBLE FOR CHARITY CARE OR CARE AT REDUCED RATES BECAUSE THE PATIENT'S INCOME EXCEEDS THE ELIGIBILITY GUIDLINES, SERVCIES RENDERED ARE RECORDED AT ESTABLISHED RATES AND ANY UNPAID ACCOUNT RECEIVABLE BALANCE IS WRITTEN OFF TO BAD DEBT EXPENSE 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 BERKSHIRE MEDICAL CENTER'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.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>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. THE HOSPITAL USED THE STANDARD MEDICARE COST REPORT TO DETERMINE MEDICARE COSTS BASED ON A STEP-DOWN METHODOLOGY. THE SHORTFALL ON THE MEDICARE PROGRAM IS RELATED TO PROGRAMS AND SERVICES PROVIDED FOR THE COMMUNITY, MANY OF WHICH ARE ONLY PROVIDED BY THE HOSPITAL IN THE GEOGRAPHIC REGION AND INCLUDE TRAUMA SERVICES, RENAL DIALYSIS SERVICES, PSYCHIATRIC AND GEROPSYCHIATRIC PROGRAMS, AND HOMECARE SERVICES. THE HOSPITAL CONSIDERS THE FULL SHORTFALL TO BE A COMMUNITY BENEFIT.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART III, LINE 9B: POPULATIONS EXEMPT FROM COLLECTION ACTIVITIESTHE FOLLOWING INDIVIDUALS AND PATIENT POPULATIONS ARE EXEMPT FROM ANY COLLECTION OR BILLING PROCEDURES PURSUANT TO STATE REGULATIONS:A. 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, "LOW INCOME PATIENTS" AS DETERMINED BY THE OFFICE OF MEDICAID1. PLEASE NOTE THAT BMC 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.2. BMC 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) BMC SHALL CEASE ITS BILLING OR COLLECTION ACTIVITIES. 3. BMC 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, BMC WILL CEASE COLLECTION ACTIVITY FOR SERVICES, PREVIOUSLY BILLED, THAT NOW FALL INTO THE ELIGIBILITY PERIOD. 4. BMC 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.5. BMC 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.B. BMC WILL NOT GARNISH A LOW INCOME PATIENT'S (AS DETERMINED BY THE OFFICE OF MEDICAID) OR THE PATIENT'S GUARANTOR'S WAGES OR EXECUTE A LIEN ON THE LOW INCOME PATIENT'S OR THE PATIENT'S GUARANTOR'S PERSONAL RESIDENCE OR MOTOR VEHICLE UNLESS: (1) THE HOSPITAL CAN SHOW THAT THE PATIENT OR THE PATIENT'S GUARANTOR HAS THE ABILITY TO PAY, (2) THE PATIENT DID NOT RESPOND TO HOSPITAL REQUESTS FOR INFORMATION OR THE PATIENT REFUSED TO COOPERATE WITH THE HOSPITAL TO SEEK AN AVAILABLE FINANCIAL ASSISTANCE PROGRAM, OR (3) FOR PURPOSES OF THE LIEN, IT WAS APPROVED BY THE HOSPITAL'S BOARD OF TRUSTEES ON AN INDIVIDUAL CASE BY CASE BASIS. C. BMC 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.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART VI, LINE 2: COMMUNITY BENEFITS MISSION STATEMENTFURTHERING OUR CHARITABLE PURPOSE, THE BERKSHIRE MEDICAL CENTER'S COMMUNITY BENEFIT MISSION IS TO IDENTIFY, PRIORITIZE AND INVEST IN OUR COMMUNITY'S HEALTH NEEDS BY PURSUING NEEDED INITIATIVES AND PROGRAMS. THE COMMUNITY BENEFIT GOALS INCLUDE SATISFYING UNMET NEEDS IN THE BERKSHIRES AND IMPROVING THE HEALTH STATUS OF OUR COMMUNITY WITH A PARTICULAR FOCUS ON ACCESS TO HEALTHCARE AND "AT RISK" POPULATIONS. RECOGNIZING THE VALUE OF BMC'S PARTNERSHIP WITH OUR COMMUNITY, BMC WILL SEEK INPUT AND MEANINGFUL COLLABORATION IN OUR EFFORT TO MEET COMMUNITY NEED. BMC WILL OUTLINE IN AN ANNUAL COMMUNITY BENEFIT PLAN, THE PRIORITIES TO BE ADDRESSED AND THE INITIATIVES TO BE FUNDED.BMC AND FAIRVIEW HOSPITAL ARE BOTH PART OF BERKSHIRE HEALTH SYSTEMS AND THEREFORE WORK TOGETHER TO MEET COMMUNITY NEED. COMMUNITY BENEFIT AND ACCESS COMMITTEEAS A STANDING COMMITTEE OF THE BOARD OF TRUSTEES - ITSELF MADE UP OF COMMUNITY VOLUNTEERS, THIS COMMITTEE IS RESPONSIBLE FOR UNDERSTANDING THE HEALTH NEEDS AND BARRIERS TO CARE IN OUR SERVICE AREA. THE COMMITTEE OVERSEES THE COMMUNITY BENEFIT PROCESS OF THE ORGANIZATION, INCLUDING HEALTH NEEDS ASSESSMENTS, DETERMINING TARGET POPULATIONS AND PRIORITIES, DEVELOPMENT OF THE COMMUNITY BENEFITS PLAN AND EVALUATING PERFORMANCE AGAINST GOALS AND OBJECTIVES. THE COMMITTEE IS COMPRISED OF PEOPLE FROM THE BOARD OF TRUSTEES AND THE COMMUNITY AT LARGE, AND MEETS MONTHLY THOUGH OUT THE YEAR. COMMUNITY BENEFITS LEADERSHIP/TEAMRUTH BLODGETT, BHS SENIOR VICE PRESIDENT, PLANNING AND DEVELOPMENT; MICHAEL LEARY, BHS DIRECTOR OF MEDIA RELATIONS; CATHIE MCHUGH, PLANNING ANALYST; BOBBIE ORSI, RN, DIRECTOR, COMMUNITY OUTREACH SERVICES; ED PERLAK, VICE PRESIDENT, COMMUNITY SERVICES; LEE SANTOS, BHS FISCAL ADMINISTRATION; PROGRAM DIRECTORS OF COMMUNITY BENEFIT PROGRAMS.COMMUNITY BENEFITS TEAM MEETINGSTHE BHS COMMUNITY BENEFITS AND ACCESS COMMITTEE MEETS MONTHLY TO DISCUSS COMMUNITY BENEFIT PROGRAMS, POTENTIAL NEW INITIATIVES, COMMUNITY NEEDS AND OUTCOMES. THROUGHOUT THE YEAR, INTERNAL COMMUNITY BENEFIT AND PROGRAM LEADERS MEET TO COORDINATE THE COMMUNITY BENEFIT PLAN AND PROGRAMS. HEALTH NEEDS ASSESSMENTBMC HAS UTILIZED AN ACTIVE COMMUNITY NEEDS ASSESSMENT AS PART OF ITS COMMUNITY BENEFIT PROCESS SINCE 1996. THE COMMUNITY NEEDS ASSESSMENT IS UPDATED ANNUALLY, AND THE UPDATE IN 2010 DIRECTED OUR EFFORTS IN 2011. BMC 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 HEALTH CARE. IN NOVEMBER 2011, WE ALSO HOSTED A COMMUNITY WIDE MEETING TO REVIEW THE HEALTH NEEDS OF OUR COMMUNITY AND SOLICIT ADDITIONAL FEEDBACK FROM OVER 70 COMMUNITY BASED ORGANIZATIONS (SEE ATTACHMENT) . THE FEEDBACK GATHERED INPUT ON SPECIFIC ACTIONS THAT COULD BE TAKEN AT AN INDIVIDUAL, FAMILY AND ORGANIZATIONAL LEVEL AS WELL AS IDENTIFYING GAPS IN SERVICE IN ADDITION TO PRIORITIZING THE MOST IMPORTANT NEEDS FOR THE COMMUNITY AS A WHOLE. 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, BMC LOOKS FOR OPPORUNITIES TO MAKE BETTER AND MORE EFFECTIVE USE OF EXISTING RESOURCES AND PROVIDERS, AS WELL AS TO IDENTIFY GAPS IN SERVICE. BMC 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. DATA SOURCESCOMMUNITY FOCUS GROUPS, HOSPITAL DATA, CONSUMER AND ADVISORY GROUPS, INTERVIEWS, MASSCHIP, PUBLIC HEALTH PERSONNEL, SURVEYS, OTHER - HEALTHY PEOPLE 2020; DEPARTMENT OF PUBLIC HEALTH BUREAU OF FAMILY AND COMMUNITY HEALTH INJURY REPORT; DEPARTMENT OF PUBLIC HEALTH PRESCRIPTION MONITORING PROGRAM DATA; PHYSICIAN MANPOWER DATA; WORKFORCE NEEDS DATA; WELLNESS DATA; EMERGENCY DEPARTMENT/TRAUMA REGISTRY; BERKSHIRE UNITED WAY; BERKSHIRE REGIONAL PLANNING COMMISSION; AND CHAMBER OF COMMERCE BLUEPRINT STUDY GOALS: STATEWIDE PRIORITIES: AS PART OF OUR PLANNING PROCESS, BMC ALSO INCORPORATES THE MA STATEWIDE PRIORITIES AS PART OF OUR LOCAL ASSESSMENT, PRIORITIES AND INITIATIVES. THE STATES PRIORITIES ARE : ADDRESS UNMET HEALTH NEEDS OF THE UNINSURED CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATIONS PROMOTING WELLNESS OF VULNERABLE POPULATIONS REDUCING HEALTH DISPARITY, SUPPORTING HEALTHCARE