TY 2019 Form 990

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) JOSEPH CASEY...................................................................... PRESIDENT & CEO	37.00 ................. 11.00		X				1,403,588	0	313,185
(2) BRIAN KELLY MD...................................................................... VP & CMO	40.00 ................. 5.00			X			559,661	0	280,249
(3) AMY PFEFFER...................................................................... CFO & TREASURER	35.00 ................. 10.00		X				488,083	0	299,200
(4) BRIAN PATEL MD...................................................................... CHIEF OF EMERGENCY SERVICES	40.00 ................. 0.00				X		494,645	0	177,417
(5) MARK MCGUIRE MD...................................................................... PHYSICIAN	40.00 ................. 0.00				X		408,237	0	192,432
(6) ALLAN RASKIN MD...................................................................... PHYSICIAN	40.00 ................. 0.00				X		290,333	0	264,691
(7) RONALD VAN NESS-OTUNNU MD...................................................................... PHYSICIAN	40.00 ................. 0.00				X		390,614	0	125,188
(8) MICHAEL DEMELIS MD...................................................................... PHYSICIAN	40.00 ................. 0.00				X		303,641	0	175,517
(9) ROBIN MORRIS...................................................................... VP OF CLINICAL OPS & INTEGRITY	45.00 ................. 0.00			X			283,904	0	180,038
(10) BRUCE AUERBACH MD...................................................................... FORMER EXEC. DIRECTOR	0.00 ................. 0.00					X	391,386	0	40,258
(11) DAVID SPOOR...................................................................... VP OF PATIENT SRVS/CHF. OF NURSING	45.00 ................. 0.00			X			241,345	0	104,957
(12) JEAN SIDDALL-BENSSON MD...................................................................... DIRECTOR & PHYSICIAN (THRU 12/2019)	2.00 ................. 41.00	X					0	210,542	149,862
(13) CAROLYN ROSS...................................................................... CHIEF HUMAN RESOURCES OFFICER	32.00 ................. 8.00			X			238,033	0	21,627
(14) ROBERT THRESHER...................................................................... CHAIR (THRU 01/20)	2.00 ................. 3.00	X	X				0	0	0
(15) COLLEEN MCGAHAN...................................................................... CLERK/DIRECTOR	2.00 ................. 1.00	X	X				0	0	0
(16) RICHARD SMITH MD...................................................................... DIRECTOR	2.00 ................. 3.00	X					0	0	0
(17) RICHARD DIGIACOMO...................................................................... DIRECTOR	2.00 ................. 1.00	X					0	0	0

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(18) MARCO ARISMENDI........................................................................ DIRECTOR	2.00 .......................1.00	X
(19) PATRICIA COCHRANE........................................................................ DIRECTOR	2.00 .......................1.00	X
(20) MARK COOPER........................................................................ DIRECTOR	2.00 .......................1.00	X
(21) DWAYNE DEMOND........................................................................ DIRECTOR	2.00 .......................3.00	X
(22) EDWARD DION JR........................................................................ DIRECTOR	2.00 .......................1.00	X
(23) ROGER FORMAN........................................................................ DIRECTOR (AS OF 01/2020)	2.00 .......................1.00	X
(24) LAURA GIGNAC........................................................................ DIRECTOR	2.00 .......................1.00	X
(25) PAUL HEROUX........................................................................ DIRECTOR	2.00 .......................1.00	X
(26) DENNIS KELLY........................................................................ DIRECTOR	2.00 .......................1.00	X
(27) JOHN KORONA........................................................................ DIRECTOR (THRU 01/2020)/CHAIR	2.00 .......................3.00	X	X
(28) THOMAS NOEL........................................................................ DIRECTOR	2.00 .......................1.00	X
(29) RALPH SCHLENKER........................................................................ DIRECTOR	2.00 .......................3.00	X
(30) BLAIR BISHER........................................................................ COO (AS OF 03/2020)	8.00 .......................37.00		X

(A) Name and business address	(B) Description of services	(C) Compensation
CROSSCOUNTRY CONSULTING LLC 1600 TYSONS BLVD SUITE 1100 MCLEAN,VA22209	CONSULTING	1,770,171
MEDASSETS SUPPLY CHAIN SYSTEMS LLC PO BOX 742081 ATLANTA,GA303742081	CONTRACT LABOR	1,133,070
ARUP LABORATORIES INC PO BOX 27964 SALT LAKE CITY,UT84127	REFERENCE LAB	942,541
ACCOUNTABLE HEALTHCARE STAFFING PO BOX 732800 DALLAS,TX753732800	CONTRACT LABOR	799,357
ATLANTIC ANESTHESIA 191 PECUNIT STREET CANTON,MA02021	PHYSICIAN SERVICES	758,000
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 33

- TIN:

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.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

STURDY MEMORIAL HOSPITAL INC

Employer identification number

04-2768252

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 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


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) 2019

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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

Gross receipts from related activities, etc. (see instructions) ..................

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

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2018. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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.)..

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

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2018. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

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.

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).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

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.

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.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

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.

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.

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).

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?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

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.

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) .

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).

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.

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.

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.

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

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) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

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

A family member of a person described in (a) above?

11b

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

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.

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.

Section C. Type II Supporting Organizations

Yes

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).

Section D. All Type III Supporting Organizations

Yes

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?

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).

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.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

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.

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.

Parent of Supported Organizations. Answer (a) and (b) below.

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.

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.

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2019

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 2019 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-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

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) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Name of the organization

STURDY MEMORIAL HOSPITAL INC

Employer identification number

04-2768252

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization STURDY MEMORIAL HOSPITAL INC

Part I Contributors	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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization STURDY MEMORIAL HOSPITAL INC		Employer identification number 04-2768252

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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization STURDY MEMORIAL HOSPITAL INC			Employer identification number 04-2768252
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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose 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

(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

(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

(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) (2019)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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

STURDY MEMORIAL HOSPITAL INC

Employer identification number

04-2768252

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

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) 2019

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 Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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? ...................................................................................................................	Yes No

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) 2016	(b) 2017	(c) 2018	(d) 2019	(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) 2019

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)

Yes|No

(b)

Amount

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:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Yes

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

13,264

Total. Add lines 1c through 1i ....................................................................................................

13,264

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

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

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

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."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

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 1B	PAID STAFF OR MANAGEMENT HOSPITAL EMPLOYEES MAY MEET WITH LOCAL AND STATE REPRESENTATIVES TO DISCUSS CURRENT ISSUES AFFECTING THE DELIVERY OF HEALTHCARE IN OUR SERVICE AREA. THE HOSPITAL WORKS TO ADVANCE INITIATIVES TO ENHANCE AND IMPROVE ACCESS TO HEALTH CARE SERVICES.
SCHEDULE C, PART II-B, LINE 1I	THE AMOUNT REPRESENTS A PERCENTAGE OF THE HOSPITAL'S ANNUAL APPORTIONMENT OF MHA/AHA AND ASSOCIATED INDUSTRIES OF MASSACHUSETTS DUES ATTRIBUTED TO LOBBYING EXPENSES. FOR FISCAL 2020 IT WAS ESTIMATED THAT 11.08% ($18,264) WAS USED FOR LOBBYING PURPOSES. THIS AMOUNT IS NETTED AGAINST A ($5,000) PRIOR YEAR OVER ACCRUAL FOR LOBBYING EXPENSES RELATED TO DIRECT CONTACT WITH A REGISTERED LOBBYIST.

Schedule C (Form 990 or 990EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

STURDY MEMORIAL HOSPITAL INC

Employer identification number

04-2768252

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 ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

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)? .............................

Yes No

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.

If the organization elected, as permitted under FASB 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.

If the organization elected, as permitted under FASB 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

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 FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2019

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

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 ....	7,799,091	7,742,025	7,443,544	6,891,557	6,886,412
b	Contributions ...	8,039	199,655	19,840	5,000
c	Net investment earnings, gains, and losses	630,094	-688	615,380	903,230	430,702
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	111,626	141,901	336,739	356,243	234,568
f	Administrative expenses ....
g	End of year balance ......	8,325,598	7,799,091	7,742,025	7,443,544	7,082,546

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

49.400 %

Term endowment SchDMd Bullet

50.600 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

Yes

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

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 .....	1,841,160		1,841,160
b	Buildings ....	111,948,898	74,000,255	37,948,643
c	Leasehold improvements			0
d	Equipment ....	69,072,650	45,598,645	23,474,005
e	Other .....	1,681,499	1,519,157	162,342
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				63,426,150

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther 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
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram 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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

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
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	5,313,036
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) 2019

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	234,619,000
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	-107,951
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	-6,913,532
e	Add lines 2a through 2d .....................			2e	-7,021,483
3	Subtract line 2e from line 1..................			3	241,640,483
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	840,287
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................			4c	840,287
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	242,480,770

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	220,498,913
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	0
3	Subtract line 2e from line 1...................			3	220,498,913
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	840,287
b	Other (Describe in Part XIII.) ............	4b	7,175,877
c	Add lines 4a and 4b.....................			4c	8,016,164
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	228,515,077

