HENRY HEYWOOD MEMORIAL HOSPITAL: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- HENRY HEYWOOD MEMORIAL HOSPITAL (EIN 04-2103581)
- Tax period
- 2009-10-01 to 2010-09-30
- Filed
- 2011-04-26
- IRS object ID
- 201141229349300594
- Schema version
- 2009v1.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
- Reasonable Cause Explanation
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-04-26T09:17:00-07:00 | Timestamp |
| Tax Period End Date | 2010-09-30 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 042103581 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HENRY HEYWOOD MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HENR | NameControl |
| Phone | 9786303420 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 242 GREEN STREET | AddressLine1 |
| City | GARDNER | City |
| State | MA | State |
| ZIP Code | 01440 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Robert Crosby | Name |
| Title | Sr VP of Finance, Treasurer, CFO | Title |
| Phone | 9786306157 | Phone |
| Date Signed | 2011-04-29 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | ROBERT CROSBY | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 242 GREEN STREET | AddressLine1 |
| City | GARDNER | City |
| State | MA | State |
| ZIP Code | 01440 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 100971490 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.heywood.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1907 | YearFormation |
| State Legal Domicile | MA | StateLegalDomicile |
| Activity Or Mission Description | Heywood Hospital is a community oriented and supported not-for-profit acute care hospital governed by a local Board of Trustees. Our mission reflects the views and adeals of, and is upheld by, our trustees, incorporators, employees, physicians and volunteers. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 21 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 20 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1011 | TotalNbrEmployees |
| Total Nbr Volunteers | 278 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1243719 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 2930001 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 90905166 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 95394047 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -1266241 | InvestmentIncomePriorYear |
| Investment Income Current Year | 167930 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1069987 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1133754 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 91952631 | TotalRevenuePriorYear |
| Total Revenue Current Year | 99625732 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 50000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 50000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 47089606 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 48844530 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 11021 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 1196 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 107753 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 44540726 | OtherExpensePriorYear |
| Other Expenses Current Year | 45560571 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 91691353 | TotalExpensesPriorYear |
| Total Expenses Current Year | 94456297 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 261278 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 5169435 | RevenuesLessExpensesCY |
| Total Assets BOY | 88289608 | TotalAssetsBOY |
| Total Assets EOY | 93803027 | TotalAssetsEOY |
| Total Liabilities BOY | 44175900 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 47803730 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 44113708 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 45999297 | NetAssetsOrFundBalancesEOY |
| Mission Description | A community oriented and supported not-for-profit acute care hospital serving those who work and live in the area. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 89674163 | Expense |
| Grants | 50000 | Grants |
| Revenue | 95394047 | Revenue |
| Description | Heywood Hospital is dedicated to the community benefit goals of improving the health status of our community, addressing the special health care needs of the underserved and collaborating with others to enhance quality and contain the growth of community health care costs. Details to this are published in "The Community Benefit Report of Heywood Hospital - Fiscal Year 2010" filed with the MA Attorney General Office on February | Description |
| Total Of Other Program Service Exp | 0 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 0 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 0 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 89674163 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 1 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 146 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1011 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Form8899 Filed | 0 | Form8899Filed |
| Form1098 C Filed | 0 | Form1098CFiled |
| Taxable Distributions | 0 | TaxableDistributions |
| Distribution To Donor | 0 | DistributionToDonor |
| Nbr Voting Governing Body Members | 21 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 20 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Robert Crosby | NamePerson |
| Telephone Number | 9786306157 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 242 Green Street | AddressLine1 |
| City | Gardner | City |
| State | MA | State |
| ZIP Code | 01440 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (32 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | FormerFormer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| Daniel Asquino | |||||||||