REFORMTARGET POPULATIONSMEDICALLY UNDERSERVED - BERKSHIRE COUNTY HAS ONE OF THE HIGHEST NUMBER OF MEDICALLY UNDERSERVED RESIDENTS IN MASSACHUSETTS. UNINSURED - DUE TO ITS ECONOMIC AND EMPLOYMENT STATUS, BERKSHIRE COUNTY HAS A SIGNIFICANT NUMBER OF INDIVIDUALS AND FAMILIES WHO ARE UNINSURED OR UNDERINSURED.SENIOR POPULATION - BERKSHIRE COUNTY HAS ONE OF THE LARGEST ELDERLY POPULATIONS IN THE STATE. RACIAL AND ETHNIC POPULATIONS - THE BERKSHIRES IS EXPERIENCING A STEADY RISE IN IMMIGRANT POPULATION, PARTICULARLY LATIN AMERICAN AND RUSSIAN IMMIGRANTS. ENTIRE GEOGRAPHIC POPULATION OF BERKSHIRE COUNTY - BERKSHIRE COUNTY IS THE MOST RURAL COUNTY IN THE STATE AND IS GEOGRAPHICALLY ISOLATED FROM LARGER COMMUNITIES. AS A RESULT, BMC IS THE PRIMARY PROVIDER OF HEALTHCARE SERVICES TO THE REGION. ECONOMICALLY VULNERABLE - BERKSHIRE COUNTY HAS ONE OF THE HIGHEST UNEMPLOYMENT AND UNDEREMPLOYMENT RATES IN THE STATE AND LOW MEDIAN INCOME. YOUTH - LOCAL HEALTHCARE STATISTICS ON YOUTH AT RISK. PREGNANCY AND CHILDBIRTH - LOCAL HEALTHCARE STATISTICS ON MATERNAL CHILD HEALTH. POPULATIONS WITH HEALTH DISPARITIES - LOCAL HEALTH DATA. COMMUNITY BENEFIT PRIORITIES* CANCER* CARDIOVASCULAR HEALTH* DIABETES* MENTAL HEALTH* OBESITY* STROKE/BLOOD PRESSURE* SUBSTANCE ABUSE* ACCESS TO HEALTHCARE MEDICAL PROFESSIONALS UNDER &amp; UNINSURED* ADOLESCENT &amp; YOUTH HEALTH* DEPRESSION* EMERGENCY PREPAREDNESS * HEALTHCARE DISPARITIES* INFECTIOUS DISEASE* INJURY PREVENTION* MATERNAL/CHILD HEALTH * SMOKINGCOMMUNITY PARTNERSPITTSFIELD PUBLIC SCHOOLS, PITTSFIELD BOARD OF HEALTH, HEAD START, BERKSHIRE COMMUNITY ACTION COUNCIL, CENTER FOR ECOLOGICAL TECHNOLOGY, TEEN PARENT PROGRAM, BRIEN CENTER FOR MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES, PITTSFIELD POLICE, MASSACHUSETTS COALITION FOR SUICIDE PREVENTION, MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, LOCAL COMMUNITY PHARMACISTS, ELDER SERVICES, PITTSFIELD SENIOR CENTER, GREYLOCK FEDERAL CREDIT UNION, BOXCAR MEDIA, YMCA, TRI-TOWN HEALTH BOARD, SHINE PROGRAM, BERKSHIRE IMMIGRANT CENTER, BERKSHIRE COMMUNITY COLLEGE, BERKSHIRE COUNTY SHERIFF'S DEPARTMENT, LOCAL AMBULANCE COMPANIES, BERKSHIRE BREAST HEALTH TEAM, COMMUNITY HEALTH PROGRAM, BERKSHIRE DISTRICT ATTORNEY, BERKSHIRE UNITED WAY, BERKSHIRE YOUTH DEVELOPMENT PROJECT, CHNA(COMMUNITY HEALTH NETWORK ASSOCIATION), LOCAL BUSINESS COMMUNITY. OTHER RESOURCES AND ORGANIZATIONS INCLUDE:MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH; UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE; BERKSHIRE COUNTY BOARDS OF HEALTH; LOCAL SCHOOL DISTRICTS; BERKSHIRE COUNTY REGIONAL PLANNING COMMISSION; BERKSHIRE UNITED WAY; BERKSHIRE, AMERICAN HEART ASSOCIATION, AMERICAN STROKE ASSOCIATION, AMERICAN DIABETES ASSOCIATION, AMERICAN CANCER SOCIETY, CHAMBER OF COMMERCE; MASSACHUSETTS MEDICAL SOCIETY; REGIONAL PAIN COLLABORATIVE; BERKSHIRE COUNTY REGIONAL EMERGENCY OPERATIONS PLANNING COMMITTEE.PROGRAM PLANNING AND EVALUATIONTHE COMMUNITY HEALTH NEEDS ASSESSMENT IS USED TO FOCUS OUR COMMUNITY BENEFIT PROGRAM AND INITIATIVE PLANNING AS WELL AS TO MONITOR RESULTS AND REPRIORITIZE FOR FUTURE EFFORTS.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART VI, LINE 3: BMC PROMINENTLY ADVERTISES THROUGHOUT THE COMMUNITY, AT ALL OF ITS FACILITIES AND ON ITS WEBSITE ITS PROGRAM KNOWN AS "ADVOCACY FOR ACCESS." THE GOAL OF THIS PROGRAM IS TO ASSIST THE UNINSURED AND UNDERINSURED IN BERKSHIRE COUNTY IN ACCESSING VARIOUS PROGRAMS THAT CAN PAY FOR HEALTHCARE SERVICES (AS WELL AS AVENUES TO RECEIVE HEALTHCARE SERVICES AT NO COST). THE ADVOCACY FOR ACCESS PROGRAM HELPS REDUCE THE PERCEPTION BY THOSE WITH AN INABILITY TO PAY FOR HEALTHCARE THAT THEIR INABILITY IS, IN FACT, A BARRIER TO NECESSARY CARE. THE STAFF FACILITATES THE APPLICATION PROCESS FOR INDIVIDUALS AND FAMILIES IN ORDER TO BENEFIT ONE OF THE SEVERAL LOW-COST HEALTH INSURANCE PROGRAMS FOR ADULTS AND CHILDREN WHO LIVE IN MASSACHUSETTS. THE STAFF RECOGNIZE THAT MANY OF THESE STATE AND FEDERAL PROGRAMS THAT CAN BE COMPLEX AND CONFUSING AND MAINTAINS AS ITS GOAL MAKING ACCESS TO HEALTH INSURANCE AS SIMPLE AS POSSIBLE. WHEN AN INDIVIDUAL OR FAMILY'S CIRCUMSTANCES CHANGE, THE ADVOCACY STAFF CAN ASSIST IN UPDATING THE APPROPRIATE AGENCY TO FACILITATE THE PROCESS.THE ADVOCACY FOR ACCESS PROGRAMS HELP THOUSANDS OF PEOPLE EACH YEAR ACCESS INSURANCE OR OTHER COVERAGE PROGRAMS TO AID THEM IN ADDRESSING THEIR HEALTHCARE NEEDS.INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE IS OFFERED TO OUR PATIENTS IN THE FOLLOWING MANNER:NOTICES OF THE AVAILABILITY OF FINANCIAL ASSISTANCE ARE POSTED THROUGHOUT THE HOSPITAL, SPECIFICALLY IN ALL SERVICE DELIVERY AREAS, FINANCIAL COUNSELING OFFICES THROUGHOUT THE CLINICAL CAMPUSES AND ALL BERKSHIRE FACULTY SERVICES PHYSICIAN PRACTICES. ADVOCACY FOR ACCESS PROGRAM STAFF ARE AVAILABLE DAILY TO MEET WITH PATIENTS WHO PRESENT AT THE EMERGENCY DEPARTMENT FOR SERVICES AS REQUESTED.APPOINTMENTS CAN BE MADE WITH THE ADVOCACY FOR ACCESS PROGRAM OFFICE TO ASSIST PATIENTS IN FILING AN ELECTRONIC APPLICATION THROUGH THE VIRTUAL GATEWAY FOR STATE FINANCIAL ASSISTANCE PROGRAMS. AT PRE-REGISTRATION, SELF-PAY PATIENTS ARE OFFERED AN APPOINTMENT WITH ADVOCACY FOR ACCESS PROGRAM OFFICE ALONG WITH AN EXPLANATION OF THE SERVICE.BROCHURES ARE DISTRIBUTED AT ALL ACCESS POINTS INFORMING PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE WITH PHONE NUMBERS TO CONTACT THE ADVOCACY FOR ACCESS PROGRAM OFFICE TO SET UP APPOINTMENTS. STATEMENTS MAILED TO PATIENTS WHO HAVE A SELF-PAY BALANCE WILL HAVE A MESSAGE INDICATING THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE AND THE PHONE NUMBERS TO CONTACT THE ADVOCACY FOR ACCESS OFFICE FOR ADDITIONAL INFORMATION. ALL PATIENT STATEMENTS HAVE A MESSAGE ON THE BACK OF THE STATEMENT INDICATING THE AVAILABILITY OF FINANCIAL ASSISTANCE.