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
PART V, LINE 4:	ENDOWMENT FUNDS STURDY MEMORIAL FOUNDATION, INC. MAINTAINS ENDOWMENT FUNDS (RESTRICTED TO PRINCIPAL) FOR THE BENEFIT OF STURDY MEMORIAL FOUNDATION, STURDY MEMORIAL HOSPITAL, INC. AND AFFILIATES. THE ENDOWMENTS CONSIST OF BOTH DONOR RESTRICTED EARNED INCOME AND UNRESTRICTED EARNED INCOME. THE FOUNDATION'S ENDOWMENT INVESTMENT POLICY IS TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO SUPPORT BOTH THE DONOR RESTRICTED REQUIREMENTS AND THE FOUNDATION SPENDING POLICY FOR UNRESTRICTED FUNDS. ANNUALLY, INCOME EARNED ON THE RESTRICTED ENDOWMENT FUNDS IN SUPPORT OF THE DONOR SPECIFIC REQUIREMENTS IS TRANSFERRED TO STURDY MEMORIAL HOSPITAL. A SMALL PORTION OF THE ENDOWMENT IS HELD IN A FUND WITH THE INCOME RESTRICTED FOR "FREE CARE" FOR PATIENTS. THE INCOME ON THIS FUND IS TRANSFERRED ANNUALLY TO STURDY MEMORIAL HOSPITAL, INC. PER THE FOUNDATION RESTRICTED INVESTMENT POLICY, 5% OF THE GENERAL ENDOWMENT IS AVAILABLE FOR SPENDING ANNUALLY AND IS PAID TO THE FOUNDATION. ANNUAL THE INVESTMENT POLICY IS UPDATED AND REVIEWED BY THE INVESTMENT COMMITTEE. THERE WAS AN UPDATE MADE TO THE ENDOWMENT BEGINNING BALANCE REPORTED THREE YEARS AGO, HENCE, THE BEGINNING BALANCE OF THE THREE YEARS AGO ENDOWMENT DOES NOT MATCH TO THE PREVIOUS YEAR ENDING BALANCE.
PART X, LINE 2:	ASC 740 THE HOSPITAL IS A NOT-FOR-PROFIT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AS AMENDED (THE CODE), AND IS GENERALLY EXEMPT FROM INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL IS REQUIRED TO ASSESS UNCERTAIN TAX POSITIONS AND HAS DETERMINED THAT THERE WERE NO SUCH POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	RECLASS FOR BAD DEBT PROVISION -7,175,877. NET ASSETS RELEASED FROM RESTRICTIONS 262,345.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	RECLASS FOR BAD DEBT PROVISION 7,175,877.

Schedule D (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

STURDY MEMORIAL HOSPITAL INC

Employer identification number

04-2768252

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other %

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: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

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.

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"? . . . . . . . . . . . . .

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

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? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	1,791,567	590,012	1,201,555	0.530 %
b	Medicaid (from Worksheet 3, column a) . . . . .	27,963,470	21,042,054	6,921,416	3.030 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	29,755,037	21,632,066	8,122,971	3.560 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	850,620	0	850,620	0.370 %
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .	10,444,278	3,599,038	6,845,240	3.000 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	30,569	0	30,569	0.010 %
j	Total. Other Benefits . .	11,325,467	3,599,038	7,726,429	3.380 %
k	Total. Add lines 7d and 7j .	41,080,504	25,231,104	15,849,400	6.940 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

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)	(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	4	2,420	2,420	0 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	1	1,765	1,765	0 %
7	Community health improvement advocacy
8	Workforce development	7	79,240	79,240	0.030 %
9	Other	6	47,506	47,506	0.020 %
10	Total	18	130,931	130,931	0.050 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

3,408,542

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. ......

788,737

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

Enter total revenue received from Medicare (including DSH and IME).....

64,269,584

Enter Medicare allowable costs of care relating to payments on line 5.....

76,438,914

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-12,169,330

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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 .........................

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) 2019

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?1Name, 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)
1	STURDY MEMORIAL HOSPITAL INC PO BOX 2963 211 PARK STREET ATTLEBORO,MA02703 WWW.STURDYMEMORIAL.ORG 2100	X	X	X

Schedule H (Form 990) 2019

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)

	STURDY MEMORIAL 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):

Yes

Community Health Needs Assessment

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?........................

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...............

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......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

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 .................

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..................................

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. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SECTION C

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

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) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	STURDY MEMORIAL HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

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):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE SECTION C

The FAP application form was widely available on a website (list url):

SEE SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE SECTION C

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	STURDY MEMORIAL HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Yes

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 nonpayment?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	STURDY MEMORIAL HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Yes

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.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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? ...............................

