Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 10-01-2010 and ending 09-30-2011
BCheck if applicable:
CName of organization
CAPE COD HEALTHCARE INC & AFFILIATES
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
25 COMMUNICATION WAY
 
Room/suite
City or town, state or country, and ZIP + 4
HYANNIS, MA02601
D Employer identification number

90-0054984
E Telephone number

G Gross receipts $ 678,334,041
F Name and address of principal officer:
MICHAEL K LAUF
25 COMMUNICATION WAY
HYANNIS,MA02601
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.CAPECODHEALTH.org
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?Click to see attachment
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet3901
K Form of organization:
 
L Year of formation:  
M State of legal domicile:
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 13
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 10
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 4,974
6 Total number of volunteers (estimate if necessary) .... 6 1,189
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 4,797,910
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 824,627
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 15,478,190 19,646,382
9 Program service revenue (Part VIII, line 2g) ......... 620,312,582 654,804,853
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... -7,436,295 2,002,939
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 1,984,305 1,834,139
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 630,338,782 678,288,313
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 330,384,178 346,523,698
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet1,060,710    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 274,832,630 279,117,560
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 605,216,808 625,641,258
19 Revenue less expenses. Subtract line 18 from line 12...... 25,121,974 52,647,055
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 664,268,451 696,444,171
21 Total liabilities (Part X, line 26)............ 288,594,470 308,032,445
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 375,673,981 388,411,726
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: SEE SCHEDULE O
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 558,182,303 including grants of $   ) (Revenue $ 654,888,254 )
PATIENT SERVICES - SEE SCHEDULES H AND O
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 558,182,303
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
Yes
 
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II.. Click to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III.. Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part IClick to see attachment
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II.......... Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III................... Click to see attachment
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. ..... Click to see list of attachments
20b
Yes
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..
21
 
No
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III.....
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II........................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule MClick to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............ Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I........................... Click to see attachment
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
 
No
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
450
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
4,974
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
13
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
10
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
No
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
MA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
MICHAEL L CONNORS
25 COMMUNICATION WAY
HYANNIS,MA02601
(508) 957-8540
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) ROBERT BIRMINGHAM
TRUSTEE
 2.0 X           0 0 0
(2) ELEANOR CLAUS
CLERK UNTIL 5/11/TRUSTEE
 2.0 X   X       0 0 0
(3) HOWARD CROW JR
TRUSTEE
 2.0 X           0 0 0
(4) MICHAEL FISHBEIN MD
TRUSTEE - MACC
 2.0 X           0 0 0
(5) PHILIP MCLOUGHLIN
TRUSTEE
 2.0 X           0 0 0
(6) GROVER BAXLEY MD
TRUSTEE - MACC
 2.0 X           131,408 0 0
(7) PATRICK MURRAY MD
TRUSTEE UNTIL 1/11
 2.0 X           0 0 0
(8) NATE RUDMAN MD
TRUSTEE
 2.0 X           0 0 0
(9) SUMNER B TILTON JR
TRUSTEE/TREASURER FROM 5/11
 2.0 X   X       0 0 0
(10) JOEL CROWELL
TRUSTEE/CLERK FROM 5/11
 2.0 X   X       0 0 0
(11) PAUL DEMEO MD
TRUSTEE
 2.0 X           27,225 0 0
(12) SUZANNE GLYNN ESQ
TRUSTEE
 2.0 X           0 0 0
(13) KEVIN BRESNAHAM MD
TRUSTEE FROM 1/11
 2.0 X           0 0 0
(14) DEWITT DAVENPORT
TRUSTEE
 2.0 X           0 0 0
(15) THOMAS WROE JR
CHAIRMAN
 2.0     X       0 0 0
(16) RICHARD F SALLUZZO MD
PRESIDENT/CEO UNTIL 12/10
 40.0     X       0 1,204,875 104,433
(17) MICHAEL K LAUF
SEE SCHEDULE O FOR TITLE
 40.0     X       0 552,726 82,428
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) WILLIAM ZAMMER
INTERIM TRSR/VICE CHAIRMAN
 2.0     X       0 0 0
(19) MICHAEL L CONNORS
SENIOR VP FINANCE/CFO
 40.0     X       0 416,646 77,921
(20) CHRISTOPHER O'CONNOR
V.P. OF DEV. AS OF 1/19/10
 40.0       X     0 290,880 24,135
(21) DIANNE KOLB
CHIEF OPERATING OFFICER - VNA
 40.0       X     0 233,535 27,304
(22) SUSAN M WING
COO - FALMOUTH HOSPITAL
 40.0       X     0 293,741 30,894
(23) MICHAEL G JONES
V.P. OF LEGAL AFFAIRS
 40.0       X     0 372,739 61,874
(24) CHARLES R HULSE
EXECUTIVE DIRECTOR - MACC
 40.0       X     0 218,900 27,289
(25) DAVID RYAN
VP OF HUMAN RESOURCES
 40.0       X     0 235,742 47,921
(26) SHERYL CROWLEY
VP INFO SYS/CIO
 40.0       X     0 275,230 34,974
(27) RICHARD B ZELMAN MD
PHYSICIAN
 40.0         X   1,268,819 0 34,974
(28) DANIEL J CANADAY MD
PHYSICIAN
 40.0         X   612,957 0 34,974
(29) GARY L SHAPIRO MD
PHYSICIAN
 40.0         X   562,727 0 38,474
(30) XIANG-YANG D GUO MD
PHYSICIAN
 40.0         X   542,228 0 37,474
(31) ROBERT R MCANAW MD
PHYSICIAN
 40.0         X   536,063 0 34,235
(32) JEFFREY S DYKENS
CONTROLLER
 40.0           X 0 242,066 34,236
(33) STEPHEN L ABBOTT
FORMER PRESIDENT/CEO
 40.0           X 0 645,256 0
(34) LINDA HABEEB MD
FORMER MEDICAL DIRECTOR - MACC
 40.0           X 235,939 0 35,866
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 3,917,366 4,982,336 769,406
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet490
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
SEMRI INC
153 WASHINGTON STREET
BELMONT,MA02478 		MRI SERVICES 3,675,526
MAYO COLLABORATIVE SERVICES INC
PO BOX 9146
MINNEAPOLIS,MN554809146 		LAB SERVICES 1,653,262
CAPE COD ANESTHESIA ASSOCIATES
110 MAIN STREET - UNIT B
HYANNIS,MA02601 		PHYSICIAN SERVICES 1,577,432
NEUROSURGEONS OF CAPE COD INC
46 NORTH STREET
HYANNIS,MA02601 		PHYSICIAN SERVICES 1,507,881
HEALTHCARE PROVIDER SERVICES
PO BOX 9399
PROVIDENCE,RI02940 		OUTSIDE BLOOD SVCS 1,081,378
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet79
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 15,760
d Related organizations...1d  
e Government grants (contributions)1e 1,510,483
f All other contributions, gifts, grants, and
similar amounts not included above1f 		18,120,139
g Noncash contributions included in lines 1a-1f:$ 560,491
h Total. Add lines 1a-1f.......MediumBullet 19,646,382
Program Service Revenue Business Code
2a PATIENT SERVICE REVENUE 900,099 630,621,712 630,621,712    
b LABORATORY SERVICES 621,500 12,215,632 7,926,447 4,289,185  
c CHILDCARE CENTER REVENUE 624,410 508,725   508,725  
d INSURANCE/AP REFUNDS 900,099 3,707,277 3,707,277    
e PROGRAM RELATED RENTAL INCOME 900,099 2,118,706 2,118,706    
f All other program service revenue . 5,632,801 5,632,801    
g Total. Add lines 2a–2f........MediumBullet 654,804,853
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 1,811,992     1,811,992
4 Income from investment of tax-exempt bond proceeds..MediumBullet 83,401 83,401    
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross Rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 99,654 7,892
b Less: cost or other basis and sales expenses    
c Gain or (loss) 99,654 7,892
d Net gain or (loss)..........MediumBullet 107,546     107,546
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a 119,670
b Less: direct expenses ...b 45,728
c Net income or (loss) from fundraising events..MediumBullet 73,942   73,942
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a CAFETERIA INCOME 900,099 1,345,797     1,345,797
b EMPLOYEE PHARMACY 900,099 414,400     414,400
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 1,760,197
12 Total revenue. See Instructions....MediumBullet 678,288,313 650,090,344 4,797,910 3,753,677
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 0  
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 158,633 27,225 131,408  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 505,423 477,605 27,818  
7 Other salaries and wages 260,196,935 228,869,466 30,691,730 635,739
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 7,747,111 6,820,048 912,962 14,101
9 Other employee benefits ....... 59,422,132 52,039,917 7,302,653 79,562
10 Payroll taxes ........... 18,493,464 16,223,265 2,209,076 61,123
11 Fees for services (non-employees):        
a Management ...... 3,125,605 2,682,178 443,427  
b Legal ......... 417,744   417,744  
c Accounting ........... 831,537   831,537  
d Lobbying ........... 0      
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 0      
g Other .......... 40,409,187 34,616,331 5,792,856  
12 Advertising and promotion .... 247,736 226,653 16,475 4,608
13 Office expenses ....... 3,044,526 2,751,980 287,067 5,479
14 Information technology ...... 6,588,971 5,700,632 862,708 25,631
15 Royalties .. 0      
16 Occupancy ........... 14,659,329 12,640,065 2,019,264  
17 Travel ............ 2,197,752 2,108,208 83,778 5,766
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 332,402 292,926 39,476  
20 Interest ........... 9,048,906 7,742,390 1,306,516  
21 Payments to affiliates ....... 33,365,035 28,510,422 4,854,613  
22 Depreciation, depletion, and amortization ..... 23,051,788 19,937,736 3,111,852 2,200
23 Insurance .............. 5,182,419 4,589,851 592,262 306
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a PROFESSIONAL FEES 1,073,899 1,068,678   5,221
b PURCHASED SERVICES 3,822,136 3,686,295 114,625 21,216
c BAD DEBTS 14,317,672 14,317,672    
d MEDICAL SUPPLIES 87,458,103 87,458,103    
e SUPPLIES 6,955,421 6,086,865 849,168 19,388
f All other expenses 22,987,392 19,307,792 3,499,230 180,370
25 Total functional expenses. Add lines 1 through 24f 625,641,258 558,182,303 66,398,245 1,060,710
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 9,262,404 1 9,379,211
2 Savings and temporary cash investments ....... 22,183,197 2 28,861,444
3 Pledges and grants receivable, net ......... 12,632,625 3 12,959,162
4 Accounts receivable, net ......... 55,044,333 4 63,151,599
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net ............. 938,528 7 2,517,951
8 Inventories for sale or use .............. 8,262,112 8 8,769,838
9 Prepaid expenses and deferred charges ............ 3,299,569 9 3,954,064
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 573,106,733
b Less: accumulated depreciation. ..... 10b 321,501,446 239,961,850 10c 251,605,287
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ...... 249,594,607 12 250,549,656
13 Investments—program-related. See Part IV, line 11 ..   13 21,499
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 63,089,226 15 64,674,460
16 Total assets. Add lines 1 through 15 (must equal line 34)... 664,268,451 16 696,444,171
Liabilities 17 Accounts payable and accrued expenses . 59,512,013 17 67,775,937
18 Grants payable ..........   18  
19 Deferred revenue .......... 29,907 19 13,408
20 Tax-exempt bond liabilities .......... 169,235,869 20 162,966,917
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties .. 111,497 23 0
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 59,705,184 25 77,276,183
26 Total liabilities. Add lines 17 through 25..... 288,594,470 26 308,032,445
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 290,636,416 27 315,843,107
28 Temporarily restricted net assets ..... 58,473,635 28 46,462,504
29 Permanently restricted net assets ..... 26,563,930 29 26,106,115
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 375,673,981 33 388,411,726
34 Total liabilities and net assets/fund balances ..... 664,268,451 34 696,444,171
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
678,288,313
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
625,641,258
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
52,647,055
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
375,673,981
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
-39,909,310
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
388,411,726
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
Yes
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
CAPE COD HEALTHCARE INC & AFFILIATES
 
Employer identification number

90-0054984
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
CAPE COD HEALTHCARE INC & AFFILIATES
 
Employer identification number

90-0054984
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
CAPE COD HEALTHCARE INC & AFFILIATES
  		Employer identification number

90-0054984
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
CAPE COD HEALTHCARE INC & AFFILIATES
  		Employer identification number

90-0054984
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
CAPE COD HEALTHCARE INC & AFFILIATES
  		Employer identification number

90-0054984
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
CAPE COD HEALTHCARE INC & AFFILIATES
 
Employer identification number

90-0054984
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities ....................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2010

Schedule C (Form 990 or 990-EZ) 2010
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
Organization's
Totals 		(b) Affiliated Group
Totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots non-taxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2010


Schedule C (Form 990 or 990-EZ) 2010
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? If "Yes," describe in Part IV ..........................
Yes
 
1
j
Total. lines 1c through 1i ...................................
1
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
No
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
PART II-B, LINE 1I FALMOUTH HOSPITAL ASSOCIATION, INC. AND CAPE COD HOSPITAL PAY MEMBERSHIP DUES TO THE MASSACHUSETTS HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION WHICH MAY ENGAGE IN LOBBYING ACTIVITIES. THEREFORE, A PORTION OF THE DUES MAY BE ATTRIBUTABLE TO LOBBYING ACTIVITIES.
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
CAPE COD HEALTHCARE INC & AFFILIATES
 
Employer identification number

90-0054984
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a 1
b Total acreage restricted by conservation easements .................. 2b 13.07
c Number of conservation easements on a certified historic structure included in (a) ..... 2c 0
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d 0
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet0
4
Number of states where property subject to conservation easement is located SchDMd Bullet1
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet1.00
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $ 400
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 34,043,109 31,383,995 31,217,343
b Contributions ........ 361,842 1,110,670 760,805
c Investment earnings or losses ... -1,080,437 2,116,186 148,865
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		685,875 567,742 743,018
f Administrative expenses ....      
g End of year balance ...... 32,638,639 34,043,109 31,383,995
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet21.000 %
b
Permanent endowment: SchDMd Bullet79.000 %
c
Term endowment: SchDMd Bullet0 %
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   23,203,910 23,203,910
b Buildings ................   293,123,428 115,735,577 177,387,851
c Leasehold improvements ............   3,053,818 2,141,911 911,907
d Equipment ................   239,652,044 197,749,328 41,902,716
e Other .................   14,073,533 5,874,630 8,198,903
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 251,605,287
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
(3)Other
(A) LONG-TERM INVESTMENTS 		170,787,103 F

(B) AGREEMENT / INDENTURE 		21,642,641 F

(C) TEMP RESTRICTED INVESTMENTS 		32,066,371 F

(D) PERM RESTRICTED INVESTMENTS 		19,559,802 F

(E) TRUST 		6,493,739 F




Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet 250,549,656
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) DUE FROM AFFILIATES 49,993,260
(2) NET DEFFERED FINANCING COSTS 5,411,205
(3) GOODWILL 7,980,353
(4) EST SETTLEMENTS W/ 3RD PARTIES 1,031,731
(5) OTHER ASSETS 257,911




Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 64,674,460
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes 0
FHA SERIES A SWAP INVESTMENT 67,118
ABANDONED PROPERTY LIAB. 20,467
DUE TO AFFILIATES 48,637,030
EST. SETTLEMENTS W 3RD PARTIES 18,569,697
JV SHIELDS LIABILITY 328,612
OTHER CURRENT LIABILITIES 479,149
OTHER LONG-TERM LIABILITIES 9,174,110


Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 77,276,183
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
SCHEDULE D, PART II, LINE 9   THE CONSERVATION EASEMENT IS INCLUDED IN LAND ON THE BALANCE SHEET IN PART X, LINE 10.
SCHEDULE D, PART V, LINE 4   THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS IS TO FURTHER THE HEALTHCARE MISSION OF CAPE COD HEALTHCARE AND ITS AFFILIATES.
PART X   THE ORGANIZATION DOES NOT HAVE A FIN 48 FOOTNOTE AS ANY UNCERTAIN TAX POSITIONS WERE DEEMED IMMATERIAL.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE F
(Form 990)

Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,
Part IV, line 14b, 15, or 16.
Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
CAPE COD HEALTHCARE INC & AFFILIATES
 
Employer identification number

90-0054984
Part I
General Information on Activities Outside the United States. Complete if the organization answered
“Yes” to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of the grants or
assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used to award
the grants or assistance? ...................................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of grant funds outside the
United States.
3
Activites per Region. (Use Part V if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees or agents in region or independent contractors (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total
expenditures for region/investments
in region
Central America and the Caribbean 1 0 Program Services CAPTIVE INSURANCE 2,872,657
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total ..... 1 0 2,872,657
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b) 1 0 2,872,657
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990,
Part IV, line 15, for any recipient who received more than $5,000. Check this box if no one recipient received more than $5,000 ........ MediumBullet
Use Part V if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount of
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2
Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .....MediumBullet
 
3
Enter total number of other organizations or entities ........................MediumBullet
 
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Use Part V if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926 (see instructions for Form 926).................
2 Did the organization have an interest in a foreign trust during the tax year? If " Yes," the organization may be required to file Form 3520 and/or Form 3520-A. (see instructions for Forms 3520 and 3520-A)..........
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with respect to Certain Foreign Corporations. (see instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see instructions for Form 8621)
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with respect to Certain Foreign Partnerships. (see instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see instructions for Form 5713)................................................
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 5
Part V
Supplemental Information
Complete this part to provide the information (see instructions) required in Part I, line 2, and any additional information.
Identifier ReturnReference Explanation
SCHEDULE F, PART I, COLUMN F   EXPENSES ARE CODED IN THE GENERAL LEDGER TO THE CAPTIVE INSURANCE COMPANY.
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Schedule F (Form 990) 2010
Additional Data


Software ID:  
Software Version:  



SCHEDULE G
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,
or if the organization entered more than $15,000 on Form 990-EZ, line 6a.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
CAPE COD HEALTHCARE INC & AFFILIATES
 
Employer identification number

90-0054984
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.
(a) Event #1

SUMMER EVENING
(event type) 		(b) Event #2

 
(event type) 		(c) Other Events

0
(total number) 		(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 135,430     135,430
2 Less: Charitable
contributions . . . 		15,760     15,760
3 Gross income (line 1
minus line 2) . . . 		119,670     119,670
VerticalDirectExpenses 4 Cash prizes . . . 0     0
5 Non-cash prizes . . 0     0
6 Rent/facility costs . . 12,696     12,696
7 Food and beverages . . 23,476     23,476
8 Entertainment . . . 6,175     6,175
9 Other direct expenses . 3,381     3,381
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 45,728
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow 73,942
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (Add col. (a) through col. (c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
 
 
 
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," Explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," Explain:
 
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ...........................
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 3
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
 
b
An outside facility ........................
13b
 
14
Provide the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)
Identifier ReturnReference Explanation
Schedule G (Form 990 or 990-EZ) 2010
Additional Data


Software ID:  
Software Version:  
SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
CAPE COD HEALTHCARE INC & AFFILIATES
 
Employer identification number

90-0054984
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
Yes
 
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
Yes
 
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
 
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) .. 		    11,345,850 8,903,157 2,442,693 0.400 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		    28,793,296 18,179,337 10,613,959 1.740 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....     34,376,508 26,002,240 8,374,268 1.370 %
dTotal Charity Care and
Means-Tested Government Programs ..... 		    74,515,654 53,084,734 21,430,920 3.510 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		    1,018,505   1,018,505 0.170 %
f Health professions education
(from Worksheet 5) .. 		    558,757 167,807 390,950 0.060 %
g Subsidized health services
(from Worksheet 6) .. 		    76,696,293 53,376,790 23,319,504 3.810 %
h Research (from Worksheet 7)            
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		    876,572   876,572 0.140 %
jTotal Other Benefits ...     79,150,127 53,544,597 25,605,531 4.180 %
kTotal. Add lines 7d and 7j. ..     153,665,781 106,629,331 47,036,451 7.690 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building     2,184     0 %
7 Community health improvement advocacy     35,000     0 %
8 Workforce development     743,246     0.120 %
9 Other            
10 Total     780,430     0.120 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense (at cost).....
2
7,898,351
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
394,918
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
206,084,077
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
191,327,407
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
14,756,670
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
1CAPE COD RADIATION
  		  50.000 % 0 % 0 %
2THERAPY SERVICESLLC
  		RADIATION THERAPY      
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?2
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 CAPE COD HOSPITAL
27 PARK STREET
HYANNIS,MA02601 		X X         X    
2 FALMOUTH HOSPITAL ASSOCIATION INC
100 TER HEUN DRIVE
FALMOUTH,MA02540 		X X         X    
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:CAPE COD HOSPITAL
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14    
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16    
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:FALMOUTH HOSPITAL ASSOCIATION INC
Line Number of Hospital Facility (from Schedule H, Part V, Section A):2