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART VI, LINE 4: BERKSHIRE COUNTY IS A LARGELY RURAL AREA LOCATED AT THE FAR WESTERN END OF MASSACHUSETTS, ADJACENT TO NEW YORK STATE TO THE WEST, VERMONT TO THE NORTH AND CONNECTICUT TO THE SOUTH. COMPRISING ROUGHLY 15% OF THE LAND MASS OF MASSACHUSETTS, ITS APPROXIMATELY 131,000 RESIDENTS ACCOUNT FOR 2% OF THE POPULATION OF THE COMMONWEALTH.THE POPULATION IS RELATIVELY HOMOGENEOUS ETHNICALLY:WHITE NON-HISPANIC PERSONS: 92.5%BLACK NON-HISPANIC PERSONS : 2.7%HISPANIC PERSONS: 3.5%ASIAN PERSONS: 1.2%THE COUNTY IS COMPRISED OF THREE DISTINCT SUB-REGIONS: NORTH, SOUTH AND CENTRAL WHICH FORM THE OVERALL COUNTY PROFILE OF A LARGELY RURAL AREA WITH SMALL URBAN, AGRARIAN, AND POST-INDUSTRIAL TOWNS AND CITIES. WHILE TIED TOGETHER ECONOMICALLY, SOCIALLY AND POLITICALLY, EACH SUB-REGION REFLECTS A DEGREE OF SOCIAL AND ECONOMIC DIFFERENCES, PRIMARILY DUE TO THE 50-MILE LENGTH OF THE COUNTY FROM NORTH TO SOUTH. BERKSHIRE COUNTY IS A COMMUNITY IN TRANSITION FROM AN ECONOMY RELYING ON MANUFACTURING TO A SERVICE SECTOR DEPENDENT ECONOMY. THE GENERAL ELECTRIC COMPANY, WHICH AT ONE POINT IN THE 1970S EMPLOYED UPWARDS OF 15,000 PEOPLE, SOLD THE LAST SEGMENT OF ITS BUSINESS IN THE BERKSHIRES (GE PLASTICS, WHICH EMPLOYED ABOUT 500 PEOPLE) TO A SAUDI ARABIAN OWNED COMPANY, SABIC. OTHER MAJOR EMPLOYERS, FOR EXAMPLE, SPRAGUE ELECTRIC (ELECTRICAL COMPONENTS) AND BELOIT-JONES (PAPER MAKING MACHINERY) ALSO CLOSED.THE LAST TWO YEARS HAVE SEEN THE CLOSING OF FIVE PAPER MILLS IN THE COUNTY, WHICH HAD ACCOUNTED FOR A LARGE PART OF THE REMAINING INDUSTRIAL BASE IN THE AREA.SUBSEQUENTLY, THE COUNTY HAS TAKEN ADVANTAGE OF ITS RURAL ENVIRONMENT, CULTURAL ATTRACTIONS, AND ITS SMALL TOWN ATMOSPHERE TO DEVELOP A THREE SEASON TOURIST/VACATION "DESTINATION" PROXIMAL TO THE NEW YORK AND BOSTON METROPOLITAN AREAS (WITHIN A THREE HOUR DRIVE).ALTHOUGH THIS EFFORT HAS BEEN MET WITH A REASONABLE LEVEL OF SUCCESS (UPWARDS OF 2 MILLION TOURISTS VISIT EACH YEAR), THE JOBS CREATED IN THIS EMPLOYMENT SECTOR CANNOT ADEQUATELY REPLACE WHAT HAS BEEN LOST DUE TO THE MAJOR DEINDUSTRIALIZATION OF THE COUNTY OVER THE LAST TWO DECADES. THIS IS REFLECTED IN THE ECONOMIC DEMOGRAPHIC OF THE COUNTY COMPARED TO THE COMMONWEALTH OF MASSACHUSETTS:PER CAPITA INCOME IS 16% BELOW THE STATE AVERAGEMEDIAN HOUSEHOLD INCOME IS 31% BELOW THE STATE AVERAGE% POPULATION BELOW 200% OF THE POVERTY LEVEL IS 20% HIGHER THAN THE STATE% OF CHILDREN LESS THAN 18 YEARS OF AGE LIVING BELOW 100% OF THE POVERTY LINE IS 10% HIGHER THAN THE STATE54.4% OF PREGNANT WOMEN RECEIVE PUBLICLY FINANCED PRENATAL CARE COMPARED TO 36.1% STATEWIDE.THE POPULATION DEMOGRAPHIC HAS BEEN SIMILARLY AFFECTED:2.8 % OF A POPULATION DECLINE IN THE COUNTY FROM 2000 TO 2010 FOLLOWING A 3.25 % DROP IN POPULATION FROM 1990-2000. % PERSONS UNDER THE AGE OF 20 YEARS IN THE COUNTY IS 10% LOWER THAN THE STATEWIDE AVERAGE.% PERSONS AGE 65 AND OLDER IS APPROXIMATELY 1/3 HIGHER THAN THE STATE (18.5% VS. 13.7%)THE EDUCATION PROFILE OF COUNTY RESIDENTS REFLECTS THE ECONOMIC AND POPULATION DEMOGRAPHIC:THE PERCENTAGE OF RESIDENTS AGE 25+ WHO HAVE GRADUATED HIGH SCHOOL (89.9%) IS ABOUT THE SAME AS THE STATE EXPERIENCE (88.4%).THE PERCENTAGE OF RESIDENTS AGE 25+ WITH A BACHELORS DEGREE OR HIGHER IS APPROX. 25.6% LOWER THAN THE COMMONWEALTH AS A WHOLE (30.1% VS. 37.8%).THE CUMULATIVE IMPACT OF THIS TRANSITION HAS HAD A SIGNIFICANT IMPACT ON THE FABRIC OF THE COMMUNITY. TRADITIONAL SUPPORT SYSTEMS OF FAMILY, SCHOOLS AND RELIGION, HAVE BEEN CHALLENGED BY THESE DEVELOPMENTS:ALCOHOL AND DRUG ABUSE ARE SIGNIFICANT ISSUES. COUNTY RESIDENTS ARE ADMITTED INTO SUBSTANCE ABUSE TREATMENT AT A FAR GREATER RATE THAN THE STATE AVERAGE.THE SUICIDE RATE IN BERKSHIRE COUNTY IS HIGHER THAN THE STATE AVERAGE. (12.1 VS. 7.8 STATEWIDE)IN 2008, THE COMMUNITIES OF NORTH ADAMS AND PITTSFIELD (THE TWO LARGEST COMMUNITIES IN BERKSHIRE COUNTY) WERE RANKED 1RST AND 2ND RESPECTIVELY STATEWIDE IN REPORTING RATE FOR CHILD MALTREATMENT. (NORTH ADAMS AT 156.9 REPORTED PER 1000 RESIDENT CHILDREN AND PITTSFIELD AT 142.2 REPORTED PER 1000 RESIDENT CHILDREN COMPARED TO A STATEWIDE RATE OF 52.9 PER 1000.) IN TERMS OF VICTIMIZATION RATES (SUPPORTED ALLEGATIONS) NORTH ADAMS AT 68.3 AND PITTSFIELD AT 57.2 WERE 3RD AND 6TH STATEWIDE RESPECTIVELY COMPARED TO A STATEWIDE AVERAGE OF 24.4. (MASS. DEPARTMENT OF CHILDREN AND FAMILIES JAN. 2010)THE CITY OF PITTSFIELD IS ONE OF SIX CITIES IN MASSACHUSETTS WITH THE HIGHEST LEVEL OF DIVISION OF YOUTH SERVICES INVOLVEMENT IN THE COMMONWEALTH. (MASS. JUVENILE JUSTICE ADVISORY CTE. REPORT TO THE GOVERNOR MAY 2007)IN 8TH GRADE IN 2009, 45% OF BERKSHIRE COUNTY STUDENTS SELF REPORTED ALCOHOL USE. IN 12TH GRADE THE PERCENTAGE WAS 82% IN 2009. (2009 PREVENTION NEEDS ASSESSMENT SURVEY RESULTS: BERKSHIRE COUNTY. BERKSHIRE YOUTH DEVELOPMENT PROJECT)25% OF 12TH GRADE STUDENTS REPORTED BEING DRUNK OR HIGH AT SCHOOL IN 2009.(2009 PREVENTION NEEDS ASSESSMENT SURVEY) THE SCHOOL POPULATION OF THE COUNTY HAS BECOME INCREASINGLY MOBILE AND UNSTABLE IN RESPONSE TO AN UNPRECEDENTED INCREASE IN HOUSING COSTS IN SOUTHERN BERKSHIRE COUNTY DUE PRIMARILY TO THE INFLUX OF SECOND HOME BUYERS. FAMILIES ARE RELOCATING TO LOWER COST HOUSING IN THE CENTRAL AND NORTHERN PARTS OF THE COUNTIES DISRUPTING ESTABLISHED SCHOOL SUPPORT SYSTEMS FOR THEIR CHILDREN (SCHOOL MOBILITY RATES BERKSHIRE HILLS REGIONAL SCHOOL DISTRICT).THE BERKSHIRE COUNTY JUVENILE RESOURCE CENTER TRUANCY, INTERVENTION, AND SUSPENSION/EXPULSION ALTERNATIVE PROGRAM SERVES OVER 460 YOUTHS/YEAR. (MASS. JUVENILE JUSTICE ADVISORY CTE. REPORT)1852 JUVENILE CASES WERE OPENED IN BERKSHIRE JUVENILE COURT (70% MALE, 30% FEMALE) (OFFICE OF BERKSHIRE DISTRICT ATTORNEY DAVID CAPELESS MAY 2010)14 CHURCHES CLOSED WITHIN THE LAST THREE YEARS.THE IMPACT OF THE LOCAL "ENVIRONMENT" ON YOUTH AND ITS IMPLICATIONS FOR THE FUTURE OF THE COUNTY IS FURTHER MAGNIFIED BY TWO SIGNIFICANT FINDINGS: THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH HAS IDENTIFIED BERKSHIRE COUNTY AS BEING AT HIGH RISK FOR YOUTH SUICIDE (ONE OF EIGHT AREAS OUT OF 27 DEFINED AREAS).A COUNTY-WIDE EFFORT TO ADDRESS THIS ISSUE HAS BEEN INITIATED. UNDER THE AUSPICES OF THE COMMUNITY HEALTH NETWORK OF THE BERKSHIRES (COMPRISED OF MEMBERS OF THE HEALTHCARE AND JUVENILE SERVICES PROVIDERS IN THE COUNTY), GRANT FUNDING FROM THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH HAS BEEN OBTAINED (ONE OF ONLY THREE PROPOSALS FUNDED) TO INITIATE A THREE YEAR YOUTH SUICIDE PREVENTION PROGRAM. THE FOCUS OF THIS EFFORT IS TO HELP COMMUNITY ORGANIZATIONS WORKING WITH ADOLESCENTS TO ESTABLISH SUSTAINABLE ACTIVITIES TO PROVIDE SUPPORTIVE ENVIRONMENTS FOR YOUTH, IDENTIFY YOUTH AT RISK, AND MAKE APPROPRIATE REFERRALS TO THE INTERVENTION SAFETY NET. THE NUMBER OF BIRTHS IN BERKSHIRE COUNTY IS DECLINING BUT THE PERCENTAGES OF BIRTHS TO ADOLESCENT MOTHERS IN BERKSHIRE COUNTY AS WELL AS THE TEEN BIRTH RATE ARE HIGHER THAN THE REST OF THE STATE.IN BERKSHIRE COUNTY, 10.7% OF THE BIRTHS/YR ARE BABIES BORN TO ADOLESCENTS (122 BIRTHS) COMPARED 6% STATEWIDE. THE TEEN PREGNANCY RATE IN BERKSHIRE COUNTY HAS INCREASED OVER 20% OVER THE PAST DECADE COMPARED TO A 21% DECLINE STATEWIDE OVER THE SAME PERIOD OF TIME. (UNITED WAY 2010 COMMUNITY IMPACT REPORT COMPLETED BY THE BERKSHIRE REGIONAL PLANNING COMMISSION)HEALTH STATUSTHE ROBERT WOOD JOHNSON FOUNDATION AND THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE PRESENTED THE 2010 COUNTY HEALTH RANKINGS, A COLLECTION OF 50 REPORTS THAT REFLECT THE OVERALL HEALTH OF COUNTIES IN EVERY STATE ACROSS THE COUNTRY.SUMMARY HEALTH OUTCOMES &amp; HEALTH FACTORS RANKINGSCOUNTIES RECEIVE TWO SUMMARY RANKS: HEALTH OUTCOMES HEALTH FACTORS EACH OF THESE RANKS REPRESENTS A WEIGHTED SUMMARY OF A NUMBER OF MEASURES. HEALTH OUTCOMES REPRESENT HOW HEALTHY A COUNTY IS WHILE HEALTH FACTORS ARE WHAT INFLUENCES THE HEALTH OF THE COUNTY. THE INFORMATION BELOW REFLECTS THE SOCIAL AND ECONOMIC STATUS OF OUR COMMUNITY AND INFLUENCES OUR HEALTH STATUS.OUT OF THE FOURTEEN COUNTIES OF MASSACHUSETTS, BERKSHIRE COUNTY RANKED 10TH FOR MORTALITY, 11TH FOR MORBIDITY, HEALTH BEHAVIORS, SOCIAL &amp; ECOMIC FACTORS, 12TH FOR PHYSICAL ENVIRONMENT AND 1ST FOR CLINCIAL CARE.CHRONIC DISEASE: HYPERTENSION HTN PREVALENCE IN MULTIPLE WORKSITES AVERAGES AT APPROXIMATELY 30%. IN WORKSITES WITH ACTIVE WELLNESS PROGRAMS, THE PERCENTAGE OF EMPLOYEES WITH HTN IS APPROXIMATELY 17%. 