2011-08-12T08:18:16-05:00 2010-09-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2009-10-01 222563464 NORTHERN BERKSHIRE COMMUNITY SERVICES NORT 4134588127 71 HOSPITAL AVE NORTH ADAMS MA 01247 CHRISTOPHER HICKEY 2011-08-10 true Brian D Todd 4178658701 2009 2016-02-24 21:20:13Z CHRISTOPHER HICKEY 71 HOSPITAL AVE NORTH ADAMS MA 01247 30346686 false X www.nbhealth.org X 1999 MA OPERATION OF FACILITIES AND PROGRAMS PROVIDING HEALTH, HOUSING AND OTHER RELATED AND SUPPORTIVE SERVICES PRIMARILY TO THE ELDERLY. X 17 15 377 15 0 0 0 0 15177685 13141085 4653 -4569154 0 0 15182338 8571931 0 0 0 0 10412771 9275471 0 0 0 8903523 8057613 19316294 17333084 -4133956 -8761153 27632339 3384168 39601982 24170451 -11969643 -20786283 THE ORGANIZATION'S MISSION IS TO PROVIDE EXCEPTIONAL HEALTHCARE FROM THE HEART. false false 12195325 11300913 THE ORGANIZATION OPERATES SWEET BROOK TRANSITIONAL CARE AND LIVING CENTERS. SWEET BROOK IS AS A 184-BED SKILLED NURSING FACILITY DEDICATED TO PROVIDING LONG TERM AND ELDER CARE TO RESIDENTS OF NORTHERN BERKSHIRE COUNTY. THE CONFIGURATION OF THE NURSING HOME'S NURSING BED UNITS, INCLUDING THE 83 BEDS DEDICATED TO RESIDENTS WITH ALZHEIMER'S AND OTHER MEMORY DISORDERS, IS 20 PRIVATE, 94 SEMI-PRIVATE, 54 THREE BED UNITS, AND 16 FOUR BED UNITS, FOR A TOTAL OF 184 NURSING BEDS. SWEETBROOK REGISTERED 47,761 PATIENT DAYS IN FY2010 AND AN AVERAGE CENSUS OF 81.47%. SEE SCHEDULE O FOR ADDITIONAL DETAILS. 2001973 1840172 THE ORGANIZATION OPERATES SWEETWOOD CONTINUED CARE RETIREMENT COMMUNITY. SWEETWOOD IS A RESIDENTIAL COMMUNITY OFFERING A UNIQUE SETTING FOR RETIREMENT AND ASSISTED LIVING WITH LUXURY SUITES AVAILABLE IN 1 OR 2 BEDROOM AND 1-1/2 OR 2 BATH DESIGNS. THE CONFIGURATION OF SWEETWOOD'S UNITS ARE 14 ONE BEDROOM, 3 LARGE ONE BEDROOM, 45 TWO BEDROOM, 4 LARGE TWO BEDROOM, AND 4 DELUXE TWO BEDROOM, FOR A TOTAL OF 70 UNITS. SWEETWOOD RECORDED AN AVERAGE OF 37 BILLED UNITS IN FY2010. SEE SCHEDULE O FOR ADDITIONAL DETAILS. 14197298 true false false true false false false false false true false false false false false false false false false false false false false true false false false false false false false false false false false true false true false false false true 52 0 true 377 true false false false false false false false false false 17 15 false true false false true true true true true false false true true true true true true true false X CHRISTOPHER HICKEY 4136645505 71 HOSPITAL AVE NORTH ADAMS MA 01247 JANE ALLEN 1.0 X 0 0 0 ELLEN BERNSTEIN 1.0 X 0 0 0 JULIA BOLTON 1.0 X 0 0 0 STEPHEN FIX 1.0 X 0 0 0 BILL GREENWALD 1.0 X 0 0 0 BRUCE GRINNELL 1.0 X 0 0 0 RICHARD JETTE 1.0 X 0 0 0 STEPHEN KLASS 1.0 X 0 0 0 JONATHAN CLUETT 1.0 X 0 0 0 BYRON