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
UMASS MEMORIAL HEALTH CARE INC
& AFFILIATES - GROUP RETURN
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
328 SHREWSBURY STREET
 
Room/suite
City or town, state or country, and ZIP + 4
WORCESTER, MA01604
D Employer identification number

91-2155626
E Telephone number

G Gross receipts $ 2,892,357,181
F Name and address of principal officer:
TODD A KEATING
328 SHREWSBURY STREET
WORCESTER,MA01604
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.UMASSMEMORIAL.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet3642
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: UMASS MEMORIAL HEALTH CARE IS COMMITTED TO IMPROVING THE HEALTH OF THE PEOPLE OF CENTRAL NEW ENGLAND THROUGH EXCELLENCE IN CLINICAL CARE, SERVICE, TEACHING AND RESEARCH.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 204
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 108
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 16,705
6 Total number of volunteers (estimate if necessary) .... 6 1,323
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 41,960,974
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 15,161,118 15,191,447
9 Program service revenue (Part VIII, line 2g) ......... 2,521,334,903 2,528,300,113
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 8,545,452 18,774,670
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 49,436,143 51,218,788
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 2,594,477,616 2,613,485,018
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 2,060,000 2,064,000
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) 1,173,766,137 1,213,599,587
16a Professional fundraising fees (Part IX, column (A), line 11e).... 2,082,186 1,602,995
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet2,542,608    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 1,350,886,524 1,351,659,364
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 2,528,794,847 2,568,925,946
19 Revenue less expenses. Subtract line 18 from line 12...... 65,682,769 44,559,072
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 1,964,348,828 1,872,279,772
21 Total liabilities (Part X, line 26)............ 1,317,539,288 1,275,306,773
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 646,809,540 596,972,999
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: UMASS MEMORIAL HEATLH CARE IS COMMITTED TO IMPROVING THE HEALTH OF THE PEOPLE OF CENTRAL NEW ENGLAND THROUGH EXCELLENCE IN CLINICAL CARE, SERVICE, TEACHING AND RESEARCH.
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 $ 1,081,573,856 including grants of $ 2,000,000 ) (Revenue $ 1,320,415,698 )
UMASS MEMORIAL MEDICAL CENTERUMASS MEMORIAL MEDICAL CENTER IS COMMITTED TO IMPROVING THE HEALTH OF THE PEOPLE OF CENTRAL NEW ENGLAND THROUGH EXCELLENCE IN CLINICAL CARE, SERVICE, TEACHING AND RESEARCH. UMASS MEMORIAL MEDICAL CENTER DOES THIS BY PROVIDING INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO THE RESIDENTS OF CENTRAL NEW ENGLAND WITHOUT REGARD TO THEIR ABILITY TO PAY.FY2011 KEY STATISTICS - TOTAL DISCHARGES: 42,727 TOTAL SURGICAL CASES: 30,536 TOTAL ER VISITS: 140,915
4b (Code:   ) (Expenses $ 419,336,379 including grants of $   ) (Revenue $ 451,247,651 )
UMASS MEMORIAL MEDICAL GROUPTHE UMASS MEMORIAL MEDICAL GROUP IS A MULTISPECIALTY GROUP PRACTICE OF PHYSICIANS WHOSE MISSION AND PURPOSE IS TO SUPPORT THE CLINICAL, EDUCATIONAL, RESEARCH AND COMMUNITY SERVICE MISSIONS OF UMASS MEMORIAL HEALTH CARE AND UMASS MEMORIAL MEDICAL CENTER. UMASS MEMORIAL MEDICAL GROUP ACCOMPLISHES THIS MISSION BY PROVIDING MEDICAL CARE TO RESIDENTS OF CENTRAL NEW ENGLAND WITHOUT REGARD TO THEIR ABILITY TO PAY.
4c (Code:   ) (Expenses $ 298,183,721 including grants of $   ) (Revenue $ 351,248,326 )
UMASS MEMORIAL COMMUNITY HOSPITALS THE UMASS MEMORIAL COMMUNITY HOSPITALS (CLINTON HOSPITAL, HEALTH ALLIANCE HOSPITALS, INC., MARLBOROUGHHOSPITAL, WING MEMORIAL HOSPITAL AND MEDICAL CENTERS) ARE COMMITTED TO IMPROVING THE HEALTH OF THE PEOPLE OF THE COMMUNITIES THAT THEY SERVE THROUGH EXCELLENCE IN CLINICAL CARE AND SERVICE. EACH OF THESE HOSPITALS ACCOMPLISHES THIS GOAL BY PROVIDING INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO THE RESIDENTS OF THEIR COMMUNITIES WITHOUT REGARD TO THEIR ABILITY TO PAY.FY2011 KEY STATISTICS - TOTAL DISCHARGES: 16,285 TOTAL SURGICAL CASES: 10,758 TOTAL ER VISITS: 125,706
(Code:   ) (Expenses $ 349,400,251 including grants of $ 64,000 ) (Revenue $ 405,388,438 )
OTHER UMASS MEMORIAL ENTITIESUMASS MEMORIAL HAS A NUMBER OF SUBSIDIARY ENTITIES THAT FUNCTION PRIMARILY TO DELIVER HEALTH CARE TO PATIENTS OR TO SUPPORT THE DELIVERY OF HEALTH CARE TO PATIENTS OF HEALTH CARE TO PATIENTS OF UMASS MEMORIAL. THEY ACCOMPLISH THIS THROUGH THE DELIVERY OF HEALTH CARE SERVICES WITHOUT REGARD TO THE PATIENT'S ABILITY TO PAY. THEY ALSO ACCOMPLISH THIS BY PROVIDING SUPPORT, OVERSIGHT, ADMINISTRATIVE SERVICES OR PATIENT ADVOCACY SERVICES TO THE PATIENTS OF UMASS MEMORIAL, CENTRAL NEW ENGLAND, AND OTHER GEOGRAPHIES.
4d Other program services. (Describe in Schedule O.)
(Expenses $ 349,400,251 including grants of $ 64,000 ) (Revenue $ 405,388,438 )
4e Total program service expensesMediumBullet$ 2,148,494,207
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
 
No
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
 
No
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
Yes
 
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.........
14b
 
No
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..
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..
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
Yes
 
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 attachment
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.. Click to see attachment
21
Yes
 
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..... Click to see attachment
22
Yes
 
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 list of attachments
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
Yes
 
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
Yes
 
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
Yes
 
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
Yes
 
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
Yes
 
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
1,798
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
 
 
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
16,705
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
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletCJ
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
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
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
204
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
108
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
Yes
 
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
Yes
 
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
ROBERT FELDMANN
328 SHREWSBURY STREET
WORCESTER,MA01604
(508) 856-1104
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) ANDRIENI JULIA MD
DIRECTOR, UMASS MEMORIAL MEDICAL GROUP, INC.
 31.00 X           307,606 0 21,832
(2) ARONSON MICHAEL P MD
DIRECTOR, UNTIL 6/2011, UMASS MEMORIAL HEALTH CARE
 25.00 X           48,299 0 13,705
(3) AROUS ELIAS J MD
DIRECTOR, UNTIL 6/21/11, UMASS MEMORIAL MEDICAL GR
 32.00 X           602,908 0 35,594
(4) AYERS DAVID MD
DIRECTOR, UNTIL 6/21/11, UMASS MEMORIAL MEDICAL GR
 33.00 X           543,086 0 38,299
(5) BAGLEY PETER H MD
CHAIRPERSON,UNTIL 6/21/11, UMASS MEMORIAL MEDICAL
 27.00 X           443,075 0 105,522
(6) BROWN ALAN P MD
DIRECTOR, UNTIL 6/21/11, UMASS MEMORIAL MEDICAL GR
 31.00 X           161,221 0 30,694
(7) CARLUCCI DANIEL MD
DIRECTOR, MARLBOROUGH HOSPITAL
 32.00 X           302,316 0 39,548
(8) CAVAGNARO CHARLES III MD
PRESIDENT, WING MEMORIAL HOSPITAL
 40.00 X   X       384,679 0 151,941
(9) CHANDLER WILLIS
DIRECTOR, CLINTON HOSPITAL ASSOCIATION
 40.00 X           331,428 0 72,205
(10) CHESHIRE BRYAN MD
DIRECTOR, UNTIL 12/31/10, MARLBOROUGH HOSPITAL
 35.00 X           235,350 0 14,197
(11) CIRILLO BETTYANN MD
DIRECTOR, UNTIL 2/10, COORDINATED PRIMARY CARE, IN
 40.00 X           254,436 0 28,646
(12) COFONE MICHAEL J
TREASURER, DIRECTOR, CENTRAL NEW ENGLAND HEALTHALL
 40.00 X   X       380,572 0 24,668
(13) CORBETT WILLIAM MD
DIRECTOR, MARLBOROUGH HOSPITAL
 40.00 X           373,194 0 72,861
(14) DALY SHEILA
PRESIDENT, DIRECTOR, CLINTON HOSPITAL ASSOCIATION
 40.00 X   X       252,122 0 109,017
(15) FELICE MARIANNE E MD
DIRECTOR, UNTIL 6/21/11, UMASS MEMORIAL MEDICAL GR
 22.00 X           218,554 0 44,837
(16) FERGUSON R KEVIN MD
DIRECTOR, UMASS MEMORIAL MEDICAL GROUP, INC.
 40.00 X           227,930 0 33,710
(17) FERRUCCI JOSEPH MD
DIRECTOR, CMMIC, INC.
 24.00 X           389,910 0 37,562
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) GUNDERSEN JASON MD
DIRECTOR, UNTIL 12/10/10, MARLBOROUGH HOSPITAL
 40.00 X           385,933 0 22,411
(19) KAUR SHUBJEET MD
DIRECTOR, UNTIL 6/21/11, UMASS MEMORIAL MEDICAL GR
 27.00 X           293,499 0 38,299
(20) KEATING TODD A
TREASURER & CFO, DIRECTOR, UMASS MEMORIAL HEALTH C
 40.00 X   X       617,471 0 199,171
(21) KENNEDY KATHRYN MD
DIRECTOR, UMASS MEMORIAL MEDICAL GROUP, INC.
 36.00 X           270,678 0 37,468
(22) LAPIDAS GARY N
PRESIDENT, DIRECTOR, UMASS MEMORIAL HEALTH VENTURE
 40.00 X   X       475,940 0 171,080
(23) LASSER DANIEL H MD
DIRECTOR, UMASS MEMORIAL MEDICAL GROUP, INC.
 20.00 X           308,105 0 164,460
(24) LINDHOLM MARY S MD
DIRECTOR, UNTIL 6/21/11, UMASS MEMORIAL MEDICAL GR
 36.00 X           133,329 0 30,773
(25) MAGUIRE DAVID L MD
DIRECTOR, WING MEMORIAL HOSPITAL
 40.00 X           240,987 0 9,898
(26) MANNING GORDON MD
DIRECTOR, UNTIL 6/21/11, UMASS MEMORIAL MEDICAL GR
 40.00 X           188,038 0 54,937
(27) MATTA LALITA MD
DIRECTOR, MARLBOROUGH HOSPITAL
 40.00 X           27,195 0 1,618
(28) MESSINA LOUIS MD
DIRECTOR, UMASS MEMORIAL MEDICAL GROUP, INC.
 36.00 X           501,354 0 35,594
(29) MULDOON PATRICK L
PRESIDENT, DIRECTOR, CENTRAL NEW ENGLAND HEALTHALL
 40.00 X   X       496,989 0 156,879
(30) O'BRIEN JOHN G
PRESIDENT & CEO, DIRECTOR, UMASS MEMORIAL HEALTH C
 40.00 X   X       1,340,405 0 997,518
(31) OKIKE O NSIDINANYA MD
DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC.
 40.00 X           361,231 0 55,729
(32) O'LEARY DANIEL MD
DIRECTOR, COORDINATED PRIMARY CARE, INC.
 40.00 X           56,103 0 484
(33) PAPPAS ARTHUR MD
DIRECTOR, UMASS MEMORIAL HOSPITALS, INC.
 16.00 X           13,386 0 25,818
(34) POLANOWICZ JOHN
PRESIDENT, UNTIL 5/6/11, MARLBOROUGH HOSPITAL
 40.00 X   X       358,599 0 116,659
(35) POWER DIANE MD
DIRECTOR, UNTIL 9/30/10, CENTRAL NEW ENGLAND HEALT
 40.00 X           255,402 0 31,784
(36) SLAYTON VAL MD
DIRECTOR, UNTIL 7/28/10, COORDINATED PRIMARY CARE,
 40.00 X           443,198 0 16,816
(37) SOAR BART MD
DIRECTOR, WING MEMORIAL HOSPITAL
 40.00 X           168,782 0 17,177
(38) SWENSON DANA
DIRECTOR, UMASS MEMORIAL REALTY, INC.
 40.00 X           287,350 0 107,313
(39) TOSI STEPHEN E MD
DIRECTOR, CLINTON HOSPITAL ASSOCIATION
 40.00 X           763,459 0 83,566
(40) UMANZOR RENE M MD
DIRECTOR, UNTIL 9/2011, WING MEMORIAL HOSPITAL
 36.00 X           220,299 0 30,789
(41) VOLTURO GREGORY MD
DIRECTOR, UNTIL 6/21/11, UMASS MEMORIAL MEDICAL GR
 25.00 X           317,819 0 38,299
(42) WESOLOWSKI PAUL
DIRECTOR, COORDINATED PRIMARY CARE, INC.
 40.00 X           170,078 0 18,989
(43) ZIEDONIS DOUGLAS MD
PRESIDENT, UMASS MEMORIAL BEHAVIORAL HEALTH SYSTEM
 20.00 X   X       218,140 0 37,373
(44) ALLEN GAIL
DIRECTOR, HEALTH ALLIANCE HOSPITALS, INC.
 1.00 X           0 0 0
(45) ANDERSON ELAINE
DIRECTOR, WING MEMORIAL HOSPITAL
 1.00 X           0 0 0
(46) ANTONIONI ROBERT
DIRECTOR, UMASS MEMORIAL BEHAVIORAL HEALTH SYSTEM,
 1.00 X           0 0 0
(47) BABINEAU ROBERT JR MD
DIRECTOR, CENTRAL NEW ENGLAND HEALTHALLIANCE, INC.
 1.00 X           0 0 0
(48) BENNETT DAVID L
CHAIRPERSON, UMASS MEMORIAL HEALTH CARE, INC.
 1.00 X           0 0 0
(49) BENNETT RICHARD K
CHAIRPERSON, MARLBOROUGH HOSPITAL
 1.00 X           0 0 0
(50) BERGERON ARTHUR
DIRECTOR, MARLBOROUGH HOSPITAL
 1.00 X           0 0 0
(51) BERKEY DENNIS D
DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC.
 1.00 X           0 0 0
(52) BERRY SARAH G
DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC.
 1.00 X           0 0 0
(53) BOUDREAU NORMAN
DIRECTOR, CENTRAL NEW ENGLAND HEALTHALLIANCE, INC.
 1.00 X           0 0 0
(54) BOVENZI LESLIE
DIRECTOR, CENTRAL NEW ENGLAND HEALTHALLIANCE, INC.
 1.00 X           0 0 0
(55) BUDD JOHN H
DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC.
 1.00 X           0 0 0
(56) CARLSON MARY
DIRECTOR, MARLBOROUGH HOSPITAL
 1.00 X           0 0 0
(57) CARROLL BRIAN K
DIRECTOR, UNTIL 3/2011, UMASS MEMORIAL HEALTH VENT
 1.00 X           0 0 0
(58) CATALINA FERNANDO MD
DIRECTOR, CENTRAL NEW ENGLAND HEALTHALLIANCE, INC.
 1.00 X           0 0 0
(59) CHERUBINI J PAUL
DIRECTOR, CLINTON HOSPITAL ASSOCIATION
 1.00 X           0 0 0
(60) CHRISTENSEN RONALD
DIRECTOR, WING MEMORIAL HOSPITAL
 1.00 X           0 0 0
(61) CLEMENTI JOHN
DIRECTOR, CENTRAL NEW ENGLAND HEALTHALLIANCE, INC.
 1.00 X           0 0 0
(62) COLLINS MICHAEL MD
DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC.
 1.00 X           0 0 0
(63) CONNORS MARTIN JR
DIRECTOR, CENTRAL NEW ENGLAND HEALTHALLIANCE, INC.
 1.00 X           0 0 0
(64) COOLIDGE KATHERINE
DIRECTOR, WING MEMORIAL HOSPITAL
 1.00 X           0 0 0
(65) CORNELL LOIS D
DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC.
 1.00 X           0 0 0
(66) CROCKER FREDERICK G
DIRECTOR, UMASS MEMORIAL HEALTH VENTURES, INC.
 1.00 X           0 0 0
(67) D'ALELIO EDWARD
DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC.
 1.00 X           0 0 0
(68) DAVIS DIX F
DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC.
 1.00 X           0 0 0
(69) DELROSARIO GENE MD
DIRECTOR, CLINTON HOSPITAL ASSOCIATION
 1.00 X           0 0 0
(70) DENNEHY RAYMOND III
DIRECTOR, HEALTH ALLIANCE HOME HEALTH AND HOSPICE,
 1.00 X           0 0 0
(71) DESROCHERS ROLAND
DIRECTOR, UNTIL 5/12/11, WING MEMORIAL HOSPITAL
 1.00 X           0 0 0
(72) DIGERONIMO ARTHUR P JR
DIRECTOR, CENTRAL NEW ENGLAND HEALTHALLIANCE, INC.
 1.00 X           0 0 0
(73) DITULLIO DANIEL
DIRECTOR, CLINTON HOSPITAL FOUNDATION, INC.
 1.00 X           0 0 0
(74) DOBECK PAM
DIRECTOR, CLINTON HOSPITAL FOUNDATION, INC.
 1.00 X           0 0 0
(75) D'ONFRO PAUL
CHAIRPERSON, CENTRAL NEW ENGLAND HEALTHALLIANCE, I
 1.00 X           0 0 0
(76) FERRIS CORNELIUS A
DIRECTOR, UNTIL 2/11/11, MARLBOROUGH HOSPITAL
 1.00 X           0 0 0
(77) FITCH ROGER
DIRECTOR, UMASS MEMORIAL BEHAVIORAL HEALTH SYSTEM,
 1.00 X           0 0 0
(78) FLOTTE TERENCE MD
DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC.
 1.00 X           0 0 0
(79) GIBLIN DAVID R
DIRECTOR, MARLBOROUGH HOSPITAL
 1.00 X           0 0 0
(80) GRAY JENNIFER
DIRECTOR, CLINTON HOSPITAL ASSOCIATION
 1.00 X           0 0 0
(81) GREGORIUS PATRICK
DIRECTOR, WING MEMORIAL HOSPITAL
 1.00 X           0 0 0
(82) HAVELES ROBERT
DIRECTOR, WING MEMORIAL HOSPITAL
 1.00 X           0 0 0
(83) HENEBRY CLARK
DIRECTOR, CLINTON HOSPITAL ASSOCIATION
 1.00 X           0 0 0
(84) HEWITT FRANK
DIRECTOR, CLINTON HOSPITAL FOUNDATION, INC.
 1.00 X           0 0 0
(85) HOLLISTER MATT
FIRST VICE PRESIDENT, CLINTON HOSPITAL FOUNDATION,
 1.00 X           0 0 0
(86) JACOBSON M HOWARD
DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC.
 1.00 X           0 0 0
(87) JEFFERSON PHILIP W JR
DIRECTOR, UNTIL 12/17/10, MARLBOROUGH HOSPITAL
 1.00 X           0 0 0
(88) JOHNSON JOANNE
DIRECTOR, UMASS MEMORIAL BEHAVIORAL HEALTH SYSTEM,
 1.00 X           0 0 0
(89) KAPLAN DANIEL
DIRECTOR, UMASS MEMORIAL MEDICAL GROUP, INC.
 1.00 X           0 0 0
(90) KATSOUNAKIS THEA
DIRECTOR, WING MEMORIAL HOSPITAL
 1.00 X           0 0 0
(91) KELLEHER WILLIAM D JR
DIRECTOR, UMASS MEMORIAL HEALTH VENTURES, INC.
 1.00 X           0 0 0
(92) LENHARDT STEPHEN W SR
DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC.
 1.00 X           0 0 0
(93) LYONS CYNTHIA
DIRECTOR, WING MEMORIAL HOSPITAL
 1.00 X           0 0 0
(94) LYONS MICHAEL MD
DIRECTOR, CENTRAL NEW ENGLAND HEALTHALLIANCE, INC.
 1.00 X           0 0 0
(95) MACNEILL HARRIS L
DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC.
 1.00 X           0 0 0
(96) MANZI EDWARD
DIRECTOR, UMASS MEMORIAL BEHAVIORAL HEALTH SYSTEM,
 1.00 X           0 0 0
(97) MCGRAIL WILLIAM ESQUIRE
DIRECTOR, CLINTON HOSPITAL ASSOCIATION
 1.00 X           0 0 0
(98) MCMAHON RICHARD MD
DIRECTOR, MARLBOROUGH HOSPITAL
 1.00 X           0 0 0
(99) MCMULLEN CYNTHIA M EDD
DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC.
 1.00 X           0 0 0
(100) MCNAMARA MARY ELLEN
DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC.
 1.00 X           0 0 0
(101) MENDOZA STEVEN
DIRECTOR, CLINTON HOSPITAL ASSOCIATION
 1.00 X           0 0 0
(102) MERCADANTE ANTHONY J
DIRECTOR, HEALTH ALLIANCE HOME HEALTH AND HOSPICE,
 1.00 X           0 0 0
(103) MITCHELL LINDA
DIRECTOR, WING MEMORIAL HOSPITAL
 1.00 X           0 0 0
(104) MOLLOY ANN K
DIRECTOR, MARLBOROUGH HOSPITAL
 1.00 X           0 0 0
(105) MORRILLY DARLENE
DIRECTOR, HEALTH ALLIANCE HOME HEALTH AND HOSPICE,
 1.00 X           0 0 0
(106) MURPHY MICHAEL D
VICE CHAIRPERSON, MARLBOROUGH HOSPITAL
 1.00 X           0 0 0
(107) NOONAN EDWARD J
DIRECTOR, WING MEMORIAL HOSPITAL
 1.00 X           0 0 0
(108) PAEN GENARO
DIRECTOR, CLINTON HOSPITAL FOUNDATION, INC.
 1.00 X           0 0 0
(109) PARRY EDWARD J III
VICE CHAIRPERSON, UMASS MEMORIAL HEALTH CARE, INC.
 1.00 X           0 0 0
(110) PAULINO JEANNE
DIRECTOR, CLINTON HOSPITAL ASSOCIATION
 1.00 X           0 0 0
(111) PEDERSON THORU
DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC.
 1.00 X           0 0 0
(112) PEREZ JUDGE LUIS
DIRECTOR, CENTRAL NEW ENGLAND HEALTHALLIANCE, INC.
 1.00 X           0 0 0
(113) PHANEUF JAMES
CHAIRPERSON, WING MEMORIAL HOSPITAL
 1.00 X           0 0 0
(114) PURCELL PHILIP E
DIRECTOR, MARLBOROUGH HOSPITAL
 1.00 X           0 0 0
(115) RICHER GERALD P
DIRECTOR, MARLBOROUGH HOSPITAL
 1.00 X           0 0 0
(116) RIVARD MICHAEL
DIRECTOR, CENTRAL NEW ENGLAND HEALTHALLIANCE, INC.
 1.00 X           0 0 0
(117) SCULLY PAUL
DIRECTOR, WING MEMORIAL HOSPITAL
 1.00 X           0 0 0
(118) SEYMOUR-ROUTE PAULETTE PHD
DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC.
 1.00 X           0 0 0
(119) SHEA JAMES P
DIRECTOR, UNTIL 2/15/11, MARLBOROUGH HOSPITAL
 1.00 X           0 0 0
(120) SHEA JOHN ESQUIRE
DIRECTOR, UMASS MEMORIAL BEHAVIORAL HEALTH SYSTEM,
 1.00 X           0 0 0
(121) SHELTON R LESLIE MD
DIRECTOR, CENTRAL NEW ENGLAND HEALTHALLIANCE, INC.
 1.00 X           0 0 0
(122) SIMMONS IRINA
DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC.
 1.00 X           0 0 0
(123) ST AMAND JAMES
DIRECTOR, WING MEMORIAL HOSPITAL
 1.00 X           0 0 0
(124) STARR STANLEY B JR
DIRECTOR, UNTIL 6/11, CLINTON HOSPITAL FOUNDATION,
 1.00 X           0 0 0
(125) STECYK MARKIAN MD
DIRECTOR, MARLBOROUGH HOSPITAL
 1.00 X           0 0 0
(126) SULLIVAN WILLIAM F SR
DIRECTOR, UMASS MEMORIAL HEALTH VENTURES, INC.
 1.00 X           0 0 0
(127) TAYLOR HARVEY MD
DIRECTOR, MARLBOROUGH HOSPITAL
 1.00 X           0 0 0
(128) TURLEY PATRICK
DIRECTOR, WING MEMORIAL HOSPITAL
 1.00 X           0 0 0
(129) WHITNEY MARY
DIRECTOR, CENTRAL NEW ENGLAND HEALTHALLIANCE, INC.
 1.00 X           0 0 0
(130) WILSON JACK
DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC.
 1.00 X           0 0 0
(131) YOUNG LYNDA M
DIRECTOR, UMASS MEMORIAL HEALTH CARE, INC.
 1.00 X           0 0 0
(132) ALLICON KEARY T
TREASURER, WING MEMORIAL HOSPITAL
 40.00     X       156,418 0 41,241
(133) BERGAN THOMAS
PRESIDENT, CMMIC, INC.
 40.00     X       253,624 0 328,020
(134) BROWN DOUGLAS S
SECRETARY, UMASS MEMORIAL HEALTH CARE, INC.
 40.00     X       501,307 0 135,994
(135) D'AMBRA ANN-MARIA
SECRETARY, MARLBOROUGH HOSPITAL
 40.00     X       46,591 0 7,569
(136) DICKSON ERIC MD
PRESIDENT, UMASS MEMORIAL MEDICAL GROUP, INC.
 40.00     X       407,774 0 94,107
(137) DION JEFFREY
TREASURER, UNTIL 9/9/11, MARLBOROUGH HOSPITAL
 40.00     X       177,568 0 44,986
(138) EKSTROM DEBORAH
PRESIDENT, COMMUNITY HEALTHLINK, INC.
 40.00     X       253,325 0 116,023
(139) FELDMANN ROBERT
TREASURER, UMASS MEMORIAL LABORATORIES, INC.
 40.00     X       328,411 0 144,011
(140) FRAKER MURIEL E ESQUIRE
SECRETARY, UMASS MEMORIAL MEDICAL GROUP, INC.
 40.00     X       172,636 0 78,841
(141) MCCUE STEVEN
TREASURER, CLINTON HOSPITAL ASSOCIATION
 40.00     X       160,622 0 28,032
(142) MILLER LAUREN B
SECRETARY, WING MEMORIAL HOSPITAL
 40.00     X       77,476 0 11,579
(143) MORABITO NANCY E
SECRETARY, CLINTON HOSPITAL ASSOCIATION
 40.00     X       57,348 0 1,338
(144) MORIN LYNN A
SECRETARY, CENTRAL NEW ENGLAND HEALTHALLIANCE, INC
 40.00     X       78,034 0 7,210
(145) O'BRIEN WILLIAM H
SECRETARY, UMASS MEMORIAL BEHAVIORAL HEALTH SYSTEM
 40.00     X       110,650 0 53,033
(146) SMITH FRANCIS W
CLERK, UMASS MEMORIAL HEALTH VENTURES, INC.
 40.00     X       179,097 0 50,558
(147) STREETER MICHELE M
TREASURER, UMASS MEMORIAL MEDICAL GROUP, INC.
 40.00     X       357,332 0 116,926
(148) BLUTE MICHAEL
DIRECTOR, CANCER CENTER OF EXCELLENCE
 40.00       X     524,834 0 75,444
(149) BRENCKLE GEORGE PHD
SR. VP, CHIEF INFORMATION OFFICER
 40.00       X     383,725 0 119,808
(150) DALEY JENNIFER MD
EXECUTIVE VP, CHIEF OPERATING OFFICER
 40.00       X     424,921 0 59,872
(151) DIAMOND VICTORIA
SR. VP, OPERATIONS
 40.00       X     321,806 0 121,220
(152) ETTINGER WALTER H MD
PRESIDENT - MEDICAL CENTER
 40.00       X     920,700 0 299,452
(153) FISHER BARBARA
SR. VP, OPERATIONS
 40.00       X     317,118 0 105,356
(154) HYLKA SHARON
SR. VP, HOSPITAL ADMIN.
 40.00       X     392,709 0 241,101
(155) KLUGMAN ROBERT MD
CHIEF QUALITY OFFICER
 40.00       X     502,672 0 242,845
(156) KRUGER NANCY
SR. VP, CHIEF NURSING OFFICER
 40.00       X     419,715 0 68,373
(157) PHILLIPS ROBERT A
MED DIR, HEART & VASCULAR COE
 40.00       X     799,751 0 238,506
(158) RANDOLPH JOHN T
VP, CHIEF COMPLIANCE OFFICER
 40.00       X     234,335 0 138,086
(159) WEBB PATRICIA
SR. VP, CHIEF HR OFFICER, UNTIL 1/2/11
 40.00       X     417,377 0 113,889
(160) ANDERSON MILTON C
SR. VP, CHIEF OF HR
 40.00       X     0 0 0
(161) FAIRCHILD DAVID MD
SR. VP, CLINICAL INTEGRATION
 40.00       X     0 0 0
(162) MAYKEL JUSTIN MD
PHYSICIAN, CHIEF OF COLORECTAL SURGERY - MED GROUP
 30.00         X   562,589 0 34,857
(163) BUSCONI BRIAN D MD
PHYSICIAN, DIVISION CHIEF OF ORTHOPEDICS - MED GRO
 33.00         X   545,085 0 35,594
(164) ZIVNY JAROSLAV MD
PHYSICIAN, DIRECTOR OF GASTROENTEROLOGY - MED GROU
 33.00         X   543,818 0 40,465
(165) MALONEY MARY E MD
PHYSICIAN, CHIEF OF DERMATOLOGY - MED GROUP
 30.00         X   513,877 0 35,594
(166) LEVEY JOHN MD
PHYSICIAN, CLINICAL CHIEF OF GASTROENTEROLOGY - ME
 30.00         X   505,207 0 35,594
(167) WARRING WENDY
FORMER EXECUTIVE VICE PRESIDENT, UNTIL 9/1/06
 0.00           X 117,663 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 26,136,570 0 6,641,264
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet2,330
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
Yes
 
