2012-08-15T16:54:23-05:00 2011-09-30 990 2010-10-01 222755258 BHS MANAGEMENT SERVICES INC BHSM 4134472508 725 NORTH STREET PITTSFIELD MA 012014109 DARLENE RODOWICZ 4134472809 2012-08-15 0 2010 2016-02-24 21:20:13Z DARLENE RODOWICZ 725 NORTH STREET PITTSFIELD MA 012014109 41519875 0 X WWW.BHS1.ORG X 1986 MA PROVIDE MANAGEMENT SERVICES TO NOT-FOR-PROFIT CO.S INCLUDING AFFILIATES OF BERKSHIRE HEALTH SYSTEMS 24 20 347 0 0 0 0 0 39487225 41519875 0 0 0 0 39487225 41519875 0 0 0 0 25817075 26066977 0 0 0 13670150 15452898 39487225 41519875 0 0 4953729 5372113 4953729 5372113 0 0 TO PROVIDE MANAGEMENT SERVICES TO NOT-FOR-PROFIT CORPORATIONS INCLUDING CONTROLLED AFFILIATES OF BERKSHIRE HEALTH SYSTEMS 0 0 41519875 41519875 BHS MANAGEMENT SERVICES PROVIDES MANAGEMENT SERVICES TO NOT FOR PROFIT CORPORATIONS INCLUDING CONTROLLED AFFILIATES OF BERKSHIRE HEALTH SYSTEMS, INC. THIS COORDINATED EFFORT PROVIDES FINANCIAL ACCOUNTING AND ADMINISTRATIVE SERVICES WHICH ALLOWS THE SYSTEM TO OPERATE MORE EFFICIENTLY, REACT MORE QUICKLY AND PERFORM IN AN INTEGRATED MANNER 41519875 1 0 0 1 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 111 0 1 347 1 0 0 0 0 0 0 0 0 0 0 X 24 20 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X DARLENE RODOWICZ 4134472809 725 NORTH STREET PITTSFIED MA 01201 JEROME J ANDERSON 2.00 X 0 0 0 THOMAS O ANDREWS 2.00 X 0 0 0 ALFRED A BARBALUNGA 2.00 X 0 0 0 BRONLY S BOYD 2.00 X X 0 0 0 BRIAN T BURKE MD 2.00 X 0 200213 37926 KIT DOBELLE 2.00 X 0 0 0 TIMOTHY C DOHERTY 2.00 X X 0 0 0 RICHARD M DOHONEY 2.00 X 0 0 0 BRIAN H FAIRBANK 2.00 X 0 0 0 A KING FRANCIS 2.00 X 0 0 0 DENNIS J HOGAN 2.00 X 0 0 0 EDMUND H HORNSTEIN DO 2.00 X 0 87569 0 JOHN R KEARNS MD 2.00 X 0 0 0 SUSAN M KORMANIK 2.00 X 0 0 0 LORINDA ACKLEY MAZUR 2.00 X 0 0 0 JOAN M MCFALLS 2.00 X 0 0 0 LAURIE NORTON MOFFATT 2.00 X 0 0 0 DAVID E PHELPS 58.00 X X 522520 0 39741 PAUL E RAVERTA 2.00 X 0 0 0 CAROLE G SIEGEL 2.00 X 0 0 0 GEORGE T SMITH 2.00 X 0 0 0 MARILYN L SPERLING 2.00 X 0 0 0 ANN H TRABULSI 2.00 X 0 0 0 ROBERT P WESPISER 2.00 X 0 132035 0 THADDEUS S WELCH 2.00 X 0 0 0 DARLENE RODOWICZ 51.00 X 329477 0 35957 PHELPSD ONE-TIME RETIREMENT BEN ADJ 0.10 X 1085553 0 0 CHERYL M BOUDREAU 41.00 X 79974 0 13078 WILLIAM JONES JR 50.00 X 386910 0 34811 ARTHUR MILANO 50.00 X 191326 0 31820 WILLIAM YOUNG 50.00 X 236809 0 32793 EUGENE DELLEA 50.00 X 207428 0 19464 ANTHONY J RINALDI 50.00 X 214655 0 34921 JOHN ROGERS 50.00 X 342931 0 35958 LISA TRUMBLE 50.00 X 263865 0 29148 JILL M ZUCCO 50.00 X 208876 0 35481 4070324 419817 381098 36 0 1 0 ERNST & YOUNG 200 CLARENDON STREET BOSTON MA 02116 AUDITING SERVICES 571140 CAIN HIBBARD & MYERS 66 WEST STREET PITTSFIELD MA 01201 LEGAL SERVICES 564826 MEDICAL INFORMATION TECHNOLOGY MEDITECH CIRCLE WESTWOOD MA 02090 SOFTWARE MAINTENANCE 526109 