40% OF EMPLOYEES HAVE PRE-HYPERTENSION IN &gt;2000 EMPLOYEES (WORKSITES) WITH HTN, 26% HAVE BP"S "NOT AT GOAL"CONTINUED ON SCHEDULE O.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART VI, LINE 6: THE GOVERNING BODY OF BMC CONSISTS OF 25 COMMUNITY VOLUNTEERS, THREE PHYSICIAN REPRESENTATIVES OF THE HOSPITALS' MEDICAL STAFFS 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. BMC MAINTAINS A PATIENT AND FAMILY COUNCIL TO PROVIDE INPUT AND ADVICE ON A WIDE RANGE OF SERVICE TOPICS.THE MEDICAL STAFF OF BMC 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.BMC REGULARLY EXPENDS PERSONNEL AND FINANCIAL RESOURCES IN SUPPORT OF COMMUNITY INITIATIVES THAT PROMOTE IMPROVEMENTS IN COMMUNITY HEALTH AND WELL-BEING AND FOR WHICH IT DOES NOT EXPECT REIMBURSEMENT. THE BERKSHIRE COUNTY COMMUNITY HAS LONG LABORED UNDER A CRITICAL PHYSICIAN SHORTAGE IN VARIOUS SPECIALTIES AND BMC HAVE IN RECENT YEARS EXPENDED SIGNIFICANT PERSONNEL TIME AND FINANCIAL RESOURCES IN RECRUITING PHYSICIANS TO THE AREA AS DIRECT EMPLOYEES OF BMC OR ITS AFFILIATES. MOREOVER, BMC HAS, IN APPROPRIATE WAYS, PROVIDED SUBSTANTIAL ASSISTANCE TO COMMUNITY MEDICAL PRACTICES TO RECRUIT AND SUPPORT THE PRACTICE START-UP OF NEW PHYSICIANS IN NEEDED SPECIALTIES. AS IS DISCUSSED AT GREATER LENGTH ELSEWHERE IN THIS SUPPLEMENTAL INFORMATION, BMC HAVE EXTENSIVE COMMUNITY OUTREACH PROGRAMS AND SUPPORT, COMPREHENSIVE, COMMUNITY-BASED TO ADDRESS SUCH DIVERSE HEALTHCARE CHALLENGES AS DIABETES, HEART FAILURE AND CHRONIC PAIN MANAGEMENT/NARCOTICS MISUSE AND DIVERSION.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART VI, LINE 7: BMC IS A PART OF AN INTEGRATED, NON-PROFIT HEALTHCARE SYSTEM THAT INCLUDES (A) A TEACHING HOSPITAL, (B) A CRITICAL ACCESS COMMUNITY HOSPITAL, (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. BMC 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 SYSTEMS COMPONENT ENTITIES. BMC, 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.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>REPORTS FILED WITH STATES</Identifier>
        <ReturnReference>PART VI, LINE 7</ReturnReference>
        <Explanation>MA</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <SeverancePayment>0</SeverancePayment>
      <SupplementalNonqualRetirePlan>0</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>0</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>0</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>0</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>0</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>0</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>0</AnyNonFixedPayments>
      <InitialContractException>0</InitialContractException>
      <Form990ScheduleJPartII>
        <NamePerson>BRIAN T BURKE</NamePerson>
        <BaseCompensationFilingOrg>0</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>182388</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>17824</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>9396</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>0</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>28530</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>0</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>238138</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>DAVID E PHELPS</NamePerson>
        <BaseCompensationFilingOrg>0</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>466255</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>56265</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>11025</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>0</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>28716</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>0</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>562261</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>DARLENE RODOWICZ</NamePerson>
        <BaseCompensationFilingOrg>0</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>275147</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>54330</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>11025</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>0</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>24933</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>0</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>365435</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>PHELPS D 1-TIME RETIREMENT BENE ADJ</NamePerson>
        <BaseCompensationFilingOrg>0</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>1085553</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>0</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>0</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>1085553</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>RONALD HAYDEN</NamePerson>
        <BaseCompensationFilingOrg>377723</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>39867</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>23242</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>10723</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>26363</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>477918</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>DIANE KELLY</NamePerson>
        <BaseCompensationFilingOrg>203613</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>44690</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>10514</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>25652</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>284469</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>MARK VANDEN BOSCH</NamePerson>
