2012-08-14T14:46:29-07:00 2011-09-30 990 2010-10-01 042103602 MILFORD REGIONAL MEDICAL CENTER INC MILF 5084731190 14 PROSPECT STREET MILFORD MA 017573090 JEANNE P LYNSKEY 5084731190 2012-08-15 2010 2016-02-24 21:20:13Z Jeanne P Lynskey 14 Prospect Street Milford MA 017573090 199347841 0 X WWW.MILFORDREGIONAL.ORG X 1903 MA Milford Regional Medical Center Inc mission statement is to provide quality healthcare services to our community with dignity, compassion, and respect. 22 14 1998 412 455413 0 444254 883873 180826582 184662502 496880 324847 7581002 10172216 189348718 196043438 0 0 0 0 101878655 102450233 0 25000 934455 81629629 82030645 183508284 184505878 5840434 11537560 180101338 185316781 109858597 107587749 70242741 77729032 Milford Regional Medical Center Inc provides medical and hospital services for the sick and disabled of any race, creed, color, or nationality regardless of an individuals ability to pay. It also carries on such educational, philanthropic and scientific activities and functions as are designed to promote the general health of the communities served. 0 0 57215315 0 50698525 Inpatient care - Milford Regional Medical Center (MRMC) serves the healthcare needs of the residents of 20 communities in Central Massachusetts, a population now approaching 250,000. Guided by its mission "to provide quality healthcare services to our community with dignity, compassion and respect," MRMC strives to be responsive to diverse constituencies-individuals and families of all ages, employees and employers of large and small businesses, physicians and other healthcare providers, our school systems, our local and area officials and safety personnel, churches, community organizations, our insurers and payers and our own employees and volunteers. As a charitable hospital, we acknowledge our special concern for the needs of the unserved and underserved, especially low-income and minority populations. A full-service community and regional teaching hospital, MRMC is a 121-bed, nonprofit acute-care facility. There are approximately 200 physicians on the active medical staff and an additional 100 courtesy or consulting physicians. MRMC is affiliated with UMass Memorial Health Care as a major teaching hospital. In addition to providing basic acute care services (medical, surgical, emergency medicine, family-centered obstetrics and pediatrics), MRMC has eight state-of-the-art operating suites, consolidated surgical services (including admitting and pre-admission testing) and a medical/surgical floor with private rooms, many with advanced patient monitoring capabilities. MRMC serves approximately 8,800 medical and surgical inpatients annually. In FY2011, MRMC made further progress toward the development of a fully electronic medical record, qualifying for Meaningful Use reimbursement. In recognition of its advancements in technology and clinical excellence, MRMC was one of only two hospitals in Central Massachusetts to be named one of the region's top ranking hospitals in U.S. News & World Report's list of Best Hospitals. In addition, CEO Frank Saba was selected as the 2011 Health Executive of the year by the American College of Healthcare Executives (ACHE) in Massachusetts. 89796417 0 122646090 Outpatient care - The Hyman and Shirley Hill Health Center at Milford Regional Medical Center, completed in 1994, is a complete outpatient facility dedicated to the care, education, and wellness of thousands of patients who visit regularly for care, but rarely stay overnight. The Center provides a variety of services including laboratory, cardiac rehabilitation, endoscopic surgery, and other minor surgical services. The Women's Pavilion, opened in 1998, provides a full range of services to meet women's health needs, including digital mammography, ultrasound, bone densitrometry and advanced breast biopsy. Other diagnostic services offered to outpatients throughout the Milford Regional system include radiology, ultrasound, MRI, CT scans, PET services, nuclear medicine, cardiovascular and laboratory/pathology. Testing and rehabilitation services are offered in several locations throughout the hospital's service area to improve access for our patients. Another important outpatient program, The Center for Adolescent Health, provides comprehensive and multi-disciplinary care to more than 3,000 adolescent clients and their families on an annual basis. It is the only facility in