Form990
Click to see attachment
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Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
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OMB No. 1545-0047
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 10-01-2021 , and ending 09-30-2022
BCheck if applicable:
CName of organization
BAYSTATE MEDICAL CENTER INC
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
759 CHESTNUT STREET
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
SPRINGFIELD, MA01199
D Employer identification number

04-2790311
E Telephone number

G Gross receipts $ 1,885,074,836
F Name and address of principal officer:
RAYMOND MCCARTHY
759 CHESTNUT STREET
SPRINGFIELD,MA01199
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.BAYSTATEHEALTH.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. See instructions.
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1983
M State of legal domicile: MA
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: THE MISSION OF THE ORGANIZATION IS TO IMPROVE THE HEALTH OF THE PEOPLE IN OUR COMMUNITIES EVERY DAY, WITH QUALITY AND COMPASSION.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 21
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 2021 (Part V, line 2a) ...... 5 10,249
6 Total number of volunteers (estimate if necessary) ............. 6 142
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 40,500,383
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 60,154,211 43,012,045
9 Program service revenue (Part VIII, line 2g) ......... 1,454,708,531 1,479,412,681
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 13,214,950 117,865,107
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 76,864,075 76,027,907
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 1,604,941,767 1,716,317,740
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 9,495,000 13,513,000
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 626,525,637 711,394,940
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 864,305,325 953,087,021
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,500,325,962 1,677,994,961
19 Revenue less expenses. Subtract line 18 from line 12....... 104,615,805 38,322,779
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,934,108,608 1,548,788,530
21 Total liabilities (Part X, line 26)............. 862,831,808 755,976,190
22 Net assets or fund balances. Subtract line 21 from line 20..... 1,071,276,800 792,812,340
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
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Signature of officer Date
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Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2021)
Form 990 (2021)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: THE MISSION OF THE ORGANIZATION IS TO IMPROVE THE HEALTH OF THE PEOPLE IN OUR COMMUNITIES EVERY DAY, WITH QUALITY AND COMPASSION.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 822,915,082 including grants of $ 13,513,000 ) (Revenue $ 730,213,253 )
INPATIENT HEALTHCARE SERVICES - PROVIDING INPATIENT COMMUNITY-BASED MEDICINE AND TERTIARY CARE TO THE SURROUNDING REGION. SERVICES ARE AVAILABLE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. DURING FY22, BAYSTATE MEDICAL CENTER, INC. PROVIDED 239,855 PATIENT DAYS OF INPATIENT SERVICES, WITH 43,585 DISCHARGES.
4b (Code:   ) (Expenses $ 537,027,411 including grants of $   ) (Revenue $ 504,538,561 )
OUTPATIENT HEALTHCARE SERVICES - PROVIDING OUTPATIENT CLINICAL SERVICES TO THE SURROUNDING REGION. SERVICES ARE AVAILABLE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. DURING FY22, BAYSTATE MEDICAL CENTER, INC. HAD 335,718 OUTPATIENT VISITS.
4c (Code:   ) (Expenses $ 53,804,716 including grants of $   ) (Revenue $ 37,604,983 )
EMERGENCY DEPARTMENT SERVICES - PROVIDING EMERGENCY DEPARTMENT SERVICES TO THE SURROUNDING REGION. SERVICES ARE AVAILABLE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. DURING FY22, BAYSTATE MEDICAL CENTER, INC. HAD 99,449 EMERGENCY DEPARTMENT VISITS.
(Code:   ) (Expenses $ 147,594,321 including grants of $   ) (Revenue $ 277,917,306 )
PROVIDING PHARMACY AND SUPPORT SERVICES TO THE SURROUNDING REGION. SERVICES AVAILABLE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY.
4d Other program services (Describe in Schedule O.)
(Expenses $ 147,594,321 including grants of $   ) (Revenue $ 277,917,306 )
4e Total program service expensesMediumBullet1,561,341,530
Form 990 (2021)
Form 990 (2021)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Rev. Proc. 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
Click to see attachment......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I. See instructions. ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see list of attachments
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I .... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or 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? If "Yes," complete Schedule L, Part IIClick to see attachment...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part IIIClick to see attachment.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................Click to see attachment
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
28b
Yes
 
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
 
No
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
Yes
 
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in box 3 of Form 1096. Enter -0- if not applicable ..
1a
368
b
Enter the number of Forms W-2G included on line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
10,249
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. See instructions.
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see the instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
Page 6
Part VI
Governance, Management, and Disclosure. For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
21
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
15
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
Yes
 
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe on Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe on Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process on Schedule O. See instructions.
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
MA
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletLAURIE MARTIN759 CHESTNUT STREET   SPRINGFIELD,MA01199 (413) 794-0000
Form 990 (2021)
Form 990 (2021)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See the instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (box 5 of Form W-2, Form 1099-MISC, and/or box 1 of Form 1099-NEC) of more than $100,000 from the
organization and any related organizations.

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

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

See the instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) MARK A KEROACK MD......................................................................
TRUSTEE/PRESIDENT & CEO, BH
1.00
.................
49.00
X           0 2,310,853 32,959
(2) KEVIN P MORIARTY MD......................................................................
TRUSTEE/CHIEF PED SURGERY
1.00
.................
49.00
X           723,929 0 40,494
(3) AKINYELE K LOVELACE DO......................................................................
TRUSTEE/PER DIEM INTERNIST
1.00
.................
49.00
X           63,420 0 951
(4) ARLEY DIAZ MD......................................................................
TRUSTEE
1.00
.................
0.00
X           0 40,000 0
(5) SARA ROURKE MD......................................................................
TRUSTEE (AS OF 1/1/2022)
1.00
.................
49.00
X           7,025 0 105
(6) ROBERT J BACON......................................................................
CHAIR
1.00
.................
6.00
X   X       0 0 0
(7) CLAUDIA R COPLEIN DO......................................................................
TRUSTEE
1.00
.................
4.00
X           0 0 0
(8) COLLEEN W HOLMES......................................................................
TRUSTEE
1.00
.................
4.00
X           0 0 0
(9) DENISE R JORDAN......................................................................
TRUSTEE
1.00
.................
4.00
X           0 0 0
(10) EDWARD J NOONAN......................................................................
TRUSTEE (THRU 12/31/21)
1.00
.................
4.00
X           0 0 0
(11) ELIZABETH CARDONA......................................................................
TRUSTEE (AS OF 1/1/2022)
1.00
.................
4.00
X           0 0 0
(12) GREGORY L BRADEN MD......................................................................
TRUSTEE (THRU 12/31/21)
1.00
.................
4.00
X           0 0 0
(13) HARRIET A DEVERRY......................................................................
VICE CHAIR/ TRUSTEE
1.00
.................
6.00
X           0 0 0
(14) IRENE RODRIGUEZ MARTIN......................................................................
TRUSTEE
1.00
.................
4.00
X           0 0 0
(15) JAMES R PHANEUF......................................................................
TRUSTEE
1.00
.................
4.00
X           0 0 0
(16) JOHN F MAYBURY......................................................................
TRUSTEE
1.00
.................
4.00
X           0 0 0
(17) KATHLEEN B SCOBLE......................................................................
TRUSTEE
1.00
.................
5.00
X           0 0 0
Form 990 (2021)
Form 990 (2021)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) MARIA P GONCALVES........................................................................
TRUSTEE
1.00
.......................5.00
X           0 0 0
(19) PAUL C PICKNELLY........................................................................
TRUSTEE
1.00
.......................4.00
X           0 0 0
(20) PAUL R MURPHY........................................................................
TRUSTEE
1.00
.......................4.00
X           0 0 0
(21) RICHARD BOSSIE........................................................................
TRUSTEE (AS OF 1/1/2022)
1.00
.......................4.00
X           0 0 0
(22) RUTH H CONSTANTINE........................................................................
TRUSTEE (AS OF 2/8/2022)
1.00
.......................4.00
X           0 0 0
(23) WILLIAM R WEBBER........................................................................
TRUSTEE
1.00
.......................4.00
X           0 0 0
(24) RAYMOND MCCARTHY........................................................................
TREASURER
10.00
.......................40.00
    X       0 1,045,794 26,405
(25) FRANK J CRACOLICI........................................................................
INTERIM PRESIDENT (THRU 9/12/2022)
50.00
.......................0.00
    X       449,406 0 0
(26) KRISTIN R DELANEY........................................................................
CLERK
1.00
.......................49.00
    X       0 168,920 42,432
(27) NANCY REMILLARD........................................................................
ASSISTANT CLERK
1.00
.......................49.00
    X       0 60,157 12,044
(28) SAMUEL SKURA........................................................................
PRESIDENT (AS OF 9/13/2022)/SVP OPS
50.00
.......................0.00
    X       0 0 0
(29) MARION MCGOWAN........................................................................
EVP COO
42.00
.......................8.00
      X     0 1,417,231 228,343
(30) DOUGLAS SALVADOR MD........................................................................
SVP/CQO BH, CMO BMC
40.00
.......................10.00
      X     0 716,693 50,605
(31) TEJAS GANDHI........................................................................
VP/COO
40.00
.......................10.00
      X     0 693,184 34,524
(32) JOANNE MILLER........................................................................
VP/CHIEF NURSING OFFICER
50.00
.......................0.00
      X     233,293 0 0
(33) PETER FRIEDMANN MD........................................................................
ASSOC DEAN CHIEF RES OFFICER
50.00
.......................0.00
        X   455,424 0 41,205
(34) PETER LINDENAUER MD........................................................................
ASST DEAN POPULATION HEALTH
50.00
.......................0.00
        X   425,096 0 42,473
(35) SHELDRICK STREETE........................................................................
VP SURGICAL SERVICES
50.00
.......................0.00
        X   415,565 0 40,945
(36) AMY GOTTLEIB MD........................................................................
ASSOC DEAN CHIEF FAC DEVELOP
50.00
.......................0.00
        X   422,482 0 22,550
(37) JASMINE J PAADAM MD........................................................................
CIS PHYSICIAN LEADER
50.00
.......................0.00
        X   364,219 0 20,114
(38) NANCY SHENDELL-FALIK........................................................................
FORMER PRESIDENT/SVP HOSP OPS
0.00
.......................0.00
          X 0 2,436,284 26,936
(39) CHRISTINE KLUCZNIK........................................................................
FORMER VP/CNO
0.00
.......................0.00
          X 0 439,002 20,115
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 3,559,859 9,328,118 683,200
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet889
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
Yes
 
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
BAYSTATE MEDICAL PRACTICES

759 CHESTNUT ST
SPRINGFIELD,MA011990001
MEDICAL, EDUCATIONAL & CLINICAL SERVICES 88,732,608
BAYSTATE ADMINISTRATIVE SERVICES

759 CHESTNUT ST
SPRINGFIELD,MA011990001
MANAGEMENT SERVICES 83,884,555
SHIFTWISE

1800 SW 1ST AVE SUITE 510
PORTLAND,OR97201
CONTRACT SERVICES 72,989,634
SHIELDS SPECIALTY PHARMACY

1200 HANCOCK ST 300
QUINCY,MA02169
MANAGEMENT SERVICES 12,304,778
AFLAC

1932 WYNNTON RD
COLUMBUS,GA061150525
BENEFIT SERVICES 7,581,491
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet116
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 3,503,980
e Government grants (contributions)1e 38,282,028
f All other contributions, gifts, grants, and similar amounts not included above1f 1,226,037
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 43,012,045
 Program Service RevenueAmt Business Code
2a INPATIENT REVENUE 622110 771,595,768 771,595,768    
b OUTPATIENT REVENUE 622110 687,781,304 667,674,750 20,106,554  
c SPONSORED PROGRAM REV. 622110 12,362,806 12,362,806    
d MCD WAIVER SAFETY NET 622110 4,649,328 4,649,328    
e INTERCOMPANY REVENUE 622110 3,023,475 3,023,475    
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 1,479,412,681
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 9,031,665     9,031,665
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   174,637 6a
b Less: rental expenses   501,040 6b
c Rental income or (loss)   -326,403 6c
d Net rental income or (loss).......MediumBullet -326,403     -326,403
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 72,783,521 204,305,977 7a
b Less: cost or other basis and sales expenses 72,567,450 95,688,606 7b
c Gain or (loss) 216,071 108,617,371 7c
d Net gain or (loss).........MediumBullet 108,833,442     108,833,442
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..MediumBullet      
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..MediumBullet        
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..MediumBullet        
Business Code Miscellaneous Revenue
11a PHARMACY SERVICE 622110 37,048,788 16,676,782 20,372,006  
b INTERCOMPANY CHARGES 622110 23,716,585 23,716,585    
c CAFETERIA INCOME 622110 5,466,983     5,466,983
d All other revenue .... 10,121,954 10,094,274 21,823 5,857
e Total. Add lines 11a–11d ...... MediumBullet 76,354,310
12 Total revenue. See instructions.....MediumBullet 1,716,317,740 1,509,793,768 40,500,383 123,011,544
Form 990 (2021)
Form 990 (2021)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 13,513,000 13,513,000
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 ...........        
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ......... 52,571 52,571    
7 Other salaries and wages........ 582,443,367 528,622,395 53,820,972  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 25,505,586 23,148,846 2,356,740  
9 Other employee benefits ....... 60,941,760 55,310,911 5,630,849  
10 Payroll taxes ........... 42,451,656 38,529,237 3,922,419  
11 Fees for services (non-employees):        
a Management ...... 66,592,665 63,566,093 3,026,572  
b Legal ......... 340,006   340,006  
c Accounting ........... 655,636   655,636  
d Lobbying ........... 70,852   70,852  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 265,847,729 247,877,136 17,970,593  
12 Advertising and promotion .... 251,800 186,656 65,144  
13 Office expenses ....... 34,676,916 29,095,137 5,581,779  
14 Information technology ...... 92,028,549 91,156,126 872,423  
15 Royalties ..        
16 Occupancy ........... 22,243,964 12,519,863 9,724,101  
17 Travel ............ 1,057,859 1,028,098 29,761  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 1,678,301 1,489,145 189,156  
20 Interest ........... 7,114,966 7,114,966    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 59,874,036 49,031,937 10,842,099  
23 Insurance ... 9,360,234 7,805,905 1,554,329  
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 391,293,508 391,293,508    
b
c
d
e All other expenses        
25 Total functional expenses. Add lines 1 through 24e 1,677,994,961 1,561,341,530 116,653,431 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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2021)
Form 990 (2021)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........   1  
2 Savings and temporary cash investments ......... 259,083,197 2 62,628,865
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 213,597,776 4 250,398,626
5 Loans and other receivables from 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 .......
  5  
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) ...
  6  
7 Notes and loans receivable, net ...........   7  
8 Inventories for sale or use ............ 35,575,545 8 38,452,376
9 Prepaid expenses and deferred charges ...... 5,934,201 9 4,715,576
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,765,103,940
b Less: accumulated depreciation 10b 1,076,140,060 588,700,704 10c 688,963,880
11 Investments—publicly traded securities . 651,063,723 11 320,287,512
12 Investments—other securities. See Part IV, line 11 ..... 93,148,557 12 146,323,566
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ............... 1,552,027 14 1,552,027
15 Other assets. See Part IV, line 11 ........... 85,452,878 15 35,466,102
16 Total assets. Add lines 1 through 15 (must equal line 33)... 1,934,108,608 16 1,548,788,530
Liabilities 17 Accounts payable and accrued expenses ..... 178,931,045 17 175,228,735
18 Grants payable ...   18  
19 Deferred revenue ......... 137,620,427 19 3,397,755
20 Tax-exempt bond liabilities ......... 468,946,990 20 490,817,011
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
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 .........
  22  
23 Secured mortgages and notes payable to unrelated third parties .. 55,150,324 23 50,420,180
24 Unsecured notes and loans payable to unrelated third parties ..   24  
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 22,183,022 25 36,112,509
26 Total liabilities. Add lines 17 through 25.. 862,831,808 26 755,976,190
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 1,051,630,433 27 777,494,682
28 Net assets with donor restrictions ........... 19,646,367 28 15,317,658
Organizations that do not follow FASB ASC 958, check here MediumBullet 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 ........... 1,071,276,800 32 792,812,340
33 Total liabilities and net assets/fund balances ........ 1,934,108,608 33 1,548,788,530
Form 990 (2021)
Form 990 (2021)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
1,716,317,740
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
1,677,994,961
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
38,322,779
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
1,071,276,800
5
Net unrealized gains (losses) on investments ...............
5
-206,272,554
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-110,514,685
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
792,812,340
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain on
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2021)
Form 990 (2021)
Additional Data


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

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
BAYSTATE MEDICAL CENTER INC
 
Employer identification number

04-2790311
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.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
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) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
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) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose            
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge            
6 Total. Add lines 1 through 5            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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 on line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 0.015 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 0.035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
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 1  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
2  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations 3  
4 Amounts paid to acquire exempt-use assets 4  
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) 5  
6 Other distributions (describe in Part VI). See instructions 6  
7Total annual distributions. Add lines 1 through 6. 7  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI
). See instructions
8  
9 Distributable amount for 2021 from Section C, line 6 9  
10 Line 8 amount divided by Line 9 amount 10  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2021
(iii)
Distributable
Amount for 2021
1 Distributable amount for 2021 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2021:
a From 2016.......  
b From 2017.......  
c From 2018.......  
d From 2019.......  
e From 2020.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2021 distributable amount  
i Carryover from 2016 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2021 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2021 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2021, 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 2021. 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 2022. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2017.....  
b Excess from 2018.....  
c Excess from 2019.....  
d Excess from 2020.....  
e Excess from 2021.....  
Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021
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) 2021


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Name of the organization
BAYSTATE MEDICAL CENTER INC
 
Employer identification number

04-2790311
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that 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) (2021)
Schedule B (Form 990) (2021) Page 2
Name of organization
BAYSTATE MEDICAL CENTER INC
 
Employer identification number
04-2790311
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


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

$  


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

$  


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

$  


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

$  


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

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)
Schedule B (Form 990) (2021)
Page 3
Name of organization
BAYSTATE MEDICAL CENTER INC
 
Employer identification number

04-2790311
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) (2021)
Schedule B (Form 990) (2021)
Page 4
Name of organization
BAYSTATE MEDICAL CENTER INC
 
Employer identification number

04-2790311
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990) (2021)
Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990)

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 BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
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
BAYSTATE MEDICAL CENTER INC
 
Employer identification number

04-2790311
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

2
Political campaign activity expenditures. See instructions ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities. See instructions ..................................................................
 

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

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

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990) 2021

Schedule C (Form 990) 2021
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................    
c Total lobbying expenditures (add lines 1a and 1b) ............................................................    
d Other exempt purpose expenditures ...............................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ..................................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2018 (b) 2019 (c) 2020 (d) 2021 (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) 2021


Schedule C (Form 990) 2021
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
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
70,852
j
Total. Add lines 1c through 1i ....................................................................................................
70,852
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures. See Instructions .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
PART II-B, LINE 1: BAYSTATE MEDICAL CENTER, INC. PAYS MEMBERSHIP DUES TO THE MASSACHUSETTS HOSPITAL ASSOCIATION (MHA) $42,807 AND THE AMERICAN HOSPITAL ASSOCIATION (AHA) $28,045. THESE ORGANIZATIONS HAVE ADVISED US THAT PORTIONS OF THESE DUES ARE USED FOR LOBBYING PURPOSES FOR VARIOUS HEALTHCARE MATTERS AT THE STATE LEVEL. THE PORTION OF DUES LISTED AS LOBBYING EXPENSES FOR THE YEAR ENDING SEPTEMBER 30, 2022 IS $70,852.
Schedule C (Form 990) 2021


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," 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
2021
Open to Public Inspection
Name of the organization
BAYSTATE MEDICAL CENTER INC
 
Employer identification number

04-2790311
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under 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.
b
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 $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Term endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
 
(ii) Related organizations .................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment)
(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....   15,697,770 15,697,770
b Buildings ....   822,076,908 412,680,227 409,396,681
c Leasehold improvements   5,849,806 3,943,481 1,906,325
d Equipment ....   729,349,792 620,860,281 108,489,511
e Other .....   192,129,664 38,656,071 153,473,593
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 688,963,880
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 3
Part VII
Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........ 10,204,966 C
(3) Other
(A) SECURITIES OTHER
128,895,841 C

(B) SECURITIES REAL ESTATE
7,222,759 C
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 146,323,566
Part VIII
Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
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  
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 36,112,509
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) 2021

Schedule D (Form 990) 2021
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
SCHEDULE D, PART V: CERTAIN ENDOWMENTS ARE HELD AT BAYSTATE HEALTH FOUNDATION, INC. (BHF), AN AFFILIATE, AND ARE REPORTED AS TEMPORARILY RESTRICTED AND PERMANENTLY RESTRICTED BUT PART V HAS NOT BEEN COMPLETED AS IT IS BAYSTATE MEDICAL CENTER, INC. 04-2790311 ALREADY ADDRESSED ON BHF'S FORM 990 (EIN 04-3549011).
Schedule D (Form 990) 2021


Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" 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
2021
Open to Public Inspection
Name of the organization
BAYSTATE MEDICAL CENTER INC
 
Employer identification number

04-2790311
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    10,302,894 2,996,406 7,306,488 0.440 %
b Medicaid (from Worksheet 3, column a) . . . . .     350,949,151 252,151,605 98,797,546 5.890 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     11,697,366 10,452,894 1,244,472 0.070 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .     372,949,411 265,600,905 107,348,506 6.400 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     1,969,094 0 1,969,094 0.120 %
f Health professions education (from Worksheet 5) . . .     71,921,200 23,018,325 48,902,875 2.910 %
g Subsidized health services (from Worksheet 6) . . . .     30,561,435 17,208,218 13,353,217 0.800 %
h Research (from Worksheet 7) .     25,438,217 18,454,921 6,983,296 0.420 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     1,327,723   1,327,723 0.080 %
j Total. Other Benefits . .     131,217,669 58,681,464 72,536,205 4.330 %
k Total. Add lines 7d and 7j .     504,167,080 324,282,369 179,884,711 10.730 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development     198,564   198,564 0.010 %
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members
           
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total     198,564   198,564 0.010 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
10,213,968
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
662,650
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
344,202,479
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
360,328,952
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-16,126,473
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 BAYSTATE MEDICAL CENTER INC
759 CHESTNUT STREET
SPRINGFIELD,MA01199
2339
X X X X   X X      
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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)
BAYSTATE MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 21
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 21
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): BAYSTATEHEALTH.ORG/CHNA
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
BAYSTATE MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
HTTPS://WWW.BAYSTATEHEALTH.ORG/PATIENTS/BILLING-AND-FINANCIAL-ASSISTANCE
b
HTTPS://WWW.BAYSTATEHEALTH.ORG/PATIENTS/BILLING-AND-FINANCIAL-ASSISTANCE
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 6
Part VFacility Information (continued)

