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ANCILLARY MEDICAL SERVICES AND TESTING ARE ALSO PROVIDED ON A INPATIENT AND OUTPATIENT BASIS IN AREAS SUCH AS LABORATORY, RADIOLOGY,EKG,EEG, PHARMACY, NUCLEAR MEDICINE,PHYSICAL THERAPY,OCCUPATIONAL THERAPY,RESPIRATORY THERAPY AND I.V. 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N/A N/A CHARITY CARE COSTS FROM WORKSHEETS 1 & 2 AND UNREIMBURSED MEDICAID FROM WORKSHEET 3 AND HEALTH PROFESSIONS EDUCATION FROM WORKSHEET 5 WERE APPLIED TO ALL PATIENT SEGMENTS. ( COST TO CHARGE RATIO ) N/A BAD DEBT EXPENSE 7,927,441 HALLMARK HEALTH SYSTEM, INC. DEVELOPED A COST TO CHARGE RATIO ON WORKSHEET 2 AND APPLIED IT TO THE BAD DEBT ACCOUNT CHARGES THAT WERE ACTUALLY WRITTEN-OFF. THE FOLLOWING IS FROM THE HALLMARK HEALTH CORPORATION CONSOLIDATED AUDITED FINANCIAL STATEMENTS, OF WHICH HALLMARK HEALTH SYSTEM IS INCLUDED, RELATING TO CHARITY CARE AND BAD DEBT EXPENSE : 2010 CHARITY CARE AND COMMUNITY BENEFIT FOOTNOTE CHARITY CARE - THE CORPORATION PROVIDES CARE TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. CONSISTENT WITH ITS TAX-EXEMPT STATUS AND COMMUNITY SERVICE RESPONSIBILITIES, THE CORPORATION PROVIDES FINANCIAL ASSISTANCE IN THE FORM OF FREE OR DISCOUNTED CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER THE CORPORATION'S CHARITY CARE POLICY. IN ASSESSING A PATIENT'S INABILITY TO PAY, THE CORPORATION UTILIZES FEDERAL POVERTY INCOME GUIDELINES AND FOLLOWS PROCEDURES SET FORTH IN ITS CREDIT AND COLLECTION POLICY, WHICH HAS BEEN APPROVED BY THE COMMONWEALTH OF MASSACHUSETTS DIVISION OF HEALTHCARE FINANCE AND POLICY. BECAUSE THE CORPORATION DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THESE AMOUNTS ARE NOT REPORTED AS PATIENT SERVICE REVENUE. DURING THE YEARS ENDED SEPTEMBER 30, 2010 AND 2009, THE CORPORATION PROVIDED 4,976,000 AND 3,849,000 IN CHARITY CARE, RESPECTIVELY. THE EQUIVALENT PERCENTAGE OF CHARITY CARE TO ALL PATIENTS SERVED WAS APPROXIMATELY 0.8% AND 0.6% OF TOTAL PATIENT SERVICE CHARGES FOR THE YEARS ENDED SEPTEMBER 30, 2010 AND 2009, RESPECTIVELY. SUCH AMOUNTS AND PERCENTAGES ARE DETERMINED USING CHARGES FOREGONE BASED ON ESTABLISHED RATES. BAD DEBTS - THE PROVISION FOR BAD DEBTS IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS REFLECTS THE CHARGES AT ESTABLISHED RATES FOR SERVICES PROVIDED TO THOSE INDIVIDUALS WHO DO NOT QUALIFY FOR CHARITY CARE UNDER THE GUIDELINES DESCRIBED ABOVE, AND WHO ARE OTHERWISE UNABLE OR UNWILLING TO PAY THE CORPORATION. HEALTH SAFETY NET (FORMERLY THE UNCOMPENSATED CARE FUND) - THE COMMONWEALTH OF MASSACHUSETTS (THE "COMMONWEALTH") ADMINISTERS A HEALTH SAFETY NET (THE "HSN") TO ACT AS THE "PAYOR OF LAST RESORT" FOR COVERED HEALTH CARE SERVICES PROVIDED BY ACUTE HOSPITALS AND COMMUNITY HEALTH CENTERS IN THE COMMONWEALTH. ALL HOSPITALS HAVE BEEN ASSESSED A UNIFORM ALLOWANCE BASED ON ESTIMATES OF THEIR SHARE OF TOTAL HEALTH SAFETY NET FUNDING AND HAVE BEEN REIMBURSED FOR A PORTION OF THE COST OF ACTUAL UNCOMPENSATED CARE WHICH THEY PROVIDE, SUBJECT TO CERTAIN LIMITATIONS. REIMBURSABLE UNCOMPENSATED CARE INCLUDES NET CHARITY CARE AND BAD DEBTS RESULTING FROM EMERGENCY SERVICES. HOSPITALS' RECOVERIES FROM THE HSN ARE BASED ON REGULATED PAYMENT RATES. THE CORPORATION HAS RECORDED ITS ACTIVITY WITH THE HSN AS A COMPONENT OF NET PATIENT SERVICE REVENUE.. TOTAL UNCOMPENSATED CARE PROVIDED BY ALL RELATED CORPORATIONS FOR THE YEARS ENDED SEPTEMBER 30, 2010 AND 2009, IS AS FOLLOWS: 2010 2009 PROVISION FOR CHARITY CARE 4,975,782 3,848,552 PROVISION FOR BAD DEBTS 8,340,634 8,251,216 HSN - NET 799,707 159,118 TOTAL