Form990
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
A For the 2015 calendar year, or tax year beginning 10-01-2015 , and ending 09-30-2016
BCheck if applicable:
CName of organization
UMass Memorial Health Care Inc & Affiliates
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
306 Belmont Street
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Worcester, MA01604
D Employer identification number

91-2155626
E Telephone number

G Gross receipts $ 2,415,912,142
F Name and address of principal officer:
Sergio Melgar
306 Belmont 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
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions) Click to see attachment
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) ........ 3 166
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 89
5 Total number of individuals employed in calendar year 2015 (Part V, line 2a) ...... 5 14,420
6 Total number of volunteers (estimate if necessary) ............. 6 1,307
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 3,570,189
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 579,995
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 14,499,867 13,874,385
9 Program service revenue (Part VIII, line 2g) ......... 2,510,679,190 2,351,102,309
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 41,297,302 6,124,340
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 11,103,132 9,584,610
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 2,577,579,491 2,380,685,644
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 4,483,733 2,312,920
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 1,277,516,317 1,221,720,336
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 323,352 64,000
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet635,354    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 1,201,618,437 1,117,155,900
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 2,483,941,839 2,341,253,156
19 Revenue less expenses. Subtract line 18 from line 12....... 93,637,652 39,432,488
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 2,290,835,371 1,818,569,543
21 Total liabilities (Part X, line 26)............. 1,382,662,313 1,256,756,697
22 Net assets or fund balances. Subtract line 21 from line 20..... 908,173,058 561,812,846
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 Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2015)
Form 990 (2015)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: 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
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 organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations 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 $ 1,312,284,260 including grants of $ 2,293,555 ) (Revenue $ 1,578,234,928 )
UMASS MEMORIAL MEDICAL CENTER UMASS 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. FY 2016 KEY STATISTICS - TOTAL DISCHARGES: 38,444 TOTAL SURGICAL CASES: 28,711 TOTAL ER VISITS: 136,097
4b (Code:   ) (Expenses $ 459,464,553 including grants of $ 0 ) (Revenue $ 392,769,783 )
UMASS MEMORIAL MEDICAL GROUP THE 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 $ 218,494,804 including grants of $ 0 ) (Revenue $ 285,306,676 )
UMASS MEMORIAL COMMUNITY HOSPITALS THE UMASS MEMORIAL COMMUNITY HOSPITALS (CLINTON HOSPITAL, HEALTH ALLIANCE HOSPITALS, INC., MARLBOROUGH HOSPITAL) 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. FY 2016 KEY STATISTICS - TOTAL DISCHARGES: 11,372 TOTAL SURGICAL CASES: 7,578 TOTAL ER VISITS: 86,749
(Code:   ) (Expenses $ 76,701,756 including grants of $ 19,365 ) (Revenue $ 92,837,675 )
OTHER UMASS MEMORIAL ENTITIES - UMASS 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 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, 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 $ 76,701,756 including grants of $ 19,365 ) (Revenue $ 92,837,675 )
4e Total program service expensesMediumBullet2,066,945,373
Form 990 (2015)
Form 990 (2015)
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 (see instructions)? 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 I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? 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
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which 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 I..................
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 II...
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 .............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; 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
Yes
 
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, 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, line 10?
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 VIIClick 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.......
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 IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick 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 XClick 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 and XII .................
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 and XII 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, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
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 I (see instructions) ....Click 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...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
Form 990 (2015)
Form 990 (2015)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government 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 or other assistance to or for domestic individuals 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, line 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 lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............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), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I............
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 ...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? 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 employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III.........
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 direct or indirect 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 M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I.
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 ........
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, 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 ...
35b
 
No
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 VI
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2015)
Form 990 (2015)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
1,620
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
14,420
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” to line 3b, 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, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
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 as charitable contributions? ...
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.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? .........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring 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. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the 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 amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2015)
Form 990 (2015)
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 or note to any line 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
166
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
89
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
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
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
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete 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 this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did 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 15a or 15b, 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," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
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 made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletRobert Feldmann306 Belmont Street   Worcester,MA01604 (508) 334-0496
Form 990 (2015)
Form 990 (2015)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line 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. 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 organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) David L Bennett
 
Chairperson, UMM Health Care, Inc.
 1.0
.................
1.0 		X   X       0 0 0
(2) John Bronhard
 
Treasurer, HealthAlliance Hospitals, Inc.
 40.0
.................
0 		X   X       302,079 0 14,638
(3) Douglas S Brown
 
Secretary, UMM Health Care, Inc., Officer/Dir various
 5.0
.................
40.0 		X   X       0 738,024 254,799
(4) Fernando Catalina MD
 
Chairperson, HealthAlliance Hospitals, Inc.
 1.0
.................
0 		X   X       0 0 0
(5) Lisa Colombo
 
President, Clinton Hospital Association, Director of Hospitals Inc.
 40.0
.................
0 		X   X       34,042 0 2,038
(6) Sheila Daly
 
President until 1/16, Clinton Hospital Association, Director Community Hospitals Inc.
 40.0
.................
0 		X   X       299,827 0 59,230
(7) Eric W Dickson MD
 
President & CEO/Director, UMM Health Care, Inc., Officer/Dir various
 5.0
.................
40.0 		X   X       0 1,435,121 399,010
(8) Paul D'Onfro
 
Vice Chairperson, HealthAlliance Hospitals, Inc.
 1.0
.................
0 		X   X       0 0 0
(9) David Fairchild MD
 
President/Director until 5/15, UMM Accountable Care Organization, Inc.
 40.0
.................
0 		X   X       182,869 0 52,463
(10) John Greenwood
 
President/Director, UMM Accountable Care Organization, Inc.
 40.0
.................
0 		X   X       304,633 0 96,328
(11) Cheryl M Lapriore
 
President/Director, UMM Health Ventures, Inc.
 5.0
.................
40.0 		X   X       0 391,257 119,278
(12) William McGrail Esquire
 
Chairperson, Clinton Hospital Association
 1.0
.................
0 		X   X       0 0 0
(13) Sergio Melgar
 
Treasurer, UMM Health Care, Inc., Officer/Dir various
 5.0
.................
40.0 		X   X       0 825,672 118,182
(14) Patrick Muldoon
 
President, UMM Med Ctr, Inc.,
 40.0
.................
0 		X   X       909,316 0 367,582
(15) Michael D Murphy
 
Vice Chairperson, Marlborough Hospital
 1.0
.................
0 		X   X       0 0 0
(16) Steven Roach
 
President/Director, Marlborough Hospital
 40.0
.................
0 		X   X       431,989 0 85,818
(17) Richard Siegrist
 
Vice Chairperson, UMM Health Care, Inc.
 1.0
.................
1.0 		X   X       0 0 0
Form 990 (2015)
Form 990 (2015)
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 (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Dana E Swenson
 
President/Director, UMM Realty, Inc.
 5.0
.......................40.0 		X   X       0 300,894 115,187
(19) Stephen E Tosi MD
 
President, UMM Med Group, Inc., Director various
 40.0
.......................0 		X   X       1,140,830 0 108,842
(20) Deborah Weymouth
 
President/Director, HealthAlliance Hospitals, Inc.
 40.0
.......................0 		X   X       473,564 0 82,099
(21) Douglas Ziedonis MD
 
President/Director, UMBHS, Inc.
 20.0
.......................0 		X   X       251,258 0 43,599
(22) Howard Alfred MD
 
Director, UMM Accountable Care Organization, Inc.
 37.0
.......................0 		X           245,366 0 25,670
(23) Gail Allen
 
Director, HealthAlliance Hospitals, Inc.
 1.0
.......................0 		X           0 0 0
(24) Michael W Ames
 
Director, Clinton Hospital Association
 1.0
.......................0 		X           0 0 0
(25) Robert Babineau Jr MD
 
Director until 2/16, HealthAlliance Hospitals, Inc.
 1.0
.......................0 		X           0 0 0
(26) Peter Bagley MD
 
Director, UMM Accountable Care Organization, Inc.
 27.0
.......................0 		X           372,165 0 123,586
(27) Richard K Bennett
 
Director, UMM Health Care, Inc.
 1.0
.......................1.0 		X           0 0 0
(28) Norman Boudreau
 
Director until 2/16, HealthAlliance Hospitals, Inc.
 1.0
.......................0 		X           0 0 0
(29) Leslie Bovenzi
 
Director, HealthAlliance Hospitals, Inc.
 1.0
.......................0 		X           0 0 0
(30) Alan P Brown MD
 
Director, UMM Behavioral Health System, Inc.
 31.0
.......................0 		X           204,327 0 36,125
(31) John H Budd
 
Director until 3/16, UMM Health Ventures, Inc.
 1.0
.......................0 		X           0 0 0
(32) Daniel Carlucci MD
 
Director, Marlborough Hospital
 32.0
.......................0 		X           34,736 0 2,787
(33) J Paul Cherubini
 
Director until 4/16, Clinton Hospital Association
 1.0
.......................0 		X           0 0 0
(34) John Clementi
 
Director, HealthAlliance Hospitals, Inc.
 1.0
.......................0 		X           0 0 0
(35) Andrew Cocchiarella MD
 
Director until 3/16, Marlborough Hospital
 40.0
.......................0 		X           398,749 0 39,444
(36) Michael Collins MD
 
Director, UMM Health Care, Inc.
 1.0
.......................1.0 		X           0 0 0
(37) Benjamin H Colonero Jr
 
Director, Marlborough Hospital
 1.0
.......................0 		X           0 0 0
(38) Edward J Connor
 
Director, Clinton Hospital Association
 1.0
.......................0 		X           0 0 0
(39) William Corbett MD
 
Director, Marlborough Hospital
 40.0
.......................0 		X           516,030 0 204,950
(40) Lois D Cornell
 
Director until 6/16, UMM Health Care, Inc.
 1.0
.......................1.0 		X           0 0 0
(41) Frederick G Crocker
 
Director, UMM Health Ventures, Inc.
 1.0
.......................0 		X           0 0 0
(42) J Christopher Cutler FACHE
 
Director, UMM Medical Group, Inc.
 1.0
.......................0 		X           0 0 0
(43) Edward D'Alelio
 
Director, UMM Health Care, Inc.
 1.0
.......................1.0 		X           0 0 0
(44) Dix F Davis
 
Director, UMM Realty, Inc.
 1.0
.......................0 		X           0 0 0
(45) Arthur P DiGeronimo Jr
 
Director until 2/16, HealthAlliance Hospitals, Inc.
 1.0
.......................0 		X           0 0 0
(46) David Duncan
 
Director until 8/3/15, Coordinated Primary Care, Inc.
 40.0
.......................0 		X           108,991 0 18,481
(47) Jordan Eisenstock MD
 
Director, UMM Accountable Care Organization, Inc.
 40.0
.......................0 		X           190,976 0 11,218
(48) Kimberly Eisenstock MD
 
Director, Marlborough Hospital
 40.0
.......................0 		X           265,082 0 38,431
(49) Robert Farragher
 
Director, Clinton Hospital Association
 1.0
.......................0 		X           0 0 0
(50) Lynne Farrell
 
Director, HealthAlliance Home Health and Hospice, Inc.
 1.0
.......................0 		X           0 0 0
(51) R Kevin Ferguson MD
 
Director, UMM Med Group, Inc.
 40.0
.......................0 		X           251,753 0 38,016
(52) Robert W Finberg MD
 
Director, UMM Health Care, Inc.
 20.0
.......................5.0 		X           931,279 0 137,315
(53) William Fischer
 
Director, Marlborough Hospital
 1.0
.......................0 		X           0 0 0
(54) Roger Fitch
 
Director until 5/16, UMM Behavioral Health System, Inc.
 1.0
.......................0 		X           0 0 0
(55) Terence Flotte MD
 
Director, UMM Health Care, Inc.
 1.0
.......................1.0 		X           0 0 0
(56) Amy Grassette
 
Director, UMM Behavioral Health System, Inc.
 1.0
.......................0 		X           0 0 0
(57) Elvira Guardiola
 
Director, UMM Health Care, Inc.
 1.0
.......................1.0 		X           0 0 0
(58) Christie Hager
 
Director, HealthAlliance Hospitals, Inc.
 1.0
.......................0 		X           0 0 0
(59) David Harlan MD
 
Director, UMM Accountable Care Organization, Inc.
 20.0
.......................0 		X           160,770 0 34,529
(60) Clark Henebry
 
Director until 4/16, Clinton Hospital Association
 1.0
.......................0 		X           0 0 0
(61) Francis Hurley
 
Director, Marlborough Hospital
 1.0
.......................0 		X           0 0 0
(62) Carlos Iitsuka
 
Director until 7/16, UMM Health Ventures, Inc.
 5.0
.......................40.0 		X           0 381,923 66,666
(63) Joanne Johnson
 
Director, UMM Behavioral Health System, Inc.
 1.0
.......................0 		X           0 0 0
(64) Paul Kangas
 
Director, UMM Health Care, Inc.
 1.0
.......................1.0 		X           0 0 0
(65) Kathryn Kennedy MD
 
Director, UMM Med Group, Inc.
 36.0
.......................0 		X           299,215 0 42,714
(66) Peter Knox
 
Director, UMM Health Care, Inc.
 1.0
.......................1.0 		X           0 0 0
(67) Barbara Kupfer
 
Director, UMM Accountable Care Organization, Inc.
 1.0
.......................0 		X           0 0 0
(68) Daniel H Lasser MD
 
Director, UMM Med Group, Inc.
 20.0
.......................0 		X           269,280 0 88,938
(69) John Latimer MD
 
Director until 10/16, HealthAlliance Hospitals, Inc.
 1.0
.......................0 		X           0 0 0
(70) Shipen Li MD
 
Director, HealthAlliance Hospitals, Inc.
 40.0
.......................0 		X           324,282 0 38,420
(71) Harris L MacNeill
 
Director, UMM Health Care, Inc.
 1.0
.......................1.0 		X           0 0 0
(72) Michael Mahan
 
Director, HealthAlliance Hospitals, Inc.
 1.0
.......................0 		X           0 0 0
(73) Edward Manzi
 
Director, UMM Behavioral Health System, Inc.
 1.0
.......................0 		X           0 0 0
(74) Donata Martin
 
Director, HealthAlliance Hospitals, Inc.
 1.0
.......................0 		X           0 0 0
(75) Luis J Maseda
 
Director, Clinton Hospital Association
 1.0
.......................0 		X           0 0 0
(76) Lalita Matta MD
 
Director, UMM Accountable Care Organization, Inc.
 1.0
.......................0 		X           0 0 0
(77) Jessica McGarry
 
Director, UMM Behavioral Health System, Inc.
 1.0
.......................0 		X           0 0 0
(78) Antonia McGuire
 
Director, UMM Accountable Care Organization, Inc.
 1.0
.......................0 		X           0 0 0
(79) Cynthia M McMullen EdD
 
Director, UMM Behavioral Health System, Inc.
 1.0
.......................0 		X           0 0 0
(80) Mary Ellen McNamara
 
Director, UMM Health Care, Inc.
 1.0
.......................1.0 		X           0 0 0
(81) Anthony J Mercadante
 
Director, HealthAlliance Home Health and Hospice, Inc.
 1.0
.......................0 		X           0 0 0
(82) Nicholas Mercadante MD
 
Director, HealthAlliance Hospitals, Inc.
 1.0
.......................0 		X           0 0 0
(83) Jeffrey N Metzmaker MD
 
Director, UMM Med Group, Inc.
 29.0
.......................0 		X           431,059 0 40,121
(84) Ann K Molloy
 
Director, Marlborough Hospital
 1.0
.......................0 		X           0 0 0
(85) Dominic Nompleggi MD
 
Director, UMM Med Group, Inc.
 29.0
.......................0 		X           384,353 0 42,729
(86) Jim Notaro
 
Director, UMM Behavioral Health System, Inc.
 1.0
.......................0 		X           0 0 0
(87) O Nsidinanya Okike MD
 
Director, UMM Health Care, Inc.
 40.0
.......................5.0 		X           333,857 0 3,916
(88) Daniel O'Leary MD
 
Director, Coordinated Primary Care, Inc.
 25.0
.......................0 		X           231,203 0 8,517
(89) Edward J Parry III
 
Director, UMM Health Care, Inc.
 1.0
.......................1.0 		X           0 0 0
(90) Robert J Paulhus Jr
 
Director, Clinton Hospital Association
 1.0
.......................0 		X           0 0 0
(91) Jeanne Paulino
 
Director, Clinton Hospital Association
 1.0
.......................0 		X           0 0 0
(92) Raymond Pawlicki
 
Director, UMM Health Care, Inc.
 1.0
.......................1.0 		X           0 0 0
(93) Chris Philbin
 
Director, Clinton Hospital Association
 5.0
.......................40.0 		X           0 240,505 54,767
(94) Michael Pici MD
 
Director, UMM Accountable Care Organization, Inc.
 1.0
.......................0 		X           0 0 0
(95) Philip E Purcell
 
Director, Marlborough Hospital
 1.0
.......................0 		X           0 0 0
(96) Gerard P Richer
 
Director, Marlborough Hospital
 1.0
.......................0 		X           0 0 0
(97) Michael Rivard
 
Director, HealthAlliance Hospitals, Inc.
 1.0
.......................0 		X           0 0 0
(98) Catherine Rossi
 
Director, Clinton Hospital Association
 5.0
.......................40.0 		X           0 224,807 79,676
(99) Carol Sanchez
 
Director until 3/16, Marlborough Hospital
 1.0
.......................0 		X           0 0 0
(100) Paulette Seymour-Route PhD
 
Director, UMM Health Care, Inc.
 1.0
.......................1.0 		X           0 0 0
(101) Vibha Sharma MD
 
Director, Marlborough Hospital
 1.0
.......................0 		X           0 0 0
(102) John Shea Esquire
 
Director, UMM Behavioral Health System, Inc.
 1.0
.......................0 		X           0 0 0
(103) Robert Leslie Shelton MD
 
Director, HealthAlliance Hospitals, Inc.
 1.0
.......................0 		X           0 0 0
(104) Habib A Sioufi MD
 
Director, Clinton Hospital Association
 40.0
.......................0 		X           98,182 0 28,675
(105) Markian Stecyk MD
 
Director until 3/16, Marlborough Hospital
 1.0
.......................0 		X           0 0 0
(106) David Walton
 
Director, Marlborough Hospital
 1.0
.......................0 		X           0 0 0
(107) Mary Whitney
 
Director, HealthAlliance Hospitals, Inc.
 1.0
.......................0 		X           0 0 0
(108) Jack Wilson
 
Director, UMM Health Care, Inc.
 1.0
.......................1.0 		X           0 0 0
(109) Lynda M Young MD
 
Director, UMM Health Care, Inc.
 1.0
.......................1.0 		X           38,186 0 109
(110) Maureen Croteau
 