| Chairman | 0 | X | 0 | 0 | 0 | ||||
| Gerald Bankowski | |||||||||
| Treasurer | 0 | X | 0 | 0 | 0 | ||||
| JoAnne Parks | |||||||||
| Clerk | 0 | X | 0 | 0 | 0 | ||||
| Kenneth Pierce | |||||||||
| Vice-Chairman | 0 | X | 0 | 0 | 0 | ||||
| James Faust | |||||||||
| Trustee | 0 | X | 0 | 0 | 0 | ||||
| Joyce Fletcher | |||||||||
| Trustee | 0 | X | 0 | 0 | 0 | ||||
| John Flick | |||||||||
| Trustee | 0 | X | 0 | 0 | 0 | ||||
| James Garrison | |||||||||
| Trustee | 0 | X | 0 | 0 | 0 | ||||
| Paul Harasimowicz DMD | |||||||||
| Trustee | 0 | X | 0 | 0 | 0 | ||||
| Stephen Hemman | |||||||||
| Trustee | 0 | X | 0 | 0 | 0 | ||||
| Glenn Hunt | |||||||||
| Trustee | 0 | X | 0 | 0 | 0 | ||||
| Brian Knuuttila | |||||||||
| Trustee | 0 | X | 0 | 0 | 0 | ||||
| Anthony Kraskouskas | |||||||||
| Trustee | 0 | X | 0 | 0 | 0 | ||||
| Janet Latour | |||||||||
| Trustee | 0 | X | 0 | 0 | 0 | ||||
| John Mulqueen | |||||||||
| Trustee | 0 | X | 0 | 0 | 0 | ||||
| Michele Parker MD | |||||||||
| Trustee | 0 | X | 0 | 0 | 0 | ||||
| Tina Sbrega | |||||||||
| Trustee | 0 | X | 0 | 0 | 0 | ||||
| John Skrzypczak MD | |||||||||
| Trustee | 0 | X | 0 | 0 | 0 | ||||
| Karl Sorenson MD | |||||||||
| Trustee | 0 | X | 0 | 0 | 0 | ||||
| Edmund Taylor | |||||||||
| Trustee | 0 | X | 0 | 0 | 0 | ||||
| Daniel P Moen | |||||||||
| President / CEO | 40 | X | 359483 | 0 | 26643 | X | X | ||
| Robert Crosby | |||||||||
| Sr. VP of Finance / CFO | 40 | 0 | 0 | 0 | X | ||||
| James Mullen | |||||||||
| Sr VP of Patient Care | 40 | 199469 | 0 | 26459 | X | ||||
| Thomas Cady | |||||||||
| VP of Human Resources | 40 | 159517 | 0 | 22721 | X | ||||
| Rose Kavalchuck | |||||||||
| VP of Quality Services | 40 | 143002 | 0 | 20808 | X | ||||
| Lorie Martiska | |||||||||
| VP of Community Relations | 30 | 106482 | 0 | 10934 | X | ||||
| Theresa Koehler | |||||||||
| VP of Finance / CFP | 40 | 161079 | 0 | 14752 | X | X | |||
| Jeffrey Blake | |||||||||
| OB/GYN Physician | 32 | 0 | 436126 | 27273 | X | ||||
| Robert Terlato | |||||||||
| Cardiology Physician | 32 | 0 | 412653 | 26838 | X | ||||
| Peter Brassard | |||||||||
| Ortho Physician | 32 | 0 | 401802 | 23525 | X | ||||
| Michael Stauder | |||||||||
| Cardiology Physician | 32 | 0 | 375090 | 26143 | X | ||||
| Francis Garofalo | |||||||||
| Urologist | 32 | 0 | 324814 | 69223 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1129032 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1950485 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 295319 | TotalOtherCompensation |
| Number Individuals GT100 K | 35 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| William A Berry & Sons | |||||
| 99 Conifer Hill Drive | Danvers | MA | 01923 | Construction Services | 12885084 |
| Quartulli & Associates | |||||
| PO Box 423 | Gardner | MA | 01440 | Physical Therapy | 2720684 |
| Bay State Emergency Med | |||||
| 44 Crosby Road | Ashburnham | MA | 01430 | Emergency Rom Physicians | 2534967 |
| Alliance Healthcare Services | |||||
| 100 Bay View Circle | Newport Beach | CA | 92660 | MRI | 1221673 |
| Quest Diagnostics | |||||
| 5763 Collection Center Drive | Chicago | IL | 60693 | Contracted Services | 755533 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 33 | NumberOfContractorsGT100K |
| Federated Campaigns | 0 | FederatedCampaigns |
| Membership Dues | 0 | MembershipDues |
| Fundraising Events | 38466 | FundraisingEvents |
| Related Organizations | 0 | RelatedOrganizations |
| Government Grants | 232305 | GovernmentGrants |
| All Other Contributions | 2659230 | AllOtherContributions |
| Noncash Contributions | 0 | NoncashContributions |
| Total Contributions | 2930001 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Ancilary O/P Services | 900099 | 52898989 | 52898989 | 0 | $0 |
| Ancilary I/P & Routine Patient Services | 900099 | 41777271 | 41777271 | 0 | $0 |
| Contracted Service Revenue | 900099 | 309434 | 309434 | 0 | $0 |
| HMG Patient Revenue | 900099 | 260086 | 260086 | 0 | $0 |
| Lifeline | 900099 | 68619 | 68619 | 0 | $0 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 79648 | TotalRevenueColumn |
| Related Or Exempt Function Income | 79648 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 95394047 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 265284 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $265,284 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 13857 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $13,857 | ExclusionAmount |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 33623 | Real |
| Personal | 0 | Personal |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 33623 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 33623 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $33,623 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1134762 | Securities |
| Other | 64556 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1168772 | Securities |
| Other | 141757 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -34010 | Securities |
| Other | -77201 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -111211 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | -$111,211 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 28950 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 38466 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 35229 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -6279 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | -$6,279 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Gaming | 0 | GrossIncomeGaming |
| Gaming Direct Expenses | 0 | GamingDirectExpenses |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 0 | GrossSalesOfInventory |