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
ACS CORPORATE HEADQUARTERS
2828 NORTH HASKELL
DALLAS,TX75204 		I/S MANAGEMENT SERVICES 21,418,985
ARUP LABORATORIES INC
PO BOX 27964
SALT LAKE CITY,UT84127 		LAB SERVICES 5,768,884
WOOD ART EXHIBIT GROUP
424 MAIN STREET
CHERRY VALLEY,MA01611 		SEE SCHEDULE O - FOOTNOTE A 5,183,984
MORRISON MANAGEMENT SPECIALISTS
PO BOX 102289
ATLANTA,GA303682289 		FOOD SERVICES 4,624,062
ANGELICA CORPORATION
PO BOX 823283
PHILADELPHIA,PA191823283 		LINEN SERVICES 3,787,261
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet180
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 777,636
d Related organizations...1d 598,558
e Government grants (contributions)1e 6,203,999
f All other contributions, gifts, grants, and
similar amounts not included above1f 		7,611,254
g Noncash contributions included in lines 1a-1f:$ 64,355
h Total. Add lines 1a-1f.......MediumBullet 15,191,447
Program Service Revenue Business Code
2a NET PATIENT SERVICE RE 900,099 1,840,791,013 1,840,791,013    
b SPECIAL MEDICAID PAYME 900,099 187,999,996 187,999,996    
c AFFILIATE RELATED PROG 900,099 169,788,329 169,788,329    
d OTHER PSR & JV 900,099 165,585,106 164,289,852   1,295,254
e SYSTEM ALLOCATION REVE 900,099 142,966,270 142,966,270    
f All other program service revenue . 21,169,399 21,169,399    
g Total. Add lines 2a–2f........MediumBullet 2,528,300,113
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 11,942,604   25,290 11,917,314
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet 71,662     71,662
(i) Real (ii) Personal
6a Gross Rents 2,378,324  
b Less: rental expenses 1,200,812  
c Rental income or (loss) 1,177,512  
d Net rental income or (loss).......MediumBullet 1,177,512     1,177,512
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 282,509,740 1,557,654
b Less: cost or other basis and sales expenses 275,928,808 1,306,520
c Gain or (loss) 6,580,932 251,134
d Net gain or (loss)..........MediumBullet 6,832,066     6,832,066
8a Gross income from fundraising events (not including
$ 777,636
of contributions reported on line 1c). See Part IV, line 18 ...
a 358,183
b Less: direct expenses ...b 436,023
c Net income or (loss) from fundraising events..MediumBullet -77,840   -77,840
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        
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        
Miscellaneous Revenue Business Code
11a LAB OUTREACH PROGRAM & 621,500 42,167,106 231,422 41,935,684  
b OTHER REVENUE 900,099 3,548,501 2,124,287   1,424,214
c 1500 MD BILLING 900,099 2,384,437     2,384,437
d All other revenue .... 1,947,410     1,947,410
e Total. Add lines 11a–11d ......MediumBullet 50,047,454
12 Total revenue. See Instructions....MediumBullet 2,613,485,018 2,529,360,568 41,960,974 26,972,029
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 2,000,000 2,000,000
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22 64,000 64,000
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 28,988,507 14,008,969 14,979,538  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 918,429,133 793,550,260 124,476,661 402,212
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 71,854,300 60,715,249 11,132,556 6,495
9 Other employee benefits ....... 130,645,800 109,744,593 20,864,692 36,515
10 Payroll taxes ........... 63,681,847 54,487,853 9,174,227 19,767
11 Fees for services (non-employees):        
a Management ...... 562,607 73,234 489,373  
b Legal ......... 3,793,747 571,452 3,222,295  
c Accounting ........... 965,000   965,000  
d Lobbying ........... 1,752,623 1,752,623    
e Professional fundraising. See Part IV, line 17.. 1,602,995 1,602,995
f Investment management fees ...... 768,878   768,878  
g Other .......... 132,487,949 120,271,404 11,957,372 259,173
12 Advertising and promotion .... 1,985,045 1,512,107 409,049 63,889
13 Office expenses ....... 41,678,458 29,054,761 12,574,986 48,711
14 Information technology ...... 38,648,455 38,049,968 598,132 355
15 Royalties ..        
16 Occupancy ........... 87,222,157 72,249,650 14,954,203 18,304
17 Travel ............ 4,045,991 3,921,795 121,582 2,614
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 1,676,552 1,437,956 236,275 2,321
20 Interest ........... 18,123,942 17,342,689 781,253  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 85,518,258 67,290,720 18,220,463 7,075
23 Insurance .............. 55,999,861 53,602,791 2,395,708 1,362
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 PURCHASED SERVICES 268,037,051 209,848,591 58,185,392 3,068
b MEDICAL SUPPLIES 211,608,103 177,418,894 34,189,209  
c SYSTEM OVERHEAD ACTIVIT 157,704,222 87,656,573 70,046,003 1,646
d MEDICAL EDUCATION SERVI 137,269,837 137,269,837    
e BAD DEBTS 69,844,277 69,844,277    
f All other expenses 31,966,351 24,753,961 7,146,284 66,106
25 Total functional expenses. Add lines 1 through 24f 2,568,925,946 2,148,494,207 417,889,131 2,542,608
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 .......... 76,105,323 1 121,731,059
2 Savings and temporary cash investments ....... 157,081,704 2 176,798,916
3 Pledges and grants receivable, net ......... 3,487,300 3 2,155,912
4 Accounts receivable, net ......... 248,778,348 4 233,992,397
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L .......... 4,888,284 5 4,471,041
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 ............. 22,721,737 7 31,891,970
8 Inventories for sale or use .............. 21,961,266 8 22,550,727
9 Prepaid expenses and deferred charges ............ 24,952,745 9 22,763,905
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,558,504,273
b Less: accumulated depreciation. ..... 10b 879,633,005 662,475,699 10c 678,871,268
11 Investments—publicly traded securities .......... 380,412,217 11 377,356,855
12 Investments—other securities. See Part IV, line 11 ...... 122,472,718 12 127,541,059
13 Investments—program-related. See Part IV, line 11 .. 12,020,740 13 12,255,179
14 Intangible assets ......... 657,706 14 631,776
15 Other assets. See Part IV, line 11 ........... 226,333,041 15 59,267,708
16 Total assets. Add lines 1 through 15 (must equal line 34)... 1,964,348,828 16 1,872,279,772
Liabilities 17 Accounts payable and accrued expenses . 263,376,871 17 274,942,645
18 Grants payable ..........   18  
19 Deferred revenue .......... 4,075,556 19 5,054,227
20 Tax-exempt bond liabilities .......... 395,209,096 20 379,318,376
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 .. 46,412,288 23 51,682,999
24 Unsecured notes and loans payable to unrelated third parties .... 22,615,340 24 19,023,486
25 Other liabilities. Complete Part X of Schedule D..... 585,850,137 25 545,285,040
26 Total liabilities. Add lines 17 through 25..... 1,317,539,288 26 1,275,306,773
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 ..... 500,785,067 27 461,765,636
28 Temporarily restricted net assets ..... 69,497,127 28 58,913,271
29 Permanently restricted net assets ..... 76,527,346 29 76,294,092
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 ..... 646,809,540 33 596,972,999
34 Total liabilities and net assets/fund balances ..... 1,964,348,828 34 1,872,279,772
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
2,613,485,018
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
2,568,925,946
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
44,559,072
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
646,809,540
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
-94,395,613
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
596,972,999
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
UMASS MEMORIAL HEALTH CARE INC
& AFFILIATES - GROUP RETURN
Employer identification number

91-2155626
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
UMASS MEMORIAL HEALTH CARE INC
& AFFILIATES - GROUP RETURN
Employer identification number

91-2155626
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
UMASS MEMORIAL HEALTH CARE INC
& AFFILIATES - GROUP RETURN 		Employer identification number

91-2155626
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
UMASS MEMORIAL HEALTH CARE INC
& AFFILIATES - GROUP RETURN 		Employer identification number

91-2155626
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
UMASS MEMORIAL HEALTH CARE INC
& AFFILIATES - GROUP RETURN 		Employer identification number

91-2155626
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
UMASS MEMORIAL HEALTH CARE INC
& AFFILIATES - GROUP RETURN
Employer identification number

91-2155626
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? .......................
Yes
 
864,640
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? ......
Yes
 
887,983
i
Other activities? If "Yes," describe in Part IV ..........................
 
No
 
j
Total. lines 1c through 1i ...................................
1,752,623
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? .......
 
 
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
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
UMASS MEMORIAL HEALTH CARE INC
& AFFILIATES - GROUP RETURN
Employer identification number

91-2155626
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  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
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 Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
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 .... 104,017,758 98,561,352 97,341,571
b Contributions ........ 316,330 1,245,442 172,660
c Investment earnings or losses ... -2,402,463 5,785,214 510,787
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		3,636,662 1,574,250 -536,334
f Administrative expenses ....      
g End of year balance ...... 98,294,963 104,017,758 98,561,352
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet78.000 %
c
Term endowment: SchDMd Bullet22.000 %
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)
Yes
 
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
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 .................   7,746,102 7,746,102
b Buildings ................   802,821,590 422,427,040 380,394,550
c Leasehold improvements ............   34,398,186 18,803,126 15,595,060
d Equipment ................   631,951,201 432,092,227 199,858,974
e Other .................   81,587,194 6,310,612 75,276,582
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 678,871,268
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) TIFF ABSOLUTE RETURN POOL (6,291 SHARES) 		21,563,639 F

(B) TIFF PRIVATE EQUITY PARTNERS 2006 (2,590,699 SHARES) 		2,590,699 F

(C) FRANK RUSSELL GLOBAL PRIVATE EQUITY FUND (977,448 SHARES) 		977,448 F

(D) GMO MULTI-STRATEGY FUND (OFFSHORE) LP (12,177,685 SHARES) 		12,177,685 F

(E) BENEFICIAL INTEREST IN TRUSTS 		66,905,446 F

(F) AETOS CAPITAL LONG/SHORT STRATEGIES (79,905 SHARES) 		7,498,098 F

(G) AETOS CAPITAL DISTRESSED INV STRATEGIES (26,692 SHARES) 		3,098,685 F

(H) AETOS CAPITAL MULTI-STRATEGY ARBITRAGE (27,019 SHARES) 		2,787,758 F

(I) MPPLTD/PORTFOLIO CLASS A (4,954 SHARES) 		455,942 F

(J) TIFF ABSOLUTE RETURN POOL CLASS C (3,871 SHARES) 		6,165,561 F

(K) MET WEST ENHANCED TALF STRATEGY FUND (3,209,248 SHARES) 		3,209,248 F

(L) INCOME RESEARCH AND MGMT (LB HOLDINGS) (200,000 SHARES) 		32,000 F

(M) INCOME RESEARCH AND MGMT (LB HOLDINGS) (415,000 SHARES) 		78,850 F
Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet 127,541,059
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








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
DUE TO UMASS MEDICAL SCHOOL 9,057,413
THIRD PARTY LIABILITIES 61,327,563
DUE TO RELATED PARTIES 28,385,625
ACCRUED PENSION POST RETIREMENT BENEFITS 359,707,649
O/S LOSS RESERVES 30,515,992
ESTIMATED MALPRACTICE COSTS 28,010,403
OTHER 681,519
ANNUITY PAYABLE 726,373
LT LIABILITY ARO 10,752,427
ACCRUED LT LIABILITIES 3,554,191
CLAIMS RESERVES 89,125
CONTRIBUTION PAYABLE 36,730
MEDICARE RESERVES 30,000
NOTES PAYABLE TO UMMHC (MED CENTER) 12,410,030
Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 545,285,040
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 2,613,485,018
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 2,568,925,946
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 44,559,072
4 Net unrealized gains (losses) on investments .......................... 4 -19,474,382
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8 -74,921,231
9 Total adjustments (net). Add lines 4 - 8 ............................. 9 -94,395,613
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 -49,836,541
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
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: FIN 48 FOOTNOTE: INCOME TAXES: THE SYSTEM FOLLOWS A TWO-STEP APPROACH FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN. THE SUBSTANTIAL MAJORITY OF UMASS MEMORIAL AND ITS AFFILIATE ENTITIES ARE RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT UNDER SECTION 501 (C) (3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THESE ENTITIES WILL NOT INCUR ANY LIABILITY FOR FEDERAL INCOME TAXES EXCEPT FOR TAX ON UNRELATED BUSINESS INCOME. CERTAIN AFFILIATES ARE TAXABLE ENTITIES. THE MEASUREMENT OF THE AMOUNTS RECORDED AS A PROVISION FOR INCOME TAXES BASED UPON THE AFOREMENTIONED APPROACH IS NOT MATERIAL AND IS RECORDED AS PART OF SUPPLIES AND OTHER EXPENSE IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS. THE SYSTEM DOES NOT BELIEVE IT HAS ANY SIGNIFICANT UNCERTAIN TAX POSITIONS.
PART XI, LINE 8 - OTHER ADJUSTMENTS:   NET ASSETS RELEASED FROM RESTRICTIONS 4,768,664. PENSION RELATED CHANGES OTHER THAN NET PERIODIC BENEFIT COST -70,678,363. BOOK/TAX DIFFERENCES FROM S CORP K-1 472,818. CHANGE IN BENEFICIAL INTERESTS IN PERPETUAL TRUSTS -5,149,554. MISCELLANEOUS 47. NET ASSETS RELEASED FROM RESTRICTION FOR PPE 5,005,601. TEMPORARY RESTRICTED FUND EXPENDITURES -9,558,388. TRANSFERS (TO) FROM RELATED PARTIES 217,944.
    PART V ENDOWMENT FUNDS QUESTION 3 A (I): BANK OF AMERICA HOLDS 3 TRUST FUNDS FOR WING MEMORIAL HOSPITAL: DORNOE PARKER TRUST, RATHBONE 1950 TRUST, RATHBONE 1951 TRUST INTEREST IS PAID TO WING. BANK OF AMERICA IS AN UNRELATED ORGANIZATION. BANK OF AMERICA MERRILL LYNCH HOLDS THE BERNARD W DOYLE TRUST FOR HEALTHALLIANCE HOSPITAL. DISTRIBUTIONS ARE PAID TO HEALTHALLIANCE HOSPITAL. BANK OF AMERICA MERRILL LYNCH IS AN UNRELATED ORGANIZATION. BYN MELLON WEALTH MANAGEMENT HOLDS THE FOLLOWING TRUSTS FOR HEALTHALLIANCE HOSPITAL: TRUST U/WILL ART 11 WILLIAM H CROPPER TRUST U/WILL PAR 15 WILLIAM H CROPPER TRUST U/WILL ART 18 WILLIAM H CROPPER TRUST UNDER 2ND CODICIL OF WILL OF WILLIAM H CROPPER TRUST U/WILL 4TH COD WILLIAM H CROPPER DISTRIBUTIONS ARE PAID TO HEALTHALLIANCE HOSPITAL. BYN MELLON WEALTH MANAGEMENT IS AN UNRELATED ORGANIZATION. PART V ENDOWMENT FUNDS QUESTION 4: THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS ARE DIRECTED IN ACCORDANCE WITH THE DONOR'S INTENT INCLUDING THE PERSERVATION OF THE ORIGINAL GIFT AND VARIOUS PURPOSES INCLUDING CHARITY CARE, MEDICAL EDUCATION, RESEARCH, HEALTH CARE SERVICES, BUILDINGS AND EQUIPMENT. HEALTHALLIANCE HOSPITAL - THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS ARE DIRECTED IN ACCORDANCE WITH THE DONOR'S INTENT INCLUDING THE PRESERVATION OF THE ORIGINAL GIFT AND VARIOUS PURPOSES INCLUDING CHARITY CARE, MEDICAL EDUCATION, RESEARCH, HEALTH CARE SERVICES, BUILDINGS AND EQUIPMENT.
Schedule D (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
UMASS MEMORIAL HEALTH CARE INC
& AFFILIATES - GROUP RETURN
Employer identification number