        <BaseCompensationFilingOrg>428587</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>26765</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>10574</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>1899</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>467825</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>ANTHONY G ELLRODT</NamePerson>
        <BaseCompensationFilingOrg>409620</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>42064</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>10705</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>24957</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>487346</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>THOMAS LAPLACA</NamePerson>
        <BaseCompensationFilingOrg>380299</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>36564</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>11025</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>36875</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>464763</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>ALISON MACDONALD</NamePerson>
        <BaseCompensationFilingOrg>418916</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>14063</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>17310</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>10699</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>3591</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>464579</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>RAYMOND GARY SOHL</NamePerson>
        <BaseCompensationFilingOrg>416873</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>17919</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>810</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>5916</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>27236</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>468754</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <Identifier>SUPPLEMENTAL INFORMATION</Identifier>
        <ReturnReference>PART III</ReturnReference>
        <Explanation>RELATED COMPENSATION SCHEDULE J, PART II, SCHEDULE J-2 IN REFERENCE TO SCHEDULE J PART II, NO COMPENSATION IS PAID BY THE FILING ENTITY TO ANY OFFICER OR DIRECTOR, EXCEPT FOR DRS. HORNSTEIN AND WESPIESER, WHOSE COMPENSATION RELATE SOLELY TO SERVICES RENDERED FOR TAX EXEMPT PURPOSES AND NOT TO THEIR ROLE AS DIRECTOR. A PROPORTIONAL SHARE OF THE COMPENSATION AMOUNT IS ALLOCATED INTERNALLY TO THE FILING ENTITY FOR ACCOUNTING AND MANAGEMENT PURPOSES (SEE BELOW). COMPENSATION IS PAID TO THE OFFICERS OF THE FILING ENTITY BY BHS MANAGEMENT SERVICES, INC., A SUPPORTING ORGANIZATION THAT PROVIDES MANAGEMENT SERVICES TO THE FILING ENTITY AND 26 OTHER NOT-FOR-PROFIT, TAX-EXEMPT HEALTHCARE SERVICE ENTITIES. COMPENSATION FOR THESE INDIVIDUALS IS REVIEWED AND ESTABLISHED AT LEAST BIANNUALLY BY INDEPENDENT VOLUNTEER GOVERNING BODIES, BASED ON PERFORMANCE REVIEW AND COMPARISON TO INDEPENDENT, REGIONALLY APPROPRIATE BENCHMARKS FOR SIMILAR POSITIONS IN SIMILARLY SIZED ORGANIZATIONS, AS VERIFIED BY INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANTS. THE GOVERNING BODY HISTORICALLY TARGETED TOTAL COMPENSATION FOR MANAGEMENT EMPLOYEES AT THE 50TH PERCENTILE OF APPROPRIATE BENCHMARKS. FOR MOST OF MR. PHELPS' 20 YEAR TENURE AS CHIEF EXECUTIVE, A WRITTEN AGREEMENT BETWEEN BERKSHIRE HEALTH SYSTEMS AND MR. PHELPS HAS CALLED FOR BERKSHIRE HEALTH SYSTEMS TO FUND A RETIREMENT PROGRAM THAT, WHEN ADDED TO HIS BASE COMPENSATION AND OTHER BENEFITS, WAS INTENDED TO BRING HIS TOTAL COMPENSATION CLOSE TO THE 50TH PERCENTILE RANGE OF TOTAL COMPENSATION FOR COMPARABLE HEALTHCARE EXECUTIVES IN COMPARABLE HEALTHCARE ORGANIZATIONS, AS DETERMINED BY INDEPENDENT, NATIONALLY RECOGNIZED THIRD PARTY REVIEWERS. FOR MANY YEARS, A KEY ELEMENT OF THAT RETIREMENT PROGRAM WAS A CERTAIN LIFE INSURANCE POLICY IN WHICH BOTH BERKSHIRE HEALTH SYSTEMS AND MR. PHELPS HAD OWNERSHIP INTERESTS. IN 2010, BERKSHIRE HEALTH SYSTEMS AND MR. PHELPS AGREED TO REORGANIZE HIS RETIREMENT PROGRAM, SURRENDER HIS LIFE INSURANCE POLICY WHICH WAS, BY THEN, NO LONGER MEETING ITS GOALS AND OTHERWISE SIMPLIFY MR. PHELPS' RETIREMENT BENEFIT. AS PART OF THAT REORGANIZATION AND COMPROMISE, MR. PHELPS RECEIVED THE CASH VALUE OF THE SURRENDERED THE LIFE INSURANCE POLICY THAT HAD ACCUMULATED THROUGH HIS TENURE IN HIS CURRENT ROLE. BERKSHIRE HEALTH SYSTEMS' RETIREMENT FUNDING OBLIGATION WAS CORRESPONDINGLY REDUCED BY THAT AMOUNT. THE CASH VALUE OF THE SURRENDERED LIFE INSURANCE POLICY, REPORTED ON SCHEDULE J, PART II, LINE 4(II), COLUMN B(III), IS REFLECTED BELOW, AS IS THE PORTION OF COMPENSATION ALLOCABLE TO EACH OF THE SUPPORTED ORGANIZATIONS. INTERNAL ALLOCATION OF COMPENSATION: DAVID E. PHELPS: TOTAL 58 HOURS PER WEEK $562,262 BERKSHIRE MEDICAL CENTER, INC. 30 HOURS/58 TOTAL HOURS $291,029 BERKSHIRE FACULTY SERVICES, INC. 10/58 HOURS $96,934 FAIRVIEW HOSPITAL 4/58 HOURS $38,796 BERKSHIRE INDEMNITY COMPANY, SPC, LTD. 2/58 HOURS $19,398 BHS MANAGEMENT SERVICES, INC. 12/58 HOURS FOR THE BENEFIT OF: BERKSHIRE HEALTHCARE SYSTEMS, INC. $29,069 BOURNE MANAGEMENT SYSTEMS, INC. $ 2,305 GREENFIELD MANAGEMENT SYSTEMS, INC. $ 2,305 NEW BEDFORD MANAGEMENT SYSTEMS, INC. $ 2,305 NORTHAMPTON MANAGEMENT SYSTEMS, INC. $ 2,305 EAST LONGMEADOW MANAGEMENT SYSTEMS, INC. $ 2,305 DANVERS MANAGEMENT SYSTEMS, INC. $ 2,305 PEABODY MANAGEMENT SYSTEMS, INC. $ 2,305 SOUTH YARMOUTH MANAGEMENT SYSTEMS, INC. $ 2,305 BERKSHIRE PENNSYLVANIA, INC. $ 2,305 XENIA EAST MANAGEMENT SYSTEMS, INC. $ 2,305 WILLOWOOD OF GREAT BARRINGTON, INC. $ 4,667 WILLOWOOD OF NORTH ADAMS, INC. $ 3,486 WILLOWOOD OF WILLIAMSTOWN, INC. $ 3,486 HILLCREST EXTENDED CARE SERVICES, INC. $ 8153 BERKSHIRE RETIREMENT COMMUNITY, INC. $ 11,639 BERKSHIRE EXTENDED CARE SERVICES, INC. $ 8,153 INTEGRINURSE, INC. $ 3,486 INTEGRISCRIPT, INC. $ 3,486 HOSPICECARE IN THE BERKSHIRES, INC. $ 11,639 PITTSFIELD MANAGEMENT SYSTEMS, INC. $ 5,791 ONE TIME RETIREMENT BENEFIT ADJUSTMENT $1,085,553 DARLENE RODOWICZ: TOTAL 50 HOURS PER WEEK $365,434 BERKSHIRE MEDICAL CENTER, INC. 37 HOURS/50 TOTAL HOURS $270,421 BERKSHIRE FACULTY SERVICES, INC. 7/50 HOURS $51,161 FAIRVIEW HOSPITAL 3/50 HOURS $21,926 BERKSHIRE INDEMNITY COMPANY, SPC, LTD. 2.5/50 HOURS $18,272 BHS MANAGEMENT SERVICES, INC. 0.5/50 HOURS FOR THE BENEFIT OF: BERKSHIRE HEALTHCARE SYSTEMS, INC. $3654 CHERYL BOUDREAU: TOTAL 41 HOURS PER WEEK $93,053 BERKSHIRE MEDICAL CENTER, INC. 20 HOURS/41 TOTAL HOURS $45,375 BERKSHIRE FACULTY SERVICES, INC. 8/41 HOURS $18,155 FAIRVIEW HOSPITAL 2/41 HOURS $4,541 BERKSHIRE INDEMNITY COMPANY, SPC, LTD. 1/41 HOURS $2,270 BHS MANAGEMENT SERVICES, INC. 10/41 HOURS FOR THE BENEFIT OF: BERKSHIRE HEALTHCARE SYSTEMS, INC. $5,667 BOURNE MANAGEMENT SYSTEMS, INC. $ 456 GREENFIELD MANAGEMENT SYSTEMS, INC. $ 456 NEW BEDFORD MANAGEMENT SYSTEMS, INC. $ 456 NORTHAMPTON MANAGEMENT SYSTEMS, INC. $ 456 EAST LONGMEADOW MANAGEMENT SYSTEMS, INC. $ 456 DANVERS MANAGEMENT SYSTEMS, INC. $ 456 PEABODY MANAGEMENT SYSTEMS, INC. $ 456 SOUTH YARMOUTH MANAGEMENT SYSTEMS, INC. $ 456 BERKSHIRE PENNSYLVANIA, INC. $ 456 XENIA EAST MANAGEMENT SYSTEMS, INC. $ 456 WILLOWOOD OF GREAT BARRINGTON, INC. $ 912 WILLOWOOD OF NORTH ADAMS, INC. $ 679 WILLOWOOD OF WILLIAMSTOWN, INC. $ 679 HILLCREST EXTENDED CARE SERVICES, INC. $ 1591 BERKSHIRE RETIREMENT COMMUNITY, INC. $ 2270 BERKSHIRE EXTENDED CARE SERVICES, INC. $ 1591 INTEGRINURSE, INC. $ 679 INTEGRISCRIPT, INC. $ 679 HOSPICECARE IN THE BERKSHIRES, INC. $ 2270 PITTSFIELD MANAGEMENT SYSTEMS, INC. $ 1135</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc1053100001">