SHERMAN 1.0 X X 0 0 0 MARTHA STOREY 1.0 X 0 0 0 ERWIN STUEBNER 1.0 X 0 0 0 ARTHUR TURTON 1.0 X X 0 0 0 RICHARD PALMISANO 5.0 X X 87654 310777 40368 PAUL DONOVAN 1.0 X 0 326070 36682 DENISE RICHARDELLO 1.0 X 0 0 0 STEPHEN PAGNOTTA 1.0 X 0 0 0 CHRISTOPHER HICKEY 5.0 X 0 212147 1235 87654 848994 78285 0 false true false SODEXO FOOD SERVICE 724476 EPSTEIN BECKER GREEN UNION LAWYERS 439988 THE WEISSMAN GROUP UNION CONSULTANT 340456 WALNUT CREEK MGMT MANAGAMENT COMPANY 114989 NORTON ASSOC STAFFING AGENCY 102000 5 0 NET PATIENT SERVICE REVENUE 900099 12534319 12534319 MISCELLANEOUS 900099 606766 606766 13141085 142 142 0 0 17205459 21774755 -4569296 -4569296 -4569296 0 0 0 0 8571931 13141085 -4569154 0 0 0 0 96536 96536 0 7239606 6287857 951749 83979 75319 8660 1290035 1111407 178628 565315 485123 80192 578792 496688 82104 690590 690590 164623 164623 0 0 0 952814 817653 135161 17567 15075 2492 2189276 1878718 310558 177 152 25 0 600975 515724 85251 32098 27545 4553 0 1616 1387 229 1073668 921364 152304 0 1073262 921015 152247 242770 208332 34438 BAD DEBT 156948 156948 LICENSES, DUES & SUBSCRIPTIONS 14496 12440 2056 RECRUITING 3348 2873 475 MEDICAL SUPPLIES & DRUGS 244012 244012 REPAIRS & MAINTENANCE 12327 10578 1749 8254 7088 1166 17333084 14197298 3135786 0 231970 114393 1662842 0 1711729 2035946 36946 0 1366756 1233724 105 19157327 105 3464769 0 27632339 3384168 2090662 1390074 11704174 0 16635308 0 9171838 22780377 39601982 24170451 X -11969643 -20786283 -11969643 -20786283 27632339 3384168 X false false false X 17182340 17456798 17225470 15177685 13141085 80183378 17182340 17456798 17225470 15177685 13141085 80183378 80183378 103418 162606 64443 4653 142 335262 103418 162606 64443 4653 142 335262 17285758 17619404 17289913 15182338 13141227 80518640 0.99584 0.99481 0.00416 0.00519 X false false false false false false false false true false LOBBYING ACTIVITIES SCHEDULE C, PART II-B, LINE 1I THE ORGANIZATION IS A MEMBER OF THE MASSACHUSETTS FEDERATION OF EXTENDED CARE FACILITIES AND THE MASSACHUSETTS EXTENDED CARE FEDERATION. A PORTION OF THE DUES PAID TO MFECF MAY BE USED FOR LOBBYING PURPOSES; HOWEVER, THE SPECIFIC AMOUNT IS UNKNOWN. 105 105 105 0 DUE TO AFFILIATE 22780377 22780377 false true false false false false false false false RICHARD PALMISANO 52982 187845 11231 39822 23441 83110 3791 13437 5091 18049 96536 342263 CHRISTOPHER HICKEY 0 190526 0 10000 0 11621 0 0 0 1235 0 213382 PAUL DONOVAN 0 321561 0 0 0 4509 0 18542 0 18140 0 362752 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B RICHARD PALMISANO, CEO/PRESIDENT, PARTICIPATES IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. IN THE CURRENT YEAR, CONTRIBUTIONS WERE $93,494. BONUS SCHEDULE J RICHARD