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 8

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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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
STURDY MEMORIAL HOSPITAL, INC.	PART V, SECTION B, LINE 5: INPUT FROM PERSONS WHO REPRESENT THE COMMUNITYCOMMUNITY ENGAGEMENT AND FEEDBACK WAS AN INTEGRAL PART OF STURDY'S CHNA PROCESS. HOLLERAN CONSULTING, AN INDEPENDENT RESEARCH AND CONSULTING FIRM, COLLECTED AND INTERPRETED INFORMATION FROM SECONDARY SOURCES AND KEY INFORMANTS. KEY INFORMANTS WERE DEFINED AS COMMUNITY STAKEHOLDERS WITH EXPERT KNOWLEDGE, INCLUDING PUBLIC HEALTH AND HEALTH CARE PROFESSIONALS, SOCIAL SERVICE PROVIDERS, NON-PROFIT LEADERS, BUSINESS LEADERS, FAITH-BASED ORGANIZATIONS, AND OTHER COMMUNITY LEADERS. THE HOSPITAL IDENTIFIED THESE INDIVIDUALS WITH ASSISTANCE FROM HOLLERAN CONSULTING. FROM APRIL 5 THROUGH MAY 6, 2019, AN ONLINE KEY INFORMANT SURVEY WAS CONDUCTED. THE SURVEY WAS DESIGNED TO UNDERSTAND HEALTH ISSUES IN THE COMMUNITY, MISSING RESOURCES/SERVICES, ACCESS TO HEALTH CARE, IDENTIFICATION OF UNDERSERVED, LOW INCOME AND MINORITY POPULATIONS, AND COMMUNITY ASSETS. THE PURPOSE OF THE SURVEY WAS TO OBTAIN A COMBINATION OF QUANTITATIVE RATINGS AND QUALITATIVE FEEDBACK THROUGH CLOSED AND OPEN-ENDED QUESTIONS AROUND HEALTH ISSUES AND BARRIERS TO HEALTH CARE ACCESS IN THE COMMUNITY. SIXTY-SEVEN KEY INFORMANTS COMPLETED THE SURVEY. A COPY OF THE SURVEY TOOL AND LIST OF SURVEY PARTICIPANTS AND THEIR CONNECTION TO THE COMMUNITY IS INCORPORATED IN THE CHNA.STURDY MEMORIAL HOSPITAL, INC: PART V, SECTION B, LINE 7A: HOSPITAL FACILITY'S WEBSITE - CHNA REPORT STURDY MEMORIAL HOSPITAL'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTCAN BE FOUND AT:HTTPS://WWW.STURDYMEMORIAL.ORG/APP/FILES/PUBLIC/074AF432-28E8-4C81-8CB1-E6D6CBF29DEF/2019-CHNA.PDFSTURDY MEMORIAL HOSPITAL, INC: PART V, SECTION B, LINE 9: HOSPITAL FACILITY'S WEBSITE - IMPLEMENTATION STRATEGYSTURDY MEMORIAL'S COMMUNITY HEALTH NEEDS ASSESSMENT WAS APPROVED BY THE BOARD OF MANAGERS ON SEPTEMBER 23, 2019. THE BOARD OF MANAGERS APPROVED THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION PLAN ON JANUARY 27, 2020, WITHIN THE STATUTORY ADOPTION PERIOD. STURDY MEMORIAL HOSPITAL, INC: PART V, SECTION B, LINE 10A:THE HOSPITAL'S MOST RECENTLY ADOPTED CHNA IMPLEMENTATION STRATEGY CAN BEFOUND AT:HTTPS://WWW.STURDYMEMORIAL.ORG/APP/FILES/PUBLIC/760C1C79-D67E-41B7-B8B8-6B6DE7391458/2020-2020-IMPLEMENTATION-PLAN.PDF
STURDY MEMORIAL HOSPITAL, INC.	PART V, SECTION B, LINE 11: SIGNIFICANT NEEDSTHE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IDENTIFIED FIVE KEY COMMUNITY HEALTH ISSUES: ACCESS TO CARE, BEHAVIORAL HEALTH AND SUBSTANCE ABUSE, CANCER, CHRONIC DISEASE MANAGEMENT, AND OBESITY. THE HOSPITAL'S IMPLEMENTATION PLAN FURTHER PRIORITIZED ITS COMMUNITY HEALTH NEEDS AS: ACCESS TO CARE, BEHAVIORAL HEALTH AND SUBSTANCE ABUSE, CHRONIC DISEASE MANAGEMENT AND PREVENTION, AND CANCER PREVENTION EDUCATION AND SCREENING. IT WAS DETERMINED THAT OBESITY WOULD BE ADDRESSED AS PART OF CHRONIC DISEASE MANAGEMENT AND PREVENTION. ACCESS TO CARE: STURDY WILL ADDRESS BARRIERS TO ACCESSING CARE BY INCREASING PROVIDERS IN ITS SERVICE AREA. THE CHNA DETERMINED THAT THE PROVIDER DENSITY IN STURDY'S PRIMARY SERVICE AREA IS LOWER THAN OTHER MASSACHUSETTS COMMUNITIES. STURDY PLANS TO RECRUIT AND RETAIN MORE PROVIDERS AT BOTH THE HOSPITAL AND STURDY MEMORIAL ASSOCIATES (SMA), AN AFFILIATE. STURDY ALSO PLANS TO REDUCE BARRIERS TO CARE BY INVESTIGATING/IDENTIFYING TELEMEDICINE OPPORTUNITIES AND OFF-HOURS CLINICS THAT CAN ACCOMMODATE INDIVIDUALS WHO HAVE LIMITED DAYTIME FLEXIBILITY. OTHER INITIATIVES WILL ASSIST INDIVIDUALS WITH LIMITED TRANSPORTATION OPTIONS, HELP CONNECT EMERGENCY DEPARTMENT PATIENTS WITH PRIMARY CARE PHYSICIANS, HELP CONNECT THE UNINSURED/UNDERINSURED TO FINANCIAL COUNSELORS AND PARTNER WITH LOCAL DENTIST OFFICES FOR SCREENING.BEHAVIORAL HEALTH AND SUBSTANCE ABUSE: MANY RESPONDENTS TO THE KEY INFORMANT SURVEY CONDUCTED THROUGH THE CHNA PROCESS LISTED ACCESS TO BEHAVIORAL HEALTH AND TREATMENT OF SUBSTANCE ABUSE DISORDERS AS THE MOST SIGNIFICANT PROBLEMS FACING STURDY'S PRIMARY AND SECONDARY SERVICE AREAS. ACCESS AND INTEGRATION/COORDINATION OF SERVICES WAS SEEN AS INADEQUATE COMPARED TO THE NEEDS OF THE COMMUNITY. STURDY PLANS TO ADDRESS THIS NEED BY CONTINUING TO PROVIDE TREATMENT AND SERVICES, AS WELL AS PARTNER WITH COLUMN HEALTH, A PROVIDER OF INTEGRATED MENTAL HEALTH/SUBSTANCE ABUSE PROGRAMS. OTHER INITIATIVES WILL CONTINUE SCREENING AND EDUCATION, INCREASE PRIMARY AND SPECIALTY PROVIDERS WITHIN SMA WITH INTEGRATED BEHAVIORAL HEALTH SERVICES, COLLABORATE WITH LOCAL ORGANIZATIONS TO ADDRESS THE HIGH PERCENTAGE OF AT-RISK YOUTH IN THE SERVICE AREA, WORK WITH COMMUNITY ORGANIZATIONS TO CREATE A COMPREHENSIVE LIST OF MENTAL HEALTH PROVIDERS IN STURDY'S SERVICE AREA, AND EXPLORE TELEHEALTH OPTIONS FOR BEHAVIORAL HEALTH PATIENTS.CHRONIC DISEASE PREVENTION AND MANAGEMENT: KEY INFORMANTS RECOGNIZED THAT HEALTH BEHAVIORS ARE OFTEN CORRELATED WITH CERTAIN CHRONIC HEALTH CONDITIONS. CHRONIC ILLNESSES SUCH AS CANCER AND HEART DISEASE, ARE THE LEADING CAUSES OF DEATH IN STURDY'S PRIMARY AND SECONDARY SERVICE AREAS. INDIVIDUALS OFTEN LACK THE TIME, KNOWLEDGE AND RESOURCES TO MANAGE CHRONIC ILLNESS. STURDY PLANS TO CONTINUE TO HOLD HEALTH FAIRS FOR SCREENING AND COMMUNITY EDUCATION. ALSO, THE HOSPITAL WILL SUPPORT CURRENT PROGRAMS THAT INCREASE PHYSICAL ACTIVITY OPPORTUNITIES FOR AT-RISK INDIVIDUALS. STURDY PLANS TO IMPROVE CARE COORDINATION FOR DIABETIC/PRE-DIABETIC PATIENTS AND INCREASE SCREENING FOR PRE-DIABETIC PATIENTS. STURDY WILL EXPLORE OPPORTUNITIES/PROGRAMS THAT INCREASE ACCESS TO HEALTHY FOODS, SUPPORT NUTRITION EDUCATION AND DETERMINE IF A NEW SMOKING CESSATION PROGRAM SHOULD BE IMPLEMENTED. THE HOSPITAL WILL CONTINUE TO COLLABORATE WITH THE HEALTHY LIVING CONSORTIUM TO INCREASE EDUCATION AND AWARENESS IN THE COMMUNITY.CANCER PREVENTION EDUCATION AND SCREENING: CANCER IS A LEADING CAUSE OF DEATH IN BOTH THE HOSPITAL'S PRIMARY AND SECONDARY SERVICE AREAS. STURDY'S OBJECTIVE IS TO PROVIDE SERVICES TO DECREASE CANCER MORTALITY WITHIN ITS SERVICE AREA. TO DO THIS, THE HOSPITAL WILL CONTINUE TO OFFER EARLY DETECTION AND PREVENTION THROUGH VARIOUS SCREENINGS, EDUCATION AND SUPPORT PROGRAMS. THIS INCLUDES PROVIDING EARLY INTERVENTION AND SCREENING AND EARLY NAVIGATION FOR PATIENTS WITH ABNORMAL FINDINGS ON BREAST IMAGING. STURDY WILL ENHANCE ITS CURRENT ONCOLOGY PROGRAM AND DEVELOP ADDITIONAL SERVICES, ADDING PROVIDERS AND FACILITATING RELATIONSHIPS BETWEEN PRIMARY CARE PROVIDERS AND ONCOLOGISTS. NURSE NAVIGATIONS WILL REDUCE BARRIERS TO CARE BY IDENTIFYING UNINSURED/UNDERINSURED PATIENTS AND HELPING PATIENTS WITH TRANSPORTATION.LACK OF AFFORDABLE HOUSING IN OUR PRIMARY AND SECONDARY SERVICE AREAS WAS NOTED BY MANY RESPONDENTS AS A BARRIER TO CARE. STURDY MEMORIAL HOSPITAL ACKNOWLEDGES THAT THE INABILITY TO SECURE AFFORDABLE HOUSING IS A DIFFICULTY FACED BY MANY RESIDENTS IN OUR AREA BUT IS UNABLE TO FULLY ADDRESS THIS ISSUE AS IT IS BEYOND OUR SCOPE AS A HEALTHCARE PROVIDER.STURDY MEMORIAL HOSPITAL, INC: PART V, SECTION B, LINE 16A:OTHER FINANCIAL ASSISTANCE POLICY PUBLICITY METHODS STURDY MEMORIAL HOSPITAL'S FINANCIAL ASSISTANCE POLICY CAN BE FOUND AT:HTTPS://WWW.STURDYMEMORIAL.ORG/APP/FILES/PUBLIC/467DC58C-0840-4574-AC85-D82F49D994F4/SMH-FAP-POLICY---UPDATED-FOR-FY19.PDFSTURDY MEMORIAL HOSPITAL, INC: PART V, SECTION B, LINE 16B: THE HOSPITAL'S FAP APPLICATION FORMS CAN BE FOUND AT: HTTPS://WWW.STURDYMEMORIAL.ORG/APP/FILES/PUBLIC/721/ACA-ENGLISH-FY20.PDFSTURDY MEMORIAL HOSPITAL, INC: PART V, SECTION B, LINE 16C: THE HOSPITAL'S FAP PLAIN LANGUAGE SUMMARY CAN BE FOUND AT:HTTPS://WWW.STURDYMEMORIAL.ORG/APP/FILES/PUBLIC/71188A53-E09D-4E9C-B3FD-6177B8902E91/FAP-PLAIN-LANGUAGE-FY20-ENGLISH.PDF
STURDY MEMORIAL HOSPITAL, INC.	PART V, SECTION B, LINE 16J: THE HOSPITAL'S POLICY IS ATTACHED TO BILLING INVOICES. ADDITIONALLY, STURDY MEMORIAL MAKES THIS INFORMATION AVAILABLE AT LOCATIONS THROUGHOUT ITS FACILITY-IN THE MAIN LOBBY, EMERGENCY DEPARTMENT, PATIENT REGISTRATION, AND FINANCIAL COUNSELORS' OFFICE. INDIVIDUALS IN OUR COMMUNITY WITHOUT INSURANCE ARE DIRECTED TO A FINANCIAL COUNSELOR WHO WILL PROVIDE THEM WITH STURDY'S FINANCIAL ASSISTANCE POLICY AS WELL AS RESOURCES AVAILABLE TO THEM THROUGH MASSHEALTH OR THE COMMONWEALTH'S HEALTH SAFETY NET. FINANCIAL COUNSELORS WILL ASSIST ANYONE IN COMPLETING AN APPLICATION FOR FREE OR SUBSIDIZED CARE, AS WELL AS MASSHEALTH. THIS SERVICE IS AVAILABLE TO ANYONE IN THE COMMUNITY.
SCHEDULE H, PART V, SECTION B, LINE 20	NOTIFICATION OF FINANCIAL ASSISTANCEFOR PLANNED ADMISSIONS, PATIENTS ARE NOTIFIED OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY PRIOR TO ADMISSION. EMERGENT PATIENTS ARE NOTIFIED PRIOR TO DISCHARGE OR THE FOLLOWING BUSINESS DAY. PATIENTS ARRIVING AT THE HOSPITAL FOR OUTPATIENT VISITS ARE NOTIFIED OF THE FINANCIAL ASSISTANCE POLICY AT THE TIME OF REGISTRATION (IF REGISTERED AT THE MAIN REGISTRATION AREA). NOTIFICATION IS ALSO INCLUDED WITH PATIENT BILLS.