Billing and Collections
BAYSTATE MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
BAYSTATE MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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
BAYSTATE MEDICAL CENTER, INC. PART V, SECTION B, LINE 5: BAYSTATE HEALTH HOSPITALS SERVE AS PART OF THE COALITION OF WESTERN MASSACHUSETTS HOSPITALS/INSURER (COALITION). THE COALITION IS A PARTNERSHIP BETWEEN EIGHT NON-PROFIT HOSPITALS/INSURER IN WESTERN MASSACHUSETTS: BAYSTATE MEDICAL CENTER, BAYSTATE FRANKLIN MEDICAL CENTER, BAYSTATE NOBLE HOSPITAL, BAYSTATE WING HOSPITAL, COOLEY DICKINSON HOSPITAL, MERCY MEDICAL CENTER (A MEMBER OF TRINITY HEALTH OF NEW ENGLAND), SHRINERS HOSPITALS FOR CHILDREN SPRINGFIELD, AND HEALTH NEW ENGLAND, A LOCAL HEALTH INSURER WHOSE SERVICE AREAS COVERS THE FOUR COUNTIES OF WESTERN MASSACHUSETTS. THE COALITION FORMED IN 2012 TO BRING HOSPITALS WITHIN WESTERN MASSACHUSETTS TOGETHER TO SHARE RESOURCES AND WORK IN PARTNERSHIP TO CONDUCT THEIR TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNAS) AND ADDRESS REGIONAL NEEDS. THE INPUT OF THE COMMUNITY AND OTHER IMPORTANT REGIONAL STAKEHOLDERS WAS AN IMPORTANT PART OF THE CHNA PROCESS. A WIDE RANGE OF STAKEHOLDERS TOOK PART IN THE 2022 CHNA PROCESS, INCLUDING LOCAL AND REGIONAL PUBLIC HEALTH AND HEALTH DEPARTMENTS, OTHER LOCAL MUNICIPAL AGENCIES, DIVERSE COMMUNITY-BASED ORGANIZATIONS, ADVOCACY ORGANIZATIONS, HEALTHCARE PROVIDERS, AND COMMUNITY RESIDENTS. THESE STAKEHOLDERS PROVIDED INPUT THROUGH A CHNA REGIONAL ADVISORY COUNCIL (RAC), FOCUS GROUPS, KEY INFORMANT INTERVIEWS, AND COMMUNITY CHATS. ADDITIONALLY, COMMUNITY FORUMS WERE CONDUCTED TOWARDS THE END OF THE CHNA PROCESS TO VET PRELIMINARY FINDINGS WITH COMMUNITY MEMBERS. PLEASE REFER TO THE HOSPITALS' CHNA APPENDIX I FOR A COMPLETE LISTING OF PUBLIC HEALTH, COMMUNITY REPRESENTATIVES, AND OTHER STAKEHOLDERS INCLUDED IN THE PROCESS.THE CHNA RAC INCLUDED REPRESENTATIVES FROM EACH COALITION MEMBER HOSPITAL/INSURER AS WELL AS PUBLIC HEALTH AND COMMUNITY STAKEHOLDERS FROM EACH HOSPITAL SERVICE AREA. STAKEHOLDERS ON THE RAC INCLUDED LOCAL AND REGIONAL PUBLIC HEALTH AND HEALTH DEPARTMENT REPRESENTATIVES; REPRESENTATIVES FROM LOCAL AND REGIONAL ORGANIZATIONS SERVING OR REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME OR POPULATIONS OF COLOR; AND INDIVIDUALS FROM ORGANIZATIONS THAT REPRESENT THE BROAD INTERESTS OF THE COMMUNITY. IN DECEMBER 2020 PREVIOUS RAC MEMBERS CONDUCTED A NEW STAKEHOLDER ANALYSIS TO ENSURE GEOGRAPHIC, SECTOR (E.G. SCHOOLS, COMMUNITY SERVICE ORGANIZATIONS, HEALTHCARE PROVIDERS, PUBLIC HEALTH, AND HOUSING), AND RACIAL/ETHNIC DIVERSITY OF RAC. THE RAC MET IN WORKGROUPS (DATA AND REPORTS, ENGAGEMENT AND DISSEMINATION, AND HEALTH EQUITY) TO GUIDE THE CONSULTANTS IN THE PROCESS OF CONDUCTING THE CHNA, AND PRIORITIZING COMMUNITY HEALTH NEEDS, CHNA FINDINGS, AND DISSEMINATION OF INFORMATION. ASSESSMENT METHODS AND FINDINGS WERE MODIFIED BASED ON THE RAC'S FEEDBACK. THE RAC CONSISTED OF ABOUT 50 PARTICIPANTS, INCLUDING COALITION MEMBERS AND CONSULTANTS. THE RAC MET MONTHLY FROM FEBRUARY 2021 THROUGH JULY 2022.KEY INFORMANT INTERVIEWS AND FOCUS GROUPS WERE CONDUCTED TO GATHER INFORMATION USED TO IDENTIFY PRIORITY HEALTH NEEDS AND ENGAGE THE COMMUNITY. KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH HEALTH CARE PROVIDERS, HEALTH CARE ADMINISTRATORS, LOCAL AND REGIONAL PUBLIC HEALTH OFFICIALS, AND LOCAL LEADERS THAT REPRESENT THE INTERESTS OF THE COMMUNITY OR THAT SERVE MEDICALLY UNDERSERVED, LOW-INCOME, OR POPULATIONS OF COLOR IN THE SERVICE AREA. INTERVIEWS WITH LOCAL AND REGIONAL PUBLIC HEALTH OFFICIALS IDENTIFIED PRIORITY HEALTH AREAS AND COMMUNITY FACTORS THAT CONTRIBUTE TO HEALTH NEEDS. FOCUS GROUP PARTICIPANTS INCLUDED COMMUNITY ORGANIZATION REPRESENTATIVES, COMMUNITY MEMBERS (LOW-INCOME, PEOPLE OF COLOR, AND OTHERS), AND OTHER COMMUNITY STAKEHOLDERS. TOPICS INCLUDED BUT WERE NOT LIMITED TO: ACCESS TO BASIC NEEDS, HEALTHCARE LANDSCAPE AND ACCESS, MENTAL HEALTH AND DOMESTIC VIOLENCE. KEY INFORMANT INTERVIEWS AND FOCUS GROUPS WERE CONDUCTED FROM FEBRUARY 2022 THROUGH MAY 2022. FOCUS GROUPS AND KEY INFORMANT INTERVIEWS ENGAGED RESIDENTS PRIMARILY IN HAMPDEN COUNTY, BUT ALSO ACROSS THE REGION.THE CHNA ALSO USED QUALITATIVE DATA FROM OTHER HOSPITAL SERVICE AREAS AS APPROPRIATE. BAYSTATE HEALTH HELD 22 CHATS, A COMMUNITY ENGAGEMENT APPROACH DEVELOPED DURING THE 2019 CHNA ITERATION. DURING COMMUNITY CHATS, RAC MEMBERS BROUGHT INFORMATION ABOUT THE CHNA AND GATHERED PRIORITIES IN REGULAR MEETINGS OF SERVICE PROVIDERS, COMMUNITY-BASED ORGANIZATIONS, AND HOSPITAL CLINICAL STAFF AND ADMINISTRATORS. WHILE THESE OUTREACH EFFORTS WERE SPEARHEADED BY BAYSTATE HEALTH, THE ENGAGEMENT AND FINDINGS BENEFITTED ALL COALITION MEMBER HOSPITALS/INSURER. CHATS WERE HELD FROM JANUARY 2022 THROUGH APRIL 2022 AND ENGAGED APPROXIMATELY 300 INDIVIDUALS.
BAYSTATE MEDICAL CENTER, INC. PART V, SECTION B, LINE 6A: THE COALITION OF WESTERN MA HOSPITALS/INSURER (COALITION) IS A PARTNERSHIP BETWEEN EIGHT NON-PROFIT HOSPITALS/INSURER IN WESTERN MASSACHUSETTS: BAYSTATE MEDICAL CENTER, BAYSTATE FRANKLIN MEDICAL CENTER, BAYSTATE NOBLE HOSPITAL, BAYSTATE WING HOSPITAL, COOLEY DICKINSON HOSPITAL, MERCY MEDICAL CENTER (A MEMBER OF TRINITY HEALTH OF NEW ENGLAND), SHRINERS HOSPITALS FOR CHILDREN SPRINGFIELD, AND HEALTH NEW ENGLAND, A LOCAL HEALTH INSURER WHOSE SERVICE AREA COVERS THE FOUR COUNTIES OF WESTERN MASSACHUSETTS. THE COALITION FORMED IN 2012 TO BRING HOSPITALS WITHIN WESTERN MASSACHUSETTS TOGETHER TO SHARE RESOURCES AND WORK IN PARTNERSHIP TO CONDUCT THEIR TRIENNIAL CHNAS AND ADDRESS REGIONAL NEEDS. AT THE END OF THE 2022 CHNA RESEARCH PROCESS, BERKSHIRE HEALTH SYSTEMS JOINED THE COALITION.
BAYSTATE MEDICAL CENTER, INC. PART V, SECTION B, LINE 6B: THE COALITION OF WESTERN MA HOSPITALS/ INSURER ENGAGED THE PUBLIC HEALTH INSTITUTE OF WESTERN MA (PHIWM), BASED IN SPRINGFIELD, MA, AS THE LEAD CONSULTANT TO CONDUCT THE CHNAS. PHIWM WAS SUPPORTED BY THREE OTHER CONSULTANT TEAMS: COMMUNITY HEALTH SOLUTIONS (CES), BASED IN NORTHAMPTON, MA; FRANKLIN REGIONAL COUNCIL OF GOVERNMENTS (FRCOG), BASED IN GREENFIELD, MA; AND PIONEER VALLEY PLANNING COMMISSION (PVPC), BASED IN SPRINGFIELD, MA. THE COALITION INCLUDES HEALTH NEW ENGLAND, A LOCAL HEALTH INSURER WHOSE SERVICE AREA COVERS THE FOUR COUNTIES OF WESTERN MASSACHUSETTS.
BAYSTATE MEDICAL CENTER, INC. PART V, SECTION B, LINE 7D: THE HOSPITAL FACILITY MADE ITS CHNA REPORT WIDELY AVAILABLE TO THE PUBLIC VIA AN EMAIL DISTRIBUTION, WITH LINKS TO THE HOSPITAL'S WEBSITE, TO COMMUNITY PARTNERS AND ORGANIZATIONS. IN ADDITION, THE CHNA REPORTS HAVE INFORMED THE IMPLEMENTATION OF COUNTY WIDE COMMUNITY HEALTH IMPROVEMENT PLANS IN FRANKLIN AND HAMPDEN COUNTIES. HOSPITAL AND CHNA CONSULTANT STAFF HAVE BEEN INVITED TO VARIOUS VENUES AND AUDIENCES TO PRESENT ON THE CHNA PROCESS AND KEY FINDINGS. ALL COALITION CHNAS WERE POSTED TO THE WEBSITE AND SHARED VIA THE OFFICE OF GOVERNMENT AND COMMUNITY RELATIONS NEWSLETTER TO OVER 500 RECIPIENTS.
BAYSTATE MEDICAL CENTER, INC. PART V, SECTION B, LINE 11: THE HOSPITAL FACILITY ANTICIPATES HEALTH NEEDS AND AVAILABLE RESOURCES MAY CHANGE, THEREFORE, A FLEXIBLE APPROACH WAS ADOPTED IN THE DEVELOPMENT OF ITS IMPLEMENTATION STRATEGY. FOR EXAMPLE, CERTAIN COMMUNITY HEALTH NEEDS MAY BECOME MORE PRONOUNCED AND REQUIRE CHANGES TO THE INITIATIVES IDENTIFIED BY THE HOSPITAL IN THE STRATEGY. OTHER COMMUNITY ORGANIZATIONS MAY ADDRESS CERTAIN NEEDS, INDICATING THAT THE HOSPITAL'S STRATEGIES SHOULD BE REFOCUSED ON ALTERNATIVE COMMUNITY HEALTH NEEDS OR ASSUME A DIFFERENT FOCUS ON THE NEEDS IDENTIFIED IN THE 2022 CHNA.THE HOSPITAL FACILITY VIEWS A COMMUNITY BENEFITS IMPLEMENTATION STRATEGY AS A "LIVING" DOCUMENT. BAYSTATE HOSPITALS HAVE ADOPTED THE TERM STRATEGIC IMPLEMENTATION PLAN (SIP), IN LIEU OF IMPLEMENTATION STRATEGY. THE SIGNIFICANT HEALTH NEEDS TO BE ADDRESSED BY THE HOSPITAL ARE REFERRED TO AS PRIORITY FOCUS AREAS IN THE SIP. DUE TO THE EVOLVING CLIMATE IN HEALTH CARE, THE HOSPITAL'S FINANCIAL HEALTH YEAR TO YEAR REMAINS UNKNOWN; THEREFORE HOSPITAL RESOURCES AND INPUTS MAY INCREASE, DECREASE, OR NEED TO BE MODIFIED. THE HOSPITAL'S SIP WORK PLAN PROVIDES AN OPPORTUNITY FOR THE HOSPITAL TO BE STRATEGIC AND FOCUSED, YET FLEXIBLE IN ITS COMMUNITY HEALTH PLANNING AND IMPROVEMENT EFFORTS. THE HOSPITAL FACILITY, IN PARTNERSHIP WITH ITS COMMUNITY BENEFITS ADVISORY COUNCIL REVIEWS THE WORK PLANS QUARTERLY AND THE HOSPITAL UPDATES THE WORK PLANS ON THE HOSPITAL WEBSITE ANNUALLY.NO HEALTH CARE SYSTEM OR HOSPITAL FACILITY CAN ADDRESS ALL THE SIGNIFICANT HEALTH NEED PRESENT IN ITS COMMUNITY. THE HOSPITAL FACILITY IS COMMITTED TO ADHERING TO ITS MISSION AND REMAINING FINANCIALLY HEALTHY SO THAT IT CAN CONTINUE TO ENHANCE ITS CLINICAL EXCELLENCE AND PATIENT EXPERIENCE, AS WELL AS ADDRESS SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE CHNA. THE HOSPITAL FACILITY'S IMPLEMENTATION STRATEGY DOES NOT EXPLICITLY ADDRESS ALL SIGNIFICANT COMMUNITY HEALTH NEEDS IDENTIFIED IN THE 2022 CHNA DUE TO:1. LIMITED RESOURCES (TIME, TALENT, AND TREASURE),2. THE HOSPITAL IS A STAKEHOLDER AND/OR PARTNER IN ADDRESSING THE NEED DIRECTLY OR INDIRECTLY THROUGH OTHER HOSPITAL CLINICAL AND SERVICE LINES AND COMMUNITY PARTNERSHIPS,3. OTHER HOSPITALS OR COMMUNITY ORGANIZATIONS WITHIN THE SERVICE AREA ARE ADDRESSING THE NEED;4. THE NEED FALLS OUTSIDE OF THE HOSPITAL'S MISSION OR LIMITED RESOURCE CAPACITY. SIGNIFICANT HEALTH NEEDS, REFERRED TO BY THE HOSPITAL AS PRIORITY FOCUS AREAS, BEING ADDRESSED BY THE HOSPITAL INCLUDE, LACK OF RESOURCES TO MEET BASIC NEEDS, WORKFORCE DEVELOPMENT, VIOLENCE AND TRAUMA AND MENTAL HEALTH AND SUBSTANCE USE WITH A FOCUS ON YOUTH MENTAL HEALTH.SIGNIFICANT HEALTH NEEDS NOT TO BE ADDRESSED INCLUDE, ENVIRONMENTAL EXPOSURES, AVAILABILITY OF PROVIDERS AND TELEHEALTH, OTHER BARRIERS TO HEALTHCARE, CHRONIC DISEASES AND OTHER HEALTH OUTCOMES.
BAYSTATE MEDICAL CENTER, INC. PART V, SECTION B, LINE 13B: ALL PATIENTS WITH ACCOUNT BALANCES (OTHER THAN BALANCES RESULTING FROM CO-PAYMENTS OR DEDUCTIBLES ON INSURED SERVICES) ARE ELIGIBLE TO RECEIVE A PROMPT PAY DISCOUNT OF 20% OF THE BALANCE FOR CLAIMS PAID IN FULL AT TIME OF SERVICE OR WITHIN 60 DAYS OF THE DATE OF THE INITIAL BILL. PATIENTS MUST REQUEST THE DISCOUNT. THE DISCOUNT CANNOT BE COMBINED WITH THE HOSPITAL SUPPLEMENTAL FINANCIAL ASSISTANCE PROGRAM. BAYSTATE MEDICAL CENTER OFFERS A CO-PAYMENT DISCOUNT PROGRAM FOR THE PATIENTS RECEIVING SERVICES IN THE EMERGENCY DEPARTMENT OF THE HOSPITAL. THIS DISCOUNT PROGRAM IS AVAILABLE TO ALL HOSPITAL EMERGENCY DEPARTMENT PATIENTS WITH CO-PAYMENT OBLIGATIONS UNDER PRIVATE OR GOVERNMENT HEALTH INSURANCE (UNLESS PROHIBITED BY LAW OR A BAYSTATE MEDICAL CENTER'S CONTRACT WITH A PRIVATE INSURER OR GOVERNMENT AUTHORITY). THESE PATIENTS MAY REDUCE THE OTHERWISE APPLICABLE EMERGENCY DEPARTMENT SERVICE CO-PAYMENT BY 10% IF THE PATIENT ELECTS TO PAY THE CO-PAYMENT AT THE CONCLUSION OF THE PATIENT'S EMERGENCY DEPARTMENT VISIT.
BAYSTATE MEDICAL CENTER, INC. PART V, SECTION B, LINE 15E: BAYSTATE MEDICAL CENTER (BMC) PROVIDES PATIENTS WITH INFORMATION ABOUT THE AVAILABILITY OF STATE PROGRAMS, HEALTH SAFETY NET, OR THE HOSPITAL SUPPLEMENTAL FINANCIAL ASSISTANCE PROGRAM WHICH MAY COVER ALL OR SOME OF THEIR UNPAID BMC BILLS AS WELL AS ABOUT BMC DISCOUNT PROGRAMS. FOR THOSE PATIENTS WHO REQUEST SUCH ASSISTANCE, THE HOSPITAL ASSISTS PATIENTS BY SCREENING THEM FOR ELIGIBILITY IN AVAILABLE STATE PROGRAMS AND ASSISTING THEM IN APPLYING FOR SUCH PROGRAMS. WHEN APPLICABLE, BMC MAY ALSO ASSIST PATIENTS IN APPLYING FOR COVERAGE OF SERVICES AS A MEDICAL HARDSHIP BASED ON THE PATIENT'S DOCUMENTED INCOME AND ALLOWABLE MEDICAL EXPENSES. BMC HAS CONTRACTED WITH THE EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES AND THE COMMONWEALTH HEALTH INSURANCE CONNECTOR AUTHORITY TO SERVE AS A CERTIFIED APPLICATION COUNSELOR ORGANIZATION. AS A CERTIFIED APPLICATION COUNSELOR (CAC), APPROPRIATE STAFF WILL INFORM A PATIENT OF THE FUNCTIONS AND RESPONSIBILITY OF A CAC, SEEK THAT THE PATIENT SIGN A CERTIFIED APPLICATION COUNSELOR DESIGNATION FORM, AND ASSIST THE PATIENT IN FINDING APPLICABLE FINANCIAL ASSISTANCE.
BAYSTATE MEDICAL CENTER, INC. PART V, SECTION B, LINE 16J: PAPER COPIES OF OUR FINANCIAL ASSISTANCE POLICY (FAP) AND THE FAP APPLICATION, AND A FAP PLAIN LANGUAGE SUMMARY AS WELL AS THE BILLING AND COLLECTIONS POLICY ARE AVAILABLE UPON REQUEST, IN ENGLISH, SPANISH, AND RUSSIAN, AND FREE OF CHARGE IN THE HOSPITAL AND BY MAIL, AS WELL AS THE HOSPITAL FACILITIES WEBSITE HTTPS://WWW.BAYSTATEHEALTH.ORG/PATIENTS/BILLING-AND-FINANCIAL-ASSISTANCE. A PLAIN LANGUAGE SUMMARY OF THE FAP IS OFFERED TO ALL PATIENTS AT ALL REGISTRATION SITES INCLUDING OUR FULL SERVICE HEALTH CENTERS IN THE COMMUNITY - BAYSTATE BRIGHTWOOD HEALTH CENTER AND BAYSTATE MASON SQUARE NEIGHBORHOOD HEALTH CENTER. IN ADDITION, COPIES OF THE FULL FAP, FAP APPLICATION AND BILLING AND COLLECTIONS POLICY ARE ALSO AVAILABLE AT ALL REGISTRATIONS SITES. COPIES OF OUR COMMUNITY HEALTH NEEDS ASSESSMENT ARE AVAILABLE FOR VIEWING AND DOWNLOAD ON OUR WEBSITE AT HTTPS://WWW.BAYSTATEHEALTH.ORG/ABOUT-US/COMMUNITY-PROGRAMS/COMMUNITY-BENEFITS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. HARD COPIES OF OUR CHNA ARE AVAILABLE UPON REQUEST FREE OF CHARGE. WE HAVE ALSO SHARED OUR CHNA WITH ALL THE COMMUNITY MEMBERS WHO WERE INVOLVED WITH CHNA AS WELL AS EACH HOSPITALS COMMUNITY BENEFITS ADVISORY COUNCIL (CBAC). THE HOSPITAL IS COMMITTED TO ONGOING EFFORTS TO WIDELY PUBLICIZE OUR FAP AND CHNA TO THE COMMUNITY, SPECIFICALLY, TO LOW-INCOME POPULATIONS. ADDITIONAL EFFORTS WILL INCLUDE PROMOTION VIA OUR HOSPITALS VARIOUS SOCIAL MEDIA PLATFORMS AND PROVIDING PRINTED MATERIALS TO KEY SOCIAL SERVICE AGENCIES AND EDUCATING THEIR STAFF THAT WORK WITH LOW INCOME POPULATIONS IN THE HOSPITALS SERVICE AREA.
BAYSTATE MEDICAL CENTER, INC. PART V, SECTION B, LINE 20E: WE RELY ON MEDICAID FOR PRESUMPTIVE ELIGIBILITY DETERMINATIONS. WE WOULD PERFORM THESE ACTIONS IF NEEDED BUT DID NOT HAVE ANY PATIENT DURING THE TAX YEAR WHERE AN ECA WAS INITIATED.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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?21
Name and address Type of Facility (describe)
1 1 - BAYSTATE AMBULATORY CARE CTR
3300 MAIN STREET
SPRINGFIELD,MA01107
OUTPATIENT PHYSICIAN OFFICES
2 2 - BAYSTATE AMBULATORY CARE CTR
140 HIGH STREET
SPRINGFIELD,MA01105
OUTPATIENT FACILITY
3 3 - BAYSTATE BREAST AND WELLNESS CENTER
100 WASON AVENUE SUITE 300
SPRINGFIELD,MA01107
OUTPATIENT FACILITY
4 4 - BAYSTATE BRIGHTWOOD HEALTH CENTER
380 PLAINFIELD STREET
SPRINGFIELD,MA01107
OUTPATIENT CLINIC
5 5 - BAYSTATE CHILDREN'S SPECIALTY CENTER
50 WASON AVENUE 1ST FLOOR
SPRINGFIELD,MA01107
OUTPATIENT FACILITY
6 6 - BAYSTATE IMAGING & TRANSPLANT SERVICES
100 WASON AVENUE GROUND FL SUITE 21
SPRINGFIELD,MA01107
OUTPATIENT FACILITY
7 7 - BAYSTATE MASON SQ NEIGHBORHOOD HLTH CTR
11 WILBRAHAM ROAD
SPRINGFIELD,MA01199
OUTPATIENT CLINIC
8 8 - BAYSTATE REHABILITATION CARE
21 DWIGHT ROAD SUITE 106
LONGMEADOW,MA01106
REHABILITATION CLINIC
9 9 - BAYSTATE REHAB CARE ADULT OP SVS
360 BIRNIE AVENUE
SPRINGFIELD,MA01107
REHABILITATION CLINIC
10 10 - BAYSTATE REHABILITATION CARE RYMD CTR
470 GRANBY RD STE 4
SOUTH HADLEY,MA01075
REHABILITATION CLINIC
11 11 - BAYSTATE SPECIALTY PHARMACY
3300 MAIN STREET
SPRINGFIELD,MA01107
OUTPATIENT FACILITY
12 12 - BMC PAIN MANAGEMENT CENTER
3400 MAIN STREET 2ND FLR
SPRINGFIELD,MA01107
OUTPATIENT FACILITY
13 13 - D'AMOUR CENTER FOR CANCER CARE
3350 MAIN STREET
SPRINGFIELD,MA01199
OUTPATIENT CANCER CENTER
14 14 - BAYSTATE MEDICAL CENTER INFUSION SUITE
2 MEDICAL CENTER DRIVE 1ST FL SUITE
1
SPRINGFIELD,MA01107
OUTPATIENT FACILITY
15 15 - BAYSTATE REHABILITATION CARE AT AGAWAM
200 SILVER STREET 1ST FLOOR SUITE
101
AGAWAM,MA01101
OUTPATIENT FACILITY
16 16 - BAYSTATE ORTHOPEDIC SURGERY CENTER
50 WASON AVENUE 1ST FLOOR
SPRINGFIELD,MA01107
OUTPATIENT FACILITY
17 17 - BAYSTATE VASCULAR SERVICES
COMMERCIAL BLDING 3500 MAIN ST 2ND
FL
SPRINGFIELD,MA01107
OUTPATIENT FACILITY
18 18 - BAYSTATE MEDICAL CENTER LABORATORIES
361 WHITNEY AVE
HOLYOKE,MA01040
OUTPATIENT FACILITY
19 19 - BAYSTATE CHILD HOSPITALIZTION PROGRAM
150 LOWER WESTFIELD ROAD SUITE 3
HOLYOKE,MA01040
OUTPATIENT FACILITY
20 20 - BAYSTATE HEALTH CLINICAL TRIALS UNIT
80 WASON AVE GROUND FLOOR
SPRINGFIELD,MA01199
OUTPATIENT FACILITY
21 21 - D'AMOUR CENTER FOR CANCER CARE ANNEX
3400 MAIN STREET 2ND FLR
SPRINGFIELD,MA01199
OUTPATIENT CANCER CENTER
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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 6A: THE HOSPITAL FACILITY FILES AN ANNUAL COMMUNITY BENEFITS REPORT ELECTRONICALLY WITH THE MASSACHUSETTS OFFICE OF THE ATTORNEY GENERAL VIA THEIR WEBSITE AT HTTPS://WWW.MASS.GOV/NONPROFIT-HOSPITAL-AND-HMO-COMMUNITY-BENEFITS. THEHOSPITAL FACILITY'S ANNUAL COMMUNITY BENEFITS REPORT IS ALSO PUBLISHED ON THE BAYSTATE HEALTH WEBSITE ATHTTPS://WWW.BAYSTATEHEALTH.ORG/ABOUT-US/COMMUNITY-PROGRAMS/COMMUNITY-BENEFITS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. THE HOSPITAL'S COMMUNITY BENEFITS REPORT PROVIDES THE OFFICE OF THE ATTORNEY GENERAL AND THE GENERAL PUBLIC IMPORTANT INFORMATION ABOUT HOW THE HOSPITAL PARTNERS WITH THE COMMUNITY TO IDENTIFY AND ADDRESS HEALTH NEEDS.
PART I, LINE 7: LINE 7A (CHARITY CARE) - COMMUNITY BENEFIT EXPENSE WAS CALCULATED BY APPLYING THE RATIO OF PATIENT CARE COST TO CHARGES, CALCULATED ON WORKSHEET 2, AGAINST TOTAL CHARITY CARE GROSS PATIENT CHARGES FROM THE AUDITED FINANCIAL STATEMENTS.LINE 7B (UNREIMBURSED MEDICAID) - COMMUNITY BENEFIT EXPENSE WAS DERIVED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM, WHICH TAKES INTO ACCOUNT ALL HOSPITAL INPATIENTS, OUTPATIENTS AND EMERGENCY ROOM PATIENTS FOR WHOM SERVICES WERE PROVIDED AND COVERED UNDER MEDICAID AND MEDICAID MANAGED CARE PLANS.LINE 7C (OTHER MEANS-TESTED PROGRAMS) - COMMUNITY BENEFIT EXPENSE WAS DERIVED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM, WHICH TAKES INTO ACCOUNT ALL HOSPITAL INPATIENTS, OUTPATIENTS AND EMERGENCY ROOM PATIENTS FOR WHOM SERVICES WERE PROVIDED AND COVERED UNDER OTHER MEANS-TESTED GOVERNMENT PROGRAMS.LINE 7E (COMMUNITY HEALTH IMPROVEMENT SERVICES & BENEFIT OPERATIONS) - COMMUNITY HEALTH IMPROVEMENT SERVICES CALCULATIONS ARE DERIVED FROM DIRECT AND INDIRECT COSTS ASSOCIATED WITH COMMUNITY BENEFIT ACTIVITIES THAT ARE ALIGNED WITH THE HOSPITAL'S 2021 COMMUNITY HEALTH NEEDS ASSESSMENT. THESE ACTIVITIES ARE CARRIED OUT TO IMPROVE COMMUNITY HEALTH AND WELLNESS AND EXTEND BEYOND PATIENT CARE, BEYOND THE WALLS OF THE HOSPITAL.COMMUNITY BENEFIT OPERATIONS CALCULATIONS ARE DERIVED FROM COSTS ASSOCIATED WITH ASSIGNED STAFF AND COMMUNITY HEALTH NEEDS AND/OR ASSETS ASSESSMENT, AS WELL AS OTHER COSTS ASSOCIATED WITH COMMUNITY BENEFITS STRATEGY AND OPERATIONS.LINE 7F (HEALTH PROFESSIONAL EDUCATION) - COMMUNITY BENEFIT EXPENSE WAS DERIVED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM.LINE 7G (SUBSIDIZED PROGRAMS) - COMMUNITY BENEFIT EXPENSE WAS DERIVED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM. THIS EXPENSE RELATES TO THE INPATIENT BEHAVIORAL HEALTH AND END OF LIFE CARE, AS WELL AS SPECIFIC OUTPATIENT PROGRAMS. THERE ARE NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS REPORTED AS SUBSIDIZED HEALTH SERVICES IN PART I, LINE 7G.LINE 7H (RESEARCH) - COMMUNITY BENEFIT EXPENSE WAS DERIVED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM. IN ADDITION TO THE RESEARCH COSTS REPORTED ON LINE 7H, THERE WAS $700,952 OF EXPENSES RELATED TO INDUSTRY-SPONSORED GRANTS THAT WE BELIEVE SHOULD BE TREATED AS COMMUNITY BENEFIT EXPENSE BECAUSE THEY WERE INCURRED TO PROMOTE THE HEALTH AND WELL-BEING OF THE LOCAL POPULATION AND ARE A KEY COMPONENT OF OUR COMMITMENT TO THE COMMUNITY.PART I, LN 7 COL(F):ESTIMATED UNCOLLECTIBLE AMOUNTS DUE FROM PATIENTS (BAD DEBT EXPENSE) IS AN IMPLICIT PRICE CONCESSION AND A DIRECT REDUCTION TO NET OPERATING REVENUE. THESE IMPLICIT PRICE CONCESSIONS ARE NOT INCLUDED IN TOTAL EXPENSES REPORTED IN PART IX, LINE 25, COLUMN (A) FOR THE PURPOSE OF CALCULATING THE PERCENTAGES IN PART 1, LINE 7, COLUMN (F).
PART II, COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL FACILITY IS COMMITTED TO CREATING HEALTHIER COMMUNITIES AND UNDERSTANDS THAT MANY STATE AND FEDERALLY MANDATED COMMUNITY BENEFIT PROGRAMS AND SERVICES ARE NOT SUFFICIENT TO ADDRESS ETHNIC, RACIAL, AND ECONOMIC HEALTH DISPARITIES AND INEQUITIES. THE HOSPITAL EMBRACES THE TRADITIONAL DEFINITION OF "HEALTH" TO INCLUDE ECONOMIC OPPORTUNITY, AFFORDABLE HOUSING, QUALITY EDUCATION, SAFE NEIGHBORHOODS, FOOD SECURITY, SOCIAL AND RACIAL JUSTICE, AND THE ARTS/CULTURE ALL ELEMENTS THAT ARE NEEDED FOR INDIVIDUALS, FAMILIES, AND COMMUNITIES TO THRIVE. THE HOSPITAL PROVIDES MANY VALUABLE SERVICES, RESOURCES, PROGRAMS, AND FINANCIAL SUPPORT - BEYOND THE WALLS OF THE HOSPITAL AND INTO THE COMMUNITIES AND HOMES OF THE PEOPLE IT SERVES; INCLUDING GRANTS AND SPONSORSHIP OF LOCAL COMMUNITY-BASED ORGANIZATIONS AND THE INVOLVEMENT OF BAYSTATE HEALTH LEADERSHIP WITH VARIOUS COMMUNITY BOARDS THAT ALIGN WITH ITS MISSION.THE HOSPITAL PROVIDED $110,000.00 TO THE ANCHOR COLLABORATIVE WHICH PROVIDES ECONOMIC ASSISTANCE TO OUR SURROUNDING COMMUNITIES. THE HOSPITAL FACILITY IS A DUES PAYING MEMBER OF THE ECONOMIC DEVELOPMENT COUNCIL OF WESTERN MASSACHUSETTS (EDC) AND SPRINGFIELD REGIONAL CHAMBER OF COMMERCE, IN THE AMOUNT OF $88,564.10. THE HOSPITAL PARTICIPATES IN THE EDC AND LOCAL CHAMBERS AS IT IS THE LARGEST EMPLOYER IN THE REGION. THE CHAMBER AND ITS MEMBERS COORDINATE ACTIVITIES TOWARD A COMMON PURPOSE OF SUSTAINABILITY AND ECONOMIC GROWTH FOR THE REGION.