UNCOMPENSATED CARE 14,116,123 12,258,886 TOTAL HALLMARK HEALTH SYSTEM,INC. UNCOMPENSATED CARE FOR FYE 2010 & 2009 2010 2009 PROVISION FOR CHARITY CARE 4,953,402 3,831,182 PROVISION FOR BAD DEBTS 7,927,441 7,831,437 HSN - NET 799,707 159,118 TOTAL UNCOMPENSATED CARE 13,680,550 11,821,737 COMMUNITY BENEFIT - IN FURTHERING ITS CHARITABLE PURPOSE, THE CORPORATION PROVIDES A WIDE VARIETY OF HEALTH CARE SERVICES TO THE COMMUNITY IN ORDER TO PROVIDE ACCESS TO APPROPRIATE CARE FOR POPULATIONS IN NEED. THE CORPORATION HAS DEVELOPED A FORMAL COMMUNITY BENEFIT PLAN, WHICH RESPONDS TO A COMPREHENSIVE ASSESSMENT OF HEALTH CARE NEEDS IN THE COMMUNITY. THE COMMUNITY BENEFIT PLAN SUPPORTS SERVICES WHICH TARGET NOT ONLY THE GENERAL POPULATION IN THE CORPORATION'S SERVICE AREA, BUT ALSO PARTICULAR POPULATIONS WITH SPECIAL HEALTH CARE NEEDS, INCLUDING THE POOR, THE ELDERLY, CHILDREN, AND MINORITY POPULATIONS. SUPPORTED SERVICES INCLUDE VARIOUS CLINICS, HEALTH SCREENING PROGRAMS, HEALTH EDUCATION PROGRAMS, AND SUPPORT GROUPS OPERATED IN THE CORPORATION'S SERVICE AREA. THE CORPORATION WORKS ACTIVELY WITH OTHER AREA SERVICE PROVIDERS TO FACILITATE THE DEVELOPMENT OF AN EFFECTIVE COMMUNITY HEALTH NETWORK. THE CORPORATION ALSO PARTICIPATES IN ACTIVITIES DESIGNED TO FOSTER AND ENHANCE THE ECONOMIC AND CIVIC ENVIRONMENT OF ITS SERVICE AREAS. MEDICARE REIMBURSEMENT SHORTFALL USING ALLOWABLE COSTS FROM MEDICARE COST REPORT. POLICY- " COLLECTION ACTIVITY IS STOPPED ONCE A PATIENT IS KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE THIS POPULATION IS EXEMPT FROM COLLECTION ACTIVITY. " 0 ALL MASS. REGISTERED INTRODUCTION HALLMARK HEALTH SYSTEM IS A NOT-FOR-PROFIT HOSPITAL THAT OPERATES TO FURTHER THE IMPROVEMENT OF THE HEALTH STATUS TO THE COMMUNITIES THAT WE SERVE THROUGH THE DELIVERY OF HEALTHCARE SERVICES AND EDUCATION. WE DO THIS BY: REINVESTING OUR SURPLUS FUNDS BACK INTO THE COMMUNITIES THROUGH VARIOUS PROGRAMS AND SERVICES MAKING SURE THAT CARE IS AVAILABLE TO EVERYONE - REGARDLESS OF HIS OR HER ABILITY TO PAY. USING COMPASSION AS THE CORNERSTONE FOR OUR WORK TO IMPROVE THE HEALTH OF OUR COMMUNITIES. PATIENTS AND THEIR FAMILIES ARE ALWAYS TREATED AS PEOPLE FIRST -ATTENDING TO THE NEEDS OF THE WHOLE PERSON. PROVIDING A RANGE OF SPECIAL BENEFITS TO THE COMMUNITY, SUCH AS PROGRAMS TO MANAGE CARE FOR PERSONS WITH CHRONIC DISEASES, HEALTH EDUCATION AND DISEASE PREVENTION INITIATIVES, OUTREACH FOR THE ELDERLY, AND CARE FOR PERSONS WHO ARE POOR OR UNINSURED. THE IRS GRANTS US TAX EXEMPTION AS A "CHARITABLE, COMMUNITY-ORIENTED ORGANIZATION." WITHOUT THIS STATUS, WE COULD NOT CONTINUE TO DELIVER THE SAME LEVEL OF COMMUNITY BENEFITS THAT ARE SO IMPORTANT AND NECESSARY.THE FOLLOWING SUMMARIZES A WIDE ARRAY OF ACTIVITIES AND SERVICES THAT MAKE UP OUR COMMUNITY SERVICE BENEFIT PROGRAMS. LINE 2: NEEDS ASSESSMENT - DESCRIBE HOW THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES: HALLMARK HEALTH SYSTEM ("HALLMARK HEALTH") REVIEWS LOCAL, STATE, FOUNDATION AND FEDERAL HEALTH AND SOCIO-ECONOMIC DATA TO IDENTIFY ITS TARGET POPULATIONS. DATA WAS ALSO REVIEWED AS NEEDED WHEN WRITING GRANT PROPOSALS TO FUND COMMUNITY BENEFITS INITIATIVES. IN 2010 HALLMARK HEALTH ALSO COMPLETED THE BI-ANNUAL LANGUAGE NEEDS ASSESSMENT FOR THE MA DEPARTMENT OF PUBLIC HEALTH AND REVIEWED INTERNAL LANGUAGE, RACE AND ETHNICITY ADMISSION STATISTICS. HALLMARK HEALTH ALSO ACTIVELY PARTICIPATED WITH THE COMMUNITY IN AN ONGOING WAY THROUGH OUR COMMUNITY OUTREACH TEAMS, AS MEMBERS OF COMMUNITY COALITIONS, AND IN THE COMMUNITY HEALTH NETWORK AREA PUBLIC HEALTH GROUPS (CHNAS). THESE METHODS