91-2155626
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
 
UMASS MEMORIAL FOUNDATION INC
333 SOUTH STREET
 
SHREWSBURY, MA01545 		FUNDRAISING Yes   5,665,576 1,602,995 4,062,581
Total .................right arrow 5,665,576 1,602,995 4,062,581
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.
MA, NH
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

HOSP GOLF TRNM
(event type) 		(b) Event #2

WINTER BALL
(event type) 		(c) Other Events

11
(total number) 		(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 288,514 277,825 569,480 1,135,819
2 Less: Charitable
contributions . . . 		190,007 204,994 382,635 777,636
3 Gross income (line 1
minus line 2) . . . 		98,507 72,831 186,845 358,183
VerticalDirectExpenses 4 Cash prizes . . .        
5 Non-cash prizes . . 29,279   15,848 45,127
6 Rent/facility costs . . 116,254   51,814 168,068
7 Food and beverages . .     12,342 12,342
8 Entertainment . . .     2,200 2,200
9 Other direct expenses . 10,318 72,831 125,137 208,286
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 436,023
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow -77,840
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
PART I, LINE 2B; COLUMN (III) PART I, LINE 2B - FUNDRAISER ADDITIONAL INFORMATION UMASS MEMORIAL FOUNDATION, INC. IS IDENTIFIED AS THE ADMINISTRATOR OF THE PHILANTHROPIC ACTIVITIES OF THE REPORTING ENTITIES OF UMASS MEMORIAL HEALTH CARE, INC. THIS INCLUDES THE COORDINATION OF ALL CHARITABLE WORK AND THE MANAGEMENT OF OFFICE OPERATIONS TO SUPPORT FUNDRAISING INCLUDING THE FOLLOWING PROCEDURES: 1) ACTIVE DEVELOPMENT WORK 2) DONOR RELATIONS AND COMMUNICATIONS 3) SERVICES TO UMASS MEMORIAL STAFF 4) CONTRIBUTION REPORTS, DONOR RECORD FILES 5) TRANSFER OF CONTRIBUTIONS RECEIVED (CONTRIBUTIONS RECEIVED BY THE FOUNDATION THAT ARE DESIGNATED TO A UMASS MEMORIAL REPORTING ENTITY ARE DEPOSITED INTO A DESIGNATED ACCOUNT OF THE RESPECTIVE REPORTING ENTITY UPON RECEIPT.) 6) EXPENDITURES OF CONTRIBUTIONS
PART I, LINE 2B; COLUMN (V) PART I, LINE 2B - FUNDRAISER ADDITIONAL INFORMATION (CONTINUED) UMASS MEMORIAL HEALTH CARE, INC. PAYS UMASS MEMORIAL FOUNDATION, INC. ITS PRORATA SHARE OF OPERATING EXPENSES BASED ON THE SPLIT OF UMASS MEMORIAL CONTRIBUTION RECEIPTS VERSUS THE OVERALL TOTAL CONTRIBUTION RECEIPTS AS COLLECTED BY THE FOUNDATION.
PART II SCHEDULE G - ADDITIONAL INFORMATION PART II, COLUMN (A) EVENT #1 THE HOSPITAL GOLF TOURNAMENT WAS HELD BY CENTRAL NEW ENGLAND HEALTHALLIANCE, INC. PART II, COLUMN (B) EVENT #2 THE WINTER BALL WAS HELD BY THE PARENT PART II, COLUMN (C) OTHER EVENTS (11EVENTS REPORTED) ARE: GOLF TOURNAMENT HELD BY WING MEMORIAL HOSPITAL CORPORATION SPEAKEASY HELD BY HEALTHALLIANCE HOSPITALS DENNEHY GOLF TOURNAMENT HELD BY HEALTH ALLIANCE HOME HEALTH AND HOSPICE, INC. LOVELIGHT HELD BY HEALTHALLIANCE HOME HEALTH AND HOSPICE, INC. GOLF TOURNAMENT HELD BY THE PARENT OTHER MISC EVENT HELD BY THE PARENT GOLF TOURNAMENT HELD BY MARLBOROUGH HOSPITAL, INC. 50'S SOCK HOP DANCE HELD BY CLINTON HOSPITAL ASSOCIATION MENTAL HEALTH MONTH DINNER HELD BY COMMUNITY HEALTHLINK, INC. SPANISH FOR KIDS HELD BY COMMUNITY HEALTHLINK, INC. DOG WALK FUNDRAISER HELD BY COMMUNITY HEALTHLINK, INC.
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
UMASS MEMORIAL HEALTH CARE INC
& AFFILIATES - GROUP RETURN
Employer identification number

91-2155626
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
Yes
 
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
 
No
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) .. 		    55,001,985 20,950,610 34,051,375 2.100 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		    261,525,939 241,606,541 19,919,398 1.230 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....     37,092,662 35,268,968 1,823,694 0.110 %
dTotal Charity Care and
Means-Tested Government Programs ..... 		    353,620,586 297,826,119 55,794,467 3.440 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		    4,050,554 2,646,887 1,403,667 0.090 %
f Health professions education
(from Worksheet 5) .. 		    190,772,451 128,258,080 62,514,371 3.860 %
g Subsidized health services
(from Worksheet 6) .. 		    91,850,494 82,836,487 9,014,007 0.560 %
h Research (from Worksheet 7)     0 0   0 %
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		    4,698,302 2,066,575 2,631,727 0.160 %
jTotal Other Benefits ...     291,371,801 215,808,029 75,563,772 4.670 %
kTotal. Add lines 7d and 7j. ..     644,992,387 513,634,148 131,358,239 8.110 %
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     16,818   16,818 0 %
2 Economic development     0      
3 Community support     13,000   13,000 0 %
4 Environmental improvements     19,000   19,000 0 %
5 Leadership development and training for community members     4,326   4,326 0 %
6 Coalition building     71,598   71,598 0 %
7 Community health improvement advocacy     1,000   1,000 0 %
8 Workforce development     766,955   766,955 0.050 %
9 Other     0      
10 Total     892,697   892,697 0.050 %
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
9,422,060
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
1,693,756
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
357,021,904
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
383,705,879
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-26,683,975
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 %
11 COMMONWEALTH PROFESSIONAL ASSURANCE COMPANY LTD
  		PROVIDES INSURANCE 100.000 % 0 % 0 %
22 UMASS MEMORIAL INVESTMENT PARTNERSHIP LLP
  		MANAGES POOLED INVESTMENTS 100.000 % 0 % 0 %
33 UMASS MEMORIAL HEALTH ALLIANCE MRI CENTER LLC
  		MAGNETIC RESONANCE IMAGING CENTER 60.000 % 0 % 0 %
44 UMASS MEMORIAL MRI OF MARLBOROUGH LLC
  		MAGNETIC RESONANCE IMAGING CENTER 56.000 % 0 % 0 %
55 MEMORIAL OFFICE CONDOMINIUM TRUST
  		CONDO ASSOCIATION THAT OWNS MEDICAL OFFICE BUILDING 53.690 % 0 % 0 %
66 UMASS MEMORIAL MRI & IMAGING CENTER LLC
  		MAGNETIC RESONANCE IMAGING CENTER 50.000 % 0 % 0 %
77 NEW ENGLAND REHABILITATION SERVICES OF CENTRAL MASSACHUSETTS INC
  		ACUTE CARE REHABILITATION FACILITY 50.000 % 0 % 0 %
88 BIO LABS INC
  		CLINICAL LABORATORY 100.000 % 0 % 0 %
99 HEALTHALLIANCE WITH PHYSICIANS INC
  		PHYSICIAN ALLIANCE 50.000 % 0 % 0 %
1010 SHIELDS IMAGING OF MASSACHUSETTS LLC
  		MANAGEMENT COMPANY FOR PET IMAGING 25.000 % 0 % 0 %
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?5
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 UMASS MEMORIAL MEDICAL CENTER INC
55 LAKE AVE 119 BELMONT STREET
WORCESTER,MA01605 		X X X X   X X    
2 HEALTHALLIANCE HOSPITAL INC
60 HOSPITAL ROAD
LEOMINSTER,MA01453 		X X   X     X    
3 MARLBOROUGH HOSPITAL
157 UNION STREET
MARLBOROUGH,MA01752 		X X   X     X    
4 WING MEMORIAL HOSPITAL CORPORATION
40 WRIGHT STREET
PALMER,MA01069 		X X         X    
5 CLINTON HOSPITAL ASSOCIATION
201 HIGHLAND STREET
CLINTON,MA01510 		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:UMASS MEMORIAL MEDICAL CENTER INC
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 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for free care: 200.000000000000%
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 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 600.000000000000%
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
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 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
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 Yes  
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 Yes  
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 Yes  
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   No
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 Yes  
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:HEALTHALLIANCE HOSPITAL 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 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for free care: 200.000000000000%
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 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 600.000000000000%
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
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 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
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 Yes  
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 Yes  
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 Yes  
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   No
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 Yes  
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:MARLBOROUGH HOSPITAL
Line Number of Hospital Facility (from Schedule H, Part V, Section A):3

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 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for free care: 200.000000000000%
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 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 600.000000000000%
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
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 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
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 Yes  
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 Yes  
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 Yes  
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   No
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 Yes  
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:WING MEMORIAL HOSPITAL CORPORATION
Line Number of Hospital Facility (from Schedule H, Part V, Section A):4

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 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for free care: 200.000000000000%
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 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 600.000000000000%
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
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 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
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 Yes  
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 Yes  
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 Yes  
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   No
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 Yes  
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:CLINTON HOSPITAL ASSOCIATION
Line Number of Hospital Facility (from Schedule H, Part V, Section A):5