PART III, LINE 2: THE COST OF BAD DEBTS REPORTED WAS CALCULATED BY APPLYING A RATIO OF COST TO CHARGES (BASED ON THE ORGANIZATION'S COST ACCOUNTING SYSTEM INCLUDING ALL HOSPITAL INPATIENTS AND OUTPATIENTS) AGAINST TOTAL IMPLICIT PRICE CONCESSIONS AS REFLECTED IN THE AUDITED FINANCIAL STATEMENTS.
PART III, LINE 3: THE PORTION OF BAD DEBT THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO MAY QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE PROGRAM WAS CALCULATED BY APPLYING THE PERCENTAGE OF BAD DEBTS BY ZIP CODE (FOR WHICH THE AVERAGE HOUSEHOLD INCOME FOR EACH ZIP CODE IS LESS THAN 150% OF THE FEDERAL POVERTY LEVEL) TO THE TOTAL COST OF BAD DEBT REPORTED IN PART III LINE 2. SINCE THIS PORTION OF BAD DEBT IS ATTRIBUTABLE TO PATIENTS RESIDING IN AN AREA WHERE THE AVERAGE INCOME IS LESS THAN 150% OF THE FEDERAL POVERTY LEVEL, IT IS HIGHLY LIKELY THESE PATIENTS WOULD HAVE QUALIFIED FOR THE ORGANIZATION'S CHARITY CARE PROGRAM HAD THEY APPLIED. FOR THIS REASON, WE BELIEVE THE AMOUNT, TOTALLING $662,650, SHOULD BE TREATED AS COMMUNITY BENEFIT EXPENSE IN PART I.
PART III, LINE 4: AS NOTED ABOVE, THE ORGANIZATION ADOPTED ACCOUNTING STANDARDS UPDATE 2014-09 EFFECTIVE OCTOBER 1, 2018, WHICH CHANGED THE WAY ENTITIES REPORT AND DISCLOSE CERTAIN FINANCIAL INFORMATION INCLUDING IMPLICIT PRICE CONCESSION (FORMERLY THE PROVISION FOR BAD DEBTS). SEE AUDITED FINANCIAL STATEMENTS, FOOTNOTE #2 (SIGNIFICANT ACCOUNTING POLICIES) ON PAGE 15 UNDER THE CAPTION "NET PATIENT SERVICE REVENUE AND PAGE 17 UNDER THE CAPTION "RECENTLY ADOPTED ACCOUNTING PRONOUNCEMENTS" FOR A DESCRIPTION OF THE ORGANIZATION'S REPORTING OF ITS IMPLICIT PRICE CONCESSIONS (FORMERLY PROVISION FOR BAD DEBTS). IF A PATIENT IS DETERMINED ELIGIBLE FOR FINANCIAL ASSISTANCE, THE APPROPRIATE ADJUSTMENT IS MADE TO THE PATIENT ACCOUNT BASED ON THEIR INCOME LEVEL.ONCE THE NECESSARY APPROVALS ARE OBTAINED,IT THEN FLOWS TO THE GENERAL LEDGER. PATIENTS APPLYING FOR A PROMPT PAYMENT DISCOUNT WILL HAVE THIS ALLOWANCE ENTERED AFTER AGREED UPON PAYMENT IS RECEIVED.
PART III, LINE 8: LINE 6 - INCLUDED ALL MEDICARE ALLOWABLE COSTS AS CALCULATED IN WORKSHEETS D-1 PART II (INPATIENT) AND D PART V (OUTPATIENT) OF THE HOSPITAL'S 2022 MEDICARE COST REPORT, NET OF MEDICARE COSTS REPORTED IN PART I, LINE 7.G, BASED ON MEDICARE COSTING PRINCIPLES. WE BELIEVE THE SHORTFALL REPORTED OF $16,126,472 SHOULD BE TREATED AS A COMMUNITY BENEFIT EXPENSE FOR TAX REPORTING PURPOSES BECAUSE PROVIDING CARE FOR THE ELDERLY IS A KEY COMPONENT OF OUR COMMITMENT TO THE COMMUNITY. THE UNREIMBURSED EXPENSES SHOLD BE TREATED SIMILARLY TO UNREIMBURSED MEDICAID SINCE THE MAJORITY OF THE LOCAL ELDERLY POPULATION IS NOT AFFLUENT.
PART III, LINE 9B: FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE: THE PATIENT MAY HAVE REQUESTED ASSISTANCE UP FRONT AT TIME OF SERVICE WITH A FINANCIAL COUNSELOR OR THE PATIENT COULD HAVE ASKED FOR ASSISTANCE AFTER RECEIVING THEIR BILL BY CONTACTING OUR PATIENT BILLING SERVICES REPRESENTATIVES. THE FINANCIAL COUNSELOR WILL ASSIST THE PATIENT IN APPLYING FOR THE APPROPRIATE TYPE OF ASSISTANCE BASED ON THEIR INCOME AND CIRCUMSTANCES. ONCE APPROVED FOR A STATE MEDICAID OR OTHER PROGRAM, ALL BILLING AND COLLECTION ACTIVITY WILL STOP (EXCEPT FOR REQUIRED CO-PAYMENTS OR DEDUCTIBLES). FOR ALL OTHER PATIENTS, OUR STATEMENTS CONTAIN INFORMATION REGARDING HOW TO APPLY FOR FINANCIAL ASSISTANCE. NOTICES CONCERNING AVAILABILITY FOR ASSISTANCE ARE ALSO POSTED AT PATIENT CARE SITES.
PART VI, LINE 2: THE BAYSTATE BOARD GOVERNANCE COMMITTEE CONVENES SEMI-ANNUALLY AND IS CHARGED WITH ADVOCATING FOR COMMUNITY BENEFITS AT THE BOARD LEVEL AND THROUGHOUT THE HEALTH SYSTEM AND BROADER COMMUNITY; ALIGNING THE SYSTEM'S FOUR (4) HOSPITAL-SPECIFIC COMMUNITY BENEFITS IMPLEMENTATION STRATEGIES WITH THE HEALTH SYSTEM'S STRATEGIC PLAN; REVIEW OF CHNA DATA; APPROVAL OF A COMMUNITY BENEFITS MISSION STATEMENT AND HEALTH PRIORITIES; REVIEW IMPACTS OF COMMUNITY BENEFITS ACTIVITIES AND INVESTMENTS; AND ENSURE BAYSTATE HEALTH'S COMMUNITY BENEFITS ARE IN COMPLIANCE WITH GUIDELINES ESTABLISHED BY THE MA ATTORNEY GENERAL AND IRS. ANNUALLY, THE OFFICE OF GOVERNMENT AND COMMUNITY RELATIONS PROVIDES UPDATES TO THE BAYSTATE BOARD OF TRUSTEES, BAYSTATE PRESIDENT'S CABINET, AND OTHER BAYSTATE LEADERSHIP TEAMS, AS REQUESTED. THE HOSPITAL COMMUNITY BENEFITS ADVISORY COUNCIL (CBAC) CONTINUES TO BRING A COMMUNITY LENS AND FILTER FOR THE HOSPITAL'S HEALTH PRIORITIES. THE CBAC PROVIDES A COMMUNITY PERSPECTIVE ON HOW TO INCREASE WELLNESS AND RESILIENCE OPPORTUNITIES FOR OPTIMAL HEALTH FOR AN ENTIRE POPULATION; GUIDANCE IN MATCHING HOSPITAL RESOURCES TO COMMUNITY RESOURCES, THUS MAKING THE MOST OF WHAT IS POSSIBLE WITH THE GOAL TO IMPROVE HEALTH STATUS AND QUALITY OF LIFE; AND POLICY ADVOCACY TO ASSURE AND RESTORE HEALTH EQUITY BY TARGETING RESOURCES FOR RESIDENTS. PARTICIPANTS ON THE HOSPITAL CBAC REPRESENT CONSTITUENCIES AND COMMUNITIES SERVED BY THE HOSPITAL. CBAC MEMBERS ARE RESPONSIBLE FOR REVIEWING COMMUNITY NEEDS ASSESSMENT DATA AND USE THIS ANALYSIS AS A FOUNDATION FOR PROVIDING THE HOSPITAL WITH INPUT ON ITS COMMUNITY BENEFITS PLANNING PROCESS.BAYSTATE HEALTH PATIENT & FAMILY ADVISORY COUNCIL (PFAC) MEMBERS PROVIDED VALUABLE INPUT IN ENHANCING CARE AT BAYSTATE HEALTH BASED ON THE KNOWLEDGE OF THE UNIQUE NEEDS OF PATIENTS AND FAMILIES. INFORMATION FROM PFAC PROVIDES HOSPITAL LEADERSHIP WITH AN ENHANCED UNDERSTANDING OF HOW TO IMPROVE QUALITY, PROGRAM DEVELOPMENT, SERVICE EXCELLENCE, COMMUNICATIONS, PATIENT SAFETY, FACILITY DESIGN, PATIENT AND FAMILY EDUCATION, PATIENT AND FAMILY SATISFACTION, AND LOYALTY. PFAC IS MADE UP OF A DIVERSE GROUP OF PATIENTS, FAMILY MEMBERS, AND COMMUNITY MEMBERS WHO REPRESENT THE COLLECTIVE VOICE OF THE PATIENTS AND FAMILIES AT BAYSTATE MEDICAL CENTER, BAYSTATE CHILDREN'S HOSPITAL, BAYSTATE FRANKLIN MEDICAL CENTER, BAYSTATE NOBLE HOSPITAL, BAYSTATE WING HOSPITAL, THE D'AMOUR CENTER FOR CANCER CARE, AND THE BEHEALTHY ACCOUNTABLE CARE ORGANIZATION (ACO) IN BAYSTATE MANAGED HEALTH CENTERS.
PART VI, LINE 3: THE HOSPITAL IS COMMITTED TO ENSURING THAT PATIENTS IN ITS COMMUNITY HAVE ACCESS TO QUALITY HEALTH CARE SERVICES WITH FAIRNESS AND RESPECT WITHOUT REGARD TO THE PATIENTS' ABILITY TO PAY. THE HOSPITAL RECOGNIZES THE COST OF NECESSARY HEALTH CARE SERVICES CAN IMPOSE A SIGNIFICANT FINANCIAL BURDEN ON PATIENTS WHO ARE UNINSURED OR UNDERINSURED, AND ACTS AFFIRMATIVELY TO LESSEN THAT BURDEN BY OFFERING ELIGIBLE PATIENTS THE OPPORTUNITY TO APPLY FOR FREE OR REDUCED COST SERVICES. THE HOSPITAL NOT ONLY OFFERS FREE AND REDUCED COST CARE AS REQUIRED BY LAW, BUT HAS ALSO VOLUNTARILY ESTABLISHED DISCOUNT AND FINANCIAL ASSISTANCE PROGRAMS THAT PROVIDE ADDITIONAL FREE AND REDUCED COST CARE TO MORE PATIENTS RESIDING WITHIN THE COMMUNITIES SERVED BY THE HOSPITAL.THE HOSPITAL RECOGNIZES THE BILLING AND COLLECTION PROCESS CAN BE BEWILDERING AND BURDENSOME FOR PATIENTS AND HAS IMPLEMENTED PROCEDURES TO MAKE THE PROCESS UNDERSTANDABLE FOR PATIENTS; TO INFORM PATIENTS ABOUT DISCOUNT AND FINANCIAL ASSISTANCE OPTIONS; AND TO ENSURE THAT PATIENTS ARE NOT SUBJECT TO AGGRESSIVE COLLECTION ACTIVITIES. CONSISTENT WITH ITS PATIENT COMMITMENT, THE HOSPITAL IS REQUIRED TO MAINTAIN A FINANCIAL ASSISTANCE POLICY AND A BILLING AND COLLECTION POLICY THAT REFLECTS ITS FINANCIAL ASSISTANCE OPTIONS AND PATIENT BILLING AND COLLECTION PROCEDURES AND COMPLIES WITH APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS.THE HOSPITAL HAS FINANCIAL COUNSELORS AVAILABLE TO HELP PATIENTS APPLY FOR FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER UNPAID HOSPITAL BILLS, INCLUDING A VARIETY OF FEDERAL AND STATE PROGRAMS AS WELL AS FINANCIAL ASSISTANCE THROUGH THE HOSPITAL. HOSPITAL FINANCIAL COUNSELORS HAVE ALL BEEN TRAINED AND CERTIFIED BY THE STATE AS CERTIFIED ACCOUNT COUNSELORS TO ASSIST PATIENTS IN APPLYING FOR AVAILABLE FEDERAL AND STATE PROGRAMS. THE HOSPITAL IS COMMITTED TO ENSURING THAT PATIENTS OR PROSPECTIVE PATIENTS IN THE COMMUNITY ARE AWARE OF FINANCIAL ASSISTANCE PROGRAMS. FOR UNINSURED OR UNDERINSURED PATIENTS, THE HOSPITAL WILL ASSIST IN APPLYING FOR AVAILABLE FINANCIAL ASSISTANCE PROGRAMS. THE HOSPITAL NOTIFIES PATIENTS OF THE AVAILABILITY OF ASSISTANCE IN BOTH THE INITIAL BILL SENT TO PATIENTS, AS WELL AS IN GENERAL NOTICES POSTED THROUGHOUT THE HOSPITAL.WHEN APPLICABLE, THE HOSPITAL ALSO ASSISTS PATIENTS IN APPLYING FOR COVERAGE OF SERVICES AS A MEDICAL HARDSHIP BASED ON THE PATIENT'S DOCUMENTED INCOME AND ALLOWABLE MEDICAL EXPENSES. THE HOSPITAL PROVIDES, UPON REQUEST, SPECIFIC INFORMATION ABOUT THE ELIGIBILITY PROCESS TO BE A LOW INCOME PATIENT UNDER EITHER THE MASSACHUSETTS HEALTH SAFETY NET PROGRAM OR ADDITIONAL ASSISTANCE FOR PATIENTS WHO ARE LOW INCOME THROUGH BAYSTATE'S OWN INTERNAL FINANCIAL ASSISTANCE PROGRAM. THE HOSPITAL ALSO NOTIFIES PATIENTS ABOUT AVAILABLE PAYMENT PLANS BASED ON THEIR FAMILY SIZE AND INCOME. BAYSTATE HEALTH'S FINANCIAL ASSISTANCE POLICY AND BILLING AND COLLECTION POLICY ARE POSTED ON THE BAYSTATEHEALTH.ORG WEBSITE AT HTTPS://WWW.BAYSTATEHEALTH.ORG/PATIENTS/BILLING-AND-FINANCIAL-ASSISTANCE. THE GOAL OF POSTING THE FINANCIAL ASSISTANCE POLICY AND THE BILLING AND COLLECTION POLICY IS TO ENSURE THAT PATIENTS OR PROSPECTIVE PATIENTS IN THE COMMUNITY ARE AWARE OF THE FINANCIAL ASSISTANCE PROGRAMS. SIGNS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS AT THE HOSPITAL ARE TRANSLATED INTO SPANISH AND RUSSIAN AS THESE LANGUAGES ARE PRIMARILY SPOKEN BY MORE THAN 1,000 OR 1% OF THE RESIDENTS IN THE HOSPITAL'S SERVICE AREA. SIGNS ARE LARGE AND CLEARLY VISIBLE. HOSPITAL SIGNS ARE 8.5 X 11 INCHES AND THE HEADER PRINT FONT IS 24 POINTS. NOTICE OF AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS ARE POSTED IN THE FOLLOWING LOCATIONS: INPATIENT, CLINIC, EMERGENCY DEPARTMENT ADMISSIONS AND/OR REGISTRATION AREAS, CENTRAL ADMISSION/REGISTRATION AREA, PATIENT FINANCIAL COUNSELOR AREAS, AND BUSINESS OFFICE AREAS THAT ARE OPEN TO PATIENTS.
PART VI, LINE 4: THE FOLLOWING "COMMUNITY INFORMATION" DESCRIPTION IS EXTRACTED FROM THE HOSPITAL'S 2022 CHNA. BAYSTATE MEDICAL CENTER (BAYSTATE MEDICAL) IS A 746-BED INDEPENDENT ACADEMIC MEDICAL CENTER AND HOME TO THE UMASS CHAN MEDICAL SCHOOL BAYSTATE. BAYSTATE MEDICAL HAS ONE OF NEW ENGLAND'S BUSIEST EMERGENCY ROOMS AND IS THE REGION'S ONLY LEVEL 1 TRAUMA CENTER. BAYSTATE MEDICAL HAS LONG PROVIDED THE REGION WITH THE HIGHEST LEVEL OF CARE FOR CONDITIONS SUCH AS CANCER, ACUTE AND CHRONIC CARDIOVASCULAR ILLNESS, AND A WIDE RANGE OF OTHER MAJOR DISEASES. THE HOSPITAL ALSO OFFERS PRE- AND POST-NATAL CARE FOR MOTHERS GIVING BIRTH AT ITS WESSON WOMEN & INFANTS' UNIT, WHICH IS HOME TO THE REGION'S ONLY LEVEL III NEONATAL INTENSIVE CARE UNIT (NICU). IN ADDITION, THE MEDICAL CENTER OFFERS THE BAYSTATE HEART & VASCULAR PROGRAM AND THE BAYSTATE REGIONAL CANCER PROGRAM, AMONG OTHER ADVANCED SPECIALTY MEDICAL, DIAGNOSTIC, AND SURGICAL SERVICE. THE COMMUNITIES SERVED BY BAYSTATE MEDICAL INCLUDE THE 23 COMMUNITIES IN HAMPDEN COUNTY, PLUS THE TOWNS OF SOUTH HADLEY AND GRANBY (LOCATED IN HAMPSHIRE COUNTY). HAMPDEN COUNTY IS HOME TO 467,871 RESIDENTS.5 SPRINGFIELD IS THE LARGEST CITY IN THE AREA AND THIRD LARGEST IN MASSACHUSETTS. THREE ADJACENT CITIES (HOLYOKE, CHICOPEE, AND WEST SPRINGFIELD) JOIN SPRINGFIELD TO CREATE A DENSELY POPULATED URBAN CORE THAT HOUSES OVER HALF OF THE COUNTY POPULATION. EAST AND WEST OF THIS CENTRAL CORE ARE SMALLER COMMUNITIES, A MAJORITY WITH POPULATIONS UNDER 20,000. THE PIONEER VALLEY TRANSIT AUTHORITY (PVTA), THE SECOND LARGEST PUBLIC TRANSIT SYSTEM IN THE STATE, SERVES 11 COMMUNITIES IN THE COMMUNITIES SERVED BY BAYSTATE MEDICAL, AND CONNECTS SUBURBAN AREAS TO THE CORE CITIES AND SERVICES. MUCH OF THE SERVICE AREA IS DEFINED AS MEDICALLY UNDERSERVED. THE SERVICE AREA HAS MORE RACIAL AND ETHNIC DIVERSITY THAN MANY OTHER PARTS OF WESTERN MASSACHUSETTS ACCORDING TO CENSUS ESTIMATES, THE COMMUNITIES SERVED BY BAYSTATE MEDICAL HAVE BECOME SLIGHTLY MORE DIVERSE SINCE THE LAST CHNA. HAMPDEN COUNTY EXPERIENCED SMALL INCREASES IN THE PROPORTION OF ALL RACIAL AND ETHNIC GROUPS EXCEPT WHITE RESIDENTS, ESPECIALLY IN THE LARGER CITIES. THE HAMPDEN COUNTY POPULATION IS NOW 60% WHITE, 23% LATINO/A/E, 8% BLACK, 5% TWO OR MORE RACES, 3% ASIAN, AND 0.1% INDIGENOUS. THE BIGGEST SUBPOPULATIONS OF LATINO/A/E RESIDENTS IN HAMPDEN COUNTY ARE PUERTO RICAN, "OTHER" LATINO/A/E ETHNICITIES, MEXICAN, AND CUBAN. FOR ASIAN RESIDENTS IN HAMPDEN COUNTY, THE BIGGEST SUBPOPULATIONS ARE "OTHER ASIAN" ETHNICITIES, CHINESE, ASIAN INDIAN, AND VIETNAMESE. THE PROPORTION OF FOREIGN-BORN RESIDENTS IN THE COMMUNITIES SERVED BY BAYSTATE MEDICAL IS CLOSE TO 9%, HALF THE STATEWIDE PROPORTION. IN SPRINGFIELD, ONE IN TEN RESIDENTS IS FOREIGN BORN. THE MEDIAN AGE OF THE COUNTY IS 39 YEARS AND CONTINUES TO CLOSELY MIRROR THE STATE, WHILE SPRINGFIELD REMAINS A RELATIVELY YOUNGER CITY WITH A MEDIAN AGE OF JUST OVER 33 YEARS. THE AGING POPULATION OF THE COMMUNITIES SERVED BY BAYSTATE MEDICAL IS GROWING SLOWLY OVER TIME, ALTHOUGH NOT AS FAST AS IN OTHER COUNTIES IN PIONEER VALLEY. THE COUNTY HAS A HIGHER PROPORTION OF RESIDENTS UNDER 65 WITH A DISABILITY (12%) THAN THE STATE OVERALL (8%), AND SPRINGFIELD'S PROPORTION OF RESIDENTS WITH A DISABILITY (16%) IS FULLY DOUBLE THAT OF THE STATE. REGARDING INCOME, A SINGLE PARENT WITH ONE CHILD IN HAMPDEN COUNTY WOULD NEED TO EARN $31.30 AN HOUR, OR $65,096 A YEAR, IN ORDER TO MEET LIVING EXPENSES. MEDIAN INCOME BY RACE IS AS FOLLOWS: $61,394 FOR ASIAN, $40,902 FOR BLACK, $27,151 FOR LATINE, $67,601 FOR WHITE, AND $36,665 FOR MULTIPLE RACES. 36.16% OF THE INSURED POPULATION IN HAMPDEN COUNTY ARE MEDICAID BENEFICIARIES, AS COMPARED TO THE STATEWIDE PERCENTAGE OF 23.45%. THE PERCENTAGE OF THE POPULATION THAT IS UNINSURED IN HAMPDEN COUNTY IS 3.14%, WHICH IS 15% HIGHER THAN THE STATEWIDE AVERAGE OF 2.72%. THERE ARE TWO OTHER NON-BAYSTATE HOSPITALS THAT SERVE THE SERVICE AREA.
PART VI, LINE 5: THE HOSPITAL FACILITY HAS A RESPONSIBILITY TO RESPOND TO HEALTH CARE NEEDS UNSUPPORTED BY GOVERNMENT PROGRAMS. IN EXCHANGE FOR THIS RESPONSIBILITY, THE HOSPITAL QUALIFIES FOR TAX-EXEMPT STATUS UNDER 501(C)(3). HOWEVER, PROVIDING HOSPITAL CARE ALONE IS NOT ENOUGH TO QUALIFY FOR TAX-EXEMPT STATUS. HOSPITALS ALSO MUST OPERATE IN THE PUBLIC INTEREST AND PROVIDE PROGRAMS THAT BENEFIT THE COMMUNITY.THE CHARITABLE MISSION OF THE HOSPITAL FACILITY, A MEMBER HOSPITAL OF BAYSTATE HEALTH, IS TO IMPROVE THE HEALTH OF THE PEOPLE IN OUR COMMUNITIES EVERY DAY, WITH QUALITY AND COMPASSION. THE HOSPITAL'S COMMUNITY BENEFITS MISSION IS TO REDUCE HEALTH DISPARITIES, PROMOTE COMMUNITY WELLNESS, AND IMPROVE ACCESS TO CARE FOR VULNERABLE POPULATIONS. THE HOSPITAL IS COMMITTED TO MEETING THE IDENTIFIED HEALTH AND WELLNESS NEEDS OF CONSTITUENCIES AND COMMUNITIES SERVED THROUGH THE COMBINED EFFORTS OF BAYSTATE HEALTH'S MEMBER ORGANIZATIONS, AFFILIATED PROVIDERS, AND COMMUNITY PARTNERS.THE HOSPITAL FACILITY MEETS ALL OF THE FACTORS REQUIRED OF MEDICAL FACILITIES IN ORDER TO MAINTAIN TAX EXEMPTION, AS FIRST DESCRIBED IN REVENUE RULING 69-545. IN SUPPORT OF PATIENT CARE AND THE MEDICAL NEEDS OF THE COMMUNITIES SERVED BY THE HOSPITAL, MEDICAL STAFF MEMBERSHIP AND PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS AND PRACTITIONERS IN WESTERN MASSACHUSETTS WHO MEET THE REQUIREMENTS FOR CREDENTIALING AND CLINICAL PRIVILEGES, WHETHER EMPLOYED BY A RELATED BAYSTATE HEALTH OR COMMUNITY-BASED ENTITY. THE HOSPITAL'S EMERGENCY DEPARTMENT IS OPEN TO ALL IN NEED OF CARE AND SERVICES; NO ONE REQUIRING EMERGENCY CARE IS DENIED TREATMENT. IN ADDITION, SURPLUS FUNDS FROM OPERATIONS ARE GENERALLY APPLIED, AS PERMITTED, TO THE FOLLOWING: IMPROVEMENTS IN PATIENT CARE, EXPANSION AND RENOVATION OF EXISTING FACILITIES, PURCHASE AND REPLACEMENT OF EQUIPMENT, DEBT SERVICE, EXPENSES ASSOCIATED WITH TRAINING OF PHYSICIANS AND OTHER HEALTH CARE PROFESSIONALS, PROFESSIONAL DEVELOPMENT OF MEDICAL AND OTHER CLINICAL STAFF, AND THE SUPPORT OF SCIENTIFIC, TRANSLATIONAL, AND CLINICAL RESEARCH.BAYSTATE HEALTH'S VOLUNTEER BOARD OF TRUSTEES, THE GOVERNING BODY OF THE ORGANIZATION AND ITS AFFILIATES, IS COMPRISED OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF BAYSTATE HEALTH AND UP TO TWENTY-TWO (22) OTHER ELECTED TRUSTEES WHO ARE REPRESENTATIVE OF THE BROAD RANGE OF INTERESTS WHICH EXIST IN THE COMMUNITIES SERVED BY BAYSTATE HEALTH AND ITS AFFILIATES. THE GOVERNANCE COMMITTEE OVERSEES THE NOMINATION OF TRUSTEES AND SUBMITS RECOMMENDATIONS TO THE BOARD OF TRUSTEES FOR MEMBERSHIP ON THE VARIOUS BOARD COMMITTEES. IN CONSIDERING NOMINATIONS OR RECOMMENDATIONS FOR TRUSTEES, DIRECTORS, COMMITTEE MEMBERS, OR OFFICERS, THE GOVERNANCE COMMITTEE SELECTS NOMINEES WHO ARE REPRESENTATIVE OF THE VARIOUS AND DIVERSE CONSTITUENCIES SERVED BY BAYSTATE HEALTH AND ITS AFFILIATES. IN PARTICULAR THE COMMITTEE NOMINATES PERSONS WHO ARE REPRESENTATIVE OF THE COMMUNITY CONSUMER INTERESTS OF THE VARIOUS NEIGHBORHOODS AND LOCALITIES WHICH ARE SERVED BY BAYSTATE HEALTH AND ITS AFFILIATES IN THE CARRYING OUT OF AND PURSUANT TO THE CHARITABLE MISSION OF THE BAYSTATE HEALTH AND ITS AFFILIATES.PLEASE REFER TO THE SECTION ABOVE IN LINE 2 FOR ADDITIONAL EXAMPLES OF THE HOSPITAL'S RESPONSIVENESS TO THE COMMUNITY AND OPPORTUNITIES FOR COMMUNITY INVOLVEMENT: INCLUDING THE BOARD OF TRUSTEES' GOVERNANCE COMMITTEE, COMMUNITY BENEFITS ADVISORY COUNCIL, AND COMMUNITY HEALTH NEEDS ASSESSMENT.
PART VI, LINE 6: BAYSTATE HEALTH IS A NOT-FOR-PROFIT INTEGRATED HEALTHCARE SYSTEM SERVING OVER 800,000 PEOPLE THROUGHOUT WESTERN MASSACHUSETTS. NATIONALLY RECOGNIZED AS A LEADER IN HEALTHCARE QUALITY AND SAFETY, BAYSTATE HEALTH HAS MORE THAN 13,000 EMPLOYEES AND SERVES A DIVERSE POPULATION OF PATIENTS AT ITS TEACHING HOSPITAL, BAYSTATE MEDICAL CENTER IN SPRINGFIELD, AS WELL AS AT BAYSTATE CHILDREN'S HOSPITAL, ITS THREE COMMUNITY HOSPITALS, SEVERAL URBAN HEALTH CENTERS, HOME CARE AND HOSPICE SERVICES, AND A NETWORK OF OVER 80 MEDICAL PRACTICES. THE FOUR HOSPITALS INCLUDE BAYSTATE MEDICAL CENTER, BAYSTATE FRANKLIN MEDICAL CENTER, BAYSTATE NOBLE HOSPITAL, AND BAYSTATE WING HOSPITAL; THE OTHER 501(C)(3) ORGANIZATIONS INCLUDE BAYSTATE MEDICAL PRACTICES, VISITING NURSE ASSOCIATION AND HOSPICE OF WESTERN NEW ENGLAND, BAYSTATE ADMINISTRATIVE SERVICES, AND BAYSTATE HEALTH FOUNDATION. BAYSTATE MEDICAL CENTER (BAYSTATE MEDICAL) IS A 780-BED INDEPENDENT ACADEMIC MEDICAL CENTER AND HOME TO THE UMASS CHAN MEDICAL SCHOOL BAYSTATE. BAYSTATE MEDICAL HAS ONE OF NEW ENGLAND'S BUSIEST EMERGENCY ROOMS AND IS THE REGION'S ONLY LEVEL 1 TRAUMA CENTER. BAYSTATE MEDICAL HAS LONG PROVIDED THE REGION WITH THE HIGHEST LEVEL OF CARE FOR CONDITIONS SUCH AS CANCER, ACUTE AND CHRONIC CARDIOVASCULAR ILLNESS, AND A WIDE RANGE OF OTHER MAJOR DISEASES. THE HOSPITAL ALSO OFFERS PRE- AND POST-NATAL CARE FOR MOTHERS GIVING BIRTH AT ITS WESSON WOMEN & INFANTS' UNIT, WHICH IS HOME TO THE REGION'S ONLY LEVEL III NEONATAL INTENSIVE CARE UNIT (NICU). IN ADDITION, THE MEDICAL CENTER OFFERS THE BAYSTATE HEART & VASCULAR PROGRAM AND THE BAYSTATE REGIONAL CANCER PROGRAM, AMONG OTHER ADVANCED SPECIALTY MEDICAL, DIAGNOSTIC, AND SURGICAL SERVICE.BAYSTATE CHILDREN'S HOSPITAL, PART OF BAYSTATE MEDICAL, IS THE ONLY ACCREDITED FULL-SERVICE CHILDREN'S HOSPITAL AND PEDIATRIC-SPECIFIC EMERGENCY DEPARTMENT IN WESTERN MASSACHUSETTS. IT PROVIDES PRIMARY AND ADVANCED MEDICAL CARE TO BABIES, CHILDREN, ADOLESCENTS, AND THEIR FAMILIES. BAYSTATE FRANKLIN MEDICAL CENTER (BAYSTATE FRANKLIN) IS AN 89-BED FACILITY LOCATED IN GREENFIELD, MASSACHUSETTS, THAT PROVIDES HIGH-QUALITY INPATIENT AND OUTPATIENT SERVICES TO RESIDENTS OF RURAL FRANKLIN COUNTY AND NORTH QUABBIN. INPATIENT SERVICES INCLUDE BEHAVIORAL HEALTH, INTENSIVE CARE, MEDICAL-SURGICAL CARE, AND OBSTETRICS/ MIDWIFERY. OUTPATIENT SERVICES INCLUDE 3D MAMMOGRAPHY, BEHAVIORAL HEALTH, CANCER CARE AND INFUSION, CARDIAC REHABILITATION AND WELLNESS, EMERGENCY CARE, HEART AND VASCULAR PRACTICE AND CLINICAL SERVICES, INTENSIVE CARE, LABORATORY SERVICES, ORTHOPEDIC SURGERY, PAIN MANAGEMENT, ENDOSCOPY AND MINOR PROCEDURES, PULMONARY REHABILITATION, RADIOLOGY, SLEEP MEDICINE, WOUND CARE, AND HYPERBARIC MEDICINE. ADDITIONALLY, THROUGH A PARTNERSHIP WITH THE COMMUNITY HEALTH CENTER OF FRANKLIN COUNTY (CHCFC), A DENTAL CLINIC IS LOCATED ONSITE, ADJACENT TO THE BAYSTATE FRANKLIN EMERGENCY DEPARTMENT.BAYSTATE NOBLE HOSPITAL (BAYSTATE NOBLE) IS A 85-BED ACUTE CARE COMMUNITY HOSPITAL HELPING PEOPLE IN THE GREATER WESTFIELD COMMUNITY, OFFERING DIRECT ACCESS TO WORLD-CLASS TECHNOLOGY, DIAGNOSTICS, AND SPECIALISTS. THE HOSPITAL WORKS TO ENSURE THAT PATIENTS HAVE ACCESS TO EXCEPTIONAL HEALTHCARE, CLOSE TO HOME. SKILLED AND COMPASSIONATE NURSES AND MEDICAL SUPPORT STAFF OFFER AN IDEAL COMBINATION OF "HIGH TECH AND "HIGH TOUCH", COMPLEMENTING AN OUTSTANDING TEAM OF DOCTORS. SERVICES INCLUDE OBSTETRICS AND GYNECOLOGY, EMERGENCY, LABORATORY, GASTROENTEROLOGY, SURGERY, CARDIOPULMONARY SERVICES AND REHABILITATION, CANCER CARE, BEHAVIORAL HEALTH, UROLOGY, NEUROLOGY, INPATIENT REHABILITATION, AND DIAGNOSTIC IMAGING, INCLUDING 3D MAMMOGRAPHY..BAYSTATE WING HOSPITAL (BAYSTATE WING) IS A 68-BED FACILITY LOCATED IN PALMER, MASSACHUSETTS HELPING PEOPLE IN A SERVICE AREA THAT INCLUDES THREE COUNTIES HAMPDEN, HAMPSHIRE, AND WORCESTER. THE HOSPITAL SERVICES APPROXIMATELY 120,000 RESIDENTS IN SEVENTEEN TOWNS, WITH OVER HALF OF THIS POPULATION LIVING IN BELCHERTOWN, LUDLOW, PALMER, WILBRAHAM, AND WARE. WE OFFER A BROAD RANGE OF MEDICAL, SURGICAL, AND PSYCHIATRIC SERVICES. OUR EXPANDED EMERGENCY DEPARTMENT (ED) PROVIDES COMPREHENSIVE EMERGENCY SERVICES FOR ADULTS AND CHILDREN AROUND THE CLOCK. THE EMERGENCY DEPARTMENT INCLUDES A SIX BED CRITICAL CARE UNIT