Central Massachusetts offering a continuum of care with a multi-disciplinary team approach to health and lifestyle challenges faced by adolescents. MRMC is also the home of The Center for Multiple Sclerosis, offering comprehensive care for patients with MS, with an emphasis on education and compassion. Recognizing a need for comprehensive cancer treatment in the region, MRMC entered into a collaboration with Dana-Farber Cancer Institute and Brigham and Women's Physicians Organization to develop a comprehensive Cancer Center which includes medical oncology and radiation oncology. This 54,000 square foot structure opened in 2008 and has made a tremendous difference to the quality of life for residents seeking cancer treatment. In FY11, MRMC provided laboratory tests, CT scans, MRI's and PET scans in the care and treatment of Cancer Center patients. Tri-County Medical Associates (TCMA) is a not-for-profit corporation that was established in 1992 as a medical group practice. It operates for the benefit of the Hospital by assisting the Hospital in carrying out its charitable purpose of promoting healthcare in its service area. TCMA employs over 70 physicians and over 300 employees. The group is principally comprised of primary care physicians including internal medicine, pediatrics, family medicine, and adolescent medicine. Specialists in the group include: obstetrics and gynecology, pulmonary and critical care, urology, sleep specialists, rheumatology, and endocrinology. 13708280 0 10862474 VNA & Hospice - The VNA and Hospice of Greater Milford (VNA) has been a part of the community since 1918, and became a department of MRMC in 1997. This merger has helped both organizations serve a broader public more efficiently and to enhance health related services across the continuum of care. The VNA provides a dignified and compassionate alternative to institutionalized care by offering professional and supportive health services in the home. The VNA has successfully integrated technology to enhance home health services, utilizing a Telehealth program that provides remote, daily monitoring of vital patient signs such as blood pressure, pulse, oxygen levels and weight, so that critical changes can be detected before an acute episode occurs requiring emergency physician or hospital care. They have also taken a leadership role in utilizing phototherapy, and were the first home health agency in Massachusetts to offer VitalStim to restore speech and improve swallowing. VNA staff share their knowledge of the community and the patients they serve across the Milford Regional system through their service on the Community Benefits Steering Committee and the Patient Care Transitions Team. 0 0 0 160720012 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 1 1 1 1 1 0 0 1 1 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 1 0 0 0 0 1 X 195 0 1 1998 1 1 1 0 0 0 1 1 0 X 22 14 1 0 0 0 1 0 0 1 1 0 1 1 0 1 1 1 1 1 1 1 0 MA X X Jeanne P Lynskey 5084731190 14 PROSPECT STREET MILFORD MA 017573090 X Lawrence J Hill 1 X 0 0 0 Kevin P Meehan 1 X 0 0 0 Christine H Burke 1 X 0 0 0 Bartholomew R Lawless 1 X 0 0 0 M Catherine Burke MD 1 X 0 0 0 Francis J Larkin 1 X 0 0 0 John A Rauth 1 X 0 0 0 Nancy F Gannett 1 X 0 0 0 Stephen G Ellis 1 X 0 0 0 Patrick R McSweeney MD 1 X 0 324439 24997 Henry C Papuga 1 X 0 0 0 Albert A Crimaldi MD 1 X 6250 0 0 William B Gannett 1 X 0 0 0 Richard G Buma 1 X 0 0 0 Warren S Heller 1 X 0 0 0 Marjorie E Kenney 1 X 0 0 0 Harold D Gould Jr 1 X 0 0 0 Roger V Calarese 10 X 0 0 0 Tina Afonso 1 X 0 0 0 Linda L Varney 1 X 0 0 0 John N Pandiscio 1 X 13000 0 0 Louis P Bertonazzi 1 X 0 0 0 Francis M Saba 50 X 490905 0 112327 Edward J Kelly 50 X 398810 0 62185 Jeanne P Lynskey 50 X 218571 0 15284 Salvatore Perla 50 X 199411 0 21413 Cheryl L Bonasoro 50 X 199604 0 7110 Linda Yates 50 X 171577 0 22539 Martin Richman 50 X 155921 0 18581 Laurence Fraize 50 X 151479 0 20445 Jennifer Childs-Roshak 50 X 163544 0 19449 Nancy Tomaso 50 X 149223 0 5434 Kamala Murali 50 X 136025 0 19972 Donna M Saul 50 X 131830 0 23283 2586150 324439 373019 77 0 1 0 Alliance Healthcare Inc PO Box 96485 Chicago IL 60693 MRI Services/PET Services 3870815 Aramark 12483 Collections Center Drive Chicago IL 60693 BioMedical Engineering Services 1459149 Milford Anesthesia Associates Inc 113 Water Street 213 Milford MA 01757 Anesthesia Services 1530188 University of Massachusetts Medical 55 Lake Ave North