HAVE PROVEN TO BE AN EFFECTIVE WAY TO REACH OUT INTO THE COMMUNITY TO GAIN LOCAL PERSPECTIVE AROUND THE HEALTH NEEDS OF AREA RESIDENTS. CURRENTLY, THERE ARE SIX COMMUNITY OUTREACH TEAMS NAMED FOR MALDEN, MEDFORD, MELROSE, WAKEFIELD, READING AND STONEHAM. BY TAILORING OUTREACH AND PROGRAMS BASED ON WHAT INDIVIDUAL COMMUNITIES VALUE MOST, HALLMARK HEALTH HAS DEVELOPED A TRUSTING RELATIONSHIP WITH LOCAL RESIDENTS. THE TEAMS CONTINUOUSLY SOLICIT INPUT FROM KEY COMMUNITY LEADERS AS WELL INCLUDING SUPERINTENDENTS OF SCHOOLS, STATE REPRESENTATIVES, BUSINESS LEADERS, FIRE AND POLICE PERSONNEL AND LOCAL HEALTH DEPARTMENTS. THE COMMUNITY TEAM FUNCTIONS ARE FURTHER EXPLAINED IN LINE 5 COMMUNITY BUILDING ACTIVITIES. ANOTHER WAY THAT HALLMARK HEALTH COMMUNICATES WITH THE COMMUNITY IS THROUGH THE PATIENT/FAMILY ADVISORY COUNCILS. THESE COUNCILS WERE FORMED TO OBTAIN FEEDBACK AND IDEAS FROM COMMUNITY MEMBERS ON HOW THE HOSPITALS CAN BE MORE RECEPTIVE TO THE UNIQUE NEEDS OF COMMUNITY RESIDENTS, ESPECIALLY THOSE OF DIVERSE BACKGROUNDS, AND TO PROMOTE THE HIGHEST QUALITY OF PATIENT-CENTERED SERVICES BY FOSTERING A STRONG PARTNERSHIP THROUGH OUTREACH ACTIVITIES WITH COMMUNITY RESIDENTS. THE COUNCILS OFTEN ASSIST HALLMARK HEALTH STAFF BY PROVIDING INPUT INTO THE PLANNING OF FUTURE COMMUNITY ACTIVITIES AND INITIATIVES. IN 2010, A LARGE HEALTH EVENT WAS PLANNED FOR THE SOUTH MEDFORD NEIGHBORHOOD AND A PROGRAM ON MAKING HOMES HEALTHIER WAS OFFERED AT MELROSE-WAKEFIELD HOSPITAL. THESE EVENTS WERE A DIRECT RESULT OF RECOMMENDATIONS FROM THE MEMBERSHIP OF THE COUNCILS. IN ADDITION, HALLMARK HEALTH FACILITATED FOUR COMMUNITY FOCUS GROUPS, REVIEWED ON-LINE AND PAPER HEALTH ASSESSMENTS COMPLETED BY COMMUNITY RESIDENTS, AND INTERVIEWED THE COMMUNITY TEAMS AND THE MEMBERS OF THE PATIENT/FAMILY ADVISORY COUNCILS. HALLMARK HEALTH STAFF AND LEADERS ARE ALSO MEMBERS OF MANY SOCIAL AND COMMUNITY HEALTH GROUPS/COALITIONS AND SHARE ANECDOTAL COMMUNITY REPORTING REGULARLY WITH THE COMMUNITY SERVICES DEPARTMENT. BASED UPON THE ABOVE NEEDS ASSESSMENT THE FOLLOWING MAJOR COMMUNITY NEEDS WERE IDENTIFIED FOR FISCAL YEAR 9/30/2010. RESIDENTS ESPECIALLY FOCUSED ON UNINSURED OR UNDERINSURED RESIDENTS OF OUR CORE COMMUNITIES AND SPECIFICALLY THE TARGET POPULATIONS IDENTIFIED, TO IMPROVE ACCESS TO CARE. THIS INCLUDES THE RECRUITMENT, EDUCATION, AND TRAINING OF NURSES, PHYSICIANS AND OTHER PRACTITIONERS NEEDED TO CARE FOR THE TARGET POPULATIONS. LOW TO MODERATE INCOME, UN-SERVED AND UNDERSERVED ELDERLY IN OUR COMMUNITIES, ESPECIALLY THOSE LIVING IN THE COMMUNITIES OF EVERETT, MALDEN, MEDFORD, MELROSE, READING, SAUGUS, STONEHAM, WAKEFIELD, AND OTHERS WHERE THE PERCENTAGE OF ELDERLY RESIDENTS IS HIGHER THAN THE STATE AVERAGE. FAMILIES WITH CHILDREN/ADOLESCENTS AT RISK DUE TO POVERTY, ISOLATION, LANGUAGE OR CULTURAL BARRIERS, DOMESTIC VIOLENCE, LACK OF SKILLS TO NAVIGATE THE HEALTH CARE SYSTEM, OR THOSE IN NEED OF DEVELOPING PARENTING SKILLS. BASED ON PUBLIC HEALTH DATA THESE EFFORTS WILL FOCUS ESPECIALLY ON FAMILIES IN BURLINGTON, EVERETT, MALDEN, MEDFORD, MELROSE, NORTH READING, READING, SAUGUS, STONEHAM, WAKEFIELD, WILMINGTON, WINCHESTER, AND WOBURN. FAMILIES AND PATIENTS COPING WITH A VARIETY OF BEHAVIORAL HEALTH ISSUES IN OUR CORE COMMUNITIES. RESIDENTS AT RISK FOR DEVELOPING CARDIOVASCULAR DISEASE OR THOSE EXPERIENCING HEALTH ISSUES DUE TO UNDIAGNOSED OR POORLY UNDERSTOOD CARDIOVASCULAR RISKS INCLUDING THOSE AT RISK FOR DEVELOPING CONGESTIVE HEART FAILURE (CHF) AND FOR SUFFERING A STROKE. COMMUNITY MEMBERS AT RISK FOR DEVELOPING DIABETES OR WITH DIABETES MANAGEMENT