| Cost Of Goods Sold | 0 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Meals Revenue | 900099 | 806592 | 0 | 0 | $806,592 |
| Purchase Discounts | 900099 | 163546 | 0 | 0 | $163,546 |
| Medical Record Copies | 561499 | 20374 | 0 | 0 | $20,374 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 115898 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $115,898 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1106410 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 99625732 | TotalRevenueColumn |
| Related Or Exempt Function Income | 95394047 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,301,684 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50000 | Total |
| Program Services | 50000 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1303283 | Total |
| Program Services | 358037 | ProgramServices |
| Management And General | 945246 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 39589926 | Total |
| Program Services | 38072570 | ProgramServices |
| Management And General | 1456126 | ManagementAndGeneral |
| Fundraising | 61230 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 632277 | Total |
| Program Services | 596789 | ProgramServices |
| Management And General | 34669 | ManagementAndGeneral |
| Fundraising | 819 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4416703 | Total |
| Program Services | 4179956 | ProgramServices |
| Management And General | 235867 | ManagementAndGeneral |
| Fundraising | 880 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2902341 | Total |
| Program Services | 2744411 | ProgramServices |
| Management And General | 153217 | ManagementAndGeneral |
| Fundraising | 4713 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 55269 | Total |
| Program Services | 17550 | ProgramServices |
| Management And General | 37719 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 95900 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 95900 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1196 | Total |
| Fundraising | 1196 | Fundraising |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10899606 | Total |
| Program Services | 10899606 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 91299 | Total |
| Program Services | 87483 | ProgramServices |
| Management And General | 3816 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14149807 | Total |
| Program Services | 13976168 | ProgramServices |
| Management And General | 170636 | ManagementAndGeneral |
| Fundraising | 3003 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 624505 | Total |
| Program Services | 624505 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1729037 | Total |
| Program Services | 1712089 | ProgramServices |
| Management And General | 16948 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40626 | Total |
| Program Services | 39928 | ProgramServices |
| Management And General | 698 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51082 | Total |
| Program Services | 34572 | ProgramServices |
| Management And General | 16510 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 395434 | Total |
| Program Services | 395434 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3393143 | Total |
| Program Services | 3365437 | ProgramServices |
| Management And General | 27706 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 771235 | Total |
| Program Services | 738635 | ProgramServices |
| Management And General | 32600 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Professional Fees | 5160342 | 4083318 | 1041112 | 35912 |
| Provisions for Bad Debt | 3600086 | 3600086 | 0 | 0 |
| Free Care | 2557514 | 2557514 | 0 | 0 |
| Subscriptions and Dues | 422694 | 97740 | 324954 | 0 |
| Laundry and Uniforms | 464555 | 464555 | 0 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1058437 | Total |
| Program Services | 977780 | ProgramServices |
| Management And General | 80657 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 94456297 | Total |
| Program Services | 89674163 | ProgramServices |
| Management And General | 4674381 | ManagementAndGeneral |
| Fundraising | 107753 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2960833 | BOY |
| EOY | 2453099 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4558140 | BOY |
| EOY | 4601826 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10849981 | BOY |
| EOY | 9520061 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 527502 | BOY |
| EOY | 235927 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1663924 | BOY |
| EOY | 1677640 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1323069 | BOY |
| EOY | 1357529 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 95538591 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 41470807 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31602555 | BOY |
| EOY | 54067784 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16838220 | BOY |
| EOY | 15174420 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1965870 | BOY |
| EOY | 2306506 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15999514 | BOY |
| EOY | 2408235 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 88289608 | BOY |
| EOY | 93803027 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13957479 | BOY |
| EOY | 16865672 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25253612 | BOY |
| EOY | 26264155 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1346692 | BOY |
| EOY | 1052456 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3618117 | BOY |
| EOY | 3621447 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44175900 | BOY |
| EOY | 47803730 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36681914 | BOY |