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 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for free care: 200.000000000000%
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 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 600.000000000000%
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
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 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
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 Yes  
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 Yes  
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 Yes  
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   No
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 Yes  
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?4
Name and address Type of Facility (Describe)
1 UMASS MEMORIAL LABORATORIES
BIOTECH ONE 365 PLANTATION STREET
WORCESTER,MA01605 		SATELLITE - LAB SERVICES
2 UMASS MEMORIAL LABORATORIES
BIOTECH ONE 365 PLANTATION STREET
WORCESTER,MA01605 		SATELLITE - LAB SERVICES
3 UMASS MEMORIAL LABORATORIES
BIOTECH ONE 365 PLANTATION STREET
WORCESTER,MA01605 		SATELLITE - LAB SERVICES
4 UMASS MEMORIAL LABORATORIES
BIOTECH ONE 365 PLANTATION STREET
WORCESTER,MA01605 		SATELLITE - LAB SERVICES
5
6
7
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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 7: THE ECLIPSYS COST ACCOUNTING DATA WAS APPLIED FOR THE PATIENT CARE THAT SUSTAINED A LOSS. CARE IS BILLED AT A PROCEDURE (CHARGE CODE) LEVEL AND THIS IS APPLIED TO THE PATIENT UTILIZATION. THIS DATA INCLUDES ALL PATIENT SEGMENTS OF CARE. EXCLUSIONS WERE APPLIED AS DIRECTED IN THE SCHEDULE. THE COST TO CHARGE WAS ACHIEVED BY TAKING THE EXPENSES (EXCLUDING BAD DEBT) AND APPLYING THEM AGAINST THE GROSS CHARGES. A COST CHARGE RATIO WAS APPLIED TO THE PATIENT CARE THAT WAS NOT BILLED TO HEALTH SAFETY NET (HSN), I.E. AMBULANCE SERVICES, MOBILE VAN PATIENT CARE, AND PRIMARY CARE WHERE THE PATIENT DID NOT FULLY COMPLETE THE FREE CARE APPLICATION.
    PART I, LINE 7G: THE ORGANIZATION REVIEWED PROGRAMS THAT WERE PROVIDED BUT WHICH INCURRED A FINANCIAL LOSS. THE LOSS IS OBTAINED AFTER REDUCING THE CHARGES TO COST, LESS THE PAYMENTS. THESE LOSSES ARE NOT INCLUDED IN PART I OR AS BAD DEBT IN PART III. MEDICAID, SELF-PAY AND FREE CARE CASES AND VISITS WERE REMOVED FROM THE TOTAL PER THE INSTRUCTIONS. THE SERVICES PROVIDED HAVE BEEN IDENTIFIED AS A COMMUNITY NEED AND IF THE ORGANIZATION NO LONGER OFFERED THE SERVICE, THE SERVICE WOULD BE UNAVAILABLE. THE SERVICES RECOGNIZED ARE: PSYCHIATRY, FAMILY AND COMMUNITY MEDICINE, NEPHROLOGY, BARRE PRIMARY CARE, PEDIATRIC PRIMARY CARE, AND MATERNITY SERVICES PROVIDED FOR DELIVERIES AND NORMAL NEWBORNS, EMERGENCY SERVICES, CARE MOBILE, PLUMLEY VILLAGE PRIMARY CARE, TRI-RIVER PRIMARY CARE, AND TB CLINIC. THE DATA REPRESENTS THE UMASS MEMORIAL MEDICAL CENTER AND THE MEMBER HOSPITALS, CLINTON, MARLBOROUGH, HEALTHALLIANCE AND WING MEMORIAL.PART I, LINE 7G: NO COST ATTRIBUTABLE TO A PHYSICIAN CLINIC IS INCLUDED IN SUBSIDIZED HEALTH SERVICES.
    PART I, L7 COL(F): BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) WHICH WAS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE AMOUNTS TO $48,795,577.
    PART II: UMASS MEMORIAL HEALTH CARE RECOGNIZES COMMUNITY BUILDING ACTIVITIES AS BEING A PART OF THOSE 'SOCIAL DETERMINANTS OF HEALTH' THAT IMPACT THE HEALTH OF THE COMMUNITY. WE INVEST IN EDUCATIONAL COLLABORATIVES, COALITION BUILDING, ADVOCACY EFFORTS, COMMUNITY GARDENS, WORKFORCE DEVELOPMENT AND LEADERSHIP TRAINING PROGRAMS THAT SUPPORT YOUTH WHO ARE AT RISK OF DEVELOPING POOR AND RISKY HEALTH BEHAVIORS AND ARE EXPERIENCING VIOLENCE DUE TO POVERTY. WE ALSO INVEST IN ENVIRONMENTAL AND PHYSICAL IMPROVEMENT PROGRAMS SUCH AS BEAUTIFICATION OF LOW INCOME NEIGHBORHOOD PARKS TO ENABLE ACCESS TO SAFE PLAYGROUNDS THAT PROMOTE PHYSICAL ACTIVITY AS A WAY TO REDUCE OBESITY. THESE PROGRAMS ARE BASED ON OUR COMMUNITY BENEFITS MISSION WHICH WAS RECOMMENDED BY A COMMUNITY BENEFITS ADVISORY COMMITTEE AND DRAWS INSPIRATION FROM THE WORLD HEALTH ORGANIZATION'S BROAD DEFINITION OF HEALTH, AS 'A STATE OF COMPLETE, PHYSICAL, MENTAL, AND SOCIAL WELL BEING AND NOT MERELY THE ABSENCE OF DISEASE.' BY ADOPTING THIS DEFINITION, UMASS MEMORIAL HEALTH CARE HAS EXPANDED ITS STRATEGY TO INCLUDE THE SOCIAL, ECONOMIC, AND POLITICAL OBSTACLES THAT PREVENT PEOPLE FROM ACHIEVING OPTIMAL HEALTH. ALL OF OUR COMMUNITY BUILDING ACTIVITIES ARE THE RESULT OF AN IDENTIFIED NEED AND ENGAGE THE COMMUNITY. THEY INCLUDE COLLABORATIVE EFFORTS, ADVOCACY ACTIVITIES AND PARTNERSHIPS THAT ENGAGE A BROAD ARRAY OF COMMUNITY STAKEHOLDERS IN ADDRESSING THESE UNMET SOCIAL DETERMINANTS OF HEALTH (COMMUNITY BUILDING ACTIVITIES).
    PART III, LINE 4: COSTING METHODOLOGY - MULTIPLIED THE GROSS PATIENT SERVICE REVENUE BY THE RATIO OF COSTS TO CHARGES CALCULATED AS REPORTED IN HOSPITALS DHCFP 403 HOSPITAL STATEMENT OF COSTS, REVENUES AND STATISTICS. THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE PERTAINING TO BAD DEBT EXPENSE, ACCOUNTS RECEIVABLE, OR THE ALLLOWANCE FOR DOUBTFUL ACCOUNTS. AMOUNTS RECORDED AS BAD DEBT EXPENSE AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS ARE PRESENTED DIRECTLY ON THE CONSOLIDATED STATEMENT OF OPERATIONS AND CONSOLIDATED BALANCE SHEETS RESPECTIVELY.
    PART III, LINE 8: THE MEDICARE SHORTFALL IS THE SUBSIDIZED AMOUNT OF CARE PROVIDED TO PATIENTS AND IS CONSIDERED A COMMUNITY BENEFIT. THIS SHORTFALL INCLUDES LOW REIMBURSEMENT FOR CAPITAL DUE TO TIMING DIFFERENCES AS MAJOR INVESTMENTS ARE MADE, PROGRAMS RELATED TO EMERGENCY AND OTHER AMBULATORY PROGRAMS.
    PART III, LINE 9B: EXEMPTION FROM SELF-PAY BILLING AND COLLECTION ACTION - THE ORGANIZATION WILL NOT INITIATE SELF-PAY BILLING AND COLLECTION ACTIVITY:A. UPON SUFFICIENT PROOF THAT A PATIENT IS A RECIPIENT OF EMERGENCY AID TO THE ELDERLY, DISABLED AND CHILDREN (EAEDC), OR ENROLLED IN THE HEALTH SAFETY NET (HSNO) OR MASSHEALTH, HEALTHY START, OR THE CHILDREN'S MEDICAL SECURITY PLAN WHOSE FAMILY INCOME IS EQUAL OR LESS THAN 400% OF THE FPL, WITH THE EXCEPTION OF CO-PAYS AND DEDUCTIBLES REQUIRED UNDER THE PROGRAM OF ASSISTANCE.B. IF THE HOSPITAL HAS PLACED THE ACCOUNT IN LEGAL OR ADMINISTRATIVE HOLD STATUS AND/OR SPECIFIC PAYMENT ARRANGEMENTS HAVE BEEN MADE WITH THE PATIENT OR GUARANTOR.C. FOR MEDICAL HARDSHIP BILLS THAT EXCEED THE MEDICAL HARDSHIP CONTRIBUTION.D. UNLESS UMMMC HAS CHECKED THE EVS SYSTEM TO DETERMINE IF THE PATIENT HAS FILED AN APPLICATION FOR MASSHEALTH.E. FOR PARTIAL HEALTH SAFETY NET ELIGIBLE PATIENTS, WITH THE EXCEPTION OF ANY DEDUCTIBLES REQUIRED.NOTE: THE ORGANIZATION MAY BILL FOR HEALTH SAFETY NET ELIGIBLE AND MEDICAL HARDSHIP PATIENTS FOR NON-MEDICALLY NECESSARY SERVICES PROVIDED AT THE REQUEST OF THE PATIENT AND FOR WHICH THE PATIENT HAS AGREED BY WRITTEN CONSENT.
HEALTHALLIANCE HOSPITAL, INC.   PART V, SECTION B, LINE 13G: PATIENTS WHO ARE SCHEDULED TO BE ADMITTED AND HAVE BEEN IDENTIFIED AS NON INSURED AND/OR IN NEED OF FINANCIAL ASSISTANCE WILL HAVE AN APPOINTMENT SCHEDULED PRIOR TO ADMISSION TO MEET WITH A FINANCIAL COUNSELOR. PATIENTS, WHO ARE ADMITTED TO THE HOSPITAL THROUGH THE EMERGENCY DEPARTMENT, WILL BE VISITED BY THE FINANCIAL COUNSELOR ONCE THE PATIENT IS ON THE INPATIENT FLOOR. THE MEETING WILL BE HELD WITH THE PATIENT AND/OR FAMILY AS THE PATIENT'S MEDICAL CONDITION PERMITS.
UMASS MEMORIAL MEDICAL CENTER, INC.   PART V, SECTION B, LINE 15E: POLICY ON LIENS-NO LIENS WILL BE INITIATED AGAINST A PATIENT'S PRIMARY RESIDENCE OR MOTOR VEHICLE WITHOUT WRITTEN APPROVAL FROM UMMMC'S BOARD OF TRUSTEES. ALL APPROVALS BY THE BOARD OF TRUSTEES WILL BE MADE ON AN INDIVIDUAL CASE BASES. WE ALSO SEND STATEMENTS AND MAKE PHONE CALLS.
HEALTHALLIANCE HOSPITAL, INC.   PART V, SECTION B, LINE 15E: POLICY ON LIENS-NO LIENS WILL BE INITIATED AGAINST A PATIENT'S PRIMARY RESIDENCE OR MOTOR VEHICLE WITHOUT WRITTEN APPROVAL FROM HEALTHALLIANCE'S BOARD OF TRUSTEES. ALL APPROVALS BY THE BOARD OF TRUSTEES WILL BE MADE ON AN INDIVIDUAL CASE BASES. WE ALSO SEND STATEMENTS AND MAKE PHONE CALLS.
MARLBOROUGH HOSPITAL   PART V, SECTION B, LINE 15E: POLICY ON LIENS-NO LIENS WILL BE INITIATED AGAINST A PATIENT'S PRIMARY RESIDENCE OR MOTOR VEHICLE WITHOUT WRITTEN APPROVAL FROM MARLBOROUGH'S BOARD OF TRUSTEES. ALL APPROVALS BY THE BOARD OF TRUSTEES WILL BE MADE ON AN INDIVIDUAL CASE BASES. WE ALSO SEND STATEMENTS AND MAKE PHONE CALLS.
WING MEMORIAL HOSPITAL CORPORATION   PART V, SECTION B, LINE 15E: POLICY ON LIENS-NO LIENS WILL BE INITIATED AGAINST A PATIENT'S PRIMARY RESIDENCE OR MOTOR VEHICLE WITHOUT WRITTEN APPROVAL FROM WING'S BOARD OF TRUSTEES. ALL APPROVALS BY THE BOARD OF TRUSTEES WILL BE MADE ON AN INDIVIDUAL CASE BASES. WE ALSO SEND STATEMENTS AND MAKE PHONE CALLS.
CLINTON HOSPITAL ASSOCIATION   PART V, SECTION B, LINE 15E: POLICY ON LIENS-NO LIENS WILL BE INITIATED AGAINST A PATIENT'S PRIMARY RESIDENCE OR MOTOR VEHICLE WITHOUT WRITTEN APPROVAL FROM CLINTON'S BOARD OF TRUSTEES. ALL APPROVALS BY THE BOARD OF TRUSTEES WILL BE MADE ON AN INDIVIDUAL CASE BASES. WE ALSO SEND STATEMENTS AND MAKE PHONE CALLS.
UMASS MEMORIAL MEDICAL CENTER, INC.   PART V, SECTION B, LINE 16E: UMMMC REFERS ACCOUNTS TO A CREDIT AGENCY WHEN WRITTEN OFF AS BAD DEBT FOR FURTHER COLLECTIONS. THESE AGENCIES CONTINUE COLLECTIONS WITHOUT IMPACT TO THE CREDIT RATING.
HEALTHALLIANCE HOSPITAL, INC.   PART V, SECTION B, LINE 16E: HEALTHALLIANCE HOSPITAL REFERS ACCOUNTS TO A CREDIT AGENCY WHEN WRITTEN OFF AS BAD DEBT FOR FURTHER COLLECTIONS. THESE AGENCIES CONTINUE COLLECTIONS WITHOUT IMPACT TO THE CREDIT RATING.
MARLBOROUGH HOSPITAL   PART V, SECTION B, LINE 16E: MARLBOROUGH ENGAGES A THIRD PARTY AGENCY TO ASSIST ON ALL SELF PAY ACCOUNTS AT ORIGINATION. THEY REFER ACCOUNTS TO A CREDIT AGENCY WHEN WRITTEN OFF AS BAD DEBT FOR FURTHER COLLECTIONS. THESE AGENCIES CONTINUE COLLECTIONS WITHOUT IMPACT TO THE CREDIT RATING.
WING MEMORIAL HOSPITAL CORPORATION   PART V, SECTION B, LINE 16E: WING REFERS ACCOUNTS TO A CREDIT AGENCY WHEN WRITTEN OFF AS BAD DEBT FOR FURTHER COLLECTIONS. THESE AGENCIES CONTINUE COLLECTIONS WITHOUT IMPACT TO THE CREDIT RATING.
CLINTON HOSPITAL ASSOCIATION   PART V, SECTION B, LINE 16E: CLINTON REFERS ACCOUNTS TO A CREDIT AGENCY WHEN WRITTEN OFF AS BAD DEBT FOR FURTHER COLLECTIONS. THESE AGENCIES CONTINUE COLLECTIONS WITHOUT IMPACT TO THE CREDIT RATING.
HEALTHALLIANCE HOSPITAL, INC.   PART V, SECTION B, LINE 17E: 1. PATIENTS WITH SELF-PAY RESPONSIBILITIES, INCLUDING EMERGENCY, ELECTIVE, SCHEDULED AND URGENT SERVICES WILL RECEIVE AN INITIAL BILL DELINEATING THE SERVICES AND AMOUNTS DUE FOR WHICH THEY ARE RESPONSIBLE.2. FOR ANY SELF-PAY RESPONSIBILITIES THAT REMAIN UNPAID AFTER THE INITIAL BILL, THE PATIENT WILL RECEIVE A SERIES OF MONTHLY STATEMENTS FOR 4 MONTHS OR UNTIL THE BALANCE IS RESOLVED, THE 4TH STATEMENT INDICATED AS A FINAL NOTICE. 3. PROVIDER ACCOUNTING STAFF WILL MAKE A TELEPHONE CALL TO ANY PATIENT WITH AN OUTSTANDING SELF-PAY BALANCE OF $1,000 OR MORE DURING THE NORMAL SELF-PAY BILLING AND COLLECTION PROCESS. 4. HAH WILL SEND A FINAL NOTICE BY CERTIFIED MAIL FOR BALANCES OVER $1,000 WHERE NOTICES HAVE NOT BEEN RETURNED AS "INCORRECT ADDRESS" OR "UNDELIVERABLE" FOR EMERGENCY CARE PATIENTS.5. ADDITIONAL NOTICES AND/OR LETTERS MAY BE SENT TO DEBTOR PATIENTS DURING THE BILLING AND COLLECTION PROCESS IN AN EFFORT TO RESOLVE OUTSTANDING BALANCES.6. RETURNED MAIL AND/OR UNDELIVERABLE MAIL WILL BE RESEARCHED BY THE PROVIDER ACCOUNTING STAFF TO OBTAINED VALID ADDRESSES. DATABASES AND PRIOR VISIT INFORMATION WILL BE UTILIZED.7. ALL SUCH EFFORTS TO COLLECT BALANCES, AS WELL AS ANY PATIENT INITIATED INQUIRIES, WILL BE DOCUMENTED ON THE GUARANTOR'S ACCOUNT AND AVAILABLE FOR REVIEW.
UMASS MEMORIAL MEDICAL CENTER, INC.   PART V, SECTION B, LINE 19D: THE HOSPITAL FACILITY BILLS GROSS CHARGES WITH A 20% PROMPT PAY DISCOUNT.
HEALTHALLIANCE HOSPITAL, INC.   PART V, SECTION B, LINE 19D: HEALTHALLIANCE CHARGES ALL PATIENTS THE PUBLISHED CHARGE. WHEN THE PATIENT HAS BEEN DETERMINED FOR A DISCOUNT, THE DISCOUNT IS THEN APPLIED TO THE TOTAL CHARGE, AND THE AMOUNT OWED BY THE GUARANTOR IS NOW REDUCED.
MARLBOROUGH HOSPITAL   PART V, SECTION B, LINE 19D: THE HOSPITAL FACILITY BILLS GROSS CHARGES WITH A 20% PROMPT PAY DISCOUNT.
WING MEMORIAL HOSPITAL CORPORATION   PART V, SECTION B, LINE 19D: THE HOSPITAL FACILITY BILLS GROSS CHARGES WITH A 20% PROMPT PAY DISCOUNT.
CLINTON HOSPITAL ASSOCIATION   PART V, SECTION B, LINE 19D: THE HOSPITAL FACILITY BILLS GROSS CHARGES WITH A 20% PROMPT PAY DISCOUNT.
UMASS MEMORIAL MEDICAL CENTER, INC.   PART V, SECTION B, LINE 21: UMMMC CHARGES ALL PATIENTS THE PUBLISHED CHARGE. WHEN THE PATIENT HAS BEEN DETERMINED FOR A DISCOUNT, THE DISCOUNT IS THEN APPLIED TO THE TOTAL CHARGE, AND THE AMOUNT OWED BY THE GUARANTOR IS NOW REDUCED.
HEALTHALLIANCE HOSPITAL, INC.   PART V, SECTION B, LINE 21: HEALTHALLIANCE CHARGES ALL PATIENTS THE PUBLISHED CHARGE. WHEN THE PATIENT HAS BEEN DETERMINED FOR A DISCOUNT, THE DISCOUNT IS THEN APPLIED TO THE TOTAL CHARGE, AND THE AMOUNT OWED BY THE GUARANTOR IS NOW REDUCED.
MARLBOROUGH HOSPITAL   PART V, SECTION B, LINE 21: MARLBOROUGH CHARGES ALL PATIENTS THE PUBLISHED CHARGE. WHEN THE PATIENT HAS BEEN DETERMINED FOR A DISCOUNT, THE DISCOUNT IS THEN APPLIED TO THE TOTAL CHARGE, AND THE AMOUNT OWED BY THE GUARANTOR IS NOW REDUCED.
WING MEMORIAL HOSPITAL CORPORATION   PART V, SECTION B, LINE 21: WING CHARGES ALL PATIENTS THE PUBLISHED CHARGE. WHEN THE PATIENT HAS BEEN DETERMINED FOR A DISCOUNT, THE DISCOUNT IS THEN APPLIED TO THE TOTAL CHARGE, AND THE AMOUNT OWED BY THE GUARANTOR IS NOW REDUCED.
CLINTON HOSPITAL ASSOCIATION   PART V, SECTION B, LINE 21: CLINTON CHARGES ALL PATIENTS THE PUBLISHED CHARGE. WHEN THE PATIENT HAS BEEN DETERMINED FOR A DISCOUNT, THE DISCOUNT IS THEN APPLIED TO THE TOTAL CHARGE, AND THE AMOUNT OWED BY THE GUARANTOR IS NOW REDUCED.
PART V, QUESTION 12 HEALTHALLIANCE HOSPITAL, INC. FINANCIAL ASSISTANCE- HAH EMPLOYS A STAFF OF FINANCIAL COUNSELORS, CUSTOMER SERVICE REPRESENTATIVES AND GUARANTOR COLLECTORS WHO ARE AVAILABLE BY PHONE OR BY APPOINTMENT TO SUPPORT PATIENTS IN APPLYING FOR FINANCIAL ASSISTANCE AND RESOLVING THEIR MEDICAL BILLS. FINANCIAL COUNSELORS, CUSTOMER SERVICE REPRESENTATIVES AND GUARANTOR COLLECTORS, PROVIDE POTENTIALLY ELIGIBLE PATIENTS WITH THE APPROPRIATE APPLICATION(S) FOR MASS HEALTH AND/OR HEALTH SAFETY NET, AND ASSIST PATIENTS WITH THE APPLICATION PROCESS.
    PART I, LINE 7B - UNDER THE MEDICAID STATE PLAN, UMMHC IS ONE OF TWO HOSPITAL SYSTEMS IN THE STATE THAT QUALIFY AS ESSENTIAL MASSHEALTH HOSPITALS, WHICH PERMITS THE STATE TO PAY IT SUPPLEMENTAL PAYMENTS IN ADDITION TO UMMHC'S STANDARD MEDICAID PAYMENT. THE STANDARD MEDICAID PAYMENT REIMBURSES UMMHC APPROXIMATELY 73% OF THE COST OF PROVIDING SERVICES TO MASSHEALTH PATIENTS. MEDICAID SUPPLEMENTAL FUNDS PROVIDE ADDITIONAL REVENUE TO THE UMMHC HEALTH CARE SYSTEM IN RECOGNITION AND SUPPORT OF UMMHC'S SPECIAL RELATIONSHIP AND OBLIGATIONS TO THE STATE'S ONLY PUBLIC MEDICAL SCHOOL TO FURTHER ITS PUBLIC MISSION AS WELL AS ITS COMMITMENT TO ITS COMMUNITY AS THE REGIONS ONLY SAFETY NET HOSPITAL. THESE SUPPLEMENTAL PAYMENTS ARE MADE PURSUANT TO A SPECIFIC PROVISION ON THE MEDICAID STATE PLAN.
    PART VI, LINE 2: EACH OF OUR HOSPITALS HAS A DESIGNATED COMMUNITY BENEFITS PROGRAM STAFF THAT HAS JOINED EFFORTS WITH THEIR RESPECTIVE COMMUNITY AND TAKEN INTO ACCOUNT INPUT FROM COMMUNITY STAKEHOLDERS IN DEVELOPMENT OF THEIR COMMUNITY NEEDS ASSESSMENT.UMASS MEMORIAL MEDICAL CENTER:UMASS MEMORIAL MEDICAL CENTER HAS ASSEMBLED A DIVERSE TEAM THAT IS IN THE PROCESS OF UPDATING THE COMMUNITY NEEDS ASSESSMENT, THE LAST COMMUNITY NEEDS ASSESSMENT, THE WORCESTER INDICATORS REPORT, WAS ANNOUNCED TO THE PUBLIC IN THE PRESENCE OF 100+ COMMUNITY LEADERS IN 2008 AND WAS THE FINAL PRODUCT OF A COLLABORATIVE EFFORT AND AN EXTENSIVE COMMUNITY ENGAGEMENT PROCESS THAT HAD UMASS MEMORIAL LEADERSHIP STAFF WORKING CLOSELY WITH COMMON PATHWAYS CHNA 8, A CITY-WIDE HEALTH COMMUNITIES INITIATIVE. UMASS MEMORIAL MEDICAL CENTER HAS COLLECTED THE DATA FOR UPDATING THIS NEEDS ASSESSMENT AND IS IN THE PROCESS OF DEVELOPING THE PLAN TO IDENTIFY PRIORITIES AND COMPLETE THE IMPLEMENTATION STRATEGY.CLINTON HOSPITAL:IN 2011, CLINTON HOSPITAL PARTICIPATED IN THE DEVELOPMENT OF A COMMUNITY NEEDS ASSESSMENT REPORT TITLED, THE COMMUNITY NEEDS ASSESSMENT OF CENTRAL MASSACHUSETTS. THE HOSPITAL WORKED WITH THE FOLLOWING ORGANIZATIONS TO COMPLETE THE ASSESSMENT: HEALTHALLIANCE HOSPITAL, COMMUNITY HEALTH NETWORK OF NORTH CENTRAL MASSACHUSETTS (CHNA 9), THE JOINT COALITION ON HEALTH OF NORTH CENTRAL MASSACHUSETTS AND THE MINORITY COALITION OF NORTH CENTRAL MASSACHUSETTS. THE HOSPITAL IS IN THE PROCESS OF IDENTIFYING PRIORITIES AND DEVELOPING AN IMPLEMENTATION PLAN.HEALTHALLIANCE HOSPITAL:IN 2011, HEALTHALLIANCE HOSPITAL PARTICIPATED IN THE DEVELOPMENT OF A COMMUNITY NEEDS ASSESSMENT REPORT TITLED, THE COMMUNITY NEEDS ASSESSMENT OF CENTRAL MASSACHUSETTS. THE HOSPITAL WORKED WITH THE FOLLOWING ORGANIZATIONS TO COMPLETE THE ASSESSMENT: CLINTON HOSPITAL, COMMUNITY HEALTH NETWORK OF NORTH CENTRAL MASSACHUSETTS (CHNA 9), THE JOINT COALITION ON HEALTH OF NORTH CENTRAL MASSACHUSETTS AND THE MINORITY COALITION OF NORTH CENTRAL MASSACHUSETTS. THE HOSPITAL IS IN THE PROCESS OF IDENTIFYING PRIORITIES AND DEVELOPING AN IMPLEMENTATION PLAN.MARLBOROUGH HOSPITAL:MARLBORO HOSPITAL CONDUCTED ITS MOST RECENT NEEDS ASSESSMENT IN FY2010/2011 WITH INPUT FROM A WIDE ARRAY OF COMMUNITY STAKEHOLDERS AND IS CURRENTLY DEVELOPING ITS PLAN TO UPDATE IDENTIFIED PRIORITIES AND DEVELOP AN IMPLEMENTATION PLAN. WING MEMORIAL HOSPITAL:WING MEMORIAL HOSPITAL IS IN THE PROCESS OF WORKING WITH SEVERAL AREA HOSPITALS AND COMMUNITY STAKEHOLDERS IN GATHERING DATA TO IDENTIFY PRIORITIES AND DEVELOP AN IMPLEMENTATION PLAN.
    PART VI, LINE 3: PATIENT ED OF ELIGIBILITY FOR ASSISTANCE - UMASS MEMORIAL INFORMS AND EDUCATES PATIENTS/OTHERS ABOUT ELIGIBILITY FOR AVAILABLE COVERAGE AND/OR CHARITY CARE BY EMPLOYING A LARGE (25+) STAFF OF FINANCIAL COUNSELORS, EXPERT IN MATCHING PATIENTS TO AVAILABLE COVERAGE AND CHARITY CARE OPTIONS AND ASSISTING PATIENTS THROUGH THE APPLICATION PROCESS. FURTHER, UMASS MEMORIAL WORKS TO CONNECT POTENTIALLY ELIGIBLE PATIENTS TO OUR FINANCIAL COUNSELORS THROUGH- WIDELY DISTRIBUTED BROCHURES- SIGNS POSTED IN HIGH TRAFFIC PATIENT AREAS- EDUCATION OF OUR CLINICIANS- ATTENDANCE AT NUMEROUS COMMUNITY OUTREACH EVENTS- REFERRAL OF ALL SELF-PAY PATIENTS AT THE POINT OF OUTPATIENT SCHEDULING/REGISTRATION- VISITS TO INPATIENTS WITHOUT HEALTH INSURANCE OR WITH COVERAGE GAPS- BILLBOARDS POSTED IN THE COMMUNITY- MESSAGES ON ALL PATIENT BILLS AND STATEMENTS- MAILINGS TO PATIENTS- CONVENIENT FINANCIAL COUNSELOR LOCATIONS WITHIN OR CONTIGUOUS TO CLINICAL AREAS.
    PART VI, LINE 4: GEOGRAPHICAL REACH - UMASS MEMORIAL HEALTH CARE SERVES APPROXIMATELY ONE MILLION RESIDENTS OF CENTRAL NEW ENGLAND. OUR CENTRAL MASSACHUSETTS SERVICE AREA INCLUDES ALL SIXTY CITIES AND TOWNS IN WORCESTER COUNTY FROM THE NEW HAMPSHIRE BORDER IN THE NORTH TO THE CONNECTICUT AND RHODE ISLAND BORDERS IN THE SOUTH. IT EXTENDS TO THE WEST INTO SEVEN TOWNS IN HAMPDEN COUNTY AND THREE TOWNS IN HAMPSHIRE COUNTY. FIVE HOSPITALS SERVE THIS GEOGRAPHIC AREA.REGIONAL DESCRIPTION - THE CENTRAL NEW ENGLAND REGION IS A MIX OF CITIES AND URBANIZED CENTERS, SUBURBS, SMALL TOWNS AND RURAL AREAS WITH SOME AGRICULTURE. SEVEN TOWNS IN OUR SERVICE AREA ARE DEFINED BY THE U.S. DEPARTMENT OF HEALTH, HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) AS RURAL BASED ON THEIR RURAL URBAN COMMUNITY AREA (RUCA) CODES, HRSA HAS DESIGNATED THE CITY OF WORCESTER A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) IN PRIMARY CARE, MENTAL HEALTH AND DENTAL SERVICES DUE TO ITS LOW INCOME POPULATION. SEVERAL TOWNS AND CITIES IN THE NORTH COUNTY ARE DESIGNATE BY HRSA AS HPSAS AND AS HAVING MEDICALLY-UNDERSERVED POPULATIONS (MUPS), ANOTHER DESIGNATION INDICATING NEED BECAUSE THEIR RESIDENTS FACE ECONOMIC, LINGUISTIC AND CULTURAL BARRIERS TO CARE. THE CITY OF WORCESTER HAS SEVERAL NEIGHBORHOODS WITH A SHORTAGE OF HEALTH PROVIDERS AND HRSA HAS DETERMINED THAT MANY CENSUS TRACTS IN THE CITY ARE MEDICALLY-UNDERSERVED AREAS (MUAS).ECONOMIC CHARACTERISTICS - THE U.S. CENSUS DATA FOR 2010 INDICATED THAT THE MEDIAN HOUSEHOLD INCOME FOR WORCESTER COUNTY WAS $29,316. FOR THE CITY OF WORCESTER, THE REGION'S LARGEST URBAN AREA, IT WAS CONSIDERABLY LOWER AT $23,135. ACCORDING TO THE CENSUS DATA, OF THE CITY'S TOTAL 181,045 RESIDENTS, 19.4% ARE LIVING BELOW THE POVERTY LEVEL. THE NUMBER OF CHILDREN UNDER THE AGE OF 18 LIVING BELOW THE POVERTY LEVEL ROSE TO 29.6% IN 2010 FROM 25% IN 2005-2009. (SOURCE: U.S. CENSUS 2010 AND 2010 AMERICAN COMMUNITY SURVEY 1-YEAR ESTIMATES, U.S. CENSUS.) THE UNEMPLOYMENT RATE IN WORCESTER COUNTY RANGED BETWEEN 9.3 IN JANUARY 2011 AND 7.2 IN DECEMBER 2011. (SOURCE: MASSACHUSETTS EXECUTIVE OFFICE OF LABOR WORKFORCE AND DEVELOPMENT.) THESE FACTORS HAVE RESULTED IN A STRONG NEED FOR FOOD ASSISTANCE SERVICES. FOR EXAMPLE, ACCORDING TO THE MASSACHUSETTS DEPARTMENT OF EDUCATION, 64% OF STUDENTS IN THE WORCESTER PUBLIC SCHOOL SYSTEM RECEIVE FREE SCHOOL LUNCH. (SOURCE: MASSACHUSETTS DEPARTMENT OF EDUCATION.) SINCE 2008, UMASS MEMORIAL HEALTH CARE FACILITIES HAVE FILED OVER 5,000 SNAP (FOOD STAMP) AND SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC) APPLICATIONS. CENTRAL MASSACHUSETTS HAS ALSO BEEN HARD-HIT BY THE FORECLOSURES CRISIS. BETWEEN 2006 AND 2011, THERE WERE NEARLY 26,000 FORECLOSURES IN WORCESTER COUNTY. (SOURCE: REALTYRAC, THE WARREN GROUP.) WHILE THE NUMBER OF FORECLOSURE PETITIONS IN THE REGION DECREASED IN 2011, THE TIME PERIOD FOR FORECLOSURES TO BE COMPLETED HAS INCREASED, SO AN UPTICK IS EXPECTED IN FORECLOSURES AS PREVIOUSLY FILED PETITIONS ARE COMPLETED IN THE COMING TWO YEARS.DEMOGRAPHIC AND HEALTH FACTORS - THE DEMOGRAPHICS OF THE REGION VARY WIDELY ACROSS THE REGION. WORCESTER COUNTY HAS A TOTAL POPULATION OF 798,552 AND IS 86% WHITE. THE CITY OF WORCESTER IS A LEADING RESETTLEMENT SITE FOR IMMIGRANTS DUE TO ITS LOWER COST OF LIVING AND AVAILABLE SERVICES AND ACCOUNTS FOR THE GREATEST INCREASE OF DIVERSITY IN THE REGION. ACCORDING TO U.S. CENSUS 2010 FIGURES, THE HISPANIC POPULATION AND OTHER NON-HISPANIC, NON-WHITE ETHNIC GROUPS HAVE NOTABLY INCREASED WHILE THE WHITE, NON-HISPANIC POPULATION HAS DECREASED. THE NUMBER OF HISPANICS LIVING IN THE CITY OF WORCESTER HAS GROWN BY 35% AND BY MORE THAN 46% STATEWIDE OVER THE PAST 10 YEARS. THE CITY'S FOREIGN BORN POPULATION IS SIGNIFICANTLY HIGHER THAN WORCESTER COUNTY AS A WHOLE, ACCOUNTING FOR THE MAJORITY OF THIS POPULATION IN THE REGION. THE CITY'S FOREIGN BORN POPULATION IS ALSO SIGNIFICANTLY HIGHER COMPARED TO THE NATION AND STATE OVERALL. ADDING TO THIS DIVERSITY IS AN INFLUX OF IMMIGRANTS AND NEW ARRIVAL REFUGEES. REFUGEES FROM IRAQ CURRENTLY ACCOUNT FOR THE GREATEST PERCENTAGE OF NEW IMMIGRANTS FOLLOWED BY REFUGEES FROM BHUTAN, BURMA AND LIBERIA. THIS GROWING DIVERSITY HAS BROADENED THE NEED FOR INTERPRETER SERVICES FOR MEDICAL CARE. FOR EXAMPLE, IN ITS FISCAL YEAR 2011, UMASS MEMORIAL HEALTH CARE DELIVERED 122,963 DOCUMENTED INTERPRETATIONS FOR MEDICAL SERVICES IN OVER 87 LANGUAGES. NINETY PERCENT OF ALL INTERPRETATIONS PROVIDED BY UMMHC WERE CONDUCTED IN: SPANISH, PORTUGUESE, VIETNAMESE, ARABIC, ALBANIAN AND AMERICAN SIGN LANGUAGE. THE REMAINING TEN PERCENT WERE CONDUCTED IN OTHER "NON-PRIMARY" LANGUAGES, THE POOL OF WHICH CONSISTS OF 81 DIFFERENT LANGUAGES. THE SENIOR POPULATION IN THE REGION ALSO CONTINUES TO GROW AS BABY BOOMERS REACH THE AGE OF 65. ACCORDING TO THE U.S. CENSUS, RESIDENTS BETWEEN THE AGES OF 20-64 ACCOUNT FOR THE MAJORITY OF THE POPULATION IN WORCESTER COUNTY AT 61%.ACCESS TO CARE - APPROXIMATELY 90% OF PEOPLE HAVE HEALTH INSURANCE. DESPITE THIS, THERE REMAINS A CHURNING OF ENROLLMENTS WITH MANY DROPPING OFF. HEALTH INSURANCE ENROLLMENT REMAINS AN ISSUE AS EVIDENCED BY UMMHC'S RATES OF ENROLLMENT ASSISTANCE IN HEALTH SAFETY NETWORK, COMMONWEALTH CARE AND MEDICAID APPLICATIONS.CHRONIC DISEASE OVERVIEW:- OVERWEIGHT & OBESITY: HIGH RATES OF OVERWEIGHT AND OBESITY ARE A LEADING PUBLIC HEALTH CONCERN IN THE REGION AND PARTICULARLY IN THE CITY OF WORCESTER. LOWER-INCOME RESIDENTS ARE SIGNIFICANTLY MORE LIKELY TO SUFFER FROM OBESITY AND OTHER DIET-RELATED HEALTH PROBLEMS. NEARLY 70% OF HISPANIC ADULTS IN THE REGION WERE OVERWEIGHT OR OBESE, BUT WITHIN ETHNIC GROUPS, BLACKS WERE MORE LIKELY TO BE OBESE. CHILDREN LIVING IN THE CITY OF WORCESTER ARE OVERWEIGHT AT HIGHER RATES THAN THE STATE AS A WHOLE. OVERALL, THE AVERAGE FOR OBESE YOUTH ENTERING FIRST GRADE IN THE CITY OF WORCESTER IS 20.25% COMPARED TO THE NATIONWIDE AVERAGE OF 10%. PARTICULARLY ALARMING IS A DRAMATIC INCREASE IN THE PAST DECADE OF OBESITY AMONG 1ST GRADERS IN THE ASIAN COMMUNITY. IN WORCESTER COUNTY, OBESITY IS MORE PREVALENT AMONG MINORITY ETHNIC GROUPS. AMONG ADULTS, NEARLY 70% OF HISPANICS WERE OVERWEIGHT OR OBESE, BUT WITHIN ETHNIC GROUPS, BLACKS WERE MORE LIKELY TO BE OBESE. (SOURCE: MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH/MASSCHIP; DALE MAGEE, COMMISSIONER, WORCESTER DEPARTMENT OF PUBLIC HEALTH, HEALTH OF WORCESTER 2011 REPORT, WORCESTER PUBLIC SCHOOLS.)- DIABETES: THE PREVALENCE OF DIABETES AMONG WORCESTER COUNTY RESIDENTS IS SLIGHTLY LOWER THAN THE STATE AS A WHOLE. DIABETES IS MORE PREVALENT AMONG BLACK AND HISPANIC POPULATIONS AND THOSE 65 YEARS OLD AND OVER. THE PREVALENCE OF HEART DISEASE IN THE REGION IS SIGNIFICANTLY HIGHER AMONG LOWER INCOME RESIDENTS.- ASTHMA: ASTHMA AFFECTS PEOPLE OF ALL AGES, RACES, GENDERS AND SOCIO-ECONOMIC STATUS, HOWEVER, IT OCCURS AT DISPROPORTIONATELY HIGHER RATES AMONG SOME ETHNIC AND RACIAL POPULATIONS. THE PREVALENCE OF ASTHMA IS HIGHER AMONG FEMALES AND HISPANIC ADULTS IN WORCESTER COUNTY COMPARED TO THE STATE AND INCREASING AMONG CHILDREN AGES 0-19 YEARS OLD. (SOURCE: MDPH, MASSCHIP CUSTOMER REPORTS.)CONTINUED ON SCHEDULE O
    PART VI, LINE 6: UMASS MEMORIAL HEALTH CARE UTILIZES QUANTITATIVE AND QUALITATIVE DATA AND COMMUNITY PARTICIPATORY ENGAGEMENT AS A MEANS TO IDENTIFY ISSUES IMPACTING THE HEALTH OF THE COMMUNITY. AS SUCH, ONE OF OUR KEY STRATEGIES IS ENSURING THAT OUR CLINICAL SYSTEM LEADERS ARE INVOLVED AND ACTIVELY PARTICIPATE IN AREA COALITIONS AND PLANNING EFFORTS. THIS MEANS THAT WE ARE CONVENING MEETINGS WITH REPRESENTATIVES FROM VARIOUS NEIGHBORHOODS, COMMUNITY ORGANIZATIONS AND NEW IMMIGRANT GROUPS, SOLICITING INPUT AND RECOMMENDATIONS, PARTICIPATING IN COMMUNITY-BASED ETHNIC EVENTS AND CO-CHAIRING INITIATIVES. FOR EXAMPLE, THE CEO OF THE CLINICAL SYSTEM AND MEMBERS OF OUR SENIOR LEADERSHIP CO-CHAIR COALITIONS AND PARTICIPATE AS MEMBERS OF MULTIPLE BOARDS THAT ARE ADDRESSING IDENTIFIED DISPARITIES AND PUBLIC HEALTH NEEDS. IN WORCESTER WE'VE PLAYED AN IMPORTANT ROLE BY FUNDING THE DEPARTMENT OF PUBLIC HEALTH COMMISSIONER'S POSITION.
    PART VI, LINE 7: UMASS MEMORIAL HEALTH CARE IS THE LARGEST NOT-FOR-PROFIT HEALTH CARE SYSTEM IN CENTRAL NEW ENGLAND. THROUGH THE COLLECTIVE EFFORTS OF UMASS MEMORIAL MEDICAL CENTER AND FOUR COMMUNITY HOSPITALS - CLINTON HOSPITAL, HEALTHALLIANCE HOSPITAL, MARLBOROUGH HOSPITAL AND WING MEMORIAL HOSPITAL AND MEDICAL CENTERS, WE ARE IMPROVING THE HEALTH OF THE PEOPLE OF CENTRAL NEW ENGLAND THROUGH EXCELLENCE IN CLINICAL CARE, SERVICE, TEACHING AND RESEARCH. OUR FIVE HOSPITALS WORK CLOSELY WITH THEIR RESPECTIVE COMMUNITIES TO IDENTIFY AND PRIORITIZE COMMUNITY NEEDS. OUR COMMUNITY BENEFITS MISSION WAS DEVELOPED AND RECOMMENDED BY A COMMUNITY BENEFITS ADVISORY COMMITTEE AND APPROVED BY THE BOARD OF TRUSTEES OF THE CLINICAL SYSTEM AND HAS BEEN ADOPTED BY ALL FIVE HOSPITALS. A STANDING COMMUNITY BENEFITS COMMITTEE HAS BEEN ESTABLISHED AT THE BOARD OF TRUSTEE LEVEL TO OVERSEE THE CLINICAL SYSTEM'S RESPONSIBILITIES TO THE COMMUNITY AND TO STRENGTHEN OUR ORGANIZATIONAL COMMITMENT AND ACCOUNTABILITY. EACH HOSPITAL'S COMMUNITY BENEFITS PROGRAM FOCUSED ON THE NEEDS OF UNDERSERVED POPULATIONS AND SUPPORTS ADDRESSING IDENTIFIED UNMET HEALTH NEEDS. IN ADDITION, EACH HOSPITAL HAS ITS OWN COMMUNITY BENEFITS PROGRAM STAFF AND AS SUCH HAS DEVELOPED COMMUNITY LINKAGES WITHIN THEIR SERVICE AREA THAT ARE WORKING TOWARDS ADDRESSING THE HEALTH NEEDS OF THEIR RESPECTIVE COMMUNITY.AS OF APRIL 1, 2012, ALL UMASS MEMORIAL HEALTH CARE HOSPITALS WILL HAVE FILED A 2011 COMMUNITY BENEFITS REPORT WITH THE MASSACHUSETTS ATTORNEY GENERAL OFFICE.
REPORTS FILED WITH STATES PART VI, LINE 7 MA
Schedule H (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
UMASS MEMORIAL HEALTH CARE INC
& AFFILIATES - GROUP RETURN
Employer identification number
91-2155626
Part I
General Information on Grants and Assistance
1
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
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) EDWARD M KENNEDY COMMUNITY HEALTH CENTER INC19 TACOMA STREET
WORCESTER,MA01605 		04-2513817 501 (C) (3) 1,000,000       SUPPORT FOR HEALTH CENTER'S MISSION
(2) FAMILY HEALTH CENTER OF WORCESTER INC26 QUEEN STREET
WORCESTER,MA01610 		04-2485308 501 (C) (3) 1,000,000       SUPPORT FOR HEALTH CENTER'S MISSION




