Worcester MA 01655 Fee for Residency Program 1015856 Quest Diagnostics Nichols Institute 12436 Collections Center Drive Chicago IL 60693 Outside lab fees 980680 10 0 0 591207 0 0 292666 102603 883873 Outpatient care 621500 123101503 122646090 455413 0 Inpatient care 622000 50698525 50698525 0 0 VNA care 621610 10862474 10862474 0 0 0 0 0 0 184662502 304450 0 0 304450 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3009911 117390 2943259 163645 66652 -46255 20397 0 0 20397 238306 0 192362 45944 0 45944 45700 5137 40563 0 0 40563 Cafeteria 900099 802776 0 0 802776 Rents 900099 2246500 0 0 2246500 Meaningful use 900099 2017816 0 0 2017816 5018617 5018617 0 0 10085709 196043438 189225706 455413 5478446 0 0 0 0 0 0 0 0 1327849 0 1327849 0 0 0 0 0 80006836 71551227 8081747 373862 1354716 1192150 149019 13547 13795841 12140340 1517543 137958 5964991 5249192 656149 59650 1983558 1936328 47230 0 743325 0 743325 0 75916 0 75916 0 0 0 0 0 25000 25000 0 0 0 0 0 0 0 0 347690 0 347690 0 33621325 32383365 1118841 119119 840264 723133 90392 26739 0 0 0 0 7594719 6131373 1417059 46287 372091 325573 42350 4168 0 0 0 0 0 0 0 0 4401258 0 4401258 0 0 0 0 0 9567258 8419187 1052398 95673 987934 869382 108673 9879 Contract Services 8356690 6660145 1673972 22573 Collection fee 440378 440378 0 0 Physician fees 2579920 2579920 0 0 Provision for bad debt 8333807 8333807 0 0 Health Safety Net 1784512 1784512 0 0 184505878 160720012 22851411 934455 4300 3940 39253020 51505316 302405 236410 22888786 23541315 0 0 0 0 0 0 2966540 3367070 3544896 1778778 168182582 80414407 92847784 87768175 0 0 4968457 4922247 0 0 0 0 13325150 12193530 180101338 185316781 15307188 17531574 0 0 0 0 84098976 82072308 0 0 0 0 6329228 4177679 0 0 4123205 3806188 109858597 107587749 X 68006932 75304261 1607868 1796830 627941 627941 70242741 77729032 180101338 185316781 X 11537560 -4051269 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 1 30708 0 30708 0 SchC_P2B_S00_L01 Schedule C, Part II-B, Line 1 The $30,708 shown on Letter H represents a portion of Massachusetts Hospital and American Hospital Association dues used for lobbying purposes as defined by Medicare. 1660561 0 25807 0 19365 0 1667003 1561182 0 118549 0 19170 0 1660561 1597614 0 -12267 0 24165 0 1561182 0 0.38 0.62 0 0 3920828 0 3920828 87199730 0 24810406 62389324 613300 0 355705 257595 72204989 0 52546543 19658446 4243735 0 2701753 1541982 87768175 Funds Held by Trustees 12176414 Accrued Interest and Dividends 17116 12193530 Amounts due to third party payors 3806188 3806188 196043438 184505878 11537560 0 0 0 0 -4240230 -4240230 7297330 195655602 0 0 0 0 0 195655602 0 387836 387836 196043438 183889994 0 0 0 0 0 183889994 0 615884 615884 184505878 SchD_P05_S00_L04 Schedule D, Part V, Line 4 The organization has a Spending Policy which provides a policy with regard to the use of Investment Income and gains on amounts held in the Endowment Funds. Further to provide a consistent, predictable level of support to operations and permit the organization to maintain the purchasing power of the amounts held in the Enodwment Fund. The amount to be made available to the operating fund will be calculated at the end of the third quarter of each fiscal year. SchD_P10_S00_L02 Schedule D, Part X, Line 2 A review has been performed of each of the Organization's Revenue Streams in relation to FIN 48. The result of the review is that the following has been identified as Unrelated Business Income: Non patient laboratory testing provided to nursing homes and non-affiliated (non Tri-County Medical Associates) physician offices. SchD_P11_S00_L08 Schedule D, Part XI, Line 8 The amount transferred to/from an affiliate is ($4,471,946). The auxiliary/gift shop income is $3,667, net change in the endowment fund $455,945, and fund raising activities ($227,902), rounding $6. SchD_P12_S00_L04b Schedule D, Part XII, Line 4b The other amount represents the following: Net Change in Endowment fund $455,945, fund raising revenue $1,910,385, Fund raising eliminations ($1,066,599) and rounding ($5). SchD_P13_S00_L04b Schedule D, Part XIII, Line 4b The other amount represents the fund raising expenses of $615,884. X X X X X X 1 Ghiorsi & Sorrenti Mack-Cali Center 50 Tice Boulevard Suite 390 Woodcliff Lake NJ 07677 Campaign Planning Study 0 0 25000 -25000 0 25000 -25000 MA Golf 11 249385 230852 18533 0 8190 23511 3640 0 10024 Melange Event FY 11 512000 354775 157225 0 0 0 39968 3000 