Schedule H (Form 990) 2019

Page 9

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?1
Name and address		Type of Facility (describe)
1	1 - MANSFIELD HEALTH CENTER 200 COPELAND DRIVE MANSFIELD,MA02488	LICENSED OUTPUT CLINIC PHYSICIAN PRACTICE
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2019

Page 10

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
PART I, LINE 7:	FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFITS CALCULATIONSTURDY MEMORIAL HOSPITAL USES THE COST TO CHARGE RATIO FOR CALCULATING AMOUNTS IN THE TABLE FOR LINE 7. THE COST TO CHARGE RATIO IS TOTAL PATIENT CARE COSTS DIVIDED BY TOTAL PATIENT CARE CHARGES PER WORKSHEET S-10, LINE 1 OF THE MEDICARE COST REPORT. BAD DEBT IS NOT INCLUDED IN ANY AMOUNTS REPORTED IN THE TABLE.SCHEDULE H, PART I, LINE 7, COLUMN (F)BAD DEBT EXPENSE OF $7,175,877 ATTRIBUTABLE TO PATIENT ACCOUNTS HAS BEEN EXCLUDED FROM THE COMPUTATION OF ALL COMMUNITY BENEFIT EXPENSE SHOWN IN PART I, LINE 7, COLUMN F.
PART II, COMMUNITY BUILDING ACTIVITIES:	STURDY MEMORIAL HOSPITAL UNDERTAKES COMMUNITY BUILDING ACTIVITIES DESIGNED TO PROMOTE THE WELLBEING OF RESIDENTS IN ITS PRIMARY AND SECONDARY SERVICE AREAS. THE HOSPITAL IS INVOLVED IN EMERGENCY MANAGEMENT AND PREPAREDNESS AND WORKS WITH OTHERS IN ITS REGION TO COORDINATE ITS PREPARATION AND RESPONSE TO CATASTROPHIC HEALTH EVENTS. THE ORGANINIZATION WORKS WITH LOCAL, STATE AND FEDERAL LAW ENFORCEMENT AND OTHER FIRST RESPONDERS ON MATTERS OF PUBLIC SAFETY. THE HOSPITAL PROVIDES TRAINING OPPORTUNITIES FOR LOCAL STUDENTS COMPLETING MEDICAL LABORATORY TECHNICIAN AND PHLEBOTOMY PROGRAMS. HIGH SCHOOL STUDENTS INTERESTED IN HEALTH CARE CAREERS MAY SHADOW STAFF MEMBERS OR PARTICIPATE IN INTERNSHIPS. SOME COMMUNITY BUILDING ACTIVITIES WERE TEMPORARILY SUSPENDED IN FY20 DUE TO THE COVID CRISIS.
PART III, LINE 2:	BAD DEBT EXPENSE - EXPLANATION FOR PART III, LINES 2, 3 AND 4ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLES AND COPAYMENT BALANCES DUE), THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.
PART III, LINE 8:	SHORTFALL TREATED AS COMMUNITY BENEFITSTURDY MEMORIAL HOSPITAL, IN KEEPING WITH ITS CHARITABLE MISSION, PROVIDES CARE TO MEDICARE ELIGIBLE PATIENTS OF THE COMMUNITY IT SERVES BEYOND THE AMOUNT IT RECEIVES FROM THE MEDICARE PROGRAM. THESE INDIVIDUALS WOULD HAVE TO TRAVEL OUT OF OUR AREA OR POSSIBLY FORGO MEDICAL TREATMENT WITHOUT THE SERVICES THE HOSPITAL PROVIDES. THE MEDICARE SHORTFALL INCURRED BY THE HOSPITAL IS VIEWED AS LESSENING THE BURDEN OF GOVERNMENT, THEREFORE PROVIDING A VALUABLE COMMUNITY BENEFIT.
PART III, LINE 9B:	DEBT COLLECTION POLICYTHE HOSPITAL'S COLLECTION POLICY CONTAINS PROCEDURES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. ONCE IT IS DETERMINED THAT A PATIENT QUALIFIES FOR FREE CARE, ALL COLLECTION PROCEDURES CEASE AND THE FULL BALANCE IS WRITTEN OFF. IF THE PATIENT QUALIFIES FOR PARTIAL FREE CARE, THE AMOUNT THAT QUALIFIES UNDER PARTIAL FREE CARE IS WRITTEN OFF AND THE REMAINING BALANCE IS SUBJECT TO NORMAL COLLECTION PROCEDURES. MASSACHUSETTS HOSPITALS ARE REQUIRED TO ADOPT CREDIT AND COLLECTION POLICIES. STATE REGULATIONS (101 CMR 613.00) OUTLINE THE SPECIFIC PROCESS FOR DETERMINING ELIGIBILITY FOR PUBLIC ASSISTANCE PROGRAMS AND HOSPITAL COLLECTION PRACTICES. THE HOSPITAL PROVIDES PATIENTS WITH INFORMATION ABOUT FREE CARE AVAILABLE THROUGH THE HOSPITAL (A SIGNIFICANT PORTION OF WHICH IS COORDINATED THROUGH THE STATE'S HEALTH SAFETY NET PROGRAM, AS WELL AS FINANCIAL ASSISTANCE PROGRAMS, SUCH AS MASSHEALTH AND COMMONWEALTH CARE, THAT ARE AVAILABLE THROUGH THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES). THE HOSPITAL EMPLOYS TWO FULL-TIME FINANCIAL COUNSELORS THAT ASSIST PATIENTS, AND ANYONE ELSE PRESENTING WHO REQUIRES ASSISTANCE, IN APPLYING FOR FREE CARE AND STATE FINANCIAL ASSISTANCE PROGRAMS THROUGH THE STATE'S UNIFORM APPLICATION. THE HOSPITAL FINANCIAL ASSISTANCE POLICY AND BILLING & COLLECTION POLICY, THAT OUTLINES ITS CHARITY CARE PRACTICES, IS FILED WITH THE MASSACHUSETTS CENTER FOR HEALTH INFORMATION AND ANALYSIS AND ALSO AVAILABLE TO PATIENTS UPON REQUEST.
PART VI, LINE 2:	WITH GUIDANCE AND OVERSIGHT FROM THE HOSPITAL'S PLANNING COMMITTEE, STURDY'S COMMUNITY BENEFITS REPORT IS DEVELOPED TO REFLECT ON ACTIVITIES FROM THE PRIOR YEAR AND PROVIDE RECOMMENDATIONS FOR THE HOSPITAL'S FOCUS ON COMMUNITY INVOLVEMENT FOR THE FOLLOWING YEAR. COMMUNITY BENEFITS PLANNING IS INTEGRATED INTO STURDY'S ANNUAL PLANNING AND BUDGETING PROCESS TO ENSURE WE EFFECTIVELY SUPPORT COMMUNITY BENEFITS PROGRAMMING. STURDY MEMORIAL HOSPITAL IS INVOLVED IN ONGOING ASSESSMENTS OF THE HEALTH NEEDS IN OUR COMMUNITIES AND PARTICIPATES IN A NUMBER OF COMMUNITY BASED PROGRAMS. CONTINUALLY BEING ENGAGED IN AND FAMILIAR WITH OUR COMMUNITIES PROVIDES US WITH OPPORTUNITIES TO IDENTIFY HEALTH ISSUES OF GREATEST CONCERN TO OUR CARE PROVIDERS AND COMMUNITY PARTNERS AND CONSIDER COMMITTING BUDGETED RESOURCES TO THOSE AREAS, WHENEVER APPROPRIATE, TO GUIDE EFFORTS TO IMPROVE COMMUNITY HEALTH AND WELLNESS. THE HOSPITAL CONSTANTLY MONITORS THE RESULTS OF PATIENT SATISFACTION SURVEYS, SERVICE STATISTICS, PROVIDER AND COMMUNITY FEEDBACK, INSURER DATA, AND OTHER LOCAL AND REGIONAL DATA. IN ADDITION, THE HOSPITAL CONTINUALLY WORKS CLOSELY WITH COMMUNITY LEADERS, SCHOOL AND SOCIAL SERVICES PERSONNEL, AND OTHER HEALTH CARE PROVIDERS TO IDENTIFY HEALTH CARE TRENDS AND NEEDS.
PART VI, LINE 3:	PATIENTS ARE INFORMED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE BY WAY OF POSTED NOTICES THROUGHOUT THE HOSPITAL AS WELL AS PRINTED FINANCIAL ASSISTANCE BROCHURES AVAILABLE IN COMMON AREAS OF THE HOSPITAL. FINANCIAL ASSISTANCE INFORMATION IS PRINTED ON ALL ITEMIZED BILLS AND PATIENT STATEMENTS. SCHEDULED SELF PAY SURGICAL DAY CARE (SDC) & INPATIENTS ARE REVIEWED PRIOR TO ADMISSION TO DETERMINE PAYMENT ARRANGEMENT OR TO COORDINATE A MEETING WITH A FINANCIAL COUNSELOR. SDC & INPATIENTS WHO ARE UNABLE TO LEAVE A DEPOSIT OR MAKE A PAYMENT ARRANGEMENT TOWARDS A LARGE OUT OF POCKET EXPENSE ARE ALSO ENCOURAGED TO MEET WITH A FINANCIAL COUNSELOR. UPON DISCHARGE FROM THE EMERGENCY CARE CENTER (ECC), UNINSURED PATIENTS ARE ENCOURAGED TO MEET WITH A FINANCIAL COUNSELOR. IF UNABLE TO SEE A FINANCIAL COUNSELOR FOLLOWING DISCHARGE, THE PATIENT IS GIVEN A FINANCIAL ASSISTANCE LETTER OUTLINING THE APPLICATION PROCESS, THE DOCUMENTS REQUIRED, TELEPHONE NUMBERS AND DIRECTIONS TO THE FINANCIAL COUNSELOR'S OFFICE. FOLLOWING AN ECC VISIT, UNINSURED PATIENTS RECEIVE A PHONE CALL FROM A PATIENT FINANCIAL SERVICES REPRESENTATIVE ENCOURAGING THE PATIENT TO MEET WITH A FINANCIAL COUNSELOR FOR FINANCIAL ASSISTANCE.
PART VI, LINE 4:	COMMUNITY INFORMATIONTHE HOSPITAL SERVES A TOTAL POPULATION BASE OF 228,800 (BASED ON 2010 U.S. CENSUS DATA) IN 12 SUBURBAN COMMUNITIES LOCATED BETWEEN BOSTON, MA AND PROVIDENCE, RI THAT IS LARGELY EDUCATED (COMPLETED HIGH SCHOOL), EMPLOYED, AND ENGLISH SPEAKING. AS A COMMUNITY RESOURCE, THE HOSPITAL HAS A PRIMARY COMMITMENT TO SERVE THE RESIDENTS OF ATTLEBORO, FOXBORO, MANSFIELD, NORTH ATTLEBORO, NORTON, PLAINVILLE, SEEKONK, REHOBOTH, AND WRENTHAM. NORFOLK, SHARON, AND WALPOLE ARE CONSIDERED PART OF OUR SECONDARY SERVICE AREA. WE ALSO SERVE BORDERING TOWNS IN NEARBY RHODE ISLAND. HOWEVER, ANYONE WHO REQUIRES CARE WILL RECEIVE IT, REGARDLESS OF PLACE OF RESIDENCE.
PART VI, LINE 5:	PROMOTION OF COMMUNITY HEALTHSTURDY MEMORIAL HOSPITAL FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH AND WELLBEING OF MEMBERS OF THE COMMUNITIES IT SERVES. IN ADDITION TO PROVIDING HEALTH CARE TO ALL, REGARDLESS OF ABILITY TO PAY. ALTHOUGH CURTAILED IN FISCAL 2020 DUE TO COVID-19, THE HOSPITAL USUALLY OFFERS NEARLY ONE HUNDRED COMMUNITY BENEFIT PROGRAMS AND EVENTS EACH YEAR. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN OUR SERVICE AREA. A MAJORITY OF THE HOSPITAL'S BOARD OF MANAGERS ARE COMPRISED OF INDIVIDUALS LIVING IN THE COMMUNITY WHO ARE INDEPENDENT CIVIC, HEALTH CARE AND BUSINESS LEADERS. SURPLUS FUNDS ARE USED TO IMPROVE OUR FACILITIES, PURCHASE STATE-OF-THE ART MEDICAL EQUIPMENT AND EXPAND OUR COMMUNITY OFFERINGS.
PART VI, LINE 6:	STURDY MEMORIAL HOSPITAL IS PART OF AN AFFILIATED HEALTH CARE SYSTEM. UNDER THE CONTROL OF ITS PARENT ORGANIZATION, STURDY MEMORIAL FOUNDATION, AFFILIATES STURDY MEMORIAL HOSPITAL AND STURDY MEMORIAL ASSOCIATES COORDINATE THE PROVISION OF HEALTH CARE SERVICES TO RESIDENTS IN ITS SERVICE AREA OF BRISTOL AND NORFOLK COUNTIES IN MASSACHUSETTS.
PART VI, LINE 7:	STATE FILING OF COMMUNITY BENEFITS REPORTSTURDY MEMORIAL HOSPITAL FILES ITS COMMUNITY BENEFITS REPORT IN MASSACHUSETTS.