| EOY | 38407900 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6425905 | BOY |
| EOY | 6585434 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1005889 | BOY |
| EOY | 1005963 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44113708 | BOY |
| EOY | 45999297 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 88289608 | BOY |
| EOY | 93803027 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 1 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 15452016 | BeginningOfYearBalance |
| Contributions | 4875 | Contributions |
| Investment Earnings Or Losses | 749235 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 0 | GrantsOrScholarships |
| Other Expenditures | 225000 | OtherExpenditures |
| Administrative Expenses | 0 | AdministrativeExpenses |
| End Of Year Balance | 15981126 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 16606107 | BeginningOfYearBalance |
| Contributions | 5250 | Contributions |
| Investment Earnings Or Losses | -659341 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 0 | GrantsOrScholarships |
| Other Expenditures | 500000 | OtherExpenditures |
| Administrative Expenses | 0 | AdministrativeExpenses |
| End Of Year Balance | 15452016 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.94 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.06 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 125271 | OtherCostOrOtherBasis |
| Book Value | 125271 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 29929038 | OtherCostOrOtherBasis |
| Depreciation | 18164941 | Depreciation |
| Book Value | 11764097 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 0 | Depreciation |
| Book Value | 0 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 32503006 | OtherCostOrOtherBasis |
| Depreciation | 23305866 | Depreciation |
| Book Value | 9197140 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 32981276 | OtherCostOrOtherBasis |
| Depreciation | 0 | Depreciation |
| Book Value | 32981276 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 54067784 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (2 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| Capital Campaign Fund | 618731 | F |
| Ret. & AD&D Policy | 1687775 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 2306506 | TotalOfBookValueSecurities |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Funds Held by Trustee | Description |
| Book Value | 2408235 | BookValue |
| Method Of Valuation | C | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 2408235 | TotalOfBookValueProgramRelated |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Est. Settlement with 3rd Party | Description |
| Amount | $3,621,447 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 3621447 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SchD_P05_S00_L04 | Schedule D, Part V, Line 4 | Perm endow funds established by donor restricted gifts and maintained to provide a permanent source of income. The principal of which is kept in perpetuity. Board Designated endow funds are established by the governing body to fund capital projects and/or improvements of the organization. |
| SchD_P10_S00_L00 | Schedule D, Part X | Footnote: The Hospital and HMG have been determined to be not-for-profit corporations as described in Section 501(c)(3), and the Realty Corp has been determined to be a not-for-profit corporation as described in Section 501(c)(2) of the IRS code, and are exempt from federal income taxes on related income pursuant to Section 501(a) of the code. The IRS has also previously determined that the Hospital is not a private foundation because it is an organization described under the IRC section 170(i)(A)(iii). Any income not substantially related to these Organizations' exempt purposes may be considered unrelated business income under IRC Section 511 and, as such, subject to tax at normal corporate rates. In accordance with generally accepted accounting principles, the Organization annually evaluates its tax status and tax positions taken with respect to its operations and financial position. Tax years from 2006 through the current year remain open for examination by federal and state taxing authorities. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Golf Classic | NameOfEvent1 |
| Gross Receipts Event1 | 67416 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 38466 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 28950 | GrossRevenueEvent1 |
| Cash Prizes Event1 | 2100 | CashPrizesEvent1 |
| Non Cash Prizes Event1 | 4054 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 13014 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 14368 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 0 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 1693 | OtherDirectExpensesEvent1 |
| Food And Beverage Other Events | 0 | FoodAndBeverageOtherEvents |
| Entertainment Other Events | 0 | EntertainmentOtherEvents |
| Gross Receipts Total | 67416 | GrossReceiptsTotal |
| Charitable Contributions Total | 38466 | CharitableContributionsTotal |
| Gross Revenue Total Events | 28950 | GrossRevenueTotalEvents |
| Cash Prizes Total Events | 2100 | CashPrizesTotalEvents |
| Non Cash Prizes Total Events | 4054 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 13014 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 14368 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 0 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 1693 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 35229 | DirectExpenseSummaryEvents |