2
Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image
2
3
Enter total number of other organizations ................................ . Bullet Image
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2010

Schedule I (Form 990) 2010
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance
(1) SCHOLARSHIPS 32 64,000      













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
OTHER INFORMATION: PART IV: PART I LINE 2: GRANTS - AT REASONABLE INTERVALS, RE-EVALUATION OF THE GRANTS WILL OCCUR TO ENSURE THAT THE ARRANGEMENTS ARE EXPECTED TO CONTINUE TO SATISFY THE STANDARD SET FORTH. THE HEALTH CENTERS WILL DOCUMENT THE RE-EVALUATION CONTEMPORANEOUSLY. PART I LINE 2: SCHOLARSHIPS - PRIOR TO THE DISTRIBUTION OF ANY AND ALL SCHOLARSHIP FUNDS, HEALTHALLIANCE REQUIRES VERIFICATION OF PROGRAM ENROLLMENT FROM ALL RECIPIENTS. PART II LINE 1(H): THE STANDARD SET FORTH IS A REASONABLE EXPECTATION THAT THE GRANTS WILL CONTRIBUTE MEANINGFULLY TO EACH OF THE HEALTH CENTER'S ABILITY TO MAINTAIN OR INCREASE THE AVAILABILITY, OR ENHANCE THE QUALITY, OF SERVICES PROVIDED TO A MEDICALLY UNDERSERVED POPULATION SERVICED BY THE HEALTH CENTERS. EACH HEALTH CENTER HAS DOCUMENTED THE BASIS FOR SAID REASONABLE EXPECTATION.
Schedule I (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
UMASS MEMORIAL HEALTH CARE INC
& AFFILIATES - GROUP RETURN
Employer identification number