Schedule H (Form 990) 2019

Additional Data

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Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
STURDY MEMORIAL HOSPITAL INC

Employer identification number
04-2768252

Part I

General Information on Grants and Assistance

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? ........................

Yes No

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 noncash assistance	(h) Purpose of grant or assistance
(1) CITY OF ATTLEBORO 77 PARK STREET ATTLEBORO,MA02703	04-6001378	GOVT	18,000				COMMUNITY SUPPORT
(2) STURDY MEMORIAL ASSOICATES 211 PARK STREET 2963 ATTLEBORO,MA02703	04-2706501	501(C)(3)	13,075,416				GENERAL SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2019

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 noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(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
PART I, LINE 2:	PROCEDURES FOR MONITORING USE OF GRANT FUNDS THE HOSPITAL PROVIDES GRANTS IN FURTHERANCE OF ITS CHARITABLE MISSION AND TO PROMOTE GENERAL WELL-BEING IN THE COMMUNITIES IT SERVES. WHEN GRANTS ARE MADE, THEY ARE REVIEWED AND APPROVED BY THE BOARD OF MANAGERS. THE HOSPITAL MONITORS GRANTS TO ENSURE THEY ARE USED FOR THEIR INTENDED PURPOSE.

Schedule I (Form 990) 2019

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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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

STURDY MEMORIAL HOSPITAL INC

Employer identification number

04-2768252

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on 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 .........

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 on Line 1a? ..

Yes

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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.

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:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

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:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

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 ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2019

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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1JOSEPH CASEY PRESIDENT & CEO	(i) (ii)	620,493 ------------- 0	162,680 ------------- 0	620,415 ------------- 0	291,430 ------------- 0	21,755 ------------- 0	1,716,773 ------------- 0	0 ------------- 0
2BRIAN KELLY MD VP & CMO	(i) (ii)	459,529 ------------- 0	42,680 ------------- 0	57,452 ------------- 0	256,494 ------------- 0	23,755 ------------- 0	839,910 ------------- 0	0 ------------- 0
3AMY PFEFFER CFO & TREASURER	(i) (ii)	373,774 ------------- 0	37,680 ------------- 0	76,629 ------------- 0	277,941 ------------- 0	21,259 ------------- 0	787,283 ------------- 0	0 ------------- 0
4BRIAN PATEL MD CHIEF OF EMERGENCY SERVICES	(i) (ii)	444,378 ------------- 0	28,680 ------------- 0	21,587 ------------- 0	155,662 ------------- 0	21,755 ------------- 0	672,062 ------------- 0	0 ------------- 0
5MARK MCGUIRE MD PHYSICIAN	(i) (ii)	377,595 ------------- 0	12,577 ------------- 0	18,065 ------------- 0	170,677 ------------- 0	21,755 ------------- 0	600,669 ------------- 0	0 ------------- 0
6ALLAN RASKIN MD PHYSICIAN	(i) (ii)	273,130 ------------- 0	1,943 ------------- 0	15,260 ------------- 0	242,936 ------------- 0	21,755 ------------- 0	555,024 ------------- 0	0 ------------- 0
7RONALD VAN NESS-OTUNNU MD PHYSICIAN	(i) (ii)	369,711 ------------- 0	4,812 ------------- 0	16,091 ------------- 0	103,433 ------------- 0	21,755 ------------- 0	515,802 ------------- 0	0 ------------- 0
8MICHAEL DEMELIS MD PHYSICIAN	(i) (ii)	286,559 ------------- 0	2,144 ------------- 0	14,938 ------------- 0	153,762 ------------- 0	21,755 ------------- 0	479,158 ------------- 0	0 ------------- 0
9ROBIN MORRIS VP OF CLINICAL OPS & INTEGRITY	(i) (ii)	232,866 ------------- 0	44,680 ------------- 0	6,358 ------------- 0	169,967 ------------- 0	10,071 ------------- 0	463,942 ------------- 0	0 ------------- 0
10BRUCE AUERBACH MD FORMER EXEC. DIRECTOR	(i) (ii)	0 ------------- 0	0 ------------- 0	391,386 ------------- 0	27,540 ------------- 0	12,718 ------------- 0	431,644 ------------- 0	0 ------------- 0
11DAVID SPOOR VP OF PATIENT SRVS/CHF. OF NURSING	(i) (ii)	210,564 ------------- 0	22,680 ------------- 0	8,101 ------------- 0	94,086 ------------- 0	10,871 ------------- 0	346,302 ------------- 0	0 ------------- 0
12JEAN SIDDALL-BENSSON MD DIRECTOR & PHYSICIAN (THRU 12/2019)	(i) (ii)	0 ------------- 206,643	0 ------------- 2,680	0 ------------- 1,219	0 ------------- 140,991	0 ------------- 8,871	0 ------------- 360,404	0 ------------- 0
13CAROLYN ROSS CHIEF HUMAN RESOURCES OFFICER	(i) (ii)	225,029 ------------- 0	12,500 ------------- 0	504 ------------- 0	267 ------------- 0	21,360 ------------- 0	259,660 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2019