64031 5 68128 5580 62548 322 0 500 2565 2575 34036 829513 591207 238306 322 8190 24011 46173 5575 108091 192362 45944 0 0 0 0 45700 5000 137 0 45700 5000 0 0 137 5137 40563 MA 1 0 1 0 0 1 Martin Richman 14 Prospect Street Milford MA 01757 0 Martin Richman 0 Vice-President of Philanthropy X 0 0 1 1 1 X 1 X 1 1 1 0 1 1 4790244 2200335 2589909 0.0147 13659079 11638470 2020609 0.0115 3163340 2273664 889676 0.0051 0 0 21612663 16112469 5500194 0.0313 0 0 373468 90545 282923 0.0016 0 1405847 684694 721153 0.0041 0 2884368 370492 2513876 0.0143 0 0 0 0 0 0 0 0 22790 0 22790 0 0 0 4686473 1145731 3540742 0.0200 0 0 26299136 17258200 9040936 0.0513 1 3500 3500 1 79781 79781 0 0 0 2 0 83281 0 83281 0 0 2569749 499732 39187327 45862970 -6675643 X 1 1 1 1 Milford Regional Medical Center Inc

14 Prospect Street Milford MA 017573090

X X X Milford Regional Medical Center Inc 1 1 X X X X X X X X X 09 1 0 1 X X X X X X X X X 0 1 1 200 0 0 1 1 X 0 0 1 X 0 1 SchH_P01_S00_L06a Schedule H, Part I, Line 6a MRMC, Inc prepares and distributes a community benefits report, made available on the hospital website and published online by the Massachusetts Attorney General. SchH_P01_S00_L07 Schedule H, Part I, Line 7 Lines 7a/b/c were calculated using Worksheets 1,2,3 provided in the instructions. Line 7f was determined by the cost & reimbursement information on the Medicare Cost Report. SchH_P01_S00_L072f Schedule H, Part I, Line 7, Column f Was calculated by dividing Column E, Net Community Benefit Expense, by the total of Part IX line 25 of the Form 990 Core Form of $184,505,878 less line 24D, Provision for Bad Debt of $8,333,807 or $176,172,071. SchH_P02_S00_L00 Schedule H, Part II MRMC, Inc. plays an active role in the economic development of our service area. Members of the senior management team serve on community boards such as the 495/Metrowest Partnership for Economic Development, Blackstone Valley Chamber of Commerce, Hopkinton Chamber of Commerce, Milford Area Chamber of Commerce, and the United Way of Tri-County. MRMC, Inc. CEO Francis Saba convened the Greater Milford Health Access Coalition to oversee a Synergy Initiative planning grant awarded by the Health Foundation of Central Massachusetts. The goal of the planning year was to develop a pilot project to improve access to healthcare for uninsured and underinsured residents of the hospital's service area. Coalition members included representatives from providers and community organizations including Tri-River Family Health Center, Reliant Medical Group, Tri-County Medical Associates, Inc., Edward M. Kennedy Community Health Center, Riverside Community Care, Milford Board of Health, Health Education and Advocacy for Latinos, Milford Public Schools. SchH_P03_S0A_L04 Schedule H, Part III, Section A, Line 4 In line 2, Worksheet A in the instructions was used by taking bad debt as reported in Milford Regional Medical Center, Inc.'s (the Hospital) audited financial statements multiplied by the cost-to-charge ratio calculated in Worksheet 2 in the Instructions. SchH_P03_S0B_L08 Schedule H, Part III, Section B, Line 8 The Hospital's Medicare Cost Report was used to determine the amount reported on Line 6. SchH_P03_S0C_L09b Schedule H, Part III, Section C, Line 9b Once it is determined that a patient qualifies for full or partial free care, all collection procedures cease and the full balance, or the amount that qualifies under partial free care, is written off. Massachusetts hospitals are required to adopt a credit and collection policy under the Health Safety Net (HSN) regulations (114.6 CMR 13.08(1)(c)) that outlines the specific process for determining eligibility for public assistance programs and hospital collection practices. Hospitals make reasonable and diligent efforts to collect the patient's insurance and other information to verify other coverage for the health care services provided by the hospital prior to deeming the services to be charity care. The Hospital provides patients with information about financial assistance programs that are available through the Massachusetts Executive Office of Health and Human Services, including charity care services that are provided through HSN, and also assist patients in applying for these services through the State's uniform application. The Hospital credit and collection policy, that outlines its charity care practices, is filed with the Massachusetts Division of Health