| Net Income Summary | -6279 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1764142 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 994467 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 769675 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0085 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12583724 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11311505 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1272219 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.014 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 14347866 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12305972 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2041894 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0225 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 667928 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 71646 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 596282 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0066 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 161859 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 161859 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0018 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 112694 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 112694 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0012 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 942481 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 71646 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 870835 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0096 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 15290347 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12377618 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2912729 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0321 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 0 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 0 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 0 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 68662 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 68662 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.0007 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 0 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 52647 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 52647 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.0006 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 2903 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 2903 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 152338 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 152338 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.0017 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 0 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Building Expense | 276550 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 276550 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.0030 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $1,654,142 | BadDebtExpenseAmount |
| Amount Attributable To | 75000 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 26470164 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 25061183 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 1408981 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Henry Heywood Memorial Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 242 Green Street | AddressLine1 |
| City | Gardner | City |
| State | MA | State |
| ZIP Code | 01440 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Costing Method Used | The costing methodology used to calculate the amounts reported in the table in Part I, for lines 7a through 7c was based on the cost to charge ratio derived from the supplied Worksheet 2, in the IRS Schedule H instructions. The costs for lines 7e through 7i were actual costs incurred. | CostingMethodUsed |
| Percent Of Total Expense Expln | The provision for Bad Debt in the amount of $3,600,086 that was reported in Part IX, Line 25, Column A was removed from the total expenses prior to calculating the percent of total expense on the Schedule H, Part I, Line 7, column f. | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | The text to the footnote in our financial statements pertains to the Allowance for Doubtful Accounts: "The Organization provides an allowance for doubtful accounts equal to estimated bad debt losses. The losses are based upon historical collection experience together with a review of the current status of the existing receivables." The costing methodology used for lines 2 was based on the cost to charge ratio dervied from the supplied Worksheet 2 in the IRS Schedule H instructions. The methodlogy used to arrive at the number on line 3 was to take the percentage of financial assistance applications that were denied due to inadequate documentation divided by the total applications received for FY10. This amounted to approximately 4.5% which was applied against the number on line 2. It is our belief that $75,000 amount of bad debt should be included as community benefit. As a tax-exempt hospital, we must provide necessary services regardless of the patient's ability to pay for the service provided. As a not-for-profit, patient care is provided to all, regardless of ability to pay for that care. Making qulaity patient care available to all in our community, regardless of their economic means, qualifies bad debts as a community benefit. | BadDebtFootnote |