Assistant Clerk, Clinton Hospital Association
 40.0
.......................0 		    X       56,311 0 23,751
(111) Ann-Maria D'Ambra
 
Assistant Secretary, Marlborough Hospital
 40.0
.......................0 		    X       51,669 0 24,532
(112) Deborah Ekstrom
 
President unitl 1/16, Community HealthLink, Inc.
 40.0
.......................0 		    X       262,264 0 101,325
(113) Katharine Bolland Eshghi
 
Assistant Secretary, UMM Health Care, Inc.
 5.0
.......................40.0 		    X       0 446,099 99,297
(114) Nicole Gagne
 
President, Community HealthLink, Inc.
 40.0
.......................0 		    X       138,931 0 51,329
(115) John Glassburn
 
Secretary, UMM Community Hospitals, Inc.
 5.0
.......................40.0 		    X       0 183,869 27,316
(116) Steven McCue
 
Treasurer, Marlborough Hospital
 40.0
.......................0 		    X       203,530 0 36,233
(117) Lynn A Morin
 
Assistant Clerk, HealthAlliance Hospitals, Inc.
 40.0
.......................0 		    X       88,305 0 7,392
(118) William O'Brien
 
Secretary, UMBHS, Inc.
 5.0
.......................40.0 		    X       0 128,872 56,969
(119) Jeffrey Olson
 
Treasurer, Clinton Hospital Assoc.
 40.0
.......................0 		    X       165,334 0 43,829
(120) Jeanne Shirshac
 
Treasurer, UMM Accountable Care Organization, Inc.
 5.0
.......................40.0 		    X       0 242,946 51,524
(121) Francis W Smith
 
Secretary, UMM Medical Group, Inc.
 5.0
.......................40.0 		    X       0 211,110 44,651
(122) Michele Streeter
 
Treasurer, UMM Med Group, Inc.
 40.0
.......................0 		    X       543,626 0 200,156
(123) James P Cyr
 
Sr. VP, Operations (UMMMC)
 40.0
.......................5.0 		      X     348,466 0 167,720
(124) Therese Day
 
VP, Finance / CFO of Med Center
 40.0
.......................5.0 		      X     370,867 0 137,469
(125) Robert Feldmann
 
VP, Corporate Controller
 5.0
.......................40.0 		      X     0 355,276 109,162
(126) Barbara Fisher
 
Sr VP, Operations (UMMMC)
 40.0
.......................5.0 		      X     353,025 0 170,362
(127) Patricia George
 
VP & Deputy CIO, until 11/15
 5.0
.......................40.0 		      X     0 386,592 51,347
(128) Margaret Hudlin MD
 
CMO/VP Perioperative Svcs, until 9/1/16
 40.0
.......................5.0 		      X     546,659 0 61,664
(129) Cathy Jewell
 
Sr VP, Chief Nursing Officer
 40.0
.......................5.0 		      X     352,592 0 137,588
(130) Bart Metzger
 
Sr VP, Chief HR Officer
 5.0
.......................40.0 		      X     0 359,315 51,512
(131) John T Randolph
 
VP, Chief Corporate Compliance
 5.0
.......................40.0 		      X     0 273,396 126,045
(132) Alice Shakman
 
Sr. VP, Operations (UMMMC)
 40.0
.......................5.0 		      X     352,925 0 125,192
(133) Jeffrey A Smith MD
 
Executive VP, COO
 40.0
.......................5.0 		      X     385,203 0 39,390
(134) Timothy Tarnowski
 
Sr VP, Chief Info Officer
 5.0
.......................40.0 		      X     0 558,717 92,115
(135) Diane Thompson
 
Sr. VP, Chief Nursing Officer until 4/9/15
 40.0
.......................5.0 		      X     549,531 0 24,956
(136) David C Ayers MD
 
Physician, Chair of Orthopedics and Physical Rehab - Med Group
 33.0
.......................0 		        X   664,005 0 42,147
(137) Adel Bozorgzadeh MD
 
Physician, Chief of Organ Transplantation - Med Group
 32.0
.......................0 		        X   737,836 0 42,729
(138) Demetrius Litwin MD
 
Physician, Chair of Surgery Dept - Med Group
 28.0
.......................0 		        X   741,852 0 45,385
(139) Ajit S Puri MD
 
Physician, Division Chief of Neuroimaging and Intervention - Med Group
 40.0
.......................0 		        X   690,581 0 38,256
(140) Jennifer Walker MD
 
Physician, Division Chief of Cardiac Surgery - Med Group
 30.0
.......................0 		        X   635,639 0 41,378
(141) Sharon Hylka
 
Former Sr. VP, Hospital Admin until 1/14
 0
.......................0 		          X 298,006 0 109
(142) Robert A Phillips MD
 
Former Med Dir, Heart & Vascular COE, until 6/7/13
 0
.......................0 		          X 783,997 0 109
(143) Arthur M Pappas MD
 
Former Director UMM Community Hospitals, Inc. until 3/27/13
 0
.......................0 		          X 13,781 0 2,129
(144) Michael J Cofone
 
Former Officer/Director until 6/14, HealthAlliance Hospitals, Inc.
 0
.......................0 		          X 93,335 0 12,518
(145) Candra D Szymanski
 
Former Interim President/Director until 12/13, Marlborough Hospital
 0
.......................0 		          X 35,868 0 1,608
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 19,884,388 7,684,396 5,414,083
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet2,658
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. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
UMass Memorial Shields Pharmacy

25 Rockwood Road
Marshfield,MA02050 		Pharmacy Management Services 19,418,849
Xerox Business Services LLC

PO Box 201322
Dallas,TX75320 		I/S Management Services 17,651,003
Quest Diagnostics Inc

PO Box 51048
Los Angeles,CA90074 		Laboratory Services 10,477,702
Innerwireless Inc

1155 Kas Drive
Richardson,TX75080 		Consulting Services 9,072,656
SODEXO INC & AFFILIATES

PO BOX 360170
PITTSBURGH,PA152515170 		Dietary Management Services 6,084,221
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet201
Form 990 (2015)
Form 990 (2015)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c 364,455
d Related organizations1d 841,042
e Government grants (contributions)1e 10,868,394
f All other contributions, gifts, grants, and similar amounts not included above1f 1,800,494
g Noncash contributions included in lines 1a-1f:$ 5,834
h Total.Add lines 1a-1f.......MediumBullet 13,874,385
Program Service RevenueAmt Business Code
2a NET PATIENT SERVICE REVENUE 622110 2,080,346,810 2,080,346,810    
b Transitional payments 622110 25,976,496 25,976,496    
c SPECIAL MEDICAID PAYMENTS 622110 196,003,744 196,003,744    
d AFFILIATE RELATED PROGRAMS 622110 8,305,494 8,305,494    
e OTHER PSR & JV income 622110 40,469,765 38,034,601 2,435,164  
f All other program service revenue. 0 0 0 0
g Total.Add lines 2a–2f.....MediumBullet 2,351,102,309
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ..........MediumBullet 5,662,159 58,510 8,123 5,595,526
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   2,745,836
b Less: rental expenses   1,454,635
c Rental income or (loss) 0 1,291,201
d Net rental income or (loss)......MediumBullet 1,291,201     1,291,201
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 801,134 33,099,803
b Less: cost or other basis and sales expenses 1,282,791 32,155,965
c Gain or (loss) -481,657 943,838
d Net gain or (loss).....MediumBullet 462,181 8,947   453,234
8a Gross income from fundraising events (not including $ 364,455of contributions reported on line 1c). See Part IV, line 18 ....
a 336,811
b Less: direct expenses ...b 333,107
c Net income or (loss) from fundraising events..MediumBullet 3,704   3,704
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        
Business Code Miscellaneous Revenue
11a Lab services 621500 1,126,902   1,126,902  
b Cafeteria income 722514 6,746,695     6,746,695
c Other income 900099 381,216 381,216    
d All other revenue .... 34,892 33,244 0 1,648
e Total. Add lines 11a–11d ...... MediumBullet 8,289,705
12 Total revenue. See Instructions......MediumBullet 2,380,685,644 2,349,149,062 3,570,189 14,092,008
Form 990 (2015)
Form 990 (2015)
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).Check if Schedule O contains a response or note to any line in this Part IX ..............
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 domestic organizations and domestic governments. See Part IV, line 21 2,293,555 2,293,555
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 19,365 19,365
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 20,973,671 14,779,530 6,194,141  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 830,241 768,436 61,805  
7 Other salaries and wages 941,290,531 811,822,891 129,146,899 320,741
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 66,849,598 57,674,874 9,171,986 2,738
9 Other employee benefits ....... 128,886,215 106,582,643 22,288,414 15,158
10 Payroll taxes ........... 62,890,080 53,699,708 9,180,206 10,166
11 Fees for services (non-employees):        
a Management ...... 23,977,410 23,977,410    
b Legal ......... 775,714 309,066 466,648  
c Accounting ........... 144,424 4,628 139,796  
d Lobbying ........... 251,639 251,639    
e Professional fundraising services. See Part IV, line 17 64,000 64,000
f Investment management fees ...... 415,857 15,949 399,908  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 315,631,600 305,011,299 10,515,629 104,672
12 Advertising and promotion .... 377,360 139,062 238,268 30
13 Office expenses ....... 20,078,277 14,946,610 5,120,362 11,305
14 Information technology ...... 6,310,345 5,165,443 1,144,902  
15 Royalties ..        
16 Occupancy ........... 57,922,688 54,868,006 3,054,682  
17 Travel ............ 2,049,101 1,944,328 104,124 649
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 1,746,271 1,226,920 518,788 563
20 Interest ........... 12,283,313 11,859,393 423,920  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 109,886,318 105,059,205 4,827,113  
23 Insurance ... 30,725,415 29,236,039 1,489,376  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a Medical supplies 274,420,140 274,412,912 7,228  
b System overhead activities 175,508,772 113,441,720 62,067,052  
c Purchased Services 46,358,519 43,354,428 2,969,384 34,707
d Other direct expenses 17,097,263 16,972,304 124,559 400
e All other expenses 21,195,474 17,108,010 4,017,239 70,225
25 Total functional expenses. Add lines 1 through 24e 2,341,253,156 2,066,945,373 273,672,429 635,354
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2015)
Form 990 (2015)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 119,788,165 1 191,489,188
2 Savings and temporary cash investments ......... 65,070,897 2 63,766,485
3 Pledges and grants receivable, net ...... 562,552 3 287,699
4 Accounts receivable, net ............. 250,995,615 4 233,620,773
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
4,703,689 5 4,939,026
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
0 6 0
7 Notes and loans receivable, net .... 33,456,546 7 708,634
8 Inventories for sale or use ........ 29,117,718 8 33,651,047
9 Prepaid expenses and deferred charges ...... 22,899,661 9 10,196,362
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,701,073,995
b Less: accumulated depreciation 10b 1,087,059,979 583,528,506 10c 614,014,016
11 Investments—publicly traded securities . 72,182,619 11 106,919,586
12 Investments—other securities. See Part IV, line 11 ..... 519,994,237 12 247,650,026
13 Investments—program-related. See Part IV, line 11 .. 63,800,082 13 77,551,505
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 524,735,084 15 233,775,196
16 Total assets. Add lines 1 through 15 (must equal line 34)... 2,290,835,371 16 1,818,569,543
Liabilities 17 Accounts payable and accrued expenses ..... 286,431,598 17 262,689,839
18 Grants payable ... 338,032 18 1,009,563
19 Deferred revenue ......... 6,297,369 19 8,501,757
20 Tax-exempt bond liabilities ......... 327,411,105 20 375,930,725
21 Escrow or custodial account liability. Complete Part IV of Schedule D 0 21 14,680
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.. 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 43,756,483 23 6,003,466
24 Unsecured notes and loans payable to unrelated third parties .. 50,000,000 24 55,000,000
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D 668,427,726 25 547,606,667
26 Total liabilities. Add lines 17 through 25.. 1,382,662,313 26 1,256,756,697
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets 747,417,618 27 463,903,452
28 Temporarily restricted net assets ........... 76,999,973 28 43,180,568
29 Permanently restricted net assets 83,755,467 29 54,728,826
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ..... 0 30 0
31 Paid-in or capital surplus, or land, building or equipment fund ... 0 31 0
32 Retained earnings, endowment, accumulated income, or other funds 0 32 0
33 Total net assets or fund balances ........... 908,173,058 33 561,812,846
34 Total liabilities and net assets/fund balances ........ 2,290,835,371 34 1,818,569,543
Form 990 (2015)
Form 990 (2015)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
2,380,685,644
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
2,341,253,156
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
39,432,488
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
908,173,058
5
Net unrealized gains (losses) on investments ...............
5
7,229,277
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-393,021,977
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
561,812,846
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line 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
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 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?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
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 (2015)
Form 990 (2015)
Additional Data


Software ID: 15000238
Software Version: 2015v3.0
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 Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
UMass Memorial Health Care Inc & Affiliates
 
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
6
7
8
9
10
11
a
b
c
d
e
f
Enter the number of supported organizations ..............  

g
Provide the following information about the supported organization(s).
(i)Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total      

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10.  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 3
Part III
Support Schedule for Organizations Described in Section 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) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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 VI.) ..            
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) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    

Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    

Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity		  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions		  
9 Distributable amount for 2015 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  

Section E - Distribution Allocations (see instructions) (i)
Excess Distributions 		(ii)
Underdistributions
Pre-2015 		(iii)
Distributable
Amount for 2015
1 Distributable amount for 2015 from Section C, line
6 		 
2 Underdistributions, if any, for years prior to 2015
(reasonable cause required--see instructions)		  
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......  
e From 2014.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2015 distributable amount  
i Carryover from 2010 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2015 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2015 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2015, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)		  
6 Remaining underdistributions for 2015. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)		  
7 Excess distributions carryover to 2016. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a
b
c Excess from 2013.......  
d From 2014.......  
e From 2015.......  
Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2015


Additional Data


Software ID: 15000238
Software Version: 2015v3.0
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.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Name of the organization
UMass Memorial Health Care Inc & Affiliates
 
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 on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, 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) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2
Name of organization
UMass Memorial Health Care Inc & Affiliates
  		Employer identification number
91-2155626
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
 
 

   
 
 
  ,    

$ RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page 3
Name of organization
UMass Memorial Health Care Inc & Affiliates
  		Employer identification number

91-2155626
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(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) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page 4
Name of organization
UMass Memorial Health Care Inc & Affiliates
  		Employer identification number

91-2155626
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. 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 $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(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) (2015)

Additional Data


Software ID: 15000238
Software Version: 2015v3.0
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 BulletInformation about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
If the organization answered "Yes" on 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" on 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" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
UMass Memorial Health Care Inc & Affiliates
 
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 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 function 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-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2015

Schedule C (Form 990 or 990-EZ) 2015
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 SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2012 (b) 2013 (c) 2014 (d) 2015 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))		  
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2015


Schedule C (Form 990 or 990-EZ) 2015
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)).
For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
251,639
j
Total. Add lines 1c through 1i ....................................................................................................
251,639
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 carry over 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) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible 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
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Amounts represent percentage of lobbying expenses included in membership dues.
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Amounts represent percentage of lobbying expenses included in membership dues.
Schedule C (Form 990 or 990EZ) 2015


Additional Data


Software ID: 15000238
Software Version: 2015v3.0

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
UMass Memorial Health Care Inc & Affiliates
 
Employer identification number

91-2155626
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year ....    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of 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 can 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" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 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, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, 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 section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, 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" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), 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 XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), 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)
Revenue included on 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 (ASC 958) relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, 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 XIII.
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" on 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 XIII and complete the following table: Amount
c Beginning balance ............................. 1c 14,575
d Additions during the year ............................ 1d 2,998
e Distributions during the year .......................... 1e 2,893
f Ending balance ................................ 1f 14,680
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" on 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 .... 117,475,856 115,101,660 112,462,194 109,418,023 98,294,963
b Contributions ... 174,883 5,757,118     2,557,800
c Net investment earnings, gains, and losses 5,899,351 -2,182,362 9,419,969 8,142,465 12,021,986
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		44,636,958 1,200,560 4,425,190 5,098,294 3,456,726
f Administrative expenses ....     2,355,313    
g End of year balance ...... 78,913,132 117,475,856 115,101,660 112,462,194 109,418,023
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet69 %
c
Temporarily restricted endowment SchDMd Bullet31 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
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)
Yes
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment) 		(b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land ...   8,807,895 8,807,895
b Buildings   816,592,345 502,096,923 314,495,422
c Leasehold improvements   22,955,026 12,110,854 10,844,172
d Equipment ...   749,226,170 568,859,754 180,366,416
e Other ...   103,492,559 3,992,448 99,500,111
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 614,014,016
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. 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) BENEFICIAL INTEREST IN TRUSTS 		66,380,579 F

(B) COMMONWEALTH PROFESSIONAL ASSURANCE COMPANY LTD 		   

(C) BIO VENTURES 		   

(D) UNITS IN INVESTMENT PARTNERSHIP 		181,269,447 F

(E) OTHER 		   
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 247,650,026
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) DUE FROM RELATED PARTIES 2,432,911
(2) CSV LIFE INSURANCE  
(3) MALPRACTICE TAIL COVERAGE 33,862,724
(4) LONG TERM SECURITY DEPOSITS 63,722
(5) OTHER NON-CURRENT ASSETS 471,544
(6) RECEIVABLE FROM MEDICAID 179,005,364
(7) DUE FROM THIRD PARTIES 17,877,251
(8) CASH SECURITY 14,680
(9) DEFERRED TAX ASSET 47,000
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 233,775,196
Part X
Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
DUE TO UMASS MEDICAL SCHOOL 139,559,305
THIRD PARTY LIABILITIES 68,355,031
DUE TO RELATED PARTIES 3,409,148
ACCRUED PENSION POST RETIREMENT BENEFITS 287,876,097
O/S LOSS RESERVES  
ESTIMATED MALPRACTICE COSTS 33,862,724
OTHER 1,792,489
ANNUITY PAYABLE  
LT LIABILITY ARO 9,858,847
ACCRUED LT LIABILITIES 842,901
CLAIMS RESERVE 89,125
MEDICARE RESERVES 30,000
NOTE PAYABLE TO AFFILIATES (MC AND UMBHS)  
OTHER LOSS RESERVE 1,931,000
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 547,606,667
2. Liability for uncertain tax positions. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
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 (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 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 XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
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 XIII.) ............ 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 XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  

Part XIII
Supplemental Information
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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Schedule D, Part V, Line 3a(i) Sch d, part v, line 3a(i) HEALTHALLIANCE HOSPITAL - YES 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. BNY MELLON WEALTH MANAGEMENT HOLDS THE FOLLOWING TRUSTS FOR HEALTHALLIANCE HOSPITAL: TRUST U/WILL PART 11 WILLIAM H CROPPER TRUST U/WILL PART 15 WILLIAM H CROPPER TRUST U/WILL PART 18 WILLIAM H CROPPER TRUST UNDER 2ND CODICIL OF WILL OF WILLIAM H CROPPER TRUST UNDER 4TH CODICIL WILLIAM H CROPPER DISTRIBUTIONS ARE PAID TO HEALTHALLIANCE HOSPITAL. BNY MELLON WEALTH MANAGEMENT IS AN UNRELATED ORGANIZATION.
Schedule D, Part V Endowment Funds The Medical Center's endowment funds are the beneficial interest in the funds held by the UMMHC (Parent EIN 04-3358566).
Schedule D, Part V, Line 1e Endowment Funds - Other expenditures for facilities and programs UMMHC (Parent) was previously included in the group return #3642 EIN 91-2155626 however effective 9/30/16 the Parent has been removed from the group return and is reported on a stand alone Form 990. Line 1e Other expenditures for facilities and programs includes the removal of the Parent's endowment funds of ($43,468,455).
Schedule D, Part IV, Line 1b Agent, trustee, custodian, or other intermediary arrangement Tenant security deposits for UMass Memorial Realty, Inc.
Schedule D, Part IV, Line 2b Explanation of escrow agreement Tenant security deposits for UMass Memorial Realty, Inc. These will be returned once the tenant vacates the property.
Schedule D, Part V, Line 4 Intended uses of endowment funds MEDICAL CENTER - THE MEDICAL CENTER'S BENEFICIAL INTEREST IN FUNDS ARE HELD BY THE PARENT, A RELATED ORGANIZATION. 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. 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. CLINTON 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. MARLBOROUGH 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, Part X, Line 2 FIN 48 (ASC 740) 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 was $301,000 and $94,500 for the years ended September 30, 2016 and 2015, respectively, 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.
Schedule D (Form 990) 2015


Additional Data


Software ID: 15000238
Software Version: 2015v3.0




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" on 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 arrowAttach to Form 990 or Form 990-EZ.
right arrowInformation about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
UMass Memorial Health Care Inc & Affiliates
 
Employer identification number

91-2155626
Part I
Fundraising Activities. Complete if the organization answered "Yes" on Form 990, Part IV, line 17.
Form 990-EZ filers are not required to complete this part.
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.


