Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (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 | |||||
| (A)
Holyoke Medical Center Inc |
222520073 | 3 | Yes | 0 | 0 | |
| (B)
Valley Health Systems Inc |
042103583 | 7 | Yes | 0 | 0 | |
| (C)
Western Mass Physician Assoc |
043202198 | 3 | No | 0 | 0 | |
| (D)
River Valley Counseling Center |
042174657 | 9 | No | 0 | 0 | |
| (E)
Holyoke Visiting Nurse Assoc |
042104310 | 9 | No | 0 | 0 | |
| Total 5 | 0 | 0 | ||||
Calendar year (or fiscal year beginning in) ![]() |
(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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(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. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(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.).. | ||||||
| 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 | ||||
| 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 |
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|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
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| 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) |
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|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part I, Line 11g, Column v & Column vi: | The Organization was formed to promote the health, charitable, and educational purposes of Valley Health Systems, Inc. and Holyoke Medical Center, Inc. by acquiring, holding, managing, maintaining, developing, or disposing of real property; and engaging in such other activities as may be appropriate and as are consistent with the laws of Massachusetts and Section 501(c)(3) of the Internal Revenue Code. During the current fiscal year, there was no monetary support provided to H-C Management Services, Inc.'s supported organizations. However, in fiscal year 2016, construction began on a new emergency department medical office building that is to be owned and operated by H-C Management Services, Inc. for the benefit of the Holyoke Medical Center, Inc. and its affiliates. See Schedule O for Form 990, Part III, Line 2 and 3 for more information. |
| Schedule A, Part IV, Section A, Line 1: | Several organizations are being listed on Schedule A, Part I, Line 11(h) as being supported organizations that are not currently listed in H-C Management, Inc.'s (HCM) organizational documents. They are being listed as supported organizations as they are wholly-owned organizations at Valley Health Systems, Inc. which is listed in HCM's organizational documents. Futhermore, it is part of HCM's true nature and exempt purpose to support any organization affiliated within the Valley Health Systems, Inc. System that is tax-exempt under 501(c)(3) of the Internal Revenue Code and is a designated public charity 509(a)(1) or 509(a)(2). Though not specifically listed in its governing documents at the time of this filing, each organization listed in Schedule A, Part I, Line 11(h) is part of a designated class of supported organizations by virtue of their affiliation with Valley Health Systems, Inc. as wholly owned subsidiaries. |
| Schedule A, Part IV, Section C, Line 1: | For the current fiscal yearend, control of H-C Management Services, Inc. and its supported organizations were vested in the same persons that control by virtue of multiple shared board members and the same executive leadership. Furthermore, Valley Health Systems, Inc. (VHS) serves as the sole corporate member of the Organization and Holyoke Medical Center. Pursuant to the Organization's bylaws VHS elects the board members of the governing body of H-C Management Services, Inc. VHS also has the power to remove any member of the governing body, with or without cause, at any time by giving written notice to such governing member. |
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Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| Form 990, Part III, line 2 | Due to a change in structure, H-C Management Services, Inc. has undertaken the acquisition, holding, management, maintance, and development of real property on behalf of Valley Health Systems, Inc. and Holyoke Medical Center, Inc. While this stated purpose was a part of the H-C Management Services, Inc.'s original governing documents, in fiscal year 2016, construction began on a new emergency department medical office building that is to be owned and operated by H-C Management Services, Inc. The building qualifies for the New Market Tax Credit (NMTC) due to its potential for creating new jobs and meeting the healthcare needs of the community and will include an emergency room, ancillary departments, and medical office space. NMTC programs were established as part of the Community Renewal Tax Relief Act of 2000. The goal of NMTC programs is to spur revitalization efforts of low-income and impoverished communities across the United States and its Territories by providing tax credit incentives to investors in certified community development entities. As a result of participation in the NMTC program, H-C Management Services will lease land from the Medical Center, own and construct the new emergency room building, and enter into an operating lease agreement with the Medical Center for the use of the property. |
| Form 990, Part III, line 3 | H-C Management Services, Inc. will no longer be tasked with managing, operating and providing management counsel and advice in connection with the provision of medical or healthcare and services ancillary to Holyoke Medical Center and its affiliates. These functions are now to be conducted by Valley Health Systems, Inc.'s, the sole-corporate member of H-C Management Services, Inc. |