91-2155626
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
Yes
 
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
Yes
 
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) ANDRIENI JULIA MD (i)
(ii)		 272,341
0 		35,244
0 		21
0 		12,250
0 		9,582
0 		329,438
0 		0
0
(2) AROUS ELIAS J MD (i)
(ii)		 571,120
0 		31,731
0 		57
0 		12,250
0 		23,344
0 		638,502
0 		0
0
(3) AYERS DAVID MD (i)
(ii)		 503,029
0 		40,000
0 		57
0 		12,250
0 		26,049
0 		581,385
0 		0
0
(4) BAGLEY PETER H MD (i)
(ii)		 235,593
0 		207,425
0 		57
0 		79,473
0 		26,049
0 		548,597
0 		0
0
(5) BROWN ALAN P MD (i)
(ii)		 152,354
0 		8,810
0 		57
0 		8,343
0 		22,351
0 		191,915
0 		0
0
(6) CARLUCCI DANIEL MD (i)
(ii)		 277,316
0 		25,000
0 		0
0 		12,250
0 		27,298
0 		341,864
0 		0
0
(7) CAVAGNARO CHARLES III MD (i)
(ii)		 298,335
0 		85,767
0 		577
0 		119,576
0 		32,365
0 		536,620
0 		0
0
(8) CHANDLER WILLIS (i)
(ii)		 259,168
0 		63,078
0 		9,182
0 		52,398
0 		19,807
0 		403,633
0 		9,182
0
(9) CHESHIRE BRYAN MD (i)
(ii)		 196,749
0 		38,544
0 		57
0 		11,770
0 		2,427
0 		249,547
0 		0
0
(10) CIRILLO BETTYANN MD (i)
(ii)		 238,900
0 		14,609
0 		927
0 		4,916
0 		23,730
0 		283,082
0 		0
0
(11) COFONE MICHAEL J (i)
(ii)		 232,044
0 		16,923
0 		131,605
0 		3,779
0 		20,889
0 		405,240
0 		0
0
(12) CORBETT WILLIAM MD (i)
(ii)		 271,744
0 		79,997
0 		21,453
0 		53,055
0 		19,806
0 		446,055
0 		21,353
0
(13) DALY SHEILA (i)
(ii)		 198,099
0 		53,446
0 		577
0 		91,325
0 		17,692
0 		361,139
0 		0
0
(14) FELICE MARIANNE E MD (i)
(ii)		 194,497
0 		24,000
0 		57
0 		18,894
0 		25,943
0 		263,391
0 		0
0
(15) FERGUSON R KEVIN MD (i)
(ii)		 180,307
0 		47,566
0 		57
0 		11,635
0 		22,075
0 		261,640
0 		0
0
(16) FERRUCCI JOSEPH MD (i)
(ii)		 358,853
0 		31,000
0 		57
0 		12,250
0 		25,312
0 		427,472
0 		0
0
(17) GUNDERSEN JASON MD (i)
(ii)		 250,675
0 		135,201
0 		57
0 		12,250
0 		10,161
0 		408,344
0 		0
0
(18) KAUR SHUBJEET MD (i)
(ii)		 267,442
0 		26,000
0 		57
0 		12,250
0 		26,049
0 		331,798
0 		0
0
(19) KEATING TODD A (i)
(ii)		 462,183
0 		115,874
0 		39,414
0 		183,185
0 		15,986
0 		816,642
0 		38,837
0
(20) KENNEDY KATHRYN MD (i)
(ii)		 208,566
0 		62,055
0 		57
0 		12,250
0 		25,218
0 		308,146
0 		0
0
(21) LAPIDAS GARY N (i)
(ii)		 359,690
0 		80,148
0 		36,102
0 		160,802
0 		10,278
0 		647,020
0 		35,525
0
(22) LASSER DANIEL H MD (i)
(ii)		 207,111
0 		100,937
0 		57
0 		140,038
0 		24,422
0 		472,565
0 		0
0
(23) LINDHOLM MARY S MD (i)
(ii)		 133,272
0 		0
0 		57
0 		7,034
0 		23,739
0 		164,102
0 		0
0
(24) MAGUIRE DAVID L MD (i)
(ii)		 196,154
0 		44,437
0 		396
0 		8,356
0 		1,542
0 		250,885
0 		0
0
(25) MANNING GORDON MD (i)
(ii)		 175,138
0 		12,843
0 		57
0 		43,500
0 		11,437
0 		242,975
0 		0
0
(26) MESSINA LOUIS MD (i)
(ii)		 403,350
0 		97,947
0 		57
0 		12,250
0 		23,344
0 		536,948
0 		0
0
(27) MULDOON PATRICK L (i)
(ii)		 381,370
0 		64,286
0 		51,333
0 		126,360
0 		30,519
0 		653,868
0 		50,756
0
(28) O'BRIEN JOHN G (i)
(ii)		 922,008
0 		253,219
0 		165,178
0 		978,472
0 		19,046
0 		2,337,923
0 		0
0
(29) OKIKE O NSIDINANYA MD (i)
(ii)		 361,231
0 		0
0 		0
0 		41,511
0 		14,218
0 		416,960
0 		0
0
(30) POLANOWICZ JOHN (i)
(ii)		 269,569
0 		57,899
0 		31,131
0 		81,885
0 		34,774
0 		475,258
0 		30,554
0
(31) POWER DIANE MD (i)
(ii)		 240,247
0 		14,042
0 		1,113
0 		4,975
0 		26,809
0 		287,186
0 		0
0
(32) SLAYTON VAL MD (i)
(ii)		 156,553
0 		0
0 		286,645
0 		3,242
0 		13,574
0 		460,014
0 		0
0
(33) SOAR BART MD (i)
(ii)		 142,678
0 		26,050
0 		54
0 		7,459
0 		9,718
0 		185,959
0 		0
0
(34) SWENSON DANA (i)
(ii)		 228,319
0 		59,031
0 		0
0 		86,987
0 		20,326
0 		394,663
0 		0
0
(35) TOSI STEPHEN E MD (i)
(ii)		 488,415
0 		117,736
0 		157,308
0 		58,078
0 		25,488
0 		847,025
0 		80,944
0
(36) UMANZOR RENE M MD (i)
(ii)		 147,644
0 		72,595
0 		60
0 		9,523
0 		21,266
0 		251,088
0 		0
0
(37) VOLTURO GREGORY MD (i)
(ii)		 245,357
0 		72,405
0 		57
0 		12,250
0 		26,049
0 		356,118
0 		0
0
(38) WESOLOWSKI PAUL (i)
(ii)		 158,357
0 		8,044
0 		3,677
0 		540
0 		18,449
0 		189,067
0 		0
0
(39) ZIEDONIS DOUGLAS MD (i)
(ii)		 184,083
0 		34,000
0 		57
0 		11,324
0 		26,049
0 		255,513
0 		0
0
(40) ALLICON KEARY T (i)
(ii)		 140,810
0 		15,608
0 		0
0 		20,758
0 		20,483
0 		197,659
0 		0
0
(41) BERGAN THOMAS (i)
(ii)		 228,073
0 		10,285
0 		15,266
0 		317,871
0 		10,149
0 		581,644
0 		15,266
0
(42) BROWN DOUGLAS S (i)
(ii)		 361,656
0 		104,096
0 		35,555
0 		114,257
0 		21,737
0 		637,301
0 		35,555
0
(43) DICKSON ERIC MD (i)
(ii)		 313,139
0 		93,375
0 		1,260
0 		60,744
0 		33,363
0 		501,881
0 		0
0
(44) DION JEFFREY (i)
(ii)		 160,168
0 		17,400
0 		0
0 		24,301
0 		20,685
0 		222,554
0 		0
0
(45) EKSTROM DEBORAH (i)
(ii)		 187,408
0 		50,641
0 		15,276
0 		91,403
0 		24,620
0 		369,348
0 		13,876
0
(46) FELDMANN ROBERT (i)
(ii)		 240,733
0 		64,118
0 		23,560
0 		122,905
0 		21,106
0 		472,422
0 		23,560
0
(47) FRAKER MURIEL E ESQUIRE (i)
(ii)		 164,204
0 		8,432
0 		0
0 		52,060
0 		26,781
0 		251,477
0 		0
0
(48) MCCUE STEVEN (i)
(ii)		 145,488
0 		15,134
0 		0
0 		9,382
0 		18,650
0 		188,654
0 		0
0
(49) O'BRIEN WILLIAM H (i)
(ii)		 110,593
0 		0
0 		57
0 		29,786
0 		23,247
0 		163,683
0 		0
0
(50) SMITH FRANCIS W (i)
(ii)		 168,759
0 		10,338
0 		0
0 		25,753
0 		24,805
0 		229,655
0 		0
0
(51) STREETER MICHELE M (i)
(ii)		 274,566
0 		66,030
0 		16,736
0 		97,120
0 		19,806
0 		474,258
0 		16,736
0
(52) BLUTE MICHAEL (i)
(ii)		 466,308
0 		58,526
0 		0
0 		48,396
0 		27,048
0 		600,278
0 		0
0
(53) BRENCKLE GEORGE PHD (i)
(ii)		 290,526
0 		68,755
0 		24,444
0 		92,534
0 		27,274
0 		503,533
0 		24,444
0
(54) DALEY JENNIFER MD (i)
(ii)		 352,559
0 		72,362
0 		0
0 		36,875
0 		22,997
0 		484,793
0 		0
0
(55) DIAMOND VICTORIA (i)
(ii)		 253,619
0 		68,187
0 		0
0 		94,476
0 		26,744
0 		443,026
0 		0
0
(56) ETTINGER WALTER H MD (i)
(ii)		 688,066
0 		170,899
0 		61,735
0 		278,909
0 		20,543
0 		1,220,152
0 		55,209
0
(57) FISHER BARBARA (i)
(ii)		 244,955
0 		55,256
0 		16,907
0 		85,550
0 		19,806
0 		422,474
0 		16,907
0
(58) HYLKA SHARON (i)
(ii)		 297,093
0 		74,085
0 		21,531
0 		220,510
0 		20,591
0 		633,810
0 		20,954
0
(59) KLUGMAN ROBERT MD (i)
(ii)		 380,371
0 		94,454
0 		27,847
0 		219,854
0 		22,991
0 		745,517
0 		27,847
0
(60) KRUGER NANCY (i)
(ii)		 287,303
0 		68,570
0 		63,842
0 		56,732
0 		11,641
0 		488,088
0 		0
0
(61) PHILLIPS ROBERT A (i)
(ii)		 581,622
0 		163,281
0 		54,848
0 		210,024
0 		28,482
0 		1,038,257
0 		54,848
0
(62) RANDOLPH JOHN T (i)
(ii)		 191,944
0 		42,391
0 		0
0 		116,014
0 		22,072
0 		372,421
0 		0
0
(63) WEBB PATRICIA (i)
(ii)		 311,409
0 		81,091
0 		24,877
0 		87,608
0 		26,281
0 		531,266
0 		24,300
0
(64) ANDERSON MILTON C (i)
(ii)		 0
0 		0
0 		0
0 		0
0 		0
0 		 
  		0
0
(65) FAIRCHILD DAVID MD (i)
(ii)		 0
0 		0
0 		0
0 		0
0 		0
0 		 
  		0
0
(66) MAYKEL JUSTIN MD (i)
(ii)		 277,609
0 		284,923
0 		57
0 		12,250
0 		22,607
0 		597,446
0 		0
0
(67) BUSCONI BRIAN D MD (i)
(ii)		 490,861
0 		54,167
0 		57
0 		12,250
0 		23,344
0 		580,679
0 		0
0
(68) ZIVNY JAROSLAV MD (i)
(ii)		 233,025
0 		310,736
0 		57
0 		12,399
0 		28,066
0 		584,283
0 		0
0
(69) MALONEY MARY E MD (i)
(ii)		 393,684
0 		120,136
0 		57
0 		12,250
0 		23,344
0 		549,471
0 		0
0
(70) LEVEY JOHN MD (i)
(ii)		 260,315
0 		244,835
0 		57
0 		12,250
0 		23,344
0 		540,801
0 		0
0
(71) WARRING WENDY (i)
(ii)		 0
0 		0
0 		117,663
0 		0
0 		0
0 		117,663
0 		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
  PART I, LINE 1A SPLIT DOLLAR GROSS UP CALCULATIONS TO JOHN O'BRIEN AND WALTER ETTINGER WHICH ARE TREATED AS TAXABLE COMPENSATION.
  PART I, LINE 4B NAME OF PARTICIPANTS IN OR RECEIVING PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN TODD A. KEATING $38,837 JOHN G. O'BRIEN $0 DOUGLAS S. BROWN $35,555 WALTER H. ETTINGER, M.D. $55,209 NANCY KRUGER $0 GEORGE BRENCKLE, PH.D. $24,444 ROBERT PHILLIPS $54,848 PATRICIA WEBB $24,300 JOHN RANDOLPH $0 SHARON HYLKA $20,954 VICTORIA DIAMOND $0 ROBERT KLUGMAN $27,847 BARBARA FISHER $16,907 WILLIS CHANDLER $9,182 THOMAS BERGAN $15,266 CHARLES CAVAGNARO, III, MD $0 WILLIAM CORBETT, MD $21,353 SHEILA DALY $0 ERIC DICKSON, MD $0 DEBORAH EKSTROM $13,876 ROBERT FELDMANN $23,560 GARY N. LAPIDAS $35,525 PATRICK L. MULDOON $50,756 JOHN POLANOWICZ $30,554 MICHELE M. STREETER $16,736 DANA SWENSON $0 STEPHEN E. TOSI, MD $80,944 MICHAEL J. COFONE $130,424 VAL SLAYTON, M.D. $170,651 MICHAEL BLUTE, M.D. $0 JENNIFER DALEY, M.D. $0
SUPPLEMENTAL INFORMATION PART III PART II - DISCLOSURES: 1) JOHN O'BRIEN'S RETIREMENT AND OTHER DEFERRED COMPENSATION AMOUNT INCLUDES A CONTINGENT DEFERRED COMPENSATION ACCRUAL OF $928,633 WHICH REMAINS THE PROPERTY OF UMASS MEMORIAL UNTIL AND UNLESS THE TERMS OF THE DEFERRED AGREEMENT ARE FULFILLED. 2) THE ABOVE DIRECTORS RECEIVE NO COMPENSATION FOR THEIR ROLE AS DIRECTORS. ALL COMPENSATION RECEIVED RELATES TO THEIR POSITION AS A PHYSICIAN/ADMINISTRATOR. PART II - UNRELATED ORGANIZATION: THE OFFICERS, DIRECTORS AND HIGHEST COMPENSATED EMPLOYEES LISTED IN PART II THAT RECEIVED COMPENSATION FROM AN UNRELATED ORGANIZATION WERE PAID FOR THEIR SERVICES RELATED TO MEDICAL RESEARCH, EDUCATION OF MEDICAL STUDENTS AND RESIDENT TRAINING. AMOUNTS INCLUDE THEIR BASE COMPENSATION AND DEFERRED COMPENSATION FOR CALENDAR YEAR 2010. THE NAME OF THE UNRELATED ORGANIZATION IS UMASS MEDICAL SCHOOL. DANIEL LASSER, M.D. $254,808 MARIANNE E. FELICE, M.D. $213,090 ELIAS J. AROUS, M.D. $151,750 PETER H. BAGLEY, M.D. $140,016 ALAN P. BROWN, M.D. $73,177 SHUBJEET KAUR, M.D. $154,503 MARY LINDHOLM, M.D. $23,075 DAVID AYERS, M.D. $150,242 GREGORY VOLTURO, M.D. $183,649 MICHAEL P. ARONSON, M.D. $37,632 BRYAN CHESHIRE, M.D. $34,485 DOUGLAS ZIEDONIS, M.D. $205,470 JOSEPH FERRUCCI, M.D. $254,202 BRIAN D. BUSCONI, M.D. $124,750 JUSTIN MAYKEL, M.D. $113,700 JULIA ANDRIENI, M.D. $17,953 DANIEL CARLUCCI, M.D. $87,892 KATHRYN KENNEDY, M.D. $33,424 LOUIS MESSINA, M.D. $74,414 JAROSLAV ZIVNY, M.D. $66,839 MARY MALONEY, M.D. $148,200 JOHN LEVEY, M.D. $101,755
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
UMASS MEMORIAL HEALTH CARE INC
& AFFILIATES - GROUP RETURN
Employer identification number
91-2155626
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-UMASS MEMORIAL SERIES D
  		04-2456011 57586CLQ6 08-18-2005 107,450,000 SEE PART V   X   X   X
B MHEFA-UMASS MEMORIAL VARIABLE RATE SERIES E
  		04-2456011 57586EH27 05-22-2009 30,000,000 SEE PART V   X   X   X
C MHEFA-UMASS MEMORIAL VARIABLE RATE SERIES F
  		04-2456011 57586EH27 05-22-2009 30,000,000 SEE PART V   X   X   X
D MHEFA-MARLBOROUGH HOSPITAL VARIABLE RATE SERIES A
  		04-2456011   11-24-2009 9,420,000 SEE PART V   X   X   X
MHEFA-UMASS MEMORIAL MASTER LEASE
  		04-2456011   12-07-2005 10,000,000 CAPITAL EQUIPMENT   X   X   X
MHEFA-UMASS MEMORIAL MASTER LEASE
  		04-2456011   12-27-2006 20,000,000 CAPITAL EQUIPMENT   X   X   X
MHEFA-UMASS MEMORIAL MASTER LEASE
  		04-2456011   04-24-2008 20,000,000 CAPITAL EQUIPMENT   X   X   X
MHEFA-UMASS MEMORIAL MASTER LEASE
  		04-2456011   07-24-2009 20,000,000 CAPITAL EQUIPMENT   X   X   X
MHEFA-UMASS MEMORIAL SERIES G
  		04-2456011   05-27-2010 60,445,000 SEE PART V   X   X   X
MHEFA-UMASS MEMORIAL MASTER LEASE
  		04-3431814   12-09-2010 20,000,000 CAPITAL EQUIPMENT   X   X   X
MHEFA-UMASS MEMORIAL SERIES H
  		04-3431814   08-10-2011 90,990,000 SEE PART V   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . . 630,000 630,000 630,000 356,000
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 110,030,036 30,056,959 30,056,959 9,420,000
4 Gross proceeds in reserve funds . . 10,835,303      
5 Capitalized interest from proceeds. 5,411,300 666,836 630,782 226,989
6 Proceeds in refunding escrow. . . . . 60,722,232   90,832,107  
7 Issuance costs from proceeds . . . 1,384,731 205,455 118,700 78,458
8 Credit enhancement from proceeds.        
9 Working capital expenditures from proceeds . . 2,935,890 717,238 152,952  
10 Capital expenditures from proceeds . . 95,000,000 26,703,915 26,723,915 9,341,542
11 Other spent proceeds . .        
12 Other unspent proceeds. . . 3,147,590 3,147,590 3,214,343  
13 Year of substantial completion . . . 2006 2012 2012 2009
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue?   X   X X X    
15 Were the bonds issued as part of an advance refunding issue?   X   X   X   X
16 Has the final allocation of proceeds been made? . . X     X   X X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X   X   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   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .   X   X   X   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     X   X   X
b Are there any research agreements that may result in private business use of bond-financed property? . .   X   X   X   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   X   X   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 0.580 %      
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        
6 Total of lines 4 and 5 . . .. . . . . . 0.580 %      
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X   X   X   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   X   X  
2 Is the bond issue a variable rate issue?   X X   X   X  
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X   X   X   X
b Name of provider .  
  		 
  		 
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .   X       X    
e Was a hedge terminated? .   X       X    
4a Were gross proceeds invested in a GIC? .   X   X   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   X   X
6 Did the bond issue qualify for an exception to rebate? . . .   X X   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
PART I - BOND ISSUE MHEFA - UMASS MEMORIAL, SERIES D PART I COLUMN (C ) CUSIP #: 57586CLQ6 PART I COLUMN (F) DESCRIPTION OF PURPOSE: COMPLETION OF THE EXPANSION OF THE EMERGENCY DEPT AND ROUTINE CAPITAL EQUIPMENT AND/OR RENOVATION PROJECTS
PART I - BOND ISSUE MHEFA - UMASS MEMORIAL VARIABLE RATE, SERIES E PART I COLUMN (C ) CUSIP #: 57586EH27 PART I COLUMN (F) DESCRIPTION OF PURPOSE: RENOVATION, EQUIPPING AND CONSTRUCTION FOR CLINICAL, SUPPORT SERVICE AND INFRASTRUCTURE PROJECTS
PART I - BOND ISSUE MHEFA - UMASS MEMORIAL VARIABLE RATE, SERIES F PART I COLUMN (C ) CUSIP #: 57586EH27 PART I COLUMN (F) DESCRIPTION OF PURPOSE: RENOVATION, EQUIPPING AND CONSTRUCTION FOR CLINICAL, SUPPORT SERVICE AND INFRASTRUCTURE PROJECTS
PART I - BOND ISSUE MHEFA - MARLBOROUGH HOSPITAL VARIABLE RATE, SERIES A PART I COLUMN (F) DESCRIPTION OF PURPOSE: PAY OFF HEFA POOL O LOAN, ER RENOVATIONS,EICU EQUIPMENT,CT SCAN LEASE,MAMMOGRAPHY UNIT
PART I - BOND ISSUE MHEFA - UMASS MEMORIAL, SERIES G PART I COLUMN (C ) CUSIP #: 57586EUS8 - 57586EUT6 - 57586EUU3 - 57586EUV1 - 57586EUW9 - 57586EUX7 - 57586EVE8 - 57586EUY5 - 57586EVF5 - 57586EUZ2 - 57586EVG3 - 57586EVA6 - 57586EVH1 - 57586EVB4 - 57586EVJ7 - 57586EVC2 - 57586EVD0 PART I COLUMN (F) DESCRIPTION OF PURPOSE: REFUNDING OF CENTRAL NEW ENGLAND HEALTH ALLIANCE SERIES A BOND (1993) AND MEDICAL CENTER OF CENTRAL MASSACHUSETTS, SERIES B (1992)
PART I - BOND ISSUE MHEFA - UMASS MEMORIAL, SERIES H PART I COLUMN (C ) CUSIP #: 57583UGP7 - 57583UGQ5 - 57583UGR3 - 57583UGS1 - 57583UGT9 - 57583UGU6 - 57583UGV4 - 57583UGW2 - 57583UHC5 - 57583UGX0 - 57583UGY8 - 57583UGZ5 - 57583UHA9 - 57583UHB7 PART I COLUMN (F) DESCRIPTION OF PURPOSE: PARTIAL REFUNDING OF MEDICAL CENTER VARIABLE RATE SERIES A BONDS (1998), REFUNDING IN FULL OF CENTRAL NEW ENGLAND HEALTH ALLIANCE SERIES B BONDS (1998) AND UMASS MEMORIAL SERIES C (2001).
PART II = PROCEEDS DIFFERNCE BETWEEN PART I, COLUMN(E) AND PART II, LINE 3 MHEFA - UMASS MEMORIAL, SERIES D COLUMN (E) ISSUE PRICE OF $107,450,000; ADD ISSUE PREMIUM OF $604,814, ADD INTEREST EARNED ON PROCEEDS OF $2,935,890, LESS ISSUE DISCOUNT OF ($960,668), EQUALS LINE 3 OF $110,030,036. MHEFA - UMASS MEMORIAL VARIABLE RATE, SERIES E COLUMN (E) ISSUE PRICE OF $30,000,000; ADD INTEREST EARNED ON PROCEEDS OF $56,959, EQUALS LINE 3 OF $30,056,959. MHEFA - UMASS MEMORIAL VARIABLE RATE, SERIES F COLUMN (E) ISSUE PRICE OF $30,000,000; ADD INTEREST EARNED ON PROCEEDS OF $56,959, EQUALS LINE 3 OF $30,056,959. MHEFA - UMASS MEMORIAL MASTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $717,238, EQUALS LINE 3 OF $20,717,238. MHEFA - UMASS MEMORIAL MASTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $152,952, EQUALS LINE 3 OF $20,152,952. MHEFA - UMASS MEMORIAL MASTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $24,254, EQUALS LINE 3 OF $20,024,254. MHEFA - UMASS MEMORIAL MASTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $5,301, EQUALS LINE 3 OF $20,005,301. MHEFA - UMASS MEMORIAL, SERIES G COLUMN (E) ISSUE PRICE OF $60,445,000; ADD ISSUE PREMIUM OF $1,388,656 ADD INTEREST EARNED ON PROCEEDS OF $176, EQUALS LINE 3 OF $61,833,832. MHEFA - UMASS MEMORIAL, SERIES H COLUMN (E) ISSUE PRICE OF $90,990,000; ADD ISSUE PREMIUM OF $1,303,778, EQUALS LINE 3 OF $92,293,778.
Schedule K (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
UMASS MEMORIAL HEALTH CARE INC
& AFFILIATES - GROUP RETURN
Employer identification number
91-2155626
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-UMASS MEMORIAL SERIES D
  		04-2456011 57586CLQ6 08-18-2005 107,450,000 SEE PART V   X   X   X
B MHEFA-UMASS MEMORIAL VARIABLE RATE SERIES E
  		04-2456011 57586EH27 05-22-2009 30,000,000 SEE PART V   X   X   X
C MHEFA-UMASS MEMORIAL VARIABLE RATE SERIES F
  		04-2456011 57586EH27 05-22-2009 30,000,000 SEE PART V   X   X   X
D MHEFA-MARLBOROUGH HOSPITAL VARIABLE RATE SERIES A
  		04-2456011   11-24-2009 9,420,000 SEE PART V   X   X   X
MHEFA-UMASS MEMORIAL MASTER LEASE
  		04-2456011   12-07-2005 10,000,000 CAPITAL EQUIPMENT   X   X   X
MHEFA-UMASS MEMORIAL MASTER LEASE
  		04-2456011   12-27-2006 20,000,000 CAPITAL EQUIPMENT   X   X   X
MHEFA-UMASS MEMORIAL MASTER LEASE
  		04-2456011   04-24-2008 20,000,000 CAPITAL EQUIPMENT   X   X   X
MHEFA-UMASS MEMORIAL MASTER LEASE
  		04-2456011   07-24-2009 20,000,000 CAPITAL EQUIPMENT   X   X   X
MHEFA-UMASS MEMORIAL SERIES G
  		04-2456011   05-27-2010 60,445,000 SEE PART V   X   X   X
MHEFA-UMASS MEMORIAL MASTER LEASE
  		04-3431814   12-09-2010 20,000,000 CAPITAL EQUIPMENT   X   X   X
MHEFA-UMASS MEMORIAL SERIES H
  		04-3431814   08-10-2011 90,990,000 SEE PART V   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . . 630,000 630,000 630,000 356,000
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 110,030,036 30,056,959 30,056,959 9,420,000
4 Gross proceeds in reserve funds . . 10,835,303      
5 Capitalized interest from proceeds. 5,411,300 666,836 630,782 226,989
6 Proceeds in refunding escrow. . . . . 60,722,232   90,832,107  
7 Issuance costs from proceeds . . . 1,384,731 205,455 118,700 78,458
8 Credit enhancement from proceeds.        
9 Working capital expenditures from proceeds . . 2,935,890 717,238 152,952  
10 Capital expenditures from proceeds . . 95,000,000 26,703,915 26,723,915 9,341,542
11 Other spent proceeds . .        
12 Other unspent proceeds. . . 3,147,590 3,147,590 3,214,343  
13 Year of substantial completion . . . 2006 2012 2012 2009
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue?   X   X X X    
15 Were the bonds issued as part of an advance refunding issue?   X   X   X   X
16 Has the final allocation of proceeds been made? . . X     X   X X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X   X   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   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .   X   X   X   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     X   X   X
b Are there any research agreements that may result in private business use of bond-financed property? . .   X   X   X   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   X   X   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 0.580 %      
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        
6 Total of lines 4 and 5 . . .. . . . . . 0.580 %      
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X   X   X   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   X   X  
2 Is the bond issue a variable rate issue?   X X   X   X  
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X   X   X   X
b Name of provider .  
  		 