| Shortfall As Community Benefit | The Allowable costs on Line 6 were obtained from our FY2010 Medicare cost report, Worksheet D schedules. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | Heywood Hospital provides patients with information about financial assistance programs that are available through the Commonwealth of Massachusetts or through Heywood Hospital's own financial assistance program, which may cover all or some of their unpaid hospital bills. For those patients that request such assistance, Heywod Hospital assists patients by screening them for eligibility in an available public program and assisting them in applying for the program. These programs include, but are not limited to MassHealth, Commonwealth Care, Children's Medical Security Plan, Healthy Start, Health Safety Net, and others. It is the patient's obligation to provide Heywood Hospital with accurate and timely information to determine if the patient is eligible to apply for certain health insurance programs. If the patient or guarantor is unable to provide the necessary information, Heywood Hospital may make reasonable efforts to obtain any additional information from other sources. Information that Heywood Hospital obtains will be maintained in accordance with applicable federal and state privacy and security laws. The screening and application process for a public health insurance program is done throught the Virtual Gateway, which is an internet portal designed by the MA Executive Office of Health and Human Services. The Virtual Gateway manages the applciation process from the programs listed above, which is available for children, adults, seniors, veterans, homeless and disabled individuals. Heywood Hospital specifically assists the patient in completing the application and securing the necessary documentation required by the applicable financial assistance program. Heywood Hospital will then submit this documentation to the Commonwealth Office of Medicaid and assist the patient in securing any additional documentation if such is requested by the Commonwealth after completing the application. All Virtual Gateway applications are reviewed and processed by the Commonwealth of MA, Office of Medicaid. Special circumstance applications are reviewed and approved by the MA Division of Health Care Finance and Policy. Hospitals have no role in the determination of program eligibility made by the Commonwealth, but at the patient's request may take a direct role in appealing or seeking information related to the coverage decisions. It is still the patient's responsibility to inform Heywood Hospital of all coverage decisions made by the Commonwealth to ensure accurate and timely adjudication of all hospital bills. If the patient does not comply with the request for documentation, then our standard collection procedures apply. | DebtCollectionPolicy |
| General Explanation | Part I, Line 6B: The organization makes it's annual Community Benefit Report available to the public by transmitting the report electronically to the Attorney General's Community Benefit office which then makes it public on their website. We filed this years report on April 1, 2011. | GeneralExplanation |
| Needs Assessment | Heywood Hospital co-chairs the Joint Coalition on Health which undertakes comprehensive assessments of community needs and assets every 3-5 years. The Coalition released an 88 page report on March 18, 2009 entitled The Mental Health and Substance Abuse Assessment of North Central Massachusetts. This report was the work of a committee from the coalition and a paid consultant who was funded through Heywood Hospital and other partners in the Coalition. This report included quantitative and qualitative data, including focus groups, interviews and surveys to identify key issues, concerns and assets with respect to mental health and substance abuse in the region. The Joint Coalition also worked collaboratively with two other coalitions to complete The Comprehensive Health Assessment of North Central Massachusetts. This 173 page report includes demographic information, health status indicators, racial and ethnic disparity data and information on social determinants of health, as well as qualitative information gathered through a consultant and the Minority Coalition of North Central Mass. A pdf file of this report is attached. | NeedsAssessment |
| Patient Education Assistance | Heywood has a very aggressive and comprehensive program called GHAP to inform patients and members of the community about their eligibility for assistance and to assist them with enrollment and access to care. The goal is to inform the community about insurance options before they present to the Hospital for care. Many referrals come from area physicians to the program. The GHAP program was begun at Heywood in 1998 to connect uninsured patients with insurance and care. In addition to postings within the Hospital, the GHAP program is marketed throughout the community and self-pay patients who present to the ED receive a follow-up call from GHAP staff to offer assistance. In addition, the GHAP program does outreach to community organizations and presents information monthly to the newly un-employed at the local unemployment office. GHAP also works collaboratively with Patient Accounts to assist patients who have difficulty paying their bill. GHAP has been nationally recognized by AHA and is part of a five-organization network model for patient access that has received state grant funding. In 2010, GHAP enrolled 4,500 patients into health insurance and assisted a total of 15,000 patients with information and applications. | PatientEducationAssistance |