Care Finance and Policy and also available to patients upon request. SchH_P05_S0B_L03 Schedule H, Part V, Section B, Line 3 Milford Regional Medical Center, Inc. is a member of and host site for Region 6 of the Community Health Network Area (CHNA-6), one of 27 coalitions across the state established by the Massachusetts Department of Public Health. This group meets bi-monthly throughout the year to discuss healthcare issues relevant to our service area. Membership is made up of representatives from a variety of social service agencies, schools, councils on aging, area and individual town health agents and departments, as well as disease prevention advocates. The hospital partnered with CHNA-6 in 2009 to complete a formal community health needs assessment conducted by independent consultant Sarah Lange of Legacy Consulting. In addition, the hospital engaged public health consultants Paul Hattis and Anthony Schlaff in FY 10 to conduct internal and external focus groups to ensure that the data in this assessment continues to accurately reflect the needs of our service area. Their report included recommendations to improve the utilization of assessment data to inform community benefits programming and to strengthen oversight and evaluation. The hosptial's CEO Frank Saba chairs the Community Benefits Steering Committee, charged with a comprehensive process of data analysis and priority setting that includes continuing dialogue with internal and external stakeholders. SchH_P05_S0B_L05 Schedule H, Part V, Section B, Line 5 The Needs Assessment was made available to the members of CHNA-6 and to other community coalitions. SchH_P05_S0B_L07 Schedule H, Part V, Section B, Line 7 The Hospital has made every attempt to address the needs identified within the Needs Assessment through policies such as its own non-smoking campus and through leadership of community partnerships to address specific issues. Given the scope of issues identified in the assessment, this work will be ongoing. SchH_P05_S0B_L21 Schedule H, Part V, Section B, Line 21 At the Hospital, all patients are charged the gross charges for any services. Upon contact from an uninsured patient, a discussion occurs which may result in the discounting of gross charges. SchH_P06_S00_L02 Schedule H, Part VI, Line 2 The Hospital stays current with studies by other agencies, including a recent Central Massachusetts Agency on Aging survey of Central Massachusetts and the annual Adolescent Health Survey conducted by the MetroWest Health Foundation. In addition to CHNA-6, other community coalitions provide another important source of information on emerging health needs. SchH_P06_S00_L03 Schedule H, Part VI, Line 3 Patients are informed of the availability of financial assistance by way of patient statements printed with financial assistance information. At the time of discharge from the Emergency Department, uninsured patients are encouraged to meet with an on-site Financial Counselor. If unable to see a Financial Counselor at the time of discharge, the patient is given a screening letter that gives contact information for our financial assistance department. The day following an emergency room visit a form is generated on each uninsured patient and sent to the Financial Counselors. At that time, the Financial Counselors contacts the patient to coordinate a meeting to apply for assistance. Scheduled self-pay Surgical Day Care (SDC) & Inpatients are reviewed prior to admission to determine payment arrangements or to coordinate a meeting with a Financial Counselor. Insured SDC & Inpatients who are unable to leave a deposit or make payment arrangements towards a large out of pocket expense are also encouraged to meet with a Financial Counselor. SchH_P06_S00_L04 Schedule H, Part VI, Line 4 The Hospital serves the healthcare needs of the residents of 19 communities in Central Massachusetts, spanning 3 separate counties: Worcester, Norfolk and Middlesex. The Hospital's primary service area consists of Milford, Franklin, Bellingham, Northbridge, Whitinsville, Uxbridge, Blackstone, Hopedale, Medway and Mendon, a population of 145,362 according to 2010 US Census data. The Hospital's secondary service area consists of Douglas, Grafton, Hopkinton, Holliston, Millis, Wrentham, Upton, Medfield and Millville, a population of 96,310. The population of the Hospital service area has grown almost 9% over the past decade, as opposed to the