AND IS A PRIMARY STROKE CENTER DESIGNATED BY THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH (MDPH). OUR HOSPITAL OFFERS COMPREHENSIVE, PERSONALIZED, AND HIGH-QUALITY INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH AND ADDICTION TREATMENT SERVICES THROUGH THE GRISWOLD BEHAVIORAL HEALTH CENTER AND THE CENTER FOR GERIATRIC PSYCHIATRY.BAYSTATE MEDICAL PRACTICES (BMP) IS A MULTI-SPECIALTY GROUP OF OVER 1,147 PHYSICIANS AND ADVANCED PRACTICE CLINICIANS IN PRIMARY CARE, SPECIALTY, AND SURGICAL DISCIPLINES WITH MORE THAN 100 PRACTICES ACROSS 85 LOCATIONS. BMP OFFERS PATIENT-CENTERED CARE, INCLUDING: FAMILY PRACTICE, INTERNAL MEDICINE AND PEDIATRIC PROVIDERS, COMMUNITY HEALTH CENTERS, URGENT CARE CLINICS, SUBURBAN AND RURAL PRACTICES. MANY SITES ARE DESIGNATED PATIENT CENTERED MEDICAL HOMES, SIGNIFYING OUR EMPHASIS ON COMMUNICATION WITH PATIENTS, COLLABORATION AMONG PROVIDERS, AND CONTINUITY OF CARE. BMP'S POLICY IS TO PROVIDE CARE TO ANY PATIENT IN NEED OF MEDICAL CARE, REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR SUCH CARE. DEPENDENT UPON THE PATIENT'S FINANCIAL CAPABILITY TO PAY AND CONSISTENT WITH BAYSTATE HEALTH AND BMP POLICIES, BMP MAY PROVIDE SUCH CARE FREE OF CHARGE OR AT AMOUNTS BELOW ITS NORMAL CHARGES. IN TAX YEAR 2021 BMP PROVIDED $1,213,702 IN CHARITY CARE. IN ADDITION TO THE CHARITY CARE PROVIDED TO PATIENTS, BMP'S PHYSICIANS PARTICIPATE IN MANY AND VARIED ONGOING COMMUNITY OUTREACH INITIATIVES IN THE AREAS OF EDUCATION, EMPLOYMENT, SAFETY, AND HEALTH. BMP HAS ALSO TAKEN A LEADERSHIP ROLE IN STRENGTHENING THE HEALTH OF DISADVANTAGED CITIZENS IN SURROUNDING COMMUNITIES INCLUDING SPECIFIC FOCUS ON HIV/AIDS AND BY PROVIDING PHYSICIAN STAFFING FOR THREE COMMUNITY-BASED HEALTH CENTERS THROUGH BAYSTATE MEDICAL. VISITING NURSE ASSOCIATION AND HOSPICE OF WESTERN NEW ENGLAND PROVIDES THE HIGHEST QUALITY OF CARE TO PATIENTS AND FAMILIES, PRIMARILY IN THEIR HOMES. IT IS A COMPREHENSIVE HOME HEALTH, HOSPICE, AND PALLIATIVE CARE AGENCY WITH A STAFF OF OVER 250 MANAGING MORE THAN130,000VISITS ANNUALLY. EACH PATIENT AND FAMILY IS CARED FOR BY CERTIFIED AND EXPERIENCED NURSES, THERAPISTS, SOCIAL WORKERS, HOSPICE AIDES, SPIRITUAL AND BEREAVEMENT COUNSELORS, AND VOLUNTEERS IN COLLABORATION WITH THEIR PRIMARY CARE PHYSICIANS AND/OR OTHER PROVIDERS. THE HOME HEALTH TEAM WORKS TOGETHER TO ENSURE A SAFE AND SWIFT RECOVERY FROM ILLNESS, ACCIDENT, OR SURGERY IN THE COMFORT OF PATIENTS' HOME. HOME HEALTH HAS BEEN WORKING ON A ROBUST TELEMONITORING PROGRAM FOR PATIENTS WITH CHF AND COPD TO RECOGNIZE CHANGES AND AVOID HOSPITALIZATIONS. THE HOSPICE AND PALLIATIVE CARE TEAM OFFERS MEDICAL, SPIRITUAL AND OTHER SUPPORT SERVICES THROUGH ITS EXTENSIVE NETWORK OF CAREGIVERS TO SUPPORT PATIENTS FACING A SERIOUS OR LIFE LIMITING ILLNESS. THIS CARE TEAM WORKS TOGETHER, WITH BOTH THE PATIENT AND FAMILY, TO BRING UNDERSTANDING, COMFORT, DIGNITY, AND A SENSE OF PEACE, AS EACH PATIENT JOURNEY TOWARDS THE FINAL STAGE OF LIFE. HOSPICE HAS WORKED WITH BMC TO CREATE AN INPATIENT HOSPICE PROGRAM FOR PATIENTS AT END OF LIFE WITH SYMPTOMS THAT ARE DIFFICULT TO MANAGE OUTSIDE OF THE HOSPITAL ALLOWING HOSPICE LEVEL OF CARE IN AN ACUTE SETTING. BAYSTATE REFERENCE LABORATORIES (BRL) IS BAYSTATE HEALTH'S CLINICAL DIAGNOSTIC LABORATORY SERVICE, PROVIDING STATE-OF-THE-ART, CONVENIENT PATHOLOGY TESTING SERVICES TO PHYSICIANS, HOSPITALS, AND OTHER HEALTH CARE SERVICES THROUGHOUT THE REGION. BRL IS THE REGION'S LARGEST ACADEMIC MEDICAL CENTER-BASED REFERENCE LABORATORY AND IS STAFFED BY MORE THAN 20 BOARD-CERTIFIED PATHOLOGISTS AND OVER 650 TECHNOLOGISTS AND LAB SUPPORT PERSONNEL.BASED IN SPRINGFIELD, MASSACHUSETTS, HEALTH NEW ENGLAND IS A NOT-FOR-PROFIT HEALTH PLAN SERVING MEMBERS IN MASSACHUSETTS AND CONNECTICUT. A WHOLLY-OWNED SUBSIDIARY OF BAYSTATE HEALTH, HEALTH NEW ENGLAND OFFERS A RANGE OF HEALTH CARE PLANS INCLUDING COMMERCIAL, MEDICAID, AND MEDICARE SUPPLEMENTAL COVERAGE. FOR OVER 30 YEARS, HEALTH NEW ENGLAND HAS BEEN MEETING THE HEALTH CARE NEEDS OF OUR MEMBERS, AND CONTINUE TO BE THE MOST TRUSTED AND VALUED HEALTH PLAN IN OUR COMMUNITY.
IN ADDITION TO THE BRIEF DESCRIPTIONS OF THE AFFILIATED ENTITIES ABOVE, THE INFORMATION BELOW SPEAKS TO ACTIVITIES OF BAYSTATE HEALTH AND ITS AFFILIATES REGARDING PROMOTION OF COMMUNITY HEALTH.IN ADDITION TO ITS 13,000 EMPLOYEES, BAYSTATE HEALTH HAS MEDICAL STAFF, NURSES, RESIDENTS AND FELLOWS, MEDICAL STUDENTS, NURSING STUDENTS, AND ALLIED HEALTH STUDENTS WHO GAIN COMPREHENSIVE MEDICAL EDUCATION DURING THE YEAR. A RECOGNIZED LEADER IN EDUCATIONAL INNOVATION, BAYSTATE HEALTH HAS BEEN TRAINING DOCTORS SINCE 1914. IN TAX YEAR 2021, OVER 360 RESIDENTS AND FELLOWS IN 11 RESIDENCY AND 20+ FELLOWSHIP PROGRAMS TRAINED AT BAYSTATE HEALTH. IN ADDITION, BAYSTATE HEALTH PROVIDED TRAINING TO OVER 150 MEDICAL STUDENTS COMPLETING CLERKSHIPS AND ELECTIVES IN VARIOUS SPECIALTIES. 103 MEDICAL STUDENTS ENROLLED IN THE POPULATION-BASED URBAN AND RURAL COMMUNITY HEALTH (PURCH) TRACK AT UMASS CHAN MEDICAL SCHOOL BAYSTATE. THERE WERE OVER 740 NURSING STUDENTS AND OVER 300 ALLIED HEALTH STUDENTS FROM LOCAL COLLEGES AND UNIVERSITIES THAT COMPLETED CLINICAL TRAINING AS PART OF THEIR ASSOCIATE, BACCALAUREATE, MASTER'S AND POST-DOCTORAL WORK. BAYSTATE HEALTH IS A NATIONALLY ACCREDITED PROVIDER OF CONTINUING EDUCATION FOR THE ENTIRE TEAM OF HEALTH CARE PROFESSIONALS. CONTINUING EDUCATION IS PROVIDED THROUGH REGIONAL CONFERENCES, GRAND ROUNDS, AND INTERNET COURSES. DURING THE COVID PANDEMIC BAYSTATE HEALTH HAS CONTINUED TO SUPPORT THE LOCAL NURSING PROGRAM CLINICAL PLACEMENT REQUIREMENTS TO ENSURE OUTSTANDING LEARNING OPPORTUNITIES AND EXPERIENCES FOR NEW NURSES. THESE TRYING TIMES HAVE SERVED AS AN OPPORTUNITY TO BUILD OUR COLLABORATIVE PARTNERSHIPS. IN TAX YEAR 2021, A 254 NURSES GRADUATED FROM THE BAYSTATE HEALTH NURSE RESIDENCY PROGRAM. THE PROGRAM IS A 10-MONTH LONG PROGRAM FOR REGISTERED NURSES WITH LESS THAN 10 MONTHS EXPERIENCE, OFFERING PRACTICE-BASED EXPERIENCE, IN-DEPTH LEARNING, AND ONGOING PROFESSIONAL DEVELOPMENT. BAYSTATE HEALTH'S NURSE RESIDENCY PROGRAM SUCCESSFULLY ACHIEVED REACCREDITATION IN JULY 2021 AS A PRACTICE TRANSITION PROGRAM BY THE AMERICAN NURSES CREDENTIALING CENTER'S (ANCC) COMMISSION ON ACCREDITATION WITH A PLAN TO REACCREDIT IN 2025. BAYSTATE HEALTH CONTINUES TO PROVIDE A SUBSET OF NURSES WITH FORGIVABLE NURSING LOANS TOWARDS EARNING THEIR ADN, BSN, MASTERS, DNP, OR PHD IN NURSING. THE PROGRAM WAS ESTABLISHED IN 2002 AND TO DATE HAS SUPPORTED MORE THAN 600 RNS AND STUDENT NURSES PROVIDING MORE THAN $2,451,250 IN FORGIVABLE LOANS.THE BAYSTATE MEDICAL CENTER'S MIDWIFERY EDUCATION PROGRAM GRADUATED FOUR STUDENTS IN 2022. ALTHOUGH THE PANDEMIC CONTINUED TO REQUIRE SOME ADDED FLEXIBILITY, CLASSROOM AND CLINICAL EXPERIENCES CONTINUED WITHOUT INTERRUPTION. THREE STUDENTS HAVE SUCCESSFULLY PASSED THEIR CERTIFICATION BOARD EXAM AND ARE EMPLOYED AS CERTIFIED NURSE-MIDWIVES IN BEVERLY, MA; HARTFORD, CT, AND WORCESTER, MA. OUR FOURTH GRADUATE COMPLETED THE PROGRAM FOLLOWING A LEAVE OF ABSENCE AND WILL BE TAKING THE BOARD EXAM IN THE NEAR FUTURE. THE BAYSTATE MEDICAL CENTER MIDWIFERY EDUCATION PROGRAM CONTINUES TO SUPPORT AREA WORKFORCE, WITH PROGRAM ALUMNI COMPRISING 30% OF CNMS EMPLOYED IN PRACTICES IN SPRINGFIELD AND SURROUNDING AREAS.IN PARTNERSHIP WITH THE UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL, BAYSTATE HEALTH IS NOW THE REGIONAL CAMPUS FOR AN INNOVATIVE CURRICULUM TRACK CALLED PURCH (POPULATION-BASED URBAN AND RURAL COMMUNITY HEALTH). THE PURCH TRACK FOCUSES ON ADDRESSING SOCIAL DETERMINANTS OF HEALTH FOR OUR PATIENTS. THE PURCH TRACK IS DESIGNED TO PREPARE STUDENTS TO CARE FOR BAYSTATE HEALTH'S DIVERSE PATIENT POPULATIONS BY PROVIDING CLASSROOM AND CLINICAL EXPERIENCES IN A VARIETY OF CLINICAL SETTINGS, LED BY FACULTY WHO HAVE EXPERTISE IN POPULATION HEALTH AND CLINICAL EFFECTIVENESS RESEARCH. THE GOALS OF THE PROGRAM ARE TO INCREASE ACCESS TO STUDENTS IN MASSACHUSETTS SEEKING AN AFFORDABLE MEDICAL EDUCATION; TO RESPOND TO THE HEALTH CARE NEEDS OF THE COMMONWEALTH BY INCREASING THE NUMBER OF MASSACHUSETTS PHYSICIANS TRAINED IN URBAN AND RURAL PRIMARY CARE; AND TO APPLY PROVEN ACADEMIC RESEARCH METHODS TO IMPROVE POPULATION HEALTH, REDUCE HEALTH DISPARITIES, AND MAKE HEALTH CARE BETTER INTEGRATED, MORE EFFICIENT, AND MORE EFFECTIVE. OVER THE PAST TAX YEAR, THERE WERE NINE SITES THAT HOSTED POPULATION HEALTH CLERKSHIPS (PHCS), FOUR RURAL AND FIVE URBAN. THE FOLLOWING ORGANIZATIONS PARTICIPATED AS HOST SITES: MLK | MARTIN LUTHER KING JR. FAMILY SERVICES, SQUARE ONE, TAPESTRY HEALTH, ARMBROOK VILLAGE, REGREEN SPRINGFIELD, QUABOAG VALLEY COMMUNITY DEVELOPMENT CORPORATION (QVCDC), QUABOAG HILLS SUBSTANCE ABUSE ALLIANCE, BEHEALTHY PARTNERSHIP (MEDICAID ACO) POPULATION, BAYSTATE HEALTH WELLNESS ON WHEELS (WOW) BUS, AND BAYSTATE HEALTH/ROCA.BAYSTATE SPRINGFIELD EDUCATIONAL PARTNERSHIP (BSEP) REMAINED PRIMARILY ONLINE DUE TO RESTRICTIONS IN THE HOSPITAL. BSEP ENGAGED 171 (UNIQUE NUMBER OF PARTICIPANTS IS SMALLER) HIGH SCHOOL STUDENTS FROM ALL SPRINGFIELD HIGH SCHOOLS AND SEVERAL CHARTER AND PRIVATE SCHOOLS. NUMBERS CONTINUED TO BE IMPACTED BY THE ONLINE FORMAT AND DECREASED ENGAGEMENT WHILE SCHOOLS HAD RETURNED IN PERSON. STAFF COORDINATED SUMMER INTERNSHIPS AT BAYSTATE MEDICAL CENTER FOR 17 STUDENTS. BSEP TRAINED SIX (6) STUDENTS AS CERTIFIED NURSING ASSISTANTS, FOUR (4) IN PHLEBOTOMY TWO (2) OPERATING ROOM ASSISTANTS, AND FIVE (5) SUMMER SCHOLARS. IN ADDITION, 11 STUDENTS WERE PLACED IN WORK EXPERIENCE THROUGHOUT THE YEAR AS PART OF THE WORKFORCE INNOVATION AND OPPORTUNITY ACT (WIOA) PROGRAM AND OTHER FUNDED WORKFORCE DEVELOPMENT INITIATIVES. BAYSTATE HAS ALREADY JUMPED TO THE TOP OF THE MINIMUM WAGE SCALE WHICH WILL IMPACT THE NUMBER OF STUDENTS THAT CAN HAVE A WORK EXPERIENCE UNDER THE GRANT. LASTLY, 26 FORMER BSEP PARTICIPANTS WERE AWARDED $26,400 IN SCHOLARSHIPS TO SUPPORT THEIR PURSUIT OF UNDERGRADUATE AND GRADUATE EDUCATION. TOTAL BAYSTATE SCHOLARSHIPS AWARDED TO DATE NOW EXCEEDS $800,000.VOLUNTEERS ENHANCE THE WORK OF OUR EMPLOYEES AND INTERACTIONS WITH OUR PATIENTS AND FAMILIES EVERY DAY. IN 2022,VOLUNTEER SERVICES SLOWLY BROUGHT OUR VOLUNTEERS BACK TO HELP SUPPORT PATIENT, FAMILIES IN STAFF IN DESIGNATED AREAS. IN REPORTING FOR TAX YEAR 2021, 135 VOLUNTEERS SUPPORTED BMC, FOR A TOTAL OF 6,818 HOURS.IN 2022, NEARLY 240,000 SPOKEN AND SIGNED LANGUAGE INTERPRETER SESSIONS HELPED PATIENTS AND FAMILIES BETTER UNDERSTAND THEIR CARE RESULTING IN BETTER ACCESS TO AND EQUITY IN THEIR HEALTHCARE. BAYSTATE PROVIDES IN-PERSON INTERPRETERS AS WELL AS TELEPHONIC AND VIDEO INTERPRETERS OFF-SITE. OUR NATIONALLY CERTIFIED TRANSLATORS TRANSLATED MORE THAN 6,300 PAGES OF PATIENT-RELATED INFORMATION AND INSTRUCTIONS, HELPING TO ENSURE THAT OUR PATIENTS WERE WELL-INFORMED ABOUT THEIR HEALTH CONDITION(S) AND HOW TO CARE FOR THOSE CONDITIONS IN SIMPLE TERMS AND IN A LANGUAGE THEY PREFER.BAYSTATE HEALTH'S MEDICAID ACCOUNTABLE CARE ORGANIZATION (ACO), THE BEHEALTHY PARTNERSHIP (BHP) WHICH INCLUDES CARING HEALTH CENTER, HEALTH NEW ENGLAND, AND THE FOUR BAYSTATE HEALTH COMMUNITY HEALTH CENTERS SERVES APPROXIMATELY 50,000 PEOPLE AND SAW AN INCREASE DUE TO THE COVID-19 PANDEMIC IN TAX YEAR 2019 WHICH CONTINUES AT A STABLE NUMBER. IN ITS FIFTH YEAR, BHP FOCUSED ON CONTINUING TO BUILD OUT ITS CLINICAL INNOVATION STRATEGIES, INTEROPERABILITY INFRASTRUCTURE, AS WELL AS MEET ITS QUALITY STANDARDS. IN ADDITION, HEALTH EQUITY WORK WAS PRIORITIZED IN THE CLINICAL AND DATA ARENAS. THE ACO CONTINUED ITS WORK ON A COVID-19 MITIGATION WORKGROUP, WHICH INVOLVED PARTNERING WITH COMMUNITY ENTITIES SUCH AS THE SPRINGFIELD HOUSING AUTHORITY. THE ACO ALSO DEEPENED COMMUNITY LINKAGE EFFORTS TO BETTER SUPPORT OUR MEMBERS THROUGH THE FLEXIBLE SERVICES PROGRAM. COMMUNITY OUTREACH EFFORTS ARE INTRICATELY LINKED TO FUTURE STRATEGIES OF TELEHEALTH, FLEXIBLE SERVICES PROGRAMMING, AND BALANCING MEDICAL AND SOCIAL SUPPORTS FOR BETTER HEALTH OUTCOMES AND REDUCTION OF TOTAL COST OF CARE.
BAYSTATE HEALTH AND ITS AFFILIATES ARE COMMITTED TO PROVIDING THE COMMUNITIES THEY SERVE THROUGHOUT WESTERN MASSACHUSETTS WITH THE RESOURCES NECESSARY TO STAY INFORMED AND HEALTHY BY PROVIDING BOTH BASIC AND EXTENSIVE EDUCATIONAL OPPORTUNITIES SUCH AS PARENT EDUCATION CLASSES, INCLUDING "BAYSTATE'S BABIES", A PERINATAL EDUCATION AND SUPPORT PROGRAM. ALSO OFFERED ARE BREASTFEEDING CLASSES, PRENATAL/POSTNATAL CHILDBIRTH EDUCATION CLASSES, AND INFANT SAFETY CLASSES. SOME CLASSES ARE FREE WHILE OTHERS ARE OFFERED AT A REASONABLE FEE. NO ONE IS TURNED AWAY DUE TO INABILITY TO PAY. IN 2023, FACE-TO-FACE PROGRAMS WILL RESUME. ONLINE PARENT EDUCATION CLASSES THAT ARE SELF-LEARNING MODULES ARE ALSO AVAILABLE ALONG WITH SYNCHRONOUS CLASSES ON A VIRTUAL ZOOM PLATFORM WITH A LIVE PARENT EDUCATOR. BAYSTATE HEALTH CONTINUES TO OFFER FREE GROUPS VIA ZOOM INCLUDING THE BREASTFEEDING QUESTION AND ANSWER HOUR AND THE CHILDBIRTH QUESTION AND ANSWER HOUR. THE MOTHER TO MOTHER SUPPORT GROUP HAS RESUMED AS FACE-TO-FACE. CONTINUATION OF SOME VIRTUAL CLASSES AND GROUPS ARE OFFERED FOR THOSE FAMILIES WHO WOULD PREFER NOT TO BE IN A FACE-TO-FACE SETTING DUE TO ONGOING COVID-19.THE MOMS DO CARE EMPOWER PROGRAM AT BAYSTATE FRANKLIN, DESIGNED TO HELP PREGNANT WOMEN WITH OPIOID USE DISORDER (OUD) HAVE HEALTHY BABIES AND PURSUE HEALTHIER FUTURES, RECEIVED FOUR MORE YEARS OF FUNDING OF STATE OPIOID RESPONSE FUNDING THROUGH 2026 FROM THE SUBSTANCE ABUSE AND MENTAL HEALTH SERVICE ADMINISTRATION (SAMHSA) THE PROGRAM PROVIDES A MEDICAL/BEHAVIORAL HEALTH HOME TO PREGNANT, POSTPARTUM, AND PARENTING WOMEN. THE DPH HAS EXTENDED FUNDING AND EXPANDED ELIGIBILITY CRITERIA TO INCLUDE OPIOIDS, STIMULANTS AND ALCOHOL. THE PROGRAM PROVIDES PEER SUPPORT THROUGH RECOVERY COACHES AND DOULAS WHO PARTNER WITH WOMEN IN PREGNANCY AND UP TO 1 YEAR POSTPARTUM. CARE COORDINATION AND SERVICE NAVIGATION ARE ALSO PROVIDED THROUGH OBSTETRIC AND MIDWIFERY PROVIDERS AS WELL AS A LICENSED MENTAL HEALTH COUNSELOR. THE EMPOWER PROGRAM CURRENTLY SERVES APPROXIMATELY 30 WOMEN AND FAMILIES IN FRANKLIN COUNTY EACH YEAR.BAYSTATE MEDICAL IMPLEMENTED AN ENHANCED WAY TO CARE FOR NEWBORNS PHYSIOLOGICALLY DEPENDENT ON OPIOIDS AND THEIR MOTHERS CALLED THE ROOMING-IN PROGRAM. PREVIOUSLY, BABIES IMPACTED BY MATERNAL OUD WERE ADMITTED TO THE NEONATAL INTENSIVE CARE UNIT IF THEY REQUIRED PHARMACOLOGICAL TREATMENT FOR NEONATAL ABSTINENCE SYNDROME. PARENTS UNDERSTOOD LITTLE ABOUT THE PROCESS AND LENGTH OF STAY AVERAGED SEVERAL WEEKS. WITH THE ROOMING-IN PROGRAM, ELIGIBLE BABIES REMAIN WITH THEIR MOTHERS IN A PRIVATE ROOM THROUGHOUT TREATMENT, ENCOURAGING BREASTFEEDING AND BONDING. MOTHERS RECEIVE PRENATAL AND POSTNATAL EDUCATION TO BETTER UNDERSTAND THE PROCESS AND HOW TO CARE FOR THEIR BABIES, LEAVING THEM EMPOWERED WHILE SIGNIFICANTLY DECREASING LENGTH OF STAY FOR THESE BABIES.THE INSTITUTE FOR HEALTHCARE IMPROVEMENT RECOGNIZED BAYSTATE MEDICAL AND BAYSTATE HEALTH'S THREE COMMUNITY HEALTH CENTERS AS THE FIRST AGE-FRIENDLY HEALTH CARE INSTITUTIONS IN THE NATION. THE NATIONAL AGE-FRIENDLY HEALTH SYSTEM MOVEMENT FOCUSES ON IMPROVING CARE BY ATTENDING TO WHAT MATTERS MOST TO PATIENTS: MEDICATIONS, MENTAL ACTIVITY, AND MOBILITY. THE HONOR RECOGNIZED THE EFFORTS OF THE ACUTE CARE FOR ELDERS PROGRAM TEAM AND THE INTERPROFESSIONAL "GERI-PAL" TEAM WHO RECOGNIZE THE UNIQUE PROBLEMS OF OLDER ADULTS, FOCUS ON WHAT IS MOST IMPORTANT TO PATIENTS, AND EMPHASIZE KEEPING THOSE IN THEIR CARE AS INDEPENDENT AND ACTIVE AS POSSIBLE. THEY ASSIST WITH CARE PLANS, CHOOSING TREATMENT OPTIONS, RECOGNIZING DRUG SIDE EFFECTS, AND MAKING DIFFICULT DECISIONS.BAYSTATE HEALTH HAS PROVIDED A SAFE WAY TO DISPOSE OF UNWANTED MEDICATIONS AND SHARPS THROUGH THE INSTALLATION OF COLLECTION RECEPTACLES AT EACH OF ITS FOUR HOSPITALS AND SEVERAL OTHER HEALTH CARE FACILITIES. COMMUNITY MEMBERS NOW HAVE A RESOURCE FOR SAFELY AND CONFIDENTIALLY THROWING AWAY HOUSEHOLD SHARPS (NEEDLES AND OTHER SYRINGE RELATED DEVICES) AND UNUSED PRESCRIPTION MEDICATIONS. IN FISCAL YEAR 2022, BAYSTATE HEALTH COLLECTED APPROXIMATELY 3286 POUNDS OF SHARPS AND 1409 POUNDS OF MEDICATIONS FROM THE COMMUNITIES. BAYSTATE HEALTH OFFERS FREE PROGRAMS TO WOMEN AND SENIORS 55+. BAYSTATE HEALTH SENIOR CLASS IS A FREE LOYALTY PROGRAM DEDICATED TO HEALTH AND WELLNESS OFFERED EXCLUSIVELY FOR MEN AND WOMEN AGES 55 AND OVER. THE 21,000+ SENIOR CLASS MEMBERS RECEIVE A QUARTERLY NEWSLETTER AND BI-MONTHLY ENEWS WITH VALUABLE HEALTH INFORMATION, BENEFITS, AND INVITATIONS TO SPECIAL EVENTS, INCLUDING VIRTUAL EVENTS DESIGNED WITH THEIR INTERESTS IN MIND. THE FREE BAYSTATE HEALTH EVERY WOMAN LOYALTY PROGRAM OFFERS ITS 15,000+ MEMBERS THE LATEST WOMEN'S HEALTH INFORMATION THROUGH SEMINARS WITH PHYSICIANS, NURSES, AND OTHER MEDICAL PROFESSIONALS IN A COMFORTABLE AND LIVELY SETTING AS WELL AS VIRTUAL EVENTS. MEMBERS RECEIVE A QUARTERLY NEWSLETTER AND MONTHLY ENEWS. THE PROGRAM IS DESIGNED TO INCREASE KNOWLEDGE OF WOMEN'S HEALTH ISSUES, AND IN TURN, PROVIDE WOMEN WITH THE INFORMATION THEY NEED TO MAKE THE BEST DECISIONS REGARDING THEIR HEALTH.
IN TAX YEAR 2021, 18 EMPLOYEES WERE AWARDED FORGIVABLE LOANS TO PURCHASE THEIR FIRST HOME THROUGH THE MARK R. TOLOSKY BAYSTATE NEIGHBORS PROGRAM. THIS BAYSTATE HEALTH BENEFIT PROVIDES FORGIVABLE LOANS TO EMPLOYEES PURCHASING THEIR FIRST HOME IN THE COMMUNITIES SURROUNDING BAYSTATE HEALTH HOSPITALS. TO DATE, THE PROGRAM HAS PROVIDED MORE THAN $2 MILLION IN FORGIVABLE HOME LOANS.SINCE ITS INCEPTION IN 1994, RAYS OF HOPE HAS BEEN HELPING WOMEN AND MEN IN THE FIGHT AGAINST BREAST CANCER BY WALKING ALONGSIDE THEM ON THEIR CANCER JOURNEY. THROUGH THE BAYSTATE HEALTH BREAST NETWORK, RAYS OF HOPE CARES FOR THE WHOLE PERSON FROM DIAGNOSIS AND BEYOND BY SUPPORTING RESEARCH AT THE RAYS OF HOPE CENTER FOR BREAST CANCER RESEARCH, PROVIDING FUNDING FOR STATE-OF-THE-ART EQUIPMENT, BREAST HEALTH PROGRAMS, AND OUTREACH AND EDUCATION THROUGHOUT BAYSTATE HEALTH AS WELL AS PROVIDING GRANTS FOR COMPLEMENTARY THERAPIES AND CANCER PROGRAMS TO OUR COMMUNITY PARTNERS THROUGHOUT WESTERN MASSACHUSETTS. COVID-19 LEAD TO A DECREASE IN FUNDS RAISED AND THE SHUTTERING OF THE MANY COMMUNITY PROGRAMS WE NORMALLY PROVIDE GRANTS TO. SINCE 1994, RAYS OF HOPE HAS RAISED OVER $16.6 MILLION TO DATE. ALL FUNDS RAISED REMAIN IN WESTERN MASSACHUSETTS.THE UNITED WAY DEVELOPS AND SUPPORTS PROGRAMS THAT DIRECTLY IMPROVE THE LIVES OF PEOPLE IN OUR COMMUNITIES, A MISSION PROUDLY SHARED BY BAYSTATE HEALTH. BAYSTATE HEALTH IS A STRONG SUPPORTER OF THE UNITED WAY, AND A MAJOR CONTRIBUTOR TO THE ORGANIZATION WITH WORKFORCE CAMPAIGNS AND THOUSANDS OF EMPLOYEE DONORS AND VOLUNTEERS. BAYSTATE HEALTH'S CONTRIBUTIONS HELP THE UNITED WAY SERVE OUR FAMILIES, FRIENDS, COLLEAGUES, AND OTHERS WHO SEEK HELP IN DIFFERENT WAYS AND AT DIFFERENT TIMES IN THEIR LIVES. THREE COMMUNITY CAMPAIGNS ARE HELD ANNUALLY: SPRINGFIELD, WESTFIELD, AND PALMER WORKPLACE TO SUPPORT THE UNITED WAY OF PIONEER VALLEY, GREENFIELD WORKPLACE TO SUPPORT THE UNITED WAY OF FRANKLIN COUNTY, AND WARE WORKPLACE TO SUPPORT THE UNITED WAY OF HAMPSHIRE COUNTY. EMPLOYEES CAN DIRECT THEIR DONATIONS TO ONE OR ALL OF THE UNITED WAY'S ACTION AREAS: EDUCATION, INCOME, AND HEALTH, OR DESIGNATE TO A QUALIFIED AGENCY WITH A MINIMUM CONTRIBUTION. AS PART OF AN ANNUAL TRADITION, IN TAX YEAR 2021 BAYSTATE HEALTH TEAM MEMBERS GENEROUSLY DONATED HUNDREDS OF TOYS AND OTHER GREATLY NEEDED ITEMS DURING THIS YEAR'S HOLIDAY TOY DRIVES. BAYSTATE MEDICAL CENTER COLLECTED OVER 1,000 TOYS; EMPLOYEE DONATIONS WERE COMPLEMENTED WITH DONATIONS FROM OUR FRIENDS AT AMR AMBULANCE. THIS YEAR'S DONATIONS BENEFITED LOCAL CHILDREN SERVED MARTIN LUTHER KING JR. FAMILY SERVICES IN MASON SQUARE, NEW NORTH CITIZENS' COUNCIL IN THE NORTH END, AND OUR NEIGHBOR, RONALD MCDONALD HOUSE OF SPRINGFIELD (RMH). BAYSTATE FRANKLIN MEDICAL CENTER'S ANNUAL TOY/GIFT DRIVE COLLECTED DONATIONS FOR COMMUNITY ACTION PIONEER VALLEY'S FAMILY CENTER. BAYSTATE NOBLE HOSPITAL TEAM MEMBERS SHOWED THEIR HOLIDAY SPIRIT BY DONATING AN OVERWHELMING NUMBER OF TOYS AND GIFTS TO BEHAVIORAL HEALTH NETWORK LOCATED IN WESTFIELD. BAYSTATE WING HOSPITAL EMPLOYEES PARTICIPATED IN THE ANNUAL TOY AND GIFT DRIVE SUPPORTING MORE THAN 80 FAMILIES FROM WARE, PALMER, BELCHERTOWN, THE BROOKFIELDS, BRIMFIELD, WARREN AND OTHER SURROUNDING AREAS SERVED BY BEHAVIORAL HEALTH NETWORK.THIS HOLIDAY SEASON BAYSTATE HEALTH EMPLOYEES GENEROUSLY DONATED NEW TOYS AND GIFT CARDS TO BENEFIT CHILDREN AND FAMILIES IN OUR FOUR HOSPITAL SERVICE AREAS. BMC TEAM MEMBERS DONATED HUNDREDS OF TOYS TO BENEFIT CHILDREN IN THE SPRINGFIELD COMMUNITY. IN ADDITION, BH EMPLOYEES AND COMMUNITY MEMBERS DONATED TO THE BAYSTATE HEALTH FOUNDATION FOR THE PURCHASE OF NEW TOYS FOR OUR PEDIATRIC PATIENTS SERVED INPATIENT AT BAYSTATE CHILDREN'S HOSPITAL AND AT OUR THREE COMMUNITY-BASED HEALTH CENTERS. BAYSTATE HEALTH'S COMMUNITY BENEFITS PROGRAM PROVIDED HOLIDAY BASIC NEEDS GRANTS TO NEW NORTH CITIZENS' COUNCIL AND MARTIN LUTHER KING, JR. FAMILY SERVICES, BOTH BASED IN SPRINGFIELD. BAYSTATE HEALTH EASTERN REGION TEAM MEMBERS DONATED TOYS/GIFTS TO BENEFIT CHILDREN FROM WARE, PALMER, BELCHERTOWN, THE BROOKFIELDS, BRIMFIELD, AND WARREN SERVED BY BEHAVIORAL HEALTH NETWORK (BHN). FRANKLIN COUNTY CHILDREN SERVED BY COMMUNITY ACTION OF PIONEER VALLEY'S FAMILY CENTER WERE THE RECIPIENTS OF SEVERAL DOZEN TOYS AND GIFTS DONATED BY BAYSTATE FRANKLIN MEDICAL CENTER TEAM MEMBERS. BAYSTATE NOBLE HOSPITAL TEAM MEMBER DONATIONS BENEFITED GREATER WESTFIELD CHILDREN SERVED BY BEHAVIORAL HEALTH NETWORK (BHN).
PART VI, LINE 7, LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT: MA
Schedule H (Form 990) 2021
Additional Data