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14    
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16    
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 7
Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?49
Name and address Type of Facility (Describe)
1 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
2 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
3 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
4 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
5 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
6 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
7 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
8 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
9 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
10 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
11 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
12 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
13 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
14 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
15 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
16 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
17 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
18 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
19 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
20 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
21 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
22 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
23 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
24 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
25 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
26 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
27 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
28 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
29 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
30 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
31 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
32 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
33 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
34 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
35 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
36 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
37 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
38 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
39 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
40 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
41 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
42 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
43 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
44 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
45 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
46 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
47 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
48 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
49 CAPE COD HEALTHCARE CORP
88 Lewis Bay Rd
Hyannis,MA02601 		administrative
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
PART I, LINE 3C N/A PART 1, LINE 6A N/A
PART I, LINE 7, COLUMN F THE AMOUNT OF BAD DEBT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN LINE 7, COLUMN F WAS $14,317,672.
PART I, LINE 7 The amounts reported in the table were calculated using the ratio of patient care cost to charges and by following the Form 990, Schedule H instructions. The total percentage of charity care and certain other community benefits at cost in the table was calculated on a group return basis as required by the Form 990 instructions, and not on a hospital-only basis.
PART III, LINE 4 The Bad debt expense (at cost) reported in part III, Line 2 was calculated using worksheet A of the Schedule H Instructions by applying the ratio of patient care cost to charges against bad debt. Cape Cod Healthcare receives payments for services rendered from federal and state agencies (under the Medicare and Medicaid programs), managed care payors, commercial insurance companies, and patients. Patient accounts receivable are reported net of contractual allowances and reserves for denials, uncompensated care, and doubtful accounts. The level of reserves is based upon management's assessment of historical and expected net collections, business and economic conditions, trends in Federal and state governmental and private employer health care coverage and other collection indicators.
PART III, LINE 8 The costing method used to determine the Medicare (Program) Allowable Costs were determined from specific values reported in the Medicare Cost Report representing Program Costs. The general method utilized in the cost report is to take Total Allowable Costs and divide them into Total Charges to determine a Ratio of Cost to Charges (RCC). The RCC is then multiplied by the Program Charges to determine the Program Costs. Cape Cod Hospital incurs losses on certain Medicare Services not reported on the Medicare Cost Report. These services are compensated on a "Fee Schedule" basis and are not subject to settlement on the cost report. They include Laboratory and other Diagnostic services which incur a loss of $3,972,271 and physician services in the hospital that are heavily subsidized by the hospital and incur a loss of $9,172,835. The Medicare cost of diagnostic services is determined by use of the ratio of cost to charges methodology. The Medicare cost of physician services is the product of amount disallowed on the Medicare cost report for the cost of professional services and the Medicare percent of professional fees billed. Both costs have been reduced by the amounts of direct reimbursement by Medicare.
PART III, LINE 9B Cape Cod Healthcare provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because Cape Cod Healthcare does not pursue collection of amounts determined to qualify as charity care, such amounts are not reported as revenue. The charity care policy is based on the poverty income guidelines established by the Massachusetts Division of Healthcare Finance and Policy. If a patient is ineligible because his or her income exceeds the eligibility guidelines, any uncollectible accounts receivable balance is written off to bad debts.
IN ADDITION TO THE FACILITIES LISTED IN SECTION C, THE LICENSE OF FALMOUTH HOSPITAL INCLUDES THE FOLLOWING FIVE SATELLITE LOCATIONS: - FALMOUTH HOSPITAL OUTPATIENT RADIOLOGY - BOURNE HEALTH CENTER - MASHPEE HEALTH CENTER - FALMOUTH HOSPITAL REHABILITATION SERVICES - BAY RADIOLOGY OUTPATIENT DEPARTMENT FALMOUTH HOSPITAL THE LICENSE OF CAPE COD HOSPITAL INCLUDES THE FOLLOWING NINE SATELLITE LOCATIONS: - CAPE COD HOSPITAL MOBILE MRI AT FONTAINE MEDICAL CENTER - BREAST CARE/RADIOLOGY OF CAPE COD HOSPITAL - CAPE COD HOSPITAL REHABILITATION SERVICES AT WILLY'S GYM - CAPE COD HOSPITAL IMAGING SERVICES AT FONTAINE MEDICAL CENTER - PRIMARY CARE INTERNISTS - CAPE COD HOSPITAL REHABILITATION CENTER - CAPE COD HOSPITAL REHABILITATION SERVICES AT FONTAINE MEDICAL CENTER - CAPE COD HOSPITAL OB/GYN CLINIC - THE CLARK CENTER-CAPE COD HEALTHCARE CANCER SERVICES
NEEDS ASSESSMENT:   CAPE COD HEALTHCARE CONDUCTS A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT STUDY EVERY THREE YEARS. CCHC SOLICITS COMMUNITY PARTICIPATION IN THE DESIGN, DATA COLLECTION AND DEVELOPMENT OF RECOMMENDATIONS FOR THE PROGRAM. THE STUDY FINDINGS ARE THE FOUNDATION FOR PROGRAM PLANNING AND IMPLEMENTATION. IN ADDITION, THE PLAN IS UPDATED ON AN ANNUAL BASIS TO REFLECT EMERGING NEEDS BETWEEN CYCLES. CCHC SEEKS COMMUNITY FEEDBACK ABOUT THE SERVICES PROVIDED, SATISFACTION WITH SUCH SERVICES, AND SPECIFIC SERVICES NEEDED. THIS INPUT, TOGETHER WITH SECONDARY DATA FROM MULTIPLE SOURCES, IS USED TO BUILD AN AGENDA AIMED AT PROVIDING NEEDED HEALTH CARE SERVICES AND ADDITIONAL COMMUNITY-BASED PROGRAMS. CAPE COD HEALTHCARE CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT IN 2008-2009. THE ASSESSMENT, PERFORMED IN COLLABORATION WITH COMMUNITY PARTNERS FROM CAPE COD AND THE ISLANDS, CONSISTED OF DATA GATHERING AND ANALYSIS UTILIZING MULTIPLE DATA SOURCES AND HEALTH STATUS INDICATORS. THE ASSESSMENT RESULTED IN THE CREATION OF THE SALIENT HEALTH ISSUES REPORT. IN 2009 "COMMUNITY SOLUTION FORUMS" WERE ORGANIZED TO EXPLORE HOW VARIOUS POPULATIONS IN BARNSTABLE COUNTY WERE IMPACTED BY THE HEALTH ISSUES IDENTIFIED IN THE SALIENT HEALTH ISSUES REPORT. VIABLE SOLUTIONS WERE SOUGHT TO REDUCE OR ELIMINATE IDENTIFIED ISSUES. THE ASSESSMENT COMPLETED IN 2009 CONTINUES TO GUIDE THE COMMUNITY BENEFITS PROGRAM THROUGH FY12. CAPE COD HEALTHCARE BEGAN A NEW COMMUNITY HEALTH NEEDS ASSESSMENT IN FY2011. THIS STUDY WILL CONCLUDE IN FY 12 AND WILL BE THE BASIS OF COMMUNITY BENEFIT PLANNING FOR FY13 - FY15. THE FOLLOWING SOURCES WERE UTILIZED IN THE 2008-2009 COMMUNITY HEALTH NEEDS ASSESSMENT: - ASTHMA PREVENTION AND CONTROL PROGRAMS: STATE OF MASSACHUSETTS - BUREAU OF SUBSTANCE ABUSE SERVICES: MASSACHUSETTS - CAPE COD COMMISSION: OVERVIEW OF CAPE & ISLANDS POPULATION - CENTERS FOR DISEASE CONTROL AND PREVENTION - INJURY SURVEILLANCE PROGRAM: MASSACHUSETTS - JARVI REPORT 2004, CAPE & ISLAND'S BEHAVIORAL HEALTH NEEDS SURVEILLANCE AND GAPS - KEY INFORMANT INTERVIEWS - LOCAL HEALTH AGENCIES - MASSACHUSETTS CANCER REGISTRY - MASSACHUSETTS DEATHS 2000-2005 - MASSACHUSETTS HEALTH DATA CONSORTIUM - MDPH REGIONAL HEALTH STATUS INDICATORS 2007 - MONITORING THE HUMAN CONDITION STUDY 2007 BARNSTABLE COUNTY - NATIONAL INSTITUTE OF HEALTH - SENIOR MOBILITY INITIATIVE ON CAPE COD [SMICC] - U.S. CENSUS CONSULTANTS/OTHER ORGANIZATIONS (NEEDS ASSESSMENT) - BARNSTABLE COUNTY - CAPE AND ISLANDS EMS SYSTEMS, INC. - CAPE AND ISLANDS SUICIDE PREVENTION COALITION - CAPE COD IMMIGRANT CENTER - COMMUNITY ACTION COMMITTEE OF CAPE COD & ISLANDS - COUNCILS ON AGING - DUFFY HEALTH CENTER - GOSNOLD ON CAPE COD - MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH - THE BARNSTABLE HUMAN RIGHTS COMMISSION - THE CAPE AND ISLANDS COMMUNITY HEALTH NETWORK (CHNA 27) - TRI-COUNTY COLLABORATIVE FOR ORAL HEALTH EXCELLENCE DATA SOURCES (NEEDS ASSESSMENT) COMMUNITY FOCUS GROUPS, HOSPITAL, CONSUMER GROUP, INTERVIEWS, MASSCHIP, PUBLIC HEALTH PERSONNEL, SURVEYS, CHNA, OTHER - BUREAU OF SUBSTANCE ABUSE, MASS., MONITORING THE HUMAN CONDITION STUDY 2007 AND 2008, BARNSTABLE COUNTY DEPARTMENT OF HUMAN SERVICES, SALIENT HEALTH ISSUES REPORT, JUNE 2008, BARNSTABLE COUNTY, LOCAL HEALTH AGENCIES
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: FOR THOSE PATIENTS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH THEM TO ASSIST WITH APPLYING FOR AVAILABLE FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER THEIR UNPAID HOSPITAL BILLS. IN ORDER TO ASSIST UNINSURED AND UNDERINSURED PATIENTS IN FINDING AVAILABLE AND APPROPRIATE FINANCIAL ASSISTANCE PROGRAMS, THE HOSPITAL WILL PROVIDE ALL PATIENTS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PROGRAMS IN BOTH THE INITIAL BILL THAT IS SENT TO PATIENTS AS WELL AS IN GENERAL NOTICES POSTED THROUGHOUT THE HOSPITAL. THE GOAL OF THESE NOTICES IS TO INFORM PATIENTS THAT THEY MAY BE ELIGIBLE TO APPLY FOR COVERAGE WITHIN A FINANCIAL ASSISTANCE PROGRAM, SUCH AS, BUT NOT LIMITED TO, MASSHEALTH, COMMONWEALTH CARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTHY START, HEALTH SAFETY NET, OR MEDICAL HARDSHIP THROUGH THE HEALTH SAFETY NET. THE HOSPITAL WILL PROVIDE, UPON REQUEST, SPECIFIC INFORMATION ABOUT THE ELIGIBILITY PROCESS TO BE DESIGNATED A LOW INCOME PATIENT UNDER EITHER THE STATE HEALTH SAFETY NET PROGRAM OR THROUGH THE HOSPITAL'S OWN INTERNAL CHARITY CARE PROGRAM. THE HOSPITAL WILL ALSO NOTIFY THE PATIENT ABOUT PAYMENT PLANS THAT MAY BE AVAILABLE TO HIM OR HER BASED ON THE SIZE OF HIS OR HER FAMILY AND FAMILY INCOME.
COMMUNITY INFORMATION DEMOGRAPHIC OVERVIEW THE PRIMARY SERVICE AREA FOR CCHC IS DEFINED AS THE FIFTEEN TOWNS OF BARNSTABLE COUNTY, COMMONLY KNOWN AS "CAPE COD". THE AREA IS GENERALLY VIEWED AS THE LAND MASS DISSECTED FROM THE MAINLAND BY THE CAPE COD CANAL. HOWEVER, BARNSTABLE COUNTY DOES INCLUDE SECTIONS OF BOURNE WHICH ARE LOCATED "OVER THE BRIDGES." BARNSTABLE COUNTY CONSISTS OF 396 SQUARE MILES WITH A POPULATION DENSITY OF 546 PERSONS PER SQUARE MILE IN 2010. CAPE COD IS MADE UP OF DIVERSE TOWNS AND MANY VILLAGES AND DIVIDED INTO FOUR REGIONS; UPPER CAPE, MID CAPE, LOWER CAPE AND OUTER CAPE. THE OUTER CAPE IS THE MOST RURAL AREA OF CAPE COD DUE TO ITS GEOGRAPHICAL LAYOUT, DISTANCE FROM ACUTE CARE FACILITIES AND LIMITED PUBLIC TRANSPORTATION. CCHC IS WORKING COLLABORATIVELY AND BUILDING RELATIONSHIPS WITH OUTER CAPE COMMUNITY HEALTH PROGRAMS TO IMPROVE HEALTH CARE ACCESS FOR SUCH VULNERABLE POPULATIONS. THE 2010 CENSUS REPORTED THE TOTAL YEAR-ROUND RESIDENT POPULATION FOR BARNSTABLE COUNTY AT 215,888. AFTER LEADING THE STATE IN GROWTH FOR THE LAST FEW DECADES, THE BARNSTABLE COUNTY POPULATION HAS STABILIZED. OVERALL, THE CAPE POPULATION HAS DECLINED SLIGHTLY FROM 2000 TO 2010. THE UPPER CAPE, WHICH IS THE REGION CLOSEST TO THE BRIDGE, IS THE ONLY REGION FOR WHICH THERE WAS GROWTH DURING THIS TIMEFRAME. SEASONAL ESTIMATES BY THE CAPE COD CHAMBER OF COMMERCE SUGGEST THAT THE SUMMERTIME POPULATION ROUTINELY REACHES OVER 500,000 AS A RESULT OF SUMMER RESIDENTS AND VACATIONERS VISITING THE AREA. THE MOST NOTABLE DEMOGRAPHIC CHARACTERISTIC OF THE CAPE IS THE HIGH PROPORTION OF SENIOR RESIDENTS. TWENTY-FOUR PERCENT OF THE YEAR-ROUND POPULATION IS OVER THE AGE OF 65, COMPARED TO 14% FOR THE STATE AND APPROXIMATELY 13% NATIONALLY. THIS SEGMENT IS FORECASTED TO CONTINUE TO GROW. THE 2010 MEDIAN AGE FOR A BARNSTABLE COUNTY RESIDENT IS 49.9 YEARS, THE HIGHEST IN MASSACHUSETTS, COMPARED TO A STATEWIDE MEDIAN AGE OF 39.1 YEARS. THESE DEMOGRAPHIC FACTORS PLACE SIGNIFICANT DEMANDS UPON THE SYSTEM. THEREFORE, CCHC IS ACTIVELY INVOLVED IN COMMUNITY EVENTS AND SUPPORTS PATIENT AND COMMUNITY ADVOCACY THROUGH ITS COMMUNITY BENEFITS PROGRAM.
COMMUNITY BUILDING ACTIVITIES:   COALITION BUILDING CCHC has established a formal process for strategic and operational planning with the four local federally qualified community health centers. The annual planning meeting is attended by Michael Lauf, CEO CCHC, Theresa Ahern, VP Strategy and Community/Governmental Affairs CCHC, Karen Gardner, CEO Community Health Center of Cape Cod, Heidi Nelson, CEO Duffy Health Center, Sally Deane, CEO Outer Cape Health Services, and David Reidy, Executive Director Mid Upper Cape Community Health Center and other senior staff as needed. Throughout the year, CCHC also participates in quarterly health center network meetings which focus on strategic implementation, community assessment, operational improvement and program development. Additionally, CCHC community benefits staff works with the community health centers on an ongoing basis to identify and pursue opportunities to improve collaboration in regard to outreach and education, increasing access, identifying and serving vulnerable populations, developing a medical home model, and physician recruitment. ADVOCACY CCHC is active with advocacy efforts at both the state and federal level to promote delivery of services to vulnerable populations. CCHC regularly works with community-based agencies to advance public policy in a way that recognizes those who lack health insurance or access to services or who face unique health care challenges. WORKFORCE DEVELOPMENT THE PHYSICIAN RECRUITMENT PROGRAM STRIVES TO IDENTIFY AREAS OF UNMET NEED AND IMPROVE ACCESS TO PRIMARY AND SPECIALTY CARE FOR VULNERABLE POPULATIONS, ESPECIALLY THOSE OVER 65. THROUGH RIGOROUS EFFORTS HIGHLY QUALIFIED AND COMPETENT PHYSICIANS AND PHYSICIAN EXTENDERS ARE RECRUITED AND RETAINED TO MEET THE HEALTH CARE NEEDS AND PROVIDE CARE TO THE RESIDENTS OF CAPE COD.
OTHER INFORMATION: EVERY THREE YEARS CCHC CONDUCTS A COMMUNITY HEALTH NEEDS ASSESSMENT TO DETERMINE THE HEALTH CARE NEEDS OF THE RESIDENTS OF BARNSTABLE COUNTY. THIS NEEDS ASSESSMENT HELPS IDENTIFY THE MOST VULNERABLE POPULATIONS AND GAPS IN HEALTH CARE SERVICES. RESULTS HELP DRIVE COMMUNITY BENEFITS PLANNING SUCH AS, DIRECT CLINICAL PROGRAMS, HEALTH EDUCATION, WELLNESS PROMOTION, FINANCIAL SUPPORT, HEALTH CARE SUBSIDIES AND ADVOCACY EFFORTS. THE GOAL IS TO REDUCE HEALTH DISPARITIES, INCREASE ACCESS TO QUALITY HEALTH CARE, AND IMPROVE THE HEALTH/WELLNESS OF THE COMMUNITY. THE FOLLOWING IS A LIST OF THE FY11 TARGET POPULATIONS AND PRIORITIES IDENTIFIED BY THE FY2009 NEEDS ASSESSMENT. TARGET POPULATIONS: -THE MEDICALLY UNDERSERVED, UN/UNDERINSURED AND/OR THOSE WITH HEALTH DISPARITIES. -CHRONICALLY ILL RESIDENTS AFFLICTED WITH CARDIOVASCULAR-RELATED DISEASE, DIABETES, AND/OR ORAL HEALTH ISSUES. -COMMUNITY MEMBERS AFFLICTED WITH MENTAL HEALTH AND/OR SUBSTANCE ABUSE RELATED ISSUES. - GERIATRIC POPULATION, ESPECIALLY THOSE WHO ARE AT RISK AND/OR IN HARD TO REACH AREAS. - RESIDENTS WITH EMERGING HEALTH ISSUES.
CAPE COD HEALTHCARE'S COMMUNTIY BENEFIT DEPARTMENT PROVIDED THE FOLLOWING   PROGRAMS IN FY 11: FINANCIAL COUNSELING & ASSISTANCE THE FINANCIAL ASSISTANCE AND COUNSELING PROGRAM PROVIDES COMPREHENSIVE SERVICES TO COMMUNITY MEMBERS SEEKING PUBLIC INSURANCE ENROLLMENT AND RE-VERIFICATION OF ENROLLMENT INTO MASSHEALTH, COMMONWEALTH CARE AND HEALTH SAFETY NET INSURANCE PRODUCTS. FINANCIAL COUNSELORS ARE DEDICATED TO IMPROVING ACCESS TO CARE THROUGH ELIGIBILITY SCREENING, ASSESSED AFFORDABILITY AND INCOME VERIFICATION. REACH (REACHING ELDERS WITH ADDITIONAL COMMUNITY HELP): CAPE & ISLANDS EMERGENCY MEDICAL SERVICES SYSTEM (CIEMSS) THE REACH PROGRAM COORDINATES SERVICES FOR SENIORS IN THEIR HOMES THROUGH THE PROVISION OF REFERRALS TO APPROPRIATE ORGANIZATIONS. BY WORKING IN CONJUNCTION WITH COUNCILS ON AGING, ELDER SERVICES OF CAPE COD AND THE ISLANDS, VNA, EMS AND OTHER COMMUNITY PARTNERS, ISSUES SUCH AS HEALTH, SAFETY, PSYCHOLOGICAL STATUS AND SOCIAL FUNCTIONING ARE ASSESSED, AND APPROPRIATE PLANS ARE DEVELOPED TO ACHIEVE OPTIMAL DAILY LIVING STATUS FOR SENIORS ON CAPE COD. REACH ALSO OFFERS COMMUNITY-BASED TRAININGS FOR SENIOR PROVIDERS WHICH TARGET EMERGING ISSUES AND TRENDS THAT SPECIFICALLY IMPACT SENIOR HEALTH AND WELL-BEING. REFERRALS TO 292 COMMUNITY-DWELLING FRAIL ELDERS WERE MADE TO ORGANIZATIONS WHICH PROVIDED SUPPORT SERVICES TO SENIORS RESIDING ON CAPE COD. COMMUNITY BASED INTERPRETER SERVICES THE COMMUNITY BASED INTERPRETER SERVICES PROGRAM OFFERS FREE MEDICAL LANGUAGE INTERPRETATION IN COMMUNITY-BASED PHYSICIAN PRACTICES AND AT THE COMMUNITY HEALTH CENTERS FOR THE LIMITED AND NON-ENGLISH SPEAKING PATIENTS AND THEIR FAMILIES. THE AVAILABILITY OF PROFICIENT AND PROFESSIONAL INTERPRETER SERVICES ENSURES THE DELIVERY OF SAFE QUALITY HEALTH CARE AND POSITIVE CLINICAL OUTCOMES. SPECIALTY NETWORK FOR THE UNINSURED (SNU) THE SPECIALTY NETWORK FOR THE UNINSURED (SNU) IS PROVIDED IN COLLABORATION WITH THE COMMUNITY HEALTH CENTER NETWORK THROUGH ON-SITE SPECIALTY CLINICS AND VOLUNTEER PHYSICIANS. IT OFFERS ACCESS TO SPECIALTY CARE SERVICES FOR OVER SIX HUNDRED AND FIFTY UNDER/UNINSURED INDIVIDUALS AT NO CHARGE OR ON A SIGNIFICANTLY REDUCED SLIDING-SCALE FEE. ALCOHOLISM: IT TAKES A COMMUNITY "IT TAKES A COMMUNITY" IS A COLLABORATIVE PROGRAM INTENDED TO BROADEN HOSPITAL CLINICAL STAFF KNOWLEDGE OF THE DETOXIFICATION PROCESS BY INVOLVING ADDICTION SPECIALISTS FROM GOSNOLD. ALCOHOL DEPENDENT PATIENTS AT RISK FOR WITHDRAWAL AND INCREASED INCIDENCE OF DELIRIUM TREMENS WERE IDENTIFIED BY A FALMOUTH HOSPITAL ADDICTION SPECIALIST. PATIENTS WERE REFERRED TO A GOSNOLD COUNSELOR FOR ASSESSMENT, TREATMENT AND APPROPRIATE REFERRAL. SERVICES WERE ORGANIZED TO INCLUDE MEDICAL INTERVENTION, CLINICAL COUNSELING, FAMILY SUPPORT, SPECIALTY REFERRAL PROTOCOLS AND CONTINUING EDUCATION FOR NURSES AND PHYSICIANS TO INCREASE THEIR KNOWLEDGE OF ADDICTION AND IMPROVE LINKAGES TO SPECIALTY PROGRAMS, SUCH AS GOSNOLD. AIDS SUPPORT GROUP OF CAPE COD THE AIDS SUPPORT GROUP OF CAPE COD IS A FRAMEWORK OF SERVICES FOR VULNERABLE INDIVIDUALS WHO ARE MONO-INFECTED WITH THE HEPATITIS C VIRUS. THE INITIATIVE UTILIZES A MULTIFACETED APPROACH DESIGNED TO PROVIDE CASE MANAGEMENT AND SUPPORT SERVICES TO CLIENTS RECEIVING INTERFERON-BASED TREATMENT, CLIENTS NEWLY DIAGNOSED WITH THE HEPATITIS C VIRUS AND CLIENTS WITH END-STAGE LIVER DISEASE CO-INFECTED WITH AIDS. THE CORE ELEMENTS OF THE PROGRAM ARE SCREENING, SYRINGE EXCHANGE, HARM REDUCTION, EDUCATION, DRUG OVERDOSE PREVENTION AND REFERRALS FOR TREATMENT. ACCESS TO CARE FOR HOMELESS AND AT RISK ADULTS THE DUFFY HEALTH CENTER PROVIDES ACCESS TO CARE THROUGH ASSISTANCE WITH ENROLLMENT AND RE-ENROLLMENT TO HOMELESS ADULTS AND THOSE AT-RISK FOR HOMELESSNESS INTO MASSHEALTH, COMMONWEALTH CARE, AND OTHER STATE INSURANCE PRODUCTS. CLIENTS RECEIVED ONGOING ACCESS TO CARE, INCLUDING REFERRALS TO PRIMARY CARE PHYSICIANS AND OTHER APPROPRIATE PROVIDERS TO IMPROVE CHRONIC DISEASE MANAGEMENT AND PROMOTE OLDER ADULT WELLNESS. H.O.P.E PROJECT: COMMUNITY ACTION COMMITTEE OF CAPE COD THE H.O.P.E. PROGRAM OFFERS ACCESS TO HEALTH CARE SERVICES THROUGH ENROLLMENT ASSISTANCE TO INDIVIDUALS AND FAMILIES. THE PROGRAM COORDINATOR OFFERS ASSESSMENT OF AFFORDABILITY AND INCOME VERIFICATION TO DETERMINE THE CLIENT'S ABILITY TO OBTAIN MASSHEALTH, COMMONWEALTH CARE, AND OTHER STATE INSURANCE PLANS. THE COORDINATOR ALSO SERVES AS A REFERRAL SOURCE TO PRIMARY CARE PHYSICIANS, OTHER HEALTH AND HUMAN SERVICE ORGANIZATIONS. EDUCATIONAL OPPORTUNITIES EXIST FOR OPTIMIZING THE IDENTIFICATION OF SERVICES AVAILABLE TO ADDRESS THE CLIENTS' UNMET NEEDS. DETERMINATION OF NEED: OFFICE BASED OPIOID TREATMENT PROGRAM (OBOT) THE DUFFY HEALTH CENTER DEVISED AN INTEGRATED MODEL TO PROVIDE THE EVIDENCED-BASED PRACTICE OF OFFICE-BASED OPIOID TREATMENT (OBOT) IN 2009, WITH THE OBJECTIVE OF PROGRAM EXPANSION TO MEMBERS OF THE COMMUNITY HEALTH CENTER NETWORK (CHCN) BY 2011. THE DUFFY HEALTH CENTER (DHC), THE COMMUNITY HEALTH CENTER OF CAPE COD (CHCCC) AND OUTER CAPE HEALTH SERVICES (OCHS) COMPRISE THE GROUP OF CENTERS WHICH FOCUS ON ADDRESSING THE IDENTIFIED HIGH ADDICTION RATES ON CAPE COD. EACH COMMUNITY HEALTH CENTER HAS A SPECIALTY TEAM OF HIGHLY TRAINED PHYSICIANS AND NURSE PRACTITIONERS WHICH MONITOR PATIENTS CLOSELY FOR ADHERENCE TO THEIR TREATMENT PLANS TO ADDRESS THIS VERY COMPLEX ISSUE. DETERMINATION OF NEED: CHNA 27 TOTAL FUNDING OF $401,000 HAS BEEN DESIGNATED TO ADDRESS ISSUES THAT ELIMINATE HEALTH DISPARITIES, PROMOTE WELLNESS, AND PREVENT/MANAGE CHRONIC DISEASE FOR INDIVIDUALS WHO ARE ELDERLY AND/OR PERSONS WITH DISABILITIES. THIS POPULATION WAS IDENTIFIED THROUGH A COMMUNITY HEALTH NEEDS ASSESSMENT BY CAPE COD HEALTHCARE AND ENDORSED BY THE COMMUNITY HEALTH NETWORK AREA 27 (CAPE COD AND THE ISLANDS). PRESCRIPTION ASSISTANCE PROGRAM THE PRESCRIPTION ASSISTANCE PROGRAM IS A JOINT INITIATIVE OF CAPE COD HOSPITAL AND FALMOUTH HOSPITAL EMERGENCY ROOMS AND PHARMACY DEPARTMENTS AS A COMMUNITY BENEFIT TO HELP UNINSURED OR UNDERINSURED PATIENTS WHO HAVE NO OTHER VIABLE MEANS TO PAY FOR MEDICATIONS UPON DISCHARGE FROM THE ER. LAST YEAR PHARMACY VOUCHERS TOTALING OVER $23,000 WERE PROVIDED TO PATIENTS THAT MET THE FINANCIAL CRITERIA. THIS INITIATIVE ENSURES PATIENTS ARE ABLE TO COMPLY WITH THEIR DISCHARGE PLAN. TRANSPORTATION ASSISTANCE PROGRAM CAPE COD HOSPITAL AND FALMOUTH HOSPITAL PROVIDED TRANSPORTATION THROUGH ISSUANCE OF $21,500 WORTH OF TAXI VOUCHERS TO ASSIST FINANCIALLY CHALLENGED PATIENTS WHO ARE BEING DISCHARGED FROM THE EMERGENCY ROOMS AND ARE WITHOUT RESOURCES FOR BEING TRANSPORTED TO THEIR DESTINATION. KICK BUTTS - SMOKING CESSATION PROGRAM CAPE COD HEALTHCARE OFFERS FREE AND REDUCED-FEE PERSONALIZED TOBACCO CESSATION CLASSES. CLASSES FOCUS ON EDUCATING AND MOTIVATING PARTICIPANTS TO STOP UTILIZING USING TOBACCO. THE SIX-WEEK SMOKING CESSATION PROGRAMS OCCUR AT CONVENIENT LOCATIONS IN ORDER TO ACCOMMODATE POTENTIAL PARTICIPANTS. CERTIFIED SMOKING CESSATION EXPERTS FACILITATE THE PROGRAMS. SESSIONS ARE INTERACTIVE AND GROUP SIZES VARY FROM FIVE TO FIFTEEN. CANCER SURVIVORSHIP PROGRAM THE CANCER SURVIVORSHIP PROGRAM AT CAPE COD HEALTHCARE ENCOMPASSES SUPPORT, INFORMATION AND RESOURCES OFFERED TO INDIVIDUALS, FAMILIES AND FRIENDS THROUGH IN-PERSON MEETINGS AND PHONE CONTACT. SUPPORT GROUPS ARE OFFERED ON A MONTHLY BASIS, IN ADDITION TO EDUCATION AND OUTREACH TO ORGANIZATIONS AND THEIR MEMBERSHIP TO INCREASE THE KNOWLEDGE AND AWARENESS OF SURVIVORSHIP. AN ANNUAL "CELEBRATION OF LIFE" EVENT IS ORGANIZED TO EMPHASIZE THE IMPORTANCE OF SUPPORTING SURVIVORS BEYOND THEIR RECOVERY. COMMUNITY-BASED HEALTH EDUCATION AND OUTREACH CAPE COD HEALTHCARE IS COMMITTED TO PROVIDING FREE HEALTH EDUCATION AND OUTREACH IN ORDER TO ENHANCE AND PROMOTE WELLNESS, CONTRIBUTE TO THE PREVENTION OF ILLNESS AND IMPROVE THE MANAGEMENT OF CHRONIC DISEASE. HEALTH CARE PROFESSIONALS, INCLUDING PHYSICIANS AND NURSES, PROVIDE THE MOST UP-TO-DATE HEALTH AND DISEASE MANAGEMENT INFORMATION TO THE COMMUNITY AT LARGE IN ORDER TO INCREASE THEIR AWARENESS OF STRATEGIES WHICH MAY IMPROVE THEIR HEALTH STATUS AND WELL-BEING. HELPING HANDS PROGRAM THE HELPING HANDS PROGRAM OFFERS MEDICATION REVIEW AND OPTIMIZATION WITH A CLINICAL PHARMACIST IN THE PATIENT'S HOME FOR HIGH-RISK PATIENTS BEING DISCHARGED WITH A CHRONIC DISEASE, FIVE OR MORE MEDICATIONS, MULTIPLE REGIMEN CHANGES, AND WHEN AN INCREASE FALL RISK HAS BEEN IDENTIFIED. PATIENTS AND THEIR CAREGIVERS ARE PROVIDED COACHING ON SELF-MANAGEMENT OF THEIR CHRONIC DISEASE, MEDICATION MANAGEMENT AND EVALUATION FOR FALL RISK AND HOME SAFETY. SUPPORT GROUPS AND CLASSES SUPPORT GROUPS AND CLASSES ARE CONDUCTED BY HEALTH CARE PROFESSIONALS ON A REGULAR BASIS. THESE EVENTS WERE OPEN TO ALL MEMBERS OF THE COMMUNITY REGARDLESS OF THEIR PATIENT STATUS OR TIES TO A SPECIFIC HOSPITAL. INFORMATION AND RESOURCES WERE MADE AVAILABLE TO INDIVIDUALS, FAMILIES AND FRIENDS. WORKFORCE DEVELOPMENT CAPE COD HEALTHCARE RECOGNIZES THE IMPORTANCE OF WORKFORCE DEVELOPMENT, AND SUPPORTS THE OPPORTUNITY FOR STUDENTS FROM HIGH SCHOOL THROUGH GRADUATE SCHOO
AFFILIATED HEALTH CARE SYSTEMS ROLES:   THE HOSPITALS ARE PART OF AN AFFILIATED HEALTHCARE SYSTEM AND THEIR RESPECTIVE ROLES ARE: CAPE COD HOSPITAL - A NOT-FOR-PROFIT ACUTE CARE HOSPITAL LOCATED IN HYANNIS, MASSACHUSETTS FALMOUTH HOSPITAL ASSOCIATION, INC. - A NOT-FOR-PROFIT ACUTE CARE HOSPITAL LOCATED IN FALMOUTH, MASSACHUSETTS CAPE COD HEALTHCARE, INC. - A NOT-FOR-PROFIT CORPORATION THAT SERVES AS THE PARENT COMPANY OF VARIOUS ENTITIES PROVIDING HEALTH CARE SERVICES TO THE POPULATION OF CAPE COD, MASSACHUSETTS CAPE COD HEALTHCARE FOUNDATION, INC. - A NOT-FOR-PROFIT CORPORATION ORGANIZED TO PROVIDE DEVELOPMENT AND FUNDRAISING SUPPORT TO CAPE COD HEALTHCARE CAPE AND ISLANDS HEALTH SERVICES II, INC. - A NOT-FOR-PROFIT CORPORATION ORGANIZED TO PROVIDE VARIOUS NONHOSPITAL HEALTH CARE SERVICES MEDICAL AFFILIATES OF CAPE COD, INC. - A NOT-FOR-PROFIT MEDICAL GROUP PRACTICE VISITING NURSE ASSOCIATION OF CAPE COD - A NOT-FOR-PROFIT PROVIDER OF HOME HEALTH SERVICES CAPE COD HUMAN SERVICES, INC. - A NOT-FOR-PROFIT PROVIDER OF OUTPATIENT MENTAL HEALTH SERVICES FALMOUTH ASSISTED LIVING, INC., D/B/A HERITAGE AT FALMOUTH - A NOT-FOR-PROFIT CORPORATION THAT OWNS AN ASSISTED LIVING FACILITY JML CARE CENTER, INC. - A NOT-FOR-PROFIT SKILLED NURSING AND REHABILITATION FACILITY CAPE HEALTH INSURANCE COMPANY - A CAPTIVE INSURANCE COMPANY THAT PROVIDES MEDICAL PROFESSIONAL AND GENERAL LIABILITY INSURANCE TO CAPE COD HEALTHCARE CAPE COD HOSPITAL MEDICAL OFFICE BUILDING - A PROVIDER OF LEASED AND SUBLEASED SPACE TO CAPE COD HOSPITAL AND RELATED AFFILIATIONS ALL STATES WHICH ORGANIZATION FILES A COMMUNITY BENEFIT REPORT: MA
Schedule H (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
CAPE COD HEALTHCARE INC & AFFILIATES
 