(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
 
JNB ASSOCIATES
21 WATER STREET
 
AMESBURY, MA01913 		FUNDRAISING   No   64,000 -64,000
             
             
             
             
             
             
             
             
             
Total . . . . . . . . . . . . . . . . . . . . right arrow 0 64,000 -64,000
3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.
MA, NH
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2015
Schedule G (Form 990 or 990-EZ) 2015
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.




VerticalRevenue
(a) Event #1

CNEHA GOLF TOURNAMENT
(event type) 		(b) Event #2

CLINTON GOLF TOURNAMENT
(event type) 		(c) Other events

5
(total number) 		(d) Total events
(add col. (a) through col. (c))

1
Gross receipts . . . . .
275,898
121,789
303,579
701,266

2
Less: Contributions . . . .
144,331
65,407
154,717
364,455
3 Gross income (line 1 minus
line 2) . . . . . .
131,567
56,382
148,862
336,811



VerticalDirectExpenses
4 Cash prizes . . . . .        
5 Noncash prizes . . . . 30,154   22,164 52,318
6 Rent/facility costs . . . . 78,751 21,805 53,661 154,217
7 Food and beverages . . . 0 24,859 16,995 41,854
8 Entertainment . . . .        
9 Other direct expenses . . . 22,662 9,718 52,338 84,718
10 Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . . right arrow 333,107
11 Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . . right arrow 3,704
Part III
Gaming. Complete if the organization answered "Yes" on 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
Noncash prizes . . . .
 
 
 
 

4
Rent/facility costs . . . .
 
 
 
 

5
Other direct expenses . . .
22,662
9,718
52,338
84,718


6

Volunteer labor . . . .
%
%
%


7
Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow
 

8
Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow
 

9
Enter the state(s) in which the organization conducts gaming activities:
a
Is the organization licensed to conduct 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:
 
Schedule G (Form 990 or 990-EZ) 2015
Schedule G (Form 990 or 990-EZ) 2015
Page 3
11
Does the organization conduct 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? . . . . . . . . . . . . . . . . .
13
Indicate the percentage of gaming activity conducted in:
a
The organization's facility . . . . . . . . . . . . . . . . . .
13a
%
b
An outside facility . . . . . . . . . . . . . . . . . . . .
13b
%
14
Enter 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 of the third party:
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
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).
Return Reference Explanation
Schedule G, Part II PART II COL A: EVENT #1 1. THE HOSPITAL GOLF TOURNAMENT WAS HELD BY CENTRAL NEW ENGLAND HEALTHALLIANCE, INC. COL B: EVENT #2 2. THE HOSPITAL GOLF TOURNAMENT WAS HELD BY BY CLINTON HOSPITAL ASSOCIATION. COL C: OTHER EVENTS 3. SPEAKEASY HELD BY HEALTHALLIANCE HOSPITALS 4. LOVELIGHT HELD BY HEALTHALLIANCE HOME HEALTH AND HOSPICE, INC 5. GALA BALL WAS HELD BY CENTRAL NEW ENGLAND HEALTHALLIANCE, INC 6. GOLF TOURNAMENT WAS HELD BY MARLBOROUGH HOSPITAL, INC 7. MENTAL HEALTH MONTH EVENT WAS HELD BY COMMUNITY HEALTHLINK, INC.
Schedule G (Form 990 or 990-EZ) 2015
Additional Data


Software ID: 15000238
Software Version: 2015v3.0
SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
UMass Memorial Health Care Inc & Affiliates
 
Employer identification number

91-2155626
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance 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 discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did 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
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance 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 Financial Assistance at cost
(from Worksheet 1) . . . 		    37,936,908 22,992,218 14,944,690 0.80 %
b Medicaid (from Worksheet 3, column a) . . . . .     381,007,912 338,124,618 42,883,294 2.31 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     16,411,581 16,319,433 92,148 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 0 435,356,401 377,436,269 57,920,132 3.12 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     4,038,253 2,203,184 1,835,069 0.10 %
f Health professions education (from Worksheet 5) . . .     234,163,901 128,897,437 105,266,464 5.66 %
g Subsidized health services (from Worksheet 6) . . . .     89,010,247 71,335,252 17,674,995 0.95 %
h Research (from Worksheet 7) .     153,202 49,850 103,352 0.01 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     2,238,059 2,238,059 0 0 %
j Total. Other Benefits . . 0 0 329,603,662 204,723,782 124,879,880 6.72 %
k Total. Add lines 7d and 7j . 0 0 764,960,063 582,160,051 182,800,012 9.83 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(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     7,799 0 7,799 0 %
2 Economic development     0 0 0 0 %
3 Community support     8,806   8,806 0 %
4 Environmental improvements     0 0 0 0 %
5 Leadership development and
training for community members		     0 0 0 0 %
6 Coalition building     1,190 0 1,190 0 %
7 Community health improvement advocacy     0 0 0 0 %
8 Workforce development     146,727 0 146,727 0.01 %
9 Other         0 0 %
10 Total 0 0 164,522 0 164,522 0.01 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did 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. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
26,537,000
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
1,445,372
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
393,264,874
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
407,766,841
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-14,501,967
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
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(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 %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?4
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 UMASS MEMORIAL MEDICAL CENTER INC
55 LAKE AVE 119 BELMONT STREET
WORCESTER,MA01605
www.umassmemorialhealthcare.org
2124, 2841 		X X X X   X X      
2 HEALTHALLIANCE HOSPITAL INC
60 HOSPITAL ROAD
LEOMINSTER,MA01453
www.umassmemorialhealthcare.org/healthalliance-hospital
2127 		X X   X     X      
3 MARLBOROUGH HOSPITAL
157 UNION STREET
MARLBOROUGH,MA01752
www.umassmemorialhealthcare.org/marlborough-hospital
2103 		X X   X     X      
4 CLINTON HOSPITAL ASSOCIATION
201 HIGHLAND STREET
CLINTON,MA01510
www.umassmemorialhealthcare.org/clinton-hospital
2126 		X X   X     X      
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
UMASS MEMORIAL MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 14
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): https://www.umassmemorialhealthcare.org/sites/umass-memorial-hospital/files/Documents/CB%
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
UMASS MEMORIAL MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
See Sch H, Part V, Section B, Line 16i
b
See Sch H, Part V, Section B, Line 16i
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

UMASS MEMORIAL MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
HEALTHALLIANCE HOSPITAL INC
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		2
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): www.healthalliance.com
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
HEALTHALLIANCE HOSPITAL INC
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
https://www.umassmemorialhealthcare.org/healthalliance-hospital
b
https://www.umassmemorialhealthcare.org/healthalliance-hospital
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

HEALTHALLIANCE HOSPITAL INC
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
MARLBOROUGH HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		3
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): http://www.umassmemorialhealthcare.org/about-us/community-benefits-program/marlborough-h
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
MARLBOROUGH HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
https://www.umassmemorialhealthcare.org/marlborough-hospital/financial-counseling
b
https://www.umassmemorialhealthcare.org/marlborough-hospital/financial-counseling
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

MARLBOROUGH HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
CLINTON HOSPITAL ASSOCIATION
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		4
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 14
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): clintonhospital.org
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
CLINTON HOSPITAL ASSOCIATION
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
See Sch H, Part V, Section B, Line 16i
b
See Sch H, Part V, Section B, Line 16i
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