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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
2021
Open to Public
Inspection
Name of the organization
BAYSTATE MEDICAL CENTER INC
 
Employer identification number
04-2790311
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
(if applicable)
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
noncash assistance
(h) Purpose of grant
or assistance
(1) BAYSTATE HEALTH INC
759 CHESTNUT STREET
SPRINGFIELD,MA01199
04-2105941 501(C)(3) 13,503,000 0     STRATEGIC INITIATIVES
(2) CHD CANCER HOUSE OF HOPE INC
1999 WESTFIELD STREET
WEST SPRINGFIELD,MA01089
04-2503926 501(C)(3) 10,000 0     FUNDING EXPENSES OF THE MOST WELL-ATTENDED CHH PROGRAMMING UTILIZED BY WOMEN WITH BREAST CANCER.
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
2
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2021

Schedule I (Form 990) 2021
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: BAYSTATE MEDICAL CENTER, INC. MAINTAINS A CLOSE RELATIONSHIP WITH ITS GRANTEES, WHICH INCLUDE BAYSTATE HEALTH, INC. (BH). THROUGH THIS CLOSE RELATIONSHIP, MANAGEMENT IS ABLE TO ENSURE THE GRANTED MONEY IS USED FOR THE INTENDED PURPOSES.
Schedule I (Form 990) 2021