Employer identification number

90-0054984
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) CHRISTOPHER O'CONNOR (i)
(ii)		 0
250,115 		0
36,000 		0
4,765 		0
0 		0
24,135 		0
315,015 		0
0
(2) DIANNE KOLB (i)
(ii)		 0
200,710 		0
27,500 		0
5,325 		0
12,392 		0
14,912 		0
260,839 		0
0
(3) SUSAN M WING (i)
(ii)		 0
220,235 		0
42,500 		0
31,006 		0
23,956 		0
6,938 		0
324,635 		0
28,007
(4) MICHAEL G JONES (i)
(ii)		 0
306,601 		0
65,000 		0
1,138 		0
28,333 		0
33,541 		0
434,613 		0
0
(5) LINDA HABEEB MD (i)
(ii)		 235,519
0 		0
0 		420
0 		9,600
0 		26,266
0 		271,805
0 		0
0
(6) CHARLES R HULSE (i)
(ii)		 0
203,873 		0
13,251 		0
1,776 		0
8,781 		0
18,508 		0
246,189 		0
0
(7) RICHARD F SALLUZZO MD (i)
(ii)		 0
841,363 		0
255,000 		0
108,512 		0
83,280 		0
21,153 		0
1,309,308 		0
26,488
(8) MICHAEL K LAUF (i)
(ii)		 0
433,909 		0
100,000 		0
18,817 		0
51,769 		0
30,659 		0
635,154 		0
18,080
(9) MICHAEL L CONNORS (i)
(ii)		 0
335,464 		0
80,000 		0
1,182 		0
41,776 		0
36,145 		0
494,567 		0
0
(10) RICHARD B ZELMAN MD (i)
(ii)		 1,210,859
0 		50,000
0 		7,960
0 		9,800
0 		25,174
0 		1,303,793
0 		0
0
(11) DANIEL J CANADAY MD (i)
(ii)		 331,034
0 		275,157
0 		6,766
0 		9,800
0 		25,174
0 		647,931
0 		0
0
(12) GARY L SHAPIRO MD (i)
(ii)		 547,882
0 		0
0 		14,845
0 		9,800
0 		28,674
0 		601,201
0 		0
0
(13) XIANG-YANG D GUO MD (i)
(ii)		 541,598
0 		0
0 		630
0 		9,800
0 		27,674
0 		579,702
0 		0
0
(14) ROBERT R MCANAW MD (i)
(ii)		 327,331
0 		206,926
0 		1,806
0 		9,800
0 		24,435
0 		570,298
0 		0
0
(15) STEPHEN L ABBOTT (i)
(ii)		 0
0 		0
0 		0
645,256 		0
0 		0
0 		0
645,256 		0
199,912
(16) DAVID RYAN (i)
(ii)		 0
204,651 		0
30,000 		0
1,091 		0
18,892 		0
29,029 		0
283,663 		0
0
(17) JEFFREY S DYKENS (i)
(ii)		 0
214,846 		0
25,000 		0
2,220 		0
9,062 		0
25,174 		0
276,302 		0
0
(18) SHERYL CROWLEY (i)
(ii)		 0
226,600 		0
48,000 		0
630 		0
9,800 		0
25,174 		0
310,204 		0
0
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
LINE 4B: 457(F)   CAPE COD HEALTHCARE, INC. AND AFFILIATES SPONSORS A 457(F) VOLUNTARY PERSONAL DEFERRAL PLAN ("THE PLAN") FOR KEY EMPLOYEES. VESTING IS DEFERRED FOR AT LEAST TWO YEARS FROM THE DATE OF THE AWARD. THE PLAN OFFERS PARTICIPATING EMPLOYEES AN ANNUAL DEFERRAL OF CASH COMPENSATION. AMOUNTS PAID UNDER THE PLAN DURING CALENDAR YEAR 2010 WERE AS FOLLOWS: - RICHARD F. SALLUZZO, MD - $26,488 - MICHAEL K. LAUF - $18,080 - STEPHEN L. ABBOTT - $645,256 - SUSAN M. WING - $28,007 - GARY L. SHAPIRO - $1,496 (SERP) STEPHEN L. ABBOTT, FORMER PRESIDENT/CEO RECEIVED A 457(F) PAYOUT OF $645,256 AS IT WAS VESTED TWO YEARS FROM THE DATE OF TERMINATION. $199,912 REPORTED IN SCHEDULE J, PART II, COLUMN (F) WAS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS FORM 990.
THE INDIVIDUALS REPORTED IN SCHEDULE J, PART I AND SCHEDULE J-2   AS BEING PAID FROM A RELATED ORGANIZATION WERE EMPLOYEES OF, AND COMPENSATED BY CAPE COD HEALTHCARE, INC., THE PARENT CORPORATION.
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
CAPE COD HEALTHCARE INC & AFFILIATES
 
Employer identification number
90-0054984
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A MHEFA REVENUE BONDS SERIES D
  		04-2456001 57586ERMS 12-23-2004 65,000,000 CONSTRUCTION   X   X   X
B MHEFA REVENUE BONDS SERIES E
  		04-2456011 57586C7V1 06-18-2008 36,710,000 REF. OF 93 SER. A&C AND 94 SER   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . . 3,980,000 4,115,422    
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 65,000,000 36,710,000    
4 Gross proceeds in reserve funds . . 3,880,803      
5 Capitalized interest from proceeds. 2,886,949      
6 Proceeds in refunding escrow. . . . .        
7 Issuance costs from proceeds . . . 1,142,687 266,112    
8 Credit enhancement from proceeds. 2,267,966      
9 Working capital expenditures from proceeds . .        
10 Capital expenditures from proceeds . . 54,821,595      
11 Other spent proceeds . . 36,443,888 36,443,888    
12 Other unspent proceeds. . .        
13 Year of substantial completion . . . 2008
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue?   X X          
15 Were the bonds issued as part of an advance refunding issue?   X   X        
16 Has the final allocation of proceeds been made? . . X              
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X   X          
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X            
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .   X            
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use?   X            
b Are there any research agreements that may result in private business use of bond-financed property? . .   X            
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? . X              
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0 %      
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet 0 %      
6 Total of lines 4 and 5 . . .. . . . . . 0 %      
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X              
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X        
2 Is the bond issue a variable rate issue?   X X          
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X X          
b Name of provider . BANK OF AMERICA
  		BANK OF AMERICA
  		 
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .                
e Was a hedge terminated? .                
4a Were gross proceeds invested in a GIC? .   X   X        
b Name of provider .  
  		 