PRICEWATERHOUSE COOPERS 300 MADISON AVENUE NEW YORK NY 10017 CONSULTING SERVICES 483660 BERKSHIRE COMMUNITY COLLEGE 1350 WEST STREET PITTSFIELD MA 01201 EDUCATION SERVICES 202068 19 CENTRALIZED SVC FEES & 561110 41519875 41519875 41519875 41519875 41519875 0 0 2073804 2073804 18474730 18474730 643535 643535 3489942 3489942 1384966 1384966 1009683 1009683 1470120 1470120 89225 89225 3734078 3734078 1060589 1060589 2955992 2955992 3251974 3251974 914647 914647 306384 306384 44848 44848 18655 18655 EMPLOYEE RECRUITMENT 503193 503193 EDUCATION SERVICES 65482 65482 LICENSES & DUES 28028 28028 41519875 41519875 0 0 15718 16260 2300 18996 1227751 1762282 3284231 3061213 176541 223018 3531419 3351557 4953729 5372113 3711852 3970044 1241877 1402069 4953729 5372113 X 0 0 0 0 0 0 0 0 4953729 5372113 0 0 X 0 1 1 X 0 X X X 0 0 0 BERKSHIRE MEDICAL CENTER INC 042791396 3 0 0 FAIRVIEW HOSPITAL INC 042133860 3 0 0 BERKSHIRE FACULTY SERVICES INC 042995053 11B 0 0 BERKSHIRE HEALTH SYSTEMS INC 042442944 11B 0 0 4 0 SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: MONETARY SUPPORT IS NOT REQUIRED. THIS ORGANIZATION PROVIDES SUPPORT IN THE FORM OF PROVIDING MANAGEMENT SERVICES TO ITS SUPPORTED ORGANIZATIONS. 0 0 0 0 0 0 0 0 1 89225 89225 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: BHS MANAGEMENT SERVICES IS MEMBER OF "SECTION 508 HOSPITAL COALITION." 100% OF DUES ARE FOR LOBBYING. THE SECTION 508 COALITION ADVOCATES FOR INCREASED MEDICARE PAYMENTS. 308036 258137 49899 2973130 2803076 170054 3065 3065 223018 DUE FROM AFFILIATES 1956924 DEFERRED COMPENSATION 1394633 3351557 DEFERRED COMPENSATION 1394633 PENSION FORFEITURE 7436 1402069 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THERE IS NO FIN 48 FOOTNOTE IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS X X X X X 0 0 0 0 0 0 0 0 0 BRIAN T BURKE MD 0 182388 0 0 0 17825 0 9396 0 28530 0 238139 0 0 DAVID E PHELPS 466255 0 0 0 56265 0 11025 0 28716 0 562261 0 0 0 DARLENE RODOWICZ 275147 0 0 0 54330 0 11025 0 24932 0 365434 0 0 0 PHELPSD ONE-TIME RETIREMENT BEN ADJ 0 0 0 0 1085553 0 0 0 0 0 1085553 0 0 0 WILLIAM JONES JR 316344 0 0 0 70566 0 11025 0 23786 0 421721 0 0 0 ARTHUR MILANO 156824 0 0 0 34502 0 8367 0 23453 0 223146 0 0 0 WILLIAM YOUNG 192064 0 0 0 44745 0 2532 0 30261 0 269602 0 0 0 EUGENE DELLEA 163158 0 0 0 44270 0 8467 0 10997 0 226892 0 0 0 ANTHONY J RINALDI 151455 0 0 0 63200 0 8980 0 25941 0 249576 0 0 0 JOHN ROGERS 267796 0 0 0 75135 0 11025 0 24933 0 378889 0 0 0 LISA TRUMBLE 213201 0 0 0 50664 0 9441 0 19707 0 293013 0 0 0 JILL M ZUCCO 166472 0 0 0 42404 0 9143 0 26338 0 244357 0 0 0 SUPPLEMENTAL INFORMATION PART III IN REFERENCE TO SCHEDULE J PART II, NO COMPENSATION IS PAID BY THE FILING ENTITY TO ANY DIRECTOR. A PROPORTIONAL SHARE OF THE COMPENSATION AMOUNT PAID TO OFFICERS