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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
2021
Open to Public Inspection
Name of the organization
BAYSTATE MEDICAL CENTER INC
 
Employer identification number

04-2790311
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes 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 .....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2021

Schedule J (Form 990) 2021
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, 1099-MISC compensation, and/or 1099-NEC (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1NANCY SHENDELL-FALIK
FORMER PRESIDENT/SVP HOSP OPS
(i)

(ii)
0
-------------
370,366
0
-------------
0
0
-------------
2,065,918
0
-------------
5,800
0
-------------
21,136
0
-------------
2,463,220
0
-------------
4,125
2MARK A KEROACK MD
TRUSTEE/PRESIDENT & CEO, BH
(i)

(ii)
0
-------------
1,265,625
0
-------------
635,250
0
-------------
409,978
0
-------------
14,500
0
-------------
18,459
0
-------------
2,343,812
0
-------------
4,125
3MARION MCGOWAN
EVP COO
(i)

(ii)
0
-------------
761,240
0
-------------
611,713
0
-------------
44,278
0
-------------
203,721
0
-------------
24,622
0
-------------
1,645,574
0
-------------
0
4RAYMOND MCCARTHY
TREASURER
(i)

(ii)
0
-------------
621,140
0
-------------
224,219
0
-------------
200,435
0
-------------
24,650
0
-------------
1,755
0
-------------
1,072,199
0
-------------
0
5DOUGLAS SALVADOR MD
SVP/CQO BH, CMO BMC
(i)

(ii)
0
-------------
407,963
0
-------------
154,347
0
-------------
154,383
0
-------------
18,850
0
-------------
31,755
0
-------------
767,298
0
-------------
4,125
6KEVIN P MORIARTY MD
TRUSTEE/CHIEF PED SURGERY
(i)

(ii)
557,068
-------------
0
107,872
-------------
0
58,989
-------------
0
24,650
-------------
0
15,844
-------------
0
764,423
-------------
0
4,125
-------------
0
7TEJAS GANDHI
VP/COO
(i)

(ii)
0
-------------
382,974
0
-------------
111,263
0
-------------
198,947
0
-------------
5,800
0
-------------
28,724
0
-------------
727,708
0
-------------
4,125
8PETER FRIEDMANN MD
ASSOC DEAN CHIEF RES OFFICER
(i)

(ii)
342,221
-------------
0
73,800
-------------
0
39,403
-------------
0
18,850
-------------
0
22,355
-------------
0
496,629
-------------
0
4,125
-------------
0
9PETER LINDENAUER MD
ASST DEAN POPULATION HEALTH
(i)

(ii)
333,626
-------------
0
65,370
-------------
0
26,100
-------------
0
39,853
-------------
0
2,620
-------------
0
467,569
-------------
0
0
-------------
0
10CHRISTINE KLUCZNIK
FORMER VP/CNO
(i)

(ii)
0
-------------
206,050
0
-------------
65,600
0
-------------
167,352
0
-------------
16,456
0
-------------
3,659
0
-------------
459,117
0
-------------
12,600
11SHELDRICK STREETE
VP SURGICAL SERVICES
(i)

(ii)
230,406
-------------
0
53,500
-------------
0
131,659
-------------
0
15,669
-------------
0
25,276
-------------
0
456,510
-------------
0
0
-------------
0
12FRANK J CRACOLICI
INTERIM PRESIDENT (THRU 9/12/2022)
(i)

(ii)
0
-------------
0
0
-------------
0
449,406
-------------
0
0
-------------
0
0
-------------
0
449,406
-------------
0
0
-------------
0
13AMY GOTTLEIB MD
ASSOC DEAN CHIEF FAC DEVELOP
(i)

(ii)
323,378
-------------
0
68,675
-------------
0
30,429
-------------
0
18,850
-------------
0
3,700
-------------
0
445,032
-------------
0
4,125
-------------
0
14JASMINE J PAADAM MD
CIS PHYSICIAN LEADER
(i)

(ii)
332,924
-------------
0
27,333
-------------
0
3,962
-------------
0
17,400
-------------
0
2,714
-------------
0
384,333
-------------
0
0
-------------
0
15JOANNE MILLER
VP/CHIEF NURSING OFFICER
(i)

(ii)
0
-------------
0
0
-------------
0
233,293
-------------
0
0
-------------
0
0
-------------
0
233,293
-------------
0
0
-------------
0
16KRISTIN R DELANEY
CLERK
(i)

(ii)
0
-------------
151,546
0
-------------
15,990
0
-------------
1,384
0
-------------
16,223
0
-------------
26,209
0
-------------
211,352
0
-------------
0
Schedule J (Form 990) 2021

Schedule J (Form 990) 2021
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 3 THE HUMAN RESOURCES COMMITTEE OF BAYSTATE HEALTH, INC. (THE PARENT ORGANIZATION OF THE HEALTH CARE SYSTEM TO WHICH THE FILING ORGANIZATION BELONGS) HAS BEEN APPOINTED THROUGH BOARD RESOLUTION AS THE HUMAN RESOURCES COMMITTEE OF THE FILING ORGANIZATION. THIS COMMITTEE CONSISTS ENTIRELY OF INDIVIDUALS SERVING ON THE BOARD OF THE FILING ORGANIZATION. THE INDIVIDUALS RESPONSIBLE FOR DELIBERATING THE COMPENSATION ARRANGEMENT FOR THE PRESIDENT WOULD BE THOSE INDIVIDUALS WHO DO NOT HAVE A CONFLICT OF INTEREST WITH RESPECT TO THE COMPENSATION ARRANGEMENT AND WOULD BE CONSIDERED INDEPENDENT FOR COMPENSATION DELIBERATION PURPOSES. THE COMPENSATION OF THE PRESIDENT IS ESTABLISHED BASED ON INFORMATION PROVIDED BY INDEPENDENT THIRD PARTY CONSULTANTS FOR REASONABLENESS AND APPROPRIATE COMPARABILITY DATA. THE COMPENSATION IS THEN ESTABLISHED, REVIEWED AND APPROVED BY THE DULY AUTHORIZED HUMAN RESOURCES COMMITTEE OF BAYSTATE HEALTH, INC. AND ALL SUCH DELIBERATIONS AND DECISIONS ARE DOCUMENTED CONTEMPORANEOUSLY.
PART I, LINE 4A: A SEVERANCE AGREEMENT WAS IN PLACE BETWEEN BAYSTATE ADMINISTRATIVE SERVICES, INC. (BAS) AND KEY EXECUTIVES STATING THAT UNDER CERTAIN CIRCUMSTANCES THE EXECUTIVE WOULD RECEIVE COMPENSATION. NANCY SHENDELL-FALIK RECEIVED $2,000,000 FROM BAS IN 2021. CHRISTINE KLUCZNIK RECEIVED $100,928 FROM BAS IN 2021.
PART I, LINE 4B: PETER FRIEDMANN, MD - SUPPLEMENTAL RETIREMENT OF $10,877 IS INCLUDED IN COLUMN B. THIS AMOUNT CONSISTS OF $6,752 EARNED AND PAID IN 2021 AND $4,125 THAT WAS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS FORMS 990 AND THAT IS CURRENTLY REPORTED AS TAXABLE INCOME. THE AMOUNT IS LISTED IN COLUMN F IN ACCORDANCE WITH REPORTING REQUIREMENTS. SUPPLEMENTAL RETIREMENT OF $4,350 IS INCLUDED IN COLUMN C. THIS AMOUNT WAS EARNED IN 2021. TEJAS GANDHI - SUPPLEMENTAL RETIREMENT OF $5,966 IS INCLUDED IN COLUMN B. THIS AMOUNT CONSISTS OF $1,841 EARNED AND PAID IN 2021 AND $4,125 THAT WAS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS FORMS 990 AND THAT IS CURRENTLY REPORTED AS TAXABLE INCOME. THE AMOUNT IS LISTED IN COLUMN F IN ACCORDANCE WITH REPORTING REQUIREMENTS. AMY GOTTLIEB, MD - SUPPLEMENTAL RETIREMENT OF $9,168 IS INCLUDED IN COLUMN B. THIS AMOUNT CONSISTS OF $5,043 EARNED AND PAID IN 2021 AND $4,125 THAT WAS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS FORMS 990 AND THAT IS CURRENTLY REPORTED AS TAXABLE INCOME. THE AMOUNT IS LISTED IN COLUMN F IN ACCORDANCE WITH REPORTING REQUIREMENTS. SUPPLEMENTAL RETIREMENT OF $4,350 IS INCLUDED IN COLUMN C. THIS AMOUNT WAS EARNED IN 2021. MARK A. KEROACK, MD - SUPPLEMENTAL RETIREMENT OF $367,713 IS INCLUDED IN COLUMN B. THIS AMOUNT CONSISTS OF $363,588 EARNED AND PAID IN 2021 AND $4,125 THAT WAS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS FORMS 990 AND THAT IS CURRENTLY REPORTED AS TAXABLE INCOME. THE AMOUNT IS LISTED IN COLUMN F IN ACCORDANCE WITH REPORTING REQUIREMENTS. KEVIN P. MORIARTY, MD - SUPPLEMENTAL RETIREMENT OF $32,179 IS INCLUDED IN COLUMN B. THIS AMOUNT CONSISTS OF $28,054 EARNED AND PAID IN 2021 AND $4,125 THAT WAS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS FORMS 990 AND THAT IS CURRENTLY REPORTED AS TAXABLE INCOME. THE AMOUNT IS LISTED IN COLUMN F IN ACCORDANCE WITH REPORTING REQUIREMENTS. SUPPLEMENTAL RETIREMENT OF $4,350 IS INCLUDED IN COLUMN C. THIS AMOUNT WAS EARNED IN 2021. RAYMOND MCCARTHY - SUPPLEMENTAL RETIREMENT OF $160,096 IS INCLUDED IN COLUMN B. THIS AMOUNT WAS EARNED AND PAID IN 2021. SUPPLEMENTAL RETIREMENT OF $4,350 IS INCLUDED IN COLUMN C. THIS AMOUNT WAS EARNED IN 2021. DOUGLAS SALVADOR, MD - SUPPLEMENTAL RETIREMENT OF $109,101 IS INCLUDED IN COLUMN B. THIS AMOUNT CONSISTS OF $104,976 EARNED AND PAID IN 2021 AND $4,125 THAT WAS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS FORMS 990 AND THAT IS CURRENTLY REPORTED AS TAXABLE INCOME. THE AMOUNT IS LISTED IN COLUMN F IN ACCORDANCE WITH REPORTING REQUIREMENTS. SUPPLEMENTAL RETIREMENT OF $4,350 IS INCLUDED IN COLUMN C. THIS AMOUNT WAS EARNED IN 2021. MARION MCGOWAN - SUPPLEMENTAL RETIREMENT OF $189,221 IS INCLUDED IN COLUMN C. THIS AMOUNT WAS EARNED IN 2021. SHELDRICK STREETE, MD - SUPPLEMENTAL RETIREMENT OF $3,616 IS INCLUDED IN COLUMN C. THIS AMOUNT WAS EARNED IN 2021. PETER LINDENAUER, MD - SUPPLEMENTAL RETIREMENT OF $3,318 IS INCLUDED IN COLUMN B. THIS AMOUNT WAS EARNED AND PAID IN 2021. SUPPLEMENTAL RETIREMENT OF $4,350 IS INCLUDED IN COLUMN C. THIS AMOUNT WAS EARNED IN 2021. JASMINE PAADAM, MD - SUPPLEMENTAL RETIREMENT OF $2,810 IS INCLUDED IN COLUMN B. THIS AMOUNT WAS EARNED AND PAID IN 2021. NANCY SHENDELL-FALIK - SUPPLEMENTAL RETIREMENT OF $5,607 IS INCLUDED IN COLUMN B. THIS AMOUNT CONSISTS OF $1,482 EARNED AND PAID IN 2021 AND $4,125 THAT WAS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS FORMS 990 AND THAT IS CURRENTLY REPORTED AS TAXABLE INCOME. THE AMOUNT IS LISTED IN COLUMN F IN ACCORDANCE WITH REPORTING REQUIREMENTS. CHRISTINE KLUCZNIK - SUPPLEMENTAL RETIREMENT OF $20,838 IS INCLUDED IN COLUMN B. THIS AMOUNT CONSISTS OF $8,238 EARNED AND PAID IN 2021 AND $12,600 THAT WAS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS FORMS 990 AND THAT IS CURRENTLY REPORTED AS TAXABLE INCOME. THE AMOUNT IS LISTED IN COLUMN F IN ACCORDANCE WITH REPORTING REQUIREMENTS. SUPPLEMENTAL RETIREMENT OF $3,797 IS INCLUDED IN COLUMN C. THIS AMOUNT WAS EARNED IN 2021.
Schedule J (Form 990) 2021

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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part , line 24a. Provide descriptions,
explanations, and any additional information in Part .
SchKMediumBullet Attach to Form 990.

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
BAYSTATE MEDICAL CENTER INC
 
Employer identification number
04-2790311
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A MA HEALTH & EDUC FACIL AUTHORITY
 
04-2456011 57586EKC4 06-25-2009 198,611,250 MA HEFA SERIES IJK - SEE PART VI   X   X   X
B MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 000000000 08-31-2021 19,099,659 MA DFA SERIES L - SEE PART VI   X   X   X
C MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 000000000 08-09-2012 40,137,000 MA DFA SERIES M - SEE PART VI   X   X   X
D MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 57583UN79 11-06-2014 60,742,119 MA DFA SERIES N - SEE PART VI   X   X   X
MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 000000000 05-12-2016 20,000,000 MDFA SERIES O - SEE PART VI   X   X   X
MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 000000000 09-22-2016 14,062,890 MDFA COGEN LEASE - SEE PART VI   X   X   X
MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 000000000 12-29-2016 3,000,000 MDFA LA #1 LEASE - SEE PART VI   X   X   X
MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 000000000 11-15-2017 2,937,110 MDFA LA #2 LEASE - SEE PART VI   X   X   X
MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 000000000 12-21-2017 40,595,000 MA DFA SERIES P-1 - SEE PART VI   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 75,380,000 8,288,623 13,565,000 121,000
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 199,122,425 19,099,659 40,137,000 60,786,027
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 1,845,403   229,661 753,513
8 Credit enhancement from proceeds ............. 93,479      
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 132,183,543 14,076,660 3,000,772 60,032,514
11 Other spent proceeds ............. 65,000,000   39,907,339  
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2012 2021 2004 2016
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2020, a current refunding issue)? ........
X   X   X     X
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2020, an advance refunding issue)? ........
  X   X   X   X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 2
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X   X   X   X
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X     X X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X       X  
c Are there any research agreements that may result in private business use of bond-financed property? ............. X     X   X X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X           X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0.060 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0.120 % 0 % 0 % 0 %
6 Total of lines 4 and 5 ............. 0.180 % 0 % 0 % 0 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X     X X  
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X X     X   X
b Exception to rebate? ........   X   X X     X
c No rebate due? ......... X     X   X X  
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X   X   X     X
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
DATE REBATE COMPUTATION PERFORMED ISSUER NAME: MA HEALTH & EDUC. FACIL. AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 08/24/2012 ISSUER NAME: MA DEVELOPMENT FINANCE AGENCY DATE THE REBATE COMPUTATION WAS PERFORMED: 02/09/2017 ISSUER NAME: MA DEVELOPMENT FINANCE AGENCY DATE THE REBATE COMPUTATION WAS PERFORMED: 01/11/2019
BOND ISSUES SUPPLEMENTAL INFORMATION: A MHEFA SERIES I, J-1, J-2, K-1, K-2 PART I, DESCRIPTION OF PURPOSE PER THE OFFICIAL STATEMENT, THE PURPOSE OF THE BOND PROCEEDS IS: (I) TO PAY A PORTION OF THE COSTS ASSOCIATED WITH THE ACQUISITION OF LAND, SITE DEVELOPMENT, CONSTRUCTION OR ALTERATION OF BUILDINGS OR THE ACQUISITION OR INSTALLATION OF FURNISHINGS AND EQUIPMENT, REFINANCING OF, OR ANY COMBINATION OF THE FOREGOING, IN CONNECTION WITH THE CONSTRUCTION, IMPROVEMENT, EQUIPPING, AND OTHER RELATED CAPITAL EXPENDITURES OF A SEVEN-STORY, APPROXIMATELY 599,100 GROSS SQUARE FOOT PRIMARILY INPATIENT BUILDING LOCATED AT 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS, INCLUDING DEMOLITION AND SITE WORK, WHICH BUILDING WILL BE CONSTRUCTED BY BAYSTATE TOTAL HOME CARE (BTHC) AND LEASED TO BAYSTATE MEDICAL CENTER BY BTHC; (II) FOR THE ACQUISITION AND INSTALLATION OF CAPITAL EQUIPMENT AND RENOVATIONS TO EXISTING FACILITIES OF THE MEDICAL CENTER AND OTHER ROUTINE CAPITAL EXPENDITURES INCLUDED OR TO BE INCLUDED IN THE MEDICAL CENTER'S CAPITAL BUDGET OVER THE NEXT THREE YEARS FOR USE IN CONNECTION WITH THE MEDICAL CENTER'S HOSPITAL OPERATIONS; (III) FOR THE REFINANCING OF A PORTION OF AN OUTSTANDING COMMERCIAL LOAN IN THE AMOUNT OF $65,000,000 MADE BY BANK OF AMERICA, N.A. ON OCTOBER 20, 2008 TO THE MEDICAL CENTER IN CONNECTION WITH THE DEFEASANCE OF THE AUTHORITY'S REVENUE BONDS, BAYSTATE MEDICAL CENTER ISSUE, SERIES D, ISSUED SEPTEMBER 16, 1993; (IV) FOR THE FINANCING OF COSTS ASSOCIATED WITH THE ISSUANCE OF BONDS AND; (V) FINANCING OF ROUTINE CAPITAL CONSTRUCTION, RENOVATIONS, AND EQUIPPING OF VARIOUS FACILITIES OF BAYSTATE MEDICAL CENTER. B MDFA REVENUE BONDS, SERIES L (REISSUED) PART I, DESCRIPTION OF PURPOSE TO REFUND (AS A REISSUANCE) THE SERIES L BONDS ISSUED NOVEMBER 2, 2011. C - MDFA REVENUE BONDS SERIES M PART I, DESCRIPTION OF PURPOSE - THE PURPOSE OF THE BOND PROCEEDS IS: (I) TO ADVANCE REFUND $39,907,339 PRINCIPAL AMOUNT OF MASSACHUSETTS HEALTH AND EDUCATION FACILITIES AUTHORITY'S REVENUE BONDS, BAYSTATE MEDICAL CENTER (THE INSTITUTION) ISSUE, SERIES F (THE "SERIES F BONDS"), ISSUED JUNE 12, 2002 THE PROCEEDS OF WHICH FINANCED THE CONSTRUCTION OF A NEW CANCER CENTER WITH A PARTIAL THIRD FLOOR MEDICAL RECORD AND SUPPORT AREA; ACQUISITION OF A SURGERY CENTER FACILITY, CERTAIN RENOVATIONS AND EQUIPMENT ACQUISITIONS; AND (II) FINANCE COSTS OF ISSUANCE RELATING TO THE BOND. D MDFA REVENUE BONDS SERIES N PART I, DESCRIPTION OF PURPOSE THE PURPOSE OF THE BOND PROCEEDS IS: (I) CAPITAL EXPENDITURES, INCLUDING CAPITALIZED INTEREST, IN CONNECTION WITH THE FOLLOWING PROJECTS (THE "PROJECT"); A) THE BUILD-OUT OF AND EQUIPPING OF CERTAIN INTERIOR SPACE WITHIN A SEVEN-STORY, APPROXIMATELY 599,100 GROSS SQUARE FOOT PRIMARILY INPATIENT BUILDING OWNED BY BTHC AND LEASED TO BAYSTATE MEDICAL CENTER LOCATED AT 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS, SUCH BUILD-OUT TO INCLUDE INPATIENT ROOMS, OPERATING ROOMS, AND INPATIENT PHARMACY, AND B) THE ACQUISITION OF MEDICAL EQUIPMENT, INFORMATION TECHNOLOGY EQUIPMENT, AND OTHER EQUIPMENT AND ASSETS TO BE OWNED OR LEASED AND USED BY THE MEDICAL CENTER AT THE MEDICAL CENTER'S HEALTH CARE FACILITIES LOCATED AT 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS, 3300,3350,3400 AND 3601 MAIN STREET, SPRINGFIELD, MASSACHUSETTS AND 50, 80, AND 100 WASON AVENUE, SPRINGFIELD, MASSACHUSETTS, AND (II) COSTS OF ISSUANCE RELATING TO THE BONDS. E MDFA REVENUE BONDS SERIES O PART I, DESCRIPTION OF PURPOSE THE PURPOSE OF THE BOND PROCEEDS IS TO INDIRECTLY FINANCE THE FOLLOWING: (A) THE CONSTRUCTION, IMPROVEMENT, EQUIPPING, AND OTHER RELATED CAPITAL EXPENDITURES OF A SEVEN-STORY, APPROXIMATELY 599,100 GROSS SQUARE FOOT PRIMARILY INPATIENT BUILDING LOCATED AT 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS, INCLUDING DEMOLITION AND SITE WORK, WHICH BUILDING WAS CONSTRUCTED BY BTHC AND LEASED TO THE MEDICAL CENTER BY BTHC; AND (B) THE ACQUISITION AND INSTALLATION OF CAPITAL EQUIPMENT AND RENOVATIONS TO EXISTING FACILITIES OF THE MEDICAL CENTER AND OTHER ROUTINE CAPITAL EXPENDITURES INCLUDED OR TO BE INCLUDED IN THE MEDICAL CENTER'S CAPITAL BUDGET OVER A THREE-YEAR PERIOD FOR USE IN CONNECTION WITH THE MEDICAL CENTER'S HOSPITAL OPERATIONS AT THE FOLLOWING FACILITIES OF THE MEDICAL CENTER: SPRINGFIELD BUILDING (INCLUDING ALL WINGS AND ATTACHED BUILDINGS), LOCATED AT 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS (THE PRINCIPAL USES OF WHICH INCLUDE CARDIAC SERVICES, MEDICAL SERVICES, LAB, AND INPATIENT BEDS); WESSON WOMEN AND INFANTS BUILDING, 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS (THE PRINCIPAL USES OF WHICH INCLUDE BIRTHING SERVICES, NEONATAL SERVICES, AND INPATIENT BEDS); DALY BUILDING (FORMERLY THE CENTENNIAL BUILDING), 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS (THE PRINCIPAL USES OF WHICH INCLUDE EMERGENCY ROOM, RADIOLOGY, MRI, ULTRASOUND, AMBULATORY AND INPATIENT PHARMACIES, LAB, OPERATING ROOMS, INPATIENT BEDS, ELECTROPHYSIO LABS, ICU, AND PICU); DALY PARKING GARAGE, 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS (A PATIENT AND VISITOR PARKING GARAGE); D'AMOUR'S CENTER FOR CANCER CARE, 3350 MAIN STREET, SPRINGFIELD, MASSACHUSETTS (PRIMARILY USED FOR CLINICAL CANCER SERVICES); CHESTNUT BUILDING, 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS (PRIMARILY USED FOR AMBULATORY SURGERY, LIBRARY, AND SIMULATION CENTER); AND WHITNEY AVENUE BUILDING (SPECIFICALLY CAPITAL EXPENDITURES RELATED TO INFORMATION TECHNOLOGY), 361 WHITNEY AVENUE, HOLYOKE, MASSACHUSETTS (USED FOR GENERAL HEALTH SYSTEM PURPOSES). F MDFA COGEN LEASE A PART I, DESCRIPTION OF PURPOSE THE PURPOSE OF THE LEASE IS TO FINANCE THE CONSTRUCTION OF AN APPROXIMATELY 5,000 SQUARE FOOT CO-GENERATIONAL, COMBINED HEAT AND POWER PLANT PROVIDING ELECTRICITY, CHILLED WATER AND STEAM TO THE FACILITIES OF THE INSTITUTION. G MDFA LA #1 LEASE B PART I, DESCRIPTION OF PURPOSE THE PURPOSE OF THE LEASE IS TO FINANCE THE ACQUISITION AND INSTALLATION OF A LINEAR ACCELERATOR. H MDFA LA #2 LEASE PART I, DESCRIPTION OF PURPOSE THE PURPOSE OF THE LEASE IS TO FINANCE THE ACQUISITION AND INSTALLATION OF A LINEAR ACCELERATOR. I MDFA SERIES P-1 PART I, DESCRIPTION OF PURPOSE THE BOND IS BEING ISSUED FOR THE PURPOSE OF PROVIDING FUNDS TO REFUND ON AN ADVANCE BASIS A PORTION OF THE $63,380,000 AGGREGATE STATED PRINCIPAL AMOUNT OF THE REVENUE BONDS, BAYSTATE MEDICAL CENTER ISSUE, SERIES I ISSUED JUNE 25, 2009 (THE "REFUNDED BONDS"), THE PROCEEDS OF WHICH WERE USED TO PAY A PORTION OF THE CONSTRUCTION COSTS OF A NEW HOSPITAL BUILDING LOCATED AT 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS. PART I AND PART II: DIFFERENCES BETWEEN THE ISSUE PRICE (PART I) AND TOTAL PROCEEDS (PART II, LINE 3) ARE DUE TO INVESTMENT EARNINGS. PART III, LINES 4 AND 5, COLUMN A (SERIES IJK): AS THE REFUNDED BONDS WERE ISSUED PRIOR TO JANUARY 1, 2003, THIS QUESTION IS BEING ANSWERED SOLELY WITH RESPECT TO THE NEW MONEY PORTION OF THE BONDS. PART III, COLUMN C (SERIES M): AS THESE BONDS REFUNDED DEBT ISSUED PRIOR TO JANUARY 1, 2003, THE ORGANIZATION IS AVAILING ITSELF OF THE PART III REPORTING EXEMPTION AVAILABLE FOR SUCH BONDS. PART IV, LINE 6, COLUMN I (SERIES P-1): THIS QUESTION IS BEING ANSWERED WITHOUT REGARD TO A YIELD-RESTRICTED ADVANCE FUNDING ESCROW FINANCED WITH PROCEEDS OF THE BONDS.
Schedule K (Form 990) 2021

Additional Data


Software ID:  
Software Version:  


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

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part , line 24a. Provide descriptions,
explanations, and any additional information in Part .
SchKMediumBullet Attach to Form 990.