PALMISANO AND CHRISTOPHER HICKEY RECEIVE AN ANNUAL BONUS OF UP TO A CERTAIN PERCENT OF BASE SALARY UPON ACCOMPLISHMENT OF GOALS AND OBJECTIVES ESTABLISHED ANNUALLY BY THE BOARD. THEY ARE PAID BY NORTHERN BERKSHIRE HEALTHCARE, WITH A PORTION OF COMPENSATION, INCLUDING BONUS, ALLOCATED TO RELATED ORGANIZATIONS. COMPENSATION DETERMINATION SCHEDULE J, PART I, LINE 3 NORTHERN BERKSHIRE HEALTHCARE, A RELATED ORGANIZATION, DETERMINES COMPENSATION FOR THE CEO USING THE FOLLOWING METHODS: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -FORM 990 OF OTHER ORGANIZATIONS -WRITTEN EMPLOYMENT CONTRACT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE INVENTORY 2010-08-15 45167 PRCHASE PRICE ALLOCATION 273200331 GREEN FIELD - DES LLC 173 BRIDGE PLAZA NORTH 7TH FLOOR FORT LEE NJ 07024 LLC FIXED ASSETS 2010-08-15 17160292 PRCHASE PRICE ALLOCATION 273200331 GREEN FIELD - DES LLC 173 BRIDGE PLAZA NORTH 7TH FLOOR FORT LEE NJ 07024 LLC BONDS PAYABLE 2010-08-31 -13585000 COST 222563466 NORTHERN BERKSHIRE HEALTHCARE 71 HOSPITAL AVENUE NORTH ADAMS MA 02147 501(c)(3) DEBT SERVICE FUNDS 2010-08-31 1538278 COST 222563466 NORTHERN BERKSHIRE HEALTHCARE 71 HOSPITAL AVENUE NORTH ADAMS MA 01247 501(c)(3) DERIVATIVE LIABILITY 2010-08-31 -784506 COST 222563466 NORTHERN BERKSHIRE HEALTHCARE 71 HOSPITAL AVENUE NORTH ADAMS MA 01247 501(c)(3) ACCRUED INTEREST PAYABLE 2010-08-31 -103286 COST 222563466 NORTHERN BERKSHIRE HEALTHCARE 71 HOSPITAL AVENUE NORTH ADAMS MA 01247 501(c)(3) false false false false PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINES 4A & 4B 4A) SWEET BROOK IS LICENSED BY THE COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH ("DPH"), AT THE CURRENT TIME 21 BEDS HAVE BEEN REMOVED FROM SERVICE. ALL BEDS ARE ACCREDITED AS SKILLED NURSING BEDS BY THE JOINT COMMISSION, 83 OF THE BEDS ARE DUAL-ACCREDITED BY THE JOINT COMMISSION AND DESIGNATED FOR DEMENTIA CARE AND TREATMENT. SWEET BROOK OPERATES THREE DISTINCT UNITS WITHIN THE FACILITY: THE BIRCHES - A 101 BED SUB-ACUTE, SKILLED NURSING AND REHABILITATION SERVICES, LINDEN COURT - AN 83 BED DEMENTIA CARE SKILLED NURSING SERVICE, AND REHABILITATIVE SERVICES - A FULL-LINE OF REHABILITATIVE SERVICES FOR OUTPATIENTS AS WELL AS RESIDENTS. 4B) EACH UNIT IS EQUIPPED WITH A FULL KITCHEN, CARPET AND WINDOW TREATMENTS, INDIVIDUAL THERMOSTATIC CONTROL FOR HEALING AND AIR CONDITIONING, SMOKE DETECTORS, SPRINKLERS AND A 24-HOUR EMERGENCY CALL SYSTEM. SWEETWOOD'S AMENITIES INCLUDE A CENTRAL DINING FACILITY, AN INDOOR, COUNTER-CURRENT POOL, STATE-OF-THE-ART PHYSICAL FITNESS EQUIPMENT, A LIBRARY, LOUNGE, AND CONVENIENCE STORE, LIVING ROOMS, BAR, RECREATION ROOM, MEETING ROOM, AND GREENHOUSE. SWEETWOOD RESIDENTS ENJOY PERSONAL FREEDOM WHILE