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>MHEFA BHS SERIES F</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>042456011</IssuerEIN>
        <CUSIPNumber>57586CLN3</CUSIPNumber>
        <DateIssued>2005-07-15</DateIssued>
        <IssuePrice>53089428</IssuePrice>
        <DescriptionOfPurpose>REFUND SERIES C AND D BONDS</DescriptionOfPurpose>
        <Defeased>0</Defeased>
        <OnBehalfOfIssuer>0</OnBehalfOfIssuer>
        <PoolFinancing>0</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>MHEFA BHS SERIES A&amp;B</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>042456011</IssuerEIN>
        <CUSIPNumber>NONEAVAIL</CUSIPNumber>
        <DateIssued>2009-11-20</DateIssued>
        <IssuePrice>29600000</IssuePrice>
        <DescriptionOfPurpose>EQUIPMENT AND RELATED RENOVATIONS</DescriptionOfPurpose>
        <Defeased>0</Defeased>
        <OnBehalfOfIssuer>0</OnBehalfOfIssuer>
        <PoolFinancing>0</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartII>
        <AmountRetired>13270000</AmountRetired>
        <TotalProceeds>54478799</TotalProceeds>
        <AmountInReserveFund>5019000</AmountInReserveFund>
        <IssuanceCostsFromProceeds>1003800</IssuanceCostsFromProceeds>
        <CreditEnhancement>898795</CreditEnhancement>
        <WorkingCapitalExpenditures>73681</WorkingCapitalExpenditures>
        <CapitalExpenditures>9003428</CapitalExpenditures>
        <YearOfSubstCompletion>2008</YearOfSubstCompletion>
        <CurrentRefunding>1</CurrentRefunding>
        <AdvanceRefunding>0</AdvanceRefunding>
        <FinalAllocationMade>1</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>1</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartII>
        <AmountRetired>376773</AmountRetired>
        <TotalProceeds>29600000</TotalProceeds>
        <IssuanceCostsFromProceeds>307850</IssuanceCostsFromProceeds>
        <CapitalExpenditures>22559095</CapitalExpenditures>
        <YearOfSubstCompletion>2010</YearOfSubstCompletion>
        <CurrentRefunding>0</CurrentRefunding>
        <AdvanceRefunding>0</AdvanceRefunding>
        <FinalAllocationMade>1</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>1</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>0</OwningBondFinancedProperty>
        <AnyLeaseArrangements>0</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>0</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>0</AnyResearchAgreements>
        <PrcntgePrvtBusinessUseByOthers>0.00000</PrcntgePrvtBusinessUseByOthers>
        <PercentageOfPrvtBusinessReUBI>0.00000</PercentageOfPrvtBusinessReUBI>
        <TotalPrivateBusinessUse>0.00000</TotalPrivateBusinessUse>
        <PostIssuanceComplianceProcdrs>1</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>0</OwningBondFinancedProperty>
        <AnyLeaseArrangements>0</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>0</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>0</AnyResearchAgreements>
        <PrcntgePrvtBusinessUseByOthers>0.00000</PrcntgePrvtBusinessUseByOthers>
        <PercentageOfPrvtBusinessReUBI>0.00000</PercentageOfPrvtBusinessReUBI>
        <TotalPrivateBusinessUse>0.00000</TotalPrivateBusinessUse>
        <PostIssuanceComplianceProcdrs>1</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>1</Form8038TFiled>
        <VariableRateIssue>0</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>0</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>0</GrossProceedsInvestedInGIC>
        <GrossProceedsInvested>1</GrossProceedsInvested>
        <ExceptionToRebate>0</ExceptionToRebate>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>1</Form8038TFiled>
        <VariableRateIssue>0</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>0</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>0</GrossProceedsInvestedInGIC>
        <GrossProceedsInvested>1</GrossProceedsInvested>
        <ExceptionToRebate>0</ExceptionToRebate>
      </Form990ScheduleKPartIV>
    </IRS990ScheduleK>
    <IRS990ScheduleM documentId="RetDoc1042900001">
      <SecuritiesCloselyHeldStock>
        <NonCashCheckbox>X</NonCashCheckbox>
        <NumberOfContributions>1</NumberOfContributions>
        <NoncashContribsRptdF990>25942</NoncashContribsRptdF990>
        <MethodOfDeterminingRevenues>ISSUING CORP VALUATION</MethodOfDeterminingRevenues>
      </SecuritiesCloselyHeldStock>
      <AnyPropertyThatMustBeHeld>0</AnyPropertyThatMustBeHeld>
      <ReviewProcessUnusualNCGifts>1</ReviewProcessUnusualNCGifts>
      <ThirdPartiesUsed>0</ThirdPartiesUsed>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <GeneralExplanation>
        <Identifier>FORM 990, PART VI, SECTION A, LINE 3</Identifier>
        <Explanation>BERKSHIRE MEDICAL CENTER, INC. RELIES ON BHS MANAGEMENT SERVICES, INC. TO PROVIDE MANAGEMENT AND SUPPORT SERVICES FOR THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, VP GENERAL COUNSEL, AND VP OF HUMAN RESOURCES .</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>FORM 990, PART VI, SECTION A, LINE 6</Identifier>
        <Explanation>BERKSHIRE HEALTH SYSTEMS, INC. IS THE SOLE CORPORATE MEMBER OF BERKSHIRE MEDICAL CENTER, INC.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>FORM 990, PART VI, SECTION A, LINE 7A</Identifier>
        <Explanation>THE BOARD OF TRUSTEES IS COMPOSED OF THE INCUMBENT MEMBERS OF THE BOARD OF TRUSTEES OF BERKSHIRE HEALTH SYSTEMS, INC.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>FORM 990, PART VI, SECTION B, LINE 11</Identifier>
        <Explanation>BHS WILL MAKE THE FORMS 990 FOR BHS AND 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. IN ADDITION, BHS MANAGEMENT WILL REVIEW THE FORMS 990 WITH THE BHS FINANCE COMMITTEE AND ADDRESS QUESTIONS AND COMMENTS COVERING KEY ELEMENTS OF THE FORMS 990 THAT ARE OF CONCERN TO ALL OF THE FORMS 990, AND ANY SIGNIFICANT ELEMENTS THAT ARE PECULIAR TO ONE OR MORE OF THE AFFILIATES' FORMS 990.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 12C</ReturnReference>