statewide average of 3%. The residents of this region are primarily Caucasian, accounting for 93.6% of the population. Hispanics comprise 2.7% of the population, with Asians also at 2.7% and Blacks at 1.0%. The population is nearly even in terms of gender, with 51% females. The bulk of the adult population (71.6%) is between the ages of 18-54, slightly higher than the state percentage, which is 68%. There has been an influx of Egyptian, Central American and Brazilian immigrants into the area, most likely not represented in these totals, but estimated at several thousand additional residents. SchH_P06_S00_L05 Schedule H, Part VI, Line 5 The Hospital furthers its exempt purpose by striving to fulfill its mission "to provide quality healthcare services to our community with dignity, compassion and respect." We do this by providing inpatient and outpatient health care services to the residents of our service area without regard to their ability to pay, and through a range of community benefits programs and partnerships. Our corporate board represents the communities we serve, and the majority is comprised of members who reside in our service area and are not employed by the Hospital. Surplus funds are consistently invested in strategic initiatives designed to improve efficiency and patient care. In FY 11, the Hospital qualified for Meaningful Use reimbursement as a result of significant progress toward the development of a fully electronic medical record. We worked with a broad range of community partners to address unmet health needs identified by our community health needs assessment. We received a Synergy Initiative planning grant from the Health Foundation of Central Massachusetts to convene a community-wide coalition of health leaders to improve access to care for uninsured and underinsured residents of our service area. Our ongoing collaboration with Dana-Farber Cancer Institute and Brigham and Women's Physicians Organization to operate a comprehensive Cancer Center including medical oncology and radiation oncology has made a tremendous difference to the quality of life for residents seeking cancer treatment. SchH_P06_S00_L06 Schedule H, Part VI, Line 6 The Organization consists of Milford Regional Medical Center, Inc. (the "Hospital" or "Parent"), Tri-County Medical Associates, Inc. ("Tri-County"), and Milford Regional Healthcare Foundation, Inc. (the "Foundation"), collectively referred to as the "Organization". The Hospital provides medical and hospital services for the sick and disabled of any race, creed, color, or nationality regardless of an individual's ability to pay. Tri-County, a large multi-specialty group practice, operates for the benefit of the Hospital by assisting the Hospital in carrying out its charitable mission purpose of promoting healthcare in its service area. Tri-County's vision is to consistently meet the changing healthcare needs and expectations of the communitites it serves. The Foundation supports the mission of both the Hospital and Tri-County through fund raising activites. SchH_P06_S00_L07 Schedule H, Part VI, Line 7 Massachusetts X X X X X 0 1 0 0 0 0 0 0 0 M Catherine Burke MD 0 0 0 0 0 0 0 0 0 0 0 0 1488 0 Patrick R McSweeney MD 0 324439 0 0 0 0 0 0 0 24997 0 349436 0 307073 Albert A Crimaldi MD 0 0 0 0 6250 0 0 0 0 0 6250 0 17250 0 John N Pandiscio 0 0 0 0 13000 0 0 0 0 0 13000 0 13000 0 Francis M Saba 440905 0 50000 0 0 0 90406 0 21921 0 603232 0 743613 0 Edward J Kelly 358810 0 40000 0 0 0 37468 0 24717 0 460995 0 420081 0 Jeanne P Lynskey 218571 0 0 0 0 0 0 0 15284 0 233855 0 207808 0 Salvatore Perla 199411 0 0 0 0 0 0 0 21413 0 220824 0 196879 0 Cheryl L Bonasoro 199604 0 0 0 0 0 0 0 7110 0 206714 0 199333 0 Linda Yates 171577 0 0 0 0 0 0 0 22539 0 194116 0 187773 0 Martin Richman 155921 0 0 0 0 0 0 0 18581 0 174502 0 166613 0 Laurence Fraize 151479 0 0 0 0 0 0 0 20445 0 171924 0 164612 0 Nancy Tomaso 149223 0 0 0 0 0 0 0 5434 0 154657 0 148961 0 Kamala Murali 136025 0 0 0 0 0 0 0 19972 0 155997 0 148483 0 Donna M Saul 131830 0 0 0 0 0 0 0 23283 0 155113 0 146291 0 Jennifer Childs-Roshak 163544 0 0 0 0 0 0 0 19449 0 182993 0 0 0 SchJ_P01_S00_L04 Schedule J, Part I, Line 4 Francis M Saba SERP $90,406 and Edward J Kelly SERP $37,468. Massachusetts Health & Education Facilities Authority 042456011 57586CXJ9 2007-02-21 70279953 See Supplemental Information 0 0 0 1755000 0 70279953 2662312 1509967 30555914 833657 0 0 