CLINTON HOSPITAL ASSOCIATION
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 7
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Schedule H, Part V, Section B, Line 3 Facility , 1 Facility , 1 - UMass Memorial Medical Center. The most recent CHNA also includes an Impact Evaluation Summary (final Appendix) of previous CHNA.
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - UMass Memorial Medical Center. Yes, input from diverse persons who represent the community was taken into account. UMass Memorial Medical Center joined efforts with the Worcester Division of Public Health (WDPH), Fallon Health and Common Pathways, a healthy communities coalition that is comprised of 30+ health and human service organizations, in the development of its Community Health Needs Assessment (CHNA). The director of the WDPH, UMass Memorial Vice President of Community Relations, and Fallon Health co-chaired the leadership process to develop a CHNA and Community Health Improvement Plan (CHIP) for the Greater Worcester region. During the assessment process, community members were engaged in key informant interviews, focus groups, and community dialogues conducted in several low income/underserved neighborhoods, including Worcester's Bell Hill/Plumley Village neighborhood, which has a large Hispanic, Black and new immigrant population, the Main South area, which is also very low income with significant minority/medically-underserved populations. Dialogues were also held at Worcester's two community health centers and ethnic and minority-serving, community and faith-based organizations including; the Albanian Association, African Community Education, the Boys & Girls Club of Worcester, Iglesia Evangelica de Worcester, Grace Christian Centre Church the Green Hill Neighborhood Association and others. The dialogues allowed for community members of underserved areas to review and discuss a profile of the region and provide their feedback on community health-related strengths, needs, and a vision for the future. Ten community dialogue sessions were held: five sessions in Worcester, and five in the outlying communities (Shrewsbury, Grafton, Millbury, West Boylston, Leicester, and Holden). More than a total of 1,777 individuals (including participants in an online community survey) representing diverse institutions and community organizations from across the region worked together to establish a roadmap for the future health of the region. The process included a Steering Committee comprised of a diverse number of stakeholders that advised and informed the CHNA.
Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - UMass Memorial Medical Center. UMass Memorial conducted the CHNA in collaboration with the Worcester Division of Public Health and Fallon Health. Additional partners included: YWCA of Central MA South East Asian Coalition March of Dimes Worcester Public Schools Family Health Center of Worcester Edward M. Kennedy Health Center UMass Medical School Worcester Police Department Worcester Senior Center Worcester Food & Active Living Policy Council WalkBike Worcester Regional Environmental Council of Worcester MA Department of Public Health United Way of Central MA Clark University Mosakowski Institute for Public Enterprise Worcester Regional Research Bureau
Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - UMass Memorial Medical Center. The CHNA was publicly announced to the community at an event attended by more than 100 community stakeholders and hosted by the Worcester City Manager, Worcester Director of Public Health, Senior Vice President of UMass Memorial Health Care, President of the UMass Memorial Health Care Hospitals and the UMass Memorial Vice President of Community Relations. The hospital and WDPH also engaged in various media venues including; print and online articles in local news and community newspapers, CHNA-8, a Healthy Communities Coalition and interviews televised on WCCATV13.
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - UMass Memorial Medical Center. The hospital conducted its most recent Community Health Needs Assessment in tax year 2014 and developed its implementation strategy. The Board of Trustees approved the Community Health Needs Assessment on the last day of the tax year 2014 and implementation strategies were developed and approved in tax year 2015. The prioritization process was lead by the Worcester Division of Public Health, Fallon Health and the hospital Vice President of Community Benefits and included input from approximately 100 community stakeholders. This process will result in the development of the 2016 Greater Worcester Community Health Improvement Plan (CHIP). The hospital's Community Benefit Implementation Strategy has alignment with the CHIP. The other needs that are not included in the CHNA/CHIP are not being addressed because they are not a part of the identified priority CHIP Domain areas and due to limited funding.
Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - UMass Memorial Medical Center. Financial Assistance - UMassMemorial Medical Center employs a staff of Financial Counselors, Certified Application 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, Certified Application Counselors, Customer Service Representatives and Guarantor Collectors provide potentially eligible patients with the appropriate methods of applying for health care coverage as listed on the Massachusetts ConnectorCare website
Schedule H, Part V, Section B, Line 16 Facility , 2 Facility , 2 - UMASS MEMORIAL MEDICAL CENTER. Sch H, Part V, Section B, Lines 16 a-c Website for FAP, its application, and its plain language summary: https://www.umassmemorialhealthcare.org/umass-memorial-medical-center/patients-visitors/patient-resources/financial-assistance
Schedule H, Part V, Section B, Line 18d Facility , 1 Facility , 1 - UMass Memorial Medical Center. Medical Center 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 basis. We also send statements and make phone calls.
Schedule H, Part V, Section B, Line 19d Facility , 1 Facility , 1 - UMass Memorial Medical Center. 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.
Schedule H, Part V, Section B, Line 22 Facility , 1 Facility , 1 - UMass Memorial Medical Center. UMMC utilized the look back method to determine the percentage of the amount generally billed to patients as it applies to this Financial Assistance Policy. A combination of the previous year charges and payments for commercial and Medicare insurance products are used to determine the Payment on Account Factor (PAF).
Schedule H, Part V, Section B, Line 24 Facility , 1 Facility , 1 - UMass Memorial Medical Center. 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.
Schedule H, Part V, Section B, Line 3 Facility , 1 Facility , 1 - UMass Memorial - HealthAlliance Hospital. The Community Health Assessment process consisted of a comprehensive gathering of quantitative (i.e., health status indicators) and qualitative data, through focus groups with community members and through interviews with community members and community leaders. Participants were drawn from among community-based, educational, civic, governmental, and faith-based professionals, health care providers, and others, and every effort was made to ensure racial/ethnic, socioeconomic, and geographic diversity in the composition of focus groups and interview participants. HealthAlliance Hospital collaborated with the Joint Coalition on Health (JCOH) and Heywood Hospital to conduct a comprehensive Community Health Assessment that gathered, analyzed and documented qualitative and quantitative data.
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - UMass Memorial - HealthAlliance Hospital. The Community Health Assessment process consisted of a comprehensive gathering of Quantitative (i.e., health status indicators) and qualitative data, through focus groups with community members and through interviews with community members and community leaders. Participants were drawn from among community-based, educational, civic, governmental, and faith-based professionals, health care providers, and others, and every effort was made to ensure racial/ethnic, socioeconomic, and geographic diversity in the composition of focus groups and interview participants. HealthAlliance Hospital collaborated with the Joint Coalition on Health (JCOH) and Heywood Hospital to conduct a comprehensive Community Health Assessment (CHA) that gathered, analyzed and documented qualitative and quantitative data. Qualitative data for the CHA was gathered through 16 Focus Groups with 228 participants including, public health professionals, social service professionals, clinicians and other medical providers, behavioral health providers, Latino adults and youth, Hmong individuals, Black/African American adults, Brazilian adult women, Veterans, LGBTQ youth, high school students, adults with major mental illness and homeless individuals. 26 Key Informant interviews were conducted with individuals representing diverse, low-income and medically-underserved communities and populations of North Central Massachusetts.
Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - UMass Memorial - HealthAlliance Hospital. HealthAlliance Hospital conducted a Community Health Needs Assessment with Heywood Healthcare (Heywood Hospital and Athol Hospital)
Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - UMass Memorial - HealthAlliance Hospital. . The Community Health Needs Assessment was conducted with input from our community partners: Community Health Connections, Heywood Healthcare, Athol Hospital, Heywood Hospital, The Joint Coalition on Health and the Montachusett Public Health Network
Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - UMass Memorial - HealthAlliance Hospital. Community Health Assessment was made available through our website and presentations to various organizations and community forums throughout our service areas. The Community Health Assessment is also available upon request. You can find the link to our Community Health Needs Assessment here: http://www.umassmemorialhealthcare.org/sites/umass-memorial-hospital/files/Documents/Members/5-21-15%20Final%20Community_Health_Assessment_of_North_Central_MA.pdf
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - UMass Memorial - HealthAlliance Hospital. The hospital responds to priority health needs in many ways, and in times that are critical for patients in crisis. In addition to charity care, indigent care, a significant number of programs and services offered address some of the priority needs identified in the CHNA. Our hospital does not have the available resources to develop initiatives to meet all identified health needs, which makes collaboration with community resources critical.
Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - HealthAlliance Hospital. HealthAlliance Hospital 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.
Schedule H, Part V, Section B, Line 20 Facility , 1 Facility , 1 - HealthAlliance Hospital. 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.
Schedule H, Part V, Section B, Line 22 Facility , 1 Facility , 1 - HealthAlliance Hospital. HealthAlliance charges utilized a lookback method to determine the percentage of the amount generally billed to patients as it applies to this Financial Assistance Policy. A combination of the previous year charges and payments for commercial and Medicare insurance products are used to determine the Payment on Account Factor (PAF).
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Marlborough Hospital. The process included gathering community input, as well as analysis of general data collected from the hospital and publicly available data sources. The process also incorporated a survey component that was available in English, Spanish and Portuguese, as well as key informant interviews and focus groups. Numerous community partners who represent the underserved provided input. Partners included Councils on Aging, public schools' nursing directors, Departments of Public Health, Employment Options (a mental health agency), city representatives and members of local faith communities.
Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - Marlborough Hospital. The CHNA was completed in conjunction with the MetroWest Medical Center.
Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - Marlborough Hospital. The CHNA was completed in conjunction with MetroWest Health Foundation, MetroWest Medical Center, Hudson Health Department, and Framingham Health Department.
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Marlborough Hospital. The hospital responds to priority health needs in many ways, and in times that are critical for patients in crisis. In addition to charity care, indigent care, a significant number of programs and services offered address the priority needs identified in the Community Health Needs Assessment (CHNA). Our hospital does not have the available resources to develop initiatives to meet every priority health need identified, which makes collaboration with community agencies critical. The hospital is not currently addressing all chronic conditions due to limited resources.
Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - Marlborough Hospital. Financial Assistance - Marlborough Hospital employs Financial Counselors who are available by phone or by appointment to support patients in applying for financial assistance and for help resolving their medical bills. Financial Counselors provide potentially eligible patients with the appropriate methods of applying for health care coverage as listed on the Massachusetts ConnectorCare website.
Schedule H, Part V, Section B, Line 18d Facility , 1 Facility , 1 - Marlborough Hospital. 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.
Schedule H, Part V, Section B, Line 19d Facility , 1 Facility , 1 - Marlborough Hospital. 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.
Schedule H, Part V, Section B, Line 22 Facility , 1 Facility , 1 - Marlborough Hospital. Marlborough Hospital utilized the look back method to determine the percentage of the amount generally billed to patients as it applies to this Financial Assistance Policy. A combination of the previous year charges and payments for commercial and Medicare insurance products are used to determine the Payment on Account Factor (PAF).
Schedule H, Part V, Section B, Line 24 Facility , 1 Facility , 1 - Marlborough Hospital. 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.
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Clinton Hospital. Clinton hospital took into account input from the community health assessment, representatives of the community, including diverse members who were interviewed in the Community Health Assessment Focus groups for gathering qualitative data. The hospital reached out to individuals who held membership at the WHEAT Social Services food pantry, and with members of low educational attainment at The Clinton Adult Learning Center, those that live in low-income housing development, and are of Latino/multiracial ethnicity in efforts to ensure racial/ethnic, socioeconomic and geographic diversity were in the composition of the health needs assessment. The hospital specifically works on an ongoing basis with these organizations and the Community Health Network Area 9 (CHNA 9); a local coalition of public, non-profit, and private sectors working together to build healthier communities in the North Region of Massachusetts through community-based prevention planning and health promotion. Other partners included; The board of health, key stakeholders in health improvement: community area residents, coalitions, communities of faith, businesses, and providers of community-based health, education, human services, and local and state governments. Clinton Hospital utilized the information to collaborate with other local community based organizations to adopt implementation strategies that address the unmet health needs of Clinton Hospital's catchment area.
Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - Clinton Hospital. Clinton Hospital collaborated with two other hospitals in conducting the Community Health Assessment of North Central Massachusetts in a joint effort between the Massachusetts Department of Public Health's Community Health Network Area of North Central Massachusetts (CHNA 9) and the Joint Coalition on Health (JCOH) assessment. They include HealthAlliance, an affiliate of UMass Memorial Health Care and Heywood Hospital. Together, these entities have capitalized on their complementary expertise and have produced a document that can be used by stakeholders from every sector of the community to better the health and welfare of residents of North Central Massachusetts.
Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - Clinton Hospital. Clinton Hospital conducted the CHNA with the following listed organizations: Partners included: The Community Health Network Area of North Central Mass. (CHNA 9) The Joint Coalition on Health of North Central Massachusetts. The Minority Coalition of North Central Massachusetts. The qualitative work was completed with the combined efforts of the Minority Coalition of North Central Massachusetts, the Spanish American Center, Cleghorn Neighborhood Center, Heywood Hospital, HealthAlliance Hospital, WHEAT, Three Pyramids, Beautiful Gate Church, New Hope Community Church, Twin Cities CDC, Gardner CDC, Memorial Congregational Church, Montachusett Opportunity Council and many other agencies and individuals.
Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - Clinton Hospital. Clinton Hospital also presents the Community health assessment to community groups, community advisory committee, and to the hospital's Board of Trustees.
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Clinton Hospital. The hospital responds to priority health needs in many ways, and in times that are critical for North Central MA community, and patients in crisis. In addition to charity care, indigent care, several programs and services offered address the some of the priority needs identified in the CHNA. Our hospital does not have the available resources to develop initiatives to meet every priority health need identified, which makes collaboration with community assets critical.
Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - Clinton Hospital. Financial Assistance - Clinton Hospital employs a staff of Financial Counselors, Certified Application 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, Certified Application Counselors, Customer Service Representatives and Guarantor Collectors provide potentially eligible patients with the appropriate methods of applying for health care coverage as listed on the Massachusetts ConnectorCare website.
Schedule H, Part V, Section B, Line 16 Facility , 2 Facility , 2 - CLINTON HOSPITAL. Sch H, Part V, Section B, Lines 16 a-c Website for FAP, its application, and its plain language summary: https://www.umassmemorialhealthcare.org/clinton-hospital/patients-visitors/patient-resources/financial-counseling
Schedule H, Part V, Section B, Line 18d Facility , 1 Facility , 1 - Clinton. 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 basis. We also send statements and make phone calls.
Schedule H, Part V, Section B, Line 19d Facility , 1 Facility , 1 - Clinton Hospital. 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.
Schedule H, Part V, Section B, Line 22 Facility , 1 Facility , 1 - Clinton Hospital. Clinton Hospital utilized the look back method to determine the percentage of the amount generally billed to patients as it applies to this Financial Assistance Policy. A combination of the previous year charges and payments for commercial and Medicare insurance products are used to determine the Payment on Account Factor (PAF).
Schedule H, Part V, Section B, Line 24 Facility , 1 Facility , 1 - Clinton Hospital. 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.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 8
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?4
Name and address Type of Facility (describe)
1 UMASS MEMORIAL MED CENTER (LAB SVCS)
BIOTECH ONE
365 PLANTATION STREET
WORCESTER,MA01605 		SATELLITE - LAB SERVICES
2 UMASS MEMORIAL MED CENTER (PATHOLOGY)
BIOTECH THREE
ONE INNOVATION DRIVE
WORCESTER,MA01605 		SATELLITE - PATHOLOGY
3 UMASS MEMORIAL MED CENTER AMBULANCE
23 WELLS STREET
WORCESTER,MA01604 		SATELLITE - AMBULATORY SERVICES
4 UMASS MEMORIAL MED CENTER
100 PROVIDENCE STREET
WORCESTER,MA01604 		SATELLITE - AMBULATORY SERVICES
5
6
7
8
9
10
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 9
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.
Form and Line Reference Explanation
Schedule H, Part I RESEARCH EXPENSES THE AMOUNT OF RESEARCH EXPENSES FOR FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS BEING REPORTED BY UMASS MEMORIAL HEALTH CARE IS LOW SINCE THESE COSTS ARE SUPPORTED BY THE UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL. THE MEDICAL SCHOOL IS CLOSELY ASSOCIATED WITH UMASS MEMORIAL HEALTH CARE AND PROVIDES A SIGNIFICANT NUMBER OF COMMUNITY BASED PROGRAMS.
Schedule H, Part II, Line 2 COMMUNITY BUILDING ACTIVITIES Part II Community Building: Community Building - Describe how the organization's community building activities, as reported in Part II promote the health of the communities the organization serves: UMass Memorial provides workforce development and job skills training to underserved, inner-city youth through its Building Brighter Futures with Youth program (BBFWY). The program provides summer employment for youth ages 16 to 24. Founded in 2005 by the hospital through a collaborative effort with the City of Worcester, Worcester Community Action Council and other organizations, BBFWY matches placements to selected participants and offers them valuable on-the-job experience by hospital staff from departments throughout the Medical Center. The program helps to leverage additional state funding for the city. UMass Memorial employs 50 youth each summer as part of the city's summer job employment effort. Five inner city youth were placed in positions at the Grant Square community garden in the Bell Hill neighborhood through this program. In collaboration with the University of Massachusetts Medical School, Worcester Public Schools, Boys & Girls Club and the City of Worcester Youth Opportunities Office, UMass Memorial also holds a Health Career Expo for approximately 600 high school students included an introduction to over 30 health care careers and contact with local resources and nine colleges. The hospital also participates in neighborhood improvement activities in Bell Hill including the United Way Day of Caring. HealthAlliance: Part II, Community Building: For Workforce Development HealthAlliance has provided financial assistance to students who wish to pursue a career in the health care field via an internship program providing financial assistance and experience through hand on practice and observation. For Community Support, Community emergency preparedness and drills are conducted in collaboration with the Leominster and Fitchburg Fire Departments and local EMS. Marlborough Hospital: Part II Community Building Activities: Marlborough Hospital provides assistance to cognitively challenged post grad students aged 18 to 22 by helping them gain work/life skills to assist them in their transition from a school environment to a work and community setting. Additionally, disadvantaged students, including both economically or disengaged youth at risk, learn the tools to overcome barriers and move into self sustaining employment in sectors of the economy where there is a need. Clinton Hospital: Part II Community Building: Clinton Hospital is working to address basic, social and personal needs as a way to improve their communities' health. Clinton Hospital provides high school students with the opportunity of a health career preparation program. The program exposes students to health career possibilities, role models and how health organizations operate; it is also an opportunity for practical experience to learn by doing and applying the knowledge. The students learn new skills and develop their own personal and professional interests. They also expand their educational opportunities, personal network and make connections. This program was developed and implemented in response to an identified need in the community. Workforce Development is identified as a need nationally and in its most recent community health needs assessment. Clinton Hospital partnered with the Clinton public high school and the Workforce Investment Board to implement the program.
Schedule H, Part VI, Line 7 SCH H, PART VI, LINE 7 ALL FOUR HOSPITAL'S FILE INDIVIDUAL COMMUNITY BENEFIT REPORTS WITH THE MASSACHUSETTS ATTORNEY GENERAL'S OFFICE.
Schedule H, Part I, Line 7g Subsidized Health Services NOT APPLICABLE
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 0
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The Cost to Charge Ratio is utilized to calculate amounts reported for each line in Part I, Line 7
Schedule H, Part II Community Building Activities UMass Memorial Healthcare recognizes Community Building activities as being a part of the "social determinants of health" that impact the health of the community. We invest in youth workforce development for at-risk youth. 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 "as state of complete, physical, mental and social well being and not merely the absence of disease." By adopting this definition, UMass Memorial Healthcare has expanded its strategy to include the social and economic 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 activity examples include: Funding and promoting workforce and health career development opportunities for inner-city youth.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Bad Debt is calculated utilizing an aged Bad Debt Model. Significant Analysis was reviewed by Revenue Reporting and Patient Accounting that verified the majority of what the Model considers Bad Debt will more than likely be written off as Admin Allowances. Based on the Meditech/Soarian/Ambulance Variance Summary output per payer and review of the other analysis prepared, it was determined and approved that the Provision as a result of the Model should represent only the following reserves: 1) Self Pay 2) FreeCare 3) Guarantor As such, the remaining reserves calculated on all other payers are included in Payment Systems Contractual reserves and Admin Allowance reserves. Bad Debt Recoveries (payments on accounts written off as Bad Debt) are recorded on the Financial statements as a reduction to Bad Debt Expense. Bad Debt Expense of 26,537,000 is net of these recoveries.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology 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 & Statistics. Although our financial assistance policies and procedures make every effort to identify those patients who are eligible for financial assistance before the billing process begins, often it is not possible to make an appropriate determination until after the billing and collection collection cycle has commenced. The rationale for including bad debt amounts in community benefits would be to account for those patients who were classified as bad debt expense, but would have qualified for financial assistance if sufficient information had been available to make a determination of their eligibility.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote Footnote 2, page 10 of Audited Financial Statements: Allowance for Doubtful Accounts Patient accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of patient accounts receivable, the System analyzes its past history and identifies trends for each of its major categories of revenue (inpatient, outpatient and professional) to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews data about these major categories of revenue in evaluating the sufficiency of the allowance for doubtful accounts. Throughout the year, the System, after all reasonable collection efforts have been exhausted, will write off the difference between the standard rates (or discounted rates if negotiated) and the amounts actually collected against the allowance for doubtful accounts. In addition to the review of the categories of revenue, management monitors the write offs against established allowances as of a point in time to determine the appropriateness of the underlying assumptions used in estimating the allowance for doubtful accounts. Patient accounts receivable is presented net of an allowance for doubtful accounts of $50,834,000 and $55,445,000 as of September 30, 2016 and 2015, respectively, in the consolidated balance sheets. Management attributes this change in the allowance for doubtful accounts due to a decrease in accounts receivable and improvement in the aging where more current accounts are reflected in the current year. Bad debt expense for nonpatient related accounts receivable is reflected in operating expense on the statements of operations. Patient related bad debt expense is reflected as a reduction in patient service revenue in the statements of operations
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE MEDICARE COSTS ARE OBTAINED FROM THE COST REPORT FOR INPATIENT PSYCHIATRIC CAPITAL AND OUTPATIENT SERVICES. IN ADDITION, FEE BASED SERVICES, SUCH AS LABS, PT, OT, ETC, ARE DETERMINED THROUGH PS&R CHARGES TIMES OUTPATIENT COST TO CHARGE RATIO.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance A. Exemption From Self-Pay Billing and Collection Action- UMMHC will not initiate Self-Pay billing and collection activity in the following instances: 1. Upon sufficient proof that a patient is a recipient of Emergency Aid to the Elderly, Disabled and Children (EAEDC), or enrolled in MassHealth, Health Safety Net, the Children's Medical Security Plan whose family income is equal or less than 300% of the FPL or Low Income Patient designation with the exception of Dental-Only Low Income patients as determined by the office of Medicaid with the exception of co-pays and deductibles required under the Program of Assistance. 2. 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. 3. Medical Hardship bills that exceed the medical hardship contribution. 4. Medical Hardship contributions that remains outstanding during a patient's MassHealth or Low Income Patient eligibility period. 5. Unless UMMHC has checked the EVS system to determine if the patient has filed an application for MassHealth. 6. For Partial Health Safety Net eligible patients, with the exception of any deductibles required. 7. UMMHC 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. 8. UMMHC may bill a Low Income Patient at their request in order to allow the patient to meet the required CommonHealth One-Time Deductible.
Schedule H, Part V, Section B, Line 16a FAP website - UMASS MEMORIAL MEDICAL CENTER, INC: Line 16a URL: See Sch H, Part V, Section B, Line 16i; - HEALTHALLIANCE HOSPITAL, INC: Line 16a URL: https://www.umassmemorialhealthcare.org/healthalliance-hospital; - MARLBOROUGH HOSPITAL: Line 16a URL: https://www.umassmemorialhealthcare.org/marlborough-hospital/financial-counseling; - CLINTON HOSPITAL ASSOCIATION: Line 16a URL: See Sch H, Part V, Section B, Line 16i;
Schedule H, Part V, Section B, Line 16b FAP Application website - UMASS MEMORIAL MEDICAL CENTER, INC: Line 16b URL: See Sch H, Part V, Section B, Line 16i; - HEALTHALLIANCE HOSPITAL, INC: Line 16b URL: https://www.umassmemorialhealthcare.org/healthalliance-hospital; - MARLBOROUGH HOSPITAL: Line 16b URL: https://www.umassmemorialhealthcare.org/marlborough-hospital/financial-counseling; - CLINTON HOSPITAL ASSOCIATION: Line 16b URL: See Sch H, Part V, Section B, Line 16i;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website - UMASS MEMORIAL MEDICAL CENTER, INC: Line 16c URL: See Sch H, Part V, Section B, Line 16i; - HEALTHALLIANCE HOSPITAL, INC: Line 16c URL: https://www.umassmemorialhealthcare.org/healthalliance-hospital; - MARLBOROUGH HOSPITAL: Line 16c URL: https://www.umassmemorialhealthcare.org/marlborough-hospital/financial-counseling; - CLINTON HOSPITAL ASSOCIATION: Line 16c URL: See Sch H, Part V, Secton B, Line 16i;
Schedule H, Part VI, Line 2 Needs assessment In addition to conducting the Community Health Needs Assessment (CHNA), UMass Memorial Medical Center assesses the health care needs of the community it serves by working closely with the Worcester Division of Public Health on an on-going basis. Community Benefits staff hold leadership roles and/or participate in multiple coalitions and efforts focused on addressing priority areas identified in the CHNA and aligned with strategies of the Community Health Improvement Plan. In 2016, the Vice President of Community Relations co-led the establishment of the Coalition for a Healthy Greater Worcester, a healthy communities coalition that coordinates and provides accountability for CHIP Priority Area Working Groups and includes a subcommittee for oversight of DoN funds distribution. The hospital also works closely with the Worcester Free Clinics Coalition, the Worcester Public Schools and two community health centers (Family Health Center of Worcester and the Edward M. Kennedy Community Health Center) on an ongoing basis through its Ronald McDonald Care Mobile program and Prevention and Wellness Trust Fund Pediatric Asthma intervention. UMass Memorial Medical Center completed its CHNA by assembling a diverse group of community stakeholders that include, but are not limited to, members of health and human service organizations, philanthropy, communities of color, neighborhood residents and the Worcester Division of Public Health as part of the group that assisted and guided the assessment process. The hospital's Community Benefit Implementation Strategy is aligned with the CHIP. The other needs that are not included in the CHNA/CHIP are not being addressed because they are not a part of the nine identified priority CHIP Domain areas and due to limited funding. The following strategies were conducted to complete the assessment: * Conducted key informant interviews and focus groups with community-based organizations and residents * Conducted outreach efforts to medically-underserved populations and convene meetings with neighborhood/community groups * Reviewed primary and secondary data * Conducted online community survey * Organized community forums to share findings and release of final report * Organized task forces for further action to identify priority areas The following sources inform and enhance our efforts to identify priorities and unmet needs: * U.S. Census 2010 * Healthy People 2020 * National Prevention Strategy * Massachusetts Department of Education Reports including local enrollment and language data * Massachusetts Department of Employment and Training * Hospital utilization data * Massachusetts Department of Public Health/ MassCHIP * Data from various City of Worcester departments including, but not limited to, the local Division of Public Health, Neighborhood Services and Police. * Information collected from health care providers, community groups/underserved populations and individuals who have expertise on community health issues. HealthAlliance Hospital: In addition to conducting the Community Health Needs Assessment (CHNA), UMass Memorial - HealthAlliance Hospital assesses the health care needs of the community it serves by working with the Community Health Network for North Central Mass (CHNA9). The Community Benefits Team at UMass Memorial - HealthAlliance Hospital hold leadership roles in and/or participate in several coalitions, committees and boards that focus on addressing the priority areas identified. The Manager of Marketing, Public Relations and Community Relations served as a team leader for the most recent Community Health Improvement Plan with the CHNA9. Members of the Community Benefits Team also work closely with the Leominster and Fitchburg Public Schools, Community Health Center, the Spanish American Center and United Neighbors of Fitchburg. The CHNA comprehensive process consisted of collecting quantitative and qualitative data through focus groups with community members and interviews with community members and community leaders. Participants were from community-based organizations, educational, civic, governmental, faith-based professionals, health care providers, and others. We make a strong effort to ensure racial/ethnic, socioeconomic and geographic diversity in the composition of all focus groups and interviews. The Community Health Needs Assessment was conducted with HealthAlliance Hospital and Heywood Healthcare (Heywood Hospital and Athol Hospital). Marlborough Hospital: In addition to conducting the Community Health Needs Assessment (CHNA), Marlborough Hospital assesses the health care needs of the community it serves by working closely with its Community Benefits Advisory Committee (CBAC). The CBAC, is chaired by the president of the Boys and Girls Club of Metrowest who is also a hospital trustee. Other CBAC members include representatives from the Hudson and Marlborough Public Schools and the Boards of Health, agencies that focus on addiction and recovery services, the Council on Aging, the Marlborough Community Development Corporation, Wellness Council members and residents of the community. The CBAC helps to identify programs in support of the community priorities, provides feedback on an on-going basis and focuses on addressing priority areas identified in the CHNA and aligned with strategies of the Community Health Improvement Plan. The CHNA is comprised of qualitative and quantitative data collected through a community engagement process. In addition, the Community Benefits Advisory Council, comprised of members of different agencies and businesses in the area, helps to identify programs in support of the community priorities Clinton Hospital: In addition to conducting the Community Health Needs Assessment (CHNA), UMass Memorial - Clinton Hospital assesses the health care needs of the community it serves by working closely with the Community Health Network Area of North Central Massachusetts (CHNA-9) on an on-going basis to develop, implement and integrate community projects to effectively utilize community resources to create healthier communities. Community Benefits staff hold leadership roles and/or participate in multiple coalitions and efforts focused on addressing priority areas identified in the CHNA and that are aligned with strategies of the Community Health Improvement Plan (CHIP). In 2016, the Manager of Community Benefits co-led the Health Living priority area working group, one of the CHIP Priority Area Working Groups. The hospital also works closely with the Minority Coalition-Health Health Disparities Collaborative Committee which is a core group of hospitals and health centers from the North County region examining their data, identify opportunities to address health disparities and work on the social determinants of health. Clinton Hospital conducted the CHNA in collaboration with the Montachusett Public Health Network (MPHN), the Joint Coalition on Health of North Central Massachusetts (JCOH) and Community Health Network Area 9 (CHNA9) in 2014. The JCOH is a group of committed individuals and organizations working collaboratively as catalysts for change and as advocates for the underserved to improve the health and well-being of everyone in North Central Massachusetts. The Montachusett Public Health Network (MPHN) is a collaborate committee of all the board of health's covering the Montachusett region (Athol, Gardner, Fitchburg, Leominster, Westminster, Princeton, Sterling, Royalston, Phillipston, Templeton and Clinton) the stated goal of the MPHN is "raising the health status of the residents of our communities to the highest levels anywhere in the country". The Community Health Network of North Central Massachusetts (CHNA 9) is one of 17 CHNAs across Massachusetts, created by the Department of Public Health in 1992. CHNA-9 mission brings together and supports diverse voices to promote health equity in our communities. Clinton hospital took into account input from representatives of the community, including diverse members who were interviewed in the Community Health Assessment Focus groups. Clinton Hospital utilized the information in the CHNA to collaborate with other community based organizations to adopt implementation strategies that address the unmet health needs of Clinton Hospital's catchment area.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Financial Counselors, also referred to as Certified Application Counselors (CAC's) are state certified and located on all campus locations. CAC's are available to assist underinsured and uninsured patients navigate the medical benefit application process. A patient is considered uninsured or "self-pay" if they do not have insurance coverage at the time of service or for some reason the service is not covered by their health insurance. A patient is considered underinsured if a patient has health insurance coverage but still has large balances that they are responsible to pay. The objective is to ultimately obtain some form of medical coverage or charity care to help the patient pay their hospital and doctor's bills. CAC's will take the steps necessary to help patients submit applications to obtain coverage, resolve eligibility issues, upgrade their coverage to coverage that provides more benefits, choose and enroll in a MassHealth or Connector Care Health insurance plan and change these plans when necessary.
Schedule H, Part VI, Line 4 Community information Geographical Reach: The 2015 Community Health Assessment (CHNA) and subsequent Greater Worcester Community Health Improvement Plan (CHIP) focuses on the City of Worcester and the outlying communities of Shrewsbury, Millbury, West Boylston, Leicester, Grafton and Holden, a sub-section of its primary service area. This specific geographic area is the focus for the City of Worcester Division of Public Health regionalization initiative, and overlaps with the service area of many other local organizations. Focusing UMass Memorial's CHNA on this geographic area facilitates the alignment of the hospital's efforts with community and governmental partners, specifically the city health department, the area Federally Qualified Health Centers, and community-based organizations. This focus also facilitates collaboration with the CHIP Advisory Committee that implements key strategies of the CHIP so that future initiatives can be developed in a more coordinated approach. Regional Description: The City of Worcester is very ethnically-diverse, considerably more so than the nation and state overall. The number of Hispanics living in the city has grown by 35% over the past 10 years. Refugees from Iraq currently account for the greatest percentage of new immigrants (51%) followed by refugees from Bhutan, Burma, Liberia and other African nations. Health Resources and Services Administration (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. 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 2005-20091. 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. -------------------------------------------------- 1. U.S. Census 2010 and 2010 American Community Survey 1-year estimates, U.S. Census 2. Massachusetts Executive Office of Labor Workforce and Development 3. Massachusetts Department of Education Demographics: Worcester is the largest site for refugee resettlement in Massachusetts, with more than 1,600 refugees resettled in the city in the past five years. As a result, the City of Worcester's foreign born population is significantly higher than Worcester County as a whole, accounting for the majority of this population in the region. According to U.S. Census 2010 figures, the Hispanic population and other non-Hispanic, non-White ethnic groups in the city have notably increased while the white, non-Hispanic population has decreased. Reflecting this diversity, ninety percent of all medical interpretations provided by UMMHC are conducted in: Spanish, Portuguese, Vietnamese, Arabic, Albanian and American Sign Language. The remaining ten percent are 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%. HealthAlliance Hospital: Our target populations focus on medically-underserved and vulnerable groups of all ages in North Central Massachusetts. Our most vulnerable populations include children, ethnic and linguistic minorities and those living in poverty. These populations often become isolated and disenfranchised due to negligence, misperceptions and even fear. The Study Area configuration for the current assessment includes the 30 surrounding municipalities including nine (9) cities and towns. Within the Health Status and Outcomes section of the report, some data sets reflect a further distillation of data from the communities of: Princeton/East Princeton; Lancaster/South Lancaster; Groton/West Groton; Townsend/West Townsend; and Winchendon/Winchendon Springs, resulting in a presentation of data from 35 communities. The hospital is actively involved in coalition building that focuses on improving the health of the community, including the Joint Coalition on Health. The Coalition has brought positive change to the service area. HealthAlliance Hospital is also actively engaged with the CHNA 9, whose goal is continuous improvement of health status, with a focus on health equality and addressing and eliminating health disparities. Marlborough Hospital: The City of Marlborough, with a population of 39,818 (July 2015) grew 3.4% from 2010. Marlborough's population is predominately white (80%) followed by Hispanic or Latino (10%), other race is 7%, Asian 5%, black or African American 2% and 3% identify themselves as 2 or more races. Hudson has a population of 14,907 with 90% who identify themselves as white, 4% Hispanic or Latino, 2% other, 2% Asian, 1% black or African American and 2% indicate two or more races. Quantitative data also illustrate that just over three-fourths of the Massachusetts population is white (76.9%) which was largely consistent with Marlborough (80%). Both at the state level and in Marlborough, the Hispanic population was the next largest racial/ethnic group. Hudson's population followed a similar pattern, the proportion of its population that identified as white was even larger (90%) followed by Hispanic and Latino. English, Portuguese and Spanish are the predominant language for the communities the hospital serves. Clinton Hospital: Clinton Hospital primarily serves the communities of Clinton, Berlin, Bolton, Lancaster and Sterling with populations of 13,606, 2,866, 4,897, 7,582 and 9,564 respectively. The population of the total service area is 36,759. Clinton has a population of 13,606. The majority of Clinton residents are White Non-Hispanic (84%), followed by Hispanic (11.6%) and Black Non-Hispanic (1.80%). The Clinton Hospital Service Area is also primarily White Non-Hispanic (88%), followed by Hispanic (6.4%), and Black Non-Hispanic (2.8%). Clinton Hospital's Community Benefits Plan focuses on the needs of Clinton due to its large concentration of diverse, vulnerable populations.
Schedule H, Part VI, Line 5 Promotion of community health UMass Memorial has a designated Community Benefit department housed within Community Relations that is wholly dedicated to promoting the Community Benefit agenda with a special focus on Community Health Improvement. Our Community Benefits staff works very closely with multiple community organizations forging partnerships. The hospital has a strong and longstanding partnership with the Worcester Division of Public Health which has resulted in significant opportunities that have leveraged funding and implementation of preventive community-clinical linkages. In addition, we work closely with the two Federally Qualified Community Health Centers and leverage internal resources within the system to increase program capacity whenever possible. The Community Relations/Community Benefits department works closely with Pedi-Primary Care, Family and Community Medicine, Pedi-Pulmonology and Plumley Village Health Services. We also provide medical and dental services to the underserved at 11 neighborhood sites and 20 schools through the UMass Memorial Care Mobile. HealthAlliance Hospital: HealthAlliance Hospital has a Community Benefit program that is responsible for promoting the Community Benefit agenda focusing on Community Health Improvement. Our staff works very closely with multiple community organizations forging partnerships. In addition, we leverage internal resources within the system to increase program capacity whenever possible. We continue to support health education and screenings related to chronic diseases and prevalent health conditions in the community including mental/behavioral health, lung cancer/smoking cessation, chronic occlusive pulmonary disease (COPD), heart health, depression and nutrition/diabetes. The primary driving force behind the UMass Memorial - HealthAlliance Hospital Community Benefits Implementation Plan (through 2015) is the priority needs identified in the Community Health Assessment of North Central MA (CHA-NCMA) and the Montachusett Public Health Network (MPHN). One unique aspect of the current assessment is the level of attention paid to minority health issues. In addition, those responsible for gathering qualitative data made every effort to ensure racial/ethnic, socioeconomic, and geographic diversity in the composition of focus groups and with interview participants. The result is a much more comprehensive picture of the health status, issues, concerns, and assets of North Central Massachusetts. Another key feature of this community health assessment is the amount of collaboration that has gone into gathering and analyzing the data presented herein. Marlborough Hospital: Marlborough Hospital participates in area events and provides facilities for support groups. In addition, whenever possible we leverage internal resources to build capacity in our programming and we have staff that supports Community Benefits activities. Clinton Hospital: Clinton Hospital's Community Benefits Programs mirror the five core principles outlined by the Public Health Institute in terms of the "emphasis on communities with disproportionate unmet health-related needs; emphasis on primary prevention; building a seamless continuum of care; building community capacity; and collaborative governance." Target populations for Clinton Hospital's Community Benefits initiatives are identified through a community input and planning process, collaborative efforts, and a CHNA which is conducted every three years.
Schedule H, Part VI, Line 6 Affiliated health care system Our clinical system is comprised of four hospitals which each site having a dedicated Community Benefits staff that works with their respective communities in conducting a CHNA, a CHIP and an Implementation Strategy. HealthAlliance Hospital During fiscal year 2016, UMass Memorial - HealthAlliance Hospital worked with our community partners via the CHNA9 to create a North Central Community Health Improvement Plan (CHIP). The North Central CHIP is based on the 2012 and 2015 Community Health Assessments conducted for our region. In the spring and summer of 2015, members of the Community Health Network for North Central Mass (CHNA 9) steering committee analyzed the results of the recent Community Health Assessments and identified four consistent areas of need which became the four Priority Areas. To view the CHIP, click visit: http://www.chna9.com/uploads/3/4/2/5/34257345/11864_chna9_proof_r2.pdf Marlborough Hospital: Our clinical system is comprised of four hospitals which each site having a dedicated Community Benefits staff that works with their respective communities in conducting a CHNA, a CHIP and an Implementation Strategy. Clinton Hospital: Our clinical system is comprised of four hospitals which each site having a dedicated Community Benefits staff that works with their respective communities in conducting a CHNA, a CHIP and an Implementation Strategy.
Schedule H, Part VI, Line 7 State filing of community benefit report MA
Schedule H (Form 990) 2015
Additional Data