  		 
  		 
 
c Term of GIC . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? .                
5 Were any gross proceeds invested beyond an available temporary period? .   X   X        
6 Did the bond issue qualify for an exception to rebate? . . .   X   X        
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (Form 990) 2010

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
CAPE COD HEALTHCARE INC & AFFILIATES
 
Employer identification number

90-0054984
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) DR KATIE RUDMAN SPOUSE OF TRUSTEE 176,986 MACC EMPLOYEE   No
(2) DR DALE WELDON SPOUSE OF KEY EMPLOYEE 50,260 HOSPITAL EMPLOYEE   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
NonCash Contributions
Right pointing arrow large imageComplete if the organization answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
CAPE COD HEALTHCARE INC & AFFILIATES
 
Employer identification number

90-0054984
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of Contributions or items contributed 		(c)
Contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 31 560,491 VALUE OF STOCK REC'D
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( )
26 Other Right pointing arrow large image( )
27 Other Right pointing arrow large image( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
0
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell non-cash
contributions? ............................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report revenues in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) 2010
Schedule M (Form 990) 2010
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33. Also complete this part for any additional information.
Identifier Return Reference Explanation
SCHEDULE M, PART I, COLUMN (B)   THE ORGANIZATION IS REPORTING THE NUMBER OF ITEMS RECEIVED.
Schedule M (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
CAPE COD HEALTHCARE INC & AFFILIATES
 