  		 
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .   X       X    
e Was a hedge terminated? .   X       X    
4a Were gross proceeds invested in a GIC? .   X   X   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   X   X
6 Did the bond issue qualify for an exception to rebate? . . .   X X   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
PART I - BOND ISSUE MHEFA - UMASS MEMORIAL, SERIES D PART I COLUMN (C ) CUSIP #: 57586CLQ6 PART I COLUMN (F) DESCRIPTION OF PURPOSE: COMPLETION OF THE EXPANSION OF THE EMERGENCY DEPT AND ROUTINE CAPITAL EQUIPMENT AND/OR RENOVATION PROJECTS
PART I - BOND ISSUE MHEFA - UMASS MEMORIAL VARIABLE RATE, SERIES E PART I COLUMN (C ) CUSIP #: 57586EH27 PART I COLUMN (F) DESCRIPTION OF PURPOSE: RENOVATION, EQUIPPING AND CONSTRUCTION FOR CLINICAL, SUPPORT SERVICE AND INFRASTRUCTURE PROJECTS
PART I - BOND ISSUE MHEFA - UMASS MEMORIAL VARIABLE RATE, SERIES F PART I COLUMN (C ) CUSIP #: 57586EH27 PART I COLUMN (F) DESCRIPTION OF PURPOSE: RENOVATION, EQUIPPING AND CONSTRUCTION FOR CLINICAL, SUPPORT SERVICE AND INFRASTRUCTURE PROJECTS
PART I - BOND ISSUE MHEFA - MARLBOROUGH HOSPITAL VARIABLE RATE, SERIES A PART I COLUMN (F) DESCRIPTION OF PURPOSE: PAY OFF HEFA POOL O LOAN, ER RENOVATIONS,EICU EQUIPMENT,CT SCAN LEASE,MAMMOGRAPHY UNIT
PART I - BOND ISSUE MHEFA - UMASS MEMORIAL, SERIES G PART I COLUMN (C ) CUSIP #: 57586EUS8 - 57586EUT6 - 57586EUU3 - 57586EUV1 - 57586EUW9 - 57586EUX7 - 57586EVE8 - 57586EUY5 - 57586EVF5 - 57586EUZ2 - 57586EVG3 - 57586EVA6 - 57586EVH1 - 57586EVB4 - 57586EVJ7 - 57586EVC2 - 57586EVD0 PART I COLUMN (F) DESCRIPTION OF PURPOSE: REFUNDING OF CENTRAL NEW ENGLAND HEALTH ALLIANCE SERIES A BOND (1993) AND MEDICAL CENTER OF CENTRAL MASSACHUSETTS, SERIES B (1992)
PART I - BOND ISSUE MHEFA - UMASS MEMORIAL, SERIES H PART I COLUMN (C ) CUSIP #: 57583UGP7 - 57583UGQ5 - 57583UGR3 - 57583UGS1 - 57583UGT9 - 57583UGU6 - 57583UGV4 - 57583UGW2 - 57583UHC5 - 57583UGX0 - 57583UGY8 - 57583UGZ5 - 57583UHA9 - 57583UHB7 PART I COLUMN (F) DESCRIPTION OF PURPOSE: PARTIAL REFUNDING OF MEDICAL CENTER VARIABLE RATE SERIES A BONDS (1998), REFUNDING IN FULL OF CENTRAL NEW ENGLAND HEALTH ALLIANCE SERIES B BONDS (1998) AND UMASS MEMORIAL SERIES C (2001).
PART II = PROCEEDS DIFFERNCE BETWEEN PART I, COLUMN(E) AND PART II, LINE 3 MHEFA - UMASS MEMORIAL, SERIES D COLUMN (E) ISSUE PRICE OF $107,450,000; ADD ISSUE PREMIUM OF $604,814, ADD INTEREST EARNED ON PROCEEDS OF $2,935,890, LESS ISSUE DISCOUNT OF ($960,668), EQUALS LINE 3 OF $110,030,036. MHEFA - UMASS MEMORIAL VARIABLE RATE, SERIES E COLUMN (E) ISSUE PRICE OF $30,000,000; ADD INTEREST EARNED ON PROCEEDS OF $56,959, EQUALS LINE 3 OF $30,056,959. MHEFA - UMASS MEMORIAL VARIABLE RATE, SERIES F COLUMN (E) ISSUE PRICE OF $30,000,000; ADD INTEREST EARNED ON PROCEEDS OF $56,959, EQUALS LINE 3 OF $30,056,959. MHEFA - UMASS MEMORIAL MASTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $717,238, EQUALS LINE 3 OF $20,717,238. MHEFA - UMASS MEMORIAL MASTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $152,952, EQUALS LINE 3 OF $20,152,952. MHEFA - UMASS MEMORIAL MASTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $24,254, EQUALS LINE 3 OF $20,024,254. MHEFA - UMASS MEMORIAL MASTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $5,301, EQUALS LINE 3 OF $20,005,301. MHEFA - UMASS MEMORIAL, SERIES G COLUMN (E) ISSUE PRICE OF $60,445,000; ADD ISSUE PREMIUM OF $1,388,656 ADD INTEREST EARNED ON PROCEEDS OF $176, EQUALS LINE 3 OF $61,833,832. MHEFA - UMASS MEMORIAL, SERIES H COLUMN (E) ISSUE PRICE OF $90,990,000; ADD ISSUE PREMIUM OF $1,303,778, EQUALS LINE 3 OF $92,293,778.
Schedule K (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
UMASS MEMORIAL HEALTH CARE INC
& AFFILIATES - GROUP RETURN
Employer identification number
91-2155626
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-UMASS MEMORIAL SERIES D
  		04-2456011 57586CLQ6 08-18-2005 107,450,000 SEE PART V   X   X   X
B MHEFA-UMASS MEMORIAL VARIABLE RATE SERIES E
  		04-2456011 57586EH27 05-22-2009 30,000,000 SEE PART V   X   X   X
C MHEFA-UMASS MEMORIAL VARIABLE RATE SERIES F
  		04-2456011 57586EH27 05-22-2009 30,000,000 SEE PART V   X   X   X
D MHEFA-MARLBOROUGH HOSPITAL VARIABLE RATE SERIES A
  		04-2456011   11-24-2009 9,420,000 SEE PART V   X   X   X
MHEFA-UMASS MEMORIAL MASTER LEASE
  		04-2456011   12-07-2005 10,000,000 CAPITAL EQUIPMENT   X   X   X
MHEFA-UMASS MEMORIAL MASTER LEASE
  		04-2456011   12-27-2006 20,000,000 CAPITAL EQUIPMENT   X   X   X
MHEFA-UMASS MEMORIAL MASTER LEASE
  		04-2456011   04-24-2008 20,000,000 CAPITAL EQUIPMENT   X   X   X
MHEFA-UMASS MEMORIAL MASTER LEASE
  		04-2456011   07-24-2009 20,000,000 CAPITAL EQUIPMENT   X   X   X
MHEFA-UMASS MEMORIAL SERIES G
  		04-2456011   05-27-2010 60,445,000 SEE PART V   X   X   X
MHEFA-UMASS MEMORIAL MASTER LEASE
  		04-3431814   12-09-2010 20,000,000 CAPITAL EQUIPMENT   X   X   X
MHEFA-UMASS MEMORIAL SERIES H
  		04-3431814   08-10-2011 90,990,000 SEE PART V   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . . 630,000 630,000 630,000 356,000
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 110,030,036 30,056,959 30,056,959 9,420,000
4 Gross proceeds in reserve funds . . 10,835,303      
5 Capitalized interest from proceeds. 5,411,300 666,836 630,782 226,989
6 Proceeds in refunding escrow. . . . . 60,722,232   90,832,107  
7 Issuance costs from proceeds . . . 1,384,731 205,455 118,700 78,458
8 Credit enhancement from proceeds.        
9 Working capital expenditures from proceeds . . 2,935,890 717,238 152,952  
10 Capital expenditures from proceeds . . 95,000,000 26,703,915 26,723,915 9,341,542
11 Other spent proceeds . .        
12 Other unspent proceeds. . . 3,147,590 3,147,590 3,214,343  
13 Year of substantial completion . . . 2006 2012 2012 2009
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue?   X   X X X    
15 Were the bonds issued as part of an advance refunding issue?   X   X   X   X
16 Has the final allocation of proceeds been made? . . X     X   X X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X   X   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   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .   X   X   X   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     X   X   X
b Are there any research agreements that may result in private business use of bond-financed property? . .   X   X   X   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   X   X   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 0.580 %      
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        
6 Total of lines 4 and 5 . . .. . . . . . 0.580 %      
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X   X   X   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   X   X  
2 Is the bond issue a variable rate issue?   X X   X   X  
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X   X   X   X
b Name of provider .  
  		 
  		 
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .   X       X    
e Was a hedge terminated? .   X       X    
4a Were gross proceeds invested in a GIC? .   X   X   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   X   X
6 Did the bond issue qualify for an exception to rebate? . . .   X X   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
PART I - BOND ISSUE MHEFA - UMASS MEMORIAL, SERIES D PART I COLUMN (C ) CUSIP #: 57586CLQ6 PART I COLUMN (F) DESCRIPTION OF PURPOSE: COMPLETION OF THE EXPANSION OF THE EMERGENCY DEPT AND ROUTINE CAPITAL EQUIPMENT AND/OR RENOVATION PROJECTS
PART I - BOND ISSUE MHEFA - UMASS MEMORIAL VARIABLE RATE, SERIES E PART I COLUMN (C ) CUSIP #: 57586EH27 PART I COLUMN (F) DESCRIPTION OF PURPOSE: RENOVATION, EQUIPPING AND CONSTRUCTION FOR CLINICAL, SUPPORT SERVICE AND INFRASTRUCTURE PROJECTS
PART I - BOND ISSUE MHEFA - UMASS MEMORIAL VARIABLE RATE, SERIES F PART I COLUMN (C ) CUSIP #: 57586EH27 PART I COLUMN (F) DESCRIPTION OF PURPOSE: RENOVATION, EQUIPPING AND CONSTRUCTION FOR CLINICAL, SUPPORT SERVICE AND INFRASTRUCTURE PROJECTS
PART I - BOND ISSUE MHEFA - MARLBOROUGH HOSPITAL VARIABLE RATE, SERIES A PART I COLUMN (F) DESCRIPTION OF PURPOSE: PAY OFF HEFA POOL O LOAN, ER RENOVATIONS,EICU EQUIPMENT,CT SCAN LEASE,MAMMOGRAPHY UNIT
PART I - BOND ISSUE MHEFA - UMASS MEMORIAL, SERIES G PART I COLUMN (C ) CUSIP #: 57586EUS8 - 57586EUT6 - 57586EUU3 - 57586EUV1 - 57586EUW9 - 57586EUX7 - 57586EVE8 - 57586EUY5 - 57586EVF5 - 57586EUZ2 - 57586EVG3 - 57586EVA6 - 57586EVH1 - 57586EVB4 - 57586EVJ7 - 57586EVC2 - 57586EVD0 PART I COLUMN (F) DESCRIPTION OF PURPOSE: REFUNDING OF CENTRAL NEW ENGLAND HEALTH ALLIANCE SERIES A BOND (1993) AND MEDICAL CENTER OF CENTRAL MASSACHUSETTS, SERIES B (1992)
PART I - BOND ISSUE MHEFA - UMASS MEMORIAL, SERIES H PART I COLUMN (C ) CUSIP #: 57583UGP7 - 57583UGQ5 - 57583UGR3 - 57583UGS1 - 57583UGT9 - 57583UGU6 - 57583UGV4 - 57583UGW2 - 57583UHC5 - 57583UGX0 - 57583UGY8 - 57583UGZ5 - 57583UHA9 - 57583UHB7 PART I COLUMN (F) DESCRIPTION OF PURPOSE: PARTIAL REFUNDING OF MEDICAL CENTER VARIABLE RATE SERIES A BONDS (1998), REFUNDING IN FULL OF CENTRAL NEW ENGLAND HEALTH ALLIANCE SERIES B BONDS (1998) AND UMASS MEMORIAL SERIES C (2001).
PART II = PROCEEDS DIFFERNCE BETWEEN PART I, COLUMN(E) AND PART II, LINE 3 MHEFA - UMASS MEMORIAL, SERIES D COLUMN (E) ISSUE PRICE OF $107,450,000; ADD ISSUE PREMIUM OF $604,814, ADD INTEREST EARNED ON PROCEEDS OF $2,935,890, LESS ISSUE DISCOUNT OF ($960,668), EQUALS LINE 3 OF $110,030,036. MHEFA - UMASS MEMORIAL VARIABLE RATE, SERIES E COLUMN (E) ISSUE PRICE OF $30,000,000; ADD INTEREST EARNED ON PROCEEDS OF $56,959, EQUALS LINE 3 OF $30,056,959. MHEFA - UMASS MEMORIAL VARIABLE RATE, SERIES F COLUMN (E) ISSUE PRICE OF $30,000,000; ADD INTEREST EARNED ON PROCEEDS OF $56,959, EQUALS LINE 3 OF $30,056,959. MHEFA - UMASS MEMORIAL MASTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $717,238, EQUALS LINE 3 OF $20,717,238. MHEFA - UMASS MEMORIAL MASTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $152,952, EQUALS LINE 3 OF $20,152,952. MHEFA - UMASS MEMORIAL MASTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $24,254, EQUALS LINE 3 OF $20,024,254. MHEFA - UMASS MEMORIAL MASTER LEASE COLUMN (E) ISSUE PRICE OF $20,000,000; ADD INTEREST EARNED ON PROCEEDS OF $5,301, EQUALS LINE 3 OF $20,005,301. MHEFA - UMASS MEMORIAL, SERIES G COLUMN (E) ISSUE PRICE OF $60,445,000; ADD ISSUE PREMIUM OF $1,388,656 ADD INTEREST EARNED ON PROCEEDS OF $176, EQUALS LINE 3 OF $61,833,832. MHEFA - UMASS MEMORIAL, SERIES H COLUMN (E) ISSUE PRICE OF $90,990,000; ADD ISSUE PREMIUM OF $1,303,778, EQUALS LINE 3 OF $92,293,778.
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
UMASS MEMORIAL HEALTH CARE INC
& AFFILIATES - GROUP RETURN
Employer identification number

91-2155626
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
(1) WALTER ETTINGER
CSV OF LIFE INSURANCE - CURRENT KEY EMPLOYEE OF MEDICAL CENTER 		  X 707,000 364,279   No Yes   Yes  
(2) THOMAS CUMMINGS
CSV OF LIFE INSURANCE - FORMER CEO OF MARLBOROUGH HOSPITAL 		  X 377,630 212,495   No Yes   Yes  
(3) RICHARD H SCHEFFER
CSV OF LIFE INSURANCE - FORMER CEO OF WING MEMORIAL CORP. 		  X 26,660 49,542   No Yes   Yes  
(4) WILLIAM J WILLIAMS
CSV OF LIFE INSURANCE - FORMER OFFICER OF HEALTHALLIANCE HOSPITALS, INC. 		  X 1,981,627 3,552,266   No Yes   Yes  
(5) FLOYD CONNELLY
CSV OF LIFE INSURANCE - FORMER EXECUTIVE DIRECTOR OF CMMIC, INC. 		  X 455,570 292,459   No Yes   Yes  
Total ...............Small Bullet $ 4,471,041
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) GORDON MANNING MD
  		CURRENT DIRECTOR 15,600 RENTAL OF PROPERTY - INCOME   No
(2) ROBERT KLUGMAN MD
  		KEY EMPLOYEE 15,600 RENTAL OF PROPERTY - INCOME   No
(3) DANIEL J O'LEARY MD
  		CURRENT DIRECTOR 72,744 RENTAL OF PROPERTY - INCOME   No
(4) FERNANDO CATALINA MD
  		CURRENT DIRECTOR 311,058 RENTAL OF PROPERTY - INCOME   No
(5) ROBERT L SHELTON JR MD
  		CURRENT DIRECTOR 54,168 RENTAL OF PROPERTY - INCOME   No
(6) MICHAEL J LYONS MD
  		CURRENT DIRECTOR 311,508 RENTAL OF PROPERTY - INCOME   No
(7) GORDON MANNING MD
  		CURRENT DIRECTOR 216,967 RENTAL OF PROPERTY - EXPENSE   No
(8) ROBERT KLUGMAN MD
  		KEY EMPLOYEE 216,967 RENTAL OF PROPERTY - EXPENSE   No
(9) JOHN CLEMENTI
  		CURRENT DIRECTOR 140,741 RENTAL OF PROPERTY - EXPENSE   No
(10) EDWARD MANZI
  		CURRENT DIRECTOR 35,759 RENTAL OF PROPERTY - EXPENSE   No
(11) EDWARD MANZI
  		CURRENT DIRECTOR 193,320 RENTAL OF PROPERTY - EXPENSE   No
(12) EDWARD NOONAN
  		CURRENT DIRECTOR 56,133 INDEPENDENT CONTACTOR ARRANGEMENT   No
(13) ROBERT HAVELES
  		CURRENT DIRECTOR 86,142 INDEPENDENT CONTACTOR ARRANGEMENT   No
(14) PATRICK TURLEY
  		CURRENT DIRECTOR 27,904 INDEPENDENT CONTACTOR ARRANGEMENT   No
(15) ANTHONY J MERCADANTE
  		CURRENT DIRECTOR & FAMILY MEMBER OF NICHOLAS MERCADANTE 220,679 INDEPENDENT CONTACTOR ARRANGEMENT   No
(16) WILLIAM F SULLIVAN SR
  		CURRENT DIRECTOR 366,837 INDEPENDENT CONTACTOR ARRANGEMENT   No
(17) JOHN BUDD
  		CURRENT DIRECTOR 1,067,515 INDEPENDENT CONTACTOR ARRANGEMENT   No
(18) STEPHEN TOSI MD
  		CURRENT DIRECTOR 191,158 INDEPENDENT CONTACTOR ARRANGEMENT   No
(19) LYNDA YOUNG MD
  		CURRENT DIRECTOR 18,000 INDEPENDENT CONTACTOR ARRANGEMENT   No
(20) SUSAN ETTINGER
  		FAMILY MEMBER OF WALTER ETTINGER, KEY EMPLOYEE 25,605 EMPLOYMENT ARRANGEMENT   No
(21) KATHLEEN HYLKA
  		FAMILY MEMBER OF SHARON HYLKA, KEY EMPLOYEE 90,971 EMPLOYMENT ARRANGEMENT   No
(22) JOANNE D'ONFRO
  		FAMILY MEMBER OF PAUL D'ONFRO, DIRECTOR 46,564 EMPLOYMENT ARRANGEMENT   No
(23) ELLEN CARLUCCI
  		FAMILY MEMBER OF DANIEL CARLUCCI, MD, DIRECTOR 82,670 EMPLOYMENT ARRANGEMENT   No
(24) CHERYL SWENSON
  		FAMILY MEMBER OF DANA SWENSON, DIRECTOR 23,396 EMPLOYMENT ARRANGEMENT   No
(25) KATHRYN C MAY
  		FAMILY MEMBER OF DEBORAH EKSTROM, OFFICER 37,547 EMPLOYMENT ARRANGEMENT   No
(26) EILEEN HENRICKSON RN
  		FAMILY MEMBER OF DEBORAH EKSTROM, OFFICER 102,307 EMPLOYMENT ARRANGEMENT   No
(27) ELIZABETH GUNDERSEN MD
  		FAMILY MEMBER OF JASON GUNDERSEN, MD, DIRECTOR 227,281 EMPLOYMENT ARRANGEMENT   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
PART II - LOANS FROM INTERESTED PERSONS THE CASH VALUE OF LIFE INSURANCE POLICIES: AMOUNTS DUE FROM CURRENT AND FORMER OFFICERS PERTAIN TO SPLIT DOLLAR LIFE INSURANCE POLICIES OF THE RESPECTED INDIVIDUALS. THESE POLICIES WERE ORIGINATED AT VARIOUS TIMES DURING THE INSURED'S EMPLOYMENT WITH UMASS MEMORIAL HEALTH CARE, INC. THE CORRESPONDING POLICY PREMIUMS WERE FUNDED BY THE EMPLOYER AS AN EMPLOYEE BENEFIT. IN ACCORDANCE WITH IRS NOTICE 2002-8, TREASURY REGULATION 1.61-22 AND TREASURY REGULATION 1.7872-15, THESE PAYMENTS REQUIRE CLASSIFICATION AS LOANS DUE FROM THE INSURED. THESE LOAN BALANCES ARE REFLECTED AT THE LOWER OF THE DISCOUNTED CASH SURRENDER VALUE OR DISCOUNTED CUMULATIVE PREMIUMS PAID.
PART IV - BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS   SEVERAL OF OUR COMMUNITY HOSPITALS MAINTAIN LOCAL BANKING RELATIONSHIPS IN THEIR RESPECTIVE COMMUNITIES. WHICH HAVE BEEN ASSESSED AND MEET FAIR MARKET VALUE REQUIREMENTS. THE VALUE OF THESE RESPECTIVE RELATIONSHIPS ARE WELL BELOW THE DISCLOSURE THRESHOLDS.
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
UMASS MEMORIAL HEALTH CARE INC
& AFFILIATES - GROUP RETURN
Employer identification number

91-2155626
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 327 64,355 FMV/SELLING PRICE
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
 
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
Yes
 
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
THIRD PARTY USE: PART I, LINE 32B: UMASS MEMORIAL HEALTH CARE, INC. UTILIZES THE SERVICES OF UMASS MEMORIAL FOUNDATION, INC. TO SOLICIT DONOR CONTRIBUTIONS, ON OCCASION, THE ORGANIZATION RECEIVES GIFTS OF PUBLICLY TRADED STOCK. ALL GIFTS OF PUBLICLY TRADED STOCK ARE IMMEDIATELY SOLD UPON RECEIPT THROUGH AN INVESTMENT SERVICES FIRM.
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
UMASS MEMORIAL HEALTH CARE INC
& AFFILIATES - GROUP RETURN
Employer identification number