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
PART I, LINE 1A	TAX INDEMNIFICATION AND GROSS-UP PAYMENTS HOSPITAL PAYMENTS TO RETIREMENT PLANS THAT ARE TAXABLE UPFRONT, ARE PARTIALLY GROSSED UP FOR TAXES. DURING CALENDER YEAR 2019, THE EXECUTIVE DIRECTOR RECEIVED A PAYMENT (SEE SCHEDULE J, PART I, LINE 4 EXPLANATION FOR MORE DETAIL). ALSO, THE HOSPITAL PAID A BONUS TO ALL HOSPITAL EMPLOYEES. EMPLOYEES RECEIVED SAME NET AMOUNT (PRORATED FOR HOURS WORKED), WITH THE HOSPITAL EFFECTIVELY PAYING TAXES. THE HOSPITAL ALSO PROVIDES ITS SENIOR MANAGERS WITH LONG-TERM DISABILITY INSURANCE. THE COST OF THIS INSURANCE IS GROSSED UP TO EFFECTIVELY PAY FOR THE RELATED TAXES AND IS ADDED TO THE MANAGERS' GROSS EARNINGS. THIS BENEFIT WAS PROVIDED TO JOSEPH CASEY, BRUCE AUERBACH, MD, AMY PFEFFER, DAVID SPOOR, ROBIN MORRIS, BRIAN PATEL, MD, CAROLYN ROSS AND BRIAN KELLY, MD DURING CALENDAR YEAR 2019. PART I, LINE 1B: APPROVAL FOR GROSS-UP PAYMENTS THE EXECUTIVE COMMITTEE APPROVES THE SUPPLEMENTAL RETIREMENT PLAN. THE ANNUAL BONUS AND DECISION TO GROSS UP THE AMOUNT IS DISCRETIONARY AND IS SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN APPROVED BY THE BOARD OF MANAGERS.
PART I, LINES 4A-B	PART I, LINE 4A: SEVERANCE PAYMENTS BRUCE AUERBACH, MD, EXECUTIVE DIRECTOR THROUGH 8/2018, RECEIVED $383,806 IN SEVERANCE PAY IN 2019 FROM STURDY MEMORIAL HOSPITAL. THE AMOUNT WAS TREATED AS TAXABLE INCOME AND IS INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). PART I, LINE 4B: SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN STURDY MEMORIAL HOSPITAL PROVIDES A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN TO CERTAIN EXECUTIVES. SUPPLEMENTAL RETIREMENT CONTRIBUTIONS WERE MADE THROUGH NON-QUALIFIED RETIREMENT PLANS FOR QUALIFIED EMPLOYEES IN CALENDAR YEAR 2019. THE TOTAL OF NON-QUALIFIED RETIREMENT CONTRIBUTIONS IN 2019 ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). JOSEPH CASEY ($14,455) PARTICIPATED IN THE PLAN IN 2019.
PART I, LINE 7	NON-FIXED PAYMENTS COMPENSATION PACKAGES FOR THE CEO, SENIOR MANAGERS, AND LISTED PHYSICIANS INCLUDE OPPORTUNITIES TO EARN INCENTIVE COMPENSATION BASED ON A COMBINATION OF MEETING OR EXCEEDING PRE-DETERMINED GOALS. ALL INCENTIVE COMPENSATION IS SUBJECT TO REVIEW AND APPROVAL BY THE COMPENSATION COMMITTEE AND HAS BEEN REPORTED ON SCHEDULE J, PART II, COLUMN B (II).
PART II, COLUMN (C):	DEFERRED COMPENSATION THIS COLUMN INCLUDES AN ACCRUAL OF BENEFITS RELATED TO THE HOSPITAL'S DEFINED BENEFIT PLAN. THIS ACCRUAL CALCULATION IS COMPLETED BY A THIRD PARTY AND THE ACCRUAL AMOUNT MAY SHIFT DEPENDING ON THE REQUIRED DISCOUNT RATE APPLIED.