Employer identification number

90-0054984
Identifier Return Reference Explanation
Community Benefits Mission   Community Benefits Mission Statement: Cape Cod Healthcare, Inc., through its Community Benefits initiative, is committed to enhancing the quality of and access to comprehensive health care services for all the residents of Cape Cod. Through continuous assessment of community needs, coordinated planning and the allocation of resources, this commitment includes a special focus on the unmet needs of the financially disadvantaged and underserved populations. We will take a leadership role in collaborative efforts joining our resources, talent, and commitment with that of other providers, organizations and community members. The Community Benefits Mission Statement was affirmed by the CCHC Community Health Committee and the Board of Trustees in 2000 and remains in effect. Target Populations 1. Name of Target Population: The under-served, un/underinsured and/or those with health disparities. Basis for Selection: This population is selected based on well documented evidence that a significant portion of the community needs financial, programmatic, informational or educational support. The data suggests opportunity to impact the overall health status of individuals across the entire service area. Although some aspects may be currently addressed to some degree in the community, unmet needs still exist. 2. Name of Target Population: Chronically ill residents afflicted with cardiovascular-related disease, diabetes, and/or oral health issues. Basis for Selection: This population is selected based on well documented evidence that a significant portion of the community needs financial, programmatic, informational or educational support. The data suggests opportunity to impact the overall health status of individuals across the entire service area. Although some aspects may be currently addressed to some degree in the community, unmet needs still exist. 3. Name of Target Population: Community members afflicted with mental health and/or substance abuse-related issues. Basis for Selection: This population is selected based on well documented evidence that a significant portion of the community needs financial, programmatic, informational or educational support. The data suggests opportunity to impact the overall health status of individuals across the entire service area. Although some aspects may be currently addressed to some degree in the community, unmet needs still exist. 4. Name of Target Population: Geriatric population, especially those who are at risk and/or in hard to reach areas. Basis for Selection: This population is selected based on well documented evidence that a significant portion of the community needs financial, programmatic, informational or educational support. The data suggests opportunity to impact the overall health status of individuals across the entire service area. Although some aspects may be currently addressed to some degree in the community, unmet needs still exist. 5. Name of Target Population: Residents with emerging health issues. Basis for Selection: This population is designated to allow program flexibility to address community health needs not identified at the time of initial plan development. Publication of Target Populations Website, Other- Attorney General Website Hospital/HMO Web Page Publicizing Target Pop. http://www.capecodhealth.org/community
Key Accomplishments of Reporting Year   The Cape Cod Healthcare (CCHC) Community Benefits program provided funding to multiple community agencies. Throughout the year, leadership, staff and physicians worked collaboratively with community agencies to identify and develop programs that were sponsored by CCHC. The program continues to seek opportunities to develop collaborative relationships which benefit the community. The key accomplishments for FY 11 include: 1. HC expanded its collaboration with and support of the federally funded community health centers operating in Barnstable County. 2. CCHC continued its collaboration with a broad spectrum of health and human service agencies which support the residents of Barnstable County. 3. CCHC initiated the first phase of the Community Health Needs Assessment for the service area. During FY 11 the program began study design, identified and selected an independent research firm to assist with the research component and solicited the involvement of other community partners. Secondary research began and the study will conclude and be reported in FY 12. This study will serve as the basis for program planning from FY 13-15. 4. CCHC, in collaboration with the Community Health Committee, stabilized three important and ongoing programs by establishing multi-year plans and funding. These programs provide services to vulnerable populations including the uninsured, elders, people needing access to specialty physicians, and interpretive services in the community. 5. Established an internally based Community Benefits Task Force comprised of clinical, operational and corporate managers throughout CCHC to identify and quantify community benefits initiatives. The task force created an inventory of all community benefit programs which align with the target populations and stated priorities. This group also serves in an advisory capacity which identifies community needs. 6. Developed a comprehensive RFP program for direct funding of community benefit programs. This process resulted in direct funding of $100,000 to programs/agencies which address substance abuse, infectious disease and access through enrollment. 7. CCHC's Community Benefits program staff participates as an active member of CHNA 27 and its steering committee. CHNA 27 members work to build a healthier community through community-based prevention planning, health promotion and improving health status indicators of Cape Cod and the Islands residents pursuant to the mandate from the Massachusetts Department of Public Health. Plans for Next Reporting Year Plans for FY12 will continue to implement priorities established in the FY 10 strategic plan. Staff updates and amends the plan annually to reflect emerging needs. These amendments ensure that the plan has incorporated data and findings from national, regional, state and local studies, particularly those provided by the Mass Department of Public Health and Barnstable County Human Services. The FY 12 plan is compliant with all state and federal requirements.
Goals for FY2012   1. Continue to expand community collaborations to enhance the health of Cape Cod's underserved and vulnerable populations. 2. Strategically partner with the four federally qualified community health centers based on Cape Cod to increase access to primary and specialty care services. 3. Complete a Community Health Needs Assessment and utilize findings to modify the community benefits plan. 4. Develop or modify Community Benefits services to meet prioritized community health needs for FY 13-15. 5. Continue to evaluate services, events and programs for alignment with established priorities, measurable outcomes and cost effectiveness, as well as with CCHC's overall strategic direction. 6. Conduct an annual RFP process and award $150,000 in Impact Priority-Grants. Community Collaborations CCHC continuously seeks opportunities to engage the community in collaborative efforts to enhance the quality of and access to comprehensive health care services for all residents of Cape Cod. FY2012 Community Benefits Priorities 1. Increase health care access through outreach and leadership initiatives resulting in an integrated and coordinated community health care delivery system to reduce health disparities and promote health equity. 2. Create strategic collaborations with existing community health providers and partners who will foster healthy lifestyle choices and promote healthier behaviours that can prevent or delay chronic disease thereby increasing the quality of life. 3. Improve post-hospital discharge and follow-up experience of vulnerable patients, particularly elders and those with chronic disease. 4. Adopt a more preventative, wellness-oriented care model related to mental health and substance abuse. 5. Reduce health risks and unnecessary declines in quality of life through wellness and prevention approaches with attention to particularly vulnerable populations, including, but not limited to: a) Persons 65 and over b) Persons with or at risk of contracting; HIV/AIDS, Hepatitis B and C, tuberculosis and/or sexually transmitted diseases. 6. Address well documented emerging health issues identified by the MA Department of Health, and other reliable sources, such as issues related to youth populations (i.e. violence, bullying and suicide).
Community Benefits Process   Community Benefits Leadership Team A fundamental tenet of Cape Cod Healthcare's mission is to provide excellent care to members of our community. Cape Cod and Falmouth Hospitals, along with our affiliates, play an important role as safety net providers to the Cape Cod region, given our relative geographic isolation. The development of varied community collaborations, including the Community Benefits Program, is lead by Michael K. Lauf, Chief Executive Officer and Theresa M. Ahern, Vice President, Strategy, Community/Governmental Affairs. Management of the program is the responsibility of Carol A. Summersall, Director of Community Benefits and Partnerships. The Community Health Committee provides strategic oversight to the community benefits program as a designated subcommittee of the Board of Trustees. The Committee is comprised of members who work in health care services on Cape Cod, community-based organizations, community advocacy groups and county government, as well as two current members of the CCHC Board of Trustees. The Committee develops and recommends policies to the Board regarding Community Benefits programs, sets priorities and awards priority grant funding, and advises on community health issues and initiatives. Community Health Committee Members Eleanor Claus (Chair) CCHC Board Member 927 Route 6A, Yarmouth Port, MA 02675 508.362.3000 x203 eclaus@kinlingrover.com Representing: CCHC Board of Trustees Elizabeth Albert, Director Barnstable County Human Services P.O. Box 427, Barnstable, 02630 508.375.6626 balbert@barnstablecounty.org Representing: Community at Large: Mid-Cape Karen Cardeira, Director Falmouth Human Services 65 Town Hall Square, Falmouth, MA 02540 508.548.0533 kcardeira@falmouthhumanservices.org Representing: Community at Large: Upper Cape Mary Devlin, Manager Public Health and Wellness Visiting Nurses Association 255 Independence Drive, Hyannis, 02601 508.957.7619 mdevlin@vnacapecod.org VNA of Cape Cod: Provincetown to Plymouth Representing: All 5 Priorities with emphasis on Chronic Disease and Healthy Aging of the Geriatric Population Georgia Carvalho, Grants Developer Cape Cod Community College 2240 Iyannough Road, West Barnstable, 02668 508.362.2131 ext. 4492 gcarvalho@capecod.edu Representing: Education related to all 5 priorities Karen Gardner, CEO Community Health Center of Cape Cod 107 Commercial St., Mashpee, MA 02649 508.477.7090 kgardner@chcofcapecod.org Representing: Community at Large Suzanne Fay Glynn, Attorney CCHC Board Member Glynn Law Offices 49 Locust Street, Falmouth, MA 02540 508.548.8282 ljarvis@glynnlawoffices.com Representing: CCHC Board of Trustees Carmen Lebron, Manager Cape Cod Immigrant Center 624 Osterville West Barnstable Rd Unit E1 - Marstons Mills, MA 02648 508.428.0517 clebron@capecod.edu Representing: All 5 priorities with an emphasis on Immigrant population, Health disparities and Emerging Health Needs Timothy Lineaweaver, Executive Director Cape and Islands Coalition for Suicide Prevention 107 Commercial Street, Mashpee, MA 02649 tnt410@aol.com Representing: Mental Health, Substance Abuse and Suicide Brian O'Malley, MD 30 Shankpainter Road Provincetown, MA 02657 508.487.3505 bomalley@capecodhealth.org Medical Seat Representing: Community at Large: Lower/Outer Cape Elizabeth Smith, Director Lower Cape Councils on Aging (Orleans) 150 Rock Harbor Road, Orleans, 02653 508.255.6333 esmith@town.orleans.ma.us Representing: Healthy Aging to Geriatric Population, Chronic Disease and Emerging Health Needs Cape Cod Healthcare members: Theresa M. Ahern Vice President, Strategy and Community/Governmental Affairs Cape Cod Healthcare 88 Lewis Bay Road Hyannis, MA 02601 508.862.5077 tahern@capecodhealth.org Diane M. Munsell, BSN, RN, EdM Senior Manager, Community Benefits and Clinical Outreach Cape Cod Healthcare 333 North Street Hyannis, MA 02601 508.862.7896 dmunsell@capecodhealth.org Community Benefits Team Meetings The Community Health Committee Meeting Dates for FY11 were: November 18, 2010 4:00-5:30 pm February 24, 2011 4:00-5:30 pm May 5, 2011 4:00-5:30 pm August 4, 2011 4:00-5:30 pm Community Partners AIDS Support Group of Cape Cod Barnstable Equals Smart, Safe and Sober (BES3) Barnstable Human Services Barnstable High School Cape and Islands EMS Systems, Inc. Cape and Islands Suicide Prevention Coalition Cape and Islands United Way Cape Cod Chamber of Commerce Cape Cod Community College Cape Cod Community Foundation Cape Cod Immigrant Center Children's Cove Community Action Committee of Cape Cod & Islands Community Health Center of Cape Cod Councils on Aging Duffy Health Center Falmouth Human Services Gosnold on Cape Cod Housing Assistance Corporation Immigrant Center of Cape Cod Massachusetts Department of Public Health Mid-Upper Cape Community Health Center Outer Cape Health Services Parkinson Support Network of Cape Cod The Cape and Islands Community Health Network (CHNA 27) Tri-County Collaborative for Oral Health Excellence
Community Health Needs Assessment   Date Last Assessment Completed and Current Status Cape Cod Healthcare conducts a formal community health needs assessment study every three years. CCHC solicits community participation in the design, data collection and development of recommendations for the program. The study findings are the foundation for program planning and implementation. In addition, the plan is updated on an annual basis to reflect emerging needs between cycles. CCHC seeks community feedback about the services provided, satisfaction with such services, and specific services needed. This input, together with secondary data from multiple sources, is used to build an agenda aimed at providing needed health care services and additional community-based programs. Cape Cod Healthcare conducted a Community Health Needs Assessment in 2008-2009. The assessment, performed in collaboration with community partners from Cape Cod and the Islands, consisted of data gathering and analysis utilizing multiple data sources and health status indicators. The assessment resulted in the creation of the Salient Health Issues Report. In 2009 "Community Solution Forums" were organized to explore how various populations in Barnstable County were impacted by the health issues identified in the Salient Health Issues Report. Viable solutions were sought to reduce or eliminate identified issues. The assessment completed in 2009 continues to guide the Community Benefits program through FY12. Cape Cod Healthcare began a new Community Health Needs Assessment in FY2011. This study will conclude in FY 12 and will be the basis of community benefit planning for FY13 - FY15. The following sources were utilized in the 2008-2009 Community Health Needs Assessment: - Asthma Prevention and Control Programs: State of Massachusetts - Bureau of Substance Abuse Services: Massachusetts - Cape Cod Commission: Overview of Cape & Islands Population - Centers for Disease Control and Prevention - Injury Surveillance Program: Massachusetts - Jarvi Report 2004, Cape & Island's Behavioral Health Needs Surveillance and Gaps - Key Informant Interviews - Local Health Agencies - Massachusetts Cancer Registry - Massachusetts Deaths 2000-2005 - Massachusetts Health Data Consortium - MDPH Regional Health Status Indicators 2007 - Monitoring the Human Condition Study 2007 Barnstable County - National Institute of Health - Senior Mobility Initiative on Cape Cod [SMICC] - U.S. Census Consultants/Other Organizations (Needs Assessment) Barnstable County Cape and Islands EMS Systems, Inc. Cape and Islands Suicide Prevention Coalition Cape Cod Immigrant Center Community Action Committee of Cape Cod & Islands Councils on Aging Duffy Health Center Gosnold on Cape Cod Massachusetts Department of Public Health The Barnstable Human Rights Commission The Cape and Islands Community Health Network (CHNA 27) Tri-County Collaborative for Oral Health Excellence Data Sources (Needs Assessment) Community Focus Groups, Hospital, Consumer Group, Interviews, MassCHIP, Public Health Personnel, Surveys, CHNA, Other - Bureau of Substance Abuse, Mass., Monitoring the Human Condition Study 2007 and 2008, Barnstable County Department of Human Services, Salient Health Issues Report, June 2008, Barnstable County, Local Health Agencies COMMUNITY BENFEITS PROGRAMS Financial Counseling & Assistance Program Type: Community Participation/Capacity Building Initiative, Direct Services, Health Coverage Subsidies or Enrollment, Health Professional/Staff Training, Healthy Communities Partnership, Outreach to Underserved, Prevention Brief Description or Objective: The Financial Assistance and Counseling Program provides comprehensive services to community members seeking public insurance enrollment and re-verification of enrollment into MassHealth, Commonwealth Care and Health Safety Net insurance products. Financial counselors are dedicated to improving access to care through eligibility screening, assessed affordability and income verification. Target Population: Region Served: Barnstable Health Indicator: Access to Health Care, Other: Uninsured/Underinsured Sex: All Age Group: All Ethnic Group: All Language: All Goals Statewide Priority: Address Unmet Health Needs of the Uninsured, Promoting Wellness of Vulnerable Populations, Reducing Health Disparity, Supporting Healthcare Reform 1. Goal Description Increase access to care through enrollment. Goal Status Assisted 3,380 people with Gateway applications and re-verification. Ongoing 2. Goal Description Improve community awareness of state insurance programs. Goal Status Provided outreach and education, which resulted in a 23% increase over prior year in enrollment and re-enrollment for residents of Cape Cod. Ongoing Partners Cape Cod Immigrant Center http://www.ccimmigrantcenter.org/ Community Action Committee of Cape Cod and Islands http://www.cacci.cc/ Community Health Center of Cape Cod http://www.chcofcapecod.org/ Council on Aging on Cape Cod http://www.allcapecod.com/ccic/seniorcenters.cfm Duffy Health Center http://www.duffyhealthcenter.org/ Elder Services of Cape Cod & the Islands http://www.escci.org/ Martha's Vineyard Hospital http://www.mvhospital.com/ Mashpee Wampanoag http://www.mashpeewampanoagtribe.com/ Mid-Upper Cape Community Health Center http://www.hhsi.us/cape-cod/mid-upper-cape-community-health-center/ Nantucket Cottage Hospital http://www.nantuckethospital.org/ Outer Cape Health Services http://www.outercape.org/ Spaulding Rehabilitation Hospital Cape Cod http://www.rhci.org/about/news/rhcispauldingcapecod/ Visiting Nurses Association http://www.vnacapecod.org/index.html All Nursing Homes and Rehabilitation Sites on Cape Cod Various Contact Information Michael Clark, Executive Director of Patient Access, 25 Communication Way, Hyannis, MA 02601, 508.957.8464, mclark@capecodhealth.org Detailed Description Not Specified PHYSICIAN RECRUITMENT Program Type: Community Participation/Capacity Building Initiative, Healthy Communities Partnership, Outreach to Underserved, Physician/Provider Diversity, Prevention Brief Description or Objective: The Physician Recruitment program strives to identify areas of unmet need and improve access to primary and specialty care for vulnerable populations, especially those over 65. Through rigorous efforts highly qualified and competent physicians and physician extenders are recruited and retained to meet the health care needs and provide care to the residents of Cape Cod. Target Population Regions Served: Barnstable Health Indicator: Access to Health Care, Other: Uninsured/Underinsured Sex: All Age Group: All Ethnic Group: All Language: All Goals Statewide Priority: Address Unmet Health Needs of the Uninsured, Chronic Disease Management in Disadvantage Populations, Promoting Wellness of Vulnerable Populations 1. Goal Description Increase access to care through provider recruitment. Goal Status Fourteen physicians and physician extenders were recruited in FY11. Ongoing 2. Goal Description Address needs of vulnerable populations. Goal Status Recruited primary care and specialty physicians to address the unmet needs of vulnerable populations, such as the elderly. Ongoing
PARTNERS   Partner Name, Description Not Specified Partner Web Address Not Specified Contact Information Keith Ritchie, Director of Physician Services, Cape Cod Healthcare, 88 Lewis Bay Road, Hyannis, MA 02601, 508.862.5481, kritchie@capecodhealth.org REACHING ELDERS WITH ADDITIONAL COMMUNITY HELP (REACH): CAPE & ISLANDS EMERGENCY MEDICAL SERVICES SYSTEM (CIEMSS) Program Type: Community Education, Community Participation/Capacity Building Initiative, Direct Services, Health Coverage Subsidies or Enrollment, Health Professional/Staff Training, Healthy Communities Partnership, Outreach to Underserved, Prevention Brief Description or Objective: REACH coordinates services for seniors in their homes through the provision of referrals to appropriate organizations. By working in conjunction with Councils on Aging, Elder Services of Cape Cod and the Islands, VNA, EMS and other community partners, issues such as health, safety, psychological status and social functioning are assessed, and appropriate plans are developed to achieve optimal daily living status for seniors on Cape Cod. REACH also offers community-based trainings for senior providers which target emerging issues and trends that specifically impact senior health and well-being. Target Population: Regions Served: Barnstable Health Indicator: Access to Health Care, Injury and Violence, Mental Health, Other: Alzheimer Disease, Other: Elder Care, Other: First Aid/ACLS/CPR, Other: Homebound, Other: Homelessness, Other: Hospice, Other: Parkinson's Disease, Other: Safety - Home, Other: Stress Management, Other: Uninsured/Underinsured Sex: All Age Group: Adult-Elder Ethnic Group: All Language: All Goals Statewide Priority: Address Unmet Health Needs of the Uninsured, Chronic Disease Management in Disadvantage Populations, Promoting Wellness of Vulnerable Populations 1. Goal Description Increase access to care for at least 250 elders. Goal Status Referrals for 292 community-dwelling frail elders were made to organizations which provided support services to improve the overall health, safety and well being of these individuals through community collaboration and coordination. Ongoing 2. Goal Description Promote wellness initiatives which address chronic disease management. Goal Status Assisted senior service organizations in the promotion of wellness through provision of services to prevent unnecessary declines with a focus on older adults with chronic health issues. 3. GOAL DESCRIPTION Increase competency of service providers. Goal Status Competency building educational opportunities were provided to several community organizations to increase and support age-appropriate information, referral and service response. Train the trainer sessions were conducted for 20 responders. On Target Partners Partner Name, Description and Web Address Cape & Islands Emergency Medical Service System (CIEMSS) http://www.ciemss.org/ Council on Aging on Cape Cod http://www.allcapecod.com/ccic/seniorcenters.cfm Elder Services of Cape Cod http://www.escci.org/ Visiting Nurses Association http://www.vnacapecod.org/index.html Contact Information Katherine Wernier REACH Collaborative Coordinator, Reaching Elders with Additional Community Help, 66 Bayview Street, West Yarmouth, MA 02673-8203, 508.771.4510 , reach@ciemss.org Detailed Description Not Specified COMMUNITY BASED INTERPRETER SERVICES Program Type: Community Participation/Capacity Building Initiative, Direct Services, Grant/Donation/Foundation/Scholarship, Health Coverage Subsidies or Enrollment, Healthy Communities Partnership, Outreach to Underserved, Physician/Provider Diversity, Prevention, School/Health Center Partnership Brief Description or Objective: The Community Based Interpreter Services program offers free medical language interpretation in community-based physician practices and at the Community Health Centers for the limited and non-English speaking patients and their families. The availability of proficient and professional interpreter services ensures the delivery of safe quality health care and positive clinical outcomes. Target Population Regions Served: Barnstable Health Indicator: Access to Health Care, Other: Uninsured/Underinsured Sex: All Age Group: All Ethnic Group: All Language: Haitian Creole , Portuguese , Spanish Goals Statewide Priority: Address Unmet Health Needs of the Uninsured, Chronic Disease Management in Disadvantage Populations, Promoting Wellness of Vulnerable Populations, Reducing Health Disparity, Supporting Healthcare Reform 1. Goal Description Increase access to care by providing at least 1,000 medical language interpretations. Goal Status Collaborated with Community Health Centers and physician offices through outreach and education relative to interpreter services which resulted in 1,020 encounters. Ongoing 2. Goal Description Reduce health care disparities for limited and non-English speaking people. Goal Status Ensured physicians and providers understood the significance of utilizing interpreter services through the distribution of thousands of brochures and offering in-service opportunities. Ongoing Partners Partner Name, Description and Web Address Community Health Center of Cape Cod: The Specialty Network for the Uninsured http://www.chcofcapecod.org/ Community-Based Medical Offices on Cape Cod Various Contact Information Ceci Phelan-Stiles, Sr. Manager of HR Communication Systems, Cape Cod Healthcare, 60 Park Street, Hyannis, MA 02601, 508.862.7822 , cphelan-stiles@capecodhealth.org Detailed Description Not Specified SPECIALTY NETWORK FOR THE UNINSURED (SN): COMMUNITY HEALTH CENTER OF CAPE COD Program Type: Community Participation/Capacity Building Initiative, Direct Services, Grant/Donation/Foundation/Scholarship, Health Coverage Subsidies or Enrollment, Healthy Communities Partnership, Outreach to Underserved, Prevention, School/Health Center Partnership Brief Description or Objective: The Specialty Network for the Uninsured (SNU) is provided in collaboration with the Community Health Center network through on-site specialty clinics and volunteer physicians. It offers access to specialty care services for over six hundred and fifty under/uninsured individuals at no charge or on a significantly reduced sliding-scale fee. Target Population Regions Served: Barnstable Health Indicator: Access to Health Care, Other: Cancer, Other: Cancer - Breast, Other: Cancer - Cervical, Other: Cancer - Colo-rectal, Other: Cancer - Lung, Other: Cancer - Prostate, Other: Cancer - Skin, Other: Cardiac Disease, Other: Colitis/Crohn Disease, Other: Elder Care, Other: Hypertension, Other: Uninsured/Underinsured Sex: All Age Group: All Ethnic Group: All Language: English , Haitian Creole , Portuguese , Spanish Goals Statewide Priority: Address Unmet Health Needs of the Uninsured, Chronic Disease Management in Disadvantage Populations, Promoting Wellness of Vulnerable Populations, Reducing Health Disparity, Supporting Healthcare Reform 1. Goal Description Increase access to specialty care for at least 650 low-income and uninsured individuals. Goal Status The SNU provided 731 patient appointments with specialists. Ongoing 2. Goal Description Increase capability of SNU to accept patients for specialty care. Goal Status The program established agreements with 75 specialists, which represent 19 medical and surgical specialties. Ongoing 3. Goal Description Improve health care outcomes through prevention and health promotion. Goal Status Assisted patients with care coordination and referrals to cancer screenings for breast and prostate as well as eye screenings. Ongoing Partners Partner Name, Description and Web Address Community Health Center of Cape Cod http://www.chcofcapecod.org/ Contact Information Karen Gardner, CEO, 107 Commercial Street, Mashpee, MA 02649, 508.477.7090 , kgardner@chcofcapecod.org Detailed Description Not Specified