Software ID: 15000238
Software Version: 2015v3.0
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," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
UMass Memorial Health Care Inc & Affiliates
 
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 Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC 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 INC
650 LINCOLN STREET
WORCESTER,MA01605 		04-2513817 501(C)(3) 1,000,000 0 N/A N/A SUPPORT FOR HEALTH CENTER'S MISSION
(2) FAMILY HEALTH CENTER OF WORCESTER INC
26 QUEEN STREET
WORCESTER,MA01610 		04-2485308 501(C)(3) 1,000,000 0 N/A N/A SUPPORT FOR HEALTH CENTER'S MISSION
(3) UNIVERSITY OF MA MEDICAL SCHOOL
55 LAKE AVE N
WORCESTER,MA01655 		04-3167352 GOVERNMENT 273,555 0 N/A N/A $200,000 MUSCULOSKELETAL CENTER OF EXCELLENCE GRANT, $73,555 COMPLEX AORTIC ANEURYSM REPAIR STUDY
(4) MASSACHUSETTS HEALTH COUNCIL
RIVERBEND OFFICE PARK
200 RESERVIOR STREET
NEEDHAM,MA02494 		04-2296739 501 (c)(3) 5,000 0 N/A N/A ANNUAL AWARD GALA SPONSORSHIP CENTERPIECE
(5) THE SCHWARTZ CENTER FOR COMPASSIONATE HEALTHCARE
100 CAMBRIDGE STREET
SUITE 2100
BOSTON,MA02114 		04-1564655 501(c)(3) 5,000 0 N/A N/A 20TH ANNUAL KENNETH B SCHWARTZ COMPASSIONATE HEALTHCARE DINNER
(6) PHYSICIANS HEALTH SERVICES
860 WINTER STREET
WALTHAM,MA02451 		22-3234975 501(c)(3) 10,000 0 N/A N/A SUPPORT OF PHYSICIAN HEALTH SERVICES
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
6
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2015

Schedule I (Form 990) 2015
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated 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) COMUNITY SUPPORT 8 19,365 0 N/A N/A
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
Schedule I, Part II, Line 1(h) SCHEDULE I, PART II, LINE 1H MEDICAL CENTER: 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. THESE GRANTS REPRESENT HIGHLY COLLABORATIVE PROJECTS AMONG THREE DEPARTMENTS (ORTHOPEDICS, MEDICINE (PHEUMATOLOGY), AND CELL BIOLOGY) THAT FOCUS ON THE ROLE OF MICRORNAS IN THE PATHOGENESIS OF RHEUMATOID ARTHRITIS AND OSTEOARTHRITIS, AND ADDRESS THE POTENTIAL ROLE OF MICRORNAS AS BIOMARKERS OF DISEASE. THE PRIMARY OBJECTIVE OF THE PRESENT STUDY IS TO EVALUATE THE SAFETY AND EFFICACY OF PHYSICIAN-MODIFICATION OF FDA-APPROVED OFF-THE-SHELF ENDOVASCULAR GRAFTS IN THE TREATMENT OF PATIENTS WITH COMPLEX ABDOMINAL OR THOROCOABDOMINAL ANEURYSMS OR ULCERS.
Schedule I, Part III Schedule I, Part III Type of grant or assistance Central New England HealthAlliance: Community Support is related to the Doyle Community fund that offers annual grant opportunities for non-profits in the community who seek to improve health and wellness and/or who impact our youth at risk and families in need.
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. MEDICAL CENTER: 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 WlLL DOCUMENT THE RE-EVALUATION CONTEMPORANEOUSLY. MEDICAL CENTER: AS PART OF THE FUNDRAISING AGREEMENT, BI-ANNUAL UPDATES WILL BE PROVIDED TO THE SENIOR VICE PRESIDENT FOR OPERATIONS OF THE MEDICAL CENTER RESPONSIBLE FOR THE MUSCULOSKELETAL CENTER OF EXCELLENCE. MEDICAL CENTER: GRANT FUNDED ON A PER YEAR BASIS FOR THE DURATION OF THE STUDY. WITH ANNUAL COST RECONCILIATIONS PERFORMED AND PROVIDED TO THE MEDICAL CENTER
Schedule I (Form 990) 2015



Additional Data


Software ID: 15000238
Software Version: 2015v3.0


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" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
UMass Memorial Health Care Inc & Affiliates
 
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 on 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 or provision of all of the expenses described above? If "No," complete Part III to explain .........
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on 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
Yes
 
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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on 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," on line 5a or 5b, describe in Part III.
6
For persons listed on 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," on line 6a or 6b, describe in Part III.
7
For persons listed on 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 on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2015

Schedule J (Form 990) 2015
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (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 in column(B) reported as deferred on prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1John Bronhard
  Treasurer, HealthAlliance Hospitals, Inc. 		(i)

(ii)		 255,323
-------------
0 		46,254
-------------
0 		502
-------------
0 		7,641
-------------
0 		6,997
-------------
0 		316,717
-------------
0 		0
-------------
0
2Douglas S Brown
  Secretary, UMM Health Care, Inc., Officer/Dir various 		(i)

(ii)		 0
-------------
541,141 		0
-------------
145,260 		0
-------------
51,623 		0
-------------
230,248 		0
-------------
24,551 		0
-------------
992,823 		0
-------------
51,623
3Sheila Daly
  President until 1/16, Clinton Hospital Association, Director Community Hospitals Inc. 		(i)

(ii)		 213,597
-------------
0 		47,714
-------------
0 		38,516
-------------
0 		38,666
-------------
0 		20,564
-------------
0 		359,057
-------------
0 		38,516
-------------
0
4Eric W Dickson MD
  President & CEO/Director, UMM Health Care, Inc., Officer/Dir various 		(i)

(ii)		 0
-------------
929,390 		0
-------------
446,327 		0
-------------
59,404 		0
-------------
345,769 		0
-------------
53,241 		0
-------------
1,834,131 		0
-------------
57,487
5David Fairchild MD
  President/Director until 5/15, UMM Accountable Care Organization, Inc. 		(i)

(ii)		 143,812
-------------
0 		3,050
-------------
0 		36,007
-------------
0 		41,611
-------------
0 		10,852
-------------
0 		235,332
-------------
0 		36,007
-------------
0
6John Greenwood
  President/Director, UMM Accountable Care Organization, Inc. 		(i)

(ii)		 241,822
-------------
0 		46,451
-------------
0 		16,360
-------------
0 		71,711
-------------
0 		24,617
-------------
0 		400,961
-------------
0 		16,360
-------------
0
7Cheryl M Lapriore
  President/Director, UMM Health Ventures, Inc. 		(i)