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
BAYSTATE MEDICAL CENTER INC
 
Employer identification number
04-2790311
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A MA HEALTH & EDUC FACIL AUTHORITY
 
04-2456011 57586EKC4 06-25-2009 198,611,250 MA HEFA SERIES IJK - SEE PART VI   X   X   X
B MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 000000000 08-31-2021 19,099,659 MA DFA SERIES L - SEE PART VI   X   X   X
C MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 000000000 08-09-2012 40,137,000 MA DFA SERIES M - SEE PART VI   X   X   X
D MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 57583UN79 11-06-2014 60,742,119 MA DFA SERIES N - SEE PART VI   X   X   X
MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 000000000 05-12-2016 20,000,000 MDFA SERIES O - SEE PART VI   X   X   X
MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 000000000 09-22-2016 14,062,890 MDFA COGEN LEASE - SEE PART VI   X   X   X
MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 000000000 12-29-2016 3,000,000 MDFA LA #1 LEASE - SEE PART VI   X   X   X
MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 000000000 11-15-2017 2,937,110 MDFA LA #2 LEASE - SEE PART VI   X   X   X
MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 000000000 12-21-2017 40,595,000 MA DFA SERIES P-1 - SEE PART VI   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 75,380,000 8,288,623 13,565,000 121,000
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 199,122,425 19,099,659 40,137,000 60,786,027
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 1,845,403   229,661 753,513
8 Credit enhancement from proceeds ............. 93,479      
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 132,183,543 14,076,660 3,000,772 60,032,514
11 Other spent proceeds ............. 65,000,000   39,907,339  
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2012 2021 2004 2016
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2020, a current refunding issue)? ........
X   X   X     X
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2020, an advance refunding issue)? ........
  X   X   X   X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 2
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X   X   X   X
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X     X X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X       X  
c Are there any research agreements that may result in private business use of bond-financed property? ............. X     X   X X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X           X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0.060 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0.120 % 0 % 0 % 0 %
6 Total of lines 4 and 5 ............. 0.180 % 0 % 0 % 0 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X     X X  
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X X     X   X
b Exception to rebate? ........   X   X X     X
c No rebate due? ......... X     X   X X  
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X   X   X     X
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
DATE REBATE COMPUTATION PERFORMED ISSUER NAME: MA HEALTH & EDUC. FACIL. AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 08/24/2012 ISSUER NAME: MA DEVELOPMENT FINANCE AGENCY DATE THE REBATE COMPUTATION WAS PERFORMED: 02/09/2017 ISSUER NAME: MA DEVELOPMENT FINANCE AGENCY DATE THE REBATE COMPUTATION WAS PERFORMED: 01/11/2019
BOND ISSUES SUPPLEMENTAL INFORMATION: A MHEFA SERIES I, J-1, J-2, K-1, K-2 PART I, DESCRIPTION OF PURPOSE PER THE OFFICIAL STATEMENT, THE PURPOSE OF THE BOND PROCEEDS IS: (I) TO PAY A PORTION OF THE COSTS ASSOCIATED WITH THE ACQUISITION OF LAND, SITE DEVELOPMENT, CONSTRUCTION OR ALTERATION OF BUILDINGS OR THE ACQUISITION OR INSTALLATION OF FURNISHINGS AND EQUIPMENT, REFINANCING OF, OR ANY COMBINATION OF THE FOREGOING, IN CONNECTION WITH THE CONSTRUCTION, IMPROVEMENT, EQUIPPING, AND OTHER RELATED CAPITAL EXPENDITURES OF A SEVEN-STORY, APPROXIMATELY 599,100 GROSS SQUARE FOOT PRIMARILY INPATIENT BUILDING LOCATED AT 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS, INCLUDING DEMOLITION AND SITE WORK, WHICH BUILDING WILL BE CONSTRUCTED BY BAYSTATE TOTAL HOME CARE (BTHC) AND LEASED TO BAYSTATE MEDICAL CENTER BY BTHC; (II) FOR THE ACQUISITION AND INSTALLATION OF CAPITAL EQUIPMENT AND RENOVATIONS TO EXISTING FACILITIES OF THE MEDICAL CENTER AND OTHER ROUTINE CAPITAL EXPENDITURES INCLUDED OR TO BE INCLUDED IN THE MEDICAL CENTER'S CAPITAL BUDGET OVER THE NEXT THREE YEARS FOR USE IN CONNECTION WITH THE MEDICAL CENTER'S HOSPITAL OPERATIONS; (III) FOR THE REFINANCING OF A PORTION OF AN OUTSTANDING COMMERCIAL LOAN IN THE AMOUNT OF $65,000,000 MADE BY BANK OF AMERICA, N.A. ON OCTOBER 20, 2008 TO THE MEDICAL CENTER IN CONNECTION WITH THE DEFEASANCE OF THE AUTHORITY'S REVENUE BONDS, BAYSTATE MEDICAL CENTER ISSUE, SERIES D, ISSUED SEPTEMBER 16, 1993; (IV) FOR THE FINANCING OF COSTS ASSOCIATED WITH THE ISSUANCE OF BONDS AND; (V) FINANCING OF ROUTINE CAPITAL CONSTRUCTION, RENOVATIONS, AND EQUIPPING OF VARIOUS FACILITIES OF BAYSTATE MEDICAL CENTER. B MDFA REVENUE BONDS, SERIES L (REISSUED) PART I, DESCRIPTION OF PURPOSE TO REFUND (AS A REISSUANCE) THE SERIES L BONDS ISSUED NOVEMBER 2, 2011. C - MDFA REVENUE BONDS SERIES M PART I, DESCRIPTION OF PURPOSE - THE PURPOSE OF THE BOND PROCEEDS IS: (I) TO ADVANCE REFUND $39,907,339 PRINCIPAL AMOUNT OF MASSACHUSETTS HEALTH AND EDUCATION FACILITIES AUTHORITY'S REVENUE BONDS, BAYSTATE MEDICAL CENTER (THE INSTITUTION) ISSUE, SERIES F (THE "SERIES F BONDS"), ISSUED JUNE 12, 2002 THE PROCEEDS OF WHICH FINANCED THE CONSTRUCTION OF A NEW CANCER CENTER WITH A PARTIAL THIRD FLOOR MEDICAL RECORD AND SUPPORT AREA; ACQUISITION OF A SURGERY CENTER FACILITY, CERTAIN RENOVATIONS AND EQUIPMENT ACQUISITIONS; AND (II) FINANCE COSTS OF ISSUANCE RELATING TO THE BOND. D MDFA REVENUE BONDS SERIES N PART I, DESCRIPTION OF PURPOSE THE PURPOSE OF THE BOND PROCEEDS IS: (I) CAPITAL EXPENDITURES, INCLUDING CAPITALIZED INTEREST, IN CONNECTION WITH THE FOLLOWING PROJECTS (THE "PROJECT"); A) THE BUILD-OUT OF AND EQUIPPING OF CERTAIN INTERIOR SPACE WITHIN A SEVEN-STORY, APPROXIMATELY 599,100 GROSS SQUARE FOOT PRIMARILY INPATIENT BUILDING OWNED BY BTHC AND LEASED TO BAYSTATE MEDICAL CENTER LOCATED AT 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS, SUCH BUILD-OUT TO INCLUDE INPATIENT ROOMS, OPERATING ROOMS, AND INPATIENT PHARMACY, AND B) THE ACQUISITION OF MEDICAL EQUIPMENT, INFORMATION TECHNOLOGY EQUIPMENT, AND OTHER EQUIPMENT AND ASSETS TO BE OWNED OR LEASED AND USED BY THE MEDICAL CENTER AT THE MEDICAL CENTER'S HEALTH CARE FACILITIES LOCATED AT 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS, 3300,3350,3400 AND 3601 MAIN STREET, SPRINGFIELD, MASSACHUSETTS AND 50, 80, AND 100 WASON AVENUE, SPRINGFIELD, MASSACHUSETTS, AND (II) COSTS OF ISSUANCE RELATING TO THE BONDS. E MDFA REVENUE BONDS SERIES O PART I, DESCRIPTION OF PURPOSE THE PURPOSE OF THE BOND PROCEEDS IS TO INDIRECTLY FINANCE THE FOLLOWING: (A) THE CONSTRUCTION, IMPROVEMENT, EQUIPPING, AND OTHER RELATED CAPITAL EXPENDITURES OF A SEVEN-STORY, APPROXIMATELY 599,100 GROSS SQUARE FOOT PRIMARILY INPATIENT BUILDING LOCATED AT 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS, INCLUDING DEMOLITION AND SITE WORK, WHICH BUILDING WAS CONSTRUCTED BY BTHC AND LEASED TO THE MEDICAL CENTER BY BTHC; AND (B) THE ACQUISITION AND INSTALLATION OF CAPITAL EQUIPMENT AND RENOVATIONS TO EXISTING FACILITIES OF THE MEDICAL CENTER AND OTHER ROUTINE CAPITAL EXPENDITURES INCLUDED OR TO BE INCLUDED IN THE MEDICAL CENTER'S CAPITAL BUDGET OVER A THREE-YEAR PERIOD FOR USE IN CONNECTION WITH THE MEDICAL CENTER'S HOSPITAL OPERATIONS AT THE FOLLOWING FACILITIES OF THE MEDICAL CENTER: SPRINGFIELD BUILDING (INCLUDING ALL WINGS AND ATTACHED BUILDINGS), LOCATED AT 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS (THE PRINCIPAL USES OF WHICH INCLUDE CARDIAC SERVICES, MEDICAL SERVICES, LAB, AND INPATIENT BEDS); WESSON WOMEN AND INFANTS BUILDING, 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS (THE PRINCIPAL USES OF WHICH INCLUDE BIRTHING SERVICES, NEONATAL SERVICES, AND INPATIENT BEDS); DALY BUILDING (FORMERLY THE CENTENNIAL BUILDING), 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS (THE PRINCIPAL USES OF WHICH INCLUDE EMERGENCY ROOM, RADIOLOGY, MRI, ULTRASOUND, AMBULATORY AND INPATIENT PHARMACIES, LAB, OPERATING ROOMS, INPATIENT BEDS, ELECTROPHYSIO LABS, ICU, AND PICU); DALY PARKING GARAGE, 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS (A PATIENT AND VISITOR PARKING GARAGE); D'AMOUR'S CENTER FOR CANCER CARE, 3350 MAIN STREET, SPRINGFIELD, MASSACHUSETTS (PRIMARILY USED FOR CLINICAL CANCER SERVICES); CHESTNUT BUILDING, 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS (PRIMARILY USED FOR AMBULATORY SURGERY, LIBRARY, AND SIMULATION CENTER); AND WHITNEY AVENUE BUILDING (SPECIFICALLY CAPITAL EXPENDITURES RELATED TO INFORMATION TECHNOLOGY), 361 WHITNEY AVENUE, HOLYOKE, MASSACHUSETTS (USED FOR GENERAL HEALTH SYSTEM PURPOSES). F MDFA COGEN LEASE A PART I, DESCRIPTION OF PURPOSE THE PURPOSE OF THE LEASE IS TO FINANCE THE CONSTRUCTION OF AN APPROXIMATELY 5,000 SQUARE FOOT CO-GENERATIONAL, COMBINED HEAT AND POWER PLANT PROVIDING ELECTRICITY, CHILLED WATER AND STEAM TO THE FACILITIES OF THE INSTITUTION. G MDFA LA #1 LEASE B PART I, DESCRIPTION OF PURPOSE THE PURPOSE OF THE LEASE IS TO FINANCE THE ACQUISITION AND INSTALLATION OF A LINEAR ACCELERATOR. H MDFA LA #2 LEASE PART I, DESCRIPTION OF PURPOSE THE PURPOSE OF THE LEASE IS TO FINANCE THE ACQUISITION AND INSTALLATION OF A LINEAR ACCELERATOR. I MDFA SERIES P-1 PART I, DESCRIPTION OF PURPOSE THE BOND IS BEING ISSUED FOR THE PURPOSE OF PROVIDING FUNDS TO REFUND ON AN ADVANCE BASIS A PORTION OF THE $63,380,000 AGGREGATE STATED PRINCIPAL AMOUNT OF THE REVENUE BONDS, BAYSTATE MEDICAL CENTER ISSUE, SERIES I ISSUED JUNE 25, 2009 (THE "REFUNDED BONDS"), THE PROCEEDS OF WHICH WERE USED TO PAY A PORTION OF THE CONSTRUCTION COSTS OF A NEW HOSPITAL BUILDING LOCATED AT 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS. PART I AND PART II: DIFFERENCES BETWEEN THE ISSUE PRICE (PART I) AND TOTAL PROCEEDS (PART II, LINE 3) ARE DUE TO INVESTMENT EARNINGS. PART III, LINES 4 AND 5, COLUMN A (SERIES IJK): AS THE REFUNDED BONDS WERE ISSUED PRIOR TO JANUARY 1, 2003, THIS QUESTION IS BEING ANSWERED SOLELY WITH RESPECT TO THE NEW MONEY PORTION OF THE BONDS. PART III, COLUMN C (SERIES M): AS THESE BONDS REFUNDED DEBT ISSUED PRIOR TO JANUARY 1, 2003, THE ORGANIZATION IS AVAILING ITSELF OF THE PART III REPORTING EXEMPTION AVAILABLE FOR SUCH BONDS. PART IV, LINE 6, COLUMN I (SERIES P-1): THIS QUESTION IS BEING ANSWERED WITHOUT REGARD TO A YIELD-RESTRICTED ADVANCE FUNDING ESCROW FINANCED WITH PROCEEDS OF THE BONDS.
Schedule K (Form 990) 2021

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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part , line 24a. Provide descriptions,
explanations, and any additional information in Part .
SchKMediumBullet Attach to Form 990.

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
BAYSTATE MEDICAL CENTER INC
 
Employer identification number
04-2790311
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A MA HEALTH & EDUC FACIL AUTHORITY
 
04-2456011 57586EKC4 06-25-2009 198,611,250 MA HEFA SERIES IJK - SEE PART VI   X   X   X
B MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 000000000 08-31-2021 19,099,659 MA DFA SERIES L - SEE PART VI   X   X   X
C MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 000000000 08-09-2012 40,137,000 MA DFA SERIES M - SEE PART VI   X   X   X
D MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 57583UN79 11-06-2014 60,742,119 MA DFA SERIES N - SEE PART VI   X   X   X
MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 000000000 05-12-2016 20,000,000 MDFA SERIES O - SEE PART VI   X   X   X
MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 000000000 09-22-2016 14,062,890 MDFA COGEN LEASE - SEE PART VI   X   X   X
MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 000000000 12-29-2016 3,000,000 MDFA LA #1 LEASE - SEE PART VI   X   X   X
MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 000000000 11-15-2017 2,937,110 MDFA LA #2 LEASE - SEE PART VI   X   X   X
MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 000000000 12-21-2017 40,595,000 MA DFA SERIES P-1 - SEE PART VI   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 75,380,000 8,288,623 13,565,000 121,000
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 199,122,425 19,099,659 40,137,000 60,786,027
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 1,845,403   229,661 753,513
8 Credit enhancement from proceeds ............. 93,479      
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 132,183,543 14,076,660 3,000,772 60,032,514
11 Other spent proceeds ............. 65,000,000   39,907,339  
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2012 2021 2004 2016
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2020, a current refunding issue)? ........
X   X   X     X
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2020, an advance refunding issue)? ........
  X   X   X   X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 2
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X   X   X   X
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X     X X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X       X  
c Are there any research agreements that may result in private business use of bond-financed property? ............. X     X   X X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X           X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0.060 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0.120 % 0 % 0 % 0 %
6 Total of lines 4 and 5 ............. 0.180 % 0 % 0 % 0 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X     X X  
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X X     X   X
b Exception to rebate? ........   X   X X     X
c No rebate due? ......... X     X   X X  
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X   X   X     X
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
DATE REBATE COMPUTATION PERFORMED ISSUER NAME: MA HEALTH & EDUC. FACIL. AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 08/24/2012 ISSUER NAME: MA DEVELOPMENT FINANCE AGENCY DATE THE REBATE COMPUTATION WAS PERFORMED: 02/09/2017 ISSUER NAME: MA DEVELOPMENT FINANCE AGENCY DATE THE REBATE COMPUTATION WAS PERFORMED: 01/11/2019
BOND ISSUES SUPPLEMENTAL INFORMATION: A MHEFA SERIES I, J-1, J-2, K-1, K-2 PART I, DESCRIPTION OF PURPOSE PER THE OFFICIAL STATEMENT, THE PURPOSE OF THE BOND PROCEEDS IS: (I) TO PAY A PORTION OF THE COSTS ASSOCIATED WITH THE ACQUISITION OF LAND, SITE DEVELOPMENT, CONSTRUCTION OR ALTERATION OF BUILDINGS OR THE ACQUISITION OR INSTALLATION OF FURNISHINGS AND EQUIPMENT, REFINANCING OF, OR ANY COMBINATION OF THE FOREGOING, IN CONNECTION WITH THE CONSTRUCTION, IMPROVEMENT, EQUIPPING, AND OTHER RELATED CAPITAL EXPENDITURES OF A SEVEN-STORY, APPROXIMATELY 599,100 GROSS SQUARE FOOT PRIMARILY INPATIENT BUILDING LOCATED AT 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS, INCLUDING DEMOLITION AND SITE WORK, WHICH BUILDING WILL BE CONSTRUCTED BY BAYSTATE TOTAL HOME CARE (BTHC) AND LEASED TO BAYSTATE MEDICAL CENTER BY BTHC; (II) FOR THE ACQUISITION AND INSTALLATION OF CAPITAL EQUIPMENT AND RENOVATIONS TO EXISTING FACILITIES OF THE MEDICAL CENTER AND OTHER ROUTINE CAPITAL EXPENDITURES INCLUDED OR TO BE INCLUDED IN THE MEDICAL CENTER'S CAPITAL BUDGET OVER THE NEXT THREE YEARS FOR USE IN CONNECTION WITH THE MEDICAL CENTER'S HOSPITAL OPERATIONS; (III) FOR THE REFINANCING OF A PORTION OF AN OUTSTANDING COMMERCIAL LOAN IN THE AMOUNT OF $65,000,000 MADE BY BANK OF AMERICA, N.A. ON OCTOBER 20, 2008 TO THE MEDICAL CENTER IN CONNECTION WITH THE DEFEASANCE OF THE AUTHORITY'S REVENUE BONDS, BAYSTATE MEDICAL CENTER ISSUE, SERIES D, ISSUED SEPTEMBER 16, 1993; (IV) FOR THE FINANCING OF COSTS ASSOCIATED WITH THE ISSUANCE OF BONDS AND; (V) FINANCING OF ROUTINE CAPITAL CONSTRUCTION, RENOVATIONS, AND EQUIPPING OF VARIOUS FACILITIES OF BAYSTATE MEDICAL CENTER. B MDFA REVENUE BONDS, SERIES L (REISSUED) PART I, DESCRIPTION OF PURPOSE TO REFUND (AS A REISSUANCE) THE SERIES L BONDS ISSUED NOVEMBER 2, 2011. C - MDFA REVENUE BONDS SERIES M PART I, DESCRIPTION OF PURPOSE - THE PURPOSE OF THE BOND PROCEEDS IS: (I) TO ADVANCE REFUND $39,907,339 PRINCIPAL AMOUNT OF MASSACHUSETTS HEALTH AND EDUCATION FACILITIES AUTHORITY'S REVENUE BONDS, BAYSTATE MEDICAL CENTER (THE INSTITUTION) ISSUE, SERIES F (THE "SERIES F BONDS"), ISSUED JUNE 12, 2002 THE PROCEEDS OF WHICH FINANCED THE CONSTRUCTION OF A NEW CANCER CENTER WITH A PARTIAL THIRD FLOOR MEDICAL RECORD AND SUPPORT AREA; ACQUISITION OF A SURGERY CENTER FACILITY, CERTAIN RENOVATIONS AND EQUIPMENT ACQUISITIONS; AND (II) FINANCE COSTS OF ISSUANCE RELATING TO THE BOND. D MDFA REVENUE BONDS SERIES N PART I, DESCRIPTION OF PURPOSE THE PURPOSE OF THE BOND PROCEEDS IS: (I) CAPITAL EXPENDITURES, INCLUDING CAPITALIZED INTEREST, IN CONNECTION WITH THE FOLLOWING PROJECTS (THE "PROJECT"); A) THE BUILD-OUT OF AND EQUIPPING OF CERTAIN INTERIOR SPACE WITHIN A SEVEN-STORY, APPROXIMATELY 599,100 GROSS SQUARE FOOT PRIMARILY INPATIENT BUILDING OWNED BY BTHC AND LEASED TO BAYSTATE MEDICAL CENTER LOCATED AT 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS, SUCH BUILD-OUT TO INCLUDE INPATIENT ROOMS, OPERATING ROOMS, AND INPATIENT PHARMACY, AND B) THE ACQUISITION OF MEDICAL EQUIPMENT, INFORMATION TECHNOLOGY EQUIPMENT, AND OTHER EQUIPMENT AND ASSETS TO BE OWNED OR LEASED AND USED BY THE MEDICAL CENTER AT THE MEDICAL CENTER'S HEALTH CARE FACILITIES LOCATED AT 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS, 3300,3350,3400 AND 3601 MAIN STREET, SPRINGFIELD, MASSACHUSETTS AND 50, 80, AND 100 WASON AVENUE, SPRINGFIELD, MASSACHUSETTS, AND (II) COSTS OF ISSUANCE RELATING TO THE BONDS. E MDFA REVENUE BONDS SERIES O PART I, DESCRIPTION OF PURPOSE THE PURPOSE OF THE BOND PROCEEDS IS TO INDIRECTLY FINANCE THE FOLLOWING: (A) THE CONSTRUCTION, IMPROVEMENT, EQUIPPING, AND OTHER RELATED CAPITAL EXPENDITURES OF A SEVEN-STORY, APPROXIMATELY 599,100 GROSS SQUARE FOOT PRIMARILY INPATIENT BUILDING LOCATED AT 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS, INCLUDING DEMOLITION AND SITE WORK, WHICH BUILDING WAS CONSTRUCTED BY BTHC AND LEASED TO THE MEDICAL CENTER BY BTHC; AND (B) THE ACQUISITION AND INSTALLATION OF CAPITAL EQUIPMENT AND RENOVATIONS TO EXISTING FACILITIES OF THE MEDICAL CENTER AND OTHER ROUTINE CAPITAL EXPENDITURES INCLUDED OR TO BE INCLUDED IN THE MEDICAL CENTER'S CAPITAL BUDGET OVER A THREE-YEAR PERIOD FOR USE IN CONNECTION WITH THE MEDICAL CENTER'S HOSPITAL OPERATIONS AT THE FOLLOWING FACILITIES OF THE MEDICAL CENTER: SPRINGFIELD BUILDING (INCLUDING ALL WINGS AND ATTACHED BUILDINGS), LOCATED AT 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS (THE PRINCIPAL USES OF WHICH INCLUDE CARDIAC SERVICES, MEDICAL SERVICES, LAB, AND INPATIENT BEDS); WESSON WOMEN AND INFANTS BUILDING, 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS (THE PRINCIPAL USES OF WHICH INCLUDE BIRTHING SERVICES, NEONATAL SERVICES, AND INPATIENT BEDS); DALY BUILDING (FORMERLY THE CENTENNIAL BUILDING), 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS (THE PRINCIPAL USES OF WHICH INCLUDE EMERGENCY ROOM, RADIOLOGY, MRI, ULTRASOUND, AMBULATORY AND INPATIENT PHARMACIES, LAB, OPERATING ROOMS, INPATIENT BEDS, ELECTROPHYSIO LABS, ICU, AND PICU); DALY PARKING GARAGE, 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS (A PATIENT AND VISITOR PARKING GARAGE); D'AMOUR'S CENTER FOR CANCER CARE, 3350 MAIN STREET, SPRINGFIELD, MASSACHUSETTS (PRIMARILY USED FOR CLINICAL CANCER SERVICES); CHESTNUT BUILDING, 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS (PRIMARILY USED FOR AMBULATORY SURGERY, LIBRARY, AND SIMULATION CENTER); AND WHITNEY AVENUE BUILDING (SPECIFICALLY CAPITAL EXPENDITURES RELATED TO INFORMATION TECHNOLOGY), 361 WHITNEY AVENUE, HOLYOKE, MASSACHUSETTS (USED FOR GENERAL HEALTH SYSTEM PURPOSES). F MDFA COGEN LEASE A PART I, DESCRIPTION OF PURPOSE THE PURPOSE OF THE LEASE IS TO FINANCE THE CONSTRUCTION OF AN APPROXIMATELY 5,000 SQUARE FOOT CO-GENERATIONAL, COMBINED HEAT AND POWER PLANT PROVIDING ELECTRICITY, CHILLED WATER AND STEAM TO THE FACILITIES OF THE INSTITUTION. G MDFA LA #1 LEASE B PART I, DESCRIPTION OF PURPOSE THE PURPOSE OF THE LEASE IS TO FINANCE THE ACQUISITION AND INSTALLATION OF A LINEAR ACCELERATOR. H MDFA LA #2 LEASE PART I, DESCRIPTION OF PURPOSE THE PURPOSE OF THE LEASE IS TO FINANCE THE ACQUISITION AND INSTALLATION OF A LINEAR ACCELERATOR. I MDFA SERIES P-1 PART I, DESCRIPTION OF PURPOSE THE BOND IS BEING ISSUED FOR THE PURPOSE OF PROVIDING FUNDS TO REFUND ON AN ADVANCE BASIS A PORTION OF THE $63,380,000 AGGREGATE STATED PRINCIPAL AMOUNT OF THE REVENUE BONDS, BAYSTATE MEDICAL CENTER ISSUE, SERIES I ISSUED JUNE 25, 2009 (THE "REFUNDED BONDS"), THE PROCEEDS OF WHICH WERE USED TO PAY A PORTION OF THE CONSTRUCTION COSTS OF A NEW HOSPITAL BUILDING LOCATED AT 759 CHESTNUT STREET, SPRINGFIELD, MASSACHUSETTS. PART I AND PART II: DIFFERENCES BETWEEN THE ISSUE PRICE (PART I) AND TOTAL PROCEEDS (PART II, LINE 3) ARE DUE TO INVESTMENT EARNINGS. PART III, LINES 4 AND 5, COLUMN A (SERIES IJK): AS THE REFUNDED BONDS WERE ISSUED PRIOR TO JANUARY 1, 2003, THIS QUESTION IS BEING ANSWERED SOLELY WITH RESPECT TO THE NEW MONEY PORTION OF THE BONDS. PART III, COLUMN C (SERIES M): AS THESE BONDS REFUNDED DEBT ISSUED PRIOR TO JANUARY 1, 2003, THE ORGANIZATION IS AVAILING ITSELF OF THE PART III REPORTING EXEMPTION AVAILABLE FOR SUCH BONDS. PART IV, LINE 6, COLUMN I (SERIES P-1): THIS QUESTION IS BEING ANSWERED WITHOUT REGARD TO A YIELD-RESTRICTED ADVANCE FUNDING ESCROW FINANCED WITH PROCEEDS OF THE BONDS.
Schedule K (Form 990) 2021