        <Explanation>THE ORGANIZATION ENFORCES AND MONITORS ITS CONFLICT OF INTEREST POLICY BY REQUIRING ALL MEMBERS OF THE GOVERNING BODY AND SENIOR MANAGEMENT TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST (A) ANNUALLY AND (B) AS POTENTIAL CONFLICTS ARISE. SENIOR EMPLOYEES ARE NOT PERMITTED TO HAVE MATERIAL CONFLICTS OF INTEREST AND MEMBERS OF THE GOVERNING BODY ARE TO ABSTAIN FROM ACTION THAT MAY BE INFLUENCED BY THEIR CONFLICT OR POTENTIAL CONFLICT BY (A) NOT VOTING OR (B) NOT VOTING AND LEAVING THE ROOM OR (C) LEAVING THE GOVERNING BODY AS DETERMINED BY THE GOVERNING BODY.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 15</ReturnReference>
        <Explanation>PERFORMANCE AND COMPENSATION OF THE SENIOR EXECUTIVE IS REVIEWED ANNUALLY (AND OF OTHER SENIOR EXECUTIVES, PERIODICALLY) BY A SUBCOMMITTEE OF THE GOVERNING BODY WHOSE MEMBERS ARE INDEPENDENT. THE FULL GOVERNING BODY REVIEWS AND APPROVES THE COMPENSATION OF THE SENIOR EXECUTIVE. EVERY TWO OR THREE YEARS, THE ORGANIZATION ENGAGES A NATIONALLY RECOGNIZED HEALTHCARE COMPENSATION FIRM TO PROVIDE INFORMATION CONCERNING MARKET RATES OF COMPENSATION AND ASSESS THE ORGANIZATION'S COMPENSATION STRUCTURE AGAINST THOSE INDEPENDENT BENCHMARKS. THE ORGANIZATION FOLLOWED THIS PROCESS FOR YEAR ENDED 9/30/11.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION C, LINE 19</ReturnReference>
        <Explanation>GOVERNANCE DOCUMENTS, THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC AT THE OFFICE OF (A) THE CHIEF FINANCIAL OFFICER AND (B) THE VICE PRESIDENT AND GENERAL COUNSEL AT 725 NORTH STREET, PITTSFIELD MA 01201.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>PART VII, SECTION A, COLUMN B</ReturnReference>
        <Explanation>RELATED COMPENSATION: COMPENSATION PAID TO DIRECTORS HORNSTEIN AND WESPEISER IS NOT RELATED TO THEIR SERVICE AS A DIRECTOR AND IS SOLELY RELATED TO SERVICES PROVIDED TO THE ORGANIZATION FOR ITS TAX EXEMPT PURPOSES. A PROPORTIONAL SHARE OF THE HOURS WORKED AND COMPENSATION AMOUNTS PAID TO OFFICERS IS ALLOCATED INTERNALLY TO THE FILING ENTITY AND 26 OTHER TAX EXEMPT HEALTHCARE ENTITIES FOR ACCOUNTING AND MANAGEMENT PURPOSES. (SEE BELOW). DAVID E. PHELPS: TOTAL 58 HOURS PER WEEK $562,262 BERKSHIRE MEDICAL CENTER, INC. 30 HOURS/58 TOTAL HOURS $291,029 BERKSHIRE FACULTY SERVICES, INC. 10/58 HOURS $96,934 FAIRVIEW HOSPITAL 4/58 HOURS $38,796 BERKSHIRE INDEMNITY COMPANY, SPC, LTD. 2/58 HOURS $19,398 BHS MANAGEMENT SERVICES, INC. 12/58 HOURS FOR THE BENEFIT OF: BERKSHIRE HEALTHCARE SYSTEMS, INC. $29,069 BOURNE MANAGEMENT SYSTEMS, INC. $ 2,305 GREENFIELD MANAGEMENT SYSTEMS, INC. $ 2,305 NEW BEDFORD MANAGEMENT SYSTEMS, INC. $ 2,305 NORTHAMPTON MANAGEMENT SYSTEMS, INC. $ 2,305 EAST LONGMEADOW MANAGEMENT SYSTEMS, INC. $ 2,305 DANVERS MANAGEMENT SYSTEMS, INC. $ 2,305 PEABODY MANAGEMENT SYSTEMS, INC. $ 2,305 SOUTH YARMOUTH MANAGEMENT SYSTEMS, INC. $ 2,305 BERKSHIRE PENNSYLVANIA, INC. $ 2,305 XENIA EAST MANAGEMENT SYSTEMS, INC. $ 2,305 WILLOWOOD OF GREAT BARRINGTON, INC. $ 4,667 WILLOWOOD OF NORTH ADAMS, INC. $ 3,486 WILLOWOOD OF WILLIAMSTOWN, INC. $ 3,486 HILLCREST EXTENDED CARE SERVICES, INC. $ 8153 BERKSHIRE RETIREMENT COMMUNITY, INC. $ 11,639 BERKSHIRE EXTENDED CARE SERVICES, INC. $ 8,153 INTEGRINURSE, INC. $ 3,486 INTEGRISCRIPT, INC. $ 3,486 HOSPICECARE IN THE BERKSHIRES, INC. $ 11,639 PITTSFIELD MANAGEMENT SYSTEMS, INC. $ 5,791 DARLENE RODOWICZ: TOTAL 50 HOURS PER WEEK $365,434 BERKSHIRE MEDICAL CENTER, INC. 37 HOURS/50 TOTAL HOURS $270,421 BERKSHIRE FACULTY SERVICES, INC. 7/50 HOURS $51,161 FAIRVIEW HOSPITAL 3/50 HOURS $21,926 BERKSHIRE INDEMNITY COMPANY, SPC, LTD. 2.5/50 HOURS $18,272 BHS MANAGEMENT SERVICES, INC. 0.5/50 HOURS FOR THE BENEFIT OF: BERKSHIRE HEALTHCARE SYSTEMS, INC. $3654 CHERYL BOUDREAU: TOTAL 41 HOURS PER WEEK $93,053 BERKSHIRE MEDICAL CENTER, INC. 20 HOURS/41 TOTAL HOURS $45,375 BERKSHIRE FACULTY SERVICES, INC. 8/41 HOURS $18,155 FAIRVIEW HOSPITAL 2/41 HOURS $4,541 BERKSHIRE INDEMNITY COMPANY, SPC, LTD. 1/41 HOURS $2,270 BHS MANAGEMENT SERVICES, INC. 10/41 HOURS FOR THE BENEFIT OF: BERKSHIRE HEALTHCARE SYSTEMS, INC. $5,667 BOURNE MANAGEMENT SYSTEMS, INC. $ 456 GREENFIELD MANAGEMENT SYSTEMS, INC. $ 456 NEW BEDFORD MANAGEMENT SYSTEMS, INC. $ 456 NORTHAMPTON MANAGEMENT SYSTEMS, INC. $ 456 EAST LONGMEADOW MANAGEMENT SYSTEMS, INC. $ 456 DANVERS MANAGEMENT SYSTEMS, INC. $ 456 PEABODY MANAGEMENT SYSTEMS, INC. $ 456 SOUTH YARMOUTH MANAGEMENT SYSTEMS, INC. $ 456 BERKSHIRE PENNSYLVANIA, INC. $ 456 XENIA EAST MANAGEMENT SYSTEMS, INC. $ 456 WILLOWOOD OF GREAT BARRINGTON, INC. $ 912 WILLOWOOD OF NORTH ADAMS, INC. $ 679 WILLOWOOD OF WILLIAMSTOWN, INC. $ 679 HILLCREST EXTENDED CARE SERVICES, INC. $ 1591 BERKSHIRE RETIREMENT COMMUNITY, INC. $ 2270 BERKSHIRE EXTENDED CARE SERVICES, INC. $ 1591 INTEGRINURSE, INC. $ 679 INTEGRISCRIPT, INC. $ 679 HOSPICECARE IN THE BERKSHIRES, INC. $ 2270 PITTSFIELD MANAGEMENT SYSTEMS, INC. $ 1135</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>CHANGES IN NET ASSETS OR FUND BALANCES:</Identifier>
        <ReturnReference>FORM 990, PART XI, LINE 5:</ReturnReference>
        <Explanation>NET UNREALIZED LOSSES ON INVESTMENTS: -9,094,806. ASSETS RELEASED FROM RESTRICTIONS FOR OPERATING PURPOSES -88,626. TOTAL TO FORM 990, PART XI, LINE 5: -9,183,432.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>SCHEDULE H, PART VI, LINE 4</ReturnReference>
        <Explanation>NON-WORKING POPULATIONS WITH LIMITED ACCESS TO CARE (HOMELESS, LOW SOCIOECONOMIC, MENTAL HEALTH CONDITIONS AND SUBSTANCE ABUSE) SHARE A DISPROPORTIONATE BURDEN OF RISK AS EVIDENCED BY DATA FROM THE BHS COMMUNITY HEALTH VAN: 47% (168 PEOPLE OUT OF 354) HAD A BP &gt; 140/90 OF THIS GROUP, 67% (113) WERE ON BP MEDS AND BP WAS NOT CONTROLLED 33% WERE UNAWARE THEIR BP WAS HIGH RISK FACTOR PREVALENCE IN A WORKING POPULATION OF MORE THAN 1,378 HEALTH CARE PROFESSIONALS: VERY HIGH RISK N=92 (6%) FRAMINGHAM RISK &gt;20% DIABETES, CVD/STROKE CRF. CRISIS INTERVENTION HIGH RISK PREGNANCY MODERATE RISK N=368 (27%) PRESENCE OF 1 OR MORE FR &lt;10%,BP 121/81-139/89, BMI 25-29 NON SMOKER HIGH RISK N=585 (42%) PRESENCE OF 1 OR MORE FR &gt;10%, BP &gt;140/90, CHOL &gt;240, HDL &lt;40, NON-HDL &gt;160, SMOKING, BMI &gt;30, METABOLIC SYNDROME DEPRESSION LOW RISK N=333 (24%) FR &lt;10%, BP &lt;120/80, CHOLESTEROL NORMAL, NON-SMOKER, BMI &lt;25 IN WORKSITES AND IN THE COMMUNITY, RISK FACTOR PREVALENCE IS DRIVEN BY UNHEALTHY EATING BEHAVIORS, PHYSICAL