ISSUES. COMMUNITY MEMBERS AT RISK FOR DEVELOPING CANCER, WITH A SPECIAL FOCUS ON BREAST/UTERINE AND CERVICAL CANCER, SKIN CANCER, LUNG CANCER AND COLORECTAL CANCER. MEN AND WOMEN NEEDING BONE AND JOINT HEALTH AWARENESS WITH A FOCUS ON INJURY PREVENTION FOR ALL AGES; SPECIFICALLY FALLS PREVENTION, ARTHRITIS AND OSTEOPOROSIS PREVENTION AND DETECTION, AND PREVENTION OF SPORTS INJURIES. MEN, WOMEN, AND CHILDREN WITH WEIGHT MANAGEMENT ISSUES, WITH A SPECIFIC FOCUS ON OBESITY PREVENTION FOR ADULTS AND CHILDREN. THE COMMUNITY AT-LARGE TO BE PREPARED FOR EMERGENCIES, BOTH LOCAL AND MORE PERVASIVE SUCH AS SEASONAL FLU, ACCIDENTS INVOLVING LARGE NUMBERS OF VICTIMS, NATURAL DISASTERS, PANDEMIC FLU, OR TERRORIST ACTIVITIES. HALLMARK HEALTH IS COMMITTED TO AND CONTINUES TO WORK WITH LOCAL GROUPS AND OTHER HEALTH CARE PROVIDERS (HOSPITALS AND OTHER PROVIDERS) TO ACCESS WHERE PARTNERSHIPS AND COLLABORATIONS ARE POSSIBLE TO AVOID DUPLICATION OF SERVICES AND UTILIZE ITS CHARITABLE RESOURCES TO PROVIDE THE GREATEST SERVICES TO THE LARGEST POPULATION OF THOSE MOST IN NEED. MASSACHUSETTS HOSPITALS PROVIDE PATIENTS WITH INFORMATION ABOUT FINANCIAL ASSISTANCE PROGRAMS THROUGH THE COMMONWEALTH OF MA.OR THROUGH THE HOSPIAL'S OWN FINANCIAL ASSISTANCE PROGRAM AS OUTLINED IN THE CREDIT AND COLLECTION POLICY.FOR THOSE PATIENTS THAT REQUEST SUCH ASSISTANCE,THE HOSPITAL ASSISTS PATIENTS BY SCREENING THEM FOR ELIGIBILTY IN AN AVAILABLE PUBLIC PROGRAM AND ASSITING THEM IN APPLYING FOR THE PROGRAM.THE SCREENING AND APPLICATION PROCESS IS DONE THROUGH EITHER THE VIRTUAL GATEWAY( WHICH IS AN INTERNET PORTAL DESIGNED BY MASSACHUSETTS EXECUTIVE OFFICES OF HEALTH AND HUMAN SERVICES TO PROVIDE AN ONLINE APPLICATION FOR THE PROGRAMS OFFERED BY THE STATE)OR THROUGH A STANDARD PAPER APPLICATION.ALL VIRTUAL GATEWAY AND PAPER APPLICATIONS ARE REVIEWED AND PROCESSED BY THE MASSACHUSETTS OFFICE OF MEDICAID WHICH USES FEDERAL POVERTY GUIDELINES AS THE BASIS FOR DETERMINING ELIGIBILITY. HOSPITALS HAVE NO ROLE IN DETERMINING ELIGIBILITY MADE BY THE STATE, BUT AT THE PATIENT'S REQUEST MAY TAKE A DIRECT ROLE IN APPEALING OR SEEKING INFORMATION RELATED TO THE COVERAGE DECISION. HALLMARK HEALTH IS A COMMINITY HOSPITAL LOCATED APPROXIMATELY TEN(10) MILES NORTH OF BOSTON, MASSACHUSETTS.IN THE GREATER BOSTON METROPOLITAN AREA THERE ARE A SIGNIFICANT NUMBER OF ACADEMIC MEDICAL CENTERS AND COMMUNITY HOSPITALS. IN THE PRIMARY AND SECONDARY AREA COMMUNITIES OF HALLMARK HEALTH, BASED ON DPH CRITERIA USING 2006 INPATIENT DATA AND ZIP CODE ANALYSIS, THE PRIMARY SERVICE AREA INCLUDES MALDEN, MEDFORD, MELROSE, SAUGUS, AND WAKEFIELD AND THE SECONDARY SERVICE AREA INCLUDES EVERETT, LYNNFIELD, NORTH READING, READING, REVERE, STONEHAM, WILMINGTON, AND WINTHROP. FOR COMMUNITY BENEFITS THE GEOGRAPHIC AREA SERVED INCLUDES ADDITIONAL COMMUNITIES. AN EXAMPLE OF THIS IS THE NORTH SUBURBAN WOMEN, INFANTS AND CHILDREN (WIC) PROGRAM SERVES THE TOWNS OF BURLINGTON, WILMINGTON, WINCHESTER, AND WOBURN IN ADDITION TO EVERETT, MALDEN, MEDFORD, MELROSE, NORTH READING, READING, STONEHAM AND WAKEFIELD. HALLMARK HEALTH'S SERVICES AREA IS PRIMARILY WITHIN MIDDLESEX COUNTY. IN THE CORE COMMUNITIES OF HALLMARK HEALTH, WHICH INCLUDES EVERETT, MALDEN, MEDFORD, MELROSE, NORTH READING, READING, SAUGUS, STONEHAM, AND WAKEFIELD, THREE OF THE COMMUNITIES- EVERETT, MALDEN AND MEDFORD, HAVE PER CAPITA INCOME LEVELS BELOW THE STATE AVERAGE. IN EVERETT THE POVERTY RATE IS AT 11.8% AND THE UNEMPLOYMENT RATE IS ALSO HIGHER THAN THE STATE AVERAGE. MALDEN'S PER CAPITA INCOME IS 15% BELOW THE STATE AVERAGE, YET THE POVERTY