Schedule J (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

STURDY MEMORIAL HOSPITAL INC

Employer identification number

04-2768252

Return Reference	Explanation
ORGANIZATION'S MISSION (CONTINUED)	FORM 990, PART III, LINE 1 THE HOSPITAL WORKS TO ENSURE THAT AMPLE, HIGH QUALITY PRIMARY AND SPECIALTY PHYSICIAN SERVICES ARE ACCESSIBLE TO AREA RESIDENTS. ADDITIONALLY, WE TRY TO AVOID COSTLY DUPLICATION OF HEALTH CARE SERVICES BY COORDINATING WITH OTHER AREA HEALTH CARE PROVIDERS TO THE EXTENT PRACTICABLE. THE HOSPITAL PROVIDES LEADERSHIP WHILE WORKING IN COOPERATION WITH PUBLIC AND PRIVATE HEALTH ORGANIZATIONS, AS WELL AS CIVIC AND BUSINESS ORGANIZATIONS, TO MEET THE HEALTH CARE NEEDS OF OUR COMMUNITIES.
FORM 990, PART V, LINE 2A:	EMPLOYEES REPORTED ON FORM W-3 STURDY MEMORIAL HOSPITAL, INC. IS THE COMMON PAYMASTER FOR STURDY MEMORIAL ASSOCIATES, INC. AND STURDY MEMORIAL FOUNDATION, INC. THE TOTAL NUMBER OF EMPLOYEES LISTED ON PART V, LINE 2A REPRESENTS HOSPITAL EMPLOYEES INCLUDED UNDER THE COMMON PAYMASTER FILING.
FORM 990, PART VI, SECTION A, LINE 1	VOTING RIGHTS OF GOVERNING BODY THE BYLAWS OF STURDY MEMORIAL HOSPITAL, INC. STATE THAT "THE EXECUTIVE COMMITTEE SHALL HAVE THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL DURING THE INTERIM BETWEEN THE MEETINGS OF THE BOARD OF MANAGERS EXCEPT FOR SUCH MATTERS AS ARE SPECIFIED IN SECTION 55 OF THE [MASSACHUSETTS] GENERAL LAWS, CHAPTER 156B." THE EXECUTIVE COMMITTEE CONSISTS ONLY OF MEMBERS OF THE BOARD OF MANAGERS OF STURDY MEMORIAL HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 2	BUSINESS RELATIONSHIPS WITH GOVERNING BODY JOSEPH CASEY, DENNIS KELLY, PATRICIA COCHRANE AND EDWARD DION-BUSINESS RELATIONSHIP. PAUL HEROUX AND LAURA GIGNAC-BUSINESS RELATIONSHIP. IN ADDITION, OTHER PERSONS LISTED IN PART VII HAVE A "BUSINESS RELATIONSHIP" WITH ONE ANOTHER DUE TO THE OVERLAPPING BOARD STRUCTURE OF STURDY MEMORIAL FOUNDATION AND ITS AFFILIATES.
FORM 990, PART VI, SECTION A, LINE 6	MEMBERS OR STOCKHOLDERS STURDY MEMORIAL FOUNDATION, INC., A MASSACHUSETTS CHARITABLE CORPORATION, ACTING THROUGH ITS BOARD OF DIRECTORS, IS THE SOLE MEMBER OF STURDY MEMORIAL HOSPITAL, INC.
FORM 990, PART VI, SECTION A, LINE 7A	MEMBERS OR STOCKHOLDERS WHO MAY ELECT MEMBERS OF GOVERNING BODY THE BOARD OF MANAGERS OF STURDY MEMORIAL HOSPITAL, INC. CONSISTS OF THOSE PERSONS WHO SERVE AS THE DIRECTORS OF STURDY MEMORIAL FOUNDATION, INC. FOUNDATION MEMBERS ARE ELIGIBLE TO ATTEND ALL MEETINGS OF THE CORPORATION AND TO HOLD OFFICE. NEW MEMBERS ARE ELECTED TO MEMBERSHIP BY THE EXISTING MEMBERS FOR THREE YEAR TERMS.
FORM 990, PART VI, SECTION B, LINE 11B	FORM 990 REVIEW PROCESS FORM 990 IS PREPARED BY STURDY MEMORIAL'S TAX PROVIDERS, GRANT THORNTON LLP, USING INFORMATION PROVIDED BY MANAGEMENT UPON COMPLETION OF THE ANNUAL INDEPENDENT AUDIT. THE INFORMATION PROVIDED IS THE RESPONSIBILITY OF THE CFO AND STURDY'S FISCAL SERVICES DEPARTMENT. THE RETURN IS REVIEWED BY GRANT THORNTON LLP, THE CONTROLLER AND CFO, AND COMPENSATION AND BENEFIT SECTIONS ARE SPECIFICALLY REVIEWED BY THE CHIEF HUMAN RESOURCES OFFICER FOR STURDY MEMORIAL HOSPITAL, INC. FORM 990 IS THEN PRESENTED TO THE AUDIT COMMITTEE FOR REVIEW AND RECOMMENDATION OF APPROVAL. EVERY BOARD MEMBER RECEIVES FORM 990 AND ALL SCHEDULES PRIOR TO FILING THE RETURN WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C	CONFLICT OF INTEREST POLICY MONITORING & ENFORCEMENT ALL HOSPITAL LEADERSHIP AND BOARD MEMBERS COMPLETE AND SIGN AN ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE STATEMENT REQUIRES DISCLOSURE OF ANY OUTSIDE INTERESTS IN ANY BUSINESS, OUTSIDE ACTIVITY, GIFTS, OR ENTERTAINMENT THAT MAY HAVE INFLUENCED THE RESPONDENT. IN ADDITION, THESE SIGNED STATEMENTS ARE REVIEWED BY THE INTEGRITY OFFICER AND ANY POTENTIAL CONFLICTS ARE ADDRESSED AND RESOLVED. THE INTEGRITY OFFICER DISCUSSES DISCLOSED POTENTIAL CONFLICTS WITH EMPLOYEES, OFFICERS AND DIRECTORS OF THE HOSPITAL, SO THAT THEY UNDERSTAND WHAT CONSTITUTES AN INAPPROPRIATE BUSINESS ACTIVITY. ANY GIFTS RECEIVED THAT CREATE A CONFLICT OR ARE IN VIOLATION OF THE CONFLICT OF INTEREST POLICY MUST BE RETURNED. INDIVIDUALS WITH DOCUMENTED CONFLICTS MUST ABSTAIN FROM ANY DECISION MAKING SPECIFIC TO THE IDENTIFIED AREA. AN ANNUAL REPORT IS PREPARED AND PROVIDED TO THE HOSPITAL'S PRESIDENT AND CEO AS WELL AS BOARD OF MANAGERS; THIS COMPREHENSIVE REPORT INCLUDES ALL INTEGRITY COMPLIANCE ISSUES AS WELL AS ANY NEWLY IDENTIFIED CONFLICTS OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15	PROCESS FOR DETERMINING COMPENSATION COMPENSATION DECISIONS FOR THE ORGANIZATION'S CEO, CFO AND SENIOR MANAGEMENT (KEY EMPLOYEES) ARE MADE THROUGH ITS EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE CONSISTS SOLELY OF MEMBERS WHO DO NOT HAVE A CONFLICT OF INTEREST WITH REGARDS TO COMPENSATION MATTERS. THE BOARD UTILIZES AN INDEPENDENT OUTSIDE CONSULTANT TO DETERMINE EXECUTIVE COMPENSATION. THE CONSULTANT PRESENTS NATIONAL AND REGIONAL COMPARABILITY DATA FOR SIMILAR ORGANIZATIONS. THE DATA INCLUDES COMPREHENSIVE SALARY AND BENEFITS INFORMATION FOR THE CEO, CFO AND KEY EMPLOYEES INCLUDING COMPARISON OF BASE PAY, INCENTIVE PAY, BENEFITS AND TOTAL COMPENSATION. IN ADDITION, THE COMMITTEE IS PROVIDED WITH PERFORMACE INFORMATION FOR MASSACHUSETTS HOSPITALS OBTAINED THROUGH THE CENTER FOR HEALTH INFORMATION AND ANALYSIS. THE EXECUTIVE COMMITTEE REVIEWS THE COMPARATIVE DATA FOR THE CEO AND CFO AND VOTES TO APPROVE THEIR COMPENSATION. THE CEO USES COMPARATIVE MARKET DATA TO DETERMINE PROPOSED BASE PAY COMPENSATION INCREASES AND POTENTIAL INCENTIVE PAY FOR ALL OTHER SENIOR MANAGERS AND PRESENTS THIS TO THE EXECUTIVE COMMITTEE FOR THEIR CONSIDERATION. THE EXECUTIVE COMMITTEE REVIEWS ALL RELEVANT INFORMATION AND VOTES TO ACCEPT THE RECOMMENDATIONS OF THE CEO FOR SENIOR MANAGER PAY. ALL DATA PRESENTED, AS WELL AS COMPENSATION DELIBERATION AND VOTES, ARE DOCUMENTED IN THE EXECUTIVE COMMITTEE MINUTES. THE MOST RECENT COMPENSATION STUDY WAS PERFORMED IN DECEMBER OF 2018. FORM 990, PART VI, SECTION B, LINE 16B: PARTICIPATION IN JOINT VENTURE ARRANGEMENTS STURDY MEMORIAL HOSPITAL HAS A POLICY REQUIRING EVALUATION OF ITS PARTICIPATION IN JOINT VENTURE ARRANGEMENTS UNDER APPLICABLE FEDERAL AND STATE LAW. THE HOSPITAL REQUIRES THAT ANY VENTURE OR ARRANGEMENT WITH THIRD PARTIES NOT ENGAGE IN ANY ACTIVITIES THAT WOULD JEOPARDIZE THE HOSPITAL'S EXEMPTION, SUCH AS POLITICAL ACTIVITIES, SUBSTANTIAL LOBBYING, PRIVATE INUREMENT OR SUBSTANTIAL NONEXEMPT ACTIVITIES. THE HOSPITAL SHALL MAINTAIN CONTROL, PRIORITIZE ITS EXEMPT PURPOSES, ENTER CONTRACTS AT ARMS-LENGTH, REQUIRE TRANSPARENT REPORTING, AND ENSURE ANY VENTURE COMPLY WITH INTERNAL REVENUE CODE SECTION 501(R). THE HOSPITAL'S MANAGEMENT SHALL NEGOTIATE ANY VENTURES OR ARRANGEMENTS WITH THE ASSISTANCE OF LEGAL COUNSEL, IF NECESSARY, AND THE HOSPITAL'S BOARD OF MANAGERS APPROVES ANY VENTURE OR ARRANGEMENT. THE HOSPITAL CURRENTLY PARTICIPATES IN SEVERAL VENTURES, ALL RELATED TO HEALTH CARE OPERATIONS.
FORM 990, PART VI, SECTION C, LINE 19	HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC THE HOSPITAL MAKES AVAILABLE COPIES OF ITS BY-LAWS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS TO THE GENERAL PUBLIC UPON REQUEST. IMPACT OF THE COVID-19 PANDEMIC: IN MARCH 2020, THE WORLD HEALTH ORGANIZATION DECLARED COVID-19, THE DISEASE CAUSED BY THE NOVEL CORONAVIRUS, A PANDEMIC, WHICH STARTED TO AND CONTINUES TO SPREAD THROUGHOUT THE UNITED STATES OF AMERICA. AS A RESULT OF THE COVID-19 PANDEMIC, THE HOSPITAL EXPERIENCED A DECLINE IN PATIENT VISITS, ADMISSIONS, AND MEDICAL PROCEDURES PERFORMED. ELECTIVE MEDICAL PROCEDURES WERE SUSPENDED BY STATE GOVERNMENT BEGINNING IN MID-MARCH THROUGH MAY 2020, CONTRIBUTING TO A SIGNIFICANT DECLINE IN PATIENT SERVICE REVENUE DUE TO COVID-19 WHEN COMPARED TO HISTORIC AND FORECASTED RESULTS FOR THAT PERIOD. ADDITIONALLY, IN RESPONSE TO THE PANDEMIC, THE HOSPITAL INCURRED ADDITIONAL COSTS FOR TESTING, PERSONAL PROTECTIVE EQUIPMENT, THIRD-PARTY CONTRACT SERVICES AND OTHER OPERATING COSTS ASSOCIATED WITH ENSURING EMPLOYEE AND PATIENT SAFETY WHILE OPERATING DURING A PANDEMIC. SINCE MAY, THE HOSPITAL HAS BEGUN TO SEE INCREASES IN ITS PATIENT VISITS, ADMISSIONS, AND MEDICAL PROCEDURES, ALTHOUGH IN DECEMBER 2020, THE COMMONWEALTH AGAIN IMPOSED RESTRICTIONS ON INPATIENT ELECTIVE PROCEDURES. MANAGEMENT IS ACTIVELY MONITORING OPERATING REVENUE AND EXPENSES AND BASED ON THE CONTINUED UNCERTAINTIES OF COVID-19, IT IS UNABLE TO DETERMINE IF IT WILL HAVE A MATERIAL IMPACT ON ITS OPERATIONS FOR THE YEAR ENDING SEPTEMBER 30, 2021.
FORM 990, PART XI, LINE 9:	TRANSFER TO AFFILIATE -6,000,000. PENSION ADJUSTMENT -164,400. NET ASSETS RELEASED FROM RESTRICTIONS 262,345.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

STURDY MEMORIAL HOSPITAL INC

Employer identification number

04-2768252

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?
(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	Yes	No
(1)STURDY MEMORIAL ASSOCIATES INC 211 PARK STREET PO BOX 2963 ATTLEBORO,MA02703 04-2709501	PHYSICIANS	MA	501(C)(3)	LINE 12B, II	SMF		No
(2)STURDY MEMORIAL FOUNDATION INC 211 PARK STREET PO BOX 2963 ATTLEBORO,MA02703 04-2103631	DEVELOPMENT	MA	501(C)(3)	LINE 12B, II	N/A		No
(3)EMORY STREET RADIOLOGY ASSOCIATES INC 211 PARK STREET PO BOX 2963 ATTLEBORO,MA02703 04-3137282	RADIOLOGY	MA	501(C)(3)	LINE 12B, II	SMH	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2019

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	(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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(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	Yes	No
(1) SHV INC 127 PEARL STREET ATTLEBORO,MA02703 04-2855097	SALES AND RENTAL	MA	SMF	C				No

Schedule R (Form 990) 2019

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

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 .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

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

Schedule R (Form 990) 2019

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)	(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2019

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. (see instructions).

Return Reference

Explanation

RELATED TAX-EXEMPT ORGANIZATIONS

SCHEDULE R, PART II STURDY MEMORIAL ASSOCIATES, INC.'S PRIMARY ACTIVITIES: RECRUIT PHYSICIANS TO EXPAND AND IMPROVE THE AVAILABILITY OF QUALITY MEDICAL CARE IN THE STURDY MEMORIAL HOSPITAL SERVICE AREA. STURDY MEMORIAL FOUNDATION, INC.'S PRIMARY ACTIVITIES: ENGAGING IN PHILANTHROPHIC ACTIVITIES TO SUPPORT THE MISSION AND PURPOSE OF STURDY MEMORIAL HOSPITAL, INC. RELATED ORGANIZATION TAXABLE AS A CORPORATION SCHEDULE R, PART IV SHV, INC., WHICH DOES BUSINESS UNDER THE TRADE OF NAME ATTLEBORO AREA MEDICAL EQUIPMENT CO, IS A FOR-PROFIT CORPORATION ACTIVELY ENGAGED IN THE SALE AND RENTAL OF MEDICAL EQUIPMENT AND ACCESSORIES IN THE GREATER ATTLEBORO AREA. THE COMPANY EXTENDS CREDIT TO ITS CUSTOMERS AND IS PAID DIRECTLY OR BY PRIVATE INSURANCE. SHV INC. FILED ITS ARTICLES OF DISSOLUTION ON OCTOBER 9, 2019 AND THEREFORE WILL NOT BE LISTED ON THE RETURN IN FUTURE YEARS.