(ii)		 0
-------------
254,023 		0
-------------
58,020 		0
-------------
79,214 		0
-------------
95,921 		0
-------------
23,357 		0
-------------
510,536 		0
-------------
79,214
8Sergio Melgar
  Treasurer, UMM Health Care, Inc., Officer/Dir various 		(i)

(ii)		 0
-------------
650,172 		0
-------------
175,500 		0
-------------
0 		0
-------------
79,034 		0
-------------
39,149 		0
-------------
943,854 		0
-------------
0
9Patrick Muldoon
  President, UMM Med Ctr, Inc., 		(i)

(ii)		 679,820
-------------
0 		182,250
-------------
0 		47,245
-------------
0 		329,552
-------------
0 		38,030
-------------
0 		1,276,898
-------------
0 		47,245
-------------
0
10Steven Roach
  President/Director, Marlborough Hospital 		(i)

(ii)		 342,292
-------------
0 		89,697
-------------
0 		0
-------------
0 		60,319
-------------
0 		25,498
-------------
0 		517,806
-------------
0 		0
-------------
0
11Dana E Swenson
  President/Director, UMM Realty, Inc. 		(i)

(ii)		 0
-------------
245,140 		0
-------------
55,755 		0
-------------
0 		0
-------------
92,725 		0
-------------
22,462 		0
-------------
416,082 		0
-------------
0
12Stephen E Tosi MD
  President, UMM Med Group, Inc., Director various 		(i)

(ii)		 639,056
-------------
0 		172,158
-------------
0 		329,616
-------------
0 		78,643
-------------
0 		30,199
-------------
0 		1,249,672
-------------
0 		329,616
-------------
0
13Deborah Weymouth
  President/Director, HealthAlliance Hospitals, Inc. 		(i)

(ii)		 387,501
-------------
0 		86,063
-------------
0 		0
-------------
0 		66,454
-------------
0 		15,645
-------------
0 		555,662
-------------
0 		0
-------------
0
14Douglas Ziedonis MD
  President/Director, UMBHS, Inc. 		(i)

(ii)		 242,528
-------------
0 		8,730
-------------
0 		0
-------------
0 		13,151
-------------
0 		30,448
-------------
0 		294,857
-------------
0 		0
-------------
0
15Howard Alfred MD
  Director, UMM Accountable Care Organization, Inc. 		(i)

(ii)		 239,396
-------------
0 		5,970
-------------
0 		0
-------------
0 		4,992
-------------
0 		20,677
-------------
0 		271,036
-------------
0 		0
-------------
0
16Peter Bagley MD
  Director, UMM Accountable Care Organization, Inc. 		(i)

(ii)		 242,330
-------------
0 		129,835
-------------
0 		0
-------------
0 		94,107
-------------
0 		29,479
-------------
0 		495,751
-------------
0 		0
-------------
0
17Alan P Brown MD
  Director, UMM Behavioral Health System, Inc. 		(i)

(ii)		 181,627
-------------
0 		22,700
-------------
0 		0
-------------
0 		10,624
-------------
0 		25,501
-------------
0 		240,452
-------------
0 		0
-------------
0
18Andrew Cocchiarella MD
  Director until 3/16, Marlborough Hospital 		(i)

(ii)		 214,327
-------------
0 		184,423
-------------
0 		0
-------------
0 		13,250
-------------
0 		26,194
-------------
0 		438,193
-------------
0 		0
-------------
0
19William Corbett MD
  Director, Marlborough Hospital 		(i)

(ii)		 382,276
-------------
0 		101,283
-------------
0 		32,471
-------------
0 		182,485
-------------
0 		22,465
-------------
0 		720,980
-------------
0 		32,471
-------------
0
20Jordan Eisenstock MD
  Director, UMM Accountable Care Organization, Inc. 		(i)

(ii)		 147,431
-------------
0 		37,507
-------------
0 		6,038
-------------
0 		9,271
-------------
0 		1,948
-------------
0 		202,194
-------------
0 		6,038
-------------
0
21Kimberly Eisenstock MD
  Director, Marlborough Hospital 		(i)

(ii)		 227,462
-------------
0 		30,805
-------------
0 		6,815
-------------
0 		13,250
-------------
0 		25,181
-------------
0 		303,513
-------------
0 		6,815
-------------
0
22R Kevin Ferguson MD
  Director, UMM Med Group, Inc. 		(i)

(ii)		 242,994
-------------
0 		1,818
-------------
0 		6,941
-------------
0 		12,568
-------------
0 		25,448
-------------
0 		289,769
-------------
0 		6,941
-------------
0
23Robert W Finberg MD
  Director, UMM Health Care, Inc. 		(i)

(ii)		 262,809
-------------
0 		28,470
-------------
0 		640,000
-------------
0 		107,867
-------------
0 		29,448
-------------
0 		1,068,594
-------------
0 		640,000
-------------
0
24David Harlan MD
  Director, UMM Accountable Care Organization, Inc. 		(i)

(ii)		 150,770
-------------
0 		10,000
-------------
0 		0
-------------
0 		8,414
-------------
0 		26,115
-------------
0 		195,300
-------------
0 		0
-------------
0
25Carlos Iitsuka
  Director until 7/16, UMM Health Ventures, Inc. 		(i)

(ii)		 0
-------------
298,073 		0
-------------
83,850 		0
-------------
0 		0
-------------
37,197 		0
-------------
29,470 		0
-------------
448,589 		0
-------------
0
26Kathryn Kennedy MD
  Director, UMM Med Group, Inc. 		(i)

(ii)		 228,415
-------------
0 		70,800
-------------
0 		0
-------------
0 		13,250
-------------
0 		29,464
-------------
0 		341,929
-------------
0 		0
-------------
0
27Daniel H Lasser MD
  Director, UMM Med Group, Inc. 		(i)

(ii)		 216,871
-------------
0 		27,543
-------------
0 		24,866
-------------
0 		61,058
-------------
0 		27,880
-------------
0 		358,219
-------------
0 		24,866
-------------
0
28Shipen Li MD
  Director, HealthAlliance Hospitals, Inc. 		(i)

(ii)		 258,138
-------------
0 		58,641
-------------
0 		7,502
-------------
0 		13,250
-------------
0 		25,170
-------------
0 		362,702
-------------
0 		7,502
-------------
0
29Jeffrey N Metzmaker MD
  Director, UMM Med Group, Inc. 		(i)

(ii)		 311,559
-------------
0 		119,500
-------------
0 		0
-------------
0 		13,250
-------------
0 		26,871
-------------
0 		471,179
-------------
0 		0
-------------
0
30Dominic Nompleggi MD
  Director, UMM Med Group, Inc. 		(i)

(ii)		 227,976
-------------
0 		156,377
-------------
0 		0
-------------
0 		13,250
-------------
0 		29,479
-------------
0 		427,081
-------------
0 		0
-------------
0
31O Nsidinanya Okike MD
  Director, UMM Health Care, Inc. 		(i)

(ii)		 126,955
-------------
0 		0
-------------
0 		206,903
-------------
0 		1,587
-------------
0 		2,328
-------------
0 		337,773
-------------
0 		19,000
-------------
0
32Daniel O'Leary MD
  Director, Coordinated Primary Care, Inc. 		(i)

(ii)		 195,701
-------------
0 		33,735
-------------
0 		1,767
-------------
0 		4,876
-------------
0 		3,641
-------------
0 		239,720
-------------
0 		0
-------------
0
33Chris Philbin
  Director, Clinton Hospital Association 		(i)

(ii)		 0
-------------
197,596 		0
-------------
36,720 		0
-------------
6,189 		0
-------------
28,801 		0
-------------
25,965 		0
-------------
295,272 		0
-------------
6,189
34Catherine Rossi
  Director, Clinton Hospital Association 		(i)

(ii)		 0
-------------
179,541 		0
-------------
33,048 		0
-------------
12,218 		0
-------------
54,986 		0
-------------
24,690 		0
-------------
304,483 		0
-------------
12,218
35Deborah Ekstrom
  President unitl 1/16, Community HealthLink, Inc. 		(i)

(ii)		 201,175
-------------
0 		46,021
-------------
0 		15,068
-------------
0 		72,039
-------------
0 		29,286
-------------
0 		363,589
-------------
0 		14,037
-------------
0
36Katharine Bolland Eshghi
  Assistant Secretary, UMM Health Care, Inc. 		(i)

(ii)		 0
-------------
334,982 		0
-------------
75,735 		0
-------------
35,381 		0
-------------
74,940 		0
-------------
24,357 		0
-------------
545,396 		0
-------------
35,381
37Nicole Gagne
  President, Community HealthLink, Inc. 		(i)

(ii)		 109,970
-------------
0 		0
-------------
0 		28,961
-------------
0 		17,931
-------------
0 		33,398
-------------
0 		190,260
-------------
0 		0
-------------
0
38John Glassburn
  Secretary, UMM Community Hospitals, Inc. 		(i)

(ii)		 0
-------------
174,318 		0
-------------
9,551 		0
-------------
0 		0
-------------
4,854 		0
-------------
22,462 		0
-------------
211,185 		0
-------------
0
39Steven McCue
  Treasurer, Marlborough Hospital 		(i)

(ii)		 181,035
-------------
0 		22,495
-------------
0 		0
-------------
0 		13,744
-------------
0 		22,489
-------------
0 		239,763
-------------
0 		0
-------------
0
40William O'Brien
  Secretary, UMBHS, Inc. 		(i)

(ii)		 0
-------------
121,856 		0
-------------
7,015 		0
-------------
0 		0
-------------
31,003 		0
-------------
25,965 		0
-------------
185,841 		0
-------------
0
41Jeffrey Olson
  Treasurer, Clinton Hospital Assoc. 		(i)

(ii)		 144,343
-------------
0 		20,992
-------------
0 		0
-------------
0 		18,317
-------------
0 		25,511
-------------
0 		209,163
-------------
0 		0
-------------
0
42Jeanne Shirshac
  Treasurer, UMM Accountable Care Organization, Inc. 		(i)

(ii)		 0
-------------
199,214 		0
-------------
36,755 		0
-------------
6,977 		0
-------------
26,980 		0
-------------
24,545 		0
-------------
294,471 		0
-------------
6,977
43Francis W Smith
  Secretary, UMM Medical Group, Inc. 		(i)

(ii)		 0
-------------
196,526 		0
-------------
14,584 		0
-------------
0 		0
-------------
18,175 		0
-------------
26,476 		0
-------------
255,762 		0
-------------
0
44Michele Streeter
  Treasurer, UMM Med Group, Inc. 		(i)

(ii)		 405,034
-------------
0 		109,058
-------------
0 		29,533
-------------
0 		175,084
-------------
0 		25,072
-------------
0 		743,782
-------------
0 		29,533
-------------
0
45James P Cyr
  Sr. VP, Operations (UMMMC) 		(i)

(ii)		 251,134
-------------
0 		57,500
-------------
0 		39,833
-------------
0 		144,362
-------------
0 		23,357
-------------
0 		516,186
-------------
0 		39,833
-------------
0
46Therese Day
  VP, Finance / CFO of Med Center 		(i)

(ii)		 284,949
-------------
0 		64,837
-------------
0 		21,081
-------------
0 		114,112
-------------
0 		23,357
-------------
0 		508,336
-------------
0 		21,081
-------------
0
47Robert Feldmann
  VP, Corporate Controller 		(i)

(ii)		 0
-------------
265,340 		0
-------------
89,936 		0
-------------
0 		0
-------------
83,498 		0
-------------
25,664 		0
-------------
464,438 		0
-------------
0
48Barbara Fisher
  Sr VP, Operations (UMMMC) 		(i)

(ii)		 259,412
-------------
0 		59,592
-------------
0 		34,021
-------------
0 		145,401
-------------
0 		24,962
-------------
0 		523,387
-------------
0 		34,021
-------------
0
49Patricia George
  VP & Deputy CIO, until 11/15 		(i)

(ii)		 0
-------------
301,124 		0
-------------
60,469 		0
-------------
25,000 		0
-------------
35,957 		0
-------------
15,390 		0
-------------
437,939 		0
-------------
25,000
50Margaret Hudlin MD
  CMO/VP Perioperative Svcs, until 9/1/16 		(i)

(ii)		 352,077
-------------
0 		80,325
-------------
0 		114,257
-------------
0 		35,700
-------------
0 		25,964
-------------
0 		608,323
-------------
0 		114,257
-------------
0
51Cathy Jewell
  Sr VP, Chief Nursing Officer 		(i)

(ii)		 271,469
-------------
0 		16,200
-------------
0 		64,923
-------------
0 		110,865
-------------
0 		26,723
-------------
0 		490,179
-------------
0 		0
-------------
0
52Bart Metzger
  Sr VP, Chief HR Officer 		(i)

(ii)		 0
-------------
275,796 		0
-------------
73,918 		0
-------------
9,600 		0
-------------
32,921 		0
-------------
18,590 		0
-------------
410,826 		0
-------------
0
53John T Randolph
  VP, Chief Corporate Compliance 		(i)

(ii)		 0
-------------
222,205 		0
-------------
51,190 		0
-------------
0 		0
-------------
100,688 		0
-------------
25,357 		0
-------------
399,440 		0
-------------
0
54Alice Shakman
  Sr. VP, Operations (UMMMC) 		(i)

(ii)		 263,479
-------------
0 		58,826
-------------
0 		30,620
-------------
0 		113,035
-------------
0 		12,157
-------------
0 		478,117
-------------
0 		30,620
-------------
0
55Jeffrey A Smith MD
  Executive VP, COO 		(i)

(ii)		 255,953
-------------
0 		129,250
-------------
0 		0
-------------
0 		26,095
-------------
0 		13,295
-------------
0 		424,593
-------------
0 		0
-------------
0
56Timothy Tarnowski
  Sr VP, Chief Info Officer 		(i)

(ii)		 0
-------------
447,018 		0
-------------
101,250 		0
-------------
10,449 		0
-------------
54,780 		0
-------------
37,335 		0
-------------
650,832 		0
-------------
0
57Diane Thompson
  Sr. VP, Chief Nursing Officer until 4/9/15 		(i)

(ii)		 99,292
-------------
0 		45,487
-------------
0 		404,752
-------------
0 		17,153
-------------
0 		7,803
-------------
0 		574,487
-------------
0 		385,039
-------------
0
58David C Ayers MD
  Physician, Chair of Orthopedics and Physical Rehab - Med Group 		(i)

(ii)		 636,255
-------------
0 		27,750
-------------
0 		0
-------------
0 		13,250
-------------
0 		28,897
-------------
0 		706,152
-------------
0 		0
-------------
0
59Adel Bozorgzadeh MD
  Physician, Chief of Organ Transplantation - Med Group 		(i)

(ii)		 478,476
-------------
0 		259,361
-------------
0 		0
-------------
0 		13,250
-------------
0 		29,479
-------------
0 		780,565
-------------
0 		0
-------------
0
60Demetrius Litwin MD
  Physician, Chair of Surgery Dept - Med Group 		(i)

(ii)		 586,928
-------------
0 		154,924
-------------
0 		0
-------------
0 		13,250
-------------
0 		32,135
-------------
0 		787,238
-------------
0 		0
-------------
0
61Ajit S Puri MD
  Physician, Division Chief of Neuroimaging and Intervention - Med Group 		(i)

(ii)		 472,848
-------------
0 		198,733
-------------
0 		19,000
-------------
0 		13,250
-------------
0 		25,006
-------------
0 		728,836
-------------
0 		19,000
-------------
0
62Jennifer Walker MD
  Physician, Division Chief of Cardiac Surgery - Med Group 		(i)

(ii)		 510,639
-------------
0 		125,000
-------------
0 		0
-------------
0 		13,250
-------------
0 		28,128
-------------
0 		677,018
-------------
0 		0
-------------
0
63Sharon Hylka
  Former Sr. VP, Hospital Admin until 1/14 		(i)

(ii)		 0
-------------
0 		0
-------------
0 		298,006
-------------
0 		0
-------------
0 		109
-------------
0 		298,116
-------------
0 		281,427
-------------
0
64Robert A Phillips MD
  Former Med Dir, Heart & Vascular COE, until 6/7/13 		(i)

(ii)		 0
-------------
0 		0
-------------
0 		783,997
-------------
0 		0
-------------
0 		109
-------------
0 		784,106
-------------
0 		783,997
-------------
0
65Arthur M Pappas MD
  Former Director UMM Community Hospitals, Inc. until 3/27/13 		(i)

(ii)		 12,981
-------------
0 		0
-------------
0 		800
-------------
0 		2,019
-------------
0 		109
-------------
0 		15,910
-------------
0 		800
-------------
0
66Michael J Cofone
  Former Officer/Director until 6/14, HealthAlliance Hospitals, Inc. 		(i)

(ii)		 92,441
-------------
0 		0
-------------
0 		895
-------------
0 		2,861
-------------
0 		9,657
-------------
0 		105,853
-------------
0 		0
-------------
0
67Candra D Szymanski
  Former Interim President/Director until 12/13, Marlborough Hospital 		(i)

(ii)		 0
-------------
0 		0
-------------
0 		35,868
-------------
0 		1,348
-------------
0 		260
-------------
0 		37,476
-------------
0 		35,868
-------------
0
Schedule J (Form 990) 2015

Schedule J (Form 990) 2015
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
Schedule J, Part II THE ABOVE DIRECOTRS RECEIVE NO COMPENSATION FOR THEIR ROLE AS DIRECTORS. ALL COMPENSATION RECEIVED RELATES TO THEIR POSITION AS A PHYSICIAN/ADMINISTRATOR.
Schedule J, Part I, Line 4a Severance or change-of-control payment The following individuals received or had deferred severance in the reporting period: Included in Sch J Col Biii: George, Patricia $ 25,000 Hylka, Sharon $ 256,577 Szymanski, Candra D. $ 35,868 Thompson, Diane $ 245,761
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan The following individuals participated in, or received payment from, a supplemental nonqualified retirement plan in the reporting period: Officers, Directors, Trustees Bolland Eshghi, Katharine $35,381 Brown, Douglas S. $51,623 Corbett, William, MD $32,471 Daly, Sheila $38,516 Dickson, Eric W., MD $57,487 Eisenstock, Jordan, MD $6,038 Eisenstock, Kimberly, MD $6,815 Ekstrom, Deborah $14,037 Fairchild, David, MD $36,007 Ferguson, R. Kevin, MD $6,941 Finberg, Robert W., MD $640,000 Greenwood, John $16,360 Iitsuka, Carlos $- Lapriore, Cheryl M. $79,214 Lasser, Daniel H., MD $24,866 Li, Shipen, MD $7,502 Melgar, Sergio $- Muldoon, Patrick $47,245 Okike, O. Nsidinanya, MD $19,000 Philbin, Chris $6,189 Roach, Steven $- Rossi, Catherine $12,218 Shirshac, Jeanne $6,977 Sioufi, Habib A., MD $6,766 Streeter, Michele $29,533 Swenson, Dana E. $- Tosi, Stephen E., MD $329,616 Weymouth, Deborah $- Subtotal Off, Dir, Trustees $1,510,802 Key Employees: Cyr, James P. $39,833 Day, Therese $21,081 Feldmann, Robert $- Fisher, Barbara $34,021 Hudlin, Margaret, MD $114,257 Jewell, Cathy $- Metzger, Bart $- Randolph, John T. $- Shakman, Alice $30,620 Smith, Jeffrey A., MD $- Tarnowski, Timothy $- Thompson, Diane $92,217 Subtotal Key Employees $332,029 Top 5 Highest Paid Puri, Ajit S, MD $19,000 Subtotal Top 5 highest paid $19,000 Former: Hylka, Sharon $24,850 Pappas, Arthur M., MD $800 Phillips, Robert A., MD $783,997 Subtotal Former $809,647 Total $2,671,478
Schedule J (Form 990) 2015
Additional Data