LEVEL AND UNEMPLOYMENT LEVEL ARE SIMILAR TO THE STATE AVERAGE INDICATING A HIGHER PERCENT OF THE POPULATION ARE THE "WORKING POOR". MEDFORD'S PER CAPITA INCOME IS SLIGHTLY BELOW THE STATE AVERAGE AND UNEMPLOYMENT IS SLIGHTLY BETTER THAN THE REST OF THE STATE. NINETEEN PERCENT (19%) OF THE COMMUNITY IS AT 200% OF POVERTY LEVEL OR BELOW. IN ALL OF THE COMMUNITIES EXCEPT NORTH READING, THE PERCENT OF RESIDENTS' AGE 65 AND OLDER IS GREATER THAN THE STATE AVERAGE. COMMUNITY DEMOGRAPHIC DATA THE DEMOGRAPHIC DIVERSITY AND LANGUAGE NEEDS OF THE POPULATIONS IN HALLMARK HEALTH'S CORE COMMUNITIES IS DETERMINED FROM THE FOLLOWING SOURCES: PROGRAM DATA FROM THE HALLMARK HEALTH INTERPRETER SERVICES PROGRAM, HALLMARK HEALTH'S 2008 INPATIENT DATA, HALLMARK HEALTH NORTH SUBURBAN WOMEN, INFANTS AND CHILDREN (WIC) NUTRITION PROGRAM, AND HEALTHY FAMILIES. MASS CHIP US CENSUS BUREAU REPORT: SELECTED SOCIAL CHARACTERISTICS IN THE UNITED STATES 2005-2007 AMERICAN COMMUNITY SURVEY US CENSUS STATE AND COUNTY QUICKFACTS 2000 MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH REPORT: FIRST LANGUAGE IS NOT ENGLISH (FLNE) AND LIMITED ENGLISH PROFICIENCY (LEP) STUDENTS IN MASSACHUSETTS PUBLIC SCHOOLS 2005-2006 SCHOOL YEAR MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH REPORT: REFUGEE AND IMMIGRANT HEALTH PROGRAM REFUGEE ARRIVALS BY COUNTRY OF ORIGIN 2006-2010 MASSACHUSETTS SCHOOL AND DISTRICT PROFILES, 2008-2009 ENROLLMENT BY RACE/GENDER REPORT ANECDOTAL INFORMATION WAS COLLECTED FROM SOME OF HALLMARK HEALTH'S COMMUNITY PARTNERS SUCH AS THE JOINT COMMITTEE FOR CHILDREN'S HEALTH CARE IN EVERETT, HEALTHY MALDEN, INC., AND HALLMARK HEALTH COMMUNITY TEAM REPRESENTATIVES. RACIAL/ETHNIC DIVERSITY THE CULTURES REPRESENTED IN THE AFOREMENTIONED POPULATION INCLUDE, BUT ARE NOT LIMITED TO, PATIENTS FROM PUERTO RICO, THE DOMINICAN REPUBLIC, COLOMBIA, BRAZIL, CAPE VERDE, CHINA, CAMBODIA, VIETNAM, HAITI, TURKEY, ITALY, FRANCE, ALBANIA, GREECE, INDIA, THE WEST INDIES, AFRICAN NATIONS, SUCH AS CAMEROON, AFRICAN AMERICANS, EASTERN EUROPEANS, MULTI-ETHNIC FAMILIES, AND PATIENTS OF ALL CULTURES WHO ARE ALSO DEAF AND HARD OF HEARING. THE DIVERSITY OF THE HALLMARK HEALTH COMMUNITIES IS ALSO VERY DIFFERENT. BOTH EVERETT AND MALDEN HAVE POPULATIONS COMPRISED OF A HIGHER NUMBER OF BLACK RESIDENTS (7.9% IN EVERETT AND 10.1% IN MALDEN) THAN THE REST OF THE STATE AND IN MALDEN, THE PERCENTAGE OF ASIAN RESIDENTS IS 19%, ALSO HIGHER THAN THE STATE AVERAGE. IN EVERETT THE HISPANIC POPULATION IS HIGHER THAN THE STATE AVERAGE AT 11%. IN MEDFORD THE PERCENT OF BLACK RESIDENTS IS TWO PERCENT HIGHER THAN OTHER COMMUNITIES WHILE THE ASIAN POPULATION IS SLIGHTLY HIGHER THAN THE REST OF THE STATE. THE COMMUNITIES OF MELROSE, NORTH READING, READING, STONEHAM, SAUGUS, AND WAKEFIELD HAVE PRIMARILY WHITE POPULATIONS WITH SMALLER ASIAN, HISPANIC, AND BLACK POPULATIONS. HALLMARK HEALTH DATA FOR 2008 DEMONSTRATES THAT OVERALL 90.3% OF THE POPULATION USING THE FACILITIES IN FISCAL YEAR 2008 WERE WHITE, 1.30 % HISPANIC, 3.8% BLACK, 2.3% ASIAN, 0.06% NATIVE AMERICAN, AND 2.2% REPORTED THEIR RACE-ETHNICITY AS UNKNOWN. IN MIDDLESEX COUNTY IN 2007, POPULATION STATISTICS REPORT 86.1% OF THE POPULATION AS WHITE, 5.1% HISPANIC, 4.20% BLACK, 8.2% ASIAN, 0.20 % NATIVE AMERICAN AND 1.3% AS UNKNOWN FOR RACE-ETHNICITY. LANGUAGE: BASED ON STATE DATA, THE MOST COMMON LANGUAGES SPOKEN IN HALLMARK HEALTH'S SERVICE AREA, OTHER THAN ENGLISH ARE SPANISH, PORTUGUESE, CHINESE, HAITIAN CREOLE AND VIETNAMESE. OTHER LANGUAGES THAT ARE NOT AS COMMON BUT SPOKEN BY MEMBERS OF THE COMMUNITY ARE AMERICAN SIGN