Schedule R (Form 990) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: PROVIDING SAFE, HIGH QUALITY, COST EFFICIENT HEALTH CARE, AND A BROAD (CONTINUED ON SCH O). RANGE OF DIAGNOSTICS, INPATIENT, OUTPATIENT AND EMERGENCY SERVICES FOR OUR COMMUNITY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	15
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	1,868
6	Total number of volunteers (estimate if necessary) .............	6	479
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	76,537
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	20,513

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	854,060	12,589,692
9	Program service revenue (Part VIII, line 2g) .........	209,040,488	203,764,770
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	13,930,754	17,306,083
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	8,913,711	8,820,225
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	232,739,013	242,480,770
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	7,837,018	13,096,666
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	122,056,815	127,096,424
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	84,294,807	88,321,987
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	214,188,640	228,515,077
19	Revenue less expenses. Subtract line 18 from line 12.......	18,550,373	13,965,693
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	440,585,898	472,355,538
21	Total liabilities (Part X, line 26).............	38,559,549	62,373,502
22	Net assets or fund balances. Subtract line 21 from line 20.....	402,026,349	409,982,036

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 200,193,965 including grants of $ 13,096,666 ) (Revenue $ 203,764,770 )
	STURDY MEMORIAL HOSPITAL, INC. IS A NOT-FOR-PROFIT ACUTE CARE COMMUNITY HOSPITAL WHICH IS DEDICATED TO PROVIDING A BROAD RANGE OF HEALTH CARE SERVICES TO THE RESIDENTS OF ATTLEBORO, MASSACHUSETTS AND SURROUNDING COMMUNITIES. THE HOSPITAL GENERATES VIRTUALLY ALL OF ITS REVENUES IN PURSUIT OF ITS EXEMPT PURPOSES, WHICH IS TO PROVIDE COMPREHENSIVE DIAGNOSTIC, THERAPEUTIC, AND EDUCATIONAL HEALTH CARE SERVICES TO RESIDENTS OF ITS COMMUNITIES. (CONTINUED ON SCHEDULE O).THE HOSPITAL PROVIDES HIGH QUALITY CARE TO THE SICK AND INJURED, ON BOTH AN INPATIENT AND OUTPATIENT BASIS, WITHOUT REGARD TO RACE, CREED, NATIONAL ORIGIN AGE, GENDER, DISABILITY, OR ABILITY TO PAY. IN FISCAL YEAR 2020, THE HOSPITAL PROVIDED 2,959 FREE CARE VISITS AND 425 PARTIAL FREE CARE VISITS. THE HOSPITAL TREATED 10,199 INPATIENTS AND OBSERVATION PATIENTS, INCLUDING BIRTHS, OF WHICH THERE WERE 606. THE HOSPITAL TREATED 42,002 PATIENTS IN THE EMERGENCY ROOM AND PERFORMED SURGERY ON 1,534 INPATIENTS AND 7,786 OUTPATIENTS. THE HOSPITAL PROVIDES MANY OTHER SERVICES OF WHICH THE FOLLOWING IS A PARTIAL LIST: ONCOLOGY - 8,192 VISITS; MANSFIELD HEALTH CENTER - 19,484 VISITS; CARDIAC REHABILITATION - 9,623 VISITS; AND WOUND CARE - 3,345 VISITS. IN ADDITION, THE HOSPITAL PROVIDES A VARIETY OF ANCILLARY SERVICES - A PARTIAL LIST INCLUDES: LABORATORY, RADIOLOGY, MAMMOGRAPHY, COMPUTERIZED TOMOGRAPHY, MRI, NUCLEAR MEDICINE, VASCULAR, ULTRASOUND, SLEEP STUDY AND PHYSICAL THERAPY. THE HOSPITAL PROVIDED APPROXIMATELY $7,415,000 IN SERVICES FOR THOSE WHO COULD NOT PAY (FREE CARE) OR WOULD NOT PAY (BAD DEBT) IN FISCAL YEAR 2020. IN ADDITION, THE HOSPITAL PROVIDED APPROXIMATELY $9,148,000 IN UN-REIMBURSED MASSHEALTH (MEDICAID) SERVICES DURING THE YEAR. FURTHER, THE HOSPITAL PROVIDES A NUMBER OF PROGRAMS TO BENEFIT OUR COMMUNITY EITHER AT NO CHARGE OR AT REDUCED RATES. THE HOSPITAL ALSO PROVIDES LEADERSHIP IN THE INTEGRATION OF HEALTH SERVICES FOR THE COMMUNITIES IT SERVES. STURDY CONTINUES TO PARTNER WITH COLUMN HEALTH TO BRING SUBSTANCE USE DISORDER TREATMENT TO OUR COMMUNITY.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses200,193,965

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	5,493,470	210,542	2,324,621

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	12,589,692

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		12,589,692

		Business Code
2a	NET PATIENT SERVICE REVENUE	621400	198,068,175	198,068,175
b	PATIENT RELATED REVENUE, OTHER	621990	1,318,612	1,318,612
c	CAFETERIA SALES	722514	923,661			923,661
d	INCENTIVE PAYMENTS	900099	646,489	646,489
e	OTHER PROGRAM 4	900099	482,324	429,280	53,044
f	All other program service revenue.		2,325,509	2,325,509
g	Total. Add lines 2a–2f .....		203,764,770

3 Investment income (including dividends, interest, and othersimilar amounts) ......			7,731,220		23,493	7,707,727
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		32,825	6a
b	Less: rental expenses		0	6b
c	Rental income or (loss)		32,825	6c
d	Net rental income or (loss).......			32,825			32,825
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	900	151,281,219	7a
b	Less: cost or other basis and sales expenses	0	141,707,256	7b
c	Gain or (loss)	900	9,573,963	7c
d	Net gain or (loss).........			9,574,863			9,574,863
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	PENSION/POST RETIREMENT ADJSTMNTS		900099	8,787,400			8,787,400
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			8,787,400
12	Total revenue. See instructions.....			242,480,770	202,788,065	76,537	27,026,476

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	13,096,666	13,096,666
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	2,826,585		2,826,585
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	91,710,341	79,603,441	12,106,900
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	14,078,132	11,853,787	2,224,345
9	Other employee benefits .......	12,717,578	10,708,201	2,009,377
10	Payroll taxes ...........	5,763,788	4,853,110	910,678
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	238,138		238,138
c	Accounting ...........	207,125		207,125
d	Lobbying ...........	13,264		13,264
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	840,287		840,287
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	10,870,248	8,592,131	2,278,117
12	Advertising and promotion ....	282,674		282,674
13	Office expenses .......	2,859,493	2,220,620	638,873
14	Information technology ......	7,725,176	6,856,990	868,186
15	Royalties ..
16	Occupancy ...........	3,656,950	3,414,361	242,589
17	Travel ............	97,795	48,370	49,425
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	104,099	87,571	16,528
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	8,204,617	6,973,924	1,230,693
23	Insurance ...	1,095,729	707,360	388,369
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	38,713,018	38,696,032	16,986
b	PROVSN FOR DOUBTFL DEBT	7,175,877	7,175,877
c	MAINTENANCE & REPAIRS	3,111,054	2,894,178	216,876
d	LICENSES AND TAXES	2,177,224	2,158,260	18,964
e	All other expenses	949,219	253,086	696,133
25	Total functional expenses. Add lines 1 through 24e	228,515,077	200,193,965	28,321,112	0
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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			1,598	1	1,316
2	Savings and temporary cash investments .........			4,687,678	2	24,929,789
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			18,645,467	4	18,239,134
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........			0	7	0
8	Inventories for sale or use ............			4,227,155	8	5,405,436
9	Prepaid expenses and deferred charges ......			4,867,822	9	3,356,408
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	184,544,207
b	Less: accumulated depreciation	10b	121,118,057	52,477,220	10c	63,426,150
11	Investments—publicly traded securities .			314,696,903	11	312,353,553
12	Investments—other securities. See Part IV, line 11 .....			22,788,460	12	21,697,380
13	Investments—program-related. See Part IV, line 11 ..			543,804	13	3,177,072
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			17,649,791	15	19,769,300
16	Total assets. Add lines 1 through 15 (must equal line 33)...			440,585,898	16	472,355,538

17	Accounts payable and accrued expenses .....	32,406,807	17	55,060,466
18	Grants payable ...	0	18	0
19	Deferred revenue .........	73,792	19	2,000,000
20	Tax-exempt bond liabilities .........	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
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	6,078,950	25	5,313,036
26	Total liabilities. Add lines 17 through 25..	38,559,549	26	62,373,502

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	402,003,758	27	409,959,445
28	Net assets with donor restrictions ...........	22,591	28	22,591
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	402,026,349	32	409,982,036
33	Total liabilities and net assets/fund balances ........	440,585,898	33	472,355,538