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
BAYSTATE MEDICAL CENTER INC
 
Employer identification number

04-2790311
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) In default? (h) Approved by board or committee? (i) Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990) 2021
Schedule L (Form 990) 2021
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) JAMES R PHANEUF CIC
 
FAMILY MEMBER OF JAMES R. PHANEUF, CIC 49,824 SEE PART V - FAMILY MEMBER OF JAMES R. PHANEUF CIC IS EMPLOYED BY THE FILING ORGANIZATION.   No
(2) JOHN F MAYBURY
 
MAYBURY MATERIAL HANDLING MORE THAN 35% OWNED BY JOHN F. MAYBURY 26,608 SEE PART V - CONTRACTOR - MOVEABLE EQUIPMENT   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990) 2021


Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990)

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
2021
Open to Public
Inspection
Name of the organization
BAYSTATE MEDICAL CENTER INC
 
Employer identification number

04-2790311
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 1A THE FILING ORGANIZATION HAS A STANDING EXECUTIVE COMMITTEE, WHICH IS ENTITLED TO ACT BETWEEN MEETINGS OF THE BOARD, ON ALL MATTERS AS TO WHICH THE BOARD IS ENTITLED TO ACT AND PERMITTED BY LAW TO DELEGATE TO A COMMITTEE. THE MEMBERS OF THE EXECUTIVE COMMITTEE ARE THE SAME INDIVIDUALS SERVING ON THE EXECUTIVE COMMITTEE OF BAYSTATE HEALTH, INC.
FORM 990, PART VI, SECTION A, LINE 2 TWO OR MORE OF THE PERSONS LISTED IN THIS FORM 990 PART VII HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER BY VIRTUE OF SITTING ON ONE OR MORE BOARDS OF DIRECTORS OR BY SERVING IN AN EMPLOYMENT RELATIONSHIP WITH ONE OR MORE ENTITIES IN THE BAYSTATE GROUP OF AFFILIATED ENTITIES AND IN THE COMMUNITY. THE FOLLOWING TRUSTEES, OFFICERS, OR KEY EMPLOYEES HAVE A BUSINESS RELATIONSHIP: (1) MARK A. KEROACK, MD AND PAUL R. MURPHY (2) ARLEY DIAZ, MD AND GREGORY L. BRADEN, MD.
FORM 990, PART VI, SECTION A, LINE 3 BAYSTATE MEDICAL CENTER IS AFFILIATED WITH BAYSTATE ADMINISTRATIVE SERVICES, INC. (BAS) WHICH IS A 501(C) (3) ORGANIZATION. INFORMATION TECHNOLOGY, HUMAN RESOURCES, FINANCE, TREASURY, ACCOUNTING AND OTHER MANAGEMENT AND SUPPORT FUNCTIONS ARE DELEGATED TO BAS.
FORM 990, PART VI, SECTION A, LINE 6 THE FILING ORGANIZATION HAS ONE MEMBER, BAYSTATE HEALTH, INC. (BH).
FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF TRUSTEES OF THE FILING ORGANIZATION ARE THE SAME INDIVIDUALS SERVING AS MEMBERS OF THE BOARD OF TRUSTEES OF BAYSTATE HEALTH, INC. (BH) WITH THE ADDITION OF THE PRESIDENT OF THE MEDICAL STAFF OF THE FILING ORGANIZATION. THE BOARD OF TRUSTEES OF BH ARE ELECTED ANNUALLY BY THE BOARD OF TRUSTEES OF BH AT THEIR ANNUAL MEETING.
FORM 990, PART VI, SECTION A, LINE 7B UNDER MASSACHUSETTS LAW, A VOLUNTARY DISSOLUTION OF THE ORGANIZATION IS REQUIRED TO BE APPROVED BY BAYSTATE HEALTH, INC., AS THE SOLE MEMBER OF THE FILING ORGANIZATION. AS THE SOLE MEMBER, BAYSTATE HEALTH ALSO HAS THE AUTHORITY TO AMEND THE BYLAWS OF THE FILING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 8B: THE TRUSTEES OF BAYSTATE MEDICAL CENTER MEET DURING CERTAIN SCHEDULED BAYSTATE HEALTH, INC. (BH) BOARD MEETINGS. THE BH BOARD OF TRUSTEES AND ITS COMMITTEES, INCLUDING THE AUDIT AND COMPLIANCE COMMITTEE, CONTEMPORANEOUSLY DOCUMENT MEETINGS AND ACTIONS RELATIVE TO BAYSTATE MEDICAL CENTER AS WELL AS THE ANNUAL ACCEPTANCE OF THE AUDITED FINANCIAL STATEMENTS.
FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING THE FORM 990, APPROPRIATE SECTIONS WERE REVIEWED BY THE TAX, FINANCE, AND HUMAN RESOURCES AREAS OF BAYSTATE HEALTH, INC. (THE PARENT ORGANIZATION OF THE HEALTH CARE SYSTEM TO WHICH THE FILING ORGANIZATION BELONGS) AND BY OUTSIDE LEGAL COUNSEL. THE FORM 990 WAS ALSO REVIEWED BY TAX EXPERTS FROM AN INDEPENDENT ACCOUNTING FIRM AND SIGNED-OFF AS A PAID PREPARER. THE PROCESS, KEY AREAS AND ANY NEW CHANGES WERE REVIEWED PRIOR TO FILING WITH THE BAYSTATE HEALTH AUDIT AND COMPLIANCE COMMITTEE (ACC), WHICH IS COMPOSED OF TRUSTEES OF THE FILING ORGANIZATION. THE ACC MEMBERS HAD AN OPPORTUNITY TO ASK QUESTIONS REGARDING THE TAX COMPLIANCE PROCESS AND THE TAX FILINGS IN GENERAL. THE FORM 990 WAS PROVIDED TO ALL MEMBERS OF THE BOARD OF TRUSTEES PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C BAYSTATE MEDICAL CENTER IS AN AFFILIATE OF BAYSTATE HEALTH, INC. (BH). BH AND ITS AFFILIATED ENTITIES HAVE A COMPREHENSIVE CONFLICT OF INTEREST POLICY APPLICABLE TO ALL OF THE AFFILIATED ENTITIES. ALL DIRECTORS, TRUSTEES, OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES OF BH AND ITS AFFILIATES ARE ASKED TO COMPLETE AN ANNUAL "CONFLICT OF INTEREST" FORM. WE UTILIZE AN ELECTRONIC DATABASE TO RECEIVE AND MANAGE ALL CONFLICT OF INTEREST SUBMISSIONS. THIS INFORMATION IS REVIEWED BY THE CHIEF COMPLIANCE OFFICER, CHIEF EXECUTIVE OFFICER, CHAIR OF THE BOARD OF TRUSTEES, CHIEF GENERAL COUNSEL AND THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. A SUMMARY OF THE CONFLICT OF INTEREST DISCLOSURES IS PROVIDED TO THE BAYSTATE HEALTH BOARD OF TRUSTEES AND THE TAX DEPARTMENT. POTENTIAL CONFLICT OF INTEREST TRANSACTIONS ARE REVIEWED AS APPROPRIATE UNDER THE POLICY, WHICH PROVIDES FOR RECUSAL FROM DISCUSSION AND DELIBERATION BY ANY PARTY WITH A POTENTIAL CONFLICT OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15B THE COMPENSATION OF THE PRESIDENT IS REVIEWED AND DETERMINED ANNUALLY BY THE HUMAN RESOURCES COMMITTEE OF BAYSTATE HEALTH, INC. (THE PARENT ORGANIZATION OF THE HEALTH CARE SYSTEM TO WHICH THE FILING ORGANIZATION BELONGS), WHICH HAS BEEN APPOINTED THROUGH BOARD RESOLUTION AS THE HUMAN RESOURCES COMMITTEE OF THE FILING ORGANIZATION. THIS COMMITTEE CONSISTS ENTIRELY OF INDIVIDUALS SERVING ON THE BOARD OF THE FILING ORGANIZATION. THE INDIVIDUALS RESPONSIBLE FOR DELIBERATING THE COMPENSATION ARRANGEMENT FOR THE PRESIDENT WOULD BE THOSE INDIVIDUALS WHO DO NOT HAVE A CONFLICT OF INTEREST WITH RESPECT TO THE COMPENSATION ARRANGEMENT AND WOULD BE CONSIDERED INDEPENDENT FOR COMPENSATION DELIBERATION PURPOSES. THE COMPENSATION OF THE PRESIDENT IS ESTABLISHED BASED ON INFORMATION PROVIDED BY INDEPENDENT THIRD PARTY CONSULTANTS FOR REASONABLENESS AND APPROPRIATE COMPARABILITY DATA.THE COMPENSATION IS THEN ESTABLISHED, REVIEWED AND APPROVED BY THE DULY AUTHORIZED HUMAN RESOURCES COMMITTEE OF BAYSTATE HEALTH, INC. THE COMPENSATION OF THE SENIOR VICE PRESIDENT, FINANCE, CFO AND TREASURER IS REVIEWED AND DETERMINED ANNUALLY BY THE HUMAN RESOURCES COMMITTEE OF BAYSTATE HEALTH, INC. (THE PARENT ORGANIZATION OF THE HEALTH CARE SYSTEM TO WHICH THE FILING ORGANIZATION BELONGS). THIS COMMITTEE CONSISTS ENTIRELY OF INDIVIDUALS SERVING ON THE BOARD OF BAYSTATE HEALTH, INC. THE INDIVIDUALS RESPONSIBLE FOR DELIBERATING THE COMPENSATION ARRANGEMENT FOR THE SENIOR VICE PRESIDENT, FINANCE, CFO AND TREASURER AND OF OTHER OFFICERS WOULD BE THOSE INDIVIDUALS WHO DO NOT HAVE A CONFLICT OF INTEREST WITH RESPECT TO THE COMPENSATION ARRANGEMENT AND WOULD BE CONSIDERED INDEPENDENT FOR COMPENSATION DELIBERATION PURPOSES. THE COMPENSATION OF THE SENIOR VICE PRESIDENT, FINANCE, CFO AND TREASURER IS ESTABLISHED BASED ON INFORMATION PROVIDED BY INDEPENDENT THIRD PARTY CONSULTANTS FOR REASONABLENESS AND APPROPRIATE COMPARABILITY DATA.THE COMPENSATION IS THEN ESTABLISHED, REVIEWED AND APPROVED BY THE DULY AUTHORIZED HUMAN RESOURCES COMMITTEE OF BAYSTATE HEALTH, INC. THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES OF THE FILING ORGANIZATION IS DETERMINED BY THE PRESIDENT OF THE FILING ORGANIZATION IN ACCORDANCE WITH THE EXECUTIVE COMPENSATION PHILOSOPHY STATEMENT, IN CONSULTATION WITH HUMAN RESOURCES, BASED ON INFORMATION PROVIDED BY INDEPENDENT THIRD PARTY CONSULTANTS FOR REASONABLENESS INCLUDING APPROPRIATE COMPARABILITY DATA OR THE BAYSTATE HEALTH BOARD APPROVED BUDGET AND WAGE PROGRAM FOR EACH FISCAL YEAR. LINE 15A HAS BEEN ANSWERED NO BECAUSE THE PRESIDENT AND CEO IS PAID BY BAYSTATE ADMINISTRATIVE SERVICES, INC., AN AFFILIATE AND RELATED ORGANIZATION OF THE FILING ORGANIZATION.
FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AT WWW.BAYSTATEHEALTH.ORG. ARTICLES OF ORGANIZATION AND BYLAWS ARE GENERALLY AVAILABLE AT THE COMMONWEALTH OF MASSACHUSETTS WEBSITE.
FORM 990, PART VI, SECTION B, LINE 16B: BAYSTATE HEALTH, INC. HAS A JOINT VENTURE POLICY THAT COVERS AFFILIATED TAX EXEMPT ENTITIES INCLUDING BAYSTATE MEDICAL CENTER.
FORM 990, PART VII, SECTION A, LINE 5: CERTAIN OFFICERS OR TRUSTEES OF THE FILING ORGANIZATION ARE PAID BY AN ENTITY, BAYSTATE MEDICAL PRACTICES, INC. (BMP) EIN 04-2888373, WHICH IS PART OF THE HEALTH CARE SYSTEM TO WHICH THE FILING ORGANIZATION BELONGS BUT DOES NOT MEET THE TECHNICAL REQUIREMENTS AS A "RELATED ORGANIZATION" PER SCHEDULE R. COMPENSATION FROM BMP TO THE OFFICERS AND TRUSTEES OF THE FILING ORGANIZATION THEREFORE, IS REPORTED AS PAID FROM AN UNRELATED ORGANIZATION IN LINE 5 AND ACCORDING TO THE INSTRUCTIONS REPORTED AS THOUGH PAID BY THE FILING ORGANIZATION.
FORM 990, PART IX, LINE 11G OTHER-FEES, BMP SUPPORT: PROGRAM SERVICE EXPENSES 88,732,608. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 88,732,608. OTHER-FEES, LABORATORY & CLINICAL: PROGRAM SERVICE EXPENSES 15,714,616. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,714,616. OTHER-FEES, PHYSICIANS: PROGRAM SERVICE EXPENSES 16,389,943. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,389,943. OTHER-FEES, PURCHASED SVC: PROGRAM SERVICE EXPENSES 11,287,473. MANAGEMENT AND GENERAL EXPENSES 4,043,518. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,330,991. OTHER-FEES, SUPPLEMENTARY SVC: PROGRAM SERVICE EXPENSES 4,378,057. MANAGEMENT AND GENERAL EXPENSES 2,495,382. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,873,439. OTHER-FEES, SUPPLEMENTARY SVC LINEN SVCS: PROGRAM SERVICE EXPENSES 5,351,735. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,351,735. OTHER-FEES, SUPPLEMENTARY SVC CONTRACT PHARMACY: PROGRAM SERVICE EXPENSES 3,020,245. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,020,245. OTHER-FEES, EQUIP CONTRACTS/MAINT & REPAIRS: PROGRAM SERVICE EXPENSES 2,560,969. MANAGEMENT AND GENERAL EXPENSES 231,096. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,792,065. OTHER-FEES, OUTSOURCING FEES: PROGRAM SERVICE EXPENSES 1,630,126. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,630,126. OTHER-FEES, VEHICLE REPAIRS: PROGRAM SERVICE EXPENSES 343,660. MANAGEMENT AND GENERAL EXPENSES 639,176. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 982,836. OTHER-FEES, TEMPORARY HELP: PROGRAM SERVICE EXPENSES 26,098,773. MANAGEMENT AND GENERAL EXPENSES 2,248,644. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 28,347,417. OTHER-FEES, TEMPORARY EMERGENCY SVCS: PROGRAM SERVICE EXPENSES 12,601,163. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,601,163. OTHER-FEES, TEMPORARY HELP ICU MED, SURG: PROGRAM SERVICE EXPENSES 10,484,431. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,484,431. OTHER-FEES, TEMPORARY HELP H&V-M3 CARE: PROGRAM SERVICE EXPENSES 5,728,075. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,728,075. OTHER-FEES, TEMPORARY HELP RESPIRATORY: PROGRAM SERVICE EXPENSES 4,296,970. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,296,970. OTHER-FEES, TEMPORARY HELP SOUTH 5: PROGRAM SERVICE EXPENSES 3,840,127. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,840,127. OTHER-FEES, TEMPORARY HELP DALY 6B MED: PROGRAM SERVICE EXPENSES 3,639,422. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,639,422. OTHER-FEES, TEMPORARY HELP D6A BASELINE: PROGRAM SERVICE EXPENSES 3,139,253. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,139,253. OTHER-FEES, TEMPORARY HELP H&V-M5 INTERMEDIATE: PROGRAM SERVICE EXPENSES 3,095,980. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,095,980. OTHER-FEES, TEMPORARY HELP WESSON 4: PROGRAM SERVICE EXPENSES 2,306,387. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,306,387. OTHER-FEES, TEMPORARY HELP DALY 5A NEURO: PROGRAM SERVICE EXPENSES 2,300,310. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,300,310. OTHER-FEES, TEMPORARY HELP SHORT STAY: PROGRAM SERVICE EXPENSES 2,171,304. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,171,304. OTHER-FEES, TEMPORARY HELP SPRINGFIELD: PROGRAM SERVICE EXPENSES 2,021,361. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,021,361. OTHER-FEES, CONSULTING: PROGRAM SERVICE EXPENSES 1,433,219. MANAGEMENT AND GENERAL EXPENSES 3,499,048. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,932,267. OTHER-FEES, CONTRACTED SVC: PROGRAM SERVICE EXPENSES 6,125,400. MANAGEMENT AND GENERAL EXPENSES 953,469. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,078,869. OTHER FEES, CONTRACT DRUG DISPENSING: PROGRAM SERVICE EXPENSES 2,297,680. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,297,680. OTHER-FEES, SUBCONTRACTOR: PROGRAM SERVICE EXPENSES 2,092,675. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,092,675. OTHER FEES, ACCREDITATION/LICENSING: PROGRAM SERVICE EXPENSES 1,268,943. MANAGEMENT AND GENERAL EXPENSES 1,009,767. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,278,710. OTHER FEES, COURIER: PROGRAM SERVICE EXPENSES 2,711,756. MANAGEMENT AND GENERAL EXPENSES 100,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,811,756. OTHER-FEES, TRANSCRIPTION: PROGRAM SERVICE EXPENSES 814,475.
FORM 990, PART XI, LINE 9: TRANSFER FROM AFFILIATE FOR LAND, BUILDINGS AND EQUIPMENT TRANSFER OF FUNDS TO AFFILIATED COMPANIES -72,902,163. MINIMUM PENSION LIABILITY ADJUSTMENT -37,592,589. FUNDS UTILIZED FOR PROPERTY AND EQUIPMENT NET ASSETS RELEASED FROM RESTRICTIONS FROM AFFILIATES -19,933. NET ASSETS RELEASED FROM RESTRICTIONS FOR CAPITAL
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
BAYSTATE MEDICAL CENTER INC
 
Employer identification number

04-2790311
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

(1) PIONEER VALLEY INFORMATION EXCHANGE LLC
101 WASON AVENUE SUITE 200
SPRINGFIELD,MA01107
04-2790311
OPERATION OF A HEALTH INFORMATION EXCHANGE AND RELATED ACTIVITIES MA 79,572 56,096 BAYSTATE MEDICAL CENTER INC
 










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


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)BAYSTATE HEALTH INC
759 CHESTNUT STREET

SPRINGFIELD,MA01199
04-2105941
HEALTHCARE SYSTEM PARENT MA 501(C)(3) 7 BAYSTATE HEALTH INC
 
 
No
(2)BAYSTATE FRANKLIN MEDICAL CENTER
164 HIGH STREET

GREENFIELD,MA01301
04-2103575
HOSPITAL MA 501(C)(3) 3 BAYSTATE HEALTH INC
 
 
No
(3)BAYSTATE WING HOSPITAL CORPORATION
40 WRIGHT STREET

PALMER,MA01069
22-2519813
HOSPITAL MA 501(C)(3) 3 BAYSTATE HEALTH INC
 
 
No
(4)VISITING NURSE ASSN AND HOSPICE OF WESTERN NEW ENGLAND INC
30 CAPITAL DRIVE SUITE A

WEST SPRINGFIELD,MA01089
04-2105803
HOMEHEALTH AND HOSPICE CARE MA 501(C)(3) 10 BAYSTATE HEALTH INC
 
 
No
(5)BAYSTATE TOTAL HOME CARE INC
280 CHESTNUT STREET

SPRINGFIELD,MA01104
20-3260764
REAL ESTATE AND OTHER MA 501(C)(3) 12B, II BAYSTATE MEDICAL CENTER INC
 
 
No
(6)BAYSTATE ADMINISTRATIVE SERVICES INC
759 CHESTNUT STREET

SPRINGFIELD,MA01199
22-2747685
ADMINISTRATIVE SERVICES MA 501(C)(3) 12C, III-FI BAYSTATE HEALTH INC
 
 
No
(7)BAYSTATE HEALTH FOUNDATION INC
759 CHESTNUT STREET

SPRINGFIELD,MA01199
04-3549011
FUNDRAISING MA 501(C)(3) 7 BAYSTATE HEALTH INC
 
 
No
(8)BAYSTATE NOBLE HOSPITAL CORPORATION
115 WEST SILVER STREET

WESTFIELD,MA010861634
22-2537423
HOSPITAL MA 501(C)(3) 3 BAYSTATE HEALTH INC
 
 
No
(9)HEALTH NEW ENGLAND INC
MONARCH PLACE SUITE 1500

SPRINGFIELD,MA011441500
04-2864973
HMO/INSURANCE MA 501(C)(4)   BAYSTATE HEALTH INC
 
 
No
(10)HNE OF CONNECTICUT INC
MONARCH PLACE SUITE 1500

SPRINGFIELD,MA011441500
46-5190134
HMO/INSURANCE CT 501(C)(4)   HEALTH NEW ENGLAND
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



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

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




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



(k)
Percentage
ownership


Yes No Yes No
(1) AMSURG BMC LLC

1A BURTON HILLS BOULEVARD
NASHVILLE,TN372156187
84-3258572
MEDICAL SERVICES TN BAYSTATE MEDICAL CENTER INC
 
  -261 9,445,087   No     No 51.000 %
(2) BAYSTATE NEW ENGLAND ORTHOPEDIC SURGEONS ALLIANCE LLC

759 CHESTNUT STREET
SPRINGFIELD,MA01199
88-1824108
MEDICAL SERVICES MA BAYSTATE MEDICAL CENTER INC
 
        No     No 65.000 %










Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) HNE ADVISORY SERVICES INC

MONARCH PLACE SUITE 1500
SPRINGFIELD,MA011441500
04-3012347
ADMINISTRATIVE SERVICES MA N/A
C         No
(2) HNE INSURANCE SERVICES INC

MONARCH PLACE SUITE 1500
SPRINGFIELD,MA011441500
04-3183019
ANCILLIARY INSURANCE MA N/A
C         No
(3) INGRAHAM CORPORATION

759 CHESTNUT STREET
SPRINGFIELD,MA01199
04-3016257
HEALTH CARE AND OTHER BUSINESS ACTIVITIES MA N/A
C         No
(4) HNE HOLDING CORPORATION

MONARCH PLACE SUITE 1500
SPRINGFIELD,MA011441500
46-4620480
HOLDING SHARES IN SUBSIDIARY CORPORATIONS MA N/A
C         No
(5) HNE INSURANCE COMPANY INC

MONARCH PLACE SUITE 1500
SPRINGFIELD,MA011441500
45-4462433
HEALTH INS SVCS FOR MASS MEDICARE SUPPLEMENT MEMBERS MA N/A
C         No
(6) BAYSTATE HEALTH INSURANCE COMPANY LTD

NORTH CHURCH ST
GEORGETOWN    
CJ
98-0421413
OFFSHORE CAPTIVE INSURANCE CJ N/A
C         No


Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) HEALTH NEW ENGLAND INC

Q 205,909,152 FMV





Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference Explanation
Schedule R (Form 990) 2021

Additional Data


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