PRESCRIPTION ASSISTANCE PROGRAM   Program Type: Direct Services, Grant/Donation/Foundation/Scholarship, Health Coverage Subsidies or Enrollment, Healthy Communities Partnership, Outreach to Underserved Brief Description or Objective: The Prescription Assistance Program is a joint initiative of Cape Cod Hospital and Falmouth Hospital Emergency Rooms and Pharmacy Departments as a community benefit to help uninsured or underinsured patients who have no other viable means to pay for medications upon discharge from the ER. Target Population Regions Served: Barnstable Health Indicator: Access to Health Care, Other: Uninsured/Underinsured Sex: All Age Group: All Ethnic Group: All Language: All Goals Statewide Priority: Address Unmet Health Needs of the Uninsured, Chronic Disease Management in Disadvantage Populations, Promoting Wellness of Vulnerable Populations 1. Goal Description Assist people who are unable to afford medications to ensure compliance with their discharge plan. Goal Status Cape Cod Hospital and Falmouth Hospital Emergency Rooms provided pharmacy vouchers totaling $23,652 for uninsured, underinsured or financially challenged patients who were unable to afford prescriptions upon discharge. Ongoing Partners Partner Name, Description and Web Address Patients leaving the Cape Cod Hospital or Falmouth Hospital Emergency Rooms who are un/underinsured and struggling financially. n/a Local Pharmacies n/a Contact Information: Carol Summersall, RN, Director of Community Benefits and Partnerships, Cape Cod Healthcare, 297 North Street, Suite 333 Hyannis, MA 02601, 508.862.7896 , csummersall@capecodhealth.org Detailed Description: Not Specified TRANSPORTATION ASSISTANCE PROGRAM Program Type: Community Participation/Capacity Building Initiative, Direct Services, Healthy Communities Partnership, Outreach to Underserved Brief Description or Objective: Cape Cod Hospital and Falmouth Hospital provided transportation through issuance of taxi vouchers to assist financially challenged patients who are being discharged from the Emergency Rooms and are without resources for being transported to their destination. Target Population Regions Served: Barnstable Health Indicator: Access to Health Care, Other: Homelessness, Other: Safety, Other: Uninsured/Underinsured Sex: All Age Group: All Ethnic Group: All Language: All Goals Statewide Priority: Address Unmet Health Needs of the Uninsured, Promoting Wellness of Vulnerable Populations 1. Goal Description Assist people who are unable to afford or access transportation to ensure compliance with their discharge plan. Goal Status Cape Cod Hospital and Falmouth Hospital Emergency Rooms provided taxi vouchers totaling $21,523 for uninsured, underinsured or financially challenged patients upon discharge. Ongoing Partners Partner Name, Description, Web address Local Taxi Companies n/a Un/underinsured community members who are struggling financially. n/a Contact Information Carol Summersall, RN, Director of Community Benefits and Partnerships, Cape Cod Healthcare, 297 North Street, Hyannis, MA 02601, 508.862.7896, csummersall@capecodhealth.org KICK BUTTS, STOP SMOKING PROGRAM Program Type: Community Education, Community Participation/Capacity Building Initiative, Direct Services, Healthy Communities Partnership, Outreach to Underserved, Prevention, School/Health Center Partnership Brief Description or Objective: Cape Cod Healthcare offers free and reduced-fee personalized tobacco cessation classes to provide education and motivation to interested individuals that are seeking support to stop using tobacco. A six-week smoking cessation program is conducted in local community sites between Bourne and Hyannis. Certified Smoking Cessation experts facilitate the programs. Sessions are interactive and group sizes vary from five to fifteen. Target Population Regions Served: Barnstable Health Indicator: Access to Health Care, Other: Cancer, Other: Cancer - Lung, Other: Cardiac Disease, Other: Pulmonary Disease/Tuberculosis, Other: Smoking/Tobacco, Other: Uninsured/Underinsured, Tobacco Use Sex: All Age Group: All Adults, Child-Teen Ethnic Group: All Language: English Goals Statewide Priority: Address Unmet Health Needs of the Uninsured, Chronic Disease Management in Disadvantage Populations, Promoting Wellness of Vulnerable Populations 1. Goal Description Support health promotion by offering at least 6 smoking cessation classes. Goal Status Six Kick Butts, Stop Smoking Classes were offered in FY11. Approximately 50 people registered for classes. Completed Partners Partner Name, Description, Web Address Barnstable High School, Hyannis, MA http://www.barnstable.k12.ma.us/bhs/home.html Barnstable Senior Center http://www.town.barnstable.ma.us/seniorservices/ Bourne Community Center http://www.bournecouncilonaging.org/about.html Contact Information Carol Summersall, RN, Director of Community Benefits and Partnerships, Cape Cod Healthcare, 297 North Street, Suite 333, Hyannis, MA 02601, 508.862.7896, csummersall@capecodhealth.org Detailed Description Download/View Attachment(638865 KB) File Name: Kick Butts Tri-fold.pdf DETERMINATION OF NEED: OFFICE BASED OPIOD TREATMENT PROGRAM (OBOT) Program Type: Community Participation/Capacity Building Initiative, Direct Services, Grant/Donation/Foundation/Scholarship, Health Coverage Subsidies or Enrollment, Health Professional/Staff Training, Healthy Communities Partnership, Outreach to Underserved, Prevention Brief Description or Objective: The Duffy Health Center devised an integrated model to provide the evidenced-based practice of Office-Based Opioid Treatment (OBOT) in 2009, with the objective of program expansion to members of the Community Health Center Network (CHCN) by 2011. The Duffy Health Center (DHC), the Community Health Center of Cape Cod (CHCCC) and Outer Cape Health Services (OCHS) comprise the group of centers which focus on addressing the identified high addiction rates on Cape Cod. Each community health center has a specialty team of highly trained physicians and nurse practitioners which monitor patients closely for adherence to their treatment plans to address this very complex issue. Target Population Regions Served: Barnstable Health Indicator: Access to Health Care, Mental Health, Other: Alcohol and Substance Abuse, Other: Education/Learning Issues, Other: Homelessness, Other: Stress Management, Other: Uninsured/Underinsured, Substance Abuse Sex: All Age Group: All Adults Ethnic Group: All Language: English , Haitian Creole , Portuguese , Spanish Goals Statewide Priority: Address Unmet Health Needs of the Uninsured, Chronic Disease Management in Disadvantage Populations, Promoting Wellness of Vulnerable Populations, Supporting Healthcare Reform 1. Goal Description Provide Case-Care Management Services to ensure patients have a high level of staff intervention. Goal Status Patients are closely monitored to ensure adherence to program recovery protocols. In FY11 the DHC panel averaged 121 patients, the CHCCC panel average 51 patients and OCHS panel averaged 35 patients. Ongoing 2. Goal Description Increase access to program services. Goal Status OCHS joined the program in FY11, thus increasing access to services for people residing on the Lower/Outer Cape. Access to Gosnold Center is provided to all patients who need detoxification, rehab and Intensive Outpatient Services (IOP). Ongoing 3. Goal Description Recruit and retain providers. Goal Status All 3 centers actively recruited staff to maintain appropriate level of care. Ongoing recruitment is essential as a lack of capacity in any of the service areas including medical, behavioral health or case management creates barriers to treatment. Partners Partner Name, Description, Web Address Community Health Center of Cape Cod http://www.chcofcapecod.org/ Duffy Health Center http://www.duffyhealthcenter.org/ Outer Cape Health Services http://www.outercape.org/ Contact Information Heidi Nelson, FACHE, CEO 94 Main Street, Hyannis, MA 02601, 508.771.7517 , hnelson@duffyhealthcenter.org Detailed Description Not Specified
Determination of Need: CHNA 27   Program Type: Community Participation/Capacity Building Initiative, Grant/Donation/Foundation/Scholarship, Healthy Communities Partnership, Outreach to Underserved, Prevention Brief Description or Objective: Total funding of $401,000 has been designated to address issues that eliminate health disparities, promote wellness, and prevent/manage chronic disease for individuals who are elderly and/or persons with disabilities. This population was identified through a community health needs assessment by Cape Cod Healthcare and endorsed by the Community Health Network Area 27 (Cape Cod and the Islands). This program was specified as part of Cape Cod Hospital's Determination of Need requirement for the Clark Cancer Center development and licensure. FY11 is the second year of a five year program ($80,200 per year). Target Population Regions Served: Barnstable Health Indicator: Access to Health Care, Other: Uninsured/Underinsured Sex: All Age Group: Adult-Elder Ethnic Group: All Language: All Goals Statewide Priority: Address Unmet Health Needs of the Uninsured, Chronic Disease Management in Disadvantage Populations, Promoting Wellness of Vulnerable Populations 1. Goal Description Issue an RFP supporting collaborative, measurable and evidenced-based regional programs for seniors and/or disabled that provides an impact on the most urgent needs of the identified target population. Goal Status RFP awards were made in 2011 to four organizations which met this criterion. The grant awards ranged from $15,000 to $30,000 and totaled $80,200. The Cape Cod Foundation is the fiscal agent for CHNA 27, and managed the RFP review process. On Target Partners Partner Name, Description, Web Address CHNA 27 N/A The Cape Cod Foundation http://www.capecodfoundation.org/ Contact Information Carol Summersall, RN, Director of Community Benefits and Partnerships, Cape Cod Healthcare, 297 North Street, Suite 333 Hyannis, MA 02601, 508.862.7896 , csummersall@capecodhealth.org Detailed Description Not Specified H.O.P.E INSURANCE OUTREACH AND ENROLLMENT Program Type: Community Participation/Capacity Building Initiative, Direct Services, Grant/Donation/Foundation/Scholarship, Health Coverage Subsidies or Enrollment, Healthy Communities Partnership, Outreach to Underserved, Prevention Brief Description or Objective: The H.O.P.E. program offers access to health care services through enrollment assistance to individuals and families. The program coordinator offers assessment of affordability and income verification to determine the client's ability to obtain MassHealth, Commonwealth Care, and other state insurance plans. The coordinator also serves as a referral source to primary care physicians, other health and human service organizations. Educational opportunities exist for optimizing the identification of services available to address the clients unmet needs. Target Population Regions Served: Barnstable Health Indicator: Access to Health Care, Other: Uninsured/Underinsured Sex: All Age Group: All Ethnic Group: All Language: All Goals Statewide Priority: Address Unmet Health Needs of the Uninsured, Chronic Disease Management in Disadvantage Populations, Promoting Wellness of Vulnerable Populations, Supporting Healthcare Reform 1. Goal Description Increase access to care through enrollment and re-enrollment. Goal Status Enrollment benefits coordinator assisted individuals with process of determining their qualification for insurance programs, such as MassHealth. Over 1,800 enrollments and re-enrollments occurred. Ongoing 2. Goal Description Expand capacity to enroll clients. Goal Status Multi-site services were provided to improve enrolment and renewals for clients. Students, families and individuals were seen at the Barnstable School Based Health Center and the Falmouth Service Center. Ongoing 3. Goal Description Reduce health disparities through care coordination. Goal Status Gaps in services for expectant mothers were eliminated through a collaborative effort with WIC. Completed Partners Partner Name, Description and Web Address Barnstable High School www.barnstable.k12.ma.us/bhs/ Falmouth Service Center www.falmouthservicecenter.org/ Health Imperatives - Cape Cod WIC www.healthimperatives.org Contact Information Caronanne Procaccini, Interim Director, 115 Enterprise Road, Hyannis, MA 02601, 508.771.1727 , cap@cacci.cc Detailed Description Not Specified ALCOHOL: IT TAKES A COMMUNITY Program Type: Community Participation/Capacity Building Initiative, Direct Services, Grant/Donation/Foundation/Scholarship, Health Professional/Staff Training, Healthy Communities Partnership, Prevention Brief Description or Objective: "It Takes a Community" is a collaborative program intended to broaden the knowledge base of hospital clinical staff regarding the detoxification process. The program includes addiction specialists from Gosnold. Alcohol dependent patients at risk for withdrawal and increased incidence of Delirium Tremens were identified by a Falmouth Hospital addiction specialist. Patients were referred to a Gosnold counselor for assessment, treatment and appropriate referral. Services were organized to include medical intervention, clinical counseling, family support and specialty referral protocols. Continuing education for nurses and physicians was provided to increase their knowledge of addiction and improve linkages to specialty programs, such as Gosnold. Target Population Regions Served: Barnstable Health Indicator: Mental Health, Other: Alcohol and Substance Abuse, Substance Abuse Sex: All Age Group: All Adults Ethnic Group: All Language: English , Haitian Creole , Portuguese , Spanish
GOALS   Statewide Priority: Promoting Wellness of Vulnerable Populations 1. Goal Description Increase access to care for alcohol dependent individuals. Goal Status Withdrawal consultations were completed on 115 patients, which exceeded the projected number of 40 patients. Completed 2. Goal Description Reduce barriers for target population. Goal Status 51 patients accepted a referral to an addiction specialty program. Completed 3. Goal Description Implement education and intervention services. Goal Status 175 clinicians attended training sessions aimed at increasing clinician's knowledge of the identification of addiction and the post-hospital treatment options for supporting the patient upon discharge. Completed Partners Partner Name, Description and Web Address Gosnold on Cape Cod http://www.gosnold.org/ Contact Information: Raymond V. Tamasi, President/CEO, Gosnold on Cape Cod Corporate Office, 200 Ter Heun Dr., Falmouth, MA 02540, 508.540.6550, rtamasi@gosnold.org Detailed Description Not Specified AIDS SUPPORT GROUP OF CAPE COD Program Type: Direct Services, Grant/Donation/Foundation/Scholarship, Outreach to Underserved, Prevention, School/Health Center Partnership, Support Group Brief Description or Objective: The AIDS Support Group of Cape Cod is a framework of services for vulnerable individuals who are mono-infected with the Hepatitis C virus. The initiative utilizes a multifaceted approach designed to provide case management and support services to clients receiving interferon-based treatment, clients newly diagnosed with the hepatitis C virus and clients with end-stage liver disease co-infected with AIDS. The core elements of the program are screening, syringe exchange, harm reduction, education, drug overdose prevention and referrals for treatment. Target Population Regions Served: Barnstable Health Indicator: Access to Health Care, Other: Alcohol and Substance Abuse, Other: HIV/AIDS, Other: Sexually Transmitted Diseases, Other: Stress Management, Other: Uninsured/Underinsured, Substance Abuse Sex: All Age Group: Adult Ethnic Group: All Language: All Goals Statewide Priority: Address Unmet Health Needs of the Uninsured, Promoting Wellness of Vulnerable Populations 1. Goal Description Increase access to services for a vulnerable population. Goal Status Medical Case Management was offered to all clients receiving interferon-based therapy. This included: medical care/social services coordination, adherence support, HIV/STD/HCV risk reduction counseling and other need-based services. Completed 2. Goal Description Provide chronic disease management support. Goal Status The ASGCC offered clients newly diagnosed with HVC infection a range of short-term support services with the goal of sustaining care maintenance to assist in health promotion and disease prevention. Completed 3. Goal Description Manage risk and reduce harm through prevention and screening. Goal Status Prevention programs & screenings were offered by the ASGCC - immediate referrals for positive test results for viral hepatitis C were made for appropriate treatment and counseling and to reduce risk of infections of others. Completed Partners Partner Name, Description and Web Address Duffy Health Center www.duffyhealthcenter.org/ Falmouth Service Center www.falmouthservicecenter.org/ Habit OPCO habitopco.com/ Infectious Disease Clinical Services/CCHC www.capecodhealth.org Contact Information Krystin St. Onge, Interim Executive Director, 428 South Street, Hyannis, MA 02601, 508.778.1954 , kstonge@asgcc.org Detailed Description Not Specified ACCESS TO CARE FOR HOMELESS AND AT RISK ADULTS Program Type: Direct Services, Grant/Donation/Foundation/Scholarship, Health Coverage Subsidies or Enrollment, Health Screening, Healthy Communities Partnership, Outreach to Underserved, Prevention, School/Health Center Partnership Brief Description or Objective: The Duffy Health Center provides access to care through assistance with enrollment and re-enrollment to homeless adults and those at-risk for homelessness into MassHealth, Commonwealth Care, and other state insurance products. Clients received ongoing access to care, including referrals to primary care physicians and other appropriate providers to improve chronic disease management and promote adult wellness. Target Population Regions Served: Barnstable Health Indicator: Access to Health Care, Other: Homelessness, Other: Uninsured/Underinsured Sex: All Age Group: Adult Ethnic Group: All Language: All Goals Statewide Priority: Address Unmet Health Needs of the Uninsured, Chronic Disease Management in Disadvantage Populations, Promoting Wellness of Vulnerable Populations, Supporting Healthcare Reform 1. Goal Description Increase access to care for hard-to-reach populations. Goal Status The benefits coordinator facilitated 1,140 encounters which resulted in 346 enrollments and renewals into MassHealth, Commonwealth Care, and other insurance programs for hard-to- reach individuals. Ongoing 2. Goal Description Reduce barriers to primary health care through referral. Goal Status Referrals for 134 clients were made to primary care providers. The benefits coordinator is always available, either by phone or in-person to answer any questions for clients of the health center, resulting in fewer health policy terminations. Ongoing 3. Goal Description Improve system navigation by increasing client awareness. Goal Status The benefits coordinator encouraged clients to be an active participant in their health care by working with Duffy to manage the process. This approach resulted in clients improving their knowledge of how to self-navigate the system. Ongoing
PARTNERS   Partner Name, Description & Web Address Cape Cod Hospital Emergency Department www.capecodhealth.org Veterans Affairs Various Contact Information Heidi Nelson, FACHE, CEO, 94 Main Street, Hyannis, MA 02601, 508.771.7517 , hnelson@duffyhealthcenter.org Detailed Description Not Specified COMMUNITY-BASED HEALTH EDUCATION AND OUTREACH Program Type: Community Education, Health Screening, Outreach to Underserved, Prevention, School/Health Center Partnership Brief Description or Objective: Cape Cod Healthcare is committed to providing free health education and outreach in order to enhance and promote wellness, contribute to the prevention of illness and improve the management of chronic disease. Health care professionals, including physicians and nurses, provide the most up-to-date health and disease management information to the community at large in order to increase their awareness of strategies which may improve their health status and well-being. Target Population: Regions Served: Barnstable Health Indicator: Access to Health Care, Other: Arthritis, Other: Cancer, Other: Cancer - Breast, Other: Cancer - Colo-rectal, Other: Cancer - Other, Other: Cancer - Prostate, Other: Cancer - Skin, Other: Cardiac Disease, Other: Diabetes, Other: Elder Care, Other: Hypertension, Other: Nutrition, Other: Stroke, Other: Uninsured/Underinsured Sex: All Age Group: All Ethnic Group: All Language: All Goals Statewide Priority: Address Unmet Health Needs of the Uninsured, Promoting Wellness of Vulnerable Populations 1. Goal Description Provide health information and outreach programs to vulnerable populations and those with chronic illness. Goal Status Over 1,000 people participated in educational and outreach programs which addressed topics aimed at managing disease and chronic illness, such as diabetes, hypertension and arthritis. Ongoing 2. Goal Description Improve awareness of prevention and wellness through health promotion activities. Goal Status Health care providers informed participants of the importance of wellness and prevention strategies, including early detection through screening. Programs are free and are often held in community agencies that serve vulnerable populations. Ongoing Partners Partner Name, Description and Web Address American Cancer Society kerri.medeiros@cancer.org Barnstable High School www.barnstable.k12.ma.us/bhs/ Cape Cod Councils on Aging www.allcapecod.com.ccic.seniorcenters.cfm Falmouth Public Library www.falmouthpubliclibrary.org/ Parish Nurses Various Contact Information Carol Summersall, RN, Director of Community Benefits and Partnerships Cape Cod Healthcare, 297 North Street, Suite 333, Hyannis, MA 02601, 508.862.7896, csummersall@capecodhealth.org Detailed Description Not Specified SUPPORT GROUPS AND CLASSES Program Type: Community Education, Direct Services, Outreach to Underserved, Prevention, Support Group Brief Description or Objective: Support groups and classes are conducted by health care professionals on a regular basis. These events were open to all members of the community regardless of their patient status or ties to a specific hospital. Information and resources were made available to individuals, families and friends. Target Population Regions Served: Barnstable Health Indicator: Access to Health Care, Injury and Violence, Mental Health, Other: Alcohol and Substance Abuse, Other: Arthritis, Other: Bereavement, Other: Cancer, Other: Cancer - Breast, Other: Cancer - Cervical, Other: Cancer - Colo-rectal, Other: Cancer - Lung, Other: Cancer - Other, Other: Cancer - Prostate, Other: Cancer - Skin, Other: Cardiac Disease, Other: Diabetes, Other: Elder Care, Other: HIV/AIDS, Other: Hypertension, Other: Nutrition, Other: Pregnancy, Other: Sexually Transmitted Diseases, Other: Smoking/Tobacco, Other: Stroke, Other: Uninsured/Underinsured, Overweight and Obesity Sex: All Age Group: All Ethnic Group: All Language: All
GOALS   Statewide Priority: Promoting Wellness of Vulnerable Populations 1. Goal Description Increase access to services to reduce stress and improve both physical and mental health outcomes. Goal Status Provided over 2,000 hours of support groups and classes at no charge to individuals, families and friends. Included information and resources to assist participants with their specific disease or health related circumstance. Ongoing Partners Partner Name, Description & Web Address Not Specified Contact Information Carol Summersall, RN, Director of Community Benefits and Partnerships, Cape Cod Healthcare, 297 North Street, Suite 333, Hyannis, MA, 02601, 508.862.7896, csummersall@capecodhealth.org Detailed Description Not Specified WORKFORCE DEVELOPMENT Program Type: Health Professional/Staff Training, Healthy Communities Partnership, Mentorship/Career Training/Internship, School/Health Center Partnership Brief Description or Objective: Cape Cod Healthcare recognizes the importance of workforce development, and supports the opportunity for students from high school through graduate school to have a positive and professional experience through the provision of internships, shadowing and training with health care professionals and providers in several hospital departments. Training and mentoring sessions were conducted to promote interest in health care employment opportunities. Securing a steady supply of workers will mitigate future staff shortages in the workplace and provide necessary access. Target Population Regions Served: Barnstable Health Indicator: Access to Health Care Sex: All Age Group: Adult, Child-Teen Ethnic Group: All Language: All Goals Statewide Priority: Address Unmet Health Needs of the Uninsured, Promoting Wellness of Vulnerable Populations 1. Goal Description Increase access to health care through workforce development. Goal Status Provided students training, mentoring and shadowing opportunities. On target Partners Partner Name, Description & Web Address Barnstable High School www.barnstable.k12.ma.us/bhs/ Boston College Boston College Bristol Community College bristolcc.edu/ Cape Cod Community College www.capecod.edu/ Upper Cape Regional Technical School www.uppercapetech.com/ Contact Information Carol Summersall, RN, Regional Director of Community Benefits and Partnerships, Cape Cod Healthcare, 297 North Street, Suite 333 Hyannis, MA 02601, 508.862.7896, csummersall@capecodhealth.org Detailed Description Not Specified HELPING HANDS PROGRAM Program Type: Direct Services, Prevention Brief Description or Objective: The Helping Hands Program offers medication review and optimization with a clinical pharmacist in the patient's home for high-risk patients being discharged with a chronic disease, five or more medications, multiple regimen changes, and when an increase fall risk has been identified. Patients and their caregivers are provided coaching on self-management of their chronic disease, medication management and evaluation for fall risk and home safety. Target Population Regions Served: Barnstable Health Indicator: Other: Cancer, Other: Cardiac Disease, Other: Diabetes, Other: Education/Learning Issues, Other: Elder Care, Other: Homebound, Other: Hypertension, Other: Pulmonary Disease/Tuberculosis, Other: Safety - Home Sex: All Age Group: Adult, Adult-Elder Ethnic Group: All Language: All Goals Statewide Priority: Promoting Wellness of Vulnerable Populations 1. Goal Description Provide chronic disease and medication management education. Goal Status Provided 101 home visits, post-discharge, by a clinical pharmacist, at no charge, to assure patients and their caregivers were self-sufficient in managing their chronic disease state and their complex medication regime. Ongoing 2. Goal Description Increase access to services through referrals for vulnerable population. Goal Status Provided referrals at points of care to assure patients were receiving a continuum approach to services which addressed their specific plan of care including disease and medication management. Ongoing Partners Partner Name, Description & Web Address Elder Services of Cape Cod and the Islands www.escci.org/ Physician Offices across Cape Cod Skilled Nursing Facilities - various Visiting Nurse Association of Cape Cod www.vnacapecod.org/ Contact Information Molly Nadeau, Director, Case Management, Cape Cod Hospital, 60 Park Street, Hyannis, MA 02601, 508.862.7408, , mnadeau@capecodhealth.org Detailed Description Not Specified
FORM 990, PART I, LINE 1 AND PART III, LINE 1   WE WILL BE THE HEALTH SERVICE PROVIDER OF CHOICE FOR CAPE COD RESIDENTS BY ACHIEVING AND MAINTAINING THE HIGHEST STANDARDS IN HEALTH CARE DELIVERY AND SERVICE QUALITY. TO DO SO, WE WILL PARTNER WITH OTHER HEALTH AND HUMAN SERVICE PROVIDERS AS WELL AS INVEST IN NEEDED MEDICAL TECHNOLOGIES, HUMAN RESOURCES AND CLINICAL SERVICES. ABOVE ALL, WE WILL HELP IDENTIFY AND RESPOND TO THE NEEDS OF OUR COMMUNITY. TECHNOLOGIES, HUMAN RESOURCES AND CLINICAL SERVICES. ABOVE ALL, WE WILL HELP IDENTIFY AND RESPOND TO THE NEEDS OF OUR COMMUNITY. FUNCTIONAL EXPENSE NOTE FORM 990 PART I AND PART IX FUNDRAISING IS CONDUCTED ON BEHALF OF CAPE COD HEALTHCARE, INC. & AFFILIATES BY CAPE COD HEALTHCARE FOUNDATION, INC. FORM 990, PART III, LINE 6 CAPE COD HEALTHCARE, INC & AFFILIATES' VOLUNTEERS INCLUDE ITS TRUSTEES. FORM 990, PART VI, LINE 7(A) THE ORGANIZATION HAS MEMBERS/INCORPORATORS WHO ELECT THE ORGANIZATION'S TRUSTEES. FORM 990, PART VI, LINE 7(B) THE DECISIONS OF THE GOVERNING BODY THAT NEED APPROVAL BY ITS MEMBERS/INCORPORATORS INCLUDE APPROVAL OF CHANGES MADE TO THE CORPORATION'S BYLAWS AND APPROVAL WHEN THERE IS A DIVESTING OF ONE OF THE MAJOR AFFILIATES OF THE ORGANIZATION. MAJOR AFFILIATES OF THE ORGANIZATION. FORM 990, PART VI, LINE 11 THE ORGANIZATION'S FORM 990 IS REVIEWED AT SEVERAL LEVELS. THE ORGANIZATION ENGAGES A PUBLIC ACCOUNTING FIRM TO ASSIST IN THE PREPARATION AND REVIEW OF ITS FORM 990 AND WHO SIGNS AS PAID PREPARER. SENIOR MANAGEMENT OF THE ORGANIZATION IS RESPONSIBLE FOR THE TIMELY PREPARATION OF FORM 990. THE COMPLETED FORM 990 IS PROVIDED TO THE FINANCE COMMITTEE AND THE ENTIRE BOARD IN ADVANCE OF THE FILING DEADLINE. FORM 990, PART VI, LINE 12 THE ORGANIZATION MAINTAINS A CONFLICT OF INTEREST POLICY AND REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THIS POLICY. ON AN ANNUAL BASIS, EACH TRUSTEE, OFFICER AND EMPLOYEE AT THE SENIOR MANAGEMENT LEVEL COMPLETES A CONFLICT OF INTEREST DISCLOSURE FORM. THE FORMS ARE REVIEWED BY CAPE COD HEALTHCARE, INC.'S ("CCHC") DIRECTOR OF CLINICAL AND RESEARCH COMPLIANCE WHO PREPARES A SUMMARY FOR CCHC'S COMPLIANCE OFFICER. ANY MATERIAL INTERESTS SO DISCLOSED ARE PRESENTED TO THE CORPORATION'S GOVERNANCE COMMITTEE FOR REVIEW AND RESOLUTION. ALL DISCLOSURE STATEMENTS SUBMITTED BY EMPLOYEES WILL BE REVIEWED BY HUMAN RESOURCES AND/OR CCHC'S DIRECTOR OF CLINICAL AND RESEARCH COMPLIANCE. FOR ANY DISCLOSURE THAT IS CONSIDERED SUBSTANTIVE THE EMPLOYEE'S AREA MANAGER WILL BE CONSULTED TO DETERMINE IF THE SITUATION IS GENERALLY ACCEPTABLE, REQUIRES FURTHER EXAMINATION AND POSSIBLE ACTION OR IS GENERALLY NOT ACCEPTABLE. ANY ACTION PLAN CREATED TO MANAGE A CONFLICT OF INTEREST WILL BE MONITORED BY THE EMPLOYEE'S AREA MANAGER OR SUPERVISOR.
FORM 990, PART VI, LINE 15   THE ANNUAL PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS, EXECUTIVES AND KEY EMPLOYEES INCLUDE THE FOLLOWING: OFFICERS, EXECUTIVES AND KEY EMPLOYEES - OFFICER, EXECUTIVE AND KEY EMPLOYEE COMPENSATION WILL BE DETERMINED BY THE CEO AND WILL INCLUDE CONSIDERATION OF RECENT RELEVANT MARKET DATA FURNISHED BY A DISINTERESTED COMPENSATION CONSULTANT, AND A REVIEW OF JOB PERFORMANCE. THE CEO'S DETERMINATION OF SUCH COMPENSATION WILL BE SUBJECT TO THE APPROVAL OF THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THE PROCESS AND CONCLUSIONS ARE DOCUMENTED IN THE MEETING MINUTES.
FORM 990, PART VI, SECTION B, LINE 16 - JOINT VENTURE POLICY   THE ORGANIZATION HAD A JOINT VENTURE POLICY IN PLACE AND APPROVED BY AN APPROPRIATE OFFICER, BUT WAS NOT FORMALLY ADOPTED BY THE FULL BOARD OR A COMMITTEE OF THE BOARD BY THE YEAR ENDED SEPTEMBER 30, 2011. FORM 990, PART VI, LINE 19 THE ORGANIZATION MAKES ITS BYLAWS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE ALSO ATTACHED TO THE ANNUALLY FILED FORM PC, A PUBLICLY DISCLOSED TAX-EXEMPT ORGANIZATION FILING FOR THE STATE OF MASSACHUSETTS.
FORM 990, PART VII MICHAEL K. LAUF'S TITLE EXECUTIVE VP/COO UNTIL 12/10 PRESIDENT/CEO FROM 12/10 FORM 990, PART VII, COLUMN (B) THE INDIVIDUALS REPORTED AS RECEIVING COMPENSATION FROM A RELATED ORGANIZATION IN COLUMNS (E) AND (F) IN SCHEDULE J-2 ARE EMPLOYEES AT CAPE COD HEALTHCARE, INC., A TAX-EXEMPT RELATED ORGANIZATION. EACH OF THESE INDIVIDUALS HAS DEVOTED AN AVERAGE OF 40 HOURS PER WEEK TO THEIR POSITIONS AT CAPE COD HEALTHCARE, INC.
FORM 990, PART XI, LINE 5 OTHER CHANGES IN NET ASSETS OR FUND BALANCES UNREALIZED GAINS/LOSSES ($7,707,212) NET ASSETS RELEASED FROM RESTRICTION ( 3,893,351) TRANSFERS OF NET ASSETS (33,255,573) TRANSFERS TO/FROM AFFILIATES 4,388,598 OTHER 558,228 ------------- (39,909,310)
AFFILIATES INCLUDED IN GROUP RETURN   CAPE COD HOSPITAL 04-2103600 CAPE COD HUMAN SERVICES, INC. 04-2323506 CAPE & ISLANDS HEALTH SVCS II, INC. 04-3572408 FALMOUTH HOSPITAL ASSOCIATION, INC. 04-2220716 JML CARE CENTER, INC. 04-2995795 FALMOUTH ASSISTED LIVING, INC. 22-3379395 V.N.A. OF CAPE COD, INC. 04-2104159 CAPE COD HEALTHCARE FOUNDATION, INC. 04-3475950 MEDICAL AFFILIATES OF CAPE COD, INC. 04-3187299 ALL OF THE ABOVE ENTITIES CAN BE REACHED AT: 25 COMMUNICATION WAY HYANNIS, MA 02601
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
CAPE COD HEALTHCARE INC & AFFILIATES
 