LANGUAGE, ARABIC, FRENCH, ITALIAN, KHMER/CAMBODIAN, KOREAN, POLISH, RUSSIAN, AND TURKISH. IN TOTAL, RESIDENTS IN OUR SERVICE AREA SPEAK OVER 35 DIFFERENT LANGUAGES. REVIEWING MASSACHUSETTS SCHOOL DATA FOR SCHOOL YEAR 2005-2006: IN EVERETT, 42.3% OF STUDENTS IDENTIFIED AS FIRST LANGUAGE NOT ENGLISH (FLNE). EVERETT HAS THE 5TH LARGEST STUDENT POPULATION OF PORTUGUESE SPEAKERS IN THE STATE, 28.2% OF THE STUDENT POPULATION, AND 4.6% OF THE TOTAL STATE STUDENT POPULATION. IN MALDEN, 34.3% OF STUDENTS WERE FLNE. MALDEN HAS THE FOURTH LARGEST STUDENT POPULATION OF CHINESE SPEAKERS IN THE STATE, 25.7% OF THE STUDENT POPULATION, AND 6.1% OF THE TOTAL STATE STUDENT POPULATION, THE FIFTH LARGEST STUDENT POPULATION OF VIETNAMESE SPEAKERS IN THE STATE, 11.2 % OF THE TOTAL STATE STUDENT POPULATION, AND 4.2% OF THE TOTAL STATE STUDENT POPULATION: AND THE 5TH LARGEST STUDENT POPULATION OF ARABIC SPEAKERS AT 3.9% OF THE STUDENT POPULATION, AND 4.2% OF THE TOTAL STATE STUDENT POPULATION. IN MEDFORD, 16% OF THE STUDENTS WERE FLNE. IN REVERE, 39.5% OF STUDENTS WERE FLNE. REVERE HAS THE 2ND HIGHEST STUDENT POPULATION OF ARABIC SPEAKERS, 7.2% OF THE STUDENT POPULATION, AND 8.3% OF THE TOTAL STATE STUDENT POPULATION; AND THE 4TH HIGHEST STUDENT POPULATION OF KHMER SPEAKERS, 11.1% OF THE STUDENT POPULATION, AND 4.8% OF THE TOTAL STATE STUDENT POPULATION. IN WOBURN, 10.1 % OF THE STUDENTS WERE FLNE. THE INTERPRETER SERVICES DEPARTMENT ALSO NOTED AN OVERALL INCREASE IN INTERPRETER REQUESTS FROM 1,444 REQUESTS IN 2007, TO 2,178 REQUESTS IN 2008; A 33.7% INCREASE IN THE TOTAL NUMBER OF REQUESTS. HALLMARK HEALTH CONTRACTS WITH A SERVICE PROVIDER FOR A VARIETY OF LANGUAGE INTERPRETERS AND ALSO THE MASSACHUSETTS COMMISSION FOR THE DEAF AND HARD OF HEARING FOR AMERICAN SIGN LANGUAGE INTERPRETERS (ASL). THE PROGRAM ALSO EMPLOYS SOME PER DIEM STAFF INTERPRETERS TO SUPPLEMENT THE INTERPRETER SERVICES CONTRACT. IN ADDITION, THE PROGRAM OFFERS LANGUAGE LINE TELEPHONE INTERPRETER SERVICES FOR RARELY ENCOUNTERED LANGUAGES, WHEN THEY ARE UNABLE TO ACCESS TIMELY INTERPRETER SERVICES, OR FOR EMERGENCIES. AS PART OF ITS EFFORTS TO IMPROVE THE HEALTH STATUS OF ITS CORE COMMUNITIES, HALLMARK HEALTH PARTICIPATES IN A VARIETY OF BROAD-BASED COMMUNITY COALITIONS AND INITIATIVES THAT WORK TOWARDS ADDRESSING THE SPECIFIC AND GENERAL HEALTH NEEDS IN THESE CITIES AND TOWNS. A SAMPLE OF CURRENT MEMBERSHIP INCLUDE: MALDEN HIGH SCHOOL TEEN PARENT TASK FORCE, THE EVERETT COMMUNITY PARTNERSHIP AND LEAD PREVENTION COMMITTEE, MYSTIC VALLEY ELDER SERVICES PROVIDER TASK FORCE, LOCAL COUNCILS ON AGING, HEALTHY FAMILIES COMMUNITY COALITION, MEDFORD FAMILY RESOURCE COALITION, THE MELROSE SUBSTANCE ABUSE PREVENTION COALITION, AND THE MALDEN/EVERETT, AND MEDFORD FAMILY NETWORKS. A SPECIFIC EXAMPLE OF THIS COMMUNITY BUILDING IS HALLMARK HEALTH'S LEADERSHIP OF THE MELROSE ALLIANCE AGAINST VIOLENCE (MAAV). THE MELROSE ALLIANCE AGAINST VIOLENCE (MAAV) IS A NON-PROFIT, COMMUNITY-BASED ORGANIZATION THAT FOCUSES ON OUTREACH, EDUCATION AND COMMUNITY COLLABORATION IN ORDER TO RAISE AWARENESS OF THE PROBLEMS OF VIOLENCE IN MELROSE. WORKING CLOSELY WITH THE MELROSE POLICE DEPARTMENT THE BOARD OF DIRECTORS INCLUDES REPRESENTATIVES FROM THE POLICE, SCHOOLS, CLERGY, HOSPITAL, BUSINESS COMMUNITY, HEALTH DEPARTMENT, STUDENTS, AND COMMUNITY MEMBERS AT LARGE. HALLMARK HEALTH IS PARTNERING WITH MAAV ON "SAFE SPACE" A PROGRAM DESIGNED TO SUPPORT DOMESTIC VIOLENCE VICTIMS WITH RESOURCES AND PLACEMENTS. IN ADDITION, HALLMARK HEALTH HAS ESTABLISHED A NUMBER OF COMMUNITY OUTREACH TEAMS TO ASSIST WITH COLLECTION