IS ALLOCATED INTERNALLY TO THE FILING ENTITY FOR ACCOUNTING AND MANAGEMENT PURPOSES. (SEE BELOW). THE FILING ENTITY PROVIDES MANAGEMENT SERVICES TO THE FILING ENTITY AND 26 OTHER NOT FOR PROFIT, TAX EXEMPT HEALTHCARE SERVICE ENTITIES. COMPENSATION FOR OFFICERS IS REVIEWED AND ESTABLISHED AT LEAST BIANNUALLY BY THE INDEPENDENT VOLUNTEER GOVERNING BODY, 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 TARGETS 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. DAVID E. PHELPS: 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: BERKSHIRE MEDICAL CENTER, INC. 37 HOURS/51 TOTAL HOURS $270,421 BERKSHIRE FACULTY SERVICES, INC. 7/51 HOURS $51,161 FAIRVIEW HOSPITAL 3/51 HOURS $21,926 BERKSHIRE INDEMNITY COMPANY, SPC, LTD. 3/51 HOURS $18,272 BHS MANAGEMENT SERVICES, INC. 1/51 HOURS FOR THE BENEFIT OF: BERKSHIRE HEALTHCARE SYSTEMS, INC. $3654 CHERYL BOUDREAU: 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 ARTHUR D. MILANO: BERKSHIRE MEDICAL CENTER, INC. 35 HOURS/47 TOTAL HOURS $166,295 BERKSHIRE FACULTY SERVICES, INC. 8/47 HOURS $37,979 FAIRVIEW HOSPITAL 2/47 HOURS $9,506 BHS MANAGEMENT SERVICES, INC. 2/47 HOURS FOR THE BENEFIT OF: BERKSHIRE HEALTHCARE SYSTEMS, INC. $446 BOURNE MANAGEMENT SYSTEMS, INC. $ 446 GREENFIELD MANAGEMENT SYSTEMS, INC. $ 446 NEW BEDFORD MANAGEMENT SYSTEMS, INC. $ 446 NORTHAMPTON MANAGEMENT SYSTEMS, INC. $ 446 EAST LONGMEADOW MANAGEMENT SYSTEMS, INC. $ 446 DANVERS MANAGEMENT SYSTEMS, INC. $ 446 PEABODY MANAGEMENT SYSTEMS, INC. $ 446 SOUTH YARMOUTH MANAGEMENT SYSTEMS, INC. $ 446 BERKSHIRE PENNSYLVANIA, INC. $ 446 XENIA EAST MANAGEMENT SYSTEMS, INC. $ 446 WILLOWOOD OF GREAT BARRINGTON, INC. $ 446 WILLOWOOD OF NORTH ADAMS, INC. $ 446 WILLOWOOD OF WILLIAMSTOWN, INC. $ 446 HILLCREST EXTENDED CARE SERVICES, INC. $ 446 BERKSHIRE RETIREMENT COMMUNITY, INC. $ 446 BERKSHIRE EXTENDED CARE SERVICES, INC. $ 446 INTEGRINURSE, INC. $ 446 INTEGRISCRIPT, INC. $ 446 HOSPICECARE IN THE BERKSHIRES, INC. $ 446 PITTSFIELD MANAGEMENT SYSTEMS, INC. $ 446 [BERKSHIRE INDEMNITY COMPANY, SPC, LTD. 0] JOHN F. ROGERS: BERKSHIRE MEDICAL CENTER, INC. 20 HOURS /54 TOTAL HOURS $140,494 BERKSHIRE FACULTY SERVICES, INC. 10/54 HOURS $70,170 FAIRVIEW HOSPITAL 3/54 HOURS $21,066 BERKSHIRE INDEMNITY COMPANY, SPC, LTD. 8/54 HOURS $56,113 BHS MANAGEMENT SERVICES, INC. (LTC) 13/54 HOURS ALLOCATED AS AMONG LTC FACILITIES AS FOLLOWS - BERKSHIRE HEALTHCARE SYSTEMS, INC. $7,237 BOURNE MANAGEMENT SYSTEMS, INC. $ 4,509 GREENFIELD MANAGEMENT SYSTEMS, INC. $ 4,509 NEW BEDFORD MANAGEMENT SYSTEMS, INC. $ 4,509 NORTHAMPTON MANAGEMENT SYSTEMS, INC. $ 4,509 EAST LONGMEADOW MANAGEMENT SYSTEMS, INC. $ 3,599 DANVERS MANAGEMENT SYSTEMS, INC. $ 3,599 PEABODY MANAGEMENT SYSTEMS, INC. $ 3,599 SOUTH YARMOUTH MANAGEMENT SYSTEMS, INC. $ 3,599 BERKSHIRE PENNSYLVANIA, INC. $ 4,509 