EXPERIENCING THE REASSURANCE OF ROUND-THE-CLOCK SECURITY, ASSISTANCE AND THE AVAILABILITY OF EMERGENCY MEDICAL ATTENTION. SWEETWOOD PROVIDES A FULL COMPLEMENT OF SERVICES INCLUDING HOUSEKEEPING, MAINTENANCE, FULL SERVICE DINING, ACTIVITIES, TRANSPORTATION AND HEALTH MAINTENANCE SERVICES. NURSING SERVICES ARE PROVIDED BY SWEETWOOD AS ANCILLARY SERVICES TO THOSE RESIDENTS WHO REQUIRE ASSISTANCE IN ACTIVITIES OF DAILY LIVING. SKILLED NURSING SERVICES ARE AVAILABLE TO RESIDENTS IN THEIR UNITS AND ARE BILLED SEPARATELY. OUTPATIENT REHABILITATION IS ALSO AVAILABLE AT SWEET BROOK. SWEETWOOD WILL FACILITATE THE TRANSFER OF RESIDENTS WHO REQUIRE MORE COMPREHENSIVE CARE TO SWEET BROOK ON A PRIORITY BASIS IF FEASIBLE OR, ALTERNATIVELY, TO ANOTHER FACILITY OF THE RESIDENT'S CHOICE. MANAGEMENT SERVICES FORM 990, PART VI, SECTION A, LINE 3 NORTHERN BERKSHIRE HEALTHCARE AND VISITING NURSE ASSOCIATION & HOSPICE OF NORTHERN BERKSHIRE, RELATED ORGANIZATIONS, PROVIDE MANAGEMENT SERVICES TO THE ORGANIZATION. THE MANAGEMENT FEES PAID TO THESE ORGANIZATIONS ASSOCIATED WITH THIS SERVICE IS SHOWN ON PART IX, LINE 11A. MEMBERS FORM 990, PART VI, SECTION A, LINES 6, 7A & 7B THE ORGANIZATION'S SOLE MEMBER IS NORTHERN BERKSHIRE HEALTHCARE (NBH). NBH ELECTS DIRECTORS NOMINATED BY THE NOMINATING COMMITTEE. AT EACH ANNUAL MEETING, THE MEMBER DETERMINES THE NUMBER OF DIRECTORS FOR THE ENSUING YEAR. A DIRECTOR MAY BE REMOVED WITH OR WITHOUT CAUSE BY VOTE OF THE MEMBER. IN ADDITION, NBH MUST APPROVE ALL AMENDMENTS TO THE BYLAWS. FORM 990 REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11A THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE FORM 990 WILL BE INITIALLY INTERNALLY REVIEWED BY THE CFO. AFTER THIS REVIEW, THE FORM 990 WILL BE GIVEN TO THE BOARD OF DIRECTORS AT THEIR JULY MEETING. THIS WILL ALLOW FOR BOARD MEMBERS TO ASK QUESTIONS, PROVIDE COMMENTS, OR MAKE CHANGES BEFORE THE FINAL FORM 990 IS FILED. CONFLICT OF INTEREST POLICY COMPLIANCE FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY BOARD MEMBERS AND THE SENIOR EXECUTIVE TEAM ARE REQUIRED TO FILL OUT A QUESTIONNAIRE REGARDING CONFLICTS OF INTEREST. THIS YEAR THESE INDIVIDUALS ALSO RESPONDED TO A QUESTIONNAIRE DESIGNED SPECIFICALLY FOR THE FORM 990. IF THERE IS A CONFLICT OF INTEREST, THE BOARD MEMBERS OR EXECUTIVE TEAM MEMBER WOULD RECUSE THEMSELVES FROM THE VOTE. COMPENSATION DETERMINATION FORM 990, PART VI, SECTION B, LINE 15A THE BOARD COMPENSATION COMMITTEE IS COMPOSED OF INDEPENDENT TRUSTEES. THIS COMMITTEE CONDUCTS AN ANNUAL PERFORMANCE EVALUATION. THE EVALUATION IS BASED ON DIRECT OBSERVATION, THE CEO'S COMPLETION OF PRE-DETERMINED GOALS, A CEO SELF-EVALUATION, AND THE RESULTS OF WRITTEN SURVEYS DISTRIBUTED BY