OF COMMUNITY NEED INFORMATION AND HEALTH EDUCATION AND SCREENINGS. THE TEAMS HAVE SPONSORED EVENTS RANGING FROM INFORMAL (RECREATION, SPORTING EVENTS) TO FORMAL, (COMMUNITY HEALTH FAIRS) THEREBY PROMOTING MULTIPLE OPPORTUNITIES TO INTERACT WITH A WIDE RANGE OF COMMUNITY MEMBERS IN WAYS THAT BUILD A TRUSTING RELATIONSHIP, KEY TO TRULY LISTENING TO THE VOICE OF INDIVIDUAL COMMUNITY MEMBERS. AS HALLMARK HEALTH MOVES FORWARD IN ITS COMMUNITY BENEFITS PLANNING PROCESS, IT WILL CONTINUE TO UTILIZE THE COLLECTIVE KNOWLEDGE OF THE TEAMS. TO THIS AIM, THE TEAMS' ORGANIZING CHARTERS HAVE BEEN REWRITTEN TO HELP GUIDE THE MEMBERSHIP TOWARD MORE FORMAL COMMUNITY SERVICES/COMMUNITY BENEFITS ACTIVITIES. RELEVANT HEALTH DATA AND THE IDENTIFIED TARGET POPULATION LISTS IS PROVIDED FOR EACH TEAM CAPTAIN TO ASSIST THEM IN PLANNING PROGRAMS IN THEIR COMMUNITIES. CURRENTLY, THERE ARE SIX (6) COMMUNITY OUTREACH TEAMS NAMED FOR MALDEN, MEDFORD, MELROSE, WAKEFIELD, READING AND STONEHAM. THE TEAMS CONTINUOUSLY SOLICIT INPUT FROM KEY COMMUNITY LEADERS INCLUDING SUPERINTENDENTS OF SCHOOLS, STATE REPRESENTATIVES, BUSINESS LEADERS, FIRE AND POLICE PERSONNEL AND LOCAL HEALTH DEPARTMENTS. MANY OF THE EMPLOYEES AT HALLMARK HEALTH, WHO SERVE ON THE TEAMS, ALSO PARTICIPATE IN A NUMBER OF OTHER COMMUNITY GROUPS AND CIVIC ORGANIZATIONS. EMPLOYEE VOLUNTEERS STAFF THE COMMUNITY TEAMS. MORE THAN 100 EMPLOYEES, VOLUNTEERS, AND PHYSICIANS WERE INVOLVED IN A TEAM OR A TEAM-SPONSORED EVENT IN 2008. IN 2008, THE TEAM MEMBERS LOGGED MORE THAN 1,700 HOURS TOWARD TEAM EVENTS AND AS ACTIVE MEMBERS IN OVER 20 CIVIC GROUPS IN THE REGION. THE COMMUNITY TEAMS EFFORTS HAVE BEEN ACKNOWLEDGED BY FOUR AREA CHAMBERS OF COMMERCE, OTHER CIVIC ORGANIZATIONS, THE HOUSE OF REPRESENTATIVES, THE AMERICAN HOSPITAL ASSOCIATION, AND THE MASSACHUSETTS HOSPITAL ASSOCIATION. HALLMARK HEALTH HAS A 21 MEMBER COMMUNITY BOARD COMPRISED OF A MAJORITY OF COMMUNITY MEMBERS. ONLY THREE (3) OF THE 18 BOARD MEMBERS ARE EMPLOYED BY HALLMARK HEALTH OR THE HOSPITAL'S PARENT CORPORATION, HALLMARK HEALTH CORPORATION (THE CHIEF EXECUTIVE OFFICER, THE CHIEF MEDICAL OFFICER AND AN EMPLOYED PHYSICIAN MEMBER). THE MEDICAL STAFF OF HALLMARK HEALTH IS ORGANIZED IN THE PUBLIC INTEREST. MEDICAL STAFF MEMBERSHIP AND PRIVILEGES ARE OPEN AND AVAILABLE TO ALL QUALIFIED PHYSICIANS. WE HAVE A LARGE AND DIVERSE MEDICAL STAFF OF OVER 500 MEMBERS. HALLMARK HEALTH OPERATES TWO VERY ACTIVE EMERGENCY ROOMS AT ITS CAMPUSES. THEY ARE ACCESSIBLE TO ANYONE NEEDING CARE REGARDLESS OF THEIR ABILITY TO PAY. NO PART OF THE INCOME OF HALLMARK HEALTH INURES TO THE BENEFIT OF ANY PRIVATE INDIVIDUAL NOR IS ANY PRIVATE INTEREST BEING SERVED. ALL SURPLUS FUNDS ARE REINVESTED INTO THE FACILITIES, EQUIPMENT OR PROGRAMS OF HALLMARK HEALTH TO IMPROVE THE QUALITY OF PATIENT CARE, ACCESS TO CARE, ADVANCE MEDICAL PRACTICE AND TO IMPROVE COMMUNITY HEALTH STATUS. HALLMARK HEALTH'S RESPONSIVENESS TO THE NEEDS OF OUR COMMUNITIES IS EVIDENCED BY OUR WILLINGNESS TO PROVIDE AND/OR PARTICIPATE IN A BROAD RANGE OF COMMITTEES, COALITIONS, PANELS, ADVISORY GROUPS AND COMMISSIONS IN ORDER PROMOTE OUR MISSION OF IMPROVING HEALTH STATUS AND PROVIDING THE EFFICIENT DELIVERY OF HIGH QUALITY HEALTH CARE TO OUR COMMUNITIES. HALLMARK HEALTH SYSTEM IS A COMMUNITY HOSPITAL WITH MULTIPLE CAMPUSES AND IS A MEMBER OF HALLMARK HEALTH CORPORATION ("HHC"). HHC HAS OTHER MEMBER ORGANIZATIONS THAT INCLUDE A SUBSTANTIAL HOME HEALTH VISITING NURSE AND HOSPICE ENTITY AND A PHYSICIAN PRACTICE ORGANIZATION. A COMPREHENSIVE SYSTEM APPROACH IS TAKEN TO PROVIDING COMMUNITY BENEFITS. ALL