XENIA EAST MANAGEMENT SYSTEMS, INC. $ 3,599 WILLOWOOD OF GREAT BARRINGTON, INC. $ 4,509 WILLOWOOD OF NORTH ADAMS, INC. $ 4,509 WILLOWOOD OF WILLIAMSTOWN, INC. $ 5,418 HILLCREST EXTENDED CARE SERVICES, INC. $ 4,509 BERKSHIRE RETIREMENT COMMUNITY, INC. $ 4,509 BERKSHIRE EXTENDED CARE SERVICES, INC. $ 2,690 INTEGRINURSE, INC. $ 2,690 INTEGRISCRIPT, INC. $ 3,599 HOSPICECARE IN THE BERKSHIRES, INC. $ 6,327 PITTSFIELD MANAGEMENT SYSTEMS, INC. $ 4,509 FORM 990, PART VI, SECTION A, LINE 6 BERKSHIRE HEALTH SYSTEMS, INC. IS THE SOLE CORPORATE MEMBER OF BHS MANAGEMENT SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF TRUSTEES IS COMPOSED OF THE INCUMBENT MEMBERS OF THE BOARD OF TRUSTEES OF BERKSHIRE HEALTH SYSTEMS, INC. FORM 990, PART VI, SECTION B, LINE 11 BERKSHIRE HEATLH SYSTEMS ("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. FORM 990, PART VI, SECTION B, LINE 12C 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. 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 FORM 990, PART VI, SECTION B, LINE 15 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. FORM 990, PART VI, SECTION C, LINE 19 GOVERNANCE DOCUMENTS, THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC AT THE OFFICES OF (A) THE CHIEF FINANCIAL OFFICER AND (B) THE VICE PRESIDENT AND GENERAL COUNSEL AT 725 NORTH STREET, PITTSFIELD, MA 01201 AVERAGE HOURS DEVOTED TO RELATED ORGANIZATIONS FORM 990, SCHEDULE J WILLIAM C. JONES, JR. BERKSHIRE HEALTHCARE SYSTEMS, INC. - 50 HOURS/WEEK LISA M. TRUMBLE BERKSHIRE FACULTY SERVICES, INC. - 50 HOURS/WEEK ANTHONY J. RINALDI FAIRVIEW HOSPITAL, INC. - 50 HOURS/WEEK JILL M ZUCCO BERKSHIRE HEALTHCARE SYSTEMS, INC. - 50 HOURS/WEEK EUGENE A. DELLEA FAIRVIEW HOSPITAL, INC. - 50 HOURS/WEEK BRIAN T BURKE, MD FAIRVIEW HOSPITAL, INC - 48 HOURS/WEEK EDMUND H HORNSTEIN, DO BERKSHIRE MEDICAL CENTER - CONTRACTED AS NEEDED ROBERT P WESPISER BERKSHIRE MEDICAL CENTER - CONTRACTED AS NEEDED FORM 990, PART VII, SECTION A, COLUMN (B) NO COMPENSATION IS PAID BY THE FILING ENTITY TO ANY DIRECTOR. 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: 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: BERKSHIRE MEDICAL CENTER, INC. 37 HOURS/51 TOTAL HOURS $270,421 BERKSHIRE FACULTY SERVICES, INC. 7/51 HOURS $51,161 FAIRVIEW HOSPITAL 3/51 HOURS $21,926 BERKSHIRE INDEMNITY COMPANY, SPC, LTD. 3/51 HOURS $18,272 BHS MANAGEMENT SERVICES, INC. 1/51 HOURS FOR THE BENEFIT OF: BERKSHIRE HEALTHCARE SYSTEMS, INC. $3654 CHERYL BOUDREAU: 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 ARTHUR D. MILANO: BERKSHIRE MEDICAL CENTER, INC. 35 HOURS/47 TOTAL HOURS $166,295 BERKSHIRE FACULTY SERVICES, INC. 8/47 HOURS $37,979 FAIRVIEW HOSPITAL 2/47 HOURS $9,506 BHS MANAGEMENT SERVICES, INC. 2/47 HOURS FOR THE BENEFIT OF: BERKSHIRE HEALTHCARE SYSTEMS, INC. $446 BOURNE