Software ID: 15000238
Software Version: 2015v3.0
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 Part VI.
SchKMediumBullet Attach to Form 990.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
UMass Memorial Health Care Inc & Affiliates
 
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 MDFA-UMASS MEMORIAL VARIABLE RATE DEMAND REVENUE BONDS SERIES E REISSUED
  		04-3431814 000000000 04-01-2015 27,290,000 PROCEEDS OF THE BONDS USED TO REISSUE THE OUTSTANDING SERIES E BONDS   X   X   X
B MDFA-UMASS MEMORIAL VARIABLE RATE DEMAND REVENUE BONDS SERIES F REISSUED
  		04-3431814 000000000 05-21-2015 27,290,000 PROCEEDS OF THE BONDS USED TO REISSUE THE OUTSTANDING SERIES F BONDS   X   X   X
C MDFA-MARLBOROUGH HOSPITAL VARIABLE RATE SERIES A
  		04-3431814 000000000 11-24-2009 9,420,000 PAY OFF HEFA POOL O LOAN, ER RENOVATIONS, EICU EQUIPMENT, CT SCAN LEASE, MAMMOGRAPHY UNIT   X   X   X
D MHEFA-UMASS MEMORIAL SERIES G
  		04-2456011 SEEPARTVI 05-27-2010 61,833,656 REFUNDING OF CNEHA SERIES A BOND (1993) AND MEDICAL CENTER OF CENTRAL MA, SERIES B (1992)   X   X   X
MDFA-UMASS MEMORIAL MASTER LEASE
  		04-3431814 000000000 12-09-2010 20,000,000 CAPITAL EQUIPMENT   X   X   X
MDFA-UMASS MEMORIAL SERIES H
  		04-3431814 SEEPARTVI 08-10-2011 92,293,778 PART REFUND OF MED C VAR RATE SER A (98), REFUND IN FULL OF CNEHA SER B (98) &UMASS MEM SER C (01).   X   X   X
MDFA-UMASS MEMORIAL MASTER LEASE
  		04-3431814 000000000 12-28-2011 20,000,000 CAPITAL EQUIPMENT   X   X   X
MDFA-UMASS MEMORIAL MASTER LEASE
  		04-3431814 000000000 08-14-2013 20,000,000 CAPITAL EQUIPMENT   X   X   X
MDFA - UMASS MEMORIAL SERIES I
  		04-3431814 SEEPARTVI 02-02-2016 194,086,349 REFUNDING IN FULL UMASS MEM SER A REV BONDS (98) AND UMASS MEM SERIES D (05), VARIOUS CONST & EQUIP.   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired .................. 1,565,000 1,565,000 1,447,000 27,675,000
2 Amount of bonds legally defeased .............. 0 0 0 0
3 Total proceeds of issue .................. 27,290,000 27,290,000 9,420,000 61,833,836
4 Gross proceeds in reserve funds ............. 0 0 0 0
5 Capitalized interest from proceeds ............. 520,873 430,658 1,462,535 14,331,579
6 Proceeds in refunding escrows ............... 27,290,000 27,290,000 0 60,734,797
7 Issuance costs from proceeds ............... 0 0 93,458 1,099,039
8 Credit enhancement from proceeds ............. 0 0 0 0
9 Working capital expenditures from proceeds ............. 0 0 0 0
10 Capital expenditures from proceeds ............. 0 0 9,326,542 0
11 Other spent proceeds ............. 0 0 0 0
12 Other unspent proceeds ............. 0 0 0 0
13 Year of substantial completion ............. 2015 2015 2009 2010
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 Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
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 of bond-financed property? .............   X   X   X   X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? .............   X   X   X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
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 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0 % 0 % 0 % 0 %
6 Total of lines 4 and 5 ............. 0 % 0 % 0 % 0 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........ 		X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? ....... X   X     X   X
b Exception to rebate? ........   X   X X     X
c No rebate due? .........   X   X   X X  
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X   X   X     X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider ..........  
  		 
  		 
  		 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (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? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
Schedule K, Part I, Column (c) Series G CUSIP List 57586EUS8, 57586EUT6, 57586EUU3, 57586EUV1, 57586EUW9, 57586EUX7, 57586EUY5, 57586EUZ2, 57586EVA6, 57586EVB4, 57586EVC2, 57586EVD0, 57586EVE8, 57586EVF5, 57586EVG3, 57586EVH1, 57586EVJ7
Schedule K, Part I, Column (c) Series H CUSIP List 57583UGP7, 57583UGQ5, 57583UGR3, 57583UGS1, 57583UGT9, 57583UGU6, 57583UGV4, 57583UGW2, 57583UGX0, 57583UGY8, 57583UGZ5, 57583UHA9, 57583UHB7, 57583UHC5
Schedule K, Part I, Column (c) Series I CUSIP List 57584XJK8, 57584XJL6, 57584XJM4, 57584XJN2, 57584XJP7, 57584XJQ5, 57584XJR3, 57584XJS1, 57584XJT9, 57584XJU6, 57584XJV4, 57584XJW2, 57584XJX0, 57584XJY8, 57584XJZ5, 57584XKA8, 57584XKB6, 57584XKC4
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA-UMASS MEMORIAL VARIABLE RATE DEMAND REVENUE BONDS, SERIES E REISSUED n/a
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA-UMASS MEMORIAL VARIABLE RATE DEMAND REVENUE BONDS, SERIES F REISSUED n/a
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA-MARLBOROUGH HOSPITAL VARIABLE RATE, SERIES A N/A
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MHEFA-UMASS MEMORIAL, SERIES G COLUMN E ISSUE PRICE OF $61,833,656; ADD INTEREST EARNED ON PROCEEDS OF $180, EQUALS LINE 3 OF $61,833,836
Schedule K, Part IV, Line 2c COLUMN D Issuer name: MHEFA-UMASS MEMORIAL, SERIES G The calculation for computing no rebate due was performed on 10/14/2014
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA-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.
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA-UMASS MEMORIAL, SERIES H N/A
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA-UMASS MEMORIAL MASTER LEASE COLUMN E ISSUE PRICE OF $20,000,000, ADD INTEREST EARNED ON PROCEEDS OF $13,504, EQUALS LINE 3 OF $20,013,504.
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA-UMASS MEMORIAL MASTER LEASE COLUMN E ISSUE PRICE OF $20,000,000, ADD INTEREST EARNED ON PROCEEDS OF $723, EQUALS LINE 3 OF $20,000,723.
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA - UMASS MEMORIAL, SERIES I COLUMN E ISSUE PRICE OF $194,086,349, ADD INTEREST EARNED ON PROCEEDS OF $353,669, EQUALS LINE 3 OF $194,440,018.
Schedule K (Form 990) 2015

Additional Data


Software ID: 15000238
Software Version: 2015v3.0

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 Part VI.
SchKMediumBullet Attach to Form 990.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
UMass Memorial Health Care Inc & Affiliates
 
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 MDFA-UMASS MEMORIAL VARIABLE RATE DEMAND REVENUE BONDS SERIES E REISSUED
  		04-3431814 000000000 04-01-2015 27,290,000 PROCEEDS OF THE BONDS USED TO REISSUE THE OUTSTANDING SERIES E BONDS   X   X   X
B MDFA-UMASS MEMORIAL VARIABLE RATE DEMAND REVENUE BONDS SERIES F REISSUED
  		04-3431814 000000000 05-21-2015 27,290,000 PROCEEDS OF THE BONDS USED TO REISSUE THE OUTSTANDING SERIES F BONDS   X   X   X
C MDFA-MARLBOROUGH HOSPITAL VARIABLE RATE SERIES A
  		04-3431814 000000000 11-24-2009 9,420,000 PAY OFF HEFA POOL O LOAN, ER RENOVATIONS, EICU EQUIPMENT, CT SCAN LEASE, MAMMOGRAPHY UNIT   X   X   X
D MHEFA-UMASS MEMORIAL SERIES G
  		04-2456011 SEEPARTVI 05-27-2010 61,833,656 REFUNDING OF CNEHA SERIES A BOND (1993) AND MEDICAL CENTER OF CENTRAL MA, SERIES B (1992)   X   X   X
MDFA-UMASS MEMORIAL MASTER LEASE
  		04-3431814 000000000 12-09-2010 20,000,000 CAPITAL EQUIPMENT   X   X   X
MDFA-UMASS MEMORIAL SERIES H
  		04-3431814 SEEPARTVI 08-10-2011 92,293,778 PART REFUND OF MED C VAR RATE SER A (98), REFUND IN FULL OF CNEHA SER B (98) &UMASS MEM SER C (01).   X   X   X
MDFA-UMASS MEMORIAL MASTER LEASE
  		04-3431814 000000000 12-28-2011 20,000,000 CAPITAL EQUIPMENT   X   X   X
MDFA-UMASS MEMORIAL MASTER LEASE
  		04-3431814 000000000 08-14-2013 20,000,000 CAPITAL EQUIPMENT   X   X   X
MDFA - UMASS MEMORIAL SERIES I
  		04-3431814 SEEPARTVI 02-02-2016 194,086,349 REFUNDING IN FULL UMASS MEM SER A REV BONDS (98) AND UMASS MEM SERIES D (05), VARIOUS CONST & EQUIP.   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired .................. 1,565,000 1,565,000 1,447,000 27,675,000
2 Amount of bonds legally defeased .............. 0 0 0 0
3 Total proceeds of issue .................. 27,290,000 27,290,000 9,420,000 61,833,836
4 Gross proceeds in reserve funds ............. 0 0 0 0
5 Capitalized interest from proceeds ............. 520,873 430,658 1,462,535 14,331,579
6 Proceeds in refunding escrows ............... 27,290,000 27,290,000 0 60,734,797
7 Issuance costs from proceeds ............... 0 0 93,458 1,099,039
8 Credit enhancement from proceeds ............. 0 0 0 0
9 Working capital expenditures from proceeds ............. 0 0 0 0
10 Capital expenditures from proceeds ............. 0 0 9,326,542 0
11 Other spent proceeds ............. 0 0 0 0
12 Other unspent proceeds ............. 0 0 0 0
13 Year of substantial completion ............. 2015 2015 2009 2010
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 Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
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 of bond-financed property? .............   X   X   X   X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? .............   X   X   X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
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 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0 % 0 % 0 % 0 %
6 Total of lines 4 and 5 ............. 0 % 0 % 0 % 0 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........ 		X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? ....... X   X     X   X
b Exception to rebate? ........   X   X X     X
c No rebate due? .........   X   X   X X  
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X   X   X     X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider ..........  
  		 
  		 
  		 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (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? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
Schedule K, Part I, Column (c) Series G CUSIP List 57586EUS8, 57586EUT6, 57586EUU3, 57586EUV1, 57586EUW9, 57586EUX7, 57586EUY5, 57586EUZ2, 57586EVA6, 57586EVB4, 57586EVC2, 57586EVD0, 57586EVE8, 57586EVF5, 57586EVG3, 57586EVH1, 57586EVJ7
Schedule K, Part I, Column (c) Series H CUSIP List 57583UGP7, 57583UGQ5, 57583UGR3, 57583UGS1, 57583UGT9, 57583UGU6, 57583UGV4, 57583UGW2, 57583UGX0, 57583UGY8, 57583UGZ5, 57583UHA9, 57583UHB7, 57583UHC5
Schedule K, Part I, Column (c) Series I CUSIP List 57584XJK8, 57584XJL6, 57584XJM4, 57584XJN2, 57584XJP7, 57584XJQ5, 57584XJR3, 57584XJS1, 57584XJT9, 57584XJU6, 57584XJV4, 57584XJW2, 57584XJX0, 57584XJY8, 57584XJZ5, 57584XKA8, 57584XKB6, 57584XKC4
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA-UMASS MEMORIAL VARIABLE RATE DEMAND REVENUE BONDS, SERIES E REISSUED n/a
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA-UMASS MEMORIAL VARIABLE RATE DEMAND REVENUE BONDS, SERIES F REISSUED n/a
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA-MARLBOROUGH HOSPITAL VARIABLE RATE, SERIES A N/A
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MHEFA-UMASS MEMORIAL, SERIES G COLUMN E ISSUE PRICE OF $61,833,656; ADD INTEREST EARNED ON PROCEEDS OF $180, EQUALS LINE 3 OF $61,833,836
Schedule K, Part IV, Line 2c COLUMN D Issuer name: MHEFA-UMASS MEMORIAL, SERIES G The calculation for computing no rebate due was performed on 10/14/2014
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA-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.
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA-UMASS MEMORIAL, SERIES H N/A
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA-UMASS MEMORIAL MASTER LEASE COLUMN E ISSUE PRICE OF $20,000,000, ADD INTEREST EARNED ON PROCEEDS OF $13,504, EQUALS LINE 3 OF $20,013,504.
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA-UMASS MEMORIAL MASTER LEASE COLUMN E ISSUE PRICE OF $20,000,000, ADD INTEREST EARNED ON PROCEEDS OF $723, EQUALS LINE 3 OF $20,000,723.
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA - UMASS MEMORIAL, SERIES I COLUMN E ISSUE PRICE OF $194,086,349, ADD INTEREST EARNED ON PROCEEDS OF $353,669, EQUALS LINE 3 OF $194,440,018.
Schedule K (Form 990) 2015

Additional Data


Software ID: 15000238
Software Version: 2015v3.0

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 Part VI.
SchKMediumBullet Attach to Form 990.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
UMass Memorial Health Care Inc & Affiliates
 
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 MDFA-UMASS MEMORIAL VARIABLE RATE DEMAND REVENUE BONDS SERIES E REISSUED
  		04-3431814 000000000 04-01-2015 27,290,000 PROCEEDS OF THE BONDS USED TO REISSUE THE OUTSTANDING SERIES E BONDS   X   X   X
B MDFA-UMASS MEMORIAL VARIABLE RATE DEMAND REVENUE BONDS SERIES F REISSUED
  		04-3431814 000000000 05-21-2015 27,290,000 PROCEEDS OF THE BONDS USED TO REISSUE THE OUTSTANDING SERIES F BONDS   X   X   X
C MDFA-MARLBOROUGH HOSPITAL VARIABLE RATE SERIES A
  		04-3431814 000000000 11-24-2009 9,420,000 PAY OFF HEFA POOL O LOAN, ER RENOVATIONS, EICU EQUIPMENT, CT SCAN LEASE, MAMMOGRAPHY UNIT   X   X   X
D MHEFA-UMASS MEMORIAL SERIES G
  		04-2456011 SEEPARTVI 05-27-2010 61,833,656 REFUNDING OF CNEHA SERIES A BOND (1993) AND MEDICAL CENTER OF CENTRAL MA, SERIES B (1992)   X   X   X
MDFA-UMASS MEMORIAL MASTER LEASE
  		04-3431814 000000000 12-09-2010 20,000,000 CAPITAL EQUIPMENT   X   X   X
MDFA-UMASS MEMORIAL SERIES H
  		04-3431814 SEEPARTVI 08-10-2011 92,293,778 PART REFUND OF MED C VAR RATE SER A (98), REFUND IN FULL OF CNEHA SER B (98) &UMASS MEM SER C (01).   X   X   X
MDFA-UMASS MEMORIAL MASTER LEASE
  		04-3431814 000000000 12-28-2011 20,000,000 CAPITAL EQUIPMENT   X   X   X
MDFA-UMASS MEMORIAL MASTER LEASE
  		04-3431814 000000000 08-14-2013 20,000,000 CAPITAL EQUIPMENT   X   X   X
MDFA - UMASS MEMORIAL SERIES I
  		04-3431814 SEEPARTVI 02-02-2016 194,086,349 REFUNDING IN FULL UMASS MEM SER A REV BONDS (98) AND UMASS MEM SERIES D (05), VARIOUS CONST & EQUIP.   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired .................. 1,565,000 1,565,000 1,447,000 27,675,000
2 Amount of bonds legally defeased .............. 0 0 0 0
3 Total proceeds of issue .................. 27,290,000 27,290,000 9,420,000 61,833,836
4 Gross proceeds in reserve funds ............. 0 0 0 0
5 Capitalized interest from proceeds ............. 520,873 430,658 1,462,535 14,331,579
6 Proceeds in refunding escrows ............... 27,290,000 27,290,000 0 60,734,797
7 Issuance costs from proceeds ............... 0 0 93,458 1,099,039
8 Credit enhancement from proceeds ............. 0 0 0 0
9 Working capital expenditures from proceeds ............. 0 0 0 0
10 Capital expenditures from proceeds ............. 0 0 9,326,542 0
11 Other spent proceeds ............. 0 0 0 0
12 Other unspent proceeds ............. 0 0 0 0
13 Year of substantial completion ............. 2015 2015 2009 2010
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 Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
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 of bond-financed property? .............   X   X   X   X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? .............   X   X   X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
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 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0 % 0 % 0 % 0 %
6 Total of lines 4 and 5 ............. 0 % 0 % 0 % 0 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........ 		X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? ....... X   X     X   X
b Exception to rebate? ........   X   X X     X
c No rebate due? .........   X   X   X X  
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X   X   X     X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider ..........  
  		 