| Community Information | The Greater Gardner area, comprised of the City of Gardner and five surrounding towns, has a population of 60,000 people, a median income below the state average, and an unemployment rate above the state average. The community has been affected by the loss of the furniture industry over the past few decades, and by the current economic downturn. Mental Health and Substance Abuse are significant challenges for many residents of the area. The Hospital is the largest employer in the area, with close to 1,000 employees. The community is largely white, non-Hispanic, but has a growing Hispanic population. Gardner is one of three cities in the region - the others are Fitchburg and Leominster - which frequently collaborate for the betterment of the region. Heywood Hospital collaborates with the competing hospital in the Fitchburg Leominster area (HealthAlliance) on community health improvement activities, and provides the GHAP program onsite at HealthAlliance. | CommunityInformation |
| Community Building Activities | Environmental Improvements - Heywood Hospital works diligently to remove environmental hazards and waste from the community. In June 2010, Heywood Hospital began removing pharmaceutical wastes from the regular waste stream. For FY2010, there was 374 gallons of this waste removed as hazardous waste. The Hospital is working on implementing this service Hospital wide, currently it is just used in our pharmacy. Other hazardous wastes removed from the normal waste stream consist of batteries, computer parts, microwaves, CPU units, and various medical wastes. Coalition Building - Heywood Hospital is a leader in several community coalitions, including the Joint Coalition on Health, Community Health Network Area (CHNA) and the Minority Coalition. This leadership and technical support have helped leverage more than $7 million in outside funding for community health initiatives over the past 5 years. Community Health Advocacy - Heywood Hospital is a member of the Gardner Area Interagency Team "GAIT". The Gait Team is committed to the coordination and improvement of health and human services in the Greater Gardner Area. The purpose is to provide an opportunity for networking, communication and collaborations between area concerned citizens and the Community at large. To promote the development and enhancement of health and human Services in our area. To advocate on behalf of consumers seeking, receiving or in need of health and human services in our area. Heywood Hospital also provides staff for various healthcare training and enrollment sessions to the public. Workforce Development - One of the most critical benefits of a Hospital is to attract well qualified primary care physicians and specialists to the region. Heywood has a strong, collegial and supportive medical staff that provide many important services for the community outside of the hospital. Heywood Hospital has a community board of trustees consisting of community members from Gardner and surrounding towns. In addition, Hospital surpluses and philanthropic funds are invested into the provision of technologically sophisticated care and services and to maintain a modest amount of reserve. | CommunityBuildingActivities |
| Other Information | Community Benefit Mission Statement - Heywood Hospital has a long tradition of providing healthcare and other services that improve not only the health but also the quality of life in our community. Heywood Hospital dedicates our organization to the community benefit goals of: -Improving the health status of our community. -Addressing the special health problems of minorities, the poor, uninsured and other underserved populations. -Containing the growth of community helathcare costs. Such goals will be undertaken within the framework of a Community Benefit Plan which shall include such elements as: -Commitment on the part of the Board of Trustees and President/CEO/ -Specific goals and objectives. -Annual evaluation process. -Commitment of hospital resources through normal budgeting process. -Consideration of community served in all operational and policy decision. -Defined community. -Health status and needs assessment. -Opportunity for public input and comment. -The promotion of cooperative and collaborative relationships with other providers and agencies in order to carry out a broad health agenda in our community. Such community benefit goals and elements are hereby adopted and endorsed by the Board of Trustess of Heywood Hospital. | OtherInformation |
| Affiliated Health Care System | n/a | AffiliatedHealthCareSystem |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Montachusett Home Care Corp | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 680 Mechanical Street | AddressLine1 |
| City | Leominster | City |
| State | MA | State |
| ZIP Code | 01453 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 042551175 | EINOfRecipient |
| IRC Section | 501(c)(3) | IRCSection |
| Amount Of Cash Grant | 50000 | AmountOfCashGrant |
| Amount Of Non Cash Assistance | 0 | AmountOfNonCashAssistance |
| Purpose Of Grant | The funds will be used by the Community Health Network of North Central MA as support and collaborative community health assessment work. | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SchI_P01_S00_L02 | Identifier |
| Return Reference | Schedule I, Part I, Line 2 | ReturnReference |
| Explanation | Montachusett Home Care Corp and the Community Health Network of MA file an annual report with the office of Healthy Communities that contains a summary of how the funds were allocated. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Daniel P Moen | |||||||||||||
| 347401 | 0 | 0 | 0 | 12082 | 0 | 4900 | 0 | 21743 | 0 | 386126 | 0 | 466019 | 0 |
| James Mullen | |||||||||||||
| 197537 | 0 | 0 | 0 | 1932 | 0 | 4273 | 0 | 22186 | 0 | 225928 | 0 | 245013 | 0 |
| Thomas Cady | |||||||||||||
| 159012 | 0 | 0 | 0 | 506 | 0 | 1396 | 0 | 21324 | 0 | 182238 | 0 | 159040 | 0 |
| Rose Kavalchuck | |||||||||||||
| 142503 | 0 | 0 | 0 | 499 | 0 | 2941 | 0 | 17868 | 0 | 163811 | 0 | 159271 | 0 |