AFFILIATED ENTITIES PROVIDE PATIENT CARE WITHOUT CONSIDERATION OF A PATIENT'S ABILITY TO PAY. ALL SURPLUS FUNDS OF THE AFFILIATED ENTITIES IS REINVESTED IN PROVIDING ACCESS TO HEALTH SERVICES AND IMPROVING THE HEALTH STATUS OF THE COMMUNITIES SERVED. MA X X X X X false false false false false false false false false MVSACK 575123 27350 76104 5269 93550 777396 EPBUTLER MD 235112 191563 8471 4607 63142 502895 J NANIA 332950 16150 26707 4807 79060 459674 K HOPPE 218744 61400 2489 6814 289447 M TURILLI 181886 850 10896 19812 213444 S HAND 177629 12850 2223 18703 211405 M MCCARTHY 160813 21594 6454 2493 22966 214320 TGIOVE 171346 850 1750 8536 182482 BPINELLE 149336 7600 5822 1313 24589 188660 B WALLACE 158355 850 1788 8989 169982 JOSEPH PENNACCHIO MD 408495 68350 2398 18259 497502 SHELDON RANDALL MD 250000 112600 362600 R EISENBERG MD 325399 100 313 23733 349545 GAMEL A RAGHEB MD 253955 3823 3077 3232 24407 288494 ROBERT WELCH MD 225380 7299 2593 32124 267396 MHEFA (COMM OF MASS ) 042456011 57586ECF6 2008-12-19 23020000 REFUND SERIES B 1998 false false 21675000 59981 2001 true false true true false false false false false false true true false false false false 4352066 DOING BUSINESS AS FORM 990, PAGE 1, ITEM C MEDFORD MELROSE-WAKEFIELD HOSPITAL MANAGEMENT DELEGATED FORM 990, PAGE 6, PART VI, LINE 3 MANAGEMENT SERVICES ARE PERFORMED BY ONE OR MORE EMPLOYEES OF ONE OR MORE RELATED CORPORATIONS. SEE PART VII SECTION A , SCHEDULE J PART II , AND/OR SCHEDULE R PART V TRANSACTION TYPE L. CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PAGE 6, PART VI, LINE 6 HALLMARK HEALTH SYSTEM, INC. HAS MEMBERS. ELECTION OF MEMBERS AND THEIR RIGHTS FORM 990, PAGE 6, PART VI, LINE 7A MEMBERS ELECT BOARD OF TRUSTEES DECISIONS SUBJECT TO APPROVAL OF MEMBERS FORM 990, PAGE 6, PART VI, LINE 7B MEMBERS HAVE RIGHTS TO APPROVE DECISIONS OF BOARD AS REQUIRED BY THE ORGANIZATION'S ARTICLES, BYLAWS AND LAWS OF THE COMMONWEALTH OF MASSACHUSTTS. ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11 FORM 990 WAS PROVIDED TO THE GOVERNING BODY AND REVIEWED AT THE AUDIT & COMPLIANCE COMMITTEE PRIOR TO FILING. ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C ANNUALLY THE GOVERNING BODY AND KEY EMPLOYEES ARE SENT THE POLICY AND REQUIRED TO COMPLETE A DISCLOSURE FORM THAT IS SUBMITTED TO THE OFFICE OF GENERAL COUNSEL FOR REVIEW.THE CONTENTS OF THE DISCLOSURES AND ACTIONS NECESSARY TO ADDRESS CONFLICTS ARE REVIEWED WITH THE CHAIR OF THE GOVERNING BODY'S BOARD AND CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A ANNUALLY THE HUMAN RESOURCES COMMITTE OF THE ORGANIZATION COMPRISED OF INDEPENDENT DIRECTORS REVIEWS THE COMPENSATION OF THE PRESIDENT USING DATA FROM AN INDEPENDENT THIRD PARTY EVALUATION OF COMPARABLE COMPENSATION DATA TO ASSESS AND SET COMPENSATION. COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B ANNUALLY THE HUMAN RESOURCES COMMITTE OF THE ORGANIZATION COMPRISED OF INDEPENDENT DIRECTORS REVIEWS THE COMPENSATION OF THE PRESIDENT AND OTHER OFFICERS AND KEY EMPLOYEES USING DATA FROM AN INDEPENDENT THIRD PARTY EVALUATION OF COMPARABLE COMPENSATION DATA TO ASSESS AND SET COMPENSATION. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 DOCUMENTS ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST TO THE OFFICE OF GENERAL COUNSEL. REASON FOR NOT UNDERGOING REQUIRED AUDIT FORM 990, PAGE 11, PART XI, LINE 3B FINANCIAL STATEMENTS ARE COMPILED, REVIEWED AND AUDITED ON A CONSOLIDATED BASIS.HOWEVER SCHOOL OF NURSING PERFORMS REQUIRED AUDIT AS NECESSARY FOR FEDERAL AWARDS. 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