34447316 0 270787 2008 0 1 1 1 0 1 1 0 1 0.018 0 0.018 1 0 0 0 0 0 0 SchK_P01_S00_L00f Schedule K, Part I, Column f The proceeds of the Series E Bonds were applied to the following: (1) Constructing, furnishing and equipping an approximately 54,013 gross square feet, two story building on the Milford campus across the street from the Hospital building. The Cancer Center will be owned and partially occupied by the Hospital for diagnostic imaging services (including MRI, CT scan and diagnostic radiology), laboratory services and other administrative space. In addition, the Hospital has executed leases with two tenants for the Cancer Center. Dana-Farber Cancer Institute to provide medical/oncology services and Brigham and Women's Physicians Organization to provide radiation/oncology services. (2) Purchasing of four properties and demolishing three existing structures located thereon for the purpose of constructing the Cancer Center. (3) Renovating, constructing, furnishing and equipping for the approximately 2,438 gross square feet of existing space for a Cardiac Catheterization Lab on the Milford Campus. (4) Renovating approximately 8,800 square feet of existing space which previously served as the Hospital's operating room area (prior to the issuance of the Series D Bonds in 2002), to relocate outpatient and other administrative spaces. (5) Renovating the Gannett Inpatient Unit consisting of approximately 9,569 gross square feet. (6) Renovating and expanding the Cardiovascular Department consisting of approximately 1,982 gross square feet. (7) Various renovations, improvements, equipment and furnishings at the Milford Campus and the Whitinsville Division. (8) Refinancing the Series D Bonds, the proceeds of which were applied primarily for the purpose of modernizing and expanding surgical services and expanding the maternity unit. Lawrence Hill Trustee 183061 Payments were made to M Hill Companies with which the Hospital has entered into lease agreements. 0 M Catherine Burke MD Trustee 418081 Payments were made to Orion Emergency Services Inc for services provided to the Hospital. Dr. Burke is President of Orion Emergency Services, Inc. 0 Albert Crimaldi MD Trustee 133700 Payments were made to Milford Gastroenterology Associates Inc which provides services to the Hospital. Dr. Crimaldi is part owner of Milford Gastroenterology Associates, Inc. 0 X 0 FMV X 2 102603 FMV X Food for charitable fund raising event 1 0 FMV X Tickets to sporting events or entertainment for fund raising event 19 0 FMV X Travel package for fund raising events 5 0 FMV X Gift certificates and gift baskets for fund raising events 21 0 FMV X Dinner packages and beverages for fund raising events 27 0 FMV X Miscellaneous toys 8 0 FMV X Freezer for fund raising event 1 0 FMV X Computer and Ipod for fund raising event 2 0 FMV X Zoom lens for marketing department 1 0 FMV 0 0 1 0 SchM_P01_S00_L33 Schedule M, Part I, Line 33 MRMC Inc. does not currently account for certain non-cash contributions or in-kind donations as revenue. F990_P04_S00_L20b Form 990, Part IV, Line 20b Prior year figures for FY 10 contain restatements of certain assets and liabilities. F990_P04_S00_L24a Form 990, Part IV, Line 24a The proceeds of the Series E Bonds were applied to the following: (1) Constructing, furnishing and equipping an approximately 54,013 gross square feet, two story building on the Milford campus across the street from the main Hospital building. The Cancer Center will be owned and partially occupied by the Hospital for diagnostic imaging services (including MRI, CT scan and diagnostic radiology), laboratory services and other administrative space. In addition, the Hospital has executed leases with two tenants for the Cancer Center. Dana-Farber Cancer Institute to provide medical/oncology services and Brigham and Women's Physicians Organization to provide radiation/oncology services. (2) Purchasing of four properties and demolishing three existing structures located thereon for the purpose of constructing the Cancer Center. (3) Renovating, constructing, furnishing and equipping for the approximately 2,438 gross square feet of existing space for a Cardiac Catheterization Lab on the Milford campus. (4) Renovating approximately 8,800 square feet of existing space which previously served as the Hospital's operating room are (prior to the issuance of the Series D Bonds in 2002), to relocate outpatient and