  		 
  		 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (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? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
Schedule K, Part I, Column (c) Series G CUSIP List 57586EUS8, 57586EUT6, 57586EUU3, 57586EUV1, 57586EUW9, 57586EUX7, 57586EUY5, 57586EUZ2, 57586EVA6, 57586EVB4, 57586EVC2, 57586EVD0, 57586EVE8, 57586EVF5, 57586EVG3, 57586EVH1, 57586EVJ7
Schedule K, Part I, Column (c) Series H CUSIP List 57583UGP7, 57583UGQ5, 57583UGR3, 57583UGS1, 57583UGT9, 57583UGU6, 57583UGV4, 57583UGW2, 57583UGX0, 57583UGY8, 57583UGZ5, 57583UHA9, 57583UHB7, 57583UHC5
Schedule K, Part I, Column (c) Series I CUSIP List 57584XJK8, 57584XJL6, 57584XJM4, 57584XJN2, 57584XJP7, 57584XJQ5, 57584XJR3, 57584XJS1, 57584XJT9, 57584XJU6, 57584XJV4, 57584XJW2, 57584XJX0, 57584XJY8, 57584XJZ5, 57584XKA8, 57584XKB6, 57584XKC4
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA-UMASS MEMORIAL VARIABLE RATE DEMAND REVENUE BONDS, SERIES E REISSUED n/a
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA-UMASS MEMORIAL VARIABLE RATE DEMAND REVENUE BONDS, SERIES F REISSUED n/a
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA-MARLBOROUGH HOSPITAL VARIABLE RATE, SERIES A N/A
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MHEFA-UMASS MEMORIAL, SERIES G COLUMN E ISSUE PRICE OF $61,833,656; ADD INTEREST EARNED ON PROCEEDS OF $180, EQUALS LINE 3 OF $61,833,836
Schedule K, Part IV, Line 2c COLUMN D Issuer name: MHEFA-UMASS MEMORIAL, SERIES G The calculation for computing no rebate due was performed on 10/14/2014
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA-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.
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA-UMASS MEMORIAL, SERIES H N/A
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA-UMASS MEMORIAL MASTER LEASE COLUMN E ISSUE PRICE OF $20,000,000, ADD INTEREST EARNED ON PROCEEDS OF $13,504, EQUALS LINE 3 OF $20,013,504.
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA-UMASS MEMORIAL MASTER LEASE COLUMN E ISSUE PRICE OF $20,000,000, ADD INTEREST EARNED ON PROCEEDS OF $723, EQUALS LINE 3 OF $20,000,723.
Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: MDFA - UMASS MEMORIAL, SERIES I COLUMN E ISSUE PRICE OF $194,086,349, ADD INTEREST EARNED ON PROCEEDS OF $353,669, EQUALS LINE 3 OF $194,440,018.
Schedule K (Form 990) 2015

Additional Data


Software ID: 15000238
Software Version: 2015v3.0

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, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
UMass Memorial Health Care Inc & Affiliates
 
Employer identification number

91-2155626
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) 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) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by 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-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
(1) FLOYD CONNELLY
  		FORMER EXECUTIVE DIRECTOR OF CMMIC, INC. CSV OF LIFE INSURANCE   X 455,570 335,392   No Yes   Yes  
(2) THOMAS CUMMINGS
  		FORMER CEO OF MARLBOROUGH HOSPITAL CSV OF LIFE INSURANCE   X 302,877 249,690   No Yes   Yes  
(3) WILLIAM J WILLIAMS
  		FORMER OFFICER OF HEALTHALLIANCE HOSPITALS, INC. CSV OF LIFE INSURANCE   X 1,981,627 4,353,944   No Yes   Yes  
Total ...............Small Bullet $ 4,939,026
Part III
Grants or Assistance Benefiting 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 assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2015
Schedule L (Form 990 or 990-EZ) 2015
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) Robert A Babineau Jr MD PC
  		Entity more than 35% owned by Robert A. Babineau Jr., M.D., Board Director (until 2/16) 52,392 3rd Party Payer Contract Payment   No
(2) 80 Erdman Way LLC
  		Entity more than 35% owned by John R. Clementi, Board Director 100,949 Rental of Property - Expense   No
(3) Princeton Biomedical Inc
  		Entity more than 35% owned by Eric W. Dickson, M.D., Officer / Board Director 569,610 Physician Services provided by Princeton Biomedical, Inc., which is contracted through Wachusett Emergency Physicians, PC   No
(4) Marlboro Internal Medicine PC
  		Entity more than 35% owned by Lalita Matta, M.D., Board Director 40,304 3rd Party Payer Contract Payment   No
(5) Leominster Medical Associates LP
  		Entity more than 35% owned by Daniel J. O'Leary, M.D., Board Director 72,073 3rd Party Payer Contract Payment   No
(6) R Leslie Shelton MD PC
  		Entity more than 35% owned by Robert Leslie Shelton, M.D., Board Director 12,670 3rd Party Payer Contract Payment   No
(7) Ellen Carlucci
  		Family Member of Daniel Carlucci, M.D., Board Director 137,387 Employment Arrangement w/ Marlborough Hospital   No
(8) Joanne D'Onfro
  		Family Member of Paul D'Onfro, Board Director 68,047 Employment Arrangement w/ HealthAlliance Hospitals, Inc.   No
(9) Jordan Eisenstock MD
  		Family Member of Kimberly Eisenstock, M.D., Board Director 102,992 Employment Arrangement w/ UMM Medical Group, Inc.   No
(10) Kimberly Eisenstock MD
  		Family Member of Jordan Eisenstock, M.D., Board Director 306,487 Employment Arrangement w/ UMM Medical Group, Inc.   No
(11) Elaine Granville RN
  		Family Member of Cheryl Lapriore, Officer / Board Director 153,333 Employment Arrangement w/ UMM Medical Center, Inc.   No
(12) Eileen Henrickson RN
  		Family Member of Deborah Ekstrom, Officer (until 1/16) 181,768 Employment Arrangement w/ UMM Medical Center, Inc.   No
(13) Kathleen Hylka
  		Family Member of Sharon Hylka, Former Key Employee (until 1/14) 171,638 Employment Arrangement w/ UMM Medical Center, Inc.   No
(14) Kathryn C May
  		Family Member of Deborah Ekstrom, Officer (until 1/16) 66,868 Employment Arrangement w/ UMM Medical Center, Inc.   No
(15) Joshua P Szymanski
  		Family Member of Candra Szymanski, Former Board Director (until 12/13) 43,724 Employment Arrangement w/ Marlborough Hospital   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L, Part IV Business Transactions Involving Interested Persons Several of our community hospitals maintain local bank accounts in their respective communities. Each also has trustees from these banks on their boards. These banking relationships have been assessed, meet fair market value requirements, and are valued well below the disclosure thresholds.
Schedule L, Part II Loans from Interested Persons Amounts due from former officers pertain to split dollar life insurance policies of the respective 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.
Schedule L (Form 990 or 990-EZ) 2015


Additional Data


Software ID: 15000238
Software Version: 2015v3.0




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 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
UMass Memorial Health Care Inc & Affiliates
 
Employer identification number

91-2155626
Return Reference Explanation
Form 990, Part III, Line 4d Description of other program services (Expenses $ 76,701,756 including grants of $ 19,365)(Revenue $ 92,837,675) OTHER UMASS MEMORIAL ENTITIES - UMASS 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 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, OR PATIENT ADVOCACY SERVICES TO THE PATIENTS OF UMASS MEMORIAL, CENTRAL NEW ENGLAND, AND OTHER GEOGRAPHIES.
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons MARLBOROUGH HOSPITAL: CARLUCCI, DANIEL, BOARD MEMBER ELLEN CARLUCCI - Family relationship, MARLBOROUGH HOSPITAL: EISENSTOCK, KIMBERLY (BOARD MEMBER) AND EISENSTOCK, JORDAN (BOARD MEMBER) - Family relationship, ACO: EISENSTOCK, JORDAN (BOARD MEMBER) AND EISENSTOCK, KIMBERLY - Family relationship
Form 990, Part VI, Line 6 Classes of members or stockholders THERE ARE NO CLASSES OF DIRECTORS. THE VOTING RIGHTS OF EACH MEMBER'S BOARD ARE ABSOLUTE.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE MAJORITY OF ENTITIES IN THE CONSOLIDATED GROUP HAVE A SOLE MEMBER (UMMHC - Parent) 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, Line 7b Decisions requiring approval by members or stockholders THE MAJORITY OF THE ENTITIES IN THE CONSOLIDATED GROUP HAVE A SOLE MEMBER (UMMHC - Parent) 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 GUARANTEES; 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, Line 11b Review of form 990 by governing body 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, Line 12c Conflict of interest policy 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. The following groups of individuals are covered by this policy: a. All Trustees/Directors: all UMM entities b. UMMHC/UMMMC/UMMMG: Dept Heads and above; selected others c. Physicians: all employed physicians, members of any board committee, members of Medical Staff Executive Committees; others as determined appropriate THERE IS ACTIVE MONITORING by the UMMHC Dept. of Compliance AND COMMUNICATION TO ENSURE INDIVIDUALS WITH OUTSIDE RELATIONSHIPS DO NOT INAPPROPRIATELY PARTICIPATE IN BUSINESS DECISIONS OF THE ORGANIZATION, PURCHASING OR RESEARCH DECISIONS. Any conflicts identified are reported to the appropriate officer and/or governing body. We have an appropriate management plan with any individuals with outside relationships that require mitigation. Where it is necessary, individuals may provide subject matter expertise however they have no influence or authorization of decisions for the organization.
Form 990, Part VI, Line 15a Process to establish compensation of top management official COMPENSATION MATTERS FOR THE CEO AND SENIOR EXECUTIVES ARE GOVERNED AND OVERSEEN BY THE BOARD OF TRUSTEES OF THE ORGANIZATION. 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. INDEPENDENT OUTSIDE COMPENSATION CONSULTANTS PROVIDE ADVICE TO THE COMMITTEE AND THE BOARD 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, Line 15b Process to establish compensation of other employees See the explanation for Part VI, Line 15a.
Form 990, Part VI, Line 19 Required documents available to the public UMASS MEMORIAL MAKES ITS 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.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue REBATE INCOME - Total Revenue: 16992, Related or Exempt Function Revenue: 15344, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 1648; Workers compensation refund - Total Revenue: 17900, Related or Exempt Function Revenue: 17900, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 0;
Form 990, Part IX, Line 11g Other Fees Recruitment fees - Total Expense: 750929, Program Service Expense: 741340, Management and General Expenses: 9589, Fundraising Expenses: ; Clinical engineering services - Total Expense: 1258781, Program Service Expense: 1258781, Management and General Expenses: 0, Fundraising Expenses: ; Medical School participation payment & MES - Total Expense: XXX-XX-XXXX, Program Service Expense: XXX-XX-XXXX, Management and General Expenses: 0, Fundraising Expenses: ; Professional Medical Services - Total Expense: 21927094, Program Service Expense: 21927094, Management and General Expenses: 0, Fundraising Expenses: ; Transcription Services - Total Expense: 4705829, Program Service Expense: 3887271, Management and General Expenses: 818558, Fundraising Expenses: ; Answering Services - Total Expense: 226164, Program Service Expense: 220560, Management and General Expenses: 5604, Fundraising Expenses: ; Collection Agency Services - Total Expense: 2609738, Program Service Expense: 1784422, Management and General Expenses: 825316, Fundraising Expenses: ; Outside Lab Services - Total Expense: 14910852, Program Service Expense: 14910852, Management and General Expenses: 0, Fundraising Expenses: ; Linen Services - Total Expense: 4531299, Program Service Expense: 4531299, Management and General Expenses: 0, Fundraising Expenses: ; Purchased Temporary Help - Total Expense: 13126781, Program Service Expense: 10814907, Management and General Expenses: 2311874, Fundraising Expenses: ; Medical School interns and residents services - Total Expense: 40727472, Program Service Expense: 40727472, Management and General Expenses: 0, Fundraising Expenses: ; Purchased Medical School services - Total Expense: 36873047, Program Service Expense: 36873047, Management and General Expenses: 0, Fundraising Expenses: ; Neonatology Services - Total Expense: 609978, Program Service Expense: 487982, Management and General Expenses: 121996, Fundraising Expenses: ; Housekeeping Services - Total Expense: 3841608, Program Service Expense: 3048650, Management and General Expenses: 792958, Fundraising Expenses: ; Valet Parking Services - Total Expense: 3397912, Program Service Expense: 2718330, Management and General Expenses: 679582, Fundraising Expenses: ; Coding,Billing, and Staffing Services - Total Expense: 11701656, Program Service Expense: 7948657, Management and General Expenses: 3752999, Fundraising Expenses: ; HR FMLA services - Total Expense: 518380, Program Service Expense: 414704, Management and General Expenses: 103676, Fundraising Expenses: ; Landscaping Services - Total Expense: 823760, Program Service Expense: 659005, Management and General Expenses: 164755, Fundraising Expenses: ; Other - Total Expense: 1033394, Program Service Expense: 0, Management and General Expenses: 928722, Fundraising Expenses: 104672;
Exclusion of UMMHC (Parent) from group exemption #3642 UMMHC (Parent) was previously included in the group return #3642 EIN 91-2155626 however effective for the year ended 9/30/16 the Parent has been removed from the group return and is reported on a stand alone Form 990.
Form 990, Part XI, Line 9 Other changes in net assets or fund balances NET ASSETS RELEASED FROM RESTRICTION (FOR PPE) - 758821; NET ASSETS RELEASED FROM RESTRICTIONS (FOR OPERATIONS) - 1969911; PENSION-RELATED CHANGES OTHER THAN NET PERIODIC BENEFIT COST - -93808856; TRANSFERS (TO) FROM RELATED PARTIES - -62441635; CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST - -14115; BOOK INVESTMENT DIFFERENCE FROM S CORP K-1 AND OTHER JV K-1'S - 5114324; TEMPORARY RESTRICTED EXPENDITURES - -341180; PLEDGE RECEIVABLES, WRITE OFFS AND ADJUSTMENTS - 17624; MISC. - 685; ADJUSTMENT TO REMOVE PARENT FROM GROUP 990 - -XXX-XX-XXXX;
Form 990, Part XII, Line 2c Change of oversight process or selection process THE ORGANIZATION'S FINANCIAL STATEMENTS WERE AUDITED BY AN INDEPENDENT ACCOUNTING FIRM ON A CONSOLIDATED BASIS. THE ORGANIZATION HAS AN AUDIT COMMITTEE RESPONSIBLE FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AS WELL AS THE SELECTION OF AN INDEPENDENT ACCOUNTING FIRM.
Part VI, Line 8a and 8b The organization documents the board and committee meetings by taking minutes, which include all meeting discussions and actions. These written minutes are then approved at the following board and committee meetings.
Page 1 Line Hc Members of Group exemption number 3642 The Clinton Hospital Association 201 Highland Street, Clinton, MA 01510 EIN: 04-1185520 FYE: 9/30/2016 Marlborough Hospital 157 Union Street, Marlborough, MA 01752 EIN: 04-2104693 FYE: 9/30/2016 UMass Memorial Behavioral Health System, Inc. 306 Belmont Street, Worcester, MA 01604 EIN: 04-3374724 FYE: 9/30/2016 UMass Memorial Community Hospitals, Inc. 306 Belmont Street, Worcester, MA 01604 EIN: 04-3296271 FYE: 9/30/2016 UMass Memorial Health Ventures, Inc. 306 Belmont Street, Worcester, MA 01604 EIN: 22-2605679 FYE: 9/30/2016 UMass Memorial Medical Center, Inc. 306 Belmont Street, Worcester, MA 01604 EIN: 04-3358564 FYE: 9/30/2016 UMass Memorial Medical Group, Inc. 306 Belmont Street, Worcester, MA 01604 EIN: 04-2911067 FYE: 9/30/2016 UMass Memorial Realty, Inc. 306 Belmont Street, Worcester, MA 01604 EIN: 04-2805630 FYE: 9/30/2016 Community HealthLink, Inc. 72 Jaques Avenue, Worcester, MA 01610 EIN: 04-2626179 FYE: 9/30/2016 Central New England HealthAlliance, Inc. 60 Hospital Road, Leominster, MA 01453 EIN: 04-3172496 FYE: 9/30/2016 Coordinated Primary Care, Inc. 60 Hospital Road, Leominster, MA 01453 EIN: 04-3210002 FYE: 9/30/2016 HealthAlliance Home Health and Hospice, Inc. 25 Tucker Road, Leominster, MA 01453 EIN: 04-2932308 FYE: 9/30/2016 HealthAlliance Hospitals, Inc. 60 Hospital Road, Leominster, MA 01453 EIN: 04-2103555 FYE: 9/30/2016 UMass Memorial Accountable Care Organization, Inc. 306 Belmont Street, Worcester, MA 01604 EIN: 46-2871359 FYE: 9/30/2016
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2015


Additional Data


Software ID: 15000238
Software Version: 2015v3.0
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
UMass Memorial Health Care Inc & Affiliates
 
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 (if applicable) 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 entity?
Yes No
(1)UMASS MEMORIAL FOUNDATION INC
333 SOUTH STREET

SHREWSBURY,MA01545
04-3108190 		FUNDRAISING SUPPORT MA 501(c)(3 Type II NA
 
 
No
(2)HEALTHALLIANCE REALTY CORPORATION
60 HOSPITAL ROAD

LEOMINSTER,MA01473
04-2560754 		REAL ESTATE MANAGEMENT MA 501(c)(2   NA
 
 
No
(3)UMass Memorial Health Care Inc (Parent)
306 Belmont Street

Worcester,MA01604
04-3358566 		Management of Healthcare System MA 501(c)(3 Type III-FI na
 
 
No








For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
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 MRI OF MALRBOROUGH LLC

157 UNION STREET
MARLBOROUGH,MA01752
20-2293995 		MAGNETIC RESONANCE IMAGING MA MARLBOROUGH HOSPITAL
  		Related 583,940 429,221   No     No 56 %
(2) UMASS MEMORIAL HEALTHALLIANCE MRI CENTER LLC

60 HOSPITAL ROAD
LEOMINSTER,MA01453
04-3561571 		MAGNETIC RESONANCE IMAGING MA NA
  		Related 1,064,962 1,331,750   No     No 60 %










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
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) MEMORIAL OFFICE CONDOMIUM TRUST

306 BELMONT STREET
WORCESTER,MA01604
04-6616900 		CONDOMINIUM ASSOCIATION MA UMASS MEMORIAL REALTY INC
  		Trust 0 222,132 53.69 %   No
(2) BIO-LAB INC (disolved 123115)

215 WEST STREET
MILFORD,MA01757
04-2708828 		CLINICAL LABORATORY MA UMASS MEMORIAL HEALTH VENTURES INC
  		S Corporation 0 0 100 %    
(3) 116 BELMONT ST INC CO APPLETON CORP

57 SUFFOLK STREET
HOLYOKE,MA01040
04-2717865 		CONDOMINIUM ASSOCIATION MA UMASS MEMORIAL REALTY INC
  		C Corporation -1,309 164,267 63.04 %   No
(4) Commonwealth Professional Assurance Company Ltd

P O Box 1051 GT
  Grand Cayman,KY11102
CJ
98-0226143 		Insurance CJ NA
  		C Corporation         No






Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
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, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
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 related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) HEALTHALLIANCE REALTY INC

 J 402,912 FAIR VALUE
(2) HEALTHALLIANCE REALTY INC

 P 106,480 FAIR VALUE




Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
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)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(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 Yes No






























Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2015

Additional Data


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Software Version: 2015v3.0