| Lorie Martiska | |||||||||||||
| 106326 | 0 | 0 | 0 | 156 | 0 | 2130 | 0 | 8804 | 0 | 117416 | 0 | 109746 | 0 |
| Theresa Koehler | |||||||||||||
| 160962 | 0 | 0 | 0 | 117 | 0 | 0 | 0 | 14752 | 0 | 175831 | 0 | 54855 | 0 |
| Jeffrey Blake | |||||||||||||
| 0 | 435149 | 0 | 0 | 0 | 977 | 0 | 0 | 0 | 27273 | 0 | 463399 | 0 | 461498 |
| Robert Terlato | |||||||||||||
| 0 | 412039 | 0 | 0 | 0 | 614 | 0 | 0 | 0 | 26838 | 0 | 439491 | 0 | 435378 |
| Peter Brassard | |||||||||||||
| 0 | 399030 | 0 | 0 | 0 | 2772 | 0 | 0 | 0 | 23525 | 0 | 425327 | 0 | 422384 |
| Michael Stauder | |||||||||||||
| 0 | 374789 | 0 | 0 | 0 | 301 | 0 | 0 | 0 | 26143 | 0 | 401233 | 0 | 373321 |
| Francis Garofalo | |||||||||||||
| 0 | 324291 | 0 | 0 | 0 | 523 | 0 | 50000 | 0 | 19223 | 0 | 394037 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SchJ_P02_S00_L00 | Identifier |
| Return Reference | Schedule J, Part II | ReturnReference |
| Explanation | Theresa Koehler was the CFO for Fiscal Year 2009 (October 2008 - September 2009), she terminated on October 23, 2009. Robert Crosby was hired in her place on January 4, 2010 as the new CFO, but had no 2009 earnings. Francis Garofalo is a new Urologist to Heywood Medical Group. He was hired on May 4, 2009. His $50,000 of deferred compensation is for a longevity bonus that was paid to him. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer |
|---|---|---|---|---|---|---|
| MA Health & Educational Facility Authority | ||||||
| 042456011 | 57586EGT2 | 2009-03-31 | 17785000 | Funds used for new building project | 0 | 0 |
| MA Health & Educational Facility Authority | ||||||
| 042456011 | 57586C7E9 | 2008-06-19 | 6715000 | refunding and new building expense | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Amount DefeasedAmountDefeased | Amount UnspentAmountUnspent | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Working Capital ExpendituresWorkingCapitalExpenditures | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 66235 | 0 | 0 | 0 | 281690 | 0 | 17569545 | 2010 | 0 | 0 | 1 | 1 |
| 19154 | 0 | 0 | 0 | 329467 | 3597891 | 2806796 | 2008 | 1 | 0 | 1 | 1 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 1 |
| 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Term Of HedgeTermOfHedge | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|---|
| TD Bank | ||||||
| 0 | 1 | 1 | 18.7 | 0 | 0 | 1 |
| Piper Jaffrey | ||||||
| 0 | 1 | 1 | 18.7 | 0 | 0 | 1 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| F990_P06_S0B_L11 | Form 990, Part VI, Section B, Line 11 | The Staff Accountant prepares the 990 and provides to the Controller for review. The form is then sent to the CFO for final review. Once approved and signed, copies are provided to the governing body. Then, the 990 is filed by the accounting department. |
| F990_P06_S0B_L12c | Form 990, Part VI, Section B, Line 12c | Annually, a Conflict of Interest form is sent out to the managers, trustees and employees with broad discretionary authority. These forms are required to be signed and is monitored by the VP of Professional Services for completion. |
| F990_P06_S0B_L15 | Form 990, Part VI, Section B, Line 15 | Compensation for the CEO is negotiated between the CEO and the Board of Trustess based on the following: -Existing financial market conditions based on salary surveys from reputable organizations for similar positions & sized organizations. -Past accomplishments of strategic goals and objectives designed to fulfill the hospital's mission statement values. -Future strategic goals and objectives as agreed upon by the CEO and Board. -Financial capability of the organization to address existing market coditions and incumbent's expectation. Compensation for members of the Executive Team are predicated on the following: -Ability of the organization to financially meet the needs of incumbent or applicant. -The degree of responsibility and accountability to the President/CEO -Current market conditions as described in the survey data compiled by competent organizations. |
| F990_P06_S0C_L19 | Form 990, Part VI, Section C, Line 19 | The organization makes the governing documents, conflict of interest policy and financial statements available to the public by providing completed copies to the Executive Administration Assistant, who provides copies upon request. |
| SchK_P01_S00_L00a | Schedule K, Part I, Column a | The bond issued on line B was a bond issued partially to refund a previous bond balance that was issued on November 9, 1999 and to pay for a portion of a new building. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|
| Heywood Affiliated Medical Group | |||||||||
| 242 Green Street | Gardner | MA | 01440 | 043163589 | contract physicians who provide service to Heywood Hospital | MA | 501(c)(3) | 9 | N/A |
| Heywood Hospital Realty Corp | |||||||||
| 242 Green Street | Gardner | MA | 01440 | 043327447 | property holding corp which rents office space to physicians | MA | 501(c)(2) | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| Heywood Hospital Realty Corp | |
| j | 53999 |
| Heywood Affiliated Medical Group | |
| o | 479126 |
| Heywood Hospital Realty Corp | |
| p | 124863 |
| Heywood Affiliated Medical Group | |
| p | 123810 |
| Heywood Hospital Realty Corp | |
| q | 467420 |
| Heywood Affiliated Medical Group | |
| q | 2144483 |
Reasonable Cause Explanation ReasonableCauseExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | On January 28, 2011 Heywood Hospital filed a form 8868 requesting an automatic 3 month extension of time, delaying the filing due date to May 15, 2011. An approval notice was submitted to Henry Heywood Memorial Hospital on March 21, 2011 accepting the May 15th deadline. | Explanation |