other administrative spaces. (5) Renovating the Gannett Inpatient Unit consisting of approximately 9,569 gross square feet. (6) Renovating and expanding the Cardiovascular Department consisting of approximately 1,982 gross square feet. (7) Various renovations, improvements, equipment and furnishings at the Milford Campus and the Whitinsville Division. (8) Refinancing of the Series D Bonds, the proceeds of which were applied primarily for the purpose of modernizing and expanding surgical services and expanding the maternity unit. F990_P05_S00_L07g Form 990, Part V, Line 7g The organization did not receive any contributions of qualified property during the tax year. F990_P05_S00_L07h Form 990, Part V, Line 7h The organization did not receive any contributions of cars, boats, airplanes or other vehicles during the tax year. F990_P06_S0A_L02 Form 990, Part VI, Section A, Line 2 Three board of trustee members have disclosed via the organization's conflict of interest disclosure process that they have business relationships with other board members. Two board of trustee members are married to each other. F990_P06_S0A_L06 Form 990, Part VI, Section A, Line 6 The organization is governed by a Board of Trustees. In addition, the organization has incorporators who serve in an advisory capacity to the Board of Trustees. F990_P06_S0B_L11b Form 990, Part VI, Section B, Line 11b The FORM 990 was provided to the Board of Trustee Compensation Committee and reviewed by them. The FORM 990 was made available to all Trustees in the Hospital's Administration Department. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c The organization has a written Code of Business Conduct which states its conflict of interest policy. A conflict of interest disclosure statement is mailed annually to members of the board of trustees and senior management. They are required to complete the form and submit it to the Corporate Compliance Officer. The forms are reviewed and monitored. The organization also has established a hotline for any staff member who may wish to discuss a potential violation of the Code, our policy or law on an anonymous basis. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 The Compensation Committee approves all compensation plans and guidelines, as well as all compensation for the organization's senior management employees in accordance with such plans and guidelines. The committee may consult with a nationally-recognized consultant to assist it in determining that the organization's compensaton structure and ranges are reasonable. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 The organization makes it governing documents available to the public, such as it's bylaws which include the organization's conflict of interest policy, through the annual filing of the Massachusetts Division of Pulbic Charities Form PC. The Form PC is available for viewing by the public on the Massachusetts Attorney General's website and is also attached to the annual filing of the Massachusetts Form 3ABC which is submitted to town offices where the organization owns or leases property. The organization's financial statements are included in the Form PC Filing and are also included in a quarterly filing to the organization's bond holders. F990_P07_S0A_L01a Form 990, Part VII, Section A, Line 1a Two executives, as disclosed in Schedule J, receive supplemental retirement benefits. F990_P11_S00_L05 Form 990, Part XI, Line 5 The Change in Net Assets results from transferring to affiliates ($4,471,946), Auxiliary activity $3,667, fund raising activities $227,902, and change in market value $189,108. Tri-County Medical Associates Inc 9 Industrial Road Suite 5 Milford MA 01757 043159969 Physician Group MA 501(C)(3) 11A N/A MWRH Management Services Inc 14 Prospect Street Milford MA 01757 311631252 Provides office space, support to satellite clinics MA 501(C)(3) 11A N/A Milford Regional Healthcare Foundation Inc 14 Prospect Street Milford MA 01757 200773697 Fundraising MA 501(C)(3) 11A N/A Milford Whitinsville Healthcare Consortium Inc 14 Prospect Street Milford MA 01757 043248004 Physician Hospital Organization MA N/A C 0 366 0.5 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 1 0 Tri-County Medical Associates Inc i 283149 Market value Tri-County Medical Associates Inc j -75203 Market value Tri-County Medical Associates Inc q 7800000 Cost Tri-County Medical Associates Inc o -3535999 Cost