INACTIVITY, AND SMOKING. STRATEGIES ARE AIMED AT ASSISTING INDIVIDUALS TO RECOGNIZE THEIR UNIQUE HEALTH RISK PROFILE AND THEN TAKE INTENTIONAL STEPS TO IMPROVE THEIR HEALTH. IN 365 PATIENTS WITH DIABETES, 37% DID NOT HAVE BP AT GOAL IN PATIENTS SEEN WITH STROKE, 63% HAVE HTN AS PRIMARY DIAGNOSIS. APPROX 25% OF RENAL PATIENTS HAVE HTN AS CAUSE OF RENAL FAILURE. LIFETIME RISK OF DEVELOPING HBP IS 90%. HEALTH AND CLINICAL INDICATORS ADDITIONAL HEALTH INFORMATION THAT HELPS DEPICT THE PROFILE OF BERKSHIRE COUNTY INCLUDES: BERKSHIRE COUNTY HAS HIGHER THAN STATE AVERAGES FOR CARDIOVASCULAR MORTALITY RATES, ALTHOUGH THROUGH THE EFFORTS OF OUR CLINICAL CARE AND OUTREACH, THE RATE HAS DECLINED CONSISTENTLY OVER THE LAST TEN YEARS TO CLOSER WITH THE STATE. OUR AGE ADJUSTED SPECIFIC RATE FOR ALL CANCER DEATHS IS 187.1 WHICH EXCEEDS THE STATE RATE OF 178.9(PER 100,000 PERSONS) FOR SUBSTANCE ABUSE, OUR ADMISSION RATE TO DPH FUNDED TREATMENT PROGRAMS IS 2818.9 VERSUS 1636.5 FOR THE STATE, AND ALCOHOL AND OTHER DRUG RELATED HOSPITAL DISCHARGES IS 995.0 VERSUS 362.0 (PER 100,000 PERSONS) DIABETES MORTALITY RATE ALSO EXCEEDS THE STATE RATE (20.68 VERSUS 16.49) WORKFORCE SHORTAGES AND ACCESS TO CARE IN THE LAST DECADE BERKSHIRE COUNTY HAS EXPERIENCED A SHORTAGE OF PHYSICIANS FOR OUR COMMUNITY, AS WELL AS SHORTAGES FOR KEY CLINICAL SPECIALTIES, SUCH AS NURSING, RADIOLOGY AND LABORATORY. THESE SHORTAGES CREATE ACCESS TO CARE ISSUES FOR THE RESIDENTS OF BERKSHIRE COUNTY. IN THE LAST 5-8 YEARS, BMC HAS EDUCATED AND TRAINED HUNDREDS OF STAFF IN ITS CRITICAL SHORTAGE PROGRAMS AS WELL AS HELPED RECRUIT APPROXIMATELY 150 PHYSICIANS TO THE COMMUNITY, REDUCING THE COUNTY'S EXISTING SHORTAGE OF PROVIDERS BY 40 FTES. GIVEN NATIONAL SHORTAGES, INCREASED DEMAND, AND OUR RURAL LOCATION, BMC EXPECTS THAT THIS CHALLENGE OF HAVING AN ADEQUATE NUMBER OF HEALTH CARE PROFESSIONAL TO MEET THE COMMUNITY NEED WILL CONTINUE.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>DISCLOSURE STATEMENT RELATED TO FORMS 5471</ReturnReference>
        <Explanation>DISCLOSURE STATEMENT RELATED TO FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, FILED ON BEHALF OF THE TAXPAYER UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER MAY BE REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 5 FILER WITH RESPECT TO CERTAIN CONTROLLED FOREIGN CORPORATIONS (CFCS). THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE CFCS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. TAXPAYER NAME: BERKSHIRE HEALTH SYSTEMS, INC. ADDRESS: 725 NORTH ST., PITTSFIELD, MA 01201 IDENTIFYING NUMBER OF U.S. TAX RETURN WITH WHICH THE FORMS 5471 WERE OR WILL BE FILED: 04-2442944 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>BERKSHIRE HEALTH SYSTEMS INC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>725 NORTH ST</AddressLine1>
          <City>PITTSFIELD</City>
          <State>MA</State>
          <ZIPCode>01201</ZIPCode>
        </AddressUS>
        <EIN>042442944</EIN>
        <PrimaryActivities>PARENT CORP</PrimaryActivities>
        <LegalDomicileState>MA</LegalDomicileState>
        <ExemptCodeSection>501 (C)(3)</ExemptCodeSection>
        <PublicCharityStatus>11B</PublicCharityStatus>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <ControlledOrg>0</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>FAIRVIEW HOSPITAL</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>725 NORTH ST</AddressLine1>
          <City>PITTSFIELD</City>
          <State>MA</State>
          <ZIPCode>01201</ZIPCode>
        </AddressUS>
        <EIN>042133860</EIN>
        <PrimaryActivities>ACUTE CARE</PrimaryActivities>
        <LegalDomicileState>MA</LegalDomicileState>
        <ExemptCodeSection>501 (C)(3)</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <ControlledOrg>0</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>BERKSHIRE FACULTY SERVICES INC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>725 NORTH ST</AddressLine1>
          <City>PITTSFIELD</City>
          <State>MA</State>
          <ZIPCode>01201</ZIPCode>
        </AddressUS>
        <EIN>042995053</EIN>
        <PrimaryActivities>PHYSICIAN SVC</PrimaryActivities>
        <LegalDomicileState>MA</LegalDomicileState>
        <ExemptCodeSection>501 (C)(3)</ExemptCodeSection>
        <PublicCharityStatus>11B</PublicCharityStatus>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <ControlledOrg>0</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>BHS MANAGEMENT SERVICE INC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>725 NORTH ST</AddressLine1>
          <City>PITTSFIELD</City>
          <State>MA</State>
          <ZIPCode>01201</ZIPCode>
        </AddressUS>
        <EIN>222755258</EIN>
        <PrimaryActivities>MANAGEMENT</PrimaryActivities>
        <LegalDomicileState>MA</LegalDomicileState>
        <ExemptCodeSection>501 (C)(3)</ExemptCodeSection>
        <PublicCharityStatus>11B</PublicCharityStatus>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <ControlledOrg>0</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>TRI-STATE MEDICAL MANAGEMENT CORP</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>725 NORTH STREET</AddressLine1>
          <City>PITTSFIELD</City>
          <State>MA</State>
          <ZIPCode>01201</ZIPCode>
        </AddressUS>
        <EIN>042913352</EIN>
        <PrimaryActivity>REAL ESTATE MANAGEMENT</PrimaryActivity>
        <LegalDomicileState>MA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <TypeOfEntity>C</TypeOfEntity>
      </Form990ScheduleRPartIV>
      <ReceiptOfIntAnnRentsRoyalties>0</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>0</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>0</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>0</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>0</LoansOrGuaranteesFromOtherOrg>
      <SaleOfAssetsToOtherOrg>0</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>0</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>0</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>0</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>0</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>1</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>1</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>1</SharingOfFacilities>
      <SharingOfPaidEmployees>1</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>1</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>1</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>0</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>1</OtherTransferFromOtherOrg>
    </IRS990ScheduleR>
  </ReturnData>
</Return>