MANAGEMENT SYSTEMS, INC. $ 446 GREENFIELD MANAGEMENT SYSTEMS, INC. $ 446 NEW BEDFORD MANAGEMENT SYSTEMS, INC. $ 446 NORTHAMPTON MANAGEMENT SYSTEMS, INC. $ 446 EAST LONGMEADOW MANAGEMENT SYSTEMS, INC. $ 446 DANVERS MANAGEMENT SYSTEMS, INC. $ 446 PEABODY MANAGEMENT SYSTEMS, INC. $ 446 SOUTH YARMOUTH MANAGEMENT SYSTEMS, INC. $ 446 BERKSHIRE PENNSYLVANIA, INC. $ 446 XENIA EAST MANAGEMENT SYSTEMS, INC. $ 446 WILLOWOOD OF GREAT BARRINGTON, INC. $ 446 WILLOWOOD OF NORTH ADAMS, INC. $ 446 WILLOWOOD OF WILLIAMSTOWN, INC. $ 446 HILLCREST EXTENDED CARE SERVICES, INC. $ 446 BERKSHIRE RETIREMENT COMMUNITY, INC. $ 446 BERKSHIRE EXTENDED CARE SERVICES, INC. $ 446 INTEGRINURSE, INC. $ 446 INTEGRISCRIPT, INC. $ 446 HOSPICECARE IN THE BERKSHIRES, INC. $ 446 PITTSFIELD MANAGEMENT SYSTEMS, INC. $ 446 [BERKSHIRE INDEMNITY COMPANY, SPC, LTD. 0] JOHN F. ROGERS: BERKSHIRE MEDICAL CENTER, INC. 20 HOURS /54 TOTAL HOURS $140,494 BERKSHIRE FACULTY SERVICES, INC. 10/54 HOURS $70,170 FAIRVIEW HOSPITAL 3/54 HOURS $21,066 BERKSHIRE INDEMNITY COMPANY, SPC, LTD. 8/54 HOURS $56,113 BHS MANAGEMENT SERVICES, INC. (LTC) 13/54 HOURS ALLOCATED AS AMONG LTC FACILITIES AS FOLLOWS - BERKSHIRE HEALTHCARE SYSTEMS, INC. $7,237 BOURNE MANAGEMENT SYSTEMS, INC. $ 4,509 GREENFIELD MANAGEMENT SYSTEMS, INC. $ 4,509 NEW BEDFORD MANAGEMENT SYSTEMS, INC. $ 4,509 NORTHAMPTON MANAGEMENT SYSTEMS, INC. $ 4,509 EAST LONGMEADOW MANAGEMENT SYSTEMS, INC. $ 3,599 DANVERS MANAGEMENT SYSTEMS, INC. $ 3,599 PEABODY MANAGEMENT SYSTEMS, INC. $ 3,599 SOUTH YARMOUTH MANAGEMENT SYSTEMS, INC. $ 3,599 BERKSHIRE PENNSYLVANIA, INC. $ 4,509 XENIA EAST MANAGEMENT SYSTEMS, INC. $ 3,599 WILLOWOOD OF GREAT BARRINGTON, INC. $ 4,509 WILLOWOOD OF NORTH ADAMS, INC. $ 4,509 WILLOWOOD OF WILLIAMSTOWN, INC. $ 5,418 HILLCREST EXTENDED CARE SERVICES, INC. $ 4,509 BERKSHIRE RETIREMENT COMMUNITY, INC. $ 4,509 BERKSHIRE EXTENDED CARE SERVICES, INC. $ 2,690 INTEGRINURSE, INC. $ 2,690 INTEGRISCRIPT, INC. $ 3,599 HOSPICECARE IN THE BERKSHIRES, INC. $ 6,327 PITTSFIELD MANAGEMENT SYSTEMS, INC. $ 4,509 EXPLANATION OF FORM 5471 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 STREET, 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 BERKSHIRE HEALTH SYSTEMS INC 725 NORTH STREET PITTSFIELD MA 01201 042442944 PARENT CORP MA 501 (C) (3) 11B N/A 0 FAIRVIEW HOSPITAL 725 NORTH STREET PITTSFIELD MA 01201 042133860 ACUTE CARE MA 501 (C) (3) 3 0 BERKSHIRE MEDICAL CENTER INC 725 NORTH STREET PITTSFIELD MA 01201 042791396 ACUTE CARE MA 501 (C) (3) 3 0 BERKSHIRE FACULTY SERVICES INC 725 NORTH STREET PITTSFIELD MA 01201 042995053 PHYSICIAN SERVICES MA 501 (C) (3) 11B 0 TRI-STATE MEDICAL MANAGEMENT CORP 725 NORTH STREET PITTSFIELD MA 01201 042913352 REAL ESTATE MANAGEMENT MA FAIRVIEW HOSPITAL C 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 0