91-2155626
Identifier Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 2   DISCLOSURE YEAR, DISCLOSING INDIVIDUAL, TITLE/ROLE, RELATIONSHIP WITH, RELATIONSHIP UMMHC 2011 - JOHN BUDD, BOARD MEMBER, PAUL D'ONFRO (BUSINESS), ARTHUR BERGERON (BUSINESS), HARVARD PILGRIM HEALTH CARE (BOARD MEMBER) 2011 - ROBERT PHILLIPS, KEY EMPLOYEE, JULIA ANDRIENI (FAMILY) VENTURES 2011, NONE MEDICAL GROUP 2011, NONE MEMBER ENTITIES HEALTH ALLIANCE 2011 - MERCANDANTE, ANTHONY, BOARD MEMBER, NICHOLAS MERCANDANTE (FAMILY) 2011 - MERCANDANTE, NICHOLAS, BOARD MEMBER, ANTHONY MERCANDANTE (FAMILY) CHL 2011 - EKSTROM, DEBORAH, BOARD MEMBER, FIDELITY MUTUAL HOLDING COMPANY (BOARD MEMBER) & FIDELITY COOPERATIVE BANK (BUSINESS) MARLBOROUGH 2011 - MURPHY, MICHAEL, BOARD MEMBER, DANIEL CARLUCCI (BUSINESS), RICHARD BENNETT (BUSINESS), JOHN POLANOWICZ (BUSINESS), PHILIP PURCELL (BUSINESS) WING 2011 - PHANEUF, JAMES, BOARD MEMBER, CHARLES CAVAGNARO (BUSINESS), EDWARD J. NOONAN (BUSINESS), ROBERT S. HAVELES (BUSINESS), JAMES ST. AMAND (BUSINESS), PAUL SCULLY (BUSINESS), KATHERINE COOLIDGE (BUSINESS) 2011 - NOONAN, EDWARD, BOARD MEMBER, CHARLES CAVAGNARO (BUSINESS). JAMES ST. AMAND (BUSINESS) JAMES PHANEUF (BUSINESS) KATHERINE COOLIDGE (BUSINESS) ROBERT S. HAVELES (BUSINESS) PATRICK TURLEY (BUSINESS) ROLAND DESROCHERS (BUSINESS) ELAINE ANDERSON (BUSINESS) 2011 - DESROCHERS, ROLAND, BOARD MEMBER, CHARLES CAVAGNARO (BUSINESS), LINDA MITCHELL (BUSINESS) 2011 - TURLEY, PATRICK, BOARD MEMBER, LINDA MITCHELL (BUSINESS) EDWARD NOONAN (BUSINESS) RON CHRISTIANSEN (BUSINESS) PAUL SCULLY (BUSINESS) 2011 - HAVELES, ROBERT, BOARD MEMBER, EDWARD NOONAN (BUSINESS) JAMES PHANEUF (BUSINESS) LINDA MITCHELL (BUSINESS) PATRICK TURLEY (BUSINESS) 2011 - CHRISTIANSEN, RONALD, BOARD MEMBER, PATRICK TURLEY (BUSINESS) LINDA MITCHELL (BUSINESS) JAMES PHANEUF (BUSINESS) 2011- SCULLY, PAUL, BOARD MEMBER, RON CHRISTIANSEN (BUSINESS) PATRICK TURLEY (BUSINESS) ROBERT HAVELES (BUSINESS) JAMES PHANEUF (BUSINESS) CHARLES CAVAGNARO (BUSINESS) KATHERINE COOLIDGE (BUSINESS) LINDA MITCHELL (BUSINESS) ELAINE ANDERSON (BUSINESS) CLINTON 2011 - NONE
FORM 990, PART VI, SECTION A, LINE 6   THERE ARE NO CLASSES OF DIRECTORS. THE VOTING RIGHTS OF THE MEMBER'S BOARD ARE ABSOLUTE.
FORM 990, PART VI, SECTION A, LINE 7A   THE MAJORITY OF ENTITIES IN THE CONSOLIDATED GROUP HAVE A SOLE MEMBER (WHICH IS ALSO WITHIN THE CONSOLIDATED GROUP) THAT ELECTS THE BOARD OF TRUSTEES. THERE ARE NO CLASSES OF TRUSTEES. THE MAJORITY OF THE ENTITIES RESERVE TO THE MEMBER THE POWER TO REMOVE TRUSTEES, TO FILL VACANCIES, AND TO INCREASE OR DECREASE THE SIZE OF THE BOARD.
FORM 990, PART VI, SECTION A, LINE 7B   THE MAJORITY OF THE ENTITIES IN THE CONSOLIDATED GROUP HAVE A SOLE MEMBER (WHICH IS ALSO WITHIN THE CONSOLIDATED GROUP) WITH THE RIGHT TO APPROVE OR RATIFY DECISIONS OF THE ENTITY, WHICH IS EXERCISED BY THAT MEMBER'S BOARD OF TRUSTEES. THERE ARE NO CLASSES OF TRUSTEES OR MEMBERS. THUS, THE VOTING RIGHTS OF A MEMBER BOARD ARE ABSOLUTE. GENERALLY, THE SOLE MEMBER OF EACH ENTITY RESERVES THE POWER TO APPROVE MAJOR TRANSACTIONS; TO MERGE, CONSOLIDATE OR LIQUIDATE THE CORPORATION'S ASSETS; TO ADOPT ANNUAL OPERATING AND CAPITAL BUDGETS AND AMENDMENTS; TO ENTER INTO LOAN AGREEMENTS AND/OR GUARANTIES; TO APPOINT AND/OR ELECT THE PRESIDENT AND/OR CEO; TO ELECT AND/OR APPOINT AND REMOVE TRUSTEES, FILL VACANCIES, TO INCREASE OR DECREASE THE SIZE OF THE BOARD; AND TO APPROVE UNBUDGETED EXPENDITURES.
FORM 990, PART VI, SECTION B, LINE 11   SECTIONS OF THE CORE FORM 990 RELATED TO EXECUTIVE COMPENSATION AND, SCHEDULE J ARE REVIEWED IN DETAIL WITH THE ORGANIZATION'S COMPENSATION COMMITTEE OF THE BOARD. THE COMPLIANCE COMMITTEE OF THE BOARD REVIEWS ALL CONTENT ASSOCIATED WITH SCHEDULE L. THE AUDIT COMMITTEE OF THE BOARD REVIEWS THE FORM 990, INCLUDING THE ABOVE SCHEDULES AND RECOMMENDS THE FORM 990 TO THE FULL BOARD FOR APPROVAL. THE FULL BOARD IS GIVEN ACCESS TO THE FORM 990.
  FORM 990, PART VI, SECTION B, LINE 12C PAGE 6 SECTION B. POLICIES LINE 12 C: THE CONFLICT OF INTEREST POLICY REQUIRES BOARD MEMBERS AND MANAGEMENT TO COMPLETE ANNUAL DISCLOSURE STATEMENTS AND, TO UPDATE THESE DISCLOSURE STATEMENTS FOR SIGNIFICANT CHANGES IN THEIR OUTSIDE GOVERNANCE AND PROFESSIONAL ACTIVITIES OR, FINANCIAL RELATIONSHIPS AS APPROPRIATE. ADDITIONALLY, ALL TRANSACTIONS INVOLVING BOARD MEMBERS OR MANAGEMENT AND THE ORGANIZATION ARE REQUIRED TO BE APPROVED BY THE COMPLIANCE COMMITTEE OF THE BOARD AND, THERE IS ACTIVE MONITORING AND COMMUNICATION TO ENSURE INDIVIDUALS WITH OUTSIDE RELATIONSHIPS DO NOT INAPPROPRIATELY PARTICIPATE IN BUSINESS DECISIONS OF THE ORGANIZATION, PURCHASING OR RESEARCH DECISIONS.
  FORM 990, PART VI, SECTION B, LINE 15 PAGE 6 SECTION B. POLICIES LINE 15 B: AT UMASS MEMORIAL, ALL COMPENSATION MATTERS FOR THE CEO AND SENIOR EXECUTIVES THROUGHOUT THE SYSTEM (INCLUDING ALL "DISQUALIFIED PERSONS") ARE GOVERNED AND OVERSEEN BY THE BOARD OF TRUSTEES OF THE PARENT. THE BOARD APPROVED A COMPENSATION PHILOSOPHY THAT GOVERNS ALL SUCH DECISIONS. THE PHILOSOPHY INCLUDES THE OBJECTIVES OF THE PROGRAM, COMPONENTS OF EXECUTIVE COMPENSATION, THE RELEVANT MARKET, POSITIONING IN THE MARKET, FACTORS CONSIDERED IN SETTING EXECUTIVE COMPENSATION AND THE IMPORTANCE OF TYING SUCH COMPENSATION TO PERFORMANCE. THE BOARD ESTABLISHED A COMPENSATION COMMITTEE, MADE UP OF DISINTERESTED TRUSTEES, WHO ARE GIVEN THE AUTHORITY TO ESTABLISH COMPENSATION FOR ALL SENIOR EXECUTIVES, WITHIN THE PARAMETERS OF THE PHILOSOPHY, AND WITH FULL AND COMPLETE REPORTING TO THE FULL BOARD. THE COMPENSATION COMMITTEE PERFORMS ITS WORK PURSUANT TO ITS CHARTER AND A COMPENSATION POLICY THAT ESTABLISHES THE PROCESS THE COMMITTEE WILL FOLLOW IN REVIEWING AND APPROVING EXECUTIVE COMPENSATION EACH YEAR. THE COMMITTEE ENSURES THAT ITS PROCESS MEETS THE REBUTABLE PRESUMPTION OF REASONABLENESS ESTABLISHED BY THE IRS. IN ORDER TO ASSIST THE COMMITTEE IN ITS RESPONSIBILITIES, THE COMPENSATION COMMITTEE HIRES INDEPENDENT, OUTSIDE COMPENSATION CONSULTANTS TO ADVISE THE COMMITTEE AND THE BOARD ON THE REASONABLENESS OF OVERALL EXECUTIVE COMPENSATION PROGRAM, INCLUDING COMPENSATION OF THE SPECIFIC EXECUTIVES. THESE CONSULTANTS REPORT DIRECTLY TO THE COMMITTEE AND NOT TO MANAGEMENT. THE COMMITTEE WORKS WITH THESE CONSULTANTS, AND WITH LEGAL COUNSEL, TO ENSURE THAT ALL COMPENSATION PAID, AS WELL AS THE PROCESS FOLLOWED TO DETERMINE SUCH COMPENSATION, IS REASONABLE, MEETS ALL REGULATORY REQUIREMENTS AND IS COMPETITIVE WITH THE RELEVANT MARKET.
  FORM 990, PART VI, SECTION C, LINE 19 PAGE 6: UMASS MEMORIAL MAKES IT GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AS REQUIRED BY APPLICABLE STATE AND FEDERAL LAWS, AND BY REQUEST ON A CASE-BY-CASE BASIS.
  PAGE 8 PART VII SECTION B. INDEPENDENT CONTRACTORS - DESCRIPTION OF SERVICE DESCRIPTION OF SERVICES FOOTNOTE A - SPECIALTY TRADE CONTRACTORS: SUBCONTRACTS TO A VARIETY OF EXHIBIT AND MARKETING SERVICES INCLUDING BUT NOT LIMITED TO: GENERAL CONSULTATION, COST OF MATERIALS AND SUPPLIES, DESIGN, CONSTRUCTION, LABORERS. THIS VENDOR MAY ALSO SUPPLY THEIR OWN LABORERS AS OPPOSED TO SUBCONTRACT.
CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -19,474,382. NET ASSETS RELEASED FROM RESTRICTIONS 4,768,664. PENSION RELATED CHANGES OTHER THAN NET PERIODIC BENEFIT COST -70,678,363. BOOK/TAX DIFFERENCES FROM S CORP K-1 472,818. CHANGE IN BENEFICIAL INTERESTS IN PERPETUAL TRUSTS -5,149,554. MISCELLANEOUS 47. NET ASSETS RELEASED FROM RESTRICTION FOR PPE 5,005,601. TEMPORARY RESTRICTED FUND EXPENDITURES -9,558,388. TRANSFERS (TO) FROM RELATED PARTIES 217,944. TOTAL TO FORM 990, PART XI, LINE 5: -94,395,613.
GROUP RETURN PAGE 1, LINE H(B) LIST OF AFFILIATED ORGANIZATIONS THE CLINTON HOSPITAL ASSOCIATION; 201 HIGHLAND STREET, CLINTON, MA 01510 EIN: 04-1185520 FISCAL YEAR END: 9/30/2011 MARLBOROUGH HOSPITAL; 157 UNION STREET, MARLBOROUGH, MA 01752 EIN: 04-2104693 FISCAL YEAR END: 9/30/2011 UMASS MEMORIAL BEHAVIORAL HEALTH SYSTEM, INC.; 328 SHREWSBURY STREET, WORCESTER, MA 01604 EIN: 04-3374724 FISCAL YEAR END: 9/30/2011 UMASS MEMORIAL HOSPITALS, INC.; 328 SHREWSBURY STREET, WORCESTER, MA 01604 EIN: 04-3296271 FISCAL YEAR END: 9/30/2011 UMASS MEMORIAL HEALTH VENTURES, INC.; 328 SHREWSBURY STREET, WORCESTER, MA 01604 EIN: 22-2605679 FISCAL YEAR END: 9/30/2011 UMASS MEMORIAL LABORATORIES, INC.; 328 SHREWSBURY STREET, WORCESTER, MA 01604 EIN: 04-3321703 FISCAL YEAR END: 9/30/2011 UMASS MEMORIAL MEDICAL CENTER, INC.; 328 SHREWSBURY STREET, WORCESTER, MA 01604 EIN: 04-3358564 FISCAL YEAR END: 9/30/2011 UMASS MEMORIAL MEDICAL GROUP, INC.; 328 SHREWSBURY STREET, WORCESTER, MA 01604 EIN: 04-2911067 FISCAL YEAR END: 9/30/2011 UMASS MEMORIAL REALTY, INC.; 328 SHREWSBURY STREET, WORCESTER, MA 01604 EIN: 04-2805630 FISCAL YEAR END: 9/30/2011 WING MEMORIAL HOSPITAL CORP.; 40 WRIGHT STREET, PALMER, MA 01069 EIN: 22-2519813 FISCAL YEAR END: 9/30/2011 UMASS MEMORIAL HEALTH CARE, INC. (PARENT); 328 SHREWSBURY STREET, WORCESTER, MA 01604 EIN: 04-3358566 FISCAL YEAR END: 9/30/2011 COMMUNITY HEALTHLINK, INC.; 72 JAQUES AVENUE, WORCESTER, MA 01610 EIN: 04-2626179 FISCAL YEAR END: 9/30/2011 CENTRAL MASSACHUSETTS MAGNETIC IMAGING CENTER, INC.; 367 PLANTATION STREET, WORCESTER, MA 01605 EIN: 04-2981362 FISCAL YEAR END: 9/30/2011 CENTRAL NEW ENGLAND HEALTHALLIANCE, INC.; 60 HOSPITAL ROAD, LEOMINSTER, MA 01453 EIN: 04-3172496 FISCAL YEAR END: 9/30/2011 COORDINATED PRIMARY CARE, INC.; 60 HOSPITAL ROAD, LEOMINSTER, MA 01453 EIN: 04-3210002 FISCAL YEAR END: 9/30/2011 HEALTHALLIANCE HOME HEALTH AND HOSPICE, INC.; 25 TUCKER ROAD, LEOMINSTER, MA 01453 EIN: 04-2932308 FISCAL YEAR END: 9/30/2011 HEALTHALLIANCE HOSPITALS, INC.; 60 HOSPITAL ROAD, LEOMINSTER, MA 01453 EIN: 04-2103555 FISCAL YEAR END: 9/30/2011 CAITLIN RAYMOND INTERNATIONAL REGISTRY, INC.; 328 SHREWSBURY STREET, WORCESTER, MA 01604 EIN: 06-1749208 FISCAL YEAR END: 9/30/2011 CLINTON HOSPITAL FOUNDATION, INC.; 328 SHREWSBURY STREET, WORCESTER, MA 01604 EIN: 04-3357881 FISCAL YEAR END: 9/30/2011
COMMUNITY INFORMATION - CONTINUED FROM SCHEDULE H SCHEDULE H, PART VI - SUPPLEMENTAL INFORMATION - CONTINUED - CANCER: CANCER WAS THE SECOND LEADING CAUSE OF DEATH IN WORCESTER COUNTY IN 2008. (SOURCE: MASSACHUSETTS DEPARTMENT OF PUBLIC HELATH/MASSCHIP; DALE MAGEE, COMMISSIONER, WORCESTER DEPARTMENT OF PUBLIC HEALTH, HEALTH OF WORCESTER, 2011 REPORT.) OF THOSE DEATHS, LUNG CANCER ACCOUNTED FOR THE GREATEST PERCENTAGE OF CANCER-RELATED DEATHS. KEY HEALTH OBSERVATIONS IN CENTRAL MASSACHUSETTS FROM REGIONAL HEALTH FORUMS IN 2011: -RACIAL AND ETHNIC DISPARITIES ARE MAJOR FACTORS: -HEALTH DISPARITIES IDENTIFIED AMONG LATINO AND BLACK POPULATIONS ACROSS SEVERAL INDICATORS ARE A MAJOR CONCERN -OVERWEIGHT/ OBESITY IS AN INCREASING HEALTH RISK THAT CONTRIBUTES TO RISING DIABETES INCIDENCE -THE PREVALENCE OF DIABETES AMONG WORCESTER COUNTY RESIDENTS IS SLIGHTLY LOWER THAN THE STATE AS A WHOLE. HOWEVER, DIABETES IS MORE PREVALENT AMONG BLACK AND HISPANIC POPULATIONS AND THOSE 65 YEARS OLD AND OVER. -HEART DISEASE IN THE CENTRAL MASSACHUSETTS REGION IS MORE PREVALENT AMONG MALES AND HISPANIC AND LOWER-INCOME POPULATIONS. OVERALL RATES FOR HEART DISEASE IN WORCESTER COUNTY AND THE STATE ARE LOWER THAN THE NATIONAL MEDIAN. -IN WORCESTER COUNTY, SMOKING IS MOST PREVALENT AMONG YOUNG ADULTS AND LOW INCOME RESIDENTS AND AT RATES SIGNIFICANTLY HIGHER THAN THE STATE AS A WHOLE AMONG THOSE GROUPS. -PREVALENCE OF CHRONIC DISEASE AND RISKY BEHAVIORS SUCH AS SMOKING OCCUR AT HIGHER RATES AMONG THOSE WITH LESS THAN A HIGH SCHOOL DEGREE AND LOWER EDUCATIONAL ATTAINMENT. -ACCORDING TO THE WORCESTER POLICE DEPARTMENT, THE CITY OF WORCESTER HAS MORE THAN 60 GANGS CONCENTRATED IN LOW INCOME NEIGHBORHOODS. PROGRAMS THAT ADDRESS YOUTH VIOLENCE PREVENTION ARE VITAL TO ADDRESSING THIS CRITICAL PUBLIC HEALTH ISSUE, PARTICULARLY AMONG INNER-CITY, AT-RISK YOUTH. IN PARTICULARLY, YOUTH HAVE IDENTIFIED HAVING JOBS AND WORKFORCE OPPORTUNITIES, SUCH AS INTERN AND MENTORSHIP PROGRAMS AS A KEY MEANS OF PREVENTING VIOLENCE AND GANG INVOLVEMENT AMONG YOUTH. EMPLOYMENT OPPORTUNITIES ADDITIONALLY PROVIDE NEEDED FINANCES FOR LOW-INCOME YOUTH AS WELL AS EXPOSURE TO THE POSITIVE EXPERIENCE OF EARNING A PAYCHECK TO HELP BREAK THE CYCLE AND MINSETS OF POVERTY. WORCESTER COUNTY'S RESIDENTS ARE DISPROPORTIONATELY AFFECTED BY: -OBESITY/ OVERWEIGHT -INFANT MORTALITY RATES FOR BLACKS AND LATINOS (PARTICULARLY IN THE CITY OF WORCESTER) -SMOKING RATES -AIDS/ HIV AND HEPATITIS C (PARTICULARLY IN THE CITIES OF WORCESTER AND FITCHBURG) -HEROIN/ OPIODS-RELATED INCIDENTS AND DEATHS (PARTICULARLY IN THE CITIES OF WORCESTER AND FITCHBURG) -REPORTED CASES OF CHLAMYDIA INFECTION HAS BEEN INCREASING DRAMATICALLY OVER THE PAST DECADE, DUE PARTLY TO SUCCESSFUL SCREENING OF ASYMPTOMATIC INDIVIDUALS. -THE CITY OF WORCESTER IS A LEADING RESETTLEMENT SITE FOR REFUGEES. THIS GROWING DIVERSITY HAS BROADENED THE NEED FOR INTERPRETER SERVICES FOR MEDICAL CARE. IN ITS FISCAL YEAR 2011, UMASS MEMORIAL HEALTH CARE DELIVERED 122,963 DOCUMENTED INTERPRETATIONS FOR MEDICAL SERVICES IN OVER 87 LANGUAGES. HEALTH CARE SAFETY NET - UMASS MEMORIAL PROVIDES CARE TO THE LARGEST NUMBER OF LOW INCOME PATIENTS IN THE REGION. SCHEDULE H PART III, LINE 2: A COST TO CHARGE RATIO AS DESCRIBED IN PART I, LINE 7 WAS APPLIED TO THE ORGANIZATION'S BAD DEBT EXPENSE WHICH WAS THEN FURTHER REDUCED BY PAYMENTS FROM THE HEALTH SAFETY NET RELATED TO FREE CARE.
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
UMASS MEMORIAL HEALTH CARE INC
& AFFILIATES - GROUP RETURN
Employer identification number

91-2155626
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) UMASS MEMORIAL FOUNDATION INC

333 SOUTH STREET

SHREWSBURY,MA01545
04-3108190 		FUNDRAISING SUPPORT MA 501( C)(3) 11C N/A
 
No
(2) HEALTH ALLIANCE REALTY CORPORATION

326 NICHOLS ROAD

FITCHBURG,MA01420
04-2560754 		REAL ESTATE MANAGEMENT MA 501( C)(2)   N/A
 
No
(3) WING HEALTH FOUNDATION INC

40 WRIGHT STREET

PALMER,MA01069
04-2105839 		ISSUANCE OF HEALTH RELATED GRANTS MA 501( C)(3) 11B N/A
 
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
(1) UMASS MEMORIAL INVESTMENT PARTNERSHIP LLP

ONE BIOTECH PARK 365 PLANTATION ST
WORCESTER,MA01605
04-3530755 		INVESTMENT MANAGEMENT MA N/A
 EXCLUDED 514 15,238,931 331,190,863   No 25,291 Yes   100.000 %
(2) UMASS MEMORIAL MRI OF MARLBOROUGH LLC

157 UNION STREET
MARLBOROUGH,MA01752
20-2293995 		MAGNETIC RESONANCE IMAGING MA MARLBOROUGH HOSPITAL
  		RELATED 577,331 345,122   No     No 56.000 %
(3) UMASS MEMORIAL HEALTH ALLIANCE MRI CENTER LLC

60 HOSPITAL ROAD
LEOMINSTER,MA01453
04-3561571 		MAGNETIC RESONANCE IMAGING MA N/A
 RELATED 893,348 1,038,505   No     No 60.000 %








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) COMMONWEALTH PROFESSIONAL ASSURANCE CO LTD
PO BOX 1051 GT
GRAND CAYMAN    
CJ
98-0226143 		INSURANCE CJ N/A
 C 26,262,197 136,908,432 100.000 %
(2) MEMORIAL OFFICE CONDOMINIUM TRUST
328 SHREWSBURY STREET
WORCESTER,MA01604
04-6616900 		CONDOMINIUM ASSOCIATION MA UMASS MEMORIAL MEDICAL CENTER INC
  		T -5,572 144,653 53.690 %
(3) BIO-LAB INC
215 WEST STREET
MILFORD,MA01757
04-2708828 		CLINICAL LABORATORY MA UMASS MEMORIAL HEALTH VENTURES INC
  		S 364,610 1,142,577 100.000 %








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
Yes
 
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
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
 
No
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
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
 
No
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
Yes
 
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) COMMONWEALTH PROFESSIONAL ASSURANCE COMPANY LTD

 L 24,975,900 FAIR VALUE
(2) UMASS MEMORIAL MEDICAL CENTER INC

 B 7,604,048 FAIR VALUE
(3) UMASS MEMORIAL MEDICAL CENTER INC

 N 1,122,757 FAIR VALUE
(4) UMASS MEMORIAL MEDICAL GROUP INC

 Q 3,492,031 FAIR VALUE
(5) UMASS MEMORIAL MEDICAL GROUP INC

 L 4,153,854 FAIR VALUE
(6) UMASS MEMORIAL MEDICAL GROUP INC

 N 708,425 FAIR VALUE
(7) WING MEMORIAL HOSPITAL CORPORATION

 Q 300,000 FAIR VALUE
(8) UMASS MEMORIAL REALTY INC

 J 4,100,255 FAIR VALUE
(9) UMASS MEMORIAL FOUNDATION

 O 1,602,995 FAIR VALUE
(10) COMMUNITY HEALTHLINK INC

 Q 183,320 FAIR VALUE
(11) UMASS MEMORIAL HEALTH VENTURES INC

 P 349,572 FAIR VALUE
(12) UMASS MEMORIAL LABORATORIES INC

 P 2,929,357 FAIR VALUE
(13) UMASS MEMORIAL REALTY INC

 P 361,772 FAIR VALUE
(14) MARLBOROUGH HOSPITAL

 P 1,825,219 FAIR VALUE
(15) THE CLINTON HOSPITAL ASSOCIATION

 P 1,322,285 FAIR VALUE
(16) WING MEMORIAL HOSPITAL CORPORATION

 P 1,787,422 FAIR VALUE
(17) WING MEMORIAL HOSPITAL CORPORATION

 N 100,927 FAIR VALUE
(18) CENTRAL NEW ENGLAND HEALTH ALLIANCE INC

 P 2,944,509 FAIR VALUE
(19) UMASS MEMORIAL MEDICAL CENTER INC

 P 130,821,745 FAIR VALUE
(20) UMASS MEMORIAL MEDICAL GROUP INC

 P 34,322,803 FAIR VALUE
(21) CENTRAL MASSACHUSETTS MAGNETIC IMAGING CENTER INC

 P 130,896 FAIR VALUE
(22) COMMUNITY HEALTHLINK INC

 P 606,632 FAIR VALUE
(23) COMMONWEALTH PROFESSIONAL ASSURANCE COMPANY LTD

 P 21,839,224 FAIR VALUE
(24) UMASS MEMORIAL LABORATORIES INC

 R 20,014,610 FAIR VALUE
(25) UMASS MEMORIAL MEDICAL CENTER INC

 C 6,202,000 FAIR VALUE
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


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