Employer identification number

90-0054984
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity

















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) CAPE COD HEALTHCARE INC

25 COMMUNICATION WAY

HYANNIS,MA02601
22-2600704 		PARENT CORP MA 501(C)(3) 13b NA
 
 
No












For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) CAPE HEALTH INSURANCE COMPANY
PO BOX 1051GT
GRAND CAYMAN    
CJ
INSURANCE CJ N/A
 C CORP 0 0 0 %
(2) CAPE COD MEDICAL OFFICE BUILDING INC
27 PARK STREET
HYANNIS,MA02601
04-2423073 		RENTAL SRVCE MA N/A
 C CORP 15,000 38,408 100.000 %
(3) POOLED INCOME FUNDS (8)
 
 
SUPPORT MA NA
  		T      
(4) CHARITABLE LEAD TRUST (1)
 
 
SUPPORT MA NA
  		T      






Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
Yes
 
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) CAPE HEALTH INSURANCE COMPANY

 Q 2,872,657 FMV
(1)
(2)
(3)
(4)
(5)
(6)
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


Software ID:  
Software Version:  






TY 2010 AffiliateListing
Name:
CAPE COD HEALTHCARE INC & AFFILIATES
EIN: 90-0054984

Name Address EIN Name control
CAPE COD HOSPITAL 25 COMMUNICATION WAY
HYANNIS,  MA  02601
04-2103600
 CAPE
VISITING NURSE ASSN OF CAPE COD INC 25 COMMUNICATION WAY
HYANNIS,  MA  02601
04-2104159
 CAPE
FALMOUTH HOSPITAL ASSOCIATION INC 25 COMMUNICATION WAY
HYANNIS,  MA  02601
04-2220716
 CAPE
CAPE COD HUMAN SERVICES INC 25 COMMUNICATION WAY
HYANNIS,  MA  02601
04-2323506
 CAPE
MEDICAL AFFILIATES OF CAPE COD INC 25 COMMUNICATION WAY
HYANNIS,  MA  02601
04-3187299
 CAPE
CAPE COD HEALTHCARE FOUNDATION INC 25 COMMUNICATION WAY
HYANNIS,  MA  02601
04-3475950
 CAPE
CAPE & ISLANDS HEALTH SERVICES II 25 COMMUNICATION WAY
HYANNIS,  MA  02601
04-3572408
 CAPE
FALMOUTH ASSISTED LIVING INC 25 COMMUNICATION WAY
HYANNIS,  MA  02601
22-3379395
 CAPE
JML CARE CENTER INC 25 COMMUNICATION WAY
HYANNIS,  MA  02601
04-2995795
 CAPE