THE COMMITTEE TO ALL TRUSTEES, HOSPITAL AND HEALTH SYSTEM EXECUTIVES, AND EMPLOYED PHYSICIANS. THE COMMITTEE ALSO REVIEWS INDEPENDENTLY COLLECTED AND PUBLISHED MARKET DATA FOR CEO COMPENSATION AT SIMILAR FACILITIES, SUCH AS THE ANNUAL MASSACHUSETTS HOSPITAL ASSOCIATION EXECUTIVE COMPENSATION AND/OR SIMILAR DOCUMENTS. CONSIDERING THE PERFORMANCE EVALUATION AND THE MARKET DATA, THE COMPENSATION COMMITTEE THEN MAKES A RECOMMENDATION FOR ANY CHANGES TO THE CEO'S COMPENSATION, WHICH THEN REQUIRES APPROVAL BY A VOTE OF THE FULL BOARD. DURING THE ANNUAL REVIEW PROCESS, THE COMPENSATION COMMITTEE ALSO DEVELOPS THE CEO'S PERFORMANCE GOALS FOR THE UPCOMING YEAR. THE CEO CONDUCTS ANNUAL PERFORMANCE EVALUATIONS FOR EACH EXECUTIVE OR OFFICER, CONSIDERING PERFORMANCE AGAINST PRE-DETERMINED ANNUAL PERFORMANCE GOALS, PERFORMANCE AGAINST THE JOB DESCRIPTION, AND FEEDBACK SURVEYS DISTRIBUTED BY THE HUMAN RESOURCES STAFF TO A GROUP OF PEERS AND SUBORDINATES. AT THIS TIME, THE CEO ALSO REVIEWS INDEPENDENTLY COLLECTED AND PUBLISHED MARKET DATA FOR SIMILAR POSITIONS IN SIMILAR ORGANIZATIONS. BASED ON THE MERITS OF THE PERFORMANCE EVALUATION AND THE COMPARISON TO MARKET DATA, THE CEO DETERMINES ANY CHANGE TO THE OFFICERS' COMPENSATION. COMPENSATION FOR ALL EXECUTIVES AND OFFICERS IS PRESENTED TO THE BOARD OF TRUSTEES ANNUALLY FOR THEIR REVIEW AND COMMENT, BUT CHANGES TO EXECUTIVE COMPENSATION, WITH THE EXCEPTION OF THE CEO, DO NOT REQUIRE BOARD APPROVAL. ALL EXECUTIVE COMPENSATION DECISIONS ARE GUIDED BY THE ORGANIZATION'S STATEMENT OF COMPENSATION PHILOSOPHY AS WELL AS BY GUIDELINES AND REGULATIONS REGARDING EXECUTIVE COMPENSATION IN NON-PROFIT ORGANIZATIONS PUT FORWARD BY THE IRS, THE ATTORNEY GENERAL, AND OTHER RELEVANT GOVERNING BODIES. GOVERNING DOCUMENT AVAILABILITY FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. THE ORGANIZATION'S 990 IS AVAILABLE FOR VIEWING ON-SITE UPON WRITTEN REQUEST TO THE CFO. NORTHERN BERKSHIRE HEALTHCARE 71 HOSPITAL AVENUE NORTH ADAMS MA 01247 222563466 MANAGEMENT CO MA 501(C)(3) 7 NA NORTHERN BERKSHIRE REALTY CO 71 HOSPITAL AVENUE NORTH ADAMS MA 01247 222563465 PROPERTY MGMT MA 501(C)(3) 11A I NA NTHN BERKSHIRE HEALTHCARE PHYSICIANS GRP 71 HOSPITAL AVENUE NORTH ADAMS MA 01247 743253218 PHYS SERVICES MA 501(C)(3) 9 NA REACH COMMUNITY HEALTH FOUNDATION 71 HOSPITAL AVENUE NORTH ADAMS MA 01247 043470287 COMM. ACTIV. MA 501(C)(3) 7 NA VISITING NURSE ASSOCIATION & HOSPICE 71 HOSPITAL AVENUE NORTH ADAMS MA 01247 042910547 HOME HEALTH MA 501(C)(3) 9 NA NORTH ADAMS REGIONAL HOSPITAL 71 HOSPITAL AVENUE NORTH ADAMS MA 01247 041676720 HOSPITAL MA 501(C)(3) 3 NA false false false false false false false false false false false true true true true true true false