| Form 990, Part VI, Section A, line 4 | H-C Management Services, Inc. has made the following significant changes to its bylaws: 1. Under the terms describing the Organization's purpose, the Organization will no longer be tasked with managing, operating and providing management counsel and advice in connection with the provision of medical or healthcare and services ancillary to Holyoke Medical Center and its affiliates. 2. The Composition of the Board and Terms of Office were changed to consist of five members who shall serve for one-year terms. A minimum of two Directors shall be appointed from independent organizations, regardless of the number of Directors serving at any time. Independent Directors shall mean that any Independent Director so appointed shall not be any employee, officer, or director of Valley Health Systems, Inc. or Holyoke Medical Center, Inc. 3. The Board shall no longer have the power to approve any management contract or other management arrangement to include, but not be limited to, the employment of the President, either of which is of a material nature, with another entity which is not controlled directly by or affiliated with the Member. 4. The President shall no longer have the power to appoint the presidents and treasurers of Holyoke Medical Center, Inc., and all other affiliates. |
| Form 990, Part VI, Section A, line 6 | Valley Health Systems, Inc. is the sole member of H-C Management Services, Inc. |
| Form 990, Part VI, Section A, line 7a | Valley Health Systems, Inc. elects the board members of the governing body of H-C Management Services, Inc. Valley Health Systems, Inc. also has the power to remove any member of the governing body, with or without cause, at any time by giving written notice to such governing body member. |
| Form 990, Part VI, Section A, line 7b | Significant decisions of the governing body of H-C Management Services, Inc. are subject to the approval of Valley Health Systems, Inc. as specified in the Organization's bylaws. |
| Form 990, Part VI, Section A, line 8b | There are no committees with the authority to act on behalf of the governing body of the Organization. |
| Form 990, Part VI, Section B, line 11 | A copy of H-C Management Services Inc.'s Form 990 was provided to each voting member of the governing body prior to its filing with the Internal Revenue Service. The Form 990 was prepared with the assistance of an independent public accounting firm and thoroughly reviewed by the Senior Vice President of Finance and CFO and key financial staff of the Hospital prior to distibuting it to the governing body for review. |
| Form 990, Part VI, Section B, line 12c | The conflict of interest policy of H-C Management Services, Inc. (HCM) is monitored and enforced as part of the Valley Health Systems, Inc. System and is reviewed annually by the System's conflict of interest committee. HCM board members and officers complete and sign a conflict of interest questionnaire annually. All signed questionnaires are then submitted to HCM and to Valley Health Systems, Inc. (parent) for review and monitoring. |
| Form 990, Part VI, Section B, line 15 | The compensation committee of the Valley Health System, Inc. utilizes a market compensation survey to recommend to the Board the approval of its determination of the appropriate compensation of the Chief Executive Officer. During that process, the Committee also reviews the compensation levels of other senior management and key employees of the System. These individuals are not members of the compensation committee and do not participate in this process. The CEO, as a member of the Board of VHS, does not participate in the approval process of that officer's compensation. |
| Form 990, Part VI, Section C, line 19 | The governing documents, conflict of interest policy, and financial statements of Valley Health Systems and Affiliates, which includes supplemental information of the filing entity, are available to the public upon request at the Organization's administrative office at 575 Beech Street, Holyoke, MA. |
| Form 990, Part VII: | Antonio Correia, though no longer an officer of the filing organization, remained employed by Valley Health Systems, Inc. and H-C Management Services, Inc. as Chief Strategy Officer until March, 2016. Compensation and hours reflected on Form 990, Part VII and Schedule J, Part II is for his services as Chief Strategy Officer and does not reflect compensation in his capacity as a former officer of the organization. Rocco Mandaglio was listed on the Organization's 9/30/15 Form 990 as a highest compensated employee for his services as a Vice President of Physician Services. He was no longer employed with the Organization effective 9/13/15. However, as compensation for Form 990, Part VII is reported on a calendar year basis, his salary and benefits are reflected. In accordance with IRS instructions, he has been listed as a former highest paid employee as he was not employed with the Organization during the fiscal year, but his calendar year compensation was one of the top 5 highest paid employee amounts during the period covered by Form 990, Part VII. During the fiscal year following the period covered by this return, the Organization's CFO and Treasurer, Paul M. Silva, resigned his position within the affiliated hospital system. Michael J. Koziol became interim-CFO in April of 2017. Accordingly, Mr. Silva is listed in Part VII while Mr. Koziol is listed on Page 1 as the authorized signing officer. Mr. Koziol will be listed in Part VII of the Organization's 9/30/17 Form 990. |
| Form 990, Part XI, line 9: | Equity Transfer from Affiliates 1,356,733. |
| Form 990, Part XII, Line 2c: | The audit process has not changed from the prior year. |
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